4A (Expenses $ 282207922 including grants of $ 35371) (Revenue $ 303606855)
BRONSON BATTLE CREEK HOSPITAL (BBCH) IS A MEDICAL CENTER PROVIDING ACUTE CARE MEDICAL AND SURGICAL SERVICES. BBCH HAS 228 BEDS AND PROVIDES SERVICES TO THE GREATER BATTLE CREEK AREA AND SURROUNDING COMMUNITIES. BBCH FEATURES SERVICES SUCH AS BEHAVIORAL HEALTH, CANCER CARE, ROBOTIC SURGERY, WORLD-CLASS DIAGNOSITCS, AND WOUND HEALING.

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
IN 2021, BBCH'S MEDICAID COST WAS $58,768,695 MEDICAID NET REVENUE WAS $46,636,476.

4C (Expenses $ 14487003 including grants of $ 0) (Revenue $ 0)
IN FURTHERANCE OF ITS MISSION, BBCH INCURRED $14,487,003 IN BAD DEBT EXPENSE TO PROVIDE CARE TO ITS PATIENTS.

BRONSON BATTLE CREEK HOSPITAL
PART V, SECTION B, LINE 5: AT BRONSON, THE CHNA PROCESS HAD OVERSIGHT FROM A SYSTEM-WIDE ADVISORY COMMITTEE WHOSE ANALYSIS AND RECOMMENDATIONS WERE BROUGHT TO THE EXECUTIVE TEAM AND TO THE BRONSON HEALTHCARE BOARD COMMUNITY HEALTH COMMITTEE FOR FINAL DELIBERATION AND APPROVAL. THE CHNA FOR CALHOUN COUNTY WAS AN EXTERNAL COLLABORATIVE PROCESS SUPPORTED AND LED BY CALHOUN'S REGIONAL HEALTH ALLIANCE. THE FOLLOWING INDIVIDUALS AND ORGANIZATIONS CONDUCTED THE CHNA COLLABORATIVELY AS PART OF CALHOUN'S REGIONAL HEALTH ALLIANCE: ALBION HEALTH CARE ALLIANCE ASCENSION BORGESS BATTLE CREEK COMMUNITY FOUNDATION BRONSON BATTLE CREEK HOSPITAL CALHOUN COUNTY PUBLIC HEALTH DEPARTMENT CAREWELL SERVICES SOUTHWEST GRACE HEALTH BATTLE CREEK GRADUATE MEDICAL EDUCATION RESIDENCY PROGRAM INTEGRATED HEALTH PARTNERS OAKLAWN HOSPITAL OAKLAWN MEDICAL GROUP HOMER/ ALBION REGIONAL HEALTH ALLIANCE SUMMIT POINTE THE COORDINATING COUNCILSECONDARY DATA USED FOR THIS ASSESSMENT WERE COLLECTED AND ANALYZED FROM CONDUENT HEALTHY COMMUNITIES INSTITUTE'S (HCI) COMMUNITY INDICATOR DATABASE. THE DATABASE, MAINTAINED BY RESEARCHERS AND ANALYSTS AT CONDUENT HCI, INCLUDES 158 COMMUNITY INDICATORS FROM VARIOUS STATE AND NATIONAL DATA SOURCES SUCH AS MICHIGAN DEPARTMENT OF COMMUNITY HEALTH, NATIONAL CANCER INSTITUTE, AND THE AMERICAN COMMUNITY SURVEY.COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS USING KEY INFORMANT INTERVIEWS (38), FOCUS GROUPS (21), AND A COMMUNITY INPUT TOWN HALL MEETING. INDIVIDUALS WITH THE KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM STATE, LOCAL, TRIBAL, OR OTHER REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENTS (OR EQUIVALENT DEPARTMENT OR AGENCY) AS WELL AS LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. ADDITIONALLY, WHERE APPLICABLE, OTHER INDIVIDUALS WITH EXPERTISE OF LOCAL HEALTH NEEDS WERE CONSULTED. THE MAIN SOURCE OF THE SECONDARY DATA USED FOR THIS ASSESSMENT IS MICALHOUN.ORG , A WEB-BASED COMMUNITY HEALTH PLATFORM DEVELOPED BY CONDUENT HEALTHY COMMUNITIES INSTITUTE. THE MICALHOUN DASHBOARD BRINGS NON-BIASED DATA, LOCAL RESOURCES, AND A WEALTH OF INFORMATION IN ONE ACCESSIBLE, USER-FRIENDLY LOCATION. THE SECONDARY DATA ANALYSIS WAS CONDUCTED USING CONDUENT HCI'S DATA SCORING TOOL, AND THE RESULTS ARE BASED ON THE 158 HEALTH AND QUALITY OF LIFE INDICATORS THAT WERE QUERIED ON THE MICALHOUN DASHBOARD ON MARCH 4, 2019. THE DATA ARE PRIMARILY DERIVED FROM STATE AND NATIONAL PUBLIC DATA SOURCES. FOR EACH INDICATOR ON THE PLATFORM, THERE EXIST SEVERAL COMPARISONS TO ASSESS CALHOUN COUNTY'S STATUS, INCLUDING HOW CALHOUN COUNTY COMPARES TO OTHER COMMUNITIES, WHETHER HEALTH TARGETS HAVE BEEN MET, AND THE TREND OF THE INDICATOR VALUE OVER TIME. CONDUENT HCI'S DATA SCORING TOOL SYSTEMATICALLY SUMMARIZES MULTIPLE COMPARISONS TO RANK INDICATORS BASED ON HIGHEST NEED. FOR EACH INDICATOR, AND DEPENDENT UPON DATA AVAILABILITY, THE CALHOUN COUNTY VALUE IS COMPARED TO A DISTRIBUTION OF MICHIGAN AND U.S. COUNTIES, STATE AND NATIONAL VALUES, HEALTHY PEOPLE 2020 TARGETS, AND THE TREND OVER THE FOUR MOST RECENT TIME PERIODS OF MEASURE. EACH INDICATOR IS THEN GIVEN A SCORE BASED ON THE AVAILABLE COMPARISONS. THE SCORES RANGE FROM 0 TO 3, WHERE 0 INDICATES THE BEST OUTCOME AND 3 INDICATES THE WORST OUTCOME. AVAILABILITY OF EACH TYPE OF COMPARISON VARIES BY INDICATOR AND IS DEPENDENT UPON THE DATA SOURCE, COMPARABILITY WITH DATA COLLECTED FROM OTHER COMMUNITIES, AND CHANGES IN METHODOLOGY OVER TIME. THE INDICATORS ARE GROUPED INTO TOPIC AREAS FOR A HIGHER-LEVEL RANKING OF COMMUNITY HEALTH NEEDS.TOP 10 TOPICS (IN NO RANKING ORDER): SOCIAL DETERMINANTS BEHAVIORAL HEALTH ACCESS TO (CARE) HEALTH SERVICES MATERNAL, FETAL, AND INFANT HEALTH EXERCISE, NUTRITION, AND WEIGHT CHRONIC DISEASE WELLNESS & LIFESTYLE AGE AND GENDER DISPARITIES FAMILY PLANNING CANCER

BRONSON BATTLE CREEK HOSPITAL
PART V, SECTION B, LINE 6A: BRONSON LAKEVIEW HOSPITALBRONSON SOUTH HAVEN HOSPITALBRONSON METHODIST HOSPITAL

BRONSON BATTLE CREEK HOSPITAL
PART V, SECTION B, LINE 6B: BATTLE CREEK COMMUNITY FOUNDATION'S POPULATION HEALTH ALLIANCE LEADERSHIP CABINET. THE FOLLOWING INDIVIDUALS AND ORGANIZATIONS CONDUCTED THE CHNA COLLABORATIVELY AS PART OF CALHOUN'S REGIONAL HEALTH ALLIANCE: ALBION HEALTH CARE ALLIANCE ASCENSION BORGESS BATTLE CREEK COMMUNITY FOUNDATION BRONSON BATTLE CREEK HOSPITAL CALHOUN COUNTY PUBLIC HEALTH DEPARTMENT CAREWELL SERVICES SOUTHWEST GRACE HEALTH BATTLE CREEK GRADUATE MEDICAL EDUCATION RESIDENCY PROGRAM INTEGRATED HEALTH PARTNERS OAKLAWN HOSPITAL OAKLAWN MEDICAL GROUP HOMER/ ALBION REGIONAL HEALTH ALLIANCE SUMMIT POINTE THE COORDINATING COUNCIL CALHOUN COUNTY PUBLIC HEALTH DEPARTMENT CAREWELL SERVICES SOUTHWEST GRACE HEALTH BATTLE CREEK GRADUATE MEDICAL EDUCATION RESIDENCY PROGRAM INTEGRATED HEALTH PARTNERS OAKLAWN HOSPITAL OAKLAWN MEDICAL GROUP HOMER/ ALBION REGIONAL HEALTH ALLIANCE SUMMIT POINTE THE COORDINATING COUNCIL

BRONSON BATTLE CREEK HOSPITAL
PART V, SECTION B, LINE 11: THE RESULTS OF THE 2019 CHNA, COMPOUNDED BY THE STARK REALITIES OF COVID-19, HAVE URGED BRONSON TO FOCUS EFFORTS UPSTREAM TO ACKNOWLEDGE THE ROOT CAUSES OF BEHAVIORS, DEATH, AND DISEASE. AS A RESULT, THERE WAS SHARED DESIRE AND URGENCY TO BUILD COMMUNITY TRUST IN OUR 2020-2022 CHIP. AS SOUTHWEST AND SOUTHCENTRAL MICHIGAN'S ONLY CHILDREN'S HOSPITAL, WE RECOGNIZE THE RESPONSIBILITY AND OPPORTUNITY TO BUILD THIS TRUST FROM THE START. AS A RESULT, BRONSON COMMITS TO ENGAGE AND BUILD TRUST WITH FAMILY SUPPORTS TO ELIMINATE RACIAL/ETHNIC DISPARITIES AMONG BIRTHING PERSONS AND BABIES ACROSS OUR REGION (VAN BUREN, KALAMAZOO, CALHOUN COUNTIES). GIVEN THE EXTRAORDINARY CHALLENGE OF SUBSTANTIALLY AND MEASURABLY IMPROVING ACCESS TO CARE IN AN ENVIRONMENT OF LIMITED RESOURCES, BRONSON LEADERS AND COMMUNITY HEALTH BOARD COMMITTEE MEMBERS HAVE CHOSEN TO FOCUS ON TWO TARGETED HEALTH NEEDS (WORKFORCE EQUITY AND HEALTHCARE EQUITY). TO ACT ON THIS, BRONSON WILL DEPLOY SEVERAL TACTICS FOCUSED ON ELIMINATING RACIAL/ETHNIC DISPARITIES THROUGHOUT THE PERINATAL EXPERIENCE AND EMPLOYMENT EXPERIENCE AT BRONSON. THE CHIP 2020-2022 WILL SERVE AS A FIRST STEP FOR A SYSTEMATIC APPROACH TO USE COMMUNITY VOICE, DATA, AND ENGAGEMENT TO UNDERSTAND AND ADDRESS THE NEEDS OF OUR BIRTHING PERSONS, BABIES, AND FAMILIES. PROGRESS INCLUDES THE FOLLOWING: IMPROVE PATIENTS' CONNECTION TO COMMUNITY RESOURCES (E.G. FOOD SUPPORTS, TRANSPORTATION, PERINATAL MENTAL HEALTH SCREENING, LACTATION SERVICES)- IN 2021, BRONSON BEGAN EXPLORING A PARTNERSHIP WITH AUNT BERTHA TO LEVERAGE A NATIONAL COMMUNITY RESOURCE DIRECTORY WITH CLOSED-LOOP REFERRAL PROCESS INTEGRATED WITHIN ITS EHR SYSTEM. IMPROVE SOCIAL DETERMINANTS OF HEALTH (SDOH) SCREENING COLLECTION AND REFERRAL PROCESS FOR BABIES AND EXPECTING FAMILIES.SOME PRACTICES BEGAN COLLECTING ON TRANSPORTATION, REFERRALS TO PREGNANCY SUPPORT PROGRAMS AND ACCESS TO INSURANCE. EXPAND EVIDENCE-BASED MODELS (E.G. CENTERING PREGNANCY, COMMUNITY HEALTHCARE WORKERS, STRONG FATHER PROGRAMS, AND BREAST FEEDING INITIATIVES)DOULA PROGRAM PROVIDES SUPPORT TO EXPECTANT BIRTHIGN PERSONS AT THE TIME OF DELIVERY. THE OBI GRANT PROVIDES FUNDING TO SUPPORT HIGH RISK, BLACK BIRTHING PERSONS WHO ARE IN NEED OF THIS SUPPORT AT DELIVERY.CHW'S IN THE BRONSON OBSTETRICS, GYNECOLOGY AND MIDWIFERY SPECIALISTS PROVIDE SERVICES TO BIPOC MOMS AND BIRTHING PEOPLE IN OUR COMMUNITY WHO ARE AT HIGHEST RISK. BRONSON CONTINUES TO COLLABORATE AND PARTNER WITH AGENCIES BETTER SUITED TO HAVE AN IMPACT IN THE OTHER AREAS IDENTIFIED BY THE CHNA. BECAUSE OF THE INTERSECTIONALITY OF THE NEEDS IDENTIFIED, BRONSON ANTICIPATES THAT IMPROVING TRUST & ACCESS TO CARE AND EMPLOYMENT WILL IMPACT AND IMPROVE OUTCOMES FOR MANY OF THE OTHER COMMUNITY NEEDS.

BRONSON BATTLE CREEK HOSPITAL
PART V, SECTION B, LINE 20E: THE HOSPITAL ACKNOWLEDGES THAT ALL INDIVIDUALS ARE NOT EQUALLY CAPABLE OF PAYING FOR HEALTHCARE SERVICES, EITHER BY THEMSELVES OR THROUGH A THIRD PARTY INSURANCE CARRIER. THE HOSPITAL RECOGNIZES ITS RESPONSIBILITY TO OFFER CARE FOR PERSONS IN NEED, AND THEREFORE PROVIDES AND PROMOTES ACCESS TO EMERGENCY OR MEDICALLY NECESSARY SERVICES WITHOUT REGARD TO ABILITY TO PAY.THE HOSPITAL HAS SIGNS AT ENTRANCES TO THE EMERGENCY DEPARTMENT THAT INFORM PATIENTS OF THE FINANCIAL ASSISTANCE POLICY AS WELL AS THE ADMITTING AND FINANCIAL COUNSELING DEPARTMENTS. THE POLICY IS ALSO ON THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). THE PLAIN LANGUAGE SUMMARY IS INCLUDED ON ALL PATIENT STATEMENTS.PATIENTS MAY REQUEST AN APPLICATION TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE BY CALLING A PATIENT FINANCIAL COUNSELOR OR BRONSON'S BILLING DEPARTMENT. THE APPLICATION IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM).

PART V, SECTION B, LINE 20D:
THE HOSPITAL DOES NOT MAKE ANY PRESUMPTIVE ELIGIBILITY DETERMINATIONS.

PART I, LINE 3C:
THE ORGANIZATION USES THE FOLLOWING FPG TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS:200% OR BELOW OF FPL IS ENTITLED TO A 100% REDUCTION250% OF FPL IS ENTITLED TO A 90% REDUCTION300% OF FPL IS ENTITLED TO A 80% REDUCTION350% OF FPL IS ENTITLED TO A 75% REDUCTION

PART I, LINE 7:
(A) - (C) COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS INSTRUCTIONS FOR LINES A-C.(E) - (I) COSTING METHODOLOGY IS ACTUAL COSTS PER THE HOSPITAL ACCOUNTING SYSTEM FOR LINES E-I.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 14,487,004.

PART II, COMMUNITY BUILDING ACTIVITIES:
"1. PHYSICAL IMPROVEMENTS AND HOUSINGA. ACCESS TO HEALTHY FOODS & LOCAL REGIONAL SOURCING: BMH CONTINUED TO OPERATE THE BRONSON MARKET, A GIFT SHOP AND MICRO-GROCERY STORE, MAKING IT EASY AND CONVENIENT FOR STAFF AND VISITORS TO BUY FRESH, HEALTHY FOOD TO EAT OR TAKE HOME TO PREPARE. A VARIETY OF FRESH, LOCALLY GROWN AND PRODUCED FOODS NORMALLY FOUND AT THE LOCAL FARMER'S MARKETS IS AVAILABLE. BMH CONTINUES TO PRIORITIZE LOCAL FOOD SOURCING, BUT AS A RESULT OF LOCAL SUPPLY CHAIN LIMITATIONS THAT HAVE CONTINUED DURING THE PANDEMIC, THE HOSPITAL'S SOURCING AND INVESTMENT HAVE REMAINED BELOW PRE-PANDEMIC LEVELS IN 2021. B. MOBILITY INNOVATION: MEMBERS OF BRONSON STAFF WORKED CLOSELY WITH EMPLOYEES AT THE CITY OF KALAMAZOO AS THEY DESIGNED AND IMPLEMENTED STRATEGIES TO CREATE MORE COMPLETE STREETS THROUGHOUT AND BEYOND DOWNTOWN KALAMAZOO. IN MOST INSTANCES, THIS MEANT NARROWING AND/OR REDUCING THE DRIVING LANES TO CREATE MORE SPACE FOR BICYCLING FACILITIES, SIDEWALKS / PATHWAYS, ON-STREET PARKING, TRAFFIC CALMING INFRASTRUCTURE, AND OTHER AMENITIES. THESE MEASURES MAKE IT EASIER AND SAFER FOR PATIENTS, VISITORS, AND EMPLOYEES TO ACCESS THE HOSPITAL AND THE AREAS AROUND IT. C. HOUSING: SINCE 1998, BRONSON HAS INVESTED TO HELP EMPLOYEES PURCHASE HOMES IN CORE DOWNTOWN NEIGHBORHOODS CLOSE TO THE HOSPITAL CAMPUS. THE PROGRAM PROVIDES A LOAN, WHICH EMPLOYEES START PAYING BACK IN YEAR SIX AT NO INTEREST. THE MONEY COLLECTED IS THEN PUT BACK INTO THE LOAN POOL TO BE LOANED OUT AGAIN. THROUGH 2021, BRONSON'S INVESTMENT OF $577,525 HAS RESULTED IN $775,549 BEING LOANED TO 89 EMPLOYEES. IN ADDITION, A VACANT HOME THAT WAS PURCHASED BY BRONSON DUE TO ITS PROXIMITY TO CAMPUS BUT WAS NO LONGER OF STRATEGIC INTEREST WAS SOLD TO KALAMAZOO NEIGHBORHOOD HOUSING SERVICES TO BE IMPROVED AND SOLD TO A QUALIFIED BRONSON EMPLOYEE THAT HAD COMPLETED ITS FINANCIAL READINESS PROGRAM. D. ACADIA HEALTH: BRONSON FORMED A JOINT VENTURE PARTNERSHIP WITH ACADIA HEALTH TO DEVELOP A NEW BEHAVIORAL HEALTH HOSPITAL IN BATTLE CREEK, PROVIDING MUCH NEEDED BEHAVIORAL HEALTH SERVICES TO BATTLE CREEK AND THE SOUTHWEST MICHIGAN COMMUNITY. BRONSON WOULD CONTRIBUTE THE LAND AND THE BED LICENSES (CURRENTLY HOUSED AT ITS FIELDSTONE FACILITY) WHILE ACADIA WOULD PROVIDE THE CAPITAL FOR THE FACILITY DEVELOPMENT AND WOULD MANAGE THE OPERATION. THE NEW VENTURE WILL EXPAND THE SERVICES MENTAL HEALTH SERVICES PROVIDED IN THE COMMUNITY. 1. COMMUNITY SUPPORT A. COMMUNITY CONNECTIONS: BBCH PROVIDED EDUCATION FOR ELEMENTARY SCHOOL KIDS IN A PROFESSIONAL HEALTH CARE ENVIRONMENT WHILE ACTING AS MENTORS IN THE HOSPITAL SETTING WITH BIG BROTHERS BIG SISTERS. AS WELL AS, SHARING LEARNING, COORDINATING AND EXCHANGING OF INFORMATION EVERY MONTH WITH LOCAL NON-PROFIT GROUPS IN CALHOUN'S COORDINATING COUNCIL. B. INSURANCE ENROLLMENT OUTREACH AND SUPPORT: BRONSON PROVIDED OPEN ENROLLMENT ASSISTANCE FOR THE MARKETPLACE INSURANCE FROM NOVEMBER 1, 2021 TO DECEMBER 15, 2021 WITH A CAC (CERTIFIED APPLICATION COUNSELOR). BECAUSE OF COVID AND IN-PERSON ASSISTANCE NOT BEING POSSIBLE, WE MADE CAC CONTACT INFORMATION AVAILABLE ON THE HOME PAGE FOR THE MARKETPLACE AS WELL AS TO MANY COMMUNITY ORGANIZATIONS. COMMUNITY MEMBERS WERE ABLE TO CALL THE CAC AND ASK QUESTIONS TO GET A BETTER UNDERSTANDING OF THEIR OPTIONS FOR HEALTH INSURANCE. 2. COALITION BUILDING A. OPERATION FIT: BBCH LED THE RESEARCH, DEVELOPMENT, AND NOW PARTNERS IN THE OPERATION OF A COLLABORATIVE EFFORT TO FIGHT OBESITY AMONG CHILDREN. OPERATION FIT IS FOCUSED ON (1) PROMOTING PHYSICAL ACTIVITY, (2) ENCOURAGING BETTER NUTRITION AND IMPROVED LUNCHROOM ENVIRONMENT AND (3) ASSURING SUPPORT SYSTEMS THROUGH EDUCATION OF STUDENTS, PARENTS, TEACHERS AND ADMINISTRATORS. OPERATION FIT IS CURRENTLY AT WORK IN EIGHT BATTLE CREEK ELEMENTARY SCHOOLS, WE SERVED 2800 STUDENTS.B. SOUTHWEST MICHIGAN PERINATAL QUALITY IMPROVEMENT COLLABORATIVE (SWMPQI) & CALHOUN MATERNAL INFANT HEALTH COMMISSION: BRONSON CONTINUES TO PARTICIPATE IN THE MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES (MDHHS) MOTHER INFANT HEALTH & EQUITY IMPROVEMENT PLAN, A STATEWIDE EFFORT TO IMPROVE THE HEALTH OF MOMS AND BABIES IN MICHIGAN. BRONSON ALSO CONTINUES TO PARTICIPATE IN THE MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES (MDHHS) MOTHER INFANT HEALTH & EQUITY IMPROVEMENT PLAN, A STATEWIDE EFFORT TO IMPROVE THE HEALTH OF MOMS AND BABIES IN MICHIGAN. THROUGH THE SOUTHWEST MICHIGAN PERINATAL QUALITY IMPROVEMENT COLLABORATIVE, BRONSON STAFF WORKED WITH MULTIPLE MEMBERS ACROSS SEVEN COUNTIES TO CREATE ""A LOCALLY LINKED AND COORDINATED NETWORK OF SERVICES FOR BIRTHING PARENTS AND THEIR BABIES COMMITTED TO THE HIGHEST ATTAINABLE STANDARD OF HEALTH AVAILABLE IN MICHIGAN"" WITH THE VISION OF ""ZERO PREVENTABLE DEATHS. ZERO DISPARITIES."" THIS COLLABORATIVE PROVIDES FREE VIRTUAL CHILDBIRTH EDUCATION TO BIRTHING PERSONS WHERE IT IS MOST CONVENIENT FOR THEM. INSTRUCTORS EDUCATED ON LABOR, MEDICAL INTERVENTIONS, CESAREAN SECTIONS, COMFORT TECHNIQUES, AND POSTPARTUM (PHYSICAL AS WELL AS EMOTIONAL). BIRTHING PERSONS HAVE ACCESS TO INSTRUCTORS VIA EMAIL AND ARE ENCOURAGED TO REACH OUT WITH QUESTIONS OR CONCERNS. C. IN 2021. A FEW ADDITIONAL EFFORTS INCLUDE: COVID-19 VACCINATION OUTREACH; A COMMUNITY SURVEY TO UNDERSTAND VACCINATION EFFORTS AND BARRIERS, A VIRTUAL PANEL OF PROVIDERS ANSWERING QUESTIONS THE AROSE FROM SURVEY RESPONSES, SOCIAL MEDIA AND BROADCAST MEDIA MESSAGES. A PILOT PROJECT CONNECTING FIVE WOMEN OF COLOR TO LOCAL DOULAS TO ENHANCE WRAP AROUND SERVICES TO IMPROVE MATERNAL AND INFANT OUTCOMES AND POSITIVE BIRTH EXPERIENCE. VIRTUAL BREASTFEEDING EDUCATION CLASSES.3. WORKFORCE DEVELOPMENT A. LOCAL PARTNERSHIPS: BBCH, CALHOUN AREA TECHNOLOGY CENTER, AND KELLOGG COMMUNITY COLLEGE FOUNDED THE 21ST CENTURY HEALTH CAREERS PROGRAM TO ENGAGE AND ENCOURAGE HIGH SCHOOL JUNIORS AND SENIORS TO CONSIDER CAREERS IN THE MEDICAL FIELD. THIS UNIQUE PROGRAM ALLOWS IN-DEPTH EXPERIENCE WORKING SIDE-BY-SIDE WITH SKILLED PROFESSIONALS IN A RANGE OF HEALTH CARE SETTINGS. OUR 21ST CENTURY PROGRAM WAS RECOGNIZED BY THE WALL STREET JOURNAL AS A NATIONAL CAREER MODEL AND BY THE STATE OF MICHIGAN WITH ITS GOVERNOR'S EXCELLENCE IN PRACTICE AWARD FOR ACHIEVEMENT IN CAREER PREPARATION. OVER THE PAST 15 YEARS, MORE THAN 1,000 HIGH SCHOOL STUDENTS BEGAN THEIR EXPLORATION AND THEN MAPPED THEIR CAREER COURSES IN THE HEALTHCARE FIELD THROUGH THIS PROGRAM.B. WORKFORCE ENGAGEMENT AND DIVERSITY NEEDS: THE RECRUITMENT AND RETENTION OF STAFF CONTINUES TO BE A CHALLENGE FOR BRONSON AS WE DEAL WITH NATIONAL SHORTAGES IN VARIOUS HEALTHCARE OCCUPATIONS AND A LOW UNEMPLOYMENT RATE. THE MULTI-YEAR RECRUITMENT AND RETENTION PLAN IMPLEMENTED IN EARLY 2018 WAS DESIGNED TO MEET THESE CHALLENGES WITH THE FOLLOWING AREAS OF FOCUS: ENGAGED IN CAREER PREPARATION THROUGH SCHOOL AND PROFESSIONAL PARTNERSHIPS (COMPASS HIGH SCHOOLCNA PROGRAM, WOMEN'S CO-OP, MICHIGAN REHABILITATION SERVICES, YOUTH OPPORTUNITIES UNLIMITED, MICHIGAN CAREER & TECHNICAL INSTITUTE) PARTNERED WITH NORTHSIDE ASSOCIATION FOR COMMUNITY DEVELOPMENT AND THE KALAMAZOO PROMISE TO PILOT A LOW BARRIER, NEIGHBORHOOD-FOCUSED CERTIFIED NURSING ASSISTANT (CNA) TRAINING EXPANDED DIGITAL AND SOCIAL MEDIA RECRUITMENT TACTICS (E.G. HANDSHAKE ALLOWS US TO BE INTENTIONAL WITH ADVERTISING POSITIONS/EVENTS AT HISTORICALLY BLACK COLLEGES AND UNIVERSITIES) CONTINUED TO HOST RECRUITMENT EVENTS SUCH AS TEST DRIVES AND OPEN INTERVIEW/OPEN HOUSES FOR RELEVANT OPENINGS AT TARGETED LOCATIONS AS WELL AS COMMUNITY AGENCIES USED RETENTION AND SIGN ON BONUSES FOR HARD TO FILL POSITIONS ENHANCED INTERNAL CAREER DEVELOPMENT PATHWAYS DEVELOPED AND DELIVERED AN IMPLICIT BIAS COMPUTER BASED LEARNING MODULE. 4. OTHER A. SWMPIQCBRONSON ALSO CONTINUES TO PARTICIPATE IN THE MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES (MDHHS) MOTHER INFANT HEALTH & EQUITY IMPROVEMENT PLAN, A STATEWIDE EFFORT TO IMPROVE THE HEALTH OF BIRTHING PERSON AND BABIES IN MICHIGAN. THROUGH THE SOUTHWEST MICHIGAN PERINATAL QUALITY IMPROVEMENT COLLABORATIVE, BRONSON STAFF WORKED WITH MULTIPLE MEMBERS ACROSS SEVEN COUNTIES TO CREATE ""A LOCALLY LINKED AND COORDINATED NETWORK OF SERVICES FOR BIRTHING PERSON AND THEIR BABIES COMMITTED TO THE HIGHEST ATTAINABLE STANDARD OF HEALTH AVAILABLE IN MICHIGAN"" WITH THE VISION OF ""ZERO PREVENTABLE DEATHS. ZERO DISPARITIES."" THIS COLLABORATIVE PROVIDES FREE VIRTUAL CHILDBIRTH EDUCATION TO BIRTHING PERSONS WHERE IT IS MOST CONVENIENT FOR THEM. INSTRUCTORS EDUCATED ON LABOR, MEDICAL INTERVENTIONS, CESAREAN SECTIONS, COMFORT TECHNIQUES, AND POSTPARTUM (PHYSICAL AS WELL AS EMOTIONAL). BIRTHING PERSONS HAVE ACCESS TO INSTRUCTORS VIA EMAIL AND ARE ENCOURAGED TO REACH OUT WITH QUESTIONS OR CONCERNS. IN 2021. A FEW ADDITIONAL EFFORTS INCLUDE COVID-19 VACCINATION OUTREACH (A COMMUNITY SURVEY TO UNDERSTAND VACCINATION EFFORTS AND BARRIERS, A VIRTUAL PANEL OF PROVIDERS ANSWERING QUESTIONS THE AROSE FROM"

PART III, LINE 2:
UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. BAD DEBT EXPENSE IS DISCLOSED BASED ON GROSS CHARGES.

PART III, LINE 3:
BAD DEBT WRITE OFFS SUPPORT THE COMMUNITY BY PROVIDING A PORTION OF SERVICES WITHOUT PAYMENT. THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS ESTIMATED BY REVIEWING THE BAD DEBT DETAIL FOR A SPECIFIC WRITE-OFF CODE.

PART III, LINE 4:
ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.THIS INFORMATION CAN BE FOUND IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER NOTE 2, SIGNIFICANT ACCOUNTING POLICIES FOR ACCOUNTS RECEIVABLE.

PART III, LINE 8:
COSTING METHODOLOGY IS A COST TO CHARGE RATIO AS DEFINED BY THE IRS 990 INSTRUCTIONS. SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT DUE TO ITS REPRESENTATION OF COST OF A PORTION OF SERVICES PROVIDED TO THE COMMUNITY WITHOUT PAYMENT.

PART III, LINE 9B:
THE POLICY REQUIRES THE COLLECTION AGENCY BE NOTIFIED AND ACTIVITY SUSPENDED WHEN A REQUEST FOR FINANCIAL ASSISTANCE IS MADE AND A PATIENT SUBMITS AN APPLICATION ON A PREVIOUSLY LISTED ACCOUNT. THE COLLECTION AGENCY IS NOTIFIED THE SAME DAY THE APPLICATION IS RECEIVED. IF A PATIENT QUALIFIES FOR FULL FINANCIAL ASSISTANCE, THE ACCOUNT IS RETURNED TO BRONSON FROM THE AGENCY AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT QUALIFIES FOR PARTIAL FINANCIAL ASSISTANCE, A DETERMINATION IS SENT TO THE AGENCY INDICATING THE NEW BALANCE AND ANY INITIATED ECA IS REVERSED. IF THE PATIENT DOES NOT PROVIDE COMPLETE APPLICATION INFORMATION OR IS DETERMINED TO BE INELIGIBLE, A DENIAL LETTER IS ISSUED AND THE AGENCY RESUMES COLLECTION ACTIVITY. FURTHERMORE, THE POLICY REQUIRES THAT BRONSON SEND A RESPONSE TO PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE WITHIN 30 BUSINESS DAYS (45 DAYS). IF THE APPLICATION IS APPROVED, THE APPLICATION WILL WORK THROUGH THE FINAL PROCESSES. IF BRONSON NEEDS MORE INFORMATION, BRONSON MUST REQUEST IT FROM THE PATIENT WITHIN THE 45 DAY TIME FRAME. IF REQUESTED INFORMATION IS NOT RECEIVED WITHIN 15 DAYS OF THE LETTER, BRONSON WILL DENY THE APPLICATION AND A DENIAL LETTER SENT TO THE PATIENT. BRONSON WILL HOLD THE APPLICATION FOR 60 DAYS IN CASE THE REQUESTED INFORMATION COMES IN AFTER THE 15 DAYS. IF THE APPLICATION IS 60 DAYS OLD, AND REQUESTED INFORMATION IS NOT RECEIVED, THE APPLICATION IS DECLINED, AND THE PATIENT WOULD NEED TO SUBMIT A NEW APPLICATION. IF THE APPLICATION IS DECLINED, BRONSON THEN NOTIFIES THE COLLECTION AGENCY TO RESUME COLLECTIONS. SIGNATURES ARE ONLY GOOD FOR 60 DAYS WHEN BRONSON IS REQUESTING ADDITIONAL INFORMATION. ONCE AN APPLICATION IS APPROVED, THE COLLECTION AGENCY IS NOTIFIED VIA EMAIL OF THE APPROVAL PERCENTAGE OR DENIED ON THE SAME DAY THE APPLICATION IS COMPLETED.

PART VI, LINE 2:
BRONSON HEALTHCARE GROUP UTILIZES A STRATEGIC MANAGEMENT MODEL TO DEVELOP BOTH A LONG TERM (3 YEAR) AND ANNUAL STRATEGIC PLAN. INPUTS INTO THE PLAN ARE DOCUMENTED IN OUR STRATEGIC INPUT DOCUMENT. ONE OF THE IMPORTANT INPUTS INTO THIS PLAN IS THE HEALTH OF OUR COMMUNITY. IN ADDITION TO THE CHNA DATA SOURCES LISTED IN PART V SECTION B LINE 5, THE FOLLOWING SOURCES ARE USED TO INFORM OUR STRATEGIC PLAN:1. SG2 MARKET ESTIMATES2. SG2 IP/OP FORECAST3. SG2 AMBULATORY MARKET STRATEGIST4. SG2 MARKET DEMOGRAPHICS FROM CLARITAS

PART VI, LINE 3:
THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN THE EMERGENCY ROOM, THE ADMITTING DEPARTMENT, THE PATIENT FINANCIAL COUNSELING OFFICE, AND THE HOSPITAL'S WEBSITE (WWW.BRONSONHEALTH.COM). THE PLAIN LANGUAGE SUMMARY IS ALSO INCLUDED IN THE PATIENT'S DISCHARGE DOCUMENTS, ON PATIENT STATEMENTS AND THE HOSPITAL'S WEBSITE. BOTH THE POLICY AND THE PLAIN LANGUAGE SUMMARYARE AVAILABLE UPON REQUEST ARE AVAILABLE UPON REQUEST.

PART VI, LINE 7, REPORTS FILED WITH STATES
MI

PART VI, LINE 4:
BRONSON BATTLE CREEK HOSPITAL'S ACUTE CARE HOSPITAL IS LOCATED IN THE CITY OF BATTLE CREEK, A MEDIUM-SIZED COMMUNITY THAT IS BEST KNOWN AS HOME TO THE KELLOGG COMPANY. BRONSON BATTLE CREEK HOSPITAL IS PART OF THE BRONSON HEALTHCARE SYSTEM, AND IS A PARTNERSHIP BETWEEN BRONSON HEALTH CARE GROUP (51% MEMBER AND OPERATING PARTNER) AND THE BBCH COMMUNITY PARTNERS (49% MEMBER). BRONSON BATTLE CREEK HOSPITAL SERVES A NINE COUNTY REGION IN SOUTHWEST, SOUTH-CENTRAL MICHIGAN. ABOUT 81% OF PATIENTS SERVED COME FROM WITHIN CALHOUN COUNTY.PATIENT DEMOGRAPHICS8.90% <21 YEARS OF AGE18.10% 21-39 YEARS OF AGE39.10% 40-64 YEARS OF AGE33.90% 65 YEARS OF AGE AND OLDERPATIENT DIVERSITY DEMOGRAPHICS81.43% CAUCASIAN11.29% AFRICAN-AMERICAN1.30% ASIAN2.35% HISPANIC3.63% OTHERPATIENT INSURANCE DEMOGRAPHICS32.20% PRIVATE INSURANCE29.80% MEDICARE15.10% MEDICARE AND SUPPLEMENTAL INSURANCE20.70% MEDICAID OR OTHER PUBLIC ASSISTANCE2.20% NO COVERAGE

PART VI, LINE 5:
COLLABORATION WITH COMMUNITY STAKEHOLDERSAS PREVIOUSLY MENTIONED, BBCH SEEKS COMMUNITY COLLABORATORS AND STAKEHOLDERS AS PARTNERS ON MEETING COMMUNITY HEALTH NEEDS, ADDRESSING MULTI-SECTOR ISSUES, AND LEADING DISASTER/EMERGENCY EFFORTS. TOWARDS THIS END, BBCH LEADERS SERVE ON SEVERAL COMMUNITY BOARDS INCLUDING: BIGS IN BUSINESS PROGRAM, BIG BROTHERS BIG SISTERS, OPERATION FIT, COMMUNITY PARTNERS, HOUSING CONVERSATIONS, UNITED WAY OF THE BATTLE CREEK AND KALAMAZOO REGION, SENIOR HEALTH PARTNERS, AREA AGENCY ON AGING, REGION HEALTH ALLIANCE, CALHOUN CANCER CONTROL COALITION, ALBION HEALTH CARE ALLIANCE, CALHOUN COUNTY BOARD OF HEALTH, THE COORDINATING COUNCIL, INTEGRATED HEALTH PARTNERS, ROTARY, BURMA CENTER, BATTLE CREEK COMMUNITY FOUNDATION, GRACE HEALTH QUALITY IMPROVEMENT COMMITTEE. FINANCIAL SUPPORT & INSURANCE ACCESS IN 2021, APPROXIMATELY 22.05% OF BBCH'S PATIENTS WERE MEDICAID RECIPIENTS. WE HAVE THREE MEDICAID ENROLLERS ON SITE TO HELP THOSE WITHOUT INSURANCE ENROLL IN MEDICAID, OR REFER THEM TO COMMUNITY RESOURCES. BRONSON IS THE ONLY CHILDRENS HOSPITAL IN SOUTHWEST MICHIGAN AND, THEREFORE, THE SOLE PROVIDER OF INPATIENT PEDIATRICS INCLUDING PEDIATRIC INTENSIVE CARE AND NEONATAL INTENSIVE CARE. IN FACT, OVER HALF THE PATIENTS IN THE CHILDRENS HOSPITAL ARE MEDICAID RECIPIENTS. REPORTING TO THE COMMUNITYBBC CONDUCTS AN ANNUAL COMMUNITY BENEFIT INVENTORY TO AGGREGATE THE NON-MISSION MANDATED SERVICES WE PROVIDE TO THE COMMUNITY. THIS INVENTORY IS SHARED WITH BRONSON STAKEHOLDERS AND REPORTED TO THE COMMUNITY. INFORMATION IS AVAILABLE TO ALL THROUGH BRONSONHEALTH.COM

PART VI, LINE 6:
"BBCH IS PART OF AN AFFILIATED SYSTEM THAT SERVES NINE COUNTIES AND INCLUDES THREE OTHER HOSPITALS, BRONSON LAKEVIEW HOSPITAL, BRONSON SOUTH HAVEN HOSPITAL, AND BRONSON METHODIST HOSPITAL. ALL OF THESE HOSPITALS ARE CONTROLLED BY BRONSON HEALTHCARE GROUP, WHICH IS A COMMUNITY-OWNED AND GOVERNED NON-FOR-PROFIT HOLDING COMPANY. THE BRONSON HEALTHCARE GROUP (BHG) BOARD IS COMPRISED OF 19 MEMBERS FROM THE COMMUNITIES IT SERVES. EACH OF THE THREE HOSPITALS IN THE BRONSON HEALTHCARE SYSTEM ADMITS PATIENTS REGARDLESS OF ABILITY TO PAY AND PROVIDES OUTREACH SERVICES TO THEIR RESPECTIVE COMMUNITIES. IN ADDITIONAL TO THE FOUR HOSPITALS, THE BHG SYSTEM INCLUDES SEVERAL SMALLER ENTITIES WHOSE ACTIVITIES SUPPORT THE HOSPITALS AND THEIR MISSION OF ""TOGETHER, WE ADVANCE THE HEALTH OF OUR COMMUNITIES."" THESE ENTITIES INCLUDE: BRONSON HEALTHCARE GROUP, BRONSON COMMONS, BRONSON LIFESTYLE IMPROVEMENT & RESEARCH CENTER, BRONSON HEALTHCARE FOUNDATION, BRONSON AT HOME, VAN BUREN EMERGENCY MEDICAL SERVICES, AND BRONSON PROPERTIES CORPORATION."

PART II, COMMUNITY BUILDING ACTIVITIES CONTINUATION:
"FROM SURVEY RESPONSES, SOCIAL MEDIA AND BROADCAST MEDIA MESSAGES. A PILOT PROJECT CONNECTING FIVE BIRTHING PERSONS OF COLOR TO LOCAL DOULAS TO ENHANCE WRAP AROUND SERVICES TO IMPROVE MATERNAL AND INFANT OUTCOMES AND POSITIVE BIRTH EXPERIENCE. VIRTUAL BREASTFEEDING EDUCATION CLASSES.B. COVID-19 RESPONSE: IT IS HARD TO IDENTIFY ANY BRONSON DEPARTMENT OR STAFF MEMBER NOT IMPACTED PHYSICALLY, EMOTIONALLY, PERSONALLY, PROFESSIONALLY OR FINANCIALLY BY THE COVID PANDEMIC. WE FACED WORKFORCE-RELATED ISSUES LIKE EVERY EMPLOYER, YET, AS THE REGION'S LARGEST HEALTHCARE PROVIDER, OUR COMMUNITIES WERE DEPENDING ON US TO CARE FOR PATIENTS WITH AND WITHOUT COVID. BRONSON HAS MANAGED AT SEVERAL MAJOR CYCLES (AND STILL COUNTING) OF ""PREPARE-RESPOND-IMPROVE-RECOVER"" SINCE THE GOVERNOR ISSUED EXECUTIVE ORDER (EO) 2020-4, DECLARING A STATE OF EMERGENCY ON MARCH 10, 2020. MANY OF THESE CYCLES OCCURRED SIMULTANEOUSLY. WE MOBILIZED OUR INCIDENT COMMAND (IC) AND INCIDENT COMMAND CLINICAL CONSULTANTS (ICCC) ON MARCH 12 TO GUIDE THE SYSTEM'S RESPONSE TO THE COVID PANDEMIC. AS OF JANUARY 31, 2022, IC HAD BEEN OPEN FOR 690 DAYS.C. COVID-19 TESTING AND SCREENING: IN ORDER TO RESPOND TO THE URGENT NEED FOR COVID TESTING, NEW TESTING PLATFORMS NEEDED TO BE SET UP IN OUR CORE LABORATORY. FOUR DIFFERENT PLATFORMS WERE PROCURED TO HANDLE THE INCREASED VOLUME OF TESTING, ALL WHILE THE LABORATORY WAS RELOCATING TO ITS NEW BUILDING. SINCE TESTING SUPPLIES WERE NOT CONSISTENLY AVAILABLE, WE ALSO NEEDED TO SOURCE A DIVERSE GROUP OF SUPPLIERS. TO COLLECT COVID SAMPLES FOR TESTING, FOUR CURBSIDE TESTING LOCATIONS WERE SET UP ACROSS OUR SYSTEM AND SUPPORTED BY 11 ADDITIONAL FTES. APPROXIMATELY 58,177SAMPLES WERE OBTAINED THROUGH THESE COLLECTION SITES, WITH 10,465 RESULTING POSITIVE. WE CREATED A COVID TESTING DASHBOARD SO WE COULD SEE AND TREND TESTING VOLUMES AND RESULTS ON A DAILY BASIS BY LOCATION, RACE, AGE AND PAYER IN REAL TIME. THE DYNAMIC AND INTERACTIVE NATURE OF THE DASHBOARD ALLOWED US TO SEE DISPARITIES AND ADDRESS THE RAPIDLY EMERGING QUESTIONS THROUGH THE EARLY AND MIDDLE PART OF THE PANDEMIC. ON MARCH 13 2020, THE GOVERNOR ISSUED AN EO THAT REQUIRED US TO SET UP SCREENING FOR PATIENTS AND VISITORS AT LIMITED ENTRANCES AT ALL FOUR HOSPITALS THAT REMAINED THROUGH 2021. WE QUICKLY DEVELOPED A SCREENER WORKFORCE (CONSISTING OF REDEPLOYED EMPLOYEES, LOW CENSUS STAFF AND EMPLOYEE VOLUNTEERS) TO STAFF THE ENTRANCES. WE DEVOTED 28,110 HOURS TO THIS EFFORT AND 32 EMPLOYEES DEDICATED THEMSELVES TO THE SCREENING PROCESS. 818,370 EMPLOYEES SCREENED THEMSELVES, 9,012 DISTINCT EMPLOYEES USED THE SCREENING TOOL AND 39,456 NON-EMPLOYEE (CONTRACTOR, NON-EMPLOYED PROVIDER, STUDENT, ETC.) UTILIZING A NEW ONLINE TOOL THAT BRONSON DEPLOYED IN MARCH 2020D. COVID-19 STAFF SUPPORT: THE IMPACT AND SIGNIFICANT STRESS THE PANDEMIC HAS HAD ON OUR STAFF IS IMMEASURABLE. MANY PICKED UP EXTRAS SHIFTS, WERE QUARANTINED AWAY FROM THEIR FAMILIES, TOOK LIMITED VACATION TIME, VOLUNTEERED FOR SCREENING AND VACCINES, WERE FURLOUGHED, OR PROVIDED SUPPORT FOR PATIENTS WHOSE OWN FAMILIES WERE NOT ALLOWED TO VISIT. AT THE SAME TIME, MANY EMPLOYEES WERE ALSO FACING THEIR CHILDREN'S SCHOOLS SHIFTING TO VIRTUAL LEARNING OR HAD A FAMILY EMPLOYMENT OR HEALTH CRISIS. CONTACT TRACING WAS REQUIRED FOR EVERY EMPLOYEE AND PATIENT WHO TESTED POSITIVE FOR COVID. OVER THE COURSE OF THE YEAR, 1366 BRONSON EMPLOYEES TESTED POSITIVE FOR COVID AN INCREASE OF 56% FROM THE PREVIOUS YEAR. ADDITIONAL SUPPORT PROVIDED TO STAFF INCLUDED: CRITICAL INCIDENT STRESS MANAGEMENT (CISM): THE BRONSON CISM TEAM PLAYED A VITAL ROLE IN SUPPORTING THE EMOTIONAL WELL-BEING OF EMPLOYEES ACROSS THE SYSTEM. THE TEAM FACILITATED 286 INTERVENTIONS AND SERVED 2,145 INDIVIDUALS THOUGH CRITICAL INCIDENT STRESS DEBRIEFINGS, DEFUSINGS, ONE-ON-ONE SUPPORT AND DROP-IN SESSIONS. THE CISM TEAM ALSO PROVIDED CODE LAVENDER CARTS TO UNITS THAT WERE IN NEED OF IMMEDIATE SUPPORT DURING STRESSFUL OR TRAUMATIC SITUATIONS. IN ADDITION TO THESE INTERVENTIONS, THE CISM TEAM ALSO CREATED THE BE WELL TAB ON THE BRONSON INTRANET WHICH IS A COMPREHENSIVE RESOURCE PAGE THAT PROVIDES EMPLOYEES, PROVIDERS AND LEADERS WITH EASY ACCESS TO THE INFORMATION, TOOLS AND SERVICES NEEDED TO PROMOTE AND ENHANCE EMPLOYEE HEALTH AND WELL-BEING. THE CISM TEAM ALSO ASSISTED WITH THE DEPLOYMENT OF RESPITE ITEMS TO UNITS SUCH AS MASSAGE CHAIRS AND SELF-CARE PACKAGES FOR FRONTLINE STAFF. IN CREATING TOOLS TO SUPPORT EMPLOYEES EXPERIENCING BURNOUT. RESOURCES SUCH AS RESPITE ROOMS AND RESILIENCE BUDDIES HELPED CREATE AN ENVIRONMENT WHERE STAFF FELT SAFE, ACKNOWLEDGED, VALIDATED AND CARED FOR.RESPITE AREAS: RESPITE AREAS AT THE HOSPITALS PROVIDED A RELAXING, RESTORATIVE SPACE THAT STAFF USED TO STEP AWAY, REGROUP AND RE-CENTER. BHF STEPPED FORWARD TO FUND THESE AREAS, UNDERSTANDING THAT CARING FOR PATIENTS DURING THE PANDEMIC IS STRESSFUL AND TAKES AN ADDITIONAL TOLL ON FRONTLINE STAFF. ALL RESPITE AREAS INCLUDE REFRIGERATORS, COFFEEMAKERS, SNACKS, BEVERAGES, PERSONAL CARE AND SUPPORT ITEMS FOR MIND AND BODY. E. COVID-19 VACCINATION DISTRIBUTION:BRONSON DEVELOPED A DASHBOARD TO TRACK THE GEOGRAPHIC DISTRIBUTION OF COVID-19 VACCINATIONS TO HELP UNDERSTAND IF DISPARITIES EXISTED IN BRONSON'S SERVICE AREA. FILTERS AVAILABLE FOR GEOSPATIAL ANALYSIS ALLOWED US TO IDENTIFY DISPARITIES BASED, NOT JUST ON"

PART II, COMMUNITY BUILDING ACTIVITIES CONTINUATION:
"GEOGRAPHIC LOCATION, BUT ALSO BY THE CDC SOCIAL VULNERABILITY INDEX, AGE, RACE, GENDER, ETHNICITY, LANGUAGE, AND FINANCIAL CLASS. RISKS AND COMORBID MEDICAL CONDITIONS WERE ALSO INCLUDED TO ALLOW THE IDENTIFICATION OF POPULATIONS THAT PRESENTED A GREATER RISK OF HOSPITALIZATION OR SEVERE SYMPTOMS FROM A COVID-19 INFECTION. BRONSON PARTNERED WITH AGENCIES AND ORGANIZATIONS TO PROVIDE ACCESS TO COVID-19 VACCINES FOR THE DISPROPORTIONATELY IMPACTED POPULATIONS AND UNDERSERVED COMMUNITIES WITHIN OUR REGION. THROUGH A GRANT, SEVERAL CLINICS PROVIDED MULTIPLE DOSES AT CHURCHES, BUSINESSES AND SCHOOLS. AN ADDITIONAL 30 CLINICS WERE HELD BEFORE THE START OF THE GRANT. BRONSON ASSISTED WITH THESE CLINICS BY PROVIDING EITHER STAFF, VACCINES OR VOLUNTEERS. MHA ADVANCING SAFE CARE AWARD WAS AWARDED TO BRONSON FOR OUR COMMUNITY VACCINATION CLINICS. THIS AWARD IDENTIFIES HEALTH SYSTEMS THAT DEMONSTRATE A FIERCE COMMITMENT TO PROVIDING CARE TO DIFFERENT PATIENT POPULATIONS, SHOW EVIDENCE OF AN IMPROVED SAFETY CULTURE, LEAD THE CHARGE FOR QUALITY IMPROVEMENT, AND DEMONSTRATE TRANSPARENCY IN THEIR EFFORTS TO IMPROVE HEALTHCARE. WE WORKED DILIGENTLY TO EDUCATE AND PROMOTE APPROPRIATE SAFETY PRECAUTIONS AND THE IMPORTANCE OF GETTING VACCINATED. BRONSON MEDICAL EXPERTS PARTICIPATED IN HUNDREDS OF MEDIA INTERVIEWS, SEVERAL PUBLIC SERVICE ANNOUNCEMENTS WERE CREATED, AND NUMEROUS PRESS CONFERENCES WERE HELD WITH COUNTY HEALTH DEPARTMENTS AND COMMUNITY PARTNERS IN CALHOUN, KALAMAZOO AND VAN BUREN COUNTIES. 204,000 PEOPLE TURNED TO BRONSONHEALTH.COM FOR COVID-19 INFORMATION IN 2021 AN INCREASE OF 72.6% OVER 2020. 135,000 OF THEM VISITED THE COVID-19 VACCINE PAGE WHICH LINKED THEM TO MYCHART AND INSTRUCTIONS ON HOW AND WHERE TO SCHEDULE VACCINE APPOINTMENTS. NUMEROUS VIDEOS WERE CREATED WITH BRONSON'S CEO AND PROVIDERS WHICH PRESENTED FACTS TO HELP DISPEL MYTHS ABOUT VACCINE SAFETY AND EFFICACY. 249 SOCIAL MEDIA MESSAGES WERE CREATED AND SHARED ACROSS ALL HOSPITAL FACEBOOK PAGES, TWITTER, LINKEDIN AND INSTAGRAM.5. IMPLEMENTATION OF THE AHA EQUITY PLEDGE PLAN: BRONSON CREATED AN EQUITY OF CARE FRAMEWORK TO PROVIDE SYSTEM GOALS AND TACTICS FOR THE AHA EQUITY OF CARE PLEDGE. ADDITIONALLY, WE CREATED A HEALTH EQUITY OF CARE PERFORMANCE IMPROVEMENT COMMITTEE TO GUIDE THE ORGANIZATION IN THIS WORK. THERE ARE FOUR HEALTH EQUITY OF CARE GOALS: 1) BUILD AND STRENGTHEN COMMUNITY RELATIONSHIPS AND PARTNERSHIPS TO ADVANCE HEALTH EQUITY; 2) INCREASE THE COLLECTION, REPORTING AND ANALYSIS OF ACCURATE SOCIAL DEMOGRAPHIC DATA TO PRIORITIZE AND DETERMINE INTERVENTIONS; 3) IMPROVE OUR KNOWLEDGE, SKILLS AND BEHAVIORS TO MEET THE SOCIAL, CULTURAL AND LINGUISTIC NEEDS OF OUR EMPLOYEES, PATIENTS AND FAMILIES; AND 4) INCREASE THE DIVERSITY OF LEADERSHIP AND GOVERNANCE TO SUPPORT, ASSIST, AND ADVOCATE FOR EMPLOYEES, PATIENTS AND FAMILIES. BRONSON EXPANDED COLLECTION OF RACE, ETHNICITY AND LANGUAGE DATA AND BEGAN STRATIFYING PATIENT EXPERIENCE DATA BY AGE, GENDER, RACE AND ETHNICITY. WE CONTINUE TO IMPROVE OUR KNOWLEDGE, SKILLS AND BEHAVIORS TO MEET THE SOCIAL, CULTURAL AND LINGUISTIC NEEDS OF OUR EMPLOYEES, PATIENTS AND FAMILIES IN SEVERAL WAYS. WE INCREASED AMBULATORY SELF-SCHEDULING OF INTERPRETERS AND A NEW EQUITY OF CARE COMPUTER-BASED LEARNING MODULE WAS REQUIRED FOR ALL BRONSON EMPLOYEES. THE COMMUNITY HEALTH, EQUITY AND INCLUSION TEAM EDUCATED OVER 2,400 EMPLOYEES AS WELL AS 3,300 PEOPLE IN OUR PRIMARY SERVICE AREA. IN JULY, THE QUALITY OVERSIGHT BOARD COMMITTEE (QOBC) HEARD A STORY FROM A PATIENT THAT ILLUSTRATED AN OPPORTUNITY IN OUR LABOR AND DELIVERY UNIT TO ACKNOWLEDGE AND ADDRESS IMPLICIT BIASES THAT LED TO INEQUITIES IN CARE AND THE PATIENT EXPERIENCE REGARDING PAIN MANAGEMENT. IN LIGHT OF THIS PATIENT STORY, THE QOBC SUBSEQUENTLY REVIEWED PATIENT EXPERIENCE SURVEYS FROM PATIENTS DISCHARGED FROM BRONSON OB UNITS IDENTIFIED A DISPARITY IN PATIENTS' PERCEPTION OF HOW WELL THEY WERE ""INFORMED ABOUT PAIN CONTROL OPTIONS"" WHEN COMPARING MEAN SCORES OF WHITE/CAUCASIAN PATIENTS TO NON-WHITE/CAUCASIAN PATIENTS. THERE CONTINUES TO BE AN OPPORTUNITY TO IMPROVE REPRESENTATION WITHIN THE SURVEY RESPONSES; WHITE/CAUCASIAN PATIENTS COMPLETE THE SURVEY AT A HIGHER RATE THAN THEIR ACTUAL OB ENCOUNTERS.RECOGNIZING THAT THE 2020 CHIP FOCUSES ON ADDRESSING PERINATAL HEALTH DISPARITIES, THE QOBC ESTABLISHED A TASK FORCE TO ADDRESS RACIAL BIAS IN PAIN ASSESSMENT AND MANAGEMENT AMONG BIRTHING PERSONS IN LABOR. THE TASK FORCE IS IDENTIFYING CURRENT CLINICAL PRACTICES AND POLICIES FOR PAIN ASSESSMENT AND MANAGEMENT OF BRONSON LABOR AND DELIVERY PATIENTS AS WELL AS ASSESSING PROVIDER PERCEPTION OF AND PATIENT SATISFACTION WITH PAIN MANAGEMENT ACROSS RACIAL, ETHNIC AND LANGUAGE DIMENSIONS. HEALTH EQUALITY INDEX: IN EARLY 2020 AND CONTINUING FOR 2021, EACH BRONSON ENTITY PARTICIPATED IN THE HEALTH EQUALITY INDEX (HEI) FOR THE FIRST TIME. THIS SURVEY SCORES HOSPITALS BASED ON ESTABLISHED CRITERIA FOR LGBTQ+ INCLUSIVE PATIENT SERVICES AND EMPLOYMENT PRACTICES. THE CRITERIA ARE NON-DISCRIMINATION AND STAFF TRAINING, PATIENT SERVICES AND SUPPORT, EMPLOYEE BENEFITS AND POLICIES, AND PATIENT AND COMMUNITY ENGAGEMENT. THIS BASELINE ASSESSMENT HELPED US IDENTIFY OPPORTUNITIES FOR IMPROVEMENT AND ESTABLISH A BENCHMARK TO MONITOR PROGRESS TOWARDS CLOSING THE IDENTIFIED GAPS. ADDITIONALLY, HEI PARTICIPANTS HAVE ACCESS TO A LIBRARY OF RESOURCES AND TRAINING MATERIALS. A GAP ANALYSIS WAS CONDUCTED ON THE 2020 HEI SURVEY AND AN HEI WORKGROUP WAS FORMED WITH THE PURPOSE OF REVIEWING, PRIORITIZING AND ADDRESSING THE IDENTIFIED OPPORTUNITIES PRIOR TO SUBMISSION OF THE 2022 SURVEY."