4A (Expenses $ 692341348 including grants of $ 3360512) (Revenue $ 762164852)
SAINT ALPHONSUS REGIONAL MEDICAL CENTER (SARMC) IS A MEDICAL-SURGICAL/ACUTE CARE HOSPITAL LOCATED IN BOISE, IDAHO, WHOSE HISTORY STARTS OVER 100 YEARS AGO. SARMC SERVES RESIDENTS THROUGHOUT SOUTHWEST IDAHO, EASTERN OREGON AND NORTHERN NEVADA. SARMC OFFERS A FULL RANGE OF SERVICES IN AN INPATIENT AND OUTPATIENT SETTING AS WELL AS 24-HOUR EMERGENCY CARE, SURGICAL SERVICES, CANCER CARE, BREAST CARE, BRAIN INJURY PROGRAM, PEDIATRICS, SPINE CARE, AND STROKE CENTER AS WELL AS MANY OTHER SERVICES. SARMC OFFERS CONVENIENT ACCESS TO HEALTH CARE SERVICES WITH NUMEROUS HEALTH PLAZAS AND CLINIC LOCATIONS. PLEASE SEE SCHEDULE H AND VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT SERVICES, RECOGNITIONS AND AWARDS: WWW.SAINTALPHONSUS.ORG

SAINT ALPHONSUS REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E:SAINT ALPHONSUS REGIONAL MEDICAL CENTER (SARMC) INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH THIS COMMUNITY-INVOLVED SELECTION PROCESS: 1. AFFORDABLE, SAFE HOUSING AND HOMELESSNESS: AFFORDABLE AND MIXED-INCOME HOUSING DEVELOPMENT AND AVAILABILITY; HOMELESSNESS PREVENTION AND MITIGATION2. WAGES AND JOB AVAILABILITY: MINIMUM WAGE; UNEMPLOYMENT RATES; AVAILABILITY OF JOBS OVER $20/HOUR3. COST OF LIVING: COST OF HOUSING, TRANSPORTATION, FOOD, CHILDCARE, ETC. FOR RESIDENTS; POVERTY AND ALICE RATES4. MENTAL HEALTH AND WELL-BEING AND SUBSTANCE USE: ACCESS AND AVAILABILITY OF MENTAL HEALTH SERVICES; HARMFUL SUBSTANCE, TOBACCO, VAPE AND ELECTRONIC CIGARETTE USE RATES5. ACCESS TO AFFORDABLE HEALTH CARE, INCLUDING BEHAVIORAL AND DENTAL HEALTH: ACCESS TO HEALTH CARE, BEHAVIORAL HEALTH AND ORAL HEALTH CARE; AVAILABILITY OF LINGUISTICALLY AND CULTURALLY APPROPRIATE SERVICES6. EDUCATION, INCLUDING HIGH-QUALITY EARLY CHILDHOOD EDUCATION: ACCESS TO AND AVAILABILITY OF AFFORDABLE, HIGH-QUALITY CHILD EARLY CHILDHOOD EDUCATION (I.E. PRE-K) AS WELL AS K-12 AND POST-SECONDARY EDUCATION OPPORTUNITIES

SAINT ALPHONSUS REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 5: THE CHNA WAS CONDUCTED BETWEEN AUGUST 2019 AND JUNE 2020 IN PARTNERSHIP WITH THE UNITED WAY OF TREASURE VALLEY (UWTV); IT WAS APPROVED BY THE BOARD ON JUNE 19, 2020. UWTV ORGANIZED A COMMUNITY ASSESSMENT SPONSOR GROUP COMPRISED OF SAINT ALPHONSUS HEALTH SYSTEM (SAHS), TRINITY HEALTH TRANSFORMING COMMUNITIES INITIATIVE, AND JPMORGAN CHASE & CO. ADDITIONAL ADVISORY GROUP MEMBERS INCLUDED: IDAHO DEPARTMENT OF HEALTH AND WELFARE, CENTRAL DISTRICT HEALTH, SOUTHWEST DISTRICT HEALTH, VALLEY REGIONAL TRANSIT, CITY OF BOISE, CITY OF CALDWELL, GENESIS COMMUNITY HEALTH, CATCH, WOMEN'S AND CHILDREN'S ALLIANCE, AARP-IDAHO, IDAHO HOUSING AND FINANCE ASSOCIATION, IDAHO ASSOCIATION FOR THE EDUCATION OF YOUNG CHILDREN, IDAHO VOICES FOR CHILDREN, ST. LUKE'S HEALTH SYSTEM, WESTERN IDAHO COMMUNITY HEALTH COLLABORATIVE, IDAHO ORAL HEALTH ALLIANCE, IDAHO ANTI-TRAFFICKING COALITION AND UWTV.SAHS AND UWTV CONTRACTED WITH HEALTH RESOURCES IN ACTION TO PROVIDE PROJECT MANAGEMENT AND CONSULTATION AS WELL AS DEVELOPMENT OF DATA COLLECTION TOOLS. IN ADDITION, DATA INDICATORS WERE COLLECTED FROM A VARIETY OF SOURCES, INCLUDING THE TRINITY HEALTH DATA HUB, U.S. CENSUS, IDAHO DEPARTMENT OF HEALTH AND WELFARE, AND IDAHO STATE DEPARTMENT OF EDUCATION. ADDITIONAL SELF-REPORTED DEMOGRAPHICS, HEALTH BEHAVIORS, AS WELL AS OUTCOMES FROM LARGE, POPULATION-BASED SURVEYS SUCH AS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, COUNTY HEALTH RANKINGS, IDAHO VITAL STATISTICS, AND MANY OTHER SECONDARY DATA SOURCES WERE COLLECTED. LITERATURE REVIEW AND SECONDARY DATA SOURCES WERE USED TO SELECT COLLECTIVE MEASURES/INDICATORS IN THE AREAS OF EDUCATION, FINANCIAL INDEPENDENCE, AND HEALTH AT THE REGIONAL, COUNTY AND CITY LEVEL.ADDITIONAL COMMUNITY INPUT WAS COLLECTED BETWEEN AUGUST 2019 AND APRIL 2020 THROUGH 16 COMMUNITY FOCUS GROUPS WITH POPULATIONS SUCH AS IMMIGRANTS AND REFUGEES, NON-ENGLISH SPEAKERS, LGBTQIA+, OLDER ADULTS, PEOPLE EXPERIENCING HOMELESSNESS AND FOOD INSECURITY AND OTHERS, THROUGH 2,526 RESIDENT SURVEYS, AND THROUGH 25 INTERVIEWS WITH COMMUNITY LEADERS, FRONT LINE STAFF, AND SOCIAL SERVICE AND NONPROFIT ORGANIZATIONS. FOCUS GROUP HOSTS INCLUDED THE FOLLOWING ORGANIZATIONS SERVING IMPACTED POPULATIONS: LIFE'S KITCHEN, NOTUS ELEMENTARY, ELMORE COUNTY HEALTH COALITION, INTERNATIONAL RESCUE COMMITTEE, CENTRAL DISTRICT HEALTH YOUTH BEHAVIORAL COMMITTEE, WESTERN IDAHO COMMUNITY ACTION PARTNERSHIP (WICAP), OWYHEE COMMUNITY HEALTH ACTION TEAM, UNITED WAY OF TREASURE VALLEY BUSINESS PARTNERS, IDAHO COMMUNITY HEALTH WORKERS ASSOCIATION, CATCH, JESSE TREE OF IDAHO, BOISE SCHOOL DISTRICT, SACAJAWEA ELEMENTARY, GENESIS COMMUNITY HEALTH PATIENT ADVISORY BOARD, GEM COUNTY COMMUNITY HEALTH ACTION TEAM, LBGTQIA+ VOLUNTEERS, AND MERCY HOUSING SENIOR. COMMUNITY INTERVIEWS INCLUDED THE FOLLOWING ORGANIZATION PARTICIPANTS: ADA COUNTY PARAMEDICS, ADA COUNTY COMMISSIONER, ALLIES LINKED FOR THE PREVENTION OF HIV AND AIDS, BOISE SCHOOL DISTRICT, BOISE STATE UNIVERSITY, BOYS & GIRLS CLUBS ADA, BOYS & GIRLS CLUBS NAMPA, CALDWELL HOUSING AUTHORITY, CATCH, CITY OF BOISE, CITY OF CALDWELL, ECONOMIC OPPORTUNITY-JANNUS, ELMORE COUNTY COMMISSIONERS, GENESIS COMMUNITY HEALTH, GLENNS FERRY, IDAHO ANTI-TRAFFICKING COALITION, IDAHO ASSOCIATION FOR THE EDUCATION OF YOUNG CHILDREN, IDAHO BUSINESS FOR EDUCATION, IDAHO COMMISSION ON AGING, IDAHO FOODBANK, IDAHO HOUSING AND FINANCE ASSOCIATION, IDAHO ORAL HEALTH ALLIANCE, IDAHO SUICIDE PREVENTION HOTLINE, INTERNATIONAL RESCUE COMMITTEE, JESSE TREE OF IDAHO, SOUTHWEST DISTRICT HEALTH, SPEEDY FOUNDATION, VALLEY REGIONAL TRANSIT, WESTERN IDAHO COMMUNITY HEALTH COLLABORATIVE, WICAP HEADSTART, WOMEN'S AND CHILDREN'S ALLIANCE, AND WYAKIN FOUNDATION.

SAINT ALPHONSUS REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH SAINT ALPHONSUS MEDICAL CENTER-NAMPA.

SAINT ALPHONSUS REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 6B: THE CHNA WAS ALSO CONDUCTED IN PARTNERSHIP WITH THE UNITED WAY OF TREASURE VALLEY, TRINITY HEALTH TRANSFORMING COMMUNITIES INITIATIVE AND JPMORGAN CHASE & CO.

SAINT ALPHONSUS REGIONAL MEDICAL CENTER
"PART V, SECTION B, LINE 11: THE CHNA WAS CONDUCTED AND POSTED BY THE END OF FISCAL YEAR 2020; AN UPDATED IMPLEMENTATION STRATEGY WAS ADOPTED IN SEPTEMBER 2020 FOR FISCAL YEARS 2021-2023. THESE DOCUMENTS WILL GUIDE THE COMMUNITY BENEFIT WORK FOR TAX YEARS 2020-2022. SARMC IDENTIFIED FOUR SIGNIFICANT HEALTH NEEDS TO ADDRESS DURING THIS TIME PERIOD. THE IMPLEMENTATION STRATEGY WILL GUIDE HOW EACH OF THESE NEEDS ARE ADDRESSED. IN FISCAL YEAR 2022 (FY22), SARMC DEVELOPED AND/OR SUPPORTED INITIATIVES TO IMPROVE THE FOLLOWING HEALTH NEEDS:AFFORDABLE, SAFE HOUSING AND HOMELESSNESS: IN FY22, SARMC CONTINUED TO SUPPORT NEW PATH AS PART OF THE HOUSING FIRST MODEL, WHICH PROVIDED PERMANENT SHELTER AND SUPPORTIVE SERVICES TO AT LEAST 40 PEOPLE EXPERIENCING CHRONIC HOMELESSNESS. SARMC ALSO SUPPORTED JESSE TREE, WHICH PROVIDES EMERGENCY RENTAL ASSISTANCE, AND HOME PARTNERSHIP FOUNDATION, WHICH WORKS TOWARDS ENDING FAMILY HOMELESSNESS AS WELL AS PROVIDES INCLEMENT WEATHER VOUCHERS FOR HOTEL ROOMS WHEN THE MAIN SHELTERS WERE FULL. SARMC CONTINUES TO MEET REGULARLY WITH CONGREGATE SHELTER PARTNERS, BOISE CITY, AND THE CONTINUUM OF CARE TO ADDRESS COVID-19 CONCERNS, PROVIDE OVERSIGHT TO THE COVID-19 SUPPORTIVE HOTEL FOR FOLKS EXPERIENCING HOMELESSNESS NEEDING A PLACE TO QUARANTINE, AND TO PROVIDE COVID-19 VACCINES TO SHELTER GUESTS THROUGHOUT THE YEAR.COST OF LIVING: IN FY22, SARMC INITIATIVES SUPPORTED THE RIDES 2 WELLNESS PROGRAM IN PARTNERSHIP WITH VALLEY REGIONAL TRANSIT TO PROVIDE TRANSPORTATION FOR HEALTH CARE APPOINTMENTS AT SAINT ALPHONSUS. SARMC ALSO SUPPORTED LOCAL FOOD ACCESS THROUGH FUNDING TO HELP WITH THE EXPANSION OF THE IDAHO FOODBANK'S WAREHOUSE, PARTICIPATED ON THE IDAHO HUNGER RELIEF TASK FORCE, AND FUNDED LIFE'S KITCHEN WHO PROVIDED FOOD SUPPORT FOR PERSONS EXPERIENCING HOMELESSNESS WHO WERE QUARANTINED FOR COVID-19 AT A LOCAL HOTEL. SARMC CONTINUED TO HAVE A MAJOR FOCUS ON THE SOCIAL INFLUENCERS OF HEALTH THAT WERE IDENTIFIED IN THE CHNA, WITH EMPHASIS ON PREVENTING HOMELESSNESS AND ASSISTING WITH TRANSPORTATION ISSUES.MENTAL HEALTH AND WELL-BEING AND SUBSTANCE USE: AS PART OF FY22 INITIATIVES, SARMC OFFERED TOBACCO ""QUIT"" PROGRAMS. A TOBACCO TREATMENT SPECIALIST INCREASES PUBLIC AWARENESS OF TOBACCO, E-CIGARETTE, ALCOHOL AND DRUG USE PREVENTION AND CESSATION, PROMOTES AVAILABLE COMMUNITY RESOURCES (E.G. IDAHO QUITLINE), AND WORKS TO DECREASE COMMUNITY RATES OF TOBACCO AND E-CIGARETTE USE. SAINT ALPHONSUS TOBACCO FREE LIVING CONTINUED TO OFFER ONLINE CESSATION PROGRAMS. IN FY22, SARMC REPRESENTATIVES PARTICIPATED IN THE IDAHO SUICIDE PREVENTION ACTION COLLECTIVE, WHICH COLLABORATED ON THE GOALS AND OBJECTIVES OF THE IDAHO SUICIDE PREVENTION PLAN. SARMC'S FAITH COMMUNITY NURSING AND SCHOOL HEALTH PROGRAMS ALSO CONTINUED TO SUPPORT THE SIGNS OF SUICIDE PROGRAM FOR LOCAL MIDDLE AND HIGH SCHOOL STUDENTS, STAFF, AND PARENTS TO TRAIN THEM TO RECOGNIZE THE SIGNS OF SUICIDE AND PROVIDED RESOURCES TO SEEK HELP. ACCESS TO AFFORDABLE HEALTH CARE, INCLUDING BEHAVIORAL AND DENTAL HEALTH: INITIATIVES IN FY22 INCLUDED SUPPORT OF ACCESS TO MENTAL HEALTH TREATMENT THROUGH ALLUMBAUGH HOUSE, TELEPSYCHIATRY, AND SUPPORT OF OTHER SAFETY NET ORGANIZATIONS LIKE GENESIS COMMUNITY HEALTH. SARMC FOCUSED ON IMPROVING ACCESS TO HEALTH CARE BY REMOVING BARRIERS AND PROVIDING SERVICES FOR THE POOR AND UNDERSERVED THROUGH COMMUNITY PARTNERSHIPS. SARMC SUPPORTED SPECIAL REFUGEE CARE THROUGH ITS CENTER FOR GLOBAL HEALTH AND HEALING AND THE CARE (CULTURALLY APPROPRIATE RESOURCES AND EDUCATION) CLINIC FOR REFUGEE MOTHERS. SARMC ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD NOT EFFECTIVELY FOCUS ON THE TWO REMAINING SIGNIFICANT NEEDS: WAGES AND JOB AVAILABILITY, AND EDUCATION, INCLUDING HIGH-QUALITY EARLY CHILDHOOD EDUCATION. THESE NEEDS WERE NOT ADDRESSED IN FY22 DUE TO LIMITED RESOURCES AND FEASIBILITY OF REASONABLE IMPACT. HOWEVER, SARMC DOES PARTNER WITH SEVERAL ENTITIES IN THE COMMUNITY THAT DO ADDRESS THESE ISSUES."

SAINT ALPHONSUS REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS.

PART V, SECTION B, LINE 7A:
WWW.SAINTALPHONSUS.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-NEEDS-ASSESSMENT/

PART V, SECTION B, LINE 9:
AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC.

PART V, SECTION B, LINE 10A:
WWW.SAINTALPHONSUS.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-NEEDS-ASSESSMENT/IMPLEMENTATION-STRATEGY

PART V, LINE 16A, FAP WEBSITE:
WWW.SAINTALPHONSUS.ORG/FOR-PATIENTS/AFTER-YOUR-VISIT/FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

PART V, LINE 16B, FAP APPLICATION WEBSITE:
WWW.SAINTALPHONSUS.ORG/FOR-PATIENTS/AFTER-YOUR-VISIT/FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:
WWW.SAINTALPHONSUS.ORG/FOR-PATIENTS/AFTER-YOUR-VISIT/FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE/

PART I, LINE 3C:
IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS.

PART I, LINE 6A:
SAINT ALPHONSUS REGIONAL MEDICAL CENTER (SARMC) PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF IDAHO. IN ADDITION, SARMC REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.SARMC ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE.

PART I, LINE 7:
THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.

PART I, LN 7 COL(F):
THE FOLLOWING NUMBER, $25,974,568, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).

PART II, COMMUNITY BUILDING ACTIVITIES:
SARMC STRIVES TO BE A TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. SPECIFIC EXAMPLES OF FY22 COMMUNITY BUILDING ACTIVITIES ARE DESCRIBED BELOW:COMMUNITY SUPPORT: DISASTER READINESS: SARMC WORKED TO ENSURE THAT BOTH THE HOSPITAL AND THE COMMUNITY ARE PREPARED TO RESPOND IN DISASTER SCENARIOS.COALITION BUILDING: SARMC PARTICIPATED IN A VARIETY OF LOCAL BOARDS AND WORK GROUPS AIMED AT IMPROVING THE HEALTH OF OUR COMMUNITY AND MAKING OUR COMMUNITY A MORE LIVABLE PLACE, WHICH INCLUDED ACTIVE PARTICIPATION ON:- FAMILY MEDICINE RESIDENCY OF IDAHO (FMRI) BOARD: SARMC HELPED GUIDE THE CONTINUED DEVELOPMENT AND EXPANSION OF FAMILY MEDICINE RESIDENCY CAPACITY IN IDAHO, WHICH IS A CRITICAL NEED IN OUR STATE. THROUGH THIS PARTNERSHIP, WE WERE ABLE TO SUPPORT A PSYCHIATRIC RESIDENCY PROGRAM BASED IN BOISE. - TREASURE VALLEY YMCA: THE YMCA PROVIDES ACCESS TO LOW-INCOME AND VULNERABLE POPULATIONS FOR FITNESS, YOUTH EMPOWERMENT, AND MORE. THE YMCA ALSO HAS A HEALTHY LIVING CENTER FOR PEOPLE LIVING WITH CHRONIC ILLNESS. - SARMC PARTICIPATED IN SEVERAL OTHER NON-PROFIT BOARDS, SUCH AS AMERICAN HEART ASSOCIATION, FACES (FAMILY JUSTICE CENTER), WOMEN AND CHILDREN'S ALLIANCE (PREVENT DOMESTIC ABUSE), CHILDREN'S HOME SOCIETY (MENTAL HEALTH ASSISTANCE), CATHOLIC CHARITIES OF IDAHO (SOCIAL SERVICE ARM OF THE CHURCH), IDAHO VOICES FOR CHILDREN, IDAHO ASSOCIATION FOR THE EDUCATION OF YOUNG CHILDREN, TOBACCO FREE IDAHO ALLIANCE, IDAHO COMMUNITY HEALTH WORKERS ASSOCIATION, BOISE/ADA COUNTY HOMELESS COALITION, OUR PATH HOME, BOISE CONTINUUM OF CARE, AND WESTERN IDAHO COMMUNITY HEALTH COLLABORATIVE.ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT: SARMC HAS BEEN AN ACTIVE PARTICIPANT IN ADVOCACY FOR HEALTH IMPROVEMENT INITIATIVES SUCH AS:- MENTAL HEALTH ADVOCACY: SARMC PARTICIPATED IN NEW AND ONGOING COLLABORATIVE EFFORTS TO ADDRESS GAPS IN IDAHO'S BEHAVIORAL HEALTH SERVICES, AND HAS ENGAGED PARTICULARLY IN SUICIDE PREVENTION EFFORTS BY ACTIVELY PARTICIPATING IN THE IDAHO SUICIDE PREVENTION ACTION COLLECTIVE THAT HAS ADVANCED STRATEGIC PRIORITIES FOR SUICIDE PREVENTION.- HOUSING AND HOMELESSNESS ADVOCACY: SARMC PARTICIPATED IN A NUMBER OF FEDERAL ADVOCACY ACTIVITIES THIS YEAR TO PROVIDE INFORMATION AROUND HOUSING AND HOMELESSNESS WITH IDAHO CONGRESSIONAL MEMBERS, ADVOCATING FOR ONGOING FEDERAL FUNDING AND SUPPORT FOR AFFORDABLE AND WORKFORCE HOUSING AND FOR OPPORTUNITIES TO CREATE EDUCATIONAL PATHWAYS FOR HEALTH CARE WORKERS. SARMC ALSO SUPPORTED SMALLER HOMELESSNESS PREVENTION PROJECTS, INCLUDING JESSE TREE, WHICH PROVIDES RENTAL ASSISTANCE FOR VULNERABLE FAMILIES, AND THE GOOD SAMARITAN HOME, WHICH PROVIDES LOW-INCOME HOUSING. SARMC PARTICIPATED IN A MONTHLY IDAHO HOUSING WORK GROUP TO DEVELOP POLICY AGENDAS THAT INCLUDED SUPPORT/ADVOCACY FOR FUNDING THE IDAHO STATE HOUSING TRUST FUND FOR THE FIRST TIME SINCE ITS ESTABLISHMENT, AND SEVERAL STATE BILLS TO PROVIDE RENTER PROTECTIONS AND RENTAL ASSISTANCE. ADDITIONAL SARMC ADVOCACY ACTIVITIES WERE PERFORMED TO SUPPORT FUNDING FOR FULL DAY KINDERGARTEN AND PROTECTIONS FOR TELEHEALTH IN LIBRARIES.- COVID-19-SPECIFIC ADVOCACY: SARMC ACTIVELY ADVOCATED FOR PUBLIC POLICY THAT SUPPORTED EVIDENCE-BASED RESPONSE TO THE COVID-19 PANDEMIC AND APPROPRIATE SUPPORT FOR IDAHOANS WHO WERE AFFECTED BY THE PANDEMIC, INCLUDING CHILDCARE, HOUSING, TELEHEALTH AND MORE.

PART III, LINE 2:
METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.

PART III, LINE 3:
SARMC USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, SARMC IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, SARMC IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.

PART III, LINE 9B:
THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS.

PART VI, LINE 7, REPORTS FILED WITH STATES
ID

PART III, LINE 4:
"SARMC IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: ""AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED.""PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE ONE PERCENT SEQUESTRATION REDUCTION FOR THE PERIOD APRIL 1, 2022 THROUGH JUNE 30, 2022."

PART III, LINE 8:
SARMC DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.

PART VI, LINE 2:
"NEEDS ASSESSMENT - SARMC ASSESSED THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND MAKES CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL USED PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.SARMC ALSO EVALUATED INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, CLINICAL AND FINANCIAL DATA TO DETERMINE: (1) WHAT TYPES OF AMBULATORY-SENSITIVE CONDITIONS THAT ARE OTHERWISE PREVENTABLE OR SHOULD BE WELL-MANAGED IN THE COMMUNITY SETTING, ARE TREATED IN THE EMERGENCY ROOM, AND (2) TO WHAT QUANTIFIABLE EXTENT THESE CASES INVOLVE PATIENTS WHO ARE UNINSURED OR UNDER-INSURED. WE BUILT SYSTEMS TO HELP CONNECT THESE MOST ""AT-RISK"" PATIENTS WITH OUR FINANCIAL ASSISTANCE PROGRAMS AND WITH CARE PROVIDERS WHO CAN ASSIST THEM MORE REGULARLY AT A MORE APPROPRIATE LEVEL OF CARE. EVALUATION OF HOSPITAL DATA ON INDIVIDUALS EXPERIENCING HOMELESSNESS LED TO GREATER SUPPORT FOR COMMUNITY EFFORTS TO PREVENT HOMELESSNESS. WE HAVE ALSO INCREASED CARE OUTREACH EFFORTS FOR THOSE WHO ARE EXPERIENCING HOMELESSNESS, AS WELL AS CONNECTING THEM WITH FINANCIAL ASSISTANCE, TO GIVE THEM ACCESS TO CARE FROM BOTH OUR HOSPITAL AS WELL AS OTHER LOCAL HEALTH PROVIDERS.SARMC ALSO UTILIZES THE EXPERTISE OF PUBLIC HEALTH PARTNERS AND THEIR ANALYSIS OF COMMUNITY NEEDS. CHNA.ORG CONTINUES TO BE A GREAT RESOURCE TO THE HEALTH SYSTEM FOR EXAMINING PUBLICLY AVAILABLE DATA. SAHS RECEIVES REGULAR INPUT FROM PEER HEALTH ADVISORS WITHIN THE REFUGEE COMMUNITIES AND IMPLEMENTS PATIENT-FAMILY ADVISORY COUNCILS FOR COMMUNITY INPUT. SARMC ALSO HAS PERIODIC CONVERSATIONS WITH ALIGNED HEALTH CARE AND SOCIAL SUPPORT AGENCIES LIKE CATHOLIC CHARITIES OF IDAHO, WHO REACH OUT TO THE POOR AND UNDERSERVED REGARDING HEALTH TRENDS AND PRESSING NEEDS IN THEIR PATIENT/CUSTOMER POPULATIONS, AND STRATEGIZES WAYS IN WHICH THE HEALTH SYSTEM COULD PARTNER IN SERVING THESE INDIVIDUALS."

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PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SARMC COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. SARMC OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. SARMC HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. SARMC MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER.

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COMMUNITY INFORMATION - SARMC SERVES PATIENTS FROM THE PRIMARY, SECONDARY AND TERTIARY SERVICE AREAS LISTED BELOW:- PRIMARY SERVICE AREA (75% OF DISCHARGES): ADA AND CANYON COUNTIES- SECONDARY SERVICE AREA (75-90% OF DISCHARGES): BOISE, GEM, MALHEUR, PAYETTE, OWYHEE, BAKER AND UNION COUNTIES - TERTIARY SERVICE AREA (90-95% OF DISCHARGES): TWIN FALLS, VALLEY, WASHINGTON, ADAMS, BLAINE, CASSIA, GOODING AND JEROME COUNTIES- SARMC ALSO PARTICIPATES IN RURAL TELEHEALTH WORK, SERVING PSYCHIATRY NEEDS IN NORTHERN IDAHO.AREA HOSPITAL FACILITIES WITHIN SARMC'S PRIMARY SERVICE AREA INCLUDE ST. LUKE'S BOISE AND MERIDIAN, ST. LUKE'S (ELKS) REHABILITATION CENTER, TREASURE VALLEY HOSPITAL, SAINT ALPHONSUS MEDICAL CENTER-NAMPA, SAINT ALPHONSUS REGIONAL REHABILITATION HOSPITAL, WEST VALLEY MEDICAL CENTER, SAINT ALPHONSUS MEDICAL CENTER-ONTARIO, SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY, GRANDE RONDE AND VALOR HEALTH. WITH MEDIAN HOUSEHOLD INCOMES OF $66,293 IN ADA COUNTY AND $52,134 IN CANYON COUNTY, AREA RESIDENTS ARE WITHIN RANGE OF THE STATE MEDIAN OF $55,785. THE POVERTY LEVEL STANDS AT 9.4% IN ADA COUNTY AND 10.1% IN CANYON COUNTY, COMPARED TO A STATE AVERAGE OF 11.2% AND A NATIONAL AVERAGE OF 11.4%. THE PRIMARY SERVICE AREA IS A MIX OF URBAN AND RURAL COMMUNITIES WITHIN THE TREASURE VALLEY, BORDERED BY RUGGED MOUNTAINOUS TERRAIN AND DESERT. SARMC IS LOCATED IN A REGION THAT HAS EXPERIENCED RAPID POPULATION GROWTH OVER THE PAST DECADE, WITH DRAMATIC GROWTH RATES IN ADA AND CANYON COUNTIES. OTHER RELEVANT STATISTICS CHARACTERIZING SARMC'S PRIMARY SERVICE AREA ARE INCLUDED BELOW (CENSUS.GOV):TOTAL POPULATION (2020): ADA COUNTY - 494,967 (NET MIGRATION RATE OF 26% GROWTH 2010-2020)CANYON COUNTY - 231,105 (NET MIGRATION RATE OF 25.5% GROWTH 2010-2020)PERCENT WHITE PERSONS NOT HISPANIC OR LATINO (2019):ADA COUNTY - 84.3%CANYON COUNTY - 70.0%PERCENT HISPANIC/LATINO ORIGIN (2019):ADA COUNTY - 8.5%CANYON COUNTY - 25.6%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME, AGE 5+ (2015-2019):ADA COUNTY - 8.7%CANYON COUNTY - 18.7%PERCENT OF PERSONS WITHOUT HEALTH INSURANCE, UNDER AGE 65 (2015-2019):ADA COUNTY - 9.5%CANYON COUNTY - 15.3%IN 2019 (INDICATORSIDAHO.ORG), 12.7% OF IDAHO'S POPULATION UNDER THE AGE OF 65, OR 187,336 PEOPLE, HAD NO HEALTH INSURANCE COVERAGE COMPARED TO 10.8% IN ALL OF THE U.S.; THE PERCENTAGE UNDER AGE 65 WITHOUT HEALTH INSURANCE RANKED 11TH IN THE U.S.; 5.1% OF CHILDREN UNDER THE AGE OF 19, OR 23,742 CHILDREN, HAD NO HEALTH INSURANCE COVERAGE COMPARED TO 5.6% OF ALL CHILDREN IN THE U.S.; AND THE PERCENTAGE OF CHILDREN WITHOUT HEALTH COVERAGE RANKED 24TH HIGHEST OUT OF 50 STATES. THREE OF THE FOUR REFUGEE RESETTLEMENT AGENCIES IN IDAHO ARE LOCATED IN BOISE, WITH THE MAJORITY OF THE REFUGEES BEING RESETTLED IN THE BOISE AREA. SOME REFUGEES ARE HIGHLY EDUCATED WHILE OTHERS HAVE NEVER HAD THE OPPORTUNITY TO ATTEND SCHOOL. SEVERAL AGENCIES ASSIST BOTH LOCALLY AND THROUGHOUT THE STATE. UPON REVIEW OF DEMOGRAPHIC AND SOCIO-ECONOMIC DATA AND TRENDS, SEVERAL FACTORS CLEARLY HAVE AN IMPACT ON THE HEALTH STATUS OF THE COMMUNITIES SERVED BY SARMC, WITH IMPLICATIONS FOR FUTURE PLANNING. POPULATION GROWTH, ESPECIALLY IN ADA AND CANYON COUNTIES, IS EXPECTED TO CONTINUE, INCLUDING A GROWING HISPANIC POPULATION. THE SIGNIFICANT REFUGEE POPULATION CREATES GREATER LANGUAGE INTERPRETATION AND HEALTH EDUCATION NEEDS AS WELL.GROWTH IN IDAHO'S SENIOR POPULATION IS ALSO PROJECTED TO ACCELERATE, WHICH WILL LIKELY RESULT IN INCREASED HEALTH CARE SPENDING. MAMMOGRAPHY RATES, RATE OF LOW-BIRTH-WEIGHT BABIES, OBESITY, TOBACCO USE, MENTAL HEALTH AND DRINKING/DRUG USE ARE ALSO OF GREAT CONCERN. THE REGION SEES A HIGH PREVALENCE OF MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES, WITH INADEQUATE PUBLIC BEHAVIORAL HEALTH SYSTEMS IN PLACE TO MEET THE EXISTING NEEDS FOR BOTH COMMUNITY-BASED AND INPATIENT SERVICES.

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OTHER INFORMATION - CONSISTENT WITH ITS NONPROFIT STATUS, SARMC USED SURPLUS REVENUES TO REINVEST IN FACILITIES, TECHNOLOGY, AND MEDICAL SERVICES FOR THE COMMUNITY, AND COLLABORATED WITH COMMUNITY PARTNERS BY INVESTING IN NEEDED COMMUNITY PROGRAMS SUCH AS ALLUMBAUGH HOUSE (SOBERING, DETOXIFICATION AND CRISIS MENTAL HEALTH SERVICES) AND NEW PATH (HOMELESSNESS PREVENTION AND SUPPORT SERVICES). SARMC ALSO ASSESSED AND ENGAGED IN COMMUNITY HEALTH WORK THAT ADDRESSED THE SOCIAL INFLUENCERS OF HEALTH. SARMC STRONGLY SUPPORTS HEALTH CARE WORKFORCE DEVELOPMENT EFFORTS, INCLUDING SUPPORT TO THE PSYCHIATRIC, DENTAL AND INTERNAL MEDICINE RESIDENCIES AND TREASURE VALLEY NURSING PROGRAMS. SARMC SERVES AS A KEY CLINICAL TRAINING SITE FOR NEW PHYSICIANS, NURSE PRACTITIONERS, NURSES, PHARMACISTS, AND OTHER ALLIED HEALTH PROFESSIONALS, INCLUDING FAMILY MEDICAL RESIDENCY OF IDAHO.SARMC IS A LEVEL II TRAUMA CENTER AND CONTINUES TO TAKE A LEADERSHIP ROLE IN IMPROVING SYSTEMS OF CARE FOR TRAUMA PATIENTS. TRAUMA PREVENTION AND DISASTER PREPAREDNESS EFFORTS IN THE REGION ARE OFTEN LED BY SARMC STAFF, WHO IN THE PAST HAVE CHAMPIONED TOUGHER SEAT BELT AND HELMET LAWS. SARMC COORDINATED A REGIONAL TELEMEDICINE NETWORK THROUGHOUT WESTERN AND NORTHERN IDAHO AND EASTERN OREGON. SERVICES PROVIDED THROUGH THE NETWORK INCLUDE MUCH-NEEDED SERVICES SUCH AS TELEPSYCHIATRY, STROKE CARE, CLINICAL EDUCATION, AND EMERGENCY MEDICINE CONSULTATIONS TO RURAL HOSPITALS IN REMOTE LOCATIONS, OFTEN PREVENTING UNNECESSARY TRANSPORTS AND ALLOWING PATIENTS TO BE CARED FOR CLOSER TO HOME. SARMC ALSO COLLABORATED WITH UWTV TO ADDRESS COMMUNITY NEEDS INCLUDING HEALTH, EDUCATION, AND INCOME. SARMC WAS REPRESENTED ON THE UNITED WAY BOARD OF DIRECTORS AND THE HEALTH VISION COUNCIL. IN ADDITION, SARMC HAS AN ANNUAL UNITED WAY WORKPLACE GIVING CAMPAIGN TO SUPPORT UNITED WAY INITIATIVES AND GRANTS TO LOCAL NONPROFITS PRODUCING MEASURABLE OUTCOMES IN ADDRESSING TOP COMMUNITY NEEDS.SAHS CONTINUED TO BE A LEAD ADVOCATE AND FUNDER OF A HOUSING FIRST EFFORT TO PREVENT HOMELESSNESS, IN ALIGNMENT WITH CHNA-FOCUSED SOCIAL INFLUENCERS OF HEALTH WORK. SAHS RECEIVED GRANT FUNDING TO OFFER MENTAL HEALTH FIRST AID (MHFA) TRAININGS TO INTERESTED COLLEAGUES AND COMMUNITY MEMBERS AT NO COST. MHFA IS A NATIONAL PROGRAM TO TEACH SKILLS TO IDENTIFY, UNDERSTAND, AND RESPOND TO SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE. BOTH ADULT AND YOUTH MHFA TRAININGS WERE OFFERED. SAINT ALPHONSUS HEALTH SYSTEM'S EMERGENCY PREPAREDNESS EFFORTS ALLOWED FOR A RAPID RESPONSE TO THE ONGOING WAVES OF THE COVID-19 PANDEMIC. IN FY22, THOSE EFFORTS INCLUDED CONTINUED LEADERSHIP ENGAGEMENT WITH LOCAL HEALTH DEPARTMENTS AND OTHER COMMUNITY PARTNERS TO ADDRESS SUPPLY SHORTAGES, PREVENTION OF COMMUNITY SPREAD, AND FACILITY CAPACITY. SAHS PROVIDED PUBLIC MESSAGING AROUND VACCINE SAFETY AND EFFICACY AS WELL AS HOW TO HELP SLOW THE SPREAD OF COVID-19. SARMC WORKED ALONGSIDE COMMUNITY PARTNERS (CITY OF BOISE, INTERFAITH SANCTUARY, ST. LUKE'S, FMRI, AND OTHERS) TO HELP PREVENT THE SPREAD OF COVID-19 IN THE POPULATION EXPERIENCING HOMELESSNESS THROUGH DEVELOPMENT OF LOCAL QUARANTINE AND ISOLATION PROCESSES, INCLUDING HOTELING OF INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS WHO WERE SUSPECTED OR CONFIRMED COVID-19 POSITIVE. IN ADDITION, SARMC PROVIDED CASE MANAGEMENT CONSULTATION AND FUNDED MEALS FOR THOSE RESIDENTS.SAHS PROVIDED FREE COVID-19 VACCINE CLINICS TO UNDERSERVED AND RURAL AREAS THROUGHOUT THE TREASURE VALLEY. THESE CLINICS SERVED PEOPLE EXPERIENCING HOMELESSNESS, AS WELL AS MIGRANT FARMWORKER COMMUNITIES WHO WOULD OTHERWISE HAVE HAD DIFFICULTY ACCESSING THE VACCINE. IN ADDITION, THE MOBILE VACCINE CLINIC WORKED IN PARTNERSHIP WITH THE MEXICAN CONSULATE TO OFFER VACCINES IN BOISE.

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SARMC IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE BY CONNECTING SOCIAL AND CLINICAL CARE, ADDRESSING SOCIAL NEEDS, DISMANTLING SYSTEMIC RACISM, AND REDUCING HEALTH INEQUITIES. WE DO THIS BY: 1. INVESTING IN OUR COMMUNITIES, 2. ADVANCING SOCIAL CARE, AND 3. IMPACTING SOCIAL INFLUENCERS OF HEALTH.TO FURTHER OUR STRATEGY IN FISCAL YEAR 2022 (FY22), CHWB LAUNCHED TWO TRAINING SERIES TO ADVANCE HEALTH AND RACIAL EQUITY IN OUR COMMUNITIES.1. CHWB LEADER SERIES TO ADVANCE HEALTH AND RACIAL EQUITY: A YEAR-LONG PEER LEARNING SERIES TO BUILD THE CAPACITY OF OUR CHWB LEADERS TO DELIVER ON OUR CHWB STRATEGY WITH A FOCUS ON COMMUNITY LEADERSHIP AND ENGAGEMENT, AND THE USE OF A RACIAL EQUITY LENS IN ALL OF OUR DECISION MAKING. 2. COMMUNITY ENGAGEMENT TO ADVANCE RACIAL JUSTICE - PREPARING FOR IMPLEMENTATION STRATEGY: A FOUR-PART SERIES ON ENGAGING OUR COMMUNITIES IN MEANINGFUL WAYS USING A HEALTH EQUITY AND RACIAL EQUITY LENS TO BUILD LASTING PARTNERSHIPS AND IMPACTFUL IMPLEMENTATION STRATEGIES.INVESTING IN OUR COMMUNITIES - TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FY22, TRINITY HEALTH CONTRIBUTED $1.37 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. SOME EXAMPLES OF THESE INVESTMENTS INCLUDE: TRINITY HEALTH AWARDED OVER $1.6 MILLION IN COMMUNITY GRANTS THAT DIRECTLY ALIGN WITH INTERVENTIONS AND LOCAL PARTNERSHIPS IDENTIFIED IN ITS MEMBER HOSPITALS' COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION STRATEGIES, INCLUDING ACCESS TO HEALTH CARE, MENTAL HEALTH, TRANSPORTATION, COMMUNITY ENGAGEMENT, FOOD ACCESS, AND HOUSING SUPPORTS. WITH A $1.2 MILLION INITIAL INVESTMENT, TRINITY HEALTH LAUNCHED ROUND 2 OF THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), A FIVE-YEAR, INNOVATIVE FUNDING AND TECHNICAL ASSISTANCE INITIATIVE, PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS AND RESIDENTS TO ADVANCE HEALTH AND RACIAL EQUITY IN NINE OF OUR COMMUNITIES EXPERIENCING HIGH POVERTY AND OTHER VULNERABILITIES. HEALTH MINISTRIES RECEIVING TCI FUNDING ARE COLLABORATING WITH A LOCAL MULTI-SECTOR COLLABORATIVE TO DEVELOP AND IMPLEMENT EVIDENCE-BASED STRATEGIES THAT ADVANCE HEALTH AND RACIAL EQUITY THROUGH ADDRESSING AT LEAST ONE ROOT CAUSE OF POOR HEALTH IDENTIFIED IN THE DEVELOPMENT OF THEIR MOST RECENT CHNA IMPLEMENTATION STRATEGY. TRINITY HEALTH AWARDED OVER $1 MILLION IN COVID-19 FUNDING TO SUPPORT NEW AND ONGOING COMMUNITY ENGAGEMENT AND MOBILIZATION EFFORTS AROUND MAKING THE COVID-19 VACCINATION ACCESSIBLE TO ALL ELIGIBLE POPULATIONS. THIS FUNDING WAS DESIGNED TO SUPPORT ALL COMMUNITIES TO ENSURE EASY AND EQUITABLE ACCESS TO THE VACCINE BY REMOVING BARRIERS FOR ALL PEOPLE TO RECEIVE THE VACCINE, ESPECIALLY COMMUNITIES THAT HAVE LESS THAN A 75% VACCINATION RATE. WITH THIS FUNDING, HEALTH MINISTRIES FACILITATED 3,200 COVID-19 VACCINE EVENTS, ADMINISTERED 80,000 COVID-19 VACCINE DOSES, AND REACHED 874,000 PEOPLE WITH EDUCATIONAL MATERIALS ON COVID-19 AND THE BENEFITS OF VACCINATION.IN ADDITION TO THE $1.37 BILLION IN COMMUNITY BENEFIT SPENDING, OUR COMMUNITY INVESTING PROGRAM HAD THE MOST ROBUST YEAR OF LENDING SINCE THE PROGRAM'S INCEPTION OVER 20 YEARS AGO: $17.8 MILLION IN NEW LOANS AND $8.3 MILLION IN LOAN RENEWALS WERE APPROVED, FOCUSING ON BUILDING AFFORDABLE HOUSING AND INCREASING ACCESS TO EDUCATION IN PARTNERSHIP WITH OUR HEALTH MINISTRIES. ADVANCING SOCIAL CARE - TRINITY HEALTH'S SOCIAL CARE PROGRAM WAS DEVELOPED TO ADDRESS SOCIAL NEEDS, SUCH AS ACCESS TO TRANSPORTATION, CHILDCARE, OR AFFORDABLE MEDICATIONS BY FACILITATING CONNECTIONS BETWEEN OUR PATIENTS, HEALTH CARE PROVIDERS AND COMMUNITY PARTNERS THAT PROMOTE HEALTHY BEHAVIORS. HIGHLIGHTS FROM FY22 INCLUDE THE FOLLOWING SUCCESSES:- LAUNCHED TRINITY HEALTH COMMUNITY HEALTH WORKER (CHW) CERTIFICATION PROGRAM, TRAINING 86 CHWS WITH 40+ HOURS OF TRAINING, AND INCREASED CHW STAFF ACROSS MOST HEALTH MINISTRIES- LAUNCHED A SYSTEM-WIDE ASSESSMENT OF LANGUAGE ACCESS SERVICES TO RECOMMEND SYSTEM STANDARDS THAT ENSURE CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES FOR ALL OF OUR PATIENTS, THEIR COMPANIONS, AND CAREGIVERS- ENGAGED OVER 1,100 PARTICIPANTS IN THE NATIONAL DIABETES PREVENTION PROGRAM, EXCEEDING OUR PROGRAM YEAR 5 GOAL- INCREASED THE NUMBER OF ACTIVE COMMUNITY PARTNER ORGANIZATIONS ON THE COMMUNITY RESOURCE DIRECTORY BY 120% FROM FISCAL YEAR 2021- ENGAGED 5,300+ PATIENTS WHO ARE DUALLY ENROLLED IN MEDICARE AND MEDICAID IN A SOCIAL CARE OR MEDICAL CARE ACTIVITY, IN SUPPORT OF REDUCING PREVENTABLE HOSPITALIZATIONS (SUCH AS DIABETES AND ASTHMA)IMPACTING SOCIAL INFLUENCERS OF HEALTH - LEVERAGING INVESTOR POWER TO CATALYZE CORPORATE SOCIAL RESPONSIBILITY, TRINITY HEALTH'S SHAREHOLDER ADVOCACY WORK FOCUSES ON DISMANTLING RACISM ACROSS FIVE STRATEGIC FOCUS AREAS BY HOLDING CORPORATIONS ACCOUNTABLE FOR THE HUMAN RIGHTS VIOLATIONS THOSE COMPANIES PERPETUATE IN THE U.S. AND BEYOND. IN FY22, TRINITY HEALTH FACILITATED OVER 135 SHAREHOLDER ADVOCACY ENGAGEMENTS, WITH GREAT SUCCESS:- FIVE BELOW COMMITTED TO ASSESS AND MANAGE THE RISKS/HAZARDS ASSOCIATED WITH CHEMICALS OF HIGH CONCERN CONTAINED IN THEIR PRIVATE LABEL PRODUCTS- UNILEVER AGREED TO STOP FOOD AND BEVERAGE MARKETING TO CHILDREN UNDER AGE 16, AND WILL ADOPT NEW TARGETS TO REDUCE SALT, ADDED SUGARS AND CALORIES, AND INCREASE SALES OF THEIR HEALTHIER PRODUCTS- PEPSICO SET GOALS TO INCREASE POSITIVE NUTRIENTS IN THEIR PRODUCTS- PDC ENERGY ACCELERATED ITS GOAL TO END ROUTINE FLARING OF METHANE, FROM 2030 TO 2025, THUS REDUCING ENVIRONMENTAL HEALTH RISKS AND GREENHOUSE GAS EMISSIONSADDITIONALLY, TRINITY HEALTH AND OTHER MEMBERS OF THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY GUN SAFETY GROUP SUBMITTED A SHAREHOLDER RESOLUTION ASKING STURM RUGER, ONE OF THE NATION'S LEADING MANUFACTURERS OF FIREARMS, TO CONDUCT AND PUBLISH AN INDEPENDENT HUMAN RIGHTS IMPACT ASSESSMENT OF ITS POLICIES, PRACTICES AND PRODUCTS, AND MAKE RECOMMENDATIONS FOR IMPROVEMENT. THE RESOLUTION RECEIVED A 68.5% VOTE IN FAVOR, WELL ABOVE THE THRESHOLD REQUIRED FOR THE RESOLUTION TO BE RESUBMITTED IN 2023, INDICATING A LARGE MAJORITY OF STURM RUGER INVESTORS BELIEVE THE COMPANY HAS TO ADDRESS ITS HUMAN RIGHTS IMPACTS. TRINITY HEALTH AND TRINITY HEALTH OF NEW ENGLAND ARE CITED AS PART OF THE GROUP WHO MOVED FORWARD THIS RESOLUTION.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG.