4A (Expenses $ 219369798 including grants of $ 0) (Revenue $ 290880620)
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OUTPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.

4B (Expenses $ 175114447 including grants of $ 0) (Revenue $ 150995327)
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY INPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.

4C (Expenses $ 17786022 including grants of $ 0) (Revenue $ 29521986)
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY DEPARTMENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.

SCHEDULE H, PART V, SECTION B, QUESTION 5
"WHILE CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (""CHNA"") HOLY NAME MEDICAL CENTER (""HNMC"") TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. THE ORGANIZATION'S CHNA INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (THE COMMUNITY HEALTH SURVEY) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE COUNTY, STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH AN ONLINE KEY INFORMANT SURVEY OF VARIOUS COMMUNITY STAKEHOLDERS. KEY INFORMANT SURVEY -------------------- IN AN EFFORT TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, THE ORGANIZATION UTILIZED A KEY INFORMANT SURVEY AS PART OF ITS CHNA PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY THE PARTICIPATING HOSPITALS AND THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (""CHIP"") OF BERGEN COUNTY. THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PROVIDERS AND REPRESENTATIVES OF BEHAVIORAL HEALTH, CHILDREN AND FAMILIES, COMMUNITY CENTERS AND RECREATION, BERGEN COUNTY, VARIOUS MUNICIPALITIES, CULTURAL ADVOCATES AND ORGANIZATIONS FOOD RESOURCES, CLINICAL AND OTHER HEALTH SPECIALTIES, HOUSING AND HOMELESSNESS, LAW ENFORCEMENT, FIRE, EMS, OLDER ADULTS/HEALTHY AGING, PHILANTHROPY, RELIGIOUS OR FAITH-BASED ORGANIZATIONS, SERVICES FOR LOW-RESOURCE INDIVIDUALS AND FAMILIES AND A VARIETY OF OTHER COMMUNITY LEADERS. ADMINISTRATIVE AND CLINICAL LEADERSHIP FROM THE PARTICIPATING HOSPITALS WERE ALSO INCLUDED. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE INTERVIEWED BY PHONE USING A STRUCTURED INTERVIEW GUIDE DEVELOPED BY JOHN SNOW, INC. (""JSI"") AND THE CHNA STEERING COMMITTEE. IN ALL, APPROXIMATELY 80 COMMUNITY STAKEHOLDERS IN BERGEN COUNTY TOOK PART IN THE KEY INFORMANT SURVEY. IN THE PHONE SURVEY, KEY INFORMANTS WERE ASKED TO RATE THE DEGREE TO WHICH VARIOUS HEALTH ISSUES ARE A PROBLEM IN THEIR OWN COMMUNITY. FOLLOW-UP QUESTIONS ASKED THEM TO DESCRIBE WHY THEY IDENTIFY PROBLEM AREAS AS SUCH, AND HOW THESE MIGHT BE BETTER ADDRESSED. RESULTS OF THIS SURVEY ARE INCLUDED IN THE CHNA. PARTICIPATION INCLUDED REPRESENTATIVES OF THE ORGANIZATIONS LISTED BELOW: - OFFICE OF ALCOHOL AND DRUG DEPENDENCY, BERGEN COUNTY DEPT OF HEALTH SERVICES; - COMPREHENSIVE BEHAVIORAL HEALTH CARE; - DIVISION OF MENTAL HEALTH SERVICES, BERGEN COUNTY DEPT OF HEALTH SERVICES; - PARTNERSHIP FOR MATERNAL AND CHILD HEALTH; - PASCACK VALLEY HIGH SCHOOL; - CHILDREN'S AID AND FAMILY SERVICES; - DWIGHT MORROW ZONE, BERGEN FAMILY CENTER; - HACKENSACK SCHOOL DISTRICT; - COMMUNITY CENTERS AND RECREATION; - WESTWOOD RECREATION DEPARTMENT; - WYCKOFF BOARD OF HEALTH; - BERGEN COUNTY DIVISION OF COMMUNITY DEVELOPMENT; - TOWNSHIP OF TEANECK; - DIVISION OF DISABILITY SERVICES, BERGEN COUNTY DEPT OF HEALTH SERVICES; - PUBLIC HEALTH NURSE, CITY OF GARFIELD; - BERGEN COUNTY DEPARTMENT OF HEALTH SERVICES; - HEALTH AND HUMAN SERVICES COMMITTEE, BERGEN COUNTY LINKS; - HEALTH INSURANCE AGENT/INTERPRETER; - HEALTH AND WELLNESS COORDINATOR, GARDEN STATE EQUALITY; - MEALS ON WHEELS NORTH JERSEY; - REGISTERED DIETICIAN, SHOP RITE OF HILLSDALE; - REGISTERED DIETICIAN, SHOPRITE OF NORTHVALE; - VAN DYK HEALTH CARE; - BERGEN COUNTY CANCER EDUCATION AND EARLY DETECTION, BERGEN CO. DEPT. OF HEALTH SERVICES; - JEWISH HOME FAMILY; - AMERICAN CANCER SOCIETY; - BERGEN VOLUNTEER MEDICAL INITIATIVE; - CANCERCARE; - NORTH HUDSON COMMUNITY ACTION; - LEADERSHIP, BERGEN COUNTY HOSPITALS; - PHYSICIANS, BERGEN COUNTY HOSPITALS; - TRUSTEES, BERGEN COUNTY HOSPITALS; - ASIAN HEALTH SERVICES, HOLY NAME MEDICAL CENTER; - SENIOR HOUSING SERVICES; - BERGEN COUNTY HOUSING AUTHORITY; - RIDGECREST APARTMENTS; - WESTWOOD POLICE DEPARTMENT; - WESTWOOD FOR ALL AGES; - MIDLAND PARK SENIOR CENTER AND AGE-FRIENDLY RIDGEWOOD; - BERGEN COUNTY DIVISION OF SENIOR SERVICES; - AGE FRIENDLY ENGLEWOOD; - BERGEN COUNTY DIVISION OF SENIOR SERVICES; - THE RUSSELL BERRIE FOUNDATION; - RELIGIOUS OR FAITH-BASED INDIVIDUALS/REPRESENTATIVES; - FAMILY PROMISE OF RIDGEWOOD; - NORTH HUDSON COMMUNITY ACTION CORPORATION; AND - SOCIAL SERVICE ASSOCIATION OF RIDGEWOOD AND VICINITY."

SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7B
"THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM (""SYSTEM""). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.HOLYNAME.ORG/INCLUDES/FILES/HNMC-CHNA-2019.PDF ADDITIONALLY, THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP OF BERGEN COUNTY'S CHNA, WHICH INCLUDES THIS ORGANIZATION, IS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: www.holyname.org/includes/files/CHNA-Bergen-County-2019.pdf"

SCHEDULE H, PART V, SECTION B, QUESTION 7D
"IN ADDITION TO POSTING THE COMMUNITY HEALTH NEEDS ASSESSMENT (""CHNA"") ON THE MEDICAL CENTER'S WEBSITE AND MAKING A PAPER COPY AVAILABLE WITHIN THE HOSPITAL FACILITY, THE CHNA WAS DISCUSSED AT THE ANNUAL OPEN PUBLIC MEETING OF THE BERGEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN AND WAS MADE AVAILABLE AT THE MEDICAL CENTER'S ANNUAL OPEN PUBLIC MEETING."

SCHEDULE H, PART V, SECTION B, QUESTION 10A
"THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM (""SYSTEM""). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.HOLYNAME.ORG/INCLUDES/FILES/2019-IMPLEMENTATION-STRATEGY.PDF"

SCHEDULE H, PART V, SECTION B, QUESTION 11
"PRIORITY AREAS -------------- HOLY NAME'S CHNA PROVIDED MANY OPPORTUNITIES TO VET QUANTITATIVE AND QUALITATIVE FINDINGS. BASED ON THESE FINDINGS, HOLY NAME'S SERVICE LINES AND AREAS OF EXPERTISE, LEADERSHIP AND STAFF FROM HOLY NAME MEDICAL CENTER IDENTIFIED THREE COMMUNITY HEALTH PRIORITY AREAS, WHICH TOGETHER EMBODY THE LEADING HEALTH ISSUES AND BARRIERS TO CARE FOR RESIDENTS OF THE HOSPITAL'S SERVICE AREA: (1) CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS; (2) SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE; AND (3) MENTAL HEALTH AND SUBSTANCE USE DISORDERS. PRIORITY POPULATIONS -------------------- BASED ON THE CHNA'S QUANTITATIVE AND QUALITATIVE FINDINGS, THERE WAS AGREEMENT THAT THE IMPLEMENTATION STRATEGY SHOULD PRIORITIZE CERTAIN DEMOGRAPHIC AND SOCIOECONOMIC SEGMENTS OF THE POPULATION THAT HAVE COMPLEX NEEDS OR FACE ESPECIALLY SIGNIFICANT BARRIERS TO CARE. FIVE PRIORITY POPULATIONS WERE IDENTIFIED: - INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS; - OLDER ADULTS; - RACIALLY, ETHNICALLY & CULTURALLY DIVERSE POPULATIONS; - INDIVIDUALS WITH LIMITED RESOURCES; AND - YOUTH AND ADOLESCENTS. PRIORITY AREA #1: CHRONIC / COMPLEX CONDITIONS AND RISK FACTORS --------------------------------------------------------------- GOALS INCLUDE: (1) ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING AND REFERRAL/TREATMENT SERVICES (2) SUPPORT INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERS (3) ENHANCE UNDERSTANDING OF END-OF-LIFE NEEDS AND CARE OBJECTIVES ADDRESSING THESE GOALS INCLUDE: - SCREEN FOR CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS AND REFER TO APPROPRIATE SERVICES; - INCREASE THE NUMBER OF INDIVIDUALS WHO RECEIVE EDUCATION REGARDING CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS; - INCREASE SKILLS, CONFIDENCE, AND ABILITIES OF PARENTS AND CAREGIVERS; - INCREASE THE NUMBER OF INDIVIDUALS FROM PRIORITY POPULATIONS ENGAGED IN CARE; - IMPROVE COORDINATION OF CARE FOR ADULTS WITH CHRONIC/COMPLEX CONDITIONS; - PROMOTE CHRONIC DISEASE MANAGEMENT AND BEHAVIORAL CHANGE; - INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY; - INCREASE ACCESS TO END-OF-LIFE AND PALLIATIVE CARE PROGRAMS; - DECREASE SOCIAL ISOLATION AMONG OLDER ADULTS; - INCREASE THE NUMBER OF ADULTS WITH ADVANCE HEALTHCARE DIRECTIVES; AND - PROVIDE SUPPORT FOR THE HEALTH CARE OF IMPOVERISHED PERSONS IN MILOT, HAITI. PRIORITY AREA #2: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE ------------------------------------------------------------------ GOALS INCLUDE: (1) ADDRESS THE SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE ISSUES THAT INHIBIT THE ABILITY OF INDIVIDUALS TO LEAD HAPPY, HEALTHY, AND PRODUCTIVE LIVES (2) REDUCE HEALTH DISPARITIES OBJECTIVES ADDRESSING THESE GOALS INCLUDE: - SUPPORT PROGRAMS AND POLICIES THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH; - ADDRESS COMMON BARRIERS TO ACCESSING HEALTH CARE; - PROMOTE CARE COORDINATION AND ENGAGEMENT IN PRIMARY CARE; - PROMOTE CULTURAL COMPETENCY, HEALTH LITERACY, AND LINGUISTICALLY; APPROPRIATE CARE TO REDUCE HEALTH DISPARITIES AND TO INCREASE ACCESS TO SERVICES; - REDUCE INAPPROPRIATE USE OF THE EMERGENCY ROOM AND HOSPITAL READMISSIONS; AND - REDUCE TRANSPORTATION BARRIERS. PRIORITY AREA #3: MENTAL HEALTH AND SUBSTANCE ABUSE DISORDERS ------------------------------------------------------------- GOAL: (1) SUPPORT AND/OR IMPLEMENT STRATEGIES THAT PROMOTE MENTAL, EMOTIONAL, AND SOCIAL WELL-BEING OBJECTIVES ADDRESSING THIS GOAL INCLUDE: - ENHANCE IDENTIFICATION OF INDIVIDUALS WITH UNDIAGNOSED MENTAL AND BEHAVIORAL HEALTH CONDITIONS; - SUPPORT EFFORTS THAT AIM TO REDUCE THE STIGMA ASSOCIATED WITH MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER; - SUPPORT INITIATIVES THAT PROMOTE HEALTHY MENTAL, EMOTIONAL, AND SOCIAL BEHAVIORS; - EXPAND ACCESS TO BEHAVIORAL HEALTH SCREENING, TREATMENT, AND SUPPORTIVE SERVICES; - COLLABORATE WITH CLINICAL AND COMMUNITY-BASED PARTNERS TO ADDRESS MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER; AND - REDUCE USE OF OPIOIDS, ESPECIALLY OPIOID PRESCRIPTIONS ISSUED BY HNMC AND ITS AFFILIATES. NEEDS THAT WILL NOT BE ADDRESSED -------------------------------- THERE ARE ALSO COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED THROUGH HOLY NAME'S CHNA THAT WERE NOT PRIORITIZED FOR INCLUSION IN THE IMPLEMENTATION STRATEGY. REASONS FOR THIS INCLUDE: - FEASIBILITY OF HOLY NAME HAVING AN IMPACT ON THIS ISSUE IN THE SHORT OR LONG-TERM - SPECIFIC CAPABILITY OF THE ORGANIZATION - THE ISSUE IS ALREADY ADDRESSED BY COMMUNITY PARTNERS IN A WAY THAT DOES NOT WARRANT ADDITIONAL SUPPORT POVERTY/EMPLOYMENT, HOUSING STABILITY, AND CERTAIN LEVELS OF BEHAVIORAL AND SUBSTANCE ABUSE NEEDS WERE IDENTIFIED AS COMMUNITY NEEDS, BUT WERE DEEMED TO BE OUTSIDE OF HOLY NAME MEDICAL CENTER'S PRIMARY SPHERE OF INFLUENCE. HOLY NAME REMAINS OPEN AND WILLING TO WORK WITH HOSPITALS AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES SHOULD AN OPPORTUNITY ARISE. HOLY NAME MEDICAL CENTER WILL STRIVE TO PROMOTE ITS MISSION: ""WE ARE A COMMUNITY OF CAREGIVERS COMMITTED TO A MINISTRY OF HEALING, EMBRACING THE TRADITION OF CATHOLIC PRINCIPLES, THE PURSUIT OF PROFESSIONAL EXCELLENCE, AND CONSCIENTIOUS STEWARDSHIP. WE HELP OUR COMMUNITY ACHIEVE THE HIGHEST ATTAINABLE LEVEL OF HEALTH THROUGH EDUCATION, PREVENTION AND TREATMENT."" IN CONCERT WITH THIS MISSION, THE MEDICAL CENTER IS COMMITTED TO THE STRATEGIES OUTLINED BELOW AND INCLUDED WITHIN THE ORGANIZATION'S IMPLEMENTATION STRATEGY ACTION PLAN."

SCHEDULE H, PART V, SECTION B, QUESTION 16
"THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM (""SYSTEM""). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.HOLYNAME.ORG/FINANCIAL/FINANCIAL-ASSISTANCE-POLICY.ASPX"

SCHEDULE H, PART I; LINE 3C
"IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, HOLY NAME MEDICAL CENTER USES OTHER FACTORS IN DETERMINING ELIGIBILITY CRITERIA FOR FREE AND DISCOUNTED CARE. OTHER FACTORS TO DETERMINE ELIGIBILITY INCLUDE: - ASSET LEVEL; - MEDICAL INDIGENCY; - INSURANCE STATUS; - UNDERINSURANCE STATUS; AND - RESIDENCY. ADDITIONAL INFORMATION WITH RESPECT TO HNMC'S ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS OUTLINED BELOW. NEW JERSEY CHARITY CARE ----------------------- NJ CHARITY CARE IS FREE OR REDUCED CHARGE CARE WHICH IS PROVIDED TO PATIENTS WHO RECEIVE INPATIENT AND OUTPATIENT SERVICES AT ACUTE CARE HOSPITALS THROUGHOUT THE STATE OF NEW JERSEY. CHARITY CARE IS AVAILABLE ONLY FOR EMERGENT OR MEDICALLY NECESSARY HOSPITAL CARE. SOME SERVICES SUCH AS PHYSICIAN FEES, ANESTHESIOLOGY FEES, RADIOLOGY INTERPRETATION, AND OUTPATIENT PRESCRIPTIONS ARE SEPARATE FROM HOSPITAL CHARGES AND MAY NOT BE ELIGIBLE FOR REDUCTION. IN ACCORDANCE WITH CHARITY CARE GUIDELINES, PAYMENT ASSISTANCE IS AVAILABLE TO NEW JERSEY RESIDENT PATIENTS WHOSE HOUSEHOLD GROSS INCOME IS AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES AND WHO: 1. HAVE NO HEALTH COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE BILL; 2. ARE INELIGIBLE FOR ANY PRIVATE OR GOVERNMENTAL SPONSORED COVERAGE (SUCH AS MEDICAID): AND 3. MEET THE INCOME AND ASSETS CRITERIA DESCRIBED BELOW. CHARITY CARE IS AVAILABLE TO THOSE THAT DO NOT QUALIFY FOR STATE OR FEDERAL PROGRAMS. INCOME CRITERIA - PATIENTS WITH FAMILY GROSS INCOME LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY GUIDELINES (""FPG"") ARE ELIGIBLE FOR 100% CHARITY CARE COVERAGE. PATIENTS WITH FAMILY GROSS INCOME GREATER THAN 200% BUT LESS THAN OR EQUAL TO 300% OF FPG ARE ELIGIBLE FOR DISCOUNTED CARE UNDER THE CHARITY CARE PROGRAM. FREE OR DISCOUNTED CHARGES ARE DETERMINED BY THE FOLLOWING FEE SCHEDULE: INCOME AS A PERCENTAGE OF HHS POVERTY INCOME GUIDELINES: LESS THAN OR EQUAL TO 200% -- 0% OF MEDICAID RATE GREATER THAN 200% BUT LESS THAN OR EQUAL TO 225% -- 20% OF MEDICAID RATE GREATER THAN 225% BUT LESS THAN OR EQUAL TO 250% -- 40% OF MEDICAID RATE GREATER THAN 250% BUT LESS THAN OR EQUAL TO 275% -- 60% OF MEDICAID RATE GREATER THAN 275% BUT LESS THAN OR EQUAL TO 300% -- 80% OF MEDICAID RATE GREATER THAN 300% -- UNINSURED DISCOUNT RATE AVAILABLE ASSETS CRITERIA - INDIVIDUAL ASSETS CANNOT EXCEED $7,500 AND FAMILY ASSETS CANNOT EXCEED $15,000. SHOULD AN APPLICANT'S ASSETS EXCEED THESE LIMITS, HE/SHE MAY ""SPEND DOWN"" THE ASSETS TO THE ELIGIBLE LIMITS THROUGH PAYMENT OF THE EXCESS TOWARD THE HOSPITAL BILL AND OTHER APPROVED OUT-OF-POCKET MEDICAL EXPENSES. CHARITY CARE MAY BE AVAILABLE TO NON-NEW JERSEY RESIDENTS, SUBJECT TO SPECIFIC PROVISIONS (SUCH AS EMERGENCY MEDICAL CONDITIONS). NEW JERSEY UNINSURED DISCOUNT CARE RATE --------------------------------------- UNINSURED NEW JERSEY STATE RESIDENT PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE AND WHOSE INCOME FALLS LESS THAN OR EQUAL TO 500% OF THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR A DISCOUNT BASED UPON MEDICARE RATES AS PER THE NJ STATE STATUTE P.L. 2008, CHAPTER 60, APPROVED ON AUGUST 8, 2008, ASSEMBLY, NO. 2609, AS ENACTED BY THE SENATE AND GENERAL ASSEMBLY OF THE STATE OF NEW JERSEY. COMPASSIONATE CARE DISCOUNT POLICY ---------------------------------- PATIENTS WHO DO NOT QUALIFY FOR ANY HEALTHCARE RELATED GOVERNMENTAL SPONSORED COVERAGE OR PROGRAMS UNDER HNMC'S FAP AND DO NOT HAVE PRIMARY INSURANCE COVERAGE WILL BE ELIGIBLE FOR OUR COMPASSIONATE CARE DISCOUNT POLICY. THIS DISCOUNT IS APPLIED AT THE TIME OF BILLING. THE COMPASSIONATE CARE DISCOUNT IS ONLY FOR UNINSURED PATIENTS AND IS NOT DEPENDENT ON INCOME OR ASSET CRITERIA, AND NO APPLICATION IS REQUIRED. IT IS FOR ALL SELF-PAY PATIENTS THAT DO NOT QUALIFY OR DO NOT CHOOSE TO APPLY FOR ANY HOSPITAL PAYMENT ASSISTANCE PROGRAMS. DISCOUNTS APPLIED ARE FOR OUTPATIENT DIAGNOSTIC TESTING SUCH AS RADIOLOGY OR LABORATORY SERVICES, AND A FLAT FEE RATE IS APPLIED TO LEVELS OF CARE SUCH AS AN INPATIENT (I.E. MEDICAL, SURGICAL, OR ICU) OR SAME DAY SURGERY. THE COMPASSIONATE CARE DISCOUNT DOES NOT APPLY TO BALANCES AFTER INSURANCE PAYMENTS, COSMETIC SURGERY, AND OTHER SPECIAL PROGRAMS. THIS DISCOUNT WILL BE APPLIED AT THE TIME OF BILLING. AMOUNT GENERALLY BILLED (""AGB"") ------------------------------- PER INTERNAL REVENUE CODE 501(R)(5) CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE FOR FAP-ELIGIBLE INDIVIDUALS UNDER HNMC'S FAP WILL BE LIMITED TO BUT NOT BILLED MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE."

SCHEDULE H, PART I, QUESTION 6A
NOT APPLICABLE.

SCHEDULE H, PART I, QUESTION 7
THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED.

SCHEDULE H, PART II
"ACTIVITIES CLASSIFIED AS COMMUNITY BUILDING INCLUDE USE OF HOLY NAME MEDICAL CENTER'S FACILITY AND/OR EMPLOYEES TO SUPPORT EFFORTS THAT: - PROMOTE THE POSITIVE GROWTH OF THE COMMUNITY; - ASSIST DIVERSE GROUPS IN COMING TOGETHER FOR THE COMMUNITY'S SHORT AND LONG TERM BENEFIT; AND - SEEK TO PROTECT THE COMMUNITY FROM ANYTHING THAT COULD SIGNIFICANTLY AFFECT THE HEALTH AND WELL-BEING OF THE COMMUNITY. HNMC ALSO ASSISTS OTHER NON-PROFITS AND PROVIDES VARIOUS FORMS OF NON-MONETARY AID. IN ADDITION, EMPLOYEES ARE PERMITTED TO ASSIST VALID NON-PROFIT ORGANIZATIONS DURING PAID WORK TIME. AMONG THE ORGANIZATIONS AIDED ARE: NURSING HOMES, BOY SCOUTS, HOUSES OF WORSHIP, COMMUNITY SERVICE GROUPS, ROTARY CLUBS, POLICE GROUPS, ENVIRONMENTAL GROUPS AND SCHOOLS. HNMC ALSO ALLOWS THE PUBLIC TO USE VARIOUS MEETING ROOMS (IN NON-CLINICAL AREAS) AND ITS CONFERENCE CENTER FOR EVENTS. CAREER DAYS ARE HELD FOR LOCAL HIGH SCHOOLS, FOSTERING ENTRANCE OF INTERESTED AND APPLICABLE STUDENTS INTO THE HEALTH PROFESSIONS. HNMC WAS ONE OF NINE HOSPITALS IN NEW JERSEY DESIGNATED BY THE NEW JERSEY DEPARTMENT OF HEALTH (""NJDOH"") AS A REGIONAL MEDICAL COORDINATION CENTER (""MCC""). THE ONLY FACILITY IN BERGEN COUNTY TO BE SO DESIGNATED, HNMC'S ON-CAMPUS MCC WAS ABLE TO BE ACTIVATED IN THE EVENT OF PUBLIC HEALTH EMERGENCIES AND/OR A TERRORIST ATTACK CAUSING MASS CASUALTY INCIDENTS, INFECTIOUS OR COMMUNICABLE DISEASE OR OTHER TYPES OF PUBLIC HEALTH DISRUPTION. THE MCC ALSO MONITORED, ON A DAILY BASIS, SITUATIONAL AWARENESS OF LOCAL ACTIVITY. IN 2014, THE NJDOH LOST MUCH OF ITS FEDERAL FUNDING FOR THE STATEWIDE PROGRAM, CUTTING IN HALF THE NUMBER OF MCC'S IT COULD SUPPORT. HNMC CHOSE NOT TO APPLY TO RENEW ITS DESIGNATION BUT HAS MAINTAINED MOST OF ITS CAPABILITIES ON ITS OWN. GIVEN HNMC'S PROXIMITY TO NEW YORK CITY (I.E., FIVE MILES NORTH OF THE GEORGE WASHINGTON BRIDGE) EMERGENCY PREPAREDNESS IS DEEMED NECESSARY TO ENSURE THE HEALTH AND WELL-BEING OF THE COMMUNITY, REGARDLESS OF THE MCC DESIGNATION."

SCHEDULE H, PART III, SECTION B, QUESTION 8
"MEDICARE COSTS WERE DERIVED FROM THE 2021 MEDICARE COST REPORT. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL), BAD DEBT AND ASSOCIATED COSTS ARE COMMUNITY BENEFIT AND ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (""IRC"") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM ""CHARITABLE"" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT ""THE TERM CHARITABLE IS USED IN SECTION 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM ""CHARITABLE"" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE ""CHARITY CARE STANDARD."" UNDER THE STANDARD, A HOSPITAL MUST PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS WHO CANNOT PAY FOR SUCH SERVICES. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH ""REMOVED"" FROM REVENUE RULING 56-185 ""THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST."" UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE ""COMMUNITY BENEFIT STANDARD,"" HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE ""GENERALLY ACCEPTED LEGAL SENSE"" OF THE TERM ""CHARITABLE,"" AS REQUIRED BY THE DEPARTMENT OF TREASURY REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS ""PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY"" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE AMERICAN HOSPITAL ASSOCIATION (""AHA"") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA'S POSITION. AS OUTLINED IN THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. FROM THE LATEST DATA PROVIDED BY THE AHA, MEDICARE REIMBURSES HOSPITALS ONLY 87 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 42 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLE."" THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR THOSE WHO DO NOT PAY ALL, OR A PORTION OF THE ALREADY DISCOUNTED BILLED AMOUNTS UNDER OUR FINANCIAL ASSISTANCE POLICY. A 2006 CONGRESSIONAL BUDGET OFFICE (""CBO"") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT ""THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE."" - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. THE CBO CONCLUDED THAT ITS FINDINGS ""SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFIT"" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS SHOULDER IN SERVING ALL PATIENTS RE"

SCHEDULE H, PART VI, QUESTION 5
"HNMC PROMOTES THE HEALTH OF ITS COMMUNITIES IN A VARIETY OF WAYS. PLEASE REFER TO ""PROMOTION OF COMMUNITY HEALTH"" WITHIN THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O FOR ADDITIONAL INFORMATION."

SCHEDULE H, PART VI; QUESTION 6
"OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES. PEACE MINISTRIES, INC. ---------------------- PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT OF THE SYSTEM. THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER PEACE MINISTRIES, INC. OR HOLY NAME MEDICAL CENTER, INC. THE SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS IN THE STATE OF NEW JERSEY. THE PRIMARY ACTIVITY OF THE ORGANIZATION IS TO GOVERN, SUPPORT AND ADVOCATE FOR THE PUBLIC CHARITABLE MINISTRIES OF THE EASTERN REGION OF THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF PEACE. PEACE MINISTRIES, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). HOLY NAME MEDICAL CENTER ------------------------ HOLY NAME MEDICAL CENTER IS A COMPREHENSIVE, 361-BED ACUTE CARE FACILITY PROVIDING TECHNOLOGICALLY ADVANCED AND LEADING EDGE CARE ACROSS A CONTINUUM THAT ENCOMPASSES EDUCATION, PREVENTION, DIAGNOSIS, TREATMENT, REHABILITATION AND WELLNESS MAINTENANCE. OVER 1,000 PHYSICIANS, REPRESENTING DOZENS OF MEDICAL SPECIALTIES, PROVIDE PERSONAL ATTENTION IN A CULTURALLY SENSITIVE ENVIRONMENT, CREATING AN EXCEPTIONAL HEALTH CARE EXPERIENCE FOR EVERY PATIENT. HNMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, HNMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. 1. HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. HNMC OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. HNMC MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF HNMC RESTS WITH ITS BOARD OF TRUSTEES AND, TO THE EXTENT SET FORTH IN ITS BYLAWS, PEACE MINISTRIES, INC. HNMC'S BOARD IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. HOLY NAME HEALTH CARE FOUNDATION, INC. -------------------------------------- HOLY NAME HEALTH CARE FOUNDATION, INC. IS A NON-PROFIT CORPORATION THAT WAS ESTABLISHED TO RAISE FUNDS FOR THE MEDICAL CENTER AND ITS AFFILIATED ORGANIZATIONS. HOLY NAME HEALTH CARE FOUNDATION, INC. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). HOLY NAME REAL ESTATE CORPORATION --------------------------------- HOLY NAME REAL ESTATE CORPORATION IS A NON-PROFIT CORPORATION WHICH WAS ORGANIZED TO OWN, LEASE AND OPERATE PROPERTY FOR THE BENEFIT OF THE MEDICAL CENTER AND ITS AFFILIATED ORGANIZATIONS. HOLY NAME REAL ESTATE CORPORATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). HOLY NAME EMS, INC. ------------------ HOLY NAME EMS, INC. IS A NON-PROFIT CORPORATION WHICH OWNS AND OPERATES THE MEDICAL CENTER'S BASIC LIFE SUPPORT (""BLS"") AND ADVANCED LIFE SUPPORT (""ALS"") MEDICAL INTENSIVE CARE VEHICLES AND SERVICES; HOLY NAME EMS, INC. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). MS COMPREHENSIVE CARE CENTER ---------------------------- MS COMPREHENSIVE CARE CENTER IS A NON-PROFIT CORPORATION WHICH OFFERS COMPREHENSIVE MEDICAL, NURSING, BILLING, REHABILITATIVE, PSYCHOLOGICAL AND EDUCATIONAL CARE TO PATIENTS WITH MULTIPLE SCLEROSIS. MS COMPREHENSIVE CARE CENTER IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE CRUDEM FOUNDATION, INC. --------------------------- THE CRUDEM FOUNDATION, INC. IS A NON-PROFIT CORPORATION WHICH WAS ESTABLISHED TO RAISE FUNDS FOR THE HOSPITAL SACRE COEUR IN MILOT HAITI. THE CRUDEM FOUNDATION, INC. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). HOLY NAME HEALTH PHYSICIANS, P.C. --------------------------------- HOLY NAME HEALTH PHYSICIANS, P.C. IS A NON-PROFIT PROFESSIONAL CORPORATION WHICH ENGAGES IN PROFESSIONAL MEDICAL HEALTHCARE SERVICES WHICH ARE HIGH QUALITY AND COST EFFECTIVE FOR THE BENEFIT OF THE COMMUNITY AND IN SUPPORT OF THE CHARITABLE PURPOSES OF HOLY NAME MEDICAL CENTER AND ITS AFFILIATES. HOLY NAME HEALTH PHYSICIANS, P.C. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). HOLY NAME HEALTH, INC. ---------------------- Holy Name Health, Inc. is a non-profit corporation which supports the charitable purposes and tax-exempt activities of Holy Name Medical Center. The organization is currently inactive. Holy Name Health, Inc. is recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(C)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(A)(3). HNH FITNESS, LLC ---------------- HNH FITNESS, LLC IS A SINGLE MEMBER LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS HOLY NAME MEDICAL CENTER. THE ORGANIZATION OPERATES A MEDICALLY BASED FITNESS AND WELLNESS CENTER AND PHYSICAL THERAPY PRACTICE. HOLY NAME MEDICAL CENTER ACO, LLC --------------------------------- HOLY NAME MEDICAL CENTER ACO, LLC IS A SINGLE MEMBER LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS HOLY NAME MEDICAL CENTER. THE ORGANIZATION OPERATES AS ACCOUNTABLE CARE ORGANIZATION. HARMONY HEALTH ALLIANCE, LLC ---------------------------- HARMONY HEALTH ALLIANCE, LLC IS A SINGLE MEMBER LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS HOLY NAME MEDICAL CENTER. THE ORGANIZATION IS A CLINICALLY INTEGRATED NETWORK OF HEALTHCARE PROVIDERS WITH THE GOAL OF PROVIDING IMPROVED PATIENT CARE QUALITY, EXPERIENCE, EFFICIENCY AND ENGAGEMENT. HEALTH PARTNER SERVICES, INC. ----------------------------- HEALTH PARTNER SERVICES, INC. IS AN ENTITY ENGAGED IN PROVIDING MANAGEMENT SERVICES FOR HEALTHCARE PROVIDERS. PAIX TECHNOLOGIES, INC. ----------------------- PAIX TECHNOLOGIES, INC. IS AN ENTITY ENGAGED IN SELLING A SOFTWARE LICENSE FOR DEVELOPED APPLICATIONS. HOLY NAME PHYSICIAN NETWORK --------------------------- THE HOLY NAME PHYSICIAN NETWORK WAS FORMED ACCORDING TO EACH GROUP'S SPECIALIZED PRACTICE. THE ENTITIES WITHIN THE HOLY NAME PHYSICIAN NETWORK ARE OUTLINED BELOW: - PEACE HEALTH PARTNERS, P.C.; - HOUSE PHYSICIAN PARTNERS, P.C.; - HEMATOLOGY ONCOLOGY PARTNERS, P.C.; - RIVERSIDE FAMILY PRACTICE, P.C.; - RADIATION ONCOLOGY PARTNERS, P.C.; - EXCELCARE MEDICAL ASSOCIATES, P.A.; - BREAST IMAGING PARTNERS, P.C.; - HOLY NAME CARDIOLOGY ASSOCIATES, P.C.; - BREAST CARE PARTNERS, P.C.; - HOLY NAME PULMONARY ASSOCIATES, P.C.; - WOMEN'S CLINIC PARTNERS, P.C.; - MULKAY CARDIOLOGY CONSULTANTS AT HOLY NAME MEDICAL CENTER; - HOLY NAME PRIMARY CARE & SPECIALTY ASSOCIATES, P.C.; - PRIMARY CARE OF ORADELL; - HOLY NAME MEDICAL ASSOCIATES, P.C.; - NORTH JERSEY MEDICAL ASSOCIATES, P.C.; - NORTH JERSEY MEDICAL PARTNERS, P.C.; - HOLY NAME PHYSICIAN PARTNERS, P.C.; AND - HOLY NAME ANESTHESIA PARTNERS, P.C. THESE ORGANIZATIONS ENGAGE IN PROFESSIONAL MEDICAL HEALTHCARE SERVICES WHICH ARE HIGH QUALITY AND COST EFFECTIVE FOR THE BENEFIT OF THE COMMUNITY AND IN SUPPORT OF THE CHARITABLE PURPOSES OF HOLY NAME MEDICAL CENTER AND ITS AFFILIATES."

SCHEDULE H, PART VI; QUESTION 7
NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY SUBMIT A COMMUNITY BENEFIT REPORT.

SCHEDULE H, PART III, SECTION A, QUESTIONS 2, 3 & 4
BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM ITS FINANCIAL STATEMENTS, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. HNMC AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE BELOW WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF HNMC AND SUBSIDIARIES. PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE ----------------------------------------------------------- NET PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION FOR WHICH THE MEDICAL CENTER EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THE MEDICAL CENTER USES A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR CATEGORIES OF PATIENT CONTRACTS AS COLLECTIVE GROUPS RATHER THAN RECOGNIZING REVENUE ON AN INDIVIDUAL CONTRACT BASIS. THE PORTFOLIO CONSISTS OF MAJOR PAYOR CLASSES FOR INPATIENT AND OUTPATIENT REVENUE. BASED ON HISTORICAL COLLECTION TRENDS AND OTHER ANALYSES, THE MEDICAL CENTER BELIEVES THAT REVENUE RECOGNIZED BY UTILIZING THE PORTFOLIO APPROACH APPROXIMATES THE REVENUE THAT WOULD HAVE BEEN RECOGNIZED IF AN INDIVIDUAL CONTRACT APPROACH WERE USED. THE MEDICAL CENTER'S INITIAL ESTIMATE OF THE TRANSACTION PRICE FOR THE SERVICES PROVIDED TO PATIENTS SUBJECT TO REVENUE RECOGNITION IS DETERMINED BY REDUCING THE TOTAL STANDARD CHARGES RELATED TO THE PATIENT SERVICES PROVIDED BY VARIOUS ELEMENTS OF VARIABLE CONSIDERATION, INCLUDING CONTRACTUAL ADJUSTMENTS, DISCOUNTS, IMPLICIT PRICE CONCESSIONS, AND OTHER REDUCTIONS TO THE MEDICAL CENTER'S STANDARD CHARGES. THE MEDICAL CENTER DETERMINES THE TRANSACTION PRICE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL OR FORMULA DRIVEN RATES FOR THE SERVICES RENDERED (SEE DESCRIPTION OF THIRD-PARTY PAYMENT PROGRAMS BELOW). THE ESTIMATES FOR CONTRACTUAL ALLOWANCES AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, THE MEDICAL CENTER'S DISCOUNT POLICIES AND HISTORICAL EXPERIENCE. FOR UNINSURED AND UNDER-INSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE MEDICAL CENTER DETERMINES THE TRANSACTION PRICE ASSOCIATED WITH SERVICES RENDERED ON THE BASIS OF CHARGES REDUCED BY IMPLICIT PRICE CONCESSIONS. IMPLICIT PRICE CONCESSIONS INCLUDED IN THE ESTIMATE OF THE TRANSACTION PRICE ARE BASED ON THE MEDICAL CENTER'S HISTORICAL COLLECTION EXPERIENCE FOR APPLICABLE PATIENT PORTFOLIOS. GENERALLY, THE MEDICAL CENTER BILLS PATIENTS AND THIRD-PARTY PAYORS AFTER THE SERVICES ARE PERFORMED AND THE PATIENT IS DISCHARGED. NET PATIENT SERVICE REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE MEDICAL CENTER. NET PATIENT SERVICE REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL CHARGES. THE MEDICAL CENTER BELIEVES THAT THIS METHOD PROVIDES A REASONABLE DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE SERVICES NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES OR PATIENTS RECEIVING SERVICES IN THE MEDICAL CENTER'S OUTPATIENT SETTINGS. THE MEDICAL CENTER MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE MEDICAL CENTER OR THE COMMENCEMENT OF AN OUTPATIENT SERVICE TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE OR THE COMPLETION OF THE OUTPATIENT VISIT. AS SUBSTANTIALLY ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, THE MEDICAL CENTER HAS ELECTED TO NOT DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT ACUTE CARE SERVICES AT THE END OF THE REPORTING PERIOD FOR PATIENTS WHO REMAIN ADMITTED AT THAT TIME (IN-HOUSE PATIENTS). THE PERFORMANCE OBLIGATIONS FOR IN-HOUSE PATIENTS ARE GENERALLY COMPLETED WHEN THE PATIENTS ARE DISCHARGED, WHICH FOR THE MAJORITY OF THE MEDICAL CENTER'S IN-HOUSE PATIENTS OCCURS WITHIN DAYS OR WEEKS AFTER THE END OF THE REPORTING PERIOD. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. FOR THE YEAR ENDED DECEMBER 31, 2021, CHANGES IN THE MEDICAL CENTER'S ESTIMATES OF IMPLICIT PRICE CONCESSIONS, DISCOUNTS, CONTRACTUAL ADJUSTMENTS OR OTHER REDUCTIONS TO EXPECTED PAYMENTS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS WERE NOT SIGNIFICANT. PORTFOLIO COLLECTION ESTIMATES ARE UPDATED BASED ON COLLECTION TRENDS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AS OF AN FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020 WERE NOT SIGNIFICANT. THE MEDICAL CENTER HAS DETERMINED THAT THE NATURE, AMOUNT, TIMING AND UNCERTAINTY OF REVENUE AND CASH FLOWS ARE AFFECTED BY THE FOLLOWING FACTORS: PAYORS, LINES OF BUSINESS AND TIMING OF WHEN REVENUE IS RECOGNIZED.

SCHEDULE H, PART III, SECTION B, QUESTION 9B
"ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE BUT, RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF HOLY NAME MEDICAL CENTER AND ITS SUBSIDIARIES TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. ADDITIONALLY, HNMC IS COMMITTED TO BILL PATIENTS AND INSURANCE CARRIERS IN A MANNER THAT IS UNDERSTANDABLE, PROFESSIONAL, COMPASSIONATE AND IN COMPLIANCE WITH ALL STATE, LOCAL AND FEDERAL RULES INCLUDING INTERNAL REVENUE CODE SECTION 501(R). IT IS THE INTENTION THAT THE BILLING AND COLLECTION POLICY BE CONSISTENT WITH HNMC'S FINANCIAL ASSISTANCE POLICY (""FAP"") AND ANY INCONSISTENCIES SHALL BE GUIDED BY THE FAP AND APPLIED IN A MANNER THAT BENEFITS THE PATIENT. HNMC WILL FOLLOW THE FOLLOWING PROCEDURES WHEN PURSUING BILLING AND COLLECTION ACTIONS: (1) PATIENTS SHALL BE REGISTERED IN THE HOSPITAL'S INFORMATION SYSTEM IN A MANNER THAT ENSURES THE CAPTURE OF THE INFORMATION NECESSARY TO EFFECTIVELY PROVIDE MEDICALLY NECESSARY CARE AND TO PROFESSIONALLY BILL FOR SERVICES RENDERED; (2) AFTER SERVICES ARE RENDERED THE PATIENTS OR GUARANTOR'S INSURANCE (IF ANY) SHALL BE BILLED. IF THE PATIENT HAS NO INSURANCE AND WAS REGISTERED SELF-PAY THE BILL FOR SERVICES WILL BE ADJUSTED IN ACCORDANCE WITH THE HOSPITAL'S FAP; (3) THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO COLLECT FROM AN INSURANCE CARRIER PRIOR TO BILLING THE PATIENT FOR SERVICES RENDERED. IF AFTER REASONABLE EFFORTS ARE MADE TO COLLECT FROM THE INSURANCE CARRIER THE HOSPITAL SHALL SEEK ASSISTANCE FROM THE PATIENT TO CONTACT THE INSURANCE CARRIER AND RESOLVE THE OUTSTANDING CLAIM. IF THESE EFFORTS ARE NOT SUCCESSFUL THEN THE ACCOUNT MAY BE CHANGED TO A SELF-PAY ACCOUNT; (4) AFTER THE ACCOUNT, OR ANY PORTION OF SUCH ACCOUNT, IS DEEMED SELF-PAY THE HOSPITAL, OR IT'S DESIGNATED AGENT, WILL BILL THE PATIENT OR GUARANTOR FOR THE REMAINING BALANCE ON THE ACCOUNT; (5) ACCOUNTS THAT ARE DEEMED SELF-PAY WILL RECEIVE UP TO FOUR STATEMENTS AND/OR NOTICES ASKING THAT THE ACCOUNT BALANCE BE PAID; (6) AFTER EXHAUSTING REASONABLE EFFORTS OVER A PERIOD OF UP TO 120 DAYS TO COLLECT A SELF-PAY BALANCE, THE HOSPITAL MAY REFER THE ACCOUNT TO A COLLECTION AGENCY. SUCH REFERRAL SHALL NOT BE DEEMED TO BE AN EXTRAORDINARY COLLECTION ACTION (""ECA""); (7) AN ACCOUNT WITH A COLLECTION AGENCY SHALL GENERALLY BE PURSUED UP TO 180 DAYS UNLESS, AFTER CONSULTING WITH THE HOSPITAL, IT IS DETERMINED TO MAINTAIN AN ACCOUNT BEYOND THAT TIMEFRAME. IF IT IS DETERMINED BY THE HOSPITAL'S PATIENT FINANCIAL SERVICES DEPARTMENT THAT THE ACCOUNT REQUIRES AN ECA, AND SUCH ACCOUNT MEETS THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R), INCLUDING BUT NOT LIMITED TO WAITING A MINIMUM OF 120 DAYS AFTER THE FIRST POST DISCHARGE BILL TO COMMENCE ECA ACTIVITIES, THE AGENCY SHALL NOTIFY THE PATIENT IN WRITING A MINIMUM OF 30 DAYS PRIOR TO COMMENCING ECA. SUCH NOTIFICATION SHALL INCLUDE A COPY OF THE HOSPITALS PLAIN LANGUAGE SUMMARY OF THE FAP ALONG WITH A STATEMENT AS TO WHICH ECA'S THE AGENCY MAY BE TAKING. IF WITHIN THE 30 DAY NOTICE PERIOD THE PATIENT REQUESTS FINANCIAL ASSISTANCE, AND THE ACCOUNT IS NOT OLDER THAN 240 DAYS FROM THE FIRST POST DISCHARGE BILL, THEN THE PATIENT SHALL BE GIVEN TIME TO APPLY FOR FINANCIAL ASSISTANCE BEFORE ANY ECAS MAY BE INITIATED. IN THE EVENT THAT AN ECA HAS BEEN INITIATED AND THE ACCOUNT IS NOT OLDER THAN 240 DAYS FROM THE FIRST POST DISCHARGE BILLING DATE AND THE PATIENT REQUESTS FINANCIAL ASSISTANCE THEN THE ECA WILL BE SUSPENDED TO ALLOW FOR THE PATIENT TO APPLY FOR FINANCIAL ASSISTANCE. THE FIRST POST DISCHARGE BILL SHALL BE THE FIRST BILL A PATIENT RECEIVES FOR SERVICES REGARDLESS IF SERVICES ARE ONGOING. ECA'S THAT THE HOSPITAL OR ITS AGENTS MAY TAKE UPON THE EXPIRATION OF THE NOTIFICATION PERIOD INCLUDE: - REPORTING ADVERSE INFORMATION TO A CREDIT REPORTING AGENCY; - PLACING A LIEN ON PROPERTY; AND - GARNISHING WAGES."

SCHEDULE H, PART VI, QUESTION 2
"IN ACCORDANCE WITH PROVISIONS OF THE AFFORDABLE CARE ACT, ENACTED MARCH 23, 2010, HNMC BEGAN A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (""CHNA""). THE ORGANIZATION'S 1ST CHNA WAS COMPLETED IN 2013, ITS 2ND IN 2016, AND ITS MOST RECENT IN 2019. A COMPLETE NEEDS ASSESSMENT IS PERFORMED EVERY THREE YEARS AND IS MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. IN ADDITION TO THE CHNA PROCESS DESCRIBED ABOVE AND IN SCHEDULE H, SECTION B, QUESTIONS 1-12 AND SECTION C, HNMC UTILIZES A VARIETY OF MEANS BY WHICH IT IDENTIFIES AND ANALYZES PATIENT CARE NEEDS. AMONG THEM ARE: - PATIENT SATISFACTION DATA; - ANALYSIS OF DEMOGRAPHICS; - ANALYSIS OF UTILIZATION AND MARKET TRENDS; - REVIEW OF EXTERNALLY PUBLISHED DATA AND INFORMATION; - ACUITY LEVELS (DAILY PLANNING OF STAFFING); AND - INDIVIDUAL PROJECTS/EVALUATION/REVIEWS. HNMC ALSO COMMISSIONS EXTERNAL SPECIALISTS TO CONDUCT SURVEYS AND FOCUS GROUPS OF INDIVIDUALS, HOUSEHOLDS, PHYSICIANS AND OTHERS. ADDITIONALLY, HNMC IS A MEMBER OF THE BERGEN COUNTY COMMUNITY HEALTH IMPROVEMENT PROGRAM (""CHIP""), WHOSE MISSION IS TO EVALUATE AND ADDRESS THE HEALTH NEEDS OF THE COUNTY. THE CHIP PRODUCES AN EXTENSIVE, VERY USEFUL, DATABASE DEMONSTRATING THE NEEDS OF THE COUNTY'S RESIDENTS. HNMC IS A FOUNDING MEMBER OF THE NORTHERN NEW JERSEY MATERNAL-CHILD HEALTH CONSORTIUM (NOW THE PARTNERSHIP FOR MATERNAL AND CHILD HEALTH OF NORTHERN NEW JERSEY), WHOSE MISSION IS TO EDUCATE AND PROMOTE APPROPRIATE HEALTHCARE TO WOMAN AND INFANTS IN THE AREA. IN ADDITION, US CENSUS BUREAU DATA IS UTILIZED, AS IS PURCHASED MARKET DATA AND DATABASES OF ALL ACUTE AND SAME-DAY CARE THROUGHOUT BOTH NEW JERSEY AND NEW YORK, THE SOURCE OF WHICH IS BILLING DATA PROVIDED TO THE RESPECTIVE STATE DEPARTMENTS OF HEALTH. SUCH DATABASES PROVIDE PERHAPS THE GREATEST WEALTH OF CLINICAL, DEMOGRAPHIC, FINANCIAL AND OTHER INFORMATION, AND ARE EXTREMELY VALUABLE IN UNDERSTANDING AND ADDRESSING THE NEEDS OF THE COMMUNITIES SERVED BY HNMC. DATA FROM THE COUNTY AND STATE HEALTH DEPARTMENTS, AND FROM THE NEW JERSEY HOSPITAL ASSOCIATION, ARE ALSO USED. IN ADDITION, THE MEDICAL CENTER PARTICIPATES IN VARIOUS POPULATION HEALTH MODELS, AND HAS DONE SO SINCE 2013. AMONG THESE ARE THREE BUNDLED PAYMENT PROGRAMS AND A MEDICARE SHARED SAVINGS PROGRAM, AN ACO. IN ADDITION, THE HOSPITAL IS IN FIVE OTHER ACOS. THESE PROGRAMS PROIVDE CLAIMS DATA, WHICH ARE ANALYZED, PROVIDING VALUABLE INSIGHTS INTO CARE NEEDS AND INTO WAYS TO FACILITATE BETTER HEALTH AND HEALTH CARE WHILE REDUCING COSTS."

SCHEDULE H, PART VI, QUESTION 3
"IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) HOLY NAME MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY WIDELY PUBLICIZING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS WIDELY PUBLICIZED IN THE FOLLOWING WAYS: 1) TO ENSURE THE COMMUNITY SERVED BY HNMC IS AWARE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, INFORMATIVE SIGNS AND POSTERS ARE POSTED IN ENGLISH, SPANISH AND KOREAN. THESE SIGNS AND POSTERS ADVISE PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO APPLY IN PUBLIC ACCESS AREAS (EMERGENCY ROOM AND PATIENT ACCESS). 2) THE COMPLETE FINANCIAL ASSISTANCE POLICY (""FAP""), PLAIN LANGUAGE SUMMARY (""PLS"") AND FINANCIAL ASSISTANCE APPLICATION FORM AS WELL AS THE CHARITY CARE APPLICATION IS AVAILABLE ON HNMC'S WEBSITE AT: WWW.HOLYNAME.ORG/FINANCIAL. 3) THE FAP, APPLICATION AND PLS ARE ALSO AVAILABLE UPON REQUEST A FREE COPY IS AVAILABLE BY MAIL OR IN HARD COPY FORM AT HNMC'S FINANCIAL COUNSELING OFFICE AND PATIENT ACCESS DEPARTMENT ON THE MAIN FLOOR. THE ORGANIZATION'S FINANCIAL COUNSELING OFFICE IS OPEN MONDAY THROUGH FRIDAY BETWEEN 8:30AM TO 2:30PM. AN APPOINTMENT MAY BE SCHEDULED BY CALLING (201) 833-3157. 4) DURING THE INTAKE REGISTRATION PROCESS, THE PLS IS PROVIDED TO ALL PATIENTS. 5) HNMC HAS TRANSLATED ITS FAP, FINANCIAL ASSISTANCE APPLICATION FORM, AND THE PLS IN OTHER LANGUAGES WHERE THE PRIMARY LANGUAGE OF THE RESIDENTS OF THE COMMUNITY SERVED BY HNMC REPRESENTS 5% OR 1,000; WHICHEVER IS LESS; OF THE POPULATION OF INDIVIDUALS LIKELY TO BE AFFECTED OR ENCOUNTERED BY HNMC. TRANSLATED VERSIONS ARE ALSO AVAILABLE UPON REQUEST AND ARE POSTED ON HNMC'S WEBSITE. IN CIRCUMSTANCES WHERE A SIGNIFICANT NUMBER OF PATIENTS ARE NOT PROFICIENT IN READING AND WRITING ENGLISH, OR WHOSE PRIMARY LANGUAGE IS OTHER THAN WHAT HNMC HAS ALREADY TRANSLATED, MAY REQUEST ASSISTANCE IN ORDER TO COMPLETE REQUIRED FORMS."

SCHEDULE H, PART VI, QUESTION 4
"LOCATED IN TEANECK, IN THE SOUTHERN PORTION OF BERGEN COUNTY AND APPROXIMATELY FIVE MILES TO THE NORTHWEST OF NEW YORK CITY, HNMC'S PRIMARY SERVICE AREA (""PSA"") COMPRISES 15 MUNICIPALITIES IN BERGEN COUNTY AND 3 MUNICIPALITIES IN HUDSON COUNTY, NEW JERSEY. HNMC'S SECONDARY SERVICE AREA (""SSA"") INCLUDES 17 MUNICIPALITIES IN BERGEN COUNTY AND 2 MUNICIPALITIES IN HUDSON COUNTY. TOGETHER, THE PSA AND SSA ACCOUNT FOR APPROXIMATELY 80 PERCENT OF THE MEDICAL CENTER'S ADMISSION VOLUME. AS THE SOLE CATHOLIC HOSPITAL IN AN AREA THAT IS ESTIMATED AT MORE THAN 50% ROMAN CATHOLIC, HNMC ALSO DRAWS FROM TOWNS WELL BEYOND BOTH THE PSA AND SSA. THE MAJORITY OF PSA TOWNS HAVE AN AVERAGE POPULATION OF 27,500, AND ARE LOCATED IN THE SOUTHERN HALF OF BERGEN COUNTY. OVERALL, THE SERVICE AREA IS 44% HISPANIC, ALTHOUGH THE PROPORTIONS DIFFER MARKEDLY BETWEEN BERGEN AND HUDSON: 76% OF THE RESIDENTS OF BERGEN PSA TOWNS ARE NOT HISPANIC; WHILE THE FOUR HUDSON COUNTY TOWNS TOGETHER COUNT 76% OF THEIR RESIDENTS AS HISPANIC. THE RACIAL MIX OF THE PSA IS APPROXIMATELY 60% WHITE, 22% ASIAN, 10% BLACK, AND 8% OTHER, INCLUDING MULTI-RACIAL PERSONS. CERTAIN TOWNS IN THE REGION ARE HEAVILY KOREAN; KOREAN/ASIAN PRESENCE IS MUCH LESS PRONOUNCED IN THE FOUR HUDSON COUNTY TOWNS. THE BROAD AGE MAKE-UP OF THE PRIMARY SERVICE AREA INCLUDES 23% AGED UP TO 19; 50% AGED 20-54; AND 27% AGED 55 AND OLDER. THE LAST CATEGORY IS PROJECTED TO SEE THE MOST SIGNIFICANT GROWTH DURING THE NEXT FIFTEEN YEARS. WITH THE EXCEPTION OF TWO HUDSON COUNTY TOWNS, ALL SSA ZIP CODES ARE LOCATED THROUGHOUT BERGEN COUNTY. THE TOWNS IN THIS SERVICE AREA ARE MUCH SMALLER THAN THOSE OF THE PSA, AVERAGING ONLY 14,000 RESIDENTS EACH. IN STARK CONTRAST TO THE LARGELY HISPANIC HUDSON COUNTY PSA TOWNS, THE TWO HUDSON SSA TOWNS ARE ONLY 20% HISPANIC. THE OVERALL RACIAL MIX OF THE SERVICE AREA IS 76% WHITE, 13% ASIAN, 4% BLACK, AND 7% OTHER, INCLUDING MULTI-RACIAL PERSONS. THE OVERALL KOREAN PRESENCE IS SIGNIFICANT, BUT ONLY HALF THAT SEEN IN THE PRIMARY SERVICE AREA. THE AREA'S AGE MIX IS SIMILAR TO THE PSA, WITH 23% AGED UP TO 19; 51% AGED 20-54; AND 26% AGED 55 AND OLDER. THE MEDICAL CENTER'S SERVICE AREA IS PRIMARILY SUBURBAN, WITH MANY RESIDENTS WORKING OUTSIDE BERGEN COUNTY IN PLACES SUCH AS NEW YORK CITY. HOWEVER, THERE ARE LARGE EMPLOYERS IN THE SERVICE AREA, E.G., OTHER HOSPITALS, A LARGE SPORTS CHAIN, A LARGE COMMUNICATIONS FIRM, A LARGE PHARMACEUTICAL FIRM, A UNIVERSITY, AND A LARGE COMMERCIAL LABORATORY. RESIDENTS OF HNMC'S SERVICE AREA ARE ALSO SERVED BY TWO COMMUNITY HOSPITALS AND A TERTIARY CARE FACILITY WITH TRAUMA SERVICES. GIVEN THE NUMBER OF SERVICE AREA RESIDENTS WHO WORK IN NEARBY NEW YORK CITY, IT IS NOT SURPRISING THAT A SMALL PORTION OF THESE RESIDENTS ALSO RECEIVE THEIR HEALTHCARE IN MANHATTAN. HNMC'S PSA AND SSA COVER A MAJORITY OF THE TOWNS SERVICED BY THE OTHER COMMUNITY HOSPITALS, WHEREAS THE TERTIARY CARE FACILITY'S PRIMARY SERVICE AREA ALSO INCLUDES MANY TOWNS TO THE WEST THAT ARE NOT PART OF HNMC'S SERVICE AREA. NEW JERSEY IS EXPERIENCING SIGNIFICANT CONSOLIDATION OF FORMERLY INDEPENDENT HOSPITALS INTO ANY OF THREE LARGE SYSTEMS. TWO OF THE THREE HOSPITALS WITHIN HNMC'S SERVICE AREA ARE PART OF NEW JERSEY'S LARGEST SYSTEM; THE THIRD IS AWAITING APPROVAL TO JOIN THEM. WHILE THE SERVICE AREA IS PREDOMINANTLY NON-HISPANIC CAUCASIAN, BOTH HISPANICS (OF ANY RACE) AND ASIAN POPULATIONS (PRINCIPALLY KOREAN) ARE THE FASTEST GROWING GROUPS. IN RESPONSE, THE MEDICAL CENTER HAS PROGRAMS ADDRESSING THESE GROUPS' NEEDS, AND PHYSICIANS AND NURSES FLUENT IN THE APPLICABLE LANGUAGES. As the Asian population in Bergen County and the surrounding area continues to expand, Holy Name Medical Center is addressing the community's medical needs with a comprehensive, robust program, Asian Health Services (AHS). Through AHS, Holy Name provides Asian patients with high quality health care in their native language and in an environment sensitive to their culture."