4A (Expenses $ 1605118527 including grants of $ 42140) (Revenue $ 1780807669)
SEE SCHEDULE O

SCHEDULE H, PART V, SECTION B, LINE 3E
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): CHNA INPUT FROM KEY ADVISORS REPRESENTING BROAD COMMUNITY INTERESTS: INPUT FROM THE COMMUNITY SERVED 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, 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. TWIN CITIES SURGICAL HOSPITAL KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN MARCH 7, 2019, AND APRIL 5, 2019. THE FINDINGS FROM KEY INFORMANT INTERVIEWS AND FOCUS GROUPS IN TWIN CITIES SURGICAL HOSPITAL'S CHNA ARE AVAILABLE AT HTTP://WWW.SUTTERSURGICALHOSPITALNORTHVALLEY.ORG/ABOUT-US/COMMUNITY-NEEDS- ASSESSMENT.HTML

SCHEDULE H, PART V, SECTION B, LINES 6A
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): CHNA HOSPITAL COLLABORATORS: WORKING COLLABORATIVELY, RIDEOUT MEMORIAL HOSPITAL (RMH), DBA ADVENTIST HEALTH AND RIDEOUT, AND TWIN CITIES SURGICAL HOSPITAL, DBA SUTTER SURGICAL HOSPITAL NORTH VALLEY (SSHNV) CONTRACTED WITH COMMUNITY HEALTH INSIGHTS TO CONDUCT A CHNA FOR THEIR MUTUAL SERVICE AREAS.

SCHEDULE H, PART V, SECTION B, LINE 7A, 7B, AND 10A
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): HOSPITAL FACILITY WEBSITE: HTTP://WWW.SUTTERSURGICALHOSPITALNORTHVALLEY.ORG/ABOUT-US/COMMUNITY-NEEDS- ASSESSMENT.HTML OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT

SCHEDULE H, PART V, SECTION B, LINE 11
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND ARE NEEDS THAT TWIN CITIES SURGICAL HOSPITAL INTENDS TO ADDRESS THROUGH ITS IMPLEMENTATION STRATEGY: 1. ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES 2. PREVENTION OF DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION, AND ACCESS TO RESOURCES 3. ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD 4. ACCESS TO QUALITY PRIMARY HEALTH SERVICES 5. ACCESS TO SPECIALTY AND EXTENDED CARE 6. ACTIVE LIVING AND HEALTH EATING 7. SAFE AND VIOLENCE-FREE ENVIRONMENT DESCRIPTIONS OF THE COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THESE SIGNIFICANT HEALTH NEEDS CAN BE FOUND IN PART VI, ALONG WITH ADDITIONAL CRITICAL EFFORTS ON BEHALF OF TWIN CITIES SURGICAL HOSPITAL. NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. TWIN CITIES 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: WHILE THIS IS AN IMPORTANT ISSUE, TWIN CITIES SURGICAL HOSPITAL IS CURRENTLY FOCUSING ITS RESOURCES IN OTHER AREAS; HOWEVER, WE'LL CONTINUE TO LOOK FOR OPPORTUNITIES TO INCREASE ACCESS TO TRANSPORTATION.

SCHEDULE H, PART V, SECTION B, LINE 15E
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE SUTTER HEALTH WEBSITE AT: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE

SCHEDULE H, PART V, SECTION B, LINE 16J
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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
TWIN CITIES SURGICAL HOSPITAL (FACILITY 1): 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.

SCHEDULE H, PART V, SECTION B, LINE 3E
STANISLAUS SURGICAL HOSPITAL (FACILITY 2): 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
STANISLAUS SURGICAL HOSPITAL (FACILITY 2): IN CONDUCTING ITS MOST RECENT CHNA, STANISLAUS SURGICAL HOSPITAL (SSH) A FACILITY OF SUTTER VALLEY MEDICAL FOUNDATION, DID TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IN THE HOSPITAL'S SERVICE AREA. COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS THROUGH KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. DATA COLLECTED AND ANALYZED INCLUDED BOTH PRIMARY OR QUALITATIVE DATA AND SECONDARY OR QUANTITATIVE DATA. PRIMARY DATA INCLUDED 11 INTERVIEWS WITH 16 COMMUNITY HEALTH EXPERTS AS WELL AS 9 FOCUS GROUPS CONDUCTED WITH A TOTAL OF 75 COMMUNITY RESIDENTS. 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. STANISLAUS SURGICAL HOSPITAL KEY INFORMANT INTERVIEWS WERE CONDUCTED BETWEEN DECEMBER 5, 2018, AND MARCH 12, 2019. 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 2): 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 2): HOSPITAL FACILITY WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT OTHER WEBSITE: HTTPS://WWW.SUTTERHEALTH.ORG/PDF/FOR-PATIENTS/CHNA/MMC-SSH-2019-CHNA.PDF

SCHEDULE H, PART V, SECTION B, LINE 11
STANISLAUS SURGICAL HOSPITAL (FACILITY 2): 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 (FACILITY 2): 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 AND 16C
STANISLAUS SURGICAL HOSPITAL (FACILITY 2): THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY WERE PREVIOUSLY AVAILABLE ON THE SANISLAUS SURGICAL HOSPITAL WEBSITE AT: HTTPS://STANISLAUSSURGICAL.COM/FINANCIAL-ASSISTANCE AS OF 6/1/2022 SUTTER HEALTH NO LONGER OWNS OR OPERATES STANISLAUS SURGICAL HOSPITAL. THESE DOCUMENTS WERE REMOVED FROM THE WEBSITE AFTER THIS DATE.

SCHEDULE H, PART V, SECTION B, LINE 16J
STANISLAUS SURGICAL HOSPITAL (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 (ENGLISH & SPANISH). DURING PREADMISSION OR REGISTRATION ALL PATIENTS WILL BE PROVIDED THE FINANCIAL ASSISTANCE POLICY IS POSTED IN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL, INCLUDING, BUT NOT LIMITED TO THE BILLING OFFICE, ADMISSIONS OFFICE, AND PATIENT WAITING AREA. HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A COPY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST.

SCHEDULE H, PART I, LINES 3A & 3C
FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA: SUTTER VALLEY MEDICAL FOUNDATION OWNS 100% OF TWIN CITIES SURGICAL HOSPITAL, WHICH PROVIDES PREDOMINANTLY ELECTIVE SURGERIES AND DOES NOT PROVIDE EMERGENCY CARE. FOR UNINSURED PATIENTS TO BE ELIGIBLE FOR FREE CARE THIS FACILITY USES THE FEDERAL POVERTY GUIDELINES (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION TWIN CITIES SURGICAL HOSPITAL 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 MEDICAL FOUNDATION ACQUIRED A 31% OWNERSHIP INTEREST 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.

SCHEDULE H, PART I, LINE 3B
SUTTER VALLEY MEDICAL FOUNDATION IS COMMITTED TO PROVIDING CHARITY CARE. TWIN CITIES SURGICAL HOSPITAL PROVIDES FREE CARE AT HIGH PERCENTAGE OF FPG, SO 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 I, SECTION 7G
FINANCIAL ASSISTANCE/OTHER COMMUNITY BENEFITS AT COST RELATED TO SUBSIDIZED HEALTH SERVICES: THE AMOUNT OF COSTS ASSOCIATED WITH PHYSICIAN CLINICS IS $728,861.

SCHEDULE H, PART II
SUTTER VALLEY MEDICAL FOUNDATION (SVMF) DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES TO REPORT FOR 2021.

SCHEDULE H, PART III, 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, 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, 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, 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
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 5
"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. REPORTING FACILITY: #1 TWIN CITIES SURGICAL HOSPITAL THE 2019-2021 IMPLEMENTATION STRATEGY FOR TWIN CITIES SURGICAL HOSPITAL (SSHNV) DEFINES 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/BEHAVORIAL/SUBSTANCE ABUSE SERVICES FIT QUEST PROGRAM THE FIT QUEST PROGRAM IS A COMPREHENSIVE CHILDREN'S WELLNESS PROGRAM FOCUSING ON IMPROVING NUTRITION, FITNESS, AND MENTAL WELLNESS. THE ON-SITE SCHOOL PROGRAM, GEARED TOWARD 5TH AND 6TH GRADE STUDENTS, TEACHES STUDENTS EASY WAYS TO INCORPORATE HEALTHY CHOICES INTO DAILY LIVING. THE CURRICULUM IS DESIGNED TO IMPROVE OVERALL HEALTH IN A FUN AND MEANINGFUL WAY. THE FIT QUEST PROGRAM IS INCREDIBLY IMPACTFUL, REACHING OVER 40 SCHOOLS IN YUBA AND SUTTER COUNTY, PROVIDING SCHOOL ASSEMBLIES AND AN EXPANDED CURRICULUM FOCUS ON NUTRITION, PHYSICAL ACTIVITY AND MENTAL WELLNESS. THE EXPANDED CURRICULUM AND ROLE MODELING OF AND INTERACTIONS WITH THE NATURALISTS IN CHOOSING TO DRINK WATER, AND STAYING ACTIVE HAVE IMPACTED OVER 2,400 STUDENTS. SPECIALISTS HAVE BEEN ENGAGED THROUGHOUT THE PROCESS ATTENDING ASSEMBLIES AND PROVIDING GUIDANCE AND SUGGESTIONS AT PLANNING MEETINGS FOR CONTINUED ENHANCEMENTS IN THE FIT QUEST PROGRAM. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES; ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES; AND ACTIVE LIVING AND HEALTHY EATING. THE GOAL OF FIT QUEST IS TO TEACH CHILDREN HEALTHY LESSONS ABOUT THE IMPORTANCE OF PHYSICAL FITNESS, MENTAL WELLNESS AND NUTRITIOUS EATING. IN 2021, THERE WERE 882 STUDENTS SERVED. COUNSELING FOR PEOPLE EXPERIENCING OR AT-RISK FOR HOMELESSNESS FUNDING WILL ALLOW CLIENTS EXPERIENCING OR AT-RISK FOR HOMELESSNESS, WHOM DO NOT HAVE CALIFORNIA HEALTH AND WELLNESS AND BLUE SHIELD TO HAVE ACCESS TO COUNSELING WITH LICENSED MENTAL HEALTH PROFESSIONALS. COUNSELING IS OFFERED AT TWO LOCATIONS IN A PRIVATE OFFICE ALLOWING CLIENTS TO WORK ONE ON ONE WITH A COUNSELOR. COUNSELORS DETERMINE THE FREQUENCY OF COUNSELING SERVICES WITH EACH CLIENT AND HELP TO CONNECT THEM WITH ANY NEEDED OUTSIDE RESOURCES THE COUNSELOR DETERMINES IS NEEDED. THE GOAL IS TO PROVIDE COUNSELING SERVICES TO ALL CLIENTS REQUESTING ASSISTANCE WHO ARE EXPERIENCING OR AT-RISK FOR HOMELESSNESS. BY PROVIDING COUNSELING WITH LICENSED MENTAL HEALTH PROFESSIONALS, CLIENTS CAN OVERCOME PERSONAL CONCERNS AND BETTER THEIR QUALITY OF LIFE, WITH THE GOAL OF REINTEGRATING INTO THE COMMUNITY. IN 2021, THERE WERE 25 INDIVIDUALS SERVED WHO RECEIVED 49 SERVICES. PROGRAMS ADDRESSING: PREVENTION OF DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES WOMEN'S HEALTH SCREENINGS AND MAMMOGRAMS IN HONOR OF BREAST CANCER AWARENESS MONTH, SUTTER MEDICAL FOUNDATION - NORTH OFFERS NO-COST MAMMOGRAMS AND WOMEN'S HEALTH SCREENINGS. THIS PROGRAM REMAINS A KEY INITIATIVE FOR SSHNV AND A CORNERSTONE EVENT FOR THE ENTIRE YUBA/SUTTER COMMUNITY. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE; AND ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES. THE GOAL OF THE SCREENING EVENT IS TO PROVIDE NO-COST MAMMOGRAMS AND HEALTH SCREENINGS FOR WOMEN WHO OTHERWISE WOULDN'T HAVE ACCESS TO ONE, DUE TO NO INSURANCE OR A HIGH, UNAFFORDABLE DEDUCTIBLES. IN 2021, 51 MAMMOGRAMS AND 63 OF WOMEN'S HEALTH SCREENINGS WERE PROVIDED. FIT QUEST PROGRAM THE FIT QUEST PROGRAM IS A COMPREHENSIVE CHILDREN'S WELLNESS PROGRAM FOCUSING ON IMPROVING NUTRITION, FITNESS, AND MENTAL WELLNESS. THE ON-SITE SCHOOL PROGRAM, GEARED TOWARD 5TH AND 6TH GRADE STUDENTS, TEACHES STUDENTS EASY WAYS TO INCORPORATE HEALTHY CHOICES INTO DAILY LIVING. THE CURRICULUM IS DESIGNED TO IMPROVE OVERALL HEALTH IN A FUN AND MEANINGFUL WAY. THE FIT QUEST PROGRAM IS INCREDIBLY IMPACTFUL, REACHING OVER 40 SCHOOLS IN YUBA AND SUTTER COUNTY, PROVIDING SCHOOL ASSEMBLIES AND AN EXPANDED CURRICULUM FOCUS ON NUTRITION, PHYSICAL ACTIVITY AND MENTAL WELLNESS. THE EXPANDED CURRICULUM AND ROLE MODELING OF AND INTERACTIONS WITH THE NATURALISTS IN CHOOSING TO DRINK WATER, AND STAYING ACTIVE HAVE IMPACTED OVER 2,400 STUDENTS. SPECIALISTS HAVE BEEN ENGAGED THROUGHOUT THE PROCESS ATTENDING ASSEMBLIES AND PROVIDING GUIDANCE AND SUGGESTIONS AT PLANNING MEETINGS FOR CONTINUED ENHANCEMENTS IN THE FIT QUEST PROGRAM. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO MENTAL/BEHAVIORAL/SUBSTANCE ABUSE SERVICES; ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE, ACTION AND ACCESS TO RESOURCES; AND ACTIVE LIVING AND HEALTHY EATING. THE GOAL OF FIT QUEST IS TO TEACH CHILDREN HEALTHY LESSONS ABOUT THE IMPORTANCE OF PHYSICAL FITNESS, MENTAL WELLNESS AND NUTRITIOUS EATING. IN 2021, THERE WERE 882 STUDENTS SERVED. FOOD RESCUE PROGRAM IN PARTNERSHIP WITH SUTTER HEALTH, YUBA SUTTER FOOD BANK WILL EXPAND THE FOOD RESCUE PROGRAM THROUGH REPLACEMENT OF A DECOMMISSIONED TRUCK. DISTRIBUTION TARGETS PARTS OF COUNTIES VAPID OF FRESH FRUIT, VEGETABLES, AND OTHER HEALTHFUL WHOLE FOODS, USUALLY FOUND IN IMPOVERISHED AREAS. FOOD IS ALSO DISTRIBUTED TO OVER 30 PARTNER AGENCIES WHO SUPPORT FOOD ACCESS IN YUBA AND SUTTER COUNTY THROUGH A VARIETY OF PROGRAMS, INCLUDING FOOD PANTRIES AND HOT MEALS. THE GOAL OF THE PROGRAM IS TO RECOVER AN ESTIMAED 83,000 POUNDS OF SURPLUS FOOD FOR DISTRIBUTION TO NEARLY 8,000 PEOPLE WHO HAVE LIMITED ACCESS TO HEALTHY FOODS WILL IMPROVE THEIR OVERALL HEALTH AND WELL BEING. IN 2021, THERE WERE 13,781 INDIVIDUALS SERVED AND 2,222,844 POUNDS OF FOOD DISTRIBUTED. PROGRAMS ADDRESSING: ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS AND FOOD FOOD RESCUE PROGRAM IN PARTNERSHIP WITH SUTTER HEALTH, YUBA SUTTER FOOD BANK WILL EXPAND THE FOOD RESCUE PROGRAM THROUGH REPLACEMENT OF A DECOMMISSIONED TRUCK. DISTRIBUTION TARGETS PARTS OF COUNTIES VAPID OF FRESH FRUIT, VEGETABLES, AND OTHER HEALTHFUL WHOLE FOODS, USUALLY FOUND IN IMPOVERISHED AREAS. FOOD IS ALSO DISTRIBUTED TO OVER 30 PARTNER AGENCIES WHO SUPPORT FOOD ACCESS IN YUBA AND SUTTER COUNTY THROUGH A VARIETY OF PROGRAMS, INCLUDING FOOD PANTRIES AND HOT MEALS. THE GOAL OF THE PROGRAM IS TO RECOVER AN ESTIMAED 83,000 POUNDS OF SURPLUS FOOD FOR DISTRIBUTION TO NEARLY 8,000 PEOPLE WHO HAVE LIMITED ACCESS TO HEALTHY FOODS WILL IMPROVE THEIR OVERALL HEALTH AND WELL BEING. IN 2021, THERE WERE 13,781 INDIVIDUALS SERVED AND 2,222,844 POUNDS OF FOOD DISTRIBUTED. PROGRAMS ADDRESSING: ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES WOMEN'S HEALTH SCREENINGS AND MAMMOGRAMS IN HONOR OF BREAST CANCER AWARENESS MONTH, SUTTER MEDICAL FOUNDATION - NORTH OFFERS NO-COST MAMMOGRAMS AND WOMEN'S HEALTH SCREENINGS. THIS PROGRAM REMAINS A KEY INITIATIVE FOR SSHNV AND A CORNERSTONE EVENT FOR THE ENTIRE YUBA/SUTTER COMMUNITY. THIS PROGRAM ADDRESSES MULTIPLE PRIORITIZED SIGNIFICANT HEALTH NEEDS, SUCH AS ACCESS TO DISEASE AND INJURY THROUGH KNOWLEDGE; AND ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES. THE GOAL OF THE SCREENING EVENT IS TO PROVIDE NO-COST MAMMOGRAMS AND HEALTH SCREENINGS FOR WOMEN WHO OTHERWISE WOULDN'T HAVE ACCESS TO ONE, DUE TO NO INSURANCE OR A HIGH, UNAFFORDABLE DEDUCTIBLES. IN 2021, 51 MAMMOGRAMS AND 63 WOMEN'S HEALTH SCREENINGS WERE PROVIDED. PROGRAMS ADDRESSING: ACCESS TO SPECIALTY AND EXTENDED CARE YOLO CARES NEWLY FUNDED PROGRAM IN 2020. YOLOCARES PROGRAM IS COMPREHENSIVE, 24/7, 360-DEGREE, COMMUNITY-BASED PALLIATIVE CARE (INCLUDING BEHAVIORAL HEALTH SERVICES, DISEASE MANAGEMENT AND IMPROVED ACCESS TO CARE) TO PATIENTS THROUGHOUT YOLO COUNTY. YOLOCARES SERVES AS THE PRIMARY CARE PHYSICIAN FOR YOLOCARE PATIENTS IN NEED AND WILL WORK WITH PARTNERS TO COORDINATE CARE. PEER-TO-PEER EDUCATION WILL BE OFFERED TO AREA PHYSICIANS ABOUT THE YOLOCARES PROGRAM TO HELP CREATE A STREAMLINED CONTINUUM OF CARE AND REFERRAL PROCESS BETWEEN YOLOCARES, YOLO ADULT DAY HEALTH CENTER, COMMUNICARE, AND FOURTH & HOPE THROUGH EDUCATIONAL WORKSHOPS. THE PROGRAM WILL WORK TO EXPAND THE KNOWLEDGE OF PALLIATIVE CARE, YOLOCARES SERVICES, AND ADVANCE CARE PLANNING THROUGH YOLO"

SCHEDULE H, PART VI, LINE 6
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.

SCHEDULE H, PART VI, LINE 7
STATE FILING OF COMMUNITY BENEFIT REPORT: N/A

SCHEDULE H, PART VI, LINE 3
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.

SCHEDULE H, PART VI, LINE 4
REPORTING FACILITY: #1 TWIN CITIES SURGICAL HOSPITAL THE DEFINITION OF THE COMMUNITY SERVED WAS THE PRIMARY SERVICE AREA JOINTLY SHARED BY RIDEOUT MEMORIAL HOSPITAL (RMH) AND TWIN CITIES SURGICAL HOSPITAL, DBA SUTTER SURGICAL HOSPITAL NORTH VALLEY (SSHNV). THIS AREA WAS DEFINED BY FIVE ZIP CODES: 95901, 95953, 95961, 95991, AND 95993. THIS SERVICE AREA WAS DESIGNATED BECAUSE THE MAJORITY OF PATIENTS SERVED BY BOTH RMH AND SSHNV RESIDED IN THESE ZIP CODES. RMH IS LOCATED IN MARYSVILLE, CA, AND SSHNV IS LOCATED IN YUBA CITY, CA. SEPARATED BY THE FEATHER RIVER, THESE CITIES ARE LOCATED ADJACENT TO ONE ANOTHER AND ARE PART OF THE YUBA CITY METROPOLITAN STATISTICAL AREA AS DESIGNATED BY THE US OFFICE OF MANAGEMENT AND BUDGET, WHICH IS LOCATED APPROXIMATELY 40 MILES DUE NORTH OF CALIFORNIA'S CAPITAL-SACRAMENTO. THE SERVICE AREA IS HOME TO OVER 147,000 COMMUNITY RESIDENTS AND ENCOMPASSES PORTIONS OF BOTH SUTTER AND YUBA COUNTIES. THERE ARE FOUR HOSPITALS THAT SERVE THE COMMUNITY. 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 FOUR ZIP CODES THAT MET THE CRITERIA TO BE CLASSIFIED AS A COMMUNITY OF CONCERN. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED FOUR COMMUNITIES THAT MET THE CRITERIA FOR CLASSIFICATION AS A COMMUNITY OF CONCERN. THESE COMMUNITIES ARE MARYSVILLE, LIVE OAK, OLIVEHURST AND SOUTH YUBA CITY. REPORTING FACILITY: #2 STANISLAUS SURGICAL HOSPITAL THE DEFINITION OF THE COMMUNITY SERVED WAS STANISLAUS COUNTY. THIS IS THE DESIGNATED SERVICE AREA BECAUSE THE MAJORITY OF PATIENTS SERVED BY STANISLAUS SURGICAL HOSPITAL RESIDED IN THIS AREA. THERE ARE EIGHT 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. 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 FOR STANISLAUS COUNTY. 10 ZIP CODES MET THE CRITERIA TO BE CLASSIFIED AS COMMUNITIES OF CONCERN. ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA REVEALED FOUR COMMUNITIES THAT MET THE CRITERIA FOR CLASSIFICATION AS A COMMUNITY OF CONCERN. THESE COMMUNITIES ARE CERES, EMPIRE, WEST MODESTO, AIRPORT DISTRICT, OAKDALE, PATTERSON, RIVERBANK AND TURLOCK. AN IN-DEPTH VIEW OF THE DEMOGRAPHICS AND GEOGRAPHY OF THE SERVICE AREA, WITH SOURCES, IS AVAILABLE IN THE STANISLAUS SURGICAL HOSPITAL 2019 CHNA AT HTTPS://WWW.SUTTERHEALTH.ORG/FOR-PATIENTS/COMMUNITY-HEALTH-NEEDS- ASSESSMENT