4A (Expenses $ 294239774 including grants of $ 93068) (Revenue $ 324502947)
THE MERCY HOSPITAL HAS ESTABLISHED ITSELF AS ONE OF THE LEADING PROVIDERS OF HEALTH CARE SERVICES IN WESTERN MASSACHUSETTS. THE MERCY HOSPITAL IS A FULL-SERVICE ACUTE CARE HOSPITAL LICENSED FOR 182 BEDS PROVIDING SERVICES AND PROGRAMS FOR CARDIAC CARE, MATERNITY SERVICES, CANCER TREATMENT, EMERGENCY CARE, DIAGNOSTIC IMAGING, INTENSIVE CARE, CRITICAL CARE, AND SURGICAL PROCEDURES, IN AN INPATIENT AND OUTPATIENT SETTING. THE MERCY HOSPITAL ALSO PROVIDES A COMPREHENSIVE HOSPITAL-BASED REHABILITATION CENTER. PLEASE SEE SCHEDULE H AND THE WEBSITE AT WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/ FOR ADDITIONAL INFORMATION.

MERCY HOSPITAL, INC.
"PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MERCY HOSPITAL INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS 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. SOCIAL AND ECONOMIC FACTORS OR ""DETERMINANTS"" THAT INFLUENCE HEALTH:- LACK OF ACCESS AND AFFORDABILITY OF HOUSING, FOOD, AND TRANSPORTATION - EDUCATIONAL ATTAINMENT- EMPLOYMENT AND INCOME- VIOLENCE AND TRAUMA- ENVIRONMENTAL EXPOSURES AND CLIMATE CRISIS 2. BARRIERS TO HEALTHCARE ACCESS:- AVAILABILITY OF PROVIDERS AND TELEHEALTH- OTHER BARRIERS 3. HEALTH BEHAVIORS AND OUTCOMES:- YOUTH MENTAL HEALTH - MENTAL HEALTH AND SUBSTANCE USE- CHRONIC CONDITIONS AND OTHER HEALTH OUTCOMESADDITIONAL DESCRIPTIONS FOR EACH OF THE PRIORITIZED NEEDS AND SUB-NEEDS CAN BE FOUND IN THE HOSPITAL'S CHNA, WHICH IS LOCATED ON THE HOSPITAL'S WEBSITE: WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS"

MERCY HOSPITAL, INC.
PART V, SECTION B, LINE 5: THE INPUT OF THE COMMUNITY AND OTHER IMPORTANT REGIONAL STAKEHOLDERS WAS PRIORITIZED BY THE COALITION AS AN IMPORTANT PART OF THE CHNA PROCESS. BELOW ARE THE PRIMARY MECHANISMS FOR THE COMMUNITY AND STAKEHOLDER ENGAGEMENT: THE CHNA REGIONAL ADVISORY COMMITTEE (RAC) INCLUDED REPRESENTATIVES FROM EACH HOSPITAL/INSURER COALITION MEMBER AS WELL AS PUBLIC HEALTH AND COMMUNITY STAKEHOLDERS FROM EACH HOSPITAL SERVICE AREA. STAKEHOLDERS ON THE RAC INCLUDED LOCAL AND REGIONAL PUBLIC HEALTH AND HEALTH DEPARTMENT REPRESENTATIVES; REPRESENTATIVES FROM LOCAL AND REGIONAL ORGANIZATIONS SERVING OR REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME OR POPULATIONS OF COLOR; AND INDIVIDUALS FROM ORGANIZATIONS THAT REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY. THE COALITION CONDUCTED A STAKEHOLDER ANALYSIS TO ENSURE GEOGRAPHIC, SECTOR (E.G., SCHOOLS, COMMUNITY SERVICE ORGANIZATIONS, HEALTHCARE PROVIDERS, PUBLIC HEALTH, AND HOUSING), AND RACIAL/ETHNIC DIVERSITY OF THE RAC. THE RAC MET TO GUIDE THE CONSULTANTS IN THE PROCESS OF CONDUCTING THE CHNA, AND TO PRIORITIZE COMMUNITY HEALTH NEEDS, CHNA FINDINGS, AND DISSEMINATION OF INFORMATION. ASSESSMENT METHODS AND FINDINGS WERE MODIFIED BASED ON THE STEERING COMMITTEE FEEDBACK. THE RAC CONSISTED OF COMMUNITY MEMBERS, INCLUDING COALITION MEMBERS AND CONSULTANTS. THE RAC MET MONTHLY FROM 2021 THROUGH MID-2022. KEY INFORMANT INTERVIEWS, COMMUNITY CHATS AND FOCUS GROUPS WERE CONDUCTED TO BOTH GATHER INFORMATION USED TO IDENTIFY PRIORITY HEALTH NEEDS AND ENGAGE THE COMMUNITY. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH HEALTH CARE PROVIDERS, HEALTH CARE ADMINISTRATORS, LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS, AND LOCAL LEADERS THAT REPRESENT THE INTERESTS OF THE COMMUNITY OR THAT SERVE MEDICALLY UNDERSERVED, LOW-INCOME, OR POPULATIONS OF COLOR IN THE SERVICE AREA. INTERVIEWS WITH LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS WERE USED TO IDENTIFY PRIORITY HEALTH AREAS AND COMMUNITY FACTORS THAT CONTRIBUTE TO HEALTH NEEDS. COMMUNITY CHATS AND FOCUS GROUP PARTICIPANTS INCLUDED COMMUNITY ORGANIZATIONAL REPRESENTATIVES, COMMUNITY MEMBERS (LOW-INCOME, PEOPLE OF COLOR, AND OTHERS), AND OTHER COMMUNITY STAKEHOLDERS. KEY INFORMANT INTERVIEWS, COMMUNITY CHATS AND FOCUS GROUPS WERE CONDUCTED FROM 2021 THROUGH EARLY 2022. FOCUS GROUPS, COMMUNITY CHATS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED, PRIMARILY IN HAMPDEN COUNTY BUT ALSO ACROSS THE REGION. THIS CHNA ALSO USED QUALITATIVE DATA FROM OTHER HOSPITAL SERVICE AREAS AS APPROPRIATE. BELOW IS A LIST OF PUBLIC HEALTH AND COMMUNITY REPRESENTATIVES, AND OTHER STAKEHOLDERS INVOLVED IN THE PROCESS, WHICH INCLUDED REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE VULNERABLE POPULATIONS, WHICH INCLUDE CHILDREN, OLDER ADULTS, LATINOS, AFRICAN AMERICANS, AND REFUGEES, WERE REPRESENTED BY: FRANKLIN REGIONAL COUNCIL OF GOVERNMENTS, THE WOMEN'S FUND OF WESTERN MASSACHUSETTS, COLLABORATIVE FOR EDUCATIONAL SERVICES, ARMBROOK VILLAGE, WAY FINDERS, UNIVERSITY OF MASSACHUSETTS, SAMARITAN INN, SERVICENET, WESTERN MASSACHUSETTS VETERANS OUTREACH, UNITED CEREBRAL PALSY ASSOCIATION OF WESTERN MASSACHUSETTS, UNITED WAY OF THE FRANKLIN & HAMPSHIRE REGION, SPRINGFIELD DEPARTMENT OF HEALTH AND HUMAN SERVICES CITY OF SPRINGFIELD, DRUG FREE COMMUNITIES, MONTAGUE CATHOLIC SOCIAL MINISTRIES, UNITED WAY OF PIONEER VALLEY, HILLTOWN COMMUNITY HEALTH CENTER, STAVROS CENTER FOR INDEPENDENT LIVING, METROCARE OF SPRINGFIELD, CENTER FOR NEW AMERICANS, WESTERN MASS TRAINING CONSORTIUM, PARENT VILLAGES, MEN OF COLOR HEALTH AWARENESS, YOUNG WOMEN'S ADVISORY COUNCIL OF WESTERN MASSACHUSETTS, COMMUNITY ACTION PIONEER VALLEY, COMMUNITY FOUNDATION OF WESTERN MASSACHUSETTS.

MERCY HOSPITAL, INC.
PART V, SECTION B, LINE 6A: MERCY HOSPITAL IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS, A PARTNERSHIP ORIGINALLY FORMED IN 2012 WHICH NOW INCLUDES THE FOLLOWING NON-PROFIT HOSPITALS AND INSURER IN THE REGION: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HOSPITAL, MERCY MEDICAL CENTER, SHRINERS CHILDREN'S NEW ENGLAND, BERKSHIRE HEALTH SYSTEMS, AND HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREAS COVER THE FOUR COUNTIES OF WESTERN MASSACHUSETTS.

MERCY HOSPITAL, INC.
PART V, SECTION B, LINE 6B: MERCY HOSPITAL COLLABORATED WITH HEALTH NEW ENGLAND, A HEALTH INSURANCE PROVIDER, IN CONDUCTING THE CHNA.

MERCY HOSPITAL, INC.
PART V, SECTION B, LINE 11: MERCY HOSPITAL SUPPORTED INITIATIVES TO IMPROVE THE FOLLOWING SIGNIFICANT HEALTH NEEDS IN FISCAL YEAR 2022: BARRIERS TO HEALTHCARE ACCESS -MERCY HOSPITAL IMPLEMENTED AN INITIATIVE TO IMPROVE HEALTH LITERACY, ALONG WITH ACCESS TO CERVICAL CANCER SCREENINGS AND MAMMOGRAMS FOR HOMELESS WOMEN. THE IMPLEMENTATION STRATEGY'S GOAL WAS TO INCREASE THE NUMBER OF HOMELESS WOMEN WHO PARTICIPATE IN WOMEN'S HEALTH SCREENINGS. TO ACCOMPLISH THIS GOAL, MERCY HOSPITAL CONTINUED TO PERFORM CERVICAL CANCER SCREENINGS, AND VERIFIED THE CERVICAL SCREENING RECORDS AND MAMMOGRAMS PERFORMED INSIDE AND OUTSIDE OF MERCY HOSPITAL. ADDITIONALLY, MERCY HOSPITAL CONTINUED PROVIDING EDUCATION ON THE HEALTH RISKS PERTAINING TO WOMEN'S HEALTH.MERCY HOSPITAL, AS PART OF TRINITY HEALTH OF NEW ENGLAND, DEVELOPED A COMPREHENSIVE VIRTUAL CARE STRATEGY TO MEET THE NEEDS OF THE BROADER COMMUNITY. THE VIRTUAL CARE PROGRAM INCLUDED: AN ASYNCHRONOUS PLATFORM FOR URGENT CARE NEEDS, LIKE COLDS, FLU, SINUS INFECTIONS, UTI'S, PINKEYE, AND OTHER MINOR CONDITIONS; A SYNCHRONOUS PLATFORM OFFERING VIDEO VISITS FOR PRIMARY CARE, FAMILY MEDICINE AND PEDIATRICS; AND CARECONNECTOR, A 24/7 VIRTUAL ASSISTANT FOR HEALTH WHO CAN HELP WITH SYMPTOM SCREENING, VIRTUAL VISITS, PATIENT NAVIGATION, AND GETTING QUESTIONS ANSWERED.MERCY HOSPITAL, ALONG WITH ITS FELLOW PARTNERS IN THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS CONVENED TO ADDRESS HEALTH BEHAVIORS AND OUTCOMES IN THE COMMUNITY. THE NEED FOR BETTER PREVENTIVE CARE FOR YOUTH MENTAL HEALTH WAS DETERMINED TO BE A SHARED GOAL. THE COALITION PROMOTED EXPANDING THE REACH OF THE LOCAL YOUTH MENTAL HEALTH INITIATIVES INCLUDING THE YOUNG ADULT EMPOWERMENT COLLABORATIVE OF WESTERN MASSACHUSETTS, THE SPRINGFIELD YOUTH MENTAL HEALTH COALITION, AND THE HAMPDEN CHIP MENTAL HEALTH AND SUBSTANCE USE DISORDER COMMUNITY TEAM.MERCY HOSPITAL IS COMMITTED TO ADHERING TO ITS MISSION AND REMAINING GOOD STEWARDS OF ITS RESOURCES SO IT CAN CONTINUE TO ENHANCE ITS CLINICAL ACTIVITIES AND TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE FOLLOWING AREA HAS BEEN IDENTIFIED IN THE CHNA AS NEEDS THAT WERE NOT ADDRESSED IN FISCAL YEAR 2022 IN ORDER TO FOCUS EFFORTS ON ADDRESSING BARRIERS TO HEALTHCARE ACCESS: SOCIAL AND ECONOMIC DETERMINANTS THAT INFLUENCE HEALTH AND HEALTH BEHAVIORS AND OUTCOMES.

MERCY HOSPITAL, INC.
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.

MERCY HOSPITAL, INC. - 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.

THE MERCY HOSPITAL - PART V, SECTION B, LINE 7A
WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

THE MERCY HOSPITAL - PART V, SECTION B, LINE 10A:
WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

THE MERCY HOSPITAL - PART V, SECTION B, LINE 16A:
WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/

THE MERCY HOSPITAL - PART V, SECTION B, LINE 16B:
WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/

THE MERCY HOSPITAL - PART V, SECTION B, LINE 16C:
WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/

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:
MERCY HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF MASSACHUSETTS. IN ADDITION, MERCY HOSPITAL 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. IN ADDITION, MERCY HOSPITAL 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, $8,328,403, 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:
MERCY HOSPITAL 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, MERCY HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MERCY HOSPITAL IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL.

PART III, LINE 4:
"MERCY HOSPITAL 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:
MERCY HOSPITAL 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 - MERCY HOSPITAL ASSESSES 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 INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.

PART VI, LINE 7, REPORTS FILED WITH STATES
MA

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HOSPITAL 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. MERCY HOSPITAL 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. MERCY HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HOSPITAL 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 - MERCY'S SERVICE AREA, WHICH INCLUDES THE 23 COMMUNITIES IN HAMPDEN COUNTY AND GRANBY, A CITY IN HAMPSHIRE COUNTY. HAMPDEN COUNTY IS HOME TO 467,871 RESIDENTS. SPRINGFIELD IS THE LARGEST CITY IN THE SERVICE AREA AND THE THIRD LARGEST IN MASSACHUSETTS. THREE ADJACENT CITIES (HOLYOKE, CHICOPEE, AND WEST SPRINGFIELD) JOIN SPRINGFIELD TO CREATE A DENSELY POPULATED URBAN CORE THAT HOUSES OVER HALF OF THE COUNTY POPULATION. EAST AND WEST OF THIS CENTRAL CORE ARE SMALLER COMMUNITIES, A MAJORITY WITH POPULATIONS UNDER 20,000. THE PIONEER VALLEY TRANSIT AUTHORITY, THE SECOND LARGEST PUBLIC TRANSIT SYSTEM IN THE STATE, SERVES 11 COMMUNITIES IN THE SERVICE AREA, AND CONNECTS SUBURBAN AREAS TO THE CORE CITIES AND SERVICES. SPANNING THE GEOGRAPHICALLY DIVERSE SERVICE AREA, ONE FINDS A WEALTH OF COMMUNITY-BASED ORGANIZATIONS, RESOURCES, AND COLLABORATIONS; A VIBRANT ARTS AND CULTURE SCENE; ANCHOR EDUCATION, HEALTH, AND CORPORATE INSTITUTIONS; A STRONG PHILANTHROPIC NETWORK; AND OTHER ASSETS THAT CONTRIBUTE TO THE REGION'S STATUS AS A DESTINATION TO LIVE, WORK, AND PLAY.ACCORDING TO CENSUS ESTIMATES, THE SERVICE AREA HAS BECOME SLIGHTLY MORE DIVERSE SINCE THE LAST COMMUNITY HEALTH NEEDS ASSESSMENT. HAMPDEN COUNTY EXPERIENCED SMALL INCREASES IN THE PROPORTION OF ALL RACIAL AND ETHNIC GROUPS EXCEPT WHITE RESIDENTS, ESPECIALLY IN THE LARGER CITIES. THE SERVICE AREA POPULATION IS NOW 60% WHITE, 23% LATINX, 8% BLACK, 5% TWO OR MORE RACES, AND 3% ASIAN. THE PROPORTION OF FOREIGN-BORN RESIDENTS IN THE SERVICE AREA IS CLOSE TO 9%, HALF THE STATEWIDE PROPORTION. IN SPRINGFIELD, ONE IN TEN RESIDENTS IS FOREIGN BORN.THE MEDIAN AGE OF THE COUNTY IS 39 YEARS AND CONTINUES TO CLOSELY MIRROR THE STATE, WHILE SPRINGFIELD REMAINS A RELATIVELY YOUNGER CITY WITH A MEDIAN AGE OF JUST OVER 33 YEARS. THE COUNTY HAS A HIGHER PROPORTION OF RESIDENTS WITH A DISABILITY (12%) THAN THE STATE OVERALL (8%), AND SPRINGFIELD'S PROPORTION OF RESIDENTS WITH A DISABILITY (16%) IS DOUBLE THAT OF THE STATE.HAMPDEN COUNTY CONTAINS SIX ACUTE CARE HOSPITAL FACILITIES. SEVERAL AREAS AND POPULATIONS IN HAMPDEN COUNTY ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA). OVER 54% PERCENT OF HAMPDEN COUNTY RESIDENTS LIVE IN A HPSA. THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS (MUA/MUP) IN HAMPDEN COUNTY ARE PRIMARILY FOUND IN SPRINGFIELD, WEST SPRINGFIELD, WESTFIELD, BLANDFORD, AND CHESTER. MUA AND MUP ARE IDENTIFIED BASED ON AVAILABILITY OF PRIMARY CARE PROVIDERS, INFANT MORTALITY RATE, POVERTY RATE, AND PROPORTION OF OLDER ADULTS.

PART VI, LINE 5:
"MERCY HOSPITAL PROMOTED THE HEALTH OF THE COMMUNITY BY OFFERING THE FOLLOWING:HEALTH CARE FOR THE HOMELESS (HCH) - MERCY HOSPITAL'S DEPARTMENT OF COMMUNITY HEALTH PROVIDED CARE TO THE COMMUNITY'S HOMELESS POPULATION IN FRANKLIN, HAMPSHIRE, AND HAMPDEN COUNTIES THROUGH PRIMARY CARE SERVICES, HEALTH EDUCATION, CASE MANAGEMENT, MENTAL HEALTH SERVICES, AND FREE CLINICS. MORE THAN 5,000 TOTAL MEDICAL ENCOUNTERS INCLUDING MENTAL HEALTH SERVICES AND COVID-19 TEST AND VACCINE ADMINISTRATION WERE PROVIDED. IN THE ONGOING EFFORT TO IDENTIFY HOMELESS PERSONS IN WESTERN MASSACHUSETTS, THE HCH STAFF (WHICH INCLUDES PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, MEDICAL HEALTH COUNSELORS, AND MEDICAL ASSISTANTS) ASSESS HOMELESS NEEDS AND RESOURCES, DELIVERS HEALTH AND SOCIAL SERVICES, AND EVALUATES THE IMPACT.THE HCH TEAM ALSO IMPLEMENTED THE FOLLOWING TO ADDRESS HOMELESSNESS:ESG GRANT 1 - A COMMUNITY OUTREACH NURSE RN AND COMMUNITY HEALTH WORKER WORKED IN TANDEM TO PROVIDE OUTREACH SERVICES TO INDIVIDUALS WHO ARE UNWILLING/UNABLE TO SLEEP IN CONGREGATE LIVING SITUATIONS, FOCUSING ON HAMPDEN COUNTY. THEIR OUTREACH SERVICES INCLUDED CASE MANAGEMENT, EMPLOYMENT ASSISTANCE, AND JOB TRAINING, LIFE SKILLS TRAINING, MENTAL HEALTH SERVICES, AND SUBSTANCE USE TREATMENT. BASIC PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES WERE ALSO OFFERED THROUGH REFERRAL TO THE HEALTHCARE FOR THE HOMELESS CLINIC. ESG GRANT 2 - EXPANDED COMMUNITY OUTREACH EFFORTS WITH A SOCIAL WORKER AS WELL AS A SECOND COMMUNITY HEALTH WORKER. THEY WORKED IN TANDEM WITH THE ESG 1 TEAM TO PROVIDE OUTREACH SERVICES TO INDIVIDUALS WHO WERE UNWILLING/UNABLE TO SLEEP IN CONGREGATE LIVING SITUATIONS, FOCUSING ON SPRINGFIELD. COVID-19 EPIDEMIC - BESIDES OFFERING COVID-19 TESTING AND VACCINATION SERVICES TO THE COMMUNITY, MERCY HOSPITAL, AS PART OF THE TRINITY HEALTH OF NEW ENGLAND HEALTH SYSTEM, WAS INVOLVED IN A MULTIFACETED PUBLIC HEALTH AWARENESS MEDIA CAMPAIGN. COMMUNICATIONS ON COVID-19 PREVENTION, TESTING AND TREATMENT ALSO INCLUDED TARGETED MESSAGING FOR DIVERSE COMMUNITIES AS WELL AS TARGETED MESSAGING FOR CHILDREN. THE TRINITY HEALTH ""IT STARTS HERE"" CAMPAIGN SUPPORTED COVID-19 VACCINE OUTREACH, EDUCATION, AND CLINICS BY GRANTING SUBCONTRACTS TO LOCAL COMMUNITY-BASED ORGANIZATIONS WHICH INCLUDED THE PUBLIC HEALTH INSTITUTE OF WESTERN MA, BLACK SPRINGFIELD COVID-19 COALITION, NEW NORTH CITIZENS' COUNCIL, EDUCARE SPRINGFIELD, AND OPEN PANTRY COMMUNITY SERVICES, INC. THE COMMUNITIES OF FOCUS WERE COMMUNITIES OF COLOR AND THOSE WHO ARE VULNERABLE LIVING IN SPRINGFIELD. ACTIONS INCLUDED: PROVIDING VACCINES TO COMMUNITY MEMBERS AND HOSTING VACCINE CLINICS AT COMMUNITY EVENTS; HAVING BILINGUAL COMMUNITY OUTREACH CHAMPIONS GO DOOR-TO-DOOR TO ADDRESS CONCERNS AROUND THE VACCINE; ENGAGING LOCAL SOCIAL MEDIA INFLUENCERS AND RADIO STATIONS TO PROMOTE THE ""IT STARTS HERE"" CAMPAIGN ON THE IMPORTANCE OF BEING VACCINATED."

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MERCY HOSPITAL 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, AND 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.