4A (Expenses $ 49314585 including grants of $ 600) (Revenue $ 73964436)
MEMORIAL HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.

MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESSES, MEMORIAL HOSPITAL STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE, DEVELOP AND IMPLEMENT A PRIORITIZED, STRATEGIC COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR SANDUSKY COUNTY. A GAP ANALYSIS AND RESOURCE ASSESSMENT WERE COMPLETED AS PART OF THIS PROCESS.MEMORIAL HOSPITAL CONVENED A CHNA COMMITTEE TO REVIEW THE SANDUSKY COUNTY CHIP AND AVAILABLE HEALTH DATA, SELECT AND PRIORITIZE KEY INDICATORS FOR THEIR DEFINED COMMUNITY, REVIEW RESOURCES AND GAPS IN THESE AREAS, AND DEVELOP STRATEGIC PLANS TO ADDRESS THESE HEALTH ISSUES IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITAL RECEIVED FEEDBACK ON THE CHNA PLAN FROM THE SANDUSKY COUNTY PUBLIC HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A PUBLIC HEALTH EXPERT PERSPECTIVE.THE SANDUSKY COUNTY CHIP PROCESS AND GROUPS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: BELLEVUE HOSPITAL (PH), CITY OF FREMONT, COMMUNITY HEALTH SERVICES (PH), FIRELANDS COUNSELING & RECOVERY SERVICES (PH), FREMONT CITY SCHOOLS, MENTAL HEALTH AND RECOVERY SERVICES BOARD OF SANDUSKY (PH), SANDUSKY COUNTY BOARD OF DEVELOPMENTAL DISABILITIES (PH), SANDUSKY COUNTY FAMILY & CHILDREN FIRST COUNCIL (PH), SANDUSKY COUNTY HEALTH DEPARTMENT (PH), UNITED WAY OF SANDUSKY COUNTY (PH), WSOS SANDUSKY COUNTY

MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO

MEMORIAL HOSPITAL
PART V, SECTION B, LINE 11: MEMORIAL HOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:-CANCER -MENTAL HEALTH DEPRESSION SCREENINGS AND SUICIDE (PREVENTION)-CHRONIC DISEASETHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS, 2020-2022.MEMORIAL HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICAIN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2020-22 IMPLEMENTATION PLAN INCLUDE: HEALTH STATUS PERCEPTIONS, HEALTH CARE COVERAGE, ARTHRITIS, DIABETES, CARDIOVASCULAR HEALTH, ALCOHOL CONSUMPTION, MARIJUANA AND OTHER DRUG USE, TOBACCO USE, WOMEN'S HEALTH/PREGNANCY, MEN'S HEALTH, PREVENTIVE MEDICINE AND HEALTH SCREENINGS, ORAL HEALTH, PARENTING, YOUTH MENTAL HEALTH, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH MARIJUANA AND OTHER DRUG USE, YOUTH PERCEPTIONS, YOUTH SAFETY, YOUTH VIOLENCE ISSUES, YOUTH SEXUAL BEHAVIOR, CHILD HEALTH AND FUNCTIONAL STATUS, CHILD HEALTH INSURANCE/ACCESS/UTILIZATION/MEDICAL HOME, EARLY CHILDHOOD HEALTH, MIDDLE CHILDHOOD HEALTH, FAMILY FUNCTIONING/NEIGHBORHOOD/COMMUNITY CHARACTERISTICS, AND PARENT HEALTH.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2021 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. MEMORIAL HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: CANCER STRATEGY #1 - PROVIDE EDUCATION AND CANCER RESOURCE MATERIALS TO PATIENTS AND THE PUBLIC ONHIGH RISK CANCERS IDENTIFIED IN THE 2019 CHNA.ACTIONS TAKEN:- 225 EDUCATIONAL FLYERS ON THE IMPORTANCE OF CANCER SCREENINGS WERE DISTRIBUTED TO THE COMMUNITY - CANCER SCREENING BENEFITS ARTICLE REACHED 1238 INDIVIDUALS.STRATEGY #2 - PROVIDE CANCER SCREENING EDUCATION.ACTIONS TAKEN:- CANCER SCREENING INFORMATION WAS DISTRIBUTED TO APPROXIMATELY 400 COMMUNITY PARTICIPANTS AT SENIOR EXPO.STRATEGY #3 - SPONSOR PROSTATE SUPPORT GROUP. ACTIONS TAKEN:- PROSTATE CANCER SUPPORT GROUP CANCELLED DURING COVID RESTRICTIONS. HOSPITAL OFFERED TO CONTINUE TO HOST AND PROVIDE SPEAKERS FOR PROSTATE CANCER SUPPORT GROUP MEETINGS, FOLLOWING COVID RESTRICTIONS, IF MEETINGS CONTINUED OFFSITE OR VIRTUALLY.HEALTH NEED IDENTIFIED: MENTAL HEALTH DEPRESSION SCREENINGS AND SUICIDE PREVENTIONSTRATEGY #1 - CONDUCT AT LEAST ONE DEPRESSION SCREENING EVENT IN SANDUSKY COUNTY. ACTIONS TAKEN:- HOSPITAL PARTICIPATED IN THREE COMMUNITY SUICIDE PREVENTION COALTION EVENTS TO SUPPORT COMMUNITY INITIATIVES TO ADDRESS THIS ISSUE. NO DEPRESSION SCREENINGS WERE HELD DUE TO NEW GUIDELINES TO PROVIDE IMMEDIATE ACCESS TO CARE FOR PARTICIPANTS SCREENED AT HIGH RISK. STRATEGY #2 - DISTRIBUTE RESOURCE MATERIALS RELATED TO DEPRESSION AND SUICIDE TO AT LEAST FIVE COMMUNITY EVENTS.ACTIONS TAKEN: - PROVIDED EDUCATION MATERIAL TO APPROXIMATELY 400 SENIORS ON DEPRESSION AND SUICIDE AT A LOCAL SENIOR EXPO EVENT.HEALTH NEED IDENTIFIED: CHRONIC DISEASESTRATEGY #1 - PROVIDE FOOD CHOICES MEETING SODEXO MINDFUL NUTRITIONAL STANDARDS IN CAFETERIA, VENDING MACHINES AND CATERING (50% VEGETABLES AND FRUITS, 25% WHOLESOME CARBOHYDRATES, 25% LEAN PROTEINS, MINIMUM HEALTHY FATS).ACTIONS TAKEN:- CONTINUE TO MEET STRATEGIC TARGETS CURRENTLY AT 80% IN CAFE, 75% IN VENDING AND 80% IN CATERING.STRATEGY #2 - PROVIDE EXERCISE OPPORTUNITIES 5 DAYS PER WEEK TO UNDERPRIVILEGED CHILDREN IN SANDUSKY COUNTY DURING THE SUMMER SCHOOL BREAK BY PARTICIPATING WITH THE FREMONT CITY SCHOOLS PURPLE PRIDE PROGRAM. ACTIONS TAKEN:- PARTNERED WITH FREMONT CITY SCHOOLS PROVIDING FREE LUNCHES TO CHILDREN 1-18 YEARS OF AGE. MEAL DISTRIBUTION BEGAN IN MARCH AND RAN THROUGH AUGUST 2021. SERVED WITH A TOTAL OF 70,718 MEALS (THIS REPRESENTS DUPLICATION OF CHILDREN ATTENDING THE MEALS INDIVIDUAL COUNT UNKNOWN). STRATEGY #3 PROVIDE WELLNESS SCREENINGS FOR EMPLOYEES.ACTIONS TAKEN:- FIVE BLOOD PRESSURE EVENTS WERE HELD, SERVING APPROXIMATELY 40 PARTICIPANTS.STRATEGY #4 PROVIDE STROKE EDUCATION TO COMMUNITY, STAFF AND VOLUNTEERS.ACTIONS TAKEN:- 450 EDUCATIONAL STROKE FLYERS WERE DISTRIBUTED STRATEGY #5 - PROVIDE CARDIOPULMONARY CLASSES (EDUCATION).ACTIONS TAKEN:- A SYSTEM WIDE INITIATIVE WAS INITIATED TO PRODUCE VIDEO EDUCATION FOR HEALTHY EATING, WITH THIRTEEN HEART HEALTHY COOKING VIDEOS POSTED IN JULY 2021. THESE VIDEOS MAY BE SEEN ON YOUTUBE PROMEDICA TV AND ALL PROMEDICA WAITING ROOM TVS, PLAYING APPROXIMATELY TWICE EACH DAY THAT THE WAITING ROOM IS OPEN.STRATEGY #6 - PROVIDE PULMONARY CLASSES (EDUCATION). ACTIONS TAKEN:- 300 EDUCATIONAL FLYERS WERE DISTRIBUTED. - A SYSTEM WIDE INITIATIVE IN 2021 PRODUCED ONLINE VIDEO EDUCATION FOR TOBACCO AND VAPING CESSATION THAT WILL BE WIDELY RELEASED IN 2022 AND AVAILABLE ON PROMEDICA WAITING ROOM TV'S AND YOUTUBE PROMEDICA TV.STRATEGY #7 PROVIDE DIABETES CLASSES AND SUPPORT GROUP.ACTIONS TAKEN:- TWO EVENTS WERE HELD WITH 32 TOTAL PARTICIPANTS. - A SYSTEM WIDE INITIATIVE IN 2021 PRODUCED ONLINE VIDEO EDUCATION FOR DIABETES EDUCATION THAT WILL BE WIDELY RELEASED EARLY IN 2022 AND AVAILABLE ON PROMEDICA WAITING ROOM TV'S AND YOUTUBE PROMEDICA TV.

PART V, SECTION B, LINE 7A
THE 2019 CHNA CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-MEMORIAL-HOSPITAL-2019-CHNA.PDF

PART V, SECTION B, LINE 10A
THE 2020-2020 CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-MEMORIAL-HOSPITAL-2019-CHNA-IMPLEMENTATION-PLAN-2020-2022.PDF

PART V, SECTION B, LINE 16A:
THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/UNINSURED_DISCOUNT_POLICY.PDF

PART V, SECTION B, LINE 16B:
THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/FINANCIAL_ASSISTANCE_APPLICATION.PDF

PART V, SECTION B, LINE 16C:
A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/PLAIN_LANGUAGE_FINANCIAL_ASSISTANCE.PDF

PART I, LINE 3C:
IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.

PART I, LINE 6A:
MEMORIAL HOSPITAL, INC. REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.

PART I, LINE 7:
MEMORIAL HOSPITAL, INC. ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT.

PART II, COMMUNITY BUILDING ACTIVITIES:
MEMORIAL HOSPITAL, INC. PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING LOCAL ORGANIZATIONS AND ACTIVITIES THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES.

PART III, LINE 2:
"MEMORIAL HOSPITAL, INC.'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS ""LOOK-BACK"" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY."

PART III, LINE 3:
MEMORIAL HOSPITAL, INC. CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.

PART III, LINE 4:
PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 18 AND 19 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.

PART III, LINE 8:
MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM.- THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS.- MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER.- MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.MEMORIAL HOSPITAL, INC. USED THE MEDICARE ALLOWABLE COSTS PER ITS 2021 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS.

PART III, LINE 9B:
FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.

PART VI, LINE 2:
PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE.

PART VI, LINE 3:
THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.

PART VI, LINE 4:
MEMORIAL HOSPITAL, LOCATED IN FREMONT, OHIO, SERVES AN AREA PRIMARILY AROUND SANDUSKY AND SENECA COUNTIES AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 99,000. APPROXIMATELY, 19% OF THE SERVICE AREA IS AGE 65 OR OVER; 59% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $54,000; 90% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR HIGHER; 47% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. SANDUSKY COUNTY HAS A POPULATION OF APPROXIMATELY 59,000 WITH APPROXIMATELY 10% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 22% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 4% OF SANDUSKY COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SANDUSKY COUNTY IN 2021 WAS 3.4%. THE LEADING CAUSES OF DEATH IN SANDUSKY COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, LUNG DISEASE, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE AND DIABETES. ACCORDING TO 2021 COUNTY HEALTH RANKINGS, SANDUSKY COUNTY RANKED 42 OF 88 COUNTIES FOR HEALTH OUTCOMES, 51 OF 88 FOR LENGTH OF LIFE, AND 37 OF 88 FOR QUALITY OF LIFE. SENECA COUNTY HAS A POPULATION OF APPROXIMATELY 55,000 WITH APPROXIMATELY 10% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 22% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 9% OF SENECA COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR SENECA COUNTY IN 2021 WAS 3.3%. THE LEADING CAUSES OF DEATH IN HANCOCK AND SENECA COUNTIES, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, LUNG DISEASE, UNINTENTIONAL INJURIES/ACCIDENTS, DIABETES AND ALZHEIMER'S. ACCORDING TO 2021 COUNTY HEALTH RANKINGS, SENECA COUNTY RANKED 43 OF 88 COUNTIES FOR HEALTH OUTCOMES, 36 OF 88 FOR LENGTH OF LIFE, AND 54 OF 88 FOR QUALITY OF LIFE. THERE ARE ELEVEN HOSPITALS WITHIN A 30-MILE RADIUS OF MEMORIAL HOSPITAL: BELLEVUE HOSPITAL, H.B. MAGRUDER MEMORIAL HOSPITAL, MERCY HOSPITAL TIFFIN, FOSTORIA HOSPITAL ASSOCIATION, FIRELANDS REGIONAL MEDICAL CENTER, BAY PARK COMMUNITY HOSPITAL, ST. CHARLES MERCY HOSPITAL, MERCY HEALTH PERRYSBURG, WOOD COUNTY HOSPITAL, FISHER-TITUS MEDICAL CENTER, AND MERCY HOSPITAL OF WILLARD.

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MEMORIAL HOSPITAL, INC. IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2021:- THERE WERE APPROXIMATELY 300 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON MORE THAN 25 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. BOARD MEMBERSHIP IS COMPOSED OF 43% FEMALES, 20% PHYSICIANS, 11% UNDER THE AGE OF 40, AND 18% RACIAL OR ETHNIC MINORITIES. - PROMEDICA NON-PARENT BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THE UPGRADES ALLOW PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- PROMEDICA CANCER INSTITUTE (PCI) COMPLETED MORE THAN 3,300 LUNG CANCER SCREENINGS, NEARLY 55,000 SCREENING MAMMOGRAMS AND NEARLY 13,000 SCREENING COLONOSCOPIES. ADDITIONALLY, PCI CONTINUES TO BE INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT. IN 2021, APPROXIMATELY 8,000 DOSES OF THE TREATMENT WERE PROVIDED. - PROMEDICA SENIOR CARE SKILLED NURSING FACILITIES AND HOME HEALTH AND HOSPICE AGENCIES PROVIDE UNIQUE SERVICES TO VETERANS, HOLIDAY SUPPORT, SUPPORT GROUPS, AND WORKSHOPS TO ANYONE IN THE COMMUNITY WHO NEEDS ADDITIONAL HELP TO GET THROUGH THE LOSS OF A LOVED ONE. PATIENTS AND RESIDENTS' WISHES ARE GRANTED THROUGH THE ORGANIZATION'S HEART'S DESIRE PROGRAM. THROUGH GRANTS FROM THE HOSPICE MEMORIAL FUND, GRIEF CAMPS FOR CHILDREN AND ADULTS ARE OFFERED AS WELL AS EDUCATIONAL SESSIONS AND LIFE CELEBRATION EVENTS. THE FUND ALSO PROVIDES STABILIZING RESOURCES FOR HOSPICE PATIENTS AND FAMILIES IN FINANCIAL DISTRESS DUE TO THE LACK OF OR REDUCTION IN INCOME FROM TERMINAL ILLNESS OR DISEASE.- PROMEDICA CONTINUES TO EXPAND ITS OPTIONS FOR HOSPITAL-LEVEL CARE IN THE COMFORT OF A PATIENT'S HOME. PROMEDICA ACUTE CARE AT HOME COMBINES PROMEDICA'S EXTENSIVE NETWORK OF IN-HOME CARE PROVIDERS WITH A SOPHISTICATED TECHNOLOGY PLATFORM TO DELIVER SEAMLESS AND EFFECTIVE CARE AT HOME FOR PATIENTS WITH SELECT CHRONIC CONDITIONS OR DIAGNOSES SUCH AS HEART FAILURE, PNEUMONIA OR COPD. IN 2021, PROMEDICA ACUTE CARE AT HOME EXPANDED ITS SERVICES TO INCLUDE CARE FOR SELECT ONCOLOGY PATIENTS BY COLLABORATING THE PROMEDICA CANCER CENTER. THE CARE TEAM CONSISTS OF PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, AND MAY INCLUDE OTHER HEALTHCARE PROFESSIONALS, SUCH AS PHYSICAL OR OCCUPATIONAL THERAPISTS, AS NEEDED.- IN THE METRO TOLEDO AREA, PROMEDICA WORKED CLOSELY WITH LUCAS COUNTY DEPARTMENT OF HEALTH OFFICIALS TO ASSIST WITH MASS COVID VACCINE CLINICS AS WELL AS CLINICS IN UNDERSERVED AREAS OF THE COMMUNITY WHERE VACCINE HESITANCY WAS AN ONGOING CONCERN. ONE OF THE PROJECTS PROMEDICA HELPED SPEARHEAD WAS THE V PROJECT, WHICH WORKED ACROSS THE NORTHWEST OHIO COMMUNITY TO INCREASE VACCINE PARTICIPATION. THE V PROJECT HELPED TO BRING RESOURCES TO PEOPLE IN ZIP CODES THAT HAD LOWER VACCINATION PARTICIPATION RATES WITH THE GOAL OF EASING ANY BARRIERS THAT MAY HAVE PROHIBITED THEM FROM PREVIOUSLY GETTING THEIR VACCINE. - PROMEDICA ALSO ALLOCATED 20% OF THE VACCINES IT RECEIVED TO UNDERSERVED COMMUNITIES. THIS LED TO OTHER OPPORTUNITIES SUCH AS THE PARTNERSHIP WITH THE FIRST CHURCH OF GOD ON COLLINGWOOD IN TOLEDO. LED BY THE PPG CLINICAL OPERATIONS TEAM, VARIOUS TEAMS FROM ACROSS PROMEDICA CAME TOGETHER AND HELD VACCINATION CLINICS ON SUNDAYS. PROMEDICA ALSO EXPANDED PARTICIPATION IN COMMUNITY MASS COVID VACCINE CLINICS AT AN ARE UAW HALL TO REACH A LARGER PROPORTION OF THE UNDERSERVED COMMUNITIES.

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"PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2021 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, NEARLY 850 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,200 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP ('PPG"")WHO FORM A PROVIDER NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2021:- PROMEDICA MEMBERS AND AFFILIATE HOSPITALS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL,; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL. PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE PROMEDICA SENIOR CARE/HCR MANORCARE UMBRELLA.- PROMEDICA MANAGED APPROXIMATELY 2.28 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 57,200 SURGERIES, 6,000 BIRTHS, AND MORE THAN 262,600 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $259,433,000.- PROMEDICA CONTINUED TO OPERATE THREE COMMUNITY FOOD CLINICS, LOCATED AT PROMEDICA BAY PARK HOSPITAL, THE PROMEDICA HEALTH AND WELLNESS CENTER AND PROMEDICA'S CENTER FOR HEALTH SERVICES, TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2021, APPROXIMATELY 5,794 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 2,093 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 44,100 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 132,300 MEALS.- FOR ITS MICHIGAN PATIENTS, PROMEDICA PARTNERED WITH THE SOUTH MICHIGAN FOOD BANK TO DISTRIBUTE FOOD RESOURCES TO PROMEDICA PHYSICIANS GROUP OFFICES FOR PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY. IN 2021, 49 PEOPLE WERE SUPPORTED BY THE INITIATIVE. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS AT DISCHARGE SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. IN 2021, NEARLY 2,560 POUNDS OF PRODUCE WAS GROWN AT PROMEDICA FARMS, 21 PATIENTS IDENTIFIED AS FOOD INSECURE REDEEMED A VOUCHER ISSUED BY A PHYSICIAN OR DISCHARGE PLANNING, AND AN ADDITIONAL 4 PATIENTS WERE PROVIDED A FOOD BOX AND VEGGIE VOUCHER UPON DISCHARGE. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ADDITIONALLY, TWO NEW FINANCIAL OPPORTUNITY CENTERS (FOC) WERE OPENED IN FREMONT AND DEFIANCE, OHIO. MUCH LIKE THE FOC LOCATED IN UPTOWN TOLEDO, THE NEW LOCATIONS OFFER SERVICES AND ASSIST LOW TO MODERATE-INCOME FAMILIES WITH SECURING LIVING WAGE JOBS, BUILDING CREDIT, REDUCING DEBT, AND GAINING WEALTH. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION."