4A (Expenses $ 595461383 including grants of $ 0) (Revenue $ 696183920)
SEE SCHEDULE ONAPLES COMMUNITY HOSPITAL, INC. (NCH) PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. FROM ITS TWO HOSPITALS, CANCER TREATMENT CENTERS, WOUND CARE CENTERS AND OUTPATIENT REHABILITATION CENTERS, NCH PROVIDED $119,298,533 OF CHARITY CARE TO PATIENTS WHO WERE UNABLE TO PAY AND NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PROGRAM. ADDITIONALLY, NCH WROTE OFF $888,122 CLASSIFIED AS BAD DEBTS, MUCH OF WHICH REPRESENTED SERVICES DELIVERED TO INDIGENT PATIENTS, WHO DID NOT RECEIVE A CHARITY CARE DETERMINATION IN ACCORDANCE WITH THE STATE'S CRITERIA.THE SERVICES OFFERED AT NCH ARE EXTENSIVE AND INCLUDE MEDICAL, SURGICAL, OBSTETRIC, PEDIATRIC, REHABILITATIVE, PSYCHIATRIC, DIAGNOSTIC, AND EMERGENCY TREATMENT. A TOTAL OF 587 ACTIVE AND ASSOCIATE PHYSICIANS, 2,839 FULL-TIME EQUIVALENT EMPLOYEES, AND 302 VOLUNTEERS COMPRISE THE OUTSTANDING MEDICAL TEAM WORKING TOGETHER TO PROVIDE THESE SERVICES.THE TWO HOSPITALS ARE COMPRISED OF 617 ACUTE CARE BEDS, A 54 BED REHABILITATIVE UNIT, 19 NICU BEDS, AND A 23 BED PSYCHIATRIC UNIT. ADDITIONAL SPECIALTY SERVICES FOR THE CARE OF CERTAIN CRITICAL AND LIFE THREATENING MEDICAL CONDITIONS INCLUDE THE MEDICAL INTENSIVE CARE UNIT, SURGICAL INTENSIVE CARE UNIT, CARDIAC CARE UNIT, CARDIAC CATHETERIZATION UNIT AND INTERMEDIATE CARE UNIT. OTHER SPECIALTIES INCLUDE ONCOLOGY, DIAGNOSTIC SERVICES (CARDIO-DIAGNOSTICS, MAMMOGRAPHY, COMPUTERIZED TOPOGRAPHIC SCANNING (CT), AND MAGNETIC RESONANCE IMAGING (MRI), AND SPECIAL PROCEDURES SUCH AS BIOPSY, ANGIOGRAPHY, AND ANGIOPLASTY).DURING THE 2022 FISCAL YEAR, NCH HAD 29,015 INPATIENT ADMISSIONS RESULTING IN 145,987 DAYS OF CARE. ADDITIONALLY, 114,311 PATIENTS WERE TREATED IN OUR EMERGENCY CARE CENTERS.NAPLES COMMUNITY HOSPITAL, INC. RECEIVES VOLUNTEER ASSISTANCE FOR OPERATING ITS HOSPITALITY, GIFT, AND RETAIL SHOPS.NAPLES COMMUNITY HOSPITAL, INC. ALSO PROVIDES HEALTH ENHANCING EDUCATIONAL PROGRAMS IN ADDITION TO MEDICAL CARE. THESE PROGRAMS INCLUDE: WHITAKER WELLNESS CENTER; BETTER BREATHERS CLUB; MENDED HEARTS; DIABETES EDUCATION PROGRAM; CHILDBIRTH CLASSES; HEALTH FAIRS; AND CAREER DAYS. IN ADDITION, NCH SUPPORTS THE FOLLOWING: NURSES IN THE COLLIER COUNTY PUBLIC SCHOOL SYSTEM AND ATHLETIC TRAINERS AT THE LOCAL HIGH-SCHOOLS AND SPORTING EVENTS.

NAPLES COMMUNITY HOSPITAL, INC.
PART V, SECTION B, LINE 5: CHNA TAKING INTO ACCOUNT INPUT FROM THE COMMUNITYTHE NCH LEADERSHIP TEAM IS ACTIVELY INVOLVED AND PARTICIPATES IN MANY COMMUNITY RELATED ORGANIZATIONS AND GROUPS THAT ARE CONTINUALLY ASSESSING UNMET NEEDS WITHIN COLLIER COUNTY. NCH HAS HISTORICALLY WORKED WITH OUR BOARD OF TRUSTEES, COLLIER COUNTY CHILDREN'S ALLIANCE, COLLIER COUNTY PUBLIC SCHOOLS, BLUE ZONES PROJECT OF SWFL AND OTHER AGENCIES THROUGHOUT THE COMMUNITY IN ASSESSING AND COLLABORATING IN EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITY.NCH WORKS COLLABORATIVELY WITH THE FLORIDA DEPARTMENT OF HEALTH IN COLLIER COUNTY, THE COUNTY AND CITY GOVERNMENT, THE NAPLES AREA CHAMBER OF COMMERCE AND SEVERAL OTHER COMMUNITY GROUPS TO FORM THE COMMUNITY ASSESSMENT DESIGN GROUP. THE PURPOSE IS TO ASSESS THE COMMUNITY'S STRENGTHS AND OPPORTUNITIES. A NEW COMMUNITY HEALTH ASSESSMENT WAS COMPLETED IN 2022. THE 2020-2023 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PRIORITIES WERE ESTABLISHED IN 2020 BY THE HEALTHY COLLIER EXECUTIVE COMMITTEE BASED ON THE RESULTS FROM THE 2019 CHA. DOH-COLLIER FACILITATED THE CHIP PROCESS BY USING THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) STRATEGIC PLANNING MODEL. USING THE MOBILIZING FOR ACTION THROUGH THE PLANNING AND PARTNERSHIP (MAPP) FRAMEWORK, THE LEADERSHIP FOR COMMUNITY HEALTH IMPROVEMENT PLANNING (LCHIP) COMMITTEE REVIEWED THE 2019 COMMUNITY HEALTH ASSESSMENT (CHA) AND HELD DISCUSSIONS REGARDING GROUP PRIORITIES AND OBJECTIVES GOING FORWARD. THE COMMITTEE AGREED THAT THE RESULTS STRONGLY CORROBORATED THE RESULTS OF OTHER RECENT COMMUNITY ASSESSMENTS AND ACCURATELY REFLECT THE NEEDS OF COLLIER COUNTY.THE 2020-2023 CHIP WAS THEN SHAPED USING THE FIVE HIGHEST RANKED HEALTH PRIORITY AREAS FROM THE CHA RESULTS. THEY INCLUDE MENTAL HEALTH, CHRONIC DISEASES, ACCESS TO CARE, ALCOHOL AND DRUG USE, AND HEALTH OF OLDER ADULTS. MENTAL HEALTH AND ALCOHOL & DRUG USE WERE COMBINED INTO THE MENTAL HEALTH & SUBSTANCE ABUSE WORKGROUP. IN FEBRUARY AND MARCH OF 2020, THE DOH-COLLIER FACILITATORS CONVENED THE HEALTH PRIORITY WOKGROUPS TO FINALIZE THE GOALS, STRATEGIES, AND OBJECTIVES THAT EACH GROUP WILL WORK ON FOR THE NEXT THREE YEARS.HEALTH PRIORITY: MENTAL HEALTH AND SUBSTANCE ABUSEGOAL: IMPROVE IDENTIFICATION AND TREATMENT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS.OBJECTIVES:1. INCREASE THE COMBINED (HCN AND DLC) PERCENTAGE OF REFERRAL STATUS UPDATES GIVEN TO MEDICAL PROVIDERS WHO REFERRED PATIENTS FOR MENTAL HEALTH SERVICES FROM 47% IN 2021 TO 55% BY DECEMBER 2022. PROGRESS: AT THE END OF 2022, THE PERCENTAGE DECREASED TO 41.07%.2. INCREASE THE NUMBER OF INDIVIDUALS TRAINED PER YEAR IN YOUTH AND ADULT MENTAL HEALTH FIRST AID FROM 1060 IN 2019 TO 1500 BY DECEMBER 2022. PROGRESS: THE NUMBER OF INDIVIDUALS TRAINED IN 2022 WERE 2,937.HEALTH PRIORITY: CHRONIC DISEASESGOAL: DELIVER CULTURALLY RELEVANT HEALTH EDUCATION TO COLLIER COUNTY RESIDENTS IN POPULATIONS WITH DISPARITIES IN HEALTH OUTCOMES.OBJECTIVES:1. INCREASE THE NUMBER OF BLUE ZONES APPROVED WORKSITES FROM 49 IN 2019 TO 85 BY DECEMBER 2022. PROGRESS: TWENTY-ONE NEWLY APPROVED WORKSITES WERE ADDED IN 2022 WHICH RESULTED IN A TOTAL OF 87 APPROVED WORKSITES.2. INCREASE THE NUMBER OF EARLY CARE AND EDUCATION (ECE) SITES TO COMPLETE THE GO NUTRITION AND PHYSICAL ACTIVITY SELF-ASSESSMENT FOR CHILD CARE (GO NAPSACC) FROM 0 IN 2021 TO FIVE BY DECEMBER 2022. PROGRESS: THERE WERE NO NEW ECE SITES TO COMPLETE THE ASSESSMENT IN 2022. DOH-COLLIER'S RESPONSE TO THE COVID-19 PANDEMIC SLOWED PROGRAM DEVELOPMENT AND ONBOARDING.3. REACH A MINIMUM OF 2000 UNDUPLICATED SNAP-ELIGIBLE YOUTH THROUGH NUTRITION EDUCATION BY DECEMBER 2022. PROGRESS: THIS PROGRAM EXCEEDED ITS 2022 TARGET WITH 2,655 SNAP-ELIGIBLE YOUTH. 4. REACH A MINIMUM OF 150 UNDUPLICATED SNAP-ELIGIBLE ADULTS THROUGH NUTRITION EDUCATION BY DECEMBER 2022. PROGRESS: IN 2022, 315 SNAP-ELIGIBLE ADULTS PARTICIPATED IN THE PROGRAM. 5. INCREASE THE NUMBER OF PARTICIPANTS THAT COMPLETE THE HEALTHY FOR GOOD PROGRAM FROM 100 IN 2021 TO 160 BY DECEMBER 31, 2022. PROGRESS: FOR 2022, THERE WERE NO ADDITIONAL PARTICPANTS IN THIS PROGRAM.6. INCREASE THE NUMBER OF STUDENTS IMPACTED BY THE SMARTER LUNCHROOM PSE CHANGES AT SNAP ELIGIBLE SCHOOLS IN COLLIER COUNTY FROM 0 TO 25,000 BY DECEMBER 2022. PROGRESS: RESULT OF THIS OBJECTIVE WAS NOT REPORTED FOR 2022.7. INCREASE THE ANNUAL NUMBER OF REFERRALS TO THE CHILDHOOD OBESITY PROGRAM FROM THE 34142, 34116, AND 34112 ZIP CODES FROM 16 IN 2021 TO 60 BY DECEMBER 2022. PROGRESS: BY THE END OF 2022, THE NUMBER OF REFERRALS INCREASED TO 72.HEALTH PRIORITY: ACCESS TO CAREGOAL: INCREASE ACCESS TO BLOOD PRESSURE SCREENING SERVICES FOR UNINSURED COLLIER COUNTY RESIDENTS.OBJECTIVE:1. INCREASE THE NUMBER OF UNINSURED RESIDENTS PER YEAR IN COLLIER COUNTY WHO RECEIVED A BLOOD PRESSURE SCREENING FROM 12,404 IN 2019 TO 14,000 IN 2022, AN INCREASE OF ABOUT 5% PER YEAR. PROGRESS: WHILE COVID-19 TESTING DROVE PATIENTS TO THE CLINICS IN 2020, WORKGROUP MEMBERS CONCLUDED THAT MASK AND VACCINE REQUIREMENTS CONTINUED TO KEEP SOME AWAY IN 2022. THIS RESULTED IN 10,761 UNINSURED RESIDENTS RECEIVING BLOOD PRESSURE SCREENINGS.HEALTH PRIORITY: HEALTH OF OLDER ADULTSGOAL: INCREASE CAPACITY FOR OLDER ADULTS (AGE 60+) TO COMFORTABLY AND SAFELY AGE IN PLACE WITH APPROPRIATE RESOURCES IN A LIVABLE COMMUNITY.OBJECTIVES:1. INCREASE THE PERCENTAGE OF STEPS COMPLETED TO PRODUCE THE COLLIER COUNTY AGE-FRIENDLY ACTION PLAN FROM 0% IN 2021 TO 100% BY DECEMBER 2022. PROGRESS: 100% OF THE PROJECT WAS COMPLETED BY THE END OF 2022.2. INCREASE THE ANNUAL NUMBER OF COMMUNITY TOUCHPOINTS REGARDING DEMENTIA PRESENTATIONS, OUTREACH, TRAININGS, AND EVENTS FROM 83 IN 2021 TO 100 BY DECEMBER 2022. PROGRESS: AT THE END OF 2022, 78 COMMUNITY TOUCHPOINTS WERE MADE. THE CHIP SERVES AS A ROADMAP FOR CONTINUOUS IMPROVEMENT. THE CHIP WILL CONTINUE TO EVALUATE THE NEEDS OF THE COMMUNITY AND BY WORKING TOGETHER, WE CAN HAVE A SIGNIFICANT IMPACT ON COLLIER COUNTY'S HEALTH AND WELL-BEING AWARENESS.

NAPLES COMMUNITY HOSPITAL, INC.
PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIESAS PART OF AN INTEGRATED HEALTHCARE SYSTEM, THE CHNA FOR NAPLES COMMUNITY HOSPITAL AND MARCO ISLAND HOSPITAL WAS PREPARED JOINTLY.

NAPLES COMMUNITY HOSPITAL, INC.
PART V, SECTION B, LINE 11: ADDRESSING THE NEEDS IDENTIFIED IN THE CHNATHE CHNA IDENTIFIED PROBLEM AREAS THAT NEEDED TO BE ADDRESSED. THESE INCLUDE SUFFICIENT JOB EMPLOYMENT, ECONOMIC OPPORTUNITIES, ACCESS TO AFFORDABLE HOUSING, DRUG AND ALCOHOL ABUSE, SAFE ROADWAYS FOR BICYCLIST AND PEDESTRIANS, PRIMARY CARE RESOURCES, ACCESS TO AFFORDABLE HEALTHY FOOD, ACCESS TO LONG TERM CARE NEEDS, COMMUNICABLE DISEASE, OBESITY, CHRONIC DISEASE, MENTAL HEALTH, DENTAL HEALTH, ACCESS TO CARE, DISABILITIES AND UNINTENTIONAL INJURIES.UPON REVIEW OF THE FINDINGS OF THE CHNA, THE NCH LEADERSHIP TEAM CAME UP WITH FIVE KEY AREAS TO FOCUS ON WHICH INCLUDED MENTAL HEALTH, CHRONIC DISEASE (ONCOLOGY), MATERNAL AND INFANT HEALTH, HEALTH OF THE OLDER POPULATION AND HEALTH BEHAVIORS AND OUTCOMES. BELOW IS A SUMMARY OF ACTIVITIES AND INITIATIVES NCH ACHIEVED IN THE PAST THREE YEARS IN THESE SPECIFIC KEY AREAS.MENTAL HEALTHIN AN EFFORT TO EXPAND ACCESS OF OUTPATIENT BEHAVIORAL HEALTH SERVICE NCH CO-LOCATED PHYSICIAN PRACTICES AND NCH HAS BEEN PARTICIPATING IN THE COLLIER COUNTY COMMISSIONERS AD HOC TASK FORCE ON MENTAL HEALTH AND ADDICTION NEEDS IN COLLIER COUNTY. THE COMMITTEE SPONSORED A ONE-CENT SALES TAX, WHICH WAS APPROVED FOR $25 MILLION FOR IMPROVING MENTAL HEALTH IN COLLIER. IN RESPONSE TO MANAGING HIGH-RISK PSYCHIATRIC PATIENTS, NCH HAS PLACED CASE MANAGERS IN NCH EMERGENCY DEPARTMENTS TO WORK WITH FREQUENT USERS OF ED AND INPATIENT SERVICES.IN ORDER TO TARGET SEVERE DEPRESSION NCH WILL SOON BE IMPLEMENTING AN ELECTRO CONVULSIVE THERAPY PROGRAM (ECT) AND A TRANS MAGNETIC SIMULATION PROGRAM (TMS), AS WELL AS IV KETAMINE AND INTRA NASAL KETAMINE PROGRAMS WHEN APPROVED BY THE FDA.CHRONIC DISEASE (ONCOLOGY)MAMMOGRAM SCREENINGS ARE OFFERED AND PROVIDED TO UNINSURED AND UNDERINSURED PATIENTS. IN ADDITION, A COMMUNITY FAIR IS SCHEDULED EACH YEAR AT LOCAL CHURCHES, CP-3 SCREENINGS AND AN AMERICAN CANCER ASSOCIATION STUDY HAS ALSO BEEN COMPLETED.NCH HIRED CARDIO THORACIC SURGEONS WHO DEVELOPED A COMPREHENSIVE LUNG CANCER PROGRAM FOCUSING ON SCREENING, NAVIGATION, SURVIVORSHIP AND SURGICAL INTERVENTION.NCH EXPANDED ITS NURSE NAVIGATION PROGRAM WITH FOCUS ON FOLLOWING ONCOLOGY PATIENTS THROUGHOUT THE CONTINUUM OF CARE WITH SPECIAL EMPHASIS ON BREAST AND LUNG PATIENTS AS WELL AS SCREENING ACTIVITIES.MATERNAL AND INFANT HEALTHNCH IMPLEMENTED SKIN TO SKIN IN THE DELIVERY ROOM. THE SKIN TO SKIN RATE IS 96%. ALL REGISTERED NURSES IN LABOR AND DELIVERY, MOTHER/BABY, NEONATAL INTENSIVE CARE UNIT, PEDIATRICS AND PEDIATRICS ED ARE EDUCATED IN BREASTFEEDING. NCH MAINTAINS A BREASTFEEDING RATE OF 58%. NCH EMPLOYS 1 FULL-TIME AND 1 PART-TIME EQUIVALENT LACTATION CONSULTANTS WHICH ARE AVAILABLE 7 DAYS A WEEK 16 HOURS PER DAY. NCH ALSO HOSTS THE COLLIER COUNTY BREASTFEEDING COALITION WITH AN OVERALL GOAL TO INCREASE BREASTFEEDING RATES IN COLLIER COUNTY.NCH IS A HOST MEMBER OF A SUBSTANCE ABUSE COALITION AND SPONSORS REGULAR MEETINGS HELD AT NCH. THE COALITION REPORTS DATA TO THE STATE AND ALSO SUPPORTS NURSE EDUCATIONAL PROGRAMS FOR PARENTS ON THE DETRIMENTAL EFFECTS OF SUBSTANCE ABUSE FOR NEWBORNS. ALL PATIENTS AND PARENTS ARE OFFERED TDAP IMMUNIZATION AND CURRENTLY ON WOMEN AND CHILDREN'S AND PEDIATRIC NURSING UNITS A STANDING ORDER FOR TDAP ADMINISTRATION IF STATUS IS UNKNOWN. IN ADDITION, IN WOMEN AND CHILDREN'S AND PEDIATRIC NURSING UNITS ALL NCH STAFF HAVE RECEIVED THE TDAP VACCINE AS WELL AS ANY NEW STAFF.HEALTH OF THE OLDER POPULATIONNCH HAS GERIATRIC MEDICINE IN MULTIPLE NCH PHYSICIAN PRACTICES.TWO NCH PHYSICIANS ARE MEDICAL DIRECTORS OF TWO SKILLED NURSING FACILITIES IN COLLIER COUNTY.DIABETES MANAGEMENTNCH HEALTHCARE SYSTEM'S VON ARX DIABETES CENTER HAS TWO RECOGNIZED AMERICAN DIABETES PROGRAMS THAT MAINTAIN DATA COLLECTION AND REPORTING REQUIREMENTS. DIABETES SUPPORT GROUPS ARE PROVIDED TO THE COMMUNITY. ALSO, FREE PRE-DIABETES SEMINARS AND COMMUNITY LECTURES ARE OFFERED THROUGHOUT THE YEAR. PHILANTHROPIC FUNDS HAVE BEEN ALLOCATED FOR PEDIATRICS TO ASSURE THEY HAVE APPOINTMENTS SCHEDULED WITH REGISTERED DIETICIANS OR NURSES FOR UNDERINSURED OR UNINSURED CHILDREN. PHILANTHROPIC FUNDS ARE ALSO USED FOR GESTATIONAL PATIENTS PROVIDING EDUCATIONAL CLASSES, AND SUPPLIES. OUR RESULTS INCLUDE 80% OF WOMEN ACHIEVED TARGET RANGES FOR BLOOD GLUCOSE LEVELS AND 85% OF BABIES BORN MET BIRTH WEIGHT GOALS (<9 LBS.).ACCOMPLISHMENTS FOR 2022 INCLUDE, BUT ARE NOT LIMITED TO: I. THE VON ARX DIABETES CENTER SERVED 5,545 OUTPATIENT VISITS; II. SERVICES WERE EXPANDED TO MARCO ISLAND AND BONITA SPRINGS; III. EXPANDED GROCERY STORE TOURS; IV. MAINTAINED ACCREDITATION WITH THE AMERICAN DIABETES ASSOCIATION NCH WORKING WITH THE FLORIDA DEPARTMENT OF HEALTH - COLLIER COUNTY PARTICIPATED AGAIN IN THE COLLIER COUNTY COMMUNITY ASSESSMENT DESIGN GROUP. THE SCOPE OF THE GROUP IS TO DESIGN A COMMUNITY STRENGTHS/OPPORTUNITIES SURVEY. A SURVEY WAS PREPARED AND SENT OUT TO THE HEALTH CARE LEADERS, COMMUNITY FOCUS GROUPS AND HEALTH CARE STAFF. IDENTIFIED PROBLEM AREAS INCLUDED THE FOLLOWING:CHRONIC DISEASE AND MORTALITYINFECTIOUS DISEASEMATERNAL AND INFANT HEALTHINJURIESACCESS TO HEALTHCAREHEALTH BEHAVIORS AND HEALTH STATUSMENTAL HEALTHORAL HEALTHTHE HEALTH OF THE OLDER POPULATIONSUBSEQUENTLY, THE LEADERSHIP FOCUS GROUP MET TO DISCUSS BOTH THE POSITIVE AND NEGATIVE FACTORS THAT INFLUENCED THESE AREAS.THE NEXT STEP IN THE PROCESS WAS TO CONDUCT GEOGRAPHICAL AREA COMMUNITY FOCUS GROUPS. THESE GROUPS WERE CHOSEN TO REFLECT AND INCLUDE THE DIVERSITY OF COMMUNITY LOCATIONS, ETHNICITY, AND SOCIO-ECONOMIC FACTORS. THE DISTINCT AREAS OF THE COUNTY REPRESENTED UNIQUE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS. THE DIFFERENCES WERE VALUABLE AND USEFUL FOR ASSESSING AND PRIORITIZING HEALTHCARE NEEDS WITHIN OUR COMMUNITY. IN ADDITION, WE PROVIDED INPUT INTO THE ANALYSIS ON VARIOUS HEALTH INDICATORS WHICH INCLUDED THE FOLLOWING: POPULATION SOCIOECONOMIC CHARACTERISTICS INFECTIOUS DISEASE HEALTH BEHAVIORS AND HEALTH STATUS MORTALITY INDICATORS MATERNAL AND INFANT HEALTH HEALTH OF THE OLDER POPULATIONUPON REVIEW OF THE FINDINGS OF THE (CHNA) THE NCH LEADERSHIP TEAM REVIEWED THE FINDINGS. A PRIORITIZATION SESSION WAS COMPLETED WHICH WAS BASED ON THE MISSION, VISION AND CORE VALUES OF THE NCH HEALTHCARE SYSTEM WITH A PRIMARY FOCUS ON THE GOAL OF COLLIER COUNTY BECOMING THE HEALTHIEST COUNTY IN THE UNITED STATES. UPON MUCH DISCUSSION THE TEAM CAME UP WITH FOUR KEY AREAS OF FOCUS WHICH INCLUDE: MENTAL HEALTH ACCESS TO CARE CHRONIC DISEASE HEALTH OF OLDER ADULTSUNADDRESSED IDENTIFIED NEEDSALTHOUGH SEVERAL COMMUNITY NEEDS WERE IDENTIFIED, NCH MUST FOCUS OUR EXISTING CLINICAL STRENGTHS AND INFRASTRUCTURE WHERE WE CAN MAXIMIZE OUR RESOURCES TO BENEFIT THE GREATEST NUMBER OF PEOPLE IN THE COMMUNITY. NCH WILL CONTINUE TO RE-EVALUATE THE UNADDRESSED IDENTIFIED NEEDS AND PURSUE ACTION WHEN AND WHERE RESOURCES ALLOW.

NAPLES COMMUNITY HOSPITAL, INC.
PART V, SECTION B, LINE 13B: NCH HAS A POLICY THAT ALLOWS A DISCOUNT FOR SELF-PAY UNINSURED OR UNDERINSURED PATIENTS WITH INCOME AND ASSETS GREATER THAN 200% OF FPG WHEN THE FAP APPLICATION AND SUPPORTING DOCUMENTATION IS PROVIDED.NCH RETAINS DISCRETION TO PROVIDE FINANCIAL ASSISTANCE TO PATIENTS WHO FALL OUTSIDE THE FPG INCOME GUIDELINES. OTHER CONSIDERATIONS TO INCOME LEVEL ARE PERCENTAGE OF TOTAL AMOUNT CHARGED BASED ON SERVICES PROVIDED TO THE PATIENT COMPARED TO PATIENTS INCOME.

NAPLES COMMUNITY HOSPITAL, INC.
PART V, SECTION B, LINE 13H: NAPLES COMMUNITY HOSPITAL, INC.:BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS.OTHER CRITERIA USED TO DETERMINE ELIGIBILITY ARE PATIENTS WHO ARE ELIGIBLE TO RECEIVE BENEFITS FROM A GOVERNMENTAL AGENCY AS THE VICTIM OF A VIOLENT CRIME OR SEXUAL ASSAULT AND THE TREATMENT IS RELATED TO THE VIOLENT CRIME OR SEXUAL ASSAULT.

PART I, LINE 3C:
NCH USES OTHER FACTORS OTHER THAN FPG TO DETERMINE ELIGIBILTY FOR PROVIDING FREE OR DISCOUNTED CARE AS DESCRIBED BELOW.PRESUMPTIVE ELIGIBILITYPATIENTS MAY BE ELIGIBLE FOR A DISCOUNT OF THE FULL UNPAID BALANCE IN THE ABSENCE OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION FORM IF THE PATIENT MEETS ONE OF THE FOLLOWING:1. IS HOMELESS2. IS DECEASED AND HAS NO KNOWN ESTATE AVAILABLE TO PAY MEDICAL BILLS3. IS CURRENTLY ELIGIBLE FOR MEDICAID (AS PRIMARY INSURANCE) BUT WAS NOT AT DATE OF SERVICE OR MEDICAID BENEFITS ARE EXHAUSTED.4. IS ELIGIBLE TO RECEIVE BENEFITS FROM A GOVERNMENTAL AGENCY AS THE VICTIM OF A VIOLENT CRIME OR SEXUAL ASSAULT AND THE TREATMENT IS RELATED TO THE VIOLENT CRIME OR SEXUAL ASSAULT.5. A DEMONSTRATED INABILITY TO PAY FOR SERVICES BASED ON ALL AVAILABLE ASSETS. PATIENTS RECEIVING CARE IN OR FROM THE EMERGENCY DEPARTMENT WHO ARE WITHOUT FINANCIAL RESOURCES MAY BE ELIGIBLE FOR THE FAP IF THEY ARE UNEMPLOYED OR SELF-EMPLOYED AND CANNOT PROVIDE INCOME AN INCOME TAX STATEMENT, ARE INDIGENT WITHOUT ACCESS TO THE REQUIRED APPLICATION DOCUMENTATION MAY STILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE.

PART I, LINE 6A:
"RELATED PARTY DISCLOSURENAPLES COMMUNITY HOSPITAL, INC. (""NCH"") IS AN AFFILIATE OF NCH HEALTHCARE SYSTEM, INC. (""NCHS""). NCHS PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND INCLUDES THIS REPORT WITH ITS FORM 990 TAX RETURN FILING.THE COMMUNITY BENEFIT REPORT PREPARED INCLUDES ALL ORGANIZATIONS OF THE SYSTEM, INCLUDING NAPLES COMMUNITY HOSPITAL, INC."

PART I, LINE 7:
COSTING METHOD USEDTHE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINE 7 ARE BASED ON THE COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM FORM 990, SCH. H, WORKSHEET 2.

PART I, LN 7 COL(F):
BAD DEBT EXPENSE INCLUDED FORM 990, PART IX, LINE 25THE BAD DEBT EXPENSE AMOUNT INCLUDED ON FORM 990, PART IX, COLUMN 25(A) WAS $888,122 FOR THE YEAR ENDED SEPTEMBER 30, 2022. THIS AMOUNT HAS BEEN SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE REPORTED ON THE SCHEDULE H, PART I, LINE 7 TABLE.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BUILDING ACTIVITIESSHARING OUR SPACEWHEN SPACE IS AVAILABLE, NCH PROVIDES SPACE AT NO COST TO NEEDY, NOT-FOR-PROFIT ORGANIZATIONS. THE TELFORD EDUCATION CENTER IS AVAILABLE TO NOT-FOR-PROFIT HEALTHCARE RELATED GROUPS SUCH AS MENDED HEARTS AND THOSE THAT PROVIDE SUPPORT FOR STROKE AND KIDNEY PATIENTS. RESIDENTS OF MARCO BENEFITED WITH THE USE OF OUR FACILITY FOR COMMUNITY EDUCATION AND THE HOSPICE SUPPORT GROUP.CLINICAL NURSING SCHOOLTHE CLINICAL NURSING SCHOOL OF FLORIDA SOUTHWESTERN STATE COLLEGE IS PROVIDED HERE AT NCH. FOR YEARS, NCH HAS ALWAYS WELCOMED STUDENTS OF FLORIDA SOUTHWESTERN STATE COLLEGE AND LORENZO WALKER INSTITUTE OF TECHNOLOGY TO OUR FACILITIES. NCH PROVIDES ON-SITE CLASSROOMS FOR CLINICAL EDUCATION.NURSING AND RADIOLOGY SCHOLARSHIPS ARE GENEROUSLY FUNDED AT BOTH FLORIDA SOUTHWESTERN STATE COLLEGE AND FGCU.SHARING OUR EXPERTISEMEMBERS OF NCH MANAGEMENT SERVE ON COMMUNITY BOARDS IN VARIOUS CAPACITIES. WE ALSO PROVIDE EXPERTISE TO OTHER COMMUNITY ISSUES SUCH AS WORKFORCE HOUSING AND WORKFORCE DEVELOPMENT.EMPLOYING THE COMMUNITYNCH IS GROWING OUR OWN HEALTHCARE PROFESSIONALS, AND HELPING OTHERS SEEKING WORK, TO FIND IT. CAREER DAYS, JOB SHADOWING, AND LECTURES AT LOCAL MIDDLE AND HIGH SCHOOLS ENLIGHTEN STUDENTS ABOUT THE MANY OPPORTUNITIES IN THE HEALTHCARE WORLD.

PART III, LINE 2:
BAD DEBT EXPENSE, COSTING METHODOLOGY USEDBAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS IS DETERMINED BY PATIENTS THAT HAVE FILED FOR BANKRUPTCY AND/OR HAVE LOSS OF EMPLOYMENT AFTER THE DATE OF SERVICE.

PART III, LINE 3:
BAD DEBT EXPENSETHE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 2 IS BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM FORM 990, SCH. H, WORKSHEET 2.

PART III, LINE 4:
BAD DEBT FOOTNOTEBAD DEBTS REPRESENT CHARGES DEEMED UNCOLLECTIBLE DUE TO EITHER: (A) A PATIENT'S INABILITY TO QUALIFY AS CHARITY, WELFARE, OR MEDICAID, YET CLEAR FINANCIAL INDICATIONS EXIST THAT DEMONSTRATE AN INABILITY TO PAY, OR (B) A PATIENT'S REFUSAL TO PAY FOR SERVICES PROVIDED AND THE SYSTEM'S DECISION TO CEASE FURTHER COLLECTION EFFORTS. BAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS IS DETERMINED BY PATIENTS THAT HAVE FILED FOR BANKRUPTCY AND/OR HAVE LOSS OF EMPLOYMENT AFTER THE DATE OF SERVICE. THE BAD DEBT EXPENSE FOOTNOTE DISCLOSURES CAN BE FOUND ON PAGES 17 AND 18 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS FOR THE NCH HEALTHCARE SYSTEM, INC. AND SUBSIDIARIES.

PART III, LINE 8:
COSTING METHODOLOGY, MEDICARETHE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM FORM 990, SCH. H, WORKSHEET 2.CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF NCH AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE HOSPITAL TO PROVIDE SUCH SERVICES.AS A RESULT, NAPLES COMMUNITY HOSPITAL, INC. VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION.

PART III, LINE 9B:
COLLECTION PRACTICESNAPLES COMMUNITY HOSPITAL, INC. PROVIDES URGENT/EMERGENT MEDICAL SERVICES WITHOUT REGARD TO ABILITY TO PAY. NAPLES COMMUNITY HOSPITAL, INC. ALSO PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET SPECIFIC CRITERIA UNDER THE STATE'S CHARITY CARE GUIDELINES. BECAUSE NAPLES COMMUNITY HOSPITAL, INC. DOES NOT PURSUE COLLECTION OF ACCOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS REVENUE.

PART VI, LINE 4:
COMMUNITY INFORMATIONNAPLES COMMUNITY HOSPITAL, INC. SERVES A DIVERSE AND SEASONAL COMMUNITY. THE POPULATION IS APPROXIMATELY 386,598. THE MEDIAN AGE OF RESIDENTS IS 51. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IS $70,217. THE UNEMPLOYMENT RATE IS APPROXIMATELY 4.4%. THE PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS APPROXIMATELY 12.65%.

PART VI, LINE 7, REPORTS FILED WITH STATES
FL

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NEEDS ASSESSMENTTHE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IN VARIOUS WAYS. OUR LEADERSHIP TEAM IS ACTIVELY INVOLVED AND PARTICIPATES IN MANY COMMUNITY RELATED ORGANIZATIONS AND GROUPS THAT ARE CONTINUALLY ASSESSING UNMET NEEDS WITHIN COLLIER COUNTY. WE HAVE HISTORICALLY WORKED WITH OUR BOARD OF TRUSTEES, COLLIER COUNTY CHILDREN'S ALLIANCE, COLLIER COUNTY PUBLIC SCHOOLS, THE IMMOKALEE FOUNDATION, CHILDREN'S MEDICAL SERVICES, AND OTHER AGENCIES THROUGHOUT OUR COMMUNITY IN ASSESSING AND COLLABORATING IN EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITY.NCH PROVIDES MANY HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING HEALTH TO THE COMMUNITY. THE CURRENT PROGRAMS AND RESOURCES PROVIDED TO THE COMMUNITY INCLUDE THE FOLLOWING: HEALTH SEMINARS, COMMUNITY HEALTH FAIRS, FREE DIAGNOSTIC AND SCREENING TESTING, THE NEIGHBORHOOD HEALTH CLINIC, HEART PROGRAMS, CANCER SURVIVAL AWARENESS, PATIENT SUPPORT GROUPS, TWO WELLNESS CENTERS, VON ARX DIABETES CENTER, PASTORAL CARE SERVICES, AND SPONSOR AND SUPPORT CLINICAL NURSING SCHOOLS.IN ADDITION TO THE PROGRAMS LISTED, WE ARE ALSO WORKING WITH THE SAFE AND HEALTHY CHILDREN'S COALITION OF COLLIER COUNTY TO DEVELOP PROGRAMS FOR DROWNING PREVENTION, CHILDHOOD OBESITY, SAFE SLEEP EFFORTS, AND BREASTFEEDING PROGRAMS.DURING 2022, WE COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND HAVE POSTED THIS REPORT ON OUR WEBSITE (HTTP://WWW.NCHMD.ORG/ABOUT-US/ANNUAL-REPORTS). WE ARE COMMITTED TO PROMOTING EXISTING AND POTENTIAL NEW PROGRAMS TO THE COMMUNITY IN RESPONSE TO THE COMMUNITY HEALTH NEEDS ASSESSMENT. PLEASE REFER TO THIS REPORT AND DETAILED PLAN WHICH WAS REVIEWED BY THE NCH HEALTHCARE SYSTEM BOARD OF TRUSTEES AND APPROVED AT THE SEPTEMBER 27, 2022 BOARD OF TRUSTEE MEETING. INCLUDED IN THE 2022 REPORT IS THE BLUE ZONE PROJECT WHICH BEGAN IN 2015 AND IS SPONSORED BY NCH. THE BLUE ZONE PROJECT IS A COMPREHENSIVE WELL-BEING IMPROVEMENT INITIATIVE DESIGNED TO HELP PEOPLE LIVE LONGER AND BETTER BY BUILDING STRONG SOCIAL NETWORKS AND ENCOURAGING SUSTAINABLE CHANGES THROUGHOUT THE COMMUNITY THAT LEADS TO HEALTHIER CHOICES.

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INFORMATION REGARDING PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCENAPLES COMMUNITY HOSPITAL, INC. RECOGNIZES ITS RESPONSIBILITY TO COMMUNICATE ITS FINANCIAL POLICIES AND EXPECTATIONS TO PATIENTS. THE HOSPITAL INFORMS AND EDUCATES PATIENTS BY PROVIDING PATIENTS WITH THE NCH HEALTHCARE SYSTEM PATIENT RIGHTS AND RESPONSIBILITIES. INCLUDED IN THESE RIGHTS IS THE RIGHT TO BE GIVEN, UPON REQUEST, FULL MEDICAL INFORMATION AND FINANCIAL COUNSELING. IN ADDITION, A PATIENT REPRESENTATIVE WILL CONTACT PATIENTS PRIOR TO SERVICES TO EVALUATE THE PATIENT'S ABILITY TO PAY. THIS PROCESS INCLUDES OBTAINING THE PATIENT'S CURRENT FINANCIAL INFORMATION, OBTAINING A CREDIT REPORT AND REVIEWING THE PATIENT'S PAYMENT HISTORY WITH NAPLES COMMUNITY HOSPITAL, INC. PERSONS REQUIRING ASSISTANCE WITH THE UNFUNDED PORTION OF THEIR BILLS ARE ENCOURAGED TO REQUEST A CHARITY EVALUATION. NCH ALSO PROVIDES ASSISTANCE FOR PATIENTS TO APPLY FOR MEDICAID COVERAGE OR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS WHICH MAY ASSIST WITH PAYMENT FOR MEDICAL SERVICES.

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INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTHNAPLES COMMUNITY HOSPITAL, INC. PROVIDES HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING THE HEALTH OF OUR COMMUNITY. THE TYPE OF PROGRAMS/RESOURCES PROVIDED INCLUDE: HEALTH SEMINARS, COMMUNITY HEALTH FAIRS AND TESTING, REGISTERED NURSES EDUCATING FUTURE PATIENTS, SUPPORTING THE NEIGHBORHOOD HEALTH CLINIC, PHYSICIAN LED ACCESS NETWORK OF COLLIER COUNTY, HEART PROGRAMS, CANCER SURVIVAL AWARENESS, SUPPORT OF PATIENT FAMILIES, DR. JOHN BRIGGS WELLNESS CENTER, AS WELL AS THE SHARING OF SPACE AT NO COST TO NEEDY, NOT-FOR-PROFIT ORGANIZATIONS. THE ORGANIZATION ALSO SPONSORS AND SUPPORTS THE CLINICAL NURSING SCHOOLS IN THE COMMUNITY.THE ORGANIZATION'S CIVIC INVOLVEMENT INCLUDES MEMBERS OF NCH MANAGEMENT SERVING ON COMMUNITY BOARDS IN VARIOUS CAPACITIES. THE HOSPITALS HAVE ALWAYS PROVIDED EXEMPLARY PASTORAL CARE SERVICES. NCH IS ENCOURAGING THEIR OWN HEALTHCARE PROFESSIONAL BY SPONSORING CAREER DAYS, JOB SHADOWING, AND LECTURES AT LOCAL MIDDLE AND HIGH SCHOOLS ON THE MANY OPPORTUNITIES IN THE HEALTHCARE FIELD. FOR ADDITIONAL COMMUNITY ACTIVITIES THAT NAPLES COMMUNITY HOSPITAL, INC. SUPPORTS, PLEASE REFER TO FORM 990, SCHEDULE O, PART III, PROGRAM SERVICES.

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AFFILIATED HEALTHCARE SYSTEM INFORMATIONNAPLES COMMUNITY HOSPITAL, INC. IS AN AFFILIATE OF THE NCH HEALTHCARE SYSTEM, INC. NCH HEALTHCARE SYSTEM, INC. PROVIDES HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING THE HEALTH OF OUR COMMUNITY. IN ADDITION TO NAPLES COMMUNITY HOSPITAL, INC., THE NCH HEALTHCARE SYSTEM ALSO INCLUDES THE FOLLOWING NON-PROFIT ORGANIZATIONS:> MARCO ISLAND HOSPITAL, INC., OPERATES AN 11 1/2-HOUR/7-DAYS A WEEK URGENT CARE FACILITY AND SERVICES PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. DURING FYE 09/30/2022, 8,555 PATIENTS WERE TREATED. OF THESE PATIENTS, 7.32 % WERE CLASSIFIED AS MEDICAID, CHARITY, OR BAD DEBTS.> COLLIER HEALTH CARE, INC. OWNS AND LEASES HEALTHCARE FACILITIES IN NAPLES AND IMMOKALEE, FLORIDA. > NCHMD, INC. OWNS AND OPERATES PHYSICIAN MEDICAL PRACTICES AND OUTPATIENT RADIOLOGY SERVICES IN COLLIER AND LEE COUNTY, FLORIDA.