4A (Expenses $ 310029530 including grants of $ 59300) (Revenue $ 399624675)
"PIEDMONT NEWNAN HOSPITAL (""PNH"") IS A 167-BED FACILITY LOCATED IN NEWNAN, GEORGIA, AND IS THE SOLE GENERAL HOSPITAL PROVIDER IN COWETA COUNTY. OVER 400 PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN THE CITY OF NEWNAN AND THE GREATER METROPOLITAN ATLANTA AREA, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2022, THE HOSPITAL HAD 11,431 IN-PATIENT ADMISSIONS WITH A TOTAL OF 56,544 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 59,453 AND OUTPATIENT VISITS TOTALED 94,874. SURGICAL SERVICES WERE PROVIDED TO 8,537 PATIENTS."

SCHEDULE H, PART V, 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 12 STAKEHOLDERS WITHIN THE PIEDMONT NEWNAN 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, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT
https://www.piedmont.org/media/file/Community-Benefit-Needs-Assessment-PNH .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 NEWNAN 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: IMPLEMENTAITON STRATEGIES
THE BOARD OF DIRECTORS FOR PIEDMONT NEWNAN HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE-YEAR PERIOD BEGINNING WITH FY23 ON SEPTEMBER 29, 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-PNH.pdf

SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS
DURING FY22, PIEDMONT NEWNAN 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 NEWNAN 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 NEWNAN 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 HEALTHY 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 $338,191,677, LESS BAD DEBT EXPENSE OF $54,119,548 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. PNH 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. 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 Newnan serves patients from all over northeast Georgia, we consider our community to be Coweta County. We do this in recognition of the direct impact of our tax-exempt status on county residents. In Coweta County, an average 143,260 people lived in the 119.22 square mile area each year between 2015 and 2019.The population density for this area, estimated at 325 persons per square mile, is greater than the national average population density of 92 persons per square mile. The ZIP code with the highest concentration of people was 30263, where 42 percent of the county's population called home. Coweta is mostly urban, as 67 percent of community members live within an urban setting. The ZIP code with the highest concentration of rural population was 30230. Rural populations in Coweta are overwhelmingly white. Coweta County is growing, having seen a 15 percent jump in total population between 2010 and 2020. About 9 percent of the population were veterans in 2020, and nearly half were aged 65 and older. Eleven percent of the population - about 15,732 people - lived with a disability. Most of that population was between the ages of 18 and 64. Between 2015 to 2019, about 71 percent of all Coweta County residents were white, 17.01 percent were African American, 7.01 percent were Hispanic/Latino, 2.22 percent were Asian, and the remaining 4.01 percent were comprised of other races. About 25 percent of the population were 18 or younger, 13.5 percent were over the age of 65, and the remaining population were between the ages of 18-64. About six percent identified as being born outside of the US and approximately half of those do not possess US citizenship status. In 2020, 9.71 percent of the population had no form of insurance. Insurance status and health are inextricably linked. Being uninsured is generally a marker of low-income, as the overwhelming majority of those that are uninsured are also within certain ranges of the Federal Poverty Level. 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, and that's true in Coweta County. In 2020, 86 percent of those that were uninsured were adults aged 18 to 64 in 2020. Approximately 13 percent of teens and children under age 18 were uninsured. As with other indicators, race matters. Approximately 20 percent of Hispanic/Latino populations were uninsured, 27 percent of Asians were uninsured, 12.19 percent of blacks were uninsured, and 7.56 percent of whites were uninsured. Between 2015 and 2019, the median household income was $75,913, which is much 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 8,394 community members at an average wage of $30,128 in 2019 according to the US Department of Commerce. Health care and social assistance is the next largest sector, employing 7,320 workers at an average wage of $64,467. The third largest job sector is government and government enterprises, with 5,812 employed at an average wage of $66,449. According to the 2015-2019 American Community Survey, 77,991 people in the community were part of the labor force, and only 2,251 -- about 3 percent -- were unemployed as of January 2022. This figure has steadily decreased since last year, when in January 2021, 4.2 percent of the labor force was unemployed. When looking back further, the rate is nearly three times less than the unemployment rate in 2012. In Coweta County, like most of the state, minorities are far more likely to live in poverty - at least twice as likely to live in poverty. For example, in 2020, 20 percent of blacks in Coweta County were living at or below poverty, as compared to 8.6 percent of whites. Of the 52,035 total occupied households in Coweta County, 13,080 -- about 25 percent -- of the population live in cost burdened households, in which housing costs are 30 percent or more of total household income. Eighty percent of these households were occupied by renters. Approximately 10.44 percent of households had costs that exceeded 50 percent of the household income, which places the household in significant financial strain. In Coweta County, in 2019, only three of the county's 20 census tracts were food deserts. About 23,969 people lived within these census tracts. These tracts almost directly correspond with census tracts demonstrating retailers who are authorized to take SNAP benefits. In Coweta County, like with 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, 45 percent of the total population in the county have low food access, meaning about 57,146 county residents may struggle to access healthy foods. This is much worse than the state and national rates of 30.89 percent and 22.22 percent, respectively. ZIP code 30277 has the worst rate of low food access at 70.34 percent. In Coweta County, in 2020, about 9.71 percent of the population were uninsured, a figure lower than the state rate 16 percent and the national figure of 8.84 percent. When looking only at adults, the uninsured rate jumps to 15.23 percent. Rates, though, have steadily declined. In 2011, approximately 21 percent of all adults were uninsured. Location matters in Coweta for insurance rates. In ZIP codes 30289 and 30275, uninsurance rates for adults were 42.31 percent and 35.71 percent, respectively. In 2019, only 77.2 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 85.49 percent of adult beneficiaries, which is above 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 all other indicators, race and income play heavily into this. White populations are far more likely to receive preventative care than their nonwhite counterparts (76.5 percent among black populations compared to 86.49 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. Heart disease is the leading cause of death for both women and men in Coweta County, with a disproportionate impact on black populations. In 2020, the age-adjusted death rate was 233.6 persons for every 100,000 people, an increase since our last CHNA, when the data rate was 221.4 per every 100,000 people. When looking at race, there is a stark difference between African American and white populations. Although heart disease leads in county deaths, cancer remains a critical issue within the community. The cancer incidence rate for Coweta County each year, on average between 2014 and 2018, was 477.2 incidences per every 100,000 people, which equates to a diagnosis rate of an average 731 new cases each year. In 2019, 13 percent of adults aged 20 and older had diabetes, which is higher 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. Diabetes itself is often a killer, and leads in causes of deaths for minorities, particularly Hispanic/Latino populations. In 2019, 4 percent of the county's population had a diagnosis of kidney disease, a rate worse than the state and national percentages of 3.22 percent and 3.1 percent, respectively. In 2019, 33.3 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.

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. In FY22, we supported the health of our community through our 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, and 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. We created a Patient and Family and Community Council to provide meaningful input on critical areas of care in recognition of the partnership with our community as key stakeholders in quality of care. In May 2022, we hosted the Council, which provided a platform for receiving and responding to input from patients and families, allowed patients and families an opportunity to understand the healthcare system better, improved the healthcare experience for patients and families and improved safety and quality in care. We provided staff with education on opioid addiction and adopted appropriate non-opioid pain management strategies. Our leadership adopted opioid-sparing pain management order sets in the Emergency Department in June 2020 and began using the ALTO (alternatives to opiates) protocol, which have been shown to decrease opioid use by 38 percent. Patients are now at a lower risk because our electronic medical record (EPIC) flags opioid use, alerting physicians in a pop- up screen when writing discharge narcotics. The system links directly to the Georgia Prescription Drug Monitoring Program (PDMP) website, allowing providers immediate access to review the registry of a patient's-controlled substance history and prevent the prescribing of redundant or excessive opioids. Epic can also flag patient records as being potential abusers, linking them to multiple prescriptions. Additionally, our multi-specialty Clinical Governance Council has developed a program to monitor and educate physicians in opioid prescribing, utilizing specialty and procedure-specific guidelines. We also supported hospital patients with effective recovery treatment and promoted leadership and collaboration with partners in combating opioid use within the community. Programs such as Enhanced Recovery after Surgery (ERAS) are being used throughout Piedmont Healthcare to reduce inappropriate opioid prescriptions post-procedurally. Now, providers aware of opioid use disorders are encouraged to refer to a pain management specialist. Additionally, patients are provided a list of community recovery resources upon discharge. Working with community partners, our pharmacy director co-led the Drug Free Coweta Coalition and is actively involved in staff education. Furthermore, He also leads the Drug Free Coweta taskforce through the multispecialty Clinical Governance Committee to develop post procedural guidelines aimed at reducing opioid prescribing. We provided support services free of charge to cancer patients through Cancer Wellness programming. During FY22, we led 18 classes and services, including art, cooking, exercise, and massage therapy. The center is staffed by one full-time coordinator and one part-time dietitian, along with two volunteers who staff the center for several hours each week. Our participation in FY22 was 2,150 interactions total and have consistently grown year over year. We spent approximately $2,135 in printing costs for the calendar and $91,749 for our programmatic offerings and associated supplies. We continued education and importance of lung cancer screening within the community and within the hospital. Our physicians are educated on the triggers for ordering low dose CT lung screens and are equipped with resource of the electronic medical record, which will automatically flag a patient needing screening. Additionally, lung screening education was provided by a physician-led panel and was made available live via Webex and included Newnan-Coweta Chamber of Commerce members and local community business partners. We also worked to reduce cultural barriers to vital cancer prevention and education for the Latino community and raising awareness through community-based partnerships. Through a continued partnership with the Coweta Samaritan Clinic, we provided free screening mammograms, diagnostic mammograms, and breast ultrasounds for uninsured women. As a result, 117 women received free mammograms in FY22. Additionally, the Samaritan Clinic has a Spanish speaking physician's assistant, Spanish educational materials and posters displayed throughout the clinic, and Spanish educational videos on available on the Samaritan Clinic the website to aid in the reduction of cultural barriers around care. We prioritized recognizing and reducing instances of stroke in our community. We utilize the BE-FAST stroke awareness magnet to teach stroke recognition. The BE-FAST tool defines signs of a stroke as: Balance (sudden dizziness or loss of balance), Eyes (sudden vision loss or double vision), Face (look for an uneven smile), Arm (check if one arm or leg is weak), Speech (listen for slurred speech or difficulty speaking), Time (call 911 right away). The tool comprehension is validated via repeat back method. Additionally, we utilize the Stroke Score Risk Card as an educational tool for awareness of specific modifiable risk factors. The annual cost of this work is $500. We also continued in our efforts in stroke reduction by partnering directly with the community partners. Stroke awareness and blood pressure screenings were done through community outreach efforts including: Coweta Veterans, Meals on Wheels, church health fairs, social media, the Kiwanis Newnan Utilities Health Fair, Hearthside Independent Living, Community Food Bank, Encompass Health Support Group, Region 4 EMS Meeting, GSCC Classes West GA Tech Nursing Students, GSCC EMS Class, Yeager Road Community Resource Center Health Expo, Newnan Utilities Health Fair, and the Coweta County Employees Health and Wellness Fair. Finally, healthy cooking classes were offered virtually to Coweta and Fayette communities through the Piedmont Women's Heart Program. This program focuses on minority and uninsured populations at a greater risk for heart disease through collaboration with the Coweta Samaritan Clinic. Furthermore, a Piedmont cardiologist and advanced practitioner volunteer at the clinic and 72 cardiology patient visits occurred in FY22. Due to the short supply of resources caused by the Covid-19 pandemic, we were limited in their ability to coordinate providing blood pressure monitors to hypertensive low-income patients. However, we facilitated a donation of 250 blood pressure cuffs to Coweta Samaritan Clinic from Yamaha this year. We further extended our community support in FY22 through extensive community outreach efforts. These community outreach efforts included: Chamber Ladies Mamo Day at the PNBHC, Yeager Road Community Resource Center Health Expo, Newnan Utilities Health Fair, Coweta County Employees Health and Wellness Fair, Coweta Veterans, Meals on Wheels, Church Health Fairs, social media, Rotary meetings, Hearthside Independent Living, Community Food Bank, Encompass Health Support Group, Region 4 EMS Meeting, Georgia Stroke Core Curriculum Classes West GA Tech Nursing Students, and Georgia Stroke Core Curriculum EMS Classes. We promoted open communication to our community using social media. In total, four social media posts were published in FY22 and were cross-posted on all social media platform including Twitter, Instagram, LinkedIn, and Facebook. One post celebrated Heart Valve Awareness Day and educated the community on its impact while reinforcing the importance of early detection and treatment. Our other social media posts stressed the importance of physical activity and provided education on the prevalence of heart disease in women and promoted reduced-rate women's heart screenings.

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 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.