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University Hospitals Health System Inc Group Return

3605 Warrensville Center Road
Shaker Heights, OH 44122
EIN: 900059117
Individual Facility Details: Uh St John Medical Center
29000 Center Ridge Road
Westlake, OH 44145
Bed count240Medicare provider number360123Member of the Council of Teaching HospitalsYESChildren's hospitalNO

University Hospitals Health System Inc Group ReturnDisplay data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
12.23%
Spending by Community Benefit Category- 2021
(as % of total functional expenses)
* = CBI denoted preventative categories
Community Benefit Spending Compared to Functional Expenses, 2010-2021
Additional data

Community Benefit Expenditures: 2021

  • All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.

    • Operating expenses$ 4,085,584,000
      Total amount spent on community benefits
      as % of operating expenses
      $ 499,468,178
      12.23 %
  • Amount spent in the following IRS community benefit categories:
      • Financial Assistance at cost
        as % of operating expenses
        $ 49,505,851
        1.21 %
        Medicaid
        as % of operating expenses
        $ 258,480,983
        6.33 %
        Costs of other means-tested government programs
        as % of operating expenses
        $ 0
        0 %
        Health professions education
        as % of operating expenses
        $ 103,866,145
        2.54 %
        Subsidized health services
        as % of operating expenses
        $ 14,079,395
        0.34 %
        Research
        as % of operating expenses
        $ 65,502,972
        1.60 %
        Community health improvement services and community benefit operations*
        as % of operating expenses
        Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.
        $ 7,483,390
        0.18 %
        Cash and in-kind contributions for community benefit*
        as % of operating expenses
        $ 549,442
        0.01 %
        Community building*
        as % of operating expenses
        $ 34,274
        0.00 %
    • * = CBI denoted preventative categories
    • Community building activities details:
        • Did tax-exempt hospital report community building activities?YES
          Number of activities or programs (optional)0
          Physical improvements and housing0
          Economic development0
          Community support0
          Environmental improvements0
          Leadership development and training for community members0
          Coalition building0
          Community health improvement advocacy0
          Workforce development0
          Other0
          Persons served (optional)0
          Physical improvements and housing0
          Economic development0
          Community support0
          Environmental improvements0
          Leadership development and training for community members0
          Coalition building0
          Community health improvement advocacy0
          Workforce development0
          Other0
          Community building expense
          as % of operating expenses
          $ 34,274
          0.00 %
          Physical improvements and housing
          as % of community building expenses
          $ 0
          0 %
          Economic development
          as % of community building expenses
          $ 0
          0 %
          Community support
          as % of community building expenses
          $ 34,274
          100 %
          Environmental improvements
          as % of community building expenses
          $ 0
          0 %
          Leadership development and training for community members
          as % of community building expenses
          $ 0
          0 %
          Coalition building
          as % of community building expenses
          $ 0
          0 %
          Community health improvement advocacy
          as % of community building expenses
          $ 0
          0 %
          Workforce development
          as % of community building expenses
          $ 0
          0 %
          Other
          as % of community building expenses
          $ 0
          0 %
          Direct offsetting revenue$ 0
          Physical improvements and housing$ 0
          Economic development$ 0
          Community support$ 0
          Environmental improvements$ 0
          Leadership development and training for community members$ 0
          Coalition building$ 0
          Community health improvement advocacy$ 0
          Workforce development$ 0
          Other$ 0

    Other Useful Tax-exempt Hospital Information: 2021

    • In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

      • Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt
        as % of operating expenses
        $ 125,090,010
        3.06 %
        Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?NO
    • Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy

      The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

      • Does the organization have a written financial assistance (charity care) policy?YES
        Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?YES
        Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy
        as % of operating expenses
        $ 0
        0 %
    • Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
      • Reported to credit agencyNot available
    • Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.

      • After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid?YES
    • The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.

      • If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines?Not available
    • In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

      • Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute?YES

    Community Health Needs Assessment Activities: 2021

    • The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

      • Did the tax-exempt hospital report that they had conducted a CHNA?YES
        Did the CHNA define the community served by the tax-exempt hospital?YES
        Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?YES
        Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?YES
        Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?YES

    Supplemental Information: 2021

    This section presents qualitative information submitted by the hospital, verbatim from the 990H record.
    • Statement of Program Service Accomplishments
      Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
    • 4A (Expenses $ 3828173000 including grants of $ 1895000) (Revenue $ 4318525860)
      SEE SCHEDULE O.
      Facility Information
      Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.
      PART V, SECTION B
      FACILITY REPORTING GROUP A
      FACILITY REPORTING GROUP A CONSISTS OF:
      - FACILITY 1: UH CLEVELAND MEDICAL CENTER, - FACILITY 2: UH RAINBOW BABIES & CHILDREN'S HOSPITAL, - FACILITY 4: UH AHUJA MEDICAL CENTER, - FACILITY 5: UH REGIONAL HOSPITALS, - FACILITY 6: UH GENEVA MEDICAL CENTER, - FACILITY 7: UH CONNEAUT MEDICAL CENTER, - FACILITY 8: UH PARMA MEDICAL CENTER, - FACILITY 9: UH ELYRIA MEDICAL CENTER, - FACILITY 10: UH ST. JOHN MEDICAL CENTER, - FACILITY 11: UH PORTAGE MEDICAL CENTER, - FACILITY 13: UNIVERSITY HOSPITALS REHABILITATION HOSPITAL, - FACILITY 14: UH AVON REHABILITATION HOSPITAL
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE ASSESSMENT ALSO ENCOMPASSES INTERVIEW DATA FROM SEVERAL COMMUNITY STAKEHOLDERS WHO ARE EXPERTS ON THE HEALTH CARE NEEDS OF RESIDENTS IN THE COUNTY AS WELL AS EXISTING COMMUNITY VOICE DATA GATHERED BY A RANGE OF OTHER GREATER CLEVELAND ORGANIZATIONS. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 5:
      UH CLEVELAND MEDICAL CENTER'S 2019 CHNA CONSIDERED MULTIPLE DATA SOURCES, SOME PRIMARY (SURVEY OF MARKET AREA RESIDENTS AND HOSPITAL DISCHARGE DATA) AND SOME SECONDARY (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS). THE CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED MAIL SURVEYS OF HOUSEHOLDS IN SERVICE AREA COUNTIES, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, AND OTHER RELEVANT ORGANIZATIONS OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH CLEVELAND MEDICAL CENTER; DEMOGRAPHICS OF UH CLEVELAND MEDICAL CENTER'S PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); CHRONIC DISEASE (E.G. CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); HIGH FREQUENCY OF INAPPROPRIATE EMERGENCY DEPARTMENT USE; QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); CANCER TREATMENT (E.G. INCREASING EARLY DETECTION, REDUCING BARRIERS TO CANCER CARE, AND REDUCING THE HIGH CANCER MORTALITY RATES); REDUCING INCIDENCES OF CARDIOVASCULAR DISEASE (E.G. EARLY DETECTION, INCREASING PATIENTS' UNDERSTANDING OF ITS SEVERITY, AND TEACHING CARDIOVASCULAR DISEASE SELF-TREATMENT); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE AND LEAD POISONING).
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR CUYAHOGA COUNTY. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED WITH UH CLEVELAND MEDICAL CENTER IN THE JOINT CHNA FOR CUYAHOGA COUNTY: UH RAINBOW BABIES & CHILDREN'S HOSPITAL, UH AHUJA MEDICAL CENTER, UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER AND UH RICHMOND MEDICAL CENTER), UH PARMA MEDICAL CENTER, UH ST. JOHN MEDICAL CENTER, UH REHABILITATION HOSPITAL, SOUTHWEST GENERAL HEALTH CENTER, ST. VINCENT CHARITY MEDICAL CENTER, AND THE METROHEALTH SYSTEM.
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT THE JOINT CHNA FOR CUYAHOGA COUNTY: BETTER HEALTH PARTNERSHIP, CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, HEALTH IMPROVEMENT PARTNERSHIP-CUYAHOGA, POLICYBRIDGE, THE CENTER FOR HEALTH AFFAIRS, AND UNITED WAY OF GREATER CLEVELAND.
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH CLEVELAND MEDICAL CENTER IDENTIFIED THE FOLLOWING FOUR PRIORITY HEATH NEEDS AND ASSOCIATED STRATEGIES TO ADDRESS THEM: PRIORITY HEATH NEED #1: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION AND HEALTH SCREENINGS- STRATEGY #2: TARGETED SCREENING AND EDUCATION AMONG HIGH-RISK POPULATIONS- STRATEGY #3: DECREASE BARRIERS TO CANCER SCREENING AND TREATMENTPRIORITY HEALTH NEED #2: IMPROVE COMMUNITY CONDITIONS- STRATEGY #1: SAFETY TRAINING- STRATEGY #2: CO-LOCATE PROGRAMS AND SERVICES WITHIN A COMMUNITY-BASED MEDICAL CENTER IN AN UNDER-RESOURCED NEIGHBORHOOD- STRATEGY #3: HOSPITAL-BASED INTERVENTION TO INTERRUPT GUN-RELATED VIOLENCE AND RETALIATIONPRIORITY HEALTH NEED #3: MENTAL HEALTH AND ADDICTION- STRATEGY #1: COMMUNITY-BASED EDUCATION AND STRATEGIC PARTNERSHIPSPRIORITY HEALTH NEED #4: ELIMINATING STRUCTURAL RACISM- STRATEGY #1: JOB PIPELINE PROGRAM FOR MINORITIZED SECONDARY SCHOOL STUDENTS INTERESTED IN BECOMING PHYSICIANSIN ADDITION TO THE AFOREMENTIONED STRATEGIC INITIATIVES OUTLINED IN DETAIL IN THIS PLAN, THE HOSPITAL WILL EITHER BEGIN OR CONTINUE TO PROVIDE OTHER COMMUNITY BENEFIT PROGRAMS RESPONSIVE TO THE HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA. THESE MAY INCLUDE, BUT ARE NOT LIMITED TO, HEALTH EDUCATION PROGRAMS, SCREENINGS, SUPPORT GROUPS AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES; MEDICAL RESEARCH; EDUCATION FOR PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS AND ACCESS TO CARE THROUGH THE UH HOSPITAL FINANCIAL ASSISTANCE PROGRAM. THE CURRENT PLAN MOST AGGRESSIVELY AND COMPREHENSIVELY ADDRESSES THE FOUR ISSUES ABOVE AS THOSE ISSUES WERE CHOSEN BASED ON THE NUMBER OF COMMUNITY MEMBERS IMPACTED AND THE HOSPITAL BEING IN THE BEST POSITION TO HAVE A POSITIVE IMPACT ON THOSE ISSUES. THE ISSUES WHICH WERE NOT CHOSEN TO BE A FOCUS OF THIS PLAN WERE THOSE WHERE THE HOSPITAL IS NOT IN A POSITION TO HAVE A SIGNIFICANT POSITIVE IMPACT AND OR OTHERS ARE KNOWN TO BE FOCUSING ON THAT ISSUE.NOT ALL NEEDS IDENTIFIED IN THE 2019 CHNA ARE BEING ADDRESSED BUT THROUGH IMPLEMENTING THE ABOVE STRATEGIES, THE HOSPITAL ANTICIPATES THE FOLLOWING IMPROVEMENTS IN COMMUNITY HEALTH: POSITIVE IMPACT ON THE REDUCTION OF CARDIOVASCULAR DISEASE; POSITIVE IMPACT ON THE REDUCTION OF INFANT MORTALITY AND IMPROVED INFANT HEALTH; REDUCED INAPPROPRIATE EMERGENCY ROOM USE AND POSITIVE IMPACT ON THE REDUCTION OF CANCER MORTALITY RATES, FOCUSING ON LUNG, COLON, BREAST AND CERVICAL CANCERS. COINCIDENT WITH THIS WILL BE A POSITIVE IMPACT ON RATES OF TOBACCO USE. SOME NEEDS NOT BEING ADDRESSED ARE HIGH BLOOD LEAD LEVELS, CHILDHOOD ASTHMA, INFLUENZA, TOBACCO USE, AND SUICIDE PREVENTION. THESE NEEDS ARE ALSO BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 1 -- UH CLEVELAND MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE ASSESSMENT ALSO ENCOMPASSES INTERVIEW DATA FROM SEVERAL COMMUNITY STAKEHOLDERS WHO ARE EXPERTS ON THE HEALTH CARE NEEDS OF RESIDENTS IN THE COUNTY AS WELL AS EXISTING COMMUNITY VOICE DATA GATHERED BY A RANGE OF OTHER GREATER CLEVELAND ORGANIZATIONS. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 5:
      THE UH RAINBOW BABIES & CHILDREN'S MEDICAL CENTER'S 2019 ASSESSMENT CONSIDERED MULTIPLE DATA SOURCES, SOME PRIMARY (SURVEY OF MARKET AREA RESIDENTS, HOSPITAL DISCHARGE DATA) AND SOME SECONDARY (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS). THE CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED MAIL SURVEYS OF HOUSEHOLDS IN SERVICE AREA COUNTIES, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, AND OTHER RELEVANT ORGANIZATIONS OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH RAINBOW BABIES & CHILDREN'S HOSPITAL; DEMOGRAPHICS OF UH RAINBOW BABIES & CHILDREN'S HOSPITAL PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); CHRONIC DISEASE (E.G. CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); ACCESS TO DENTAL CARE FOR CHILDREN; ACCESS TO PRIMARY CARE; QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); CANCER TREATMENT (E.G. INCREASING EARLY DETECTION, REDUCING BARRIERS TO CANCER CARE, AND REDUCING THE HIGH CANCER MORTALITY RATES); REDUCING INCIDENCES OF CARDIOVASCULAR DISEASE (E.G. EARLY DETECTION, INCREASING PATIENTS' UNDERSTANDING OF ITS SEVERITY, AND TEACHING CARDIOVASCULAR DISEASE SELF-TREATMENT); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE AND LEAD POISONING); REDUCE INFANT MORTALITY (E.G. EXTREME PREMATURITY, BIRTH DEFECTS, AND SLEEP-RELATED DEATHS).
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR CUYAHOGA COUNTY. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED WITH UH RAINBOW BABIES & CHILDREN'S HOSPITAL IN THE JOINT CHNA FOR CUYAHOGA COUNTY: UH CLEVELAND MEDICAL CENTER, UH AHUJA MEDICAL CENTER, UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER AND UH RICHMOND MEDICAL CENTER), UH PARMA MEDICAL CENTER, UH ST. JOHN MEDICAL CENTER, UH REHABILITATION HOSPITAL, SOUTHWEST GENERAL HEALTH CENTER, ST. VINCENT CHARITY MEDICAL CENTER, AND THE METROHEALTH SYSTEM.
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT THE JOINT CHNA FOR CUYAHOGA COUNTY: BETTER HEALTH PARTNERSHIP, CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, HEALTH IMPROVEMENT PARTNERSHIP-CUYAHOGA, POLICYBRIDGE, THE CENTER FOR HEALTH AFFAIRS, AND UNITED WAY OF GREATER CLEVELAND.
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH RAINBOW BABIES & CHILDREN'S HOSPITAL IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEED AND ASSOCIATED STRATEGIES TO ADDRESS IT: PRIORITY HEATH NEED #1: IMPROVE COMMUNITY CONDITIONS/ELIMINATING STRUCTURAL RACISM- STRATEGY #1: MOBILE DENTAL CLINIC- STRATEGY #2: NUTRITION PROGRAMMING TO ADDRESS FOOD INSECURITY- STRATEGY #3: CENTERING PREGNANCYTHE IMPLEMENTATION STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: HIGH BLOOD LEAD LEVELS, CHILDHOOD ASTHMA, INFLUENZA, TOBACCO USE/CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND SUICIDE PREVENTION. THESE HEALTH NEEDS ARE BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 2 -- UH RAINBOW BABIES & CHILDREN'S HOSPITAL PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE ASSESSMENT ALSO ENCOMPASSES INTERVIEW DATA FROM SEVERAL COMMUNITY STAKEHOLDERS WHO ARE EXPERTS ON THE HEALTH CARE NEEDS OF RESIDENTS IN THE COUNTY AS WELL AS EXISTING COMMUNITY VOICE DATA GATHERED BY A RANGE OF OTHER GREATER CLEVELAND ORGANIZATIONS. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 5:
      UH AHUJA MEDICAL CENTER'S 2019 ASSESSMENT CONSIDERED MULTIPLE DATA SOURCES, SOME PRIMARY (SURVEY OF MARKET AREA RESIDENTS, HOSPITAL DISCHARGE DATA) AND SOME SECONDARY (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS). THE CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED MAIL SURVEYS OF HOUSEHOLDS IN SERVICE AREA COUNTIES, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH AHUJA MEDICAL CENTER; DEMOGRAPHICS OF UH AHUJA MEDICAL CENTER'S PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); CHRONIC DISEASE (E.G. CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); REDUCING HOSPITALIZATION AND DECREASING HOSPITAL READMISSION; QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); CANCER TREATMENT (E.G. INCREASING EARLY DETECTION, REDUCING BARRIERS TO CANCER CARE, AND REDUCING THE HIGH CANCER MORTALITY RATES); REDUCING INCIDENCES OF CARDIOVASCULAR DISEASE (E.G. EARLY DETECTION, INCREASING PATIENTS' UNDERSTANDING OF ITS SEVERITY, AND TEACHING CARDIOVASCULAR DISEASE SELF-TREATMENT); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE, INFANT MORTALITY, AND LEAD POISONING).
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR CUYAHOGA COUNTY. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED WITH UH AHUJA MEDICAL CENTER IN THE JOINT CHNA FOR CUYAHOGA COUNTY: UH RAINBOW BABIES & CHILDREN'S HOSPITAL, UH CLEVELAND MEDICAL CENTER, UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER AND UH RICHMOND MEDICAL CENTER), UH PARMA MEDICAL CENTER, UH ST. JOHN MEDICAL CENTER, AND UH REHABILITATION HOSPITAL, SOUTHWEST GENERAL HEALTH CENTER, ST. VINCENT CHARITY MEDICAL CENTER, AND THE METROHEALTH SYSTEM.
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT THE JOINT CHNA FOR CUYAHOGA COUNTY: BETTER HEALTH PARTNERSHIP, CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, HEALTH IMPROVEMENT PARTNERSHIP-CUYAHOGA, POLICYBRIDGE, THE CENTER FOR HEALTH AFFAIRS, AND UNITED WAY OF GREATER CLEVELAND.
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH AHUJA MEDICAL CENTER IDENTIFIES THE FOLLOWING THREE PRIORITY HEALTH NEEDS AND ASSOCIATED STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION, HEALTH SCREENING AND SUPPORT GROUPS TO PREVENT AND/OR MANAGE CHRONIC DISEASESPRIORITY HEALTH NEED #2: IMPROVE COMMUNITY CONDITIONS- STRATEGY #1: STRATEGIC PARTNERSHIPS AND PROGRAMMING TO ADDRESS SOCIAL DETERMINANTS OF HEALTH PRIORITY HEALTH NEED #3: MENTAL HEALTH AND ADDICTION- STRATEGY #1: COMMUNITY-BASED EDUCATION TO PROMOTE POSITIVE MENTAL HEALTHTHE IMPLEMENTATION STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: HIGH BLOOD LEAD LEVELS, CHILDHOOD ASTHMA, INFLUENZA, TOBACCO USE/CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND SUICIDE PREVENTION. THESE HEALTH NEEDS ARE BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 4 -- UH AHUJA MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE ASSESSMENT ALSO ENCOMPASSES INTERVIEW DATA FROM SEVERAL COMMUNITY STAKEHOLDERS WHO ARE EXPERTS ON THE HEALTH CARE NEEDS OF RESIDENTS IN THE COUNTY AS WELL AS EXISTING COMMUNITY VOICE DATA GATHERED BY A RANGE OF OTHER GREATER CLEVELAND ORGANIZATIONS. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 5:
      THE CHNA FOR THE RICHMOND CAMPUS OF UH REGIONAL HOSPITALS (UH RICHMOND MEDICAL CENTER) TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED TELEPHONE SURVEYS OF HOUSEHOLDS IN CUYAHOGA COUNTY, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH RICHMOND MEDICAL CENTER; DEMOGRAPHICS OF UH RICHMOND MEDICAL CENTER'S PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); REDUCING THE PREVALENCE OF RESPIRATORY DISEASE AND IMPROVING PATIENTS' QUALITY OF LIFE IN ACCORDANCE WITH THE DISEASE; CHRONIC DISEASE (E.G. HEART DISEASE, CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); CANCER TREATMENT (E.G. INCREASING EARLY DETECTION, REDUCING BARRIERS TO CANCER CARE, AND REDUCING THE HIGH CANCER MORTALITY RATES); REDUCING INCIDENCES OF CARDIOVASCULAR DISEASE (E.G. EARLY DETECTION, INCREASING PATIENTS' UNDERSTANDING OF ITS SEVERITY, AND TEACHING CARDIOVASCULAR DISEASE SELF-TREATMENT); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE, INFANT MORTALITY, AND LEAD POISONING).THE CHNA FOR THE BEDFORD CAMPUS OF UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER) TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED MAIL SURVEYS OF HOUSEHOLDS IN CUYAHOGA COUNTY, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS A LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCY. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH BEDFORD MEDICAL CENTER; DEMOGRAPHICS OF UH BEDFORD MEDICAL CENTER'S PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); CHRONIC DISEASE (E.G. HEART DISEASE, CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); REDUCING HOSPITALIZATION AND DECREASING HOSPITAL READMISSION; QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE, INFANT MORTALITY, AND LEAD POISONING).
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR CUYAHOGA COUNTY. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED WITH UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER AND UH RICHMOND MEDICAL CENTER) IN THE JOINT CHNA FOR CUYAHOGA COUNTY: UH RAINBOW BABIES & CHILDREN'S HOSPITAL, UH CLEVELAND MEDICAL CENTER, UH AHUJA MEDICAL CENTER, UH PARMA MEDICAL CENTER, UH ST. JOHN MEDICAL CENTER, AND UH REHABILITATION HOSPITAL, SOUTHWEST GENERAL HEALTH CENTER, ST. VINCENT CHARITY MEDICAL CENTER, AND THE METROHEALTH SYSTEM.
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT THE JOINT CHNA FOR CUYAHOGA COUNTY: BETTER HEALTH PARTNERSHIP, CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, HEALTH IMPROVEMENT PARTNERSHIP-CUYAHOGA, POLICYBRIDGE, THE CENTER FOR HEALTH AFFAIRS, AND UNITED WAY OF GREATER CLEVELAND.
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH REGIONAL HOSPITALS IDENTIFIED THE FOLLOWING TWO PRIORITY HEALTH NEEDS AND ASSOCIATED STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION AND HEALTH SCREENINGS TO PREVENT AND/OR MANAGE CHRONIC DISEASESPRIORITY HEALTH NEED #2: IMPROVE COMMUNITY CONDITIONS- STRATEGY #1: RAISE AWARENESS ABOUT HOSPITAL UTILIZATION OPTIONS AND FINANCIAL ASSISTANCE AVAILABLE FOR MEDICAL CARETHE FOLLOWING NEEDS WERE IDENTIFIED IN THE 2019 CHNA, BUT ARE NOT BEING ADDRESSED IN 2019 INCLUDE: HIGH BLOOD LEAD LEVELS, CHILDHOOD ASTHMA, INFLUENZA, TOBACCO USE/CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND SUICIDE PREVENTION. THESE NEEDS ARE BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 5 -- UH REGIONAL HOSPITALS PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS COUNTY HEALTH ASSESSMENT, CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITALIZATION ASSOCIATION, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE HOSPITAL COUNCIL OF NORTHWEST OHIO WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. THE HOSPITAL COUNCIL OF NORTHWEST OHIO RETAINED THE CENTER FOR HEALTH AFFAIRS TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION."
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 5:
      THE UH GENEVA MEDICAL CENTER'S CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY BY SURVEYS ADMINISTERED THROUGH RANDOMIZED EMAIL LIST SERVS, SOCIAL MEDIA SURVEYS, AND PUBLIC NOTICES IN ASHTABULA COUNTY. COMMUNITY LEADERS FROM THE ASHTABULA CITY HEALTH DEPARTMENT AND ASHTABULA COUNTY HEALTH DEPARTMENT OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. DATA WAS ALSO OBTAINED BY INDEPENDENT RESEARCHERS FROM THE TOLEDO-BASED HOSPITAL COUNCIL OF NORTHWEST OHIO AND THEIR PARTNERS AT THE UNIVERSITY OF TOLEDO. THE SURVEY DATA WAS COLLECTED FROM A CROSS-SECTIONAL, RANDOMIZED SAMPLE OF 1,200 ASHTABULA COUNTY RESIDENTS AGED 19 YEARS AND OLDER. THIS RETURN RATE AND SAMPLE SIZE MEANS THAT THE RESPONSES IN THE HEALTH ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: HEALTHCARE ACCESS (HEALTHCARE COVERAGE, ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, AND ORAL HEALTH), HEALTH BEHAVIORS (HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, MENTAL HEALTH), CHRONIC DISEASE (CARDIOVASCULAR HEALTH, CANCER, ASTHMA, ARTHRITIS, DIABETES, QUALITY OF LIFE), AND SOCIAL CONDITIONS (SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, AND PARENTING).
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR ASHTABILA COUNTY. UH GENEVA MEDICAL CENTER AND UH CONNEAUT MEDICAL CENTER ARE INCLUDED IN THE JOINT CHNA FOR ASHTABULA COUNTY.
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT A JOINT CHNA FOR ASHTABILA COUNTY: ASHTABULA CITY HEALTH DEPARTMENT, ASHTABULA COUNTY CHILDREN'S SERVICES, ASHTABULA COUNTY COMMISSIONERS, ASHTABULA COUNTY COMMUNITY ACTION AGENCY, ASHTABULA COUNTY EDUCATIONAL SERVICE CENTER, ASHTABULA COUNTY ENGINEERS DEPARTMENT, ASHTABULA COUNTY FAMILY & CHILDREN'S FIRST COUNCIL, ASHTABULA COUNTY HEALTH DEPARTMENT, ASHTABULA COUNTY JOB & FAMILY SERVICES, ASHTABULA COUNTY MEDICAL CENTER, ASHTABULA COUNTY MENTAL HEALTH RECOVERY BOARD, ASHTABULA COUNTY REGIONAL HOME HEALTH SERVICES, ASHTABULA COUNTY YMCA, CATHOLIC CHARITIES OF ASHTABULA COUNTY, CENTER FOR HEALTH AFFAIRS, COMMUNITY COUNSELING CENTER OF ASHTABULA COUNTY, CONNEAUT CITY HEALTH DEPARTMENT, COUNTRY NEIGHBOR, GLENBEIGH, KENT STATE UNIVERSITY-ASHTABULA, LAKE AREA RECOVERY CENTER, OHIO STATE UNIVERSITY COOPERATIVE EXTENSION-ASHTABULA COUNTY, AND SIGNATURE HEALTH/FAMILY PLANNING ASSOCIATION OF NORTHEAST OHIO.
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH GENEVA MEDICAL CENTER IDENTIFIED THE FOLLOWING TWO PRIORITY HEALTH NEEDS AND CROSSING-CUTTING FACTOR, ALONG WITH STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: CHRONIC DISEASE- STRATEGY #1: PRESCRIPTIONS FOR PHYSICAL ACTIVITY- STRATEGY #2: HYPERTENSION SCREENING AND FOLLOW UP- STRATEGY #3: DIABETES PREVENTION PROGRAM (DPP) AND PREDIABETES SCREENING AND REFERRALPRIORITY HEALTH NEED #2: MENTAL HEALTH AND ADDICTION- STRATEGY #1: SCHOOL-BASED ALCOHOL/OTHER DRUG PREVENTION PROGRAMS- STRATEGY #2: SAFE DISPOSAL OF PRESCRIPTION DRUGSCROSS-CUTTING FACTOR #1: HEALTHCARE SYSTEM AND ACCESS- STRATEGY #1: IMPROVE ACCESS TO COMPREHENSIVE PRIMARY CARE- STRATEGY #2: SCREENING FOR SOCIAL DETERMINANTS OF HEALTH (SDOH) USING A STANDARDIZED TOOL- STRATEGY #3: COMMUNITY HEALTH WORKERS (INCLUDING WORKERS IN COMMUNITY-BASED SETTINGS) TO ADDRESS SOCIAL DETERMINANTS OF HEALTHNEEDS IDENTIFIED IN 2019 WHICH ARE NOT BEING ADDRESSED INCLUDE SUICIDE PREVENTION. THIS SPECIFIC ISSUE IS BEING ADDRESSED BY OTHER PARTNERS IN ASHTABULA COUNTY.
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 6 -- UH GENEVA MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS COUNTY HEALTH ASSESSMENT, CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITALIZATION ASSOCIATION, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE HOSPITAL COUNCIL OF NORTHWEST OHIO WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. THE HOSPITAL COUNCIL OF NORTHWEST OHIO RETAINED THE CENTER FOR HEALTH AFFAIRS TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION."
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 5:
      THE UH CONNEAUT MEDICAL CENTER'S CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY BY SURVEYS ADMINISTERED THROUGH RANDOMIZED EMAIL LIST SERVS, SOCIAL MEDIA SURVEYS, AND PUBLIC NOTICES IN ASHTABULA COUNTY. COMMUNITY LEADERS FROM THE ASHTABULA CITY HEALTH DEPARTMENT AND ASHTABULA COUNTY HEALTH DEPARTMENT OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. DATA WAS ALSO OBTAINED BY INDEPENDENT RESEARCHERS FROM THE TOLEDO-BASED HOSPITAL COUNCIL OF NORTHWEST OHIO AND THEIR PARTNERS AT THE UNIVERSITY OF TOLEDO. THE SAMPLE COLLECTED BY THEM WAS A RANDOMIZED MIXTURE OF 1,200 ASHTABULA COUNTY RESIDENTS 19 YEARS AND OLDER. THIS RETURN RATE AND SAMPLE SIZE MEANS THAT THE RESPONSES IN THE HEALTH ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: HEALTHCARE ACCESS (HEALTHCARE COVERAGE, ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, AND ORAL HEALTH), HEALTH BEHAVIORS (HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, MENTAL HEALTH), CHRONIC DISEASE (CARDIOVASCULAR HEALTH, CANCER, ASTHMA, ARTHRITIS, DIABETES, QUALITY OF LIFE), AND SOCIAL CONDITIONS (SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, AND PARENTING).
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR ASHTABILA COUNTY. UH GENEVA MEDICAL CENTER AND UH CONNEAUT MEDICAL CENTER ARE INCLUDED IN THE JOINT CHNA FOR ASHTABULA COUNTY.
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT A JOINT CHNA FOR ASHTABILA COUNTY: ASHTABULA CITY HEALTH DEPARTMENT, ASHTABULA COUNTY CHILDREN'S SERVICES, ASHTABULA COUNTY COMMISSIONERS, ASHTABULA COUNTY COMMUNITY ACTION AGENCY, ASHTABULA COUNTY EDUCATIONAL SERVICE CENTER, ASHTABULA COUNTY ENGINEERS DEPARTMENT, ASHTABULA COUNTY FAMILY & CHILDREN'S FIRST COUNCIL, ASHTABULA COUNTY HEALTH DEPARTMENT, ASHTABULA COUNTY JOB & FAMILY SERVICES, ASHTABULA COUNTY MEDICAL CENTER, ASHTABULA COUNTY MENTAL HEALTH RECOVERY BOARD, ASHTABULA COUNTY REGIONAL HOME HEALTH SERVICES, ASHTABULA COUNTY YMCA, CATHOLIC CHARITIES OF ASHTABULA COUNTY, CENTER FOR HEALTH AFFAIRS, COMMUNITY COUNSELING CENTER OF ASHTABULA COUNTY, CONNEAUT CITY HEALTH DEPARTMENT, COUNTRY NEIGHBOR, GLENBEIGH, KENT STATE UNIVERSITY-ASHTABULA, LAKE AREA RECOVERY CENTER, OHIO STATE UNIVERSITY COOPERATIVE EXTENSION-ASHTABULA COUNTY, AND SIGNATURE HEALTH/FAMILY PLANNING ASSOCIATION OF NORTHEAST OHIO.
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR CONNEAUT MEDICAL CENTER IDENTIFIED THE FOLLOWING TWO PRIORITY HEALTH NEEDS AND CROSSING-CUTTING FACTOR, ALONG WITH STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: CHRONIC DISEASE- STRATEGY #1: PRESCRIPTIONS FOR PHYSICAL ACTIVITY- STRATEGY #2: HYPERTENSION SCREENING AND FOLLOW UP- STRATEGY #3: DIABETES PREVENTION PROGRAM (DPP) AND PREDIABETES SCREENING AND REFERRALPRIORITY HEALTH NEED #2: MENTAL HEALTH AND ADDICTION- STRATEGY #1: SCHOOL-BASED ALCOHOL/OTHER DRUG PREVENTION PROGRAMS- STRATEGY #2: SAFE DISPOSAL OF PRESCRIPTION DRUGSCROSS-CUTTING FACTOR #1: HEALTHCARE SYSTEM AND ACCESS- STRATEGY #1: IMPROVE ACCESS TO COMPREHENSIVE PRIMARY CARE- STRATEGY #2: SCREENING FOR SOCIAL DETERMINANTS OF HEALTH (SDOH) USING A STANDARDIZED TOOL- STRATEGY #3: COMMUNITY HEALTH WORKERS (INCLUDING WORKERS IN COMMUNITY-BASED SETTINGS) TO ADDRESS SOCIAL DETERMINANTS OF HEALTHNEEDS IDENTIFIED IN 2019 WHICH ARE NOT BEING ADDRESSED INCLUDE SUICIDE PREVENTION. THIS SPECIFIC ISSUE IS BEING ADDRESSED BY OTHER PARTNERS IN ASHTABULA COUNTY.
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 7 -- UH CONNEAUT MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE ASSESSMENT ALSO ENCOMPASSES INTERVIEW DATA FROM SEVERAL COMMUNITY STAKEHOLDERS WHO ARE EXPERTS ON THE HEALTH CARE NEEDS OF RESIDENTS IN THE COUNTY AS WELL AS EXISTING COMMUNITY VOICE DATA GATHERED BY A RANGE OF OTHER GREATER CLEVELAND ORGANIZATIONS. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 5:
      UH PARMA MEDICAL CENTER'S 2019 ASSESSMENT CONSIDERED MULTIPLE DATA SOURCES, SOME PRIMARY (SURVEY OF MARKET AREA RESIDENTS, HOSPITAL DISCHARGE DATA) AND SOME SECONDARY (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS). THE CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED MAIL SURVEYS OF HOUSEHOLDS IN SERVICE AREA COUNTIES, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, AND OTHER RELEVANT ORGANIZATIONS OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH PARMA MEDICAL CENTER; DEMOGRAPHICS OF UH PARMA MEDICAL CENTER'S PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); CHRONIC DISEASE (E.G. CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); HIGH FREQUENCY OF INAPPROPRIATE EMERGENCY DEPARTMENT USE; QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); CANCER TREATMENT (E.G. INCREASING EARLY DETECTION, REDUCING BARRIERS TO CANCER CARE, AND REDUCING THE HIGH CANCER MORTALITY RATES); REDUCING INCIDENCES OF CARDIOVASCULAR DISEASE (E.G. EARLY DETECTION, INCREASING PATIENTS' UNDERSTANDING OF ITS SEVERITY, AND TEACHING CARDIOVASCULAR DISEASE SELF-TREATMENT); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); INCREASING ACCESS TO PRIMARY CARE; MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE, INFANT MORTALITY, AND LEAD POISONING).
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR CUYAHOGA COUNTY. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED WITH UH PARMA MEDICAL CENTER IN THE JOINT CHNA FOR CUYAHOGA COUNTY: UH RAINBOW BABIES & CHILDREN'S HOSPITAL, UH CLEVELAND MEDICAL CENTER, UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER AND UH RICHMOND MEDICAL CENTER), UH AHUJA MEDICAL CENTER, UH ST. JOHN MEDICAL CENTER, AND UH REHABILITATION HOSPITAL, SOUTHWEST GENERAL HEALTH CENTER, ST. VINCENT CHARITY MEDICAL CENTER, AND THE METROHEALTH SYSTEM.
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT THE JOINT CHNA FOR CUYAHOGA COUNTY: BETTER HEALTH PARTNERSHIP, CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, HEALTH IMPROVEMENT PARTNERSHIP-CUYAHOGA, POLICYBRIDGE, THE CENTER FOR HEALTH AFFAIRS, AND UNITED WAY OF GREATER CLEVELAND.
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH PARMA MEDICAL CENTER IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEEDS AND ASSOCIATED STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION AND HEALTH SCREENINGS TO PREVENT AND/OR MANAGE CHRONIC DISEASES, PARTICULARLY FOR DIABETES AND HEART DISEASEPRIORITY HEALTH NEED #2: IMPROVE COMMUNITY CONDITIONS- STRATEGY #1: HEALTHY FOOD ACCESSTHE STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: HIGH BLOOD LEAD LEVELS, CHILDHOOD ASTHMA, INFLUENZA, TOBACCO USE/CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND SUICIDE PREVENTION. THESE NEEDS ARE BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 8 -- UH PARMA MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER FOR HEALTH AFFAIRS TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 5:
      THE UH ELYRIA MEDICAL CENTER'S CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH A RANDOMIZED TELEPHONE SURVEY OF HOUSEHOLDS IN LORAIN COUNTY, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE ELYRIA CITY HEALTH DISTRICT AND THE LORAIN COUNTY GENERAL HEALTH DISTRICT OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. SURVEYS WERE MAILED OUT TO 2,400 ADULTS IN LORAIN COUNTY. THE RESPONSE RATE FOR THE GENERAL POPULATION WAS 29%. THIS RETURN RATE AND SAMPLE SIZE MEANS THAT THE RESPONSE IN THE HEALTH ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: HEALTHCARE ACCESS (HEALTHCARE COVERAGE, ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, AND ORAL HEALTH), HEALTH BEHAVIORS (HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, MENTAL HEALTH), CHRONIC DISEASE (HEART HEALTH, CANCER, ASTHMA, ARTHRITIS, DIABETES, AND QUALITY OF LIFE), SOCIAL CONDITIONS (SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, PARENTING, MATERNAL AND INFANT HEALTH), RURAL HEALTH, SUBURBAN HEALTH, URBAN HEALTH, AND YOUTH HEALTH (WEIGHT STATUS, TOBACCO USE, ALCOHOL USE, DRUG USE, MENTAL HEALTH, SAFETY AND VIOLENCE ISSUES, AND PERCEPTIONS).
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR LORAIN COUNTY. UH ELYRIA MEDICAL CENTER, UH AVON REHABILITATION HOSPITAL, CLEVELAND CLINIC AVON HOSPITAL, MERCY HEALTH ALLEN HOSPITAL, MERCY HEALTH LORAIN HOSPITAL AND SPECIALTY HOSPITAL OF LORAIN ARE INCLUDED IN THE 2019 CHNA FOR LORAIN COUNTY.
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT A JOINT CHNA FOR LORAIN COUNTY: ALCOHOL AND DRUG ADDICTION SERVICES BOARD OF LORAIN COUNTY, LORAIN COUNTY BOARD OF MENTAL HEALTH, LORAIN COUNTY HEALTH & DENTISTRY, LORAIN COUNTY METRO PARKS, LORAIN COUNTY OFFICE ON AGING, LORAIN COUNTY PUBIC HEALTH, AND UNITED WAY OF GREATER LORAIN COUNTY.
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH ELYRIA MEDICAL CENTER IDENTIFIED THE FOLLOWING TWO PRIORITY HEATH NEEDS AND ASSOCIATED STRATEGIES TO ADDRESS THEM: PRIORITY HEATH NEED #1: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION, HEALTH SCREENINGS AND PHYSICAL ACTIVITIES TO PREVENT AND/OR MANAGE CHRONIC DISEASESPRIORITY HEATH NEED #2: CANCER- STRATEGY #1: INCREASE SCREENING AND IMMUNIZATION RATES IN THREE CANCERS WITH EVIDENCE-BASED RECOMMENDATIONS IN TARGET HIGH-RISK SUBPOPULATIONS IN LORAIN COUNTY- STRATEGY #2: DECREASE BARRIERS TO TREATMENT THE IMPLEMENTATION STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: MENTAL HEALTH AND ADDICTION AS WELL AS ACCESS TO CARE OR PREVENTION AS STAND-ALONE PRIORITIES. ASPECTS OF THESE HEALTH NEEDS ARE ENCOMPASSED IN OTHER EFFORTS BEING ADDRESSED. OTHER LORAIN COUNTY PARTNERS ARE ALSO ADDRESSING PREVENTION AND OTHER NEEDS.
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 9 -- UH ELYRIA MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE ASSESSMENT ALSO ENCOMPASSES INTERVIEW DATA FROM SEVERAL COMMUNITY STAKEHOLDERS WHO ARE EXPERTS ON THE HEALTH CARE NEEDS OF RESIDENTS IN THE COUNTY AS WELL AS EXISTING COMMUNITY VOICE DATA GATHERED BY A RANGE OF OTHER GREATER CLEVELAND ORGANIZATIONS. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 5:
      UH ST. JOHN MEDICAL CENTER'S 2019 ASSESSMENT CONSIDERED MULTIPLE DATA SOURCES, SOME PRIMARY (SURVEY OF MARKET AREA RESIDENTS, HOSPITAL DISCHARGE DATA) AND SOME SECONDARY (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS). THE CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED MAIL SURVEYS OF HOUSEHOLDS IN SERVICE AREA COUNTIES, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, AND OTHER RELEVANT ORGANIZATIONS OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH ST. JOHN MEDICAL CENTER; DEMOGRAPHICS OF UH ST. JOHN MEDICAL CENTER'S PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); CHRONIC DISEASE (E.G. CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); HIGH FREQUENCY OF INAPPROPRIATE EMERGENCY DEPARTMENT USE; QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); CANCER TREATMENT (E.G. INCREASING EARLY DETECTION, REDUCING BARRIERS TO CANCER CARE, AND REDUCING THE HIGH CANCER MORTALITY RATES); REDUCING INCIDENCES OF CARDIOVASCULAR DISEASE (E.G. EARLY DETECTION, INCREASING PATIENTS' UNDERSTANDING OF ITS SEVERITY, AND TEACHING CARDIOVASCULAR DISEASE SELF-TREATMENT); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE, INFANT MORTALITY, AND LEAD POISONING).
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR CUYAHOGA COUNTY. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED WITH UH ST. JOHN MEDICAL CENTER IN THE JOINT CHNA FOR CUYAHOGA COUNTY: UH RAINBOW BABIES & CHILDREN'S HOSPITAL, UH CLEVELAND MEDICAL CENTER, UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER AND UH RICHMOND MEDICAL CENTER), UH AHUJA MEDICAL CENTER, UH PARMA MEDICAL CENTER, AND UH REHABILITATION HOSPITAL, SOUTHWEST GENERAL HEALTH CENTER, ST. VINCENT CHARITY MEDICAL CENTER, AND THE METROHEALTH SYSTEM.
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT THE JOINT CHNA FOR CUYAHOGA COUNTY: BETTER HEALTH PARTNERSHIP, CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, HEALTH IMPROVEMENT PARTNERSHIP-CUYAHOGA, POLICYBRIDGE, THE CENTER FOR HEALTH AFFAIRS, AND UNITED WAY OF GREATER CLEVELAND.
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR ST. JOHN MEDICAL CENTER IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEEDS AND ASSOCIATED STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION, HEALTH SCREENINGS AND PHYSICAL ACTIVITIES TO PREVENT AND/OR MANAGE CHRONIC DISEASESPRIORITY HEALTH NEED #2: ENHANCE TRUST- STRATEGY #1: STRATEGIC PARTNERSHIPS AND COMMUNITY ENGAGEMENT TO BUILD AND/OR MAINTAIN TRUSTTHE HOSPITAL HAS AND WILL CONTINUE TO SUSTAIN SEVERAL EFFORTS WHICH DO ADDRESS EACH OF THE COMMUNITY HEALTH NEEDS IN SOME WAY. THE COMMUNITY HEALTH NEEDS INCLUDE: POVERTY, FOOD INSECURITY, LEAD POISONING, HEART DISEASE, CHILDHOOD ASTHMA, VACCINATION RATES, TOBACCO USE, LACK OF PHYSICAL ACTIVITY, SUICIDE, HOMICIDE/VIOLENCE, AND INFANT MORTALITY. THE IMPLEMENTATION STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: HIGH BLOOD LEAD LEVELS, CHILDHOOD ASTHMA, INFLUENZA, TOBACCO USE/CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND SUICIDE PREVENTION. THESE HEALTH NEEDS ARE BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 10 -- UH ST. JOHN MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED ECONOMIC INDICATORS SUCH AS POVERTY, UNEMPLOYMENT, STATE BUDGET DEVELOPMENTS, HOUSEHOLD INCOME AND HEALTH STATUS INDICATORS FROM SOURCES SUCH AS COUNTY HEALTH RANKINGS, THE COMMUNITY HEALTH STATUES INDICATORS PROJECT, THE OHIO DEPARTMENT OF HEALTH, THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), THE DIGNITY HEALTH COMMUNITY NEEDS INDEX, AND THE U.S. DEPARTMENT OF AGRICULTURE. DATA FROM THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) REGARDING FEDERALLY QUALIFIED HEALTH CENTERS WERE ALSO USED. MEDICALLY UNDERSERVED AREAS AND POPULATIONS, HEALTH PROFESSIONAL SHORTAGE AREAS, AND HOSPITAL UTILIZATION WERE ALSO ASSESSED.UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER FOR HEALTH AFFAIRS TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 5:
      THE UH PORTAGE MEDICAL CENTER CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. THE MAILING SURVEY WAS SENT TO 1,200 ADULTS IN PORTAGE COUNTY AND THE RESPONSE RATE WAS 27%, WHICH SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY. ADOLESCENTS WERE RANDOMLY CHOSEN AFTER APPROVAL BY SUPERINTENDENT AND PARENT APPROVAL. THE RESPONSE RATE FOR ADOLESCENTS WAS 94%. FINALLY, A CHILD SURVEY WAS SENT TO 2,400 PARENTS WITH A RESPONSE RATE OF 7% WHICH SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY AT A 7% MARGIN OF ERROR. COUNTY-LEVEL DATA, NUMEROUS CDC SITES, THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, US CENSUS DATA, AND OTHER NATIONAL AND LOCAL SOURCES WERE ALSO USED IN COLLECTING SECONDARY DATA. COMMUNITY LEADERS FROM THE PORTAGE CITY HEALTH DISTRICT AND RAVENNA CITY HEALTH DISTRICT OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: HEALTH CARE ACCESS (E.G. HEALTH CARE COVERAGE, ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, MEN/WOMEN'S HEALTH, AND ORAL HEALTH); HEALTH BEHAVIORS (E.G. HEALTH STATUS PERCEPTIONS, ADULT WEIGH STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, AND ADULT MENTAL HEALTH); CHRONIC DISEASE (E.G. CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, AND QUALITY OF LIFE); SOCIAL CONDITIONS (E.G. SOCIAL DETERMINANTS OF HEALTH AND ENVIRONMENTAL HEALTH); YOUTH HEALTH (E.G. YOUTH WEIGHT STATUES, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH SOCIAL DETERMINANTS OF HEALTH, AND YOUTH VIOLENCE); CHILD HEALTH (E.G. HEALTH AND FUNCTIONAL STATUS, HEALTH CARE ACCESS, EARLY CHILDHOOD, MIDDLE CHILDHOOD, FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH).
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 6A:
      THE FOLLOWING HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT EACH SEPARATE HOSPITAL FACILITY CHNA FOR PORTAGE COUNTY: AKRON CHILDREN'S HOSPITAL AND UH PORTAGE MEDICAL CENTER.
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT A CHNA FOR PORTAGE COUNTY: AXESSPOINTE COMMUNITY HEALTH CENTER, CHILDREN'S ADVANTAGE, COLEMAN PROFESSIONAL SERVICES, FAMILY AND CHILDREN FIRST COUNCIL, FAMILY AND COMMUNITY SERVICES, HIRAM COLLEGE, KENT CITY BOARD OF HEALTH, KENT CITY HEALTH DEPARTMENT, KENT STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH & CENTER FOR PUBLIC POLICY AND HEALTH, KENT STATE UNIVERSITY HEALTH SERVICES, KENT STATE UNIVERSITY, CENTER FOR NUTRITION OUTREACH, MENTAL HEALTH & RECOVERY BOARD OF PORTAGE COUNTY, NORTHEAST OHIO MEDICAL UNIVERSITY, OHIOCAN, PARTA, PORTAGE COUNTY BOARD OF HEALTH, PORTAGE COUNTY CHILDREN'S SERVICES , PORTAGE COUNTY COMBINED GENERAL HEALTH DISTRICT, PORTAGE COUNTY COMMISSIONERS, PORTAGE COUNTY JOB & FAMILY SERVICES, PORTAGE COUNTY SAFE COMMUNITIES COALITION, PORTAGE COUNTY SCHOOL DISTRICTS, PORTAGE COUNTY SHERIFF'S DEPARTMENT, PORTAGE COUNTY TOWNSHIP TRUSTEES, PORTAGE COUNTY VETERANS SERVICES, PORTAGE COUNTY WIC, PORTAGE LEARNING CENTERS, PORTAGE PARK DISTRICT, PORTAGE SUBSTANCE ABUSE COMMUNITY COALITION, RAVENNA CITY BOARD OF HEALTH, SEQUOIA WELLNESS, SUICIDE PREVENTION COALITION OF PORTAGE COUNTY, THE PORTAGE FOUNDATION, TOWNHALL II, AND UNITED WAY OF PORTAGE COUNTY.
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH PORTAGE MEDICAL CENTER IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEEDS AND ASSOCIATED STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: MENTAL HEALTH AND ADDICTION- STRATEGY #1: YOUTH ALCOHOL/OTHER DRUG PREVENTION AND MENTAL HEALTH PROGRAMS- STRATEGY #2: LINKS TO CESSATION SUPPORTPRIORITY HEALTH NEED #2: CHRONIC DISEASE- STRATEGY #1: FOOD INSECURITY SCREENING AND REFERRAL- STRATEGY #2: PREDIABETES SCREENING AND REFERRAL- STRATEGY #3: HYPERTENSION SCREENING AND FOLLOW UP- STRATEGY #4: COMMUNITY GARDENS PRIORITY HEALTH NEED #3: MATERNAL, INFANT, AND CHILD HEALTH- STRATEGY #1: REPRODUCTIVE HEALTH INTERVENTIONSTHE IMPLEMENTATION STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: SOCIAL DETERMINANTS OF HEALTH, HEALTHCARE SYSTEMS AND ACCESS, AND HEALTH EQUITY. ANY NEEDS NOT BEING ADDRESSED BY THE UH PORTAGE MEDICAL CENTER ARE BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 11 -- UH PORTAGE MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE ASSESSMENT ALSO ENCOMPASSES INTERVIEW DATA FROM SEVERAL COMMUNITY STAKEHOLDERS WHO ARE EXPERTS ON THE HEALTH CARE NEEDS OF RESIDENTS IN THE COUNTY AS WELL AS EXISTING COMMUNITY VOICE DATA GATHERED BY A RANGE OF OTHER GREATER CLEVELAND ORGANIZATIONS. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 5:
      UH REHABILITATION HOSPITAL'S 2019 ASSESSMENT CONSIDERED MULTIPLE DATA SOURCES, SOME PRIMARY (SURVEY OF MARKET AREA RESIDENTS, HOSPITAL DISCHARGE DATA) AND SOME SECONDARY (REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS). THE CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH RANDOMIZED MAIL SURVEYS OF HOUSEHOLDS IN SERVICE AREA COUNTIES, AS WELL AS, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE CUYAHOGA COUNTY BOARD OF HEALTH, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, AND OTHER RELEVANT ORGANIZATIONS OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: A DESCRIPTION OF THE COMMUNITY SURROUNDING THE UH REHABILITATION HOSPITAL; DEMOGRAPHICS OF UH REHABILITATION HOSPITAL'S PRIMARY AND SECONDARY MARKET AREAS (E.G. AGE, GENDER, AND RACE/ETHNICITY); HOSPITAL PATIENTS SERVED; OVERARCHING THEMES (E.G. TRUST AND STRUCTURAL RACISM); CHRONIC DISEASE (E.G. CARDIOVASCULAR DISEASE, CHILDHOOD ASTHMA, AND DIABETES); QUALITY OF LIFE INDICATORS (E.G. POVERTY, HOMICIDE RATES, AND FOOD INSECURITY); CANCER TREATMENT (E.G. INCREASING EARLY DETECTION, REDUCING BARRIERS TO CANCER CARE, AND REDUCING THE HIGH CANCER MORTALITY RATES); REDUCING INCIDENCES OF CARDIOVASCULAR DISEASE (E.G. EARLY DETECTION, INCREASING PATIENTS' UNDERSTANDING OF ITS SEVERITY, AND TEACHING CARDIOVASCULAR DISEASE SELF-TREATMENT); BEHAVIORAL RISK FACTORS (E.G. OBESITY, FLU VACCINATION RATES, PHYSICAL ACTIVITY, AND TOBACCO USE); ENVIRONMENTAL HEALTH INDICATORS (E.G. CHILDHOOD LEAD POISONING, EPA AIR QUALITY STANDARDS, AND FOODBORNE DISEASE); MENTAL HEALTH AND ADDICTION (E.G. MENTAL HEALTH/SUICIDE, OPIOIDS AND OTHER SUBSTANCE ABUSE, AND VIOLENCE); MATERNAL AND CHILD HEALTH (E.G. ADOLESCENT BIRTH RATE, INFANT MORTALITY, AND LEAD POISONING).
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR CUYAHOGA COUNTY. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED WITH UH REHABILITATION HOSPITAL - BEACHWOOD IN THE 2019 CHNA FOR CUYAHOGA COUNTY: UH CLEVELAND MEDICAL CENTER, UH RAINBOW BABIES & CHILDREN'S HOSPITAL, UH AHUJA MEDICAL CENTER, UH REGIONAL HOSPITALS UH REGIONAL HOSPITALS (UH BEDFORD MEDICAL CENTER AND UH RICHMOND MEDICAL CENTER), UH PARMA MEDICAL CENTER, UH ST. JOHN MEDICAL CENTER, SOUTHWEST GENERAL HEALTH CENTER, ST. VINCENT CHARITY MEDICAL CENTER, AND THE METROHEALTH SYSTEM.
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT THE JOINT CHNA FOR CUYAHOGA COUNTY: BETTER HEALTH PARTNERSHIP, CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CUYAHOGA COUNTY BOARD OF HEALTH, HEALTH IMPROVEMENT PARTNERSHIP-CUYAHOGA, POLICYBRIDGE, THE CENTER FOR HEALTH AFFAIRS, AND UNITED WAY OF GREATER CLEVELAND.
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH REHABILITATION HOSPITAL IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEED AND CROSSING-CUTTING FACTOR, ALONG WITH STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION AND HEALTH SCREENINGS TO PREVENT AND/OR MANAGE CHRONIC DISEASESCROSS-CUTTING FACTOR #1: IMPROVE COMMUNITY CONDITIONS- STRATEGY #1: RAISE AWARENESS ABOUT HOSPITAL UNTILIZATION OPTIONS AND FINANCIAL ASSISTANCE AVAILABLE FOR MEDICAL CARETHE IMPLEMENTATION STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: HIGH BLOOD LEAD LEVELS, CHILDHOOD ASTHMA, INFLUENZA, TOBACCO USE/CHRONIC OBSTRUCTIVE PULMONARY DISEASE, AND SUICIDE PREVENTION. THESE HEALTH NEEDS ARE BEING ADDRESSED IN UH CLINICAL SETTINGS.
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 13 -- UH REHABILITATION HOSPITAL - BEACHWOOD PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITAL ASSOCIATION, PREVENTION RESEARCH CENTER FOR HEALTHY NEIGHBORHOODS AT CASE WESTERN RESERVE UNIVERSITY, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER FOR HEALTH AFFAIRS TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 5:
      THE UH AVON REHABILITATION HOSPITAL'S CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH BOTH A RANDOMIZED TELEPHONE SURVEY OF HOUSEHOLDS IN LORAIN COUNTY, A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE ELYRIA CITY HEALTH DISTRICT AND THE LORAIN COUNTY GENERAL HEALTH DISTRICT OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. SURVEYS WERE MAILED OUT TO 2,400 ADULTS IN LORAIN COUNTY. THE RESPONSE RATE FOR THE GENERAL POPULATION WAS 29%. THIS RETURN RATE AND SAMPLE SIZE MEANS THAT THE RESPONSE IN THE HEALTH ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: HEALTHCARE ACCESS (HEALTHCARE COVERAGE, ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, AND ORAL HEALTH), HEALTH BEHAVIORS (HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, SEXUAL BEHAVIOR, MENTAL HEALTH), CHRONIC DISEASE (HEART HEALTH, CANCER, ASTHMA, ARTHRITIS, DIABETES, AND QUALITY OF LIFE), SOCIAL CONDITIONS (SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, PARENTING, MATERNAL AND INFANT HEALTH), RURAL HEALTH, SUBURBAN HEALTH, URBAN HEALTH, AND YOUTH HEALTH (WEIGHT STATUS, TOBACCO USE, ALCOHOL USE, DRUG USE, MENTAL HEALTH, SAFETY AND VIOLENCE ISSUES, AND PERCEPTIONS).
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 6A:
      THE HOSPITAL FACILITIES WORKED IN COLLABORATION WITH ONE ANOTHER TO CONDUCT A JOINT CHNA FOR LORAIN COUNTY. UH ELYRIA MEDICAL CENTER, UH AVON REHABILITATION HOSPITAL, CLEVELAND CLINIC AVON HOSPITAL, MERCY HEALTH ALLEN HOSPITAL, MERCY HEALTH LORAIN HOSPITAL, AND SPECIALTY HOSPITAL OF LORAIN ARE INCLUDED IN THE 2019 CHNA FOR LORAIN COUNTY.
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT A JOINT CHNA FOR LORAIN COUNTY: ALCOHOL AND DRUG ADDICTION SERVICES, BOARD OF LORAIN COUNTY, LORAIN COUNTY BOARD OF MENTAL HEALTH, LORAIN COUNTY HEALTH & DENTISTRY, LORAIN COUNTY METRO PARKS, LORAIN COUNTY OFFICE ON AGING, LORAIN COUNTY PUBIC HEALTH, AND UNITED WAY OF GREATER LORAIN COUNTY.
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH AVON REHABILITATION HOSPITAL IDENTIFIED THE FOLLOWING PRIORITY HEALTH NEED AND ASSOCIATED STRATEGIES TO ADDRESS IT:PRIORITY HEALTH NEED #1: CHRONIC DISEASE MANAGEMENT AND PREVENTION- STRATEGY #1: COMMUNITY-BASED EDUCATION AND HEALTH SCREENINGS TO PREVENT AND/OR MANAGE CHRONIC DISEASESTHE IMPLEMENTATION STRATEGY DOES NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA: MENTAL HEALTH AND ADDICTION AS WELL AS ACCESS TO CARE OR PREVENTION AS STAND-ALONE PRIORITIES. ASPECTS OF THESE HEALTH NEEDS ARE ENCOMPASSED IN OTHER EFFORTS BEING ADDRESSED. OTHER LORAIN COUNTY PARTNERS ARE ALSO ADDRESSING PREVENTION AND OTHER NEEDS.
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP A-FACILITY 14 -- UH AVON REHABILITATION HOSPITAL PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      PART V, SECTION B
      FACILITY REPORTING GROUP B
      FACILITY REPORTING GROUP B CONSISTS OF:
      - FACILITY 3: UH GEAUGA MEDICAL CENTER, - FACILITY 12: UH SAMARITAN MEDICAL CENTER
      GROUP B-FACILITY 3 -- UH GEAUGA MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED SOCIOECONOMIC INDICATORS, SUCH AS UNEMPLOYMENT, UNINSURED, AVERAGE LIFE EXPECTANCY, AND POVERTY INDICATORS FROM SOURCES SUCH AS COUNTY HEALTH ASSESSMENT, CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), OHIO DEPARTMENT OF HEALTH, U.S. CENSUS BUREAU, OHIO HOSPITALIZATION ASSOCIATION, AND OTHER NATIONAL, STATE AND LOCAL DATA SOURCES. THE HOSPITAL COUNCIL OF NORTHWEST OHIO WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. THE HOSPITAL COUNCIL OF NORTHWEST OHIO RETAINED THE CENTER FOR HEALTH AFFAIRS TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION."
      GROUP B-FACILITY 3 -- UH GEAUGA MEDICAL CENTER PART V, SECTION B, LINE 5:
      UH GEAUGA MEDICAL CENTER'S 2019 ASSESSMENT TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH A RANDOMIZED MAIL SURVEY OF HOUSEHOLDS IN GEAUGA COUNTY, REGIONAL FORUMS, AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. COMMUNITY LEADERS FROM THE GEAUGA COUNTY HEALTH DISTRICT AND THE LAKE COUNTY HEALTH DISTRICT OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENT PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. 1,200 SURVEYS WERE MAILED TO ADULTS IN GEAUGA COUNTY AND HAD A RESPONSE RATE OF 26%. THIS RETURN RATE AND SAMPLE SIZE MEANS THAT THE RESPONSES IN THE ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: HEALTHCARE ACCESS INDICATORS (E.G. COVERAGE, UTILIZATION, WOMEN'S HEALTH EXAMS, MEN'S HEALTH EXAMS, AND ORAL HEALTH EXAMS); HEALTH BEHAVIORS INDICATORS (E.G. ADDICTION, HEALTH STATUS PERCEPTIONS, ADULT TOBACCO, DRUG, AND ALCOHOL USE, SEXUAL BEHAVIOR, AND MENTAL HEALTH); CHRONIC DISEASE (E.G. CARDIOVASCULAR HEALTH, CANCER, ASTHMA, ARTHRITIS, DIABETES); AND SOCIAL CONDITIONS (E.G. SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, AND PARENTING).
      GROUP B-FACILITY 3 -- UH GEAUGA MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT A JOINT CHNA FOR GEAUGA COUNTY: CASA FOR KIDS OF GEAUGA COUNTY, CATHOLIC CHARITIES COMMUNITY SERVICES, CHAGRIN FALLS PARK COMMUNITY CENTER, DDC CLINIC, FAMILY PLANNING ASSOCIATION OF NORTHEAST OHIO, INC. (A DIVISION OF SIGNATURE HEALTH), FAMILY PRIDE, GEAUGA COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, GEAUGA COUNTY BOARD OF HEALTH, GEAUGA COUNTY BOARD OF MENTAL HEALTH & RECOVERY SERVICES, GEAUGA COUNTY CLERK OF COURTS, GEAUGA COUNTY COMMISSIONERS, GEAUGA COUNTY DEPARTMENT ON AGING, GEAUGA COUNTY EDUCATIONAL SERVICE CENTER: (REPRESENTING ALL GEAUGA COUNTY SCHOOL DISTRICTS), GEAUGA PUBLIC HEALTH, GEAUGA COUNTY HEALTH DISTRICT ADVISORY COUNCIL, GEAUGA COUNTY HUNGER TASK FORCE, GEAUGA COUNTY JOB AND FAMILY SERVICES, GEAUGA COUNTY PUBLIC LIBRARY SYSTEM, GEAUGA COUNTY RESIDENTS, GEAUGA COUNTY SHERIFF, GEAUGA COUNTY TOWNSHIP ASSOCIATION, GEAUGA FAMILY FIRST COUNCIL, GEAUGA PARK DISTRICT, LAKE-GEAUGA HEAD START, LAKE GEAUGA RECOVERY CENTERS, LIFE ACT, MIDDLEFIELD CARE CENTER, NAMI GEAUGA, OHIO DEPARTMENT OF HEALTH, RAVENWOOD MENTAL HEALTH CENTER, STARTING POINT, TORCHLIGHT YOUTH MENTORING ALLIANCE, UNITED WAY SERVICES OF GEAUGA COUNTY, AND WOMENSAFE, INC.
      GROUP B-FACILITY 3 -- UH GEAUGA MEDICAL CENTER PART V, SECTION B, LINE 11:
      THE 2020 IMPLEMENTATION STRATEGY FOR UH GEAUGA MEDICAL CENTER IDENTIFIES THE FOLLOWING FIVE PRIORITY HEALTH NEEDS AND TWO CROSSING-CUTTING FACTORS, ALONG WITH STRATEGIES TO ADDRESS THEM:PRIORITY HEALTH NEED #1: MENTAL HEALTH- STRATEGY #1: CAMPAIGN TO INCREASE AWARENESS OF BEHAVIORAL HEALTH WARNING SIGNSPRIORITY HEALTH NEED #2: ADDICTION- STRATEGY #1: MEDICATION ASSISTED TREATMENT (MAT)- STRATEGY #2: SCHOOL-BASED ALCOHOL/OTHER DRUG PREVENTION PROGRAMS- STRATEGY #3: NALOXONE ACCESSPRIORITY HEALTH NEED #3: CHRONIC DISEASE- STRATEGY #1: PREDIABETES SCREENING AND REFERRAL- STRATEGY #2: HYPERTENSION SCREENING AND FOLLOW UP- STRATEGY #3: WELLNESS NAVIGATION- STRATEGY #4: SCREENING EVENTSCROSS-CUTTING FACTOR #1: PUBLIC HEALTH SYSTEM, PREVENTION AND HEALTH BEHAVIORS- STRATEGY #1: EMPLOY STRATEGIES OF INTENTIONAL INCLUSION IN THE COLLECTION OF POPULATION HEALTH DATA TO ASSURE REPRESENTATION OF POPULATIONS WHO EXPERIENCE HEALTH DISPARITIES AND HEALTH INEQUITIESCROSS-CUTTING FACTOR #2: HEALTH SYSTEMS AND ACCESS- STRATEGY #1: AMISH OUTREACH PROGRAMSNEEDS IDENTIFIED IN THE 2019 CHNA BUT NOT BEING ADDRESSED BY THE HOSPITAL INCLUDE: TRAUMA INFORMED CARE, SCHOOL-BASED SOCIAL AND EMOTIONAL INSTRUCTION, DIABETES PREVENTION PROGRAM, MASS-REACH COMMUNICATIONS, EXPANDED ACCESS TO EVIDENCE BASED TOBACCO CESSATION TREATMENTS, AND OUTREACH TO INCREASE UPTAKE FOR EARNED INCOME TAX CREDITS. THESE NEEDS ARE BEING ADDRESSED BY OTHER GEAUGA PARTNERS BASED ON THEIR SPECIFIC EXPERTISE, EXPERIENCES, OR RESOURCES.
      GROUP B-FACILITY 3 -- UH GEAUGA MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP B-FACILITY 3 -- UH GEAUGA MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP B-FACILITY 3 -- UH GEAUGA MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      GROUP B-FACILITY 12 -- UH SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 3J:
      "IN ADDITION TO REPORTING THE ITEMS DESCRIBED IN PART V, SECTION B, LINES 3A THROUGH 3I, THE 2019 CHNA EXAMINED ECONOMIC INDICATORS SUCH AS POVERTY, UNEMPLOYMENT, STATE BUDGET DEVELOPMENTS, HOUSEHOLD INCOME AND HEALTH STATUS INDICATORS FROM SOURCES SUCH AS COUNTY HEALTH RANKINGS, THE COMMUNITY HEALTH STATUES INDICATORS PROJECT, THE OHIO DEPARTMENT OF HEALTH, THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), THE DIGNITY HEALTH COMMUNITY NEEDS INDEX, AND THE U.S. DEPARTMENT OF AGRICULTURE. DATA FROM THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) REGARDING FEDERALLY QUALIFIED HEALTH CENTERS WERE ALSO USED. MEDICALLY UNDERSERVED AREAS AND POPULATIONS, HEALTH PROFESSIONAL SHORTAGE AREAS, AND HOSPITAL UTILIZATION WERE ALSO ASSESSED.UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. WORKED CLOSELY WITH THE CENTER FOR HEALTH AFFAIRS (""THE CENTER"") AND THE CYPRESS RESEARCH GROUP (""CYPRESS"") TO COMPLETE THE DATA ASSESSMENT AND SUMMARY PORTIONS OF THE 2019 CHNA. UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. RETAINED THE CENTER FOR HEALTH AFFAIRS TO ASSIST IN DATA COLLECTION AND ANALYSIS TO ENSURE THE ENTIRE COMMUNITY SERVED BY THE HOSPITAL WAS CAPTURED. THE CENTER AND CYPRESS GUIDED THE PROCESS AND THEN COLLABORATED WITH THE HOSPITALS TO REVIEW PRIMARY DATA, HOSPITAL UTILIZATION AND DISCHARGE DATA, AND EVALUATION OF PROGRAM IMPACT REPORTS FROM PREVIOUS CHNA'S. THE CENTER IS THE LEADING ADVOCATE FOR NORTHEAST OHIO HOSPITALS. THE CENTER ADVOCATES ON BEHALF OF 36 HOSPITALS IN NINE COUNTIES. CYPRESS PROVIDES CUSTOM RESEARCH SERVICES TO MEET VARIOUS MARKET AND BUSINESS RESEARCH NEEDS. THEY FOCUS ON QUANTITATIVE ANALYSIS OF PRIMARY AND SECONDARY MARKET AND INDUSTRY DATA, ESPECIALLY IN THE HEALTH CARE, HI-TECH, AND HIGHER EDUCATION INDUSTRIES."
      GROUP B-FACILITY 12 -- UH SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 5:
      THE UH SAMARITAN MEDICAL CENTER CHNA TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THROUGH A SERIES OF MAIL SURVEYS AND IN-PERSON INTERVIEWS WITH COMMUNITY LEADERS. THE MAILING SURVEY WAS SENT TO 1,200 ADULTS IN ASHLAND COUNTY AND THE RESPONSE RATE WAS 30%, WHICH FORCED THE CONFIDENCE LEVEL TO RISE FROM +/- 5% TO +/-5.25%. ADOLESCENTS WERE RANDOMLY CHOSEN AFTER APPROVAL BY SUPERINTENDENT AND PARENT APPROVAL. THE RESPONSE RATE FOR ADOLESCENTS WAS 93%. COUNTY-LEVEL DATA, NUMEROUS CDC SITES, THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, US CENSUS DATA, AND OTHER NATIONAL AND LOCAL SOURCES WERE ALSO USED IN COLLECTING SECONDARY DATA. COMMUNITY LEADERS FROM THE ASHLAND CITY HEALTH DISTRICT AND THE ASHLAND COUNTY GENERAL HEALTH DISTRICT OFFERED THEIR ANALYSIS BASED ON THEIR WORK AS LOCAL GOVERNMENTAL PUBLIC HEALTH AGENCIES. PARTICIPATING COMMUNITY LEADERS PROVIDED INPUT INTO THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE 2019 REPORT ADDRESSES THE FOLLOWING BROAD TOPICS: HEALTH CARE ACCESS (E.G. HEALTH CARE COVERAGE, ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, MEN/WOMEN'S HEALTH, AND ORAL HEALTH); HEALTH BEHAVIORS (E.G. HEALTH STATUS PERCEPTIONS, ADULT WEIGH STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, AND ADULT MENTAL HEALTH); CHRONIC DISEASE (E.G. CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, AND QUALITY OF LIFE); SOCIAL CONDITIONS (E.G. SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, AND PARENTING); YOUTH HEALTH (E.G. YOUTH WEIGHT STATUES, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH SOCIAL DETERMINANTS OF HEALTH, AND YOUTH VIOLENCE).
      GROUP B-FACILITY 12 -- UH SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 6B:
      THE FOLLOWING ORGANIZATIONS WORKED IN COLLABORATION TO CONDUCT A JOINT CHNA FOR ASHLAND COUNTY: CITY OF ASHLAND, ASHLAND COUNTY HEALTH DEPARTMENT, ASHLAND COUNTY MENTAL HEALTH & RECOVERY BOARD, ASHLAND CITY SCHOOLS, MAPLETON LOCAL SCHOOLS, ASHLAND COUNTY COMMUNITY ACADEMY, ASHLAND COUNTY FAMILY & CHILDREN FIRST COUNCIL, ASHLAND COUNTY CATHOLIC CHARITIES, ASHLAND COUNTY COUNCIL ON AGING, ASHLAND COUNTY BOARD OF DEVELOPMENTAL DISABILITIES, APPLESEED COMMUNITY MENTAL HEALTH CENTER, ASHLAND COUNTY BOARD OF HEALTH, ASHLAND YMCA, ASHLAND COUNTY CHAMBER OF COMMERCE, ASHLAND PARENTING PLUS, ASHLAND COUNTY EMA, ASHLAND COUNTY JOB & FAMILY SERVICES, AND SAFE HAVEN OF ASHLAND, OHIO.
      GROUP B-FACILITY 12 -- UH SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 11:
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
      GROUP B-FACILITY 12 -- UH SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 13H:
      PATIENTS MUST MEET SEVERAL QUALIFICATIONS TO BE ELIGIBLE FOR THE UH FAP. CRITERIA OTHER THAN THOSE ALREADY CHECKED INCLUDE: - THE CARE BEING DISCOUNTED MUST BE MEDICALLY NECESSARY (NON-ELECTIVE) AND A SERVICE THAT THE OHIO MEDICAID PROGRAM WOULD COVER. - PATIENTS MUST AGREE TO ALLOW UH TO APPLY ON THEIR BEHALF FOR THIRD-PARTY PAYMENT PROGRAMS, IF APPLICABLE.
      GROUP B-FACILITY 12 -- UH SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 15E:
      THE UH FINANCIAL ASSISTANCE PROGRAM (FAP) IS INTENDED FOR ALL HOSPITAL PATIENTS WHO MEET THE CONDITIONS AND GUIDELINES OUTLINED IN THE POLICY. INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE UH FAP IS INCLUDED ON ALL HOSPITAL PATIENT STATEMENTS AND BILLS, INCLUDED ON THE UH WEBSITE, DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH FACILITIES IN AREAS OF HOSPITAL REGISTRATION AND FINANCIAL COUNSELING, AND DISPLAYED ON SIGNS AND IN BROCHURES AT ALL UH HOSPITAL FACILITIES PATIENT ACCESS AREAS OR FINANICAL ASSISTANCE OFFICES. IF A PATIENT DOES NOT QUALIFY FOR THE FAP BUT BELIEVES THEY HAVE SPECIAL CIRCUMSTANCES, THE PATIENT CAN REQUEST THAT THEIR CARE BE REVIEWED BY A UH HOSPITAL FINANCIAL COUNSELOR.
      GROUP B-FACILITY 12 -- UH SAMARITAN MEDICAL CENTER PART V, SECTION B, LINE 18E:
      NO UH HOSPITAL FACILITIES WERE PERMITTED TO ENGAGE IN ANY OF THE ACTIONS DESCRIBED IN PART V, LINE 18 BEFORE MAKING REASONABLE EFFORTS TO DETERMINE INDIVIDUALS' ELIGIBILITY UNDER THE FACILITIES' FINANCIAL ASSSTANCE POLICY.
      REPORTING GROUP A
      PART V, SECTION B, LINE 7A:HTTPS://WWW.UHHOSPITALS.ORG/ABOUT-UH/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTREPORTING GROUP APART V, SECTION B, LINE 10A:HTTPS://WWW.UHHOSPITALS.ORG/ABOUT-UH/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTREPORTING GROUP APART V, SECTION B, LINE 16A, FAP WEBSITE:HTTPS://WWW.UHHOSPITALS.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE-AND-MEDICAL-RECORDS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/REPORTING GROUP APART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.UHHOSPITALS.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE-AND-MEDICAL-RECORDS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/REPORTING GROUP APART V, SECTION B, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.UHHOSPITALS.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE-AND-MEDICAL-RECORDS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/
      REPORTING GROUP B
      PART V, SECTION B, LINE 7A:HTTPS://WWW.UHHOSPITALS.ORG/ABOUT-UH/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTREPORTING GROUP BPART V, SECTION B, LINE 10A:HTTPS://WWW.UHHOSPITALS.ORG/ABOUT-UH/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTREPORTING GROUP BPART V, SECTION B, LINE 16A, FAP WEBSITE:HTTPS://WWW.UHHOSPITALS.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE-AND-MEDICAL-RECORDS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/REPORTING GROUP BPART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.UHHOSPITALS.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE-AND-MEDICAL-RECORDS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/REPORTING GROUP BPART V, SECTION B, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.UHHOSPITALS.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE-AND-MEDICAL-RECORDS/PAY-MY-BILL/FINANCIAL-ASSISTANCE/
      Supplemental Information
      Schedule H (Form 990) Part VI
      PART I, LINE 3C:
      PLEASE REFER TO SCHEDULE H, PART V, LINE 13 A-H.
      PART I, LINE 6A:
      THE PARENT ORGANIZATION, UNIVERSITY HOSPITALS (34-0714775), PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT ENCOMPASSES ALL OF THE UNIVERSITY HOSPITALS HEALTH SYSTEM INCLUDING THE SUBORDINATE ORGANIZATIONS COMPLETING SCHEDULE H.
      PART I, LINE 7:
      "AMOUNTS CALCULATED AND REPORTED IN THIS TABLE WERE DERIVED FROM THE MOST ACCURATE, AVAILABLE SOURCES. A COST-TO-CHARGE RATIO WAS USED TO DETERMINE FINANCIAL ASSISTANCE COST USING HOSPITAL FINANCIAL STATEMENTS. MEDICAID SHORTFALL FOR GROUP SUBORDINATES WAS CALCULATED; 1) BASED ON THE TAX YEAR'S MEDICAID COST REPORT ADJUSTED TO REFLECT FULL COSTS TO DIRECT OFFSETTING REVENUE FROM THE MEDICAID COST REPORT, OR 2) BASED ON A COST-TO-CHARGE RATIO AND MEDICAID REVENUES DERIVED USING FINANCIAL STATEMENTS. INCLUDED IN THIS MEDICAID SHORTFALL IS THE OHIO STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) SHORTFALL. COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT OPERATIONS COSTS HAVE BEEN REPORTED BASED ON ACTUAL DIRECT COSTS USING ACTUAL OR AVERAGE EMPLOYEE COMPENSATION RATES AND ADDING INDIRECT COSTS WHICH ARE CALCULATED BY A COST ACCOUNTING SYSTEM AS A PERCENTAGE OF TOTAL COST. THE MEDICARE COST REPORT, ADJUSTED TO REFLECT FULL COSTS, WAS USED TO DETERMINE GROSS COMMUNITY BENEFIT EXPENSE AMOUNTS FOR HEALTH PROFESSIONS EDUCATION. DIRECT OFFSETTING REVENUES ARE INCLUDED FROM MEDICARE, CHILDREN'S HOSPITALS GRADUATE MEDICAL EDUCATION, AND MEDICAID FOR DIRECT MEDICAL EDUCATION. RESEARCH AMOUNTS WERE ALSO BASED ON THE MEDICARE COST REPORT, ADJUSTED TO REFLECT FULL COSTS, USING COSTS ASSIGNED TO RESEARCH COST CENTERS, LESS INDUSTRY-SPONSORED RESEARCH DIRECT AND INDIRECT COSTS. THE EXPENSE OF RESTRICTED CASH CONTRIBUTIONS IS REPORTED BASED ON THE ACTUAL VALUE OF THE CONTRIBUTION BEFORE INDIRECT COST. RESTRICTED IN-KIND CONTRIBUTIONS ARE REPORTED AT FAIR MARKET VALUE. IN CALCULATING GROSS AND NET COMMUNITY BENEFIT EXPENSES, CARE WAS TAKEN TO AVOID DOUBLE-COUNTING COMMUNITY BENEFIT EXPENSES. THE SYSTEM'S NET COMMUNITY BENEFIT CONTRIBUTION FOR FISCAL YEAR 2021 TOTALED $500 MILLION AS COMPARED TO THE 2020 COMMUNITY BENEFIT TOTAL OF $483 MILLION. THE 2021 COMMUNITY BENEFIT NUMBER CONSISTED OF CHARITY CARE ($50 MILLION), MEDICAID SHORTFALL ($290 MILLION), RESEARCH ($66 MILLION), EDUCATION AND TRAINING ($104 MILLION), AND COMMUNITY HEALTH IMPROVEMENT SERVICES, PROGRAMS AND SUPPORT ($22 MILLION), LESS HOSPITAL CARE ASSURANCE PROGRAM (""HCAP"") ($32 MILLION). TO MEASURE AND REPORT COMMUNITY BENEFIT, THE SYSTEM HAS FOLLOWED INTERNAL REVENUE SERVICE GUIDELINES. AS SUCH, THE INFORMATION FOR 2021 REPRESENTS THE REVISED REQUIREMENT TO OFFSET VARIOUS COMMUNITY BENEFIT PROGRAMS WITH RELATED REVENUE RECEIVED. FOR 2021, THIS REVENUE OFFSET WAS $32 MILLION. THE 2020 INFORMATION PROVIDED ABOVE ($483 MILLION) INCLUDED A REVENUE OFFSET OF $27 MILLION."
      PART I, LINE 7G:
      LINE 7G INCLUDES THE COSTS AND DIRECT OFFSETTING REVENUE ASSOCIATED WITH CERTAIN HOSPITAL SERVICES THAT QUALIFY TO BE REPORTED AS A SUBSIDIZED HEALTH SERVICE. THE TOTAL AMOUNT OF GROSS COMMUNITY BENEFIT EXPENSE INCLUDED IN LINE 7G FOR THESE CLINICS IS: $34,877,639. THE TOTAL AMOUNT OF ASSOCIATED DIRECT OFFSETTING REVENUE IS $21,606,557. THE TOTAL AMOUNT OF NET COMMUNITY BENEFIT EXPENSE INCLUDED IN LINE 7G IS $13,271,082.
      PART II, COMMUNITY BUILDING ACTIVITIES:
      COMMITMENT TO THE COMMUNITY REMAINS AT THE CORE OF THE SYSTEM'S MISSION: TO HEAL. TO TEACH. TO DISCOVER. THE SYSTEM SUPPORTS NUMEROUS COMMUNITY BUILDING ACTIVITIES THROUGH ALL SYSTEM ENTITIES AND NOT JUST THOSE REPORTED WITHIN THE UH GROUP 990. MANY OF OUR COMMUNITY BUILDING ACTIVITIES ARE DIFFICULT TO QUANTIFY OR REPORT WITHIN THE SPECIFIC CATEGORIES PROVIDED IN SCHEDULE H, AS THEY OCCUR SYSTEM-WIDE AND NOT AT SPECIFIC ENTITY LEVELS.THE SYSTEM IS PROUD TO CONTRIBUTE TO THE ECONOMIC GROWTH OF THE COMMUNITIES WE SERVE. THE UH HEALTH SYSTEM PROVIDES EMPLOYMENT DIRECTLY FOR 42,009 (6,056 REPORTED ON THE PARENT ORGANIZATION'S FORM 990, UNIVERSITY HOSPITALS HEALTH SYSTEM, INC. (34-0714775)) EMPLOYEES AND PHYSICIANS. UH PROVIDED MANY MORE COMMUNITY BUILDING ACTIVITIES, DIRECTLY AND INDIRECTLY, THROUGH NEW OR EXPANDED BUSINESS OPPORTUNITIES AND THROUGH IMPORTANT CAPITAL INVESTMENTS IN OUR FACILITIES. UH HAS COMMITTED - AND CONTINUES TO COMMIT - MILLIONS OF DOLLARS TO FACILITIES AND OPERATIONS WITHIN THE CITY OF CLEVELAND AND THROUGHOUT OUR REGION, PROVIDING CONSTRUCTION AND HOSPITAL-BASED JOBS. NEW STATE-OF-THE-ART OUTPATIENT HEALTH CENTERS IN THE REGION HAVE SPURRED ECONOMIC GROWTH WHILE GIVING PEOPLE ACCESS TO THE CARE THEY NEED CLOSE TO HOME AND EXPANDING OUR COMMUNITY BENEFIT PROGRAMS. THE SYSTEM'S SUPPLY CHAIN MANAGEMENT STRATEGY ENCOMPASSES SUPPLIER DIVERSITY TO INCLUDE MINORITY AND WOMEN-OWNED BUSINESS ENTERPRISES PROVIDING THEM OPPORTUNITIES TO BE OUR PARTNERS AND SUPPLIERS OF GOODS AND SERVICES THROUGHOUT THE SYSTEM.THE SYSTEM SEEKS TO INCORPORATE ENVIRONMENTAL RESPONSIBILITY AND IS WORKING TOWARDS REDUCING ITS ENVIRONMENTAL FOOTPRINT THROUGHOUT THE COMMUNITIES IT SERVES. WITH REGARD TO UH BUILDINGS AND MAJOR RENOVATIONS, UH ENDEVORS TO INCORPORATE DESIGN AND CONSTRUCTION STRATEGIES OF THIRD-PARTY BEST-PRACTICE GUIDES SUCH AS THE U.S. GREEN BUILDING COUNCIL'S LEADERSHIP IN ENERGY AND ENVIRONMENTAL DESIGN (LEED) CERTIFICATION SYSTEM, THE EPA'S ENERGY STAR PERFORMANCE RATING, AND HEALTHCARE WITHOUT HARM'S GREEN GUIDE FOR HEALTHCARE. RECENT CONSTRUCTION PROJECTS HAVE INCORPORATED SUSTAINABLE DESIGN STRATEGIES.
      PART III, LINE 2:
      THE COST OF BAD DEBT IS CALCULATED USING A COST TO CHARGE RATIO.ALLOWANCES ARE MADE FOR ESTIMATED DOUBTFUL ACCOUNTS BASED ON HISTORICAL EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS.
      PART III, LINE 3:
      THERE IS NO ESTIMATED AMOUNT (ZERO) OF BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE FINANCIAL ASSISTANCE POLICY. FOR PATIENTS WHO QUALIFY, THOSE PATIENTS ARE DEEMED TO BE UNABLE TO PAY AND ARE THEREFORE WRITTEN OFF TO CHARITY RATHER THAN BAD DEBT.
      PART III, LINE 8:
      UH HOSPITALS PROVIDE SERVICES TO MANY LOW-INCOME MEDICARE RECIPIENTS. THE MEDICARE LOSSES SUSTAINED AT THESE HOSPITALS ARE A RESULT OF MEDICARE REIMBURSING AT LESS THAN OPERATING COSTS. IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR HOSPITALS, PROVIDES THAT IF A HOSPITAL SERVES PATIENTS COVERED BY GOVERNMENTAL HEALTH BENEFITS (INCLUDING MEDICARE), THEN THIS INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN TURN, TREATING MEDICARE PATIENTS IS CONSIDERED A COMMUNITY BENEFIT. COSTS WERE DERIVED USING THE MEDICARE COST REPORT.
      PART III, LINE 9B:
      PATIENT LIABILITIES FOR SERVICES RENDERED BY UH HOSPITAL FACILITIES SHALL BE COLLECTED FROM ALL PATIENTS. AMOUNTS OWED BY PATIENTS QUALIFYING FOR CHARITY CARE UNDER THE UH HOSPITALS FACILITIES' CHARITY/FINANCIAL ASSISTANCE POLICY SHALL NOT BE BILLED TO PATIENTS AT AMOUNTS THAT ARE MORE THAN THE AMOUNTS GENERALLY BILLED TO MEDICARE PATIENTS.IF A PATIENT QUALIFIES FOR A 100% FINANCIAL ASSISTANCE DISCOUNT, COLLECTION OF THE ACCOUNT IS NOT PURSUED. IF A PATIENT RECEIVES A PARTIAL DISCOUNT DUE TO MEDICAL INDIGENCY UNDER THE FINANCIAL ASSISTANCE POLICY, ANY REMAINING BALANCE NOT DISCOUNTED IS TREATED IN ACCORDANCE WITH THE UH HOSPITALS COLLECTION POLICY.
      PART VI, LINE 2:
      UH ASSESSES THE HEALTH CARE NEEDS OF ITS COMMUNITIES AS PART OF THE REGULAR STRATEGIC PLANNING PROCESS WHICH INCLUDES ASSESSMENTS OF ENVIRONMENTAL, DEMOGRAPHIC, AND ECONOMIC FACTORS. THE SYSTEM ALSO USES UH PATIENT SURVEYS REGARDING HEALTH CARE UTILIZATION AND WORKS ACTIVELY WITH VARIOUS PARTNERS THROUGHOUT THE COMMUNITIES WE SERVE. UH HAS WORKED WITH COMMUNITY ORGANIZATIONS IN ITS MEDICAL CENTERS' SERVICE AREAS (I.E. NEIGHBORHOOD CONNECTIONS, LOCAL DEPARTMENTS OF PUBLIC HEALTH, LOCAL DISEASE FOUNDATIONS, ETC.). THE SYSTEM WORKS CLOSELY WITH LOCAL GOVERNMENTS AND ELECTED OFFICIALS TO UNDERSTAND THEIR COMMUNITIES' NEEDS AND WORK TO IMPLEMENT PROGRAMS AND ACTIVITIES TO ASSIST IN RESPONDING TO THOSE NEEDS. THE MEMBERS OF VARIOUS UH BOARDS ARE ACTIVE MEMBERS WITHIN THE COMMUNITIES SERVED AND PROVIDE AN UNDERSTANDING OF AND COLLABORATIVE FEEDBACK RELATED TO THE NEEDS OF THE COMMUNITIES.THE SYSTEM IS PROUD TO CONTRIBUTE TO THE HEALTH OF ITS CITIZENS AND TO BE A POSITIVE ECONOMIC FORCE IN ITS REGION. FOR MORE DETAILED INFORMATION ON THE SYSTEM'S COMMUNITY BENEFIT OR TO VIEW THE 2021 COMMUNITY BENEFIT REPORT, PLEASE VISIT THE SYSTEM'S WEBSITE AT WWW.UHHOSPITALS.ORG.
      PART VI, LINE 3:
      "UH INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT OPTIONS FOR RESOLUTION OF THEIR BALANCES, INCLUDING ASSISTANCE UNDER GOVERNMENT PROGRAMS AND UNDER THE UH FINANCIAL ASSISTANCE PROGRAM (""ASSISTANCE PROGRAM"") IN A VARIETY OF WAYS. SIGNAGE FOR THE STATE OF OHIO HEALTH CARE ASSURANCE PROGRAM (HCAP) AND THE UH PATIENT FINANCIAL ASSISTANCE PROGRAM CAN BE FOUND IN LOCATIONS WHERE PATIENTS REGISTER FOR CARE, PATIENT ACCESS AREAS, AND VARIOUS POINTS OF ENTRY SUCH AS UH EMERGENCY DEPARTMENTS. SUPPLEMENTAL BROCHURES THAT REFLECT THE UH PATIENT FINANCIAL ASSISTANCE PROGRAM AND THE HCAP PROGRAM ARE ALSO AVAILABLE. INFORMATION ABOUT THE ASSISTANCE PROGRAM CAN ALSO BE FOUND ON THE UH WEBSITE IN ADDITION TO BEING PROVIDED ON THE BACKS OF PATIENT STATEMENTS, INCLUDING A TOLL FREE PHONE NUMBER TO CALL FOR ASSISTANCE FROM A UH FINANCIAL COUNSELOR."
      PART VI, LINE 5:
      UH CONTINUES TO INVEST IN ITSELF AND THE COMMUNITY THROUGH ENHANCED CLINICAL SERVICES, EDUCATIONAL PROGRAMS, RESEARCH, AND CAPITAL IMPROVEMENTS THAT MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES AND PATIENTS IT SERVES. UH PROVIDES AN OUTSTANDING BALANCE OF HIGH-QUALITY CLINICAL CARE WITHIN ITS WALLS, AND COMMUNITY HEALTH OUTREACH TO LOCAL POPULATIONS. FOUR UH HEALTH CLINICS ARE LOCATED IN AREAS DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). THESE CLINICS INCLUDE THE DOUGLAS MOORE HEALTH CLINIC, WOMEN'S HEALTH CENTER, RAINBOW AMBULATORY PRACTICE, AND FAMILY MEDICINE CLINIC, ALL LOCATED ON THE CAMPUS OF UH CASE MEDICAL CENTER. HRSA ALSO DESIGNATES MEDICALLY UNDERSERVED AREAS (MUAS) AND MEDICALLY UNDERSERVED POPULATIONS (MUPS) BASED ON SPECIFIC CRITERIA. TWENTY-FIVE AREAS WITHIN THE UH SERVICE AREA INCLUDING CUYAHOGA, LORAIN, AND SUMMIT COUNTIES QUALIFY AS MUAS, WHILE ONE POPULATION IN KENT, PORTAGE COUNTY IS A DESIGNATED MUP. CUYAHOGA COUNTY ALONE ACCOUNTS FOR 20 MUAS LOCATED IN 13 ZIP CODES, REPRESENTING 12 TOWNS. THE UH SYSTEM'S TWO CRITICAL ACCESS HOSPITALS IN ASHTABULA COUNTY SIT IN APPALACHIA, AS DESIGNATED BY THE APPALACHIAN REGIONAL COMMISSION.UH IS COMMITTED TO TRAINING THE NEXT GENERATION OF PHYSICIANS, NURSES, SPECIALISTS AND OTHER ALLIED HEALTH CARE PROVIDERS ANNUALLY. MANY OF THESE STUDENTS AND TRAINEES COMPLETE THEIR EDUCATION AND TAKE THEIR KNOWLEDGE AND EXPERTISE TO OTHER PARTS OF THE STATE OR COUNTRY, THEREBY BENEFITING OTHER COMMUNITIES.UH WORKS TO INCREASE HEALTH AND MEDICAL KNOWLEDGE THROUGH GOVERNMENT AND NON-PROFIT FUNDED RESEARCH. THE SHARED KNOWLEDGE DERIVED FROM THESE EFFORTS IMPROVES THE HEALTH AND WELL-BEING OF PEOPLE THROUGHOUT THE NATION AND THE WORLD WHEN THEY LEAD TO NEW STANDARDS OF CARE, NEW MEDICAL DEVICES, OR BREAKTHROUGHS IN TACKLING DISEASES.AS INDICATED IN THE ABOVE RESPONSE TO PART VI, LINE 4, UH HAS MADE SIGNIFICANT INVESTMENTS IN ACCESS TO CARE FOR LOW INCOME AND VULNERABLE RESIDENTS WITHIN THE COUNTIES UH SERVES.
      PART VI, LINE 6:
      FOUR UH HEALTH CLINICS ARE LOCATED IN AREAS DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). THESE CLINICS INCLUDE THE DOUGLAS MOORE HEALTH CLINIC AND FAMILY MEDICINE CLINIC LOCATED ON THE CAMPUS OF UH CLEVELAND MEDICAL CENTER, AND THE WOMEN'S HEALTH CENTER AND RAINBOW AMBULATORY PRACTICE LOCATED OFF CAMPUS IN THE UH RAINBOW CENTER FOR WOMEN & CHILDREN. UH SERVES AN ESSENTIAL ROLE IN THE COMMUNITY BY PROVIDING DIVERSE POPULATIONS THROUGHOUT THE NORTHEAST OHIO REGION WITH COMPREHENSIVE HEALTH CARE - FROM PRIMARY CARE TO HIGHLY SPECIALIZED MEDICAL CARE FOR THE MOST SERIOUS OF HEALTH PROBLEMS. IT PROVIDES THE SAME QUALITY AND COMPASSIONATE SERVICE TO ALL, NO MATTER THEIR INCOME, ABILITY TO PAY OR SOCIOECONOMIC STATUS. UH CARES FOR THE WELL-INSURED AND THE UNINSURED; MEN, WOMEN AND CHILDREN FROM EVERY COMMUNITY IN THE REGION, FROM URBAN CENTERS, SMALL TOWNS, RURAL AREAS AND SUBURBS.
      PART VI, LINE 7, REPORTS FILED WITH STATES
      OH
      PART VI, LINE 4:
      UH CLEVELAND MEDICAL CENTERUH RAINBOW BABIES & CHILDREN'S HOSPITALUH AHUJA MEDICAL CENTERUH REGIONAL HOSPITALSUH PARMA MEDICAL CENTERUH ST. JOHN MEDICAL CENTERUH BEACHWOOD REHABILITATION HOSPITALTHE PRIMARY SERVICE AREA FOR THESE HOSPITALS IS CUYAHOGA COUNTY. AS OF THE 2017 CENSUS, THE TOTAL POPULATION FOR CUYAHOGA COUNTY IS 1,248,514. 59.0% OF THE POPULATION IDENTIFIES AS WHITE ALONE, 29.1% AFRICAN AMERICAN, 5.9% HISPANIC OR LATINO, AND 6.0% AS MORE THAN ONE RACE OR OTHER. CUYAHOGA COUNTY ALSO ENCOMPASSES THE CITY OF CLEVELAND. THE TOTAL POPULATION FOR THE CITY OF CLEVELAND AS OF 2017 IS 385,552. 32.9% OF THE POPULATION IDENTIFIES AS WHITE ALONE, 48.3% AFRICAN AMERICAN, 12.4% HISPANIC OR LATINO, AND 6.4% AS MORE THAN ONE RACE OR OTHER. CUYAHOGA COUNTY'S POPULATION IS GROWING OLDER, ON AVERAGE. THE 2016 POPULATION ESTIMATES INDICATE MINOR DIFFERENCES BETWEEN CUYAHOGA COUNTY OVERALL AND THE CITY OF CLEVELAND WITH RESPECT TO AGE GROUPS AND GENDER. ALTHOUGH SMALL, THE MOST NOTABLE DIFFERENCES INCLUDE A GREATER PERCENTAGE OF PERSONS UNDER THE AGE OF 18 AND PERSONS 18 TO 34 YEARS OF AGE LIVING IN THE CITY OF CLEVELAND COMPARED TO CUYAHOGA COUNTY AS A WHOLE. CONVERSELY, A GREATER PERCENTAGE OF INDIVIDUALS AGED 65 AND OVER ARE LIVING IN CUYAHOGA COUNTY OVERALL COMPARED TO THE CITY OF CLEVELAND. THE AVERAGE LIFE EXPECTANCY IN CUYAHOGA COUNTY IS 76.4 YEARS OLD COMPARED TO 72.2 YEARS OLD IN THE CITY OF CLEVELAND. 94.6% OF THE POPULATION IN CUYAHOGA COUNTY HAS A HIGH SCHOOL DIPLOMA OR EQUIVALENT, AND 89.9% IN THE STATE OF OHIO. AS OF 2017, 18.0% OF THE POPULATION OF THE COUNTY IS BELOW THE POVERTY LINE COMPARED TO 33.1% IN THE CITY OF CLEVELAND. BOTH OF WHICH ARE HIGHER THAN THE 14.0% AVERAGE IN OHIO.UH GEAUGA MEDICAL CENTER THE PRIMARY SERVICE AREA FOR THESE HOSPITALS IS GEAUGA COUNTY. THE TOTAL POPULATION FOR GEAUGA COUNTY AS OF THE 2017 CENSUS IS 93,895. 96.7% OF THE POPULATION IDENTIFIES AS WHITE ALONE, 1.4% AS HISPANIC OR LATINO, 1.2% AFRICAN AMERICAN, AND 3.0% AS MORE THAN ONE RACE OR OTHER. THE MEDIAN AGE IS 44.4 YEARS OLD. THE AVERAGE HOUSEHOLD SIZE IS 2.65 PEOPLE AND THE AVERAGE FAMILY SIZE IS 3.09 PEOPLE. THE MEDIAN HOME VALUE FOR THE COUNTY IS $228,000. 90.3% OF THE POPULATION HAS A HIGH SCHOOL DIPLOMA OR EQUIVALENT OR HIGHER EDUCATION LEVEL, OF THAT 38.0% HAS A BACHELOR'S DEGREE OR HIGHER LEVEL OF EDUCATION. THE PER CAPITA PERSONAL INCOME FOR THE COUNTY IS $39,513. 6.5% OF INDIVIDUALS AND 4.3% OF FAMILIES IS BELOW THE POVERTY LINE COMPARED TO THE AVERAGE 14.0% IN OHIO.UH GENEVA MEDICAL CENTERUH CONNEAUT MEDICAL CENTERTHE PRIMARY SERVICE AREA FOR THESE HOSPITALS IS ASHTABULA COUNTY. THE TOTAL POPULATION FOR ASHTABULA COUNTY AS OF THE 2017 CENSUS IS 98,622. 92.9% OF THE POPULATION IDENTIFIES AS WHITE ALONE, 4.0% AS HISPANIC OR LATINO, 3.7% AFRICAN AMERICAN, 0.5% ASIAN, AND 2.9% AS MORE THAN ONE RACE OR OTHER. THE MEDIAN AGE IS 42.5 YEARS OLD. THE AVERAGE HOUSEHOLD SIZE IS 2.48 PEOPLE AND THE AVERAGE FAMILY SIZE IS 3.05 PEOPLE. THE MEDIAN HOME VALUE FOR THE COUNTY IS $106,300. 85.7% OF THE POPULATION HAS A HIGH SCHOOL DIPLOMA OR EQUIVALENT OR HIGHER EDUCATION LEVEL, OF THAT 13.4% HAS A BACHELOR'S DEGREE OR HIGHER LEVEL OF EDUCATION. THE PER CAPITA PERSONAL INCOME FOR THE COUNTY IS $23,297. 19.8% OF INDIVIDUALS AND 14.2% OF FAMILIES IS BELOW THE POVERTY LINE COMPARED TO THE AVERAGE 14.0% IN OHIO.UH ELYRIA MEDICAL CENTERTHE PRIMARY SERVICE AREA FOR THESE HOSPITALS IS LORAIN COUNTY. THE TOTAL POPULATION FOR LORAIN COUNTY AS OF THE 2017 CENSUS IS 307,924. 78.1% OF THE POPULATION IDENTIFIES AS WHITE ALONE, 10.0% AS HISPANIC OR LATINO, 7.6% AFRICAN AMERICAN, 1.1% ASIAN, AND 3.2% AS MORE THAN ONE RACE OR OTHER. THE MEDIAN AGE IS 42.2 YEARS OLD. THE AVERAGE HOUSEHOLD SIZE IS 2.47 PEOPLE AND THE AVERAGE FAMILY SIZE IS 3.03 PEOPLE. THE MEDIAN HOME VALUE FOR THE COUNTY IS $143,600. 89.3% OF THE POPULATION HAS A HIGH SCHOOL DIPLOMA OR EQUIVALENT OR HIGHER EDUCATION LEVEL, OF THAT 23.6% HAS A BACHELOR'S DEGREE OR HIGHER LEVEL OF EDUCATION. THE PER CAPITA PERSONAL INCOME FOR THE COUNTY IS $28,525. 13.9% OF INDIVIDUALS AND 10.4% OF FAMILIES IS BELOW THE POVERTY LINE COMPARED TO THE AVERAGE 14.0% IN OHIO.UH PORTAGE MEDICAL CENTERUH PORTAGE MEDICAL CENTER IS LOCATED IN THE CITY OF RAVENNA IN PORTAGE COUNTY, OHIO. PORTAGE COUNTY IS LOCATED DIRECTLY EAST OF SUMMIT COUNTY (AKRON METRO AREA) AND SOUTHEAST OF CUYAHOGA COUNTY (CLEVELAND METRO AREA). THE HOSPITAL'S MARKET AREA INCLUDES 15 MUNICIPALITIES (EIGHT IN ITS PRIMARY MARKET AREA AND SEVEN IN ITS SECONDARY MARKET AREA). IT IS ALMOST COMPLETELY CONTAINED WITHIN PORTAGE COUNTY, OHIO. ACCORDING TO THE 2017 CENSUS, THE POPULATION IS 162,080. 91.0% OF THE POPULATION IDENTIFIES AS WHITE ALONE, 4.1% IDENTIFY AS AFRICAN AMERICAN, 1.9% IDENTIFY AS ASIAN, 1.7% IDENTIFY AS HISPANIC OR LATINO, AND 3.0% IDENTIFY AS TWO OR MORE RACES OR OTHER. THE MEDIAN AGE IN PORTAGE COUNTY IS 37.8 YEARS OLD. THE AVERAGE HOUSEHOLD SIZE IS 2.49 PEOPLE AND THE AVERAGE FAMILY SIZE IS 3.06 PEOPLE. THE MEDIAN HOME VALUE FOR THE COUNTY IS $152,000. 91.9% OF THE POPULATION HAS A HIGH DIPLOMA OR EQUIVALENT OR HIGHER EDUCATION LEVEL, AND OF THAT 27.4% HAS A BACHELOR'S DEGREE OR HIGHER. THE PER CAPITA PERSONAL INCOME IS $27,985. 14.5% OF INDIVIDUALS AND 9.3% OF FAMILIES IS BELOW THE POVERTY LINE COMPARED TO THE AVERAGE 14.0% IN OHIO. UH SAMARITAN MEDICAL CENTERUH SAMARITAN MEDICAL CENTER IS LOCATED IN ASHLAND, OHIO, WITHIN ASHLAND COUNTY, A RURAL COUNTY LOCATED SOUTHWEST OF CUYAHOGA COUNTY (CLEVELAND METRO AREA) AND NORTHEAST OF FRANKLIN COUNTY (COLUMBUS METRO AREA). ASHLAND COUNTY IS COMPRISED OF CITIES, VILLAGES AND TOWNSHIPS. ITS COUNTY SEAT IS THE CITY OF ASHLAND, WHERE THE HOSPITAL IS LOCATED. ACCORDING TO THE 2017 CENSUS, THE POPULATION IS 53,299. 98.2% OF THE POPULATION IDENTIFIES AS WHITE, 1.3% IDENTIFIES AS AFRICAN AMERICAN, 1.3% IDENTIFIES AS HISPANIC OR LATINO, 0.8% IDENTIFIES AS ASIAN, AND 2.2% IDENTIFIES AS TWO OR MORE OR OTHER. THE MEDIAN AGE IN ASHLAND COUNTY IS 40.4 YEARS OLD. THE AVERAGE HOUSEHOLD SIZE IS 2.49 PEOPLE AND THE AVERAGE FAMILY SIZE IS 3.00 PEOPLE. THE MEDIAN HOME VALUE IN THE COUNTY IS $122,000. 88.4% % OF THE POPULATION HAS A HIGH DIPLOMA OR EQUIVALENT OR HIGHER EDUCATION LEVEL, AND OF THAT 20.2% HAS A BACHELOR'S DEGREE OR HIGHER. THE PER CAPITA PERSONAL INCOME IS $72,510. 14.2% OF INDIVIDUALS AND 9.4% OF FAMILIES IS BELOW THE POVERTY LINE COMPARED TO THE AVERAGE 14.0% IN OHIO. UH REHABILITATION HOSPITAL -- AVONUH AVON REHABILITATION HOSPITAL IS LOCATED IN THE CITY OF AVON IN LORAIN COUNTY, OHIO. UH AVON REHABILITATION HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS ARE ALMOST EXCLUSIVELY CONTAINED WITHIN CUYAHOGA AND LORAIN COUNTIES. THE PRIMARY SERVICE AREA FOR UH AVON REHABILITATION HOSPITAL INCLUDES AVON AND THE SEVEN COMMUNITIES IMMEDIATELY SURROUNDING IT (ELYRIA, NORTH RIDGEVILLE, WESTLAKE, AVON LAKE, NORTH OLMSTED, SHEFFIELD LAKE/VILLAGE AND BAY VILLAGE). 61% OF UH AVON'S DISCHARGES ARE RESIDENTS OF LORAIN COUNTY. THE PRIMARY SERVICE AREA FOR UH AVON REHABILITATION HOSPITAL IS LORAIN COUNTY. THE TOTAL POPULATION FOR LORAIN COUNTY AS OF THE 2017 CENSUS IS 307,924. 78.1% OF THE POPULATION IDENTIFIES AS WHITE ALONE, 10.0% AS HISPANIC OR LATINO, 7.6% AFRICAN AMERICAN, 1.1% ASIAN, AND 3.2% AS MORE THAN ONE RACE OR OTHER. THE MEDIAN AGE IS 42.2 YEARS OLD. THE AVERAGE HOUSEHOLD SIZE IS 2.47 PEOPLE AND THE AVERAGE FAMILY SIZE IS 3.03 PEOPLE. THE MEDIAN HOME VALUE FOR THE COUNTY IS $143,600. 89.3% OF THE POPULATION HAS A HIGH SCHOOL DIPLOMA OR EQUIVALENT OR HIGHER EDUCATION LEVEL, OF THAT 23.6% HAS A BACHELOR'S DEGREE OR HIGHER LEVEL OF EDUCATION. THE PER CAPITA PERSONAL INCOME FOR THE COUNTY IS $28,525. 13.9% OF INDIVIDUALS AND 10.4% OF FAMILIES IS BELOW THE POVERTY LINE COMPARED TO THE AVERAGE 14.0% IN OHIO.