Community Benefit Insight - Tax-exempt hospital

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Lmw Healthcare Inc

The Westerly Hospital

25 Wells Street
Westerly, RI 02891

Bed count	116	Medicare provider number	410013	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 460543230

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

7.16%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 67,204 0.05 %
Medicaid as % of operating expenses	$ 6,550,053 5.12 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 293,678 0.23 %
Subsidized health services as % of operating expenses	$ 0 0 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 146,203 0.11 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 2,108,598 1.65 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 4,301,466 3.36 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 114123817 including grants of $ 18829) (Revenue $ 113323303)
SEE SCHEDULE O

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

LMW HEALTHCARE, INC.
PART V, SECTION B, LINE 5: COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. LMW HEALTHCARE INC AND ITS COMMUNITY PARTNERS SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS SHARED KNOWLEDGE AND EXPERTISE ABOUT HEALTH ISSUES, WHILE LEADERS AND REPRESENTATIVES OF NON-PROFIT AND COMMUNITY-BASED ORGANIZATIONS PROVIDED INSIGHT ON THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS.

LMW HEALTHCARE, INC.
PART V, SECTION B, LINE 6A: LMW HEALTHCARE INC PARTICIPATED IN A STATEWIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI) AND ITS MEMBER HOSPITALS.

LMW HEALTHCARE, INC.
PART V, SECTION B, LINE 6B: YES, THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH COMMUNITY PARTNERS THAT PROVIDED GUIDANCE, EXPERTISE, AND ONGOING COLLABORATION TO FOSTER COLLECTIVE IMPACT IN IMPROVING THE HEALTH AND WELLBEING OF THE GREATER WESTERLY COMMUNITY. THIS INCLUDED THE HEALTH IMPACT COLLABORATIVE OF GREATER WESTERLY AND AGE FRIENDLY WESTERLY, WHOSE MEMBER ORGANIZATIONS ARE REPRESENTATIVE OF THOSE IN THE COMMUNITY WHO SERVE UNDERSERVED, LOW-INCOME, AND HARD TO REACH POPULATIONS. THIS APPROACH TO ASSESSMENT AND PLANNING AIMS TO ENGAGE AGENCIES, ORGANIZATIONS, AND RESIDENTS IN THE AREA THROUGH PARTICIPATORY AND COLLABORATIVE APPROACHES.SCHEDULE H, PART V, SEC B, LINE 7A AND 10A:HTTPS://WWW.WESTERLYHOSPITAL.ORG/ABOUT/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.ASPX

LMW HEALTHCARE, INC.
PART V, SECTION B, LINE 11: LMW HEALTHCARE, INC. DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO GUIDE OUR EFFORTS IN RESPONDING TO OUR COMMUNITY'S NEEDS. USING RECOMMENDATIONS FROM THE PEOPLE WHO DELIVER AND USE THESE SERVICES, WE WILL FOSTER COLLABORATION TO BETTER COORDINATE OUR COMMUNITY RESOURCES. WE WILL SEEK TO BETTER CONNECT PEOPLE TO THE SERVICES THEY NEED AND REDUCE DISPARITIES IN HEALTH AND SOCIOECONOMIC MEASURES THAT STEM FROM UNDERLYING INEQUITIES IN OUR SOCIETY. WE USED THE TOP NEEDS IDENTIFIED THROUGH COMMUNITY ENGAGEMENT AS A FOUNDATION FOR OUR CHIP DEVELOPMENT TO ADDRESS THE NEEDS OF GREATEST CONCERN TO COMMUNITY MEMBERS. THESE INDIVIDUALS PROVIDED DIVERSE PERSPECTIVES ON HEALTH TRENDS, SHARED LIVED EXPERIENCES AMONG HISTORICALLY DISENFRANCHISED AND UNDERSERVED POPULATIONS, AND PROVIDED INSIGHTS INTO SERVICE DELIVERY GAPS THAT CONTRIBUTE TO HEALTH DISPARITIES AND INEQUITIES. THE COMMUNITY NEEDS ARE AFFORDABLE HEALTHCARE, BEHAVIORAL HEALTH, DRUG/ALCOHOL MISUSE, EDUCATION, FINANCIAL SECURITY, FOOD SECURITY AND HOUSING. THE CHIP PROVIDES DIRECTION FOR ADDRESSING THE HEALTH AND WELLBEING NEEDS OF THE COMMUNITY.THE CHIP WAS DEVELOPED BY A HOSPITAL TASK FORCE COMPRISED OF LEADERS FROM MULTIPLE DEPARTMENTS TO CAPTURE ALL HOSPITAL AND HEALTH SYSTEM EFFORTS THAT IMPACT THE HEALTH OF THE LOCAL COMMUNITY. CHIP GOALS REFLECT IDENTIFIED NEEDS AND WERE CONFIRMED THROUGH DISCUSSIONS WITH COMMUNITY LEADERS AND STAKEHOLDERS. OUR PRIORITY AREAS COME FROM THE TOP NEEDS IDENTIFIED BY THE CHNA AND ARE ALIGNED WITH THOSE OF OUR COLLECTIVE IMPACT PARTNERSHIP, THE HEALTH IMPROVEMENT COLLABORATIVE OF GREATER WESTERLY: ACCESS TO CARE, BEHAVIORAL HEALTH, COMMUNITY HEALTH AND WELLBEING, AND HEALTHY LIVING. THESE PRIORITY AREAS REFLECT THE GREATEST NEEDS IN THE COMMUNITY WITH HEALTH SYSTEM AND HOSPITAL GENERATED STRATEGIES FOR ACTION AND ALIGN WITH STATEWIDE EFFORTS IN RHODE ISLAND AND CONNECTICUT.

LMW HEALTHCARE, INC.
PART V, SECTION B, LINE 13H: THESE PROGRAMS COVER EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ONLY.

PART V, SECTION B, LINE 3E:
THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TRACKS THE HEALTH AND WELLBEING OF OUR COMMUNITY AND MONITORS THE SOCIAL AND ENVIRONMENTAL FACTORS THAT INFLUENCE HEALTH OUTCOMES. THESE DATA ILLUMINATE HEALTH DISPARITIES ACROSS POPULATION GROUPS AND GEOGRAPHIES AND HELP US DIRECT RESOURCES TO ADVANCE HEALTH EQUITY. THE CHNA FINDINGS GUIDE HEALTHCARE SERVICES AND HEALTH IMPROVEMENT EFFORTS, AS WELL AS SERVE AS A COMMUNITY RESOURCE FOR GRANT MAKING, ADVOCACY, AND TO SUPPORT THE MANY PROGRAMS PROVIDED BY HEALTH AND SOCIAL SERVICE PARTNERS.IT IS IMPERATIVE TO PRIORITIZE RESOURCES AND ACTIVITIES TOWARD THE MOST PRESSING AND CROSS-CUTTING HEALTH NEEDS WITHIN OUR COMMUNITY. THESE SIGNIFICANT HEALTH NEEDS INCLUDE HEALTH OUTCOMES AND RISK FACTORS RELATED TO AFFORDABLE HEALTHCARE, BEHAVIORAL HEALTH, DRUG/ALCOHOL MISUSE, EDUCATION, FINANCIAL SECURITY, FOOD SECURITY AND HOUSING. IN DETERMINING THE ISSUES ON WHICH TO FOCUS EFFORTS OVER THE NEXT THREE-YEAR CYCLE, WESTERLY HOSPITAL COLLECTED FEEDBACK FROM COMMUNITY PARTNERS AND SOUGHT TO ALIGN WITH COMMUNITY INITIATIVES INCLUDING THE TOWN OF WESTERLY COMPREHENSIVE PLAN, AGE-FRIENDLY WESTERLY, AND HEALTHY BODIES HEALTHY MINDS WASHINGTON COUNTY. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B AND 16C:HTTPS://WWW.WESTERLYHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE.ASPX

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
"IT IS THE PHILOSOPHY AND POLICY OF LMW HEALTHCARE INC THAT MEDICALLY NECESSARY HEALTH CARE SERVICES SHOULD BE AVAILABLE TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY.CHARITY CARE APPLIES TO ALL UNINSURED PATIENTS (DEFINED AS EARNING LESS THAN 250% OF THE POVERTY GUIDELINES). CARE WILL BE PROVIDED FREE FOR THOSE UNINSURED PATIENTS WHO REQUEST ASSISTANCE AND VERIFY THEIR ANNUAL INCOME IS LESS THAN 250% OF THE FEDERAL INCOME POVERTY LEVEL (""FPL"")."

PART I, LINE 7:
THE HOSPITAL USES A COST ACCOUNTING SYSTEM, STRATA, TO CALCULATE THE AMOUNTS PRESENTED IN PART I, LINE 7 IN CONJUNCTION WITH ESTIMATING THE COST OF FREE CARE AND CHARITY CARE, THE RATIO OF COST TO CHARGE PERCENTAGE UTILITIZING THE COMPONENTS FROM THE HOSPITAL'S FINANCIAL STATEMENTS.

PART II, COMMUNITY BUILDING ACTIVITIES:
LMW HEALTHCARE, ALONG WITH MANY OTHER HOSPITALS ACROSS THE COUNTRY, UTILIZES THE COMMUNITY BENEFITS INVENTORY FOR SOCIAL ACCOUNTABILITY (CBISA) DATABASE DEVELOPED BY LYON SOFTWARE TO CATALOG ITS COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES AND THE GUIDELINES DEVELOPED BY THE CATHOLIC HOSPITAL ASSOCIATION (CHA) IN ORDER TO CATALOG THESE BENEFITS. THESE TWO ORGANIZATIONS HAVE WORKED TOGETHER FOR OVER 30 YEARS TO PROVIDE SUPPORT TO NOT-FOR-PROFIT HOSPITALS TO DEVELOP AND SUSTAIN EFFECTIVE COMMUNITY BENEFIT PROGRAMS.THE MOST RECENT VERSION OF THE CHA GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT DEFINES COMMUNITY BUILDING ACTIVITIES AS ACTIVITIES THE ORGANIZATION ENGAGES IN TO PROTECT OR IMPROVE THE HEALTH AND SAFETY OF ITS RESIDENTS. THESE ACTIVITIES ARE CATEGORIZED INTO EIGHT DISTINCT AREAS INCLUDING PHYSICAL IMPROVEMENT AND HOUSING, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS, LEADERSHIP DEVELOPMENT AND TRAINING, COALITION BUILDING, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, AND WORKFORCE DEVELOPMENT.LMW HEALTHCARE ENHANCES THE LIVES OF THOSE WE SERVE BY PROVIDING ACCESS TO INTEGRATED, HIGH-VALUE, PATIENT-CENTERED CARE IN COLLABORATION WITH OTHERS WHO SHARE OUR VALUES. AS SUCH, LMW HEALTHCARE IS INCREASINGLY AWARE OF HOW SOCIAL DETERMINANTS IMPACT THE HEALTH OF INDIVIDUALS AND COMMUNITIES. A PERSON'S HEALTH AND CHANCES OF BECOMING SICK AND DYING EARLY ARE GREATLY INFLUENCED BY POWERFUL SOCIAL FACTORS SUCH AS EDUCATION, INCOME, NUTRITION, HOUSING AND NEIGHBORHOODS.THROUGH THE WORK OF THE NEWLY LAUNCHED AGE FRIENDLY WESTERLY INITIATIVE, LMW HEALTHCARE IS SUPPORTING WORK ACROSS THE AARP DOMAINS OF LIVEABILITY FOR OLDER RESIDENTS WHICH INCORPORATE EFFORTS ON SOCIAL DETERMINANTS. INITIAL EFFORTS HAVE INCLUDED STRATEGIES TO ADDRESS HOUSING NEEDS IN GREATER WESTERLY, INCLUDING THE DEVELOPMENT OF A WESTERLY VILLAGE, A SYSTEM OF MUTUAL AID THAT SUPPORTS OLDER RESIDENTS IN STAYING IN THEIR HOMES SAFELY.

PART III, LINE 2:
LMW HEALTHCARE INC USES A COST REPORTING SYSTEM TO DETERMINE THE BAD DEBT EXPENSE. THE AMOUNT OF BAD DEBT EXPENSE (AT COST) REPORTED ON PART III, LINE 2 IS TAKEN DIRECTLY FROM THE GENERAL LEDGER.

PART III, LINE 3:
THE ORGANIZATION DOES NOT CURRENTLY HAVE A METHODOLOGY TO ACCURATELY QUANTIFY OR ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE THAT WOULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.

PART III, LINE 8:
THE MEDICARE SHORTFALL REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON COST REPORTING. THE COSTING METHOD WAS FROM THE MEDICARE COST REPORT'S OWN METHODOLOGY OF ALLOCATING COST BY DEPARTMENT AND DERIVING A RATIO OF COST TO CHARGE. THIS AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY LMW HEALTHCARE. LMW HEALTHCARE MUST SUBSIDIZE THE COST OF CARE TO MEDICARE BENEFICIARIES WITH OTHER REVENUES.

PART III, LINE 9B:
IN ACCORDANCE WITH ITS WRITTEN CREDIT AND COLLECTION POLICY, LMW HEALTHCARE INC WILL NOT PURSUE COLLECTION EFFORTS, DIRECTLY OR THROUGH COLLECTION AGENCIES, ON THE PORTION OF A PATIENT'S BILL FOR WHICH THAT PATIENT HAS ESTABLISHED ELIGIBILITY FOR CHARITY CARE.

PART VI, LINE 2:
COMMUNITY NEEDS ARE ROUTINELY REVIEWED AND ADDRESSED AS PART OF THE OPERATIONS AND SERVICE LINE TEAMS AT LMW HEALTHCARE. THESE MULTI-DISCIPLINARY GROUPS PROVIDE ANALYSIS AND INSIGHT INTO PATIENT UTILIZATION TRENDS ACROSS OUR DELIVERY OF CARE AND ARE REVIEWED IN TANDEM WITH CARE MANAGEMENT AND PATIENT SATISFACTION RESULTS AND OTHER COMMUNITY FEEDBACK. COUPLED WITH THE RECENTLY COMPLETED COMMUNITY NEEDS ASSESSMENT, THIS INFORMATION ASSISTS WITH THE DEVELOPMENT OF NEW INITIATIVES, PARTNERSHIPS, PROGRAMS, AND SERVICES TO BENEFIT OUR COMMUNITY.

PART VI, LINE 3:
"IN ACCORDANCE WITH ITS CHARITY CARE POLICY, LMW HEALTHCARE NOTIFIES PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE USING SEVERAL METHODS.1) SIGNAGE INDICATING THE AVAILABILITY OF CHARITY CARE IS POSTED IN ENGLISH AND SPANISH IN PATIENT ACCOUNTS, HEALTH ACCESS MANAGEMENT AND CERTAIN CLINICAL AREAS. SUMMARIES OF THE PROGRAMS WILL ALSO BE AVAILABLE IN THOSE AREAS.2) PATIENT FINANCIAL ADVISORS WILL ATTEMPT TO VISIT ALL INPATIENTS REGISTERED AS SELF PAY PATIENTS. A SUMMARY EXPLAINING CHARITY CARE WILL BE GIVEN TO THE PATIENT OR GUARANTOR WHEN THIS VISIT OCCURS.3) PATIENTS WITH NO INSURANCE WILL RECEIVE AN INITIAL LETTER WITHIN ONE WEEK OF DISCHARGE INFORMING THEM THEY ARE CONSIDERED ""UNINSURED"". IT IS THE RESPONSIBILITY OF THE PATIENT TO ADVISE LMW IF THEY BELIEVE THEY QUALIFY AS ""UNINSURED"" (AT OR UNDER 250% OF THE FPG).4) A SERIES OF MONTHLY STATEMENTS WILL BE SENT FOLLOWING DISCHARGE. EACH STATEMENT WILL REMIND THE PATIENT OF THE AVAILABILITY OF CHARITY CARE."

PART VI, LINE 6:
THE ENTITIES OF LAWRENCE+MEMORIAL HEALTHCARE INCLUDING LMW HEALTHCARE, THE (VNASC), AND LAWRENCE+MEMORIAL HOSPITAL ARE PART OF YALE NEW HAVEN HEALTH. THE YALE NEW HAVEN HEALTH SYSTEM'S FUNDAMENTAL MISSION IS TO ENSURE THAT THE DELIVERY NETWORKS SUCH AS LMW HEALTHCARE ASSOCIATED WITH THE SYSTEM PROMOTE THE HEALTH OF THE COMMUNITIES THEY SERVE AND ENSURE THAT ALL PATIENTS HAVE ACCESS TO APPROPRIATE HEALTHCARE SERVICES. THE YALE NEW HAVEN HEALTH SYSTEM REQUIRES ITS HOSPITALS TO INCORPORATE PLANS TO PROMOTE HEALTHY COMMUNITIES WITHIN THE HOSPITAL'S EXISTING BUSINESS PLANS AND IMPLEMENTATION STRATEGIES FOR WHICH THEY ARE HELD ACCOUNTABLE. IN ADDITION, REGULAR REPORTING ON COMMUNITY BENEFITS IS REQUIRED ON A ROUTINE BASIS.

PART VI, LINE 7, REPORTS FILED WITH STATES
RI

PART III, LINE 4:
"LMW HEALTHCARE INC (""WESTERLY HOSPITAL"") IS INCLUDED IN THE CONSOLIDATED YALE NEW HAVEN HEALTH SERVICES CORPORATION AUDITED FINANCIAL STATEMENTS. FOLLOWING IS THE FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS:THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE BROADER COMMUNITY. SERVICES PROVIDED TO THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES, AND/OR WHO ARE UNINSURED OR UNDERINSURED.THE SYSTEM PROVIDES FREE CARE PROGRAMS FOR QUALIFYING PATIENTS. IN ACCORDANCE WITH THE ESTABLISHED POLICIES OF THE SYSTEM, DURING THE REGISTRATION, BILLING, AND COLLECTION PROCESS, A PATIENT'S ELIGIBILITY FOR FREE CARE FUNDS IS DETERMINED. FOR PATIENTS WHO WERE DETERMINED BY THE SYSTEM TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS. FOR PATIENTS WHO DO NOT AVAIL THEMSELVES OF ANY FREE CARE PROGRAM, AND WHOSE ABILITY TO PAY CANNOT BE DETERMINED BY THE SYSTEM, CARE GIVEN BUT NOT PAID FOR IS CLASSIFIED AS CHARITY CARE.TOGETHER, CHARITY CARE AND FREE CARE REPRESENT UNCOMPENSATED CARE. THE ESTIMATED COST OF TOTAL UNCOMPENSATED CARE IS APPROXIMATELY $78.4 MILLION AND $87.7 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY. THE ESTIMATED COST OF UNCOMPENSATED CARE IS BASED ON THE RATIO OF COST TO CHARGES, AS DETERMINED BY CLAIMS ACTIVITY.THE ALLOCATION BETWEEN IMPLICIT PRICE CONCESSION AND CHARITY CARE IS DETERMINED BASED ON MANAGEMENT'S ANALYSIS ON THE PREVIOUS 12 MONTHS OF HOSPITAL DATA. THIS ANALYSIS CALCULATES THE ACTUAL PERCENTAGE OF ACCOUNTS WRITTEN OFF OR DESIGNATED AS IMPLICIT PRICE CONCESSIONS VERSUS CHARITY CARE WHILE TAKING INTO ACCOUNT THE TOTAL COSTS INCURRED BY THE SYSTEM FOR EACH ACCOUNT ANALYZED.THE CONNECTICUT DISPROPORTIONATE SHARE HOSPITAL PROGRAM (CDSHP) WAS ESTABLISHED TO PROVIDE FUNDS TO HOSPITALS FOR THE PROVISION OF UNCOMPENSATED CARE AND IS FUNDED, IN PART, BY AN ASSESSMENT ON HOSPITAL NET PATIENT SERVICE REVENUE. THE SYSTEM MADE PAYMENTS INTO THE CDSHP OF $317.2 MILLION AND $326.6 MILLION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY, FOR THE ASSESSMENT.DURING THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, THE SYSTEM RECEIVED $197.3 MILLION AND $187.8 MILLION, RESPECTIVELY, IN CDSHP DISTRIBUTIONS. THESE ARE RECORDED IN NET PATIENT SERVICE REVENUE.ADDITIONALLY, THE SYSTEM PROVIDES BENEFITS FOR THE BROADER COMMUNITY, WHICH INCLUDES SERVICES PROVIDED TO OTHER NEEDY POPULATIONS THAT MAY NOT QUALIFY AS POOR BUT NEED SPECIAL SERVICES AND SUPPORT. BENEFITS INCLUDE THE COST OF HEALTH PROMOTION AND EDUCATION OF THE GENERAL COMMUNITY, INTERNS AND RESIDENTS, HEALTH SCREENINGS, AND MEDICAL RESEARCH. THE BENEFITS ARE PROVIDED THROUGH THE COMMUNITY HEALTH CENTERS, SOME OF WHICH SERVICE NON ENGLISH SPEAKING RESIDENTS, DISABLED CHILDREN, AND VARIOUS COMMUNITY SUPPORT GROUPS.THE SYSTEM VOLUNTARILY ASSISTS WITH THE DIRECT FUNDING OF SEVERAL CITY OF NEW HAVEN PROGRAMS, INCLUDING AN ECONOMIC DEVELOPMENT PROGRAM AND A YOUTH INITIATIVE PROGRAM. IN ADDITION TO THE QUANTIFIABLE SERVICES DEFINED ABOVE, THE SYSTEM PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY THROUGH ITS ADVOCACY OF COMMUNITY SERVICE BY EMPLOYEES. THE SYSTEM'S EMPLOYEES SERVE NUMEROUS ORGANIZATIONS THROUGH BOARD REPRESENTATION, MEMBERSHIP IN ASSOCIATIONS AND OTHER RELATED ACTIVITIES. THE SYSTEM ALSO SOLICITS THE ASSISTANCE OF OTHER HEALTHCARE PROFESSIONALS TO PROVIDE THEIR SERVICES AT NO CHARGE THROUGH PARTICIPATION IN VARIOUS COMMUNITY SEMINARS AND TRAINING PROGRAMS."

PART VI, LINE 4:
TO DEFINE COMMUNITY FOR COMMUNITY HEALTH NEEDS ASSESSMENT PURPOSES, WESTERLY HOSPITAL USES A GEOGRAPHIC APPROACH FOCUSING 11 ZIP CODES SPANNING THE SOUTHWEST AND CENTRAL PORTIONS OF WASHINGTON COUNTY, RHODE ISLAND. THESE COMMUNITIES ARE SERVED BY WESTERLY HOSPITAL REPRESENTING APPROXIMATELY 50% OF TOTAL DISCHARGES AND DO NOT OVERLAP WITH CHNA AREAS IDENTIFIED BY OTHER ACUTE CARE HOSPITALS AND/OR COLLABORATIONS. UPON DEFINING THE GEOGRAPHIC AREA AND POPULATION SERVED IN GREATER WESTERLY, LMW HEALTHCARE WAS DILIGENT TO ENSURE THAT NO GROUPS, ESPECIALLY MINORITY, LOW-INCOME OR MEDICALLY UNDER-SERVED, WERE EXCLUDED.NUMEROUS FACTORS ARE ASSOCIATED WITH THE HEALTH OF A COMMUNITY INCLUDING WHAT RESOURCES AND SERVICES ARE AVAILABLE AS WELL AS WHO LIVES IN THE COMMUNITY. WHILE INDIVIDUAL CHARACTERISTICS SUCH AS AGE, GENDER, RACE, AND ETHNICITY HAVE AN IMPACT ON PEOPLE'S HEALTH, THE DISTRIBUTION OF THESE CHARACTERISTICS ACROSS A COMMUNITY IS ALSO CRITICALLY IMPORTANT AND CAN AFFECT THE NUMBER AND TYPE OF SERVICES AND RESOURCES AVAILABLE. THE GREATER WESTERLY REGION HAS A POPULATION OF 48,579. THE LIFE EXPECTANCY IN WASHINGTON COUNTY IS 81.0 YEARS COMPARED TO 79.8 IN RHODE ISLAND. THE LIFE EXPECTANCY RATE FOR WASHINGTON COUNTY RESIDENTS OF ASIAN ETHNICITY IS 89 AND 89.9 FOR LATINX ORIGIN. IN GREATER WESTERLY APPROXIMATELY 95% OF THE TOTAL POPULATION IDENTIFIED AS WHITE COMPARED TO 92.9% IN WASHINGTON COUNTY, 80.5% IN RHODE ISLAND AND 72.5% IN THE UNITED STATES. WESTERLY IS A DESIGNATED AGE-FRIENDLY COMMUNITY AND IS DEDICATED TO SUPPORTING PROGRAMS AND INITIATIVES THAT ENHANCE HEALTH, PARTICIPATION, AND SECURITY OF OLDER ADULTS. THE OLDER ADULT (65 AND OVER) IN WESTERLY (22%) AND WASHINGTON COUNTY (19.9%) ARE HIGHER THAN THE STATE OF RHODE ISLAND (16.8%).INCOME AND POVERTY ARE CLOSELY CONNECTED TO HEALTH OUTCOMES. A HIGHER INCOME MAKES IT EASIER TO LIVE IN A SAFE NEIGHBORHOOD WITH GOOD SCHOOLS AND MANY RECREATIONAL OPPORTUNITIES. HIGHER WAGE EARNERS ARE BETTER ABLE TO BUY MEDICAL INSURANCE AND MEDICAL CARE, PURCHASE NUTRITIOUS FOODS, AND OBTAIN QUALITY CHILDCARE THAN THOSE EARNING LOWER WAGES. COMMUNITIES WHERE RESIDENTS HAVE LOWER INCOME LEVELS HAVE BEEN SHOWN TO HAVE HIGHER RATES OF ASTHMA, DIABETES, AND HEART DISEASE, AND LOWER LIFE EXPECTANCIES. WASHINGTON COUNTY ($85,531) HAS THE HIGHEST MEDIAN HOUSEHOLD INCOME IN RHODE ISLAND, COMPARED TO ONLY $67,167 IN THE STATE. DISPARITIES EXIST WITHIN THE COUNTY WHERE 8.6% OF PEOPLE ARE IN POVERTY, 9.2% OF CHILDREN IN POVERTY, AND 5.7% OF OLDER ADULTS (65 AND OVER). THE PROPORTION OF RESIDENTS IN WASHINGTON COUNTY WITH A BACHELOR'S DEGREE OR HIGHER (46.1%) WAS HIGHER THAN THE STATE OVERALL (34.2%). HOWEVER, ONLY 34% OF LATINX ORIGIN AND 31.3% OF INDIVIDUALS IDENTIFYING AS BLACK / AFRICAN AMERICAN HOLD A BACHELOR'S DEGREE. IN WASHINGTON COUNTY 5.1% OF THE POPULATION HAS LESS THAN A HIGH SCHOOL DIPLOMA AND 22.8% ARE HIGH SCHOOL GRADUATES OR HAVE A GED.

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AS A COMMUNITY HEALTH CARE SERVICES PROVIDER, LMW HEALTHCARE REMAINS ATTENTIVE TO HEALTH AND WELL-BEING THROUGH EDUCATION, OUTREACH, AND OTHER INNOVATIVE SERVICES. DURING FISCAL YEAR 2022, LMW HEALTHCARE INVESTED OVER $9.2 MILLION IN FINANCIAL AND IN-KIND CONTRIBUTIONS THROUGH THREE WIDE-RANGING PROGRAMS: GUARANTEEING ACCESS TO CARE; ADVANCING CAREERS IN HEALTH CARE AND PROMOTING HEALTH & WELLNESS. LMW HEALTHCARE ALSO CONTRIBUTES TO THE COMMUNITY IN WAYS THAT ARE NOT QUANTIFIED AS PART OF COMMUNITY BENEFITS AND SERVES AS AN IMPORTANT COMMUNITY RESOURCE. THIS INCLUDES HAVING A COMMUNITY-BASED BOARD OF TRUSTEES WITH A MAJORITY MEMBERS RESIDING OR WORKING IN THE AREA SERVED BY THE HOSPITAL. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. IN FISCAL YEAR 2022 THERE WERE A TOTAL OF 311 MEMBERS OF THE LMW HEALTHCARE MEDICAL STAFF. LMW HEALTHCARE IS A 125-BED HOSPITAL SERVING 4,700 INPATIENTS AND 144,586 OUTPATIENT ENCOUNTERS IN 2022. WESTERLY HOSPITAL PROVIDES WASHINGTON (RHODE ISLAND) AND NEW LONDON (CONNECTICUT) COUNTY RESIDENTS A WIDE ARRAY OF MEDICAL, SURGICAL, LABORATORY AND REHABILITATIVE SERVICES. IT OFFERS INTERVENTIONAL PAIN MANAGEMENT, WOUND CARE AND ANTICOAGULATION CLINIC AND CARDIAC PULMONARY REHABILITATION SERVICES. IT IS ALSO THE SITE OF THE FIRST SMILOW CANCER HOSPITAL CARE CENTER IN RHODE ISLAND. LMW HEALTHCARE IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN WESTERLY WITH 743 EMPLOYEES IN 2022.

Operating expenses	$ 127,923,831
Total amount spent on community benefits as % of operating expenses	$ 9,165,736 7.16 %