4A (Expenses $ 404973048 including grants of $ 219432) (Revenue $ 434144169)
SEE SCHEDULE O

LAWRENCE + MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. LAWRENCE+MEMORIAL HOSPITAL AND ITS COMMUNITY PARTNERS SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS.SCHEDULE H, PART V, SEC B, LINE 7A AND 10A:HTTPS://WWW.LMHOSPITAL.ORG/ABOUT/COMMUNITY-INVOLVEMENT/COMMUNITY-PARTNERSHIPS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

LAWRENCE + MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: YES, THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH COMMUNITY PARTNERS THAT PROVIDED GUIDANCE, EXPERTISE, AND ONGOING COLLABORATION TO FOSTER COLLECTIVE IMPACT IN IMPROVING THE HEALTH AND WELLBEING OF THE GREATER NEW LONDON COMMUNITY. THIS INCLUDED THE HEALTH IMPROVEMENT COLLABORATIVE OF SOUTHEASTERN CONNECTICUT, WHOSE MEMBER ORGANIZATIONS ARE REPRESENTATIVE OF THOSE IN THE COMMUNITY WHO SERVE UNDERSERVED, LOW-INCOME, AND HARD TO REACH POPULATIONS. THIS APPROACH TO ASSESSMENT AND PLANNING AIMS TO ENGAGE AGENCIES, ORGANIZATIONS, AND RESIDENTS IN THE AREA THROUGH PARTICIPATORY AND COLLABORATIVE APPROACHES.

LAWRENCE + MEMORIAL HOSPITAL
PART V, SECTION B, LINE 11: LAWRENCE+MEMORIAL HOSPITAL DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO GUIDE OUR EFFORTS IN RESPONDING TO OUR COMMUNITY'S NEEDS. USING RECOMMENDATIONS FROM THE PEOPLE WHO DELIVER AND USE THESE SERVICES, WE WILL FOSTER COLLABORATION TO BETTER COORDINATE OUR COMMUNITY RESOURCES. WE WILL SEEK TO BETTER CONNECT PEOPLE TO THE SERVICES THEY NEED AND REDUCE DISPARITIES IN HEALTH AND SOCIOECONOMIC MEASURES THAT STEM FROM UNDERLYING INEQUITIES IN OUR SOCIETY. WE USED THE TOP NEEDS IDENTIFIED THROUGH COMMUNITY ENGAGEMENT AS A FOUNDATION FOR OUR CHIP DEVELOPMENT TO ADDRESS THE NEEDS OF GREATEST CONCERN TO COMMUNITY MEMBERS. THESE INDIVIDUALS PROVIDED DIVERSE PERSPECTIVES ON HEALTH TRENDS, SHARED LIVED EXPERIENCES AMONG HISTORICALLY DISENFRANCHISED AND UNDERSERVED POPULATIONS, AND PROVIDED INSIGHTS INTO SERVICE DELIVERY GAPS THAT CONTRIBUTE TO HEALTH DISPARITIES AND INEQUITIES. THE COMMUNITY NEEDS ARE AFFORDABLE HEALTHCARE, BEHAVIORAL HEALTH, DRUG/ALCOHOL MISUSE, EDUCATION, FINANCIAL SECURITY, FOOD SECURITY AND HOUSING. THE CHIP PROVIDES DIRECTION FOR ADDRESSING THE HEALTH AND WELLBEING NEEDS OF THE COMMUNITY.THE CHIP WAS DEVELOPED BY A HOSPITAL TASK FORCE COMPRISED OF LEADERS FROM MULTIPLE DEPARTMENTS TO CAPTURE ALL HOSPITAL AND HEALTH SYSTEM EFFORTS THAT IMPACT THE HEALTH OF THE LOCAL COMMUNITY. CHIP GOALS REFLECT IDENTIFIED NEEDS AND WERE CONFIRMED THROUGH DISCUSSIONS WITH COMMUNITY LEADERS AND STAKEHOLDERS. OUR PRIORITY AREAS COME FROM THE TOP NEEDS IDENTIFIED BY THE CHNA AND ARE ALIGNED WITH THOSE OF OUR COLLECTIVE IMPACT PARTNERSHIP, THE HEALTH IMPROVEMENT COLLABORATIVE (HIC) OF SOUTHEASTERN CONNECTICUT: ACCESS TO CARE, BEHAVIORAL HEALTH, COMMUNITY HEALTH AND WELLBEING, AND HEALTHY LIVING. THESE PRIORITY AREAS REFLECT THE GREATEST NEEDS IN THE COMMUNITY WITH HEALTH SYSTEM AND HOSPITAL GENERATED STRATEGIES FOR ACTION AND ALIGNMENT WITH STATEWIDE EFFORTS IN THE STATE OF CONNECTICUT HEALTH IMPROVEMENT PLAN.

LAWRENCE + MEMORIAL HOSPITAL
PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ONLY.

LAWRENCE + MEMORIAL HOSPITAL
PART V, SECTION B, LINE 16J: WEBSITE PROVIDES DIRECT EMAIL LINK TO FINANCIAL COUNSELORS.

SCHEDULE H, PART V, SECTION B, LINE 16A, 16B AND 16C:
WWW.LMHOSPITAL.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPX

PART I, LINE 3C:
THE FINANCIAL ASSISTANCE POLICY PROVIDES THAT THE PATIENT MUST SUBMIT A FINANCIAL ASSISTANCE APPLICATION.

PART I, LINE 7:
THE HOSPITAL USES A COST ACCOUNTING SYSTEM, STRATA, TO CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7 IN CONJUNCTION WITH ESTIMATING THE COST OF FREE CARE AND CHARITY CARE, THE RATIO OF COST TO CHARGE PERCENTAGE UTILITIZING THE COMPONENTS FROM THE HOSPITAL'S FINANCIAL STATEMENTS.

PART II, COMMUNITY BUILDING ACTIVITIES:
LAWRENCE+MEMORIAL HOSPITAL, ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER 30 YEARS TO PROVIDE SUPPORT TO NOT-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS ACTIVITIES THE ORGANIZATION ENGAGES IN TO PROTECT OR IMPROVE THE HEALTH AND SAFETY OF ITS RESIDENTS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING, COALITION BUILDING, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, AND WORKFORCE DEVELOPMENT.L+M HOSPITAL ENHANCES THE LIVES OF THOSE WE SERVE BY PROVIDING ACCESS TO INTEGRATED, HIGH-VALUE, PATIENT-CENTERED CARE IN COLLABORATION WITH OTHERS WHO SHARE OUR VALUES. AS SUCH, L+M HOSPITAL IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING, AND NEIGHBORHOODS. DURING FISCAL YEAR 2022, L+M HOSPITAL PROVIDED $18,300 IN FINANCIAL AND IN-KIND DONATIONS IN THE AREA OF COMMUNITY BUILDING ACTIVITIES. THE HOSPITAL CONSIDERS THESE INVESTMENTS PART OF ITS OVERALL COMMITMENT OF BUILDING STRONGER NEIGHBORHOODS. LAWRENCE+MEMORIAL PROVIDES SUPPORT TO OTHER ORGANIZATIONS ADDRESSING THE ISSUE OF FOOD INSECURITY, SOCIAL COHESION, AND ECONOMIC VITALITY.

PART III, LINE 2:
"LAWRENCE + MEMORIAL HOSPITAL (""L+M OR ""L+M HOSPITAL"") USES A COST REPORTING SYSTEM TO DETERMINE THE BAD DEBT EXPENSE. THE AMOUNT OF BAD DEBT EXPENSE (AT COST) REPORTED ON PART III, LINE 2 IS TAKEN DIRECTLY FROM THE AUDITED FINANCIAL STATEMENTS.DUE TO THE ADOPTION OF ASU NO. 2014-09 REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENTS. RATHER IT IS TREATED AS A PRICE CONCESSION. BAD DEBT IS DETERMINED IF THERE WAS AN ADVERSE EVENT THAT PREVENTED A PATIENT FROM BEING ABLE TO PAY THE EXPECTED AMOUNT. FOR THE PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY UNCOLLECTED AMOUNTS BUT DID NOT, THESE UNCOLLECTED AMOUNTS ARE TREATED AS IMPLICIT PRICE CONCESSIONS. THE HOSPITAL IS REPORTING BOTH BAD DEBT AND IMPLICIT PRICE CONCESSIONS ON SCHEDULE H, PART III, LINE 2."

PART III, LINE 3:
THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.

PART III, LINE 8:
THE MEDICARE SHORTFALL REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON COST REPORTING. THE COSTING METHOD WAS FROM THE MEDICARE COST REPORT'S OWN METHODOLOGY OF ALLOCATING COST BY DEPARTMENT AND DERIVING A RATIO OF COST TO CHARGES. THIS AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY LAWRENCE & MEMORIAL HOSPITAL. ACCORDINGLY, LAWRENCE + MEMORIAL HOSPITAL MUST SUBSIDIZE THE COST OF CARE PROVIDED TO MEDICARE BENEFICIARIES WITH OTHER REVENUES.

PART III, LINE 9B:
IT IS THE HOSPITAL'S POLICY TO TREAT ALL PATIENTS EQUITABLY WITH RESPECT AND COMPASSION, FROM THE BEDSIDE TO THE BILLING OFFICE. THE HOSPITAL WILL PURSUE PATIENT ACCOUNTS, DIRECTLY AND THROUGH ITS COLLECTION AGENTS, FAIRLY AND CONSISTENTLY TAKING INTO CONSIDERATION DEMONSTRATED FINANCIAL NEED. AS PART OF ITS COLLECTION PROCESS, THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO DETERMINE IF AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. IN THE EVENT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION AS DEFINED BY LAW AND HOSPITAL POLICY.

PART VI, LINE 2:
COMMUNITY NEEDS ARE ROUTINELY REVIEWED AND ADDRESSED AS PART OF THE OPERATIONS AND SERVICE LINE TEAMS AT LAWRENCE+MEMORIAL HOSPITAL. THESE MULTI-DISCIPLINARY GROUPS PROVIDE ANALYSIS AND INSIGHT INTO PATIENT UTILIZATION TRENDS ACROSS OUR DELIVERY OF CARE AND ARE REVIEWED IN TANDEM WITH CARE MANAGEMENT AND PATIENT SATISFACTION RESULTS AND OTHER COMMUNITY FEEDBACK. COUPLED WITH THE RECENTLY COMPLETED COMMUNITY NEEDS ASSESSMENT, THIS INFORMATION ASSISTS WITH THE DEVELOPMENT OF NEW INITIATIVES, PARTNERSHIPS, PROGRAMS, AND SERVICES TO BENEFIT OUR COMMUNITY.

PART VI, LINE 3:
LAWRENCE + MEMORIAL HOSPITAL INFORMS INDIVIDUALS ABOUT ITS FINANCIAL ASSISTANCE PROGRAMS ON ITS WEBSITE, THROUGH VISIBLE POSTINGS AND COMMUNICATIONS AT POINTS OF REGISTRATION AND FRONT LINE ACCESS. THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND SUMMARY ARE AVAILABLE ONREQUEST WITHOUT CHARGE BY MAIL, INCLUDING AT THE ADMITTING DEPARTMENT. FURTHER, PATIENTS RECEIVE A SUMMARY OF FINANCIAL ASSISTANCE PROGRAMS, INCLUDING ELIGIBILITY REQUIREMENTS THROUGH A FIRST STATEMENT MAILER AS PART OF THE BILLING PROCESS. THESE COMMUNICATIONS INCLUDE TELEPHONE NUMBERS AND THE POINT OF CONTACT FOR INDIVIDUALS TO VISIT OR CALL. THEHOSPITAL HAS RESOURCES TO ASSIST PATIENTS WITH STATE OF CONNECTICUT MEDICAID APPLICATIONS.

PART VI, LINE 6:
THE ENTITIES OF LAWRENCE+MEMORIAL HEALTHCARE INCLUDING L+M HOSPITAL, THE VISITING NURSE ASSOCIATION OF SOUTHEASTERN CT (VNASC), AND WESTERLY HOSPITAL ARE PART OF YALE NEW HAVEN HEALTH. THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS SUCH AS L+M HOSPITAL ASSOCIATED WITH THE SYSTEM PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE AND ENSURE THAT ALL PATIENTS HAVE ACCESS TO APPROPRIATE HEALTHCARE SERVICES. THE YALE NEW HAVEN HEALTH SYSTEM REQUIRES ITS HOSPITALS TO INCORPORATE PLANS TO PROMOTE HEALTHY COMMUNITIES WITHIN THE HOSPITAL'S EXISTING BUSINESS PLANS AND IMPLEMENTATION STRATEGIES FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A ROUTINE BASIS.

PART VI, LINE 7, REPORTS FILED WITH STATES
CT

PART III, LINE 4:
LAWRENCE + MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED YALE NEW HAVEN HEALTH SERVICES CORPORATION AUDITED FINANCIAL STATEMENTS. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS:THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES, AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE SYSTEM PROVIDES FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE SYSTEM, DURING THE REGISTRATION, BILLING, AND COLLECTION PROCESS, A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE SYSTEM TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM, AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE SYSTEM, CARE GIVEN BUT NOT PAID FOR IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND FREE CARE REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $78.4 MILLION AND $87.7 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY HOSPITAL SPECIFIC DATA.THE ALLOCATION BETWEEN IMPLICIT PRICE CONCESSION AND CHARITY CARE IS DETERMINED BASED ON MANAGEMENT'S ANALYSIS ON THE PREVIOUS 12 MONTHS OF HOSPITAL DATA. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS IMPLICIT PRICE CONCESSIONS VERSUS CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE SYSTEM FOR EACH ACCOUNT ANALYZED.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM (CDSHP) WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY AN ASSESSMENT ON HOSPITAL PATIENT SERVICE REVENUE. THE SYSTEM MADE PAYMENTS INTO THE CDSHP OF $317.2 MILLION AND $326.6 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY, FOR THE ASSESSMENT.DURING THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, THE SYSTEM RECEIVED $197.3 MILLION AND $187.8 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS. THESE ARE RECORDED IN PATIENT SERVICE REVENUE.ADDITIONALLY, THE SYSTEM PROVIDES BENEFITS FOR THE BROADER COMMUNITY, WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS. THE SYSTEM VOLUNTARILY ASSISTS WITH THE DIRECT FUNDING OF SEVERAL CITY OF NEW HAVEN PROGRAMS, INCLUDING AN ECONOMIC DEVELOPMENT PROGRAM AND A YOUTH INITIATIVE PROGRAM.IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE SYSTEM PROVIDES BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE SYSTEM'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS AND OTHER RELATED ACTIVITIES. THE SYSTEM ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTHCARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS.

PART VI, LINE 4:
TO DEFINE COMMUNITY FOR COMMUNITY HEALTH NEEDS ASSESSMENT PURPOSES, L+M HOSPITAL USES A GEOGRAPHIC APPROACH FOCUSING ON THE 10 TOWNS ALONG THE CONNECTICUT SHORELINE BETWEEN RHODE ISLAND AND THE CONNECTICUT RIVER: EAST LYME, GROTON, LEDYARD, LYME, MONTVILLE, NEW LONDON, NORTH STONINGTON, OLD LYME, STONINGTON, AND WATERFORD. THESE COMMUNITIES ARE SERVED BY L+M HOSPITAL REPRESENTING APPROXIMATELY 50% OF TOTAL DISCHARGES AND DO NOT OVERLAP WITH CHNA AREAS IDENTIFIED BY OTHER ACUTE CARE HOSPITALS AND/OR COLLABORATIONS. UPON DEFINING THE GEOGRAPHIC AREA AND POPULATION SERVED IN GREATER NEW LONDON, L+M HOSPITAL WAS DILIGENT TO ENSURE THAT NO GROUPS, ESPECIALLY MINORITY, LOW-INCOME OR MEDICALLY UNDER-SERVED, WERE EXCLUDED.NUMEROUS FACTORS ARE ASSOCIATED WITH THE HEALTH OF A COMMUNITY INCLUDING WHAT RESOURCES AND SERVICES ARE AVAILABLE AS WELL AS WHO LIVES IN THE COMMUNITY. WHILE INDIVIDUAL CHARACTERISTICS SUCH AS AGE, GENDER, RACE, AND ETHNICITY HAVE AN IMPACT ON PEOPLE'S HEALTH, THE DISTRIBUTION OF THESE CHARACTERISTICS ACROSS A COMMUNITY IS ALSO CRITICALLY IMPORTANT AND CAN AFFECT THE NUMBER AND TYPE OF SERVICES AND RESOURCES AVAILABLE. THE GREATER NEW LONDON REGION HAS A POPULATION OF 151,774. THE LIFE EXPECTANCY IN YEARS ACROSS THE REGION VARIES BETWEEN 83.9 YEARS IN ONE SHORELINE TOWN TO 77.2 YEARS IN NEW LONDON. IN GREATER NEW LONDON 74% OF THE TOTAL POPULATION IDENTIFIED AS WHITE, 12% AS HISPANIC, AND 5% AS BLACK. IN THE CITY OF NEW LONDON, 45% IDENTIFIED AS WHITE, 33% HISPANIC AND 13% BLACK. THE TOWNS IN THE REGION VARY DRAMATICALLY IN TERMS OF THEIR RACIAL AND ETHNIC COMPOSITION BUT ARE ALL GROWING MORE DIVERSE THAN THE STATE OF CONNECTICUT WITH 67% OF THE POPULATION IDENTIFYING AS WHITE, 16% HISPANIC, AND 10% BLACK. EACH AREA INCLUDED 7 TO 9% OF THE POPULATION THAT IDENTIFIED AS OTHER.INCOME AND POVERTY ARE CLOSELY CONNECTED TO HEALTH OUTCOMES. A HIGHER INCOME MAKES IT EASIER TO LIVE IN A SAFE NEIGHBORHOOD WITH GOOD SCHOOLS AND MANY RECREATIONAL OPPORTUNITIES. HIGHER WAGE EARNERS ARE BETTER ABLE TO BUY MEDICAL INSURANCE AND MEDICAL CARE, PURCHASE NUTRITIOUS FOODS, AND OBTAIN QUALITY CHILDCARE THAN THOSE EARNING LOWER WAGES. COMMUNITIES WHERE RESIDENTS HAVE LOWER INCOME LEVELS HAVE BEEN SHOWN TO HAVE HIGHER RATES OF ASTHMA, DIABETES, AND HEART DISEASE, AND LOWER LIFE EXPECTANCIES. THERE WERE WIDE GAPS IN MEDIAN HOUSEHOLD INCOME, RANGING FROM $46,298 IN NEW LONDON TO $100,435 IN LYME. THE PROPORTION OF RESIDENTS IN THE GREATER NEW LONDON REGION WITH A COLLEGE DEGREE OR HIGHER (37%) WAS ROUGHLY THE SAME AS THE STATE OVERALL (39%). ONLY 25% OF CITY OF NEW LONDON ADULTS HAD A COLLEGE DEGREE OR HIGHER. THIS DATA DEMONSTRATES THAT THERE ARE SIGNIFICANT INEQUITIES RELATED TO HIGHER EDUCATION WITH BETWEEN 63 AND 75% OF THE POPULATION WITH NO HIGH SCHOOL DIPLOMA OR A HIGH SCHOOL DIPLOMA OR EQUIVALENT AND SOME COLLEGE.

PART VI, LINE 5:
AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, L+M HOSPITAL REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH, AND OTHER INNOVATIVE SERVICES. DURING 2022, L+M INVESTED $70.2 MILLION IN FINANCIAL AND IN-KIND CONTRIBUTIONS THROUGH FIVE WIDE-RANGING PROGRAMS: GUARANTEEING ACCESS TO CARE; ADVANCING CAREERS IN HEALTH CARE; PROMOTING HEALTH & WELLNESS; BUILDING STRONGER NEIGHBORHOODS; AND CREATING HEALTHIER COMMUNITIES.L+M HOSPITAL ALSO CONTRIBUTES TO THE COMMUNITY IN WAYS THAT ARE NOT QUANTIFIED AS PART OF COMMUNITY BENEFITS AND SERVES AS AN IMPORTANT COMMUNITY RESOURCE. THIS INCLUDES HAVING A COMMUNITY-BASED BOARD OF TRUSTEES WITH A MAJORITY MEMBERS RESIDING OR WORKING IN THE AREA SERVED BY THE HOSPITAL. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. IN FISCAL YEAR 2022 THERE WERE A TOTAL OF 760 MEMBERS ON THE L+M HOSPITAL MEDICAL STAFF. L+M HOSPITAL, FOUNDED IN 1912, IS A 308-BED HOSPITAL SERVING 16,970 INPATIENTS AND 371,079 OUTPATIENT ENCOUNTERS IN 2022. LAWRENCE + MEMORIAL INCLUDES SOUTHEASTERN CONNECTICUT'S ONLY NEWBORN INTENSIVE CARE UNIT, A WOUND AND HYPERBARIC CENTER, AND AN ACUTE REHABILITATION UNIT. THE SMILOW CANCER HOSPITAL CARE CENTER IN WATERFORD, CONNECTICUT, PROVIDES MEDICAL ONCOLOGY SERVICES, GYNECOLOGIC ONCOLOGY, AND RADIATION ONCOLOGY L+M HOSPITAL IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN SOUTHEASTERN CT WITH 2,553 EMPLOYEES IN 2022.