4A (Expenses $ 184052731 including grants of $ 32241) (Revenue $ 217119762)
COLUMBIA ST. MARY'S, INC. EXISTS AS THE PARENT CORPORATION IN THE COLUMBIA ST. MARY'S SYSTEM, WHICH IS COMPRISED OF 3 HOSPITALS, (COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE, INC., COLUMBIA ST. MARY'S HOSPITAL OZAUKEE, INC., AND SACRED HEART REHABILITATION INSTITUTE, INC.), COMMUNITY CLINICS, THE COLUMBIA COLLEGE OF NURSING, A PARTNERSHIP WITH THE ORTHOPAEDIC HOSPITAL OF WISCONSIN, A PARTNERSHIP WITH THE SLEEP WELLNESS INSTITUTE, AND URGENT CARE CENTERS. AS PART OF THE ASCENSION CATHOLIC HEALTH MINISTRY, THE FILING ORGANIZATION SERVED IN SUPPORT OF ASCENSION'S COMMITMENT TO BOTH CARE FOR PATIENTS AND COMMUNITIES AND SUPPORT CAREGIVERS AND OTHER ASSOCIATES THROUGH THE CHALLENGES OF THE COVID-19 GLOBAL PANDEMIC IN FY22.

Schedule H, Part V, Section B, Line 2
During Fiscal Year 2022, Columbia St. Mary's, Inc. 51% owed joint venture, AW Emerus LLC, opened three new micro hospital facilities: Ascension Wisconsin Hospital - Greenfield opened in September 2021; Ascension Wisconsin Hospital - Waukesha opened in October 2021; Ascension Wisconsin Hospital - Menomonee Falls opened in September 2021.

Schedule H, Part V, Section B, Line 3E
TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED.

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - ORTHOPAEDIC HOSPITAL OF WISCONSIN. THE MOST RECENT ORTHOPAEDIC HOSPITAL OF WISCONSIN'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS PREPARED BY JOINT VENTURE PARTNER, ASCENSION WISCONSIN, AND CONDUCTED IN COLLABORATION WITH OTHER HEALTH SYSTEMS AND THE PUBLIC HEALTH AGENCIES IN MILWAUKEE COUNTY TO TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. SPECIAL ATTENTION WAS GIVEN TO THE NEEDS OF INDIVIDUALS AND COMMUNITIES WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. COMMUNITY INPUT WAS OBTAINED THROUGH THE FOLLOWING METHODS: --COMMUNITY SURVEY: AN ONLINE COMMUNITY SURVEY AVAILABLE IN ENGLISH AND SPANISH WAS CONDUCTED WITH THE MILWAUKEE HEALTH CARE PARTNERSHIP AND CONDUENT HEALTHY COMMUNITIES INSTITUTE TO GATHER THE PERCEPTIONS, THOUGHTS, OPINIONS AND CONCERNS OF THE COMMUNITY. THE COMMUNITY SURVEY WAS PROMOTED ACROSS MILWAUKEE COUNTY FROM AUGUST 17, 2021, THROUGH OCTOBER 4, 2021. PAPER SURVEYS WERE ALSO AVAILABLE IN CERTAIN LOCATIONS. --KEY STAKEHOLDER INTERVIEWS: CONDUCTED BETWEEN AUGUST 2021 AND SEPTEMBER 2021, A SERIES OF 49 ONE-ON-ONE INTERVIEWS WERE CONDUCTED BY THE PARTNER HEALTH SYSTEMS TO GATHER FEEDBACK FROM KEY STAKEHOLDERS ON THE HEALTH NEEDS AND ASSETS OF MILWAUKEE COUNTY. THESE REPRESENTATIVES FROM DIFFERENT ORGANIZATIONS AND AGENCIES INCLUDED PARTICIPANTS FROM LOCAL HEALTH DEPARTMENTS AND REPRESENTATIVES OF ORGANIZATIONS THAT SERVE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. A LIST OF THE ORGANIZATIONS THAT PROVIDED INPUT ARE LISTED BELOW. UNITED COMMUNITY CENTER CORE EL CENTRO VIVENT HEALTH GREATER MILWAUKEE FOUNDATION IMPACT INC. ZILBER FAMILY FOUNDATION MILWAUKEE COUNTY DISTRICT ATTORNEY'S OFFICE MILWAUKEE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES MILWAUKEE RESCUE MISSION / SAFE HARBOR UNITED WAY OF GREATER MILWAUKEE & WAUKESHA COUNTY SOJOURNER FAMILY PEACE CENTER UNITEWI DISABILITY RIGHTS WISCONSIN CHILDREN'S HEALTH ALLIANCE OF WISCONSIN / MILWAUKEE COUNTY ORAL HEALTH TASK FORCE MUSLIM COMMUNITY & HEALTH CENTER ZILBER SCHOOL OF PUBLIC HEALTH MILWAUKEE CENTER FOR INDEPENDENCE MILWAUKEE COUNTY OFFICE ON AFRICAN AMERICAN AFFAIRS MILWAUKEE FIRE DEPARTMENT MILWAUKEE PUBLIC SCHOOLS CITY OF MILWAUKEE HEALTH DEPARTMENT INSTITUTE FOR HEALTH AND EQUITY AT THE MEDICAL COLLEGE OF WISCONSIN LUTHERAN SOCIAL SERVICES OF WISCONSIN AND UPPER MICHIGAN, INC. COMMUNITY ADVOCATES INC. GERALD L. IGNACE INDIAN HEALTH CENTER, INC. MILWAUKEE COUNTY BEHAVIORAL HEALTH DIVISION SIXTEENTH STREET COMMUNITY HEALTH CENTERS, MILWAUKEE LATINO HEALTH COALITION FEEDING AMERICA EASTERN WISCONSIN MILWAUKEE VA MEDICAL CENTER INTERFAITH CONFERENCE OF GREATER MILWAUKEE OFFICE OF THE MAYOR - CITY OF MILWAUKEE MILWAUKEE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES ASCENSION WISCONSIN / SHERMAN PARK BUILD HEALTH MILWAUKEE HEALTH DEPARTMENT, OFFICE OF VIOLENCE PREVENTION JOURNEY HOUSE MENTAL HEALTH AMERICA OF WISCONSIN DIVERSE & RESILIENT MILWAUKEE URBAN LEAGUE SOCIAL DEVELOPMENT COMMISSION SOUTHEAST ASIAN EDUCATIONAL DEVELOPMENT OF WISCONSIN, INC. YWCA SOUTHEAST WISCONSIN BOYS & GIRLS CLUBS OF GREATER MILWAUKEE MILWAUKEE POLICE DEPARTMENT UNITED COMMUNITY CENTER P3 DEVELOPMENT GROUP SAFE & SOUND BADER PHILANTHROPIES --FOCUS GROUPS: FOUR FOCUS GROUPS WERE CONDUCTED IN OCTOBER 2021 AND NOVEMBER 2021. FOCUS GROUPS WERE PURPOSEFULLY IDENTIFIED TO REPRESENT SAFETY NET CLINICS, PUBLIC HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS SERVING CHILDREN AND ADOLESCENTS AND REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS SERVING LOW-INCOME POPULATIONS. A LIST OF THE ORGANIZATIONS THAT PROVIDED INPUT ARE LISTED BELOW. LISC ZILBER FAMILY FOUNDATION IMPACT211 MILWAUKEE COUNTY HOUSING ADMINISTRATOR NORTHWEST SIDE COMMUNITY DEVELOPMENT CORPORATION MILWAUKEE HEALTH CARE PARTNERSHIP ALL4KIDS URBAN UNDERGROUND AND YOUTH JUSTICE MILWAUKEE URBAN UNDERGROUND OFFICE OF VIOLENCE PREVENTION I HAVE A DREAM FOUNDATION ALIVE MKE PEAK MILWAUKEE CONSORTIUM FOR HMONG HEALTH VEL R. PHILLIPS SCHOOL, WAUWATOSA SCHOOL DISTRICT WEST ALLIS HEALTH DEPARTMENT CITY OF MILWAUKEE HEALTH DEPARTMENT FRANKLIN HEALTH DEPARTMENT OAK CREEK HEALTH DEPARTMENT GREENFIELD HEALTH DEPARTMENT CUDAHY HEALTH DEPARTMENT NORTH SHORE HEALTH DEPARTMENT WAUWATOSA HEALTH DEPARTMENT SOUTH MILWAUKEE HEALTH DEPARTMENT GREENDALE HEALTH DEPARTMENT FC3 COLLABORATIVE

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - ORTHOPAEDIC HOSPITAL OF WISCONSIN. THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE, INC., ASCENSION ST. FRANCIS HOSPITAL, ASCENSION SE HOSPITAL ST. JOSEPH CAMPUS, ASCENSION SE HOSPITAL FRANKLIN CAMPUS, WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN, SACRED HEART REHABILITATION HOSPITAL, ADVOCATE AURORA HEALTH, CHILDREN'S HOSPITAL OF WISCONSIN, FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN.

Schedule H, Part V, Section B, Line 6b Facility A, 1
Facility A, 1 - ORTHOPAEDIC HOSPITAL OF WISCONSIN. THE CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL FACILITIES MILWAUKEE HEALTHCARE PARTNERSHIP

Schedule H, Part V, Section B, Line 11 Facility A, 1
Facility A, 1 - ORTHOPAEDIC HOSPITAL OF WISCONSIN. BASED ON THE CHNA COMPLETED IN 2019, THE HOSPITAL COMPLETED A 2019-2022 IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY COMMUNITY HEALTH NEEDS. IN FISCAL YEAR 2022 (TAX YEAR 2021), THE HOSPITAL TOOK THE FOLLOWING ACTIONS TO ADDRESS THE PRIORITY NEEDS: CHRONIC DISEASE PREVENTION: -DONATED FUNDS TO SUPPORT A PRODUCE PRESCRIPTION PROGRAM TO INCREASE ACCESS TO FRUITS AND VEGETABLES FOR PEOPLE WITH LIMITED ACCESS TO HEALTHY FOODS -IN PARTNERSHIP WITH ASCENSION WISCONSIN HOSPITALS, ATTENDED COMMUNITY EVENTS TO PROVIDE EDUCATION ON MAINTAINING PHYSICAL ACTIVITY *WHILE ALL PRIORITIZED SIGNIFICANT NEEDS WERE ADDRESSED, COVID-19 DISRUPTED SOME ORIGINAL IMPLEMENTATION STRATEGIES. THE HOSPITALS NEEDED TO MODIFY, DISCONTINUE OR ADD TO CURRENT STRATEGIES TO PROTECT THE HEALTH AND WELLBEING OF STAFF, PATIENTS AND COMMUNITY MEMBERS. ********** THE ORTHOPAEDIC HOSPITAL OF WISCONSIN (OHOW) UNDERSTANDS THE IMPORTANCE OF ALL THE HEALTH NEEDS OF THE COMMUNITY AND IS COMMITTED TO PLAYING A ROLE IN IMPROVING THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE. FOR THE PURPOSES OF THE 2019 CHNA, WE HAVE CHOSEN TO FOCUS OUR EFFORTS ON THE PRIORITY LISTED ABOVE. THE FOLLOWING HEALTH NEEDS WERE NOT SELECTED TO BE INCLUDED IN THIS PLAN FOR THE REASONS DESCRIBED BELOW. --ACCESS TO CARE: RECOGNIZING THE IMPORTANCE OF PROVIDING CARE FOR ALL, OHOW RELIES ON ITS REFERRING PARTNERS TO ENSURE THAT PATIENTS ARE ASSISTED IN SEEKING AND OBTAINING HEALTHCARE COVERAGE AND SERVICES. AS AN ORTHOPAEDIC HOSPITAL SERVING A SPECIFIC RANGE OF PATIENT NEEDS, THE FOLLOWING NEEDS ARE OUTSIDE THE EXPERTISE OF THE HOSPITAL AND SCOPE OF SERVICES WE PROVIDE AND WILL NOT BE ADDRESSED IN OUR COMMUNITY HEALTH IMPROVEMENT PLAN: --ALCOHOL AND SUBSTANCE USE --INFANT MORTALITY --MENTAL HEALTH --VIOLENCE --SEXUALLY TRANSMITTED INFECTIONS *********** BASED ON THE CHNA COMPLETED IN JUNE 2022, THE HOSPITAL WILL WORK ON EXECUTING A 2022-2025 IMPLEMENTATION STRATEGY TO ADDRESS THE FOLLOWING PRIORITY NEEDS: CHRONIC DISEASE AND PREVENTION: -ENGAGE AND EDUCATE COMMUNITY MEMBERS ABOUT HEALTH AND PREVENTION -EXPAND OPPORTUNITIES FOR COMMUNITY MEMBERS TO BE ENGAGED IN HEALTHY LIVING ACTIVITIES -PROMOTE SCREENINGS AND INTERVENTIONS FOR CHRONIC DISEASE PREVENTION -EDUCATE PATIENTS AND ASSOCIATES ABOUT HEALTHY LIVING AND RESOURCES ********** ORTHOPAEDIC HOSPITAL OF WISCONSIN UNDERSTANDS THE IMPORTANCE OF ALL THE HEALTH NEEDS OF THE COMMUNITY AND IS COMMITTED TO PLAYING AN ACTIVE ROLE IN IMPROVING THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES. FOR THE PURPOSES OF THIS CHNA, ORTHOPAEDIC HOSPITAL OF WISCONSIN HAS CHOSEN TO FOCUS ITS EFFORTS ON THE PRIORITY LISTED ABOVE. THE FOLLOWING SIGNIFICANT NEEDS WERE NOT SELECTED FOR THE (TAX YEAR) 2021 CHNA CYCLE: ACCESS TO CARE, ALCOHOL AND DRUG USE, COMMUNITY SAFETY, MENTAL HEALTH AND SAFE AND AFFORDABLE HOUSING. BELOW IS THE RATIONALE BEHIND NOT PRIORITIZING THESE ISSUES. --ACCESS TO CARE: ORTHOPAEDIC HOSPITAL OF WISCONSIN HAS A COMMITMENT TO AND RESPECT FOR EACH PERSON'S DIGNITY WITH A SPECIAL CONCERN FOR THOSE WHO STRUGGLE WITH BARRIERS TO ACCESS HEALTHCARE SERVICES AND ALREADY PROVIDES FINANCIAL ASSISTANCE TO CERTAIN INDIVIDUALS WHO RECEIVE MEDICALLY NECESSARY CARE FROM OHOW. --ALCOHOL AND DRUG USE, COMMUNITY SAFETY, MENTAL HEALTH AND SAFE AND AFFORDABLE HOUSING: OHOW IS A SMALL SPECIALTY HOSPITAL WITH FOCUS ON A SPECIFIC RANGE OF PATIENT NEEDS AND THESE NEEDS ARE OUTSIDE THE EXPERTISE, CAPACITY AND SCOPE OF SERVICES PROVIDED. HOWEVER, ORTHOPAEDIC HOSPITAL OF WISCONSIN IS COMMITTED TO PARTICIPATING WITH PARTNERS IN ADDRESSING THESE NEEDS AND WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO DO SO.

Schedule H, Part I, Line 3c FACTORS OTHER THAN FPG
"IN ADDITION TO FPG, THE ORGANIZATION USES MEDICAL INDIGENCY, ASSET TEST, INSURANCE STATUS AND RESIDENCY AS OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A PATIENT MAY NOT BE ELIGIBLE FOR THE FINANCIAL ASSISTANCE IF SUCH PATIENT IS DEEMED TO HAVE SUFFICIENT ASSETS TO PAY PURSUANT TO AN ""ASSET TEST."" THE ASSET TEST INVOLVES A SUBSTANTIVE ASSESSMENT OF A PATIENT'S ABILITY TO PAY BASED ON THE CATEGORIES OF ASSETS MEASURED IN THE FAP APPLICATION. A PATIENT WITH SUCH ASSETS THAT EXCEED 250% OF SUCH PATIENT'S FPL AMOUNT MAY NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. AN ASSET TEST APPLIES IF A PATIENT HAS ELIGIBLE LIQUID ASSETS THAT EXCEED 250% OF THE PATIENT'S FPG LEVEL FOR CONSIDERATION OF FINANCIAL ASSISTANCE ELIGIBILITY. LIQUID ASSETS INCLUDE ASSETS THAT CAN BE CONVERTED TO CASH WITHIN 1 YEAR. THESE INCLUDE ITEMS SUCH AS CHECKING ACCOUNTS, SAVINGS ACCOUNTS, TRUST FUNDS AND LUXURY ITEMS SUCH AS RECREATIONAL VEHICLES, BOATS, A SECOND HOME, ETC."

Schedule H, Part I, Line 5a BUDGET AMOUNTS FOR FREE OR DISCOUNTED CARE
THE ORGANIZATION ADMINISTERS ITS FINANCIAL ASSISTANCE POLICY IN ACCORDANCE WITH THE TERMS OF THE POLICY.

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
"THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (""CHA"") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED."

Schedule H, Part II Community Building Activities
THERE WERE NO COMMUNITY BUILDING ACTIVITIES TO REPORT THIS YEAR. ALL REPORTED ACTIVITIES QUALIFY AS COMMUNITY BENEFIT AND ARE DESCRIBED IN THE NARRATIVE UNDER SCH H PART I LINE 7.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IN FISCAL YEAR 2022 WAS $637,284 AT CHARGES, ($140,693 AT COST).

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
BASED ON THE ORGANIZATION'S ADMINISTRATION OF ITS FINANCIAL ASSISTANCE PROGRAM, NO ESTIMATE FOR BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DEEMED APPLICABLE TO HOSPITAL OPERATIONS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
THE ORGANIZATION IS PART OFASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSESBAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 17-20, OF THE AUDITED FINANCIAL STATEMENTS.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE GROSS CHARGES TO CALCULATE MEDICARE COSTS, WHICH ARE THEN COMPARED TO MEDICARE PAYMENTS RECEIVED, TO DETERMINE A MEDICARE GAIN OR LOSS. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT A MEDICARE SHORTFALL (LOSS) IS NOT TREATED AS COMMUNITY BENEFIT, EVEN THOUGH THE HOSPITAL HAS INCURRED LOSSES IN PROVIDING CARE TO MEDICARE PATIENTS. THEREFORE, NONE OF THE AMOUNT ON LINE 7 IS TREATED AS COMMUNITY BENEFIT.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
THE FILING ORGANIZATION FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED IF ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED FOR THE AMOUNTS FOR WHICH THE PATIENT QUALIFIES.

Schedule H, Part V, Section B, Line 16a FAP website
A - ORTHOPAEDIC HOSPITAL OF WISCONSIN: Line 16a URL: https://www.ohow.com/financial-assistance/; B - Ascension Wisconsin Hospital - Greenfield: Line 16a URL: https://healthcare.ascension.org/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - ORTHOPAEDIC HOSPITAL OF WISCONSIN: Line 16b URL: https://www.ohow.com/financial-assistance/; B - Ascension Wisconsin Hospital - Greenfield: Line 16b URL: https://healthcare.ascension.org/financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - ORTHOPAEDIC HOSPITAL OF WISCONSIN: Line 16c URL: https://www.ohow.com/financial-assistance/; B - Ascension Wisconsin Hospital - Greenfield: Line 16c URL: https://healthcare.ascension.org/financial-assistance;

Schedule H, Part VI, Line 4 Community information
COLUMBIA ST. MARY'S, INC. SERVES A PRIMARY SERVICE AREA OF EASTERN MILWAUKEE COUNTY. ORTHOPAEDIC HOSPITAL OF WISCONSIN IS LOCATED IN AN URBAN COMMUNITY WITHIN MILWAUKEE COUNTY. THE POPULATION OF MILWAUKEE COUNTY IS APPROXIMATELY 939,000 WITH OVER 16% OF HOUSEHOLDS LIVING AT OR BELOW THE FEDERAL POVERTY THRESHOLD. THE MEDIAN INCOME IS $53,418. APPROXIMATELY 7% OF THE INDIVIDUALS LIVING IN THE COUNTY ARE UNINSURED AND 34% ARE MEDICAID RECIPIENTS. THERE ARE A TOTAL OF 14 HOSPITALS IN MILWAUKEE COUNTY. AREAS OF MILWAUKEE COUNTY ARE DESIGNATED AS PRIMARY CARE, MENTAL HEALTH CARE AND DENTAL HEALTH CARE SHORTAGE AREAS.

Schedule H, Part VI, Line 5 Promotion of community health
COLUMBIA ST. MARY'S, INC. MANAGEMENT COMMITTEE IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF THE MANAGEMENT COMMITTEE RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA; WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. COLUMBIA ST. MARY'S, INC. EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. COLUMBIA ST. MARY'S, INC. APPLIES SURPLUS FUNDS TO FUND IMPROVEMENTS IN PATIENT CARE AND MEDICAL EDUCATION.

Schedule H, Part VI, Line 2 Needs assessment
IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, ORTHOPAEDIC HOSPITAL OF WISCONSIN USES BOTH HOSPITAL DATA AND RELIABLE THIRD-PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES, TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED. ORTHOPAEDIC HOSPITAL OF WISCONSIN UTILIZES THIS INFORMATION TO DETERMINE AND DEVELOP PROGRAMS AND SERVICES TO BE PROVIDED FOR THE COMMUNITY. THESE NEEDS AND INITIATIVES ARE PRESENTED TO SENIOR LEADERSHIP AND MANAGEMENT COMMITTEE MEMBERS TO ENSURE THE FINDINGS ARE CONSIDERED IN DEVELOPING THE ORGANIZATION'S STRATEGY, POLICY DEVELOPMENT, AND INTERNAL FINANCIAL AND OPERATIONAL DECISIONS. INITIATIVES DURING THE YEAR INCLUDED FREE EDUCATIONAL SESSIONS AT VARIOUS LOCATIONS WITHIN THE COMMUNITY. THESE EDUCATIONAL SESSIONS INCLUDED INFORMATION RELATED TO PHYSICAL THERAPY, SURGICAL AND ALTERNATIVE OPTIONS.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
COLUMBIA ST. MARY'S, INC. IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTHCARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, OUR FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. THE FOLLOWING DOCUMENTS ARE WIDELY PUBLICIZED ON THE ORGANIZATION'S WEBSITE AT HTTPS://WWW.OHOW.COM/FINANCIAL-ASSISTANCE/: - FINANCIAL ASSISTANCE POLICY SUMMARY - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION - BILLING AND COLLECTION POLICY THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. COLUMBIA ST. MARY'S, INC. INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. COLUMBIA ST. MARY'S, INC. INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 6 Affiliated health care system
COLUMBIA ST. MARY'S, INC. IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. THE ORTHOPAEDIC HOSPITAL OF WISCONSIN IS AN AFFILIATE OF COLUMBIA ST. MARY'S, INC. THE HOSPITAL'S AFFILIATES ARE LARGE MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT MINISTRIES INCLUDING HOSPITAL AND NON-HOSPITAL MINISTRIES (PHYSICIAN GROUP PRACTICES, HOSPITAL ORGANIZATIONS, RESEARCH, HOME HEALTH, DURABLE MEDICAL EQUIPMENT AND SENIOR FACILITIES). THESE MINISTRIES WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF SERVING AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS ESPECIALLY THOSE WHO ARE VULNERABLE. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION AND RESEARCH. THE ORGANIZATIONS WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, STATE AND NATIONAL LEVEL.