4A (Expenses $ 976192546 including grants of $ 2063730) (Revenue $ 995823004)
SEE SCHEDULE O

LUTHERAN MEDICAL CENTER
"PART V, SECTION B, LINE 5: LUTHERAN MEDICAL CENTER PARTICIPATED IN A COLLABORATIVE PROCESS TO CONDUCT THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), ALONG WITH JEFFERSON COUNTY PUBLIC HEALTH AND ST. ANTHONY HOSPITAL (CENTURA). A NUMBER OF COMMUNITY BASED ORGANIZATIONS WERE INVOLVED IN THE PROCESS AS WELL.COMMUNITY SURVEYTHE 2021 PUBLIC HEALTH PARTNERSHIP COMMUNITY HEALTH AND WELLBEING SURVEY GATHERED THE OPINIONS OF RESIDENTS IN JEFFERSON, CLEAR CREEK AND GILPIN COUNTIES. DEVELOPING THE QUESTIONNAIRE WAS A COLLABORATIVE EFFORT BETWEEN POLCO STAFF AND STAKEHOLDERS FROM JEFFERSON COUNTY PUBLIC HEALTH (JCPH), WITH INPUT FROM MOUNTAIN YOUTH NETWORK, CLEAR CREEK COUNTY PUBLIC AND ENVIRONMENTAL HEALTH, GILPIN COUNTY PUBLIC HEALTH, AND OTHER HEALTH STAKEHOLDERS WITHIN JEFFERSON COUNTY. THIS SURVEY WAS IMPLEMENTED IN MAY THROUGH JULY 2021. A TOTAL OF 8,400 HOUSEHOLDS WERE RANDOMLY SELECTED TO RECEIVE MAILED INVITATIONS TO COMPLETE AN ONLINE SURVEY AND/OR TO COMPLETE AND MAIL BACK A PAPER SURVEY. HOUSEHOLDS WERE SELECTED RANDOMLY FROM A USPS LIST OF HOUSEHOLDS IN THE THREE COUNTIES AND STRATIFIED BY MAJOR CITIES WITHIN THE COUNTIES. USPS LISTS ARE BEST FOR ENSURING ALL HOUSEHOLDS IN A GIVEN AREA ARE INCLUDED IN THE SAMPLING FRAME AND THEREFORE HAVE AN EQUAL CHANCE OF BEING SELECTED TO PARTICIPATE. THE SURVEYS AND MAILED INVITATIONS WERE ALSO TRANSLATED INTO SPANISH. THE JCPH AND PARTNERS WERE PROVIDED A SEPARATE URL TO SHARE AN INVITATION TO AN ""OPEN PARTICIPATION"" SURVEY, WHERE ALL RESIDENTS WHO RECEIVED NOTICE THROUGH SOCIAL MEDIA OR OTHER COMMUNICATION CHANNELS COULD COMPLETE THE SURVEY. A TOTAL OF 486 COMPLETED THE RANDOM SAMPLE SURVEY (1 IN SPANISH) FOR A RESPONSE RATE OF 7% AND AN OVERALL MARGIN OF ERROR OF 5%. ADDITIONALLY, 503 COMPLETED THE OPEN PARTICIPATION SURVEY (3 IN SPANISH). THE RESULTS FROM THESE TWO EFFORTS WERE STATISTICALLY COMPARED AND THE TWO DATA SETS WERE COMBINED FOR ANALYSIS. THE RESULTS OF EACH EFFORT WERE WEIGHTED TO REFLECT THE DEMOGRAPHIC PROFILE OF EACH OF THE SUB-GEOGRAPHIES WITHIN EACH COUNTY THAT WERE INCLUDED IN THE STUDY, AND THEN WEIGHTED TO REFLECT THEIR PROPORTION OF THE POPULATION IN THE COUNTY AND THE REGION OVERALL."

GOOD SAMARITAN MEDICAL CENTER
PART V, SECTION B, LINE 5: GOOD SAMARITAN MEDICAL CENTER (GSMC) IS AN ACUTE-CARE HOSPITAL LOCATED IN THE CITY OF LAFAYETTE, COLORADO AND WHILE LAFAYETTE IS SITUATED IN BOULDER COUNTY, THE HOSPITAL SERVICE AREA INCLUDES COMMUNITIES IN BOULDER, BROOMFIELD, ADAMS, JEFFERSON, GILPIN AND WELD COUNTIES. WE ARE COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY. IN SO DOING, GSMC WORKED CLOSELY WITH COMMUNITY PARTNERS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2021. THE GOAL FOR THE CHNA WAS TO DETERMINE CURRENT AND PROJECTED FUTURE HEALTH CARE NEEDS IN THE GSMC PRIMARY COMMITMENT AREA AND TO IDENTIFY GAPS IN SERVICES TO IMPROVE THE HEALTH OF OUR COMMUNITY. WE UTILIZED FOUR METHODS OF COLLECTING PRIMARY DATA: COMMUNITY LEADER PRIORITIZATION MEETINGS; PUBLIC INPUT AT COMMUNITY EVENTS; ONLINE COMMUNITY SURVEYS; AND KEY INFORMANT PHONE SURVEYS.COMMUNITY LEADER PRIORITIZATION MEETINGSHOSPITAL LEADERS, DEPARTMENTAL REPRESENTATIVES, AND LEADERS FROM THE COMMUNITY MET ON JULY 6, 2021, TO DISCUSS AND PRIORITIZE THE SIGNIFICANT NEEDS. THE MEETING WAS A HYBRID OF IN-PERSON AND VIRTUAL PARTICIPATION USING GOOGLE MEET. THE GROUP RECEIVED A SUMMARY OF THE SECONDARY DATA RESULTS. FOLLOWING THE PRESENTATION, ATTENDEES MET IN SMALL GROUPS TO DISCUSS THE 13 COMMUNITY NEEDS. AFTER THE SMALL GROUP DISCUSSIONS, THEY WERE ASKED TO INDIVIDUALLY PRIORITIZE THE TOP SIX ISSUES IN THE GOOD SAMARITAN MEDICAL CENTER SERVICE AREA. THE PARTICIPANTS IN THE ROOM WERE GIVEN FIVE VOTING DOTS AND ASKED TO PLACE A DOT NEXT TO FIVE ISSUES OF GREATEST IMPORTANCE. EACH DOT REPRESENTED ONE POINT. PARTICIPANTS WHO JOINED VIRTUALLY SUBMITTED THEIR TOP FIVE ISSUES IN THE GOOGLE MEET CHAT. AFTER EVERYONE VOTED, THE VOTES WERE TALLIED UP. THE SIX ISSUES WITH THE MOST POINTS BECAME THE TOP SIX PRIORITY NEEDS.A SECOND ROUND OF PRIORITIZATION TO INCORPORATE PRIMARY DATA COLLECTED, CONSISTED OF HOSPITAL LEADERS, DEPARTMENTAL REPRESENTATIVES, AND LEADERS FROM THE COMMUNITY. THE MEETING OCCURRED ON SEPTEMBER 13, 2021 TO DETERMINE THE PRIORITY NEEDS TO ADDRESS FOR THE NEXT THREE YEARS. THE MEETING WAS A HYBRID OF IN-PERSON AND VIRTUAL PARTICIPANTS USING GOOGLE MEET. THE GROUP RECEIVED A SUMMARY OF THE PRIMARY DATA COLLECTED FROM KEY INFORMANT PHONE INTERVIEWS, PUBLIC INPUT FROM COMMUNITY EVENTS, AND OPINIONS COLLECTED FROM A COMMUNITY ONLINE SURVEY. FOLLOWING THE PRESENTATION, THE ATTENDEES WERE GIVEN TIME TO DISCUSS THE SIX ISSUES AND WERE ASKED TO INDIVIDUALLY PRIORITIZE THE TOP TWO ISSUES IN THE GOOD SAMARITAN MEDICAL CENTER SURROUNDING AREA. THE PARTICIPANTS THAT WERE IN THE ROOM WERE ASKED TO RANK THEIR NUMBER ONE AND NUMBER TWO ISSUES FOR THE COMMUNITY. THE NUMBER ONE ISSUE WAS GIVEN TWO POINTS AND THE NUMBER TWO ISSUE WAS GIVEN ONE POINT. PEOPLE WHO JOINED VIRTUALLY SUBMITTED THEIR TOP TWO ISSUES, IN ORDER, IN THE GOOGLE MEET CHAT.ORGANIZATIONS THAT TOOK PART IN THESE MEETINGS INCLUDED: LAFAYETTE AND BROOMFIELD SENIOR CENTER, BROOMFIELD FISH, BOULDER VALLEY SCHOOL DISTRICT, VIA MOBILITY, BOULDER COUNTY PUBLIC HEALTH, TRU COMMUNITY CARE, MENTAL HEALTH PARTNERS, BROOMFIELD COUNTY PUBLIC HEALTH, CLINICA FAMILY HEALTH CENTER, SISTER CARMEN COMMUNITY CENTER, AND BOULDER COUNTY AREA AGENCY ON AGING.PUBLIC INPUT AT COMMUNITY EVENTS GOOD SAMARITAN MEDICAL CENTER ENGAGED COMMUNITY MEMBERS AT TWO EVENTS TO FURTHER DISCUSS AND PRIORITIZE THE NEEDS. THE FIRST COMMUNITY EVENT WAS HELD ON AUGUST 5, 2021, AT THE ADAMS COUNTY SENIOR RESOURCE FAIR AND ENGAGED 45 PEOPLE. THE SECOND EVENT WAS AUGUST 21, 2021, AT THE LAFAYETTE PEACH FESTIVAL AND ENGAGED 230 PEOPLE. A POSTER WITH THE TOP IDENTIFIED ISSUES WAS USED TO SOLICIT COMMUNITY INPUT. COMMUNITY MEMBERS WERE ASKED TO THINK ABOUT THE BIGGEST PROBLEMS IN THE COMMUNITY. THEY WERE THEN GIVEN TWO VOTES. THE PROBLEM THAT THEY FELT WAS THE WORST IN THE COMMUNITY RECEIVED A NUMBER ONE VOTE AND WAS WORTH TWO POINTS. THEIR CHOICES FOR THE SECOND BIGGEST PROBLEM RECEIVED A NUMBER TWO VOTE AND WAS WORTH ONE POINT. ONLINE COMMUNITY SURVEYSTHE COLORADO HEALTH INSTITUTE (CHI), A DENVER-BASED RESEARCH AND DATA ANALYSIS FIRM THAT WORKS TO PROVIDE HEALTH DECISION SUPPORT AND INSIGHTS, DEVELOPED AND CONDUCTED A COMMUNITY SURVEY ON BEHALF OF SCL HEALTH. THE SURVEY WAS ADMINISTERED TO MORE THAN 300 PEOPLE IN SCL HEALTH'S FRONT RANGE SERVICE REGION, INCLUDING DENVER, JEFFERSON, ADAMS, BROOMFIELD AND BOULDER COUNTIES, FROM AUGUST 10 TO AUGUST 23, 2021. THE SURVEY WAS PROVIDED IN ENGLISH AND SPANISH. CHI SENT THE ELECTRONIC SURVEY LINK TO POTENTIAL PARTICIPANTS BY EMAIL USING CONSTANT CONTACT, WITH LIMITED ADDITIONAL OUTREACH THROUGH PERSONAL EMAILS AND SOCIAL MEDIA POSTS. SCL HEALTH'S INTERNAL COMMUNICATIONS TEAM ASSISTED WITH SURVEY DISSEMINATION BY SENDING TARGETED EMAILS TO LOCAL CONTACTS. THROUGH THE USE OF ZIP CODE IDENTIFICATION, SURVEY RESULTS WERE SEGMENTED BY EACH HOSPITAL'S SERVICE AREA. OF THE RESPONDENTS, 75 WERE RESIDENTS OF GSMC'S SERVICE AREA COUNTIES. KEY INFORMANT PHONE SURVEYSTWELVE (12) PHONE INTERVIEWS WERE CONDUCTED FOR THE CHNA FROM JULY 26 TO SEPTEMBER 9, 2021. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN ADAMS AND WELD COUNTIES WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE MEDICAL CENTER. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN A PHONE INTERVIEW. THE STAKEHOLDER INTERVIEWS WERE STRUCTURED TO OBTAIN GREATER DEPTH AND RICHNESS OF INFORMATION ON COMMUNITY NEEDS IDENTIFIED AS PRIORITIES THROUGH A DISCUSSION CONDUCTED WITH COMMUNITY REPRESENTATIVES PRIOR TO THE INTERVIEWS. FIRST, INTERVIEW PARTICIPANTS WERE ASKED TO DESCRIBE, FROM THEIR PERSPECTIVES, SOME OF THE MAJOR ISSUES IMPACTING THE COMMUNITY AS WELL AS THE SOCIAL DETERMINANTS OF HEALTH CONTRIBUTING TO POOR HEALTH IN THE COMMUNITY. INTERVIEW PARTICIPANTS WERE ALSO ASKED TO RATE THE IMPACT AND IMPORTANCE OF EACH NEED PRIOR TO PARTICIPATING IN THE TELEPHONE INTERVIEWS THROUGH A BRIEF SURVEY. DURING THE INTERVIEWS, PARTICIPANTS WERE ASKED TO SHARE THEIR PERSPECTIVES ON THE ISSUES, CHALLENGES AND BARRIERS RELATIVE TO THE IDENTIFIED HEALTH NEEDS (I.E.; WHAT MAKES EACH HEALTH NEED A SIGNIFICANT ISSUE IN THE COMMUNITY? WHAT ARE THE CHALLENGES PEOPLE FACE IN ADDRESSING THESE NEEDS?), ALONG WITH IDENTIFYING KNOWN RESOURCES TO ADDRESS THESE HEALTH NEEDS, SUCH AS SERVICES, PROGRAMS AND/OR COMMUNITY EFFORTS.ORGANIZATIONS THAT PARTICIPATED INCLUDED: COLORADO COMMUNITY HEALTH ALLIANCE, CENTURA HEALTH, CITY AND COUNTY OF BROOMFIELD, THE REFUGE, BOULDER COUNTY PUBLIC HEALTH, OUT BOULDER COUNTY, COAL CREEK MEALS ON WHEELS, BEHAVIORAL HEALTH GROUP, AND THE UNIVERSITY OF COLORADO, BOULDER.

LUTHERAN MEDICAL CENTER
PART V, SECTION B, LINE 6A: SAINT ANTHONY HOSPITAL

LUTHERAN MEDICAL CENTER
PART V, SECTION B, LINE 6B: JEFFERSON COUNTY DEPARTMENT OF PUBLIC HEALTH, ARVADA CHAMBER, ARVADA FIRE, BRIGHT BY THREE, CITY OF EDGEWATER, CITY OF LAKEWOOD, CITY OF LAKEWOOD RECREATION, CITY OF WESTMINISTER, CITY OF WHEAT RIDGE, COLORADO COMMUNITY HEALTH ALLIANCE, COMMUNITY FIRST FOUNDATION, CONSORTIUM OF OLDER ADULTS, CREA RESULTS, EVERGREEN FIRE, FAMILY TREE, JEFFCO VETERANS SERVICES, JEFFERSON CENTER FOR MENTAL HEALTH, CONSERVATION COLORADO, JEFFERSON COUNTY HOUSING AUTHORITY, JEFFERSON COUNTY PUBLIC LIBRARIES, METRO COMMUNITY PROVIDER NETWORK, REGIS UNIVERSITY, SENIOR RESOURCES CENTER, SCL LUTHERAN MEDICAL CENTER, STATE SENATOR DISTRICT 20, THE ACTION CENTER, WEST CHAMBER, WEST METRO FIRE, TRI COUNTY PUBLIC HEALTH, WEST PINES.

GOOD SAMARITAN MEDICAL CENTER
PART V, SECTION B, LINE 6B: THE FOLLOWING ORGANIZATIONS LISTED PARTICIPATED THE CHNA PROCESS:BEHAVIORAL HEALTH GROUPBOULDER AREA AGENCY ON AGINGBOULDER COUNTY PUBLIC HEALTHBOULDER VALLEY SCHOOL DISTRICTBROOMFIELD FISHBROOMFIELD COUNTY PUBLIC HEALTHCENTURA HEALTHCITY AND COUNTY OF BROOMFIELDCLINICA FAMILY HEALTH SERVICES, COAL CREEK MEALS ON WHEELSCOLORADO COMMUNITY HEALTH ALLIANCELAFAYETTE AND BROOMFIELD SENIOR CENTERMENTAL HEALTH PARTNERSOUT BOULDER COUNTYTHE REFUGESISTER CARMEN COMMUNITY CENTERTRU COMMUNITY CAREUNIVERSITY OF COLORADO, BOULDERVIA MOBILITYLUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 7A, HOSPITAL FACILITY'S WEBSITE:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 7A, HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 10A, HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY POSTED ON WEBSITE:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-IMPROVEMENT-PLAN/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 10A, HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY POSTED ON WEBSITE:HTTPS://WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-IMPROVEMENT-PLAN/

GOOD SAMARITAN MEDICAL CENTER
PART V, SECTION B, LINE 7D: COPIES OF THE CHNA WERE DISTRIBUTED AT VARIOUS COMMUNITY COALITIONS AND RESOURCE MEETINGS BY THE REGIONAL DIRECTOR OF COMMUNITY HEALTH IMPROVEMENT AND TO COMMUNITY ORGANIZATIONS UPON REQUEST.

LUTHERAN MEDICAL CENTER
PART V, SECTION B, LINE 11: THROUGH THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN COLLABORATION WITH SAINT ANTHONY HOSPITAL AND JEFFERSON COUNTY DEPARTMENT OF PUBLIC HEALTH, THREE NEEDS SURFACED AS THE MOST PRESSING FOR JEFFERSON COUNTY: 1. MENTAL HEALTH AND SUBSTANCE USE 2. FOOD INSECURITY 3. HOUSING.MENTAL HEALTH AND SUBSTANCE USEOFFER MENTAL HEALTH FIRST AID TRAINING IN COMMUNITY: ELEVEN COMMUNITY-BASED TRAININGS WERE OFFERED WITHIN COMMUNITY-BASED ORGANIZATIONS, WHICH REACHED 111 COMMUNITY MEMBERS.GROW PARTICIPATION IN THE ROCKY MOUNTAIN CRISIS PARTNERS SUICIDAL IDEATION/ATTEMPT FOLLOW-UP PROGRAM: PROGRAM EXPANDED TO INCLUDE REFERRAL FROM WEST PINES AND THE LMC EMERGENCY DEPARTMENT. 208 INDIVIDUALS WERE REFERRED OVER THE PERIOD TO RECEIVE 90 DAYS OF FOLLOW-UP SUPPORT. TRACKING INDICATED THAT NO PARTICIPANTS READMITTED IN THE LMC SYSTEM FOR A SUICIDE ATTEMPT.INCREASE PARTICIPATION IN THE RECOVERY NURSE ADVOCATE PROGRAM FOR NEW AND EXPECTANT MOTHERS: BEGINNING WITH A BASELINE OF EIGHT PARTICIPANTS (2018) IN THE LONG-TERM, SUBSTANCE USE RECOVERY GROUP, THE GROUP EXPANDED TO 16 IN THE-2019. 2020 SAW A DECLINE IN IN-PERSON ATTENDANCE AS THE PANDEMIC TOOK HOLD. 2021 EXPERIENCED AN UPWARD TRAJECTORY WITH 11 NEW OR EXPECTANT MOTHERS RECEIVING PROGRAM SERVICES.FOOD INSECURITYINCREASE PROCUREMENT OF LOCALLY PRODUCED FOOD TO SUPPORT HEALTHY FOOD SYSTEMS: LMC HAS PARTNERED WITH HEALTHCARE WITHOUT HARM TO BUILD A SYSTEM FOR PURCHASING LOCALLY PRODUCED BEANS FOR USE IN THE HOSPITAL PATIENT FOOD PREPARATION AND CAFETERIA MEALS. PURCHASING LOCALLY GROWN FOOD SUPPORTS A HEALTHY FOOD DELIVERY SYSTEM THAT MAKES HEALTHY FOOD MORE AVAILABLE TO THOSE WHO NEED IT. EXPAND FOOD FARMACY TO SERVE DURING COVID: OUR ABILITY TO ENGAGE COMMUNITY MEMBERS AROUND NUTRITION EDUCATION AND TO OFFER FOOD ACCESS WAS IMPACTED BY COVID RESTRICTIONS. IN RESPONSE, LMC DEVELOPED A VIRTUAL PROGRAM CALLED HEALTHY U. TO DATE 23 FOOD INSECURE COMMUNITY MEMBERS HAVE PARTICIPATED IN THE 12-WEEK PROGRAM WHICH PAIRS ONLINE EDUCATION ABOUT NUTRITION AND IN-PERSON HEALTH VISITS.HOUSINGINVEST IN EVICTION MITIGATION FUND AT THE ACTION CENTER JEFFERSON COUNTY: A $30,000 DONATION WAS MADE TO THE EVICTION MITIGATION FUND WITH THE SPECIFIC INTENT THAT IT BE USED TO SUPPORT INDIVIDUALS AND FAMILIES WHO MAY NARROWLY MISS CERTAIN STANDARDS FOR FEDERAL ASSISTANCE. TO DATE, 54 FAMILIES HAVE BEEN ABLE TO STAY IN THEIR HOMES.SUPPORT MEDICAL RESPITE FOR UNHOUSED INDIVIDUALS WHO NEED TO QUARANTINE BASED ON A POSITIVE COVID TEST: MOTEL VOUCHERS WERE PURCHASED BY LMC FOR USE BY HOMELESS NAVIGATORS WHEN FACED WITH NEEDING TO HOUSE COVID POSITIVE INDIVIDUALS. ADDITIONAL PRIORITIES NOT ADDRESSED LUTHERAN MEDICAL CENTER (LMC) RECOGNIZES THAT THE OTHER HEALTH NEEDS AND INDICATORS IDENTIFIED IN THE 2021 LMC COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS ARE IMPORTANT FOR THE HOSPITAL AND THE COMMUNITIES IT SERVES. NUMEROUS OTHER ORGANIZATIONS ARE CONCURRENTLY ADDRESSING MANY OF THESE REMAINING NEEDS. THEREFORE, DUE TO LIMITED EXPERTISE AND RESOURCES AT THE INDIVIDUAL HOSPITAL LEVEL LMC HAS NARROWED ITS TOP PRIORITIES TO THE FOCUS AREAS LISTED ABOVE. LMC WILL, HOWEVER, CONTINUE TO BUILD PARTNERSHIPS WITH OTHER COMMUNITY AGENCIES IN OUR PRIMARY SERVICE AREA IN ORDER TO EXPAND OUR FOOTPRINT AS FAR AS POSSIBLE INTO ALL RELEVANT HEALTH PRIORITY AREAS WITHOUT OVERTAXING AVAILABLE RESOURCES IN OUR IDENTIFIED PRIORITY AREAS. COMMUNITY-BUILDING ACTIVITIES ARE THOSE THAT IMPROVE THE HEALTH AND SAFETY OF COMMUNITY MEMBERS BY ADDRESSING THE ROOT CAUSES OF PROBLEMS (E.G. POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS). IN 2021, LMC CONTINUED TO EXPAND SEVERAL PARTNERSHIPS INTENDED TO DIRECTLY ADDRESS THE HEALTH AND SAFETY NEEDS OF RESIDENTS OF JEFFERSON COUNTY. ONE EXAMPLE IS A STRENGTHENED COLLABORATION WITH COMMUNITY TABLE, RED ROCKS COMMUNITY COLLEGE, AND STRIDE. THROUGH THIS MULTISECTORIAL PARTNERSHIP WE HAVE BEEN ABLE TO IDENTIFY AND OFFER PROGRAMMING TO FOOD INSECURE JEFFERSON COUNTY RESIDENTS WHO HAVE A CHRONIC HEALTH CONDITION THAT IS MANAGEABLE THROUGH DIET. THROUGH EDUCATION, FREQUENT BIOMETRIC SCREENING, COOKING CLASSES, AND BUILDING TRUSTED RELATIONSHIPS COMMUNITY MEMBERS HAVE BEEN ABLE TO SEE CHANGES IN THEIR HEALTH RELATED TO CHANGES IN DIETARY HABITS AND FOOD ACCESS.2021 ALSO SAW DEVELOPMENT OF A NEW PARTNERSHIP WITH THE JEFFERSON COUNTY PUBLIC LIBRARY. LMC IS FINANCIALLY SUPPORTING THE DEVELOPMENT OF NEW PROGRAMMING TARGETING THE MENTAL HEALTH NEEDS OF COMMUNITY MEMBERS EXPERIENCING UNSTABLE HOUSING AND SUBSTANCE USE ISSUES. WEEKLY PROGRAM MEETINGS WILL PROVIDE AN OPPORTUNITY FOR COMMUNITY MEMBERS TO MEET ONE-ON-ONE WITH A MENTAL HEALTH PROFESSIONAL.

GOOD SAMARITAN MEDICAL CENTER
"PART V, SECTION B, LINE 11: UNINTENTIONAL INJURIES-IN 2021, SEVEN ""STOP THE BLEED"" TRAININGS WERE OFFERED REACHING 211 COMMUNITY MEMBERS. THIS TRAINING INSTRUCTED PARTICIPANTS ABOUT THE THREE QUICK ACTIONS THAT CAN BE USED TO STOP LIFE-THREATENING BLEEDING IN A SEVERELY INJURED PERSON. PARTICIPANTS IN THE TRAINING RECEIVED EDUCATION AND WERE ABLE TO PRACTICE WHAT THEY HAD LEARNED.-THE INJURY PREVENTION DEPARTMENT HAS ALWAYS PROVIDED SEVERAL CLASSES AND EVENTS TO ADDRESS INJURIES DUE TO FALLS. THE POPULAR ""MATTER OF BALANCE"" CLASS WHICH IS OFFERED THROUGH THE NATIONAL COUNCIL ON AGING AND SPONSORED LOCALLY BY THE BOULDER AREA AGING ON AGING (BCAAA), WAS NOT ABLE TO BE OFFERED IN PERSON IN 2021 AND WAS NOT DELIVERED ONLINE. FALL PREVENTION EDUCATION WAS OFFERED AT FESTIVALS AND FAIRS IN COLLABORATION WITH NORTH METRO FIRE AND REACHED 270 INDIVIDUALS.-GSMC WAS ABLE TO OFFER SOME CLASSES IN 2021 TO ADDRESS FALL PREVENTION. (AMP) IS A 10-CLASS COURSE CREATED BY THE NATIONAL COUNCIL ON AGING TO HELP OLDER ADULTS MAKE THE MOST OF THEIR LIVES AS THEY AGE. FALL PREVENTION IS ONE OF THE CLASSES IN AMP AND IT OUTLINES WAYS TO PREVENT FALLS AND HOW TO REDUCE THE RISK OF FALLING.-DUE TO COVID RESTRICTIONS, THE ANNUAL FALL PREVENTION WEEK ACTIVITIES HAD TO BE MODIFIED. THE INJURY PREVENTION COORDINATOR WORKED WITH A VIDEOGRAPHER TO PRODUCE THREE FALL PREVENTION VIDEOS. THE VIDEOS FEATURED A PHYSICAL THERAPIST INSTRUCTING THE VIEWER ON THE FOLLOWING TOPICS: TIPS ON HOW TO AVOID FALLS, HOW TO USE ASSISTIVE DEVICES, AND TIPS FOR GOING UPSTAIRS. A LINK WAS SENT OUT IN A NEWSLETTER THAT WENT OUT TO ALL OF THE BCAAA CLIENTS. SINCE SEPTEMBER OF 2021, THE VIDEOS HAVE RECEIVED 31,400 VIEWS ON GSMC'S FACEBOOK PAGE, 98 VIEWS ON VIMEO AND 21 VIEWS ON YOUTUBE. -BICYCLE SAFETY AND HELMET DISTRIBUTION - 121 ATTENDED THE TRAINING AND 57 HELMETS WERE DISTRIBUTED. CHILDREN RECEIVED A PROFESSIONAL FITTING FOR THE HELMETS IN ADDITION TO RECEIVING THE FREE HELMET. -GSMC OPERATED A CHILD CAR SEAT CHECK FOR THE COMMUNITY TO PREVENT CHILDHOOD INJURIES FROM AUTO ACCIDENTS. THE SEATS WERE CHECKED TO MAKE SURE THAT THEY WERE INSTALLED CORRECTLY AND THAT THEY WERE NOT DAMAGED OR ON A RECALL LIST. ANY SEAT THAT WAS FOUND TO BE DEFECTIVE, RECALLED OR OTHERWISE A DANGER TO THE CHILD WAS REPLACED AT NO COST TO THE FAMILY. THE PROGRAM WAS USUALLY DONE IN-PERSON BUT DUE TO COVID, THE PROGRAM WAS PROVIDED VIRTUALLY FOR PART OF THE YEAR. 1,061 CAR SEATS WERE EXAMINED IN 2021. NONE NEEDED TO BE REPLACED. CARDIOVASCULAR DISEASE-THE GSMC EMS OUTREACH COORDINATOR PROVIDED TRAINING AND RECERTIFICATION CLASSES (CPR, PALS AND ACLS) AT NO COST TO LOCAL EMS PROFESSIONALS. CONTINUING EDUCATION OCCURRED THROUGHOUT THE YEAR AT THREE LOCAL FIRE STATIONS SERVING 624 PERSONS. HE ALSO PROVIDED RECERTIFICATION CLASSES TO 64 LOCAL FIRST RESPONDERS THROUGHOUT THE YEAR.-GSMC HOSTED A BOOTH AT THE LAFAYETTE PEACH FESTIVAL WHICH SAW AN ATTENDANCE OF CLOSE TO 20,000 PEOPLE. IT IS ESTIMATED THAT AT LEAST 2,000 STOPPED AT THE BOOTH AND SPOKE WITH OUR STAFF WHO ARE KNOWLEDGEABLE ABOUT CARDIOVASCULAR HEALTH. -GSMC WAS ABLE TO OFFER SOME CLASSES IN 2021 TO ADDRESS TOPICS RELATED TO CARDIOVASCULAR HEALTH WITHIN THE AGING MASTERY PROGRAM (AMP). AMP IS A 10-CLASS COURSE CREATED BY THE NATIONAL COUNCIL ON AGING TO HELP OLDER ADULTS MAKE THE MOST OF THEIR LIVES AS THEY AGE. TWO CLASSES RELATED TO CARDIOVASCULAR HEALTH ARE HEALTHY EATING AND EXERCISE.-IN ORDER TO PREVENT DEATH FROM CARDIAC EVENTS IN THE COMMUNITY, GOOD SAMARITAN PURCHASED AN AED TO DONATE TO BIG ELK VOLUNTEER FIRE DEPARTMENT AND PROVIDED TRAINING ON THE EQUIPMENT. -GSMC IN 2021 HOSTED A BI-MONTHLY STROKE SUPPORT GROUP IN COORDINATION WITH THE ROCKY MOUNTAIN STROKE CENTER (ATTENDANCE IN 2021: 250). ROCKY MOUNTAIN STROKE CENTER ALSO PROVIDED 83 INDIVIDUAL COUNSELING SESSIONS THROUGHOUT THE YEAR.HEALTH PRIORITIES NOT ADDRESSEDTHE REMAINDER OF NEEDS IDENTIFIED IN THE CHNA ARE IMPORTANT TO GSMC, BUT DUE TO LIMITED RESOURCES AT THE HOSPITAL LEVEL, AND THE AVAILABILITY OF COMMUNITY ORGANIZATIONS WHO ARE ALREADY ADDRESSING THESE NEEDS, GSMC WILL FOCUS PRIMARILY ON ITS SELECTED PRIORITIES. GSMC WILL CONTINUE TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ENSURE OTHER NEEDS AND HEALTH INDICATORS ARE SUPPORTED. SOME OF THE ORGANIZATIONS ACTIVELY ADDRESSING OTHER HEALTH PRIORITIES INCLUDE: BOULDER COUNTY PUBLIC HEALTH, BROOMFIELD PUBLIC HEALTH DEPARTMENT, CATHOLIC CHARITIES, UNITED WAY, AMERICAN CANCER SOCIETY, MENTAL HEALTH PARTNERS, WOMEN'S HEALTH."

SCHEDULE H, PART V, SECTION B, LINE 16
LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 16A, FINANCIAL ASSISTANCE POLICY WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 16A, FINANCIAL ASSISTANCE POLICY WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 16B, FINANCIAL ASSISTANCE APPLICATION WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 16B, FINANCIAL ASSISTANCE APPLICATION WEBSITE:WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/LUTHERAN MEDICAL CENTER:PART V, SECTION B, LINE 16C, FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY:WWW.SCLHEALTH.ORG/LOCATIONS/LUTHERAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/GOOD SAMARITAN MEDICAL CENTER:PART V, SECTION B, LINE 16C, FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY:WWW.SCLHEALTH.ORG/LOCATIONS/GOOD-SAMARITAN-MEDICAL-CENTER/PATIENTS-VISITORS/BILLING-PRICING/FINANCIAL-ASSISTANCE/

PART I, LINE 6A:
THIS ORGANIZATION IS PART OF SCL HEALTH SYSTEM WHICH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC.

PART I, LINE 7:
THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 19,744,503.

PART II, COMMUNITY BUILDING ACTIVITIES:
LUTHERAN MEDICAL CENTER:COMMUNITY-BUILDING ACTIVITIES ARE THOSE THAT IMPROVE THE HEALTH AND SAFETY OF COMMUNITY MEMBERS BY ADDRESSING THE ROOT CAUSES OF PROBLEMS (E.G. POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS). IN 2021, LMC CONTINUED TO EXPAND SEVERAL PARTNERSHIPS INTENDED TO DIRECTLY ADDRESS THE HEALTH AND SAFETY NEEDS OF RESIDENTS OF JEFFERSON COUNTY. ONE EXAMPLE IS A STRENGTHENED COLLABORATION WITH COMMUNITY TABLE, RED ROCKS COMMUNITY COLLEGE, AND STRIDE. THROUGH THIS MULTISECTORIAL PARTNERSHIP WE HAVE BEEN ABLE TO IDENTIFY AND OFFER PROGRAMMING TO FOOD INSECURE JEFFERSON COUNTY RESIDENTS WHO HAVE A CHRONIC HEALTH CONDITION THAT IS MANAGEABLE THROUGH DIET. THROUGH EDUCATION, FREQUENT BIOMETRIC SCREENING, COOKING CLASSES, AND BUILDING TRUSTED RELATIONSHIPS COMMUNITY MEMBERS HAVE BEEN ABLE TO SEE CHANGES IN THEIR HEALTH RELATED TO CHANGES IN DIETARY HABITS AND FOOD ACCESS.2021 ALSO SAW DEVELOPMENT OF A NEW PARTNERSHIP WITH THE JEFFERSON COUNTY PUBLIC LIBRARY. LMC IS FINANCIALLY SUPPORTING THE DEVELOPMENT OF NEW PROGRAMMING TARGETING THE MENTAL HEALTH NEEDS OF COMMUNITY MEMBERS EXPERIENCING UNSTABLE HOUSING AND SUBSTANCE USE ISSUES. WEEKLY PROGRAM MEETINGS WILL PROVIDE AN OPPORTUNITY FOR COMMUNITY MEMBERS TO MEET ONE-ON-ONE WITH A MENTAL HEALTH PROFESSIONAL.GOOD SAMARITAN MEDICAL CENTER:COMMUNITY-BUILDING ACTIVITIES ARE THOSE THAT IMPROVE THE HEALTH AND SAFETY OF COMMUNITY MEMBERS BY ADDRESSING THE ROOT CAUSES OF PROBLEMS (E.G. POVERTY, HOMELESSNESS, AND ENVIRONMENTAL HAZARDS). GOOD SAMARITAN MEDICAL CENTER (GSMC) CONTINUES TO BE INTENTIONAL IN BUILDING COMMUNITY RELATIONSHIPS WITH LOCAL ORGANIZATIONS TO ADDRESS THE HEALTH OF OUR COMMUNITY. THIS IS ADDRESSED THROUGH STAFF PARTICIPATION ON SEVERAL COMMUNITY BOARDS, INVESTMENT IN COMMUNITY WORK GROUPS AND COALITIONS, SUCH AS THE BOULDER COUNTY PUBLIC HEALTH IMPROVEMENT PROCESS (PHIP) STEERING COMMITTEE. PROVIDED SUPPORT FOR EMERGENCY PREPAREDNESS AND DISASTER READINESS. ACTIVELY WORK WITH LOCAL STAKEHOLDERS TO ENSURE SOCIAL DETERMINANTS OF HEALTH ARE INCLUDED IN COMMUNITY IMPROVEMENT PROJECTS - HEALTH PROFESSIONS EDUCATION, HOUSING, AND SAFETY.PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR THE REPORTING OF BAD DEBT.

PART III, LINE 2:
THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.

PART III, LINE 8:
"THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE ""ALLOWABLE COSTS"" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS.TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO."

PART VI, LINE 4:
LUTHERAN MEDICAL CENTER:LUTHERAN MEDICAL CENTER (LMC) IS SITUATED IN THE WESTERN PORTION OF THE DENVER METROPOLITAN AREA IN THE CITY OF WHEAT RIDGE, COLORADO. THIS ACUTE CARE FACILITY HAS A SERVICE AREA THAT SERVES SEVERAL COMMUNITIES IN THE WESTERN METROPOLITAN AREA INCLUDING WHEAT RIDGE, ARVADA, GOLDEN, LAKEWOOD, WESTMINSTER AS WELL AS COMMUNITIES IN THE FOOTHILLS OF THE FRONT RANGE. LMC'S PRIMARY SERVICE AREA CONSISTS OF 18 STANDARD ZIP CODES, MAINLY LOCATED IN JEFFERSON COUNTY (13 ZIP CODES), BUT ALSO REPRESENTED BY ZIP CODES IN THE COUNTIES OF DENVER (3 ZIP CODES), ADAMS (1 ZIP CODE) AND GILPIN (1 ZIP CODE). THE SECONDARY SERVICE AREA INCLUDES 20 ZIP CODES AND EXTENDS THROUGH ADAMS COUNTY, BROOMFIELD COUNTY, CLEAR CREEK COUNTY, DENVER COUNTY AND JEFFERSON COUNTY. THE PRIMARY SERVICE AREA IS DEFINED AS THE GEOGRAPHIC AREA OF CONTIGUOUS ZIP CODES FROM WHICH THE HOSPITAL DRAWS APPROXIMATELY 75% OF ITS INPATIENT DISCHARGES AND THE COMBINED PRIMARY AND SECONDARY SERVICE AREA IS BASED ON APPROXIMATELY 90% OF DISCHARGES. LMC'S MAIN CONCENTRATION OF CARE IS PROVIDED TO THE COMMUNITIES OF WHEAT RIDGE, ARVADA AND GOLDEN. 50% OF THE CARE SITE'S DISCHARGES COME FROM EIGHT ZIP CODES WITHIN THOSE CITIES. ADDITIONALLY, LMC SERVICES THE MOST PATIENTS WITHIN ITS PRIMARY SERVICE AREA WHEN COMPARED TO OTHER HOSPITALS FURNISHING CLOSE TO 30% OF THE INPATIENT CARE. LMC AND SAINT ANTHONY HOSPITAL ARE THE ACUTE CARE PROVIDERS IN ALL OF JEFFERSON COUNTY WITH LMC BEING THE ONLY TO OFFER MATERNITY SERVICES. THERE ARE TWO ACUTE CARE HOSPITALS LOCATED IN THE SECONDARY SERVICE AREA, NORTH SUBURBAN MEDICAL CENTER (AN AFFILIATE OF THE FOR-PROFIT HEALTHONE SYSTEM) AND DENVER HEALTH (GOVERNMENT OWNED). BESIDES LMC AND GOOD SAMARITAN MEDICAL CENTER, THERE ARE FIVE OTHER NOT-FOR-PROFIT HOSPITALS IN THE COMMUNITY:- ST. ANTHONY NORTH HOSPITAL-CENTURA HEALTH, WESTMINSTER- ST. ANTHONY WEST HOSPITAL-CENTURA HEALTH, LAKEWOOD- AVISTA ADVENTIST HOSPITAL-CENTURA HEALTH, LOUISVILLE- LONGMONT UNITED HOSPITAL, LONGMONT- BOULDER COMMUNITY HOSPITAL, BOULDERTHERE IS ALSO ONE FOR-PROFIT HOSPITAL, NORTH SUBURBAN MEDICAL CENTER-HEALTHONE,THORNTON.THE COMMUNITY SERVED BY LMC CONTAINS THE FOLLOWING DEMOGRAPHIC INFORMATION, UPDATED FOR 2021, USING THE RESOURCES OF COUNTY HEALTH RANKINGS, US CENSUS DATA, STATE HEALTH DEPARTMENT DATA AND THE EXISTING CHNA.POPULATIONFROM 2015 - 2019, THE AVERAGE POPULATION OF THE LUTHERAN MEDICAL CENTER (LMC) SERVICE AREA WAS 595,832. JEFFERSON COUNTY'S POPULATION WAS 574,798. COLORADO'S TOTAL POPULATION WAS 5,610,349.YOUTH, AGES 0 - 19 MAKE UP 20% OF THE POPULATION IN THE SERVICE AREA. 63.5% OF THE POPULATION WAS 20 TO 64 YEARS OLD AND 16.4% WERE 65 YEARS AND OLDER. THE SERVICE AREA HAD A LOWER PERCENTAGE OF YOUTH, AGES 0-19, AND A HIGHER PERCENTAGE OF ADULTS, AGES 45 AND OLDER, THAN IN THE STATE.IN THE SERVICE AREA, LITTLETON (80127) HAD THE LARGEST PERCENTAGE OF YOUTH, AGES 5-17, (23.7%) AND KITTREDGE HAD THE SMALLEST PERCENTAGE OF YOUTH (4.2%). BUFFALO CREEK HAD THE HIGHEST PERCENTAGE OF SENIORS (26.8%) AND KITTREDGE HAD THE LOWEST PERCENT OF SENIORS IN THE SERVICE AREA (9.4%). THE MEDIAN AGE IN JEFFERSON COUNTY WAS 40.3 YEARS.RACE AND ETHNICITYIN THE SERVICE AREA, 80.2% OF THE POPULATION IS WHITE, 12.9% ARE HISPANIC/LATINX, 3.0% ARE ASIAN, AND 1.1% ARE BLACK/AFRICAN AMERICAN. THE LMC SERVICE AREA HAD MORE WHITE AND ASIAN RESIDENTS THAN JEFFERSON COUNTY.IN THE SERVICE AREA, BUFFALO CREEK HAS THE HIGHEST PERCENTAGE OF WHITE RESIDENTS (98.7%). DENVER 80226 HAS THE HIGHEST PERCENTAGE OF HISPANIC OR LATINX RESIDENTS (31.6%). IDLEDALE 80453 HAS THE HIGHEST PERCENTAGE OF ASIANS (17.3%) AND DENVER 80235 HAS THE HIGHEST PERCENTAGE OF BLACKS (5.8%) IN THE SERVICE AREA.LANGUAGEOVER THREE-QUARTERS OF THE SERVICE AREA POPULATION, AGES 5 YEARS AND OLDER, SPEAK ONLY ENGLISH IN THE HOME (90.2%). 9.8% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND 5.2% OF THE POPULATION SPEAKS SPANISH IN THE HOME. COLORADO'S RATES OF SPANISH SPEAKING AT THE HOME AND SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME WERE HIGHER THAN THE SERVICE AREA.GOOD SAMARITAN MEDICAL CENTER:GOOD SAMARITAN MEDICAL CENTER (GSMC) IS LOCATED IN THE CITY OF LAFAYETTE, COLORADO. WHILE LAFAYETTE IS SITUATED IN BOULDER COUNTY, THE HOSPITAL SERVICE AREA INCLUDES COMMUNITIES IN ADAMS, BOULDER, BROOMFIELD, GILPIN, JEFFERSON, AND WELD COUNTIES. TOTAL POPULATION: ON AVERAGE, FROM 2015 TO 2019, THE POPULATION OF THE GSMC SERVICE AREA WAS 1,111,074. ADAMS COUNTY HAD A POPULATION OF 504,108, BOULDER COUNTY'S POPULATION WAS 322,510, AND BROOMFIELD COUNTY'S POPULATION WAS 67,886.POPULATION BY GENDER: IN THE GSMC SERVICE AREA, 50.3% WERE MALE AND 49.7% WERE FEMALE.POPULATION BY AGE: YOUTH AGES 0 TO 19 COMPRISE 26.5% OF THE POPULATION IN THE SERVICE AREA. JUST OVER 61% OF THE POPULATION WAS 20 TO 64 YEARS OLD, AND 12.6% WERE AGES 65 YEARS AND OLDER. ADAMS AND WELD COUNTIES HAD THE HIGHEST PERCENTAGE OF YOUTH, AGES 0-19, (29.3%). GILPIN COUNTY HAD THE HIGHEST PERCENTAGE OF SENIORS (17.9%) AS A PROPORTION OF THE TOTAL POPULATION. POPULATION BY YOUTH, AGES 0-17 AND SENIORS, AGES 65+, AND MEDIAN AGE: COMMERCE CITY HAD THE LARGEST PERCENTAGE OF YOUTH, AGES 5-17 (32.8%) AND BOULDER (80310- UNIVERSITY OF COLORADO) HAD THE SMALLEST PERCENTAGE OF YOUTH (0.3%) IN THE SERVICE AREA. BOULDER (80310-UNIVERSITY OF COLORADO) ALSO HAD THE SMALLEST PERCENTAGE OF SENIORS (0.0%). WHEAT RIDGE (80033) HAD THE HIGHEST PERCENTAGE OF SENIORS (19.8%) IN THE SERVICE AREA. THE SERVICE AREA HAD A MEDIAN AGE OF 36.4 YEARS. MEDIAN AGE IN ADAMS COUNTY WAS 33.8 YEARS AND IN 34.4 YEARS IN WELD COUNTY WHICH WERE LOWER THAN THE STATE MEDIAN OF 36.7 YEARS. ALL OTHER COUNTIES HAD MEDIAN AGES THAT WERE HIGHER THAN THE STATE MEDIAN WHICH INCLUDE BOULDER COUNTY 36.6, BROOMFIELD COUNTY 37.8, JEFFERSON COUNTY 40.3, AND GILPIN COUNTY 49.0.RACE/ ETHNICITY: IN THE SERVICE AREA, 69.3% OF THE POPULATION IS WHITE, 22.7% ARE HISPANIC/LATINX, 3.9% ARE ASIAN, AND 1.2% ARE BLACK/AFRICAN AMERICAN. THE SERVICE AREA HAD A GREATER PERCENTAGE OF WHITE, LATINX, AND ASIAN-AMERICAN INDIVIDUALS THAN COLORADO OVERALL. RACE/ ETHNICITY BY PLACE: OVER HALF OF THE POPULATION IN COMMERCE CITY (53.4%) IS HISPANIC OR LATINX. BROOMFIELD 80023 HAD THE HIGHEST PERCENTAGE OF ASIANS (7.4%) IN THE SERVICE AREA. GOLDEN (80403) HAD THE HIGHEST PERCENTAGE OF WHITES (90.9%) AND COMMERCE CITY (80022) HAD THE LARGEST PERCENTAGE OF AFRICAN AMERICANS (4.7%) IN THE SERVICE AREA. CITIZENSHIP, 2019: AMONG AREA COUNTIES, 15.3% OF ADAMS COUNTY, 10.7% OF BOULDER COUNTY, 8.9% OF BROOMFIELD COUNTY, 8.7% OF WELD COUNTY, 6.4% OF JEFFERSON COUNTY, AND 4.6% GILPIN COUNTY RESIDENTS WERE FOREIGN BORN. THIS WAS HIGHER THAN THE 9.7% OF THE STATE POPULATION WHO WERE FOREIGN BORN. OF THE FOREIGN BORN IN WELD COUNTY, 64.3% WERE NOT U.S. CITIZENS, FOLLOWED BY ADAMS COUNTY 63.1%, BOULDER COUNTY 57.4%, GILPIN COUNTY 54.3%, JEFFERSON COUNTY 45.7% AND BROOMFIELD HAD THE LOWEST PERCENTAGE, 41%, OF FOREIGN BORN RESIDENTS THAT WERE NOT U.S. CITIZENS. LANGUAGE SPOKEN AT HOME FOR THE POPULATION 5 YEARS AND OVER: IN THE SERVICE AREA, 87.9% OF THE POPULATION, AGES 5 YEARS AND OLDER, SPEAK ONLY ENGLISH IN THE HOME. JUST UNDER 18% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND 12.1% OF THE POPULATION SPEAKS SPANISH AT HOME. ADAMS COUNTY HAD THE HIGHEST RATE OF RESIDENTS SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME (29.0%) AND GILPIN COUNTY HAD THE LOWEST (6.7%). ADAMS COUNTY HAD THE HIGHEST RATE OF RESIDENTS WHO SPEAK SPANISH AT HOME (23.6%) AND GILPIN COUNTY HAD THE LOWEST RATE OF RESIDENTS WHO SPEAK SPANISH AT HOME (2.7%).SOCIAL AND ECONOMIC FACTORS RANKINGS: THE COUNTY HEALTH RANKINGS RANKS COUNTIES ACCORDING TO HEALTH FACTORS DATA. SOCIAL AND ECONOMIC INDICATORS ARE EXAMINED AS A CONTRIBUTOR TO THE HEALTH OF A COUNTY'S RESIDENTS. COLORADO'S 64 COUNTIES ARE RANKED ACCORDING TO SOCIAL AND ECONOMIC FACTORS WITH 1 BEING THE COUNTY WITH THE BEST FACTORS TO 64 FOR THAT COUNTY WITH THE POOREST FACTORS. THIS RANKING EXAMINES: HIGH SCHOOL GRADUATION RATES; UNEMPLOYMENT; CHILDREN IN POVERTY; SOCIAL SUPPORT; AND OTHERS. ADAMS COUNTY IS RANKED 38TH, WELD COUNTY CAME IN 28TH, FOLLOWED BY GILPIN COUNTY AT 6TH, JEFFERSON COUNTY AT 15TH, BOULDER COUNTY 13TH, AND BROOMFIELD COUNTY RANKED 2ND. ECONOMICS, 2020: THE MEDIAN HOUSEHOLD INCOME IN THE STATE WAS $77,104. THE COUNTY INCOMES WERE (FROM HIGHEST TO LOWEST) BROOMFIELD ($106,892), JEFFERSON ($89,696), BOULDER ($88,341), WELD ($78,160), ADAMS ($75,341), AND GILPIN ($74,806). SEE CONTINUATION BELOW

SCHEDULE H, PART VI, LINE 4
CONTINUED NARRATIVEGOOD SAMARITAN MEDICAL CENTER:HEALTH FACTORS RANKINGS: THE OVERALL RANKINGS IN HEALTH FACTORS REPRESENT WHAT INFLUENCES THE HEALTH OF A COUNTY. THEY ARE AN ESTIMATE OF THE FUTURE HEALTH OF COUNTIES AS COMPARED TO OTHER COUNTIES WITHIN A STATE. THE RANKS ARE BASED ON FOUR TYPES OF MEASURES: HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC, AND PHYSICAL ENVIRONMENT FACTORS. ADAMS COUNTY RANKED 41ST, FOLLOWED BY WELD COUNTY 27TH, JEFFERSON COUNTY 13TH, GILPIN COUNTY 8TH, BOULDER COUNTY 4TH AND BROOMFIELD COUNTY 2ND.HEALTH OUTCOMES RANKINGS: COUNTY HEALTH RANKINGS EXAMINES HEALTHY BEHAVIORS AND RANKS COUNTIES ACCORDING TO HEALTH BEHAVIOR DATA. COLORADO'S 64 COUNTIES ARE RANKED FROM 1 (HEALTHIEST) TO 64 (LEAST HEALTHY) BASED ON A NUMBER OF INDICATORS THAT INCLUDE: ADULT SMOKING, OBESITY, PHYSICAL INACTIVITY, EXCESSIVE DRINKING, SEXUALLY TRANSMITTED INFECTIONS, AND OTHERS. ALL COUNTIES WERE IN THE TOP HALF FOR HEALTH OUTCOMES. ADAMS WAS THE LOWEST AT 30, FOLLOWED BY GILPIN COUNTY AT 28, WELD COUNTY AT 19, JEFFERSON COUNTY AT 12, BOULDER COUNTY AT NUMBER 5 AND BROOMFIELD COUNTY AT 4 FOR COLORADO. EMPLOYMENT STATUS FOR THE POPULATION 16 AND OVER (2019): WITHIN THE SERVICE AREA, BOULDER (UNIVERSITY OF COLORADO) 80310 (11.9%) AND WESTMINSTER 80030 (6.7%) HAD THE HIGHEST UNEMPLOYMENT RATES AND BLACK HAWK HAD THE LOWEST UNEMPLOYMENT RATE (1.2%). AMONG THE COUNTIES IN THE SERVICE REGION, GILPIN COUNTY HAD THE LOWEST UNEMPLOYMENT RATE (1.5%) AND BOULDER COUNTY HAD THE HIGHEST (4.2%). THE UNEMPLOYMENT RATE FOR THE HOSPITAL SERVICE AREA WAS 4.0%. COLORADO HAD A HIGHER UNEMPLOYMENT RATE (4.3%) THAN THE SERVICE AREA.POVERTY LEVELS, 2019: POVERTY THRESHOLDS ARE USED FOR CALCULATING OFFICIAL POVERTY POPULATION STATISTICS AND ARE UPDATED EACH YEAR BY THE CENSUS BUREAU. FOR 2021, THE FEDERAL POVERTY THRESHOLD FOR ONE PERSON WAS $12,880, AND FOR A FAMILY OF FOUR IT IS $26,500.2 IN THE SERVICE AREA, 9.2% OF THE POPULATION WAS LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL), AND 22.1% WERE CONSIDERED LOW-INCOME (LIVING AT OR BELOW 200% FPL). THESE POVERTY RATES WERE LOWER THAN THE COUNTY RATES. OF THE COUNTIES IN THE SERVICE AREA, ADAMS COUNTY HAD THE HIGHEST RATE OF RESIDENTS LIVING BELOW 200% OF THE FEDERAL POVERTY LEVEL (29.0%) AND BROOMFIELD COUNTY HAD THE LOWEST RATE (13.6%). BOULDER COUNTY HAD THE HIGHEST RATE OF RESIDENTS LIVING BELOW 100% OF THE FEDERAL POVERTY LEVEL (11.7%) AND GILPIN COUNTY HAD THE LOWEST (4.9%).FREE AND REDUCED-PRICE MEALS ELIGIBILITY, 2017 - 2018: THE NUMBER OF STUDENTS ELIGIBLE FOR THE FREE AND REDUCED-PRICE MEAL (FRPM) PROGRAM IS ONE INDICATOR OF THE SOCIOECONOMIC STATUS OF A SCHOOL DISTRICT'S STUDENT POPULATION. THE PERCENT OF STUDENTS IN ADAMS COUNTY ELIGIBLE FOR THE FRPM PROGRAM WAS 54.3%. IN WELD COUNTY, 42.8% OF STUDENTS WERE ELIGIBLE FOR THE PROGRAM. ADAMS COUNTY HAD THE HIGHEST RATE OF STUDENTS ELIGIBLE FOR FREE AND REDUCED- PRICE MEALS (54.3%) AND BROOMFIELD COUNTY HAD THE LOWEST (18.1%). JUST UNDER 42% OF COLORADO STUDENTS WERE ELIGIBLE FOR THE FRPM PROGRAM.EDUCATIONAL ATTAINMENT (25+): AMONG THE SERVICE AREA POPULATION, AGES 25 AND OLDER, 8.4% HAD NOT ATTAINED A HIGH SCHOOL DIPLOMA. 91.6% OF ADULTS WERE HIGH SCHOOL GRADUATES. 19.3% OF THE POPULATION IN THE SERVICE AREA HAD SOME COLLEGE WITH NO DEGREE, AND 43.9% HAD A BACHELOR'S DEGREE OR HIGHER. BOULDER COUNTY HAD THE HIGHEST RATE OF BACHELOR DEGREE ATTAINMENT AMONG ITS RESIDENTS (62.1%), AND ADAMS COUNTY HAD THE LOWEST (24.3%). ADAMS COUNTY HAD THE HIGHEST RATE OF ADULTS WITHOUT A HIGH SCHOOL DIPLOMA (16.2%) AND GILPIN COUNTY HAD THE LOWEST RATE (1.5%). GILPIN COUNTY HAD THE HIGHEST HIGH SCHOOL GRADUATION RATE (98.5%) AND ADAMS COUNTY HAD THE LOWEST (83.8%). HIGH SCHOOL GRADUATES, 2015 - 2019: HIGH SCHOOL GRADUATION RATES ARE THE PERCENTAGE OF HIGH SCHOOL GRADUATES THAT GRADUATED FOUR YEARS AFTER STARTING NINTH GRADE. GILPIN COUNTY HAD THE HIGHEST HIGH SCHOOL GRADUATION RATE (98.5%) AND ADAMS COUNTY HAD THE LOWEST (83.3%). THE STATE RATE WAS AT 91.7%. THE HEALTHY PEOPLE 2030 OBJECTIVE FOR HIGH SCHOOL GRADUATION IS 90.7%. ONLY ADAMS AND WELD COUNTIES WERE BELOW THE STATE AND HEALTHY PEOPLE 2030 RATES.HOMELESS POINT-IN-TIME COUNT, JANUARY 2020: A HOMELESS POINT IN TIME (PIT) COUNT IS A FEDERALLY MANDATED COUNT OF PERSONS EXPERIENCING HOMELESSNESS AT ANY GIVEN NIGHT IN A COMMUNITY. IN 2020, THE WELD COUNTY PIT COUNT WAS JANUARY 28, AND, GIVEN THE NEWNESS OF THE NORTHERN COLORADO CONTINUUM OF CARE, ONLY A SHELTERED COUNT WAS COMPLETED. THE TOTAL NUMBER OF SHELTERED HOMELESS IN WELD COUNTY AT THE PIT COUNT IN 2020 WAS 240 PERSONS. ABOUT 73% OF THE SHELTERED HOMELESS WERE HOUSED IN EMERGENCY SHELTERS, 15% WERE CHRONICALLY HOMELESS AND 34% HAD A DISABLING CONDITION.FERTILITY RATE, PER 1,000 WOMEN AGES 15-44: IN 2019, THE GENERAL FERTILITY RATE PER 1,000 WOMEN, AGES 15 TO 44, IN ADAMS COUNTY WAS 59.5. IN THE SERVICE AREA, GILPIN COUNTY HAD THE LOWEST GENERAL FERTILITY RATE IN THE SERVICE AREA (29.8 PER 1,000 WOMEN), AND WELD COUNTY HAD THE HIGHEST FERTILITY RATE (61.5 PER 1,000 WOMEN). COLORADO'S FERTILITY RATE WAS 53.7 PER 1,000 WOMEN.LATE ENTRY INTO PRENATAL CARE (AFTER FIRST TRIMESTER) / NO CARE, 2017-2019: ADEQUATE PRENATAL CARE CAN PREVENT HEALTH RISKS IN WOMEN AND PREVENT HEALTH PROBLEMS FOR THE MOTHER AND CHILD. THE HEALTHY PEOPLE 2030 OBJECTIVE IS FOR 80.5% OF WOMEN TO RECEIVE EARLY AND ADEQUATE PRENATAL CARE. 90.1% OF WOMEN IN HSR 16 (BOULDER AND BROOMFIELD COUNTIES) RECEIVED CARE IN THE FIRST TRIMESTER (8.9% DID NOT). HSR 17, GILPIN COUNTY, HAD THE LOWEST RATE OF PRENATAL CARE AMONG PREGNANT WOMEN IN THE SERVICE AREA (88.3%) AND HSR 21, JEFFERSON COUNTY HAD THE HIGHEST RATE (94.7%). 89.9% OF PREGNANT WOMEN IN COLORADO RECEIVED PRENATAL CARE (10.1% DID NOT).LOW BIRTH WEIGHT (UNDER 2,500 G), 2018: LOW BIRTH WEIGHT IS A NEGATIVE BIRTH INDICATOR. BABIES BORN AT A LOW BIRTH WEIGHT ARE AT HIGHER RISK FOR DISEASE, DISABILITY AND POSSIBLY DEATH. FOR THIS MEASUREMENT, A LOWER RATE IS A BETTER INDICATOR. BOULDER COUNTY HAD A 7.8% RATE AND BROOMFIELD COUNTY HAD A 9.3% RATE OF LOW-BIRTH WEIGHT AMONG SINGLE BABY BIRTHS. GILPIN COUNTY HAD THE HIGHEST RATE OF LOW-BIRTH-WEIGHT SINGLE BIRTHS (14.3%), AND BOULDER COUNTY HAD THE LOWEST RATE (7.8%). 9.4% OF COLORADO BIRTHS WERE LOW WEIGHT.INFANT MORTALITY RATE, 2018: THE INFANT MORTALITY RATE IS THE NUMBER OF DEATHS OF INFANTS (LESS THAN ONE YEAR OLD) PER 1,000 LIVE BIRTHS. THE HEALTHY PEOPLE 2030 OBJECTIVE HAS AN INFANT MORTALITY RATE GOAL OF 5.0 PER 1,000 LIVE BIRTHS. THE INFANT MORTALITY RATE IN BOULDER COUNTY WAS 3.7 PER 1,000 LIVE BIRTHS AND IN WELD COUNTY IT WAS 4.8 PER 1,000 LIVE BIRTHS. THE RATES IN ALL COUNTIES EXCEPT ADAMS COUNTY ARE LOWER THAN THE HEALTHY PEOPLE 2030 OBJECTIVE. JEFFERSON COUNTY HAD THE LOWEST INFANT MORTALITY RATE (3.6), AND ADAMS COUNTY HAD THE HIGHEST INFANT MORTALITY RATE (5.2). COLORADO HAD AN INFANT MORTALITY RATE OF 4.6.AGE-ADJUSTED DEATH RATE, ALL CAUSES, 2020: WHEN ADJUSTED FOR AGE, THE DEATH RATE FOR ADAMS COUNTY WAS 925.4 PER 100,000 PERSONS, JEFFERSON COUNTY WAS 712.3, WELD COUNTY 697.1, GILPIN COUNTY 628.9, BOULDER COUNTY WAS 600.3 PER 100,000 PERSONS AND IN BROOMFIELD COUNTY THE DEATH RATE WAS 581.2 PER 100,000 PERSONS. ALL COUNTIES EXCEPT ADAMS COUNTY WERE BELOW THE STATE RATE OF 738.7.PREMATURE DEATH RATE 2018: A PREMATURE DEATH RATE IS A DEATH RATE FOR A PERSON UNDER THE AGE OF 75. THE PREMATURE DEATH RATE IN BOULDER COUNTY WAS 205.4 PER 100,000 PERSONS AND IN BROOMFIELD COUNTY, THE PREMATURE DEATH RATE WAS 209.6 PER 100,000 PERSONS. ADAMS COUNTY HAD THE HIGHEST PREMATURE AGE-ADJUSTED DEATH RATE AMONG THE COUNTIES IN THE SERVICE REGION (318.8 PER 100,000 PERSONS), AND BOULDER COUNTY HAD THE LOWEST (205.4 PER 100,000 PERSONS). CANCER DEATH RATE, AGE-ADJUSTED DEATH RATES PER 100,000 PERSONS, 2020: ADAMS COUNTY HAD THE HIGHEST AGE-ADJUSTED RATE OF DEATH FOR ALL CANCERS AT 140.3 AND GILPIN COUNTY WAS THE LOWEST AT 105.4 PER 100,000 PERSONS. ADAMS COUNTY AND WELD COUNTY (133.2 PER 100,000) WERE HIGHER THAN THE STATE RATE OF DEATH BY CANCER (125.1) AND HIGHER THAN THE HEALTHY PEOPLE 2030 OBJECTIVE OF 122.7 PER 100,000 PERSONS FOR ALL CANCERS. ALL OTHER COUNTIES WERE BELOW THE STATE AND HEALTHY PEOPLE 2030 RATES.HEART DISEASE DEATH RATE, AGE - ADJUSTED DEATH RATE PER 100,000 PERSONS, 2020: ADAMS COUNTY HAS AN AGE- ADJUSTED RATE OF DEATH DUE TO HEART DISEASE OF 149.7 FOLLOWED BY JEFFERSON COUNTY OF 127.2, GILPIN COUNTY 107.0, WELD COUNTY 115.8, BROOMFIELD COUNTY 91.5, AND BOULDER COUNTY OF 106.8 PER 100,000 PERSONS. THE RATE FOR THE STATE OF COLORADO WAS 124.7.STROKE DEATH RATE, AGE - ADJUSTED PER 100,000 PERSONS, 2020: THE RATE OF DEATH FOR CEREBROVASCULAR DISEASE IN ADAMS COUNTY WAS 43.8, BOULDER COUNTY 37.2, JEFFERSON COUNTY 31.1, BROOMFIELD COUNTY 23.3 AND WELD COUNTY 27.5 PER 100,000 PERSONS. THE RATE FOR THE STATE OF COLORADO WAS 34.9.

PART III, LINE 4:
THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE IN THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES THE BAD DEBT ALLOWANCE AND BAD DEBT EXPENSE: NET PATIENT SERVICE REVENUE GENERALLY RELATES TO CONTRACTS WITH PATIENTS IN WHICH THE PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO PATIENTS OVER A PERIOD OF TIME. REVENUE IS ESTIMATED FOR PATIENTS WHO HAVE NOT BEEN DISCHARGED AS OF THE REPORTING PERIOD BASED ON ACTUAL CHARGES INCURRED TO DATE IN RELATION TO TOTAL EXPECTED CHARGES. SCL HEALTH BELIEVES THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. THE CONTRACTUAL RELATIONSHIP WITH PATIENTS ALSO TYPICALLY INVOLVES A THIRD-PARTY PAYOR (MEDICARE, MEDICAID, MANAGED CARE PLANS, AND COMMERCIAL INSURANCE COMPANIES), AND THE TRANSACTION PRICES FOR THE SERVICES PROVIDED ARE DEPENDENT UPON THE TERMS PROVIDED BY OR NEGOTIATED WITH THE THIRD-PARTY PAYORS. THE PAYMENT ARRANGEMENTS WITH THIRD-PARTY PAYORS FOR THE SERVICES PROVIDED TO THE RELATED PATIENTS TYPICALLY SPECIFY PAYMENT OR REIMBURSEMENT TO SCL HEALTH AT OTHER-THAN-STANDARD CHARGES. BECAUSE ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, SCL HEALTH HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION NOT TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY SATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY SATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD. NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED AND INCLUDES ESTIMATES OF IMPLICIT PRICE CONCESSIONS AND RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS, AND INVESTIGATIONS. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO UNINSURED PATIENTS AND PATIENTS WITH CO-PAYS, CO-INSURANCE, AND DEDUCTIBLES AND ARE ESTIMATED BASED ON HISTORICAL COLLECTION DATA. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, OR INVESTIGATIONS.

PART III, LINE 9B:
AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WEMAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TOTHOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED.

PART VI, LINE 2:
LUTHERAN MEDICAL CENTER:AS PART OF LUTHERAN MEDICAL CENTER'S CORE VALUE OF SERVICE TO THE POOR AND VULNERABLE, THE HOSPITAL TAKES STEPS TO DETERMINE WHERE THERE IS THE MOST NEED IN ORDER TO PROVIDE THE GREATEST GOOD THROUGH INCREMENTAL REVIEW OF CURRENT NEEDS ACROSS THE COMMUNITIES SERVED. AS AN ACTIVE MEMBER AND LEADER OF THE NEWLY FORMED JEFFERSON COUNTY HEALTH ALLIANCE, THE HOSPITAL IS IN TOUCH WITH CURRENT NEEDS AND POISED TO RESPOND WHEN NEW NEEDS ARE IDENTIFIED. AN EXAMPLE OF THIS RESPONSIVE APPROACH CAN BE FOUND IN THE LMC PIVOT RELATED TO ITS VACCINE RESPONSE WHEN LAGS IN UPTAKE WERE IDENTIFIED. AS DATA REVEALED A DISPROPORTIONATELY LOW PARTICIPATION IN COVID VACCINATION AMONG COMMUNITY MEMBERS IDENTIFYING AS HISPANIC, LMC INITIATED A COMMUNICATION EFFORT. WIDE DISSEMINATION OF SPANISH LANGUAGE FLYERS, SPANISH SPEAKING COMMUNITY NAVIGATORS, AND CHANGES TO THE ID AND INSURANCE PREFERENCES ALL LEAD TO A 112% INCREASE IN UPTAKE IN THE POPULATION OF FOCUS.GOOD SAMARITAN MEDICAL CENTER:IN ADDITION TO THE CHNA PROCESS, GSMC ACTIVELY PARTICIPATES WITH COMMUNITY COALITIONS AND WORK GROUPS WHO WORK ON SPECIFIC HEALTH ISSUES WITHIN THE COMMUNITY. THESE PARTNERSHIPS ENABLE AN ABILITY TO REVIEW OUTCOME METRICS ON HEALTH ISSUES IN A MORE DYNAMIC FASHION, EITHER THROUGH PROGRAM DELIVERY RESULTS, SERVICES TO VULNERABLE POPULATIONS AND/OR ANNUAL MEETINGS. INTERNAL TRACKING AND REVIEWS ARE COMPLETED IN ORDER TO CONFIRM THAT GSMC PROGRAMS ARE MEETING THEIR GOALS TO ADDRESS THE NEEDS OF THE COMMUNITY.

PART VI, LINE 3:
THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS AND THROUGH THE PATIENT PORTAL, MYCHART. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.

PART VI, LINE 6:
"THE ORGANIZATION IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION: ""WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE."" WE STRIVE TO PROVIDE HIGH-QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE IN EACH OF OUR HOSPITAL SITES AND THEIR RESPECTIVE COMMUNITIES, AS WELL AS IN A VARIETY OF OUTPATIENT SETTINGS AND IN THE HOME. SCLHS IS A FAITH-BASED, NONPROFIT HEALTHCARE ORGANIZATION THAT OPERATES EIGHT HOSPITALS, TWO SAFETY NET CLINICS, ONE CHILDREN'S MENTAL HEALTH CENTER, HOME HEALTH AND MORE THAN 200 PHYSICIAN CLINICS IN THREE STATES - COLORADO, KANSAS AND MONTANA. THE HEALTH SYSTEM INCLUDES MORE THAN 15,700 EMPLOYEES AND MORE THAN 500 EMPLOYED PHYSICIANS.AS OUR HEALTH SYSTEM GROWS, WE'RE LEVERAGING THAT GROWTH TO ACHIEVE BENEFITS OF SCALE - IDENTIFYING COST AND OTHER ADVANTAGES THAT WE GAIN DUE TO OUR SIZE. WE'RE ALSO WORKING TO STREAMLINE AND UNIFY OUR SYSTEM-WIDE PROCESSES TO ELIMINATE COSTLY DUPLICATION OF EFFORT. WE ACTIVELY ENCOURAGE OUR PEOPLE TO PURSUE CREATIVE IDEAS THAT IMPROVE EFFICIENCY, SERVICE AND THE OVERALL CARE EXPERIENCE. WHEN OUR ASSOCIATES OR LEADERSHIP TEAMS IDENTIFY BEST PRACTICES IN ANY AREA OF CARE, WE RAPIDLY REPLICATE THOSE ACROSS ALL CARE SITES.THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. ADDITIONALLY, SCLHS BENEFITS AFFILIATES THROUGH QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE INFORMATION TECHNOLOGY IMPLEMENTATION AND INFRASTRUCTURE; STRATEGIC AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; FINANCE ADMINISTRATION, REVENUE CYCLE SUPPORT, BENEFITS ADMINISTRATION, RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, LEGAL SERVICES, TAX SERVICES AND MISSION INTEGRATION."

SCHEDULE H, PART VI, LINE 4
CIGARETTE/E-CIGARETTE SMOKING, 2016-2018: THE HEALTHY PEOPLE 2030 OBJECTIVE IS 5% OF THE POPULATION WHO SMOKE CIGARETTES. ALL SERVICE AREA COUNTIES EXCEED THIS RATE. 8% OF PREGNANT MOTHERS IN JEFFERSON COUNTY AND 7.8% IN GILPIN COUNTY SMOKED DURING THEIR PREGNANCY. AMONG STUDENTS WHO REPORTED USING AN E-CIGARETTE IN THE PAST 30 DAYS, RATES RANGED FROM 23.4% IN HSR 14, ADAMS COUNTY, TO 29.3% IN HSR 18, WELD COUNTY. HSR 17, GILPIN COUNTY, HAD THE HIGHEST RATES OF STUDENTS REPORTING SMOKING CIGARETTES IN THE LAST 30 DAYS (8.7%). ABOUT 15% OF COLORADO ADULTS SMOKE CIGARETTES AND 5.7% OF COLORADO HIGH SCHOOL STUDENTS REPORTED SMOKING CIGARETTES ONE OR MORE TIMES IN THE PAST 30 DAYS. 26.1% OF STUDENTS REPORTED USING AN ELECTRONIC VAPOR PRODUCT ONE OR MORE TIMES WITHIN THE PAST 30 DAYS, AND 6.1% OF PREGNANT WOMEN IN COLORADO REPORTED SMOKING CIGARETTES. FREQUENT MENTAL DISTRESS, ADULT, 2018: THE PERCENTAGE OF THE ADULT POPULATION REPORTING MORE THAN 14 DAYS OF POOR MENTAL HEALTH PER MONTH WAS 10.0% IN BOULDER COUNTY AND 11.8% IN ADAMS COUNTY. BROOMFIELD COUNTY HAD THE HIGHEST LEVEL OF FREQUENT MENTAL DISTRESS AMONG ADULTS (15.4%) IN THE SERVICE AREA, AND JEFFERSON COUNTY HAD THE LOWEST LEVEL OF FREQUENT MENTAL DISTRESS AMONG ADULTS (9.8%). JUST UNDER 11% OF COLORADO ADULTS REPORTED FREQUENT MENTAL DISTRESS. BINGE DRINKING, ADULTS, 2016- 2018: BINGE DRINKING IS DEFINED AS FIVE OR MORE DRINKS ON ONE OCCASION FOR MEN AND FOUR OR MORE DRINKS FOR WOMEN. THE HEALTHY PEOPLE 2030 OBJECTIVE IS THAT ONLY 25.4% OF ADULTS ENGAGE IN BINGE DRINKING IN THE PAST MONTH. HEAVY DRINKING IS DEFINED AS MORE THAN TWO DRINKS PER DAY FOR MEN AND MORE THAN ONE DRINK A DAY FOR WOMEN. IN THE SERVICE AREA, HSR 16 (BOULDER AND BROOMFIELD COUNTIES) HAD THE HIGHEST RATES OF DRINKING AMONG STUDENTS WITH 36.6% OF STUDENTS REPORTING HAVING HAD AT LEAST 1 DRINK IN THE PAST 30 DAYS. HSR 21, JEFFERSON COUNTY, HAD THE HIGHEST LEVEL OF BINGE DRINKING (21.4%) IN THE SERVICE AREA. SEVEN PERCENT OF COLORADO RESIDENTS REPORTED HEAVY DRINKING WITHIN THE PAST MONTH AND 19.1% REPORTED BINGE DRINKING WITHIN THE PAST MONTH. JUST UNDER 30% OF HIGH SCHOOL STUDENTS REPORTED HAVING AT LEAST 1 DRINK IN THE PAST 30 DAYS IN COLORADO.

PART VI, LINE 5:
"LUTHERAN MEDICAL CENTER:LMC HAS A MULTITUDE OF PROGRAMS IN PLACE THROUGH ITS CANCER CENTER, NEUROVASCULAR CENTER, TRAUMA CENTER AND THROUGH COMMUNITY OUTREACH. A VARIETY OF CLASSES ARE OFFERED ON WEIGHT MANAGEMENT AND MAINTAINING A HEALTHY LIFESTYLE. SUPPORT GROUPS FOR CANCER PATIENTS ARE ALSO OFFERED. ADDITIONALLY, LMC ROUTINELY OFFERS COMMUNITY HEALTH EDUCATION, SKIN CANCER SCREENINGS, BREAST CANCER SURVIVORSHIP PROGRAMS, CLASSES FOR PROSPECTIVE PARENTS AND DIABETES MANAGEMENT CLASSES, TO NAME A FEW. LMC PARTNERS WITH SAFETY NET CLINICS SUCH AS STRIDE. LMC ALSO RECOGNIZES THE ESSENTIAL NEED TO ENHANCE AND IMPROVE MEDICAL OUTCOMES, QUALITY, AND SERVICES. THE OBJECTIVES OF THESE PROGRAMS ARE TO BE A HIGHLY RELIABLE ORGANIZATION, OFFER HIGH QUALITY CARE, PROVIDE SAFETY FOR PATIENTS AND STAFF, AND BE COST EFFECTIVE. THE QUALITY INDICATORS ARE IN ALIGNMENT WITH MAJOR PUBLICLY COMPARABLE DATABASES INCLUDING THE COLORADO HEALTH AND HOSPITAL ASSOCIATION AND CENTERS FOR MEDICARE AND MEDICAID SERVICES. GOOD SAMARITAN MEDICAL CENTER:COLLECTIVELY WITH ITS 234 LICENSED BEDS, GOOD SAMARITAN MEDICAL CENTER (GSMC) HAS SERVED ITS COMMUNITY BY PROVIDING COMPREHENSIVE MEDICAL SERVICES INCLUDING CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, WOMEN AND FAMILY, EMERGENCY AND TRAUMA, NEONATAL INTENSIVE CARE, NEUROLOGY, NEUROSURGERY, OB/GYN, GENERAL SURGICAL AND MEDICAL, PRIMARY CARE, INTERNAL MEDICINE, BEHAVIORAL HEALTH, SENIOR EMERGENCY DEPARTMENT CARE, PALLIATIVE & HOSPICE CARE AND INTEGRATIVE HEALTH SERVICES.COMMUNITY OUTREACH PROGRAMS: OUTREACH PROGRAMS WERE STILL IMPACTED IN 2021 BY COVID RESTRICTIONS AND NOT ALL CLASSES AND OUTREACH EFFORTS HAVE RETURNED TO THE NORMAL. -GSMC PROVIDED FREE COVID VACCINATION CLINICS TO THE PUBLIC ADMINISTERING OVER 28,000 VACCINES.-BABY'S FIRST RIDE- PROVIDED 1061 CAR SEAT CHECKS-AGING MASTERY PROGRAM- THIS IS A COURSE TO HELP OLDER ADULTS IMPROVE HEALTHY BEHAVIORS AND TO LEARN BEHAVIORS THAT WILL INCREASE WELL-BEING AS THEY AGE. THE CLASS CONSISTS OF TEN 1.5 HOUR CLASSES AND COVER TOPICS SUCH AS: FALL PREVENTION; MEDICATION MANAGEMENT; HEALTHY EATING AND HYDRATION; FINANCIAL FITNESS; COMMUNITY ENGAGEMENT AND ADVANCE PLANNING. TWELVE PEOPLE ATTENDED THIS CLASS.-CANCER SUPPORT GROUP: TWO GROUPS- ONE SPECIFICALLY FOR YOUNG ADULTS WITH CANCER. OFFERED BY THE CANCER CENTERS OF COLORADO AT GSMC-STROKE SUPPORT GROUP- VIRTUAL GROUP DONE IN COLLABORATION WITH THE ROCKY MOUNTAIN STROKE CENTER.-""DOING GOOD"" GRANT - EIGHT GRANTS DISTRIBUTED IN 2021 WORTH NEARLY $114,000. 1) VIA MOBILITY, 2) SISTER CARMEN COMMUNITY CENTER, 3) BROOMFIELD FISH, 4) BROOMFIELD PARKS AND RECREATION, 5) BICYCLE COLORADO, 6) CLINICA FAMILY HEALTH, 7) WOW! CHILDREN'S MUSEUM, 8) MENTAL HEALTH PARTNERS. LOCAL NON-PROFITS WROTE A 4 PAGE APPLICATION TO APPLY FOR THE FUNDS.-EMS PROGRAM TO PROVIDE CONTINUING EDUCATION TO LOCAL EMS PROVIDERS- 624 ENCOUNTERS (FREDERICK-FIRESTONE FIRE DEPARTMENT, LAFAYETTE FIRE DEPARTMENT, PLEASANT VIEW FIRE DEPARTMENT)-EMS PROGRAM TO PROVIDE EDUCATIONAL FOLLOW UP TO EMS PROVIDERS WHO DROPPED OFF PATIENTS AT GSMC- 782 ENCOUNTERS ANNUAL TRAUMA CONFERENCE FOR GSMC AND EMS PROVIDERS (VIRTUAL IN 2021) 282 ATTENDEES-RECERTIFICATION FOR EMS PROVIDERS (39 ENCOUNTERS) PROVIDES PARAMEDIC REFRESHER COURSE, CPR AND AED TRAINING, BASIC EKG TRAINING-IN KIND DONATIONS TO PROJECT CURE IN EXCESS OF $90,000.-QPR SUICIDE PREVENTION TRAINING- 70 STAFF AND COMMUNITY MEMBERS PARTICIPATED IN THIS 1 HOUR COURSE-STUDENT CLINICALS- 212 STUDENTS COMPLETED THEIR CLINICAL ROTATIONS IN NURSING, PHARMACY, RADIOLOGY, LABORATORY, PHYSICAL MEDICINE, SURGERY AT GSMC-WHAT DO YOU CONSIDER LETHAL- TEEN DRIVER TRAINING WHICH ADDRESSES DISTRACTED AND RECKLESS DRIVING. 28 PEOPLE ATTENDED THE CLASS IN 2021.-FRIENDS DON'T LET FRIENDS FALL OBSTACLE COURSE- FALL PREVENTION TRAINING FOR OLDER ADULTS- 27 PEOPLE ATTENDED THE CLASS IN 2021.-BICYCLE SAFETY AND HELMET DISTRIBUTION- 121 ATTENDED THE TRAINING AND 57 HELMETS WERE DISTRIBUTED-FALL PREVENTION EDUCATION AT FESTIVALS AND FAIRS IN COLLABORATION WITH NORTH METRO FIRE- 270 ENCOUNTERS-PROVIDED $500 TO COMMUNITY REACH CENTER TO COVER COST FOR MENTAL HEALTH FIRST AID TRAINING.WE ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, IN RESPONSE TO DIRECT REQUESTS FROM COMMUNITY ORGANIZATIONS AND RESIDENTS. FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS, OUR COMMUNITY INVOLVEMENT TAKES MANY FORMS. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT RESIDENTS ARE INFORMED ABOUT AVAILABLE SERVICES. WHEN GSMC HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO CARE FOR UNMET NEED AREAS."

SCHEDULE H, PART VI, LINE 4
UNINTENTIONAL INJURY DEATH RATE, AGE - ADJUSTED PER 100,000 PERSONS, 2020: ADAMS COUNTY HAD THE HIGHEST RATE AT 65.6 FOLLOWED BY GILPIN COUNTY AT 61.6, JEFFERSON COUNTY 60.8, WELD COUNTY 54.7, BOULDER COUNTY 42.4, AND BROOMFIELD COUNTY 39.6 PER 100,000 PERSONS. THESE ALL EXCEED THE HEALTHY PEOPLE 2030 OBJECTIVE FOR UNINTENTIONAL INJURY DEATHS OF 43.2 PER 100,000 PERSONS.DIABETES DEATH RATE, AGE ADJUSTED PER 100,000 PERSONS, 2020: THE AGE - ADJUSTED DEATH RATE FOR DIABETES WAS HIGHEST IN ADAMS COUNTY AT 24.3 FOLLOWED BY WELD COUNTY 20.9, BROOMFIELD COUNTY 12.1, JEFFERSON COUNTY 12.0, AND BOULDER COUNTY 10.6 PER 100,000 PERSONS.PNEUMONIA DEATH RATE, AGE- ADJUSTED PER 100,000 PERSONS, 2020: THE DEATH RATE FROM PNEUMONIA HIGHEST IN ADAMS COUNTY WAS 6.7, FOLLOWED BY BROOMFIELD COUNTY AT 5.9, WELD COUNTY 5.8, BOULDER COUNTY 5.6, AND JEFFERSON COUNTY AT 5.3 PER 100,000 PERSONS. THE RATE FOR THE STATE OF COLORADO WAS 5.8 PER 100,000 PERSONS.SUICIDE DEATH RATE, AGE-ADJUSTED PER 100,000 PERSONS, 2020: THE COUNTY WITH THE HIGHEST RATE OF DEATH BY SUICIDE WAS ADAMS COUNTY AT 22.0 PER 100,000, FOLLOWED BY WELD COUNTY 17.0, JEFFERSON COUNTY 19.3, BOULDER COUNTY 17.7, AND BROOMFIELD COUNTY 8.6 PER 100,000 PERSONS. ALL COUNTIES EXCEPT BROOMFIELD AND THE STATE RATE OF 21.4 EXCEED THE HEALTHY PEOPLE OBJECTIVE OF 12.8 DEATHS PER 100,000 PERSONS.DRUG-INDUCED DEATH RATE, AGE - ADJUSTED PER 100,000 PERSONS. 2020: THE HIGHEST RATE OF DRUG- INDUCED DEATHS IS SEEN IN GILPIN COUNTY AT 57.8, FOLLOWED BY JEFFERSON COUNTY 29.2, ADAMS COUNTY 26.7, WELD COUNTY 16.2, BOULDER COUNTY 15.7 AND BROOMFIELD COUNTY 13.9 PER 100,000 PERSONS.THE AGE-ADJUSTED DRUG-INDUCED DEATH RATE FOR THE STATE IS 25.5. ALCOHOL LIVER DISEASE, AGE- ADJUSTED PER 100,000 PERSONS, 2016: THE RATE OF DEATH DUE TO ALCOHOL LIVER DISEASE WAS HIGHEST IN ADAMS COUNTY AT 19.9 FOLLOWED BY JEFFERSON COUNTY 12.4, BOULDER COUNTY 9.9, WELD COUNTY 9.3, AND BROOMFIELD COUNTY 6.1 PER 100,000 PERSONS. THE RATE FOR THE STATE WAS 13.5. HIV/ AIDS MORTALITY, AGE- ADJUSTED PER 100,000 PERSONS, 2020: THE RATE OF DEATH DUE TO HIV/AIDS WAS 1.0 IN ADAMS COUNTY AND 0.9 IN JEFFERSON COUNTY. THE RATES FOR THE OTHER COUNTIES WERE TOO LOW TO BE RECORDED. THE STATE RATE WAS 0.7.HEALTH INSURANCE COVERAGE, CIVILIAN NONINSTITUTIONALIZED POPULATION, AGES 18-64: HEALTH INSURANCE COVERAGE IS CONSIDERED A KEY COMPONENT TO ACCESS HEALTH CARE. THE HEALTHY PEOPLE 2030 OBJECTIVE IS FOR 92.1% OF THE POPULATION TO HAVE HEALTH INSURANCE COVERAGE. IN THE SERVICE AREA, 93.8% OF THE POPULATION WAS INSURED. INSURANCE COVERAGE IN HSR 16 (BOULDER AND BROOMFIELD COUNTIES) WAS 94.7%. INSURANCE COVERAGE WAS HIGHER IN HSR 18, WELD COUNTY (95.9%) THAN IN HSR 14, ADAMS COUNTY (90.9%). INSURANCE COVERAGE WAS HIGHEST IN HSR 21, JEFFERSON COUNTY (97.4%), AND LOWEST IN HSR 17, GILPIN COUNTY (88.2%). HEALTH INSURANCE COVERAGE RANGED FROM 85.3% IN DENVER 80260 TO 99.4% IN BOULDER 80310. COLORADO HAD 93.5% INSURANCE COVERAGE ACROSS THE STATE. UNINSURED CHILDREN, AGE 0-18 2019: THE PERCENTAGE OF UNINSURED CHILDREN UNDER THE AGE OF 18 WAS HIGHEST ADAMS AND WELD COUNTIES (4.6%) FOLLOWED BY JEFFERSON COUNTY (3.5%), BOULDER COUNTY (2.1%). BROOMFIELD COUNTY (2.0%) HAD THE LOWEST RATE OF UNINSURED CHILDREN IN THE SERVICE AREA. EXCEPT FOR ADAMS AND WELD COUNTIES, ALL COUNTIES HAD LOWER RATES THAN THE STATE RATE OF 4.5%.ADULTS WITH UNMET MEDICAL NEED DUE TO COST: NEARLY 15% OF ADULTS IN HSR 17 (GILPIN, CLEAR CREEK, PARK AND TELLER COUNTIES) AND 12% OF ADULTS IN HRS 18, WELD COUNTY HAD AN UNMET MEDICAL NEED AND WERE NOT ABLE TO AFFORD CARE. HSR 16 (BOULDER AND BROOMFIELD COUNTIES) HAD THE LOWEST RATES OF FOREGONE MEDICAL CARE DUE TO COST AMONG COUNTIES IN THE SERVICE AREA (8.1%), AND HSR 14, ADAMS COUNTY HAD THE HIGHEST RATE (16.9%). JUST UNDER 13% OF COLORADO RESIDENTS DID NOT GET NEEDED CARE. PRIMARY CARE PHYSICIANS, NUMBER AND RATIO, 2019: THE PRIMARY CARE PHYSICIAN RATIO REPRESENTS THE NUMBER OF LICENSED PHYSICIANS PER 1,000 PERSONS. WELD COUNTY HAD THE LOWEST RATE OF PRIMARY CARE PHYSICIANS IN THE SERVICE AT 0.9 PER 1,000 PERSONS AND GILPIN AND BOULDER COUNTIES HAD THE HIGHEST RATE OF PHYSICIANS AT 2.5 PER 1,000 PERSONS. THERE WERE 3.1 LICENSED PHYSICIANS PER 1,000 PERSONS IN COLORADO. ADULTS WITH UNMET DENTAL CARE DUE TO COST, 2019: MORE THAN 18% OF ADULTS DID NOT GET THE DENTAL CARE THEY NEEDED IN HSR 16, (BOULDER AND BROOMFIELD COUNTIES) BECAUSE OF COST. HSR 17, GILPIN COUNTY, HAD THE HIGHEST RATE OF FOREGONE DENTAL CARE DUE TO COST (26.4%), AND HSR 18, WELD COUNTY, HAD THE LOWEST RATE (16.8%). HSR 16, (BOULDER AND BROOMFIELD COUNTIES) HAD THE HIGHEST RATES OF ADULT DENTAL VISITS (82.1%), AND HSR 14, ADAMS COUNTY HAD THE LOWEST (69.1%). NEARLY 74% OF COLORADO RESIDENTS HAD A DENTAL VISIT LAST YEAR AND 20.6% NEEDED DENTAL CARE BUT DID NOT GET IT DUE TO COST. MENTAL HEALTH PROVIDERS, NUMBER AND RATIO, 2020: MENTAL HEALTH PROVIDERS INCLUDE PSYCHIATRISTS, CLINICAL PSYCHOLOGISTS, CLINICAL SOCIAL WORKERS, PSYCHIATRIC NURSE SPECIALISTS, AND MARRIAGE AND FAMILY THERAPISTS WHO MEET CERTAIN QUALIFICATIONS AND CERTIFICATIONS. BOULDER COUNTY HAD THE MOST MENTAL HEALTH PROVIDERS (6.3 PER 1,000 PERSONS) IN THE SERVICE AREA AND WELD HAD THE FEWEST (1.7 PER 1,000 PERSONS). GILPIN COUNTY HAD THE MOST MENTAL HEALTH TREATMENT FACILITIES AT 1.66 PER 10,000 PERSONS AND BOULDER COUNTY HAD THE LEAST (0.12 PER 10,000 PERSONS). COLORADO HAD 2.7 MENTAL HEALTH PROVIDERS PER 1,000 PERSONS AND 0.28 MENTAL HEALTH TREATMENT FACILITIES PER 10,000 PERSONS. FAIR OR POOR HEALTH, ADULTS, 2018: WHEN ASKED TO SELF-REPORT ON HEALTH STATUS WITHIN THE PAST MONTH. ADAMS COUNTY HAD THE HIGHEST RATE OF SELF-REPORTED POOR PHYSICAL HEALTH (11.8%), AND BROOMFIELD COUNTY HAD THE LOWEST RATE (8.2%). 9.1% OF ADULTS IN COLORADO REPORTED POOR PHYSICAL HEALTH FOR 14 OR MORE DAYS WITHIN THE LAST MONTH. ASTHMA PREVALENCE, PERCENT OF ADULT POPULATION (18 AND OLDER), 2018: THE PREVALENCE OF ASTHMA IS 11.3% IN ADAMS COUNTY, BEING THE HIGHEST, 9.7% IN JEFFERSON COUNTY, 8.7% IN WELD COUNTY, 8.0% IN BROOMFIELD COUNTY, 6.9% IN GILPIN COUNTY AND 6.7% IN BOULDER COUNTY, BEING THE LOWEST PERCENTAGE. ONLY ADAMS AND JEFFERSON COUNTY RATES WERE HIGHER THAN THE STATE RATE OF 8.9%.ADULT DIABETES PREVALENCE, 2018: THE PERCENTAGE OF ADULT DIABETES IS THE HIGHEST IN WELD COUNTY 8.6%,FOLLOWED BY ADAMS COUNTY WITH 8.4%, JEFFERSON COUNTY 6.3%, BROOMFIELD AND BOULDER COUNTY 5.9%, AND GILPIN COUNTY 4.0%, BEING THE LOWEST. ONLY ADAMS AND WELD COUNTY RATES WERE HIGHER THAN THE STATE RATE OF 6.8%.HIGH BLOOD PRESSURE, 2018: THE PERCENTAGE OF HIGH BLOOD PRESSURE IS THE HIGHEST IN GILPIN COUNTY 33.7%, FOLLOWED BY ADAMS COUNTY WITH 26.3%, WELD COUNTY 25.1%, JEFFERSON COUNTY 24.6%, BROOMFIELD COUNTY 23.9%, AND BEING THE LOWEST, BOULDER COUNTY OF 22.6%. ONLY GILPIN AND ADAMS COUNTY RATES WERE HIGHER THAN THE STATE RATE OF 25.8%.SEXUALLY TRANSMITTED INFECTIONS, PER 100,000 PERSONS, 2018: RATES OF HIV, CHLAMYDIA AND GONORRHEA WERE HIGHEST IN ADAMS COUNTY COMPARED TO OTHER SERVICE AREA COUNTIES. CHLAMYDIA HAD THE HIGHEST INCIDENCE RATES OF A SEXUALLY TRANSMITTED INFECTION: 571.2 PER 100,000 PERSONS IN ADAMS COUNTY AND 458.2 PER 100,000 PERSONS IN WELD COUNTY. GILPIN COUNTY HAD THE LOWEST RATES OF GONORRHEA (49.2 PER 100,000 PERSONS), AND CHLAMYDIA (65.6 PER 100,000 PERSONS) AMONG THE COUNTIES IN THE SERVICE AREA. ADULT OVERWEIGHT (BMI 25.5 TO 29.9) AND ADULT OBESE (BMI > 30), 2018: IN THE SERVICE AREA, ADAMS COUNTY HAD THE HIGHEST RATE OF OVERWEIGHT OR OBESE ADULTS AS A PERCENTAGE OF THE POPULATION (67.6%), AND WELD COUNTY HAD THE HIGHEST RATE OF ADULT OBESITY (29.3%). JUST MORE THAN 58% OF COLORADO IS OVERWEIGHT OR OBESE AND 22.6% OF THE POPULATION IS OBESE.PHYSICAL ACTIVITY, 2018: IN THE SERVICE AREA, BOULDER COUNTY HAD THE LOWEST RATE OF PHYSICAL INACTIVITY (9.8%), AND BROOMFIELD COUNTY HAD THE HIGHEST LEVEL OF ACCESSIBILITY TO LOCATIONS FOR PHYSICAL ACTIVITY (99.5%). SLIGHTLY MORE THAN 90% OF COLORADO RESIDENTS HAD ACCESS TO LOCATIONS FOR PHYSICAL ACTIVITY AND 16.1% OF COLORADO RESIDENTS REPORTED NO LEISURE TIME PHYSICAL ACTIVITY.