4A (Expenses $ 146678788 including grants of $ 0) (Revenue $ 263416566)
See Schedule O

4B (Expenses $ 176297518 including grants of $ 0) (Revenue $ 155101988)
See Schedule O

4C (Expenses $ 54627398 including grants of $ 0) (Revenue $ 45849308)
See Schedule O

4D (Expenses $ 0 including grants of $ -320131) (Revenue $ 0)
Additional Grants

Schedule H, Part V, Section B, Line 3E
BASED ON THE TEXAS HEALTH INSTITUTE (THI) REVIEW OF DATA, TEN PRIORITY NEED AREAS EMERGED. THIS LIST WAS PRESENTED TO THE LOCAL NEEDS PRIORITIZATION COMMITTEE CONSISTING OF STAKEHOLDERS ASSEMBLED FROM THROUGHOUT THE CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM SERVICE AREA. THE COMMITTEE WAS ASKED TO (A) VALIDATE THE DATA-BASED PRIORITIES, AND (B) DISTILL AND RANK THE LIST OF TEN PRIORITIES INTO A TARGETED, ACTIONABLE GROUP OF FIVE. PARTICIPANTS IN THE NEEDS PRIORITIZATION PROCESS WERE ENCOURAGED TO CONSIDER THE FOLLOWING CRITERIA WHEN SELECTING WHAT NEEDS TO ELEVATE IN IMPORTANCE OVER OTHERS: -MAGNITUDE OF THE PROBLEM (NUMBER OF PEOPLE AFFECTED) -SEVERITY OF THE PROBLEM (BURDEN OF MORBIDITY AND MORTALITY DUE TO THE PROBLEM) -ORGANIZATIONAL CAPACITY TO ADDRESS THE PROBLEM -IMPACT OF THE PROBLEM ON VULNERABLE POPULATIONS -EXISTING RESOURCES ALREADY ADDRESSING THE PROBLEM -RISK ASSOCIATED WITH DELAYING TARGETED INTERVENTION ON THE PROBLEM -INFLUENCE ONE PROBLEM MAY HAVE ON ADDRESSING OTHER RELATED PROBLEMS THE TOP FIVE NEEDS DECIDED BY THE COMMUNITY STAKEHOLDERS WERE: ACCESS TO MENTAL AND BEHAVIORAL HEALTH; ACCESS TO PRIMARY CARE; TRANSPORTATION; HEALTHCARE DISPARITIES; AND FOOD INSECURITY.

Schedule H, Part V, Section B, Line 3 Facility A, 1
Facility A, 1 - See Schedule H, Part V, Section A. OUR MISSION AND VISION STATEMENTS WERE INCLUDED TO GIVE THE PUBLIC AN AWARENESS OF OUR COMMUNITY FOCUS AND CHRISTIAN MINISTRY DEDICATION TO SERVE THE UNDERSERVED. SERVE THE UNDERSERVED.

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - See Schedule H, Part V, Section A. THE CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM IS A NON-PROFIT, CATHOLIC, INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT INCLUDES THREE ACUTE CARE HOSPITALS - CHRISTUS SOUTHEAST TEXAS ST. ELIZABETH, CHRISTUS ST. MARY OUTPATIENT CENTER MID COUNTY, AND CHRISTUS SOUTHEAST TEXAS JASPER MEMORIAL. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM'S DEDICATED STAFF PROVIDE SPECIALTY CARE THAT IS TAILORED TO THE INDIVIDUAL NEEDS OF EVERY PATIENT, AIMING TO DELIVER HIGH-QUALITY SERVICES WITH EXCELLENT CLINICAL OUTCOMES. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM WORKS CLOSELY WITH THE LOCAL COMMUNITY TO ENSURE THAT REGIONAL HEALTH NEEDS ARE IDENTIFIED AND INCORPORATED INTO SYSTEM-WIDE PLANNING AND STRATEGY. TO THIS END, CHRISTUS HEALTH COMMISSIONED TEXAS HEALTH INSTITUTE (THI) TO CONDUCT AND PRODUCE THE 2023-2025 COMMUNITY HEALTH NEEDS ASSESSMENT FOR CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM, REQUIRED BY LAW TO BE PERFORMED ONCE EVERY THREE YEARS AS A CONDITION OF 501(C)(3) TAX-EXEMPT STATUS. IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT, THI STAFF AND CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM COMMUNITY STAKEHOLDERS ANALYZED OVER 40 DIFFERENT INDICATORS, SPANNING DEMOGRAPHICS, SOCIOECONOMIC FACTORS, HEALTH BEHAVIORS, CLINICAL CARE, AND HEALTH OUTCOMES. REPORT FINDINGS COMBINE DATA FROM PUBLICLY AVAILABLE SOURCES, INTERNAL HOSPITAL DATA, AND INPUT FROM THOSE WITH CLOSE KNOWLEDGE OF THE LOCAL PUBLIC HEALTH AND HEALTH CARE SYSTEMS TO PRESENT A COMPREHENSIVE OVERVIEW OF UNMET HEALTH NEEDS IN THE REGION.

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - See Schedule H, Part V, Section A. REPRESENTATIVES FROM CHRISTUS HEALTH CONTRIBUTED CONTACT INFORMATION OF 19 PEOPLE WHO REPRESENT THE BROAD INTERESTS OF SOUTHEAST TEXAS AND WHO POSSESS KNOWLEDGE ABOUT THE REGION'S HEALTH-RELATED CHALLENGES. THESE KEY STAKEHOLDERS INCLUDED NONPROFIT LEADERS, HEALTH DEPARTMENT AUTHORITIES, PUBLIC SCHOOL LEADERS, HEALTHCARE PROVIDERS AND LEADERS, ELECTED OFFICIALS, LOCAL AND STATE AGENCIES, LAW ENFORCEMENT AGENCIES, PERSONS REPRESENTING DISTINCT GEOGRAPHIC AREAS, AND PERSONS REPRESENTING DIVERSE RACIAL/ETHNIC GROUPS. TO RECRUIT INTERVIEWEES, THE THI TEAM CONTACTED KEY INFORMANTS BY EMAIL AND TELEPHONE. THI CONDUCTED TEN INTERVIEWS BETWEEN SEPTEMBER AND DECEMBER 2018, EACH LASTING BETWEEN 30 AND 60 MINUTES.

Schedule H, Part V, Section B, Line 6b Facility A, 1
Facility A, 1 - See Schedule H, Part V, Section A. REPRESENTATIVES FROM CHRISTUS HEALTH CONTRIBUTED CONTACT INFORMATION OF 19 PEOPLE WHO REPRESENT THE BROAD INTERESTS OF SOUTHEAST TEXAS AND WHO POSSESS KNOWLEDGE ABOUT THE REGION'S HEALTH-RELATED CHALLENGES. THESE KEY STAKEHOLDERS INCLUDED NONPROFIT LEADERS, HEALTH DEPARTMENT AUTHORITIES, PUBLIC SCHOOL LEADERS, HEALTHCARE PROVIDERS AND LEADERS, ELECTED OFFICIALS, LOCAL AND STATE AGENCIES, LAW ENFORCEMENT AGENCIES, PERSONS REPRESENTING DISTINCT GEOGRAPHIC AREAS, AND PERSONS REPRESENTING DIVERSE RACIAL/ETHNIC GROUPS. TO RECRUIT INTERVIEWEES, THE THI TEAM CONTACTED KEY INFORMANTS BY EMAIL AND TELEPHONE. THI CONDUCTED EIGHT INTERVIEWS BETWEEN SEPTEMBER AND DECEMBER 2018, EACH LASTING BETWEEN 30 AND 60 MINUTES. POTENTIAL PARTICIPANTS WERE IDENTIFIED BY CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM LEADERSHIP. MOST PARTICIPANTS WERE RECRUITED THROUGH ORGANIZATIONS THAT PROVIDE HEALTH CARE OR RELATED SERVICES TO COMMUNITY RESIDENTS (E.G., CLINICS, COMMUNITY ORGANIZATIONS, SOCIAL SERVICE AGENCIES). ELECTED OFFICIALS AND GOVERNMENT LEADERS WERE ALSO INVITED TO PARTICIPATE. TO ASSIST WITH RECRUITMENT, THE LOCAL CHRISTUS HEALTH LIAISON RECRUITED 21 STAKEHOLDERS WHO REPRESENTED SPECIFIC GROUPS, OCCUPATIONS, OR PERSPECTIVES IMPORTANT TO THE PROJECT. SIXTEEN PEOPLE PARTICIPATED IN THE FOCUS GROUP.

Schedule H, Part V, Section B, Line 7 Facility A, 1
Facility A, 1 - See Schedule H, Part V, Section A. IN ADDITION TO MAKING OUR CHNA REPORT AVAILABLE TO THE PUBLIC ON OUR WEBSITE, IT IS ALSO AVAILABLE UPON REQUEST AS EITHER AN ELECTRONIC VERSION OR A HARDCOPY. THESE ARE AVAILABLE FREE OF CHARGE UPON REQUEST. IT IS POSTED ON OUR WEBSITE AT https://www.christushealth.org/connect/community/community-needs

Schedule H, Part V, Section B, Line 11 Facility A, 1
Facility A, 1 - See Schedule H, Part V, Section A. BASED ON THE THI REVIEW OF DATA, TEN PRIORITY NEED AREAS EMERGED. THIS LIST WAS PRESENTED TO THE LOCAL NEEDS PRIORITIZATION COMMITTEE CONSISTING OF STAKEHOLDERS ASSEMBLED FROM THROUGHOUT THE CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM SERVICE AREA. THE COMMITTEE WAS ASKED TO (A) VALIDATE THE DATA-BASED PRIORITIES, AND (B) DISTILL AND RANK THE LIST OF TEN PRIORITIES INTO A TARGETED, ACTIONABLE GROUP OF FIVE. PARTICIPANTS IN THE NEEDS PRIORITIZATION PROCESS WERE ENCOURAGED TO CONSIDER THE FOLLOWING CRITERIA WHEN SELECTING WHAT NEEDS TO ELEVATE IN IMPORTANCE OVER OTHERS: -MAGNITUDE OF THE PROBLEM (NUMBER OF PEOPLE AFFECTED) -SEVERITY OF THE PROBLEM (BURDEN OF MORBIDITY AND MORTALITY DUE TO THE PROBLEM) -ORGANIZATIONAL CAPACITY TO ADDRESS THE PROBLEM -IMPACT OF THE PROBLEM ON VULNERABLE POPULATIONS -EXISTING RESOURCES ALREADY ADDRESSING THE PROBLEM -RISK ASSOCIATED WITH DELAYING TARGETED INTERVENTION ON THE PROBLEM -INFLUENCE ONE PROBLEM MAY HAVE ON ADDRESSING OTHER RELATED PROBLEMS THE TOP FIVE NEEDS DECIDED BY THE COMMUNITY STAKEHOLDERS WERE: ACCESS TO MENTAL AND BEHAVIORAL HEALTH; ACCESS TO PRIMARY CARE; TRANSPORTATION; HEALTHCARE DISPARITIES; AND FOOD INSECURITY. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM (CSETHS) WILL ENHANCE ACCESS TO MENTAL AND BEHAVIORAL HEALTH BY STRENGTHENING AWARENESS AND TRAINING ABOUT MENTAL AND BEHAVIORAL HEALTH TO IMPROVE THEIR ABILITY TO SERVE PATIENTS WITH BEHAVIORAL AND MENTAL HEALTH DIAGNOSIS AND PROTECT PATIENTS FROM OTHER PATIENTS DISPLAYING SIGNS ASSOCIATED WITH SUBSTANCE ABUSE OR MENTAL/BEHAVIORAL HEALTH DISORDERS. CSETHS HAS A THREE-PRONG STRATEGY TO IMPROVE ACCESS TO PRIMARY CARE. THIS INCLUDES COLLABORATION WITH FEDERALLY QUALIFIED HEALTH CENTERS TO ENSURE PATIENTS HAVE A MEDICAL HOME, GREATER USE OF BILINGUAL OUTREACH WORKERS TO HELP PATIENTS AVOID HOSPITALIZATION THROUGH PREVENTION AND DISEASE MANAGEMENT, AND EFFORTS TO RECRUIT MORE PROVIDERS IN ITS OWN PHYSICIAN GROUP. TRANSPORTAION NEEDS CAN BE PROBLEMATIC TO RESOLVE DUE TO THE MANY VARIED INDIVIDUAL PATIENT SITUATIONS. CSETHS WILL PUBLISH INFORMATION TO HELP THE PUBLIC BE AWARE OF MEDICAID TRANSPORTATION SERVICES, SOUTHEAST TEXAS TRANSIT, GULF COAST FQHC, AND OTHER SERVICES. RESEARCH OF UBER OR LYFT TRANSPORATION MAY RESULT IN CONTRACTS TO LEVERAGE THESE RESOURCES. IN ADDITION, CONTRACTING TO PROVIDE A VAN MAY BE CONSIDERED. HEALTHCARE DISPARITIES ARE BEING ADDRESSED BY INVESTING IN EDUCATION, DETECTION AND MANAGEMENT IN HYPERTENSION, INCLUDING THE USE OF A COMMUNITY HEALTH WORKER. FOOD INSECURITY IS BEING ADDRESSED BY MOBILIZING STAFF AND COLLABORATING WITH FOOD BANKS, INCLUDING THE NEW CATHOLIC CHARITIES FOOD BANK TO EMPHASIZE FRESH PRODUCE, PANTRIES THAT ACT AS FOOD BANK SATELLITES, AND OTHER COMMUNITY BASED NONPROFITS TO ADDRESS THIS, SUCH AS SENIOR NUTRITION SERVICES (MEALS ON WHEELS). NEEDS THAT THE COMMUNITY FOCUS GROUP DID NOT PRIORITIZE AS THE TOP FIVE TO BE MET INCLUDED UNHEALTHY BEHAVIORS, PREVENTABLE HOSPITAL STAYS, MATERNAL CHILD HEALTH, COPD, AND DIABETES. ALL OF THESE WERE RECOGNIZED AS IMPORTANT BUT THEY WERE ALREADY BEING ADDRESSED TO THE EXTENT THAT COMMUNITY RESOURCES ALLOWED AND OTHER NEEDS WERE EVEN GREATER. PRIORITIES WERE EVALUATED ACCORDING TO ISSUE PREVALENCE AND SEVERITY, BASED ON COUNTY AND REGIONAL SECONDARY DATA. INPUT PROVIDED BY KEY INFORMANTS, FOCUS GROUP PARTICIPANTS, AND OTHER COMMUNITY STAKEHOLDERS WAS ALSO HEAVILY CONSIDERED, ESPECIALLY FOR PRIORITY AREAS WHERE SECONDARY DATA ARE LESS AVAILABLE. THE COMMITTEE CONSIDERED A NUMBER OF CRITERIA IN DISTILLING TOP PRIORITIES, INCLUDING MAGNITUDE AND SEVERITY OF EACH PROBLEM, CSETHS ORGANIZATIONAL CAPACITY TO ADDRESS THE PROBLEM, IMPACT OF THE PROBLEM ON VULNERABLE POPULATIONS, EXISTING RESOURCES ALREADY ADDRESSING THE PROBLEM, AND POTENTIAL RISK ASSOCIATED WITH DELAYING INTERVENTION ON THE PROBLEM.

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

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

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

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

Schedule H, Part V, Section B, Line 17
DID THE HOSPITAL FACILITY HAVE IN PLACE DURING THE TAX YEAR A SEPARATE BILLING AND COLLECTIONS POLICY, OR A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINED ACTION THE HOSPITAL FACILITY MAY TAKE UPON NON-PAYMENT? THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS. DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS. SEND STATEMENTS AND MAKE PHONE CALLS. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS.

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

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

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

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

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

Schedule H, Part V, Section A LINE 3
WEBSITE FOR CHRISTUS ST. MARY OUTPATIENT CENTER MIDCOUNTY IS: HTTPS://WWW.CHRISTUSHEALTH.ORG/SOUTHEAST-TEXAS/SOUTHEAST-TEXAS-OUTPATIENT-CENTER-MID-COUNTY

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

Schedule H, Part I, Line 7b UNREIMBURSED MEDICAID
CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM REINVESTS ALL SURPLUS FUNDS BACK IN TO THE COMMUNITIES WE SERVE THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES.

Schedule H, Part I, Line 7 DESC OF FINANCIAL ASSIST AND OTHER COMMUNITY BENEFITS AS % OF TOTAL COSTS
THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS REPORTED ON PART I, LINE 7K, COLUMN (C) AS A PERCENTAGE OF TOTAL EXPENSE IS 20.1%, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN (F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE.

Schedule H, Part II
DURING FY2022, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKED TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTH CARE SERVICES FOR THE COMMUNITIES WE SERVE.

Schedule H, Part I, Line 7 COL (F) - BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION
TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) IS 446,477,387. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $32,039,617. THIS LEAVES A TOTAL EXPENSE OF $414,437,770 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).

Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE
CHRISTUS SOUTHEAST TEXAS - ST. ELIZABETH; CHRISTUS SOUTHEAST TEXAS - ST. MARY; CHRISTUS SOUTHEAST TEXAS JASPER MEMORIAL: HTTPS://WWW.CHRISTUSHEALTH.ORG/-/MEDIA/CHRISTUS-HEALTH/PLAN-CARE/FILES/BILL-PAY/FINANCIAL-ASSISTANCE/FINANCIAL-LANGUAGE-DOCUMENTS/FINANCIAL-ASSISTANCE-POLICY-ENGLISH.ASHX

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

Schedule H, Part I, Line 7i CASH AND IN-KIND CONTRIBUTIONS
CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM MADE OVER $1,111,410 IN CASH AND IN KIND CONTRIBUTIONS DURING FISCAL YEAR 2022. THE AFOREMENTIONED AMOUNT IS DETERMINED IN ACCORDANCE WITH REPORTING RULES FOR SCHEDULE H, WORKSHEET 8. AS SUCH THIS AMOUNT DIFFERS FROM GRANTS REPORTED AT FORM 990, SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS AND PART IX, LINES 1 THROUGH 3 GRANTS AND OTHER ASSISTANCE. CHRISTUS HEALTH ESTABLISHED THE CHRISTUS FUND, A GRANT FUND TO PROVIDE RESOURCES TO NONPROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION, AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. CHRISTUS FUND GRANTS TOTALED $424,400 AWARDED AND $424,400 DISTRIBUTED BY CHRISTUS HEALTH TO NONPROFIT ORGANIZATIONS LOCATED IN THE COMMUNITY SERVED BY CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM. THE GRANT DOLLARS WERE USED TO SUPPORT PROGRAMS THAT PROMOTE THE HEALTH OF THE COMMUNITY THAT CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM SERVES, INCLUDING SUPPORT TO PROGRAMS THAT PROVIDE HEALTH CARE SERVICES TO THE UNINSURED. ALL GRANTS MADE TO OUTSIDE ORGANIZATIONS THROUGH THE CHRISTUS FUND ARE MADE TO NONPROFIT ORGANIZATIONS THAT SUPPORT THE HEALTH OF THE COMMUNITY. THESE GRANT DOLLARS ARE NOT INCLUDED ON SCHEDULE H, PART I, LINE 7(I). INDIGENT CARE OF $1,111,410 IS INCLUDED IN SCHEDULE H, PART I, LINE 7(I).

Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE
CHRISTUS SOUTHEAST TEXAS - ST. ELIZABETH; CHRISTUS SOUTHEAST TEXAS - ST. MARY; CHRISTUS SOUTHEAST TEXAS JASPER MEMORIAL: HTTPS://WWW.CHRISTUSHEALTH.ORG/-/MEDIA/CHRISTUS-HEALTH/PLAN-CARE/FILES/BILL-PAY/FINANCIAL-ASSISTANCE/FINANCIAL-LANGUAGE-DOCUMENTS/2021PLAINLANGUAGESUMMARYHOSPITALENGLISH.ASHX

Schedule H, Part I, Line 7g Subsidized Health Services
NO COSTS WERE ATTRIBUTED TO PHYSICIAN CLINICS.

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
LINE 7A: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7B: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7E: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7F: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7G: SUBSIDIZED HEALTH SERVICES COST IS AT FMV LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS

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

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

Schedule H, Part III, Line 8 Community benefit methodology for determining medicare costs
THE MEDICAL CENTER USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES.

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

Schedule H, Part V, Section B, Line 16a FAP website
A - CHRISTUS HOSPITAL - ST. ELIZABETH: Line 16a URL: SEE SUPP INFO;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - CHRISTUS HOSPITAL - ST. ELIZABETH: Line 16b URL: SEE SUPP INFO;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - CHRISTUS HOSPITAL - ST. ELIZABETH: Line 16c URL: SEE SUPP INFO;

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

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
THE FILING ORGANIZATION RECOGNIZES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. IN ORDER TO ASSESS THE BAD DEBT ACCOUNTS THAT WOULD LIKELY QUALIFY FOR CHARITY CARE, THE FOLLOWING CRITERIA WERE ESTABLISHED BASED ON AN ANALYSIS OF HISTORICAL DATA OF CHRISTUS HEALTH AND ITS RELATED ORGANIZATIONS: 1. PARO SCORE OF LESS THAN OR EQUAL TO 586, WHICH IS A PREDICTOR DEFINING THE LIKELY SOCIOECONOMIC CONDITIONS FOR THE PATIENT; 2. ESTIMATED FEDERAL POVERTY LEVEL OF LESS THAN OR EQUAL TO 226%, WHICH IS BASED ON ESTIMATED HOUSEHOLD SIZE AND HOUSEHOLD ESTIMATED INCOME; AND 3. THIRD PARTY DATA AVAILABLE ON PATIENT ACCOUNTS WHICH INDICATE THAT THE PATIENT IS NOT A HOMEOWNER OR A PROBABLE HOMEOWNER. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERISTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2022, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 3.73% OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THESE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING JUNE 30, 2022. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 0.63% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2022 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2022 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011.

Schedule H, Part VI, Line 2 Needs assessment
CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM HAS DEVELOPED THE 2019 COMMUNITY HEALTH IMPLEMENTATION PLAN BASED UPON PRIORITIZATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. CHRISTUS SOUTHEAST TEXAS HEALTH FACILITIES HAVE THE COMMON GOAL OF STRIVING TOWARD ENSURING THAT BEST PRACTICES AND STANDARDS OF CARE ARE PRACTICAL AS WELL AS REALISTIC. THE OBJECTIVES FOR FY 2019 ARE PROPOSED TO MEET THE IDENTIFIED NEEDS IN THE COMMUNITIES WE SERVE DEVELOPING AND IMPLEMENTING PROGRAMS TO PROVIDE CARE IN CLINICALLY APPROPRIATE SETTINGS, THUS REDUCING EMERGENCY DEPARTMENT VISITS AND PREVENTABLE HOSPITALIZATIONS. THE COMMUNITY HEALTH PRIORITIES OF CHRISTUS HEALTH SOUTHEAST TEXAS ARE TO RESPOND TO THE HEALTH CARE NEEDS THROUGH ITS THREE-CAMPUS HOSPITAL SYSTEM, HEALTH CARE CLINICS, PHYSICIAN PRACTICES, OUTPATIENT SERVICES AND COMMUNITY BASED PROGRAMS. COUNTIES LOCATED IN SOUTHEAST TEXAS WERE CONSIDERED TO BE MEDICALLY UNDERSERVED. ACCORDING TO COUNTY HEALTH STATISTICS IN OUR PUBLISHED 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, COUNTIES IN SOUTHEAST TEXAS HAVE HIGHER THAN STATE AVERAGES FOR PERSONS WITH CARDIOVASCULAR DISEASE, CHRONIC LOWER RESPIRATORY DISEASE, AND DIABETES. ALL DATA IS AVAILABLE TO THE PUBLIC AND POSTED ON OUR HOSPITAL WEBSITE IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT DONE IN 2019 WITH COMMUNITY COLLABORATION, AND OUR COMMUNITY HEALTH IMPLEMENTATION PLAN ALSO DONE IN PARTNERSHIP WITH COMMUNITY MEMBERS. COMMUNITY DELIVERY WILL CONTINUE TO FOCUS ON THE UNINSURED WITH ADDED EMPHASIS ON CHRONIC ILLNESSES. SERVICES ARE BASED ON BEST PRACTICES DEVELOPMENT AND IMPLEMENTATION OF EVIDENCE BASED COMMUNITY HEALTH SERVICES. OUR 2019 PLAN REFLECTS THIS FOCUS.

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

Schedule H, Part VI, Line 4 Community information
"CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM SERVES A SIX-COUNTY REGION (HENCEFORTH REFERRED TO AS ""REPORT AREA OR ""SERVICE AREA""), CONSISTING OF A TOTAL POPULATION OF NEARLY HALF A MILLION RESIDENTS. OVER 50% OF THE REGION'S POPULATION RESIDES IN JEFFERSON COUNTY, WHICH CONTAINS BEAUMONT AND PORT ARTHUR, THE REPORT AREA'S LARGEST CITIES. 88% OF RESIDENTS OF THE REPORT AREA LIVE IN URBAN COUNTIES, WHILE THE REMAINING 12% ARE IN RURAL COUNTIES. THE POPULATION OF THE REPORT AREA REPRESENTS APPROXIMATELY 2% OF TEXAS' TOTAL POPULATION. SIXTY PERCENT OF PERSONS LIVING IN THE REPORT AREA ARE WORKING-AGE ADULTS. OF THE REMAINING POPULATION, 7% ARE IN INFANCY OR EARLY CHILDHOOD, 17% ARE SCHOOL-AGE CHILDREN, AND 16% ARE OVER THE AGE OF 65. OVERALL, THE POPULATION RESIDING IN THE REPORT AREA IS SLIGHTLY OLDER THAN THE POPULATION OF TEXAS. JUST 12% OF TEXAS' POPULATION IS COMPRISED OF ADULTS OVER AGE 65. FOCUS GROUP PARTICIPANTS ACKNOWLEDGED THE UNIQUE CHALLENGES ASSOCIATED WITH THE AGING POPULATION, CHARACTERIZING OLDER ADULTS AS THE REGION'S FASTEST GROWING DEMOGRAPHIC SEGMENT. THE AVAILABILITY OF PROGRAMS DESIGNED TO SUPPORT PEOPLE WHO ARE GROWING OLDER AND LEAVING THE WORKFORCE WAS DESCRIBED AS LIMITED, AND PARTICIPANTS STRESSED THE NEED FOR CHRISTUS TO PLAN PROACTIVELY AND WITH URGENCY FOR THE NEEDS OF THE OVER-65 AGE GROUP. THE REPORT AREA IS HOME TO A RACIALLY AND ETHNICALLY DIVERSE POPULATION THAT DIFFERS SLIGHTLY IN COMPOSITION FROM THE RACIAL/ETHNIC DEMOGRAPHICS OF TEXAS. NEARLY 40% OF TEXANS ARE HISPANIC/LATINO, COMPARED TO JUST OVER 13% OF RESIDENTS OF THE REPORT AREA. AMONG THE NON-HISPANIC/LATINO POPULATION, 60% ARE WHITE, 23.0% ARE BLACK, AND 4% ARE ASIAN OR OTHER. NEARLY A QUARTER OF REPORT AREA RESIDENTS ARE BLACK, SUBSTANTIALLY EXCEEDING THE PROPORTION OF BLACK RESIDENTS IN THE STATE OF TEXAS. PERSONS BELONGING TO NATIVE HAWAIIAN/PACIFIC ISLANDER AND NATIVE AMERICAN/ALASKA NATIVE RACE CATEGORIES EACH COMPRISE FEWER THAN 0.5% OF THE REPORT AREA POPULATION. EDUCATIONAL ATTAINMENT IN THE CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM SERVICE AREA IS SLIGHTLY HIGHER THAN IN TEXAS AS A WHOLE. JUST 14.8% OF REPORT AREA RESIDENTS OVER AGE 25 LACK A HIGH SCHOOL DIPLOMA, COMPARED T0 17.7% OF TEXANS. THE HIGH SCHOOL GRADUATION RATES IN TEXAS AND THE REPORT AREA ARE SIMILAR (86.5%). CONSOLIDATED MEDIAN INCOME DATA FOR THE REPORT AREA IS NOT AVAILABLE, BUT COUNTY-LEVEL DATA SHOW THAT HARDIN COUNTY HAS THE HIGHEST MEDIAN FAMILY INCOME OF ALL COUNTIES IN THE SERVICE AREA ($68,750), WHILE NEWTON COUNTY'S MEDIAN FAMILY INCOME IS LOWEST ($49,806). POVERTY IS FAIRLY WIDESPREAD IN THE SERVICE AREA, WITH 38% OF REPORT AREA RESIDENTS EARNING ANNUAL INCOMES AT OR BELOW 200% OF FEDERAL POVERTY LEVEL (FPL). ACCORDING TO 2019 FEDERAL GUIDELINES, 200% FPL CORRESPONDS TO AN INCOME OF $51,500 PER YEAR FOR A FAMILY OF FOUR."

Schedule H, Part VI, Line 6 Affiliated health care system
CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM IS PART OF CHRISTUS HEALTH, AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM COMPRISED OF ALMOST 350 SERVICES AND FACILITIES INCLUDING MORE THAN 60 HOSPITALS AND LONG TERM CARE FACILITIES, 175 CLINICS AND OUTPATIENT CENTERS, AND OTHER COMMUNITY HEALTH MINISTRIES AND COMMUNITY DEVELOPMENT VENTURES. CHRISTUS SERVICES CAN BE FOUND IN: ARKANSAS, GEORGIA, IOWA, LOUISIANA, NEW MEXICO, TEXAS, IN SIX PROVINCES OF MEXICO, AND IN SANTIAGO, CHILE. A COMMON MISSION, CORE VALUES, AND VISION UNITE THE HEALTH SYSTEM. EACH REGION, INCLUDING CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM, DEVELOPS FIVE-YEAR AND TEN-YEAR STRATEGIC PLANS THAT HELP SET THE YEARLY OPERATIONAL PLANS AND BUDGETS. REGIONAL STRATEGIC GOALS ARE SET IN COLLABORATION WITH CHRISTUS HEALTH AND INCLUDE METRICS THAT WILL BE USED TO MEASURE COMMUNITY BENEFIT, CLINICAL OUTCOMES, PATIENT SATISFACTION, AND ASSOCIATE ENGAGEMENT. CHRISTUS HEALTH PROVIDES UPDATED MARKET, DEMOGRAPHICS, AND HEALTH INDICATOR DATA ON AN ANNUAL BASIS. THE DATA SUPPLIED FROM CHRISTUS HEALTH ALONG WITH THE SYSTEM WIDE STRATEGIC INITIATIVES ARE CONSISTENT WITH THE COMMUNITY NEEDS ASSESSMENT OF THE REGION. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM, IN TURN, PARTNERS WITH OTHER NONPROFIT GROUPS (CHURCHES, HEALTH CARE PROVIDERS, AND GOVERNMENT AGENCIES) TO CREATE COLLABORATIONS WHERE HEALTH NEEDS CAN BE ADDRESSED AND THE GENERAL HEALTH OF INDIVIDUALS AND THE COMMUNITY IS IMPROVED.

Schedule H, Part VI, Line 5 Promotion of community health
THE CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM PROVIDES HEALTH CARE SERVICES AT THREE CAMPUSES, INCLUDING THE 425-BED CHRISTUS HOSPITAL ST. ELIZABETH IN BEAUMONT, TEXAS; THE 2-BED CHRISTUS ST. MARY OUTPATIENT CENTER IN PORT ARTHUR TEXAS; AND CHRISTUS JASPER MEMORIAL HOSPITAL, A 49-BED HOSPITAL IN JASPER, TEXAS. EACH OF THE THREE HOSPITALS IN THE CHRISTUS SOUTHEAST TEXAS REGION PROVIDES A 24 HOUR EMERGENCY DEPARTMENT THAT IS OPEN TO SERVE THOSE IN NEED OF EMERGENCY CARE, REGARDLESS OF THEIR ABILITY TO PAY. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE IN THE COMMUNITIES IT SERVES. IT CONDUCTS ITS ACTIVITIES AND SERVES ITS HEALTH CARE PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM ALSO SUPPORTS MANY LOCAL COMMUNITY HEALTH SERVICES, INCLUDING TWO RURAL CLINICS IN JASPER, TEXAS AND KIRBYVILLE, TEXAS. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM IS A PARTNER IN JEFFERSON COUNTY CLINICAL SERVICES, INC. WHICH PROVIDES PHYSICIAN HEALTH CARE SERVICES TO INDIGENT PATIENTS. IN ADDITION, THE ORGANIZATION HAS PARTIAL OWNERSHIP IN: ST. ELIZABETH REHABILITATION PARTNERS, LLP, A REHABILITATION CENTER; AND SOUTHEAST TEXAS CANCER CENTERS, LP, A CANCER TREATMENT ORGANIZATION. THE FACILITIES OF CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM SHARE ONE OBJECTIVE, WHICH IS TO LEAD THE WAY TO A HEALTHIER COMMUNITY. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM COLLABORATES WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS TO FACILITATE AND STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTH CARE SERVICES FOR ALL, INCLUDING THE MOST VULNERABLE AND UNDERSERVED POPULATIONS. IN AN EFFORT TO MEET AND ADDRESS THE IDENTIFIED HEALTH CARE NEEDS IN THE COMMUNITIES WE SERVE, CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM PROVIDES ACCESS TO HEALTH CARE SERVICES THROUGH PROGRAMS AND LOCAL COMMUNITY PARTNERS AND SERVICE ORGANIZATIONS. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM ALSO PROVIDES SERVICES FOR THE BROADER COMMUNITY AS A PART OF THE OVERALL COMMUNITY BENEFIT. A LARGE SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS INCLUDING NURSING STUDENTS AND OTHER ALLIED HEALTH PROFESSIONALS. HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NONPROFIT HEALTH CARE AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. THE THREE FACILITIES OF CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM (CHRISTUS HOSPITAL - ST. ELIZABETH, CHRISTUS - ST. MARY OUTPATIENT CENTER MID COUNTY AND JASPER MEMORIAL HOSPITAL) PROVIDE A NUMBER OF SERVICES FOR THE BENEFIT OF THE COMMUNITY INCLUDING LEADERSHIP ACTIVITIES. UNDERSTANDING THE NEED TO PROVIDE ACCESS TO HEALTH CARE TO AS MUCH OF THE PUBLIC AS POSSIBLE, CHRISTUS HEALTH PARTICIPATES IN GOVERNMENT SPONSORED HEALTH CARE PROGRAMS, INCLUDING MEDICAID, MEDICARE, CHAMPUS, TRICARE, USFHP AND OTHER GOVERNMENT PROGRAMS. IN ADDITION, CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM PROVIDES SPECIFIC PROGRAMS TO PROVIDE DISCOUNTED OR FREE SERVICES TO THOSE IN NEED WHO LACK MEDICAL INSURANCE OR WHO DO NOT PARTICIPATE IN GOVERNMENT SPONSORED PROGRAMS. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM BELIEVES THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES' LIVES AND CREATE SUSTAINABLE HEALTH IN OUR COMMUNITIES. BY COLLABORATING WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS, CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEMS' VARIOUS ENTITIES HAVE STRENGTHENED THEIR ROLES AS MAJOR PROVIDERS OF COMPREHENSIVE, ACCESSIBLE HEALTH CARE SERVICES. CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. WE MADE CASH DONATIONS IN ADDITION TO GRANTS AWARDED TO HELP SUCH CAUSES LIKE THE FIGHT AGAINST CANCER, DIABETES, HEART DISEASE, AND THE PROVISION OF A CONTINUUM OF CARE FOR OUR ELDERLY AND THOSE SUFFERING FROM HIV/AIDS. AS A NONPROFIT ORGANIZATION AND AS A PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKE-UP OF THE AREA WE SERVE GUIDES CHRISTUS HEALTH SOUTHEAST TEXAS HEALTH SYSTEM. WE ARE PRIVILEGED TO HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS WHO ARE GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. ALL PERSONS EMPLOYED AND AFFILIATED WITH CHRISTUS SOUTHEAST TEXAS HEALTH SYSTEM ARE REQUIRED TO COMPLETE ANNUAL CONFLICT OF INTEREST STATEMENTS. CHRISTUS HEALTH REINVESTS ALL SURPLUS FUNDS BACK INTO THE COMMUNITIES IT SERVES THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. DURING FY 2022, CHRISTUS HEALTH ADVOCATED FOR IMPROVEMENT IN PUBLIC POLICIES AND WORKED TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY FOR GREATER ACCESS TO HEALTH CARE SERVICES FOR ALL.