4A (Expenses $ 24239635 including grants of $ 0) (Revenue $ 27614722)
YOAKUM COMMUNITY HOSPITAL (YCH) IS A NOT-FOR-PROFIT, CRITICAL-ACCESS HOSPITAL DELIVERING COMPREHENSIVE SERVICES WITH COMPASSION AND COMMITMENT. HOSPITAL LEADERSHIP AND PHYSICIANS WORK TOGETHER TO GUIDE THE DIRECTION OF THE FACILITY. THE BUSY, 23-BED COMMUNITY HOSPITAL HAS SERVED NEIGHBORS IN YOAKUM AND THE SURROUNDING AREA FOR 100 YEARS. THE YCH MEDICAL STAFF OF 23 PHYSICIANS INCLUDES NOT ONLY FAMILY PHYSICIANS BUT ALSO THOSE CERTIFIED IN A NUMBER OF MAJOR HEALTHCARE SPECIALTIES. MORE THAN 80 YCH STAFF NURSES PROVIDE SPECIAL EXPERTISE AND A COMPASSIONATE BEDSIDE MANNER. THE HOSPITAL PROVIDES A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES TO MEET THE EVOLVING HEALTH CARE NEEDS OF OUR COMMUNITY, WHICH INCLUDE LABORATORY, REHABILITATION, IMAGING, EMERGENCY, GENERAL MEDICINE, DIABETES EDUCATION, SLEEP DISORDER TREATMENT, SURGERY AND THE MANY MEDICAL SPECIALISTS WHO SCHEDULE PATIENT APPOINTMENTS AT THE YCH OUTPATIENT CLINIC. THE YCH TEAM TAKES PRIDE IN THE FACILITY'S QUALITY OF CARE AND OUR ONGOING COMMITMENT TO PATIENTS IN YOAKUM AND THE SURROUNDING COMMUNITIES. ADDITIONAL INFORMATION REGARDING YCH FOR FISCAL YEAR ENDED JUNE 30, 2022: - THE HOSPITAL PERFORMED 354 LIFESAVING SURGERIES. - YCH ADMITTED 571 LOCAL PATIENTS IN THE ACUTE STATE OF ILLNESS AND MANAGED 5,435 EMERGENCY ROOM VISITS WITH THE RAPID, RELIABLE CARE OUR COMMUNITY DESERVES. - THE EMERGENCY SERVICES AT YCH HAVE EARNED THE HOSPITAL DISTINGUISHED RECOGNITION AS THE FIRST LEVEL IV TRAUMA CENTER IN THE AREA. - IN 2007, YOAKUM CHAMBER OF COMMERCE PRESENTED YCH WITH ITS BUSINESS OF THE YEAR AWARD, AND THE HOSPITAL ALSO RECEIVED THE 2007 TEXAS HEALTH CARE QUALITY IMPROVEMENT AWARD. - IN 2012, YOAKUM COMMUNITY HOSPITAL RECEIVED THE 2012 TEXAS HEALTH CARE QUALITY IMPROVEMENT BRONZE AWARD. HOSPITAL SERVICES: YCH PROVIDES A BROAD RANGE OF SERVICES TO MEET THE EVOLVING HEALTH CARE NEEDS OF OUR COMMUNITY, WHICH INCLUDE: - UP-TO-DATE LABORATORY, PHYSICAL THERAPY AND RADIOLOGY SERVICES-INCLUDING MRI, MAMMOGRAPHY, CT, RADIOGRAPHY/FLUOROSCOPY AND ULTRASOUND DIAGNOSTIC SERVICES. - LONE STAR EMERGENCY PHYSICIANS IN YOAKUM COMMUNITY HOSPITAL'S EMERGENCY ROOM TREAT TRAUMA PATIENTS AT ANY TIME OF DAY OR NIGHT, SEVEN DAYS A WEEK. - MEDICAL SPECIALISTS, INCLUDING CARDIOLOGY, EAR, NOSE AND THROAT,GASTROENTEROLOGY, GENERAL SURGERY, OPHTHALMOLOGY, ORTHOPEDICS, OB/GYN, PODIATRY AND UROLOGY PHYSICIANS WHO SCHEDULE PATIENT APPOINTMENTS AT THE YCH OUTPATIENT CLINIC ON A REGULAR BASIS. - SURGICAL SERVICES FOR MANY INPATIENT AND OUTPATIENT PROCEDURES IN OUR FULLY EQUIPPED OPERATING ROOMS. - CONVENIENT ACCESS TO NUMEROUS OUTPATIENT SERVICES FOR PATIENTS WITH SLEEP DISORDERS, DIABETES AND PULMONARY REHABILITATION NEEDS.

Schedule H, Part V, Section B, Line 3E
THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CHNA FOR YOAKUM COMMUNITY HOSPITAL ARE PRESENTED AS A PRIORITIZED DESCRIPTION.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - YOAKUM COMMUNITY HOSPITAL. YOAKUM COMMUNITY HOSPITAL, (YCH), IS A 23-BED HOSPITAL LOCATED IN THE TEXAS HILL COUNTRY AND HAS PROVIDED HEALTHCARE TO THIS AREA SINCE 1922. THE HOSPITAL PROVIDES A BROAD RANGE OF INPATIENT AND OUTPATIENT HEALTHCARE SERVICES TO MEET THE EVOLVING HEALTH CARE NEEDS OF ITS COMMUNITY AND IS THE ONLY LEVEL IV TRAUMA CENTER IN THE AREA. THE SERVICES YCH PROVIDES INCLUDE LABORATORY, REHABILITATION, IMAGING, EMERGENCY AND URGENT CARE, GENERAL MEDICINE, DIABETES EDUCATION, TREATMENT FOR SLEEP DISORDERS, SURGERY, CARDIOLOGY, AND THE MANY SPECIALTY PHYSICIANS WHO SCHEDULE PATIENT APPOINTMENTS AT THE YCH OUTPATIENT CLINIC. PATIENTS BENEFIT FROM THE LATEST MEDICAL TECHNOLOGY ALONG WITH COMPREHENSIVE HEALTH CARE DELIVERED BY HIGHLY SKILLED PHYSICIANS, NURSES, AND PROFESSIONAL STAFF. BASED ON HOSPITAL INPATIENT DISCHARGE DATA. THE DEFINED SERVICE AREA OF YCH IS DEWITT AND LAVACA COUNTIES IN TEXAS. BOTH COUNTIES COMBINED COMPRISE 94.4% OF FISCAL YEAR 2021 INPATIENT DISCHARGES. THE POPULATION OF DEWITT COUNTY IS EXPECTED TO DECREASE 0.9% FROM 2021 (20,265) TO 2026 (20,092) AND THE POPULATION OF LAVACA COUNTY IS EXPECTED TO INCREASE 2.2% FROM 2021 (20,466) TO 2026 (20,910), WITH THE EXPECTED GROWTH RATE OF BOTH COUNTIES FALLING BELOW THE 7.9% EXPECTED GROWTH RATE FOR THE STATE OF TEXAS FROM 2021 (29,969,514) TO 2026 (32,346,738). AS OF 2021, THE RACIAL/ETHNIC BREAKOUT OF DEWITT COUNTY WAS 74.0% WHITE, 8.3% BLACK, 0.4%, ASIAN, 0.6% AMERICAN INDIAN AND 16.6% ALL OTHERS. THE RACIAL/ETHNIC BREAKOUT OF LAVACA COUNTY IN 2021 WAS 84.2% WHITE, 6.0% BLACK, 0.6% ASIAN, 0.5% AMERICAN INDIAN AND 8.8% ALL OTHERS. HISPANIC IS CLASSIFIED AS AN ETHNICITY AND THEREFORE IS CATEGORIZED SEPARATELY FROM WHITE, BLACK, ASIAN, AMERICAN INDIAN AND ALL OTHERS. BY 2026, THE WHITE NON-HISPANIC POPULATION IN DEWITT COUNTY IS EXPECTED TO DECREASE BY 2.0% AND TO INCREASE BY 1.1% IN LAVACA COUNTY. BY 2026, THE BLACK POPULATION IS EXPECTED TO DECREASE BY 5.6% IN DEWITT COUNTY AND BY 2.7% IN LAVACA COUNTY. THE ASIAN POPULATION IS EXPECTED TO INCREASE BY 21.1% IN DEWITT COUNTY AND BY 24.0% IN LAVACA COUNTY BY 2026. THE AMERICAN INDIAN POPULATION IS ALSO EXPECTED TO INCREASE BY 9.4% IN DEWITT COUNTY AND BY 20.4% IN LAVACA COUNTY. ALL OTHER RACIAL/ETHNIC GROUPS ARE EXPECTED TO INCREASE BY 5.8% IN DEWITT COUNTY AND BY 13.1% IN LAVACA COUNTY BY 2026. THE HISPANIC POPULATION IS EXPECTED TO INCREASE BY 5.1% IN DEWITT COUNTY AND BY 14.3% IN LAVACA COUNTY BY 2026. BETWEEN 2011 AND 2019, THE PERCENT OF FOREIGN-BORN RESIDENTS INCREASED IN DEWITT COUNTY, THE STATE AND THE NATION, WHILE THE PERCENT DECREASED IN LAVACA COUNTY. IN 2015-2019, DEWITT COUNTY (3.7%) HAD A LOWER PERCENT OF FOREIGN-BORN RESIDENTS THAN LAVACA COUNTY (5.0%) AND A LOWER PERCENT THAN THE STATE (17.0%) AND THE NATION (13.6%). AS OF 2021, LAVACA COUNTY (47.6 YEARS) HAS AN OLDER MEDIAN AGE THAN DEWITT COUNTY (43.7 YEARS) AND THE STATE OF TEXAS (35.3 YEARS). THE MEDIAN AGE IN BOTH COUNTIES AND THE STATE IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT FIVE YEARS (2021-2026). AS OF 2021, THE MEDIAN HOUSEHOLD INCOME IN BOTH DEWITT ($58,109) AND LAVACA ($58,596) COUNTIES WAS LOWER THAN THAT OF THE STATE ($63,524). BETWEEN 2021 AND 2026, THE MEDIAN HOUSEHOLD INCOMES IN DEWITT COUNTY, LAVACA COUNTY AND THE STATE ARE EXPECTED TO INCREASE. DEWITT COUNTY (13.1%) AND LAVACA COUNTY (17.5%) HAVE A LOWER PERCENTAGE OF RESIDENTS WITH A BACHELOR OR ADVANCED DEGREE THAN THE STATE (31.3%) (2021). IN 2014-2018, 16.0% OF THE NATION LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 26.0% OF THE NATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2014-2018, 24.5% OF THE POPULATION IN TEXAS LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 26.2% OF THE POPULATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2014-2018, THE DISTRESS SCORE IN DEWITT COUNTY WAS 72.4 WHICH FALLS WITHIN THE AT RISK ECONOMIC CATEGORY, WHILE THE DISTRESS SCORE IN LAVACA COUNTY WAS 47.6 WHICH FALLS WITHIN THE MID-TIER ECONOMIC CATEGORY AND IS MORE PROSPEROUS AS COMPARED TO OTHER COUNTIES IN THE STATE. WITH RESPECT TO UNEMPLOYMENT, RATES IN BOTH DEWITT AND LAVACA COUNTIES AND THE STATE INCREASED BETWEEN 2018 AND 2020. IN 2020, BOTH DEWITT (6.0) AND LAVACA (5.2) COUNTIES HAD A HIGHER UNEMPLOYMENT RATE THAN THE STATE (7.6). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN DEWITT AND LAVACA COUNTIES DECREASED. FOR LAVACA AND DEWITT COUNTIES, MAY 2021 HAD THE LOWEST UNEMPLOYMENT RATE (4.8 AND 5.4, RESPECTIVELY) AS COMPARED TO JUNE AND JULY WITH THE HIGHEST RATE (6.7 AND 8.1, RESPECTIVELY). AS OF 2019, THE MAJORITY OF EMPLOYED PERSONS IN DEWITT COUNTY ARE WITHIN CONSTRUCTION AND EXTRACTION OCCUPATIONS AS COMPARED TO LAVACA COUNTY, WHERE THE MAJORITY OF EMPLOYED PERSONS ARE WITHIN PRODUCTION OCCUPATIONS. THE MOST COMMON EMPLOYED GROUPINGS IN DEWITT COUNTY ARE CONSTRUCTION AND EXTRACTION OCCUPATIONS (13.6%); OFFICE AND ADMINISTRATIVE SUPPORT OCCUPATIONS (12.3%); MANAGEMENT OCCUPATIONS (10.6%); SALES AND RELATED OCCUPATIONS (9.0%); AND PRODUCTION OCCUPATIONS (7.7%). IN LAVACA COUNTY, THE MOST COMMON EMPLOYED GROUPINGS ARE PRODUCTION OCCUPATIONS (12.2%); OFFICE AND ADMINISTRATIVE SUPPORT OCCUPATIONS (10.9%); SALES AND RELATED OCCUPATIONS (10.4%); MANAGEMENT OCCUPATIONS (10.0%); AND CONSTRUCTION AND EXTRACTION OCCUPATIONS (8.1%). IN 2015-2019, DRIVING ALONE WAS THE MOST FREQUENT MEANS OF TRANSPORTATION TO WORK F0R BOTH DEWITT AND LAVACA COUNTIES AND THE STATE. IN 2015-2019, LAVACA COUNTY (13.0%) HAD THE HIGHEST PERCENT OF PEOPLE WHO CARPOOLED TO WORK AS COMPARED TO DEWITT COUNTY (8.0%) AND THE STATE (10.0%). DEWITT COUNTY (25.7 MINUTES) HAD A SHORTER MEAN TRAVEL TIME TO WORK THAN LAVACA COUNTY (28.5 MINUTES) AND THE STATE (27.2 MINUTES) (2015-2019). IN 2021, DEWITT COUNTY (22.8%) HAD THE HIGHEST PERCENTAGE OF FAMILIES LIVING BELOW THE POVERTY LEVEL AS COMPARED TO LAVACA COUNTY (19.1%) AND THE STATE (18.0%). BETWEEN 2015 AND 2019, THE PERCENTAGE OF CHILDREN (<18 YEARS) LIVING BELOW POVERTY IN DEWITT COUNTY, LAVACA COUNTY, AND THE STATE OVERALL DECREASED. IN 2019, DEWITT COUNTY (24.3%) HAD A HIGHER PERCENTAGE OF CHILDREN (<18 YEARS) LIVING BELOW POVERTY THAN THE STATE (19.2%), WHILE THE RATE IN LAVACA COUNTY (14.5%) WAS LOWER THAN THE STATE. ACCORDING TO FEEDING AMERICA, DEWITT COUNTY (14.8%) HAD THE HIGHEST ESTIMATED PERCENT OF RESIDENTS WHO ARE FOOD INSECURE AS COMPARED TO LAVACA COUNTY (13.9%) AND THE STATE (14.1%) (2019). ADDITIONALLY, 19.2% OF THE YOUTH POPULATION (UNDER 18 YEARS OF AGE) IN DEWITT COUNTY ARE FOOD INSECURE, AS COMPARED TO 19.0% IN LAVACA COUNTY AND 19.6% IN TEXAS (2019). THE AVERAGE MEAL COST FOR A DEWITT COUNTY RESIDENT IS $2.67, AS COMPARED TO $2.65 IN LAVACA COUNTY AND $2.68 IN TEXAS (2019). BETWEEN 2014 AND 2018, DEWITT COUNTY MAINTAINED A HIGHER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS THAN LAVACA COUNTY AND THE STATE. ADDITIONALLY, THE PERCENTAGE OF SNAP BENEFIT RECIPIENTS IN BOTH COUNTIES OVERALL INCREASED BETWEEN 2014 AND 2018. IN 2018, DEWITT COUNTY (14.7%) HAD A HIGHER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SNAP BENEFITS THAN BOTH LAVACA COUNTY (9.8%) AND THE STATE (12.2%). IN 2018-2019, DEWITT COUNTY (63.7%) HAD THE HIGHEST PERCENTAGE OF PUBLIC SCHOOL STUDENTS ELIGIBLE FOR FREE OR REDUCED PRICE LUNCH THAN LAVACA COUNTY (41.8%), THE STATE (60.5%) AND THE NATION (49.5%). DEWITT COUNTY (96.6%) AND LAVACA COUNTY (96.5%) HAVE A HIGHER HIGH SCHOOL GRADUATION RATE THAN THE STATE (91.3%) AND THE NATION (87.4%) (2018-2019). CANCER IS THE LEADING CAUSE OF DEATH IN DEWITT COUNTY AND SECOND LEADING CAUSE OF DEATH IN BOTH LAVACA COUNTY AND THE STATE (2015-2019). BETWEEN 2017 AND 2019, CANCER MORTALITY RATES OVERALL INCREASED IN DEWITT AND LAVACA COUNTIES AND DECREASED IN THE STATE. IN 2019, THE CANCER MORTALITY RATE IN DEWITT COUNTY (191.5 PER 100,000) WAS HIGHER THAN BOTH LAVACA COUNTY (154.1 PER 100,000) AND THE STATE (143.5 PER 100,000). HEART DISEASE IS THE SECOND LEADING CAUSE OF DEATH IN DEWITT COUNTY, AND THE LEADING CAUSE OF DEATH IN BOTH LAVACA COUNTY AND THE STATE (2017-2019). BETWEEN 2017 AND 2019, HEART DISEASE MORTALITY RATES OVERALL DECREASED IN BOTH LAVACA COUNTY AND THE STATE AND INCREASED IN DEWITT COUNTY. IN 2017-2019, THE HEART DISEASE MORTALITY RATE IN DEWITT COUNTY (195.0 PER 100,000) WAS HIGHER THAN BOTH LAVACA COUNTY (187.1 PER 100,000) AND IN THE STATE (167.5 PER 100,000). CEREBROVASCULAR DISEASE IS THE THIRD LEADING CAUSE OF DEATH IN DEWITT COUNTY AND THE STATE AND THE FOURTH LEADING CAUSE OF DEATH IN LAVACA COUNTY (2015-2019). BETWEEN 2015 AND 2019, CEREBROVASCULAR DISEASE MORTALITY RATES DECREASED IN BOTH COUNTIES AND THE STATE.

Schedule H, Part V, Section B, Line 5 Facility , 2
"Facility , 2 - YOAKUM COMMUNITY HOSPITAL - CONTINUED. IN 2017-2019, THE CEREBROVASCULAR DISEASE MORTALITY RATE IN DEWITT COUNTY (50.2 PER 100,000) WAS HIGHER THAN BOTH LAVACA COUNTY (31.6 PER 100,000) AND THE STATE (40.2 PER 100,000). DIABETES MELLITUS IS THE FOURTH LEADING CAUSE OF DEATH IN DEWITT COUNTY, THE SEVENTH LEADING CAUSE OF DEATH IN THE STATE, AND THE TENTH LEADING CAUSE OF DEATH IN LAVACA COUNTY (2015-2019). BETWEEN 2015 AND 2019, DIABETES MORTALITY RATES INCREASED IN BOTH DEWITT COUNTY AND THE STATE. IN 2017-2019, THE DIABETES MORTALITY RATE IN DEWITT COUNTY (51.9 PER 100,000) WAS HIGHER THAN THE STATE RATE (22.0 PER 100,000). FATAL ACCIDENTS ARE THE FIFTH LEADING CAUSE OF DEATH IN BOTH DEWITT COUNTY AND THE STATE, AND THE THIRD LEADING CAUSE OF DEATH IN LAVACA COUNTY (2015-2019). BETWEEN 2015 AND 2019, ACCIDENT MORTALITY RATES DECREASED IN DEWITT COUNTY, INCREASED IN LAVACA COUNTY, AND SLIGHTLY INCREASED IN THE STATE. IN 2017-2019, THE ACCIDENT MORTALITY RATE IN LAVACA COUNTY (63.3 PER 100,000) WAS HIGHER THAN THE RATE IN DEWITT COUNTY (36.5 PER 100,000) AND THE STATE RATE (38.7 PER 100,000). THE LEADING CAUSE OF FATAL ACCIDENTS IN DEWITT COUNTY AND LAVACA COUNTY IS DUE TO MOTOR VEHICLE ACCIDENTS (2017-2019). CHRONIC LOWER RESPIRATORY DISEASE (CLRD), ALZHEIMER'S DISEASE, SEPTICEMIA, CHRONIC LIVER DISEASE AND CIRRHOSIS AND INTENTIONAL SELF HARM (SUICIDE) ARE ALSO, LEADING CAUSES OF DEATH IN EITHER DEWITT AND LAVACA COUNTY OR IN BOTH COUNTIES. AS OF NOVEMBER 8, 2021, THE PERCENT OF THE POPULATION (AGE 5+) THAT IS FULLY VACCINATED FOR COVID-19 IN DEWITT COUNTY (43.3%) IS LOWER THAN LAVACA COUNTY (44,9%) AND ALSO LOWER THAN THE STATE (57.8%). BETWEEN 2014 AND 2020, OBESITY PREVALENCE RATES IN ADULTS (AGE 18+) YCH 3 COUNTY AREA AND THE STATE INCREASED. IN 2016-2020, YCH 3 COUNTY AREA (33.9%) HAD A SLIGHTLY LOWER PERCENT OF OBESE ADULTS (AGE 18+) THAN THE STATE (34.2%). LAVACA COUNTY (68.0%) HAS THE HIGHEST RATE OF MEDICARE FEEFORSERVICE RESIDENTS WITH HYPERTENSION AS COMPARED TO DEWITT COUNTY (63.9%), THE STATE (59.9%) AND THE NATION (57.2 %) (2018). BETWEEN 2016 AND 2020, ASTHMA PREVALENCE RATES IN ADULTS (AGE 18+) IN THE STATE OVERALL INCREASED. IN 2015-2019, YCH 3 COUNTY AREA (8.3%) HAD A LOWER PERCENTAGE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH ASTHMA THAN THE STATE (12.6%). BETWEEN 2014 AND 2020, ARTHRITIS PREVALENCE RATES IN ADULTS (AGE 18+) IN YCH 3 COUNTY AREA DECREASED WHILE RATES IN THE STATE SLIGHTLY INCREASED. IN 2016-2020, YCH 3 COUNTY AREA (21.9%) HAD A SLIGHTLY HIGHER PERCENTGE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH ARTHRITIS THAN THE STATE (21.2%). BETWEEN 2014 AND 2020, THE RATE OF ADULTS (AGE 18+) IN THE STATE THAT HAVE BEEN DIAGNOSED WITH A DEPRESSIVE DISORDER INCREASED. IN 2015-2019, YCH 3 COUNTY AREA (11.4%) HAD A HIGHER PERCENTAGE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH A DEPRESSIVE DISORDER THAN THE STATE (15.8%). BETWEEN 2014 AND 2020, THE PERCENT OF ADULTS (AGE 18+) WHO SELF-REPORTED THAT THEY HAD A DISABILITY IN THE STATE INCREASED. THE PERCENT OF ADULTS (AGE 18+) WHO SELFREPORTED THAT THEY HAD A DISABILITY IN YCH 3 COUNTY AREA (35.9%) IS HIGHER THAN THE STATE (26.3%) (2016-2020). AS OF 2019, BOTH DEWITT (23.0%) AND LAVACA (20.7%) COUNTIES HAVE LOWER RATES OF UNINSURED ADULTS (AGE 18-64) AS COMPARED TO THE STATE (24.3%). BOTH DEWITT AND LAVACA COUNTIES AND THE STATE EXPERIENCED SLIGHT INCREASES IN THE PERCENTAGE OF UNINSURED ADULTS (AGE 18-64) BETWEEN 2015 AND 2019. A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT (""CHNA"") WAS CONDUCTED FOR YOAKUM COMMUNITY HOSPITAL (YCH) BY COMMUNITY HOSPITAL CORPORATION (CHC). THIS CHNA UTILIZES RELEVANT HEALTH DATA AND STAKEHOLDER INPUT TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS IN DEWITT AND LAVACA COUNTIES IN TEXAS. COMMUNITY INPUT WAS RECEIVED DURING INTERVIEWS CONDUCTED BY CHC FROM JUNE 3, 2021 - JUNE 30, 2021. THE CHNA IS DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED ON DECEMBER 29, 2014. THE YCH BOARD REVIEWED AND ADOPTED THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ON MARCH 23, 2022. INTERVIEW METHODOLOGY: YCH WORKED WITH CHC IN THE DEVELOPMENT OF ITS CHNA. YCH PROVIDED ESSENTIAL DATA AND RESOURCES NECESSARY TO INITIATE AND COMPLETE THE PROCESS, INCLUDING THE DEFINITION OF THE HOSPITAL'S STUDY AREA AND THE IDENTIFICATION OF KEY COMMUNITY STAKEHOLDERS TO BE INTERVIEWED. BACKGROUND INFORMATION ABOUT YCH, INCLUDING THE MISSION, VISION, VALUES, AND HOSPITAL SERVICES WAS PROVIDED BY THE HOSPITAL OR TAKEN FROM ITS WEBSITE. POPULATION DEMOGRAPHICS INFORMATION WAS COLLECTED BY CHC USING SOURCES WHICH INCLUDED STRATASAN, THE U.S. CENSUS BUREAU AND THE UNITED STATES BUREAU OF LABOR STATISTICS AND INCLUDED INFORMATION REGARDING POPULATION CHANGE BY RACE, ETHNICITY, AGE, MEDIAN HOUSEHOLD INCOME, UNEMPLOYMENT AND ECONOMIC STATISTICS IN THE STUDY AREA. HEALTH DATA WAS ALSO COLLECTED FROM A VARIETY OF SOURCES, INCLUDING BUT NOT LIMITED TO, THE ROBERT WOOD JOHNSON FOUNDATION, TEXAS DEPARTMENT OF HEALTH AND HUMAN SERVICES, SPARKMAP, UNITED STATES CENSUS BUREAU AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. YCH PROVIDED CHC WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN DEWITT AND LAVACA COUNTIES, INCLUDING PUBLIC HEALTH REPRESENTATIVES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, SIXTEEN IN DEPTH INTERVIEWS WERE CONDUCTED USING A STRUCTURED INTERVIEW GUIDE, WITH THE TWO GROUPS OUTLINED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS ISSUED DECEMBER 29, 2014. DISCUSSED WERE THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. WITH RESPECT TO INDIVIDUALS PROVIDING INPUT, IT WAS NOTED IN THE CHNA THAT 62.5% OF THOSE PROVIDING INPUT ARE MEMBERS OF A MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATION IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS. 18.8% OF THOSE PROVIDING INPUT WORK FOR A 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 AND 18.8% OF THOSE PROVIDING INPUT ARE COMMUNTIY LEADERS. INTERVIEWEES INCLUDED: * SANDRA BERGEY, DDS: FAMILY DENTIST, SANDRA B. BERGEY, DDS * LISA CAMPOS: IHC COORDINATOR FOR DEWITT COUNTY, HEALTH DEPARTMENT ADMINISTRATOR - IHC DEPARTMENT * GRACE FOREMAN: LEAD PHARMACIST, YOAKUM DISCOUNT PHARMACY * BLAKE GOODMAN, M.D.: EMERGENCY MEDICINEPHYSICIAN, YOAKUM COMMUNITY HOSPITAL * HOLLY HAAS, FNP: FAMILY NURSE PRACTITIONER, YOAKUM FAMILY PRACTICE * BECKY JANAK: PROGRAM DIRECTOR, COMMUNITY CONNECTIONS OF LAVACA COUNTY * SHEILA JANSKY: HUMAN SERVICE TECHNICIAN, LAVACA COUNTY HEALTH DEPARTMENT * TOM KELLEY: SUPERINTENDENT, YOAKUM ISD; BOARD MEMBER, YOAKUM COMMUNITY HOSPITAL * KATHY KOSTELNIK: UNDERWRITER, HOCHHEIM PRAIRIE INSURANCE * STEPHANIE LERCH: DIRECTOR OF NEW HORIZONS, YOAKUM COMMUNITY HOSPITAL * DEBBIE LONG: DIRECTOR OF PATIENT ACCESS/OUTPATIENT CLINIC, YOAKUM COMMUNITY HOSPITAL * CARL O'NEILL: MAYOR, CITY OF YOAKUM * ANNIE RODRIGUEZ: CITY COUNCIL MEMBER, CITY OF YOAKUM * ELORINE SITKA: VICE PRESIDENT, YOAKUM NATIONAL BANK; BOARD CHAIR, YOAKUM COMMUNITY HOSPITAL * CAROLYN STRONG: DIRECTOR, FOOD BANK * LAUREN WERNER: PUBLIC HEALTH NURSE, LAVACA COUNTY HEALTH DEPARTMENT POPULATIONS THAT WERE IDENTIFIED AS THE MOST AT RISK FOR INADEQUATE CARE IN THE COMMUNITY BY INTERVIEWEES WERE: ELDERLY, LOW INCOME/WORKING POOR, RACIAL/ETHNIC GROUPS, TEENAGERS/ADOLESCENTS, UN/UNDERINSURED, OBSTETRIC POPULATION AND VETERANS. THESE UNDERSERVED GROUPS WERE IDENTIFIED AS MOST AT RISK FOR INADEQUATE CARE DUE TO THE FOLLOWING: ELDERLY - TRANSPORTATION BARRIERS - LACK OF LOCAL SPECIALTY SERVICES - SOCIAL ISOLATION - LITERACY - SAFE, AFFORDABLE HOUSING - ACCESS TO AFFORDABLE PRESCRIPTIONS LOW INCOME/WORKING POOR - LACK OF LOCAL, AFFORDABLE PREVENTIVE CARE, AND SPECIALTY CARE OPTIONS - LACK OF BILINGUAL HEALTHCARE PROVIDERS - TRANSPORTATION BARRIERS RACIAL/ETHNIC - LACK OF BILINGUAL HEALTHCARE PROVIDERS - HEALTHY LIFESTYLE EDUCATION TEENAGERS/ADOLESCENTS - INCREASING NEED FOR BROAD SEX EDUCATION - NEED FOR MENTAL HEALTH SERVICES - HEALTHY LIFESTYLE EDUCATION - DRUG PREVENTION AND EDUCATION UN/UNDERINSURED - LACK OF LOCAL, AFFORDABLE PREVENTIVE CARE, DENTAL CARE, AND SPECIALTY CARE OPTIONS - OVERUSE OF EMERGENCY ROOM AS CLINIC OBSTETRIC POPULATION - NEW MOM EDUCATION VETERANS - LACK OF ACCESS TO LOCAL RESOURCES AND SERVICES"

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - YOAKUM COMMUNITY HOSPITAL. THE MOST RECENTLY CONDUCTED CHNA IDENTIFIED FOUR SIGNIFICANT NEEDS IN THE COMMUNITY SERVED BY YOAKUM COMMUNITY HOSPITAL, (YCH). THE NEEDS WERE IDENTIFIED BY ASSESSING THE PREVALENCE OF THE ISSUES FOUND WITHIN THE HEALTH DATA FINDINGS, COMBINED WITH THE FREQUENCY AND SEVERITY OF MENTIONS IN COMMUNITY INPUT. HOSPITAL LEADERSHIP MET WITH COMMUNITY HOSPITAL CORPORATION, (CHC), TO REVIEW THE RESEARCH FINDINGS AND PRIORITIZE THE COMMUNITY HEALTH NEEDS. THE FINAL LIST OF PRIORITIZED NEEDS IS AS FOLLOWS: 1. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS. 2. ACCESS TO SPECIALTY CARE SERVICES AND PROVIDERS. 3. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES. 4. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS. THE CHNA TEAM PARTICIPATED IN A PRIORITIZATION PROCESS USING A STRUCTURED MATRIX TO RANK THE COMMUNITY HEALTH NEEDS BASED ON THREE CHARACTERISTICS: SIZE AND PREVALENCE OF THE ISSUE, EFFECTIVENESS OF INTERVENTIONS AND THE HOSPITAL'S CAPACITY TO ADDRESS THE NEED. ONCE THIS PRIORITIZATION PROCESS WAS COMPLETE, HOSPITAL LEADERSHIP DISCUSSED THE RESULTS AND DECIDED TO ADDRESS ALL OF THE FOUR PRIORITIZED NEEDS IN VARIOUS CAPACITIES THROUGH A HOSPITAL SPECIFIC IMPLEMENTATION PLAN. PRIORITY #1: ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS OBJECTIVE: INCREASE ACCESS TO MENTAL HEALTH SERVICES AND PROVIDERS IN THE COMMUNITY 1.A. THE HOSPITAL WILL CONTINUE TO OFFER THE EMPLOYEE ASSISTANCE PROGRAM (EAP) THROUGH BEACON HEALTH OPTIONS TO HELP EMPLOYEES NAVIGATE VARIOUS LIFE CHALLENGES. 1.B. THE NEW HORIZONS PROGRAM IS AVAILABLE AT YOAKUM COMMUNITY HOSPITAL FOR PATIENTS AGE 50 AND ABOVE. THIS PROGRAM IS DESIGNED TO ADDRESS A SIGNIFICANT NEED IN OUR COMMUNITY FOR THOSE WHO ARE EXPERIENCING DIFFICULT BEHAVIOR, MENTAL, EMOTIONAL, AND/OR PHYSICAL CHANGES THAT ARE IMPACTING THEIR QUALITY OF LIFE. NEW HORIZONS AT YOAKUM COMMUNITY HOSPITAL PROVIDES A MENTAL HEALTH ASSESSMENT AND APPROPRIATE INTERVENTIONS FOR THESE INDIVIDUALS. INDIVIDUAL THERAPY IS NOW OFFERED TO ADULTS AGE 18+ IN THE COMMUNITY. 1.C. YCH WILL CONTINUE TO COLLECT AND PUBLISH DATA FROM THE NEW HORIZONS PROGRAM TO CONFIRM ITS POSITIVE IMPACT ON THE NEED OF MENTAL AND BEHAVIORAL HEALTH WITHIN ITS AGING COMMUNITY. 1.D. THE HOSPITAL CURRENTLY EMPLOYS TWO MASTERS OF SOCIAL WORK CANDIDATES THAT ARE WORKING TO COMPLETE THEIR CREDENTIALS AND HOURS IN ORDER TO BECOME LICENSED CLINICAL SOCIAL WORKERS. 1.E. YCH WILL PROVIDE VOUCHERS TO 9 LOCAL PHYSICIANS THAT ALLOW THEM TO REFER 2 - 3 UNINSURED OR UNDERINSURED PERSONS TO YCH SOCIAL WORKERS. 1.F. YCH PROVIDES SEXUAL ASSAULT NURSE EXAMINER (SANE) SERVICES IN CONJUNCTION WITH THE LOCAL NORMA'S HOUSE ORGANIZATION. 1.G. YCH WILL CONTINUE TO PROMOTE THE LOCAL SUICIDE PREVENTION HOTLINE FOR APPLICABLE PATIENTS AS NEEDED. 1.H. YCH MAINTAINS A PROCESS TO QUICKEN THE APPROPRIATE CARE FOR PATIENTS REQUIRING MENTAL AND BEHAVIORAL HEALTH CARE SERVICES WITH PROVIDERS. 1.I. YCH IS PARTICIPATING IN COLLABORATIVE CARE BETWEEN FAMILY PRACTICE PHYSICIANS AND MENTAL HEALTH CARE PROVIDERS THROUGH THE USE OF NEW COLLABORATIVE CARE CODES. THESE CODES REQUIRE COLLABORATION BETWEEN TEAM MEMBERS FOR PHYSICIANS TO BILL FOR THE INDIVIDUAL COUNSELING AND/OR PROGRAM SERVICES. PRIORITY #2: ACCESS TO SPECIALTY CARE SERVICES AND PROVIDERS OBJECTIVE: INCREASE ACCESS TO SPECIALTY CARE SERVICES AND PROVIDERS IN THE COMMUNITY 2.A. YCH WILL CONTINUE TO CONSULT ITS MEDICAL STAFF DEVELOPMENT PLAN TO DETERMINE THE PHYSICIAN NEEDS OF THE COMMUNITY AND CONSIDER THE RECRUITMENT OF PROVIDERS ACCORDINGLY. 2.B. YCH WILL CONTINUE TO SUPPORT MEDICAL STAFF DEVELOPMENT EFFORTS THROUGH PROMOTION OF AVAILABLE PHYSICIANS AND MAINTAINING AN UPDATED PHYSICIAN DIRECTORY FOR DISTRIBUTION. THE HOSPITAL INTRODUCES ALL NEW PHYSICIANS THROUGH ADVERTISEMENTS IN THE LOCAL NEWSPAPER IN LINE WITH STARK REGULATIONS. 2.C. YCH PROVIDES AN OUTPATIENT CLINIC FOR ROTATING SPECIALISTS IN ORDER TO INCREASE ACCESS TO SPECIALTY CARE FOR LOCAL RESIDENTS, INCLUDING - BUT NOT LIMITED TO - OB/GYN, CARDIOLOGY, GENERAL SURGERY, AND PODIATRY. 2.D. YCH PROVIDES WOUND CARE, HYPERBARIC CENTER AND BIOFIRE LAB SERVICES. 2.E. YCH WILL CONTINUE TO PROVIDE THE GOLD STANDARD OF BOTH CARE AND TECHNOLOGY THROUGH ITS NEW 3D-TOMOSYNTHESIS MAMMOGRAPHY UNIT. 2.F. YCH WILL CONTINUE TO PROVIDE THE TELENEUROLOGY AND TELESTROKE PROGRAM, AS WELL AS READING SERVICES FOR EEGS, THROUGH ITS PARTNERSHIP WITH ST. DAVIDS. 2.G. YCH ASSISTS IN SETTING UP FOLLOW-UP APPOINTMENTS WITH NECESSARY PROVIDERS FOR ANY PATIENTS DISCHARGED FROM INPATIENT CARE. 2.H. YCH CASE MANAGEMENT SERVICES WILL ASSIST IN COORDINATING FOLLOW-UP CARE FOR PATIENTS AS NEEDED. 2.I. UPON DISCHARGE FROM INPATIENT CARE, PATIENTS RECEIVE A COPY OF THEIR WRITTEN DISCHARGE SUMMARY AND AN ELECTRONIC SUMMARY IS SENT TO THEIR PRIMARY CARE PROVIDER AS WELL. UPON DISCHARGE FROM THE EMERGENCY ROOM, PATIENTS' PRIMARY CARE PROVIDERS ARE PROVIDED WITH A SUMMARY OF THEIR EMERGENT VISIT. 2.J. YCH WILL CONTINUE TO INCREASE AWARENESS OF ITS SERVICE OFFERINGS, SUCH AS WATER THERAPY, GERIATRIC PSYCH, WOUND CARE AND EMERGENCY STROKE CARE IN THE COMMUNITY. THIS WILL BE DONE VIA BILLBOARD AND DIRECT MAIL ADVERTISEMENTS, AS WELL AS UPDATING THE HOSPITAL'S WEBSITE AND FACEBOOK PAGE. 2.K. YCH IS A DESIGNATED SUPPORT LEVEL III STROKE FACILITY BY THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES AND WILL CONTINUE ITS ONGOING COMMITMENT TO ENSURE QUALITY CARE IS AVAILABLE FOR STROKE PATIENTS IN ITS AREA. PRIORITY #3: PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES. OBJECTIVE: HEALTHY LIFESTYLE EDUCATION AND PREVENTION RESOURCES AT THE HOSPITAL AND IN THE COMMUNITY. 3.A. YCH WILL CONTINUE TO REACH OUT TO THE COMMUNITY BY OFFERING NUMEROUS CLASSES, SPEAKERS AND OTHER INFORMATIVE ACTIVITIES. HOSPITAL PERSONNEL ARE MADE AVAILABLE AS SPEAKERS FOR CIVIC GROUPS, INDUSTRIAL PARTNERS, MEDIA APPEARANCES AND HEALTH FAIRS TO ADDRESS HEALTH TOPICS OF PARTICULAR CONCERN TO THE PUBLIC UPON REQUEST. 3.B. YCH OFFERS REDUCED PRICE WELLNESS SCREENINGS TO LOCAL BUSINESSES (I.E., HOCHHIEM PRAIRIE), INCLUDING FREE BLOOD PRESSURE, A1C, CHOLESTEROL SCREENINGS AND PSAS FOR MEN UPON REQUEST. 3.C. YCH WILL CONTINUE TO SUPPORT AND PARTICIPATE IN LOCAL HEALTH-RELATED EVENTS TO SHARE INFORMATION ON HEALTH EDUCATION AND PROVIDE VARIOUS WELLNESS SCREENINGS. 3.D. YCH PHYSICAL THERAPY DEPARTMENT AND LOCAL PHYSICIANS HELP WITH THE ANNUAL ATHLETIC PREPARTICIPATION SPORTS PHYSICALS FOR THE LOCAL JUNIOR HIGH AND HIGH SCHOOLS AT NO COST. THIS INCLUDES YOAKUM ISD, SWEET HOME ISD, AND ST. JOSEPH CATHOLIC SCHOOL. 3.E. THE HOSPITAL WILL CONTINUE TO PROVIDE FREE MEETING SPACE FOR VARIOUS SUPPORT GROUPS TO INCREASE AWARENESS ABOUT DISEASES AND RESOURCES OFFERED THROUGH THE COMMUNITY AS APPROPRIATE. EXAMPLES INCLUDE, BUT ARE NOT LIMITED TO, THE ALZHEIMER'S SUPPORT GROUP, PATIENTS IN THE TEXAS A&M DIABETIC EDUCATION PROGRAM, AND THE YOAKUM GARDEN CLUB. 3.F. THE HOSPITAL WILL CONTINUE TO COORDINATE WITH SOUTH TEXAS BLOOD AND TISSUE CENTER TO PARTICIPATE IN BLOOD DRIVES ON A QUARTERLY BASIS, WHICH ARE OPEN TO HOSPITAL EMPLOYEES AND THE COMMUNITY. 3.G. THE HOSPITAL WILL CONTINUE TO PROVIDE A LOCATION FOR WIC. 3.H. YCH WILL SERVE AS A SITE FOR PROPER MEDICATION DISPOSAL TO ENCOURAGE THE SAFE DISPOSAL OF UNUSED AND REMAINDER MEDICATIONS FOR RESIDENTS IN THE COMMUNITY. 3.I. UPON DISCHARGE, YCH PHARMACISTS CALL PATIENTS WITHIN THE FIRST 24-72 HOURS TO ENSURE THAT THEIR MEDICATION PROCESS IS UNDERSTOOD AND TO ANSWER ANY QUESTIONS. 3.J. THE HOSPITAL WILL CONTINUE TO ENGAGE IN A VARIETY OF EMPLOYEE WELLNESS INITIATIVES, INCLUDING: PROMOTING EMPLOYEE AND FAMILY WELLNESS VIA ASSET HEALTH; OFFERING TELADOC SERVICES; OFFERING NEED SPECIFIC SPECIAL PROGRAMS; ENCOURAGING PARTICIPATION IN QUARTERLY WELLNESS CHALLENGES; SMOKING CESSATION; COLLABORATING WITH HOSPITAL CAFETERIA PROVIDERS TO HIGHLIGHT HEALTHY FOOD OPTIONS; PROMOTING FITNESS OPPORTUNITIES; CHARITABLE FITNESS EVENTS; PROVIDING MENTAL HEALTH EDUCATION VIA THE EMPLOYEE ASSISTANCE PROGRAM; CONTINUING TO IMPLEMENT THE TOBACCO-FREE NEW HIRE POLICY; AND OFFERING THE FIDUCIOUS PROGRAM FOR EMPLOYEES WITH STUDENT LOAN PAYMENTS.

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - YOAKUM COMMUNITY HOSPITAL - CONTINUED. 3.K. YCH WILL CONTINUE TO ENCOURAGE AND SUPPORT EMPLOYEES IN PHYSICAL ACTIVITY AND WELLNESS (I.E., SOFTBALL TOURNAMENT, DASH FOR DOWN 5K, EMPLOYEE WEIGHT LOSS CHALLENGE, ETC.). ADDITIONALLY, YCH WILL PAY FOR HALF OF THE EXPENSE FOR AN EMPLOYEE'S GYM MEMBERSHIP IN ORDER TO ENCOURAGE EMPLOYEES TO MAINTAIN AN ACTIVE LIFESTYLE. 3.L. YCH WILL CONTINUE TO SERVE AS A CLINICAL SITE FOR LVN AND RESPIRATORY STUDENTS AT VICTORIA COLLEGE. 3.M. YCH PERSONNEL SERVE IN LEADERSHIP ROLES AND AS VOLUNTEERS WITH MANY AGENCIES AND COMMITTEES IN THE COMMUNITY, INCLUDING THE ROTARY CLUB AND THE LOCAL BOY SCOUTS OF AMERICA CHAPTER. PRIORITY #4: ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS OBJECTIVE: PARTICIPATE IN INITIATIVES AND CREATE OPPORTUNITIES TO INCREASE ACCESS TO AFFORDABLE CARE AND REDUCE HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS, SUCH AS THE MINORITY AND GEOGRAPHICALLY ISOLATED POPULATIONS. 4.A. YCH WILL CONTINUE TO PROVIDE PUBLIC SERVICE MATERIAL PERTAINING TO WELLNESS BENEFITS NOW COVERED UNDER THE AFFORDABLE CARE ACT (ACA), AS WELL AS FREE ACA COUNSELING FROM A CERTIFIED APPLICATION COUNSELOR. 4.B. YCH PROVIDES THE MD SAVE PROGRAM FOR SELF-PAY AND THOSE WITH HIGH DEDUCTIBLES IN ORDER TO OFFER CERTAIN SERVICES AT A DISCOUNTED RATE TO ASSIST THE COMMUNITY WITH THEIR HIGH DEDUCTIBLE PLANS OR INDIVIDUALS WHO ARE UNINSURED. 4.C. YCH WILL PARTICIPATE IN THE 340B PHARMACY PROGRAM WHICH PROVIDES DISCOUNTED PHARMACY PRICING TO INDIGENT PATIENTS. 4.D. YCH PROVIDES MEDICATION SUPPORT TO INDIGENT PATIENTS THROUGH THE TAX DISTRICT AND THEIR ALLOWANCE OF ADDITIONAL FUNDING AND INCREASING THE DOLLAR AMOUNT PROVIDED. 4.E. YCH WILL CONTINUE TO PROMOTE EDUCATION AMONG THE YOUTH POPULATION BY PROVIDING TOURS OF VARIOUS DEPARTMENTS, SUCH AS THE EMERGENCY ROOM, TO JUNIOR HIGH AND HIGH SCHOOL STUDENTS REGARDING AGE APPROPRIATE SAFETY TOPICS RELATING TO EACH RESPECTIVE DEPARTMENT UPON REQUEST. 4.F. THE EMPLOYEES OF YCH ARE DEDICATED TO ENHANCING COMMUNITY WELLNESS THROUGH THE CLUB MED PROGRAM. WITH CLUB MED, YCH LEADERSHIP AND STAFF VOLUNTEER TO MEET MONTHLY WITH JUNIOR AND SENIOR HIGH SCHOOL STUDENTS AT SHINER, MOULTON AND YOAKUM TO DISCUSS CAREERS IN HEALTHCARE AT THE HOSPITAL FACILITY SCHOLARSHIPS ARE PROVIDED TO ONE SHINER, ONE MOULTON, AND ONE YOAKUM STUDENT. 4.G. YCH PROVIDES NON-HEALTHCARE CPR CLASSES TO LOCAL GROUPS UPON REQUEST (I.E., BOY SCOUT TROOP). 4.H. YCH HAS A CONTRACT WITH AN INTERPRETING SERVICE TO PROVIDE TRANSLATION SERVICES FOR NON-ENGLISH SPEAKING PATIENTS AND FAMILIES AS NEEDED. 4.I. YCH'S CASE MANAGEMENT DEPARTMENT CONTINUES TO IDENTIFY COMPLEX PATIENTS WITH MULTIPLE CHRONIC ILLNESSES AND PROVIDE ADDITIONAL HOSPITAL SUPPORT AS APPROPRIATE. 4.J. YCH WILL CONTINUE TO EVALUATE THE HOSPITAL'S INFRASTRUCTURE, WITH A PARTICULAR EMPHASIS ON MAINTAINING ELDERLY OR HANDICAP-FRIENDLY BUILDING ELEMENTS. 4.K. YCH WILL CONTINUE TO PROVIDE LAB WORK FOR THE ELDERLY THROUGH THE PHLEBOTOMIST THAT GOES TO THE LOCAL NURSING HOMES. 4.L. DURING THE MONTH OF OCTOBER, YCH PROVIDES PHYSICIANS WITH VOUCHERS TO DISTRIBUTE TO UNFUNDED PATIENTS NEEDING MAMMOGRAPHY SERVICES. 4.M. YCH WILL CONTINUE TO HOST DRIVE EVENTS TO BENEFIT VARIOUS GROUPS WITHIN THE COMMUNITY. 4.N. YCH WILL CONTINUE ITS CONTRACT WITH AKIN AMBULANCE SERVICES AS A NEW, LOCAL EMS PROVIDER. 4.O. YCH AND LOCAL NURSING HOMES, HOME HEALTH AGENCIES, AND PHARMACIES WILL CONTINUE TO CO-SPONSOR QUARTERLY LUNCH AND LEARNS THAT PROVIDE INFORMATION ON ROTATING HEALTH-RELATED TOPICS, SPECIFICALLY SURROUNDING THE ELDERLY (I.E., MEDICARE, GERIATRIC MENTAL HEALTH) FREE OF CHARGE TO THE COMMUNITY. EVENTS ARE HELD AT LOCAL CHURCHES, EVENT CENTERS, ETC. 4.P. YCH PARTNERS WITH THE GOLDEN CRESCENT AREA ON AGING TO HOST MEDICARE OPEN ENROLLMENT FOR SENIORS IN THE COMMUNITY.

Schedule H, Part V, Section B, Line 20 Facility , 1
Facility , 1 - YOAKUM COMMUNITY HOSPITAL. YOAKUM COMMUNITY HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS ON ANY OUTSTANDING PATIENT ACCOUNTS.

Schedule H, Part I, Line 3c PART I, LINE 3C
THE ASSETS TEST IS USED IN ORDER TO DETERMINE THE AMOUNT OF DISCOUNTED CARE. PAY STUBS FOR PATIENT & SPOUSE, LAST YEAR'S TAX RETURN, SOCIAL SECURITY AWARD LETTER ARE REQUIRED IF EMPLOYED. IF UNEMPLOYED, FOOD STAMP APPROVAL/DENIAL, UNEMPLOYMENT APPROVAL/DENIAL AND LAST YEAR'S TAX RETURN ARE REQUIRED. THE PATIENT IS ALSO REQUIRED TO SUBMIT A FINANCIAL INFORMATION FORM SHOWING BILLS, BANK ACCOUNTS, AND ANY OTHER SUPPORT THEY MAY BE RECEIVING TO DETERMINE IF THEY ARE ELIGIBLE FOR CHARITY CARE.

Schedule H, Part I, Line 6a PART I, LINE 6A
THE COMMUNITY BENEFIT REPORT FOR FISCAL YEAR ENDING JUNE 30, 2022 WAS PREPARED BY OUR CORPORATE OFFICE, COMMUNITY HOSPITAL CORPORATION.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE BASED ON CERTAIN ASSUMPTIONS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE NET REALIZABLE VALUE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE NET REALIZABLE VALUE IS BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGES, WHICH IS BASED ON CURRENT CONTRACT PRICES OR HISTORICAL CLAIMS PAID DATA BY PAYOR. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE NET REALIZABLE VALUE IS DETERMINED USING ESTIMATES OF HISTORICAL COLLECTION EXPERIENCE. THESE ESTIMATES ARE ADJUSTED FOR RECOVERIES AND ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
INPATIENT ACUTE CARE SERVICES AND SUBSTANTIALLY ALL OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC AND OTHER FACTORS. THE HOSPITAL IS REIMBURSED FOR CERTAIN SERVICES AT TENTATIVE RATES WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS BY THE HOSPITAL AND AUDITS THEREOF BY THE MEDICARE ADMINISTRATIVE CONTRACTOR.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
IF A PATIENT OF YOAKUM COMMUNITY HOSPITAL QUALIFIES FOR ITS CHARITY CARE POLICY THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. PATIENT ACCOUNTS WITH REMAINING BALANCES WILL BE REASSESSED TO DETERMINE THEIR ABILITY TO PAY AND WILL EITHER BE ELIGIBLE TO PARTICIPATE IN A PAYMENT PLAN OR THEIR ACCOUNT BALANCE WILL BE WRITTEN OFF.

Schedule H, Part V, Section B, Line 16a FAP website
- YOAKUM COMMUNITY HOSPITAL: Line 16a URL: HTTPS://WWW.YOAKUMHOSPITAL.ORG/ABOUT-YOAKUM-HOSPITAL/FINANCIAL-ASSISTANCE/;

Schedule H, Part V, Section B, Line 16b FAP Application website
- YOAKUM COMMUNITY HOSPITAL: Line 16b URL: HTTPS://WWW.YOAKUMHOSPITAL.ORG/ABOUT-YOAKUM-HOSPITAL/FINANCIAL-ASSISTANCE/;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- YOAKUM COMMUNITY HOSPITAL: Line 16c URL: HTTPS://WWW.YOAKUMHOSPITAL.ORG/ABOUT-YOAKUM-HOSPITAL/FINANCIAL-ASSISTANCE/;

Schedule H, Part VI, Line 2 Needs assessment
NEEDS ASSESSMENT AS REPORTED IN SCHEDULE H, PART V, SECTION B, LINES 1-7, YOAKUM COMMUNITY HOSPITAL, (YCH), CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING FISCAL YEAR 6/30/2022. YCH'S LEADERSHIP DEVELOPED AN IMPLEMENTATION PLAN TO IDENTIFY SPECIFIC ACTIVITIES AND SERVICES WHICH DIRECTLY ADDRESS THE TOP PRIORITIES. THE OBJECTIVES WERE IDENTIFIED BY STUDYING THE PRIORITIZED HEALTH NEEDS, WITHIN THE CONTEXT OF THE HOSPITAL'S OVERALL STRATEGIC PLAN AND THE AVAILABILITY OF FINITE RESOURCES. THE PLAN INCLUDES A RATIONALE FOR EACH PRIORITY, FOLLOWED BY OBJECTIVES, SPECIFIC IMPLEMENTATION ACTIVITIES, RESPONSIBLE LEADERS, ANNUAL UPDATES AND PROGRESS, AND KEY RESULTS (AS APPROPRIATE). THE CHNA AND IMPLEMENTATION STRATEGY FOR TAX YEAR 2021, WAS REVIEWED AND ADOPTED BY THE HOSPITAL'S GOVERNING BOARD ON MARCH 23, 2022. THE HOSPITAL'S CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN THE FINAL REGULATIONS RELEASED DECEMBER 29, 2014. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY. THE HEALTH CARE NEEDS FOR THE COMMUNITY SERVED ARE DETERMINED BY ASSESSING THE PREVALENCE OF THE ISSUES IDENTIFIED IN THE HEALTH DATA FINDINGS, COMBINED WITH THE FREQUENCY AND SEVERITY OF MENTIONS IN THE INTERVIEWS CONDUCTED WITH PERSONS HAVING SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN ECTOR COUNTY, INCLUDING PUBLIC HEALTH REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATION PROFESSIONALS, CHARITIES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS.

Schedule H, Part VI, Line 6 Affiliated health care system
YOAKUM COMMUNITY HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. YOAKUM COMMUNITY HOSPITAL IS A 23 BED CRITICAL ACCESS HOSPITAL OFFERING GENERAL MEDICAL AND S URGICAL CARE TO THE CITIZENS OF YOAKUM AND THE SURROUNDING COMMUNITIES. ESTABLISHED IN 1922, YOAKUM COMMUNITY HOSPITAL HAS BEEN AN INTEGRAL PART OF THE COMMUNITY SINCE ITS INCEPTION AND CONTINUES TO SEARCH FOR WAYS TO BETTER SERVE OUR COMMUNITY.

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

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
"PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE WE HAVE A COPY OF OUR CHARITY CARE POLICY POSTED ON OUR HOSPITAL WEBSITE AND HAVE AN ELIGIBILITY CONSULTANT ON SITE WHO WILL SCREEN ALL CUSTOMERS WHO ARE SELF PAY FOR ALL PROGRAMS THEY MAY BE ELIGIBLE FOR. OUR INSURED CUSTOMERS ARE ALSO REFERRED TO THE ELIGIBILITY CONSULTANT IF THEY ARE NOT ABLE TO SET UP FINANCIAL ARRANGEMENTS AFTER THEY ARE MOVED TO BEING SELF PAY. WE HAVE SIGNS POSTED IN OUR REGISTRATION AREA STATING ""YCH PROVIDES FINANCIAL ASSISTANCE THROUGH OUR CHARITY OR INDIGENT PROGRAMS TO THOSE WHO QUALIFY. SEE REGISTRATION CLERK FOR MORE INFORMATION."" OUR BILLING STATEMENTS ALSO HAVE CONTACT INFORMATION FOR CUSTOMERS WHO CANNOT PAY THE CLAIM IN FULL TO CALL TO DISCUSS MORE PAYMENT OPTIONS."

Schedule H, Part VI, Line 4 Community information
YOAKUM COMMUNITY HOSPITAL, (YCH), IS CENTRALLY LOCATED APPROXIMATELY 200 MILES FROM SAN ANTONIO AND HOUSTON. YCH SERVES DEWITT AND LAVACA COUNTIES IN TEXAS. THE POPULATION IN DEWITT COUNTY IS 20,265 (2021) AND IS EXPECTED TO DECREASE 0.9% BY THE YEAR 2026. THE POPULATION IN LAVACA COUNTY IS 20,466 (2021) AND IS EXPECTED TO INCREASE 2,2% BY THE YEAR 2026. THE MAJORITY OF RESIDENTS IN BOTH DEWITT AND LAVACA COUNTIES IDENTIFY AS WHITE-NON HISPANIC AT 74.0% AND 84.2%, RESPECTIVELY, (2021). BECAUSE THE HISPANIC MEMBERS OF THE POPULATION ARE CONSIDERED AN ETHNICITY, THE NUMBERS ARE CALCULATED SEPARATELY FROM OTHER RACES. AS OF 2021, THE HISPANIC POPULATION IN DEWITT COUNTY IS 5.1% AND IN LAVACA COUNTY IS 14.3%. THE ASIAN PFOPULATION IS THE FASTEST GROWING POPULATION IN DEWITT COUNTY. BY 2026 IT IS EXPECTED TO INCREASE BY 22.5%. THE FASTEST GROWING POPULATION IN LAVACA COUNTY IS THE AMERICAN INDIAN POPULATION AND THE ASIAN POPULATION WITH BOTH POPULATIONS EXPECTED TO INCREASE 20.4% BY 2026. AS OF 2021, LAVACA COUNTY (47.6 YEARS) HAS AN OLDER MEDIAN AGE THAN BOTH DEWITT COUNTY (43.7 YEARS) AND THE STATE OF TEXAS. (35.3 YEARS) 2021. THE MEDIUM AGES IN DEWITT COUNTY, LAVACA COUNTY AND THE STATE IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT FIVE YEARS. IN 2020, DEWITT COUNTY (6.0) AND LAVACA COUNTY (5.2%) HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE (7.6). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN BOTH DEWITT AND LAVACA COUNTIES DECREASED. FOR DEWITT COUNTY, MAY 2021 HAD THE LOWEST UNEMPLOYMENT RATE (5.4) AS COMPARED TO JULY 2021 WHICH HAD THE HIGHEST RATE. (8.1) FOR LAVACA COUNTY, MAY 2021 HAD THE LOWEST UNEMPLOYMENT RATE ALSO (4.8) AS COMPARED TO JUNE 2021, WITH THE HIGHEST RATE (6.7). IN 2021, THE MEDIAN HOUSEHOLD INCOME IN BOTH DEWITT COUNTY ($58,109) AND LAVACA COUNTY ($58,596) IS LOWER THAN THE STATE OF TEXAS. ($63,524). DEWITT COUNTY AND LAVACA COUNTY HAVE A LOWER EDUCATIONAL ATTAINMENT RATES THAN THE STATE (2021). DEWITT COUNTY HAS A HIGHER PERCENTAGE OF FAMILIES LIVING BELOW THE POVERTY LEVEL THAN LAVACA COUNTY AND THE STATE. AS OF 2019, DEWITT COUNTY HAD LOWER RATES OF OVERALL FOOD INSECURITY AND CHILD FOOD INSECURITY THAN LAVACA COUNTY AND THE STATE OF TEXAS. THE AVERAGE MEAL COST FOR DEWITT COUNTY WAS SLIGHTLY HIGHER THAN IN LAVACA COUNTY AND BOTH WERE SLIGHLY LOWER THAN IN THE AVERAGE MEAL COST IN THE STATE. AS OF 2019, BOTH DEWITT COUNTY (23.0%) AND LAVACA COUNTY (20.7%) HAVE A SLIGHTLY LOWER RATE OF UNINSURED ADULTS (AGE 18-64) THAN THE STATE. (24.3%) CANCER AND HEART DISEASE ARE THE TWO LEADING CAUSES OF DEATH IN DEWITT AND LAVACA COUNTIES. OVERALL MORTALITY RATES IN DEWITT COUNTY WAS HIGHER THAN IN LAVACA COUNTY AND THE STATE BETWEEN 2017 AND 2019. BOTH LAVACA COUNTY AND DEWITT COUNTY HAVE HIGHER PREVALENCE RATES OF HIGH BLOOD PRESSURE FOR MEDICARE BENEFICIARIES THAN THE STATE (2018). THE PERCENTAGE OF MEDICARE BENEFICIARIES WITH DIABETES IN DEWITT COUNTY WAS HIGHER THAN BOTH LAVACA COUNTY AND THE STATE. IN 2017, OBESITY PREVELANCE RATES WERE HIGHER IN LAVACA COUNTY THAN IN DEWITT COUNTY AND THE STATE. SEDENTARY LIFESTYLE AND CULTURAL FACTORS ARE ALL CONTRIBUTORS TO THESE CHRONIC HEALTH CONDITIONS. AS OF NOVEMBER 8, 2021, THE PERCENT OF THE POPULATION (AGE 5+) THAT IS FULLY VACCINATED IN DEWITT COUNTY (43.3%) WITH THE COVID-19 VACCINE, IS LOWER THAN LAVACA COUNTY (44.9%) AND LOWER THAN THE STATE (57.8%). THERE ARE HIGHER PERCENTAGES OF RESIDENTS PARTICIPATING IN UNHEALTHY LIFESTYLE BEHAVIORS SUCH AS TOBACCO USE IN DEWITT AND LAVACA COUNTIES THAN THE STATE. WITH REGARD TO MATERNAL AND CHILD HEALTH, DEWITT AND LAVACA COUNTIES HAVE LOWER RATES OF MOTHERS RECEIVING INADEQUATE PRENATAL CARE THAN THE STATE. DEWITT COUNTY HAS HIGHER TEEN (AGE 0-19 YEARS) BIRTH RATES THAN LAVACA COUNTY AND THE STATE.

Schedule H, Part VI, Line 5 Promotion of community health
PROMOTION OF COMMUNITY HEALTH YCH HOLDS VARIOUS ACTIVITIES TO PROMOTE HEALTH CARE TO OUR COMMUNITY. YCH AND LOCAL NURSING HOMES, HOME HEALTH AGENCIES, AND PHARMACIES CONTINUE TO CO-SPONSOR QUARTERLY LUNCH AND LEARNS THAT PROVIDE INFORMATION ON ROTATING HEALTH RELATED TOPICS, SPECIFICALLY SURROUNDING THE ELDERLY (I.E., MEDICARE, GERIATRIC MENTAL HEALTH) FREE OF CHARGE TO THE COMMUNITY. EVENTS ARE HELD AT LOCAL CHURCHES, EVENT CENTERS, ETC. YCH ALSO PROMOTES EDUCATION AMONG THE YOUTH POPULATION BY PROVIDING TOURS OF VARIOUS HOSPITAL DEPARTMENTS, SUCH AS THE EMERGENCY ROOM, TO JUNIOR HIGH AND HIGH SCHOOL STUDENTS REGARDING AGE APPROPRIATE SAFETY TOPICS RELATING TO EACH RESPECTIVE DEPARTMENT. THE YCH PHYSICAL THERAPY DEPARTMENT AND LOCAL PHYSICIANS HELP WITH THE ANNUAL ATHLETIC PRE-PARTICIPATION SPORTS PHYSICALS FOR THE LOCAL JUNIOR HIGH AND HIGH SCHOOLS AT NO COST. THIS INCLUDES YOAKUM ISD, SWEET HOME ISD, AND ST. JOSEPH CATHOLIC SCHOOL. THE HOSPITAL ALSO PROVIDES NON-HEALTHCARE CPR CLASSES TO LOCAL GROUPS UPON REQUEST. YCH PERSONNEL SERVE IN LEADERSHIP ROLES AND AS VOLUNTEERS WITH MANY AGENCIES AND COMMITTEES IN THE COMMUNITY, INCLUDING THE ROTARY CLUB AND THE LOCAL BOY SCOUTS OF AMERICA CHAPTER. THE HOSPITAL ALSO HOSTS DRIVE EVENTS TO BENEFIT VARIOUS GROUPS WITHIN THE COMMUNITY, SUCH AS LOCAL FOOD DRIVE DONATIONS, TOYS FOR TOTS DURING THE HOLIDAYS, AND SUPPORTING ABUSED CHILDREN AT NORMA'S HOUSE DURING THE HOLIDAY SEASON. ADDITIONALLY, THE HOSPITAL CONTINUES TO COORDINATE WITH SOUTH TEXAS BLOOD AND TISSUE CENTER TO PARTICIPATE IN BLOOD DRIVES ON A QUARTERLY BASIS, WHICH ARE OPEN TO HOSPITAL EMPLOYEES AND THE COMMUNITY. SCREENINGS TO LOCAL BUSINESSES FOR BLOOD PRESSURE, CHOLESTEROL, AND GLUCOSE LEVELS), ARE ALSO OFFERED FREE OF CHARGE. YCH WILL CONTINUE TO PROVIDE FREE MEETING SPACE FOR VARIOUS SUPPORT GROUPS TO INCREASE AWARENESS ABOUT DISEASES AND RESOURCES OFFERED THROUGH THE COMMUNITY AS APPROPRIATE. EXAMPLES INCLUDE, BUT ARE NOT LIMITED TO, THE ALZHEIMER'S SUPPORT GROUP, PATIENTS IN THE TEXAS A&M DIABETIC EDUCATION PROGRAM, AND THE YOAKUM GARDEN CLUB. DUE TO THE PANDEMIC SOME COMMUNITY HEALTH ACTIVITIES WERE CURTAILED DURING THE FISCAL YEAR ENDED JUNE 30, 2022.