4A (Expenses $ 349023012 including grants of $ 2672297) (Revenue $ 336130601)
MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL (MLKCH) IS A COMPLETELY NEW FACILITY REPLACING A PRIOR COUNTY FACILITY THAT WAS CLOSED DUE TO QUALITY OF CARE ISSUES IN 2007. MLKCH IS A UNIQUE PRIVATE-PUBLIC PARTNERSHIP. AS A PRIVATE, NON-PROFIT FREESTANDING 501(C)(3) CORPORATION, MLKCH LEASES A COMPLETELY NEW $280 MILLION HOSPITAL FACILITY FROM THE COUNTY OF LOS ANGELES. MLKCH WAS LICENSED BY THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH ON APRIL 28, 2015 AND OPENED TO PATIENT CARE ON MAY 14, 2015. AFTER INITIAL LICENSING, MLKCH PASSED THROUGH THE FOLLOWING MILESTONES AS IT BECAME FULLY OPERATIONAL:- ACCREDITED BY THE JOINT COMMISSION ON JUNE 30, 2015- OPENED ITS EMERGENCY DEPARTMENT ON JULY 7, 2015- BEGAN ACCEPTING RESCUE AMBULANCES ON AUGUST 11, 2015- STAGED A PHASED OPENING OF ITS INPATIENT FACILITIES SO THAT ALL INPATIENT BEDS WERE OPENED AND STAFFED BY DECEMBER 2015. SINCE THEN, HOSPITAL HAS CREDENTIALED ALMOST 400 PHYSICIANS AND HIRED OVER 2,000 EMPLOYEES AND CONTRACTORS TO MEET THE EXPECTED VOLUME OF PATIENTS. MLKCH'S SERVICE AREA IS ONE OF THE POOREST IN METROPOLITAN LOS ANGELES AND SUFFERS FROM A SEVERE SHORTAGE OF PHYSICIANS. AS A RESULT, EMERGENCY DEPARTMENT VOLUME HAS CONSISTENTLY EXCEEDED PROJECTIONS.IN JANUARY 2020, THE HOSPITAL, THROUGH WORKING WITH A DEVELOPER AND THE COUNTY OF LOS ANGELES, COMPLETED THE CONSTRUCTION A 50,000 SQ. FT. MEDICAL OFFICE BUILDING, A TWO STORY BUILDING ADJACENT TO THE HOSPITAL. THE HOSPITAL WILL BE EXPANDING OUTPATIENT SERVICES TO INCLUDE WOUND CARE AND OTHER SERVICES. IN THE FISCAL YEAR ENDED JUNE 30, 2022, MLKCH SERVED ITS COMMUNITY BY PROVIDING 9,269 ACUTE INPATIENT ADMISSIONS, 45,728 ACUTE INPATIENT DAYS, 580 DELIVERIES, 1,934 INPATIENT SURGERIES, 156 OUTPATIENT SURGERIES, 100,189 OUTPATIENT AND INPATIENT EMERGENCY VISITS, AND 5,488 OUTPATIENT OBSERVATION VISITS.IN JULY 2022, MLKCH RECEIVED A FIVE STAR RATING BY THE MEDICARE PROGRAM. THIS IS THE HIGHEST RATING THAT A HOSPITAL CAN RECEIVE AND WAS BASED ON SUPERIOR OUTCOMES IN MORTALITY, SAFETY OF CARE, READMISSIONS, PATIENT EXPERIENCE, AND TIMELY AND EFFECTIVE CARE.

MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL
PART V, SECTION B, LINE 5: INPUT WAS OBTAINED FROM COMMUNITY MEMBERS AND LEADERS WHO REPRESENT THE BROAD INTERESTS OF THE MLKCH SERVICE AREA THROUGH KEY INFORMANT INTERVIEWS, COMMUNITY INPUT, FOCUS GROUPS, AND COMMUNITY CONVENINGS. INTERVIEWEES AND INFORMANTS INCLUDED: PUBLIC HEALTH EXPERTS; REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS; LOCAL HEALTHCARE PROVIDERS; AND LOCAL HEALTH AND OTHER DEPARTMENT OR AGENCIES THAT HAVE CURRENT DATA RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY MLKCH. DURING THE INTERVIEWS AND OTHER ASSESSMENTS, PARTICIPANTS WERE ASKED TO IDENTIFY MAJOR HEALTH ISSUES IN THE COMMUNITY, AND SOCIOECONOMIC, BEHAVIORAL, ENVIRONMENTAL OR CLINICAL FACTORS CONTRIBUTING TO POOR HEALTH. INTERVIEWEES SHARED THEIR PERSPECTIVES ON THESE ISSUES, IDENTIFIED CHALLENGES AND BARRIERS TO IMPROVING COMMUNITY HEALTH, AND DISCUSSED POTENTIAL RESOURCES TO ADDRESS THESE HEALTH NEEDS. OVER 100 STAKEHOLDERS FROM APPROXIMATELY 60 ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS PROVIDED INPUT INTO THE DEVELOPMENT OF THE CHNA. THOSE INTERVIEWED INCLUDE, BUT NOT LIMITED TO, REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: MARTIN LUTHER KING JR. COMMUNITY HOSPITAL, LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH, LOS ANGELES COUNTY DEPARTMENT OF HELATH SERVICES, EISNER PEDIATRIC AND FAMILY MEDICAL CENTER, LOS ANGELES COUNTY FIRE DEPARTMENT, HOUSING AUTHORITY FOR THE CITY OF LOS ANGELES, ST. JOHN'S WELL CHILD AND FAMILY CENTER, CHARLES R. DREW UNIVERSITY OF MEDICINE AND SCIENCE, LA CARE HEALTH PLAN, T.H.E. (TO HELP EVERYONE) HELATH AND WELLNESS CENTERS, WATTS HEALTHCARE, SOUTHSIDE COALITION OF COMMUNITY HEALTH CENTERS, MARTIN LUTHER KING JR. OUTPATIENT CENTER, DISTRICT ATTORNEY COUNTY OF LOS ANGELES, SHIELDS FOR FAMILIES, LOS ANGELES SENTINEL, , BETHEL MISSIONARY BAPTIST CHURCH, COMMUNITY COALITION OF SOUTH LOS ANGELES, BLACK WOMEN FOR WELLNESS, SCOPE/AGENDA, THE WATTS LABOR COMMUNITY ACTION COMMITTEE, AND OTHER ORGANIZATIONS REPRESENTIVE OF THE COMMUNITY.

MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL
PART V, SECTION B, LINE 6B: THE CHNA INCLUDES A COMPREHENSIVE QUANTITATIVE AND QUALITATIVE ASSESSMENT OF THE CRITICAL FACTORS THAT AFFECT OVERALL HEALTH AND WELLNESS IN THE COMMUNITY OF MLK COMMUNITY HOSPITAL. THESE ASSESSMENTS WERE CONDUCTED BY PREMIER, INC., A NATIONALLY RECOGNIZED HEALTHCARE CONSULTING ORGANIZATION THAT SPECIALIZES IN ADVISORY SERVICES AND IDENTIFYING COMMUNITY NEEDS FOR UNDERSERVED POPULATIONS.

MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL
PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCORPORATED DEMOGRAPHIC AND HEALTH DATA FOR THE COMMUNITIES SERVED BY MLKCH. SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED USING PRIMARY AND SECONDARY DATA COLLECTED FROM A VARIETY OF LOCAL, COUNTY, AND STATE SOURCES. IN ADDITION, INTERVIEWS WERE CONDUCTED TO GATHER INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. HEALTH INDICATORS WERE CONSIDERED SIGNIFICANT NEEDS WHEN THEY EXCEEDED BENCHMARK DATA, SPECIFICALLY COUNTY OR STATE RATES OR HEALTHY PEOPLE 2020 OBJECTIVES. INPUT FROM INTERVIEWS HELPED MLKCH PRIORITIZE IDENTIFIED HEALTH NEEDS. THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED THROUGH THE CHNA: (I) ACCESS TO PREVENTIVE, PRIMARY AND SPECIALTY CARE, (II) MANAGEMENT OF CHRONIC HEALTH CONDITIONS, (III) BEHAVIORAL HEALTH, (IV) EDUCATION AND SCREENINGS, (V) HOMELESS HEALTH, (VI) AND SOCIAL DETERMINANTS OF HEALTH. MLKCH ADDRESSES ALL OF THESE SIGNIFICANT HEALTH NEEDS IN ITS 2020-2023 IMPLEMENTATION STRATEGY.ACCESS TO PREVENTIVE, PRIMARY, AND SPECIALTY CARE IS A SIGNIFICANT HEALTH NEED AS COMMUNITY RESIDENTS HAVE INADEQUATE ACCESS TO A BROAD RANGE OF MEDICAL AND DENTAL SERVICES. WITH A GOAL OF INCREASING ACCESS TO PREVENTIVE, PRIMARY, SPECIALTY, AND DENTAL HEALTH CARE FOR MEDICALLY UNDERSERVED POPULATIONS, MLKCH HAS OUTLINED A NUMBER OF PROGRAMS AND STRATEGIES TO ADDRESS THIS SIGNIFICANT HEALTH NEED. SUCH PROGRAMS INCLUDE: (I) HELPING RESIDENTS ESTABLISH MEDICAL HOMES AND CONNECT TO PRIMARY AND SPECIALTY PROVIDERS, (II) PROVIDING TRANSPORTATION ASSISTANCE TO CONNECT PATIENTS TO MEDICAL PROVIDERS, (III) EXPANDING ACCESS TO HEALTHCARE AND SOCIAL SERVICES USING TELEHEALTH SERVICES, (IV) DEVELOPING FACILITIES, STAFFING, AND INFRASTRUCTURE TO INCREASE CAPACITY FOR SPECIALIZED MEDICAL SERVICES, INCLUDING MOBILE HEALTH, (V) PROVIDING ACCESS TO PRENATAL AND POSTNATAL SERVICES AND SUPPORT FOR EXPECTANT MOTHERS IN THE COMMUNITY, (VI) PROVDING RESIDENTS WITH ASSISTANCE TO ENROLL IN COUNTY AND GOVERNMENTAL HEALTH INSURANCE OR SOCIAL SERVICE PROGRAMS, AND (VII) PROVIDING ELIGIBLE LOW-INCOME PERSONS WITH FREE AND DISCOUNTED HEALTHCARE SERVICES THROUGH THE HOSPITAL'S FINANCIAL ASSISTANCE (CHARITY CARE) POLICY. TO HELP ACHIEVE THESE GOALS, MLKCH PARTNERS WITH HEALTH ADVOCATES, GYANT FOR TELEHEALTH COMMUNICATIONS, THE COUNTY OF LOS ANGELES DEPARTMENT OF SOCIAL SERVICES, COMMUNITY PARTNERS AND PROVIDERS, LOS ANGELES COUNTY FIRST 5 LA WELCOME BABY PROGRAM, WHOLE PERSON CARE LOS ANGELES MLK COMMUNITY MEDICAL FOUNDATION, LOCAL PUBLIC AND PRIVATE TRANSPORTATION PROVIDERS, INSURANCE PLANS WITH A TRANSPORTATION BENEFIT, AND THE COUNTY OF LOS ANGELES.TO ADDRESS THE HEALTH NEED OF BEHAVIORAL HEALTH, MLKCH HAS OUTLINED A VARIETY OF PROGRAMS AND STRATEGIES TO INCREASE AVAILABILITY OF RESOURCES TO STABILIZE AND IMPROVE BEHAVIORAL HEALTH CONDITIONS. THESE PROGRAMS AND STRATEGIES INCLUDE: (I) IMRPOVING CLINICAL OUTCOMES IN PATIENTS WITH CHRONIC MEDICAL CONDITIONS BY IDENTIFYING AND ADDRESSING UNDERLYING MENTAL HEALTH AND SUBSTANCE USE CO-MORBIDITIES AND CONNECTING RESIDENTS TO THEIR APPROPRIATE HEALTH HOME, (II) IMPROVING ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES USING TLEEHEALTH CONSULTS WITH BEHAVIORAL HELATH SPECIALISTS, AND (III) CREATING A PROCESS FOR IDENTIFYING VICTIMS OF HUMAN TRAFFICKING AND PROVIDE REFERRALS FOR HUMAN TRAFFICKING CARE AND RELATED RESOURCES. MLKCH PARTNERS WITH ORGANIZATIONS SUCH AS THE MLK COMMUNITY MEDICAL GROUP INTEGRATED BEHAVIORAL HEALTH TEAM, SOCIAL SERVICE PROVIDERS, EXODUS RECOVERY AT MLK MEDICAL CENTER, LICENSED AND CERTIFIES MENTAL HEALTH PROVIDERS, WHOLE PERSON CARE LOS ANGELES, DIGNITY HEALTH HUMAN TRAFFICKING RESPONSE PROGRAM, LOS ANGELES COUNTY DISTRICT ATTORNEY'S BUREAU OF VICTIM SERVICES, LOS ANGELES POLICE DEPARTMENT AND LA SHERIFF'S CENTURY STATION. CHRONIC DISEASE MANAGEMENT IS A SIGNIFICANT HEALTH NEED, AS EVIDENCED BY THE HIGH PREVALENCE OF POORLY MANAGED CHRONIC DISEASES RESULTING IN BAD HEALTH OUTCOMES. MLKCH HAS OUTLINED A NUMBER OF PROGRAMS AND STRATEGIES TO COMBAT THIS HEALTH NEED, WHICH INCLUDES: (I) PROVIDNG CLINICAL BEST PRACTICES AND COMPREHENSIVE CARE FOR DIABETES AND TREATMENT OF PATIENTS WITH OTHER CHRONIC CONDITIONS, (II) PROVIDING RESIDENTS' SCREENINGS, HEALTH EDUCATION, AND PEER SUPPORT THROUGH FOOD ACCESS INITIATIVES, (III) PROVIDING, EDUCATING, AND MODELING HEALTHY FOOD CHOICES IN THE COMMNITY AT THE MLKCH CAFETERIA AND MLK CAMPUS FARMERS' MARKET, AND (IV) SUPPORTING COMMUNITY EFFORTS TO INTRODUCE HEALTHY, AFFORDABLE FOOD TO THE SOUTH LA COMMUNITY BY PROVIDING AND PROMOTING NUTRITION AND PHYSICAL ACTIVITY CLASSES AND CONNECTING PATIENTS TO FOOD BENEFIT PROGRAMS. TO ACHIEVE ITS DESIRED IMPACT OF REDUCING MORBIDITY AND MORTALITY ASSOCIATED WITH THESE CHRONIC DISEASES, MLKCH PARTNERS WITH SUCH ORGANIZATIONS INCLUDING MLK COMMUNITY MEDICAL FOUNDATION, MLKCH DIABETES CARE COMMITTEE, COMMUNITY PROVIDERS, MLKCH RECIPE FOR HEALTH FOOD ACCESS PROGRAM OFFERING FRESH PRODUCE AND EDUCATION, MLKCH FOOD AND NUTRITION SERVICES TEAM AND DIETITIANS, SUSTAINABLE ECONOMIC ENTERPRISES OF LOS ANGELES, LA COUNTY CALFRESH PROGRAM, CEDARS-SINAI MEDICAL CENTER HEALTHY HABITS PROGRAM, LA CARE FAMILY RESOURCE CENTER, AND COMMUNIY GROVERY STORES.EDUCATION AND SCREENINGS IS A NEED FOR THE COMMUNITY AROUND MLKCH AND MLKCH WILL CONTINUE TO PROMOTE A HEALTHIER COMMUNITY THROUGH COMMUNITY CLASSES, IMMUNIZATION RESOURCES, AND EDUCATION FOR PREVENTIVE HEALTH. MLKCH HAS COME UP WITH A NUMBER OF PROGRAMS AND STRATEGIES TO ADDRESS THIS NEED, WHICH INCLUDES: (I) PROVIDING RESIDENTS WITH FLU SHOTS AND VACCINATION EDUCATION THROUGH A HEALTHCARE PARTNERSHIP EFFORT, COMMUNITY FLU CAMPAIGN, (II) PROVIDING SCREENINGS, HEALTH EDUCATION, AND PEER SUPPORT THROUGH MLKCH COMMUNITY OUTREACH PROGRAMS, (III) EXPANING AVAILABILITY FOR MATERNAL AND INFANT CARE, EDUCATION AND RESOURCES, AND SUPPORT FOR MOTHERS IN THE COMMUNITY, AND (IV) HELPING COMMUNITY MEMBERS CONNECTS WITH THE RANGE OF MEDICAL CARE AND SOCIAL SERVICES THEY NEED. TO ACHIEVE THIS DESIRED IMPACT OF REDUCING VACCINE-PREVENTABLE VIRUSES AND PROMOTING HEALTH SCREENINGS AND EDUCATION AMONG POPULATION LESS LIKELY TO SEEK CARE, MLKCH PARTNERS WITH CEDARS-SINAI MEDICAL CENTER, LA COUNTY DEPARTMENT OF PUBLIC HEALTH, IMMUNIZA LOS ANGELES, COMMUNITY HEALTH PARTNERS, HOUSING AUTHORITY OF THE CITY OF LOS ANGELES, MLKCH KNOW YOUR BASICS PROGRAM (A PROGRAM OFFERING HEALTH SCREENINGS AND EDUCATIONS IN PUBLIC GATHERING PLACES SUCH AS CHURCHES, SHOPPING CENTERS, HEALTH FAIRS, BARBERSHOPS), COMMUNITY BARBERSHOP PARTNERS, AREA NURSING SCHOOLS, COMMUNITY VOLUNTEER NURSES, MLKCH BABY FRIENDLY COORIDNATOR, AND COPE HEALTH SOLUTIONS (MEDICAL AND SOCIAL SERVICE NAVIGATORS).HOMELESS HEALTH IS A NEED THE COMMUNITY OF MLKCH FACES AT AN EXTREME RATE AND MLKCH INTENDS TO ADDRESS THIS BY IMPROVING ACCESS TO HEALTHCARE, HOUSING, AND OTHER SOCIAL SERVICES FOR PERSONS EXPERIENCING HOMELESSNESS SO THEY CAN BETTER MANAGE AND STABILIZE THEIR HEALTH. MLKCH DEVELOPED PROGRAMS AND STRATEGIES TO ADDRESS THESE NEEDS, WHICH INDLUDE: (I) PROVIDING HIGH QUALITY STREET-BASED MEDICAL SERVICES AND PROVIDERS AND HOSPITAL-BASED CONSULTATIVE SERVICES TO ADMITTED MLKCH PATIENTS WHO ARE EXPERIENCING HOMELESSNESS. STREET-BASED SERVICES ARE PROVIDED ON-SITE WHERE THE HOMELESS RESIDE, (II) PROVIDING DIRECT PATIENT SUPPORT BY NAVIGATING THE HOMELESS TO IMMEDIATE CASE MANAGEMENT SERVICES, (III) HELPING INDIVIDUALS WHO ARE HOMELESS ACCESS HOUSING, FOOD, TOILETRIES, CLOTHING, TRANSPORTATION, SOCIAL SERVICES, AND SUPPORT AVAILABLE THROUGH MEASURE H AND OTHER PUBLIC INITIATIVES, AND (IV) DEVELOPING INCREASED NUMBERS OF RESERVED SHELTER BEDS TO IMPROVE RECUPERATIVE CARE AND CONNECTION TO COMMUNITY CASE MANAGEMENT AND HOUSING SERVICES. TO ACHIEVE THIS DESIRE OF INCREASING ACCESS TO CARE FOR PEOPLE EXPERIENCING HOMELESSNESS AND INCREASING ASSISTANCE TO NAVIGATE SOCIAL SERVICE AND BASIC NEEDS, MLKCH PARTNERS WITH THE MLKCH STREET MEDICINE DEPARTMENT, STREET MEDICINE PROGRAM OF UNIVERSITY OF SOUTHER CALIFORNIA KECK SCHOOL OF MEDICINE, WHOLE PERSON CARE LOS ANGELES, MLKCH HOMELESS SERVICES TEAM AND COMMUNITY ORGANIZATIONS, SHELTERS AND COMMUNITY SERVICE PROVIDERS FOR INDIVIDUALS EXPERIENCING HOMELESSNESS, MLK OUTHPATIENT CENTER, HARBOR UCLA COUNTY HOSPITAL, AND TEMPORARY HOUSING AND POST-ACTUE CARE PROVIDERS.SOCIAL DETERMINANTS OF HEALTH IS A SIGNIFICANT HEALTH NEED, AND MLKCH INTENDS TO ADDRESS FOUR OF THESE DETERMINANTS: INSURANCE ENROLLMENT SUPPORT FOR CARE, HOUSING FOR COMMUNITY MEMBERS, TRANPORTATION TO HEALTH APPOINTMENTS, AND HEALTHY FOOD MODELS. TO ADDRESS THESE NEEDS, MLKCH HAS OUTLINED A NUMBER OF PROGRAMS AND STRATEGIES, INCLUDING: (I) PROVIDING RESIDENTS WITH ASSISTANCE TO ENROLL IN COUNTY AND GOVERNMENTAL HEALTH INSURANCE OR SOCIAL SERVICE PROGRAMS, (II) DEVELOPING INCREASED NUMBERS OF RESERVED BEDS TO IMPROVE RECUPERATIVE CARE AND CONNECTION TO COMMUNITY CASE MANAGEMENT AND HOUSING SERVICES, (III) PROVI

PART I, LINE 7:
THE COST ACCOUNTING SYSTEM USED ADDRESSES ALL PATIENT SEGMENTS INPATIENT, OBSERVATION, AND ANCILLARY SERVICES. THE INPATIENT COST WAS CALCULATED BASED ON THE PER DIEM RATE BY FACILITY LOCATION (I.E. ICU, NURSERY). THE ANCILLARY SERVICES WERE CALCULATED BASED ON A COST OF CARE RATE.

PART I, LINE 7G:
DUE TO THE DEMOGRAPHICS AND PAYOR MIX OF THE HOSPITAL SERVICE AREA, COMBINED WITH THE SEVERE PHYSICIAN SHORTAGE IN THE HOSPITAL'S SERVICE AREA, MLKCH'S EMERGENCY DEPARTMENT OPERATES AT A SIGNIFICANT LOSS; DIRECT OPERATING COSTS ARE MUCH HIGHER THAN REVENUE RECEIVED FROM THESE SERVICES. AS SUCH, THE ENTIRE EMERGENCY DEPARTMENT IS REFLECTED AS A SUBSIDIZED HEALTH SERVICE.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BENEFIT SERVICES INCLUDE MLKCH EXPERTISE AND RESOURCES DEVOTED TO STRENGTHENING AND BUILDING OUR COMMUNITY. HOSPITAL LEADERS SERVE ON LOCAL, REGIONAL, AND STATE-LEVEL BOARDS, PARTICIPATING IN DECISIONS THAT ADDRESS HEALTH IMPROVEMENT AND SUPPORT HEALTH POLICY THAT WILL BENEFIT OUR COMMUNITY. KNOW YOUR BASICS, OUR SIGNATURE COMMUNITY HEALTH PROGRAM OFFERS SCREENINGS, HEALTH EDUCATION RESOURCE REFERRALS, CONNECTION TO MEDICAL HOMES, INSURANCE EDUCATION, AND PEER SUPPORT TO RESIDENTS THROUGHOUT SOUTH LOS ANGELES. KNOW YOUR BASICS REACHES COMMUNITY MEMBERS WHERE THEY LIVE IN THEIR EVERYDAY LIVES SHOPPING MALLS, FARMERS' MARKETS, AND COMMUNITY HEALTH FAIRS. DURING THIS PAST YEAR, AS MORE COMMUNTY EVENTS WERE RE-OPENING, MLKCH REACHED OVER 100,000 COMMUNITY MEMBERS WITH HEALTH EDUCATION, PARTNERED WITH 16 ORGANIZATIONS IN COMMUNITY EVENTS, AND DELIVERED 955 HEALTH SCREENINGS.HOMELESSNESS CONTINUES TO BE A KEY FOCUS AREA FOR THE HOSPITAL'S WORK. THE NUMBER OF HOMELESS PEOPLE IN OUR COMMUNITY IS SIGNIFICANT, AND HEALTH DISPARITIES AMONG THIS GROUP CONTINUE TO GROW. MANY HOMELESS REPEATEDLY RETURN TO OUR EMERGENCY DEPARTMENT SEEKING A SAFE PLACE TO CONNECT TO THE PROGRAMS AND SERVICES THEY NEED TO MANAGE THEIR CONDITIONS. IN RESPONSE, WE ENHANCED OUR CARE COORDINATION SERVICES AND EXPANDED OUR NETWORK OF EXTERNAL PARTNERS TO GIVE HOMELESS PATIENTS MORE PLACEMENT OPTION. WE HAVE DEDICATED HOMELESS SERVICES LIASONS AND COMMUNITY HEALTH WORKERS TO HELP OUR PATIENTS NAVIGATE RESOURCES CRITICAL TO THEIR HEALTH. AS PART OF OUR COMMUNITY BENEFIT PLAN WE CONTRIBUTE TO THE COST OF RECUPERATIVE CARE FOR UNINSURED AND UNDERINSURED PATIENTS AND PARTICIPATE IN ESTABLISHED TRANSITIONAL HOUSING PARTNERSHIPS, INCLUDING THE LOCAL HOMELESS COALITION AND THE HOMELESS OUTREACH PROGRAM INTEGRATED CARE SYSTEM.

PART III, LINE 2:
ALL SELF-PAY ACCOUNTS, INCLUDING THOSE WRITTEN OFF TO BAD DEBT ARE DISCOUNTED TO THE HOSPITAL'S APPROXIMATE COST USING A COST-TO-CHARGE RATIO OF APPROXIMATELY 81% (I.E. APPROXIMATE COST EQUALS 19% OF CHARGES).

PART III, LINE 4:
THE ORGANIZATION'S FINANCIAL STATEMENTS DOES NOT HAVE A SEPARATE FOOTNOTE WHICH DESCRIBES BAD DEBT EXPENSE. HOWEVER, PAGE 12 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS, WHICH IS ATTACHED TO THIS RETURN, INCLUDES A FOOTNOTE RELATED TO ALLOWANCE FOR DOUBTFUL ACCOUNTS.

PART III, LINE 8:
NONE OF THE SHORTFALL LISTED ON PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT.

PART III, LINE 9B:
MLKCH'S MANAGEMENT HAS DEVELOPED POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTIONS ACTION AND REPORTING TO CREDIT AGENCIES) THAT TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR AGOVERNMENTAL PROGRAM OR FOR CHARITY FROM MLKCH, AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS WITH MLKCH. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, MLKCH MAY OFFER EXTENDED PAYMENT PLANS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES, AND WILL CEASE COLLECTION EFFORTS. MLKCH WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS WAGE GARNISHMENTS, LIENS ON PRIMARY RESIDENCES, OR OTHER LEGAL ACTIONS FOR ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR CHARITY CARE UNDER THIS FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS WILL INCLUDE:1. VALIDATING THAT THE PATIENT OWES THE UNPAID BILLS AND THAT SOURCES OF THIRD-PARTY PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY THE HOSPITAL;2. DOCUMENTATION THAT MLKCH HAS OR HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE PURSUANT TO THIS POLICY AND THAT THE PATIENT HAS NOT COMPLIED WITH THE HOSPITAL'S APPLICATION REQUIREMENTS;3. DOCUMENTATION THAT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE ON A PRESUMPTIVE BASIS;4. DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THAT PLAN.

PART VI, LINE 3:
INFORMATION REGARDING A PATIENT'S ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS POSTED IN THE MAIN PATIENT WAITING AREAS OF THE FACILITY. ADDITIONALLY, ALL PATIENTS ARE GIVEN WRITTEN INFORMATION UPON ADMISSION THAT DISCUSSES AVAILABILITY OF THE PROGRAMS AND PROVIDES CONTACT INFORMATION. PATIENT ACCESS COUNSELORS ARE ALSO AVAILABLE, AND THE DEPARTMENT OF PUBLIC SERVICES IS ON SITE TO ASSIST THE PUBLIC.

PART VI, LINE 5:
THE EMPLOYEES AND MEDICAL STAFF OF MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL PROVIDE COMMUNITY SERVICES FOCUSED ON HEALTH AND HEALING. THESE SERVICES RANGE FROM PROVIDING HEALTH EDUCATION AT COMMUNITY EVENTS TO DESIGNING AND LAUNCHING PROGRAMS AIMED TO ADDRESS KEY COMMUNITY NEEDS, OFTEN IN COLLABORATION WITH OTHER COMMUNITY PARTNERS AND NON-PROFIT ORGANIZATIONS. ADDITIONALLY, THE HOSPITAL EXTENDS MEDICAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES.

PART VI, LINE 7
MLKCH FILES A COMMUNITY BENEFIT REPORT IN CALIFORNIA.

PART VI, LINE 2:
THE CHNA INCLUDES QUALITATIVE AND QUANTITATIVE MARKET RESEARCH, AS WELL AS USING EXTERNAL DATA SOURCES. IN ADDITION TO THE CHNA, THE ORGANIZATION PREPARES AN IMPLEMENTATION STRATEGY TO PRIORITIZE THE NEEDS OF THE COMMUNITY INFORMED BY THE CHNA FINDINGS. AN ANNUAL COMMUNITY BENEFIT REPORT AND PLAN IS ALSO PREPARED, WHICH TRACKS ANNUAL PROGRESS ON THE ACTIVITIES AND SERVICES MLKCH DOES TO ADDRESS HEALTH CARE NEEDS OF THE COMMUNITY. IN FY2022, MLKCH CONTINUED TO EXPAND ACCESS TO QUALITY CARE AND HEALTH EDUCATION THROUGHOUT OUR SOUTH LOS ANGELES COMMUNITY. PROGRAMS WERE IMPLEMENTED OR EXPANDED TO ADDRESS NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. USING THE FRAMEWORK DEVELOPED IN THE IMPLEMENTATION STRATEGY, SERVICES FOR COMMUNITY HEALTH IMPROVEMENT EXTENDED ACROSS SIX KEY CATEGORIES:1. ACCESS TO PREVENTIVE, PRIMARY, AND SPECIALTY CARE2. BEHAVIORAL HEALTH 3. MANAGEMENT OF CHRONIC HEALTH CONDITIONS4. EDUCATION AND SCREENINGS5. HOMELESS HEALTH6. SOCIAL DETERMINANTS OF HEALTHSOME HIGHLIGHTED PROGRAMS THAT CONTINUE TO DEVELOP AND ADDRESS THE KEY PRIORITY NEEDS ARE KNOW YOUR BASICS HEALTH SCREENING AND EDUCATION PROGRAM, MAN UP! MEN'S HEALTH BARBERSHOP PROGRAM, RECIPE FOR HEALTH FOOD ACCESS PROGRAM, THE MATERNAL AND INFANT HEALTH EDUCATION CLASSES AND SUPPORT GROUP, AND THE INTEGRATED BEHAVIORAL HEALTH PROGRAM.KNOW YOUR BASICS, OUR SIGNATURE COMMUNITY HEALTH PROGRAM, OFFERS SCREENINGS, HEALTH EDUCATION, RESOURCE REFERRALS, AND PEER SUPPORT TO RESIDENTS THROUGHOUT SOUTH LOS ANGELES. KNOW YOUR BASICS REACHES COMMUNITY MEMBERS WHERE THEY LIVE IN THEIR EVERYDAY LIVES - SHOPPING MALLS, FARMERS' MARKETS, COMMUNITY HEALTH FAIRS, BARBER SHOPS, BEAUTY SALONS, CHURCHES, SCHOOLS, AND HOUSING PROJECTS. NURSING STUDENTS FROM TWO LOCAL COLLEGES AND NURSE ORGANIZATIONS CONDUCTED HEALTH SCREENINGS FOR GLUCOSE, BLOOD PRESSURE, AND BODY MASS INDEX (BMI). DURING THIS PAST YEAR WE REACHED OVER 100,000 COMMUNITY MEMBERS WITH HEALTH EDUCATION, PARTNERED WITH 16 ORGANIZATIONS IN COMMUNITY EVENTS, AND DELIVERED 955 HEALTH SCREENINGS. KNOW YOUR BASICS ALSO PROVIDES FLU VACCINES AND EDUCATION TO ENSURE THE COMMUNITY HAS ACCESS TO FREE VACCINES AND IS PROTECTED FROM THE INFLUENZA VIRUS. DURING FY 2022 MLKCH PROVIDED OVER 100 FLU VACCINES.THE MAN UP! MEN'S HEALTH BARBERSHOP CAMPAIGN WAS LAUNCHED IN JANUARY 2019 AS AN EXTENSION OF OUR KNOW YOUR BASICS PROGRAM, TARGETING AN AUDIENCE THAT HAS HISTORICALLY BEEN SLOW TO ADDRESS PRIMARY CARE NEEDS. BLOOD PRESSURE, GLUCOSE, AND BMI SCREENINGS AS WELL AS HEALTH AND PROSTATE CANCER EDUCATION WERE OFFERED TO MEN IN BARBERSHOPS THROUGHOUT THE COMMUNITY. WE PARTNERED WITH EIGHT LOCAL BARBERSHOPS TO PROVIDE INFORMATION ON HEART DISEASE, DIABETES, OBESITY, AND PROSTATE CANCER. DURING THIS PAST YEAR THE MLKCH OUTREACH TEAM RE-LAUNCHED IN 2022 PROVIDING AROUND 200 SCREENINGS TO MEN IN THE COMMUNITY.TO SUPPORT OUR PATIENTS WHO EXPERIENCE BOTH CHRONIC CONDITIONS AND FOOD INSECURITY, THE HOSPITAL AND THE MLK COMMUNITY MEDICAL FOUNDATION LAUNCHED A FOOD PRESCRIPTION PROGRAM IN 2019. RECIPE FOR HEALTH OFFERS THE PATIENT A WEEKLY SUPPLY OF FRESH FRUITS AND VEGETABLES, ALONG WITH COOKING AND NUTRITION CLASSES THAT HELP PATIENTS LEARN HOW FOOD CHOICES CAN IMPROVE THEIR HEALTH. FAMILY MEMBERS OFTEN BENEFIT ALONG WITH THE PATIENT, BUILDING HEALTHY HABITS ACROSS GENERATIONS. SINCE ITS LAUNCH IN MARCH 2019, THE RECIPE FOR HEALTH TEAM HAS ENROLLED OVER 760 PARTICIPANTS AND PROVIDED OVER 7,500 FRESH PRODUCE PACKAGES TO PARTICIPANTS AND THEIR FAMILIES. DESPITE THE EMERGENCE OF THE COVID CRISIS, THE PROGRAM CONTINUED TO SHOW SIGNIFICANT IMPROVEMENTS FOR PARTICIPANTS. IMPROVEMENTS IN HEALTH ARE CONTINUING TO BE REPORTED AND WILL CONTINUE TO BE EVALUATED FOR IMPACT IN FY 2023.TO IMPROVE ACCESS TO EDUCATION FOR MOTHERS AND TO EXTEND MATERNAL BEST PRACTICES, OUR PERINATAL TEAM HOSTS COMMUNITY PROGRAMS FOR NEW AND EXPECTANT MOTHERS: THE FIRST 48 HOURS CLASS AND THE MOMMY SUPPORT GROUP. FIRST 48 HOURS TEACHES COMMUNITY MEMBERS WHAT TO EXPECT IN THE FIRST DAYS AFTER DELIVERY. THE FREE COURSE INCLUDES INFORMATION ON TESTING, IMMUNIZATIONS, CHANGES TO THE MOTHER'S BODY, AND BREASTFEEDING EDUCATION. THE MOMMY GROUP IS A FREE COMMUNITY PEER SUPPORT GROUP. TOPICS ARE EXTENSIVE AND INCLUDE FEEDING CHECKS FOR BABY, A HEALTHY DIET FOR MOM, STAGES OF BREASTFEEDING, PUMPING, AND RETURNING TO WORK AND SCHOOL WHILE BREASTFEEDING. THE TEAM PROVIDED EDUCATIONA ND SUPPORT TO OVER 40 NEW MOMS AND CONTINUES TO EXPAND ITS REACH EVERY YEAR. A RESULT OF THIS EXPANSION INCLUDES THE COMMUNITY LACTATION OUTPATIENT CLINIC THAT MLKCH LAUNCH THAT PAST 2022.A SIGNIFICANT NUMBER OF MLKCH PATIENTS EXPERIENCE BEHAVIORAL HEALTH CHALLENGES, OFTEN IN COMBINATION WITH CHRONIC HEALTH CONDITIONS. IN RESPONSE, THIS PAST YEAR MLKCH BUILT UPON AN INNOVATIVE DESIGN FOR THE TREATMENT OF MENTAL HEALTH, PHYSICAL HEALTH AND SUBSTANCE USE DISORDERS. THE INTEGRATED BEHAVIORAL HEALTH (IBH) PROGRAM OFFERED ASSESSMENT AT THE FIRST POINT OF PATIENT CONTACT, ESTABLISHING POTENTIAL LINKS BETWEEN A CHRONIC MEDICAL CONDITION AND A BEHAVIORAL HEALTH CONCERN. THIS ALLOWED FOR THE EARLY INTERVENTION OF A BEHAVIORAL HEALTH TEAM WHO CAN THEN FOLLOW THE PATIENT FROM INPATIENT CARE TO APPROPRIATE LONG-TERM CARE SUPPORT IN AN OUTPATIENT SETTING. THROUGH THIS PROGRAM, 1,036 PATIENTS WERE REFERRED TO BEHAVIORAL HEALTH SERVICES AND 442 PATIENTS WERE REFERRED TO OUTPATIENT DOCTORS OR OTHER TREATMENT PROGRAMS.ALMOST A QUARTER OF OUR COMMUNITY MEMBERS WHO ARE EXPERIENCING HOMELESSNESS HAVE AT LEAST ONE OR MORE POORLY MANAGED HEALTH CONDITIONS. THROUGH OUR HOMELESS SERVICES, OUTREACH, AND SUPPORT TEAM WE PROVIDED SUPPORT TO IMPROVE THEIR ACCESS TO HEALTH CARE, HOUSING, AND OFFERED OTHER SOCIAL SERVICES FOR BASIC NEEDS (CLOTHING, TRANSPORTATION, MEDICATION, AND TOILETIRES) SO THEY CAN BETTER MANAGE AND STABILIZE THEIR HEALTH.PROGRAMS SUCH AS THESE ARE CONTINUOUSLY BEING EVALUATED FOR ITS EFFECTIVENESS TO ADDRESS THE OVERALL HEALTH OF THE MLKCH POPULATION. THE FOLLOWING 2023 CHNA WILL CONTINUE TO EVOLVE THESE PROGRAMS AND IDENTIFY OTHER AREAS OF OPPORTUNITY TO ADDRESS FOR FURTHER IMPACT.

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MLKCH'S SERVICE AREA IS DEFINED AS THE GEOGRAPHIC REGION CONSISTING OF SERVICE PLANNING AREA (SPA) 6, AS WELL AS THOSE ZIP CODES LOCATED WITHIN A THREE-MILE RADIUS FROM THE HOSPITAL FACILITY. THE TOTAL POPULATION WITHIN THE MLKCH SERVICE AREA IS ESTIMATED TO BE 1,314,330. THE MAJORITY OF THE SERVICE AREA RESIDENTS LIVE IN LOS ANGELES (60.6%), WITH THE REMAINING 39.4% LIVING IN COMPTON AND SURROUNDING COMMUNITIES. WITHIN MLKCH'S SERVICE AREA, 48.8% OF THE SERVICE AREA'S POPULATION IS MALE, AND 51.2% IS FEMALE. WHILE THE SERVICE AREA POPULATION IS RELATIVELY YOUNGER COMPARED TO THAT OF THE COUNTY (68% OF THE POPULATION IS AGED 0-44 COMPARED TO THAT OF THE COUNTY AT 60%), THE NUMBER OF RESIDENTS 65 YEARS OLD OR GREATER IS PROJECTED TO GROW THE FASTES (17.4% INCREASE OVER THE NEXT FIVE YEARS). THE AGE COHORT 15 TO 44 YEARS REPRESENTS 45.3% OF THE COMMUNITY'S TOTAL POPULATION. THE POPULATION AGE COHORT 0 TO 14 YEARS REPRESENTS 22.7% OF THE TOTAL SERVICE AREA POPULATION.OVERALL, MLKCH'S SERVICE AREA IS PRIMARILY HISPANIC/LATINO (72.2%); 20.7% IS AFRICAN AMERICAN; 2.9% OF THE RESIDENTS ARE NATIVE HAWAIIAN/ASIAN PACIFIC ISLANDER; 2.5% ARE WHITE; AND 1.6% ARE AMERICAN INDIAN/ALASKAN/NATIVE, AND OTHER RACE OR MULTIPLE RACE/ETHNICITY COMBINED. WITHIN THE SERVICE AREA, NEARLY HALF OF THE COMMUNITY HAS IDENTIFIED SPANISH AS THEIR PRIMARY LANGUAGE. WITHIN THE SERVICE AREA, THE MEDIAN AND AVERAGE HOUSEHOLD INCOMES ARE LOWER THAN THAT OF LOS ANGELES COUNTY. ADDITIONALLY, THE MLKCH COMMUNITY HAS A HIGHER RATE OF POVERTY WHEN COMPARED TO LOS ANGELES AND THE STATE OF CALIFORNIA OVERALL, WITH ALMOST A THIRD (21.5%) OF THE POPULATION AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (17.3% FOR LOS ANGELES COUNTY). FURTHER, EACH OF THE CITIES THAT COMPRISE MLKCH'S SERVICE AREA HAVE UNEMPLOYMENT RATES THAT EXCEED THAT FOR THE COUNTY AND STATE OVERALL. A HIGH PROPORTION OF THE COMMUNITY QUALIFIES FOR PUBLIC ASSISTANCE PROGRAMS AND INCOME ASSISTANCE WHEN COMPARED TO LOS ANGELES AND THE STATE OVERALL. THESE TRENDS ARE DIRECTLY RELATED TO THE DISPROPORTIONATELY HIGHER UNEMPLOYMENT AND POVERTY RATES, AND LOWER HOUSEHOLD INCOMES IN MLKCH'S COMMUNITY. IN REGARDS TO EDUCATION, 39.0% OF MLKCH'S COMMUNITY RESIDENTS AGE 25 YEARS OR OLDER DO NOT HAVE A HIGH SCHOOL DIPLOMA, COMPARED TO 21.0% FOR LOS ANGELES COUNTY OVERALL. FURTHER, ONLY 11.6% OF AREA RESIDENTS HAVE EARNED A BACHELOR'S DEGREE.WITHIN MLKCH'S SERVICE AREA, 71.5% OF ADULTS PERCEIVE THEIR NEIGHBORHOODS TO BE SAFE, THE LOWEST PERCEIVED NEIGHBORHOOD SAFETY OF ALL SERVICE PLANNING AREAS IN LOS ANGELES COUNTY (85.0% FOR LOS ANGELES COUNTY OVERALL). ADDITIONALLY, PORTIONS OF THE SERVICE AREA ALSO HAVE HIGHER RATES OF PROPERTY AND VIOLENT CRIMES WHEN COMPARED TO THE COUNTY AND STATE OVERALL. HIGH RATES OF PROPERTY AND VIOLENT CRIMES IN A COMMUNITY COMPROMISE INDIVIDUALS' PHYSICAL SAFETY, AND ARE DETRIMENTAL TO OVERALL MENTAL HEALTH, AND DETER RESIDENTS FROM PURSUING HEALTHY BEHAVIORS (E.G. WALKING OUTDOORS) FROM FEAR OF HARM.