4A (Expenses $ 214304744 including grants of $ 1000) (Revenue $ 258989876)
GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION (GCHSC) IS A WHOLLY-OWNED SUBSIDIARY OF LOYOLA UNIVERSITY HEALTH SYSTEM. GCHSC OPERATES MACNEAL HOSPITAL, A 374-BED TEACHING HOSPITAL LOCATED IN BERWYN, ILLINOIS, PROVIDING QUALITY HEALTH CARE TO THE CITY OF CHICAGO AND THE NEAR WESTERN SUBURBS. MACNEAL HOSPITAL OFFERS COMPREHENSIVE AND COMPASSIONATE SERVICES THAT INCLUDE OBSTETRICS, ORTHOPAEDICS, CARDIOLOGY, CARDIAC REHABILITATION, SPORTS MEDICINE, REHABILITATION SERVICES, ONCOLOGY, HOME HEALTH, EMERGENCY AND IMMEDIATE CARE SERVICES, BARIATRIC SURGERY, AND MUCH MORE. WE ALSO OFFER THE LARGEST BEHAVIORAL HEALTH SERVICES PROGRAM IN THE CHICAGO AREA.DURING FISCAL YEAR 2022, GCHSC PROVIDED OVER 60,000 DAYS OF HEALTH CARE SERVICES AND OVER 192,000 OUTPATIENT VISITS TO THE COMMUNITY.MACNEAL HOSPITAL PROVIDES EXCELLENT MEDICAL EDUCATION PROGRAMS, INCLUDING THE FIRST FAMILY MEDICINE RESIDENCY PROGRAM ESTABLISHED IN ILLINOIS, WHICH REMAINS ONE OF THE LARGEST AND MOST DYNAMIC OF ITS KIND. WE ARE COMMITTED TO SERVING OUR COMMUNITIES WITH EDUCATIONAL OFFERINGS.

MACNEAL HOSPITAL
PART V, SECTION B, LINE 3J: LINE 3J: N/ALINE 3E: MACNEAL HOSPITAL 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 A COMMUNITY-INVOLVED SELECTION PROCESS: 1. MENTAL HEALTH 2. SOCIAL AND STRUCTURAL INFLUENCERS OF HEALTH 3. COMMUNITY COMMUNICATION AND COMMUNITY LEADER ENGAGEMENT 4. ACCESS TO HEALTH CARE 5. CHRONIC DISEASE

MACNEAL HOSPITAL
PART V, SECTION B, LINE 5: THE ALLIANCE FOR HEALTH EQUITY (AHE) CONDUCTED A COLLABORATIVE CHNA BETWEEN MAY 2021 AND MARCH 2022. AHE IS A COLLABORATIVE OF 35 HOSPITALS WORKING WITH HEALTH DEPARTMENTS AND REGIONAL AND COMMUNITY-BASED ORGANIZATIONS TO IMPROVE HEALTH EQUITY, WELLNESS, AND QUALITY OF LIFE ACROSS CHICAGO AND SUBURBAN COOK COUNTY. LOYOLA MEDICINE IS A FOUNDING MEMBER OF AHE SINCE ITS LAUNCH IN 2015. THE COLLABORATIVE CHNA IN COOK COUNTY IS AN IMPORTANT FOUNDATION FOR THE WORK OF AHE, WHOSE PURPOSE IS TO IMPROVE POPULATION AND COMMUNITY HEALTH. THE 2022 CHNA IS THE THIRD COLLABORATIVE CHNA IN COOK COUNTY, ILLINOIS. THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI), THE BACKBONE ORGANIZATION FOR AHE, WORKS CLOSELY WITH THE STEERING COMMITTEE TO DESIGN THE CHNA TO MEET REGULATORY REQUIREMENTS UNDER THE AFFORDABLE CARE ACT AND TO ENSURE CLOSE COLLABORATION WITH THE CHICAGO DEPARTMENT OF PUBLIC HEALTH (CDPH) AND COOK COUNTY DEPARTMENT OF PUBLIC HEALTH (CCDPH) ON THEIR COMMUNITY HEALTH ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLANNING PROCESSES. LOYOLA MEDICINE ENGAGED COMMUNITY MEMBERS AND STAKEHOLDERS IN THE CHNA BOTH THROUGH AHE AND THROUGH PARTNERSHIPS WITH COALITIONS AND COMMUNITY GROUPS IN THE AREAS OF BERWYN-CICERO AND MAYWOOD-MELROSE PARK. LOYOLA MEDICINE AND AHE PRIORITIZED ENGAGEMENT OF COMMUNITY MEMBERS AND COMMUNITY-BASED ORGANIZATIONS AS A CRITICAL COMPONENT OF ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS.THE ALLIANCE FOR HEALTH EQUITY'S METHODS OF COMMUNITY ENGAGEMENT FOR THE CHNA AND IMPLEMENTATION STRATEGIES INCLUDED: - GATHERING INPUT FROM COMMUNITY RESIDENTS WHO ARE UNDERREPRESENTED IN TRADITIONAL ASSESSMENT AND IMPLEMENTATION PLANNING PROCESSES; - PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS FOR COLLECTION OF COMMUNITY INPUT THROUGH SURVEYS AND FOCUS GROUPS; - ENGAGING COMMUNITY-BASED ORGANIZATIONS AND COMMUNITY RESIDENTS AS MEMBERS OF IMPLEMENTATION COMMITTEES AND WORKGROUPS; - UTILIZING THE EXPERTISE OF THE MEMBERS OF IMPLEMENTATION COMMITTEES AND WORKGROUPS IN ASSESSMENT DESIGN, DATA INTERPRETATION, AND IDENTIFICATION OF EFFECTIVE IMPLEMENTATION STRATEGIES AND EVALUATION METRICS; - WORKING WITH HOSPITAL AND HEALTH DEPARTMENT COMMUNITY ADVISORY GROUPS TO GATHER INPUT FOR THE CHNA AND IMPLEMENTATION STRATEGIES; AND - PARTNERING WITH LOCAL COALITIONS TO SUPPORT AND ALIGN WITH EXISTING COMMUNITY-DRIVEN EFFORTS. THE COMMUNITY-BASED ORGANIZATIONS ENGAGED IN AHE REPRESENT A BROAD RANGE OF SECTORS SUCH AS WORKFORCE DEVELOPMENT, HOUSING AND HOMELESS SERVICES, FOOD ACCESS AND FOOD JUSTICE, COMMUNITY SAFETY, PLANNING AND COMMUNITY DEVELOPMENT, IMMIGRANT RIGHTS, YOUTH DEVELOPMENT, COMMUNITY ORGANIZING, FAITH COMMUNITIES, MENTAL HEALTH SERVICES, SUBSTANCE USE SERVICES, POLICY AND ADVOCACY, TRANSPORTATION, OLDER ADULT SERVICES, HEALTH CARE SERVICES, HIGHER EDUCATION, AND MANY OTHERS. ALL COMMUNITY PARTNERS WORK WITH OR REPRESENT COMMUNITIES THAT ARE DISPROPORTIONATELY AFFECTED BY HEALTH INEQUITIES SUCH AS COMMUNITIES OF COLOR, IMMIGRANTS, YOUTH, OLDER ADULTS AND CAREGIVERS, LGBTQ+, INDIVIDUALS EXPERIENCING HOMELESSNESS OR HOUSING INSTABILITY, INDIVIDUALS LIVING WITH MENTAL ILLNESS OR SUBSTANCE USE DISORDERS, INDIVIDUALS WITH DISABILITIES, VETERANS, AND UNEMPLOYED YOUTH AND ADULTS. THE AHE 2022 CHNA PROCESS FOR COOK COUNTY RELIED UPON INPUT FROM OVER 5,200 COMMUNITY INPUT SURVEYS, WHICH WERE DISTRIBUTED IN BOTH ONLINE AND PRINTED FORMATS IN ENGLISH AND SPANISH; 43 FOCUS GROUPS WITH EXISTING AHE WORKGROUPS; AND POPULATION DATA COLLECTED BY HEALTH DEPARTMENTS. WHERE NECESSARY AND APPLICABLE, EXISTING RESEARCH PROVIDED RELIABLE INFORMATION IN DETERMINING COUNTY-WIDE PRIORITY HEALTH ISSUES. LOYOLA MEDICINE PARTNERED WITH INTERNAL EXPERTS AND THE COMMUNITY COALITIONS TO IDENTIFY PRIORITIES BY CONSIDERING MULTIPLE FACTORS, INCLUDING HEALTH EQUITY GOALS, COMMUNITY PRIORITIES, URGENCY, FEASIBILITY, EXISTING PRIORITIES, AND ALIGNMENT WITH THE EXISTING WORK OF HEALTH DEPARTMENTS, OTHER HOSPITALS, AND COMMUNITY PARTNERS. AS PART OF THE AHE COMMUNITY INPUT SURVEY CONDUCTED BETWEEN SEPTEMBER AND DECEMBER 2021, 313 COMMUNITY MEMBERS IN THE MACNEAL HOSPITAL SERVICE AREA RESPONDED TO SHARE TOP COMMUNITY HEALTH ISSUES, NEEDED IMPROVEMENTS, RESOURCES, AND PANDEMIC IMPACTS. LOYOLA MEDICINE INTENTIONALLY STRUCTURED DEEPER ENGAGEMENT OF LOCAL COMMUNITIES DURING THE PHASE OF PRIORITIZING COMMUNITY HEALTH NEEDS. SPECIFICALLY, WE WORKED WITH CICERO COMMUNITY COLLABORATIVE, THE COMMUNITY ALLIANCE OF MELROSE PARK, PROVISO PARTNERS FOR HEALTH AND PROVISO TOWNSHIP MINISTERIAL ALLIANCE TO HOST MEETINGS THROUGHOUT MARCH AND APRIL 2022 TO REVIEW CHNA DATA AND PROVIDE INPUT ON PRIORITIES.

MACNEAL HOSPITAL
PART V, SECTION B, LINE 6A: AHE MEMBER HOSPITALS PARTICIPATING IN THE 2022 COOK COUNTY CHNA PROCESS INCLUDED ADVOCATE AURORA CHILDREN'S HOSPITAL, ADVOCATE AURORA CHRIST MEDICAL CENTER, ADVOCATE AURORA ILLINOIS MASONIC MEDICAL CENTER, ADVOCATE AURORA LUTHERAN GENERAL HOSPITAL, ADVOCATE AURORA SOUTH SUBURBAN HOSPITAL, ADVOCATE AURORA TRINITY HOSPITAL, ADVENT HEALTH MEDICAL CENTER LA GRANGE, ASCENSION ALEXIAN BROTHERS MEDICAL CENTER, ELK GROVE VILLAGE, ASCENSION HOLY FAMILY MEDICAL CENTER, ASCENSION RESURRECTION MEDICAL CENTER, ASCENSION ST. ALEXIUS MEDICAL CENTER AND ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL, ASCENSION SAINT FRANCIS HOSPITAL, ASCENSION SAINT JOSEPH HOSPITAL, ASCENSION SAINTS MARY AND ELIZABETH MEDICAL CENTER, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, HUMBOLDT PARK HEALTH, JACKSON PARK HOSPITAL, THE LORETTO HOSPITAL, LOYOLA MEDICINE - GOTTLIEB MEMORIAL HOSPITAL, LOYOLA MEDICINE - LOYOLA UNIVERSITY MEDICAL CENTER, LOYOLA MEDICINE - MACNEAL HOSPITAL, NORTHWESTERN MEMORIAL HOSPITAL, NORTHWESTERN PALOS COMMUNITY HOSPITAL, OSF LITTLE COMPANY OF MARY MEDICAL CENTER, ROSELAND COMMUNITY HOSPITAL, RUSH OAK PARK RUSH UNIVERSITY MEDICAL CENTER, SINAI HEALTH SYSTEM - HOLY CROSS HOSPITAL, SINAI HEALTH SYSTEM - MOUNT SINAI HOSPITAL, SINAI HEALTH SYSTEM - SCHWAB REHABILITATION HOSPITAL, SOUTH SHORE HOSPITAL, SWEDISH HOSPITAL, AND UNIVERSITY OF ILLINOIS HOSPITAL AND HEALTH SCIENCES SYSTEM.

MACNEAL HOSPITAL
PART V, SECTION B, LINE 6B: OTHER THAN HOSPITAL FACILITIES, ORGANIZATIONS THAT PARTICIPATED IN THE 2022 COOK COUNTY CHNA INCLUDED THE CHICAGO DEPARTMENT OF PUBLIC HEALTH, COOK COUNTY DEPARTMENT OF PUBLIC HEALTH, COOK COUNTY HEALTH, WEST COOK COALITION (WCC), PROVISO PARTNERS FOR HEALTH (PP4H), PROVISO TOWNSHIP MINISTERIAL ALLIANCE (PTMAN), CICERO COMMUNITY COLLABORATIVE (CCC), AND THE COMMUNITY ALLIANCE OF MELROSE PARK.

MACNEAL HOSPITAL
PART V, SECTION B, LINE 7D: IN ADDITION TO PUBLICIZING THE CHNA ON THE HOSPITAL WEBSITE AND MAKING PAPER COPIES AVAILABLE AT THE HOSPITAL FACILITY. ALL LOYOLA MEDICINE COMMUNITY BENEFIT COUNCIL MEMBERS RECEIVED AN EMAILED COPY OF THE CHNA.

MACNEAL HOSPITAL
PART V, SECTION B, LINE 11: IN FY22, MACNEAL HOSPITAL ADDRESSED MENTAL HEALTH AND SOCIAL AND STRUCTURAL INFLUENCERS OF HEALTH, AND ALSO SUPPORTED FY22 COMMUNITY INITIATIVES:MENTAL HEALTH MACNEAL HOSPITAL SUPPORTED AND COLLABORATED WITH BEHAVIORAL HEALTH ORGANIZATIONS ON MENTAL HEALTH AND SUBSTANCE USE DISORDERS. IN PARTNERSHIP WITH GATEWAY FOUNDATION, MACNEAL STAFFED ITS EMERGENCY ROOM WITH RECOVERY COACHES WHO OFFERED SUBSTANCE USE DISORDER RESOURCES AND SUPPORT TO PATIENTS WITH OPIOID USE. SOCIAL DETERMINANTS OF HEALTH DURING FY22, MACNEAL HOSPITAL CONTINUED TO ADDRESS HOUSING INSECURITY THROUGH ITS COLLABORATION WITH A HOUSING PARTNER THAT OFFERS TRANSITIONAL HOUSING. MACNEAL HOSPITAL PHYSICIANS AND RESIDENTS PROVIDE FREE MEDICAL RESPITE CARE FOR PATIENTS WHO ARE EXPERIENCING HOMELESSNESS. IN FY22, THE MEDICAL RESPITE COMMITTEE, CONSISTING OF LOYOLA MEDICINE LEADERSHIP AND EXTERNAL PARTNERS, ADDRESSED HOMELESSNESS. THE COMMITTEE MEETS ONCE A MONTH TO DISCUSS PATIENT UPDATES REGARDING NEEDS/BARRIERS, TRANSITIONAL HOUSING OPPORTUNITIES FOR THE PATIENTS, AND GROWTH AND FUNDING OPPORTUNITIES.THE MACNEAL SURPLUS PROJECT WAS ESTABLISHED IN MARCH 2021 TO PROVIDE NUTRITIONAL HEALTH AND ELIMINATE FOOD INSECURITY AND WASTE BY DISTRIBUTION OF SURPLUS FOOD FROM THE HOSPITAL CAFETERIA TO CREATE FOOD ACCESS AND ADDRESS FOOD INSECURITY. THE HOSPITAL CAFETERIA'S FOOD SURPLUS PROJECT PARTNERED AND DELIVERED TO A LOCAL HOMELESS ORGANIZATION, SOJOURNER HOUSE MEDICAL RESPITE FACILITY, IN PARTNERSHIP WITH HOUSING FORWARD. IN FY22, MACNEAL HOSPITAL DELIVERED AND DONATED OVER 1,000 MEALS.THROUGH LUMC, MACNEAL HOSPITAL WAS ABLE TO UTILIZE COMMUNITY HEALTH WORKERS TO SCREEN PATIENTS FOR SOCIAL DETERMINANTS OF HEALTH. PATIENTS WHO SCREENED POSITIVE FOR SOCIAL NEEDS (FOOD, HOUSING, HEALTH CARE AND EMPLOYMENT) WERE PROVIDED RESOURCES OR CONNECTED TO COMMUNITY-BASED OR GOVERNMENT ORGANIZATIONS FOR ASSISTANCE. MACNEAL HOSPITAL ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH ARE THE MOST PRESSING, UNDER- ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. MACNEAL HOSPITAL DID NOT ADDRESS THE FOLLOWING HEALTH NEEDS:COMMUNITY COMMUNICATION AND LEADER ENGAGEMENT - MACNEAL HOSPITAL DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE OUR COMMUNITY STAKEHOLDER FEEDBACK DID NOT INDICATE IT WAS THE MOST URGENTLY NEEDED. MACNEAL HOSPITAL LEADERSHIP AND STAFF CURRENTLY PARTICIPATE IN COMMUNITY COALITIONS AND COMMUNITY EVENTS WITHIN THE MACNEAL HOSPITAL SERVICE AREA AND WILL CONTINUE TO PARTICIPATE IN THESE EFFORTS.ACCESS TO HEALTH CARE - MACNEAL HOSPITAL DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE STAKEHOLDERS DID NOT DETERMINE THIS WAS THE MOST URGENTLY NEEDED. MACNEAL HOSPITAL CONTINUES THEIR COMMITMENT TO SERVING UNINSURED AND UNDERINSURED PATIENTS BY PROVIDING ENROLLMENT ASSISTANCE AND THROUGH THE ACCESS TO CARE CLINIC.CHRONIC DISEASE - MACNEAL HOSPITAL DID NOT DIRECTLY ADDRESS THIS NEED BECAUSE THESE EFFORTS ARE CURRENTLY ADDRESSED AND PROVIDED THROUGH OUR DIABETES PREVENTION PROGRAM AND OTHER CHRONIC DISEASE SCREENING AND MANAGEMENT.

MACNEAL HOSPITAL
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.LOYOLAMEDICINE.ORG/ABOUT-LOYOLA/COMMUNITY-BENEFIT

PART V, SECTION B, LINE 10A:
WWW.LOYOLAMEDICINE.ORG/ABOUT-LOYOLA/COMMUNITY-BENEFIT

PART V, SECTION B, LINE 16A
WWW.LOYOLAMEDICINE.ORG/FOR-PATIENTS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE-POLICY

PART V, SECTION B, LINE 16B
WWW.LOYOLAMEDICINE.ORG/FOR-PATIENTS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE-POLICY

PART V, SECTION B, LINE 16C
WWW.LOYOLAMEDICINE.ORG/FOR-PATIENTS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE-POLICY

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:
GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION (GCHSC) PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT IT SUBMITS TO THE STATE OF ILLINOIS.IN ADDITION, GCHSC 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.GCHSC 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, $7,033,441, 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 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:
GCHSC 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, GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.

PART III, LINE 4:
"GCHSC 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:
GCHSC 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 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 2:
NEEDS ASSESSMENT - MACNEAL HOSPITAL ASSESSED THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE 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 HAVE INDICATED POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.

PART VI, LINE 7, REPORTS FILED WITH STATES
IL

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - GCHSC 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. GCHSC 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. GCHSC HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. GCHSC 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.

PART VI, LINE 4:
COMMUNITY INFORMATION - MACNEAL HOSPITAL (MNH) IS A 374-BED COMMUNITY TEACHING HOSPITAL LOCATED IN BERWYN, IL. MACNEAL HOSPITAL'S CHNA COMMUNITY SERVICE AREA INCLUDES 23 ZIP CODES IN WEST SUBURBAN COOK COUNTY AND THE SOUTHWEST SIDE OF CHICAGO. LOYOLA MEDICINE DEFINES THE CHNA SERVICE AREA AS THE PRIMARY SERVICE AREAS FOR THE HOSPITAL, MAKING SURE TO INCLUDE ANY NEARBY COMMUNITIES OF HIGHEST NEED. THE MACNEAL HOSPITAL SERVICE AREA IS HOME TO 811,170 COMMUNITY MEMBERS. FIFTY-TWO PERCENT (52%) OF THE POPULATION IDENTIFIES AS HISPANIC/LATINX, 27% NON-HISPANIC WHITE, 17% BLACK, 2% ASIAN, AND 1.2% TWO OR MORE RACES. (AMERICAN COMMUNITY SURVEY, 2016-2020) TWENTY-SIX PERCENT (26%) OF THE POPULATION ARE CHILDREN AND YOUTH UNDER 18, 61% ARE 18-64, AND 13% ARE OLDER ADULTS OVER 65. THE MACNEAL HOSPITAL SERVICE AREA HAS A GREATER PERCENTAGE OF COMMUNITY MEMBERS THAT IDENTIFY AS HISPANIC/ LATINX COMPARED TO THE COUNTY, STATE, AND U.S. IN THE MACNEAL HOSPITAL SERVICE AREA, NEARLY 12% OF HOUSEHOLDS ARE LIMITED ENGLISH PROFICIENT, COMPARED TO ONLY 4% STATEWIDE. AT LEAST 10 HOSPITALS PROVIDE SERVICES TO ALL OR A PORTION OF MNH'S SERVICE AREA. IN FY22, MACNEAL SERVED 12.5% OF THE 70,592 DISCHARGED INPATIENTS FROM THIS PRIMARY SERVICE AREA (SOURCE: COMPDATA). MACNEAL HAD MORE THAN 50,000 EMERGENCY DEPARTMENT VISITS. THE EMERGENCY DEPARTMENT IS A LEVEL II TRAUMA CENTER RECOGNIZED BY THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH AS AN EMERGENCY DEPARTMENT APPROVED FOR PEDIATRICS (EDAP).

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OTHER INFORMATION - MACNEAL HOSPITAL (MNH) IS COMMITTED TO PROVIDING COMMUNITY SERVICES BEYOND ITS WALLS. BUILDING ON LOYOLA MEDICINE'S TEACHING TRADITION, MNH SUPPORTS HOSPITAL-BASED EDUCATION AND TRAINING FOR CLINICAL STUDENTS. MNH PROVIDES CLINICAL SUPERVISION AND A TRAINING FACILITY FOR NURSING.MACNEAL HOSPITAL IS COMMITTED TO PROVIDING HEALTH CARE SERVICES TO ALL PATIENTS BASED ON MEDICAL NECESSITY. FOR PATIENTS WHO REQUIRE FINANCIAL ASSISTANCE OR WHO EXPERIENCE TEMPORARY FINANCIAL HARDSHIP, LOYOLA MEDICINE OFFERS SEVERAL ASSISTANCE AND PAYMENT OPTIONS, INCLUDING CHARITY AND DISCOUNTED CARE AS WELL AS SHORT-TERM AND LONG-TERM PAYMENT PLANS.MNH CONTINUES TO INCREASE ITS COMMITMENT TO UNINSURED AND UNDERINSURED PATIENTS AT THE ACCESS TO CARE CLINIC AT LOYOLA'S MAYWOOD PRIMARY CARE CLINIC. SINCE 2012, LOYOLA MEDICINE HAS PROVIDED FREE OR SIGNIFICANTLY DISCOUNTED CARE TO LOW-INCOME AND UNDOCUMENTED PATIENTS. THIS IS THE LARGEST PRIMARY CARE SITE WITHIN ACCESS TO CARE'S NETWORK. IN ADDITION TO PRIMARY CARE, THE CLINIC EXPANDED TO PROVIDE FREE AND LOW-COST MENTAL HEALTH COUNSELING SESSIONS TO PATIENTS. MNH PROVIDED $219,100 TO FUND ENROLLMENT ASSISTANCE FOR MEDICAID ELIGIBILITY, SSI/SSDI, AND AFFORDABLE CARE ACT COVERAGE SCREENING, APPLICATION ASSISTANCE, AND ENROLLMENT TO 1,329 PATIENTS WHO IDENTIFIED AS BEING UNINSURED OR UNDERINSURED.MACNEAL CONTINUED A COORDINATED EFFORT TO OFFER PATIENTS EVIDENCE-BASED CHRONIC DISEASE PREVENTION AND MANAGEMENT PROGRAMS THROUGH THE DEVELOPMENT OF STRONG PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS SUCH AS THE DIABETES PREVENTION PROGRAM (DPP). THE DPP SERVICES TRANSITIONED FROM IN-PERSON TO VIRTUAL DUE TO THE PANDEMIC.LOYOLA MEDICINE PARTICIPATED IN HEALTH CARE ADVOCACY ON BEHALF OF THE COMMUNITIES IT SERVES. TRINITY HEALTH HAS BEEN AT THE FOREFRONT OF EFFORTS TO ENACT MEANINGFUL HEALTH CARE REFORM SINCE 2006. IN FY22, ADVOCACY EFFORTS INCLUDED POLICY CHANGES TO THE COVID-19 RESPONSE, IMPROVED PUBLIC HEALTH INFRASTRUCTURE, EXPANDED ACCESS TO CARE, AND ADDRESSING FOOD INSECURITY AND RACIAL EQUITY. STATE LEGISLATORS' DISCUSSIONS OCCURRED IN COLLABORATION WITH LOYOLA MEDICINE LOBBYISTS AND THE ILLINOIS HOSPITAL ASSOCIATION. MNH'S COVID-19 EMERGENCY PREPAREDNESS RESPONSE INCLUDED JOINING AN EMERGENCY OPERATIONS CENTER (EOC) ESTABLISHED BY LOYOLA MEDICINE LEADERSHIP THAT SET OBJECTIVES, SAFETY PROTOCOLS, PPE, ALTERNATIVE STAFFING MATRIX, SURGE, FINANCIAL RECORDING PROTOCOLS, AND COMPLYING WITH THE COVID-19 DATA REPORTING REQUIREMENTS TO IDPH, IEMA.A MEMBER OF LOYOLA MEDICINE STAFF SERVES AS CHAIR OF THE ILLINOIS REGION 8 HEALTHCARE COALITION (HCC), INCLUDING LIAISING BETWEEN PARTICIPATING HOSPITALS, PUBLIC HEALTH AGENCIES, NON-HOSPITAL HEALTH ENTITIES, EMERGENCY MANAGEMENT AGENCIES AND FIRST RESPONDERS. REGIONAL AND STATE SITUATIONAL REPORTS WERE PRODUCED AND DISSEMINATED TO OVER 70 HCC MEMBERS. RESPONSE SUPPLIES AMASSED THROUGH THE ASPR HOSPITAL PREPAREDNESS PROGRAM AND THROUGH STRATEGIC NATIONAL STOCKPILE (SNS) REQUESTS SUBMITTED BY LUMC WERE DISTRIBUTED TO HCC MEMBERS. LOYOLA MEDICINE PARTNERED WITH IDPH FOR STAFFING OPTIONS. IN JANUARY 2022, LOYOLA MEDICINE OPENED A REGIONAL INCIDENT COMMAND FOR OMICRON RESPONSE AND CREATED AN EMERGENCY STAFFING PLAN.IN APRIL 2022, LOYOLA MEDICINE PARTICIPATED IN A MULTIREGIONAL MEDICAL RESPONSE SURGE EXERCISE (MRSE) TO ADDRESS COMMUNICATIONS, SURGE, TRANSPORT RESOURCES NECESSARY, AND RESOURCE REQUESTS THROUGHOUT REGIONS.THROUGH LUMC AND TRINITY HEALTH IT STARTS HERE FUNDS, MACNEAL WAS ABLE TO OFFER VACCINATIONS TO COMMUNITY MEMBERS FREE OF CHARGE. LOYOLA MEDICINE IS COMMITTED TO IMPROVING ACCESS TO AND PROMOTION OF HEALTHIER FOODS AND BEVERAGES FOR COLLEAGUES, PATIENTS, AND VISITORS BY INVESTING AND PROVIDING A HEALTHIER RETAIL ENVIRONMENT FOR THOSE WE SERVE THROUGH OUR MENUS, CAFETERIA SELECTIONS AND VENDING MACHINE OPTIONS.

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GCHSC 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.