4A (Expenses $ 570185799 including grants of $ 644988) (Revenue $ 592538462)
HOLY CROSS HOSPITAL IS A 557-BED COMMUNITY HOSPITAL LOCATED IN FT. LAUDERDALE, FLORIDA, IN OPERATION SINCE 1955. THE HOSPITAL SPECIALIZES IN HEART BYPASS SURGERY, HIP AND KNEE REPLACEMENT, HEART FAILURE, AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE. THE HOSPITAL IS ALSO WELL-REGARDED IN THE SPECIALTIES OF GERIATRICS, GYNECOLOGY, ORTHOPEDICS AND UROLOGY. IN FY22, THE HOSPITAL SERVED THE COMMUNITY BY PROVIDING OVER 75,000 DAYS OF INPATIENT CARE, AND OVER 575,000 OUTPATIENT VISITS. HOLY CROSS IS THE ONLY FAITH-BASED ACUTE CARE HOSPITAL IN BROWARD COUNTY.PLEASE VISIT SCHEDULE H AND THE WEBSITE FOR ADDITIONAL INFORMATION ABOUT SERVICES, RECOGNITIONS AND AWARDS: WWW.HOLY-CROSS.COM

HOLY CROSS HOSPITAL, INC.
PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E:HOLY CROSS HOSPITAL INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED FACILITATED SELECTION PROCESS: HEALTH NEEDS:1) BEHAVIORAL HEALTH2) DIABETES/OBESITY3) HEART DISEASE AND STROKE4) CANCER5) MATERNAL AND INFANT HEALTH6) ALZHEIMER'S DISEASE7) HIV/AIDS8) SICKLE CELLSOCIAL DETERMINANT OF HEALTH NEEDS:1) HEALTH CARE ACCESS AND QUALITY2) ECONOMIC STABILITY3) HOUSING/HOMELESSNESS4) FOOD ENVIRONMENT5) SAFETY AND CRIME

HOLY CROSS HOSPITAL, INC.
PART V, SECTION B, LINE 5: MEMBERS OF THE HOLY CROSS HOSPITAL COMMUNITY NEEDS ASSESSMENT ADVISORY COUNCIL PARTICIPATED IN FIVE MEETINGS BETWEEN AUGUST AND NOVEMBER 2021. HOLY CROSS HOSPITAL'S CHNA PROCESS ALSO INCLUDED DEFINING THE COMMUNITY, ANALYZING SECONDARY DATA SETS TO ASSESS THE HEALTH STATUS OF THE COMMUNITY, CONDUCTED PRIMARY QUALITATIVE DATA COLLECTION THROUGH SURVEYS, FOCUS GROUPS, KEY INFORMANT INTERVIEWS AND COMMUNITY CONVERSATIONS. THE DATA WAS THEN ANALYZED BY THE COMMUNITY HEALTH ADVISORY COMMITTEE AND COUNCIL TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS WITHIN THE HOLY CROSS STRATEGIC PLANNING AREA. THE COLLABORATIVE PROCESS RESULTED IN ACTION PLANNING AND THE FORMULATION OF THE IMPLEMENTATION STRATEGY. ORGANIZATIONS THAT COMPRISED THE HOLY CROSS HOSPITAL COMMUNITY NEEDS ASSESSMENT ADVISORY COMMITTEE REPRESENTED MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN OUR SERVICE AREA. MEMBERS INCLUDED REPRESENTATIVES AND COLLABORATIVE PARTNERS FROM THE COMMUNITY, INCLUDING: THE DEPARTMENT OF HEALTH-BROWARD COUNTY, BROWARD HOUSING AUTHORITY, YMCA OF SOUTH FL, THE URBAN LEAGUE OF BROWARD COUNTY, HOPE SOUTH FL, SOUTH FL HUNGER COALITION, BROWARD COUNTY MEDICAL ASSOCIATION, THE UNITED WAY, THE UNITED WAY COMMISSION ON SUBSTANCE ABUSE, THE CHILDREN'S SERVICES COUNCIL, SUNSERVE, BROWARD HEALTHY START COALITION, BROWARD SHERIFF'S OFFICE-COMMUNITY PROGRAMS, MEALS ON WHEELS OF SOUTH FL, CLINICA LUZ DEL MUNDO (LIGHT OF THE WORLD CLINIC), LIVING WATERS CLINIC, AMERICAN CANCER SOCIETY, WOMEN IN DISTRESS, JACK AND JILL CHILDREN'S CENTER, CHRISTINE E. LYNN COLLEGE OF NURSING FL ATLANTIC UNIVERSITY, HEALTHY FAMILIES BROWARD, SICKLE CELL DISEASE ASSOCIATION OF BROWARD COUNTY, HEALING ARTS INSTITUTE OF SOUTH FL, SOUTH FL INSTITUTE ON AGING, BOYS TOWN SOUTH FL, BROWARD COUNTY PUBLIC SCHOOLS FAMILY MATTERS THERAPEUTIC SERVICES, BROWARD SHERIFF'S OFFICE POMPANO BEACH, FIRST UNITED METHODIST CHURCH, WOMEN IMPACTING NEIGHBORHOODS, INC., AND SECOND CHANCE SOCIETY. TOGETHER, THIS DIVERSE GROUP OF INDIVIDUALS REPRESENTED NUMEROUS POPULATIONS THAT LIVE, PLAY, AND WORK IN THE BROWARD COMMUNITY.ADDITIONALLY, MANY COMMUNITY-BASED ORGANIZATIONS, INDIVIDUALS, AND KEY INFORMANTS WHO REPRESENT AND/OR PROVIDE DIRECT SERVICES TO THOSE WHO ARE MARGINALIZED ALSO PROVIDED COMMUNITY INPUT INTO THE CHNA PROCESS. THEY REPRESENTED: HOMELESS FAMILIES, INDIVIDUALS, AND VETERANS; FAMILIES AND INDIVIDUALS WHO ARE FOOD INSECURE; WOMEN AND FAMILIES AT HIGH RISK OF LOW BIRTHWEIGHT INFANTS AND ABUSE; FAMILIES WHO LIVE BELOW THE FEDERAL POVERTY LEVEL; AT-RISK TEENS; PHYSICALLY, EMOTIONALLY, AND/OR MENTALLY ABUSED INDIVIDUALS; SUBSTANCE USERS AND ABUSERS; UNDOCUMENTED INDIVIDUALS; AND INDIVIDUALS WITH BEHAVIORAL/MENTAL HEALTH DISORDERS. FEEDBACK WAS RECEIVED FROM: 42 COMMUNITY CONVERSATION PARTICIPANTS; FIVE COMMUNITY FOCUS GROUPS CONDUCTED IN ENGLISH, CREOLE, AND SPANISH WITH 57 PARTICIPANTS; EIGHT KEY-INFORMANT INTERVIEWS; FOUR PROVIDER FOCUS GROUPS WITH 53 PARTICIPANTS IN MULTIPLE SPECIALTY AREAS, INCLUDING MATERNAL CHILD HEALTH, SPECIAL NEEDS, SUBSTANCE ABUSE/MENTAL HEALTH, LGBTQ & TRANSGENDER YOUTH, AND LOW-INCOME INDIVIDUALS AND FAMILIES, AND 400 SURVEYS STRATIFIED ACROSS THE COUNTY CONDUCTED BY BROWARD REGIONAL HEALTH PLANNING COUNCIL COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY.

HOLY CROSS HOSPITAL, INC.
PART V, SECTION B, LINE 11: HOLY CROSS HOSPITAL IS A COMMITTED COMMUNITY PARTNER, WORKING WITH NUMEROUS PUBLIC AND COMMUNITY AGENCIES IN ITS EFFORTS TO IMPROVE THE COMMUNITY HEALTH AND WELL-BEING OF BROWARD COUNTY RESIDENTS. STRATEGY FOCUSES ON SPECIFIC POPULATIONS AND GEOGRAPHIES MOST IMPACTED BY THE NEEDS BEING ADDRESSED. RACIAL EQUITY PRINCIPLES WERE USED THROUGHOUT THE DEVELOPMENT OF THIS PLAN AND WILL CONTINUE TO BE USED DURING THE IMPLEMENTATION. THE STRATEGIES IMPLEMENTED WILL MOSTLY FOCUS ON POLICY, SYSTEMS AND ENVIRONMENTAL CHANGE AS THESE SYSTEMS CHANGES ARE NEEDED TO DISMANTLE RACISM AND PROMOTE HEALTH AND WELLBEING FOR ALL MEMBERS OF THE COMMUNITIES WE SERVE. SIGNIFICANT COMMUNITY COLLABORATIONS INCLUDE: - YMCA OF BROWARD COUNTY, HOLY CROSS MEDICAL GROUP, DEPARTMENT OF HEALTH, VOLUNTEER CLINICS, VACCINES FOR CHILDREN & FL SHOTS, EQUALITY FL, SUNSERVE, OUR FUND, COMMUNITY FOUNDATION OF BROWARD / HEALTHCARE ACCESS AND QUALITY- SOUTH FLORIDA HUNGER COALITION, LIFENET 4 FAMILIES & FEEDING SOUTH FL, 33311 COMMUNITY COALITION MEMBERS AND NEIGHBORHOOD ASSOCIATIONS / FOOD ENVIRONMENT - FL DEPARTMENT OF HEALTH, MADE IN BROWARD, FAMILY HEALTH CENTER, HOLY CROSS MEDICAL GROUP - DIABETES/OBESITY HOLY CROSS HOSPITAL'S IMPLEMENTATION STRATEGY IS DESIGNED TO ADDRESS THE PRIORITY AREAS IDENTIFIED IN THE CHNA. FOLLOWING ARE THE PRIORITIES ASSIGNED TO THE COMPONENTS OF THE IMPLEMENTATION STRATEGY:1. HEALTHCARE ACCESS AND QUALITY2. FOOD ENVIRONMENT3. DIABETES/OBESITYTHE FOLLOWING ARE PROGRAM EXAMPLES OF HOW WE ARE ADDRESSING EACH NEED:HEALTHCARE ACCESS AND QUALITY - IN FISCAL YEAR 2022, HOLY CROSS HEALTH PROVIDED COVID-19 OUTREACH EDUCATION AND REFERRAL SERVICE TO 45,056 INDIVIDUALS. WITH SPECIAL EMPHASIS PLACED ON OUTREACHING TO HESITANT POPULATIONS, ESPECIALLY BIPOC (BLACK INDIGENOUS PEOPLE OF COLOR) AND HISPANICS, 9,323 DOSES OF THE COVID-19 VACCINE WERE ADMINISTERED TO HCH AND HCMG PATIENTS, COLLEAGUES, AND COMMUNITY MEMBERS. IN AN EFFORT TO 'CATCH UP' ON MISSED CHILDHOOD IMMUNIZATIONS, COMMUNITY HEALTH AND WELL-BEING (CHWB) CLINICAL STAFF MADE GREAT EFFORTS TO PROVIDE VACCINES AT COMMUNITY-BASED BACK TO SCHOOL FAIRS, RESULTING IN 240 INFANTS, TODDLERS, AND SCHOOL AGE YOUTH RECEIVING THEIR CHILDHOOD VACCINES. HOLY CROSS HOSPITAL'S CHWB DEPARTMENT IS ADDRESSING THIS OUTSTANDING COMMUNITY NEED BY OPENING A PRIMARY CARE NURSE-LED CLINIC IN THE SISTRUNK, ZIP CODE 33311, NEIGHBORHOOD BY MARCH 2023. THIS WILL PROVIDE EASY ACCESS TO HEALTHCARE AND HEALTHCARE INSURANCE ELIGIBILITY SERVICES TO RESIDENTS IN THE SISTRUNK NEIGHBORHOOD. A MAJOR RENOVATION OF THE HOLY CROSS FAMILY HEALTH CENTER WILL PROVIDE PRIMARY CARE AND SOCIAL SUPPORT SERVICES THEREBY INCREASING THE NUMBER OF PRIMARY CARE PHYSICIANS AND HEALTHCARE PROVIDERS PRACTICING IN THE ZIP CODE 33334 NEIGHBORHOOD. EFFORTS TO MAINTAIN COMPLETION OF CULTURAL COMPETENCY/HUMILITY TRAINING IN 2023 AMONG HEALTHCARE STAFF, ESPECIALLY THOSE WORKING WITH LOW LITERACY AND BLACK AND CARIBBEAN POPULATIONS AND LGBTQ+ WILL BE PARAMOUNT AND A MAJOR EFFORT.FOOD ENVIRONMENT - FOOD INSECURITY, A MAJOR ISSUE IN BROWARD COUNTY, IS ADDRESSED BY THE CHWB TEAM BY PROVIDING ACCESS TO MEALS AND PARTICIPATION IN THE SUMMER BREAK SPOT PROGRAM. THIS YEAR, 9,407 INDIVIDUALS WERE PROVIDED WITH NON-PERISHABLE FOOD PACKAGES AND 312 CHILDREN WERE PROVIDED WITH A PORTION-CONTROLLED, NUTRITIOUS LUNCH AND SNACK.THROUGH THE TRANSFORMING COMMUNITY INITIATIVE, A PARTNERSHIP WITH HOLY CROSS AND THE SOUTH FLORIDA HUNGER COALITION WILL WORK WITH THE COMMUNITY OVER THE NEXT 5 YEARS TO ENVISION AND EXECUTE A COMMUNITY SOLUTION TO FOOD INSECURITY WITHIN THE SISTRUNK NEIGHBORHOOD. IMPLEMENTATION OF COMMUNITY MEETINGS WITH KEY STAKEHOLDERS INCLUDING COMMUNITY MEMBERS, VOLUNTEERS, TRADITIONAL/RELIGIOUS/POLITICAL LEADERS, PARTNERS, AND SERVICE PROVIDERS TO IDENTIFY KEY AREAS OF IMPACT AND IN COLLABORATION WITH LOCAL COMMUNITY PARTNERS AND RESIDENTS, DEVELOP POLICY/ENVIRONMENTAL CHANGE TO ADVANCE FOOD INSECURITY.DIABETES/OBESITY - DIABETES/OBESITY IS A KEY FOCAL POINT FOR PROGRAMMING AND THIS YEAR, THE CHWB TEAM PROVIDED 520 DIABETES PREVENTION CLASSES TO 256 INDIVIDUALS. DUE TO ON-GOING COVID-19 PRECAUTIONS AND INDIVIDUAL CONVENIENCE, THESE CLASSES WERE PROVIDED IN-PERSON, VIRTUALLY, AND VIA DISTANCE LEARNING. IN ADDITION, THE DIABETES SELF-MANAGEMENT EDUCATION PROGRAM PROVIDED 370 INDIVIDUAL APPOINTMENTS, 105 UNDUPLICATED INDIVIDUALS ATTENDED GROUP CLASSES, AND 287 DUPLICATED INDIVIDUALS ATTENDED GROUP CLASSES FOR DIABETIC PATIENTS.IN A CONCERTED EFFORT TO CURB THE ON-GOING AND GROWING DILEMMA OF DIABETES AND OBESITY WITHIN THE SISTRUNK COMMUNITY, HOLY CROSS WILL HIRE A DIABETES COMMUNITY HEALTH WORKER THAT WILL BE EMBEDDED IN THE PRIMARY CARE AT THE SISTRUNK LOCATION IN EARLY 2023 TO PROVIDE INDIVIDUAL EDUCATION SESSIONS, LIFESTYLE CHANGE CLASSES, AND SOCIAL CARE SCREENINGS/LINKAGES TO AT-RISK INDIVIDUALS. IN ADDITION, A PEDIATRIC LIFESTYLE CHANGE PROGRAM WILL BE PILOTED WITH PARTICIPANTS FOCUSING ON CHILDREN PREDISPOSED FOR DIABETES AS WELL AS THEIR FAMILY UNITS. FINALLY, A CULINARY MEDICINE PROGRAM WILL BE INCEPTED AT THE FAMILY HEALTH CENTER BY END OF 2023 TO PROVIDE A CURRICULUM FOCUSED ON THE PREVENTION AND MANAGEMENT OF DIABETES AND BEHAVIOR CHANGE.SOCIAL INFLUENCERS OF HEALTH - IN FISCAL YEAR 2022, CHWB HEALTH SERVICES AND EDUCATION WERE PROVIDED TO AUGMENT COMMUNITY AGENCIES WHO TARGET INDIVIDUALS AND FAMILIES EXPERIENCING LIMITED INCOME, CONSTRAINED EARNINGS, EVICTIONS, JOB LOSS, AND SINGLE-HEADED HOUSEHOLDS CONTRIBUTING TO ECONOMIC HARDSHIP. CHWB CONTINUED (VIRTUAL AND LIMITED IN-PERSON) COMMITTEE PARTICIPATION ON BROWARD'S HOMELESS COALITION, SOUTH FLORIDA HUNGER COALITION, SUMMER BREAKSPOT, AND MOBILE FOOD PANTRY. ADDITIONALLY, DIRECT SERVICES WERE PROVIDED IN FISCAL YEAR 2022 TO THE HOMELESS POPULATION IN PARTNERSHIP WITH LOCAL SOCIAL SERVICE AGENCIES AND VOLUNTEER CLINICS. THE HOSPITAL ALSO CONTINUED TO PROVIDE A JUST WAGE FOR ITS ASSOCIATES.HOLY CROSS HEALTH 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 ARE THE MOST PRESSING, UNDER- ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. HOLY CROSS HEALTH IS PARTNERED WITH LOCAL COMMUNITY RESOURCES THAT PROVIDE SPECIALIZED SERVICES AND ENSURES THAT PATIENTS RECEIVE THE CARE AND TREATMENT THEY NEED. HOLY CROSS HEALTH DID NOT DIRECTLY ADDRESS THE FOLLOWING HEALTH AND SOCIAL NEEDS IN FISCAL YEAR 2022: BEHAVIORAL HEALTH, HEART DISEASE AND STROKE, CANCER, MATERNAL AND INFANT HEALTH, ALZHEIMER'S DISEASE, HIV/AIDS, SICKLE CELL, ECONOMIC STABILITY, HOUSING/HOMELESSNESS, AND SAFETY AND CRIME.

HOLY CROSS HOSPITAL, INC.
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.

HOLY CROSS HOSPITAL, INC. - PART V, SECTION B, LINE 7A:
WWW.HOLY-CROSS.COM/COMMUNITY-NEEDS-ASSESSMENT

HOLY CROSS HOSPITAL, INC. - 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.

HOLY CROSS HOSPITAL, INC. - PART V, SECTION B, LINE 10A:
WWW.HOLY-CROSS.COM/COMMUNITY-NEEDS-ASSESSMENT

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:
HOLY CROSS HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF FLORIDA. IN ADDITION, HOLY CROSS 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, HOLY CROSS 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, $24,588,143, 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:
HOLY CROSS 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, HOLY CROSS HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, HOLY CROSS 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:
"HOLY CROSS 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:
HOLY CROSS 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 - MEMBERS OF THE HOSPITAL'S LEADERSHIP ROUTINELY PARTICIPATE ON NUMEROUS COMMUNITY COMMITTEES THAT PROVIDE ONGOING INFORMATION, INPUT, AND INSIGHT INTO THE COMMUNITY'S HEALTH CARE NEEDS. AWARENESS OF OUR COMMUNITY NEEDS IS ALSO MONITORED BY REGULARLY SCANNING THE ENVIRONMENT, REVIEWING COMMUNITY REPORT CARDS AND INFORMATION PROVIDED BY OTHER INSTITUTIONS, MONITORING VITAL STATISTICS, LOCAL MORBIDITY AND MORTALITY RATES, COUNTY HEALTH RANKINGS, AND PEOPLE-CENTERED 2030 GOALS, AND BY CONTINUING RELATIONSHIPS WITH THE LOCAL HEALTH DEPARTMENT AND OTHER HEALTH CARE PROVIDERS AND HEALTH PLANNERS.

PART VI, LINE 5:
"OTHER INFORMATION - HOLY CROSS HOSPITAL IS DEVOTED TO IMPROVING THE HEALTH OUTCOMES OF THE POOR, DISENFRANCHISED, HOMELESS, MARGINALIZED, AND NEEDY WHO LIVE IN OUR BACKYARDS, NEIGHBORHOODS, AND COMMUNITY. THE FOLLOWING PROGRAMS ARE EXAMPLES OF ACTIONS THE HOSPITAL IS TAKING, INCLUDING THE NUMERICAL PRIORITY FROM THE CHNA IMPLEMENTATION STRATEGY. AS THE COVID-19 EPIDEMIC CONTINUED IN FISCAL YEAR 2022, COMMUNITY-BASED PROGRAMMING MODIFICATIONS WERE NECESSARY AND THE HOSPITAL PIVOTED TO ADDRESS COVID-19 RELATED CONCERNS, AND ALL IN-PERSON SERVICES CONTINUED TO BE GREATLY REDUCED.SCHOOL HEALTH PROGRAM -GOALS: IMPROVE HEALTH TO PROMOTE STUDENT HEALTH AND LEARNING.CHNA IMPLEMENTATION PLAN:- #1/#2 COMMUNITY EDUCATION AND PREVENTATIVE CARE: PROVIDE STUDENT EDUCATION ON HEALTH AND WELLNESS TO INCREASE PREVENTATIVE UTILIZATION OF HEALTH CARE SYSTEMS- #3 ACCESS TO CARE: PROVIDE ACCESS TO IMMUNIZATIONS AND SCHOOL-BASED HEALTH SERVICESOUTCOMES AND MEASUREMENT:647 STUDENTS AND EDUCATORS WERE PROVIDED WITH:- VISION, HEARING, AND SCOLIOSIS SCREENING- 7TH GRADE VACCINATIONS, REPRESENTING APPROXIMATELY 10% OF INCOMING 7TH GRADE STUDENTS - COVID-19 ON-SITE IMMUNIZATIONS, EDUCATION, PPE, AND GUIDELINES- BACK TO SCHOOL HEALTH FAIRS AND IMMUNIZATIONS- BLOODBORNE PATHOGEN AND CPR CLASSESGROWING HEALTHY KIDS PROGRAM -GOALS: BUILD KNOWLEDGE, SKILLS, AND POSITIVE ATTITUDES REGARDING HEALTH. CHNA IMPLEMENTATION PLAN:- #1 COMMUNITY EDUCATION: PROVIDE EDUCATION FOR HEALTHY LIFESTYLE CHOICES AND IMPORTANCE OF NUTRITION AND PHYSICAL ACTIVITY TO YOUTH IN PUBLIC, PAROCHIAL AND VIRTUAL SCHOOL SYSTEMS- #2 PREVENTATIVE CARE: DIRECT LINK BETWEEN PHYSICAL ACTIVITY AND DECREASE IN MENTAL HEALTH DISORDERS, PROVIDING YOUTH AN OPPORTUNITY TO PARTICIPATE IN POSITIVE ACTIVITIESOUTCOMES AND MEASUREMENT:-10,747 STUDENTS, TEACHERS AND INDIVIDUALS ATTENDED VIRTUAL CLASSES VIA ZOOM AND CANVAS. VIRTUAL CLASSES INCLUDED: YOGA, BALANCE, PHYSICAL FITNESS, MELT METHOD, HEALTH AND WELLNESS, AND HEALTHY COOKING.PARISH NURSE PROGRAM -GOALS: MAINTAIN INDEPENDENCE AND OPTIMAL PHYSICAL, MENTAL AND EMOTIONAL HEALTH.CHNA IMPLEMENTATION PLAN:- #2 PREVENTATIVE CARE: TRANSPORTATION PROGRAM FACILITATES SOCIAL INTERACTION BETWEEN SENIORS BY PROVIDING TRANSPORTATION TO MEDICAL APPOINTMENTS AND SOCIAL ACTIVITIES- #3 ACCESS TO CARE: PROVIDE VULNERABLE POPULATIONS WITH ACCESS TO HEALTH CARE AND TIMELY MANAGEMENT OF CHRONIC DISEASES, TO DECREASE EMERGENCY DEPARTMENT UTILIZATION AND THE LIKELIHOOD OF THE DISEASES PROGRESSING INTO A HEALTH CRISIS- #4 SOCIAL INFLUENCERS OF HEALTH: PROVIDE HEALTH CARE SERVICES, ACCESS TO NUTRITIOUS MEALS, AND TRANSPORTATION TO VULNERABLE POPULATIONS IN BROWARD COUNTYOUTCOMES AND MEASUREMENT:11,577 PERSONS AND/OR FAMILIES RECEIVED:- HEALTH ASSESSMENT, EDUCATION, AND MONITORING OF CHRONIC DISEASES LIKE HYPERTENSION, DIABETES, AND CONGESTIVE HEART FAILURE- HEALTH SERVICES SPECIFIC FOR INDIVIDUALS IDENTIFIED AND REFERRED FOR ""HUMAN TRAFFICKING"" - FOOD THROUGH LOCAL HOSPITAL-BASED DISTRIBUTIONCHRONIC DISEASE MANAGEMENT - GOALS: IMPROVE HEALTH AND WELLNESS IN PATIENTS WITH CHRONIC DISEASES.CHNA IMPLEMENTATION PLAN: - #2 PREVENTATIVE CARE: PROVIDE STUDENT EDUCATION ON HEALTH AND WELLNESS TO INCREASE UTILIZATION OF PREVENTATIVE CARE- #3 ACCESS TO CARE: PROVIDE ACCESS TO CHRONIC DISEASE MANAGEMENTOUTCOMES AND MEASUREMENT:- 825 DIABETIC CLIENTS PROVIDED WITH HEALTH COACHING, NUTRITION ASSESSMENTS AND DISCUSSIONS, AND DISEASE SELF-MANAGEMENT CLASSES- 7,049 INDIVIDUALS WERE PROVIDED WITH NATIONAL DIABETES PREVENTION PROGRAMMING THROUGH IN-PERSON, VIRTUAL AND DISTANCE GROUPS IN PARTNERSHIP WITH THE BROWARD COUNTY PUBLIC SCHOOLS, BROWARD COLLEGE, SOUTH FLORIDA INSTITUTE ON AGING, MEMORIAL HEALTHCARE SYSTEM, HOLY CROSS MEDICAL GROUP PHYSICIANS, AND THE COMMUNITY AT-LARGE- 13 NEW COACHES TRAINEDCOMMUNITY HEALTH WORKER - CARE COORDINATION PROGRAM -GOALS: IMPROVE HEALTH AND WELLNESS IN ATTRIBUTED PATIENTS WITH CHRONIC DISEASES.CHNA IMPLEMENTATION PLAN: - #2 PREVENTATIVE CARE: PROVIDE HEALTH AND WELLNESS EDUCATION TO INCREASE UTILIZATION OF PREVENTATIVE CARE- #3/#4 ACCESS TO CARE AND SOCIAL INFLUENCERS OF HEALTH: PROVIDE ACCESS TO CARE COORDINATION FOR CHRONIC DISEASE MANAGEMENTOUTCOMES AND MEASUREMENT:8,087 INDIVIDUALS RECEIVED:- COMMUNITY HEALTH WORKER SERVICES LINKING THEM WITH COMMUNITY-BASED ORGANIZATIONS AND SERVICES NEEDEDTHE PROGRAM WORKS CLOSELY WITH, AND REFERRALS ARE RECEIVED BY THE ADVANCED PRACTICE MANAGEMENT/POPULATION HEALTH TEAM. CLIENT PATHWAYS HAVE INCLUDED: FOOD SECURITY AND EMERGENCY MEALS, TRANSPORTATION, PRIMARY AND SPECIALTY CARE, VA BENEFITS, SOCIAL SECURITY DISABILITY BENEFITS, MENTAL HEALTH, MEDICAL EQUIPMENT, EMERGENCY RESPONSE SYSTEMS, SUBSTANCE USE TREATMENT, NURSING FACILITY PLACEMENT, HOUSING, HOME HEALTH CARE, AND DENTAL SERVICES.PARTNERS IN BREAST HEALTH (PIBH) PROGRAM -GOALS: DECREASE LATE-STAGE BREAST CANCER DIAGNOSIS IN THE HOPE OF SAVING LIVES.CHNA IMPLEMENTATION PLAN: - #1 COMMUNITY EDUCATION: COMMUNITY EDUCATION IS PROVIDED AT HEALTH FAIRS AND CHURCH EVENTS, AND VULNERABLE POPULATIONS ARE EDUCATED ON THE IMPORTANCE OF ANNUAL SCREENING AND EARLY DETECTION- #3 ACCESS TO CARE: PROVIDE FREE BREAST IMAGING SERVICES TO VULNERABLE POPULATIONS (LOW INCOME, UNDOCUMENTED IMMIGRATION STATUS, AND THOSE WHO ARE INELIGIBLE FOR HEALTH CARE SERVICES THROUGH OTHER PROGRAMS)OUTCOMES AND MEASUREMENT:3,200 INDIVIDUALS RECEIVED: - LOWER-INCOME, UNINSURED INDIVIDUALS RECEIVED CLINICAL BREAST SERVICES FROM A NURSE PRACTITIONER AND LINKAGE TO SCREENING SERVICES- CLINICAL BREAST EXAMS, SCREENING AND/OR DIAGNOSTIC MAMMOGRAPHY, BREAST ULTRASOUND, BREAST MRI AND BREAST BIOPSY SERVICES WERE PROVIDED TO UNINSURED LOWER-INCOME CLIENTS - TRANSPORTATION TO/FROM APPOINTMENTS- 20 CLIENTS WERE DIAGNOSED WITH BREAST CANCER- SUPPORT GROUP EDUCATION AND SERVICES- 100% NEWLY DIAGNOSED BREAST CANCER PATIENTS WERE LINKED INTO THE SERVICE CONTINUUMHEALTHY VENDING - GOALS: IMPROVE THE FOOD AND BEVERAGE ENVIRONMENT BY IMPLEMENTING ""HEALTHY VENDING,"" A PROVEN OBESITY-PREVENTION STRATEGY.CHNA IMPLEMENTATION PLAN: - #2 PREVENTIVE CARE: TRINITY HEALTH'S PEOPLE-CENTERED 2021 STRATEGIC PLAN PRIORITIZES OBESITY PREVENTION, WHICH HAS BECOME A NATIONAL EPIDEMICOUTCOMES AND MEASUREMENT:- 100% OF ITEMS SOLD IN VENDING ENVIRONMENTS MEET THE ""HEALTHIER STOCKING STANDARD""TOBACCO 21 AND SMOKE FREE CAMPUS - GOALS: REDUCE TOBACCO USE.CHNA IMPLEMENTATION PLAN: - #1/#2 COMMUNITY EDUCATION AND PREVENTIVE CARE: SUPPORT ""TOBACCO 21 AND STRONG CLEAN INDOOR AIR LAWS THAT ARE INCLUSIVE OF E-CIGARETTESOUTCOMES AND MEASUREMENT:- EXECUTIVE COMMITTEE MEMBER OF BROWARD COUNTY'S TOBACCO FREE PARTNERSHIP- TOBACCO 21 ADVOCACY AT THE STATE LEGISLATURE- USE OF SOCIAL MEDIA CAMPAIGNS, PRESS RELEASES, AND EDUCATIONAL FORUMS TO PROMOTE TOBACCO 21, SMOKE-FREE MOVIES, TOBACCO-FREE BEACHES, TAKE BACK THE SHELVES, CLEAN INDOOR ACTCOVID-19 EMERGENCY PREPAREDNESS EFFORTS -GOALS: RESPOND TO THE COMMUNITY'S NEED FOR COVID-19 TESTING AND HEALTH CARE.CHNA IMPLEMENTATION PLAN:- PRIORITY #1/2 COMMUNITY EDUCATION AND PREVENTION: PROVIDE HEALTH EDUCATION TO THE COMMUNITY REGARDING PREVENTION, PROTECTION, AND SPREAD, TO DECREASE INCIDENCE- #3 ACCESS TO CARE: PROVIDE ACCESS TO TESTING AND TREATMENT SERVICES TO VULNERABLE POPULATIONS (LOW INCOME, UNDOCUMENTED IMMIGRANTS, AND THOSE WHO ARE INELIGIBLE FOR HEALTH CARE SERVICES THROUGH OTHER PROGRAMS)- #4 SOCIAL INFLUENCERS OF HEALTH: PROVIDE HEALTH CARE SUPPORT SERVICES, FOLLOW-UP CARE, AND SOCIAL CARE TO VULNERABLE AND INFECTED POPULATIONS IN BROWARD COUNTY OUTCOMES AND MEASUREMENT:45,056 INDIVIDUALS RECEIVED:- COVID-19 [HESITANCY] OUTREACH EDUCATION AND REFERRAL SERVICES- COVID-19 PRIMARY AND BOOSTER VACCINESTRANSFORMING COMMUNITY INITIATIVE (TCI) -GOALS: RESPOND TO THE COMMUNITY'S NEED FOR COVID-19 TESTING AND HEALTH CARE.CHNA IMPLEMENTATION PLAN:- PRIORITY #7 SOCIAL INFLUENCERS OF HEALTH: PROVIDE HEALTH CARE SUPPORT SERVICES, FOLLOW-UP CARE, AND SOCIAL CARE TO VULNERABLE AND INFECTED POPULATIONS IN BROWARD COUNTY OUTCOMES AND MEASUREMENT- COMMUNITY HEALTH AND WELL-BEING WAS AWARDED A PLANNING GRANT FOR THEIR INITIATIVE. A PARTNERSHIP WAS ESTABLISHED, AND A LEAD COMMUNITY ORGANIZATION IDENTIFIED - THE SOUTH FLORIDA HUNGER COALITION. THE PROJECT WILL FOCUS ON FOOD SECURITY SPECIFICALLY IN THE 33311 ZIP-CODE AREA WITH A HYPER-FOCUS ON THE SISTRUNK NEIGHBORHOOD. ADDITIONAL COMMUNITY AGENCIES THAT WILL COLLABORATE ON THIS INITIATIVE INCLUDE, BUT ARE NOT LIMITED TO: L.A. LEE MIZELL CENTER, THE AFRICAN AMERICAN RESEARCH LIBRARY, SMITTY'S RESTAURANT, 4-H CLUB, JACK AND JILL EARLY LEARNING CENTER, AND HEALTHY START. INITIAL DISCUSSIONS AND PLANS FOR THE 3-YEAR COMMUNITY-BASED PROJECT HAVE BEEN INITIATED."

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PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - HOLY CROSS 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. HOLY CROSS 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. HOLY CROSS HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. HOLY CROSS 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.

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COMMUNITY INFORMATION - BROWARD COUNTY IS THE SECOND LARGEST COUNTY IN THE STATE AND RANKS HIGH IN DIVERSITY. ABOUT 35% OF THE POPULATION IS 65 AND OVER AND THIS PERCENTAGE CONTINUES TO GROW. THE OLD AGE DEPENDENCY RATIO, WHICH IS THE RATIO OF OLDER DEPENDENTS (65+) TO THE WORKING POPULATION (15-64), IS 31.3%.ABOUT 37% OF HOUSEHOLDS ARE WALKING A FINANCIAL TIGHTROPE - THEY ARE UNABLE TO KEEP AND GROW THEIR FINANCIAL ASSETS AND ARE ONE EMERGENCY FROM FALLING INTO CRISIS. THE INCREASED DEMAND FOR AFFORDABLE RENTAL HOUSING FOR WORKING POOR FAMILIES AND THE HOMELESS IS PARAMOUNT IN THE COMMUNITY. BROWARD COUNTY HAS ALSO BEEN SIGNIFICANTLY IMPACTED BY UNEMPLOYMENT (4.5% IN 2001 VS. 8.7% 2018), REFLECTING THE ECONOMIC CRISIS. NEARLY 15% OF BROWARD RESIDENTS LIVE IN POVERTY. OF THE FAMILIES WITH CHILDREN UNDER THE AGE OF 18, 15.6% WERE REPORTED AT OR BELOW THE FEDERAL POVERTY LEVEL. ABOUT 43% OF CHILDREN IN BROWARD COUNTY FALL BELOW 200% OF THE FEDERAL POVERTY LEVEL. 26% OF ADULTS 18-64 YEARS OF AGE ARE UNINSURED, 14% OF WHOM ARE UNDER AGE 19. THERE HAS BEEN A STEADY INCREASE IN THE NUMBER OF INDIVIDUALS AND FAMILIES RECEIVING PUBLIC ASSISTANCE (MEDICAID AND FOOD STAMPS). THE UNINSURED RATE HAS BEEN INCREASING OVER TIME FOR BROWARD COUNTY, AND IT IS ESTIMATED THAT 24% OF NON-INSTITUTIONALIZED CIVILIAN RESIDENTS ARE UNINSURED.THE HOLY CROSS STRATEGIC PLANNING AREA IS DEFINED GEOGRAPHICALLY BY WHERE 90% OF HOSPITAL DISCHARGES ARE REPRESENTED. THE AREA ENCOMPASSES A TOTAL OF 36 ZIP CODES THAT ARE GROUPED AS FOLLOWS: PRIMARY SERVICE AREA (13 ZIP CODES), SECONDARY SERVICE AREA (16 ZIP CODES), AND STRATEGIC PLANNING AREA (7 ZIP CODES).

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HOLY CROSS 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.