4A (Expenses $ 12283316 including grants of $ 1203) (Revenue $ 18567896)
SEE SCHEDULE O

SCHEDULE H, PART V, SECTION B, LINE 3J
"THE 2022 JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDED WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS. THIS CHNA INCLUDED A LITANY OF MULTI-SECTOR CHNA COLLABORATORS INCLUDING INDIVIDUALS, ORGANIZATIONS, AND GOVERNMENTAL AGENCIES THAT WERE CONSULTED AND CONTRIBUTED SPECIAL KNOWLEDGE OF MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS AND/OR EXPERTISE IN PUBLIC HEALTH. THESE HOSPITALS ARE PROUD TO BE PART OF WELLSTAR, THE LARGEST HEALTH SYSTEM IN GEORGIA, KNOWN NATIONALLY FOR ITS INNOVATIVE CARE MODELS, FOCUSED ON IMPROVING QUALITY AND ACCESS TO HEALTHCARE. WELLSTAR ALSO INCLUDES WELLSTAR MEDICAL GROUP, 367 MEDICAL OFFICE LOCATIONS, OUTPATIENT CENTERS, HEALTH PARKS, A PEDIATRIC CENTER, NURSING CENTERS, HOSPICE, HOMECARE, AS WELL AS INPATIENT HOSPITALS: WELLSTAR ATLANTA MEDICAL CENTER, WELLSTAR ATLANTA MEDICAL CENTER SOUTH, WELLSTAR COBB, WELLSTAR DOUGLAS, WELLSTAR KENNESTONE, WELLSTAR NORTH FULTON, WELLSTAR PAULDING, WELLSTAR SPALDING REGIONAL, WELLSTAR SYLVAN GROVE, WELLSTAR WEST GEORGIA, AND WELLSTAR WINDY HILL HOSPITALS. WELLSTAR SPALDING REGIONAL HOSPITAL THE 160-BED WELLSTAR SPALDING REGIONAL HOSPITAL SUPPORTS MORE THAN 110,000 PATIENTS ANNUALLY. FULLY ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION, WELLSTAR SPALDING REGIONAL HOSPITAL'S MEDICAL SPECIALTIES INCLUDE EMERGENCY SERVICES, CARDIAC HEALTH, PRIMARY STROKE CENTER, ORTHOPEDIC & JOINT HEALTH, WOMEN'S SERVICES, AND ONCOLOGY. WELLSTAR SPALDING REGIONAL HOSPITAL ALSO OPERATES SEVERAL SPECIALIZED OUTPATIENT FACILITIES: CENTER FOR REHABILITATION, CENTER FOR SLEEP MEDICINE, AND CENTER FOR WOUND HEALING AND HYPERBARIC MEDICINE. WELLSTAR SPALDING REGIONAL HOSPITAL HAS RECEIVED SEVERAL AWARDS AND RECOMMENDATIONS, INCLUDING MULTIPLE JOINT COMMISSION ACCREDITATIONS AND DISTINCTIONS FROM THE AMERICAN HEART ASSOCIATION, GEORGIA ASSOCIATION OF EMERGENCY MEDICAL SERVICES, AND AMERICAN COLLEGE OF SURGEONS. THE CENTER FOR WOUND HEALING AND HYPERBARIC MEDICINE HAS BEEN NAMED A NATIONAL CENTER OF DISTINCTION. THE PRIMARY STROKE CENTER WAS PRESENTED WITH THE GOLD PLUS TARGET: STROKE HONOR ROLL ELITE AWARD BY THE AMERICAN HEART ASSOCIATION AND THE AMERICAN STROKE ASSOCIATION. THE HOSPITAL'S EMERGENCY MEDICAL SERVICES HAS BEEN NAMED ""BEST IN THE STATEGIVEN THE GOLD AWARD FOR CARDIAC SERVICES FROM THE PRESTIGIOUS AMERICAN HEART ASSOCIATION. WELLSTAR SYLVAN GROVE HOSPITAL WELLSTAR SYLVAN GROVE HOSPITAL, A 25-BED HOSPITAL IN JACKSON, GEORGIA, SUPPORTS THE HEALTH NEEDS OF MORE THAN 15,800 PATIENTS ANNUALLY. SPECIALTIES AT WELLSTAR SYLVAN GROVE HOSPITAL INCLUDE EMERGENCY SERVICES, INPATIENT CENTER FOR REHABILITATION, SWING BEDS, AND DIAGNOSTICS AND PULMONARY EVALUATION PROGRAMS. WELLSTAR SYLVAN GROVE HOSPITAL OFFERS 24- HOUR EMERGENCY SERVICES AND PROVIDES INPATIENT PROGRAMS FOCUSED ON OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPY. PROGRAMS ARE DESIGNED FOR RECOVERY FROM DIVERSE CONDITIONS, INCLUDING JOINT REPLACEMENT, VARIOUS SURGERIES, STROKE, CARDIAC, AND RESISTANT WOUNDS THAT CANNOT BE TREATED THROUGH OUTPATIENT MEANS. THE HOSPITAL ALSO OFFERS POST-ACUTE, EXTENDED CARE AND PERSONALIZED NURSING CARE AND TREATMENT. WELLSTAR SYLVAN GROVE HOSPITAL IS NATIONALLY RECOGNIZED FOR PATIENT SAFETY AND QUALITY AND LOCALLY KNOWN FOR ITS FRIENDLINESS, PERSONALIZED CARE, AND COMMUNITY INVOLVEMENT. IN 2017, WELLSTAR SYLVAN GROVE HOSPITAL WAS NAMED A TOP RURAL HOSPITAL BY THE LEAPFROG GROUP. THE 2010 AFFORDABLE CARE ACT (ACA) REQUIRES ALL NOT-FOR-PROFIT HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEED ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY EVERY THREE YEARS TO BETTER MEET THE HEALTH NEEDS OF UNDER-RESOURCED POPULATIONS LIVING IN THE COMMUNITIES THEY SERVE. WELLSTAR SPALDING REGIONAL HOSPITAL AND WELLSTAR SYLVAN GROVE HOSPITAL SERVE THE SAME GEOGRAPHICAL COMMUNITY AND HAVE CHOSEN TO COMPLETE A JOINT CHNA AND IMPLEMENTATION PLANNING PROCESS. THE COMPREHENSIVE CHNA THAT MEETS INDUSTRY STANDARDS INCLUDING IRS FINAL REGULATIONS OF SECTION 501(R) ENTITLED ""ADDITIONAL REQUIREMENTS FOR CHARITABLE HOSPITALS"" CAN BE ACCESSED HERE: HTTPS://WWW.WELLSTAR.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT"

SCHEDULE H, PART V, SECTION B, LINE 5
GEORGIA HEALTH POLICY CENTER (GHPC) PARTNERED WITH WELLSTAR TO IMPLEMENT A COLLABORATIVE AND COMPREHENSIVE CHNA PROCESS. GHPC, HOUSED WITHIN GEORGIA STATE UNIVERSITY'S ANDREW YOUNG SCHOOL OF POLICY STUDIES, PROVIDES EVIDENCE-BASED RESEARCH, PROGRAM DEVELOPMENT, AND POLICY GUIDANCE LOCALLY, STATEWIDE, AND NATIONALLY TO IMPROVE COMMUNITIES' HEALTH STATUS. WITH MORE THAN 25 YEARS OF SERVICE, GHPC FOCUSES ON SOLUTIONS TO THE TOUGHEST ISSUES FACING HEALTHCARE TODAY, INCLUDING INSURANCE COVERAGE, LONG-TERM CARE, CHILDREN'S HEALTH, AND THE DEVELOPMENT OF RURAL AND URBAN HEALTH SYSTEMS. GHPC HAS BEEN SUPPORTING HOSPITAL PARTNERS IN MEETING THE CHNA COMPONENTS OF IRS REGULATIONS SINCE THEIR INCEPTION IN 2010. INPUT FROM COMMUNITY REPRESENTATIVES & COMMUNITY SOURCES: THE SECONDARY DATA WAS COMPILED FROM A VARIETY OF SOURCES THAT ARE RELIABLE AND REPRESENTATIVE OF THE COMMUNITY SERVED BY WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS. DATA SOURCES INCLUDE, BUT ARE NOT LIMITED TO: - COUNTY HEALTH RANKINGS AND ROADMAPS - EMORY UNIVERSITY'S ROLLINS SCHOOL OF PUBLIC HEALTH'S AIDSVU - GEORGIA BUREAU OF INVESTIGATION - GEORGIA DEPARTMENT OF PUBLIC HEALTH'S ONLINE ANALYTICAL STATISTICAL INFORMATION SYSTEM (OASIS) - GEORGIA RURAL HEALTH INNOVATION CENTER'S GEORGIA HEALTH DATA HUB - HEALTH RESOURCES SERVICES ADMINISTRATION'S HEALTH PROFESSIONAL SHORTAGE AREAS DATABASE - KAISER PERMANENTE'S COMMUNITY HEALTH NEEDS DASHBOARD - TRUVEN HEALTH ANALYTICS' COMMUNITY NEEDS INDEX - U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY SECONDARY DATA WERE ANALYZED AT THE ZIP CODE AND COUNTY LEVEL. MOST PUBLICLY AVAILABLE DATA ARE NOT AVAILABLE AT A SUB-COUNTY LEVEL. WHERE SMALLER DATA POINTS WERE AVAILABLE (I.E. FOR CENSUS TRACTS OR ZIP CODES), THEY WERE INCLUDED. TO BETTER UNDERSTAND THE EXPERIENCE AND NEEDS OF RESIDENTS SERVED BY THE HOSPITALS, SEVERAL TYPES OF PRIMARY DATA WERE COLLECTED. PRIMARY DATA COLLECTION INCLUDED: QUALITATIVE DATA INCLUDED: 1. COVID-19 LOCAL IMPACT SURVEY - GHPC USED A COMPREHENSIVE REVIEW OF LITERATURE PUBLISHED DURING THE COVID-19 PANDEMIC TO CREATE A 20-QUESTION SURVEY TO BETTER UNDERSTAND HOW THE PANDEMIC INFLUENCED THE HEALTH OF COMMUNITIES SERVED BY WELLSTAR HEALTH SYSTEM. NEARLY 1,000 STAKEHOLDERS WERE INVITED TO COMPLETE THE SURVEY. OF THE 204 RESPONSES RECEIVED FOR THE HEALTH SYSTEM, 24 RESPONDENTS REPRESENTED BUTTS, LAMAR, PIKE, AND SPALDING COUNTIES. 2. FOCUS GROUPS WITH RESIDENTS - GHPC RECRUITED AND CONDUCTED ONE FOCUS GROUP AMONG RESIDENTS LIVING IN THE COMMUNITY SERVED BY WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE HOSPITALS. GHPC DESIGNED FACILITATION GUIDES FOR FOCUS GROUP DISCUSSIONS. RESIDENTS WERE RECRUITED USING A THIRD-PARTY RECRUITING FIRM. RECRUITMENT STRATEGIES FOCUSED ON RESIDENTS THAT HAD CHARACTERISTICS REPRESENTATIVE OF THE BROADER COMMUNITY, SPECIFICALLY AREAS THAT EXPERIENCE DISPARITIES AND LOW SOCIOECONOMIC STATUS. THE FOCUS GROUP LASTED APPROXIMATELY 1.5 HOURS, DURING WHICH TIME TRAINED FACILITATORS LED 6 TO 12 PARTICIPANTS THROUGH A DISCUSSION ABOUT THE HEALTH OF THEIR COMMUNITY, HEALTH NEEDS, RESOURCES AVAILABLE TO MEET HEALTH NEEDS, AND RECOMMENDATIONS TO ADDRESS COMMUNITY HEALTH NEEDS. 3. ONE-ON-ONE INTERVIEWS WITH COMMUNITY LEADERS - LEADERS ASKED TO PARTICIPATE IN THE INTERVIEW PROCESS ENCOMPASSED A WIDE VARIETY OF PROFESSIONAL BACKGROUNDS INCLUDING (1) PUBLIC HEALTH EXPERTISE, (2) PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH-RELATED DATA AND (3) REPRESENTATIVES OF UNDERSERVED POPULATIONS. THE INTERVIEWS OFFERED COMMUNITY LEADERS AN OPPORTUNITY TO PROVIDE FEEDBACK ON THE NEEDS OF THE COMMUNITY, SECONDARY DATA RESOURCES, AND OTHER INFORMATION RELEVANT TO THE CHNA. QUALITATIVE DATA WERE GATHERED FROM 24 COMMUNITY LEADERS IN THE AREA SERVED BY THE HOSPITALS. COMMUNITY LEADERS REPRESENTED ORGANIZATIONS SUCH AS BUTTS COLLABORATIVE, GRIFFIN SPALDING COUNTY UNITED WAY, PIKE COLLABORATIVE, SOUTHSIDE MEDICAL CENTER, AMONG OTHERS. EACH INTERVIEW WAS CONDUCTED BY GHPC STAFF AND LASTED APPROXIMATELY 45 MINUTES. ALL RESPONDENTS WERE ASKED THE SAME SET OF QUESTIONS DEVELOPED BY GHPC. THE PURPOSE OF THESE INTERVIEWS WAS FOR COMMUNITY LEADERS TO IDENTIFY HEALTH ISSUES AND CONCERNS AFFECTING RESIDENTS IN THE COMMUNITIES SERVED BY THE HOSPITALS, AS WELL AS WAYS TO ADDRESS CITED CONCERNS. THE WELLSTAR COMMUNITY HEALTH COUNCIL PROVIDED OVERSIGHT AND GUIDANCE TO THE CHNA TEAM BY REVIEWING AND PROVIDING FEEDBACK ON THE ASSESSMENT PROCESS AND INPUTS THROUGHOUT THE ASSESSMENT PROCESS. WELLSTAR SPALDING REGIONAL HOSPITAL AND WELLSTAR SYLVAN GROVE HOSPITAL LEADERSHIP, INCLUDING THE REGIONAL HEALTH BOARD, WERE ALSO ENGAGED TO INFORM THE SERVICE AREA DEFINITION, LIST COMMUNITY LEADERS FOR STAKEHOLDER INTERVIEWS, AND FINAL COMMUNITY HEALTH NEEDS.

SCHEDULE H, PART V, SECTION B, LINE 6A
ORGANIZATIONS INCLUDED IN COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): AS AN INTEGRATED HEALTH SYSTEM, WELLSTAR HEALTH SYSTEM SUBMITTED A JOINT 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT INCLUDED WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE HOSPITALS. THE 2022 CHNA FOR THE HOSPITALS (WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE) DEFINE ITS PRIMARY SERVICE AREA AS ONE COMMUNITY. THIS CONSOLIDATION APPROACH IS SIMILAR TO PAST CHNA REPORTS - INCLUDING WELLSTAR'S 2019 CHNA - AND IMPLEMENTATION STRATEGIES BECAUSE OF WELLSTAR'S SYSTEM-WIDE DELIVERY SYSTEM OF COMMUNITY BENEFIT SERVICES. IN ADDITION, THIS ENHANCES WELLSTAR'S ABILITY TO BEST LEVERAGE ITS ECONOMIES OF SCALE AND SERVICES TO ADDRESS THE PRIORITIZED HEALTH NEEDS OF THE COMMUNITY, ESPECIALLY THE MOST VULNERABLE. FOR THE WELLSTAR HOSPITALS AND ITS COLLABORATIVE COMMUNITY PARTNERS, THE JOINT APPROACH TO ADDRESSING PRIORITY HEALTH NEEDS MAXIMIZES RESOURCES TO ENHANCE CARE ACCESS, STRENGTHENS PARTNERSHIPS FOR SHARED RESPONSIBILITY AND HELPS IMPROVE OVERALL COMMUNITY HEALTH. - THE JOINT WELLSTAR HOSPITAL CHNA REPORT MEETS THE REQUIREMENTS OF SECTION 501(R)(3). - GUIDED AT THE SYSTEM LEVEL, WELLSTAR HOSPITALS SOLICITED THE HELP OF STATE AND LOCAL HEALTH DEPARTMENTS AND KEY INFORMANTS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY AND COLLABORATED IN A FOCUS GROUP TO SOLICIT AND RECEIVE INPUT FROM RESIDENTS, INCLUDING ITS MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. - THE 2022 CHNA REPORT DOCUMENTS THE CHNA PROCESS AND CONTAINS ALL OF THE ELEMENTS DESCRIBED IN THE IRS'S 501(R)(3) SECTION IN THE CODE OF REGULATIONS AS IT RELATES TO COMMUNITY HEALTH NEEDS ASSESSMENTS. - THE WELLSTAR HEALTH SYSTEM BOARD OF TRUSTEES ADOPTED THE JOINT CHNA AND ITS IMPLEMENTATION STRATEGY ON JUNE 2, 2022. - THE JOINT CHNA REPORT IS CLEARLY IDENTIFIED AS APPLYING TO THE HOSPITAL FACILITY. ALL OF WELLSTAR HOSPITALS ARE NOTED ON THE COVER OF THE JOINT CHNA. THE CHNA INCLUDES RELEVANT COUNTY-SPECIFIC PRIMARY AND SECONDARY DATA. - ALL OF THE COLLABORATING HOSPITAL FACILITIES AND ORGANIZATIONS INCLUDED IN THE JOINT CHNA REPORT DEFINE THEIR COMMUNITY TO BE THE SAME. BASED UPON WELLSTAR'S: - SYSTEM-BASED MODEL FOR DELIVERING MOST ALL COMMUNITY BENEFIT SERVICES AND EVALUATING ITS IMPACT (AGAIN, TO LEVERAGE THE ECONOMIES OF SCALE AND SERVICES TO DELIVER PROGRAM THAT ADDRESS THE PRIORITY NEEDS) - OVERLAPPING HOSPITAL - CATCHMENT AREAS - SIMILAR COMMUNITY HEALTH NEEDS' KEY FINDINGS AND THEMES BASED UPON INTENSIVE QUANTITATIVE AND QUALITATIVE DATA AND THE WORK OF THE WELLSTAR COMMUNITY HEALTH COLLABORATIVE TO IDENTIFY THE PRIORITY NEEDS OF THE OVERALL COMMUNITY (REPRESENTATIVES FROM WELLSTAR SERVICES LINES, HOSPITALS, DEPARTMENTS AND THE COMMUNITY STAKEHOLDERS) BASED ON THE SEVERITY OF THE NEED AND ASSETS OF WELLSTAR AND ITS COMMUNITY STAKEHOLDERS AND PARTNERS TO ADDRESS THE NEED.

SCHEDULE H, PART V, SECTION B, LINE 7A
"WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE HOSPITALS SERVE THE SAME GEOGRAPHIC COMMUNITY AND HAVE CHOSEN TO COMPLETE A JOINT CHNA AND IMPLEMENTATION STRATEGIES TO MEET 501(R) REQUIREMENTS. THE CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND ON THE FOLLOWING WEB ADDRESS: WWW.WELLSTAR.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICKING ON ""WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS"". A THREE-YEAR REVIEW CAN BE FOUND AT THE SAME ADDRESS."

SCHEDULE H, PART V, SECTION B, LINE 10A
"WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE HOSPITALS SERVE THE SAME GEOGRAPHIC COMMUNITY AND HAVE CHOSEN TO COMPLETE A JOINT CHNA AND IMPLEMENTATION STRATEGIES TO MEET 501(R) REQUIREMENTS. THE CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND ON THE FOLLOWING WEB ADDRESS: WWW.WELLSTAR.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICKING ON ""WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS"". A THREE-YEAR REVIEW CAN BE FOUND AT THE SAME ADDRESS."

SCHEDULE H, PART V, SECTION B, LINE 11
"PROGRAMS & STRATEGIES TO ADDRESS THE NEEDS OF THE COMMUNITY: WELLSTAR CONTRACTED WITH GEORGIA HEALTH POLICY CENTER (GHPC) TO COLLABORATE ON ITS 2022 CHNA TO IDENTIFY NEEDS AND RESOURCES IN ITS COMMUNITY. GHPC EXAMINED SECONDARY DATA, A LITERATURE REVIEW OF THE IMPACT OF COVID-19 ON COMMUNITY HEALTH, AND CONSIDERED INPUT FROM PUBLIC HEALTH EXPERTS AND COMMUNITY LEADERS AND REPRESENTATIVES. UPON REVIEW OF THE PRIMARY AND SECONDARY DATA, WELLSTAR USED A SET OF CRITERIA, INCLUDING IMPORTANCE TO STAKEHOLDERS, RELATIVE BURDEN, CURRENT CAPACITY, EXISTING COMMUNITY HEALTH INITIATIVES, AND DISPARITIES TO IDENTIFY AND PRIORITIZE THE SIGNIFICANT HEALTH NEEDS FACING THE COMMUNITY. GHPC DOCUMENTED THEM IN A WRITTEN CHNA REPORT AND AN ACCOMPANYING IMPLEMENTATION STRATEGY. FROM THE SIGNIFICANT HEALTH NEEDS IDENTIFIED BY CHNA RESEARCH CONDUCTED, THE FOLLOWING HEALTH NEEDS WERE VALUATED AS PRIORITY FOR ALL HOSPITALS IN WELLSTAR HEALTH SYSTEM: 1. ACCESS TO APPROPRIATE HEALTHCARE 2. BEHAVIORAL HEALTH 3. MATERNAL AND CHILD HEALTH 4. HEALTHY LIVING (INCLUDING ACCESS TO FOOD, PHYSICAL ACTIVITY, AND CHRONIC DISEASE PREVENTION AND MANAGEMENT) 5. HOUSING 6. POVERTY ADDITIONAL NEEDS IN THE WELLSTAR SPALDING AND SYLVAN GROVE HOSPITALS SERVICE AREA 7. SEXUALLY TRANSMITTED DISEASES (HIV/AIDS AND STIS) 8. VIOLENCE AND CRIME 9. EDUCATION 10. TRANSPORTATION 11. INTERNET ACCESS WHEN COMPARED TO 2019, THE 2022 COMMUNITY HEALTH NEEDS FOR WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE HOSPITALS ARE BROADER IN FOCUS AND TAKE INTO CONSIDERATION THE LONG-TERM IMPACT OF THE GLOBAL PANDEMIC. THE 2019 COMMUNITY HEALTH NEEDS DID NOT CHANGE AND ARE INCLUDED IN THE NEWLY STATED 2022 COMMUNITY HEALTH NEEDS. THROUGH THE CHNA PROCESS, THE HEALTH SYSTEM PRIORITIZED AND ESTABLISHED IMPLEMENTATION STRATEGIES FOR SIX PRIORITY AREAS. IMPLEMENTATION STRATEGIES FOR EACH NEED WERE RECOMMENDED DURING KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUPS WITH SENIOR LEADERSHIP. THE STRATEGIES WERE LATER REVIEWED BY WELLSTAR'S SENIOR LEADERSHIP AND VETTED BY THE WELLSTAR BOARD OF TRUSTEES' COMMUNITY ADVOCACY AND ENGAGEMENT COMMITTEE, THE WELLSTAR BOARD OF TRUSTEES AND THE WELLSTAR CENTER FOR HEALTH EQUITY COMMITTEE, THE CONDUITS FOR SYSTEM-WIDE DELIVERY OF EQUITY CENTRIC IMPROVEMENT SERVICES AND EDUCATION. IMPLEMENTATION STRATEGIES WERE ALSO INFORMED BY COMMUNITY MEMBERS WHO ATTENDED A COMMUNITY SUMMIT. DURING THE SUMMIT, GHPC GUIDED ATTENDEES THROUGH A HEALTH NEEDS PRIORITIZATION PROCESS, AND USED GROUP EXERCISES TO SOLICIT INSIGHTS ON STRATEGIES AND PARTNERS WELLSTAR SHOULD ADOPT TO ADDRESS PRIORITIZED HEALTH NEEDS. ACTION AREAS FOR IMPLEMENTATION TO IMPROVE COMMUNITY HEALTH ARE INFLUENCED BY THE FULL SPECTRUM OF THE PUBLIC HEALTH SYSTEM, IN WHICH WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE HOSPITALS PLAY A VITAL ROLE. EACH ACTION AREA IS FACILITATED UNDER WELLSTAR'S CENTER FOR HEALTH EQUITY. WELLSTAR CENTER FOR HEALTH EQUITY: THE PURPOSE OF THE WELLSTAR CENTER FOR HEALTH EQUITY IS TO ACCELERATE OUR STRATEGIC EFFORTS TO ADDRESS THE PRIORITY HEALTH NEEDS OF THE COMMUNITIES WE SERVE. OUR APPROACH INCLUDES COMMUNITY ENGAGEMENT, STRATEGIC PARTNERSHIPS, INTERNAL TRANSFORMATION, CAPACITY BUILDING, AND HEALTH POLICY AND SYSTEM ADVOCACY. THE SIX STRATEGIC DOMAINS FOR THE CENTER FOR HEALTH EQUITY BASED ON INSIGHTS FROM THE 2022 CHNA ARE AS FOLLOWS: 1. ACCESS TO HEALTHCARE 2. BEHAVIORAL HEALTH 3. FOOD ACCCESS AND HEALTHY LIVING 4. HOUSING 5. PEDIATRICS (INFANT AND CHILD HEALTH) 6. WOMEN'S HEALTH (MATERNAL HEALTH) WELLSTAR CENTER FOR HEALTH EQUITY COMMITTEE: WELLSTAR CENTER FOR HEALTH EQUITY COMMITTEE (WCHEC) IS A CROSS-FUNCTIONAL COMMITTEE THAT REPRESENTS MULTIPLE FACETS OF WELLSTAR HEALTH SYSTEM. - IN RESPONSE TO CHNA FINDINGS AND THE DIVERSITY OF WELLSTAR COMMUNITIES, WCHEC WAS EXPANDED TO INCREASE WELLSTAR'S CAPACITY TO SUPPORT THE CENTER FOR HEALTH EQUITY'S STRATEGIES. - BY ENGAGING A MORE DIVERSE SELECTION OF WELLSTAR LEADERSHIP AND SUBJECT MATTER EXPERTS, THE CENTER'S PRIORITIES AND INITIATIVES CAN BEST REFLECT THE CAPACITY OF THE ORGANIZATION TO IMPACT AND MEET THE COMMUNITY'S NEEDS. - THIS EXPANSION ALSO HELPS THE CENTER INCREASE COORDINATION OF EFFORTS, LEVERAGE PARTNERSHIPS AND MAXIMIZE EFFICIENCY AND STRATEGIC ALIGNMENT, WITHIN AND ACROSS WELLSTAR HEALTH SYSTEM. - THIS IS DONE BY WCHEC MEMBERS GUIDING AND INFORMING THE STRATEGIC PLANNING AND IMPLEMENTATION PROCESS FOR GREATER INSTITUTIONAL ALIGNMENT AND IMPACT. THE FOLLOWING DESCRIBES SELECTED STRATEGIES FOR ADDRESSING COMMUNITY NEEDS. WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS HAVE CHOSEN NOT TO DEVELOP A STRATEGY TARGETING POVERTY IN THE COMMUNITIES THEY SERVE BECAUSE THERE ARE MANY CAPABLE COMMUNITY-BASED ORGANIZATIONS AND SOCIAL SERVICE AGENCIES MEETING THE NEEDS OF RESIDENTS EXPERIENCING POVERTY. WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS WILL ADDRESS POVERTY THROUGH MANY OF THE STRATEGIES THEY IMPLEMENT TO ADDRESS EACH OF THE SELECTED PRIORITIES, AND THEY WILL CONTINUE TO PARTNER WITH ORGANIZATIONS AND AGENCIES SERVING RESIDENTS EXPERIENCING POVERTY. 1. ACCESS TO HEALTHCARE - CONTEXT: ACCORDING TO COMMUNITY LEADERS, THERE ARE MANY REASONS FOR POOR ACCESS TO APPROPRIATE HEALTHCARE, INCLUDING LACK OF AFFORDABLE INSURANCE, LACK OF SERVICE PROVIDERS, LACK OF TRUST, AND LACK OF RELIABLE PUBLIC TRANSPORTATION. ACCESS TO COMPREHENSIVE, QUALITY HEALTH CARE SERVICES IS IMPORTANT FOR PROMOTING AND MAINTAINING HEALTH, PREVENTING AND MANAGING DISEASE, REDUCING UNNECESSARY DISABILITY AND PREMATURE DEATH, AND ACHIEVING HEALTH EQUITY. -EXAMPLE WELLSTAR INTERVENTIONS: -COMMUNITY CLINIC NETWORK: WELLSTAR SUPPORTS CARE LINKAGES FOR COMMUNITY RESIDENTS WITH LIMITED HEALTH CARE ACCESS BY MAINTAINING AND CREATING FORMALIZED RELATIONSHIPS WITH COMMUNITY SAFETY-NET CLINICS AND GRADUATE MEDICAL EDUCATION (GME) CLINICS THAT PROVIDE SUBSIDIZED CARE. -COMMUNITY TRANSFORMATION PROGRAM: INCREASING ACCESS TO CARE AND SOCIAL SUPPORT THROUGH TECHNOLOGY; WELLSTAR COMMUNITY HEALTH AND CENTER FOR HEALTH EQUITY FUNDS NON-PROFIT COMMUNITY-BASED PARTNERS TO LEVERAGE TECHNOLOGY TO PRODUCE LONG-TERM, SUSTAINABLE CHANGES IN COMMUNITIES WE SERVE. INITIATIVES ARE TAILORED TO A COMMUNITY NEED AND IN ALIGNMENT WITH EACH PARTNER'S MISSION. AT THE END OF 12 MONTHS, PARTNERS ARE EXPECTED TO DEMONSTRATE IMPROVEMENTS IN: - ACCESS TO HEALTH CARE SO THAT RESIDENTS RECEIVE TIMELY, HIGH-QUALITY, AND CULTURALLY-APPROPRIATE MEDICAL CARE WHEN THEY NEED IT; OR, - ACCESS TO SOCIAL DETERMINANTS OF HEALTH SUPPORT SERVICES SO THAT RESIDENTS RECEIVE TIMELY, HIGH-QUALITY FOOD, EMPLOYMENT, HOUSING, TRANSPORTATION, EDUCATION, AND LEGAL RESOURCES TO IMPROVE DAILY LIVING WHEN THEY NEED IT. -COLORECTAL CANCER SCREENING: IN PARTNERSHIP WITH BLKHLTH AND COTTONELLE, WELLSTAR COMMUNITY HEALTH AND CENTER FOR HEALTH EQUITY DISTRIBUTES HOME COLORECTAL CANCER SCREENING KITS TO AT-RISK COMMUNITY RESIDENTS THROUGH FAITH COMMUNITIES WITHIN THE WELLSTAR CONGREGATIONAL HEALTH NETWORK. RESIDENTS ARE CONNECTED TO FOLLOW-UP RESOURCES IF THEY DO NOT HAVE A HEALTH CARE PROVIDER OR LACK INSURANCE. -MAMMOGRAPHY VOUCHER DISTRIBUTION: PARTNERSHIP WITH THE WELLSTAR FOUNDATION, SUSAN G. KOMEN GREATER ATLANTA AND IT'S THE JOURNEY, INC. PROVIDES FREE MAMMOGRAMS FOR UNDERSERVED WOMEN WITH A FOCUS ON OUTREACH TO AFRICAN AMERICAN AND HISPANIC WOMEN. 2. BEHAVIORAL HEALTH -CONTEXT: SUICIDE IS A PUBLIC HEALTH ISSUE THAT AFFECTS PEOPLE OF ALL AGES, RACES AND ETHNICITIES. DEVASTATING CONSEQUENCES OF THE OPIOID EPIDEMIC INCLUDE INCREASES IN OPIOID MISUSE AND RELATED OVERDOSES. -EXAMPLE WELLSTAR INTERVENTIONS: -CONGREGATIONAL HEALTH NETWORK ""SOUL SUPPORT"" PROGRAM: THIS PROGRAM, COMPRISED OF THREE EVIDENCE-BASED INTERVENTIONS, AIMS TO INCREASE ACCESS TO BEHAVIORAL HEALTH EDUCATION, TRAININGS, AND RESOURCES AT CONGREGATIONS ACROSS THE WELLSTAR SERVICE AREA. -OPIOID TASKFORCE: THREE PHYSICIAN-LED WORK GROUPS COMMITTED TO PREVENTION, TREATMENT AND RECOVERY, TARGET VARIOUS POPULATIONS INTERNALLY (TEAM-BASED) AND EXTERNALLY (COMMUNITY-BASED): (1) PROVIDER AND PATIENT EDUCATION, (2) CLINICAL INITIATIVES AND (3) COMMUNITY AWARENESS AND ENGAGEMENT. -WELLSTAR ZERO SUICIDES INITIATIVE: EQUIPS MENTAL HEALTH PROFESSIONALS AND DIRECT CARE STAFF WITH KNOWLEDGE OF SUICIDALITY SIGNS AND THE NECESSARY NEXT STEPS, IN THE EVENT OF AN UNEXPECTED MENTAL HEALTH EPISODE TO ENSURE PATIENTS ARE SAFE AND PROPERLY SUPPORTED IN CARE AND COMMUNITY. 3. FOOD ACCESS AND HEALTHY LIVING -CONTEXT: UNDERSERVED COMMUNITIES MAY BE FOOD DESERTS IN WHICH THERE IS LIMITED PUBLIC TRANSPORTATION, AND GROCERY STORES ARE LOCATED SEVERAL MILES AWAY. THESE COMMUNITIES ARE ALSO TARGETED BY FAST-FOOD MARKETING. COMMUNITY LEADERS AND RESIDENTS INDICATED THAT THERE ARE BARRIERS TO HEALTHY LIVING, INCLUDING KNOWLEDGE AND ACCESS TO HEALTHY FOOD, AS WELL AS BENEFICIAL AMENITIES. -EXAMPLE WELLSTAR INTERVENTIONS: -MOBILE MARKET: IN NOVEMBER 2020, WELLSTAR LAUNCHED A NEW ""MOBILE MARKET"" COLLABORATION WITH GOODR, A COMMUNITY-BASED ORGANIZATION THAT PROVIDES RE-D"

SCHEDULE H, PART V, SECTION B, LINE 13B
FAP ELIGIBILITY CRITERIA - INCOME LEVEL OTHER THAN FPG: THE HOSPITAL ABIDES BY THE FINANCIAL ASSISTANCE REQUIREMENTS UNDER IRC 501(R)(5). IRC 501(R)(5) REQUIRES HEALTH CARE FACILITIES TO LIMIT THE AMOUNTS CHARGED FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT IS PROVIDED TO INDIVIDUALS ELIGIBLE FOR ASSISTANCE UNDER THE HEALTH CARE FACILITIES FINANCIAL ASSISTANCE POLICY TO NOT MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE. THE HOSPITAL EXTENDS ITS SLIDING SCALE FOR FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBILITY WELL BEYOND THE MINIMUM GOVERNMENT LEVELS TO 300% OF FPG. WELLSTAR HAS CHOSEN TO USE THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES AS THE TRIGGER TO NOT EXCEED IN THE APPLICATION OF THE DISCOUNTS/AMOUNTS CHARGED TO PATIENTS, ON OUR SLIDING SCALE.

SCHEDULE H, PART V, SECTION B, LINE 13H
FAP ELIGIBILITY CRITERIA - OTHER CRITERIA: OTHER SPECIAL CIRCUMSTANCES MAY QUALIFY A PATIENT FOR FULL INDIGENT OR SLIDING SCALE CHARITY BENEFITS. SPECIAL CIRCUMSTANCES MAY INCLUDE BUT NOT LIMITED TO: - PATIENT DECEASED, WITH VERIFICATION THAT THERE IS NO ESTATE. - UNABLE TO CONTACT PATIENT BUT PROPENSITY TO PAY SOFTWARE RETURNS A LOW ABILITY/LOW PROPENSITY DESIGNATION.

SCHEDULE H, PART V, SECTION B, LINE 15E
METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE: IN ORDER TO QUALIFY FOR FINANCIAL ASSISTANCE, COOPERATION WITH WELLSTAR HEALTH SYSTEM HOSPITAL FINANCIAL ASSISTANCE STAFF IS NECESSARY IN IDENTIFYING AND DETERMINING ALTERNATIVE SOURCES OF PAYMENT OR COVERAGE FROM PUBLIC AND PRIVATE PAYMENT PROGRAMS. IN PARTICULAR, ALL APPLICANTS FILING A FAP APPLICATION FOR FINANCIAL ASSISTANCE MUST PROVIDE PROOF OF HOUSEHOLD INCOME AND HOUSEHOLD ASSETS BY PROVIDING ANY OR ALL OF THE FOLLOWING THAT ARE APPLICABLE: - PROVIDE THREE (3) MONTHS OF THE MOST RECENT PAYCHECK STUBS OR A STATEMENT FROM EMPLOYER VERIFYING GROSS WAGES - IRS W-2 ISSUED DURING THE PAST YEAR - MOST RECENT IRS FORM 1040 - MOST RECENT TWO (2) MONTHS OF BANK STATEMENTS FOR EACH CHECKING, SAVINGS, MONEY MARKET OR OTHER BANK OR INVESTMENT ACCOUNT - WRITTEN STATEMENTS FOR THE MOST RECENT TWO (2) MONTHS FOR ALL OTHER INCOME (E.G., UNEMPLOYMENT COMPENSATION, DISABILITY, RETIREMENT, STUDENT LOANS, AWARD LETTER FROM SOCIAL SECURITY OFFICE, CURRENT PROFIT AND LOSS REPORT FOR ALL SELF-EMPLOYED APPLICANTS, ALIMONY DOCUMENTATION, CHILD SUPPORT DOCUMENTATION, ETC.) - UNEMPLOYMENT COMPENSATION DENIAL LETTER - DOCUMENTATION OF ASSET VALUES, INCLUDING, WITHOUT LIMITATION, PROPERTY TAX STATEMENTS, CERTIFICATES OF DEPOSIT, 401K, 403B, IRA AND OTHER INVESTMENT STATEMENTS - CONTRIBUTION STATEMENTS FROM INDIVIDUALS WHO CONTRIBUTE INCOME OR IN-KIND ASSISTANCE TO THE PATIENT. FINANCIAL ASSISTANCE POLICY ELIGIBILITY WILL BE DETERMINED BASED ON A THOROUGH REVIEW OF THE SUBMITTED INFORMATION.

SCHEDULE H, PART V, SECTION B, LINE 16A
THE WELLSTAR HEALTH SYSTEM COMMUNITY FINANCIAL ASSISTANCE POLICY CAN BE FOUND ON ITS WEBSITE: HTTPS://WWW.WELLSTAR.ORG/FINANCIAL-POLICY-AND-PRIVACY-INFO/FINANCIAL-ASSIS TANCE-PROGRAM-POLICY

SCHEDULE H, PART V, SECTION B, LINE 16B
"THE WELLSTAR HEALTH SYSTEM FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND ON ITS WEBSITE: HTTPS://WWW.WELLSTAR.ORG/FINANCIAL-POLICY-AND-PRIVACY-INFO/FINANCIAL-ASSIS TANCE-PROGRAM-POLICY AND CLICKING ""APPLICATION"" IN THE RIGHT NAVIGATION BOX TITLED ""RESOURCES'. A WINDOW WILL APPEAR CONTAINING THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM APPLICATION IN ITS ENTIRETY."

SCHEDULE H, PART V, SECTION B, LINE 16C
THE PLAIN LANGUAGE SUMMARY OF THE WELLSTAR HEALTH SYSTEM FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND ON ITS WEBSITE: HTTPS://WWW.WELLSTAR.ORG/FINANCIAL-POLICY-AND-PRIVACY-INFO/FINANCIAL-ASSIS TANCE-PROGRAM-POLICY

SCHEDULE H, PART V, SECTION B, LINE 16J
PUBLICATION OF THE FINANCIAL POLICY (FAP): IN ADDITION TO THE OTHER METHODS OF POSTING THE FINANCIAL ASSISTANCE POLICY, THE HOSPITAL MAKES AVAILABLE FOR PATIENTS IN ADMISSIONS AND OUTPATIENT REGISTRATION AREAS A PROMINENTLY DISPLAYED SIGN STATING FINANCIAL ASSISTANCE IS AVAILABLE AND A BROCHURE INCLUDING FREQUENTLY ASKED QUESTIONS.

SCHEDULE H, PART V, SECTION B, LINE 20E
ADDITIONAL EFFORTS MADE BEFORE COLLECTIONS ACTION INITIATED: THE HOSPITAL FACILITY ALSO NOTIFIED INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY ONLINE AT: HTTPS://WWW.WELLSTAR.ORG/FINANCIAL-POLICY-AND-PRIVACY-INFO/FINANCIAL-ASSIS TANCE-PROGRAM-POLICY FURTHERMORE, THE HOSPITAL FACILITY UTILIZES A PROPENSITY TO PAY SOFTWARE. INDIVIDUALS WITH A LOW ABILITY/LOW PROPENSITY DESIGNATION MAY QUALIFY FOR FULL INDIGENT OR SLIDING SCALE CHARITY BENEFITS.

SCHEDULE H, PART I, LINE 6A
PUBLICATION OF COMMUNITY BENEFIT REPORT: WELLSTAR SYLVAN GROVE HOSPITAL IS AN AFFILIATE OF WELLSTAR HEALTH SYSTEM, INC. WHICH ON AN ANNUAL BASIS ISSUES A COMMUNITY BENEFIT REPORT. THIS REPORT IS SUBSEQUENTLY DISTRIBUTED IN AND AROUND THE FIVE-COUNTY PRIMARY SERVICE AREA OF THE HEALTH SYSTEM. ON AN ANNUAL BASIS THE HOSPITAL REPORTS ITS COMMUNITY HEALTH BENEFITS REPORT TO THE GEORGIA HOSPITAL ASSOCIATION (GHA). GHA AGGREGATES THE HOSPITAL SPECIFIC REPORTS INTO A STATEWIDE COMMUNITY HEALTH BENEFIT REPORT. THE STATE OF GEORGIA ALSO REQUIRES HOSPITALS TO FILE THE HOSPITAL FINANCIAL SURVEY AND THE INDIGENT CARE TRUST FUND SURVEY SO THAT IT CAN COLLECT INFORMATION ON HOSPITAL FINANCIAL CLASS CATEGORIES AND ALSO TO DETERMINE THE AMOUNT OF UNCOMPENSATED CARE BY HOSPITAL.

SCHEDULE H, PART I, LINE 7
COST TO CHARGE RATIO: FOR PURPOSES OF THE IRS FORM 990, SCHEDULE H, WELLSTAR HEALTH SYSTEM AND AFFILIATES (INCLUDING WELLSTAR SYLVAN GROVE HOSPITAL) HAVE ESTIMATED THE CURRENT YEAR COST TO CHARGE RATIO FOR EACH HOSPITAL AS IT IS REPORTED IN THE ANNUAL COMMUNITY BENEFIT REPORT AND AS IT WILL BE REPORTED IN THE STATE'S ANNUAL HOSPITAL FINANCIAL SURVEY.

SCHEDULE H, PART III, SECTION A, LINE 2
METHODOLOGY USED TO ESTIMATE BAD DEBT: THE REPORTED BAD DEBT CHARGES IS DERIVED FROM UNPAID BALANCES OF PATIENT ACCOUNTS THAT ARE DEEMED UNCOLLECTABLE AFTER 120 DAYS OF COLLECTION EFFORT BY THE HOSPITAL'S PATIENT FINANCIAL SERVICES STAFF. THE UNPAID PATIENT ACCOUNTS ARE THEN SENT TO COLLECTION AGENCIES AND ANY COLLECTED AMOUNT IS DEEMED AS BAD DEBT RECOVERY. THE SOURCE OF THIS DATA IS THE HOSPITAL'S DETAILED FINANCIAL TRIAL BALANCE. THE NET REPORTED BAD DEBT CHARGES ARE THEN MULTIPLIED BY THE HOSPITAL FINANCIAL SURVEY CALCULATED COST TO CHARGE RATIO TO ARRIVE AT THE ESTIMATED BAD DEBT EXPENSE.

SCHEDULE H, PART III, SECTION B, LINE 8
MEDICARE SURPLUS: WELLSTAR SYLVAN GROVE HOSPITAL IS A PROVIDER OF INPATIENT AND OUTPATIENT SERVICES TO MEDICARE PROGRAM BENEFICIARIES AT DETERMINED RATES. WITHOUT THE PARTICIPATION IN THE MEDICARE PROGRAM THESE PATIENTS MAY NOT HAVE HAD CONVENIENT ACCESS TO THOSE SERVICES. THE MEDICARE SURPLUS ON SCHEDULE H, PART III, SECTION B, LINE 7 REPRESENTS THE UNCOMPENSATED DIFFERENCE BETWEEN THE EXPECTED REIMBURSEMENT AND THE MEDICARE CHARGES FOR THOSE SERVICES STATED AT COST. WE DETERMINE A COST TO CHARGE RATIO FOR MEDICARE PATIENTS AS PART OF THE ANNUAL FILING OF THE MEDICARE COST REPORT.

SCHEDULE H, PART III, SECTION C, LINE 9B
COLLECTION PRACTICES: THE POLICY WRITTEN FOR COLLECTION PRACTICES THAT APPLIES TO ALL WELLSTAR HEALTH SYSTEM ENTITIES INCORPORATES GUIDELINES FOR PERSONNEL IN THE ADMISSIONS AND PATIENT ACCESS AREAS TO BE TRAINED IN IDENTIFYING PATIENTS THAT MIGHT QUALIFY FOR FINANCIAL ASSISTANCE. IT IS ALSO THE POLICY OF ALL WELLSTAR FACILITIES TO HAVE AT LEAST ONE EMPLOYEE OR CONTRACTOR AVAILABLE AT ALL TIMES, ESPECIALLY IN THE HOSPITALS WITH EMERGENCY ROOMS, WHO CAN PROVIDE ASSISTANCE WITH THE PAPERWORK NECESSARY TO HELP PATIENTS WHO WOULD QUALIFY FOR GOVERNMENTAL AND OTHER ASSISTANCE PROGRAMS.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL PROVIDES NOTICE OF THE AVAILABILITY OF COMMUNITY FINANCIAL ASSISTANCE THROUGH THE FINANCIAL ASSISTANCE POLICY (FAP) VIA: - SIGNAGE - PATIENT BROCHURE - BILLING STATEMENT - COLLECTION ACTION LETTER - ONLINE AT: HTTPS://WWW.WELLSTAR.ORG/FINANCIAL-POLICY-AND-PRIVACY-INFO/FINANCIAL-ASSIS TANCE-PROGRAM-POLICY WELLSTAR SYLVAN GROVE HOSPITAL PROVIDES ITS PATIENTS WITH HOSPITAL PERSONNEL OR CONTRACTED PERSONNEL WHO ARE TRAINED IN ALL ASPECTS OF GOVERNMENTAL PROGRAMS, PAYMENTS PLANS, CHARITY DISCOUNTS, AND OTHER FINANCIAL ASSISTANCE OFFERED TO ASSIST THEM IN THEIR HOSPITAL BILLS. IF THE PATIENT IS ELIGIBLE FOR FEDERAL OR STATE ASSISTANCE PROGRAMS, A STAFF MEMBER IS KNOWLEDGEABLE IN THE STEPS NECESSARY TO QUALIFY THOSE INDIVIDUALS. IF A PATIENT IS INDIGENT OR CHARITY ELIGIBLE THEY WILL BE OFFERED ASSISTANCE THROUGH THE HOSPITAL'S CHARITY AND INDIGENT CARE POLICY INCLUDING THE STATE'S INDIGENT CARE TRUST FUND. IF THE PATIENT HAS NO OTHER INSURANCE AND FAILS TO QUALIFY FOR INDIGENT CARE ASSISTANCE, THE FINANCIAL COUNSELOR CAN THEN OFFER THE PATIENT AN OPPORTUNITY TO ACCEPT A PAYMENT PLAN WITH DISCOUNTED PAYMENT OPTIONS BASED ON THEIR ABILITY TO PAY IMMEDIATELY OR OVER TIME. ALL PATIENTS ARE AFFORDED THESE OPPORTUNITIES.

SCHEDULE H, PART VI, LINE 5
"PROMOTION OF COMMUNITY HEALTH: WELLSTAR SYLVAN GROVE HOSPITAL, INC. (AFFILIATE OF WELLSTAR HEALTH SYSTEM, INC.) OPERATES AS A CHARITABLE ORGANIZATIONS CONSISTENT WITH THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE ""COMMUNITY BENEFIT STANDARD"" OF IRS RULING 69-545. IN THIS REGARD THE GOVERNING BODY OF THE ORGANIZATION AND/OR ITS PARENT IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY, MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA CONSISTENT WITH THE SIZE AND NATURE OF THE FACILITY; AND THE HOSPITAL PROVIDES CARE TO THE NEEDY MEMBERS OF THE COMMUNITY CONSISTENT WITH ITS CHARITY CARE POLICY. THE HOSPITAL'S EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT OF PATIENT CARE, COMMUNITY BENEFIT ACTIVITIES INCLUDING HEALTH EDUCATION, PREVENTIVE SCREENINGS AND HEALTH FAIRS, RESEARCH, SUBSIDIZED HEALTH SERVICES, AND CHARITY CARE WELLSTAR SYLVAN GROVE HOSPITAL COMMITTED APPROXIMATELY $830,000 IN CAPITAL EXPENDITURES FOR THE YEAR TO MEET THOSE NEEDS."

SCHEDULE H, PART VI, LINE 7
STATE FILING OF COMMUNITY HEALTH BENEFIT REPORT: ON AN ANNUAL BASIS THE HOSPITAL REPORTS ITS COMMUNITY HEALTH BENEFITS REPORT TO THE GEORGIA HOSPITAL ASSOCIATION (GHA). GHA AGGREGATES THE HOSPITAL SPECIFIC REPORTS INTO A STATEWIDE COMMUNITY HEALTH BENEFIT REPORT. THE STATE OF GEORGIA ALSO REQUIRES HOSPITALS TO FILE THE HOSPITAL FINANCIAL SURVEY AND THE INDIGENT CARE TRUST FUND SURVEY SO THAT IT CAN COLLECT INFORMATION ON HOSPITAL FINANCIAL CLASS CATEGORIES AND ALSO TO DETERMINE THE AMOUNT OF UNCOMPENSATED CARE BY HOSPITAL.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: GEORGIA HEALTH POLICY CENTER (GHPC) PARTNERED WITH WELLSTAR TO IMPLEMENT A COLLABORATIVE AND COMPREHENSIVE CHNA PROCESS. GHPC, HOUSED WITHIN GEORGIA STATE UNIVERSITY'S ANDREW YOUNG SCHOOL OF POLICY STUDIES, PROVIDES EVIDENCE-BASED RESEARCH, PROGRAM DEVELOPMENT, AND POLICY GUIDANCE LOCALLY, STATEWIDE, AND NATIONALLY TO IMPROVE COMMUNITIES' HEALTH STATUS. WITH MORE THAN 25 YEARS OF SERVICE, GHPC FOCUSES ON SOLUTIONS TO THE TOUGHEST ISSUES FACING HEALTHCARE TODAY, INCLUDING INSURANCE COVERAGE, LONG-TERM CARE, CHILDREN'S HEALTH, AND THE DEVELOPMENT OF RURAL AND URBAN HEALTH SYSTEMS. GHPC HAS BEEN SUPPORTING HOSPITAL PARTNERS IN MEETING THE CHNA COMPONENTS OF IRS REGULATIONS SINCE THEIR INCEPTION IN 2010. INPUT FROM COMMUNITY REPRESENTATIVES & COMMUNITY SOURCES: THE SECONDARY DATA WAS COMPILED FROM A VARIETY OF SOURCES THAT ARE RELIABLE AND REPRESENTATIVE OF THE COMMUNITY SERVED BY WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS. DATA SOURCES INCLUDE, BUT ARE NOT LIMITED TO: - COUNTY HEALTH RANKINGS AND ROADMAPS - EMORY UNIVERSITY'S ROLLINS SCHOOL OF PUBLIC HEALTH'S AIDSVU - GEORGIA BUREAU OF INVESTIGATION - GEORGIA DEPARTMENT OF PUBLIC HEALTH'S ONLINE ANALYTICAL STATISTICAL INFORMATION SYSTEM (OASIS) - GEORGIA RURAL HEALTH INNOVATION CENTER'S GEORGIA HEALTH DATA HUB - HEALTH RESOURCES SERVICES ADMINISTRATION'S HEALTH PROFESSIONAL SHORTAGE AREAS DATABASE - KAISER PERMANENTE'S COMMUNITY HEALTH NEEDS DASHBOARD - TRUVEN HEALTH ANALYTICS' COMMUNITY NEEDS INDEX - U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY SECONDARY DATA WERE ANALYZED AT THE ZIP CODE AND COUNTY LEVEL. MOST PUBLICLY AVAILABLE DATA ARE NOT AVAILABLE AT A SUB-COUNTY LEVEL. WHERE SMALLER DATA POINTS WERE AVAILABLE (I.E. FOR CENSUS TRACTS OR ZIP CODES), THEY WERE INCLUDED. TO BETTER UNDERSTAND THE EXPERIENCE AND NEEDS OF RESIDENTS SERVED BY THE HOSPITALS, SEVERAL TYPES OF PRIMARY DATA WERE COLLECTED. PRIMARY DATA COLLECTION INCLUDED: QUALITATIVE DATA INCLUDED: 1. COVID-19 LOCAL IMPACT SURVEY - GHPC USED A COMPREHENSIVE REVIEW OF LITERATURE PUBLISHED DURING THE COVID-19 PANDEMIC TO CREATE A 20-QUESTION SURVEY TO BETTER UNDERSTAND HOW THE PANDEMIC INFLUENCED THE HEALTH OF COMMUNITIES SERVED BY WELLSTAR HEALTH SYSTEM. NEARLY 1,000 STAKEHOLDERS WERE INVITED TO COMPLETE THE SURVEY. OF THE 204 RESPONSES RECEIVED FOR THE HEALTH SYSTEM, 24 RESPONDENTS REPRESENTED BUTTS, LAMAR, PIKE, AND SPALDING COUNTIES. 2. FOCUS GROUPS WITH RESIDENTS - GHPC RECRUITED AND CONDUCTED ONE FOCUS GROUP AMONG RESIDENTS LIVING IN THE COMMUNITY SERVED BY WELLSTAR SPALDING REGIONAL AND WELLSTAR SYLVAN GROVE HOSPITALS. GHPC DESIGNED FACILITATION GUIDES FOR FOCUS GROUP DISCUSSIONS. RESIDENTS WERE RECRUITED USING A THIRD-PARTY RECRUITING FIRM. RECRUITMENT STRATEGIES FOCUSED ON RESIDENTS THAT HAD CHARACTERISTICS REPRESENTATIVE OF THE BROADER COMMUNITY, SPECIFICALLY AREAS THAT EXPERIENCE DISPARITIES AND LOW SOCIOECONOMIC STATUS. THE FOCUS GROUP LASTED APPROXIMATELY 1.5 HOURS, DURING WHICH TIME TRAINED FACILITATORS LED 6 TO 12 PARTICIPANTS THROUGH A DISCUSSION ABOUT THE HEALTH OF THEIR COMMUNITY, HEALTH NEEDS, RESOURCES AVAILABLE TO MEET HEALTH NEEDS, AND RECOMMENDATIONS TO ADDRESS COMMUNITY HEALTH NEEDS. 3. ONE-ON-ONE INTERVIEWS WITH COMMUNITY LEADERS - LEADERS ASKED TO PARTICIPATE IN THE INTERVIEW PROCESS ENCOMPASSED A WIDE VARIETY OF PROFESSIONAL BACKGROUNDS INCLUDING (1) PUBLIC HEALTH EXPERTISE, (2) PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH-RELATED DATA AND (3) REPRESENTATIVES OF UNDERSERVED POPULATIONS. THE INTERVIEWS OFFERED COMMUNITY LEADERS AN OPPORTUNITY TO PROVIDE FEEDBACK ON THE NEEDS OF THE COMMUNITY, SECONDARY DATA RESOURCES, AND OTHER INFORMATION RELEVANT TO THE CHNA. QUALITATIVE DATA WERE GATHERED FROM 24 COMMUNITY LEADERS IN THE AREA SERVED BY THE HOSPITALS. COMMUNITY LEADERS REPRESENTED ORGANIZATIONS SUCH AS BUTTS COLLABORATIVE, GRIFFIN SPALDING COUNTY UNITED WAY, PIKE COLLABORATIVE, SOUTHSIDE MEDICAL CENTER, AMONG OTHERS. EACH INTERVIEW WAS CONDUCTED BY GHPC STAFF AND LASTED APPROXIMATELY 45 MINUTES. ALL RESPONDENTS WERE ASKED THE SAME SET OF QUESTIONS DEVELOPED BY GHPC. THE PURPOSE OF THESE INTERVIEWS WAS FOR COMMUNITY LEADERS TO IDENTIFY HEALTH ISSUES AND CONCERNS AFFECTING RESIDENTS IN THE COMMUNITIES SERVED BY THE HOSPITALS, AS WELL AS WAYS TO ADDRESS CITED CONCERNS. THE WELLSTAR COMMUNITY HEALTH COUNCIL PROVIDED OVERSIGHT AND GUIDANCE TO THE CHNA TEAM BY REVIEWING AND PROVIDING FEEDBACK ON THE ASSESSMENT PROCESS AND INPUTS THROUGHOUT THE ASSESSMENT PROCESS. WELLSTAR SPALDING REGIONAL HOSPITAL AND WELLSTAR SYLVAN GROVE HOSPITAL LEADERSHIP, INCLUDING THE REGIONAL HEALTH BOARD, WERE ALSO ENGAGED TO INFORM THE SERVICE AREA DEFINITION, LIST COMMUNITY LEADERS FOR STAKEHOLDER INTERVIEWS, AND FINAL COMMUNITY HEALTH NEEDS.

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: WELLSTAR HEALTH SYSTEM, THE LARGEST HEALTH SYSTEM IN GEORGIA, IS KNOWN NATIONALLY FOR ITS INNOVATIVE CARE MODELS, FOCUSED ON IMPROVING QUALITY AND ACCESS TO HEALTHCARE. WELLSTAR CONSISTS OF WELLSTAR MEDICAL GROUP, 367 MEDICAL OFFICE LOCATIONS, OUTPATIENT CENTERS, HEALTH PARKS, A PEDIATRIC CENTER, NURSING CENTERS, HOSPICE, HOMECARE, AS WELL AS 11 INPATIENT HOSPITALS: WELLSTAR ATLANTA MEDICAL CENTER, WELLSTAR ATLANTA MEDICAL CENTER SOUTH, WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER (ANCHORED BY WELLSTAR KENNESTONE HOSPITAL), WELLSTAR WEST GEORGIA MEDICAL CENTER, AND WELLSTAR COBB, DOUGLAS, NORTH FULTON, PAULDING, SPALDING REGIONAL, SYLVAN GROVE AND WINDY HILL HOSPITALS. AS A NOT-FOR-PROFIT, WELLSTAR CONTINUES TO REINVEST IN THE HEALTH OF THE COMMUNITIES IT SERVES WITH NEW TECHNOLOGIES AND TREATMENTS. FOR MORE INFORMATION, VISIT: HTTPS://WWW.WELLSTAR.ORG

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: WELLSTAR SPALDING REGIONAL AND SYLVAN GROVE HOSPITALS ARE LOCATED IN GRIFFIN AND JACKSON, GEORGIA, RESPECTIVELY, APPROXIMATELY 40-45 MILES SOUTH OF ATLANTA. FOR THE PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE PRIMARY SERVICE AREA FOR THE HOSPITAL IS DEFINED AS THE SIX ZIP CODES FROM WHICH 75 PERCENT OF DISCHARGED INPATIENTS ORIGINATED DURING THE PREVIOUS YEAR. THE ZIP CODES ARE FROM BUTTS, LAMAR, PIKE, AND SPALDING COUNTIES, WITH ONE ZIP CODE FROM CLAYTON COUNTY ROUNDING OUT THE HOSPITAL SERVICE AREA. THE AREA DEFINITION WAS VERIFIED BY WELLSTAR COMMUNITY HEALTH COUNCIL MEMBERS. THE COMMUNITY HEALTH NEEDS ASSESSMENT CONSIDERS THE POPULATION OF RESIDENTS LIVING IN THE SIX RESIDENTIAL ZIP CODE AREAS REGARDLESS OF THE USE OF SERVICES PROVIDED BY WELLSTAR OR ANY OTHER PROVIDER. MORE SPECIFICALLY, THIS ASSESSMENT FOCUSES ON RESIDENTS IN THE SERVICE AREA WHO ARE MEDICALLY UNDER-RESOURCED OR AT RISK OF POOR HEALTH OUTCOMES. THE REFERENCED ZIP CODES ARE AS FOLLOWS: 30204, 30223, 30224, 30228, 30233, AND 30292. COMPARED TO THE STATE, THE SERVICE AREA HAS AN OLDER POPULATION, WITH 16.7 PERCENT OF THE SERVICE AREA'S POPULATION 65 YEARS OLD OR OLDER. THE MEDIAN AGE IS 38 TO 40 YEARS OLD, COMPARED TO 36.7 YEARS OLD AT THE STATE LEVEL. THE SERVICE AREA IS ALSO LESS DIVERSE COMPARED TO THE STATE, WITH 65 PERCENT WHITE (COMPARED TO 52 PERCENT FOR THE STATE). WITHIN THE SERVICE AREA, PIKE COUNTY'S POPULATION IS 86.9 PERCENT WHITE. SPALDING COUNTY IS HOME TO THE LARGEST HISPANIC POPULATION WHEN COMPARED TO THE SERVICE AREA, THOUGH SMALLER THAN STATE AVERAGE (4.6 PERCENT VS. 3.6 AND 9.5 PERCENT, RESPECTIVELY). THE SERVICE AREA HAS A LOWER POPULATION WITH LIMITED ENGLISH PROFICIENCY (1.2 PERCENT) THAN THE STATE (3.0 PERCENT). THE COUNTIES IN THE SERVICE AREA HAVE LOWER MEDIAN INCOMES THAN THE STATE ($58,700) WITH THE EXCEPTION OF PIKE COUNTY ($64,878), WHERE THE MEDIAN INCOME IS HIGHER. TOTAL POPULATION: -BUTTS COUNTY: 24,090 -LAMAR COUNTY: 18,672 -PIKE COUNTY: 18,327 -SPALDING COUNTY: 65,306 INCOME DISTRIBUTION (2015-19): BUTTS COUNTY MEDIAN INCOME: $43,471 -LESS THAN $15,000: 13.5% -$15,000 - 24,999: 11.5% -$25,000 - 34,999: 12.7% -$35,000 - 49,999: 14.0% -$50,000 - 74,999: 10.5% -$75,000 - 99,999: 18.1% -OVER $100,000: 14.1% LAMAR COUNTY MEDIAN INCOME: $44,846 -LESS THAN $15,000: 18.9% -$15,000 - 24,999: 11.6% -$25,000 - 34,999: 9.8% -$35,000 - 49,999: 13.5% -$50,000 - 74,999: 18.6% -$75,000 - 99,999: 11.9% -OVER $100,000: 15.7% PIKE COUNTY MEDIAN INCOME: $64,878 -LESS THAN $15,000: 11.0% -$15,000 - 24,999: 6.5% -$25,000 - 34,999: 7.5% -$35,000 - 49,999: 13.9% -$50,000 - 74,999: 18.5% -$75,000 - 99,999: 14.7% -OVER $100,000: 28.0% SPALDING COUNTY MEDIAN INCOME: $47,111 -LESS THAN $15,000: 12.9% -$15,000 - 24,999: 11.0% -$25,000 - 34,999: 11.7% -$35,000 - 49,999: 16.5% -$50,000 - 74,999: 19.9% -$75,000 - 99,999: 12.0% -OVER $100,000: 15.9% AGE DISTRIBUTION: -BUTTS COUNTY MEDIAN AGE: 38.4 -0 - 17: 20.5% -18 - 64: 64.1% -65 +: 15.4% -LAMAR COUNTY MEDIAN AGE: 38.1 -0 - 17: 20.9% -18 - 64: 62.4% -65 +: 16.8% -PIKE COUNTY MEDIAN AGE: 40.5 -0 - 17: 23.5% -18 - 64: 61.0% -65 +: 15.5% -SPALDING COUNTY MEDIAN AGE: 38.9 -0 - 17: 23.8% -18 - 64: 58.5% -65 +: 17.7% RACE/ETHNIC DISTRIBUTION: BUTTS COUNTY -BLACK: 28.9% -ASIAN: 0.4% -HISPANIC: 3.3% -NON-HISPANIC WHITE: 66.1% -LIMITED ENGLISH: 1.2% LAMAR COUNTY -BLACK: 29.4% -ASIAN: 0.5% -HISPANIC: 2.5% -NON-HISPANIC WHITE: 65.2% -LIMITED ENGLISH: 0.6% PIKE COUNTY -BLACK: 8.9% -ASIAN: 0.5% -HISPANIC: 1.6% -NON-HISPANIC WHITE: 86.9% -LIMITED ENGLISH: 0.6% SPALDING COUNTY -BLACK: 34.1% -ASIAN: 1.0% -HISPANIC: 4.6% -NON-HISPANIC WHITE: 58.5% -LIMITED ENGLISH: 1.6%