4A (Expenses $ 130685124 including grants of $ 184451) (Revenue $ 159675592)
SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS

LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION
PART V, SECTION B, LINE 5: TO COMPREHENSIVELY UNDERSTAND AND DESCRIBE THE NEEDS OF THE COMMUNITIES HEALTHPARTNERS SERVES, WE SYSTEMATICALLY IDENTIFIED A LIST OF PUBLICLY AVAILABLE DATA SOURCES AND A LIST OF INTERNALLY AVAILABLE HEALTHPARTNERS DATA SOURCES. WITH THE CHNA WORKGROUP THAT HAD EXPERTISE FROM PUBLIC HEALTH, HEALTHCARE AND EPIDEMIOLOGY, WE CAREFULLY REVIEWED THE LIST TO IDENTIFY OPPORTUNITIES WITH A SPECIFIC LENS TOWARDS INCLUDING MEMBERS WITH UNIQUE INSIGHT INTO NEEDS OF OUR UNDERSERVED COMMUNITIES WHERE HEALTH AND OTHER DISPARITIES EXIST. TO FURTHER ROUND OUT UNDERSTANDING, WE SOUGHT ADDITIONAL DATA SOURCES TOGETHER WITH OUR COMMUNITY PARTNERS. WHERE OPPORTUNITIES STILL REMAIN FOR BETTER UNDERSTANDING DUE TO LACK OF CURRENTLY AVAILABLE DATA, WE HAVE NOTED IN THE REPORT. FOR EXAMPLE, WE IDENTIFIED SPECIFIC GAPS IN DATA AVAILABLE TO UNDERSTAND THE COVID-19 PANDEMIC CONTEXT AND THE INFLUENCE OF STRUCTURAL RACISM ON THE NEEDS AREAS. THUS, WE SPECIFICALLY DESIGNED OUR QUALITATIVE COMMUNITY CONVERSATIONS AND OUR QUANTITATIVE HEALTHPARTNERS PROVIDER SURVEYS TO FILL THESE GAPS. HEALTHPARTNERS PROVIDER SURVEYS: SELECT HEALTHPARTNERS STAFF WHO PROVIDE DIRECT CARE FOR OUR PATIENTS WERE INVITED BY HOSPITAL LEADERS AND THE CHNA EXPERT PANEL MEMBERS TO COMPLETE A BRIEF WEB SURVEY ABOUT THE NEEDS OF THE PATIENTS THEY SERVE. THE SURVEY WAS DEVELOPED BY AN EXPERT SURVEY METHODOLOGIST WITH INPUT FROM THE CHNA WORKGROUP. OVERALL, 444 PROVIDERS INCLUDING DOCTORS, CARE COORDINATORS, PHARMACISTS, PHYSICAL OR OCCUPATIONAL THERAPISTS, DIETITIANS, NURSES, AND SOCIAL WORKERS COMPLETED SURVEYS ACROSS ALL HEALTHPARTNERS HOSPITALS. DESCRIPTIVE STATISTICS AND A THEMATIC ANALYSIS WERE COMPLETED AND INCLUDED IN THE NEEDS AREA SUMMARIES BELOW.COMMUNITY CONVERSATIONS: A TOTAL OF 41 COMMUNITY CONVERSATIONS WERE HELD OR ATTENDED BY HEALTHPARTNERS WORKGROUP MEMBERS. RESULTS WERE SUMMARIZED AND KEY THEMES AND QUOTES WERE ADDED TO THE NEEDS AREA SUMMARIES THROUGHOUT. ADDITIONAL DETAILS ABOUT THE COMMUNITY CONVERSATIONS CAN BE FOUND IN THE APPENDIX OF THE LAKEVIEW HOSPITAL'S 2021 CHNA AT HTTPS://WWW.HEALTHPARTNERS.COM/CARE/HOSPITALS/LAKEVIEW/ABOUT/COMMUNITY-HEALTH-NEEDS/

LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION
PART V, SECTION B, LINE 6A: HEALTHPARTNERS COLLABORATED ACROSS EIGHT HOSPITALS WITHIN ITS FAMILY OF CARE FOR THE 2021 CHNA: AMERY HOSPITAL & CLINIC (AMERY, WI) HUDSON HOSPITAL & CLINIC (HUDSON, WI) LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION HOSPITAL (STILLWATER, MN) PARK NICOLLET HEALTH SERVICES INCLUDING PARK NICOLLET METHODIST HOSPITAL (ST. LOUIS PARK, MN) REGIONS HOSPITAL (ST. PAUL, MN) HUTCHINSON HEALTH (HUTCHINSON, MN) WESTFIELDS HOSPITAL & CLINIC (NEW RICHMOND, WI) HEALTHPARTNERS RC, DBA OLIVIA HOSPITAL & CLINIC, OLIVIA, MN

LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION
PART V, SECTION B, LINE 11: PROGRESS ON 2018 GOALS IN 2021ACCESS TO CAREGOAL: IMPROVE ACCESS TO CARE THAT IS APPROPRIATE, AFFORDABLE, AND CONVENIENT, -CONTINUED TO INCREASE WEBSITE ACCESS TO PATIENT AND COMMUNITY ACCESS TO HEALTH INFORMATION AND APPOINTMENT SCHEDULING. -IMPROVED GEOGRAPHIC ACCESS OF CARE FOR PATIENTS THROUGH COORDINATION OF APPOINTMENT SCHEDULING BETWEEN FIVE SITES IN THE ST. CROIX VALLEY AREA.-SIGNIFICANTLY INCREASED TELEMEDICINE FOR PRIMARY, SPECIALTY AND BEHAVIORAL HEALTH SERVICES IN A VERY SHORT TIME FRAME TO INCREASE ACCESS DURING PANDEMIC RESTRICTIONS. -EXPANDED HOSPICE, HOME CARE AND PALLIATIVE CARE SERVICES TO BETTER SERVE ALL ST. CROIX VALLEY COMMUNITIES. CONTINUED TO SERVE PATIENTS DURING PANDEMIC. -CONTINUED PATIENT EXPERIENCE IN ADVISORY COUNCILS IN A VIRTUAL FORMAT, TO BETTER UNDERSTAND AND IMPROVE CARE EXPERIENCE DURING PANDEMIC.ACCESS TO HEALTH GOAL: STRENGTHEN EXISTING AND EXPLORE NEW COMMUNITY PARTNERSHIPS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH PROMOTE EARLY CHILDHOOD BRAIN DEVELOPMENT, PROMOTE SUSTAINABLE OPERATIONS. -NEW PARTNERSHIPS WERE ESTABLISHED AND EXISTING PARTNERSHIP STRENGTHENED TO MEET COMMUNITY NEEDS. -COMMUNITY HEALTH ACTION TEAM (CHAT) CONTINUED TO ENGAGE COMMUNITY LEADERS TO COLLABORATE AND PARTNER DURING THE PANDEMIC, PROVIDING UPDATES AND CROSS-PROMOTING HEALTH MESSAGES TO THE COMMUNITY.-HEALTH AND WELL-BEING ADVISORY COMMITTEE CONTINUED TO GUIDE COMMUNITY HEALTH EFFORTS AND RESPONSE THROUGH CROSS-SECTOR COLLABORATION. -UPDATED COMMUNITY RESOURCE LIST TO INCLUDE NEW RESOURCES AND SUPPORT DURING COVID PANDEMIC; AVAILABLE TO PATIENTS, STAFF AND COMMUNITY MEMBERS.-COLLABORATED WITH WASHINGTON COUNTY TO SUPPORT AND COMMUNICATE NEW SOURCES OF FOOD FOR FOOD INSECURE RESIDENTS.-DISTRIBUTED MORE THAN 500 BOOKS TO CHILDREN IN CLINICS THROUGH REACH OUT AND READ. LITTLE MOMENTS COUNT OFFERED VIRTUAL TRAINING AND RESOURCES TO CONTINUE MOMENTUM OF COLLABORATION TO PROMOTE EARLY CHILDHOOD BRAIN DEVELOPMENT.-INCREASED RECYCLING AND PURCHASES OF SUSTAINABLY PRODUCED AND LOCAL FOODS AND BEVERAGES. -REDUCED WASTE TO LANDFILLS, MEAT PURCHASES, SINGLE USE PLASTIC BOTTLES, ELECTRICITY, NATURAL GAS AND WATER USE AND TOTAL GREENHOUSE EMISSIONS. INCREASED USE OF ENVIRONMENTALLY PREFERRED AND RECYCLED PAPER AND OFFICE SUPPLIES. MENTAL HEALTH AND WELL-BEING GOAL: REDUCE THE STIGMA SURROUNDING MENTAL ILLNESS. INCREASE ACCESS TO EDUCATION AND RESOURCES AROUND MENTAL HEALTH AND WELL-BEING AND SERVICES.THE HOSPITAL IS A PARTNER IN MAKE IT OK, A PROGRAM FOCUSED ON REDUCING THE STIGMA OF MENTAL ILLNESS. IN 2021, THE REACH OF THE MAKE IT OK CAMPAIGN EXPANDED THROUGH TRAINING LOCAL AMBASSADORS, PROMOTION, AND PARTNERSHIPS WITH LOCAL AGENCIES AND PUBLIC HEALTH. DESPITE THE CHALLENGE OF COVID-19, MAKE IT OK MADE PROGRESS IN REDUCING THE STIGMA OF MENTAL ILLNESS WITH THE FOLLOWING IMPACT:-RECEIVED 81,349 WEBSITE VISITS WITH 62,780 UNIQUE VISITORS IN 2021. THE MAKE IT OK TOOLS AND RESOURCES WERE DOWNLOADED MORE THAN 500 TIMES BY PEOPLE IN 250 US CITIES AND 25 MINNESOTA COUNTIES.-HELD 11 AMBASSADOR TRAININGS BOTH IN PERSON AND VIRTUALLY, MOBILIZING AN ADDITIONAL 200 AMBASSADORS. -REACHED MORE THAN 2,000 PEOPLE THROUGH COMMUNITY PRESENTATIONS, EVENTS AND TABLING. MORE THAN 90 PERCENT OF PARTICIPANTS REPORTED INCREASED KNOWLEDGE ABOUT MENTAL ILLNESS AND GREATER CONFIDENCE IN TALKING ABOUT MENTAL ILLNESS AS A RESULT OF THE PRESENTATIONS.-MAKE IT OK HAS BEEN A KEY PARTNER IN A COMPREHENSIVE APPROACH TO MENTAL HEALTH FOR STUDENTS IN THE LOCAL SCHOOLS.-IN A SURVEY OF MAKE IT OK AMBASSADORS IN OCTOBER 2021, 88% SAID THAT MAKE IT OK WAS MORE IMPORTANT THAN EVER IN A TIME OF SOCIAL ISOLATION AND EMOTIONAL STRESS FOR MANY IN OUR COMMUNITIES.-MORE THAN 500 AMBASSADORS ARE NOW TRAINED IN THE ST. CROIX VALLEY AREA. MORE THAN 90 PERCENT OF PARTICIPANTS REPORTED INCREASED KNOWLEDGE ABOUT MENTAL ILLNESS AND GREATER CONFIDENCE IN TALKING ABOUT MENTAL ILLNESS AS A RESULT OF THE PRESENTATIONS-OFFERED BEATING THE BLUES AND RESILIENCY RESOURCES AT NO CHARGE TO MEMBERS, PATIENTS AND EMPLOYEES. MENTAL HEALTH RESOURCES PROMOTED AS KEY PART OF EMPLOYEE WELL-BEING PROGRAM. HOSPITAL CONVENES AND PARTICIPATES IN MULTIPLE COLLABORATIVES FOCUSING ON MENTAL HEALTH. -INCREASED VALLEY-WIDE USE OF BEHAVIORAL HEALTH TELEHEALTH (BHTV) PROGRAM FOR PATIENTS ACCESSING EMERGENCY DEPARTMENT CARE DURING A MENTAL HEALTH CRISIS.-BEHAVIORAL HEALTH TEAM SERVED OUR COMMUNITY IN NEW AND DIFFERENT WAYS, INCLUDING SOME DIGITAL/VIRTUAL FORMATS, INCLUDING PODCASTS. SIX PODCASTS WERE RECORDED IN 2021, PRIMARILY WITH A MENTAL HEALTH FOCUS ON TOPICS SUCH AS DEPRESSION, ANXIETY AND STRESS RELIEF. IN TOTAL, THESE HAVE BEEN ACCESSED OVER 400 TIMES.-CONTINUED: INCREASING TELEHEALTH CAPACITY FOR BEHAVIORAL HEALTH APPOINTMENTS.-CONTINUED: COLLABORATED WITH PARTNERS HAVE IMPROVED AWARENESS INCLUDING COUNTY DHS, OTHER HOSPITALS AND CLINICS, MAKE IT OK, NAMI, AND OTHERS (BEHAVIORAL HEALTH CO-OP).-CONTINUED: INTEGRATED BEHAVIORAL HEALTH INTO TOTAL HEALTH CARE AT ALL LOCATIONS.NUTRITION AND PHYSICAL ACTIVITY GOALS: PROMOTE AND SUPPORT PHYSICAL ACTIVITY AND NUTRITION AND SUPPORT AND ENCOURAGE HEALTHY FOOD AND PHYSICAL ACTIVITY ENVIRONMENT CHANGE. POWERUP IS OUR KEY COMMUNITY-WIDE HEALTH INITIATIVE THAT INSPIRES AND ENGAGES THE ENTIRE COMMUNITY TO PROMOTE BETTER EATING AND PHYSICAL ACTIVITIES SO YOUTH CAN REACH THEIR FULL POTENTIAL. WE WORK WITH HUNDREDS OF PARTNERS ACROSS THE REGION RESULTING IN A HIGH LEVEL OF COMMUNITY AND SCHOOL ENGAGEMENT, STRONGER SCHOOL WELLNESS POLICIES AND PRACTICES; MORE FREE AND LOW-COST OPTIONS FOR PHYSICAL ACTIVITY INCLUDING OPEN GYMS; PARTNERSHIPS WITH STATE AND LOCAL PARKS; TRANSFORMED FOOD PANTRIES, CAFETERIAS AND CONCESSIONS; AND COMMUNITY MOMENTUM TO CREATE CHANGE. KEY RESULTS INCLUDE:-NEW POWERUP4KIDS.ORG WEB PLATFORM WITH IMPROVED NAVIGATION, NEW RESOURCES FOR AT-HOME FAMILY ACTIVITIES AND SCHOOL RESOURCES FOR VIRTUAL AND IN-PERSON LEARNING ENVIRONMENTS.-ONLINE RECIPE GALLERY, WITH MORE THAN 300 KIDAPPROVED RECIPES.-VIDEO GALLERY FOR SCHOOLS AND FAMILIES WITH PHYSICAL ACTIVITY AND FOOD IDEAS FOR KIDS, CLASSROOMS AND FAMILIES.-POWERUP SCHOOL CHALLENGE PROGRAM WAS REVISED TO PROVIDE SCHOOLS AND YOUTH SERVING ORGANIZATIONS TO COMPLETE THE CHALLENGE IN A FLEXIBLE WAY, ONLINE OR IN PERSON. THE PROGRAM INSPIRES STUDENTS TO EAT BETTER AND MOVE MORE, AND IN 2021 REACHED ELEMENTARY AGE STUDENTS IN 476 CLASSROOMS IN 23 ST. CROIX VALLEY AREA SCHOOLS. THE TOTAL PROGRAM REACHED STUDENTS IN 54 SCHOOLS AND MORE THAN 900 CLASSROOMS THROUGHOUT MINNESOTA AND WISCONSIN.-THE THREEWEEK WINTER WARMUP CHALLENGE INSPIRED KIDS TO STAY ACTIVE DURING THE COLD MONTHS AND WAS IMPLEMENTED IN LOCAL SCHOOLS IN A VIRTUAL FORMAT, REACHING 70 ELEMENTARY CLASSROOMS IN FOUR VALLEY SCHOOL DISTRICTS.-POWERUP WORKED WITH PARTNERS TO HELP INSPIRE AND INFLUENCE THEIR COMMUNITIES, INCLUDING 19 OPEN GYMS IN JANUARY AND FEBRUARY 2021 PRIOR TO RESTRICTIONS.SUBSTANCE ABUSEREDUCED OPIOID PRESCRIPTIONS, DOSES, AND PATIENTS MEETING CHRONIC OPIOID USE CRITERIA. THROUGH COLLABORATIVE EFFORTS WITH PHARMACY, PRESCRIBERS AND PAIN CLINICS, ACHIEVED SIGNIFICANT REDUCTION IN OPIOID PRESCRIBING IN OUR CARE SYSTEM.-VALLEY-WIDE , SINCE 2016, THERE HAS BEEN A 68% AND 52% REDUCTION IN OPIOIDS PRESCRIBED AT DISCHARGE IN HOSITALS AND EMERGENCY DEPARTMENTS, RESPECTIVELY. -INCREASED AWARENESS AND ACCESS OF TREATMENT FOR SUBSTANCE ABUSE. -REDUCED ACCIDENTAL POISONING AND DRUG ABUSE BY OFFERING FREE AND ENVIRONMENTALLY FRIENDLY MEDICATION COLLECTION AT OUR HOSPITALS AND CLINICS FOR THE COMMUNITY. PROMOTED COMMUNITY PRESCRIPTION TAKE-BACK LOCATIONS AND DISPOSAL BAGS, COLLECTING 449 LBS. AT LAKEVIEW IN 2021.

LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION
PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS LISTED ON THE BACK OF THE PATIENT STATEMENT PER THE MINNESOTA ATTORNEY GENERAL (AG) AGREEMENT.

LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION
PART V, SECTION B, LINE 24: WHEN A PATIENT IS UNINSURED THERE HAVE BEEN INSTANCES WHERE A PORTION OF THE BALANCE IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINING BALANCE IS COVERED BY CHARITY CARE. EXAMPLE: AN UNINSURED PATIENT HAS $1,000 IN GROSS CHARGES FOR AN EMERGENCY ROOM VISIT. THE PATIENT QUALIFIES FOR CHARITY CARE AND ALSO IS ELIGIBLE FOR THE UNINSURED DISCOUNT. A PORTION OF THE GROSS CHARGES IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINDER BY CHARITY CARE, WHICH MAY TOTAL AN AMOUNT EQUAL TO THE GROSS CHARGE FOR THAT VISIT.

PART V LINE 20A
LAKEVIEW HOSPITAL DOES NOT PERFORM ANY ECAS (EXTRAORDINARY COLLECTION ACTIONS), THEREFORE WE WOULD NOT GIVE A PATIENT A WRITTEN NOTICE OF DOING SO.

PART I, LINE 7:
ACTUAL COSTS WERE ESTIMATED USING A COST-TO-CHARGE RATIO AND EXCLUDING BAD DEBT.

PART I, LINE 7E: COMMUNITY HEALTH IMPROVEMENT SERVICES
LAKEVIEW HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY. LAKEVIEW HOSPITAL PROVIDED COMMUNITY ACTIVITIES AND PROGRAMS WHICH WERE SUBSIDIZED BY THE HOSPITAL IN ORDER TO IMPROVE COMMUNITY HEALTH. SEE SCHEDULE O, 1. COMMUNITY HEALTH IMPROVEMENT SERVICES FOR THE TYPES OF CLASSES AND EVENTS PROVIDED TO THE COMMUNITY. THE NET COST OF PROVIDING COMMUNITY HEALTH IMPROVEMENT AND OPERATIONS ASSOCIATED WITH OFFERING CLASSES AND SUPPORT GROUPS IN 2021 WAS $77,734. LAKEVIEW HOSPITAL PROVIDED SUPPORT SERVICES TO PATIENTS AND FAMILIES IN MANY WAYS DURING 2021. MOST NOTABLY, LAKEVIEW HOSPITAL PROVIDED NURSE NAVIGATORS FOR BREAST HEALTH AND CANCER SUPPORT TO ASSIST PATIENTS WITH SCHEDULING, COORDINATION, FOLLOW-UP APPOINTMENTS, AND PROVIDING CONSULTS AND COMFORT TO THOSE PATIENTS DIAGNOSED WITH CANCER. THE NET COST OF THIS PROGRAM WAS $283,755 IN 2021. THE CHAPLAINCY PROGRAM AT LAKEVIEW HOSPITAL ALSO PROVIDED OUTREACH SERVICES, INCLUDING BEREAVEMENT GROUP CLASSES, AT A NET COMMUNITY BENEFIT COST OF $22,310.STAFF HOURS TO GATHER AND REPORT COMMUNITY BENEFIT INFORMATION TOTALED 902 HOURS AND $50,080 IN COMMUNITY BENEFIT EXPENSE FOR 2021.

PART I, LINE 7F: HEALTH PROFESSIONS EDUCATION
LAKEVIEW HOSPITAL COORDINATES AND SUPPORTS WEEKLY CONTINUING MEDICAL EDUCATION (CME) PROGRAMS FOR STAFF AND COMMUNITY EDUCATION. TOTAL DIRECT COSTS FOR STIPENDS, PURCHASED SERVICES, SUPPLIES, ROOM RENTALS AND INDIRECT COSTS FOR THE YEAR WERE $60,657.IN 2021, OUR STAFF PROVIDED PRECEPTOR TIME TO STUDENT PROFESSIONAL INTERNS IN PHARMACY AND NURSING AT A NET COST OF $215,869.

PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES
LAKEVIEW HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES, EVEN AT A FINANCIAL LOSS. IN 2021, LAKEVIEW HOSPITAL SUBSIDIZED INPATIENT AND OUTPATIENT HEALTH SERVICES, INCLUDING CLINICAL DIABETES AND NUTRITION, LABOR AND DELIVERY SERVICES, AND HOMECARE SERVICES, TOTALING $4,300,686.

PART I, LINE 7I: CONTRIBUTIONS FOR COMMUNITY BENEFIT
TO FORM PARTNERSHIPS THAT IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES, LAKEVIEW HOSPITAL PROVIDES GRANTS TO LOCAL ORGANIZATIONS. OUR GRANTMAKING EMPOWERS OUR COMMUNITIES AND BUILDS MOMENTUM FOR INNOVATIVE PROGRAMS AND SERVICES THAT MAKE A DIRECT IMPACT ON LOCAL HEALTH PRIORITIES.LAKEVIEW HEALTH FOUNDATION'S BOARD OF DIRECTORS HAS OVERSIGHT OF THE DISBURSEMENT OF HEALTH AND WELL-BEING GRANTS ON BEHALF OF LAKEVIEW HOSPITAL. NINETEEN GRANTS WERE APPROVED IN 2021, WHICH BENEFITED THE COMMUNITY. INKIND CONTRIBUTIONS INCLUDED SUPPORT OF MISSION TRIPS FOR EMPLOYEES AND PHARMACEUTICALS. SEE SCHEDULE O, SECTION 4. CASH AND IN-KIND CONTRIBUTIONS, FOR DETAIL ON GRANTS OFFERED, SPONSORSHIPS PROVIDED, AND INKIND SUPPORT GIVEN IN 2021.LAKEVIEW HOSPITAL'S DONATIONS TO COMMUNITYBASED TAXEXEMPT ORGANIZATIONS IN THE FORM OF SPONSORSHIPS, GRANTS, DONATIONS TO MATTER FOUNDATION AND SUPPLIES FOR MEDICAL MISSION TRIPS TOTALED $205,590 IN 2021.

PART II, COMMUNITY BUILDING ACTIVITIES:
LAKEVIEW HOSPITAL CONTINUOUSLY FOCUSES ON SUSTAINABILITY EFFORTS. IN 2021, $53,749 IN COSTS WERE EXPENDED IN THESE EFFORTS. SEE SCHEDULE O, SECTION 5. COMMUNITY BUILDING ACTIVITIES, FOR MORE DETAIL.OTHER COMMUNITY BUILDING ACTIVITIES INCLUDED LEADERSHIP ATTENDING COMMUNITY EVENTS PROMOTING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS AND HOSPITAL LEADERS HOLDING A HEALTH & WELLNESS DAY FOR ST. CROIX LEADERSHIP IN THE VALLEY PARTICIPANTS.

PART III, LINE 4:
SEE THE ORGANIZATION'S FOOTNOTES 1.O AND 1.Q, ON PAGE 25 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENT.

PART III, LINE 8:
THE MEDICARE COST IS DERIVED BASED ON THE RATIO OF MEDICARE FFS CHARGES TO TOTAL CHARGES MULTIPLIED BY TOTAL EXPENSES (LESS CHARITY CARE & BAD DEBT). NONE OF THE MEDICARE FFS LOSS REPORTED ON SCHEDULE H, PART III, LINE 7 IS TREATED AS COMMUNITY BENEFIT ON SCHEDULE H, PART I, LINE 7A.THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:1) IT PROVIDES SERVICES TO A SIGNIFICANT PORTION OF OUR SERVICE POPULATION AT A NEGATIVE MARGIN; 2) THE HOSPITAL WOULD DISCONTINUE PROVIDING SERVICES TO MEDICARE PATIENTS IF THE DECISION WERE BASED STRICTLY ON A FINANCIAL BASIS; 3) THERE IS A COMMUNITY NEED TO PROVIDE THESE SERVICES LOCALLY; 4) IF THE HOSPITAL DID NOT PROVIDE THESE SERVICES; THEY WOULD BECOME THE OBLIGATION OF THE GOVERNMENT.

PART III, LINE 9B:
IF LAKEVIEW HOSPITAL DETERMINES THAT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, AND IF THE PATIENT IS ELIGIBLE FOR DISCOUNTED (AND NOT FREE) CARE, THEY WILL PROVIDE THE PATIENT WITH A BILLING STATEMENT AND APPROVAL OR DECLINATION LETTER REGARDING THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. LAKEVIEW HOSPITAL WILL REFUND ANY PAYMENT THE PATIENT MADE FOR CARE WHICH EXCEEDS THE AMOUNT THAT IS DETERMINED TO BE PATIENT RESPONSIBILITY. THEY WILL ALSO TAKE REASONABLE MEASURES TO REVERSE ANY COLLECTION ACTIONS THAT MAY HAVE BEEN INITIATED AGAINST THE PATIENT.

PART III, SECTION A, LINE 2: BAD DEBT EXPENSE METHODOLOGY
"THE ""ACTUAL COST"" OF BAD DEBT EXPENSE IS ESTIMATED. BAD DEBT EXPENSE REPRESENTS THOSE ACCOUNTS RECEIVABLE WRITTEN OFF FROM PATIENTS THAT HAVE NOT PAID THEIR BILL AND HAVE NOT APPLIED FOR FINANCIAL ASSISTANCE. THE BAD DEBT AMOUNT IS THE RECEIVABLE AFTER INSURANCE PAYMENT AND ADJUSTMENTS HAVE ALREADY BEEN MADE, INCLUDING ADJUSTMENTS FOR SELF-PAY IN ACCORDANCE WITH THE AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL'S OFFICE. SINCE REDUCTIONS HAVE ALREADY BEEN MADE FOR DISCOUNTS AND OTHER ALLOWANCES, THE ENTIRE BALANCE IS CONSIDERED BAD DEBT AND NO FURTHER REDUCTIONS ARE CONSIDERED.THE PROVISIONS FOR BAD DEBT FOOTNOTE IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS IS INCLUDED IN SECTION 1, PART (P), PAGES 11 AND 12."

PART VI, LINE 4:
LAKEVIEW HOSPITAL SERVES THE EASTERN TWIN CITIES' METRO AREA AND WESTERN WISCONSIN. LAKEVIEW HOSPITAL'S CORE SERVICE AREA INCLUDES STILLWATER, BAYPORT, LAKE ELMO, LAKELAND, AND MARINE ON ST. CROIX, MN ALONG WITH HOULTON AND SOMERSET, WI. PRIMARY SERVICE AREAS ARE HUDSON, NEW RICHMOND AND STAR PRAIRIE, WI, AND AFTON, MN. SECONDARY SERVICE AREAS ARE NEARBY CITIES IN EASTERN MINNESOTA AND WESTERN WISCONSIN.

PART VI, LINE 5:
"LAKEVIEW HOSPITAL PROVIDED EDUCATION SCHOLARSHIPS TO PEOPLE WITH DIABETES THAT REQUIRED NUTRITION AND LIFE-STYLE EDUCATION; THEY ALSO PROVIDED FREE LAB AND PHARMACY SERVICES FOR PATIENTS OF THE ST. CROIX FAMILY MEDICAL CENTER, A LOCAL MEDICAL CLINIC THAT PROVIDES FREE AND DISCOUNTED SERVICES FOR INDIGENT AND LOW INCOME PATIENTS OF THE AREA. FOR ADDITIONAL DISCUSSION, SEE FORM 990, SCHEDULE O - ""EXEMPT PURPOSE AND ACHIEVEMENTS""."

PART VI, LINE 6:
AS A MEMBER OF LAKEVIEW HEALTH, LAKEVEIW HOSPITAL PARTICIPATES WITH THE MULTI-SPECIALTY CLINIC AND HEALTH SYSTEM LEADERSHIP WITHIN OUR OVERALL ORGANIZATION IN PROVIDING ACCESS TO CARE, SUPPORT GROUPS, EDUCATIONAL ACTIVITIES, AND FINANCIAL CONTRIBUTIONS TO THE MARKET AREA DESCRIBED ABOVE. THE MULTI-SPECIALTY CLINIC FURTHER PARTICIPATES IN MINNESOTA COMMUNITY MEASUREMENT, PRACTICES AND MEASURES PROVIDER, PERFORMANCE WITH SPECIFIC PREVENTIVE CARE METRICS AND SPECIFIC CHRONIC DISEASE MANAGEMENT METRICS. IN 2011, LAKEVIEW HEALTH AFFILIATED WITH HEALTHPARTNERS. THE MISSION OF HEALTHPARTNERS IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY.

PART VI, LINE 2:
TO COMPREHENSIVELY UNDERSTAND AND DESCRIBE THE NEEDS OF THE COMMUNITIES HEALTHPARTNERS SERVES, WE SYSTEMATICALLY IDENTIFIED A LIST OF PUBLICLY AVAILABLE DATA SOURCES AND A LIST OF INTERNALLY AVAILABLE HEALTHPARTNERS DATA SOURCES. WITH THE CHNA WORKGROUP THAT HAD EXPERTISE FROM PUBLIC HEALTH, HEALTHCARE AND EPIDEMIOLOGY, WE CAREFULLY REVIEWED THE LIST TO IDENTIFY OPPORTUNITIES WITH A SPECIFIC LENS TOWARDS INCLUDING MEMBERS WITH UNIQUE INSIGHT INTO NEEDS OF OUR UNDERSERVED COMMUNITIES WHERE HEALTH AND OTHER DISPARITIES EXIST. TO FURTHER ROUND OUT UNDERSTANDING, WE SOUGHT ADDITIONAL DATA SOURCES TOGETHER WITH OUR COMMUNITY PARTNERS. WHERE OPPORTUNITIES STILL REMAIN FOR BETTER UNDERSTANDING DUE TO LACK OF CURRENTLY AVAILABLE DATA, WE HAVE NOTED IN THE REPORT. FOR EXAMPLE, WE IDENTIFIED SPECIFIC GAPS IN DATA AVAILABLE TO UNDERSTAND THE COVID-19 PANDEMIC CONTEXT AND THE INFLUENCE OF STRUCTURAL RACISM ON THE NEEDS AREAS. THUS, WE SPECIFICALLY DESIGNED OUR QUALITATIVE COMMUNITY CONVERSATIONS AND OUR QUANTITATIVE HEALTHPARTNERS PROVIDER SURVEYS TO FILL THESE GAPS. HEALTHPARTNERS PROVIDER SURVEYS: SELECT HEALTHPARTNERS STAFF WHO PROVIDE DIRECT CARE FOR OUR PATIENTS WERE INVITED BY HOSPITAL LEADERS AND THE CHNA EXPERT PANEL MEMBERS TO COMPLETE A BRIEF WEB SURVEY ABOUT THE NEEDS OF THE PATIENTS THEY SERVE. THE SURVEY WAS DEVELOPED BY AN EXPERT SURVEY METHODOLOGIST WITH INPUT FROM THE CHNA WORKGROUP. OVERALL, 444 PROVIDERS INCLUDING DOCTORS, CARE COORDINATORS, PHARMACISTS, PHYSICAL OR OCCUPATIONAL THERAPISTS, DIETITIANS, NURSES, AND SOCIAL WORKERS COMPLETED SURVEYS ACROSS ALL HEALTHPARTNERS HOSPITALS. DESCRIPTIVE STATISTICS AND A THEMATIC ANALYSIS WERE COMPLETED AND INCLUDED IN THE NEEDS AREA SUMMARIES BELOW.COMMUNITY CONVERSATIONS: A TOTAL OF 41 COMMUNITY CONVERSATIONS WERE HELD OR ATTENDED BY HEALTHPARTNERS WORKGROUP MEMBERS. RESULTS WERE SUMMARIZED AND KEY THEMES AND QUOTES WERE ADDED TO THE NEEDS AREA SUMMARIES THROUGHOUT. ADDITIONAL DETAILS ABOUT THE COMMUNITY CONVERSATIONS CAN BE FOUND IN THE APPENDIX OF THE LAKEVIEW HOSPITAL'S 2021 CHNA AT HTTPS://WWW.HEALTHPARTNERS.COM/CARE/HOSPITALS/LAKEVIEW/ABOUT/COMMUNITY-HEALTH-NEEDS/

PART VI, LINE 3:
LAKEVIEW HOSPITAL DEFINES FINANCIAL ASSISTANCE AS THE COST OF CARE DELIVERED TO PATIENTS WHO HAVE A NEED FOR MEDICALLY NECESSARY TREATMENT BUT WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY; PATIENTS WHO ARE UNABLE TO PAY THE REMAINING BALANCE LEFT BY THEIR INSURANCE; AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION.LAKEVIEW HOSPITAL IS COMPLIANT WITH THE 501R FEDERAL REGULATIONS, AND PROVIDES EASY ACCESS TO THE FINANCIAL ASSISTANCE PROGRAM INCLUDING THE FINANCIAL ASSISTANCE POLICY (FAP), APPLICATION, AND PLAIN LANGUAGE SUMMARY. THE FINANCIAL ASSISTANCE PROGRAM AND LISTS OF PROVIDERS COVERED BY THE PROGRAM IS ALSO WIDELY PUBLICIZED AND AVAILABLE ON LAKEVIEW HOSPITAL'S WEBSITE.TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE POLICY, AND GOVERNMENT PROGRAMS, EACH PATIENT IS OFFERED AND PROVIDED WITH THE FINANCIAL ASSISTANCE PROGRAM POLICY AT REGISTRATION. THIS INFORMATION IS ALSO IS ALSO PROVIDED IN PUBLIC LOCATIONS, INCLUDING REGISTRATION, ON PATIENT STATEMENTS, AND LAKEIVEW HOSPITAL'S PUBLIC WEBSITE, HTTPS://WWW.HEALTHPARTNERS.COM/CARE/HOSPITALS/LAKEVIEW/.IN ADDITION TO FINANCIAL COUNSELING, THE HOSPITAL HAS STAFF SOCIAL WORKERS AND CASE MANAGERS TO HANDLE CRISIS INTERVENTIONS, EMERGENCY ROOM NEEDS, AND PATIENT AFTERCARE.TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE, EACH PATIENT BILLING STATEMENT AND COLLECTIONS LETTER PRODUCED BY LAKEVIEW HOSPITAL INCLUDE THE FOLLOWING NOTICE: LAKEVIEW HOSPITAL OFFERS A FINANCIAL ASSISTANCE PROGRAM. FOR COPIES OF OUR APPLICATION, FINANCIAL ASSISTANCE POLICY, AND PLAIN LANGUAGE SUMMARY, WHICH INCLUDE INFORMATION ON ELIGIBILITY AND HOW WE CALCULATE FINANCIAL ASSISTANCE, PLEASE VISIT HTTPS://WWW.HEALTHPARTNERS.COM/CARE/HOSPITALS/LAKEVIEW/. OUR PATIENT FINANCIAL SERVICES TEAM CAN HELP YOU ENROLL IN THIS PROGRAM. PLEASE CALL 651-430-4533.

PART VI, LINE 7, REPORTS FILED WITH STATES
MN