4A (Expenses $ 311356515 including grants of $ 260007) (Revenue $ 558682519)
GENESIS PROVIDES ACUTE CARE SERVICES INCLUDING MEDICAL, SURGICAL, OBSTETRICAL, PEDIATRIC AND CRITICAL CARE. GENESIS PROVIDES A WIDE RANGE OF DIAGNOSTIC AND SUPPORT SERVICES FOR INPATIENTS AND OUTPATIENTS. THESE SERVICES ARE COMPRISED OF LABORATORY, IMAGING SERVICES, CARDIAC, AND PHARMACY. LABORATORY SERVICES INCLUDE CHEMISTRY, PATHOLOGY, MICROBIOLOGY, HEMATOLOGY, CYTOLOGY, AND PHLEBOTOMY. IMAGING SERVICES INCLUDES RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, CT SCAN, PET SCAN, MAMMOGRAPHY AND BONE DENSITY SCANNING.GENESIS HEART & VASCULAR SERVICES PROVIDE NEEDED HEART CARE FROM PREVENTION TO REHABILITATION. OUR BOARD-CERTIFIED SPECIALISTS INCLUDE CARDIOLOGISTS, CARDIOTHORACIC VASCULAR SURGEONS, ELECTROPHYSIOLOGISTS, INTERVENTIONAL CARDIOLOGISTS, CARDIAC ANESTHESIOLOGISTS AND CARDIAC REHAB SPECIALISTS. THE CARDIOTHORACIC AND VASCULAR SURGICAL TEAMS PERFORM A WIDE VARIETY OF COMPLEX AND HIGH-RISK CARDIAC, THORACIC AND VASCULAR PROCEDURES INCLUDING OPEN HEART SURGERY. OUR CARDIAC TEAM TAKES OUR PATIENTS FROM EVALUATION AND DIAGNOSIS THROUGH LIFESTYLE CHANGES AND TREATMENTS. ALSO INCLUDED IN OUR CARDIAC SERVICES ARE OUR CLINICS AND SPECIALTY PROGRAMS. THESE INCLUDE AN ANTICOAGULATION CLINIC, A CONGESTIVE HEART FAILURE CLINIC, A DEVICE CLINIC, A VEIN CLINIC AND A CARDIAC REHABILITATION PROGRAM. GENESIS IS AN ACCREDITED CHEST PAIN CENTER WITH PCI, AN ACCREDITED ECHOCARDIOGRAPHY FACILITY. RESPIRATORY SERVICES - GENESIS RESPIRATORY & LUNG PROVIDES SERVICES FOR A VARIETY OF LUNG CONDITIONS AND DISEASES INCLUDING LUNG SURGERIES AND RESPIRATORY THERAPY. OUR TEAM, INCLUDING BOARD-CERTIFIED PULMONOLOGISTS, PROVIDE CARE AND TREATMENT FOR PATIENTS WITH PNEUMONIA, LUNG CANCER, BLACK LUNG DISEASE, RESPIRATORY FAILURE, COLLAPSED LUNG, AND OTHER PLEURAL DISEASES. THE GENESIS ORTHOPEDIC TEAM OF BOARD-CERTIFIED SURGEONS, SPECIALLY TRAINED NURSES, AND REHABILITATION THERAPISTS WORK TOGETHER TO DIAGNOSE AND TREAT THE MUSCULOSKELETAL ISSUES OF OUR PATIENTS. SERVICES RANGE FROM ADVANCED IMAGING TESTING THROUGH TO REHABILITATION. SURGICAL SURGERIES INCLUDE NUMEROUS PROCEDURES INCLUDING REPLACEMENT OF THE HIP, KNEE, OR SHOULDER AS WELL AS VARIOUS SURGERIES INVOLVING THE HAND. THE SPECIALIZED REHABILITATION PROGRAM SPEEDS RECOVERY AFTER A SERIOUS INJURY OR SURGERY RELATED TO A BONE, JOINT, LIGAMENT, TENDON OR MUSCLE. IN ADDITION TO PHYSICAL AND OCCUPATIONAL THERAPY, GENESIS ALSO PROVIDES AMPUTEE AND PROSTHETICS THERAPY AND TRAINING.

GENESIS HOSPITAL
"PART V, SECTION B, LINE 5: A PARTNERSHIP WAS DEVELOPED TO DO A COMBINED HEALTH DEPARTMENTS AND GENESIS CHNA. THE GENESIS SERVICE AREA (GSA) COUNTY HEALTH DEPARTMENTS AND OHIO UNIVERSITY COLLABORATED TO DESIGN A MECHANISM TO COMPLETE THE 2021 CHNA. THIS PARTNERSHIP BECAME THE SOUTHEASTERN OHIO HEALTH IMPROVEMENT COLLABORATIVE (SOHIC) AND IS MADE UP OF COSHOCTON CITY AND COUNTY HEALTH DEPARTMENTS, GENESIS, MORGAN COUNTY HEALTH DEPARTMENT, NOBLE COUNTY HEALTH DEPARTMENT, PERRY COUNTY HEALTH DEPARTMENT, ZANESVILLE-MUSKINGUM COUNTY HEALTH DEPARTMENT, OHIO ALLIANCE FOR POPULATION HEALTH, OHIO UNIVERSITY'S (OU) COLLEGE OF HEALTH SCIENCES AND PROFESSIONS, AND THE OU'S VOINOVICH SCHOOL OF LEADERSHIP AND PUBLIC SERVICE. SOHIC CONTRACTED WITH THE NORTHWEST HOSPITAL COUNCIL OF OHIO TO DESIGN THE ASSESSMENT TOOLS, ADD RELEVANT SECONDARY AND MORTALITY DATA, AND DEVELOP THE REPORTS. THE INFORMATION CONTAINED IN THE 2021 CHNA REPORT ARE BASED UPON DATA OBTAINED FROM RESPONSES TO WRITTEN COMMUNITY HEALTH SURVEYS (CHS) THAT WERE COLLECTED FROM APRIL THROUGH MAY 2021. THE CHS FOCUSED ON ADULTS AGES 19 AND OLDER. IN ORDER TO MAINTAIN COMPLETE OBJECTIVITY THROUGHOUT THE SURVEY PROCESS, THE COLLABORATIVE ENGAGED THE SERVICES OF THE HOSPITAL COUNCIL OF NORTHWEST OHIO AND OHIO UNIVERSITY TO ADMINISTER THE SURVEYS AND COMPILE THE RESULTS. SURVEYS WERE ALSO CONDUCTED WITH KEY LEADERS FROM THE GSA COUNTIES. THESE SURVEYS WERE INCLUDED IN THE ANALYSIS OF THIS REPORT AND INFORMED PRIORITIZATION OF ALL THE RESULTS TO IDENTIFY THE TOP HEALTH NEEDS OF OUR COMMUNITIES. GENESIS COMMUNITY BENEFIT STEERING COMMITTEE PRIORITIZED THE INFORMATION AND DETERMINED SIX TOP HEALTH NEEDS: MENTAL HEALTH ISSUES, HEART DISEASE, CANCER, STROKE, DIABETES, AND SOCIAL DETERMINANTS OF HEALTH.PROCESS AND METHODS FOR ENGAGING COMMUNITY: MULTIPLE SECTORS, INCLUDING THE GENERAL PUBLIC, WERE ASKED THROUGH EMAIL LIST SERVS, SOCIAL MEDIA, AND PUBLIC NOTICES TO PARTICIPATE IN THE PROCESS, INCLUDING DEFINING THE SCOPE OF THE PROJECT, CHOOSING QUESTIONS FOR THE CHS, REVIEWING INITIAL DATA, PLANNING A COMMUNITY RELEASE, AND IDENTIFYING AND PRIORITIZING NEEDS. SOHIC WORKED TOGETHER TO CREATE ONE COMPREHENSIVE CHNA, WITH MORE THAN 88 COMMUNITY MEMBERS ATTENDING THE COUNTIES' RELEASE OF THE REPORT AND PROVIDING FEEDBACK ON THE KEY ISSUES FOR THE GSA.PRIMARY DATA COLLECTION METHODS:THE FINDINGS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT ARE BASED ON SELF-ADMINISTERED CHS USING A STRUCTURED QUESTIONNAIRE. THE QUESTIONS WERE MODELED AFTER THE SURVEY INSTRUMENTS USED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) FOR THEIR NATIONAL AND STATE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). THE HCNO ASSISTED WITH CHS DEVELOPMENT, GUIDED THE HEALTH ASSESSMENT PROCESS, AND INTEGRATED SOURCES OF PRIMARY AND SECONDARY DATA INTO THE FINAL REPORT. OU SOUGHT INSTITUTIONAL REVIEW BOARD (IRB) APPROVAL FOR THE CHS, ADMINISTERED THE CHS, AND COLLECTED THE DATA.THIS CHS COMPLETION PROCESS WAS CROSS-SECTIONAL IN NATURE AND INCLUDED A WRITTEN CHS OF ADULTS WITHIN COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY COUNTIES. FROM THE BEGINNING, COMMUNITY LEADERS AND MEMBERS WERE ACTIVELY ENGAGED IN THE CHS PLANNING PROCESS AND HELPED DEFINE THE CONTENT, SCOPE, AND SEQUENCE OF THE CHS. ACTIVE ENGAGEMENT OF COMMUNITY MEMBERS THROUGHOUT THE CHNA PLANNING PROCESS IS REGARDED AS AN IMPORTANT STEP IN COMPLETING A VALID CHNA.ONE ADULT CHS INSTRUMENT WAS DESIGNED FOR THE CHNA. AS A FIRST STEP IN THE DESIGN PROCESS, HEALTH EDUCATION RESEARCHERS FROM THE UNIVERSITY OF TOLEDO AND STAFF MEMBERS FROM HCNO MET TO DISCUSS POTENTIAL SOURCES OF VALID AND RELIABLE CHS ITEMS THAT WOULD BE APPROPRIATE TO ASSESS THE HEALTH STATUS AND HEALTH NEEDS OF ADULTS. THE INVESTIGATORS DECIDED TO DERIVE THE MAJORITY OF THE ADULT SURVEY ITEMS FROM THE BRFSS. THIS DECISION WAS BASED ON BEING ABLE TO COMPARE LOCAL DATA WITH STATE AND NATIONAL DATA. THE PROJECT COORDINATOR FROM HCNO CONDUCTED A MEETING WITH SOHIC. DURING THIS MEETING, HCNO AND SOHIC REVIEWED AND DISCUSSED BANKS OF POTENTIAL SURVEY QUESTIONS FROM THE BRFSS. BASED ON INPUT FROM SOHIC, THE PROJECT COORDINATOR COMPOSED A DRAFT ADULT CHS CONTAINING 110 ITEMS. IRB APPROVAL WAS GRANTED TO OU BY OU'S SOCIAL AND BEHAVIORAL IRB.THE SAMPLING FRAME FOR THE ADULT CHS CONSISTED OF ADULTS AGES 19 AND OLDER LIVING IN COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY COUNTIES. SEE BELOW FOR THE ESTIMATED NUMBER OF PEOPLE AGES 19 AND OLDER LIVING IN EACH COUNTY. THE HCNO STAFF ANALYSTS CONDUCTED A POWER ANALYSIS TO DETERMINE WHAT SAMPLE SIZE WAS NEEDED TO ENSURE A 95% CONFIDENCE LEVEL WITH A CORRESPONDING MARGIN OF ERROR OF 6% (I.E., THERE CAN BE 95% ASSURANCE THAT THE ""TRUE"" POPULATION RESPONSES ARE WITHIN A 6% MARGIN OF ERROR OF THE CHS FINDINGS)THE RANDOM SAMPLE OF MAILING ADDRESSES OF ADULTS FROM COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY COUNTIES WAS OBTAINED FROM MELISSA DATA CORPORATION IN RANCHO SANTA MARGARITA, CALIFORNIA. CHS WERE MAILED IN EARLY APRIL 2021 AND RETURNED THROUGH MID-MAY 2021.PRIOR TO MAILING THE CHS, OU MAILED AN ADVANCE LETTER TO 2,000 ADULTS IN EACH COUNTY (COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY). THIS ADVANCE LETTER WAS PRINTED ON SOHIC STATIONERY AND SIGNED ON BEHALF OF THE GROUP BY THE CO-CHAIRS LINDA SUPPLEE OF GENESIS AND ANGELA DEROLPH OF THE PERRY COUNTY HEALTH DEPARTMENT. THE LETTER INTRODUCED THE CHNA PROJECT AND INFORMED READERS THAT THEY MAY BE RANDOMLY SELECTED TO RECEIVE THE CHS. THE LETTER ALSO EXPLAINED THAT THE RESPONDENTS' CONFIDENTIALITY WOULD BE PROTECTED, AND IT ENCOURAGED THE READERS TO COMPLETE AND RETURN THE CHS PROMPTLY IF THEY WERE SELECTED. LETTERS RETURNED AS UNDELIVERABLE WERE NOT REPLACED WITH ANOTHER POTENTIAL RESPONDENT TO RECEIVE THE CHS. LASTLY, IT IS IMPORTANT TO NOTE THAT THE ADVANCE WAVE LETTER STATED THAT IF THE RECIPIENT WAS SELECTED TO RECEIVE THE CHS, THEY WOULD RECEIVE A $2 BILL AS A THANK YOU FOR THEIR TIME TO COMPLETE THE CHS. AFTER SENDING THE LETTER, OU ENCOUNTERED PROBLEMS WITH THIS RECRUITMENT STRATEGY DUE TO INSTITUTIONAL RULES ABOUT EXCHANGING MONEY. A GIFT CARD DRAWING REPLACED THE $2 BILL INCENTIVE THAT WAS ORIGINALLY NOTED. THE LETTER INCLUDED ADDITIONAL INFORMATION REGARDING THE DRAWING WITH INFORMATION ON HOW TO ENTER BY FILLING OUT A POSTAGE-PAID CARD THAT WAS INCLUDED IN THE MAILING. INDIVIDUALS RECEIVING THE CHS AND POST CARD WERE ASKED TO PROVIDE EITHER THEIR PHONE NUMBER OR EMAIL ADDRESS AND INSTRUCTED TO MAIL THE POSTAGE PAID, POST CARD SEPARATELY FROM THEIR CHS. THIRTEEN WEEKS FOLLOWING THE ADVANCE LETTER, AN ADDITIONAL MAILING WAS ADMINISTERED. THE MAILING INCLUDED A PERSONALIZED, HAND SIGNED COVER LETTER (ON SOHIC STATIONERY) DESCRIBING THE PURPOSE OF THE CHS AND THE CHANCES OF WINNING A GIFT CARD, THE QUESTIONNAIRE, A SELF-ADDRESSED STAMPED RETURN ENVELOPE, AND A POSTCARD TO ENTER THE DRAWING FOR A $100 OR $25 GIFT CARD. THE MAILING MATERIALS WERE INCLUDED IN A LARGE COLORED ENVELOPE. A TOTAL OF 3,000 CHS PER COUNTY WERE SENT OUT BY OU. HSAS RETURNED AS UNDELIVERABLE WERE NOT REPLACED WITH ANOTHER POTENTIAL RESPONDENT.INDIVIDUAL CHS RESPONSES WERE ANONYMOUS. ONLY GROUP DATA WAS AVAILABLE. ALL DATA WAS ANALYZED BY HEALTH EDUCATION RESEARCHERS AT THE UNIVERSITY OF TOLEDO USING STATISTICAL PRODUCT AND SERVICE SOLUTIONS 26.0 (SPSS). CROSSTABS WERE USED TO CALCULATE DESCRIPTIVE STATISTICS FOR THE DATA PRESENTED IN THIS REPORT. TO BE REPRESENTATIVE OF EACH COUNTY, THE ADULT CHS DATA COLLECTED WAS WEIGHTED BY AGE, GENDER, RACE, AND INCOME USING CENSUS DATA.DATA FROM SAMPLE SURVEYS HAVE THE POTENTIAL FOR BIAS IF THERE ARE DIFFERENT RATES OF RESPONSE FOR DIFFERENT SEGMENTS OF THE POPULATION. IN OTHER WORDS, SOME SUBGROUPS OF THE POPULATION MAY BE MORE REPRESENTED IN THE COMPLETED SURVEYS THAN THEY ARE IN THE POPULATION FROM WHICH THOSE SURVEYS ARE SAMPLED. IF A SAMPLE HAS 25% OF ITS RESPONDENTS BEING MALE AND 75% BEING FEMALE, THEN THE SAMPLE IS BIASED TOWARDS THE VIEWS OF FEMALES (IF FEMALES RESPOND DIFFERENTLY THAN MALES). THIS SAME PHENOMENON HOLDS TRUE FOR ANY POSSIBLE CHARACTERISTIC THAT MAY ALTER HOW AN INDIVIDUAL RESPONDS TO THE SURVEY ITEMS. IN SOME CASES, THE PROCEDURES OF THE SURVEY METHODS MAY PURPOSEFULLY OVER-SAMPLE A SEGMENT OF THE POPULATION IN ORDER TO GAIN AN APPROPRIATE NUMBER OF RESPONSES FROM THAT SUBGROUP FOR APPROPRIATE DATA ANALYSIS WHEN INVESTIGATING THEM SEPARATELY (THIS IS OFTEN DONE FOR MINORITY GROUPS). WHETHER THE OVER-SAMPLING IS DONE INADVERTENTLY OR PURPOSEFULLY, THE DATA NEEDS TO BE WEIGHTED SO THAT THE PROPORTIONED CHARACTERISTICS OF THE SAMPLE ACCURATELY REFLECT THE PROPORTIONED CHARACTERISTICS OF THE POPULATION. IN THE 2021 COSHOCTON, MORGAN, MUSKINGUM, NOBLE, AND PERRY SURVEYS, A WEIGHTING WAS APPLIED PRIOR TO THE ANALYSIS THAT WEIGHTED THE SURVEY RESPONDENTS TO REFLECT THE ACTUAL DISTRIBUTION OF EACH COUNTY BASED ON AGE, SEX, RACE, AND INCOME."

GENESIS HOSPITAL
PART V, SECTION B, LINE 6B: THE SOUTHEAST OHIO HEALTH IMPROVEMENT COLLABORATIVE (SOHIC) COMMISSIONED AND FUNDED THE COMMUNITY HEALTH NEEDS ASSESSMENT: COSHOCTON CITY HEALTH DEPARTMENT COSHOCTON COUNTY HEALTH DEPARTMENT GENESIS HEALTHCARE SYSTEM MORGAN COUNTY HEALTH DEPARTMENT NOBLE COUNTY HEALTH DEPARTMENT OHIO ALLIANCE FOR POPULATION HEALTH OHIO UNIVERSITY'S (OU) COLLEGE OF HEALTH SCIENCES AND PROFESSIONS OU'S VOINOVICH SCHOOL OF LEADERSHIP AND PUBLIC SERVICE PERRY COUNTY HEALTH DEPARTMENT ZANESVILLE/MUSKINGUM COUNTY HEALTH DEPARTMENT

GENESIS HOSPITAL
PART V, SECTION B, LINE 7D: THE CHNA REPORT IS AVAILABLE ON OUR WEBSITE AT HTTP://GENESISHCS.ORG, AT THE BOTTOM OF THE FRONT PAGE. THE REPORT WAS SHARED WITH COMMUNITY PARTNERS AND COPIES ARE AVAILABLE FOR FREE UPON REQUEST.

GENESIS HOSPITAL
PART V, SECTION B, LINE 11: THIS IMPLEMENTATION STRATEGY (IS) OUTLINES THE GENESIS SERVICE LINE'S PLANS TO ADDRESS THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2021 CHNA. SERVICE LINES CONSIDERED SPECIFIC PROGRAMS, RESOURCES, AND PRIORITIES FOR THE COMMUNITY WHEN DEVELOPING THIS STRATEGY. SERVICE LINES INVOLVED IN THE DESIGN INCLUDE: BEHAVIORAL HEALTH CANCER SERVICES DIABETES & NUTRITION SERVICES EDUCATIONAL SERVICES EMERGENCY SERVICES HEART & VASCULAR SERVICES HOSPICE & PALLIATIVE CARE MARKETING & PUBLIC RELATIONS MISSION NURSELINE ORTHOPEDIC CENTER PATIENT EXPERIENCE PERRY COUNTY EMERGENCY DEPARTMENT POPULATION HEALTH PULMONARY SERVICES REHABILITATION & AMBULATORY SERVICES SPIRITUAL CARE TRAUMA SERVICES, VOLUNTEER SERVICES WOMEN'S & CHILDREN'S SERVICE SIX TOP COMMUNITY HEALTH PRIORITIES WERE IDENTIFIED AND WILL BE OF PRIMARY FOCUS:1. MENTAL HEALTH ISSUES2. HEART DISEASE3. CANCER4. STROKE5. DIABETES6. SOCIAL DETERMINANTS OF HEALTHFOR THOSE NEEDS NOT CAPTURED IN THE TOP SIX PRIORITY FOCUS AREAS, THERE ARE ADDITIONAL COMMUNITY BENEFIT INITIATIVES THAT WILL BE PROVIDED FOR THE OTHER AREAS OF NEEDS. THOSE ADDITIONAL INITIATIVES ARE DEFINED IN THE IMPLEMENTATION STRATEGY. EDUCATIONAL SERVICES EMERGENCY SERVICES HOSPICE & PALLIATIVE CARE MARKETING & PUBLIC RELATIONS MISSION NURSELINE ORTHOPEDIC CENTER PATIENT EXPERIENCE PERRY COUNTY EMERGENCY DEPARTMENT PULMONARY SERVICES REHABILITATION & AMBULATORY SERVICES SPIRITUAL CARE TRAUMA SERVICES, VOLUNTEER SERVICES WOMEN'S & CHILDREN'S SERVICE

SCHEDULE H, PART V, LINE 5 CON'T:
MULTIPLE SETS OF WEIGHTINGS WERE CREATED AND USED IN THE STATISTICAL SOFTWARE PACKAGE (SPSS 26.0) WHEN CALCULATING FREQUENCIES. FOR ANALYSES DONE FOR THE ENTIRE SAMPLE AND ANALYSES DONE BASED ON SUBGROUPS OTHER THAN AGE, RACE, SEX, OR INCOME THE WEIGHTINGS THAT WERE CALCULATED BASED ON THE PRODUCT OF THE FOUR WEIGHTING VARIABLES (AGE, RACE, SEX, INCOME) FOR EACH INDIVIDUAL. WHEN ANALYSES WERE DONE COMPARING GROUPS WITHIN ONE OF THE FOUR WEIGHTING VARIABLES (E.G., SMOKING STATUS BY RACE/ETHNICITY), THAT SPECIFIC VARIABLE WAS NOT USED IN THE WEIGHTING SCORE THAT WAS APPLIED IN THE SOFTWARE PACKAGE. IN THE EXAMPLE SMOKING STATUS BY RACE, THE WEIGHTING SCORE THAT WAS APPLIED DURING ANALYSIS INCLUDED ONLY AGE, SEX, AND INCOME. THUS, A TOTAL OF EIGHT WEIGHTING SCORES FOR EACH INDIVIDUAL WERE CREATED AND APPLIED DEPENDING ON THE ANALYSIS CONDUCTED.

PART I, LINE 7:
COSTS OF CHARITY CARE AND COMMUNITY BENEFIT ACTIVITIES WERE CALCULATED USING THE HOSPITAL'S COST ACCOUNTING SYSTEM.PART I, LINE 7, COLUMN (F): PERCENTAGE OF TOTAL EXPENSES WAS CALCULATED BASED ON TOTAL EXPENSES LESS BAD DEBT EXPENSE AS REPORTED ON FORM 990, PART IX.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 20,676,788.

PART II, COMMUNITY BUILDING ACTIVITIES:
GENESIS HAS AN ACTIVE PRESENCE ON MANY COMMITTEES INVOLVED IN FINDING LOW COST SOLUTIONS TO PHYSICAL AND MENTAL HEALTH ISSUES PREVALENT IN OUR COMMUNITIES, WITH PARTICULAR FOCUS ON SERVING LOW-INCOME, UNINSURED OR OTHERWISE UNDERSERVED. THESE ACTIVITIES ARE CAPTURED IN CBISA AS IN-KIND CONTRIBUTIONS BY THE SERVICE LINES UNDER COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. COMMUNITY BUILDING ACTIVITIES ARE CURRENTLY NOT PART OF THE DOCUMENTATION FOR COMMUNITY BENEFIT.

PART III, LINE 2:
BAD DEBT IS CALCULATED USING GROSS CHARGES.

PART III, LINE 3:
NO BAD DEBT IS ESTIMATED TO RELATE TO CHARITY CARE.

PART III, LINE 4:
"THE FINANCIAL STATEMENT FOOTNOTE RELATED TO BAD DEBT IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENT FOOTNOTE 1 ""NATURE OF BUSINESS AND SIGNIFICANT ACCOUNTING POLICIES"" GROUPED WITH ACCOUNTS RECEIVABLE ON PAGE 9."

PART III, LINE 8:
THE SYSTEM TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE REASONS FOR THIS TREATMENT INCLUDES (1) NON-NEGOTIABLE MEDICARE RATES ARE SOMETIMES NOT ALIGNED WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; (2) THE SYSTEM IS ALLEVIATING THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES; AND (3) IRS REV. RUL. 69-545 NOTES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS ACTION INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.

PART III, LINE 9B:
ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY (PLS) OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE FROM THE HOSPITAL. AT LEAST THREE SEPARATE COMMUNICATIONS WILL BE MAILED TO THE LAST KNOWN ADDRESS OF THE RESPONSIBLE PARTY ALSO CONTAINING THE PLS. AT LEAST 60 DAYS WILL LAPSE BETWEEN THE FIRST AND THIRD REQUIRED COMMUNICATION. DETAILED ITEMIZED STATEMENTS WILL BE MADE AVAILABLE UPON REQUEST EXCEPT WHERE PROHIBITED BY STATE OR FEDERAL REGULATIONS. ACCOUNTS WITH ZERO BALANCES WILL NOT RECEIVE THREE SEPARATE COMMUNICATIONS; HOWEVER, THESE ACCOUNT HOLDERS MAY ALSO BE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE. ALL RESPONSIBLE PARTIES WILL RECEIVE WRITTEN NOTIFICATION REGARDING EXTRAORDINARY COLLECTION ACTIONS (ECA) THAT MAY COMMENCE IF ACTION IS NOT TAKEN. THIRTY DAYS WILL LAPSE BETWEEN ISSUANCE OF NOTIFICATION AND COMMENCEMENT OF ECA. ACTION TAKEN BY THE RESPONSIBLE PARTY CONSTITUTES MAKING PAYMENT ARRANGEMENTS FOR THE AMOUNT DUE OR COMPLETING A FINANCIAL ASSISTANCE APPLICATION. ACCOUNTS GO TO FULL COLLECTION AFTER DAY 120 IF NO PRIOR ARRANGEMENTS HAVE BEEN MADE. COLLECTION AGENCIES ARE INSTRUCTED TO MAKE PHONE CALLS AND SEND LETTERS. IF THEY CANNOT RESOLVE THE BALANCE, OR HAVE NOT BEEN ABLE TO MAKE PAYMENT ARRANGEMENTS, THE ACCOUNT IS SENT BACK TO GENESIS AS NON-COLLECTIBLE IN 18 MONTHS.

PART VI, LINE 2:
GENESIS HEALTHCARE SYSTEM, AS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, IS DEDICATED TO MEETING THE HEALTH NEEDS OF OUR COMMUNITIES, REGARDLESS OF ONE'S ABILITY TO PAY. WE ENCOURAGE AND SUPPORT COLLABORATION WITH OTHER COMMUNITY PARTNERS TO IDENTIFY, RESPOND TO AND STRIVE TO IMPROVE THE HEALTH-RELATED NEEDS OF THE POOR, THE UNDERSERVED, AND THE COMMUNITY AT LARGE. WE PLEDGE ALL AVAILABLE FINANCIAL RESOURCES - AFTER OUR OPERATING EXPENSES ARE MET - TO RESPOND TO THE COMMUNITY'S HEALTH NEEDS WITH SERVICE INITIATIVES, FINANCIAL AND PROFESSIONAL SUPPORT, AND EDUCATION AND WELLNESS PROGRAMS.THE COMMUNITY BENEFIT COMMITTEE COLLABORATES WITH GENESIS ADMINISTRATION AND DEPARTMENTS AND WITH COMMUNITY AGENCIES IN OUR DEFINED GEOGRAPHIC MARKET, INCLUDING BUT NOT LIMITED TO THE PUBLIC HEALTH DEPARTMENTS, MUSKINGUM VALLEY HEALTH CENTERS, AND THE UNITED WAY, TO ASSESS COMMUNITY HEALTH NEEDS AND STRENGTHS; DEVELOP A COMMUNITY BENEFIT PLAN WITH STRATEGIC GOALS AND INTERVENTIONS; MONITOR IMPLEMENTATION OF COMMUNITY BENEFIT ACTIVITIES; EVALUATE COMMUNITY BENEFIT ACTIVITIES; ADVOCATE FOR THE COMMUNITY BENEFIT PROGRAMS; AND ASSIST IN TELLING THE GENESIS HOSPITAL COMMUNITY BENEFIT STORY.

PART VI, LINE 3:
GENESIS HAS SIGNAGE STRATEGICALLY LOCATED IN THE FACILITY (REGISTRATION AREAS AND CASHIER AREAS) ADVISING OF FREE CARE. BILLING STATEMENTS ALSO CONTAIN THIS INFORMATION ALONG WITH A CHARITY CARE APPLICATION PRINTED ON THE REVERSE SIDE OF THE BILL. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. WE HAVE REGISTRATION STAFF THAT WORK IN THE EMERGENCY DEPARTMENT TO SCREEN PATIENTS FOR POTENTIAL MEDICAID QUALIFIERS IF THE PATIENT ALLOWS. FOR INPATIENTS, WE HAVE RESOURCE COUNSELING STAFF THAT SCREEN SELF-PAY, UNDERINSURED AND MEDICARE ONLY PATIENTS FOR MEDICAID AND/OR CHARITY.

PART VI, LINE 4:
OUR GEOGRAPHIC MARKET AREA IS A SIX-COUNTY RURAL REGION OF SOUTHEAST OHIO, INCLUDING MUSKINGUM, MORGAN, PERRY, COSHOCTON, GUERNSEY AND NOBLE COUNTIES. IN 2019, TOTAL MARKET AREA POPULATION WAS APPROXIMATELY 226,453, WITH MUSKINGUM COUNTY (86,131) REPRESENTING THE LARGEST COUNTY. MEDIAN HOUSEHOLD INCOME LEVELS RANGE FROM $46,883 TO $52,105 WHICH IS PREDOMINATELY LOWER THAN THE STATE MEDIAN HOUSEHOLD INCOME OF $58,704 AND EVEN LOWER THAN THE NATIONAL MEDIAN HOUSEHOLD INCOME OF $65,712. 17.8 % PEOPLE LIVING BELOW POVERTY LEVEL IN THE REGION VERSES 14.5% FOR THE STATE AND 13% FOR THE NATION. IN 2019, CHILDREN IN POVERTY RANGE FROM 16% TO 22.2% IN OUR REGION COMPARED TO 18% FOR THE STATE OF OHIO.

PART VI, LINE 6:
GENESIS HOSPITAL AND ITS AFFILIATES ARE REACHING OUT TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH COMMUNITY INITIATIVES, MANY BASED ON PREVENTION. SOME EXAMPLES INCLUDE:- PROVIDING CLINICAL EXPERIENCES FOR NURSING, MEDICAL, AND OTHER HEALTH PROFESSIONAL STUDENTS - COMMUNITY HEALTH EDUCATION/HEALTH PROMOTION INITIATIVES ON VARIOUS HEALTH TOPICS - PROVIDE HEALTHCARE SUPPORT SERVICES SUCH AS NURSELINE- SUBSIDIZED HEALTH SERVICES SUCH AS THE VACCINATIONS FOR COVID-19 AND MEDICAL CLINICS FOR COVID POSITIVE MEMBERS- SUPPORT GROUPS ARE AVAILABLE FOR VARIOUS HEALTH CONDITIONS

PART VI, LINE 5:
ONGOING COMMUNITY HEALTH EDUCATION IS PROVIDED THROUGH REGULARLY SCHEDULED HEALTH AND WELLNESS PROGRAMS PRESENTED BY GENESIS STAFF AND AFFILIATED PHYSICIANS. PREVENTATIVE HEALTH SCREENINGS ARE PROVIDED FOR PULSE OX AND I.M.P.A.C.T (IMMEDIATE POST-CONCUSSION ASSESSMENT AND COGNITIVE TESTING). PROGRAM TOPICS ARE BASED ON COMMUNITY NEED AS DETERMINED BY FEEDBACK FROM PARTICIPANTS, THE COMMUNITY BENEIFIT COMMITTEE AND SERVICE LINE LEADERS. GENESIS ALSO REGULARLY PROVIDES HEALTH AND WELLNESS PROMOTION THROUGH COMMUNITY-BASED HEALTH FAIRS AND EVENTS HELD THROUGHOUT THE COMMUNITY. CLINICAL EXPERIENCES ARE OFFERED FOR HEALTHCARE STUDENTS AS WELL AS TRAINING OPPORTUNITIES FOR HEALTHCARE PROFESSIONALS.GENESIS COMMUNITY AMBULANCE SERVICE BEGAN GIVING PATIENTS WHO WERE IN NEED OF TRANSPORATION FREE RIDES HOME IN 2021 AS WELL, BECAUSE MANY LOCAL TRANSPORATION AGENCIES (BUSSES, TAXIS) WOULD NOT GIVE RIDES TO PATIENTS WHO MAY HAVE BEEN EXPOSED TO COVID-19, OR TESTED POSITIVE, DURING THEIR HOSPITAL STAY. IN 2022 GENESIS HEALTHCARE SYSTEM BEGAN REIMBURSING THE COSTS OF THESE RIDES, THOUGH THEY BEGAN IN 2021. ACCESS TO TRANSPORATION CONTINUES TO BE A GREAT NEED IN THE GENESIS SERVICE AREA.