4A (Expenses $ 118515700 including grants of $ 4300) (Revenue $ 148333230)
MERCY MEMORIAL HOSPITAL CORPORATION IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O.

MERCY MEMORIAL HOSPITAL CORPORATION
PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT SURVEY, PMRH STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS THROUGH THE BUILDING HEALTHY COMMUNITIES COALITION OF MONROE COUNTY TO COLLABORATE, DEVELOP AND IMPLEMENT A PRIORITIZED, STRATEGIC COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR MONROE COUNTY. A GAP ANALYSIS AND RESOURCE ASSESSMENT WAS CONDUCTED AS PART OF THIS PROCESS.IN 2019, PROMEDICA MONROE HOSPITAL CONVENED A CHNA COMMITTEE TO REVIEW THE WORK OF THE BUILDING HEALTHY COMMUNITIES COALITION OF MONROE COUNTY AND THE COUNTY HEALTH ASSESSMENT AND PLAN THAT INCLUDED GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITAL RECEIVED FEEDBACK ON THE CHNA PLAN FROM THE MONROE COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A PUBLIC HEALTH EXPERT PERSPECTIVE.THE BUILDING HEALTHY COMMUNITIES COALITION OF MONROE COUNTY CHIP PROCESS INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: MONROE COUNTY HEALTH DEPARTMENT, PROMEDICA MONROE REGIONAL HOSPITAL, MONROE CENTER FOR HEALTHY AGING, DELANEY COUNSELING SERVICES, GREAT START COLLABORATIVE, FAMILY COUNSELING AND SHELTER SERVICES, CITY OF MONROE, MONROE COUNTY MENTAL HEALTH AUTHORITY, MONROE COUNTY COMMISSION ON AGING, LAKE ERIE TRANSIT, MONROE COUNTY OPPORTUNITY PROGRAM, COMMUNITY FOUNDATION OF MONROE COUNTY, MONROE COUNTY SUBSTANCE ABUSE COALITION, MONROE COUNTY INTERMEDIATE SCHOOL DISTRICT, UNITED WAY OF MONROE COUNTY, CATHOLIC CHARITIES OF SE MICHIGAN, AMERICAN CANCER SOCIETY, FAMILY MEDICAL CENTER, MICHIGAN STATE POLICE, MONROE FAMILY YMCA, RSVP, CASA, SENATOR GARY PETERS, MENTAL HEALTH PARTNERSHIP OF SOUTHEAST MI, MONROE COUNTY COMMUNITY COLLEGE, MICHIGAN STATE UNIVERSITY EXTENSION, AMERICAN CANCER SOCIETY, MONROE COUNTY ISD, MONROE COUNTY COMMUNITY PLANNING, CAN COUNCIL.

MERCY MEMORIAL HOSPITAL CORPORATION
PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO

MERCY MEMORIAL HOSPITAL CORPORATION
PART V, SECTION B, LINE 11: MERCY MEMORIAL HOSPITAL CORPORATION CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- CHRONIC DISEASE PREVENTION- SOCIAL DETERMINANTS OF HEALTH FOOD INSECURITY- MENTAL HEALTH- OBESITY PHYSICAL ACTIVITY- TOBACCO/VAPING- OPIOID CESSATIONTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022. MERCY MEMORIAL HOSPITAL CORPORATION DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: HEALTH STATUS PERCEPTIONS, HEALTH CARE COVERAGE, HEALTH CARE ACCESS AND UTILIZATION, PREVENTIVE MEDICINE, MEN'S HEALTH, WOMEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, CANCER, ASTHMA, ARTHRITIS, DIABETES, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL HEALTH, PARENTING, YOUTH WEIGHT/NUTRITION/PHYSICAL ACTIVITY, YOUTH SEXUAL BEHAVIOR, YOUTH ALCOHOL CONSUMPTION, YOUTH DRUG USE, YOUTH SAFETY/BULLYING/DANGER/VIOLENCE, COMMUNITY DOMAIN, FAMILY DOMAIN, INDIVIDUAL/PEER DOMAIN, AND SCHOOL DOMAIN.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2021 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. MERCY MEMORIAL HOSPITAL CORPORATION TOOK THE FOLLOWING ACTIONS DURING TAX YEAR 2021 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: CHRONIC DISEASE PREVENTIONSTRATEGY #1 - HOLD 2 RISK AWARENESS AND EDUCATIONAL SESSIONS EACH YEAR THAT PROVIDE SCREENINGS, EDUCATION AND INFORMATION THAT INCLUDE BUT ARE NOT LIMITED TO STROKE, CANCER AND OTHER VARIOUS TOPICS AND ISSUES THAT ARE IMPORTANT TO MONROE COUNTY FAMILIESACTIONS TAKEN:- TWENTY-EIGHT (28) EDUCATION SESSIONS FOCUSED ON COPD, STROKE, CHILDBIRTH, BREASTFEEDING, HEALTHY EATING, CANCER AND OTHER HEALTH RELATED TOPICS WERE OFFERED IN 2021. - 598 PARTICIPANTS ATTENDED EDUCATION SESSIONS AND EVENTS, SUCH AS THE RECOVERY ADVOCACY WARRIORS ANNUAL RECOVERY EVENT, HEALTH ODYSSEY SESSIONS, STROKE EDUCATION ENGAGEMENTS, AND CHILDBIRTH AND BREASTFEEDING WORKSHOPS IN 2021. - FIFTEEN (15) PATIENTS RECEIVED NO COST WOMEN'S HEALTH SCREENINGS THROUGH BREAST AND CERVICAL CANCER PROGRAM (BCCP) IN 2021.HEALTH NEED IDENTIFIED - SOCIAL DETERMINANTS OF HEALTH FOOD INSECURITY STRATEGY #1 - PARTNER WITH COMMUNITY GROUPS TO INCREASE ACCESS TO FOOD AND DEPLOYMENT OF FOOD PRESCRIPTIONS. ACTIONS TAKEN:- THIRTY (30) FOOD PRESCRIPTIONS/REFERRALS WERE MADE TO COMMUNITY FOOD AGENCIES IN 2021.STRATEGY #2 - DEVELOP FOOD RECLAMATION PROGRAM AND ASSESS/MEASURE ANNUALLY.ACTIONS TAKEN:- HOSPITAL NUTRITION SERVICES RECLAIMED AND DONATED 350 POUNDS OF FOOD, AND ALSO DONATED $300 OF COOKING PANS TO OAKS OF RIGHTEOUSNESS FOOD PANTRY.STRATEGY #3 - EVALUATE EMPLOYEE FOOD INSECURITY NEED AND DEPLOY FOOD.ACTIONS TAKEN:- 3 HOSPITAL EMPLOYEES FOOD ASSISTANCE IN 2021. ONE OF THE THREE EMPLOYEES WAS IDENTIFIED WITH MULTIPLE SOCIAL DETERMINANTS OF HEALTH AND WAS CONNECTED TO A GAS CARD, KROGER GIFT CARD FOR GROCERIES, AND A LOCAL CHURCH FOOD CLOSET FOR ADDITIONAL FOOD RESOURCES. HEALTH NEED IDENTIFIED: MENTAL HEALTHSTRATEGY #1 - HOLD SCREENINGS AND EDUCATIONAL SESSIONS EACH YEAR THAT PROVIDE INFORMATION ON VARIOUS TOPICS THAT INCLUDE BUT ARE NOT LIMITED TO ANXIETY, DEPRESSION, SUICIDE AWARENESS, SUICIDE PREVENTION, BULLYING AND OTHER ISSUES THAT ARE IMPORTANT MONROE COUNTY FAMILIES.ACTIONS TAKEN:- 475 EDUCATIONAL RESOURCES WERE DISTRIBUTED TO COMMUNITY MEMBERS AND PATIENTS IN 2021. COMMUNITY MENTAL HEALTH MYSTRENGTH APPLICATION, SUICIDE PREVENTION, AND PROMEDICA MENTAL HEALTH RESOURCE GUIDES WERE DISTRIBUTED IN 2021.STRATEGY #2 - CONTINUE TO UPDATE COMMUNITY RESOURCE GUIDE FOR MONROE COUNTY AND PROVIDE LINK TO COMMUNITY MEMBERS ANNUALLY. ACTIONS TAKEN: - UPDATED RESOURCE GUIDE IN 3RD QUARTER 2021. GUIDE LINK CONTINUES TO BE AVAILABLE FOR THE COMMUNITY ONLINE TO ASSIST COMMUNITY IN FINDING RESOURCES FOR MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT. 373 COPIES WERE DISTRIBUTED IN PUBLIC ORGANIZATIONS IN 4TH QUARTER 2021.- 25 SUICIDE PREVENTION AND OUTPATIENT BEHAVIORAL HEALTH RESOURCES WERE DISTRIBUTED AT ANNUAL RECOVERY PICNIC.- IN 4TH QUARTER 2021 FOUR EDUCATION SESSIONS WERE PROVIDED AT HEALTH ODYSSEY ON DEPRESSION AND ANXIETY, MEMORY LOSS AND THE YOUTH SUMMIT.HEALTH NEED IDENTIFIED: OBESITY/PHYSICAL ACTIVITYSTRATEGY #1 - PHYSICAL TRAINING A. EXPLORE OPPORTUNITIES AND STRATEGY FOR EXERCISE VOUCHER PROGRAM WITH LOCAL FITNESS CENTERSB. WORK WITH LOCAL PROVIDERS ON SCREENING AND EXERCISE PRESCRIPTION PROGRAM. ACTIONS TAKEN:- FIFTY (50) BE ACTIVE MONROE MAPS WERE DISTRIBUTED AT COVID SCREENING STATIONS IN THE HOSPTIAL. (LOCAL FITNESS CENTERS WERE NOT INTERESTED IN PARTICIPATING IN VOUCHER PROGRAM SO DISTRIBUTION OF MAPS WAS PUT IN PLACE IN 2020).- THE DOCUMENT WAS SHARED ELECTRONICALLY WITH 15 BUILDING HEALTHY COMMUNITIES COALITION MEMBERS AS PART OF THE GROUPS WELLNESS OUTREACH COMMITTEE ACTIVITIES IN 2021. REACH IS UNKNOWN. STRATEGY # 2 - NUTRITION EDUCATION - WORK WITH PROMEDICA WELLNESS TO PROVIDE NUTRITIONAL WELLNESS TIPS TO BE DISTRIBUTED TO COMMUNITY.ACTIONS TAKEN: COPD EDUCATION AT RECOVERY PICNIC WAS MENTIONED ABOVE- ELECTRONIC PROMEDICA WELLNESS NUTRITION TIPS AND PROPER FRUIT AND VEGETABLE STORAGE, WAS SHARED WITH 10 BUILDING HEALTHY COMMUNITY PARTNERS WITH CALL TO ACTION TO SHARE WITH THE COMMUNITY PARTICIPATING ORGANIZATIONS SERVETO ENCOURAGE HEALTHY EATING AS PART OF THE COALITION'S WELLNESS OUTREACH COMMITTEE. REACH IS UNKNOWN. HEALTH NEED IDENTIFIED: TOBACCO/VAPING EDUCATION STRATEGY #1 - PROVIDE TOBACCO/VAPING CESSATION EDUCATION TO BOTH ADULTS AND YOUTH POPULATIONS.ACTIONS TAKEN:- IN 2021, PROMEDICA DEVELOPED A NICOTINE CESSATION ONLINE CURRICULUM TO PRODUCE AND POST ONLINE IN 2022.STRATEGY #2 - COLLABORATE WITH COMMUNITY TOBACCO/VAPING TREATMENT PROGRAMS IN AN EFFORT TO REDUCE COMMUNITY DEPENDENCE.ACTIONS TAKEN:- THREE (3) COLLABORATIVE PROGRAMS WERE PROVIDED IN 2021, WITH: FORMATION OF BHCC WELLNESS OUTREACH COMMITTEE; DISTRIBUTION OF ACCESS TO BHCC VAPING WEBINAR; 50 EDUCATION FLYERS DISTRIBUTED AT COVID SCREENING STATIONS LOCATED AT THE MAIN ENTRANCE OF THE HOSPITAL; AND LUNG HEALTH EDUCATION PROVIDED IN 3RD QUARTER, 2021.STRATEGY #3 - PROVIDE TOBACCO CESSATION MATERIALS AND STAFF EDUCATION TO COMMUNITY AGENCIES.ACTIONS TAKEN:- MONROE COUNTY SUBTANCE ABUSE COALITION HOSTED 1 VAPING CESSATION EVENT. FLYERS WERE DISTRIBUTED AT COVID SCREENING STATIONS LOCATED AT THE MAIN ENTRANCE OF THE HOSPITAL.- 203 PROMEDICA TOBACCO CESSATION PROGRAM MATERIALS AND SUBSTABCE ABUSE COALITION VAPING CESSATION SESSION MATERIALS WERE DISTRIBUTED TO COMMUNITY ORGANIZATIONSHEALTH NEED IDENTIFIED: OPIOID CESSATIONSTRATEGY #1 - DEVELOP OPIOID KIT DISTRIBUTION PROGRAM YEAR ONE. MONITOR USE IN FOLLOWING YEARS. ACTIONS TAKEN:- PROMEDICA IMPLEMENTED THE NALOXONE LEAVE BEHIND PROGRAM WITH LOCAL EMS IN 2021. - FOUR (4) NALOXONE KITS WERE DISTRIBUTED TO EMS AND PROVIDED TO COMMUNITY MEMBERS OR FAMILIES EXPERIENCING SUBSTANCE OR OPIOID USE DISORDER. STRATEGY #2 - EDUCATION ON OPIOIDS, TRAUMA AND OTHER HIGH-RISK BEHAVIORS.ACTIONS TAKEN:- 106 EDUCATIONAL MATERIALS RELATED TO INJURY, TRAUMA, STOP THE BLEED AND HARM REDUCTION WERE PROVIDED AT LOCAL SCHOOLS, YMCA, AND MONROE COUNTY.

PART V, SECTION B, LINE 7A
THE 2019 CHNA CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-MONROE-REGIONAL-HOSPITAL-2019-CHNA.PDF

PART V, SECTION B, LINE 10A
THE 2020-2020 CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-MONROE-REGIONAL-HOSPITAL-2019-CHNA-IMPLEMENTATION-PLAN-2020-2022.PDF

PART V, SECTION B, LINE 16A:
THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/UNINSURED_DISCOUNT_POLICY.PDF

PART V, SECTION B, LINE 16B:
THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/FINANCIAL_ASSISTANCE_APPLICATION.PDF

PART V, SECTION B, LINE 16C:
A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/PLAIN_LANGUAGE_FINANCIAL_ASSISTANCE.PDF

PART I, LINE 3C:
IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.

PART I, LINE 6A:
MERCY MEMORIAL HOSPITAL CORPORATION REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT.

PART I, LINE 7:
MERCY MEMORIAL HOSPITAL CORPORATION CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS.

PART II, COMMUNITY BUILDING ACTIVITIES:
PROMEDICA MONROE REGIONAL HOSPITAL PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING LOCAL ORGANIZATIONS AND ACTIVITIES THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES.

PART III, LINE 2:
"MERCY MEMORIAL HOSPITAL CORPORATION'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS ""LOOK-BACK"" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY."

PART III, LINE 3:
MERCY MEMORIAL HOSPITAL CORPORATION ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT.

PART III, LINE 4:
PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 18 AND 19 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION.

PART III, LINE 8:
MERCY MEMORIAL HOSPITAL CORPORATION USED THE MEDICARE ALLOWABLE COSTS PER ITS 2021 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS.

PART III, LINE 9B:
FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING.

PART VI, LINE 2:
PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE.

PART VI, LINE 3:
THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS.

PART VI, LINE 4:
PROMEDICA MONROE REGIONAL HOSPITAL, LOCATED IN MONROE, MICHIGAN, SERVES AN AREA PRIMARILY AROUND MONROE COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 109,000. APPROXIMATELY, 19% OF THE SERVICE AREA IS AGE 65 OR OVER; 60% IS BETWEEN AGE 18 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $62,000; 91% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 39% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. MONROE COUNTY HAS A POPULATION OF APPROXIMATELY 155,000 WITH APPROXIMATELY 10% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 15% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 9% OF MONROE COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR MONROE COUNTY IN 2021 WAS 4.3%. THE LEADING CAUSES OF DEATH IN MONROE COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, COVID, UNINTENTIONAL INJURIES/ACCIDENTS, STROKE, LUNG DISEASE, ALZHEIMER'S, AND DIABETES. ACCORDING TO 2021 COUNTY HEALTH RANKINGS, MONROE COUNTY RANKED 39 OF 83 COUNTIES FOR HEALTH OUTCOMES, 51 OF 83 FOR LENGTH OF LIFE, AND 27 OF 83 FOR QUALITY OF LIFE. THERE ARE EIGHTEEN HOSPITALS WITHIN A 30-MILE RADIUS OF PROMEDICA MONROE REGIONAL HOSPITAL: MERCY MEMORIAL HOSPITAL SYSTEM, BEAUMONT HOSPITAL TRENTON, ST. VINCENT MERCY MEDICAL CENTER, ST. ANNE MERCY HOSPITAL, THE TOLEDO HOSPITAL, ST. CHARLES MERCY HOSPITAL, BAY PARK COMMUNITY HOSPITAL, FLOWER HOSPITAL, BEAUMONT HOSPITAL TAYLOR, HENRY FORD WYANDOTTE HOSPITAL, UNIVERSITY OF TOLEDO MEDICAL CENTER, BEAUMONT HOSPITAL WAYNE, ST. JOSEPH MERCY SALINE HOSPITAL, BEAUMONT HOSPITAL DEARBORN, ST. JOSEPH MERCY ANN ARBOR HOSPITAL, GARDEN CITY HOSPITAL, HERRICK MEMORIAL HOSPITAL, INC., AND ST. LUKE'S HOSPITAL.

PART VI, LINE 5:
PROMEDICA MONROE REGIONAL HOSPITAL IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2021: - THERE WERE APPROXIMATELY 300 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON MORE THAN 25 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. BOARD MEMBERSHIP IS COMPOSED OF 43% FEMALES, 20% PHYSICIANS, 11% UNDER THE AGE OF 40, AND 18% RACIAL OR ETHNIC MINORITIES. - PROMEDICA NON-PARENT BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THE UPGRADES ALLOW PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- PROMEDICA CANCER INSTITUTE (PCI) COMPLETED MORE THAN 3,300 LUNG CANCER SCREENINGS, NEARLY 55,000 SCREENING MAMMOGRAMS AND NEARLY 13,000 SCREENING COLONOSCOPIES. ADDITIONALLY, PCI CONTINUES TO BE INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT. IN 2021, APPROXIMATELY 8,000 DOSES OF THE TREATMENT WERE PROVIDED. - PROMEDICA SENIOR CARE SKILLED NURSING FACILITIES AND HOME HEALTH AND HOSPICE AGENCIES PROVIDE UNIQUE SERVICES TO VETERANS, HOLIDAY SUPPORT, SUPPORT GROUPS, AND WORKSHOPS TO ANYONE IN THE COMMUNITY WHO NEEDS ADDITIONAL HELP TO GET THROUGH THE LOSS OF A LOVED ONE. PATIENTS AND RESIDENTS' WISHES ARE GRANTED THROUGH THE ORGANIZATION'S HEART'S DESIRE PROGRAM. THROUGH GRANTS FROM THE HOSPICE MEMORIAL FUND, GRIEF CAMPS FOR CHILDREN AND ADULTS ARE OFFERED AS WELL AS EDUCATIONAL SESSIONS AND LIFE CELEBRATION EVENTS. THE FUND ALSO PROVIDES STABILIZING RESOURCES FOR HOSPICE PATIENTS AND FAMILIES IN FINANCIAL DISTRESS DUE TO THE LACK OF OR REDUCTION IN INCOME FROM TERMINAL ILLNESS OR DISEASE.- PROMEDICA CONTINUES TO EXPAND ITS OPTIONS FOR HOSPITAL-LEVEL CARE IN THE COMFORT OF A PATIENT'S HOME. PROMEDICA ACUTE CARE AT HOME COMBINES PROMEDICA'S EXTENSIVE NETWORK OF IN-HOME CARE PROVIDERS WITH A SOPHISTICATED TECHNOLOGY PLATFORM TO DELIVER SEAMLESS AND EFFECTIVE CARE AT HOME FOR PATIENTS WITH SELECT CHRONIC CONDITIONS OR DIAGNOSES SUCH AS HEART FAILURE, PNEUMONIA OR COPD. IN 2021, PROMEDICA ACUTE CARE AT HOME EXPANDED ITS SERVICES TO INCLUDE CARE FOR SELECT ONCOLOGY PATIENTS BY COLLABORATING THE PROMEDICA CANCER CENTER. THE CARE TEAM CONSISTS OF PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, AND MAY INCLUDE OTHER HEALTHCARE PROFESSIONALS, SUCH AS PHYSICAL OR OCCUPATIONAL THERAPISTS, AS NEEDED.- IN THE METRO TOLEDO AREA, PROMEDICA WORKED CLOSELY WITH LUCAS COUNTY DEPARTMENT OF HEALTH OFFICIALS TO ASSIST WITH MASS COVID VACCINE CLINICS AS WELL AS CLINICS IN UNDERSERVED AREAS OF THE COMMUNITY WHERE VACCINE HESITANCY WAS AN ONGOING CONCERN. ONE OF THE PROJECTS PROMEDICA HELPED SPEARHEAD WAS THE V PROJECT, WHICH WORKED ACROSS THE NORTHWEST OHIO COMMUNITY TO INCREASE VACCINE PARTICIPATION. THE V PROJECT HELPED TO BRING RESOURCES TO PEOPLE IN ZIP CODES THAT HAD LOWER VACCINATION PARTICIPATION RATES WITH THE GOAL OF EASING ANY BARRIERS THAT MAY HAVE PROHIBITED THEM FROM PREVIOUSLY GETTING THEIR VACCINE. - PROMEDICA ALSO ALLOCATED 20% OF THE VACCINES IT RECEIVED TO UNDERSERVED COMMUNITIES. THIS LED TO OTHER OPPORTUNITIES SUCH AS THE PARTNERSHIP WITH THE FIRST CHURCH OF GOD ON COLLINGWOOD IN TOLEDO. LED BY THE PPG CLINICAL OPERATIONS TEAM, VARIOUS TEAMS FROM ACROSS PROMEDICA CAME TOGETHER AND HELD VACCINATION CLINICS ON SUNDAYS. PROMEDICA ALSO EXPANDED PARTICIPATION IN COMMUNITY MASS COVID VACCINE CLINICS AT AN ARE UAW HALL TO REACH A LARGER PROPORTION OF THE UNDERSERVED COMMUNITIES.

PART VI, LINE 6:
"PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2021 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, NEARLY 850 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,200 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP ('PPG"")WHO FORM A PROVIDER NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2021:- PROMEDICA MEMBERS AND AFFILIATE HOSPITALS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL,; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL. PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE PROMEDICA SENIOR CARE/HCR MANORCARE UMBRELLA.- PROMEDICA MANAGED APPROXIMATELY 2.28 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 57,200 SURGERIES, 6,000 BIRTHS, AND MORE THAN 262,600 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $259,433,000.- PROMEDICA CONTINUED TO OPERATE THREE COMMUNITY FOOD CLINICS, LOCATED AT PROMEDICA BAY PARK HOSPITAL, THE PROMEDICA HEALTH AND WELLNESS CENTER AND PROMEDICA'S CENTER FOR HEALTH SERVICES, TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2021, APPROXIMATELY 5,794 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 2,093 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 44,100 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 132,300 MEALS.- FOR ITS MICHIGAN PATIENTS, PROMEDICA PARTNERED WITH THE SOUTH MICHIGAN FOOD BANK TO DISTRIBUTE FOOD RESOURCES TO PROMEDICA PHYSICIANS GROUP OFFICES FOR PATIENTS SCREENING POSITIVE FOR FOOD INSECURITY. IN 2021, 49 PEOPLE WERE SUPPORTED BY THE INITIATIVE. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS AT DISCHARGE SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. IN 2021, NEARLY 2,560 POUNDS OF PRODUCE WAS GROWN AT PROMEDICA FARMS, 21 PATIENTS IDENTIFIED AS FOOD INSECURE REDEEMED A VOUCHER ISSUED BY A PHYSICIAN OR DISCHARGE PLANNING, AND AN ADDITIONAL 4 PATIENTS WERE PROVIDED A FOOD BOX AND VEGGIE VOUCHER UPON DISCHARGE. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ADDITIONALLY, TWO NEW FINANCIAL OPPORTUNITY CENTERS (FOC) WERE OPENED IN FREMONT AND DEFIANCE, OHIO. MUCH LIKE THE FOC LOCATED IN UPTOWN TOLEDO, THE NEW LOCATIONS OFFER SERVICES AND ASSIST LOW TO MODERATE-INCOME FAMILIES WITH SECURING LIVING WAGE JOBS, BUILDING CREDIT, REDUCING DEBT, AND GAINING WEALTH. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION."