4A (Expenses $ 564843128 including grants of $ 4270411) (Revenue $ 737172426)
THE ORGANIZATION OPERATES A 258 BED LICENSED HOSPITAL PROVIDING HEALTHCARE TO THE GENERAL PUBLIC OF THE GREATER MONTEREY PENINSULA. DURING 2021, THERE WERE 13,003 ADMISSIONS; 61,582 ADULT PATIENT DAYS; 444,338 OUTPATIENT VISITS; 8,459 SURGERIES; 50,379 EMERGENCY ROOM VISITS; 43,600 HOSPICE BENEFIT DAYS; AND 1,073 BIRTHS.

COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA
PART V, SECTION B, LINE 5: IN 2019, COMMUNITY HOSPITAL COMPLETED AN UPDATED AND COMPREHENSIVE ASSESSMENT OF OUR COMMUNITY'S UNMET HEALTHCARE NEEDS. PROFESSIONAL RESEARCH CONSULTANTS (PRC) WAS RETAINED TO CONDUCT A STATISTICALLY VALID TELEPHONE SURVEY OF 1,000 RANDOMLY SELECTED LOCAL ADULTS AS WELL AS FACILITATE GROUP DISCUSSIONS WITH PUBLIC HEALTH PROFESSIONALS FROM THE COMMUNITY. ALL OF THE DATA WAS THEN COMPILED AND BENCHMARKED AGAINST THE GOALS OF THE NATIONAL HEALTHY PEOPLE 2020 INITIATIVE SPONSORED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES.

COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA
"PART V, SECTION B, LINE 11: IN CONSIDERATION OF THE TOP HEALTH PRIORITIES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND TAKING INTO ACCOUNT HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS, AND STRATEGIC PRIORITIES CHOMP WILL FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO ADDRESS: (I) ACCESS TO HEALTH SERVICES, (II) DIABETES, (III) MENTAL HEALTH, AND (IV) SUBSTANCE ABUSE.TO ADDRESS THE HEALTH NEED OF ""ACCESS TO HEALTH SERVICES"", CHOMP HAS OUTLINED 3 STRATEGIES:1) PROVIDE FUNDING SUPPORT AIMED AT IMPROVING ACCESS TO PRIMARY CARE FOR UNDERSERVED POPULATIONS. THIS INCLUDES FINANCIAL SUPPORT FOR MONTEREY COUNTY HEALTH DEPARTMENT'S MEDICAL CLINICS IN SEASIDE AND MARINA, FINANCIAL SUPPORT FOR A SCHOOL NURSE ASSIGNED TO UNDERSERVED MONTEREY PENINSULA UNIFIED SCHOOL DISTRICT SITES, AND FINANCIAL SUPPORT AND STAFF RESOURCES FOR THE MONTAGE HEALTH MOBILE CLINIC TO SERVE THE HOMELESS POPULATION AND SUPPORT FOR MOGO URGENT CARE.2) PROVIDE MEDICALLY NECESSARY HOSPITAL SERVICES FOR THOSE WHO ARE UNABLE TO PAY FOR THEM. THIS INCLUDES ASSISTANCE THROUGH THE FINANCIAL ASSISTANCE PROGRAM, WHICH INCLUDES DISCOUNTED PAYMENTS AND SPONSORED CARE (CHARITY CARE) FOR MEDICALLY NECESSARY HOSPITAL SERVICES.3) RECRUIT AND RETAIN PHYSICIANS IN SPECIALTIES WHERE A LOCAL SHORTAGE IS DEMONSTRATED. THIS INCLUDES PROVIDING FINANCIAL ASSISTANCE TO RECRUIT ADDITIONAL PHYSICIANS IN DEMONSTRATED-SHORTAGE SPECIALTIES TO PRACTICE IN THE COMMUNITY AND SUPPORT THEIR ABILITY TO ESTABLISH SUSTAINABLE PRACTICES IN THE PRIMARY SERVICE AREA AS WELL AS REQUIRING PHYSICIANS WHO RECEIVE RECRUITMENT ASSISTANCE TO ACCEPT REFERRALS FROM THE HOSPITAL FOR PATIENTS WITH ALL FORMS OF HEALTH INSURANCE ACCEPTED BY THE HOSPITAL, INCLUDING MEDICARE AND MEDI-CAL.TO ADDRESS THE HEALTH NEED TO DIABETES, CHOMP HAS OUTLINED 3 STRATEGIES:1) INCREASE AWARENESS AND IDENTIFICATION OF PREDIABETES AND DIABETES. THIS INCLUDES PROVIDING COMMUNITY OUTREACH TO BOTH THE PUBLIC AND PROVIDERS TO INCREASE AWARENESS OF THE DISEASE, DIABETES, AND PREDIABETES SCREENING RECOMMENDATIONS, AND RELATED EDUCATIONAL OPPORTUNITIES, AS WELL AS INCREASING THE AVAILABILITY OF PREDIABETES AND DIABETES SELF-ASSESSMENT TOOLS AND MEDICAL SCREENINGS. ADDITIONALLY, CHOMP WILL CONTINUE TO PARTNER WITH THE DIABETES COLLECTIVE.2) IMPROVE ACCESS TO PREDIABETES AND DIABETES EDUCATION AND PREVENTION SERVICES. TO ACCOMPLISH THIS, CHOMP WILL INCREASE UTILIZATION OF EXISTING EDUCATION AND PREVENTION SERVICES BY SUPPORTING THE REFERRAL PROCESS FROM PHYSICIANS AND OTHER MEDICAL PROVIDERS. ADDITIONALLY, THIS ENTAILS INCREASING THE AVAILABILITY OF REMOTE EDUCATION PROGRAMS.3) CONTINUE TO PROVIDE NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT MANAGEMENT CURRICULUM THROUGH CHOMP'S KIDS EAT RIGHT PROGRAM.TO ADDRESS THE HEALTH NEED OF MENTAL HEALTH, CHOMP HAS OUTLINED 2 STRATEGIES:1) SUPPORT AND IMPROVE ACCESS TO CARE FOR MENTAL HEALTH SERVICES BY INCREASING THE NUMBER OF MENTAL HEALTH PRACTITIONERS IN OUTPATIENT BEHAVIORAL HEALTH SERVICES AT HARTNELL PROFESSIONAL CENTER AND/OR AVAILABLE INDIVIDUAL APPOINTMENTS. CHOMP WILL ALSO CONTINUE TO PROVIDE RELIEF THROUGH THE FINANCIAL ASSISTANCE PROGRAM FOR HOSPITAL-PROVIDED MENTAL HEALTH SERVICES.2) SUPPORT AND IMPROVE ACCESS TO CARE FOR MENTAL HEALTH SERVICES FOR CHILDREN AND ADOLESCENTS. IN COLLABORATION WITH OHANA, CHOMP WILL EXPAND THE NUMBER OF DIAGNOSTIC EVALUATIONS COMPLETED BY SOCIAL WORKERS AND REVIEWED BY A BEHAVIORAL HEALTH TEAM (CHILD PSYCHOLOGIST AND PSYCHIATRISTS). ADDITIONALLY, CHOMP WILL EXPAND ACCESS TO EFFECTIVE PSYCHOTHERAPY FOR THE MOST COMMON PSYCHIATRIC ILLNESSES OF YOUTH, INCLUDING INDIVIDUAL AND GROUP TREATMENTS.TO ADDRESS THE HEALTH NEED OF SUBSTANCE ABUSE, CHOMP HAS OUTLINED 3 STRATEGIES:1) INCREASE COMMUNITY AWARENESS OF SAFE USE OF OPIOID PRESCRIPTION MEDICATIONS, REDUCE INAPPROPRIATE PRESCRIBING OF PAIN MEDICATIONS, AND INCREASE AWARENESS OF THE DANGERS OF STREET OPIOIDS THROUGH THE PRESCRIBE SAFE PROGRAM. CHOMP WILL ACCOMPLISH THIS BY OFFERING EDUCATION TO THE PUBLIC AND MEDICAL COMMUNITY ON THE DANGER OF DRUGS, PROVIDE SAFE MEDICATION DISPOSAL SITES, AND PROVIDE NALOXONE AND TRAINING TO THE COMMUNITY, HEALTHCARE WORKS, AND FIRST RESPONDERS.2) IDENTIFY RESOURCES FOR PATIENTS WITH ALCOHOL AND DRUG DEPENDENCY. CHOMP WILL ACCOMPLISH THIS BY ENSURING THAT EVIDENCED-BASED SUBSTANCE ABUSE USE DISORDER TREATMENTS ARE ACCESSIBLE IN THE EMERGENCY DEPARTMENT (WHICH WILL HAVE A SUBSTANCE ABUSE NAVIGATORS) AND IN ALL OTHER HOSPITAL DEPARTMENTS, AS WELL BY REFERRING PATIENTS FOR ONGOING CARE, SUPPORT, AND FOLLOW-UP.3) EXPAND SUBSTANCE RECOVERY CARE TO PATIENTS THROUGH THE RECOVERY CENTER'S INTENSIVE OUTPATIENT PROGRAM, AS WELL AS OFFERING SUPPORT FOR RECOVERY CENTER ALUMNI. CHOMP WILL COLLABORATE WITH LOCAL CLINICS AND CENTERS FOR IMPROVING RECOVERY CARE IN OUR COMMUNITY.WHILE CHOMP HAS CHOSEN SPECIFIC COMMUNITY HEALTH NEEDS TO ADDRESS, THE HOSPITAL WILL CONTINUE TO PROVIDE A SIGNIFICANT ARRAY OF COMMUNITY HEALTH SERVICES IN SUPPORT OF THE OTHER IDENTIFIED NEEDS AS WELL. BELOW ARE THE IDENTIFIED HEALTH NEEDS NOT SELECTED FOR FOCUS DURING THE 2020-2022 IMPLEMENTATION PERIOD, ALONG WITH THE REASON THEY WERE NOT SELECTED:POTENTIALLY DISABLING CONDITIONS: THE HOSPITAL AND OTHER COMMUNITY ORGANIZATIONS CURRENTLY PROVIDE A SIGNIFICANT NUMBER OF SUPPORT GROUPS AND CLASSES ADDRESSING THIS NEED.HEART DISEASE AND STROKE: THE HOSPITAL CURRENTLY PROVIDES PROGRAMS, CLASSES, AND A SUPPORT GROUP ADDRESSING THIS NEED. OTHER COMMUNITY ORGANIZATIONS ARE ALSO ADDRESSING THIS ISSUE.INJURY AND VIOLENCE: THIS NEED FALLS MORE WITHIN THE PURVIEW OF LAW ENFORCEMENT AND OTHER GOVERNMENT AGENCIES. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS A FOCUS AREA FOR THIS PLANNING PERIOD.FAMILY PLANNING: OTHER COMMUNITY ORGANIZATIONS AND CLASSES PROVIDED BY THE HOSPITAL ARE CURRENTLY ADDRESSING THIS NEED.NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT: THE HOSPITAL CURRENTLY PROVIDES EDUCATION AND CLASSES ADDRESSING THIS NEED. OTHER COMMUNITY ORGANIZATIONS ARE ALSO ADDRESSING THIS NEED.CANCER: THE HOSPITAL AND OTHER COMMUNITY ORGANIZATIONS CURRENTLY PROVIDE A SIGNIFICANT NUMBER OF SUPPORT GROUPS AND CLASSES ADDRESSING THIS NEED, IN ADDITION TO A COMPREHENSIVE ARRAY OF DIAGNOSTIC AND TREATMENT SERVICES.RESPIRATORY DISEASES: THE HOSPITAL CURRENTLY OFFERS SERVICES AND EDUCATION ADDRESSING THIS NEED.TOBACCO USE: OTHER COMMUNITY ORGANIZATIONS AND A CLASS PROVIDED BY THE HOSPITAL ARE CURRENTLY ADDRESSING THIS NEED."

PART I, LINE 7:
A RATIO OF COST TO CHARGES FROM WORKSHEET 2 WAS USED ON LINE (A). ALL OTHER LINES IN THIS SECTION EITHER USE DIRECTLY ATTRIBUTABLE EXPENSES FROM THE GENERAL LEDGER OR RELY ON ESTIMATES FROM OUR COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS.

PART III, LINE 2:
CHOMP PROVIDES FOR ESTIMATED LOSSES ON PATIENT ACCOUNTS RECEIVABLE BASED ON PRIOR BAD DEBT EXPERIENCE. BAD DEBT IS NET OF BOTH PAYMENTS AND DISCOUNTS. RECOVERIES FROM PREVIOUSLY CHARGED-OFF ACCOUNTS ARE RECORDED WHEN RECEIVED. THE AMOUNT ATTRIBUTABLE TO INDIVIDUALS WHO MAY QUALIFY FOR CHARITY CARE IS BASED ON AN INTERNAL ESTIMATE.

PART III, LINE 3:
THE AMOUNT ATTRIBUTABLE TO INDIVIDUALS WHO MAY QUALIFY FOR CHARITY CARE IS BASED ON AN INTERNAL ESTIMATE; IT IS ESTIMATED THAT 40% OF BAD DEBT WOULD QUALIFY FOR CHARITY CARE, BUT REFUSE AN APPLICATION, ARE HOMELESS, OR OTHERWISE.

PART III, LINE 4:
CHOMP PROVIDES FOR ESTIMATED LOSSES ON PATIENT ACCOUNTS RECEIVABLE BASED ON PRIOR BAD DEBT EXPERIENCE AND GENERALLY DOES NOT CHARGE INTEREST ON PAST DUE BALANCES. PAST DUE STATUS IS BASED UPON THE DATE OF SERVICES PROVIDED. UNCOLLECTIBLE RECEIVABLES ARE CHARGED OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES FROM PREVIOUSLY CHARGED-OFF ACCOUNTS ARE RECORDED WHEN RECEIVED.CHOMP USES A FIRM CALLED CAREPAYMENT TO OFFER SELF-PAY PATIENTS THE OPPORTUNITY TO HAVE AN INTEREST-FREE EXTENDED PAYMENT PROGRAM. CAREPAYMENT TAKES OVER THE PATIENT ACCOUNTS RECEIVABLE FROM CHOMP AT A DISCOUNT, AND WORKS WITH THE PATIENTS TO COME UP WITH AN AGREEABLE PAYMENT PLAN. CAREPAYMENT HAS FULL RECOURSE WITH CHOMP TO RECOVER ANY UNPAID BALANCES.

PART III, LINE 8:
"THE MEDICARE SHORTFALL AT THE HOSPITAL IS A SUBSTANTIAL FIGURE. OUR COMMUNITY HAS A SIGNIFICANT MEDICARE POPULATION AND WE EXIST TO SERVE THAT COMMUNITY. IN OUR OPINION, 100% OF THE MEDICARE SHORTFALL MEETS COMMUNITY BENEFIT CRITERIA BASED ON THE DEFINITION OF ""COMMUNITY HEALTH IMPROVEMENT SERVICES"" AS DEFINED IN THE 990 INSTRUCTIONS. THAT IS, ""ACTIVITIES OR PROGRAMS CARRIED OUT OR SUPPORTED FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH THAT ARE SUBSIDIZED BY THE HEALTH CARE ORGANIZATION."" COSTS ASSIGNED TO MEDICARE PATIENTS ARE BASED ON THE REPORTED AMOUNTS FOUND IN THE HOSPITAL COST REPORT. THOSE COSTS ARE ALLOCATED TO MEDICARE PATIENTS BASED ON THE RATIOS DEVELOPED WITHIN THAT COST REPORT."

PART III, LINE 9B:
"COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA PURSUES A COLLECTION POLICY IN KEEPING WITH BEST PRACTICES IN THE INDUSTRY, CALIFORNIA HOSPITAL ASSOCIATION (CHA) RECOMMENDATIONS, THE HOSPITAL FAIR PRICING POLICIES ACT, AND ALL FEDERAL, STATE AND LOCAL LAWS GOVERNING THE COLLECTION OF A PATIENT DEBT. THE HOSPITAL WILL CLEARLY AND CONSPICUOUSLY POST AND MAINTAIN SIGNS NOTIFYING PATIENTS OF THE HOSPITAL'S SPONSORED CARE AND DISCOUNT PAYMENT PROGRAMS, AND THE AVAILABILITY OF FUNDS FROM OTHER PROGRAMS TO ASSIST WITH PAYMENT OF BILLS. THE SIGNS ARE PLACED IN EVERY REGISTRATION SITE, THE PATIENT BUSINESS OFFICE, THE EMERGENCY DEPARTMENT, THE BILLING OFFICE, THE ADMISSIONS OFFICE, AND OTHER OUTPATIENT SETTINGS. PATIENT BUSINESS SERVICES SHALL ADHERE TO THE GUIDELINES DESCRIBED BELOW IN THE COLLECTION OF ANY PATIENT DEBT TO THE HOSPITAL STEMMING FROM MEDICAL SERVICES RENDERED AT ANY SITE OR IN ANY DEPARTMENT. EVERY PATIENT WILL BE ACCORDED RESPECT AND TREATED WITH DIGNITY AT ALL TIMES. THESE COLLECTION GUIDELINES ARE ESTABLISHED UNDER THE AUTHORITY OF THE PATIENT BUSINESS SERVICES DEPARTMENT, AND DEBTS WILL NOT BE ADVANCED FOR COLLECTION WITHOUT REVIEW BASED ON THE AUTHORIZATION PROCESS BY DOLLAR THRESHOLD. THE DECISION TO ADVANCE A DEBT FOR COLLECTION WILL BE MADE ON A CASE-BY-CASE BASIS, FOLLOWING THE POLICY AND PROCESSES SET FORTH BELOW. THE COLLECTION PROCESS MAY BE AUTOMATED IF CERTAIN CRITERIA ARE MET. THE DECISION TO ADVANCE A DEBT FOR COLLECTION WILL BE BASED ON SUCH FACTORS AS LACK OF PAYMENT, FAILURE TO APPLY FOR AVAILABLE PROGRAMS, FAILURE TO RESPOND TO HOSPITAL REQUESTS, OR FAILURE TO CONTACT THE HOSPITAL IN RESPONSE TO A BILL. AT THE DISCRETION OF THE PATIENT BUSINESS SERVICES AND FOLLOWING THE AUTHORIZATION PROCESS BY DOLLAR THRESHOLD BELOW, A DEBT MAY BE ADVANCED FOR COLLECTION IF PAYMENT IN FULL IS NOT RECEIVED WITHIN 30 DAYS OF THE INITIAL BILL, SUBJECT TO THE LIMITATIONS STATED BELOW. REGARDLESS OF THE AGE OF A BILL, THE HOSPITAL WILL ALWAYS BE OPEN TO COMPROMISE REGARDING A DEBT. COLLECTION IS INITIALLY CONDUCTED BY THE HOSPITAL BUT MAY BE ADVANCED FOR COLLECTION BY AN EXTERNAL COLLECTION AGENCY OR LEGAL ACTION AS SET FORTH BELOW. THIS COLLECTION POLICY GOVERNS ALL COMMUNICATIONS BETWEEN THE HOSPITAL AND A PATIENT CONCERNING COLLECTION OF AMOUNTS OWED TO THE HOSPITAL. POLICY APPLIES TO ALL PATIENT TYPES AND ALL VISIT TYPES. COLLECTION PROCEDURES WILL VARY DEPENDING ON THE TYPE OF VISIT, WITH SPONSORED CARE/DISCOUNT ELIGIBLE PATIENTS OUTLINED BELOW: 1. PATIENT HAS APPLIED OR QUALIFIED FOR THE HOSPITAL'S SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM. PATIENTS WHO MEET INCOME AND/OR ASSET REQUIREMENTS MAY QUALIFY FOR THE HOSPITAL'S SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM. ALL EFFORTS SHOULD BE MADE TO DETERMINE ELIGIBILITY FOR THESE PROGRAMS PRE-SERVICE IF POSSIBLE, OR AS SOON AS PRACTICABLE AFTER SERVICES ARE PROVIDED. THE HOSPITAL'S SOCIAL SERVICES DEPARTMENT OR THE PATIENT BUSINESS SERVICES DEPARTMENT WILL REVIEW APPLICATIONS FOR SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM ELIGIBILITY IN ACCORDANCE WITH HOSPITAL POLICY. WHILE THE PATIENT'S APPLICATION IS PENDING, THE HOSPITAL MAY SEND BILLING STATEMENTS, BUT WILL NOT COMMENCE ANY COLLECTION ACTIVITY. 2. COLLECTING FOR A VISIT FROM A PATIENT WHO IS ELIGIBLE FOR THE HOSPITAL'S SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM. UPON REACHING A DETERMINATION THAT THE PATIENT IS ELIGIBLE FOR THE SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM, THE HOSPITAL WILL DETERMINE THE AMOUNT OWED BY THE PATIENT IN ACCORDANCE WITH THE HOSPITAL'S SPONSORED CARE & DISCOUNT PAYMENT PROGRAM POLICY. IF THE PATIENT IS NOT ABLE TO PAY THE AMOUNT DUE IN A LUMP SUM, THE PATIENT WILL BE OFFERED THE OPPORTUNITY TO NEGOTIATE AND AGREE TO A PAYMENT PLAN. THE PATIENT WILL BE ADVISED THAT THE PAYMENTS WILL BE INTEREST FREE PROVIDED THEY ARE TIMELY MADE, BUT IF THE PATIENT FAILS TO MAKE ALL SCHEDULED PAYMENTS DURING ANY 90-DAY PERIOD, THE HOSPITAL MAY TERMINATE THE EXTENDED PAYMENT PLAN AND THE ENTIRE OUTSTANDING BALANCE WILL BE DUE, TOGETHER WITH INTEREST ON THE REMAINING BALANCE AT THE MAXIMUM LEGAL RATE. IF THE PATIENT CHOOSES TO ENTER INTO A PAYMENT PLAN, THE SPONSORED CARE & DISCOUNT PAYMENT PROGRAM PAYMENT PLAN SHOULD BE COMPLETED AND THE PATIENT SHOULD SIGN THAT PLAN. IF THE PATIENT HAS SIGNED A SPONSORED CARE & DISCOUNT PAYMENT PROGRAM PAYMENT PLAN, AND THE PATIENT FAILS TO TIMELY MAKE ALL SCHEDULED PAYMENTS DURING ANY 90-DAY PERIOD, THE HOSPITAL MAY TERMINATE THE PAYMENT PLAN. BEFORE TERMINATING THE PAYMENT PLAN, THE HOSPITAL WILL CONTACT THE PATIENT BY TELEPHONE AND IN WRITING AND INFORM THE PATIENT THAT THE PAYMENT PLAN MAY BE TERMINATED DUE TO DEFAULT IN SCHEDULED PAYMENTS. IF THE PATIENT REQUESTS, THE HOSPITAL WILL RENEGOTIATE THE PAYMENT PLAN. THE HOSPITAL WILL NOT REPORT ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY OR BEGIN A CIVIL ACTION AGAINST THE PATIENT FOR NONPAYMENT BEFORE THE PAYMENT PLAN IS TERMINATED. THE HOSPITAL WILL NOT USE THE MONETARY ASSET INFORMATION IT OBTAINED IN DETERMINING ELIGIBILITY FOR THE SPONSORED CARE PROGRAM FOR COLLECTION ACTIVITIES. INFORMATION CONCERNING INCOME AND MONETARY ASSETS THAT ARE OBTAINED AS PART OF THE ELIGIBILITY DETERMINATION ARE MAINTAINED SEPARATELY FROM THE PATIENT'S COLLECTION FILE. FOR A PERIOD OF 150 DAYS AFTER THE INITIAL BILLING TO THE PATIENT, THE HOSPITAL WILL NOT REPORT ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY CONCERNING, OR COMMENCE A CIVIL ACTION AGAINST, A PATIENT WHO LACKS COVERAGE OR PROVIDES INFORMATION THAT HE OR SHE MAY BE ELIGIBLE FOR THE SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM. IF A PATIENT IS ATTEMPTING TO QUALIFY FOR THE DISCOUNT PAYMENT OR SPONSORED CARE PROGRAM AND IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL BY NEGOTIATING A PAYMENT PLAN OR MAKING REASONABLE, REGULAR PAYMENTS ON HIS/HER BILL, THE HOSPITAL WILL NOT SEND THE PATIENT'S VISIT TO A COLLECTION AGENCY UNLESS THE AGENCY AGREES TO COMPLY WITH THE HOSPITAL'S COLLECTION POLICY AND THE HOSPITAL FAIR PRICING POLICIES ACT. THE HOSPITAL WILL NOT USE WAGE GARNISHMENTS OR LIENS ON PRIMARY RESIDENCES AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS FROM PATIENTS WHO ARE ELIGIBLE FOR THE DISCOUNT PAYMENT OR SPONSORED CARE PROGRAM. IF A PATIENT APPEALS THE HOSPITAL'S DECISION CONCERNING ELIGIBILITY OR LEVEL OF BENEFITS OF THE PATIENT FOR EITHER THE SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM, OR APPEALS A COVERAGE OF DETERMINATION OF A THIRD PARTY, THE HOSPITAL WILL NOT REPORT ADVERSE INFORMATION TO A CONSUMER CREDIT REPORTING AGENCY CONCERNING, OR COMMENCE A CIVIL ACTION AGAINST, THE PATIENT PROVIDED THE PATIENT HAS FILED AN APPEAL IN COMPLIANCE WITH THE HOSPITAL'S SPONSORED CARE & DISCOUNT PAYMENT PROGRAM POLICY, OR MAKES A REASONABLE EFFORT TO COMMUNICATE WITH THE HOSPITAL ABOUT THE PROGRESS OF ANY COVERAGE APPEAL PENDING WITH A THIRD PARTY. THE HOSPITAL WILL NOT BEGIN THE 150-DAY PERIOD REFERENCED ABOVE UNTIL AFTER THE RESOLUTION OF THE PATIENT'S APPEAL IS COMPLETED TO AFFORD THE PATIENT THE FULL 150 DAYS TO MAKE PAYMENT. BEFORE BEGINNING ANY COLLECTION ACTIVITY AGAINST ANY PATIENT, INCLUDING THOSE WHO ARE NOT ELIGIBLE FOR THE SPONSORED CARE OR DISCOUNT PAYMENT PROGRAMS, THE HOSPITAL WILL PROVIDE THE PATIENT WITH A CLEAR AND CONSPICUOUS NOTICE OF THE PATIENT'S RIGHTS UNDER THE FAIR PRICING POLICIES ACT, THE ROSENTHAL FAIR DEBT COLLECTION PRACTICES ACT, AND THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT. THE NOTICE WILL STATE: ""STATE AND FEDERAL LAW REQUIRE DEBT COLLECTORS TO TREAT YOU FAIRLY AND PROHIBIT DEBT COLLECTORS FROM MAKING FALSE STATEMENTS OR THREATS OF VIOLENCE, USING OBSCENE OR PROFANE LANGUAGE, AND MAKING IMPROPER COMMUNICATIONS WITH THIRD PARTIES, INCLUDING YOUR EMPLOYER. EXCEPT UNDER UNUSUAL CIRCUMSTANCES, DEBT COLLECTORS MAY NOT CONTACT YOU BEFORE 8:00 A.M. OR AFTER 9:00 P.M. IN GENERAL, A DEBT COLLECTOR MAY NOT GIVE INFORMATION ABOUT YOUR DEBT TO ANOTHER PERSON, OTHER THAN YOUR ATTORNEY OR SPOUSE. A DEBT COLLECTOR MAY CONTACT ANOTHER PERSON TO CONFIRM YOUR LOCATION OR ENFORCE A JUDGMENT. FOR MORE INFORMATION ABOUT DEBT COLLECTION ACTIVITIES, YOU MAY CONTACT THE FEDERAL TRADE COMMISSION BY TELEPHONE AT 877-FTC-HELP (382-4357) OR ONLINE AT WWW.FTC.GOV. NONPROFIT CREDIT COUNSELING SERVICES MAY BE AVAILABLE IN THE AREA. IF YOU ARE UNINSURED OR HAVE HIGH MEDICAL COSTS, PLEASE CONTACT COMMUNITY HOSPITAL'S PATIENT BUSINESS SERVICES DEPARTMENT AT (831) 625-4922 OR (888) 625-4922 FOR INFORMATION ON DISCOUNTS AND PROGRAMS FOR WHICH YOU MAY BE ELIGIBLE, INCLUDING THE MEDI-CAL PROGRAM. IF YOU HAVE COVERAGE, PLEASE TELL US SO THAT WE MAY BILL YOUR PLAN."" THIS NOTICE WILL ALSO BE GIVEN IN ANY DOCUMENT INDICATING THAT THE COMMENCEMENT OF COLLECTION ACTIVITIES MAY OCCUR. ANY AMOUNT COLLECTED FROM A PATIENT IN EXCESS OF THE AMOUNT DUE UNDER THE HOSPITAL'S SPONSORED CARE OR DISCOUNT PAYMENT POLICY WILL BE REFUNDED TO THE PATIENT, TOGETHER WITH INTEREST THEREON."

PART VI, LINE 2:
IN 2019, COMMUNITY HOSPITAL COMPLETED AN UPDATED AND COMPREHENSIVE ASSESSMENT OF OUR COMMUNITY'S UNMET HEALTHCARE NEEDS. PROFESSIONAL RESEARCH CONSULTANTS (PRC) WAS RETAINED TO CONDUCT A STATISTICALLY VALID TELEPHONE SURVEY OF 1,000 RANDOMLY SELECTED LOCAL ADULTS AS WELL AS FACILITATE GROUP DISCUSSIONS WITH PUBLIC HEALTH PROFESSIONALS FROM THE COMMUNITY. ALL OF THE DATA WAS THEN COMPILED AND BENCHMARKED AGAINST THE GOALS OF THE NATIONAL HEALTHY PEOPLE 2020 INITIATIVE SPONSORED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES.

PART VI, LINE 3:
"PATIENT BUSINESS SERVICES AND THE SOCIAL SERVICES DEPARTMENT SCREEN APPLICANTS FOR THE SPONSORED CARE AND DISCOUNT PROGRAMS. COMPLETED APPLICATIONS, INCLUDING REQUIRED DOCUMENTATION, ARE SUBMITTED TO PATIENT BUSINESS SERVICES OR SOCIAL SERVICES FOR INITIAL REVIEW AND FOLLOW UP. THE PATIENT/RESPONSIBLE PARTY, AND/OR SERVICE DEPARTMENT ARE NOTIFIED OF THE FINAL ELIGIBILITY DECISION IN WRITING. SHOULD THERE BE ANY DISPUTE AS TO THE DECISION MADE BY THE HOSPITAL ON THE ELIGIBILITY OR LEVEL OF ELIGIBILITY OF THE PATIENT FOR EITHER THE SPONSORED CARE OR DISCOUNT PAYMENT PROGRAM, AN APPEAL OF THE DECISION MAY BE MADE TO THE DIRECTOR OF PATIENT BUSINESS SERVICES. FOR PATIENTS IN THE OUTPATIENT IMMUNOLOGY SERVICES CLINIC, A NURSE CASE MANAGER MAY PROVIDE INITIAL FINANCIAL SCREENING. EACH PATIENT ROOM INCLUDES A BROCHURE ""WELCOME TO COMMUNITY HOSPITAL."" THIS BROCHURE INCLUDES INFORMATION REGARDING OUR FINANCIAL ASSISTANCE PROGRAM. IN ADDITION, COMMUNITY HOSPITAL PUBLICLY DISPLAYS INFORMATION ON THE GENERAL PROGRAM IN KEY SERVICE LOCATIONS AND PROVIDES INFORMATION TO EVERY PATIENT AT THE TIME OF REGISTRATION FOR SERVICES AND ENCLOSED WITH BILLING STATEMENTS. INFORMATION ON SPECIALTY PROGRAMS (E.G., FREE BASELINE MAMMOGRAPHY THROUGH THE SHERRY COCKLE FUND AND REHABILITATION SERVICES THROUGH THE THOMAS A. WORK, JR., FUND) ARE PROVIDED TO PATIENTS WHO REGISTER FOR THESE SPECIFIC SERVICES. THROUGH ITS PUBLIC WEB SITE, COMMUNITY HOSPITAL ALSO PUBLICIZES THE SPONSORED CARE AND DISCOUNT PROGRAMS AND ILLUSTRATES THE BENEFITS OF THE PROGRAM. A FORMAL PRESENTATION ABOUT HOSPITAL BILLING PRACTICES AND SPONSORED CARE REQUIREMENTS IS PROVIDED TO COMMUNITY GROUPS ON REQUEST BY OUR PATIENT BUSINESS SERVICES DEPARTMENT. IN ADDITION, THE HOSPITAL PUBLICIZES SPONSORED CARE FOR HIV/AIDS PATIENTS THROUGH REGULAR REPORTS TO COLLABORATING COMMUNITY ORGANIZATIONS ON THE PROGRAM USAGE AND THE POPULATION SERVED. FINANCIAL COUNSELORS WORK IN CONJUNCTION WITH A PRIVATE VENDOR (DIVERSIFIED HEALTH RESOURCES) TO GUIDE UNINSURED PATIENTS THROUGH THE PROCESS OF OBTAINING AVAILABLE GOVERNMENT BENEFITS, SUCH AS MEDI-CAL OR OTHER STATE PROGRAMS. THESE COUNSELORS ALSO ASSIST THOSE PATIENTS THROUGH THE QUALIFICATION PROCESS."

PART VI, LINE 5:
THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IN MANY WAYS, AS OUTLINED IN THE COMMUNITY BENEFIT REPORT. CHOMP'S BOARD OF TRUSTEES IS COMPRISED OF VOLUNTEERS FROM THE COMMUNITY. THE MEDICAL STAFF IS OPEN. CHOMP'S SISTER ORGANIZATION, COMMUNITY HEALTH INNOVATIONS IS DEDICATED ENTIRELY TO POPULATION HEALTH. CARE MANAGERS THROUGHOUT THE COMMUNITY ASSIST IN PARTNERING PATIENTS WITH COMMUNITY RESOURCES.

PART VI, LINE 6:
COMMUNITY HEALTH INNOVATIONS IS DEDICATED ENTIRELY TO POPULATION HEALTH. CARE MANAGERS THROUGHOUT THE COMMUNITY ASSIST IN PARTNERING PATIENTS WITH COMMUNITY RESOURCES. MONTAGE MEDICAL GROUP IS COMPRISED OF PRIMARY AND SPECIALTY PROVIDERS TO IMPROVE ACCESS TO CARE IN THE COMMUNITY. ASPIRE HEALTH PLAN OFFERS AN AFFORDABLE ALTERNATIVE FOR INSURANCE COVERAGE FOR MEDICARE-ELIGIBLE COMMUNITY MEMBERS.

PART VI, LINE 7, REPORTS FILED WITH STATES
CA

PART VI, LINE 4:
COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA'S COMMUNITY, AS DEFINED FOR THE PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDED EACH OF THE RESIDENTIAL ZIP CODES THAT COMPRISE THE HOSPITAL'S PRIMARY SERVICE AREA (PSA), INCLUDING: 93950, 93940, 93941, 93942, 93943, 93944, 93920, 93921, 93922, 93923, 93955, 93933, 93953, 93908 AND 93924. THIS INCLUDED MONTEREY, CARMEL, BIG SUR, SEASIDE, MARINA, PACIFIC GROVE, PEBBLE BEACH, THE HIGHWAY 68 CORRIDOR, AND CARMEL VALLEY.THE POPULATION OF THE HOSPITAL'S PRIMARY SERVICE AREA IS ESTIMATED AT 143,307 PEOPLE. IT IS PREDOMINANTLY NON-HISPANIC WHITE BUT ALSO HAS A SUBSTANTIAL HISPANIC POPULATION. THE DEMOGRAPHIC BREAKDOWN, ACCORDING TO THE US CENSUS BUREAU, IS NON-HISPANIC WHITE (60.7 PERCENT), HISPANIC (21 PERCENT), ASIAN (8.6 PERCENT), AFRICAN AMERICAN/BLACK (3.8 PERCENT), AND OTHER (5.4 PERCENT).