4A (Expenses $ 61815167 including grants of $ 0) (Revenue $ 75169894)
SEE SCHEDULE O.AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA2021 WAS MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSOVER THE LAST TWO YEARS, PROVIDENCE ADVANCED A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION, AND ENVIRONMENTAL STEWARDSHIP. WE UPDATED OUR INTEGRATED STRATEGIC & FINANCIAL PLAN TO MORE CLEARLY EXPRESS OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. IN 2021, OUR SUSTAINABLE AND INCLUSIVE PURCHASING PROGRAM COMMITTED TO INCREASE OUR SPEND WITH WOMEN AND MINORITY OWNED BUSINESS ENTERPRISES BY OVER $300 MILLION ACROSS THE NEXT FIVE YEARS. WE ALSO DEPLOY AN INVESTING PORTFOLIO WHICH INCLUDES SHAREHOLDER ADVOCACY, IMPACT INVESTING, AND SOCIALLY CONSCIOUS PORTFOLIO SCREENS. IN 2021, PROVIDENCE MADE PROGRESS TOWARDS ITS CLIMATE COMMITMENT TO BECOME CARBON NEGATIVE BY 2030. WE ARE IMPLEMENTING AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL.2021 PROGRAM SERVICE ACCOMPLISHMENTS: (JANUARY 1 - DECEMBER 31, 2021)GRACE MEDICAL CENTER, A MEMBER OF COVENANT HEALTHCOVENANT HEALTH HAS A RICH HISTORY IN THE TEXAS/NEW MEXICO REGION. WHILE HEALTH CARE IN OUR REGION HAS CHANGED OVER THE YEARS, OUR COMMITMENT TO FULFILLING OUR MISSION, VISION, VALUES AND PROMISE HAVE NOT WAIVERED.BELOW WE HIGHLIGHT TWO PRIORITY AREA ACCOMPLISHMENTS ACROSS COVENANT HOSPITALSMENTAL AND BEHAVIORAL HEALTHPRIORITY 1: MENTAL AND BEHAVIORAL HEALTH MENTAL AND BEHAVIORAL HEALTH TREATMENT, INTERVENTION AND PREVENTION SERVICES FOR THE COMMUNITY, INCLUDING RELATED ISSUES SUCH AS SUBSTANCE USENO TIME IN RECENT HISTORY TESTED MENTAL AND BEHAVIORAL HEALTH MORE THAN THE COVID-19 PANDEMIC OF 2020-2021. DURING 2020 COVENANT HEALTH OPENED A COMMUNITY RESOURCE CENTER WITHIN THE LUBBOCK YWCA BUILDING WITH EXPANDED SERVICES CONTINUING INTO 2021. THIS CENTER CONTINUES TO EXPAND ACCESS TO MENTAL HEALTH COUNSELING SERVICES FOR LOW-INCOME AND UN0INSURED. ADDITIONALLY TELE-COUNSELING SERVICES CONTINUED IN 2021 WHICH ALLOWED OUR OUTREACH COUNSELING CENTER TO PROVIDE COUNSELING SERVICES FOR LOW-INCOME AND UN-INSURED PERSON IN OUR REGION AND PROVIDES ACCESS TO THOSE FACING BARRIERS SUCH AS TRANSPORTATION. COVENANT HEALTH BEGAN AN ANTI-STIGMA CAMPAIGN FOR MENTAL AND BEHAVIORAL HEALTH IN 2020 WHICH CONTINUED INTO 2021 FOR THE ENTIRE REGION. COVENANT COMMUNITY COUNSELING CENTER IS AN OUTREACH COUNSELING CLINIC RUN AND FUNDED BY COVENANT HEALTH. THIS IS A COUNSELING CENTER FOR THE COMMUNITY, PROVIDING ACCESS TO LOW INCOME PERSONS IN THE SERVICE AREA. IN 2021 OUR CARE COORDINATION COMMUNITY-BASED TEAMS ADDED A TEAM DEDICATED SOLELY TO MENTAL HEALTH OUTREACH. WE ALSO CONTINUE TO PARTNER WITH LOCAL NON-PROFITS AND IN 2021 A MENTAL HEALTH VOUCHER PROGRAM WAS FUNDED BY COVENANT HEALTH FOR CATHOLIC CHARITIES.SAFE, AFFORDABLE, STABLE HOUSING AND PERMANENT SUPPORTIVE HOUSING SOLUTIONSPRIORITY 2: SAFE, AFFORDABLE, STABLE HOUSING AND PERMANENT SUPPORTIVE HOUSING SOLUTIONS FOR PEOPLE EXPERIENCING CHRONIC HOMELESSNESSCOVENANT SUPPORTS OUR LOCAL NON-PROFITS WITH BOTH FUNDING AND IN-KIND SUPPORT. IN 2021 LUBBOCK, COVENANT HEALTH SUPPORTED OPEN DOOR, A LOCAL NONPROFIT ORGANIZATION WORKING TO CULTIVATE COMMUNITY AND OPPORTUNITY FOR PEOPLE ACROSS THE REGION EXPERIENCING HOMELESSNESS AND POVERTY. ALL COVENANT SERVICE AREAS ARE SUPPORTED BY OPEN DOOR. USING A COMMUNITY-BASED MODEL, THE OPEN DOOR TEAM CREATES A WELCOMING AND SUPPORTIVE ENVIRONMENT FOR PEOPLE TO ACCESS SELF-CARE, HYGIENE AND FIRST AID SERVICES. IN 2021, COVENANT HEALTH PROVIDED AN $88,000 COMMUNITY BENEFIT WELLNESS GRANT TO OPEN DOOR TO SUPPORT ITS PERMANENT SUPPORTIVE HOUSING PROGRAM AND COMMUNITY CENTER. THE PERMANENT SUPPORTIVE HOUSING PROGRAM PRIORITIZES HOUSING FIRST, IN TANDEM WITH WRAP-AROUND SERVICES THAT MEET BASIC HUMAN AND SOCIAL NEEDS. THIS PROGRAM HELPS PEOPLE GET ON THEIR FEET SO THEY ARE BETTER PREPARED TO REACH THEIR EMPLOYMENT AND EDUCATION GOALS. THE PERMANENT SUPPORTIVE HOUSING PROGRAM SERVED 85 INDIVIDUALS IN 2021. IN 2021, THE PERMANENT SUPPORTIVE HOUSING PROGRAM OPERATED BY OPEN DOOR IN LUBBOCK, TEXAS, SERVED 85 INDIVIDUALS. COVENANT HEALTH SUPPORTED THIS PARTNER WITH AN $88,000 COMMUNITY BENEFIT WELLNESS GRANT.

GRACE MEDICAL CENTER
PART V, SECTION B, LINE 3J: SCHEDULE H, PART V, SECTION B, LINE 3E:THE SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED THROUGH THE CHNA PROCESS AND ARE LISTED IN RANK ORDER (PRIORITIZED).

GRACE MEDICAL CENTER
"PART V, SECTION B, LINE 5: TO BETTER UNDERSTAND THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS, COVENANT HEALTH LUBBOCK HOSPITALS IN PARTNERSHIP WITH COVENANT HEALTH LEVELLAND AND COVENANT HEALTH PLAINVIEW, HELD TEN STAKEHOLDER FOCUS GROUPS IN WHICH NONPROFIT AND GOVERNMENT STAKEHOLDERS, AS WELL AS PUBLIC HEALTH EXPERTS, DISCUSSED THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF THE SERVICE AREA. STAKEHOLDERS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. ADDITIONALLY, COMMUNITY MEMBERS WHO UTILIZE OUTREACH SERVICES COMPLETED JUST UNDER ONE HUNDRED COMMUNITY SURVEYS. BELOW IS A HIGH-LEVEL SUMMARY OF THE FINDINGS FROM THESE SESSIONS; FULL DETAILS ON THE PROTOCOLS AND METHODOLOGY ARE AVAILABLE IN APPENDIX 3 WHICH IS AVAILABLE ONLINE ON COVENANT HEALTH'S WEBSITE FINDINGS FROM LUBBOCK STAKEHOLDER LISTENING SESSIONS (LUBBOCK COUNTY) STAKEHOLDERS WERE ASKED TO SPEAK TO THE UNMET HEALTH-RELATED NEEDS IN THE LUBBOCK COMMUNITY. FULL DETAILS ON THE PARTICIPANTS AND FINDINGS FROM THE LUBBOCK LISTENING SESSIONS ARE AVAILABLE IN APPENDIX 3A.UNMET HEALTH-RELATED NEEDS LUBBOCK COUNTY STAKEHOLDERS WERE MOST CONCERNED ABOUT THE FOLLOWING HEALTH-RELATED NEEDS:1. BEHAVIORAL HEALTH CHALLENGES (INCLUDES BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDER) AND ACCESS TO BEHAVIORAL HEALTH CARE2. ACCESS TO HEALTH CARE SERVICES3. HOMELESSNESS/ LACK OF SAFE, AFFORDABLE HOUSING4. ECONOMIC INSECURITY5. ACCESS TO COMMUNITY RESOURCES6. FOOD INSECURITY, INCLUDING OBESITY AND NUTRITIONBECAUSE OF THE SUBSTANTIAL NUMBER OF STAKEHOLDERS, 27, THAT PARTICIPATED IN THE LUBBOCK LISTENING SESSIONS, THE HEALTH-RELATED NEEDS WERE DIVIDED INTO ""HIGH PRIORITY AND ""MEDIUM PRIORITY"" CATEGORIES BASED ON THE STAKEHOLDERS' INPUT. THEREFORE, THE TOP THREE NEEDS, BEHAVIORAL HEALTH, ACCESS TO HEALTH CARE SERVICES, AND HOMELESSNESS WERE CONSIDERED HIGH PRIORITY NEEDS, WHILE THE REMAINING THREE, ECONOMIC INSECURITY, ACCESS TO COMMUNITY RESOURCES, AND FOOD INSECURITY, WERE CONSIDERED MEDIUM PRIORITY NEEDS."

GRACE MEDICAL CENTER
PART V, SECTION B, LINE 6A: THE NEEDS ASSESSMENT WAS CONDUCTED AS A COLLABORATIVE EFFORT BETWEEN THE FOLLOWING COVENANT HEALTH ENTITIES: COVENANT HEALTH MEDICAL CENTER, GRACE, COVENANT HEALTH CHILDREN'S, COVENANT HEALTH PLAINVIEW, COVENANT HEALTH LEVELLAND AND COVENANT SPECIALTY HOSPITAL (JOINT VENTURE).THESE FACILITIES ARE REFERRED TO COLLECTIVELY AS COVENANT HEALTH AND ALL SERVE THE SAME GEOGRAPHIC SERVICE AREA OF WEST TEXAS AND EASTERN NEW MEXICO.

GRACE MEDICAL CENTER
PART V, SECTION B, LINE 11: COVENANT HEALTH IS WORKING BOTH INTERNALLY AND WITH COMMUNITY PARTNERS TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFY BY THE COMMUNITY HEALTH NEEDS ASSESSMENT. COVENANT HEALTH'S FY21-23 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON THE FOLLOWING PRIORITY AREAS:2021 PRIORITY NEEDS RANKED SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS:PRIORITY 1: MENTAL AND BEHAVIORAL HEALTHMENTAL AND BEHAVIORAL HEALTH TREATMENT, INTERVENTION AND PREVENTION SERVICES FOR THE COMMUNITY, INCLUDING RELATED ISSUES SUCH AS SUBSTANCE USE2021 ACCOMPLISHMENTS: DURING 2020 COVENANT HEALTH OPENED A COMMUNITY RESOURCE CENTER WITHIN THE LUBBOCK YWCA BUILDING WITH EXPANDED SERVICES CONTINUED INTO 2021. THIS CENTER WILL CONTINUE TO EXPAND ACCESS TO MENTAL HEALTH COUNSELING SERVICES FOR LOW-INCOME AND UNINSURED. ADDITIONALLY TELE-COUNSELING SERVICES CONTINUED IN 2021 WHICH ALLOWED OUR OUTREACH COUNSELING CENTER TO CONTINUE TO PROVIDE COUNSELING SERVICES FOR LOW-INCOME AND UN-INSURED PERSON IN OUR REGION AND PROVIDES ACCESS TO THOSE WITHOUT TRANSPORTATION. COVENANT HEALTH BEGAN AN ANTI-STIGMA CAMPAIGN FOR MENTAL AND BEHAVIORAL HEALTH IN 2020 WHICH CONTINUED INTO 2021 FOR THE ENTIRE REGION. COVENANT HEALTH ALSO DIRECTLY RUNS OUTREACH COUNSELING CLINIC FOR THE COMMUNITY, WHICH IS AVAILABLE TO LOW INCOME PERSONS IN THE SERVICE AREA. IN 2021 OUR CARE COORDINATION COMMUNITY BASED TEAMS ADDED A TEAM DEDICATED SOLELY TO MENTAL HEALTH OUTREACH. A MENTAL HEALTH VOUCHER PROGRAM WAS FUNDED BY COVENANT HEALTH FOR CATHOLIC CHARITES IN 2021.PRIORITY 2: ACCESS TO HEALTH SERVICESACCESS TO HEALTH SERVICES INCLUDING BUT NOT LIMITED TO PREVENTION, MENTAL HEALTH, ORAL HEALTH, PRESCRIPTION ASSISTANCE, HEALTH/COMMUNITY NAVIGATION, TRANSPORTATION AND HEALTH EDUCATION/PREVENTION SERVICES2021 ACCOMPLISHMENTS: CONTINUED EXPANSION COMMUNITY CARE COORDINATION SERVICES TO CONNECT VULNERABLE PERSONS TO MEDICAL HOMES, MENTAL HEALTH CARE AND PRESCRIPTION PROGRAMS; IN 2021 ADDED A FIXED SITE DENTAL OUTREACH CLINIC IN HALE COUNTY WAS CONTINUED AND RECEIVED A GRANT TO PROVIDE DENTURES TO HALE COUNTY RESIDENTS IN NEED; COVENANT HEALTH PROVIDED GRANTS AND DONATIONS TO VARIOUS LOCAL COMMUNITY CLINICS AND HEALTH CENTERS; PROVIDED GRANT AND IN-KIND STAFF SUPPORT TO PRESCRIPTION ASSISTANCE PROGRAM WITH CATHOLIC CHARITIES; IN BOTH 2020 AND 2021 COVENANT HEALTH SUPPORTED LOCAL HEALTH DEPARTMENTS IN ENSURING COMMUNITY ACCESS TO COVID VACCINATIONS AND COVID EDUCATION-SPECIFIC OUTREACH WAS DESIGNED TO MEET THE NEEDS OF HISTORICALLY UNDERSERVED POPULATIONS AND WITH A HEALTH EQUITY FOCUS.PRIORITY 3: HOUSING INSECURITY/HOMELESSNESSSAFE, AFFORDABLE, STABLE HOUSING AND PERMANENT SUPPORTIVE HOUSING SOLUTIONS FOR PEOPLE EXPERIENCING CHRONIC HOMELESSNESS2021 ACCOMPLISHMENTS: PROVIDED GRANT FUNDING TO OPEN DOOR FOR EXPANSION OF PERMANENT SUPPORTIVE HOUSING PROGRAM; CONNECTED COVENANT CARE COORDINATION/NAVIGATION, COUNSELING AND HEALTH EDUCATION SERVICES TO NON-PROFITS ADDRESSING HOUSING AND HOMELESSNESS TO BETTER PROVIDE WRAP AROUND SERVICES; PROVIDED CAREGIVERS TO VOLUNTEER AT HOUSING OUTREACH NON-PROFITS AND ALSO WITH HABITAT FOR HUMANITY; PROVIDED GRANT FUNDS TO HABITAT FOR HUMANITY AND TO OTHER NON-PROFITS ADDRESSING SOCIAL DETERMINANTS OF HEALTH INCLUDING HOUSING.PRIORITY 4: FOOD INSECURITY AND NUTRITIONACCESS TO HEALTHY FOOD, NUTRITION EDUCATION, AND HEALTHY LIFESTYLE SUPPORT2021 ACCOMPLISHMENTS: SCREENED FOR FOOD INSECURITY WITHIN COMMUNITY CARE COORDINATION PROGRAM AND CONNECTED INDIVIDUALS IN NEED WITH FOOD ASSISTANCE AND SNAP ENROLLMENT ASSISTANCE; PROVIDED GRANT FUNDS TO DOUBLE UP FOOD BUCKS TO PROVIDE FRESH FARM GROWN FOOD ALTERNATIVES TO FAMILIES ON FOOD ASSISTANCE PROGRAMS FOR THE ENTIRE SERVICE REGION; PROVIDED FREE HEALTH AND NUTRITION EDUCATION SERVICES THROUGH COVENANT HEALTH EDUCATION OUTREACH; PROVIDED TELE-HEALTH EDUCATION TO THOSE IN NEED; INVESTED FUNDING AFTER SCHOOL FEEDING PROGRAM WITH THE DREAM CENTER; SUPPORT LOCAL FOOD BANKS AND FOOD KITCHENS.POTENTIAL RESOURCES AVAILABLE TO ADDRESS SIGNIFICANT HEALTH NEEDSUNDERSTANDING THE POTENTIAL RESOURCES TO ADDRESS SIGNIFICANT HEALTH NEEDS IS FUNDAMENTAL TO DETERMINING CURRENT STATE CAPACITY AND GAPS. THE ORGANIZED HEALTH CARE DELIVERY SYSTEMS INCLUDE THE LOCAL HEALTH DEPARTMENTS, SEVERAL FEDERALLY QUALIFIED HEALTH CENTERS, COVENANT HEALTH HOSPITALS AND CLINICS, TEXAS TECH HEALTH SCIENCES CENTER, STARCARE, AND UNIVERSITY MEDICAL CENTER. WITHIN COVENANT HEALTH, DIRECT OUTREACH PROGRAMS ARE DESIGNATED TO ADDRESS COMMUNITY NEEDS. IN ADDITION, THERE ARE NUMEROUS SOCIAL SERVICE NON-PROFIT AGENCIES, FAITH-BASED ORGANIZATIONS, AND PRIVATE AND PUBLIC-SCHOOL SYSTEMS THAT CONTRIBUTE RESOURCES TO ADDRESS THESE IDENTIFIED NEEDS. FOR A LIST OF POTENTIALLY AVAILABLE RESOURCES AVAILABLE TO ADDRESS SIGNIFICANT HEALTH NEEDS SEE APPENDIX 5 OF THE CHNA.FOR MORE INFORMATION ON THE KEY STRATEGIES FOR ADDRESSING THESE HEALTH NEEDS GO TO THE COVENANT HEALTH FY21-23 CB PLAN LOCATED AVAILABLE ONLINE AT HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSNEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUING OUR MISSION THROUGH PROVIDING WELLNESS AND PREVENTION COMMUNITY GRANTS AND SPONSORSHIPS/DONATIONS TO NON-PROFITS ADDRESSING IDENTIFIED NEEDS. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESS AND AN EXPLANATION IS PROVIDED BELOW:ECONOMIC INSECURITY, ACCESS TO COMMUNITY RESOURCES, WORKFORCE ISSUES, AND TRANSPORTATION THESE NEEDS WILL BE INDIRECTLY ADDRESSED THROUGH OUTREACH EFFORTS AND INTERNAL PROGRAMMING; HOWEVER, COVENANT HEALTH DID NOT SELECT THESE AS PRIORITY FOCUS AREAS. COVENANT HEALTH WORKS CLOSELY WITH THE NON-PROFITS COMMUNITY, AGENCIES AND ORGANIZATIONS THAT PROVIDE MORE DIRECT OUTREACH AND HAVE THE RESOURCES AND EXPERTISE TO LEAD INITIATIVES TO ADDRESS THESE NEEDS. IN ADDITION, COVENANT HEALTH WILL COLLABORATE WITH CASA OF THE SOUTH PLAINS, CATHOLIC CHARITIES, THE DREAM CENTER, THE YWCA, SOUTH PLAINS COMMUNITY ACTION, LOCAL FQHCS AND OTHER LOCAL NON-PROFITS THAT ADDRESS THE AFOREMENTIONED COMMUNITY NEEDS TO COORDINATE CARE AND REFERRALS TO ADDRESS THESE UNMET NEEDS.

GRACE MEDICAL CENTER
PART V, SECTION B, LINE 13H: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.

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

SCHEDULE H, PART V, SECTION B, LINE 7A:
"HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE ""TEXAS"" TAB."

SCHEDULE H, PART V, SECTION B, LINE 10A:
"HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSPLEASE LOOK IN THE ""TEXAS"" TAB."

SCHEDULE H, PART V, SECTION B, LINE 16A:
HTTPS://GRACEHEALTHSYSTEM.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/

SCHEDULE H, PART V, SECTION B, LINE 16B:
HTTPS://GRACEHEALTHSYSTEM.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/

SCHEDULE H, PART V, SECTION B, LINE 16C:
HTTPS://GRACEHEALTHSYSTEM.COM/FOR-PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/

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

PART I, LINE 6A:
LUBBOCK HERITAGE HOSPITAL, LLC PREPRARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/TEXAS

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

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

PART III, LINE 3:
THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY.

PART III, LINE 4:
AS A RESULT OF ADOPTING ASU 2014-09, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019.

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

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

PART VI, LINE 2:
NEEDS ASSESSMENTCOVENANT HEALTH AS PART OF ITS STRATEGIC PLANNING PROCESS DEVELOPS A FIVE-YEAR STRATEGIC PLAN WHICH ESTABLISHES A VISION FOR THE ORGANIZATION WHILE SETTING A GUIDE FOR THE ANNUAL STRATEGIC PLAN. AS PART OF THE PLANNING PROCESS, WE ANALYZE EXTERNAL MARKET INFORMATION (INCLUDING BUT NOT LIMITED TO POPULATION ESTIMATES, DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION, REGIONAL USE RATES AND MARKET UTILIZATION TREND ANALYSES) AND INTERNAL INFORMATION (INCLUDING BUT NOT LIMITED TO INPATIENT, OUTPATIENT/SAME DAY, AND EMERGENCY VISIT DATA BY PATIENT ORIGIN, BY AGE COHORTS, BY RACE AND ETHNICITY AND INCOME STRATA) TO BETTER UNDERSTAND THE NEEDS OF OUR PATIENTS AND COMMUNITY. THIS WORK IS USED TO DEVELOP SERVICE AND PHYSICIAN/PROVIDER NEED PROJECTIONS TO DETERMINE GAPS IN OUR COMMUNITY. AS A FAITH-BASED PROVIDER THIS INFORMATION ALSO IS USED TO DETERMINE NEEDS FOR THE UNDERSERVED AND VULNERABLE IN OUR COMMUNITY AND REGION.

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

PART VI, LINE 5:
PROMOTION OF COMMUNITY HEALTHCOVENANT MEDICAL CENTER, GRACE MEDICAL CENTER, COVENANT CHILDREN'S, COVENANT HEALTH LEVELLAND AND COVENANT HEALTH PLAINVIEW ALL PROVIDE VITAL COMMUNITY HEALTH SERVICES AND ADDRESS THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. COVENANT HEALTH IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.

PART VI, LINE 7, REPORTS FILED WITH STATES
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PART VI, LINE 4:
"COMMUNITY INFORMATIONCOVENANT HEALTH PROVIDES WEST TEXAS AND EASTERN NEW MEXICO COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE CHNA SERVICE AREA, INCLUDING LUBBOCK, HOCKLEY, AND HALE COUNTIES, IS HOME TO APPROXIMATELY 379,000 PEOPLE.THE SERVICE AREA FOR COVENANT MEDICAL CENTER, GRACE, COVENANT CHILDREN'S HOSPITAL, COVENANT SPECIALTY HOSPITAL, AND GRACE HOSPITAL IS THE ENTIRETY OF LUBBOCK COUNTY. COVENANT LEVELLAND SERVES HOCKLEY COUNTY, AND COVENANT PLAINVIEW SERVES HALE COUNTY. DUE TO THE LEVEL OF CARE PROVIDED AT THESE SIX HOSPITALS, COVENANT HOSPITALS SEE PATIENTS FROM SURROUNDING COUNTIES, ALTHOUGH FOR THE PURPOSES OF THIS CHNA, THE TOTAL SERVICE AREAS WILL INCLUDE LUBBOCK, HOCKLEY, AND HALE COUNTIES. DATA COLLECTED IN THIS CHNA FOCUS ON THESE THREE COUNTIES, WHICH ARE WITHIN A GEOGRAPHIC AREA THAT IS DIRECTLY SERVED BY THE COVENANT COMMUNITY HEALTH OUTREACH PROGRAMS.SURROUNDING COUNTIES OUTSIDE OF THE CHNA SERVICE AREA WHERE PATIENTS MAY LIVE INCLUDE THE FOLLOWING: CASTRO, SWISHER, BAILY, COCHRAN, YOAKUM, GAINES, DAWSON, SCURRY, LAMB, TERRY, LYNN, GARZA, CROSBY, AND FLOYD COUNTIES IN TEXAS, AS WELL AS CURRY, ROOSEVELT, LEA, AND EDDY IN NEW MEXICO. FOR THE MOST PART, THE AGE DISTRIBUTION FOR AGE GROUPS 85+ AND UNDER 5 YEARS ARE ROUGHLY PROPORTIONAL ACROSS THE BROADER SERVICE AREA, HIGH NEED SERVICE AREA, AND THREE COUNTIES. WHILE THE BROADER AND HIGH NEED SERVICE AREAS ARE ROUGHLY PROPORTIONAL, HALE COUNTY HAS A SLIGHTLY GREATER PROPORTION OF PEOPLE UNDER 18 YEARS. PEOPLE BETWEEN 18 AND 34 ARE SUBSTANTIALLY MORE LIKELY TO LIVE IN A HIGH NEED AREA, LIKELY YOUNG FAMILIES AND THOSE IN AND AROUND COLLEGE TOWNS. THOSE AGES 35 TO 84 ARE LESS LIKELY TO LIVE IN A HIGH NEED AREA. THE POPULATION OF LUBBOCK COUNTY IS APPROXIMATELY 5 TIMES THAT OF HALE AND HOCKLEY COUNTIES COMBINED.THE HISPANIC POPULATION IS OVER-REPRESENTED IN THE HIGH NEED COMMUNITIES, REPRESENTING NEARLY 50% OF THE POPULATION IN THOSE AREAS COMPARED TO 31% IN THE BROADER SERVICE AREA. THOSE WHO IDENTIFY AS WHITE ARE LESS LIKELY TO LIVE IN HIGH NEED COMMUNITIES, WHILE THOSE WHO IDENTIFY AS ""OTHER"" RACE POPULATION AND AS BLACK ARE MORE LIKELY TO LIVE IN THE HIGH NEED COMMUNITIES. WHILE THE BLACK POPULATION MAKES UP NEARLY 4% OF THE BROADER SERVICE AREA, THEY MAKE UP ALMOST 11% OF THE HIGH NEED SERVICE AREA. APPROXIMATELY 60% OF THE POPULATION IN HALE COUNTY IDENTIFIES AS HISPANIC, AS DO NEARLY 50% OF THE POPULATION OF HOCKLEY COUNTY. THE MEDIAN INCOME FOR THE HIGH NEED SERVICE AREA IS LOWER THAN THAT OF ALL THREE COUNTIES AND THE STATE OF TEXAS. IT IS ALSO ABOUT HALF THE MEDIAN INCOME OF THE BROADER SERVICE AREA. CENSUS TRACTS WITH THE LOWEST MEDIAN HOUSEHOLDS' INCOMES ARE FOUND NEAR COVENANT MEDICAL CENTER, COVENANT CHILDRENS, GRACE MEDICAL CENTER AND COVENANT HEALTH PLAINVIEW. SEVERE HOUSING COST BURDEN IS DEFINED AS HOUSEHOLDS THAT ARE SPENDING 50% OR MORE OF THEIR INCOME ON HOUSING COSTS. THE HIGH NEED SERVICE AREA HAS A HIGHER PERCENTAGE OF RENTER HOUSEHOLDS WITH SEVERE HOUSING COST BURDEN THAN EACH OF THE COUNTIES IN THE TOTAL SERVICE AREA AND THE STATE OF TEXAS.LUBBOCK COUNTY HAS THE HIGHEST PERCENTAGE OF HOUSEHOLDS THAT ARE SEVERELY HOUSING COST BURDEN WHEN COMPARED TO HALE AND HOCKLEY COUNTIES. CENSUS TRACTS AROUND COVENANT MEDICAL CENTER, COVENANT CHILDRENS, AND GRACE MEDICAL CENTER HAVE THE HIGHEST PERCENTAGE OF HOUSEHOLDS THAT ARE SEVERELY HOUSING COST BURDENED IN THE SERVICE AREA.THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS HPSAS) AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). LARGE PORTIONS OF THE COVENANT HEALTH SERVICE AREA ARE DESIGNATED AS SHORTAGE AREAS.OTHER HOSPITALS IN SERVICE AREAHOSPITALS SERVING LUBBOCK COUNTY INCLUDE: UMC HEALTH SYSTEM, COVENANT MEDICAL CENTER, COVENANT SPECIALTY HOSPITAL, COVENANT CHILDREN'S HOSPITAL, COVENANT GRACE SURGICAL HOSPITAL."

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