4A (Expenses $ 272090029 including grants of $ 3921447) (Revenue $ 462987292)
BON SECOURS-RICHMOND HEALTH SYSTEM IS A MISSION-DRIVEN, NONPROFIT, CATHOLIC HEALTH SYSTEM. BON SECOURS-RICHMOND HEALTH SYSTEM OPERATES ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, AMBULATORY AGENCIES, AND OTHER HEALTHCARE ORGANIZATIONS. BON SECOURS-RICHMOND HEALTH SYSTEM SUPPORTS ITS subsidiary members in their effort to provide compassionate, quality healthcare services to those in need, including the poor and dying, for the purpose of alleviating human suffering and bringing people to wholeness in the midst of pain and loss.

4B (Expenses $ 1015561226 including grants of $ 51170) (Revenue $ 1389764711)
THE FIVE HOSPITALS INCLUDED ON THIS RETURN EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITIES AND BRINGING GOOD HELP TO THOSE IN NEEED, ESPECIALLY PEOPLE WHO ARE POOR, DYING AND UNDERSERVED. THIS IS ACCOMPLISHED BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF HUMAN DIGNITY, INTEGRITY, COMPASSION, STEWARDSHIP, AND SERVICE. TOTAL COMMUNITY BENEFIT PROVIDED IN 2021 WAS $64,149,084.

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center LLC, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital. In order to obtain input from the community, three initiatives were advanced: a Community Health Needs Assessment Steering Committee was convened, a community engagement survey was conducted, and several community conversations were held. The purpose of the CHNA Steering Committee is to support the CHNA process by engaging community members and providing feedback on the findings. All organizations involved with the CHNA Steering Committee have special knowledge of public health and underserved populations in the service area. Organizations involved in the Steering Committee are identified as having either a) conducted a previous Community Health Needs Assessment/Community Health Assessment due to IRS or accreditation requirements or b) already engaged in regional population health assessment. From January 2018 to April 2019 Steering Committee members served as key informants representing medically underserved, low- income or minority populations. The committee met bi-monthly to identify regional indicators and to inform the community engagement strategy for the creation of this document. Additionally, a survey to assess community health needs was conducted as part of the CHNA process during a six-week period between January and February 2019. One thousand one hundred (1100) individuals responded listing their top five health concerns. Seven Community Conversations occurred in March of 2019 as part of the CHNA process in which 60 individuals participated from all of the core jurisdictions. The purpose of the conversation was to elicit feedback from community members about publicly available health data describing health conditions in the service areas and to review the survey results to further explore the findings. The top 10 health issues as identified from the survey results were presented to the attendees and they were asked to 1) rank the health issues according to which issues impacted them and the people close to them the most and 2) from a community perspective, rank the issues that should be addressed to improve the overall health of the region. Additional detail can be found on the Bon Secours website at https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center LLC, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital. Bon Secours - St. Mary's Hospital of Richmond LLC Bon Secours - Memorial Regional Medical Center LLC Bon Secours - St. Francis Medical Center LLC Bon Secours - Richmond Community Hospital, LLC Rappahannock General Hospital

Schedule H, Part V, Section B, Line 11 Facility A, 1
"Facility A, 1 - Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center LLC, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital. Bon Secours Richmond Health System (BSR) BSR is comprised of Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital, Bon Secours - Southern Virginia Medical Center, and Bon Secours - Southside Medical Center. BSR will address each need identified in its CHNA with regional strategies. Unless noted below, all BSR hospitals participated in the regional strategies. Chronic Disease Implementation Activities: Goal: Improve overall chronic disease status by increasing equitable access to high quality health care services. 2021 Strategies and Outcomes: * BSR supports community partners by providing high- quality clinical services to uninsured and underinsured populations through investment and advocacy. During 2021, the support from BSR included: - Provided $700k to support and/or expand safety area net clinics providing chronic disease management services to enable uninsured patients with chronic diseases to manage their health conditions, facilitate patient's' ability to acquire affordable medications, enhance patient's understanding of their conditions, and reduce emergency health care visits. - Worked with area free clinics and FQHCs to create the Greater Richmond Safety Net Collaborative to assess safety net capacity and expand access for patients. In 2021, the collaborative created the new online platform that identified appropriate referral sources for patients and care managers. - Partnered with Shalom Farms, an area non-profit providing wellness services, by providing 2 Diabetes Prevention Programs (DPP) and 2 Food Rx Programs. All programs were free of charge and open to anyone who qualified. The DPP achieved CDC certification as a result. - Coordinated programs with VCU Health to establish a work group comprised of health systems, health departments and schools to identify referral pathways for children with Asthma. In 2021, BSR identified specific pediatric linkages and coordination with other area health systems and health departments with a focus on immunizations and back to school physicals. - Partners with clinical staff and non-profit organizations to discharge uninsured patients to Medical Homes with a goal to increase control of chronic disease through available follow-up appointments and reduce readmissions. In 2021, BSR created transitions of care appointments for patients discharged from hospitals to ensure follow-up care appointment with primary care providers. Additionally, BSR developed a partnership with safety net clinic to ensure appropriate follow-up care for the most vulnerable and signed an agreement to join the referral platform ""Unite VA"". - Help to enhance understanding of insurance usage to first time consumers and ensure continued coverage. BSR provided enrollment support for uninsured patients. In 2021, BSR allocated 2 FTEs to Medicaid enrollment and other financial assistance services, resulting in Medicaid enrollment assistance provided to 233 patients. * Providing primary care services to the uninsured through the Care-A-Van mobile health clinic remained a priority for BSR. During 2021, nearly 13,000 patient visits occurred through this program. * During 2021, BSR signed the lease and broke ground on a $3 million fixed site clinic to support uninsured patients in South Richmond. * BSR continued to provide comprehensive chronic disease management services to patients by providing medical homes and financial assistance for uninsured patients through community health and the medical group. * In an effort to enhance the understanding of nutrition for chronic disease patients BSR established a diabetes prevention program to uninsured residents of the area in 2021. * BSR worked to facilitate a smooth transition of care from emergency department/admissions hospitals settings to post hospital setting follow-ups by establishing a pathway for uninsured patients to seek follow up care for complex chronic diseases. During 2021, over 1,000 patients were served using this pathway. * Continued efforts were made to leverage the collective influence of Richmond's congregations to improve the overall health status in the East end of Richmond by providing health education and offerings. In 2021, BSR continued the Congregational Health Initiative which was comprised of 7 local congregations that facilitated COVID-19 vaccinations for vulnerable residents and provided a connection to healthcare resources. * During the year BSR co-lead the East End Diabetes Coalition (EEDC). The EEDC's main goal is to catalog diabetes providers in the East End of Richmond to connect community members to resources. In 2021, the EEDC implemented the regional guide in tandem with individual counseling provided to East End residents. The Community Nutrition Outreach team began two new community programs that were included in the resource guide. These programs were The Diabetes Prevention Program and the Food Rx Program. * During 2021, BSR provided over 5,000 COVID-19 vaccinations to vulnerable neighborhoods with high incidence of Covid-19. * Throughout the year BSR hosted 385 Flu Clinics that distributed 12,089 flu vaccines. Additionally, BSR hosted 43 wellness clinics that provided PPDs, A1c screenings, and biometric screenings to community members."

Schedule H, Part V, Section B, Line 11 Facility A, 2
Facility A, 2 - CONTINUED DESCRIPTION: Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center LLC, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital. Behavioral Health Implementation Activities: Goal: Improve behavioral health status by increasing the availability of appropriate, quality mental health and addiction services. 2021 Strategies and Outcomes: * BSR continued to support area non-profits who provide comprehensive behavioral health services to the uninsured by providing more than $500k in grants to expand access during 2021. * As an advocate for increased substance, alcohol, and drug abuse programs and resources, BSR revised internal policies and procedures to reduce unnecessary opioid prescribing by its providers. Additionally, during 2021, BSR provided SUD training to over 100 providers. * During 2021, BSR worked with housing and homeless partners to ensure every child and adult had the availability of stable and affordable housing and provided over $800k across the housing continuum. * Collaborations with BSR and community partners occurred during the year to increase mental health awareness by providing screenings, support groups, education, and programs to the public. BSR contributed to these collaboration efforts by deploying a Violence Response team who provided 220 hours of education sessions in 2021. * BSR worked with Free Clinics and FQHCs to bring low or no cost mental health services into area public school systems. In 2021, BSR provided mental health counseling services to Powhatan Middle and High schools. * Efforts were made by BSR to ensure patients receive depression screenings and follow-up in primary care settings. Of the total patients seen by primary care providers 91% received the depression screening in 2021. * During the year BSR worked on the development of strategies to overcome mental health provider shortages and improve mental health provider stability. In 2021, the Richmond market consolidated outpatient behavioral health and improved inpatient services and identified an expansion opportunity for 2022. * BSR seeks to integrate behavioral health with primary care by collaborating with health departments, safety net providers, and community providers to increase the number of mental health patients who receive counseling following their primary care physician's recommendation. This will also enhance the capacity for the treatment of anxiety/depression in primary care settings and ensure behavioral health practitioners are available in primary care in primary care settings. During 2021, BSR provided $50k through partnerships with Health Brigade to expand these services. * BSR intends to implement SBIRT in its emergency departments. The education of ED staff on SBIRT screenings and community resources to ensure warm handoffs occur launched during 2021 but was put on hold until 2022 due to COVID-19. * During 2021, BSR implemented an annual Opioid education webinar for all associates across the market to increase mental health awareness. The education webinar was provided to nearly 10k associates in 2021. * BSR continues to expand behavioral health services available through community health programs by identifying new providers, volunteers, and partners to enhance services offered via mobile health and fixed-site locations. During 2021, BSR developed a plan to increase FTEs of bi-lingual LCSW in 2022, once the planned fixed-site is completed. This fixed-site will be a market-wide referral source of the uninsured. * During 2021, BSR successfully launched the Life Matters program to expand behavioral health service resources available to all employees and expanded the offering through the Called to Shine platform and the Be Well employee resource. * Due to the impact of COVID-19, several of the programs and strategies that BSR intended to implement to address this health need were delayed with plans to resume these programs in 2022. Social Determinants of Health Implementation Activities: Goal: Reduce health disparity by ensuring that every community has social and economic opportunities to thrive. 2021 Strategies and Outcomes: * BSR Supports area non-profits who are building affordable housing units that offset displacement, expanding home ownership and affordable rental housing options, closing gaps along the education and achievement continuum, and providing early childhood education programs and advocacy. In 2021, BSR donated over $800k in direct services and investments in affordable housing and neighborhood assets. * In 2021, BSR donated nearly $700k in direct services and investments to area non-profits who are along the education continuum and who are providing expanded access to early childhood programs. * In 2021, BSR donated almost $400k in direct services and investments to area non-profits who are providing financial literacy services. * BSR continues to focus on programs to improve neighborhood infrastructure through corridor development in the East End. BSR supports long-term sustainability of community spaces such as the Sarah Garland Jones Center (SGJC) in the East End, enhancement of community oneness and collaboration, and providing space for Health Education and workforce development, and improving aesthetics of the neighborhood. In 2021, BSR hosted 10 community events at the SGJC and 2 community events in the neighborhood greenspace. * BSR will identify opportunities to enhance the environment and promote place-making. BSR provides over $100k annually to support the PULSE Rapid Transit System. In 2021, BSR worked in collaboration with Greater Richmond Transit to identify 14 bus stops in the East End to receive bus shelters. The bus shelters that were built were a result of a $200k investment made by BSR. * Through 2021 BSR participated in community meetings and advocated for the redevelopment of Nine Mile Road Corridor. This included building new and/or replacement of sidewalks and streetlights along the full corridor. * In an effort to support entrepreneurship tied to the local supply chain and entrepreneurial offerings in the public school system BSR has requested funding to continue the partnership with the Claude Moore Society. This partnership which began in 2020 is a five-year effort to develop Claude Moore Scholars at Meadowbrook high School in North Chesterfield. BSR provides work-based learning experiences and appropriate employment opportunities to these scholars. * BSR remained committed to advocating for food access and food education during 2021 by investing $75k in Shalom Farms, a non-profit sustainable agricultural organization, to double their farming production yield. Additionally, BSR served as a member of the Virginia Food Access Coalition which testified and supported Virginia Food Access Investment Program and Funding Legislation during the Virginia Assembly. * BSR continues to focus on increased screenings and coordination of resources to support individuals with needs related to the social determinants of health. In 2021, BSR provided the following: - Established an interdisciplinary team that co-managed 12 complex patients. - Hired a designated FTE community health worker who served 897 patients. - Created the SDOH screening tool for social needs screening which was implemented in 2021 and performed 142 screenings. - Created a master resource list of community partners and resources to address patient needs and provided to SDOH team.

Schedule H, Part V, Section B, Line 11 Facility A, 3
Facility A, 3 - CONTINUED DESCRIPTION 2: Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center LLC, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital. Stress / Trauma Implementation Activities: Goal: Promote the well-being, safety, and overall health of individuals by decreasing the occurrences of Adverse Childhood Experiences within communities. 2021 Strategies and Outcomes: * BSR supports community partners who are collaborating to promote safer and supportive communities through investment and advocacy. In 2021, the following actions occurred: - Provided $60k of investment to fund SCAN TRAUMA Informed Networks that addresses the impacts of trauma and adverse childhood experiences through 170 in state networks with 540 individual members. - Increased HVIP advocates from 3 to 6 to address increase in community demand. - Established and will continue to Chair the Richmond Regional Human Trafficking Collaborative which is aimed at enhancing awareness to the issue of human trafficking. - Continued development of a trauma informed leadership team in partnership with SCAN. The activity was paused due to Covid-19 but will restart in 2022. * In an effort to ensure all victims of violence, abuse, and stress have access to high quality, timely forensic nurses for evaluation and treatment, BSR provides in-house forensic nursing services across the market. In 2021, BSR had 18 forensic nurses and established a hospital-based violence intervention program that hired and trained 6 advocates. During 2021, 2,934 patients were served by these programs. * During 2021, BSR continued the Clinicians Against Gun Violence campaign to engage physicians in conversations around gun violence. BSR's Diversity and Inclusion team created and hosted a Difference in Dialogue panel and follow-up break out discussion for all associates. * To further the enhancement of staff awareness levels of trauma BSR created a mandatory education webinar with nearly 10k associates completing the webinar by the end of 2021. All prioritized needs in the CHNA have been addressed.

Schedule H, Part V, Section B, Line 13 Facility A, 1
Facility A, 1 - Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center LLC, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT OR FAMILY MEMBER TO COMPLETE AN APPLICATION INCLUDING GROSS INCOME FOR A MINIMUM OF 3 MONTHS (UP TO 12 MONTHS) PRIOR TO THE DATE OF APPLICATION OR DATE OF SERVICE. PROOF OF INCOME IS REQUIRED WITH THE EXCEPTIONS OF PATIENTS WHO QUALIFY FOR PRESUMPTIVE ELIGIBILITY. PROOF OF INCOME IS NOT REQUIRED IF A PATIENT OR FAMILY MEMBER ATTESTS TO AN INCOME LEVEL THAT QUALIFIES THE APPLICANT FOR DISCOUNTED CARE UNDER OHIO'S HEALTHCARE ASSURANCE PROGRAM (HCAP). THIRD PARTY INCOME SCORING MAY BE USED TO VERIFY INCOME IN SITUATIONS WHERE INCOME VERIFICATION IS UNABLE TO BE OBTAINED THROUGH OTHER METHODS. Patients are presumed to be eligible for financial assistance based on individual life circumstances including but not limited to when the Patient's income is below 200% Federal Poverty Guidelines and considered self-pay, the Patient is discharged to a SNF, the Patient is deceased with no known estate and below 200% Federal Poverty Guidelines, the patient is supported by State-funded prescription programs, the patient is Homeless or received care from a homeless clinic, the patient has Participated in Women, Infants and Children programs (WIC), the patient is eligible for Food stamps, the patient is eligible for Subsidized school lunch program, the patient is eligible for other state or local assistance programs that are unfunded (e.g., Medicaid spend-down), the Patient is referred through the National Association of Free Clinics, the patient provides Low income/subsidized housing as a valid address, or Other significant barriers are present.

Schedule H, Part V, Section B, Line 13 Facility A, 1
Facility A, 1 - Bon Secours - St. Mary's Hospital of Richmond LLC, Bon Secours - Memorial Regional Medical Center LLC, Bon Secours - St. Francis Medical Center LLC, Bon Secours - Richmond Community Hospital, LLC, Rappahannock General Hospital. There are situations where individuals may not have reported income but have significant assets available to pay for healthcare services. In these situations, BON SECOURS MERCY HEALTH may evaluate and require documented proof of any assets that are categorized as convertible to cash and unnecessary for the patient's essential daily living expenses. PATIENTS WHO LIVE IN THE COMMUNITY SERVED BY A BON SECOURS MERCY HEALTH HOSPITAL WILL BE OFFERED HEALTHCARE FINANCIAL ASSISTANCE. FOR THOSE PATIENTS LIVING OUTSIDE OF THE COMMUNITY, EXTENUATING CIRCUMSTANCES MUST BE DOCUMENTED AND APPROVED BY THE PFS MANAGER AND BE MEDICALLY NECESSARY OR EMERGENT IN NATURE. A LIST OF THE ZIP CODES OF THE COMMUNITY SERVED FOR EACH BON SECOURS MERCY HEALTH HOSPITAL IS MAINTAINED IN A SEPARATE DOCUMENT AND READILY AVAILABLE VIA THE CONTACT LIST AT THE END OF THE POLICY LOCATED AT https://www.bonsecours.com/patient-resources/financial-assistance. BON SECOURS MERCY HEALTH'S FINANCIAL ASSISTANCE POLICY REQUIRES A PATIENT TO APPLY FOR HEALTH INSURANCE COVERAGE AND/OR ENTER THE MARKETPLACE/EXCHANGE BEFORE FINANCIAL ASSISTANCE MAY BE EXTENDED. EXCEPTIONS TO THIS POLICY INCLUDE PATIENTS DISCHARGED TO A SKILLED NURSING FACILITY, PATIENTS WHO ARE DECEASED WITH NO ESTATE, AND PATIENTS WHO HAVE DOCUMENTED HOMELESSNESS.

Schedule H, Part I, Line 7e Community Health Improvement Services
Bon Secours Richmond Health System hospitals incurred significant additional costs in responding to the COVID-19 pandemic in 2021. Certain costs associated with health care support services, including executive and other employee time spent planning for and recovering from the public health emergency and for planning for community COVID-19 vaccine services were included as Community Health Improvement Services. These costs were not directly reimbursed by any provider relief funds or other government funding sources.

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
Bon Secours Mercy HEalth, Inc.

Schedule H, Part I, Line 7g Subsidized Health Services
Bon Secours Richmond Health System, Inc. OPERATES THE RICHMOND HOPE THERAPY CENTER CLINIC. THE AMOUNT OF SUBSIDIZED HEALTH SERVICES ATTRIBUTABLE TO THE PHYSICIAN CLINIC IS $174,369.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
111709358

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
Cost of financial assistance at cost was calculated with a cost to charge ratio using worksheet 2. The cost related to Medicaid patients was determined using Bon Secours Mercy Health's cost accounting system and included both inpatients and outpatients for traditional Medicaid and Medicaid managed care plans. For subsidized services Bon Secours Mercy Health's cost accounting system used to determine cost related to the specific service excluding traditional Medicaid and Medicaid managed care patients. Costs for charity and bad debt accounts are deducted using a ration of cost to charge specific to that subsidized service. Costs for other programs reflect the direct and indirect costs of providing those programs.

Schedule H, Part II Community Building Activities
Bon Secours Mercy Health (BSMH) addresses various community concerns including health improvement, poverty, workforce development, and access to health care. BSMH hospitals conduct community health education and support groups, health fairs and screenings for the communities served. BSMH hospitals work with state and local leadership to address community needs and provide healthcare services to the poor and underserved. BSMH is committed to addressing the social determinants of health (SDOH) and social needs for patients and communities throughout our footprint. With a deep understanding of both areas, the team is working systematically across the ministry and in our local communities to ensure we respond holistically and impactfully. BSMH addresses SDOH through its Community Health Needs Assessment (CHNA), Community, investment strategy, advocacy/public policy partnerships, and cross sector solutions. BSMH addresses social needs through SDOH patient assessment, health education/promotion programs, capacity building of local community resources, and closed loop referral system. BSMH hospitals provide programs to improve the physical surroundings and housing in the communities served. Inadequate housing has a negative impact on the health of residents in the area by leading to violence in the neighborhoods. A robust economy positively impacts residents covered by health insurance and improves the capacity of the community to support health services. Additional detail regarding BSMH's community building activities and the promotion of health of its communities can be found in its 2021 Community Health Annual Report available at https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON BON SECOURS MERCY HEALTH'S (BSMH) HISTORICAL COLLECTION EXPERIENCE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. BSMH'S CONCENTRATION OF CREDIT RISK RELATED TO NET PATIENT ACCOUNTS IS LIMITED DUE TO THE DIVERSITY OF PATIENTS AND PAYORS. NET PATIENT ACCOUNTS CONSIST OF AMOUNTS DUE FROM GOVERNMENTAL PROGRAMS (PRIMARILY MEDICARE AND MEDICAID), PRIVATE INSURANCE COMPANIES, MANAGED CARE PROGRAMS AND PATIENTS THEMSELVES. NET PATIENT SERVICE REVENUE FOR SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE IS RECOGNIZED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED. BSMH RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, BSMH RECOGNIZES REVENUE WHEN SERVICES ARE PROVIDED. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF BSMH'S ININSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, BSMH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. ANY DISCOUNTS APPLIED TO SELF-PAY PATIENTS WOULD BE DEEMED EITHER CHARITY OR A CONTRACTUAL ADJUSTMENT. BAD DEBT WOULD BE BASED ON THE BALANCE AFTER THE CHARITY OR CONTRACTUAL ADJUSTMENT THAT IS DEEMED UNCOLLECTABLE FOLLOWING A REASONABLE COLLECTION EFFORT.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
"BON SECOURS MERCY HEALTH (BSMH) FOLLOWS THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY (""CHA GUIDELINES"") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE MEDICARE LOSSES AS COMMUNITY BENEFIT. BSMH'S COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE MEDICARE AMOUNTS IN PART III."

Schedule H, Part V, Section B, Line 16a FAP website
A - BON SECOURS - ST. MARY'S HOSPITAL OF RICHMOND LLC: Line 16a URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - BON SECOURS - ST. MARY'S HOSPITAL OF RICHMOND LLC: Line 16b URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - BON SECOURS - ST. MARY'S HOSPITAL OF RICHMOND LLC: Line 16c URL: HTTPS://WWW.BONSECOURS.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE;

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
"BON SECOURS MERCY HEALTH'S (BSMH) FINANCIAL ASSISTANCE POLICY DOES NOT PERMIT THE COST OF PATIENTS WHO ARE UNCOOPERATIVE OR UNABLE TO BE LOCATED TO BE RECLASSIFIED FROM FINANCIAL ASSISTANCE TO BAD DEBT. BSMH'S FINANCIAL ASSISTANCE POLICY REQUIRES AN APPLICATION AND SUPPORTING DOCUMENTATION. THEREFORE, ZERO DOLLARS ARE BEING REPORTED ON PART III, LINE 3 AS AMOUNTS INCLUDED IN BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER BSMH'S FINANCIAL ASSISTANCE POLICY. THE HOSPITALS FOLLOW THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY (""CHA GUIDELINES"") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE BAD DEBT EXPENSE AS COMMUNITY BENEFIT."

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
BON SECOURS MERCY HEALTH'S (BSMH) AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. BSMH ELECTED TO EARLY ADOPT ASU 2011-07. ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AS AN OPERATING EXPENSE. NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, 2. SIGNIFICANT ACCOUNTING POLICIES, (d) NET PATIENT ACCOUNTS AND NET PATIENT SERVICE REVENUE (PAGE 10) STATES Patient receivables are recorded at net realizable value based on certain assumptions determined by payor class. For third party payors including Medicare, Medicaid, and commercial insurance, the net realizable value is based on the estimated contractual reimbursement percentage, which is based on current contract prices or historical paid claims data by payor. For self-pay receivables, which includes patients who are uninsured and the patient responsibility portion for patients with insurance, the net realizable value is determined using estimates of historical collection experience. These estimates are adjusted for estimated conversions of patient responsibility portions, expected recoveries and any anticipated changes in trends.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAYS AND AFTER, AS WELL AS WITH EACH BILLING NOTICE. BILLS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT REFUSE TO DO SO; WHEN PATIENTS REFUSE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL. Patients that are presumed to be eligible for financial assistance based on individual life circumstances will be provided 100% financial assistance. Patients determined to have presumptive financial assistance eligibility will not be required to meet income criteria, asset eligibility criteria, or fill out a financial assistance application. BSMH utilizes available resources (e.g. technology solutions, service organizations, etc.) to obtain information such as credit scores to assist in determining a patient's presumed eligibility.

Schedule H, Part VI, Line 2 Needs assessment
BON SECOURS RICHMOND HEALTH SYSTEM (BSR) HOSPITALS ASSESS AND CONTINUALLY RESPOND TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. BSR HOSPITALS JOIN AN EXISTING COMMUNITY-BASED NEEDS ASSESSMENT EVERY THREE YEARS AND UPDATES ARE PROVIDED BETWEEN ASSESSMENTS. BSR HOSPITALS INCORPORATE PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. BSR HOSPITALS RECOGNIZE THE HEALTH OF THE COMMUNITY IS INFLUENCED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS, NOT JUST BY DISEASE AND ILLNESS. OUR COMMUNITY BENEFIT INCLUDES BOTH QUALITATIVE AND QUANTITATIVE DATA; DEMOGRAPHICS INCLUDING RACE, AGE, AND ETHNICITY; SOCIOECONOMIC DATA INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES; PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS; AND DATA ON HEALTH DISPARITIES IN HEALTH OUTCOMES AMONG MINORITY GROUPS. BSR HAS A DEDICATED STAFF TO ASSIST IN THE COMMUNITY BENEFIT EFFORT. BSR'S COMMUNITY BENEFITS COMMITTEES MEET TO PROVIDE OVERSIGHT TO THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. BSR HOSPITALS WORK CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS IN THE AREA, PARTNERING WITH SOME TO PROVIDE SERVICES TO AVOID DUPLICATION.

Schedule H, Part VI, Line 5 Promotion of community health
BON SECOURS RICHMOND HEALTH SYSTEM (BSR) HOSPITALS OPERATE EMERGENCY ROOMS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, BSR HOSPITALS ALSO PROVIDE MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. BSR HOSPITALS OPERATE TRAUMA SERVICES, AIR AMBULANCE SERVICES, DISEASE MANAGEMENT, WOUND CARE, SPECIALTY CLINICS, DEVELOPMENTAL THERAPY, HOSPICE, HOME CARE, CRISIS INTERVENTION, BEHAVIORAL SERVICES AND SUBSTANCE ABUSE SERVICES. BSR HOSPITALS HAVE OPEN MEDICAL STAFFS WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITIES SERVED BY BSR HOSPITALS. THE BON SECOURS MERCY HEALTH BOARD AND ITS MARKET GOVERNING BOARDS ARE COMPOSED OF MEMBERS OF THE COMMUNITIES SERVED WHO DIRECT AND GUIDE MANAGEMENT IN CARRYING OUT THE MISSION OF BON SECOURS MERCY HEALTH. BOARD MEMBERS ARE SELECTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO BON SECOURS MERCY HEALTH AND ITS AFFILIATED HOSPITALS IN FULFILLING ITS MISSION OF PROVIDING HEALTHCARE SERVICES TO THE POOR AND UNDER SERVED. BSR HOSPITALS ENGAGE IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS. BSR HOSPITALS PROVIDE RESIDENCY PROGRAMS AND OTHER TRAINING PROGRAMS. BSR HOSPITALS PARTICIPATE IN MEDICAID, MEDICARE, CHAMPUS, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. BSR HOSPITAL'S EMERGENCY DEPARTMENTS TREAT AN INCREASING NUMBER OF PATIENTS WHO USE THE FACILITY FOR PRIMARY CARE NEEDS. PATIENT DEMOGRAPHICS REFLECT THE CHANGING COMMUNITY. AS IN OTHER COMMUNITIES, SOME AREA PHYSICIANS PLACE LIMITS ON THEIR ACCEPTANCE OF MEDICAID PATIENTS. IN ADDITION, SOME PRIMARY CARE PHYSICIANS REFER PATIENTS WITH AFTER-HOURS NEEDS DIRECTLY TO AREA EMERGENCY ROOMS. COMMUNITY GROUPS AND INDIVIDUALS ARE VERY SUPPORTIVE OF BON SECOURS MERCY HEALTH. BON SECOURS MERCY HEALTH FORGES COLLABORATIVE RELATIONSHIPS WITH THE FEDERALLY QUALIFIED HEALTH CENTERS IN ITS COMMUNITIES.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
BON SECOURS RICHMOND HEALTH SYSTEM (BSR) HOSPITALS POST THE BON SECOURS MERCY HEALTH (BSMH) CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. BSR HOSPITALS PROVIDE A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS AND WITH DISCHARGE MATERIALS. ADDITIONALLY, A COPY OF THE POLICY OR A SUMMARY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IS INCLUDED IN PATIENT BILLS. BSR HOSPITALS DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. THE HOSPITAL ELIGIBILITY LINK PROGRAM (HELP) IS A FREE REFERRAL SERVICE PROVIDED BY BSR HOSPITALS. THE PURPOSE OF HELP IS TO ASSIST PATIENTS IN OBTAINING MEDICAL BENEFITS THROUGH FEDERAL, STATE, AND HOSPITAL PROGRAMS. HELP REPRESENTATIVES WILL PROVIDE THE FOLLOWING SERVICES AT NO COST TO THE PATIENT: *EXPLORE ELIGIBILITY UNDER PUBLIC ASSISTANCE PROGRAMS *FILE APPLICATIONS ON PATIENT'S BEHALF *SCHEDULE AND ATTEND APPOINTMENTS *PROVIDE TRANSPORTATION WHEN NECESSARY *PROVIDE MEDICAL DOCUMENTATION TO SOCIAL SECURITY ADMINISTRATION FOR DISABILITY CLAIMS. THROUGH HELP, PATIENTS AND THEIR COUNSELORS LOOK AT WHAT OPTIONS ARE AVAILABLE. BSR HOSPITALS UNDERSTAND THAT NOT EVERYONE CAN PAY FOR HEALTHCARE SERVICES. HELP IS HERE TO OFFER OPTIONS AND ASSISTANCE FOR THOSE WHO ARE UNINSURED OR UNDERINSURED. HELP IS AN EXTENSION OF BSR'S MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY WITH EMPHASIS ON THE POOR AND UNDERSERVED. MEETING THE NEEDS OF THOSE WITH LIMITED RESOURCES HAS ALWAYS BEEN THE HEART OF OUR MISSION. BSR IS PROUD TO MAKE OUR FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO THE PUBLIC THROUGH OUR WEBSITE, WHICH CAN BE FOUND AT: https://www.bonsecours.com/patient-resources/financial-assistance OTHER PATIENT EDUCATION INFORMATION THAT IS PROVIDED FOR ELIGIBILITY OF ASSISTANCE IS AS FOLLOWS: *BILINGUAL REPRESENTATIVES ARE AVAILABLE IN OUR CUSTOMER SERVICE DEPARTMENTS. *STAFF TRAINING ON HOSPITAL CARE ASSURANCE PROGRAM (HCAP) AND HOSPITAL FINANCIAL ASSISTANCE (HFA) WAS PROVIDED. TRAINING INCLUDED A MANUAL AND IN-DEPTH INFORMATION REGARDING THE PREPARATION OF THE COST REPORT LOGS, ACCURATE COMPLETION OF THE HCAP APPLICATION AS WELL AS AN OVERVIEW OF THE FAQ'S PROVIDED BY THE OHIO HOSPITAL ASSOCIATION. *STAFF TRAINING PROVIDED BY SOCIAL SECURITY ADMINISTRATION TO ASSIST PATIENTS IN OBTAINING DISABILITY BENEFITS. *FINANCIAL ASSISTANCE COUNSELORS WORK WITH CASE MANAGERS TO EXPEDITE THE TRANSFER OF PATIENTS TO EXTENDED CARE FACILITIES. *FEDERAL POVERTY GUIDELINES ARE POSTED ON OUR WEBSITE AS WELL AS A COPY OF OUR CHARITY APPLICATION. *ALL THIRD PARTIES THAT WORK ON BEHALF OF THE ORGANIZATION TO COLLECT FEES (SUCH AS COLLECTION AGENCIES AND LAW FIRMS) ARE REQUIRED TO FOLLOW BSR'S POLICIES REGARDING PATIENT NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. *CONSISTENT REVIEW OF SELF PAY PATIENTS FOR RETROACTIVE MEDICAID COVERAGE. *SERVICES PROVIDED BY VENDOR TO REACH OUT TO PATIENTS IN BAD DEBT TO SCREEN FOR HCAP ELIGIBILITY.

Schedule H, Part VI, Line 4 Community information
"THE COMMUNITY FOR EACH HOSPITAL IN THE BON SECOURS RICHMOND HEALTH SYSTEM (BSR) IS DEFINED BOTH BY MISSION AND GEOGRAPHY. THE GEOGRAPHIC COMMUNITY IS DEFINED BY EACH HOSPITAL'S IMMEDIATELY CONTIGUOUS AREAS AS WELL AS BY THE BROADER SURROUNDING COUNTIES/REGIONS WHERE THE MAJORITY OF DISCHARGED PATIENTS RESIDE. ADDITIONALLY, THE COMMUNITY INCLUDES PATIENTS WHO REQUIRE THE EXPERTISE AND SPECIALIZED SERVICES OF A BSR HOSPITAL. Bon Secours Richmond Health System serves the larger Richmond, Virginia metropolitan area and includes four hospital facilities, Richmond Community Hospital, Memorial Regional Medical Center, St. Mary's Hospital, and St. Francis Medical Center, whose service areas largely overlap. While the hospitals serve patients from many cities and counties, the majority of patients fall within the counties of Chesterfield, Henrico, Hanover and the City of Richmond totaling approximately 1,067,000 residents. For the purpose of this CHNA, we refer to these as the ""Richmond Core Service Area."" The Richmond Core Service Area is primarily Caucasian and African American. When the demographics of the City of Richmond are viewed alone, we find a much lower percentage of Caucasians and a much higher percentage of African Americans than the community overall. The population age distribution for the Richmond Core Service Area is similar to Virginia overall with the exception of the City of Richmond, which has a higher percentage of 19-64 year olds (69%) and lower percentages of children (18%) and older adults (13%). Median household incomes in the United States are less than those found in Virginia overall. The Richmond Core Service Area counties of Henrico, Hanover and Chesterfield all have higher median household incomes than the U.S. overall. In contrast, the City of Richmond has a much lower median household income as compared to the U.S. and Virginia overall. Compared to Virginia, the percentage of uninsured adults is highest in the City of Richmond and lowest in Hanover County. The percentages of uninsured children show a much lower degree of variance. Bon Secours Richmond Health System also includes Rappahannock General HOspital (RGH). For purposes of the CHNA, RGH defines the three counties of Lancaster, Middlesex and Northumberland as the community it serves as many secondary data sources are county specific and enable comparison to data for the state of Virginia and the United States. The counties of Lancaster, Middlesex, and Northumberland are collectively referred to as the ""Northern Neck Core Service Area"". Approximately 35,000 residents reside in the Northern Neck Core Service Areas. The population is relatively evenly distributed among the three counties. The actual population served by the hospital is closer to 40,000. The RGH community is predominantly White (over 70%), with a large African American population. Compared to Virginia as a whole, RGH has a larger percentage of African Americans but has less ethnic diversity, due to a lower percentage of Hispanics, Asians, and Native Americans. The RGH community is comprised of approximately 20% more older adults (65+) than Virginia and the nation, and a comparatively lower percentage of children (age <18). Middlesex has a greater percentage of adults (19-64) residing in the community and fewer older adults (65+) compared to Lancaster and Northumberland. The median household incomes for Lancaster, Middlesex and Northumberland are lower than the Virginia state average of $68,766 and the national average of $57,652. While Middlesex has lower rates of unemployment than Virginia, the median household income is lower than Virginia and consistent with Lancaster and Northumberland. Compared to Virginia, the percentage of uninsured adults is higher in Lancaster, Middlesex, and Northumberland. The leading causes of death in the Northern Neck Service Area are cancer and diseases of the heart. ADDITIONAL DETAIL REGARDING THE COMMUNITY FOR EACH HOSPITAL IN THE BSR SYSTEM CAN BE FOUND IN EACH HOSPITAL'S CHNA AT THE FOLLOWING LINK: https://www.bonsecours.com/about-us/community-commitment/community-health-needs-assessment"

Schedule H, Part VI, Line 6 Affiliated health care system
"BON SECOURS RICHMOND HEALTH SYSTEM is a member of Bon Secours Mercy Health, Inc., a Maryland nonprofit, nonstock membership corporation (BSMH), and all of the other entities that are controlled directly or indirectly by BSMH are described collectively as the System. The System was organized in June 1983 to fulfill the healthcare mission of the United States Province of the Congregation of the Sisters of Bon Secours of Paris, a congregation of religious women of the Roman Catholic Church founded in France in 1824. The System's activities are in the states of Ohio, New York, Pennsylvania, Maryland, Virginia, Kentucky, South Carolina, and Florida, each referred to as a local system. The Ministry of BSMH aids those in need, particularly those who are sick and dying, by offering services that include but are not limited to acute inpatient, outpatient, pastoral, palliative, home health, nursing home, rehabilitative, primary and secondary care and assisted living without regard to race, religion, color, gender, age, marital status, national origin, sexual orientation, or disability. As a member of the Catholic health ministry and a member of BSMH, this organization and its related entities are called to continue the healing ministry of Jesus. We exist to benefit the people living in the communities it serves. Through all of the services offered to the community, the mission is ""to bring compassion to health care and to be good help to those in need, especially those who are poor and dying. As a System of caregivers, we commit ourselves to help bring people and communities to health and wholeness as part of the healing ministry of Jesus Christ and the Catholic Church."" This organization and related organizations share the BSMH Vision. BSMH's vision to partner with communities to create a more humane world, build social justice for all and provide exceptional value for those served is implemented through its Strategic Quality Plan which provides focus in four goal areas for the current three year period (2019-2021). - Co-Create Healthy Communities: We recognize that the factors which drive health outcomes extend well beyond the scope of traditional health care services. Thus, we commit to improve the health of communities through partnership and collaboration with a broad range of constituencies including committed community residents - Be Person Centric: We recognize that those whom we serve are increasingly engaged in their own care and are seeking convenience, affordability and reliability. Thus, we commit to anticipate and respond to the changing expectations of health care consumers, and to ensure that we engage each person in an individualized plan for health with a focus on prevention and wellness. - Serve Those Who Are Vulnerable: We recognize, by our Catholic identity, that the struggle for a more humane world is not an option, but an integral part of spreading the gospel. Thus, we commit to serve those who are vulnerable in many ways, addressing health disparities, sustaining global ministries, healing the environment and working to end violence and oppression. - Strengthen Our Culture and Capabilities: We recognize that the health care delivery system is undergoing rapid change with increasing complexity. Thus, we commit to liberate the potential of our people by strengthening individual and collective capabilities with respect to ministry leadership, knowledge, analytics, innovation and finances. Please see Schedule R for listings of the related organizations. Each of the reported entities play a role in achieving the vision of BSMH and the SQP (Strategic Quality Plan). System-wide community benefit for 2021 per the audit footnote is as follows: Total 2021 Community Benefit: $605.3 Million Benefits to the Broader Community: $138.9 million Unreimbursed Care for Those Who Are Poor and Qualify for Medicaid: $371.6 million Cost of Care for Those Who Could Not Afford to Pay: $94.8 million Community Benefit as Percent of Total Expense: 5.7 percent."