4A (Expenses $ 193648281 including grants of $ 92796) (Revenue $ 234784472)
EXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY MEDICALLY NECESSARY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT (STATEMENT OF PROGRAM SERVICES) WHICH INCLUDES DETAILED INFORMATION REGARDING THE VARIOUS SERVICES PROVIDED BY THIS ORGANIZATION.

SCHEDULE H, PART V, SECTION B, QUESTION 5
"IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT (""CHNA"") THIS ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITAL FACILITIES. THIS ORGANIZATION WORKED IN COLLABORATION WITH THE WALTER RAND INSTITUTE FOR PUBLIC AFFAIRS (""WRI"") AT RUTGERS UNIVERSITY-CAMDEN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM TO CONDUCT THE CHNA. FOR THE PURPOSE OF THIS ASSESSMENT, COMMUNITY IS DEFINED AS THE THREE COUNTIES IN THE INSPIRA HEALTH NETWORK SERVICE AREA (GLOUCESTER, CUMBERLAND, AND SALEM COUNTIES). TO ACHIEVE THE GOAL OF OBTAINING LOCALLY ACTIONABLE INFORMATION FOR IMPROVING HEALTH, THIS CHNA EMPLOYED A MIXED-METHODS ITERATIVE STRATEGY OF DATA COLLECTION THAT COMBINED QUANTITATIVE AND QUALITATIVE ANALYSIS OF PRIMARY DATA COLLECTED FROM COMMUNITY MEMBERS WITH QUANTITATIVE ANALYSIS OF SECONDARY DATA. THE TWO FUNDAMENTALS OF OUR APPROACH ARE RIGOROUS DATA ANALYSIS AND COMMUNITY VOICE; TO THAT END, WE USED A VARIETY OF METHODS AND TOOLS TO ANALYZE THE DATA WE COLLECTED FROM PARTICIPANTS AND SOURCES IDENTIFIED THROUGH CONSULTATION WITH TRUSTED COMMUNITY PARTNERS IN EACH COUNTY. KEY INFORMANT INTERVIEWS ------------------------ KEY INFORMANTS WERE INTERVIEWED TO GATHER A COMBINATION OF QUANTITATIVE AND QUALITATIVE FEEDBACK THROUGH OPEN-ENDED QUESTIONS. KEY INFORMANTS WERE DEFINED AS COMMUNITY STAKEHOLDERS WITH EXPERT KNOWLEDGE AND INCLUDED PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS, SOCIAL SERVICE PROVIDERS, NON-PROFIT LEADERS, BUSINESS LEADERS, FAITH-BASED ORGANIZATIONS, COUNTY GOVERNMENT, AND OTHER COMMUNITY LEADERS. 10 INTERVIEWS WERE CONDUCTED WITH KEY REPRESENTATIVES IN THE COUNTIES AND DESIGNATED INSPIRA HEALTH NETWORK STAFF. THE INTERVIEWS WERE COMPLETED USING A SEMI-STRUCTURED RESEARCH INSTRUMENT. THE PURPOSE OF THE RESEARCH PROJECT WAS EXPLAINED TO POTENTIAL PARTICIPANTS AND INFORMED CONSENT WAS OBTAINED PRIOR TO THE DATA COLLECTION PROCESS, FOLLOWING THE APPROVED IRB PROTOCOL. INTERVIEW PARTICIPANTS WERE ASKED TO THINK ABOUT AND SHARE THEIR PERSPECTIVES ON ACCESS TO CARE, HEALTH EDUCATION AND COMMUNICATION, AS WELL AS THE BARRIERS RESIDENTS FACE IN OBTAINING HEALTH CARE. OTHER AREAS OF INQUIRY INCLUDED THE STRENGTHS OF THE HEALTH CARE SERVICE DELIVERY SYSTEM AS WELL AS ITS WEAKNESSES AND POTENTIAL IMPROVEMENTS. BOTH THE RESEARCH INSTRUMENT AND THE PROTOCOL FOR THE INTERVIEW WERE DEVELOPED BASED ON THE GROUNDED THEORY APPROACH WITHIN THE QUALITATIVE RESEARCH FRAMEWORK. FOCUS GROUPS ------------ FOCUS GROUPS WERE CONDUCTED AMONG CUMBERLAND COUNTY RESIDENTS TO GATHER QUALITATIVE FEEDBACK REGARDING ACCESS TO CARE, KEY HEALTH ISSUES, AND HEALTH EDUCATION AND COMMUNICATION. WE CONDUCTED 13 DIFFERENT FOCUS GROUPS WITH COMMUNITY MEMBERS (N=10) AND STAKEHOLDERS (N=3) ACROSS THE THREE COUNTIES. OUR MAIN OBJECTIVE WAS TO GATHER THE COMMUNITY MEMBERS THOUGHTS ON HEALTH ISSUES (SUCH AS ACCESS TO CARE, HEALTH EDUCATION, AND COMMUNICATION) AND ANY BARRIERS RESIDENTS MAY CONFRONT IN OBTAINING CARE. ADDITIONAL AREAS OF INQUIRY INCLUDED THE STRENGTHS OF THE HEALTH CARE SERVICE DELIVERY SYSTEM AS WELL AS ITS WEAKNESSES AND POSSIBLE IMPROVEMENTS. THE FOCUS GROUP FORMAT ALLOWED COMMUNITY MEMBERS TO EXPRESS THEIR OPINIONS, SUGGESTIONS, AND RECOMMENDATIONS IN A CONFIDENTIAL FORMAT. BECAUSE THEY LIVE AND WORK WITHIN THE NETWORKS SERVICE AREAS, COMMUNITY MEMBERS INPUT IS CRUCIAL TO THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOCUS GROUPS PRODUCE A LARGE AMOUNT OF INFORMATION IN A SHORT TIME PERIOD. IN ADDITION, FOCUS GROUPS ELICIT WIDE-RANGING VIEWS ON DESIGNATED TOPICS. OUR FOCUS GROUPS CONSISTED OF A SEMI-STRUCTURED GROUP INTERVIEW. FOCUS GROUPS RANGED IN SIZE FROM 4-20 PARTICIPANTS. INFORMED CONSENT WAS OBTAINED AFTER THE PURPOSE OF THE FOCUS GROUP WAS EXPLAINED AND PRIOR TO THE DATA COLLECTION PROCESS, FOLLOWING THE APPROVED IRB PROTOCOL. ONE RESEARCH TEAM MEMBER FACILITATED THE FOCUS GROUP AND ONE TO TWO ADDITIONAL RESEARCH TEAM MEMBERS TOOK DETAILED NOTES. FOLLOWING EACH FOCUS GROUP, THE RESEARCH TEAM COMPILED A REPORT. COMMUNITY SURVEY ---------------- WE ALSO SOUGHT COMMUNITY ENGAGEMENT THROUGH THE WIDESPREAD DISSEMINATION OF A COMMUNITY SURVEY (N=891). THE SURVEY WAS COMPRISED OF 66 ITEMS, FORMATTED FOR ELECTRONIC AND PAPER DISTRIBUTION BOTH IN ENGLISH AND SPANISH. THE SPANISH SURVEYS WERE TRANSLATED FROM ENGLISH AND THEN BACK-TRANSLATED BY CERTIFIED TRANSLATORS ON THE RESEARCH TEAM. THE PARTICIPANT RESPONSE TIME WAS APPROXIMATELY 15 MINUTES FOR THE ELECTRONIC VERSION AND 30 MINUTES FOR THE PAPER VERSION. THE RESEARCH TEAM UTILIZED QUALTRICS, A WEB-BASED SURVEY PLATFORM, FOR THE DEVELOPMENT AND DISTRIBUTION OF THE ELECTRONIC FORMAT OF THE COMMUNITY SURVEY. SURVEY ITEM FORMATS INCLUDE MULTIPLE CHOICE; FILL IN, LIKERT SCALE, AND RANKING, THE SURVEY WAS LAUNCHED ON JUNE 8, 2018 AND CLOSED ON NOVEMBER 24, 2018 (24 WEEKS) AND WAS DESIGNED TO COMPLEMENT THE QUALITATIVE FOCUS GROUP AND INTERVIEW DATA TO PROVIDE A COMPREHENSIVE PICTURE OF THE HEALTH STATUS, NEEDS, AND RESOURCES AS IDENTIFIED BY RESIDENTS OF CUMBERLAND, GLOUCESTER, AND SALEM COUNTIES."

SCHEDULE H, PART V, SECTION B, QUESTION 6A & 6B
"THE NETWORK WORKED IN COLLABORATION WITH THE WALTER RAND INSTITUTE FOR PUBLIC AFFAIRS (""WRI"") AT RUTGERS UNIVERSITY-CAMDEN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM TO CONDUCT THE CHNA. WRI PROVIDED THE FOLLOWING ASSISTANCE: - COLLECTED AND INTERPRETED DATA FROM SECONDARY DATA SOURCES; - ANALYZED AND INTERPRETED DATA FROM KEY INFORMANT INTERVIEWS; - COLLECTED, ANALYZED, AND INTERPRETED DATA FROM FOCUS GROUPS; - CONDUCTED, ANALYZED, AND INTERPRETED DATA FROM THE ONLINE COMMUNITY SURVEY; AND - PREPARED THE CHNA REPORT."

SCHEDULE H, PART V, SECTION B, QUESTION 7A
"THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; 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.INSPIRAHEALTHNETWORK.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS"

SCHEDULE H, PART V, SECTION B, QUESTION 10A
"THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; 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 ORGANIZATION ISSUED A JOINT IMPLEMENTATION STRATEGY FOR EACH OF THE INSPIRA HEALTH NETWORK HOSPITAL FACILITIES. THIS JOINT IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS"

SCHEDULE H, PART V, SECTION B, QUESTION 11
THE NETWORK HAS CREATED ONE SET OF IMPLEMENTATION STRATEGIES WHICH INCLUDES ALL OF ITS HOSPITAL FACILITIES. THE ORGANIZATION'S JOINT IMPLEMENTATION STRATEGY DESCRIBES THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE ORGANIZATIONS CHNA. THROUGH THE ASSESSMENT OF ITS COMMUNITIES THE ORGANIZATION IDENTIFIED THE FOLLOWING KEY PRIORITIES: OBESITY, SUBSTANCE ABUSE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND TRANSPORTATION. THE ORGANIZATION INTENDS TO TAKE THE FOLLOWING ACTIONS WITH RESPECT TO EACH IDENTIFIED COMMUNITY HEALTH NEED. OBESITY ------- COMMUNITY MEMBERS RANKED OBESITY AS THE TOP HEALTH ISSUE IN THEIR COMMUNITIES. NATIONALLY, OBESITY IS ALSO A CONCERN, WITH HEALTH CARE COSTS AND MORTALITY RELATED TO OBESITY RAPIDLY OVERCOMING TOBACCO-RELATED COSTS/MORTALITY. SINCE 2000, THE ADULT OBESITY RATE IN NEW JERSEY HAS INCREASED BY OVER 60%. THIS PERIOD HAS ALSO SEEN AN INCREASE IN THE BURDEN OF OBESITY-RELATED DISEASES SUCH AS DIABETES, HYPERTENSION, AND HEART DISEASE. PROJECTIONS FOR THE CHRONIC DISEASE BURDEN RELATED TO OBESITY ARE DIRE, WITH AN EXPECTED FOUR-FOLD INCREASE IN THE NUMBER OF HEART DISEASE CASES WITHIN THE NEXT 20 YEARS. EVEN MORE TROUBLING IS THAT OBESITY AND RELATED CHRONIC HEALTH CONDITIONS OCCUR AT HIGHER RATES IN SOUTHERN NEW JERSEY THAN THEY DO IN THE REST OF THE STATE AND NATIONALLY. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - IMPLEMENT COMMUNITY EDUCATION PROGRAMS RELATED TO NUTRITION AND PHYSICAL ACTIVITY - IMPROVE ACCESS TO HEALTHY FOOD THROUGH CHARITABLE CONTRIBUTIONS, EMPLOYEE VOLUNTEER OPPORTUNITIES, AND INNOVATIVE COMMUNITY PARTNERSHIPS - IDENTIFY RISK FACTORS FOR CHRONIC DISEASE THROUGH EARLY DETECTION AND SCREENINGS - INCREASE RESIDENTS AWARENESS OF RISK FACTORS FOR CHRONIC DISEASE SUBSTANCE ABUSE --------------- IN 2017, THE GOVERNOR OF NEW JERSEY DECLARED OPIOID ABUSE A PUBLIC HEALTH CRISIS IN THE STATE. COMMUNITY MEMBERS ALSO EXPRESSED INTENSE CONCERN ABOUT SUBSTANCE ABUSE, THE LACK OF RESOURCES TO COMBAT SUBSTANCES ABUSE, AND THE IMPACT OF SUBSTANCE ABUSE ON FRIENDS AND FAMILY MEMBERS. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - PREVENT PATIENTS FROM BECOMING ADDICTED TO PAIN MEDICATIONS - IDENTIFY PATIENTS WHO ARE ADDICTED TO MEDICATIONS - DECREASE OVERDOSES AND DRUG-INDUCED DEATHS - INCREASE TOBACCO SCREENING IN HEALTH CARE SETTINGS - REDUCE ED UTILIZATION FOR SUBSTANCE ABUSE-RELATED ISSUES MENTAL HEALTH ------------- THE RATES OF SUICIDE ARE INCREASING IN GLOUCESTER, SALEM, AND CUMBERLAND COUNTIES. RATE OF SUICIDE IS HIGHER THAN STATE RATE IN GLOUCESTER, SALEM, AND CUMBERLAND COUNTIES. RESIDENTS REPORT A HIGH NUMBER OF POOR MENTAL HEALTH DAYS. COMMUNITY MEMBERS SAID THAT MENTAL AND BEHAVIORAL HEALTH WERE IMPORTANT ISSUES FACING THEIR COMMUNITIES IN GENERAL, AND THEMSELVES SPECIFICALLY. INCREASE ACCESS TO MENTAL HEALTH TREATMENT IS INCLUDED AMONG THE HEALTHY PEOPLE 2020 OBJECTIVES. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - PARTICIPATE IN COMMUNITY PLANNING PROCESS TO ADDRESS BEHAVIORAL HEALTH AND ACCESS TO SERVICES - INCREASE AWARENESS AND IDENTIFICATION OF MENTAL HEALTH DISORDERS - INCREASE SCREENING FOR BEHAVIORAL HEALTH NEEDS IN PRIMARY CARE AND SPECIALTY CARE SETTINGS - WORK WITH AREA HOSPITALS TO DEVELOP A RANGE OF COLLABORATIVE APPROACHES TO IMPROVE THE CARE OF THE PATIENTS WITH BEHAVIORAL HEALTH CONDITIONS - INCREASE THE PROPORTION OF ADULTS WHO RECEIVE MENTAL HEALTH TREATMENT - INCREASE THE PROPORTION OF HOMELESS ADULTS WHO RECEIVE MENTAL HEALTH SERVICES - REDUCE ED UTILIZATION FOR MENTAL HEALTH RELATED ISSUES - PROVIDE EDUCATION ABOUT WARNING SIGNS OF MENTAL/BEHAVIORAL HEALTH CONDITIONS TRANSPORTATION -------------- COMMUNITY MEMBERS REPORTED THAT PUBLIC TRANSPORTATION WAS AN IMPORTANT MISSING RESOURCE AND THAT ACCESS TO RELIABLE TRANSPORTATION WAS AN IMPORTANT BARRIER TO CARE. ACCESS TO RELIABLE TRANSPORTATION IS IMPORTANT FOR PEOPLE WITH CHRONIC DISEASES. RESEARCH SUGGESTS THAT FOR INDIVIDUALS WITH LIMITED ECONOMIC RESOURCES, TRANSPORTATION TO PROVIDER VISITS AND PHARMACIES MAY BE A SIGNIFICANT BARRIER TO CARE THAT CAN ALTER HEALTH OUTCOMES. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - DEFINE GAPS IN PROCESS, PROCEDURE, AND INFRASTRUCTURE - IMPLEMENT FREE-OF-CHARGE NON-EMERGENT TRANSPORTATION TO PATIENTS WITH ACCESS PROBLEMS TO MEDICAL CARE - COMPLETE SOFTWARE INTEGRATION WITH PROVIDERS FOR COORDINATION OF TRANSPORTATION INSPIRA HEALTH WILL NOT TAKE ACTION ON THE FOLLOWING HEALTH NEED: ACCESS TO HEALTH CARE LACK OF FACILITIES OR PROVIDERS GENERALLY, LACK OF FACILITIES OR PROVIDERS WAS A STRONG CONCERN FOR COMMUNITY MEMBERS IN SALEM COUNTY, AND MUCH LESS OF A CONCERN FOR COMMUNITY MEMBERS IN GLOUCESTER AND CUMBERLAND COUNTIES. INSPIRA HEALTH WILL CONTINUE TO ACKNOWLEDGE THE IMPACT OF THIS HEALTH NEED AND REMAIN COMMITTED TO THE ISSUES THEY REPRESENT. THE HOSPITAL ALSO STAYS COMMITTED TO ADDRESSING ALL THE NEEDS OF THE COMMUNITY WHEN POSSIBLE. DUE TO FINANCIAL RESTRICTIONS AND THE ABILITY OF OTHER INSTITUTIONS TO ADDRESS THE SAME ISSUES. INSPIRA HEALTH WILL FOCUS ON OBESITY, SUBSTANCE ABUSE, MENTAL HEALTH, AND TRANSPORTATION.

SCHEDULE H, PART V, SECTION B, QUESTION 16
"THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; 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.INSPIRAHEALTHNETWORK.ORG/FAP"

SCHEDULE H, PART I; LINE 3C
"IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE ORGANIZATION USES OTHER FACTORS IN DETERMINING ELIGIBILITY CRITERIA FOR FREE AND DISCOUNTED CARE. AS OUTLINED IN PART V, SECTION B, QUESTION 13, OTHER FACTORS TO DETERMINE ELIGIBILITY INCLUDE: - ASSET LEVEL; - MEDICAL INDIGENCY; - INSURANCE STATUS; - UNDERINSURANCE STATUS; AND - RESIDENCY. ADDITIONAL INFORMATION WITH RESPECT TO THE ORGANIZATION'S ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS OUTLINED BELOW. NEW JERSEY HOSPITAL CHARITY CARE PAYMENT ASSISTANCE PROGRAM (""CHARITY CARE"") ------------------------------------------------------------------------- CHARITY CARE IS A NEW JERSEY PROGRAM IN WHICH FREE OR DISCOUNTED CARE IS AVAILABLE TO PATIENTS WHO RECEIVE INPATIENT AND OUTPATIENT SERVICES AT ACUTE CARE HOSPITALS THROUGHOUT THE STATE OF NEW JERSEY. HOSPITAL ASSISTANCE AND REDUCED CHARGE CARE ARE ONLY AVAILABLE FOR NECESSARY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. PATIENTS MAY BE ELIGIBLE FOR CHARITY CARE IF THEY ARE NEW JERSEY RESIDENTS WHO: 1) HAVE NO HEALTH COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE HOSPITAL BILL (UNINSURED OR UNDERINSURED); 2) ARE INELIGIBLE FOR ANY PRIVATE OR GOVERNMENTAL SPONSORED COVERAGE (SUCH AS MEDICAID); AND 3) MEET THE FOLLOWING INCOME AND ASSET ELIGIBILITY CRITERIA DESCRIBED BELOW. INCOME CRITERIA: PATIENTS WITH FAMILY GROSS INCOME LESS THAN OR EQUAL TO 200% OF FEDERAL POVERTY GUIDELINES (""FPG"") ARE ELIGIBLE FOR 100% CHARITY CARE COVERAGE. PATIENTS WITH FAMILY GROSS INCOME GREATER THAN 200% AND LESS THAN OR EQUAL TO 300% OF FPG ARE ELIGIBLE FOR DISCOUNTED CARE. FREE CARE OR PARTIALLY COVERED CHARGES WILL BE DETERMINED BY USE OF THE NEW JERSEY DEPARTMENT OF HEALTH FEE SCHEDULE. IF PATIENTS ON THE 20% TO 80% SLIDING FEE SCALE ARE RESPONSIBLE FOR QUALIFIED OUT-OF-POCKET PAID MEDICAL EXPENSES IN EXCESS OF 30% OF THEIR GROSS ANNUAL INCOME (I.E. BILLS UNPAID BY OTHER PARTIES), THEN THE AMOUNT IN EXCESS OF 30% IS CONSIDERED HOSPITAL CARE PAYMENT ASSISTANCE. ASSET CRITERIA: CHARITY CARE INCLUDES ASSET ELIGIBILITY THRESHOLDS WHICH STATES THAT INDIVIDUAL ASSETS CANNOT EXCEED $7,500 AND FAMILY ASSETS CANNOT EXCEED $15,000 AS OF THE DATE OF SERVICE. CHARITY CARE MAY BE AVAILABLE TO NON-NEW JERSEY RESIDENTS, REQUIRING IMMEDIATE MEDICAL ATTENTION FOR AN EMERGENCY MEDICAL CONDITION. NEW JERSEY UNINSURED DISCOUNT (PUBLIC LAW 2008, C. 60) ------------------------------------------------------ UNINSURED PATIENTS WITH FAMILY GROSS INCOME LESS THAN 500% OF FPG MAY BE ELIGIBLE FOR DISCOUNTED CARE UNDER THIS PROGRAM. ELIGIBLE INDIVIDUALS MUST BE NEW JERSEY RESIDENTS. NJ FAMILYCARE ------------- NJ FAMILYCARE IS NEW JERSEY'S PUBLICLY FUNDED HEALTH INSURANCE PROGRAM WHICH INCLUDES CHIP, MEDICAID AND MEDICAID EXPANSION POPULATIONS. NJ FAMILYCARE IS A FEDERAL AND STATE FUNDED HEALTH INSURANCE PROGRAM CREATED TO HELP QUALIFIED NEW JERSEY RESIDENTS OF ANY AGE ACCESS TO AFFORDABLE HEALTH INSURANCE. NJ FAMILYCARE IS FOR PEOPLE WHO DO NOT HAVE EMPLOYER INSURANCE. FINANCIAL ELIGIBILITY FOR INDIVIDUALS SEEKING ELIGIBILITY FOR NJ FAMILYCARE WILL BE BASED ON THEIR MODIFIED ADJUSTED GROSS INCOME (""MAGI""). NJFAMILYCARE ELIGIBILITY GUIDELINES ARE ESTABLISHED BY THE STATE OF NEW JERSEY AND CAN BE FOUND AT WWW.NJFAMILYCARE.ORG. NEW JERSEY CANCER EDUCATION AND EARLY DETECTION (""NJCEED"") ---------------------------------------------------------- THE NJCEED PROGRAM PROVIDES COMPREHENSIVE OUTREACH, EDUCATION AND SCREENING SERVICES FOR BREAST, CERVICAL, COLORECTAL AND PROSTATE CANCERS. A PATIENT MUST BE UNINSURED OR UNDERINSURED AND MUST HAVE FAMILY GROSS INCOME AT OR BELOW 250% OF FPG TO BE ELIGIBLE. ADDITIONAL INFORMATION CAN BE FOUND AT THE FOLLOWING WEBSITE: WWW.NJ.GOV/HEALTH/CANCER/NJCEED. CATASTROPHIC ILLNESS IN CHILDREN RELIEF FUND -------------------------------------------- THE CATASTROPHIC ILLNESS IN CHILDREN RELIEF FUND PROVIDES FINANCIAL ASSISTANCE TO FAMILIES OF CHILDREN WITH A CATASTROPHIC ILLNESS. IN ORDER TO BE ELIGIBLE, HOSPITAL EXPENSES MUST EXCEED 10% OF THE FAMILY'S GROSS INCOME, PLUS 15% OF ANY EXCESS INCOME OVER $100,000, THE CHILD MUST HAVE BEEN 21 YEARS OR YOUNGER WHEN THE MEDICAL EXPENSES WERE INCURRED AND THE FAMILY MUST HAVE LIVED IN NEW JERSEY FOR THREE MONTHS IMMEDIATELY PRIOR TO THE DATE OF APPLICATION. ADDITIONAL INFORMATION CAN BE FOUND AT THE FOLLOWING WEBSITE: WWW.STATE.NJ.US/HUMANSERVICES/CICRF/HOME. NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE ----------------------------------------------- THE STATE OF NEW JERSEY HAS ESTABLISHED THE NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE TO COMPENSATE VICTIMS OF CRIME FOR LOSSES AND EXPENSES, INCLUDING CERTAIN MEDICAL EXPENSES, RESULTING FROM CERTAIN CRIMINAL ACTS. IN ORDER TO BE ELIGIBLE FOR NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE THE CRIME MUST HAVE OCCURRED IN NEW JERSEY OR MUST RELATE TO A NEW JERSEY RESIDENT VICTIMIZED OUTSIDE OF THE STATE, THE VICTIM MUST HAVE REPORTED THE CRIME TO POLICE WITHIN NINE MONTHS AND VICTIM MUST COOPERATE WITH THE INVESTIGATION AND PROSECUTION OF THE CRIME. THE CLAIM MUST BE FILED WITHIN THREE YEARS OF THE DATE OF THE CRIME AND THE PATIENT MUST BE AN INNOCENT VICTIM OF THE CRIME. ADDITIONAL INFORMATION CAN BE FOUND AT WWW.NJ.GOV/OAG/NJVICTIMS/INDEX.HTML HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM ----------------------------------------------------- PATIENTS THAT DO NOT QUALIFY FOR ANY OF THE GOVERNMENT FUNDED PROGRAMS OR NEW JERSEY CHARITY CARE MAY ELECT TO BE SCREENED BY FINANCIAL COUNSELING FOR THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM. PATIENTS MAY BE ELIGIBLE FOR DISCOUNTS UNDER THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM IF THEIR FAMILY GROSS INCOME IS BETWEEN 225% AND 550% OF FPL. ADDITIONALLY, IF THESE PATIENTS HAVE ASSETS IN EXCESS OF $50,000 THEY MAY BE REQUIRED TO PROVIDE PROOF OF ASSETS. PURSUANT TO INTERNAL REVENUE CODE SECTION 501(R)(5), IN THE CASE OF EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, FAP-ELIGIBLE PATIENTS WILL NOT BE CHARGED MORE THAN AN INDIVIDUAL WHO HAS INSURANCE COVERING SUCH CARE. PATIENTS MAY BE ELIGIBLE FOR THIS DISCOUNT IF THEY ARE UNINSURED AND HAVE FAMILY GROSS INCOME LESS THAN 550% OF FPG. ADDITIONALLY, UNDERINSURED PATIENTS MAY BE ELIGIBLE IF THEIR FAMILY GROSS INCOME IS GREATER THAN 200% BUT LESS THAN OR EQUAL TO 300% OF FPG."

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

SCHEDULE H, PART I; QUESTION 7
THE ORGANIZATION UTILIZED THE COST ACCOUNTING SYSTEM.

SCHEDULE H, PART II
COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY INSPIRA HEALTH NETWORK IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF OUR COMMUNITIES. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. IMC PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS, COMMUNITY AND PROVIDERS. PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS DEDICATE THEIR KNOWLEDGE AND TIME TO ENSURE THE COMMUNITY IS WELL EDUCATED ON TOPICS PROMOTING HEALTHY LIVING.

SCHEDULE H, PART III, SECTION A; QUESTION 4
THE FOOTNOTE BELOW EXPLAINS THE ORGANIZATIONS METHODOLOGY WITH RESPECT TO PATIENT ACCOUNTS RECEIVABLE. THE NETWORK ASSESSES COLLECTABILITY ON PATIENT CONTRACTS PRIOR TO THE RECOGNITION OF NET PATIENT SERVICE REVENUE. PATIENT ACCOUNTS RECEIVABLE, NET, ARE RECORDED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THE NETWORK HAS EXHAUSTED ALL COLLECTION EFFORTS AND DETERMINES ACCOUNTS ARE IMPAIRED BASED ON CHANGES IN CREDIT WORTHINESS.

SCHEDULE H, PART III, SECTION B; QUESTION 8
"MEDICARE COSTS WERE DERIVED FROM THE 2019 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, AS OF 2017, 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"

SCHEDULE H, PART III, SECTION B; QUESTION 9B
"ACCOUNTS CONSIDERED TO BE FINANCIAL ASSISTANCE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF INSPIRA HEALTH NETWORK (""INSPIRA"") TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. ADDITIONALLY, INSPIRA IS COMMITTED TO BILLING PATIENTS AND INSURANCE CARRIERS IN A MANNER THAT IS IN COMPLIANCE WITH ALL STATE, LOCAL AND FEDERAL REGULATIONS. THE ORGANIZATION'S BILLING AND COLLECTION POLICIES AND PROCEDURES ARE OUTLINED WITHIN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (""FAP""). THIS POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ACCORDING TO INSPIRAS BILLING AND COLLECTION POLICY INSPIRA ABIDES BY THE FOLLOWING PROCEDURES WHEN PURSUING BILLING AND COLLECTION ACTIONS: BILLING PROCEDURES ------------------ UNTIL PATIENTS ARE DEEMED ELIGIBLE AND APPROVED FOR FINANCIAL ASSISTANCE UNDER THIS POLICY, INSPIRA WILL CONTINUE ITS NORMAL BILLING AND COLLECTION ACTIVITIES AS FOLLOWS: (1) INSPIRA WILL PROVIDE SUFFICIENT ACCOUNT FOLLOW-UP SERVICE TO ENSURE THAT INSURERS AND PATIENTS RECEIVE ACCURATE ACCOUNT AND BILLING INFORMATION. (2) PATIENTS WILL HAVE THE OPPORTUNITY TO MAKE PAYMENT AND/OR APPLY FOR FINANCIAL ASSISTANCE FOR ALL OUTSTANDING BALANCES. THE BILLING PROCESS IS PERFORMED IN ACCORDANCE WITH THE FOLLOWING GUIDELINES: - FOR ALL INSURED PATIENTS, INSPIRA BILLS ALL THIRD-PARTY PAYER INFORMATION (AS PROVIDED BY OR VERIFIED BY THE PATIENT) ON A TIMELY BASIS. - IF A CLAIM IS DENIED (OR NOT PROCESSED) BY A PAYER DUE TO A HOSPITAL ERROR, INSPIRA WILL NOT BILL THE PATIENT FOR ANY AMOUNT IN EXCESS OF THAT FOR WHICH THE PATIENT WOULD HAVE BEEN LIABLE HAD THE PAYER PAID THE CLAIM. - AFTER CLAIMS ARE PROCESSED BY PAYERS, INSPIRA BILLS PATIENTS ON A TIMELY BASIS FOR THEIR RESPECTIVE LIABILITY AMOUNTS AS DETERMINED BY THEIR INSURERS. - ALL UNINSURED PATIENTS ARE BILLED DIRECTLY ON A TIMELY BASIS. - ACCOUNTS MAY BE REFERRED FOR COLLECTION IF THERE IS REASONABLE BASIS TO BELIEVE THAT THE PATIENT OWES THE DEBT. HOWEVER, ACCOUNTS MAY BE PLACED WITH A COLLECTION AGENCY NO SOONER THAN 120 DAYS FROM THE DATE OF FIRST POST-DISCHARGE BILLING STATEMENT (""NOTIFICATION PERIOD""). ACCOUNTS MAY BE REFERRED FOR COLLECTION IF ALL THIRD-PARTY PAYERS HAVE BEEN PROPERLY BILLED BY INSPIRA AND THE REMAINING DEBT IS THE FINANCIAL RESPONSIBILITY OF THE PATIENT. THE ORGANIZATION SHALL NOT BILL A PATIENT FOR ANY AMOUNT THAT AN INSURANCE COMPANY IS OBLIGATED TO PAY UNLESS THE INSURANCE COMPANY IS REFUSING TO PAY THE AMOUNT PENDING ADDITIONAL INFORMATION OR COMMUNICATION FROM THE PATIENT. INSPIRA DOES NOT REFER ACCOUNTS FOR COLLECTION WHILE A CLAIM ON THE ACCOUNT IS STILL PENDING PAYER PAYMENT UNLESS THE PAYER IS REFUSING TO PAY THE AMOUNT PENDING ADDITIONAL INFORMATION OR COMMUNICATION FROM THE PATIENT. CUSTOMER SERVICE ---------------- DURING THE BILLING AND COLLECTION PROCESS, INSPIRA PROVIDES QUALITY CUSTOMER SERVICE BY COMPLYING WITH THE FOLLOWING GUIDELINES: (1) INSPIRA DOES NOT TOLERATE ABUSIVE, HARASSING, OFFENSIVE, DECEPTIVE, OR MISLEADING LANGUAGE OR CONDUCT BY ITS EMPLOYEES. (2) INSPIRA MAINTAINS A STREAMLINED PROCESS FOR PATIENT QUESTIONS AND DISPUTES, WHICH INCLUDES A PHONE NUMBER PATIENTS MAY CALL, EMAIL ADDRESS, AND A BUSINESS OFFICE ADDRESS TO WHICH THEY MAY WRITE. THIS INFORMATION WILL BE LISTED ON ALL PATIENT STATEMENTS. (3) AFTER RECEIVING A COMMUNICATION FROM THE PATIENT (BY PHONE, EMAIL, OR IN WRITING), INSPIRA STAFF WILL RETURN CALLS TO PATIENTS AS PROMPTLY AS POSSIBLE (BUT NO MORE THAN ONE BUSINESS DAY AFTER THE CALL, EMAIL OR LETTER WAS RECEIVED). (4) INSPIRA MAINTAINS A DAILY COMPLAINT AND ISSUE LOG OF PATIENTS COMPLAINTS. THE COMPLAINT AND ISSUE LOG WILL BE REVIEWED PERIODICALLY BY THE PATIENT ACCOUNTS MANAGER AND CASH SUPERVISOR AND THE INFORMATION PROVIDED WILL BE USED TO ENHANCE AND IMPROVE THE BILLING AND COLLECTIONS PROCESS. ALL PATIENTS MAY REQUEST AN ITEMIZED STATEMENT FOR THEIR ACCOUNTS AT ANY TIME. ALL PATIENTS WILL HAVE THE OPPORTUNITY TO CONTACT HOSPITAL REGARDING FINANCIAL ASSISTANCE FOR THEIR ACCOUNTS. COMPLIANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(6) ------------------------------------------------------- INSPIRA DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (""ECAS"") AS DEFINED BY INTERNAL REVENUE CODE SECTION 501(R) PRIOR TO THE END OF THE NOTIFICATION PERIOD. ONCE A COMPLETED FAP APPLICATION IS RECEIVED, HOSPITAL, OR ANY COLLECTION AGENCIES WORKING ON THEIR BEHALF, WILL: 1) SUSPENDED ANY ECAS AGAINST THE INDIVIDUAL; 2) MAKE AND DOCUMENT AN ELIGIBILITY DETERMINATION IN A TIMELY MANNER; 3) NOTIFY THE RESPONSIBLE PARTY OR INDIVIDUAL IN WRITING OF THE DETERMINATION AND BASIS FOR DETERMINATION; AND 4) IF DEEMED FAP-ELIGIBLE INSPIRA WILL: - PROVIDE A BILLING STATEMENT INDICATING THE AMOUNT THE FAP-ELIGIBLE INDIVIDUAL OWES, HOW THAT AMOUNT WAS DETERMINED AND HOW INFORMATION PERTAINING TO AMOUNTS GENERALLY BILLED MAY BE OBTAINED; AND - REFUND ANY EXCESS PAYMENTS MADE BY THE INDIVIDUAL. INSPIRA DOES NOT ENGAGE IN ANY ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE, SUCH AS BY DEMANDING THE EMERGENCY DEPARTMENT PATIENTS PAY BEFORE RECEIVING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR BY PERMITTING DEBT COLLECTION ACTIVITIES IN THE EMERGENCY DEPARTMENT OR OTHER AREAS WHERE SUCH ACTIVITIES COULD INTERFERE WITH THE PROVISION OF EMERGENCY CARE ON A NON-DISCRIMINATORY BASIS."

SCHEDULE H, PART VI; QUESTION 6
"OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE INSPIRA HEALTH NETWORK: NOT-FOR-PROFIT INSPIRA HEALTH NETWORK ENTITIES ============================================== INSPIRA HEALTH NETWORK, INC. ---------------------------- INSPIRA HEALTH NETWORK, INC. (""NETWORK"") IS THE TAX-EXEMPT PARENT OF THE INSPIRA HEALTH NETWORK (""SYSTEM""). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER THE NETWORK OR ANOTHER NETWORK AFFILIATE CONTROLLED BY THE NETWORK. THE NETWORK IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY AND IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). INSPIRA MEDICAL CENTERS, INC. ----------------------------- INSPIRA MEDICAL CENTERS, INC. IS COMPRISED OF THREE HOSPITAL FACILITIES, INSPIRA MEDICAL CENTER ELMER, INSPIRA MEDICAL CENTER VINELAND AND INSPIRA MEDICAL CENTER MULLICA HILL. IMC IS A GENERAL MEDICAL, SURGICAL AND TEACHING HOSPITAL THAT IS RECOGNIZED BY IRS AS AN IRC 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, IMC PROVIDES EMERGENCY AND 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, IMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. INSPIRA MEDICAL CENTER WOODBURY, INC. ------------------------------------- INSPIRA MEDICAL CENTER WOODBURY, INC. (""IMCW"") IS LOCATED IN WOODBURY, GLOUCESTER COUNTY, NEW JERSEY, IS A 305-BED ACUTE CARE FACILITY. IMCW IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, IMCW 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, IMCW OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC. DURING 2019. INSPIRA HOMECARE & HOSPICECARE, INC. ------------------------------------ INSPIRA HOMECARE & HOSPICECARE, 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)(2). THE ORGANIZATION HAS AN OWNERSHIP INTEREST IN TRI-COUNTY HOME AND HOSPICE CARE LLC; AN ENTITY ORGANIZED TO OWN AND OPERATE HOME HEALTHCARE AND HOSPICE AGENCIES IN GLOUCESTER, SALEM AND CUMBERLAND COUNTIES. THIS ORGANIZATION PROVIDES QUALITY HOME CARE AND HOSPICE CARE SERVICES IN THE REGION IN FURTHERANCE OF ITS TAX-EXEMPT AND CHARITABLE PURPOSES. INSPIRA HEALTH NETWORK LIFE, INC. --------------------------------- INSPIRA HEALTH NETWORK LIFE, 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)(2). THE ORGANIZATION PROVIDES HEALTHCARE SERVICES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. TRI-COUNTY CARDIOVASCULAR SERVICES, P.C. ---------------------------------------- TRI-COUNTY CARDIOVASCULAR SERVICES, P.C. 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. THE ORGANIZATION PROVIDED PHYSICIAN SERVICES IN SOUTHERN NEW JERSEY. THE ORGANIZATION IS CURRENTLY INACTIVE. INSPIRA HEALTH CONNECTIONS, P.C. -------------------------------- INSPIRA HEALTH CONNECTIONS, P.C. 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. THIS ORGANIZATION PROVIDES PHYSICIAN SERVICES IN SOUTHERN NEW JERSEY. INSPIRA HEALTH NETWORK FOUNDATION CUMBERLAND/SALEM, INC. -------------------------------------------------------- INSPIRA HEALTH NETWORK FOUNDATION CUMBERLAND/SALEM, 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). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF INSPIRA HEALTH NETWORK, INC.; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT 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. THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA HEALTH NETWORK FOUNDATION GLOUCESTER COUNTY, INC. DURING 2019. INSPIRA HEALTH NETWORK FOUNDATION GLOUCESTER COUNTY, INC. --------------------------------------------------------- INSPIRA HEALTH NETWORK FOUNDATION GLOUCESTER COUNTY, 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). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF INSPIRA HEALTH NETWORK, INC.; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT 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. INSPIRA DEPTFORD HEALTHPARK, LLC -------------------------------- INSPIRA DEPTFORD HEALTHPARK, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS INSPIRA MEDICAL CENTERS, INC. INSPIRA CARE CONNECT, LLC ------------------------- INSPIRA CARE CONNECT, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS INSPIRA HEALTH NETWORK, INC. THE MISSION OF THIS ORGANIZATION IS TO ESTABLISH A GROUP OF COORDINATED HEALTHCARE PROVIDERS WHICH AGREE TO BE ACCOUNTABLE FOR THE QUALITY, COST AND OVERALL CARE FOR AN ASSIGNED GROUP OF MEDICARE BENEFICIARIES. FOR-PROFIT INSPIRA HEALTH NETWORK ENTITIES ========================================== BRIDGETON PHYSICIANS OFFICE CENTER, L.P. ---------------------------------------- BRIDGETON PHYSICIANS OFFICE CENTER, L.P. IS A PARTNERSHIP OWNED BY INSPIRA HEALTH NETWORK AFFILIATES. THIS ORGANIZATION ENGAGES IN REAL ESTATE ACTIVITY. GLOUCESTER COUNTY SURGERY CENTER, LLC ------------------------------------- GLOUCESTER COUNTY SURGERY CENTER, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP CONTROLLED BY RED BANK DEVELOPMENT CORPORATION. GLOUCESTER COUNTY SURGERY CENTER, LLC PROVIDES HEALTHCARE SERVICES TO INDIVIDUALS. INSPIRA HEALTH PARTNERS, LLC ---------------------------- INSPIRA HEALTH PARTNERS, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP. THE ORGANIZATION IS A CLINICALLY INTEGRATED PHYSICIAN-HOSPITAL ENTERPRISE WHICH IS DESIGNED TO ACHIEVE IMPROVEMENT IN HEALTHCARE QUALITY, EFFICIENCY AND COST. INSPIRA HEALTH NETWORK, INC. OWNS 51% OF INSPIRA HEALTH PARTNERS, LLC. OAK & MAIN SURGICENTER, LLC --------------------------- OAK & MAIN SURGICENTER, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP OWNED BY INSPIRA MEDICAL CENTERS, INC. THIS ORGANIZATION PROVIDES HEALTHCARE SERVICES TO INDIVIDUALS. INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC ---------------------------------------------- INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP. THIS ORGANIZATION MANAGES AND OPERATES URGENT CARE SERVICE CENTERS IN SOUTHERN NEW JERSEY. INSPIRA HEALTH MANAGEMENT CORPORATION, INC. OWNS 60.5% OF INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC. WOODBURY MEDICAL CENTER ASSOCIATES, LLP --------------------------------------- WOODBURY MEDICAL CENTER ASSOCIATES, LLP IS A LIMITED LIABILITY PARTNERSHIP. THE ORGANIZATION PROVIDES MEDICAL SERVICES IN SOUTHERN NEW JERSEY. DURING 2019, RED BANK DEVELOPMENT CORPORATION, INC. BECAME THE SOLE OWNER OF WOODBURY MEDICAL CENTER ASSOCIATES, LLP. COOPER BONE & JOINT, P.C. ------------------------- COOPER BONE & JOINT INSTITUTE (COOPER UNIVERSITY HEALTH CARE) PARTNERED WITH INSPIRA MEDICAL CENTER WOODBURY, INC. TO OFFER PATIENTS ACCESS TO THE LATEST ORTHOPAEDIC ADVANCEMENTS. INSPIRA MEDICAL CENTER WOODBURY, INC. IS A 50% SHAREHOLDER IN COOPER BONE & JOINT, P.C. THIS ORGANIZATION IS CURRENTLY INACTIVE. INSPIRA HEALTH MANAGEMENT CORPORATION, INC. ------------------------------------------- INSPIRA HEALTH MANAGEMENT CORPORATION IS AN ENTITY WHOSE SOLE SHAREHOLDER IS INSPIRA HEALTH NETWORK, INC. THE ORGANIZATION IS LOCATED IN BRIDGETON, CUMBERLAND COUNTY, NEW JERSEY AND PROVIDES HEALTH, WELLNESS AND MANAGEMENT SERVICES. INSPIRA HEALTH NETWORK M"

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

SCHEDULE H, PART VI; QUESTION 2
IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS OUTLINED IN SCHEDULE H, SECTION B, QUESTIONS 1-12 AND SECTION C, THIS ORGANIZATION CONDUCTS A REVIEW OF KEY FACTOR INFORMATION ANNUAL WHICH INCLUDES: A REVIEW OF HEALTHCARE UTILIZATION OF ITS SERVICE AREA POPULATION BY SERVICES (UROLOGY, CARDIOLOGY, OBSTETRICS, ETC.) FOR DETERMINING INCREASED OR DECREASED HEALTH NEEDS; HEALTHCARE SERVICES ESTIMATES AND FORECASTS (BOTH INPATIENT AND OUTPATIENT); ASSESSMENTS OF LOCAL DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION; AND, A REVIEW OF HEALTH STATUS/NEEDS ASSESSMENTS AND STUDIES CONDUCTED BY EXTERNAL PARTIES. THE ORGANIZATION CONDUCTS AN EXTENSIVE SERVICE AREA PHYSICIAN NEEDS STUDY (BY PRIMARY AND SPECIALTY) EVERY THREE TO FIVE YEARS. SPECIFIC SPECIALTY NEEDS ARE CONDUCTED FOR IDENTIFIED GAPS IN SERVICE. THESE REVIEWS INFORM MEDICAL STAFF DEVELOPMENT AT THE MEDICAL CENTER TO ASSURE RESPONSIVENESS TO IDENTIFIED COMMUNITY NEEDS. THE ORGANIZATION COLLABORATES WITH COMMUNITY PARTNERS TO PLAN AND CONDUCT HEALTH NEEDS ASSESSMENTS TO ASSESS AND ADDRESS HEALTH NEEDS OF THE COMMUNITY IT SERVES. THE WIDE-BASED COLLABORATIVE PARTNERSHIP RETAINS AN OUTSIDE CONSULTING FIRM TO ASSESS COMMUNITY DATA AND PERCEPTION. COMMUNITY DATA IS COLLECTED FROM COUNTY HEALTH PROFILES, HEALTH STATISTICS, DEMOGRAPHICS, SOCIOECONOMIC DATA, PHONE SURVEYS, PAPER SURVEYS AND FOCUS GROUPS. FROM THOSE ASSESSMENTS, COMMUNITY HEALTH IMPROVEMENT PLANS ARE PUBLISHED IDENTIFYING THE SPECIFIC HEALTH PRIORITIES. THROUGH A PLANNED AND ORGANIZED EFFORT, THE GROUP WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES BY TAPPING THE RESOURCES OF THE COMMUNITY AND COLLABORATING ON INITIATIVES. INSPIRA HEALTH NETWORK ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION, EXPERTISE, RESOURCES AND CAPACITY. IN ADDITION TO THESE ORGANIZED NEEDS ASSESSMENT EFFORTS, VARIOUS INSPIRA LEADERSHIP ATTEND COMMUNITY MEETINGS WITH LOCAL PROVIDERS, LOCAL HEALTH DEPARTMENTS, LOCAL POLITICIANS, ORGANIZATIONS AND COMMUNITY LEADERS TO DISCUSS THE HEALTH NEEDS OF THE POPULATION.

SCHEDULE H, PART VI; QUESTION 3
"IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY WIDELY PUBLICIZING VARIOUS DOCUMENTS. THESE DOCUMENTS ARE WIDELY PUBLICIZED IN THE FOLLOWING WAYS: (1) THE FINANCIAL ASSISTANCE POLICY (""FAP""), FINANCIAL ASSISTANCE APPLICATION (""APPLICATION"") AND PLAIN LANGUAGE SUMMERY (""PLS"") ARE ALL AVAILABLE ON-LINE AT THE FOLLOWING WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/FAP (2) PAPER COPIES OF THE FAP, APPLICATION AND THE PLS ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL AND ARE AVAILABLE IN AT VARIOUS AREAS THROUGHOUT THE HOSPITAL FACILITY WHICH INCLUDE THE HOSPITAL ADMISSIONS DEPARTMENT AND THE OUTPATIENT AND EMERGENCY ROOM REGISTRATION AREAS. (3) THE FAP, APPLICATION AND PLS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH (""LEP"") THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY SERVED BY THE ORGANIZATIONS PRIMARY SERVICE AREA. (4) ALL PATIENTS ARE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE PROCESS. ADDITIONALLY, SIGNS OR DISPLAYS ARE CONSPICUOUSLY POSTED IN PUBLIC MEDICAL CENTER LOCATIONS INCLUDING ALL ADMISSIONS/REGISTRATION AREAS AND THE EMERGENCY DEPARTMENT, THAT NOTIFY AND INFORM PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL BILLING STATEMENTS INCLUDE CONSPICUOUS WRITTEN NOTICE WHICH INFORMS PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. INSPIRA ALSO INFORMS AND NOTIFIES MEMBERS OF THE COMMUNITY SERVED ABOUT THE FAP. INSPIRA ACCOMPLISHES THIS THROUGH THE CUMBERLAND/SALEM/GLOUCESTER HEALTH & WELLNESS ALLIANCE (""ALLIANCE"") WHICH IS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION FOR WHICH INSPIRA PLAYED AN INTEGRAL ROLE IN ORGANIZING. THE ALLIANCE HAS MORE THAN 40 MEMBERS COMPRISED OF SOCIAL SERVICE AGENCIES SCATTERED THROUGHOUT INSPIRAS PRIMARY SERVICE AREA OF CUMBERLAND, SALEM AND GLOUCESTER COUNTIES. THEY INCLUDE, BUT ARE NOT LIMITED TO, FEDERALLY QUALIFIED HEALTH CENTERS, YMCAS, UNITED WAYS, SCHOOL SYSTEMS, GATEWAY COMMUNITY ACTION PARTNERSHIP, THE LOCAL COUNTY COLLEGES, FAMCARE,INC., COUNTY PROSECUTORS OFFICE, SCRATCH COALITION (ADDICTION SERVICES), ROBINS NEST, LOCAL HEALTH DEPARTMENTS (MUNICIPAL AND COUNTY), CHAMBERS OF COMMERCE, FAMILY SUCCESS CENTERS, RUTGERS COOPERATIVE EXTENSION, NJ FAMILY PLANNING, THE SOUTHWEST COUNCIL, SOUTHERN NJ PERINATAL COOPERATIVE. THE ALLIANCE MEETS REGULARLY AND ASSISTS WITH DRAFTING AND IMPLEMENTATION OF OUR COMMUNITY HEALTH NEEDS ASSESSMENTS FOR ALL THREE COUNTIES WITHIN INSPIRAS PRIMARY MARKET."

SCHEDULE H, PART VI; QUESTION 5
COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY THIS ORGANIZATION IMPROVE THE MEDICAL AND SOCIO-ECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH NUMEROUS ACTIVITIES WHICH ARE NOT A PART OF PART I CHARITY CARE AND OTHER COMMUNITY BENEFITS, AND ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. THESE ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS SUCH AS EDUCATION, POVERTY, UNEMPLOYMENT, ACCESS TO CARE, HEALTH ADVOCACY AND ECONOMIC DEVELOPMENT. THIS ORGANIZATION HOLDS ANNUAL MEETINGS OPEN TO THE PUBLIC FOR ALL HOSPITAL LOCATIONS. THE ORGANIZATIONS GOVERNING BOARDS ARE COMPRISED OF BUSINESS PROFESSIONALS AND COMMUNITY MEMBERS ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NOT EMPLOYEES OF THE ORGANIZATION. THESE VOLUNTEERS PROVIDE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL SYSTEM IN THEIR OVERSIGHT ROLE. ALL QUALIFIED PHYSICIANS IN THE COMMUNITY ARE EXTENDED MEDICAL STAFF PRIVILEGES BY THEIR RESPECTIVE DEPARTMENTS. UNDER THE DIRECTIVE OF THE ORGANIZATION'S CORPORATE FINANCE OFFICE, SURPLUS FUNDS ARE UTILIZED FOR CAPITAL PROJECTS TO IMPROVE SERVICES, PURCHASE EQUIPMENT, MAINTAIN ACCESS TO CARE TO A HISTORICALLY UNDERSERVED AND LOW-INCOME COMMUNITY AND IMPROVE ACCESS TO PATIENT SERVICES, WHICH IN TURN, BENEFIT THE COMMUNITY. THESE SERVICES INCLUDE, BUT NOT LIMITED TO, THE FOLLOWING: 1) EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON HEALTHY AGING, CHILDBIRTH, INFANT CARE, EARLY PREGNANCY AND MORE; 2) FREE BLOOD PRESSURE AND DIABETES SCREENING, AND MAMMOGRAMS TO QUALIFYING INDIVIDUALS, FREE OR LOW-COST SCREENINGS FOR BREAST, PROSTATE, SKIN AND COLORECTAL CANCERS; 3) PREVENTATIVE HEALTH EDUCATION; 4) ACCESS TO SATELLITE EMERGENCY DEPARTMENT AND EXPANSION OF EMERGENCY DEPARTMENTS AT BOTH HOSPITALS TO ACCOMMODATE INCREASE IN EMERGENCY DEPARTMENT PATIENTS; 5) IMPROVED EFFICIENCY AND CLINICAL QUALITY; 6) INVESTMENT IN MEDICAL EDUCATION AND RESEARCH; AND 7) ACCESS TO ADVANCED TECHNOLOGY AND CLINICAL TRIALS FOR LATEST TREATMENTS. PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

SCHEDULE H, PART VI; QUESTION 4
INSPIRA HEALTH NETWORK IS A CHARITABLE, NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE RESIDENTS OF SOUTHWEST NEW JERSEY. INSPIRA HEALTH NETWORK WAS ESTABLISHED IN NOVEMBER 2012 THROUGH THE MERGER OF SOUTH JERSEY HEALTHCARE AND UNDERWOOD-MEMORIAL HOSPITAL. THE NETWORK, WHICH TRACES ITS ROOTS TO 1899, NOW COMPRISES THREE HOSPITALS, FOUR MULTI-SPECIALTY HEALTH CENTERS, AND A TOTAL OF MORE THAN 60 LOCATIONS. THESE INCLUDE OUTPATIENT IMAGING AND REHABILITATION CENTERS; NUMEROUS SPECIALTY CENTERS, INCLUDING SLEEP MEDICINE, CARDIAC TESTING AND WOUND CARE; AND MORE THAN TWO DOZEN PRIMARY AND SPECIALTY PHYSICIAN PRACTICES IN CUMBERLAND, GLOUCESTER AND SALEM COUNTIES. WITH A MEDICAL STAFF OF MORE THAN 1,100 PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, INSPIRA HEALTH NETWORK PROVIDES EVIDENCE-BASED CARE TO HELP EACH PATIENT ACHIEVE THE BEST POSSIBLE OUTCOME. INSPIRA HEALTH NETWORK DEFINED THEIR CURRENT SERVICE AREA BASED ON AN ANALYSIS OF THE GEOGRAPHIC AREA WHERE INDIVIDUALS UTILIZING THEIR SERVICES RESIDE. INSPIRA HEALTH NETWORKS SERVICE AREA IS CONSIDERED TO BE THE CUMBERLAND, GLOUCESTER, AND SALEM COUNTY COMMUNITIES. THE COUNTIES ARE SITUATED IN THE SOUTHWESTERN PART OF NEW JERSEY AND ENCOMPASS A TOTAL POPULATION OF APPROXIMATELY 504,000 IN 2019. AS PART OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, ONE OF THE INITIAL UNDERTAKINGS OF WAS TO CREATE A SECONDARY DATA PROFILE. THE SECONDARY DATA IS COMPRISED OF DATA OBTAINED FROM EXISTING RESOURCES AND INCLUDES DEMOGRAPHIC AND HOUSEHOLD STATISTICS, EDUCATION AND INCOME MEASURES, MORBIDITY AND MORTALITY RATES, AND HEALTH INDICATORS, AMONG OTHER DATA POINTS. THE DATA WAS GATHERED AND INTEGRATED INTO A GRAPHICAL REPORT TO PORTRAY THE CURRENT HEALTH AND SOCIO-ECONOMIC STATUS OF RESIDENTS IN ITS PRIMARY SERVICE AREAS. SECONDARY DATA WAS COLLECTED FROM REPUTABLE SOURCES INCLUDING THE U.S. CENSUS BUREAU, CENTERS FOR DISEASE CONTROL AND PREVENTION AND NEW JERSEY DEPARTMENT OF HEALTH. THE PROFILE DETAILS DATA COVERING THE FOLLOWING AREAS: POPULATION STATISTICS --------------------- CUMBERLAND COUNTY: - THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 31.8% AND 21.9%; RESPECTIVELY. - THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 27.9%. - 15.6% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. GLOUCESTER COUNTY: - THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 6.7% AND 11.2%; RESPECTIVELY. - THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 8.8% - 16.3% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. SALEM COUNTY: - THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 9.8% AND 14.8%; RESPECTIVELY. - THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 8.5%. - 19.0% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. HOUSEHOLD STATISTICS -------------------- CUMBERLAND COUNTY: - THE MEDIAN HOME VALUE IN CUMBERLAND COUNTY IS $162,500. - THE AVERAGE FAMILY SIZE 2.77 INDIVIDUALS. GLOUCESTER COUNTY: - THE MEDIAN HOME VALUE IN GLOUCESTER COUNTY IS $216,700. - THE AVERAGE FAMILY SIZE 2.74 INDIVIDUALS. SALEM COUNTY: - THE MEDIAN HOME VALUE IN SALEM COUNTY IS $185,300. - THE AVERAGE FAMILY SIZE 2.59 INDIVIDUALS. INCOME STATISTICS ----------------- CUMBERLAND COUNTY: - THE MEDIAN INCOME FOR HOUSEHOLDS IS $52,593 - THE PROPORTION OF PERSONS LIVING IN POVERTY IS 15.2% GLOUCESTER COUNTY: - THE MEDIAN INCOME FOR HOUSEHOLDS IS $85,160 - THE PROPORTION OF PERSONS LIVING IN POVERTY IS 7.5% SALEM COUNTY: - THE MEDIAN INCOME FOR HOUSEHOLDS IS $64,309 - THE PROPORTION OF PERSONS LIVING IN POVERTY IS 11.2%. EMPLOYMENT STATISTICS --------------------- CUMBERLAND COUNTY: UNEMPLOYMENT RATE IN APRIL 2018 WAS 6.6% GLOUCESTER COUNTY: UNEMPLOYMENT RATE IN APRIL 2018 WAS 4% SALEM COUNTY: UNEMPLOYMENT RATE IN APRIL WAS 5.3% EDUCATION STATISTICS -------------------- CUMBERLAND COUNTY: - 77.3% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - 14.3% OF RESIDENTS HAVE EARNED A BACHELORS DEGREE OR HIGHER. GLOUCESTER COUNTY: - 88.9% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - 30% OF RESIDENTS HAVE EARNED A BACHELORS DEGREE OR HIGHER. SALEM COUNTY: - 87.7% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - 20.9% OF RESIDENTS HAVE EARNED A BACHELORS DEGREE OR HIGHER. COUNTY HEALTH RANKINGS ---------------------- - CUMBERLAND COUNTY RECEIVED THE WORST RANKING FOR HEALTH OUTCOMES, MORTALITY, QUALITY OF LIFE, HEALTH FACTORS AND BEHAVIORS, AND SOCIAL AND ECONOMIC FACTORS (21 OF 21) IN NEW JERSEY. - GLOUCESTER COUNTY RECEIVED POOR RANKINGS FOR QUALITY OF LIFE, HEALTH BEHAVIORS, AND PHYSICAL ENVIRONMENT (18 OF 21, 18 OF 21, AND 20 OF 21 RESPECTIVELY). - SALEM COUNTY RECEIVED POOR RANKINGS FOR HEALTH OUTCOMES, MORTALITY, HEALTH FACTORS, HEALTH BEHAVIORS, AND PHYSICAL ENVIRONMENT (19 OF 21, 20 OF 21, 20 OF 21, 20 OF 21, AND 19 OF 21 RESPECTIVELY). - ALL COUNTIES RECEIVED A POOR RANKING FOR CLINICAL CARE.