4A (Expenses $ 39329374 including grants of $ 0) (Revenue $ 42021286)
SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC. IS A 163-BED HOSPITAL CAMPUS (25 HOSPITAL BEDS, 100 NURSING HOME BEDS, 38 ASSISTED LIVING APARTMENT BEDS) PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2021, SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC. HAD A TOTAL OF 38,956 PATIENT DAYS (INCLUDES NH/APT DAYS) OF SERVICE. THE HOSPITAL ALSO PROVIDED SERVICES FOR 24,033 OUTPATIENT VISITS, WHICH INCLUDED 2,670 OF EMERGENCY ROOM VISITS AND 340 OUTPATIENT SURGERIES. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS.

SAINT ELIZABETH'S HOSPITAL OF WABASHA INC
PART V, SECTION B, LINE 5: FACILITY NAME: SAINT ELIZABETH'SHOSPITAL OF WABASHA, INCDESCRIPTION: SAINT ELIZABETH'S IS COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. SAINT ELIZABETH'S AND THE WABASHA COUNTY PUBLIC HEALTH DEPARTMENT USED THE FOLLOWING METHODS TO LISTEN TO COMMUNITY MEMBERS' THOUGHTS ON THE STRENGTHS AND CHALLENGES OF BEING A HEALTHY COMMUNITY. THESE METHODS PROVIDED US WITH ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING OUR COMMUNITIES.INPUT FROM COMMUNITY LEADERS:INPUT WAS RECEIVED FROM COMMUNITY STAKEHOLDERS IN MULTIPLE WAYS. A COMMUNITY STAKEHOLDER MEETING WAS HELD ON JULY 26, 2018. THE MEETING WAS CONVENED BY SAINT ELIZABETH'S AND THE WABASHA COUNTY PUBLIC HEALTH DEPARTMENT. DURING THE MEETING, EXPERTS PRESENTED THE DATA AND ENGAGED ATTENDEES IN DISCUSSION AND A FACILITATED PRIORITIZATION PROCESS.LISTED BELOW ARE THE COMMUNITY LEADERS WHO PROVIDED INPUT ABOUT THE NEEDS OF THE COMMUNITY, INCLUDING AN INDICATION OF WHICH MEDICALLY UNDERSERVED, LOW INCOME OR MINORITY POPULATIONS (IF ANY) THEY SPECIFICALLY REPRESENTED. (NOTE: THE ORGANIZATIONS IN WABASHA COUNTY LARGELY FOCUS ON THE ENTIRE POPULATION. DUE TO THE SMALL POPULATION, FEW ORGANIZATIONS FOCUS EXCLUSIVELY ON MEDICALLY UNDERSERVED OR LOW-INCOME INDIVIDUALS. THERE ARE NO ORGANIZATIONS THAT FOCUS EXCLUSIVELY ON MINORITY POPULATIONS GIVEN THE DEMOGRAPHICS. RESOURCES FOR INDIVIDUALS WHO ARE HISPANIC ARE AVAILABLE IN THE NEIGHBORING COUNTY.)-WABASHA COUNTY PUBLIC HEALTH DEPARTMENT-SAINT ELIZABETH'S MEDICAL CENTER-HIAWATHA VALLEY MENTAL HEALTH CENTER*-UNITED WAY-THREE RIVERS COMMUNITY ACTION**-SOUTH COUNTRY HEALTH ALLIANCE***-WINONA STATE UNIVERSITY-CREST REGIONAL MENTAL HEALTH COALITION-MINNESOTA DEPARTMENT OF HEALTH*DENOTES ORGANIZATIONS OR PROGRAMS REPRESENTING MEDICALLY UNDERSERVED POPULATIONS.**DENOTES ORGANIZATIONS OR PROGRAMS REPRESENTING LOW INCOME POPULATIONS.***DENOTES ORGANIZATIONS OR PROGRAMS REPRESENTING MINORITY POPULATIONS.AT THE JULY STAKEHOLDER MEETING, A WORKSHEET WAS DISTRIBUTED TO ALL ATTENDEES. THE WORKSHEET PROVIDED A FRAMEWORK FOR TAKING NOTES THAT WOULD ASSIST ATTENDEES IN ASKING QUESTIONS, OFFERING FEEDBACK AND ENGAGING IN A PRIORITIZATION PROCESS. STAKEHOLDERS WHO COULD NOT ATTEND THE JULY MEETING WERE GIVEN THE DATA PACKET, WORKSHEET, PRIORITIZATION CRITERIA AND RANKING TOOL FOR SELECTING PRIORITIES.PRIOR TO THE ASSESSMENT, TWO COMMUNITY ORGANIZATIONS, THREE RIVERS COMMUNITY ACTION AND UNITED WAY, HAD RECENTLY COMPLETED THEIR OWN NEEDS ASSESSMENTS. THE THREE RIVERS COMMUNITY ACTION ASSESSMENT WAS COMPLETED IN AUGUST 2017 AND THE UNITED WAY ASSESSMENT WAS COMPLETED IN SPRING 2018. THEIR PROCESSES INCLUDED INPUT FROM LOW-INCOME CLIENTS, SENIORS, COMMUNITY BUSINESSES AND ORGANIZATIONS AND SERVICE PROVIDERS. THE INPUT OBTAINED THROUGH THOSE ASSESSMENTS WAS REVIEWED BY SAINT ELIZABETH'S AND THE WABASHA COUNTY PUBLIC HEALTH DEPARTMENT, AS WELL AS THE ATTENDEES AT THE COMMUNITY STAKEHOLDER MEETING.FOLLOWING THE JULY STAKEHOLDER MEETING, THE CHNA EXECUTIVE TEAM MET TO REVIEW THE RESULTS OF THE MEETING AND FINALIZE THE PRIORITIES. ORGANIZATIONS REPRESENTED ON THE EXECUTIVE TEAM INCLUDED SAINT ELIZABETH'S, WABASHA COUNTY PUBLIC HEALTH AND MINNESOTA DEPARTMENT OF HEALTH.INPUT FROM MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND/OR ORGANIZATIONS THAT REPRESENT THOSE POPULATIONSST. ELIZABETH'S HOSPITAL OF WABASHA, INC. IS FUELED BY A COMMITMENT TO HUMAN DIGNITY, THE COMMON GOOD, JUSTICE AND SOLIDARITY. WE BELIEVE THE CHNA PROCESS MUST BE INFORMED BY DIRECT INPUT FROM PERSONS WHO EXPERIENCE HEALTH DISPARITIES BASED ON INCOME AND/OR RACE AND ETHNICITY. WITH THAT IN MIND, SAINT ELIZABETH'S INCLUDED AND HIGHLIGHTED THE DATA FROM NEEDS ASSESSMENTS CONDUCTED BY THREE RIVERS COMMUNITY ACTION AND UNITED WAY, BOTH SERVING VULNERABLE AND LOW-INCOME INDIVIDUALS. DATA WAS COLLECTED THROUGH SURVEYS, FOCUS GROUPS, AND INFORMANT INTERVIEWS. AS PART OF THE PROCESS TO SELECT THE HEALTH PRIORITIES, STRONG CONSIDERATION WAS GIVEN TO HOW INDIVIDUALS WHO ARE MORE VULNERABLE ARE IMPACTED BY THE HEALTH ISSUES.

SAINT ELIZABETH'S HOSPITAL OF WABASHA INC
PART V, SECTION B, LINE 6B: SAINT ELIZABETH'S CONDUCTED THE CHNA AND IMPROVEMENT PLAN DEVELOPMENT JOINTLY WITH WABASHA COUNTY PUBLIC HEALTH DEPARTMENT. IN ADDITION, OTHER AGENCIES, ORGANIZATIONS, AND CITIZENS ACTIVELY PARTICIPATE IN THE DEVELOPMENT OF IMPROVEMENT STRATEGIES FOR THE PRIORITIES SELECTED.

SAINT ELIZABETH'S HOSPITAL OF WABASHA INC
"PART V, SECTION B, LINE 11: THE CURRENT CHNA/COMMUNITY HEALTH IMPROVEMENT PLAN CYCLE (2019-2022) WILL BE COMPLETED ON DECEMBER 31, 2022. THIS DATE WAS POSTPONED FROM JUNE 30, 2022 DUE TO A CHANGE IN THE FISCAL YEAR OF SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC. BECAUSE OF A NEW SPONSORSHIP WITH GUNDERSEN HEALTH SYSTEM. THE CURRENT GOALS, STRATEGIES AND INDICTORS FOLLOW:MENTAL HEALTH (2019-2022)GOAL: IMPROVE THE MENTAL HEALTH OF INDIVIDUALS IN WABASHA COUNTYLONG-TERM PERFORMANCE INDICATOR: BY 2023, THE RESIDENTS OF WABASHA COUNTY WILL REDUCE THE AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS IN THE LAST 30 DAYS FROM 2.8 (2016) TO 2.6. (SOURCE: COUNTY HEALTH RANKINGS)STRATEGY: SUICIDE PREVENTION TRAININGTHE WABASHA COUNTY MENTAL HEALTH ACTION TEAM WILL IMPLEMENT SUICIDE PREVENTION TRAINING IN THE COMMUNITY. ONE EXAMPLE OF A TRAINING IS QUESTION, PERSUADE, REFER (QPR). THE QPR TRAINING IS USED TO EDUCATE ANYONE IN THE COMMUNITY - TEACHERS, COACHES, PARENTS AND OTHERS - TO LEARN HOW TO ASK ABOUT SUICIDALITY, PERSUADE INDIVIDUALS THEY HAVE VALUE AND TO SEEK HELP AND HOW TO EFFECTIVELY ASSIST WITH REFERRING SOMEONE FOR HELP. AS PART OF THE WABASHA COUNTY MENTAL HEALTH ACTION TEAM, THE MEDICAL CENTER WILL: IDENTIFY AND RECRUIT INTENDED AUDIENCES (E.G., HEALTH AND SOCIAL SERVICES PROFESSIONALS, LAW ENFORCEMENT AND FIRST RESPONDERS, CLERGY AND FAITH COMMUNITIES, AND THE PUBLIC) CONDUCT SUICIDE PREVENTION TRAININGS ANNUALLY ACROSS AUDIENCESCOLLABORATIVE PARTNERS: WABASHA COUNTY MENTAL HEALTH ACTION TEAM ZUMBRO VALLEY MENTAL HEALTH WABASHA COUNTY SOCIAL SERVICES HIAWATHA VALLEY MENTAL HEALTH NAMI GUNDERSEN ST. ELIZABETH'S HOSPITAL AND CLINICS RESOURCES COMMITTED: STAFF TIMEMEDIUM-TERM INDICATOR: BY JUNE 30, 2022, 90 PERCENT OF TRAINING PARTICIPANTS WILL REPORT AN INCREASED UNDERSTANDING OF WHEN AND HOW TO UTILIZE GATEKEEPER SKILLS (E.G., ABILITY TO ENGAGE IN ACTIVE LISTENING, ASK CLARIFYING QUESTIONS AND MAKE AN APPROPRIATE REFERRAL).STRATEGY: PROMOTE AWARENESS OF MENTAL HEALTH CRISIS RESOURCESWABASHA COUNTY CURRENTLY HAS ACCESS TO REGIONAL RESOURCES THAT INCLUDE A TRAINED MOBILE CRISIS RESPONSE TEAM AND A 24-HOUR MENTAL HEALTH CRISIS HOTLINE. THE MENTAL HEALTH ACTION TEAM WILL WORK WITH ITS PARTNERS TO INCREASE THE UTILIZATION OF THESE RESOURCES. INITIATIVES INCLUDE: DEVELOP A COMMUNICATION PLAN TO BUILD GREATER AWARENESS OF MOBILE CRISIS RESOURCES AMONG INTENDED AUDIENCES (HEALTH AND SOCIAL SERVICES PROFESSIONALS, LAW ENFORCEMENT AND FIRST RESPONDERS, WORKPLACES, CLERGY AND FAITH COMMUNITIES AND THE PUBLIC) IMPLEMENT THE PLAN TRACK HOTLINE CALL VOLUMES AND NUMBER OF MOBILE CRISIS TEAM DISPATCHESCOLLABORATIVE PARTNERS: WABASHA COUNTY MENTAL HEALTH ACTION TEAM ZUMBRO VALLEY MENTAL HEALTH HIAWATHA VALLEY MENTAL HEALTH WABASHA COUNTY SOCIAL SERVICES NAMI GUNDERSEN ST. ELIZABETH'S HOSPITAL AND CLINICS RESOURCES COMMITTED: STAFF TIMEMEDIUM-TERM INDICATORS: BY JUNE 30, 2022, MOBILE CRISIS RESPONSE TEAMS WILL REPORT A 10 PERCENT INCREASE IN USE OF THE MOBILE CRISIS TEAM BY WABASHA COUNTY RESIDENTS. (BASELINE TBD.) BY JUNE 30, 2022, MOBILE CRISIS RESPONSE TEAMS WILL REPORT A 10 PERCENT INCREASE IN USE OF THE CRISIS HOTLINE BY WABASHA COUNTY RESIDENTS. (BASELINE TBD.) BY JUNE 30, 2022, VISITS TO GUNDERSEN ST. ELIZABETH'S EMERGENCY DEPARTMENT WITH A MENTAL HEALTH DIAGNOSIS WILL DECLINE BY FIVE PERCENT DUE TO AN INCREASE IN THE USE OF THE MOBILE UNIT AND CRISIS HOTLINE. (BASELINE TBD.)STRATEGY: PROMOTE MENTAL HEALTH PEER SUPPORT GROUPSTHE LOCAL NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) CONNECTION RECOVERY SUPPORT GROUP IS A FREE, PEER-LED SUPPORT GROUP FOR ADULTS LIVING WITH MENTAL ILLNESS. PARTICIPANTS GAIN INSIGHT FROM HEARING THE CHALLENGES AND SUCCESSES OF OTHERS. GROUPS ARE LED BY NAMI-TRAINED FACILITATORS, WHO HAVE EXPERIENCED MENTAL ILLNESS. NAMI'S SUPPORT GROUPS ARE UNIQUE BECAUSE THEY FOLLOW A STRUCTURED MODEL TO ENSURE PARTICIPANTS HAVE AN OPPORTUNITY TO BE HEARD AND RECEIVE WHAT THEY NEED. THE GROUPS MEET ON A BI-WEEKLY, WEEKLY, OR MONTHLY BASIS. PEER SUPPORT IS CURRENTLY NOT AVAILABLE IN WABASHA COUNTY. THE MENTAL HEALTH ACTION TEAM WILL: INITIATE A PEER SUPPORT PROGRAM IN WABASHA COUNTY RECRUIT A TRAINED PEER SUPPORT FACILITATOR PROMOTE THE PEER SUPPORT PROGRAM IN THE WABASHA AREA MEASURE THE IMPACT OF THE PEER SUPPORT GROUPCOLLABORATIVE PARTNERS: WABASHA COUNTY MENTAL HEALTH ACTION TEAM ZUMBRO VALLEY MENTAL HEALTH HIAWATHA VALLEY MENTAL HEALTH WABASHA COUNTY SOCIAL SERVICES NAMI GUNDERSEN ST. ELIZABETH'S RESOURCES COMMITTED: STAFF TIMEMEDIUM-TERM INDICATOR: BY JUNE 30, 2022, 75 PERCENT OF PEER SUPPORT PARTICIPANTS WILL REPORT APPLYING NEWLY LEARNED COPING SKILLS THAT IMPROVE THEIR ABILITY TO BETTER MANAGE THEIR CHRONIC MENTAL ILLNESS.STRATEGY: STRENGTHEN HEALTHCARE'S ROLE IN IMPROVING MENTAL HEALTHGUNDERSEN ST. ELIZABETH'S IS EXPANDING ITS INTERNAL CAPACITY TO IMPROVE MENTAL HEALTH IN WABASHA COUNTY. GUNDERSEN ST. ELIZABETH'S WILL IMPROVE ITS INTERNAL TRAINING, PROTOCOLS, AND SYSTEMS TO BETTER SCREEN, REACH AND TREAT INDIVIDUALS WITH MENTAL HEALTH ISSUES.AS PART OF THAT EFFORT, GUNDERSEN ST. ELIZABETH'S WILL: ONBOARD A PSYCHIATRIST / PSYCHIATRIC NURSE TEAM; THE TEAM WILL PROVIDE MENTAL HEALTH ASSESSMENTS, MEDICATION MANAGEMENT AND COUNSELING TO PATIENTS WITHIN THE PRIMARY CARE SETTING DEVELOP AND IMPLEMENT A MENTAL HEALTH TRAINING AND EDUCATION PLAN FOCUSED ON PRIMARY CARE, EMERGENCY DEPARTMENT AND HOSPITAL PROVIDERS IMPLEMENT A MULTI-DISCIPLINARY COLLABORATIVE APPROACH TO MENTAL HEALTH CARE WITHIN THE CLINIC WORK WITH EXTERNAL AGENCIES (E.G., HIAWATHA VALLEY MENTAL HEALTH) TO ASSURE APPROPRIATE RESOURCES AND REFERRALSRESOURCES COMMITTED: STAFF TIMEMEDIUM-TERM INDICATORS: BY JUNE 2022, 100 PERCENT OF PRIMARY CARE, EMERGENCY DEPARTMENT, HOSPITAL PROVIDERS AND STAFF WILL HAVE RECEIVED TRAINING IN MENTAL HEALTH SCREENING, MANAGEMENT, AND REFERRAL. BY JUNE 2022, DEPRESSION SCREENING AND REMISSION SYSTEMS/PROTOCOLS USED IN PRIMARY CARE SETTING WILL BE TRACKED, MONITORED, AND REPORTED TO MINNESOTA COMMUNITY MEASURES. SENIOR HEALTH (2019-2022)GOAL: BUILD A DEMENTIA FRIENDLY WABASHA COUNTYLONG-TERM PERFORMANCE INDICATOR(S): BY JUNE 30, 2023, THE NUMBER OF WABASHA COUNTY AGENCIES/ORGANIZATIONS THAT HAVE BECOME 'DEMENTIA FRIENDLY OR OTHERWISE ADDRESSED DEMENTIA WILL INCREASE FROM 0 TO 10.STRATEGY: EQUIP WABASHA COUNTY COMMUNITIES TO BE ""DEMENTIA FRIENDLY""DEMENTIA FRIENDS IS AN INTERNATIONAL MOVEMENT THAT IS STRIVING TO CREATE MORE DEMENTIA-FRIENDLY COMMUNITIES BY CHANGING THE WAY PEOPLE THINK, ACT, AND TALK ABOUT DEMENTIA. THE EFFORT FOCUSES ON RAISING AWARENESS, REDUCING STIGMA, AND SUPPORTING RESIDENTS WHO ARE TOUCHED BY DEMENTIA. BY HELPING EVERYONE IN A COMMUNITY UNDERSTAND WHAT DEMENTIA IS AND HOW IT AFFECTS PEOPLE, EACH PERSON CAN MAKE A DIFFERENCE FOR SOMEONE LIVING WITH DEMENTIA. THE SENIOR HEALTH ACTION TEAM WILL: LAUNCH DEMENTIA FRIENDS THROUGHOUT WABASHA COUNTY, INCLUDING THE FACILITATION OF DEMENTIA FRIENDS CHAMPION TRAINING COURSES AND INFORMATION SESSIONS HOST DEMENTIA FRIENDS TRAINING AND INFORMATION SESSIONS IN THE WABASHA AREA TO INCREASE THE COMMUNITY'S ABILITY TO ADDRESS DEMENTIA ESTABLISH ""SPARK!"" CULTURAL PROGRAM FOR PEOPLE WITH MEMORY LOSS IN PARTNERSHIP WITH INTERESTED ORGANIZATIONS. SPARK! PROGRAMS ARE DESIGNED TO KEEP PARTICIPANTS ACTIVELY ENGAGED IN THEIR COMMUNITIES BY PROVIDING EXPERIENCES THAT STIMULATE CONVERSATIONS, PROVIDE PEER SUPPORT, AND INSPIRE CREATIVITY THROUGH ENGAGEMENT IN MUSEUM EXPERIENCES, WORKSHOPS, AND PROGRAMSMEDIUM-TERM INDICATOR: BY JUNE 30, 2022, AT LEAST 10 AGENCIES REPRESENTING HEALTHCARE, SOCIAL SERVICES, LAW AND LEGAL, FAITH, BUSINESS AND COMMUNITY SECTORS WILL HAVE PARTICIPATED IN DEMENTIA FRIENDS TRAINING. STRATEGY: SUSTAIN CAREGIVERS BY OFFERING INFORMATION, RESOURCES AND SUPPORTINCREASING ACCESS TO RESOURCES AND SOCIAL CONNECTIONS CAN HELP IMPROVE CAREGIVERS' QUALITY OF LIFE. ONE WAY TO DO THIS IS THROUGH MEMORY CAFS. MEMORY CAFS ARE EVIDENCE-BASED SOCIAL GATHERINGS FOR PATIENTS WITH DEMENTIA AND THEIR CAREGIVERS THAT OFFER SOCIAL INTERACTION, RESOURCES, AND SUPPORT.THE SENIOR HEALTH ACTION TEAM WILL: ESTABLISH UP TO THREE MEMORY CAFS THROUGHOUT WABASHA COUNTY THAT PROVIDE ONGOING SOCIAL SUPPORT GATHERINGS FOR INDIVIDUALS LIVING WITH DEMENTIA AND THEIR CARE PARTNERS CONTINUE TO PROMOTE AND OFFER RESOURCES AND PROGRAMMING THAT BENEFIT CAREGIVERSMEDIUM-TERM INDICATORS: BY JUNE 30, 2022, THREE MEMORY CAFS WILL BE OPERATIONAL IN WABASHA COUNTY. BY JUNE 30, 2022, 90 PERCENT OF MEMORY CAF CAREGIVER PARTICIPANTS WILL REPORT BEING SUPPORTED SOCIALLY AND WITH RESOURCES AT THE MEMORY CAF. BY JUNE 30, 2022, 90 PERCENT OF MEMORY CAF CAREGIVER PARTICIPANTS WILL REPORT REDUCED STRESS BECAUSE OF THE MEMORY CAF.STRATEGY: INCREASE DETECTION OF DEMENT"

PART V, LINE 7A
HTTPS://WWW.GUNDERSENHEALTH.ORG/COMMUNITY-ASSESSMENT

PART I, LINE 3C:
"PATIENTS WITH DEMONSTRATED FINANCIAL NEEDS WITH INCOME GREATER THAN 400% OF THE FPL MAY BE ELIGIBLE FOR CONSIDERATION UNDER A ""MEANS TEST"" FOR SOME DISCOUNT OF THEIR CHARGES FOR SERVICES FROM THE ORGANIZATION BASED ON A SUBSTANTIVE ASSESSMENT OF THEIR ABILITY TO PAY. THIS TEST CAPS TOTAL BALANCE DUE AT 25% OF TOTAL INCOME. A PATIENT ELIGIBLE FOR THE ""MEANS TEST"" DISCOUNT WILL NOT BE CHARGED MORE THAN THE CALCULATED AGB CHARGES."

PART I, LINE 7:
"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."

PART II, COMMUNITY BUILDING ACTIVITIES:
SAINT ELIZABETH'S MEDICAL CENTER SUPPORTS A YOUTH READING PROGRAM. ACCORDING TO THE COUNTY HEALTH RANKINGS SITE, BETTER EDUCATED INDIVIDUALS LIVE LONGER, HEALTHIER LIVES THAN THOSE WITH LESS EDUCATION, AND THEIR CHILDREN ARE MORE LIKELY TO THRIVE. THIS IS TRUE EVEN WHEN FACTORS LIKE INCOME ARE TAKEN INTO ACCOUNT. SAINT ELIZABETH'S LEADERS PARTICIPATE IN MANY LOCAL ORGANIZATIONS AND COLLABORATIVE EFFORTS THAT HELP IMPROVE THE COMMUNITY. THESE INCLUDE THE LOCAL CHAMBER OF COMMERCE AND THE WABASHA AREA COMMUNITY RESOURCE CENTER. BY WORKING TOGETHER WITH OTHER ORGANIZATIONS IN THE COMMUNITY, WE EXPECT TO HAVE A GREATER IMPACT ON HEALTH. ACCORDING TO THE COUNTY HEALTH RANKINGS SITE, WITH A SHARED VISION AND COMMITMENT TO IMPROVED HEALTH, WORKING TOGETHER CAN YIELD BETTER RESULTS THAN WORKING ALONE. SAINT ELIZABETH MEDICAL CENTER PROVIDED JOB SHADOWING EXPERIENCES TO STUDENTS. ASSURING THAT RURAL COMMUNITIES HAVE A VIBRANT HEALTH CARE WORKFORCE IN THE FUTURE WILL HELP INCREASE ACCESS TO QUALITY OF CARE IN THE FUTURE.SAINT ELIZABETH MEDICAL CENTER ALSO CONDUCTS A COMMUNITY SHARPS PROGRAM. BY SAFELY REMOVING SHARPS FROM THE ENVIRONMENT, WE MAKE THE COMMUNITY SAFER IN TERMS OF INJURY AND INFECTION.

PART III, LINE 2:
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 GUNDERSEN HEALTH SYSTEM. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THECOST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IS $1,139,117, ($847,947 AT COST).

PART III, LINE 3:
THE ORGANIZATION HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS.

PART III, LINE 4:
THE ORGANIZATION IS PART OF THE GUNDERSEN HEALTH SYSTEM'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 18.

PART III, LINE 8:
A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ST. ELIZABETH'S HOSPITAL OF WABASHA, INC. FOLLOWS THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT.

PART III, LINE 9B:
THE ORGANIZATION FOLLOWS GUNDERSEN HEALTH SYSTEM'S 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. 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.

PART VI, LINE 2:
IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, SAINT ELIZABETH'S MEDICAL CENTER USES BOTH HOSPITAL DATA AND RELIABLE, THIRD PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES, TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED. SAINT ELIZABETH'S MEDICAL CENTER UTILIZES THIS INFORMATION TO DETERMINE DEVELOP PROGRAMS AND SERVICES TO BE PROVIDED FOR THE COMMUNITY. THESE NEEDS AND INITIATIVES ARE PRESENTED TO SENIOR LEADERSHIP AND BOARD MEMBERS TO ENSURE THE FINDINGS ARE CONSIDERED IN DEVELOPING THE ORGANIZATION'S STRATEGY, POLICY DEVELOPMENT, AND INTERNAL FINANCIAL AND OPERATIONAL DECISIONS.

PART VI, LINE 4:
SAINT ELIZABETH'S MEDICAL CENTER PRIMARILY SERVES THE RESIDENTS OF WABASHA COUNTY, MINNESOTA, AND THE SURROUNDING COUNTIES IN A RURAL AREA OF EASTERN MINNESOTA AND WESTERN WISCONSIN. THE POPULATION OF WABASHA COUNTY IS APPROXIMATELY 21,000, WITH 7% OF RESIDENTS LIVING AT OR BELOW THE FEDERAL POVERTY THRESHOLD. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $62,000. APPROXIMATELY 5% OF THE INDIVIDUALS LIVING IN THE COUNTY ARE UNINSURED AND 12.7% RECEIVE MEDICAID. WABASHA COUNTY IS A DESIGNATED PRIMARY CARE SHORTAGE AREA. THERE IS ONE HOSPITAL (SAINT ELIZABETH'S MEDICAL CENTER) IN WABASHA COUNTY.

PART VI, LINE 7, REPORTS FILED WITH STATES
MN

PART VI, LINE 3:
THE ORGANIZATION GOES TO GREAT LENGTHS IN ORDER TO INFORM AND EDUCATE PATIENTS/PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THE CHARITY CARE POLICY AND APPLICATION IS POSTED ON THE ORGANIZATION'S WEBSITE. ADMISSIONS, SOCIAL SERVICES, AND OTHER KEY AREAS CONTAIN SUMMARY INFORMATION OF THE CHARITY CARE POLICY. AS PART OF THE INTAKE/DISCHARGE PROCESS, PATIENTS ARE PROVIDED WITH A COPY OF THE POLICY AND OTHER IMPORTANT INFORMATION FOR FINANCIAL ASSISTANCE. IF DURING THE COURSE OF THE PATIENT REGISTRATION PROCESS, CARE ENCOUNTER, TREATMENT, OR UPON DISCHARGE IT BECOMES EVIDENT THAT A PATIENT MAY NEED FINANCIAL ASSISTANCE; THE PATIENT SHALL BE REFERRED TO THE ORGANIZATION'S COMMUNITY CARE PROGRAM. PATIENTS MAY BE IDENTIFIED AS NEEDING FINANCIAL ASSISTANCE AT ANY TIME DURING THE COURSE OF AN ENCOUNTER. A REFERRAL FOR CONSIDERATION OF COMMUNITY CARE FINANCIAL ASSISTANCE CAN BE INITIATED BY ANY MEMBER OF THE HOSPITAL'S WORKFORCE, INCLUDING MEDICAL STAFF MEMBERS, WHO BECOME AWARE OF THE PATIENT'S POTENTIAL NEED FOR COMMUNITY CARE FINANCIAL ASSISTANCE. THE COMMUNITY CARE POLICY WAS ALSO TRANSLATED INTO DIALECTS PREVALENT IN THE COMMUNITY IN ORDER TO REACH OUT TO THOSE THAT MAY SPEAK ANOTHER LANGUAGE (SPANISH). PATIENT REGISTRATION STAFF AND FINANCIAL COUNSELORS ARE PROVIDED WITH SCRIPTS TO FOLLOW WHEN INTERACTING WITH PATIENTS. AS PART OF THE CHARITY CARE PROCESS, PATIENTS MUST REGISTER WITH THE COUNTY PUBLIC ASSISTANCE TO SEE IF THEY MAY QUALIFY UNDER ANY OTHER FEDERAL OR STATE PROGRAMS.

PART VI, LINE 5:
THE ORGANIZATION STRIVES TO FURTHER ITS EXEMPT PURPOSES BY THE FOLLOWING:-THE ORGANIZATION'S GOVERNING BOARD CONSISTS PRIMARILY OF PERSONS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA WHO ARE NOT EMPLOYEES OF THE ORGANIZATION.-AS MENTIONED, THE ORGANIZATION PROVIDES SEVERAL SERVICES WHICH ARE NOT OTHERWISE AVAILABLE BEING IN A RURAL SETTING.-BASED ON THE ORGANIZATION'S MISSION, EMERGENCY ROOMS ARE MADE AVAILABLE TO ALL PATIENTS REGARDLESS OF THE ABILITY TO PAY.-THE ORGANIZATION ALSO PARTICIPATES IN THE EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS THROUGH INTERNSHIP PROGRAMS.-THE HOSPITAL PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH PROGRAMS (MEDICARE, MEDICAID, CHAMPUS, TRICARE).-THE HOSPITAL OFFERS VOLUNTEER OPPORTUNITIES TO THE COMMUNITY OR EVIDENCE OF THE ORGANIZATION'S RESPONSIVENESS TO THE COMMUNITY, INCLUDING OPPORTUNITIES FOR COMMUNITY INVOLVEMENT IN GOVERNANCE AND ADVISORY GROUPS. EXAMPLES OF PROGRAMS THAT WERE ESTABLISHED IN THE TAX YEAR THAT RESPONDED TO COMMUNITY NEEDS INCLUDE:-THE FACILITY STRIVES TO BE A LOW-COST/LOW-CHARGE FACILITY.-ADVOCATE COMMUNITY WIDE, STATE OR NATIONAL EFFORTS TO IMPROVE HEALTH OF THE POPULATION AND INCREASE ACCESS. - PARTNERSHIPS WITH OTHERS IN THE COMMUNITY (INCLUDING PUBLIC HEALTH DEPARTMENTS) TO IMPROVE COMMUNITY HEALTH AND WELL-BEING.- THE ROLE OF THE EMERGENCY DEPARTMENT AND URGENT CARE UNITS IN SERVING ALL PERSONS REGARDLESS OF ABILITY TO PAY.- AVAILABILITY OF FINANCIAL ASSISTANCE AND SLIDING SCALE DISCOUNTS AND CHANGES TO FINANCIAL ASSISTANCE OR COLLECTION POLICIES THAT WOULD BE VIEWED AS CONSTRUCTIVE.- THE ORGANIZATION IS A SOLE COMMUNITY HOSPITAL.- COMMUNITY MEMBERS UTILIZE THE HOSPITAL AS A VEHICLE TO CONNECT WITH AND CONTRIBUTE TO INDIVIDUALS AND THE OVERALL COMMUNITY THROUGH PHILANTHROPY AND VOLUNTEERING.- PROGRAMS ARE HAVING AN IMPACT ON COMMUNITY HEALTH ESPECIALLY PREVENTION ACTIVITIES, EFFORTS TO IMPROVE HEALTH AND INCREASE ACCESS TO HEALTH CARE SERVICES AND REDUCING HEALTH CARE COSTS. BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO DIALYSIS, DIAGNOSTICS, EMERGENCY SERVICES AND URGENT CARE, SURGICAL SERVICES, EXTENDED CARE, LABORATORY AND RADIOLOGY SERVICES, REHAB SERVICE, PRIMARY CARE, SPECIALTY MEDICINE, SLEEP ASSESSMENT SERVICES, RETAIL PHARMACY AND RESPIRATORY THERAPY SERVICES.

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SAINT ELIZABETH'S HOSPITAL OF WABASHA, INC IS AFFILIATED WITH GUNDERSEN LUTHERAN HEALTH SYSTEM. GUNDERSEN LUTHERAN HEALTH SYSTEM IS AN INTEGRATED HEALTH CARE SYSTEM THAT PROVIDES COMPREHENSIVE MEDICAL CARE TO PATIENTS PRIMARILY IN WISCONSIN, AS WELL AS IN IOWA AND MINNESOTA, BY OPERATING HOSPITALS, CLINICS, HEALTH PLANS, LONG-TERM CARE FACILITIES, AMBULANCE SERVICES, A FOUNDATION, AND AN ENERGY-PRODUCING COMPANY, IN ADDITION TO PROVIDING MEDICAL AND HEALTH/WELLNESS EDUCATION AND COMMUNITY OUTREACH, AND CONDUCTING MEDICAL EDUCATION AND CLINICALLY BASED RESEARCH. AS PART OF ITS OVERALL STRATEGY, THE SYSTEM HAS AFFILIATED WITH SEVERAL CRITICAL ACCESS HOSPITALS (CAHS) THAT ENABLE HIGHLY TRAINED PHYSICIANS TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, AND CLINICAL CARE SERVICES TO PATIENTS IN THEIR COMMUNITIES.