4A (Expenses $ 14108942 including grants of $ 0) (Revenue $ 13432728)
GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES.

4B (Expenses $ 13220 including grants of $ 13220) (Revenue $ 0)
COMMUNITY BENEFIT OUTREACH ACTIVITIES CONDUCTED BY THE ORGANIZATION INCLUDING HEALTH EDUCATION SEMINARS, HEALTH FAIRS, AND DONATIONS TO OTHER NON-PROFIT ENTITIES.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - JAY HOSPITAL, INC.. THE CHNA PROCESS WAS CONDUCTED THROUGH ACHIEVE HEALTHY ESCAROSA (AHER), OUR COMMUNITY'S COLLECTIVE IMPACT COLLABORATION FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITY SO THAT EVERYONE CAN LIVE WELL AND THRIVE. AHER HAS REPLACED THE FORMER THE LIVE WELL PARTNERSHIP FOR THE ROLES OF CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR ESCAMBIA AND SANTA ROSA COUNTIES IN FLORIDA AND TO SUPPORT AND PROMOTE COLLABORATIVE INITIATIVES THAT ADDRESS IDENTIFIED HEALTH PRIORITIES. THIS COLLECTIVE EFFORT RESULTED IN 2,937 VIABLE SURVEYS, THE LARGEST NUMBER OF COMMUNITY SURVEY RESPONSES TO DATE. AN EFFORT WAS MADE TO INVOLVE INDIVIDUALS FROM MANY DIFFERENT SECTORS OF THE LOCAL ECONOMY IN DEVELOPING THIS CHNA. THE CHNA PLANNING TEAM, COMPRISED OF THE FLORIDA DEPARTMENT OF HEALTH IN ESCAMBIA AND SANTA ROSA COUNTIES, AREA HOSPITALS AND HEALTH PROVIDERS, EDUCATIONAL INSTITUTIONS, AREA HEALTH COALITIONS, NONPROFIT ORGANIZATIONS AND OTHERS, WAS ESTABLISHED TO PROVIDE GUIDANCE AND INPUT THROUGHOUT DATA GATHERING, ANALYSIS, AND PRODUCTION OF THE CHNA. THE CHNA PLANNING TEAM PROVIDED INPUT ON THEIR PERCEPTIONS OF HEALTH AND HEALTH SERVICES, REVIEWED HEALTH OUTCOMES, NARROWED THE FOCUS TO THE TOP HEALTH PRIORITIES ACROSS BOTH COUNTIES, AND APPROVED THIS REPORT. BELOW IS A ROSTER OF THE CHNA PLANNING TEAM. CHNA PLANNING COMMITTEE - RESPONSIBLE FOR PLANNING, DATA COLLECTION/ANALYSIS, COMMUNICATION AND REPORT WRITING: * ADRIENNE MAYGARDEN, ASCENSION SACRED HEART * DR. DEBRA VINCI, UNIVERSITY OF WEST FLORIDA * DR. PATRICIA BARRINGTON, UNIVERSITY OF WEST FLORIDA * JEN GROVE, BAPTIST HEALTH CARE * JOY SHARP, BAPTIST HEALTH CARE * KIMBERLY PACE, FLORIDA DEPARTMENT OF HEALTH- ESCAMBIA * LAURA GILLIAM, UNITED WAY OF WEST FLORIDA * MATT DOBSON, CHAIR, FLORIDA DEPARTMENT OF HEALTH - SANTA ROSA * NICOLE GISLASON, UNIVERSITY OF WEST FLORIDA HAAS CENTER * NICHOLAS BILLINGS, UNIVERSITY OF WEST FLORIDA * SANDRA DONALDSON, COMMUNITY HEALTH NORTHWEST FLORIDA

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - JAY HOSPITAL, INC.. THE CHNA PROCESS WAS FACILITATED BY AHER, A NONPROFIT ORGANIZATION WHOSE MISSION IS TO UNITE AND ALIGN RESOURCES TO IMPROVE THE HEALTH AND WELL-BEING OF ESCAMBIA AND SANTA ROSA COUNTIES. THE CHNA PLANNING COMMITTEE INCLUDED REPRESENTATION FROM BAPTIST HEALTH CARE AND ASCENSION SACRED HEART.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - JAY HOSPITAL, INC.. NON-HOSPITAL STAKEHOLDER MEMBERS OF THE CHNA PLANNING COMMITTEE INCLUDED REPRESENTATIVES FROM THE FLORIDA DEPARTMENTS OF HEALTH IN ESCAMBIA AND SANTA ROSA COUNTIES, COMMUNITY HEALTH NORTHWEST FLORIDA (A FEDERALLY QUALIFIED HEALTH CENTER), THE UNIVERSITY OF WEST FLORIDA, AND THE UNITED WAY OF WEST FLORIDA.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - JAY HOSPITAL, INC. BAPTIST HEALTH CARE (PARENT OF JAY HOSPITAL, INC.) RECOGNIZED THAT SUSTAINED COMMUNITY HEALTH IMPROVEMENT HAPPENS WHEN ORGANIZATIONS FROM ALL SECTORS OF THE COMMUNITY LANDSCAPE TAKE OWNERSHIP OF THE COMMUNITY'S HEALTH AND WORK TOGETHER FOR IMPROVEMENT. AS SUCH, AHER HOSTED A COMMUNITY CONVENING IN FEBRUARY OF 2022, DURING WHICH COMMUNITY MEMBERS WERE INTRODUCED TO THE PRIORITY FOCUS AREAS AND OTHER HEALTH METRICS THROUGH A REVIEW OF THE CHNA. THE CONVENING ALSO SERVED AS AN ACTION PLANNING WORKSHOP, IN WHICH PARTICIPANTS WERE ENCOURAGED TO PROVIDE INPUT TO ONE OF THE SIX PRIORITY HEALTH FOCUS AREAS. THE AHER EXECUTIVE COMMITTEE HAS TAKEN THE INPUTS PROVIDED AND IS IN THE PROCESS OF DEVELOPING A DRAFT ACTION PLAN TO SHARE WITH PARTICIPANTS AND THE BROADER COMMUNITY. THE CHNA RESULTS AND SUBSEQUENT PLANNING DISCUSSIONS DETERMINED THE PRIORITIZED FOCUS AREAS ARE: OVERWEIGHT AND OBESITY SUBSTANCE ABUSE MENTAL HEALTH CHILD ABUSE ACCESS TO HEALTHCARE FOOD INSECURITY BAPTIST HEALTH CARE (PARENT OF JAY HOSPITAL, INC.) SERVES AS A LEADER AND CONVENER OF THESE EFFORTS AND IS ACTIVELY ENGAGED IN MULTIPLE WAYS IN THIS ENHANCED APPROACH TO HEALTH AND WELLNESS IN THE COMMUNITIES WE SERVE. JENNIFER GROVE, VP EXTERNAL RELATIONS OF BAPTIST HEALTH CARE, SERVES AS THE CHAIR OF ACHIEVE HEALTHY ESCAROSA, AND VARIOUS OTHER TEAM MEMBERS PARTICIPATE IN THE DATA, COMMUNICATIONS, AND CHNA COMMITTEES OF AHER. IN ADDITION, BAPTIST LEADERS AND TEAM MEMBERS ARE ACTIVELY ENGAGED IN THE COMMUNITY HEALTH IMPROVEMENT PLANNING PROCESS, THROUGH WHICH AHER WILL CONVENE WORKGROUPS TO BUILD ACTION PLANS IN EACH OF THESE PRIORITIZED FOCUS AREAS FOR THE COMMUNITY. BAPTIST ALREADY ENGAGES IN COLLABORATIONS AND DIRECT SERVICE IN MANY OF THESE PRIORITIZED FOCUS AREAS, AND LOOKS FORWARD TO THE COMPLETION OF THE COMMUNITY HEALTH IMPROVEMENT PLAN IN 2022 AND CONTINUED COLLABORATION WITH OTHER COMMUNITY PARTNERS TO IMPACT THE OUTCOMES IN THESE PRIORITIZED FOCUS AREAS.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - JAY HOSPITAL. IN ADDITION TO THE FPG THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDINGENCY AND INSURANCE STATUS IN DETERMINING FREE OR DISCOUNTED CARE.

Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care
IN ADDITION TO THE FPG THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDINGENCY AND INSURANCE STATUS IN DETERMINING FREE OR DISCOUNTED CARE.

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
The costing methodology used in determining the amount reported on Line 7 is the cost to charge ratio calculated pursuant to the IRS schedule H worksheet 2 instructions.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORT HAS BEEN FOLLOWED IN ACCORDANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS, AND SUBSEQUENT RECOVERIES ARE ADDED. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
BAD DEBT IS NOT INCLUDED AS PART OF JAY HOSPITAL'S COMMUNITY BENEFIT. APPROXIMATELY 24.14% OF JAY HOSPITAL'S PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. THIS MEANS THAT APPROXIMATELY $610,985, OR 24.14%, OF JAY'S HOSPITAL'S BAD DEBT EXPENSE COULD BE INCLUDED AS COMMUNITY BENEFIT HAD THOSE INDIVIDUALS GONE THROUGH THE FINANCIAL ASSISTANCE PROCESS.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST, AND THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE ENTIRE COST OF PROVIDING CARE TO MEDICARE PATIENTS CAUSING THE ORGANIZATION TO USE OTHER SURPLUS FUNDS TO COVER THE SHORTFALL. HOWEVER, THE ORGANIZATION PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF THIS SHORTFALL, WHICH RELIEVES THE STATE AND FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR THE CARE OF MEDICARE BENEFICIARIES.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
PATIENTS ARE DEEMED FINANCIALLY INDIGENT IF (A) THEY ARE UNINSURSED OR UNDERINSURED AND (B) THEIR INCOME IS BELOW 300% OF FPL (BASED UPON THE PATIENT'S HOUSEHOLD INCOME AS DEFINED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN THE FEDERAL REGISTER AS THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES). IF A PATIENT IS FOUND TO BE FINANCIALLY INDIGENT OR MEDICALLY INDIGENT, APPROPRITE FINANCIAL ASSISTANCE DISCOUNTS ARE APPLIED TO THE PATIENT'S ACCOUNT. FOR ANY PATIENT THAT QUALIFIES UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THE PATIENT ACCOUNT IS WRITTEN OFF AS CHARITY CARE AND THE ORGANIZATION DOES NOT PURSUE ANY COLLECTIONS.

Schedule H, Part V, Section B, Line 16a FAP website
- JAY HOSPITAL: Line 16a URL: HTTPS://EBAPTISTHEALTHCARE.ORG/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES;

Schedule H, Part V, Section B, Line 16b FAP Application website
- JAY HOSPITAL: Line 16b URL: HTTPS://EBAPTISTHEALTHCARE.ORG/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- JAY HOSPITAL: Line 16c URL: HTTPS://EBAPTISTHEALTHCARE.ORG/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES;

Schedule H, Part VI, Line 2 Needs assessment
PART OF THE ORGANIZATION'S MISSION IS TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE AND COMMUNITIES SERVED. IN RESPONSE TO THIS MISSION, THE ORGANIZATION HELPS ENSURE THAT ALL CITIZENS ARE AFFORDED ACCESS TO HEALTH CARE BY INVESTING IN COMMUNITY HEALTH, AND BY PARTICIPATING IN AND LEADING COLLABORATIVE, COMMUNITY-WIDE PARTNERSHIPS. FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND OTHER PROGRAMS THAT ARE OFFERED FOCUS ON AREAS THAT HAVE BEEN IDENTIFIED THROUGH INTERNAL STUDIES AND EXTERNAL SOURCES AS CRITICAL HEALTH CONCERNS IN THE SURROUNDING COMMUNITIES. A FULL COPY OF THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED USING THE FOLLOWING WEBSITE: HTTPS://WWW.EBAPTISTHEALTHCARE.ORG/COMMUNITY/CHNA

Schedule H, Part VI, Line 4 Community information
JAY HOSPITAL, INC. OPERATES IN SANTA ROSA COUNTY, FLORIDA. APPROXIMATELY 198,000 INDIVIDUALS RESIDE IN THIS COUNTY, 8.9% OF WHICH LIVE BELOW POVERTY LEVEL. WHEN CONSIDERING THESE FACTORS, MORE THAN 18,000 RESIDENTS COULD BE ELIGIBLE TO QUALIFY FOR CHARITY CARE. APPROXIMATELY 24.14% OF JAY HOSPITAL'S PATIENTS DURING FY2022 WERE UNINSURED OR WERE MEDICAID RECIPIENTS. THREE HOSPITALS, INCLUDING JAY HOSPITAL, ARE LOCATED IN SANTA ROSA COUNTY.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
JAY EMPLOYEES WORKING IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS AREAS HAVE BEEN TRAINED TO BE FULLY VERSED IN ALL FINANCIAL ASSISTANCE-RELATED POLICIES, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND BE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE REPRESENTATIVES. FOR NON-EMERGENCY PURPOSES, EVERY FILE FOR A PATIENT THAT HAS PRE-SCHEDULED AN OFFICE VISIT OR PROCEDURE IS REVIEWED BEFORE THE PATIENT ARRIVES AT THE HOSPITAL. A FINANCIAL COUNSELOR IS ASSIGNED TO THAT PATIENT IF IT IS DETERMINED THAT THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ETC. ALSO, WHEN A PATIENT RECEIVES A BILL, THE ORGANIZATION INCLUDES PAPERWORK EXPLAINING THAT FINANCIAL ASSISTANCE IS AVAILABLE. JAY HOSPITAL HAS POSTED MULTILINGUAL NOTICES OF FINANCIAL ASSISTANCE POLICIES IN THE EMERGENCY DEPARTMENT. SAID NOTICES HAVE BEEN PUBLISHED IN ENGLISH AND SPANISH, AND HAVE BEEN MADE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. JAY HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS FOR APPLYING FOR ASSISTANCE. ALSO, JAY HOSPITAL HAS POSTED A SUMMARY OF ITS CURRENT CHARITY CARE POLICY ON ITS INTERNET WEBSITE.

Schedule H, Part VI, Line 5 Promotion of community health
THE ORGANIZATION DOES NOT LIMIT MEDICAL STAFF PRIVILEGES TO THE ORGANIZATION'S EMPLOYED PHYSICIANS BUT EXTENDS THOSE PRIVILEGES TO QUALIFIED PHYSICIANS FOR MOST AREAS OF SERVICE. THE ORGANIZATION'S BOARD OF DIRECTORS PRIMARILY CONSISTS OF COMMUNITYLEADERS AND RESIDENTS WHO ARE INDEPENDENT OF THE ORGANIZATION. THE ORGANIZATION STRIVES TO EDUCATE ALL BOARD MEMBERS REGARDING THE HEALTH NEEDS OF THE COMMUNITY AND HOW THESE NEEDS RELATE TO THE ORGANIZATION'S MISSION AND VALUES. THE ORGANIZATION SEEKS TO STRATEGICALLY ALLOCATE AVAILABLE FUNDS TO BENEFIT THE SURROUNDING COMMUNITIES. FOCUS AREAS INCLUDE INCREASING THE TYPES OF CARE TO BE PROVIDED TO THE COMMUNITY, IMPROVING THE QUALITY OF PATIENT CARE, AND FURTHERING MEDICAL EDUCATION AND RESEARCH.

Schedule H, Part VI, Line 6 Affiliated health care system
ALTHOUGH THE ORGANIZATION MAY OPERATE IN DIFFERENT SERVICE AREAS WHEN COMPARED TO ITS AFFILIATES, ALL AFFILIATES WORK COLLABORATIVELY TO ENSURE THAT THE NEEDS OF THE COMMUNITIES ARE BEING ADDRESSED. THE ORGANIZATION PARTICIPATES IN MANY FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND HEALTH FAIRS THAT BENEFIT ALL COMMUNITIES WITHIN THE SYSTEM AND ARE NOT LIMITED TO THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. AFFILIATED ENTITIES INCLUDE: - BAPTIST HEALTH CARE CORPORATION - PARENT ORGANIZATION PROVIDING STRATEGIC MANAGEMENT AND SUPPORT SERVICES - Baptist Health Care, Inc.: OPERATES BAPTIST HOSPITAL AND GULF BREEZE HOSPITALS - BAPTIST HEALTH CARE FOUNDATION, INC. - PROVIDES FINANCIAL AND FUNDRAISING ASSISTANCE FOR ALL AFFILIATES - BAPTIST URGENT CARE, LLC - DELIVER AMBULATORY ARE IN A DEDICATED MEDICAL FACILITY OUTSIDE OF A TRADITIONAL EMERGENCY ROOM.