4A (Expenses $ 2051593171 including grants of $ 7992655) (Revenue $ 2958432698)
THE FILING ORGANIZATION IS A PART OF THE ASCENSION CATHOLIC HEALTH MINISTRY. ASCENSION IS A FAITH-BASED HEALTHCARE ORGANIZATION THAT DELIVERS PERSONALIZED, COMPASSIONATE CARE TO ALL, ESPECIALLY TO THOSE WHO NEED IT THE MOST. As the leading provider of health services in Central Texas (an 11-county region), Ascension Seton (Seton) also provides a number of distinctive services to the community: the only Level I trauma facilities; the only free-standing children's hospital; the only free-standing inpatient behavioral health hospital; the only heart transplant center; and the only University of Texas medical residency programs. Seton contributes to the positive health status of the communities it serves and continues to build and strengthen sustainable collaborative efforts to benefit the health of individuals, families and society as a whole. Seton has a mission to care for the community it serves with a special concern for the poor and the vulnerable. Ascension Seton is a 1,575-bed hospital system providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2023, Ascension Seton treated 65,856 adults and children for a total of 381,430 patient days of service. The hospital also provided services for 824,827 outpatient visits, which included 33,981 outpatient surgeries and 321,568 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions.

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 - ALL ASCENSION SETON HOSPITALS. The Ascension Seton CHNA represents the following: A,1 - Dell Children's Medical Center of Central Texas A,2 - Ascension Seton Medical Center Austin A,3 - Dell Seton Medical Center at the University of Texas A,4 - Ascension Seton Williamson A,5 - Ascension Seton Hays A,6 - Ascension Seton Northwest A,7 - Ascension Seton Highland Lakes A,8 - Ascension Seton Southwest A,9 - Ascension Seton Edgar B. Davis A,10 - Ascension Seton Bastrop A,11 - Ascension Seton Smithville A,12 - Ascension Seton Shoal Creek A,13 - PAM Rehabilitation Hospital of Round Rock (JV) A,14 - Northwest Hills Surgical Hospital (JV) The 2021 CHNA was conducted from July 2021 to January 2022, and utilized processes which incorporated data from both primary and secondary sources. Primary data sources, sometimes called qualitative data, 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. Together with the efforts of our hospital partners and consultants, an estimated total of 230 individuals participated in focus groups or interviews, held between July 2021 and December 2021. Populations represented by participants included medically underserved, low-income, minority groups, and rural, urban and suburban groups. Multiple methods were used to gather community input, including key stakeholder interviews, community focus groups and a community survey. Recognizing its vital importance in understanding the health needs and assets of the community, Ascension Seton, in collaboration with hospital partners at St. David's Foundation, Baylor Scott and White, and public health leaders for Travis and Williamson counties solicited input from a range of public health and social service providers that represent the broad interest of Ascension Seton service area. 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. Ascension Seton drew from a number of sources to complete the qualitative analysis for this CHNA. A series of 19 focus groups with approximately 100 participants were conducted by Alpinista Consulting to gather input from community members in the following counties: Burnet, Llano, Blanco, Fayette, Lee and Gonzales, along with Travis and Williamson for focus groups that focused on children's needs. Ascension Seton also received feedback from community members in Bastrop, Caldwell, Hays and Williamson counties from the Texas Health Institute (THI) through a partnership agreement with hospital partner St. David's Foundation. THI conducted a total of 11 focus groups in these four counties, with three each (two in English and one in Spanish) in Bastrop, Caldwell and Hays counties, and two (both in English) in Williamson county. A total of 58 community residents participated in those across the counties. Finally, as part of collaborations led by public health departments in Travis and Williamson counties, Ascension Seton received reports from the community focus groups conducted in each of those counties. As part of the CHA Task Force, hospital partner Baylor Scott and White contracted with IBM Watson to conduct a focus group which included representatives from county government, church organizations, providers, local non-profits, and other community-based organizations. Most of the participants work with at-risk populations; the group at-large serve low-income populations, minorities, the medically under-served and homeless populations. A series of 14 one-on-one interviews were conducted by the Ascension Texas Community Benefit team to gather feedback from key stakeholders on the health needs and assets of Ascension Texas. These interviews represented 14 different organizations and agencies. Some agencies also participated in the focus groups, held between September 2021 and October 2021. Sectors represented by participants included community non-profits, foundations, social service providers and health organizations. A survey was conducted by Ascension Seton to gather the perceptions, thoughts, opinions, and concerns of the community regarding health outcomes, health care access, and social determinants of health for Ascension Seton. Fifty- one individuals participated in the survey, held between August 2021 and October 2021. Ascension Seton associates were also invited to participate in multiple focus groups and discussions related to the creation of the CHNA. The following organizations were represented during stakeholder interviews conducted in 2021: - 4:12 Kids - Advocacy Outreach - Affordable Central Texas - AGE of Central Texas - Amigos de Jesus - Austin Clubhouse - Austin Asian Community Health Initiative - Bastrop County Cares - Baylor Scott & White Health - Blanco Chamber of Commerce - Blanco County EMS - Bluebonnet Trails - Boys & Girls Club of the Austin Area - Buda Food Pantry - Catholic Charities of Central Texas - Central Health - Central Texas Food Bank - Central Texas Interfaith - Children's Optimal Health - City of Manor - City of Pflugerville - City of Smithville - City of Taylor - Combined Community Action, Inc. - Community Care - Community Health Centers of South Central Texas - Dickey Museum & Multipurpose Center - Faith Action in georgetown - First Methodist Church San Marcos - Georgetown Chamber of Commerce - Georgetown Health Foundation - Georgetown Independent School District - Gonzales County - Harris-Ross Head Start - Hays County Food Bank - Hays County Indigent Health Care Program - Integral Care - Interagency Support Council of eastern Williamson County, Inc. - Lampasas ISD - Lone Star Circle of Care - Luling City Council - Mobile Outreach Team Williamson County Emergency Services - Partners in Hope - Partnerships for Children - Pavilion Clubhouse of Williamson County - People's Community Clinic - Regarding Cancer - School District in Hays County - Texas Department of State Health Services - The Caring Place - United Way of Williamson County - Where We Thrive - Williamson County and City and Health District - Williamson County Child Advocacy Center - Williamson County Indigent Care Program - Workforce Solutions Rural Capital Area - Texas A&M College of Nursing The following organizations were represented during stakeholder focus groups conducted in 2021: - Bluebonnet Trails - Catholic Charities of Central Texas - Central Texas Food Bank - Child Protective Services - Dell Medical School at The University of Texas - Lone Star Circle of Care - Michael and Susan Dell Foundation - NAMI Central Texas - Texas Department of State Health Services - The Hogg Foundation - United Way of Greater Austin - YMCA Travis County - YMCA Williamson County

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - ALL SETON HOSPITALS. The Ascension Seton CHNA represents the following list of 14 hospital facilities: A,1 - Dell Children's Medical Center of Central Texas A,2 - Ascension Seton Medical Center Austin A,3 - Dell Seton Medical Center at the University of Texas A,4 - Ascension Seton Williamson A,5 - Ascension Seton Hays A,6 - Ascension Seton Northwest A,7 - Ascension Seton Highland Lakes A,8 - Ascension Seton Southwest A,9 - Ascension Seton Edgar B. Davis A,10 - Ascension Seton Bastrop A,11 - Ascension Seton Smithville A,12 - Ascension Seton Shoal Creek A,13 - PAM Rehabilitation Hospital of Round Rock (JV) A,14 - Northwest Hills Surgical Hospital (JV) The other Ascension hospital facilities with which the reporting hospitals conducted the CHNA include: - Cedar Park Regional Medical Center (JV) - Warm Springs Rehabilitation Hospital of Kyle (JV) - Central Texas Rehabilitation Hospital (JV) The other hospital facilities with which the reporting hospitals conducted the CHNA include: - St. David's Foundation, which represents various hospital facilities that serve Travis, Williamson, Hays, Bastrop and Caldwell counties within the Ascension Seton service area - Baylor Scott & White Health, which represent various hospital facilities serving Travis, Williamson, Hays, Llano, Burnet, and Blanco counties within the Ascension Seton service area

Schedule H, Part V, Section B, Line 6b Facility A, 1
Facility A, 1 - ALL ASCENSION SETON HOSPITALS. The Ascension Seton CHNA represents the following: A,1 - Dell Children's Medical Center of Central Texas A,2 - Ascension Seton Medical Center Austin A,3 - Dell Seton Medical Center at the University of Texas A,4 - Ascension Seton Williamson A,5 - Ascension Seton Hays A,6 - Ascension Seton Northwest A,7 - Ascension Seton Highland Lakes A,8 - Ascension Seton Southwest A,9 - Ascension Seton Edgar B. Davis A,10 - Ascension Seton Bastrop A,11 - Ascension Seton Smithville A,12 - Ascension Seton Shoal Creek A,13 - PAM Rehabilitation Hospital of Round Rock (JV) A,14 - Northwest Hills Surgical Hospital (JV) The Ascension Seton CHNA was completed in partnership with the following non-hospital facilities 1. Austin Public Health and collaborative partners including: - Capital Metro - Central Health - City of Austin Transportation Department - Travis County - Integral Care - The University of Texas at Austin Dell Medical School - The University of Texas Health Science Center at Houston, School of Public Health 2. Williamson County & Cities Health District and collaborative partners including: - Williamson County - Bluebonnet Trails Community Services - Georgetown Health Foundation - Healthy Williamson County Coalition - Lone Star Circle of Care - Opportunities for Williamson & Burnet Counties - United Way of Williamson County

Schedule H, Part V, Section B, Line 11 Facility A, 1
Facility A, 1 - ALL ASCENSION SETON FACILITIES - PART 1. PART 1: During the 2021 Community Health Needs Assessment (CHNA) process, which included both quantitative and qualitative analysis, Ascension Seton identified and prioritized four main needs for the 11 county service area including Bastrop, Blanco, Burnet, Caldwell, Fayette, Gonzales, Hays, Lee, Llano, Travis and Williamson Counties which include: (1) Access to Care (2) Mental and Behavioral Health (3) Social Determinants of Health (4) Health Equity. To address the needs identified in the 2021 CHNA, an Implementation Strategy (IS) for each Ascension Seton facility was adopted in August of 2022. Each plan identifies the action the hospital, with the support of the Ascension Seton network, plans to take to address the prioritized needs. Since Ascension Seton has multiple sites throughout Travis County, both inpatient and outpatient, some actions described in the Implementation Strategies are not strictly operated by any one facility. The various actions included in the Implementation Strategy are not intended to be exhaustive or inclusive of every single Ascension Texas strategy, initiative or program. Instead, the plan highlights the most significant actions that each hospital has undertaken to address the health needs prioritized in the CHNA including those strategies that are expected to make the most significant impact on the delivery of healthcare in the region for the poor and vulnerable. As required by IRS guidelines, for each need, each Ascension Seton facility has identified key actions to address the need: - The anticipated impact of these actions - Available resources to address the need - Potential collaborations These items are addressed by each of the following Ascension Seton facilities: A,1 - Dell Children's Medical Center of Central Texas A,2 - Ascension Seton Medical Center Austin A,3 - Dell Seton Medical Center at the University of Texas A,4 - Ascension Seton Williamson A,5 - Ascension Seton Hays A,6 - Ascension Seton Northwest A,7 - Ascension Seton Highland Lakes A,8 - Ascension Seton Southwest A,9 - Ascension Seton Edgar B. Davis A,10 - Ascension Seton Bastrop A,11 - Ascension Seton Smithville A,12 - Ascension Seton Shoal Creek A,13 - PAM Rehabilitation Hospital of Round Rock (JV) A,14 - Northwest Hills Surgical Hospital (JV) A,1 - Dell Children's Medical Center of Central Texas The Implementation Strategy for Dell Children's Medical Center of Central Texas addresses all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Dell Children's Medical Center of Central Texas to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members. Host health education and activities in partnership with community partners to reach diverse community populations. - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. Access to Care Progress to Date: - The Dell Children's Injury Prevention program offers various community education opportunities with local partners to provide child safety resources and education to vulnerable populations in the Safe Kids Austin service area. DCMC also hosted a wellness event designed to provide resources, education and information to students and families served by Title 1 schools. Dell Children's offers camps for children with disabilities to access age-appropriate therapeutic activities. In addition, services to increase access to care are provided to local schools on an ongoing basis including campus health rooms and sports physicals. - The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high-risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations for adolescents through two statewide initiatives. DMCC will recruit a network of primary care physicians to be in the CPAN network, provide child tele-psychiatry consults at primary care visits through CPAN, and provide school districts with tele-psychiatry support for students, families and faculty through Texas Child Access Through Telemedicine (TCHATT). Mental and Behavioral Health Progress to Date: - In this fiscal year, primary care physicians enrolled in CPAN increased to 997 total with 444 tele-psychiatry consults provided through primary care visits. Through the TCHATT program, 3,409 student appointments were completed along with 462 school staff consults. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services - Address social needs related to housing and community safety through investments and trainings SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. The Ascension Human Trafficking Hub hosted in person and virtual Human Trafficking Awareness & Education for the Healthcare Professional training for Dell Children's Medical Center associates. Through this course, associates learn to identify red flags and indicators of human trafficking in their care setting. Health Equity: Deepen Community Partnerships with organizations that advance health in underserved populations by working with community partners to support vulnerable community members through ongoing engagement and investments. - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Dell Children's Medical Center and the Ascension Seton system are engaged in partnerships with various community organizations with special attention to underserved populations including: organizations who work with families who have immigrated to provide navigation and legal services, school districts in the service area, regional Federally Qualified Health Centers (FQHCs), Austin Community Foundation, American Heart Association, the Workers Defense Project, and Austin Black Physicians Association. Dell Children's Medical Center associates lead the Center for Resiliency, open to all Ascension associates, which includes Diversity Equity & Inclusion Book Club that meets monthly and can be used for a continuing education credit. The Center for Resiliency also includes safe spaces for conversations and training for healthcare providers related to current challenges. Training is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. A,2 - Ascension Seton Medical Center Austin The Implementation Strategy for Ascension Seton Medical Center Austin addresses all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Medical Center Austin to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members. Host health education and activities in partnership with community partners to reach diverse community populations. - Expand health and social services for women and new mothers by providing referrals to Family Connects, an evidence-based home-visiting nurse program available to all families with newborns at no cost to the family - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. (CONTINUED)

Schedule H, Part V, Section B, Line 11 Facility A, 2
Facility A, 2 - ALL ASCENSION SETON FACILITIES - PART 2. PART 2: Access Progress to date: - Changes in staffing caused barriers to implementing community-based education, hospital leaders continue to look for opportunities to support patients with education or connection to community-based education and resources. Referrals to Family Connects began in this fiscal year and continued to increase each quarter with over 600 referrals during the year. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas provide tele support for psychiatric consults in all Ascension Seton EDs. A group of psychiatrists also cover both Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin in person to provide consultations on the medical floors. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services - Address social needs related to housing and community safety through investments and trainings SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. The Ascension Human Trafficking Hub hosted in person and virtual Human Trafficking Awareness & Education for the Healthcare Professional training for Ascension Seton Medical Center Austin associates. Through this course, associates learn to identify red flags and indicators of human trafficking in their care setting. Health Equity: - Deepen Community Partnerships with organizations that advance health in underserved populations by working with community partners to support vulnerable community members through ongoing engagement and investments. - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Ascension Seton Medical Center Austin and the Ascension Seton system are engaged in partnerships with various community organizations with special attention to underserved populations including: Farm Share Austin, local doula organizations, The United Way and city of Austin public health nurses, regional Federally Qualified Health Centers (FQHCs), Austin Community Foundation, American Heart Association, Workers Defense Project, and Austin Black Physicians Association. Ascension Seton Medical Center Austin provides training on health equity to all nursing residents. Training is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. A,3 - Dell Seton Medical Center at the University of Texas The Implementation Strategy for Dell Seton Medical Center at the University of Texas addresses all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Dell Seton Medical Center at the University of Texas to address each of the identified community health needs include those listed below. Access to Care: - Offer access to prescriptions through Dispensary of Hope for patients who cannot pay for prescriptions by providing free or discounted medications and testing supplies to all uninsured and underinsured individuals who qualify. - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. Access to Care Progress to Date: - In this fiscal year, over 450 patients received free or discounted medications and/or testing supplies through the Dispensary of Hope program at the on-site pharmacy operated at Dell Seton Medical Center at The University of Texas. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high-risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Dell Seton Medical Center at The University of Texas has a dedicated psychiatric emergency department housed within the emergency department which includes 5 beds and is open 24/7 365 days a year. It provides full service, in person evaluation and management services. In addition there are a group of psychiatrists who cover both Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin in person to provide consultations on the medical floors. The psychiatrists at Dell Seton Medical Center at The University of Texas provide tele support to other Seton hospitals. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services - Address social needs related to housing and community safety through investments and trainings SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. The Ascension Human Trafficking Hub hosted in person and virtual Human Trafficking Awareness & Education for the Healthcare Professional training for Dell Seton Medical Center at UT associates. Through this course, associates learn to identify red flags and indicators of human trafficking in their care setting. Health Equity: - Deepen Community Partnerships with organizations that advance health in underserved populations by working with community partners to support vulnerable community members through ongoing engagement and investments. - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Dell Seton Medical Center at The University of Texas the and Ascension Seton system are engaged in partnerships with various community organizations with special attention to underserved populations including: regional Federally Qualified Health Centers (FQHCs), Austin Community Foundation, American Heart Association, Workers Defense Project, and Austin Black Physicians Association. Dell Seton Medical Center at The University of Texas is working in partnership with Central Health, the County Healthcare District, to support an outpatient dialysis access for patients who would not have coverage otherwise. Dell Seton Medical Center at The University of Texas collects z-codes to identify patients who have social needs. Training is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. (CONTINUED)

Schedule H, Part V, Section B, Line 11 Facility A, 3
Facility A, 3 - ALL ASCENSION SETON FACILITIES - PART 3. PART 3: A,4 - Ascension Seton Williamson Ascension Seton Williamson will address all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies in the Ascension Seton Williamson Implementation Strategy to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members. Host health education and activities in partnership with community partners to reach diverse community populations. - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. Access to Care Progress to Date: - Postpartum support groups and cardiac yoga classes were offered but are on pause due to changes in staffing causing barriers to implementing community-based education. Hospital leaders continue to look for opportunities to support patients with education or connection to community-based education and resources. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Williamson. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Ascension Seton Williamson and the Ascension Seton system are engaged in partnerships with various community organizations with special attention to underserved populations including: local doula organizations, regional Federally Qualified Health Centers (FQHCs), Austin Community Foundation, American Heart Association, Workers Defense Project, and Austin Black Physicians Association. Ascension Seton Williamson participates in the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) Respectful Maternity Care study which includes regular associate engagement on topics related to health equity, bias, communication skills and building trust with patients in maternal care. Additional training is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. A,5 - Ascension Seton Hays Ascension Seton Hays will address all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Hays to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members. Host health education and activities in partnership with community partners to reach diverse community populations. - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. Access to Care Progress to Date: - Services offered by Ascension Seton Hays include Stop the Bleed sessions and flu vaccine clinics that served 80 people. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Hays. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Training for Ascension Seton Hays associates is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. Additionally, related to the social determinants of health strategy identified, initial training on utilizing the platform Neighborhood Resource is available as a tool for connecting patients to social and community-based clinical services and additional work on this is expected to continue. A,6 - Ascension Seton Northwest The Implementation Strategy for Ascension Seton Northwest addresses all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Northwest to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members. Host health education and activities in partnership with community partners to reach diverse community populations. - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. Access to Care Progress to Date: - In FY23, 77 attendees were served through a community event and a lunch and learn educational community session. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. (CONTINUED)

Schedule H, Part V, Section B, Line 11 Facility A, 4
Facility A, 4 - ALL ASCENSION SETON FACILITIES - PART 4. PART 4: Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Northwest. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Deepen Community Partnerships with organizations that advance health in underserved populations by working with community partners to support vulnerable community members through ongoing engagement and investments. - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Ascension Seton Northwest and the Ascension Seton system are engaged in partnerships with various community organizations with special attention to underserved populations including: regional Federally Qualified Health Centers (FQHCs), Austin Community Foundation, American Heart Association, Workers Defense Project, and Austin Black Physicians Association. Training is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. Additionally, related to the social determinants of health strategy identified, initial training on utilizing the platform Neighborhood Resource is available as a tool for connecting patients to social and community-based clinical services and additional work on this is expected to continue. A,7 - Ascension Seton Highland Lakes Ascension Seton Highland Lakes will address all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies in the Ascension Seton Highland Lakes Implementation Strategy to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members. Host health education and activities in partnership with community partners to reach diverse community populations. - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. - Increase access points and capacity for primary care services at the Rural Health Clinic (RHC) by providing access to primary care services in rural communities. Access to Care Progress to Date: - This fiscal year Ascension Seton Highland Lakes organized Big and Loud Crowd and a total of 556 individuals attended the events. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Ascension Seton Highland Lakes operates 8 Rural Health Clinics in providing over 51,000 visits this year, increasing access points to primary care in communities designated as shortage areas. Mental Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Highland Lakes. In addition, Ascension Seton Highland Lakes works in partnership with Bluebonnet Trails Community Services to increase capacity for virtual psychiatric consultations. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - Ascension Seton Highland Lakes offers food to-go packages for patients who are food insecure in partnership with their on-site kitchen and participate in community coalitions related to food insecurity. The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Ascension Seton Highland Lakes operates a pedi-van that provides mobile health screenings to underserved community members and rural health clinics that offer primary care in areas of low healthcare access. Training for Ascension Seton Highland Lakes associates is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. Additionally, related to the social determinants of health strategy identified, initial training on utilizing the platform Neighborhood Resource is available as a tool for connecting patients to social and community-based clinical services and additional work on this is expected to continue. A,8 - Ascension Seton Southwest The Implementation Strategy for Ascension Seton Southwest addresses all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Southwest to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members. Host health education and activities in partnership with community partners to reach diverse community populations. - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. Access to Care Progress to Date: - Changes in staffing caused barriers to implementing community-based education, hospital leaders continue to look for opportunities to support patients with education or connection to community-based education and resources. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Southwest. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. (CONTINUED)

Schedule H, Part V, Section B, Line 11 Facility A, 5
Facility A, 5 - ALL ASCENSION SETON FACILITIES - PART 5. PART 5: Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Training for Ascension Seton Southwest associates is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. Additionally, related to the social determinants of health strategy identified, initial training on utilizing the platform Neighborhood Resource is available as a tool for connecting patients to social and community-based clinical services and additional work on this is expected to continue. A,9 - Ascension Seton Edgar B Davis Ascension Seton Edgar B. Davis will address all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Edgar B Davis to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members by hosting health education events and activities in partnership with community partners to reach diverse community populations - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. - Increase access points and capacity for primary care services at the Rural Health Clinic (RHC) by providing access to primary care services in rural communities. Access to Care Progress to Date: - This fiscal year 678 individuals were provided help applying for prescription assistance services by Ascension Seton Edgar B Davis. Ascension Seton Edgar B Davis provided health services through the County Indigent Program. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Ascension Seton Edgar B Davis operates 6 Rural Health Clinics in providing over 52,000 visits this year, increasing access points to primary care in communities designated as shortage areas. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Edgar B. Davis. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: Ascension Seton Edgar B. Davis associates participate in community coalitions to collaborate and strengthen the network of care with partners who serve those most in need. The hospital also operates rural health clinics that offer primary care in areas of low healthcare access. Training for Ascension Seton Edgar B. Davis associates is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. Additionally, related to the social determinants of health strategy identified, initial training on utilizing the platform Neighborhood Resource is available as a tool for connecting patients to social and community-based clinical services and additional work on this is expected to continue. A,10 - Ascension Seton Bastrop Ascension Seton Bastrop will address all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Bastrop to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members by hosting health education events and activities in partnership with community partners to reach diverse community populations - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. - Increase access points and capacity for primary care services at the Rural Health Clinic (RHC) by providing access to primary care services in rural communities. Access to Care Progress to Date: - In FY23, Bastrop provided health education to 200 individuals through Bastrop Community Cares, 100 individuals through Bastrop ISD and also participated in collaborative local health planning through Bastrop County Cares Interagency Coalition The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Bastrop. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Ascension Seton Bastrop associates participate in community coalitions to collaborate and strengthen the network of care with partners who serve those most in need. Training for Ascension Seton Bastrop associates is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. Additionally, related to the social determinants of health strategy identified, initial training on utilizing the platform Neighborhood Resource is available as a tool for connecting patients to social and community-based clinical services and additional work on this is expected to continue. (CONTINUED)

Schedule H, Part V, Section B, Line 11 Facility A, 6
Facility A, 6 - ALL ASCENSION SETON FACILITIES - PART 6. PART 6: A,11 - Ascension Seton Smithville Ascension Seton Smithville will address all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Smithville to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital and community-based education and assistance with health resources to improve access to services for community members by hosting health education events and activities in partnership with community partners to reach diverse community populations - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. - Increase access points and capacity for primary care services at the Rural Health Clinic (RHC) by providing access to primary care services in rural communities. Access to Care Progress to Date: - In this fiscal year, Ascension Seton Smithville provided health education to 300 attendees at community events and participated in local health planning with Smithville Whole Health Coalition. Ascension Seton Smithville provided help applying for prescription assistance to 663 individuals. The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high-risk pregnant people. Ascension Seton Smithville operates two Rural Health Clinics in providing over 13,000 visits this year, increasing access points to primary care in communities designated as shortage areas. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health through access to psychiatric consultations in the Emergency Department (ED) when requested. Mental and Behavioral Health Progress to Date: - Psychiatrists at Dell Seton Medical Center at The University of Texas and Ascension Seton Medical Center Austin provide psychiatric consultations virtually to patients at all other Ascension Seton hospital EDs including Ascension Seton Smithville. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Ascension Seton Smithville associates participate in community coalitions to collaborate and strengthen the network of care with partners who serve those most in need. The hospital also operates rural health clinics that offer primary care in areas of low healthcare access. Training for Ascension Seton Smithville associates is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. Additionally, related to the social determinants of health strategy identified, initial training on utilizing the platform Neighborhood Resource is available as a tool for connecting patients to social and community-based clinical services and additional work on this is expected to continue. A,12 - Ascension Seton Shoal Creek The Implementation Strategy for Ascension Seton Shoal Creek addresses all four needs identified in the 2021 Ascension Seton Region. Hospital-based strategies at Ascension Seton Shoal Creek to address each of the identified community health needs include those listed below. Access to Care: - Increase access points and capacity for primary care services utilizing an integrated care structure for triage and scheduling for both in person and telehealth visits and optimizing remote patient monitoring for a broad array of health conditions and eligible populations. Access to Care progress to Date: - The scope for the integrated care structure project was reduced and the program is not taking hospital referrals at this time. The model is still being utilized for Ascension Medical Group patients with specific conditions including congestive heart failure, hypertension, and hypertension in high risk pregnant people. Mental and Behavioral Health: - Improve network of care for Mental and Behavioral Health by conducting Behavioral Health Assessments virtually and in person at no cost to the patient to identify appropriate level of care for community-based mental health services within the Ascension Seton service area Mental and Behavioral Health Progress to Date: - Ascension Seton Shoal Creek provided no-cost behavioral health assessments for over 1200 individuals this year to identify the appropriate level of community mental health care needed. This assessment is critical in the ecosystem of community mental health care as it identifies eligibility for services provided by county programs. Ascension Seton Shoal Creek also provides navigation assistance for individuals to help connect them with services in the community; this is available for patients and also available to community members via telephone. Social Determinants of Health (SDOH): - Connect patients with social needs to community resources through the use of technology that connects people in need to community organizations who offer free and reduced cost services SDOH Progress to Date: - The Neighborhood Resource platform is available to be used by all Ascension associates to assist patients in finding free or reduced cost community-based services. Initial training on the platform was conducted, workflow barriers were identified and are being addressed. Health Equity: - Identify and address barriers to care within the community, with special attention to persons who are underserved and/or marginalized by providing training related to poverty, health equity, social determinants of health, and identification of resources. Health Equity Progress to Date: - Ascension Seton Shoal Creek offers a 24 hour navigation hotline that individuals can call if they are in need of behavioral health services but concerned about how to pay for them. Navigators clinicians talk with callers and help them schedule a no-cost behavioral health assessment. Ascension Seton Shoal Creek offers a clothing closet to individuals who may need clean clothes upon discharge; primarily intended but not exclusive to helping patients who are experiencing homelessness. The kitchen at the hospital also donates unused food each week. Training for Ascension Seton Shoal Creek associates is available through the Ascension ABIDE framework related to unconscious bias, psychological safety and health equity in clinical environments. . A,13 - PAM Rehabilitation Hospital of Round Rock (JV) PAM Round Rock will address access to care, identified in the 2021 Ascension Seton CHNA. PAM Round Rock will not address mental and behavioral health, social determinants of health, or health equity in this Implementation Strategy. Mental and behavioral health, social determinants of health and health equity will be addressed by Ascension Seton Williamson, which is also in Williamson County. Hospital-based strategies in the PAM Round Rock Implementation Strategy to address each of the identified community health needs include those listed below. Access to Care: - Hold free monthly support groups with guest speakers focused on health education - Provide transportation services for patients unable to attend outpatient services Access to Care Progress to Date: - PAM Health Rehabilitation Hospital of Round Rock supports our community by offering free transportation for established out-patients who lose transportation support. PAM is currently working with community partners Ascension and other inpatient rehab facilities to create support groups for specialty groups in the area. (CONTINUED)

Schedule H, Part V, Section B, Line 11 Facility A, 7
Facility A, 7 - ALL ASCENSION SETON FACILITIES - PART 7. PART 7: A14 - Northwest Hills Surgical Hospital (JV) Northwest Hills Surgical Hospital will address access to care, identified in the 2021 Ascension Seton CHNA. Northwest Hills Surgical Hospital will not address mental and behavioral health, social determinants of health, or health equity in this Implementation Strategy. Mental and behavioral health, social determinants of health and health equity will be addressed by several other Ascension Seton hospitals which are located in the same county. Hospital-based strategies in the Northwest Hills Surgical Hospital Implementation Strategy to address each of the identified community health needs include those listed below. Access to Care: - Offer hospital resources and time to provide health screening services and educational materials for community members to be aware of their health and resources available to them - Provide consistent, safe meeting spaces for support groups and care organizations Access Progress to Date: - Northwest Hills Surgical Hospital continues to offer screenings and education for community members to be aware of their health and the resources available to them, and provides space for support groups and care organization meetings.

Schedule H, Part V, Section B, Line 16 WEB SITES FOR FINANCIAL ASSISTANCE
THE FAP, FAP APPLICATION FORM AND PLAIN LANGUAGE SUMMARY CAN BE LOCATED AT: FOR ALL ENTITIES NOT LISTED SEPARATELY BELOW: https://healthcare.ascension.org/financial-assistance PAM REHABILITATION HOSPITAL OF ROUND ROCK: https://pamhealth.com/facilities/find-facility/rehabilitation-hospitals/pam-rehabilitation-hospital-round-rock/financial-assistance-policy NORTHWEST HILLS SURGICAL HOSPITAL: https://northwesthillssurgical.com/contact/finassist.html

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 II Community Building Activities
There were no community building activities to report this year. All reported activities qualify as community benefit and are described in the narrative under Sch H Part Part I Line 7.

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 2023 WAS $344,103,220 AT CHARGES ($54,429,710 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 17-19, 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
ASCENSION SETON 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. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS 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 - Ascension Seton Medical Center Austin: Line 16a URL: SEE PT VI;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - Ascension Seton Medical Center Austin: Line 16b URL: SEE PT VI;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - Ascension Seton Medical Center Austin: Line 16c URL: SEE PT VI;

Schedule H, Part VI, Line 4 Community information
THE TOTAL POPULATION OF THE 11 COUNTY PRIMARY SERVICE AREA IS ESTIMATED TO BE 2,587,597 RESIDENTS IN CALENDAR YEAR 2023 AND IS EXPECTED TO INCREASE BY APPROXIMATELY 7.5% TO 2,781,934 RESIDENTS IN FIVE YEARS. THE AVERAGE INCOME OF THE PRIMARY SERVICE AREA IS $122,981 BASED ON CLARITAS-ENVIRONICS 2023 APPROXIMATELY 7.3% OF THE SERVICE AREA RESIDENTS LIVE BELOW THE POVERTY LINE, WITH 20% UNINSURED OR MEDICAID PATIENTS. WITHIN THE PRIMARY SERVICE AREA, THERE ARE 20 FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS. THERE ARE 38 OTHER ACUTE CARE HOSPITALS LOCATED WITHIN THE PRIMARY SERVICE AREA.

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

Schedule H, Part VI, Line 2 Needs assessment
ASCENSION SETON USES INTERNAL AND EXTERNAL DATA AND REPORTS FROM THIRD PARTIES, INCLUDING GOVERNMENT SOURCES, TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES WE SERVE. THESE REPORTS PROVIDE KEY INFORMATION ABOUT HEALTH, SOCIOECONOMIC, DEMOGRAPHIC FACTORS THAT IDENTIFY AREAS OF NEED AND INFORM OUR STRATEGIES THAT HELP TO MEET THOSE NEEDS OF OUR COMMUNITY. THESE REPORTS INCLUDE, BUT ARE NOT LIMITED TO: 1. LOCAL AND STATE DEPARTMENT OF HEALTH REPORTS 2. LOCAL GOVERNMENT PLANNING DEPARTMENTS 3. US CENSUS BUREAU 4. ECONOMIC IMPACT STUDIES 5. SG2 HEALTHCARE INTELLIGENCE 6. HEALTHCARE CLAIMS DATASETS 7. STATE DATASETS 8. CMS 9. CDC 10.INTERNAL DATA SETS. ASCENSION SETON UTILIZES INFORMATION FROM THESE SECONDARY SOURCES TO DEVELOP PROGRAMS AND PROVIDE APPROPRIATE SERVICES NEEDED THROUGHOUT THE REGION. IN ADDITION, ASCENSION SETON 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
ASCENSION SETON 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, ASCENSION SETON'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; ASCENSION SETON PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. ASCENSION SETON 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/texas ASCENSION SETON 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. ASCENSION SETON 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. ASCENSION SETON INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 5 Promotion of community health
ASCENSION SETON'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF THE HOSPITAL GOVERNING BODIES RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA; WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. APPLICATIONS FOR MEDICAL STAFF PRIVILEGES AT ASCENSION SETON HOSPITAL FACILITIES ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY, SUBJECT TO COMPLETING AN ASCENSION SETON APPLICATION AND HOSPITAL PRIVILEGING PROCESS TO ENSURE THAT THE APPLICANT PHYSICIAN MEETS THE REQUIREMENTS FOR THE PRIVILEGES REQUESTED BY THE APPLICANT PHYSICIAN. ASCENSION SETON IS CONTINUOUSLY IMPROVING ITS PATIENT CARE SERVICES TO ADDRESS THE NEEDS OF THE COMMUNITY WE SERVE. SURPLUS FUNDS GENERATED FROM ASCENSION TEXAS' OPERATIONS ARE REINVESTED IN THE ORGANIZATION'S ACTIVITIES, INCLUDING PATIENT CARE.

Schedule H, Part VI, Line 6 Affiliated health care system
ASCENSION SETON 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. 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. ASCENSION SETON OPERATES HOSPITAL FACILITIES IN TRAVIS, HAYS, WILLIAMSON, BURNET, CALDWELL AND BASTROP COUNTIES AND IS PART OF ASCENSION TEXAS, WHICH OWNS AND OPERATES, DIRECTLY AND INDIRECTLY THROUGH JOINT VENTURES, HEALTH CARE RELATED ENTITIES, INCLUDING ASCENSION SETON MEDICAL CENTER AUSTIN, DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS, DELL SETON MEDICAL CENTER AT THE UNIVERSITY OF TEXAS, ASCENSION SETON HAYS, ASCENSION SETON WILLIAMSON, ASCENSION SETON NORTHWEST, ASCENSION SETON HIGHLAND LAKES, ASCENSION SETON SOUTHWEST, ASCENSION SETON EDGAR B. DAVIS, ASCENSION SETON SHOAL CREEK, ASCENSION SETON SMITHVILLE, ASCENSION SETON BASTROP, PAM REHABILITATION HOSPITAL OF ROUND ROCK, NORTHWEST HILLS SURGICAL HOSPITAL, CEDAR PARK REGIONAL MEDICAL CENTER, SETON MEDICAL CENTER HARKER HEIGHTS, WARM SPRINGS REHABILITATION HOSPIAL OF KYLE, CENTRAL TEXAS REHABILITATON HOSPITAL AND ASCENSION PROVIDENCE. THE HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF CENTRAL TEXAS AND BEYOND.