4A (Expenses $ 198935820 including grants of $ 0) (Revenue $ 163280247)
See Schedule O

4B (Expenses $ 109612811 including grants of $ 0) (Revenue $ 56662199)
See Schedule O

4C (Expenses $ 19041759 including grants of $ 0) (Revenue $ 193308251)
See Schedule O

4D (Expenses $ 2507754 including grants of $ 1909268) (Revenue $ 0)
COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED ROOTED IN OUR MISSION AND TRADITION, THE FOUNDERS AND SPONSORS OF CHRISTUS HEALTH AND THOSE WHO CO-MINISTER WITH THEM SEEK NEW AND INNOVATIVE WAYS OF DELIVERING QUALITY HEALTH CARE THAT IS BOTH AFFORDABLE AND ACCESSIBLE TO ALL. TODAY, MORE THAN EVER, WE MUST AIM TO IMPROVE THE TOTAL HEALTH STATUS OF THE COMMUNITY THROUGH PROGRAMS THAT PLACE OUR SERVICES WHERE THEY ARE NEEDED MOST, WITH SPECIAL ATTENTION AND PREFERENCE GIVEN TO PROGRAMS THAT SUPPORT AND BENEFIT THE HEALTH AND WELFARE OF THE POOR AND UNDERSERVED. COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED REPRESENT THE UNPAID COST OF SERVICES PROVIDED FOR WHICH A PATIENT IS NOT BILLED, OR FOR WHICH A FEE HAS BEEN ASSESSED THAT RECOVERS ONLY A PORTION OF THE COST OF THE RENDERED SERVICE. THIS CATEGORY INCLUDES INITIATIVES THAT REACH OUT TO THOSE IN NEED THROUGH COMMUNITY HEALTH AND SOCIAL PROGRAMS. THESE PROGRAMS SEEK JUSTICE FOR THE VULNERABLE AND WORK TO BRING ABOUT CHANGES IN OUR POLITICAL AND ECONOMIC SYSTEMS. THE PROGRAMS COVER A BROAD SPECTRUM OF SERVICES FROM CHARITY CLINICS TO IMMUNIZATIONS FOR CHILDREN AND SENIORS, TRANSPORTATION SERVICES, AND A VARIETY OF OTHER SOCIAL SERVICES. CHRISTUS HEALTH ARK-LA-TEX PROVIDES MEDICATION ASSISTANCE FOR COMMUNITY RESIDENTS WHO ARE UNABLE TO AFFORD THE MEDICATIONS THEY NEED. THE HOSPITALS WORK WITH COMMUNITY PHARMACIES AND OTHER PHARMACEUTICAL COMPANIES TO IDENTIFY THESE PATIENTS AND THEN DISTRIBUTE THE NEEDED MEDICATIONS TO THEM. COLLABORATIVE EFFORTS WITH GENESIS PRIME CARE, ALL FOR KIDS PEDIATRIC CLINIC AND RANDY SAMS HOMELESS SHELTER PROVIDE PRIMARY CARE TO MEET THE NEEDS OF THE POOR, UNDERSERVED AND HOMELESS. CHRISTUS HEALTH ARK-LA-TEX ALSO SUPPORTS THE NEEDS OF SPECIAL POPULATIONS IN THE COMMUNITY BY PROVIDING HEALTH SCREENINGS AND EDUCATION FOR EARLY DETECTION OF CANCER AND HEART DISEASE AS WELL AS SCREENINGS AND IMMUNIZATIONS FOR CHILDREN THROUGH A MOBILE HEALTH CLINIC. HEALTH EDUCATION PROGRAMS, SCREENINGS AND ADULT IMMUNIZATIONS ASSIST OTHER TARGETED POPULATIONS SUCH AS PERSONS AGE 65 OR OLDER AND AFRICAN-AMERICANS. CHRISTUS HEALTH HAS ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT-FOR-PROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. WE BELIEVE THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES' LIVES AND CREATE SUSTAINABLE HEALTH IN OUR COMMUNITIES. THE CHRISTUS FUND HAS INVESTED A TOTAL OF $230,000 IN THE ARK-LA-TEX REGION IN FY 2022. HARVEST TEXARKANA AND CASA OF NORTHEAST TX, TWO COMMUNITY AGENCIES SERVING TO IMPROVE THE HEALTH OF THEIR COMMUNITIES WERE RECIPIENTS OF THESE FUNDS. SEVERAL CHRISTUS REGIONS PROVIDE INDIGENT FUNDING DONATIONS OR GRANTS TO AID THE COUNTIES IN WHICH THEY, OR ANOTHER CHRISTUS REGION, SERVE. SUCH GRANTS MAY BE PAID TO THE COUNTY DIRECTLY OR VIA ANOTHER HOSPITAL OR HEALTHCARE ORGANIZATION IN THE AREA. THIS CHARITABLE DONATION HELPS RELIEVE THE ADDITIONAL EXPENSE OF HEALTH CARE FOR THE INDIGENT POPULATION WITHIN OUR COMMUNITIES THAT CHRISTUS MAY NOT DIRECTLY SERVE IN ONE OF OUR HOSPITALS. THIS IS A RESULT OF OUR MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, ESPECIALLY TO THE POOR AND UNDERSERVED. COMMUNITY SERVICES FOR THE BROADER COMMUNITY THE GREATEST SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS. IN ORDER TO PROVIDE CLINICALLY TRAINED PROFESSIONALS, CHRISTUS HEALTH ARK-LA-TEX COOPERATES WITH THE UNIVERSITY OF ARKANSAS MEDICAL SCIENCES AREA HEALTH EDUCATION CENTER-SOUTHWEST TO PROVIDE SUPPORT FOR THE MEDICAL LABORATORY SCIENCES PROGRAM. IN EFFORTS TO MEET THE NEEDS FOR PRIMARY CARE PHYSICIANS IN THE AREA, CHRISTUS PROVIDES SUPPORT FOR A THREE-YEAR PRIMARY CARE RESIDENCY PROGRAM FOR PHYSICIANS THROUGH THE UNIVERSITY OF ARKANSAS MEDICAL SCIENCES AREA HEALTH EDUCATION CENTER-SOUTHWEST. HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS HEALTH ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. WE MADE CASH DONATIONS, IN ADDITION TO GRANTS AWARDED THROUGH THE CHRISTUS FUND, TO SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, PROVISION OF A CONTINUUM OF CARE FOR OUR ELDERLY, HIV/AIDS AND FOR MANY OTHER EQUALLY WORTHY PURPOSES. DURING FY 2022, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY FOR GREATER ACCESS TO HEALTH CARE SERVICES FOR THE CONSTITUENTS WE SERVE.

Schedule H, Part V, Section B, Line 3E
NEEDS PRIORITIZATION OCCURRED IN TWO PHASES. THE FIRST PHASE INCLUDED A DATA-BASED PRIORITIZATION FROM THE THI TEAM IN ADVANCE OF CONVENING A NEEDS PRIORITIZATION COMMITTEE COMPRISED OF LOCAL STAKEHOLDERS. THE SECOND STEP WAS TO FACILITATE A COMMMUNITY-DRIVEN REFINEMENT OF THE DATA-BASED PRIORITIES, USING NOMINAL GROUP TECHNIQUE TO GENERATE A PRIORITIZED NEEDS LIST. THI STAFF FACILITATED THE NOMINAL GROUP TECHNIQUE AT A NEEDS PRIORITIZATION MEETING THAT TOOK PLACE IN JANUARY 2019. THI STAFF INFORMED THE CSMHS LIAISON ABOUT THE PURPOSE OF THIS MEETING AND APPROPRIATE LOGISTICS WERE ARRANGED. THE LOCAL LIAISON RECRUITED INDIVIDUALS FROM THE COMMUNITY TO SERVE ON THE NEEDS PRIORITIZATION COMMITTEE, AND 28 PEOPLE ULTIMATELY ATTENDED THE MEETING. THI STAFF PRESENTED THE INITIAL ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA, A LIST OF DATA-BASED PRIORITIES, AND LED THE GROUP IN THE NOMINAL GROUP TECHNIQUE EXERCISE TO DISTILL A FINAL LIST OF TOP PRIORITIES. PARTICIPANTS IDENTIFIED AND SCORED THEIR TOP PRIORITIES, AND THE FACILITATORS FROM THI CONSOLIDATED INDIVIDUAL PARTICIPANTS' SCORES TO GENERATE AN OVERALL RANKING, WHICH WAS RELAYED BACK TO THE GROUP FOR FURTHER DISCUSSION. THE PRIORITIZATION COMMITTEE REACHED CONSENSUS ON THE COMPOSITE RANKING BEFORE FINALIZING THE PRIORITY HEALTH NEEDS LIST. SIGNIFICANT NEEDS ARE PRIORITIZED AND PRESENTED IN THIS SECTION ARE A SERIES OF IMPLEMENTATION STRATEGIES CONTAINING: 1.MENTAL HEALTH: CSMHS SEEKS TO SUSTAIN AND ENHANCES COLLABORATION AND REFERRAL RELATIONSHIPS WITH LOCAL MENTAL/BEHAVORIAL HEALTH SERVICE PROVIDERS. 2.CHRONIC ILLNESS: CSMHS SEEKS TO IMPROVE UNDERSTANDING AND MANAGEMENT OF CHRONIC DISEASE FOCUSING ON READMISSIONS, DIABETES, HYPERTENSION AND CANCER IN COLLABORATION WITH TRANSITIONAL CARE PROGRAM PARTNER AND GENESIS PRIMECARE. 3.HEALTH SYSTEM PERFORMANCE: CSMHS SEEKS TO IMPROVE ACCESS TO HEALTH CARE AND PROMOTE HEALTHY BEHAVIORS IN THE COMMUNITY IN COLLABORATION WITH GENESIS PRIMECARE, CATHOLIC CHARITIES OF EAST TEXAS AND UTILITZATION OF GO-NOODLE RESOURCES IN AREA SCHOOLS. 4.AGING POPULATIONS: CSMHS SEEKS TO IMPROVE HEALTH CARE AND PROVIDE HEALTH EDUCATION FOR THE AGING POPULATION IN THE COMMUNITY. 5.LACK OF UNEMPLOYMENT OPPORTUNITIES: CSMHS SEEKS TO COLLABORATE WITH THE AR-TX REGIONAL ECONOMIC DEVELOPMENT INCORPORATION TO ASSIST WITH JOB CREATION AND OTHER ECONOMIC DEVELOPMENT OPPORTUNITIES.

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - SEE SCHEDULE H, PART V, SECTION A. CHNA INPUT FROM PERSONS REPRESENTING THE COMMUNITY METHODOLOGY: REVIEW OF LITERATURE AND QUANTITATIVE DATA - THI STAFF CONDUCTED A LITERATURE REVIEW USING PREVIOUSLY PUBLISHED COMMUNITY HEALTH NEEDS ASSESSMENTS AND OTHER REPORTS FOCUSED ON HEALTH IN THE TEXARKANA REGION. THE FINDINGS FROM PREVIOUS COMMUNITY NEEDS ASSESSMENTS AND PROGRESS REPORTING ON INITIATIVES LAUNCHED IN RESPONSE TO THESE NEEDS ASSESSMENTS WERE INCORPORATED INTO PROJECT DESIGN, INTERVIEWS AND FOCUS GROUPS, AND THIS REPORT AS APPLICABLE. IN AN EFFORT TO STANDARDIZE THE CHNA PROCESS ACROSS ALL CHRISTUS FACILITIES, THI STAFF COLLABORATED WITH THE LOUISIANA PUBLIC HEALTH INSTITUTE (LPHI) TO DESIGN AND CONDUCT THE NEEDS ASSESSMENTS. THI AND LPHI FOLLOWED A MIXED METHODS APPROACH OF DATA COLLECTION, ACCESSED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES, INCLUDING BOTH QUALITATIVE AND QUANTITATIVE MEASURES. THE CONSTRUCTION OF THIS CHNA BEGAN WITH COLLECTION AND REVIEW OF THE QUANTITATIVE DATA THAT DERIVE FROM SECONDARY SOURCES. UNLESS OTHERWISE SPECIFIED, ALL DATA WERE ACCESSED FROM COMMUNITY COMMONS, A REPOSITORY OF COMMUNITY-LEVEL DATA COMPILED FROM SOURCES INCLUDING, BUT NOT LIMITED TO, THE AMERICAN COMMUNITY SURVEY, U.S. CENSUS BUREAU, THE CDC BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AND THE NATIONAL VITAL STATISTICS SYSTEM. THE MOST RECENT DATA AVAILABLE FROM THIS SOURCE WERE EXAMINED FOR THE REPORT AREA IN AGGREGATE AND BY COUNTY ACROSS SEVERAL DIMENSIONS, INCLUDING SOCIO-DEMOGRAPHICS, HEALTH RISK BEHAVIORS, ACCESS TO CARE, AND CLINICAL OUTCOMES. THE THI TEAM SUBSEQUENTLY OBTAINED INTERNAL DATA FROM THE TWO CSMHS ACUTE CARE HOSPITALS AND CONDUCTED A DESCRIPTIVE ANALYSIS. TOGETHER, THI STAFF REVIEWED OVER 40 MEASURES AND CATEGORIZED THEM FOR HIGHER-LEVEL EXAMINATION. KEY INFORMANT INTERVIEWS PURPOSE THE PURPOSE OF IN-DEPTH INTERVIEWS WAS TO GATHER A BROAD SAMPLE OF PERSPECTIVES ON SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. FINDINGS FROM INTERVIEWS INFORMED THE DESIGN OF THE FOCUS GROUP AND WERE INCORPORATED INTO THE RESULTS TO LEND CONTEXT TO QUANTITATIVE PATTERNS AND TRENDS. SEMI-STRUCTURED INTERVIEWS FOLLOWED A PRE-DESIGNED QUESTIONNAIRE COVERING THE IDENTIFICATION OF HEALTH NEEDS, COMMUNITY RESOURCES, AND POSSIBLE OPPORTUNITIES FOR ACTION. THE INTERVIEWER ASKED ABOUT BARRIERS AND REASONS FOR UNMET HEALTH NEEDS, EXISTING CAPACITY, NEEDED RESOURCES, AND POTENTIAL SOLUTIONS THAT COULD ENHANCE WELL-BEING IN THE COMMUNITY, EITHER FOR SPECIFIC SUBGROUPS OR THE POPULATION AT-LARGE. THE FULL LENGTH KEY INFORMANT INTERVIEW PROTOCOL CAN BE FOUND IN APPENDIX B OF THIS REPORT. SAMPLE AND RECRUITMENT: REPRESENTATIVES FROM CSMHS CONTRIBUTED CONTACT INFORMATION FOR 16 PEOPLE WHO REPRESENT THE BROAD INTERESTS OF TEXARKANA AND WHO POSSESS KNOWLEDGE ABOUT THE REGION'S HEALTH-RELATED CHALLENGES. THESE KEY STAKEHOLDERS INCLUDED NONPROFIT LEADERS, HEALTH DEPARTMENT AUTHORITIES, UNIVERSITY AND COLLEGE LEADERS, HEALTHCARE PROVIDERS OR LEADERS, HUMAN SERVICES PROVIDERS, LOCAL AND STATE AGENCIES, PEOPLE REPRESENTING DISTINCT GEOGRAPHIC AREAS, AND PEOPLE REPRESENTING DIVERSE RACIAL/ETHNIC GROUPS. THE THI TEAM CONTACTED THESE 16 KEY INFORMANTS BY EMAIL AND TELEPHONE, AND NINE INDIVIDUALS RESPONDED TO THE REQUEST. THI CONDUCTED NINE INTERVIEWS BETWEEN SEPTEMBER AND DECEMBER 2018, EACH LASTING BETWEEN 30 AND 60 MINUTES. TRANSCRIPTION: THE IDENTITIES OF KEY INFORMANTS AND TRANSCRIBED CONTENT OF THEIR STATEMENTS WILL REMAIN CONFIDENTIAL. FOCUS GROUP: PURPOSE AND QUESTIONS TO ADDRESS THE PURPOSE OF THE FOCUS GROUP WAS TO OBTAIN CLARITY AROUND NEEDS AND CONCEPTS PROPOSED FOR INCLUSION IN THE CHNA REPORT, AND TO APPROXIMATE A GROUP RESPONSE TO ALL IDEAS PUT FORTH. THE GROUP FOLLOWED A SEMI-STRUCTURED PROTOCOL INTENDED TO ELICIT RESPONSES ALIGNED WITH THE FOLLOWING OBJECTIVES: 1. IDENTIFY SIGNIFICANT HEALTH NEEDS, 2. IDENTIFY COMMUNITY RESOURCES TO MEET ITS HEALTH NEEDS, 3. IDENTIFY BARRIERS AND REASONS FOR UNMET HEALTH NEEDS, AND 4. IDENTIFY SUPPORTS, PROGRAMS, AND SERVICES THAT WOULD HELP TO IMPROVE THE NEEDS OR ISSUES. THI STAFF FINALIZED THE DESIGN OF THE FOCUS GROUP GUIDE AFTER DISCUSSIONS WITH CSMHS STAFF, A REVIEW OF THE QUANTITATIVE DATA, AND ANALYSIS OF INTERVIEW DATA COLLECTED PRIOR TO THE FOCUS GROUP. RECRUITMENT AND SAMPLE: POTENTIAL PARTICIPANTS WERE IDENTIFIED BY CSMHS LEADERSHIP. MOST PARTICIPANTS WERE RECRUITED THROUGH ORGANIZATIONS THAT PROVIDE HEALTH CARE OR RELATED SERVICES TO COMMUNITY RESIDENTS (E.G., CLINICS, COMMUNITY ORGANIZATIONS, SOCIAL SERVICE AGENCIES). ELECTED OFFICIALS AND GOVERNMENT LEADERS WERE ALSO INVITED TO PARTICIPATE. TO ASSIST WITH RECRUITMENT, THE LOCAL CHRISTUS LIAISON RECRUITED STAKEHOLDERS WHO REPRESENTED SPECIFIC GROUPS, OCCUPATIONS, OR PERSPECTIVES IMPORTANT TO THE PROJECT. TWELVE PEOPLE PARTICIPATED IN THE FOCUS GROUP. ADMINISTERING FOCUS GROUP AND COLLECTING DATA: THE FOCUS GROUP LASTED TWO HOURS. THE FACILITATOR OPENED WITH A GENERAL ASSESSMENT OF THE FOCUS GROUP PARTICIPANTS' VIEWS OF THE HEALTH PROFILE OF THEIR COMMUNITY, INVITING GENERAL COMMENTS WITH OPEN-ENDED QUESTIONS ABOUT HEALTH NEEDS. NEXT, THE FACILITATOR FOLLOWED WITH PROBES REGARDING ANY HEALTH NEEDS THAT AROSE IN THE QUANTITATIVE AND QUALITATIVE ANALYSES BUT DID NOT APPEAR IN THE GROUP MEMBERS' INITIAL RESPONSES. AN ASSISTANT MODERATOR TOOK NOTES AND RECORDED THE GROUP RESPONSES. THI STAFF CODED ALL TRANSCRIPTS, IDENTIFYING AND CONSOLIDATING THE MAIN THEMES. FROM SUCCESSIVE READINGS OF TRANSCRIPTS, THE THI TEAM METHODICALLY ANALYZED TRANSCRIPT CONTENT TO PRODUCE A PROGRESSIVELY REFINED CODING SCHEME. FROM THIS CODING SCHEME, SEVERAL PREDOMINANT THEMES EMERGED THAT WERE USED TO CONSTRUCT THE FINAL SUMMARIES. NEEDS PRIORITIZATION: NEEDS PRIORITIZATION OCCURRED IN TWO PHASES. THE FIRST PHASE INCLUDED A DATA-BASED PRIORITIZATION FROM THE THI TEAM IN ADVANCE OF CONVENING A NEEDS PRIORITIZATION COMMITTEE COMPRISED OF LOCAL STAKEHOLDERS. THE SECOND STEP WAS TO FACILITATE A COMMUNITY-DRIVEN REFINEMENT OF THE DATA-BASED PRIORITIES, USING NOMINAL GROUP TECHNIQUE TO GENERATE A PRIORITIZED NEEDS LIST. THI STAFF FACILITATED THE NOMINAL GROUP TECHNIQUE AT A NEEDS PRIORITIZATION MEETING THAT TOOK PLACE IN JANUARY 2019. THI STAFF INFORMED THE CSMHS LIAISON ABOUT THE PURPOSE OF THIS MEETING AND APPROPRIATE LOGISTICS WERE ARRANGED. THE LOCAL LIAISON RECRUITED PARTICIPANTS TO SERVE ON THE NEEDS PRIORITIZATION COMMITTEE, AND 28 PEOPLE ULTIMATELY ATTENDED THE MEETING. THI STAFF PRESENTED THE INITIAL ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA, A LIST OF DATA-BASED PRIORITIES, AND LED THE GROUP IN THE NOMINAL GROUP TECHNIQUE EXERCISE TO DISTILL A FINAL LIST OF TOP PRIORITIES. PARTICIPANTS IDENTIFIED AND SCORED THEIR TOP PRIORITIES, AND THE FACILITATORS FROM THI CONSOLIDATED INDIVIDUAL PARTICIPANTS' SCORES TO GENERATE AN OVERALL RANKING, WHICH WAS RELAYED BACK TO THE GROUP FOR FURTHER DISCUSSION. THE PRIORITIZATION COMMITTEE REACHED CONSENSUS ON THE COMPOSITE RANKING BEFORE FINALIZING THE PRIORITY HEALTH NEEDS LIST.

Schedule H, Part V, Section B, Line 11 Facility A, 1
Facility A, 1 - SEE SCHEDULE H, PART V, SECTION A. SELECTED IMPLEMENTATION STRATEGY: PRESENTED IN THIS SECTION ARE A SERIES OF IMPLEMENTATION STRATEGIES CONTAINING THE DETAILED GOALS AND ACTIONS CSMHS IS UNDERTAKING IN A THREE YEAR PERIOD TO RESPOND TO EACH PRIORITY HEALTH NEED LISTED. A PRIORITY STRATEGY STATEMENT DESCRIBES EACH OBJECTIVE AND INTRODUCES MAJOR ACTIONS THAT WILL BE PURSUED TO DELIVER IMPROVEMENTS. MAJOR ACTIONS ARE PRESENTED WITH SUB-ACTIONS IDENTIFYING SPECIFIC PARTNERS AND RESOURCES TO BE ENGAGED IN THE IMPROVEMENT EFFORT. ACTIONS AND SUB-ACTIONS ARE LINKED WITH ANTICIPATED OUTCOMES, WHICH PRESENT A VISION OF HOW THE STATUS OF EACH HEALTH NEED WILL CHANGE WHEN THE ACTIONS ARE COMPLETED. 1.MENTAL HEALTH: CSMHS SEEKS TO SUSTAIN AND ENHANCES COLLABORATION AND REFERRAL RELATIONSHIPS WITH LOCAL MENTAL/BEHAVORIAL HEALTH SERVICE PROVIDERS. 2.CHRONIC ILLNESS: CSMHS SEEKS TO IMPROVE UNDERSTANDING AND MANAGEMENT OF CHRONIC DISEASE FOCUSING ON READMISSIONS, DIABETES, HYPERTENSION AND CANCER IN COLLABORATION WITH TRANSITIONAL CARE PROGRAM PARTNER AND GENESIS PRIMECARE. 3.HEALTH SYSTEM PERFORMANCE: CSMHS SEEKS TO IMPROVE ACCESS TO HEALTH CARE AND PROMOTE HEALTHY BEHAVIORS IN THE COMMUNITY IN COLLABORATION WITH GENESIS PRIMECARE, CATHOLIC CHARITIES OF EAST TEXAS AND UTILIZATION OF GO-NOODLE RESOURCES IN AREA SCHOOLS. 4.AGING POPULATIONS: CSMHS SEEKS TO IMPROVE HEALTH CARE AND PROVIDE HEALTH EDUCATION FOR THE AGING POPULATION IN THE COMMUNITY. 5.LACK OF UNEMPLOYMENT OPPORTUNITIES: CSMHS SEEKS TO COLLABORATE WITH THE AR-TX REGIONAL ECONOMIC DEVELOPMENT INCORPORATION TO ASSIST WITH JOB CREATION AND OTHER ECONOMIC DEVELOPMENT OPPORTUNITIES. A COMMITTEE OF EXPERTS WERE TASKED WITH REVIEWING THE FINDINGS AND DISTILLING A BROAD LIST OF TEN INDICATORS INTO A LIST OF FIVE PRIORITY HEALTH NEEDS FOR TARGETED, NEAR-TERM ACTION. THIS COMMITTEE WAS COMPRISED OF BOTH HOSPITAL STAFF AND EXTERNAL COMMUNITY HEALTH PARTNERS WHO PARTICIPATED IN THE CHNA FORMULATION. PRIORITIES WERE EVALUATED ACCORDING TO ISSUE PREVALENCE AND SEVERITY, BASED ON COUNTY AND REGIONAL SECONDARY DATA. INPUT PROVIDED BY KEY INFORMANTS, FOCUS GROUPS PARTICIPANTS, AND OTHER COMMUNITY STAKEHOLDERS WAS ALSO HEAVILY CONSIDERED, ESPECIALLY FOR PRIORITY AREAS WHERE SECONDARY ARE LESS AVAILABLE. THE COMMITTEE CONSIDERED A NUMBER OF CRITERIA IN DISTILLING TOP PRIORITIES, INCLUDING MAGNITUDE AND SEVERITY OF EACH PROBLEM, CSMHS'S ORGANIZATIONAL CAPACITY TO ADDRESS THE PROBLEM, IMPACT OF THE PROBLEM ON VULNERABLE POPULATIONS, EXISTING RESOURCES ALREADY ADDRESSING THE PROBLEM, AND POTENTIAL RISK ASSOCIATED WITH DELAYING INTERVENTION ON THE PROBLEM. THE COMMITTEE'S FINAL LIST OF FIVE PRIORITY NEEDS IS PRESENTED IN RANK ORDER BELOW. THIS PRIORITY LIST OF HEALTH NEEDS LAYS THE FOUNDATION FOR CSMHS TO REMAIN AN ACTIVE, INFORMED PARTNER IN POPULATION HEALTH IN THE REGION FOR YEARS TO COME. FOLLOWING THE NEEDS PRIORIZATION COMMITTEE MEETING, HOSPITAL STAFF CONVENED TO STRATEGIZE PLANNED RESPONSES TO PRIORITY HEATH NEEDS, IDENTIFY POTENTIAL COMMUNITY PARTNERS FOR PLANNED INITIATIVES, AND IDENTIFY ACTIONS, SUB ACTIONS, AND ANTICIPATED OUTCOMES OF IMPROVEMENT PLAN EFFORTS.

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

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

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

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

Schedule H, Part V, Section B, Line 17 ACTIONS IN THE EVENT OF NON-PAYMENT
THE ORGANIZATION DOES NOT HAVE A POLICY THAT ADDRESSES ACTIONS IN THE EVENT OF NON-PAYMENT. THE ORGANIZATION DOES NOT PURSUE ANY OF THE LISTED ACTIONS AT LINES 18 OR 19 IN PURSUIT OF COLLECTIONS FROM INDIVIDUALS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE THE PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER CHRISTUS HEALTH MANAGEMENT DIRECTIVE 11.

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

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

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

Schedule H, Part I, Line 3c FEDERAL POVERTY GUIDELINES
THE ORGANIZATION USES FEDERAL PROVERTY GUIDELINES.

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

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

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

Schedule H, Part VI, Line 7 COMMUNITY BENEFIT REPORT
A COMMUNITY BENEFIT REPORT IS FILED FOR THE STATE OF TEXAS IN THE FORM OF THE ANNUAL STATEMENT OF COMMUNITY BENEFITS STANDARD (ASCBS) FORM AS REQUIRED BY THE HEALTH AND SAFETY CODE, SECTIONS 311.045 AND 311.046. THE CODE REQUIRES NONPROFIT HOSPITALS TO FILE THE ASCBS FORM AND ANNUAL REPORT OF THE COMMUNITY BENEFITS PLAN WITH THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES (DSHS).THE 2013 ASCBS FORM IS EXPANDED TO COLLECT THE INFORMATION ON CHARITY CARE POLICIES AND COMMUNITY BENEFITS IN A STANDARDIZED FORMAT. ALL CHRISTUS HEALTH ENTITIES INCLUDING FACILITIES LOCATED IN STATES THAT DO NOT REQUIRE ANNUAL COMMUNITY BENEFIT REPORTING (I.E., LOUISIANA, AND NEW MEXICO), FOLLOW THE SAME REPORTING RULES AS OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT, COPYRIGHT 2020. TOTAL COMMUNITY BENEFIT FOR CHRISTUS HEALTH IS ALSO REPORTED IN THE ANNUAL REPORT PREPARED AND DISTRIBUTED BY THE SYSTEM OFFICE.

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

Schedule H, Part I, Line 7 Column (F)
PERCENT OF TOTAL EXPENSE TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN(A) IS $384,089,349. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $9,769,405. THIS LEAVES A TOTAL EXPENSE OF $374,319,944 FOR PURPOSES OF CALCULATING LINE 7, COLUMN(F).

Schedule H, Part I, Line 7 Column (F)
DESCRIPTION OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS AS PERCENTAGE OF TOTAL COSTS THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS REPORTED ON PART I, LINE 7K, COLUMN(C) AS A PERCENTAGE OF TOTAL EXPENSE IS 19.77%, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN(F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE.

Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE
https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/v2financial-assistance-application.ashx

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

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
CHRISTUS HEALTH

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

Schedule H, Part II Community Building Activities
THE CHRISTUS HEALTH ADVOCACY DEPARTMENT WORKS IN PARTNERSHIP WITH LOCAL, STATE AND FEDERAL POLICY MAKERS TO ENSURE ACTIVITIES AND PROGRAMS ARE IN PLACE THAT WILL ENHANCE PUBLIC HEALTH THROUGH IMPROVED ACCESS TO HEALTH SERVICES AND ADVANCE GENERAL KNOWLEDGE. DURING FY 2022, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES BY WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTHCARE SERVICES FOR THE CONSTITUENTS WE SERVE. ADVOCACY EFFORTS FOCUS ON THE NEEDS OF CHILDREN, SENIORS AND OTHER VULNERABLE POPULATIONS BY PROMOTING PROGRAMS SUCH AS HEALTH SCREENINGS AND EDUCATION FOR EARLY DETECTION OF CANCER AND HEART DISEASE AS WELL AS PROVIDING IMMUNIZATIONS TO THESE POPULATIONS.

Schedule H, Part I, Line 7i CASH AND IN-KIND CONTRIBUTIONS
CHRISTUS HEALTH ARK-LA-TEX MADE OVER $680,225 IN CASH AND IN KIND CONTRIBUTIONS DURING FISCAL YEAR 2022. THE AFOREMENTIONED AMOUNT IS DETERMINED IN ACCORDANCE WITH REPORTING RULES FOR SCHEDULE H, WORKSHEET 8. AS SUCH THIS AMOUNT DIFFERS FROM GRANTS REPORTED AT FORM 990, SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS AND PART IX, LINES 1 THROUGH 3 GRANTS AND OTHER ASSISTANCE. CHRISTUS HEALTH ESTABLISHED THE CHRISTUS FUND, A GRANT FUND TO PROVIDE RESOURCES TO NONPROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION, AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. CHRISTUS FUND GRANTS TOTALING $160,000 WERE DONATED BY CHRISTUS HEALTH TO NONPROFIT ORGANIZATIONS LOCATED IN THE COMMUNITY SERVED BY CHRISTUS HEALTH ARK-LA-TEX. THE GRANT DOLLARS ARE USED TO SUPPORT PROGRAMS THAT PROMOTE THE HEALTH OF THE COMMUNITY THAT CHRISTUS HEALTH ARK-LA-TEX SERVES. ALL GRANTS MADE TO OUTSIDE ORGANIZATIONS THROUGH THE CHRISTUS FUND ARE MADE TO NONPROFIT ORGANIZATIONS THAT SUPPORT THE HEALTH OF THE COMMUNITY. THESE GRANT DOLLARS ARE NOT INCLUDED ON SCHEDULE H, PART I, LINE 7(I). INDIGENT FUNDING EXPENSE OF $378,640 IS INCLUDED IN SCHEDULE H, PART I, LINE 7(I).

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

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
THE FILING ORGANIZATION RECOGNIZES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERISTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2022, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 3.73% OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THESE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING JUNE 30, 2022. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 0.6015% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2022 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2011 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011.

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

Schedule H, Part V, Section B, Line 16a FAP website
A - CHRISTUS ST. MICHAEL HEALTH SYSTEM: Line 16a URL: https://www.christushealth.org/plan-care/bill-pay/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - CHRISTUS ST. MICHAEL HEALTH SYSTEM: Line 16b URL: SEE SUPPLEMENTAL INFO;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - CHRISTUS ST. MICHAEL HEALTH SYSTEM: Line 16c URL: SEE SUPPLEMENTAL INFO;

Schedule H, Part VI, Line 2 Needs assessment
CHRISTUS HEALTH ARK-LA-TEX, IN COLLABORATION WITH AREA COMMUNITY STAKEHOLDERS DEVELOPED THE 2023 - 2025 COMMUNITY BENEFIT PLAN. AREA COMMUNITY STAKEHOLDERS PARTICIPATED IN A COMMUNITY NEEDS SURVEY TO EXAMINE AND AFFIRM FINDINGS OF THE COMMUNITY HEALTH NEEDS AS WELL AS THE TIME AND RESOURCES REQUIRED TO ADDRESS ALL OF THE UNMET NEEDS IN THE CHRISTUS ARK-LA-TEX REGION. THE GROUP HAS COMMITTED TO CONTINUE WORK RELATED TO THE COMMUNITY HEALTH NEEDS ASSESSMENT IN THE ARK-LA-TEX REGION FOR THE LONG-TERM.

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

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE AMOUNT ON SCHEDULE H, PART III, LINE 6 IS DETERMINED BY CALCULATING MEDICARE ALLOWABLE COSTS USING WORKSHEET A OF THE MEDICARE COST REPORT. WORKSHEET A OF THE MEDICARE COST REPORT REQUIRES THE ORGANIZATION TO REMOVE NON-ALLOWABLE EXPENSES FROM TOTAL EXPENSES VIA THE ADJUSTMENTS TO EXPENSES WORKSHEETS WITHIN THE MEDICARE COST REPORT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE FILING ORGANIZATION ASSOCIATED WITH THE FILING ORGANIZATION'S PROVISIONS OF SERVICES TO MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 7 WOULD EQUAL A SURPLUS OF $3,555,576 IF TOTAL EXPENSES ALLOCABLE TO MEDICARE SERVICES WERE SUBSTITUTED ON SCHEDULE H, PART III, LINE 6.

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

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
CHRISTUS HEALTH ARK-LA-TEX MAKES EVERY EFFORT TO EDUCATE PATIENTS ON ITS CHARITY AND DISCOUNT POLICY AND ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS DURING REGISTRATION, PRE-REGISTRATION (FOR SCHEDULED TESTS AND SURGERIES), POST REGISTRATION (DURING THEIR HOSPITALIZATION) AND FOLLOWING DISCHARGE (TELEPHONE OR WRITTEN INQUIRY) IN LANGUAGES APPROPRIATE FOR THE POPULATION BEING SERVED. PATIENTS ARE GIVEN INFORMATION AND FORMS BY A FINANCIAL COUNSELOR WHO HELPS THEM COMPLETE THE FORMS DURING THEIR INPATIENT OR OUTPATIENT VISITS. PATIENTS ARE ASKED TO BRING OR MAIL SUPPORTING DOCUMENTATION TO DETERMINE INCOME, ASSETS AND HOUSEHOLD EXPENSES. THE BUSINESS OFFICE REVIEWS THE APPLICATION BASED ON THE INFORMATION PROVIDED BY THE PATIENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE OR A DISCOUNT, A NEW BILL IS GENERATED. PATIENTS WHO DO NOT PROVIDE THE REQUIRED DOCUMENTATION ARE CONSIDERED INELIGIBLE AND ARE BILLED ACCORDINGLY. IF THE DOCUMENTATION IS PROVIDED AT A LATER TIME, THE PATIENT MAY THEN BE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR A DISCOUNT. DOCUMENTATION IS RETAINED BY THE BILLING OFFICE FOR SEVEN YEARS. A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY IS POSTED IN PROMINENT PLACES THROUGHOUT THE HOSPITALS, INCLUDING BUT NOT LIMITED TO THE EMERGENCY ROOM WAITING AREAS AND THE ADMISSIONS OFFICE WAITING AREAS, AS REQUIRED BY BOTH THE STATE OF TEXAS COMMUNITY BENEFIT STANDARD (WHICH ADDRESSES THE DUTIES AND RESPONSIBILITIES OF NONPROFIT HOSPITALS) AND CHRISTUS HEALTH COMMUNITY BENEFIT GUIDELINES #50. IN ADDITION, A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY AND INFORMATION OF FINANCIAL ASSISTANCE ARE ALSO POSTED ON THE CHRISTUS HEALTH WEBSITE. THE INFORMATION OF FINANCIAL ASSISTANCE INCLUDES EXPLANATIONS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, WHO QUALIFIES, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE.

Schedule H, Part VI, Line 4 Community information
CHRISTUS HEALTH ARK-LA-TEX IS LOCATED IN TEXARKANA, TEXAS. THE REPORT AREA CONSISTS OF BOWIE AND CASS COUNTIES IN TEXAS AND MILLER AND LITTLE RIVER COUNTIES IN ARKANSAS CONSISTING OF A TOTAL POPULATION OF 180,367 RESIDENTS. MORE THAN 75% OF THE REPORT AREA'S POPULATION RESIDES IN BOWIE COUNTY AND MILLER COUNTY, AND THE REMAINING RESIDE IN CASS COUNTY AND LITTLE RIVER COUNTY. 83% RESIDENTS OF THE REPORT AREA LIVE IN AN URBAN ENVIRONMENT, WHILE THE REMAINING 17% ARE RURAL WHICH MIRRORS THE URBAN-RURAL BREAKDOWN OF TEXAS POPULATION STATEWIDE. TEXARKANA, TEXAS AND TEXARKANA, ARKANSAS ARE THE LARGEST CITIES IN THE REPORT AREA AND ARE LOCATED IN BOWIE AND MILLER COUNTIES, RESPECTIVELY. THE REPORT AREA POPULATION CONSISTS OF APPROXIMATELY 68.6 PERCENT NON-HISPANIC WHITE AND 22.8 PERCENT NON-HISPANIC BLACK ACCORDING TO 2016 US CENSUS DATA. THE HIGH SCHOOL GRADUATION RATE IN THE REPORT AREA IS ON PAR WITH US GRADUATION RATE AND EXCEEDS THAT OF BOTH TEXAS AND ARKANSAS. COUNTY LEVEL DATA SHOW MEDIAN HOUSEHOLD INCOME $51,925 FOR BOWIE COUNTY AND $50,961 FOR MILLER COUNTY WHICH IN TURN IS HIGHER THAN LITTLE RIVER COUNTY ($47,682) AND CASS COUNTY ($50,017) AS OF 2016. THIS INCOME LEVEL IS ON PAR WITH THE STATEWIDE MEDIAN INCOME OF ARKANSAS ($53,123) BUT SUBSTANTIALLY LOWER THAN TEXAS' MEDIAN FAMILY INCOME ($64,585). CHRISTUS ARK-LA-TEX PROVIDES THE BEST CARE POSSIBLE REGARDLESS OF AN INDIVIDUALS'S ABILITY TO PAY.

Schedule H, Part VI, Line 5 Promotion of community health
CHRISTUS HEALTH ARK-LA-TEX RESPONDS TO THE HEALTH CARE NEEDS OF THE COMMUNITY THROUGH SERVICES PROVIDED AT CHRISTUS ST. MICHAEL HEALTH SYSTEM, WHICH INCLUDES CHRISTUS ST. MICHAEL HOSPITAL, A 311-BED ACUTE CARE HOSPITAL; CHRISTUS ST. MICHAEL HOSPITAL - ATLANTA, A 43-BED ACUTE CARE HOSPITAL; CHRISTUS ST. MICHAEL REHABILITATION HOSPITAL, A 50-BED HOSPITAL; CHRISTUS ST. MICHAEL OUTPATIENT REHABILITATION CENTER AND CHRISTUS ST. MICHAEL IMAGING CENTER. CHRISTUS HEALTH ARK LA-TEX PROVIDES 24 HOUR EMERGENCY DEPARTMENTS, LEVEL III TRAUMA DESIGNATION AT CHRISTUS ST. MICHAEL AND LEVEL IV TRAUMA DESIGNATION AT CHRISTUS ST. MICHAEL HOSPITAL ATLANTA, THAT ARE OPEN TO SERVE ALL THOSE IN NEED OF EMERGENCY CARE, REGARDLESS OF THEIR ABILITY TO PAY. CHRISTUS HEALTH ARK-LA-TEX WORKS TO STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTH CARE SERVICES FOR ALL, ESPECIALLY THE VULNERABLE AND UNDERSERVED POPULATIONS. THE BOWIE COUNTY, TEXAS POPULATION AND MILLER COUNTY, ARKANSAS POPULATION IS 136,605. TEXARKANA, TEXAS AND TEXARKANA, ARKANSAS ARE THE LARGEST CITIES SURROUNDING CHRISTUS HEALTH ARK-LA-TEX. ROOTED IN OUR MISSION AND TRADITION,THE FOUNDERS AND SPONSORS OF CHRISTUS HEALTH ARE CONSTANTLY SEEKING INNOVATIVE WAYS OF DELIVERING QUALITY HEALTH CARE THAT IS BOTH AFFORDABLE AND ACCESSIBLE TO ALL. COLLABORATIVE EFFORTS WITH GENESIS PRIME CARE AND RANDY SAMS HOMELESS SHELTER PROVIDE PRIMARY CARE TO MEET THE NEEDS OF THE POOR, UNDERSERVED AND THE HOMELESS. CHRISTUS HEALTH ARK-LA-TEX ALSO SUPPORTS THE NEEDS OF SPECIAL POPULATIONS IN THE COMMUNITY BY PROVIDING EDUCATION FOR EARLY DETECTION OF CANCER AND HEART DISEASE AS WELL AS HEALTH SCREENINGS AND IMMUNIZATIONS FOR DISEASE DETECTION AND PREVENTION WITHSPECIAL ATTENTION GIVEN TO CHILDREN, SENIORS AND OTHER VULNERABLE POPULATIONS THROUGH A MOBILE HEALTH CLINIC. HEALTH EDUCATION PROGRAMS, SCREENINGS AND ADULT IMMUNIZATIONS ASSIST OTHER TARGETED POPULATIONS SUCH AS PERSONS AGE 65 OR OLDER AND AFRICAN AMERICANS. CHRISTUS HEALTH ARK-LA-TEX PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES. IT CONDUCTS ITS ACTIVITIES AND SERVES ITS HEALTH CARE MISSION WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. CHRISTUS HEALTH ARK-LA-TEX COLLABORATES WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS TO STRENGTHEN ITS ROLE AS A MAJOR PROVIDER OF COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES. CHRISTUS HEALTH ARK-LA-TEX PROVIDES MEDICATION ASSISTANCE FOR COMMUNITY RESIDENTS WHO ARE UNABLE TO AFFORD THE MEDICATIONS THEY NEED. THE HOSPITALS WORK WITH COMMUNITY PHARMACIES AND OTHER PHARMACEUTICAL COMPANIES TO IDENTIFY THESE PATIENTS AND DISTRIBUTE THE NEEDED MEDICATIONS TO SUCH PERSONS. COMMUNITY SERVICES FOR A BROADER COMMUNITY IS ALSO A PART OF CHRISTUS HEALTH ARK-LA-TEX'S OVERALL COMMUNITY BENEFIT. THE GREATEST SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS (GRADUATE MEDICAL EDUCATION, NURSING STUDENTS, ALLIED HEALTH PROFESSIONALS, PHARMACISTS, ETC). HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS ARK-LA-TEX HAD OVER $1,042,658 IN HEALTH PROFESSIONS EDUCATION EXPENSES DURING FY 2022 THAT INCLUDED STUDENT INTERNSHIPS, CLINICAL EXPERIENCE AND OTHER EDUCATION FOR PHYSICIANS, NURSES, TECHNICIANS, ADMINISTRATORS, SOCIAL WORKERS, THERAPISTS AND PASTORAL CARE PROFESSIONALS. CHRISTUS HEALTH HAS ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT-FOR-PROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES, AND PHILOSOPHY OF A HEALTHY COMMUNITY. WE BELIEVE THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES' LIVES AND CREATE SUSTAINABLE HEALTH IN OUR COMMUNITIES. DURING FY 2022 THE TOTAL GRANT MONEY DISTRIBUTED BY CHRISTUS HEALTH TO THE ARK LA-TEX REGION WAS $230,000. CHRISTUS HEALTH ARK-LA-TEX ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. CASH DONATIONS, IN ADDITION TO GRANTS AWARDED THROUGH THE CHRISTUS FUND, SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, DIABETES, HEART DISEASE, PROVISION OF A CONTINUUM OF CARE FOR OUR ELDERLY, HIV/AIDS PREVENTION, AND MANY OTHER EQUALLY WORTHY PURPOSES. CHRISTUS HEALTH REINVESTS ALL SURPLUS FUNDS BACK INTO THE COMMUNITIES IT SERVES THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. DURING FY 2022, CHRISTUS HEALTH ADVOCATED FOR IMPROVEMENT PUBLIC POLICES AND WORKED TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY FOR GREATER ACCESS TO HEALTH CARE SERVICES FOR ALL. AS A NOT FOR PROFIT ORGANIZATION AND AS PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKEUP OF THE AREA WE SERVE GUIDES CHRISTUS HEALTH ARK-LA TEX. WE ARE PRIVILEGED TO HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS WHO ARE GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKEUP OF THE AREA WE SERVE GUIDES CHRISTUS HEALTH ARK-LA-TEX. ALL PERSONS EMPLOYED AND AFFILIATED WITH CHRISTUS ARK-LA-TEX ARE REQUIRED TO COMPLETE ANNUAL CONFLICT OF INTEREST STATEMENTS.

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