4A (Expenses $ 3388427295 including grants of $ 18917823) (Revenue $ 4079050180)
SEE SCHEDULE O

REPORTING GROUP: A
PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PART V, LINE 5 (GROUP A) SUTTER ROSEVILLE MEDICAL CENTER (A, 3): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER ROSEVILLE MEDICAL CENTER, A FACILITY OF SUTTER VALLEY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). INPUT FROM THE COMMUNITY SERVED BY SUTTER ROSEVILLE MEDICAL CENTER WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WERE COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WAS USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM 40 DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. SUTTER ROSEVILLE MEDICAL CENTER KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN JUNE 19, 2018, AND MAY 23, 2019. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER ROSEVILLE MEDICAL CENTER'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SUTTER SOLANO MEDICAL CENTER (A, 4): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER SOLANO MEDICAL CENTER, A FACILITY OF SUTTER VALLEY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). INPUT FROM THE COMMUNITY SERVED BY SUTTER SOLANO MEDICAL CENTER WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WAS COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WERE USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. SUTTER SOLANO MEDICAL CENTER KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN AUGUST 13, 2018, AND OCTOBER 26, 2018. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER SOLANO MEDICAL CENTER'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SUTTER AUBURN FAITH HOSPITAL (A, 7): IN CONDUCTING ITS MOST RECENT SUTTER AUBURN FAITH HOSPITAL (SAFH), A FACILITY OF SUTTER VALLEY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). INPUT FROM THE COMMUNITY SERVED BY SAFH WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WERE COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WAS USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. SUTTER AUBURN FAITH HOSPITAL KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN MARCH 19, 2019, AND APRIL 10, 2019. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER AUBURN FAITH HOSPITAL'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SUTTER AMADOR HOSPITAL (A, 8): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER AMADOR HOSPITAL (SAH), A FACILITY OF SUTTER VALLEY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). INPUT FROM THE COMMUNITY WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED A

SCHEDULE H, PART V, SECTION B, LINES 6A
(GROUP A) COMMUNITY HEALTH INSIGHTS WAS HIRED TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENTS ON BEHALF OF THE FOLLOWING ORGANIZATIONS, ALL SERVING PORTIONS OF OR THE SAME COUNTIES: - SUTTER ROSEVILLE MEDICAL CENTER - SUTTER SOLANO MEDICAL CENTER - SUTTER AUBURN FAITH HOSPITAL - SUTTER AMADOR HOSPITAL - SUTTER DAVIS HOSPITAL IN PARTNERSHIP WITH WOODLAND MEMORIAL HOSPITAL AND YOLO COUNTY HEALTH & HUMAN SERVICES COMMUNITY HEALTH BRANCH PART V, LINE 7A, 7B, 10A FILING ORG WEBSITES: - SUTTER ROSEVILLE MEDICAL CENTER (A, 3): HTTP://WWW.SUTTERROSEVILLE.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML - SUTTER SOLANO MEDICAL CENTER (A, 4): HTTP://WWW.SUTTERSOLANO.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML - SUTTER AUBURN FAITH HOSPITAL (A, 7): HTTP://WWW.SUTTERAUBURNFAITH.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML - SUTTER AMADOR HOSPITAL (A, 8): HTTP://WWW.SUTTERAMADOR.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML - SUTTER DAVIS HOSPITAL (A, 9): HTTP://WWW.SUTTERDAVIS.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML - OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 11
(GROUP A) SUTTER ROSEVILLE MEDICAL CENTER (A, 3): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER ROSEVILLE MEDICAL CENTER INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIOR/SUBSTANCE-ABUSE SERVICES 2. ACCESS TO QUALITY PRIMARY HEALTHCARE SERVICES 3. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD 4. ACCESS AND FUNCTIONAL NEEDS 5. INJURY AND DISEASE PREVENTION AND MANAGEMENT 6. ACCESS TO SPECIALTY AND EXTENDED CARE 7. ACTIVE LIVING AND HEALTHY EATING DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER ROSEVILLE MEDICAL CENTER IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL PLANS TO ADDRESS ALL SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. SUTTER SOLANO MEDICAL CENTER (A, 4): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER SOLANO MEDICAL CENTER INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE-ABUSE SERVICES 2. INJURY AND DISEASE PREVENTION AND MANAGEMENT 3. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 4. ACCESS TO BASIC NEEDS, SUCH AS HOUSING, JOBS, AND FOOD 5. ACTIVE LIVING AND HEALTH EATING DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER SOLANO MEDICAL CENTER IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. INCREASING COMMUNITY CONNECTION 2. ACCESS AND FUNCTIONAL NEEDS 3. SAFE AND VIOLENCE-FREE ENVIRONMENT 4. POLLUTION-FREE LIVING ENVIRONMENT SUTTER AUBURN FAITH HOSPITAL (A, 7): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER AUBURN FAITH HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 2. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD 3. ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES 4. INJURY AND DISEASE PREVENTION AND MANAGEMENT 5. ACCESS AND FUNCTIONAL NEEDS 6. ACTIVE LIVING AND HEALTHY EATING DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER AUBURN FAITH HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ACCESS TO SPECIALTY AND EXTENDED CARE SUTTER AMADOR HOSPITAL (A, 8): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER AMADOR HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES 2. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 3. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD 4. INJURY AND DISEASE PREVENTION MANAGEMENT 5. ACCESS AND FUNCTIONAL NEEDS 6. ACCESS TO DENTAL CARE AND PREVENTIVE SERVICES 7. ACCESS TO SPECIALTY AND EXTENDED CARE DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. SUTTER AMADOR HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL PLANS TO ADDRESS ALL SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. SUTTER DAVIS HOSPITAL (A, 9): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER DAVIS HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES 2. INJURY AND DISEASE PREVENTION AND MANAGEMENT 3. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS AND FOOD 4. ACTIVE LIVING AND HEALTH EATING 5. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 6. ACCESS AND FUNCTIONAL NEEDS 7. ACCESS TO SPECIALTY AND EXTENDED CARE 8. SAFE AND VIOLENCE-FREE ENVIRONMENT: DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SDH IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE IMPLEMENTATION STRATEGY PLAN DOES NOT INCLUDE SPECIFIC PLANS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE FOLLOWING REASONS: 1. POLLUTION-FREE LIVING ENVIRONMENTS: WHILE THIS IS AN IMPORTANT ISSUE, THIS IS NOT SOMETHING THAT WE ARE ABLE TO GREATLY AFFECT THROUGH COMMUNITY BENEFIT; THEREFORE, WE ARE FOCUSING OUR RESOURCES ELSEWHERE, ESPECIALLY GIVEN THAT REGIONAL COMMUNITY PARTNERS LIKE SACOG, THE CLEANER AIR PARTNERSHIP AND OTHERS, ARE WORKING ON THESE VITAL ISSUES. 2. ACCESS TO DENTAL CARE AND PREVENTATIVE SERVICES: WE ARE CONTINUOUSLY LOOKING FOR OPPORTUNITIES TO PROVIDE COLLABORATIVE DENTAL CARE OPTIONS TO THE UNDERSERVED COMMUNITIES; HOWEVER, WE HAVE NOT YET FOUND THE PERFECT FIT IN YOLO COUNTY. ALTHOUGH WE DON'T HAVE CURRENT PLANS TO ADDRESS DENTAL CARE AND PREVENTATIVE SERVICES, THERE IS ALWAYS A CHANCE THAT ONE MAY DEVELOP IN THE YEARS AHEAD. AIR PARTNERSHIP AND OTHERS, ARE WORKING ON THESE VITAL ISSUES.

SCHEDULE H, PART V, SECTION B, LINE 15E
(GROUP A) METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, 16C (GROUP A) THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER VALLEY HOSPITALS WEBSITE AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16J (GROUP A) MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. Schedule H, Part V, Section B, Line 22D (GROUP A) AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.

REPORTING GROUP: B, SUTTER MEDICAL CENTER
Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. Schedule H, Part V, Section B, Line 5 (GROUP B) SUTTER MEDICAL CENTER SACRAMENTO INCLUDES THE FOLLOWING FACILITIES LISTED IN PART V SECTION A: SUTTER MED CENTER AND SUTTER CENTER FOR PSYCHIATRY. IN CONDUCTING ITS MOST RECENT CHNA, SUTTER MEDICAL CENTER SACRAMENTO, A FACILITY OF SUTTER VALLEY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). INPUT FROM THE COMMUNITY IN SACRAMENTO WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS LIVING IN IDENTIFIED COMMUNITIES OF CONCERN OR REPRESENTING COMMUNITIES EXPERIENCING HEALTH DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS OF INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WERE COLLECTED THROUGH NOTE-TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SACRAMENTO REGION, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIODEMOGRAPHIC DATA, WERE USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED, FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE COUNTY TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. FOCUS-GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES, OR COMMUNITIES OF CONCERN. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. SUTTER MEDICAL CENTER SACRAMENTO AND SUTTER CENTER FOR PSYCHIATRY KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN MAY 23, 2018, AND OCTOBER 18, 2018. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN SUTTER MEDICAL CENTER'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT Schedule H, Part V, Section B, Lines 6A (GROUP B) COMMUNITY HEALTH INSIGHTS CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT ON BEHALF OF A COLLECTION OF THREE NONPROFIT HOSPITALS, ALL SERVING PORTIONS OF OR THE SAME COMMUNITIES, INCLUDING SUTTER HEALTH AFFILIATES, DIGNITY HEALTH AFFILIATES, AND UC DAVIS HEALTH.

SCHEDULE H, PART V, SECTION B, LINE 7A
FILING ORG WEBSITES: - SUTTER MEDICAL CENTER SACRAMENTO HTTP://WWW.SUTTERMEDICALCENTER.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 11
SUTTER MEDICAL CENTER SACRAMENTO (GROUP B): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER MEDICAL CENTER, SACRAMENTO INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE-ABUSE SERVICES 2. ACCESS TO QUALITY PRIMARY HEALTHCARE SERVICES 3. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD 4. ACCESS TO SPECIALTY AND EXTENDED CARE 5. ACCESS TO ACTIVE LIVING AND HEALTHY EATING 6. SYSTEM NAVIGATION 7. CULTURAL COMPETENCY DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER MEDICAL CENTER, SACRAMENTO IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE IMPLEMENTATION STRATEGY DOES NOT INCLUDE SPECIFIC PLANS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. INJURY AND DISEASE PREVENTION AND MANAGEMENT: WHILE MANY OF OUR PROGRAMS EXPAND ACCESS TO PRIMARY CARE, IN TURN, CONNECTING PATIENTS WITH DISEASE PREVENTION, MANAGEMENT AND TREATMENT RESOURCES, THIS IS NOT A PRIMARY FOCUS IN THE SMCS. 2. SAFE AND VIOLENCE FREE ENVIRONMENT: SMCS PLANS TO IDENTIFY PARTNERSHIPS AND STRENGTHEN RELATIONSHIPS WITH ORGANIZATIONS IN THE NEAR FUTURE TO COLLABORATE ON INITIATIVES TO ADDRESS SAFE AND VIOLENCE FREE ENVIRONMENTS IN SACRAMENTO COUNTIES. 3. ACCESS TO MEETING FUNCTIONAL NEEDS (TRANSPORTATION AND PHYSICAL MOBILITY): SMCS PLANS TO IDENTIFY PARTNERSHIPS AND STRENGTHEN RELATIONSHIPS WITH ORGANIZATIONS IN THE NEAR FUTURE TO COLLABORATE ON INITIATIVES TO ADDRESS ACCESS TO MEETING FUNCTIONAL NEEDS IN SACRAMENTO COUNTIES. SCHEDULE H, PART V, SECTION B, LINE 15E (GROUP B) METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE.

Schedule H, Part V, Section B, Lines 16A, 16B, 16C
(GROUP B) THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER VALLEY HOSPITALS WEBSITE AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE

SCHEDULE H, PART V, SECTION B, LINE 16J
(GROUP B) MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.

SCHEDULE H, PART V, SECTION B, LINE 22D
(GROUP B) AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.

REPORTING FACILITY: #2, MEMORIAL MEDICAL CENTER
SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

SCHEDULE H, PART V, SECTION B, LINE 5
MEMORIAL MEDICAL CENTER (FACILITY 2): IN CONDUCTING ITS MOST RECENT CHNA, MEMORIAL MEDICAL CENTER (MMC) A FACILITY OF SUTTER VALLEY HOSPITALS, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. INPUT FROM THE COMMUNITY SERVED BY BOTH MEMORIAL MEDICAL CENTER AND STANISLAUS SURGICAL HOSPITAL WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WERE COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WAS USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. MEMORIAL MEDICAL CENTER KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN DECEMBER 5, 2018, AND DECEMBER 19, 2019. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN MEMORIAL MEDICAL CENTER'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 6
MEMORIAL MEDICAL CENTER (FACILITY 2): COMMUNITY HEALTH INSIGHTS CONDUCTED THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ON BEHALF OF MEMORIAL MEDICAL CENTER OF MODESTO AND STANISLAUS SURGICAL HOSPITAL. PART V, SECTION B, LINE 7A, 7B AND 10A MEMORIAL MEDICAL CENTER (FACILITY 2): HTTP://WWW.MEMORIALMEDICALCENTER.ORG/ABOUT/COMMUNITY-BENEFIT.HTML

SCHEDULE H, PART V, SECTION B, LINE 11
MEMORIAL MEDICAL CENTER (FACILITY 2): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT MEMORIAL MEDICAL CENTER INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO BASIC NEEDS, SUCH AS HOUSING, JOBS, AND FOOD 2. ACCESS TO MENTAL, BEHAVIORAL, AND SUBSTANCE-ABUSE SERVICES 3. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 4. SAFE AND VIOLENCE-FREE ENVIRONMENT 5. INJURY AND DISEASE PREVENTION AND MANAGEMENT 6. ACTIVE LIVING AND HEALTHY EATING DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL THE HEATH NEEDS IN THE COMMUNITY. MEMORIAL MEDICAL CENTER IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ACCESS AND FUNCTIONAL NEEDS - TRANSPORTATION AND PHYSICAL DISABILITY - WHILE OUR IMPLEMENTATION PLAN DOES NOT DIRECTLY ADDRESS ISSUES OF TRANSPORTATION AND PHYSICAL DISABILITY, MANY OF OUR PROGRAMS WILL OFFER CLIENTS REFERRALS TO TRANSPORTATION SERVICES SO THAT THEY CAN ACCESS MEDICAL APPOINTMENTS. 2. ACCESS TO SPECIALTY AND EXTENDED CARE - OUR FOCUS IN STANISLAUS COUNTY IS PRIMARILY ON EXPANDING ACCESS TO PRIMARY CARE THROUGH PARTNERSHIPS WITH OUR FQHC AND COMMUNITY PARTNERS. HOWEVER, SEVERAL OF THESE PROGRAMS WHICH INCREASE ACCESS TO PRIMARY CARE WILL ALSO HELP PATIENTS BECOME CONNECTED TO SPECIALTY CARE ONCE THEY ARE ESTABLISHED WITH A PCP. 3. POLLUTION-FREE LIVING ENVIRONMENT - DUE TO LIMITED RESOURCES AND ABILITY TO IMPACT ENVIRONMENTAL POLICIES, THE HOSPITAL DOES NOT INTEND TO DIRECTLY ADDRESS THIS HEALTH ISSUE AT THIS TIME.

SCHEDULE H, PART V, SECTION B, LINE 15E
Memorial Medical Center (Facility 2): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C Memorial Medical Center (Facility 2): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE MEMORIAL MEDICAL CENTER WEBSITE AT: HTTP://WWW.MEMORIALMEDICALCENTER.ORG/ABOUT/FINANCIAL-ASSISTANCE.HTML

SCHEDULE H, PART V, SECTION B, LINE 16J
Memorial Medical Center (Facility 2): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.

SCHEDULE H, PART V, SECTION B, LINE 22D
Memorial Medical Center (Facility 2): AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.

REPORTING FACILITY: #5, SUTTER TRACY COMMUNITY HOSPITAL
SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA

SCHEDULE H, PART V, SECTION B, LINE 5
SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): IN CONDUCTING ITS MOST RECENT CHNA, SUTTER TRACY COMMUNITY HOSPITAL DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA (HSA). COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS USING KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND SURVEYS. INDIVIDUALS WITH THE KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM LOCAL GOVERNMENTAL AND PUBLIC HEALTH AGENCIES AS WELL AS LEADERS, REPRESENTATIVES, OR MEMBERS OF UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. ADDITIONALLY, WHERE APPLICABLE, OTHER INDIVIDUALS WITH EXPERTISE OF LOCAL HEALTH NEEDS WERE CONSULTED. AD LUCEM CONSULTING CONDUCTED KEY INFORMANT INTERVIEWS WITH ELEVEN INDIVIDUALS REPRESENTING DIVERSE SECTORS INCLUDING: PUBLIC HEALTH, HEALTH CARE, COMMUNITY-BASED ORGANIZATIONS, SOCIAL SERVICES, EDUCATION AND GOVERNMENT. THE KEY INFORMANTS WERE IDENTIFIED BY HEALTHIER SAN JOAQUIN COLLABORATIVE CORE TEAM MEMBERS. ALL INTERVIEWS WERE CONDUCTED BY TELEPHONE IN ENGLISH AND TOOK APPROXIMATELY 30-45 MINUTES TO COMPLETE. THE INTERVIEWS FOLLOWED A STANDARD SET OF INTERVIEW QUESTIONS AND THE INTERVIEWER TOOK DETAILED NOTES DURING THE CALL. AT THE BEGINNING OF THE INTERVIEW, CONFIDENTIALITY WAS ASSURED AND THE RESPONDENTS WERE INVITED TO SKIP QUESTIONS WHICH WERE NOT APPLICABLE TO THE RESPONDENT'S EXPERIENCE. THIRTY-ONE COMMUNITY RESIDENT FOCUS GROUPS WERE CONDUCTED IN GEOGRAPHIC AREAS WITHIN SAN JOAQUIN COUNTY, INCLUDING STOCKTON, LODI, TRACY AND MANTECA. NINETEEN GROUPS WERE CONDUCTED IN ENGLISH, TEN WERE CONDUCTED IN SPANISH, ONE WAS CONDUCTED IN TAGALOG AND ONE WAS CONDUCTED IN CAMBODIAN. PARTICIPANTS WERE TEENS, ADULTS, AND OLDER ADULTS, WHO REPRESENTED UNDERSERVED, LOW-INCOME, AND VARIED ETHNIC COMMUNITIES. SUTTER TRACY COMMUNITY HOSPITAL KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN AUGUST 23, 2018, AND DECEMBER 2018. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN THE SUTTER TRACY COMMUNITY HOSPITAL'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 6
SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): THE SAN JOAQUIN COUNTY 2019 CHNA WAS AN EFFORT OF THE HEALTHIER SAN JOAQUIN COLLABORATIVE THAT INCLUDED SAN JOAQUIN PUBLIC HEALTH SERVICES, SAN JOAQUIN'S NONPROFIT HOSPITALS AS WELL AS MANY PARTNER ORGANIZATIONS AND INDIVIDUALS THROUGHOUT THE COMMUNITY. THE CHNA WAS LED BY A CORE TEAM THAT WAS RESPONSIBLE FOR PLANNING AND KEY DECISION-MAKING, INCLUDING PROVIDING INPUT TO DEVELOPING DATA COLLECTION INSTRUMENTS, WORKING ALONGSIDE AD LUCEM CONSULTING TO COLLECT AND ANALYZE DATA, AND REVIEWING AND COMMENTING ON THE REPORT. THE BROADLY REPRESENTATIVE CHNA STEERING COMMITTEE SUPPORTED THE PROCESS BY COLLECTING PRIMARY DATA AND PARTICIPATING IN DATA REVIEW AND HEALTH NEED PRIORITIZATION. CORE TEAM MEMBERS 1. ADVENTIST HEALTH LODI MEMORIAL 2. COMMUNITY MEDICAL CENTERS 3. DAMERON HOSPITAL 4. DIGNITY HEALTH ST. JOSEPH'S MEDICAL CENTER 5. FIRST 5 SAN JOAQUIN 6. HEALTH NET 7. HEALTH PLAN OF SAN JOAQUIN 8. KAISER PERMANENTE 9. SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES 10. SUTTER HEALTH (SUTTER TRACY COMMUNITY HOSPITAL)

SCHEDULE H, PART V, SECTION B, LINES 7A, 7B AND 10A
SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): HTTPS://WWW.SUTTERHEALTH.ORG/STCH/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 11
SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT SUTTER TRACY COMMUNITY HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. MENTAL HEALTH 2. ECONOMIC SECURITY 3. OBESITY/HEALTH EATING, ACTIVE LIVING/DIABETES 4. ACCESS TO CARE 5. VIOLENCE/INJURY PREVENTION DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. SUTTER TRACY COMMUNITY HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. SUBSTANCE ABUSE AND TOBACCO - WHILE OUR STRATEGY DOES NOT DIRECTLY FOCUS ON SUBSTANCE ABUSE AND TOBACCO, THIS IS AN AREA THAT WILL BE ADDRESSED THROUGH OUR INVESTMENTS IN ACCESS TO CARE AND ECONOMIC SECURITY. MANY INDIVIDUALS EXPERIENCING HOMELESSNESS OR AT-RISK OF BECOMING HOMELESS ARE ALSO GRAPPLING WITH MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES, SO THROUGH PROGRAMS SUCH AS STREET OUTREACH, HOMELESS SHELTERS, AND RECUPERATIVE CARE, WE WILL LIKELY BE CONNECTING INDIVIDUALS TO THE APPROPRIATE SUBSTANCE ABUSE REFERRALS AS NEEDED. 2. ASTHMA - ASTHMA IS NOT SPECIFICALLY ADDRESSED IN OUR IMPLEMENTATION PLAN AS AN AREA OF FOCUS, BUT WE RECOGNIZE ITS PREVALENCE IN SAN JOAQUIN COUNTY AND MANY OF OUR OTHER STRATEGIES WILL SEEK TO ADDRESS THIS CHRONIC CONDITION. THROUGH OUR INVESTMENTS IN ACCESS TO CARE, WE WILL SEEK TO IDENTIFY INDIVIDUALS WITH ASTHMA AND CONNECT THEM WITH A PRIMARY CARE PROVIDER SO THAT THEY CAN APPROPRIATELY MANAGE THEIR CONDITION. 3. ORAL HEALTH - ALTHOUGH THE HOSPITAL DOES NOT HAVE A SPECIFIC STRATEGY TO ADDRESS THIS COMPONENT OF OVERALL HEALTH, IT DOES INTEND TO INDIRECTLY ADDRESS THE PRIORITY FINDING THROUGH THE VARIOUS OTHER INTERVENTIONS AS MENTIONED IN THIS REPORT. MANY OF THE STRATEGIES IN THIS PLAN LOOK TO PROVIDE WHOLE-PERSON CARE, AND WILL OFFER REFERRALS TO ORAL HEALTH CARE RESOURCES TO INDIVIDUALS AS NECESSARY. 4. CLIMATE AND HEALTH - DUE TO LIMITED RESOURCES AND ABILITY TO IMPACT ENVIRONMENTAL POLICIES, THE HOSPITAL DOES NOT INTEND TO DIRECTLY ADDRESS THIS HEALTH ISSUE AT THIS TIME.

SCHEDULE H, PART V, SECTION B, LINE 15E
SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER TRACY COMMUNITY HOSPITAL WEBSITE AT: HTTP://WWW.SUTTERTRACY.ORG/ABOUT/FINANCIAL-ASSISTANCE.HTML

SCHEDULE H, PART V, SECTION B, LINE 16J
SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.

SCHEDULE H, PART V, SECTION B, LINE 22D
SUTTER TRACY COMMUNITY HOSPITAL (FACILITY 5): AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.

REPORTING FACILITY: #10, MEMORIAL HOSPITAL LOS BANOS
Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

SCHEDULE H, PART V, SECTION B, LINE 5
MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): IN CONDUCTING ITS MOST RECENT CHNA, MEMORIAL HOSPITAL LOS BANOS DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY THE STUDY SPONSORS; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 49 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. THESE INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROVIDERS, SOCIAL SERVICES PROVIDERS AND OTHER COMMUNITY LEADERS. THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. IN THE ONLINE SURVEY, KEY INFORMANTS WERE ASKED TO RATE THE DEGREE TO WHICH VARIOUS HEALTH ISSUES ARE A PROBLEM IN THEIR OWN COMMUNITY. FOLLOW-UP QUESTIONS ASKED THEM TO DESCRIBE WHY THEY IDENTIFY PROBLEM AREAS AS SUCH AND HOW THESE MIGHT BETTER BE ADDRESSED. RESULTS OF THEIR RATINGS, AS WELL AS THEIR VERBATIM COMMENTS, ARE INCLUDED THROUGHOUT THIS REPORT AS THEY RELATE TO THE VARIOUS OTHER DATA PRESENTED. MEMORIAL HOSPITAL LOS BANOS KEY INFORMANT INTERVIEWS WERE CONDUCTED IN 2018. THE FINDINGS FROM KEY INFORMANT SURVEY IN THE MEMORIAL HOSPITAL LOS BANOS'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 6
MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): PROFESSIONAL RESEARCH CONSULTANTS, INC. CONDUCTED THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT FOR MEMORIAL HOSPITAL LOS BANOS, MERCY MEDICAL CENTER MERCED AND VALLEY CHILDREN'S HOSPITAL.

SCHEDULE H, PART V, SECTION B, LINES 7A, 7B AND 10A
MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): HTTP://WWW.MEMORIALLOSBANOS.ORG/ABOUT/COMMUNITY-NEEDS-ASSESSMENT.HTML OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 11
MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ARE NEEDS THAT MEMORIAL HOSPITAL LOS BANOS INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. MENTAL HEALTH 2. NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT 3. ACCESS TO HEALTH SERVICES DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. MEMORIAL HOSPITAL LOS BANOS IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. SUBSTANCE ABUSE - OUR PLAN DOES NOT ADDRESS SUBSTANCE ABUSE DIRECTLY, HOWEVER, WE ANTICIPATE OUR STREET MEDICINE AND RESPITE CARE PROGRAMS WILL HELP ASSIST INDIVIDUALS EXPERIENCING SUBSTANCE ABUSE ISSUES AND REFER THEM TO APPROPRIATE RESOURCES. 2. DIABETES - WHILE WE WILL NOT INVEST IN THIS AREA, OUR PROGRAMS IN HEALTHY EATING AND ACTIVE LIVING WILL ADDRESS THE UPSTREAM SOCIAL DETERMINANTS OF HEALTH WHICH COULD LEAD TO DIABETES LATER IN LIFE. 3. HEART DISEASE AND STROKE - WHILE WE WILL NOT INVEST IN THIS AREA, OUR PROGRAMS IN HEALTHY EATING AND ACTIVE LIVING WILL ADDRESS THE UPSTREAM SOCIAL DETERMINANTS OF HEALTH WHICH COULD LEAD TO HEART DISEASE AND STROKE LATER IN LIFE. 4. TOBACCO USE - WE DO NOT PLAN TO ADDRESS TOBACCO ABUSE DIRECTLY, HOWEVER, WE ANTICIPATE OUR INVESTMENTS IN YOUTH PROGRAMS WILL HELP ENCOURAGE HEALTHIER LIFESTYLE HABITS FOR KIDS THAT WILL LEAD TO A DECREASED LIKELIHOOD OF TOBACCO USE LATER IN LIFE. 5. RESPIRATORY DISEASES - WE DO NOT FEEL RESPIRATORY DISEASE IS AS PRESSING AS OTHER HEALTH NEEDS IDENTIFIED IN OUR ASSESSMENT FOR THIS COMMUNITY, SO DUE TO LIMITED TIME AND RESOURCES WE ARE CHOOSING NOT TO ADDRESS THIS HEALTH NEED DIRECTLY. 6. INJURY AND VIOLENCE - OUR IMPLEMENTATION PLAN WILL NOT SPECIFICALLY ADDRESS INJURY AND VIOLENCE, HOWEVER OUR GOAL IS TO DECREASE THE LIKELIHOOD OF INJURY AND VIOLENCE THROUGH INVESTMENTS IN YOUTH PROGRAMS THAT WILL KEEP KIDS SAFE AND IN A POSITIVE ENVIRONMENT. 7. INFANT AND FAMILY PLANNING - WHILE OUR COMMUNITY HEALTH PROGRAMS ARE NOT FOCUSED ON INFANT AND FAMILY PLANNING, THE MEMORIAL HOSPITAL LOS BANOS RURAL HEALTH CLINIC DOES PROVIDE GYNECOLOGY AND WOMEN'S HEALTH SERVICES AS WELL AS PRENATAL CARE TO UNDERSERVED POPULATIONS. 8. CANCER - WE DO NOT FEEL CANCER IS AS PRESSING AS OTHER HEALTH NEEDS IDENTIFIED IN OUR ASSESSMENT FOR THIS COMMUNITY, SO DUE TO LIMITED TIME AND RESOURCES WE WILL NOT SEEK TO ADDRESS THIS HEALTH NEED DIRECTLY. 9. KIDNEY DISEASE - WE DO NOT FEEL RESPIRATORY DISEASE IS AS PRESSING AS OTHER HEALTH NEEDS IDENTIFIED IN THIS ASSESSMENT, SO DUE TO LIMITED TIME AND RESOURCES WE ARE CHOOSING NOT TO ADDRESS THIS HEALTH NEED DIRECTLY. 10. DEMENTIA/ALZHEIMER'S DISEASE - GIVEN LIMITED TIME AND RESOURCES AND OUR FOCUS ON OTHER PRIORITY NEEDS, WE WILL NOT BE ADDRESSING DEMENTIA AND ALZHEIMER'S DURING THIS IMPLEMENTATION CYCLE. HOWEVER, WE WILL BE INCREASING OUR MENTAL HEALTH INVESTMENTS WHICH COULD OVERLAP WITH THOSE EXPERIENCING DEMENTIA OR ALZHEIMER'S. 11. POTENTIALLY DISABLING CONDITIONS - GIVEN LIMITED TIME AND RESOURCES AND OUR FOCUS ON OTHER PRIORITY NEEDS, WE WILL NOT BE ADDRESSING POTENTIALLY DISABLING CONDITIONS DURING THIS IMPLEMENTATION CYCLE.

SCHEDULE H, PART V, SECTION B, LINE 15E
MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY REQUEST ASSISTANCE WITH COMPLETING THE APPLICATION FOR FINANCIAL ASSISTANCE IN PERSON AT THE HOSPITAL, OVER THE PHONE, THROUGH THE MAIL, OR VIA THE SUTTER HEALTH WEBSITE. SCHEDULE H, PART V, LINES 16A, 16B, & 16C MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE MEMORIAL HOSPITAL LOS BANOS WEBSITE AT: HTTP://WWW.MEMORIALLOSBANOS.ORG/ABOUT/FINANCIAL-ASSISTANCE.HTML

SCHEDULE H, PART V, SECTION B, LINE 16J
MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE ORGANIZATION IN THE PRINCIPAL NEWSPAPER IN THE COMMUNITY OR WHEN DOING SO IS NOT PRACTICAL SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THE INFORMATION OR USE OTHER MEANS THAT WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY. SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.

SCHEDULE H, PART V, SECTION B, LINE 22D
MEMORIAL HOSPITAL LOS BANOS (FACILITY 10): AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR FULL WRITE OFF OF ALL CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 400% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED BECAUSE ELIGIBLE PATIENTS DO NOT PAY ANY AMOUNT.

REPORTING FACILITY: #11, STANISLAUS SURGICAL HOSPITAL
Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

SCHEDULE H, PART V, SECTION B, LINE 5
INPUT FROM THE COMMUNITY SERVED BY BOTH MEMORIAL MEDICAL CENTER AND STANISLAUS SURGICAL HOSPITAL WAS COLLECTED THROUGH TWO MAIN MECHANISMS. FIRST, KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY HEALTH EXPERTS AND AREA SERVICE PROVIDERS (I.E., MEMBERS OF SOCIAL-SERVICE NONPROFIT ORGANIZATIONS AND RELATED HEALTHCARE ORGANIZATIONS). THESE INTERVIEWS OCCURRED IN BOTH ONE-ON-ONE AND IN GROUP INTERVIEW SETTINGS. SECOND, FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS THAT WERE IDENTIFIED AS POPULATIONS EXPERIENCING DISPARITIES. ALL PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS FOR INVOLVEMENT IN THE INTERVIEW. ALL INTERVIEW DATA WERE COLLECTED THROUGH NOTE TAKING AND, IN SOME INSTANCES, RECORDING. PRIMARY DATA COLLECTION WITH KEY INFORMANTS INCLUDED TWO PHASES. FIRST, PHASE ONE BEGAN BY INTERVIEWING AREA-WIDE SERVICE PROVIDERS WITH KNOWLEDGE OF THE SERVICE AREA, INCLUDING INPUT FROM THE DESIGNATED PUBLIC HEALTH DEPARTMENT. DATA FROM THESE AREA-WIDE INFORMANTS, COUPLED WITH SOCIO-DEMOGRAPHIC DATA, WAS USED TO IDENTIFY ADDITIONAL KEY INFORMANTS FOR THE ASSESSMENT THAT WERE INCLUDED IN PHASE TWO. AS A PART OF THE INTERVIEW PROCESS, ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. THE INTERVIEWER ASKED EACH PARTICIPANT TO VERBALLY EXPLAIN WHAT VULNERABLE POPULATIONS EXISTED IN THE COUNTY. AS NEEDED FOR A VISUAL AID, KEY INFORMANTS WERE PROVIDED A MAP OF THE HSA TO DIRECTLY POINT TO THE GEOGRAPHIC LOCATIONS OF THESE VULNERABLE COMMUNITIES. ADDITIONAL KEY INFORMANT INTERVIEWS WERE FOCUSED ON THE GEOGRAPHIC LOCATIONS AND/OR SUBGROUPS IDENTIFIED IN THE EARLIER PHASE. FOCUS GROUP INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS LIVING IN GEOGRAPHIC AREAS OF THE SERVICE AREA IDENTIFIED AS LOCATIONS OR POPULATIONS EXPERIENCING A DISPARATE AMOUNT OF POOR SOCIOECONOMIC CONDITIONS AND POOR HEALTH OUTCOMES. RECRUITMENT CONSISTED OF REFERRALS FROM DESIGNATED SERVICE PROVIDERS REPRESENTING VULNERABLE POPULATIONS, AS WELL AS DIRECT OUTREACH TO SPECIAL POPULATION GROUPS. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN STANISLAUS SURGICAL HOSPITAL'S CHNA ARE AVAILABLE AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 6
STANISLAUS SURGICAL HOSPITAL (FACILITY 11): COMMUNITY HEALTH INSIGHTS CONDUCTED THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ON BEHALF OF MEMORIAL MEDICAL CENTER OF MODESTO AND STANISLAUS SURGICAL HOSPITAL.

SCHEDULE H, PART V, SECTION B, LINE 7A, 7B AND 10A
STANISLAUS SURGICAL HOSPITAL (FACILITY 11): HTTPS://WWW.SUTTERHEALTH.ORG/PDF/FOR-PATIENTS/CHNA/MMC-SSH-2019-CHNA.PDF OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 11
STANISLAUS SURGICAL HOSPITAL (FACILITY 11): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT STANISLAUS SURGICAL HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO BASIC NEEDS, SUCH AS HOUSING, JOBS, AND FOOD 2. ACCESS TO MENTAL, BEHAVIORAL, AND SUBSTANCE-ABUSE SERVICES 3. ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES 4. SAFE AND VIOLENCE-FREE ENVIRONMENT 5. INJURY AND DISEASE PREVENTION AND MANAGEMENT 6. ACTIVE LIVING AND HEALTHY EATING DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI. NO HOSPITAL CAN ADDRESS ALL THE HEATH NEEDS IN THE COMMUNITY. STANISLAUS SURGICAL HOSPITAL IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE HOSPITAL DOES NOT PLAN TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 1. ACCESS AND FUNCTIONAL NEEDS - TRANSPORTATION AND PHYSICAL DISABILITY - WHILE OUR IMPLEMENTATION PLAN DOES NOT DIRECTLY ADDRESS ISSUES OF TRANSPORTATION AND PHYSICAL DISABILITY, MANY OF OUR PROGRAMS WILL OFFER CLIENTS REFERRALS TO TRANSPORTATION SERVICES SO THAT THEY CAN ACCESS MEDICAL APPOINTMENTS. 2. ACCESS TO SPECIALTY AND EXTENDED CARE - OUR FOCUS IN STANISLAUS COUNTY IS PRIMARILY ON EXPANDING ACCESS TO PRIMARY CARE THROUGH PARTNERSHIPS WITH OUR FQHC AND COMMUNITY PARTNERS. HOWEVER, SEVERAL OF THESE PROGRAMS WHICH INCREASE ACCESS TO PRIMARY CARE WILL ALSO HELP PATIENTS BECOME CONNECTED TO SPECIALTY CARE ONCE THEY ARE ESTABLISHED WITH A PCP. 3. POLLUTION-FREE LIVING ENVIRONMENT - DUE TO LIMITED RESOURCES AND ABILITY TO IMPACT ENVIRONMENTAL POLICIES, THE HOSPITAL DOES NOT INTEND TO DIRECTLY ADDRESS THIS HEALTH ISSUE AT THIS TIME.

Schedule H, Part V, Section B, Line 15E
STANISLAUS SURGICAL HOSPITAL (11) METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE-OTHER: PATIENTS MAY SUBMIT CHARITY CARE APPLICATION TO THE COLLECTIONS SUPERVISOR. Schedule H, Part V, Section B, Lines 16A, 16B, & 16C STANISLAUS SURGICAL HOSPITAL (11): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE STANISLAUS SURGICAL HOSPITAL WEBSITE AT: HTTPS://STANISLAUSSURGICAL.COM/FINANCIAL-ASSISTANCE

Schedule H, Part V, Section B, Line 16J
STANISLAUS SURGICAL HOSPITAL (11): MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE PRIMARY LANGUAGES OF THE HOSPITAL'S SERVICE AREA. DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND ALSO INFORMATION REGARDING THE RIGHT TO REQUEST AN ESTIMATE OF THEIR FINANCIAL RESPONSIBILITY FOR SERVICES. PATIENTS WHO MAY BE UNINSURED WILL BE ASSIGNED A FINANCIAL COUNSELOR WHO WILL VISIT WITH THE PATIENT IN PERSON AT THE HOSPITAL AND CAN PROVIDE ADDITIONAL INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY AND ASSIST WITH THE APPLICATION PROCESS. AT THE TIME OF DISCHARGE ALL PATIENTS WILL BE PROVIDED THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY.

Schedule H, Part V, Section B, Line 22D
STANISLAUS SURGICAL HOSPITAL (11): AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR SLIDING SCALE CHARGES FOR AN UNINSURED PATIENT WITH A FAMILY INCOME AT OR BELOW 350% OF THE MOST RECENT FEDERAL POVERTY LEVEL. IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-5, THIS ORGANIZATION ADOPTS THE PROSPECTIVE MEDICARE METHOD FOR AMOUNTS GENERALLY BILLED; HOWEVER, PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT FINANCIALLY RESPONSIBLE FOR MORE THAN THE AMOUNTS GENERALLY BILLED.

SCHEDULE H, PART I, LINES 3A & 3C
FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION THE ORGANIZATION HAS A HIGH MEDICAL COST CHARITY CARE CATEGORY IN WHICH A WRITE OFF OF THE PATIENT RESPONSIBILITY FOR HOSPITAL SERVICES CAN OCCUR IF THE INSURED PATIENT HAS FAMILY INCOME AT OR BELOW 400% FPG AND EXPENSES INCURRED FOR THEMSELVES OR THEIR FAMILY EXCEED 10% OF THE PATIENT'S FAMILY INCOME. SUTTER VALLEY HOSPITALS ACQUIRED A 20% OWNERSHIP INTEREST IN STANISLAUS SURGICAL HOSPITAL IN 2016. THIS HOSPITAL PROVIDES PREDOMINANTLY ELECTIVE SURGERIES AND DOES NOT PROVIDE EMERGENCY CARE. STANISLAUS SURGICAL HOSPITAL PROVIDES FREE CHARITY CARE FOR MEDICALLY NECESSARY PROCEDURES FOR UNINSURED PATIENTS FOR FAMILY INCOMES THAT ARE AT OR BELOW 100% OF FPG. PART I, LINE 3B SUTTER VALLEY HOSPITALS IS COMMITTED TO PROVIDING CHARITY CARE. SUTTER VALLEY HOSPITALS PROVIDES FREE CARE AT a HIGH PERCENTAGE OF FPG. IT DOES NOT PROVIDE DISCOUNTED CARE. STANISLAUS SURGICAL HOSPITAL PROVIDES DISCOUNTED CHARITY CARE BASED ON A SLIDING SCALE UP TO 350% OF FPG.

SCHEDULE H, PART I, LINE 7
COSTING METHODOLOGY USED: COST TO CHARGE RATIO UTILIZING WORKSHEET 2 METHODOLOGY.

SCHEDULE H, PART II
COMMUNITY BUILDING ACTIVITIES: SUTTER VALLEY HOSPITALS DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT IN 2021.

SCHEDULE H, PART III, SECTION A, LINE 4
BAD DEBT, AUDIT FOOTNOTE: THE ORGANIZATION IS AN AFFILIATE OF SUTTER HEALTH WHICH UNDERWENT A SYSTEM-WIDE AUDIT. THE AUDIT REPORT DOES NOT INCLUDE A BAD DEBT EXPENSE FOOTNOTE. EFFECTIVE JANUARY 1, 2018, SUTTER ENTITIES IMPLEMENTED THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS UPDATE (ASU), REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE ACCOUNTING CHANGE MODIFIED BAD DEBT REPORTING, AND AS A RESULT, BAD DEBT IS ONLY REPORTED IN LIMITED SITUATIONS.

SCHEDULE H, PART III, SECTION B, LINE 7
MEDICARE COSTS: MEDICARE COST REPORTS THAT THE ORGANIZATION FILES DO NOT INCLUDE ALL OF THE COSTS REQUIRED TO TREAT MEDICARE PATIENTS.

SCHEDULE H, PART III, SECTION B, LINE 8
COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. COMMUNITY BENEFIT MEDICARE SHORTFALL: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT.

SCHEDULE H, PART III, SECTION B, LINE 9B
DEBT COLLECTION POLICY: COLLECTION PRACTICES ARE CONSISTENT FOR ALL PATIENTS AND COMPLY WITH APPLICABLE PROVISIONS OF FEDERAL AND CALIFORNIA LAW. DURING PREADMISSION OR REGISTRATION, THE HOSPITAL PROVIDES ALL PATIENTS WITH INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. AN UNINSURED PATIENT WHO INDICATES THE FINANCIAL INABILITY TO PAY A BILL IS EVALUATED FOR FINANCIAL ASSISTANCE. AT DISCHARGE PATIENTS WILL BE GIVEN AN APPLICATION WHICH WILL DOCUMENT THE PATIENT'S OVERALL FINANCIAL SITUATION. IF AN UNINSURED PATIENT DOES NOT COMPLETE THE APPLICATION FORM WITHIN 30 DAYS OF DELIVERY, THE HOSPITAL WILL NOTIFY THE PATIENT THAT THE APPLICATION HAS NOT BEEN RECEIVED AND WILL PROVIDE THE PATIENT AN ADDITIONAL 210 DAYS TO COMPLETE THE APPLICATION. IF A PATIENT HAS APPLIED FOR CHARITY CARE, HAS BEEN APPROVED TO RECEIVE CHARITY CARE, OR IS COOPERATING WITH THE HOSPITAL'S EFFORTS TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, THE HOSPITAL WILL NOT PURSUE COLLECTIONS.

SCHEDULE H, PART VI, LINE 2
SUTTER MEDICAL CENTER SACRAMENTO: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. MEMORIAL MEDICAL CENTER: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER ROSEVILLE MEDICAL CENTER: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER SOLANO MEDICAL CENTER: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER TRACY COMMUNITY HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER AUBURN FAITH HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER AMADOR HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. SUTTER DAVIS HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. MEMORIAL HOSPITAL LOS BANOS: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED. STANISLAUS SURGICAL HOSPITAL: THE ORGANIZATION DOES NOT CONDUCT ANY ADDITIONAL COMMUNITY HEALTH CARE NEEDS ASSESSMENTS OUTSIDE OF THE 2019 - 2021 COMMUNITY HEALTH NEEDS ASSESSMENT REFERENCED.

SCHEDULE H, PART VI, LINE 4
SUTTER MEDICAL CENTER SACRAMENTO (SMCS): THE HOSPITAL SERVICE AREA (HSA) IS DEFINED AS THE GEOGRAPHIC AREA (BY ZIP CODE) IN WHICH SUTTER MEDICAL CENTER AND SUTTER CENTER FOR PSYCHIATRY RECEIVES ITS TOP 80% OF DISCHARGES. THERE ARE FOUR HOSPITALS THAT SERVE THE COMMUNITY. SACRAMENTO COUNTY HAS OVER 30 CITIES, CENSUS-DESIGNATED PLACES, AND UNINCORPORATED COMMUNITIES THAT INCLUDE NEIGHBORHOODS WITH RICH HERITAGES SUCH AS OAK PARK, KNOWN AS SACRAMENTO'S FIRST SUBURB, TO NEWER COMMUNITIES SUCH AS THE CITY OF RANCHO CORDOVA, INCORPORATED IN 2003. SACRAMENTO COUNTY RANKS AS CALIFORNIA'S 31ST-MOST OVERALL HEALTHY COUNTY AMONG THE 58 IN THE STATE. THE AREA IS SERVED BY A NUMBER OF HEALTHCARE ORGANIZATIONS, INCLUDING THOSE THAT COLLABORATED IN THIS ASSESSMENT. IN THIS CHNA, TWO ADDITIONAL ZIP CODES FROM EL DORADO COUNTY, A NEIGHBORING COUNTY EAST OF SACRAMENTO, WERE INCLUDED TO CAPTURE THE PORTION OF THE COMMUNITY SERVED BY MERCY HOSPITAL OF FOLSOM, LOCATED NEAR THE BORDER OF THESE TWO COUNTIES. WITH SOME EXCEPTIONS, FINDINGS DESCRIBED IN THIS REPORT ARE ORGANIZED BOTH AT THE COUNTY LEVEL AND, AS DETAILED LATER IN THIS REPORT, BY DESIGNATED REGIONS WITHIN THE COUNTY. THE DEFINITION OF THE COMMUNITY SERVED INCLUDED MOST PORTIONS OF SACRAMENTO COUNTY, AND A SMALL PORTION OF WESTERN EL DORADO COUNTY, CALIFORNIA. REGARDED AS A HIGHLY DIVERSE COMMUNITY, SACRAMENTO COUNTY COVERS 994 SQUARE MILES AND IS HOME TO APPROXIMATELY 1.5 MILLION RESIDENTS. THE CHNA USES THIS DEFINITION OF THE COMMUNITY SERVED, AS THIS IS THE PRIMARY GEOGRAPHIC AREA SERVED BY THE SEVEN NONPROFIT HOSPITALS THAT COLLABORATED ON THIS CHNA. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE 2019 SUTTER MEDICAL CENTER CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT MEMORIAL MEDICAL CENTER: THE DEFINITION OF THE COMMUNITY SERVED WAS STANISLAUS COUNTY. THIS IS THE DESIGNATED SERVICE AREA BECAUSE THE MAJORITY OF PATIENTS SERVED BY MEMORIAL MEDICAL CENTER RESIDED IN THIS AREA. THERE ARE THREE HOSPITALS THAT SERVE THE COMMUNITY. LOCATED IN CALIFORNIA'S CENTRAL VALLEY, THE COUNTY COVERS APPROXIMATELY 1,500 SQUARE MILES AND IS HOME TO OVER 530,000 RESIDENTS. IT IS THE 16TH MOST POPULOUS AMONG CALIFORNIA'S 58 COUNTIES. THERE ARE NINE INCORPORATED CITIES IN THE COUNTY INCLUDING CERES, HUGHSON, MODESTO, NEWMAN, OAKDALE, PATTERSON, RIVERBANK, TURLOCK, AND WATERFORD. OF THESE, MODESTO, THE COUNTY SEAT, IS THE MOST POPULOUS ACCOUNTING FOR APPROXIMATELY 40% OF THE COUNTY'S POPULATION; TURLOCK IS THE SECOND, FOLLOWED BY CERES. THE TWO LARGEST RACE/ETHNIC GROUPS IN THE COUNTY ARE THOSE OF HISPANIC OR LATINO ORIGIN (44.8%), FOLLOWED BY CAUCASIANS (43.5%). AGRICULTURE PLAYS A SIGNIFICANT ROLE IN THE COUNTY, THUS THE COUNTY'S LARGEST EMPLOYERS ARE IN THE AGRICULTURE AND FOOD RELATED INDUSTRIES. THE ROBERT WOOD JOHNSON'S COUNTY HEALTH RANKINGS RANKED STANISLAUS COUNTY THE 41ST MOST HEALTHY AMONG CALIFORNIA'S 58 COUNTIES. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA, WITH SOURCES, IS AVAILABLE IN THE MEMORIAL MEDICAL CENTER'S 2019 CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SUTTER ROSEVILLE MEDICAL CENTER: THE DEFINITION OF THE COMMUNITY SERVED WAS THE PRIMARY SERVICE AREA OF SRMC. THE SERVICE AREA WAS DEFINED BY 21 ZIP CODES IN SOUTHERN PLACER AND NORTHERN SACRAMENTO COUNTIES. THIS SERVICE AREA WAS DESIGNATED BECAUSE THE MAJORITY OF PATIENTS SERVED BY SRMC RESIDED IN THESE ZIP CODES. COLLECTIVELY, OVER 700,000 RESIDENTS LIVE IN THE SERVICE AREA. THERE ARE FOUR HOSPITALS THAT SERVE THE COMMUNITY. THOUGH LOCATED IN PLACER COUNTY, THE HOSPITAL SERVES A DIVERSE POPULATION ACROSS BOTH PLACER AND SACRAMENTO COUNTIES. SITUATED IN ROSEVILLE ALONG THE I-80 CORRIDOR THAT RUNS FROM THE SAN FRANCISCO BAY AREA TO RENO, NEVADA AND BEYOND, SRMC SITS NEAR THE BORDER OF THESE TWO COUNTIES. IN PLACER COUNTY THERE WERE 11 ZIP CODES INCLUDED IN THE SERVICE AREA AND INCLUDED COMMUNITIES SUCH AS GRANITE BAY, LINCOLN, LOOMIS, PENRYN, ROCKLIN, ROSEVILLE, AND SHERIDAN. THE TOTAL POPULATION OF THESE ZIP CODES IS 287,586. IN SACRAMENTO COUNTY THERE WERE 10 ZIP CODES INCLUDED IN THE ASSESSMENT, AND THESE ENCOMPASSED COMMUNITIES SUCH AS ANTELOPE, CARMICHAEL, CITRUS HEIGHTS, FOLSOM, NORTH HIGHLANDS, AND ORANGEVALE. THE TOTAL POPULATION OF THESE ZIP CODES IS 415,837. COLLECTIVELY, THE SRMC SERVICE AREA IS HOME TO JUST OVER 700,000 RESIDENTS. THE ROBERT WOOD JOHNSON'S COUNTY HEALTH RANKINGS RANKED PLACER THE FOURTH HEALTHIEST COUNTY AMONG CALIFORNIA'S 58, WHILE SACRAMENTO WAS RANKED 31ST. THOUGH NEIGHBORING COUNTIES, PLACER AND SACRAMENTO HAVE DIFFERENCES IN THE CHARACTERISTICS OF THEIR POPULATIONS. FOR EXAMPLE, THE MEDIAN INCOME FOR PLACER COUNTY WAS $76,926 COMPARED TO SACRAMENTO COUNTY AT $57,509. THE CHARACTERISTICS FOR EACH ZIP CODE IN THE SERVICE AREA ARE PRESENTED IN TABLE 1 OF THE CHNA. THESE ARE COMPARED TO THE STATE AND COUNTY CHARACTERISTICS FOR DESCRIPTIVE PURPOSES. ANY ZIP CODE WITH RATES THAT VARIED NEGATIVELY OR PERFORMED POORLY WHEN COMPARED TO THE STATE OR COUNTY BENCHMARK WERE HIGHLIGHTED. EACH ZIP CODE IS COMPARED TO THE RATES OF THE COUNTY IN WHICH IT RESIDES. COMMUNITIES OF CONCERN ARE GEOGRAPHIC AREAS WITHIN THE SERVICE AREA THAT HAVE THE GREATEST CONCENTRATION OF POOR HEALTH OUTCOMES AND ARE HOME TO MORE MEDICALLY UNDERSERVED, LOW INCOME, AND DIVERSE POPULATIONS AT GREATER RISK FOR POORER HEALTH. COMMUNITIES OF CONCERN ARE IMPORTANT TO THE OVERALL CHNA METHODOLOGY BECAUSE, AFTER THE SERVICE AREA IS ASSESSED MORE BROADLY, THEY ALLOW FOR A FOCUS ON THOSE PORTIONS OF THE REGION LIKELY EXPERIENCING THE GREATEST HEALTH DISPARITIES. GEOGRAPHIC COMMUNITIES OF CONCERN WERE IDENTIFIED USING A COMBINATION OF PRIMARY AND SECONDARY DATA SOURCES. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED SEVEN ZIP CODES THAT MET THE CRITERIA TO BE CLASSIFIED AS A COMMUNITY OF CONCERN. THESE ARE NOTED IN ZIP CODE ORDER IN TABLE 2 OF THE CHNA, WITH THE CENSUS POPULATION PROVIDED FOR EACH, AND ARE DISPLAYED IN FIGURE 5 OF THE CHNA. THE TOTAL POPULATION OF COMMUNITIES OF CONCERN WAS 415,837 WHICH WAS 59.1% OF THE TOTAL POPULATION SERVED. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE SUTTER ROSEVILLE MEDICAL CENTER CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SUTTER SOLANO MEDICAL CENTER: THE DEFINITION OF THE COMMUNITY SERVED INCLUDED THE PRIMARY SERVICE AREA OF THE HOSPITAL, THE CITY OF VALLEJO, CALIFORNIA, AND SURROUNDING COMMUNITIES AS DEFINED BY SIX ZIP CODES-94503, 94510, 94589, 94590, 94591, AND 94592. THIS IS THE DESIGNATED SERVICE AREA BECAUSE THE MAJORITY OF PATIENTS SERVED BY SSMC RESIDED IN THESE ZIP CODES. CONSIDERED A NORTH SAN FRANCISCO BAY COMMUNITY, VALLEJO IS AN INCORPORATED CITY IN SOLANO COUNTY. THE SERVICE AREA INCLUDED ONE ZIP CODE, 94503 (AMERICAN CANYON), LOCATED IN NAPA COUNTY. THE TOTAL POPULATION OF THE SERVICE AREA WAS 170,925. THERE ARE THREE HOSPITALS THAT SERVE THE COMMUNITY. POPULATION CHARACTERISTICS FOR EACH ZIP CODE IN THE SERVICE AREA ARE PRESENTED IN TABLE 1 OF THE CHNA. THESE ARE COMPARED TO THE STATE AND COUNTY CHARACTERISTICS FOR DESCRIPTIVE PURPOSES. ANY ZIP CODE WITH RATES THAT VARIED NEGATIVELY WHEN COMPARED TO THE STATE OR COUNTY BENCHMARKS IS HIGHLIGHTED. BECAUSE AMERICAN CANYON IS LOCATED IN NAPA COUNTY, RATES FROM THIS ZIP CODE (94503) ARE COMPARED ONLY TO THE NAPA COUNTY AND STATE BENCHMARKS. SOLANO COUNTY RESIDENT MEDIAN INCOME IS $69,227 AND NAPA COUNTY IS $74,609 COMPARED TO CALIFORNIA MEDIAN INCOME OF $63,783. TWO ZIP CODES WITHIN SOLANO COUNTY FALL UNDER THE STATE MEDIAN INCOME AT $57,316 IN 94589 AND $41,530 AT 94590. COMMUNITIES OF CONCERN ARE GEOGRAPHIC AREAS WITHIN THE SERVICE AREA THAT HAVE THE GREATEST CONCENTRATION OF POOR HEALTH OUTCOMES AND ARE HOME TO MORE MEDICALLY UNDERSERVED, LOW-INCOME, AND DIVERSE POPULATIONS AT GREATER RISK FOR POORER HEALTH. COMMUNITIES OF CONCERN ARE IMPORTANT TO THE OVERALL CHNA METHODOLOGY BECAUSE, AFTER THE SERVICE AREA HAS BEEN ASSESSED MORE BROADLY, THEY ALLOW FOR A FOCUS ON THOSE PORTIONS OF THE REGION LIKELY EXPERIENCING THE GREATEST HEALTH DISPARITIES. GEOGRAPHIC COMMUNITIES OF CONCERN WERE IDENTIFIED USING A COMBINATION OF PRIMARY AND SECONDARY DATA SOURCES. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED TWO ZIP CODES THAT MET THE CRITERIA TO BE CLASSIFIED AS COMMUNITIES OF CONCERN. THE TWO ZIP CODES IDENTIFIED AS COMMUNITIES OF CONCERN CONSIST OF A TOTAL POPULATION OF 67,400 WHICH WAS 39.4% OF THE TOTAL POPULATION OF THE SERVICE AREA FOR SUTTER SOLANO MEDICAL CENTER. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA IS AVAILABLE IN THE SUTTER MEDICAL CENTER CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT SUTTER TRACY COMMUNITY HOSPITAL: THE DEFININTION OF THE COMMUNITY SERVED IS SAN JOAQUIN COUNTY, ONE OF CALIFORNIA'S FASTEST GROWING COUNTIES, I

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"PROMOTION OF COMMUNITY HEALTH: SUTTER HEALTH'S MISSION IS TO ""ENHANCE THE WELL-BEING OF THE PEOPLE IN THE COMMUNITIES WE SERVE, THROUGH A NOT-FOR-PROFIT COMMITMENT TO COMPASSION AND EXCELLENCE IN HEALTH CARE SERVICES."" SUTTER HEALTH'S MISSION REACHES BEYOND THE WALLS OF OUR HOSPITALS AND FACILITIES. OUR AFFILIATES FURTHER THEIR TAX-EXEMPT PURPOSE BY: - BUILDING RELATIONSHIPS OF TRUST BY WORKING COLLABORATIVELY WITH COMMUNITY GROUPS, SCHOOLS AND GOVERNMENT ORGANIZATIONS TO EFFECTIVELY LEVERAGE RESOURCES AND ADDRESS IDENTIFIED COMMUNITY NEEDS; - SUPPORTING NONPROFIT ORGANIZATIONS THAT ARE COMMITTED TO COMMUNITY HEALTH IMPROVEMENT THROUGH FINANCIAL INVESTMENTS, IN-KIND SERVICES AND EMPLOYEE VOLUNTEERISM; AND - PROVIDING GENEROUS CHARITY CARE POLICIES FOR OUR MOST VULNERABLE COMMUNITY MEMBERS. SUTTER MEDICAL CENTER SACRAMENTO & SUTTER CENTER FOR PSYCHIATRY (REPORTING FACILITY B, 6) THE 2019 - 2021 IMPLEMENTATION STRATEGIES FOR SUTTER MEDICAL CENTER SACRAMENTO (SMCS) AND SUTTER CENTER FOR PSYCHIATRY DEFINE A VARIETY OF PROGRAMS AND PARTNERSHIPS THAT ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVES. A FEW OF THOSE PROGRAMS AND PARTNERSHIPS ARE DESCRIBED BELOW. PROGRAMS ADDRESSING: ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE-ABUSE SERVICES AREA WIDE MENTAL HEALTH STRATEGY THE NEED FOR MENTAL HEALTH SERVICES AND RESOURCES, ESPECIALLY FOR THE UNDERSERVED, HAS REACHED A BREAKING POINT ACROSS THE SUTTER HEALTH VALLEY OPERATING UNIT. THIS IS WHY WE ARE FOCUSED ON BUILDING A COMPREHENSIVE MENTAL HEALTH STRATEGY THAT INTEGRATES KEY ELEMENTS SUCH AS POLICY AND ADVOCACY, COUNTY SPECIFIC INVESTMENTS, STIGMA REDUCTION, INCREASED AWARENESS AND EDUCATION, WITH TANGIBLE OUTREACH SUCH AS EXPANDED MENTAL HEALTH RESOURCES TO PROFESSIONALS IN THE WORKPLACE AND TELEPYSCH OPTIONS TO THE UNDERSERVED. BY LINKING THESE VARIOUS STRATEGIES AND EFFORTS THROUGH ENGAGING IN STATEWIDE PARTNERSHIPS, REPLICATING BEST PRACTICES, AND SECURING INNOVATION GRANTS AND AWARD OPPORTUNITIES, WE HAVE THE ABILITY TO CREATE A SEAMLESS NETWORK OF MENTAL HEALTH CARE RESOURCES SO DESPERATELY NEEDED IN THE COMMUNITIES WE SERVE. IN 2021, THE MENTAL HEALTH STRATEGY HELPED WITH THE FOLLOWING INITIATIVES: . LAUNCH THE 988-CRISIS LINE GOING LIVE ON JULY 26, 2022 . PASS SB803 FOR PEER CERTIFICATION. . SECURE FUNDING FOR SB71/BRING CA HOME IN AMOUNT OF $2 BILLION OVER TWO YEARS AND AN UNSPECIFIED AMOUNT FUTURE FUNDING. . ADVOCATE FOR FUNDING FOR BOARD AND CARE WITH THE COUNTY BEHAVIORAL HEALTH DIRECTORS ASSOCIATION AND OTHER ORGANIZATIONS SERVING PEOPLE LIVING WITH SEVERE MENTAL ILLNESS AND/OR SUBSTANCE USE DISORDER. RESULTING IN SECURING $803 MILLION, WITH PROGRAM DETAILS STILL TO BE FLESHED OUT. PROPOSE CHILDREN AND YOUTH INITIATIVE AND ASSIST SECRETARY GHALY TO DEVELOP WHAT BECAME ONE OF THE GOVERNOR'S SIGNATURE BUDGET ACHIEVEMENTS: $4.5 BILLION OVER FIVE YEARS TO MEET THE BEHAVIORAL HEALTH NEEDS OF CHILDREN. SUICIDE PREVENTION ED FOLLOW-UP PROGRAM THE EMERGENCY DEPARTMENT SUICIDE PREVENTION FOLLOW UP PROGRAM IS DESIGNED TO PREVENT SUICIDE DURING A HIGH-RISK PERIOD, AND POST DISCHARGE, PROVIDE EMOTIONAL SUPPORT, AND CONTINUE EVIDENCE-BASED RISK ASSESSMENT AND MONITORING FOR ONGOING SUICIDALITY. THAT INCLUDES PERSONALIZED SAFE PLANS, EDUCATIONAL AND SENSITIVE OUTREACH MATERIALS ABOUT SURVIVING A SUICIDE ATTEMPT AND RECOVERY, 24-HOUR ACCESS TO CRISIS LINES, AND REFERRALS TO COMMUNITY-BASED RESOURCES FOR ONGOING TREATMENT AND SUPPORT. THE GOAL OF THE SUICIDE PREVENTION PROGRAM IS TO WRAP PATIENTS WITH SERVICES AND SUPPORT FOLLOWING A SUICIDE ATTEMPT OR SUICIDAL IDEATION. IN 2021, 29 CLIENTS RECEIVED SUPPORTIVE SERVICES. TRIAGE NAVIGATOR PROGRAM THE TRIAGE NAVIGATOR HAS BECOME AN IMPORTANT PART OF THE ED AND PSYCH RESPONSE TEAM AND A VITAL RESOURCE FOR PATIENTS SUFFERING FROM A MENTAL HEALTH CRISIS. THE TRIAGE NAVIGATOR CONNECTS WITH COMPLEX PATIENTS WHO ARE NOT ONLY BATTLING MENTAL HEALTH ISSUES, BUT ALSO HAVE COUNTLESS OTHER CHALLENGES AROUND SUBSTANCE ABUSE, HOMELESSNESS, POVERTY AND OTHER HEALTH PROBLEMS. THE TRIAGE NAVIGATOR, THROUGH THE OFFERING OF SPECIALIZED, WRAP-AROUND SERVICES, IS MAKING A POSITIVE IMPACT ON THE LIVES OF PATIENTS. THE GOAL OF THE TRIAGE NAVIGATOR IS TO PROVIDE A LINKAGE BETWEEN OUR UNDERSERVED POPULATION AND BEHAVIORAL/MENTAL HEALTH RESOURCES. IN 2021, 286 INDIVIDUALS WERE REFERRED, AND 161 INDIVIDUALS WERE SCREENED AND LINKED TO BEHAVIORAL/MENTAL HEALTH RESOURCES. PROGRAMS ADDRESSING: ACCESS TO QUALITY PRIMARY HEALTHCARE SERVICES EMERGENCY DEPARTMENT NAVIGATOR (ED NAVIGATOR) THE ED NAVIGATOR SERVES AS A VISIBLE ED-BASED STAFF MEMBER. UPON REFERRAL FROM A SUTTER EMPLOYEE (AND AFTER PATIENT AGREEMENT), ED NAVIGATORS ATTEND TO PATIENTS IN THE ED AND COMPLETE AN ASSESSMENT FOR T3 CASE-MANAGEMENT SERVICES. UPON ASSESSMENT, THE ED NAVIGATOR DETERMINES AND IDENTIFIES PATIENT NEEDS FOR COMMUNITY-BASED RESOURCES AND/OR CASE-MANAGEMENT SERVICES, SUCH AS PROVIDING A PATIENT LINKAGE TO A PRIMARY CARE PROVIDER AND ESTABLISHING A MEDICAL HOME. THE GOAL OF THE ED NAVIGATOR IS TO CONNECT PATIENTS WITH HEALTH AND SOCIAL SERVICES, AND ULTIMATELY A MEDICAL HOME, AS WELL AS OTHER PROGRAMS (LIKE T3) WHEN APPROPRIATE. IN 2021, 142 INDIVIDUALS WERE SERVED AND PROVIDED 745 SERVICE REFERRALS TO COMMUNITY RESOURCES. HEALTH NAVIGATION: REDUCING BARRIERS TO CARE THE SACRAMENTO HEALTH NAVIGATOR PROGRAM EXPANDS HEALTH NAVIGATION SERVICES IN SACRAMENTO 11 COUNTY AND CONNECTS THOUSANDS OF LOW-INCOME RESIDENTS TO AFFORDABLE HEALTH CARE COVERAGE. THE OVERALL GOAL OF THE PROJECT IS TO ESTABLISH MEDICAL HOMES, THEREBY REDUCING DEPENDENCE ON EMERGENCY ROOM SYSTEMS OF CARE. THE COMMUNITY NEEDS ADDRESSED BY THIS PROJECT, ALL OF WHICH SUPPORT THE UNDER-INSURED AND UNINSURED, INCLUDE: 1) ACCESS TO PRIMARY CARE, 2) ACCESS TO PREVENTIVE CARE, AND 3) ACCESS TO DENTAL CARE. IN 2021, 5,961 INDIVIDUALS WERE SERVED AND PROVIDED 2,835 SERVICES. INTERIM CARE PROGRAM (ICP) A COLLABORATIVE OF THE FOUR HEALTH CARE SYSTEMS AND WELLSPACE HEALTH, VOLUNTEERS OF AMERICA AND SACRAMENTO COUNTY, THE SACRAMENTO INTERIM CARE PROGRAM (ICP) IS A RESPITE-CARE SHELTER FOR HOMELESS PATIENTS DISCHARGED FROM HOSPITALS. THE ICP WRAPS PEOPLE WITH HEALTH AND SOCIAL SERVICES, WHILE GIVING THEM A PLACE TO HEAL. STARTED IN 2005, THE ICP LINKS PEOPLE IN NEED TO VITAL COMMUNITY SERVICES WHILE GIVING THEM A PLACE TO HEAL. THE CLIENTS WHO ARE ENROLLED IN THE ICP ARE HOMELESS ADULT INDIVIDUALS WHO OTHERWISE WOULD BE DISCHARGED TO THE STREET OR CARED FOR IN AN INPATIENT SETTING ONLY. THE PROGRAM IS DESIGNED TO OFFER CLIENTS UP TO SIX WEEKS DURING WHICH THEY CAN FOCUS ON RECOVERY AND DEVELOPING A PLAN FOR THEIR HOUSING AND CARE UPON DISCHARGE. THIS INNOVATIVE COMMUNITY PARTNERSHIP PROVIDES TEMPORARY RESPITE HOUSING THAT OFFER HOMELESS MEN AND WOMEN A PLACE TO RECUPERATE FROM THEIR MEDICAL CONDITIONS, LINK THEM TO VITAL COMMUNITY SERVICES, AND PROVIDE THEM A PLACE TO HEAL. THE ICP SEEKS TO CONNECT PATIENTS WITH A MEDICAL HOME, SOCIAL SUPPORT AND HOUSING. IN 2021, ICP SERVED 988 INDIVIDUALS, PROVIDING 13,711 SERVICES. ICP HELPED PEOPLE IMPROVE THEIR OVERALL HEALTH BY WRAPPING THEM WITH SERVICES AND TREATING THE WHOLE PERSON THROUGH LINKAGE TO APPROPRIATE HEALTH CARE, SHELTER, AND OTHER SOCIAL SUPPORT SERVICES. INTERIM CARE PROGRAM PLUS (ICP+) SMCS OFFERS AN ""EXPANDED ICP"" ICP+ AIMED TO MEET THE NEEDS OF PATIENTS WITH MORE COMPLEX NEEDS AND ACUTE HEALTH ISSUES. THE PROGRAM OFFERS SHORT-TERM (60-90 DAYS) RESPITE CENTER SERVING HOMELESS INDIVIDUALS' POST-HOSPITALIZATION. CATERS TO INDIVIDUALS WITH HIGHER MEDICAL ACUITY. OFFERS INTENSIVE CASE MGMT., ACCESS TO LVNS & CNAS, MEDICATION EDUC., TRANSPORTATION, & REFERRALS. ICP+ SEEKS TO CONNECT PATIENTS WITH A MEDICAL HOME, SOCIAL SUPPORT, AND HOUSING. IN 2021, ICP+ SERVED 434 INDIVIDUALS, PROVIDING 431,803 SERVICES. ICP+ HELPED PEOPLE IMPROVE THEIR OVERALL HEALTH BY WRAPPING THEM WITH SERVICES AND TREATING THE WHOLE PERSON THROUGH LINKAGE TO APPROPRIATE HEALTH CARE, SHELTER, AND OTHER SOCIAL SUPPORT SERVICES. TRIAGE, TRANSPORT, TREATMENT (T3) T3 PROVIDES CASE MANAGEMENT SERVICES FOR PEOPLE WHO FREQUENTLY ACCESS THE SMCS EDS FOR INAPPROPRIATE AND NON-URGENT NEEDS, BY CONNECTING VULNERABLE PATIENTS TO VITAL RESOURCES SUCH AS HOUSING, PRIMARY CARE, MENTAL AND BEHAVIORAL HEALTH SERVICES, TRANSPORTATION, SUBSTANCE ABUSE TREATMENT AND OTHER KEY COMMUNITY RESOURCES. BY LINKING THESE PATIENTS TO THE RIGHT CARE, IN THE RIGHT PLACE, AT THE RIGHT TIME AND WRAPPING THEM WITH SERVICES, WE SEE A DRASTIC IMPROVEMENT TO THE HEALTH AND OVERALL QUALITY OF LIFE FOR THIS OFTEN UNDERSERVED, PATIENT POPULATION. THE GOAL OF T3 IS TO WRAP PATIENTS WITH HEALTH AND SOCIAL SERVICES, AND ULTIMATELY A MEDICAL HOME. IN 2021, T3 SERVED 592 INDIVIDUALS, PROVIDING 6,666 SERVICES TO COMMUNITY RESOURCES. TRIAGE, TRANSPORT, AND TREATMENT PLUS (T3+) T3+ IS SIMILAR TO T3, EXCEPT PATIENTS ARE IDENTIFIED IN AN INPATIENT SETTING AND ARE OFTEN MORE COMPLEX. THE T3+ NAVIGATOR FOLLOWS PATIENTS AFTE"

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STATE FILING OF COMMUNITY BENEFIT REPORT: CALIFORNIA

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PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SUTTER HOSPITALS FOLLOW A SUTTER HEALTH SYSTEM-WIDE FINANCIAL ASSISTANCE POLICY, WHICH INCLUDES THE FOLLOWING DETAILS OF HOW THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE. LANGUAGES: THE POLICY SHALL BE AVAILABLE IN THE PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA. IN ADDITION, ALL NOTICES/COMMUNICATIONS PROVIDED IN THIS SECTION SHALL BE AVAILABLE IN PRIMARY LANGUAGE(S) OF HOSPITAL'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. INFORMATION PROVIDED TO PATIENTS DURING THE PROVISION OF HOSPITAL SERVICES: A. DURING PREADMISSION OR REGISTRATION (OR AS SOON THEREAFTER AS PRACTICABLE) HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND IDENTIFY THE DEPARTMENT THAT PATIENTS CAN VISIT TO RECEIVE INFORMATION ABOUT, AND ASSISTANCE WITH APPLYING FOR, FINANCIAL ASSISTANCE. B. FINANCIAL ASSISTANCE COUNSELORS: PATIENTS WHO MAY BE UNINSURED PATIENTS SHALL BE ASSIGNED FINANCIAL COUNSELORS, WHO SHALL VISIT WITH THE PATIENTS IN PERSON AT THE HOSPITAL, PROVIDE PATIENTS A FINANCIAL ASSISTANCE APPLICATION, ASSIST WITH THE APPLICATION PROCESS, AND PROVIDE A CONTACT INFORMATION FOR THE PATIENT TO CALL FOR QUESTIONS. C. EMERGENCY SERVICES: IN THE CASE OF EMERGENCY SERVICES, HOSPITALS SHALL PROVIDE ALL PATIENTS A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AS SOON AS PRACTICABLE AFTER STABILIZATION OF THE PATIENT'S EMERGENCY MEDICAL CONDITION OR UPON DISCHARGE. D. APPLICATIONS PROVIDED AT DISCHARGE: AT THE TIME OF DISCHARGE, HOSPITALS SHALL PROVIDE ALL PATIENTS WITH A COPY OF A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. E. INFORMATION PROVIDE TO PATIENTS AT OTHER TIMES: 1. CONTACT INFORMATION WHICH INCLUDES A PHONE NUMBER AND HOSPITAL DEPARTMENT TO OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE AND ASSISTANCE WITH THE APPLICATION PROCESS. 2. BILLING STATEMENTS: BILLING STATEMENTS PROVIDED TO PATIENTS SHALL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, A PHONE NUMBER FOR PATIENTS TO CALL WITH QUESTIONS ABOUT FINANCIAL ASSISTANCE, AND THE WEBSITE ADDRESS WHERE PATIENTS CAN OBTAIN ADDITIONAL INFORMATION ABOUT FINANCIAL ASSISTANCE INCLUDING THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY OF THE POLICY, AND THE APPLICATION FOR FINANCIAL ASSISTANCE. 3. UPON REQUEST: HOSPITALS SHALL PROVIDE PATIENTS WITH PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST AND WITHOUT CHARGE. F. PUBLICITY OF FINANCIAL ASSISTANCE INFORMATION 1. PUBLIC POSTING: HOSPITALS SHALL POST COPIES OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IN A PROMINENT LOCATION IN THE EMERGENCY ROOM, ADMISSIONS AREA, AND ANY OTHER LOCATION IN THE HOSPITAL WHERE THERE IS A HIGH VOLUME OF PATIENT TRAFFIC, INCLUDING BUT NOT LIMITED TO THE WAITING ROOMS, BILLING OFFICES, AND HOSPITAL OUTPATIENT SERVICE SETTINGS. THESE PUBLIC NOTICES SHALL INCLUDE INFORMATION ABOUT THE RIGHT TO REQUEST AN ESTIMATE OF FINANCIAL RESPONSIBILITY FOR SERVICES. 2. WEBSITE: THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY SHALL BE AVAILABLE IN A PROMINENT PLACE ON THE SUTTER HEALTH WEBSITE (WWW.SUTTERHEALTH.ORG) AND ON EACH INDIVIDUAL HOSPITAL'S WEBSITE. PERSONS SEEKING INFORMATION ABOUT FINANCIAL ASSISTANCE SHALL NOT BE REQUIRED TO CREATE AN ACCOUNT OR PROVIDE ANY PERSONAL INFORMATION BEFORE RECEIVING INFORMATION ABOUT FINANCIAL ASSISTANCE. 3. MAIL: PATIENTS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE POLICY, APPLICATION FOR FINANCIAL ASSISTANCE AND PLAIN LANGUAGE SUMMARY BE SENT BY MAIL, AT NO COST TO THE PATIENT. 4. ADVERTISEMENTS/PRESS RELEASES: AS NECESSARY AND ON AT LEAST AN ANNUAL BASIS, SUTTER HEALTH WILL PLACE AN ADVERTISEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AT HOSPITALS IN THE PRINCIPAL NEWSPAPER(S) IN THE COMMUNITIES SERVED BY SUTTER HEALTH, OR WHEN DOING SO IS NOT PRACTICAL, SUTTER WILL ISSUE A PRESS RELEASE CONTAINING THIS INFORMATION, OR USE OTHER MEANS THAT SUTTER HEALTH CONCLUDES WILL WIDELY PUBLICIZE THE AVAILABILITY OF THE POLICY TO AFFECTED PATIENTS IN OUR COMMUNITIES. 5. COMMUNITY AWARENESS: SUTTER HEALTH WILL WORK WITH AFFILIATED ORGANIZATIONS, PHYSICIANS, COMMUNITY CLINICS AND OTHER HEALTH CARE PROVIDERS TO NOTIFY MEMBERS OF THE COMMUNITY (ESPECIALLY THOSE WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.

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SUTTER HEALTH IS THE NOT-FOR-PROFIT PARENT OF NOT-FOR-PROFIT AND FOR-PROFIT COMPANIES THAT TOGETHER FORM AN INTEGRATED HEALTHCARE SYSTEM LOCATED IN NORTHERN CALIFORNIA. THE SYSTEM IS COMMITTED TO HEALTH EQUITY, COMMUNITY PARTNERSHIPS AND INNOVATIVE, HIGH-QUALITY PATIENT CARE. OUR OVER 65,000 EMPLOYEES AND ASSOCIATED CLINICIANS SERVE MORE THAN 3 MILLION PATIENTS THROUGH OUR HOSPITALS, CLINICS AND HOME HEALTH SERVICES. LEARN MORE ABOUT HOW WE'RE TRANSFORMING HEALTHCARE AT SUTTERHEALTH.ORG AND VITALS.SUTTERHEALTH.ORG SUTTER HEALTH'S TOTAL INVESTMENT IN COMMUNITY BENEFIT IN 2021 WAS $872 MILLION. THIS AMOUNT INCLUDES TRADITIONAL CHARITY CARE AND UNREIMBURSED COSTS OF PROVIDING CARE TO MEDI-CAL PATIENTS. THIS AMOUNT ALSO INCLUDES INVESTMENTS IN COMMUNITY HEALTH PROGRAMS TO ADDRESS PRIORITIZED HEALTH NEEDS AS IDENTIFIED BY REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENTS. AS PART OF SUTTER HEALTH'S COMMITMENT TO FULFILL ITS NOT-FOR-PROFIT MISSION AND HELP SERVE SOME OF THE MOST VULNERABLE IN ITS COMMUNITIES, THE SUTTER HEALTH NETWORK HAS IMPLEMENTED CHARITY CARE POLICIES TO HELP PROVIDE ACCESS TO MEDICALLY NECESSARY CARE FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2021, SUTTER HEALTH INVESTED $91 MILLION IN CHARITY CARE. OVERALL, SINCE THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT, GREATER NUMBERS OF PREVIOUSLY UNINSURED PEOPLE NOW HAVE MORE ACCESS TO HEALTHCARE COVERAGE THROUGH THE MEDI-CAL AND MEDICARE PROGRAMS. THE PAYMENTS FOR PATIENTS WHO ARE COVERED BY MEDI-CAL AND MEDICARE DO NOT COVER THE FULL COSTS OF PROVIDING CARE. IN 2021, SUTTER HEALTH INVESTED $557 MILLION MORE THAN THE STATE PAID TO CARE FOR MEDI-CAL PATIENTS. THROUGH COMMUNITY BENEFIT INVESTMENTS, SUTTER HELPED LOCAL COMMUNITIES ACCESS PRIMARY, MENTAL HEALTH AND ADDICTION CARE, AND BASIC NEEDS SUCH AS HOUSING, JOBS AND FOOD. SEE MORE ABOUT HOW SUTTER HEALTH REINVESTS INTO THE COMMUNITY BY VISITING SUTTERPARTNERS.ORG.