4A (Expenses $ 67756757 including grants of $ 1292) (Revenue $ 65344100)
JOHNSON MEMORIAL HOSPITAL IS A GENERAL, ACUTE-CARE FACILITY OFFERING A COMPREHENSIVE SPAN OF INPATIENT AND OUTPATIENT SERVICES TO THE RESIDENTS OF NORTH CENTRAL CONNECTICUT AND NEIGHBORING MASSACHUSETTS TOWNS. THE HOSPITAL PROVIDES MEDICAL AND SURGICAL CARE, OBSTETRICS, MENTAL HEALTH, EMERGENCY AND INTENSIVE CARE, ONCOLOGY, REHABILITATION, PAIN MANAGEMENT, AND MORE. THE HOSPITAL ACHIEVED THE MAXIMUM AWARD FOR ITS QUALITY OF CARE FROM THE JOINT COMMISSION, WHICH ACCREDITS HEALTH CARE ORGANIZATIONS.PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT SERVICES, RECOGNITIONS AND AWARDS: WWW.TRINITYHEALTHOFNE.ORG/LOCATION/JOHNSON-MEMORIAL-HOSPITAL-1

JOHNSON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: JOHNSON MEMORIAL HOSPITAL INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS. 1. SUBSTANCE ABUSE/MENTAL HEALTH2. AGING POPULATION & ISOLATION3. HOMELESSNESS4. SMOKING/VAPING5. OBESITY

JOHNSON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: THIS CHNA FOCUSED ON THE GREATER HARTFORD AREA-LEVEL DATA AND DATA FOR SELECT COMMUNITIES AS AVAILABLE. THE INPUT OF THE COMMUNITY, ESPECIALLY FROM THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, WAS PRIORITIZED AS AN IMPORTANT PART OF THE CHNA PROCESS. BELOW ARE THE PRIMARY MECHANISMS FOR DATA COLLECTION AND COMMUNITY & STAKEHOLDER ENGAGEMENT:LITERATURE REVIEW:- REVIEW OF EXISTING ASSESSMENT REPORTS PUBLISHED SINCE 2019 THAT WERE COMPLETED BY COMMUNITY AND REGIONAL AGENCIES SERVING THE GREATER HARTFORD AREA- THIS ALSO INCLUDED A REVIEW OF THE PREVIOUS 2019 CHNA WHICH SHOWED THE FOLLOWING TOP SIGNIFICANT HEALTH NEEDS: SUBSTANCE ABUSE/MENTAL HEALTH, AGING POPULATION & ISOLATION, HOMELESSNESS, SMOKING/VAPING, OBESITYQUANTITATIVE DATA COLLECTION AND ANALYSIS:- ANALYSIS OF SOCIAL, ECONOMIC, AND HEALTH DATA FROM TRINITY HEALTH CARES DATA HUB, DATAHAVEN, CT DEPARTMENT OF PUBLIC HEALTH, CT HOSPITAL ASSOCIATION, THE U.S CENSUS BUREAU, THE COUNTY HEALTH RANKING REPORTS, AND A VARIETY OF OTHER DATA SOURCESQUALITATIVE DATA COLLECTION AND ANALYSIS:- COMMUNITY CONVERSATIONS AND STAKEHOLDER PRIORITIZATION SESSIONS - OF THE 9 SESSIONS HELD, 2 WERE CONDUCTED IN SPANISH (SPRING/SUMMER 2022)- KEY INFORMANT PRIORITIZATION SESSION WHICH INCLUDED PUBLIC HEALTH OFFICIALS (SPRING 2022)

JOHNSON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6A: JOHNSON MEMORIAL HOSPITAL COLLABORATED WITH THE FOLLOWING HOSPITAL FACILITIES IN CONDUCTING ITS MOST RECENT CHNA: CONNECTICUT CHILDREN'S MEDICAL CENTER, HARTFORD HOSPITAL, SAINT FRANCIS HOSPITAL AND MEDICAL CENTER, MOUNT SINAI REHABILITATION HOSPITAL AND SAINT MARY'S HOSPITAL.

JOHNSON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: JOHNSON MEMORIAL HOSPITAL ALSO COLLABORATED WITH THE FOLLOWING COMMUNITY ORGANIZATIONS WHILE CONDUCTING ITS MOST RECENT CHNA: DATAHAVEN AND THE UNITED WAY OF CENTRAL AND NORTHEASTERN CONNECTICUT.

JOHNSON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 11: JOHNSON MEMORIAL HOSPITAL FOCUSED ON AND SUPPORTED INITIATIVES TO IMPROVE THE FOLLOWING SIGNIFICANT HEALTH NEEDS:OBESITY - THE NUTRITION CARE SERVICES TEAM AT JOHNSON MEMORIAL HOSPITAL INCLUDES A GROUP OF DIETITIANS COMMITTED TO MEETING THE NUTRITIONAL NEEDS OF INDIVIDUALS. THE NUTRITION CARE SERVICES TEAM CONTINUED PROVIDING GUIDANCE WITH NUTRITIONAL GOALS SUCH AS, WEIGHT-GAIN, WEIGHT-LOSS AND IMPROVED GLUCOSE MANAGEMENT. THE DIETITIANS WORKED WITH CUSTOMIZED PLANS, TAILORED TO EACH INDIVIDUAL'S SPECIFIC GOALS AND PREFERENCES. THEY OFFERED EDUCATION AND THERAPY FOR WEIGHT MANAGEMENT, DIABETES MANAGEMENT, NUTRITION SUPPORT AND MEAL PLANNING. SUBSTANCE ABUSE, MENTAL HEALTH, AND SMOKING/VAPING - BEHAVIORAL HEALTH SERVICES ARE OFFERED BY JOHNSON MEMORIAL HOSPITAL TREATING INDIVIDUALS WHO HAVE SUBSTANCE ABUSE ISSUES, AS WELL AS THOSE WITH CO-OCCURRING DISORDERS. THE STAFF CONTINUED THEIR FOCUS ON EDUCATION AND SUPPORT OF THOSE IN EARLY RECOVERY, EASING THE TRANSITION TOWARD HEALTHIER FUNCTIONING. SERVICES INCLUDED: SUBSTANCE ABUSE ASSESSMENTS, SUBSTANCE ABUSE CONSULTS, PSYCHIATRIC CONSULTS, INDIVIDUALIZED TREATMENT PLANNING, AFTERCARE PLANNING, REFERRALS, ADDICTION EDUCATION, RELAPSE PREVENTION SKILLS, TWELVE STEP EDUCATION, AND FAMILY EDUCATION.JOHNSON MEMORIAL HOSPITAL ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH IT DEEMED MOST PRESSING, UNDER-ADDRESSED, AND WITHIN ITS ABILITY TO INFLUENCE. JOHNSON MEMORIAL HOSPITAL DID NOT TAKE ACTION ON THE FOLLOWING HEALTH NEEDS: HOMELESSNESS - THE HOSPITAL DID NOT DIRECTLY ADDRESS HOMELESSNESS BECAUSE THE LOCAL SUBSTANCE ABUSE AND MENTAL HEALTH'S COMMUNITY CARE TEAM (CCT) INCLUDES CARE COORDINATION FOR HOMELESS PATIENTS. RURAL HOMELESSNESS IS A COMPLICATED PROBLEM THAT IS NOT WELL UNDERSTOOD. JOHNSON MEMORIAL HOSPITAL'S STAFF'S INTENTION IS TO BETTER DEFINE THE PROBLEM AND EXPLORE POTENTIAL MODELS FOR ADDRESSING THIS PRIORITIZED HEALTH NEED. THE AGING POPULATION AND ISOLATION - THE AGING POPULATION AND ISOLATION NEED WAS NOT DIRECTLY ADDRESSED AS OTHER AGENCIES ARE FOCUSED ON THIS ISSUE. RESOURCES THAT THE HOSPITAL HAS THAT IMPACT THIS NEED WILL BE LEVERAGED WITH COMMUNITY PARTNERS WHERE APPROPRIATE.

JOHNSON MEMORIAL HOSPITAL
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

JOHNSON MEMORIAL HOSPITAL - PART V, SECTION B, LINE 7A:
WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

JOHNSON MEMORIAL HOSPITAL - PART V, SECTION B, LINE 9:
AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.

JOHNSON MEMORIAL HOSPITAL - PART V, SECTION B, LINE 10A:
WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

JOHNSON MEMORIAL HOSPITAL - PART V, SECTION B, LINE 16A:
WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/

JOHNSON MEMORIAL HOSPITAL - PART V, SECTION B, LINE 16B:
WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/

JOHNSON MEMORIAL HOSPITAL - PART V, SECTION B, LINE 16C:
WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/

PART I, LINE 3C:
IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.

PART I, LINE 6A:
JOHNSON MEMORIAL HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, JOHNSON MEMORIAL HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE.

PART I, LINE 7:
THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.

PART I, LN 7 COL(F):
THE FOLLOWING NUMBER, $2,069,359, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).

PART III, LINE 2:
METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.

PART III, LINE 3:
JOHNSON MEMORIAL HOSPITAL USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, JOHNSON MEMORIAL HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, JOHNSON MEMORIAL HOSPITAL IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.

PART III, LINE 4:
"JOHNSON MEMORIAL HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: ""AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED.""PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE ONE PERCENT SEQUESTRATION REDUCTION FOR THE PERIOD APRIL 1, 2022 THROUGH JUNE 30, 2022."

PART III, LINE 8:
JOHNSON MEMORIAL HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.

PART III, LINE 9B:
THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS.

PART VI, LINE 2:
NEEDS ASSESSMENT - JOHNSON MEMORIAL HOSPITAL ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES, AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PARTICIPATION BY STAFF ON COMMUNITY BOARDS AND COUNCILS IMPROVES COMMUNITY CONNECTIONS AND SERVES TO SUPPORT KNOWLEDGE OF COMMUNITY HEALTH CARE NEEDS. HOSPITAL STAFF ARE EMBEDDED IN THE COMMUNITY AND PARTICIPATE IN ACTIVITIES PROVEN TO KEEP THEM AWARE OF THE NEEDS OF COMMUNITY MEMBERS. COMMUNITY ENGAGEMENT ACTIVITIES, LIKE THE SEEDS OF KINDNESS CAMPAIGN, PROVIDE AN OPPORTUNITY FOR COMMUNITY RESIDENTS AND HOSPITAL STAFF TO ENGAGE IN AN ACTIVITY OUTSIDE OF THE CLINICAL CARE SETTING.

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - JOHNSON MEMORIAL HOSPITAL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. JOHNSON MEMORIAL HOSPITAL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. JOHNSON MEMORIAL HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. JOHNSON MEMORIAL HOSPITAL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER.

PART VI, LINE 4:
"COMMUNITY INFORMATION - THE COMMUNITY OF GREATER HARTFORD IS GENERALLY DEFINED AS THE AREA SERVED BY THE CAPITOL REGION COUNCIL OF GOVERNMENTS, WHICH CONSISTS OF 38 CITIES AND TOWNS ALONG WITH THE SUBURBS FURTHER OUT FROM THE HARTFORD CITY CENTER. THE POPULATION FOR EACH OF GREATER HARTFORD'S 38 CITIES, TOWNS, AND SUBURBS (WITH 2020 POPULATIONS) IS: ANDOVER (3,151), AVON (18,932), BERLIN (20,175), BLOOMFIELD (21,535), BOLTON (4,858,) CANTON (10,124), COLUMBIA (5,272), COVENTRY (12,235), EAST GRANBY (5,214), EAST HARTFORD (51,045), EAST WINDSOR (11,190), ELLINGTON (16,426), ENFIELD (42,141), FARMINGTON (26,712), GLASTONBURY (35,159), GRANBY (10,903), HARTFORD (121,054), HEBRON (9,098), MANCHESTER (59,713), MANSFIELD (25,892), MARLBOROUGH (6,133), NEW BRITAIN (74,135), NEWINGTON (30,536), PLAINVILLE (17,525), ROCKY HILL (20,845), SIMSBURY (24,517), SOMERS (10,255), SOUTH WINDSOR (26,918), SOUTHINGTON (43,501), STAFFORD (11,472), SUFFIELD (15,752), TOLLAND (14,563), VERNON (30,215), WEST HARTFORD (64,083), WETHERSFIELD (27,298), WILLINGTON (5,566), WINDSOR (29,492), WINDSOR LOCKS (12,613).THE DIVERSITY OF GREATER HARTFORD IS RELATIVELY SIMILAR TO STATEWIDE WITH 36% OF THE POPULATION BEING NON-WHITE. BOTH GREATER HARTFORD AND CONNECTICUT HAVE EXPERIENCED AN INCREASE IN DIVERSITY, ESPECIALLY AMONG THOSE UNDER 18. AMONG THE REGION'S FOREIGN-BORN POPULATION, THE MOST COMMON COUNTRIES OF ORIGIN ARE JAMAICA (IN HARTFORD) AND INDIA (IN MOST SURROUNDING SUBURBS). THE MAJORITY OF THE GREATER HARTFORD'S HOUSEHOLDS ARE FAMILIES. AS CONNECTICUT'S PREDOMINANTLY WHITE BABY BOOMERS AGE, YOUNGER GENERATIONS ARE DRIVING THE STATE'S INCREASED RACIAL AND ETHNIC DIVERSITY. BLACK AND LATINO POPULATIONS IN PARTICULAR SKEW MUCH YOUNGER THAN WHITE POPULATIONS. OVER THE PAST 40 YEARS, NEIGHBORHOOD INCOME INEQUALITY HAS GROWN STATEWIDE AS THE SHARE OF THE POPULATION LIVING IN WEALTHY OR POOR NEIGHBORHOODS HAS INCREASED AND THE POPULATION IN MIDDLE INCOME AREAS DECLINED IN A PROCESS KNOWN AS ""ECONOMIC SORTING,"" WHICH THEN LEADS TO FURTHER DISPARITIES IN ACCESS TO ECONOMIC OPPORTUNITY, HEALTHY ENVIRONMENTS, AND MUNICIPAL RESOURCES.WITHIN THE GREATER HARTFORD AREA, THE FEDERAL HEALTH RESOURCES & SERVICES ADMINISTRATION HAS DESIGNATED MEDICALLY UNDERSERVED AREAS/POPULATIONS. THERE ARE SEVEN OTHER HOSPITALS SERVING THE GREATER HARTFORD COMMUNITY."

PART VI, LINE 5:
OTHER INFORMATION - JOHNSON MEMORIAL HOSPITAL, AS PART OF THE TRINITY HEALTH OF NEW ENGLAND HEALTH SYSTEM, WAS INVOLVED IN A MULTIFACETED PUBLIC HEALTH AWARENESS MEDIA CAMPAIGN REGARDING COVID-19 PREVENTION, TESTING, VACCINATION, AND TREATMENT WHICH INTENTIONALLY INCLUDED SPECIFIC MESSAGING FOR CHILDREN AND DIVERSE COMMUNITIES.AS PART OF A BROAD EMERGENCY HEALTH RESPONSE TO THE CORONAVIRUS, TRINITY HEALTH OF NEW ENGLAND SET UP FURI (FEVER UPPER RESPIRATORY INFECTION) CLINICS. THE PURPOSE OF THESE CLINICS IS TO KEEP PEOPLE WHO ARE EXPERIENCING SYMPTOMS OF AN UPPER RESPIRATORY TRACT ILLNESS OUT OF THE EMERGENCY DEPARTMENTS AND PHYSICIAN OFFICES. THIS HELPS TO LIMIT THE SPREAD OF DISEASE AMONG VULNERABLE POPULATIONS, SUCH AS THE ELDERLY. THE FURI CLINICS CAN ASSESS AND TREAT POTENTIALLY LARGE NUMBERS OF PEOPLE WITH APPROPRIATE LEVELS OF INFECTION CONTROL.

PART VI, LINE 6:
JOHNSON MEMORIAL HOSPITAL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE BY CONNECTING SOCIAL AND CLINICAL CARE, ADDRESSING SOCIAL NEEDS, DISMANTLING SYSTEMIC RACISM, AND REDUCING HEALTH INEQUITIES. WE DO THIS BY: 1. INVESTING IN OUR COMMUNITIES, 2. ADVANCING SOCIAL CARE, AND 3. IMPACTING SOCIAL INFLUENCERS OF HEALTH.TO FURTHER OUR STRATEGY IN FISCAL YEAR 2022 (FY22), CHWB LAUNCHED TWO TRAINING SERIES TO ADVANCE HEALTH AND RACIAL EQUITY IN OUR COMMUNITIES.1. CHWB LEADER SERIES TO ADVANCE HEALTH AND RACIAL EQUITY: A YEAR-LONG PEER LEARNING SERIES TO BUILD THE CAPACITY OF OUR CHWB LEADERS TO DELIVER ON OUR CHWB STRATEGY WITH A FOCUS ON COMMUNITY LEADERSHIP AND ENGAGEMENT, AND THE USE OF A RACIAL EQUITY LENS IN ALL OF OUR DECISION MAKING. 2. COMMUNITY ENGAGEMENT TO ADVANCE RACIAL JUSTICE - PREPARING FOR IMPLEMENTATION STRATEGY: A FOUR-PART SERIES ON ENGAGING OUR COMMUNITIES IN MEANINGFUL WAYS USING A HEALTH EQUITY AND RACIAL EQUITY LENS TO BUILD LASTING PARTNERSHIPS AND IMPACTFUL IMPLEMENTATION STRATEGIES.INVESTING IN OUR COMMUNITIES - TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FY22, TRINITY HEALTH CONTRIBUTED $1.37 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. SOME EXAMPLES OF THESE INVESTMENTS INCLUDE: TRINITY HEALTH AWARDED OVER $1.6 MILLION IN COMMUNITY GRANTS THAT DIRECTLY ALIGN WITH INTERVENTIONS AND LOCAL PARTNERSHIPS IDENTIFIED IN ITS MEMBER HOSPITALS' COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION STRATEGIES, INCLUDING ACCESS TO HEALTH CARE, MENTAL HEALTH, TRANSPORTATION, COMMUNITY ENGAGEMENT, FOOD ACCESS, AND HOUSING SUPPORTS. WITH A $1.2 MILLION INITIAL INVESTMENT, TRINITY HEALTH LAUNCHED ROUND 2 OF THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), A FIVE-YEAR, INNOVATIVE FUNDING AND TECHNICAL ASSISTANCE INITIATIVE, PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS AND RESIDENTS TO ADVANCE HEALTH AND RACIAL EQUITY IN NINE OF OUR COMMUNITIES EXPERIENCING HIGH POVERTY AND OTHER VULNERABILITIES. HEALTH MINISTRIES RECEIVING TCI FUNDING ARE COLLABORATING WITH A LOCAL MULTI-SECTOR COLLABORATIVE TO DEVELOP AND IMPLEMENT EVIDENCE-BASED STRATEGIES THAT ADVANCE HEALTH AND RACIAL EQUITY THROUGH ADDRESSING AT LEAST ONE ROOT CAUSE OF POOR HEALTH IDENTIFIED IN THE DEVELOPMENT OF THEIR MOST RECENT CHNA IMPLEMENTATION STRATEGY. TRINITY HEALTH AWARDED OVER $1 MILLION IN COVID-19 FUNDING TO SUPPORT NEW AND ONGOING COMMUNITY ENGAGEMENT AND MOBILIZATION EFFORTS AROUND MAKING THE COVID-19 VACCINATION ACCESSIBLE TO ALL ELIGIBLE POPULATIONS. THIS FUNDING WAS DESIGNED TO SUPPORT ALL COMMUNITIES TO ENSURE EASY AND EQUITABLE ACCESS TO THE VACCINE BY REMOVING BARRIERS FOR ALL PEOPLE TO RECEIVE THE VACCINE, ESPECIALLY COMMUNITIES THAT HAVE LESS THAN A 75% VACCINATION RATE. WITH THIS FUNDING, HEALTH MINISTRIES FACILITATED 3,200 COVID-19 VACCINE EVENTS, ADMINISTERED 80,000 COVID-19 VACCINE DOSES, AND REACHED 874,000 PEOPLE WITH EDUCATIONAL MATERIALS ON COVID-19 AND THE BENEFITS OF VACCINATION.IN ADDITION TO THE $1.37 BILLION IN COMMUNITY BENEFIT SPENDING, OUR COMMUNITY INVESTING PROGRAM HAD THE MOST ROBUST YEAR OF LENDING SINCE THE PROGRAM'S INCEPTION OVER 20 YEARS AGO: $17.8 MILLION IN NEW LOANS AND $8.3 MILLION IN LOAN RENEWALS WERE APPROVED, FOCUSING ON BUILDING AFFORDABLE HOUSING AND INCREASING ACCESS TO EDUCATION IN PARTNERSHIP WITH OUR HEALTH MINISTRIES. ADVANCING SOCIAL CARE - TRINITY HEALTH'S SOCIAL CARE PROGRAM WAS DEVELOPED TO ADDRESS SOCIAL NEEDS, SUCH AS ACCESS TO TRANSPORTATION, CHILDCARE, OR AFFORDABLE MEDICATIONS BY FACILITATING CONNECTIONS BETWEEN OUR PATIENTS, HEALTH CARE PROVIDERS AND COMMUNITY PARTNERS THAT PROMOTE HEALTHY BEHAVIORS. HIGHLIGHTS FROM FY22 INCLUDE THE FOLLOWING SUCCESSES:- LAUNCHED TRINITY HEALTH COMMUNITY HEALTH WORKER (CHW) CERTIFICATION PROGRAM, TRAINING 86 CHWS WITH 40+ HOURS OF TRAINING, AND INCREASED CHW STAFF ACROSS MOST HEALTH MINISTRIES- LAUNCHED A SYSTEM-WIDE ASSESSMENT OF LANGUAGE ACCESS SERVICES TO RECOMMEND SYSTEM STANDARDS THAT ENSURE CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES FOR ALL OF OUR PATIENTS, THEIR COMPANIONS, AND CAREGIVERS- ENGAGED OVER 1,100 PARTICIPANTS IN THE NATIONAL DIABETES PREVENTION PROGRAM, EXCEEDING OUR PROGRAM YEAR 5 GOAL- INCREASED THE NUMBER OF ACTIVE COMMUNITY PARTNER ORGANIZATIONS ON THE COMMUNITY RESOURCE DIRECTORY BY 120% FROM FISCAL YEAR 2021- ENGAGED 5,300+ PATIENTS WHO ARE DUALLY ENROLLED IN MEDICARE AND MEDICAID IN A SOCIAL CARE OR MEDICAL CARE ACTIVITY, IN SUPPORT OF REDUCING PREVENTABLE HOSPITALIZATIONS (SUCH AS DIABETES AND ASTHMA)IMPACTING SOCIAL INFLUENCERS OF HEALTH - LEVERAGING INVESTOR POWER TO CATALYZE CORPORATE SOCIAL RESPONSIBILITY, TRINITY HEALTH'S SHAREHOLDER ADVOCACY WORK FOCUSES ON DISMANTLING RACISM ACROSS FIVE STRATEGIC FOCUS AREAS BY HOLDING CORPORATIONS ACCOUNTABLE FOR THE HUMAN RIGHTS VIOLATIONS THOSE COMPANIES PERPETUATE IN THE U.S. AND BEYOND. IN FY22, TRINITY HEALTH FACILITATED OVER 135 SHAREHOLDER ADVOCACY ENGAGEMENTS, WITH GREAT SUCCESS:- FIVE BELOW COMMITTED TO ASSESS AND MANAGE THE RISKS/HAZARDS ASSOCIATED WITH CHEMICALS OF HIGH CONCERN CONTAINED IN THEIR PRIVATE LABEL PRODUCTS- UNILEVER AGREED TO STOP FOOD AND BEVERAGE MARKETING TO CHILDREN UNDER AGE 16, AND WILL ADOPT NEW TARGETS TO REDUCE SALT, ADDED SUGARS AND CALORIES, AND INCREASE SALES OF THEIR HEALTHIER PRODUCTS- PEPSICO SET GOALS TO INCREASE POSITIVE NUTRIENTS IN THEIR PRODUCTS- PDC ENERGY ACCELERATED ITS GOAL TO END ROUTINE FLARING OF METHANE, FROM 2030 TO 2025, THUS REDUCING ENVIRONMENTAL HEALTH RISKS AND GREENHOUSE GAS EMISSIONSADDITIONALLY, TRINITY HEALTH AND OTHER MEMBERS OF THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY GUN SAFETY GROUP SUBMITTED A SHAREHOLDER RESOLUTION ASKING STURM RUGER, ONE OF THE NATION'S LEADING MANUFACTURERS OF FIREARMS, TO CONDUCT AND PUBLISH AN INDEPENDENT HUMAN RIGHTS IMPACT ASSESSMENT OF ITS POLICIES, PRACTICES AND PRODUCTS, AND MAKE RECOMMENDATIONS FOR IMPROVEMENT. THE RESOLUTION RECEIVED A 68.5% VOTE IN FAVOR, WELL ABOVE THE THRESHOLD REQUIRED FOR THE RESOLUTION TO BE RESUBMITTED IN 2023, INDICATING A LARGE MAJORITY OF STURM RUGER INVESTORS BELIEVE THE COMPANY HAS TO ADDRESS ITS HUMAN RIGHTS IMPACTS. TRINITY HEALTH AND TRINITY HEALTH OF NEW ENGLAND ARE CITED AS PART OF THE GROUP WHO MOVED FORWARD THIS RESOLUTION.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.