4A (Expenses $ 52158735 including grants of $ 0) (Revenue $ 64769890)
MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) OPERATES A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL WHICH PROVIDES PRIMARY AND SECONDARY HEALTH CARE. MAHHC PRIMARY SERVICE AREA INCLUDES BRIDGEWATER, BROWNSVILLE, HARTLAND, READING, WEATHERSFIELD, WINDSOR, & WOODSTOCK (VT) AS WELL AS CLAREMONT, CORNISH, AND PLAINFIELD (NH). THE HOSPITAL PROVIDES ESSENTIAL HEALTH CARE SERVICES INCLUDING EMERGENCY DEPARTMENT/MEDICAL/SURGICAL INPATIENT, AND ANCILLARY DIAGNOSTIC TESTS, IMAGING/RADIOLOGY PROCEDURES, AND WELLNESS/PREVENTION SERVICES. MAHHC STAFFS A TOTAL OF 25 ACUTE MEDICAL/SURGICAL BEDS AND 10 ACUTE REHABILITATION BEDS. DURING THE YEAR, THERE WERE 920 DISCHARGES, 1,640 SURGERIES, 70,517 LAB TESTS, AND 14,897 IMAGING PROCEDURES. MAHHC IDENTIFIED ACCESS TO PRIMARY CARE AS A CENTRAL COMMUNITY NEED AND IS COMMITTED TO PROVIDING THE PHYSICIAN SERVICES OF FAMILY PRACTICE, INTERNAL MEDICINE AND PEDIATRICS IN WINDSOR AND WOODSTOCK. MAHHC PROVIDES FREE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA. FOREGONE CHARGES FURNISHED UNDER MAHHC'S FREE CARE POLICY AMOUNT TO $562,795 IN FY22.

Schedule H, Part V, Section B, Line 3E
THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - WINDSOR HOSPITAL CORPORATION. METHODS EMPLOYED IN THE ASSESSMENT INCLUDED A SURVEY OF AREA RESIDENTS MADE AVAILABLE THROUGH THE ELECTRONIC MAIL, PHYSICAL PRINTED SURVEYS DISTRIBUTED THROUGH THE COMMUNITYS' WEBSITE LINKS, A SURVEY OF KEY COMMUNITY STAKEHOLDERS WHO ARE AGENCY, MUNICIPAL OR HEALTH AND HUMAN SERVICE / COMMUNITY LEADERS, A SERIES OF ELEVEN COMMUNITY DISCUSSION GROUPS CONVENED IN THE MT. ASCUTNEY HOSPITAL SERVICE AREA, AND A REVIEW OF AVAILABLE POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS WAS DONE. THE ORGANIZATIONS OTHER THAN HOSPITALS CONSULTED IN CONDUCTING THE CHNA INCLUDED LAKE SUNAPEE REGION VNA AND HOSPICE, VISITNG NURSE AND HOSPICE OF VT AND NH (HOME-VISITNG PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FOR SENIORS WITH COMPLEX HEALTH NEEDS), THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE/JSI, AND OTHER COMMUNITY ORGANIZATIONS SERVING PEOPLE AFFECTED BY POVERTY AND POOR HEALTH. THESE GROUPS HELPED TO RECEIVE INPUT FROM ALL SECTORS, INCLUDNG THE UNINSURED, INCOME-VULNERABLE, AND MEDICALLY UNDERSERVED POPULATIONS. AT THE BEGINNING OF THE KEY COMMUNITY STAKEHOLDER SURVEY, RESPONDENTS WERE ASKED TO INDICATE THE REGION THEY PRIMARILY SERVE OR ARE MOST FAMILIAR WITH. A TOTAL OF 57 KEY STAKEHOLDER RESPONDENTS INDICATED THAT THEIR RESPONSES WERE REFLECTIVE OF THE GREATER WINDSOR AREA. RESPONDENTS REPRESENTED THE FOLLOWING SECTORS: - HUMAN SERVICE/SOCIAL SERVICES - EDUCATION/YOUTH SERVICES - COMMUNITY MEMBER/VOLUNTEER - PUBLIC HEALTH - MUNICIPAL/COUNTY/STATE GOVERNMENT - MEDICAL CARE/HOSPITAL - FAITH ORGANIZATION - LONG-TERM CARE - MENTAL HEALTH/BEHAVIORAL HEALTH - CIVIC/CULTURAL ORGANIZATION - FIRE/EMERGENCY MEDICAL SERVICE - HOME HEALTH CARE - BUSINESS/OTHER

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - WINDSOR HOSPITAL CORPORATION. THE CHNA WAs CONDUCTED WITH OTHER HOSPITAL FACILITIES INCLUDING DARTMOUTH-HITCHCOCK, ALICE PECK DAY MEMORIAL HOSPITAL, NEW LONDON HOSPITAL, AND VALLEY REGIONAL HEALTHCARE.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - WINDSOR HOSPITAL CORPORATION. ORGANIZATIONS, OTHER THAN HOSPITALS WHO PARTICIPATED WITH MAHHC TO CONDUCT THE CHNA INCLUDED: LAKE SUNAPEE REGION VNA AND HOSPICE, VISITING NURSE AND HOSPICE FOR VT AND NH, TECHNICAL SUPPORT FROM THE NEW HAMPSHIRE COMMUNITY HEALTH INSTITUTE/JSI; COMMUNITY PARTNERS WHO ASSISTED IN DISSEMINATING THE CHNA THROUGH THEIR NETWORKS INCLUDED WINDSOR SOUTHEAST SUPERVISORY UNION, WINDSOR CENTRAL SUPERVISORY UNION, HUMAN SERVICE AGENCIES FROM THE GREATER UPPER VALLEY INTEGRATED SERVICES TEAM, MAHHC IMMUNIZATION CLINICS, LOCAL BLACK LIVES MATTER/JEDI COMMITTEE, PARENT-CHILD CENTERS, VERMONT STUDENT ASSISTANCE CORPORATION, SOUTH EASTERN VERMONT COMMUNITY ACTION, ECONOMIC SERVICES, WISE, VEGGIE VAN GO, LOCAL TOWN GOVERNMENT'S, AND WINDSOR VT ROTARY.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - WINDSOR HOSPITAL CORPORATION. THE CHNA REPORT WAS PREPARED AND MADE AVAILABLE AND DISTRIBUTED THROUGH PRESENTATIONS MADE TO THE HOSPITAL'S BOARD OF TRUSTEES, THE MT. ASCUTNEY COMMUNITY HEALTH COMMITTEE, AS WELL AS THE BLUEPRINT COMMUNITY HEALTH TEAM, WINDSOR CONNECTION RESOURCE CENTER, PATCH TEAM, WINDSOR HSA COMMUNITY COLLABORATIVE, GREATER UPPER VALLEY INTEGRATED SERVICES TEAM, MAHHC COMMUNITY HEALTH COMMITTEE AND A REGIONAL CONVENING OF ALL NETWORKS AND WORKGROUPS OF THE COMMUNITY HEALTH IMPLEMENTATION PLAN. AN ELECTRONIC COPY WAS DISSEMINATED TO THE LOCAL TOWN SELECTBOARDS OF WINDSOR, HARTLAND, WEATHERSFIELD, BROWNSVILLE, AND WOODSTOCK. THE CHNA AND ALL INFORMATION IN THE NEEDS ASSESSMENT IS AVAILABLE FOR STAKEHOLDERS. THE CHNA IS ALSO AVAILABLE, UPON REQUEST, VIA PAPER COPY AT THE HOSPITAL'S MAIN INFORMATION DESK.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - WINDSOR HOSPITAL CORPORATION. THE MISSION OF MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (MAHHC) IS TO IMPROVE THE LIVES OF THOSE WE SERVE. TO ACCOMPLISH THIS, WE AND OUR COMMUNITY PARTNERS REGULARLY REACH OUT TO ENGAGE IN DIALOGUE WITH PEOPLE ACROSS OUR AREA ABOUT PRESSING HEALTH NEEDS. THE RESULT OF THIS WORK IS A COMPREHENSIVE LOCAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THIS ASSESSMENT IS DESIGNED TO IDENTIFY COMMUNITY HEALTH CONCERNS AND PRIORITIES AND LEAD TO OPPORTUNITIES TO IMPROVE COMMUNITY HEALTH AND HEALTHCARE DELIVERY SYSTEMS. THE GEOGRAPHIC AREA COVERED BY THE ASSESSMENT INCLUDES 13 MUNICIPALITIES IN VERMONT AND NEW HAMPSHIRE THAT COMPRISE THE MAHHC SERVICE AREA. THE CHNA LEADS TO A LOCAL COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WITH STRATEGIES AND METRICS TO IMPROVE HEALTH AND REDUCE RISKS LEADING TO CHRONIC DISEASE NOT ONLY FOR INDIVIDUALS, BUT FOR THE ENTIRE COMMUNITY. THIS CHNA/CHIP PROCESS, WHICH INCORPORATES INPUT FROM PEOPLE WHO REPRESENT THE COMMUNITY'S BROAD INTERESTS, IS AN ESSENTIAL PART OF CREATING AN ACCOUNTABLE COMMUNITY FOR HEALTH. THE ASSESSMENT PROCESS FOSTERS ENGAGEMENT, AND THE RESULTS HELP US TO UNDERSTAND THE SPECIFIC ISSUES FACING OUR COMMUNITIES SO THAT WE CAN DEVELOP EFFECTIVE, COLLECTIVE IMPACT SOLUTIONS. IN FISCAL YEAR 2022, WE IMPLEMENTED THE FOLLOWING PROGRAMS WITHIN OUR COMMUNITY HEALTH IMPROVEMENT PLAN DESIGNED TO ADDRESS THE PRIORITY HEALTH NEEDS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. ACCESS TO MENTAL HEALTH ACCESS TO MENTAL HEALTH WAS OUR #1 COMMUNITY HEALTH NEED. DURING 2022, WE INCREASED ACCESS TO OUR MSW PROVIDING SERVICES AS PART OF OUR PATIENT CENTERED MEDICAL HOME. OUR WORK WITH THE WINDSOR CONNECTION RESOURCE CENTER PROVIDED MENTAL HEALTH COUNSELING SESSIONS. WE EMBEDDED A MENTAL HEALTH CLINICIAN INTO OUR PEDIATRIC CARE PRACTICE, AND ESTABLISHED WEEKLY CARE MANAGEMENT SESSIONS TO ADDRESS THE MENTAL HEALTH NEEDS OF YOUTH WITH PROLONGED STAYS IN OUR EMERGENCY ROOM. WE INCREASED OVER 100% FROM BASELINE THE NUMBER OF SCREENINGS OF PATIENTS FOR DEPRESSION AND ANXIETY. ALCOHOL AND SUBSTANCE MISUSE ALCOHOL AND SUBSTANCE MISUSE WAS OUR #2 COMMUNITY HEALTH NEED. DURING 2022, WE CONTINUED OUR COMMUNITY-BASED INVESTMENTS IN SUBSTANCE USE PREVENTION BY SUBAWARDING $101,463 TO 10 COMMUNITY ORGANIZATIONS TO IMPLEMENT BEST-PRACTICE PREVENTION STRATEGIES. WE CONTINUE ROBUST TWICE ANNUAL DEA DRUG TAKE BACK EVENT COLLECTIONS, AND MAINTAIN OUR POLICY CLEARING HOUSE FOR AREA DECISION MAKERS. WE UPDATED A HEALTH DISPARITY DATA REPORT AND CONTINUED ROBUST IMPLEMENTATION OF OUR WWW.WEAREWORTHWHILE.ORG ANTI SELF-STIGMA CAMPAIGN. WE WORKED TIRELESSLY TO PREVENT OPIOID DEATHS. WE CONTINUED OUR INITIATIVES REGARDING MEDICATION-ASSISTED TREATMENT INDUCTION IN OUR EMERGENCY DEPARTMENT (ED). WE CONTINUED OUTREACH AFTER OVERDOSE INITIATIVES THROUGH PARTNERSHIPS WITH AREA POLICE, EMS, AND RECOVERY COACH PARTNERSHPS WHO RESPOND TO THE PATIENT AND FAMILY WITH SUPPORT, EDUCATION, RESOURCES AND REFERRAL TO TREATMENT. MAHHC ED IS ALSO A NARCAN DISTRIBUTION SITE FOR THE COMMUNITY. WE HAVE WORKED WITH THE SYRINGE SERVICE PROGRAM AND CONNECTICUT VALLEY ADDICTION RECOVERY (CVAR) TO INCREASE EDUCATION AND ACCESS TO NARCAN. WE ALSO CONTINUED OUR AGREEMENT TO HOST RECOVERY COACHES 7 DAYS A WEEK 24 HOURS A DAY IN OUR EMERGENCY DEPARTMENT. RECOVERY COACHES FOLLOW UP WITH PATIENTS AFTER ED DISCHARGE TO PROVIDE SUPPORT IN THE FIRST 10 DAYS AND BEYOND. RECOVERY COACHES HAVE BECOME ACTIVE MEMBERS IN OUR ALCOHOL AND SUBSTANCE MISUSE WORKGROUP FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. ACCESS TO AFFORDABLE HEALTH INSURANCE AND PRESCRIPTION MEDICATION ACCESS TO AFFORDABLE HEALTH INSURANCE AND PRESCRIPTION MEDICATION WAS OUR #3 COMMUNITY HEALTH NEED. WE CONTINUE TO PROVIDE ACCESS TO ESSENTIAL HEALTHCARE NEEDS SUCH AS HEALTH INSURANCE, MEDICATION ASSISTANCE, AND DENTAL PROCEDURE FINANCIAL SUPPORT. STRENGTHENING FAMILIES OUR #4 COMMUNITY HEALTH NEED, INCLUDED WORK IN CONJUNCTION WITH THE PEDIATRIC CLINIC AND THE COMMUNITY TO OVERCOME POVERTY AND FAMILY STRESS BY INCREASING SKILLS AND CAPACITY FOR POSITIVE RELATIONSHIPS IN THE FAMILY UNIT. IN 2022, OUR FAMILY WELLNESS PROGRAM SERVED 201 PATIENTS, IN 571 SESSIONS, REACHING FAMILIES FROM 20 TOWNS IN VT AND 8 TOWNS IN NH. THE STRENGTHENING FAMILIES NETWORK AND PROJECT LAUNCH HAVE COLLABORATED ON A DATA COLLECTION TOOLS FOR FACILITATORS TO COLLECT RESULT BASED ACCOUNTABILITY (RBA) MEASURES, INCLUDING QUESTIONS FOCUSED ON SOCIAL CONNECTEDNESS. WE INVESTED TIME AND EXPERTISE IN SUPPORTING ONGOING, WEEKLY PLAYGROUP CONNECTIONS AND MONTHLY CIRCLE OF SECURITY PARENTING SESSIONS, ONLINE AND IN PERSON. WE CONTINUE TO OFFER THE NATIONALLY RECOGNIZED DULCE PROGRAM, ENTERING THE 4TH YEAR WITH MT. ASCUTNEY PEDIATRICS. THERE ARE 99 FAMILIES ENGAGED IN THE DULCE ELEMENT OF PEDIATRICS. DULCE PARTNERS INCLUDE: THE VERMONT DEPARTMENT OF HEALTH, ONECARE VERMONT, TWO PARENT-CHILD CENTERS AND VERMONT LEGAL AID. ACCESS TO PRIMARY CARE ACCESS TO PRIMARY CARE EFFORTS, OUR #5 COMMUNITY HEALTH NEED, CONTINUED IN OUR 12TH YEAR AS A NCQA RECOGNIZED PATIENT CENTERED MEDICAL HOME. WE CONTINUE TO RECRUIT AND RETAIN PRIMARY CARE PROVIDERS. OUR COMMUNITY HEALTH TEAM CONTINUES TO PROVIDE CARE COORDINATION, EDUCATION, AND INTERVENTIONS TO IMPROVE THE QUALITY OF CARE AND ADDRESS THE SOCIAL DETERMINENTS OF HEALTH FOR CHRONIC CARE PATIENTS ACROSS THE CARE CONTINUUM. WE PROVIDED SELF-MANAGEMENT CARE TO PREVENT DISEASE, REDUCE COMPLICATIONS AND IMPROVE THE QUALITY OF LIFE FOR THOSE WITH CHRONIC CONDITIONS. QUALITY INITIATIVES IN 2022 INCLUDED DIABETES CARE, HYPERTENSION, SUBSTANCE USE DISORDER, AND DEPRESSION SCREENING. SENIOR HEALTH SENIOR HEALTH IS OUR #6 COMMUNITY HEALTH NEED. WITH MULTISECTOR REPRESENTATION, THIS COMMUNITY HEALTH IMPROVEMENT WORKGROUP BROUGHT TOGETHER ALL AREA AGING IN PLACE GROUPS, WIDELY DISEMINATED AGING IN PLACE BOOKS, AND LINED UP A SERIES OF INFORMATIONAL/EDUCATIONAL SESSIONS ON VARIOUS TOPICS. THIS GROUP ALSO DISTRIBUTED OVER 600 SENIOR HEALTH QUICK GUIDE MAGNETS WITHIN THE COMMUNITY. WE WORKED WITH SUPPORT AND SERVICES AT HOME (SASH) AND HOUSING AND SUPPORT SERVICES (HASS) TO PROVIDE CARE IN WINDSOR VILLAGE AND THE COMMUNITY FOR APPROXIMATELY 100 HIGH RISK ELDERS. THIS WORK INCLUDES STAFFING, CARE COORDINATION AND PROGRAM DEVELOPMENT. IN THE 2022 TAX YEAR WE WORKED WITH SEVCA TO PROVIDE TAX ASSISTANCE TO 86 AREA RESIDENTS AND HOSTED ADVANCE DIRECTIVE CLINICS IN TWO TOWNS. WE ALSO COORDINATE VOLUNTEERS IN ACTION (VIA) WHICH PROVIDES SERVICES FOR INDIVIDUALS WHO ARE OLDER AND/OR DISABLED (ESPECIALLY THOSE LACKING FAMILIAL SUPPORT CLOSE BY). MANY OF OUR SERVICES SUPPORT OPPORTUNITIES TO STAY AT HOME AND MAINTAIN INDEPENDENCE WHILE AGING. AFFORDABLE HOUSING AFFORDABLE HOUSING IS OUR #7 COMMUNITY HEALTH NEED. WE CONVENED A MULTISECTOR WORKGROUP, COMMUNITY HEALTH IMPLEMENTATION PLAN AFFORDABLE HOUSING, TO ADDRESS THE LACK OF AFFORDABLE HOMES IN OUR COMMUNITIES. IN 2022, A MULTISECTOR WORKGROUP CONTINUED TO PROMOTE VERMONT'S HOME SHARE PROGRAM. EDUCATION WAS DONE AMONG MEMBERS TO EXPAND THE PILOT HOMESHARE PROGRAM ESTABISHED IN 2021. DENTAL CARE DENTAL CARE IS THE #8 COMMUNITY HEALTH NEED, WHICH OUR COMMUNITY HEALTH TEAM AND WINDSOR COMMUNITY HEALTH CLINIC LINKED PATIENTS AND NEED WITH DENTAL HOMES. WITH THE HELP OF GENEROUS GRANTS AND DONATIONS, WE PROVIDED $6,918 IN DENTAL VOUCHERS TO ELIGIBLE PATIENTS. THROUGH GENEROUS DONATIONS FROM NORTHEAST DELTA DENTAL, MAHHC PROVIDED EDUCATION AND DENTAL SUPPLIES TO 220 FAMILIES AND ESTABLISHED A DENTAL HYGENIST IN THE AREA SCHOOLS WHO PROVIDED ASSESSMENTS TO 37 STUDENTS AND MADE FOLLOW UP PLANS FOR FLOURIDE APPLICATIONS FOR ELIGIBLE STUDENTS. FOOD SECURITY FOOD SECURITY WAS IDENTIFIED AS A PRIORITY WITHIN OUR COMMUNITY HEALTH IMPLEMENTATION PLAN. MEALS ON WHEELS WERE PROVIDED THROUGH VOLUNTEERS IN ACTION. OUR MEALS ON WHEELS VOLUNTEERS DELIVERED OVER 350 MEALS PER WEEK OVER AN ESTIMATED 18,000 TOTAL MILES COLLECTIVELY. THROUGHOUT THE ENTIRE PANDEMIC, OUR COURAGEOUS AND GENEROUS VOLUNTEERS HAVE CONTINUED TO BAG AND DELIVER MEALS ON WHEELS WITH NO INTERRUPTION IN SERVICE. WORKING WITH SENIOR SOLUTIONS, WE ORGANIZED AND WORKED WITH THE VERMONT FOOD BANK ON THE VEGGIEVANGO MONTHLY PROGRAM WHICH DISTRIBUTES FREE PRODUCE SERVING 3860 HOUSEHOLDS IN 2022. (Continued in Part VI of Schedule H)

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - Windsor Hospital Corporation. Patients whose family income exceeds 300% of FPL may be eligible to receive a discount based on the self-pay balance. Discounts will be granted such that the total self-pay bill does not exceed 10% of 2 years gross income, plus 10% of assets in excess of the sheltered asset calculation as described in the policy. Any discounts for patients whose family exceeds 300% of FPL must be approved by the financial assistance appeals committee based on a written appeal from the patient or responsible party.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - Windsor Hospital Corporation. MAHHC applies a discount, calculated annually, to the FAP eligible patient's gross charges and balances where there is no insurance, or to medically necessary services processed by insurance carriers resulting in a balance, which the patient is expected to pay. This assures a patient is not billed at an amount greater than generally billed to patients with insurance. This policy is reference in the Financial Assistance for Healthcare Services policy (FAP).

Schedule H, Part V, Section B, Line 16 Facility , 1
Facility , 1 - Windsor Hospital Corporation. THE FINANCIAL ASSISTANCE POLICY IS POSTED ON MAHHC'S WEBSITE, INCLUDING THE VERBATIM POLICY AND A SHORTER, MORE PATIENT-FRIENDLY PLAIN-LANGUAGE SUMMARY. MAHHC PROVIDES THE PLAIN-LANGUAGE SUMMARY BROCHURE TO ALL INPATIENTS, EMERGENCY DEPARTMENT INTAKES, UNINSURED, AND SELF-PAY INDIVIDUALS. MAHHC CONTINUES TO NOTIFY PATIENTS ON THE BACK OF THE BILLING STATEMENT ABOUT FINANCIAL ASSISTANCE AVAILABLE TO THEM. ADDITIONALLY, MAHHC POSTS INFORMATION ABOUT THE POLICY IN PUBLIC AREAS THROUGHOUT THE FACILITIES INCLUDING ADMISSION OFFICES, PUBLIC AREA BOARDS THROUGHOUT THE FACILITIES, THE EMERGENCY ROOMS, AND FINANCIAL ASSISTANCE POLICY BROCHURES IN PATIENT AREAS. MAHHC SCREENS 100% OF UNINSURED INPATIENT AND SAME-DAY PATIENTS PRIOR TO ADMISSION. AS PART OF THIS PROCESS, MAHHC CHECKS ALL STATE AND FEDERAL PROGRAMS TO SEE IF INDIVIDUALS ARE ELIGIBLE FOR ASSISTANCE. PATIENTS ARE ALSO SCREENED TO DETERMINE QUALIFICATION FOR FINANCIAL ASSISTANCE AND THE APPLICATION IS PROVIDED AND/OR COMPLETED AT THIS TIME.

Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT
THE STATE OF VERMONT DOES NOT ADMINISTER ANY COMMUNITY BENEFIT REPORTING REGULATIONS.

Schedule H, Part V, Section B, Line 11 ADDRESSING NEEDS IDENTIFIED IN CHNA
(Continued from Schedule H, Part V, Line 11, Section C) THE FOOD SECURITY CHIP WORKGROUP WORKS TO INCREASE ACCESS TO FOOD FOR PEOPLE IN THE COMMUNITY. THEY CONDUCTED A FOOD SECURITY GAP ASSESSMENT VIA A GIS MAPPING PROJECT, ESTABLISHED NON-STIGMATIZING SOCIAL MEDIA CAMPAIGNS, AND CREATED A WEBSITE FOR AREA FOOD RESOURCES. THEY ALSO HELPED TO ORGANIZE AND COORDINATE THE SUMMER MEALS PROGRAM WITH AREA SCHOOL SYSTEMS RUNNING FEDERAL MEAL PROGRAMS. THIS WORKGROUP IS ABLE TO EXPAND THE SUMMER MEALS PROGRAM ACROSS MORE WEEKS AND TO MORE FAMILIES. ACCESS TO TRANSPORTATION VOLUNTEER TRANSPORTATION IN 2O22 RESULTED IN OVER 1,000 VOLUNTEER RIDES, DRIVING 13,000 MILES. THE RIDES TO WELLNESS PROGRAM ALSO PROVIDED 3,355 MILES OF RIDES IN THE YEAR.

Schedule H, Part I, Line 7g Subsidized Health Services
The organization did not include any subsidized health service costs attributable to a physician clinic on part I, line 7G.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
0

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
A cost-to-charge ratio is used in calculating the amounts in lines 7a. A cost accounting system which addresses all patients' segments was used to calculate the amounts reported in the table for all other lines. There is no amount of bad debt included in line 7.

Schedule H, Part II Community Building Activities
THE COMMUNITY BUILDING ACTIVITIES INCLUDE COLLABORATIONS WITH VARIOUS LOCAL AGENCIES SUCH AS THE HOUSING COMMUNITY HEALTH IMPROVEMENT PLAN WORKGROUP AND THE WINDSOR IMPROVEMENT CORPORATION TO IMPROVE THE HEALTH OF THE PEOPLE IN THE AREAS THAT MAHHC SERVES.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
AS A RESULT OF NEW ACCOUNTING GUIDANCE (STATEMENT 15 AND ASC 606), EFFECTIVE FY21 BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDED AS A REDUCTION IN NET PATIENT REVENUE.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
Bad Debt is no longer treated as an expense effective FY21 as a result of new accounting guidance (Statement 15 and ASC 606). As a result, an amount attributable to patients eligible under the organization's financial assistance policy is unable to be reasonably estimated.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
AS A RESULT OF ACCOUNTING CHANGES (ASC 606), BAD DEBT IS NO LONGER AN EXPENSE, BUT IS INCLUDE AS A REDUCTION IN NET PATIENT REVENUE. THEREFORE, THERE IS NO SEPARATE FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
The shortfall represents the PPS reimbursement difference of the rehab units. Since the reimbursement does not cover the costs of these units, a subsidy is created. Because the hospital determined that these services are important to the service area, the hospital covers the subsidy. The costing methodology used in the calculation was the cost to charge ratio.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
MAHHC's collection policy and charitable care policies are consistently applied to all patients. Our collection policy applies to any balance owed by the patient whether it is a balance after insurance, a balance with no insurance, or a balance after an adjustment for partial charitable care. Statements and write-off criteria are the same for all like balances, regardless of the reason for the balance and regardless of whether it is a balance after charitable care or not. Patients for financial assistance receive the appropriate adjustment on their bill. If a balance remains after that adjustment, they are billed according to the collection policy for it.

Schedule H, Part V, Section B, Line 16a FAP website
- Windsor Hospital Corporation: Line 16a URL: https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- Windsor Hospital Corporation: Line 16b URL: https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- Windsor Hospital Corporation: Line 16c URL: https://www.mtascutneyhospital.org/your-visit/billing-and-financial-assistance;

Schedule H, Part VI, Line 2 Needs assessment
IN THE FIRST HALF OF 2021 A COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED BY MT. ASCUTNEY HOSPITAL AND HEALTH CENTER IN PARTNERSHIP WITH DARTMOUTH-HITCHCOCK, ALICE PECK DAY MEMORIAL HOSPITAL, VALLEY REGIONAL HEALTH CARE, NEW LONDON HOSPITAL, VISITING NURSE AND HOSPICE OF VERMONT AND NEW HAMPSHIRE, AND THE JOHN SNOW INSTITUTE. THE PURPOSE OF THE ASSESSMENT WAS TO IDENTIFY COMMUNITY HEALTH NEEDS, PRIORITIES AND OPPORTUNITIES FOR COMMUNITY HEALTH AND HEALTH CARE DELIVERY SYSTEM IMPROVEMENT. FOR THE PURPOSE OF THE ASSESSMENT THE GEOGRAPHIC AREA FOR MT. ASCUTNEY HOSPITAL AND HEALTH CENTER WAS 13 MUNICIPALITIES IN VERMONT AND NEW HAMPSHIRE WITH A TOTAL RESIDENT POPULATION OF 44,035 PEOPLE. METHODS EMPLOYED IN THE ASSESSMENT INCLUDED SURVEYS OF COMMUNITY RESIDENTS MADE AVAILABLE ONLINE AND ON PAPER PLACED IN NUMEROUS LOCATIONS THROUGHOUT THE REGION. WE DID A DIRECT EMAIL SURVEY OF KEY STAKEHOLDERS AND COMMUNITY LEADERS REPRESENTING MULTIPLE COMMUNITY SECTORS. WE ORGANIZED AND DELIVERED A SET OF COMMUNITY DISCUSSION GROUPS. WE COMPILED THE RESULTS FROM THE ASSESSMENT ACTIVITIES AND FOCUSED SPECIFICALLY ON BEHAVIORAL HEALTH NEEDS AND GAPS AND A REVIEW OF POPULATION DEMOGRAPHICS AND HEALTH STATUS INDICATORS. ALL INFORMATION FROM THE COLLECTIVE ACTIVITIES WERE ANALYZED TO PRODUCE THE ASSESSMENT WHICH LEAD US IN FOCUSING OUR WORK TO SERVE VULNERABLE AND DISPROPORTIONALLY SERVED POPULATIONS IN THE REGION INCLUDING POPULATIONS THAT EXPERIENCE LIMITED HEALTHCARE TO HEALTH-RELATED SERVICES OR RESOURCES DUE TO INCOME, AGE, DISABILITY AND SOCIAL OR PHYSICAL ISOLATION. IN ADDITION, THE MAHHC COMMUNITY HEALTH STAFF PARTICIPATE IN OR LEAD MULTIPLE COMMUNITY COALITIONS AND PROJECTS CONNECTING US TO A WIDE ARRAY OF COMMUNITY-BASED HEALTH, MUNICIPAL, SCHOOL, SERVICE ORGANIZATION, REGIONAL PLANNING AND STATE PUBLIC HEALTH STAKEHOLDERS. WE REGULARLY REVIEW EMERGING VT STATE HEALTH DATA; QUANTITATIVE AND QUALITATIVE DATA FROM LOCAL SOURCES (NEWSPAPERS, REGIONAL PLANNING OFFICES, COMMUNITY FORUMS), AND CONVERSATIONS WITH COMMUNITY PARTNERS TO IDENTIFY CONCERNS THAT ARE EMERGING, INTENSIFYING, OR ARE THE SOURCE OF LOCAL ATTENTION SINCE THE LAST CHNA WAS CONDUCTED.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
PATIENTS WHO ARE IDENTIFIED AS WITHOUT INSURANCE AT REGISTRATION OR REFERRED TO BY A PHYSICIAN/PROVIDER ARE PROVIDED WITH INFORMATION AS TO AVAILABLE LOCAL, STATE AND FEDERAL SERVICES BY DEDICATED STAFF. PATIENTS ARE ALSO ASSISTED IN APPLYING FOR HEALTH INSURANCE, WHETHER ON THE COMMERCIAL EXCHANGE OR WITH GOVERNMENTAL INSURERS. INFORMATION AND THE APPLICATION FOR FINANCIAL ASSISTANCE IS PROVIDED, ALONG WITH ASSISTANCE IN COMPLETING THE APPLICATION IF NEEDED. THE APPLICATIONS ARE REVIEWED TO ASSURE THAT ALL REQUIRED INFORMATION IS PROVIDED. THE WEBSITE, PATIENT STATEMENTS, AND FINANCIAL BROCHURES ALL INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE AND HOW TO APPLY.

Schedule H, Part VI, Line 4 Community information
MAHHC'S PRIMARY SERVICE AREA INCLUDES BRIDGEWATER, BROWNSVILLE, HARTLAND, READING, WEATHERSFIELD, WINDSOR, AND WOODSTOCK (VT) AS WELL AS CLAREMONT, CORNISH, AND PLAINFIELD (NH). MAHHC IS THE LARGEST EMPLOYER IN THE TOWN OF WINDSOR, WITH MANY OF ITS RESIDENTS HAVING LOWER THAN AVERAGE PAYING JOBS AND WHO STRUGGLE WITH FINANCIAL STABILITY, WHICH INCLUDES TRANSPORTATION DIFFICULTIES.

Schedule H, Part VI, Line 5 Promotion of community health
THE HOSPITAL SUPPORTS A DIRECTOR OF COMMUNITY HEALTH, THE MT. ASCUTNEY PREVENTION PROGRAM (MAPP) AND A COMMUNITY HEALTH COMMITTEE WHICH IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES. OUR STAFF CONTINUE TO ORGANIZE, LEAD AND IMPLEMENT POPULATION HEALTH PROGRAMS, HEALTH PROMOTION AND PREVENTION PROGRAMS THAT ADDRESS HIGH RISK BEHAVIOR SUCH AS ALCOHOL, TOBACCO AND DRUG MISUSE. WE PROMOTE EXERCISE AND NUTRITION PROGRAMS. WE ORGANIZED AND IMPLEMENTED THE COMMUNITY HEALTH IMPLEMENTATION PLAN. WE SERVE AS AN INTEGRATOR AND LEADER OF COMMUNITY HEALTH BY CHAIRING AND LEADING THE FOLLOWING COMMUNITY COLLABORATIONS; THE WINDSOR HSA COMMUNITY COLLABORATIVE, THE WINDSOR PATCH TEAM, THE BLUEPRINT FOR HEALTH CARE COORDINATION TEAM, THE 6 MULTISECTOR WORK GROUPS RESULTING FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT. More than half of the MAHHC Board of Trustees are independent of the organization and the Dartmouth-Health system and reside within the community service area, supporting the health of the local communities. MAHHC EXTENDS PROFESSIONAL STAFF PRIVILEGES TO QUALIFIED AND APPROPRIATE PHYSICIANS AND ALLIED MIDLEVEL PROVIDERS. THIS INCLUDES PHYSICIANS AND MIDLEVEL WHO ARE EMPLOYEES OF DARTMOUTH HITCHCOCK CLINIC, MARY HITCHCOCK MEMORIAL HOSPITAL, AND DARTMOUTH COLLEGE, WHO ALSO MAY HOLD A FACULTY APPOINTMENT AT GEISEL SCHOOL OF MEDICINE. IN ADDITION TO DH-RELATED PHYSICIANS AND MIDLEVEL PROVIDERS, MAHHC EXTENDS PRIVILEGES TO QUALIFIED AND APPROPRIATE PHYSICIANS AND MIDLEVEL PROVIDERS WHO ARE EMPLOYED BY MT. ASCUTNEY HOSPITAL AND HEALTH CENTER AND OTHER QUALIFIED AND APPROPRIATE INDEPENDENT PRACTITIONERS.

Schedule H, Part VI, Line 6 Affiliated health care system
THE HOSPITAL'S DIRECTOR OF COMMUNITY HEALTH IS AN ACTIVE PARTICIPANT IN THE REGIONAL COMMUNITY HEALTH COMMITTEE WHICH IS LEAD AND ORGANIZED BY DARTMOUTH-HITCHCOCK. THE HOSPITAL IS AFFILIATED, FORMALLY, WITH DARTMOUTH-HITCHCOCK AS ARE THE OTHER LOCAL HOSPITALS, ALICE PECK DAY MEMORIAL HOSPITAL, NEW LONDON HOSPITAL, AND VALLEY REGIONAL HOSPITAL. THESE HOSPITAL REPRESENTATIVES COLLABORATE AND COMPARE SOLUTIONS AND OFFER SUPPORT TO EACH OTHER IN OUR COMMUNITY HEALTH PROGRAMS.