2024-11-12T13:03:20-06:00 2023-12-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 46240 990 2023-01-01 351865344 COMMUNITY HOWARD REGIONAL HEALTH INC COMM 7654538371 3500 S LAFOUNTAIN STREET KOKOMO IN 46902 DEREK MCMICHAEL VP-HOSPITAL ADMINISTRATOR 7654538547 2024-11-06 1 0 CASSE TATE P01271193 3175802000 2024-11-05 2023 2024-10-15 13:58:12Z DEREK MCMICHAEL 3500 S LAFOUNTAIN STREET KOKOMO IN 46902 233501457 0 X WWW.ECOMMUNITY.COM/HOWARD X 1992 IN OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED. 9 6 891 25 0 0 9667199 5635477 197204456 216627686 505233 1529302 625451 633670 208002339 224426135 48350 41250 0 0 71358857 72537331 0 0 0 113105326 121075939 184512533 193654520 23489806 30771615 348559048 385282322 11695102 8188857 336863946 377093465 X OUR MISSION IS TO PROVIDE EXCEPTIONAL QUALITY, PATIENT-CENTERED CARE. IN KEEPING WITH OUR MISSION, WE EMBRACE THE FOLLOWING VALUES: COMPASSION AND UNDERSTANDING; CUSTOMER SERVICE; DEDICATION AND COMMITMENT TO PROVIDE THE HIGHEST QUALITY SERVICES AND TO MEET THE NEEDS OF OUR COMMUNITY; RESPECT FOR OUR PATIENTS, VISITORS, PHYSICIANS, AND STAFF; SAFETY; A SAFE AND POSITIVE WORKING ENVIRONMENT; AND TRUTH AND INTEGRITY IN ALL ENCOUNTERS AND SERVICES OFFERED. 0 0 141223020 216697611 COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") OPERATES AN ACUTE CARE FULL SERVICE HOSPITAL IN KOKOMO, INDIANA WITH 107 STAFFED BEDS. IN 2023, THE MAIN HOSPITAL SERVED 4,808 INPATIENTS WITH A TOTAL OF 17,252 INPATIENT DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED 304,595 OUTPATIENT VISITS, WHICH INCLUDED 32,626 EMERGENCY VISITS. CHRH PROVIDES SERVICES INCLUDING WOMEN AND CHILDREN'S HEALTHCARE, CANCER CARE, CARDIOVASCULAR CARE, SURGICAL SERVICES, BEHAVIORAL HEALTH, AND PEDIATRIC SERVICES. 41250 41250 PROVIDED DONATIONS TO OTHER ORGANIZATIONS IN THE CENTRAL INDIANA COMMUNITY SERVED BY CHRH. 141264270 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 891 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 1 1 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 1 0 X BRIAN MCCONNELL 3173554212 8180 CLEARVISTA PKWY 200 INDIANAPOLIS IN 46256 X ELIZABETH THARP MBA BSN RN SVP-HOSPITAL ACUTE SERVICES/CNO 2.00 48.00 X X 0 543274 299033 COURTNEY HOLLAND MD DIRECTOR 2.00 53.00 X 0 697118 144728 SYED KHAN MD PSYCHIATRIST 50.00 0.00 X 679399 0 45218 BENJAMIN CHIU MD VICE CHAIR THROUGH JUNE 2023 2.00 48.00 X X 0 459081 125307 JENNIFER HINDMAN DIRECTOR/VP-HOSP ADMIN THR MAR 2023 12.50 37.50 X X 85616 256849 139739 LAXESHKUMAR PATEL MD PSYCHIATRIST 50.00 0.00 X 292481 0 99234 DOUGLAS COOK MD PSYCHIATRIST 50.00 0.00 X 285406 0 95812 JOHN BILO VP-FINANCE 48.00 2.00 X 0 254068 114588 DEREK MCMICHAEL VP-HOSPITAL ADMINISTRATOR 48.00 2.00 X 258715 0 90105 JOHN SCHILTZ MD PSYCHIATRIST 50.00 0.00 X 295529 0 94744 SHILPA PURI MD PSYCHIATRIST 50.00 0.00 X 276037 0 45772 DIANE COGDELL DIRECTOR 2.00 0.00 X 0 0 0 ROBERT HAYES CHAIR THROUGH JUNE 2023 2.00 0.00 X X 0 0 0 KAREN MCLEAN CHAIR 2.00 0.00 X X 0 0 0 SHARON REED DIRECTOR 2.00 0.00 X 0 0 0 TRISH SEVERNS DIRECTOR 2.00 0.00 X 0 0 0 REBECCA VENT VICE CHAIR 2.00 0.00 X X 0 0 0 BRIDGET WHITMORE SECRETARY 2.00 0.00 X X 0 0 0 2173183 2210390 1294280 114 0 1 0 QUEST (MACL) DIAGNOSTICS CLINICAL LABS 2560 N SHADELAND AVE INDPLS IN 46219 LABORATORY SERVICES 5857388 QUALITY PLUMBING & HEATING INC 3515 N REED RD KOKOMO IN 46901 HEATING AND COOLING INSTALLATIONS 2542005 COMMUNITY ANESTHESIA ASSOCIATES 7150 CLEARVISTA DRIVE INDIANAPOLIS IN 46256 MEDICAL 2214955 J AND J ELECTRIC OF INDIANA INC 3180 W ST RD 18 KOKOMO IN 46903 ELECTRICAL WORK 1532558 HAYES BROTHERS INC 1241 EAST 400 SOUTH KOKOMO IN 46902 COMMERCIAL CONSTRUCTION 1502951 27 1412691 4222786 5635477 PATIENT SERVICES 622110 215629750 215629750 RENT INCOME 531120 997936 997936 216627686 852303 852303 9752221 100 9058298 17024 693923 -16924 676999 676999 COFFEE SHOP/DIETARY SALES 722515 563745 563745 SCHOOL BASED CLINICS 621399 53960 53960 PURCHASE DISCOUNT 900099 9572 9572 6393 6393 633670 224426135 216697611 0 2093047 X 41250 41250 469370 469370 58043500 49022053 9021447 2215868 1893901 321967 7621504 6385292 1236212 4187089 3505563 681526 65710 65710 49930681 14297844 35632837 73941 22061 51880 2709440 2012699 696741 704148 364415 339733 5783639 4845530 938109 186292 154843 31449 19201 12700 6501 8685443 6116043 2569400 MEDICAL SUPPLIES 40117384 40117384 HAF PROGRAM FEES 9637668 9637668 NONCONTROLLING INTEREST 2435531 2435531 PROPERTY TAX 314051 152936 161115 412810 246557 166253 193654520 141264270 52390250 0 4320 2940 4049331 2889253 25043874 22573967 25833 15833 5533803 5618054 432477 372641 170277188 80713638 88836764 89563550 50767237 57239898 347515 347515 10593 4237 173507301 206654434 348559048 385282322 3045867 1400056 8649235 6788801 11695102 8188857 X 336863946 377093465 336863946 377093465 348559048 385282322 X 30771615 5030342 4427562 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4163000 4163000 110625221 40284225 70340996 756026 412376 343650 49484174 35709533 13774641 5248767 4307504 941263 89563550 DUE FROM AFFILIATES 200292701 THIRD PARTY RECEIVABLE 4919661 RIGHT-OF-USE OPERATING ASSET 1442072 206654434 THIRD PARTY SETTLEMENTS 5130173 RIGHT-OF-USE OPERATING LIABILITY 1444551 ASBESTOS LIABILITY 171369 GUARANTEE LIABILITY 42708 6788801 1 1 X 1 X 1 X 1 1 1 0 1 1 2380 530125 530125 0.00270 35572 42198808 41295551 903257 0.00470 37952 42728933 41295551 1433382 0.00740 13 2785 2097825 105 2097720 0.01080 2 60 2484297 1334189 1150108 0.00590 3 141003 141003 0.00080 18 2845 4723125 1334294 3388831 0.01750 18 40797 47452058 42629845 4822213 0.02490 1 328498 328498 0.00170 1 328498 328498 0.00170 1 1382808 1215350 33023152 35755579 -2732427 X 1 1 1 HOWARD COMMUNITY SURGERY CENTER SURGERY 0.47940 0.33260 1 1 COMMUNITY HOWARD REGIONAL HEALTH 3500 S LAFOUNTAIN STREET KOKOMO IN 46902 WWW.ECOMMUNITY.COM 22-005007-1 X X X COMMUNITY HOWARD REGIONAL HEALTH 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 200.000000000000 300.000000000000 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 1 X 0 X X X X 1 X 0 0 PART V, SECTION A: PART V, SECTION B, LINE 7A:HTTPS://WWW.ECOMMUNITY.COM/COMMUNITY-BENEFIT/ARCHIVED-REPORTSPART V, SECTION B, LINE 10A:HTTPS://WWW.ECOMMUNITY.COM/COMMUNITY-BENEFIT/ARCHIVED-REPORTS COMMUNITY HOWARD REGIONAL HEALTH PART V, SECTION B, LINE 5: IN 2021, COMMUNITY HOWARD REGIONAL HEALTH CONDUCTED A CHNA TO UNDERSTAND THE GREATEST HEALTH NEEDS IN THE COMMUNITIES SERVED. THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROADER NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE CHNA ALSO INCLUDED ORGANIZATIONS OTHER THAN HOSPITALS. COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY COLLECTING AND ANALYZING DATA FROM MULTIPLE SOURCES. STATISTICS FOR NUMEROUS COMMUNITY HEALTH STATUS, HEALTH CARE ACCESS, AND RELATED INDICATORS WERE ANALYZED, INCLUDING DATA PROVIDED BY LOCAL, STATE, AND FEDERAL GOVERNMENT AGENCIES, LOCAL COMMUNITY SERVICE ORGANIZATIONS, AND COMMUNITY HEALTH NETWORK. COMPARISONS TO BENCHMARKS WERE MADE WHERE POSSIBLE. FINDINGS FROM RECENT ASSESSMENTS OF THE COMMUNITY'S HEALTH NEEDS CONDUCTED BY OTHER ORGANIZATIONS (E.G., LOCAL HEALTH DEPARTMENTS) WERE REVIEWED AS WELL.INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS CONSIDERED THROUGH KEY INFORMANT INTERVIEWS AND COMMUNITY MEETINGS. STAKEHOLDERS INCLUDED: INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; LOCAL PUBLIC HEALTH DEPARTMENTS; HOSPITAL STAFF AND PROVIDERS; REPRESENTATIVES OF SOCIAL SERVICE ORGANIZATIONS; REPRESENTATIVES OF FAITH-BASED ORGANIZATIONS; REPRESENTATIVES OF LOCAL UNIVERSITIES AND SCHOOLS; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. VIRTUAL COMMUNITY INPUT SESSIONS WERE HELD BETWEEN MAY AND JULY OF 2021. INVITATIONS AND PRESENTATIONS FOR THESE VIRTUAL SESSIONS WERE ORGANIZED BY COUNTY TO ENSURE WE COULD HEAR FROM THOUGHT-LEADERS SERVING IN THE SPECIFIC COMMUNITY. FOR A COMPLETE LIST OF PARTICIPANTS, PLEASE SEE THE ATTACHED COMMUNITY BENEFIT REPORT. COMMUNITY HOWARD REGIONAL HEALTH PART V, SECTION B, LINE 6A: THE CHNA FOR COMMUNITY HOWARD REGIONAL HEALTH WAS A COLLABORATIVE EFFORT WITH ALL HOSPITALS WITHIN COMMUNITY HEALTH NETWORK (CHNW) - COMMUNITY HOSPITAL EAST, COMMUNITY HOSPITAL NORTH, COMMUNITY HOSPITAL SOUTH AND COMMUNITY HOSPITAL ANDERSON. IN ADDITION TO THE NETWORK HOSPITALS, COMMUNITY HOWARD REGIONAL HEALTH ALSO COLLABORATED WITH OTHER INDIANA HEALTH SYSTEMS TO COLLECT PRIMARY DATA THROUGH ONLINE COMMUNITY MEETINGS AND KEY STAKEHOLDER INTERVIEWS. THESE HEALTH SYSTEMS INCLUDE ASCENSION ST. VINCENT'S INDIANA, IU HEALTH, AND RIVERVIEW HEALTH. COMMUNITY HOWARD REGIONAL HEALTH PART V, SECTION B, LINE 6B: COMMUNITY HOWARD REGIONAL HEALTH WORKED WITH VERITE HEALTHCARE CONSULTING, LLC (VERITE) TO COMPLETE THE CHNA.PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS WERE DETERMINED TO BE "SIGNIFICANT" IF THEY WERE IDENTIFIED AS PROBLEMATIC IN AT LEAST TWO OF THE FOLLOWING THREE DATA SOURCES: (1) THE MOST RECENTLY AVAILABLE SECONDARY DATA REGARDING THE COMMUNITY'S HEALTH, (2) RECENT ASSESSMENTS DEVELOPED BY THE STATE AND LOCAL ORGANIZATIONS, AND (3) INPUT FROM COMMUNITY STAKEHOLDERS WHO PARTICIPATED IN THE COMMUNITY MEETING, KEY INFORMANT INTERVIEW PROCESS, AND STAFF SURVEYS. THE IMPLEMENTATION STRATEGIES WERE DRAFTED FOR EACH REGION AND DESCRIBE HOW THE HOSPITALS PLAN TO ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED. THE HOSPITALS REVIEWED THE CHNA FINDINGS AND APPLIED THE FOLLOWING CRITERIA TO DETERMINE THE MOST APPROPRIATE NEEDS FOR THE REGIONS TO ADDRESS: 1. THE EXTENT TO WHICH THE HOSPITAL HAS RESOURCES AND COMPETENCIES TO ADDRESS THE NEED.2. THE IMPACT THAT THE HOSPITAL COULD HAVE ON THE NEED (I.E. THE NUMBER OF LIVES THE HOSPITAL CAN IMPACT)3. THE FREQUENCY WITH WHICH STAKEHOLDERS IDENTIFIED THE NEEDS AS A SIGNIFICANT PRIORITY4. THE EXTENT OF COMMUNITY SUPPORT FOR THE HOSPITAL TO ADDRESS THE ISSUE AND POTENTIAL FOR PARTNERSHIPS TO ADDRESS THE ISSUECOMMUNITY HOWARD REGIONAL HEALTH WILL ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2021 CHNA, THESE INCLUDE: MENTAL HEALTH/SUBSTANCE USE, CHRONIC DISEASE, SOCIAL DETERMINANTS OF HEALTH (SDOH), COVID-19 AND MATERNAL/INFANT HEALTH. TOBACCO USE WILL NOT BE ADDRESSED BY CHRH IN THE IMPLEMENTATION PLAN. CHRH STAFF ARE ACTIVELY INVOLVED IN TOBACCO PREVENTION AND CESSATION ACTIVITIES IN PARTNERSHIP WITH THE HOWARD COUNTY TOBACCO FREE COALITION. THIS COALITION HAS BEEN A LEADER IN THE COMMUNITY IN ADDRESSING TOBACCO USE. CHRH WILL CONTINUE TO SUPPORT THE WORK OF THE COALITION TO REDUCE TOBACCO USE ACROSS HOWARD COUNTY. COMMUNITY HOWARD REGIONAL HEALTH PART V, SECTION B, LINE 11: COMMUNITY HOWARD REGIONAL HEALTH IS ADDRESSING THE NEEDS IDENTIFIED IN THE FOLLOWING WAYS: MENTAL HEALTH/SUBSTANCE USECOMMUNITY HEALTH NETWORK OPIOID STEWARDSHIP PROGRAM: CHNW HAS DEDICATED RESOURCES TO THE PREVENTION OF OPIOID USE DISORDER AND OVERDOSE DEATHS. THE OPIOID STEWARDSHIP PROGRAM INCLUDES SAFE OPIOID PRESCRIBING TRAINING FOR PRIMARY CARE AND SPECIALTY CARE PRACTITIONERS. BY PARTNERING WITH BOSTON UNIVERSITY SCHOOL OF MEDICINE, A LONGSTANDING LEADER IN EDUCATIONAL EXCELLENCE, WE BROUGHT AWARD WINNING CURRICULUM TO COMMUNITY HEALTH NETWORK TO EDUCATE OUR PRACTITIONERS HOW TO SAFELY AND EFFECTIVELY MANAGE PATIENTS ACUTE AND/OR CHRONIC PAIN INCLUDING SAFE OPIOID PRESCRIBING MEASURES WHEN OPIOIDS ARE MEDICALLY NECESSARY. NARCAN PROGRAM: CHNW IS DEDICATED TO THE PREVENTION OF OVERDOSE DEATHS THROUGH OUR NARCAN PROGRAM. NARCAN IS THE DRUG THAT CAN REVERSE THE EFFECTS OF OPIOIDS SUCH AS HEROIN, METHADONE AND OXYCODONE. OUR PROGRAM PROVIDES A NARCAN KIT TO PATIENTS AND THEIR FAMILIES WHO ARE AT RISK FOR AN OPIOID OVERDOSE WHEN THEY HAVE BEEN DISCHARGED FROM AN EMERGENCY DEPARTMENT OR THE BEHAVIORAL HEALTH PAVILION. THROUGH PARTNERSHIPS WITH COMMUNITY NONPROFIT ORGANIZATIONS SUCH AS OVERDOSE LIFELINE AND THE BEECH GROVE COMPREHENSIVE DRUG FREE COALITION WE PROVIDED OPIOID OVERDOSE AWARENESS TRAINING AND FREE NARCAN KITS TO THE COMMUNITIES WE SERVE. IN 2023, 630 NARCAN KITS WERE DISTRIBUTED.SCHOOL-BASED BEHAVIORAL CARE SERVICES: CHNW'S SCHOOL-BASED CARE SERVICES PROVIDES COORDINATED, MULTI-SERVICE 'ON THE SPOT' CARE DIRECTLY IN SCHOOLS TO STUDENTS IN NEED BY WAY OF AN EMBEDDED COORDINATED TEAM OF SCHOOL NURSES, SCHOOL BEHAVIORAL HEALTH PROFESSIONALS, SCHOOL SPORTS MEDICINE & ATHLETIC TRAINING PROFESSIONALS, AND VIRTUAL CARE PROVIDERS. THE PROGRAM ALSO AIMS TO HELP KEEP SCHOOL TEACHERS, STAFF, EMPLOYEES, AND ADMINISTRATORS HEALTHY AND AVAILABLE TO SUPPORT KIDS IN SCHOOLS BY WAY OF ONSITE HEALTH & WELLNESS CLINICS AND EAP SERVICES FOR SCHOOL EMPLOYEES AND THEIR DEPENDENTS. CHNW PROVIDES OVER 150 BEHAVIORAL STAFF EMPLOYEES TO 143 SCHOOLS THROUGHOUT CENTRAL INDIANA. THESE ON-SITE BEHAVIORAL HEALTH SPECIALISTS PROVIDE SERVICES SUCH AS, COUNSELING, LIFE-SKILLS TRAINING, CRISIS RESPONSE, TRAUMA AND DEPRESSION SCREENINGS, STAFF EDUCATION AND TRAINING, TESTING, FAMILY SERVICES AND MORE. CHNW SCHOOL-BASED BEHAVIORAL HEALTH CAREGIVERS HAD 140,231 ENCOUNTERS WITH STUDENTS, FAMILIES AND STAFF IN 2023.CHRONIC DISEASEDIABETES EDUCATION CLASSES: CHNW PROVIDES FREE VIRTUAL DIABETES EDUCATION AND SUPPORT COURSES FOR PATIENTS AND COMMUNITY MEMBERS. EACH COURSE CONSISTS OF TWO CLASSES. COURSES ARE HELD AT VARIOUS TIMES THROUGHOUT THE MONTH TO ENSURE ACCESS FOR ALL WHO ARE INTERESTED. IN 2023, 42 MULTI CLASS SESSIONS WERE HELD.FAITH HEALTH INITIATIVE PROGRAM: TRAINS AND SUPPORTS A NETWORK OF FAITH COMMUNITY NURSES (FCNS) WHO CAN CREATE SUSTAINABLE ENGAGED HEALTH MINISTRIES AND ACTIVITIES IN THEIR RESPECTIVE FAITH COMMUNITIES. THESE FCNS PROVIDE CHRONIC DISEASE MANAGEMENT SUPPORT, MENTAL HEALTH SUPPORT THROUGH HEALTH MINISTRIES WITHIN THEIR FAITH COMMUNITIES.COMMUNITY CAREMOBILE: THE HOWARD REGION'S COMMUNITY CAREMOBILE OUTREACH SERVICE BRINGS CARE AND ASSISTANCE TO THE PLACES THEY ARE NEEDED MOST YEAR-ROUND - EVERYTHING FROM SCREENINGS AND FREE FLU SHOTS TO A COOL AND COMFORTABLE PLACE FOR BREASTFEEDING MOMS TO CARE FOR THEIR INFANTS DURING A HOT SUMMER FAIR. STARTING IN 2022, COMMUNITY HOWARD UTILIZED THE CAREMOBILE TO OFFER MOBILE COVID-19 VACCINATION CLINICS AND ALSO PARTNERED WITH THE HOWARD COUNTY DEPARTMENT OF HEALTH TO HELP DELIVER MOBILE COVID-19 TESTING TO UNDERSERVED AREAS. IN 2023, THE CAREMOBILE WAS USED TO OFFER MORE THAN 1,400 BLOOD PRESSURE OR BLOOD GLUCOSE SCREENINGS AND MORE THAN 150 FREE FLU SHOTS AT EVENTS ACROSS KOKOMO AND THE HOSPITAL PARTNERED WITH THE MINORITY HEALTH ALLIANCE TO UTILIZE THE CAREMOBILE TO PERFORM PHYSICAL BREAST EXAMS. IN ADDITION, HOSPITAL STAFF ALSO OFFERED GENERAL HEALTH INFORMATION TO THOUSANDS OF ATTENDEES AT EVENTS ACROSS HOWARD COUNTY, INCLUDING THE WEEK-LONG COUNTY FAIR. SOCIAL DETERMINANTS OF HEALTH (SDOH)WELLFUND: THE WELLFUND EXISTS TO HELP PATIENTS NAVIGATE HEALTHCARE COVERAGE OPTIONS, INCLUDING INITIAL ENROLLMENT AND ONGOING MAINTENANCE OF COVERAGE. PATIENTS HAVE DIRECT ACCESS TO WELLFUND PATIENT ADVOCATES DURING PRE-SERVICE, ADMISSION AND POST-DISCHARGE FOR QUESTIONS AND DETERMINING WHICH PLAN BEST MEETS THEIR NEEDS. IN 2023, WELLFUND PATIENT ADVOCATES ASSISTED OVER 29,006 INDIVIDUALS WITH ENROLLMENT ASSISTANCE. THE WELLFUND PATIENT ADVOCATES ARE AVAILABLE TO MEET WITH PATIENTS IN PERSON OR OVER THE PHONE TO HELP WITH ENROLLMENT.SDOH SCREENING: A NETWORK-WIDE SDOH SCREENING PROGRAM WAS ROLLED OUT IN Q1 OF 2021. UTILIZING THE EPIC SDOH SCREENING TOOL, PATIENTS ADMITTED TO CHNW HOSPITALS, OB PATIENTS AND PRIMARY CARE PATIENTS ARE PROVIDED A COMPREHENSIVE SDOH SCREENING TO IDENTIFY ANY NEEDS THAT COULD IMPACT THE OVERALL HEALTH AND WELL-BEING OF THE PATIENT. CAREGIVERS ARE TRAINED ON HOW TO PROVIDE REFERRAL RESOURCES TO ASSIST THE PATIENT IN ADDRESSING THEIR IDENTIFIED NEED. PATIENTS NEEDING ADDITIONAL FOLLOW-UP ARE REFERRED FOR ADDITIONAL ASSISTANCE BY A CASE MANAGER OR HEALTH ADVOCATE. IN 2023, 133,643 PATIENTS WERE SCREENED.SCHOOL-BASED CLINICAL CARE: CHNW'S SCHOOL-BASED PROGRAMS COVER A WIDE RANGE OF NEEDS FOR YOUTH ACROSS CENTRAL INDIANA AND PLAY A CRITICAL ROLE IN KEEPING CHILDREN HEALTHY IN THE CLASSROOM SO THEY CAN LEARN. ONSITE NURSES ADDRESS STUDENTS' NEEDS IN THE SCHOOL AND AFTER-SCHOOL SETTING, HELPING TO ENSURE CONSISTENCY IN CARE AND LESS TIME AWAY FROM THE CLASSROOM. THESE NURSING SERVICES ARE PRIMARILY OFFERED FREE OF CHARGE TO SCHOOLS THANKS TO CHNW'S ONGOING COMMITMENT TO ENHANCING HEALTH FOR FUTURE GENERATIONS. NURSES ASSESS HEALTH CONDITIONS, DERIVE NURSING DIAGNOSES, EXECUTE A NURSING REGIMEN, ADVOCATE FOR HEALTH, EXECUTE A MEDICAL REGIMEN DELEGATED BY A PHYSICIAN, TEACH, ADMINISTER AND EVALUATE CARE FOR STUDENTS EVERY DAY. IN ADDITION, FOR STUDENTS FACING CHRONIC HEALTH CONDITIONS AND ONGOING HEALTH NEEDS, MEDICATIONS PRESCRIBED BY PHYSICIANS ARE ADMINISTERED BY CHNW'S SCHOOL-BASED NURSING STAFF. SERVICES ALSO INCLUDE PHYSICALS, IMMUNIZATIONS, HEALTH COACHING INCLUDING BLOOD PRESSURE AND CHOLESTEROL SCREENING AND A VARIETY OF ADDITIONAL SERVICES HELPING TEACHERS AND FACULTY ADDRESSING EVERYTHING FROM ALLERGIES TO ANXIETY AND BULLYING.MATERNAL/INFANT HEALTHNURSE-FAMILY PARTNERSHIP (NFP): GOODWILL OF CENTRAL & SOUTHERN INDIANA IMPLEMENTED THE NURSE-FAMILY PARTNERSHIP (NFP), A NURSE HOME-VISITING PROGRAM SERVING LOW-INCOME MOTHERS AND BABIES.MILK FOR HEALTHY BABIES - THE MILK BANK: THREE COMMUNITY HOSPITALS ARE HOME TO AN INDIANA MOTHERS' MILK BANK MILK DEPOT. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. WHEN A MOTHER'S OWN MILK IS NOT AVAILABLE, PASTEURIZED DONOR HUMAN MILK IS DISPERSED BY PRESCRIPTION OR HOSPITAL ORDER PRIMARILY TO PREMATURE INFANTS IN HOSPITAL NEONATAL INTENSIVE CARE UNITS. COMMUNITY HOSPITAL NORTH, COMMUNITY HOWARD REGIONAL HEALTH, AND COMMUNITY HOSPITAL ANDERSON PARTICIPATE IN THE MILK BANK PROGRAM. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. FACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 16AECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 16BECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 1, COMMUNITY HOWARD REGIONAL HEALTH - PART V, LINE 16CECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICY 4 1 - COMMUNITY COUNSELING CENTER 205 N JACKSON FRANKFORT IN 46041 HEALTH CARE 2 - FRANCES HOUSE 3322 FRANCES LANE KOKOMO IN 46901 HEALTH CARE 3 - ASSERTIVE COMMUNITY TREATMENT 416 PILLARS PLACE KOKOMO IN 46902 HEALTH CARE 4 - TIPTON BEHAVIORAL CARE 202 S WEST STREET SUITE B TIPTON IN 46072 HEALTH CARE PART I, LINE 3C: OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARECHRH ALSO CONSIDERS THE PATIENT'S MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY WHEN CONSIDERING THE PATIENT FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: RELATED ORGANIZATION INFORMATIONA COMMUNITY BENEFIT REPORT IS COMPLETED FOR THE COMMUNITY HEALTH NETWORK INCLUDING COMMUNITY HOWARD REGIONAL HEALTH AND OTHER TAX-EXEMPT AFFILIATES OF THE NETWORK. PART I, LINE 7: COSTING METHODOLOGY EXPLANATIONA COST TO CHARGE RATIO WAS UTILIZED TO DETERMINE COSTS FOR LINES A THROUGH C IN THE TABLE. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. LINES E THROUGH I OF THE TABLE ARE BASED ON ACTUAL INCURRED EXPENSES. PART II - COMMUNITY BUILDING ACTIVITIES:1. PHYSICAL IMPROVEMENTS AND HOUSING - CHRH PARTICIPATED IN THE WESTERN SCHOOL CORPORATION'S INCLUSIVE PLAYGROUND PROJECT WHICH HELPED BUILDING A NEW PLAYGROUND TO ALLOW CHILDREN WITH SPECIAL NEEDS TO PARTICIPATE ON THE PLAYGROUND WITH OTHER CHILDREN.2. ECONOMIC DEVELOPMENT - CHNW HAS CREATED AND PARTICIPATED IN VARIOUS ACTIVITIES TO MAKE A LASTING IMPACT ON THE COMMUNITIES THEY SUPPORT EVERY YEAR. THESE ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO, VOLUNTEERING WITH CANCER PATIENTS, READING WITH KIDS AT AFTER SCHOOL PROGRAMS AND PROVIDING SUPPORT FOR ENTREPRENEURS, SMALL BUSINESSES AND LARGE CORPORATIONS.3. COMMUNITY SUPPORT - CHNW CONTINUES TO SUPPORT OUR COMMUNITIES IN VARIOUS WAYS SUCH AS SUPPORTING THE LOCAL BOYS AND GIRLS CLUBS, PROVIDING TRAINING TO MENTAL HEALTH AND PEER RESPONDERS IN CENTRAL INDIANA, AND LEADING A TEAM THAT PROVIDES CRISIS INTERVENTION AND PSYCHOLOGICAL FIRST AID.4. ENVIRONMENTAL IMPROVEMENTS - NOTHING TO REPORT.5. LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY - CHNW PROVIDES TRAINING TO LAW ENFORCEMENT AND OTHER FIRST RESPONDERS ON A VARIETY OF ISSUES REGARDING MENTAL ILLNESS, SUBSTANCE ABUSE DISORDERS, SUICIDE PREVENTION AND COMMUNICATION SKILLS.6. COALITION BUILDING - THE COALITIONS THE CHNW MEMEBERS ARE A PART OF WORK TOWARDS MAKING THEIR COMMUNITIES SAFER AND HEALTHIER, IMPROVING THE QUALITY OF LIFE, EDUCATING THE YOUTH AND TRANSFORMING URBAN NEIGHBORHOODS.7. COMMUNITY HEALTH IMPROVEMENT ADVOCACY - CHNW MEMBERS ADVOCATE AND HELP CARING FOR VICTIMS OF VIOLENCE, ABUSE OR NEGLECT, ESPECIALLY SEXUAL ASSAULT AND INTERPERSONAL VIOLENCE. CHNW CAREGIVERS ARE ALSO A PART OF INDIANA'S BEHAVIORAL HEALTH AND HUMAN SERVICES LICENSING BOARD WHICH WORKS TO PROTECT THE CITIZENS OF INDIANA FROM UNQUALIFIED AND/OR UNETHICAL PRACTITIONERS.8. WORKFORCE DEVELOPMENT - CHNW HOSTS MANY HOURS EACH YEAR ON PROFESSIONAL DEVELOPMENT/WORKSHOPS AND CONFERENCES AND CLINICAL EDUCATION.FOR FURTHER DETAIL SEE THE ATTACHED IRS SCHEDULE H SUPPLEMENTAL INFORMATION REPORT PART III, LINE 2: BAD DEBT EXPENSE METHODOLOGYTHE COST TO CHARGE RATIO UTILIZED FOR PURPOSES OF REPORTING BAD DEBT COSTS WAS DERIVED FROM WORKSHEET 2 AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS.ADDITIONALLY, COMMUNITY HEALTH NETWORK ADOPTED A NEW STANDARD RELATED TO REVENUE RECOGNITION AND CODIFIED IN THE FASB ACCOUNTING STANDARDS CODIFICATION ("ASC") AS TOPIC 606 ("ASC 606") IN FISCAL YEAR 2018. BECAUSE OF THE ADOPTION OF THIS STANDARD FROM AN ACCOUNTING PRESENTATION STANDPOINT, THE NETWORK NO LONGER EXPLICITLY REPORTS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. HOWEVER, THE NETWORK STILL DOES INCUR A SIGNIFICANT AMOUNT OF ADJUSTMENTS TO PATIENT'S ACCOUNTS FOR THOSE WHO DO NOT PAY THEIR PATIENT BALANCE WHICH RESULTS IN A SIGNIFICANT AND MATERIAL COST TO THE NETWORK. AS SUCH THE NETWORK WILL CONTINUE TO REPORT IN LINE 2 THE AMOUNT OF ADJUSTMENTS RELATED TO ADJUSTMENTS PREVIOUSLY IDENTIFIED AS BAD DEBT.PART III, LINE 4:THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING WITHIN THE FOOTNOTES:PATIENT ACCOUNTS RECEIVABLE AT DECEMBER 31, 2023 AND 2022, ARE REPORTED AT THE AMOUNTS THAT REFLECTS THE CONSIDERATION WHICH THE NETWORK EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDIDNG PATIENT CARE, AS FURTHER DESCRIBED IN NOTE 2. THE COLLECTION OF OUTSTANDING RECEIVABLES FOR MEDICARE, MEDICAID, MANAGED CARE AND COMMERCIAL INSURANCE PAYERS, AND PATIENTS IS THE NETWORK'S PRIMARY SOURCE OF CASH AND IS CRITICAL TO THE NETWORK'S OPERATING PERFORMANCE. THE PRIMARY COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE CARRIER HAS PAID THE AMOUNTS COVERED BY THE APPLICABLE AGREEMENT, BUT PATIENT RESPONSIBILITY AMOUNTS (DEDUCTIBLES AND COINSURANCE) REMAIN OUTSTANDING. THE NETWORK GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYER AGREEMENTS. THE CONCENTRATION OF NET RECEIVABLES BY PAYER CLASS FOR BOTH PATIENTS AND THIRD-PARTY PAYERS AT DECEMBER 31, 2023 AND 2022 IS AS FOLLOWS. NET RECEIVABLE FOR PATIENTS INCLUDES UNINSURED BALANCES WHICH ARE THE RESPONSIBILITY OF THE PATIENT ASSOCIATED WITH THIRD-PARTY PAYERS LISTED BELOW: 2023 2022MEDICARE 24% 22%MEDICAID 11% 11%MANAGED CARE AND COMMERCIAL INSURANCE 54% 57%PATIENTS 11% 10% 100% 100%CHARITY CARETHE NETWORK MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE NETWORK PROVIDES 100% CHARITY CARE TO PATIENTS WHOSE INCOME LEVEL IS EQUAL TO OR BELOW 200% OF THE FEDERAL POVERTY LINE. PATIENTS WITH INCOME LEVELS RANGING FROM 200%-300% OF THE CURRENT YEAR'S FEDERAL POVERTY LEVEL WILL QUALIFY FOR PARTIAL ASSISTANCE DETERMINED BY A SLIDING SCALE. THE NETWORK USES COST AS THE MEASUREMENT BASIS FOR CHARITY CARE DISCLOSURE PURPOSES WITH THE COST BEING IDENTIFIED AS THE DIRECT AND INDIRECT COSTS OF PROVIDING THE CHARITY CARE. CHARITY CARE AT COST WAS $12,628(000) AND $8,058(000) FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, RESPECTIVELY. CHARITY CARE COST WAS ESTIMATED ON THE APPLICATION OF THE ASSOCIATED COST-TO-CHARGE RATIOS.PATIENT SERVICE REVENUETHE NETWORK'S REVENUES GENERALLY RELATE TO CONTRACTS WITH PATIENTS IN WHICH THE NETWORK'S PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO THE PATIENTS. PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE NETWORK EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYERS (INCLUDING GOVERNMENT PROGRAMS AND MANAGED CARE AND COMMERCIAL INSURANCE COMPANIES) AND INCLUDE VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE NETWORK BILLS THE PATIENTS AND THIRD-PARTY PAYERS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED OR THE PATIENT IS DISCHARGED FROM THE FACILITY. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. THE NETWORK DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYERS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE NETWORK'S POLICY, AND IMPLICIT PRICE CONCESSIONS.PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE NETWORK. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED OR ACTUAL CHARGES. THE NETWORK BELIEVES THAT THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS IN OUR HOSPITALS RECEIVING INPATIENT ACUTE CARE SERVICES. THE NETWORK MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED AT A POINT IN TIME, WHICH INCLUDES OUTPATIENT SERVICES, IS GENERALLY RECOGNIZED WHEN SERVICES ARE PROVIDED TO OUR PATIENTS AND THE NETWORK DOES NOT BELIEVE IT IS REQUIRED TO PROVIDE ADDITIONAL SERVICES TO THE PATIENT.BECAUSE ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, THE NETWORK HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION PROVIDED IN FASB ASC 606-10-50-14A AND, THEREFORE, IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OBLIGATIONS REFERRED TO PREVIOUSLY ARE PRIMARILY RELATED TO INPATIENT ACUTE CARE SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN THE PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD.THE NETWORK DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. MANAGEMENT CONTINUALLY REVIEWS THE CONTRACTUAL ESTIMATION PROCESS TO CONSIDER AND INCORPORATE UPDATES TO LAWS AND REGULATIONS AND THE FREQUENT CHANGES IN MANAGED CARE CONTRACTUAL TERMS RESULTING FROM CONTRACT RENEGOTIATIONS AND RENEWALS. ESTIMATES OF CONTRACTUAL ADJUSTMENTS UNDER MANAGED CARE AND COMMERCIAL INSURANCE PLANS ARE BASED UPON THE PAYMENT TERMS SPECIFIED IN THE RELATED CONTRACTUAL AGREEMENTS. THE PAYMENT ARRANGEMENTS WITH THIRD-PARTY PAYERS PROVIDE FOR PAYMENTS TO THE NETWORK AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES.GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYERS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE NETWORK ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. AT DECEMBER 31, 2023 AND 2022, ESTIMATED IMPLICIT PRICE CONCESSIONS OF $668,478(000) AND $767,782(000), RESPECTIVELY, WERE RECORDED TO ADJUST REVENUES TO THE ESTIMATED AMOUNTS THE NETWORK EXPECTS TO COLLECT.ESTIMATED IMPLICIT PRICE CONCESSIONS ARE RECORDED FOR ALL UNINSURED ACCOUNTS, WHICH INCLUDES UNINSURED PATIENTS AND UNINSURED COPAYMENT AND DEDUCTIBLE AMOUNTS FOR PATIENTS WHO HAVE HEALTH CARE COVERAGE, REGARDLESS OF THE AGING OF THOSE ACCOUNTS. THE ESTIMATES FOR IMPLICIT PRICE CONCESSIONS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL WRITE-OFFS AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL, STATE AND PRIVATE EMPLOYER HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS AS A PRIMARY SOURCE OF INFORMATION IN ESTIMATING THE COLLECTABILITY OF OUR ACCOUNTS RECEIVABLE. THE NETWORK PERFORMS A HINDSIGHT ANALYSIS QUARTERLY, UTILIZING HISTORICAL ACCOUNTS RECEIVABLE COLLECTION AND WRITE-OFF DATA. THE NETWORK BELIEVES ITS QUARTERLY UPDATES TO THE ESTIMATED IMPLICIT PRICE CONCESSION AMOUNTS AT EACH OF ITS HOSPITAL FACILITIES PROVIDE REASONABLE VALUATION ESTIMATES OF THE NETWORK'S REVENUES AND ACCOUNTS RECEIVABLE. PART III, LINE 4: BEGINNING JUNE 2012, THE STATE OF INDIANA OFFERED VOLUNTARY PARTICIPATION IN THE STATE OF INDIANA'S HAF PROGRAM. THE STATE OF INDIANA IMPLEMENTED THIS PROGRAM TO UTILIZE SUPPLEMENTAL REIMBURSEMENT PROGRAMS FOR THE PURPOSE OF PROVIDING REIMBURSEMENT TO PROVIDERS TO OFFSET A PORTION OF THE COST OF PROVIDING CARE TO MEDICAID AND INDIGENT PATIENTS. THIS PROGRAM IS DESIGNED WITH INPUT FROM CMS AND IS FUNDED WITH A COMBINATION OF STATE AND FEDERAL RESOURCES, INCLUDING FEES OR TAXES LEVIED ON THE PROVIDERS.REIMBURSEMENT UNDER THE PROGRAM IS REFLECTED WITHIN PATIENT SERVICE REVENUE AND THE FEES PAID FOR PARTICIPATION IN THE HAF PROGRAM ARE RECORDED IN SUPPLIES AND OTHER EXPENSES WITHIN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. THE FEES AND REIMBURSEMENTS ARE SETTLED MONTHLY. REVENUE RECOGNIZED RELATED TO THE HAF PROGRAM WAS $403,287(000) AND $348,441(000) FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, RESPECTIVELY. EXPENSE FOR FEES RELATED TO THE HAF PROGRAM WAS $108,347(000) AND $108,199(000) FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, RESPECTIVELY.THE HAF PROGRAM RUNS ON AN ANNUAL CYCLE FROM JULY 1 TO JUNE 30 AND IS EFFECTIVE UNTIL JUNE 30, 2023. THE CONSOLIDATED BALANCE SHEETS AT DECEMBER 31, 2023 AND 2022 INCLUDED HAF ACTIVITY OF $20,460(000) AND ($11,127)(000), RESPECTIVELY, IN ESTIMATED THIRD-PARTY PAYER SETTLEMENTS RECEIVABLE (PAYABLE) RELATED TO THE HAF PROGRAM. PART III, LINE 8: PER THE 990 INSTRUCTIONS THE MEDICARE COST REPORT WAS UTILIZED TO DETERMINE THE MEDICARE SHORTFALL. HOWEVER, THE MEDICARE COST REPORT IS NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH MEDICARE PROGRAMS SUCH AS PHYSICIAN SERVICES AND SERVICES BILLED VIA FREE STANDING CLINICS. FURTHER THE MEDICARE COST REPORT EXCLUDES REVENUES AND COSTS OF MEDICARE PARTS C AND D. THE MEDICARE SHORTFALL ATTRIBUTED TO THOSE AREAS NOT INCLUDED ON THE MEDICARE COST REPORT IS $9,070,294. AS SUCH, THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS $11,802,721. MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 54.13% OF THE OVERALL PAYER MIX FOR THIS ORGANIZATION. PART III, LINE 9B: COLLECTION PRACTICES EXPLANATIONNOTWITHSTANDING ANY OTHER PROVISION OF ANY OTHER POLICY AT COMMUNITY REGARDING BILLING AND COLLECTION MATTERS, COMMUNITY WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS BEFORE IT MAKES REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL WHO HAS AN UNPAID BILL FROM COMMUNITY IS ELIGIBLE FOR FINANCIAL ASSISTANCE FROM UNDER THIS POLICY. THE ACTIONS COMMUNITY MAY TAKE IN THE EVENT OF NONPAYMENT AND THE PROCESS AND TIME FRAMES FOR TAKING THESE ACTIONS ARE MORE FULLY DESCRIBED IN COMMUNITY'S BILLING AND COLLECTIONS POLICY. PART VI, LINE 2 - NEEDS ASSESSMENT IN ADDITION TO THE TRIENNIAL CHNA, COMMUNITY HOWARD REGIONAL HEALTH CONTINUALLY ASSESSES THE NEEDS OF OUR PATIENTS AND THE COMMUNITY SERVED. COMMUNITY HEALTH NETWORK WORKS COLLABORATIVELY WITH OUR PEER HEALTH SYSTEM TO DISCUSS TRENDS AND WAYS IN WHICH THE HEALTH SYSTEMS CAN WORK TOGETHER TO ADDRESS THE NEEDS OF THE COMMUNITY. COMMUNITY HEALTH NETWORK ASSESSES THE SDOH NEEDS OF OUR PATIENTS BY EVALUATING DATA FROM THE COMMUNITY CONNECTIONS PLATFORM, A FREE SEARCH ENGINE THAT ALLOWS COMMUNITY MEMBERS TO ANONYMOUSLY SEARCH FOR SOCIAL CARE RESOURCES. INTERNALLY, CHNW HAS ACCESS TO A ROBUST DATA ANALYTICS TEAM AND TOOLS WHICH DEVELOP DASHBOARDS TO HELP TRACK AND MONITOR THE HEALTH NEEDS OF THOSE SERVED. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE COMMUNITY WILL UNDERTAKE THE FOLLOWING EFFORTS TO WIDELY PUBLICIZE ITS FINANCIAL ASSISTANCE POLICY:1) WRITTEN NOTIFICATION - A PLAN LANGUAGE SUMMARY WILL BE POSTED IN EACH PATIENT REGISTRATION AND WAITING AREA AND AVAILABLE ONLINE AT ECOMMUNITY.COM. IN THE CASE OF SERVICES RENDERED IN THE HOME, THE FINANCIAL ASSISTANCE SUMMARY WILL BE PROVIDED TO THE RESPONSIBLE PARTY DURING THE FIRST IN-HOME VISIT. ALL PUBLICATIONS AND INFORMATIONAL MATERIALS RELATED TO THE FINANCIAL ASSISTANCE PROGRAM WILL BE TRANSLATED INTO LANGUAGES APPROPRIATE TO THE POPULATION IN THE SERVICE AREA.2) ORAL NOTIFICATION: ALL POINTS OF ACCESS WILL MAKE EVERY EFFORT TO INFORM EACH RESPONSIBLE PARTY ABOUT THE EXISTENCE OF COMMUNITY'S FINANCIAL ASSISTANCE PROGRAM IN THE APPROPRIATE LANGUAGE DURING ANY PRE-ADMISSION, REGISTRATION, ADMISSION OR DISCHARGE PROCESS. ADDITIONALLY, THE POST-SERVICE COLLECTION PROCESS WILL INTEGRATE NOTIFICATION OF THE AVAILABILITY OF ASSISTANCE INTO THE STANDARD PROCESS WHEN COLLECTION EFFORTS FAIL.3) STATEMENT NOTIFICATIONS: STATEMENTS WILL PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM.4) "ABOUT YOUR BILL: FREQUENTLY ASKED QUESTIONS:" COPIES OF THESE DOCUMENTS WILL BE AVAILABLE IN PATIENT REGISTRATION AREAS, THROUGH THE BUSINESS OFFICES AND PATIENT FINANCIAL COUNSELORS.5) COMMUNITY WILL MAKE REASONABLE EFFORTS TO INFORM AND NOTIFY RESIDENTS OF THE COMMUNITY SERVED ABOUT THE FINANCIAL ASSISTANCE POLICY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. MODES OF DELIVERY OF THIS INFORMATION MAY INCLUDE NEWSLETTERS, BROCHURES AND/OR THE PROVISION OF ONLINE ACCESS. PART VI, LINE 4 - COMMUNITY INFORMATION THE POPULATION SERVED BY COMMUNITY HOWARD REGIONAL HEALTH IS EXPECTED TO INCREASE BY 1.4% FROM 2019 TO 2025 WITH THE 2019 POPULATION AT 82,331. THE RACIAL AND ETHNIC MAKE-UP OF THE COMMUNITY IS, 85.1% WHITE, 7.5% BLACK, 3.4% HISPANIC AND 4.1% OTHER. THE FASTEST GROWING AGE GROUP IS THOSE AGED 65+. 14.9% OF THE POPULATION LIVES IN POVERTY. PART VI, LINE 5 - PROMOTION OF COMMUNITY OF HEALTH A MAJORITY OF COMMUNITY HEALTH NETWORK'S (COMMUNITY) BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN COMMUNITY'S PRIMARY SERVICE AREAS. COMMUNITY EXTENDS MEDICAL PRIVILEGES TO ALL PHYSICIANS WHO MEET THE CREDENTIALING QUALIFICATIONS NECESSARY FOR APPOINTMENT TO ITS MEDICAL STAFF. COMMUNITY DOES NOT DENY APPOINTMENT BASED ON GENDER, RACE, CREED, OR NATIONAL ORIGIN. COMMUNITY, IN COLLABORATION WITH MARIAN UNIVERSITY OSTEOPATHIC SCHOOL OF MEDICINE, TRAINS THE NEXT GENERATION OF PHYSICIANS IN A LEARNING ENVIRONMENT. COMMUNITY APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM COMMUNITY HOWARD REGIONAL HEALTH IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. SEE THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR HOW CHNW IS INVOLVED IN PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA 1 UNITED WAY OF HOWARD COUNTY 210 WEST WALNUT STREET KOKOMO IN 46901 350877579 501(C)(3) 36000 0 BUDDY BAG PROGRAM KOKOMO FAMILY YMCA 114 N UNION ST KOKOMO IN 46901 350893511 501(C)(3) 5250 0 GENERAL SUPPORT 2 0 PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS PRIOR TO THE DISBURSEMENT OF ANY GRANT PROCEEDS, CHRH ENSURES THAT THE PURPOSE OF THE GRANT IS CONSISTENT WITH CHRH'S CHARITABLE PURPOSES. THE TERMS OF ALL GRANTS REQUIRE THAT THE RECIPIENT EXPEND THE FUNDS SOLELY FOR CHARITABLE PURPOSES. 0 1 0 0 0 0 0 1 0 ELIZABETH THARP MBA BSN RN SVP-HOSPITAL ACUTE SERVICES/CNO 0 519670 0 0 0 23604 0 278131 0 20902 0 842307 0 0 COURTNEY HOLLAND MD DIRECTOR 0 619993 0 0 0 77125 0 113140 0 31588 0 841846 0 0 SYED KHAN MD PSYCHIATRIST 490202 0 0 0 189197 0 10863 0 34355 0 724617 0 0 0 BENJAMIN CHIU MD VICE CHAIR THROUGH JUNE 2023 0 435489 0 0 0 23592 0 87798 0 37509 0 584388 0 0 JENNIFER HINDMAN DIRECTOR/VP-HOSP ADMIN THR MAR 2023 85043 255128 0 0 573 1721 26400 79202 8534 25603 120550 361654 0 0 LAXESHKUMAR PATEL MD PSYCHIATRIST 268960 0 0 0 23521 0 69402 0 29832 0 391715 0 0 0 DOUGLAS COOK MD PSYCHIATRIST 223306 0 0 0 62100 0 60353 0 35459 0 381218 0 0 0 JOHN BILO VP-FINANCE 0 253321 0 0 0 747 0 92091 0 22497 0 368656 0 0 DEREK MCMICHAEL VP-HOSPITAL ADMINISTRATOR 235140 0 0 0 23575 0 90105 0 0 0 348820 0 0 0 JOHN SCHILTZ MD PSYCHIATRIST 294505 0 0 0 1024 0 60937 0 33807 0 390273 0 0 0 SHILPA PURI MD PSYCHIATRIST 258495 0 0 0 17542 0 16915 0 28857 0 321809 0 0 0 PART III - OTHER ADDITIONAL INFORMATION PART I, LINE 3 - RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") CEO/EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY COMMUNITY HEALTH NETWORK, INC. ("CHNW"), A RELATED 501(C)(3) ORGANIZATION. CHNW USES THE FOLLOWING IN DETERMINING THE CEO'S COMPENSATION: 1) COMPENSATION SURVEY OR STUDY PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS COMMUNITY HEALTH NETWORK, INC. RESTORATION PLAN COMMUNITY HEALTH NETWORK, INC. ("COMMUNITY") ADOPTED THIS COMMUNITY HEALTH NETWORK RESTORATION PLAN ("PLAN") AS OF DECEMBER 1, 2017 TO PROVIDE A SUPPLEMENTAL INCOME FOR RETIREMENT UPON VESTING IN THE BENEFITS AS DESCRIBED IN THE PLAN DOCUMENT. COMMUNITY HOWARD REGIONAL HEALTH, INC. ("CHRH") IS INCLUDED IN THE PLAN. THE PLAN IS DESIGNED UNDER CODE SECTION 457(F) AS A "TOP-HAT PLAN" (I.E. AN UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). ELIGIBILITY: INDIVIDUALS WHO HAVE THE TITLE OF PRESIDENT, SENIOR VICE PRESIDENT OR EXECUTIVE VICE PRESIDENT AND WHOSE PLAN COMPENSATION FOR THE APPLICABLE PLAN YEAR EXCEEDS THE ANNUAL COMPENSATION LIMIT UNDER CODE SECTION 401(A)(17), AS ADJUSTED FROM TIME TO TIME. CONTRIBUTIONS: 1. MATCHING CONTRIBUTIONS. IF A PARTICIPANT RECEIVES THE MAXIMUM PERMISSIBLE MATCHING CONTRIBUTION UNDER THE COMMUNITY HEALTH NETWORK 401(K) RETIREMENT PLAN, THEY WILL RECEIVE A MATCHING CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE MAXIMUM PERMITTED MATCHING CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. 2. NON-ELECTIVE CONTRIBUTIONS. IF A PARTICIPANT RECEIVES A NON-ELECTIVE CONTRIBUTION IN THE 401(K) PLAN, THEY WILL RECEIVE A NON-ELECTIVE CONTRIBUTION IN THE PLAN THAT IS EQUAL TO THEIR COMPENSATION THAT IS GREATER THAN THE 401(K) PLAN LIMIT MULTIPLIED BY THE NON-ELECTIVE CONTRIBUTION PERCENTAGE IN THE 401(K) PLAN FOR THAT YEAR. NOTE THAT NO NON-ELECTIVE CONTRIBUTIONS ARE CURRENTLY BEING MADE TO THE 401(K) PLAN. CONTRIBUTIONS WILL BE CREDITED TO A PARTICIPANT'S ACCOUNT AS SOON AS ADMINISTRATIVELY FEASIBLE FOLLOWING THE END OF THE PLAN YEAR TO WHICH THE CONTRIBUTIONS RELATE. VESTING: A PARTICIPANT WILL BE 100% VESTED IN HIS ACCOUNT UPON THE EARLIEST TO OCCUR OF THE FOLLOWING: 1. ATTAINMENT OF AGE 65 PRIOR TO SEPARATION FROM SERVICE 2. DISABILITY 3. INVOLUNTARY SEPARATION FROM SERVICE FOR A REASON OTHER THAN FOR CAUSE 4. SEPARATION FROM SERVICE FOR GOOD REASON 5. A NONCOMPETITIVE PARTICIPANT'S COMPLIANCE WITH ALL TERMS OF A NONCOMPETING AGREEMENT, OR 6. DEATH FORFEITURES: IF ACCOUNT IS NOT VESTED AS DESCRIBED ABOVE, THE ACCOUNT WILL BE COMPLETELY FORFEITED. AMOUNTS FORFEITED DURING A PLAN YEAR REMAIN A GENERAL ASSET OF COMMUNITY. PART I, LINE 7 - NON-FIXED PAYMENTS PROVIDED CHRH PARTICIPATES IN THE NETWORK'S SENIOR LEADERSHIP INCENTIVE PROGRAM. CERTAIN INDIVIDUALS OF THE LEADERSHIP TEAM PARTICIPATE IN THIS PROGRAM. THE PROGRAM WAS ADOPTED BY THE EXECUTIVE COMPENSATION COMMITTEE, AND IS INTENDED TO INFLUENECE OUTSTANDING PERFORMANCE BY THE SENIOR LEADERS, AS MEASURED AGAINST ORGANIZATIONAL PERFORMANCE. THE PROGRAM IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT COMMUNITY MEMBERS. THE INCENTIVE COMPENSATION THAT IS AWARDED IS INCLUDED IN TOTAL COMPENSATION TO THE EXECUTIVE. THE TOTAL COMPENSATION (INCLUDING ANY PAYMENTS UNDER THE PROGRAM) IS SUBJECT TO THE REVIEW AND APPROVAL OF THE EXECUTIVE COMPENSATION COMMITTEE AND INDEPENDENT COMPENSATION CONSULTANT, IN CONSIDERATION OF CODE SECTION 4958 (AND THE CORRESPONDING TREASURY REGULATIONS) TO ENSURE THAT IT REFLECTS ARM'S LENGTH, FAIR MARKET TERMS. FORM 990, PART V, LINE 1A - BOX 3 OF FORM 1096 FORM 1096 WAS PROCESSED UNDER THE NAME AND FEDERAL IDENTIFICATION NUMBER OF COMMUNITY HEALTH NETWORK, INC, THE PARENT ORGANIZATION AND A 501(C)(3) ENTITY. FORM 990, PART IV, LINE 22 - GRANTS OR OTHER ASSISTANCE COMMUNITY HOWARD REGIONAL HEALTH, INC. DOES PROVIDE ASSISTANCE TO INDIVIDUALS PURSUANT TO CHNW'S CHARITABLE CARE POLICY, BUT SUCH ASSISTANCE DOES NOT SHOW UP AS AN EXPENDITURE ON THE INCOME AND EXPENSE STATEMENT, THEREFORE THIS QUESTION IS ANSWERED NO. FORM 990, PART VI, SECTION A, LINE 2 RELATED PARTY INFORMATION AMONG OFFICERS JENNIFER HINDMAN SERVED AS A KEY EMPLOYEE OF COMMUNITY HEALTH NETWORK ("CHNW"). ELIZABETH THARP AND JOHN BILO ARE EMPLOYED BY CHNW. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DELEGATED CHRH HAS DELEGATED EXCLUSIVE AUTHORITY TO COMMUNITY HEALTH NETWORK ("CHNW"), A 501(C)(3) ENTITY AND CHRH'S SOLE MEMBER, ACTING THROUGH CHNW'S BOARD OF DIRECTORS, IN THE FOLLOWING SUBSTANTIVE AREAS: STRATEGIC PLANNING, CAPITAL ACCESS, BUDGETING AND ALLOCATION, AUDIT AND COMPLIANCE, EXECUTIVE COMPENSATION, AND DISPUTE RESOLUTION. IN ADDITION, CHNW MUST APPROVE ANY MODIFICATION, REPEAL AMENDMENT, OR RESTATEMENT OF CHRH'S ARTICLES OF INCORPORATION. FINALLY, CHNW MUST APPROVE ANY MATERIAL SALE OR DISPOSITION OF THE ASSETS OF CHRH. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS CHNW IS THE SOLE MEMBER OF CHRH. IN 2023, THE BYLAWS WERE AMENDED TO ELIMINATE THE REVIEW OF THE OFFICER COMPENSATION BY THE BOARD ACTING IN ACCORDANCE WITH THE MEMBER'S (CHNW) POLICIES, AS THAT ANALYSIS AND DECISION MAKING IS UNDERTAKEN BY CHNW'S EXECUTIVE COMPENSATION COMMITTEE. IN ADDITION, THE DETERMINATION OF A QUORUM WAS REVISED TO STATE THAT AT ANY MEETING OF MEMBER, THE PRESENCE OF THE MEMBER THROUGH ONE OR MORE DULY AUTHORIZED REPRESENTATIVES SHALL CONSTITUTE A QUORUM. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS COMMUNITY HEALTH NETWORK, INC. IS THE SOLE MEMBER OF CHRH. CHNW IS AN EXEMPT ORGANIZATION PURSUANT TO SECTION 501(C)(3). FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS AND THEIR RIGHTS COMMUNITY HEALTH NETWORK, INC. AS THE SOLE MEMBER OF CHRH APPOINTS A MAJORITY OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL OF MEMBERS THE FOLLOWING GOVERNANCE ITEMS REQUIRE THE WRITTEN APPROVAL OF THE MEMBER (CHNW): A) AMENDMENT OF ORGANIZATIONAL DOCUMENTS; B) THE INCURRENCE OF ANY UNBUDGETED INDEBTEDNESS OR LOANS ABOVE $750,000; C) THE FORMATION OF LEGAL ENTITIES, THE SALE, TRANSFER OR SUBSTANTIAL CHANGE IN USE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHRH, OR THE DIVESTURE, DISSOLUTION, CLOSURE, MERGER, CONSOLIDATION OR REORGANIZATION OF CHRH; D) THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY WHEN SUCH TRANSACTION IS ABOVE $1,000,000, DURING ANY FISCAL YEAR; E) DISPOSITION OF ASSETS ON DISSOLUTION; F) APPROVAL OF THE ANNUAL CAPITAL AND OPERATING BUDGETS, PLANS, OR FORECASTS APPROVED BY THE BOARD; G) THE SELECTION OF THE INDEPENDENT AUDITING FIRM EITHER DIRECTLY OR THROUGH THE MEMBER'S AUDIT, COMPLIANCE COMMITTEE, AND FINANCE COMMITTEE; H) THE DETERMINATION OF PHYSICIAN, PRESIDENT, AND SENIOR LEADERS COMPENSATION; I) ALL UNBUDGETED CAPITAL IMPROVEMENTS, ADDITIONS AND STRUCTURAL CHANGES TO THE PROPERTY GREATER THAN THE BUDGETED AMOUNT BY $500,000 PER FISCAL YEAR IN THE AGGREGATE; J) STRATEGIC PLANS; K) THE HIRING AND FIRING OF THE PRESIDENT SUBJECT TO THE PRIOR OPPORTUNITY FOR THE BOARD TO REVIEW AND COMMENT, AND L) THE COMMENCEMENT OR DISCONTINUATION OF ANY LINE OF BUSINESS OR HEALTHCARE SERVICES TO BE PROVIDED AT THE CORPORATION'S FACILITIES. FORM 990, PART VI, SECTION B, LINE 11B ORGANIZATION'S PROCESS TO REVIEW FORM 990 CHNW HAS ASSUMED RESPONSIBILITY FOR CHRH'S AUDIT, COMPLIANCE, FINANCE AND EXECUTIVE COMPENSATION MATTERS, INCLUDING SPECIFICALLY THE PREPARATION AND REVIEW OF CHRH'S FORM 990. CHNW'S BOARD OF DIRECTORS HAS DELEGATED AUTHORITY FOR THE REVIEW OF CHRH'S FORM 990 TO TWO COMMITTEES COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS: A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE REVIEWED THE COMPENSATION ASPECTS OF CHRH'S FORM 990, AND B) THE NETWORK FINANCE COMITTEE REVIEWED THE REMAINDER OF THE CHRH'S FORM 990. IN ADDITION, CHRH'S OUTSIDE ACCOUNTING FIRM AND LAW FIRM REVIEWED THE FORM 990 PRIOR TO FILING. CHRH AND CHNW UTILIZED THIS PROCESS TO ENSURE THAT CHRH'S FORM 990 RECEIVED SUBSTANTIVE REVIEW BY DIRECTORS AND PROFESSIONALS WITH SPECIFIC KNOWLEDGE OF CHRH'S ACTIVITIES AND EXTENSIVE FINANCIAL, ACCOUNTING AND TAX EXPERTISE. FORM 990, PART VI, SECTION B, LINE 12C ENFORCEMENT OF CONFLICTS POLICY CHNW HAS ASSUMED RESPONSIBILITY FOR CHRH'S AUDIT AND COMPLIANCE MATTERS. CHNW HAS ADOPTED A CONFLICT OF INTEREST POLICY THAT APPLIES TO CHRH. THE CONFLICT OF INTEREST POLICY REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO SUBMIT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE. THE ANNUAL DISCLOSURE REQUIRES DIRECTORS, OFFICERS, AND KEY EMPLOYEES TO DISCLOSE, IN WRITING, ANY KNOWN FINANCIAL INTEREST THAT THE INDIVIDUAL (TOGETHER WITH FAMILY MEMBERS) HAS IN ANY BUSINESS ENTITY THAT TRANSACTS BUSINESS WITH CHRH. IN ADDITION, DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO IMMEDIATELY DISCLOSE ANY POSSIBLE CONFLICT OF INTEREST THAT ARISES MID-YEAR IN RELATION TO A PROPOSED TRANSACTION. THE CONFLICT OF INTEREST POLICY REQUIRES THAT ANY INDIVIDUAL WITH A CONFLICT BE RECUSED FROM THE DECISION MAKING PROCESS, THAT INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS DETERMINE THAT THE PROPOSED TRANSACTION IS IN THE BEST INTEREST OF CHRH, AND THE TRANSACTION MUST BE APPROVED BY A VOTE OF INDEPENDENT DIRECTORS OR COMMITTEE MEMBERS WITHOUT THE PARTICIPATION OF ANY INTERESTED INDIVIDUAL. THE ANNUAL CONFLICT DISCLOSURE STATEMENTS ARE SUBMITTED TO, AND REVIEWED BY, CHNW'S AUDIT COMMITTEE, COMPOSED OF INDEPENDENT DIRECTORS. IN ADDITION, THE EXECUTIVE STAFF AND GENERAL COUNSEL OF THE NETWORK ARE RESPONSIBLE FOR MONITORING ANY POSSIBLE CONFLICT TRANSACTIONS THAT ARISE AND MANAGING THEM TO ENSURE THAT ALL TRANSACTIONS REPRESENT ARMS LENGTH, FAIR MARKET VALUE TERMS FOR THE BENEFIT OF CHRH. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICIAL AS A MEMBER OF THE NETWORK, CHRH IS SUBJECT TO THE EXECUTIVE COMPENSATION PRACTICES AND PROCEDURES OF CHNW, THE NETWORK PARENT. CHNW HAS ADOPTED AN EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY THAT APPLIES TO CHRH. THE PURPOSE OF THE POLICY IS TO ENSURE THAT CHRH'S COMPENSATION ARRANGEMENTS WITH RELATED PARTIES ARE EVALUATED AND ENTERED AT ARMS LENGTH AND THAT ANY COMPENSATION THAT IS PAID TO A RELATED PARTY IS REASONABLE AND REFLECTS FAIR MARKET VALUE. THIS POLICY ENCOURAGES THE APPLICATION OF THE REBUTTABLE PRESUMPTION STANDARD OF CODE SECTION 4958 AND THE RELATED TREASURY REGULATIONS BY: A) EXCLUDING ANY INTERESTED PARTY FROM THE DECISION MAKING PROCESS, B) REQUIRING DISINTERESTED BOARD OR COMMITTEE MEMBERS TO OBTAIN AND RELY UPON COMPARABILITY DATA WHEN SETTING THE PROPOSED COMPENSATION TERMS, C) REQUIRING APPROVAL OF THE TRANSACTION IN ADVANCE BY DISINTERESTED DIRECTORS OR COMMITTE MEMBERS, AND D) REQUIRING CONTEMPORANEOUS DOCUMENTATION (I.E. MINUTES) REFLECTING THE DECISION AND THE PROCESS BY WHICH IT WAS MADE. CHNW HAS DELEGATED AUTHORITY REGARDING CHRH'S EXECUTIVE COMPENSATION TO A) THE NETWORK EXECUTIVE COMPENSATION COMMITTEE, COMPOSED OF INDEPENDENT OUTSIDE DIRECTORS, WHICH IS RESPONSIBLE FOR APPLYING THE TERMS AND PROCESS OF THE EXECUTIVE COMPENSATION AND INTERMEDIATE SANCTIONS POLICY AS OUTLINED ABOVE, AND B) THE NETWORK CHIEF HUMAN RESOURCES OFFICER WHO IS RESPONSIBLE FOR OBTAINING COMPARATIVE SALARY MARKET DATA FOR THE CHIEF EXECUTIVE OFFICER, OFFICERS, AND KEY EMPLOYEES, ENGAGING AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE REASONABLE COMPENSATION ANALYSIS AND/OR CONFIRM THE REASONABLENESS OF COMPENSATION, AND PROVIDING STAFF SUPPORT TO THE NETWORK EXECUTIVE COMPENSATION COMMITTEE. DURING 2023, THE NETWORK EXECUTIVE COMPENSATION COMMITTEE FOLLOWED THIS PROCESS FOR ALL SENIOR EXECUTIVE LEADERS. FORM 990, PART VI, SECTION B, LINE 15B - COMPENSATION PROCESS FOR OFFICERS SEE LINE 15A ABOVE FORM 990, PART VI, LINE 16B - JOINT VENTURE PROCEDURE JOINT VENTURE OPERATING AGREEMENTS INVOLVING CHRH INCLUDE PROVISIONS TO PROTECT CHRH'S TAX-EXEMPT STATUS AND ENSURE THE JOINT VENTURE IS STRUCTURED TO FURTHER THE ORGANIZATION'S TAX-EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC REQUIREMENTS RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. CHRH CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL JOINT VENTURES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS DISCLOSURE EXPLANATION A) THE ARTICLES OF INCORPORATION AND BUSINESS ENTITY REPORT ARE ON FILE WITH THE INDIANA SECRETARY OF STATE AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST TO THE INDIANA SECRETARY OF STATE OR FREE OF CHARGE ON THE SECRETARY OF STATE'S WEBSITE. B) AS A MEMBER OF THE NETWORK, CHRH HAS ADOPTED THE NETWORK CONFLICT OF INTEREST POLICY. WHILE THIS POLICY IS NOT AVAILABLE TO THE PUBLIC, THE NETWORK'S DEFINITION OF A CONFLICT OF INTEREST AND HOW TO REPORT SUCH AN INCIDENT IS DESCRIBED IN THE NETWORK RESPONSIBILITY AND COMPLIANCE PROGRAM ("NRCP") MANUAL WHICH IS POSTED ON THE NETWORK'S WEBSITE, ECOMMUNITY.COM. THIS MANUAL IS AVAILABLE FOR THE PUBLIC TO REVIEW. C) CHRH DOES NOT HAVE INDIVIDUALLY AUDITED FINANCIAL STATEMENTS. ITS FINANCIAL RESULTS ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF CHNW AND AFFILIATES. AS SUCH, THERE ARE NO INDIVIDUAL FINANCIAL STATEMENTS TO POST. CHRH DOES FILE THE 990 TAX RETURN ON AN ANNUAL BASIS WHICH IS AVAILABLE UPON REQUEST AND/OR AVAILABLE ON A DELAYED BASIS ON GUIDESTAR.ORG. D) COMMUNITY HEALTH NETWORK, INC. AND AFFILIATES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VII - ADDITIONAL INFORMATION PART VII, SECTION B - INDEPENDENT CONTRACTOR DISCLOSURE COMPENSATION TO HAYES BROTHERS, INC. INCLUDES MATERIAL COSTS. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,639,353. MANAGEMENT AND GENERAL EXPENSES 8,558,660. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,198,013. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 201,944. MANAGEMENT AND GENERAL EXPENSES 2,625,933. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,827,877. NETWORK ALLOCATIONS: PROGRAM SERVICE EXPENSES 8,694,848. MANAGEMENT AND GENERAL EXPENSES 20,305,260. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,000,108. LAB SERVICES: PROGRAM SERVICE EXPENSES 1,761,699. MANAGEMENT AND GENERAL EXPENSES 4,142,984. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,904,683. FORM 990, PART XI, LINE 9: CHANGE IN EQUITY INVESTMENT -197,845. RECLASSIFICATION OF INTERCOMPANY BALANCES 4,551,678. CHANGE IN ELIMINATIONS 4,990,456. HOWARD SURGERY CENTER DISTRIBUTIONS -4,916,727. FORM 990, PART XII, LINE 3A - REQUIRED AUDIT CHRH IS INCLUDED IN THE COMMUNITY HEALTH NETWORK, INC. 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