4A (Expenses $ 776757106 including grants of $ 1386243) (Revenue $ 792566864)
SCHEDULE OAS THE CORONAVIRUS PANDEMIC KEPT PEOPLE UNSURE AND UNCOMFORTABLE WITH THE UNKNOWN, BRIDGEPORT HOSPITAL REMAINED A CONSTANT SOURCE OF WORLD-CLASS CARE, AS WELL AS INFORMATION BASED IN FACT AND SCIENCE, FOR PATIENTS, EMPLOYEES AND COMMUNITY. PART OF THE CITY'S DIVERSE FABRIC SINCE 1878, BRIDGEPORT HOSPITAL STRENGTHENED ITS BOND FOR A COMMUNITY COMING TOGETHER TO FIND BALANCE IN A NEW NORMAL.THE PANDEMIC AMPLIFIED THE SHORTAGE OF HEALTHCARE PROVIDERS ACROSS THE STATE AND COUNTRY ALSO EXTENDED TO EMERGENCY MEDICAL PERSONNEL. TO FACILITATE AND STANDARDIZE PARAMEDIC TRAINING AND ADDRESS THE ONGOING PARAMEDIC SHORTAGE IN CONNECTICUT, BRIDGEPORT HOSPITAL PARTNERED WITH SHELTON-BASED ECHO HOSE AMBULANCE AND YALE CENTER OF EMERGENCY MEDICAL SERVICES ON A NEW PARAMEDIC TRAINING PROGRAM DESIGNED TO PROVIDE NEW PARAMEDICS TO LOCAL EMS PARTNERS.ADVANCES IN CLINICAL CARERECOGNIZING THAT THE BENEFITS OF THE HOME ENVIRONMENT IN PATIENTS' RECOVERY, BRIDGEPORT HOSPITAL, AS PART OF YALE NEW HAVEN HEALTH, LAUNCHED THE HOME HOSPITAL PROGRAM WHICH PROVIDES HIGH-ACUITY, HOSPITAL-LEVEL CARE TO PATIENTS IN THEIR HOMES. THE PROGRAM SERVES MEDICARE PATIENTS MEETING CERTAIN CLINICAL AND SOCIAL STABILITY CRITERIA WHO LIVE WITHIN 25 MILES OF BRIDGEPORT AND YALE NEW HAVEN HOSPITALS. THROUGH IN-PERSON VISITS AND TELEHEALTH TECHNOLOGY, THE PROGRAM BRINGS A RANGE OF HOSPITAL SERVICES TO THE HOMES OF PATIENTS WITH HEART FAILURE, PNEUMONIA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CELLULITIS AND OTHER CONDITIONS.BRIDGEPORT HOSPITAL, WORKING WITH ITS YALE NEW HAVEN HEALTH PARTNERS, ALSO LAUNCHED A HOME INFUSION PROGRAM, CONTINUING TO HELP PATIENTS RECEIVE SAFE, HIGH-QUALITY CARE IN THEIR HOMES. ELIGIBLE PATIENTS RECEIVE INFUSION TREATMENTS AT HOME FOR CONDITIONS THAT, IN THE PAST, MAY HAVE REQUIRED A HOSPITAL OR INFUSION CLINIC VISIT. INFUSIONS ARE PREPARED BY THE HEALTH SYSTEM'S INFUSION PHARMACY; EDUCATION AND ADMINISTRATION ARE PROVIDED BY AN INFUSION NURSE. SERVICES RANGE FROM ROUTINE INTRAVENOUS HYDRATION, PARENTERAL NUTRITION, ANTIBIOTIC THERAPY AND IMMUNE AND MONOCLONAL THERAPIES.THE HEART AND VASCULAR CENTER AT BRIDGEPORT HOSPITAL MARKED A MILESTONE WITH ITS 400TH TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) PROCEDURE SINCE ITS FIRST IN 2016. A MINIMALLY INVASIVE TREATMENT, APPROVED BY THE FDA FOR LOW-RISK PATIENTS WITH SEVERE AORTIC STENOSIS, TAVR REPLACES THE VALVE WITHOUT OPEN-HEART SURGERY, WHICH MEANS LESS TIME IN THE HOSPITAL AND A FASTER RECOVERY.BRIDGEPORT HOSPITAL WAS THE FIRST FACILITY IN CONNECTICUT TO USE LAPAROSCOPIC RADIOFREQUENCY ABLATION, A MINIMALLY INVASIVE TREATMENT, FOR SYMPTOMATIC NON-CANCEROUS UTERINE FIBROIDS. STUDIES SHOW THAT THE TREATMENT, APPROVED BY THE FDA TO TREAT FIBROIDS, REDUCES THE SIZE OF FIBROIDS FROM ABOUT 40-70 PERCENT.YALE NEW HAVEN HEALTH OPENED A NEW DIGESTIVE HEALTH CENTER IN WESTPORT, WHICH PROVIDES COORDINATED CARE AT ONE LOCATION FOR MEDICAL AND SURGICAL PATIENTS INCLUDING BARIATRIC, COLORECTAL AND HERNIA SURGERIES. WHILE MOST SURGERIES ARE PERFORMED AT BRIDGEPORT HOSPITAL OR PARK AVENUE MEDICAL CENTER IN TRUMBULL, PATIENTS HAVE THE CONVENIENCE OF ATTENDING PRE- AND POST-SURGERY APPOINTMENTS IN WESTPORT.BRIDGEPORT HOSPITAL'S BRIDGEPORT AND MILFORD CAMPUSES, ALONG WITH ITS YALE NEW HAVEN HEALTH MEMBER HOSPITALS, RECEIVED THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS (ACEP) ELITE HEALTH SYSTEM GERIATRIC EMERGENCY DEPARTMENT ACCREDITATION. EIGHT YALE NEW HAVEN HEALTH FACILITIES WERE DESIGNATED AS SENIOR FRIENDLY, AND YALE NEW HAVEN HEALTH SYSTEM WAS AMONG ONLY 13 HEALTH SYSTEMS NATIONWIDE TO RECEIVE THE ACCREDITATION. PHYSICIANS PROVIDE SPECIALIZED EMERGENCY CARE TO PATIENTS AGES 65 AND OLDER, INCLUDING SCREENING FOR DELIRIUM.COMMUNITY FOCUSEMPLOYEES ACROSS BRIDGEPORT HOSPITAL'S TWO CAMPUSES DONATED OVER 3,600 DIAPERS FOR DISTRIBUTION TO FAMILIES IN NEED THROUGH COMMUNITY-BASED ORGANIZATIONS SUCH AS THE CENTER FOR FAMILY JUSTICE AND DIAPER BANK OF CONNECTICUT. GIVEN THAT ONE IN THREE FAMILIES STRUGGLES TO AFFORD DIAPERS TO KEEP THEIR BABIES CLEAN, DRY AND HEALTHY, THE HOSPITAL JOINED THE HEALTH SYSTEM IN DONATING ADDITIONAL SUPPLIES AND RESOURCES TO PURCHASE APPROXIMATELY 34,000 ADDITIONAL DIAPERS.TO BETTER ADDRESS FOOD INSECURITY ACROSS COMMUNITIES SERVED BY BRIDGEPORT HOSPITAL AND YALE NEW HAVEN HEALTH, HUNDREDS OF EMPLOYEES AND MEDICAL STAFF DONATED 19,156 POUNDS OF FOOD TO HUNGER-RELIEF ORGANIZATIONS DURING THE SECOND #GIVEHEALTHY ONLINE FOOD DRIVE. THE DONATED FOOD REPRESENTED NEARLY 16,000 MEALS FOR PEOPLE IN NEED THROUGHOUT CONNECTICUT AND IN WESTERLY, RHODE ISLAND. THREE YEARS AND COUNTING, BRIDGEPORT HOSPITAL CONTINUED ITS FREE MONTHLY COMMUNITY FOOD DISTRIBUTION, BENEFITING MORE THAN 6,000 LOCAL FAMILIES WITH OVER 400 HOSPITAL STAFF VOLUNTEERS DONATED THEIR TIME. THE HOSPITAL ALSO SPONSORED A FARM STAND FOR BRIDGEPORT RESIDENTS, WORKING WITH BRIDGEPORT FARMERS MARKET COLLABORATIVE AND END HUNGER CONNECTICUT'S FRESH MATCH PROGRAM, AS WELL AS A FOOD VOUCHER PROGRAM WITH THE VILLAGE OF DEVON FARMERS MARKET IN MILFORD, THE MILFORD DEPARTMENT OF HUMAN SERVICES AND THE MILFORD BOYS AND GIRLS CLUB.

PART V, SECTION A:
THIS STATE LICENSE FOR THE HOSPITAL LOCATION LISTED IN SCHEDULE H, PART V, SECTION A, ALSO COVERS VARIOUS SATELLITE LOCATIONS OPERATED UNDER AND EXPRESSLY LISTED ON THE SAME STATE HOSPITAL LICENSE.

BRIDGEPORT HOSPITAL
PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. BRIDGEPORT 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.

BRIDGEPORT HOSPITAL
PART V, SECTION B, LINE 6A: YES, ST. VINCENT'S MEDICAL CENTER, ALSO LOCATED IN BRIDGEPORT.

BRIDGEPORT 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 BRIDGEPORT COMMUNITY. THIS INCLUDED THE HEALTH IMPROVEMENT ALLIANCE, 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.PART V, SECTION B, LINE 7A - HOSPITAL FACILITY'S WEBSITE HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT PART V, SECTION B, LINE 10A:HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/ABOUT/COMMUNITY/HEALTH-NEEDS-ASSESSMENT

BRIDGEPORT HOSPITAL
PART V, SECTION B, LINE 11: BRIDGEPORT 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 ALLIANCE: COMMUNITY HEALTH AND WELLBEING, ACCESS TO CARE, BEHAVIORAL HEALTH, CHILD 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.

BRIDGEPORT HOSPITAL
PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER MEDICALLY NECESSARY CARE ONLY.PART V, SECTION B, LINE 16A, 16B AND 16C:HTTPS://WWW.BRIDGEPORTHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPX

SCHEDULE H, PART V, SECTION D
THE FACILITY LOCATIONS LISTED IN SCHEDULE H, PART V, SECTION D, INCLUDE OFF-CAMPUS OUTPATIENT HEALTH CARE FACILITIES THAT BRIDGEPORT HOSPITAL OPERATED DURING THE TAX YEAR UNDER ITS STATE HOSPITAL LICENSE.PART V, SECTION B, LINE 3E:THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TRACKS THE HEALTH AND WELLBEING OF OUR COMMUNITY AND MONITORS THE SOCIAL AND ENVIRONMENTAL FACTORS THAT INFLUENCE HEALTH OUTCOMES. THESE DATA ILLUMINATE HEALTH DISPARITIES ACROSS POPULATION GROUPS AND GEOGRAPHIES AND HELP US DIRECT RESOURCES TO ADVANCE HEALTH EQUITY. THROUGH THE CHNA, BRIDGEPORT HOSPITAL AND ITS PARTNERS CONFIRMED OUR UNDERSTANDING OF COMMUNITY HEALTH PRIORITIES AND GATHERED NEW INSIGHTS TOWARD COLLABORATIVE SOLUTIONS. CONDUCTING THE CHNA DURING THE COVID-19 PANDEMIC AFFORDED A UNIQUE VIEW OF OUR COMMUNITY'S RESOURCES AND NEEDS. WE SAW THE STRENGTH OF OUR COMMUNITY COME TOGETHER TO HELP ONE ANOTHER. WE WITNESSED INNOVATIVE AND SWIFT RESPONSES TO A HEALTH AND ECONOMIC CRISIS. WE ALSO DOCUMENTED GAPS IN OUR SERVICE DELIVERY SYSTEMS THAT REFLECT LONGSTANDING INEQUITIES IN OUR SOCIETY. TO DETERMINE COMMUNITY HEALTH PRIORITIES, WE MUST CONSIDER WHAT THE DATA SHOW, AND MORE IMPORTANTLY, WHAT OUR COMMUNITY SEES AS THE MOST PRESSING HEALTH CONCERNS. THE CHNA DATA AND STAKEHOLDER INPUT REINFORCED THAT THE AREAS WE'VE BEEN FOCUSED ON ARE STILL THE MOST PRESSING NEEDS IN OUR COMMUNITY. THESE SIGNIFICANT HEALTH NEEDS INCLUDE HEALTH OUTCOMES AND RISK FACTORS RELATED TO CHRONIC DISEASE, MENTAL HEALTH AND SUBSTANCE ABUSE, MORTALITY AND MORBIDITY INCLUDE SELF-REPORTED HEALTH STATUS, NEIGHBORHOOD ENVIRONMENTS AND FINANCIAL STRESS. THROUGH COMMUNITY CONVERSATIONS, WE ASKED HOW RESIDENTS EXPERIENCE THESE ISSUES IN THEIR DAY TO DAY LIVES, AND HOW WE COULD DO A BETTER JOB HELPING THEM TO LIVE A HEALTHIER LIFE.

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:
BRIDGEPORT 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. BRIDGEPORT 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, BRIDGEPORT HOSPITAL PROVIDED $53,260 IN FINANCIAL AND IN-KIND DONATIONS TO SUPPORT JOB TRAINING, ECONOMIC DEVELOPMENT, AND OTHER ESSENTIAL SERVICES. THE HOSPITAL CONSIDERS THESE INVESTMENTS PART OF ITS OVERALL COMMITMENT OF BUILDING STRONGER NEIGHBORHOODS. EXAMPLES BELOW FOCUS ON THE AREAS OF REVITALIZING OUR NEIGHBORHOODS AND CREATING EDUCATIONAL OPPORTUNITIES.REVITALIZING OUR NEIGHBORHOODSSEVERAL YEARS AGO, THE CITY OF BRIDGEPORT ORGANIZED NEIGHBORHOOD REVITALIZATION ZONES (NRZS) TO EXPAND AND IMPROVE BUSINESS AND HOUSING IN LOW-TO-MODERATE INCOME NEIGHBORHOODS OR AREAS WITHIN NEIGHBORHOODS. THE NRZS RECEIVE TECHNICAL ASSISTANCE FROM THE CITY AND OUTSIDE CONSULTANTS, AND ENGAGE NEIGHBORHOOD RESIDENTS, NON-PROFITS, BUSINESSES, AND FAITH-BASED ORGANIZATIONS TO MEET AND FORM STAKEHOLDER GROUPS. THESE GROUPS IDENTIFY THE PRIORITIES AND NEEDS OF THE NEIGHBORHOODS AND ARE ELIGIBLE TO BORROW STATE MONEY TO PURCHASE BLIGHTED PROPERTIES OR OFFER LOW-INTEREST LOANS TO QUALIFYING BUSINESSES FOR FACADE IMPROVEMENTS. HOSPITAL LEADERSHIP HAS BEEN ACTIVELY ENGAGED IN THE NRZ PROCESS FROM THE ONSET WITH REPRESENTATIVES SERVING ON COMMITTEES ORGANIZED IN THE CITY'S EAST END, EAST SIDE AND MILL HILL NEIGHBORHOODS, WHICH ARE LOCATED NEAR THE HOSPITAL. HOSPITAL STAFF ALSO SERVE AS VITAL REPRESENTATIVES OF NEIGHBORHOOD ORGANIZATIONS. AS PART OF A SUSTAINABILITY PROGRAM AIMED AT ADDRESSING FOOD INSECURITY, BRIDGEPORT HOSPITAL AND FOOD RESCUE USA TEAMED UP TO RECOVER FOOD THAT HAS BEEN PREPARED BUT NOT SERVED FROM THE HOSPITAL AND DONATED TO LOCAL HUNGER RELIEF ORGANIZATIONS.CREATING EDUCATIONAL OPPORTUNITIESHIGHER EDUCATIONAL ATTAINMENT IS ASSOCIATED WITH BETTER HEALTH STATUS AND LONGER LIFE. FOR EXAMPLE, ADULTS AGED 25-50 YEARS WHO HAVE A COLLEGE DEGREE WILL ON AVERAGE LIVE FIVE YEARS LONGER THAN THOSE WITH LESS THAN A HIGH SCHOOL EDUCATION. A SCHOOL SUPPLY DRIVE WAS HELD ON BOTH CAMPUSES OF THE HOSPITAL FOR STUDENTS AT THE HALL ELEMENTARY SCHOOL, LOCATED IN THE MILL HILL NEIGHBORHOOD OF BRIDGEPORT, AND MILFORD K-12 SCHOOLS. HOSPITAL EMPLOYEES CONTRIBUTED HUNDREDS OF ITEMS RANGING FROM PENS AND PENCILS TO NOTEBOOKS, BACKPACKS, AND OTHER ITEMS TO HELP ASSIST STUDENTS TO BEGIN THEIR SCHOOL YEAR.

PART III, LINE 2:
IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE HOSPITAL, DURING THE REGISTRATION, BILLING AND COLLECTION PROCESS A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. THE HOSPITAL'S COST ACCOUNTING SYSTEM UTILIZES PATIENT-SPECIFIC DATA TO ACCUMULATE AND DERIVE COSTS RELATED TO THESE BAD DEBT ACCOUNTS.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 ENTIRE MEDICARE LOSS PRESENTED SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO MEDICARE BENEFICIARIES, IRS REVENUE RULING 69-545 INDICATES THAT HOSPITALS OPERATE FOR THE PROMOTION OF HEALTH IN THE COMMUNITY WHEN IT PROVIDES CARE TO PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, THE HOSPITAL PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF MEDICARE SHORTFALLS (REDUCING THE BURDEN ON THE GOVERNMENT), AND MANY OF THE MEDICARE PARTICIPANTS WOULD HAVE QUALIFIED FOR THE CHARITY CARE OR OTHER MEANS TESTED PROGRAMS ABSENT BEING ENROLLED IN THE MEDICARE PROGRAM. THE MEDICARE SHORTFALL REPORTED IS DETERMINED BY THE HOSPITAL'S COST ACCOUNTING SYSTEM, STRATAJAZZ.

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 BRIDGEPORT 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 COMMUNITY NEEDS ASSESSMENT, THIS INFORMATION ASSISTS WITH THE DEVELOPMENT OF NEW INITIATIVES, PARTNERSHIPS, PROGRAMS, AND SERVICES TO BENEFIT OUR COMMUNITY.

PART III, LINE 4:
BRIDGEPORT HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR YALE NEW HAVEN HEALTH SERVICES CORPORATION (YNHHSC). THE CONSOLIDATED FINANCIAL STATEMENTS FOR YNHHSC INCLUDES THE FOLLOWING FOOTNOTE REGARDING UNCOMPENSATED CARE AND COMMUNITY BENEFIT EXPENSE ON PAGE 20: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 NET 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 NET 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 ADDITIONAL 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 3:
BRIDGEPORT 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 ON REQUEST WITHOUT CHARGE BY MAIL, INCLUDING AT 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 POINT OF CONTACT FOR INDIVIDUALS TO VISIT OR CALL. THE HOSPITAL HAS RESOURCES TO ASSIST PATIENTS WITH STATE OF CONNECTICUT MEDICAID APPLICATIONS.

PART VI, LINE 4:
TO DEFINE COMMUNITY FOR CHNA PURPOSES, THIS GREATER BRIDGEPORT COMMUNITY HEALTH NEEDS ASSESSMENT USES A GEOGRAPHIC APPROACH FOCUSING ON SEVEN TOWNS WITHIN FAIRFIELD COUNTY AND NEW HAVEN COUNTY, CT: BRIDGEPORT, EASTON, FAIRFIELD, MILFORD, MONROE, STRATFORD, AND TRUMBULL. THESE COMMUNITIES ARE SERVED BY BOTH BRIDGEPORT HOSPITAL AND ST. VINCENT'S MEDICAL CENTER REPRESENTING AT LEAST 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 BRIDGEPORT, THE HEALTH IMPROVEMENT ALLIANCE AND BRIDGEPORT HOSPITAL WERE 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 BRIDGEPORT AREA HAS A TOTAL POPULATION OF 376,892. THE LIFE EXPECTANCY IN YEARS ACROSS THE REGION VARIES BETWEEN 83.4 YEARS IN EASTON TO 77.6 YEARS IN BRIDGEPORT. IN GREATER BRIDGEPORT 56% OF THE TOTAL POPULATION IDENTIFIED AS WHITE, 21% AS HISPANIC, AND 16% AS BLACK. IN THE CITY OF BRIDGEPORT, 32% IDENTIFIED AS WHITE, 41% HISPANIC AND 20% 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 68% OF THE POPULATION IDENTIFYING AS WHITE, 16% HISPANIC, AND 10% BLACK. EACH AREA INCLUDED 5 TO 7% 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 $46,662 IN BRIDGEPORT TO $157,448 IN EASTON. THE PROPORTION OF RESIDENTS IN THE GREATER BRIDGEPORT REGION WITH A COLLEGE DEGREE OR HIGHER (38%) WAS ROUGHLY THE SAME AS THE STATE OVERALL (39%). ONLY 19% OF CITY OF BRIDGEPORT ADULTS HAD A COLLEGE DEGREE OR HIGHER. THIS DATA DEMONSTRATES THAT THERE ARE SIGNIFICANT INEQUITIES RELATED TO HIGHER EDUCATION WITH BETWEEN 62 AND 82% OF THE POPULATION WITH NO HIGH SCHOOL DIPLOMA OR A HIGH SCHOOL DIPLOMA OR EQUIVALENT AND SOME COLLEGE.

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THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS SUCH AS BRIDGEPORT 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.

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AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, BRIDGEPORT HOSPITAL REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH AND OTHER INNOVATIVE SERVICES OFFERED ON BOTH ITS CAMPUSES. DURING 2022, BRIDGEPORT HOSPITAL INVESTED $139.6 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.BRIDGEPORT 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 1,923 MEMBERS ON THE BRIDGEPORT HOSPITAL MEDICAL STAFF. BRIDGEPORT HOSPITAL, FOUNDED IN 1878, IS A 501-BED URBAN TEACHING HOSPITAL SERVING 30,407 INPATIENTS AND 601,342 OUTPATIENT ENCOUNTERS IN 2022. IT IS HOME TO THE ONLY BURN CENTER IN CONNECTICUT AND FEATURES THE SECOND INPATIENT CAMPUS OF YALE NEW HAVEN CHILDREN'S HOSPITAL. IT OFFERS SPECIALIZED SERVICES IN CANCER, GERIATRICS, NEUROLOGY AND NEUROSURGERY AND CARDIAC CARE. BRIDGEPORT HOSPITAL IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN BRIDGEPORT AND MILFORD WITH 3,231 EMPLOYEES IN 2022.

PART VI, LINE 7, REPORTS FILED WITH STATES
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