4A (Expenses $ 19763642 including grants of $ 876) (Revenue $ 22655368)
St. John Sapulpa, Inc. is a 25-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2022, St. John Sapulpa, Inc. treated 641 adults and children for a total of 4,611 patient days of service. The hospital also provided services for 27,480 outpatient visits, which included 194 outpatient surgeries and 15,025 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. As part of the Ascension Catholic health ministry, the filing organization served in support of Ascension's commitment to both care for patients and communities and support caregivers and other associates through the challenges of the COVID-19 global pandemic in FY22.

Schedule H, Part V, Section B, Line 3E
TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - St. John Sapulpa. RECOGNIZING ITS VITAL IMPORTANCE IN UNDERSTANDING THE HEALTH NEEDS AND ASSETS OF THE COMMUNITY, ST. JOHN SAPULPA TOOK INTO ACCOUNT INPUT FROM INDIVIDUALS AND ORGANIZATIONS REPRESENTING THE PERSPECTIVES OF: 1) PUBLIC HEALTH PRACTICE AND RESEARCH; 2) INDIVIDUALS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, OR CONSIDERED AMONG THE MINORITY POPULATIONS SERVED BY THE HOSPITAL; AND 3) THE BROADER COMMUNITY AT LARGE AND THOSE WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED. MULTIPLE METHODS WERE USED TO GATHER COMMUNITY INPUT, INCLUDING FOCUS GROUPS WITH COMMUNITY RESIDENTS AND INTERVIEWS WITH KEY STAKEHOLDERS, VULNERABLE POPULATION HYBRID ADMINISTRATOR/CLIENT GROUPS, AND CIVIC LEADERS. THESE METHODS PROVIDED ADDITIONAL CONSIDERATIONS ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING CREEK COUNTY. THE METHODS AND PROCESSES ARE OUTLINED BELOW. ORGANIZATIONS THAT PROVIDED INPUT ARE LISTED IN APPENDIX C OF THE CHNA REPORT. A SERIES OF FIVE FOCUS GROUPS WERE FACILITATED BY A CONSULTANT, SEVEN RIVERS CONSULTING LLC, TO GATHER FEEDBACK FROM COMMUNITY MEMBERS ON THE HEALTH NEEDS AND ASSETS OF CREEK COUNTY. BECAUSE OF THE COVID-19 PANDEMIC (PARTICULARLY THE OMICRON SPIKE IN EARLY CALENDAR YEAR 2022), FOCUS GROUPS WERE CONDUCTED ENTIRELY ONLINE, USING ZOOM VIDEO CONFERENCES. THIRTEEN INDIVIDUALS PARTICIPATED IN THE FOCUS GROUPS, HELD IN JANUARY AND FEBRUARY 2022. THIS GROUP OF PARTICIPANTS WAS DEFINED AS GENERAL COMMUNITY MEMBERS OF VARIOUS DEMOGRAPHICS RESIDING IN CREEK COUNTY. WHILE THE FOCUS GROUPS DO NOT PORTRAY AN EXACT REPRESENTATION OF THE REGION'S DIVERSE POPULATION, WE ESTIMATE THEY REPRESENTED THE COLLECTIVE SPIRIT OF ASSETS, NEEDS, CONCERNS, AND FEARS AMONG THOSE LIVING IN CREEK COUNTY. ALL INTERVIEWEES RECEIVED AN INCENTIVE FOR THEIR PARTICIPATION: A $20 GIFT CARD TO A LOCAL GAS STATION CHAIN. A SERIES OF 22 INTERVIEWS WERE CONDUCTED BY SEVEN RIVERS CONSULTING TO GATHER FEEDBACK FROM KEY STAKEHOLDERS, VULNERABLE POPULATION HYBRID ADMINISTRATOR/CLIENT GROUPS, AND CIVIC LEADERS ON THE HEALTH NEEDS AND ASSETS OF CREEK COUNTY. THESE GROUPS OF PARTICIPANTS WERE DEFINED AS FOLLOWS: - KEY STAKEHOLDERS: MEMBERS OF AN ORGANIZATION OR AGENCY OPERATING IN AND/OR SERVING PEOPLE FROM CREEK COUNTY - VULNERABLE POPULATION GROUPS: ONE OR MORE LEADERS OF AN ORGANIZATION OR AGENCY WHOSE PRINCIPAL MISSION INCLUDES SERVING VULNERABLE AND/OR HISTORICALLY MARGINALIZED POPULATIONS IN CREEK COUNTY AND ONE OR MORE CLIENTS/PATIENTS SERVED BY THE ORGANIZATION/AGENCY - CIVIC LEADERS: PEOPLE SERVING IN A CIVIC LEADERSHIP ROLE (E.G., MAYOR, CITY COUNCILOR, PUBLIC HEALTH DIRECTOR, ETC.) SOME INDIVIDUALS AND ORGANIZATIONS INTERVIEWED REPRESENTED POPULATIONS BOTH IN AND BEYOND CREEK COUNTY. TWENTY-SIX REPRESENTATIVES FROM 22 DIFFERENT ORGANIZATIONS/AGENCIES PARTICIPATED IN THE INTERVIEWS, HELD BETWEEN OCTOBER 2021 AND JANUARY 2022. NOTES FROM EVERY ENCOUNTER WERE TRANSCRIBED. THE RAW QUALITATIVE TEXT WAS ANALYZED AND SORTED BY THEMES.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - St. John Sapulpa. THE OTHER HOSPITAL FACILITIES WITH WHICH ST. JOHN SAPULPA CONDUCTED ITS CHNA INCLUDE: - ST. JOHN MEDICAL CENTER - OWASSO MEDICAL FACILITY - ST. JOHN BROKEN ARROW - JANE PHILLIPS MEMORIAL MEDICAL CENTER - JANE PHILLIPS NOWATA HEALTH CENTER

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - St. John Sapulpa. THE OTHER ORGANIZATIONS WITH WHICH ST. JOHN SAPULPA CONDUCTED ITS CHNA INCLUDE: - TULSA HEALTH DEPARTMENT

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - St. John Sapulpa - 1. TAX YEAR 2018 IMPLEMENTATION STRATEGY DURING TAX YEAR 2021, ST. JOHN SAPULPA CONTINUED ITS WORK TO ADDRESS THE FOLLOWING SIGNIFICANT NEEDS IDENTIFIED THROUGH THE TAX YEAR 2018 CHNA: ACCESS TO CARE, BEHAVIORAL HEALTH, HEALTHY LIFESTYLES, AND ADVERSE CHILDHOOD EXPERIENCES. THE SUMMARIZED ACTION PLANS BELOW REFLECT THE PROGRESS MADE BY ST. JOHN SAPULPA DURING THIS TIME. THE ACTION PLANS REFLECT THE MODIFICATIONS MADE AS A RESULT OF THE ACUTE COMMUNITY CONCERN ASSESSMENT PERFORMED IN TAX YEAR 2020, WHEN SOME OBJECTIVES WERE ADDED OR ADJUSTED AS A RESULT OF THE COVID-19 PANDEMIC, AS WELL AS EVENTS AND CIVIC UNREST SURROUNDING RACIAL INJUSTICE, THAT OCCURRED THAT YEAR AND CONTINUE TO AFFECT THE COMMUNITY. PRIORITIZED NEED 1: ACCESS TO CARE GOAL 1: REMOVE BARRIERS OF ACCESS TO HEALTHCARE FOR THOSE LIVING IN POVERTY AND/OR OTHERWISE DEEMED VULNERABLE WITHIN OUR SERVICE AREA. GOAL 1 > STRATEGY 1: WORK TO EXPAND MEDICAID TO THE POINT THAT IT INCREASES COVERAGE FOR THOSE MOST VULNERABLE IN OKLAHOMA (MEDICAID EXPANSION). ANTICIPATED IMPACT: - PARTICIPATE AS A COLLABORATING PARTNER WITH THE YES ON 802 CAMPAIGN TO HELP ATTAIN 178,000 SIGNATURES TO PUT A QUESTION ON THE 2020 BALLOT TO EXPAND MEDICAID COVERAGE TO ELIGIBLE RESIDENTS WITH AN INCOME OF UP TO 133 PERCENT OF THE FEDERAL POVERTY LIMIT (FPL). - ADVOCATE FOR VOTERS IN THE STATE OF OKLAHOMA TO ADOPT A BALLOT INITIATIVE TO EXPAND MEDICAID COVERAGE TO ELIGIBLE RESIDENTS WITH AN INCOME OF UP TO 133 PERCENT OF THE FPL. - IF INITIATIVE IS ADOPTED, HELP HEALTHCARE COMMUNITY PREPARE FOR MEDICAID EXPANSION. BY JULY 2021, SOONERCARE WOULD BEGIN OFFERING COVERAGE SERVICES TO NEW RECIPIENTS DUE TO EXPANSION OF MEDICAID COVERAGE WITH AS LIMITED RESTRICTIONS TO ELIGIBILITY AS POSSIBLE. PROGRESS: - INCREASED STAFFING OF TEMPORARY WORKFORCE TO ASSIST WITH THE SURGE IN NEED FOR MEDICAID ENROLLMENT ASSISTANCE. - CONTINUED TO INCREASE PHYSICIAN COVERAGE AS NEEDED IN RESPONSE TO MEDICAID EXPANSION IN A CONCERTED EFFORT TO ASSIST PATIENTS WITH ENROLLMENT. GOAL 1 > STRATEGY 2: CREATE A WELCOMING ENVIRONMENT BY DEVELOPING AND IMPLEMENTING A PLAN TO ASSIST THOSE LIVING IN POVERTY AND/OR POPULATIONS OTHERWISE DEEMED VULNERABLE AS WELL AS THEIR CAREGIVERS WITH NAVIGATING OUR HEALTHCARE FACILITIES. ANTICIPATED IMPACT: - BY THE END OF EACH TAX YEAR (2019-2021), ASSESS IMPROVED TRENDS IN RELATED PATIENT EXPERIENCE MEASURE OUTCOMES FOR TAX YEARS 2019-2021, USING TAX YEAR 2018 AS BASELINE. - ADDED IN TAX YEAR 2020: HELP ADDRESS RACIAL INEQUITIES AND DISPARITIES BY FORMING COMMUNITY PARTNERSHIPS WITH KEY STAKEHOLDERS OF THIS CAUSE. - ADDED IN TAX YEAR 2020: EXPLORE OPTIONS FOR SOCIAL WORK NAVIGATION FOR VULNERABLE POPULATIONS TO HELP ADDRESS BARRIERS TO ACCESSING HEALTHCARE. - ADDED IN TAX YEAR 2020: PARTICIPATE IN THE ACCOUNTABLE HEALTH COMMUNITIES PROGRAM IN PARTNERSHIP WITH MYHEALTH, TULSA HEALTH DEPARTMENT AND MORE THAN 4,800 COMMUNITY SERVICE PROVIDERS. ASSESS RESULTS AT LEAST ANNUALLY. PROGRESS: - ALTHOUGH MEETINGS WERE HELD WITH NATIONAL PFE TEAM IN EARLY TAX YEAR 2021 TO DISCUSS ASSESSMENT PLANS, THE OBJECTIVE TO ""ASSESS IMPROVED TRENDS IN RELATED PATIENT EXPERIENCE MEASURE OUTCOMES"" WAS PUT ON HOLD DUE TO THE COVID-19 PANDEMIC AND HOSPITAL RECOVERY. - WHILE THE OBJECTIVE TO ""ASSESS APPLICABLE BIAS REPORTING SUBMITTED THROUGH VARIANCE PROCESS TO QUALITY/RISK MANAGEMENT WITH TAX YEAR 2018 AS BASELINE"" WAS NOTED AS EXCUSED IN TAX YEAR 2020 DUE TO THE COVID-19 PANDEMIC, THE REVIEW WAS RE-INITIATED. A TEAM MET IN DECEMBER 2021 TO EXPLORE HOW POTENTIAL BIAS IN VARIANCE REPORTING COULD BE IDENTIFIED AND MONITORED ON AN ANNUAL BASIS. - THE COMMUNITY BENEFIT TEAM AND LOCAL ABIDE COMMITTEE CONTINUED TO WORK WITH THE 1921 TULSA RACE MASSACRE CENTENNIAL COMMISSION ON PARTNERSHIP OPPORTUNITIES. - TWO-YEAR FUNDING CONTINUED FOR SOCIAL WORK NAVIGATOR DEDICATED TO HELPING DISCHARGE HOSPITAL PATIENTS WITH A PRIMARY DIAGNOSIS OF A PSYCHIATRIC CONDITION OR SUBSTANCE ABUSE. NAVIGATOR TRACKED REFERRAL SITES TO HELP DETERMINE RATIO OF ATTEMPTED REFERRALS TO SUCCESSFUL REFERRALS. - AHC PROGRAM DELIVERY AND RESPONSE RATES AND TOTAL NUMBER OF IDENTIFIED SOCIAL NEEDS WERE ASSESSED AT THE END OF THE YEAR AND COMPARED WITH STATE AVERAGES. - IN OCTOBER 2021, ST. JOHN HEALTH SYSTEM, INC. BEGAN OFFERING NAVIGATION SERVICES TO UNINSURED PATIENTS WITH SOCIAL NEEDS, REGARDLESS OF PAST EMERGENCY ROOM VISITS (COMPARED WITH THE PAST MODEL, WHICH WAS FOR MEDICARE AND MEDICAID PATIENTS WITH AT LEAST TWO ER VISITS IN THE LAST 12 MONTHS). GOAL 2: REDUCE REGIONAL INEQUITY IN ACCESSING HEALTHCARE PROVIDERS, SERVICES AND RESOURCES. GOAL 2 > STRATEGY 1: TARGET SPECIFIC ZIP CODES IN THE COMMUNITIES WE SERVE IDENTIFIED AS EXPERIENCING HEALTH DISPARITIES AND POOR HEALTH OUTCOMES FOR POSSIBLE DEVELOPMENT OF TELEMEDICINE SERVICES. ANTICIPATED IMPACT: - COMPLETE RESEARCH ON OTHER TELEMEDICINE PROGRAMS BY THE END OF TAX YEAR 2019. - DEVELOP A PLAN FOR REACHING PATIENTS, THE SERVICES TO BE DELIVERED, AND THE PROVIDERS OF THE SERVICES BY THE END OF TAX YEAR 2019. - MAKE THE GO / NO GO DECISION BY THE END OF THE FIRST QUARTER OF TAX YEAR 2020 (09/30/21). - DEVELOP THE PILOT IMPLEMENTATION PLAN OR THE ALTERNATIVE PLAN BY THE END OF FY 2022. PROGRESS: - PLAN DEVELOPMENT FOR A SCHOOL-BASED TELEHEALTH PROGRAM WAS DELAYED IN SUMMER 2021 DUE TO A SURGE IN COVID-19 AND HOSPITAL RECOVERY EFFORTS. HOWEVER, RESEARCH WAS COMPLETED AS PLANNED. - A TELEMEDICINE TASK FORCE WAS DEVELOPED. FACILITY-TO-FACILITY TELEMEDICINE CONSULTS WERE IMPLEMENTED FOR ADDITIONAL SPECIALTIES: NEUROLOGY, CARDIOLOGY AND INFECTIOUS DISEASE (FOLLOWING BEHAVIORAL HEALTH, WHICH WAS IMPLEMENTED DURING THE PRIOR TAX YEAR). GOAL 2 > STRATEGY 2: PROMOTE AWARENESS OF, AND ACCESS TO, HEALTHCARE FOR UNDERSERVED POPULATIONS WITHIN COMMUNITIES WE SERVE THROUGH MEDICAL MISSION AT HOME (MM@H) EVENTS AND OTHER OPPORTUNITIES TO REACH THOSE IN NEED. ANTICIPATED IMPACT: - PLAN AND HOST AT LEAST THREE MEDICAL MISSION AT HOME (MM@H) EVENT TO ADDRESS HEALTHCARE NEEDS OF VULNERABLE COMMUNITIES, AS IDENTIFIED IN THE CHNAS, BY THE END OF TAX YEAR 2019. - OBTAIN SURVEY FEEDBACK FROM AT LEAST 25 PERCENT OF PATIENTS AND VOLUNTEERS TO DETERMINE EFFECTIVENESS OF SERVICES OFFERED BY END OF TAX YEAR 2019. - SUBMIT A LIST OF ACTIVITIES PERFORMED WITHIN THE HEALTH SYSTEM TO PROMOTE ACCESS TO CARE TO THE ASCENSION VP OF MISSION INTEGRATION AND CBISA TASK FORCE BY THE END OF EACH FISCAL YEAR. - ENTER FY TAX YEAR 2019 MM@H SURVEY DATA INTO SPREADSHEET FOR EVALUATION BY MM@H STEERING COMMITTEE; PLAN AND IMPLEMENT MM@H BY END OF TAX YEAR 2020. - ENTER TAX YEAR 2020 MM@H SURVEY DATA INTO SPREADSHEET FOR EVALUATION BY MM@H STEERING COMMITTEE; PLAN AND IMPLEMENT MM@H BY END OF FY TAX YEAR 2021. PROGRESS: - ACTIVITIES PERFORMED WITHIN THE HEALTH SYSTEM TO PROMOTE ACCESS TO CARE WERE PRESENTED TO THE MISSION COMMITTEE OF THE MINISTRY MARKET BOARD (INCLUDING THE CHIEF MISSION INTEGRATION OFFICER) AND REPORTED IN THE CBISA COMMUNITY BENEFIT REPORTING DATABASE AS APPLICABLE THROUGHOUT THE TAX YEAR. - ALL OTHER OBJECTIVES WERE COMPLETED IN TAX YEARS 2019 AND 2020. PRIORITIZED NEED 2: BEHAVIORAL HEALTH GOAL 1: ASSESS THE OPPORTUNITY FOR AND/OR IMPLEMENT INTENSIVE OUTPATIENT GERIATRIC PSYCHIATRIC PROGRAMS, IF VIABLE, FOR SENIORS 65+ WITH BEHAVIORAL HEALTH ISSUES IN AREAS OF NEED IN NORTHEASTERN OKLAHOMA. GOAL 1 > STRATEGY 1: IMPLEMENT INTENSIVE OUTPATIENT GERIATRIC PSYCHIATRIC PROGRAM IN CREEK COUNTY. ANTICIPATED IMPACT: - ROLL-OUT INTENSIVE OUTPATIENT GERIATRIC PSYCHIATRIC PROGRAM AT ST. JOHN SAPULPA. - MARKET INTENSIVE OUTPATIENT GERIATRIC PSYCHIATRIC PROGRAM INTERNALLY WITHIN ST. JOHN HEALTH SYSTEM, INC. AS WELL AS TO 10 POTENTIAL COMMUNITY REFERRAL SOURCES WITHIN SERVICE AREA. - COMPLETE ANNUAL REVIEW OF ST. JOHN SAPULPA INTENSIVE OUTPATIENT GERIATRIC PSYCHIATRIC PROGRAM. IMPLEMENT MODIFICATIONS TO PROGRAM AS NECESSARY BASED ON FINDINGS FROM ANNUAL REVIEW. PROGRESS: - ALL OBJECTIVES WERE COMPLETED IN TAX YEARS 2019 AND 2020. GOAL 2: ADVANCE ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL ENGAGEMENT IN COMMUNITY COALITIONS AND COLLABORATIVES TO PROMOTE BEHAVIORAL HEALTH WELLNESS IN THE COMMUNITIES WE SERVE. GOAL 2 > STRATEGY 1: IDENTIFY COMMUNITY COALITIONS AND OTHER COLLABORATIVES WITH PARTNERSHIP OPPORTUNITIES TO PROMOTE BEHAVIORAL HEALTH WELLNESS; ENCOURAGE HEALTH SYSTEM AND HOSPITAL REPRESENTATION/INVOLVEMENT BY ASSOCIATES AS DEEMED APPROPRIATE."

Schedule H, Part V, Section B, Line 11 Facility , 2
"Facility , 2 - St. John Sapulpa - 2. ANTICIPATED IMPACT: - BY END OF TAX YEAR 2019 ENSURE ONE ASSOCIATE PER CHNA-DEFINED COUNTY IS ENGAGED WITH A COMMUNITY COALITION OR COLLABORATIVE. - INCREASE OVERALL ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL ASSOCIATE PARTICIPATION BY 5% WITH BEHAVIORAL HEALTH COALITIONS AND COLLABORATIVES IN THE COMMUNITIES WE SERVE, AND WHICH ST. JOHN HEALTH SYSTEM, INC. AND THE HOSPITAL ARE NOT CURRENTLY IN PARTNERSHIP BY THE END OF FY 2022. PROGRESS: - ASSOCIATES FROM ALL FOUR COUNTIES SERVED BY ST. JOHN HEALTH SYSTEM, INC. CONTINUE TO SERVE ON COMMUNITY COMMITTEES OR COALITIONS WORKING TO ADDRESS LOCAL MENTAL/BEHAVIORAL HEALTH ISSUES. - THE BEHAVIORAL HEALTH TEAM ESTABLISHED A WORKING RELATIONSHIP WITH CHESS HEALTH FOR STREAMLINED COMMUNITY RESOURCE REFERRALS. - THE CHIEF ADVOCACY OFFICER AND BEHAVIORAL HEALTH LEAD JOINED A PARKSIDE COMMITTEE FOCUSED ON ADOLESCENT MENTAL/BEHAVIORAL HEALTH. - THE CHIEF ADVOCACY OFFICER AND BEHAVIORAL HEALTH LEAD JOINED A COLLABORATION WITH SAINT FRANCIS HEALTH SYSTEM AND HEALTHY MINDS. - TWO-YEAR FUNDING CONTINUED FOR SOCIAL WORK NAVIGATOR DEDICATED TO HELPING DISCHARGE HOSPITAL PATIENTS WITH A PRIMARY DIAGNOSIS OF A PSYCHIATRIC CONDITION OR SUBSTANCE ABUSE. NAVIGATOR TRACKED REFERRAL SITES TO HELP DETERMINE RATIO OF ATTEMPTED REFERRALS TO SUCCESSFUL REFERRALS. PRIORITIZED NEED 3: HEALTHY LIFESTYLES GOAL 1: ADDRESS FOOD INSECURITY THROUGH COMMUNITY COLLABORATION AND STRENGTHENING OF COMMUNITY RESOURCES. GOAL 1 > STRATEGY 1: EXPLORE COLLABORATIVE OPPORTUNITIES TO DEVELOP AN INITIATIVE(S) TO ADDRESS FOOD INSECURITY IN COMMUNITIES WE SERVE IN NORTHEASTERN OKLAHOMA. IF VIABLE, DEVELOP AND IMPLEMENT INITIATIVE(S). ANTICIPATED IMPACT: - MEET WITH 5-10 POTENTIAL COMMUNITY PARTNERS (ENCOMPASSES COMMUNITIES SURROUNDING ALL SIX ST. JOHN HEALTH SYSTEM, INC. HOSPITALS) BY 12/31/19. - DEVELOP ASSESSMENT PLAN TO OUTLINE RESEARCH ON EVIDENCE-BASED PROGRAMS AND TRACK PARTNERSHIP OPPORTUNITIES BY THE END OF TAX YEAR 2019. - IF DEEMED VIABLE, DEVELOP AND IMPLEMENT INITIATIVE(S) FOR IDENTIFIED OPPORTUNITIES ON A PILOT BASIS DURING TAX YEAR 2020. - DURING TAX YEAR 2021, PERFORM ASSESSMENT OF PILOT AND DEVELOP PLAN TO EXPAND THROUGHOUT THE ST. JOHN HEALTH SYSTEM, INC. IF VIABLE. PROGRESS: - CONDUCTED A PROGRAM ASSESSMENT OF THE INTERNAL ASSOCIATE FOOD VOUCHER PROGRAM TO HELP ADDRESS FOOD INSECURITY AMONG ST. JOHN HEALTH SYSTEM, INC. ASSOCIATES IN OCTOBER 2021. DUE TO DECLINING PARTICIPATION SINCE IMPLEMENTATION AS A RESPONSE TO THE COVID-19 PANDEMIC, THE PROGRAM SUNSETTED JUNE 30, 2022. - THE COMMUNITY BENEFIT TEAM MET SEVERAL TIMES DURING Q2 AND Q3 WITH A NATIONAL LEAD REGARDING ""LISTENING SESSIONS"" WITH PARTICIPANTS OF THE ASSOCIATE FOOD VOUCHER PROGRAM, AS WELL AS PLANS TO OFFER LOW-COST, HEALTHY MEAL OPTIONS ON SITE DURING MARCH 2022 AS A PILOT OF THE HEALTHY FOOD ACCESS INITIATIVE. AS OF THE END OF TAX YEAR 2021, PLANS TO EXPAND THE PROGRAM ARE STILL TO BE DETERMINED. - CONTINUED PARTNERSHIPS WITH AND FUNDING SUPPORT OF VARIOUS COMMUNITY ORGANIZATIONS WORKING TO ADDRESS FOOD INSECURITY, INCLUDING FRESH RX, COMMUNITY FOOD BANK OF EASTERN OKLAHOMA, MARY MARTHA OUTREACH, FOOD ON THE MOVE, CARING COMMUNITY FRIENDS, AND OTHERS. YEAR-END REPORTS FOR THOSE SUPPORTED FINANCIALLY WERE COLLECTED AND ASSESSED. - INITIAL IMPLEMENTATION STRATEGY PLANS TO EXPLORE OPTIONS FOR ON-SITE FOOD PANTRIES WERE CANCELED DUE TO THE COVID-19 PANDEMIC AND HOSPITAL RECOVERY EFFORTS. GOAL 2: REDUCE THE HEALTH IMPACT OF TOBACCO USE IN COMMUNITIES WE SERVE. (ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL ACKNOWLEDGE THE TRADITIONAL AND SACRED USE OF TOBACCO AMONG AMERICAN INDIAN PEOPLE LIVING IN OKLAHOMA). GOAL 2 > STRATEGY 1: ASSESS OPPORTUNITIES FOR SYSTEMATIC SCREENING AND INTERVENTION FOR PATIENTS IDENTIFIED AS TOBACCO USERS IN AMBULATORY AND INPATIENT SETTINGS IN COMMUNITIES WE SERVE. ANTICIPATED IMPACT: - BY END OF TAX YEAR 2019: DEVELOP ASSESSMENT PLAN TO OUTLINE RESEARCH ON EVIDENCE-BASED TOBACCO SCREENING AND INTERVENTION PROGRAMS. - BY END OF TAX YEAR 2020: ASSESS AND COMPLETE INFORMATICS NEEDED FOR SCREENING AND INTERVENTION SERVICES, IF VIABLE, TO ENABLE SYSTEMATIC SCREENING AND INTERVENTION FOR TOBACCO USERS IN FACILITIES. - BY END OF TAX YEAR 2021: IMPLEMENT AND/OR ADVANCE SYSTEMATIC SCREENING AND INTERVENTION IN INPATIENT AND AMBULATORY SETTINGS BASED ON YEAR 1 FINDINGS. PROGRESS: - A 12-MINUTE TOBACCO CESSATION EDUCATION/TRAINING VIDEO PROVIDED BY HOSPITALS HELPING PATIENTS QUIT (HHPQ) WAS UPLOADED INTO THE ONLINE TRAINING/EDUCATION PLATFORM FOR ASSOCIATES. - RE-INITIATED A PROJECT IN Q1 THAT WOULD ALLOW E-REFERRALS DIRECTLY FROM THE ELECTRONIC MEDICAL RECORD AND PRODUCE A RESULTS MESSAGE FROM THE OKLAHOMA TOBACCO HELPLINE (1-800-QUIT). THE HOSPITAL MADE PLANS TO ENGAGE ASCENSION MEDICAL GROUP ST. JOHN TO STREAMLINE A PROCESS ACROSS ALL FACILITIES. AMBULATORY SERVICES WOULD ALSO BE ABLE TO UTILIZE THE E-REFERRALS. - INTERFACE TESTING ON THE EON SOFTWARE TOOK PLACE IN SEPTEMBER 2021. THE RADIOLOGY PROJECT TEAM CONTINUED TO MEET WEEKLY. GOAL 2 > STRATEGY 2: EXPLORE OPPORTUNITIES TO HELP IDENTIFY AND WORK WITH OUR ASSOCIATES REQUESTING ASSISTANCE WITH TOBACCO CESSATION. ANTICIPATED IMPACT: - BY END OF TAX YEAR 2019: DEVELOP ASSESSMENT PLAN TO OUTLINE RESEARCH ON EVIDENCE-BASED PROGRAMS. - BY END OF TAX YEAR 2020: IF OPPORTUNITIES AVAILABLE, PRESENT FINDINGS TO HEALTH SYSTEM AND HOSPITAL LEADERSHIP TO ADVOCATE FOR PROGRAM IMPLEMENTATION. - IF VIABLE, IMPLEMENT PROGRAM IN TAX YEAR 2021. PROGRESS: - FOLLOWING REVIEW OF THE SMARTHEALTH HEALTH RISK ASSESSMENT, THE VP OF HUMAN RESOURCES AND PHYSICIAN RELATIONS TEAM CONNECTED WITH SMARTHEALTH TO REQUEST ADDITIONAL QUESTIONS ABOUT SMOKING DETAILS AND WHETHER THE INDIVIDUAL HAS HAD A LUNG CANCER SCREENING IN THE PAST YEAR TO HELP IDENTIFY TOBACCO USERS MOST AT RISK. THE ASCENSION MANAGER OF ASSOCIATE HEALTH BROUGHT FORTH THE RECOMMENDATION TO THE QUESTIONNAIRE VENDOR, VIRGIN PULSE. GOAL 3: ADVANCE HOSPITAL ENGAGEMENT IN COMMUNITY COALITIONS AND COLLABORATIVES TO PROMOTE HEALTHY LIFESTYLES AND CHRONIC DISEASE PREVENTION IN THE COMMUNITIES WE SERVE. GOAL 3 > STRATEGY 1: IDENTIFY COMMUNITY COALITIONS AND COLLABORATIVES WITH PARTNERSHIP OPPORTUNITIES TO PROMOTE HEALTHY LIFESTYLES AND CHRONIC DISEASE PREVENTION. ENCOURAGE ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL REPRESENTATION/INVOLVEMENT BY ASSOCIATES AS DEEMED APPROPRIATE. ANTICIPATED IMPACT: - ENSURE AT LEAST ONE ASSOCIATE PER HOSPITAL FACILITY (ENCOMPASSES ALL SIX ST. JOHN HEALTH SYSTEM, INC. HOSPITALS) IS INVOLVED WITH A COMMUNITY COALITION OR SIMILAR ORGANIZATION IN THE RESPECTIVE COMMUNITY SERVED BY THE END OF TAX YEAR 2019. - INCREASE OVERALL TRACKED PARTICIPATION BY ASSOCIATES WITH COMMUNITY ORGANIZATIONS AND EVENTS BY 5% FROM TAX YEAR 2018 TO TAX YEAR 2019 (ENCOMPASSES ALL SIX ST. JOHN HEALTH SYSTEM, INC. HOSPITALS). - INCREASE OVERALL TRACKED PARTICIPATION BY ASSOCIATES WITH COMMUNITY ORGANIZATIONS AND EVENTS BY ANOTHER 5% FROM TAX YEAR 2019 TO TAX YEAR 2020 (ENCOMPASSES ALL SIX ST. JOHN HEALTH SYSTEM, INC. HOSPITALS). PROGRESS: - ALL OBJECTIVES WERE COMPLETED IN TAX YEARS 2019 AND 2020. - CONTINUED TO RELAY TO COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) REPORTERS AND SENIOR LEADERS THAT PARTICIPATION OF ASSOCIATES WITH COMMUNITY ORGANIZATIONS, IF MEETING ALL COMMUNITY BENEFIT GUIDELINES, SHOULD BE REPORTED. PRIORITIZED NEED 4: ADVERSE CHILDHOOD EXPERIENCES (ACES) GOAL 1: COMBAT HUMAN TRAFFICKING IN THE COMMUNITIES WE SERVE THROUGH EFFORTS TO SUPPORT THE NEEDS OF HUMAN TRAFFICKING VICTIMS OR THOSE AT RISK OF BEING TRAFFICKED IN A TRAUMA-INFORMED MANNER, TAKING INTO CONSIDERATION THE CORRELATION BETWEEN ACES AND HUMAN TRAFFICKING. GOAL 1 > STRATEGY 1: INCREASE COMMUNITY AWARENESS ON THE CORRELATION BETWEEN HIGH ACE SCORES AND HUMAN TRAFFICKING AS WELL AS THE IMPACT OF ACES ON HEALTH OUTCOMES. ANTICIPATED IMPACT: - BY THE END OF THE SECOND QUARTER OF TAX YEAR 2019, MEET WITH THE OKLAHOMA COALITION AGAINST HUMAN TRAFFICKING TO IDENTIFY EDUCATION NEEDS IN THE COMMUNITY. - CONDUCT EDUCATION ON ACES AND HUMAN TRAFFICKING TO AT LEAST 15 COMMUNITY AGENCIES OR ORGANIZATIONS BY THE END OF FY 2022. PROGRESS: - ALL OBJECTIVES WERE COMPLETED IN TAX YEARS 2019 AND 2020. - IN TAX YEAR 2021, EDUCATION ACES AND HUMAN TRAFFICKING IN THE COMMUNITY CONTINUED, INCLUDING PRESENTATIONS TO: QUIKTRIP FUNDERS ROUNDTABLE (AUGUST 2021), PRIMARY CARE PHYSICIAN CONFERENCE (OCTOBER 2021), OKLAHOMA HOSPITAL ASSOCIATION (JANUARY 2022), THREE SESSIONS WITH HILLCREST HEALTH SYSTEM CHAPLAINS (FEBRUARY, MARCH AND APRIL 2022), IDABEL MEDICAL GROUP (APRIL 2022), AND THE SPRING (APRIL 2022)."

Schedule H, Part V, Section B, Line 11 Facility , 3
Facility , 3 - St. John Sapulpa - 3. GOAL 1 > STRATEGY 2: ADVANCE THE ST. JOHN HEALTH SYSTEM, INC. HUMAN TRAFFICKING EDUCATION AND RESPONSE PROGRAM TO SERVE VICTIMS OF HUMAN TRAFFICKING. ANTICIPATED IMPACT: - DEVELOP AT LEAST THREE ADDITIONAL COMMUNITY PARTNERSHIPS TO STRENGTHEN COMMUNITY AWARENESS AND COLLABORATION TO COMBAT HUMAN TRAFFICKING IN THE COMMUNITIES WE SERVE BY THE END OF TAX YEAR 2019. - CONDUCT AT LEAST TWO HUMAN TRAFFICKING EDUCATION/AWARENESS EVENTS FOR EACH OF THE SIX ST. JOHN HEALTH SYSTEM, INC. HOSPITAL FACILITIES AND OUTPATIENT CLINICS BY THE END OF TAX YEAR 2019. - COMPLETE DISSEMINATION OF ASSESSMENT POCKET TOOLS TO KEY ENTRY POINTS AT ST. JOHN HEALTH SYSTEM, INC. HOSPITALS BY THE END OF TAX YEAR 2019. - COMPLETE DISSEMINATION OF ASSESSMENT POCKET TOOLS TO OUTPATIENT CLINICS BY THE END OF FY 2022. PROGRESS: - DISTRIBUTED HUMAN TRAFFICKING ASSESSMENT POCKET TOOLS TO CLINICS AS PART OF CLINICAL EDUCATION. - ALL OTHER OBJECTIVES WERE COMPLETED IN TAX YEARS 2019 AND 2020. GOAL 2: ADDRESS AND MITIGATE ADVERSE HEALTH OUTCOMES PRENATALLY AND BIRTH TO 18 YEARS OF AGE IN COMMUNITIES WE SERVE. GOAL 2 > STRATEGY 1: EXPAND THE ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL SUSPECTED CHILD ABUSE AND NEGLECT (SCAN) COMMITTEE TO INCLUDE COMMUNITY EXPERTS AND/OR LIAISONS, AS WELL AS HOSPITAL REPRESENTATION. ANTICIPATED IMPACT: - EXPLORE OPPORTUNITIES FOR THE EXPANSION OF THE SCAN COMMITTEE, AS EVIDENCED BY COMMITTEE MEETING MINUTES BY THE END OF TAX YEAR 2019. - IMPLEMENT OPPORTUNITIES FOR SCAN COMMITTEE IMPROVEMENT, AS IDENTIFIED IN TAX YEAR 2019 AND AS EVIDENCED BY A REVISED SCAN COMMITTEE CHARTER, IF APPROPRIATE, BY THE END OF TAX YEAR 2020. - IF APPROPRIATE, DEFINE A REPORTING STRUCTURE OF THE QUALITY METRICS RELATED TO SCAN BY THE END OF FY 2022. PROGRESS: - SCAN COMMITTEE MET MONTHLY WITH INTERDISCIPLINARY TEAMS TO REVIEW CASES. - PEDIATRICIAN ON SCAN COMMITTEE ASSISTED WITH MEDICAL STAFF CREDENTIALING FOR UNIVERSITY OF OKLAHOMA COMMUNITY CHILD ABUSE PEDIATRICIAN AND OU PEDIATRICS FELLOWS. - NEW SOCIAL WORKER AND NEW PEDIATRIC CLINICAL NURSE SPECIALIST JOINED SCAN COMMITTEE IN FALL 2021. - REVIEWED OKLAHOMA MOTHERS AND NEWBORNS AFFECTED BY OPIOIDS (OMNO) DATA REPORT FOR POTENTIAL STANDARDS FOR QUALITY METRICS. HOWEVER, A REPORTING STRUCTURE WAS NOT DEFINED; THEREFORE, THE OBJECTIVE WAS DELAYED DUE TO STAFF TURNOVER. GOAL 2 > STRATEGY 2: SUSTAIN AND/OR EXPAND CURRENT SERVICES AND PARTNERSHIPS TARGETING CARE OF PREGNANT WOMEN AND CHILDREN BIRTH TO 3 YEARS OF AGE THROUGHOUT ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL. ANTICIPATED IMPACT: - ASSESS CURRENT PROGRAMS, ACTIVITIES AND COMMUNITY PARTNERSHIPS THROUGHOUT ST. JOHN HEALTH SYSTEM, INC., INCLUDING BUT NOT LIMITED TO CAPACITY, UTILIZATION AND OPPORTUNITY FOR EXPANSION TO OTHER AREAS OF ST. JOHN HEALTH SYSTEM, INC. TO SUPPORT THE CARE OF PREGNANT WOMEN AND CHILDREN BIRTH TO 3 YEARS OF AGE AND DEVELOP AN ACTION PLAN BY THE END OF TAX YEAR 2019. - IF VIABLE, IMPLEMENT PILOT AND/OR EXPANSION OF COLLABORATION WITH COMMUNITY PARTNERS TO SUPPORT THE CARE OF PREGNANT WOMEN AND CHILDREN BIRTH TO 3 YEARS OF AGE BY THE END OF TAX YEAR 2021. PROGRESS: - BEGAN PARTICIPATION IN INITIATIVES TARGETING OPIOID EXPOSURE PRENATALLY AND AFTER BIRTH. WORKED TO GET AGREEMENT IN PLACE FOR COUNSELING SERVICES AND OTHER BEHAVIORAL HEALTH SUPPORT FOR FAMILIES IMPACTED. - EXPLORED AN OPPORTUNITY TO PARTICIPATE IN THE BIRTH THROUGH EIGHT STRATEGY FOR TULSA (BEST) RESEARCH STUDY. BEST IS A COLLABORATIVE APPROACH FOR SEAMLESS, MULTI-SECTOR CONTINUUM OF HIGH-QUALITY PROGRAMS AND SERVICES FOR YOUNG CHILDREN AND FAMILIES. THE AMERICAN INSTITUTES FOR RESEARCH (AIR) IS CONDUCTING A SIX-YEAR STUDY OF THE BEST APPROACH TO LEARN ABOUT PARENTS' EXPERIENCES AND THEIR CHILDREN'S DEVELOPMENT. THE OPPORTUNITY WAS PUT ON HOLD DUE TO A THIRD COVID-19 SURGE, HOSPITAL RECOVERY EFFORTS, AND STAFF TURNOVER, BUT IS EXPECTED TO BE REVISITED IN THE FUTURE. GOAL 3: STRENGTHEN ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL ASSOCIATE AWARENESS OF THE ROLE OF ACES IN HEALTH OUTCOMES, AS WELL AS TO HOW BEST TO RESPOND TO THE NEEDS OF THOSE MOST VULNERABLE. GOAL 3 > STRATEGY 1: PARTNER WITH COMMUNITY AGENCIES AND COALITIONS TO INCREASE ST. JOHN HEALTH SYSTEM, INC. ASSOCIATE AWARENESS OF THE ROLE OF ACES IN ADVERSE HEALTH OUTCOMES AND HOMELESSNESS AND HOW BEST TO RESPOND TO THE NEEDS OF INDIVIDUALS EXPERIENCING OR AT RISK FOR HOMELESSNESS THROUGH COLLABORATIVE CARE COORDINATION AND LINKAGE TO COMMUNITY RESOURCES AND SUPPORT. ANTICIPATED IMPACT: - EXPLORE OPPORTUNITIES FOR COMMUNITY PARTNERSHIP AND COLLABORATION TO ADDRESS ACES IN THE COMMUNITIES SERVED BY ST. JOHN HEALTH SYSTEM, INC. PROGRESS: - OBJECTIVE WAS COMPLETED IN TAX YEAR 2020. GOAL 4: IMPLEMENT EDUCATION AND ASSESSMENT TOOLS TO RAISE AWARENESS OF THE IMPACT OF ACES ON ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL ASSOCIATES AND THEIR FAMILIES IN SUPPORT THE WHOLE PERSON AND A MODEL COMMUNITY OF ENGAGED ASSOCIATES. GOAL 4 > STRATEGY 1: PROVIDE EDUCATION TO ST. JOHN HEALTH SYSTEM, INC. AND HOSPITAL LEADERS ON THE PREVALENCE OF ACES, THEIR IMPACT ON HEALTH AND OTHER OUTCOMES, AND HOW TO IDENTIFY RISK FACTORS AND AVAILABLE RESOURCES TO SUPPORT ASSOCIATES WHO EXPERIENCE OR ARE AT RISK OF ADVERSE OUTCOMES AS RESULT OF ACES. ANTICIPATED IMPACT: - PARTICIPATE IN ASCENSION THRIVE PROGRAM DESIGNED TO DEVELOP SOLUTIONS TO ADDRESS GENERAL BENEFIT NEEDS, SOCIAL DETERMINANTS OF HEALTH, AND ECONOMIC ISSUES EXPERIENCED BY ECONOMICALLY VULNERABLE ASSOCIATES, SOME OF WHOM EXPERIENCE OR ARE AT RISK OF ADVERSE OUTCOMES AS A RESULT OF ACES. PROGRESS: - THE VP OF HUMAN RESOURCES FROM ST. JOHN HEALTH SYSTEM, INC. PARTICIPATED ON THE ASCENSION THRIVE TEAM, WHICH LOOKED AT WAYS TO UNDERSTAND BARRIERS AND IMPROVE HOW THE ORGANIZATION COMMUNICATES OFFERINGS TO ASSOCIATES. LISTENING SESSIONS WITH ASSOCIATES WERE HELD IN SEPTEMBER 2021 TO UNDERSTAND BETTER THEIR AWARENESS OF CURRENT BENEFIT PROGRAMS, COMMUNICATION PREFERENCES, AND UNIQUE SOCIAL AND ECONOMIC ISSUES. TARGETED COMMUNICATIONS DESIGNED TO RECRUIT LISTENING SESSION PARTICIPANTS WERE DISTRIBUTED TO A SMALL NUMBER OF ASSOCIATES WITHIN THE MARKET. INFORMATION GATHERED DURING LISTENING SESSIONS IS BEING USED TO INFORM STRATEGIES FOR DESIGNING, COMMUNICATING, AND DEPLOYING CURRENT AND FUTURE BENEFIT PROGRAMS. TAX YEAR 2021 IMPLEMENTATION STRATEGY IN ST. JOHN SAPULPA'S MOST RECENT CHNA, THE FOLLOWING SIGNIFICANT NEEDS WERE IDENTIFIED FOR CREEK COUNTY: - MENTAL AND BEHAVIORAL HEALTH - ACCESS TO CARE: BARRIERS TO PRIMARY CARE - DIET AND EXERCISE: ACCESS TO HEALTHY FOOD - ALCOHOL AND DRUG USE: ACCESS TO TREATMENT AND RECOVERY SERVICES - COVID-19 - HOUSING AND TRANSIT: RELIABLE TRANSPORTATION - EDUCATION: HEALTH LITERACY ROUNDING DISCUSSIONS WITH MARKET AND HOSPITAL LEADERS, AS WELL AS OTHER KEY STAKEHOLDERS, FURTHER DELINEATED COMMON THEMES AMONG THE SETS OF NEEDS. ACCORDINGLY, IT WAS DETERMINED THAT A MARKETWIDE APPROACH TO ADDRESS TOGETHER THE MOST PRESSING NEEDS OF THE COMMUNITY WOULD BE MOST EFFECTIVE AND IMPACTFUL. HEALTH EQUITY AND SOCIAL JUSTICE ARE INTENTIONAL AND UNIVERSAL THEMES WITHIN THE CHNA PROCESS. OUR COMMITMENT TO ADDRESSING HEALTH NEEDS FLOWS FROM A CHARITABLE MISSION TO PROVIDE ALL PERSONS THE OPPORTUNITY FOR HEALTH AND WELL-BEING, ESPECIALLY VULNERABLE INDIVIDUALS AND HISTORICALLY MARGINALIZED POPULATIONS - BOTH INSIDE HOSPITAL AND CLINIC WALLS AND THROUGHOUT THE COMMUNITY. THAT MEANS WORKING CLOSELY WITH EACH COMMUNITY WE SERVE, PARTNERING WITH LOCAL ORGANIZATIONS AND KEY STAKEHOLDERS TO EXAMINE DRIVERS OF HEALTH THROUGH A LENS OF COMPASSION AND SOLIDARITY. ACCORDINGLY, IT WAS DETERMINED THAT HEALTH EQUITY AND SOCIAL DETERMINANTS OF HEALTH SHOULD BE UNDERLYING CURRENTS OF ALL STRATEGIES AND TACTICS TO ADDRESS NEEDS OF THE COMMUNITY. IN ADDITION, IT IS TAKEN INTO CONSIDERATION THAT PROFOUND DISPARITIES EMERGED FROM OR WERE EXACERBATED BY THE COVID-19 PANDEMIC AND CONTINUE TO AFFECT THE COMMUNITY. THE SIGNIFICANT NEEDS THAT WERE PRIORITIZED BY THE HOSPITAL TO ADDRESS THROUGH THE THREE-YEAR CHNA IMPLEMENTATION STRATEGY ARE: ACCESS TO CARE, MENTAL AND BEHAVIORAL HEALTH, FOOD SECURITY, AND ALCOHOL AND DRUG USE.

Schedule H, Part V, Section B, Line 11 Facility , 4
Facility , 4 - St. John Sapulpa - 4. NEEDS THAT WILL NOT BE ADDRESSED DIRECTLY: ST. JOHN HEALTH SYSTEM, INC. AND THE HOSPITAL ARE COMMITTED TO IMPROVING COMMUNITY HEALTH BY ADDRESSING PRIORITIZED HEALTH NEEDS. THE TAX YEAR 2021 CHNA INEVITABLY IDENTIFIED MORE SIGNIFICANT HEALTH NEEDS THAN THE HEALTH SYSTEM, HOSPITALS AND COMMUNITY PARTNERS CAN OR SHOULD ADDRESS AS PRIORITY HEALTH NEEDS. IT WOULD NOT BE PRUDENT TO SPREAD HOSPITAL AND COMMUNITY RESOURCES ACROSS TOO MANY INITIATIVES. ACCORDINGLY, ST. JOHN HEALTH SYSTEM, INC. AND THE HOSPITAL AND COMMUNITY PARTNERS INSTEAD DECIDED TO FOCUS ATTENTION ON PRIORITY AREAS TO HELP ENSURE SUFFICIENT RESOURCES ARE AVAILABLE. IT WAS DISCUSSED AT LENGTH THAT THESE REMAINING HEALTH TOPICS, WHILE NOT CHOSEN AS PRIORITIES, ARE INTERRELATED TO THE FOUR CHOSEN PRIORITIES AND WILL THEREFORE BE ADDRESSED INDIRECTLY. FURTHERMORE, AND AS AFOREMENTIONED, SOCIAL DETERMINANTS OF HEALTH WERE DEEMED AN UNDERLYING CURRENT OF THE CHOSEN PRIORITIES, WHICH WILL ULTIMATELY CROSS OVER EFFORTS INTO OTHER NEED AREAS. ALL DIRECT AND INDIRECT EFFORTS TO IMPROVE THE COMMUNITY'S HEALTH ARE INTENDED TO UPHOLD THE HEALTH SYSTEM AND HOSPITAL'S MISSION TO SERVE ALL PEOPLE, WITH SPECIAL ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. BASED ON THE PRIORITIZATION CRITERIA, THE HEALTH NEEDS IDENTIFIED THROUGH THE CHNA THAT ST. JOHN SAPULPA DOES NOT PLAN TO ADDRESS AT THIS TIME INCLUDE: - COVID-19: THIS NEED WAS NOT SELECTED BECAUSE IT WAS DETERMINED TO BE AN UNDERLYING CURRENT OF ALL STRATEGIES AND TACTICS TO ADDRESS PRIORITY HEALTH NEEDS. - RELIABLE TRANSPORTATION: THIS NEED WAS NOT SELECTED AS AN INDIVIDUAL NEED ON ITS OWN BECAUSE IT IS ENCOMPASSED WITHIN ACCESS TO CARE. - HEALTH LITERACY: THIS NEED WAS NOT SELECTED BECAUSE IT DID NOT RANK AS HIGH AS OTHER NEEDS. IN ADDITION, STAFF CAPACITY IS EXTREMELY LIMITED, WHICH WOULD BE A MAJOR BARRIER TO HEALTH LITERACY STRATEGIES. ADDITIONAL FACTORS IMPACT THE HOSPITAL'S ABILITY TO FULLY ADDRESS ALL PRIORITY NEEDS, INCLUDING THE FOLLOWING: - NEED BEING ADDRESSED BY OTHERS - INSUFFICIENT RESOURCES (FINANCIAL AND PERSONNEL) TO ADDRESS THE NEED - ISSUE IS NOT A PRIORITY FOR COMMUNITY MEMBERS AND THEREFORE APPROACH IS UNLIKELY TO SUCCEED - LACK OF EVIDENCE-BASED APPROACH FOR ADDRESSING THE PROBLEM - NEED IS NOT AS PRESSING AS OTHER PROBLEMS - NEED IS NOT AS LIKELY TO BE RESOLVED AS OTHER PROBLEMS - HOSPITAL AND/OR HEALTH SYSTEM DOES NOT HAVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED WHILE COVID-19, RELIABLE TRANSPORTATION, AND HEALTH LITERACY ARE NOT THE FOCUS OF THIS IMPLEMENTATION STRATEGY, ST. JOHN SAPULPA MAY CONSIDER INVESTING RESOURCES IN THESE AREAS AS APPROPRIATE, DEPENDING ON OPPORTUNITIES TO LEVERAGE ORGANIZATIONAL AND COMMUNITY ASSETS. THESE ISSUES DESERVE FURTHER ATTENTION AND STUDY BY HEALTH SYSTEMS, AS THEY REFLECT IMPORTANT FACTORS ADVERSELY AFFECTING CREEK COUNTY. ALSO, THIS REPORT DOES NOT ENCOMPASS A COMPLETE INVENTORY OF EVERYTHING ST. JOHN SAPULPA DOES TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. THE HOSPITAL UNDERSTANDS THE IMPORTANCE OF ALL COMMUNITY NEEDS AND IS COMMITTED TO PLAYING AN ACTIVE ROLE IN ADDRESSING THEM. TO ADDRESS THE PRIORITIZED NEEDS IDENTIFIED IN THE 2021 CHNA, A SUBSEQUENT IMPLEMENTATION STRATEGY FOR EACH ST. JOHN HEALTH SYSTEM, INC. FACILITY WAS ADOPTED. DUE TO THE TIMING OF THE RECENTLY ADOPTED IMPLEMENTATION STRATEGY, IMPACT WILL BE REPORTED STARTING NEXT YEAR.

Schedule H, Part I, Line 3c FACTORS OTHER THAN FPG
"IN ADDITION TO FPG, THE ORGANIZATION USES MEDICAL INDIGENCY, ASSET TEST, INSURANCE STATUS AND RESIDENCY AS OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A Patient may not be eligible for the financial assistance if such Patient is deemed to have sufficient assets to pay pursuant to an ""Asset Test."" The Asset Test involves a substantive assessment of a Patient's ability to pay based on the categories of assets measured in the FAP Application. A Patient with such assets that exceed 250% of such Patient's FPL amount may not be eligible for financial assistance. AN ASSET TEST APPLIES IF A PATIENT HAS ELIGIBLE LIQUID ASSETS THAT EXCEED 250% OF THE PATIENT'S FPG LEVEL FOR CONSIDERATION OF FINANCIAL ASSISTANCE ELIGIBILITY. LIQUID ASSETS INCLUDE ASSETS THAT CAN BE CONVERTED TO CASH WITHIN 1 YEAR. THESE INCLUDE ITEMS SUCH AS CHECKING ACCOUNTS, SAVINGS ACCOUNTS, TRUST FUNDS AND LUXURY ITEMS SUCH AS RECREATIONAL VEHICLES, BOATS, A SECOND HOME, ETC."

Schedule H, Part I, Line 5a BUDGET AMOUNTS FOR FREE OR DISCOUNTED CARE
THE ORGANIZATION ADMINISTERS ITS FINANCIAL ASSISTANCE POLICY IN ACCORDANCE WITH THE TERMS OF THE POLICY.

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
ST. JOHN SAPULPA, INC. REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE FOLLOWING RELATED ORGANIZATION'S ANNUAL COMMUNITY BENEFIT REPORT: St. John Health System EIN 73-1215174

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
"THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (""CHA"") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED."

Schedule H, Part II Community Building Activities
THERE WERE NO COMMUNITY BUILDING ACTIVITIES TO REPORT THIS YEAR. ALL REPORTED ACTIVITIES QUALIFY AS COMMUNITY BENEFIT AND ARE DESCRIBED IN THE NARRATIVE UNDER SCHEDULE H PART I, LINE 7.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2022 was $2,825,103 at charges, ($734,527 at cost).

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
BASED ON THE ORGANIZATION'S ADMINISTRATION OF ITS FINANCIAL ASSISTANCE PROGRAM, NO ESTIMATE FOR BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DEEMED APPLICABLE TO HOSPITAL OPERATIONS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
THE ORGANIZATION IS PART OFASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSESBAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 17-20, OF THE AUDITED FINANCIAL STATEMENTS.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE GROSS CHARGES TO CALCULATE MEDICARE COSTS, WHICH ARE THEN COMPARED TO MEDICARE PAYMENTS RECEIVED, TO DETERMINE A MEDICARE GAIN OR LOSS. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT A MEDICARE SHORTFALL (LOSS) IS NOT TREATED AS COMMUNITY BENEFIT, EVEN THOUGH THE HOSPITAL HAS INCURRED LOSSES IN PROVIDING CARE TO MEDICARE PATIENTS. THEREFORE, NONE OF THE AMOUNT ON LINE 7 IS TREATED AS COMMUNITY BENEFIT.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
ST. JOHN SAPULPA, INC. FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED IF ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED FOR THE AMOUNTS FOR WHICH THE PATIENT QUALIFIES.

Schedule H, Part V, Section B, Line 16a FAP website
- St. John Sapulpa: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- St. John Sapulpa: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- St. John Sapulpa: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part VI, Line 5 Promotion of community health
ST. JOHN SAPULPA, INC.'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF ST. JOHN SAPULPA, INC. GOVERNING BODY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA; WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. ST. JOHN SAPULPA, INC. APPLIES SURPLUS FUNDS TO FUND IMPROVEMENTS IN COMMUNITY HEALTH AND WELLNESS, MEDICAL ACCESS, PATIENT CARE, MEDICAL EDUCATION AND RESEARCH BY DONATIONS TO OR PARTNERING WITH NON-PROFIT AGENCIES, COMMUNITY ORGANIZATIONS AND UNIVERSITIES.

Schedule H, Part VI, Line 2 Needs assessment
ST. JOHN SAPULPA, INC.USES RELIABLE, THIRD PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED AND INCLUDE BUT ARE NOT LIMITED TO REPORTS FROM: - LOCAL DEPARTMENTS OF HEALTH - OKLAHOMA STATE DEPARTMENT OF HEALTH - LOCAL GOVERNMENT PLANNING DEPARTMENTS - LOCAL UNIVERSITIES - US CENSUS BUREAU - ECONOMIC IMPACT STUDIES - OKLAHOMA HOSPITAL ASSOCIATION - COMMUNITY SERVICE COUNCIL OF GREATER TULSA - CENTERS FOR MEDICARE & MEDICAID SERVICES - AMERICAN COMMUNITY SURVEY - AMERICAN LUNG ASSOCIATION - ANNIE E. CASEY FOUNDATION - CENTERS FOR DISEASE CONTROL AND PREVENTION - COUNTY HEALTH RANKINGS - FEEDING AMERICA - NATIONAL CANCER INSTITUTE - NATIONAL CENTER FOR EDUCATION STATISTICS - OKLAHOMA STATE BUREAU OF INVESTIGATION - SMALL AREA HEALTH INSURANCE ESTIMATES - THE DARTMOUTH ATLAS OF HEALTHCARE - U.S. BUREAU OF LABOR STATISTICS - U.S. DEPARTMENT OF AGRICULTURE - FOOD ENVIRONMENT ATLAS - U.S. ENVIRONMENTAL PROTECTION AGENCY - ST. JOHN MEDICAL ACCESS PROGRAM AND SAFETY-NET CLINIC PARTNERS - COMMUNITY PARTNER AGENCIES ST. JOHN SAPULPA, INC. UTILIZES INFORMATION FROM THESE SECONDARY SOURCES TO DEVELOP PROGRAMS AND PROVIDE SERVICES THROUGHOUT THE REGION. IN ADDITION, ST. JOHN SAPULPA, INC. CONSIDERS THE HEALTH CARE NEEDS OF THE OVERALL COMMUNITY WHEN EVALUATING INTERNAL FINANCIAL AND OPERATIONAL DECISIONS.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
ST. JOHN SAPULPA, INC. IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, ST. JOHN SAPULPA, INC.'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; ST. JOHN HOSPITAL, INC. PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. ST. JOHN SAPULPA, Inc. WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE - https://healthcare.ascension.org/financial-assistance/oklahoma ST. JOHN SAPULPA, Inc. MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. ST. JOHN SAPULPA, Inc. INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. ST. JOHN SAPULPA, Inc. INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 4 Community information
ST. JOHN SAPULPA, INC. IS A GROWING COMMUNITY HOSPITAL WHOSE PRIMARY SERVICE AREA IS CREEK COUNTY, OKLA., AND THE SURROUNDING COUNTIES. HOWEVER, ST. JOHN SAPULPA, INC. SERVES PATIENTS WHO LIVE THROUGHOUT THE NORTHEASTERN OKLAHOMA REGION AND BEYOND. FOR THE PURPOSES OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT, THE COMMUNITY SERVED IS DEFINED AS CREEK COUNTY. THE DECISION TO FOCUS ON THE GEOPOLITICAL DEFINITION OF CREEK COUNTY WAS LARGELY INFLUENCED BY THE FACT THAT A SIGNIFICANT NUMBER OF PATIENTS WHO UTILIZE ST. JOHN SAPULPA, INC.SERVICES RESIDE IN CREEK COUNTY. ST. JOHN SAPULPA, INC. IS BASED OUT OF THE CITY OF SAPULPA. ACCORDINGLY, SAPULPA SERVES AS THE PRIMARY AREA OF FOCUS WITHIN THE CREEK COUNTY COMMUNITY. ST. JOHN SAPULPA, INC.'S COMMUNITY HEALTH IMPROVEMENT EFFORTS THAT RESULT FROM THIS COMMUNITY HEALTH NEEDS ASSESSMENT WILL PRIMARILY CENTER ON SAPULPA. HOWEVER, AN EFFORT WAS MADE TO CONSIDER THE HEALTH NEEDS AND ASSETS OF CREEK COUNTY AS A WHOLE, AND OUR EFFORTS WILL ALSO EXTEND TO OTHER CITIES AND TOWNS WITHIN CREEK COUNTY BASED ON LESSONS LEARNED THROUGH OUR WORK WITH THE SAPULPA COMMUNITY. CREEK COUNTY HAS AN ESTIMATED POPULATION OF 72,029. ACCORDING TO THE 2021 COUNTY HEALTH RANKINGS, CREEK COUNTY RANKS 37TH OUT OF 77 OKLAHOMA COUNTIES IN OVERALL HEALTH OUTCOMES AND 36TH OUT OF 77 OKLAHOMA COUNTIES IN OVERALL HEALTH FACTORS. ROUGHLY 4.6% OF THE POPULATION IN CREEK COUNTY IS HISPANIC/LATINO, 10.8% NATIVE AMERICAN, 2.3% BLACK/AFRICAN AMERICAN, AND 78.9% WHITE/CAUCASIAN. THE MEDIAN HOUSEHOLD INCOME IS LOWER COMPARED TO THE STATE OF OKLAHOMA AT ABOUT $49,578 ANNUALLY; UNEMPLOYMENT RATE IS 4.2% IN CREEK COUNTY WHICH IS LOWER THAN THE STATE, AND THE U.S.; AND ROUGHLY 14% OF CREEK COUNTY FAMILIES ARE LIVING IN POVERTY, WHICH IS LOWER THAN THE STATE, BUT HIGHER THAN THE U.S. CREEK COUNTY'S UNINSURED RATE IS 15.6% WHICH IS ON PAR WITH THE STATE'S RATE, BUT HIGHER THAN THE U.S. CREEK COUNTY IS REPORTED TO HAVE GENERAL MEDICAL/SURGICAL HOSPITAL AND 2 CRITICAL ACCESS HOSPITALS, TO RURAL CLINICS AND A FREE CLINIC, TO A PROVIDER OF INDIAN SERVICES (TRIBAL) AND AN URGENT CARE CENTER. ACCORDING TO THE US HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) DATA WAREHOUSE 2018 REPORT, THERE ARE TWO AREAS DESIGNATED AS MEDICALLY UNDERSERVED AREAS IN CREEK COUNTY. CREEK COUNTY IS CONSIDERED A MEDICALLY UNDERSERVED AREA.

Schedule H, Part VI, Line 6 Affiliated health care system
ST. JOHN SAPULPA, INC. IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. ST. JOHN SAPULPA, INC. OPERATES A HOSPITAL FACILITY IN CREEK COUNTY AND IS PART OF ST. JOHN HEALTH SYSTEM WHICH OWNS AND OPERATES HEALTH CARE RELATED ENTITIES, INCLUDING JANE PHILLIPS MEMORIAL MEDICAL CENTER, JANE PHILLIPS NOWATA HEALTH CENTER, OWASSO MEDICAL FACILITY, ST. JOHN BROKEN ARROW, ST. JOHN SAPULPA AND ST JOHN MEDICAL CENTER. THE HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF EASTERN OKLAHOMA AND SOUTHEASTERN KANSAS.