4A (Expenses $ 13457335 including grants of $ 0) (Revenue $ 16204660)
Saint Thomas Hickman Hospital is a 48-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2022, Saint Thomas Hickman Hospital treated 119 adults and children for a total of 10,235 patient days of service. The hospital also provided services for 26,330 outpatient visits, including 4,546 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. As part of the Ascension Catholic health ministry, the filing organization served in support of Ascension's commitment to both care for patients and communities and support caregivers and other associates through the challenges of the COVID-19 global pandemic in FY22.

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

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - Saint Thomas Hickman Hospital. IN JULY 2021, SAINT THOMAS HICKMAN HOSPITAL BEGAN A COMMUNITY HEALTH NEEDS ASSESSMENT FOR HICKMAN COUNTY AND SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY USING SEVERAL METHODS: -COMMUNITY MEMBERS PARTICIPATED IN TWELVE INDIVIDUAL INTERVIEWS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES FROM OCTOBER 21, 2021 THROUGH NOVEMBER 30, 2001. -A COMMUNITY SURVEY WAS DISTRIBUTED AND 114 RESPONSES WERE COLLECTED FROM OCTOBER 6, 2021 THROUGH NOVEMBER 15, 2021. -HICKMAN COUNTY HEALTH COUNCIL MEETINGS WERE HELD ON THE FOLLOWING DATES: *OCTOBER 6, 2021 - REVIEW THE SECONDARY DATA AND RECEIVE LINK TO COMMUNITY SURVEYS *NOVEMBER 3, 2021 - ASK QUESTIONS ABOUT THE SECONDARY DATA AND RECEIVE UPDATE ON SURVEY RESPONSES AND INTERVIEW PROGRESS *DECEMBER 1, 2021 - REVIEW THE INTERVIEW SUMMARY AND COMMUNITY SURVEY SUMMARY *FEBRUARY 2, 2022 - DETERMINE AND PRIORITIZE THE MOST SIGNIFICANT HEALTH NEEDS IN THE COUNTY RECOGNIZING ITS VITAL IMPORTANCE IN UNDERSTANDING THE HEALTH NEEDS AND ASSETS OF THE COMMUNITY, STRATASAN CONSULTED WITH A RANGE OF PUBLIC HEALTH AND SOCIAL SERVICE PROVIDERS THAT REPRESENT THE BROAD INTEREST OF HICKMAN COUNTY. A CONCERTED EFFORT WAS MADE TO ENSURE THAT THE INDIVIDUALS AND ORGANIZATIONS REPRESENTED THE NEEDS AND PERSPECTIVES OF: 1) PUBLIC HEALTH PRACTICE AND RESEARCH; 2) INDIVIDUALS WHO ARE MEDICALLY UNDERSERVED, ARE LOW-INCOME, OR CONSIDERED AMONG THE MINORITY POPULATIONS SERVED BY THE HOSPITAL; AND 3) THE BROADER COMMUNITY AT LARGE AND THOSE WHO REPRESENT THE BROAD INTERESTS AND NEEDS OF THE COMMUNITY SERVED. MULTIPLE METHODS WERE USED TO GATHER COMMUNITY INPUT, INCLUDING KEY STAKEHOLDER INTERVIEWS, COMMUNITY SURVEY AND COLLABORATION WITH THE HICKMAN COUNTY HEALTH COUNCIL. THESE METHODS PROVIDED ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING HICKMAN COUNTY. A SUMMARY OF THE PROCESS AND RESULTS IS OUTLINED BELOW.THE HEALTH EDUCATOR, HICKMAN & PERRY COUNTY HEALTH DEPARTMENTS IS CHAIRPERSON OF THE HICKMAN COUNTY HEALTH COUNCIL WHICH COORDINATED THE CHNA PROCESS. ADDITIONALLY MONTHLY MEETINGS WERE HELD WITH THE HEALTH EDUCATOR AND THE PUBLIC HEALTH PROGRAM DIRECTOR FOR THE SOUTH-CENTRAL REGIONAL HEALTH OFFICE TO COORDINATE ACTIVITIES BETWEEN THE HEALTH COUNCIL MEETINGS. THESE INDIVIDUALS WERE INSTRUMENTAL IN PROVIDING GUIDANCE, ASSISTANCE AND KNOWLEDGE TO THE COMMUNITY HEALTH IMPROVEMENT PROCESS. THE HICKMAN COUNTY HEALTH COUNCIL IS COMPRISED OF 85 MEMBERS REPRESENTING CHILD ADVOCACY, SCHOOLS, INSURANCE PAYERS, PROVIDERS (HEALTH DEPARTMENT, HOSPITALS, MENTAL HEALTH PROVIDERS, COUNSELORS, PHYSICIANS), EMPLOYERS, BUSINESSES, PASTORS, DOMESTIC VIOLENCE, YOUTH AND FAMILY DEVELOPMENT AGENCIES, UT EXTENSION SERVICES, NEWSPAPER, ECONOMIC AND COMMUNITY DEVELOPMENT, DRUG PREVENTION, AND LOCAL GOVERNMENT. TWELVE COMMUNITY MEMBERS WERE INTERVIEWED. THOSE SELECTED WERE CHOSEN BASED ON THEIR KNOWLEDGE OF HICKMAN COUNTY AND ITS HEALTH NEEDS. THE HOSPITAL AND HEALTH DEPARTMENT RECOMMENDED THE INTERVIEWEES WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY. THE INTERVIEWEES INCLUDED TENNESSEE DEPARTMENT OF HEALTH, CENTERVILLE CHURCH OF CHRIST, HICKMAN COUNTY COORDINATED SCHOOLS, HICKMAN COUNTY SENIOR CENTER, HICKMAN COUNTY COURT, HICKMAN HEALTH COUNCIL & UT EXTENSION, SOUTH CENTRAL HUMAN RESOURCE AGENCY-HEADSTART, SCHOOL SYSTEM AWARE PROGRAM, EMERGENCY MEDICAL SYSTEM, ECONOMIC AND COMMUNITY DEVELOPMENT, HICKMAN COUNTY GOVERNMENT AND HICKMAN COUNTY TIMES. THE ONLINE SURVEY WAS DISTRIBUTED THROUGH THE HICKMAN COUNTY HEALTH COUNCIL WHICH REPRESENTS A VERY BROAD SWATHE OF THE COMMUNITY REPRESENTING 46 DIFFERENT AGENCIES AND ORGANIZATIONS. SURVEYS WERE ALSO DISTRIBUTED TO THE PEOPLE WHO WERE INTERVIEWED TO ENCOURAGE LARGER REPRESENTATION FROM THE COMMUNITY. MANY OF THE INTERVIEWEES WERE SELECTED BECAUSE THEY REPRESENTED THE MEDICALLY UNDERSERVED, UNINSURED AND MINORITY POPULATIONS. SINCE THE ONLINE SURVEY WAS DISTRIBUTED THROUGH THE HICKMAN COUNTY HEALTH COUNCIL, THE MEDICALLY UNDERSERVED AND UNINSURED WERE TARGETED AS WELL AS THE GENERAL POPULATION.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - Saint Thomas Hickman Hospital. The Tax year 2021 CHNA WAS CONDUCTED IN PARTNERSHIP WITH THE TENNESSEE DEPARTMENT OF HEALTH, HICKMAN COUNTY HEALTH DEPARTMENT, AND THE HICKMAN COUNTY HEALTH COUNCIL.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - SAINT THOMAS HICKMAN HOSPITAL (Part I of II). SAINT THOMAS HICKMAN HOSPITAL'S tax year 2018 CHNA IMPLEMENTATION STRATEGY ADDRESSED THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO CARE MENTAL HEALTH HEALTHY WEIGHT SUBSTANCE MISUSE THE INFORMATION BELOW DESCRIBES THE ACTIONS TAKEN DURING THE tax year 2018 CHNA TO ADDRESS EACH PRIORITY NEED AND INDICATORS OF IMPROVEMENT. THE COVID-19 PANDEMIC HAD A PROFOUND IMPACT ON SAINT THOMAS HICKMAN 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. PRIORITY NEED: ACCESS TO CARE 1. GROW THE DISPENSARY OF HOPE TO PROVIDE MEDICATION ASSISTANCE FOR UNINSURED AND UNDERINSURED COMMUNITY MEMBERS *FY20 1,356 PERSONS SERVED, 4,450 PATIENT ENCOUNTERS, 5,983 PRESCRIPTIONS FILLED FOR A TOTAL MONETARY INVESTMENT OF $274,825 *FY21 1,394 PERSONS SERVED, 4,468 PATIENT ENCOUNTERS, 5,270 PRESCRIPTIONS FILLED FOR A TOTAL MONETARY INVESTMENT OF $282,929 *FY 22 675 PERSONS SERVED, 2,171 PATIENT ENCOUNTERS, 2,773 PRESCRIPTIONS FILLED FOR A TOTAL MONETARY INVESTMENT OF $120,921 2. PROVIDE RESOURCE NAVIGATION, INCLUDING HEALTH INSURANCE ENROLLMENT AND ASSISTANCE UNDERSTANDING COVERAGE AND CONNECTING WITH RESOURCES TO SUPPORT SOCIAL DETERMINANTS OF HEALTH *FY20 654 ENCOUNTERS *FY21 541 ENCOUNTERS *FY22 200+ ENCOUNTERS 3. MAXIMIZE USE OF MOBILE HEALTH UNITS *FY20 EVENTS ON HOLD DUE TO COVID *FY21 11 VISITS TO HICKMAN COUNTY WHERE 4 UNINSURED WOMEN RECEIVED MAMMOGRAMS *FY22 2 VISITS TO HICKMAN COUNTY SO FAR THIS YEAR. 3 UNINSURED WOMEN HAVE RECEIVED MAMMOGRAMS 4. ADDRESS TRANSPORTATION CONCERNS BY PARTNERING WITH SOUTH CENTRAL AREA TRANSIT SERVICE (SCATS) *FY20 724 RIDES REPORTED *FY 21 1397 RIDES REPORTED *FY22 MORE THAN 1700 RIDES REPORTED 5. 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, $2,000 TENNESSEE JUSTICE CENTER *FY22 NONE FUNDED 6. 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 7. 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 PRIORITY NEED: MENTAL HEALTH 1. OFFER EMOTIONAL SUPPORT THROUGH THE HOSTING OF A SUPPORT GROUP FOR THOSE IN THE ROLE OF CARING (OR SUPPORTING THOSE WHO ARE CARING) FOR SOMEONE WITH ALZHEIMER'S DISEASE OR ANY CHRONIC MEDICAL CONDITION *FY20 IN-PERSON MEETINGS WERE PAUSED IN FY20 DUE TO COVID-19 AND WILL RESUME WHEN SAFE TO DO SO *FY21THE GROUP HAS STARTED TO MEET VIRTUALLY *FY22 DATA IS STILL BEING COLLECTED FOR THIS YEAR 2. PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS *FY20 $4,000 WOMEN ARE SAFE *FY21 NONE FUNDED *FY22 NONE FUNDED 3. INTEGRATE BEHAVIORAL HEALTH SERVICES WITH PRIMARY MEDICAL CARE TO CARE FOR THE BEHAVIORAL AS WELL AS PHYSICAL NEEDS OF UNDERSERVED HICKMAN 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 4. EDUCATE HOSPITAL AND ER STAFF ON SUICIDE PREVENTION AND WARNING SIGNS THROUGH ZERO SUICIDE INITIATIVE *FY20 NO ACTIONS TAKEN *FY21 ER STAFF HAS BEEN CONNECTED TO MATERIALS/INFORMATION FROM TN SUICIDE PREVENTION NETWORK; CONTINUE TO EMBED STAFF INTO TN SUICIDE PREVENTION NETWORK *FY22 NO FURTHER ACTIONS TAKEN 5. IMPROVE COMMUNITY KNOWLEDGE OF WELLNESS AND DISEASE PREVENTION BY OFFERING A SERIES OF EDUCATIONAL COURSES, APPROACHING BOTH THE PHYSICAL AND MENTAL ASPECTS OF PRIORITY HEALTH AREAS IN HICKMAN COUNTY *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN PRIORITY NEED: HEALTHY WEIGHT 1. PROVIDE FOOD BOXES, SENSITIVE TO CHRONIC CONDITIONS, TO COMMUNITY MEMBERS WHO ARE EXPERIENCING FOOD INSECURITY *FY20 273 FOOD BOXES DISTRIBUTED TO COMMUNITY MEMBERS IN NEED *FY21 175 FOOD BOXES DISTRIBUTED TO COMMUNITY MEMBERS IN NEEd *FY22 DUE TO STAFFING CHANGES WE DO NOT HAVE DATA FOR THE CURRENT FISCAL YEAR BUT WILL WORK TO COLLECT IT BEFORE THE END OF THE YEAR. 2. PROVIDE COMMUNITY-BASED ORGANIZATIONS WITH FINANCIAL SUPPORT TOWARD THEIR WORK IN ONE OF THE PRIORITIZED NEED AREAS *FY20 NONE FUNDED *FY21 $5,000 NUNNELLY COMMUNITY CENTER WALKING TRACK, $8,750, INSPIRITUS *FY22 NONE FUNDED 3. PROVIDE CPR/FIRST AID CLASSES FOR HICKMAN COUNTY SCHOOLS FACULTY AND STAFF *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN 4. IMPROVE COMMUNITY KNOWLEDGE OF WELLNESS AND DISEASE PREVENTION BY OFFERING A SERIES OF EDUCATIONAL COURSES, APPROACHING BOTH THE PHYSICAL AND MENTAL ASPECTS OF PRIORITY HEALTH AREAS IN HICKMAN COUNTY *FY20 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN PRIORITY NEED: SUBSTANCE MISUSE 1. INTEGRATE AND DEVELOP PARTNERSHIP WITH BUFFALO VALLEY, INC. BY OFFERING SUBSTANCE MISUSE SERVICES TO COMMUNITY MEMBERS WHO ARE SUFFERING FROM ADDICTION *FY20 PARTNERSHIP INITIATED AND DEVELOPED WITH BUFFALO VALLEY INC - COVID DELAYS *FY21 SEARCHING TO HIRE A LCSW *FY22 CONTINUE TO SEARCH TO HIRE A LCSW 2. IDENTIFY VULNERABLE POPULATIONS AT RISK FOR OPIOID MISUSE AT ER AND RHC AND PROVIDE RESOURCES FOR PREVENTION, SUPPORT AND TREATMENT *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 NO ACTION STEPS TAKEN *FY21 NO ACTION STEPS TAKEN *FY22 NO ACTION STEPS TAKEN

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - SAINT THOMAS HICKMAN HOSPITAL - PART II OF II. FOLLOWING THE COMPLETION OF THE TAX YEAR 2021 COMMUNITY HEALTH NEEDS ASSESSMENT, SAINT THOMAS HICKMAN HOSPITAL IN COLLABORATION WITH THE HICKMAN COUNTY HEALTH COUNCIL HAS SELECTED THE PRIORITIZED NEEDS OUTLINED BELOW FOR ITS tax year 2021 CHNA IMPLEMENTATION STRATEGY: ACCESS TO CARE MENTAL HEALTH SUBSTANCE MISUSE SAINT THOMAS HICKMAN HOSPITAL UNDERSTANDS 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. THE IMPLEMENTATION STRATEGIES BELOW 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 HOSPITAL 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. PRIORITIZED HEALTH NEED: ACCESS TO CARE -PROVIDE HEALTH INSURANCE ENROLLMENT AND NAVIGATION ASSISTANCE TO COMMUNITY MEMBERS WHO ARE UNINSURED OR UNDERINSURED -BUILDING AND REFINING PIPELINE PROGRAMS TO SUPPORT HEALTHCARE KNOWLEDGE BASE -INCREASE ACCESS TO CARE THROUGH MOBILE HEALTH -PROVIDE FREE OR LOW-COST PRESCRIPTIONS FOR QUALIFYING UNDERINSURED AND UNINSURED INDIVIDUALS -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 HICKMAN HOSPITAL WILL DEVELOP A COMPREHENSIVE MEASUREMENT AND EVALUATION PROCESS FOR THE IMPLEMENTATION STRATEGY. THE MINISTRY 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. SAINT THOMAS HICKMAN HOSPITAL USES A TRACKING SYSTEM 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. Saint Thomas Hickman Hospital will be addressing all prioritized health needs that have been identified for Ascension Tennessee.

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 $2,318,790 at charges, ($1,113,019 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 HICKMAN HOSPITAL 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
- Saint Thomas Hickman Hospital: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;

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

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

Schedule H, Part VI, Line 4 Community information
Saint Thomas Hickman Hospital, serves one county in its primary service area with 82.1% of the hospital's annual admissions coming from Hickman County. The PSA has approximately 25,750 residents and is projected to grow by 3.9% over the next five years. Median age in the PSA is 41.9, the projected five-year median age is 42.6. In the PSA, the 18-44 age range is projected to grow by 3.3% and the 65+ age range is projected to grow by 16.8% over the next five years. PSA median household income is $50,997. Hickman County is designated as a medically underserved area. There are no other acute care hospitals located within the primary service area.

Schedule H, Part VI, Line 5 Promotion of community health
Saint Thomas Hickman Hospital governing body consists of persons representing diverse aspects and interests of the community. Many members of Saint Thomas Hickman Hospital's governing body reside in the primary service area and who are neither employees nor independent contractors of the organization, nor family members thereof. Saint Thomas Hickman Hospital extends medical staff privileges to all qualified physicians in its communities for some or all of its departments or specialties. Saint Thomas Hickman Hospital applies surplus funds for improvements in patient care with over $305K invested back into patient care projects in FY22.

Schedule H, Part VI, Line 2 Needs assessment
Saint Thomas Hickman Hospital d/b/a Ascension Saint Thomas Hickman uses 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: -US Census Bureau -Economic Impact Studies -Sg2 healthcare intelligence -Healthcare claims datasets -State datasets -CMS -Internal data sets -ACO, physician supply, and aligned Health Partnerships Saint Thomas Hickman Hospital 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 HICKMAN HOSPITAL IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, SAINT THOMAS HICKMAN 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 HICKMAN 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 HICKMAN HOSPITAL 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/locations/tennessee/tnnas/centerville-ascension-saint-thomas-hickman/financial-assistance-and-mdsave SAINT THOMAS HICKMAN HOSPITAL 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 HICKMAN HOSPITAL 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 HICKMAN HOSPITAL INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 6 Affiliated health care system
Saint Thomas Hickman Hospital IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. Saint Thomas Hickman Hospital operates a facility in Middle Tennessee and is 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.