4A (Expenses $ 867740213 including grants of $ 9715905) (Revenue $ 1233603274)
See Schedule OBaylor University Medical Center at Dallas (BUMC) is a faith-based, nonprofit 914 bed acute care hospital providing exemplary patient care services to the residents of the Dallas-Fort Worth Metroplex since 1903. BUMC is a major patient care, research and medical education center of the Southwest and serves local, national and international patients caring for more than 300,000 patients per year.BUMC is affiliated with Baylor Scott & White Health (BSWH), a faith-based nationally acclaimed network of acute care hospitals and related health care entities providing quality patient care, medical education, medical research and other community services to the residents of North and Central Texas. As the largest not-for-profit health care system in Texas and one of the largest in the United States, BSWH was born from the 2013 combination of Baylor Health Care System and Scott & White Healthcare. Today, BSWH includes 50 hospitals, over 1,100 patient care sites, more than 7,500 active physicians, approximately 48,000 employees and the Scott & White Health Plan. BUMC is one of the system's two flagship hospitals and provides inpatient and outpatient medical services in over 20 specialties to treat individuals with diseases, illnesses and injuries of varying complexities. Services include providing patients with innovative methods of prevention, diagnosis, treatment, education and support consistent with a quality teaching and research hospital. Multidisciplinary interaction among physicians helps ensure comprehensive care for all stages of illness through all stages of life. Many of the major health care programs have received national recognition and honors, including the Level I Trauma Center, a Level III 83-Bed Neonatal Intensive Care Unit, transplant program, neuroscience center, digestive disease center, orthopaedic institute and a new dedicated cancer hospital and center. During the fiscal year, BUMC admitted 37,895 patients resulting in 228,056 days of care, delivered 4,539 babies, and received 106,711 emergency department visits. Additionally, BUMC provided community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $239,698,724 and provided community benefits (as reported on the Internal Revenue Service (IRS) Form 990, Schedule H) of $144,460,403 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $103,968,435 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H.See Schedule H for more information regarding these services and how BUMC promotes the health of the communities.

4B (Expenses $ 34097701 including grants of $ 0) (Revenue $ 12284335)
See Schedule OMedical education is a crucial part of BUMC's mission. BUMC commits resources to help address the shortage of health care professionals including partnering with other educational institutions and similar organizations. BUMC provided medical residency programs for the training of future physicians, nurses and other health professionals in an effort to increase the supply of health care professionals nation-wide. During the year, BUMC served 276 medical residency students. Assisting with the preparation of future nurses at entry and advanced levels of nursing is critical in establishing a workforce of qualified nurses. During the year, BUMC invested in training 387 undergraduate nurses. Total unreimbursed cost of these medical education programs is $21,813,366.

4C (Expenses $ 25724624 including grants of $ 25724624) (Revenue $ 0)
See Schedule OMoving scientific theory from the research bench to clinical trials and ultimately to the patient's bedside is central to BSWH's commitment to patient-centered medical research. During the year, BUMC supported clinical research development costs, research papers and studies through Baylor Scott & White Research Institute (BSW Research), at a cost of $25,724,624. At BSW Research alone, more than 1,000 patient-focused research projects are underway.

Baylor Scott & White Emergency Hosp
Part V, Section B, Line 5: Focus groups with ten (10) participants, as well as six (6) key informant interviews, were conducted September through November of 2015 in order to take into account the input of persons representing the broad interests of the community served. The focus groups and interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into community needs. The focus group was designed to familiarize participants with the CHNA process and gain a better understanding of priority health needs from the community's perspective. Focus groups were formatted for individual as well as small group feedback and also helped identify other community organizations already addressing health needs in the community. Truven Health also conducted key informant interviews for the community served. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the various drivers which contributed to health issues. In order to qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community; as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income, and minority populations in the community. In order to ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations, and other healthcare providers (including physicians). The following is a list of groups consulted: United Way of Tarrant County, City Square, United Way of West Ellis County, United Way of Denton County, YWCA of Metropolitan Dallas, Collin County Health Care Services, Injury Prevention Center of Greater Dallas, Parkland Health and Hospital System, Metrocrest Community Clinic, Mental Health America of Greater Dallas, Bridge-Breast Network, JPS Health Network/Regional Health Partnership District 10, Tarrant County Hospital District, JPS Health Network Trinity Springs Pavilion for Psychiatric Services, Christian Community Action, AIDS Arms, Inc., Metrocare Services

Baylor Scott&White Surg Hosp at Sherman
Part V, Section B, Line 5: In addition to analyzing quantitative data, ten (10) key informant interviews were conducted in May of 2017 to take into account the input of persons representing the broad interests of the community served. The interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into its needs. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the factors contributing to that health status.To qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community, as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income and minority populations in the community.To ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations and other healthcare providers.In addition to soliciting input from public health and various interests of the community, hospitals are also required to take into consideration written input received on their most recently conducted CHNA and subsequent implementation strategies. Baylor Scott & White Surgical Hospital at Sherman was not previously subject to IRC Section 501(r) and the CHNA requirements, therefore, no written input has been received on prior CHNAs. Subsequent CHNAs will include input received on the assessment and implementation plan. BSWH has an active portal on their website where the assessment for Baylor Scott & White Surgical Hospital at Sherman has been made available and asking for public comment or feedback on the report findings. This information is located at CommunityNeeds.BSWHealth.com.Input collected from the participants during the interviews was organized into themes around community needs and compared to the quantitative data findings.

Baylor Scott & White Emer Hosp Rockwall
Part V, Section B, Line 5: Focus group with ten (10) participants, as well as six (6) key informant interviews, were conducted September through November of 2015 in order to take into account the input of persons representing the broad interests of the community served. The focus groups and interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into community needs. The focus group was designed to familiarize participants with the CHNA process and gain a better understanding of priority health needs from the community's perspective. Focus groups were formatted for individual as well as small group feedback and also helped identify other community organizations already addressing health needs in the community. Truven Health also conducted key informant interviews for the community served. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the various drivers which contributed to health issues. In order to qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community; as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income, and minority populations in the community. In order to ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations, and other healthcare providers (including physicians). The following is a list of groups consulted: United Way of Tarrant County, City Square, United Way of West Ellis County, United Way of Denton County, YWCA of Metropolitan Dallas, Collin County Health Care Services, Injury Prevention Center of Greater Dallas, Parkland Health and Hospital System, Metrocrest Community Clinic, Mental Health America of Greater Dallas, Bridge-Breast Network, JPS Health Network/Regional Health Partnership District 10, Tarrant County Hospital District, JPS Health Network Trinity Springs Pavilion for Psychiatric Services, Christian Community Action, AIDS Arms, Inc., Metrocare Services

Baylor Scott & White Emergency Hosp
Part V, Section B, Line 6a: NoneBaylor Emergency Medical Centers:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2016, the 15th day of the fifth month after the 2015 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Baylor Scott&White Surg Hosp at Sherman
Part V, Section B, Line 6a: NoneBaylor Scott & White Surgical Hospital at Sherman:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2017, the 15th day of the fifth month after the 2016 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Baylor Scott & White Emer Hosp Rockwall
Part V, Section B, Line 6a: Baylor Scott & White Medical Center-Sunnyvale and Baylor Scott & White Medical Center-Lake PointeBaylor Emergency Medical Center at Rockwall:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2016, the 15th day of the fifth month after the 2015 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Baylor S&W Texas Spine & Joint Hospital
Part V, Section B, Line 2: In August 2017, the organization acquired Baylor Scott & White Texas Spine & Joint Hospital (formerly known as Texas Spine and Joint Hospital) through a partnership named Texas Spine and Joint Hospital LLC in which the organization is the controlling partner. A community health needs assessment and implementation strategy will be completed within the prescribed time for newly acquired hospital facilities in accordance with Treas. Reg 1.501(r)-3(d)(1).

Baylor Scott & White Emergency Hosp
Part V, Section B, Line 11: The hospital is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The hospital will address significant community health needs based on their intersection with the stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Affordable healthcare/healthcare cost.The primary goal of the hospital is to increase the community's access to high quality emergency health care through an experienced staff and state-of-the-art resources and serve all regardless of the ability to pay. As a partner with Baylor Scott & White Health, the hospitals have expanded its provision of financial assistance to eligible patients by providing free or discounted care as outlined in the BSWH system financial assistance policy. The hospitals have agreed to provide the same level of financial assistance as other BSWH nonprofit hospitals and to be consistent with certain state requirements applicable to nonprofit hospitals. Certain hospitals not meeting minimum thresholds are required to make a contribution/grant to other affiliated nonprofit hospitals to help those hospital treat indigent patients. The following identified need has not been addressed in the joint community benefit implementation plan because there are multiple other community and state agencies whose expertise and infrastructure are better suited for addressing these needs: Mental/behavioral health, Chronic Illness, Physical Inactivity, Dental Services, and Hyperlipidemia.

Baylor Scott&White Surg Hosp at Sherman
"Part V, Section B, Line 11: The hospital is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The hospital will address significant community health needs based on its intersection with its stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Chronic Disease, Economic Status/Poverty, Access to Care: Healthcare Cost for the un/Underinsured, Un/Underinsured Population, Access to Primary Care Provider (Physician and Non-Physician), Substance Abuse, Mental Health, Access to Exercise Opportunities. Community Health Screenings - Similar to national trends, residents in the Hospitals' service area exhibit increasing diagnoses ofChronic conditions. It is common that the pathology for one condition may also affect other body systems, resulting in co-occurrence or multiple chronic conditions (MCC). The presence of MCC's adds a layer of complexity to disease management. The Hospital conducts screenings for MCC's including body fat analysis, BMI, and injury prevention.Financial Assistance - Certain hospitals operated through a partnership have expanded their provision of financial assistance to eligible patients by providing free or discounted care as outlined in the BSWH system financial assistance policy. Those hospitals have agreed to follow the BSWH financial assistance policy as other BSWH nonprofit hospitals. Certain hospitals not meeting minimum thresholds are required to make a contribution/grant to other affiliated nonprofit hospitals to help those hospitals treat indigent patients.Financial Donations - The hospital will support community partners in developing/delivering health services that address health care costs and affordability through the provision of financial support to address health care costs and affordability in the community.Physician Recruitment - The hospital is collaborating with HealthTexas Provider Network and may provide initial income guarantee support for a physician who comes from outside its market and can satisfy a community need. Recruitment of physicians for areas identified as medically underserved (MUAs) or other community needs assessment aids in relieving the burden of lack of access to care for medically under-insured or un-insured populations. The age and characteristics of a state's population has a direct impact on the health care system. The state's population is growing at an explosive pace - twice as fast as the national average. During this 10 year period, Texas had the fourth highest percentage growth and ranked first in the number of residents added during this period. And, like the rest of the country, the Texas population is aging and in need of more health care services, which puts added demands on the system. The Hospital seeks to allay the physician shortage, thereby better managing the growing health needs of the community.Mental Health First Aid - The hospital will partner with the Dallas Fort Worth Hospital Council to provide lay-person mental health first aid training in Grayson county. There is an expressed need for services to treat conditions other than ""the big 3"" (bipolar disorder, schizophrenia, personality disorder) in Grayson County. The County reports potential gaps in mental health services with a mental health resident to provider ratio of 980:1 compared to the national ratio of 529:1. Additionally, the county is a designated Health Professional Shortage Area (HPSA) for mental health providers. Grayson County reports higher rates of mentally unhealthy days than the State of Texas. Grayson County reports mentally unhealthy days at 3.2 days per month. State rates for mentally unhealthy days are reported at 3.0 days per month.Specific actions can be found in the implementation strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. The following identified need has not been addressed in the community benefit implementation plan because there are other community and state agencies whose expertise and infrastructure are better suited for addressing the need: Economic Status/Poverty, Substance Abuse, and Access to Exercise Opportunities."

Baylor Scott & White Emer Hosp Rockwall
Part V, Section B, Line 11: The hospital is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The hospital has teamed up with other hospital facilities in the community to complete a joint community health needs assessment and develop a joint implementation strategy to meet certain federal and state requirements. These hospitals will address significant community health needs based on their intersection with the stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Healthcare cost/affordability. The primary goal of the hospital is to increase the community's access to high quality emergency health care through an experienced staff and state-of-the-art resources and serve all regardless of the ability to pay. As a partner with Baylor Scott & White Health, the hospitals have expanded its provision of financial assistance to eligible patients by providing free or discounted care as outlined in the BSWH system financial assistance policy. The hospitals have agreed to provide the same level of financial assistance as other BSWH nonprofit hospitals and to be consistent with certain state requirements applicable to nonprofit hospitals. Certain hospitals not meeting minimum thresholds are required to make a contribution/grant to other affiliated nonprofit hospitals to help those hospital treat indigent patients.Additional actions can be found in the joint implementation strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. The following identified needs have not been specifically addressed by the hospital because the needs are being addressed by other affiliated hospitals in the joint community benefit implementation plan or because there are other community and state agencies whose expertise and infrastructure are better suited for addressing these needs: Mental/behavioral health; Chronic Disease (obesity), Preventable Admissions - Adult Uncontrolled Diabetes, Lack of dentists and Teen births.

Baylor Scott & White Emergency Hosp
Part V, Section B, Line 16j: Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Baylor Scott&White Surg Hosp at Sherman
Part V, Section B, Line 16j: Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Baylor Scott & White Emer Hosp Rockwall
Part V, Section B, Line 16j: Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Baylor S&W Texas Spine & Joint Hospital
Part V, Section B, Line 16j: Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Part V, Section B
Facility Reporting Group A

Facility Reporting Group A consists of:
- Facility 1: Baylor University Medical Center, - Facility 3: Baylor Scott&White Heart & Vascular Hospital

Facility Reporting Group A Part V, Section B, line 5:
Focus groups with ten (10) participants, as well as eight (8) key informant interviews, were conducted September through November of 2015 in order to take into account the input of persons representing the broad interests of the community served. The focus groups and interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into community needs. The focus group was designed to familiarize participants with the CHNA process and gain a better understanding of priority health needs from the community's perspective. Focus groups were formatted for individual as well as small group feedback and also helped identify other community organizations already addressing health needs in the community. Truven Health also conducted key informant interviews for the community served. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the various drivers which contributed to health issues. In order to qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community; as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income, and minority populations in the community. In order to ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations, and other healthcare providers (including physicians). The following is a list of groups consulted: United Way of Tarrant County, City Square, United Way of West Ellis County, United Way of Denton County, YWCA of Metropolitan Dallas, Collin County Health Care Services, Injury Prevention Center of Greater Dallas, Parkland Health and Hospital System, Metrocrest Community Clinic, Mental Health America of Greater Dallas, Bridge-Breast Network, JPS Health Network/Regional Health Partnership District 10, Tarrant County Hospital District, JPS Health Network Trinity Springs Pavilion for Psychiatric Services, Christian Community Action, AIDS Arms, Inc., Metrocare Services

Facility Reporting Group A Part V, Section B, line 6a:
Baylor University Medical Center, Baylor Institute for Rehabilitation at Northwest Dallas, Baylor Heart and Vascular Hospital, Baylor Medical Center at Uptown, Baylor Institute for Rehabilitation, North Central Surgical Center, Baylor Institute for Rehabilitation at Frisco, Baylor Scott & White Medical Center - Carrollton, Baylor Scott & White Medical Center - Frisco, Baylor Scott & White Medical Center - Garland, Baylor Scott & White Medical Center - McKinney, Baylor Scott & White Medical Center - Plano, The Heart Hospital Baylor Denton, The Heart Hospital Baylor Plano, Baylor Scott & White Medical Center - Irving, Baylor Surgical Hospital at Las Colinas, Baylor Scott & White Medical Center - White Rock, Baylor Scott & White Medical Center - CentennialFacility Reporting Group A:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2016, the 15th day of the fifth month after the 2015 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Facility Reporting Group A Part V, Section B, line 11:
The hospital organization is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The organization's hospital facilities have teamed up with other hospital facilities in the community to complete a joint community health needs assessment and develop a joint implementation strategy to meet certain federal and state requirements. These hospitals will address significant community health needs based on their intersection with the stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Access to Care for Middle to Lower Socioeconomic status, Mental/Behavioral Health, Preventable Admissions- Uncontrolled Diabetes, and Lack of Dental Providers.Chronic Disease Management - The Baylor Community Clinic houses a carved out chronic disease management program to provide focused and dedicated education and care for low to middle socio-economic status patients with diabetes, cardiovascular diseases ((i.e. congestive heart failure) and respiratory diseases (asthma/chronic obstructive pulmonary disease) within a primary care setting. Specific staff, comprised of community health workers (CHW) and nurse care managers, address the complex clinical and prevention needs of these patients and spend time specifically on management of these diseases. The focus of this time and education with patients not only entails clinical counseling, but also includes prevention components focused on lifestyle issues and self- management. The other key advantage that patients receive as part of this program is point of care testing for diabetes (HbA1c testing and glucose testing using test strips) and asthma (Peak Flow Meter Assessments). This will help to overcome the barrier of patients' non-compliance with completing lab orders and any financial or transportation issues that arise in obtaining these important lab results.Heart Heath Education & Screenings - The hospital will provide heart health education and screenings to economically challenged populations within the community.Medical Education/Physicians - Medical education is a crucial part of the hospital's mission. Being one of the nations' largest private teaching hospitals, the System annually trains residents and fellows in eight specialties and 13 subspecialties. These quality teaching programs add many dimensions to the System's ability to serve patients. Residents in the hospitals' program graduate with demonstrated competence in population health management, continuous quality improvement, and the importance of patient satisfaction. Residents work with physician's assistants and are active managers of the patient-centered medical home, often assuming leadership roles in clinic and hospital operations. To help address the state's health care workforce shortage, the Texas A&M Health Science Center College of Medicine and the hospitals have joined forces to establish a Clinical Training Program in Dallas for students to complete clinical rotations in surgery, internal medicine, family medicine, psychiatry, pediatrics, and obstetrics/gynecology at the hospital and other clinical affiliates over their last two years of residency. While residents and fellows of the hospital are not required to work for an affiliate of BSWH, most remain in North Texas upon completion of their program, providing a continuous supply of well-trained medical professionals for the region.Mental/Behavioral Health Clinics - This project co-locates and integrates behavioral health services into the outpatient primary care setting. The model provides a Licensed Clinical Social Worker (LCSW) for basic counseling services. The LCSW addresses behavioral health needs such as: anxiety, depression, and substance abuse issues. The screening tools used are evidence based and include: PHQ2 or 9, GAD-7 and alcohol and substance abuse screens. Additionally, the LCSW will be supported by a Community Health Worker (CHW) to help with the screening and referral processes. This staff can be triaged to clinics and community locations to provide behavioral health services. The behavioral health program requires the LCSW and CHW to work together with the primary care team to: 1) identify the patients who have behavioral health issues, 2) coordinate the patient's care and appointments to fit both the behavioral health and primary care appointment in the same visit and 3) help the primary care team to identify those patients whose behavioral health issues are impeding the management of their acute/chronic disease management models. We expect that approximately 85-90% of these patients will be Medicaid/Uninsured.ED Mental Health Initiative - Implement process on how to protect patients with suicidal or homicidal ideations including one-to-one sitters, utilization of mobile assessment teams, safe environment checklists all with the goal to keep all patients entering the ED safe. Connect patients identified with mental or behavioral health needs to community resources including both inpatient and outpatient treatment. For those with other mental illness, social workers will connect them with outpatient resources through Dallas MetroCare and other surrounding community clinics. This initiative will be provided regardless of the patient's ability to pay. Baylor Scott & White Health and Wellness Center is the area's first and only diabetes health and wellness facility addressing the region's health care needs relative to chronic disease management, including diabetes management, specifically for the underserved and underinsured. As a collaborative effort between Baylor Scott & White Health and the City of Dallas, the goal of the center is to weave chronic disease and management into the fabric of the community so that it is a natural and convenient part of life in the neighborhood. The center provides an integrative care model including an on-site physician and nurse practitioner, visiting medical specialists, referral coordinators for specialty and ancillary care, diabetes management educators, access to affordable chronic disease and diabetes medications, nutrition and healthy cooking classes and physical activity programs including aerobics, walking clinics and weight training. The efforts already have paid huge dividends for this underserved population. More than 5,500 community members have participated in the center's programs. Dental Care Access/Cancer & Transplant Patients - The dental clinic at Baylor Charles A. Sammons Cancer Center's Outpatient Oncology Clinic specializes in dental care for cancer and transplant patients whose need for dental care is often urgent. Preexisting or untreated dental disease can complicate treatment for cancer and transplant patients. Once treatment begins, oral complications can compromise patients' health and quality of life, ultimately affecting their ability to complete prescribed treatment. Therefore medically necessary oral care before, during, and after cancer and transplant treatment can prevent or reduce the incidence and severity of oral complications, enhancing both patient survival and quality of life. The dental lab at the Cancer Center provides such treatment for Baylor Scott and White cancer patients as well as patients from the community on a case by case basis and is provided at a discount and as a response to documented need. Additional actions can be found in the joint implementation strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. The following identified needs have not been specifically addressed by these hospitals because the needs are being addressed by other affiliated hospitals in the joint community benefit implementation plan or because there are other community and state agencies whose expertise and infrastructure are better suited for addressing these needs: Teen Pregnancy and Drug Abuse. Although these needs are not formally addressed in the joint implementation strategy, the hospitals have made financial contributions during the year to agencies who are dedicated to supporting the needs and accompanying issues.

Facility Reporting Group A Part V, Section B, line 16j:
Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Part V, Section B
Facility Reporting Group B

Facility Reporting Group B consists of:
- Facility 9: Baylor Scott&White Surg Hosp-Ft Worth, - Facility 10: Baylor Scott&White Ortho & Spine Hosp, - Facility 13: Baylor Scott&White Med Ctr-Trophy Club, - Facility 17: Baylor Scott & White Emergency Hosp

Facility Reporting Group B Part V, Section B, line 5:
Focus groups with ten (10) participants, as well as six (6) key informant interviews, were conducted September through November of 2015 in order to take into account the input of persons representing the broad interests of the community served. The focus groups and interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into community needs. The focus group was designed to familiarize participants with the CHNA process and gain a better understanding of priority health needs from the community's perspective. Focus groups were formatted for individual as well as small group feedback and also helped identify other community organizations already addressing health needs in the community. Truven Health also conducted key informant interviews for the community served. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the various drivers which contributed to health issues. In order to qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community; as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income, and minority populations in the community. In order to ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations, and other healthcare providers (including physicians). The following is a list of groups consulted: United Way of Tarrant County, City Square, United Way of West Ellis County, United Way of Denton County, YWCA of Metropolitan Dallas, Collin County Health Care Services, Injury Prevention Center of Greater Dallas, Parkland Health and Hospital System, Metrocrest Community Clinic, Mental Health America of Greater Dallas, Bridge-Breast Network, JPS Health Network/Regional Health Partnership District 10, Tarrant County Hospital District, JPS Health Network Trinity Springs Pavilion for Psychiatric Services, Christian Community Action, AIDS Arms, Inc., Metrocare Services

Facility Reporting Group B Part V, Section B, line 6a:
Baylor Scott & White All Saints Medical Center - Fort Worth, Baylor Institute for Rehabilitation at Fort Worth, Baylor Scott & White Medical Center - Grapevine, Baylor Surgical Hospital at Fort Worth, Baylor Medical Center at Trophy Club, Baylor Orthopaedic and Spine Hospital at Arlington, Baylor Emergency Medical Center at Burleson, Baylor Emergency Medical Center at MansfieldFacility Reporting Group B:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2016, the 15th day of the fifth month after the 2015 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Facility Reporting Group B Part V, Section B, line 11:
The hospital organization is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The organization's hospital facilities have teamed up with other hospital facilities in the community to complete a joint community health needs assessment and develop a joint implementation strategy to meet certain federal and state requirements. These hospitals will address significant community health needs based on their intersection with the stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Access to Care for middle to lower socioeconomic status and MD and Non-MD primary care providers to population ratio.Financial Assistance - Certain hospitals operated through a partnership have expanded their provision of financial assistance to eligible patients by providing free or discounted care as outlined in the BSWH system financial assistance policy. Those hospitals have agreed to follow the BSWH financial assistance policy as other BSWH nonprofit hospitals. Certain hospitals not meeting minimum thresholds are required to make a contribution/grant to other affiliated nonprofit hospitals to help those hospitals treat indigent patients.Workforce Development - The hospital will recruit physicians and other health professionals for areas identified as medically underserved. The Hospital seeks to allay the physician shortage, thereby better managing the growing health needs of the community.Additional actions can be found in the joint implementation strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. The following identified needs have not been specifically addressed by these hospitals because the needs are being addressed by other affiliated hospitals in the joint community benefit implementation plan or because there are other community and state agencies whose expertise and infrastructure are better suited for addressing these needs: Mental/behavioral health; Chronic disease; dentist to population ratio; and health and wellness promotion.

Facility Reporting Group B Part V, Section B, line 16j:
Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Part V, Section B
Facility Reporting Group C

Facility Reporting Group C consists of:
- Facility 2: Baylor Scott&White Med Ctr-Lake Pointe, - Facility 6: Baylor Scott&White Med Ctr-Sunnyvale

Facility Reporting Group C Part V, Section B, line 5:
Focus group with ten (10) participants, as well as six (6) key informant interviews, were conducted September through November of 2015 in order to take into account the input of persons representing the broad interests of the community served. The focus groups and interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into community needs. The focus group was designed to familiarize participants with the CHNA process and gain a better understanding of priority health needs from the community's perspective. Focus groups were formatted for individual as well as small group feedback and also helped identify other community organizations already addressing health needs in the community. Truven Health also conducted key informant interviews for the community served. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the various drivers which contributed to health issues. In order to qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community; as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income, and minority populations in the community. In order to ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations, and other healthcare providers (including physicians). The following is a list of groups consulted: United Way of Tarrant County, City Square, United Way of West Ellis County, United Way of Denton County, YWCA of Metropolitan Dallas, Collin County Health Care Services, Injury Prevention Center of Greater Dallas, Parkland Health and Hospital System, Metrocrest Community Clinic, Mental Health America of Greater Dallas, Bridge-Breast Network, JPS Health Network/Regional Health Partnership District 10, Tarrant County Hospital District, JPS Health Network Trinity Springs Pavilion for Psychiatric Services, Christian Community Action, AIDS Arms, Inc., Metrocare Services

Facility Reporting Group C Part V, Section B, line 6a:
Baylor Scott & White Medical Center - Sunnyvale, Baylor Emergency Medical Center at Rockwall, Baylor Scott & White Medical Center - Lake PointeFacility Reporting Group C:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2016, the 15th day of the fifth month after the 2015 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Facility Reporting Group C Part V, Section B, line 11:
The hospital organization is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The organization's hospital facilities have teamed up with other hospital facilities in the community to complete a joint community health needs assessment and develop a joint implementation strategy to meet certain federal and state requirements. These hospitals will address significant community health needs based on their intersection with the stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Healthcare cost/affordability, Mental/behavioral health; Chronic Disease (obesity), and preventable admissions - adult uncontrolled diabetes. Financial Assistance - Certain hospitals operated through a partnership have expanded their provision of financial assistance to eligible patients by providing free or discounted care as outlined in the BSWH system financial assistance policy. Those hospitals have agreed to follow the BSWH financial assistance policy as other BSWH nonprofit hospitals. Certain hospitals not meeting minimum thresholds are required to make a contribution/grant to other affiliated nonprofit hospitals to help those hospitals treat indigent patients.Enrollment Services - Health care support services are provided by the hospital to increase access and quality of care in health services to individuals, especially persons living in poverty and those in vulnerable situations. Through its agreement with Path to Health and Medical Eligibility and Enrollment Program, the hospital provides staff to assist in the qualification of the medically under-served for programs that will enable their access to care, such as Medicaid, Medicare, SCHIP and other government programs or charity care programs for use in any hospital within or outside the Hospital.Financial Donations - The hospital will support community partners in developing/delivering health services that address health care costs and affordability through the provision of financial support to address health care costs and affordability in the community.Physician Recruitment - The hospitals are collaborating with Health Texas Provider Network to recruit physician into the communities that would provide more access for Medicaid patients. Recruitment of physicians for areas identified as medically underserved (MUAs) or other community needs assessment aids in relieving the burden of lack of access to care for medically under-insured or un-insured populations. The age and characteristics of a state's population has a direct impact on the health care system. The state's population is growing at an explosive pace - twice as fast as the national average. During this 10 year period, Texas had the fourth highest percentage growth and ranked first in the number of residents added during this period. And, like the rest of the country, the Texas population is aging and in need of more health care services, which puts added demands on the system. The Hospital seeks to allay the physician shortage, thereby better managing the growing health needs of the community.Community Resourcing - Utilize community resources to their utmost capacity to address the treatment of depression for the community's most vulnerable population through the provision of appropriate referrals to community partners that provide services for depression.Financial Donation - Community Health Service Development - Support community partners in developing/delivering health services that address obesity in the community through provision of financial support to agencies addressing obesity in the community.Community Health Education/Diabetes - The hospital will provide adult diabetes education and support groups for people and their families living with diabetes. Diabetes education is the cornerstone of diabetes management, because diabetes requires day-to-day knowledge of nutrition, exercise, monitoring, and medication.Patient Centered Medical Home/Medication Management - The hospital will expand or enhance the delivery of care provided through the Patient-Centered Medical Home (PCMH) model through partnership of the hospital, Tenet Healthcare and Mission East Dallas. Patients discharged from the hospital who are high-risk for diabetes, or chronic disease patients can seek follow-up care and medication management in an ambulatory care setting.Diabetes Care Expansion - With the Collin County Adult Clinic (CCAC), the hospital will expand access to primary care through expanded primary care clinic hours/staffing, enhanced diabetes and hypertension management and education, wellness checkups and screenings for women, and seamless referrals for HIV/AIDS issues and testing.Impact One-Eighty - The hospital will contract with Impact One-Eighty to provide inpatient medical withdrawal stabilization services for voluntary under-served or under-insured patients who have decided to turn away from alcohol and drugs. Impact One-Eighty will assist with discharge planning by assisting patients with entering into appropriate after care programs and services for follow up.Additional actions can be found in the joint implementation strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. The following identified needs have not been specifically addressed by these hospitals because the needs are being addressed by other affiliated hospitals in the joint community benefit implementation plan or because there are other community and state agencies whose expertise and infrastructure are better suited for addressing these needs: Lack of dentists and Teen births.

Facility Reporting Group C Part V, Section B, line 16j:
Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Part V, Section B
Facility Reporting Group D

Facility Reporting Group D consists of:
- Facility 5: Baylor Scott&White Med Ctr-White Rock, - Facility 8: Baylor Scott&White Med Ctr-Centennial

Facility Reporting Group D Part V, Section B, line 5:
Focus groups with ten (10) participants, as well as eight (8) key informant interviews, were conducted September through November of 2015 in order to take into account the input of persons representing the broad interests of the community served. The focus groups and interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into community needs. The focus group was designed to familiarize participants with the CHNA process and gain a better understanding of priority health needs from the community's perspective. Focus groups were formatted for individual as well as small group feedback and also helped identify other community organizations already addressing health needs in the community. Truven Health also conducted key informant interviews for the community served. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the various drivers which contributed to health issues. In order to qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community; as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income, and minority populations in the community. In order to ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations, and other healthcare providers (including physicians). The following is a list of groups consulted: United Way of Tarrant County, City Square, United Way of West Ellis County, United Way of Denton County, YWCA of Metropolitan Dallas, Collin County Health Care Services, Injury Prevention Center of Greater Dallas, Parkland Health and Hospital System, Metrocrest Community Clinic, Mental Health America of Greater Dallas, Bridge-Breast Network, JPS Health Network/Regional Health Partnership District 10, Tarrant County Hospital District, JPS Health Network Trinity Springs Pavilion for Psychiatric Services, Christian Community Action, AIDS Arms, Inc., Metrocare Services

Facility Reporting Group D Part V, Section B, line 6a:
Baylor University Medical Center, Baylor Institute for Rehabilitation at Northwest Dallas, Baylor Heart and Vascular Hospital, Baylor Medical Center at Uptown, Baylor Institute for Rehabilitation, North Central Surgical Center, Baylor Institute for Rehabilitation at Frisco, Baylor Scott & White Medical Center - Carrollton, Baylor Scott & White Medical Center - Frisco, Baylor Scott & White Medical Center - Garland, Baylor Scott & White Medical Center - McKinney, Baylor Scott & White Medical Center - Plano, The Heart Hospital Baylor Denton, The Heart Hospital Baylor Plano, Baylor Scott & White Medical Center - Irving, Baylor Surgical Hospital at Las Colinas, Baylor Scott & White Medical Center - White Rock, Baylor Scott & White Medical Center - CentennialFacility Reporting Group D:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2016, the 15th day of the fifth month after the 2015 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Facility Reporting Group D Part V, Section B, line 11:
The hospital organization is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The organization's hospital facilities have teamed up with other hospital facilities in the community to complete a joint community health needs assessment and develop a joint implementation strategy to meet certain federal and state requirements. These hospitals will address significant community health needs based on their intersection with the stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Access to Care for middle to lower socioeconomic status and preventable admissions- uncontrolled diabetes.Financial Assistance - Certain hospitals operated through a partnership have expanded their provision of financial assistance to eligible patients by providing free or discounted care as outlined in the BSWH system financial assistance policy. Those hospitals have agreed to follow the BSWH financial assistance policy as other BSWH nonprofit hospitals. Certain hospitals not meeting minimum thresholds are required to make a contribution/grant to other affiliated nonprofit hospitals to help those hospitals treat indigent patients.Enrollment Services - The hospitals will provide assistance to enroll in public programs, such as SCHIP and Medicaid. These health care support services are provided by the hospital to increase access and quality of care in health services to individuals, especially persons living in poverty and those in vulnerable situations. The hospital provides staff to assist in the qualification of the medically under-served for programs that will enable their access to care, such as Medicaid, Medicare, SCHIP and other government programs or charity care programs for use in any hospital within or outside the hospital.Primary care and specialty physician access - The hospitals are collaborating with Health Texas Provider Network to recruit physician into the communities that would provide more access for Medicaid patients. Recruitment of physicians for areas identified as medically underserved (MUAs) or other community needs assessment aids in relieving the burden of lack of access to care for medically under-insured or un-insured populations. The age and characteristics of a state's population has a direct impact on the health care system. The state's population is growing at an explosive pace - twice as fast as the national average. During this 10 year period, Texas had the fourth highest percentage growth and ranked first in the number of residents added during this period. And, like the rest of the country, the Texas population is aging and in need of more health care services, which puts added demands on the system. The Hospital seeks to allay the physician shortage, thereby better managing the growing health needs of the community.Community Health Education/Screenings - Community health education activities are carried out at the hospitals and in the community to improve community health and extend the reach of the hospitals beyond patient care activities. These services do not generate patient care bills and include such activities as community health education, community-based clinical health services and screenings for under-insured and uninsured persons, support groups, and self -help programs.Additional actions can be found in the joint implementation strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. The following identified needs have not been specifically addressed by these hospitals because the needs are being addressed by other affiliated hospitals in the joint community benefit implementation plan or because there are other community and state agencies whose expertise and infrastructure are better suited for addressing these needs: Mental Health, Lack of Dental Provider, Teen Births and Drug Abuse.

Facility Reporting Group D Part V, Section B, line 16j:
Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Part V, Section B
Facility Reporting Group E

Facility Reporting Group E consists of:
- Facility 7: Baylor Scott & White Med Ctr-Frisco, - Facility 11: North Central Surgical Center, - Facility 14: Baylor Scott & White Med Ctr-Uptown, - Facility 15: Baylor Surgical Hosp at Las Colinas

Facility Reporting Group E Part V, Section B, line 5:
Focus groups with ten (10) participants, as well as eight (8) key informant interviews, were conducted September through November of 2015 in order to take into account the input of persons representing the broad interests of the community served. The focus groups and interviews were conducted to solicit feedback from leaders and representatives who serve the community and have insight into community needs. The focus group was designed to familiarize participants with the CHNA process and gain a better understanding of priority health needs from the community's perspective. Focus groups were formatted for individual as well as small group feedback and also helped identify other community organizations already addressing health needs in the community. Truven Health also conducted key informant interviews for the community served. The interviews were designed to help understand and gain insight into how participants felt about the general health status of the community and the various drivers which contributed to health issues. In order to qualitatively assess the health needs for the community, participation was solicited from at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community; as well as individuals or organizations serving and/or representing the interests of medically underserved, low-income, and minority populations in the community. In order to ensure the input received also represented the broad interests of the community served, participation was also sought from community leaders/groups, public health organizations, other healthcare organizations, and other healthcare providers (including physicians). The following is a list of groups consulted: United Way of Tarrant County, City Square, United Way of West Ellis County, United Way of Denton County, YWCA of Metropolitan Dallas, Collin County Health Care Services, Injury Prevention Center of Greater Dallas, Parkland Health and Hospital System, Metrocrest Community Clinic, Mental Health America of Greater Dallas, Bridge-Breast Network, JPS Health Network/Regional Health Partnership District 10, Tarrant County Hospital District, JPS Health Network Trinity Springs Pavilion for Psychiatric Services, Christian Community Action, AIDS Arms, Inc., Metrocare Services

Facility Reporting Group E Part V, Section B, line 6a:
Baylor University Medical Center, Baylor Institute for Rehabilitation at Northwest Dallas, Baylor Heart and Vascular Hospital, Baylor Medical Center at Uptown, Baylor Institute for Rehabilitation, North Central Surgical Center, Baylor Institute for Rehabilitation at Frisco, Baylor Scott & White Medical Center - Carrollton, Baylor Scott & White Medical Center - Frisco, Baylor Scott & White Medical Center - Garland, Baylor Scott & White Medical Center - McKinney, Baylor Scott & White Medical Center - Plano, The Heart Hospital Baylor Denton, The Heart Hospital Baylor Plano, Baylor Scott & White Medical Center - Irving, Baylor Surgical Hospital at Las Colinas, Baylor Scott & White Medical Center - White Rock, Baylor Scott & White Medical Center - CentennialFacility Reporting Group E:Part V, Section B, Line 9: The hospital adopted its most recent Implementation Strategy before November 15, 2016, the 15th day of the fifth month after the 2015 tax year as described in IRS Regulation Section 1.501(r)-3(c)(5).

Facility Reporting Group E Part V, Section B, line 11:
The hospital organization is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization which continues to provide a wide range of important health care services and community benefits. The organization's hospital facilities have teamed up with other hospital facilities in the community to complete a joint community health needs assessment and develop a joint implementation strategy to meet certain federal and state requirements. These hospitals will address significant community health needs based on their intersection with the stated mission and key clinical strengths. Below are key actions that were taken during the year to address the following needs: Access to Care for Middle to Lower Socioeconomic status.Financial Assistance - Certain hospitals operated through a partnership have expanded their provision of financial assistance to eligible patients by providing free or discounted care as outlined in the BSWH system financial assistance policy. Those hospitals have agreed to follow the BSWH financial assistance policy as other BSWH nonprofit hospitals. Certain hospitals not meeting minimum thresholds are required to make a contribution/grant to other affiliated nonprofit hospitals to help those hospitals treat indigent patients.Workforce Development - The hospital will recruit physicians and other health professionals for areas identified as medically underserved. The Hospital seeks to allay the physician shortage, thereby better managing the growing health needs of the community.Enrollment Services - Health care support services are provided by the hospital to increase access and quality of care in health services to individuals, especially persons living in poverty and those in vulnerable situations. Through its agreement with Path to Health and Medical Eligibility and Enrollment Program, the hospital provides staff to assist in the qualification of the medically under-served for programs that will enable their access to care, such as Medicaid, Medicare, SCHIP and other government programs or charity care programs for use in any hospital within or outside the Hospital.Additional actions can be found in the joint implementation strategy that is made widely available on the website listed in Schedule H, Part V, Section B, Line 10a. The following identified needs have not been specifically addressed by these hospitals because the needs are being addressed by other affiliated hospitals in the joint community benefit implementation plan or because there are other community and state agencies whose expertise and infrastructure are better suited for addressing these needs: Mental/Behavioral Health, Preventable Admissions- Uncontrolled Diabetes, Lack of Dental Providers, Teen Pregnancy and Drug Abuse. Although these needs are not formally addressed in the joint implementation strategy, the hospitals have made financial contributions during the year to agencies who are dedicated to supporting the needs and accompanying issues.

Facility Reporting Group E Part V, Section B, line 16j:
Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital may receive help from a financial counselor. These services are also offered through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

Part I, Line 3c:
"and Line 3b: In addition to providing free care to financially indigent patients at 200% of the federal poverty guidelines (""FPG""), the organization provides discounted care to the medically indigent which is based on both the FPG (up to 500%) and the percentage of the patient's total bills from all providers in relation to the patient's annual income."

Part I, Line 6a:
The organization prepares and files an Annual Report of Community Benefit Plan with the Texas Department of State Health Services. This report is made available through the organization's website at http://communityneeds.bswhealth.com/

Part I, Line 7:
A ratio of patient care cost to charges, as determined in Worksheet 2, was used to report the amounts in Part I, Lines 7a - 7d. For amounts reported on lines 7e - 7k, actual expenses for each community benefit activity are tracked and reported using both community benefit software and/or the organization's cost accounting system.Part I, Line 7b, Column (d): Includes payments from the State 1115 Waiver Medicaid Program for uncompensated care, which funds are to be used to expand indigent care.Part I, Line 7i, Column (c): Includes charity care payments of $13,345,237 that are made directly to or on the behalf of a local public hospital and/or other nonprofit organizations for the treatment of indigent patients of those organizations.

Part I, Line 7g:
The organization operates senior health centers despite a financial loss after removing the unreimbursed cost of providing charity care and Medicaid. These services are provided to meet an identified community need and otherwise may not be available if not provided by the organization in these underserved areas of the community.

Part I, Ln 7 Col(f):
The amount of bad debt expense included on Form 990, Part IX, line 25, but removed for Schedule H, Part I, Line 7, Column (f) totaled $0.

Part III, Line 4:
"As stated in the combined audited financial statements, ""The System maintains allowances for uncollectible accounts for estimated losses resulting from a payor's inability to make payments on accounts. The System assesses the reasonableness of the allowance account based on the historical write-offs, cash collections, the aging of the accounts and other economic factors. Accounts are written off when collection efforts have been exhausted. Management continually monitors and adjusts its allowance associated with its receivables."" Bad debt does not include amounts for patients who are known to qualify under the organization's charity care policy. The amount of bad debt attributable to patient's accounts is net of contractual allowance, payments received and recoveries of bad debt previously written off. The Organization has entered zero on Schedule H, Part III, Line 3; however, based on prior experience and certain demographics and other information obtained during admission, the organization believes a portion of the bad debt expenses (estimated to range from 1-5%) would be attributable to patients that would otherwise qualify for charity care. Despite all of the effort and ways the organization educates patients about qualifying for its charity care program as demonstrated in Part VI, question 3 below, many uninsured patients either refuse or fail to complete a charity care application or provide sufficient information at the time of admission, during their stay or after being discharged to qualify for assistance under the organization's charity care policy."

Part III, Line 8:
The amount reported on Part III, Section B, line 7 was calculated in accordance with the Schedule H instructions utilizing the organization's allowable cost reported in the Medicare cost report based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to providing quality care to these patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded as allowable cost in the cost reports. Using the same methodology to calculate the unreimbursed cost of providing charity care and Medicaid (using applicable Schedule H Worksheets) would result in a shortfall of $146,042,735, which is $113,004,114 higher than the shortfall reported on Part III, Section B, Line 7. The organization believes that all of the shortfall should be considered as a community benefit for the following reasons. First, the IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health benefits, including for example Medicare, is an indication that the hospital operates for the promotion of health in the community. Second, the organization provides care to Medicare patients regardless of this shortfall, i.e., loss, and thereby relieves the state and federal government of the burden of paying the full cost for the care of Medicare beneficiaries. Medicare does not provide sufficient reimbursement to cover the entire cost of providing care to these patients causing the organization to use other surplus funds to cover the shortfall. It is expected that reimbursement under the Medicare program will continue to decline and therefore may further limit access to care due to the anticipated reduction of participating Medicare providers in the community. As a result, the care for these patients will likely increase at, and rest on the shoulders of, nonprofit hospitals or county hospital districts. Third, many of the Medicare participants have low fixed incomes and therefore would qualify for charity care or other means tested government programs absent being enrolled in the Medicare program. Fourth, Texas nonprofit hospitals must provide a minimum level of community benefit in order to obtain exemption from state and local taxes. According to the current Texas Health and Safety Code, the unreimbursed cost of Medicare is considered to be a community benefit in determining these state statutory requirements as it helps relieve a governmental burden of providing this care that would otherwise be provided through the county hospital system in Texas.

Part III, Line 9b:
The organization's patient billing and collection policy prohibits any collection efforts for the portion of the account balance that qualifies for financial assistance under the organization's financial assistance policy. For any remaining balances due, the same policy contains the actions that may be taken in the event of nonpayment, which are applied equally to all patient types. The policy is made widely available to the public on the organization's website https://www.bswhealth.com/financialassistance.

Part VI, Line 2:
During the fiscal year ending June 30, 2016, the Organization conducted a Community Health Needs Assessment (CHNA) to assess the health care needs of the community for each of its licensed hospital facilities and developed an implementation strategy to address the needs identified in the CHNAs. The CHNAs were conducted in accordance with state and federal guidelines including Internal Revenue Code Section 501(r) and the Texas Health and Safety Code Section 311. These CHNAs and implementation strategies have been made widely available to the public and are located on the Organization's website at the following address: http://communityneeds.bswhealth.com/.

Part VI, Line 3:
The organization is committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Patients who may qualify for financial assistance through the organization's charity care program or other federal, state and local government programs are informed and educated about their eligibility in several ways including, but not limited to, the following: 1) posting signs and notices regarding the financial assistance policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's financial assistance program in the local newspapers: 3) information regarding financial assistance, including the organization's financial assistance policy, is posted on the organization's website: 4) notices about the organization's financial assistance policy is posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization may provide free financial counselors to help inpatients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's financial assistance program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. The organization has the 501(r) policies available on its website in eight languages: English, Spanish, Russian, Korean, Vietnamese, Arabic, French and Chinese. The organization can also accommodate other languages including American Sign Language as needed.

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The organization operates multiple hospital facilities that primarily serve the geographical urban area of Collin, Dallas, Denton, Grayson, Johnson, Kaufman, Rockwall and Tarrant counties. Additional information regarding the community can also be found below, and in each of the hospital's community health needs assessment and implementation strategy located on the organization's website at http://communityneeds.bswhealth.com/. Collin County's population is approximately 914, 127, median household income is $59,532 with 6.6% of the population living in poverty. Dallas County's population is approximately 2,553,385, median household income is $51,824 with 17.9% of the population living in poverty. Denton County's population is approximately 780,612, median household income is $75,898 with 8.0% of the population living in poverty. Grayson County's population is approximately 131,003, median household income is $52,826 with 16.0% of the population living in poverty. Kaufman County's population is approximately 114,690, median household income is $60,438 with 13.1% of the population living in poverty. Johnson County's population is approximately 159,990, median household income is $58,685 with 11.4% of the population living in poverty. Rockwall County's population is approximately 90,861, median household income is $92,150 with 6.0% of the population living in poverty. There are approximately 135 hospitals serving 28 medically underserved areas within these counties.

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With the oversight of an independent volunteer community board and Baylor Scott & White Holdings, the organization's ultimate parent, the organization's hospital facilities and/or other health care facilities have promoted health and benefited the community by providing exemplary health care, medical education, research and other community services. The organization's governing body is comprised of a majority of volunteer community representatives that provide leadership and governance for the organization. The members of the governing body contribute their wisdom, insights, and expertise to ensure the organization is fulfilling its mission and charitable purpose while providing efficient administrative support services and direction for the organization. The members are well respected residents and/or own businesses in the organization's primary or secondary service area and understand the needs of the community. The medical staff of the organization is open to all physicians in the community who meet membership and clinical privilege requirements. As a nonprofit organization surplus funds are continuously invested back to the community and are utilized to maintain access to limited patient services or expand access points of care to patients throughout the community. These efforts are generally targeted to meet the community health needs identified in the community health needs assessment conducted by each of the hospital facilities. More information of these efforts can be found in the written implementation strategies that have been made widely available to the public and are located on the organization's website at the following address: http://communityneeds.bswhealth.com/. Below are summaries of a few of the hospital's key patient care services or community benefit programs designed to promote the health of the community. The organization provides financial assistance in the form of charity care to patients who are indigent and satisfy certain requirements. Additionally, the organization is committed to treating patients who are eligible for means tested government programs such as Medicaid and other government sponsored programs including Medicare, which is provided regardless of the reimbursement shortfall, and thereby relieves the state and federal government of the burden of paying the full cost of care for these patients. Often, patients are unaware of the federal, state and local programs open to them for financial assistance, or they are unable to access them due to the cumbersome enrollment process required to receive these benefits. The organization offers assistance in enrollment to these government programs or extends financial assistance in the form of charity care through the organization's Financial Assistance Policy which can be located on the organization's website at https://www.bswhealth.com/financialassistance.The organization provides a comprehensive Level I trauma center; one of only three adult trauma centers in Dallas, covering 21 counties and five million residents. The trauma services division has dedicated trauma and stroke teams, providing 24-hour coverage of emergency services. The Riggs Emergency Department has more than 75,000 square feet, 85 patient treatment rooms, with dedicated areas specifically for trauma care and minor emergency care. The Women and Children's Center at the organization provides obstetric and gynecological services, including advanced technology for prenatal diagnosis and care; labor and delivery; high-risk infant care; genetic counseling; and family education. The organization operates a Level III bed neonatal intensive care unit (NICU) which is the highest level of care. The organization's Neuroscience Center offers services to diagnose and treat all types of neurological disorders, injury and disease, including tumors of the central nervous system; stroke; spine care; seizure disorders; movement disorders and cognitive disorders. This nationally recognized center of excellence is also home to the region's first nationally certified stroke program. The transplant program at the organization is a national leader in solid organ transplantation and was one of the first three programs worldwide to have performed more than 4,000 adult liver transplants. Since the program's inception in 1984, transplant surgeons on the medical staff have performed nearly 11,000 transplants, including liver, kidney, pancreas, heart, lung, and uterus transplants. In 2012 the organization opened the T. Boone Pickens Baylor Cancer Hospital, the first dedicated cancer hospital in North Texas as part of the organization's cancer services expansion. The new inpatient hospital will house 120 beds, a pharmacy, patient and family support areas, and the bone marrow transplant unit. The hospital is connected to a new 467,000 square foot outpatient cancer center offering a patient navigation system, advanced technology and integrative therapies for the treatment of every kind of cancer. The expanded center will include outpatient radiation and chemotherapy as well as expanded support groups, and educational resources and programs.The organization's digestive care center offers advanced and comprehensive inpatient and outpatient treatment for digestive and liver disorders by providing a full-range of diagnostic and therapeutic services. The centers' 18,000 square-foot gastrointestinal (GI) physiology and endoscopy laboratory provides physicians with the ability to perform esophageal motility studies, pH monitoring, manometry testing and double balloon endoscopy, in addition to typical endoscopic procedures in a centrally located area. The GI analytical lab also offers digestive disease clinical research opportunities for physicians and patients. The organization provides heart and vascular services to the community through the Baylor Jack and Jane Hamilton Heart and Vascular Hospital. The organization's Heart and Vascular Institute, in partnership with Baylor Scott & White Research Institute, coordinates research studies involving cardiac surgery, cardiology, cardiac and vascular intervention, electrophysiology, vascular surgery and cardiovascular disease prevention. Medical education is a crucial part of the organization's mission. The organization annually trains residents and fellows in 10 specialties and 24 subspecialties. As a renowned teaching hospital, the organization attracts first-rate medical specialists who help improve the level of medical care for the entire community and provide a continuous supply of well-trained medical professionals for the North Texas region. To help address the state's health care workforce shortage, the Texas A&M Health Science Center College of Medicine and the organization have joined forces to establish a Clinical Training Program in Dallas for students to complete clinical rotations in surgery, internal medicine, family medicine, psychiatry, pediatrics, and obstetrics/gynecology at the organization and other clinical affiliates over their last two years of residency. The organization is also committed to assisting with the preparation of future nurses at entry as well as advanced levels of the profession to establish a workforce of qualified nurses. The organization promotes and supports both basic and translational research activities to ensure innovative treatments are quickly available to patients in unique need through the Baylor Scott & White Research Institute (BSWRI). In fiscal year ending June 30, 2018, the organization sponsored research studies totaling more than $25 million conducting more than 1,000 active research studies. Research discoveries of the organization and BSWRI are frequently published in major peer-reviewed scientific journals and reported to national and international medical and scientific audiences.The organization partners with other organizations to provide access to health care services for an underserved population, those living in poverty, in areas where infant mortality is high and where there is a shortage of primary care physicians. The organization has teamed with the City of Dallas to improve care for people with diabetes by creating a new care model focused on health care, education and research in South Dallas. By providing financial support, the Diabetes Health and Wellness Institute at Juanita J. Craft Recreation Center is the cornerstone of the organization's care model to treat patients in the South Dallas region to address the region's health care needs relative to diabetes. The center provides access to medical care and preventative health education to a historically underserved and low-income community experiencing disparate health outcomes relative to the most commonly-encountered health conditions associated with diabetes.

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TX

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The organization is affiliated with Baylor Scott & White Health (BSWH or the System), a faith based nationally acclaimed network of acute care hospitals and related health care entities providing quality patient care, medical education, medical research and other community services to the communities of North and Central Texas. BSWH is the largest not-for-profit health care system in the State of Texas and one of the largest in the United States as measured by total operating revenue of $9.5 Billion and total assets of $12.1 billion based on the fiscal year ended June 30, 2018. Today, BSWH includes 50 hospitals, over 1,100 patient care sites, more than 7,500 active physicians, approximately 48,000 employees and the Scott & White Health Plan. The System includes a robust spectrum of owned, operated, ventured and affiliated philanthropic foundations, a research institute, physician clinics and networks, acute care hospitals, short-stay hospitals, specialty hospitals, ambulatory surgery centers, free standing emergency medical centers, free standing imaging centers, retail pharmacies, an accountable care organization, a health plan and other health care providers all which fall under the common control of BSW Holdings. Under the guidance of an independent community board, the System follows one single mission, vision and values focusing on quality patient centered care while meeting the demands of health care reform, the changing needs of patients and extraordinary recent advances in clinical care. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation's exemplary health care organizations.Community benefits are provided through the provision of financial assistance, governmental sponsored programs (such as Medicaid and Medicare), medical research, medical education, community health improvement services, donations to other nonprofit health care providers, and many other community service activities. During the year, the affiliated nonprofit hospitals reported community benefits (as reported to the Texas Department of State Health Services, and in accordance with the State of Texas Statutory methodology) in excess of $954,038,000. The System's nonprofit hospitals provided community benefits (as reported on the IRS Form 990, Schedule H) in excess of $532,010,000 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $380,665,000 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H. As part of the System, certain affiliates make grants and/or contributions to other related nonprofit affiliates to help financially support and/or fund worthy community benefits activities. The System has also established a patient transfer system among the affiliated hospitals allowing patients needing a particular level of care to be transferred as needed to a related hospital that can provide that service in an efficient and effective manner. As part of the System, all hospitals and other affiliated health care providers are required to adhere to high standards for medical quality, patient safety and patient satisfaction. These standards are set forth by BSW Holdings, the organization's parent, which helps ensures consistency across the System.