4A (Expenses $ 10861871 including grants of $ 10822) (Revenue $ 12493078)
SEE SCHEDULE H

CARRINGTON HEALTH CENTER
PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, CHI ST ALEXIUS HEALTH CARRINGTON TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. TO HELP INFORM FUTURE DECISIONS AND STRATEGIC PLANNING, CHI ST. ALEXIUS HEALTH CARRINGTON MEDICAL CENTER (CMC) AND FOSTER COUNTY PUBLIC HEALTH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2021, THE PREVIOUS CHNA HAVING BEEN CONDUCTED IN 2019. THE CENTER FOR RURAL HEALTH (CRH) AT THE UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE AND HEALTH SCIENCES (UNDSMHS) FACILITATED THE ASSESSMENT PROCESS, WHICH SOLICITED INPUT FROM AREA COMMUNITY MEMBERS AND HEALTHCARE PROFESSIONALS AS WELL AS ANALYSIS OF COMMUNITY HEALTH-RELATED DATA. TO GATHER FEEDBACK FROM THE COMMUNITY, RESIDENTS OF THE AREA WERE GIVEN THE OPPORTUNITY TO PARTICIPATE IN A SURVEY. ONE HUNDRED SEVENTY-ONE CMC SERVICE AREA RESIDENTS COMPLETED THE SURVEY. ADDITIONAL INFORMATION WAS COLLECTED THROUGH FIVE KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS. THE INPUT FROM THE RESIDENTS, WHO PRIMARILY RESIDE IN EDDY COUNTY AND FOSTER COUNTY, REPRESENTED THE BROAD INTERESTS OF THE COMMUNITIES IN THE SERVICE AREA. TOGETHER WITH SECONDARY DATA GATHERED FROM A WIDE RANGE OF SOURCES, THE SURVEY PRESENTS A SNAPSHOT OF THE HEALTH NEEDS AND CONCERNS IN THE COMMUNITY.

CARRINGTON HEALTH CENTER
PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH FOSTER COUNTY PUBLIC HEALTH.

CARRINGTON HEALTH CENTER
PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.

SCHEDULE H, PART V, SECTION B, LINE 7A
HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/COMMUNITY-HEALTH-NEED-ASSESSMENTS

SCHEDULE H, PART V, SECTION B, LINE 10A
HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/COMMUNITY-HEALTH-NEED-ASSESSMENTS

PART V, SECTION B, LINE 3E:
THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

PART V, SECTION B, LINE 11:
THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2022. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/COMMUNITY-HEALTH-NEED-ASSESSMENTSTHE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY AND SECONDARY DATA FROM A COMMUNITY HEALTH SURVEY AND INTERVIEWS TOP HEALTH NEEDS (FROM 2022 CHNA): 1. MENTAL HEALTH FOR ALL AGES (INCLUDES DEPRESSION/ANXIETY/SUICIDE/ STRESS)2. ABILITY TO RETAIN PRIMARY CARE PROVIDERS AND NURSES3. ENOUGH CHILD DAYCARE SERVICES4. ALCOHOL USE & ABUSE (ALL AGES)FOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: MENTAL HEALTH FOR ALL AGES (INCLUDES DEPRESSION/ANXIETY/SUICIDE/ STRESS)TO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:- ADVERTISE JOB OPENINGS BEYOND THE NORMAL MARKET: PROVIDE AN ADVERTISING STRATEGY THAT REACHES BEYOND THE NORMAL RANGE OF JOB OPENINGS IN THE STATE OF NORTH DAKOTA.- COORDINATE VIDEOS ON SOCIAL MEDIA FOR PUBLIC VIEWING: HAVE EMPLOYEE PROMOTE THE FACILITY IN SOCIAL MEDIA VIDEOS TO SHOW THE ENVIRONMENT IN WHICH THE EMPLOYEE WORK.PRIORITY HEALTH NEED #2: MENTAL HEALTH FOR ALL AGES (INCLUDES DEPRESSION/ANXIETY/SUICIDE/ STRESS)TO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:- IMPLEMENT A COACHING BOYS INTO MEN PROGRAM WITH AREA COACHES: TO PROVIDE A SPACE FOR MIDDLE SCHOOL AND HIGH SCHOOL BOY ATHLETES TO HEAR ABOUT THE IMPORTANCE OF MENTAL HEALTH. TO EDUCATE BOY ATHLETES IN PROPER SOCIAL BOUNDARIES.- IMPLEMENT A FEMALE VERSION OF COACHING BOYS INTO MEN WITH AREA COACHES (THIS PROGRAM IS CURRENTLY BEING DEVELOPED): TO PROVIDE A SPACE FOR MIDDLE SCHOOL AND HIGH SCHOOL GIRL ATHLETES TO HEAR ABOUT THE IMPORTANCE OF MENTAL HEALTH. TO EDUCATE GIRL ATHLETES IN PROPER SOCIAL BOUNDARIES.THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS FOR THE FOLLOWING REASONS: NEED 3: ENOUGH CHILD DAYCARE SERVICES: THE HOSPITAL DOES NOT HAVE THE RESOURCES TO MEET THIS NEED.NEED 4: ALCOHOL USE & ABUSE (ALL AGES): THE HOSPITAL DOES NOT HAVE THE RESOURCES TO MEET THIS NEED.THE FOLLOWING TOP HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED AS PART OF THE CHNA AND IMPLEMENTATION STRATEGY PLAN APPROVED IN 2019. ALTHOUGH A MORE RECENT CHNA WAS COMPLETED IN 2022, THE RELATED IMPLEMENTATION PLAN WAS NOT APPROVED UNTIL JULY, 2022. THEREFORE THE WORK DESCRIBED BELOW IS TIED TO THE 2019 ASSESSMENT AND PLANS AND REPRESENTS WORK CARRIED OUT BY THE HOSPITAL DURING FISCAL YEAR 2022.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA OBTAINED THROUGH THE COMMUNITY HEALTH SURVEY AND KEY INFORMANT SURVEY, AS WELL AS A REVIEW OF SECONDARY DATA ON A VARIETY OF HEALTH INDICATORS.TOP HEALTH NEEDS (FROM 2019 CHNA):1. ABILITY TO RETAIN PRIMARY CARE PROVIDERS (MD, DO, NP, PA):2. ATTRACTING AND RETAINING YOUNG FAMILIES:3. NOT ENOUGH AFFORDABLE HOUSING:4. AVAILABILITY OF RESOURCES TO HELP ELDERLY STAY IN THEIR HOMES: 5. ADULT AND YOUTH ALCOHOL USE AND ABUSE: FOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: ABILITY TO RETAIN PRIMARY CARE PROVIDERS (MD, DO, NP, PA):TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:FY22 ACTIONS AND IMPACT:CHI ST ALEXIUS HEALTH CARRINGTON HELD QUARTERLY MEETINGS WITH A COMMITTEE OF FIVE COMMUNITY RESOURCE PEOPLE WHO WERE INVITED TO EACH MEETING TO OFFER SUGGESTIONS. ONLY TWO OF THE FIVE COMMUNITY MEMBERS ATTENDED REGULARLY. SUGGESTIONS IMPLEMENTED FROM THE COMMUNITY GROUP TO ADD TO CARRINGTON HEALTH CENTER'S ALREADY EXISTING PLAN FOR ONSITE RECRUITMENT. THE COMMITTEE INVITED AREA HEALTHCARE PROVIDERS TO A MEET AND GREET OFF SITE OF CHI WHICH WAS HELD AT A LOCAL VENUE. VERY POOR ATTENDANCE BY AREA HEALTHCARE PROVIDERS. INVITATIONS WERE SENT OUT VIA EMAIL, PHONE CALLS, AND POSTCARD REMINDERS WERE SENT ONE WEEK PRIOR TO THE MEETING. PRIOR TO MARCH 2020 WHEN THE COVID-19 PANDEMIC STARTED THE COMMITTEE STOPPED ONSITE RECRUITMENT AND COMMUNITY INVOLVEMENT. THREE CANDIDATES WERE BROUGHT FORWARD. TWO OFFERS WERE MADE AND TURNED DOWN. ONE CANDIDATE WAS NOT CONSIDERED A GOOD FIT AND THEREFORE NO OFFER WAS EXTENDED. IN THE FALL OF 2020 A MODIFIED RECRUITMENT WAS ARRANGED FOR ONE CANDIDATE FOR AN ONSITE VISIT. NO OFFER EXTENDED.MEASURES: NONE TO REPORT.PRIORITY HEALTH NEED #2: ATTRACTING AND RETAINING YOUNG FAMILIES:TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:FY22 ACTIONS AND IMPACT:CHI ST ALEXIUS HEALTH CARRINGTON AND COMMUNITY MEMBERS CREATED A COMMITTEE TO ADDRESS THIS NEED. THE COMMITTEE APPLIED FOR AND RECEIVED A GRANT TO PROMOTE THE NEED. THE GRANT ALLOWED FOR THE COMMITTEE TO HAVE YOUNG FAMILIES INTERVIEWED FOR TELEVISION COMMERCIALS. THE MAIN FOCUS OF THE INTERVIEWS WAS ASKING WHY THE YOUNG FAMILY CHOSE CARRINGTON IN WHICH TO LIVE AND WORK. THE COMMERCIALS WERE AIRED LOCALLY UNTIL 2021.MEASURES: NONE TO REPORT.PRIORITY HEALTH NEED #3: NOT ENOUGH AFFORDABLE HOUSING:TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:FY22 ACTIONS AND IMPACT:CHI ST ALEXIUS HEALTH CARRINGTON STARTED A COMMITTEE WITH LOCAL COMMUNITY MEMBERS TO ADDRESS THIS NEED. THE MEETINGS WERE NOT SUCCESSFUL AND NOTHING MUCH HAPPENED WITH THE COMMITTEE. HOWEVER, A LOCAL PRIVATE COMPANY BEGAN TO BUILD AFFORDABLE HOUSING IN 2021 OUTSIDE THE PURVIEW OF THE COMMITTEE. THE COMMITTEE ATTEMPTED TO INTERVIEW THE PRIVATE COMPANY MULTIPLE TIMES BUT EACH TIME THE COMPANY DECLINED THE INTERVIEW.MEASURES: NONE TO REPORT.

PART V, SECTION B, LINE 11 (CONT'D):
"PRIORITY HEALTH NEED #4: AVAILABILITY OF RESOURCES TO HELP ELDERLY STAY IN THEIR HOMES:TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:FY22 ACTIONS AND IMPACT: SINCE THE LAST CHNA PROCESS, FOSTER COUNTY PUBLIC HEALTH CONDUCTED A ROUND TABLE MEETING WITH COUNTY PARTNERS TO DISCUSS ACCESS TO SERVICES FOR ELDERLY TO REMAIN IN THEIR HOMES. DUE TO THE COVID-19 PANDEMIC, THE GROUP STRUGGLED TO MEET DUE TO COMMUNITY DISEASE LEVELS AS WELL AS COVID-19 RESPONSE ACTIVITIES.HOWEVER, FOSTER COUNTY PUBLIC HEALTH WAS ABLE TO ADDRESS A SUBSTANTIAL GAP IN THE COMMUNITY AND WORK WITH COMMUNITY PARTNERS TO CREATE AN ADULT AND AGING SERVICES RESOURCE GUIDE. THE GUIDE ASSISTS COUNTY RESIDENTS WITH IDENTIFICATION OF RESOURCES AS WELL AS HOW TO ACCESS THEM AND AIDS THE ELDERLY, THEIR FAMILIES, AND HEALTH CARE PROFESSIONALS TO RETAIN THE ELDERLY IN THEIR HOMES AND IN OUR COMMUNITY. THE RESOURCE GUIDE WILL BE DISTRIBUTED IN THE FALL OF 2021 AND AVAILABLE IN THE COMMUNITY THROUGH THE CARRINGTON SENIOR CITIZEN CENTER, MEALS ON WHEELS, FCPH, CHI ST. ALEXIUS HEALTH CARRINGTON, CARRINGTON'S DAILY BREAD, GOLDEN ACRES MANOR AND ESTATES, CHI HEALTH AT HOME, AMONG OTHERS. THE GUIDE WILL ALSO BE AVAILABLE ONLINE. THE BOOKLETS WILL BE USED AS A RESOURCE IN DISCHARGE PLANNING FOR THE HOSPITAL, NURSING HOME, AND HOME HEALTH. FAMILY MEMBERS WILL BE ABLE TO FIND SERVICES TO KEEP ELDERLY RELATIVES IN THEIR HOMES LONGER. ELDERLY COMMUNITY MEMBERS WILL ALSO FIND MORE COMFORT AND SAFETY IN THEIR OWN HOMES. FOSTER COUNTY PUBLIC HEALTH WORKED WITH ITS OWN STAFF, AS WELL AS COLLABORATED WITH CARRINGTON CITY LIBRARY AND CARRINGTON SENIOR CENTER TO ASSIST ELDERLY IN ACCESSING REGISTRATION FOR COVID-19 VACCINES AS WELL AS PARTICIPATING IN SURVEY RESPONSES FOR CENSUS DATA COLLECTIONS.FOSTER COUNTY PUBLIC HEALTH WORKED WITH SOUTH CENTRAL TRANSPORTATION TO CREATE FREE RIDES FOR ALL CITIZENS NEEDING TRANSPORT TO/FROM COVID-19 VACCINE CLINICSMEASURES: NONE TO REPORT.PRIORITY HEALTH NEED #5: ADULT AND YOUTH ALCOHOL USE AND ABUSE:TO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:FY22 ACTIONS AND IMPACT:THE COMMUNITY WAS CONCERNED DURING THE LAST CHNA PROCESS ABOUT THE AMOUNT OF ADULT AND YOUTH ALCOHOL USE AND ABUSE IN THE SERVICE AREA. IN ORDER TO CONTINUE TO REDUCE ALCOHOL USE AMONG YOUTH IN FOSTER COUNTY AND TO ADDRESS THE COMMUNITY NORM OF THE BELIEF BY ADULTS THAT UNDERAGE DRINKING IS ACCEPTABLE AT A CERTAIN AGE BELOW 21 AND IS A RITE OF PASSAGE, FCPH IMPLEMENTED THE PROJECT NORTHLAND CURRICULUM IN THE CARRINGTON AND MIDKOTA PUBLIC SCHOOLS. THE PROJECT NORTHLAND CURRICULUM HAS A STRONG FAMILY COMPONENT. BY WORKING WITH STUDENTS AND PARENTS, FCPH IS AIMING TO SET PROTECTIVE FACTORS IN PLACE EARLY AND TO CHALLENGE AND CHANGE THE COMMUNITY NORMS. IN THE CARRINGTON MIDDLE SCHOOL, THE PROJECT NORTHLAND CURRICULUM WAS TAUGHT TO THE 6TH AND 7TH GRADERS. THE 8TH GRADE CLASS WILL BE ADDED IN THE UPCOMING YEAR. IN THE MIDKOTA MIDDLE SCHOOL THE PROJECT NORTHLAND CURRICULUM WAS TAUGHT TO THE 7TH AND 8TH GRADERS. THE MIDKOTA MIDDLE SCHOOL DOES NOT HAVE 6TH GRADE IN THEIR SCHOOL OR IN THEIR COUNTY.PROJECT NORTHLAND IS AN EVIDENCE-BASED SERIES FOR MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS. PROJECT NORTHLAND INTERVENTIONS TARGET ALL STUDENTS, PUTTING IT IN THE CATEGORY OF UNIVERSAL PREVENTION EFFORTS OR PRIMARY PREVENTION. THE NEEDS OF MOST STUDENTS FOR INFORMATION AND SKILLS ARE MET AT THIS LEVEL. THIS ALCOHOL-USE PREVENTION PROGRAM IS BACKED BY MORE THAN EIGHTEEN YEARS OF RESEARCH AND MORE THAN FORTY-FIVE SCIENTIFIC PUBLICATIONS. THE GOALS OF PROJECT NORTHLAND ARE TO DELAY THE AGE WHEN YOUNG PEOPLE BEGIN DRINKING, REDUCE ALCOHOL USE AMONG YOUNG PEOPLE WHO HAVE ALREADY TRIED DRINKING, AND LIMIT THE NUMBER OF ALCOHOL-RELATED PROBLEMS OF YOUNG PEOPLE. RESEARCH HAS SHOWN THAT, IN ADDITION TO EFFECTIVELY ACHIEVING ITS ALCOHOL PREVENTION GOALS, PROJECT NORTHLAND CAN SIGNIFICANTLY REDUCE TEENS' MARIJUANA AND TOBACCO USE. PROJECT NORTHLAND IS A NATIONALLY RECOGNIZED ALCOHOL-USE PREVENTION PROGRAM. THE FOUR PROJECT NORTHLAND CURRICULA WERE DEVELOPED AT THE UNIVERSITY OF MINNESOTA FROM RESEARCH FUNDED BY THE NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM.THE PROJECT NORTHLAND CURRICULA INVITE PARTICIPATION AND EXPERIENTIAL LEARNING AT HOME, IN THE CLASSROOM, AND IN THE LOCAL COMMUNITY. A VITAL ASPECT OF PROJECT NORTHLAND IS THIS MULTIFACETED APPROACH. PREVENTION RESEARCH SHOWS THAT ADDRESSING ALCOHOL USE AT MULTIPLE LEVELS STRENGTHENS OUTCOMES. INCORPORATING BEST PRACTICES FOR EFFECTIVE PREVENTION, THE CURRICULUM ENGAGES STUDENTS AS INDIVIDUALS AND ADDRESSES INFLUENCES IN THE FAMILY, WITH PEERS, AT SCHOOL, AND IN THE LOCAL COMMUNITY AND BROADER SOCIETY. PROJECT NORTHLAND ADDRESSES THESE DOMAINS MORE COMPREHENSIVELY THAN ANY OTHER PREVENTION PROGRAM. PROJECT NORTHLAND UTILIZES PEER-LED, EXPERIENTIAL, ACTIVITY DRIVEN LEARNING STRATEGIES TO ACTIVELY EDUCATE STUDENTS. FAMILIES ARE ENLISTED TO SUPPORT A ""NO USE"" MESSAGE, WHILE COMMUNITIES MOBILIZE TO REDUCE YOUTH ACCESS TO ALCOHOL AND TO PROMOTE ALCOHOL FREE NORMS FOR YOUTH. THE CURRICULA ARE USER FRIENDLY FOR TEACHERS, FUN FOR STUDENTS, INVITING TO FAMILIES, AND EFFECTIVE IN PREVENTING ALCOHOL USE. ALSO, TO REDUCE YOUTH AND ADULT ALCOHOL USE AND TO CHALLENGE AND CHANGE THE COMMUNITY NORMS, A MEDIA CAMPAIGN WAS IMPLEMENTED WITH FACEBOOK POSTS AND VIDEOS, LOCAL BILLBOARDS, RADIO SPOTS, A PARENTS LEAD CAMPAIGN, AND OTHER MEDIUMS. FCPH HAS ALSO HOSTED ALTERNATIVE ACTIVITIES FOR YOUTH DURING THE SUMMERS AT THE FAIR AND AT THE COMMUNITY POOL.MEASURES: NONE TO REPORT."

SCHEDULE H, PART V, SECTION B, LINE 16A
HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE

SCHEDULE H, PART V, SECTION B, LINE 16B
HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE

SCHEDULE H, PART V, SECTION B, LINE 16C
HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE

PART I, LINE 3C:
UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:- THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.- THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS.- THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:- RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;- HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;- PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);- FOOD STAMP ELIGIBILITY;- ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);- LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR- PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE.

PART I, LINE 7:
"COMMONSPIRIT HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (""CBISA"") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS."

PART III, LINE 2:
THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE.

PART III, LINE 3:
CARRINGTON HEALTH CENTER MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. CARRINGTON HEALTH CENTER'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. CARRINGTON HEALTH CENTER ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, CARRINGTON HEALTH CENTER DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE.

PART VI, LINE 7, REPORTS FILED WITH STATES
ND

PART III, LINE 4:
"CARRINGTON HEALTH CENTER DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 12-13.""PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES."""

PART III, LINE 8:
COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARRINGTON HEALTH CENTER'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $363,690 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS.

PART III, LINE 9B:
COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.

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INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.

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FOSTER COUNTY'S POPULATION FROM 2010 TO 2019 DECREASED BY 3.8%, AND EDDY COUNTY'S POPULATION DECREASED 4.1%. THE AVERAGE NUMBER OF RESIDENTS UNDER AGE 18 (21.5%) FOR FOSTER COUNTY COMES IN 2.1 PERCENTAGE POINTS LOWER THAN THE NORTH DAKOTA AVERAGE (23.6%), AND EDDY COUNTY COMES IN .2% LOWER THAN THE STATE AVERAGE. THE PERCENTAGE OF RESIDENTS, AGES 65 AND OLDER, IS ALMOST 7% HIGHER FOR FOSTER COUNTY (22.6%) AND 8% HIGHER FOR EDDY COUNTY THAN THE NORTH DAKOTA AVERAGE (15.7%), AND THE RATE OF EDUCATION IS ALMOST 2.5% LOWER FOR FOSTER COUNTY (90.3%) AND ABOUT 4% LOWER FOR EDDY COUNTY (89.4%) THAN THE NORTH DAKOTA AVERAGE (92.6%). THE MEDIAN HOUSEHOLD INCOME IN EDDY COUNTY ($54,868) IS MUCH LOWER THAN THE STATE AVERAGE FOR NORTH DAKOTA ($64,894), WHEREAS FOSTER COUNTY ($61,425) IS JUST SLIGHTLY LOWER. DATA COMPILED BY COUNTY HEALTH RANKINGS SHOW EDDY COUNTY AND FOSTER COUNTY ARE DOING BETTER THAN NORTH DAKOTA IN HEALTH OUTCOMES/FACTORS FOR 15 CATEGORIES; EDDY COUNTY IS DOING BETTER THAN NORTH DAKOTA IN HEALTH OUTCOMES/FACTORS FOR SEVEN CATEGORIES; AND FOSTER COUNTY IS DOING BETTER THAN NORTH DAKOTA IN HEALTH OUTCOMES/FACTORS FOR 15 CATEGORIES. EDDY COUNTY AND FOSTER COUNTY, ACCORDING TO COUNTY HEALTH RANKINGS DATA, ARE PERFORMING POORLY RELATIVE TO THE REST OF THE STATE IN 13 OUTCOME/FACTOR CATEGORIES; EDDY COUNTY IS PERFORMING WORSE THAN THE STATE AVERAGE IN NINE CATEGORIES; AND FOSTER COUNTY IS PERFORMING WORSE THAN THE STATE AVERAGE IN SEVEN CATEGORIES.

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FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS.

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THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. AS OF JUNE 30, 2022, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,200 CARE SITES, CONSISTING OF 142 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2022, COMMONSPIRIT HEALTH PROVIDED MORE THAN $3.16 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.89 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.9 BILLION IN FISCAL YEAR 2022, HAS TOTAL ASSETS OF APPROXIMATELY $50.31 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY.