2024-05-15T09:00:32-05:00 2023-06-30 990 2022-07-01 941437713 SAINT AGNES MEDICAL CENTER SAIN 5594503000 1303 EAST HERNDON AVENUE FRESNO CA 93720 JENNY HERNANDEZ VP OF FINANCE 5594503000 2024-05-15 JENNY HERNANDEZ 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z GURVINDER KAUR MD 1303 EAST HERNDON AVENUE FRESNO CA 93720 628103910 0 0928 X WWW.SAMC.COM X 1958 CA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES. 16 13 3843 89 176074 9219 13001642 7347889 596682943 607725553 20831483 4308388 4819974 5463362 635336042 624845192 1610717 1073219 0 0 251642975 307336789 0 0 643343 393364165 372734129 646617857 681144137 -11281815 -56298945 734162920 647710377 231959813 237120467 502203107 410589910 X WE, SAINT AGNES MEDICAL CENTER AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. SAINT AGNES MEDICAL CENTER IS A MEMBER OF TRINITY HEALTH. 0 0 631304013 1073219 608983159 SAINT AGNES MEDICAL CENTER, LOCATED IN FRESNO, CALIFORNIA, IS AN ACUTE-CARE HOSPITAL SERVING THE RESIDENTS IN FOUR LOCAL COUNTIES; FRESNO, MADERA, KINGS, AND TULARE. SAINT AGNES MEDICAL CENTER OPERATES A 436-BED, STATE-OF-THE-ART MEDICAL CENTER CAMPUS, BRINGING TOGETHER THE MOST ADVANCED EQUIPMENT AND FACILITIES, AND THE EXPERTISE OF TOP-RANKED PHYSICIANS AND STAFF. FOR OVER 80 YEARS, SAINT AGNES MEDICAL CENTER HAS PROMISED TO PROVIDE THE HIGHEST QUALITY, MOST COMPASSIONATE HEALTH CARE TO THE PEOPLE IN THE SAN JOAQUIN VALLEY. FROM EMERGENCY, DIAGNOSTIC AND REHABILITATIVE SERVICES TO CARDIAC, CANCER, NEUROLOGICAL AND ORTHOPEDIC CARE, SAINT AGNES MEDICAL CENTER CAN BE TRUSTED TO BE THERE TO SERVE THE PEOPLE OF THESE COMMUNITIES FOR YEARS TO COME. IN FISCAL YEAR 2023, THE HOSPITAL PROVIDED 115,671 PATIENT DAYS OF HEALTH CARE SERVICES TO THE COMMUNITY.PLEASE SEE SCHEDULE H AND VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.SAMC.COM 631304013 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 455 0 1 3843 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 16 13 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 CA X STEPHANIE PLISCHKE 2083674504 1303 E HERNDON AVENUE FRESNO CA 93720 BENJAMIN CARTER DIRECTOR AS OF 4/23; TRINITY COO 2.00 53.00 X 0 2758940 98795 ODETTE BOLANO DIRECTOR, CEO WEST REGION AS OF 5/23 1.00 54.00 X X 0 1142266 223555 SHERI SHAPIRO DIRECTOR, TRINITY SVP THROUGH 3/23 2.00 48.00 X 0 1293472 52332 NANCY HOLLINGSWORTH DIRECTOR, PRESIDENT & CEO THR 5/23 54.00 1.00 X X 0 892175 67034 DAVID SPIVEY DIR, INT PRES AS OF 6/23; TH CONS 55.00 0.00 X X 0 887462 64057 W EUGENE EGERTON MD CHIEF MEDICAL OFFICER THR 1/23 50.00 0.00 X 0 604133 45938 STACY VAILLANCOURT CHIEF OPERATING OFFICER 50.00 0.00 X 0 473326 43191 DEANETTE SISSON CHIEF NURSING OFFICER 50.00 0.00 X 0 398768 39641 RICK WOLF SECRETARY; ASSOCIATE COUNSEL 50.00 0.00 X 0 335788 43842 GERALD MARGOSIAN COORDINATOR PHARMACY OPERATIONS 50.00 0.00 X 312903 0 50772 MICHAEL FREUDIGER CHARGE PHARMACIST 50.00 0.00 X 329076 0 23215 EDNANN NAZ CHIEF MEDICAL INFORMATICS OFFICER 50.00 0.00 X 306020 0 35248 JOCELYN LLEMIT CLINICAL NURSE 50.00 0.00 X 293247 0 44694 DOROTA FAULK CLINICAL NURSE 50.00 0.00 X 291833 0 34777 JUDGE ROBERT OLIVER DIRECTOR; CHAIR 3.00 1.00 X X 0 0 0 LUIS SANTANA DIRECTOR; VICE CHAIR 2.00 0.00 X X 0 0 0 TERRI DONOVAN PAID BY MGMT CO TREASURER; INTERIM VP OF FINANCE 50.00 0.00 X 0 0 0 MARY BOWLER CSC DIRECTOR 2.00 0.00 X 0 0 0 PILAR DELACRUZ SAMOULIAN DIRECTOR 2.00 0.00 X 0 0 0 ALLEN EVANS MD DIRECTOR 2.00 0.00 X 0 0 0 SUSAN KUSZMAR DIRECTOR 2.00 0.00 X 0 0 0 JULIE MALDONADO DIRECTOR 2.00 0.00 X 0 0 0 TERRENCE O'ROURKE MD DIRECTOR 2.00 0.00 X 0 0 0 DALPINDER SANDHU MD DIRECTOR 2.00 0.00 X 0 0 0 RON WATHEN DIRECTOR 2.00 0.00 X 0 0 0 DORA WESTERLUND DIRECTOR 2.00 0.00 X 0 0 0 PAO YANG DIRECTOR 2.00 0.00 X 0 0 0 JANET YOUNG DIRECTOR 2.00 0.00 X 0 0 0 1533079 8786330 867091 817 0 1 0 HALLMARK HEALTH CARE SOLUTIONS INC PO BOX 22937 NEW YORK NY 108872937 TEMPORARY MEDICAL STAFFING SERVICES 32358382 AMERISOURCEBERGEN DRUG CORP 1 WEST FIRST AVENUE CONSHOHOCKEN PA 19428 PHARMACEUTICAL SERVICES 13171393 STRATEGIC STAFFING SOLUTIONS 645 GRISWOLD STREET DETROIT MI 48226 TEMPORARY MEDICAL STAFFING SERVICES 8803635 CARDINAL VALUELINK 7000 CARDINAL PLACE DUBLIN OH 43017 DISTRIBUTION SERVICES 6457567 NISC 820 UNIVERSITY CITY BLVD SUITE 5 BLACKSBURG VA 24060 HARDWARE AND SOFTWARE SERVICES 6435085 112 85148 300371 6633006 329364 7347889 NET PATIENT SERVICE REVENUE 622110 607725553 607549479 176074 607725553 2300913 2300913 4563967 3040281 1523686 1523686 1523686 2004975 2500 0 0 2004975 2500 2007475 2007475 402449 85148 218437 184012 184012 CAFETERIA REVENUE 722514 2321984 2321984 OTHER RELATED REVENUE 621110 880556 880556 MANAGEMENT SERVICE REVENUE 541610 553124 553124 3755664 624845192 608983159 176074 8338070 867336 867336 205883 205883 3895355 3895355 73408 73408 258598687 249630043 8635847 332797 15255159 14624706 610960 19493 10722131 10397113 311147 13871 18792049 18053826 713525 24698 660375 660375 504119 504119 133800 133800 107482 107482 226516 226516 60795303 58326436 2423171 45696 1480201 171609 1293816 14776 5508106 3955432 1518820 33854 22855265 18277956 4577309 15031467 12994490 2024259 12718 131788 112315 19473 486021 448164 18524 19333 3553103 3553103 21328199 19813890 1510491 3818 6840478 6840478 MEDICAL SUPPLIES EXP 95724957 95724957 I/C PURCHASED SERVICES 57913728 41656187 16257541 HOSPITAL PROVIDER TAX 42818138 42818138 BAD DEBT EXPENSE 22092298 22092298 14542785 10005870 4414626 122289 681144137 631304013 49196781 643343 266879 756275 101375 56470 202066893 238434873 805618 491900 10260707 9054742 763329 944325 613187938 414068339 194595490 199119599 155481619 77907941 102695655 59427380 1181250 876623 65944105 60640249 734162920 647710377 81751146 100165795 1075751 3728843 109244 38770 149023672 133187059 231959813 237120467 X 490459543 397075614 11743564 13514296 502203107 410589910 734162920 647710377 X -56298945 7460420 -42774672 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 73024 1 107482 0 0 180506 0 PART II-B, LINE 1: SAINT AGNES MEDICAL CENTER HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED SAINT AGNES MEDICAL CENTER WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. SAINT AGNES MEDICAL CENTER ALSO PAID A THIRD PARTY LOBBYING FIRM DURING THE YEAR TO LOBBY FOR OR AGAINST LEGISLATION DETERMINED TO BE OF INTEREST OF SAINT AGNES MEDICAL CENTER. 5482729 1201 -18881 5465049 7183017 185445 -3490 1882243 5482729 5991896 173500 1017621 7183017 5621188 1000 209120 -160588 5991896 5593467 20267 -7305 -14759 5621188 0.00000 1.00000 0.00000 0 0 2045927 8448466 10494393 274934852 174363270 100571582 4235966 3331089 904877 283151871 236373980 46777891 40370856 40370856 199119599 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 11287123 F EQUITY METHOD INVESTMENTS 39436934 C HEDGE FUNDS 8703323 F 59427380 INTERCOMPANY OTHER LT ASSETS 32091751 MISCELLANEOUS RECEIVABLES 979566 INTERCOMPANY ACCOUNTS RECEIVABLE 20971661 INVESTMENT IN UNCONSOL. AFFILIATES 897040 OTHER LONG TERM ASSETS 1229974 OPERATING LEASE RIGHT-OF-USE ASSETS 4470257 60640249 INTERCOMPANY ACCOUNTS PAYABLE 33702447 ASSET RETIREMENT OBLIGATION (FIN 47) 2625928 INTERCOMPANY NOTES PAYABLE 91610667 OTHER LONG-TERM LIABILITIES 282950 OTHER CURRENT LIABILITIES 472205 OPERATING LEASE LIABILITIES 4492862 133187059 PART V, LINE 4: SAINT AGNES MEDICAL CENTER'S ENDOWMENT FUNDS ARE USED FOR CAPITAL ACQUISITIONS, STAFF EDUCATION, AND HEALTH CARE OPERATIONS. PRESIDENT'S CLASSIC 152423 22550 129873 20487 3881 33066 CASINO NIGHT 335174 62598 272576 2282 37944 54640 9194 56943 487597 85148 402449 2282 58431 58521 9194 90009 218437 184012 1 1 X 1 X 1 X 1 1 0 1 1 1860258 1860258 0.00280 220774338 168209049 52565289 0.07980 222634596 168209049 54425547 0.08260 19 18381 1833315 396371 1436944 0.00220 4 23920 30200361 12663943 17536418 0.02660 1 404 22651 22651 0.00000 6 1983 945112 945112 0.00140 30 44688 33001439 13060314 19941125 0.03020 30 44688 255636035 181269363 74366672 0.11280 1 311212 300371 10841 0.00000 1 560 1443 1443 0.00000 2 560 312655 300371 12284 0.00000 1 22092298 0 161794661 169053572 -7258911 X 1 1 1 RENAISSANCE SURGERY CENTER LLC AMBULATORY SURGICAL SERVICES 0.25550 0.49000 2 FRESNO SURGERY CENTER LP AMBULATORY SURGICAL SERVICES 0.35750 0.28650 3 CENTRAL CALIFORNIA HEALTHCARE HOLDINGS LLC HEALTH CARE MANAGEMENT 0.35750 0.28650 2 1 SAINT AGNES MEDICAL CENTER 1303 E HERNDON AVE FRESNO CA 93720 WWW.SAMC.COM HOSPITAL LICENSE # 040000173 X X X X 2 FRESNO SURGICAL HOSPITAL 6125 N FRESNO STREET FRESNO CA 93710 WWW.FRESNOSURGICALHOSPITAL.COM HOSPITAL LICENSE # 040000332 X X SAINT AGNES MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X 1 23 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 FRESNO SURGICAL HOSPITAL 2 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X 1 23 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 1 1 X X X 1 X WWW.FRESNOSURGICALHOSPITAL.COM/PATIENTS-VISITORS/ X WWW.FRESNOSURGICALHOSPITAL.COM/PATIENTS-VISITORS/ X WWW.FRESNOSURGICALHOSPITAL.COM/PATIENTS-VISITORS/ X X X X X X 1 X 0 X X X X 0 X X 0 0 SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: SAINT AGNES MEDICAL CENTER & FRESNO SURGICAL HOSPITAL:SAINT AGNES MEDICAL CENTER (SAMC) AND FRESNO SURGICAL HOSPITAL (FSH) INCLUDED IN THEIR JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS. THE FOLLOWING HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY INVOLVED SELECTION PROCESS USING A BASIC PRIORITY RATING METHOD. THIS METHOD CONSIDERS FOUR CRITERIA, INCLUDING POTENTIAL IMPACT ON THE GREATEST NUMBER OF PEOPLE, SEVERITY, MAGNITUDE AND URGENCY OF THE NEED, THE EFFECTIVENESS OF POSSIBLE INTERVENTIONS AND PROPRIETY. THE SCORES FOR EACH HEALTH NEED WERE AVERAGED AND RANKED BY SIGNIFICANCE AS FOLLOWS: 1. POVERTY2. POOR AIR QUALITY/POLLUTION3. HOMELESSNESS4. FOOD INSECURITY5. SAFETY/NEIGHBORHOOD CRIME6. LACK OF AFFORDABLE/ACCEPTABLE HOUSING7. INSURANCE BARRIER/ACCESS TO MEDICAL CARE8. NOT ENOUGH PROVIDERS/TREATMENT LOCATIONS/LONG WAIT TIMES9. EXPENSIVE MEDICAL CARE10. LACK OF PROVIDER COMPASSION/DISCRIMINATION11. LACK OF TRANSPORTATIONTO CONDUCT THE 2022 CHNA, SAMC AND FSH PARTNERED WITH OTHER CENTRAL VALLEY HOSPITALS, DEPARTMENTS OF PUBLIC HEALTH FOR FRESNO AND MADERA COUNTIES AND THE HOSPITAL COUNCIL OF NORTHERN CALIFORNIA. THESE ENTITIES FORMED A DATA ADVISORY COMMITTEE WHICH APPROACHED THE CHNA PROCESS WITH AN EQUITY LENS, ENSURING THAT POPULATIONS, COMMUNITIES AND HIGH PRIORITY ZIP CODES CHALLENGED WITH HEALTH AND HEALTH CARE DISPARITIES REMAINED A FOCAL POINT. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 5: SAINT AGNES MEDICAL CENTER & FRESNO SURGICAL HOSPITAL:THREE METHODS OF PRIMARY DATA COLLECTION TOOK PLACE BETWEEN OCTOBER 25 AND DECEMBER 10, 2021. THE METHODS INCLUDED ONLINE AND IN-PERSON SURVEYS, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. TO ENSURE MAXIMUM INPUT WAS PROVIDED FOR THE CHNA, THE COMMITTEE DIRECTED THE HOSPITAL COUNCIL TO CONTRACT WITH LOCAL COMMUNITY-BASED ORGANIZATIONS (CBO) SERVING AREAS OF HIGH NEED AND WHOM ALREADY HAD A TRUSTING RELATIONSHIP AND STRONG COMMUNITY ENGAGEMENT IN THE IDENTIFIED COMMUNITIES. IN FRESNO, THE CBOS INCLUDED:- CULTIVA LA SALUD, A NON-PROFIT CBO DEDICATED TO CREATING HEALTH EQUITY IN THE SAN JOAQUIN VALLEY BY FOSTERING CHANGES IN COMMUNITIES THAT SUPPORT HEALTHY EATING AND ACTIVE LIVING. SERVICES PROVIDED BY CULTIVA INCLUDE LEADERSHIP DEVELOPMENT TRAINING, HEALTH AND WELLNESS PROGRAMS, AND COVID-19 EDUCATION AND AWARENESS. THE AGENCY SERVES FARMWORKERS AND LOW-INCOME RESIDENTS IN EIGHT COUNTIES OF THE CENTRAL VALLEY, INCLUDING FRESNO AND MADERA. - EVERY NEIGHBORHOOD PARTNERSHIP (ENP), A NON-PROFIT CBO WHOSE WORK FOCUSES ON NEIGHBORHOOD DEVELOPMENT, HEALTH AND WELLNESS PROGRAMS, LITERACY PROGRAMS, SATURDAY SPORTS AND CHURCH EQUIPPING. POPULATIONS SERVED BY ENP INCLUDE YOUTH, ADULT RESIDENTS AND CHURCH LEADERS WITHIN THE FRESNO CITY LIMITS. - THE FRESNO CENTER, A NON-PROFIT CBO THAT SERVES SOUTHEAST ASIAN HMONG, CAMBODIAN, LAO, THAI, PUNJABI, INDIGENOUS MEXICAN AND VIETNAMESE RESIDENTS IN FRESNO COUNTY. SERVICES INCLUDE EXPERT TRANSLATION AND CROSS-CULTURAL PROGRAMS, MED-CAL HEALTH ENROLLMENT, TOBACCO CESSATION, IMMIGRATION SERVICES, COVID-19 RELIEF, ONE-STOP CENTER FOR MENTAL HEALTH, COMMUNITY RESOURCE CONNECTIONS AND CRISIS SERVICES. - FRESNO INTERDENOMINATIONAL REFUGEE MINISTRIES, A FAITH-BASED COMMUNITY ORGANIZATION WHOSE MISSION IS TO PROVIDE WRAP-AROUND SERVICES FOR REFUGEES OF SOUTHEAST ASIAN, SLAVIC AND AFRICAN ORIGIN. SERVICES INCLUDE AFTER-SCHOOL PROGRAMS, REFUGEE ADVOCACY, MENTAL HEALTH PROGRAMS, AND COMMUNITY GARDENS.IN MADERA, THE PARTNERS INCLUDED:- UNITED WAY OF FRESNO AND MADERA COUNTIES (UNITED WAY), AN AGENCY THAT ENGAGES IN 1,800 COMMUNITIES ACROSS MORE THAN 40 COUNTRIES AND TERRITORIES WORLDWIDE. THEIR MISSION IS TO IMPROVE LIVES BY MOBILIZING THE CARING POWER OF COMMUNITIES TO ADVANCE THE COMMON GOOD. SERVICES IN THE AREA INCLUDE 2-1-1, 24/7 HOTLINE, FREE TAX PREPARATION, OUTREACH PROGRAM, BASIC NEEDS CONNECTIONS AND COVID-19 EDUCATION AND AWARENESS. UNITED WAY'S CHNA ROLE INCLUDED WORKING WITH GRASS-ROOTS AGENCIES AND RESIDENTS TO BUILD COMMUNITY CAPACITY FOR CONDUCTING ASSESSMENTS. UNITED WAY COLLABORATED WITH MEMBERS OF LIVE WELL MADERA. - LIVE WELL MADERA, A COLLABORATIVE COMPOSED OF COUNTYWIDE GOVERNMENT AGENCY REPRESENTATIVES, HEALTH CARE PROVIDERS, HEALTH PLANS, BUSINESS, EDUCATION, LAW ENFORCEMENT, COMMUNITY-BASED AGENCIES, FAITH-BASED STAKEHOLDERS AND RESIDENTS, ALL COMMITTED TO IMPROVING COMMUNITY WELLNESS THROUGH FOCUSES ALIGNED ACTION. THE COLLABORATIVE PLAYS A CRUCIAL ROLE IN EXPANDING ACCESS, ADDRESSING HEALTH EQUITY, AND MAKING HEALTHY BEHAVIORS AND ENVIRONMENTS THE SOCIAL NORM FOR THE COUNTY'S MORE THAN 150,000 RESIDENTS. ONLINE SURVEYS WERE SOLICITED BY INVITATION ONLY, BASED ON A CONVENIENCE SAMPLING. TO ENSURE THE SURVEY SAMPLE REFLECTED A WIDE VARIETY OF SOCIOECONOMIC LEVELS, AGE AND RACE/ETHNICITY, AND RURAL GEOGRAPHIC REGIONS, THE SURVEY WAS OFFERED TO COMMUNITY GROUPS BY CONTRACTED CBOS. HARD COPY SURVEYS WERE SHARED WITH COMMUNITY GROUPS TO FACILITATE BROAD-BASED REPRESENTATION OF SENIORS 65+ AND UNDERSERVED POPULATIONS IN HIGH PRIORITY ZIP CODES. HIGH PRIORITY ZIP CODES ARE AREAS WHERE AT LEAST 40% OF THE POPULATION IS BLACK OR HISPANIC AND THE AVERAGE EARNINGS FOR THE COMMUNITY IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL GUIDELINE ($52,400 FOR A FAMILY OF FOUR). A TOTAL OF 2,876 SURVEYS WERE COLLECTED FOR FRESNO AND MADERA COUNTIES. IN FRESNO COUNTY, FOCUS GROUPS WERE FACILITATED BY CONTRACTED CBOS. IN MADERA COUNTY, THE WORK WAS COORDINATED BY UNITED WAY OF FRESNO AND MADERA COUNTIES WHO PARTNERED WITH LIVE WELL MADERA. COMMUNITY MEMBERS ATTENDED IN PERSON AND ON ZOOM, WITH MORE THAN 50% OF THE SESSIONS BEING CONDUCTED IN PERSON. A TOTAL OF 36 FOCUS GROUPS WERE COMPLETED. THIRTY-ONE INDIVIDUAL STAKEHOLDERS IN THE COMMUNITY WERE IDENTIFIED DURING THE CHNA PLANNING PROCESS AND PROVIDED A UNIQUE PERSPECTIVE ON THE HEALTH OF THE COMMUNITY, HEALTH CARE DELIVERY SYSTEM AND OVERALL CONDITIONS THAT INFLUENCE HEALTH BEHAVIORS. THEIR ORGANIZATIONS REPRESENTED CONSTITUENTS INCLUDING MEMBERS OF MEDICALLY UNDERSERVED POPULATIONS EXPERIENCING HEALTH DISPARITIES, OR POPULATIONS AT RISK OF NOT RECEIVING ADEQUATE MEDICAL CARE AS A RESULT OF BEING UNINSURED OR UNDERINSURED, OR DUE TO GEOGRAPHIC, LANGUAGE, FINANCIAL OR OTHER BARRIERS. KEY STAKEHOLDERS REPRESENTED: - BLACK WELLNESS & PROSPERITY CENTER- CENTRO BINACIONAL PARA EL DESARROLLO INDIGENA- CITY OF MADERA- COMMUNITY ACTION PARTNERSHIP AGENCY OF MADERA COUNTY - FIRST 5 MADERA- FRESNO COUNTY DEPARTMENT OF BEHAVIORAL HEALTH- FRESNO COUNTY SUPERINTENDENT OF SCHOOLS- FRESNO UNIFIED SCHOOL DISTRICT- LEADERSHIP COUNCIL FOR JUSTICE ACCOUNTABILITY - MADERA COUNTY DEPARTMENT OF SOCIAL SERVICES- MADERA COUNTY SUPERINTENDENT OF SCHOOLS- MADERA COMMUNITY COLLEGE- PARENT INSTITUTE FOR QUALITY EDUCATION QUALITATIVE AND QUANTITATIVE DATA WAS ANALYZED BY CALIFORNIA STATE UNIVERSITY FRESNO'S CENTRAL VALLEY HEALTH POLICY INSTITUTE (CVHPI). CVHPI FACILITATES REGIONAL RESEARCH, LEADERSHIP TRAINING AND GRADUATE EDUCATION PROGRAMS TO ADDRESS EMERGING HEALTHY POLICY ISSUES THAT INFLUENCE THE HEALTH STATUS OF PEOPLE LIVING IN CENTRAL CALIFORNIA. CVHPI USED A GROUNDED THEORY APPROACH TO IDENTIFY COMMON TOPICS OF FOCUS GROUP DISCUSSIONS AND THEMES. ALL THEMES WERE GROUPED INTO BROADER, MORE INCLUSIVE SOCIAL DETERMINANT OF HEALTH DOMAINS, INCLUDING ECONOMIC STABILITY, EDUCATION ACCESS, SOCIAL AND HEALTH AND HEALTH BEHAVIOR, HEALTH CARE ACCESS AND QUALITY, NEIGHBORHOOD AND ENVIRONMENT, SOCIAL AND COMMUNITY CONTEXT, AND A SPECIFIC DOMAIN ON COVID-19 RELATED ISSUES. FOCUS GROUP AND KEY INFORMANT DATA WERE ANALYZED INDEPENDENTLY OF EACH OTHER. HOWEVER, THE SAME METHOD WAS USED TO ANALYZE BOTH DATA SETS. THEMES GATHERED FROM FOCUS GROUP DISCUSSIONS WERE COMPARED TO A LIST OF THEMES GATHERED FROM KEY INFORMANT INTERVIEWS PLUS A COMPOSITE SCORE USING QUANTITATIVE DATA WAS USED TO CREATE A HIGH PRIORITY LIST. AS PART OF THE CHNA, FORTY-EIGHT ADVISORS WERE CONVENED TO PRIORITIZE THE IDENTIFIED HEALTH NEEDS. THE ADVISORS INCLUDED RESIDENTS, PROMOTERS, COMMUNITY HEALTH LEADERS, LAW ENFORCEMENT, SCHOOL HEALTH, COUNTY AGENCY PERSONNEL, HOUSING AGENCY REPRESENTATIVES, YOUTH, COMMUNITY-BASED ORGANIZATION LEADERS, WHO WERE SELECTED BASED ON THEIR KNOWLEDGE AND INVOLVEMENT IN THE FRESNO AND MADERA COMMUNITIES.SECONDARY DATA FROM THE TRINITY HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT DATA REPORT (TRINITYHEALTHDATAHUB.ORG), AND THE FRESNO MADERA COUNTIES' POINT-IN-TIME HOMELESS COUNT WAS USED DURING THE PRIORITIZATION PROCESS. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING HOSPITALS: FRESNO SURGICAL HOSPITAL, CLOVIS COMMUNITY MEDICAL CENTER, COMMUNITY REGIONAL MEDICAL CENTER (INCLUDES COMMUNITY BEHAVIORAL HEALTH CENTER), MADERA COMMUNITY HOSPITAL, AND VALLEY CHILDREN'S HEALTHCARE. FRESNO SURGICAL HOSPITAL PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING HOSPITALS: SAINT AGNES MEDICAL CENTER, CLOVIS COMMUNITY MEDICAL CENTER, COMMUNITY REGIONAL MEDICAL CENTER (INCLUDES COMMUNITY BEHAVIORAL HEALTH CENTER); MADERA COMMUNITY HOSPITAL, AND VALLEY CHILDREN'S HEALTHCARE. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA WAS ALSO CONDUCTED IN COLLABORATION WITH THE DEPARTMENTS OF PUBLIC HEALTH FOR BOTH FRESNO AND MADERA COUNTIES. FRESNO SURGICAL HOSPITAL PART V, SECTION B, LINE 6B: THE CHNA WAS ALSO CONDUCTED IN COLLABORATION WITH THE DEPARTMENTS OF PUBLIC HEALTH FOR BOTH FRESNO AND MADERA COUNTIES. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 11: IN FISCAL YEAR 2023, SAMC ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT CHNA:NOT ENOUGH PROVIDERS/TREATMENT LOCATIONS/LONG WAIT TIMES - SAMC CONTINUED TO PROVIDE OPPORTUNITIES FOR LICENSED AND UNLICENSED HEALTH CARE PROVIDERS TO ENHANCE THEIR PROFESSIONAL KNOWLEDGE AND SKILLS. SAMC'S CONTINUING MEDICAL EDUCATION PROGRAM STRIVES TO IMPROVE AND INCREASE PATIENT CARE IN THE CENTRAL VALLEY, SPECIFICALLY IN FRESNO AND MADERA. SAMC PROVIDED MORE THAN 19,807 TRAINING HOURS TO 2,799 NURSING AND OTHER PROFESSIONS WHICH IMPACTED AND INVESTED ALMOST $14.4 MILLION IN NET COMMUNITY BENEFIT IN THE FOLLOWING MANNER:SAMC PARTNERED WITH LOCAL COLLEGES, UNIVERSITIES, AND SPECIALTY SCHOOLS TO PROVIDE A CLINICAL SETTING FOR UNDERGRADUATE AND VOCATIONAL TRAINING TO NURSES AND NURSING STUDENTS WORKING TO OBTAIN CERTIFICATES AND/OR LICENSURE TO ADVANCE THEIR CAREERS IN THE HEALTH CARE INDUSTRY. SAMC ALSO OFFERED A CLINICAL SETTING FOR THE FOLLOWING PROFESSIONS SEEKING TO OBTAIN RELATED CERTIFICATES AND LICENSES: PARAMEDICS, RESPIRATORY THERAPY, PHARMACY TECHNICIANS, IMAGING, PHYSICAL THERAPY, HEALTH INFORMATION MANAGEMENT, DIETETICS, SOCIAL WORK, PHLEBOTOMIST TECHNICIANS, AND CARDIAC SONOGRAPHY TECHNICIANS. FRESNO COUNTY HAS ONE OF THE LOWEST DOCTOR-TO-PATIENT POPULATION RATIOS IN THE STATE AND SAMC IS COMMITTED TO EDUCATING THE NEXT GENERATION OF PHYSICIANS THROUGH ITS GRADUATE MEDICAL EDUCATION (GME) PROGRAM. THE RESIDENCY PROGRAM BENEFITED THE LOCAL COMMUNITY BY RECRUITING RESIDENTS FROM THE SAMC GME PROGRAM'S GRADUATES TO STAY AND PRACTICE MEDICINE IN THE CENTRAL VALLEY. SAMC WELCOMED NEW COHORTS OF PHYSICIAN RESIDENTS INCLUDING FAMILY MEDICINE RESIDENTS, INTERNAL MEDICINE RESIDENTS, AND EMERGENCY MEDICINE RESIDENTS PLUS TRANSITIONAL YEAR RESIDENTS. IN FEBRUARY 2023, SAMC PARTNERED WITH THE FRESNO COUNTY PUBLIC HEALTH DEPARTMENT'S RURAL MOBILE HEALTH INITIATIVE. SAMC THIRD AND FOURTH-YEAR FAMILY AND INTERNAL MEDICINE RESIDENTS WORKED ALONG-SIDE THE FRESNO STATE NURSING PROGRAM TO PROVIDE A LEARNING ENVIRONMENT FOR STUDENTS. THE MOBILE HEALTH PROGRAM PROVIDED HEALTH SCREENINGS, VACCINATIONS, CHRONIC DISEASE PREVENTION EDUCATION TO 294 FARMWORKERS AND PEOPLE EXPERIENCING HOMELESSNESS IN FRESNO COUNTY.A PARTNERSHIP BETWEEN SAMC'S HOLY CROSS HEALTH AND WELLNESS CENTER, WESTCARE OF CALIFORNIA, AND KINGS VIEW PROVIDED SERVICES TO MORE THAN 360 PEOPLE. THE CENTER INCREASED ACCESS AND DECREASED WAITING TIMES FOR BEHAVIORAL HEALTH, SUBSTANCE USE AND MENTAL HEALTH SERVICES AND SUPPORT GROUPS TO PEOPLE EXPERIENCING POVERTY. ADDITIONALLY, SAMC'S SUBSTANCE USE NAVIGATOR PROVIDED LINKS TO SERVICES AND NAVIGATION SUPPORT TO MORE THAN 400 PATIENTS EXPERIENCING SUBSTANCE USE ISSUES. FOOD INSECURITY - IN FISCAL YEAR 2023, SAMC PROVIDED FOOD AND RESOURCE CONNECTIONS TO MORE THAN 1,800 PEOPLE EXPERIENCING HOMELESSNESS AND TO PATIENTS EXPERIENCING POVERTY AND MEDICAL FRAGILITY. COMMUNITY HEALTH WORKERS CONNECTED PATIENTS TO FOOD DISTRIBUTION SITES, COMMUNITY-BASED ORGANIZATIONS, AND FOOD DELIVERY. SAINT AGNES ALSO PROVIDED MEALS TO PATIENTS EXPERIENCING HOMELESSNESS TO MEET SB1152 REQUIREMENTS. IN TOTAL, MORE THAN $24,000 IN NET COMMUNITY BENEFIT WAS PROVIDED TO ENSURE ACCESS TO HEALTH FOODS. ADDITIONALLY, SAMC STAFF PARTICIPATED AS ADVISORS TO THE FOOD SECURITY NETWORK AND FRESNO COUNTY HEALTH IMPROVEMENT PARTNERSHIP. LACK OF TRANSPORTATION - SAMC PROVIDED 2,240 QUALIFYING PATIENTS TRANSPORTATION UPON DISCHARGE, PATIENTS AND HEALTH HUB CLIENTS WERE ALSO PROVIDED TRANSPORTATION TO AND FROM MEDICAL AND SOCIAL SERVICE APPOINTMENTS FOR A TOTAL OF $64,850.HOMELESSNESS - WHILE HOMELESSNESS ITSELF WAS NOT DIRECTLY ADDRESSED IN FISCAL YEAR 2023, SERVICES AT THE HOLY CROSS HEALTH AND WELLNESS CENTER PROVIDED 4,588 LOW-INCOME AND UNSHELTERED WOMEN WITH BASIC NEEDS, SUCH AS SHOWERS, CLOTHING, HYGIENE KITS, BABY FORMULA, DIAPERS AND LAUNDRY SERVICES. IN FISCAL YEAR 2023, SAMC INVESTED $321,171 NET COMMUNITY BENEFIT TO SUPPORT THESE SERVICES. INSURANCE BARRIER/ACCESS TO MEDICAL CARE - SAMC PROVIDED IN FISCAL YEAR 2023 SERVICES THROUGH THE HEALTH HUB AND PROVIDED 1,733 PATIENTS WITH INSURANCE ENROLLMENT ASSISTANCE. FRESNO SURGICAL HOSPITAL AND SAMC OFFERED FINANCIAL ASSISTANCE FOR QUALIFYING PATIENTS AND COMMUNITY MEMBERS. SAMC ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. FOR THIS REASON, SAMC DID NOT ACT ON THE FOLLOWING ISSUES: POVERTY; POOR AIR QUALITY/POLLUTION; SAFETY/NEIGHBORHOOD CRIME; LACK OF AFFORDABLE/ACCEPTABLE HOUSING; EXPENSIVE MEDICAL CARE; AND LACK OF PROVIDER COMPASSION/DISCRIMINATION. FRESNO SURGICAL HOSPITAL PART V, SECTION B, LINE 11: FRESNO SURGICAL HOSPITAL:INSURANCE BARRIER/ACCESS TO MEDICAL CARE - FSH AND SAMC OFFERED FINANCIAL ASSISTANCE FOR QUALIFYING PATIENTS AND COMMUNITY MEMBERS. FSH ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. FOR THIS REASON, FSH DID NOT ACT ON THE FOLLOWING ISSUES: NOT ENOUGH PROVIDERS/TREATMENT LOCATIONS/LONG WAIT TIMES; FOOD INSECURITY; LACK OF TRANSPORTATION; HOMELESSNESS; POVERTY; POOR AIR QUALITY/POLLUTION; SAFETY/NEIGHBORHOOD CRIME; LACK OF AFFORDABLE/ACCEPTABLE HOUSING; EXPENSIVE MEDICAL CARE; AND LACK OF PROVIDER COMPASSION/DISCRIMINATION. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. SAINT AGNES MEDICAL CENTER PART V, SECTION B, LINE 16J: THE FOLLOWING ORGANIZATIONS RECEIVED THE PLAIN LANGUAGE SUMMARY OF THE FAP: THE MEXICAN CONSULATE, READING AND BEYOND, THE UNITED WAY, CENTRO LA FAMILIA, FIRST 5 FRESNO COUNTY, FRESNO RESCUE MISSION, FRESNO COMMUNITY FOOD BANK. SAINT AGNES MEDICAL CENTER: PART V, SECTION B, LINE 9: THE THREE-YEAR IMPLEMENTATION STRATEGY FOR SAINT AGNES MEDICAL CENTER AND FRESNO SURGICAL HOSPITAL WAS INITIALLY ADOPTED BY THE BOARD OF DIRECTORS ON 11/10/2022. YEAR TWO STRATEGIES WERE ADDED, AND IMPROVEMENTS WERE MADE AND THE IMPLEMENTATION STRATEGY WAS READOPTED ON 11/30/2023. THE REVISED IMPLEMENTATION STRATEGY CAN BE FOUND ON THE SYSTEM WEBSITE. SAINT AGNES MEDICAL CENTER: PART V, SECTION B, LINE 7A:.WWW.SAMC.COM/ABOUT-US/COMMUNITY-BENEFITS/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION SAINT AGNES MEDICAL CENTER: PART V, SECTION B, LINE 10A:WWW.SAMC.COM/ABOUT-US/COMMUNITY-BENEFITS/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION FRESNO SURGICAL HOSPITAL: PART V, SECTION B, LINE 9: THE THREE-YEAR IMPLEMENTATION STRATEGY FOR SAINT AGNES MEDICAL CENTER AND FRESNO SURGICAL HOSPITAL WAS INITIALLY ADOPTED BY THE BOARD OF DIRECTORS 11/10/2022. YEAR TWO STRATEGIES WERE ADDED, AND IMPROVEMENTS WERE MADE AND THE IMPLEMENTATION STRATEGY WAS READOPTED 11/30/2023. THE REVISED IMPLEMENTATION STRATEGY CAN BE FOUND ON THE SYSTEM WEBSITE. FRESNO SURGICAL HOSPITAL: PART V, SECTION B, LINE 7A:WWW.FRESNOSURGICALHOSPITAL.COM/PATIENTS-VISITORS FRESNO SURGICAL HOSPITAL: PART V, SECTION B, LINE 10A:WWW.FRESNOSURGICALHOSPITAL.COM/PATIENTS-VISITORS FRESNO SURGICAL HOSPITAL: PART V, SECTION B, LINE 7B:WWW.SAMC.COM/ABOUT-US/COMMUNITY-BENEFITS/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION SAINT AGNES MEDICAL CENTER: PART V, SECTION B, LINE 7B:WWW.FRESNOSURGICALCENTER.COM/PATIENTS-VISITORS PART V, LINE 16A: SAINT AGNES MEDICAL CENTERWWW.SAMC.COM/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ PART V, LINE 16B: SAINT AGNES MEDICAL CENTERWWW.SAMC.COM/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ PART V, LINE 16C: SAINT AGNES MEDICAL CENTERWWW.SAMC.COM/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ 4 1 - SUMMIT SURGICAL 1630 E HERNDON AVE SUITE 100 FRESNO CA 93720 OUTPATIENT SURGERY CENTER 2 - RENAISSANCE SURGERY CENTER 2365 E FIR AVENUE FRESNO CA 93720 OUTPATIENT SURGERY CENTER 3 - SAINT AGNES NORTHWEST LABORATORY 4770 W HERNDON AVENUE FRESNO CA 93722 LABORATORY 4 - HOLY CROSS CLINIC AT PORVELLO HOUSE 412 F STREET FRESNO CA 93703 MEDICAL/DENTAL PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: SAINT AGNES MEDICAL CENTER (SAMC) PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF CALIFORNIA. IN ADDITION, SAMC REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.SAMC ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $22,092,298, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: SAFETY/NEIGHBORHOOD CRIME-IN FISCAL YEAR 2023, SAINT AGNES MEDICAL CENTER AND TRINITY HEALTH, AS PART OF ITS TRANSFORMING COMMUNITIES INITIATIVE, PROVIDED FUNDING TO FRESNO HOUSING'S CALIFORNIA AVENUE NEIGHBORHOOD. THE INITIATIVE CONVENED RESIDENTS TO CONDUCT A ROOT CAUSE ANALYSIS AND DEVELOP AN IMPLEMENTATION PLAN FOR FUTURE STRATEGIC INTERVENTIONS TO ADDRESS NEIGHBORHOOD SAFETY IN THE 93706 ZIP CODE AREA. A TOTAL OF $311,212 WAS PROVIDED TO SUPPORT THIS WORK. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: SAMC USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, SAINT AGNES MEDICAL CENTER IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, SAINT AGNES MEDICAL CENTER IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: SAMC IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: "AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: SAMC DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - IN ADDITION TO THE CHNA, SAMC AND FRESNO SURGICAL HOSPITAL (FSH) CONTINUALLY ASSESS THE HEALTH STATUS OF THEIR COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS. AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY, PATIENT DATA, PUBLIC HEALTH DATA, PUBLISHED COUNTY HEALTH RANKINGS, MARKET STUDIES, AND OTHER REPORTS ARE ANALYZED ON A REGULAR BASIS TO HELP DETERMINE TRENDS AND EMERGING HEALTH NEEDS FOR THE SERVICE AREA. ONGOING PARTICIPATION IN LOCAL AREA STAKEHOLDER MEETINGS, COMMUNITY ROUNDTABLES AND HEALTH STRATEGY FORUMS ALLOW FOR ALIGNMENT WITH LOCAL COMMUNITY-BASED ORGANIZATIONS AND STRATEGIES. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SAMC COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. SAMC OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. NOTIFICATION ABOUT FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. PART VI, LINE 4: COMMUNITY INFORMATION - FOR THE PURPOSES OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT, SAMC AND FSH USED THE GEOGRAPHIC AREA FROM WHICH MOST PATIENTS COME FOR CARE AS THE COMMUNITY SERVED. THIS AREA INCLUDES FRESNO AND MADERA COUNTIES, WHICH ACCORDING TO THE U.S. CENSUS BUREAU, TOGETHER COVER 8,164 SQUARE MILES AND MORE THAN 1.5 MILLION ACRES. ADDITIONALLY, THE REPORT AREA HAS A TOTAL POPULATION OF 1,139,954 WITH 12.8% OF THE PERSONS LIVING WITHIN THE REPORT AREA IDENTIFYING AS NON-CITIZENS AND OVER 50% IDENTIFYING AS HISPANIC OR LATINO. THE DESIGNATED SERVICE AREA IS AN AREA OF IMMENSE NEED, WITH FEWER HEALTH RESOURCES THAN THE REST OF THE STATE. IT IS A REGION OF GREAT DIVERSITY, WITH BOTH URBAN AND RURAL POPULATIONS, AND MANY IMMIGRANTS. THE DIVERSITY OF THE REGION IS REFLECTED IN THE WIDE RANGE OF LANGUAGES SPOKEN IN EACH COUNTY. WITHIN THE SERVICE AREA, 18.4% OF RESIDENTS AGES 5 AND OLDER HAVE LIMITED ENGLISH PROFICIENCY. ANOTHER FACTOR IMPACTING SAMC AND FSH'S PRIMARY SERVICE AREA IS THE LOW RATE OF PRIMARY CARE PHYSICIANS IN THE REGION, AND CONSEQUENTLY, A LARGE PROPORTION OF THE POPULATION LIVES WITHIN ONE OF THE 176 HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA). HPSAS ARE DEFINED AS HAVING SHORTAGES OF PRIMARY MEDICAL CARE, DENTAL OR MENTAL HEALTH PROVIDERS. THIS INDICATOR IS RELEVANT BECAUSE A SHORTAGE OF HEALTH PROFESSIONALS CONTRIBUTES TO ACCESS AND HEALTH STATUS ISSUES. PROVIDER RATE PER 100,000 POPULATION IS 79.61 WITH 87 LOCATIONS IN FRESNO COUNTY AND IS 75.2 WITH 19 LOCATIONS IN MADERA COUNTY COMPARED TO A PROVIDER RATE OF 101.38 PER 100,000 WITH 1280 LOCATIONS IN CALIFORNIA. FURTHER COMPOUNDING THE ISSUE IS THE HIGH RATE OF ADULTS AND CHILDREN THAT LACK INSURANCE. THESE FACTORS IMPACT RATES OF PREVENTABLE HOSPITALIZATIONS, POTENTIAL YEARS OF LIFE LOST, AND THE NUMBER OF PEOPLE WHO DO NOT RECEIVE PREVENTATIVE CARE. A COMMUNITY'S HEALTH IS ALSO AFFECTED BY THE PHYSICAL ENVIRONMENT. A SAFE, CLEAN ENVIRONMENT THAT PROVIDES ACCESS TO HEALTHY FOOD AND RECREATIONAL OPPORTUNITIES IS IMPORTANT TO MAINTAINING AND IMPROVING COMMUNITY HEALTH. WITHIN THE FRESNO AND MADERA SERVICE AREA, 24% OF LOW-INCOME POPULATION IN FRESNO AND MADERA HAVE LOW FOOD ACCESS. A RELATIVELY HIGH NUMBER OF HOUSEHOLDS IN MADERA (8.3%) AND FRESNO (23.6%) LIVE MORE THAN ONE-HALF MILE FROM A SUPERMARKET AND HAVE NO RELIABLE TRANSPORTATION. THE PERCENTAGE OF FRESNO AND MADERA RESIDENTS, AGE 18 AND OLDER WHO ARE OBESE IS HIGHER THAN THE CALIFORNIA STATE AVERAGE (24%). PART VI, LINE 5: OTHER INFORMATION - IN FISCAL YEAR 2023, SAMC CONTINUED TO PROMOTE HEALTH IN THE COMMUNITY BY SUPPORTING COMMUNITY-BASED ORGANIZATIONS FINANCIALLY OR WITH BOARD MEMBERSHIP. THEY INCLUDED THE FOLLOWING: AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, CATHOLIC CHARITIES, CSUF, HMONG NURSES ASSOCIATION, FRESNO AREA HISPANIC FOUNDATION, FOUNDATION FOR CLOVIS SCHOOLS, CLINICAL PASTORAL EDUCATION OF CENTRAL CALIFORNIA, VALLEY CAREGIVER RESOURCES, MARJAREE MASON CENTER, AMERICAN CANCER SOCIETY, COURT APPOINTED SPECIAL ADVOCATES OF FRESNO AND MADERA COUNTIES, FRESNO POLICE & NEIGHBORHOOD WATCH ASSOCIATION, MADE FOR THEM, RIGHT TO LIFE, SIERRA CLUB OF FRESNO, UNITED WAY OF FRESNO AND MADERA COUNTIES, AND HOSPITAL COUNCIL OF CENTRAL AND NORTHERN CALIFORNIA. IN ADDITION, SAMC CONTINUED TO PROMOTE HEALTH IN THE COMMUNITY THROUGH A VARIETY OF ACTIVITIES AND INVOLVEMENT, INCLUDING THE FOLLOWING:ADDRESSING SOCIAL INFLUENCERS (DETERMINANTS) OF HEALTH - SAMC BELIEVES THAT EVERYONE HAS THE RIGHT TO A STANDARD OF LIVING THAT PROMOTES HEALTH AND WELL-BEING IN ALL AREAS OF LIFE, INCLUDING ACCESS TO FOOD, CLOTHING, STABLE HOUSING, MEDICAL CARE AND CRITICAL SOCIAL SERVICES, REGARDLESS OF SOCIOECONOMIC FACTORS. PEOPLE WHO ARE MEDICALLY VULNERABLE AND WHO FACE SOCIAL CHALLENGES WITH RESOURCES SUCH AS PRIMARY CARE, SPECIALTY CARE, INSURANCE ENROLLMENT, TRANSPORTATION, HOUSING, AND OTHER SOCIAL RESOURCES HAVE A MUCH MORE DIFFICULT TIME MANAGING THEIR HEALTH. IN ADDITION TO PROVIDING CLINICAL CONNECTIONS, THE SAMC HEALTH HUB COMMUNITY HEALTH WORKERS PROVIDED MORE THAN 2,355 CONNECTIONS TO SOCIAL CARE RESOURCES INCLUDING: 31% TO FOOD RESOURCES, 31% TO FINANCIAL RESOURCES, 28.5% TO HOUSING ASSISTANCE. THE IMPACT THAT THE SAMC HEALTH HUB HAS HAD ON PATIENTS AND THEIR FAMILIES HAS RESULTED IN BETTER COORDINATION OF CARE AND INCREASED AWARENESS BY CLINICIANS OF THE EFFECTS THAT SOCIAL INFLUENCERS HAVE ON PEOPLE. PART VI, LINE 6: SAMC IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE - EMPHASIZING THE NECESSITY TO INTEGRATE SOCIAL AND CLINICAL CARE. WE DO THIS BY: 1. ADDRESSING PATIENT SOCIAL NEEDS, 2. INVESTING IN OUR COMMUNITIES, AND 3. STRENGTHENING THE IMPACT OF OUR COMMUNITY BENEFIT. TRINITY HEALTH CHWB TEAMS LEAD THE DEVELOPMENT AND IMPLEMENTATION OF TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES AND FOCUS INTENTIONALLY ON ENGAGING COMMUNITIES AND RESIDENTS EXPERIENCING POVERTY AND OTHER VULNERABILITIES. WE BELIEVE THAT COMMUNITY MEMBERS AND COMMUNITIES THAT ARE THE MOST IMPACTED BY RACISM AND OTHER FORMS OF DISCRIMINATION EXPERIENCE THE GREATEST DISPARITIES AND INEQUITIES IN HEALTH OUTCOMES AND SHOULD BE INCLUSIVELY ENGAGED IN ALL COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT EFFORTS. THROUGHOUT OUR WORK, WE DISMANTLE OPPRESSIVE SYSTEMS, AND BUILD COMMUNITY CAPACITY AND PARTNERSHIPS.TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2023 (FY23), TRINITY HEALTH CONTRIBUTED $1.47 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. IN ADDITION TO ANNUAL COMMUNITY BENEFIT SPENDING, TRINITY HEALTH IMPLEMENTS A SOCIALLY RESPONSIBLE INVESTING PROGRAM. AS OF THE END OF FY23, $62.7 MILLION (INCLUDING $7.0 MILLION IN NEW LENDING) WAS ALLOCATED IN THE FOLLOWING AREAS:- HOUSING: BUILDING AFFORDABLE HOUSING; IMPROVING ACCESS TO SENIOR HOUSING; AND COMBATTING HOMELESSNESS ($35.5 MILLION)- EDUCATION: SUPPORTING STUDENTS ENTERING THE HEALTH PROFESSIONS ($10.1 MILLION)- FACILITIES: BUILDING COMMUNITY FACILITIES FOR NONPROFITS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS ($9.7 MILLION)- ECONOMIC DEVELOPMENT: ENCOURAGING SMALL BUSINESS DEVELOPMENT, CREATING LOCAL JOBS AND SUPPORTING ACCESS TO HEALTHY FOODS; QUALITY CHILDCARE; AND OTHER COMMUNITY SERVICES ($7.4 MILLION)ACROSS THE SYSTEM, NEARLY 700,000 OF PATIENTS SEEN IN PRIMARY CARE SETTINGS WERE SCREENED FOR SOCIAL NEEDS. FOR ABOUT 30% OF THOSE PATIENTS, AT LEAST ONE SOCIAL NEED WAS IDENTIFIED. TOGETHERCARE - TRINITY HEALTH'S ELECTRONIC HEALTH RECORD, POWERED BY EPIC - HAS MADE IT POSSIBLE FOR TRINITY HEALTH TO STANDARDIZE SCREENING FOR SOCIAL NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES THROUGH THE COMMUNITY RESOURCE DIRECTORY (COMMUNITYRESOURCES.TRINITY-HEALTH.ORG). COMMUNITY HEALTH WORKERS (CHW'S) SERVE AS LIAISONS BETWEEN HEALTH AND SOCIAL SERVICES. TRINITY HEALTH CHW'S PARTNERED WITH POPULATION HEALTH NURSES AND SOCIAL WORK CARE MANAGERS TO SERVE MEDICARE PATIENTS AT RISK FOR PREVENTABLE HOSPITALIZATIONS, RESULTING IN A DECREASE IN PREVENTABLE HOSPITALIZATIONS FOR THE MEDICARE POPULATION OVERALL, AND ALSO FOR LOW-INCOME PATIENTS DUALLY ENROLLED IN MEDICARE AND MEDICAID. CHW'S ADVANCE SOCIAL AND CLINICAL CARE INTEGRATION BY ASSESSING AND ADDRESSING A PATIENT'S SOCIAL NEEDS, HOME ENVIRONMENT AND OTHER SOCIAL RISK FACTORS, AND ULTIMATELY CONNECTING THE PATIENT (AND THEIR FAMILY) TO SERVICES WITHIN THE COMMUNITY. TRINITY HEALTH PROVIDES A 40+ HOUR FOUNDATIONAL CHW AND CHRONIC DISEASE-SPECIFIC TRAINING TO TRINITY HEALTH-EMPLOYED CHW'S AND ALSO TO COMMUNITY PARTNERS THAT EMPLOY CHW'S. IN 2017, TRINITY HEALTH RECEIVED A SIX-YEAR, $8.5 MILLION GRANT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION TO INCREASE THE NUMBER OF NATIONAL DIABETES PREVENTION PROGRAM (DPP) DELIVERY SITES, INCREASE PROGRAM ENROLLMENT, MAINTAIN PARTICIPATION RATES, AND INCREASE BENEFIT COVERAGE. IN ADDITION, THE GRANT WAS USED TO STANDARDIZE CLINICAL SCREENING AND DETECTION OF DIABETES. DURING THE GRANT PERIOD, TRINITY HEALTH BUILT THE NATIONAL DPP INTO ITS ELECTRONIC HEALTH RECORD SYSTEM TO MAKE IDENTIFYING PATIENTS AND ENROLLING THEM IN THE PROGRAM EASIER. SINCE SEPTEMBER 2017, OVER 6,000 PARTICIPANTS HAVE ENROLLED IN A TRINITY HEALTH NATIONAL DPP AND HAVE COLLECTIVELY LOST A TOTAL OF OVER 51,000 POUNDS.LASTLY, TRINITY HEALTH'S FY23 SHAREHOLDER ADVOCACY PRIORITIES FOCUSED ON IMPROVING CORPORATE POLICIES AND PRACTICES THAT IMPACT COMMUNITIES, WITH THE AIM OF REDUCING STRUCTURAL RACISM AND HEALTH INEQUITIES. TRINITY HEALTH, IN COLLABORATION WITH ITS PARTNERS THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY AND THE INVESTOR ENVIRONMENTAL HEALTH NETWORK, FILED SHAREHOLDER PROPOSALS AT 20 COMPANIES. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 MEDICAL MINISTRIES INTERNATIONAL 1004 SAN JOSE AVENUE 122 CLOVIS CA 93612 770498274 501(C)(3) 0 862336 COST MEDICAL SUPPLIES SPONSORSHIP/DONATION BLACK WELLNESS & PROSPERITY CENTER 2201 CALAVERAS STREET FRESNO CA 93721 843848144 501(C)(3) 5000 0 SPONSORSHIP/DONATION 2 0 PHARMACEUTICALS 5 662 FUNERAL EXPENSES 7 1540 HOUSING/IN-HOME CARE 6 3740 TRANSPORTATION VOUCHERS 4202 169607 MEDICAL EQUIPMENT 183 5798 NUTRITION SERVICES 1854 24536 PART I, LINE 2: DONATIONS MADE BY SAINT AGNES MEDICAL CENTER TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 BENJAMIN CARTER DIRECTOR AS OF 4/23; TRINITY COO 0 1408317 0 910000 0 440623 0 18300 0 80495 0 2857735 0 0 ODETTE BOLANO DIRECTOR, CEO WEST REGION AS OF 5/23 0 672223 0 301500 0 168543 0 187255 0 36300 0 1365821 0 139219 SHERI SHAPIRO DIRECTOR, TRINITY SVP THROUGH 3/23 0 756441 0 337500 0 199531 0 13725 0 38607 0 1345804 0 0 NANCY HOLLINGSWORTH DIRECTOR, PRESIDENT & CEO THR 5/23 0 546933 0 192500 0 152742 0 22875 0 44159 0 959209 0 0 DAVID SPIVEY DIR, INT PRES AS OF 6/23; TH CONS 0 554152 0 186604 0 146706 0 22875 0 41182 0 951519 0 0 W EUGENE EGERTON MD CHIEF MEDICAL OFFICER THR 1/23 0 471694 0 93852 0 38587 0 13725 0 32213 0 650071 0 0 STACY VAILLANCOURT CHIEF OPERATING OFFICER 0 364360 0 73308 0 35658 0 18300 0 24891 0 516517 0 0 DEANETTE SISSON CHIEF NURSING OFFICER 0 311327 0 63013 0 24428 0 13725 0 25916 0 438409 0 781 RICK WOLF SECRETARY; ASSOCIATE COUNSEL 0 289654 0 29543 0 16591 0 13725 0 30117 0 379630 0 0 GERALD MARGOSIAN COORDINATOR PHARMACY OPERATIONS 282549 0 1500 0 28854 0 22875 0 27897 0 363675 0 0 0 MICHAEL FREUDIGER CHARGE PHARMACIST 304088 0 1500 0 23488 0 13725 0 9490 0 352291 0 0 0 EDNANN NAZ CHIEF MEDICAL INFORMATICS OFFICER 304705 0 1000 0 315 0 10715 0 24533 0 341268 0 0 0 JOCELYN LLEMIT CLINICAL NURSE 269714 0 7500 0 16033 0 18097 0 26597 0 337941 0 0 0 DOROTA FAULK CLINICAL NURSE 284016 0 7500 0 317 0 13310 0 21467 0 326610 0 0 0 PART I, LINE 3 SAINT AGNES MEDICAL CENTER IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. SAINT AGNES MEDICAL CENTER'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF SAINT AGNES MEDICAL CENTER'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2022, AND THEIR NON-VESTED BENEFITS FOR 2022 WERE ACCRUED. THE FOLLOWING PAYOUTS FOR 2022 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: BENJAMIN CARTER - $392,875 ODETTE BOLANO - $141,786 NANCY HOLLINGSWORTH - $128,713 SHERI SHAPIRO - $183,225 DAVID SPIVEY - $125,161 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ACCRUAL FOR 2022 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: ODETTE BOLANO - $173,530 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($305,000 FOR 2022). THE FOLLOWING PAYOUTS FOR 2022 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: W. EUGENE EGERTON, MD - $7,781 DEANETTE SISSON - $3,148 STACY VAILLANCOURT - $3,791 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. KELSEY VAILLANCOURT FAMILY MEMEMBER OF STACY VAILLANCOURT, KEY EMPLOYEE 73408 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 3 SAINT AGNES MEDICAL CENTER HAS CONTRACTED WITH HEALTHSOURCE PARTNERS FOR THE PROVISION OF INTERIM CFO SERVICES. IN CALENDAR YEAR 2022, SAINT AGNES MEDICAL CENTER PAID $629,137 TO HEALTHSOURCE PARTNERS FOR TERRI DONOVAN'S SERVICES AS INTERIM CFO OF SAINT AGNES MEDICAL CENTER. SAINT AGNES MEDICAL CENTER DOES NOT KNOW HOW MUCH TERRI DONOVAN RECEIVED AS WAGES FROM HEALTHSOURCE PARTNERS IN CALENDAR 2022. FORM 990, PART VI, SECTION A, LINE 4 SAINT AGNES MEDICAL CENTER AMENDED ITS BYLAWS EFFECTIVE MAY 11, 2023. THE AMENDED BYLAWS NOW STATE THAT THE BOARD OF DIRECTORS WILL HAVE TWO ADDITIONAL MEMBERS FROM A RELATED ORGANIZATION, SAINT ALPHONSUS HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SAINT AGNES MEDICAL CENTER IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF SAINT AGNES MEDICAL CENTER. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF SAINT AGNES MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR SAINT AGNES MEDICAL CENTER IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C SAINT AGNES MEDICAL CENTER HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF SAINT AGNES MEDICAL CENTER, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF SAINT AGNES MEDICAL CENTER AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF SAINT AGNES MEDICAL CENTER (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO SAINT AGNES MEDICAL CENTER OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF SAINT AGNES MEDICAL CENTER (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF SAINT AGNES MEDICAL CENTER. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF SAINT AGNES MEDICAL CENTER IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO OF SAINT AGNES MEDICAL CENTER ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR OTHER EXECUTIVES WHO ARE NOT PART OF THE REBUTTABLE PRESUMPTION PROCESS, TRINITY HEALTH USES A MARKET ANALYSIS TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 SAINT AGNES MEDICAL CENTER IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, SAINT AGNES MEDICAL CENTER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. SAINT AGNES MEDICAL CENTER'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER TO AFFILIATES -37,189,134. EQUITY LOSS IN UNCONSOLIDATED AFFILIATES -793. ASSET IMPAIRMENT -5,584,745. FORM 990, PART XII, LINE 2: SAINT AGNES MEDICAL CENTER'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY23 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD CT 06105 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL HEALTH FOUNDATION-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 521025476 FOUNDATION NJ 501(C)(3) LINE 7 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH LIFE INC 7500 K JOHNSON BOULEVARD BORDENTOWN NJ 08505 222797282 PACE PROGRAM NJ 501(C)(3) LINE 10 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH MEDICAL GROUP-EAST TRENTON PA 601 HAMILTON AVENUE TRENTON NJ 08629 832199054 HEALTH CARE SERVICES NJ 501(C)(3) LINE 3 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 223431049 HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA STREET COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP 5315 ELLIOTT DR 102 YPSILANTI MI 48197 382507173 HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVENUE DES MOINES IA 50314 420680448 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST SW ELKADER IA 52043 420818642 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY COMMUNITY HOSPITAL GROUP LLC 1 COVENANT FOUNDATION INC 3421 WEST NINTH STREET WATERLOO IA 50702 421295784 FOUNDATION IA 501(C)(3) LINE 7 COVENANT MEDICAL CENTER INC 1 COVENANT MEDICAL CENTER INC 3421 WEST NINTH STREET WATERLOO IA 50702 421264647 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 WHEATON FRANCISCAN HEALTHCARE-IOWA INC 1 DILEY RIDGE MEDICAL CENTER 3100 EASTON SQUARE PL STE 300 COLUMBUS OH 43219 342032340 HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMBRACING AGE INC 333 BUTTERNUT DRIVE DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 12B, II ST JOSEPH'S HEALTH INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 HOME AIDE SERVICE OF EASTERN NEW YORK INC 1 FARREN CARE CENTER INC PO BOX 9184 FARMINGTON HILLS MI 48333 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 TRINITY CONTINUING CARE SERVICES 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL INC 1 GENESIS HEALTH SERVICES FOUNDATION 1227 E RUSHOLME STREET DAVENPORT IA 52803 421421670 FOUNDATION IA 501(C)(3) LINE 7 GENESIS HEALTH SYSTEM 1 GENESIS HEALTH SYSTEM 1227 E RUSHOLME STREET DAVENPORT IA 52803 421418847 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 GENESIS HEALTH SYSTEM (IL) 801 ILLINI DRIVE SILVIS IL 61282 363616314 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST 1227 E RUSHOLME STREET DAVENPORT IA 52803 391905171 EMPLOYEE BENEFIT TRUST IA 501(C)(3) LINE 12A, I GENESIS HEALTH SYSTEM 1 GENESIS MEDICAL CENTER ALEDO 409 NW 9TH AVENUE ALEDO IL 61231 454475683 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 GENESIS HEALTH SYSTEM (IL) 1 GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR MI 48105 208072723 FOUNDATION MI 501(C)(3) LINE 12A, I GLACIER HILLS INC 1 GLACIER HILLS INC 1200 EARHART RD ANN ARBOR MI 48105 381891500 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 TRINITY HEALTH GEORGIA INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GOTTLIEB MEMORIAL FOUNDATION 701 WEST NORTH AVENUE MELROSE PARK IL 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