4A (Expenses $ 1514107967 including grants of $ 1837084) (Revenue $ 1872046034)
General hospital, Long-Term Care and physician services provided to the community: 2,624,350 persons were benefited in 2021 with quantifiable community benefits of $79,491,990.

Riverside Rehabilitation Hospital
"Line 3E: The significant health needs of the community identified in the CNHA are prioritized according to the community needs. Line 5: As described in the CHNA, Riverside conducted a community survey between June 2018 and May 2019 to obtain input for the Community Health Needs Assessment. In partnership with other regional healthcare systems, the Peninsula Community Health Collaborative, non-profit organizations, and the Virginia Department of Health conducted a joint survey utilizing SurveyMonkey. There were two versions of the survey: one for community members which was distributed on each system's website, social media outlets and community meetings; and one for community, medical and public health leaders which was emailed to an identified list of key stakeholders jointly from all of the health systems under the signature of the Medical Director of the Peninsula Health District of the Virginia Department of Health. The specific list of organization affiliations can be found in Appendix A of the CHNA. In addition to the survey, multiple public health sources were consulted in the assembly of the needs assessment. These included CDC's WONDER database, Virginia Department of Health statistics, Virginia Health Information, Urban Institute for the Virginia Health Care Foundation, American Community Survey and the US Health Resources and Service Administration. Line 7A: https://www.riversideonline.com/about/community/community-health-needs-ass essments Line 7D: In addition to the website and the hardcopy available at the facility the report was also mailed to several community leaders. Line 10a: https://www.riversideonline.com/about_riverside/Community/community-health -needs-assessment.cfm LINE 11 BEHAVIORAL/MENTAL HEALTH AND SUBSTANCE ABUSE: AS NATIONAL STATISTICS HAVE SHOWN, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE HAVE BECOME INCREASINGLY IMPORTANT AS THE NUMBER OF INDIVIDUALS SUFFERING WITH THESE ISSUES HAS GROWN THROUGHOUT THE PANDEMIC. RIVERSIDE HAS INCREASED ITS FOCUS ON GROWING THE PROGRAMS AVAILABLE TO SUPPORT INDIVIDUALS FACING BEHAVIORAL HEALTH AND SUBSTANCE ABUSE ISSUES. IN SEPTEMBER 2021, RIVERSIDE CONTINUED TO GROW BY ADDING ITS INTENSIVE OUTPATIENT PROGRAM TO TREAT ADDICTION. WORK WAS ALSO DONE IN 2021 TO PREPARE FOR THE 2022 OPENING OF THE PARTIAL HOSPITALIZATION PROGRAM. FOOD INSECURITIES: FOOD INSECURITY CONTINUED TO BE A SIGNIFICANT PROBLEM IN THE REGION AS THE PANDEMIC ENTERED ITS SECOND YEAR. RIVERSIDE CONTINUED ITS EFFORTS WITH THE HEALTHY FOOD BOX PROGRAM AT RIVERSIDE BRENTWOOD WHERE INDIVIDUALS WITH DIABETES WHO WERE FOOD INSECURE WERE GIVEN ACCESS TO HEALTHY FOOD BOXES AND HEALTH COACHING. THE PROGRAM CONTINUED TO BE A SUCCESS AND HAS SERVED AS A MODEL FOR A SECOND PROGRAM TO BE ROLLED OUT AT THE 25TH STREET CLINIC IN 2022 AS PART OF AN INCREASING FOCUS ON ""FOOD AS MEDICINE."" ADDITIONALLY, RIVERSIDE CONTINUED TO PARTNER WITH THE LOCAL FOODBANK FOR FOOD DRIVES AS WELL AS INDIVIDUAL PRACTICES HOSTING LOCAL DRIVES TO HELP INDIVIDUAL PATIENTS DIRECTLY. HEALTH INSURANCE COVERAGE/ACCESS TO CARE: 2021 HAD TWO AREAS OF FOCUS FOR THIS ISSUE AT RIVERSIDE. FIRST, RIVERSIDE CONTINUED TO PUSH OUT MESSAGES ABOUT CONTINUING TO RECEIVE PREVENTATIVE HEALTH CARE (SUCH AS ANNUAL PHYSICALS OR ANNUAL WELLNESS VISITS) AS WELL AS SCREENINGS (SUCH AS MAMMOGRAPHY AND COLONOSCOPY) AS SO MANY INDIVIDUALS DELAYED THESE CRITICAL SERVICES DURING 2020. ADDITIONALLY, RIVERSIDE CREATED ITS RIVERSIDE MEDICARE ADVANTAGE COMPLETE PLAN THAT OPENED FOR ENROLLMENT IN OCTOBER 2021. RIVERSIDE FELT THE PROGRAM WAS AN IMPORTANT WAY TO BRING PEOPLE THE ADDITIONAL HEALTH COVERAGE THEY NEEDED FOR LESS OUT OF POCKET COSTS. ADDITIONALLY, THROUGH OUR NETWORK OF CARE WE COULD PROVIDE A BETTER HEALTH CARE EXPERIENCE THOUGH MORE COORDINATION AND FACETIME WITH THE PROVIDERS. NEOPLASMS OF THE LUNG: IN 2021 RIVERSIDE CONTINUED TO PROMOTE THE IMPORTANCE OF LOW DOSE CT LUNG CANCER SCREENING AS AN IMPORTANT TOOL IN DIAGNOSING LUNG CANCER EARLY SO IT IS MORE EASILY TREATED. RIVERSIDE INVESTED IN PATIENT TESTIMONIAL VIDEOS SO INDIVIDUALS WHO HAD CAUGHT AN EARLY-STAGE CANCER WITH THE LOW DOSE CT SCREENING COULD SHARE THEIR STORIES AND HELP INSPIRE OTHERS TO BE SCREENED. ADDITIONALLY, IN NOVEMBER (NATIONAL LUNG CANCER AWARENESS MONTH AND THE DATE OF THE GREAT AMERICAN SMOKEOUT), RIVERSIDE WORKED CLOSELY WITH PROVIDERS FROM MULTIPLE SPECIALTIES TO SHARE EDUCATION ABOUT THE MULTITUDE OF BENEFITS FROM QUITTING SMOKING. MATERNAL AND INFANT CARE: WITH ITS ADVANCED L&D CAPABILITIES AND THE SPECIAL CARE NURSERY, RIVERSIDE CONTINUED TO PROVIDE A SAFE AND HEALTHY START TO OUR NEWEST AND YOUNGEST COMMUNITY MEMBERS IN 2021. IN ADDITION TO THE CLINICAL OFFERINGS, RIVERSIDE CONTINUED ITS FOCUS ON COMMUNITY EDUCATION TO SUPPORT NEW FAMILIES IN THEIR LIVES TOGETHER. SPECIFICALLY, RIVERSIDE HOSTED BREASTFEEDING EDUCATION CLASSES, LACTATION SUPPORT, NEW PARENT CLASSES, INFANT CPR, BIG BROTHER/BIG SISTER AND OTHER EDUCATION TO HELP ENSURE FAMILIES ARE STARTING OFF ON THE RIGHT FOOT. IN 2021 A SPECIAL FOCUS WAS COMMUNITY HEALTH EDUCATION ON HEALTHY SLEEPING FOR PARENTS AND NEW BABIES. COLON CANCER: RIVERSIDE CONTINUED TO FOCUS ON THE IMPORTANCE OF SCREENING AND EARLY DIAGNOSIS FOR COLON CANCER AND PUSHED MESSAGES AROUND DIFFERENT TYPES OF SCREENINGS, INCLUDING COLONOSCOPY, FIT AND STOOL DNA TESTING. THE LATTER HALF OF 2021 WAS FOCUSED ON DEVELOPING COLON CANCER AWARENESS MONTH FOR 2022 WHICH HAD AN ADDITIONAL FOCUS ON REACHING MINORITY PATIENTS. ALSO, IN 2021 RIVERSIDE ADDED AN ADDITIONAL GASTROENTEROLOGIST TO HELP INCREASE CAPACITY IN THIS AREA. AGING SERVICES FOCUSED ON ALZHEIMER'S AND DEMENTIA: LEAD BY OUR CENTER FOR EXCELLENCE IN AGING AND LIFELONG HEALTH, RIVERSIDE CONTINUES TO OFFER LEADERSHIP AT A NATIONAL LEVEL FOR THE IMPORTANCE OF CARING FOR MEMORY CARE PATIENTS AND THEIR CAREGIVERS. WITH PROGRAMS SUCH AS CAREGIVER COMMONS, CARE TO PLAN, CARING FOR YOU LESSONS, MEMORY CAF AND OUR SENIOR CARE NAVIGATORS, RIVERSIDE STANDS READY TO PROVIDE SUPPORT AND ASSISTANCE TO THE DEDICATED INDIVIDUALS CARING FOR THEIR LOVED ONES. RIVERSIDE HAS ALSO FORMED OUTSTANDING CONNECTIONS WITH NATIONAL PROGRAMS SUCH AS THE ROSALYNN CARTER INSTITUTE FOR CAREGIVING AND THE FAMILY CAREGIVER ALLIANCE TO HELP FAMILIES. THESE PROGRAMS ARE IN ADDITION TO OUR SENIOR LIVING OPTIONS FOR INDIVIDUALS WITH ADVANCED MEMORY ISSUES AS WELL AS IN ADDITION TO OUR OUTSTANDING CLINICIANS AT THE RIVERSIDE NEUROLOGICAL AND SPINE INSTITUTE. IN 2021 RIVERSIDE CONTINUED TO RECRUIT TALENTED CLINICIANS TO JOIN THE TEAM AND SERVE OUR COMMUNITY. IN ADDITION TO THE IDENTIFIED NEEDS FROM THE CHNA, THE CARE OF OUR COMMUNITY THROUGH THE COVID-19 PANDEMIC CONTINUED TO BE OUR TOP FOCUS THROUGHOUT 2021. SPECIFICALLY, BETWEEN DECEMBER 16TH, 2020 (OUR FIRST DATE OF VACCINE GIVEN) TO DEC. 16TH, 2021, RIVERSIDE HEALTH SYSTEM WAS ABLE TO VACCINATE OVER 100,000 INDIVIDUALS WITH OVER 225,000 INDIVIDUAL DOSES. OUR COMMUNITY CLINICS, CLINICAL LEADERSHIP AND REFINED SUPPLY CHAIN SYSTEM WAS ABLE TO OBTAIN, STORE AND DISTRIBUTE THE VACCINES TO OUR COMMUNITIES, FOR WHICH RIVERSIDE IS EXTREMELY PROUD. THE COMMUNITY LEADERSHIP WAS SUCH THAT MULTIPLE RIVERSIDE PHARMACISTS WERE HONORED AT A STATE LEVEL FOR THEIR CONTRIBUTIONS DURING THE PANDEMIC. THE ITEMS DETERMINED TO NOT BE THE HIGHEST PRIORITIES INCLUDED FOR THE CHNA ARE NOTED BELOW. ITEMS ON THE LIST MAY BE ALREADY BEING ADDRESSED THROUGH OTHER RIVERSIDE PROGRAMS, SUCH AS HEART DISEASE, SMOKING CESSATION PROGRAMS, CHRONIC PAIN, SMOKING, RESPIRATORY CARE, DOMESTIC VIOLENCE, AND REPRODUCTIVE HEALTH. SOME ISSUES WERE OUTSIDE OF THE AREA OF EXPERTISE OF THE HEALTH SYSTEM, SUCH AS THE FOSTER CARE SYSTEM. ITEMS SUCH AS INFANT MORTALITY ARE IMPORTANT, BUT NOT NECESSARILY AN ITEM THAT COULD BE IMPACTED SIGNIFICANTLY BY THE HEALTH SYSTEM IN A THREE-YEAR PERIOD AND INSTEAD WILL BE ADDRESSED THROUGH OUR CONTINUED PRE- AND POST-NATAL CARE PROGRAMS. OTHER ITEMS NOT RANKED AS TOP HEALTH PROBLEMS THROUGH EITHER THE QUALITATIVE OR QUANTITATIVE DATA ASSESSMENTS INCLUDED: ENVIRONMENTAL HEALTH, DROWNING/WATER SAFETY, AUTISM, HIV/AIDS, DENTAL/ORAL CARE, NEUROLOGICAL PROBLEMS, ARTHRITIS, RENAL DISEASE, ORTHOPEDIC PROBLEMS, SEXUALLY TRANSMITTED INFECTIONS, PHYSICAL DISABILITIES, AND BULLYING. Line 16A: WWW.RIVERSIDE-REHABILITATION.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANC IAL-ASSISTANCE/ Line 16B: WWW.RIVERSIDE-REHABILITATION.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANC IAL-ASSISTANCE/ Line 16C: WWW.RIVERSIDE-REHABILITATION.COM/PATIENTS-AND-CAREGIVERS/ADMISSIONS/FINANC IAL-ASSISTANCE/ Line 20b. While the hospital facility made reasonable efforts to orally notify all individuals about the FAP and FAP application process, this may not have been uniformly performed for 100% of the patients receiving treatment despite the hospital's best efforts. LINE 20D: PRESUMPTIVE ELIGIBILITY IS NOT USED. DUE TO THE LIMITED NUMBER OF PATIENTS AND APPLICANTS FOR FINANCIAL ASSISTANCE, PERSONNEL WORK WITH PATIENTS TO COMPLETE THE APP"

Select Specialty Hospital-Hampton Roads
"LINE 3E. THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CNHA ARE PRIORITIZED ACCORDING TO THE COMMUNITY NEEDS. LINE 5: AS DESCRIBED IN THE CHNA, RIVERSIDE CONDUCTED A COMMUNITY SURVEY BETWEEN JUNE 2018 TO MAY 2019 TO OBTAIN INPUT FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. IN PARTNERSHIP WITH OTHER REGIONAL HEALTHCARE SYSTEMS, THE PENINSULA COMMUNITY HEALTH COLLABORATIVE, NON-PROFIT ORGANIZATIONS, AND THE VIRGINIA DEPARTMENT OF HEALTH CONDUCTED A JOINT SURVEY UTILIZING SURVEYMONKEY. THERE WERE TWO VERSIONS OF THE SURVEY: ONE FOR COMMUNITY MEMBERS WHICH WAS DISTRIBUTED ON EACH SYSTEM'S WEBSITE, SOCIAL MEDIA OUTLETS AND COMMUNITY MEETINGS; AND ONE FOR COMMUNITY, MEDICAL AND PUBLIC HEALTH LEADERS WHICH WAS EMAILED TO AN IDENTIFIED LIST OF KEY STAKEHOLDERS JOINTLY FROM ALL OF THE HEALTH SYSTEMS UNDER THE SIGNATURE OF THE MEDICAL DIRECTOR OF THE PENINSULA HEALTH DISTRICT OF THE VIRGINIA DEPARTMENT OF HEALTH. THE SPECIFIC LIST OF ORGANIZATION AFFILIATIONS CAN BE FOUND IN APPENDIX A OF THE CHNA. IN ADDITION TO THE SURVEY, MULTIPLE PUBLIC HEALTH SOURCES WERE CONSULTED IN THE ASSEMBLY OF THE NEEDS ASSESSMENT. THESE INCLUDED CDC'S WONDER DATABASE, VIRGINIA DEPARTMENT OF HEALTH STATISTICS, VIRGINIA HEALTH INFORMATION, URBAN INSTITUTE FOR THE VIRGINIA HEALTH CARE FOUNDATION, AMERICAN COMMUNITY SURVEY AND THE US HEALTH RESOURCES AND SERVICE ADMINISTRATION. LINE 7 A: HTTPS://RESOURCES.SELECTMEDICAL.COM/COMMUNICATIONS/SELECT-SPECIALTY-HOSPIT AL-HAMPTON-ROADS/2019-CHNA-SSH-HAMPTON-ROADS.PDF LINE 7D: IN ADDITION TO THE WEBSITE AND THE HARDCOPY AVAILABLE AT THE FACILITY THE REPORT WAS ALSO MAILED TO SEVERAL COMMUNITY LEADERS. LINE 10A: HTTPS://RESOURCES.SELECTMEDICAL.COM/COMMUNICATIONS/SELECT-SPECIALTY-HOSPIT AL-HAMPTON-ROADS/2019-CHNA-SSH-HAMPTON-ROADS.PDF LINE 11 BEHAVIORAL/MENTAL HEALTH AND SUBSTANCE ABUSE: AS NATIONAL STATISTICS HAVE SHOWN, BEHAVIORAL HEALTH AND SUBSTANCE ABUSE HAVE BECOME INCREASINGLY IMPORTANT AS THE NUMBER OF INDIVIDUALS SUFFERING WITH THESE ISSUES HAS GROWN THROUGHOUT THE PANDEMIC. RIVERSIDE HAS INCREASED ITS FOCUS ON GROWING THE PROGRAMS AVAILABLE TO SUPPORT INDIVIDUALS FACING BEHAVIORAL HEALTH AND SUBSTANCE ABUSE ISSUES. IN SEPTEMBER 2021, RIVERSIDE CONTINUED TO GROW BY ADDING ITS INTENSIVE OUTPATIENT PROGRAM TO TREAT ADDICTION. WORK WAS ALSO DONE IN 2021 TO PREPARE FOR THE 2022 OPENING OF THE PARTIAL HOSPITALIZATION PROGRAM. FOOD INSECURITIES: FOOD INSECURITY CONTINUED TO BE A SIGNIFICANT PROBLEM IN THE REGION AS THE PANDEMIC ENTERED ITS SECOND YEAR. RIVERSIDE CONTINUED ITS EFFORTS WITH THE HEALTHY FOOD BOX PROGRAM AT RIVERSIDE BRENTWOOD WHERE INDIVIDUALS WITH DIABETES WHO WERE FOOD INSECURE WERE GIVEN ACCESS TO HEALTHY FOOD BOXES AND HEALTH COACHING. THE PROGRAM CONTINUED TO BE A SUCCESS AND HAS SERVED AS A MODEL FOR A SECOND PROGRAM TO BE ROLLED OUT AT THE 25TH STREET CLINIC IN 2022 AS PART OF AN INCREASING FOCUS ON ""FOOD AS MEDICINE."" ADDITIONALLY, RIVERSIDE CONTINUED TO PARTNER WITH THE LOCAL FOODBANK FOR FOOD DRIVES AS WELL AS INDIVIDUAL PRACTICES HOSTING LOCAL DRIVES TO HELP INDIVIDUAL PATIENTS DIRECTLY. HEALTH INSURANCE COVERAGE/ACCESS TO CARE: 2021 HAD TWO AREAS OF FOCUS FOR THIS ISSUE AT RIVERSIDE. FIRST, RIVERSIDE CONTINUED TO PUSH OUT MESSAGES ABOUT CONTINUING TO RECEIVE PREVENTATIVE HEALTH CARE (SUCH AS ANNUAL PHYSICALS OR ANNUAL WELLNESS VISITS) AS WELL AS SCREENINGS (SUCH AS MAMMOGRAPHY AND COLONOSCOPY) AS SO MANY INDIVIDUALS DELAYED THESE CRITICAL SERVICES DURING 2020. ADDITIONALLY, RIVERSIDE CREATED ITS RIVERSIDE MEDICARE ADVANTAGE COMPLETE PLAN THAT OPENED FOR ENROLLMENT IN OCTOBER 2021. RIVERSIDE FELT THE PROGRAM WAS AN IMPORTANT WAY TO BRING PEOPLE THE ADDITIONAL HEALTH COVERAGE THEY NEEDED FOR LESS OUT OF POCKET COSTS. ADDITIONALLY, THROUGH OUR NETWORK OF CARE WE COULD PROVIDE A BETTER HEALTH CARE EXPERIENCE THOUGH MORE COORDINATION AND FACETIME WITH THE PROVIDERS. NEOPLASMS OF THE LUNG: IN 2021 RIVERSIDE CONTINUED TO PROMOTE THE IMPORTANCE OF LOW DOSE CT LUNG CANCER SCREENING AS AN IMPORTANT TOOL IN DIAGNOSING LUNG CANCER EARLY SO IT IS MORE EASILY TREATED. RIVERSIDE INVESTED IN PATIENT TESTIMONIAL VIDEOS SO INDIVIDUALS WHO HAD CAUGHT AN EARLY-STAGE CANCER WITH THE LOW DOSE CT SCREENING COULD SHARE THEIR STORIES AND HELP INSPIRE OTHERS TO BE SCREENED. ADDITIONALLY, IN NOVEMBER (NATIONAL LUNG CANCER AWARENESS MONTH AND THE DATE OF THE GREAT AMERICAN SMOKEOUT), RIVERSIDE WORKED CLOSELY WITH PROVIDERS FROM MULTIPLE SPECIALTIES TO SHARE EDUCATION ABOUT THE MULTITUDE OF BENEFITS FROM QUITTING SMOKING. MATERNAL AND INFANT CARE: WITH ITS ADVANCED L&D CAPABILITIES AND THE SPECIAL CARE NURSERY, RIVERSIDE CONTINUED TO PROVIDE A SAFE AND HEALTHY START TO OUR NEWEST AND YOUNGEST COMMUNITY MEMBERS IN 2021. IN ADDITION TO THE CLINICAL OFFERINGS, RIVERSIDE CONTINUED ITS FOCUS ON COMMUNITY EDUCATION TO SUPPORT NEW FAMILIES IN THEIR LIVES TOGETHER. SPECIFICALLY, RIVERSIDE HOSTED BREASTFEEDING EDUCATION CLASSES, LACTATION SUPPORT, NEW PARENT CLASSES, INFANT CPR, BIG BROTHER/BIG SISTER AND OTHER EDUCATION TO HELP ENSURE FAMILIES ARE STARTING OFF ON THE RIGHT FOOT. IN 2021 A SPECIAL FOCUS WAS COMMUNITY HEALTH EDUCATION ON HEALTHY SLEEPING FOR PARENTS AND NEW BABIES. COLON CANCER: RIVERSIDE CONTINUED TO FOCUS ON THE IMPORTANCE OF SCREENING AND EARLY DIAGNOSIS FOR COLON CANCER AND PUSHED MESSAGES AROUND DIFFERENT TYPES OF SCREENINGS, INCLUDING COLONOSCOPY, FIT AND STOOL DNA TESTING. THE LATTER HALF OF 2021 WAS FOCUSED ON DEVELOPING COLON CANCER AWARENESS MONTH FOR 2022 WHICH HAD AN ADDITIONAL FOCUS ON REACHING MINORITY PATIENTS. ALSO, IN 2021 RIVERSIDE ADDED AN ADDITIONAL GASTROENTEROLOGIST TO HELP INCREASE CAPACITY IN THIS AREA. AGING SERVICES FOCUSED ON ALZHEIMER'S AND DEMENTIA: LEAD BY OUR CENTER FOR EXCELLENCE IN AGING AND LIFELONG HEALTH, RIVERSIDE CONTINUES TO OFFER LEADERSHIP AT A NATIONAL LEVEL FOR THE IMPORTANCE OF CARING FOR MEMORY CARE PATIENTS AND THEIR CAREGIVERS. WITH PROGRAMS SUCH AS CAREGIVER COMMONS, CARE TO PLAN, CARING FOR YOU LESSONS, MEMORY CAF AND OUR SENIOR CARE NAVIGATORS, RIVERSIDE STANDS READY TO PROVIDE SUPPORT AND ASSISTANCE TO THE DEDICATED INDIVIDUALS CARING FOR THEIR LOVED ONES. RIVERSIDE HAS ALSO FORMED OUTSTANDING CONNECTIONS WITH NATIONAL PROGRAMS SUCH AS THE ROSALYNN CARTER INSTITUTE FOR CAREGIVING AND THE FAMILY CAREGIVER ALLIANCE TO HELP FAMILIES. THESE PROGRAMS ARE IN ADDITION TO OUR SENIOR LIVING OPTIONS FOR INDIVIDUALS WITH ADVANCED MEMORY ISSUES AS WELL AS IN ADDITION TO OUR OUTSTANDING CLINICIANS AT THE RIVERSIDE NEUROLOGICAL AND SPINE INSTITUTE. IN 2021 RIVERSIDE CONTINUED TO RECRUIT TALENTED CLINICIANS TO JOIN THE TEAM AND SERVE OUR COMMUNITY. IN ADDITION TO THE IDENTIFIED NEEDS FROM THE CHNA, THE CARE OF OUR COMMUNITY THROUGH THE COVID-19 PANDEMIC CONTINUED TO BE OUR TOP FOCUS THROUGHOUT 2021. SPECIFICALLY, BETWEEN DECEMBER 16TH, 2020 (OUR FIRST DATE OF VACCINE GIVEN) TO DEC. 16TH, 2021, RIVERSIDE HEALTH SYSTEM WAS ABLE TO VACCINATE OVER 100,000 INDIVIDUALS WITH OVER 225,000 INDIVIDUAL DOSES. OUR COMMUNITY CLINICS, CLINICAL LEADERSHIP AND REFINED SUPPLY CHAIN SYSTEM WAS ABLE TO OBTAIN, STORE AND DISTRIBUTE THE VACCINES TO OUR COMMUNITIES, FOR WHICH RIVERSIDE IS EXTREMELY PROUD. THE COMMUNITY LEADERSHIP WAS SUCH THAT MULTIPLE RIVERSIDE PHARMACISTS WERE HONORED AT A STATE LEVEL FOR THEIR CONTRIBUTIONS DURING THE PANDEMIC. THE ITEMS DETERMINED TO NOT BE THE HIGHEST PRIORITIES INCLUDED FOR THE CHNA ARE NOTED BELOW. ITEMS ON THE LIST MAY BE ALREADY BEING ADDRESSED THROUGH OTHER RIVERSIDE PROGRAMS, SUCH AS HEART DISEASE, SMOKING CESSATION PROGRAMS, CHRONIC PAIN, SMOKING, RESPIRATORY CARE, DOMESTIC VIOLENCE, AND REPRODUCTIVE HEALTH. SOME ISSUES WERE OUTSIDE OF THE AREA OF EXPERTISE OF THE HEALTH SYSTEM, SUCH AS THE FOSTER CARE SYSTEM. ITEMS SUCH AS INFANT MORTALITY ARE IMPORTANT, BUT NOT NECESSARILY AN ITEM THAT COULD BE IMPACTED SIGNIFICANTLY BY THE HEALTH SYSTEM IN A THREE-YEAR PERIOD AND INSTEAD WILL BE ADDRESSED THROUGH OUR CONTINUED PRE- AND POST-NATAL CARE PROGRAMS. OTHER ITEMS NOT RANKED AS TOP HEALTH PROBLEMS THROUGH EITHER THE QUALITATIVE OR QUANTITATIVE DATA ASSESSMENTS INCLUDED: ENVIRONMENTAL HEALTH, DROWNING/WATER SAFETY, AUTISM, HIV/AIDS, DENTAL/ORAL CARE, NEUROLOGICAL PROBLEMS, ARTHRITIS, RENAL DISEASE, ORTHOPEDIC PROBLEMS, SEXUALLY TRANSMITTED INFECTIONS, PHYSICAL DISABILITIES, AND BULLYING. LINE 16 A: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/VA/NEWPORT-NE WS/HAMPTON-ROADS/ LINE 16 B: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/VA/NEWPORT-NE WS/HAMPTON-ROADS/ LINE 16 C: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/VA/NEWPORT-NE WS/HAMPTON-ROADS/ LINE 20B. WHILE THE HOSPITAL FACILITY MADE REASONABLE EFFORTS TO ORALLY NOTIFY ALL INDIVIDUALS ABOUT THE FAP AND FAP APPLICATION PROCESS, THIS MAY NOT HAVE BEEN UNIFORMLY PERFORMED FOR 100% OF THE PATIENTS RECEIVING TREATMENT DESPITE THE HOSPITAL'S BEST EFFORTS. LINE 20D: PRESUMPTIVE ELIGIBILITY IS NOT USED. DUE TO THE LIMITED NUMBER OF PATIENTS AND APPLICANT"

A
"Line 3E: The significant health needs of the community identified in the CNHA are prioritized according to the community needs. Line 5: As described in the CHNA, Riverside conducted a community survey between June 2018 and May 2019 to obtain input for the Community Health Needs Assessment. In partnership with other regional healthcare systems, the Peninsula Community Health Collaborative, non-profit organizations, and the Virginia Department of Health conducted a joint survey utilizing SurveyMonkey. There were two versions of the survey: one for community members which was distributed on each system's website, social media outlets and community meetings; and one for community, medical and public health leaders which was emailed to an identified list of key stakeholders jointly from all of the health systems under the signature of the Medical Director of the Peninsula Health District of the Virginia Department of Health. The specific list of organization affiliations can be found in Appendix A of the CHNA. In addition to the survey, multiple public health sources were consulted in the assembly of the needs assessment. These included CDC's WONDER database, Virginia Department of Health statistics, Virginia Health Information, Urban Institute for the Virginia Health Care Foundation, American Community Survey and the US Health Resources and Service Administration. Line 7A: https://www.riversideonline.com/about/community/community-health-needs-ass essments Line 7D: In addition to the website and the hardcopy available at the facility the report was also mailed to several community leaders. Line 10a: https://www.riversideonline.com/about_riverside/Community/community-health -needs-assessment.cfm Line 11: Riverside Regional Medical Center As explained in the CHNA, the significant needs to be addressed include: Behavioral/Mental Health and Substance Abuse: As national statistics have shown, behavioral health and substance abuse have become increasingly important as the number of individuals suffering with these issues has grown throughout the pandemic. Over the past year Riverside Behavioral Health Center has focused on growth and restructure to meet community and patient need. The building began significant renovations to develop private rooms and sensory de-escalation areas. Work will conclude in 2022, creating 4 inpatient acute units where there were previously 3. We added specific Detox beds and in addition, there was an Addiction outpatient suite built and Addiction Intensive Outpatient Services began. Food Insecurities: Food insecurity continued to be a significant problem in the region as the pandemic entered its second year. Riverside continued its efforts with the Healthy Food Box program at Riverside Brentwood where individuals with diabetes who were food insecure were given access to healthy food boxes and health coaching. The program continued to be a success and has served as a model for a second program to be rolled out at the 25th street clinic in 2022 as part of an increasing focus on ""food as medicine."" Additionally, Riverside continued to partner with the local foodbank for food drives as well as individual practices hosting local drives to help individual patients directly. Health Insurance Coverage/Access to Care: 2021 had two areas of focus for this issue at Riverside. First, Riverside continued to push out messages about continuing to receive preventative health care (such as annual physicals or annual wellness visits) as well as screenings (such as mammography and colonoscopy) as so many individuals delayed these critical services during 2020. Additionally, Riverside created its Riverside Medicare Advantage Complete plan that opened for enrollment in October 2021. Riverside felt the program was an important way to bring people the additional health coverage they needed for less out of pocket costs. Additionally, through our network of care we could provide a better health care experience though more coordination and facetime with the providers. Neoplasms of the Lung: In 2021 Riverside continued to promote the importance of Low Dose CT Lung Cancer Screening as an important tool in diagnosing lung cancer early so it is more easily treated. Riverside invested in patient testimonial videos so individuals who had caught an early-stage cancer with the Low Dose CT screening could share their stories and help inspire others to be screened. Additionally, in November (National Lung Cancer Awareness Month and the date of the Great American Smokeout), Riverside worked closely with providers from multiple specialties to share education about the multitude of benefits from quitting smoking. Maternal and Infant Care: With its advanced L&D capabilities and the Special Care Nursery, Riverside continued to provide a safe and healthy start to our newest and youngest community members in 2021. In addition to the clinical offerings, Riverside continued its focus on community education to support new families in their lives together. Specifically, Riverside hosted breastfeeding education classes, lactation support, new parent classes, infant CPR, Big Brother/Big Sister and other education to help ensure families are starting off on the right foot. In 2021 a special focus was community health education on healthy sleeping for parents and new babies. Colon Cancer: Riverside continued to focus on the importance of screening and early diagnosis for colon cancer and pushed messages around different types of screenings, including colonoscopy, FIT and stool DNA testing. The latter half of 2021 was focused on developing Colon Cancer Awareness Month for 2022 which had an additional focus on reaching minority patients. Also, in 2021 Riverside added an additional gastroenterologist to help increase capacity in this area. Aging Services focused on Alzheimer's and Dementia: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the importance of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring for their loved ones. Riverside has also formed outstanding connections with National programs such as the Rosalynn Carter Institute for Caregiving and the Family Caregiver Alliance to help families. These programs are in addition to our senior living options for individuals with advanced memory issues as well as in addition to our outstanding clinicians at the Riverside Neurological and Spine Institute. In 2021 Riverside continued to recruit talented clinicians to join the team and serve our community. In addition to the identified needs from the CHNA, the care of our community through the COVID-19 Pandemic continued to be our top focus throughout 2021. Specifically, between December 16th, 2020 (our first date of vaccine given) to Dec. 16th, 2021, Riverside Health System was able to vaccinate over 100,000 individuals with over 225,000 individual doses. Our community clinics, clinical leadership and refined supply chain system was able to obtain, store and distribute the vaccines to our communities, for which Riverside is extremely proud. The community leadership was such that multiple Riverside pharmacists were honored at a state level for their contributions during the pandemic. The items determined to not be the highest priorities included for the CHNA are noted below. Some listed items may be addressed through other Riverside programs, such as heart disease, smoking cessation programs, chronic pain, smoking, respiratory care, domestic violence, and reproductive health. Some issues were outside of the area of expertise of the health system, such as the foster care system. Items such as infant mortality are important, but not necessarily an item that could be impacted significantly by the health system in a three-year period and instead will be addressed through our continued pre- and post-natal care programs. Other items not ranked as top health problems through either the qualitative or quantitative data assessments included: environmental health, drowning/water safety, autism, HIV/AIDS, dental/oral care, neurological problems, arthritis, renal disease, orthopedic problems, sexually transmitted infections, physical disabilities, and bullying. Line 11: Walter Reed Hospital As explained in the CHNA, the significant needs to be addressed include: Aging Services: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the important of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring fo"

Part VI
"Line 3E: The significant health needs of the community identified in the CNHA are prioritized according to the community needs. Line 5: As described in the CHNA, Riverside conducted a community survey between June 2018 and May 2019 to obtain input for the Community Health Needs Assessment. In partnership with other regional healthcare systems, the Peninsula Community Health Collaborative, non-profit organizations, and the Virginia Department of Health conducted a joint survey utilizing SurveyMonkey. There were two versions of the survey: one for community members which was distributed on each system's website, social media outlets and community meetings; and one for community, medical and public health leaders which was emailed to an identified list of key stakeholders jointly from all of the health systems under the signature of the Medical Director of the Peninsula Health District of the Virginia Department of Health. The specific list of organization affiliations can be found in Appendix A of the CHNA. In addition to the survey, multiple public health sources were consulted in the assembly of the needs assessment. These included CDC's WONDER database, Virginia Department of Health statistics, Virginia Health Information, Urban Institute for the Virginia Health Care Foundation, American Community Survey and the US Health Resources and Service Administration. Line 7A: https://www.riversideonline.com/about/community/community-health-needs-ass essments Line 7D: In addition to the website and the hardcopy available at the facility the report was also mailed to several community leaders. Line 10a: https://www.riversideonline.com/about_riverside/Community/community-health -needs-assessment.cfm Line 11: Riverside Regional Medical Center As explained in the CHNA, the significant needs to be addressed include: Behavioral/Mental Health and Substance Abuse: As national statistics have shown, behavioral health and substance abuse have become increasingly important as the number of individuals suffering with these issues has grown throughout the pandemic. Over the past year Riverside Behavioral Health Center has focused on growth and restructure to meet community and patient need. The building began significant renovations to develop private rooms and sensory de-escalation areas. Work will conclude in 2022, creating 4 inpatient acute units where there were previously 3. We added specific Detox beds and in addition, there was an Addiction outpatient suite built and Addiction Intensive Outpatient Services began. Food Insecurities: Food insecurity continued to be a significant problem in the region as the pandemic entered its second year. Riverside continued its efforts with the Healthy Food Box program at Riverside Brentwood where individuals with diabetes who were food insecure were given access to healthy food boxes and health coaching. The program continued to be a success and has served as a model for a second program to be rolled out at the 25th street clinic in 2022 as part of an increasing focus on ""food as medicine."" Additionally, Riverside continued to partner with the local foodbank for food drives as well as individual practices hosting local drives to help individual patients directly. Health Insurance Coverage/Access to Care: 2021 had two areas of focus for this issue at Riverside. First, Riverside continued to push out messages about continuing to receive preventative health care (such as annual physicals or annual wellness visits) as well as screenings (such as mammography and colonoscopy) as so many individuals delayed these critical services during 2020. Additionally, Riverside created its Riverside Medicare Advantage Complete plan that opened for enrollment in October 2021. Riverside felt the program was an important way to bring people the additional health coverage they needed for less out of pocket costs. Additionally, through our network of care we could provide a better health care experience though more coordination and facetime with the providers. Neoplasms of the Lung: In 2021 Riverside continued to promote the importance of Low Dose CT Lung Cancer Screening as an important tool in diagnosing lung cancer early so it is more easily treated. Riverside invested in patient testimonial videos so individuals who had caught an early-stage cancer with the Low Dose CT screening could share their stories and help inspire others to be screened. Additionally, in November (National Lung Cancer Awareness Month and the date of the Great American Smokeout), Riverside worked closely with providers from multiple specialties to share education about the multitude of benefits from quitting smoking. Maternal and Infant Care: With its advanced L&D capabilities and the Special Care Nursery, Riverside continued to provide a safe and healthy start to our newest and youngest community members in 2021. In addition to the clinical offerings, Riverside continued its focus on community education to support new families in their lives together. Specifically, Riverside hosted breastfeeding education classes, lactation support, new parent classes, infant CPR, Big Brother/Big Sister and other education to help ensure families are starting off on the right foot. In 2021 a special focus was community health education on healthy sleeping for parents and new babies. Colon Cancer: Riverside continued to focus on the importance of screening and early diagnosis for colon cancer and pushed messages around different types of screenings, including colonoscopy, FIT and stool DNA testing. The latter half of 2021 was focused on developing Colon Cancer Awareness Month for 2022 which had an additional focus on reaching minority patients. Also, in 2021 Riverside added an additional gastroenterologist to help increase capacity in this area. Aging Services focused on Alzheimer's and Dementia: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the importance of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring for their loved ones. Riverside has also formed outstanding connections with National programs such as the Rosalynn Carter Institute for Caregiving and the Family Caregiver Alliance to help families. These programs are in addition to our senior living options for individuals with advanced memory issues as well as in addition to our outstanding clinicians at the Riverside Neurological and Spine Institute. In 2021 Riverside continued to recruit talented clinicians to join the team and serve our community. In addition to the identified needs from the CHNA, the care of our community through the COVID-19 Pandemic continued to be our top focus throughout 2021. Specifically, between December 16th, 2020 (our first date of vaccine given) to Dec. 16th, 2021, Riverside Health System was able to vaccinate over 100,000 individuals with over 225,000 individual doses. Our community clinics, clinical leadership and refined supply chain system was able to obtain, store and distribute the vaccines to our communities, for which Riverside is extremely proud. The community leadership was such that multiple Riverside pharmacists were honored at a state level for their contributions during the pandemic. The items determined to not be the highest priorities included for the CHNA are noted below. Some listed items may be addressed through other Riverside programs, such as heart disease, smoking cessation programs, chronic pain, smoking, respiratory care, domestic violence, and reproductive health. Some issues were outside of the area of expertise of the health system, such as the foster care system. Items such as infant mortality are important, but not necessarily an item that could be impacted significantly by the health system in a three-year period and instead will be addressed through our continued pre- and post-natal care programs. Other items not ranked as top health problems through either the qualitative or quantitative data assessments included: environmental health, drowning/water safety, autism, HIV/AIDS, dental/oral care, neurological problems, arthritis, renal disease, orthopedic problems, sexually transmitted infections, physical disabilities, and bullying. Line 11: Walter Reed Hospital As explained in the CHNA, the significant needs to be addressed include: Aging Services: Lead by our Center for Excellence in Aging and Lifelong Health, Riverside continues to offer leadership at a national level for the important of caring for memory care patients and their caregivers. With programs such as Caregiver Commons, Care to Plan, Caring for You Lessons, Memory Caf and our Senior Care Navigators, Riverside stands ready to provide support and assistance to the dedicated individuals caring fo"