4A (Expenses $ 227411756 including grants of $ 0) (Revenue $ 241785992)
PIEDMONT EASTSIDE HOSPITAL, INC. IS A 281-BED FACILITY LOCATED IN THE CITY OF SNELLVILLE IN GWINNETT COUNTY, GEORGIA. OVER 500 PRIMARY CARE AND SPECIALTY PHYSICIANS OF THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN SNELLVILLE AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2022, THE HOSPITAL HAD 9,347 IN-PATIENT ADMISSIONS WITH A TOTAL OF 58,188 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 47,785 AND OUTPAITENT VISITS TOTALED 51,432. SURGICAL SERVICES WERE PROVIDED TO 4,593 PATIENTS.

SCHEDULE H, PART V, SECTION B, LINES 1 AND 2: NEW HOSPITAL ENTITY
"Piedmont Eastside Hospital, Inc. (""PEM"") was created as a new entity on May 24, 2021 and is the 501(c)(3) tax-exempt parent of Eastside Medical Center LLC, a disregarded entity, which was acquired from HCA Healthcare, a for-profit company. Piedmont filed the PEM Form 1023 application for recognition of exemption under Section 501(c)(3) of the Internal Revenue Code on July 27, 2021, and received its IRS Determination Letter reflecting PEM's status as a 501(c)(3) organization with public charity status 170(b)(1)(A)(iii) on March 21, 2022. The IRS 501(c)(3) status per the Determination Letter is retroactive with an effective date of exemption of May 24, 2021. 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 7 STAKEHOLDERS WITHIN THE PIEDMONT EASTSIDE 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-PEH .pdf

SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA
IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT EASTSIDE MEDICAL CENTER 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 EASTSIDE MEDICAL CENTER APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE-YEAR PERIOD BEGINNING WITH FY23 ON AUGUST 25, 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-PEH.pdf

SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS
DURING FY22, PIEDMONT EASTSIDE MEDICAL CENTER 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 EASTSIDE MEDICAL CENTER 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 EASTSIDE MEDICAL CENTER IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) PROMOTING HEALTHY BEHAVIORS TO REDUCE PREVENTABLE CONDITIONS AND DISEASES

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 $256,843,828, LESS BAD DEBT EXPENSE OF $53,925,230 FROM FORM 990, PART IX, LINE 24(A). 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 DOUBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYER 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. PEH 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 PATIENTS 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 Eastside serves patients from a multi-county area, for purposes of this CHNA, we consider our community to be Gwinnett County. We do this in recognition of the direct impact of our tax-exempt status on county residents. In Gwinnett County, 926,414 people lived in the 430.76 square mile area in 2020. The population density for this area, estimated at 2,151 persons per square mile, is much greater than the state average population density of 181 people per square mile and the national average population density of 92 persons per square mile. The ZIP code with the highest concentration of people was 30044, where 10 percent of the county's population called home. Gwinnett is almost entirely urban, as 99.51 percent live within an urban setting. Gwinnett County is growing, having seen a 19 percent increase in total population between 2010 and 2020. Young adults are moving to the area, with a migration rate of 38 percent between 2010 and 2020. About 6 percent of the population were veterans in 2020, and most were 65 or older. Seven percent of the population - about 65,250 people - lived with a disability. Most of that population were between the ages of 18 and 64. About three-quarters of the population drove alone to work in 2019, and 16 percent of those drove more than an hour each way. Both are figures likely impacted by COVID-19. About 27 percent of the population were 17 or younger, 10 percent were over the age of 65, and the remaining population were between the ages of 18-64. Between 2015 and 2019, about 36 percent of all Gwinnett County residents were white, 27 percent were black or African American, 12 percent were Asian, and 21 percent were Hispanic/Latino. A quarter of the population identified as being born outside of the US and 13 percent of the county's population does not have citizenship status. Between 2015 and 2019, the median household income was $72,787, which is higher than state and national levels, which are $58,700 and $62,843, respectively. When broken down by the four dominant races in the community, income disparities are evident. Of employers in the community, the largest sector by employment size is retail trade, which employed 61,1944 community members at an average annual wage of $35,252 in 2019, according to the US Department of Commerce. Waste management was the second largest sector, with 53,250 people employed at an average annual wage of $29,252. Construction was the third largest sector, with 47,993 people employed at an average annual wage of $38,443. According to the 2015-2019 American Community Survey, 484,306 people in the community were part of the labor force, and only 14,810 -- about 3 percent -- were unemployed as of March 2022. This figure has steadily decreased since last year, when in January 2021, 3.5 percent of the labor force was unemployed. When looking back further, the rate is twice that of the unemployment rate in 2012. In 2020, 14 percent of the county's population lived at or below the Federal Poverty Level (FPL), and 37 percent lived at 200 percent of the FPL. In 2022, the FPL placed a family of four as having a total household income of $27,750. Even when living at twice the FPL, families are likely unable to afford many of life's basics. In Gwinnett County, like most of the state, minorities are more likely to live in poverty. For example, in 2020, 15 percent of Hispanic/Latino populations and 10 percent of blacks were living at or below poverty, as compared to 8 percent of whites. Of the 300,000 total occupied households in Gwinnett County in 2020, about 96,000 -- 32 percent -- of the population live in cost burdened households, in which housing costs are 30 percent or more of total household income. Nearly 15 percent of households had costs that exceeded 50 percent of the household income, which places the household in significant financial strain. In Gwinnett County, in 2019, 18 of the county's 113 census tracts were food deserts, as shown in the map to the right. About 116,000 people lived within these census tracts. These tracts almost directly correspond with census tracts demonstrating retailers who are authorized to take SNAP benefits. In Gwinnett, like in most of the state, those retailers tend to be convenience and discount stores that carry limited, if any, healthy foods. Increasingly, discount stores like Dollar General do have some sort of produce section, but that is inconsistent among communities. 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 2021 Food Access Research Atlas database, nearly 39 percent of the total population in the county have low food access, meaning about 312,922 county residents may struggle to access healthy foods. This is higher than the state rate of 30.89 percent. In 2019, about 76 percent of adults aged 18 or older saw a doctor for a routine check-up the previous year, a measure that is likely over-reported and is lower than both state and national averages. For Medicare recipients, this number jumps to 83 percent of adult beneficiaries, which is above both state and national averages. Heart disease is a leading cause of death for both women and men in Gwinnett County. Between 2016 and 2020, the age-adjusted death rate was 123.4 deaths for every 100,000 people, which is lower than the state and national averages of 178.0 and 164.8 heart-related deaths per 100,000 people, respectively. In 2020, 4.8 percent of adults had a diagnosis with heart disease. Between 2016 and 2020, there were 1,171 deaths due to stroke, representing an age-adjusted death rate of 36 deaths per every 100,000 people. Men are more likely to die from stroke than women, as are black populations. The cardiovascular disease hospitalization rate in 2018 was 8.7 hospitalizations per every 1,000 Medicare beneficiaries, which is lower than the state and national rates of 12.2 and 11.8, respectively. The hospitalization rate for stroke is also below state and national rates, with 7.9 hospitalizations per every 1,000 Medicare beneficiaries, as compared to the state rate of 9.3 and the national rate of 8.4. These hospitalization rates for heart disease and stroke among Medicare recipients have remained relatively steady over the last five years. Although heart disease leads in county deaths, cancer remains a critical issue within the community. The cancer incidence rate for Gwinnett County each year, on average between 2014 and 2018, was 452.8 diagnoses per every 100,000, which equates to an average 3,624 new cases each year. When comparing to state and national average, though, Gwinnett County fares worse when it comes to certain screenings. For example, only 28 percent of female Medicare beneficiaries had a recent mammogram in 2019, which is lower than both state and national averages. When looking at all adults, that figure jumped to 78 percent, which is slightly higher than the state rate. Rates of pap smear tests, though, are lower than state and national rates, with about 83 percent of females 21 to 65 having had a pap smear within the previous three years, when surveyed in 2019. Colorectal screenings are also lower than state and national rates, with only 63 percent of adults having had a colorectal cancer screening at some point in their lives. In 2019, 9.5 percent of county adults aged 20 and older had diabetes, a figure slightly lower than the state rate of 9.8 percent. Diabetes is a prevalent problem in the US, often indicating an unhealthy lifestyle and puts individuals at risk for further health issues. This figure has steadily grown over the years. Among the Medicare population, about 26 percent of beneficiaries have diabetes. In 2019, 2.7 percent of the county's population had a diagnosis of kidney disease, a rate lower than state and national percentages of 3.22 percent and 3.1 percent, respectively. In 2019, 31.2 percent of adults 18 and older reported having high cholesterol of the total population. Too much cholesterol puts you at risk for heart disease and stroke, two of the main causes of death within the county. In 2019, 32 percent of adults 18 and older had a diagnosis of high blood pressure. High blood pressure can damage your arteries by making them less elastic, which decreases the flow of blood and oxygen to your heart and leads to heart disease.

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 - Promote healthy behaviors to reduce preventable conditions and diseases 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. Please note that Piedmont Eastside became a nonprofit organization in August 2021 and therefore did not have a robust community benefit plan in place due to its previous status as a for-profit hospital. In FY22, we conducted several community-facing activities to support cardiovascular health. These included partnering with the Walton County EMS and Gwinnett County Fire to conduct multiple Lunch 'n Learns on heart health. We also provided free blood pressure checks at the Alexander Park Heart Health Walk. Each month, we provided space at no cost for instructors to teach about breastfeeding and how to prepare for a baby's arrival with other expectant moms in the community. The class, which is hosted twice each month, covers ways breastfeeding is beneficial to mom and baby, baby-led feeding, and maintaining milk supply. These classes are held in partnership with health departments throughout Gwinnett, Newton, and Rockdale counties.

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.