4A (Expenses $ 371507247 including grants of $ 0) (Revenue $ 252718964)
"COMMITMENT TO BENEFITING OUR COMMUNITIES - PATIENT CARE SERVICES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION, FOUNDED IN 1869 BY THE SISTERS OF CHARITY OF THE INCARNATE WORD, IS THE ONLY CATHOLIC FAITH-BASED, NON-PROFIT HEALTH CARE SYSTEM IN SAN ANTONIO AND NEW BRAUNFELS. WITH THE MISSION ""TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST,"" CHRISTUS HEALTH IS CHALLENGED TO REACH OUT TO, AND BEYOND, MORE THAN 60 COMMUNITIES WE SERVE TO HELP THOSE IN NEED. THE VISION OF CHRISTUS HEALTH, AS A CATHOLIC, FAITH-BASED MINISTRY, IS TO BE A LEADER, A PARTNER AND AN ADVOCATE IN THE CREATION OF INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES SO THAT ALL MAY EXPERIENCE GOD'S HEALING PRESENCE AND LOVE. ONE OF THE TOP HEALTH CARE ORGANIZATIONS IN SOUTH TEXAS, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. IT HAS FIVE HOSPITAL CAMPUSES. IT SERVICES THE SOUTHWESTERN BORDER OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY. THE AREA COMPRISES A POPULATION OF MORE THAN 2.6 MILLION INDIVIDUALS. THE POPULATION CONSISTS OF 55% HISPANIC AND 36% CAUCASIAN. THE MEDIAN INCOME FOR THE CITY OF SAN ANTONIO IS $60,799, AND HIGH SCHOOL GRADUATES REPRESENT 26% OF THE POPULATION. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION HAS FIVE HOSPITAL CAMPUSES: (1) CHRISTUS SANTA ROSA MEDICAL CENTER, LOCATED IN THE SOUTH TEXAS MEDICAL CENTER; (2) CHILDREN'S HOSPITAL OF SAN ANTONIO, LOCATED IN DOWNTOWN SAN ANTONIO; (3) CHRISTUS SANTA ROSA -WESTOVER HILLS IN THE WESTOVER HILLS AREA OF SAN ANTONIO; (4) CHRISTUS SANTA ROSA ALAMO HEIGHTS; (5) CHRISTUS SANTA ROSA NEW BRAUNFELS, LOCATED IN NEW BRAUNFELS, TEXAS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S OTHER HEALTH FACILITIES INCLUDE CHRISTUS SANTA ROSA FAMILY HEALTH CENTER, A CLINICAL OUTPATIENT CARE ORGANIZATION WHICH SERVES AS A LEVEL 3 CERTIFIED PATIENT CENTERED MEDICAL HOME AND AS A HOSPITAL-BASED ACADEMIC TRAINING PROGRAM FOR 21 FAMILY MEDICINE RESIDENTS. IN ADDITION, THE ORGANIZATION OWNS A MAJORITY INTEREST IN TWO JOINT VENTURES - CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER-NEW BRAUNFELS AND CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTERS-SAN ANTONIO, WHICH WAS 3 LOCATIONS. NEARLY 150 PHYSICIANS SERVE THE SURGERY CENTERS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS ALSO A PARTNER OF MCKENNA EQUIPMENT LEASING, LP, WHICH PROVIDES MEDICAL EQUIPMENT LEASING SERVICES. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS ALSO ONE OF THE COLLABORATING PARTNERS IN BEXAR COUNTY CLINICAL SERVICES, INC. WHICH PROVIDES PHYSICIAN AND OTHER CLINICAL HEALTH CARE SERVICES TO MEDICAID AND INDIGENT PATIENTS. EACH OF THE FACILITIES OF CHRISTUS SANTA ROSA SHARES ONE OBJECTIVE -- WHICH IS TO LEAD THE WAY TO A HEALTHIER COMMUNITY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. ITS SERVICE TO THE SOUTHERN AND WESTERN BORDERS OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY AREA COVERS A POPULATION OF MORE THAN 3.5 MILLION INDIVIDUALS. IN FISCAL YEAR 2013 ALONE, WE WERE PRIVILEGED TO SERVE HUNDREDS OF THOUSANDS OF INDIVIDUALS IN VARIOUS WAYS INCLUDING 197,841 VISITS TO OUR EMERGENCY DEPARTMENT; 5,977 INPATIENT SURGERY PROCEDURES; 35,056 OUTPATIENT SURGERY VISITS; 24,365 PATIENTS WHO WERE ADMITTED TO OUR HOSPITALS FOR CARE; AND 193,568 PATIENTS WHO RECEIVED OUTPATIENT CARE AT OUR FACILITIES. TOUCHING THE LIVES OF THE PEOPLE AROUND US IS WHAT MAKES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION STAND APART. ALLOWING OTHERS TO TOUCH US GIVES US A VISION FOR THE MEDICALLY NEEDY IN EACH OF THE COMMUNITIES WE SERVE. WHETHER IT IS THE LIFE OF A CHILD EXPECTING A FUTURE FILLED WITH MIRACLES, THE LIFE OF A MAN IN NEED OF A CRITICAL HEART SURGERY, OR THE LIFE OF A WOMAN ABOUT TO GIVE BIRTH TO HER FIRST CHILD, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION WORKS TO PROVIDE THE BEST CARE POSSIBLE REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. BY COLLABORATING WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S VARIOUS ENTITIES HAVE STRENGTHENED THEIR ROLES AS MAJOR PROVIDERS OF COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES. THESE PARTNERSHIPS WITH THE COMMUNITY HAVE BEEN A BLESSING BY HELPING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION EXTEND SERVICES TO THOSE IN NEED. FURTHERMORE, INVESTMENT IN COMMUNITY SERVICES WOULD NOT BE POSSIBLE WITHOUT DEDICATED EMPLOYEES AND VOLUNTEERS. THEY HELP TO BUILD STRONG RELATIONSHIPS BETWEEN THE HOSPITALS, OTHER HEALTH CARE MINISTRIES AND THE COMMUNITIES WHICH NURTURE CHRISTUS HEALTH'S MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST. OUR EMPLOYEES WORK BOTH INSIDE THE WALLS OF OUR HEALTH CARE FACILITIES AND IN THE COMMUNITY AND ARE COMMITTED TO REACHING BEYOND THE TRADITIONAL HOSPITAL WALLS TO HELP OUR COMMUNITIES MAINTAIN GOOD HEALTH. UNDERSTANDING THE NEED TO PROVIDE ACCESS TO HEALTH CARE TO AS MUCH OF THE PUBLIC AS POSSIBLE, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS, INCLUDING MEDICAID, MEDICARE, CHAMPUS, TRICARE AND OTHERS. IN ADDITION, WE OFFER SPECIFIC PROGRAMS TO PROVIDE DISCOUNTED SERVICES TO THOSE IN NEED WHO DO NOT HAVE MEDICAL INSURANCE OR WHO DO NOT PARTICIPATE IN GOVERNMENT-SPONSORED PROGRAMS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES, INCLUDING FOUR AMBULATORY SURGICAL CENTERS THAT OFFER AN ARRAY OF SERVICES. IT CONDUCTS ITS ACTIVITIES AND SERVES ITS PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION OFFERS SERVICES SUCH AS: COMPREHENSIVE PEDIATRIC CARE, INCLUDING A NEONATAL INTENSIVE CARE UNIT; A 45-BED, LEVEL III C NURSERY PROVIDING BOTH INTENSIVE AND INTERMEDIATE CARE TO CRITICALLY ILL INFANTS REQUIRING MEDICAL AND/OR SURGICAL INTERVENTIONS SUCH AS THE NEONATAL ECMO PROGRAM THAT PROVIDES VENO-VENOUS OR VENO-ARTERIAL EXTRACORPOREAL LIFE SUPPORT FOR UP TO TWO INFANTS IN THE NICU; THE TITANIUM RIB IMPLANT PROGRAM; THE CHRISTUS TRANSPLANT INSTITUTE (CTI); AND A WOUND CARE AND HYPERBARIC CENTER. IN ADDITION, WE OFFER THE FOLLOWING: CARDIAC CARE THAT IS NATIONALLY CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) AND ACCREDITED AS A CHEST PAIN CENTER WITH PERCUTANEOUS CORONARY INTERVENTION (PCI) DESIGNATION FROM THE SOCIETY OF CHEST PAIN CENTERS (SCPC); A COMPREHENSIVE CANCER PROGRAM; COMPLETE OBSTETRICAL AND NEWBORN SERVICES; SURGICAL UNITS; A DIABETES CARE PROGRAM; AND STATE-OF-THE-ART MEDICAL CARE FOR CHILDREN WITH AN ARRAY OF SPECIALTY SERVICES AND ORTHOPEDIC SERVICES. WE ALSO OFFER REHABILITATION TREATMENT FOR THOSE WHO HAVE EXPERIENCED A STROKE, A SPINAL CORD INJURY, CLOSED HEAD INJURIES AND MORE. EACH CAMPUS OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A 24-HOUR EMERGENCY ROOM THAT IS OPEN TO SERVE ALL THOSE IN NEED OF EMERGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. AS A NOT-FOR-PROFIT ORGANIZATION AND AS PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE AREA WE SERVE GUIDES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. WE HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING PROCESS. THE PHYSICIANS ASSIST OUR CONTINUOUS EFFORTS TO IMPROVE SERVICE TO OUR PATIENTS, QUALITY OF CARE, AND HOSPITAL EFFICIENCY."

4B (Expenses $ 143400051 including grants of $ 0) (Revenue $ 194371190)
COMMUNITY BENEFIT REPORTING - CHARITY CARE AND MEDICAID CHRISTUS ADHERES TO THE CATHOLIC HEALTH ASSOCIATION'S A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT (2012), AND COMPLIES WITH THE STATE OF TEXAS REQUIREMENTS FOR REPORTING. COMMUNITY BENEFIT, REPORTED AS UNPAID COSTS, INCLUDES BOTH CHARITY CARE AND COMMUNITY SERVICES. TO THE LIMITS OF ITS RESOURCES, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS AN INSTITUTION OF PURELY PUBLIC CHARITY; THUS, THE MOST TANGIBLE EXPRESSION OF CHARITABLE PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES TO THOSE PERSONS WHO ARE UNABLE TO PAY. THIS FALLS INTO TWO CATEGORIES: CHARITY CARE AND UNPAID GOVERNMENT INDIGENT CARE. IN KEEPING WITH THE MISSION, VALUES, AND VISION OF CHRISTUS HEALTH, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES CHARITY CARE SERVICES IN A MANNER THAT RESPECTS THE DIGNITY OF THE PATIENTS AND THEIR FAMILIES. CHARITY CARE IS PROVIDED WITHOUT CHARGE OR AT A CHARGE THAT IS LESS THAN THE USUAL CHARGE FOR SUCH SERVICES. THE DETERMINATION AS TO THE AMOUNT TO BE CHARGED, IF ANY, IS MADE ACCORDING TO A PATIENT'S ABILITY TO PAY AS DETERMINED BY ESTABLISHED ELIGIBILITY CRITERIA. FOR UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM AT OR UNDER 200 PERCENT OF THE FEDERAL POVERTY LEVEL (FPL), SERVICES ARE PROVIDED WITHOUT ANY EXPECTATION OF PAYMENT. UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM BETWEEN 200 AND 400 PERCENT OF FPL ARE CHARGED BASED ON A SLIDING SCALE, AND THOSE ABOVE 400 PERCENT RECEIVE DISCOUNTS BASED ON THE UNINSURED FEE SCHEDULE. NO PATIENT IS REFUSED NECESSARY MEDICAL CARE BASED ON THE INABILITY TO PAY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS AN ACTIVE PARTICIPANT IN THE STATE OF TEXAS MEDICAID PROGRAMS AND WORKS WITH OTHER STATE MEDICAID PROGRAMS TO ENSURE PATIENTS HAVE FULL ACCESS TO THEIR BENEFITS. THOSE PROGRAMS SEEK TO PROVIDE PAYMENT FOR HEALTH CARE SERVICES TO INDIVIDUALS WHO MEET CERTAIN FINANCIAL AND OTHER REQUIREMENTS. FINANCIAL REQUIREMENTS INCLUDE EVALUATION OF BOTH ASSETS AND INCOME.

4C (Expenses $ 12833983 including grants of $ 0) (Revenue $ 149869027)
OTHER GOVERNMENT SPONSORED SERVICES IN ADDITION TO THE PROVISION OF CHARITY CARE AND OTHER COMMUNITY SERVICES, CHRISTUS HEALTH PROVIDES SERVICES TO PERSONS COVERED UNDER GOVERNMENT-SPONSORED PROGRAMS, INCLUDING MEDICARE AND TRICARE. THE COSTS NOT REIMBURSED FOR THESE SERVICES ARE REPORTED TO THE STATE OF TEXAS. THEY ARE NOT INCLUDED IN REPORTS PREPARED FOLLOWING CATHOLIC HEALTH ASSOCIATION GUIDELINES. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES SERVICES TO PERSONS COVERED UNDER THE FEDERAL MEDICARE PROGRAM, AND IN FACT, THIS IS THE LARGEST SINGLE PAYOR CLASSIFICATION OF PATIENTS SERVED BY THIS HOSPITAL. THE PAYMENT RATE FOR INPATIENT SERVICES IS ON A PER-CASE RATE, CALCULATED BASED ON THE DIAGNOSTIC-RELATED GROUP (DRG) INTO WHICH THE PATIENT IS CATEGORIZED. MEDICARE REIMBURSES OUTPATIENT SERVICES BASED ON ITS FEE SCHEDULE.

PART I, LINE 5 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. 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. PART I, LINE 7B UNREIMBURSED MEDICAID CHRISTUS SANTA ROSA HEALTH CARE CORPORATION REINVESTS ALL SURPLUS FUNDS BACK IN TO THE COMMUNITIES WE SERVE THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. PART I, LINE 7, COLUMN (F) PERCENT OF TOTAL EXPENSE TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) IS $609,812,829. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $53,155,067. THIS LEAVES A TOTAL EXPENSE OF $556,657,762 FOR PURPOSES OF CALCULATING LINES 7, COLUMN (F). 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 38.41%, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN (F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE. PART I, LINE 7I CASH AND IN-KIND CONTRIBUTIONS CHRISTUS SANTA ROSA HEALTH CARE CORPORATION MADE OVER $30,105,770 IN CASH AND IN KIND CONTRIBUTIONS DURING FISCAL YEAR 2013. 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 $245,000 WERE DONATED BY CHRISTUS HEALTH TO NONPROFIT ORGANIZATIONS LOCATED IN THE COMMUNITY SERVED BY CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. THE GRANT DOLLARS WERE USED TO SUPPORT PROGRAMS THAT PROMOTE THE HEALTH OF THE COMMUNITIES THAT CHRISTUS SANTA ROSA HEALTH CARE CORPORATION SERVES. ALL GRANTS MADE TO OUTSIDE ORGANIZATIONS THROUGH THE CHRISTUS FUND ARE MADE TO NONPROFIT ORGANIZATIONS THAT SUPPORT THE COMMUNITY. INDIGENT FUNDING EXPENSE OF $30,039,210 IS INCLUDED IN SCHEDULE H, PART I, LINE 7(I). PART I, LINE 7 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 PART II COMMUNITY BUILDING ACTIVITIES THE CHRISTUS HEALTH BOARD OF DIRECTORS APPROVED FUNDING OF A COMMUNITY DIRECT INVESTMENT (CDI) LOAN PROGRAM TO ENSURE THAT THE WORK OF SOCIAL ACCOUNTABILITY AND MORAL AND ETHICAL STEWARDSHIP CONTINUE IN SPITE OF CHALLENGING FISCAL CONDITIONS FACED BY LOCAL OPERATING ENTITIES. THE PURPOSE OF THE CDI PROGRAM IS TO SUPPORT COMMUNITY DRIVEN INITIATIVES, PRIMARILY FOR AFFORDABLE HOUSING AND ECONOMIC DEVELOPMENT BY PROVIDING FINANCING AT BELOW MARKET INTEREST RATES TO NONPROFIT ORGANIZATIONS AT TERMS NOT EXCEEDING MORE THAN FIVE YEARS. THE INCOME EARNED AT THE MARKET RATE LESS OUR LOAN RATE (FOREGONE INCOME) IS CONSIDERED A COMMUNITY BENEFIT FOR REPORTING PURPOSES. THE FOREGONE INTEREST FOR THE CHRISTUS SANTA ROSA REGION IN FISCAL YEAR ENDING JUNE 30, 2013 WAS $22,124. IN AN EFFORT TO MEET AND ADDRESS THE IDENTIFIED HEALTH CARE NEEDS IN THE COMMUNITIES IT SERVES, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES ACCESS TO HEALTH CARE SERVICES THROUGH PROGRAMS AND LOCAL COMMUNITY PARTNERS AND SERVICE ORGANIZATIONS. THE CHRISTUS HEALTH ADVOCACY DEPARTMENT IS WORKING IN PARTNERSHIP WITH LOCAL, STATE AND FEDERAL POLICY MAKERS TO ENSURE ACTIVITIES AND PROGRAMS ARE IN PLACE THAT WILL ENHANCE PUBLIC HEALTH AND ADVANCE GENERAL KNOWLEDGE THROUGH IMPROVED ACCESS TO HEALTH SERVICES AND ADVANCE GENERAL KNOWLEDGE. DURING FY 2013, 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. THESE ARE SOME OF THE MAIN COMMUNITY BUILDING ACTIVITIES THAT ARE IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, AND ADVANCING KNOWLEDGE. PART III, SECTION A, 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."

PART III, SECTION A, LINE 2 METHODOLOGY USED IN DETERMINING BAD DEBT
"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. PART III, SECTION A, LINE 3 ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ORGANIZATION'S CHARITY CARE POLICY THE FILING ORGANIZATION RECOGNIZES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. IN ORDER TO ASSESS THE BAD DEBT ACCOUNTS THAT WOULD LIKELY QUALIFY FOR CHARITY CARE, THE FOLLOWING CRITERIA WERE ESTABLISHED BASED ON AN ANALYSIS OF HISTORICAL DATA OF CHRISTUS HEALTH AND ITS RELATED ORGANIZATIONS: 1. PARO SCORE OF LESS THAN OR EQUAL TO 586, WHICH IS A PREDICTOR DEFINING THE LIKELY SOCIOECONOMIC CONDITIONS FOR THE PATIENT; 2. ESTIMATED FEDERAL POVERTY LEVEL OF LESS THAN OR EQUAL TO 226%, WHICH IS BASED ON ESTIMATED HOUSEHOLD SIZE AND HOUSEHOLD ESTIMATED INCOME; AND 3. THIRD PARTY DATA AVAILABLE ON PATIENT ACCOUNTS WHICH INDICATE THAT THE PATIENT IS NOT A HOMEOWNER OR A PROBABLE HOMEOWNER. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERISTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2013, 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 29.32% 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, 2013. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 3.21% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2013 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. PART III, SECTION A, LINE 4 BAD DEBT EXPENSE 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 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. THE SYSTEM CONSIDERS CRITICAL ACCOUNTING POLICIES TO BE THOSE THAT REQUIRE MORE SIGNIFICANT JUDGMENTS AND ESTIMATES IN THE PREPARATION OF ITS FINANCIAL STATEMENTS, INCLUDING THE FOLLOWING: RECOGNITION OF NET PATIENT REVENUES, WHICH INCLUDE CONTRACTUAL ALLOWANCES; PROVISIONS FOR BAD DEBT; RESERVES FOR LOSSES AND EXPENSES RELATED TO HEALTH CARE PROFESSIONAL AND GENERAL LIABILITIES; DETERMINATION OF FAIR VALUES OF CERTAIN FINANCIAL INSTRUMENTS; DETERMINATION OF FAIR VALUE OF CERTAIN GOODWILL AND LONG-LIVED ASSETS; AND RISKS AND ASSUMPTIONS FOR MEASUREMENT OF PENSION AND RETIREE MEDICAL LIABILITIES. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN MAKING ITS JUDGMENT AND ESTIMATES. ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THESE ESTIMATES."" PART III, SECTION B, LINE 8 EXTENT TO WHICH SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT COSTING METHODOLOGY THE SHORTFALL ON PART III, LINE 7 IS NOT COUNTED AS A COMMUNITY BENEFIT. 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 SHORTFALL OF ($30,259,783) IF TOTAL EXPENSES ALLOCABLE TO MEDICARE SERVICES WERE SUBSTITUTED ON SCHEDULE H, PART III, LINE 6. PART III, SECTION C, LINE 9B COLLECTION POLICY IT IS THE POLICY OF THE ORGANIZATION TO PURSUE COLLECTIONS OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. CHRISTUS HEALTH APPLIES ITS COLLECTION EFFORTS CONSISTENTLY AND FAIRLY TO ALL PATIENTS REGARDLESS OF INSURANCE. IF A PATIENT DOES NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR OUTSTANDING BALANCES, THE GOAL OF THE ORGANIZATION IS TO QUALIFY THESE PATIENTS THROUGH THE ORGANIZATION'S CHARITY POLICY OR SCREEN THE PATIENTS THROUGH ORGANIZATION'S PRESUMPTIVE CHARITY TESTS. IF THE PATIENT QUALIFIES UNDER EITHER POLICY THE ACCOUNT WILL BE WRITTEN OFF BASED UPON LEVEL OF QUALIFICATION. THESE POLICIES SUPPORT THE MISSION AND VISION OF THE ORGANIZATION AND ARE APPROVED BY SENIOR LEADERSHIP. SCHEDULE H, PART V, SECTION B, LINE 3 INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING QUANTITATIVE DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS FOR THE COUNTY. QUANTITATIVE DATA WAS COMPILED AND ANALYZED FROM A NUMBER OF SOURCES, INCLUDING THE U.S. CENSUS, CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, TEXAS DEPARTMENT OF STATE HEALTH SERVICES, SAN ANTONIO METROPOLITAN HEALTH DISTRICT, AND NOW DATA. TYPES OF DATA INCLUDED PUBLIC HEALTH DISEASE SURVEILLANCE DATA, HOSPITALIZATION RECORDS, VITAL STATISTICS BASED ON BIRTH AND DEATH DATA, AND SELF-REPORTS OF HEALTH BEHAVIORS FROM LARGE, POPULATION-BASED SURVEYS, SUCH AS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY AND YOUTH RISK BEHAVIOR SURVEY. WHEN POSSIBLE, DATA WAS PROVIDED DOWN TO THE SUBSECTOR LEVEL TO PROVIDE RELEVANT INFORMATION FOR MORE GRANULAR GEOGRAPHIC AREAS WITHIN BEXAR COUNTY. TO COMPLIMENT THESE QUANTITATIVE DATA, QUALITATIVE INFORMATION WAS COLLECTED FROM 14 FOCUS GROUPS, 19 INTERVIEWS, AND 4 COMMUNITY DIALOGUES. FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED WITH PEOPLE FROM ACROSS BEXAR COUNTY, AND WITH A RANGE OF INDIVIDUALS REPRESENTING DIFFERENT AUDIENCES, INCLUDING RESIDENTS, FAITH COMMUNITIES, SOCIAL SERVICE PROVIDERS, HOSPITAL ADMINISTRATORS, COUNTY AND LOCAL GOVERNMENT OFFICIALS, AND PUBLIC HEALTH LEADERS. ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED OVER 280 INDIVIDUALS. IN COMAL COUNTY, THE ASSESSMENT USES A MODEL ADAPTED FROM THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS ENTITLED MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS. THE MAPP ASSESSMENTS AND THE ISSUES THEY ADDRESS PROVIDE A DEEPER UNDERSTANDING OF THE ISSUES THAT RESIDENTS FEEL ARE IMPORTANT BY ANSWERING THE QUESTIONS. THE QUESTIONS WERE EXPLORED IN 2 WAYS. FIRST, A SERIES OF 12 FOCUSED GROUP DISCUSSIONS INVOLVING MORE THAN 100 PARTICIPANTS WAS CONDUCTED TO IDENTIFY KEY ISSUES FOR THE COMMUNITY. THIS PROCESS ALSO YIELDED A ROSTER OF INTERESTED AND ACTIVE PERSON WHO WERE LATER INVITED TO PARTICIPATE IN AN ONLINE SURVEY DESIGNED TO ASSESS THE DEGREE OF CONCERN ABOUT EACH KEY ISSUE AND RANK THE TOP FOU"

PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
"CHRISTUS SANTA ROSA HEALTH CARE CORPORATION MAKES EVERY EFFORT TO EDUCATE PATIENTS ON ITS CHARITY AND DISCOUNT POLICY AND ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS DURING REGISTRATION, PRE REGISTRATION (FOR SCHEDULED TESTS AND SURGERIES), POST REGISTRATION (DURING THEIR HOSPITALIZATION) AND FOLLOWING DISCHARGE (TELEPHONE OR WRITTEN INQUIRY) IN LANGUAGES APPROPRIATE FOR THE POPULATION BEING SERVED. PATIENTS ARE GIVEN INFORMATION AND FORMS BY A FINANCIAL COUNSELOR WHO HELPS THEM COMPLETE THE FORMS DURING THEIR INPATIENT AND OUTPATIENT VISITS. PATIENTS ARE ASKED TO BRING OR MAIL SUPPORTING DOCUMENTATION TO DETERMINE INCOME, ASSETS AND HOUSEHOLD EXPENSES. THE BUSINESS OFFICE REVIEWS THE APPLICATION BASED ON THE INFORMATION PROVIDED BY THE PATIENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE OR A DISCOUNT, A NEW BILL IS GENERATED. PATIENTS WHO DO NOT PROVIDE THE REQUIRED DOCUMENTATION ARE CONSIDERED INELIGIBLE AND ARE BILLED ACCORDINGLY. IF THE DOCUMENTATION IS PROVIDED AT A LATER TIME, THE PATIENT MAY THEN BE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR A DISCOUNT. DOCUMENTATION IS RETAINED BY THE BILLING OFFICE FOR SEVEN YEARS. A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY IS POSTED IN PROMINENT PLACES THROUGHOUT THE HOSPITALS, INCLUDING BUT NOT LIMITED TO THE EMERGENCY ROOM WAITING AREAS AND THE ADMISSIONS OFFICE WAITING AREAS, AS REQUIRED BY BOTH THE STATE OF TEXAS COMMUNITY BENEFIT STANDARD (WHICH ADDRESSES THE DUTIES AND RESPONSIBILITIES OF NONPROFIT HOSPITALS) AND CHRISTUS HEALTH COMMUNITY BENEFIT GUIDELINES #050. IN ADDITION, A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY AND INFORMATION ON FINANCIAL ASSISTANCE ARE ALSO POSTED ON THE CHRISTUS HEALTH WEBSITE. THE INFORMATION ON FINANCIAL ASSISTANCE INCLUDES EXPLANATIONS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, WHO QUALIFIES, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4 COMMUNITY INFORMATION CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. IT HAS FIVE HOSPITAL CAMPUSES. IT SERVICES THE SOUTHWESTERN BORDER OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY. THE AREA COMPRISES A POPULATION OF MORE THAN 2.6 MILLION INDIVIDUALS. THE POPULATION CONSISTS OF 55% HISPANIC AND 36% CAUCASIAN. THE MEDIAN INCOME FOR THE CITY OF SAN ANTONIO IS $60,799, AND HIGH SCHOOL GRADUATES REPRESENT 26% OF THE POPULATION. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES. IT CONDUCTS ITS ACTIVITIES AND ITS HEALTH CARE PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. ONE OF THE TOP HEALTH CARE ORGANIZATIONS IN SOUTH TEXAS, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION HAS FIVE HOSPITAL CAMPUSES: (1) CHRISTUS SANTA ROSA MEDICAL CENTER, LOCATED IN THE SOUTH TEXAS MEDICAL CENTER; (2) CHILDREN'S HOSPITAL OF SAN ANTONIO, LOCATED IN DOWNTOWN SAN ANTONIO; (3)CHRISTUS SANTA ROSA -WESTOVER HILLS IN THE WESTOVER HILLS AREA OF SAN ANTONIO; (4) CHRISTUS SANTA ROSA ALAMO HEIGHTS; AND (5) CHRISTUS SANTA ROSA NEW BRAUNFELS, LOCATED IN NEW BRAUNFELS, TEXAS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S OTHER HEALTH FACILITIES INCLUDE CHRISTUS SANTA ROSA FAMILY HEALTH CENTER, A CLINICAL OUTPATIENT CARE ORGANIZATION WHICH SERVES AS A LEVEL 3 CERTIFIED PATIENT CENTERED MEDICAL HOME AND AS A HOSPITAL-BASED ACADEMIC TRAINING PROGRAM FOR 21 FAMILY MEDICINE RESIDENTS. IN ADDITION, THE ORGANIZATION OWNS A MAJORITY INTEREST IN CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER-NEW BRAUNFELS, A JOINT VENTURE WITH NEARLY 150 PHYSICIANS AND A MAJORITY INTEREST IN CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTERS-SAN ANTONIO, WHICH HAS 3 LOCATIONS. THE ORGANIZATION ALSO OWNS A PARTIAL INTEREST IN NEW BRAUNFELS SURGICAL CENTER, LLC. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS ALSO A PARTNER OF MCKENNA EQUIPMENT LEASING, LP, WHICH PROVIDES MEDICAL EQUIPMENT LEASING SERVICES. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS ALSO ONE OF THE COLLABORATING PARTNERS IN BEXAR COUNTY CLINICAL SERVICES, INC. WHICH PROVIDE PHYSICIAN AND OTHER HEALTH CARE SERVICES TO MEDICAID AND INDIGENT PATIENTS. EACH OF THE FACILITIES OF CHRISTUS SANTA ROSA SHARES ONE OBJECTIVE - TO LEAD THE WAY TO A HEALTHIER COMMUNITY. EACH OF THE FIVE HOSPITALS OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A 24 HOUR EMERGENCY ROOM THAT IS OPEN TO SERVE ALL THOSE IN NEED OF EMERGENCY CARE, REGARDLESS OF ABILITY TO PAY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION WORKS TO FACILITATE AND STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTH CARE SERVICES FOR ALL, PARTICULARLY THE VULNERABLE AND UNDERSERVED POPULATIONS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ALSO SUPPORTS MANY LOCAL COMMUNITY HEALTH SERVICES, OFFERING CONVENIENT LOCATIONS FOR PRIMARY CARE THROUGH FAMILY HEALTH CLINICS AND MOBILE HEALTH CLINICS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION OFFERS SERVICES SUCH AS: COMPREHENSIVE PEDIATRIC CARE, INCLUDING A NEONATAL INTENSIVE CARE UNIT, A 45-BED, LEVEL III C NURSERY PROVIDING BOTH INTENSIVE AND INTERMEDIATE CARE TO CRITICALLY ILL INFANTS REQUIRING MEDICAL AND/OR SURGICAL INTERVENTIONS SUCH AS THE NEONATAL ECMO PROGRAM THAT PROVIDES VENO-VENOUS OR VENO-ARTERIAL EXTRACORPOREAL LIFE SUPPORT FOR UP TO TWO INFANTS IN THE NICU; THE TITANIUM RIB IMPLANT PROGRAM; THE CHRISTUS TRANSPLANT INSTITUTE (CTI); AND A WOUND CARE AND HYPERBARIC CENTER. IN ADDITION, WE OFFER THE FOLLOWING: CARDIAC CARE THAT IS NATIONALLY CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) AND ACCREDITED AS A CHEST PAIN CENTER WITH PERCUTANEOUS CORONARY INTERVENTION (PCI) DESIGNATION FROM THE SOCIETY OF CHEST PAIN CENTERS (SCPC); A COMPREHENSIVE CANCER PROGRAM; COMPLETE OBSTETRICAL AND NEWBORN SERVICES; SURGICAL UNITS; A DIABETES CARE PROGRAM; AND STATE-OF-THE-ART MEDICAL CARE FOR CHILDREN WITH AN ARRAY OF SPECIALTY SERVICES AND ORTHOPEDIC SERVICES. WE ALSO OFFER REHABILITATION TREATMENT FOR THOSE WHO HAVE EXPERIENCED A STROKE, A SPINAL CORD INJURY, CLOSED HEAD INJURIES AND MORE. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION COLLABORATES WITH COMMUNITIES, CHURCHES, AND OTHER HEALTH CARE ORGANIZATIONS TO PROVIDE COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES AND PROACTIVE HEALTH CARE PROGRAMS. THE HEALTH COLLABORATIVE'S (AS DEFINED IN SCHEDULE H, PART VI, QUESTION 2) EXISTING PRIORITIES OF FITNESS AND NUTRITION, AS THEY RELATE TO DIABETES AND OBESITY, WILL CONTINUE TO BE ADDRESSED THROUGH THE CHRONIC CARE MANAGEMENT FOR CHILDREN AND ADULTS AS WELL AS PREVENTATIVE CARE AND HEALTH EDUCATION THROUGH COLLABORATIVE RELATIONSHIPS WITH SCHOOL DISTRICTS. THE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION COMMUNITY BENEFIT PLAN (""THE PLAN"") SUPPORTS THE INITIATIVES OF THE HEALTH COLLABORATIVE. THE PLAN FOCUSES ON COMMUNITY INITIATIVES THAT CAN IMPACT FAMILY MEMBERS OF ALL AGES WITH DIABETES, HEART DISEASE, OBESITY AND CANCER. THESE INITIATIVES ARE PROVIDED THROUGH A PEDIATRIC MOBILE CLINIC, SCHOOL-BASED HEALTH CENTERS, COMMUNITY HEALTH WORKER PROGRAMS AND DIABETES EDUCATION PROGRAMS. THE PLAN INCLUDES THE WORK PERFORMED AT THE CENTER FOR MIRACLES WHICH IS DEDICATED TO PROVIDING FREE SERVICES FOR ABUSED/NEGLECTED CHILDREN AND THEIR AFFECTED FAMILY MEMBERS. OTHER EFFORTS ARE TO PROVIDE APPLICATION ASSISTANCE TO MEDICAID/CHIP PATIENTS TO ENSURE HEALTH CARE OPPORTUNITIES ARE OFFERED TO WOMEN AND CHILDREN. WOMEN, INFANT AND CHILDREN (WIC) SERVICES PROVIDE NUTRITION/BREASTFEEDING EDUCATION AND FOOD VOUCHERS TO HELP DECREASE THE INCIDENCE OF LOW BIRTH WEIGHT INFANTS AND IMPROVE INFANT MORTALITY RATES IN BEXAR COUNTY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ALSO PROVIDES SERVICES FOR THE BROADER COMMUNITY AS A PART OF ITS OVERALL COMMUNITY BENEFIT. THE GREATEST SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS (I.E., GRADUATE MEDICAL EDUCATION, NURSING STUDENTS, ALLIED HEALTH PROFESSIONS, PHARMACISTS, ETC). HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NONPROFIT HEALTH CARE. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION HAD NET EXPENSES OF OVER $4.5 MILLION IN HEALTH PROFESSIONS EDUCATION DURING FY 2013 THAT INCLUDED STUDENT INTERNSHIPS, CLINICAL EXPERIENCE AND OTHER EDUCATION FOR PHYSICIANS, NURSES, PHYSICAL THERAPISTS AND OTHER HEALTH PROFESSIONS STUDENTS. CHRISTUS HEALTH REINVESTS ALL SURPLUS FUNDS BACK INTO THE COMMUNITIES IT SERVES THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. 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 SANTA ROSA HEALTH CARE CORPORATION. WE ARE PRIVILEGED TO HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US"

PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM
CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS PART OF CHRISTUS HEALTH, AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM COMPRISED OF ALMOST 350 SERVICES AND FACILITIES INCLUDING MORE THAN 60 HOSPITALS AND LONG TERM CARE FACILITIES, 175 CLINICS AND OUTPATIENT CENTERS, AND OTHER COMMUNITY HEALTH MINISTRIES AND COMMUNITY DEVELOPMENT VENTURES. CHRISTUS SERVICES CAN BE FOUND IN: ARKANSAS, GEORGIA, IOWA, LOUISIANA, MISSOURI, NEW MEXICO, TEXAS, AND IN SIX PROVINCES OF MEXICO. A COMMON MISSION, CORE VALUES, AND VISION UNITE THE HEALTH SYSTEM. EACH REGION, INCLUDING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION, 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 SANTA ROSA HEALTH CARE CORPORATION, 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. 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 2012 ASCBS FORM IS EXPANDED TO COLLECT THE INFORMATION ON CHARITY CARE POLICIES AND COMMUNITY BENEFITS IN A STANDARDIZED FORMAT. ALL CHRISTUS HEALTH ENTITIES INCLUDING FACILITIES LOCATED IN STATES THAT DO NOT REQUIRE ANNUAL COMMUNITY BENEFIT REPORTING (I.E., LOUISIANA, AND NEW MEXICO), FOLLOW THE SAME REPORTING RULES AS OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT, COPYRIGHT 2008. TOTAL COMMUNITY BENEFIT FOR CHRISTUS HEALTH IS ALSO REPORTED IN THE ANNUAL REPORT PREPARED AND DISTRIBUTED BY THE SYSTEM OFFICE. STATE FILING OF COMMUNITY BENEFIT REPORT: TX SCHEDULE H, PART VI, LINE 8 THE NARRATIVE INFORMATION PROVIDED FOR THE APPLICABLE LINES IN PART VI, LINE 1 APPLIES TO ALL HOSPITAL FACILITIES UNDER THIS LEGAL ENTITY.