4A (Expenses $ 535551238 including grants of $ 0) (Revenue $ 320356286)
4A PROGRAM SERVICE -CHARITY, UNINSURED, UNDERINSURED AND INDIGENT CARE: IN THE 1800'S ATLANTA'S INDIGENT SICK HAD NO PLACE TO GO TO RECEIVE MEDICAL TREATMENT FOR ILLNESS OR INJURY. THEREFORE, A DRIVE WAS BEGUN TO BUILD GRADY MEMORIAL HOSPITAL (GRADY). ON JUNE 1, 1892, GRADY ADMITTED ITS FIRST PATIENT. AS OF TODAY, GRADY CONTINUES TO BE THE SAFETY NET HOSPITAL FOR THE UNINSURED AND UNDERINSURED CITIZENS OF FULTON AND DEKALB COUNTIES AND THE STATE OF GEORGIA. AS THE LARGEST SAFETY NET HOSPITAL IN THE STATE AND ONE OF THE LARGEST IN THE COUNTRY, ITS MISSION IS (1) TO PROVIDE MEDICAL SERVICES TO UNINSURED, UNDERINSURED, OR INDIGENT PATIENTS; (2) TO PROVIDE AN OPEN ACCESS POLICY FOR RESIDENTS OF FULTON AND DEKALB COUNTIES REGARDLESS OF THEIR ABILITY TO PAY; (3) AND TO PROVIDE A PROVISION FOR SIGNIFICANT UNCOMPENSATED INDIGENT AND CHARITY CARE. DURING 2021, GRADY PROVIDED CARE TO MORE THAN 114,225 UNDER AND UNINSURED PATIENTS WHICH REPRESENT APPROXIMATELY 59% OF ITS TOTAL PATIENTS WITH ABOUT 460,287 PATIENT ENCOUNTERS, COSTING APPROXIMATELY $ 536M. GRADY RECEIVES SOME REIMBURSEMENT FROM FULTON AND DEKALB COUNTIES, MEDICAID, AND SOME FUNDING FROM THE STATE OF GEORGIA'S INDIGENT CARE TRUST FUND (INCLUDING FEDERAL MATCHING FUNDS) TO HELP SUPPORT THE COSTS OF CARING FOR SO MANY IN THE REGION. GRADY HAS BEEN AND CONTINUES TO BE SIGNIFICANTLY CHALLENGED BY THE FINANCIAL BURDEN OF PROVIDING SO MUCH FREE CARE TO THE REGION.

4B (Expenses $ 120869103 including grants of $ 16767283) (Revenue $ 68306004)
4B PROGRAM SERVICE -GRADUATE MEDICAL EDUCATION: GRADY MEMORIAL HOSPITAL CORPORATION (GMHC) HAS AFFILIATION AGREEMENTS WITH EMORY UNIVERSITY AND MOREHOUSE SCHOOLS OF MEDICINE TO SUPPORT THE TEACHING AND SUPERVISION OF RESIDENTS IN THE ORGANIZATION, AS WELL AS TO PROVIDE PROFESSIONAL CLINICAL AND ADMINISTRATIVE SERVICES. IN 2021 MORE THAN 1,000 RESIDENTS AND FELLOWS FROM EMORY AND MOREHOUSE PROGRAMS ROTATED THROUGH A BROAD SPECTRUM OF SERVICES IN THE ORGANIZATION. ADDITIONALLY, HUNDREDS OF MEDICAL STUDENTS BENEFITED FROM TRAINING IN THE ORGANIZATION. GMHC OFFERS UNIQUE LEARNING EXPERIENCES FOR RESIDENTS BY PROVIDING EXPOSURE TO TRAUMA, BURN, INFECTIOUS DISEASE, SICKLE CELL, NEUROLOGY AND OTHER COMPLEX CASES AND HOSTS A SIGNIFICANT NUMBER OF CLINICAL RESEARCH TRIALS TO ENHANCE THE RESIDENTS' EDUCATIONAL EXPERIENCE. GMHC PROVIDED IN EXCESS OF $121M IN SUPPORT RELATIVE TO TEACHING SERVICES. IN 2021, REIMBURSEMENT FOR TEACHING SERVICES FROM MEDICARE, MEDICAID AND OTHER GOVERNMENTAL FUNDS TOTALED $ 68M.

4C (Expenses $ 109608452 including grants of $ 0) (Revenue $ 136458121)
4C PROGRAM SERVICE -EMERGENCY AND TRAUMA SERVICES: GRADY OPERATES ONE OF THE BUSIEST EMERGENCY DEPARTMENTS IN THE EASTERN UNITED STATES AND THE COUNTRY'S LARGEST HOSPITAL-BASED AMBULANCE SERVICE. GMHC OPERATES THE LARGEST LEVEL 1 TRAUMA CENTER IN THE ATLANTA METROPOLITAN AREA WHICH HANDLED 11,000 ACUTE TRAUMA CASES IN 2021. ADDITIONALLY, AS PART OF ITS TRAUMA SERVICE, GMHC OPERATES ONE OF ONLY TWO BURN CENTERS IN GEORGIA. THE NATIONALLY ACCLAIMED EMERGENCY CARE CENTER (ECC) HANDLED 111,592 EMERGENCY CASES IN 2021. THE EMERGENCY ROOM WAS THE INTAKE POINT FOR 22,000 OF THE SAFETY NET HOSPITAL'S TOTAL ADMISSIONS. GRADY'S EMS DIVISION STATEWIDE EMS OPERATION IS THE EXCLUSIVE 911 AMBULANCE PROVIDER FOR THE CITY OF ATLANTA INCLUDING SOUTH FULTON COUNTY, ALBANY, BALDWIN, BEN HILL, BROOKS, COOK, DECATUR, HANCOCK, MCINTOSH, MITCHELL, SEMINOLE, AND WORTH COUNTIES IN GEORGIA. THE GRADY EMS TEAM OF OVER 1350 EMS PROFESSIONALS HANDLE MORE THAN 246,000 CALLS THROUGHTOUT GEORGIA, IN 2021. ADDITIONALLY, GRADY EMS ALSO MANAGES A MOBILE INTEGRATED HEALTH (MIH) CARE PROGRAM WHICH PROVIDES PRE AND POST HOSPITAL CARE FOR PATIENTS IN AN EFFORT TO REDUCE THE STRAIN ON EMS AND ECC. MIH ALSO INCREASES ACCESS TO PREVENTATIVE CARE, WORKING TO REDUCE HOSPITAL RE-ADMITS AND LOWER LENGTH OF HOSPITAL STAYS. ALSO NOTABLE, GRADY EMS OPERATES ATLANTA'S LARGEST SPECIALIZED EVENT EMS DIVISION SERVING STADIUMS, CONCERTS, MARATHONS, AND FESTIVALS THROUGHOUT THE CITY OF ATLANTA.

4D (Expenses $ 941346553 including grants of $ 0) (Revenue $ 1442632525)
GRADY'S OTHER PROGRAMS INCLUDE NATIONALLY RECOGNIZED PROGRAMS IN THE AREAS OF INFECTIOUS DISEASE, DIABETES, AND SICKLE CELL AS WELL AS REGIONAL SERVICE FOR NEONATAL TRANSPORT, MATERNAL AND INFANT PROJECT, CARDIOVASCULAR HEALTH, PSYCHOLOGY, BURN, CANCER AND MARCUS STROKE AND NEUROSCIENCE CENTER. PRIMARY CARE SERVICES ARE ALSO PROVIDED THROUGH HOSPITAL MAIN-CAMPUS DEPARTMENTS AND NEIGHBORHOOD CLINICS.

Schedule H, Part V, Section B, Line 5-GRADY MEMORIAL HOSPITAL
GEORGIA STATE UNIVERSITY'S GEORGIA HEALTH POLICY CENTER, WHICH LED THE COLLABORATIVE CHNA PROCESS, INTERVIEWED NEARLY 30 INDIVIDUAL STAKEHOLDERS AND CONDUCTED FOCUS GROUPS AND/OR LISTENING SESSIONS WITH TWO GROUPS OF GRADY PROVIDERS AND NINE GROUPS OF RESIDENTS REPRESENTING FOUR DIFFERENT POPULATIONS. INTERVIEWEES INCLUDED TWO REPRESENTIVES FROM DEKALB COUNTY BOARD OF HEALTH, PARTNERS FOR HOME, GEORGIA EQUALITY, MERCY CARE HEALTH CENTER FOR THE HOMELESS, KAISER PERMANENTE, CATHOLIC CHARITIES, ATLANTA REGIONAL COMMISSION, UNITED WAY, A VARIETY OF GOVERNMENT OFFICIALS REPRESENTING CITY OF CHAMBLEE, DEKALB COUNTY AND FULTON COUNTY, AMONG OTHERS. FOCUS GROUPS WERE CONDUCTED TO ASSESS THE NEEDS OF FULTON RESIDENTS, DEKALB RESIDENTS, VIETNAMESE SENIORS, LATINOS, CANCER PATIENTS AND PATIENTS WITH BEHAVIORAL HEALTH CONDITIONS.

Schedule H, Part V, Section B, Line 5-HUGHES SPALDING CHILDRENS HOSPITAL
HUGHES SPALDING CHILDRENS HOSPITAL IS MANAGED BY CHILDRENS HEALTHCARE OF ATLANTA

Schedule H, Part V, Section B, Line 6a-GRADY MEMORIAL HOSPITAL
GRADY'S CHNA WAS CONDUCTED COLLABORATIVELY THROUGH THE ATLANTA REGIONAL COLLABORATIVE FOR HEALTH IMPROVEMENT (ARCHI). WELLSTAR HOSPITALS PARTICIPATED IN THIS 2019 CHNA PROCESS

Schedule H, Part V, Section B, Line 6a-HUGHES SPALDING CHILDRENS HOSPITAL
GRADY'S CHNA WAS CONDUCTED COLLABORATIVELY THROUGH THE ATLANTA REGIONAL COLLABORATIVE FOR HEALTH IMPROVEMENT (ARCHI). WELLSTAR HOSPITALS PARTICIPATED IN THIS 2019 CHNA PROCESS

Schedule H, Part V, Section B, Line 6b-GRADY MEMORIAL HOSPITAL
MERCY CARE HEALTH CARE CENTER FOR THE HOMELESS AND KAISER PERMANENTE OF GEORGIA ALSO PARTICIPATED IN ARCHI'S COLLABORATIVE CHNA TO INFORM THEIR ORGANIZATION'S COMMUNITY HEALTH PRIORITIES. ADDITIONALLY, MANY OTHER HEALTHCARE, PUBLIC HEALTH, ACADEMIC, NON-PROFIT AND PHILANTHROPIC ORGANIZATIONS ARE MEMBERS OF ARCHI AND HELPED TO FORM THE 2019 CHNA. SOME OT THESE ORGANIZATIONS INCLUDE ATLANTA REGIONAL COMMISSION, UNITED WAY OF GREATER ATLANTA, CARTER CENTER, CENTERS FOR DISEASE CONTROL AND PREVENTION, GEORGIA DEPARTMENT OF PUBLIC HEALTH, AND GEORGIA HEALTH POLICY CENTER, AMONG OTHERS.

Schedule H, Part V, Section B, Line 6b-HUGHES SPALDING CHILDRENS HOSPITAL
MERCY CARE HEALTH CARE CENTER FOR THE HOMELESS AND KAISER PERMANENTE OF GEORGIA ALSO PARTICIPATED IN ARCHI'S COLLABORATIVE CHNA TO INFORM THEIR ORGANIZATION'S COMMUNITY HEALTH PRIORITIES. ADDITIONALLY, MANY OTHER HEALTHCARE, PUBLIC HEALTH, ACADEMIC, NON-PROFIT AND PHILANTHROPIC ORGANIZATIONS ARE MEMBERS OF ARCHI AND HELPED TO FORM THE 2019 CHNA. SOME OT THESE ORGANIZATIONS INCLUDE ATLANTA REGIONAL COMMISSION, UNITED WAY OF GREATER ATLANTA, CARTER CENTER, CENTERS FOR DISEASE CONTROL AND PREVENTION, GEORGIA DEPARTMENT OF PUBLIC HEALTH, AND GEORGIA HEALTH POLICY CENTER, AMONG OTHERS.

Schedule H, Part V, Section B, Line 11-GRADY MEMORIAL HOSPITAL
Grady's most recent CHNA was conducted in 2019 and our Implementation Strategy (IS) was adopted at the end of 2019. Listed below is an overview of our work in 2021, which addressed the CHNA priorities: 1. IMPROVE COORDINATION OF CARE FOR GRADY PATIENTS WITH DIABETES, HYPERTENSION, PROSTATE CANCER, HIV/AIDS AND BEHAVIORAL HEALTH CONDITIONS. Since launching in 2020, Grady's Trauma Recovery Center (TRC) has provided behavioral health counseling and wrap around services to more than 50 patients who are survivors of violent crime. Grady TRC provides trauma-informed clinical case management, psychotherapy, crisis intervention, medication management, and legal advocacy at no cost to survivors and secondary victims of physical assault, firearm violence, domestic violence, human trafficking, and sexual assault. In 2021, the TRC team moved into its own clinical space, hired additional providers, and collaborated with many Grady departments to train staff on how to identify and refer eligible patients. Grady's orthopedic surgeons are leading the way in developing a new position in health care to provide trauma-informed care and comprehensive pain management focused on physical and mental wellness. Life Care Specialists (LCS), a critical part of Grady's ortho-trauma team, are helping to prevent opioid dependence. LCSs attend patient appointments for up to a year to assess the need for resources and pain management strategies. Based on the individual patient needs, the LCS will provide a variety of support from education to referrals and care coordination to training on evidence-based nonpharmaceutical pain management techniques. Grady completed a pilot study in 2020 and began a randomized control trial with more than 200 patients in 2021. Grady's Ponce de Leon Center specializes in comprehensive care of patients with HIV. To better support African American women with HIV who have multiple co-morbidities, have missed appointments, and are having difficulties sustaining viral suppression, Ponce launched the Black Women First Initiative. This two-part bundled intervention is comprised of patient navigation and self-efficacy. The program leverages a mobile app to foster increased patient engagement in the care plan and a Patient Navigator to support the patient. The Navigator orients the patient on the app, provides structured education sessions, interacts with patients through messaging on the app, helps schedule appointments, and acts as a liaison between the patient and the entire care team. The app also offers an opportunity for enrolled participants to interact and uplift each other and learn about resources for employment and housing support. By the end of 2021, Ponce had enrolled 43 patients. All were reporting a high level of medication adherence and reduced viral load, and 25 had achieved viral suppression. 2. INCREASE OPPORTUNITIES FOR ALL GEORGIANS, WITH A FOCUS ON PERSONS SERVED BY GRADY HEALTH SYSTEM, TO ACCESS HEALTHCARE. In 2021, Grady worked diligently to support the community and our patient population in understanding the benefits of obtaining the COVID-19 vaccine and improving access to the vaccine. Overall, Grady administered over 41,000 COVID-19 vaccines to patients and community members in 2021. Grady employed COVID-19 navigators to conduct outreach campaigns with patients and host community events. The navigators were able to connect with over 10,000 patients via text and phone calls to share information about vaccine availability, schedule appointments and transportation, and answer questions. Vaccines were also available in all clinics, in the Emergency Department and a temporary clinic built out in the hospital lobby. During this pandemic, MIH expanded its services to care for Grady patients, employees, and community members impacted by COVID. Through collaboration with Population Health and Strategy, MIH's impact extended into the community. Twenty onsite vaccine events were held at senior living facilities (Berean Village, Heritage Station) and local organizations (MARTA, Focused Community Strategies, and Sheltering Arms) where over 900 vaccines were administered to both residents and employees. The emergency use authorization of monoclonal antibody (MAB) in the outpatient setting created additional opportunity for MIH provide COVID-related treatment in the home for both Grady patients and employees. Close to 150 patients received MAB treatment in the home. Additionally, an initiative launched in 2020 to contact seniors at high risk of COVID in grew substantially in 2021. Medical students from Emory University and Morehouse Schools of Medicine contacted 2,200 patients in 2021. They provided phone-based health and safety education, social support, and resource connection. With in-person services still limited in 2021, Grady's financial services and many of the benefits screening initiatives continued to be offered primarily via telephone support. In 2021, Grady completed Medicaid enrollment for an estimated 2,235 patients. Grady also continued referring patients to the Atlanta Community Food Bank and Wholesome Wave Georgia for assistance with SNAP enrollment. 3. INCREASE PATIENT AND COMMUNITY ENGAGEMENT IN HEALTHY BEHAVIORS TO PREVENT DIABETES, HYPERTENSION, HIV, UNINTENTIONAL INJURIES, AND HOMICIDE. With Atlanta at the center of the HIV epidemic, Grady continues to provide critical access to HIV pre-exposure prophylaxis (PrEP) and sexual health services to prevent HIV. In 2021, Grady's PrEP program achieved notable growth and quality improvement leading to greater impact. Streamlined processes improved both medication refills and net margin. Updated and expanded web and social media marketing efforts contributed to volume growth. In 2021, the PrEP program was awarded the Emory at Grady Community Impact Award and received new grant funding from the Emory Medical Care Foundation. After many cancer screenings were delayed during the first year of the COVID pandemic, Grady prioritized getting our community back up to date on these critical preventive care services. Through an American Cancer Society and NFL Crucial Catch grant, Grady took a multi-pronged approach to increasing access to breast cancer screenings. In 2021 screening efforts resulted in included, 11,375 screening mammograms, 2,680 orders for diagnostic imaging, and 115 breast cancer diagnoses. Overall, these efforts resulted in a 42% improvement in breast cancer screening compliance, increasing from 31% of patients being up to date to 44% by December 2021. Crucial Catch grant funds were used to cover the cost of screening procedures, as well as support enhanced patient engagement efforts including patient navigators and transportation support. Navigators sent more than 11,000 reminders, assisted with rescheduling, and provided patient education. The Cancer Center also held six virtual education events with community partners and one internal event educating other Grady providers on the breast cancer screening referral process. Grady also expanded Saturday screening events to specifically target patients that had gone over one year without a screening. Between June and September, nearly 100 patients were screened at these events. Grady received a second American Cancer Society and NFL Crucial Catch grant to increase access to lung cancer screening. Similar comprehensive patient engagement efforts were implemented throughout 2021 to identify high risk patients and connect them to low-dose CT screenings. Patient Navigators made reminder calls, scheduled appointments, educated patients, and provided transportation support when needed. Several Cancer Center team members also participated in community events to provide education on the risks associated with lung cancer and proper prevention and detection methods. In 2021, Grady's Injury and Violence team engaged community members in various events to promote injury and violence prevention. Grady hosted a Gun Violence Awareness event and participated in Peace Week ATL and Midnight Basketball with the Mayor's Office. Grady experts also did numerous webinars, lectures, and panel discussions for academic institutions and community partners, podcasts and radio shows on the root causes of injury. They also expertise on intimate partner violence and hospital-based solutions in op-eds featured in the AJC and USA Today. Grady's Food as Medicine partnership continued to grow in 2021. By opening up referrals to the Food Pharmacy from Grady's Heart and Vascular clinics and Women's Services, more patients experiencing food insecurity and managing chronic conditions were able to connect to the food prescription program. More than 400 patients were enrolled in the food prescription program and the food pharmacy increased food distribution from 6,500 to 10,000 pounds per month. (Continued on Sch H Part VI Line II)

Schedule H, Part V, Section B, Line 11-HUGHES SPALDING CHILDRENS HOSPITAL
INDIRECTLY BENEFITS FROM GMHC PLAN

Schedule H, Part V, Section B, Line 13h-GRADY MEMORIAL HOSPITAL
REFER TO THE FINANCIAL ASSISTANCE POLICY (FAP) ATTACHED. FOR PROCESS, DEFINITIONS, AND TIER LEVELS, DISCOUNTED CARE WITH COPAYMENTS FOR PATIENTS WITH VERIFIED INCOME LEVELS OF ANNUAL GROSS FAMILY INCOMES FROM 251% TO 400% OF CURRENT FEDERAL PROVERTY INCOME LEVEL (FPI) AND HOMELESS WITH 0% FPI QUALIFY FOR FEE CARE UP TO 400% FPL WITH SOME COPAY.

Schedule H, Part V, Section B, Line 13h-HUGHES SPALDING CHILDRENS HOSPITAL
REFER TO THE FINANCIAL ASSISTANCE POLICY (FAP) ATTACHED. FOR PROCESS, DEFINITIONS, AND TIER LEVELS, DISCOUNTED CARE WITH COPAYMENTS FOR PATIENTS WITH VERIFIED INCOME LEVELS OF ANNUAL GROSS FAMILY INCOMES FROM 251% TO 400% OF CURRENT FEDERAL PROVERTY INCOME LEVEL (FPI) AND HOMELESS WITH 0% FPI QUALIFY FOR FEE CARE UP TO 400% FPL WITH SOME COPAY.

Schedule H, Part V, Section B, Line 15e-GRADY MEMORIAL HOSPITAL
THE FINANCIAL COUNSELORS WILL ADVISE ELGIBILE PATIENTS VERBALLY AS TO WHERE AND HOW TO APPLY FOR FOOD STAMPS AND DETERMINE IF THEY MEET CRITERIA FOR MEDICAID. SOCIAL WORKERS WILL TYPICALLY PROVIDE INFORMATION REGARDING HOUSING, FOOD STAMPS, AND OTHER SERVICES TO PATIENTS. A FINANCIAL COUNSELOR MAY DETERMINE IF A PATIENT MEETS CRITERIA FOR PRESUMPTIVE MEDICAID, WOMEN'S HEALTH MEDICAID, WOMEN'S MEDICAID WAIVER, CANCER STATE AID, CRIME VICTIMS COMPENSATION PROGRAM, RIGHT FROM THE START MEDICAID FOR NEWBORNS, EMERGENCY MEDICAL ASSISTANCE, MEDICAID FOR UNDOCUMENTED WOMEN WHO DELIVER THEIR NEWBORNS, PRESUMPTIVE MEDICAID, LOW INCOME MEDICAID, ETC. AND COMPLETE THE APPLICATION AS APPROPRIATE. THE FINANCIAL COUNSELOR MAY ALSO PREFER A PATIENT TO APPLY FOR MEDICAID WITH THE DEPARTMENT OF FAMILY AND CHILDRENS' SERVICES-GRADY OUTREACH UNIT. GMHC HAS VENDOR PARTNERSHIPS ON CAMPUS WHERE BY REPRESENTATIVES ARE COMPLETING APPLICATIONS FOR ELIGIBLE PATIENTS FOR VARIOUS MEDICAID PROGRAMS SUCH AS THOSE ABOVE, SSI, SSD, ETC.

Schedule H, Part V, Section B, Line 15e-HUGHES SPALDING CHILDRENS HOSPITAL
THE FINANCIAL ASSISTANCE PROGRAM POLICY, APPLICATION AND INSTRUCTIONS ARE PUBLICIZED TO INCLUDE CHILDREN'S HEALTHCARE OF ATLANTA WEBSITE. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE ELECTRONICALLY VIA EMAIL, MAY APPLY IN PERSON, BY MAIL, OR MAY QUALIFY AT THE POINT OF REGISTRATION THROUGH A PRESUMPTIVE AUTOMATED THIRD PARTY SOFTWARE.

Schedule H, Part V, Section B, Line 16a-GRADY MEMORIAL HOSPITAL
FAP POLICY IS ON THE INTERNET AT HHPS://WWW.GRADYHEALTH.ORG/BILLING-INSURANCE/financial-assistance-program

Schedule H, Part V, Section B, Line 16b-GRADY MEMORIAL HOSPITAL
FAP APPLICATION IS ON THE INTERNET AT HTTPS://WWW.GRADYHEALTH.ORG/WP-CONTENT/UPLOADS/FAP-APPLICATION.PDF

Schedule H, Part V, Section B, Line 16c-GRADY MEMORIAL HOSPITAL
FAP PLAIN LANGUAGE SUMMARY CAN BE FOUND ONLINE AT HTTPS://WWW.GRADYHEALTH.ORG/FINANCIAL-ASSISTANCE-PROGRAM/

Schedule H, Part V, Section B, Line 20a-GRADY MEMORIAL HOSPITAL
THIS PROCEDURE WAS NOT PART OF ELIGIBILITY PROCESS PER #19 ABOVE

Schedule H, Part V, Section B, Line 20a-HUGHES SPALDING CHILDRENS HOSPITAL
THIS PROCESS WAS NOT PERFORMED

Schedule H, Part V, Section B, Line 20b-GRADY MEMORIAL HOSPITAL
THIS PROCEDURE WAS NOT PART OF ELIGIBILITY PROCESS PER #19 ABOVE

Schedule H, Part V, Section B, Line 20b-HUGHES SPALDING CHILDRENS HOSPITAL
THIS PROCEDURE WAS NOT PART OF THE ELIGIBILITY PROCESS PER #19 ABOVE

Schedule H, Part V, Section B, Line 20c-GRADY MEMORIAL HOSPITAL
THIS PROCEDURE WAS NOT PART OF ELIGIBILITY PROCESS PER #19 ABOVE

Schedule H, Part V, Section B, Line 20d-GRADY MEMORIAL HOSPITAL
THIS PROCEDURE WAS NOT PART OF ELIGIBILITY PROCESS PER #19 ABOVE

Schedule H, Part V, Section B, Line 20d-HUGHES SPALDING CHILDRENS HOSPITAL
THIS PROCESS WAS NOT PERFORMED

Schedule H, Part I, Line 3c
THE FEDERAL POVERTY GUIDELINES (FPF) ARE USED TO DETERMINE THE ELIGIBILITY FOR FREE OR DISCOUNTED CARE WITH 400% OF FPG BEING THE UPPER LIMIT OF QUALIFICATION TO THE PROGRAMS.

Schedule H, Part I, Line 6a
2021 COMMUNITY BENEFIT REPORT WAS NOT DUE FOR RESUBMISSION IN 2021, BUT WAS UPDATED IN 2021.

Schedule H, Part I, Line 7
CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COSTS WERE DETERMINED USING DATA FROM THE AUDITED FINANCIAL STATEMENTS AND THE 2021 FILED MEDICARE AND MEDICAID COST REPORTS

Schedule H, Part II
GRADY IS A MEMBER ORGANIZATION OF THE ATLANTA REGIONAL COLLABORATIVE FOR HEALTH IMPROVEMENT (ARCHI) ARCHI IS AN INTERDISCIPLINARY COALITION WORKING TO I MPROVE THE REGION'S (DEKALB AND FULTON COUNTIES) HEALTH THROUGH A COLLABORATIVE APPROACH TO CHNAS AND SUBSEQUENT HEALTH IMPROVEMENT INITIATIVES. GRADY HOLDS A SEAT ON THE ARCHI STERRING COMMITTEE FOR ONGOING LEADERSHIP AND CONNECTIVITIY TO HEALTH IMPROVEMENT INITIATIVES, AND HAS SIGNED THE ARCHI MEMEBERSHIP AGREEMENT IN SUPPORT OF SUSTAINABILITY AND AN ORGANIZATION STRUCTURE. GRADY ALSO PROVIDES FUNDING TO ARCHI TO SUPPORT THE STAFFING, DATA ANALYTICS, AND PARTNERSHIP BUILDING ACTIVITIES. GRADY CONTINUES TO WORK WITH AND THROUGH ARCHI TO CONDUCT ITS CHNAS IN ORDER TO MAXIMIZE THE IMPACT OF COMMUNITY INVESTMENT IN HEALTH IMPROVEMENT.

Schedule H, Part III, Section A, Line 4
GMHC ALSO INCURS SIGNIFICANT COSTS ASSOCIATED WITH CARE FOR THE UNDER AND UNISURED THAT DO NOT APPLY AND/OR QUALIFY FOR CHARITY CARE ASSISTANCE. GMHC INCURRED BAD DEBT EXPENSE OF APPROXIMATELY $549M VALUED IN GROSS CHARGES. ON LINE 2, THE COST FOR BAD DEBT EXPENSE IS BASED UPON THE PATIENT CARE COST TO CHARGE PERCENTAGE OF 17% OF ACTUAL PROVISION OF $93M IN 2021

Schedule H, Part III, Section B, Line 8
EXPENSES ARE REPORTED FROM THE MEDICARE COST REPORT CMS-2552-86 FOR THE YEAR ENDED 12/31/21

Schedule H, Part III, Section C, Line 9b
THE ORGANIZATION HAS UNIQUE ELIGIBILITY CODES TO EACH PATIENT QUALIFYING FOR CHARITY CARE TO ALLOW IT TO WRITE-OFF THE CHARITY CARE PRIOR TO THE COLLECITON PROCESS.

Schedule H, Part VI, Line 2
IN ADDITION TO GRADY'S CHNA, MANY OF THE COALITIONS THAT GRADY PARTICIPATES IN, OR PARTNERS WITH OUTSIDE ORGANIZATIONS, ALSO ASSESS THE NEEDS OF THEIR COMMUNITIES OR TARGET POPULATIONS. MANY OF WHICH ALIGN OR OVERLAP WITH GRADY'S COMMUNITY, COALITIONS OR PARTNER ORGANIZATIONS WITH ASSESSMENTS THAT ALSO INFORM GRADY'S WORK INCLUDE ARTHUR BLANK FOUNDATION'S WESTSIDE ON THE RISE INITITIVE, ATLANTA BELTLINE PARTNERSHIP, GEORGIA STATE DEPARTMENT OF PUBLIC HEALTH, ATLANTA REGIONAL COMMISSION, UNITED WAY, MERCY CARE, AND THE ATLANTA REGIONAL COMMUNITY FOOD BANK. CONTINUATION FROM SCH H SEC C LINE 11 : Fresh Food Carts (FFCs) also made healthy eating easier for patients at our neighborhood health centers. That program distributed more than 356,000 pounds of produce across 47 events with nearly 12,000 patient visits. Finally, Grady provided more than 12,000 home-delivered meals to over 600 patients after discharge from the hospital. In addition to patients experiencing food insecurity, Grady expanded the service to patients admitted with COVID-19. The medically tailored meals purchased through Open Hand support patient health, food access and safety during a critical recovery period.

Schedule H, Part VI, Line 3
PER STATE REGULATIONS, GMHC PLACES ANNUAL ICTF NOTICES IN THE LOCAL NEWSPAPER AND SIGNAGE IS POSTED, ADVISING PATIENTS OF ALL CHARITY CARE PROGRAMS WITHIN THE ORGANIZATION, BASED ON THE PATIENT'S FINANCIAL CIRCUMSTANCES, AND MEDICAL CONDITION. A FINANCIAL COUNSEOR WILL CONSULT WITH THE PATIENT TO DETERMINE BEST FIT FOR THE CRITERIA OF THE VARIOUS ASSISTANCE PROGRAMS. THE APPROPRIATE APPLICATION IS COMPLETED AND THE FINANCIAL ASSISTANCE PROGRAM IS EXPLAINED TO THE PATIENT SIMULTANEOUSLY.

Schedule H, Part VI, Line 4
GRADY IS THE SAFETY-NET PROVIDER FOR FULTON AND DEKALB COUNTIES, OUR PRIMARY SERVICE AREA. ABOUT 2 MILLION PEOPLE LIVE IN THESE TWO COUNTIES AND THEY ARE YOUNGER AND MORE DIVERSE, WITH A HIGHER PERCENTAGE OF LIMITED ENGLISH-SPEAKING SKILLS, AND ACCORDING TO GRADY'S 2019 CHNA. AFRICAN AMERICANS MAKE UP 54% AND 44% OF THE POPULATION OF DEKALB AND FULTON COUNTIES REPSECTIVELY, AND 16-18% OF RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL, AN INCREASE FROM THE PREVIOUS CHNA. GRADY ALSO PROVIDES SPECIALIZED SERVICES TO THE GREATER METRO AREA, WHICH THE ATLANTA REGIONAL COMMISSION DEFINES AS A 10 COUNTY REGION WITH A TOTAL POPULATION OF 4.7 MILLION. THE REGION CONTINUES TO GROW AND BECOME INCREASINGLY DIVERSE.

Schedule H, Part VI, Line 5
In 2021, Grady participated in a City-wide effort to rapidly rehouse individuals on the housing queue in the City of Atlanta. This collaborative effort led by Partners for HOME included 10 different case management agencies, Open Doors, Project Community Connections Inc. (PCCI), and City of Atlanta. The collaborative housed about 700 clients of the 800 goal in 2021. Three Grady case managers successfully housed 74 households, most of whom were chronically homeless. Grady also employed a Housing Support Navigator to help connect patients experiencing homelessness with various community resources based on the individual's needs. The navigator assists social workers with coordinated entry referrals through the City of Atlanta Continuum of Care's Homeless Management Information System (HMIS), a first for Grady, and a significant improvement in care coordination between the health and homelessness systems. Grady built new skills and capacity to address the housing needs of our patients through this program. In the first 8 months of the program, 323 referrals were reviewed and assessed, 286 patients received resources from the housing support navigator, and 65 patients were connected to a 90-day transitional housing program Grady's Injury Prevention Team continued to work on the statewide expansion of the Cardiff Model, which allows stakeholders to create local maps of where violence occurs by combining anonymous information about the location and timing of violent events reported at the hospital with existing law enforcement records. This information and predictive analysis are then used to develop public health strategies and environmental approaches to address violence. Since 2020, Grady and the Atlanta-based Cardiff team are surveying hospitals and their community partners to assess readiness to implement Cardiff. The team has also been involved in more than 20 conversations with health systems, police departments, city governments, public health partners, and researchers throughout the country that are beginning to implement or are interested in the Cardiff model.

Schedule H, Part VI, Line 6
GRADY TRAINS MORE THAN 1,000 EMORY AND MOREHOUSE INTERNS AND RESIDENTS EACH YEAR.

Schedule H, Part VI, Line 7
GMHC FILES A COMMUNITY BENEFIT REPORT IN GEORGIA