4A (Expenses $ 73163283 including grants of $ 6169) (Revenue $ 81860298)
SAINT ALPHONSUS MEDICAL CENTER-ONTARIO (SAMC-ONTARIO) IS A COMMUNITY HOSPITAL LOCATED IN ONTARIO, OREGON. SAMC-ONTARIO IS A 49-BED ACUTE CARE HOSPITAL SERVING ONTARIO, AS WELL AS EASTERN OREGON AND SOUTHWESTERN IDAHO. THE HOSPITAL OFFERS A FULL RANGE OF SERVICES IN AN INPATIENT AND OUTPATIENT SETTING AS WELL AS 24 HOUR EMERGENCY CARE, SURGICAL SERVICES, CANCER CARE, MATERNITY CARE, NEUROLOGY, ORTHOPEDICS AND CRITICAL CARE, AMONG MANY OTHER SERVICES. SAMC-ONTARIO OFFERS CONVENIENT ACCESS TO HEALTH CARE SERVICES WITH TWO SEPARATE CLINIC LOCATIONS. PLEASE SEE SCHEDULE H AND VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT SERVICES, RECOGNITIONS AND AWARDS: WWW.SAINTALPHONSUS.ORG/ONTARIO

ST. ALPHONSUS MEDICAL CENTER-ONTARIO
PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E:SAINT ALPHONSUS MEDICAL CENTER-ONTARIO (SAMC-ONTARIO) INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH THIS COMMUNITY-INVOLVED SELECTION PROCESS: 1. AFFORDABLE, SAFE HOUSING, INCLUDING HOMELESSNESS: AFFORDABLE AND MIXED-INCOME HOUSING DEVELOPMENT AND AVAILABILITY; HOMELESSNESS PREVENTION AND MITIGATION2. SUBSTANCE USE, INCLUDING TOBACCO AND VAPE USE: HARMFUL SUBSTANCE, TOBACCO, VAPE AND ELECTRONIC CIGARETTE USE RATES3. CHILDCARE AND EDUCATION: ACCESS TO AND AVAILABILITY OF AFFORDABLE, HIGH QUALITY CHILDCARE AND EARLY CHILDHOOD EDUCATION (I.E. PRE-K) AS WELL AS K-12 AND POST-SECONDARY EDUCATION OPPORTUNITIES4. ACCESS TO HEALTH CARE, INCLUDING ORAL HEALTH: ACCESS TO HEALTH CARE AND ORAL HEALTH CARE; AVAILABILITY OF LINGUISTICALLY AND CULTURALLY APPROPRIATE SERVICES5. TRANSPORTATION: ACCESS AND UTILIZATION OF PUBLIC TRANSIT; COMMUTE TIMES; NUMBER OF INDIVIDUALS WITH ACCESS TO CARS

ST. ALPHONSUS MEDICAL CENTER-ONTARIO
PART V, SECTION B, LINE 5: THE CHNA WAS CONDUCTED BETWEEN AUGUST 2019 AND JUNE 2020; IT WAS APPROVED BY THE BOARD ON JUNE 15, 2020. IN ADDITION TO SAINT ALPHONSUS, MEMBERS OF THE ADVISORY COMMITTEE INCLUDED: OREGON STATE UNIVERSITY (OSU) EXTENSION, SOUTHWEST DISTRICT HEALTH, VALLEY FAMILY HEALTH, OREGON DEPARTMENT OF HUMAN SERVICES, GOBHI, TREASURE VALLEY RELIEF NURSERY, COMMUNITY IN ACTION, TREASURE VALLEY COMMUNITY COLLEGE, EUVALCREE, ONTARIO SCHOOL DISTRICT, MALHEUR EDUCATION SERVICE DISTRICT, AND MALHEUR COUNTY HEALTH DEPARTMENT.SAINT ALPHONSUS HEALTH SYSTEM (SAHS) CONTRACTED WITH HEALTH RESOURCES IN ACTION TO PROVIDE PROJECT MANAGEMENT AND CONSULTATION AS WELL AS DEVELOPMENT OF DATA COLLECTION TOOLS. IN ADDITION, DATA INDICATORS WERE COLLECTED FROM A VARIETY OF SOURCES, INCLUDING THE TRINITY HEALTH DATA HUB, U.S. CENSUS, OREGON DEPARTMENT OF HUMAN SERVICES, COUNTY HEALTH RANKINGS, AND MANY OTHER SECONDARY DATA SOURCES. LITERATURE REVIEW AND SECONDARY DATA SOURCES WERE USED TO SELECT COLLECTIVE MEASURES/INDICATORS IN THE AREAS OF EDUCATION, FINANCIAL INDEPENDENCE, AND HEALTH AT THE REGIONAL, COUNTY AND CITY LEVEL. WHEREVER POSSIBLE, COMMUNITY HEALTH INDICATOR DATA WAS COLLECTED TO ALLOW COMPARISONS BETWEEN COUNTY, STATE AND NATIONAL RATES. ADDITIONAL COMMUNITY INPUT WAS COLLECTED BETWEEN AUGUST 2019 AND APRIL 2020 THROUGH 11 COMMUNITY FOCUS GROUPS WITH POPULATIONS SUCH AS IMMIGRANTS AND REFUGEES, NON-ENGLISH SPEAKERS, LGBTQIA+, OLDER ADULTS, PEOPLE EXPERIENCING HOMELESSNESS AND FOOD INSECURITY AND OTHERS, THROUGH 318 RESIDENT SURVEYS, AND THROUGH 11 INTERVIEWS WITH COMMUNITY LEADERS, FRONT LINE STAFF, AND SOCIAL SERVICE AND NONPROFIT ORGANIZATIONS.FOCUS GROUP HOSTS INCLUDED THE FOLLOWING ORGANIZATIONS SERVING IMPACTED POPULATIONS: CRADLE TO CAREER PARTNERS, EUVALCREE, FOUR RIVERS WELCOME CENTER, LGBTQIA+ PARTNERS, MALHEUR COUNTY COMMUNITY SERVICES, MALHEUR COUNTY UNITED FOR HOUSING TASK FORCE, NYSSA FOOD BANK, ORIGINS FAITH COMMUNITY, FRUITLAND HEALTH PLAZA, SOUTHWEST DISTRICT HEALTH - PAYETTE AND WASHINGTON COUNTY CHATS, WEISER LIBRARY, AND WEISER SENIOR CENTER.COMMUNITY INTERVIEWS INCLUDED THE FOLLOWING ORGANIZATION PARTICIPANTS: PROJECT DOVE, CITY OF ONTARIO, ANGEL WINGS, MALHEUR COUNTY, VALLEY FAMILY HEALTH, COMMUNITY IN ACTION, MALHEUR COUNTY SHERIFF, MALHEUR COUNTY COURT, MALHEUR COUNTY HEALTH DEPARTMENT, AND EASTERN OREGON BORDER ECONOMIC DEVELOPMENT REGION.

ST. ALPHONSUS MEDICAL CENTER-ONTARIO
"PART V, SECTION B, LINE 11: THE CHNA WAS CONDUCTED AND POSTED BY THE END OF FISCAL YEAR 2020; AN UPDATED IMPLEMENTATION STRATEGY WAS ADOPTED IN SEPTEMBER 2020 FOR FISCAL YEARS 2021-2023. THESE DOCUMENTS WILL GUIDE THE COMMUNITY BENEFIT WORK FOR TAX YEARS 2020-2022. SAMC-ONTARIO IDENTIFIED FIVE SIGNIFICANT HEALTH NEEDS TO ADDRESS DURING THIS TIME PERIOD. THE IMPLEMENTATION STRATEGY WILL GUIDE HOW EACH OF THESE NEEDS ARE ADDRESSED. IN FISCAL YEAR 2022 (FY22), SAMC-ONTARIO DEVELOPED AND/OR SUPPORTED INITIATIVES TO IMPROVE THE FOLLOWING HEALTH NEEDS:AFFORDABLE, SAFE HOUSING, INCLUDING HOMELESSNESS: IN FY22, SAMC-ONTARIO INITIATIVES SUPPORTED LOCAL, AFFORDABLE HOUSING OPTIONS VIA PARTICIPATION IN A LOCAL HOUSING TASK FORCE, AND HOSTING ""HOUSING AS HEALTH CARE"" MEETINGS. SAMC-ONTARIO FACILITATED COMMUNITY AND FINANCIAL SUPPORT FOR THE PRESBYTERIAN COMMUNITY CARE CENTER CONVERSION TO AFFORDABLE HOUSING UNITS WITH ONSITE SPACE FOR HEALTH CARE AND SOCIAL SERVICES IN ONTARIO, WHICH INCLUDED CONSULTATION, DATA, AND LETTERS OF SUPPORT FOR LOW-INCOME HOUSING TAX CREDIT APPLICATIONS. SUBSTANCE USE, INCLUDING TOBACCO AND VAPE USE: AS PART OF FY22 INITIATIVES, SAMC-ONTARIO CONTINUED TO OFFER ONLINE AND ZOOM OPTIONS FOR TOBACCO CESSATION CURRICULUM THROUGH THE SAINT ALPHONSUS TOBACCO FREE LIVING PROGRAM. A TOBACCO TREATMENT SPECIALIST PROMOTED AVAILABLE COMMUNITY RESOURCES AND WORKED TO DECREASE COMMUNITY RATES OF TOBACCO AND E-CIGARETTE USE.CHILDCARE AND EDUCATION: IN FY22, SAMC-ONTARIO WORKED TO IMPROVE LOCAL GRADUATION RATES VIA PROVISION OF ENHANCED TRAINING AND DEVELOPMENT OPPORTUNITIES THROUGH EXISTING EDUCATIONAL INSTITUTIONS IN THE COMMUNITY, INCLUDING A PARTNERSHIP WITH TREASURE VALLEY COMMUNITY COLLEGE TO SUPPORT A MEDICAL ASSISTANT PROGRAM TO FILL NEEDED POSITIONS THROUGHOUT THE TREASURE VALLEY. SAMC-ONTARIO CONTINUED ITS SUPPORT OF THE TREASURE VALLEY TECHNICAL (TVT) PROGRAM BY SERVING AS AN EDUCATION SITE FOR CERTIFIED NURSING ASSISTANT (CNA) STUDENTS, PROVIDING SPEAKERS AND MENTORS TO STUDENTS, ACTING IN AN ADVISORY ROLE FOR THE TVT BOARD AND THE CNA PROGRAM, PROVIDING SUPPLIES FOR CNA CLASSES, AS WELL AS PROVIDING FREE MEDICAL SCREENING TO ALLOW CNA STUDENTS TO BE LICENSED IN THE STATE OF OREGON. ACCESS TO HEALTH CARE, INCLUDING ORAL HEALTH: IN FY22, SAMC-ONTARIO PROVIDED ENROLLMENT ASSISTANCE IN PUBLIC PROGRAMS, INCLUDING MEDICAID, FOR OREGON AND IDAHO. ADDITIONALLY, SAINT ALPHONSUS HEALTH SYSTEM CONTINUED TO DEVELOP A SOCIAL CARE HUB TO ASSESS THE SOCIAL CARE NEEDS (E.G., HOUSING, FOOD, CHILDCARE, EMPLOYMENT) OF SELECT PATIENT POPULATIONS, AND TO MAKE REFERRALS, INCLUDING ORAL HEALTH NEEDS, THROUGH COMMUNITY HEALTH WORKERS AND THE ADOPTION OF A COMMUNITY RESOURCE DIRECTORY.TRANSPORTATION: SAMC-ONTARIO CONTINUED TO PROVIDE SUPPORT TO LOCAL ORGANIZATIONS, INCLUDING LOCAL TAXIS, TO PROVIDE TRANSPORTATION ACCESS FOR HEALTH CARE APPOINTMENTS TO PATIENTS EXPERIENCING FINANCIAL BARRIERS.SAMC-ONTARIO ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED, AND WITHIN ITS ABILITY TO INFLUENCE. SAMC-ONTARIO DID NOT TAKE ACTION ON THE FOLLOWING IDENTIFIED NEEDS IN FY22 DUE TO COMPETING PRIORITIES AND AN ATTEMPT TO REDUCE DUPLICATION OF EFFORTS:FINANCIAL STABILITY AND COST OF LIVING: SAMC-ONTARIO DID NOT DIRECTLY ADDRESS THIS COMMUNITY NEED BECAUSE IT IS ADDRESSED BY OTHER ORGANIZATIONS WITHIN THE COMMUNITY. HOWEVER, SAMC-ONTARIO IS COMMITTED TO PARTICIPATING IN AFFORDABLE AND MIXED-INCOME HOUSING PROJECTS, ASSISTING WITH PATIENT TRANSPORTATION NEEDS, AND MAKING REFERRALS FOR PATIENTS AND COLLEAGUES TO COMMUNITY-BASED RESOURCES TO ADDRESS BASIC NEEDS THROUGH THE SOCIAL CARE HUB AND A COMMUNITY RESOURCE DIRECTORY, AS OUTLINED IN OTHER STRATEGIES ADDRESSED IN THE CHNA.MENTAL HEALTH AND WELL-BEING: SAMC-ONTARIO DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE IT IS ADDRESSED BY OTHER ORGANIZATIONS WITHIN THE COMMUNITY. SAMC-ONTARIO PROVIDES REFERRALS AND SUPPORT TO LIFEWAYS AND OTHER PROVIDERS OF BEHAVIORAL HEALTH SERVICES IN THE ONTARIO REGION. ADDITIONALLY, ""QUESTION PERSUADE REFER"" SUICIDE PREVENTION TRAINING IS MADE AVAILABLE TO SAMC-ONTARIO COLLEAGUES.CHRONIC DISEASES: SAMC-ONTARIO DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE IT IS ADDRESSED BY OTHER ORGANIZATIONS WITHIN THE COMMUNITY. WHILE SAMC-ONTARIO AND SAINT ALPHONSUS MEDICAL GROUP FRUITLAND HEALTH PLAZA PROVIDE MEDICAL SERVICES FOR THE PREVENTION AND MITIGATION OF CHRONIC DISEASES, THEY ALSO PROVIDE REFERRALS FOR PATIENTS TO OTHER COMMUNITY-BASED SERVICES TO ADDRESS THEIR NEEDS RELATED TO CHRONIC DISEASES.WAGES AND JOB AVAILABILITY: SAMC-ONTARIO DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE IT IS ADDRESSED BY OTHER ORGANIZATIONS WITHIN THE COMMUNITY AND IS OUTSIDE THE PURVIEW OF OUR HEALTH CARE ORGANIZATION. HOWEVER, SAMC-ONTARIO IS COMMITTED TO PROVIDING LIVABLE WAGES, ABOVE THE LOCAL MINIMUM WAGE, TO THE COLLEAGUES WE EMPLOY THROUGHOUT THE COMMUNITY.SEXUALLY TRANSMITTED INFECTIONS: SAMC-ONTARIO DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE IT IS ADDRESSED BY OTHER ORGANIZATIONS WITHIN THE COMMUNITY. IN PARTICULAR, THE MALHEUR COUNTY HEALTH DEPARTMENT AND OTHERS PROVIDE THESE SERVICES AND ARE A REFERRAL SOURCE FOR SAMC-ONTARIO PATIENTS.FOOD SECURITY: SAMC-ONTARIO DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE IT IS ADDRESSED BY OTHER ORGANIZATIONS WITHIN THE COMMUNITY. SAMC-ONTARIO STAFF DO PARTICIPATE IN THE WESTERN TREASURE VALLEY HUNGER RELIEF TASK FORCE AND SUPPORT OSU EXTENSION AND LOCAL FOOD PANTRIES FOR THE PROVISION OF FOOD. ADDITIONALLY, SAMC-ONTARIO ADDRESSES FOOD SECURITY THROUGH THE SOCIAL CARE HUB AND REFERRALS THROUGH A COMMUNITY RESOURCE DIRECTORY.PHYSICAL ACTIVITY AND RECREATION OPPORTUNITIES: SAMC-ONTARIO DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE IT IS ADDRESSED BY OTHER ORGANIZATIONS WITHIN THE COMMUNITY AND IS OUTSIDE THE PURVIEW OF THE HEALTH SYSTEM. SAMC-ONTARIO DOES SPONSOR AND PROVIDE ATHLETIC TRAINERS TO THE ONTARIO SCHOOL DISTRICT AND TREASURE VALLEY COMMUNITY COLLEGE TO SUPPORT LOCAL ATHLETES."

ST. ALPHONSUS MEDICAL CENTER-ONTARIO
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

PART V, SECTION B, LINE 7A:
WWW.SAINTALPHONSUS.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-NEEDS-ASSESSMENT/

PART V, SECTION B, LINE 9:
AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.

PART V, SECTION B, LINE 10A:
WWW.SAINTALPHONSUS.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-NEEDS-ASSESSMENT/IMPLEMENTATION-STRATEGY

PART V, LINE 16A, FAP WEBSITE:
WWW.SAINTALPHONSUS.ORG/FOR-PATIENTS/AFTER-YOUR-VISIT/FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

PART V, LINE 16B, FAP APPLICATION WEBSITE:
WWW.SAINTALPHONSUS.ORG/FOR-PATIENTS/AFTER-YOUR-VISIT/FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:
WWW.SAINTALPHONSUS.ORG/FOR-PATIENTS/AFTER-YOUR-VISIT/FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

PART I, LINE 3C:
IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.

PART I, LINE 6A:
SAINT ALPHONSUS MEDICAL CENTER-ONTARIO (SAMC-ONTARIO) PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF OREGON. IN ADDITION, SAMC-ONTARIO REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.SAMC-ONTARIO ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE.

PART I, LINE 7:
THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.

PART I, LN 7 COL(F):
THE FOLLOWING NUMBER, $3,193,330, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).

PART II, COMMUNITY BUILDING ACTIVITIES:
COALITION BUILDING: IN FISCAL YEAR 2022, SAMC-ONTARIO STAFF PARTICIPATED IN SEVERAL COMMUNITY COALITIONS TO ADDRESS TRAUMA, MENTAL HEALTH AND HOUSING, INCLUDING PAYETTE COUNTY LEPC, TRAUMA ADVISORY BOARD, MALHEUR COUNTY MENTAL HEALTH, OREGON STATE TRAUMA ADVISORY BOARD, AND MALHEUR COUNTY HOUSING WORK GROUP.

PART III, LINE 2:
METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.

PART III, LINE 3:
SAMC-ONTARIO USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, SAMC-ONTARIO IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, SAMC-ONTARIO IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.

PART III, LINE 4:
"SAMC-ONTARIO IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: ""AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED.""PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE ONE PERCENT SEQUESTRATION REDUCTION FOR THE PERIOD APRIL 1, 2022 THROUGH JUNE 30, 2022."

PART III, LINE 8:
SAMC-ONTARIO DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.

PART III, LINE 9B:
THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS.

PART VI, LINE 7, REPORTS FILED WITH STATES
OR

PART VI, LINE 2:
NEED ASSESSMENT - SAMC-ONTARIO ASSESSES THE HEALTH STATUS OF ITS COMMUNITY BOTH IN PARTNERSHIP WITH COMMUNITY COALITIONS AND AS PART OF THE NORMAL COURSE OF OPERATIONS, AND MAKES CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.SAMC-ONTARIO ALSO UTILIZES THE EXPERTISE OF PUBLIC HEALTH PARTNERS AND THEIR ANALYSIS OF COMMUNITY NEEDS. SAMC-ONTARIO EXAMINED SEVERAL OTHER LOCAL NEEDS ASSESSMENTS AND OBTAINED INPUT FROM ORGANIZATIONS INVOLVED IN THOSE ASSESSMENTS, INCLUDING OUR EXTERNAL REVIEW COMMITTEE (FOUR RIVERS HEALTHY COMMUNITIES OREGON), THE MALHEUR COUNTY HEALTH DEPARTMENT AND THE EASTERN OREGON COORDINATED CARE ORGANIZATION TO IDENTIFY NEEDS BEING ADDRESSED BY OTHER AGENCIES.

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SAMC-ONTARIO COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. SAMC-ONTARIO OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. SAMC-ONTARIO HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. SAMC-ONTARIO MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER.

PART VI, LINE 4:
"COMMUNITY INFORMATION - SAMC-ONTARIO IS SITUATED IN MALHEUR COUNTY, WHICH IS THE SECOND LARGEST COUNTY IN OREGON. LOCATED IN THE SOUTHEASTERN-MOST CORNER OF THE STATE, IT COVERS 9,926 SQUARE MILES. BY DEFINITION, MALHEUR COUNTY IS CONSIDERED ""FRONTIER"" WITH A MERE 3.2 PERSONS PER SQUARE MILE - ALTHOUGH THE POPULATION IS FAIRLY CLUSTERED TOGETHER IN SMALL COMMUNITIES. GEOGRAPHIC ISOLATION RESULTS IN CHALLENGES IN ACCESSING OREGON SERVICES. WHILE IDAHO IS IN CLOSE PROXIMITY, RESIDENTS OF MALHEUR COUNTY ARE OFTEN UNABLE TO UTILIZE GOVERNMENT SERVICES ACROSS STATE LINES. THE COUNTY HAS AN ESTIMATED TOTAL OF 31,571 RESIDENTS (APRIL 2020, CENSUS.GOV), OVER A THIRD OF WHOM LIVE IN THE CITY OF ONTARIO (11,645 RESIDENTS). THE LOCAL ECONOMY IS LARGELY BASED ON AGRICULTURE AND FARMING, AND THE COUNTY IS 94% RANGELAND.MALHEUR COUNTY IS NOTABLE FOR A HIGHER THAN AVERAGE HISPANIC/LATINO POPULATION (34.6%, 2015-2019, CENSUS.GOV), MANY OF WHOM ARE SEASONAL, OR MIGRANT, AGRICULTURE WORKERS. THIS IS ALSO EVIDENCED BY A HIGHER THAN AVERAGE PERCENTAGE OF LANGUAGES OTHER THAN ENGLISH SPOKEN AT HOME AT 25.3% (2015-2019, CENSUS.GOV). MALHEUR COUNTY IS ALSO NOTABLE FOR A POPULATION DENSITY OF 3.2 PERSONS PER SQUARE MILE, WHERE RESIDENTS MUST TRAVEL LONG DISTANCES FOR SERVICES. MALHEUR COUNTY HAS THE LOWEST MEDIAN HOUSEHOLD INCOME IN THE STATE AT $43,313, COMPARED TO $62,818 AT A STATE LEVEL AND $62,843 AT THE U.S. LEVEL. THE POVERTY LEVEL, AT 21.0%, IS THE HIGHEST OF THE THREE COUNTIES IN THE HOSPITAL'S SERVICE AREA, AND IS SIGNIFICANTLY ABOVE STATE (11.4%) AND U.S. (11.4%) LEVELS.ATTAINING SAFE, AFFORDABLE HOUSING AND THE ABILITY TO EARN A LIVABLE WAGE WERE THE HIGHEST RATED BARRIERS TO FINANCIAL STABILITY IDENTIFIED IN THE 2020 CHNA. LOW WAGES ALSO CONTRIBUTE TO THE OTHER MOST FREQUENTLY IDENTIFIED BARRIERS AS WELL, WITH INABILITY TO FIND OR MOVE UP INTO HIGHER PAYING JOBS IDENTIFIED AS A CONCERN. HIGH HOUSING COST BURDENS FURTHER EXACERBATE THE DIFFICULTIES OF THOSE WITH LOW INCOME LEVELS."

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OTHER INFORMATION - SAMC-ONTARIO STRONGLY SUPPORTS HEALTH CARE WORKFORCE DEVELOPMENT EFFORTS, INCLUDING ANNUAL FINANCIAL SUPPORT TO THE TREASURE VALLEY COMMUNITY COLLEGE NURSING PROGRAM. IN ADDITION, SAMC-ONTARIO SERVES AS A KEY CLINICAL TRAINING SITE FOR NURSES AND OTHER ALLIED HEALTH PROFESSIONALS.SAMC-ONTARIO OFFERS A VARIETY OF HEALTH EDUCATION AND SCREENING OPPORTUNITIES FREE OF CHARGE, INCLUDING CARDIAC & STROKE SCREENINGS, FREE LIPID PROFILES, MAMMOGRAMS AND MORE. THESE SCREENINGS ARE AN OPPORTUNITY TO CONNECT PARTICIPANTS WITH A PRIMARY CARE PROVIDER FOR FURTHER HEALTH GUIDANCE. IN ADDITION, SAMC-ONTARIO ASSESSED AND ENGAGED IN COMMUNITY HEALTH WORK THAT ADDRESSED THE SOCIAL INFLUENCERS OF HEALTH.SAINT ALPHONSUS HEALTH SYSTEM'S EMERGENCY PREPAREDNESS EFFORTS ALLOWED FOR A RAPID RESPONSE TO THE ONGOING WAVES OF THE COVID-19 PANDEMIC. IN FY22, THOSE EFFORTS INCLUDED CONTINUED LEADERSHIP ENGAGEMENT WITH LOCAL HEALTH DEPARTMENTS AND OTHER COMMUNITY PARTNERS TO ADDRESS SUPPLY SHORTAGES, PREVENTION OF COMMUNITY SPREAD, AND FACILITY CAPACITY. SAHS PROVIDED PUBLIC MESSAGING AROUND VACCINE SAFETY AND EFFICACY AS WELL AS HOW TO HELP SLOW THE SPREAD OF COVID-19. SAMC-ONTARIO WORKED ALONGSIDE A COMMUNITY PARTNER, COMMUNITY IN ACTION, TO HELP PREVENT THE SPREAD OF COVID-19 IN THE POPULATION EXPERIENCING HOMELESSNESS THROUGH DEVELOPMENT OF LOCAL QUARANTINE AND ISOLATION PROCESSES IN MALHEUR COUNTY. SAHS PROVIDED MOBILE COVID-19 VACCINE CLINICS IN THE ONTARIO AREA TO REACH THOSE WHO WOULD OTHERWISE HAVE HAD DIFFICULTY ACCESSING THE VACCINE.

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SAMC-ONTARIO IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE BY CONNECTING SOCIAL AND CLINICAL CARE, ADDRESSING SOCIAL NEEDS, DISMANTLING SYSTEMIC RACISM, AND REDUCING HEALTH INEQUITIES. WE DO THIS BY: 1. INVESTING IN OUR COMMUNITIES, 2. ADVANCING SOCIAL CARE, AND 3. IMPACTING SOCIAL INFLUENCERS OF HEALTH.TO FURTHER OUR STRATEGY IN FISCAL YEAR 2022 (FY22), CHWB LAUNCHED TWO TRAINING SERIES TO ADVANCE HEALTH AND RACIAL EQUITY IN OUR COMMUNITIES.1. CHWB LEADER SERIES TO ADVANCE HEALTH AND RACIAL EQUITY: A YEAR-LONG PEER LEARNING SERIES TO BUILD THE CAPACITY OF OUR CHWB LEADERS TO DELIVER ON OUR CHWB STRATEGY WITH A FOCUS ON COMMUNITY LEADERSHIP AND ENGAGEMENT, AND THE USE OF A RACIAL EQUITY LENS IN ALL OF OUR DECISION MAKING. 2. COMMUNITY ENGAGEMENT TO ADVANCE RACIAL JUSTICE - PREPARING FOR IMPLEMENTATION STRATEGY: A FOUR-PART SERIES ON ENGAGING OUR COMMUNITIES IN MEANINGFUL WAYS USING A HEALTH EQUITY AND RACIAL EQUITY LENS TO BUILD LASTING PARTNERSHIPS AND IMPACTFUL IMPLEMENTATION STRATEGIES.INVESTING IN OUR COMMUNITIES - TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FY22, TRINITY HEALTH CONTRIBUTED $1.37 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. SOME EXAMPLES OF THESE INVESTMENTS INCLUDE: TRINITY HEALTH AWARDED OVER $1.6 MILLION IN COMMUNITY GRANTS THAT DIRECTLY ALIGN WITH INTERVENTIONS AND LOCAL PARTNERSHIPS IDENTIFIED IN ITS MEMBER HOSPITALS' COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION STRATEGIES, INCLUDING ACCESS TO HEALTH CARE, MENTAL HEALTH, TRANSPORTATION, COMMUNITY ENGAGEMENT, FOOD ACCESS, AND HOUSING SUPPORTS. WITH A $1.2 MILLION INITIAL INVESTMENT, TRINITY HEALTH LAUNCHED ROUND 2 OF THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), A FIVE-YEAR, INNOVATIVE FUNDING AND TECHNICAL ASSISTANCE INITIATIVE, PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS AND RESIDENTS TO ADVANCE HEALTH AND RACIAL EQUITY IN NINE OF OUR COMMUNITIES EXPERIENCING HIGH POVERTY AND OTHER VULNERABILITIES. HEALTH MINISTRIES RECEIVING TCI FUNDING ARE COLLABORATING WITH A LOCAL MULTI-SECTOR COLLABORATIVE TO DEVELOP AND IMPLEMENT EVIDENCE-BASED STRATEGIES THAT ADVANCE HEALTH AND RACIAL EQUITY THROUGH ADDRESSING AT LEAST ONE ROOT CAUSE OF POOR HEALTH IDENTIFIED IN THE DEVELOPMENT OF THEIR MOST RECENT CHNA IMPLEMENTATION STRATEGY. TRINITY HEALTH AWARDED OVER $1 MILLION IN COVID-19 FUNDING TO SUPPORT NEW AND ONGOING COMMUNITY ENGAGEMENT AND MOBILIZATION EFFORTS AROUND MAKING THE COVID-19 VACCINATION ACCESSIBLE TO ALL ELIGIBLE POPULATIONS. THIS FUNDING WAS DESIGNED TO SUPPORT ALL COMMUNITIES TO ENSURE EASY AND EQUITABLE ACCESS TO THE VACCINE BY REMOVING BARRIERS FOR ALL PEOPLE TO RECEIVE THE VACCINE, ESPECIALLY COMMUNITIES THAT HAVE LESS THAN A 75% VACCINATION RATE. WITH THIS FUNDING, HEALTH MINISTRIES FACILITATED 3,200 COVID-19 VACCINE EVENTS, ADMINISTERED 80,000 COVID-19 VACCINE DOSES, AND REACHED 874,000 PEOPLE WITH EDUCATIONAL MATERIALS ON COVID-19 AND THE BENEFITS OF VACCINATION.IN ADDITION TO THE $1.37 BILLION IN COMMUNITY BENEFIT SPENDING, OUR COMMUNITY INVESTING PROGRAM HAD THE MOST ROBUST YEAR OF LENDING SINCE THE PROGRAM'S INCEPTION OVER 20 YEARS AGO: $17.8 MILLION IN NEW LOANS AND $8.3 MILLION IN LOAN RENEWALS WERE APPROVED, FOCUSING ON BUILDING AFFORDABLE HOUSING AND INCREASING ACCESS TO EDUCATION IN PARTNERSHIP WITH OUR HEALTH MINISTRIES. ADVANCING SOCIAL CARE - TRINITY HEALTH'S SOCIAL CARE PROGRAM WAS DEVELOPED TO ADDRESS SOCIAL NEEDS, SUCH AS ACCESS TO TRANSPORTATION, CHILDCARE, OR AFFORDABLE MEDICATIONS BY FACILITATING CONNECTIONS BETWEEN OUR PATIENTS, HEALTH CARE PROVIDERS AND COMMUNITY PARTNERS THAT PROMOTE HEALTHY BEHAVIORS. HIGHLIGHTS FROM FY22 INCLUDE THE FOLLOWING SUCCESSES:- LAUNCHED TRINITY HEALTH COMMUNITY HEALTH WORKER (CHW) CERTIFICATION PROGRAM, TRAINING 86 CHWS WITH 40+ HOURS OF TRAINING, AND INCREASED CHW STAFF ACROSS MOST HEALTH MINISTRIES- LAUNCHED A SYSTEM-WIDE ASSESSMENT OF LANGUAGE ACCESS SERVICES TO RECOMMEND SYSTEM STANDARDS THAT ENSURE CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES FOR ALL OF OUR PATIENTS, THEIR COMPANIONS, AND CAREGIVERS- ENGAGED OVER 1,100 PARTICIPANTS IN THE NATIONAL DIABETES PREVENTION PROGRAM, EXCEEDING OUR PROGRAM YEAR 5 GOAL- INCREASED THE NUMBER OF ACTIVE COMMUNITY PARTNER ORGANIZATIONS ON THE COMMUNITY RESOURCE DIRECTORY BY 120% FROM FISCAL YEAR 2021- ENGAGED 5,300+ PATIENTS WHO ARE DUALLY ENROLLED IN MEDICARE AND MEDICAID IN A SOCIAL CARE OR MEDICAL CARE ACTIVITY, IN SUPPORT OF REDUCING PREVENTABLE HOSPITALIZATIONS (SUCH AS DIABETES AND ASTHMA)IMPACTING SOCIAL INFLUENCERS OF HEALTH - LEVERAGING INVESTOR POWER TO CATALYZE CORPORATE SOCIAL RESPONSIBILITY, TRINITY HEALTH'S SHAREHOLDER ADVOCACY WORK FOCUSES ON DISMANTLING RACISM ACROSS FIVE STRATEGIC FOCUS AREAS BY HOLDING CORPORATIONS ACCOUNTABLE FOR THE HUMAN RIGHTS VIOLATIONS THOSE COMPANIES PERPETUATE IN THE U.S. AND BEYOND. IN FY22, TRINITY HEALTH FACILITATED OVER 135 SHAREHOLDER ADVOCACY ENGAGEMENTS, WITH GREAT SUCCESS:- FIVE BELOW COMMITTED TO ASSESS AND MANAGE THE RISKS/HAZARDS ASSOCIATED WITH CHEMICALS OF HIGH CONCERN CONTAINED IN THEIR PRIVATE LABEL PRODUCTS- UNILEVER AGREED TO STOP FOOD AND BEVERAGE MARKETING TO CHILDREN UNDER AGE 16, AND WILL ADOPT NEW TARGETS TO REDUCE SALT, ADDED SUGARS AND CALORIES, AND INCREASE SALES OF THEIR HEALTHIER PRODUCTS- PEPSICO SET GOALS TO INCREASE POSITIVE NUTRIENTS IN THEIR PRODUCTS- PDC ENERGY ACCELERATED ITS GOAL TO END ROUTINE FLARING OF METHANE, FROM 2030 TO 2025, THUS REDUCING ENVIRONMENTAL HEALTH RISKS AND GREENHOUSE GAS EMISSIONSADDITIONALLY, TRINITY HEALTH AND OTHER MEMBERS OF THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY GUN SAFETY GROUP SUBMITTED A SHAREHOLDER RESOLUTION ASKING STURM RUGER, ONE OF THE NATION'S LEADING MANUFACTURERS OF FIREARMS, TO CONDUCT AND PUBLISH AN INDEPENDENT HUMAN RIGHTS IMPACT ASSESSMENT OF ITS POLICIES, PRACTICES AND PRODUCTS, AND MAKE RECOMMENDATIONS FOR IMPROVEMENT. THE RESOLUTION RECEIVED A 68.5% VOTE IN FAVOR, WELL ABOVE THE THRESHOLD REQUIRED FOR THE RESOLUTION TO BE RESUBMITTED IN 2023, INDICATING A LARGE MAJORITY OF STURM RUGER INVESTORS BELIEVE THE COMPANY HAS TO ADDRESS ITS HUMAN RIGHTS IMPACTS. TRINITY HEALTH AND TRINITY HEALTH OF NEW ENGLAND ARE CITED AS PART OF THE GROUP WHO MOVED FORWARD THIS RESOLUTION.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.