4A (Expenses $ 1096400532 including grants of $ 6000) (Revenue $ 1296772714)
"PIEDMONT HOSPITAL (""PH"") IS A 643-BED FACILITY THAT HAS BEEN SERVING THE CITY OF ATLANTA IN FULTON COUNTY, GEORGIA, FOR MORE THAN A CENTURY. OVER 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN THE CITY AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2022, THE HOSPITAL HAD 26,897 IN-PATIENT ADMISSIONS WITH A TOTAL OF 154,757 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 60,617 AND OUTPATIENT VISITS TOTALED 310,627. SURGICAL SERVICES WERE PROVIDED TO 23,394 PATIENTS."

SCHEDULE H, PART V, SECTION B, LINE 5: COMMUNITY REPRESENTATION
AS A PART OF OUR PROCESS, WE INTERVIEWED NEARLY 245 STAKEHOLDERS, POLICY MAKERS AND LAWMAKERS REPRESENTING PUBLIC HEALTH, LOW-INCOME POPULATIONS, MINORITIES, CHRONIC CONDITIONS, OLDER ADULTS, AND OUR COMMUNITIES. THESE INCLUDED 17 STAKEHOLDERS WITHIN THE PIEDMONT ATLANTA COMMUNITY, WHO GAVE THEIR PERSPECTIVES ON COMMUNITY HEALTH THROUGH THE LENS OF THEIR ROLE WITHIN THE COMMUNITY. THESE INTERVIEWS WERE CONDUCTED FOR PEOPLE REPRESENTING THE ENTIRE REGION. SPECIFICALLY, WE INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS AND INDIVIDUALS REPRESENTING OUR MOST VULNERABLE PATIENTS. THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS AND LEADERSHIP FROM ALL 19 HOSPITALS WERE ACTIVELY INFORMED AND ENGAGED THROUGHOUT THIS PROCESS.

SCHEDULE H, PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT
https://www.piedmont.org/media/file/Community-Benefit-Needs-Assessment-PAH .pdf

SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA
IN ADDITION TO MAKING ITS CHNA AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT HOSPITAL SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS.

SCHEDULE H, PART V, LINE 10A: IMPLEMENTATION STRATEGIES WEBSITE
THE BOARD OF DIRECTORS FOR PIEDMONT HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE-YEAR PERIOD BEGINNING WITH FY23 ON SEPTEMBER 20, 2022, WITHIN THE GRACE PERIOD FOLLOWING THE APPROVAL OF THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING LINK IS FOR THE IMPLEMENTATION STRATEGY EFFECTIVE THROUGH JUNE 30, 2025. https://www.piedmont.org/media/file/Community-Benefit-Implementation-Strat egy-PAH.pdf

SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS
DURING FY22, PIEDMONT HOSPITAL CONDUCTED ITS FOURTH CHNA, AGAIN BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT HOSPITAL DETERMINED AND PRIORITIZED THE COMMUNITY HEALTH NEEDS IT WOULD ADDRESS BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND THE AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES NECESSARY TO ADDRESS THE ISSUE. ALL PRIORITIES ARE VIEWED THROUGH THE LENS OF HEALTH DISPARITIES, WITH PARTICULAR ATTENTION PAID TO IMPROVING OUTCOMES FOR THOSE MOST VULNERABLE DUE TO INCOME AND RACE. BASED ON THE CHNA, PIEDMONT HOSPITAL IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, CANCER (3) PROMOTING HEALTH BEHAVIORS TO REDUCE PREVENTABLE CONDITIONS, DISEASES, AND ADDICTION (4) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, HEART DISEASE

SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE POLICY WEBSITES
FINANCIAL ASSISTANCE POLICY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-POLICY.PDF FINANCIAL ASSISTANCE APPLICATION - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-APPLICATION.PDF FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-PLAIN-LANGUAGE-SU MMARY-ENGLISH.PDF

SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS
SCHEDULE H, PART I, LINE 6A PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT We regularly report to the community our community benefit activities in several ways. Each year, we prepare a systemwide community benefit report that is available to the public through publication on our website. We also make available our IRS Form 990 Schedule H on our website and provide copies to anyone upon request. We also provide information on community benefit programming to local, state, and federal lawmakers through our government affairs office and online at piedmont.org.

SCHEDULE H, PART I, LINE 7(F)
PERCENT OF TOTAL EXPENSE THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $1,256,366,774, LESS BAD DEBT EXPENSE OF $99,916,272 FROM FORM 990, PART IX, LINE 24(B).

SCHEDULE H, PART I, LINE 7
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM.

SCHEDULE H, PART III, LINES 2-4
BAD DEBT EXPENSE CALCULATION AND FOOTNOTE The provision for bad debts is based upon leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators. Periodically, leadership assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category. The results of the review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible receivables. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PIEDMONT HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE.

SCHEDULE H, PART III, LINE 8
MEDICARE SHORTFALLS AS COMMUNITY BENEFIT The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing our allowable Medicare cost as reported in the Medicare cost report, which is based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to provide quality healthcare for Medicare patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded from allowable cost in the Medicare Cost Report. We believe our Medicare shortfall reported on Part III, Line 7 of Schedule H, should be considered a community benefit as the IRS community benefit standard includes the provision of care to elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication we operate to promote health in the community. Our policy is to treat Medicare patients, regardless of the extent to which Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by us in honor of our commitment to treat elderly patients. Many of these patients live on a low, fixed income, and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare.

SCHEDULE H, PART III, LINE 9(B)
"COLLECTION PRACTICES INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM (""SCHIP""), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY."

SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION
"While Piedmont Atlanta serves patients from Georgia and beyond, we consider our community to be Fulton County. We do this in recognition of the direct impact of our tax-exempt status on county residents. In Fulton County, 1,051,550 people lived in the 526.69 square mile area in 2020. The population density for this area, estimated at 1,997 persons per square mile, is the densest in the state, predictably. The county is growing, with a 16 percent increase in total population between 2010 and 2020. Hispanic or Latino populations saw the highest jump at 19 percent during that time. Fulton County is almost entirely urban, and only one percent of the population lived in a rural area in 2020. The median age of people living within the county was 35, a little younger than state and national averages. About 22 percent of the population were 18 or younger, 12 percent were over the age of 65, and the rest were between ages of 18-64. Thirteen percent of the population identified as being born outside of the US and seven percent of the total population do not possess US citizenship status. About five percent of county residents were veterans in 2020, and the majority were between the ages of 35 and 54. About 10 percent of the county population lived with a disability in 2020, and most were over the age of 65. About 7 percent of the county's population aged 25 and older had no high school diploma in 2020, an indicator that is relevant as educational attainment is directly tied to positive health outcomes. Black or African American populations were most likely to not hold a high school diploma, at about three times the rate of their white counterparts. Hispanic or Latino populations are twice as likely to not have a high school diploma. In 2020, ten percent of the county's population was uninsured. Being uninsured is generally a marker of low income, and the overwhelming majority of those that are uninsured are also within certain ranges of the Federal Poverty Level (FPL). This means these populations are also likely to face the myriad of other social determinants of health (SDH), like housing and food insecurity. Adults aged 18 to 64 are most likely to be uninsured in Fulton County. In 2020, 14.6 percent of the population was uninsured. Minorities were much more likely to be uninsured. Additionally, nearly 17 percent of the county's population were covered through Medicaid, the state-federal public health insurance program for low-income children and adults. Most of these recipients were low-income children, as 34 percent of all children were enrolled in Medicaid, as compared to eight percent of adults aged 18 to 64 and 17 percent of adults 65 and older. In 2020, the median household income was $72,741, which is above state and national median incomes, which are $61,224 and $64,994, respectively. When broken down by the four dominant races in the community, income disparities are evident among Hispanic/Latino populations. Of employers in the community, in 2020, the largest sector by employment size was professional, scientific, and technical services, which employed 144,719 people at an average wage of $103,009. Government and government enterprises was the next largest sector, employing 109,246 people at an average wage of $93,235. Health care and social assistance was the third largest sector, employing 109,206 people at an average wage of $70,880. As of April 2022, of the 579,202 people included in the labor force, 563,177 were employed, leading to an unemployment rate of 2.8 percent of the county population. This indicator is relevant because unemployment creates financial instability and barriers to access including insurance coverage, health services, healthy food, and other necessities that contribute to poor health status. This rate has steadily dropped since January 2021, when the unemployment rate was 4.6 percent. When looking back further, the rate is nearly four times less than the unemployment rate in 2012. In Fulton County, nearly 51,000 households received SNAP benefits in December 2020, representing 11.91 percent of the total population. The median income of a household receiving SNAP benefits was $23,326, though there is variation among ZIP codes. Of all households in Fulton County in 2020, one-third were cost burdened, meaning their housing costs are 30 percent or more of total household income. Forty-six percent were occupied by renters. Approximately 16 percent of households had costs that exceeded 50 percent of the household income, which places the household in significant financial strain. This is worse than both state and national rates. The county has a food insecurity rate of 16.7 percent, as about 168,680 community members were unsure how they would access adequate food at some point over the last year. Unfortunately, many of these community members are ineligible for public assistance via SNAP, WIC (Special Supplemental Nutrition Program for Women, Infants and Children), free or reduced cost school meals, the Commodity Supplemental Food Program (CSFP), or The Emergency Food Assistance Program (TEFAP). In 2020, of the 44,690 food insecure children in the county, 39 percent were ineligible for public assistance programs. Communities that lack affordable and nutritious food are commonly known as ""food deserts."" There are 44 food desert census tracts within the county, meaning about 209,915 people do not have ready access to healthy foods. Low food access is defined as living more than 0.5 mile from the nearest supermarket, supercenter, or large grocery store. This indicator is relevant because it highlights populations and geographies facing food insecurity. According to the 2019 Food Access Research Atlas database, 30 percent of the county's low-income population in the county have low food access, meaning about 272,000 county residents may struggle to access healthy foods. As with other indicators, the bulk of this is within South Fulton, though more northern parts of the county do see this issue. In 2019, 77 percent of adults aged 18 or older saw a doctor for a routine check-up the previous year, a measure that is on par with both state and national averages. For Medicare recipients, this number increases to 79 percent of adult beneficiaries, which is below both state and national averages. Routine check-ups are a critical component to maintaining good health and identifying conditions that can be treated affordably in a community-based setting. Absent that, even simple-to-treat conditions can escalate to deeper issues, eventually requiring more intensive care, later stage diagnoses, or reduced life expectancy. As with most other indicators, race and income play heavily into this. White populations are far more likely to receive preventative care than their black counterparts (78 percent among black populations compared to 85 percent among white populations), and those with insurance are also much more likely to go to the doctor for a routine check-up than those without insurance. In 2018, about 29 percent of men and 31 percent of women aged 65 and older were up to date on their core preventative services, including routine cancer screenings, vaccinations, and other age-appropriate services. Both statistics are below state and national averages. Heart disease is the leading cause of age-adjusted death in Fulton County. Between 2016 and 2020, there were 6,939 deaths attributed to heart disease. The age-adjusted death rate was 141.6 deaths for every 100,000 people, which is better than both state and national averages, and is a rate that has steadily decreased over the last ten years. There are similar trends with stroke deaths. Between 2016 and 2020, there were 1,941 deaths due to stroke, resulting in an age-adjusted death rate of 41.2 deaths per every 100,000 people. This is between the state and national rates of 43.2 and 37.6 deaths, respectively. As of 2019, approximately 3.1 percent of adults aged 18 and older have had at least one stroke, a statistic slightly better than state and national rates. The concentration of adults that have had a stroke is highest in South Fulton. Among the Medicare population, approximately 4.1 percent have been diagnosed with a stroke as of 2018, a figure that has remained steady over the last decade. The hospitalization rates for heart disease and stroke among Medicare recipients have steadily decreased over the last five years, though they are still high. The cardiovascular disease hospitalization rate in 2018 was 8.6 hospitalizations per every 1,000 Medicare beneficiaries, which is better than the state and national rates of 12.2 and 11.8, respectively. The hospitalization rate for stroke is lower than state and national rates, at 7.6 hospitalizations per every 1,000 Medicare beneficiaries, versus the state rate of 9.3 and the national rate of 8.4. In 2019, 71,300 of the county's adults aged 20 and older had diabetes, equaling 8.8 percent of the county's population, which was l"

SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT
We are not required to file a community benefit report; however, we are required to file with the Georgia Department of Community Health information on our indigent and charity care, as well as our Medicaid and Medicare shortfalls.

SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT
As a designated 501(c)(3) nonprofit hospital, we are required by the Internal Revenue System to conduct a triennial community health needs assessment (CHNA), in accordance with regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, we hope to better understand local health challenges, identify health trends in our community, determine gaps in the current health delivery system and craft a plan to address those gaps and the identified health needs. In FY22, we conducted our fourth triennial CHNA. FY22 also marked the third year of our FY19 Implementation Strategy. The CHNA was led by the Piedmont Healthcare community benefits team and consulting organization Public Goods Group, with input and direction from Piedmont leadership and Piedmont Healthcare's Department of External Affairs. Process The CHNA started with a definition of our community, which is our home county due to the impact of our tax-exempt status. Property taxes make up the largest segment of a hospital's tax exemption, which impacts county revenues. Because of this, we aim to ensure that we are providing ample benefit to our county and its residents. Additionally, we take into consideration patient origin, especially that of our lower-income patients such as those who qualify for financial assistance or receive insurance coverage through Medicaid. Our secondary communities are considered the areas in which we have the highest concentration of patients fitting that criterion, including ones from nearby communities. Once we established our primary and secondary communities, we then conducted an analysis of available public health data. This included resources from: US Census, US Health and Human Services' Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2017, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data were internally sourced. We then interviewed key stakeholders who have a particular expertise or knowledge of our communities. Specifically, we interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, the philanthropic community, mental health agencies, elected officials and individuals representing our most vulnerable patients. An internal survey was also conducted throughout the healthcare system for both clinical and non-clinical employees. Information was gathered on knowledge and understanding of community benefit and current programs, as well as suggestions for how we can better serve our patients and communities. Approximately 1,053 employees spanning the system responded. Additionally, we conducted a community-based survey that was widely advertised to the community. Once both qualitative and quantitative data was gathered, we authored the preliminary report, which was then vetted and reviewed by hospital and health system leadership. In this report, we identified several key community health needs that emerged during the assessment process. The chosen priorities were recommended by the community benefit department with sign-off from hospital and board leadership. The following criteria were used to establish the priorities: - The number of persons affected; - The seriousness of the issue; - Whether the health need particularly affected persons living in poverty or reflected health disparities; and, - Availability of community and/or hospital resources to address the need. All priorities are viewed through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. The priorities we chose reflected a collective agreement on what hospital leadership, staff and the community felt was most important and within our ability to positively impact the issue. Once priorities were approved by the board of directors, we then authored the CHNA and presented our findings and recommendations to the hospital's board of directors for their input and approval. Our priorities A key component of the CHNA is to identify the top health priorities we will address over fiscal years 2023, 2024, and 2025. These priorities will guide our community benefit work. They are, in no order: - Ensure affordable access to health, mental, and dental care - Reduce preventable instances of and deaths from cancer - Promote healthy behaviors to reduce preventable conditions, diseases, and addiction - Reduce preventable instances of and deaths from heart disease With each priority, we work to achieve greater health equity by reducing the impact of poverty and other socioeconomic indicators. This means that health equity is built into each priority, which is demonstrated through our implementation strategies. Our subsequent implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY22 community health needs assessment. The implementation strategy was designed to be executed over a three-year period and included specific metrics by which we would be able to evaluate our work and its impact. The implementation strategy was developed by utilizing community feedback from the assessment in partnership with the system community benefits department, our leadership, and our board of directors. We included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs.

SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY
We understand that not everyone can pay their hospital bill due to their insurance status or a limited income, and because of this, we offer financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices in patient bills, and posted notices in key areas of the hospital. These locations are the emergency room, admitting and registration departments, our business office, and patient financial services offices that are located on site. We also publish and widely publicize a plain language summary of this financial assistance care policy on our website, as well as the full policy. Referral of patients for financial assistance may be made by any staff or medical staff member at the hospital, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We help our partners in understanding the policy, how it relates to their populations, and receive feedback in ways our financial assistance programming could be improved.

SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH
"We actively promote the health of our community through clinic-hospital partnerships; community-based health screenings; educational activities; community building activities; the operation of a 24-hour emergency department available to the entire community; the operation of an emergency room open to all members of the community without regard to ability to pay; a governance board composed of community members; use of surplus revenue for facilities improvement, patient care, medical training, education, and research; the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid; and an open medical staff with privileges available to all qualifying physicians. It's important to note that COVID-19 continued to have a significant impact on our proactive community benefit programs, as most in-person events and classes remained. We continued to create programming that was responsive to the pandemic, including migrating to online platforms for vital community-based programming. That said, there were some programs that remained in-person, including those related to our heart programs. In FY22, we offered numerous proactive community benefit programs meant to boost the health of the community it serves. This includes the provision of laboratory and diagnostic services to two local charitable clinics - the Grant Park Clinic and the Center for Black Women's Wellness - as well as Federally Qualified Health Center Good Samaritan Health Center Atlanta. This came at a total cost of $393,892 in FY22. These clinics are vital lifelines for low-income, uninsured adults in the Atlanta area. The Piedmont Women's Heart program is a holistic wellness program that aims to prevent the onset and support those with cardiovascular disease through high-caliber education and wellness coaching. We target health, nutrition, stress resilience, and intentional movement. Program highlights include Women's Heart, a free program that relies on philanthropic support to promote equity and access for all women, regardless of where they receive their health care. These programs included weekly yoga and meditation classes, monthly hikes, store tours, and nutrition classes. We continued this program in FY22. We also continued our Sixty Plus Services, which is a program of education, support and consultation for Piedmont patients who are 60 years and older and their caregivers. We support healthy aging, maximizing independence through information on care options and costs of care, quality of life through advance care planning and caregiver support through education and counseling. Sixty Plus is available to all community members, regardless of whether they receive care at Piedmont. In FY22, we also provided health professions education to students and residents training to be health professionals. That year, the hospital oversaw training at a cost of $3,345,638. This program is vital in training future health professionals who need that crucial hands-on learning. In June 2022, our leaders welcomed a group of 70 high school students through the nonprofit 21st Century Leaders as to help them learn about healthcare career opportunities. The students came from 50 high schools across the state. Approximately one-third of the students in this program received free or reduced-price lunch and 80 percent were minorities. Employees from all different areas of the hospital participated, as did Chief Executive Officer Patrick M. Battey, M.D., Chief Medical Officer Andy Jaffal, M.D., and Chief Operating Officer Josh Roberts. We also participated in a health fair at the historical Ebenezer Baptist Church, where they distributed COVID test kits and provided blood pressure screenings. Roughly 60 people visited the Piedmont tables. We are a Cristo Rey Atlanta Jesuit High School corporate work-study partner. Each school year, Piedmont sponsors four students, who work mostly in administrative and medical assistant roles. The students spend five workdays a month at Piedmont Atlanta. Cristo Rey ""educates young people of limited economic means."" In FY22, we began a New Parent Support Group. The group is designed to provide an extra layer of support during the first few months of parenthood. It is peer-led, but a registered nurse participates to direct the conversation, as needed. Cohorts meet twice a month for six months, and some cohorts even continue to meet beyond the Piedmont-facilitated group. In FY22, nearly 60 people participated in our New Parent Support Group. Our employees also donated seven extra-large moving boxes worth of self-care and household items to families coming out of homelessness through the United for the Holidays presented by Piedmont donation drive. This drive as well as a related holiday event was in partnership with Atlanta United and Parents Prosper. More than 25 Atlanta-area families in need benefited. Additionally, we donated approximately 4,000 pounds of food through the nonprofit Second Helpings that otherwise would have gone to waste, creating 3,120 meals in 2022. Finally, in FY22, we hosted monthly blood drives with the American Red Cross. A total of 137 units of blood were collected from these drives."

SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM
We are part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 19 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Our community relations team works directly with the community. Our community benefit department oversees the community benefit activities on behalf of all hospitals throughout the system, and this includes conducting the triennial CHNA and subsequent implementation strategy, ensuring the financial assistance policy is communicated to the community, maintaining the community benefit webpage, authoring the community benefit annual report, preparing board materials, developing and executing the community benefit grants program and compiling all community benefit figures. Each hospital and certain departments of Piedmont Healthcare execute community benefit programming, such as our revenue department, which oversees the financial assistance program.