4A (Expenses $ 69803963 including grants of $ 575783) (Revenue $ 85594083)
Baptist Medical Center of Nassau, Inc. (BMCN) is a highly advanced, extremely well-equipped community hospital located on Amelia Island, serving Nassau County and its surrounding area. The hospital provides a full spectrum of inpatient and outpatient services and 24-hour emergency care. The medical staff includes highly trained physicians in 26 different specialties along with a 24/7 hospitalist program. BMCN is an accredited chest pain center, acute stroke readiness hospital and has earned ANCC magnet recognition for excellence in patient care and named top general hospital by the LeapFrog Group with safety grade A. Baptist Nassau offers many advanced services and technologies not typically seen in a community hospital including a 30,000 square foot surgery/procedural center, advanced imaging (64-channel CT and MRI), breast health program with digital 3D mammography, 24/7 intensivist coverage ICU through telemedicine, non-invasive cardiology and cardiac rehabilitation center . Inpatients are cared for in ultra-modernized building, which offers 48 private patient suites. BMCN was one of the first community hospitals in the nation to convert to an electronic medical record system. Baptist Medical Center of Nassau is fully integrated within a five hospital system of Baptist Health System, Inc. (BHS). Inpatient pediatric care is provided by Wolfson Children's Hospital in Jacksonville. During the fiscal year, there were 417 employees, 62 beds, 3,145 admissions accounting for 10,894 patient days, and 22,088 emergency room visits. As part of BHS, the region's only community-owned, faith-based healthcare system, BMCN is committed to improving the health of everyone in its community, regardless of their ability to pay. BMCN provided the following uncompensated care and community benefit for the fiscal year ended September 30, 2022: (1) charity care, $1.9 million, (2) unreimbursed Medicaid costs, $1.5 million, (3) unreimbursed Medicare costs, $13.9 million, and (4) specific community programs, $763 thousand, for a total of $18.1 million of uncompensated care and community benefit. BMCN's primary focus is addressing unmet health needs, particularly among vulnerable populations who have limited resources and access to health care. BMCN has gone beyond the delivery of essential health care to improve the lives of individuals and the overall quality of life in our region. Baptist health's community health committee guides the community health efforts. This committee provides strategic direction related to community health activities and ensures focus on key priorities that align with Baptist health's mission. A cornerstone of our commitment to the community is caring for the health of vulnerable, uninsured and underserved people among us. One of BMCN's guiding principles of community health is to collaborate with other local organizations to leverage our collective expertise and strength for the health benefits of the community. This collaborative approach helps ensure efficiency and avoids duplication of effort, resulting in enhancement of the lives of area residents at every life stage and income level. BMCN community health needs assessment includes: (1) access to care (2) maternal and behavioral health (3) poverty (4) chronic disease (5) maternal and child health (6) transportation, (7) housing, (8) cancer and (9) social determinants of health.

Schedule H, Part V, Section B, Line 3E
The significant health needs of the community are identified on our CHNA. The methodology to determine the significance of the community health needs and prioritization of the health needs are also described in our CHNA.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - Baptist Medical Center of Nassau, Inc.. The Community Health Needs Assessment was conducted to identify priority health needs within each community served by each hospital and to inform development of implementation strategies to address the identified needs selected by each hospital based on their ability to impact them. Additionally, the Partnership focuses collaborative efforts to include the five-county service area of Baker, Clay, Duval, Nassau, and St. Johns. The CHNAs were conducted to respond to federal regulatory requirements and sought to identify significant health needs for geographic areas and populations by focusing on the following questions: * Who in the community is most vulnerable in terms of health status or access to care? * What are the unique health status and/or access needs for these populations? * Where do these people live in the community? * Why are these problems present? * How are disparities based on racial and ethnic inequities affecting health? * What social determinants of health can the health systems significantly address? Primary Data: Significant changes from traditional methods of community engagement to virtual engagement platforms were necessary due to the nature of the COVID-19 pandemic. Primary data gathered from various segments of the community with special knowledge and expertise in public health included residents, stakeholder organizations, and hospital staff. The Health Planning Council collected data through (1) virtual key stakeholder interviews, (2) virtual focus groups, and (3) a community survey, in English and Spanish, distributed throughout the service area through online and paper submissions. Over 350 community members contributed their input on the community's health and health-related needs, barriers, and opportunities for Baptist Medical Center Nassau, with special focus on healthy equity in population health and community wellness. The Partnership especially solicited input from members of or representatives of vulnerable and underserved populations through key informant interviews and focus group discussions. There were 13 key informant interviews, 4 focus groups, 33 focus group participants, 308 survey respondents, and a total of 354 participants. Key informant interviews were conducted with 13 community experts who either served or represented underserved communities (such as low-income individuals and groups experiencing disparities in health outcomes or health access). In addition, seven of the focus groups included community members and advocates who are members of underserved communities. Secondary Data: Secondary data used for this assessment were collected and analyzed through universal measures recommended by Healthy People 2030 to evaluate the health status of communities and populations served by the Partnership. Data was obtained from the Behavioral Risk Factor Surveillance System, County Health Rankings and Roadmaps, Florida CHARTS, Florida Department of Health, Local Community Health Assessments, Hospital Utilization Reports, U.S. Census, and the Youth Risk Behavior Surveillance System. Indicators were used to evaluate areas of health and quality of life in the following areas through an equity lens: * Accessing Healthcare Services/Resources * Adolescent Health * Asthma * Cancer * Children's Health * Hospitalization and Incidence Ranking * COVID-19 * Diabetes * Disabilities * Fatal Injury * Health Outcomes * Health Factors * Healthcare Utilization * Healthcare Access * Heart Disease and Stroke * Household Income * Infectious Disease * Leading Causes of Death * Life Expectancy * Maternal and Infant Health * Mental Health * Pediatric Health * Poverty Indicators * Substance Abuse * Veterans' Health Indicator values for Duval and St. Johns counties were compared to other Florida counties. Other considerations in weighing relative areas of need included comparisons to Florida state values and national values. Based on these comparisons in conjunction with primary data, health needs were identified and ranked from high to low need.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - Baptist Medical Center of Nassau, Inc.. 12 hospitals: (Baptist Medical Center Jacksonville, Baptist Medical Center South, Wolfson Children's Hospital, Baptist Medical Center of the Beaches, Inc., Ascension St. Vincent's Medical Center Clay, Ascension St. Vincent's Medical Center Riverside, Ascension St. Vincent's Medical Center Southside, Brooks Rehabilitation Hospital Bartram, Brooks Rehabilitation Hospital University, Mayo Clinic Jacksonville, UF Health Jacksonville and UF Health North)

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - Baptist Medical Center of Nassau, Inc.. Public release was held May 26, 2022 with all health system CEOs presenting the assessment methodology, the needs identified in the assessment, and the needs prioritized by each hospital. The public release was attended by approximately 50 people including media representatives. Newspaper articles and television stories reported on the assessment and informed community members where they could find each hospital's assessment and implementation plans. Link to story in the Florida Times-Union - https://www.jacksonville.com/story/news/healthcare/2022/05/30/jacksonville-area-hospitals-release-report-community-health-issues/9905670002/

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - Baptist Medical Center of Nassau, Inc.. Access to Care The significant health need of access refers to access issues across the spectrum of both health and quality of life topic areas, including access to health services, transportation, housing, and nutritious food. Access issues were compiled due to their inextricable nature in impacting health behaviors and health outcomes. During the last three-year CHNA cycle, Access to Care was a priority health need addressed by Baptist Medical Center Nassau. As access issues for Nassau residents continue to increase, the focus on this priority will continue into the 2022-2024 CHNA cycle. Key Issues Identified in the Assessment: * Factors contributing to chronic disease include food deserts, level of access to physical activity, and air quality. * Transportation is identified as a need - 91% of CHNA survey respondents from zip code 32034 indicated they do not have access to public transportation. * Nassau County 2018-2020 age-adjusted rates of chronic disease: - Asthma: The hospitalization rate was 2.95x higher for Black patients than White patients - Congestive heart failure: The hospitalization rate was 1.85x higher for Black patients than White patients - Diabetes: The hospitalization rate was 3.21x higher for Black patients than White patients - Stroke: The death rate was 2.03x higher for Black people than White people * Cancer is the second leading cause of death in the region behind heart disease. The three leading cancer death incidences are: breast cancer deaths (females), lung cancer deaths (females males), prostate cancer deaths (males) - Nassau County 2018-2020 age-adjusted death rates: Breast cancer: The death rate was 2.05x higher for Black females than White females Lung cancer: The death rate was 1.49x higher for Black people than White people

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - Baptist Medical Center of Nassau, Inc.. Access to Care: Goals: Increase access to health services for un- and under-insured people in the BMCN service area. Strategies: * Continue partnership with organizations to increase access to care. * Continue partnership with Starting Point to increase access to behavioral health treatment * Continue partnership with Nassau County Council on Aging to provide transportation to doctor's appointments and errands * Provide community partners with education on chronic diseases Metrics/What we are measuring: * Number of people served * Evaluate health and wellness of participants in diabetes, hypertension and mental health * Number of people engaging in treatment * Evaluation of health and wellbeing of patients Potential Partnering/External Organizations: * Barnabas Center * Nassau County Council on Aging * Faith Partners * Starting Point Results: * Year 1 (October 1, 2021 - September 30, 2022) * Barnabas Center served 607 un- and under-insured patients 81 diabetic patients were served, of which 73 were seen at least twice during the 12-month period, and of those, 68.5% reported reaching within normal levels (HbA1c less than 7% or 8%) 204 hypertensive patients were served, of which 180 were seen at least twice during the 12-month period, and of those, 75.6% measured less than 140/90 171 patients were seen at least one time with a previous or new diagnosis of mental health, of which 132 patients scored a 10 or greater on the PHQ9. 132 were referred for treatment, and 85 (64.4%) participated in treatment * Year 1 (October 1, 2021 - September 30, 2022) - 2,008 patients identified by the Baptist ED, 286 were screened or referred to our Integrated Care Team, resulting in a 14% referral rate. It should be noted that patients may have been admitted due to medical issues or COVID-19, which would not likely result in a referral. 100% of referrals had an identified care coordinator assigned to them and 28% (80) of those identified engaged in care coordination services 59% (47) of those receiving care coordination achieved stabilization through community care providers * Year 1 (October 1, 2021 - September 30, 2022) - 237 seniors and low-income individuals were provided transportation to medical appointments - 4,334 trips were provided - Nassau Council on Aging will be engaged in FY23 to ensure seniors are receiving transportation for flu shots. * Year 1 (October 1, 2021 - September 30, 2022) - Health education series Total attendance: 236 January: Dementia Cognition February: Heart Health March: Colorectal Cancer May: Stroke Awareness July: Diabetes August: Nutrition September: Mental Health - 96.3% agreed or strongly agreed that the webinars delivered the information they expected to receive - 92.5% agreed or strongly agreed that because of the webinar, they gained new knowledge that will help them with their well-being - 95.3% agreed or strongly agreed that they plan to apply what they learned

Schedule H, Part V, Section B, Line 11 Facility , 3
Facility , 3 - Baptist Medical Center of Nassau, Inc.. Mental and Behavioral Health : Mental health is an integral and essential component of health. It is a state of well-being in which individuals realize their abilities, cope with the everyday stresses of life, work productively, and contribute to their community. Baptist Health has made behavioral health services a priority, providing comprehensive inpatient and outpatient services to both children and adults. Mental Health was a priority health need addressed by Baptist Medical Center Nassau in the last three-year CHNA cycle, and the focus on this health need continues into this CHNA cycle as behavioral health needs of Jacksonville residents continue to increase. Key Issues Identified in the Assessment: * Mental Health was one of the most mentioned health concerns. * Priority issues identified involving mental health include lack of providers; cost; stigma; youth mental health; telehealth; suicide; LGBTQ mental health - The 2020 Nassau County age-adjusted rates per 100,000 persons for opioid overdose deaths were 27.2 and drug overdose deaths were 31.4, while the state's rates respectively were 29.9 and 36.0.

Schedule H, Part V, Section B, Line 11 Facility , 4
Facility , 4 - Baptist Medical Center of Nassau, Inc.. Mental and Behavioral Health Goal: 1. A healthy community with easy and timely access to high quality services when needed: 24-hour support and timely appointments (2 weeks - counseling, 4 weeks - psychiatry) More providers delivering the most advanced care Strong care continuum (enough of the right type of care) Seamless transitions along the care continuum Mental illness decriminalized Stigma eliminated and crises prevented Community advocating improvement Non-medical needs addressed (social determinants of health) 2. Decrease isolation of seniors Strategies: Continue offering evidence-based trainings proven to reduce stigma of mental illness and help people access care (MHFA, YMFA, teen MHFA, and/or QPR). Convene a leadership task force of providers, elected leaders and people with lived experience to prioritize identified opportunities and develop a plan for action Host community-wide conferences on mental health to reduce stigma and barriers to care. Beginning in 2022, participate in Project Save Lives to provide access to peer support for ED patients with mental health and substance use disorder for the purpose of getting them into treatment. Friendly callers - seniors developing phone friendships with seniors Metrics/What we are measuring: * Number of people trained in adult MHFA by 2024 * 1,000 students trained in teen MHFA, QPR and/or YMHFA * Evaluate participant satisfaction * Measure crisis calls (schools, EMT, police) * Evaluate the impact of each initiative according to its focus * Rate of behavioral health ED visits * Number of people attending the conference * Satisfaction surveys * Percentage of identified people who met with peer specialist * Percentage of people who enter treatment * Percentage of people who did or didn't consent to services and are readmitted into ED * Number of volunteers in program * Number of seniors in program * Number of phone calls * Total time invested in calls * Quality of phone calls (reported by volunteers Potential Partnering/External Organizations: * Florida's First Coast YMCA * National Council for Behavioral Health * Starting Point * Hope Street Inc. * Karyn Purvis Institute of Child Development at TCU * Community mental health providers * Faith organizations * Universities * Starting Point Behavioral Healthcare * Baptist Health Auxiliary * Nassau Council on Aging Results: Year 1 (October 1, 2021 - September 30, 2022) * 521 10th grade Nassau students completed Teenage MHFA * NEF: 50 Adult MHFA classes were offered in which 624 participants were trained - 83% of participants rated the course as helpful and informative * NEF: 13 Youth MHFA classes were offered in which 179 participants were trained Year 1 (October 1, 2021 - September 30, 2022) * Hope Healing JAX: Building a Trauma Responsive Jacksonville was created in partnership with Hope Street, Inc. and the Karyn Purvis Institute of Child Development at Texas Christian University as a Jacksonville city-wide initiative to: (1) foster awareness and culture change; (2) prevent and reduce ACEs and trauma; (3) nurture learning committees. Wolfson Children's Hospital is represented with a member on a Hope Healing JAX Steering Committee to implement these objectives. Year 1 (October 1, 2021 - September 30, 2022) * The 2022 Mental Health Conference - Access and Advocacy: A Community Conversation, was hosted on April 27, 2022, with 191 individuals in attendance. - The keynote address and presentation materials were posted on the Baptist Health Social Responsibility website - 100% of survey respondents (n=34) rated the conference quality as excellent or good Year 1 (October 1, 2021 - September 30, 2022) * There were 286 patient encounters, of which 80 (28%) engaged in care coordination services. - 25 (8.7%) of those referred to care coordination had a 30 day readmission from their last ED visit Year 1 (October 1, 2021 - September 30, 2022) * 27 volunteers (2 for BMC Beaches, 9 for BMC Jacksonville, 4 for BMC Clay/South, and 12 team members) * 36 community members * 928 phone calls * 473.1 hours invested in calls * Quality of phone calls (reported by volunteers) - 703 phones calls rated - Excellent: 87.34% (614) - Pretty Good: 9.82% (69) - OK: 1.71% (12) - Weak: 0.57% (4) - Poor: 0.57% (4)

Schedule H, Part V, Section B, Line 11 Facility , 5
Facility , 5 - Baptist Medical Center of Nassau, Inc.. Maternal and Child Health In 2020 17,920 babies were born in Northeast Florida with 817 being born in Nassau County and Baptist Medical Center Nassau delivering over 300. Maternal health refers to the health of women during pregnancy, childbirth, and the postnatal period. Each stage should be a positive experience, ensuring women and their babies reach their full potential for health and well-being. Children's health is the extent to which individual children or groups of children are able or enabled to develop and realize their potential, satisfy their needs, and develop the capacities that allow them to interact successfully with their biological, physical, and social environments. Child health is the foundation to adult health and overall well-being. At Baptist Health, we are committed to providing quality care through every stage of life. Key Issues Identified in the Assessment: * The Nassau County age-adjusted rate for all deaths ages 1-5 is 38.6, higher than the state rate of 24.4 and highest in Northeast Florida. * The Nassau County age-adjusted rate for unintentional injury deaths ages 1-5, is 30.9 compared to a state rate of 9.4. * The rate of children age 1-5 in foster care is 269, the highest in Northeast Florida and higher than the state rate of 220.4.

Schedule H, Part V, Section B, Line 11 Facility , 6
"Facility , 6 - Baptist Medical Center of Nassau, Inc.. Maternal and child health: Goals: 1. Zero preventable deaths. Zero health disparities. 2. All children can see. Strategies: * Partner with the Northeast Florida Healthy Start Coalition to address needs of moms and babies, including program and policy solutions. * Expand WELLCome Home initiative to Nassau in 2023 * Offer classes increasing awareness of safe sleep practices and CPR to expectants mothers. * Provide access to screenings, exams and glasses for children in need Metrics/What we are measuring: * Infant mortality * Pre-term births * Low Birth-weight babies * Number of moms connected through phone and/or in-home support * Number of participants to class * Number of screenings, exams and glasses provided * Percentage of students who failed a vision screening, who received an eye exam, and who received prescription glasses * Number and percent of students who fail vision screenings multiple years Potential Partnering/External Organizations: * Barnabas * Florida Blue * Northeast Florida Healthy Start Coalition * Home visiting programs * Florida Department of Health * Departments of Health in NEFL * School districts in NEFL * Vision is Priceless Results: Year 1 (October 1, 2021 - September 30, 2022) * 140 mothers referred to Northeast Florida Healthy Start Coalition WELLcome Home visiting nurse - 110 mothers consented and participated to the WELLcome Home nurse visit and education (78.6% completion) - 110 mothers educated on safe sleep practices and 73 mothers educated on infant and/or maternal nutrition * Northeast Florida Healthy Start Coalition community health workers targeted zip codes 32209 and 32210 as a Fetal Infant Mortality Review action plan to decrease infant mortality. - 182 initial intakes completed by the community health workers with pregnant women - Community health workers referred 111 mothers to maternal and child health home visiting programs - More than 100 cases were connected to a home visiting program from an initial intake * 2021 Infant mortality rates - Florida: 5.9/1,000 live births - Nassau: 2.4/1,000 live births * 2021 Preterm births - Florida: 23,179 (10.85%) - Nassau: 95 (11.46%) * 2021 Low birth weight babies - Florida: 19,211 (8.99%) - Nassau: 62 (7.48%) Year 1 (October 1, 2021 - September 30, 2022) * 1311 mothers called after discharge delivery, and 758 mothers participated in the WELLcome Home call back education program. * 132 mothers referred to Northeast Florida Healthy Start Coalition * 71 mothers referred to lactation consultation services * 10 mothers connected to maternal mental health services * Expanded WELLcome Home to include Baptist Medical Center Beaches Year 1 (October 1, 2021 - September 30, 2022) * A total of 456 adults were provided with safe sleep education. * Participated in 8 community events and 8 classes offering safe sleep practices and education * 532,207 total media impressions covering safe sleep education * ""First Year Baby Safety Essentials"" virtual classes included demonstration of infant/child CPR and addressed choking, first aid, and unintentional injury prevention. There were 8 classes offered to a total of 92 participants. Year 1 (October 1, 2021 - September 30, 2022) * 30,495 children received vision screenings for the early detection of vision issues - 1,265 (4.15%) of students failed the screening and received comprehensive eye exams while at school - 1,075 (84.98%) of students who were examined, received prescription glasses * 1,227 Nassau children screened. Vision is Priceless is currently in conversations with the Nassau Department of Health regarding the opportunity to provide mobile vision services."

Schedule H, Part V, Section B, Line 11 Facility , 7
Facility , 7 - Baptist Medical Center of Nassau, Inc.. Social Determinants of Health While the traditional role of health care is to treat patients' physical symptoms and medical conditions, clinical care accounts for only about 20% of an individual's health outcomes. An individual's habits and behaviors account for about 30% of quality and length of life. The social, economic, and environmental factors, also known as Social Determinants of Health (SDOH), determine 50% of an individual's health outcomes, and they affect an individual's ability to stay healthy and recover from illness, manage chronic conditions, and maintain overall well-being. The Healthy People Initiative organized SDOH around 5 key domains: Economic stability; Education access and quality; Health care access and quality; Neighborhood and built environment; and Social and community context. Key Issues Identified in the Assessment: * Cost of care (copays, prescriptions) was commonly cited as an inhibiting factor for individuals who have difficult accessing medical and dental services. * Top economic issues affecting health also include lack of a living wage and lack of affordable healthcare and insurance. * CHNA survey respondents and interviewees indicated a community-wide concern regarding the lack of affordable and safe housing.

Schedule H, Part V, Section B, Line 11 Facility , 8
Facility , 8 - Baptist Medical Center of Nassau, Inc.. Social Determinants of Health: Goals: Address social needs that prevent people from achieving optimal health Strategies: * Increase employment opportunities * Increase access to healthy food * Ensure seniors have access to in-home and other supports for health and wellbeing * Implement Find Help (Aunt Bertha) referral system for patients and community members Metrics/What we are measuring: * Percentage of people hired in low life expectancy zip codes * Percentage of identified FQHC and free clinic patients screened for food insecurity * Percentage of patients connected with food assistance programs * Number of home-delivered food boxes or meals * Number of seniors receiving in-home support * Number of organizations receiving referrals through Find Help Potential Partnering/External Organizations: * CareerSource * Barnabas * Nassau Council on Aging * Community-based organizations addressing social needs Results: Year 1 (October 1, 2021 - September 30, 2022) * A partnership was created with CareerSource to provide job fairs in identified zip codes. Due to unforeseen circumstances with Hurricane Ian, the initiative was postponed to 2023. Year 1 (January 1, 2022 - December 30, 2022) * 586 patients were screened (100%) for food insecurity, and 53 patients (9%) were enrolled in the Food for Healthy Living Program Year 1 (October 1, 2021 - September 30, 2022) * Nassau Council on Aging (COA) provided transportation for 237 seniors and low-income individuals to medical appointments and medical procedures * Nassau COA also provided 25 home health aides/CNAs to assist 207 seniors with in-home care and medication management. Year 1 (October 1, 2021 - September 30, 2022) * Implementation of findhelp occurred through the summer as the Epic EMR was being setup for a late July start. Thirty-six organizations received 46 referrals between them from May to September.

Schedule H, Part V, Section B, Line 11 Facility , 9
Facility , 9 - Baptist Medical Center of Nassau, Inc.. No entity can address all the health needs present in its community. Baptist Nassau is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization so that it can continue to provide a wide range of community benefits. This plan does not include specific strategies to address the following health priorities that were identified in the 2021 Community Health Needs Assessment; however, each of these health needs will continue to be addressed through partnerships and ongoing initiatives: Areas of Poverty - This need is being addressed by other entities in Northeast Florida, including United Way of Northeast Florida, which is supported by Baptist Health. Baptist Nassau does not anticipate implementing additional initiatives to address poverty. The hospital does not have sufficient resources to effectuate a significant change in this area, and believes resources devoted to its health plan should focus on other significant community health needs. Chronic Disease - With support from Baptist Nassau, Barnabas Center provides health services, crisis assistance, and food programs that help people get back on their feet. It is better suited to connect residents with a primary care doctor and navigate community resources to address chronic disease concerns. Baptist Nassau does not anticipate implementing additional initiatives to address chronic disease. Transportation - Baptist Nassau provides funding to the Nassau County Council on Aging to support transportation for local seniors to medical appointments and other errands. Given this investment, Baptist Nassau will focus on other significant community health needs. The hospital is committed to addressing other social determinants of health. Housing - Nassau Habitat for Humanity, United Way, and other organizations in Northeast Florida are better positioned to assist residents with housing needs. Baptist Health is committed to addressing social determinants of health and will advocate for ways to ensure residents have the means to a healthy life. Cancer - Baptist MD Anderson Cancer Center is part of the Baptist Nassau services and participates in outreach and educational activities throughout Northeast Florida. Given this significant investment in cancer care and education in the Baptist Nassau service area, the hospital will focus on other significant community health needs.

Schedule H, Part V, Section B, Line 20 Facility , 1
"Facility , 1 - Baptist Medical Center of Nassau, Inc.. Charity or Discounted Care posters are located in the Emergency Rooms and Patient Admission areas to inform patients of financial assistance and who to contact regarding financial assistance. AT PATIENT ACCESS POINTS, ""GUIDELINES FOR CHARITY CARE ELIGIBILITY"" CARDS ARE PROVIDED THAT CONTAIN FINANCIAL DISCOUNT AND CHARITY CARE INFORMATION. THIS INCLUDES A GENERAL CHART OF ELIGIBLE INCOME LEVELS AND ENCOURAGES PATIENTS TO SPEAK WITH OUR PATIENT FINANCIAL ADVOCATES TO ARRANGE A FINANCIAL EVALUATION. All billing statements conspicuously display the phone number, address, and website which directs patients to our financial assistance advocates and contains all financial assistance information. ALL APPLICANTS FOR FINANCIAL ASSISTANCE ARE MAINTAINED WHETHER OR NOT THE PATIENT QUALIFIES. All attempts to contact the patient are exhausted before sending to collections. All patients are sent through a system that analyses the financial position of the individual. All patients who are scored a certain number in accordance with our policy and who have not already applied for financial assistance are automatically deemed eligible for financial assistance."

Schedule H, Part VI, Line 7 State Filing of the Community Benefit Report
Baptist Health System, Inc. (BHS), parent company of the filing organization, is located within the northeast Florida quadrant. There are no requirements for state filing in Florida of the annual community benefit report. However, BHS does publish the report and it is available upon request or at the www.baptistjax.com website.

Schedule H, Part II, Line 3 Community Support
Tipping the Scale - Youth Mentoring Program: Ten Baptist Health employees volunteered their time to provide one-to-one mentoring for 13 high school students every other week. The students who participate in the program are from our most vulnerable communities and low-income families. In this career guidance mentoring program, mentors introduce students to various careers in healthcare. In addition, they serve as supporters and encouragers for teens as they navigate the challenges of adolescence. Tipping the Scale - Summer Employment Experience: New employment opportunities are provided to teenagers 16-18 years old after successful completion of an eight-week job readiness training program. Teens are provided exposure to the scope of practice for one of their top three areas of career interest at our flagship hospital system. This exposure to real-life careers motivates them to prepare appropriately for their life after high school. Session topics included how to be successful on the job, resume writing, the interview and hiring process, money management, accountability and consequences, and interpersonal skills. Sixty teenagers participated in the job readiness training, but only 21 were a part of and completed the summer sessions with 2 at Baptist Medical Center Nassau.

Schedule H, Part II, Line 6 Coalition Building
Episcopal Children's Services Health Services Advisory Council for Baker, Clay, Duval, and Nassau counties provides a network of community connections to support Head Start and Early Head Start programs with integrated, comprehensive health services. Wolfson Children's Hospital representatives are active members in these councils and provide services to Head Start and Early Head Start centers such as health education and access to healthcare. Florida Mental Health Advocacy Coalition, through the local Nation Alliance on Mental Illness, is a non-profit, non-partisan coalition of organizations that advocate for policy changes to improve the quality of life for those who live with a mental illness and/or substance use disorder in the state of Florida. Jacksonville Nonprofit Hospital Partnership came together to develop a multi-hospital system collaborative community health needs assessment. The Partnership is a network of five health systems that are a shared voice to improve population health by eliminating the gaps that prevent quality, integrated health care and to improve access to resources that support a healthier lifestyle. During FY 2016, the Partnership initiated, and continues today, a collaboration to reduce stigma and crises related to mental illness through a community implementation of Mental Health First Aid, a best-practices program recognized by the Substance Abuse and Mental Health Services Administration. Nassau Community Health Improvement Coalition - Baptist Nassau is a member of the Nassau Community Health Improvement Coalition (NCHIC). NCHIC is a coalition of local agencies, organizations, community groups and community members with the common goal of improving the overall health of the Nassau County community. The Coalition works to improve the level of health in the area through awareness, education, partnership, prevention, service delivery, and policy development, so that individuals achieve their potential to live healthy, active lifestyles. Nassau County Behavioral Healthcare Consortium is a group of mental and behavioral health agencies and advocates that meet monthly to promote communication and collaboration between consortium partners and other community organizations. The group currently aims to create a trauma informed community by providing community education in multiple settings throughout the county to increase awareness of the effects of physical abuse, substance use, and trauma on child development and adult health. Nassau Racial Equity Coalition (NREC) seeks to improve opportunities for racial minorities by removing barriers and inequities. NREC is composed of representatives of the key institutions in Nassau County that will develop and implement actions consistent with the mission that will achieve the vision for equality. Current committees are focusing on education, health, law enforcement, marketing and development, and opportunities.

Schedule H, Part II, Line 7 Community Health Improvement Advocacy
CHNA Priority Access to Care: Baptist Medical Center Nassau (BMCN) partnered with Barnabas Center located in Nassau County to provide access to primary health care for people who are un- and under-insured. In addition to providing funding for Barnabas Center operations, BMCN provided lab and other medical services in-kind for the center. Baptist Nassau also partnered with the Nassau County Council on Aging to support home health services for seniors and the provision of transportation for elderly and people without transportation in a county that does not have public transportation. A partnership with Starting Point Behavioral Health increased access to mental health treatment for individuals assigned a care coordinator. CHNA Priority Mental and Behavioral Health: BMCN partnered with Starting Point Behavioral Health to provide Mental Health First Aid training. Mental Health First Aid teaches participants a five-step action plan to assess a situation, select and implement interventions, and secure appropriate care for an individual showing signs of mental illness or substance abuse disorders. Baptist Medical Center Nassau also partnered with Starting Point to provide access to treatment for uninsured and underinsured people in Nassau County who are addicted to and abusing substances. BMCN provided funding and referrals for ED patients to receive services with appropriate permission. Baptist Health also held a Behavioral Health Conference to address health and well-being in Northeast Florida. CHNA Priority Maternal and Child Health: In addition to supporting access to care for adults without insurance, Baptist Health partnered with the Northeast Florida Healthy Start Coalition to research infant mortality and implement solutions such as home visits by nurses and community health workers. In partnership with Florida Blue, UF Health, and Northeast Florida Healthy Start Coalition, Baptist also developed the WELLcome Home visiting program which focuses on newborn and maternal education for families that is being replicated at other Baptist facilities. CHNA Priority Social Determinants of Health: For support services and bridging gaps in care, BMCN partnered with the Nassau Council on Aging. The organization provided transposition for seniors and low-income individuals and provided home health aides and certified nursing assistants for in-home care. The Barnabas Center screened patients for food insecurity, and regarding employment opportunities, a partnership with CareerSource was initiated to target identified zip codes with low life expectancies. Baptist Medical Center Nassau also partnered with the Museum of Science and History to educate adult and youth visitors about health systems and how to be healthy.

Schedule H, Part II, Line 8 Workforce Development
Baptist Medical Center Nassau provided Clinical Education and Training to undergraduate and graduate student interns procuring degrees in nursing and other health care professions provided by Baptist Health clinicians. In fiscal year 2022, Baptist Medical Center Nassau provided 189 (199 in FY21, 135 in FY20, 265 in FY19) students with 3,998 hours of clinical education supervision.

Schedule H, Part II, Line 9 Other
Mental Health First Aid - Baptist Health provided 8-hour certification training in Mental Health First Aid (MHFA), Youth and Adult, to 803 (1,107 in FY21, 1,114 in FY 20 and 2,517 in FY 19) community members. Baptist Health Nassau provided MHFA, Teenager, to 521 10th grade Nassau student. Baptist Health provided 8 health education sessions on various topics to on average 33 attendees during fiscal year 2022.

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
Baptist Health System, Inc.

Schedule H, Part I, Line 7g Subsidized Health Services
THERE WERE NO PHYSICIAN CLINIC COSTS INCLUDED IN THE SUBSIDIZED HEALTH SERVICES COST.

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
0

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
WE OBTAINED OUR COST USING OUR CCA ACCOUNTING SYSTEM TO DEVELOP PAYOR-LEVEL RCC'S WHICH WERE APPLIED TO PAYOR CHARGES TO CALCULATE COST.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
Patient service revenues are reported at estimated net realizable amounts for services rendered. BHS recognizes patient service revenues associated with patients who have third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for charity care, revenue is recognized on the basis of discounted rates in accordance with BHS' policy. Patient service revenues are reduced by the provision for bad debts and accounts receivable are reduced by an allowance for uncollectible accounts. These amounts are based on management's assessment of historical and expected net collections for each major payor source, considering business and economic conditions, trends in health care coverage and other collection indicators. Management regularly reviews collections data by major payor sources in evaluating the sufficiency of the allowance for uncollectible accounts. On the basis of historical experience, a significant portion of BHS' self-pay patients will be unable or unwilling to pay for the services provided. Thus, BHS records a significant provision for bad debts in the period services are provided related to self-pay patients. For receivables associated with patients who have third-party coverage, BHS analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary. Accounts receivable are written off after collection efforts have been followed in accordance with BHS' policies.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
The entire provision for bad debts is recorded as a deduction from patient service revenues. None of the provision is included in the expenses of the Form 990 including Schedule H and the calculation of community benefit.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
Baptist Health System, Inc. and Subsidiaries Notes to Consolidated Financial Statements Footnote 2, Significant Accounting Policies, Page 16.

Schedule H, Part III, Line 8 Community benefit methodology for determining medicare costs
Medicare allowable costs of care based on the organization's cost accounting system which is used to determine the amount reported on Line 6. None of the shortfall reported on Line 7 is included in Schedule H, Part I. The shortfall reported on Line 7 should be treated as community benefit because the revenue received from Medicare reimbursements does not exceed the cost of providing Medicare services. The organization will continue to provide excellent patient care to the Medicare patient population in our community.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
Yes, the organization does have a written debt collection policy. The policy does not specifically address those patients who are known to qualify or have applied for charity care as the organization does not bill these patients. The organization's cost accounting system identifies all patients who have a pending or approved charity application. The organization would only bill the patient if, after multiple attempts to obtain any needed documentation from the patient to complete the charity approval process, the patient was noncompliant.

Schedule H, Part V, Section B, Line 16a FAP website
- Baptist Medical Center of Nassau, Inc.: Line 16a URL: https://www.baptistjax.com/patient-info/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- Baptist Medical Center of Nassau, Inc.: Line 16b URL: https://www.baptistjax.com/patient-info/financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- Baptist Medical Center of Nassau, Inc.: Line 16c URL: https://www.baptistjax.com/patient-info/financial-assistance;

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
"At patient access points, ""Guidelines for Charity Care Eligibility"" cards are provided that contains financial discount and charity care information. This includes a general chart of eligible income levels and encourages patients to speak with one of our patient financial advocates to arrange a financial evaluation. The organization sends statements to patients who have applied for charity care but have not provided all the documentation that is required to make a determination; letters are sent by the organization requesting the information to complete their application."

Schedule H, Part VI, Line 6 Affiliated health care system
Baptist Health System, Inc. (BHS) is the parent affiliate of Baptist Medical Center of Nassau, Inc. (BMCN). The Social Responsibility and Community Health team at BHS coordinates the funding of nonprofit partners for BMCN and works with our employees in facilitating volunteer opportunities across our community. Members of the BMCN Board of Directors also serve on the Social Responsibility and Community Health committee. BMCN works closely with a number of nonprofit partners to meet the community health needs of Nassau County, Florida.

Schedule H, Part VI, Line 2 Needs assessment
Baptist Health System Inc. (BHS), parent company of the filing organization, is a member of the Jacksonville Community Benefit Partnership that is a collaborative of 5 hospitals who work together to access and address important community health needs. Data is gathered from the Florida Health Community Health Assessment Resource Tool Set (CHARTS) website which serves as a source of population data and health statistics about Florida and its counties. Queries, reports, and individual indicators are available for Baker, Clay, Duval, Nassau, and St. Johns counties. In addition, with the implementation of the Epic EMR, Baptist Health is developing reports to improve identification of healthcare and social needs of patients and the communities they live in.

Schedule H, Part VI, Line 4 Community information
Baptist Medical Center Nassau's service area is Nassau County, which has a total land area of 648.6 square miles and a resident population of 96,444. Fernandina Beach is located on Amelia Island, the county's one inhabited island. The racial makeup of the area is 84.92% White, 5.36% Black or African American, 1.13% Asian, 0.43% Native American, 0.08% Pacific Islander, 1.57% from other races, and 6.51% from two or more races. Hispanic or Latino of any race is 5.75% of the population. The population's age groups are 19.19% under 18, 6.92% from 18-24, 22.2% from 25-44, 27.1% from 45- 64, and 24.59% who are 65+. The median age is 46.4 years. The median and average household incomes are $76,427 and $98,554, respectively. The percentage of families below the poverty line is 7.61% and 4.55% for families with children. There is one Federally Designated Medically Underserved Area present in the service area.

Schedule H, Part VI, Line 5 Promotion of community health
Baptist Health System, Inc. (BHS) continues to maintain an open medical staff. A designated Social Responsibility Community Health Board Committee is established to provide direction to the community health work based on the community need within the five county area served by BHS. In FY22, BHS provided over $44 Million in charity care to people who where under/un-insured, over $19 million in community benefit, and over $4 Million in direct cash to the community to support nonprofit organizations that provide health services to the underserved and low income community. Some of the nonprofit organizations provide primary care for the uninsured and the underinsured. Some provide behavioral health services to families who would not otherwise have access while others provide health services and transportation for the frail elderly.