4A (Expenses $ 463389668 including grants of $ 13923) (Revenue $ 555302116)
EXPENSES INCURRED IN PROVIDING EMERGENCY AND MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

SCHEDULE H, PART V, SECTION B, QUESTION 5
"FOR THE 2022 REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (""RCHNA""), THE DEPARTMENT OF TREASURY AND THE INTERNAL REVENUE SERVICE (""IRS"") ENCOURAGED CROSS INSTITUTION COLLABORATION. TO THAT END JEFFERSON HEALTH - NORTHEAST (""JHNE"") PARTICIPATED IN A REGIONAL COLLABORATIVE EFFORT FOR THIS CHNA CYCLE. RECOGNIZING THAT HOSPITALS AND HEALTH SYSTEMS OFTEN MUTUALLY SERVE THE SAME COMMUNITIES, A GROUP OF LOCAL HOSPITALS AND HEALTH SYSTEMS HAVE AGAIN COLLABORATED ON A SOUTHEASTERN PENNSYLVANIA (SEPA) REGIONAL CHNA (RCHNA), WITH SPECIFIC FOCUS ON BUCKS, CHESTER, DELAWARE MONTGOMERY, AND PHILADELPHIA COUNTIES. THIS CONTINUED COLLABORATION ENABLES CONTINUITY OF APPROACH, WHILE ALSO PROVIDING OPPORTUNITIES TO EXPAND AND IMPROVE UPON THE LAST ASSESSMENT PROCESS. PARTICIPANTS RECOGNIZE THAT THE CHNA IS AN IMPORTANT PART OF HOW HEALTH SYSTEMS, MULTI-SECTOR PARTNERS, AND COMMUNITIES WORK TOGETHER TO ACHIEVE MEANINGFUL AND POSITIVE COMMUNITY CHANGE. IN ADDITION TO THE SHARED LEARNING, INCREASED EFFICIENCIES AND REDUCED COMMUNITY BURDEN OFFERED BY THE COLLABORATIVE APPROACH, PARTICIPANTS HAVE DERIVED PARTICULAR BENEFIT FROM MUTUAL SUPPORT IN THE FACE OF THE COVID-19 PANDEMIC AND ITS CASCADING IMPACTS. IN RESPONSE TO THE CRISES OF THE PAST SEVERAL YEARS, THE 2022 RCHNA IS EXPLICITLY GROUNDED IN AN APPROACH THAT SEEKS TO ADVANCE HEALTH EQUITY AND AUTHENTIC COMMUNITY ENGAGEMENT. COMMUNITY/STAKEHOLDER INPUT: COMMUNITY MEETINGS WERE COORDINATED BY HEALTH CARE IMPROVEMENT FOUNDATION (HCIF) AND PHILADELPHIA ASSOCIATION OF COMMUNITY DEVELOPMENT CORPORATIONS (PACDC) AND FACILITATED BY TWO EXPERTS IN QUALITATIVE DATA COLLECTION AND ANALYSIS ENGAGED AS QUALITATIVE LEAD CONSULTANTS. FOR ALL DISCUSSIONS HCIF, GUIDED BY A QUALITATIVE TEAM COMPOSED OF A SUBSET OF STEERING COMMITTEE REPRESENTATIVES, COORDINATED THE QUALITATIVE COMPONENTS OF THE ASSESSMENT WHICH INCLUDED: 26 VIRTUAL FOCUS GROUP-STYLE ""COMMUNITY CONVERSATIONS"" HELD TO GATHER INPUT FROM RESIDENTS OF GEOGRAPHIC COMMUNITIES ACROSS ALL 5 COUNTIES. 21 VIRTUAL FOCUS GROUP DISCUSSIONS CENTERED ON ""SPOTLIGHT"" TOPICS CONDUCTED WITH COMMUNITY ORGANIZATIONS AND LOCAL GOVERNMENT AGENCY REPRESENTATIVES. TOPICS COVERED INCLUDED BEHAVIORAL HEALTH, CHRONIC DISEASE, FOOD INSECURITY, HOUSING AND HOMELESSNESS, OLDER ADULTS AND CARE, RACISM AND DISCRIMINATION IN HEALTH CARE, SUBSTANCE USE, AND VIOLENCE."

SCHEDULE H, PART V, SECTION B; LINES 6A & 6B
JHNE PARTICIPATED IN PARTNERSHIP WITH THE STEERING COMMITTEE OF REPRESENTATIVES FROM PARTNERING HOSPITALS AND HEALTH SYSTEMS, THE PROJECT TEAM, COMPOSED OF STAFF FROM THE PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH (PDPH), PHILADELPHIA ASSOCIATION OF COMMUNITY DEVELOPMENT CORPORATIONS (PACDC) AND HEALTH CARE IMPROVEMENT FOUNDATION (HCIF). THE PROJECT TEAM DEVELOPED A COLLABORATIVE, COMMUNITY-ENGAGED APPROACH THAT INVOLVED COLLECTING AND ANALYZING QUANTITATIVE AND QUALITATIVE DATA AND AGGREGATING DATA FROM A VARIETY OF SECONDARY SOURCES TO COMPREHENSIVELY ASSESS THE HEALTH STATUS OF THE REGION. THE ASSESSMENT RESULTED IN A LIST OF PRIORITY HEALTH NEEDS THAT WILL BE USED BY THE PARTICIPATING HOSPITALS AND HEALTH SYSTEMS TO DEVELOP IMPLEMENTATION PLANS OUTLINING HOW THEY WILL ADDRESS THESE NEEDS INDIVIDUALLY AND IN COLLABORATION WITH OTHER PARTNERS. AS PART OF INTEGRATION, THE COMMUNITY HEALTH AND COMMUNITY BENEFIT LEADERS OF JHNE WORKED COLLABORATIVELY WITH COLLEAGUES AND REPRESENTATIVES OF OTHER HOSPITALS AND HEALTH SYSTEMS IN THE REGION. COACH, A REGIONAL COLLABORATIVE: (COLLABORATIVE OPPORTUNITIES TO ADVANCE COMMUNITY HEALTH, SOUTHEASTERN PA). PARTICIPATING HOSPITALS INCLUDED: AN INITIATIVE SPONSORED BY THE HOSPITAL AND HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA [HAP] TO BRING TOGETHER HOSPITALS, PUBLIC HEALTH, AND COMMUNITY PARTNERS TO ADDRESS COMMUNITY HEALTH ISSUES IN SOUTHEASTERN, PENNSYLVANIA. PARTNERING HEALTH SYSTEMS AND HOSPITALS: - CHILDREN'S HOSPITAL OF PHILADELPHIA AND MIDDLEMAN FAMILY PAVILION AT CHOP, KING OF PRUSSIA, PA - DOYLESTOWN HEALTH: DOYLESTOWN HOSPITAL - GRAND VIEW HEALTH: GRAND VIEW HOSPITAL - JEFFERSON HEALTH: EINSTEIN MEDICAL CENTER ELKINS PARK; EINSTEIN MEDICAL CENTER MONTGOMERY; EINSTEIN MEDICAL CENTER PHILADELPHIA; JEFFERSON ABINGTON HOSPITAL; - JEFFERSON BUCKS HOSPITAL; JEFFERSON FRANKFORD HOSPITAL, JEFFERSON HOSPITAL FOR NEUROSCIENCE; JEFFERSON LANSDALE HOSPITAL; JEFFERSON METHODIST HOSPITAL; JEFFERSON TORRESDALE HOSPITAL; MAGEE REHABILITATION HOSPITAL; MOSS REHAB; ROTHMAN ORTHOPEDIC SPECIALTY HOSPITAL AND THOMAS JEFFERSON UNIVERSITY HOSPITAL - MAIN LINE HEALTH: BRYN MAWR HOSPITAL; BRYN MAWR REHABILITATION HOSPITAL; LANKENAU MEDICAL CENTER; PAOLI HOSPITAL; RIDDLE HOSPITAL - PENN MEDICINE: CHESTER COUNTY HOSPITAL; HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA; HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA - CEDAR AVENUE; PENN PRESBYTERIAN MEDICAL CENTER AND PENNSYLVANIA HOSPITAL - REDEEMER HEALTH: HOLY REDEEMER HOSPITAL - TEMPLE UNIVERSITY HEALTH SYSTEM: FOX CHASE CANCER CENTER; TEMPLE UNIVERSITY HOSPITAL; TEMPLE UNIVERSITY HOSPITAL - EPISCOPAL CAMPUS; TEMPLE UNIVERSITY HOSPITAL - JEANES CAMPUS AND TEMPLE UNIVERSITY HOSPITAL - NORTHEASTERN CAMPUS - TRINITY HEALTH MID-ATLANTIC: MERCY CATHOLIC MEDICAL CENTER; MERCY FITZGERALD HOSPITAL CAMPUS; NAZARETH HOSPITAL; ST. MARY MEDICAL CENTER AND ST. MARY REHABILITATION HOSPITAL JHNE COLLABORATED WITH THE ABOVE LISTED HOSPITALS AND HEALTH SYSTEMS, WORKING WITH JEFFERSON HEALTH COLLEAGUES TO COMPLETE THE JUNE 30, 2022 REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT [RCHNA]. JHNE COLLABORATED WITH AND RECEIVED SUPPORT DURING THE CHNA PROCESS FROM: - CHESTER COUNTY HEALTH DEPARTMENT; - DELAWARE COUNTY HEALTH DEPARTMENT; - HEALTH CARE IMPROVEMENT FOUNDATION; - MONTGOMERY COUNTY OFFICE OF PUBLIC HEALTH; - PHILADELPHIA ASSOCIATION OF COMMUNITY DEVELOPMENT CORPORATIONS; AND - PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH.

SCHEDULE H, PART V, SECTION B, QUESTION 7A
THE ORGANIZATION IS AN AFFILIATE WITHIN THOMAS JEFFERSON UNIVERSITY/JEFFERSON HEALTH; A COMPREHENSIVE PROFESSIONAL UNIVERSITY AND TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, WITH A TRIPARTITE MISSION OF EDUCATION, RESEARCH AND PATIENT CARE. DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE 2022 RCHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: HTTPS://WWW.JEFFERSONHEALTH.ORG/ABOUT-US/COMMUNITY/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, QUESTION 10A
THE ORGANIZATION IS AN AFFILIATE WITHIN THOMAS JEFFERSON UNIVERSITY/JEFFERSON HEALTH; A COMPREHENSIVE PROFESSIONAL UNIVERSITY AND TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, WITH A TRIPARTITE MISSION OF EDUCATION, RESEARCH AND PATIENT CARE. DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 10, IS THE HOME PAGE FOR THE SYSTEM. THE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: HTTPS://WWW.JEFFERSONHEALTH.ORG/ABOUT-US/COMMUNITY/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, QUESTION 11
"THE MOST RECENT, REQUIRED CHNA WAS COMPLETED IN JUNE 2022. TO ADDRESS THE NEEDS IDENTIFIED IN THE 2022 RCHNA PROCESS, THE HEALTH SYSTEM CONVENED ACTION TEAMS CONSISTING OF KEY COMMUNITY STAKEHOLDERS AND JHNE ADMINISTRATIVE AND CLINICAL LEADERS TO DEVELOP AND IMPLEMENT GOALS AND ACTION PLANS OR IMPLEMENTATION PLANS. THE IMPLEMENTATION PLANS ARE POSTED TO THE HEALTH SYSTEM'S WEBSITE AND INCLUDE: MENTAL HEALTH CONDITIONS, SUBSTANCE USE AND RELATED DISORDERS, CHRONIC DISEASE PREVENTION AND MANAGEMENT, ACCESS TO AFFORDABLE PRIMARY AND SPECIALTY CARE, HEALTHCARE AND HEALTH RESOURCE NAVIGATION, AND FOOD ACCESS. THE FOLLOWING TWO PRIORITIES ARE ADDRESSED WITHIN NORMAL HOSPITAL OPERATIONS: LINGUISTICALLY AND CULTURALLY APPROPRIATE SERVICES AND RACISM AND DISCRIMINATION IN HEALTHCARE SETTINGS. THE HEALTH SYSTEM WILL NOT DIRECTLY FOCUS ON THE FOUR PRIORITIES WHICH ARE ADDRESSED THROUGH WORK WITH LOCAL AND REGIONAL COLLABORATIVES AND REFERRALS TO COMMUNITY OR GOVERNMENT RESOURCES: COMMUNITY VIOLENCE, HOUSING, SOCIOECONOMIC DISADVANTAGE [E.G., POVERTY, UNEMPLOYMENT] AND NEIGHBORHOOD CONDITIONS [E.G., BLIGHT, GREENSPACE, AIR/WATER QUALITY, ETC.]. THOSE PRIORITIES ARE BEYOND THE SCOPE OF JHNE AND ARE BEING ADDRESSED BY OTHER COMMUNITY BASED AND GOVERNMENT ORGANIZATIONS. JHNE WILL COLLABORATE WITH GROUPS OF EXPERTS IN THESE AREAS TO FOSTER APPROPRIATE AND SAFE REFERRALS AND IDENTIFY OPPORTUNITIES FOR PARTNERSHIP AND INCLUSION IN COMMUNITY BENEFIT INITIATIVES. HOSPITALS ARE NOT REQUIRED TO, NOR CAN THEY MEET ALL UNMET NEEDS IN THE COMMUNITY. ANY UNMET NEEDS NOT ADDRESSED BY THE APPROVED IMPLEMENTATION PLANS ARE ALREADY BEING ADDRESSED IN THE SERVICE AREA BY THE HOSPITAL, OTHER HEALTHCARE PROVIDERS, GOVERNMENT, AND LOCAL NON-PROFIT ORGANIZATIONS. IN FY20, THE AUNT BERTHA PLATFORM, A NETWORK OF SOCIAL SERVICE INFORMATION, WAS ADOPTED BY JEFFERSON HEALTH AND POSTED TO OUR WEBSITE. THIS PLATFORM IN 2022 IS NOW KNOWN AS ""FIND HELPWAS NAMED JEFFERSON COMMUNITY RESOURCES AND PLACED ON THE HEALTH SYSTEM WEBSITE; COMMUNICATED TO WORKFORCE AND KEY COMMUNITY STAKEHOLDERS AND INCORPORATED IN EPIC (NEW ELECTRONIC MEDICAL RECORD) MODULE FOR FY22. OUR PRIORITY UNMET NEEDS IN THE IMPLEMENTATION PLANS ARE INTEGRAL TO OUR COMMUNITY BENEFIT STRATEGY. JHNE LEADERS CONTINUE TO MONITOR NEW PROGRAM DEVELOPMENT AND SERVICES WITH COLLABORATIVE PARTNERS, INCLUDING COACH AND LOCAL AND REGIONAL COLLABORATIVES SUCH AS INDIAN VALLEY CHARACTER COUNTS COALITION, BUCKS-MONT COLLABORATIVE, MONTGOMERY COUNTY HEALTH ALLIANCE AND THE REGIONAL OVERDOSE PREVENTION COLLABORATIVE. IN ADDITION, COMMUNITY HEALTH PROFESSIONALS COLLABORATE WITH JEFFERSON COLLEAGUES TO IMPROVE HEALTH STATUS IN CONJUNCTION WITH THE HOSPITAL'S PARTNERSHIPS. BEST AND PROMISING PRACTICES ARE SHARED WITH THE AIM OF ENHANCING INFRASTRUCTURE, STRETCHING RESOURCES, AND INCORPORATING KNOWLEDGE ABOUT SOCIAL DETERMINANTS OF HEALTH AND HEALTH LITERACY TO BETTER THE POPULATION'S HEALTH AND WELL-BEING. COMMUNITY HEALTH LEADERS WILL CONTINUE TO MONITOR THE CHANGING LANDSCAPE. PLEASE REFER TO THE ORGANIZATION'S IMPLEMENTATION STRATEGY FOR ADDITIONAL INFORMATION."

SCHEDULE H, PART V, SECTION B; QUESTION 16
THE ORGANIZATION IS AN AFFILIATE WITHIN THOMAS JEFFERSON UNIVERSITY/JEFFERSON HEALTH; A COMPREHENSIVE PROFESSIONAL UNIVERSITY AND TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, WITH A TRIPARTITE MISSION OF EDUCATION, RESEARCH AND PATIENT CARE. DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE SYSTEM'S WEBSITE: https://www.jeffersonhealth.org/pay-my-bill/financial-assistance

SCHEDULE H, PART I, LINE 3C
"JHNE IS COMMITTED TO PROVIDING MEDICAL CARE IN A CARING AND COMPASSIONATE MANNER REGARDLESS OF THE PATIENT'S FINANCIAL CIRCUMSTANCES, IN COMPLIANCE WITH THE DEPARTMENT OF TREASURY INTERNAL REVENUE SERVICE SECTION 501(R). THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (""FAP"") EXISTS TO OFFER FINANCIAL ASSISTANCE FOR MEDICALLY NECESSARY CARE TO BOTH UNINSURED AND UNDER-INSURED INDIVIDUALS BASED UPON THEIR ABILITY TO PAY. THE GRANTING OF FINANCIAL ASSISTANCE WILL NOT TAKE INTO ACCOUNT AGE, GENDER, RACE, SOCIAL STATUS, SEXUAL ORIENTATION OR RELIGIOUS AFFILIATION. PATIENTS SEEKING EMERGENCY CARE SHALL BE TREATED WITHOUT REGARD TO ABILITY TO PAY FOR SUCH CARE. AS REFLECTED IN SCHEDULE H, PART V, SECTION B, QUESTION 13, IN ADDITION TO FEDERAL POVERTY GUIDELINES (""FPG"") JHNE USES THE FOLLOWING CRITERIA WHEN DETERMINING A PATIENT'S ELIGIBILITY FOR FREE OR DISCOUNTED FINANCIAL ASSISTANCE: - ASSET LEVEL; - MEDICAL INDIGENCY; - INSURANCE STATUS; - UNDERINSURANCE STATUS; AND - RESIDENCY. IN ACCORDANCE WITH THE ORGANIZATION'S FAP, A PATIENT MAY QUALIFY FOR DISCOUNTS ON MEDICAL CARE IF THERE IS NO HEALTH INSURANCE AVAILABLE, OR HAS HEALTH INSURANCE, BUT THAT INSURANCE DOES NOT FULLY COVER THE MEDICAL CARE NEEDED, SUCH AS EXHAUSTED BENEFITS, AND ALL OF THE FOLLOWING APPLY: - THE PATIENT IS NOT ELIGIBLE FOR STATE MEDICAL ASSISTANCE OR OTHER AVAILABLE ASSISTANCE PROGRAMS; - THE PATIENT MEETS THE CRITERIA FOR FINANCIAL ASSISTANCE DESCRIBED IN THIS POLICY; AND - THE PATIENT PROVIDES THE NECESSARY DOCUMENTS AND COMPLETES NECESSARY PAPERWORK. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON FINANCIAL NEED. PATIENTS WITH FAMILY GROSS INCOME LESS THAN OR EQUAL TO 200% OF FEDERAL POVERTY LEVEL (""FPL"") ARE ELIGIBLE FOR 100% COMPASSIONATE CARE (FREE CARE). PATIENTS WITH FAMILY GROSS INCOME GREATER THAN 200% BUT LESS THAN OR EQUAL TO 500% OF FEDERAL POVERTY LEVEL (""FPL"") ARE ELIGIBLE FOR PARTIAL COMPASSIONATE CARE (DISCOUNTED CARE). ELIGIBILITY FOR FINANCIAL ASSISTANCE IS ALSO DETERMINED BY THE PATIENT'S OR GUARANTOR'S ABILITY TO PAY AFTER ALL INSURANCE HAS BEEN UTILIZED OR LIQUID RESOURCES EXHAUSTED (EXCLUDING RETIREMENT FUNDS). JHNE WILL NOT CONSIDER THE PATIENT'S HOUSE, CAR, RETIREMENT ACCOUNTS, AND OTHER ""NON-LIQUID"" ASSETS. HOWEVER, IT IS RECOGNIZED THAT THERE IS A SMALL PERCENT OF THE UNINSURED PATIENT POPULATION THAT HAS SUBSTANTIAL ASSETS AND COULD EASILY AFFORD TO PAY FOR HEALTHCARE SERVICES, BUT WHOM, BECAUSE OF HAVING TAX-EXEMPT INCOME, WILL NOT HAVE INCOME REFLECTED ON A TAX RETURN. SUCH INDIVIDUALS MAY NOT QUALIFY FOR FINANCIAL ASSISTANCE. FOR UNINSURED PATIENTS, THERE IS AN AUTOMATIC INITIAL DISCOUNT WHICH SHALL EQUATE TO AN AMOUNT NO GREATER THAN 115% OF THE MEDICARE FEE SCHEDULE. A PATIENT UNABLE TO PAY THE UNINSURED RATE IS ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE."

SCHEDULE H, PART I, LINE 6A
NOT APPLICABLE.

SCHEDULE H, PART I, LINE 7
WORKSHEETS 2 AND 3 WERE USED TO CALCULATE THE COST TO CHARGE RATIO FOR FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID. ALL OTHER COSTS WERE EITHER OBTAINED FROM THE HOSPITAL'S COST ACCOUNTING, COST REPORTING OR GENERAL LEDGER SYSTEMS. The organization has included within subsidized health services various services because it meets an identified community need. A service meets an identified community need because it was identified in one of its most recent CHNA's or identified through other means and the organization reasonably feels that if the organization no longer offered the service: (1) the service would be unavailable in the community; (2) the community's capacity to provide the service would be below the community's need; or (3) the service would become the responsibility of government or another tax-exempt organization. Subsidized health services include funding to support certain professional physician services and various other hospital and healthcare system programs in accordance with the above criteria.

SCHEDULE H, PART II
COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY THIS ORGANIZATION IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. JHNE PROMOTES NUMEROUS COMMUNITY BASED & HEALTH PROFESSIONAL PROGRAMS AND SERVICES THROUGHOUT THE YEAR, INCLUDING COMMUNITY HEALTH FAIRS AND SCREENINGS AND COMMUNITY SERVICE ACTIVITIES, HIGH SCHOOL SPORTS PHYSICALS, HEALTH PROFESSIONAL EDUCATION PROGRAMS, INCLUDING BUT NOT LIMITED TO, THE SCHOOL OF NURSING, AND EDUCATION RESPIRATORY PROGRAMS.

SCHEDULE H, PART III, LINES 2, 3 & 4
"BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM ITS INTERNAL FINANCIAL STATEMENTS. THE ORGANIZATION IS AN AFFILIATE WITHIN THOMAS JEFFERSON UNIVERSITY/JEFFERSON HEALTH; A COMPREHENSIVE PROFESSIONAL UNIVERSITY AND TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM (""SYSTEM""), WITH A TRIPARTITE MISSION OF EDUCATION, RESEARCH AND PATIENT CARE. PLEASE REFER TO THE NET PATIENT SERVICE REVENUE SECTION WITHIN FOOTNOTE 1 (PAGES 10 & 11) OF THE SYSTEM'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION ON THIS TOPIC AND THE REPORTING OF THE NETWORK'S REVENUE RECOGNITION."

SCHEDULE H, PART III, LINE 8
"MEDICARE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT FILED BY THE ORGANIZATION. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE INTERNAL REVENUE SERVICE (""IRS""). THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (""IRC"") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM ""CHARITABLE"", A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT ""[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE: IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM ""CHARITABLE"" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE ""CHARITY CARE STANDARD."" UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH ""REMOVE[D]"" FROM REVENUE RULING 56-185 ""THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST."" UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE ""COMMUNITY BENEFIT STANDARD,"" HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE ""GENERALLY ACCEPTED LEGAL SENSE"" OF THE TERM ""CHARITABLE,"" AS REQUIRED BY TREAS. REG. 1.501(C)(3) 1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS ""PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY"" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE AMERICAN HOSPITAL ASSOCIATION (""AHA"") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007, WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION (""MEDPAC"") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLES."" THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THERE ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE (""CBO"") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT ""THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE."" - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 10% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS ""SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS"" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS"

SCHEDULE H, PART VI; QUESTION 6
"The organization is an affiliate within Thomas Jefferson University/Jefferson Health; a comprehensive professional university and tax-exempt integrated healthcare delivery system (""system""), with a tripartite mission of education, research and patient care. TJUH System, Abington Health, Jefferson Health - Northeast System, Kennedy Health System, Magee Rehabilitation Hospital and Albert Einstein Healthcare Network are integrated healthcare organizations that provide inpatient, outpatient and emergency care services through acute care, ambulatory care, physician and other primary care services for the residents of southern New Jersey and the greater Philadelphia region. TJU is the sole corporate member of these organizations. Outlined below is a summary of the entities which comprise the system: Thomas Jefferson University --------------------------- Thomas Jefferson University (""TJU"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(1). TJU is the parent company that financially and corporately integrates Thomas Jefferson University among its subsidiary entities. TJU is an innovative health sciences University that conducts research and offers undergraduate and graduate instruction through the Sidney Kimmel Medical College at Thomas Jefferson University (""SKMC"") as well as the Jefferson colleges of nursing, pharmacy, health professions, population health, rehabilitation sciences and life sciences. TJU's educational programs are fully accredited and it educates over 4,000 students annually. TJUH System ----------- TJUH System (""TJUHS"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). TJUHS is the holding company to provide overall planning, management and support services for various other hospitals and other organizations. Thomas Jefferson University Hospitals, Inc. ------------------------------------------- Thomas Jefferson University Hospitals, Inc. includes Thomas Jefferson University Hospital, Jefferson Hospital for Neuroscience and Methodist Hospital (collectively referred to as TJUH). TJUH promotes the health of the communities it serves in southeastern Pennsylvania, southern New Jersey, and Delaware primarily by providing hospital, sub-acute, outpatient, and physician services and by providing facilities in which students, physicians, nurses, and other healthcare professionals are trained in a clinical setting. TJUH is recognized by the Internal Revenue Service as an Internal Revenue Code 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, TJUH provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, national origin, gender, gender identity or expression, sexual orientation, age, status as an individual with a handicap/disability or ability to pay. Moreover, no individuals are denied necessary medical care, treatment or services. TJUH operates consistently with the criteria outlined in IRS revenue ruling 69-545. Emergency Transport Associates, Inc. ------------------------------------ Emergency Transport Associates, Inc. (""ETA"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(2). ETA seeks to provide high quality air and ground medical transportation services to patients who are admitted to or discharged from Jefferson facilities. Jeffex, Inc. ------------ Jeffex, Inc. is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). Jeffex, Inc. is a supporting organization of the system whose activities include operating a pharmacy for patients and employees. Jefferson Physician Services ---------------------------- Jefferson Physician Services (""JPS"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization supports the charitable purposes, programs and services of the system; primarily its tax-exempt acute care hospitals, which provide medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. In addition, by practicing medicine, engaging in medical education and working to improve the welfare of individuals, the organization comprises a component of the clinical service physician practice plans of the system's teaching hospitals and is an integral part of these institutions. Jefferson Medical Care ---------------------- Jefferson Medical Care (""JMC"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization supports the charitable purposes, programs and services of the system; primarily its tax-exempt acute care hospitals, which provide medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. In addition, by practicing medicine, engaging in medical education and working to improve the welfare of individuals, the organization comprises a component of the clinical service physician practice plans of the system's teaching hospitals and is an integral part of these institutions. The Jefferson Club (a/k/a Jefferson Faculty Club) ------------------------------------------------- The Jefferson Club a/k/a Jefferson Faculty Club (""JC"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization is currently inactive. Jefferson University Physicians ------------------------------- Jefferson University Physicians (""JUP"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization supports the charitable purposes, programs and services of the system; primarily its tax-exempt acute care hospitals, which provide medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. In addition, by practicing medicine, engaging in medical education and working to improve the welfare of individuals, the organization comprises a component of the clinical service physician practice plans of the system's teaching hospitals and is an integral part of these institutions. Jefferson University Physicians of New Jersey, P.C. --------------------------------------------------- Jefferson University Physicians of NJ, P.C. (""JUPNJ"") is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization supports the charitable purposes, programs and services of the system; primarily its tax-exempt acute care hospitals, which provide medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. In addition, by practicing medicine, engaging in medical education and working to improve the welfare of individuals, the organization comprises a component of the clinical service physician practice plans of the system's teaching hospitals and is an integral part of these institutions. Methodist Associates in Healthcare, Inc. ---------------------------------------- Methodist Associates in Healthcare, Inc. is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization supports the charitable purposes, programs and services of the system; primarily its tax-exempt acute care hospitals, which provide medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. In addition, by practicing medicine, engaging in medical education and working to improve the welfare of individuals, the organization comprises a component of the clinical service physician practice plans of th"

SCHEDULE H, PART VI; QUESTION 7
NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN PENNSYLVANIA AND NEW JERSEY. NO COMMUNITY BENEFIT REPORT IS REQUIRED TO BE FILED WITH EITHER PENNSYLVANIA OR NEW JERSEY.

SCHEDULE H, PART III, SECTION C; LINE 9B
"JHNE PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. TO FULFILL ITS MISSION OF PROVIDING COMPASSIONATE, HIGH-QUALITY CARE TO ALL PATIENTS IT SERVES, JHNE MUST ALSO ENSURE ITS OWN FINANCIAL VIABILITY. IN ORDER TO SECURE REIMBURSEMENT OF COSTS FOR SERVICES PROVIDED, EVERY EFFORT IS MADE TO ASSIST PATIENTS IN OBTAINING INSURANCE COVERAGE THROUGH MEDICAL ASSISTANCE (MA), CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) OR OTHER FEDERAL, STATE, OR CITY CARE COVERAGE SOURCES. JHNE PROVIDES FINANCIAL ASSISTANCE TO THOSE PATIENTS WHO ARE UNABLE TO PAY BASED UPON THE ELIGIBILITY CRITERIA INCLUDED IN THEIR FINANCIAL ASSISTANCE POLICY. BILLING & COLLECTION EFFORTS ---------------------------- WHILE QUALIFICATION FOR FINANCIAL ASSISTANCE IS IDEALLY DETERMINED PRIOR TO, OR AT THE TIME OF SERVICE, JHNE CONTINUES TO REVIEW SUCH DETERMINATIONS AS OTHER FINANCIAL RESOURCES ARE DISCOVERED DURING THE BILLING AND COLLECTION PROCESS. AFTER AN UNINSURED OR UNDER-INSURED PATIENT'S ACCOUNT IS REDUCED TO THE UNINSURED DISCOUNT OR THE FINANCIAL ASSISTANCE DISCOUNT RATE, WHICHEVER IS APPLICABLE, THE PATIENT IS RESPONSIBLE FOR THE REMAINDER OF ANY OUTSTANDING PATIENT BALANCES. PATIENTS WILL RECEIVE AN INITIAL STATEMENT INDICATING THEIR BALANCE DUE ALONG WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND WHO TO CONTACT. SELF-PAY BALANCES GO THROUGH A PRE-COLLECTION AGENCY PLACEMENT PROCESS THAT MAY ENTAIL THE MAILING OF STATEMENTS OR LETTERS AND/OR PHONE CALLS IN ORDER TO COLLECT PAYMENT ON OPEN BALANCES. ONCE OPEN BALANCE ACCOUNTS COMPLETE THE PRE-COLLECTION DUNNING CYCLE, (120 DAYS OR MORE) WITH NO PAYMENT OR PROOF OF ELIGIBILITY FOR FINANCIAL ASSISTANCE OR OTHER PROGRAMS, THE ACCOUNTS WILL BE TRANSFERRED TO A PROFESSIONAL COLLECTION AGENCY. IF A FINANCIAL ASSISTANCE APPLICATION AND APPROPRIATE SUPPORTING DOCUMENTS HAVE BEEN SUBMITTED AND A DECISION IS PENDING, THE ACCOUNT WILL BE HELD FROM AGENCY PLACEMENT. IN SOME CASES, A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE MAY NOT HAVE BEEN IDENTIFIED PRIOR TO SENDING THE ACCOUNT TO AN EXTERNAL COLLECTION AGENCY. EACH AGENCY WILL BE MADE AWARE OF THE FINANCIAL ASSISTANCE POLICY AND WILL WORK WITH THE PROVIDER TO ASCERTAIN PATIENT ELIGIBILITY. EXTRAORDINARY COLLECTION ACTIONS (""ECAS"") WILL NOT BE UNDERTAKEN DURING THE INITIAL NOTIFICATION PERIOD OF THE 120 DAYS FROM THE FIRST POST-DISCHARGE BILLING STATEMENT AND UNTIL SUCH TIME AS A 30 DAY INITIATION OF ECA NOTICE HAS BEEN SENT TO THE INDIVIDUAL. THE 30 DAY ECA INITIATION NOTICE WILL CONTAIN THE ECA ACTION THAT THE PROVIDER INTENDS TO UNDERTAKE AND THE DATE AT WHICH TIME THIS WOULD OCCUR. A COPY OF THE ORGANIZATION'S PLAIN LANGUAGE SUMMARY WILL ACCOMPANY THE 30 DAY ECA INITIATION NOTICE. IF THE PATIENT SUBMITS A FINANCIAL ASSISTANCE APPLICATION, JHNE WILL SUSPEND ANY ECAS UNTIL THE PATIENT'S FINANCIAL ASSISTANCE ELIGIBILITY IS DETERMINED AND THE PATIENT IS INFORMED OF THEIR ELIGIBILITY. IF A PATIENT ACCOUNT IS REFERRED TO AN OUTSIDE AGENCY, THAT AGENCY MUST FIRST AGREE TO ABIDE BY JHNE'S FINANCIAL ASSISTANCE POLICY IN RELATION TO ITS COLLECTION EFFORTS. NO EXTERNAL COLLECTION AGENCY ARE PERMITTED TO ENGAGE IN ECAS UNLESS AUTHORIZED BY JHNE. AFTER THE ABOVE-DESCRIBED STEPS HAVE BEEN TAKEN, JHNE MAY USE ECAS WITH THE RESPECT TO THE PATIENT ACCOUNT OF AN UNINSURED OR UNDER-INSURED AND MAY FURTHER CONSIDER CREDIT BUREAU REPORTING AND/OR LEGAL ACTION AS APPROPRIATE. THE SYSTEM'S GENERAL COUNSEL IS REQUIRED TO APPROVE ALL LAWSUITS PRIOR TO THE ECA COMMENCING. FINAL AUTHORITY FOR DETERMINING THAT JHNE HAS MADE ADEQUATE ATTEMPTS TO INFORM A PATIENT OF THE FINANCIAL ASSISTANCE POLICY, AND THUS MAY INITIATE THE USE ECAS, RESTS WITH THE ORGANIZATION'S VICE PRESIDENT DIRECTOR OF REVENUE CYCLE OPERATIONS."

SCHEDULE H, PART VI; QUESTION 4
JEFFERSON HEALTH - NORTHEAST, COMPRISED OF JEFFERSON BUCKS HOSPITAL, JEFFERSON FRANKFORD HOSPITAL, AND JEFFERSON TORRESDALE HOSPITAL, IS A DIVISION OF JEFFERSON HEALTH AND SERVES PATIENTS IN NORTHEAST PHILADELPHIA AND LOWER BUCKS COUNTY. HEALTH SYSTEMS WITHIN JEFFERSON HEALTH DEFINE THEIR SERVICE AREAS AS ZIP CODES INCLUDING 75% OF ADMISSIONS, AND/OR ZIP CODES MOST PROXIMATE TO ALL HOSPITALS. JEFFERSON HEALTH - NORTHEAST DEFINES ITS TARGETED SERVICE AREA AS THE FOLLOWING ZIP CODES IN BUCKS AND PHILADELPHIA COUNTIES. BUCKS COUNTY: 18940, 18954, 18966, 18974, 19007, 19020, 19021, 19030, 19047, 19053, 19054, 19055, 19056, 19057, 19067 PHILADELPHIA COUNTY: 19111, 19114, 19115, 19116, 19120, 19124, 19125, 19134, 19135, 19136, 19137, 19140, 19149, 19152, 19154 THE SERVICE AREA POPULATION TOTALS 886,424 INDIVIDUALS. THE DEMOGRAPHICS INCLUDE THE AGE DISTRIBUTION OF 25.2% FOR 0-19 YEARS OF AGE; 33.7% OF 20-44 YEARS OF AGE, 26.3% FOR 45-64 YEARS OF AGE AND 14.8% FOR 65+. THE MEDIAN HOUSEHOLD INCOME IS $64,046. 48.6% OF THE POPULATION IS MALE AND 51.4% IS FEMALE. 11.3% OF THE POPULATION SPEAKS ENGLISH LESS THAN VERY WELL. THE RACIAL COMPOSITION INCLUDES 60.9% WHITE, 7.1% ASIAN, 13.3% BLACK, 16.2% HISPANIC/LATINO AND 2.4% OTHER.

SCHEDULE H, PART VI; QUESTION 2
"AS A NON-PROFIT INTERNAL REVENUE CODE 501(C)(3) ORGANIZATION, JEFFERSON HEALTH - NORTHEAST HAS A STRONG MISSION OF COMMUNITY SERVICE AND OUTREACH. THE COLLABORATIVE PROCESS THIS ORGANIZATION BEGAN IN THE SUMMER 2021. RECOGNIZING THAT HOSPITALS AND HEALTH SYSTEMS OFTEN MUTUALLY SERVE THE SAME COMMUNITIES, A GROUP OF LOCAL HOSPITALS AND HEALTH SYSTEMS HAVE AGAIN COLLABORATED ON A SOUTHEASTERN PA (SEPA) REGIONAL CHNA (RCHNA), WITH SPECIFIC FOCUS ON BUCKS, CHESTER, DELAWARE, MONTGOMERY AND PHILADELPHIA COUNTIES. THIS COLLABORATIVE RCHNA OFFERED: INCREASED COLLABORATION AMONG LOCAL HOSPITALS/HEALTH SYSTEMS SERVING THIS REGION; REDUCED DUPLICATION OF ACTIVITIES AND COMMUNITY BURDEN FROM PARTICIPATION IN MULTIPLE COMMUNITY MEETINGS; REDUCED HOSPITAL/HEALTH SYSTEM COSTS IN RCHNA REPORT DEVELOPMENT; OPPORTUNITIES FOR SHARED LEARNING; ESTABLISHMENT OF A STRONG FOUNDATION FOR COORDINATED EFFORTS TO ADDRESS HIGHEST PRIORITY COMMUNITY NEEDS. THE COLLABORATIVE APPROACH: HOSPITALS AND HEALTH SYSTEMS AND SUPPORTING PARTNERS COLLABORATIVELY DEVELOPED THE RCHNA THAT OUTLINES HEALTH PRIORITIES FOR THE REGION. THE HOSPITALS AND HEALTH SYSTEMS PRODUCED IMPLEMENTATION PLANS THAT MAY INVOLVE FURTHER COLLABORATION TO ADDRESS SHARED PRIORITIES. FROM JULY 2021 TO JUNE 2022, THE PHILADELPHIA DEPARTMENT OF PUBLIC HEALTH (PDPH) LED COLLECTION OF A VARIETY OF QUANTITATIVE INDICATORS OF HEALTH OUTCOMES AND FACTORS INFLUENCING HEALTH FROM A VARIETY OF DATA SOURCES. DATA COLLECTION INCLUDED PDPH SYNTHESIZED FINDINGS OF HIGH PRIORITY AREAS; PRIORITIES WERE RANKED USING A MODIFIED HANLON METHOD. AT THE SAME TIME, COMMUNITY STAKEHOLDER INPUT PROCESS EVOLVED: COMMUNITY MEETINGS WERE COORDINATED BY HEALTH CARE IMPROVEMENT FOUNDATION (HCIF) AND PHILADELPHIA ASSOCIATION OF COMMUNITY DEVELOPMENT CORPORATIONS (PACDC) AND FACILITATED BY TWO IN QUALITATIVE DATA ANALYSIS AND COLLECTION. STAKEHOLDER FOCUS GROUPS WERE CONDUCTED BY HCIF. IN PARTNERSHIP WITH THE STEERING COMMITTEE OF REPRESENTATIVES FROM PARTNERING HOSPITALS AND HEALTH SYSTEMS, THE PROJECT TEAM, COMPOSED OF STAFF FROM THE PDPH AND HCIF AND PHILADELPHIA ASSOCIATION OF COMMUNITY DEVELOPMENT CORPORATIONS (PACDC) DEVELOPED A COLLABORATIVE, COMMUNITY-ENGAGED APPROACH THAT INVOLVED COLLECTING AND ANALYZING QUANTITATIVE AND QUALITATIVE DATA AND AGGREGATING DATA FROM A VARIETY OF SECONDARY SOURCES TO COMPREHENSIVELY ASSESS THE HEALTH STATUS OF THE REGION. THE ASSESSMENT RESULTED IN A LIST OF PRIORITY HEALTH NEEDS THAT WILL BE USED BY THE PARTICIPATING HOSPITALS AND HEALTH SYSTEMS TO DEVELOP IMPLEMENTATION PLANS OUTLINING HOW THEY WILL ADDRESS THESE NEEDS INDIVIDUALLY AND IN COLLABORATION WITH OTHER PARTNERS. QUANTITATIVE DATA WERE ACQUIRED FROM LOCAL, STATE AND FEDERAL SOURCES AND FOCUSED ON INDICATORS THAT WERE UNIFORMLY AVAILABLE AT THE ZIP CODE LEVEL ACROSS THE REGION. THE PDPH TEAM, WHICH INCLUDED EXPERTS IN EPIDEMIOLOGICAL AND GEOSPATIAL ANALYSES, COMPILED, ANALYZED, AND AGGREGATED OVER 60 HEALTH INDICATORS ENCOMPASSING DATA ON COMMUNITY DEMOGRAPHIC CHARACTERISTICS, COVID-19, CHRONIC DISEASE AND HEALTH BEHAVIORS, INFANT AND CHILD HEALTH, BEHAVIORAL HEALTH, INJURIES, ACCESS TO CARE AND SOCIAL AND ECONOMIC CONDITIONS. HCIF, GUIDED BY A QUALITATIVE TEAM COMPOSED OF A SUBSET OF STEERING COMMITTEE REPRESENTATIVES OF THE HEALTH SYSTEMS, COORDINATED THE QUALITATIVE COMPONENTS OF THE ASSESSMENT, WHICH INCLUDED: 26 VIRTUAL FOCUS GROUP-STYLE ""COMMUNITY CONVERSATIONS"" HELD TO GATHER INPUT FROM RESIDENTS OF GEOGRAPHIC COMMUNITIES ACROSS ALL FIVE COUNTIES; 21 VIRTUAL FOCUS GROUP DISCUSSIONS CENTERED ON ""SPOTLIGHT"" TOPICS CONDUCTED WITH COMMUNITY ORGANIZATIONS AND LOCAL GOVERNMENT AGENCY REPRESENTATIVES. TOPICS COVERED INCLUDED BEHAVIORAL HEALTH, CHRONIC DISEASE, FOOD INSECURITY, HOUSING AND HOMELESSNESS, OLDER ADULTS AND CARE, RACISM AND DISCRIMINATION IN HEALTH CARE, SUBSTANCE USE, AND VIOLENCE. TWO EXPERTS IN QUALITATIVE DATA COLLECTION AND ANALYSIS ENGAGED AS QUALITATIVE LEAD CONSULTANTS FACILITATED ALL OF THESE DISCUSSIONS, ANALYZED THE QUALITATIVE DATA, AND SUMMARIZED KEY FINDINGS. IN ADDITION, THE PROJECT TEAM EITHER UNDERTOOK DIRECTLY OR SUPPORTED PARTNERS WITH TARGETED PRIMARY DATA COLLECTION TO BETTER UNDERSTAND THE NEEDS OF PARTICULAR COMMUNITIES OR POPULATIONS. THESE FOCUS AREAS AND COMMUNITIES WERE EITHER SPECIFIC TO DIFFERENT TYPE OF FACILITIES WITHIN PARTICIPATING HEALTH SYSTEMS (I.E., CANCER CENTERS, REHABILITATION FACILITIES OR REFLECTED GAPS IN THE 2019 RCHNA: CANCER; DISABILITY; IMMIGRANT, REFUGEE, AND HERITAGE COMMUNITIES; AND YOUTH VOICE. FINALLY, SECONDARY DATA IN THE FORM OF REPORTS AND SUMMARIES FROM OTHER COMMUNITY ENGAGEMENT EFFORTS WERE ALSO INCORPORATED INTO THE REPORT. ALL DATA WERE SYNTHESIZED BY HCIF STAFF AND A LIST OF 12 COMMUNITY HEALTH PRIORITIES WAS PRESENTED TO THE STEERING COMMITTEE. USING A MODIFIED HANLON RANKING METHOD, EACH PARTICIPATING HOSPITAL AND HEALTH SYSTEM RATED THE PRIORITIES. AN AVERAGE RATING WAS CALCULATED, AND THE COMMUNITY HEALTH PRIORITIES WERE ORGANIZED IN PRIORITY ORDER BASED ON: SIZE OF HEALTH PROBLEM, IMPORTANCE TO THE COMMUNITY, CAPACITY OF HOSPITALS/HEALTH SYSTEMS TO ADDRESS, ALIGNMENT WITH MISSION AND STRATEGIC DIRECTION AND AVAILABILITY OF EXISTING COLLABORATIVE EFFORTS. POTENTIAL SOLUTIONS FOR EACH OF THE COMMUNITY HEALTH PRIORITIES, BASED ON FINDINGS FROM THE QUALITATIVE DATA COLLECTION WERE ALSO INCLUDED. IN ADDITION, THIS ORGANIZATION WORKS WITH LOCAL PROVIDERS TO PLAN AND DISCUSS HEALTH NEEDS OF THE POPULATION. LEADERS WITHIN THE ORGANIZATION CONTINUE TO ATTEND LOCAL AND REGIONAL COMMUNITY ORGANIZATION MEETINGS AND COUNTY COLLABORATIVES. REGIONAL COUNTY COLLABORATIVES INCLUDE THE HEALTHCARE SYSTEM WITH REPRESENTATION FROM LOCAL POLITICIANS, LOCAL COMMUNITY HEALTH CENTERS, EMERGENCY HEALTH PROVIDERS AND OTHER COMMUNITY HEALTH LEADERS. IN ADDITION, DURING THE CHNA PROCESS, JEFFERSON HEALTH - NORTHEAST CONTINUED TO PARTICIPATE IN COACH WHICH FOCUSED ON FOOD INSECURITY, FUTURE RCHNA, AND TRAUMA INFORMED CARE AND MENTAL HEALTH."

SCHEDULE H, PART VI; QUESTION 3
JHNE IS COMMITTED TO PROVIDING MEDICAL CARE IN A CARING AND COMPASSIONATE MANNER REGARDLESS OF THE PATIENT'S FINANCIAL CIRCUMSTANCES. ADDITIONALLY, THE ORGANIZATION WIDELY PUBLICIZES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ORDER TO ENCOURAGE ITS PATIENTS TO APPLY, IF THEY ARE ELIGIBLE. THE FOLLOWING MEASURES ARE USED TO PUBLICIZE THIS POLICY TO THE COMMUNITY AND PATIENTS. COMMUNICATION IS WRITTEN IN CONSUMER-FRIENDLY TERMINOLOGY AND IN LANGUAGES THAT PATIENTS CAN UNDERSTAND. JHNE PROVIDES TRAINING TO APPROPRIATE ADMINISTRATIVE AND CLINICAL STAFF THAT INTERACTS WITH PATIENTS ABOUT FINANCIAL ASSISTANCE AVAILABILITY, HOW TO COMMUNICATE THAT AVAILABILITY TO PATIENTS, AND HOW TO DIRECT PATIENTS TO APPROPRIATE FINANCIAL ASSISTANCE STAFF. COMMUNITY NOTIFICATION ---------------------- THIS ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION FORMS AND A PLAIN LANGUAGE SUMMARY ARE MADE AVAILABLE TO THE COMMUNITY IN ENGLISH AS WELL AS ANY PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 5% OR 1,000 INDIVIDUALS, WHICHEVER IS LESS, OF THE PRIMARY COMMUNITIES SERVED. THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORMS, AND PLAIN LANGUAGE SUMMARY ARE ALSO MADE AVAILABLE, FREE OF CHARGE AS FOLLOWS: 1) ON THE JHNE WEBSITE AT https://www.jeffersonhealth.org/pay-my-bill/financial-assistance 2) BY MAIL WHEN A PATIENT CALLS OR CONTACTS ANY JHNE HOSPITAL FACILITY AT THE FOLLOWING TELEPHONE NUMBERS: JEFFERSON BUCKS HOSPITAL (215) 949 5117; JEFFERSON FRANKFORD HOSPITAL (215) 831-2036; AND JEFFERSON TORRESDALE HOSPITAL (215) 612-3393. 3) IN PERSON, WITHOUT APPOINTMENT, AT THE FOLLOWING HOSPITAL LOCATIONS: JEFFERSON BUCKS HOSPITAL 380 NORTH OXFORD VALLEY ROAD LANGHORNE, PA 19047 JEFFERSON FRANKFORD HOSPITAL 4900 FRANKFORD AVENUE PHILADELPHIA, PA 19124 JEFFERSON TORRESDALE HOSPITAL 10800 KNIGHTS ROAD PHILADELPHIA, PA 19114 4) AS PART OF THE INTAKE OR DISCHARGE PROCESS, PAPER COPIES OF THE PLAIN LANGUAGE SUMMARY ARE OFFERED TO INDIVIDUALS WHO ARE PROVIDED CARE BY THE FACILITY. PERSONAL NOTIFICATION --------------------- JHNE USES REASONABLE EFFORTS TO NOTIFY PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY. THE FOLLOWING METHODS TO NOTIFY PATIENTS: 1) AT THE TIME OF SCHEDULING, PRE-REGISTRATION, OR REGISTRATION OF ELECTIVE SERVICES, THE PATIENT WILL BE ASKED FOR INSURANCE COVERAGE. IF THE PATIENT IS AN UNINSURED PATIENT, THE PATIENT WILL BE INFORMED OF THE FINANCIAL ASSISTANCE POLICY AND, IF REQUESTED, WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE POLICY UNLESS THE TREATING PHYSICIAN ADVISES THE FINANCIAL COUNSELOR OR REGISTRATION REPRESENTATIVE THAT SUCH TREATMENT IS MEDICALLY NECESSARY, PATIENTS REQUESTING NON-EMERGENT ADMISSIONS OR OUTPATIENT SERVICES WILL NOT BE SCHEDULED FOR SERVICES UNTIL THE PATIENT HAS COMPLIED WITH MEETING THEIR FINANCIAL OBLIGATIONS. 2) IN THE CASE OF EMERGENCY OR URGENT SERVICES THAT ARE NOT SCHEDULED, A FINANCIAL COUNSELOR OR PATIENT REPRESENTATIVE WILL VISIT AS NECESSARY, WITH PATIENTS, IN PERSON, AT SERVICE SITES. 3) ALL BILLING STATEMENTS INCLUDE A REFERENCE TO THE FINANCIAL ASSISTANCE POLICY AND A CONTACT NUMBER AND EMAIL ADDRESS AS WELL AS REFERENCE TO A WEB SITE FOR ACCESS TO MORE INFORMATION. 4) STAFF WILL DISCUSS THE FINANCIAL ASSISTANCE POLICY, WHEN APPROPRIATE, DURING BILLING AND CUSTOMER SERVICE PHONE CONTACTS WITH PATIENTS. ADDITIONALLY, JHNE PROVIDES FINANCIAL COUNSELING SERVICES TO GO OVER PATIENT BILLS AND ANSWER ANY QUESTIONS A PATIENT MAY HAVE.

SCHEDULE H, PART VI; QUESTION 5
JHNE AIMS TO PROVIDE EXCEPTIONAL PATIENT CARE AND CUSTOMER SERVICE TO MEMBERS OF THE COMMUNITIES SERVED BY THE HOSPITALS AND TO RECOGNIZE A PATIENT'S RIGHT TO CONSIDERATE AND RESPECTFUL CARE, REGARDLESS OF ABILITY TO PAY. JHNE IS THE LARGEST HEALTHCARE PROVIDER IN NORTHEAST PHILADELPHIA AND LOWER BUCKS COUNTY. EACH OF THE ORGANIZATION'S THREE COMMUNITY HOSPITALS DEDICATE RESOURCES TO COMMUNITY BENEFIT ACTIVITIES INCLUDING EDUCATIONAL SEMINARS ON PERTINENT TOPICS AS IDENTIFIED IN THE CHNA, FREE HEALTH SCREENINGS, AND A VARIETY OF SUPPORT GROUPS TO ASSIST PATIENTS AND THEIR FAMILY MEMBERS MANAGE ILLNESS. ALL QUALIFIED PHYSICIANS ARE EXTENDED PRIVILEGES BY THEIR RESPECTIVE DEPARTMENTS WHERE OPENINGS EXIST. UNDER THE DIRECTIVE OF THE ORGANIZATION'S CORPORATE FINANCE OFFICE, SURPLUS FUNDS ARE UTILIZED FOR CAPITAL PROJECTS TO IMPROVE SERVICES OR PURCHASE EQUIPMENT WHICH IN TURN, BENEFIT THE COMMUNITY. PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.