4A (Expenses $ 346431192 including grants of $ 2235502) (Revenue $ 367322577)
SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE HEALTH CARE FOR EVERYONE REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE TODAY. TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES: -PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA.-SWEDISH HEALTH SERVICES IN SEATTLE, WA.2021 WAS A YEAR MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSOVER THE LAST TWO YEARS, PROVIDENCE ADVANCED A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION, AND ENVIRONMENTAL STEWARDSHIP. WE UPDATED OUR INTEGRATED STRATEGIC & FINANCIAL PLAN TO MORE CLEARLY EXPRESS OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. IN 2021, OUR SUSTAINABLE AND INCLUSIVE PURCHASING PROGRAM COMMITTED TO INCREASE OUR SPEND WITH WOMEN AND MINORITY OWNED BUSINESS ENTERPRISES BY OVER $300 MILLION ACROSS THE NEXT FIVE YEARS. WE ALSO DEPLOY AN INVESTING PORTFOLIO WHICH INCLUDES SHAREHOLDER ADVOCACY, IMPACT INVESTING, AND SOCIALLY CONSCIOUS PORTFOLIO SCREENS. IN 2021, PROVIDENCE MADE PROGRESS TOWARDS ITS CLIMATE COMMITMENT TO BECOME CARBON NEGATIVE BY 2030. WE ARE IMPLEMENTING AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL.REALIZING OUR MISSIONST. MARY MEDICAL CENTER IS PART OF NEWLY FORMED PROVIDENCE ST. JOSEPH HEALTH. ST. MARY MEDICAL CENTER IS AN ACUTE-CARE HOSPITAL FOUNDED IN 1956 IN APPLE VALLEY, CA. IT BECAME A MEMBER OF ST. JOSEPH HEALTH IN 1994. THE FACILITY HAS 212 LICENSED BEDS AND A STAFF OF MORE THAN 1,751 AND PROFESSIONAL RELATIONSHIPS WITH MORE THAN 300 LOCAL PHYSICIANS. MAJOR PROGRAMS AND SERVICES INCLUDE CARDIAC CARE, CRITICAL CARE, DIAGNOSTIC IMAGING, EMERGENCY MEDICINE AND OBSTETRICS.2021 ROGRAM SERVICE ACCOMPLISHMENTS: (JANUARY 1 - DECEMBER 31, 2021)IN 2021, PROVIDENCE ST. MARY MEDICAL CENTER CONTINUED ITS TRADITION OF COMPASSION AND DEDICATION TO OUR COMMUNITIES BY INVESTING TO ADDRESS COMMUNITY NEED. IN 2021, SMMC FOCUSED ON ADDRESSING COVID-19, ACCESS TO RESOURCES, MENTAL HEALTH & SUBSTANCE USE, HOUSING AND HOMELESSNESS, AND OBESITY.PRIORITY 1: ACCESS TO RESOURCES INCLUDES MOST BARRIERS TO ACCESSING HEALTH CARE SERVICES AND OTHER NECESSARY RESOURCES, SUCH AS TRANSPORTATION, A SHORTAGE OF PROVIDERS, PARTICULARLY SPECIALISTS SUCH AS PEDIATRICIANS, DENTISTS, AND ORTHOPEDISTS, LANGUAGE BARRIERS, AND RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS. THIS NEED EMERGED AS A CONSISTENT PRIORITY. IN THE PREVIOUS CHNA PROCESS, ACCESS TO RESOURCES WAS A MAJOR DISCUSSION POINT IN EVERY FOCUS GROUP AND RECEIVED SUBSTANTIAL SUPPORT IN THE COMMUNITY FORUM. DATA SHOWS THAT THE COUNTY OF SAN BERNARDINO HAS RELATIVELY FEW PHYSICIANS AND DENTIST COMPARED TO THE STATE OF CALIFORNIA AVERAGES. THE COMMUNITY BENEFIT COMMITTEE DISCUSSED EXPANDING COMMUNITY BENEFIT PROGRAMS AND CLINIC VISITS TO THE POOR. IN 2021 THIS NEED WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS: 1. BRIDGES FOR FAMILIES RESOURCE CENTER OFFERED NURTURING PARENTING PROGRAM TO FAMILIES AND CONNECTED THEM TO OTHER RESOURCES.2. MOTHER/BABY ASSESSMENT CENTER LACTATION CLINIC INPATIENT LACTATION SUPPORT AND FOLLOW-UP CLINIC PROVIDED BREASTFEEDING SUPPORT WITH LACTATION SPECIALISTS TO HELP MAKE BREASTFEEDING MORE COMFORTABLE FOR BOTH MOM AND BABY. THEY SAW ANY MOTHER AND BABY, REGARDLESS OF WHERE THEY DELIVER, INSURANCE STATUS, AND A MEDICAL HOME. PRIORITY 2: MENTAL HEALTH & SUBSTANCE USE COVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES. INCLUDES ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS HEALTH CONDITIONS SUCH AS MENTAL ILLNESS AND ADVERSE CHILDHOOD EXPERIENCES. SUBSTANCE USE PERTAINS TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. IT DOES NOT ENCOMPASS CIGARETTE SMOKING, WHICH WAS CONSIDERED SEPARATELY. MENTAL HEALTH CHALLENGES CAN IMPEDE PEOPLE'S ABILITIES TO REALIZE THEIR POTENTIAL, COPE WITH STRESSES, WORK PRODUCTIVELY AND FRUITFULLY, AND MAKE CONTRIBUTIONS TO THEIR COMMUNITIES. THESE WERE COMBINED BY THE COMMUNITY BENEFIT COMMITTEE. COMMITTEE MEMBERS DISCUSSED THAT MENTAL HEALTH WILL BE A PRIORITY FOCUS OF PROVIDENCE ST. JOSEPH HEALTH OVER THE NEXT TEN YEARS. MENTAL HEALTH WAS A FREQUENT THEME IN THE 2017 CHNA FOCUS GROUPS AND THE FORUM, PARTICULARLY FOCUSING ON THE STRESSES CAUSED BY ECONOMIC INSECURITY, THE CHALLENGES FACED BY CHILDREN AND TEENS, AND THE LACK OF PROVIDERS. DATA SHOWS THAT THERE ARE RELATIVELY LOW PROVIDERS IN THE COUNTY OF SAN BERNARDINO WHEN COMPARED TO THE STATE. IN 2021, MENTAL HEALTH & SUBSTANCE USE WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS:1. BRIDGES FOR FAMILIES RESOURCE CENTER PROVIDED SHORT-TERM COUNSELING FOR INDIVIDUALS, COUPLES, AND FAMILIES.2. LIFE SKILLS AWARENESS YOUTH SUICIDE PREVENTION NAVIGATION PROGRAM.3. HESPERIA UNIFIED SCHOOL DISTRICT WORKING WITH THIS SCHOOL DISTRICT TO ADDRESS MENTAL HEALTH NEEDS OF SCHOOL AGE STUDENTS.4. GRANT - ST. JOHN OF GOD GRANT WAS RESTRICTED TO INTEGRATE MENTAL HEALTH SERVICES WITH 90 DAY SUBSTANCE ABUSE TREATMENT AND REHABILITATION PROGRAM. PRIORTY 3: HOUSING & HOMELESSNESS PRIMARILY FOCUSED ON THE CONDITION OF HOMELESSNESS, INCLUDING HELPING HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. HOMELESSNESS AND AFFORDABLE HOUSING ARE SIGNIFICANT NEEDS IN OUR COMMUNITIES. HOMELESSNESS HAS A RIPPLE EFFECT THROUGHOUT THE COMMUNITY; IT IMPACTS THE AVAILABILITY OF HEALTHCARE RESOURCES, CRIME AND SAFETY, THE WORKFORCE, AND THE USE OF TAX DOLLARS. AFFORDABLE HOUSING BENEFITS OUR COMMUNITIES AND CREATES STRONGER OUTCOMES IN EMPLOYMENT, HEALTH AND EDUCATION. SOCIAL DETERMINANTS OF HEALTH, LIKE HOUSING, HAVE A SUBSTANTIAL IMPACT ON HEALTH BEHAVIORS AND HEALTH OUTCOMES. ADDRESSING HOUSING INSTABILITY, HOUSING AFFORDABILITY, AND PREVENTING HOMELESSNESS WILL IMPROVE HEALTH AND THE COMMUNITIES WE SERVE. IN 2021, HOUSING AND HOMELESSNESS WAS ADDRESSED BY:1. BRIDGES FAMILY RESOURCE CENTER, WHICH PROVIDED HEALTH AND SOCIAL SERVICES TO LOW-INCOME RESIDENTS IN THE HIGH DESERT. SERVICES INCLUDE CONNECTING RESIDENTS TO HOUSING RESOURCES. 2. HOSPITAL PATIENTS REQUIRING HOUSING AND RECUPERATIVE CARE WERE CONNECTED WITH AND/OR PROVIDED LOCAL ROOM AND BOARD PAID BY THE HOSPITAL.3. ADVOCATING FOR MORE AFFORDABLE HOUSING THROUGH ACTIVE PARTICIPATION IN COMMUNITY COLLABOARTIVE EFFORTS LIKE THE VICTORVILLE HOMELESS TASKFORCE AND HIGH DESERT INTERSECTIONS HOMELESSNESS COMMITTEEPRIORITY 4: OBESITY PRIMARILY DEFINED AS THE HEALTH CONDITION IN WHICH INDIVIDUALS ARE SUFFICIENTLY OVERWEIGHT AS TO HAVE DETRIMENTAL EFFECTS ON THEIR OVERALL HEALTH. THIS DOES NOT INCLUDE ISSUES OF EXERCISE OR FOOD CHOICES, WHICH ARE LISTED AS SEPARATE ISSUES. OBESITY WAS FREQUENTLY DISCUSSED IN THE 2017 CHNA FOCUS GROUPS, PARTICULARLY IN CONJUNCTION WITH ROOT CAUSES SUCH AS NUTRITION AND LACK OF EXERCISE, WITH CHALLENGES WITH WALKABILITY.

SCHEDULE H, PART V, SECTION B, LINE 3E
"THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS.SCHEDULE H, PART V, SECTION B, LINE 5FOR THE 2021 CHNA, ALL IN-PERSON EVENTS INCLUDING FOCUS GROUPS WERE CANCELLED TO MITIGATE THE SPREAD OF COVID-19. DESPITE THE LIMITATIONS IMPOSED BY THE PANDEMIC IN SECURING COMMUNITY INPUT, THE HOSPITAL LEVERAGED PREVIOUSLY COLLECTED INFORMATION FROM LOCAL PARTNERS IN SAN BERNARDINO COUNTY. INPUT AND DATA WERE OBTAINED FROM THE 2020 COMMUNITY VITAL SIGNS INITIATIVE CONDUCTED BY THE SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH (SBC-DPH). SBC-DPH'S COMMUNITY VITAL SIGNS WAS A COMMUNITY DRIVEN INITIATIVE THAT SOUGHT TO DEVELOP A COMMUNITY TRANSFORMATION PLAN. AS PART OF THIS INITIATIVE, SBC-DPH SURVEYED COMMUNITY RESIDENTS AND STAKEHOLDERS TO BETTER UNDERSTAND THE KEY ISSUES AND HOW THE SOCIAL DETERMINATES IMPACT HEALTH. THROUGH ITS ADMINISTRATION, THE ONLINE SURVEY WAS ABLE TO SECURE THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS ON PLATFORMS FREQUENTED MOST TO SECURE HIGHER RESPONSE RATE AND THUS A REPRESENTATIVE SAMPLE. THE FOLLOWING THREE CATEGORIES COMPRISED SBC-DPH'S VITAL SIGN SURVEY: (1) HEALTH; (2) COMMUNITY SAFETY EDUCATION AND ECONOMY; AND (3) NEIGHBORHOOD RATINGS.A FULL REPORT OF FINDINGS FROM THE SURVEY CAN BE FOUND ON THE SAN BERNARDINO COUNTY PUBLIC HEALTH'S WEBSITE. FINDINGS SHARED HERE ARE FILTERED TO INCLUDE RESPONDENTS FROM PROVIDENCE ST. MARY MEDICAL CENTER'S PRIMARY SERVICE AREA, INCLUDING ADELANTO, APPLE VALLEY, HESPERIA, VICTORVILLE, AND THE ADELANTO-HIGH DESERT DETENTION CENTER; HOWEVER, FINDINGS FROM THE DETENTION CENTER WERE NOT AVAILABLE FOR THE HEALTH PRIORITIES SECTION. A TOTAL OF 222 STAKEHOLDERS AND OVER 1,000 RESIDENTS COMPLETED THE SURVEY. STAKEHOLDERS WERE RESPONDING ON BEHALF OF THEIR ORGANIZATIONS AND RESIDENTS RESPONDED BASED ON THEIR OWN EXPERIENCES. COMMUNITY RESIDENT SURVEY FINDINGS IN THE ""HEALTH CATEGORY,"" COMMUNITY RESIDENTS IN THE SERVICE AREA IDENTIFIED THE FOLLOWING TOP THREE HEALTH PRIORITIES FOR THEIR COMMUNITIES: 1. MENTAL HEALTH PROBLEMS (ANXIETY, DEPRESSION, ETC.) 2. OBESITY/OVERWEIGHT 3. SMOKING / TOBACCO USE / VAPING / E-CIGARETTE ACCESS THE NUMBER OF VOTES FOR MENTAL HEALTH PROBLEMS WAS SUBSTANTIALLY HIGHER (114 VOTES) THAN OBESITY/OVERWEIGHT (85 VOTES). IN THE ""COMMUNITY SAFETY, EDUCATION AND ECONOMIC CATEGORY,"" COMMUNITY RESIDENTS IN THE SERVICE AREA IDENTIFIED THE FOLLOWING TOP THREE PRIORITIES: 1. HOMELESSNESS 2. POVERTY 3. HIGH HOUSING COSTS (PURCHASE OR RENTAL) THIS CATEGORY RECEIVED AN OVERWHELMING RESPONSE FOR HOMELESSNESS. THERE WERE 138 VOTES FOR HOMELESSNESS COMPARED TO 86 FOR POVERTY. IN THE ""NEIGHBORHOOD RATINGS CATEGORY,"" RESIDENTS WERE ASKED TO RATE THEIR NEIGHBORHOODS (ON A POOR TO EXCELLENT SCALE) ON THE FOLLOWING CATEGORIES: - HEALTH AND WELLNESS: THE MOST COMMON RATING WAS ""FAIR,"" FOLLOWED BY ""GOOD."" - ECONOMY: THE MOST COMMON RATING WAS ""FAIR,"" FOLLOWED BY ""POOR."" - EDUCATION: THE MOST COMMON RATING WAS ""FAIR,"" FOLLOWED CLOSELY BY ""GOOD."" - SAFETY: THE MOST COMMON RATING WAS ""FAIR,"" FOLLOWED CLOSELY BY ""POOR."" - ENVIRONMENT: SURVEY RESPONDENTS WERE PRIMARILY SPLIT BETWEEN ""POOR,"" ""FAIR, AND ""GOOD."" - HOUSING: THE MOST COMMON RATING WAS ""POOR,"" ALTHOUGH ""FAIR AND ""GOOD"" WERE ALSO COMMON. - TRANSPORTATION: THE MOST COMMON RATING WAS ""FAIR,"" ALTHOUGH ""POOR AND ""GOOD"" WERE ALSO COMMON. COMMUNITY STAKEHOLDER SURVEY FINDINGS IN THE ""HEALTH CATEGORY,"" COMMUNITY STAKEHOLDERS IN THE SERVICE AREA IDENTIFIED THE FOLLOWING TOP THREE HEALTH PRIORITIES FOR THEIR COMMUNITIES: 1. MENTAL HEALTH PROBLEMS (ANXIETY, DEPRESSION, ETC.) 2. SHORTAGE OF HEALTH PROFESSIONALS 3. POOR NUTRITION/DIET. THE NUMBER OF VOTES FOR MENTAL HEALTH PROBLEMS WAS SUBSTANTIALLY HIGHER (30 VOTES) THAN SHORTAGE OF HEALTH PROFESSIONALS AND POOR NUTRITION/DIET (BOTH 19 VOTES). IN THE ""COMMUNITY SAFETY, EDUCATION AND ECONOMIC CATEGORY,"" COMMUNITY STAKEHOLDERS IN THE SERVICE AREA IDENTIFIED THE FOLLOWING TOP THREE HEALTH PRIORITIES: 1. HOMELESSNESS 2. POVERTY 3. VIOLENT CRIME THERE WERE 24 VOTES FOR HOMELESSNESS COMPARED TO 14 FOR POVERTY.THE SEVENTEEN (17) PARTICIPANTS OF THE STAKEHOLDER SURVEY (OUR HOSPITAL PARTICIPATED) SPANNED THE FOLLOWING SECTORS: CLINICAL, COMMUNITY ORGANIZATIONS, DENTAL, EDUCATION, FAITH-BASED, HOSPITAL, LOCAL GOVERNMENT, LOCAL MEDICAID PLAN, MENTAL HEALTH, PUBLIC HEALTH MENTAL HEALTH, PUBLIC HEALTH AND PUBLIC SAFETY. THE PARTICIPATING AGENCIES ARE AS FOLLOWS:1. BORREGO HEALTH 2. CENTER FOR ORAL HEALTH 3. COMMUNITY HEALTH ACTION NETWORK (C.H.A.N.) 4. EL SOL 5. FAITH ADVISORY COUNCIL FOR COMMUNITY TRANSFORMATION 6. FIRST 5, SAN BERNARDINO 7. HEALTH ASSESSMENT AND RESEARCH COMMUNITIES (H.A.R.C.) 8. INLAND EMPIRE HEALTH PLAN (I.E.H.P.) 9. INSTITUTE FOR PUBLIC STRATEGIES (R.O.O.T.) 10. SAN BERNARDINO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH 11. SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH12. SAN BERNARDINO COUNTY SHERIFF DEPARTMENT13. SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS14. SAN BERNARDINO COUNTY TRANSITIONAL ASSISTANCE DEPARTMENT15. ST. MARY MEDICAL CENTER16. THE GATE CHURCH17. VICTOR VALLEY RESCUE MISSIONSCHEDULE H, PART V, SECTION B, LINE 7A:CHNA WEBSITE ADDRESS:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE ""SOUTHERN CALIFORNIA"" TABSCHEDULE H, PART V, SECTION B, LINE 10A:IMPLEMENTATION STRATEGY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE ""SOUTHERN CALIFORNIA"" TAB"

SCHEDULE H, PART V, SECTION B, LINE 11
"FOR CALENDAR YEARS 2021 - 2023 THE HOSPITAL IDENTIFIED AND WILL FOCUS ON THE FOLLOWING FOUR (4) PRIORITIES: PRIORITY 1: ACCESS TO RESOURCES INCLUDES MOST BARRIERS TO ACCESSING HEALTH CARE SERVICES AND OTHER NECESSARY RESOURCES, SUCH AS TRANSPORTATION, A SHORTAGE OF PROVIDERS, PARTICULARLY SPECIALISTS SUCH AS PEDIATRICIANS, DENTISTS, AND ORTHOPEDISTS, LANGUAGE BARRIERS, AND RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS. THIS NEED EMERGED AS A CONSISTENT PRIORITY. IN 2021 ACCESS TO RESOURCES WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS: 1. BRIDGES FOR FAMILIES RESOURCE CENTER OFFERED NURTURING PARENTING PROGRAM TO FAMILIES AND CONNECTED THEM TO OTHER RESOURCES. 2. GRANT TO ST MARY HEALTH CENTER, A HRSA DESIGNATED FEDERALLY QUALIFIED HEALTH CENTER (FQHC) THIS FQHC IS BEING FINANCIALLY SUPPORTED BY ST. MARY MEDICAL CENTER. THE CLINIC OPERATES THE HEALTHY BEGINNINGS MIDWIFERY PROGRAM, WHICH HAS TRAINED PRENATAL STAFF GOING TO POPULATIONS THAT EXPERIENCES DIFFICULTIES IN OBTAINING NEEDED PREGNANCY RELATED SERVICES IN THE CITIES OF ADELANTO, APPLE VALLEY AND HESPERIA. 3. MOTHER/BABY ASSESSMENT CENTER LACTATION IN PATIENT LACTATION SUPPORT AND FOLLOW-UP CLINIC PROVIDED BREASTFEEDING SUPPORT WITH LACTATION SPECIALISTS TO HELP MAKE BREASTFEEDING MORE COMFORTABLE FOR BOTH MOM AND BABY. THEY SAW ANY MOTHER AND BABY, REGARDLESS OF WHERE THEY DELIVER, INSURANCE STATUS, AND MEDICAL HOME. PRIORITY 2: MENTAL HEALTH & SUBSTANCE USE COVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES. INCLUDES ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS HEALTH CONDITIONS SUCH AS MENTAL ILLNESS AND ADVERSE CHILDHOOD EXPERIENCES. SUBSTANCE USE PERTAINS TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. IT DOES NOT ENCOMPASS CIGARETTE SMOKING, WHICH WAS CONSIDERED SEPARATELY. MENTAL HEALTH CHALLENGES CAN IMPEDE PEOPLE'S ABILITIES TO REALIZE THEIR POTENTIAL, COPE WITH STRESSES, WORK PRODUCTIVELY AND FRUITFULLY, AND MAKE CONTRIBUTIONS TO THEIR COMMUNITIES. THESE WERE COMBINED BY THE COMMUNITY BENEFIT COMMITTEE. COMMITTEE MEMBERS DISCUSSED THAT MENTAL HEALTH WILL BE A PRIORITY FOCUS OF PROVIDENCE ST. JOSEPH HEALTH OVER THE NEXT TEN YEARS. MENTAL HEALTH WAS A FREQUENT THEME IN THE 2017 CHNA FOCUS GROUPS AND THE FORUM, PARTICULARLY FOCUSING ON THE STRESSES CAUSED BY ECONOMIC INSECURITY, THE CHALLENGES FACED BY CHILDREN AND TEENS, AND THE LACK OF PROVIDERS. DATA SHOWS THAT THERE ARE RELATIVELY LOW PROVIDERS IN THE COUNTY OF SAN BERNARDINO WHEN COMPARED TO THE STATE. IN 2021, MENTAL HEALTH & SUBSTANCE USE WAS ADDRESSED BY THE FOLLOWING COMMUNITY BENEFIT PROGRAMS: 1. BRIDGES FOR FAMILIES RESOURCE CENTER PROVIDED SHORT-TERM COUNSELING FOR INDIVIDUALS, COUPLES, AND FAMILIES. 2. LIFE SKILLS AWARENESS YOUTH SUICIDE PREVENTION NAVIGATION PROGRAM. 3. HESPERIA UNIFIED SCHOOL DISTRICT WORKING WITH THIS SCHOOL DISTRICT TO ADDRESS MENTAL HEALTH NEEDS OF SCHOOL AGE STUDENTS. 4. GRANT - ST. JOHN OF GOD GRANT WAS RESTRICTED TO INTEGRATE MENTAL HEALTH SERVICES WITH 90 DAY SUBSTANCE ABUSE TREATMENT AND REHABILITATION PROGRAM. PRIORITY 3: HOUSING & HOMELESSNESS PRIMARILY FOCUSED ON THE CONDITION OF HOMELESSNESS, INCLUDING HELPING HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. HOMELESSNESS AND AFFORDABLE HOUSING ARE SIGNIFICANT NEEDS IN OUR COMMUNITIES. HOMELESSNESS HAS A RIPPLE EFFECT THROUGHOUT THE COMMUNITY; IT IMPACTS THE AVAILABILITY OF HEALTHCARE RESOURCES, CRIME AND SAFETY, THE WORKFORCE, AND THE USE OF TAX DOLLARS. AFFORDABLE HOUSING BENEFITS OUR COMMUNITIES AND CREATES STRONGER OUTCOMES IN EMPLOYMENT, HEALTH AND EDUCATION. SOCIAL DETERMINANTS OF HEALTH, LIKE HOUSING, HAVE A SUBSTANTIAL IMPACT ON HEALTH BEHAVIORS AND HEALTH OUTCOMES. ADDRESSING HOUSING INSTABILITY, HOUSING AFFORDABILITY, AND PREVENTING HOMELESSNESS WILL IMPROVE HEALTH AND THE COMMUNITIES WE SERVE. IN 2021, HOUSING AND HOMELESSNESS WAS ADDRESSED BY: BRIDGES FAMILY RESOURCE CENTER, WHICH PROVIDED HEALTH AND SOCIAL SERVICES TO LOW-INCOME RESIDENTS IN THE HIGH DESERT. SERVICES INCLUDE CONNECTING RESIDENTS TO HOUSING RESOURCES. HOSPITAL PATIENTS REQUIRING HOUSING AND RECUPERATIVE CARE WERE CONNECTED WITH AND/OR PROVIDED LOCAL ROOM AND BOARD PAID BY THE HOSPITAL. ADVOCATING FOR MORE AFFORDABLE HOUSING THROUGH ACTIVE PARTICIPATION IN COMMUNITY COLLABOARTIVE EFFORTS LIKE THE VICTORVILLE HOMELESS TASKFORCE AND HIGH DESERT INTERSECTIONS HOMELESSNESS COMMITTEE. PRIORITY 4: OBESITY PRIMARILY DEFINED AS THE HEALTH CONDITION IN WHICH INDIVIDUALS ARE SUFFICIENTLY OVERWEIGHT AS TO HAVE DETRIMENTAL EFFECTS ON THEIR OVERALL HEALTH. THIS DOES NOT INCLUDE ISSUES OF EXERCISE OR FOOD CHOICES, WHICH ARE LISTED AS SEPARATE ISSUES. OBESITY WAS FREQUENTLY DISCUSSED IN THE 2017 CHNA FOCUS GROUPS, PARTICULARLY IN CONJUNCTION WITH ROOT CAUSES SUCH AS NUTRITION AND LACK OF EXERCISE, WITH CHALLENGES WITH WALKABILITY. IN 2021, OBESITY WAS ADDRESSED THROUGH FUNDING FROM A CALFRESH GRANT RECEIVED FROM THE SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH. THROUGH THIS GRANT WE PROVIDE ONLINE NUTRITION CLASSES TO ADULTS WITHIN THE HOSPITAL'S PRIMARY SERVICE AREA. DUE TO THE PANDEMIC, FREE OPPORTUNITIES FOR PHYSICAL ACTIVITY THAT NORMALLY ACCOMPANY THE NUTRITION CLASSES WERE CANCELLED. NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM IT IS IMPOSSIBLE FOR A SINGLE HOSPITAL ALONE TO ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. OUR MISSION, ""AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE,"" IS BEST LIVED BY PARTNERING WITH LIKE-MINDED ORGANIZATIONS THAT COUNT WITH THE CAPACITY AND EXPERTISE TO ADDRESS THE NEEDS OF SAN BERNARDINO COUNTY RESIDENTS. WE ARE COMMITTED TO LIVING OUT OUR MISSION THROUGH OUR OWN COMMUNITY BENEFIT PROGRAMS, PARTNERSHIP WITH LIKE-MINDED PARTNERS, AND BUILDING THE CAPACITY OF OTHER NON-PROFITS BY PROVIDING FUNDING. FURTHERMORE, PROVIDENCE ST. MARY MEDICAL CENTER WILL ENDORSE LOCAL NON-PROFIT ORGANIZATIONS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT ST. MARY MEDICA CENTER'S SERVICE AREAS. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE HOSPITAL'S 2021 CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW: DIABETES: SPECIFICALLY FOCUSED DIABETES AWARENESS AND PREVENTION. ST. MARY HEALTH CENTERS, A HRSA DESIGNATED FEDERALLY QUALIFIED HEALTH CENTER PROVIDES PRIMARY MEDICAL CARE TO RESIDENTS WITH LOW-INCOMES WHO HAVE DIABETES. ATTHERE APPLE VALLEY, HESPERIA, AND VICTORVILLE LOCATIONS. THE DIABETES PROGRAM, RUN BY THE ST. MARY HEALTH CENTERS, ADDRESSED THIS NEED. THIS IS THE ONLY AMERICAN DIABETES ASSOCIATION CERTIFIED PROGRAM IN THE HOSPITAL'S SERVICE AREA. THE PROGRAM EXPANDS NUTRITIONAL AND CERTIFIED DIABETES TRAINED STAFF FROM HOSPITAL-BASED DIABETES AND CHILD OBESITY PROGRAMS. PROGRAM STAFF CONTINUE PARTICIPATING IN REGIONAL DIABETES WORKGROUP SHARING BEST PRACTICES. A REFERRAL RELATIONSHIP HAS BEEN ESTABLISHED BETWEEN ST. MARY HEALTH CENTERS AND ST. MARY HIGH DESERT MEDICAL GROUP. FOOD AND NUTRITION: CONCERNS ABOUT HEALTHY EATING HABITS, NUTRITION KNOWLEDGE, AND CHALLENGES OF COST AND AVAILABILITY OF HEALTHY OPTIONS. THIS NEED IS ADDRESSED BY LIKE-MINDED PARTNERSA COLLECTIVE IMPACT APPROACH TO INCREASE HEALTH FOOD ACCESS AND COMSUMPTION ARE BEING TACKLED BY THE COMMUNITY ACTION PARTNERSHIP AND HIGH DESERT FOOD COLLABORATIVE. NON-PROFITS OUTSIDE OUR REGION ARE BEING APPROACHED, AS WAS THE CASE WITH LOS ANGELES BASED FOOD FORWARD. THIS NON-PROFIT WAS RECRUITED TO PROVIDE DONATIONS OF FRESH FRUITS AND VEGETABLES TO LOCAL FOOD PANTRIES OPERATED IN ADELANTO, APPLE VALLEY, PHELAN AND VICTORVILLE. HIGH DESERT SECOND CHANCE FOOD BANK SUPPORT CHURCHES, THAT OPERATE THE MAJORITY OF FOOD PANTRIES IN THE HOSPITAL'S SERVICE AREA: BROKEN HEARTS MINISTRY, THE LORD'S TABLE, ANOTHER LEVEL FOR WOMEN, VICTOR VALLEY RESCUE MISSION. OTHER NON-PROFITS WORKING AROUND THIS NEED ARE THE HIGH DESERT OUTREACH CENTER, SQUASH4FRIENDS, AND SCHOOLS THAT ARE HOSTING SUMMER MEAL PROGRAMS. COMMUNITY ACTION PARTNERSHIP RECEIVED A PLANNING GRANT FROM THE ST. JOSEPH COMMUNITY PARTNERSHIP FUND, TO BEGIN DEVELOPING A TIMELINE FOR OPENING A LOCAL HIGH DESERT OFFICE THAT WOULD INCLUDE A SMALL FOOD PANTRY."

SCHEDULE H, PART V, SECTION B, LINE 11 (CONT'D)
"PHYSICAL ACTIVITY: IN ADDITION TO THE BEHAVIOR ITSELF, IT ALSO INCLUDES ISSUES AROUND ACCESS TO PLACES TO EXERCISE AND PEOPLE NOT HAVING ENOUGH TIME TO EXERCISE. THIS ISSUE IS TIED VERY CLOSELY TO OBESITY (WHICH WAS IDENTIFIED AS A PRIORITY) AND WILL BE ADDRESSED BY THE CALFRESH GRANT RECEIVED FROM THE SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH. DUE TO COVID-19, COUPLED WITH STATE OF CALIFORNIA AND SAN BERNARDINO COUNTY PUBLIC HEALTH ORDERS TO MAINTAIN SOCIAL DISTANCING, PHYSICAL ACTIVITY CLASSES WERE CANCELLED TO AVOID THE SPREADING OF THE NOVEL VIRUS. POVERTY: IDENTIFIED AS A ROOT CAUSE OF OTHER HEALTH ISSUES, THIS ISSUE COVERS THE EFFECTS OF POVERTY AND ECONOMIC CONCERNS AS WELL AS DIFFICULTIES AROUND FINDING JOBS THAT PAY LIVABLE SALARIES. GIVEN OTHER PRIORITIES, RESOURCE CONSTRAINTS AND LACK OF EXPERTISE, THIS ISSUE WAS NOT SELECTED. ST. MARY MEDICAL CENTER WILL COLLABORATE WITH LOCAL CITY ECONOMIC DEVELOPMENT DEPARTMENTSAND THE WORKFORCE DEVELOPMENT DEPARTMENT THAT ADDRESS THIS NEED. IN ADDITION, AS A CATHOLIC INSTITUTION WE FOLLOW CATHOLIC SOCIAL TEACHING, WHICH IN REGARD TO JOBS AND SALARIES WE BELIEVE THAT, ""THE ECONOMY MUST SERVE PEOPLE, NOT THE OTHER WAY AROUND. WORK IS MORE THAN A WAY TO MAKE A LIVING; IT IS A FORM OF CONTINUING PARTICIPATION IN GOD'S CREATION. IF THE DIGNITY OF WORK IS TO BE PROTECTED, THEN THE BASIC RIGHTS OF WORKERS MUST BE RESPECTED THE RIGHT TO PRODUCTIVE WORK, TO DECENT AND FAIR WAGES, TO THE ORGANIZATION AND JOINING OF UNIONS, TO PRIVATE PROPERTY AND TO ECONOMIC INITIATIVE."" ENVIRONMENTAL POLLUTION: INCLUDES INDUSTRIAL POLLUTION BUT ALSO VERMIN, TRASH, AND DUST DUE TO DRYNESS AND A LACK OF PAVED ROADS. ORGANIZATIONS WORKING ON THIS NEED ARE THE MOJAVE AIR QUALITY MANAGEMENT DISTRICT, SAN BERNARDINO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH AND THE COMMUNITY ACTION PARTNERSHIP THROUGH THEIR LEAD PAINT ABATEMENT OF RESIDENTIAL HOUSING. GIVEN OTHER PRIORITIES RAISED DURING OUR MOST RECENT CHNA, THIS ISSUE BECAME A LOWER PRIORITY COMPARED TO OTHERS. PROVIDENCE ST. MARY MEDICAL CENTER HAS COMMITTED TO BEING CARBON NEGATIVE BY 2030. THIS EFFORT WILL INVOLVE ALL HOSPITAL STAFF. THE REGIONAL DIRECTOR OF COMMUNITY HEALTH INVESTMENT HAS BEEN APPOINTED TO THE SYSTEM ENVIRONMENTAL JUSTICE WORK GROUP. CRIME: ENCOMPASSES THE INCIDENCE OF CRIME AND VIOLENCE AS WELL AS THE FEAR OF IT, WHICH PREVENTS PEOPLE FROM USING OPEN SPACE OR ENJOYING THEIR COMMUNITY, NEGATIVELY IMPACTING WALKABILITY. BY WORKING WITH LOCAL LAW ENFORCEMENT OFFICES, SCHOOL DISTRICTS, AND ELECTED OFFICIALS, OUR HOPE IS THAT CRIME WILL GO DOWN AND THE IMAGE OF THE HIGH DESERT REGION WILL IMPROVE, ATTRACTING NEW EMPLOYERS TO THIS REGION. ONE PROJECT FUNDED BY THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND, ADDRESSES CRIME AND SAFETY. RESIDENTS OF OLD TOWN VICTORVILLE (R.O.O.T.) IS A GRASSROOTS EFFORTS RUN BY VICTORVILLE RESIDENTS TO ADDRESS SAFETY ISSUES THAT IMPACT THE HEALTH OF THEIR NEIGHBORHOOD. OLD TOWN VICTORVILLE IS PARTICULARLY IMPACTED AS THE MAJORITY OF THE HOMELESS POPULATION (VICTORVILLE HAS THE SECOND HIGHEST HOMELESS POPULATION IN THE ENTIRE SAN BERNARDINO COUNTY) IS CONCENTRATED IN THAT SECTION. THE HIGH DESERT HAS MANY JAILS AND PRISONS, WITH MOST RELEASING THEIR PRISONER POPULATION IN OLD TOWN VICTORVILLE. R.O.O.T. BEGAN ADVOCATING FOR ENVIRONMENTAL CHANGES, LIKE BRIGHTER STREET LIGHTS AND NEW LIGHTS IN ALLEYS, WHICH HAS HAPPENED, AND RESIDENTS ARE REPORTING THAT THEY FEEL CRIME HAS LOWERED. A NAVIGATION PARTNERSHIP ENSURES THAT NEWLY RELEASED PRISONERS ARE HOUSED AND/OR REUNITED WITH FAMILY AND NOT DROPPED OFF IN OLD TOWN VICTORVILLE, AS WAS THE PREVIOUS PRACTICE. VICTORVILLE RESIDENTS PASSED MEASURE P IN NOVEMBER OF 2020. THIS LOCAL SALES TAX WENT INTO EFFECT IN 2021 AND ADDED MORE FIRE AND POLICE PERSONNEL, CODE ENFORCEMENT INCLUDING RESOURCES TO HELP THOSE EXPERIENCING HOMELESSNESS. MEASURE P WILL SET UP A COMMITTEE TO ENSURE TAX DOLLARS COLLECTED WILL BE USED IN THE INTENDED FORM - ADDRESSING SAFETY AND HOMELESSNESS. SMOKING/TOBACCO/VAPING: GIVEN OTHER PRIORITIES RAISED DURING THE MOST RECENT 2021 CHNA, THIS NICTONINE PRODUCT USE BECAME A LOWER PRIORITY COMPARED TO OTHERS. THE CALIFORNIA HEALTH COLLABORATIVE IS ACTIVE IN THE HIGH DESERT. THIS ORGANIZATION EDUCATES, INFORMS AND DRIVES POLICY TO REDUCE TOBACCO RELATED HEALTH DISPARITIES, IMPROVE HEALTH EQUITY, AND EXPOSURE TO SECONDHAND SMOKE IN PUBLIC AND NON-RECREATIONAL PLACES. THIS ORGANIZATION WAS INVOLVED IN TEACHING HIGH SCHOOL STUDENTS AT ADELANTO HIGH SCHOOL TO ADDRESS CITY COUNCIL MEMBERS ABOUT THE HARM OF VAPING AND THE NEED FOR POLICY TO PENALIZE RETAILERS THAT SELL TO MINORS TO REDUCE UNDERAGE USE BY LIMITING ACCESS. IN ADDITION, ST. MARY MEDICAL CENTER WILL COLLABORATE, WHEN FEASIBLE, WITH ORGANIZATIONS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL TO ADDRESS THESE UNMET NEEDS."

SCHEDULE H PART V, LINE 13A
1/1/2021 5/14/2021 ST. MARY MEDICAL CENTER 100% DISCOUNT WAS UP TO 200% FPL AND 75% DISCOUNT BETWEEN 201% TO 500% FPL. EFFECTIVE 5/15/21 THROUGH 12/31/2021, ST. MARY MEDICAL CENTER 100% DISCOUNT WAS UP TO 300% FPL AND 75% DISCOUNT BETWEEN 301% TO 350% FPL.SCHEDULE H, PART V, SECTION B, LINE 13HTHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE.

SCHEDULE H, PART V, SECTION B, LINE 16A
FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/ORANGE-COUNTY-AND-HIGH-DESERT

SCHEDULE H, PART V, SECTION B, LINE 16B
FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/ORANGE-COUNTY-AND-HIGH-DESERT/FINANCIAL-ASSISTANCE#TABCONTENT-1-PANE-3

SCHEDULE H, PART V, SECTION B, LINE 16C
FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/PLAIN-LANGUAGE-SUMMARY

PART V, SECTION B, LINE 24
FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.

PART I, LINE 3C:
IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.

PART I, LINE 6A:
ST. JOSEPH HEALTH, ST. MARY PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE ATHTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/ST-MARY-MEDICAL-CENTER/ABOUT-US/COMMUNITY-BENEFIT

PART I, LINE 7:
THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO AND GENERAL LEDGER.

PART I, LINE 7G:
NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.

PART III, LINE 4:
AS A RESULT OF ADOPTING ASU 2014-09 AS DESCRIBED IN NOTE 1, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2021.

PART III, LINE 8:
COMMUNITY BENEFITSTHE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.

PART III, LINE 9B:
COLLECTION ACTIVITYOUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THIS INFORMATION IS INCLUDED IN OUR CHARITY POLICY HOWEVER THIS DETAIL IS NOT ADDRESSED IN OUR COLLECTION POLICY.

PART VI, LINE 2:
"NEEDS ASSESSMENTOUR COMMUNITY BENEFIT PLAN IS ALIGNED WITH ST. MARY MEDICAL CENTER'S STRATEGIC PLAN.1. DEVELOPING A NETWORK OF CARE - COMMUNITY CLINICS, WHICH INCLUDES THE ""BRIGHT FUTURES MOBILE VAN"" IS EXPANDING CLINIC SERVICE DAYS AND GOING TO OTHER CITIES LIKE LUCERNE VALLEY. HIGH DESERT ST. MARY MEDICAL GROUP, AN AFFILIATE OF THE HOSPITAL, IS ALSO POISED TO INCREASE THE NETWORK OF CARE IN THE HIGH DESERT REGION THROUGH PRIMARY CARE AND CHRONIC DISEASE MANAGEMENT CLINICAL SERVICES FOR NEW AND EXISTING PATIENTS.2. POPULATION HEALTH - FAITH-BASED ORGANIZATIONS FROM ALL DENOMINATIONS ARE APPROACHED ON CREATING AND CONTINUING A HEALTH MINISTRY, ADDRESSING BOTH SPIRITUAL AND HEALTH CARE NEEDS."

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE.

PART VI, LINE 5:
"PROMOTION OF COMMUNITY HEALTHST. MARY MEDICAL CENTER PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. ST. MARY MEDICAL CENTER IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1. A COMMUNITY HEALTH COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES.2. OPEN MEDICAL STAFF3. ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. PLEASE SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. LOCAL COMMUNITY HEALTH COMMITTEE:THE ROLE OF THE ST. MARY MEDICAL CENTER'S COMMUNITY HEALTH COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE COMMUNITY HEALTH COMMITTEE ACTS IN ACCORDANCE WITH A BOARD APPROVED CHARTER. THE COMMUNITY HEALTH COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS ""IDENTIFIED SIGNIFICANT NEEDS"" IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES. THE COMMUNITY HEALTH COMMITTEE HAS A MINIMUM OF EIGHT (8) MEMBERS INCLUDING THREE (3) MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES FIVE (5) MEMBERS OF THE BOARD OF TRUSTEES AND FIVE (5) COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE COMMUNITY HEALTH COMMITTEE GENERALLY MEETS QUARTERLY, AND BECAUSE OF SOCIAL DISTANCING DUE TO COVID-19, THE MEETINGS HAVE BEEN HELD VIRTUALLY."

PART VI, LINE 7, REPORTS FILED WITH STATES
CA

PART VI, LINE 4:
"COMMUNITY INFORMATIONST. MARY MEDICAL CENTER PROVIDES THE VICTOR VALLEY AND BARSTOW COMMUNITIES WITH ACCESS TO ADVANCED CARE. THE FACILITY IS THE ONLY PROVIDENCE ST. JOSEPH HEALTH HOSPITAL OPERATING IN SAN BERNARDINO COUNTY AND THE ONLY NON-PROFIT HOSPITAL IN THE HIGH DESERT REGION. THE HOSPITAL'S TOTAL SERVICE AREA EXTENDS FROM HIGHWAY 58 AND THE I-15 FREEWAY IN THE NORTH, HIGHWAY 395 AND THE I-15 FREEWAY IN THE SOUTH, UNINCORPORATED COMMUNITIES INCLUDING LUCERNE VALLEY IN THE EAST AND UNINCORPORATED COMMUNITIES OF EL MIRAGE IN THE WEST. OUR HOSPITAL'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF ADELANTO, APPLE VALLEY, BARSTOW, HESPERIA, ORO GRANDE, VICTORVILLE, AND SEVERAL SMALLER UNINCORPORATED COMMUNITIES (I.E., HELENDALE, LUCERNE VALLEY, OAK HILLS, PHELAN, SNOWLINE, AND WRIGHTWOOD). TOTAL SERVICE AREA:THE HOSPITAL'S TOTAL SERVICE AREA INCLUDES CENSUS TRACTS INSIDE THE CITIES OF ADELANTO, APPLE VALLEY, HELENDALE, HESPERIA, LUCERNE VALLEY, PHELAN, ORO GRANDE, AND VICTORVILLE. THIS IS INCLUSIVE OF A POPULATION OF APPROXIMATELY 375,000 PEOPLE AND REPRESENTS DISTRICT 1 OF THE COUNTY'S PUBLIC HEALTH COMMUNITY VITAL SIGNS PROJECT. THE TOTAL SERVICE AREA WAS LATER DIVIDED INTO THE ""BROADER SERVICE AREA AND ""HIGH NEED SERVICE AREA"" (TOTAL SERVICE AREA = BROADER SERVICE AREA + HIGH NEED SERVICE AREA). OF THE OVER 370,000 PERMANENT RESIDENTS IN THE TOTAL SERVICE AREA, ROUGHLY 44% LIVE IN THE HIGH NEED AREA, DEFINED BY LOWER LIFE EXPECTANCY AT BIRTH, LOWER HIGH SCHOOL GRADUATION RATES, AND MORE HOUSEHOLDS AT OR BELOW 200% FEDERAL POVERTY LEVEL (FPL) COMPARED TO CENSUS TRACTS IN THE TOTAL SERVICE AREA. FOR REFERENCE, 200% FPL IS EQUIVALENT TO AN ANNUAL HOUSEHOLD INCOME OF $51,500 OR LESS FOR A FAMILY OF 4. THESE HOUSEHOLDS ARE MORE LIKELY TO REGULARLY MAKE SPENDING TRADEOFFS REGARDING UTILITIES, RENT, GROCERIES, MEDICINE, AND OTHER BASIC EXPENSES. ADELANTO IN ITS ENTIRETY IS DESIGNATED AS A HIGH NEED SERVICE AREA, AS WELL AS SOME SECTIONS OF APPLE VALLEY, HESPERIA, AND VICTORVILLE.POPULATION AND AGE DEMOGRAPHICS:THE POPULATION IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA MAKES UP 17% OF SAN BERNARDINO COUNTY. THE HIGH NEED SERVICE AREA HAS A HIGHER PERCENTAGE OF PEOPLE UNDER 34 YEARS COMPARED TO THE BROADER SERVICE AREA.POPULATION BY RACE AND ETHNICITY: INDIVIDUALS WHO IDENTIFY AS HISPANIC, ""OTHER"" RACE, AND BLACK ARE MORE LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS. PEOPLE IDENTIFYING AS ASIAN AND WHITE ARE LESS LIKELY TO LIVE IN HIGH NEED CENSUS TRACTS.SOCIOECONOMIC INDICATORS:THE POPULATION IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA IS MORE LIKELY TO BE AT OR BELOW 200% FPL COMPARED TO SAN BERNARDINO COUNTY OVERALL, INCLUDING NEARLY 60% OF HOUSEHOLDS IN THE ""HIGH NEED SERVICE AREA."" THE MEDIAN INCOME IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA IS ALMOST $8,000 LOWER THAN THAT OF THE COUNTY OVERALL. THE MEDIAN INCOME FOR HOUSEHOLDS IN THE HIGH NEED CENSUS TRACTS ARE APPROXIMATELY $20,000 LOWER THAN THE ""BROADER SERVICE AREA.""HOUSING COST BURDEN:SEVERE HOUSING COST BURDEN REPRESENTS HOUSEHOLDS THAT SPEND 50% OR MORE OF THEIR INCOME ON HOUSING COSTS. A SLIGHTLY GREATER PROPORTION OF RENTER HOUSEHOLDS ARE SEVERELY HOUSING COST BURDENED IN ST. MARY MEDICAL CENTER'S TOTAL SERVICE AREA COMPARED TO SAN BERNARDINO COUNTY. ON AVERAGE, ABOUT 31% OF HOUSEHOLDS IN THE TOTAL SERVICE AREA ARE SEVERELY BURDENED BY HOUSING COST. IN THE ""HIGH NEED SERVICE AREA,"" 35% OF RENTER HOUSEHOLDS ARE SEVERELY HOUSING COST BURDENED, COMPARED TO 26% IN THE ""BROADER SERVICE AREA.""HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND MEDICALLY UNDERSERVED AREAS (MUA) & MEDICALLY UNDERSERVED POPULATIONS (MUP):THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA) DEMOGRAPHICS (I.E., LOW-INCOME POPULATION) OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). ST. MARY MEDICAL CENTER IS LOCATED IN A REGION LISTED AS A MEDICAL HEALTH PROFESSIONAL SHORTAGE AREA FOR PRIMARY CARE AND MENTAL HEALTH. MEDICALLY UNDERSERVED AREAS (MUA) AND MEDICALLY UNDERSERVED POPULATIONS (MUP) ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MUA ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL ""UNDER SERVICE."" MUP ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MUA AND MUP ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. THE AREA WEST OF THE HOSPITAL INCLUDING PORTIONS OF VICTORVILLE AND ADELANTO ARE DESIGNATED MUAS, SIGNIFYING THE IMPORTANCE OF ST. MARY MEDICAL CENTER TO THE COMMUNITY IT SERVES. OTHER HOSPITALS IN THE TOTAL SERVICE AREA:OTHER HOSPITAL IN THE COMMUNITY INCLUDE: DESERT VALLEY HOSPITAL AND VICTOR VALLEY GLOBAL MEDICAL CENTER. ST. MARY MEDICAL CENTER IS THE ONLY NON-PROFIT HOSPITAL IN THE ENTIRE HIGH DESERT REGION."

PART VI, LINE 6:
AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE HEALTH CARE FOR EVERYONE REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE TODAY. TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES: - PROVIDENCE ACROSS SEVEN WESTERN STATES - COVENANT HEALTH IN WEST TEXAS - PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA - HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA- KADLEC IN SOUTHEAST WASHINGTON - PACIFIC MEDICAL CENTERS IN SEATTLE, WA. - SWEDISH HEALTH SERVICES IN SEATTLE, WA. 2021 WAS A YEAR MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.