4A (Expenses $ 1030716379 including grants of $ 441044) (Revenue $ 1149423948)
THE HOSPITAL'S OPERATING PLAN INCORPORATES PROVISIONS FOR INDIVIDUALS WHO DO NOT POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. OUR COMMITMENT TO OUR COMMUNITY EXTENDS TO FREE OR SUBSIDIZED INDIVIDUAL CARE, SUBSIDIZED EDUCATION OF HEALTHCARE PROFESSIONALS, DISCOUNTED FEES FOR PARTICIPANTS IN GOVERNMENT PROGRAMS, COMMUNITY HEALTH EDUCATION AND TO OTHER COMMUNITY AGENCIES. SPECIFIC COMMUNITY SERVICES AND PROGRAMS INCLUDE: WELLNESS AND PREVENTION EDUCATION PROGRAMS, COMMUNITY DIAGNOSTIC SCREENING PROGRAMS, SENIOR CITIZEN HEALTH AWARENESS PROGRAMS, AWARENESS PROGRAMS FOR YOUTH AT RISK, AND AWARENESS PROGRAMS FOR PERSONS WITH SPECIAL PHYSICAL OR MENTAL NEEDS. INDIVIDUALS SERVED AMOUNTED TO 126,314 VISITS TO OUR EMERGENCY DEPARTMENTS, 6,816 INPATIENT SURGERY PROCEDURES, 18,813 OUTPATIENT SURGERY PROCEDURES, 30,363 PATIENTS WHO WERE ADMITTED TO OUR HOSPITALS FOR CARE, AND 602,850 PATIENTS WHO RECEIVED OUTPATIENT CARE. CHRISTUS NORTHEAST HEALTH SYSTEM CORPORATION SERVES AS A TRAINING SITE FOR STUDENTS PURSING DEGREES IN NURSING, ALLIED HEALTH, ADVANCE PRACTICE NURSING AND MEDICINE. CNTHSC ASSOCIATES SERVE AS FORMAL PRECEPTORS FOR THESE STUDENT WHILE ON SITE. ASSOCIATE PRECEPTORS INCLUDE REGISTERED NURSES, ADVANCE PRACTICE REGISTERED NURSES, RADIOLOGIC TECHNOLOGISTS AND PHYSICIANS. GME PROGRAMS ARE NOT INCLUDED. THESE PROGRAMS ADDRESS COMMUNITY-WIDE WORKFORCE ISSUES - NOT THE WORKFORCE NEEDS OF THE HEALTH CARE ORGANIZATION. THESE HEALTH CAREER MENTORING PROJECTS INCLUDE JOB SHADOWING. MANY TIMES IT IS ALSO A COMMUNITY COLLABORATION THAT INCLUDES SCHOOLS, COLLEGES, UNIVERSITIES, OR PRIVATE BUSINESSES. IT MAY ALSO INCLUDE SPECIAL NEED STUDENTS. OFFERINGS WILL BE AVAILABLE FOR STUDENTS FROM ALL ECONOMIC AREAS AND NEEDS. HOURS SPENT INTERVIEWING, ORIENTING, SCHEDULING, AND TOURING HIGH SCHOOL AND COLLEGE JOB SHADOW STUDENTS. ORIENTATIONS INCLUDE TRAINING ON OUR HEALTH SYSTEM, CONFIDENTIALITY AND HIPPA, INFECTION CONTROL, HOSPITAL CODES, AND OTHER POLICIES AND PROCEDURES. THE CHRISTUS NORTHEAST TEXAS SPORTS MEDICINE PROGRAM HAS A SOLID MISSION THAT CONTRIBUTES TO THE OVERALL HEALTH OF THE COMMUNITY BY FOCUSING ON THE LONG-TERM PROBLEM OF TYPE II DIABETES AND OBESITY IN SCHOOL AGE CHILDREN. BY PROVIDING GRADUATE ASSISTANT ATHLETIC TRAINERS ON THE CAMPUSES THROUGHOUT THE CHRISTUS TYLER MARKET, FREE SATURDAY MORNING SPORTS INJURY CLINICS AND FREE PRE-PARTICIPATION SCREENINGS, THE PROGRAM HELPS TO: -PREVENT INJURIES AND QUICKLY EVALUATE AND DIAGNOSE INJURIES -DIRECT RAPID REFERRAL TO SPECIALIST PHYSICIANS -REHABILITATION AND FASTER RETURN TO NORMAL LIFE -WORK WITH STUDENT ACCIDENT INSURANCE -KEEP FINANCIAL LOSSES TO A MINIMUM TO ENSURE SCHOOLS CAN AFFORD STUDENT ACCIDENT INSURANCE

Schedule H, Part V, Section B, Line 3E
CHRISTUS MOTHER FRANCES HOSPITAL - TYLER IDENTIFIED AND ADDRESSED THE FOLLOWING PRIORITIES THROUGH ITS IMPLEMENTATION PLAN: 1) BEHAVIORAL HEALTH 2) HIGH EMERGENCY DEPARTMENT USE 3) SPECIALTY CARE AND CHRONIC ILLNESS 4) PRIMARY CARE AND ELDERLY NEEDS 5) EDUCATION

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - SEE SCHEDULE, H, PART V, SECTION A. IN THE MOST RECENT CHNA PERSONS FROM THE COMMUNITY PARTICIPATED IN FOCUS GROUPS WITH INPUT TO HELP IDENTIFY AND DISCUSS THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. THE INTERVIEWEES INCLUDED BUT WERE NOT LIMITED TO, INDIVIDUALS FORM THE FOLLOWING ORGANIZATIONS: TYLER FAMILY CIRCLE OF CARE, LITERACY COUNCIL OF TYLER, ANDREWS CENTER, NORTHEAST TEXAS PUBLIC HEALTH DISTRICT, CITY OF TYLER, EAST TEXAS HUMAN NEEDS NETWORK, BEHAVIORAL HEALTH LEADERSHIP TEAM, HELPING OTHERS PURSUE ENRICHMENT (HOPE), CHEROKEE COUNTY PUBLIC HEALTH, CITY OF JACKSONVILLE, JACKSONVILLE CHAMBER COMMERCE, RANDY GORHAM, CPA, ALZHEIMER'S ALLIANCE OF SMITH COUNTY, BETHESDA HEALTH CLINIC, CATHOLIC CHARITIES DIOCESE OF TYLER, TYLER JUNIOR COLLEGE, UNIVERSITY OF TEXAS AT TYLER, EAST TEXAS CRISIS CENTER, SAMARITAN COUNSELING CENTER OF EAST TEXAS.

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - SEE SCHEDULE, H, PART V, SECTION A. CHRISTUS MOTHER FRANCES HOSPITAL, LOUIS PEACHES OWEN HEART HOSPITAL, CHRISTUS MOTHER FRANCES HOSPITAL - JACKSONVILLE, CHRISTUS MOTHER FRANCES HOSPITAL - WINNSBORO, CHRISTUS MOTHER FRANCES HOSPITAL - SULPHUR SPRINGS, CHRISTUS MOTHER FRANCES - SOUTH TYLER.

Schedule H, Part V, Section B, Line 11 Facility A, 1
Facility A, 1 - SEE SCHEDULE, H, PART V, SECTION A. THE NEEDS IDENTIFIED IN CHNA: MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE IDENTIFIED AND ADDRESSED THE FOLLOWING PRIORITIES THROUGH ITS IMPLEMENTATION PLAN: 1) BEHAVIORAL HEALTH 2) HIGH EMERGENCY DEPARTMENT USE 3) SPECIALTY CARE AND CHRONIC ILLNESS 4) PRIMARY CARE AND ELDERLY NEEDS 5) EDUCATION CNTHSC'S CHIP FOR THE UPCOMING TRIENNIUM REFLECTS THE ORGANIZATION'S ONGOING PURSUIT OF REGIONAL HEALTH EQUITY AND COMMITMENT TO PROMOTE CONDITIONS THAT ALLOW EVERY PERSON TO ATTAIN THE HIGHEST POSSIBLE STANDARD OF HEALTH. 1) BEHAVIORAL HEALTH: - EXPAND AND SUPPORT BEHAVIORAL HEALTH SERVICES IN THE COMMUNITY FOR INDIVIDUALS AND FAMILIES. - ADDRESS SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH. 2) HIGH EMERGENCY DEPARTMENT USE: - EDUCATE THE PUBLIC ON THE APPROPRIATE USE OF THE EMERGENCY DEPARTMENT AND ALTERNATIVE COMMUNITY RESOURCES. - SUPPORT AND EXPAND ACCESS TO FQHC SERVICES AS A SUBSTITUTE FOR INAPPROPRIATE ED USE. - TRACK REFERRALS TO FQHC'S AND INAPPROPRIATE USE OF THE ED. 3) SPECIALTY CARE AND CHRONIC ILLNESS: - SUPPORT ONGOING AND NEW CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION PROGRAMS. - PROVIDE FREE ORTHOPEDIC SERVICES TO LOW INCOME SCHOOLS, INCLUDING (1) ON-SITE SERVICES AND SCREENINGS, AND (2) FREE/SUBSIDIZED ORTHOPEDIC AND SPORTS MEDICINE PROFESSIONALS AS NEEDED. - PROVIDE MAMMOGRAM PROGRAMS AS LOW-INCOME WOMEN IN NEED OF SCREENING IN THE COMMUNITY THROUGH THE MOBILE MAMMOGRAPHY UNIT OR CLINICS. 4) ACCESS TO PRIMARY CARE AND ELDERLY NEEDS: - SUPPORT AND EXPAND ACCESS TO FQHC - PROVIDE COMMUNITY - BASED SCREENING, ASSESSMENTS, AND EDUCATION TO LOW INCOME, UNINSURED, AND SPECIAL REQUEST POPULATIONS. - CONDUCT PRELIMINARY ANALYSIS AND PLANNING TO SECURE VACCINES FOR LOW INCOME PATIENTS AND PARTICIPATE IN COMMUNITY PUBLIC HEALTH ISSUES FOCUSING ON HEALTH DISPARITIES, HYPERTENSION, DIABETES, ETC., AND TO PROVIDE LEADERSHIP AS REQUESTED. 5) EDUCATION: - MAINTAIN AND INCREASE EDUCATION AND TRAINING OPPORTUNITIES FOR HEALTH PROFESSIONALS WHILE ENCOURAGING YOUTH AND YOUNG ADULTS TO ENTER CAREERS AS HEALTH PROFESSIONALS OR PARA-PROFESSIONALS.

Schedule H, Part V, Section B, Line 13 Facility A, 1
Facility A, 1 - SEE SCHEDULE, H, PART V, SECTION A. UNDER THE HOSPITAL'S POLICY, PATIENTS WHO WERE UNINSURED AND MET CERTAIN FINANCIAL CRITERIA WERE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE POLICY ALSO PROVIDED FOR ASSISTANCE FOR MEDICALLY INDIGENT PATIENTS. IN GENERAL, PATIENTS WHO WERE BELOW 300% OF FEDERAL POVERTY GUIDELINES RECEIVED FREE CARE. PATIENTS WHO WERE UNINSURED AND ABOVE 300% OF THE FEDERAL POVERTY GUIDELINES WERE BILLED RATES CONSISTENT WITH AMOUNTS GENERALLY BILLED TO COMMERCIAL PAYERS. PATIENTS WHO WERE UNINSURED AND BETWEEN 300% AND 400% OF FEDERAL POVERTY GUIDELINES COULD APPLY FOR ADDITIONAL ASSISTANCE TO PAY AMOUNTS LESS THAN AGB.

Schedule H, Part V, Section B, Line 15 Facility A, 1
Facility A, 1 - SEE SCHEDULE, H, PART V, SECTION A. IN ADDITION TO REGULAR APPLICATIONS, THE HOSPITAL ALSO ASSESSED PATIENTS FOR PRESUMPTIVE ELIGIBILITY TO FACILITATE GIVING ASSISTANCE TO NEEDY PATIENTS. THE HOSPITAL IMPLEMENTED ELECTRONIC ELIGIBILITY TOOLS THAT USED PATIENT DEMOGRAPHIC DATA, CREDIT REPORTS, AND OTHER PUBLICLY AVAILABLE INFORMATION TO ESTIMATE A PATIENT'S INCOME, ASSETS, AND LIQUIDITY. PATIENTS WERE SCREENED AS PART OF THE COLLECTION ATTEMPT PROCESS. WHEN ELECTRONIC SCREENING WAS USED AS THE BASIS FOR PRESUMPTIVE ELIGIBILITY, THE HIGHEST DISCOUNT OF FULL FREE CARE WAS GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. IF A PATIENT DID NOT QUALIFY UNDER THE ELECTRONIC ENROLLMENT PROCESS, THE PATIENT COULD STILL BE CONSIDERED UNDER THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS.

Schedule H, Part V, Section B, Line 16 Facility A, 1
Facility A, 1 - SEE SCHEDULE, H, PART V, SECTION A. A SUMMARY OF THE POLICY AND DOCUMENTS NEEDED TO APPLY FOR ASSISTANCE WAS WIDELY AVAILABLE AT WWW.CHRISTUSHEALTH.ORG/CHARITYCARE. (THIS WEBSITE WAS THE FIRST RESULT IN GOOGLE WHEN PATIENTS SEARCHED FOR THE HOSPITAL NAME AND CHARITY CARE OR FINANCIAL ASSISTANCE.) EFFECTIVE JULY 1, 2016, THE INDIVIDUAL HOSPITAL'S HOMEPAGE HAD A CONSPICUOUS FINANCIAL ASSISTANCE LINK DIRECTING PATIENTS TO THE CHARITY CARE HOMEPAGE. FINANCIAL COUNSELORS ALSO PUBLICIZED THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING ONE-ON-ONE VISITS WITH PATIENTS. THE HOSPITAL ATTEMPTED TO PROVIDE ALL UNINSURED PATIENTS WITH FINANCIAL COUNSELING. SPENDING TIME FACE-TO-FACE WITH PATIENTS ALLOWED COUNSELORS TO FACILITATE THE APPLICATION PROCESS FOR PATIENTS WHO OTHERWISE MIGHT NOT HAVE SOUGHT ASSISTANCE. COUNSELORS HELPED COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND EVALUATE PAYMENT PLANS FOR OUTSTANDING BALANCES. UNINSURED PATIENTS WERE SCREENED FOR MEDICAID ELIGIBILITY, AND COUNSELORS ALSO ASSISTED ELIGIBLE PATIENTS IN COMPLETING THOSE APPLICATIONS.

Schedule H, Part V, Section B, Line 20 Facility A, 1
Facility A, 1 - SEE SCHEDULE, H, PART V, SECTION A. WHEN COLLECTION CALLS RESULTED IN PATIENT CONTACT, BUSINESS AGENTS PERFORMED A VERBAL SCREENING TO SEE IF THE PATIENT MIGHT BE ELIGIBLE FOR CHARITY CARE. IN ADDITION, BILLING STATEMENTS CONTAINED THE FOLLOWING NOTICE: YOU MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON YOUR INCOME LEVEL. IF YOU DO NOT QUALIFY AND CANNOT MAKE PAYMENT IN FULL, WE WILL WORK WITH YOU TO SET UP AN ACCEPTABLE PAYMENT PLAN. WORK WITH YOU TO SET UP AN ACCEPTABLE PAYMENT PLAN.

Schedule H, Part V, Section B, Line 17
THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS.

Schedule H, Part V, Section B, Line 18
THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS.

Schedule H, Part V, Section B, Line 22
THE HOSPITAL USED THE AVERAGE COMMERCIAL INSURANCE REIMBURSEMENT RATE FROM FISCAL YEAR ENDING 6/30/22 TO DETERMINE AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS AVERAGE RATE WAS THE AVERAGE REIMBURSEMENT RECEIVED FOR CATEGORIES OF SERVICES FROM ALL PRIVATE INSURERS THAT REIMBURSE HOSPITALS ACROSS THE CHRISTUS HEALTH SYSTEM, EXCEPT FOR ST. VINCENT AND LONG-TERM HOSPITALS, AND EXCLUDING IMPLANT AND DRUG CONTRIBUTION DOLLARS. ALL UNINSURED PATIENTS WERE CHARGED NO MORE THAN 40% OF CHARGES FOR THE RELEVANT SERVICE LINE. PATIENTS ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE WERE CHARGED NO MORE THAN THE AVERAGE RATE (FOR INCOME LEVELS FROM 301% TO 400% OF FPL) OR RECEIVED FREE CARE (FOR INCOMES AT OR BELOW 300% FPL). FOR LAB SERVICES, ELIGIBLE PATIENTS WERE CHARGED A PERCENTAGE OF THE MEDICARE RATE.

Schedule H, Part I, Line 3c
FACTORS OTHER THAN THE FPG DETERMINING FREE OR DISCOUNTED CARE THE HOSPITAL USES THE FOLLOWING FACTORS IN ITS DETERMINATION: 1) ASSET LEVEL 2) MEDICAL INDIGENCY 3) INSURANCE STATUS 4) UNDERSINSURANCE STATUS 5) GREATER THAN 400% UNDER THE CATASTROPHIC CAP PROVISION 6) RESIDENCY

Schedule H, Part I, Line 5a BUDGETED CHARITY CARE
THE ORGANIZATION BUDGETS CHARITY CARE FOR INTERNAL FINANCIAL REVIEW PURPOSES ONLY. THE PROVISION OF CHARITY CARE IS NOT LIMITED TO AMOUNTS ESTABLISHED FOR BUDGETARY PURPOSES.

Schedule H, Part I, Line 6a ANNUAL COMMUNITY BENEFIT REPORT
A REPORT OF COMMUNITY BENEFIT IS INCLUDED IN A WRITTEN ANNUAL REPORT FOR CHRISTUS HEALTH, THE ORGANIZATION'S PARENT COMPANY. CHRISTUS HEALTH IS AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM FORMED IN 1999 WITH A MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST. THE ANNUAL COMMUNITY BENEFIT REPORT SUMMARIZES ACTIVITIES AND PROGRAMS CONDUCTED DURING THE PAST YEAR TO IMPROVE HEALTH INCLUDING PROACTIVE COMMUNITY HEALTH SERVICES. HOWEVER, THE ANNUAL REPORT IS ONLY A SNAPSHOT OF HOW THE ORGANIZATION DISTINGUISHES ITSELF IN ITS VISION TO BE A LEADER, A PARTNER, AND AN ADVOCATE IN CREATING INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES.

Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE
TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) IS $1,115,445,059. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $92,183,742. THIS LEAVES A TOTAL EXPENSE OF $1,023,261,317 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).

Schedule H, Part I, Line 7f FIN ASSISTANCE/OTHER BENEFITS AS PERCENTAGE OF COST
THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS REPORTED ON PART I, LINE 7K, COLUMN (C) AS A PERCENTAGE OF TOTAL EXPENSE IS 11.99 PERCENT, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN (F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE.

Schedule H, Part I, Line 7i CASH AND IN-KIND CONTRIBUTIONS
MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE MADE OVER $11,785,264 IN CASH AND IN KIND CONTRIBUTIONS DURING FISCAL YEAR 2022. THE AFOREMENTIONED AMOUNT IS DETERMINED IN ACCORDANCE WITH REPORTING RULES FOR SCHEDULE H, WORKSHEET 8. AS SUCH THIS AMOUNT DIFFERS FROM GRANTS REPORTED AT FORM 990, SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS AND PART IX, LINES 1 THROUGH 3 GRANTS AND OTHER ASSISTANCE.

Schedule H, Part III, Line 1 BAD DEBT REPORTING IN ACCORDANCE WITH HFMA STATEMENT 15
CHRISTUS HEALTH FOLLOWS IN PRINCIPLE HEALTHCARE FINANCIAL MANAGEMENT ASSOCATION STATEMENT NO. 15. THE SYSTEM HAS ADOPTED AN UNCOMPENSATED CARE POLICY WHERE REVENUE FROM SERVICES PROVIDED TO THE UNINSURED IS RECOGNIZED AT THE TIME OF PAYMENT, RATHER THAN AT THE TIME OF SERVICE. THIS POLICY IS THE RESULT OF A LACK OF REASONABLE ASSURANCE OF COLLECTION FOR SERVICES PROVIDED TO THE UNINSURED DUE TO THE SYSTEM'S HISTORICALLY LOW COLLECTION RATE. MANAGEMENT HAS ESTIMATED THAT THE DIFFERENCE BETWEEN RECORDING REVENUE FROM THE UNINSURED ON A CASH BASIS, RATHER THAN THE ACCRUAL BASIS, IS IMMATERIAL. ACCORDINGLY, ALL ACCOUNTS RECEIVABLE FROM THE UNINSURED HAVE BEEN FULLY RESERVED IN THE ALLOWANCE FOR UNCOMPENSATED CARE.

Schedule H, Part I, Line 7 EXPLANATION OFCOSTING METHODOLOGYUSED FOR CALCULATING LINE 7 TABLE:
LINE 7A: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7B: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7C: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7E: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7F: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7G: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7H: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS

Schedule H, Part V, Section B, Line 7 OTHER WEBSITE
https://www.christushealth.org/-/media/christus-health/connect-with-christus/files/community-involvement-and-commitment/implementation-plan-and-needs-assessment/2020_2022_community-health-needs-assessment--tmf-tyler.ashx

Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE
HTTPS://WWW.CHRISTUSHEALTH.ORG/-/MEDIA/CHRISTUS-HEALTH/PLAN-CARE/FILES/BILL-PAY/FINANCIAL-ASSISTANCE/FINANCIAL-LANGUAGE-DOCUMENTS/V2FINANCIAL-ASSISTANCE-APPLICATION.ASHX

Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE
https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/2021plainlanguagesummaryhospitalenglish.ashx

Schedule H, Part II Community Building Activities
THE CHRISTUS HEALTH ADVOCACY DEPARTMENT IS WORKING IN PARTNERSHIP WITH LOCAL, STATE AND FEDERAL POLICY MAKERS TO ENSURE ACTIVITIES AND PROGRAMS ARE IN PLACE THAT WILL ENHANCE PUBLIC HEALTH AND ADVANCE GENERAL KNOWLEDGE. DURING FY 2022, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES, AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTH CARE SERVICES FOR THE PATIENTS WE SERVE. SOME OF THE MAIN COMMUNITY BUILDING ACTIVITIES ARE IMPROVING ACCESS TO HEALTH SERVICES AND BUILDING COLLABORATIVE RELATIONSHIPS WITH OTHER ORGANIZATIONS SEEKING TO ADDRESS CHRONIC CONDITIONS THAT DISPROPORTIONATELY IMPACT THE POOR AND UNDERSERVED.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE (TOTAL OF ALL HOSPITAL FACILITIES) IS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL STATEMENTS, WHICH IS COMPUTED AS BAD DEBT NET OF CONTRACTUAL ALLOWANCE, PAYMENTS RECEIVED AND RECOVERIES OF BAD DEBT PREVIOUSLY WRITTEN OFF.

Schedule H, Part VI, Line 7 COMMUNITY BENEFIT REPORT
A COMMUNITY BENEFIT REPORT IS FILED FOR THE STATE OF TEXAS IN THE FORM OF THE ANNUAL STATEMENT OF COMMUNITY BENEFITS STANDARD (ASCBS) FORM AS REQUIRED BY THE HEALTH AND SAFETY CODE, SECTIONS 311.045 AND 311.046. THE CODE REQUIRES NONPROFIT HOSPITALS TO FILE THE ASCBS FORM AND ANNUAL REPORT OF THE COMMUNITY BENEFITS PLAN WITH THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES (DSHS). THE 2012 ASCBS FORM IS EXPANDED TO COLLECT THE INFORMATION ON CHARITY CARE POLICIES AND COMMUNITY BENEFITS IN A STANDARDIZED FORMAT. ALL CHRISTUS HEALTH ENTITIES INCLUDING FACILITIES LOCATED IN STATES THAT DO NOT REQUIRE ANNUAL COMMUNITY BENEFIT REPORTING (I.E., LOUISIANA, AND NEW MEXICO), FOLLOW THE SAME REPORTING RULES AS OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT, COPYRIGHT 2015. TOTAL COMMUNITY BENEFIT FOR CHRISTUS HEALTH IS ALSO REPORTED IN THE ANNUAL REPORT PREPARED AND DISTRIBUTED BY THE SYSTEM OFFICE.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
THE FILING ORGANIZATION RECOGNIZED THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30 PERCENT OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERSTIC OF OTHER WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2022, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 3.73 PERCENT OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING JUNE 30, 2022. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 0.4860 PERCENT OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2022 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2011 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
THE FOOTNOTE TO THE CHRISTUS HEALTH CONSOLIDATED FINANCIAL STATEMENTS SAYS, THE PREPARATION OF THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES (U.S. GAAP) REQUIRES MANAGEMENT OF THE SYSTEM TO MAKE ASSUMPTIONS, ESTIMATES, AND JUDGMENTS THAT AFFECT THE AMOUNTS REPORTED IN THE FINANCIAL STATEMENTS, INCLUDING THE NOTES THERETO, AND RELATED DISCLOSURES OF COMMITMENTS AND CONTINGENCIES, IF ANY AT THE DATE OF THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN MAKING ITS JUDGMENT AND ESTIMATES. ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THESE ESTIMATES.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE MEDICAL CENTER USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. THE SHORTFALL ON PART III, LINE 7 IS NOT COUNTED AS A COMMUNITY BENEFIT. THE AMOUNT ON SCHEDULE H, PART III, LINE 6 IS DETERMINED BY CALCULATING MEDICARE ALLOWABLE COSTS USING WORKSHEET A OF THE MEDICARE COST REPORT. WORKSHEET A OF THE MEDICARE COST REPORT REQUIRES THE ORGANIZATION TO REMOVE NON-ALLOWABLE EXPENSES FROM TOTAL EXPENSES VIA THE ADJUSTMENTS TO EXPENSES WORKSHEETS WITHIN THE MEDICARE COST REPORT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE FILING ORGANIZATION ASSOCIATED WITH THE FILING ORGANIZATION'S PROVISIONS OF SERVICES TO MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 7 WOULD EQUAL A SHORTFALL OF ($981,725) IF TOTAL EXPENSES ALLOWABLE TO MEDICARE SERVICES WERE SUBSTITUTED ON SCHEDULE H, PART III, LINE 6.

Schedule H, Part V, Section B, Line 16a FAP website
A - MOTHER FRANCES REG. HEALTHCARE CENTER: Line 16a URL: https://www.christushealth.org/plan-care/bill-pay/financial-assistance; A - TYLER REHAB ASSOCIATES, LP: Line 16a URL: SEE PART V, SECTION C;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - MOTHER FRANCES REG. HEALTHCARE CENTER: Line 16b URL: SEE SUPPLEMENTAL INFO; A - TYLER REHAB ASSOCIATES, LP: Line 16b URL: SEE PART V, SECTION C;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - MOTHER FRANCES REG. HEALTHCARE CENTER: Line 16c URL: SEE SUPPLEMENTAL INFO; A - TYLER REHAB ASSOCIATES, LP: Line 16c URL: SEE PART V, SECTION C;

Schedule H, Part VI, Line 4 Community information
THE HOSPITAL OWNS AND OPERATES A 476 LICENSED BED GENERAL ACUTE CARE HOSPITAL AND RELATED HEALTHCARE FACILITIES IN TYLER, TEXAS. THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF SMITH COUNTY WITH A POPULATION OF APPROXIMATELY 225,290 RESIDENTS. THE MEDIAN HOUSEHOLD INCOME FOR THE SERVICE AREA IS $49,364, WITH 16% HOUSEHOLDS LIVE AT OR BELOW THE POVERTY LEVEL AND 34% AT LOW INCOME. THE HOSPITAL'S SERVICE AREA HAS AN UNINSURED RATE OF 33% OF THE POPULATION AND 43% HAVING MENTAL ILLNESS.

Schedule H, Part VI, Line 6 Affiliated health care system
MOTHER FRANCES HOSPITAL-TYLER IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED CHRISTUS NORTHEAST TEXAS HEALTH SYSTEM COROPORATION. CHRISTUS NORTHEAST TEXAS IS A FAITH-BASED ORGANIZATION DEDICATED TO CREATING HEALTHY LIVES FOR PEOPLE AND COMMUNITIES. MFH-TYLER AND ITS AFFILIATES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ACUTE CARE FACILITIES AND CRITICAL ACCESS FACILITIES WHOSE OPERATIONS CONSIST PRIMARILY OF PROVIDING INPATIENT AND OUTPATIENT ACUTE CARE AND MEDICAL SERVICES TO PATIENTS RESIDING IN EAST TEXAS.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
IT IS THE POLICY OF THE ORGANIZATION TO PURSUE COLLECTIONS OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. CHRISTUS HEALTH APPLIES ITS COLLECTION EFFORTS CONSISTENTLY AND FAIRLY TO ALL PATIENTS REGARDLESS OF INSURANCE. IF A PATIENT DOES NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR OUTSTANDING BALANCES, THE GOAL OF THE ORGANIZATION IS TO QUALIFY THESE PATIENTS THROUGH THE ORGANIZATION'S CHARITY POLICY OR SCREEN THE PATIENTS THROUGH ORGANIZATION'S PRESUMPTIVE CHARITY TESTS. IF THE PATIENT QUALIFIES UNDER EITHER POLICY THE ACCOUNT WILL BE WRITTEN OFF BASED UPON LEVEL OF QUALIFICATION. THESE POLICIES SUPPORT THE MISSION AND VISION OF THE ORGANIZATION AND ARE APPROVED BY SENIOR LEADERSHIP.

Schedule H, Part VI, Line 2 Needs assessment
THE HOSPITAL'S COMMUNITY HEALTH PROFILES PROVIDE A SNAPSHOT OF SUBURBAN, URBAN, AND RURAL SERVICE AREAS WITHIN TEXAS USING KEY HEALTH INDICATORS, WHICH FACILITATE COMPARISONS LOCALLY, REGIONALLY, AND OVER TIME. COMMUNITY HEALTH PROFILES ARE INTENDED TO ASSIST INTERNAL STAKEHOLDERS, COMMUNITY HEALTH COUNCIL MEMBERS, AND THE COMMUNITY HEALTH IMPROVEMENT DEPARTMENT IN DECIDING WHERE TO ALLOCATE RESOURCES AND ADDRESS HEALTH INEQUALITIES. ALL ENTITY ADVOCATES USE NATIONAL, STATE, AND LOCAL SECONDARY AND PRIMARY DATA SOURCES TO PROVIDE A CURRENT OVERVIEW OF LOCAL HEALTH NEEDS, FACTORS IMPACTING DISEASE AND INJURY BURDEN, SOCIOECONOMIC STATUS, ACCESS TO HEALTH CARE, AGE DISTRIBUTION, INDICATORS AND LIFESTYLE BEHAVIORS. THIS DATA IS USED TO GALVANIZE JOINT COMMUNITY HEALTH EFFORTS TO IMPROVE HEALTH AND REDUCE HEALTH INEQUALITIES AND TO EMPOWER THE GREATER COMMUNITY.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
MOTHER FRANCIS HOSPITAL - TYLER MAKES EVERY EFFORT TO EDUCATE PATIENTS ON ITS CHARITY AND DISCOUNT POLICY AND ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS DURING REGISTRATION, PRE REGISTRATION (FOR SCHEDULED TESTS AND SURGERIES), POST REGISTRATION (DURING THEIR HOSPITALIZATION) AND FOLLOWING DISCHARGE (TELEPHONE OR WRITTEN INQUIRY) IN LANGUAGES APPROPRIATE FOR THE POPULATION BEING SERVED. PATIENTS ARE GIVEN INFORMATION AND FORMS BY A FINANCIAL COUNSELOR WHO HELPS THEM COMPLETE THE FORMS DURING THEIR INPATIENT AND OUTPATIENT VISITS. PATIENTS ARE ASKED TO BRING OR MAIL SUPPORTING DOCUMENTATION TO DETERMINE INCOME, ASSETS AND HOUSEHOLD EXPENSES. THE BUSINESS OFFICE REVIEWS THE APPLICATION BASED ON THE INFORMATION PROVIDED BY THE PATIENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE OR A DISCOUNT, A NEW BILL IS GENERATED. PATIENTS WHO DO NOT PROVIDE THE REQUIRED DOCUMENTATION ARE CONSIDERED INELIGIBLE AND ARE BILLED ACCORDINGLY. IF THE DOCUMENTATION IS PROVIDED AT A LATER TIME, THE PATIENT MAY THEN BE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR A DISCOUNT. DOCUMENTATION IS RETAINED BY THE BILLING OFFICE FOR SEVEN YEARS. A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY IS POSTED IN PROMINENT PLACES THROUGHOUT THE HOSPITALS, INCLUDING BUT NOT LIMITED TO THE EMERGENCY ROOM WAITING AREAS AND THE ADMISSIONS OFFICE WAITING AREAS, AS REQUIRED BY BOTH THE STATE OF TEXAS COMMUNITY BENEFIT STANDARD (WHICH ADDRESSES THE DUTIES AND RESPONSIBILITIES OF NONPROFIT HOSPITALS) AND CHRISTUS HEALTH COMMUNITY BENEFIT GUIDELINES #050. IN ADDITION, A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY AND INFORMATION ON FINANCIAL ASSISTANCE ARE ALSO POSTED ON THE CHRISTUS HEALTH WEBSITE. THE INFORMATION ON FINANCIAL ASSISTANCE INCLUDES EXPLANATIONS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, WHO QUALIFIES, AND HOW TO APPLY FOR FINANCIAL ASSITANCE.

Schedule H, Part VI, Line 7 State filing of community benefit report
TX

Schedule H, Part VI, Line 5 Promotion of community health
1. TYLER FAMILY CIRCLE OF CARE -WOMEN'S SERVICES/CHILDREN'S SERVICES/FAMILY AND SPECIAL NEEDS CLINICS DESCRIPTION: THESE CLINICS PROVIDE MEDICAL CARE SERVICES TO ALL AGES OF PATIENTS. THE CLINICS SEE MEDICAID, MEDICARE, CHIP/CHIP PERINATE, SELF-PAY,UNINSURED/UNDERSERVED, AND SERVING THOSE WITHOUT THE ABILITY TO PAY REGARDLESS OF THEIR COUNTY OF RESIDENCE. A COMMUNITY BENEFIT IS PAID TO COVER THE COSTS OF 60 OF THE IT SERVICES AND SYSTEM. THE PRIMARY OBJECTIVE IS TO REDUCE THE NUMBER OF WOMEN WHO DELIVERED BABIES WITH NO PRENATAL CARE OR CHILDBIRTH EDUCATION AND REDUCE THE NUMBER OF SICK INFANTS BORN. SOCIAL WORKERS HELP CLIENTS BECOME ELIGIBLE FOR MEDICAID, WIC, AND OTHER FINANCIAL ASSISTANCE. THIS FACILITY PROVIDES ACCESS TO WELL-BABY CARE AND SICK BABY CARE FOR NEW MOTHERS WHO WERE PROVIDED CARE AT THE TYLER FAMILY CIRCLE OF CARE - WOMEN'S SERVICE AND FOR THE MEDICALLY UNDERSERVED CHILDREN OF EAST TEXAS. THIS CLINIC HAS THE HIGHEST PERCENTAGE OF AT-RISK ETHNIC GROUPS. 2. EMERGENCY EDUCATION DESCRIPTION: DETAILED INSTRUCTION AND HANDS ON PARTICIPATION IS OFFERED FOR CERTIFICATION IN AREAS INCLUDING CPR, FIRST AID, AND AED USE. COURSES ARE OFFERED TO SCHOOL DISTRICT AND SPONSORS FOR UIL PROGRAMS ON AN ASNEEDED BASIS. HUNDREDS OF PEOPLE WERE TRAINED ACROSS MULTIPLE COUNTIES,SCHOOL DISTRICTS, AND CHURCHES. THE SPORTS TRAINING PROGRAM PROVIDES MANY OF THESE SERVICES. 3. CHRISTUS NORTHEAST TEXAS HEALTH SYSTEM COPORATION WEBSITE DESCRIPTION: THE CNTHSC WEBSITE https://www.christushealth.org/locations/tyler-hospital PROVIDE A LARGE AMOUNT OF INFORMATION ABOUT THE HEALTH SYSTEM, TRINITY PHYSICIANS, UPCOMING CLASSES AND EVENTS AND A WEALTH OF HEALTH INFORMATION. THIS NOW INCLUDES THE IMPLEMENTATION OF MYCHART FOR PERSONAL HEALTH INFORMATION DIRECTLY. 4. COMMUNITY PARTNERSHIPS DESCRIPTION: ASSISTANCE WAS PROVIDED BOTH FINANCIALLY AND WITH STAFFING FOR GROUPS AND ORGANIZATIONS TO PROVIDE COLLABORATIVE PROGRAMS, SERVICES, AND HEALTH INFORMATION. PROJECTS INCLUDED OVER 80 OPPORTUNITIES, INCLUDING SCHOOL-BASED PROGRAMS, YOUTH PROGRAMS, AND GENERAL PUBLIC EVENTS, TO PROVIDE ASSISTANCE AND SUPPORT AND TO EDUCATE THE PUBLIC ON PROGRAMS OFFERED BY, AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, ALZHEIMER'S ALLIANCE, BOY SCOUTS, NURSING PROGRAMS, CHAMPIONS FOR CHILDREN'S, SAMARITAN'S COUNSELING, AND PUBLIC AND PRIVATE SCHOOLS. 5. UNITED WAY DESCRIPTION: OUR EMPLOYEES PROVIDED FINANCIAL SUPPORT TO ASSIST WITH THE DESIGN, DEVELOPMENT, FUNDING AND MISSION DEVELOPMENT OF OVER 30 NON-PROFIT AGENCIES IN THE COMMUNITY PROVIDING SERVICES TO CHILDREN AND FAMILIES AT-RISK REGARDLESS OF THEIR ABILITY TO PAY FOR THOSE SERVICES. THE HOSPITAL PROVIDES AN ADDITIONAL DONATION TO THE UNITED WAY IN ADDITION TO THE INDIVIDUAL DONATIONS. 6. HEALTH EDUCATION/SCREENING PROGRAMS DESCRIPTION: COMMUNITY EDUCATION FOR HEALTHY LIFE STYLES WAS OFFERED THROUGHOUT THE REGION FOR A VARIETY OF CONDITIONS. VARIOUS WALKS ARE INCLUDED AS WELL AS STRESS MANAGEMENT, DIABETES EDUCATION, HEART HEALTH, AND CANCER AWARENESS SCREENINGS. THE WOMEN WITH HEART PROGRAM ALSO OFFERED EDUCATION ON HEART DISEASE IN 4 COUNTIES. 7. SCHOOL ASSISTANCE DESCRIPTION: OVER 4,000 HIGH SCHOOL PHYSICALS AND PRE-PARTICIPATIONS EXAMS WERE DONE AT NO COST TO THE SCHOOLS. ADDITIONALLY, OVER 200 STUDENT ATHLETES WERE SEEN FOR FREE IN SATURDAY SPORTS CLINICS. ALL PROGRAMS ARE OPEN TO ANYONE TO PARTICIPATE PROVIDED THEY HAVE PRENATAL APPROVAL. SUPPORT FOR ON-SITE TRAINERS IS ALSO PROVIDED ON AN AS NEEDED BASIS. 8. YOUTH FITNESS DESCRIPTION: SPORTS TRAINING PROGRAM, INJURY PREVENTION AND HEALING, RUNNING CLASSES, WALKING PROGRAMS, AND NUTRITIONAL PROGRAMS WERE OFFERED TO EDUCATE YOUTHS AND YOUNG ADULTS ON THE POTENTIALS FOR INJURIES AND THE LONG-TERM EFFECTS OF NOT CARING FOR THE BODY. EXAMPLES WOULD INCLUDE: TYLER SOCCER ASSOCIATION, SUMMER FOOTBALL WHILE OTHER PROGRAMS WOULD INCLUDE ASSISTANCE WITH LOCAL BASKETBALL, VOLLEYBALL, TRACK, AND OTHER TRADITIONAL GROUP PROGRAMS WITH NON-PROFITS AND SCHOOL DISTRICTS. 9. JOB SHADOWING DESCRIPTION: CHRISTUS NORTHEAST TEXAS MADE A DECISION TO PARTICIPATE AND LEAD THE WAY ON HELPING TO DEVELOP SKILLS CHILDREN NEED TO LEARN AND BECOME INTERESTED IN HEALTHCARE CAREERS. THROUGH OUR VOLUNTEER SERVICES PROGRAM TRAINING, JOB SHADOWING, STUDENT PROGRAMS, ETC. ARE OFFERED TO INDIVIDUALS, SCHOOLS, COMMUNITY COLLEGES AND FOUR YEAR INSTITUTIONS NOT ONLY IN OUR MAIN HOSPITALS BUT IN CLINICS THROUGHOUT OUR SERVICE AREA. 10. ROSS BREAST CENTER MOBILE UNIT DESCRIPTION: ROSS BREAST CENTER MOBILE MAMMOGRAPHY UNIT GOES OUT IN THE NORTHEAST TEXAS REGIONAL COMMUNITY. THE MOBILE MAMMOGRAPHY IS SET UP STRATEGICALLY ACROSS NORTHEAST TEXAS AND ALSO IN RURAL AREAS TO ACCOMMODATE LOW INCOME MEDICAID WOMEN WHO MAY NOT OTHERWISE HAVE MEANS OF TRANSPORTATION. THE MOBILE UNIT IS SET UP FOR APPOINTMENTS AND FOR WALK-IN AVAILABILITY.