4A (Expenses $ 4391508037 including grants of $ 13172701) (Revenue $ 5394184418)
Memorial Hermann Health System is a nonprofit, values-driven, community-owned health system dedicated to improving health. Our vision is to create healthier communities, now and for generations to come. Our values are community, compassion, credibility, and courage. Charting a better future. A future that's built upon the HEALTH of our community. This is the driving force for Memorial Hermann, redefining health care for the individuals and many diverse populations we serve. Our 6,700 affiliated physicians and 27,000 employees practice the highest standards of safe, evidence-based, quality care to provide a personalized and outcome-oriented experience across our more than 300 care delivery sites. As one of the largest not-for-profit health systems in Southeast Texas, Memorial Hermann has an award-winning and nationally acclaimed Accountable Care Organization, 17 hospitals and numerous specialty programs and services conveniently located throughout the Greater Houston area. Memorial Hermann-Texas Medical Center is one of the nation's busiest Level I trauma centers and serves as the primary teaching hospital for McGovern Medical School at UTHealth. U.S. News & World Report for 2018-2019 ranks TIRR Memorial Hermann as the best rehabilitation hospital in Texas and No. 3 in the United States. This is the 29th consecutive year TIRR Memorial Hermann has been ranked in the top 10 nationally. Memorial Hermann-Texas Medical Center was also listed in the U.S. News rankings in the specialty areas of Cardiology and Heart Surgery, Ear, Nose and Throat, and Gastroenterology and GI Surgery. Children's Memorial Hermann Hospital was nationally ranked in Pediatric Cardiology and Heart Surgery, as well as Pediatric Neurology and Neurosurgery. The Heart Center at Children's Memorial Hermann Hospital has earned the Society of Thoracic Surgeons' (STS) highest rating for quality related to patient care and congenital heart surgery outcomes. Only 12 pediatric heart programs in the United States and Canada earned the distinguished STS three-star rating for congenital heart surgery, following analysis of data collected from 119 participating programs from January 2014 to December 2017. The STS star rating system is one of the most highly regarded overall measures of quality in health care, comparing the nationally benchmarked outcomes of cardiothoracic surgery programs in the U.S. and Canada. For the seventh time, Memorial Hermann Memorial City Medical Center was named one of the nation's top 100 hospitals by IBM Watson Health. Formerly known as the Truven Health Analytics 100 Top Hospitals, the study spotlights the best-performing hospitals based on a scorecard of publicly available clinical, operational and patient satisfaction metrics and data. Memorial Hermann Southeast Hospital, Memorial Hermann Greater Heights Hospital, Memorial Hermann Southwest Hospital and Memorial Hermann The Woodlands Medical Center all have received Chest Pain Center accreditation from The Joint Commission (TJC). An independent, not-for-profit organization, TJC accredits and certifies nearly 21,000 healthcare organizations and programs in the United States. Healthcare organizations that have received this accreditation have demonstrated a high level of expertise in dealing with patients with heart attack symptoms. Memorial Hermann-Texas Medical Center (TMC) and Memorial Hermann Memorial City Medical Center earned national recognition as top performers for superior quality and safety by the Vizient Quality and Accountability Study. Memorial Hermann-TMC received the 2018 Bernard A. Birnbaum, MD, Quality Leadership Award for Academic Medical Centers, and ranked ninth of 99 participating academic medical centers. Memorial Hermann Memorial City received the 2018 Bernard A. Birnbaum, MD, Quality Leadership Award for Complex Teaching Medical Centers, ranking seventh among 100 participating teaching medical centers. Memorial Hermann Sugar Land Hospital was named a recipient of the 2016 Malcolm Baldrige National Quality Award, the nation's highest Presidential honor for performance excellence. U.S. Commerce Secretary Penny Pritzker made the announcement recognizing Memorial Hermann Sugar Land for its outstanding commitment to sustainable excellence through innovation, improvement and visionary leadership. Since the healthcare category was introduced in 1999, only 21 healthcare organizations nationwide have been awarded the Malcolm Baldrige National Quality Award. Memorial Hermann Sugar Land was the first Houston area hospital and the third in Texas to win the prestigious award. For more than 112 years, our focus has been the best interest of our community. During the fiscal year, Memorial Hermann Health System provided community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $1,082,928,550 and more than $525 million (as reported on the Internal Revenue Service Form 990, Schedule H) annually through school-based health centers and other community benefit programs. During the fiscal year, Memorial Hermann admitted 174,649 patients resulting in 907,590 days of care, delivered 25,303 babies, had 700,134 emergency visits, and 1,560,760 diagnostic and therapy visits. Now and for generations to come, the health of our community will be at the center of what we do-charting a better future for all.

PART V, SECTION B, LINE 5
MEMORIAL HERMANN HEALTH SYSTEM JOINED WITH THE EPISCOPAL HEALTH FOUNDATION (EHF) IN THEIR KEY INFORMANT INTERVIEW INITIATIVE SUPPORTING FOUR GREATER HOUSTON AREA HOSPITAL SYSTEMS IN PREPARING THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS. THE COLLABORATING HOSPITALS OF THIS INITIATIVE INCLUDED MEMORIAL HERMANN, CHI ST. LUKE'S HEALTH, HOUSTON METHODIST, AND TEXAS CHILDREN'S. THROUGH THIS PARTNERSHIP, A TOTAL OF 53 INTERVIEWS WERE CONDUCTED WITH STAKEHOLDERS FROM A RANGE OF SECTORS SUCH AS GOVERNMENT, HEALTHCARE, BUSINESS, AND COMMUNITY SERVICE ORGANIZATIONS. AN ADDITIONAL 11 INTERVIEWS WERE CONDUCTED FOR MEMORIAL HERMANN COUNTIES NOT SHARED BY THE COLLABORATIVE. WHILE SOCIAL AND EPIDEMIOLOGICAL DATA CAN PROVIDE A HELPFUL PORTRAIT OF A COMMUNITY, IT DOES NOT TELL THE WHOLE STORY. IT IS CRITICAL TO UNDERSTAND PEOPLE'S HEALTH ISSUES OF CONCERN, THEIR PERCEPTIONS OF THE HEALTH OF THEIR COMMUNITY, THE PERCEIVED STRENGTHS AND ASSETS OF THE COMMUNITY, AND THE VISION THAT RESIDENTS HAVE FOR THE FUTURE OF THEIR COMMUNITY. SECONDARY DATA WAS SUPPLEMENTED BY A COMMUNITY SURVEY COLLECTED THROUGH AN ONLINE SURVEY. THIS SURVEY CONSISTED OF 11 QUESTIONS RELATED TO TOP HEALTH NEEDS IN THE COMMUNITY, INDIVIDUALS' PERCEPTION OF THEIR OVERALL HEALTH, AND WEEKLY EXERCISE HABITS. THE COMMUNITY SURVEY WAS DISTRIBUTED ONLINE THROUGH SURVEYMONKEY FROM OCTOBER 23RD THROUGH NOVEMBER 27TH OF 2018. THE SURVEY WAS MADE AVAILABLE IN BOTH ENGLISH AND SPANISH. PAPER SURVEYS WERE ALSO MADE AVAILABLE AND ANSWERS TO THE PAPER SURVEY WERE ENTERED INTO THE SURVEYMONKEY TOOL. A TOTAL OF 285 RESPONSES WERE COLLECTED. SURVEY RESPONDENTS WERE ASKED TO SELECT TOP ISSUES MOST AFFECTING THE COMMUNITY'S QUALITY OF LIFE. THE MAJORITY OF RESPONDENTS IDENTIFIED DIABETES, OBESITY/OVERWEIGHT, SUBSTANCE ABUSE, AND MENTAL HEALTH AND MENTAL DISORDERS AS TOP ISSUES IN THE COMMUNITY. INTERVIEWEES WHO WERE ASKED TO PARTICIPATE WERE RECOGNIZED AS HAVING EXPERTISE IN PUBLIC HEALTH, SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS AND/OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL, AND/OR COULD SPEAK TO THE NEEDS OF MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS. COMMUNITY LEADERS WITH SPECIFIC EXPERIENCE WORKING WITH PRIORITY POPULATIONS, SUCH AS WOMEN, CHILDREN, PEOPLE OF COLOR, THE DISABLED, AND MORE, WERE ALSO A FOCUS. THE FOLLOWING LIST OF ORGANIZATIONS CONTRIBUTED KEY INFORMANT INTERVIEWS; ACCESSHEALTH (FQHC) (FORT BEND FAMILY HEALTH CENTER); AIDS FOUNDATION OF HOUSTON; ASSOCIATION FOR THE ADVANCEMENT OF MEXICAN AMERICANS; AVENUE CDC; CATHOLIC CHARITIES - ARCHDIOCESE OF GALVESTON; CATHOLIC CHARITIES - FORT BEND; CHILD ADVOCATES OF FORT BEND; CHILDREN AT RISK; CHRIST CLINIC; CITY OF HOUSTON, DEPARTMENT OF PARKS AND RECREATION; COASTAL AREA HEALTH EDUCATION CENTERS (AHEC); COMMUNITY HEALTH CHOICE; EL CENTRO DE CORAZON; EPISCOPAL HEALTH FOUNDATION; FORT BEND COUNTY HEALTH AND HUMAN SERVICES; FORT BEND COUNTY SHERIFF'S OFFICE; FORT BEND REGIONAL COUNCIL ON SUBSTANCE ABUSE; FORT BEND SENIORS MEALS ON WHEELS; FORT BEND WOMEN'S CENTER; GALVESTON COUNTY HEALTH DISTRICT; GALVESTON COUNTY MENTAL HEALTH DEPUTIES; GREATER HOUSTON PARTNERSHIP; GREATER HOUSTON WOMEN'S CHAMBER OF COMMERCE; GULF COAST MEDICAL FOUNDATION; HARRIS COUNTY PUBLIC HEALTH; HEALTHCARE FOR THE HOMELESS - HOUSTON; HOPE CLINIC (FQHC); HOUSTON FOOD BANK; HOUSTON HEALTH DEPARTMENT; HOUSTON HOUSING AUTHORITY; HOUSTON INDEPENDENT SCHOOL DISTRICT; INTERFAITH COMMUNITY CLINIC; KINDER INSTITUTE; LEGACY COMMUNITY HEALTH; LIBERTY COUNTY SHERIFF'S OFFICE; LONE STAR FAMILY HEALTH CENTER; MIDTOWN ARTS AND THEATER CENTER HOUSTON; MONTGOMERY COUNTY WOMEN'S CENTER; BAKER-RIPLEY EARLY HEAD START; PATIENT CARE INTERVENTION CENTER (PCIC); PRAIRIE VIEW A&M UNIVERSITY; SANTA MARIA HOSTEL, INC.; THE ARC OF FORT BEND COUNTY; THE HARRIS CENTER FOR MENTAL HEALTH AND IDD (FORMERLY MHMRA); THE ROSE; THE WOMEN'S HOME; TRI-COUNTY SERVICES BEHAVIORAL HEALTHCARE; UNITED WAY OF BRAZORIA COUNTY; UNITED WAY OF GREATER HOUSTON; UNITED WAY OF HARRIS AND MONTGOMERY COUNTY; WEST CHAMBERS MEDICAL CENTER (FQHC); YMCA OF GREATER HOUSTON. CHNA's WERE DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED ON DECEMBER 29, 2014.

PART V, SECTION B, LINE 6A
CHI ST. LUKE'S HEALTH, HOUSTON METHODIST, TEXAS CHILDREN'S

PART V, SECTION B, LINE 6B
EPISCOPAL HEALTH FOUNDATION

PART V, SECTION B, LINE 11
AS THE LARGEST HEALTH SYSTEM IN SOUTHEAST TEXAS SERVING THE FOURTH LARGEST AND FASTEST-GROWING METROPOLITAN AREA IN THE UNITED STATES, MEMORIAL HERMANN IS COMMITTED TO BEING A STEWARD OF THE COMMUNITY'S HEALTH-NOT ONLY BY DELIVERING HIGH QUALITY SERVICES FOR THE ADULTS AND CHILDREN WHO SEEK CARE AT A MEMORIAL HERMANN FACILITY, BUT THROUGH PROGRAMS AND COLLABORATIONS COMMITTED TO MAKING THE GREATER HOUSTON AREA A HEALTHIER AND MORE VITAL PLACE TO LIVE. HEALTH EDUCATION, HEALTHY FOODS, SAFE PLACES TO EXERCISE, AND ACCESS TO HEALTH AND BEHAVIORAL HEALTH SERVICES ARE VITAL TO IMPROVING THE OVERALL HEALTH OF RESIDENTS SINCE LACK OF THESE EFFORTS CONTRIBUTES TO THE ESCALATING CHRONIC DISEASE EPIDEMIC. THUS TO SUPPORT AND ENGAGE OUR COMMUNITY, OUR FOUNDATION FOR OUR WORK RESTS ON FOUR PILLARS: FOCUSING ON IMPROVING ACCESS THROUGH PROGRAMMING, EDUCATION AND SOCIAL SERVICE SUPPORT; PROMOTING THE IMPORTANCE OF A HEALTHY DIET THROUGH SCREENING AND CREATING ACCESS TO NUTRITIOUS FOODS; FOSTERING IMPROVED HEALTH THROUGH EXERCISE WITH CULTURALLY APPROPRIATE ACTIVITIES; AND, ADDRESSING EMOTIONAL WELL-BEING THROUGH INNOVATIVE ACCESS POINTS. SIGNATURE, CORNERSTONE INITIATIVES SUPPORTING THE FOUR PILLARS INCLUDE: HEALTH CENTERS FOR SCHOOLS; MOBILE DENTAL VANS; ER NAVIGATORS; COMMUNITY RESOURCE CENTER; NURSE HEALTH LINE; STEPHEALTHY (REDUCE OBESITY); PARK ACTIVATIONS; NEIGHBORHOOD HEALTH CENTERS; PSYCHIATRIC RESPONSE TEAM; MENTAL HEALTH CRISIS CLINICS. THE 2019 CHNA FINDINGS RESULTED FROM THE ANALYSIS OF AN EXTENSIVE SET OF SECONDARY DATA (OVER 100 INDICATORS FROM NATIONAL AND STATE DATA SOURCES) AND PRIMARY DATA COLLECTED FROM COMMUNITY LEADERS, NON-HEALTH PROFESSIONALS, AND ORGANIZATIONS SERVING THE COMMUNITY AT LARGE, VULNERABLE POPULATIONS, AND/OR POPULATIONS WITH UNMET HEALTH NEEDS. THROUGH AN EXAMINATION OF THE PRIMARY AND SECONDARY DATA, THE FOLLOWING TOP HEALTH NEEDS WERE IDENTIFIED: ACCESS TO HEALTH SERVICES; CANCERS; CHILDREN'S HEALTH; DIABETES; ECONOMY; EDUCATION; FOOD INSECURITY; HEART DISEASE/STROKE; LACK OF HEALTH INSURANCE; LOW-INCOME/UNDERSERVED; MENTAL HEALTH; OBESITY; OLDER ADULTS/AGING; SUBSTANCE ABUSE; TRANSPORTATION. STAKEHOLDERS FROM THE 13 LICENSED FACILITIES IN THE MEMORIAL HERMANN HEALTH SYSTEM COMPLETED A SURVEY TO PRIORITIZE THE SIGNIFICANT HEALTH ISSUES, BASED ON CRITERIA INCLUDING HEALTH IMPACT AND RISK AS WELL AS CONSIDERATION OF MEMORIAL HERMANN'S STRATEGIC FOCUS. WITH MEMORIAL HERMANN'S FOUR PILLARS DESIGNED TO DELIVER EFFECTIVE UPSTREAM INTERVENTIONS, ADDRESSING THE ABOVE IDENTIFIED COMMUNITY NEEDS CONTINUE TO FALL WITHIN OUR FOUR PILLARS: ACCESS TO HEALTHCARE; EMOTIONAL WELL-BEING; FOOD AS HEALTH; EXERCISE IS MEDICINE. THE CHNA PROCESS ENABLES EACH HOSPITAL WITHIN MEMORIAL HERMANN TO DEVELOP PROGRAMS AND SERVICES THAT ADVANCE THE HEALTH OF ITS COMMUNITY, BUILDING THE FOUNDATION FOR SYSTEMIC CHANGE ACROSS THE GREATER HOUSTON AREA. MANY ARE REPRESENTED WITHIN THE SPECIFIC HOSPITAL'S IMPLEMENTATIONS STRATEGIES, AND INCLUDE THE SIGNATURE, CORNERSTONE INITIATIVES DELINEATED ABOVE. OTHERS ARE ONGOING PROGRAMS COLLECTED VIA COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) AND INCLUDE THE FOLLOWING: ATHLETIC MEDICAL COVERAGE FOR SCHOOLS; MEDICAL COVERAGE FOR RACES; INJURY CLINICS; WORKSHOPS FOR COACHES; BLOOD DRIVES; CLASSES AND SEMINARS: BREAST FEEDING, CARDIOVASCULAR; COLORECTAL; INFANT CPR; COOKING DEMONSTRATIONS; FITNESS AND NUTRITION; JOINT SYMPOSIUM AND JOINT REPLACEMENT; PEDIATRIC WEIGHT MANAGEMENT; SUPER SIBLING; TEEN PREGNANCY/PARENTING; TEEN DRIVER SAFETY; TRAUMA AND BLEEDING CONTROL; WEIGHT LOSS. CHILD AND SAFETY SEAT DISTRIBUTION. COMMUNITY HEALTH EDUCATION: ALZHEIMER'S DISEASE; BREAST CANCER AWARENESS; CANCER PREVENTION AND TESTING; CAREER NIGHT; DISCOUNTED DIABETES EDUCATION; DISTRACTED DRIVING; EDUCATION/OUTREACH FOR SENIORS; EDUCATION AND SUPPORT GROUPS FOR CANCER PATIENTS: ART, SELF-GUIDED ART THERAPY, LYMPHEDEMA, BREAST CANCER, ONCOLOGY NUTRITION THERAPY, STRESS RELIEF, LOOK GOOD FEEL BETTER, YOGA, MEDITATION AND HEALTH EATING ADVICES; IMMUNOTHERAPY; INJURY AND FALL PREVENTION AND AWARENESS; KIDNEY DISEASES; MEN'S HEALTH; MENTAL HEALTH AND ANXIETY IN STUDENTS; OPIOIDS; PARENTING/SIBLINGS ;PROSTATE CANCER AWARENESS; SLEEP APNEA; STROKE SIGNS; WOMEN'S HEALTH; WOUND CARE. EDUCATION FOR NURSES, NURSING STUDENTS, AND SCHOOL NURSES. FOOD, BOOK, BACKPACK DRIVES; HEALTH FAIRS; INSURANCE COVERAGE ASSISTANCE; MEDICAL TRANSPORTATION, TRANSPORTATION VOUCHERS; NAVIGATION SERVICES TO MEET THE NEEDS OF UNINSURED AND UNDERINSURED PATIENTS; POST-POLIO PATIENTS; VETERANS AND RESEARCH SUBJECTS SUPPORTED BY SPECIAL FUNDS; PROMOTION OF ACCESS TO HEALTHY FOOD; FARMERS MARKETS; SAFE PHYSICAL ACTIVITIES; NUTRITION THERAPY. SCREENINGS: ATHLETIC HEART SCREENINGS; BIOMETRIC, BLOOD PRESSURE; IMPACT CONCUSSION TESTING; LOW DOSE CT LUNG CANCER, MAMMOGRAMS AND BREAST ULTRASOUNDS FOR UNDERSERVED WOMEN; PROSTATE; STROKE; SKIN; SPORTS PHYSICALS; SUPPORT OF AREA WALK/RUN/TRI EVENTS; SUPPORT GROUPS FOR: ALZHEIMER'S; AMPUTEES; BARIATRIC; BETTER BREATHERS; BREAST FEEDING; CAREGIVER; CHRONIC DISEASE; DIABETICS; EPILEPSY; GRIEF; MENDED HEARTS; MULTIPLE SCLEROSIS NICU; OBESITY; PARKINSON'S DISEASE; SMOKING CESSATION; SUBSTANCE ABUSE; STROKE; TEEN PARENTS; TRANSPLANT PATIENTS; TRAUMATIC BRAIN INJURY; TELEMEDICINE CONSULTS FOR STROKE AND PEDI SURGERY; VOLUNTEER CLINICS; WALK WITH A DOC; WEIGHT MANAGEMENT

PART V, SECTION A, HOSPITAL FACILTIES
During the fiscal year, two hospital facilities, Memorial Hermann First Colony Hospital and Memorial Hermann Tomball Hospital, ceased operations. Both hospital facilities were part of a joint venture, MH Emerus JV, LLC, between Memorial Hermann Health System and Emerus Investment Company V, LLC, a wholly owned subsidiary of Emerus Holdings, Inc.

PART I, LINE 3C
PATIENTS WHO HAVE AN OUTSTANDING ACCOUNT BALANCE OWED ON THEIR HOSPITAL BILLS MAY BE ELIGIBLE FOR A DISCOUNT IF ALL OF THE FOLLOWING CRITERIA ARE MET: 1) BALANCE EXCEEDS TEN PERCENT OF THE PERSON'S ANNUAL GROSS FAMILY INCOME; 2) THEY ARE UNABLE TO PAY ALL OR A PORTION OF THE REMAINING BILL BALANCE; AND 3) THE BILL BALANCE IS AT LEAST $5,000. UNDER THESE CIRCUMSTANCES, THE PATIENT OR GUARANTOR IS EXPECTED TO COOPERATE WITH THE FINANCIAL ASSISTANCE PROCESS AND SUPPLY PERSONAL OR FINANCIAL INFORMATION AND DOCUMENTATION RELEVANT TO MAKING A DETERMINATION OF ELIGIBILITY. IF APPROVED, THE PATIENT WILL BE RESPONSIBLE FOR PAYING NO MORE THAN TEN PERCENT OF THEIR ANNUAL GROSS FAMILY INCOME TOWARDS THE REMAINING OUTSTANDING ACCOUNT BALANCES OR AGB DISCOUNT WILL BE APPLIED, WHICHEVER IS LESS AND MOST BENEFICIAL FOR THE PATIENT'S FINANCIAL SITUATION.

PART I, LINE 6A
MEMORIAL HERMANN HEALTH SYSTEM PREPARES AND FILES AN ANNUAL REPORT OF COMMUNITY BENEFIT PLAN WITH THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES. THIS REPORT IS MADE AVAILABLE THROUGH THE ORGANIZATION'S WEBPAGE AT HTTPS://COMMUNITYBENEFIT.MEMORIALHERMANN.ORG/ABOUT-US/REPORT-TO-THE-COMMUN ITY/

PART I, LINE 7
A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINES 7A THROUGH 7C. THE AMOUNTS FOR LINES 7E THROUGH 7I COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE NOT BASED ON A COST-TO-CHARGE RATIO.

PART I, LINE 7, COLUMN (F)
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT REMOVED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN COLUMN (F) TOTALED $0.

PART III, LINE 2
BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED UNDER SIGNIFICANT ACCOUNTING POLICIES WITHIN SECTION NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.

PART III, LINE 4
FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE LOCATED ON PAGES 8 THROUGH 10 ON MEMORIAL HERMANN HEALTH SYSTEM'S FISCAL YEAR ENDING 2019 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. MEMORIAL HERMANN ENTERED ZERO ON SCHEDULE H, PART III, LINE 3. FROM PRIOR EXPERIENCE, THE ORGANIZATION BELIEVES A PORTION OF BAD DEBT EXPENSE MAY BE ATTRIBUTABLE TO PATIENTS WHOM WOULD OTHERWISE QUALIFY FOR FINANCIAL ASSISTANCE. THE ORGANIZATION ESTIMATES THIS COULD RANGE FROM 0-5 PERCENT. MEMORIAL HERMANN MAKES EFFORTS TO EDUCATE PATIENTS ABOUT ITS FINANCIAL ASSISTANCE PROGRAM. REGARDLESS, PATIENTS MAY CHOOSE NOT TO APPLY FOR FINANCIAL ASSISTANCE OR PROVIDE COMPLETE APPLICATIONS. SEE PART VI SUPPLEMENTAL INFORMATION LINE 3C NARRATIVE FOR MORE INFORMATION REGARDING MEMORIAL HERMANN'S EFFORTS TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.

PART III, LINE 8
REASONS WHY THE MEDICARE SHORTFALL REPORTED ON LINE 7, IF ANY, SHOULD BE TREATED AS A COMMUNITY BENEFIT INCLUDE: ABSENT THE MEDICARE PROGRAM, MANY OF THE INDIVIDUALS WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; AS PAYMENTS TO TREAT MEDICARE INDIVIDUALS ARE BELOW COST OF CARE, THE BURDENS OF GOVERNMENT ARE RELIEVED RELATIVE TO THESE PATIENTS, MEMORIAL HERMANN HEALTH SYSTEM PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF ANY MEDICARE SHORTFALL; THE REAL POSSIBILITY THAT CONTINUED REDUCTIONS IN REIMBURSEMENT MAY CREATE FURTHER DIFFICULTIES IN ACCESS TO CARE FOR MEDICARE PATIENTS; FINANCIAL RESOURCES UTILIZED TO COVER ANY MEDICARE SHORTFALL IS NO LONGER AVAILABLE TO COVER FINANCIAL ASSISTANCE AND ANY OTHER COMMUNITY BENEFIT NEEDS; IRS REVENUE RULING 69-545 PROVIDES, IN PART, THAT HOSPITALS SERVING PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING AS AN EXAMPLE MEDICARE, IS AN INDICATION THAT THE HOSPITAL OPERATES FOR THE PROMOTION OF HEALTH IN THE COMMUNITY; TEXAS NONPROFIT HOSPITALS MUST PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT IN ORDER TO OBTAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO THE CURRENT TEXAS HEALTH AND SAFETY CODE, THE UNREIMBURSED COST OF MEDICARE IS CONSIDERED TO BE A COMMUNITY BENEFIT IN DETERMINING THESE STATE STATUTORY REQUIREMENTS AS IT HELPS RELIEVE A GOVERNMENTAL BURDEN OF PROVIDING THIS CARE THAT WOULD OTHERWISE BE PROVIDED THROUGH THE COUNTY HOSPITAL SYSTEM IN TEXAS. THE AMOUNT REPORTED IN PART III, SECTION B, ON LINE 7 WAS CALCULATED IN ACCORDANCE WITH THE SCHEDULE H INSTRUCTIONS UTILIZING THE ORGANIZATION'S ALLOWABLE COST REPORTED IN THE MEDICARE COST REPORTED BASED ON A COST TO CHARGE RATIO.

PART III, LINE 9B
MEMORIAL HERMANN HEALTH SYSTEM'S BILLING AND COLLECTION POLICY PROHIBITS ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT'S ACCOUNT BALANCE THAT QUALIFIES FOR ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. WITH RESPECT TO ANY REMAINING BALANCE DUE, IF ANY, THE BILLING AND COLLECTION POLICY CONTAINS ACTIONS WHICH MAY BE TAKEN IN THE EVENT OF NONPAYMENT, AND ARE APPLIED EQUALLY TO ALL PATIENT TYPES.

PART VI, LINE 5
MEMORIAL HERMANN HEALTH SYSTEM WORKS WITH OTHER HEALTHCARE PROVIDERS, GOVERNMENT AGENCIES, BUSINESS LEADERS AND COMMUNITY STAKEHOLDERS TO ENSURE THAT ALL RESIDENTS OF THE GREATER HOUSTON AREA HAVE ACCESS TO THE CARE AND SERVICES THEY NEED TO IMPROVE THEIR QUALITY OF LIFE AND THE OVERALL HEALTH OF THE COMMUNITY. PROGRAMS ARE DESIGNED TO PROVIDE CARE FOR UNINSURED AND UNDERINSURED CHILDREN; TO REACH THOSE HOUSTONIANS NEEDING AFFORDABLE CARE; TO SUPPORT THE EXISTING INFRASTRUCTURE OF NON-PROFIT CLINICS AND FQHCS; TO EDUCATE INDIVIDUALS AND THEIR FAMILIES ON HOW TO ACCESS THE HEALTHCARE AVAILABLE TO THEM; AND TO PROMOTE A CULTURE OF HEALTH THROUGH HEALTH INITIATIVES DESIGNED TO REDUCE OBESITY AND INCREASE ACCESS TO HEALTHY FOOD, INCREASE PHYSICAL ACTIVITY, IMPROVE HEALTH AND REDUCE CHRONIC CONDITIONS. HEALTH EDUCATION, HEALTHY FOODS, SAFE PLACES TO EXERCISE, AND ACCESS TO HEALTH AND BEHAVIORAL HEALTH SERVICES ARE VITAL TO IMPROVING THE OVERALL HEALTH OF RESIDENTS SINCE LACK OF THESE EFFORTS CONTRIBUTES TO THE ESCALATING CHRONIC DISEASE EPIDEMIC. THUS TO SUPPORT AND ENGAGE OUR COMMUNITY OUR FOUNDATION FOR OUR WORK RESTS ON FOUR PILLARS--FOCUSING ON IMPROVING ACCESS THROUGH PROGRAMMING, EDUCATION AND SOCIAL SERVICE SUPPORT; PROMOTING THE IMPORTANCE OF A HEALTHY DIET THROUGH SCREENING AND CREATING ACCESS TO NUTRITIOUS FOODS; FOSTERING IMPROVED HEALTH THROUGH EXERCISE WITH CULTURALLY APPROPRIATE ACTIVITIES; AND, ADDRESSING EMOTIONAL WELL-BEING THROUGH INNOVATIVE ACCESS POINTS. COMMITTED TO MAKING THE GREATER HOUSTON AREA A HEALTHIER AND MORE VITAL PLACE TO LIVE, AND SPANNING THESE FOUR INTERCONNECTING PILLARS, MEMORIAL HERMANN SUPPORTS THE FOLLOWING INITIATIVES: TEN MEMORIAL HERMANN HEALTH CENTERS FOR SCHOOLS, ESTABLISHED IN 1996, OFFER ACCESS TO PRIMARY MEDICAL AND MENTAL HEALTH SERVICES TO UNDERSERVED CHILDREN AT 82 SCHOOLS IN THE GREATER HOUSTON AREA. THE MEMORIAL HERMANN MOBILE DENTAL CLINIC, ESTABLISHED IN 2000, HAS THREE DENTAL VANS AND PROVIDES ACCESS TO PREVENTATIVE AND RESTORATIVE DENTAL SERVICES AT NINE HEALTH CENTERS FOR SCHOOLS' SITES AND IS ACCESSIBLE AS A DENTAL HOME FOR UNINSURED STUDENTS. SERVING THE COMMUNITY SINCE 2008, THE MEMORIAL HERMANN ER NAVIGATION PROGRAM PLACES CERTIFIED COMMUNITY HEALTH WORKERS WHO HAVE THE TRAINING, CULTURAL UNDERSTANDING AND LINGUISTIC CAPACITY TO HELP THE UNINSURED, WHO DISPROPORTIONATELY USE EMERGENCY ROOMS FOR HEALTHCARE, 'NAVIGATE' THE COMPLEX HEALTH SYSTEM, OBTAIN A MEDICAL HOME, SCHEDULE APPOINTMENTS, SECURE NEEDED SOCIAL SERVICES AND COPE WITH FUTURE HEALTHCARE CONCERNS. IN 2017, ADDED COMPONENTS WERE HEALTH LITERACY OUTREACH, HEALTH CARE AND DISEASE PREVENTION WORKSHOPS AND HEALTH PROMOTION. MEMORIAL HERMANN NEIGHBORHOOD HEALTH CENTERS ARE STRATEGICALLY LOCATED NEAR TWO OF HOUSTON'S BUSIEST ERS, ARE OPEN EXTENDED HOURS AND SERVE AS A MEDICAL HOME TO UNINSURED AND UNDERINSURED WORKING FAMILIES. THE GOAL IS TO PROVIDE THIS POPULATION WITH THE PROVISION OF PREVENTIVE, ACUTE, AND CHRONIC CARE. MEMORIAL HERMANN MEDICAL MISSIONS (MHMM) EXISTS TO FINANCE, FACILITATE, AND ENCOURAGE PHYSICIAN LED TEAMS INTO THIRD WORLD COUNTRIES. MHMM PROVIDES SUPPLIES, PHARMACEUTICALS, AND SCHOLARSHIPS FOR NON-PHYSICIAN TEAM MEMBERS. MHMM FACILITATES BY LINKING PHYSICIANS AND SUPPORT TEAMS TOGETHER; ADVISING ON PASSPORTS, VACCINATIONS, AIR TRAVEL; AND COORDINATING NECESSARY SUPPLIES. MHMM ENCOURAGES BY SHARING THE KNOWLEDGE OF PAST EXPERIENCES; COMMUNICATING WHAT A MEDICAL MISSION MEANS TO A POVERTY OR DISASTER STRICKEN AREA; AND COACHING ON SAFETY PRACTICES SO THAT PARTICIPANTS FEEL COMFORTABLE IN THEIR NEW SURROUNDINGS. IN 2014 THE PSYCHIATRIC RESPONSE CASE MANAGEMENT PROGRAM WAS INTRODUCED TO ADDRESS THE GAP IN THE MENTAL AND BEHAVIORAL CARE SERVICES BY CONNECTING PATIENTS TO OUTPATIENT TREATMENT AND OTHER COMMUNITY RESOURCES. THE INITIATIVE WAS DESIGNED TO PROVIDE INTENSIVE, COMMUNITY-BASED CASE MANAGEMENT SERVICES FOR THOSE WITH BEHAVIORAL HEALTH DIAGNOSIS AND A HISTORY OF MULTIPLE HOSPITALIZATIONS. UNDER THIS PROGRAM, PATIENTS ARE ACTIVELY ENGAGED IN THE DEVELOPMENT OF THEIR OWN MENTAL HEALTH CARE PLAN AND LONG-TERM RECOVERY GOALS WITH THE ULTIMATE OBJECTIVE OF IMPROVED PATIENT WELLNESS AND GOAL ACHIEVEMENT. THE CASE MANAGEMENT PROGRAM WORKS CLOSELY WITH MEMORIAL HERMANN'S PSYCHIATRIC RESPONSE TEAM, IN WHICH MENTAL HEALTH CLINICIANS EVALUATE, STABILIZE, ARRANGE FOR TRANSFERS AND DEVELOP AFTERCARE PLANS FOR PATIENTS IN EMERGENCY ROOM AND MEDICAL INPATIENT SETTINGS. THE PSYCHIATRIC RESPONSE TEAM REFERS PATIENTS TO MORE THAN 200 MENTAL HEALTH COMMUNITY TREATMENT PROVIDERS WITHIN HARRIS, FORT BEND AND MONTGOMERY COUNTIES. THIS LARGE REFERRAL NETWORK ALLOWS THE PROGRAM TO LEVERAGE THE PATIENTS WITH INSURANCE TO OBTAIN CARE FOR THOSE WITHOUT. THIS NETWORK ALSO ELIMINATES A SINGLE FACILITY FROM COMPETING WITH ALL LOCAL EMERGENCY CENTERS FOR LIMITED PSYCHIATRIC RESOURCES. THE NURSE HEALTH LINE WAS ESTABLISHED IN 2014 AS A FREE TELEPHONE SERVICE FOR GREATER HOUSTON RESIDENTS WHO ARE EXPERIENCING A HEALTH CONCERN AND ARE UNSURE OF WHAT TO DO OR WHERE TO GO. EXPERIENCED, BILINGUAL NURSES USE THEIR TRAINING AND EXPERTISE TO CONDUCT ASSESSMENTS BY PHONE, AND ARE AVAILABLE TO ANSWER CALLS 24 HOURS A DAY, SEVEN DAYS A WEEK FOR ANY RESIDENT LIVING IN HARRIS OR SURROUNDING COUNTIES. THEY HELP CALLERS DECIDE WHEN AND WHERE TO GO FOR MEDICAL CARE AND ASSIST WITH SOCIAL SERVICE REFERRALS AND TRANSPORTATION NEEDS. CALLERS RECEIVE HEALTHCARE ADVICE AND EDUCATION USING NATIONALLY RECOGNIZED STANDARDIZED PROTOCOLS. MEMORIAL HERMANN BEGAN SCREENING PATIENTS FOR FOOD INSECURITY IN 2015 IN A FEW SELECT CLINICS AND HAVE SINCE EXPANDED THROUGHOUT THE SYSTEM. PATIENTS IDENTIFIED AS FOOD INSECURE RECEIVE SUPPORT IN APPLYING FOR BENEFITS, A REFERRAL TO THE HOUSTON FOOD BANK, AND GUIDANCE ON QUESTIONS TO ASK FOR AN APPROPRIATE FOOD PANTRY REFERRAL. SINCE ROLLING OUT THE QUESTIONS WE HAVE TEAMED UP WITH SEVERAL AGENCIES TO TAKE PROGRAMMING SUPPORT TO A NEXT LEVEL. IN A PILOT PROGRAM, MEALS THAT HEAL, DISCHARGED PATIENTS IDENTIFIED IN NEED OF PREPARED, HOT MEALS TO SUPPORT A SUCCESSFUL HEALING PROCESS AT HOME ARE DELIVERED NUTRITIOUS MEALS FOR AS LONG AS IS NECESSARY. THE TRAJECTORY OF THIS INITIATIVE LEADS TO EXERCISE, AND IMPLEMENTATION OF THE EVIDENCED-BASED EXERCISE IS MEDICINE PROGRAM WHICH INCORPORATES EXERCISE AS A VITAL SIGN INTO PHYSICIAN OFFICES, EXERCISE PRESCRIPTIONS, AND ACTIVATION OF PARKS. TOGETHER THESE PROGRAMS IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH COMBATING BEHAVIORS LEADING TO CHRONIC DISEASE. OUR WORK INCREASINGLY ENCOMPASSES WORKING WITHIN COLLABORATIVES AND GRANTS. THROUGH CMS' ACCOUNTABLE HEALTH COMMUNITIES GRANT WE ARE, ALONG WITH THE SCHOOL OF PUBLIC HEALTH AND TWO OTHER HEALTH SYSTEMS, SCREENING AND REFERRING FOR SOCIAL DETERMINANTS OF HEALTH TO DETERMINE THE IMPACT THAT ADDRESSING SOCIAL DETERMINANTS OF HEALTH HAS ON HEALTH STATUS. THROUGH PASADENA VIBRANT COMMUNITY COLLABORATIVE AGENCY GOALS REVOLVE AROUND THE ENGAGEMENT IN ONGOING DIALOGUES ABOUT AND ACTIVITIES AROUND THE IMPORTANCE OF HEALTHY BEHAVIORS. THROUGH HEALTHY WOMEN HOUSTON WE ARE COLLABORATING TO ADDRESS MATERNAL MORTALITY AND MORBIDITY IN SPECIFIC, HIGH RISK COMMUNITIES INTEGRATING HEALTH, BEHAVIORAL, AND SOCIAL SUPPORTS FOR PREGNANT AND POST-PARTUM WOMEN. A NEW MODEL FOR WORKING WITH PARTNERS IS OUR MEMORIAL HERMANN COMMUNITY RESOURCE CENTER AT SOUTHWEST HOSPITAL. THE CENTER IS DESIGNED TO OFFER THE ER DEPARTMENT, ONSITE PHYSICIANS AND CARE MANAGERS, AS WELL AS COMMUNITY MEMBERS WITH: ACCESSING COMMUNITY RESOURCES, SOME OF WHICH WILL PROVIDE SCHEDULED SERVICES ON SITE; COMPLETING ELIGIBILITY APPLICATIONS; AND, RECEIVING INFORMATION AND EDUCATION ON PUBLIC HEALTH AND SOCIAL SERVICES. TO DATE, SPECIFIC SERVICES INCLUDE: ASSISTANCE ENROLLING IN PUBLIC HEALTH INSURANCE; APPLICATIONS FOR PUBLIC SOCIAL SERVICES (SNAP, WIC, ETC.); AND REFERRALS TO THE ONSITE PARTNERS THAT HAVE BEGUN TO PROVIDE WEEKLY SCHEDULES AT THE CENTER (HOUSTON FOOD BANK, AREA FEDERALLY QUALIFIED HEALTH CENTERS, MEMORIAL HERMANN BEHAVIORAL HEALTH AND CHRONIC DISEASE PRESCRIPTION ASSISTANCE). AS WE WORK WITH OUR CLIENTS AND COMMUNITY, WE ARE CONTINUALLY ASSESSING THE NEED AND OPPORTUNITIES FOR NEW PARTNERS. THE GOAL IS FOR COLLABORATION WITH PATIENTS, THE COMMUNITY, AND SERVICE PROVIDERS TO RESULT IN UPSTREAM FACTORS AND EFFORTS. A SECOND EFFORT TO BRIDGE THE COMMUNITY'S NEEDS IS ONEBRIDGE HEALTH NETWORK, UNDER IMPLEMENTATION TO ADDRESS THE NEED FOR SPECIALTY CARE FOR THE UNINSURED POPULATION AT 150% OF POVERTY. THE NETWORK WILL ALLOW SPECIALISTS TO PROVIDE CARE TO UNINSURED PATIENTS IN A CONTROLLED ENVIRONMENT BY AGREEING TO SEE 'X' PATIENTS PER YEAR. THE ROLE OF THE PROVIDER HEALTH NETWORK IS TO VET THE PATIENTS, ENSURE PRE-SPECIALTY VISIT TESTING IS COMPLETED, PROVIDE NAVIGATION SUPPORT FOR OTHER QUALITY OF LIFE NEEDS, AND ENSURE SEAMLESS TRANSITION FROM REFERRING PRIMARY CARE PROVIDER TO SPECIALIST AND BACK TO PRIMARY CARE PROVIDER. MEMORIAL HERMANN FINANCI

PART VI, LINE 7
TEXAS

PART VI, LINE 2
IMPROVING THE HEALTH OF A COMMUNITY IS ESSENTIAL TO ENHANCING THE QUALITY OF LIFE FOR RESIDENTS IN THE REGION AND SUPPORTING FUTURE SOCIAL AND ECONOMIC WELL-BEING. IN 2013, IN 2016, AND MOST RECENTLY IN 2019 MEMORIAL HERMANN HEALTH SYSTEM ENGAGED IN A COMMUNITY HEALTH PLANNING PROCESS THAT WAS TWO-FOLD: (1) A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO IDENTIFY THE HEALTH-RELATED NEEDS AND STRENGTHS OF THE COMMUNITY AND (2) A STRATEGIC IMPLEMENTATION PLAN (SIP) TO IDENTIFY MAJOR HEALTH PRIORITIES, DEVELOP GOALS, AND SELECT STRATEGIES AND IDENTIFY PARTNERS TO ADDRESS THESE PRIORITY ISSUES ACROSS THE COMMUNITY. THE CHNA WAS GUIDED BY A PARTICIPATORY, COLLABORATIVE APPROACH, WHICH EXAMINED HEALTH IN ITS BROADEST SENSE. THIS PROCESS INCLUDED INTEGRATING EXISTING SECONDARY DATA ON SOCIAL, ECONOMIC, AND HEALTH ISSUES IN THE REGION WITH QUALITATIVE INFORMATION FROM A COMMUNITY SURVEY WITH COMMUNITY RESIDENTS AND SERVICE PROVIDERS AND INTERVIEWS WITH COMMUNITY STAKEHOLDERS. THE CHNAS WERE CONDUCTED IN ACCORDANCE WITH STATE AND FEDERAL GUIDELINES INCLUDING IRC SECTION 501(R) AND THE TEXAS HEALTH AND SAFETY CODE SECTION 311.

PART VI, LINE 3
MEMORIAL HERMANN HEALTH SYSTEM IS COMMITTED TO MAKING HEALTHIER COMMUNITIES, NOW AND FOR GENERATIONS TO COME. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE THROUGH MEMORIAL HERMANN'S FINANCIAL ASSISTANCE PROGRAM MAY BE NOTIFIED IN THE FOLLOWING WAYS: PATIENT CONSENT-THE HEALTH CARE CONSENT THAT IS SIGNED UPON REGISTRATION FOR HEALTHCARE SERVICES INCLUDES A STATEMENT THAT IF CHARITY SERVICES ARE REQUIRED, ELIGIBILITY DETERMINATION SHOULD BE REQUESTED UPON ADMISSION TO THE HOSPITAL OR UPON RECEIPT OF ITEMIZED BILL OR STATEMENT; FINANCIAL COUNSELING: MEMORIAL HERMANN PATIENTS ARE ENCOURAGED TO SEEK INFORMATION FROM THEIR HOSPITAL'S FINANCIAL COUNSELOR IF THEY ANTICIPATE DIFFICULTY PAYING THEIR PORTION OF THE HOSPITAL BILL. OUR FINANCIAL COUNSELORS WILL MAKE EVERY EFFORT TO ASSIST PATIENTS WHO ARE UNINSURED, UNDERINSURED, OR FACE OTHER FINANCIAL CHALLENGES ASSOCIATED WITH PAYING FOR THE HEALTH CARE SERVICES WE PROVIDE. FINANCIAL COUNSELORS MAY SCREEN PATIENTS FOR ELIGIBILITY FOR A VARIETY OF GOVERNMENT FUNDED PROGRAMS, ASSIST WITH A WORKER'S COMPENSATION OR LIABILITY CLAIM, SET UP AN EXTENDED TIME PAYMENT PLAN, OR HELP PATIENTS APPLY FOR FINANCIAL ASSISTANCE; PLAIN LANGUAGE SUMMARY AND APPLICATION-A PAPER COPY OF THE PLAIN LANGUAGE SUMMARY OF MEMORIAL HERMANN'S FAP AND A PAPER COPY OF THE FINANCIAL ASSISTANCE APPLICATION WILL BE MADE AVAILABLE TO ALL PATIENTS AT THE EARLIEST PRACTICAL TIME OF SERVICE. MEMORIAL HERMANN WILL HAVE FREE PAPER COPIES OF THESE DOCUMENTS AVAILABLE UPON REQUEST IN THE EMERGENCY DEPARTMENT AND REGISTRATION AREAS. FREE PAPER COPIES ARE ALSO AVAILABLE BY MAIL OR BY CALLING 713-338-5502 OR 1-800-526-2121, OPTION 5; TRANSLATED COPIES AVAILABLE: MEMORIAL HERMANN TRANSLATES ITS FAP, PLAIN LANGUAGE SUMMARY, FINANCIAL ASSISTANCE APPLICATION, AND BILLING AND COLLECTIONS POLICY FOR LIMITED ENGLISH PROFICIENT INDIVIDUALS REPRESENTING THE LESSER OF FIVE PERCENT OR 1,000 INDIVIDUALS OF THE COMMUNITY SERVED BY ITS HOSPITAL FACILITIES. MEMORIAL HERMANN MAKES FREE COPIES OF THESE DOCUMENTS AVAILABLE ON THE MEMORIAL HERMANN WEBSITE AND UPON REQUEST IN THE EMERGENCY DEPARTMENT AND HOSPITAL REGISTRATION AREAS. FREE PAPER COPIES ARE ALSO AVAILABLE BY MAIL BY CALLING 713-338-5502 OR 1-800-526-2121, OPTION 5; SIGNAGE- ALL FINANCIAL ASSISTANCE SIGNAGE WILL BE CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PUBLIC, INCLUDING, BUT NOT LIMITED TO, MEMORIAL HERMANN EMERGENCY DEPARTMENT AND PATIENT REGISTRATION AREAS. SIGNAGE WILL INDICATE THAT FINANCIAL ASSISTANCE IS AVAILABLE AND THE PHONE NUMBER TO REACH A FINANCIAL COUNSELOR FOR MORE INFORMATION; WEBSITE-MEMORIAL HERMANN'S POST NOTICE IN A PROMINENT PLACE ON ITS WEBSITE THAT FINANCIAL ASSISTANCE IS AVAILABLE, WITH AN EXPLANATION OF THE FINANCIAL ASSISTANCE APPLICATION PROCESS. MEMORIAL HERMANN POSTS ITS FAP WITH A LIST OF PROVIDERS WHO ARE COVERED AND NOT COVERED UNDER THE FAP, PLAIN LANGUAGE SUMMARY, FINANCIAL ASSISTANCE APPLICATION, AND THE BILLING AND COLLECTIONS POLICY ON MEMORIAL HERMANN'S WEBSITE; PATIENT BILLS AND STATEMENTS- PATIENT STATEMENTS WILL INCLUDE A REQUEST THAT THE PATIENT IS RESPONSIBLE TO INFORM MEMORIAL HERMANN OF ANY AVAILABLE HEALTH INSURANCE COVERAGE, AND WILL INCLUDE A NOTICE OF THE MEMORIAL HERMANN FAP, A TELEPHONE NUMBER TO REQUEST FINANCIAL ASSISTANCE, AND THE WEBSITE ADDRESS WHERE FINANCIAL ASSISTANCE DOCUMENTS CAN BE OBTAINED; MAIL OR FAX: PATIENTS MAY MAIL OR FAX A WRITTEN REQUEST FOR FREE COPIES OF THESE DOCUMENTS TO THE ADDRESS BELOW AND INCLUDING THE INDIVIDUAL'S FULL NAME AND RETURN MAILING ADDRESS TO WHICH THEY WANT MEMORIAL HERMANN TO SEND THE COPIES. MEMORIAL HERMANN HEALTH SYSTEM, ATTN: FINANCIAL ASSISTANCE, 909 FROSTWOOD, SUITE 3:100 HOUSTON, TEXAS 77024, FAX: 713-338-6500

PART VI, LINE 4
MEMORIAL HERMANN SERVES GREATER HOUSTON, A MULTI-COUNTY AREA ALONG THE GULF COAST IN SOUTHEAST TEXAS WHERE SEVERAL COUNTIES ARE WITHOUT HOSPITAL DISTRICT SERVICES. AN ESTIMATED 7.1 MILLION PEOPLE IN THE HOUSTON- THE WOODLANDS- SUGAR LAND METROPOLITAN STATISTICAL AREA (MSA), THE 5TH LARGEST MSA IN THE UNITED STATES, AND ONE OF THE FASTEST GROWING. THIS GROWTH HAS STRAINED HEALTH AND SOCIAL INFRASTRUCTURE, WITH SOME COMMUNITIES LACKING EASY ACCESS TO HEALTHY FOODS, SAFE ROADS, AFFORDABLE HOUSING AND ADEQUATE SIDEWALKS. A SOURCE OF STRENGTH IN A GLOBAL ECONOMY, HOUSTON PRIZES ITS RACIAL AND ETHNIC DIVERSITY. ACCORDING TO THE U.S. CENSUS, HOUSTON'S HARRIS COUNTY, THE METROPOLITAN AREA'S DOMINANT COUNTY, IS 43.3 PERCENT HISPANIC, 29.1 PERCENT WHITE, 19.9 PERCENT BLACK OR AFRICAN AMERICAN, 7.4 PERCENT ASIAN/PACIFIC ISLANDER AND .3 PERCENT OTHER. ROUGHLY 49 PERCENT OF HOUSTON RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. 27 PERCENT OF THE TOTAL POPULATION ARE MINORS AND 10 PERCENT ARE OVER 65 YEARS OF AGE, RESULTING IN A POTENTIAL WORKFORCE (18-64 YEARS) OF APPROXIMATELY 4.3 MILLION INDIVIDUALS. DESPITE THIS POSSIBILITY FOR ECONOMIC SUCCESS, ONLY 30 PERCENT OF THE 25 AND OLDER YEARS OF AGE POPULATION HAVE A COLLEGE DEGREE OR HIGHER, READYING THEM FOR HOUSTON'S GROWING BUSINESS AND INDUSTRY OPPORTUNITIES. THERE ARE POCKETS OF POVERTY THROUGHOUT THE AREA AND SOME RESIDENTS FACE TOUGH ECONOMIC CHALLENGES WHICH CAN AFFECT THEIR HEALTH AND THE HEALTH OF THEIR FAMILY. 16 PERCENT OF ALL RESIDENTS FALL AT OR BELOW THE 2018 FEDERAL POVERTY THRESHOLD. PROPELLED BY HOUSTON'S FAST GROWING IMMIGRANT POPULATION, YOUNG ADULT POPULATION, AND HIGH PERCENTAGE OF PART-TIME WORKERS, 20.7 PERCENT OF HOUSTONIANS LACK HEALTH INSURANCE OF ANY KIND. NEARLY ONE IN FOUR RESIDENTS ARE FOREIGN BORN, CONTRIBUTING TO A WIDE VARIETY OF CULTURES AND ETHNICITIES PRESENT IN THE REGION. IMMIGRATION IS A MAJOR PART OF THE IDENTITY OF THE CITY OF HOUSTON AND THE GREATER HOUSTON METROPOLITAN AREA. BETWEEN 2000 AND 2017 HOUSTON'S IMMIGRANT POPULATION GREW BY 23 PERCENT, HOWEVER, IN 2017, IMMIGRANT GROWTH IN THE SURROUNDING COUNTIES SURPASSED HARRIS COUNTY. ADDITIONALLY, HARRIS COUNTY HAS ONE OF THE LARGEST REFUGEE POPULATIONS IN THE U.S. 16.6 PERCENT OF THE TOTAL HARRIS COUNTY POPULATION IS FOOD INSECURE. COUPLED WITH THIS IS THE RISING RATE OF OBESITY AS THE SINGLE BIGGEST THREAT TO THE GREATER HOUSTON AREA-66.7 PERCENT OF HOUSTONIANS ARE OVERWEIGHT. OBESITY AND CONCERNS RELATED TO MAINTAINING A HEALTHY LIFESTYLE ARE CHALLENGES WITH RESIDENTS FACING BARRIERS, RANGING FROM A LACK OF TIME TO CULTURAL ISSUES INVOLVING CULTURAL NORMS TO STRUCTURAL CHALLENGES SUCH AS LIVING IN A FOOD DESERT OR HAVING LIMITED ACCESS TO SIDEWALKS, RECREATIONAL FACILITIES, OR AFFORDABLE FRUITS AND VEGETABLES. HEALTH EDUCATION, PREVENTION, AND INCREASED ACCESS TO HEALTHCARE ARE VITAL TO IMPROVING THE OVERALL HEALTH OF RESIDENTS WHOSE LEADING CAUSES OF HEALTH ISSUES ARE MENTAL HEALTH PROBLEMS, DIABETES, OBESITY (ADULT), OBESITY (CHILDREN), SUBSTANCE ABUSE, HEART DISEASE/STROKE, CANCER AND HIGH BLOOD PRESSURE. THE MOST PREVALENT CHRONIC DISEASES ARE DIABETES, OBESITY, HIGH BLOOD PRESSURE, CANCER, HEART FAILURE AND ASTHMA. WITH 13 PERCENT OF THE HOUSTON AREA POPULATION SELF-REPORTING 14 OR MORE POOR MENTAL HEALTH DAYS, THE NEED FOR INCREASED ACCESS TO BEHAVIORAL HEALTH CARE IS SIGNIFICANT.

PART VI, LINE 6
CHARTING A BETTER FUTURE. A FUTURE THAT'S BUILT UPON THE HEALTH OF OUR COMMUNITY. THIS IS THE DRIVING FORCE FOR MEMORIAL HERMANN, REDEFINING HEALTH CARE FOR THE INDIVIDUALS AND MANY DIVERSE POPULATIONS WE SERVE. OUR 6,700 AFFILIATED PHYSICIANS AND 27,000 EMPLOYEES PRACTICE THE HIGHEST STANDARDS OF SAFE, EVIDENCE-BASED, QUALITY CARE TO PROVIDE A PERSONALIZED AND OUTCOME-ORIENTED EXPERIENCE ACROSS OUR MORE THAN 300 CARE DELIVERY SITES. AS ONE OF THE LARGEST NOT-FOR-PROFIT HEALTH SYSTEMS IN SOUTHEAST TEXAS, MEMORIAL HERMANN HAS AN AWARD-WINNING AND NATIONALLY ACCLAIMED ACCOUNTABLE CARE ORGANIZATION, 13 HOSPITAL FACILITIES AND NUMEROUS SPECIALTY PROGRAMS AND SERVICES CONVENIENTLY LOCATED THROUGHOUT THE GREATER HOUSTON AREA. MEMORIAL HERMANN-TEXAS MEDICAL CENTER IS ONE OF THE NATION'S BUSIEST LEVEL I TRAUMA CENTERS AND SERVES AS THE PRIMARY TEACHING HOSPITAL FOR MCGOVERN MEDICAL SCHOOL AT UTHEALTH. FOR MORE THAN 112 YEARS, OUR FOCUS HAS BEEN THE BEST INTEREST OF OUR COMMUNITY, CONTRIBUTING MORE THAN $588 MILLION ANNUALLY THROUGH SCHOOL-BASED HEALTH CENTERS AND OTHER COMMUNITY BENEFIT PROGRAMS. NOW AND FOR GENERATIONS TO COME, THE HEALTH OF OUR COMMUNITY WILL BE AT THE CENTER OF WHAT WE DO - CHARTING A BETTER FUTURE FOR ALL. ALL ASPECTS OF THE HEALTH SYSTEM - CARE DELIVERY, PHYSICIANS AND HEALTH SOLUTIONS ARE BROUGHT TOGETHER TO CREATE A TRULY INTEGRATED HEALTH SYSTEM. THIS BREADTH OF SERVICE UNIQUELY POSITIONS MEMORIAL HERMANN TO COLLABORATE WITH OTHER PROVIDERS TO ASSESS AND CREATE HEALTH CARE SOLUTIONS FOR INDIVIDUALS IN GREATER HOUSTON'S DIVERSE COMMUNITIES; TO PROVIDE SUPERIOR QUALITY, COST-EFFICIENT, INNOVATIVE AND COMPASSIONATE CARE; TO SUPPORT TEACHING AND RESEARCH TO ADVANCE THE HEALTH PROFESSIONALS AND HEALTH CARE OF TOMORROW; AND TO PROVIDE HOLISTIC HEALTH CARE WHICH ADDRESSES THE PHYSICAL, SOCIAL, PSYCHOLOGICAL AND SPIRITUAL NEEDS OF INDIVIDUALS. OUR MEMORIAL HERMANN PHYSICIAN NETWORK, MHMD, COMPRISES PHYSICIANS FROM MEMORIAL HERMANN MEDICAL GROUP, UTHEALTH AND PRIVATE PHYSICIANS AND SPECIALISTS. WE OFFER LEADING-EDGE CLINICAL EXPERTISE, PATIENT-CENTERED CARE, AND LEADING EDGE TECHNOLOGY AND INNOVATION. THROUGH MEMORIAL HERMANN'S SUBSIDIARY, MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION (MHCBC), MEMORIAL HERMANN IMPLEMENTS PROGRAMS TO WORK WITH OTHER HEALTHCARE PROVIDERS, GOVERNMENT AGENCIES, BUSINESS LEADERS AND COMMUNITY STAKEHOLDERS TO ENSURE THAT ALL RESIDENTS OF THE GREATER HOUSTON AREA HAVE ACCESS TO THE CARE THEY NEED TO IMPROVE THEIR QUALITY OF LIFE AND THE OVERALL HEALTH OF THE COMMUNITY. THE MISSION OF MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION IS TO TEST AND MEASURE INNOVATIVE SOLUTIONS THAT PROMOTE GOOD HEALTH FOR THE INDIVIDUAL, THE HEALTH SYSTEM AND THE COMMUNITY. MHCBC COLLABORATES WITH OTHERS AS WELL AS CREATES SIGNATURE, EVIDENCE-BASED WAYS TO IMPROVE THE COMMUNITIES WHERE PEOPLE LIVE, WORK, LEARN, AND PLAY. MHCBC AREAS OF EXPERTISE SPAN ACCESS AND NAVIGATION, NUTRITION AND PHYSICAL ACTIVITY, SUPPORT OF THE WHOLE PERSON, AND RIGOROUS OUTCOME MEASUREMENT. PRIMARY PROGRAM FOCUS INCLUDE EDUCATION ON, ACCESS TO, AND PROVISION OF PRIMARY MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICE SUPPORT TO UNDERSERVED POPULATIONS; FOOD AS HEALTH; AND, EXERCISE AS MEDICINE. NEW PROGRAMS ARE PILOTED, AND PROVED PROGRAMS ARE REPLICATED IN THE COMMUNITY. COMMUNITY BENEFIT CORPORATION FUNDING TENETS INCLUDE: PROVISION OF PRIMARY AND/OR SPECIALTY CARE FOR THE UNINSURED AND UNDERINSURED; CONTRIBUTION TO THE EXISTING INFRASTRUCTURE OF NON-PROFIT CLINICS AND FQHC'S; PROGRAMS, PRACTICES, AND POLICIES THAT AFFECT THE HEALTH OF INDIVIDUALS, FAMILIES, AND COMMUNITIES; COMMITMENT TO MEASUREMENT; EXISTENCE OF COLLABORATIVE PARTNERS; PROGRAMMATIC INCLUSION OF HEALTH EDUCATION AND LITERACY; STRIVE TOWARDS SUSTAINABILITY. AS REQUIRED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT-SECTION 501(R)(3)-REQUIREMENT OF THE ACA, MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION SUPPORTS THE MEMORIAL HERMANN HEALTH SYSTEM LICENSED ACUTE CARE, REHAB, AND SURGICAL AND ER HOSPITALS IN CONDUCTING COMMUNITY NEEDS ASSESSMENTS. THE CORRESPONDING IMPLEMENTATIONS STRATEGIES BALANCE THE INDIVIDUALITY OF THE DIFFERENT HOSPITALS WITH THE SYSTEM STRATEGY OF COLLECTIVELY SUPPORTING COMMUNITY OBJECTIVES TO ACHIEVE THE NECESSARY ALIGNMENT AND LEVERAGE TO IMPACT TRUE COMMUNITY CHANGE.