4A (Expenses $ 3591268458 including grants of $ 0) (Revenue $ 4315108017)
"Inova Health Care Services (IHCS) is part of the Inova Health System whose mission is to serve the needs of the community by establishing, maintaining, and operating hospital facilities, programs, and other shared service arrangements; carrying on health-related education activities; promoting and conducting scientific research; and engaging in activities designed to promote the general health of the community. All five of Inova Health System's hospitals have been rated with 5 out of 5 stars in the most recent Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Rating System report. Inova is the only health system in the country comprised of more than three hospitals where all are 5-star rated. A CMS five-star quality rating is based on extensive data that measures patient experience, infection rates, readmissions and mortality.IHCS includes a centralized System Office and the various unincorporated and incorporated subsidiaries. The unincorporated subsidiaries of IHCS include: Inova Fairfax Hospital, Inova Mount Vernon Hospital, Inova Fair Oaks Hospital, Inova Alexandria Hospital, Inova Loudoun Hospital, ACCESS of Reston, ACCESS of Fairfax, Inova Research Center, Assisted Living Facilities, Inova Physical Rehabilitation Services, Inova Urgent Care Centers, Inova Employee Assistance, and Behavioral Health and Addiction Treatment.PROGRAM SERVICESAcute care services are provided on three campuses in Fairfax County, one campus in Loudoun County, and one campus in the City of Alexandria in Virginia. Services provided include emergency and trauma facilities, inpatient and outpatient services, and a variety of ancillary and specialized services. During 2021, IHCS admissions and observations cases totaled 128,353, outpatient visits totaled 645,946, emergency visits totaled 389,308 (25,060 of the total ER visits were at the Springfield Healthplex, 17,211 at the Lorton Healthplex, and 12,912 at the Ashburn Healthplex) and deliveries totaled 19,022. The acute care program services provided by these hospitals are described more fully below.Inova Fairfax Hospital (IFH) includes the Inova Heart and Vascular Institute, Inova Women's Hospital, Inova Fairfax Hospital for Children, and the Inova Schar Cancer Institute. The hospital, located in Central Fairfax County is a 928-licensed bed tertiary care hospital providing comprehensive medical and surgical services which include emergency/trauma, cardiac, transplant, cancer, obstetric, pediatric, neonatal, stroke, and extensive outpatient services. During 2020, as part of the ""Pandemic Response Executive Order 52"", IFH shifted 20 beds from IFH to ILH. Inova Fairfax Hospital is the home of Northern Virginia's only Level 1 emergency and trauma center and the state-of-the-art Women's and Children's Center. In addition, Inova Fairfax Hospital is a teaching hospital providing clinical training through medical residency, nursing, and paramedical education programs.Inova Mount Vernon Hospital (IMVH) is a 249-licensed bed acute-care hospital serving Southeastern Fairfax County. Inova Mount Vernon Hospital provides a full-service, 24-hour emergency department; broad range of diagnostic, medical, and surgical services; inpatient psychiatric services; the Dorothea R. Fischer Wound Healing Center, and a specialized hyperbaric oxygen therapy program used to treat conditions requiring increased oxygen flow to body tissues (such as grafts and certain types of burns). During 2020, as part of the ""Pandemic Response Executive Order 52"", the allotment to Inova Mt. Vernon Hospital was 12 beds. These are added to our licensed beds to bring the total from 237 to 249. Inova Mount Vernon Hospital also operates the Lorton Healthplex, a 24-hour free standing emergency facility and the Inova Center for Rehabilitation, a nationally-known accredited program providing inpatient and outpatient rehabilitative services.Inova Fair Oaks Hospital (IFOH) is a top-ranked 174-bed acute care community hospital serving the rapidly growing suburbs of Northern Virginia. Signature service lines include spine, weight loss, joint replacement, and minimally invasive surgery. During 2020, as part of the ""Pandemic Response Executive Order 52"", IFOH shifted 8 beds from IFOH to ILH. State-of-the-art cancer care and maternity services are also signature offerings. Inova Fair Oaks Hospital is a fully accredited Comprehensive Center for Bariatric Surgery. Inova Alexandria Hospital (IAH) is a 302-licensed bed general acute care hospital, which opened on January 23, 1873. Inova Alexandria Hospital provides a spectrum of diagnostic services, including full-body CT scanning, MRI, and a cardiac catheterization laboratory; a variety of inpatient medical, surgical, and orthopedic services; comprehensive outpatient services, including outpatient surgery, physical medicine, and rehabilitation; and a 24-hour emergency department as well as the Springfield Healthplex, a free standing emergency facility. In addition, specialized obstetric and pediatric services are provided by the hospital's Maternal and Infant Health Center and a children's unit. Inova Loudoun Hospital (ILH) is a 183-licensed bed general acute care hospital, which first opened its doors in 1912. During 2020, as part of the ""Pandemic Response Executive Order 52"", ILH received 20 beds from IFH and 8 beds from IFOH. These were added to bring the total licensed-beds from 183 to 211. ILH provides a full-service 24-hour emergency department as well as two freestanding emergency rooms; 23 intensive care beds; a spectrum of diagnostic services, including full-body CT scanning, MRI, and a cardiac catheterization laboratory; a variety of inpatient medical, surgical, and orthopedic services, and comprehensive outpatient services including outpatient surgery, physical medicine and rehabilitation services, and radiation therapy. In addition, obstetrical and pediatric services are provided by ILH's Ladies' Board Birthing Inn, a pediatric emergency department and an inpatient pediatric unit. Specific acute care programs include:Cardiovascular Care: Inova Heart and Vascular Institute (""IHVI"") offers a variety of services at all five Inova Hospitals and in nearly 60 outpatient locations throughout the northern Virginia region. Inova Fairfax Medical Campus is home to IHVI's dedicated heart hospital, which serves as the hub of the system's cardiac, vascular and pulmonary services. IHVI's clinical capabilities cover the full spectrum of complex cardiovascular and pulmonary care from medical evaluation and diagnostic testing through the most innovative minimally invasive surgical techniques and complex open surgeries, including heart and lung transplantation. IHVI's outstanding performance has been recognized by many measures, including U.S. News & World Report (2021-2022) rankings as ""High Performing"" in seven cardiac specialties: abdominal aortic aneurysm (AAA) repair, aortic valve surgery, cardiology, heart attack, heart bypass surgery, heart failure and transcatheter aortic valve replacement (TAVR). IHVI has also achieved recognition from the American College of Cardiology as a ""Proven Quality Program"" for its participation and performance in the National Cardiovascular Data Registry (NCDR) database, 3-star ratings (the highest rating) from the Society of Thoracic Surgeons, and ratings from Healthgrades as one of ""America's 100 Best Hospitals for Cardiac Care"", ""America's 50 Best Hospitals for Cardiac Surgery and ""Pulmonary Care Excellence Award"". The AHA recognized IHVI as a Mitral Valve Repair Reference Center Award and Extracorporeal Life Support Organization (ELSO) awarded IHVI as a Gold Award of Excellence. IHVI is ranked among the nation's top performing hospitals for patient safety, patient satisfaction and clinical outcomes.IHVI is also a leader in minimally invasive heart valve repair and surgery. Inova Heart and Vascular Institute operates one of the country's busiest structural heart programs (13th in the country), performing minimally invasive transcatheter procedures to treat valvular heart disease and other heart defects. Additionally, IHVI is 14th in the nation in number of Heart Transplants and with excellent outcomes, making Inova one of the top heart transplant programs in the country. The IHVI multidisciplinary cardiogenic shock team is a model of excellence having set a new standard for patient survival rates. The robust Cardiology and Advanced Lung Research Programs provide innovative research to keep IHVI on the leading edge of diagnosis and treatment options for the community."

4B (Expenses $ 38007157 including grants of $ 0) (Revenue $ 20167172)
Inova Research Center - Medical Students The Inova Research Center (IRC), including research and academic activities, is centered at the Inova Fairfax Hospital. In 2021, The Inova campus of the University of Virginia had a total of 36 third year and 36 fourth year medical students who spent their clerkship and fourth year at Inova Fairfax Hospital. In addition, 180 students came to Inova Hospitals for a four-week rotation in 2021.Pharmacy Students and ResidentsAlso located on the Inova campus is the VCU School of Pharmacy which partners with clinicians and practitioners across Inova and Northern Virginia to help educate and train an increasing number of pharmacy students each year. In 2021, 53 third and fourth year pharmacy students completed didactic and experiential learning experiences across Northern Virginia with the Inova Health System. Pharmacy practitioners precepted 196 Introductory Pharmacy Practice Experiences (IPPEs) and Advanced Pharmacy Practice Experiences (APPEs), with all students from the VCU School of Pharmacy. With the advent of the Shenandoah School of Pharmacy at the Inova Center for Personalized Health beginning in 2017, system wide, Inova precepted 44 IPPE's, 84 APPE's by Shenandoah University faculty during 2021.In addition, there are pharmacy post-graduate training opportunities offered at three Inova institutions. Inova Fairfax Hospital offers 4 PGY-1 Pharmacy Practice Residency positons, as well as a PGY-2 Emergency Medicine Pharmacy Residency position and a PGY-2 Critical Care Residency position. Inova Alexandria and Inova Mount Vernon Hospitals each offer 2 PGY-1 Pharmacy Practice Residency positions, as well as one PGY-2 Ambulatory Care residency position for a total of 11 post-graduate training opportunities across Inova Health System. The Claude Moore Health Education CenterThe Claude Moore Health Education Center on the campus of Inova Fairfax Hospital features 11,000 square feet of space dedicated to the educational needs of medical and nursing students as well as residents and fellows. This state-of-the-art Center includes both medical and surgical simulation centers, enabling students to learn through hands-on experience. The Center features two dedicated research floors to support the extensive activities of the Office of Research at Inova where numerous active clinical trials and ongoing outcomes and laboratory research projects are conducted. Many of these clinical and research opportunities are conducted in partnership with universities and other research entities. The unreimbursed cost of these programs in 2021 was $17.8 million. Residents/FellowsInova sponsors accredited residency training programs in: Family Medicine, Pediatrics, General Surgery, Internal Medicine, OB/GYN, Neurosurgery and Podiatry. In addition, Inova also sponsors accredited fellowships in Surgical Critical Care, Pediatric Emergency Medicine, Pediatric Hospitalist Medicine, Cardiology, Hematology/Oncology, Orthopedic Sports Medicine, Family Sports Medicine, Breast Surgery, and Bariatric surgery. Inova supports training programs from affiliates in Emergency Medicine, Psychiatry, Orthopedics, Ophthalmology, Family Practice, Critical Care, Anesthesia, PM&R and a number of other medical and surgical specialties. Inova also supports integrated fellowships with National Capital Consortium in Vascular Surgery, Female Pelvic Medicine and Reconstructive Surgery, and Gynecology/Oncology. In all, Inova trained 734 individual residents/fellows (200 FTEs) from 34 specialties in 2021. As a teaching facility, Inova Fairfax Hospital incurs typical, additional expenses associated with teaching facilities including physician teaching costs and resident salaries, the cost of maintaining higher levels of technology required to support a teaching program and charges resulting from extra tests ordered for instructional purposes. The direct cost of these programs in 2021 was approximately $18.7 million.

4D (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
Each year, IHCS designates funds for the development and continuation of identified, accessible direct care programs and services benefiting those most in need in the community. Many of these programs and services are not billed to the patient or are provided at a fee structure below the actual cost of the service. In addition to providing the direct care subsidized service, Inova also provides disease-prevention programs, health and exercise classes, health education and health screenings and other programs within the community in support of the IHCS mission. In 2021, Inova provided over 250,000 people with health education, prevention and wellness programs, health fairs and screenings, and clinically related services resulting in over 130,000 visits for direct health care services at an unreimbursed cost of approximately $36.0 million. These services and programs are described below. Inova Cares Clinic for Women and ChildrenThe Inova Cares Clinic for Women (ICCW) was created in 1960 to serve the uninsured women of Fairfax County, offering a wide range of OB/GYN services for those in need. This program is a service offered to the community in collaboration with the local Health Departments, serving uninsured and low-income patients up to 400% of the Federal Poverty Guidelines (FPG). The clinics work in partnership with the Fairfax and Loudoun County Health Departments, IFH, and ILH to promote early and continuous prenatal care for the culturally diverse population who are its patients. Inova Cares Clinic for Women provides comprehensive outpatient obstetrical services and gynecological care as well as non-stress testing, and LEEP and colposcopy procedures at little to no cost to the patient. The clinic provides specialty gynecological care service as well, including maternal fetal medicine, GYN/Onc, and Uro/GYN. In addition to medical services, the clinic also provides support services including radiology, laboratory, genetic testing, diabetes management, case management, social work, family planning, and nutritional counseling. In 2021, ICCW provided over 32,374 patient encounters for over 4,472 patients, 3,142 newly established. Additionally, ICCW supported over 1,783 deliveries at Inova medical campuses. The Inova Cares Clinic for Children (ICCC) was created in 1993 as a response to the inability of uninsured or Medicaid mothers to secure an affordable medical home for their children. ICCC is recognized as an accredited Patient Centered Medical Home by the National Committee for Quality Assurance, and serves as a medical home for newborns up to 21 years of age. The Inova Cares Clinic for Children provides comprehensive pediatric services that includes well-child care, immunizations, episodic care (sick visits), and school/sports physicals, immunizations, and nutritional counseling. In 2021, the Inova Cares Clinic for Children provided 23,305 clinical services to over 7,517 patients and 2,956 newly established patients.Inova Alexandria Hospital (IAH) OB ClinicIAH donates space on the campus to the Casey Clinic, a community health center currently run by Neighborhood Health, a Federally Qualified Health Center that is funded by the State of Virginia, Alexandria Health Department and the City Of Alexandria to provide primary healthcare services to low-income and uninsured children and adults that are residents of the City of Alexandria. IAH funds the clinic physicians who provide OB patient prenatal examinations and delivery at Inova Alexandria Hospital. Inova Juniper Program, HIV Clinical and Education ServicesInova Juniper Program (IJP) provides outpatient primary medical care, mental health therapy, substance abuse counseling, pharmaceutical assistance, and medical case management services to 1,638 Ryan White funded persons living with HIV disease in the suburban Virginia region. To maximize accessibility for clients, services are provided at the main location in Fairfax, as well as six satellite clinics (Dumfries, Manassas, Mt. Vernon, Falls Church, Leesburg, and Herndon), hospitals, homes, and other community locations throughout the region. Major accomplishments of IJP for 2021 include:Served 1,638 patients living with HIV, providing 40,783 services.Provided 6,714 medical case management services to 833 Ryan White funded clients living with HIV. Provided 349 clients with mental health services and 10 clients with substance abuse outpatient care.Conducted 101 hours of education reaching 615 participants.Conducted 104 HIV tests (primarily at-home tests due to COVID-19) with known seroprevalence of 3.8% across Northern Virginia.Successfully adapted to primarily virtual prevention and education programs to support, motivate and educate healthcare professionals, the public, and people living with HIV. Programs are targeted to incarcerated men and women, men who have sex with men, youth, and the general population. HIV testing, outreach groups, and patient navigation services are also provided.Life with Cancer Life with Cancer, part of the of the Inova Dwight and Martha Schar Cancer Institute, has become Northern Virginia's premier cancer education, wellness, and psychosocial support organization. A variety of integrative therapies, wellness programs, groups and classes are offered to patients (adults and children), survivors, family members (adults and children), friends and staff as well as community organizations. Programs are evidence-based [supported by Society of Integrative Oncology (SIO), The American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN)] and designed to help individuals and the community understand cancer, cancer treatments, survivorship, grief and bereavement and how to maintain physical and psychological health. Life with Cancer's facilities are strategically located throughout the Northern Virginia area with the centerpiece of outpatient care provided at the Life with Cancer Family Center, adjacent to the Inova Fairfax Medical Campus. At the newest location, Inova Schar Cancer Institute (ISCI) - Fairfax, Life with Cancer clinical staff are fully integrated in all 7 clinics to provide the best patient experience possible. Life with Cancer is primarily supported by generous donations from the community, and therefore, all services are available at no charge with minimal exceptions, no matter where the patient's cancer treatment is received. Those exceptions include psychiatry, which is billed to insurance, and oncology massage and acupuncture, for which patients may pay for additional sessions beyond what is offered for free. In 2021, philanthropic funds allowed Life with Cancer to offer 3 free oncology massage sessions and 6 free acupuncture sessions to cancer patients. By the close of 2021, Life with Cancer had provided 23,791 clinical patient encounters, in-person and via telehealth, which included 1,671 educational classes, groups and wellness programs for adults, children and adolescents with 22,921 participants. 15,536 individuals alone participated in exercise/activity programs and Life with Cancer expert dietitians provided 2,549 nutrition counseling appointments to adults and children with cancer as well as caregivers. The Pediatric Program, led by a Pediatric Chief Psychologist, provided the highest quality pediatric care, education, and support for patients and families through more than 3,695 clinical encounters. Life with Cancer psycho-oncologist, who provides whole-person, humanistic, and patient-centered care conducted 1,169 patient consultations.Inova Lions Eye ClinicAdministered by Inova Health System (IHS), the Ophthalmology Clinic provides ophthalmic specialty services to the indigent including treatment of glaucoma, retina, and cataracts. Inova Lions Eye Clinic provides a part-time ophthalmologist, an ophthalmic technician, and a receptionist for the clinic. The remaining physicians volunteer their services. In 2021, Inova Lions Eye Clinic was able to resume normal operations and increased the number of patients served following the significant drop that resulted from the COVID-19 impact in 2020. The number of unique patients served in 2021 increased to 1,345 and total visits increased to 4,786.

Part V, Section A:
The surgery centers listed as hospital facilities 6-10 in Part V, Section A are part of the hospital facilities' CHNAs already conducted and have followed the hospital facilities' financial assistance policy. The surgery centers are reported specifically in the hospital facilities' CHNAs and are listed as hospital facilities in Part V, Section A.

Part V, Section B
Facility Reporting Group A

Facility Reporting Group A consists of:
- Facility 1: INOVA FAIRFAX HOSPITAL, - Facility 2: INOVA ALEXANDRIA HOSPITAL, - Facility 3: INOVA LOUDOUN HOSPITAL, - Facility 4: INOVA FAIR OAKS HOSPITAL, - Facility 5: INOVA MOUNT VERNON HOSPITAL, - Facility 6: INOVA LOUDOUN AMBULATORY SURGERY CENTER LLC, - Facility 7: NORTHERN VIRGINIA SURGERY CENTER LLC, - Facility 8: FRANCONIA-SPRINGFIELD SURGERY CENTER LLC, - Facility 9: MCLEAN AMBULATORY SURGERY CENTER LLC, - Facility 10: INOVA AMBULATORY SURGERY CENTER AT LORTON LLC

Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 3j:
Question 3eInova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Eight areas were identified as the most significant health needs for the IFH community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Mental Health; Neighborhood and Built Environment; Obesity, Nutrition, and Physical Activity; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IFH-IMASC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Fairfax Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.

Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 5:
For Inova Fairfax Hospital :The IFH-IMASC CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, Inova staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmentCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities.

Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 6a:
Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)

Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 11:
"BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, Inova leadership, Fairfax Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Fairfax Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, mental health stakeholders, Neighborhood Health FQHC, Area Health Education Center, and county teams including the Community Services Board, Neighborhood and Community Services, Public Schools, and the Health Department.Inova in the CommunityAction Committee conversations in Fairfax and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Fairfax, this included participating in events such as County-led Health Resource Fairs in Annandale and the Lee District, LatinX AIDS Awareness Day and HIV testing at Northern Virginia Community College (NVCC), World AIDS Day Awareness testing at NVCC, Community Health Fair at Groveton Baptist Church, and the launch of Dream Big at West Potomac Academy of Fairfax County Public Schools. Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting ""wheel"" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: The Women's Center who will expand access to effective, equitable, and affordable mental health services for more than 60 low-income Fairfax County residents; and NOVA Scripts Central who provides affordable pharmacy services to low-income, uninsured residents across Northern Virginia and will improve access to culturally competent and linguistically appropriate health information. Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: ""A Call for Transformation: Impactful Strategies for Sustainable Change."" This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA)."

Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 13h:
Calculate family size

Group A-Facility 1 -- INOVA FAIRFAX HOSPITAL AND MCLEAN SURGER Part V, Section B, line 16j:
Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.

Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 3j:
Question 3eInova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Ten areas were identified as the most significant health needs for the IAH/IFFSC community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Mental Health; Neighborhood and Built Environment; Obesity, Nutrition, and Physical Activity; Oral Health; Sexual and Reproductive Health; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IAH-IFFSC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Alexandria Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities

Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 5:
For IAH:Throughout the CHNA/CHA, the Alexandria Health Department (AHD) and Inova worked with community partners and developed public meetings, pop-up events and targeted outreach plans to engage residents who are not always represented. Following are the core strategies AHD used to capture a wide variety of community perspectives and priorities. Inova was an active participant in these activities but relied on AHD core strength in community engagement to lead the process. Throughout the assessment, input was received from diverse sources including the local health department, Inova staff, representatives of key community groups and individual community members. The Community Health Assessment Steering Committee - comprised of community members - guided Alexandria's CHA focus, process and decision-making each step of the way. Through monthly meetings, this group advised AHD staff on outreach strategies, public meeting structure and how to prioritize data using equity as a primary lens. Organization represented include:Alexandria Bicycle and Pedestrian Advisory CommitteeAlexandria City Public SchoolsAlexandria Commission for WomenAlexandria Commission on AgingAlexandria Commission on HIV/AIDSAlexandria Health DepartmentAlexandria Redevelopment and Housing AuthorityAlexandria School Health Advisory BoardCasa ChirilaguaEconomic Opportunities CommissionFriends of Alexandria Mental Health CenterFriends of Guest House Inova Health SystemMedical Reserve CorpsMotley FoolNeighborhood Health (FQHC)Northern Virginia Health FoundationPartnership for a Healthier AlexandriaTheater ChurchPublic MeetingsAHD hosted three community meetings to ensure transparency and engage community members in the CHA process. Meeting locations were selected deliberately for geographic diversity, proximity to public transit, and easy accessibility for those with limited mobility. AHD provided meals and interpreter services in Spanish, Arabic, and Amharic at all meetings. These public meetings were advertised through City of Alexandria media channels, local newspapers, Medical Reserve Corps volunteer flyer distribution, tabling at community events, and email outreach to various partners and other local government agencies.Kickoff and Creating a Vision for Health: April 26, 2018, First Baptist ChurchIntro to Data Collection: July 26, 2018, Durant Recreation CenterGathering Evidence and Examining Results: November 3, 2018, George Washington Middle SchoolBuilding a Healthier Alexandria Together: Community Health Assessment Report Release: June 26, 2019, Beth El Hebrew CongregationPhotoVoicePhotoVoice is a method to crowdsource information using pictures. AHD introduced the concept during the July 26, 2018 public meeting and asked attendees to submit photos that capture either what people are proud of in Alexandria or what could be improved. Participants could submit up to five photos with captions through email or text message. PhotoVoice participants submitted more than 70 pictures and captions. A subset of this group met on August 9, 2018 to discuss the images and sort them into categories. The resulting categories are: equitable access to green space, accessibility in our food system, community cohesion, children and youth, environment and mobility. A full gallery of the images are on Instagram @AlexHealthMatters.Public Health Pop-UpsDuring the Community Themes and Strengths Assessment (CTSA) public survey, AHD staff organized 26 public health pop-ups to collect surveys and promote the November 3, 2018 community meeting. These pop-up locations were selected to meet residents where they are and encourage survey participation from community members who may not be fully engaged in civic processes because of time, awareness, literacy, or language barriers. A combination of AHD employees and Medical Reserve Corps volunteers staffed all of the pop-ups, which were mostly held on evenings and weekends. Of the nearly 1,800 completed CTSA surveys, almost half were collected during public health pop-ups.In addition to the pop-ups, Inova and AHD staff worked with a number of local organizations to administer and collect surveys on their premises on an ongoing basis, such as the Department of Community and Human Services, the Alexandria Redevelopment and Housing Authority, Tenants and Workers United, and Casa Chirilagua. Finally, all AHD locations - 4480 King Street clinics and WIC, Teen Wellness Center at TC Williams, and the Casey Center - administered the survey to clients. Additionally, Inova promoted the online survey on its website and through community partners including safety net providers, social service agencies and others.

Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 6a:
Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)

Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 11:
"BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, IAH leadership, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Alexandria Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith based organizations, mental health stakeholders, community businesses and organizations, the Concerned Citizen Network of Alexandria (CCNA), Tenants and Workers United, American Foundation for Suicide Prevention, Medical Reserve Corp - Alexandria, Volunteers of Alexandria, Animal Welfare League of Alexandria, Four Mile Run, Neighborhood Health FQHC, and city teams including Community and Human Services, Parks and Recreation, Public Schools, and Race and Social Equity, Alexandria elected officials, Northern Virginia Community College, and community members that reside in the Alexandria Neighborhoods. Inova in the CommunityAction Committee conversations in Alexandria and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Alexandria, this included the Coat and Vaccine with CCNA at St. Joseph's Catholic Church in Old Town, Back to School Health Fair, two Pets and People Community Event's with the Animal Welfare League of Alexandria in Arlandria, and the Spring 2Motion Movement Challenge for the City of Alexandria. Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting ""wheel"" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: Boys & Girls Clubs of Greater Washington - Funds were used to expand the Triple Play and Healthy Habits programs, which encourage good nutrition, physical activity, healthy relationships, and active learning.Capital Youth Empowerment Program - Funds were used to boost the Fathers in Tech project, which teaches workforce skills to Arlington, Fairfax, and Alexandria fathers living in Black, Indigenous and People of Color (BIPOC) communities.Carpenter's Shelter Inc - Funds were used to improve access to medical and mental health care among homeless adults and children in Alexandria and help them transition to sustainable homes. La Cocina VA - Funds were used to expand the Healthy Food Assistance program to fight hunger and obesity among immigrants, children, homeless people, veterans, the unemployed, and the underemployed in Arlington.Nueva Vida, Inc- Funds were used to create culturally sensitive cancer and mental health support for the medically under-resourced Latino/a population in Alexandria City and Fairfax County.SCAN of Northern Virginia - Funds were used to increase access to child abuse prevention resources, assessments and medical care for families in Alexandria.The Campagna Center - Funds were used to subsidize the New Neighbors program, which provides students with access to high-quality English language instruction to improve their employment and future opportunities to thrive in the community.The Child and Family Network Centers - Funds were used to provide pre-kindergarten physicals, vaccinations and medical screenings to more than 100 four-year-olds in underserved West End and Alexandria communities."

Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 13h:
Calculate family size

Group A-Facility 2 -- INOVA ALEXANDRIA HOSPITAL AND FRANCONIA Part V, Section B, line 16j:
Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.

Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 3j:
Question 3eInova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Nine areas were identified as the most significant health needs for the ILH/ILASC community: Chronic Conditions, Economic Stability, Healthcare Access, Infectious Disease and Immunization, Injuries and Violence, Mental Health, Neighborhood and Built Environment, Oral Health, and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, ILH-ILASC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Loudoun Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.

Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 5:
For ILH:While a regional approach guided the CHNA/CHA, each jurisdiction used its own process for community outreach and engagement. As much as possible, the process centered on existing resources, partnerships, and local needs and values. This method ensures that any new initiatives accurately reflect community priorities. Inova and the Loudoun County Health Department planned and produced the Loudoun assessment together. Each member of the team contributed to the assessment in different ways, utilizing individual strengths. As a part of the collaborative process leading this assessment, the Loudoun County Health Director and the Loudoun Health Council provided valuable insight and knowledge, and input was received from diverse sources including the local health department, hospital staff, representatives of key community groups and individual community members.This 2019 Community Health Needs Assessment (CHNA)/Community Health Assessment (CHA) process gathered community input through two main methods - Forces of Change discussions and the community survey.Forces of Change discussions bring together individuals working in and with the community, who represent a broad diversity of stakeholders. Participants included individuals with special knowledge of or expertise in public health; local public health departments; agencies with current data or information about the health and social needs of the community; representatives of social service organizations; business leaders, and leaders, representatives, and members of medically underserved, low income, and minority populations. Inova and Loudoun County Health Department representatives conducted Forces of Change sessions with the Loudoun Health Council, Loudoun Human Services Network, and the Loudoun County Chamber of Commerce.Inova, the Health Department and the Loudoun Health Council promoted the community survey to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese (Mandarin), English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities. Surveys were also distributed to families through the Loudoun County Public School system.

Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 6a:
Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL)

Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 11:
"BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, Inova leadership, Fairfax Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Fair Oaks Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, Healthworks FQHC, Northern Virginia Family Services, Cornerstones, Western Fairfax Christian Ministries, and county teams including the Health Department, Neighborhood and Community Services, Community Services Board, and Public Schools.Inova in the CommunityAction Committee conversations in the Fair Oaks region and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Fair Oaks, this included participating in events with Western Fairfax Christian Ministries, Cornerstones, and Opportunity Neighborhood.Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting ""wheel"" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: YMCA of Metropolitan Washington's location in Reston to support both its health promotion programs and its Food and Health Hub program that provides home-delivered local produce to food insecure residents and those with chronic health conditions living. Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: ""A Call for Transformation: Impactful Strategies for Sustainable Change"". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA)."

Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 13h:
Calculate family size

Group A-Facility 3 -- INOVA LOUDOUN HOSPITAL AND LOUDOUN SURGE Part V, Section B, line 16j:
Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.

Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 3j:
Question 3eInova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Seven areas were identified as the most significant health needs for the IFOH/INVSC community: Chronic Conditions, Economic Stability, Healthcare Access, Injuries and Violence, Mental Health, Neighborhood and Built Environment, and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IFOH-INVSC has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Fair Oaks Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.

Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 5:
For IFOH:The IFOH-INVSC CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, Inova staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmenCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities.

Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 6a:
Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center at Lorton (IASCL) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)

Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 11:
"BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoMembers of the Community Health Division, Inova leadership, Fairfax Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Mt. Vernon Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, primary and secondary education institutions, community businesses and organizations, mental health stakeholders, United Community, Neighborhood Health FQHC, and county teams including the Community Services Board, Public Schools, the Health Department, Equity, and Neighborhood and Community Services, and community members who reside in the Mt. Vernon neighborhoods. Inova in the CommunityAction Committee conversations in Mt. Vernon and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Mt. Vernon, this included participating in events such as a Juneteenth celebration at Creekside, Multicultural Community Day at Sequoyah, Multicultural Community Day at Audubon, Woodlawn Apartments Community Day, the Trunk and Treat Halloween Resource Fair at the Sacramento Neighborhood Center, and a month of culturally competent holiday season events in December for the Audubon Community. Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting ""wheel"" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: United Community who help families find fresh foods and health services and coordinate a Health Work Group to improve community health outcomes and develop a sustainable system for healthy food access, and Our Minds Matter who support peer and programmatic suicide prevention programs and mental health resources in Annandale, Falls Church, Justice, Mount Vernon and West Potomac High Schools in Fairfax County.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: ""A Call for Transformation: Impactful Strategies for Sustainable Change"". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA)."

Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 13h:
Calculate family size

Group A-Facility 4 -- INOVA FAIR OAKS HOSPITAL AND NORTHERN VA Part V, Section B, line 16j:
Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.

Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 3j:
Question 3eInova Mount Vernon Hospital (IMVH) and Inova Ambulatory Surgery Center (IASCL) at Lorton completed a Community Health Needs Assessment (CHNA) in 2019 and found that numerous health status and access problems are present in the community. Eight areas were identified as the most significant health needs for the IMVH/IASCL community: Chronic Conditions; Economic Stability; Healthcare Access; Injuries and Violence; Maternal, Infant, and Child Health; Mental Health; Neighborhood and Built Environment; and Tobacco and Substance Use. Within these areas there was no prioritization or ranking.Based on the CHNA results, a three-year Implementation Strategy was developed to address the community benefit service area for calendar (tax) years 2020 through 2022. Priorities were based on community need as determined by quantitative data and community input, as well as on health system expertise, resources, strengths of existing programming and partnerships, and alignment with national, state, and local health goals. Based on the CHNA recommendations, IMVH-IASCL has identified as its community benefit priorities Chronic Conditions, Behavioral Health, and Health Access. These three priorities were selected by all Inova facilities, as they appeared on the needs list of each region, align with state goals, and can be addressed not only in the individual locales, but also through a system approach across the entire Northern Virginia region. Using this methodology, approaches can be customized to meet the specific needs in each region. The 3-year Implementation Strategy was approved by the Inova Health Care Services Board.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in 2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system wide approaches to improving CHNA-identified health needs and the Mt. Vernon Regional Action Committee consisting of Inova team members and community partners identifies local needs and opportunities.

Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 5:
For IMVH:The IMVH-IASCL CHNA adopts knowledge gained during the Fairfax County Health Department's CHA, as well as additional community input. As a part of the collaborative process leading this CHNA, the Fairfax County Health Director and Strategic Planner provided valuable insight and knowledge, and input was received from diverse sources including the local health departments, hospital staff, representatives of key community groups and individual community members.The Fairfax CHA examined a variety of other community assessments to extrapolate significant health needs and themes. The main tool utilized in this process was an analysis of these community assessments produced by key groups and partners in the community. Some assessments examined a broad range of health-related indicators, and others studied a specific program area or health-related issue. Diverse sectors of the community were broadly represented, and together these assessments provide a comprehensive profile of the Fairfax community. The 12 assessments included in the Fairfax County CHA were the following: Community Health DashboardFairfax County Youth SurveyFairfax County Human Services Needs AssessmentInova Community Health Needs AssessmentKaiser Permanente Community Health Needs Assessment,Community Assessment for Public Health Emergency ResponseFairfax Food Council Community Food AssessmentCulturally and Linguistically Appropriate Services SurveyEquitable Growth Profile of Fairfax CountyA Study in Contrasts: Why Life Expectancy Varies in Northern VirginiaFairfax County Park Authority Needs Assessment, The State of the Health Care Workforce in Northern Virginia. For more information on the Fairfax County CHA, visit www.fairfaxcounty.gov/livehealthy.Additionally, Inova staff gathered feedback from the Partnership for a Healthier Fairfax Steering Committee and the Fairfax County Multicultural Advisory Council through targeted focus group questions.Inova and the health departments gathered community input through a public survey promoted to partners and residents alike. The survey was available in print or online in nine languages (Amharic, Arabic, Chinese [Mandarin], English, Farsi, Korean, Spanish, Vietnamese and Urdu). Printed copies were provided to partners and local clinics, as well as health department facilities.

Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 6a:
Inova Fair Oaks Hospital (IFOH) and Inova Northern Virginia Surgery Center (INVSC) Inova Alexandria Hospital (IAH) and Inova Franconia-Springfield Surgery Center (IFFSC)Inova Fairfax Hospital (IFH) and Inova McLean Ambulatory Surgery Center (IMASC) Inova Loudoun Hospital (ILH) and Inova Loudoun Ambulatory Surgery Center (ILASC)

Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 11:
"BackgroundA Community Health Needs Assessment (CHNA) was conducted in 2019 to identify the significant health needs in the community and to inform development of an Implementation Strategy to address those needs. This process also responds to regulatory requirements, which mandate that tax-exempt hospital facilities conduct a CHNA every three years and adopt an Implementation Strategy that addresses significant community health needs.One main aim of the Implementation Strategy is to guide the hospital's community benefit activities for the period of 2020-2022. Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs. The CHNA process encourages hospitals to focus on improving the health of the communities they serve, and not to select outreach efforts based solely on internal growth priorities. Implementation Strategies should be broad based and work with community entities to improve health outside the walls of the hospital, increase prevention efforts and improve public health.Chronic Conditions, Healthcare Access, and Behavioral Health were chosen as the priority areas for the 2020-2022 Implementation Strategy.Update - Year TwoImplementation StructureMembers of the Community Health Division, Inova leadership, Loudoun Health Department, and community partners have been working diligently on the priority areas set forth in the 2019 CHNA Implementation Strategy.Due to significant changes to the social and health landscapes, the Implementation Strategy was shifted in mid-2020 to include the lenses of health equity, antiracism, and social determinants of health. A structure was implemented whereby a steering committee addresses system-wide approaches to improving CHNA-identified health needs and the Loudoun Community Action Committee consisting of Inova team members and community partners identifies local needs and opportunities and develops partnerships to address them. The Steering Committee meets monthly to identify needs and opportunities throughout the system. The Action Committee also meets monthly and brings together representatives from multiple Inova departments, faith-based organizations, Healthworks FQHC, Loudoun Free Clinic, Loudoun Hunger Relief, Northern Virginia Family Services, Area Health Education Center, and county teams including the Health Department; Human Services; Mental Health, Substance Abuse, and Developmental Services; and Public Schools.Inova in the CommunityAction Committee conversations in Loudoun and across Northern Virginia brought to light the need for Inova to have an increased presence in and engagement with its local communities to build trust. A tool was developed to collect information from Inova team members with interest in sharing their expertise at community events and activities. Rather than create events, Inova works with local non-profit, faith, clinical, government, and neighborhood partners to collaboratively deliver resources at events and activities designed and attended by community members. Inova team members volunteer their time and expertise at a variety of events including health fairs, health education sessions, workforce development opportunities, and community celebrations. In Loudoun, this included participating in events such as SterlingFest and being present at Loudoun Hunger Relief food distribution events.Creating a Diverse WorkforceDream Big, Inova's health equity-based workforce development initiative, aims to increase racial and ethnic diversity in the healthcare workforce to better reflect and represent the communities Inova has the privilege to serve. The program was created in 2021 and gives minority youth an up-close look at a variety of healthcare careers and roles. Inova team members of diverse backgrounds and professions - known as the Dream Team - created short videos highlighting their career journeys. Team members visit Title 1 middle and high schools in Northern Virginia to show the videos and share their work-life experiences. The goal is to inspire young people to visualize their own healthcare career success stories.In addition, Inova Community Health and Inova Talent Acquisition joined forces to develop resources for youth and adults who aspire to a healthcare career. Information includes positions that don't require post-secondary education, career ladders and tuition assistance options at Inova. These materials can help students determine next steps after high school, as well as offer adults opportunities to join the healthcare field. It's a win-win - providing the community with career opportunities and economic stability and providing Inova with a culturally responsive and representative workforce. Social Determinants of Health ScreeningIn 2021, Inova established a Clinical Effectiveness sprint to implement Social Determinants of Health screenings across the system. The screening tool is made up of validated questions assessing need in a wide array of social determinants. The project brought together a team representing all aspects of the Inova workforce to determine how the tool and resulting ""wheel"" should be presented, who it should be available to, and what was necessary to begin socializing its use. The tool launched at the end of August following the project and a variety of mechanisms are in place to gather the information, including directly from patients, via the MyChart patient portal. A resource page was created on the Inova intranet to assist in the use of the tool and referrals based on individual responses. The system is in the process of implementing the UniteUs/Unite Virginia platform for active referrals to social services and non-profit partners, and the Inova team is encouraging referral partners to join the platform as well. This will close the loop for those using the screening tool and needing easy access to resources for patients.Community Health FundEvery year Inova provides Community Health Fund grants to non-profit organizations in Northern Virginia providing services aligned with the CHNA. In 2021, the overall award amount was doubled to $240,000. Awardees included: Loudoun Literacy Council who will help more than 700 adults and children participate in reading and English as a Second Language programs including Health Education and Literacy, Intervention Instruction, Story Walks, Head Start, and Starting Toward Excellence in Preschool.Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: ""A Call for Transformation: Impactful Strategies for Sustainable Change"". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA)."

Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 13h:
Calculate family size

Group A-Facility 5 -- INOVA MOUNT VERNON HOSPITAL AND LORTON S Part V, Section B, line 16j:
Financial Aid Brochures explaining the charity policy are available throughout the Hospital. ER Rooms and waiting rooms have charity notifications posted in their areas, and the brochures are also posted on Inova's website.

PART V, SECTION B, LINE 11 INOVA FAIRFAX HOSPITAL
"COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get ""shots in arms"" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Later, the program partnered with the Fairfax County Health Department to continue in-home vaccinations and boosters. Among those who received the vaccine were homebound ElderLink patients over the age of 65. ElderLink is a partnership between Inova and the Fairfax County Area Agency on Aging that promotes the well-being of older adults and caregivers. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a virtual town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Even so, there are many activities in these areas throughout the Inova system."

PART V, SECTION B, LINE 11 INOVA ALEXANDRIA HOSPITAL
"Community Health WorkersInova is a member of the Virginia Hospital & Healthcare Association and participated in its HealthBegins cohort to use health disparity data to drive interventions. A charter was developed to identify and address food insecurity and access in the area bordering Fairfax County and the City of Alexandria. This effort led to increased interest in the use of Community Health Workers (CHW) to partner with individuals and communities to promote health and address social determinants of health. In 2020, a CHW was hired for the charter region and another was identified for zip codes in eastern Loudoun County. CHW roles are now present in all Inova Cares Clinic for Families sites located in regions with high rates of health disparities.Healthcare Disparities ConferenceIn October, Inova presented the third annual Healthcare Disparities Conference entitled: ""A Call for Transformation: Impactful Strategies for Sustainable Change"". This event reached healthcare workers and community partners across Northern Virginia and throughout the United States with topics addressing strategies for implementing individual, team, community, and systemic change to address health disparities and improve the health and wellbeing of culturally and ethnically diverse patients. Speakers shared their experiences with advancing health equity and implementing change in their practice settings and communities. Participants learned how to be a community ally by supporting practice and policy changes that promote health equity.The partnership that coordinated this CME-accredited event includes Inova, George Mason University, Virginia Area Health Education Center, and the Integrated Translational Health Research Institute of Virginia (iTHRIV CTSA).COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get ""shots in arms"" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Even so, there are many activities in these areas throughout the Inova system."

PART V, SECTION B, LINE 11 INOVA FAIROAKS HOSPITAL
"COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get ""shots in arms"" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Later, the program partnered with the Fairfax County Health Department to continue in-home vaccinations and boosters. Among those who received the vaccine were homebound ElderLink patients over the age of 65. ElderLink is a partnership between Inova and the Fairfax County Area Agency on Aging that promotes the well-being of older adults and caregivers. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, and obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system."

PART V, SECTION B, LINE 11 INOVA MT VERNON HOSPITAL
"COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get ""shots in arms"" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Later, the program partnered with the Fairfax County Health Department to continue in-home vaccinations and boosters. Among those who received the vaccine were homebound ElderLink patients over the age of 65. ElderLink is a partnership between Inova and the Fairfax County Area Agency on Aging that promotes the well-being of older adults and caregivers. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as cultural competency, obesity, and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system."

PART V, SECTION B, LINE 11 INOVA LOUDOUN HOSPITAL
"COVID-19 Vaccination Efforts in the CommunityAs the COVID-19 pandemic persisted, Inova collaborated with multiple community partners to get ""shots in arms"" across the region.Inova's first large-scale vaccine distribution center, which opened at the Inova Center for Personalized Health in late 2020, was soon vaccinating up to 4,000 Inova team members per day. In early 2021, Inova served as the primary source of vaccines for public and private school teachers and employees, and vaccinated community members aged 65+ by appointment. To accommodate increasing demand, the site moved to the Inova Stonebridge COVID-19 Vaccination Center in the City of Alexandria and began accepting walk-in appointments from the general public in mid-March. The site also offered drive-through vaccinations to improve access. Members of Volunteer Fairfax, the Fairfax County Community Emergency Response Team, and the Virginia National Guard helped with patient movement and flow. The Fairfax County Medical Reserve Corps provided 10 volunteers each day in addition to the 100 Inova team members needed daily to administer vaccines. By the end of 2021 more than 450,000 vaccines had been administered.For those who couldn't leave their homes to get a vaccine, the Inova Medical House Calls was one of the first groups to operationalize in-home vaccines in early 2021. Between January and March, the team administered 1,260 doses to 655 homebound older adults and family caregivers without wasting a single dose. Despite widespread availability as the year progressed, some community members did not have access or were reluctant to get the vaccine. To reach them, Inova Cares Clinic for Families (ICCF) teamed up with local health departments in Fairfax, Loudoun and Prince Williams counties, which linked ICCF with pastors from local African American churches to rally their congregations. Faith leaders became incredibly important in building trusted relationships between healthcare systems and communities they serve to improve access to care for all. The churches helped to coordinate transportation to ICCF locations, and ICCF set aside clinic days and times during non-work hours to meet the needs of this community.In addition, ICCF's Community Health Workers and the Loudoun County Health Department focused on reaching Latino communities. Connections were made at local churches and businesses, as well as community events including food distribution days hosted by Loudoun Hunger Relief. As a result of these joint outreach efforts, more than 4,000 community members were vaccinated at designated ICCF sites. Inova team members administered the shots while church volunteers and health department workers coordinated registration and flow. To educate the community and encourage people to get the COVID-19 vaccine, Inova created and participated in a number of messaging campaigns, including: Get the Vaccine! - Inova produced 45 videos to address vaccine hesitancy and reinforce that the vaccine is safe and effective. Inova physicians from a variety of cultural backgrounds and specialties, including general and internal medicine, surgery, OB-GYN and pediatrics, participated. Providers recorded the message in English and their native languages. Inova also used the videos to engage faith, school and business leaders who found them useful in reaching congregations, families and customers. Vax UP FCPS - In mid-October, Fairfax County Public Schools (FCPS) reached out to request a partnership with Inova's pediatricians to address the questions and concerns of parents considering vaccinating their soon-to-be eligible 5- to 11-year-olds. Within a few weeks, and in time for the official authorization, the joint Inova-FCPS team created videos answering some of the most common questions about the COVID-19 vaccine for kids. These videos were posted to the FCPS page and were made available on the Inova Get the Vaccine! page to maximize their reach in all areas of Northern Virginia.Understanding the COVID-19 Vaccination - In February, Inova team members held a virtual town hall with Black church leaders to discuss the vaccine, address hesitancy and discuss messaging for congregations. This well-informed and collaborative conversation helped shape Inova's outreach efforts to our vulnerable and marginalized populations, while supporting faith leaders in their efforts to keep their communities healthy.Expansion of Community Health Clinics and ProgramsInova continued to grow its community presence through the expansion of clinics and programs into specific neighborhoods which are open to individuals throughout Northern Virginia. Inova Ewing FACT and Inova Cares Clinic for Women opened new clinics in Alexandria to add to their existing presence in Fairfax and Loudoun Counties. Inova Cares Clinic for Families opened a Herndon location to add to its presence in Alexandria, Annandale, Sterling, and Manassas. Inova Medical House Calls continued to grow its service area to include Mt. Vernon. In 2022, Inova's Community Health Division will launch two new programs in the region that address community need - Inova Pride Clinic for LGBTQ+ individuals and Inova Cares for Behavioral Health. Both programs were in development in 2021 and are expected to launch in the first half of 2022.Health Needs the Hospital Will Not AddressNo hospital facility can address all health needs present in its community. The hospital is committed to remaining financially healthy so that it can grow to enhance clinical services and to continue providing a range of community benefits. The hospital's Implementation Strategy focuses on meeting the priority and specified community health needs described above. Certain issues are beyond the scope of the hospital and the hospital has insufficient resources to make a meaningful impact. Other topics, such as cultural competency, Lyme Disease, and obesity and obesity-related concerns are not covered as priority target areas in this plan. Even so, there are many activities in these areas throughout the Inova system."

Part I, Line 3c:
Catastrophic Financial Assistance: Catastrophic Financial Assistance is available for patients who do not qualify for free care based on the criteria above, who, due to the nature and extent of services provided, have significant care-related financial obligations in relation to household income and other potentially available resources. In such circumstances, the patient responsibility will be limited to the lesser of 15% of Family Income or the Amounts Generally Billed.

Part I, Line 6a:
The Community Benefit Report is included in the consolidated Inova Health System report to the community on INOVA.org website.

Part I, Line 7:
Cost to charge ratio method is used based on table 2 in the instructions. Total operating expense is divided by Total Gross Revenue to arrive at the cost to charge ratio.

Part I, Line 7g:
Cost of Physician Clinic is $7,404,120.

Part I, Line 7, Column (f):
The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 54,795,565.

Part II, Community Building Activities:
Inova's Office of Sustainability provides community building support focused on environmental improvements that in turn, benefit community health. Environmental Mission Statement:Inova Health System is committed to establishing an environmental program that is safer and healthier for patients, employees and the community.Community Building Environmental Improvements Waste ManagementInova has been focused on waste reduction strategies including recycling and segregation since 2008. Throughout the hospitals there is a single stream recycling process along with focused efforts on reducing regulated medical waste. In 2021, Inova recycled or diverted more than 3.2 million pounds of material from local landfills and waste to energy facilities.Specialized areas recycling/reuse: Inova has implemented specialized recycling programs to capture specific materials throughout the hospitals such as electronics, batteries, reusable equipment and more. Inova continued the food waste composting program at Inova Fair Oaks Hospital, diverting approximately 600 pounds of food waste each week. EnergyDuring 2021, Inova continued to make progress towards its energy goal of reducing energy use intensity (EUI) by 20 percent. A variety of projects including exterior lighting upgrades, specific interior lighting projects, HVAC improvements and energy monitoring, were implemented. These efforts result in cost savings and improved resilience for the overall health of the community.WaterInova continues to maintain native plantings and low-impact irrigation systems for landscaping as well as reduce water consumption in our hospitals through the routine replacement of less efficient plumbing fixtures. BuildingsInova is currently working on a number of projects pursuing LEED certification including the Inova Center for Personalized Health along with Inova Fairfax Hospital. Inova has also embarked on integrating LEED into the design of the new hospitals at Landmark and Springfield, along with the Healthplex at Oakville. The goal of Inova's green building efforts is to ensure that our buildings are operated in the most efficient manner, leading to both operational savings as well as improved outcomes. TransportationInova continues its collaboration with Fairfax County Department of Transportation to promote alternative commuting options for team members resulting in fewer single-occupancy vehicle trips. The Inova Fairfax Hospital achieved their required mode-split in 2021, with 23% of team members using some sort of alternative mode of transportation. Inova Mount Vernon Hospital also met their mode-split requirement with more than 15% of team members using some form of alternative transportation. The telehealth program also continued in 2021, with approximately 22,000 telehealth visits each month. This equates to approximately 1,000 daily patient trips avoided across all Inova facilities. This benefits not only the environment but patients, team members, and the community by reducing the number of cars on the road. FoodInova continues to promote and serve local and sustainable foods throughout Inova hospitals with 15% of food spend categorized as sustainable. Inova hospitals continued to focus on purchasing meat without routine use of antibiotics. In 2021, 35% of poultry served were certified as antibiotic free. These initiatives are important for the health of all patients and the community, and also support local farms. Inova sponsors the Northern Virginia Chapter of Buy Fresh, Buy Local, a nationally recognized program that is dedicated to reintroducing Americans to their food - the seeds it grows from, the farmers who produce it, and the routes that carry it from the fields to their tables. In 2021, Inova continued the Community Supported Agriculture (CSA) Program to help team members access local and sustainable foods. Team members purchased more than 1,692 orders, contributing to their personal health as well as the health of the planet. CommunityInova engages with peer organizations locally and nationally on sustainable practices through a combination of virtual speaking engagements, news article publications and informal discussion.

Part III, Line 8:
The organization does not treat any Medicare shortfall as community benefit. The amounts are taken directly from the Medicare Cost Reports as filed using a cost to charge ratio method.

PART III, Line 2 and 3:
Actual bad debt expense is multiplied by the cost to charge ratio used in computing charity care expense in Part I. The provision for bad debts is recognized when providing an allowance for uncollectible accounts.There are no estimated amounts for bad debt expense attributable to patients under the organization's charity care policy.

Part VI, Line 5:
Inova Health System's investment in the communities across Northern Virginia is evident through numerous targeted community programs. These programs provide access to care for low income, uninsured, underinsured and vulnerable populations; promote health and wellness; increase health literacy; provide the support and infrastructure for disaster preparedness; and provide programs to support development of our future healthcare workforce to meet the healthcare needs of the communities served. All Inova healthcare facilities have open medical staffs to provide the maximum access to qualified physicians. A Community Board of Trustees provides fiscal and quality oversight for Inova Health Care Services' facilities to ensure the vision and mission of the organization is achieved.Access to Care ProgramsInova's Population and Community Health Division is organized to address a wide-spectrum of community healthcare needs. In addition to the programs already described in the core form program, activities that provide infrastructure support and services focused on vulnerable populations to increase access to healthcare services for the communities served by Inova Health System include the following programs:Inova established a Safety Net Specialty Care Provider Network in partnership with Fairfax County. The physician leader engaged numerous Inova specialty care practices to accept referrals at Medicare rates from community primary care settings such as federally qualified health centers and free clinics. In order to ensure access to specialties not available at Inova, a specialty network including community providers was then established with the same referral arrangement. With funding support from the county, Inova facilitates payment to community specialists that are not part of Inova's charity care for patients otherwise unable to pay for those services. The program was designed utilizing an Inova coordinator who assists the referring clinic, the patient, and the specialty provider with scheduling and navigating the completion of required documentation. The specialties patients are able to access through this program include: Gastroenterology, ENT, Dermatology, Nephrology, Colorectal Surgery, Allergy, Infectious Disease and Pulmonary. There were 326 patients who benefitted from the Safety Net Specialty Fund in 2021.Inova's Partnership for Healthier Communities (PHC) provides children and families with comprehensive application and enrollment assistance to connect them with an appropriate and affordable source of health care services. In 2021, the program assisted over 20,568 children and adults with access to a source of comprehensive health care services such as Medicaid, FAMIS or local safety net providers (3,822 in Medicaid/FAMIS). PHC expanded efforts in 2019 with the onset of Medicaid expansion in Virginia (including a name change from Partnership for Healthier Kids to reflect the updated mission and outreach activities).Care Connection for Children (CCC) is part of the Virginia Department of Health statewide network serving children and youth with special healthcare needs. Professional care coordinators partner with families to coordinate care and find the best healthcare and community resources in Northern Virginia. CCC is committed to helping children maximize their potential in a caring, innovative and culturally sensitive manner. Services are always free and provided regardless of income, health insurance or legal status. In 2021, CCC served 729 families.Inova Cares Clinic for Community BridgingInova Cares Clinic for Community Bridging (ICCCB) was developed to bridge gaps in care that patients experience as they transfer across care delivery settings between illness and recovery. The service focuses on transitional medical care and community collaboration in order to improve health outcomes of patients at the highest risk who lack access to needed resources. ICCCB has locations in Alexandria, Fairfax and Leesburg. The services offered support patients being discharged from an Inova hospital or Inova emergency room who either do not have a medical home or cannot get an appointment with their Primary Care Provider (PCP) within 72 hours following a hospital admission. Patients are typically followed by a hospitalist or nurse practitioner for one to three visits, while the patient and the care team work together to establish a permanent medical home in the community for the patient or transition the patient back to their PCP. Care includes medication reconciliation, medical management and anti-coagulation management if needed as well as referrals to assist with social determinants of health. ICCCB seeks to provide services that will enhance the lives of patients so that they may better manage their healthcare and live longer, more productive lives. In 2021, ICCCB served over 4,000 patients with over 8,000 visit encounters. Over 1,000 visits were in support of patients recovering from COVID-19. Inova Kellar Center Inova Kellar Center (IKC) is a community based behavioral health program and special education school founded by Inova in 1991 with a gift from Fairfax County residents, Art and Betty Kellar, to address a gap in mental health and substance abuse services for children and adolescents. Currently IKC offers a full continuum of mental health services from outpatient therapies and medication management to after school Intensive Outpatient Programs and a full day Partial Hospitalization Program. The Kellar School, a private special education day school for students with emotional, social, and behavioral needs provides academic instruction within a therapeutic environment. The Center provided 85,098 hours of both in-person and tele-psych programming, treatment, and education to children, adolescents, and families in 2021. Inova Ewing Forensic Assessment and Consultation Teams (FACT)The Inova Ewing FACT Department (FACT) is a comprehensive, outpatient forensic nursing program for children and adults. Established in the late 1990s, the Inova Ewing FACT Department has provided specialized care for victims of sexual abuse, domestic violence, human trafficking, and child abuse. FACT serves all of Northern Virginia including Fairfax, Arlington, Loudoun, and Prince William counties, the cities of Alexandria and Falls Church, parts of Fauquier and Stafford counties, military installations, universities and the FBI. The department also performs courtesy exams for outlying jurisdictions including the District of Columbia, Maryland, and West Virginia and beyond. The program has grown significantly over the years and now provides services in the areas of sexual assault, intimate partner/domestic violence, physical child abuse, strangulation, and human sex trafficking. In 2021, the department had 897 patient encounters with a 37% increase in follow-up visits. This is a very meaningful message about enhanced victim support following the initial visit. The department also expanded by opening a new clinic in Alexandria in 2021 allowing for more patient capacity and ease of access. Currently we have clinics available to patients in Falls Church, Leesburg, Vienna, and Alexandria. Health Promotion and Preventative Care ProgramsTo support patients experiencing food insecurity, the Inova Cares Clinic for Women and Children created an emergency food pantry. The pantry serves patients in emergency situations, meaning they have little or no food at home. In 2021, the pantry served more than 60 patients, reaching nearly 300 individuals including household members.Inova also continued to grow the Inova Healthy Plate Club, which helps children and their families learn about the importance of healthy eating. In 2021, the Inova Healthy Plate Club continued its virtual program and returned to the classroom. Nearly 500 students participated in the virtual program in 2021, with more than 180 virtual classes taught. Approximately 40 students participated in the in-person classes, which started again in fall 2021. Lastly, the Inova Healthy Plate Club provided education to more than 700 individuals at community events. During the holidays, Inova Team Members came together to donate more than 7,000 pounds of food to patients in-need. The food went to patients at the Inova Cares Clinic for Women & Children; the Inova Cares Clinic for Families; Care Connections for Children; Inova Ewing FACT Department; and the Inova Fairfax Lung Transplant & Cystic Fibrosis Center.

Part VI, Line 6:
Organization is part of Inova Health System included in description under Line 5.

PART VI, Line 7:
Organization has no state filings.

Part III, Line 4:
BAD DEBT FOOTNOTE FROM INOVA HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTSPatient accounts receivable include charges for amounts due from all patients less price concessions relating to allowances for the excess of established charges over the payments to be received on behalf of patients covered by Medicare, Medicaid and other insurers. The estimated implicit price concessions 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. Periodically throughout the year, management assesses the adequacy of the price concessions based upon historical experience of self-pay accounts receivable, including those balances after insurance payments and not covered by insurance. The results of this review are then used to make any modifications to the estimated implicit price concessions. There have been no significant changes in the current year to the underlying assumptions used by IHS to estimate the amount expected to be received. Patient accounts receivable are written off after collection efforts have been followed in accordance with IHS policies.

Part III, Line 9b:
"Patients who have not applied for Financial Assistance under this policy are subject to Inova's normal billing and collections processes.All patient responsibility portions of Inova's accounts will process through Inova's billing and collection systems for effective collections within federal guidelines. Patient responsibility portions will be processed through pre-billing, statement, and follow-up in automated and systematic steps. All collections actions will be in compliance with the Fair Debt Collection Practices Act and ACA International's Code of Ethics and Professional Responsibility.Patients will receive statements for 120 days. After 120 days, with no contact from the patient and without the establishment of acceptable payment terms, accounts will be transferred to a professional collection agency. If continued non-payment occurs beyond a reasonable period of time, Inova may take additional actions on the account.If a patient wishes to make payment arrangements and does not have resources to pay the account in full, the patient should make Inova aware of their situation and Inova will offer payment plans.No Inova entity or third-party collections agent will impose extraordinary collections actions (""ECAs"") such as legal actions or adverse credit reporting against any patient, without first making reasonable efforts to determine whether that patient is eligible for Financial Assistance under this policy. These reasonable efforts include:Assuring that no ECAs are imposed for at least 120 days from the date of the first billing statement.Providing a 30-day written notice that includes information about Inova's Financial Assistance Policy and about any intended ECAs to be imposed in the event of nonpayment.Providing oral notification of any intended ECAs to be imposed in the event of nonpayment.If a patient is determined to be eligible for Financial Assistance after payment is received or after an ECA has been imposed, the account will be adjusted and the collections action will be reversed.The Vice President of Revenue Cycle Operations or his/her designee is responsible for determining whether Inova has made reasonable efforts to determine whether an individual is FAP-eligible and whether one or more ECAs may be imposed."

Part VI, Line 3:
Inova Health System utilizes a multifaceted approach to educate and inform patients and the public about Inova's Financial Assistance Policy (FAP) or sometimes referred to as the Charity Care Policy. Information regarding this policy is kept up to date and widely publicized on the Inova website and through signage. Upon admission to any Inova hospital or any visit to outpatient facilities or clinics including emergency departments, Inova has information posted regarding patient rights and responsibilities. In addition, Inova provides information about the charity care program and referrals to meet with Inova financial counselors who assist patients in completing Inova's charity care application. This financial information is reviewed by the Inova Patient Accounts Department with the patient contacted if additional information is required in order to make a determination. The patient is subsequently provided a letter, notifying them as to whether or not they qualify for charity care.Inova also has Medicaid eligibility workers on-site in all hospitals, in the Inova Cares Clinics (clinic for low income families) and in the community as part of the Partnership for Healthier Communities Access to Care program. Inova partners with schools across the jurisdiction to provide information about state funded health programs for children and contact information to meet with an eligibility worker responsible for enrolling families in state Medicaid programs. These eligibility workers also go out into the community attending community events such as health fairs, faith-based community activities and other family centered community events to proactively meet with families to encourage enrollment in programs for which they are eligible. Inova has a section of the public website dedicated to information about financial assistance resources.

Part VI, Line 2:
Inova Health System (IHS) completed a Community Health Needs Assessment (CHNA) in 2019 to identify priority health status and access issues for particular geographic areas and populations by focusing on the following questions: What are the biggest health challenges? Who is most affected? Where are the unmet needs for services? What are the health inequities?Inova's CHNAs consider multiple data sources, including secondary data (regarding demographics, health status indicators, and measures of health care access), assessments prepared by other organizations in recent years, and primary data derived from surveys, interviews, and focus groups of persons who represent the broad interests of the community, including those with expertise in public health.The following topics and data are assessed in Inova's CHNA report:Demographics, e.g., numbers and locations of vulnerable people;Economic issues, e.g., poverty and unemployment rates, and impacts of state or local budget changes;Community issues, e.g., homelessness, housing, environmental concerns, crime, and availability of social services;Health status indicators, e.g. morbidity rates for various diseases and conditions, and mortality rates for leading causes of death;Health access indicators, e.g., uninsured rates, discharges for ambulatory care sensitive conditions (ACSC), and use of emergency departments for non-emergent care;Health disparities indicators; andAvailability of healthcare facilities and resources. The assessment identifies a list of significant community health needs.As a result of this work and previous work, three priority areas will be the focus for the next three years. While the approach to addressing these areas may differ from one community to another, the system-wide selection of priority areas will add value to efforts in each region. The two Directors of Community Health Programs are coordinating plans with Inova and community leaders to ensure plans are implemented effectively and in partnership with existing frameworks and resources in each of the respective communities. The two Directors of Community Health Programs are centralized to the system under the Vice President of Community/Population Health and thereby assures system coordinated efforts are centralized and reflective of Inova Health System's work across Northern Virginia.The various Public Health Departments also conduct community health assessments using the framework of the Mobilizing for Action through Planning and Partnerships (MAPP) process. Due to the timing of these processes, the information from the MAPP health needs assessments in the jurisdictions served by Inova Health System were incorporated differently into the community health needs assessment process and Implementation Strategies in 2019. Fairfax and Arlington Health Departments conducted their own MAPP process and collaborated with Inova, Alexandria conducted its process jointly with Inova but reported separately, and the Loudoun MAPP process was conducted jointly with Inova. The MAPP process leads to an ongoing community-driven planning process that is designed to provide information for improving the community's delivery of the ten essential public health services. This process brings together a diverse group of key community stakeholders including local government, human service organizations, schools and universities, healthcare consumers, advocacy groups, hospitals, faith institutions, youth development organizations, economic and philanthropic groups, etc. to identify strengths and weaknesses in the ten essential areas to provide a foundation for community health planning. In addition to these activities, Inova is continually garnering feedback on existing safety net and community programs from participants through satisfaction surveys, focus groups, participating in regional and local health related groups such as the Northern Virginia Health Services Coalition, and meeting with various cultural and ethnic groups in the community. Internal utilization and outcomes data, review of best practices, regional and national benchmark data, and other external sources such as the Metropolitan Washington Council of Governments (COG) demographic data are used to develop strategic goals for health improvement activities. Collectively, all this information is utilized in assessing community health needs to guide strategic planning efforts.

Part VI, Line 4:
"Inova Health Care Services (IHCS) is a not-for-profit corporation and a subsidiary of the parent organization, Inova Health System Foundation (Inova). Inova provides healthcare and related services throughout Northern Virginia and the greater metropolitan Washington, D.C. area, including certain contiguous counties of Virginia and Maryland. Northern Virginia is one of the fastest growing urban communities in the United States. With approximately 1,304 square miles, the region is the most densely populated in the Commonwealth of Virginia. Northern Virginia is comprised of several distinct communities, including the cities of Alexandria, Fairfax, Falls Church, Manassas and Manassas Park, and the counties of Arlington, Fairfax, Loudoun, and Prince William. The eastern sections are urbanized with attendant health problems of overcrowding and increasing demand for health services and public programs. The western regions include rapidly growing communities and rural settings.The region's population served by IHCS is expected to grow steadily through 2035, adding approximately 71,000 people per year, according to the Metropolitan Washington Council of Governments (""MWCOG""). Population will be spurred by the long-term strength of the region's economy, high rates of in-migration and international immigration. The region's population that is 65 years of age and older is expected to grow 20% over the next 5 years, while the number of children will increase by about 4% during the same time period. (MWCOG and ESRI)Northern Virginia's racial and ethnic diversity is more pronounced than in the rest of the state. With increasing diversity, economically disadvantaged populations and multiple languages, the need for access to culturally appropriate, flexible health care continues to grow. The Northern Virginia geographic region in 2019 was 49% minority, while the nation reflects about 40% minority population in 2019 (American Community Survey (ACS) U.S. Census Bureau). Fairfax County, with more than one million residents, is the largest jurisdiction in Northern Virginia and has the largest minority population. In Fairfax County in 2020, Asians, Hispanics, and African Americans represented 47.4%, of the county's population, respectively (Fairfax County Economic, Demographic and Statistical Research, 2020 Decennial Census survey data). According to the US Census Bureau Small Area Health Insurance Estimates (SAHIE) in 2019 approximately 9.1% of the total population under the age of 65 (about 89,030 people) in Fairfax County lacked healthcare insurance. Of the people living in Fairfax County whose family incomes are at or below 200% of the federal poverty level, SAHIE estimates that 27% (about 36,208 people) were uninsured in 2019.Area residents most likely to be uninsured are those whose family incomes are at or below 200% of the poverty level, young adults (age 18-44), people of racial backgrounds other than White, unemployed individuals, part-time workers, and people who work at companies with fewer than 50 employees. Serving this population poses significant cultural and linguistic challenges, and these uninsured citizens are widely distributed in terms of age, geographic region, and health status."

PART VI, LINE 5 Continued:
Language and Disability ServicesThe Language and Disability Services Department is dedicated to ensuring equal access to Inova's services regardless of language preference or the need for special accommodations. In support of patient safety and satisfaction, language interpretation and document translations are provided at every Inova facility to facilitate communication with the 17% of Inova's patient population who are Limited English Proficient (LEP) and the 0.2% of clients who are Deaf or Hard of Hearing (D/HH). In 2021, medical interpreters delivered 169,923 hours of interpretation in 350 languages, and 17,881 hours in American Sign Language. Additionally, vital documents totaling 1,103,332 English words were translated into Inova's top languages.Cash and In-Kind Contributions to Community GroupsInova donates space, cash, and in-kind support such as utilities, landscaping/grounds keeping, housekeeping, and donated staff time to a number of community groups and services. Inova supports NOVA Scripts, the Center for Multicultural Human Services, and the Northern Virginia Dental Clinic. Inova also provides financial support to The Loudoun Free Clinic, HealthWorks for Northern Virginia, and Neighborhood Health, the local Federally Qualified Health Centers. In 2021, Inova donated over $3.1 million for these groups covering both cash and in-kind transactions.Additionally, as part of Inova's efforts to harness the collective power of community partners, agencies, and organizations to create positive social impact, Inova provided $240,000 in community grants. Applicants were required to present programs or projects addressing the population health needs described in the Inova Community Health Needs Assessments. The following programs were funded in 2021.Boys & Girls Clubs of Greater Washington - $20,000.00. Funds were used to expand the Triple Play and Healthy Habits programs, which encourage good nutrition, physical activity, healthy relationships, and active learning.Capital Youth Empowerment Program - $20,000.00. Funds were used to boost the Fathers in Tech project, which teaches workforce skills to Arlington, Fairfax, and Alexandria fathers living in Black, Indigenous and People of Color (BIPOC) communities.Carpenter's Shelter Inc - $20,000.00. Funds were used to improve access to medical and mental health care among homeless adults and children in Alexandria, and help them transition to sustainable homes. La Cocina VA - $18,431.00. Funds were used to expand the Healthy Food Assistance program to fight hunger and obesity among immigrants, children, homeless people, veterans, the unemployed, and the underemployed in Arlington.Loudoun Literacy Council - $10,000.00. Funds were used to help more than 700 adults and children participate in reading and English as a Second Language programs including Health Education and Literacy, Intervention Instruction, Story Walks, Head Start, and Starting Toward Excellence in Preschool.NOVA Scripts Central - $15,000.00. Funds were used to provide affordable pharmacy services to low-income, uninsured residents across Northern Virginia, and improve access to culturally competent and linguistically appropriate health information. Nueva Vida, Inc- $11,569.00. Funds were used to create culturally sensitive cancer and mental health support for the medically under-resourced Latino/a population in Alexandria City and Fairfax County.Our Minds Matter - $20,000.00. Funds were used to support peer and programmatic suicide prevention programs and mental health resources in Annandale, Falls Church, Justice, Mount Vernon and West Potomac High Schools in Fairfax County.SCAN of Northern Virginia - $20,000.00. Funds were used to increase access to child abuse prevention resources, assessments and medical care for families in Alexandria.The Campagna Center - $20,000.00. Funds were used to subsidize the New Neighbors program, which provides students with access to high-quality English language instruction to improve their employment and future opportunities to thrive in the community.The Child and Family Network Centers - $15,000.00. Funds were used to provide pre-kindergarten physicals, vaccinations and medical screenings to more than 100 four-year-olds in underserved West End and Alexandria communities.The Women's Center - $20,000.00. Funds were used to expand access to effective, equitable, and affordable mental health services for more than 60 low-income Fairfax County residents. United Community - $20,000.00. Funds were used to help families find fresh foods and health services, and coordinate a Health Work Group to improve community health outcomes and develop a sustainable system for healthy food access. YMCA of Metropolitan Washington - $10,000.00. Funds were used to support both its health promotion programs and its Food and Health Hub program that provides home-delivered local produce to food insecure residents and those with chronic health conditions living in Reston.