4A (Expenses $ 340998767 including grants of $ 265962) (Revenue $ 409344489)
ASCENSION GENESYS HOSPITAL is a 412-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2022, ASCENSION GENESYS HOSPITAL treated 17,810 adults and children for a total of 96,861 patient days of service. The hospital also provided services for 198,839 outpatient visits, which included 7,799 outpatient surgeries and 51,238 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. As part of the Ascension Catholic health ministry, the filing organization served in support of Ascension's commitment to both care for patients and communities and support caregivers and other associates through the challenges of the COVID-19 global pandemic in FY22.

Schedule H, Part V, Section B, Line 3E
TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - ASCENSION GENESYS HOSPITAL. In Ascension Genesys Hospital's most recent CHNA (Tax Year 2021) community input was obtained through the following methods from July 2021 - June 2022: 1) Quantitative data, both public and private, is provided by the sources listed in this section; 2) Literature reviews are completed to identify state and national benchmarks that relate to the indicators/metrics measured through the quantitative data sources; 3) Social determinant of health (SDOH) needs screening data collected in aggregate from partnering patient-centered medical home practices and GFHC programs (such as Genesee CHAP) for aggregate analysis; and 4) Qualitative data provided through a community health needs assessment survey which was distributed by the Greater Flint Health Coalition, the 2022 CHNA primary partner organizations (to patients visiting clinical delivery sites as well as stakeholders), and the GFHC Community Referral Network (to residents served in community locations). The survey was also shared via social media channels and the network of the Greater Flint Health Coalition. The 2022 CHNA's utilization of multiple types of data collection and aggregation methods allowed for data-driven input across a broad range of community informed indicators relating to overall population health, social determinants of health (including geographic/location differences in health outcomes), and the needs of disadvantaged populations including uninsured persons, low-income persons, and minority groups within the Genesee County community. 5) More than 17,000 unique community residents surveyed through multiple survey instruments (e.g. CHNA Community Resident Survey, GFHC program and partner-led Social Determinants of Health Screening Surveys) relevant to developing a broad collection of community informed input. Following the collection, aggregation, and analysis of more than 500 metrics within the CHNA, the data was then shared strategically through the Greater Flint Health Coalition's established network of collaborative partners. The Greater Flint Health Coalition (GFHC) regularly convenes residents, subject matter experts, and community/institutional organizations representing multi-sector interests through the engagement of representatives from business, education, public health, physicians, hospitals, health insurers, safety-net providers, community-based organizations, residents, policymakers, foundations, labor, and media. The following list represents the organizations that participated in the 2021 CHNA process: *Blue Cross Blue Shield of Michigan *City of Flint *Genesee County Department of Health and Human Services *Genesee County Health Department *Genesee County Medical Society *Genesee County Osteopathic Society *Genesee Health Plan *Genesee Health System (Genesee County Community Mental Health) *Genesee Intermediate School District *Greater Flint Health Coalition *Health Alliance Plan *Hamilton Community Health Network *Hurley Medical Center *Meridian Health Plan of Michigan *McLaren Flint *McLaren Health Plan *Molina Healthcare of Michigan *Mott Children's Health Center *Region 10 Prepaid Inpatient Health Plan (PIHP) *United Way of Genesee County The GFHC's Community Referral Network and Outreach Strategy Workgroup, with representation from approximately 50 community-based organizations as well as residents (representing all community demographics), also have been convened to discuss and inform relevant community health needs, data, resources, and programs.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - ASCENSION GENESYS HOSPITAL. The tax year 2021 CHNA was conducted with THE FOLLOWING HOSPITAL FACILITIES: -Mott Children's Health Center -HURLEY MEDICAL CENTER -MCLAREN-FLINT

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - ASCENSION GENESYS HOSPITAL. The tax year 2021 CHNA was conducted with THE FOLLOWING non-HOSPITAL FACILITY: -GREATER FLINT HEALTH COALITION

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - ASCENSION GENESYS HOSPITAL - Part 1. Ascension Genesys Hospital leadership in collaboration with the Ascension Genesys Hospital CHNA Steering Committee assessed how the tax year 2018 (FY2019) Genesee County CHNA Priority Health Needs aligned with both current and projected Ascension Genesys programs/initiatives to inform the prioritization of four of these as primary areas of focus for the next three years. These four priority areas - 1. Mental Health; 2. Obesity and Health Behaviors; 3. Healthcare Access; and 4. Chronic Disease Burden - were selected because of the potential to extend the reach of Genesys' current services into the community (i.e.: Behavioral Telehealth); improve the health of specific populations (i.e.: people with diabetes/pre-diabetes; Veterans); and/or provide opportunities to collaborate/partner with other organizations to leverage community resources and achieve greater impact (i.e.: EVANS Project). It is important to note that these priority areas often overlap with each and with priority needs not selected. Although not called out specifically as focus areas for Genesys, we will view each of our four priority areas through the lens of Social Determinants of Health and Health Equity which concentrate our efforts to serve community residents who are poor and most vulnerable due to social, economic, and environmental conditions. The FY2020 - FY2022 Ascension Genesys Hospital Community Health Implementation Strategy for the tax year 2018 chna addressed the prioritized needs in the following ways: Prioritized Need: Mental Health/Substance Use Disorder STRATEGY: Build capacity of the Ascension Genesys Hospital Emergency Department (ED) to identify, assess, and treat patients with Substance Use Disorder (SUD) by implementing the Medically Assisted Treatment (MAT) Protocol. - All community partner videos have been completed that highlight OUD resources to be utilized within the OUD Subject Matter Expert (SME) training or as stand alone education. These videos also include personal testimonies from persons who have suffered OUD and addictions to provide real life stories about stigma and barriers to treatment. The Ascension Genesys OUD Treatment Protocol is almost complete, an algorithm for the identification, assessment, treatment and referral of patients with OUD/SUD for patients who present for care in the Emergency Department. OUD SME training is scheduled for October 18th , 19th, and 20th. SMEs will participate in an 8-hour training with topics including: Opioid Addiction, Risk Factors, Physical & Psychological Impact, Stigma, MOUD, Barriers to Treatment, Trauma Informed Care, Treatment Options, Ascension Genesys OUD Treatment Protocol, and Community Resources. The OUD Multidisciplinary Team met on September 29, 2021. 16 patients initiated on medication in the hospital. 12 patients received prescriptions upon discharge (naloxone intranasal/take home Naloxone Kits) 37 patients referred to an outpatient provider via warm handoff. - MAT Electronic Health Record (EHR) order set has been completed for the existing MAT protocol to be implemented in EHR. Additional progress has been made on the development of the OUD ED protocol to identify, assess, medically treat and refer patients with OUD with a completion date expected before the end of January. Continued Development of an electronic OUD resource binder on the home page including a QR code to easily access resources as well as continued development of a patient resource QR Code to obtain OUD resources - Generic format. - Team is continuing to work with Information Technology (IT) department to add the following items to the Genesys ED OUD note: Number of OUD-related overdose ED encounters, Number of patients who were screened for OUD, Number of patients who declined MOUD treatment, Number of patients with OUD who received a consult from a social worker, Addition of the OUD screening tool to EMR (enhance triage questions that will trigger an OUD screening/DAST as indicated), and Add OUD QR Code to discharge papers. Genesys has trained 5 OUD Subject Matter Experts (4 in ED and 1 in-patient) in a condensed 2-hour format covering Treatment Options, Ascension Genesys OUD Treatment Protocol, and Community Resources. They are available to respond to pages (AMS Connect) and requests for OUD consults. Additional progress has been made on the development of the OUD ED protocol to identify, assess, medically treat and refer patients with OUD with a completion date expected before the end of April, 2022. A draft protocol is complete and ready for review and final approval STRATEGY: Build capacity at Ascension Genesys Hillside Center for Behavioral Health (HS) to expand access to behavioral health services by adding additional practitioners (Psychiatrists and Mid-Level) and implementing a tele-behavioral health program - The Hillside team is in need to recruit additional therapists. Currently in the early stages of adding a nurse practitioner who recently signed the letter of intent. Genesys Physician Hospital Organization (PHO) update - Implementation of the Collaborative Care Behavioral Health Program within the Primary Care Physician (PCP) office in 2021 with expansion to 27 PCPs in total by year end of 2022. We have employed Masters of Social Work Clinicians that serve as Behavioral Health Care Managers. The Care Managers work closing with the patient. Full assessments and care plans are developed. The Care Manager meets weekly with psychiatry for consultation and the PCP is provided with treatment recommendations from the Psychiatrist. This is providing quick access to the best treatment for our patients. STRATEGY: Build the capacity of Ascension Genesys Hospital Department Associates (Emergency, Observation, Women & Children, Neuro) to identify, assess, treat, and initiate community outreach to refer and coordinate optimal support services for victims of Human Trafficking (HT) across the continuum of care. - HT SME Engagement Tool has been approved. HT SME-training informational sessions (30-min, virtual) will be held; associates interested in becoming HT SME will be invited to complete the SME self-assessment. The HT SME education module is nearing completion; CME credits are being applied for currently. Prioritized Need: Obesity and Health Behaviors STRATEGY: Implement the Ascension DREAM (Diabetes Resources for Education And Motivation) project which will embed a computer-assisted Motivational Interviewing (MI) enhancement into Diabetes Prevention Program (DPP) and Diabetes Self-Management Education (DSME) curriculums to guide patients in setting behavior change goals resulting in improved behavior change readiness and sustained self-directed change. - DREAM portal is fully functional. The team continues to deliver classes virtually. 221 people participated to-date - DREAM team has continued to make progress in program implementation and show some initial encouraging short-term outcomes: 144 (out of 187) patients completed a goal from May 2020 - November 2021; 65 patients were contacted for 3-month goal progress (*45% of patients); and 78% of these patients are meeting at least one of their goals 50-100%, (*Typically, only about 20% of people respond to report goal progress.) Team has seen increased data-reporting from patients on their health behavior change goals (45% response rate and 78% of respondents who report meeting their goals at a rate of 50-100%) than prior to utilizing Motivational Interviewing. Team continues to see an increase in virtual program enrollment. Compared to the 19 patients from May-September 2020; 34 patients from October-December 2020; and 52 from January-June 2021, 82 people participated from July-December 2021. Given the rise in COVID-19 variants, there was no indication of when in-person classes would be reinstated.

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - Ascension Genesys Hospital - Part 2. Prioritized Need: Healthcare Access STRATEGY: Implement emPOWER Genesee in collaboration with Genesee Health Plan, Consumers Energy, and Huntington Bank to engage a vulnerable Genesee County population by assisting residents to achieve optimal utilization of healthcare, financial, energy assistance services, and community resources. - Summary of customer interactions, services provided, and community resource referrals made by the Community Navigator at Consumers Energy Payment Center in Q1 include: 70 - Assistance Provided (Assistance with applying for utility assistance, health services or other services), 44 - Community Referrals (Referral/resources provided to other community programs/services only), 8 - Assistance & Referral (Assistance with applying for utility/bill assistance, health services or other services and referral(s) to other community program/services), and 0 - Other Customer Interactions (Face to Face customer contact in payment center.). Genesys leadership approved Year 3 funding ($25,000.) Also, Genesee Health Plan Community Partnership Award was awarded to Genesys on Friday, September 17, 2021 during the annual awards event. - Community Navigator has continued to receive referrals from Genesys for mental health services via Doxy platform. Summary of customer interactions, services provided, and community resource referrals made by the Community Navigator at Consumers Energy Payment Center in Q2 include: 119 - Assistance Provided (Assistance with applying for utility assistance, health services or other services), 58 - Community Referrals (Referral/resources provided to other community programs/services only), 51 client interactions - QR Code has been added to all posters and postcards to connect current/potential clients directly to Community Navigator. Summary of customer interactions, services provided, and community resource referrals made by the Community Navigator at Consumers Energy Payment Center in Q3 include: 165 - Assistance Provided (Assistance with applying for utility assistance, health services or other services), 74 - Community Referrals (Referral/resources provided to other community programs/services only); and 226 client interactions. Prioritized Need: Chronic Disease Burden STRATEGY: Implement the Ascension Genesys Hospital Palliative Care (PC) Program by creating a community-facing, best practice model care to identify, assess, and provide optimal PC services for patients with a serious illness in need of specialized medical care and their families. - Genesys PHO update - Team has an outlined plan and depending on funding, will open a Chronic Care full wrap around service clinic to serve our population in 2022. This would include Primary Care, BH, Pharmacy, etc Ascension Genesys Hospital did not directly address the following priority health needs identified within the 2019 CHNA: Social Determinants of Health, Substance Use, Child Health & Development, Safe & Affordable Drinking Water, Effective Care Delivery for an Aging Population, Maternal & Infant Health, Sexual Health, Health Equity. It is important to note however, that priority areas not selected often overlap with those that were selected such as Mental Health and Substance Use; and as stated above, although not called out specifically as focus areas for Genesys, we will view each of our four priority areas through the lens of Social Determinants of Health and Health Equity which concentrate our efforts to serve community residents who are poor and most vulnerable. While critically important to overall community health, needs not addressed did not meet internally determined criteria that prioritized addressing needs by either continuing or expanding current programs, services and initiatives to steward resources and achieve the greatest community impact; or because other service providers in the community are better resourced to address these priorities. Ascension Genesys will work collaboratively with community organizations as appropriate to ensure optimal service coordination and utilization. The FY2023-FY2025 Community Health Implementation Strategy will address the tax year 2021 chna following needs: Priority Need: Mental Health - Inclusive of stress, anxiety and depression *Strategy: Through a coordinated and transformational approach, Ascension Michigan hospitals will improve access to behavioral healthcare for vulnerable populations. *Strategy: Increase involvement in and support of community health activities to address mental health-focused needs Priority Need: Addiction *Strategy: Provide medications and supplies to patients with Opioid Use Disorder (OUD) or who are at increased risk of opioid overdose, and provide education to learners to decrease the stigma associated with OUD *Strategy: Increase involvement in and support of community health activities to address addiction-focused needs Priority Need: Chronic Disease *Strategy: Provide outreach screenings for underserved populations to improve access to healthcare services in Genesee County *Strategy: Improve collaboration and coordination between Ascension Genesys Hospital providers, including Ascension Medical Group outpatient clinics and Genesys PHO, and Ascension Genesys Diabetes & Nutrition Learning Center through a diabetic & prediabetic referral protocol *Strategy: Increase involvement in and support of community health activities to address chronic disease-focused needs Priority Need: Maternal and Child Health *Strategy: The goal of Ascension is to reduce complications associated with severe maternal morbidities (SMM) and improve access to timely and adequate prenatal and postpartum care to prevent poor birth outcomes *Strategy: Increase involvement in and support of community health activities to address maternal and child health Ascension Genesys Hospital will not address the following significant needs in the 2021 (Tax Year) Implementation Strategy: Social Determinants of Health, Obesity & Healthy Behaviors, Health Care Access, Health Inequities (including the burden of systemic racism), Safe & Affordable Drinking Water, and COVID-19 The significant needs listed above were not selected by Ascension Genesys Hospital as prioritized needs in this CHNA cycle. While critically important to overall community health, these specific needs did not meet internally determined criteria that prioritized needs by either continuing or expanding current programs, services and initiatives to steward resources and achieve the greatest community impact. For the areas not chosen, there are other service providers in the community better resourced to address these priorities. Ascension Genesys Hospital will work collaboratively with these organizations as appropriate to ensure optimal service coordination and utilization.

Schedule H, Part I, Line 3c factors other than fpg
"IN ADDITION TO FPG, THE ORGANIZATION USES MEDICAL INDIGENCY, ASSET TEST, INSURANCE STATUS AND RESIDENCY AS OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A Patient may not be eligible for the financial assistance if such Patient is deemed to have sufficient assets to pay pursuant to an ""Asset Test."" The Asset Test involves a substantive assessment of a Patient's ability to pay based on the categories of assets measured in the FAP Application. A Patient with such assets that exceed 250% of such Patient's FPL amount may not be eligible for financial assistance. AN ASSET TEST APPLIES IF A PATIENT HAS ELIGIBLE LIQUID ASSETS THAT EXCEED 250% OF THE PATIENT'S FPG LEVEL FOR CONSIDERATION OF FINANCIAL ASSISTANCE ELIGIBILITY. LIQUID ASSETS INCLUDE ASSETS THAT CAN BE CONVERTED TO CASH WITHIN 1 YEAR. THESE INCLUDE ITEMS SUCH AS CHECKING ACCOUNTS, SAVINGS ACCOUNTS, TRUST FUNDS AND LUXURY ITEMS SUCH AS RECREATIONAL VEHICLES, BOATS, A SECOND HOME, ETC."

Schedule H, Part I, Line 5a BUDGET AMOUNTS FOR FREE OR DISCOUNTED CARE
THE ORGANIZATION ADMINISTERS ITS FINANCIAL ASSISTANCE POLICY IN ACCORDANCE WITH THE TERMS OF THE POLICY.

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
"THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (""CHA"") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED."

Schedule H, Part II Community Building Activities
Research shows the social determinants and quality of life play a major role in the health status of individuals and communities. Community building activities, which focus on improving the quality of life within a community, ultimately influence and improve health status. The Community Building dollars reported in FY22 for Ascension Genesys Hospital were related to Environmental Improvements, one of the social determinants of health.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2022 was $12,152,248 at charges, ($3,725,174 at cost).

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
BASED ON THE ORGANIZATION'S ADMINISTRATION OF ITS FINANCIAL ASSISTANCE PROGRAM, NO ESTIMATE FOR BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DEEMED APPLICABLE TO HOSPITAL OPERATIONS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
THE ORGANIZATION IS PART OFASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSESBAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 17-20, OF THE AUDITED FINANCIAL STATEMENTS.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE GROSS CHARGES TO CALCULATE MEDICARE COSTS, WHICH ARE THEN COMPARED TO MEDICARE PAYMENTS RECEIVED, TO DETERMINE A MEDICARE GAIN OR LOSS. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT A MEDICARE SHORTFALL (LOSS) IS NOT TREATED AS COMMUNITY BENEFIT, EVEN THOUGH THE HOSPITAL HAS INCURRED LOSSES IN PROVIDING CARE TO MEDICARE PATIENTS. THEREFORE, NONE OF THE AMOUNT ON LINE 7 IS TREATED AS COMMUNITY BENEFIT.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
ASCENSION GENESYS HOSPITAL FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED IF ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED FOR THE AMOUNTS FOR WHICH THE PATIENT QUALIFIES.

Schedule H, Part V, Section B, Line 16a FAP website
- ASCENSION GENESYS HOSPITAL: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- ASCENSION GENESYS HOSPITAL: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- ASCENSION GENESYS HOSPITAL: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part VI, Line 4 Community information
The total population of Genesee county is estimated to be 416,403 residents in calendar year 2023 and is estimated to decrease by -6,396 residents or -1.54% over the next five years (Sg2/Claritas Pop-Facts 2023). There are an estimated 170,581 households. The county includes both urban (Flint) and suburban populations. There are federally designated medically underserved areas located within the urban areas of the county. The median household income in Genesee county is $50,269, based on the United States Census Bureau (in 2020 dollars, 2016-2020). Approximately 18.3% of the service area persons live below the poverty line. There are three acute care hospitals located in Genesee County.

Schedule H, Part VI, Line 5 Promotion of community health
ASCENSION MICHIGAN'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING ASCENSION MICHIGAN'S SERVICE AREAS AND INCLUDES MEMBERS WITH DIVERSE ASPECTS AND INTERESTS OF THE SERVICE AREA. MEMBERS OF THE GOVERNING BODY RESIDE IN THE ORGANIZATION'S SERVICE AREA AND ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. ASCENSION GENESYS HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. ASCENSION GENESYS HOSPITAL APPLIES SURPLUS FUNDS TO FUND IMPROVEMENTS IN PATIENT CARE.

Schedule H, Part VI, Line 2 Needs assessment
Ascension Genesys Hospital uses internal and external data and reports from third parties, including government sources, to assess the healthcare needs of the communities we serve. These reports provide key information about health, socioeconomic, demographic factors that identify areas of need and inform our strategies that help to meet those needs of our community. These reports include, but are not limited to: *Sg2 Healthcare Intelligence *State Datasets *Internal Data Sets Ascension Genesys Hospital utilizes information from these secondary sources to develop programs and provide appropriate services needed throughout the region. In addition, Ascension Genesys Hospital considers the health care needs of the overall community when evaluating internal financial and operational decisions.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
ASCENSION GENESYS HOSPITAL IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, ASCENSION GENESYS HOSPITAL'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; ASCENSION GENESYS HOSPITAL PROVIDES FULL FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 250% OF THE FEDERAL POVERTY LEVEL AND SLIDING SCALE ASSISTANCE FOR THOSE UP TO 400% OF THE FEDERAL POVERTY LEVEL. ASCENSION GENESYS HOSPITAL WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE - https://healthcare.ascension.org/locations/michigan/migra/grand-blanc-ascension-genesys-hospital/financial-assistance ASCENSION GENESYS HOSPITAL MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. ASCENSION GENESYS HOSPITAL INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. ASCENSION GENESYS HOSPITAL INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 6 Affiliated health care system
ASCENSION GENESYS HOSPITAL IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. ASCENSION GENESYS HOSPITAL OPERATES A HOSPITAL FACILITY IN GENESEE COUNTY MICHIGAN AND IS PART OF ASCENSION HEALTH. ASCENSION ALSO OPERATES HOSPITALS IN THE EASTERN PORTION OF THE STATE INCLUDING ASCENSION ST. JOHN HOSPITAL, ASCENSION RIVER DISTRICT HOSPITAL, ASCENSION MACOMB OAKLAND HOSPITAL WARREN CAMPUS, ASCENSION MACOMB OAKLAND HOSPITAL MADISON HEIGHTS CAMPUS, ASCENSION PROVIDENCE HOSPITAL SOUTHFIELD CAMPUS, ASCENSION PROVIDENCE HOSPITAL NOVI CAMPUS, ASCENSION PROVIDENCE ROCHESTER HOSPITAL, ASCENSION ST. MARY'S HOSPITAL, ASCENSION STANDISH HOSPITAL, ASCENSION ST. JOSEPH HOSPITAL AND ASCENSION BRIGHTON CENTER FOR RECOVERY. ASCENSION ALSO OWNS AND OPERATES OTHER HEALTH CARE RELATED ENTITIES IN SOUTHWEST MICHIGAN INCLUDING ASCENSION BORGESS ALLEGAN HOSPITAL, ASCENSION BORGESS PIPP HOSPITAL, ASCENSION BORGESS LEE HOSPITAL AND ASCENSION BORGESS HOSPITAL. THE HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF ASCENSION GENESYS HOSPITAL'S SERVICE AREA IN MID-MICHIGAN.