4A (Expenses $ 36097592 including grants of $ 0) (Revenue $ 36669628)
BRONSON SOUTH HAVEN HOSPITAL (BSHH) IS A 49-BED HOSPITAL. BSHH OFFERS A FULL RANGE OF ACUTE CARE FOR INPATIENTS AND IS A WELL-ESTABLISHED DESTINATION FOR EMERGENCY CARE. BSHH OPERATES A FULL-SERVICE, 24/7 EMERGENCY DEPARTMENT THAT TYPICALLY HANDLES OVER 15,000 PATIENT VISITS ANNUALLY, REGARDLESS OF THEIR ABILITY TO PAY. OUTPATIENT SERVICES ARE PROVIDED AT THE HOSPITAL, AS WELL AS AT A RURAL HEALTH CLINIC IN SOUTH HAVEN, MICHIGAN. BSHH ALSO PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE USE OF ITS WELLNESS CENTER. THE WELLNESS CENTER HOSTS EDUCATIONAL CLASSES THAT PROMOTE A HEALTHY ACTIVE LIFESTYLE. THESE CLASSES RANGE FROM EATING HEALTHIER AND PROMOTING PHYSICAL ACTIVITY. THE WELLNESS CENTER ALSO PROVIDES SCHOLARSHIPS TO THOSE IN THE COMMUNITY THAT NEED FINANCIAL ASSISTANCE AND THOSE THAT ARE IN NEED ARE GIVEN PRIORITY IN THE CLASSES.

4B (Expenses $ 0 including grants of $ 0) (Revenue $ 0)
IN 2021, BSH'S MEDICAID COST WAS $9,101,366 AND MEDICAID NET REVENUE WAS $4,806,656.

4C (Expenses $ 2731964 including grants of $ 0) (Revenue $ 0)
IN 2021 IN FURTHERANCE OF ITS MISSION, BSH INCURRED $2,731,964 IN BAD DEBT TO PROVIDE CARE TO ITS PATIENTS.

BRONSON SOUTH HAVEN HOSPITAL
PART V, SECTION B, LINE 5: BRONSON SOUTH HAVEN HOSPITAL (BSHH):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 PROCESS INCLUDED A REVIEW OF BRONSON'S PREVIOUS ASSESSMENTS, ANALYSIS OF OVER 150 CURRENT INDICATORS IN EACH COUNTY AND DISCUSSION OF THE SECONDARY DATA AVAILABLE AT THE COUNTY LEVEL. BRONSON ALSO SOUGHT PERSPECTIVE FROM MICHIGAN PUBLIC HEALTH INSTITUTE AND W.E. UPJOHN INSTITUTE FOR EMPLOYMENT RESEARCH TO PROVIDE CONSULTANT SUPPORT FOR THE PROJECT. BECAUSE THERE ARE INHERENT LIMITATIONS AND GAPS IN SECONDARY DATA, THERE WAS A HEAVY EMPHASIS ON COMMUNITY VOICE AND INPUT TO IDENTIFY THE GREATEST NEEDS IN OUR COMMUNITIES. THE ANALYSIS IN THIS DOCUMENT REPRESENTS THE MOST IMPORTANT ISSUES FROM 10 FOCUS GROUPS AND 10 INTERVIEWS AND 223 COMMUNITY VOICES. THE FOLLOWING INDIVIDUALS AND ORGANIZATIONS WERE ENGAGED IN THE CHNA TO REPRESENT THE INTERESTS OF THE COMMUNITY:VAN BUREN/CASS DISTRICT HEALTH DEPARTMENTVAN BUREN COMMUNITY MENTAL HEALTH AUTHORITY VAN BUREN INTERMEDIATE SCHOOL DISTRICTREGION IV AREA AGENCY ON AGING, INC.MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICESH.O.P.E. PARENT RESOURCE CENTERUNITED CHRISTIAN SERVICESVAN BUREN UNITED CIVIC CENTERBRONSON WELLNESS CENTER VAN BUREN SUBSTANCE ABUSE TASK FORCESENIOR SERVICES OF VAN BUREN COUNTY OUTCENTER SOUTHWEST MICHIGANUNITED WAY OF SOUTHWEST MICHIGANVAN BUREN COUNTY 36TH JUDICIAL CIRCUIT COURTTRI-COUNTY HEAD START SOUTH HAVEN PUBLIC SCHOOLSCITY OF SOUTH HAVENMICHIGAN WORKFORCE DEVELOPMENT AGENCY, FIELD SERVICESTO NARROW DOWN THE PRIMARY DATA RESULTS, MICHIGAN PUBLIC HEALTH INSTITUTE RAN THE FREQUENCY OF REFERENCES ACROSS EACH TOPIC BELOW. BRONSON DECIDED TO MAKE THE CUT OFF FOR THE TOP 10 MAJOR TOPICS FROM FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. FOR THE PURPOSES OF THE FINAL REPORT, THE COMMUNITY STAKEHOLDERS AGREED TO NOT RANK THE TOPICS, SO THAT ALL OF THESE ISSUES CAN BE ELEVATED COLLECTIVELY. THIS ALSO EMPHASIZES THAT THE NEEDS BELOW DID NOT EMERGE INDEPENDENTLY. TOP 10 TOPICS (IN NO RANKING ORDER): LAWS & POLICIES PERSONAL EXPERIENCES OF CLASSISM SOCIAL SUPPORTS PROXIMITY TO HEALTHY FOOD & FOOD SECURITY MENTAL HEALTH & SUBSTANCE ABUSE COMMUNITY CONNECTEDNESS COMMUNITY DEVELOPMENT & CAPACITY BUILDING HEALTHCARE SOCIAL SERVICES INCOME & POVERTY IN AN EFFORT TO HONOR THE LIVED EXPERIENCE, THE MAJORITY OF THIS REPORT REFLECTS THE PRIMARY RESULTS FROM FOCUS GROUPS AND INTERVIEWS THROUGHOUT THE COUNTY. THEREFORE, THE QUANTITATIVE DATA PRESENTED ALONGSIDE THE THEMES IS TO SUPPORT AND AUGMENT COMMUNITY VOICE. BRONSON ALSO WANTS TO RECOGNIZE THE DIFFERENCES IN THE LIVED EXPERIENCE IN RURAL AND URBAN AREAS. IN ORDER TO LOOK AT THESE DIFFERENCES, WE INCLUDED DATA AT THE COUNTY, SUB-COUNTY, AND NEIGHBORHOOD LEVEL, WHEN POSSIBLE. SOURCES INCLUDE: U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY MICHIGAN DEPARTMENT OF COMMUNITY HEALTH CENTER FOR DISEASE CONTROL & PREVENTION MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES MICHIGAN SCHOOL DATA UNITED WAY OF MICHIGAN ALICE DATA

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

BRONSON SOUTH HAVEN HOSPITAL
PART V, SECTION B, LINE 6B: VAN BUREN COUNTY HEALTH DEPARTMENT

BRONSON SOUTH HAVEN 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 MOTHERS 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 IS DEPLOYING SEVERAL TACTICS FOCUSED ON ELIMINATING RACIAL/ETHNIC DISPARITIES THROUGHOUT THE PERINATAL EXPERIENCE AND EMPLOYMENT EXPERIENCE AT BRONSON. THE CHIP 2020-2022 SERVES AS A FIRST STEP FOR A SYSTEMATIC APPROACH TO USE COMMUNITY VOICE, DATA, AND ENGAGEMENT TO UNDERSTAND AND ADDRESS THE NEEDS OF OUR MOTHERS, 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 MOMS AT THE TIME OF DELIVERY. THE OBI GRANT PROVIDES FUNDING TO SUPPORT HIGH RISK, BLACK MOTHERS 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 IN VAN BUREN COUNTY.

BRONSON SOUTH HAVEN 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 $ 2,731,964.

PART II, COMMUNITY BUILDING ACTIVITIES:
"1. COALITION BUILDING A. SOUTHWEST MICHIGAN PERINATAL COLLABORATIVE: 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. 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 MOTHERS 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 MOTHERS WHERE IT IS MOST CONVENIENT FOR THEM. INSTRUCTORS EDUCATED ON LABOR, MEDICAL INTERVENTIONS, CESAREAN SECTIONS, COMFORT TECHNIQUES, AND POSTPARTUM (PHYSICAL AS WELL AS EMOTIONAL). MOTHERS HAVE ACCESS TO INSTRUCTORS VIA EMAIL AND ARE ENCOURAGED TO REACH OUT WITH QUESTIONS OR CONCERNS. B. VAN BUREN COMMUNITY HEALTH COMMITTEE: FORMED IN 2018, THE FOCUS OF THIS COLLABORATIVE HAS BEEN TO ELEVATE COMMUNITY VOICE TO ADDRESS THE ROOT CAUSES OF HEALTH DISPARITIES IN VAN BUREN COUNTY. BRONSON HEALTHCARE SERVES IN A LEADERSHIP CAPACITY AND HAS CONTINUED TO SUPPORT THE COLLABORATIVE WITH VARIOUS COMMUNITY HEALTH INITIATIVES. IN RESPONSE THE CHNA, THE COLLABORATIVE APPLIED AND WAS REWARDED A $200,000 PLANNING GRANT FROM MICHIGAN HEALTH ENDOWMENT FUND. PROJECT STARTED FALL OF 2021. THE AGING HEALTH EQUITY & POLICY PLANNING PROJECT IS A COMMUNITY-INFORMED AND DATA-DRIVEN PLAN DEVELOPMENT PROCESS TO IDENTIFY AND ADDRESS THE ROOT CAUSES OF DISPARATE HEALTH OUTCOMES AMONG MINORITY OLDER ADULTS LIVING IN VAN BUREN COUNTY AND DEVELOP AN ACTIONABLE STRATEGIC PLAN TO BUILD COMMUNITY CAPACITY AND CONNECTEDNESS IN ORDER TO IMPACT SYSTEMS-LEVEL POLICY CHANGE THEREBY IMPROVING THE HEALTH OF OLDER ADULTS AND REDUCING HEALTH CARE COSTS2. COMMUNITY SUPPORTA. 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.3. WORKFORCE DEVELOPMENT A. VOCATIONAL INITIATIVE: BSHH WORKS WITH LOCAL SCHOOL SYSTEMS TO PROVIDE CAREER DAY PROGRAMS AND VOCATIONAL TECH SCHOOL-TO-WORK INITIATIVES.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. C. SWMPQCBRONSON 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 PERSONS 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 MOTHERS 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 MOTHERS 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 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.D. 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 LEAST SEVEN 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 AND REMAINS OPEN TODAY.E. 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.D 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 2020F. 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"

PART III, LINE 2:
UNCOLLECTIBLE AMOUNTS ARE WRITEN 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 WRITEOFFS SUPPORT THE COMMUNITY BY PROVIDING A PORTION OF SERVICES WITHOUT PAYMENT. THE AMOUNT OF BAD DEBT EXPENSES 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 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 SUMMARY ARE AVAILABLE UPON REQUEST.

PART VI, LINE 4:
BRONSON SOUTH HAVEN HOSPITAL (BSHH) SERVES VAN BUREN COUNTY WHICH HAS APPROXIMATELY 75,000 RESIDENTS. THE COUNTY IS AGRICULTURAL AND HAS HIGHER THAN STATE AVERAGE UNEMPLOYMENT. BSHH PROVIDES TWO RURAL HEALTH CLINICS IN BOTH SOUTH HAVEN AND BANGOR, AS WELL AS 5 OTHER PRIMARY AND SPECIALTY PRACTICES IN SOUTH HAVEN TO PROVIDE ACCESS TO CARE. BSHH PRACTICES ALSO SERVE ALLEGAN COUNTY, WHICH IS WITHIN SEVERAL MILES OF THE MAIN HOSPITAL CAMPUS. ALL CLINICS ACCEPT PATIENTS REGARDLESS OF ABILITY TO PAY AND HAVE CHARITY CARE PROCESSES IN PLACE.

PART VI, LINE 7, REPORTS FILED WITH STATES
MI

PART VI, LINE 5:
"COLLABORATION WITH COMMUNITY STAKEHOLDERSAS PREVIOUSLY MENTIONED, BSHH SEEKS COMMUNITY COLLABORATORS AND STAKEHOLDERS AS PARTNERS ON MEETING COMMUNITY HEALTH NEEDS, ADDRESSING MULTI-SECTOR ISSUES, AND LEADING DISASTER/EMERGENCY EFFORTS. TOWARDS THIS END, BSHH AND ITS EMPLOYEES ACTIVELY PARTICIPATE IN AND PROVIDE SUPPORT TO MANY COMMUNITY ORGANIZATIONS. THESE INCLUDE PARTICIPATION IN THE 5TH DISTRICT MEDICAL RESPONSE COALITION, VAN BUREN COUNTY MEDICAL COUNTRY AUTHORITY, VAN BUREN EMERGENCY OPERATIONS AND LOCAL EMERGENCY PLANNING COMMITTEES, HEALTH FAIRS AND EXPOS, UNITED WAY OF SOUTHWEST MICHIGAN, VAN BUREN COMMUNITY HEALTH COMMITTEE, VAN BUREN HUMAN SERVICES COLLABORATIVE, SOUTH HAVEN PUBLIC SCHOOL WELLNESS POLICY COMMITTEE, AND GIRLS ON THE RUN OF SOUTHWEST MICHIGAN ADVISORY BOARD. HEALTH PROMOTIONBSHH PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A HOST OF EDUCATIONAL PROGRAMS AND ACTIVITIES, INCLUDING CPR CLASSES, BLOOD PRESSURE SCREENINGS, MAMMOGRAPHY SCREENINGS AND HEALTHY LIVING CLASSES TO THE COMMUNITY. HEALTHY LIVING EDUCATIONSNAP-ED AT BRONSON: (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM EDUCATION) THE BRONSON HEALTH FOUNDATION RECEIVED A $153,742.00 SNAP-ED GRANT TO FUND COMMUNITY FIT!, A NUTRITION AND PHYSICAL ACTIVITY EDUCATION AND HEALTH PROMOTION PROGRAM FOR INCOME-ELIGIBLE ADULTS, YOUTH, AND FAMILIES IN VAN BUREN COUNTY, KALAMAZOO AND BATTLE CREEK. EDUCATION SNAP-ED COMMUNITY NUTRITION EDUCATION SERIES EAT SMART, LIVE STRONG: EAT SMART, LIVE STRONG (OLDER ADULTS) WAS PROVIDED VIRTUALLY TO PARTICIPANTS. THE CLASSES INCLUDED ENGAGING LESSONS AND DISCUSSION, A LIVE FOOD DEMONSTRATION, AND PHYSICAL ACTIVITY OPPORTUNITIES. REACH: > 25 SNAP-ED HEALTHY SCHOOLS, HEALTHY COMMUNITIES FOR YOUTH: - BRONSON HEALTH EDUCATORS TAUGHT 30 NUTRITION EDUCATION SERIES IN GRADES K-5, CONSISTING OF 4-5 LESSONS EACH TO SOUTH HAVEN PUBLIC SCHOOLS STUDENTS THROUGH A COMBINATION OF FACE-TO-FACE, HYBRID, AND VIRTUAL INSTRUCTION METHODS. REACH: > 550 LINKING LESSONS. STUDENTS RECEIVED NUTRITION EDUCATION IN REGARDS TO THE IMPORTANCE OF BREAKFAST, HEALTHY SNACKS, AND MY PLATE, PARTICIPATED IN ENGAGING ACTIVITIES, AND RECEIVED A HEALTHY SNACK RELATED TO THE LESSON. REACH: > 70 THE LEARNING KITCHEN. TAUGHT A COOKING AND HEALTHY LIVING PROGRAM, VIRTUALLY THROUGH KVCC CULINARY CENTER TO STUDENTS AND FAMILIES IN JR. HIGH. REACH: > 70 COOK, CHOMP, CHAT - COOK, CHOMP AND CHAT WAS A FREE, -DAY NUTRITION EDUCATION AND HANDS-ON COOKING EXPERIENCE THAT STUDENTS COULD ENROLL IN AS PART THE SCHOOL DISTRICT'S SUMMER CAMP-TYPE EDUCATIONAL OFFERINGS. STUDENTS LEARNED ABOUT MY PLATE, PRACTICED BASIC KITCHEN AND FOOD SAFETY SKILLS, AND PREPARED AND RECIPES. REACH: 20 STUDENTS SOCIAL MEDIA NUDGES, VIRTUAL EVENTS AND EDUCATION AND WEB-BASED RESOURCES SOCIAL MEDIA - MS. ISABEL EATS 27, 2-3 MINUTE, HEALTH PROMOTING VIDEOS DISTRIBUTED THROUGH SOUTH HAVEN PUBLIC SCHOOLS TO STUDENTS AND FAMILIES VIA THE SD WEB SITE AND FACEBOOK PAGES. REACH: > 3,500 VIEWS SOCIAL MEDIA - PARIS'S KITCHEN COOKING VIDEOS - VIRTUAL VIDEOS POSTED ON FACEBOOK TO COMPLEMENT THE LEARNING KITCHEN. 12 VIDEOS WERE CREATED. REACH > 30, 000 VIEWS ZOOM-BASED EVENTS - LET'S MAKE DINNER! A ZOOM-BASED FAMILY COOKING CLASS FEATURING LOCAL HEROES AS GUEST CHEFS. 3 COMMUNITY EVENTS. VIRTUAL EDUCATION - HEALTH THROUGH LITERACY - ASYNCHRONOUS LEARNING, VIA MFF'S HEALTH THROUGH LITERACY PROGRAM, OFFERED TO STUDENTS LEARNING AT HOME DUE TO THE PANDEMIC. 25 VIDEOS WITH A BOOK READING AND CONNECTION QUESTIONS WERE CREATED AND DISTRIBUTED. REACH > 100 STUDENTS WEB-BASED RESOURCE - COMMUNITY FAMILY FUN GUIDES TWO COMMUNITY-SPECIFIC DOWNLOADABLE RESOURCE BOOKLETS DESIGNED FOR FAMILIES THAT ENCOURAGES THEM TO BE MORE ACTIVE AND INFORM THEM OF LOW AND NO COST PHYSICAL ACTIVITY OPPORTUNITIES AVAILABLE THEIR COMMUNITIES. REACH COMMUNITY WIDE AVAILABILITY VIA THE WEB WEB BASED RESOURCE EAT SMART, LIVE STRONG COOKBOOK. THIS OLDER-ADULT FOCUSED COOKBOOK PROVIDES HEALTHY, QUICK, AND BUDGET FRIENDLY RECIPES DESIGNED FOR SMALL HOUSEHOLDS. REACH COMMUNITY WIDE AVAILABILITY VIA THE WEBCOMMUNITY PARTNERSHIP INITIATIVES FOOD EXPLORERS BOOK BAGS TAKE HOME FAMILY BOOK BAGS TO INSPIRE INCREASED READING TIME AND HEALTHY EATING BEHAVIORS WERE CREATED AND DONATED TO TWO LOCAL LIBRARIES (SOUTH HAVEN AND COVERT). THE BAGS LINK NUTRITION EDUCATION WITH READING. EACH BAG CONTAINED BOOKS AND TAKE HOME RESOURCES FOR FAMILIES TO KEEP. REACH: > 50 FAMILIES LOCAL WELLNESS POLICY IMPROVEMENT. STRUCTURED COMMITTEE MEETINGS WITH 15+ COMMUNITY MEMBERS TO REVIEW AND EDIT THE SCHOOL DISTRICT'S LWP AND CREATE AN ACTION PLAN. REACH: HPS DISTRICT PRODUCE FOR PANTRIES. GRASS ROOTS INITIATIVE TO INCREASE AND IMPROVE THE AMOUNT OF HIGH QUALITY PRODUCE OFFERED TO CLIENTS AT A FOOD PANTRY. REACH: > 300 PEOPLE FOOD ENVIRONMENT SCAN. AN ASSESSMENT TO UNCOVER STUDENT/FAMILY NEED RELATED TO FOOD INSECURITY IN KALAMAZOO AND COMSTOCK SCHOOL DISTRICTS. REACH: TWO SCHOOL DISTRICTS FARMERS AS PARTNERS - DEVELOPED A UNIQUE RELATIONSHIP WITH SEVERAL FARMERS TO PROVIDE HIGH QUALITY PRODUCE TO THE LOCAL FOOD PANTRY IMPROVING FOOD PANTRY OFFERINGS AND INCREASING FINANCIAL STABILITY OF FARMERS. CHALK THE WALK - AN EVENT WHERE FAMILIES WERE ENCOURAGED TO WALK THE VAN BUREN TRAIL, AND CHALK THEIR OWN ARTWORK ON THE TRAIL WITH INSPIRING AND POSITIVE MESSAGES FOR THOSE WALKING THE TRAIL TO ENJOY, AS WELL AS RECEIVE INFORMATION AND GIVEAWAYS FROM DIFFERENT STATIONS. REACH: >100 WALK TO SCHOOL DAYS - THIS INITIATIVE WAS A PARTNERSHIP WITH SAFE ROUTES TO SCHOOL AND FAMILIES WERE ENCOURAGED TO PARTICIPATE IN THE ""WALKING SCHOOL BUS"". STUDENTS WALKED ABOUT A MILE TO SCHOOL IN ORDER TO START THEIR DAY OFF RIGHT WITH SOME PA AND OUTDOOR TIME. REACH: > 30 STUDENTS AND PARENTS REPORTING TO THE COMMUNITYBSHH 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:
"BSHH IS PART OF AN AFFILIATED SYSTEM THAT SERVES NINE COUNTIES AND INCLUDES THREE OTHER HOSPITALS, BRONSON BATTLE CREEK HOSPITAL, BRONSON LAKEVIEW 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:
"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. G. 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 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.H. 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 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 2020-2022 CHIP FOCUSES ON ADDRESSING PERINATAL HEALTH DISPARITIES, THE QOBC ESTABLISHED A TASK FORCE TO ADDRESS RACIAL BIAS IN PAIN ASSESSMENT AND MANAGEMENT AMONG MOTHERS 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."