4A (Expenses $ 232821210 including grants of $ 0) (Revenue $ 397914535)
Parkview Medical Center is licensed for 350 beds and provides a full range of healthcare services including the region's most experienced certified level II trauma center and the region's first certified Stroke Center. See Schedule O for continuation.

4B (Expenses $ 21079888 including grants of $ 0) (Revenue $ 42856021)
PARKVIEW MEDICAL CENTER's, 66 BED EMERGENCY DEPARTMENT TREATS A VARIETY OF MEDICAL CONDITIONS, RANGING FROM MINOR CUTS AND ILLNESSES TO LIFE THREATENING INJURIES. THE REGIONAL EMERGENCY/TRAUMA DEPARTMENT HAD 75,037 PATIENT VISITS THIS YEAR, AND SERVES RESIDENTS FROM SOUTHEASTERN COLORADO TO NORTHERN NEW MEXICO AND WESTERN KANSAS. SEE SCHEDULE O FOR CONTINUATION.

4C (Expenses $ 60638533 including grants of $ 0) (Revenue $ 113176166)
SURGICAL SERVICES AT PARKVIEW MEDICAL CENTER TREATED 4,135 INPATIENTS THIS YEAR. THE SURGEONS THAT PERFORM THE PROCEDURES REPRESENT MANY SPECIALTIES, INCLUDING GENERAL SURGERY, CARDIOTHORACIC, VASCULAR, ONCOLOGY, UROLOGY, GYNECLOLGIC, ORTHOPAEDIC, NEUROSURGICAL, PEDIATIRCS, OPHTHALMOLOGIC, ENDOSCOPY, EAR, NOSE & THROAT AND PLASTIC. THE SURGEONS AT PARKVIEW MEDICAL CENTER HAVE ACCESS TO LEADING-EDGE TECHNOLOGY AND EQUIPMENT, INCLUDING MINIMALLY INVASIVE SURGICAL PROCEDURES.

PART V, SECTION B, LINE 5
Parkview Medical Center (PMC) developed a strategic plan to improve the health of Pueblo County residents. The PMC Community Health Needs Assessment (CHNA) involved residents of Southern Colorado, using an online social media platform and a standard paper/pencil questionnaire to gather input from all areas of the community. The assessment is designed to identify needs and create objectives and action plans to be utilized by PMC to improve the health of the Pueblo and Southern Colorado community. The CHNA works in conjunction with the annual Parkview Community Benefits and Implementation Report and the annual Hospital Community Benefit Accountability. The process for the PMC CHNA was initialized by the Patient Protection and Affordable Care Act (ACA). The implementation of the CHNA involved collecting data, evaluating the data to determine the needs of the residents and area, and then establishing objectives to meet the greatest identified need of the community. PMC wants to make an impact in the community by working with other agencies to provide the best preventative practices. After extensive data gathering and feedback from the Pueblo and Southern Colorado community, in 2021- 2023 PMC will be focusing on access to healthcare as a social determinate of health. Specifically, the connection between people's access to and understanding of health services and their own health. In July of 2021, PMC hosted 6 small videos related to preventable care, healthy eating, physical activity, and alcohol and other drug use. Additionally, PMC integrated the Transitional Care Center and Online Patient Education Platform for online access to healthcare needs. Upon launching online healthcare access, PMC released QR codes to share created health topic videos with patients. In January 2022, PMC integrated access to the Online Patient Education Platform beyond on-line services for patients to experience during in-patient stays and through their established patient portal account.

PART V, SECTION B, LINE 6A
THE NEEDS ASSESSMENT WAS CONDUCTED WITH PUEBLO WEST EMERGENCY SERVICES. Part V, Section B, Line 6B In preparation for the 2021 needs assessment, PMC partnered with the Pueblo City-County Health Department and over 30 local organizations who worked together on a common goal to identify the greatest needs of the county. These include: A Caring Pregnancy Center ACOVA American Medical Response AMR American Red Cross Catholic Charities Chamber of Commerce City Parks and Recreation City of Pueblo Colorado Bluesky Colorado State University- Pueblo Cooperative Care Center County of Pueblo Crossroads Turning Points CSU Extension El Centro de los Pobres Health Solutions Junior Achievement La Leche League Posada Pueblo Alliance for Healthy Teens Pueblo Care and Share Food Bank of Southern Colorado Pueblo City School District 60 Pueblo Department of Pueblo Health and Environment Pueblo City Police Department Pueblo Community Health Center Pueblo Cooperative Care Center Pueblo County Department of Human Services Pueblo County Sheriffs Department Pueblo Fire Department Pueblo Latino Chamber of Commerce Pueblo Rescue Mission Pueblo School District 70 Pueblo StepUp Pueblo Triple Aim Corporation Saint Mary-Corwin - Centura Health Senior Resource Development Agency SRDA The Greater Pueblo Chamber of Commerce United Way of Pueblo County YMCA of Pueblo YWCA

PART V, SECTION B, LINE 11
Parkview Medical Center's primary focus for 2021-2023 will be the implementation of the Online Patient Education Platform. The Online Patient Education Platform will be implemented to utilize short pre-recorded and live health topic videos for residents of Southern Colorado, to engage and promote healthy behaviors and meet people where they are using up-to-date technology in real time. This platform will provide educational videos on preventable care, healthy eating, activity, alcohol and other drug use. They will integrate the Transitional Care Center and Online Patient Education Platform to provide follow-up contact with discharged patients and provide video links with specific health-related topic information. PART V, SECTION B, LINE 13B, PARKVIEW MEDICAL CENTER The hospital determines discounted care for individuals who have failed to meet the requirements for eligibility with either Colorado Medicaid or Colorado Indigent Care Program (CICP) and prove to be actively working with the Parkview Medical Center financial services staff to resolve any or all accounts receivable account balances.

PART V, SECTION B, LINE 13H, PARKVIEW MEDICAL CENTER
Patient receiving financial assistance will be required to undergo means testing in order to establish eligibility: A. Fail to meet the requirements for eligibility with either Colorado Medicaid or Colorado Indigent Care Program (CICP). B. Prove an inability to meet hospital financing options, which include hospital financed payment plans at 12 months or bank financed loans for longer periods. C. Have income above but not limited to the maximum thresholds for CICP (300% of the federal poverty guidelines) and prove an inability to develop a payment plan. D. Prove to be actively working with the Parkview Medical Center financial services staff to resolve any or all accounts receivable account balances.

PART V, SECTION B, LINE 13H, PUEBLO WEST EMERGENCY SERVICES
Patient receiving financial assistance will be required to undergo means testing in order to establish eligibility: A. Fail to meet the requirements for eligibility with either Colorado Medicaid or Colorado Indigent Care Program (CICP). B. Prove an inability to meet hospital financing options, which include hospital financed payment plans at 12 months or bank financed loans for longer periods. C. Have income above but not limited to the maximum thresholds for CICP (300% of the federal poverty guidelines) and prove an inability to develop a payment plan. D. Prove to be actively working with the Parkview Medical Center financial services staff to resolve any or all accounts receivable account balances.

PART V, SECTION B, LINE 22B, PARKVIEW MEDICAL CENTER
IN JANUARY, PARKVIEW WILL USE THE IRS LOOK BACK METHOD FOR AGB DETERMINATION. THIS WILL BE ACCOMPLISHED BY TAKING AN AGGREGATED AVERAGE OF ALL MEDICARE, MEDICAID AND CONTRACTED PAYER CLAIMS FROM THE PREVIOUS 12 MONTHS. SEE IRS CODE 501 (R) PUBLISHED DECEMBER 29, 2014.

PART V, SECTION B, LINE 22B, PUEBLO WEST EMERGENCY SERVICES
IN JANUARY, PARKVIEW WILL USE THE IRS LOOK BACK METHOD FOR AGB DETERMINATION. THIS WILL BE ACCOMPLISHED BY TAKING AN AGGREGATED AVERAGE OF ALL MEDICARE, MEDICAID AND CONTRACTED PAYER CLAIMS FROM THE PREVIOUS 12 MONTHS. SEE IRS CODE 501 (R) PUBLISHED DECEMBER 29, 2014.

PART V, SECTION B, LINE 16A
FAP AVAILABLE ON THE WEBSITE: http://www.parkviewmc.com/financial-assistance/

PART V, SECTION B, LINE 16B
FAP AVAILABLE ON THE WEBSITE: http://www.parkviewmc.com/financial-assistance/

PART V, SECTION B, LINE 16C
PLAN LANGUAGE SUMMARY IS AVAILABLE ON THE WEBSITE: http://www.parkviewmc.com/financial-assistance/

PART V, SEC B LIne 7a & 10a - Website of Community Health Needs Assessment
HOSPITAL FACILITY'S WEBSITE for Community Health Needs assessment and Implementation Strategy: https://www.parkviewmc.com/communityeducation/community-health-needs-asses ment/

PART V, SECTION B, LINE 18
EACH PATIENT WILL RECEIVE NOTIFICATION OF THE FAP PRIOR TO ANY EXTRAORDINARY COLLECTION ACTIONS. MEDICAL CENTER IS GIVEN 120-DAY PERIOD IN WHICH TO NOTIFY THE PATIENT OF FINANCIAL ASSISTANCE POLICY PRIOR TO TAKING ANY EXTRAORDINARY ACTION. PMC'S COLLECTION ACTIONS ARE BUT NOT LIMITED TO 3 PATIENT STATEMENTS, 1-2 PHONE CALL ATTEMPTS, 1 FINAL NOTICE LETTER AND PLACEMENT WITH A COLLECTION AGENCY. THE ONLY EXTRAORDINARY COLLECITON ACTIONS THAT THE MEDICAL CENTER ALLOWS IS CREDIT REPORTING AND SEEKING JUDGEMENT FOR WAGE GARNISHMENT.

PART I, LINE 7
The methodology used to calculate the amounts reported on, Part 1, line 7, is a cost accounting system. This cost accounting system addresses all patient segments. The figures reported on the table, line 7, used the cost-to charge ratio that was calculated from the Internal Revenue Services, Ratio of Patient Care Cost-to Charges as found in the instructions for Schedule H, Form 990. PART I, LINE 7, column (f) Bad debt expense in the amount of 39,125,087 is included on Form 990, Part IX, line 25, but is subtracted for purposes of calculating the percentages in this column.

PART II, LINE 8
PARKVIEW MEDICAL CENTER PROMOTES WORKFORCE DEVELOPMENT BY RECRUITING PHYSICIANS BASED ON COMMUNITY NEEDS ASSESSMENTS FOR CERTAIN MEDICAL SPECIALTIES. PHYSICIANS ARE RECRUITED TO RELOCATE TO PUEBLO AS EITHER AN EMPLOYEE OF THE MEDICAL CENTER OR TO ESTABLISH A MEDICAL PRACTICE IN PUEBLO. THE PHYSICIANS RECIEVE PAYMENTS FOR RELOCATION EXPENSES AND INCOME GUARANTEES, IN EXCHANGE FOR PRACTICING IN THE PUEBLO AREA FOR A SET NUMBER OF YEARS.

PART III, LINE 4
The Medical Center grants equal access to health care services to all members of its community regardless of financial status. The Medical Center attempts to maximize net patient service revenue by qualifying indigent patients for state funded programs. It is the Medical Center's policy to bill for, and pursue collection of, all services rendered. At the point in time that a charge is believed to be uncollectible, the related receivable is written off. Annual provisions are made for estimated uncompensated services, which include bad debts and other uncollectible amounts. The medical center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Medical Center does not pursue collection of amounts determinded to qualify as charity care, they are not reported as revenue. The cost methodology used in determining the amounts reported as bad debt expense is using a cost-to charges ratio. The amount of bad debts attributabe to patient accounts is multiplied by the ratio of patient care cost to charges to calculate the estimated cost of bad debts attributable to patient accounts.

PART III, LINE 8
REVENUES FROM THE MEDICARE PROGRAM ACCOUNTED FOR APPROXIMATELY 30% OF THE MEDICAL CENTER'S NET PATIENT SERVICES REVENUE FOR THE YEAR ENDED JUNE 30, 2022. THE MEDICARE SHORTFALL MAKES UP A LARGE PORTION OF UNCOMPENSATED CARE. UNCOMPENSATED CARE IS PART OF FULFILLING THE MEDICAL CENTER'S COMMUNITY MISSION TO PROVIDED QUALITY HEALTHCARE SERVICES THAT IMPROVE THE HEALTH OF THE COMMUNITY. MEDICARE COSTS WERE CALCULATED FROM THE MEDICARE COST REPORT FOR THE FYE JUNE 30, 2022. THE MEDICARE COST REPORT UTILIZES THE COST TO CHARGE RATIOS BY DEPARTMENT AT THE MEDICAL CENTER TO THE MEDICARE REVENUE FOR THE DEPARTMENT. THEY ALSO CALCULATED UTILIZING THE COST REPORT MEDICARE COSTS RELATED TO PHYSICIAN SERVICES THAT ARE BILLED TO THE MEDICARE PART B PROGRAM AND CHARGES ARE NOT PART OF THE MEDICARE COST REPORT. IN THIS INSTANCE THERE IS NOT A COST OF CHARGE RATIO.

PART III, LINE 9B
The Medical Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. The Medical Center does not pursue collection of amounts determined to qualify as charity care.

PART VI, LINE 2
Parkview Medical Center reviews county-level data from hospital admissions, as well as the Colorado Department of Public Health and Environment, collaborates with local public health and physicians, and solicits input from community agencies/community members via networks and events in order to better understand disease states and address gaps in education/service delivery.

PART VI, LINE 3
THE MEDICAL CENTER EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S DISCOUNT POLICY UPON ADMISSION OR PRIOR TO DISMISSAL. PATIENTS ARE ENCOURAGED TO APPLY FOR MEDICAID, COLORADO INDIGENT CARE PROGRAM OR PARKVIEW MEDICAL CENTERS DISCOUNTS IF THEY ARE WITHOUT RESOURCES. THE CREDIT/COLLECTION DEPARTMENT OR FINANCIAL COUNSELOR MAY REVIEW WITH THE PATIENT OR GUARANTOR ANY ACCOUNT WHERE THERE IS PARTIAL OR NO INSURANCE COVERAGE.

PART VI, LINE 4
Parkview Medical Center provides acute and behavioral health services in Pueblo and 14 surrounding counties. As a private, non-profit organization, Parkview is licensed for 350 acute beds and provides a full range of healthcare services including the region's only certified and verified Level II Trauma Center and the region's first certified Stroke Center. The zip codes of Pueblo County that make up the primary use of PMC services are 81001, 81002, 81003, 81004, 81005, 81006, 81007 and 81008. PMC sees on average 1,400 inpatients each month, with approximately 80 percent being Pueblo County residents and the remaining 20 percent of patients are from outlying Southern Colorado counties and beyond. The largest populated area is Pueblo County with a population of 168,424. The majority of the population lives in the City of Pueblo. However, there are several rural areas known as St. Charles Mesa, Avondale, Boone, Colorado City, Rye, and Beulah The population demographics in Pueblo County includes 76.3 percent White alone, 13.4 percent black or African American, 1.3 percent American Indian and Alaska Native, 5.9 percent Asian, 18.5 percent Hispanic or Latino, and 60.1 percent White non Hispanic or Latino, 42.2 percent White non-Hispanic, 52.6 percent Hispanic or Latino, 2.1 percent Black, 0.5 percent American Indian/Alaskan Native and 0.8 percent are Asian. Pueblo County school districts report a high school completion rate of 92.2 percent, which is higher than the Colorado average (80.3percent). Pueblo County has seen a 24.8 percent increase in employment from 2017 to 2018. Health care and social assistance are the leading industries.

PART VI, LINE 5
PARKVIEW MEDICAL CENTER houses a marketing outreach, parkview mobile nurses Department, whose mission is to promote the health and well-being of Pueblo and southeastern Colorado communities though a variety of programs and services that reach across the life span. Educational Initiatives are created in an effort to effect change though: -Establishing collaborative partnerships within the community -Promoting health and well-being -Serving as a liaison on behalf of Parkview Medical Center throughout the business, provider, and educational sectors -Providing opportunities to students of all ages interested in pursuing healthcare careers - step program -Advocating healthy lifestyles Education is provided on injury prevention/safety, women's health concerns, clinical screenings, and worksite health/wellness. On average, the department provides direct educational services to over 10,000 individuals each year PARKVIEW MEDICAL CENTER'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE PUEBLO, COLORADO AREA. THE MAJORITY OF THE ORGANIZATION'S BOARD MEMBERS ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE MEDICAL CENTER. THE BOARD OF DIRECTORS IS MADE UP MOSTLY OF COMMUNITY BUSINESS PEOPLE INTERESTED IN MAINTAINING QUALITY HEALTH CARE IN PUEBLO. THE MEDICAL CENTER EXTENDS MEDICAL STAFF PRIVILDGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR MOST DEPARTMENTS. THE MEDICAL Center ALSO ACTIVELY RECRUITS AND ENCOURAGES RELOCATION OF PHYSICIANS TO PUEBLO, COLORADO. PARKVIEW MEDICAL CENTER IS THE LARGEST NON-GOVERNMENT, NONPROFIT PRIVATE SECTOR EMPLOYER IN PUEBLO COUNTY. THE WORKFORCE OF THE MEDICAL CENTER HAS A STRONG IMPACT ON THE COMMUNITY THE ANNUAL PAYROLL CONTRIBUTES MILLIONS TO THE ECONOMY. THE MEDICAL CENTER IS ONE OF THE LARGEST PROPERTY TAX PAYERS IN PUEBLO, AS THE MEDICAL CENTER PAYS PROPERTY TAXES ON ALL OF THE MEDICAL OFFICE BUILDINGS FUNDS REMAINING AFTER EXPENSES ARE REINVESTED IN EQUIPMENT AND BUILDINGS TO MAINTAIN A STATE-OF-THE-ART FACILITY THAT DELIVERS HIGH QUALITY HEALTHCARE. THE MEDICAL CENTER IS CONSTANTLY SEEKING NEW TECHNOLOGY AND SERVICES THAT ARE NEEDED IN THE REGION. PARKVIEW MEDICAL CENTER HAS A STRONG SENSE OF OWNERSHIP IN THE COMMUNITY AND IS COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR THE RESIDENTS OF PUEBLO AND SOUTHEASTERN COLORADO.

PART VI, LINE 6
PARKVIEW HEALTH SYSTEM, INC. IS A NONPROFIT CORPORATION THAT CONTROLS AND IS THE SOLE OWNER OF PARKVIEW MEDICAL CENTER, PARKVIEW FOUNDATION, PARKVIEW ANCILLARY SERVICES CORPORATION AND PUEBLO HEALTH CARE. PARKVIEW MEDICAL CENTER IS INCORPORATED IN COLORADO AS A COLORADO NONPROFIT CORPORATION FOR THE PURPOSE OF CONDUCTING THE DAY-TO-DAY OPERATION OF THE HOSPITAL FACILITIES. THE MEDICAL CENTER OFFERS ACUTE HEALTHCARE AND BEHAVIORAL MEDICINE SPECIALTY SERVICES. PARKVIEW FOUNDATION IS A COLORADO NONPROFIT CORPORATION. THE FOUNDATION IS ORGANIZED TO SUPPORT THE HEALTH SYSTEM AND TO PROMOTE ITS FISCAL AND PUBLIC STATURE. THE FOUNDATION IS RESPONSIBLE FOR SOLICITING, PRESERVING AND MONITORING THE FUNDS IT GENERATES FOR THE MEDICAL PARKVIEW ANCILARY SERVICE CORPORATION IS A SINGLE MEMBER LLC AND IS CONTROLLED BY PARKVIEW HEALTH SYSTEMS, INC. IT OPERATES TO SUPPORT THE ACTIVITIES OF THE HEALTH SYSTEM THROUGH PHYSICIAN PRACTICE OPERATIONS. PUEBLO HEALTH CARE IS A FOR-PROFIT CORPORATION. PUEBLO HEALTH CARE PROVIDES THE PHYSICIAN PARTNERS WITH SERVICE AND SUPPORT FOR PHYSICIAN CONTRACTING AND ADMISTRATIVE DUTIES.