4A (Expenses $ 45633859 including grants of $ 0) (Revenue $ 70054957)
HSHS ST. JOSEPH'S HOSPITAL, BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS PROVIDES QUALITY HEALTH CARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS ESSENTIAL TO THE CONTINUED OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS ARE ABLE TO AFFORD REQUIRED MEDICAL SERVICES. OUR MISSION IS TO SERVE THE COMMUNITY WITH THE BEST QUALITY HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. INHERENT IN OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF COMMUNITY SUPPORT ACTIVITIES. IN OUR TAX YEAR BEGINNING JULY 1, 2021 AND ENDING JUNE 30, 2022, HSHS ST. JOSEPH'S HOSPITAL, BREESE PROVIDED SERVICES TO 1,485 INPATIENTS UTILIZING 4,777 DAYS OF CARE. IN ADDITION, HSHS ST. JOSEPH'S HOSPITAL, BREESE PROVIDED SERVICES TO 72,684 OUTPATIENTS. HSHS ST. JOSEPH'S HOSPITAL, BREESE PROVIDES QUALITY MEDICAL CARE TO THE POOR AT NO COST THROUGH OUR CHRISTIAN CARE PROGRAM. IN ADDITION, THE HOSPITAL PARTICIPATES IN THE ILLINOIS MEDICAID PROGRAM, WHICH REIMBURSES THE HOSPITAL AT RATES SUBSTANTIALLY BELOW THE COST OF PROVIDING THE SERVICES. FULFILLING OUR MISSION TO THE COMMUNITY, SERVICES WERE PROVIDED TO 3,618 MEDICAID PATIENTS. THE COST OF PROVIDING SERVICES TO MEDICAID PATIENTS EXCEEDED REIMBURSEMENT UNDER THE STATE OF ILLINOIS MEDICAID PROGRAM BY $2,175,477. THE TOTAL UNREIMBURSED VALUE OF PROVIDING CARE TO THE POOR IS $2,172,477. HSHS ST. JOSEPH'S HOSPITAL, BREESE PROVIDES QUALITY MEDICAL CARE TO MEMBERS OF THE BROADER COMMUNITY THROUGH PARTICIPATION IN THE MEDICARE PROGRAM AND THROUGH EDUCATIONAL PROGRAMS AND ACTIVITIES AT A REDUCED PRICE, OR AT NO COST. HSHS ST. JOSEPH'S HOSPITAL, BREESE PROVIDED MEDICAL SERVICES TO 22,384 MEDICARE AND MEDICARED MANAGED CARE PATIENTS.

Schedule H, Part V, Section B, Line 3E
Yes, the significant health needs are a prioritized description of the significant health needs of the community and were identified through the CHNA process.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - HSHS St. Joseph's Hospital Breese. St. Joseph's Hospital undertook an eight-month planning and implementation effort to develop the CHNA, identify and prioritize community health needs for its service area and formulate an implementation plan to guide ongoing population health initiatives with like-missioned partners and collaborators. These planning and development activities included the following internal and external steps: 1. Identified the CHNA core group comprised of St. Joseph's Hospital and Clinton County Health Department. 2. Convened a community advisory committee to solicit input and help narrow identified priorities. 3. Conducted a community survey to get input from community members around the priorities identified. 4. Convened an internal advisory committee respective to each organization to force rank the final priorities and select the FY2022-FY2024 CHNA priorities. External St. Joseph's Hospital worked with core group partners to leverage existing relationships and provide diverse input for a comprehensive review and analysis of community health needs in Clinton County. Representation on the community advisory council (CAC) was sought from health and social service organizations that: 1. Serve low-income populations 2. Serve at-risk populations 3. Serve minority members of the community 4. Represent the general community The following community stakeholders were invited to serve on the external advisory committee: * HSHS St. Joseph's Hospital* * Catholic Charities* * City of Breese * City of New Baden * Clinton County Coroner's Office * Clinton County Health Department* * City Police/County Sheriff's Department * University of Illinois Extension * Wesclin Community Unit School District (CUSD) #3* * Carlyle Senior Center * Greater Clinton County Chamber * County Board Chair * CEFS Community Action Agency* * Breese Area Ministerial Alliance* * Denotes groups representing the under resourced in our community including low-income seniors, children living in poverty and families who struggle with shelter and food.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - HSHS St. Joseph's Hospital Breese. Yes, the hospital conducted its FY2021 CHNA with HSHS St. Joseph's Hospital and: * Catholic Charities* * City of Breese * City of New Baden * Clinton County Coroner's Office * Clinton County Health Department* * City Police/County Sheriff's Department * University of Illinois Extension * Wesclin Community Unit School District (CUSD) #3* * Carlyle Senior Center * Greater Clinton County Chamber * County Board Chair * CEFS Community Action Agency* * Breese Area Ministerial Alliance*

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - HSHS St. Joseph's Hospital Breese. In FY2021, HSHS St. Joseph's Breese Hospital conducted a CHNA. The hospital partnered with other agencies and reviewed primary and secondary data. Then the internal work group gathered and based on the data and the prioritization process, the following priority community health needs were selected: 1. Access to Mental Health and Behavioral Health Services 2. Chronic Conditions 3. Workforce Development FY2022 Highlights and Outcomes: A partnership with Gateway Foundation launched in FY2022 to identify, connect, screen and develop a treatment plan for persons presenting in the ED with substance use disorder. This initiative employs an engagement specialist who works with the provider to identify referral and linkages to address the patients addiction. The recovery coach helps the patient transition back in the community when exiting residential treatment. St. Joseph's Hospital along with three others in southern Illinois engaged in an 18-month planning process to identify solutions to crisis screening gaps in the emergency department. In FY2023, the plan will be presented to strategy and finance teams with the goal of deploying in January 2023. As part of this plan, SJB will have 365-day psychiatric coverage in the emergency department. SJB has used the better part of FY2022 to vet and operationalize the use of a determinants of health screening tool for every patient entering the hospital. The goal is to expand this to Primary care physician settings as well. This tool will allow us to make referrals to social service agencies in direct response to our patient's social needs. HSHS launched a DEI committee in FY2022. SJB participates in the Workforce Subcommittee to explore internal and external gaps in workforce readiness, obtainment, and success. Additionally, transportation continues to be a FY2022 focus specifically to assist individuals in accessing medical, dental and other personal appointments. As an outcome of the prioritization process, the following community health needs were also identified but will not be addressed directly by the hospital for reasons indicated: * Affordable Housing: While not a direct priority issue, affordable housing challenges and barriers will be explored within the strategic plan of workforce barriers. * Human Trafficking: This is an ever-growing issue in all communities across Illinois and the nation. HSHS St. Joseph's Hospital will be represented on the Illinois Human Trafficking Task Force by the HSHS Illinois division. While not a direct priority area, HSHS and St. Joseph's Hospital will continue to raise awareness in HSHS facilities and the community on identification and response to human trafficking. * Maternal Health and Child Health: St. Joseph's is not focusing on this need as part of the CHNA. St. Joseph's continues to offer obstetrics, prenatal and neonatal support, in addition to comprehensive women's services. With a comprehensive line of obstetrical, pediatric, and cardiovascular care programs, among many others services, St. Joseph's Hospital Breese has spent years helping women manage and maintain their health in a variety of crucial ways. * Nutrition and Healthy Eating (Access and Knowledge): While not a direct priority issue, nutrition and healthy eating will be addressed within chronic disease education and prevention strategies. * Oral Health: St. Joseph's Hospital will work closely with the surrounding county health departments to raise awareness and provide patient referrals for dental services. * Transportation: Less than 12% of respondents identified transportation as a barrier or challenge. Additionally, St. Joseph's Hospital recently supported a rural transportation grant application to increases transportation for medical appointments across counties. St. Joseph's Hospital continues to offer transportation services through its Friends Van. * Poverty and Disparities in Economy: While not a top priority, the workforce development strategies developed will assist in further preparing individuals for employment.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - St. Joseph's Hospital. Presumptive eligibility is presumed under certain circumstances for uninsured patients based on their enrollment in other means-tested programs or other sources of information, not provided directly by the patient. Once determined, presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 6c. Wisconsin Department of Health Services Housing Assistance Program 7. Participation in Women, Infants and Children programs (WIC); 8. Supplemental Nutrition Assistance Program (SNAP) eligibility; 9. Low Income Home Energy Assistance Program (LIHEAP); 10. Wisconsin Home Energy Assistance Program (WHEAP); 11. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 12. Receipt of grant assistance for medical services

Schedule H, Part I, Line 7g Subsidized Health Services
SCH H, PART I, LINE 7G INCLUDES SUBSIDIZED HEALTH SERVICES RELATED TO THE HOSPITAL'S RURAL HEALTH CLINICS.

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED WORKSHEET 2 WAS USED TO CALCULATE A COST TO CHARGE RATIO USING INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORTS. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET 1 TO CALCULATE THE COST OF FINANCIAL ASSISTANCE PROVIDED AND WORKSHEET 3 TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. THE COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH PROGRAM, AND DONATIONS ARE STATED AT ACTUAL COST (when applicable). THE COST OF THESE ITEMS ARE TRACKED THROUGH THE GENERAL LEDGER PROCESS AND THROUGH OTHER ACCOUNTING SOFTWARE.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
FOR FINANCIAL STATEMENT PURPOSES, HOSPITAL SISTERS HEALTH SYSTEM HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
The text of the footnote to the organization's financial statements that describes bad debt expense can be found on pages 16-17 in the HSHS Consolidated Audit Report.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE HOSPITAL CONTINUALLY STRIVES TO PROVIDE EXCELLENT PATIENT CARE IN THE MOST COST EFFECTIVE FASHION. NONETHELESS, THE MEDICARE PROGRAM, IN MANY CASES, DOES NOT PROVIDE PAYMENT THAT COVERS THE FULL COST OF THE CARE PROVIDED. SINCE IT IS THE MISSION OF THE HOSPITAL TO RESPOND TO COMMUNITY NEED, HOSPITAL LEADERSHIP CONTINUALLY ADVOCATES FOR IMPROVED MEDICARE PAYMENT SO THAT THE COST OF QUALITY CARE TO THOSE PATIENTS WHO ARE NOT ABLE TO AFFORD IT IS NOT COMPROMISED AND IS FAIRLY SUBSIDIZED BY ALL PAYERS. THE IRS DOES NOT CLASSIFY THIS SHORTFALL IN MEDICARE PAYMENTS AS COMMUNITY BENEFIT. HOWEVER, WE BELIEVE IT IS AN IMPORTANT CONTRIBUTION MADE BY THE HOSPITAL TO THE HEALTH AND WELL-BEING OF THE COMMUNITY. IF THE MEDICARE PROGRAM DID NOT EXIST, MANY MEDICARE PATIENTS WOULD BE ELIGIBLE FOR FINANCIAL ASSISTANCE OR OTHER MEANS-TESTED GOVERNMENT PROGRAMS. FURTHER, BY ABSORBING THIS SHORTFALL AND PROVIDING CARE BELOW COST TO THESE INDIVIDUALS, THE HOSPITAL IS RELIEVING THE BURDEN OF THE GOVERNMENT. ACCORDINGLY, THIS SHORTFALL RESTRICTS THE HOSPITAL'S ABILITY TO MAKE FUNDS AVAILABLE TO PROVIDE FOR FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT. THE HOSPITAL'S MEDICARE SHORTFALL AT COST FOR FISCAL YEAR 2022 WAS $308,472.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
Every effort is made prior to, during and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and provide adequate documentation. If the patient qualified for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualified for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections. The hospital will make reasonable efforts to determine whether a patient is eligible under the financial assistance policy before it engages in an ECA. To the extent a patient is determined to be eligible for financial assistance under the FAP, the hospital will take all reasonably available measures to reverse any ECA taken against the patient to obtain payment for the care.

Schedule H, Part V, Section B, Line 16a FAP website
- ST. JOSEPH'S HOSPITAL: Line 16a URL: http://www.hshs.org/FAP;

Schedule H, Part V, Section B, Line 16b FAP Application website
- ST. JOSEPH'S HOSPITAL: Line 16b URL: http://www.hshs.org/FAP;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- ST. JOSEPH'S HOSPITAL: Line 16c URL: http://www.hshs.org/FAP;

Schedule H, Part VI, Line 7 State filing of community benefit report
IL

Schedule H, Part VI, Line 2 Needs assessment
St. Joseph's Hospital is a leading member of the Clinton County Health Improvement Coalition. The Coalition consists of 30 individuals representing 20 agencies. Their meetings are held quarterly and the Steering Committee for the group also meets an additional four times during the year. During the meetings held, members provide an update on activities of their organization and the needs of those they serve. This provides the hospital with an ongoing assessment of the health needs in the community. In addition to representatives from public health, attendees include representatives of a local minority population. Meetings of the hospital's Patient Family Advisory Committee, Community Engagement Council, and HSHS St. Joseph's Hospital Foundation are held each quarter. Members are provided updates on the hospital's services and how the hospital is meeting the community's health needs. During the meeting, members are also provided an opportunity to provide feedback about any concerns heard from other community residents. Members of the Board of Directors and Foundation Leadership Council are asked for input throughout the year. In addition, hospital colleagues represent the hospital at various community group meetings, which provides a way to learn of any emerging needs and to offer support. Feedback is also obtained through ongoing patient surveys to patients receiving care on the inpatient unit, emergency department, surgical services and outpatient areas. Community members attending the eight local health fairs held throughout the year are also asked to complete a survey. The survey asks for their input about needs in the community. Individuals are also asked to identify what they consider to be the highest priority need.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
The Registration Department provides brochures to patients upon registration regarding the Financial Assistance Program available to them at the Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. To better serve our patient population, the Hospital offers information on our financial assistance program in Spanish. This includes the Financial Assistance Policy, Brochure and Application, which allows the hospital to serve populations in its county and the surrounding area for whom Spanish is their primary language. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the Internet address where the policy can be obtained. A third-party vendor also assists individuals in determining their eligibility for state health plans or insurance on the open health insurance marketplace. They can also assist with the application process.

Schedule H, Part VI, Line 4 Community information
St. Joseph's Hospital's service area is comprised of approximately 503 square miles with a population of approximately 37,562 residents and a population density of 75 people per square mile. The service area consists of the following cities and rural communities: Albers, Aviston, Bartelso, Beckemeyer, Breese, Carlyle, Centralia, Damiansville, Germantown, Hoffman, Huey, Keyesport, New Baden, and Trenton. St. Joseph's is the sole hospital provider in the county and does not exclude Medically Underserved Areas (MUAs), low income or minority populations from its service area. Based on the U.S. Census Bureau's information, the population of the entire county has held about the same over the past six years. The median age is 39 years of age with 15.7% of the population over the age of 65 compared to 13.5% over the age of 65 in the state of Illinois. Cultural diversity is increasing with slight growth seen in the Hispanic population of 13% since 2016. A higher proportion of the Clinton County population (11.8%) is disabled than the state (10.73%). Current unemployment rate is 3.7%. Median household income has risen to $66,639, which is slightly above the median household income for Illinois at $55,278. Persons living below the federal poverty level are 8.87% of the population, an increase of 1%. The proportion of residents who are food insecure in Clinton County (8.7%) is lower than the state (10.1%), though the percent of the food insecure population ineligible for assistance (46%) is higher than the state rate of 32%. Per the most recent US Census information, 4.5% of Clinton County residents under the age of 65 years old are without health insurance. Of those insured under 65 years of age, 28% are covered by public insurance. Clinton County is in an area designed as a shortage area for primary care health professionals (HPSA). This designation is made by the U.S. Department of Health & Human Services. The designation is also in place for mental health professionals.

Schedule H, Part VI, Line 5 Promotion of community health
As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), St. Joseph's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1897, the hospital brings a healing presence and improves the health of our community, especially those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of Breese and surrounding areas. The hospital is governed by a Board of Directors, most of whom reside in the hospital's primary service area and are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that St. Joseph's Hospital is responding to community need. In FY2019, for example, reports are provided to Board members throughout the year to update them on community health initiatives as well as an annual report. This provides them an opportunity to give input and directional guidance. In addition, St. Joseph's Hospital receives community support and guidance through the Patient Family Advisory Council, Community Engagement Council, and HSHS St. Joseph's Foundation Leadership Council. The Family Advisory Council and Community Engagement Council meeting quarterly, while the Foundation Leadership Council meetings every other month. These groups provide feedback from the community on additional services or improvements needed, as well as helps the hospital understand the community's perception of those services and identify potentials opportunities for improvement. St. Joseph's Hospital is blessed with a strong volunteer program. Volunteers are active in many hospital departments daily and donate many more hours throughout the year to hospital-sponsored community programs. Consistent with its exempt purpose, St. Joseph's Hospital has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Joseph's Hospital reinvests surplus funds to support the mission of the organization and promote the health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. St. Joseph's Hospital also devotes significant resources to access for patients who cannot afford care, along with other Community Benefits. In FY2022, St. Joseph's Hospital provided more than $3.48 million in Community Benefit, including financial assistance at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. St. Joseph's Hospital provides a range of Community Benefit initiatives and programs that further our mission and long-standing commitment to our community. In many cases, these Community Benefits would not exist without the leadership role played by St. Joseph's Hospital and they often relieve a burden that would otherwise be carried by government.

Schedule H, Part VI, Line 6 Affiliated health care system
Headquartered in Springfield, Illinois, Hospital Sisters Health System (HSHS) is a highly integrated, multi-institutional health care system comprised of 15 hospitals and more than 200 physician practice sites in Illinois and Wisconsin. HSHS is sponsored by Hospital Sisters Ministries (HSM), which is a public juridic person of the Roman Catholic Church. HSHS continues the health care ministries begun by its founders, the Hospital Sisters of St. Francis, more than 140 years ago, in rural and midsized communities throughout Illinois and Wisconsin. HSHS provides compassionate, holistic, high quality, and cost-effective health care through its acute care hospitals, physician practices, home health programs, palliative and hospice programs, and community outreach services. In addition, HSHS affiliated hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Our mission calls us to reveal and embody Christ's healing love for all people, and we extend our high quality Franciscan health care ministry beyond the walls of our hospitals by providing community health improvement services with special emphasis on the poor and vulnerable. In addition to providing community health improvement services to the broader community, HSHS cares for everyone who comes to its facilities, regardless of their ability to pay. In tandem with a variety of cross sector community partners, HSHS's Community Benefit initiatives are strategically planned and professionally implemented to improve access to health care services; enhance the health of the community; advance medical or general health care knowledge; and relieve or reduce the burden of government to improve health. The COVID-19 pandemic caused an unprecedented disruption in healthcare services across the United States. HSHS responded with services that benefited our communities, including free telehealth screenings, free testing, and coordination with other healthcare providers in the communities we serve to best ensure access to needed care. In FY2022, HSHS collectively provided $218.9 million in Community Benefit (8.3% of total hospital expenses). Of the total Community Benefit provided, HSHS spent $11.6 million provided for Financial Assistance (aka Charity Care) and $146.1 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $23.2 million. HSHS hospitals also recorded $68.7 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care.