4A (Expenses $ 200083791 including grants of $ 134260) (Revenue $ 234503723)
ASCENSION PROVIDENCE ROCHESTER HOSPITAL is a 226-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2022, ASCENSION PROVIDENCE ROCHESTER HOSPITAL treated 11,034 adults and children for a total of 49,206 patient days of service. The hospital also provided services for 194,363 outpatient visits, which included 4,649 outpatient surgeries and 27,806 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 PROVIDENCE ROCHESTER HOSPITAL. ASCENSION PROVIDENCE ROCHESTER HOSPITAL follows the seven-step process for completing the CHNA with input from the CHNA Advisory Board. The tax year 2021 CHNA was conducted from August 2021 to March 2022 and utilized a hybrid model with primary components of the Healthy Communities Model and the Mobilizing for Action through Planning and Partnerships (MAPP) Model which incorporated data from both primary and secondary sources. Primary data sources included information provided by groups/individuals, e.g., community residents, health care consumers, health care professionals, community stakeholders, and multi-sector representatives. Special attention was given to the needs of individuals and communities who are more vulnerable, and to unmet health needs or gaps in services. Community stakeholders of different ages, socioeconomic status, occupations, and cultural backgrounds were invited to participate. ASCENSION PROVIDENCE ROCHESTER HOSPITAL established an Advisory Board with members from all sectors of our community. The Advisory Board, including Ad Hoc members, assisted in the distribution of the survey. In addition to the surveys, ASCENSION PROVIDENCE ROCHESTER HOSPITAL conducted three focus group sessions with participants of low income and Medicaid populations and those that serve them. Secondary data was compiled and reviewed to understand the health status of the community. Measures reviewed included chronic disease, social and economic factors, and healthcare access and utilization trends in the community and were gathered from reputable and reliable sources. ASCENSION PROVIDENCE ROCHESTER HOSPITAL, with contracted assistance from Southeastern Michigan Health Association (SEMHA), analyzed secondary data of over 30 indicators and gathered community input through community surveys and focus groups to identify the needs in the Oakland, Macomb, and Lapeer counties. In collaboration with community partners, ASCENSION PROVIDENCE ROCHESTER HOSPITAL used a phased prioritization approach to determine the most crucial needs for community stakeholders to address. A series of three (3) focus groups were conducted by ASCENSION PROVIDENCE ROCHESTER HOSPITAL to gather feedback from the community on the health needs and assets of Neighborhood House staff and clients and Wayne State Internal Medicine Residency clinic patients. These groups were selected, and 33 individuals participated in the focus groups, held between October 2021 and November 2021. Populations represented by participants included low-income and Medicaid populations and those that serve them. A survey was conducted by ASCENSION PROVIDENCE ROCHESTER HOSPITAL and Ascension Southeast Michigan to gather the perceptions, thoughts, opinions, and concerns of the community regarding healthy behaviors, mental health, physical health, substance use, Social Determinants of Health (SDoH), access to care, and COVID-19 for Oakland, Macomb, and Lapeer Counties. 750 individuals participated in the survey, with 157 identified as within the service area of ASCENSION PROVIDENCE ROCHESTER HOSPITAL. The survey was held between August 2021 and November 2021. The data gathered and analyzed provides valuable insight into the issues of importance to the community. The survey contained 36 questions and was distributed to all demographics of the community through online and paper copies utilizing internal and external partners in the Advisory Board to aid in distribution. The survey was distributed electronically by email invitations sent to Advisory Board members and all sectors of the community. Paper copies were available at all community events and at the Older Persons' Commission. ASCENSION PROVIDENCE ROCHESTER HOSPITAL and Ascension Southeast Michigan Hospitals collaborated to create a steering committee that reviewed the primary and secondary data to identify the significant needs. The ASCENSION PROVIDENCE ROCHESTER HOSPITAL Advisory Board conducted the Hanlon Method to determine the prioritized needs. Ascension has defined ""prioritized needs"" as the significant needs which have been prioritized by the hospital to address through the three-year CHNA implementation strategy: Chronic Disease - This need was selected because chronic disease prevention and treatment will decrease preventable deaths and increase the quality of life of the population served. Mental Health- This need was selected because mental health issues are associated with increased rates of smoking, physical inactivity, obesity and substance abuse. As a result, these physical health problems can lead to chronic disease, injury, disability and death. Access to Care - This need was selected because access to affordable, quality health care is important to physical, social and mental health. The ASCENSION PROVIDENCE ROCHESTER HOSPITAL CHNA process included an advisory board composed of business and community leaders, public health, and representatives from organizations serving the underprivileged in our community. Members included representatives from: *Oakland County Health Department *Older Persons' Commission *Oakland County Sheriff *Rochester Police Department *City of Rochester Hills *Rochester Area Counseling Services *Macomb County Health Department *North Oakland YMCA *Easterseals of Michigan *Rochester Community Schools *Rochester Hills Public Library *Rochester Hills Fire Departments *Oakland University *Neighborhood House *Rochester Academic Family Medicine *Rochester Downtown Development Authority *Rochester Regional Chamber of Commerce *Wayne State University School of Medicine Residents"

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - ASCENSION PROVIDENCE ROCHESTER HOSPITAL. In ASCENSION PROVIDENCE ROCHESTER HOSPITAL's tax year 2018 (FY2019) CHNA, the following were identified as significant needs in the community. Cardiac Health, Healthy Lifestyles and Mental Wellness. The FY2019-2022 implementation strategies specifically address the needs in the following ways: Priority Need #1: Cardiac Health with the goal to improve cardiovascular health in the community by increasing utilization of the cardiac clinic. We addressed this need by: *Developing evidence-based educational materials and providing outreach to over 3000 community members (even during the pandemic with limited access) *Increasing utilization of the cardiac clinic by over 70% *Reducing 30 day readmission rate from 29% to 0% Priority Need #2: Healthy Lifestyles with the goal to improve overall health by increasing awareness of healthy lifestyles through expansion of the CDC evidenced-based Diabetes Prevention Program (DPP) specifically targeting at-risk individuals. We addressed this need by: *Training additional DPP Lifestyle Coaches *Increasing the number of Diabetes Prevention Programs offered from 2 per year to 4 per year. A virtual platform was created to increase access for those that may have transportation or other barriers preventing them from attending the weekly program. *Provided a diabetes scholarship for patients to receive nutrition therapy that was not covered by their insurance. Priority Need #3: Mental Wellness with the goal to improve overall mental health and wellness in our community by reducing the stigma and increasing awareness. We addressed this need by: *Creating a community collaboration task force with key stakeholders. *Conducted a community survey, analyzed data and launched an awareness campaign that included the distribution of over 2000 wellness toolkits to youth and seniors in the community during the pandemic. *Provided community education programming both in person and virtually. *Collaborated with community partners to provide over 1000 mental health screenings and Mental Health First Aid training for over 200 participants. *Identified and distributed a comprehensive resource guide to assist with mental health and other resources in our community. Ascension Providence Rochester Hospital is committed to improving community health by directly, and indirectly, addressing community needs. However, certain factors impacted Ascension Providence Rochester Hospital's ability to fully address all of the identified needs. Identified needs that will not be addressed were determined by availability of services in the community. Chronic diseases with substantial support in the community such as cancer, lung disease and arthritis are supported by strong Ascension Providence Rochester Hospital programs with a variety of available resources in addition to the support of the American Cancer Society, American Lung Association and the Arthritis Foundation. In Ascension Providence Rochester Hospital's tax year 2021 (FY22) CHNA, the following were identified as significant needs in the community: Significant Need #1 Chronic Disease: -Cardiovascular Disease -Diabetes -Obese Significant Need #2 Mental Health: Significant Need #3 Access to Care: -No Routine Physical Check-up -No Health Care Coverage -No Dental Visit Significant Need #4 Health Factors/Behaviors: -High Blood Pressure -High Cholesterol -Adequate Physical Activity - lack of -Binge Drinking Following the completion of the current CHNA, ASCENSION PROVIDENCE ROCHESTER HOSPITAL has selected the prioritized needs outlined below for its tax year 2021 (FY2022) implementation strategy. Ascension has defined ""prioritized needs'' as the significant needs which have been prioritized by the hospital to address through the three-year CHNA cycle: Prioritized Need #1 Chronic Disease: Increase awareness in the community and improve chronic disease prevention and treatment to decrease preventable deaths and increase the quality of life. Prioritized Need #2 Access to care: Access to affordable, quality and convenient health care is essential to physical, social and mental health. Prioritized Need #3 Mental Health: Mental health challenges are associated with numerous physical health complications such as increased rates of smoking, physical inactivity, obesity and substance abuse. The FY2023-FY2025 Ascension Providence Rochester Hospital Community Health Implementation Strategy will address the prioritized needs in the following ways: Chronic Disease *Implement Age-Friendly Health System in 5 departments by FY25 *Increase the number of diabetes and nutrition education program participants by 15% by the end of FY25 Access to Care *Provide 5 educational and health screening programs/events per fiscal year for the target population (40-60 year old adults) promoting primary care and routine physical exams *Provide free physical assessments and screenings with at least 1 poor/vulnerable population per fiscal year. Mental Health *Provide mental health education, training and resources in the community *Provide resources and tools to support behavioral health patients in the Emergency Department. *Provided free meeting space for mental health support groups. Based on the prioritization criteria, the health needs identified through the CHNA ASCENSION PROVIDENCE ROCHESTER HOSPITAL does not plan to address at this time include: No Healthcare Coverage: Although no healthcare coverage was an identified need, Ascension has a very robust process for assisting those without healthcare coverage to obtain it; Ascension is committed to providing care to all and has a very generous charity care program. In addition, our county data of uninsured is 6%, the same as the U.S. Top Performers. No Dental Visits: ASCENSION PROVIDENCE ROCHESTER HOSPITAL does not provide dental services but will work with our community partners to assist those that may need those services. Cancer, COPD and Asthma, Stroke, and Kidney Disease: Services and resources are available and accessible in our community for each of these health needs and ASCENSION PROVIDENCE ROCHESTER HOSPITAL collaborates with the American Cancer Society, American Lung Association and American Kidney Foundation to help meet these needs in our community. In addition, ASCENSION PROVIDENCE ROCHESTER HOSPITAL is a Joint Commission Accredited Stroke Center and has identified stroke as a strategic priority for many years. While these needs are not the focus of this implementation strategy, ASCENSION PROVIDENCE ROCHESTER HOSPITAL may consider investing resources in these areas as appropriate, depending on opportunities to leverage organizational assets in partnership with local communities and organizations. Also, this report does not encompass a complete inventory of everything ASCENSION PROVIDENCE ROCHESTER HOSPITAL does to support health within the community."

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
Community Building activities improve the quality of life within a community, improving the health status of individuals and groups of individuals. APRH participated in local Chambers of Commerce, Rotary Clubs, Older Persons' Commission, County Community Health Improvement, Community Coalition groups and City meetings and events to build a community of health and wellness. The dollars report for FY2022 are related to improvement of health in the community by participating in these activities.

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 $9,098,650 AT CHARGES, ($3,038,175 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 PROVIDENCE ROCHESTER 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 PROVIDENCE ROCHESTER HOSPITAL: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;

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

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

Schedule H, Part VI, Line 5 Promotion of community health
ASCENSION PROVIDENCE ROCHESTER HOSPITAL 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 PROVIDENCE ROCHESTER HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. ASCENSION PROVIDENCE ROCHESTER HOSPITAL APPLIES SURPLUS FUNDS TO FUND IMPROVEMENTS IN PATIENT CARE.

Schedule H, Part VI, Line 2 Needs assessment
Ascension Providence Rochester 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 Providence Rochester Hospital utilizes information from these secondary sources to develop programs and provide appropriate services needed throughout the region. In addition, Ascension Providence Rochester 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 PROVIDENCE ROCHESTER 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 PROVIDENCE ROCHESTER 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 PROVIDENCE ROCHESTER 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 PROVIDENCE ROCHESTER 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/miroc/rochester-ascension-providence-rochester-hospital/financial-assistance ASCENSION PROVIDENCE ROCHESTER 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 PROVIDENCE ROCHESTER 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 PROVIDENCE ROCHESTER HOSPITAL INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 4 Community information
Ascension Providence Rochester Hospital is located in northern Oakland County. The total population of Oakland county is estimated to be 1,305,733 residents in calendar year 2023 and is estimated to increase by 15,555 residents or 1.19% over the next five years (Sg2/Claritas Pop-Facts 2023). There are an estimated 509,589 households. The county is in the metro Detroit area and is urban. There is a federally designated medically underserved area in Oakland County located in Pontiac. The median household income in Oakland county is $81,587, based on the United States Census Bureau (in 2020 dollars, 2016-2020). Approximately 7.8% of the service area persons live below the poverty line. There are 12 acute care hospitals located in Ascension Providence Rochester Hospital's primary service area (including 4 Ascension Hospitals - Providence Southfield Campus, Providence Novi Campus, Ascension Providence Rochester Hospital and Ascension Macomb Oakland Madison Heights Campus which borders Macomb County). There are also 3 specialty/surgical hospitals and 2 psychiatric hospitals.

Schedule H, Part VI, Line 6 Affiliated health care system
ASCENSION PROVIDENCE ROCHESTER 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 PROVIDENCE ROCHESTER HOSPITAL OPERATES A HOSPITAL FACILITY IN OAKLAND 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 GENESYS 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 PROVIDENCE ROCHESTER HOSPITAL'S SERVICE AREA IN OAKLAND COUNTY.