4A (Expenses $ 4103499453 including grants of $ 2191061) (Revenue $ 5111181106)
THE TWENTY-EIGHT HOSPITALS INCLUDED ON THIS RETURN EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITIES AND BRINGING GOOD HELP TO THOSE IN NEED, ESPECIALLY PEOPLE WHO ARE POOR, DYING AND UNDERSERVED. THIS IS ACCOMPLISHED BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF HUMAN DIGNITY, INTEGRITY, COMPASSION, STEWARDSHIP, AND SERVICE. TOTAL COMMUNITY BENEFIT PROVIDED IN 2021 WAS $419,937,487.

4B (Expenses $ 2617211972 including grants of $ 0) (Revenue $ 2052170326)
BON SECOURS MERCY HEALTH IS A MISSION-DRIVEN, NONPROFIT, CATHOLIC HEALTH SYSTEM. BON SECOURS MERCY HEALTH OPERATES ACUTE CARE HOSPITALS, LONG-TERM CARE FACILITIES, HOUSING SITES FOR THE ELDERLY, HOME HEALTH AGENCIES, HOSPICE PROGRAMS, WELLNESS CENTERS AND OTHER HEALTHCARE ORGANIZATIONS. BON SECOURS MERCY HEALTH'S HOME OFFICE PROVIDES SERVICES AND SUPPORT TO THE ENTIRE SYSTEM, INCLUDING BUT NOT LIMITED TO: PROVIDING GOVERNANCE, MANAGEMENT OVERSIGHT, STRATEGIC LEADERSHIP, FOCUSING RESOURCES TO ASSURE THE HEALING MISSION, PROVIDING ACCESS TO LOWER COST DEBT FINANCING TO SUPPORT OPERATIONS, IMPROVING CLINICAL OUTCOMES AND REDUCING OPERATING COSTS.

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - Mercy Health - St. Vincent Medical Center LLC, Mercy Health - St. Anne Hospital LLC, Mercy Health - St. Charles Hospital LLC, St. Vincent Mercy Children's Hospital, Mercy Health - Perrysburg Hospital. The hospitals participated in a county-wide health needs assessment for Lucas County, which was coordinated by The Hospital Council of Northwest Ohio. The county-wide health needs assessment was cross-sectional in nature and included a written survey of adults (19 years of age and older), youth (ages 12-18), and children (ages 0-11). Input from persons representing the broad interest of the community was taken into account via stakeholder interviews and end-user surveys which included individuals with specific knowledge of or expertise in public health, the local health department, agencies with current data or information about the health needs of the community, and leaders, representatives and members of medically underserved, low income, and minority populations, and populations with chronic disease needs. Local community agencies were invited to participate in the health assessment process, including choosing questions for the surveys, providing local data, reviewing draft reports and planning the community event, release of the data and setting priorities. The needs of the population, especially those who are medically underserved, low-income, minority populations and populations with chronic disease needs, were taken into account through the sample methodology that surveyed these populations and over-sampled minority populations. In addition, the organizations that serve these populations participated in the health assessment and community planning process, such as Toledo-Lucas County CareNet, Toledo-Lucas County Commission on Minority Health, United Way of Greater Toledo, etc. Three specific population groups, adults (ages 19-75 years), youth (grades 6-12), and children (ages 0-5 and 6-11 years) were surveyed. To facilitate the Community Health Improvement Process, the Toledo-Lucas County Health Department, along with local hospitals, invited key community leaders to participate in an organized process of strategic planning to improve the health of residents of the county. The National Association of City County Health Officer's (NACCHO) strategic planning tool, Mobilizing for Action through Planning and Partnerships (MAPP), was used throughout this process. Beginning in October 2017, Healthy Lucas County met five times to review the process and timeline, finalize committee members, create or review the vision, choose priorities based on quantitative and qualitative data, rank the priorities, assess existing resources and community strengths, identify gaps in community resources, and draft plans to address the needs. Health problems were ranked based on magnitude, seriousness of consequences and feasibility of correcting the issue. Quantitative and qualitative data was used to prioritize the target areas. In addition, existing programs, services and activities in the community were identified that address the priority target impact area. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 5 Facility A, 2
Facility A, 2 - Mercy Health - St. Rita's Medical Center LLC. As part of the community health needs assessment (CHNA) process, many community stakeholders from Allen, Auglaize, and Putnam counties came together to create one county-level community health assessment (CHA) for each of their respective counties. As a result, these partnerships have resulted in less duplication, increased collaboration, and sharing of resources. Therefore, the data for this CHNA was obtained from the 2016 Putnam County CHA, 2017 Allen County CHA, and 2017 Auglaize County CHA. This community health needs assessment (CHNA) was cross-sectional in nature and included a written survey of adults within Allen, Auglaize, and Putnam Counties, as well as youth within Allen and Auglaize Counties. While Allen and Auglaize counties collect county-level youth health data, Putnam County does not. However, the Putnam County Task Force, does collect health data for individual grade levels using the PRIDE survey, which Mercy Health financially supports in addition to being a member of the task force. Two survey instruments were designed, and pilot tested for this study: one for adults and one for adolescents in grades 6-12. Input from members of the community was obtained through various methods for each county. Question selection meetings, questionnaires, rough draft meetings, community data release events, and written comments from community stakeholders were the main methods of collecting community feedback. Committee members expressed their opinions, needs, services or specific health-related topics while choosing certain questions to ask on the adult and adolescent questionnaires. The committee requested secondary data and correlations at rough draft meetings. Questions and written comments from the public were received at the community data release event from the community stakeholder perceptions worksheets. From the beginning, community leaders were actively engaged in the planning process and helped define the content, scope, and sequence of the study. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid CHNA. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 5 Facility A, 3
Facility A, 3 - Mercy Health - Willard Hospital LLC. Mercy Health - Willard Hospital is a key stakeholder and partner of Huron County Health Partners, a collaborative strategic planning process involving many community agencies and coalitions from various sectors. Huron County Health Partners commissioned a Community Health Needs Assessment (CHNA) for Huron County to assess and identify the health needs of the community. The CHNA was conducted by various social service, business and government organizations in Huron County to collect data that reports the health and health behaviors of Huron County residents. Data was collected for this assessment with the assistance of the Hospital Council of Northwest Ohio. This community health assessment was cross-sectional in nature and included a written survey of adults, youth, and parents within Huron County. From the beginning, community leaders were actively engaged in the planning process and helped define the content, scope, and sequence of the study. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment. From the beginning phases of the Huron County CHNA, community leaders were actively engaged in the planning process and helped define the content, scope and sequence of the project. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment. Under the leadership of the Hospital Council of Northwest Ohio, the survey questions were drafted and reviewed in a series of meetings with the planning committee from Huron County. Local community agencies were invited to participate in the health assessment process, including choosing questions for the surveys, providing local data, reviewing draft reports, planning the community event, releasing the data and setting priorities. The needs of the population, especially those who are medically under-served, low-income, minority or face a chronic disease, were taken into account through a sample methodology that surveyed these populations and over-sampled minority populations. In addition, the organizations that serve these populations participated in the health assessment and community planning process, including the Huron County Public Health, Fisher-Titus Medical Center, Mercy Health - Willard Hospital, The Bellevue Hospital and Norwalk Area United Fund. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 5 Facility A, 4
Facility A, 4 - Mercy Health - Defiance Hospital LLC. Mercy Health - Defiance Hospital participated in a Community Health Needs Assessment (CHNA) process coordinated by POWER Defiance County Coalition. The CHNA was conducted by various social service, business and government organizations in Defiance County to collect data that reports the health and health behaviors of Defiance County residents. Data was collected for this assessment with the assistance of the Hospital Council of Northwest Ohio. The most recent Defiance County Health Assessment was cross-sectional in nature and included a written survey of adults, adolescents and parents within Defiance County between January to March 2018. From the beginning phases of the Defiance County CHA, community leaders were actively engaged in the planning process and helped define the content, scope and sequence of the project. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment. Under the leadership of the Hospital Council of Northwest Ohio, the survey questions were drafted and reviewed in a series of meetings held at the end of 2017 with the planning committee from Defiance County. The needs of the population, especially those who are medically under-served, low-income, minority populations and populations with chronic disease needs, were accounted for through the sample methodology that surveyed these populations and over-sampled minority populations. In addition, the organizations that serve these populations participated in the health assessment and community planning process. Those participating organizations are listed below. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 5 Facility A, 5
"Facility A, 5 - Mercy Health - St. Elizabeth Health Center, Mercy Health - St. Elizabeth Boardman Health Center, Mercy Health - St. Joseph Health Center. Mercy Health - St. Elizabeth Health Center, Mercy Health - St. Elizabeth Boardman Health Center, and Mercy Health - St. Joseph Health Center, collectively referred to as ""MHY,"" was a lead partner with Mahoning and Trumbull County Health Partners (MTCHP) in completing the CHNA process which was carried out from March 2018 through August 2019 with over 25 planning meetings and conference calls. MTCHP contracted with the Hospital Council of Northwest Ohio (HCNO) to guide the CHNA process. HCNO collected the data, guided the health assessment process, and integrated sources of primary and secondary data for Mahoning County and Trumbull County Community Health Assessment reports. The process for the CHNA was cross-sectional in nature and included a written survey of adults within Mahoning and Trumbull Counties and focus groups of at-risk populations as well as incorporation of other health data sources to provide a comprehensive assessment of the health of the residents of Mahoning and Trumbull Counties. Mahoning County and Trumbull County adults (ages 19 and older) participated in a written, self-administered health assessment survey from September 2018 through January 2019. Initially, seven focus groups were conducted in November 2018 with residents from several at-risk or underserved populations including, African American, Hispanic/Latino, senior, young adult, low-income, and residents from rural areas. Community Release Events were held June 6, 2019 in both Mahoning and Trumbull counties to present the survey and focus group data and get input from the community. Community members had the opportunity to provide feedback through discussion at the event, by written comments on a feedback form and by submitting comments to the health department websites. Based on these comments, additional focus groups were held in June 2019 for African Americans, Hispanic/Latino, low income, LGBTQIA+, and young adults. The community participated in Community Health Improvement Plan (CHIP) planning meetings on June 27, July 8, July 25 and August 27, 2019 in Mahoning and Trumbull counties to identify and prioritize significant health needs. MHY staff attended and shared significant health needs previously identified by MHY Executive and Service Line Leaders. Each participant was asked to identify what they perceived to be the top five health problems, and this generated a list of 25-30 health needs. From this list, organizations voted to determine the top health needs in each county. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment"

Schedule H, Part V, Section B, Line 5 Facility A, 6
"Facility A, 6 - Mercy Health - Regional Medical Center LLC, Mercy Health - Allen Hospital LLC. The Mercy Health Lorain Market (""Mercy Health Lorain"") worked collaboratively with the Lorain County Public Health in the development and the implementation of the Community Health Assessment for all of Lorain County. The data for the Lorain County CHA was compiled and collected in 2018 and released on May 23, 2019. The Lorain County CHA was a cross-sectional in nature survey which included a written survey of adults and an electronic survey of youth with Lorain County. Mercy Health Lorain and Lorain County Public Health contracted with the Hospital Council of Northwest Ohio (HCNO), a neutral, regional, and non-profit hospital association, to facilitate the CHNA, CHA and CHIP. Several community stakeholders participated in the process and were members of the Lorain County CHIP Steering Committee. Under the direction of HCNO, the Lorain County CHA included community input in its assessment process in several different ways as follows: surveyed adults and youth in the community; engaged in a Community Themes and Strengths Assessment (CTSA) to gain a deeper understanding on what the residents of Lorain County felt were most important; collected Quality of Survey Survey responses to 394 community members; and participated in a Forces of Change Assessment to identify forces such as legislation, technology, and other impending changes that affect the community and its public health system. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment"

Schedule H, Part V, Section B, Line 5 Facility A, 7
Facility A, 7 - Jewish Hospital LLC, Mercy Health - West Hospital LLC, Mercy Health - Anderson Hospital LLC, Mercy Health - Fairfield Hospital LLC, Mercy Health - Clermont Hospital LLC. Mercy Health Cincinnati participated alongside regional health partners and hospitals to develop the 2019 Community Health Needs Assessment (CHNA). Hospital members of the Health Collaborative and Greater Dayton Area Hospital Association (GDAHA) joined the collaboration which resulted in a robust portrait of the larger Southwest Ohio region. Numerous qualitative and quantitative data methods were leveraged to identify, collect, interpret, and analyze data. CHNA Consultants sought data that reflected recent as well as emerging issues by people who lived in the hospitals' service areas, with attention to vulnerable populations and social determinants of health. Primary data from meetings and surveys was collected from April through July of 2018. The technique of discourse analysis was used to categorize comments, sort and count them, and calculate how often ideas were repeated. Secondary data started with the resources of County Health Rankings with additional data from reputable national and state sources in Indiana, Kentucky, and Ohio. The process included an oversampling of vulnerable populations including African Americans; Elderly residents; Latino residents; LBGTQ+ residents; refugees from Rwanda; and urban residents. Community Need Index scores were utilized to identify the likelihood of healthcare disparities at the ZIP Code level for all ZIP Codes in 25 counties. The regional CHNA included 35 hospitals, 28 local health departments, more than 1,400 healthcare consumers, and organizations and non-profits serving the needs of residents across 25 counties in the Greater Cincinnati and Dayton areas. Community input was received through a series of community meetings and surveys. From April to July 2018, there were 42 meetings, held in 23 counties, which attracted representatives of community organizations, the general public, and/or members of medically underserved and vulnerable populations. A total of 440 people attended 42 meetings. Of these, 283 were speaking on behalf of an organization; 127 were individuals representing their own point of views; 17 represented themselves and an organization; and 13 did not check either box to identify if they were attending as an individual or representing an agency. Additionally, online surveys were distributed throughout the Region cataloguing responses from individuals (828), agencies (96), and public health departments (28). The CHNA team used SurveyMonkey (Gold) for tracking responses at meetings, interviews, and surveys creating custom tags for each response. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - Mercy Health - St. Vincent Medical Center LLC, Mercy Health - St. Anne Hospital LLC, Mercy Health - St. Charles Hospital LLC, St. Vincent Mercy Children's Hospital, Mercy Health - Perrysburg Hospital. Promedica Health System Community Memorial Hospital Mercy Health - St. Vincent Medical Center Mercy Health - St. Anne Hospital Mercy Health - St. Charles Hospital Mercy Health - Perrysburg Hospital St. Vincent Mercy Children's Hospital

Schedule H, Part V, Section B, Line 6a Facility A, 2
Facility A, 2 - Mercy Health - St. Rita's Medical Center LLC. Lima Memorial Health System Institute of Orthopaedic Surgery Blanchard Valley Health System, Putnam County Grand Lake Health Systems

Schedule H, Part V, Section B, Line 6a Facility A, 3
Facility A, 3 - Mercy Health - Willard Hospital LLC. The Bellevue Hospital FisherTitus Medical Center

Schedule H, Part V, Section B, Line 6a Facility A, 4
Facility A, 4 - MERCY HEALTH - DEFIANCE HOSPITAL LLC. ProMedica Defiance Regional Hospital

Schedule H, Part V, Section B, Line 6a Facility A, 5
Facility A, 5 - Mercy Health - St. Elizabeth Health Center, Mercy Health - St. Elizabeth Boardman Health Center, Mercy Health - St. Joseph Health Center. Mercy Health - St. Elizabeth Health Center Mercy Health - St. Elizabeth Boardman Health Center Mercy Health - St. Joseph Health Center

Schedule H, Part V, Section B, Line 6a Facility A, 6
Facility A, 6 - Mercy Health - Regional Medical Center LLC, Mercy Health - Allen Hospital LLC. Specialty Hospital of Lorain University Hospitals Elyria Medical Center Cleveland Clinic Avon Hospital Mercy Health - Allen Hospital Mercy Health - Regional Medical Center

Schedule H, Part V, Section B, Line 6a Facility A, 7
Facility A, 7 - Jewish Hospital LLC, Mercy Health - West Hospital LLC, Mercy Health - Anderson Hospital LLC, Mercy Health - Fairfield Hospital LLC, Mercy Health - Clermont Hospital LLC. The Christ Hospital Health Network Cincinnati Children's Hospital Medical Center Clinton Memorial Hospital Highpoint Health Fort Hamilton Hospital Grandview Medical Center Greene Memorial Hospital Kettering Behavioral Medic Center Kettering Medical Center Soin Medical Center Southview Medical Center Sycamore Medical Center Lindner Center of HOPE Mercy Health - Anderson Hospital Mercy Health - West Hospital Mercy HEalth - Clermont Hospital Mercy Health - Fairfield HOspital Jewish Hospital LLC Mercy Health - Springfield Regional Medical Center Mercy Health - Urbana Hospital Atrium Medical Center Miami Valley Hospital Miami Valley Hospital North Miami Valley Hospital South Upper Valley Medical Center Bethesda Butler Hospital Bethesda North HOspital Good Samaritan Hospital McCullough Hyde Memorial Hospital TriHealth Evendale Hospital Daniel Drake Center for Post-Acute Care University of Cincinnati Medical Center West Chester Hospital Wayne HealthCare Wilson Health

Schedule H, Part V, Section B, Line 6b Facility A, 1
Facility A, 1 - Mercy Health - St. Vincent Medical Center LLC, Mercy Health - St. Anne Hospital LLC, Mercy Health - St. Charles Hospital LLC, St. Vincent Mercy Children's Hospital, Mercy Health - Perrysburg Hospital. Adelante Advocates for Basic Legal Equality, Inc. American Cancer Society Area Office on Aging of Northwest Ohio, Inc. Family and Child Abuse Prevention Center Healthy Lucas County Hospital Council of Northwest Ohio Lake Erie West Traffic Safety Lucas County Family and Children First Mental Health Recovery Services Board of Lucas County New Concepts Neighborhood Health Association Ottawa Hills Schools Ohio State University Extension Toledo Community Foundation Toledo Fire and Rescue Department Toledo Lucas County CareNet Toledo Lucas County Health Department Toledo Public Schools United Way of Greater Toledo United Pastors of Social Empowerment YMCA Live Well Toledo YWCA Hope Center Toledo Lucas-County Health Department Toledo Public Schools Pediatricare Associates, Inc.

Schedule H, Part V, Section B, Line 6b Facility A, 2
Facility A, 2 - Mercy Health - St. Rita's Medical Center LLC. Activate Allen County Allen County Public Health Auglaize County Board of Developmental Disabilities Auglaize County Commissioners Auglaize County Council on Aging Auglaize County Family and Children First Council Auglaize County Head Start Auglaize County Health Department Auglaize County Job and Family Services Auglaize County Juvenile Court Hancock, Hardin, Wyandot and Putnam Community Action Commission, Putnam County Health Partners of Western Ohio Mental Health and Recovery Services Board, Allen and Auglaize County New Bremen Local Schools, Auglaize County Pathways Counseling Center, Inc., Putnam County Putnam County Council on Aging Putnam County Family and Children First Council Putnam County Health Department Putnam County Homecare and Hospice The Mental Health, Alcohol and Drug Addiction Recovery Board of Putnam County The Ohio State University, Lima Campus United Way of Greater Lima United Way of Putnam County University of Toledo Wapakoneta City Schools Waynesfield-Goshen Local Schools West Ohio Community Action Partnership

Schedule H, Part V, Section B, Line 6b Facility A, 3
Facility A, 3 - Mercy Health - Willard Hospital LLC. Firelands Counseling and Recovery Services Huron County Health Partners Hospital Council of Northwest Ohio Huron County Public Health Huron County Commissioners Huron County Mental Health and Addiction Services (MHAS) Board Huron County Schools (School districts of Bellevue, Monroeville, New London, Norwalk, South Central, Western Reserve and Willard, St. Paul High and Immaculate Conception) National Alliance of Mental Illness (NAMI) of Huron County University of Toledo

Schedule H, Part V, Section B, Line 6b Facility A, 4
Facility A, 4 - Mercy Health - Defiance Hospital LLC. City of Defiance CPC Women's Health Resource Defiance Area Foundation Defiance Area YMCA Defiance City Schools Defiance County Commissioners Defiance County Emergency Management Agency Defiance County General Health District Defiance County Help Me Grow - Early Intervention Defiance County Juvenile Court Defiance County - Ohio State University Extension Office Defiance Development and Visitors Bureau Defiance County Family and Children First Council Four County ADAMhs Board Four County Family Center Hicksvilee Village Northwestern Ohio Community Action Commission Recovery Services of Northwest Ohio United Way of Defiance County

Schedule H, Part V, Section B, Line 6b Facility A, 5
Facility A, 5 - Mercy Health - Regional Medical Center LLC, Mercy Health - Allen Hospital LLC. Lorain County Public Health Hospital Council of Northwest Ohio (HCNO) Alcohol and Drug Addiction Services Board of Lorain County Lorain County Board of Mental Health Lorain County Health and Dentistry Lorain County Metro Parks Lorain County Office of Aging Lorain County Public Health Mental Health, Addiction and Recovery Services Board of Lorain County Lorain County Community College

Schedule H, Part V, Section B, Line 6b Facility A, 6
Facility A, 6 - Mercy Health - St. Elizabeth Health Center, Mercy Health - St. Elizabeth Boardman Health Center, Mercy Health - St. Joseph Health Center. Mahoning County Public Health Trumbull County Combined Health District Healthy Community Partnership Mahoning Valley Youngstown City Health District Mahoning County Mental Health and Recovery Board Mercy Health Foundation Mahoning Valley Trumbull County Mental Health and Recovery Board Warren City Health District

Schedule H, Part V, Section B, Line 6b Facility A, 7
Facility A, 7 - Jewish Hospital LLC, Mercy Health - West Hospital LLC, Mercy Health - Anderson Hospital LLC, Mercy Health - Fairfield Hospital LLC, Mercy Health - Clermont Hospital LLC. The Health Collaborative in Cincinnati Greater Dayton Area Hospital Association Public Health - Dayton & Montgomery County Southwest District of the Association of Ohio Health Commissioners Gwen Finegan - Lead Consultant and Project Manager

Schedule H, Part V, Section B, Line 11 Facility A, 1
"Facility A, 1 - Mercy Health - St. Vincent Medical Center LLC, Mercy Health - St. Anne Hospital LLC, Mercy Health - St. Charles Hospital LLC, St. Vincent Mercy Children's Hospital, Mercy Health Perrysburg Hospital. Mercy Health Toledo is comprised of Mercy Health - St. Vincent Medical Center, St. Vincent Mercy Children's Hospital, Mercy Health Perrysburg Hospital, Mercy Health - St. Anne Hospital, and Mercy Health - St. Charles Hospital. These hospitals are collectively referred to as ""Mercy Health Toledo (MHT)."" MHT address each need identified in its CHNA with regional strategies. Unless noted below, all MHT hospitals participated in the regional strategies. Chronic Disease Implementation Activities: Goal: Improve access to adult patients with chronic disease. Improve Population Health Engagement through Community Paramedicine. Improve access to health foods for patients living in identified food desert. Increase footprint for health outreach programming. 2021 Strategies and Outcomes: * MHT continued its efforts to deploy adult oriented, community health worker (CHW) led, care coordination programs in medical settings to refer adults to community resources and health education. The goal of 2021 was to enroll 100 adult patients in care coordination services and this goal was surpassed with 150 adult patients enrolled. MHT hired additional CHWs in April to further their efforts. * MHT continued their support of the Community Paramedicine Program in order to reduce emergency department utilization rates, inpatient admission, and increase primary care engagement. During 2021, 10 new patients were enrolled to the Community Paramedicine Program. Of all of the current patients in the program, there was no increase in ED utilization and 72 patients in the program had reduced ED visits. All patients enrolled into the program were connected to needed social resources. Due to covid-19 and a staffing crisis further efforts were postponed until 2022. * MHT plans to implement several other programs to address this need, including deploying a nutrition prescription program linked to food pharmacies and expanding the Mercy Kids in Action and Starting Fresh programs to additional locations in Toledo. Due to COVID-19, these projects were delayed and will resume in 2022. Mental Health Implementation Activities: Goal: Reduce number of suicide attempts. Increase youth mental health services. 2021 Strategies and Outcomes: * Due to COVID-19 the C-SSRS Screening process and training to decrease suicide ideation were put on hold until 2022. * Due to COVID-19, MHT's plans to implement a training program during 2021 were delayed until 2022. * MHT has a three-year plan to investigate the feasibility to expanding mental health services for youth. This project was put on hold until 2022 due to COVID-19 and the sale of St. Vincent Mercy Children's Hospital. Addiction/Drug and Opiate Use Implementation Activities: Goal: Reduce youth substance abuse. 2021 Strategies and Outcomes: * MHT plans to implement Generation Rx, a school-based alcohol and drug prevention program to reduce youth substance abuse, in six new schools within Lucas County by the end of 2022. No progress was made during 2021 due to COVID-19 restrictions in schools. Maternal and Infant Health/Infant Mortality Implementation Activities: Goal: Increase access to health care. Increase the number of pregnant women receiving lead testing during pregnancy. 2021 Strategies and Outcomes: * The Pathways Community HUB Model helps communities work together to support their vulnerable populations. Local community health workers work closely with families to connect to social and medical services to remove barriers to health. During 2021, 220 women were served by the program. * During 2021, MHT began to explore the feasibility of implementing lead testing of pregnant women in all MHT OB/GYN clinics with baseline data gathered for future years. Additionally, MHT created a protocol for testing and follow-up care. The protocol implemented is that all pregnant women are offered a lead test and if the patient test reveals high lead levels, she is referred to CHW trained in lead education. Health Care System and Access to Care Implementation Activities: Goal: Increase the cultural competence of Mercy Health Toledo staff. 2021 Strategies and Outcomes: * MHT continued to investigate the feasibility of implementing implicit bias training to MHT staff. Due COVID-19, the training of the instructors was paused until 2022. Social Determinants of Health Implementation Activities: Goal: Increase early childhood home visiting programs. 2021 Strategies and Outcomes: * MHT will create an internal process for referring patients to home visiting programs and educate staff on the benefits of the program, enroll patients and families in the program with a goal to increase number of children ready for kindergarten. In 2021, 252 families were served by the program which is a large increase from the 38 families served in 2020. All prioritized needs in the hospital CHNA have been addressed."

Schedule H, Part V, Section B, Line 11 Facility A, 2
Facility A, 2 - Mercy Health - St. Rita's Medical Center LLC. Mercy Health - St. Rita's Medical Center LLC (SRMC) Chronic Disease Implementation Activities: Goal: Reduce heart disease. Create a Paramedicine to assist with transition of care. Expand Meds-to-Beds Program. Reduce diabetes. Increase the number of cancer screenings reported. 2021 Strategies and Outcomes: * SRMC will continue to implement school-based nutrition and physical activity programming, such as GoNoodle and the Activated School Challenge, in schools. In 2021, SRMC served 35,190 total persons, including 23,112 GoNoodle engagements and 6,689 Activated School Challenge engagements. The total persons served was an increase from the 34,893-baseline established in 2018. * During 2021, SRMC was exploring grant opportunities for a paramedicine program, however there were immediate needs and gaps in care to help address smoking use and the disparities in prostate cancer screenings for African Americans that SRMC utilized their Mission outreach grants instead. * The Meds-to-Beds Program is a free service that offers education about medication and delivers prescriptions and over-the-counter medications to patients before they leave the hospital. SRMC expanded its Meds-to-Beds program to 3,668 patients delivering 11,645 total prescriptions in 2021. * SRMC continues to collaborate with Mercy Health- Lima ambulatory care practices to identify and track the number of people receiving A1C screenings, education, and/or treatment. During 2021, SRMC had 82.8% of the total ambulatory care patients maintain A1c<9 compared to its goal of 80%. * SRMC is leveraging and increasing awareness around the Diabetes Prevention Program and Diabetes Clinic and working on building referrals and educate providers on the Diabetes Prevention Program. During 2021, 20 participants completed the program and currently 85% of patients of the Diabetes Clinic have an A1c<9. * SRMC provides cancer awareness, outreach, and screening efforts focused on breast, colon and lung cancers within the minority community. SRMC took the following actions during 2021: - A colorectal screening event was held with 17 kits distributed with a 71% return rate. Event was held as Cancer on Commission (Coc) screening event for 2021. CQUIP data showed more patients have Stage 3 and Stage 4 colorectal cancer - 165 needs assessments were completed by the community at large to gather data on health insurance status, primary care provider access, social determinants of health needs, and date of last preventative cancer screening - Offered free prostate screening to 39 African American men resulting in 4 referrals to primary care and appropriate PSA screenings - A Mammogram pilot was started in August of 2021 to identify and offer screening to non-adherent patients amongst the various family medicine practices. At the end of the year 34 new patients were scheduled for a mammogram Mental Health and Addiction Implementation Activities: Goal: Reduce youth substance abuse. Increase drug and alcohol screening. Offer alternative therapies to behavioral health patients, other than medication, for coping and strengthening positive mental and spiritual well-being. Increase access to Naloxone. 2021 Strategies and Outcomes: * SRMC supports a comprehensive school-based strategy collaborated in conjunction with the Mental Health & Recovery Services Board to help address behavior-based issues. The strategy includes implementing programs that include: GoNoodle, GenRx, Saturday Steps, Activated School Challenge and Resiliency Grant through the Legacy Fund. In 2021, 21 schools were offered evidence based QPR training to their teachers and staff through the PASS program, to help provide tools and resources designed to reduce the risk of suicidal behaviors by providing innovative, practical and proven suicide prevention training. The goal to expand the number of schools to 15 was greatly surpassed. * Mercy Health - Lima continues to explore the feasibility to implement SBIRT screening within primary care offices and beyond the hospital setting. In 2021, SRMC implemented digitized versions of the SBIRT screening at 2 family medicine practices which surpassed the goal of 1. * SRMC collaborated with community partners to determine alternative therapy options for behavioral health patients, such as art therapy, music therapy, etc. In 2021, SRMC served a total of 685 patients in the Art Therapy program, and 7 individuals were taking classes at ArtSpace Lima upon discharge per the constructed pathway. Additionally, SRMC implemented a Pre/Post Survey in March of 2021 to measure the effect of Art Therapy on stress, mood, energy, ability process emotions, pain level, and ability to relax and by the end of the year 321 patients took the survey with 63% indicated improvements on 4 of the 7 items listed. * During 2021, SRMC offered 96 Naloxone kits through the outpatient pharmacy to patients, and 64 outpatient prescriptions were written by the emergency department. SRMC's goal for 2021 was to add one additional project DAWN o naloxone site and that goal was surpassed with 14 added sites. All 11 local Mercy health Primary Care and Family Medicine practices currently serve as naloxone distribution sites. Maternal and Infant Health Implementation Activities: Goal: Offer addiction counseling to pregnant women. Increase breastfeeding. Increase home visiting that begins prenatally. 2021 Strategies and Outcomes: * SRMC continued the Embrace Program, which offers addiction counseling to pregnant women through OB/GYN specialists. During 2021, SRMC continued this program at OB GYN Specialists of Lima which comprises 8 OB GYNspecialists and had 35 total referrals. * SRMC continues to increase the number of staff certified in lactation counseling to provide increased breastfeeding support at birth facilities. In 2021, SRMC currently has 9 mom/baby RN's that are Certified Lactation Counselors and 3 of which that are International Board-Certified Lactation Consultants. In 2021, 645 of the total 1,486 live births were breastfed at birth. * SRMC continues to focus on improving collaboration with the pharmacy to increase the Vitamin D supplementation provided to infants. In 2021, the baseline data was collected, which will be used to track progress in future years. * During 2021, SRMC conducted 729 home visits before and after birth. SRMC intends to increase the number of home visits and will utilize 2021 as its baseline for future progress. * SRMC staff educated its healthcare providers on home visiting programs and identifying additional staff to do home visiting. SRMC has a Home Visiting Task Force that meets quarterly to review goals and additional ways to help educate providers. The Task force consists of providers, care coordinators, nursing staff, support staff and community partners. Additionally, SRMC received an ODH grant to help address maternal/infant health in Allen County, which home visiting is a key focus.

Schedule H, Part V, Section B, Line 11 Facility A, 3
Facility A, 3 - Continued Description: Mercy Health - St. Rita's Medical Center LLC. Social Determinants of Health (Including Access to Care) Implementation Activities: Goal: Support Activate Allen County (a local coalition of key stakeholders) to address the health & wellbeing of the community. 2021 Strategies and Outcomes: * During 2021, SRMC continued to be a key sponsor of the Activate Allen County coalition and to engage in leadership and work groups to help address their goals and objectives to address this need. * Initiatives of the coalition and SRMC in 2021 included: - Housing: securing funding through DCI investment program to address housing as part of a place-based strategy. Additionally, an LLC was developed with the sole role of helping residents improve their housing options, while simultaneously disrupting generational poverty for those who live there. The LLC will rehab and renovate local homes with the intent to encourage home ownership and eliminate rent-burden. Mercy Health - Lima is also tied into the Health Anchor Network (HAN) place-based investing strategy to invest funds towards the housing need. - Food Insecurity: Piloting Green Prescription program through Family Medicine Resident Clinic screening patients for food insecurity, connecting them to care coordination and existing community resources within community.. The Green Prescription program is in partnership with West Ohio Food Bank, Family Medicine Residents, Mercy Health Care Coordinators and Activate Allen County. SRMC also utilizes the Vital-Hunger Sign Questionnaire to assess food insecurity and provide those who are food insecure with an emergency food box. A total of 45 food boxes were distributed - Transportation: Mercy Express- 5,446 patients provided transportation to and from medical appointments. Medication: Mercy Action- Mercy Action helps to improve access to health services for underserved persons, reduce and eliminate the cost barrier to patient access to prescribed medication, and provide a needed service to the community and public broadly, including uninsured persons and patients. 2,398 patients were provided with medication at no cost to the patient based on financial needs. Public Health System, Prevention and Health Behaviors Implementation Activities: Goal: Reduce smoking. 2021 Strategies and Outcomes: * SRMC continued its collaboration and support of the work of Tobacco Free Coalition and the Activate Change-Quit program that was established in 2020. During 2021, the program had 221 referrals, 70 new patients, 616 total patient contacts, 45 patients completing the entire 12 week course, and 15 patients remaining tobacco free at 180 days after the completion of the course. All prioritized needs in the hospital CHNA have been addressed.

Schedule H, Part V, Section B, Line 11 Facility A, 4
Facility A, 4 - Mercy Health - Willard Hospital LLC. Mercy Health - Willard Hospital Chronic Disease Implementation Activities: Goal: Improving physical health by providing education on healthy eating habits, exercise and chronic disease management through the Complete Health Improvement Program (CHIP). 2020 Strategies and Outcomes: * Mercy Health Willard continued to provide free health screenings to all employees during 2021. * Due to the impact of COVID-19, many of the programs and strategies that Mercy Health Willard intended to implement to address this health need were delayed until 2022. Mercy Health Willard plans to resume these programs in 2022. Mental Health/Substance Abuse Implementation Activities: Goal: Improve mental health and substance abuse awareness in Huron County 2020 Strategies and Outcomes: * Counseling services were available through Firelands Counseling and Recovery Services. * Due to the impact of COVID-19, many of the programs and strategies that Mercy Health Willard intended to implement to address this health need were delayed until 2022. Mercy Health Willard plans to resume these programs in 2022. Mercy Health Willard will not directly address Injury and Violence Prevention community need as other organizations in Huron County are specifically designed and better prepared to respond to this need through resources and experience. Mercy Health Willard will support them as needed.

Schedule H, Part V, Section B, Line 11 Facility A, 5
Facility A, 5 - Mercy Health - Defiance Hospital LLC. Mercy Health - Defiance Hospital Mental Health and Addiction Implementation Activities: Goal: Through proven and promising best practices, effective programs will be better able to help achieve the Healthy People 2020 Mental Health and Mental Disorders Objectives to improve mental health through prevention and ensure access to appropriate, quality mental health services. To increase community awareness of the problem of addiction and of the availability of effective treatment opportunities. 2021 Strategies and Outcomes: * Mercy Health Defiance continues to support the Four County L.O.S.S. (Local Outreach to Suicide Survivors) program by providing volunteers for call responses. * During 2021 Mercy Health Defiance provided drop boxes for drugs in their emergency department for the local community to help safely dispose of drugs. * Mercy Health Defiance continues to remain active with the Four County ADAMhs and the POWER Defiance County Coalition boards by having two 2 staff members serving on each board. * Due to the impact of COVID-19, many of the programs and strategies that Mercy Health Defiance intended to implement to address this health need were delayed until 2022. Mercy Health Defiance plans to resume these programs in 2022. Chronic Disease Implementation Activities: Goal: Reduce the percentages of overweight or obese adults and children and reduce the percentage of heart disease in adults in Defiance County by implementing a communitywide physical activity and nutrition campaign in collaboration with at least 4 Defiance County organizations. 2021 Strategies and Outcomes: * Mercy Health Defiance continues to maintain the walking path on property owned by Defiance County and adjacent to Mercy property. Increase Injury prevention Implementation Activities: Goal: Reduce the number of falls in the adult population and increase the number of parents who put their child to sleep on his/her back. 2021 Strategies and Outcomes: * Mercy Health Defiance continued community collaboration with POWER Defiance County Coalition and active participation in workgroups to address the community needs and strategies. * Due to the impact of COVID-19, many of the programs and strategies that Mercy Health Defiance intended to implement to address this health need were delayed until 2022. Mercy Health Defiance plans to resume these programs in 2022. All prioritized needs in the hospital CHNA have been addressed.

Schedule H, Part V, Section B, Line 11 Facility A, 6
"Facility A, 6 - Mercy Health - Regional Medical Center LLC, Mercy Health - Allen Hospital LLC. Mercy Health - Lorain is comprised of Mercy Health - Lorain Regional Medical Center and Mercy Health - Allen Hospital. These hospitals are collectively referred to as ""Mercy Health Lorain."" Mercy Health Lorain address each need identified in its CHNA with regional strategies. Unless noted below, all Mercy Health Lorain hospitals participated in the regional strategies. Chronic Disease Implementation Activities: Goal: The Mercy Health Lorain Market will look at the main factors that impact Chronic Disease - Obesity, Diabetes and Heart disease by using diabetes and food education coupled with an exercise prescription program to bring awareness to the impact it has on the body. 2021 Strategies and Outcomes: * In partnership with United in Glory and Thrive! Mercy Health Lorain created and kicked off two new programs that focused on Men's Chronic Diseases during 2021: United in Glory focused on minorities in the area and had 30 participants; Thrive! focused on people in the southern portion of the county and had 20 participants. The various Men's Chronic Disease programs were developed from the ground up and have had a total of 110 participants since their inception. * Mercy Health Lorain continued their exercise prescription program to connect patients to free/low-cost exercise options and develop a relationship with the individual's primary care provider throughout the county. Although the exercise facility was closed for a short period of time due to the COVID-19 pandemic, the exercise prescription program was restarted in 2021. In 2021, they combined their exercise program with Amherst High School and had 1 physician prescribe 25 coupons. * During 2021, Mercy Health Lorain continued their food prescription program connecting patients to health food options throughout the county. Programs included participation from Second Harvest Food Bank, Salvation Army of Lorain and Elyria, and Oberlin Community Services Center. Through the year Mercy Health Lorain extended the reach of the program with their OB/GYN practice, Mercy Health Family Outreach and Produce Perks. Mercy Health Lorain also partnered with Second Harvest Food Bank to provide access to food while the food prescription program with Produce Perks was being setup. Cancer - Men and Women Implementation Activities: Goal: Mercy Health Lorain Market will increase cancer awareness for men and women between the ages of 50-75 throughout Lorain County on the three top ranking cancers: Breast; Colon; and Prostate Cancer. 2021 Strategies and Outcomes: * During 2021, Mercy Health Lorain increased presence, awareness and Mammogram screenings with a continued highlight in the Southern portion of Lorain County. Mercy Health Lorain provided 6,121 mammograms during 2021 which was an increase of 141 patients from 2020 during a time of the pandemic when access to testing has been a challenge. * Access to testing was a barrier during the pandemic. Mercy Health Lorain utilized all of its grant dollars to pay for Mammograms that individuals could not afford. * Mercy Health Lorain continued to increase presence, awareness and Colorectal screenings for both men and women by providing 2,461 screenings, which was a significant increase from 2020 due to the impact of the Pandemic in 2020. * Mercy Health Lorain developed an educational symposium in partnership with United in Glory and Thrive!, which was provided via Zoom by a Mercy Health Lorain physician, and created Talk to a Provider event during 2021. * During 2021, Mercy Health Lorain had 224 total Men receive education and screenings on prostate cancer. This was a 28% increase from 2020 which surpassed the goal of a 15% increase year over year. * Mercy Health Lorain in partnership with United in Glory and Thrive! held a prostate education symposium with Dr. Chris Haas. Maternal and Child Health Implementation Activities: Goal: Mercy Health Lorain Market will focus on Infant mortality by decreasing the number of preterm births in which the gestational period is less than 37 weeks. 2021 Strategies and Outcomes: * Mercy Health Lorain collaborated with Mercy Health Resources Mothers Program to connect with 325 pregnant women through Lorain County during 2021 and provide at home visits to help gestational periods exceed 37 weeks. * The COVID-19 pandemic had a significant impact on Mercy Health Lorain's strategies to address this need and resulted in delayed referrals to the program. Mercy Health Lorain continues to explore new programs and opportunities and has a new recruitment plan with area high schools. Mental Health Implementation Activities: Goal: The Mercy Health Lorain Market will increase the number of patients that access and utilize Mercy Health for care for their mental health. 2021 Strategies and Outcomes: * During 2021, Mercy Health Lorain collaborated with Lorain County Community College (LCCC) and the local high schools to raise awareness to careers in mental health. A program with LCCC is still in process to be implemented but is experiencing delays due to Covid-19 and the increase in online learning and virtual work. However, Mercy Health Lorain was able to implement the high school program and provided 2 tours with Rising Stars and Leadership Lorain County. High school students are still not able to shadow at the hospital due to Covid-19. * Mercy Health Lorain continues to focus on increasing utilization of mental health services through use of Clinical Psychologists. In 2021, Mercy Health Lorain increased the total number of providers to 10 and had 5,904 patients utilized these services which surpasses their goal of a 3% increase over 3 years. * To increase suicide awareness through programs and partnerships, Mercy Health Lorain offered 2 suicide awareness/prevention sessions over Zoom during 2021. Mercy Health Lorain also held a Brown bag luncheon and a Parish Nursing Volunteer session to review mental health in the area. Substance Abuse Implementation Activities: Goal: Mercy Health Lorain Market will increase substance abuse education and connect addiction support to those in need throughout Lorain County. 2021 Strategies and Outcomes: * During 2021, Mercy Health Lorain worked to enhance the opioid/substance abuse awareness and education for high school students throughout the county with a goal to complete 6 courses throughout the county by the end of the three-year period. In collaboration with the Lorain County Overdose Addiction Task Force (LCOAT), three virtual sessions on drug awareness and the stigma of drug use were provided to local high school students in 2021. A member of the Mercy Health Lorain Community Health team leads the LCOAT collaboration. * Mercy Health Lorain continued to provide education through the Let's Get Real Program. Despite COVID-19 and the decrease in patients seen in the ER, this program had 420 patient referrals in 2021 which surpassed the 225 patients seen in 2020. Access to Care Implementation Activities: Goal: Mercy Health Lorain Market will increase the number of patients that choose a Primary Care Physician or Nurse Practitioner. 2021 Strategies and Outcomes: * Mercy Health Lorain educates the community on the benefits of selecting a Primary Care Physician (PCP) to care for their health and mental needs through introduction talks and discussions through our relationships with the Mercy Health Parish Nursing program. Due to a surge in COVID-19, the implementation of this program in the ERs was delayed but was still able to schedule 5 patients with a PCP through the ER in 2021. * During 2021, Parish Nursing scheduled 50 patients with a PCP. However Mercy Health Lorain expects to provide wider access to Mercy Health Physician referrals for a greater impact and connection."

Schedule H, Part V, Section B, Line 11 Facility A, 7
Facility A, 7 - CONTINUED DESCRIPTION: Mercy Health - Regional Medical Center LLC, Mercy Health - Allen Hospital LLC. Social Determinants of Health/Health Equity Implementation Activities: Goal: Mercy Health Lorain Market will eliminate implicit bias towards patients and the community we serve in order to improve health equity (Social Determinants of Heath). 2021 Strategies and Outcomes: * During 2021, Mercy Health Lorain continued their cultural competency and implicit bias training for all new hires. All new hires are required to complete this training program. * In collaboration with the Diversity and Inclusion Committee, Mercy Health Lorain developed a luncheon educational series, called Brown Bag Luncheon Diversity and Inclusion Educational Moment, to raise awareness to the diversity needs of the community as we care for them. Throughout the launch year 7 sessions were held with 266 employees in attendance. * Mercy Health Lorain worked in collaboration with the Lorain County Public Health in determining and improving health equity throughout Lorain County. During 202 the Census was completed, and the census data was received in Q2 2021. This data will be utilized for the next community health needs assessment. Significant needs not addressed by the hospital PREVENTATIVE HEALTH Mercy Health Lorain will not directly focus on Preventative Health as other organizations in Lorain County are specifically designed and better prepared to respond to this need through resources and experience. Mercy will support them as needed. Mercy Health Lorain will ensure that a level of preventative health is included in each goal of Community Health Needs Assessment and Community Health Needs Implementation Plan. Mercy will continue collaboration efforts with the County to address this need. SEXUALLY TRANSMITTED DISEASES - STD'S Mercy Health Lorain will not directly work on the Sexually Transmitted Diseases (STD's) community need as there are other organizations in Lorain County specifically designed and better prepared both through resources and experience to respond to this need. We will continue to work with our physicians such as Primary Physicians, Nurse Practitioners and OB/GYN's that will run into this test outcome more frequently ensuring they have the medicinal and support resources needed.

Schedule H, Part V, Section B, Line 11 Facility A, 8
"Facility A, 8 - Mercy Health - St. Elizabeth Health Center, Mercy Health - St. Elizabeth Boardman Health Center, Mercy Health - St. Joseph Health Center. Mercy Health - Youngstown Market is comprised of the Mercy Health - St. Elizabeth Youngstown Hospital, Mercy Health - St. Elizabeth Boardman Hospital, and Mercy Health - St. Joseph Warren Hospital. These hospitals are collectively referred to as ""Mercy Health Youngstown"" (MHY). MHY will address each need identified in its CHNA with regional strategies. Unless noted below, all MHY hospitals participated in the regional strategies. Mental Health Implementation Activities: Goal: Improve the behavioral health of the community. 2021 Strategies and Outcomes: * Mercy Health - St. Elizabeth Youngstown Hospital continues to educate primary care providers on screening tools and evidence-based treatment for mental health and addiction through the use of a mental health and addiction assessment and referral program. In 2021, Mercy Health - St. Elizabeth Youngstown Hospital had the following number of individuals screened and referred for treatment/assessment with standard screening tools PHQ - 8,417 screened with 193 referred, AUDIT - 7,024 screened with 194 referred, and DAST - 7,946 screened with 79 referred. * Mercy Health - St. Elizabeth Youngstown Hospital will increase prevention and education on tobacco use by increase the number of outreach and education events and prevention lessons in schools. These events were postponed until 2022 due to covid-19. * Mercy Health - St. Elizabeth Youngstown Hospital continued its Trauma Informed Care sub-committee to help increase knowledge and awareness of trauma informed care. In 2021, two virtual workshops were held with continuing education credits awarded upon completion. Chronic Disease with a Focus on Cardiovascular Disease and Obesity Implementation Activities: Goal: Reduce the impact of chronic disease and obesity on our community. 2021 Strategies and Outcomes: * MHY continued its focus on increasing the number of free or reduced cost prediabetes screenings in the community with a focus on reaching target populations. In 2021, MHY offered Glucose Screenings to 364 patients, Prediabetes Screenings to 281 patients, and HA1c Screenings to 100 patients. * MHY will also focus on increasing the number of free or reduced cost hypertension screenings in the community with a focus on reaching target populations. In 2021, MHY offered blood pressure screenings to 2,561 patients * During 2021, MHY continued its collaborations and local community efforts, including: - Healthy Community Partnership Mahoning Valley - participation in steering committee and two action teams, Healthy Food and Parks and Green Spaces - Trumbull County Creating Healthy Communities Coalition * MHY discontinued the MHY Fruit and Vegetable Prescription Program to reduce chronic disease through healthy food options for residents within the area. However, MHY continues to work closely with other programs on this initiative and has provided funding to those community organizations. Maternal and Infant Health Implementation Activities: Goal: 1. Total preterm births: Percent of live births that are preterm:<37 weeks gestation (Baseline: 14%, Ohio Department of Health, 2018) 2. Infant mortality: Rate of infant deaths per 1,000 live births (Baseline: 7.8, Ohio Department of Health, 2013-2017) 3. Low birth weights: Percent of births in which the newborn weighed <2,500 grams (Baseline: 12%, Ohio Department of Health, 2018) 2021 Strategies and Outcomes: * Mercy Health - St. Elizabeth Boardman Hospital provided prenatal and post-partum education for mothers and fathers by initiating the ""Learn N Go"" app. The ""Learn N Go"" app continued in 2021 and had 418 active registered users. The need for digital learning increased significantly due to COVID so lactation consultants visited patients in OB/GYN offices and instructed on accessing the app during pregnancy. The lactation consultants were also equipped with iPads that will be used to enroll patients at the bedside. The plans are to increase the number of women enrolled in 2022 by connecting mothers participating in maternal health programs. * During 2021, MHY continued to participate and convene in meetings on the development and strategies throughout Trumbull County Maternal and Infant Health Coalition. * In an effort to increase the use of progesterone for eligible pregnant women, MHY gathered data to identify how progesterone candidates are currently identified and track progesterone distribution to eligible pregnant women. During 2021, 31 eligible pregnant women who delivered at St. Elizabeth Boardman Hospital received progesterone. * Due to COVID-19 and the impact of the pandemic, several of the programs and strategies were reduced or placed on hold until 2022. Social Determinants of Health with a Focus on Cultural Bias and Inequity, Access to Care, Transportation and Housing Implementation Activities: Goal: Improve overall health by eliminating and/or decreasing barriers to receive high quality care. 2021 Strategies and Outcomes: * MHY is focused on improving healthy equity associate education and trainings to increase competency of serving diverse patients and community members. The goal for 2021 was to implement implicit bias training for MHY associates and that goal was achieved with 129 associates receiving 3R Bias and Anti-Racism training. Among those 129 associates that completed the training, 68 were frontline leaders and 16 were nursing leaders. * During 2021, Youngstown piloted an implementation of SDOH screening and process referral to resources within the market's primary care practices. The pilot program was successfully implemented and performs SDOH screenings for transportation, finances, housing, and food insecurity. By Q4 2021 all primary care practices have begun intimate partner violence screenings. * MHY and the Community Health team continues to participate in community efforts to address SDOH, with a focus on cultural bias and inequity, access to care, transportation and housing. MHY is represented on the steering committee of the Healthy Community Partnership Mahoning Valley (HCP) which has action teams addressing healthy food retail, active transportation and parks and green spaces. HCP also has been working with a lens to develop and support initiatives to reduce racial inequity. MHY has representatives on M/Y Baby's 1st and MORE 1st Birthdays coalitions working to reduce infant mortality, preterm births and low birth weights with a focus on reaching our African American community. We are represented on the Mahoning County Homeless Continuum of Care and the Healthy Homes Healthy Families working to reduce lead poisoning. We also are represented on the Trumbull County Creating Healthy Communities Coalition whose focus is strategies for active living and healthy eating. All prioritized needs in the hospital CHNA have been addressed."

Schedule H, Part V, Section B, Line 11 Facility A, 9
"Facility A, 9 - Mercy Health - Anderson Hospital, Mercy Health - Clermont Hospital, Mercy Health - Fairfield Hospital, Jewish Hospital LLC, Mercy Health - West Hospital. Mercy Health Cincinnati is comprised of Mercy Health - Anderson Hospital, Mercy Health - Clermont Hospital, Mercy Health - Fairfield Hospital, Jewish Hospital LLC, and Mercy Health - West Hospital. These hospitals are collectively referred to as ""Mercy Health Cincinnati."" Mercy Health Cincinnati will address each need identified in its CHNA with regional strategies. Unless noted below, all Mercy Health Cincinnati hospitals participated in the regional strategies. Substance Abuse Implementation Activities: Goal: Reduce unintentional drug overdose deaths. 2021 Strategies and Outcomes: * During 2021, Mercy Health Cincinnati provided a Mercy Serves AmeriCorps Program which is a unique, service-learning program preparing the next generation of healthcare leaders to think differently about healthcare by exposing them to patient care at its most challenging level. Participants work alongside Emergency Department staff to provide critical support to patients with opiate-use disorders. They screen, provide brief interventions and referrals, and follow patients after discharge, serving as a supportive resource throughout the treatment process. More importantly, participants work for the patient - they advocate, listen and support any patient who is ready for treatment with the necessary resources and follow up throughout their recovery. Funding is resourced through a federal grant (managed by Bon Secours Mercy Health Foundation), Bon Secours Mercy Health Foundation and Community Health- Cincinnati. 7 members enrolled in the 2021 - 2022 class with 71% retention rate. Mercy Serves members were reintroduced back into the Emergency Department in December. * The Mercy Serves AmeriCorps Program worked with 291 patients during 2021 and all 18 patients with current/former substance abuse reached during the 72-hour follow-up call period reported reduced use or an identified plan of action toward recovery/treatment because of the actions of the program. Mental Health Implementation Activities: Goal: Improve coverage rates; reduce percentage of uninsured patients. Decrease unnecessary ED utilization. 2021 Strategies and Outcomes: * The Mercy Health Partnership Program provides supportive services for uninsured/underinsured patients or those at risk for losing their coverage. Three LSWs serve the Cincinnati Region and take referrals from ambulatory and acute providers. Mercy Health Cincinnati assists with funding this program. * The Mercy Health Partnership Program, which is supported by Mercy Health Cincinnati, continued to help individuals maintain their care through prescription benefits and co-pay support while providing case management and community connections to help move clients from a state of crisis to self-sufficiency. During 2021, there were 2,900 total encounters with perspective patients. Mercy Health Cincinnati provided financial assistance to 226 patients, 130 patients completed Medicaid applications, and 4 patients were provided emergency assistance. * Mercy Health Cincinnati partnered with Healthcare Access Now to develop the Community Health Worker (CHW) Program. This program provides support for socially complex and medically underserved communities who struggle to get the support they need to stay healthy. This is achieved by addressing frequent and unnecessary utilization often attributed to social and financial circumstance and leverages evidence-based pathways to help patients navigate a complex matrix of services and find their way through to better health. During 2021, 21 clients were referred to the program with 8 enrolling and averaging 2 visits each. The enrolled patients started 55 pathways and fully completed 75% pathways before year end with an additional 4% being close to completion. Access to Care Implementation Activities: Goal: Reduce chronic absenteeism, improve school performance, reduce trauma/adverse childhood experiences (ACE's), reduce health disparities, reduce ED utilization, and increase early identification of cancer 2021 Strategies and Outcomes: * Mercy Health's School-Based Health Centers provide critical healthcare access to students and their families by offering a location that is safe, convenient, and accessible. These health centers are strategically placed within medical deserts and open to the community to help support the broader primary care needs. 75% of those served have Medicaid coverage and another 4% have no insurance coverage at all. The school-based health team works alongside school leadership, community organizations and families to ensure children and adolescents have the resources they need to thrive in the classroom and beyond. During the 2020-2021 school year the school-based health centers had 2,298 total visits with 17.44% or 401 visits being Well Child Checks. This is an increase from the 13.5% of Well Child Checks during the previous school year. * The school-based health centers continued their efforts to provide Body Mass Index (BMI) screenings and to increase the number of patients with a healthy BMI. For the 2020-2021 school year, 61.4% of health center users between the ages of 3 and 20 receive a BMI screening. * During the 2020-2021 school year the school-based health centers continued to work alongside school leadership to reduce the number of students identified as chronic absenteeism in the area. Chronic absenteeism is defined as any student missing 10% or more of the school year for any reason. * Mercy Health Cincinnati provides community clinics that provide critical primary care access to uninsured and underinsured patients. During 2021, the Mercy Care Clinic Anderson served 629 patients and the Mercy Care Clinic Clermont served 308 patients. * Mercy Health Cincinnati operates a Mobile Mammography Program. The Mobile Mammography Program has two mobile units offering screening mammograms at various locations throughout the Greater Cincinnati region ensuring everyone has access to the preventative care they need for early cancer detection and intervention. The Mobile Mammography Program served 3,347 patients and provided screenings and education materials in 2021. Chronic Disease and Healthy Behaviors Implementation Activities: Goal: Reduce food insecurity, heart disease, diabetes, and health disparities. 2021 Strategies and Outcomes: * Mercy Health Cincinnati provides funding and resources to the Healthy Neighborhoods program which addresses individual barriers and community conditions to address food insecurity and improve the health and wellness of underserved communities in the Greater Cincinnati Region. The Heathy Neighborhoods program includes robust assessment of the local food systems in neighborhoods surrounding our primary care offices and school-based health centers, especially those serving high numbers of Medicaid patients. It also provides healthy food vouchers, nutrition incentives and supportive programming to families seen by participating Mercy Health PCPs. During 2021, 33 total patients enrolled in the program with 28 remaining active throughout the year. Of the 33 enrolled patients 70% improved their body mass index, 73% improved either their diastolic or systolic blood pressure measurements, 69% improved their fasting glucose, and 56% had improvements in their A1c levels. * Mercy Health Cincinnati also used the Healthy Neighborhoods program to deliver $45,269 worth of produce to patients and their households. These patients consisted of 60 expectant mothers, 5 nutrition insecure adults, 29 patients with diet-related diseases, and 30 adults with diabetes. Infant Mortality Implementation Activities: Goal: Reduce the infant mortality rate (deaths/1,000 live births). 2021 Strategies and Outcomes: * Mercy Health Cincinnati provided a Perinatal Outreach Program that encompasses external partnerships and internal programs aimed at addressing infant mortality. During 2021, Mercy Health Cincinnati served 114 clients with 788 total pathways completed. * In 2021, Mercy Health Cincinnati referred 4 participants of the Perinatal Outreach Program to grief and loss group opportunities with a partner organization and enrolled 10 clients in ongoing therapy. * The Perinatal Outreach Program tracks the number of health birth outcomes to gauge progress made in the Cincinnati area. In 2021, 93% or 40 babies were born with Healthy birth weight as an outcome of the program. All prioritized needs in the hospital CHNA have been addressed."

Schedule H, Part V, Section B, Line 13 Facility A, 1
Facility A, 1 - BON SECOURS MERCY HEALTH HOSPITALS. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT OR FAMILY MEMBER TO COMPLETE AN APPLICATION INCLUDING GROSS INCOME FOR A MINIMUM OF 3 MONTHS (UP TO 12 MONTHS) PRIOR TO THE DATE OF APPLICATION OR DATE OF SERVICE. PROOF OF INCOME IS REQUIRED WITH THE EXCEPTIONS OF PATIENTS WHO QUALIFY FOR PRESUMPTIVE ELIGIBILITY. PROOF OF INCOME IS NOT REQUIRED IF A PATIENT OR FAMILY MEMEBER ATTESTS TO AN INCOME LEVEL THAT QUALIFIES THE APPLICANT FOR DISCOUNTED CARE UNDER OHIO'S HEALTHCARE ASSURANCE PROGRAM (HCAP). THIRD PARTY INCOME SCORING MAY BE USED TO VERIFY INCOME IN SITUATIONS WHERE INCOME VERIFICATION IS UNABLE TO BE OBTAINED THROUGH OTHER METHODS. Patients are presumed to be eligible for financial assistance based on individual life circumstances including but not limited to when the Patient's income is below 200% Federal Poverty Guidelines and considered self-pay, the Patient is discharged to a SNF, the Patient is deceased with no known estate and below 200% Federal Poverty Guidelines, the patient is supported by State-funded prescription programs, the patient is Homeless or received care from a homeless clinic, the patient has Participated in Women, Infants and Children programs (WIC), the patient is eligible for Food stamps, the patient is eligible Subsidized school lunch program, the patient is eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down), the Patient is referred through the National Association of Free Clinics, the patient provides Low income/subsidized housing as a valid address, or Other significant barriers are present.

Schedule H, Part V, Section B, Line 13 Facility A, 1
Facility A, 1 - BON SECOURS MERCY HEALTH HOSPITALS. There are situations where individuals may not have reported income but have significant assets available to pay for healthcare services. In these situations, BON SECOURS MERCY HEALTH may evaluate and require documented proof of any assets that are categorized as convertible to cash and unnecessary for the patient's essential daily living expenses. PATIENTS WHO LIVE IN THE COMMUNITY SERVED BY A BON SECOURS MERCY HEALTH HOSPITAL WILL BE OFFERED HEALTHCARE FINANCIAL ASSISTANCE. FOR THOSE PATIENTS LIVING OUTSIDE OF THE COMMUNITY, EXTENUATING CIRCUMSTANCES MUST BE DOCUMENTED AND APPROVED BY THE PFS MANAGER AND BE MEDICALLY NECESSARY OR EMERGENT IN NATURE. A LIST OF THE ZIP CODES OF THE COMMUNITY SERVED FOR EACH BON SECOURS MERCY HEALTH HOSPITAL IS MAINTAINED IN A SEPARATE DOCUMENT AND READILY AVAILABLE VIA THE CONTACT LIST AT THE END OF THE POLICY LOCATED AT HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE AND AT https://www.bonsecours.com/patient-resources/financial-assistance. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT TO APPLY FOR HEALTH INSURANCE COVERAGE AND/OR ENTER THE MARKETPLACE/EXCHANGE BEFORE FINANCIAL ASSISTANCE MAY BE EXTENDED. EXCEPTIONS TO THIS POLICY INCLUDE PATIENTS DISCHARGED TO A SKILLED NURSING FACILITY, PATIENTS WHO ARE DECEASED WITH NO ESTATE, AND PATIENTS WHO HAVE DOCUMENTED HOMELESSNESS.

Schedule H, Part V, Section B, Line 5 Facility B, 1
Facility B, 1 - BON SECOURS - DEPAUL MEDICAL CENTER LLC. In collaboration with Children's Hospital of The King's Daughters, Sentara Healthcare, and the Virginia Department of Health - Norfolk and Virginia Beach, an online and hard copy survey was disseminated in English and Spanish. The survey was distributed widely via Bon Secours networks, as well as meetings, clinics and programs supported by Bon Secours DePaul Medical Center, such as the Care-A-Van, a mobile medical unit that provides care to the uninsured population, in the East Ocean View site of the Bon Secours Hampton Roads Health Communities initiative, Bon Secours DePaul Medical Center Senior Health members, and a Norfolk LGBTQ community resource site. The survey was taken by 330 residents and key stakeholders who indicated Norfolk and Virginia Beach as their primary service area. Individuals were asked to choose the top five health issues and services they thought should be addressed in their community. Epidemiological data was provided by the Virginia Department of Health - Portsmouth. A total of 11 focus group meetings called Community Dialogues were held in the Hampton Roads region in which 283 individuals participated. The purpose of the meetings was to elicit feedback from community members about publically available health data describing health conditions in the service area and to review the online survey results to further explore the findings. Six Community Dialogues were held in Norfolk and Virginia Beach in which 108 individuals participated. The meetings began with community members participating in a matrix exercise in which they selected the three most important of the top ten health concerns identified in the Survey. Following matrix exercise, a presentation explaining the CHNA process was shown. For sessions with larger numbers in attendance, participants were then divided into groups to discuss the top concerns identified in the matrix exercise. Smaller sessions were discussed as a single group. Breakout session facilitators lead the discussions with the following questions: Why are these issues? What is causing the issues? What can be done to address the issues? Comments were written down by a staff member or volunteer. Bon Secours DePaul Medical Center's senior leadership team met to review primary and secondary data gathered through the CHNA process (community meetings, community and key stakeholder surveys, and meetings with regional health systems and health departments). The team evaluated each of the top ten health concerns and services that need strengthening identified, the hospitals strategic goals, services currently provided, available hospital resources, and the current CHNA Implementation Plan's progress. Additional detail can be found on the Bon Secours website at www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment

Schedule H, Part V, Section B, Line 5 Facility B, 2
Facility B, 2 - BON SECOURS - MARY IMMACULATE HOSPITAL LLC. Mary Immaculate Hospital (MIH) collaborated with Children's Hospital of The King's Daughters, Sentara Healthcare, and the Virginia Department of Health - Peninsula and Hampton, to obtain input from the community. An online and hard copy survey was disseminated in English and Spanish. The survey was distributed widely via Bon Secours networks, as well as meetings, clinics and programs supported by MIH, such as the Care-A-Van, a mobile medical unit that provides care to the uninsured population, MIH SeniorHealth members, and a LGBTQ community resource site. The survey was taken by 443 residents and key stakeholders who indicated Newport News, Hampton, Gloucester, Poquoson, Williamsburg, James City County or York County as their primary service area. Individuals were asked to choose the top five health issues and services they thought should be addressed in their community. A total of 11 focus group meetings called Community Dialogues were held in the Hampton Roads region in which 283 individuals participated. The purpose of the meetings was to elicit feedback from community members about publically available health data describing health conditions in the service area and to review the online survey results to further explore the findings. Three Community Dialogues were held in the Mary Immaculate community, including one with the Hispanic community. The meetings began with community members participating in a matrix exercise in which they selected the three most important of the top ten health concerns identified in the survey. Following the matrix exercise, a presentation explaining the CHNA process was shown. For sessions with larger numbers in attendance, participants were then divided into groups to discuss the top concerns identified in the matrix exercise. Smaller sessions were discussed as a single group. Breakout session facilitators lead the discussions with the following questions: Why are these issues? What is causing the issues? What can be done to address the issues? Comments were written down by a staff member or volunteer. Mary Immaculate Hospital's senior leadership team met to review primary and secondary data gathered through the CHNA process (community meetings, community and key stakeholder surveys, and meetings with regional health systems and health departments). The team evaluated each of the top ten health concerns and services that need strengthening identified, the hospitals strategic goals, services currently provided, available hospital resources, and the current CHNA Implementation Plan's progress. Additional detail can be found on the Bon Secours website at https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment

Schedule H, Part V, Section B, Line 5 Facility B, 3
Facility B, 3 - BON SECOURS - MARYVIEW HOSPITAL LLC. A collaborative team from Maryview Medical Center, Children's Hospital of The King's Daughters, Sentara Healthcare, Riverside Health System and the Virginia Department of Health - Portsmouth (Collaborative) began meeting in May 2018 to begin the work on the 2020 - 2022 Community Health Needs Assessment. In order to obtain input from the community, an online and hard-copy survey was disseminated in English and Spanish. The survey was distributed widely via Bon Secours networks, as well as meetings, clinics and programs supported by Maryview Hospital, such as the Care-A-Van, a mobile medical unit that provides care to the uninsured population; the Maryview Foundation Health Center (free clinic); Bon Secours Maryview Hospital Senior Health members; and an LGBTQ community resource site. The survey was taken by 271 residents and key stakeholders who indicated Chesapeake, Portsmouth or Suffolk as their primary service area. Individuals were asked to choose the top five health issues and services they thought should be addressed in their community. Overall, survey participants represent a blend of perspectives across age, race and income. Epidemiological data was provided by the Virginia Department of Health - Portsmouth. A total of 11 focus group meetings called Community Dialogues were held in the Hampton Roads region in which 283 individuals participated. The purpose of the meetings was to elicit feedback from community members about publically available health data describing health conditions in the service area and to review the online survey results to further explore the findings. The meetings began with community members participating in a matrix exercise in which they selected the three most important of the top ten health concerns identified in the Survey. Following the matrix exercise, a presentation explaining the CHNA process was shown. For sessions with larger numbers in attendance, participants were then divided into groups to discuss the top concerns identified in the matrix exercise. Smaller sessions were discussed as a single group. Breakout session facilitators lead the discussions with the following questions: Why are these issues? What is causing the issues? What can be done to address the issues? Comments were written down by a staff member or volunteer. Maryview Medical Center's senior leadership team met to review primary and secondary data gathered through the CHNA process (community meetings, community and key stakeholder surveys, and meetings with regional health systems and health departments). The team evaluated each of the top ten health concerns and services that need strengthening identified, the hospitals strategic goals, services currently provided, available hospital resources, and the current CHNA Implementation Plan's progress. Additional detail can be found on the Bon Secours website at https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment

Schedule H, Part V, Section B, Line 6a Facility B, 1
Facility B, 1 - BON SECOURS - DEPAUL MEDICAL CENTER LLC, BON SECOURS - MARY IMMACULATE HOSPITAL LLC, BON SECOURS - MARYVIEW HOSPITAL LLC. Children's Hospital of The King's Daughters Sentara Healthcare BON SECOURS - DEPAUL MEDICAL CENTER LLC BON SECOURS - MARY IMMACULATE HOSPITAL LLC BON SECOURS - MARYVIEW HOSPITAL LLC

Schedule H, Part V, Section B, Line 6b Facility B, 1
Facility B, 1 - BON SECOURS - DEPAUL MEDICAL CENTER LLC. Virginia Department of Health - Norfolk and Virginia Beach

Schedule H, Part V, Section B, Line 6b Facility B, 2
Facility B, 2 - BON SECOURS - MARYVIEW HOSPITAL LLC. Virginia Department of Health - Portsmouth

Schedule H, Part V, Section B, Line 6b Facility B, 3
Facility B, 3 - BON SECOURS - MARY IMMACULATE HOSPITAL LLC. Virginia Department of Health - Peninsula and Hampton

Schedule H, Part V, Section B, Line 11 Facility B, 1
Facility B, 1 - BON SECOURS - DEPAUL MEDICAL CENTER LLC. In early 2021, Bon Secours Mercy Health announced its plans to close Bon Secours DePaul Medical Center LLC (DMC). All hospital operations ceased as of March 31, 2021, and any physician and acute care services previously under DMC that would remain open consolidated under Bon Secours Maryview Medical Center LLC. Due to the closure, DMC did not take any actions to address the needs identified in the CHNA or Implementation Strategy during 2021.

Schedule H, Part V, Section B, Line 11 Facility B, 2
"Facility B, 2 - BON SECOURS - MARY IMMACULATE HOSPITAL LLC. Bon Secours - Mary Immaculate Hospital (MIH) Alcohol and Substance Abuse Implementation Activities: Goal: Reduce risk of opioid dependency and addiction in community. 2021 Strategies and Outcomes: * MIH will increase awareness and implementation of SBIRT and MAT through the Emergency Department. During 2021, MIH Emergency Department staff were identified as a priority group for training and Suboxone waiver. Throughout the year training and quality metrics were aligned and MAT training took place for ED providers. * MIH worked to increase awareness of opioid and substance abuse risks among all hospital employees by developing staff training on substance abuse and providing training to all employees. During 2021, MIH performed the following actions in order to achieve this goal: - held a ""Words Matter"" town hall with their employees - implemented a workday training for all associates - worked with Peninsula Community Opioid Response to apply for a CDC Drug Free Communities grant to expand education - Provided REVIVE program training to a subset of associates and developing a plan so they could become certified trainers for others * MIH continues to increase awareness of opioid and substance abuse risks through school and community partnerships. Planned School programs were placed on hold due to Covid-19, but engagement with the schools continued through collaboration with PCOR. Chronic health in Aging Adults Implementation Activities: Goal: Improve access to healthcare opportunity to treat and manage chronic conditions for aging population. 2021 Strategies and Outcomes: * MIH will partner with medical providers and community groups to provide education at SeniorHealth Lunch & Learns on five health topics from the CHNA survey. Speakers will provide a pre- and post- test to group to demonstrate knowledge gained. During 2021, these events were postponed due to Covid-19. * Throughout the year MIH implemented their plan to improve the quality-of-care delivery for the aging population through NICHE program membership. During 2021, MIH developed and implemented the strategies needed to meet the NICHE program senior-friendly designation and provided all associates with NICHE program education. * MIH continued its focus on increasing awareness of congestive heart failure (CHF) risks through a CHF cohort study. The community-based portion was placed on hold during 2021 due to Covid-19, but MIH was able to establish a partnership with the American Heart Association to expand opportunities for community education and disease management. Inpatient education has also continued. Obesity Implementation Activities: Goal: Positively impact the incidence of childhood and adult obesity. 2021 Strategies and Outcomes: * MIH is working towards expanding the Passport to Health program that began in the East Ocean View area of Norfolk to Newport News. The Passport to Health program is aimed at reducing the incidence of obesity through a variety of weight loss and physical activity programs. The program was implemented in Newport News in 2021 and a baseline initial Body Mass Index of the 28 participating families was established. * During 2021, MIH will focus on reducing the incidence of obesity through a variety of Bon Secours In-Motion and Medical Surgical weight loss and physical activity programs. Due to staffing issues related to Covid-19 most programs were not held. However, MIH did expand its support in community events that promoted physical activity. MIH will not add any additional strategies to directly address the Behavioral/Mental Health community need and thus not be making it one of its top priorities. MIH will continue the mental health initiatives identified in the previous CHNA through offering community education. Referrals to local community service boards by the emergency department Life Coaches and the Bon Secours Care-A-Van will also continue. Active participation in coalitions addressing behavioral/mental health, especially in the area of opioid abuse, will continue. MIH will not add any additional strategies to directly address the Diabetes community need and thus not be making it one of its top priorities. Resources are limited within the organization to prioritize all of the needs. There are other providers and organizations addressing these needs with specialized programs and services. MIH will continue the diabetes initiatives identified in the previous CHNA through offering community education. Active participation in coalitions addressing diabetes will continue."

Schedule H, Part V, Section B, Line 11 Facility B, 3
Facility B, 3 - BON SECOURS - MARYVIEW HOSPITAL LLC. Bon Secours - Maryview Hospital (Maryview) Alcohol and Substance Abuse Implementation Activities: Goal: Reduce risk of opioid dependency and addiction in community. 2021 Strategies and Outcomes: * To reduce risk of opioid dependency and addiction, Maryview will monitor opiate prescribing patterns within the hospital. During 2021, 101 patients per 1,000 were prescribed opiates from the Maryview ER and 95 patients per 1,000 were prescribed opiates from inpatient care. These metrics will be used as a baseline to track future prescription patterns and to reduce those frequencies. Currently the ER has seen a reduction in patients receiving opioids from 2020. * Maryview intends to increase awareness of opioid and substance abuse risks by partnering with clinical staff and community partners to provide opioid and other resiliency training within middle and high schools within the market. Due to COVID-19, planned school interactions were postponed to 2022. Heart Conditions/Diabetes Implementation Activities: Goal: Improve access to healthcare opportunity to treat and manage cardiovascular disease. 2021 Strategies and Outcomes: * During 2021, Maryview tracked readmissions among STEMI and CHF patients to establish a baseline for future years progress on the improvement of readmission conversion rates for these types of patients. The baseline established for 2021 was 17.86% of patients with readmission at a 100% conversion rate. * Maryview provided one on one patient education for diabetes management at the hospital prior to discharge. Additional initiatives to provide diabetes community education classes were postponed due to COVID-19 but are planned to begin again in 2022. Chronic health in Aging Adults Implementation Activities: Goal: Improve access to healthcare opportunity to treat and manage chronic conditions for aging population. 2021 Strategies and Outcomes: * Maryview will partner with medical providers and community groups to provide education at SeniorHealth Lunch & Learns on five health topics from the CHNA survey. Speakers will provide a pre- and post- test to group to demonstrate knowledge gained. These events were postponed to 2022 due to COVID-19. Overweight/Obesity Implementation Activities: Goal: Positively impact the incidence of childhood and adult obesity. 2021 Strategies and Outcomes: * Maryview continued its partnership with Healthy Portsmouth to develop programs and educational opportunities. During 2021, Maryview implemented a Passport to Health Program to address physical activity and healthy eating. * During 2021, Maryview worked to reduce the incidence of obesity with a 12-week physical activity program. There were 25 participants that started a medical weight loss program and at the end of the program patients realized a reduction in average starting BMI of 38.84 to current BMI of 33.28. Additionally, Maryview expanded the program to community settings by supporting races, high school sporting events, and the Passport to Health Program. * Maryview continued its partnership with several middle and high schools to provide nutrition and physical activity education to students during 2021 however, no programs were held due to covid-19. Behavioral/Mental Health Implementation Activities: Goal: Improve behavioral/mental health through efforts around suicide prevention. Protect the dignity of behavioral/mental health patients and community by providing space in Maryview Behavioral Medicine Services for court sessions and substance abuse support groups. 2021 Strategies and Outcomes: * Maryview maintained a safe cafe environment by performing an environmental risk assessment to identify and rate risks. In 2021, the environmental risk assessment was completed and evaluated. Measures, such as daily shift rounding, were immediately implemented to mitigate any identified risks. * Maryview worked to reduce sentinel events while maintaining patient safety by ensuring completion of daily assessments for all admissions during 2021. Maryview placed its high-risk patients on appropriate monitoring. * To reduce the suicide rate of patients who were recently treated and released from a healthcare setting, Maryview placed follow-up calls with all discharged patients within 24 hours. Maryview assured all patients were connected to outpatient resources prior to discharge, utilized social workers to safely discharge patients, collaborated with outpatient services to offer alternative services for discharged patients, and postponed unsafe discharge until all necessary measures were met. * During 2021, Maryview provided space for the Portsmouth Department of Justice to hold court and counselling sessions at the Maryview Behavioral Medicine Services within the hospital to protect the dignity for behavioral/mental health patients and community. 241 people were served through court partnership in 2021. * Maryview also provides space for various behavioral and mental health support groups, such as Alcoholics Anonymous, Narcotics Anonymous, and Gamblers Anonymous, to meet. All prioritized needs in the hospital CHNA have been addressed.

Schedule H, Part V, Section B, Line 13 Facility B, 1
Facility B, 1 - BON SECOURS MERCY HEALTH HOSPITALS. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT OR FAMILY MEMBER TO COMPLETE AN APPLICATION INCLUDING GROSS INCOME FOR A MINIMUM OF 3 MONTHS (UP TO 12 MONTHS) PRIOR TO THE DATE OF APPLICATION OR DATE OF SERVICE. PROOF OF INCOME IS REQUIRED WITH THE EXCEPTIONS OF PATIENTS WHO QUALIFY FOR PRESUMPTIVE ELIGIBILITY. PROOF OF INCOME IS NOT REQUIRED IF A PATIENT OR FAMILY MEMEBER ATTESTS TO AN INCOME LEVEL THAT QUALIFIES THE APPLICANT FOR DISCOUNTED CARE UNDER OHIO'S HEALTHCARE ASSURANCE PROGRAM (HCAP). THIRD PARTY INCOME SCORING MAY BE USED TO VERIFY INCOME IN SITUATIONS WHERE INCOME VERIFICATION IS UNABLE TO BE OBTAINED THROUGH OTHER METHODS. Patients are presumed to be eligible for financial assistance based on individual life circumstances including but not limited to when the Patient's income is below 200% Federal Poverty Guidelines and considered self-pay, the Patient is discharged to a SNF, the Patient is deceased with no known estate and below 200% Federal Poverty Guidelines, the patient is supported by State-funded prescription programs, the patient is Homeless or received care from a homeless clinic, the patient has Participated in Women, Infants and Children programs (WIC), the patient is eligible for Food stamps, the patient is eligible Subsidized school lunch program, the patient is eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down), the Patient is referred through the National Association of Free Clinics, the patient provides Low income/subsidized housing as a valid address, or Other significant barriers are present.

Schedule H, Part V, Section B, Line 13 Facility B, 1
Facility B, 1 - BON SECOURS MERCY HEALTH HOSPITALS. There are situations where individuals may not have reported income but have significant assets available to pay for healthcare services. In these situations, BON SECOURS MERCY HEALTH may evaluate and require documented proof of any assets that are categorized as convertible to cash and unnecessary for the patient's essential daily living expenses. PATIENTS WHO LIVE IN THE COMMUNITY SERVED BY A BON SECOURS MERCY HEALTH HOSPITAL WILL BE OFFERED HEALTHCARE FINANCIAL ASSISTANCE. FOR THOSE PATIENTS LIVING OUTSIDE OF THE COMMUNITY, EXTENUATING CIRCUMSTANCES MUST BE DOCUMENTED AND APPROVED BY THE PFS MANAGER AND BE MEDICALLY NECESSARY OR EMERGENT IN NATURE. A LIST OF THE ZIP CODES OF THE COMMUNITY SERVED FOR EACH BON SECOURS MERCY HEALTH HOSPITAL IS MAINTAINED IN A SEPARATE DOCUMENT AND READILY AVAILABLE VIA THE CONTACT LIST AT THE END OF THE POLICY LOCATED AT HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE AND AT https://www.bonsecours.com/patient-resources/financial-assistance. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT TO APPLY FOR HEALTH INSURANCE COVERAGE AND/OR ENTER THE MARKETPLACE/EXCHANGE BEFORE FINANCIAL ASSISTANCE MAY BE EXTENDED. EXCEPTIONS TO THIS POLICY INCLUDE PATIENTS DISCHARGED TO A SKILLED NURSING FACILITY, PATIENTS WHO ARE DECEASED WITH NO ESTATE, AND PATIENTS WHO HAVE DOCUMENTED HOMELESSNESS.

Schedule H, Part V, Section B, Line 5 Facility D, 1
Facility D, 1 - Mercy Health - Lourdes Hospital, LLC. Lourdes Hospital engaged Crowe LLP to gather information and data in order to complete its CHNA. Lourdes Hospital obtained input from twenty-two stakeholders representing public health, local government officials, various nonprofit organizations, local churches through face-to-face meetings. In addition, three focus groups were conducted to obtain input from public health, social service agencies, local governmental agencies, public schools and libraries. One-on-one interviews were performed with leaders from 22 community organizations/agencies representing public health, local government officials, various nonprofit organizations, local churches and Lourdes Hospital. Interviews were conducted between October 29 and November 13, 2018. To ensure consistency in the topics covered a semi-structured interview guide was used. All interviews were conducted by Crowe. Feedback was gathered on pressing health care concerns, access challenges and identification of populations with serious unmet health care needs. Approaches to improve the community's health were also solicited. Three focus groups were conducted between October 29 and 31, 2018. To assure that medically underserved were included in this CHNA, focus group participants represented agencies serving persons who are homeless, disabled, victims of domestic violence, unemployed and/or persons with low-income. Focus groups were held in McCracken, Marshall and Graves Counties and 42 individuals participated in the focus group sessions. Focus groups explored areas to identify significant health needs of the community as well as potential ways to address identified needs. Each participant was also asked to provide their opinion as to the top three issues that Lourdes Hospital should focus its community benefit investments over the next 3-5 years. Survey results from a 2018 Community Survey conducted by the Purchase District Health Department regarding important health issues facing the community and the most serious risky behaviors in the community were reviewed and included in the CHNA. The CHNA relied heavily on input from key stakeholders that participated in one-on-one interviews and/or focus groups. Stakeholders identified significant health needs and resources available to address those needs. Stakeholders who participated in one-on-one interviews identified serious health issues, financial and non-financial barriers to care, underserved populations and provided input for prioritizing health needs. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 6a Facility D, 1
Facility D, 1 - Mercy Health - Lourdes Hospital LLC. Marshall County Hospital, Murray-Calloway County Hospital

Schedule H, Part V, Section B, Line 11 Facility D, 1
Facility D, 1 - Mercy Health-Lourdes Hospital LLC. Mercy Health - Lourdes Hospital LLC Cancer Implementation Activities: Goal: Reduce the number of preventable deaths caused by cancer through increasing access to screening, implementing prevention programs based on risk factors, and promoting healthy living. 2021 Strategies and Outcomes: * Lourdes Hospital requires a Successful Certificate of Need application for state-of-the-art radiotherapy program that, combined with medical oncology program, will offer full-service cancer services to the region. In 2020, the Certificate of Need application was completed and submitted. The Scheduled Certificate of Need decision is still in process and scheduled to be final in 2022. * Full-service cancer services, including both surgical and medical oncology services, were available during 2021. The number of surgeries saw a large increase with 7,808 total surgeries being performed throughout the year. * Lourdes Hospital worked on further expansion of high-risk cancer genetics testing beyond mammography and GYN services to include lung cancer screening and colonoscopy services. Screened patients greatly increased from 45 patients tested in 2020 to 314 patients tested during 2021. * During 2021, Lourdes Hospital offered several types of cancer screenings to the community at large with the following results: - 55 free skin cancer screenings offered at a free community skin cancer screening event held on November 6, 2021, in partnership with Kentucky Cancer Program, Paducah Dermatology, Murray State University, and Baptist Health Paducah - 659 Low Dose CT Lung screenings at Lourdes Hospital - 6,205 Mammograms at Lourdes Hospital - 2,704 Colonoscopies at Lourdes Hospital * Lourdes Hospital provided a free full six-week smoking cessation class virtually in collaboration with community partners and the American Lung Association. The class had four participants in 2021. Mental Health Implementation Activities: Goal: Improve prevention, early detection, and access to mental and behavioral health resources through collaborative partnerships. 2021 Strategies and Outcomes: * Lourdes Hospital continued efforts to increase access to behavioral health services in collaboration with community partners. In 2021, Lourdes Hospital provided inpatient behavioral health services to 580 patients, and outpatient behavioral health services to 9,531 patients. * Lourdes Hospital planned to host Camp Robin in April 2021 however, due to COVID-19 the decision was made to cancel the camp. Lourdes plans to continue the Camp in the future once it can be safely held. * Lourdes Hospital continued to participate in community events with partner programs focused on suicide awareness and prevention. In October 2021, Lourdes Hospital participated in and donated to the American Foundation for Suicide Prevention's Out of the Darkness Walk for Suicide Prevention. * In partnership with Four Rivers Behavioral Health, Lourdes Hospital offered free training sessions to educate attendees on how to save a life from suicide. The one-hour suicide prevention training session utilized the Question, Persuade, Refer (QPR) technique. Due to the COVID pandemic, these were held virtually in 2021 and had 6 attendees. Substance Use Disorder Implementation Activities: Goal: Provide community with resources to prevent and recognize substance use disorder. 2021 Strategies and Outcomes: * Lourdes Hospital works with community partners and law enforcement to raise awareness on Western Kentucky drug trends and combating the opioid epidemic in our community, with a focus on adolescents and parents. In 2021, Lourdes Hospital partnered with the Paducah Police Department and Purchase District Health Department for DEA Drug Take Back Day events in the spring and fall on the hospital campus. 429 pounds of medication at two events were collected and given to the DEA for safe disposal. * The Kentucky Agency for Substance Abuse Policy (KY ASAP) was created to help manage local policies and prevention efforts that affect alcohol and substance abuse. Lourdes Hospital sits on McCracken County ASAP, Graves County ASAP, and Marshall County ASAP coalitions. In 2021, 580 inpatients and 9,531 outpatients were served in office visits. * Lourdes Hospital partnered with the Purchase District Health Department in late 2021 to distribute free Narcan nasal spray to at-risk patients discharging after an overdose. 6 Narcan kits were given to patients after discharge. * Lourdes Hospital provided Hospice/Homecare with a box of Deterra pouches for safe disposal of prescription opioids. All patients with controlled substance prescriptions in Retail Pharmacy and discharged from the hospital were offered Deterra pouches. In 2021, 500 Deterra bags were distributed. Chronic Illness Implementation Activities: Goal: Prevent and reduce chronic disease by focusing on risk factors and healthy behavior changes. 2021 Strategies and Outcomes: * Lourdes Hospital continued partnership with the Community Health Worker (CHW) program. The Community Health Worker program is run through Purchase Area Health Connections and Purchase District Health Department, focused on reducing readmissions for chronic diseases. In 2021, the following measures were accomplished: - Track readmissions to monitor progress. In 2021, there were 885 readmissions. - Lourdes referred 237 patients to the CHW program in 2021. - 96 patients completed CHF program. 30 additional patients began the program but did not successfully complete. * In 2021, Lourdes Hospital was an active participant in 14 various community health coalitions, including: multiple county health coalitions, Purchase Area Health Connections, and the United Way's Community Impact/COVID-19 Response Committee. * In 2021, Lourdes Hospital held free flu shot events with a variety of community partners and administered 508 doses. Additionally, Lourdes Hospital donated 400 remaining flu shot doses to four local non-profit organizations. In total 908 doses were administered throughout the year. * Lourdes Hospital continued its participation in region-wide Purchase Area Diabetes Connection health coalition. The Annual Diabetes Health Fair was held in October 2021. Lourdes Hospital provided Wound Care education and free flu shots to 120 participants. All prioritized needs in the hospital CHNA have been addressed

Schedule H, Part V, Section B, Line 13 Facility D, 1
Facility D, 1 - BON SECOURS MERCY HEALTH HOSPITALS. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT OR FAMILY MEMBER TO COMPLETE AN APPLICATION INCLUDING GROSS INCOME FOR A MINIMUM OF 3 MONTHS (UP TO 12 MONTHS) PRIOR TO THE DATE OF APPLICATION OR DATE OF SERVICE. PROOF OF INCOME IS REQUIRED WITH THE EXCEPTIONS OF PATIENTS WHO QUALIFY FOR PRESUMPTIVE ELIGIBILITY. PROOF OF INCOME IS NOT REQUIRED IF A PATIENT OR FAMILY MEMEBER ATTESTS TO AN INCOME LEVEL THAT QUALIFIES THE APPLICANT FOR DISCOUNTED CARE UNDER OHIO'S HEALTHCARE ASSURANCE PROGRAM (HCAP). THIRD PARTY INCOME SCORING MAY BE USED TO VERIFY INCOME IN SITUATIONS WHERE INCOME VERIFICATION IS UNABLE TO BE OBTAINED THROUGH OTHER METHODS. Patients are presumed to be eligible for financial assistance based on individual life circumstances including but not limited to when the Patient's income is below 200% Federal Poverty Guidelines and considered self-pay, the Patient is discharged to a SNF, the Patient is deceased with no known estate and below 200% Federal Poverty Guidelines, the patient is supported by State-funded prescription programs, the patient is Homeless or received care from a homeless clinic, the patient has Participated in Women, Infants and Children programs (WIC), the patient is eligible for Food stamps, the patient is eligible Subsidized school lunch program, the patient is eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down), the Patient is referred through the National Association of Free Clinics, the patient provides Low income/subsidized housing as a valid address, or Other significant barriers are present.

Schedule H, Part V, Section B, Line 13 Facility D, 1
Facility D, 1 - BON SECOURS MERCY HEALTH HOSPITALS. There are situations where individuals may not have reported income but have significant assets available to pay for healthcare services. In these situations, BON SECOURS MERCY HEALTH may evaluate and require documented proof of any assets that are categorized as convertible to cash and unnecessary for the patient's essential daily living expenses. PATIENTS WHO LIVE IN THE COMMUNITY SERVED BY A BON SECOURS MERCY HEALTH HOSPITAL WILL BE OFFERED HEALTHCARE FINANCIAL ASSISTANCE. FOR THOSE PATIENTS LIVING OUTSIDE OF THE COMMUNITY, EXTENUATING CIRCUMSTANCES MUST BE DOCUMENTED AND APPROVED BY THE PFS MANAGER AND BE MEDICALLY NECESSARY OR EMERGENT IN NATURE. A LIST OF THE ZIP CODES OF THE COMMUNITY SERVED FOR EACH BON SECOURS MERCY HEALTH HOSPITAL IS MAINTAINED IN A SEPARATE DOCUMENT AND READILY AVAILABLE VIA THE CONTACT LIST AT THE END OF THE POLICY LOCATED AT HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE AND AT https://www.bonsecours.com/patient-resources/financial-assistance. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT TO APPLY FOR HEALTH INSURANCE COVERAGE AND/OR ENTER THE MARKETPLACE/EXCHANGE BEFORE FINANCIAL ASSISTANCE MAY BE EXTENDED. EXCEPTIONS TO THIS POLICY INCLUDE PATIENTS DISCHARGED TO A SKILLED NURSING FACILITY, PATIENTS WHO ARE DECEASED WITH NO ESTATE, AND PATIENTS WHO HAVE DOCUMENTED HOMELESSNESS.

Schedule H, Part V, Section B, Line 2
Effective January 1, 2020, the assets and business operations of Southside Regional Medical Center was acquired by Bon Secours Mercy Health Petersburg LLC. Bon Secours Mercy Health Petersburg LLC dba Bon Secours - Southside Medical Center was licensed as a hospital on January 1, 2020. Effective January 1, 2020, the assets and business operations of Southern Virginia Regional Medical Center was acquired by Bon Secours Mercy Health Emporia LLC . Bon Secours Mercy Health Emporia LLC dba Bon Secours -Southern Virginia Medical Center was licensed as a hospital on January 1, 2020. Bon Secours Mercy Health Petersburg LLC and Bon Secours Mercy Health Emporia LLC are single member limited liability companies of Bon Secours Richmond, LLC. Bon Secours Richmond, LLC is a single member limited liability company of Bon Secours Mercy Health, Inc, a tax exempt 501(c)(3) organization. As such, Bon Secours Mercy Health Petersburg LLC and Bon Secours Mercy Health Emporia, LLC are tax-exempt 501(c)(3) organizations as of January 1, 2020.

Schedule H, Part V, Section B, Line 5 Facility G, 1
"Facility G, 1 - Bon Secours - Southside Medical Center, Bon Secours - Southern Virginia Medical Center. Bon Secours - Southside Medical Center and Bon Secours - Southern Virginia Medical Center, collectively referred to as ""Bon Secours Richmond South"", performed its Community Health Needs Assessment by examining qualitative input provided by community members coupled with quantitative data on health conditions in the area. The data was compiled from public documents prepared by the Cameron Foundation, United Way, and the Crater Health District. Quantitative data presented in this report was gathered from publicly available sources through the Virginia Department of Health and BeHealthyRVA. As the report was prepared during the COVID-19 pandemic, a grassroots approach was taken in order to obtain input from the community. We did so by engaging the community in an online survey, virtual community conversations, and conducting 1:1 key informant interviews. A survey to assess community health needs was conducted as part of the CHNA process during a six-week period between July and August 2020. A total of 324 individual responses were collected. Individuals were asked to ""Please choose the TOP 5 health issues you think should be addressed in your community"" from a list of 13 health issues. Individuals were then asked to ""Please choose the TOP 5 causes of poor health in your community"" from a list of 14 health causes. Interviews were conducted with local content experts to gain insight on top community health needs and the root causes of these health needs. Interviews took place with local law enforcement, local health care nurses, non-profit community partners, and local spiritual leaders. These conversations eluded to what was later confirmed in the online community engagement survey and community conversations. As this report was conducted during the COVID-19 pandemic, two virtual community conversations were held via Zoom in October 2020. A group of 75 key informants, consisting of local community leaders and members were invited to join and the meeting information was widely distributed to the public. A total of 62 participants attended the meetings. The purpose of the community conversations was to dig deeper into the results of the CHNA community engagement survey, specifically surrounding the identified top health issues and causes along with how the COVID-19 pandemic and social justice issues have impacted the health of these communities. Lastly, the purpose of this meeting was to elicit feedback from community members about publicly available health data describing health conditions in the service areas. The top 10 health issues as identified from the survey results were presented to the attendees and they were asked to 1) identify 3 health issues that could be addressed in the next two years, 2) identify root causes that contribute to these health issues (i.e. social determinants, racism, inequities, etc.), and 3) what is currently being done to help address these health issues? Where are there gaps? Conversations with community leaders and community members, as well as findings from the online engagement survey, helped to identify top health issues and associated root causes of health issues. Additionally, these discussions helped to identify significant linkages between each identified health need. Furthermore, the themes of Equity, Poverty, and Race were discussed as underlying concerns related to all of the health issues and causes identified. Leaders within the Community Health Division at Bon Secours Richmond Health System grouped the identified needs into the following categories based on the feedback provided by the community: 1) Chronic Disease, 2) Behavioral Health, 3) Social Determinants of Health, and 4) Stress/Trauma. Community health leaders presented the data gathered through the CHNA process (publicly available health data, online survey, virtual community conversations, and key informant interviews). Recognizing the importance of each of the health concerns identified, the team evaluated them, the hospital's strategic goals, and services currently provided. Based on these criteria, the team narrowed their focus to the top four health concerns. The team then determined the areas in which they could have the greatest impact. Additional detail can be found on the Bon Secours website at https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment"

Schedule H, Part V, Section B, Line 6a Facility G, 1
Facility G, 1 - Bon Secours - Southside Medical Center, Bon Secours - Southern Virginia Medical Center. Bon Secours - Southside Medical Center Bon Secours - Southern Virginia Medical Center

Schedule H, Part V, Section B, Line 11 Facility G, 1
"Facility G, 1 - Bon Secours - Southside Medical Center, Bon Secours - Southern Virginia Medical Center. Bon Secours Richmond Health System (BSR) BSR is comprised of Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital, Bon Secours - Southern Virginia Medical Center, and Bon Secours - Southside Medical Center. BSR will address each need identified in its CHNA with regional strategies. Unless noted below, all BSR hospitals participated in the regional strategies. Chronic Disease Implementation Activities: Goal: Improve overall chronic disease status by increasing equitable access to high quality health care services. 2021 Strategies and Outcomes: * BSR supports community partners by providing high- quality clinical services to uninsured and underinsured populations through investment and advocacy. During 2021, the support from BSR included: - Provided $700k to support and/or expand safety area net clinics providing chronic disease management services to enable uninsured patients with chronic diseases to manage their health conditions, facilitate patient's' ability to acquire affordable medications, enhance patient's understanding of their conditions, and reduce emergency health care visits. - Worked with area free clinics and FQHCs to create the Greater Richmond Safety Net Collaborative to assess safety net capacity and expand access for patients. In 2021, the collaborative created the new online platform that identified appropriate referral sources for patients and care managers. - Partnered with Shalom Farms, an area non-profit providing wellness services, by providing 2 Diabetes Prevention Programs (DPP) and 2 Food Rx Programs. All programs were free of charge and open to anyone who qualified. The DPP achieved CDC certification as a result. - Coordinated programs with VCU Health to establish a work group comprised of health systems, health departments and schools to identify referral pathways for children with Asthma. In 2021, BSR identified specific pediatric linkages and coordination with other area health systems and health departments with a focus on immunizations and back to school physicals. - Partners with clinical staff and non-profit organizations to discharge uninsured patients to Medical Homes with a goal to increase control of chronic disease through available follow-up appointments and reduce readmissions. In 2021, BSR created transitions of care appointments for patients discharged from hospitals to ensure follow-up care appointment with primary care providers. Additionally, BSR developed a partnership with safety net clinic to ensure appropriate follow-up care for the most vulnerable and signed an agreement to join the referral platform ""Unite VA"". - Help to enhance understanding of insurance usage to first time consumers and ensure continued coverage. BSR provided enrollment support for uninsured patients. In 2021, BSR allocated 2 FTEs to Medicaid enrollment and other financial assistance services, resulting in Medicaid enrollment assistance provided to 233 patients. * Providing primary care services to the uninsured through the Care-A-Van mobile health clinic remained a priority for BSR. During 2021, nearly 13,000 patient visits occurred through this program. * During 2021, BSR signed the lease and broke ground on a $3 million fixed site clinic to support uninsured patients in South Richmond. * BSR continued to provide comprehensive chronic disease management services to patients by providing medical homes and financial assistance for uninsured patients through community health and the medical group. * In an effort to enhance the understanding of nutrition for chronic disease patients BSR established a diabetes prevention program to uninsured residents of the area in 2021. * BSR worked to facilitate a smooth transition of care from emergency department/admissions hospitals settings to post hospital setting follow-ups by establishing a pathway for uninsured patients to seek follow up care for complex chronic diseases. During 2021, over 1,000 patients were served using this pathway. * Continued efforts were made to leverage the collective influence of Richmond's congregations to improve the overall health status in the East end of Richmond by providing health education and offerings. In 2021, BSR continued the Congregational Health Initiative which was comprised of 7 local congregations that facilitated COVID-19 vaccinations for vulnerable residents and provided a connection to healthcare resources. * During the year BSR co-lead the East End Diabetes Coalition (EEDC). The EEDC's main goal is to catalog diabetes providers in the East End of Richmond to connect community members to resources. In 2021, the EEDC implemented the regional guide in tandem with individual counseling provided to East End residents. The Community Nutrition Outreach team began two new community programs that were included in the resource guide. These programs were The Diabetes Prevention Program and the Food Rx Program. * During 2021, BSR provided over 5,000 COVID-19 vaccinations to vulnerable neighborhoods with high incidence of Covid-19. * Throughout the year BSR hosted 385 Flu Clinics that distributed 12,089 flu vaccines. Additionally, BSR hosted 43 wellness clinics that provided PPDs, A1c screenings, and biometric screenings to community members."

Schedule H, Part V, Section B, Line 11 Facility G, 2
Facility G, 2 - CONTINUED DESCRIPTION: Bon Secours - Southside Medical Center, Bon Secours - Southern Virginia Medical Center. Behavioral Health Implementation Activities: Goal: Improve behavioral health status by increasing the availability of appropriate, quality mental health and addiction services. 2021 Strategies and Outcomes: * BSR continued to support area non-profits who provide comprehensive behavioral health services to the uninsured by providing more than $500k in grants to expand access during 2021. * As an advocate for increased substance, alcohol, and drug abuse programs and resources, BSR revised internal policies and procedures to reduce unnecessary opioid prescribing by its providers. Additionally, during 2021, BSR provided SUD training to over 100 providers. * During 2021, BSR worked with housing and homeless partners to ensure every child and adult had the availability of stable and affordable housing and provided over $800k across the housing continuum. * Collaborations with BSR and community partners occurred during the year to increase mental health awareness by providing screenings, support groups, education, and programs to the public. BSR contributed to these collaboration efforts by deploying a Violence Response team who provided 220 hours of education sessions in 2021. * BSR worked with Free Clinics and FQHCs to bring low or no cost mental health services into area public school systems. In 2021, BSR provided mental health counseling services to Powhatan Middle and High schools. * Efforts were made by BSR to ensure patients receive depression screenings and follow-up in primary care settings. Of the total patients seen by primary care providers 91% received the depression screening in 2021. * During the year BSR worked on the development of strategies to overcome mental health provider shortages and improve mental health provider stability. In 2021, the Richmond market consolidated outpatient behavioral health and improved inpatient services and identified an expansion opportunity for 2022. * BSR seeks to integrate behavioral health with primary care by collaborating with health departments, safety net providers, and community providers to increase the number of mental health patients who receive counseling following their primary care physician's recommendation. This will also enhance the capacity for the treatment of anxiety/depression in primary care settings and ensure behavioral health practitioners are available in primary care in primary care settings. During 2021, BSR provided $50k through partnerships with Health Brigade to expand these services. * BSR intends to implement SBIRT in its emergency departments. The education of ED staff on SBIRT screenings and community resources to ensure warm handoffs occur launched during 2021 but was put on hold until 2022 due to COVID-19. * During 2021, BSR implemented an annual Opioid education webinar for all associates across the market to increase mental health awareness. The education webinar was provided to nearly 10k associates in 2021. * BSR continues to expand behavioral health services available through community health programs by identifying new providers, volunteers, and partners to enhance services offered via mobile health and fixed-site locations. During 2021, BSR developed a plan to increase FTEs of bi-lingual LCSW in 2022, once the planned fixed-site is completed. This fixed-site will be a market-wide referral source of the uninsured. * During 2021, BSR successfully launched the Life Matters program to expand behavioral health service resources available to all employees and expanded the offering through the Called to Shine platform and the Be Well employee resource. * Due to the impact of COVID-19, several of the programs and strategies that BSR intended to implement to address this health need were delayed with plans to resume these programs in 2022. Social Determinants of Health Implementation Activities: Goal: Reduce health disparity by ensuring that every community has social and economic opportunities to thrive. 2021 Strategies and Outcomes: * BSR Supports area non-profits who are building affordable housing units that offset displacement, expanding home ownership and affordable rental housing options, closing gaps along the education and achievement continuum, and providing early childhood education programs and advocacy. In 2021, BSR donated over $800k in direct services and investments in affordable housing and neighborhood assets. * In 2021, BSR donated nearly $700k in direct services and investments to area non-profits who are along the education continuum and who are providing expanded access to early childhood programs. * In 2021, BSR donated almost $400k in direct services and investments to area non-profits who are providing financial literacy services. * BSR continues to focus on programs to improve neighborhood infrastructure through corridor development in the East End. BSR supports long-term sustainability of community spaces such as the Sarah Garland Jones Center (SGJC) in the East End, enhancement of community oneness and collaboration, and providing space for Health Education and workforce development, and improving aesthetics of the neighborhood. In 2021, BSR hosted 10 community events at the SGJC and 2 community events in the neighborhood greenspace. * BSR will identify opportunities to enhance the environment and promote place-making. BSR provides over $100k annually to support the PULSE Rapid Transit System. In 2021, BSR worked in collaboration with Greater Richmond Transit to identify 14 bus stops in the East End to receive bus shelters. The bus shelters that were built were a result of a $200k investment made by BSR. * Through 2021 BSR participated in community meetings and advocated for the redevelopment of Nine Mile Road Corridor. This included building new and/or replacement of sidewalks and streetlights along the full corridor. * In an effort to support entrepreneurship tied to the local supply chain and entrepreneurial offerings in the public school system BSR has requested funding to continue the partnership with the Claude Moore Society. This partnership which began in 2020 is a five-year effort to develop Claude Moore Scholars at Meadowbrook high School in North Chesterfield. BSR provides work-based learning experiences and appropriate employment opportunities to these scholars. * BSR remained committed to advocating for food access and food education during 2021 by investing $75k in Shalom Farms, a non-profit sustainable agricultural organization, to double their farming production yield. Additionally, BSR served as a member of the Virginia Food Access Coalition which testified and supported Virginia Food Access Investment Program and Funding Legislation during the Virginia Assembly. * BSR continues to focus on increased screenings and coordination of resources to support individuals with needs related to the social determinants of health. In 2021, BSR provided the following: - Established an interdisciplinary team that co-managed 12 complex patients. - Hired a designated FTE community health worker who served 897 patients. - Created the SDOH screening tool for social needs screening which was implemented in 2021 and performed 142 screenings. - Created a master resource list of community partners and resources to address patient needs and provided to SDOH team.

Schedule H, Part V, Section B, Line 11 Facility G, 3
Facility G, 3 - CONTINUED DESCRIPTION 2: Bon Secours - Southside Medical Center, Bon Secours - Southern Virginia Medical Center. Stress / Trauma Implementation Activities: Goal: Promote the well-being, safety, and overall health of individuals by decreasing the occurrences of Adverse Childhood Experiences within communities. 2021 Strategies and Outcomes: * BSR supports community partners who are collaborating to promote safer and supportive communities through investment and advocacy. In 2021, the following actions occurred: - Provided $60k of investment to fund SCAN TRAUMA Informed Networks that addresses the impacts of trauma and adverse childhood experiences through 170 in state networks with 540 individual members. - Increased HVIP advocates from 3 to 6 to address increase in community demand. - Established and will continue to Chair the Richmond Regional Human Trafficking Collaborative which is aimed at enhancing awareness to the issue of human trafficking. - Continued development of a trauma informed leadership team in partnership with SCAN. The activity was paused due to Covid-19 but will restart in 2022. * In an effort to ensure all victims of violence, abuse, and stress have access to high quality, timely forensic nurses for evaluation and treatment, BSR provides in-house forensic nursing services across the market. In 2021, BSR had 18 forensic nurses and established a hospital-based violence intervention program that hired and trained 6 advocates. During 2021, 2,934 patients were served by these programs. * During 2021, BSR continued the Clinicians Against Gun Violence campaign to engage physicians in conversations around gun violence. BSR's Diversity and Inclusion team created and hosted a Difference in Dialogue panel and follow-up break out discussion for all associates. * To further the enhancement of staff awareness levels of trauma BSR created a mandatory education webinar with nearly 10k associates completing the webinar by the end of 2021. All prioritized needs in the CHNA have been addressed.

Schedule H, Part V, Section B, Line 13 Facility G, 1
Facility G, 1 - BON SECOURS MERCY HEALTH HOSPITALS. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT OR FAMILY MEMBER TO COMPLETE AN APPLICATION INCLUDING GROSS INCOME FOR A MINIMUM OF 3 MONTHS (UP TO 12 MONTHS) PRIOR TO THE DATE OF APPLICATION OR DATE OF SERVICE. PROOF OF INCOME IS REQUIRED WITH THE EXCEPTIONS OF PATIENTS WHO QUALIFY FOR PRESUMPTIVE ELIGIBILITY. PROOF OF INCOME IS NOT REQUIRED IF A PATIENT OR FAMILY MEMEBER ATTESTS TO AN INCOME LEVEL THAT QUALIFIES THE APPLICANT FOR DISCOUNTED CARE UNDER OHIO'S HEALTHCARE ASSURANCE PROGRAM (HCAP). THIRD PARTY INCOME SCORING MAY BE USED TO VERIFY INCOME IN SITUATIONS WHERE INCOME VERIFICATION IS UNABLE TO BE OBTAINED THROUGH OTHER METHODS. Patients are presumed to be eligible for financial assistance based on individual life circumstances including but not limited to when the Patient's income is below 200% Federal Poverty Guidelines and considered self-pay, the Patient is discharged to a SNF, the Patient is deceased with no known estate and below 200% Federal Poverty Guidelines, the patient is supported by State-funded prescription programs, the patient is Homeless or received care from a homeless clinic, the patient has Participated in Women, Infants and Children programs (WIC), the patient is eligible for Food stamps, the patient is eligible Subsidized school lunch program, the patient is eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down), the Patient is referred through the National Association of Free Clinics, the patient provides Low income/subsidized housing as a valid address, or Other significant barriers are present.

Schedule H, Part V, Section B, Line 13 Facility G, 1
Facility G, 1 - BON SECOURS MERCY HEALTH HOSPITALS. There are situations where individuals may not have reported income but have significant assets available to pay for healthcare services. In these situations, BON SECOURS MERCY HEALTH may evaluate and require documented proof of any assets that are categorized as convertible to cash and unnecessary for the patient's essential daily living expenses. PATIENTS WHO LIVE IN THE COMMUNITY SERVED BY A BON SECOURS MERCY HEALTH HOSPITAL WILL BE OFFERED HEALTHCARE FINANCIAL ASSISTANCE. FOR THOSE PATIENTS LIVING OUTSIDE OF THE COMMUNITY, EXTENUATING CIRCUMSTANCES MUST BE DOCUMENTED AND APPROVED BY THE PFS MANAGER AND BE MEDICALLY NECESSARY OR EMERGENT IN NATURE. A LIST OF THE ZIP CODES OF THE COMMUNITY SERVED FOR EACH BON SECOURS MERCY HEALTH HOSPITAL IS MAINTAINED IN A SEPARATE DOCUMENT AND READILY AVAILABLE VIA THE CONTACT LIST AT THE END OF THE POLICY LOCATED AT HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE AND AT https://www.bonsecours.com/patient-resources/financial-assistance. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT TO APPLY FOR HEALTH INSURANCE COVERAGE AND/OR ENTER THE MARKETPLACE/EXCHANGE BEFORE FINANCIAL ASSISTANCE MAY BE EXTENDED. EXCEPTIONS TO THIS POLICY INCLUDE PATIENTS DISCHARGED TO A SKILLED NURSING FACILITY, PATIENTS WHO ARE DECEASED WITH NO ESTATE, AND PATIENTS WHO HAVE DOCUMENTED HOMELESSNESS.

Schedule H, Part V, Section B, Line 5 Facility C, 1
Facility C, 1 - Mercy Health - Tiffin Hospital LLC. Mercy Health - Tiffin Hospital is a key stakeholder and partner of the Seneca County Health Alliance, a collaborative strategic planning process involving many community agencies and coalitions from various sectors. The Seneca County Health Alliance developed a Community Health Needs Assessment (CHNA) for Seneca County to assess and identify the health needs of the community. The CHNA was conducted by various social service, business and government organizations in Seneca County to collect data that reports the health and health behaviors of Seneca County residents. Data was collected for this assessment with the assistance of the Hospital Council of Northwest Ohio (HCNO). From the beginning phases of the Seneca County CHNA, community leaders were actively engaged in the planning process and helped define the content, scope and sequence of the project. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment. Under the leadership of the HCNO, the survey questions were drafted and reviewed in a series of meetings with the planning committee from Seneca County. Local community agencies were invited to participate in the health assessment process, including choosing questions for the surveys, providing local data, reviewing draft reports and planning the community event, release of the data and setting priorities. The needs of the population, especially those who are medically underserved, low-income, minority populations and populations with chronic disease needs, were taken into account through the sample methodology that surveyed these populations and over-sampled minority populations. In addition, the organizations that serve these populations participated in the health assessment and community planning process, such as Seneca County School District, Seneca County Commission on Aging, Seneca County United Way. During the Spring of 2019, a survey instrument was designed to assess the health status and needs of adults in the community. The project coordinator from the HCNO conducted a series of meetings with the Seneca County Health Alliance. During these meetings, HCNO and the Seneca County Health Alliance reviewed and discussed banks of potential survey questions. The surveys were distributed to 1,200 adults in Seneca County. Additionally, HCNO obtained the results from a youth health survey offered by the Ohio Department of Mental Health and Addiction Services, Ohio Department of Health, and Ohio Department of Education that was administered to Seneca County youth in grades 7-12 in 2018 to 2019. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 5 Facility C, 2
Facility C, 2 - Mercy Health - Marcum and Wallace Hospital LLC. Marcum and Wallace Hospital (MWH) contracted with the Community and Economic Development Initiative of Kentucky (CEDIK) and with the University of Kentucky in the summer of 2019 to conduct a Community Health Needs Assessment (CHNA). The CHNA relied heavily on input from local residents and health-related organizations. The primary sources of data included one-on-one interviews with numerous local stakeholders, a variety of local focus groups, and survey data gathered from individuals within the service area. Combined input was received from local public health departments, social agencies, healthcare providers and local employers within the geographic service region. Through both the focus groups and the surveys, questions asked how the respondent felt the hospital could address the health needs of the community. Four focus groups for 41 participants were held between May and October 2019. A survey was developed with MWH staff and the Community Steering Committee which focused on the service are populations overall health and wellbeing as well as the medical diagnosis in the service area and was available in paper form and online. A mobile survey option was used to increase the number of surveys completed. Each member of the steering committee was responsible for distributing and collecting surveys as well as sharing the mobile link with coworkers and the populations that they served. The surveys were available at MWH, public health departments, the Interfaith Wellness Ministry, Estill County Schools and Carhartt, Inc. 483 surveys were completed and returned. The Community Steering Committee reviewed the results of the surveys completed and input received from the community focus groups, compared the survey and focus group data to the various health data, and made recommendations to MWH for CHNA health priorities to be addressed. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 6b Facility C, 1
Facility C, 1 - Mercy Health - Tiffin Hospital LLC. Firelands Counseling and Recovery Services Fostoria Community Schools Fostoria United Way Hospital Council of Northwest Ohio Mental Health and Recovery Services Board of Seneca, Sandusky and Wyandot Counties Seneca County Children and Family First Council Seneca County Health Alliance Seneca County Health Department Tiffin City Schools Tiffin-Seneca United Way

Schedule H, Part V, Section B, Line 6b Facility C, 2
Facility C, 2 - Mercy Health - Marcum and Wallace Hospital LLC. Estill County EMS Interfaith Wellness Ministry KY River Foothills Development Council, Inc Powell County Health Department Housing Authority of Irvine Kentucky River District Health Department Estill Development Alliance Estill County Chamber of Commerce Estill County Schools Lee County Fiscal Court Carhartt Community and Economic Development Initiative of Kentucky (CEDIK) at the University of Kentucky

Schedule H, Part V, Section B, Line 11 Facility C, 1
"Facility C, 1 - Mercy Health - Tiffin Hospital LLC. Mercy Health - Tiffin Hospital Mental Health and Substance Abuse Implementation Activities: Goal: Increase awareness of adult and youth mental health and addiction issues of Seneca County 2021 Strategies and Outcomes: * During 2021, Mercy Health Tiffin implemented a new screening program with ER personnel called ""Screening, Brief Intervention and Referral to Treatment"" (SBIRT). Providers at Mercy Health Tiffin continues to screen for mental health concerns and provide referrals to counseling or addiction services. * Mercy Health Tiffin continues to support Firelands Counseling and Recovery Services, which provides a safe site for afterhours counseling and recovery services. * Due to the impact of COVID-19, many of the programs and strategies that Mercy Health Tiffin intended to implement to address this health need were delayed until 2022. Mercy Health Tiffin plans to resume these programs in 2022. Preventative Health/Chronic Disease Implementation Activities: Goal: Focus on prevention of chronic illnesses of adults and youth of Seneca County. 2021 Strategies and Outcomes: * Mercy Health Tiffin continued to provide free health screenings to all employees during 2021. * Due to the impact of COVID-19, many of the programs and strategies that Mercy Health Tiffin intended to implement to address this health need were delayed until 2022. Mercy Health Tiffin plans to resume these programs in 2022. All prioritized needs in the hospital CHNA have been addressed."

Schedule H, Part V, Section B, Line 11 Facility C, 2
Facility C, 2 - Mercy Health - Marcum and Wallace Hospital LLC. Mercy Health - Marcum and Wallace Hospital Substance Abuse Implementation Activities: Goal: Increase substance abuse education and awareness of treatment resources within the community ensuring prevention and recognition of substance abuse. 2021 Strategies and Outcomes: * During 2021, Marcum and Wallace Hospital (MWH) participated in a Social Emotional Learning Night at the local intermediate school and was able to provide prevention education to students and families. * The HELP (Healing, Empowering, Living Program) Team, also known as the Quick Response Team (QRT), provides a coordinated response to the opioid crisis in Estill County. The HELP Team is comprised of a Peer Support Specialist, Community Paramedic and Behavioral Health Consultant. The goal of the team is to build relationships that are respectful and work hand in hand with people to get the help they need. MWH participates in this program. During 2021, 1 program was available to the service area. * MWH worked to achieve their goal of enhancing partnerships with local boards and civic organizations through increased staff and leader membership. During 2021, the goal was to have 1 new meeting/member, and this was surpassed with 4 new members added and 3 new meetings held during the year. * During 2021, MWH collaborated with KY-ASAP to provide a community-wide Narcan Training Day in Estill County in July. The event promoted community awareness and education about substance abuse and provided Narcan Training. Mental Health Implementation Activities: Goal: Increase awareness and improve access to mental and behavioral health services within the service area. 2021 Strategies and Outcomes: * During 2021, MWH hired a new LCSW to be used as the Behavioral Health Consultant that provided the following health services. * During 2021, MWH provided behavioral health services within the MWH ED and primary care clinics, including via telehealth encounters. MWH had 53 total encounters in 2021. * MWH worked to increase community awareness of behavioral health issues and resources available to address behavioral health needs during 2021 by having 10 discussions and communications with community leaders. * During 2021, MWH worked to increase early intervention treatments by providing patient assessments completed by the behavioral health consultant. 53 early interventions occurred in 2021. * MWH worked throughout 2021 to ensure they were represented on community advocacy boards and groups and increase the number of community board involvements by MWH leaders. MWH had a goal to attend 55 meeting, this was surpassed by participating in 65 meetings virtually. Obesity Implementation Activities: Goal: Increase awareness of the impact obesity has on one's overall health including impact on chronic illness and encourage health heating habits and an active lifestyle. 2021 Strategies and Outcomes: * During 2021, MWH promoted increased physical activity and proper nutrition to fight obesity by hosting 1 event and providing healthy choices educational information. MWH provided healthy choices virtual education to 5th grade students at West Irvine Intermediate. * MWH collaborated with Ladies' Healthy Heart Virtual Events to offer educational community-based events. 12 totals events were during 2021 held. Cardiologist, Paula Hollingsworth presented on facts, preventative measures, and potential scenarios to participants. * MHW printed educational items to distributed to Citizens Guaranty Bank, Hardy Oil, and all area back to school nights for employee/member nutrition education. MHW also hosted 2 family meal kit events which served 240 persons. * During 2021, MHW implemented a voucher program that served 100 patients monthly for 9 months with education, dietary consultation, and access. * MWH successfully continued the Population Health Management (PHM) clinic that began in November 2020 with a Nurse Practitioner and Pharmacist seeing patients. During 2021, the goal was to see 6 patients, but that goal was surpassed with 7 patients seen. All prioritized needs in the hospital CHNA have been addressed.

Schedule H, Part V, Section B, Line 13 Facility C, 1
Facility C, 1 - BON SECOURS MERCY HEALTH HOSPITALS. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT OR FAMILY MEMBER TO COMPLETE AN APPLICATION INCLUDING GROSS INCOME FOR A MINIMUM OF 3 MONTHS (UP TO 12 MONTHS) PRIOR TO THE DATE OF APPLICATION OR DATE OF SERVICE. PROOF OF INCOME IS REQUIRED WITH THE EXCEPTIONS OF PATIENTS WHO QUALIFY FOR PRESUMPTIVE ELIGIBILITY. PROOF OF INCOME IS NOT REQUIRED IF A PATIENT OR FAMILY MEMEBER ATTESTS TO AN INCOME LEVEL THAT QUALIFIES THE APPLICANT FOR DISCOUNTED CARE UNDER OHIO'S HEALTHCARE ASSURANCE PROGRAM (HCAP). THIRD PARTY INCOME SCORING MAY BE USED TO VERIFY INCOME IN SITUATIONS WHERE INCOME VERIFICATION IS UNABLE TO BE OBTAINED THROUGH OTHER METHODS. Patients are presumed to be eligible for financial assistance based on individual life circumstances including but not limited to when the Patient's income is below 200% Federal Poverty Guidelines and considered self-pay, the Patient is discharged to a SNF, the Patient is deceased with no known estate and below 200% Federal Poverty Guidelines, the patient is supported by State-funded prescription programs, the patient is Homeless or received care from a homeless clinic, the patient has Participated in Women, Infants and Children programs (WIC), the patient is eligible for Food stamps, the patient is eligible Subsidized school lunch program, the patient is eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down), the Patient is referred through the National Association of Free Clinics, the patient provides Low income/subsidized housing as a valid address, or Other significant barriers are present.

Schedule H, Part V, Section B, Line 13 Facility C, 1
Facility C, 1 - BON SECOURS MERCY HEALTH HOSPITALS. There are situations where individuals may not have reported income but have significant assets available to pay for healthcare services. In these situations, BON SECOURS MERCY HEALTH may evaluate and require documented proof of any assets that are categorized as convertible to cash and unnecessary for the patient's essential daily living expenses. PATIENTS WHO LIVE IN THE COMMUNITY SERVED BY A BON SECOURS MERCY HEALTH HOSPITAL WILL BE OFFERED HEALTHCARE FINANCIAL ASSISTANCE. FOR THOSE PATIENTS LIVING OUTSIDE OF THE COMMUNITY, EXTENUATING CIRCUMSTANCES MUST BE DOCUMENTED AND APPROVED BY THE PFS MANAGER AND BE MEDICALLY NECESSARY OR EMERGENT IN NATURE. A LIST OF THE ZIP CODES OF THE COMMUNITY SERVED FOR EACH BON SECOURS MERCY HEALTH HOSPITAL IS MAINTAINED IN A SEPARATE DOCUMENT AND READILY AVAILABLE VIA THE CONTACT LIST AT THE END OF THE POLICY LOCATED AT HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE AND AT https://www.bonsecours.com/patient-resources/financial-assistance. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT TO APPLY FOR HEALTH INSURANCE COVERAGE AND/OR ENTER THE MARKETPLACE/EXCHANGE BEFORE FINANCIAL ASSISTANCE MAY BE EXTENDED. EXCEPTIONS TO THIS POLICY INCLUDE PATIENTS DISCHARGED TO A SKILLED NURSING FACILITY, PATIENTS WHO ARE DECEASED WITH NO ESTATE, AND PATIENTS WHO HAVE DOCUMENTED HOMELESSNESS.

Schedule H, Part V, Section B, Line 2
Effective January 1, 2020, the assets and business operations of Southampton Memorial Hospital was acquired by Bon Secours Mercy Health Franklin LLC dba Bon Secours - Southampton Medical Center. Bon Secours Mercy Health Franklin LLC was licensed as a hospital on January 1, 2020. Bon Secours Mercy Health Franklin LLC is a single member limited liability company of Bon Secours Hampton Roads Health System, LLC. Bon Secours Hampton Roads Health System, LLC is a single member limited liability company of Bon Secours Mercy Health, Inc, a tax exempt 501(c)(3) organization. As such, Bon Secours Mercy Health Franklin LLC is a tax-exempt 501(c)(3) organization as of January 1, 2020.

Schedule H, Part V, Section B, Line 5 Facility E, 1
Facility E, 1 - BON SECOURS - SOUTHAMPTON MEDICAL CENTER. Bon Secours - Southampton Medical Center in collaboration with Bon Secours Mary Immaculate Hospital, Sentara Healthcare, Children's Hospital of the King's Daughters, Riverside Health System, the Peninsula Health District, and the Hampton Health district, collectively known as The Peninsula Community Health Collaborative (PCHC), began meeting in May 2018 to begin the work on the 2020 - 2022 Community Health Needs Assessment. In order to obtain input from the community, an online and hard-copy Community Health Assessment Survey (Survey) was disseminated in English and Spanish to the community and key stakeholders. The survey was disseminated from October 23, 2019 through December 12, 2019 and was widely distributed via Bon Secours and PCHC networks, as well as meetings, clinics and programs. Overall, survey participants represent a blend of perspectives across age, race and income. A total of 12 focus group meetings called Community Dialogues were held in the Hampton Roads region in which 300 individuals participated. The purpose of the meetings was to elicit feedback from community members about publicly available health data describing health conditions in the service area and to review the online survey results to further explore the findings. The meetings began with community members participating in a matrix exercise in which they selected the three most important of the top ten health concerns identified in the Survey. Following the matrix exercise, a presentation explaining the CHNA process was shown. For sessions with larger numbers in attendance, participants were then divided into groups to discuss the top concerns identified in the matrix exercise. Smaller sessions were discussed as a single group. Breakout session facilitators lead the discussions with the following questions: Why are these issues? What is causing the issues? What can be done to address the issues? Comments were then written down by a staff member or volunteer. Bon Secours - Southampton Medical Center's senior leadership team met to review primary and secondary data gathered through the CHNA process (community meetings, community and key stakeholder surveys, and meetings with regional health systems and health departments). Recognizing the importance of each of the health concerns identified, the team evaluated them, the hospital's strategic goals, and services currently provided. Based on these criteria, the team narrowed their focus to the top five health concerns selected by both the community and key stakeholders. The team then determined the areas in which they could have the greatest impact. Additional detail can be found on the Bon Secours website at https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment

Schedule H, Part V, Section B, Line 6a Facility E, 1
Facility E, 1 - BON SECOURS - SOUTHAMPTON MEDICAL CENTER. Children's Hospital of The King's Daughters Sentara CarePlex Sentara Williamsburg Regional Medical Center Riverside Doctor's Hospital Williamsburg Riverside Regional Medical Center Riverside Behavioral Health Center Riverside Rehabilitation Hospital Hampton Roads Specialty Hospital Riverside Walter Reed Hospital Bon Secours Mary Immaculate Hospital

Schedule H, Part V, Section B, Line 6b Facility E, 1
Facility E, 1 - BON SECOURS - SOUTHAMPTON MEDICAL CENTER. Virginia Department of Health - Peninsula and Hampton

Schedule H, Part V, Section B, Line 11 Facility E, 1
Facility E, 1 - BON SECOURS - SOUTHAMPTON MEDICAL CENTER. Bon Secours - Southampton Medical Center (Southampton) Heart Conditions/Diabetes Implementation Activities: Goal: Improve knowledge and access to healthcare opportunities to treat and manage cardiovascular disease. 2021 Strategies and Outcomes: * Southampton continues to establish consistent, high-quality processes across the continuum of care for heart conditions. Patients with heart conditions, such as hypertension and congestive heart failure, are controlled through ongoing care management. * Southampton worked to increase community health through education, screenings, and programming around heart disease throughout the year. Southampton's efforts resulted in establishing partnerships with New Hope Baptist Church, Hayden Village Center, Foodbank, and other organizations to embed health education into the community. * Due to the impact of COVID-19, many of the programs and strategies that Southampton intended to implement to address this health need were delayed until 2022. Southampton plans to resume these programs in 2022. Chronic Health in Aging Adults Implementation Activities: Goal: Improve access to healthcare opportunity to treat and manage chronic conditions for aging population. 2021 Strategies and Outcomes: * Improving community health around chronic disease conditions, including diabetes and obesity/overweight, through clinical interventions was a key strategy for Southampton throughout 2021. During the year Southampton partnered with Bon Secours Medical Group practices to effectively monitor A1c for patients with diabetes and implement effective treatment regimens. Bon Secours Medical Group supported these efforts put forth by Southampton by implementing effective treatment regimens and establishing a baseline for annual Medicare wellness visits to ensure screenings are being performed to identify chronic disease. * Southampton established a partnership with Hayden Village Center during 2021. Southampton provided supported programming at Hayden Village Center and continues to provide primary care to the uninsured at this location. * During 2021, Southampton established a partnership with Western Tidewater Health Department Certified Diabetes Educator. Programs are being planned by the partnership for 2022. * Due to the impact of COVID-19, many of the programs and strategies that Southampton intended to implement to address this health need were delayed until 2022. Southampton plans to resume these programs in 2022. Significant Needs Not Addressed by the Hospital Alcohol and Substance Abuse Southampton Memorial Hospital will not add any additional strategies to directly address this community need and thus not be making it one of its top priorities. Referrals to local community service boards will also continue. Active participation in coalitions addressing Alcohol and Substance Abuse will continue. There are other resources in the Southampton service area with more resources or expertise to address alcohol and substance abuse. Behavioral/Mental Health Southampton Memorial Hospital will not add any additional strategies to directly address this community need and thus not be making it one of its top priorities. Referrals to local community service boards will also continue. Active participation in coalitions addressing behavioral/mental health, especially in the area of opioid abuse, will continue. There are other resources in the Southampton service area with more resources or expertise to address behavioral and mental health. Smoking/Tobacco Use Southampton Memorial Hospital will not add any additional strategies to directly address this community need and thus not be making it one of its top priorities. Referrals to local community service boards will also continue. Active participation in coalitions addressing Smoking/Tobacco Use will continue. There are other resources in the Southampton service area with more resources or expertise to address Smoking/Tobacco use.

Schedule H, Part V, Section B, Line 13 Facility E, 1
Facility E, 1 - BON SECOURS MERCY HEALTH HOSPITALS. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT OR FAMILY MEMBER TO COMPLETE AN APPLICATION INCLUDING GROSS INCOME FOR A MINIMUM OF 3 MONTHS (UP TO 12 MONTHS) PRIOR TO THE DATE OF APPLICATION OR DATE OF SERVICE. PROOF OF INCOME IS REQUIRED WITH THE EXCEPTIONS OF PATIENTS WHO QUALIFY FOR PRESUMPTIVE ELIGIBILITY. PROOF OF INCOME IS NOT REQUIRED IF A PATIENT OR FAMILY MEMEBER ATTESTS TO AN INCOME LEVEL THAT QUALIFIES THE APPLICANT FOR DISCOUNTED CARE UNDER OHIO'S HEALTHCARE ASSURANCE PROGRAM (HCAP). THIRD PARTY INCOME SCORING MAY BE USED TO VERIFY INCOME IN SITUATIONS WHERE INCOME VERIFICATION IS UNABLE TO BE OBTAINED THROUGH OTHER METHODS. Patients are presumed to be eligible for financial assistance based on individual life circumstances including but not limited to when the Patient's income is below 200% Federal Poverty Guidelines and considered self-pay, the Patient is discharged to a SNF, the Patient is deceased with no known estate and below 200% Federal Poverty Guidelines, the patient is supported by State-funded prescription programs, the patient is Homeless or received care from a homeless clinic, the patient has Participated in Women, Infants and Children programs (WIC), the patient is eligible for Food stamps, the patient is eligible Subsidized school lunch program, the patient is eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down), the Patient is referred through the National Association of Free Clinics, the patient provides Low income/subsidized housing as a valid address, or Other significant barriers are present.

Schedule H, Part V, Section B, Line 13 Facility E, 1
Facility E, 1 - BON SECOURS MERCY HEALTH HOSPITALS. There are situations where individuals may not have reported income but have significant assets available to pay for healthcare services. In these situations, BON SECOURS MERCY HEALTH may evaluate and require documented proof of any assets that are categorized as convertible to cash and unnecessary for the patient's essential daily living expenses. PATIENTS WHO LIVE IN THE COMMUNITY SERVED BY A BON SECOURS MERCY HEALTH HOSPITAL WILL BE OFFERED HEALTHCARE FINANCIAL ASSISTANCE. FOR THOSE PATIENTS LIVING OUTSIDE OF THE COMMUNITY, EXTENUATING CIRCUMSTANCES MUST BE DOCUMENTED AND APPROVED BY THE PFS MANAGER AND BE MEDICALLY NECESSARY OR EMERGENT IN NATURE. A LIST OF THE ZIP CODES OF THE COMMUNITY SERVED FOR EACH BON SECOURS MERCY HEALTH HOSPITAL IS MAINTAINED IN A SEPARATE DOCUMENT AND READILY AVAILABLE VIA THE CONTACT LIST AT THE END OF THE POLICY LOCATED AT HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE AND AT https://www.bonsecours.com/patient-resources/financial-assistance. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT TO APPLY FOR HEALTH INSURANCE COVERAGE AND/OR ENTER THE MARKETPLACE/EXCHANGE BEFORE FINANCIAL ASSISTANCE MAY BE EXTENDED. EXCEPTIONS TO THIS POLICY INCLUDE PATIENTS DISCHARGED TO A SKILLED NURSING FACILITY, PATIENTS WHO ARE DECEASED WITH NO ESTATE, AND PATIENTS WHO HAVE DOCUMENTED HOMELESSNESS.

Schedule H, Part V, Section B, Line 5 Facility F, 1
Facility F, 1 - Institute for Orthopaedic Surgery. As part of the community health needs assessment (CHNA) process, many community stakeholders from Allen, Auglaize, and Putnam counties came together to create one county-level community health assessment (CHA) for each of their respective counties. As a result, these partnerships have resulted in less duplication, increased collaboration, and sharing of resources. Therefore, the data for this CHNA was obtained from the 2016 Putnam County CHA, 2017 Allen County CHA, and 2017 Auglaize County CHA. This community health needs assessment (CHNA) was cross-sectional in nature and included a written survey of adults within Allen, Auglaize, and Putnam Counties, as well as youth within Allen and Auglaize Counties. While Allen and Auglaize counties collect county-level youth health data, Putnam County does not. However, the Putnam County Task Force, does collect health data for individual grade levels using the PRIDE survey, which Mercy Health financially supports in addition to being a member of the task force. Two survey instruments were designed, and pilot tested for this study: one for adults and one for adolescents in grades 6-12. Input from members of the community was obtained through various methods for each county. Question selection meetings, questionnaires, rough draft meetings, community data release events, and written comments from community stakeholders were the main methods of collecting community feedback. Committee members expressed their opinions, needs, services or specific health-related topics while choosing certain questions to ask on the adult and adolescent questionnaires. The committee requested secondary data and correlations at rough draft meetings. Questions and written comments from the public were received at the community data release event from the community stakeholder perceptions worksheets. From the beginning, community leaders were actively engaged in the planning process and helped define the content, scope, and sequence of the study. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid CHNA. Additional detail can be found on the Mercy Health website at https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment

Schedule H, Part V, Section B, Line 6a Facility F, 1
Facility F, 1 - Institute for Orthopaedic Surgery. Lima Memorial Health System Mercy Health - St. Rita's Medical Center Blanchard Valley Health System, Putnam County Grand Lake Health Systems

Schedule H, Part V, Section B, Line 6b Facility F, 1
Facility F, 1 - Institute for Orthopaedic Surgery. Activate Allen County Allen County Public Health Auglaize County Board of Developmental Disabilities Auglaize County Commissioners Auglaize County Council on Aging Auglaize County Family and Children First Council Auglaize County Head Start Auglaize County Health Department Auglaize County Job and Family Services Auglaize County Juvenile Court Hancock, Hardin, Wyandot and Putnam Community Action Commission, Putnam County Health Partners of Western Ohio Mental Health and Recovery Services Board, Allen and Auglaize County New Bremen Local Schools, Auglaize County Pathways Counseling Center, Inc., Putnam County Putnam County Council on Aging Putnam County Family and Children First Council Putnam County Health Department Putnam County Homecare and Hospice The Mental Health, Alcohol and Drug Addiction Recovery Board of Putnam County The Ohio State University, Lima Campus United Way of Greater Lima United Way of Putnam County University of Toledo Wapakoneta City Schools Waynesfield-Goshen Local Schools West Ohio Community Action Partnership

Schedule H, Part V, Section B, Line 11 Facility F, 1
"Facility F, 1 - Institute for Orthopaedic Surgery. The Institute of Orthopaedic Surgery (IOS) Mental Health and Addiction Implementation Activities: Goal: Improve mental well-being through prevention, early detection and by ensuring access to appropriate, quality mental health services. Reduce substance abuse in the primary service area to protect the health, safety and quality of life for everyone. Reduce substance abuse in the primary service area to protect the health, safety and quality of life 2021 Strategies and Outcomes: * IOS continues to have pre-admission testing nurses perform screenings of patients for ""suicidal thoughts of harming themselves."" In 2021, 6,270 patients were screened. Individuals who reported prior thoughts of self-harm and not currently receiving treatment were offered contact information for mental health resources. * During 2021, IOS continued to maintain its list of substance abuse resources located within the Case Management Department. The pharmacy department facilitated increased awareness among staff and patients of the National Prescription Drug take back days in 2021. * IOS continued its participation in St. Rita's Health Partners Opiate Addiction Task Force during 2021. The Task Force also posts information about medication take-back days when they occur. The Institute for Orthopaedic Surgery (IOS) is an orthopaedic surgical specialty hospital that provides specialized services focused on acute recovery. Because of this, the prioritization team determined there is a limited ability to impact several of the prioritized health needs, including: * Chronic Disease * Maternal and Infant Health * Cross-cutting factor: Access to Care * Cross-cutting factor: Social determinants of health * Cross-cutting factor: Public health system, prevention and health behaviors"

Schedule H, Part V, Section B, Line 13 Facility F, 1
Facility F, 1 - Institute for Orthopaedic Surgery. IOS's financial assistance policy requires a patient or family member to complete an application including gross income for a minimum of 3 months (up to 12 months) prior to the date of application or date of service. Proof of income is required with the exceptions of patients discharged to a skilled nursing facility, patients who are deceased with no estate, and patients who have documented homelessness. Third party income scoring may be used to verify income in situations where income verification is unable to be obtained through other methods.

Schedule H, Part V, Section B, Line 13 Facility F, 1
Facility F, 1 - Institute for Orthopaedic Surgery. IOS's financial assistance policy requires proof that Health Savings Account and/or Medical Savings Account funds be depleted prior to providing healthcare financial assistance. Patients who live in the community served by IOS (Allen county and counties contiguous to Allen county) will be offered healthcare financial assistance. For those patients living outside of the geographic area, extenuating circumstances must be documented and approved by the Administrative Director. IOS's financial assistance policy may require a patient to apply for health insurance coverage or enter the marketplace/exchange before financial assistance may be extended. Exceptions to this policy include patients discharged to a SNF, patients who are deceased with no estate, and patients who have documented homelessness.

Schedule H, Part I, Line 7e Community Health Improvement Services
BSMH hospitals incurred significant additional costs in responding to the COVID-19 pandemic in 2020 and 2021. Certain costs associated with health care support services, including executive and other employee time spent planning for and recovering from the public health emergency and for planning for community COVID-19 vaccine services were included as Community Health Improvement Services. These costs were not directly reimbursed by any provider relief funds or other government funding sources.

Schedule H, Part I, Line 7g Subsidized Health Services
$4,815,210 of costs attributable to physician clinics was included as subsidized health services in 2021. These clinics provide community benefit by improving access to physician services for the poor and underserved.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
486852697

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
Cost of financial assistance at cost was calculated with a cost to charge ratio using worksheet 2. The cost related to Medicaid patients was determined using Bon Secours Mercy Health's cost accounting system and included both inpatients and outpatients for traditional Medicaid and Medicaid managed care plans. For subsidized services Bon Secours Mercy Health's cost accounting system was used to determine costs related to the specific service excluding traditional Medicaid and Medicaid managed care patients. Costs for charity and bad debt accounts are deducted using a ration of cost to charge specific to that subsidized service. Costs for other programs reflect the direct and indirect costs of providing those programs.

Schedule H, Part II Community Building Activities
Bon Secours Mercy Health (BSMH) addresses various community concerns including health improvement, poverty, workforce development, and access to health care. BSMH hospitals conduct community health education and support groups, health fairs and screenings for the communities served. BSMH hospitals work with state and local leadership to address community needs and provide healthcare services to the poor and underserved. BSMH is committed to addressing the social determinants of health (SDOH) and social needs for patients and communities throughout our footprint. With a deep understanding of both areas, the team is working systematically across the ministry and in our local communities to ensure we respond holistically and impactfully. BSMH addresses SDOH through its Community Health Needs Assessment (CHNA), Community, investment strategy, advocacy/public policy partnerships, and cross sector solutions. BSMH addresses social needs through SDOH patient assessment, health education/promotion programs, capacity building of local community resources, and closed loop referral system. BSMH hospitals provide programs to improve the physical surroundings and housing in the communities served. Inadequate housing has a negative impact on the health of residents in the area by leading to violence in the neighborhoods. A robust economy positively impacts residents covered by health insurance and improves the capacity of the community to support health services. Additional detail regarding BSMH's community building activities and the promotion of health of its communities can be found in its 2021 Community Health Annual Report available at https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment and https://www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON BON SECOURS MERCY HEALTH'S (BSMH) HISTORICAL COLLECTION EXPERIENCE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. BSMH'S CONCENTRATION OF CREDIT RISK RELATED TO NET PATIENT ACCOUNTS IS LIMITED DUE TO THE DIVERSITY OF PATIENTS AND PAYORS. NET PATIENT ACCOUNTS CONSIST OF AMOUNTS DUE FROM GOVERNMENTAL PROGRAMS (PRIMARILY MEDICARE AND MEDICAID), PRIVATE INSURANCE COMPANIES, MANAGED CARE PROGRAMS AND PATIENTS THEMSELVES. NET PATIENT SERVICE REVENUE FOR SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE IS RECOGNIZED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED. BSMH RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, BSMH RECOGNIZES REVENUE WHEN SERVICES ARE PROVIDED. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF BSMH'S ININSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, BSMH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. ANY DISCOUNTS APPLIED TO SELF-PAY PATIENTS WOULD BE DEEMED EITHER CHARITY OR A CONTRACTUAL ADJUSTMENT. BAD DEBT WOULD BE BASED ON THE BALANCE AFTER THE CHARITY OR CONTRACTUAL ADJUSTMENT THAT IS DEEMED UNCOLLECTABLE FOLLOWING A REASONABLE COLLECTION EFFORT.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
"BON SECOURS MERCY HEALTH (BSMH) FOLLOWS THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY (""CHA GUIDELINES"") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE MEDICARE LOSSES AS COMMUNITY BENEFIT. BSMH'S COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE MEDICARE AMOUNTS IN PART III."

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
"BON SECOURS MERCY HEALTH'S (BSMH) FINANCIAL ASSISTANCE POLICY DOES NOT PERMIT THE COST OF PATIENTS WHO ARE UNCOOPERATIVE OR UNABLE TO BE LOCATED TO BE RECLASSIFIED FROM FINANCIAL ASSISTANCE TO BAD DEBT. BSMH'S FINANCIAL ASSISTANCE POLICY REQUIRES AN APPLICATION AND SUPPORTING DOCUMENTATION. THEREFORE, ZERO DOLLARS ARE BEING REPORTED ON PART III, LINE 3 AS AMOUNTS INCLUDED IN BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER BSMH'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FOLLOWS THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY (""CHA GUIDELINES"") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE BAD DEBT EXPENSE AS COMMUNITY BENEFIT."

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
BON SECOURS MERCY HEALTH'S (BSMH) AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. BSMH ELECTED TO EARLY ADOPT ASU 2011-07. ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AS AN OPERATING EXPENSE. NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, 2. SIGNIFICANT ACCOUNTING POLICIES, (d) NET PATIENT ACCOUNTS AND NET PATIENT SERVICE REVENUE (PAGE 10) STATES Patient receivables are recorded at net realizable value based on certain assumptions determined by payor class. For third party payors including Medicare, Medicaid, and commercial insurance, the net realizable value is based on the estimated contractual reimbursement percentage, which is based on current contract prices or historical paid claims data by payor. For self-pay receivables, which includes patients who are uninsured and the patient responsibility portion for patients with insurance, the net realizable value is determined using estimates of historical collection experience. These estimates are adjusted for estimated conversions of patient responsibility portions, expected recoveries and any anticipated changes in trends.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAYS AND AFTER, AS WELL AS WITH EACH BILLING NOTICE. BILLS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT REFUSE TO DO SO; WHEN PATIENTS REFUSE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL. Patients that are presumed to be eligible for financial assistance based on individual life circumstances will be provided 100% financial assistance. Patients determined to have presumptive financial assistance eligibility will not be required to meet income criteria, asset eligibility criteria, or fill out a financial assistance application. BSMH utilizes available resources (e.g. technology solutions, service organizations, etc.) to obtain information such as credit scores to assist in determining a patient's presumed eligibility.

Schedule H, Part V, Section B, Line 16a FAP website
A - Mercy Health - St. Vincent Medical Center LLC: Line 16a URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; B - BON SECOURS - MARYVIEW HOSPITAL LLC: Line 16a URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; D - Mercy Health - Lourdes Hospital LLC: Line 16a URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; G - BON SECOURS - SOUTHSIDE MEDICAL CENTER: Line 16a URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; C - Mercy Health - Tiffin Hospital LLC: Line 16a URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; E - BON SECOURS - SOUTHAMPTON MEDICAL CENTER: Line 16a URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; F - Institute for Orthopaedic Surgery: Line 16a URL: HTTPS://WWW.IOSHOSPITAL.COM/ORTHOPAEDICS/HOSPITALBILLINGFINANCIALASSISTANCEPOLICY.ASPX;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - Mercy Health - St. Vincent Medical Center LLC: Line 16b URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; B - BON SECOURS - MARYVIEW HOSPITAL LLC: Line 16b URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; D - Mercy Health - Lourdes Hospital LLC: Line 16b URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; G - BON SECOURS - SOUTHSIDE MEDICAL CENTER: Line 16b URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; C - Mercy Health - Tiffin Hospital LLC: Line 16b URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; E - BON SECOURS - SOUTHAMPTON MEDICAL CENTER: Line 16b URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; F - Institute for Orthopaedic Surgery: Line 16b URL: HTTPS://WWW.IOSHOSPITAL.COM/ORTHOPAEDICS/HOSPITALBILLINGFINANCIALASSISTANCEPOLICY.ASPX;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - Mercy Health - St. Vincent Medical Center LLC: Line 16c URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; B - BON SECOURS - MARYVIEW HOSPITAL LLC: Line 16c URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; D - Mercy Health - Lourdes Hospital LLC: Line 16c URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; G - BON SECOURS - SOUTHSIDE MEDICAL CENTER: Line 16c URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; C - Mercy Health - Tiffin Hospital LLC: Line 16c URL: HTTPS://WWW.MERCY.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; E - BON SECOURS - SOUTHAMPTON MEDICAL CENTER: Line 16c URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE; F - Institute for Orthopaedic Surgery: Line 16c URL: HTTPS://WWW.IOSHOSPITAL.COM/ORTHOPAEDICS/HOSPITALBILLINGFINANCIALASSISTANCEPOLICY.ASPX;

Schedule H, Part VI, Line 2 Needs assessment
BON SECOURS MERCY HEALTH (BSMH) HOSPITALS ASSESS AND CONTINUALLY RESPOND TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. BSMH HOSPITALS JOIN AN EXISTING COMMUNITY-BASED NEEDS ASSESSMENT EVERY THREE YEARS AND UPDATES ARE PROVIDED BETWEEN ASSESSMENTS. BSMH HOSPITALS INCORPORATE PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. BSMH HOSPITALS RECOGNIZE THE HEALTH OF THE COMMUNITY IS INFLUENCED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS, NOT JUST BY DISEASE AND ILLNESS. OUR COMMUNITY BENEFIT INCLUDES BOTH QUALITATIVE AND QUANTITATIVE DATA; DEMOGRAPHICS INCLUDING RACE, AGE, AND ETHNICITY; SOCIOECONOMIC DATA INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES; PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS; AND DATA ON HEALTH DISPARITIES IN HEALTH OUTCOMES AMONG MINORITY GROUPS. BSMH HAS A DEDICATED STAFF TO ASSIST IN THE COMMUNITY BENEFIT EFFORT. BSMH'S COMMUNITY BENEFITS COMMITTEES MEET TO PROVIDE OVERSIGHT TO THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. BSMH HOSPITALS WORK CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS IN THE AREA, PARTNERING WITH SOME TO PROVIDE SERVICES TO AVOID DUPLICATION.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
BON SECOURS MERCY HEALTH (BSMH) HOSPITALS POST THEIR CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. BSMH HOSPITALS PROVIDE A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS AND WITH DISCHARGE MATERIALS. ADDITIONALLY, A COPY OF THE POLICY OR A SUMMARY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IS INCLUDED IN PATIENT BILLS. BSMH HOSPITALS DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. THE HOSPITAL ELIGIBILITY LINK PROGRAM (HELP) IS A FREE REFERRAL SERVICE PROVIDED BY BSMH HOSPITALS. THE PURPOSE OF HELP IS TO ASSIST PATIENTS IN OBTAINING MEDICAL BENEFITS THROUGH FEDERAL, STATE, AND HOSPITAL PROGRAMS. HELP REPRESENTATIVES WILL PROVIDE THE FOLLOWING SERVICES AT NO COST TO THE PATIENT: *EXPLORE ELIGIBILITY UNDER PUBLIC ASSISTANCE PROGRAMS *FILE APPLICATIONS ON PATIENT'S BEHALF *SCHEDULE AND ATTEND APPOINTMENTS *PROVIDE TRANSPORTATION WHEN NECESSARY *PROVIDE MEDICAL DOCUMENTATION TO SOCIAL SECURITY ADMINISTRATION FOR DISABILITY CLAIMS. THROUGH HELP, PATIENTS AND THEIR COUNSELORS LOOK AT WHAT OPTIONS ARE AVAILABLE. BSMH HOSPITALS UNDERSTAND THAT NOT EVERYONE CAN PAY FOR HEALTHCARE SERVICES. HELP IS HERE TO OFFER OPTIONS AND ASSISTANCE FOR THOSE WHO ARE UNINSURED OR UNDERINSURED. HELP IS AN EXTENSION OF BSMH'S MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY WITH EMPHASIS ON THE POOR AND UNDERSERVED. MEETING THE NEEDS OF THOSE WITH LIMITED RESOURCES HAS ALWAYS BEEN THE HEART OF OUR MISSION. BSMH IS PROUD TO MAKE OUR FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO THE PUBLIC THROUGH ANY OF OUR WEBSITES, WHICH CAN BE FOUND AT: https://bsmhealth.org/financial-assistance/ https://www.mercy.com/patient-resources/financial-assistance https://www.bonsecours.com/patient-resources/financial-assistance OTHER PATIENT EDUCATION INFORMATION THAT IS PROVIDED FOR ELIGIBILITY OF ASSISTANCE IS AS FOLLOWS: *BILINGUAL REPRESENTATIVES ARE AVAILABLE IN OUR CUSTOMER SERVICE DEPARTMENTS. *STAFF TRAINING ON HOSPITAL CARE ASSURANCE PROGRAM (HCAP) AND HOSPITAL FINANCIAL ASSISTANCE (HFA) WAS PROVIDED. TRAINING INCLUDED A MANUAL AND IN-DEPTH INFORMATION REGARDING THE PREPARATION OF THE COST REPORT LOGS, ACCURATE COMPLETION OF THE HCAP APPLICATION AS WELL AS AN OVERVIEW OF THE FAQ'S PROVIDED BY THE OHIO HOSPITAL ASSOCIATION. *STAFF TRAINING PROVIDED BY SOCIAL SECURITY ADMINISTRATION TO ASSIST PATIENTS IN OBTAINING DISABILITY BENEFITS. *FINANCIAL ASSISTANCE COUNSELORS WORK WITH CASE MANAGERS TO EXPEDITE THE TRANSFER OF PATIENTS TO EXTENDED CARE FACILITIES. *FEDERAL POVERTY GUIDELINES ARE POSTED ON OUR WEBSITE AS WELL AS A COPY OF OUR CHARITY APPLICATION. *ALL THIRD PARTIES THAT WORK ON BEHALF OF THE ORGANIZATION TO COLLECT FEES (SUCH AS COLLECTION AGENCIES AND LAW FIRMS) ARE REQUIRED TO FOLLOW BSMH'S POLICIES REGARDING PATIENT NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. *CONSISTENT REVIEW OF SELF PAY PATIENTS FOR RETROACTIVE MEDICAID COVERAGE. *SERVICES PROVIDED BY VENDOR TO REACH OUT TO PATIENTS IN BAD DEBT TO SCREEN FOR HCAP ELIGIBILITY. ADDITIONAL DETAIL REGARDING THE BON SECOURS MERCY HEALTH HEALTHCARE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT THE FOLLOWING LINKS: https://www.bonsecours.com/patient-resources/financial-assistance https://www.mercy.com/patient-resources/financial-assistance ADDITIONAL DETAIL REGARDING THE FINANCIAL ASSISTANCE POLICY FOR INSTITUTE FOR ORTHOPAEDIC SURGERY CAN BE FOUND AT THE FOLLOWING LINK: https://www.ioshospital.com/orthopaedics/hospitalBillingFinancialAssistance.aspx

Schedule H, Part VI, Line 4 Community information
THE COMMUNITY FOR EACH HOSPITAL IN THE BON SECOURS MERCY HEALTH (BSMH) SYSTEM IS DEFINED BOTH BY MISSION AND GEOGRAPHY. THE GEOGRAPHIC COMMUNITY IS DEFINED BY EACH HOSPITAL'S IMMEDIATELY CONTIGUOUS AREAS AS WELL AS BY THE BROADER SURROUNDING COUNTIES/REGIONS WHERE THE MAJORITY OF DISCHARGED PATIENTS RESIDE. ADDITIONALLY, THE COMMUNITY INCLUDES PATIENTS WHO REQUIRE THE EXPERTISE AND SPECIALIZED SERVICES OF A BSMH HOSPITAL. ADDITIONAL DETAIL REGARDING THE COMMUNITY FOR EACH HOSPITAL IN THE BSMH SYSTEM CAN BE FOUND IN EACH HOSPITAL'S CHNA AT THE FOLLOWING LINKS: HTTPS://WWW.MERCY.COM/ABOUT-US/MISSION/GIVING-BACK/COMMUNITY-HEALTH-NEEDS-ASSESSMENT https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment ADDITIONAL DETAIL REGARDING THE COMMUNITY FOR INSTITUTE FOR ORTHOPAEDIC SURGERY CAN BE FOUND IN THE HOSPITAL'S CHNA AT THE FOLLOWING LINK: https://www.ioshospital.com/orthopaedics/communityHealthNeedsAssessment.aspx

Schedule H, Part VI, Line 5 Promotion of community health
BON SECOURS MERCY HEALTH (BSMH) HOSPITALS OPERATE EMERGENCY ROOMS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, BSMH HOSPITALS ALSO PROVIDE MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. BSMH HOSPITALS OPERATE TRAUMA SERVICES, AIR AMBULANCE SERVICES, DISEASE MANAGEMENT, WOUND CARE, SPECIALTY CLINICS, DEVELOPMENTAL THERAPY, HOSPICE, HOME CARE, CRISIS INTERVENTION, BEHAVIORAL SERVICES AND SUBSTANCE ABUSE SERVICES. BSMH HOSPITALS HAVE OPEN MEDICAL STAFFS WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITIES SERVED BY BSMH HOSPITALS. THE BSMH BOARD AND ITS MARKET GOVERNING BOARDS ARE COMPOSED OF MEMBERS OF THE COMMUNITIES SERVED WHO DIRECT AND GUIDE MANAGEMENT IN CARRYING OUT THE MISSION OF BSMH. BOARD MEMBERS ARE SELECTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO BSMH AND ITS AFFILIATED HOSPITALS IN FULFILLING ITS MISSION OF PROVIDING HEALTHCARE SERVICES TO THE POOR AND UNDER SERVED. BSMH HOSPITALS ENGAGE IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS. BSMH HOSPITALS PROVIDE RESIDENCY PROGRAMS AND OTHER TRAINING PROGRAMS. BSMH HOSPITALS PARTICIPATE IN MEDICAID, MEDICARE, CHAMPUS, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. BSMH HOSPITAL'S EMERGENCY DEPARTMENTS TREAT AN INCREASING NUMBER OF PATIENTS WHO USE THE FACILITY FOR PRIMARY CARE NEEDS. PATIENT DEMOGRAPHICS REFLECT THE CHANGING COMMUNITY. AS IN OTHER COMMUNITIES, SOME AREA PHYSICIANS PLACE LIMITS ON THEIR ACCEPTANCE OF MEDICAID PATIENTS. IN ADDITION, SOME PRIMARY CARE PHYSICIANS REFER PATIENTS WITH AFTER-HOURS NEEDS DIRECTLY TO AREA EMERGENCY ROOMS. COMMUNITY GROUPS AND INDIVIDUALS ARE VERY SUPPORTIVE OF BSMH. BSMH FORGES COLLABORATIVE RELATIONSHIPS WITH THE FEDERALLY QUALIFIED HEALTH CENTERS IN ITS COMMUNITIES.

Schedule H, Part VI, Line 6 Affiliated health care system
"Bon Secours Mercy Health, Inc., a Maryland nonprofit, nonstock membership corporation (BSMH), and all of the other entities that are controlled directly or indirectly by BSMH are described collectively as the System. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of Ohio, New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSMH aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. As a member of the Catholic health ministry and a member of BSMH, this organization and its related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is ""to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church."" This organization and related organizations share the BSMH Vision. BSMH's vision to partner with communities to create a more humane world, build social justice for all and provide exceptional value for those served is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2019-2021). - Co-Create Healthy Communities: We recognize that the factors which drive health outcomes extend well beyond the scope of traditional health care services. Thus, we commit to improve the health of communities through partnership and collaboration with a broad range of constituencies including committed community residents - Be Person Centric: We recognize that those whom we serve are increasingly engaged in their own care and are seeking convenience, affordability and reliability. Thus, we commit to anticipate and respond to the changing expectations of health care consumers, and to ensure that we engage each person in an individualized plan for health with a focus on prevention and wellness. - Serve Those Who Are Vulnerable: We recognize, by our Catholic identity, that the struggle for a more humane world is not an option, but an integral part of spreading the gospel. Thus, we commit to serve those who are vulnerable in many ways, addressing health disparities, sustaining global ministries, healing the environment and working to end violence and oppression. - Strengthen Our Culture and Capabilities: We recognize that the health care delivery system is undergoing rapid change with increasing complexity. Thus, we commit to liberate the potential of our people by strengthening individual and collective capabilities with respect to ministry leadership, knowledge, analytics, innovation and finances. Please see Schedule R for listings of the related organizations. Each of the reported entities play a role in achieving the vision of BSMH and the SQP (Strategic Quality Plan). System-wide community benefit for 2021 per the audit footnote is as follows: Total 2021 Community Benefit: $605.3 Million Benefits to the Broader Community: $138.9 million Unreimbursed Care for Those Who Are Poor and Qualify for Medicaid: $371.6 million Cost of Care for Those Who Could Not Afford to Pay: $94.8 million Community Benefit as Percent of Total Expense: 5.7 percent."