4A (Expenses $ 83421898 including grants of $ 62100) (Revenue $ 101491117)
SAINT THOMAS REGIONAL HOSPITALS operates four hospitals namely, Saint Thomas Stones River Hospital, Saint Thomas DeKalb Hospital, Saint Thomas Highlands Hospital, and Saint Thomas River Park Hospital with a combined total of 184 BEDs PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. During fiscal year 2022, Saint Thomas Regional Hospitals treated 4,350 adults and children for a total of 25,361 patient days of service. The hospital also provided services for 83,337 outpatient visits, which included 3,339 outpatient surgeries and 45,979 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. As part of the Ascension Catholic health ministry, the filing organization served in support of Ascension's commitment to both care for patients and communities and support caregivers and other associates through the challenges of the COVID-19 global pandemic in FY22.

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

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - A1 - Saint Thomas River Park Hospital. IN JULY 2021, SAINT THOMAS RIVER PARK HOSPITAL BEGAN A COMMUNITY HEALTH NEEDS ASSESSMENT FOR WARREN COUNTY AND SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY USING SEVERAL METHODS: - INFORMATION GATHERING, USING SECONDARY PUBLIC HEALTH SOURCES, OCCURRED IN JANUARY 2022. - COMMUNITY MEMBERS PARTICIPATED IN ELEVEN INDIVIDUAL INTERVIEWS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES FROM OCTOBER 21, 2021, THROUGH JANUARY 31, 2022. - A COMMUNITY SURVEY WAS DISTRIBUTED AND 50 RESPONSES WERE COLLECTED FROM OCTOBER 6, 2021, THROUGH JANUARY 31, 2022. - A COMMUNITY STAKEHOLDER GROUP MET ON FEBRUARY 24, 2022, TO PRIORITIZE THE MOST SIGNIFICANT COMMUNITY ISSUES. THE tax year 2021 CHNA WAS CONDUCTED FROM JULY 2021 TO FEBRUARY 2022 AND UTILIZED A DERIVATION OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) PROCESS, WHICH INCORPORATED DATA FROM BOTH PRIMARY AND SECONDARY SOURCES. PRIMARY DATA SOURCES INCLUDED INFORMATION PROVIDED BY GROUPS/INDIVIDUALS, E.G., COMMUNITY RESIDENTS, HEALTH CARE CONSUMERS, HEALTH CARE PROFESSIONALS, COMMUNITY STAKEHOLDERS, AND MULTI-SECTOR REPRESENTATIVES. SPECIAL ATTENTION WAS GIVEN TO THE NEEDS OF INDIVIDUALS AND COMMUNITIES WHO ARE MORE VULNERABLE, AND TO UNMET HEALTH NEEDS OR GAPS IN SERVICES. ELEVEN COMMUNITY STAKEHOLDERS WERE INTERVIEWED INDIVIDUALLY FOR THEIR INSIGHTS ON COMMUNITY HEALTH ISSUES. FIFTY COMMUNITY MEMBERS PARTICIPATED IN AN ONLINE SURVEY FOR THEIR INSIGHTS ON COMMUNITY HEALTH ISSUES AND PRIORITIES. KEY STAKEHOLDER INTERVIEWS AND A LISTENING SESSION WERE CONDUCTED BY STRATASAN (A HEALTHCARE ANALYTICS AND CONSULTING GROUP BASED IN NASHVILLE) IN COLLABORATION WITH SAINT THOMAS STAFF TO GATHER FEEDBACK FROM KEY STAKEHOLDERS ON THE HEALTH NEEDS AND ASSETS OF WARREN COUNTY. ORGANIZATIONS REPRESENTED BY PARTICIPANTS INCLUDED: - TENNESSEE DEPARTMENT OF HEALTH - CHURCH OF GOD OF PROPHECY - CENTERSTONE MENTAL HEALTH - WARREN COUNTY CHAMBER OF COMMERCE - TENNESSEE COMMISSION ON CHILDREN AND FAMILIES - TENNESSEE HOSPITAL ASSOCIATION - END SLAVERY - TENNCARE - AGEWELL - TENNESSEE PUBLIC HEALTH ASSOCIATION

Schedule H, Part V, Section B, Line 5 Facility A, 2
Facility A, 2 - A2 - Saint Thomas DeKalb Hospital. IN JULY 2021, SAINT THOMAS DEKALB HOSPITAL BEGAN A COMMUNITY HEALTH NEEDS ASSESSMENT FOR DEKALB COUNTY AND SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY USING SEVERAL METHODS: -INFORMATION GATHERING, USING SECONDARY PUBLIC HEALTH SOURCES, OCCURRED IN JANUARY 2022. - COMMUNITY MEMBERS PARTICIPATED IN TWELVE INDIVIDUAL INTERVIEWS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES FROM NOVEMBER 1, 2021, THROUGH FEBRUARY 15, 2022. -A COMMUNITY SURVEY WAS DISTRIBUTED AND 91 RESPONSES WERE COLLECTED FROM OCTOBER 6, 2021, THROUGH JANUARY 31, 2022. - A FINAL COMMUNITY PRIORITIZATION SURVEY WAS DISTRIBUTED FROM FEBRUARY 15 THROUGH FEBRUARY 28 AND 97 SURVEYS WERE COMPLETED. KEY STAKEHOLDER INTERVIEWS AND A LISTENING SESSION WERE CONDUCTED BY STRATASAN (A HEALTHCARE ANALYTICS AND CONSULTING GROUP BASED IN NASHVILLE) IN COLLABORATION WITH SAINT THOMAS STAFF TO GATHER FEEDBACK FROM KEY STAKEHOLDERS ON THE HEALTH NEEDS AND ASSETS OF DEKALB COUNTY. ORGANIZATIONS REPRESENTED BY PARTICIPANTS INCLUDED: - TENNESSEE DEPARTMENT OF HEALTH - DEKALB COUNTY SCHOOLS - DEKALB COUNTY SHERIFF'S OFFICE - DEKALB COUNTY LOCAL GOVERNMENT - SAINT THOMAS DEKALB HOSPITAL - TENNESSEE COMMISSION ON CHILDREN AND FAMILIES - TENNESSEE HOSPITAL ASSOCIATION - END SLAVERY - TENNCARE - AGEWELL - TENNESSEE PUBLIC HEALTH ASSOCIATION

Schedule H, Part V, Section B, Line 5 Facility A, 3
Facility A, 3 - A3 - Saint Thomas Highlands Hospital. IN JULY 2021, SAINT THOMAS HIGHLANDS HOSPITAL BEGAN A COMMUNITY HEALTH NEEDS ASSESSMENT FOR WHITE COUNTY AND SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY USING SEVERAL METHODS: -INFORMATION GATHERING, USING SECONDARY PUBLIC HEALTH SOURCES, OCCURRED IN JANUARY 2022. -COMMUNITY MEMBERS PARTICIPATED IN TEN INDIVIDUAL INTERVIEWS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES FROM NOVEMBER 1, 2021, THROUGH FEBRUARY 15, 2022. -A COMMUNITY SURVEY WAS DISTRIBUTED AND 42 RESPONSES WERE COLLECTED FROM OCTOBER 6, 2021, THROUGH JANUARY 31, 2022. -A FINAL COMMUNITY NEED PRIORITIZATION SURVEY WAS DISTRIBUTED FROM FEBRUARY 15 THROUGH FEBRUARY 28, 2022, AND 83 SURVEYS WERE COMPLETED. A SERIES OF TEN ONE-ON-ONE INTERVIEWS WERE CONDUCTED BY STRATASAN IN COLLABORATION WITH SAINT THOMAS STAFF TO GATHER FEEDBACK FROM KEY STAKEHOLDERS ON THE HEALTH NEEDS AND ASSETS OF WHITE COUNTY. TEN REPRESENTATIVES FROM TEN DIFFERENT ORGANIZATIONS AND AGENCIES PARTICIPATED IN THE FOCUS GROUPS, HELD BETWEEN DECEMBER 2021 AND FEBRUARY 2022. SECTORS REPRESENTED BY PARTICIPANTS INCLUDED: -TENNESSEE DEPARTMENT OF HEALTH -WHITE COUNTY SCHOOLS -SAINT THOMAS HIGHLANDS HOSPITAL -WHITE COUNTY HIGH SCHOOL - SCHOOL HEALTH -TENNESSEE COMMISSION ON CHILDREN AND FAMILIES -TENNESSEE HOSPITAL ASSOCIATION -END SLAVERY -TENNCARE -AGEWELL -TENNESSEE PUBLIC HEALTH ASSOCIATION

Schedule H, Part V, Section B, Line 5 Facility A, 4
Facility A, 4 - A4 - SAINT THOMAS STONES RIVER HOSPITAL. IN JULY 2021, SAINT THOMAS STONES RIVER BEGAN A COMMUNITY HEALTH NEEDS ASSESSMENT FOR CANNON COUNTY AND SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY USING SEVERAL METHODS: -INFORMATION GATHERING, USING SECONDARY PUBLIC HEALTH SOURCES, OCCURRED IN JANUARY 2022. - COMMUNITY MEMBERS PARTICIPATED IN THIRTEEN INDIVIDUAL INTERVIEWS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES FROM NOVEMBER 1, 2021, THROUGH FEBRUARY 15, 2022. - A COMMUNITY SURVEY WAS DISTRIBUTED AND 27 RESPONSES WERE COLLECTED FROM OCTOBER 6, 2021, THROUGH FEBRUARY 14, 2022. - A SECOND COMMUNITY SURVEY WAS DISTRIBUTED FROM FEBRUARY 15, 2022, THROUGH FEBRUARY 28, 2022, AND 77 SURVEYS WERE COMPLETED. TWELVE COMMUNITY STAKEHOLDERS WERE INTERVIEWED INDIVIDUALLY FOR THEIR INSIGHTS ON COMMUNITY HEALTH ISSUES. TWENTY-SEVEN COMMUNITY MEMBERS PARTICIPATED IN AN ONLINE SURVEY FOR THEIR INSIGHTS ON COMMUNITY HEALTH ISSUES AND PRIORITIES. AN ADDITIONAL SEVENTY-SEVEN COMMUNITY MEMBERS ASSISTED IN THE PRIORITIZATION OF TOP NEEDS. KEY STAKEHOLDER INTERVIEWS AND A LISTENING SESSION WERE CONDUCTED BY STRATASAN (A HEALTHCARE ANALYTICS AND CONSULTING GROUP BASED IN NASHVILLE) IN COLLABORATION WITH SAINT THOMAS STAFF TO GATHER FEEDBACK FROM KEY STAKEHOLDERS ON THE HEALTH NEEDS AND ASSETS OF CANNON COUNTY. ORGANIZATIONS REPRESENTED BY PARTICIPANTS INCLUDED: - TENNESSEE DEPARTMENT OF HEALTH - CANNON COUNTY SCHOOLS - UNITED WAY OF RUTHERFORD AND CANNON COUNTIES - CANNON COUNTY GOVERNMENT - SAINT THOMAS STONES RIVER HOSPITAL - CHAMBER OF COMMERCE - TENNESSEE COMMISSION ON CHILDREN AND FAMILIES - TENNESSEE HOSPITAL ASSOCIATION - END SLAVERY -TENNCARE - AGEWELL - TENNESSEE PUBLIC HEALTH ASSOCIATION

Schedule H, Part V, Section B, Line 6b Facility A, 1
Facility A, 1 - Facility Reporting Group A (1-4). All four hospitals and Saint Thomas Health conducted a Community Health Needs Assessment (CHNA) collaboratively with Stratasan, a healthcare consulting firm, TENNESSEE DEPARTMENT OF HEALTH, WARREN COUNTY DEPARTMENT OF HEALTH, DEKLB COUNTY DEPARTMENT OF HEALTH, CANNON COUNTY DEPARTMENT OF HEALTH, AND WHITE COUNTY DEPARTMENT OF HEALTH.

Schedule H, Part V, Section B, Line 11 Facility A, 1
"Facility A, 1 - FACILITY REPORTING GROUP A (1-4). FOLLOWING THE COMPLETION OF THE tax year 2021 CHNA ASSESSMENT, SIGNIFICANT NEEDS WERE FURTHER NARROWED DOWN TO A SET OF PRIORITIZED NEEDS THAT THE HOSPITAL WILL ADDRESS WITHIN THE IMPLEMENTATION STRATEGY. TO ARRIVE AT THE PRIORITIZED NEEDS, SAINT THOMAS RIVER PARK, SAINT THOMAS DEKALB, SAINT THOMAS STONES RIVER, AND SAINT THOMAS HIGHLANDS HOSPITAL COLLABORATED WITH THEIR RESPECTIVE COMMUNITY MEMBERS, EITHER BY SURVEY OR IN-PERSON MEETING, TO PRIORITIZE THE TOP 3-4 NEEDS IN THE COMMUNITY. THOSE HOSPITALS IDENTIFIED ADDITIONAL CRITERIA TO PRIORITIZE THE SIGNIFICANT NEEDS INCLUDING: -HEALTH EQUITY LENS AND FRAMEWORK - HAVE DISPARITIES FOR LOW-INCOME AND PEOPLE OF COLOR BEEN IDENTIFIED THROUGH THE CHNA PROCESS? -FEASIBILITY - THE ABILITY TO MAKE PROGRESS AND CAPTURE DATA RELATED TO HEALTH IMPACT. -COMMUNITY READINESS AND MOMENTUM - IS THE COMMUNITY READY TO ADDRESS OR MODIFY INTERVENTIONS TO ADDRESS THE ISSUE? -ALIGNMENT WITH OTHERS - IS THIS NEED IN ALIGNMENT WITH OUR ORGANIZATION'S STRENGTHS? HAS THIS NEED ALSO BEEN IDENTIFIED IN THE COMMUNITY? -SOCIAL DETERMINANTS OF HEALTH FOLLOWING THE COMPLETION OF THE TAX YEAR 2021 CHNA, SAINT THOMAS RIVER PARK HOSPITAL, SAINT THOMAS STONES RIVER HOSPITAL, SAINT THOMAS DEKALB HOSPITAL, AND SAINT THOMAS HIGHLANDS HOSPITAL, HAS SELECTED THE PRIORITIZED NEEDS OUTLINED BELOW FOR ITS TAX YEAR 2021 IMPLEMENTATION STRATEGY. ASCENSION HAS DEFINED ""PRIORITIZED NEEDS'' AS THE SIGNIFICANT NEEDS WHICH HAVE BEEN PRIORITIZED BY THE HOSPITAL TO ADDRESS THROUGH THE THREE-YEAR CHNA CYCLE: ACCESS TO CARE - THIS NEED WAS SELECTED BECAUSE ACCESS TO CARE IS IN ALIGNMENT WITH THE ORGANIZATIONAL STRENGTHS AND PRIORITIES, AND WAS IDENTIFIED AS A TOP PRIORITY BY MOST ASCENSION TENNESSEE MINISTRIES. MENTAL HEALTH - THIS NEED WAS SELECTED BECAUSE MENTAL HEALTH WAS ONE OF THE OVERALL TOP NEEDS IDENTIFIED BY ASCENSION TENNESSEE MINISTRIES DURING THE 2021 CHNA PROCESS. SUBSTANCE MISUSE - THIS NEED WAS SELECTED BECAUSE SUBSTANCE MISUSE WAS ONE OF THE OVERALL TOP NEEDS IDENTIFIED BY ASCENSION TENNESSEE MINISTRIES DURING THE 2021 CHNA PROCESS. SAINT THOMAS RIVER PARK HOSPITAL, SAINT THOMAS STONES RIVER HOSPITAL, SAINT THOMAS DEKALB HOSPITAL, AND SAINT THOMAS HIGHLANDS HOSPITAL UNDERSTAND THE IMPORTANCE OF ALL THE HEALTH NEEDS OF THE COMMUNITY AND IS COMMITTED TO PLAYING AN ACTIVE ROLE IN IMPROVING THE HEALTH OF THE PEOPLE IN THE COMMUNITY'S IT SERVES. FOR THE PURPOSES OF THIS IMPLEMENTATION STRATEGY, SAINT THOMAS RIVER PARK HOSPITAL, SAINT THOMAS STONES RIVER HOSPITAL, SAINT THOMAS DEKALB HOSPITAL, AND SAINT THOMAS HIGHLANDS HOSPITAL HAVE CHOSEN TO FOCUS ITS EFFORTS ON THE PRIORITIES LISTED ABOVE. DURING THE CHNA AND IMPLEMENTATION STRATEGY BRAINSTORMING PHASE ACROSS THE ASCENSION TENNESSEE MINISTRY (8 COUNTIES), COMMUNITY BENEFIT AND HOSPITAL LEADERS AGREED TO A COLLECTIVE IMPACT MODEL TOWARD ADDRESSING NEEDS THAT APPEARED IN MULTIPLE COUNTIES. THIS MODEL IS AN EFFORT TO ALLOCATE RESOURCES IN WAYS THAT CAN MORE MEANINGFULLY IMPACT PRIORITY AREAS. THE 3 NEEDS CHOSEN (ACCESS TO CARE, MENTAL HEALTH, AND SUBSTANCE MISUSE) WERE PRIORITIZED IN 5 OR MORE OF THE (8) COUNTIES SURVEYED. HOWEVER, ADDITIONAL NEEDS AND SOCIAL DRIVERS THAT WERE IDENTIFIED IN EACH COMMUNITY WILL BE MONITORED AND ADDRESSED THROUGH FOCUS PRIORITY AREAS. COMMUNITY STAKEHOLDERS IN WARREN COUNTY DECIDED UPON THE FOLLOWING NEEDS: POVERTY/LOW-INCOME HOUSING, SUBSTANCE MISUSE, MENTAL HEALTH; AND ACCESS TO AFFORDABLE HEALTHCARE AND INSURANCE. COMMUNITY STAKEHOLDERS IN CANNON COUNTY DECIDED UPON THE FOLLOWING NEEDS: HEALTHY LIFESTYLES, SUBSTANCE MISUSE, MENTAL HEALTH; AND ACCESS TO AFFORDABLE HEALTHCARE AND INSURANCE. COMMUNITY STAKEHOLDERS IN DEKALB COUNTY DECIDED UPON THE FOLLOWING NEEDS: POVERTY/LOW-INCOME/UNHOUSE POPULATION, SUBSTANCE MISUSE; MENTAL HEALTH; AND HEALTHY LIFESTYLES. COMMUNITY STAKEHOLDERS IN WHITE COUNTY DECIDED UPON THE FOLLOWING NEEDS: POVERTY/LOW-INCOME HOUSING, SUBSTANCE MISUSE, MENTAL HEALTH; AND ACCESS TO AFFORDABLE HEALTHCARE AND INSURANCE. SAINT THOMAS RIVER PARK HOSPITAL, SAINT THOMAS STONES RIVER HOSPITAL, SAINT THOMAS DEKALB HOSPITAL, AND SAINT THOMAS HIGHLANDS HOSPITAL PLAN TO ADDRESS THESE NEEDS PRIORITIZED IN THE COMMUNITY, WITH PRIORITY GIVEN TO ACCESS TO CARE, MENTAL HEALTH AND SUBSTANCE MISUSE. THE IMPLEMENTATION STRATEGIES FOR THE SAINT THOMAS RIVER PARK HOSPITAL, SAINT THOMAS STONES RIVER HOSPITAL, SAINT THOMAS DEKALB HOSPITAL, AND SAINT THOMAS HIGHLANDS HOSPITAL ARE BASED ON PRIORITIZED NEEDS FROM THE HOSPITAL'S MOST RECENT CHNA. THESE STRATEGIES AND ACTION PLANS REPRESENT WHERE THE HOSPITAL WILL FOCUS ITS COMMUNITY EFFORTS OVER THE NEXT THREE YEARS. WHILE THESE REMAIN A PRIORITY, THE HOSPITALS WILL CONTINUE TO OFFER ADDITIONAL PROGRAMS AND SERVICES TO MEET THE NEEDS OF THE COMMUNITY, WITH SPECIAL ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. FOR FY23-25, THE FOLLOWING STRATEGIES ARE PLANNED FOR SAINT THOMAS RIVER PARK: PRIORITIZED HEALTH NEED: ACCESS TO CARE -INCREASE ACCESS TO CARE THROUGH MOBILE HEALTH -PROVIDE FREE OF LOW-COST PRESCRIPTIONS FOR QUALIFYING UNDERINSURED AND UNINSURED INDIVIDUALS -IMPROVE MATERNAL HEALTH OUTCOMES -IDENTIFY AND ADDRESS BARRIERS TO CARE WITHIN THE COMMUNITY, WITH SPECIAL ATTENTIONS TO PERSONS WHO ARE UNDERSERVED AND/OR MARGINALIZED -ENHANCE COORDINATION AND NAVIGATION OF RESOURCES PRIORITIZED HEALTH NEED: SUBSTANCE MISUSE -INCREASE OPPORTUNITIES FOR PATIENTS TO ENGAGE IN SUBSTANCE USE DISORDER PREVENTION, IDENTIFICATION AND TREATMENT PRIORITIZED HEALTH NEED: MENTAL HEALTH -INTEGRATE MENTAL HEALTH SERVICES, SUPPORT AND/OR EDUCATION INTO DESIGNATED RURAL HEALTH CLINIC AND/OR EMERGENCY DEPARTMENT FOR FY23-25, THE FOLLOWING STRATEGIES ARE PLANNED FOR SAINT THOMAS STONES RIVER: PRIORITIZED HEALTH NEED: ACCESS TO CARE -INCREASE ACCESS TO CARE THROUGH MOBILE HEALTH -IDENTIFY AND ADDRESS BARRIERS TO CARE WITHIN THE COMMUNITY, WITH SPECIAL ATTENTIONS TO PERSONS WHO ARE UNDERSERVED AND/OR MARGINALIZED -ENHANCE COORDINATION AND NAVIGATION OF RESOURCES PRIORITIZED HEALTH NEED: SUBSTANCE MISUSE -INCREASE OPPORTUNITIES FOR PATIENTS TO ENGAGE IN SUBSTANCE USE DISORDER PREVENTION, IDENTIFICATION AND TREATMENT PRIORITIZED HEALTH NEED: MENTAL HEALTH -INTEGRATE MENTAL HEALTH SERVICES, SUPPORT AND/OR EDUCATION INTO DESIGNATED RURAL HEALTH CLINIC AND/OR EMERGENCY DEPARTMENT FOR FY23-25, THE FOLLOWING STRATEGIES ARE PLANNED FOR SAINT THOMAS DEKALB: PRIORITIZED HEALTH NEED: ACCESS TO CARE -INCREASE ACCESS TO CARE THROUGH MOBILE HEALTH -IDENTIFY AND ADDRESS BARRIERS TO CARE WITHIN THE COMMUNITY, WITH SPECIAL ATTENTIONS TO PERSONS WHO ARE UNDERSERVED AND/OR MARGINALIZED -ENHANCE COORDINATION AND NAVIGATION OF RESOURCES PRIORITIZED HEALTH NEED: SUBSTANCE MISUSE -INCREASE OPPORTUNITIES FOR PATIENTS TO ENGAGE IN SUBSTANCE USE DISORDER PREVENTION, IDENTIFICATION AND TREATMENT PRIORITIZED HEALTH NEED: MENTAL HEALTH -INTEGRATE MENTAL HEALTH SERVICES, SUPPORT AND/OR EDUCATION INTO DESIGNATED RURAL HEALTH CLINIC AND/OR EMERGENCY DEPARTMENT FOR FY23-25, THE FOLLOWING STRATEGIES ARE PLANNED FOR SAINT THOMAS HIGHLANDS: PRIORITIZED HEALTH NEED: ACCESS TO CARE -INCREASE ACCESS TO CARE THROUGH MOBILE HEALTH -IDENTIFY AND ADDRESS BARRIERS TO CARE WITHIN THE COMMUNITY, WITH SPECIAL ATTENTIONS TO PERSONS WHO ARE UNDERSERVED AND/OR MARGINALIZED -ENHANCE COORDINATION AND NAVIGATION OF RESOURCES PRIORITIZED HEALTH NEED: SUBSTANCE MISUSE -INCREASE OPPORTUNITIES FOR PATIENTS TO ENGAGE IN SUBSTANCE USE DISORDER PREVENTION, IDENTIFICATION AND TREATMENT PRIORITIZED HEALTH NEED: MENTAL HEALTH -INTEGRATE MENTAL HEALTH SERVICES, SUPPORT AND/OR EDUCATION INTO DESIGNATED RURAL HEALTH CLINIC AND/OR EMERGENCY DEPARTMENT SAINT THOMAS RIVER PARK HOSPITAL, SAINT THOMAS STONES RIVER HOSPITAL, SAINT THOMAS DEKALB HOSPITAL, AND SAINT THOMAS HIGHLANDS HOSPITAL HAVE DEVELOPED A MEASUREMENT AND EVALUATION PROCESS FOR THEIR IMPLEMENTATION STRATEGIES. THE MINISTRY AND 501R COMMITTEE FOR SAINT THOMAS WILL MONITOR AND EVALUATE THE ACTION PLANS OUTLINED IN THIS PLAN FOR THE PURPOSE OF REPORTING AND DOCUMENTING THE IMPACT THESE ACTION PLANS HAVE ON THE COMMUNITY. A TRACKING SYSTEM WILL BE USED TO CAPTURE COMMUNITY BENEFIT ACTIVITIES AND IMPLEMENTATION. TO ENSURE ACCOUNTABILITY, DATA WILL BE AGGREGATED INTO AN ANNUAL COMMUNITY BENEFIT REPORT THAT WILL BE MADE AVAILABLE TO THE COMMUNITY."

Schedule H, Part V, Section B, Line 11 Facility A, 2
Facility A, 2 - A1 - SAINT THOMAS RIVER PARK HOSPITAL. SAINT THOMAS RIVER PARK HOSPITAL'S tax year 2018 CHNA IMPLEMENTATION STRATEGY ADDRESSED THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO CARE MENTAL HEALTH HEALTHY WEIGHT SUBSTANCE MISUSE THE COVID-19 PANDEMIC HAD A PROFOUND IMPACT ON SAINT THOMAS RIVER PARK HOSPITAL'S ABILITY TO CARRY OUT MANY STRATEGIES. LIKE MANY HEALTH SYSTEMS, STAFF CAPACITY SHIFTED IN 2020; WHILE SOME OF OUR STRATEGIES WERE ABLE TO ADAPT, MANY WERE NOT ABLE TO BE IMPLEMENTED OR FULLY COMPLETED. AN IMPORTANT PIECE OF THE THREE-YEAR CHNA CYCLE IS REVISITING THE PROGRESS MADE ON PRIORITY NEEDS SET FORTH IN THE PRECEDING CHNA. BY REVIEWING THE ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT NEEDS AND EVALUATING THE IMPACT THOSE ACTIONS HAVE MADE IN THE COMMUNITY, IT IS POSSIBLE TO BETTER TARGET RESOURCES AND EFFORTS DURING THE NEXT CHNA CYCLE.THE INFORMATION BELOW DESCRIBES THE ACTIONS TAKEN DURING THE tax year 2018 CHNA TO ADDRESS EACH PRIORITY NEED AND INDICATORS OF IMPROVEMENT. PRIORITY NEED: ACCESS TO CARE 1.) GROW THE DISPENSARY OF HOPE TO PROVIDE MEDICATION ASSISTANCE FOR UNINSURED AND UNDERINSURED COMMUNITY MEMBERS. *FY20 NO ACTION STEPS TAKEN. *FY21 ACTION STEPS TAKEN TOWARD OPENING A NEW DISPENSARY OF HOPE DURING SUMMER 2021. *FY22 RIBBON CUTTING ON JULY, 27TH, 2021. MORE THAN 1,000 PRESCRIPTIONS FILLED FOR UNINSURED/UNDERINSURED COMMUNITY MEMBERS. 2.) MAXIMIZE USE OF MOBILE HEALTH UNITS *FY20 EVENTS ON HOLD DUE TO COVID *FY21 MOBILE HEALTH UNITS WERE HEAVILY UTILIZED TO ASSIST WITH COVID VACCINE CLINICS *FY22 REGROUPING MEETING SCHEDULED 3.) PROVIDE IN-KIND RADIOLOGY SERVICES TO COMMUNITY MEMBERS BEING SERVED AT THE BEERSHEBA SPRINGS CLINIC. *FY20 - EVENTS ON HOLD DUE TO COVID *FY21- 40 ENCOUNTERS FOR A TOTAL OF NEARLY $54,000 IN SERVICES FOR UNINSURED/UNDERINSURED COMMUNITY MEMBERS *FY22 - 6 ENCOUNTERS FOR A TOTAL OF NEARLY $13,000 IN SERVICES FOR UNINSURED/UNDERINSURED COMMUNITY MEMBERS 4.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $1,000 FAMILY & CHILDREN'S SERVICE, $960 TENNESSEE JUSTICE CENTER *FY21 $1,250 FAMILY & CHILDREN'S SERVICE, $2,000 TENNESSEE JUSTICE CENTER *FY22 $5,000 MY FATHER'S CLOSET 5.) IMPROVE ACCESS TO CARE VIA TELEMEDICINE CONSULTATIONS, INCLUDING WHEN ACUTE STROKE SYMPTOMS ARE PRESENT *FY20 APPROXIMATELY 140 COMMUNITY MEMBERS WERE ABLE TO USE THIS SERVICE IN THE FIRST TWO QUARTERS OF FY20, RESULTING IN A NET LOSS TO AST OF $1909. DURING THE PANDEMIC, MORE EMPHASIS WAS PLACED ON THE NEED TO REIMBURSE FOR TELEHEALTH VISITS, THUS CHANGING THIS TO A SERVICE THAT IS NOW REIMBURSED. *FY21 NO LONGER COUNTED AS COMMUNITY BENEFIT *FY22 NO LONGER COUNTED AS COMMUNITY BENEFIT PRIORITY NEED: MENTAL HEALTH 1.) INTEGRATE BEHAVIORAL HEALTH SERVICES WITH PRIMARY MEDICAL CARE TO CARE FOR THE BEHAVIORAL AS WELL AS PHYSICAL NEEDS OF UNDERSERVED WARREN COUNTY RESIDENTS. *FY20 NO ACTION STEPS TAKEN *FY21ADDED A BEHAVIORAL HEALTH SCREENING QUESTIONNAIRE TO THE CHECK-IN PROCESS AT OUR SOME PILOT PRIMARY CARE CLINICS AND EMERGENCY DEPARTMENTS TO HELP IDENTIFY POTENTIAL NEEDS. *FY22 MORE THAN 78,000 COMMUNITY MEMBERS IN TENNESSEE HAVE RECEIVED A BEHAVIORAL HEALTH SCREENING SINCE WE BEGAN COLLECTING DATA IN FY21. 2.) EMPOWER VICTIMS OF SEXUAL ASSAULT THROUGH THE PROVISION OF SEXUAL ASSAULT NURSE EXAMINER CARE AND ADVOCACY, ENSURING THAT VICTIMS RECEIVE TRAUMA-INFORMED CARE AND ARE CONNECTED TO APPROPRIATE RESOURCES. *FY20 NONE REPORTED *FY21 10 PATIENTS SERVED *FY22 DATA COLLECTION IS IN PROCESS FOR THIS FISCAL YEAR. 3.) UTILIZE VOLUNTEER CHAPLAINS TO PROVIDE PASTORAL CARE IN THE COMMUNITY. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 4.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $5,000 HAVEN OF HOPE *FY21 $5,600 HAVEN OF HOPE *FY22 $5,600 HAVEN OF HOPE PRIORITY NEED: HEALTHY WEIGHT 1.) IMPLEMENT A HEALTHY FOOD PANTRY WITHIN THE GOOD SAMARITAN CHARITY CARE CLINIC ASSISTING COMMUNITY MEMBERS WITH DIETARY SUPPORT AND CHRONIC-RELATED ISSUES. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 NONE FUNDED *FY21 NONE FUNDED *FY22 NONE FUNDED PRIORITY NEED: SUBSTANCE MISUSE 1.) SUPPORT AND BUILD CAPACITY WITHIN THE FAITH HEALTH TASK FORCE, A GRASSROOTS COMMUNITY COALITION WHOSE GOAL IS TO IMPROVE COMMUNITY HEALTH. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 NONE FUNDED *FY21 NONE FUNDED *FY22 NONE FUNDED

Schedule H, Part V, Section B, Line 11 Facility A, 3
Facility A, 3 - A2 - SAINT THOMAS DEKALB HOSPTAL. SAINT THOMAS DEKALB HOSPITAL'S tax year 2018 CHNA IMPLEMENTATION STRATEGY ADDRESSED THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO CARE MENTAL HEALTH HEALTHY WEIGHT SUBSTANCE MISUSE. THE COVID-19 PANDEMIC HAD A PROFOUND IMPACT ON SAINT THOMAS DEKALB HOSPITAL'S ABILITY TO CARRY OUT MANY STRATEGIES. LIKE MANY HEALTH SYSTEMS, STAFF CAPACITY SHIFTED IN 2020; WHILE SOME OF OUR STRATEGIES WERE ABLE TO ADAPT, MANY WERE NOT ABLE TO BE IMPLEMENTED OR FULLY COMPLETED. AN IMPORTANT PIECE OF THE THREE-YEAR CHNA CYCLE IS REVISITING THE PROGRESS MADE ON PRIORITY NEEDS SET FORTH IN THE PRECEDING CHNA. BY REVIEWING THE ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT NEEDS AND EVALUATING THE IMPACT THOSE ACTIONS HAVE MADE IN THE COMMUNITY, IT IS POSSIBLE TO BETTER TARGET RESOURCES AND EFFORTS DURING THE NEXT CHNA CYCLE.THE INFORMATION BELOW DESCRIBES THE ACTIONS TAKEN DURING THE tax year 2018 CHNA TO ADDRESS EACH PRIORITY NEED AND INDICATORS OF IMPROVEMENT. PRIORITY NEED: ACCESS TO CARE 1.) OPERATE AND INCREASE ACCESS TO SPECIALTY SERVICES, INCLUDING SAINT THOMAS MEDICAL PARTNERS SMITHVILLE HEART CLINIC *FY20 NO PROVIDERS ADDED *FY21 ADDED SEVERAL PROVIDERS WITH SPECIALTIES INCLUDING: OB/GYN, OPTOMETRY, ALLERGIST, CARDIOLOGIST, PODIATRIST *FY22 NO PROVIDERS ADDED 2.) OPERATE AND IMPROVE ACCESS TO MOBILE HEALTH UNITS, INCLUDING MOBILE MAMMOGRAPHY *FY20 NO VISITS TOOK PLACE IN FY20 *FY21 MOBILE UNITS HEAVILY UTILIZED FOR COVID VACCINATION CLINICS IN THE COMMUNITY *FY22 2 MEETINGS HAVE TAKEN PLACE WITH ADMINISTRATORS TO IDENTIFY OPPORTUNITIES FOR MOBILE UNITS WITHIN DEKALB COUNTY 3.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $1,000 FAMILY & CHILDREN'S SERVICE $960 TENNESSEE JUSTICE CENTER *FY21 $1,250 FAMILY & CHILDREN'S SERVICES, $2,000 TENNESSEE JUSTICE CENTER *FY22 NONE FUNDED 4.) IMPROVE ACCESS TO CARE VIA TELEMEDICINE CONSULTATIONS, INCLUDING WHEN ACUTE STROKE SYMPTOMS ARE PRESENT *FY20 APPROXIMATELY 140 COMMUNITY MEMBERS WERE ABLE TO USE THIS SERVICE IN THE FIRST TWO QUARTERS OF FY20, RESULTING IN A NET LOSS TO AST OF $1909. DURING THE PANDEMIC, MORE EMPHASIS WAS PLACED ON THE NEED TO REIMBURSE FOR TELEHEALTH VISITS, THUS CHANGING THIS TO A SERVICE THAT IS NOW REIMBURSED. *FY21 NO LONGER COUNTED AS COMMUNITY BENEFIT *FY22 NO LONGER COUNTED AS COMMUNITY BENEFIT PRIORITY NEED: MENTAL HEALTH 1.) INTEGRATE BEHAVIORAL HEALTH SERVICES WITH PRIMARY MEDICAL CARE TO CARE FOR THE BEHAVIORAL AS WELL AS PHYSICAL NEEDS OF UNDERSERVED DEKALB COUNTY RESIDENTS. *FY20 NO ACTION STEPS TAKEN *FY21ADDED A BEHAVIORAL HEALTH SCREENING QUESTIONNAIRE TO THE CHECK-IN PROCESS AT OUR SOME PILOT PRIMARY CARE CLINICS AND EMERGENCY DEPARTMENTS TO HELP IDENTIFY POTENTIAL NEEDS *FY22 MORE THAN 78,000 COMMUNITY MEMBERS IN TENNESSEE HAVE RECEIVED A BEHAVIORAL HEALTH SCREENING SINCE WE BEGAN COLLECTING DATA IN FY21 3.) EMPOWER VICTIMS OF SEXUAL ASSAULT THROUGH THE PROVISION OF SEXUAL ASSAULT NURSE EXAMINER CARE AND ADVOCACY, ENSURING THAT VICTIMS RECEIVE TRAUMA-INFORMED CARE AND ARE CONNECTED TO APPROPRIATE RESOURCES. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 4.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $17,500 HAVEN OF HOPE *FY21$19,600 HAVEN OF HOPE *FY22 $19,600 HAVEN OF HOPE PRIORITY NEED: HEALTHY WEIGHT 1.) EXPLORE CREATION OF COMMUNITY GARDENS AND INCREASE EDUCATION OPPORTUNITIES REGARDING HEALTHY EATING AND ACTIVE LIVING. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 NONE FUNDED *FY21 NONE FUNDED *FY22 NONE FUNDED PRIORITY NEED: SUBSTANCE MISUSE 1.) SUPPORT AND BUILD CAPACITY WITHIN THE FAITH HEALTH TASK FORCE, A GRASSROOTS COMMUNITY COALITION WHOSE GOAL IS TO IMPROVE COMMUNITY HEALTH. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 NOT STARTED *FY21NONE FUNDED *FY22 NONE FUNDED

Schedule H, Part V, Section B, Line 11 Facility A, 4
Facility A, 4 - A3 - SAINT THOMAS HIGHLANDS HOSPITAL. SAINT THOMAS HIGHLANDS HOSPITAL'S tax year 2018 CHNA IMPLEMENTATION STRATEGY ADDRESSED THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO CARE MENTAL HEALTH HEALTHY WEIGHT SUBSTANCE MISUSE THE COVID-19 PANDEMIC HAD A PROFOUND IMPACT ON SAINT THOMAS HIGHLANDS HOSPITAL'S ABILITY TO CARRY OUT MANY STRATEGIES. LIKE MANY HEALTH SYSTEMS, STAFF CAPACITY SHIFTED IN 2020; WHILE SOME OF OUR STRATEGIES WERE ABLE TO ADAPT, MANY WERE NOT ABLE TO BE IMPLEMENTED OR FULLY COMPLETED. AN IMPORTANT PIECE OF THE THREE-YEAR CHNA CYCLE IS REVISITING THE PROGRESS MADE ON PRIORITY NEEDS SET FORTH IN THE PRECEDING CHNA. BY REVIEWING THE ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT NEEDS AND EVALUATING THE IMPACT THOSE ACTIONS HAVE MADE IN THE COMMUNITY, IT IS POSSIBLE TO BETTER TARGET RESOURCES AND EFFORTS DURING THE NEXT CHNA CYCLE.THE INFORMATION BELOW DESCRIBES THE ACTIONS TAKEN DURING THE tax year 2018 CHNA TO ADDRESS EACH PRIORITY NEED AND INDICATORS OF IMPROVEMENT. PRIORITY NEED: ACCESS TO CARE 1.) IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES. *FY20 NO ACTION STEPS TAKEN *FY21 EXPANDED VIRTUAL AND SAME-DAY SERVICES. ADDED PROVIDERS OF THE FOLLOWING SPECIALTIES: PRIMARY CARE, PSYCHIATRY, CARDIOLOGY *FY22 NO FURTHER ADDITIONS NOTED 2.) MAXIMIZE USE OF MOBILE HEALTH UNITS *FY20 EVENTS ON HOLD DUE TO COVID *FY21 EVENTS ON HOLD DUE TO COVID *FY22 PLANNING MEETINGS HAVE RESUMED TO IDENTIFY OPPORTUNITIES TO UTILIZE MOBILE HEALTH UNITS 3.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $1,000 FAMILY & CHILDREN'S SERVICE, $960 TENNESSEE JUSTICE CENTER *FY21 $1,250 FAMILY & CHILDREN'S SERVICE, $2,000 TENNESSEE JUSTICE CENTER *FY22 $10,000 WHITE COUNTY SCHOOLS 4.) IMPROVE ACCESS TO CARE VIA TELEMEDICINE CONSULTATIONS, INCLUDING WHEN ACUTE STROKE SYMPTOMS ARE PRESENT *FY20 APPROXIMATELY 140 COMMUNITY MEMBERS WERE ABLE TO USE THIS SERVICE IN THE FIRST TWO QUARTERS OF FY20, RESULTING IN A NET LOSS TO AST OF $1909. DURING THE PANDEMIC, MORE EMPHASIS WAS PLACED ON THE NEED TO REIMBURSE FOR TELEHEALTH VISITS, THUS CHANGING THIS TO A SERVICE THAT IS NOW REIMBURSED. *FY21 NO LONGER COUNTED AS COMMUNITY BENEFIT *FY22 NO LONGER COUNTED AS COMMUNITY BENEFIT PRIORITY NEED: MENTAL HEALTH 1.) INTEGRATE BEHAVIORAL HEALTH SERVICES WITH PRIMARY MEDICAL CARE TO CARE FOR THE BEHAVIORAL AS WELL AS PHYSICAL NEEDS OF UNDERSERVED WHITE COUNTY RESIDENTS. *FY20 NO ACTION STEPS TAKEN *FY21 ADDED A BEHAVIORAL HEALTH SCREENING QUESTIONNAIRE TO THE CHECK-IN PROCESS AT OUR SOME PILOT PRIMARY CARE CLINICS AND EMERGENCY DEPARTMENTS TO HELP IDENTIFY POTENTIAL NEEDS *FY22 MORE THAN 78,000 COMMUNITY MEMBERS IN TENNESSEE HAVE RECEIVED A BEHAVIORAL HEALTH SCREENING SINCE WE BEGAN COLLECTING DATA IN FY21 2.) PROVIDE COMMUNITY SUPPORT FOR THOSE SUFFERING FROM ALZHEIMER'S DISEASE BY HOSTING ALZHEIMER'S SUPPORT GROUP. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 3.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $1,500 HAVEN OF HOPE *FY21 $1,700 HAVEN OF HOPE *FY22 $1,700 HAVEN OF HOPE PRIORITY NEED: HEALTHY WEIGHT 1.) EXPLORE OPPORTUNITIES TO INCREASE ACTIVE LIVING AND HEALTHY EATING. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $3,000 SECOND HARVEST FOOD BANK MOBILE PANTRY *FY21$6,000 SECOND HARVEST FOOD BANK MOBILE PANTRY *FY22 $6,000 SECOND HARVEST FOOD BANK MOBILE PANTRY PRIORITY NEED: SUBSTANCE MISUSE 1.) EXPLORE AND ENHANCE EXISTING RESOURCES AND MOBILIZATIONS IN THE COMMUNITY RELATED TO SUBSTANCE MISUSE. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 NONE FUNDED *FY21 NONE FUNDED *FY22 NONE FUNDED

Schedule H, Part V, Section B, Line 11 Facility A, 5
Facility A, 5 - A4- SAINT THOMAS STONES RIVER HOSPITAL. SAINT THOMAS STONES RIVER HOSPITAL'S tax year 2018 CHNA IMPLEMENTATION STRATEGY ADDRESSED THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO CARE MENTAL HEALTH HEALTHY WEIGHT SUBSTANCE MISUSE THE COVID-19 PANDEMIC HAD A PROFOUND IMPACT ON SAINT THOMAS STONES RIVER HOSPITAL'S ABILITY TO CARRY OUT MANY STRATEGIES. LIKE MANY HEALTH SYSTEMS, STAFF CAPACITY SHIFTED IN 2020; WHILE SOME OF OUR STRATEGIES WERE ABLE TO ADAPT, MANY WERE NOT ABLE TO BE IMPLEMENTED OR FULLY COMPLETED. AN IMPORTANT PIECE OF THE THREE-YEAR CHNA CYCLE IS REVISITING THE PROGRESS MADE ON PRIORITY NEEDS SET FORTH IN THE PRECEDING CHNA. BY REVIEWING THE ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT NEEDS AND EVALUATING THE IMPACT THOSE ACTIONS HAVE MADE IN THE COMMUNITY, IT IS POSSIBLE TO BETTER TARGET RESOURCES AND EFFORTS DURING THE NEXT CHNA CYCLE.THE INFORMATION BELOW DESCRIBES THE ACTIONS TAKEN DURING THE tax year 2018 CHNA TO ADDRESS EACH PRIORITY NEED AND INDICATORS OF IMPROVEMENT. PRIORITY NEED: ACCESS TO CARE 1.) MAXIMIZE USE OF MOBILE HEALTH UNITS *FY20 COMMUNITY EVENTS ON HOLD DUE TO COVID *FY21 COMMUNITY EVENTS ON HOLD DUE TO COVID *FY22 PLANNING MEETINGS HAVE RESUMED TO IDENTIFY OPPORTUNITIES TO UTILIZE MOBILE HEALTH UNITS 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $1,000 FAMILY & CHILDREN'S SERVICE *FY21 $1,250 FAMILY & CHILDREN'S SERVICE *FY22 NONE FUNDED 3.) IMPROVE ACCESS TO CARE VIA TELEMEDICINE CONSULTATIONS, INCLUDING WHEN ACUTE STROKE SYMPTOMS ARE PRESENT. *FY20 APPROXIMATELY 140 COMMUNITY MEMBERS WERE ABLE TO USE THIS SERVICE IN THE FIRST TWO QUARTERS OF FY20, RESULTING IN A NET LOSS TO AST OF $1,909. DURING THE PANDEMIC, MORE EMPHASIS WAS PLACED ON THE NEED TO REIMBURSE FOR TELEHEALTH VISITS, THUS CHANGING THIS TO A SERVICE THAT IS NOW REIMBURSED. *FY21 NO LONGER COUNTED AS COMMUNITY BENEFIT *FY22 NO LONGER COUNTED AS COMMUNITY BENEFIT PRIORITY NEED: MENTAL HEALTH 1.) INTEGRATE BEHAVIORAL HEALTH SERVICES WITH PRIMARY MEDICAL CARE TO CARE FOR THE BEHAVIORAL AS WELL AS PHYSICAL NEEDS OF UNDERSERVED CANNON COUNTY RESIDENTS. *FY20 NO ACTION STEPS TAKEN *FY21 ADDED A BEHAVIORAL HEALTH SCREENING QUESTIONNAIRE TO THE CHECK-IN PROCESS AT OUR SOME PILOT PRIMARY CARE CLINICS AND EMERGENCY DEPARTMENTS TO HELP IDENTIFY POTENTIAL NEEDS *FY22 MORE THAN 78,000 COMMUNITY MEMBERS IN TENNESSEE HAVE RECEIVED A BEHAVIORAL HEALTH SCREENING SINCE WE BEGAN COLLECTING DATA IN FY21 2.) EMPOWER VICTIMS OF SEXUAL ASSAULT THROUGH THE PROVISION OF SEXUAL ASSAULT NURSE EXAMINER CARE AND ADVOCACY, ENSURING THAT VICTIMS RECEIVE TRAUMA-INFORMED CARE AND ARE CONNECTED TO APPROPRIATE RESOURCES. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 3.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $5,000 HAVEN OF HOPE *FY21 $1,100 HAVEN OF HOPE *FY22 $1,000 HAVEN OF HOPE PRIORITY NEED: HEALTHY WEIGHT 1.) EXPLORE OPPORTUNITIES TO INCREASE ACTIVE LIVING AND HEALTHY EATING, INCLUDING EDUCATIONAL OPPORTUNITIES WITH CANNON COUNTY SCHOOLS. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 $3,000 SECOND HARVEST FOOD BANK MOBILE PANTRY *FY21 $6,000 SECOND HARVEST FOOD BANK MOBILE PANTRY *FY22 $6,000 SECOND HARVEST FOOD BANK MOBILE PANTRY PRIORITY NEED: SUBSTANCE MISUSE 1.) INCREASE KNOWLEDGE, AWARENESS AND PARTICIPATION AROUND SUBSTANCE ABUSE. *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 2.) PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS. *FY20 NONE FUNDED *FY21NONE FUNDED *FY22 NONE FUNDED

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

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

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

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2022 was $10,574,102 at charges, ($2,038,042 at cost).

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

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

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

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

Schedule H, Part V, Section B, Line 16a FAP website
A - Saint Thomas River Park Hospital: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - Saint Thomas River Park Hospital: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - Saint Thomas River Park Hospital: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part VI, Line 2 Needs assessment
Saint Thomas Regional Hospitals, represented as Saint Thomas DeKalb Hospital, LLC d/b/a Ascension Saint Thomas DeKalb, Saint Thomas Highlands Hospital, LLC d/b/a Ascension Saint Thomas Highlands, Saint Thomas River Park Hospital, LLC d/b/a Ascension Saint Thomas River Park and Saint Thomas Stones River Hospital, LLC d/b/a Ascension Saint Thomas Stones River, use several internal databases and external reports from third parties, including government sources, to assess the healthcare needs of the communities served. The information provides key indicators about health, socioeconomic status, disparities, and other demographics that identify areas of focus and inform our strategies. These reports include, but are not limited to: -Local Government Planning Departments -US Census Bureau -Sg2 healthcare intelligence -Healthcare claims datasets -State datasets -CMS -Internal data sets -ACO, physician supply, and aligned Health Partnerships Saint Thomas Regional Hospitals utilizes information from these sources to develop programs and provide appropriate services needed throughout the region. In addition, Saint Thomas Health d/b/a Ascension Saint Thomas considers the health care needs of the overall community when evaluating internal financial and operational decisions.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
SAINT THOMAS REGIONAL HOSPITALS ARE COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SAINT THOMAS REGIONAL HOSPITAL'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; SAINT THOMAS REGIONAL HOSPITAL PROVIDES FULL FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 250% OF THE FEDERAL POVERTY LEVEL AND SLIDING SCALE ASSISTANCE UP TO 400% OF THE FEDERAL POVERTY LEVEL. SAINT THOMAS REGIONAL HOSPITALS WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE - https://healthcare.ascension.org/financial-assistance/tennessee SAINT THOMAS REGIONAL HOSPITALS MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. SAINT THOMAS REGIONAL HOSPITALS INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. SAINT THOMAS REGIONAL HOSPITALS INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 4 Community information
Saint Thomas Regional Hospitals serves a primary service area (PSA) of five counties with 77.7% of the hospitals' annual admissions originating from these counties. The PSA has approximately 459,584K residents and is projected to grow by 6.8% over the next five years. Median age in the PSA is 36.3. Projected five-year median age is 37.8. In the PSA, the 18-44 age range is projected to grow by 3.8% and the 65+ age range is projected to grow by 23.3% over the next five years. PSA median household income is $69,774. Within the five-county primary service area, there are two counties designated as a medically underserved population and two counties designated as a medically underserved area. There are three other acute care hospitals located within the primary service area.

Schedule H, Part VI, Line 5 Promotion of community health
Saint Thomas Regional Hospitals is governed by the Ascension Saint Thomas Board of Directors and consists of persons representing diverse aspects and interests of the community. Many members of Ascension Saint Thomas' governing body reside in the organization's primary service area and who are neither employees nor independent contractors of the organization, nor family members thereof. Saint Thomas Regional Hospitals extends medical staff privileges to all qualified physicians in their communities for some or all of its departments or specialties. Saint Thomas Regional Hospitals applied surplus funds for improvements in patient care with over $7.9M invested back into patient care projects in FY22. Additionally, these facilities support ongoing medical education to physicians and other patient care providers. Finally, Saint Thomas Regional Hospitals provided over $15.2M in care to the poor in FY22 through its affiliated clinics operations and hospital programs.

Schedule H, Part VI, Line 6 Affiliated health care system
Saint Thomas Regional HospitalsIS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. Saint Thomas Regional Hospitals operate facilities in Middle Tennessee and are part of Saint Thomas Health d/b/a Ascension Saint Thomas which owns and operates health care related entities, including 12 hospital campuses, in addition to a comprehensive network of affiliated joint ventures, medical practices, clinics and rehabilitation facilities across Middle Tennessee.