2024-05-10T17:27:30-05:00 2023-06-30 366055558 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2022-07-01 851620990 PENN STATE HEALTH LANCASTER MEDICAL CENTER PENN 7175318477 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 TRACY L MOYER VP FINANCIAL SERVICES 7175318477 2024-05-10 1 TRACY MOYER 999009999 0 RUSSLEE ARMSTRONG P00288383 2155614200 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STEPHEN MASSINI 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 69315129 0 X WWW.PENNSTATEHEALTH.ORG/LOCATIONS X 2020 PA TO CONTINUALLY IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE OF PENNSYLVANIA, AND BEYOND. 5 0 624 0 0 0 447 254186 0 68946034 0 1042 89734 113867 90181 69315129 0 6252723 0 0 1695427 55614807 0 0 0 7317406 79798258 9012833 141665788 -8922652 -72350659 308739987 383709757 315141112 455349574 -6401125 -71639817 X PENN STATE HEALTH LANCASTER MEDICAL CENTER'S MISSION IS TO CONTINUALLY IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN PENNSYLVANIA; PROVIDE EXCELLENT, COMPASSIONATE, CULTURALLY RESPONSIVE AND EQUITABLE CARE; (CONTINUED SCHEDULE O)EDUCATE AND TRAIN HEALTH CARE PROFESSIONALS; ADVANCE EVIDENCE-BASED MEDICAL INNOVATION THROUGH RESEARCH AND DISCOVERY. 0 0 80874689 6252723 68949236 PENN STATE HEALTH LANCASTER MEDICAL CENTER OPENED ON OCTOBER 3, 2022. PENN STATE HEALTH LANCASTER MEDICAL CENTER PROVIDES COMPLETE MEDICAL AND SURGICAL SERVICES, A STATE-OF-THE-ART EMERGENCY DEPARTMENT, SPECIALTY INPATIENT SERVICES AND ADVANCED IMAGING FOR PEOPLE IN LANCASTER AND YORK COUNTIES. THE 142-BED ACUTE CARE MEDICAL CENTER IS FUNDAMENTALLY COMMITTED TO PROVIDING COMPASSIONATE, INCLUSIVE AND EQUITABLE CARE AND THROUGH ITS DIVERSE WORKFORCE.PATIENTS AND THEIR FAMILIES CAN RECEIVE THE MOST ADVANCED CARE IN MODERN, PATIENT-CENTERED AREAS OF INPATIENT SERVICES, INLCUDING: CARDIAC CATHETERIZATION, CRITICAL CARE, EMERGENCY MEDICINE, LABOR AND DELIVERY, AND SURGERY. (CONTINUED IN SCHEDULE O)OUTPATIENT SERVICES INLCUDE: ENDOSCOPY, IMAGING SERVICES, LAB SERVICES, NONINVASIVE DIAGNOSTIC CARDIOLOGY AND WOMEN'S SERVICES. 80874689 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 0 0 0 1 X 0 0 624 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 PA X TRACY L MOYER VICE PRESIDENT FINA 7177632100 100 CRYSTAL A DR MC CA210 HERSHEY PA 17033 X STEPHEN MASSINI DIR & CHAIR / PSH CEO 1.00 49.00 X X 0 1599857 61645 DEBORAH ADDO DIRECTOR / PSH COO 1.00 49.00 X 0 920763 48852 PAULA TINCH DIRECTOR / PSH CFO & EVP 1.00 49.00 X 0 808482 119863 JUDITH HLAFCSAK DIRECTOR / PSH CHIEF OF STAFF 1.00 39.00 X 0 570939 70889 JOSEPH FRANK DIRECTOR / PRESIDENT 24.50 25.50 X X 526256 0 78321 CLAIRE MOONEY SVP AND CHIEF OPERATING OFFICER 50.00 0.00 X 342310 0 60984 NICOLE LEHMAN INTERIM SEC. (PSU EMP) 1.00 49.00 X 0 276742 97256 EDWARD CHABALOWSKI TREASURER / VP & CFO 1.00 49.00 X 0 313487 51208 ROSS DARROW VICE PRESIDENT, TREASURER 1.00 49.00 X 0 301878 61619 KATHLEEN MILLER ASSOC. SECRETARY 1.00 39.00 X 0 99552 10921 BARBARA ZUPPA VP, CHIEF NURSING OFFICER 40.00 0.00 X 214301 0 31307 MARK JAROWENKO VP OF MEDICAL AFFAIRS 40.00 0.00 X 182699 0 14958 CHANHAK BINSANN STAFF PHARMACIST 40.00 0.00 X 144659 0 41926 KIMBERLEE YOUNG PHARMACIST 40.00 0.00 X 156696 0 17907 BISRAT MULUGETA ACUTE CARE CLINICAL PHARMACIST 40.00 0.00 X 144088 0 24272 LISA HOWELL DIRECTOR OF SURGICAL SERVICES 40.00 0.00 X 149265 0 18422 ANNEMARIE BOYAN FMR SEC/PSH GC (PSU EMP) (THRU 2/22) 0.00 0.00 X 0 142089 12694 1860274 5033789 823044 21 1 1 0 SODEXO INC 111 SOUTH FRONT STREET HARRISBURG PA 17101 PURCHASED SERVICES 1977276 M3T CORPORATION 2250 BUMBLE BEE HOLLOW ROAD MECHANICSBURG PA 17055 IT SERVICES 324270 JOHNSON CONTROLS INC 5757 N GREEN BAY AVENUE MILWAUKEE WI 53209 CONSTRUCTION SERVICES 217710 BERKSHIRE SYSTEMS GROUP INC 50 S MUSEUM ROAD READING PA 196072425 CONSTRUCTION SERVICES 215939 STANTEC CONSULTING SERVICES 139580 COLLECTIONS CNTR DR CHICAGO IL 60693 PURCHASED SERVICES 147637 5 254186 254186 NET PATIENT SERVICES 622110 68441433 68441433 OTHER HEALTHCARE RELATED REV. 622110 504601 504601 68946034 1042 1042 110665 0 110665 110665 110665 OTHER REVENUE 900099 3202 3202 3202 69315129 68949236 0 111707 X 6252723 6252723 1253478 964175 289303 44286682 39411155 4875527 858951 858951 5714843 63367 5651476 3500853 3500853 15797366 8248716 7548650 3754 3754 6153508 4350016 1803492 1666903 38233 1628670 55970 49145 6825 12221 1200 11021 9281796 9281796 20831875 4380801 16451074 585645 295695 289950 MEDICAL SUPPLIES 16270655 16270655 ALLOCATED CORPORATE SVC 8390579 8390579 LICENSES FEES 354906 273273 81633 EDUCATION 65892 19653 46239 327188 252128 75060 141665788 80874689 60791099 0 1800 8085 18497202 14198 2695217 1087744 1373319 377644992 18910911 307629960 358734081 0 2408138 308739987 383709757 11790870 11765667 303350242 443583907 315141112 455349574 X -6401125 -71639817 -6401125 -71639817 308739987 383709757 -72350659 7111967 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 16144872 16144872 317592203 14033526 303558677 43907917 4877385 39030532 358734081 DUE TO AFFILIATES 440632263 LEASE LIABILITY 2540265 MEDICAL MALPRACTICE 226369 WORKERS COMP ACCRUED PAYABLE 158253 SELF INSURANCE LIABILITIES 26757 443583907 1 1 1 X 300.000000000000 1 X 1 1 0 1 1 43568 43568 0.00030 5566687 167445 5399242 0.03810 5610255 167445 5442810 0.03840 36361 74836 74836 0.00050 50 22130 22130 0.00020 4248 90333 90333 0.00060 40659 187299 187299 0.00130 40659 5797554 167445 5630109 0.03970 1 6536657 9174052 28428542 -19254490 X 1 1 1 1 PENN STATE HEALTH LANCASTER MED CENTER 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 WWW.PENNSTATEHEALTH.ORG/LOCATIONS 50720101 X X X X PENN STATE HEALTH LANCASTER MED CENTER 1 1 1 X X X X X X X X X 21 1 1 1 1 X WWW.PENNSTATEHEALTH.ORG/COMMUNITY X 1 22 1 WWW.PENNSTATEHEALTH.ORG/COMMUNITY 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE PART V NARRATIVE X SEE PART V NARRATIVE X SEE PART V NARRATIVE X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 5 INPUT FOR COMMUNITY HEALTH NEEDS ASSESSMENT:PENN STATE HEALTH, THE OVERALL PARENT OF THE HEALTH SYSTEM IN WHICH PSHLMC IS AFFILIATED, IS COMMITTED TO UNDERSTANDING AND ADDRESSING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. IN ORDER TO BEST DO THAT, THE HEALTH SYSTEM COMPLETED ITS 2021 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CHNA PROCESS THE 2021 CHNA USED BOTH PRIMARY AND SECONDARY METHODS TO SOLICIT COMMUNITY INPUT AND COMPARE HEALTH TRENDS AND DISPARITIES ACROSS THE SIX-COUNTY SERVICE AREA. THE CHNA TIMELINE COMPLIED WITH IRS TAX CODE 501(R) REQUIREMENTS TO CONDUCT A CHNA EVERY THREE YEARS, AS SET FORTH BY THE AFFORDABLE CARE ACT. SPECIFIC CHNA STEPS INCLUDED:-KICKOFF MEETING TO ANNOUNCE THE START OF THE CHNA PROCESS AND HOST ALL INTERNAL COMMUNITY-MINDED STAFF MEMBERS. THEY PROVIDED INPUT ON COMMUNITY PARTNERS TO ENGAGE BASED ON HIGH-NEED AREAS, AS DEFINED BY COMMUNITY NEED INDEX (CNI) SCORES-MONTHLY LEADERSHIP MEETINGS, INCLUDING ALL HOSPITALS, TO REVIEW PROGRESS AND PROVIDE FEEDBACK-A KEY INFORMANT SURVEY WITH 317 COMMUNITY LEADERS AND STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS-A COMMUNITY MEMBER SURVEY (CMS) COMPLETED BY 2,778 INDIVIDUALS, WITH 2,532 RESPONSES ABLE TO BE USED BASED UPON COUNTY OF RESIDENCE AND AGE-AN ANALYSIS OF EXISTING SECONDARY DATA SOURCES, INCLUDING PUBLIC HEALTH STATISTICS, DEMOGRAPHIC AND SOCIAL MEASURES AND HEALTH CARE UTILIZATION-TWO PARTNER FORUMS, WITH REPRESENTATIVES FROM DIVERSE COMMUNITY-BASED AND PUBLIC HEALTH ORGANIZATIONS, TO GATHER INSIGHT ON COMMUNITY HEALTH NEEDS AND FOSTER COLLABORATION TOWARD COMMUNITY HEALTH IMPROVEMENT - THE FIRST FORUM HOSTED 112 PARTICIPANTS AND THE SECOND 103 PARTICIPANTS-REVIEW OF THE CURRENT CHNA IMPLEMENTATION PLAN AND AVAILABLE RESOURCES-PRIORITIZATION OF IDENTIFIED COMMUNITY HEALTH NEEDS TO DETERMINE THE MOST PRESSING ISSUES ON WHICH TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS KEY INFORMANT SURVEY A KEY INFORMANT SURVEY WAS CONDUCTED ELECTRONICALLY TO SOLICIT INFORMATION ABOUT COMMUNITY HEALTH NEEDS. A TOTAL OF 317 INDIVIDUALS RESPONDED TO THE SURVEY, INCLUDING HEALTH AND SOCIAL SERVICE PROVIDERS; COMMUNITY AND STATEWIDE PUBLIC HEALTH EXPERTS; CIVIC, RELIGIOUS AND SOCIAL LEADERS; COMMUNITY PLANNERS, POLICYMAKERS AND ELECTED OFFICIALS; AND OTHERS REPRESENTING DIVERSE POPULATIONS, INCLUDING MINORITY, LOW-INCOME, LGBTQ+ AND OTHER UNDERSERVED OR VULNERABLE POPULATIONS. THE SURVEY WAS AVAILABLE IN ENGLISH AND SPANISH AND INCLUDED A DISABILITY AND LANGUAGE ACCOMMODATION STATEMENT. IT WAS OPEN FOR A LONGER PERIOD OF TIME COMPARED TO PAST CHNA CYCLES, FROM NOVEMBER 2020 TO MARCH 2021, DUE TO THE COVID-19 PANDEMIC. QR CODES AND LINKS TO THE SURVEY WERE SHARED MULTIPLE TIMES VIA EMAIL, AS WELL AS AT VIRTUAL MEETINGS AND PROFESSIONAL EDUCATION SESSIONS. KEY INFORMANTS WERE ASKED A SERIES OF QUESTIONS ABOUT THEIR PERCEPTIONS OF COMMUNITY HEALTH, INCLUDING HEALTH DRIVERS, BARRIERS TO CARE, COMMUNITY INFRASTRUCTURE AND RECOMMENDATIONS FOR COMMUNITY HEALTH IMPROVEMENT. RESPONDENTS REPRESENTED EXCELLENT GEOGRAPHIC BALANCE ACROSS THE SIX COUNTY AREA, AS FOLLOWS: BERKS COUNTY (124, 39.1%), CUMBERLAND COUNTY (123, 38.8%), DAUPHIN COUNTY (167, 52.7%), LANCASTER COUNTY (97, 30.6%), LEBANON COUNTY (97, 30.6%), PERRY COUNTY (100, 31.6%) AND OTHER (67, 21.1%). RESPONDENTS WERE ABLE TO SELECT MULTIPLE COUNTIES, SO THE NUMBER OF INDIVIDUAL RESPONDENTS AND PERCENTAGES DO NOT ADD UP TO 317 AND 100%, RESPECTIVELY. ABOUT 40% OF RESPONDENTS PROVIDED SERVICES TO ALL RESIDENTS. OF THOSE ORGANIZATIONS THAT FOCUSED PRIMARILY ON A SPECIAL POPULATION, MOST SERVED LOW-INCOME/POOR (35%), FAMILIES (27%) OR CHILDREN/YOUTH (27%). "OTHER" POPULATIONS SERVED, AS INDICATED BY 5% OF RESPONDENTS, INCLUDED ARABIC, NEPALESE, VETERANS, PREGNANT WOMEN, SINGLE PARENTS, COLLEGE STUDENTS AND INDIVIDUALS AFFECTED BY SPECIFIC ISSUES, INCLUDING HIV/AIDS, MENTAL HEALTH, INTELLECTUAL DISABILITIES, EPILEPSY OR SUBSTANCE USE. COMMUNITY MEMBER SURVEYA COMMUNITY MEMBER SURVEY WAS CONDUCTED WITH RESIDENTS ACROSS THE SIX-COUNTY COMMUNITY TO GATHER INSIGHTS INTO HEALTH STATUS, RISK BEHAVIORS, BARRIERS TO ACCESSING HEALTH SERVICES AND THE HEALTH AND SOCIAL NEEDS OF VULNERABLE COMMUNITY MEMBERS. THE SURVEY WAS CONDUCTED WITH ADULTS AGE 18 OR OVER AND INCLUDED LOW-INCOME, UNDERSERVED OR MINORITY POPULATIONS. DUE TO THE COVID-19 PANDEMIC LIMITING IN-PERSON OPPORTUNITIES, THE SURVEY WAS CONDUCTED OVER A LONGER PERIOD, FROM SEPTEMBER 2020 TO APRIL 2021, THAN PAST CHNA CYCLES. ELECTRONIC AND PAPER VERSIONS OF THE SURVEY WERE AVAILABLE IN ENGLISH AND SPANISH, AND THEY INCLUDED A DISABILITY AND LANGUAGE ACCOMMODATION STATEMENT. PAPER SURVEYS WERE COLLECTED AT 29 COMMUNITY PARTNER PHYSICAL LOCATIONS, PRIMARILY FOCUSED ON UNDERSERVED COMMUNITIES. ADVERTISING CARDS, INCLUDING QR CODES AND LINKS, WERE SHARED AT COMMUNITY EVENTS WHERE IN-PERSON SURVEYING COULD NOT BE ACCOMMODATED DUE TO COVID-19. PAPER AND VIRTUAL ADVERTISING MATERIALS WERE SHARED EXTENSIVELY BY OUR COMMUNITY PARTNERS VIA THEIR VIRTUAL EVENTS AND EDUCATIONAL SESSIONS, WITH SUPPORT GROUPS, IN COMMUNITY AND PROFESSIONAL NEWSLETTERS, WITH FORMER PATIENT/CLIENT EMAIL LISTS, VIA PRESS RELEASE CYCLES, FROM SEPTEMBER 2020 TO APRIL 2021, AND THROUGH SOCIAL MEDIA ARTICLES. THE SURVEY WAS NOT INTENDED TO BE A REPRESENTATIVE SAMPLE OF THE GREATER COMMUNITY, BUT RATHER PROVIDE GENERAL INSIGHTS INTO RESPONDENTS' PERCEPTIONS AND HEALTH STATUS. THE SURVEY DATA WERE ANALYZED BY COUNTY AND RACE/ETHNICITY. (NOTE: RACIAL/ETHNIC DATA WAS NOT ANALYZED FOR GROUPS WITH FEWER THAN 10 RESPONDENTS.) A TOTAL OF 2,778 INDIVIDUALS COMPLETED THE SURVEY ACROSS THE SIX-COUNTY SERVICE AREA, AND 2,532 RESPONSES WERE ABLE TO BE USED BASED UPON COUNTY OF RESIDENCE AND AGE. THE LARGEST PERCENTAGES OF RESPONDENTS RESIDED IN DAUPHIN COUNTY (43%) AND BERKS COUNTY (19%), WHICH ARE THE HOME COUNTIES OF THE MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENNSYLVANIA PSYCHIATRIC INSTITUTE AND PENN STATE HEALTH REHABILITATION HOSPITAL. THE LARGEST PERCENTAGES OF RESPONDENTS WERE FEMALE (67.5%) AND WHITE (87.4%). NINE PERCENT OF RESPONDENTS IDENTIFIED AS HISPANIC OR LATINO AND 5% OF RESPONDENTS IDENTIFIED AS BLACK OR AFRICAN AMERICAN. THE MOST REPRESENTED AGE GROUPS WERE 65 TO 74 (23.4%) AND 55 TO 64 (22.6%). APPROXIMATELY 19% OF RESPONDENTS REPORTED A HOUSEHOLD INCOME OF $34,999 OR LESS. ABOUT 2.8% DID NOT COMPLETE HIGH SCHOOL, WHILE 15.6% GRADUATED HIGH SCHOOL OR EARNED A GED. SEVENTY-SEVEN PERCENT OF RESPONDENTS HAVE SOME COLLEGE EXPERIENCE, INCLUDING EARNING AN ASSOCIATE, BACHELOR'S OR MASTER'S DEGREE. ABOUT HALF OF THE RESPONDENTS WERE EMPLOYED, WHILE THE OTHER HALF WAS NOT WORKING DUE TO BEING RETIRED (32.7%), UNEMPLOYED (4.4%), UNABLE TO WORK (4.1%) OR FOR OTHER REASONS. DEMOGRAPHIC DATA FOR ALL SURVEY RESPONDENTS CAN BE FOUND IN THE FULL REPORT AT HTTPS://WWW.PENNSTATEHEALTH.ORG/COMMUNITY. COMMUNITY MEMBERS WERE ASKED TO PROVIDE THEIR FEEDBACK ON PREVIOUS CHNAS CONDUCTED BY PENN STATE HEALTH AS PART OF THE KEY INFORMANT SURVEY, AS WELL AS DURING THE COMMUNITY PARTNER FORUMS. THE OPPORTUNITY TO PROVIDE FEEDBACK IS ALSO AVAILABLE TO THE GENERAL PUBLIC ON AN ONGOING BASIS VIA A LINK POSTED ON PENNSTATEHEALTH.ORG/COMMUNITY. OVERALL, THE FEEDBACK WAS POSITIVE, WITH MANY COMMENTS INDICATING THAT RESPONDENTS FELT PENN STATE HEALTH HAS BEEN DOING AN EXCELLENT JOB WITH FACILITATING COLLABORATION, FOSTERING PARTNERSHIPS AND DOCUMENTING AND SHARING FINDINGS. SOME RESPONDENTS EXPRESSED A DESIRE FOR PENN STATE HEALTH TO HAVE A STRONGER PRESENCE IN VARIOUS GEOGRAPHICAL LOCATIONS AND TO UTILIZE ITS INFLUENCE TO HAVE AN IMPACT ON SYSTEMIC FACTORS THAT INFLUENCE HEALTH. A FULL LIST OF COMMENTS RECEIVED IS INCLUDED IN APPENDIX C OF THE FULL REPORT. PART V, SECTION B, LINE 6A / 6B OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSESSMENT: FOR THIS 2021, FOURTH ASSESSMENT CYCLE, PENN STATE HEALTH FORMED A COLLECTIVE WORKGROUP THAT INCLUDED THE FOLLOWING HOSPITALS:-PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER-PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER-PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER-PENN STATE HEALTH HAMPDEN MEDICAL CENTER-PENNSYLVANIA PSYCHIATRIC INSTITUTE-PENN STATE HEALTH REHABILITATION HOSPITAL-PENN STATE HEALTH LANCASTER MEDICAL CENTER**** SINCE PENN STATE HEALTH LANCASTER MEDICAL CENTER WAS UNDER CONSTRUCTION DURING THIS ASSESSMENT, THIS COMMUNITY WAS ALSO INCLUDED. THE DEPARTMENT OF PUBLIC HEALTH SCIENCES AT PENN STATE COLLEGE OF MEDICINE COORDINATED THE CHNA EFFORTS. IT ALSO INCLUDED KEY COMMUNITY STAKEHOLDERS TO IDENTIFY AND ADDRESS THE NEEDS OF RESIDENTS LIVING IN THE SIX-COUNTY COMMUNITY. APPENDIX B OF THE FULL REPORT AVAILABLE AT HTTPS://WWW.PENNSTATEHEALTH.ORG/COMMUNITY CONTAINS A LIST OF COMMUNITY PARTNER ORGANIZATIONS THAT PARTICIPATED IN ANY ASPECT OF THE ASSESSMENT PROCESS. PLEASE NOTE THIS LIST MAY NOT BE ALL-INCLUSIVE SINCE PARTICIPANTS COULD REMAIN ANONYMOUS. PART V, SECTION B, LINE 11 THREE PRIORITIZED COMMUNITY HEALTH NEEDSTHE 2021 CHNA GATHERED COMMUNITY INPUT AND COMPARED HEALTH TRENDS AND DISPARITIES ACROSS THE SIX-COUNTY SERVICE AREA. BASED ON THIS WORK, OUR HOSPITALS, IN COLLABORATION WITH OUR COMMUNITY PARTNERS, WILL FOCUS SYSTEM-WIDE HEALTH IMPROVEMENT EFFORTS OVER THE THREE-YEAR CYCLE FROM JULY 1, 2022, TO JUNE 30, 2025 ON THE IDENTIFIED PRIORITY AREAS OF 1) MENTAL HEALTH 2) HEALTH EQUITY AND 3) WELLNESS AND DISEASE PREVENTION. ALL PRIORITIES IDENTIFIED THROUGH THE CHNA WILL BE ADDRESSED. MENTAL HEALTH INCLUDES A FOCUS ON COMMUNITY GROUPS, SUCH AS THE LGBTQ+ COMMUNITY, PEOPLE OF COLOR AND YOUTH. SUBSTANCE USE DISORDER WILL ALSO BE ADDRESSED UNDER THIS PRIORITY. HEALTH EQUITY COVERS CONCERNS THAT INCLUDE ACCESS TO CARE, ELDER ISSUES WITH ACCESS, SOCIAL DETERMINANTS OF HEALTH, RACISM, DIVERSITY, TRANSPORTATION AND HOUSING. WELLNESS AND DISEASE PREVENTION ENCOMPASSES FOOD ACCESS AND NUTRITION, SUBSTANCE USE PREVENTION, CHRONIC DISEASE PREVENTION, HEALTH EDUCATION AND PHYSICAL ACTIVITY. THESE PRIORITIES ARE INTERRELATED, AND ONE CANNOT BE ADDRESSED WITHOUT THE OTHER. IMPLEMENTATION PLAN TO DEVELOP OUR IMPLEMENTATION PLAN, INTERNAL EMPLOYEES AND COMMUNITY PARTNERS ATTENDED A KICKOFF MEETING, WHERE CHNA FINDINGS AND PARTNER FORUM RECOMMENDATIONS WERE SHARED. PARTICIPANTS ORGANIZED INTO THE FOLLOWING TASK FORCES TO BEST DEVELOP OUR PLAN: 1) MENTAL HEALTH; 2) HEALTH EQUITY; 3) CHRONIC DISEASE AND RISK FACTOR PREVENTION; 4) NUTRITION AND FOOD ACCESS; AND 5) PHYSICAL ACTIVITY. THESE TASK FORCES MET FROM NOVEMBER 2021 TO FEBRUARY 2022 TO DISCUSS KEY FINDINGS FROM THE CHNA; EXPLORE UNDERSERVED COMMUNITIES THROUGH REVIEW OF COMMUNITY NEED INDEX (CNI) SCORES, LIFE EXPECTANCY MEASURES AND OTHER KEY SOCIAL DETERMINANTS OF HEALTH; FIND ADDITIONAL COMMUNITY PARTNER RESOURCES; AND DEVELOP A PLAN. THE PLAN INCLUDES KEY PROGRAM DESCRIPTIONS, GOALS AND OBJECTIVES TO BE MET OVER THE NEXT THREE YEARS. DUE TO THE OVERLAPPING NATURE OF OUR PRIORITIES, ALL FIVE TASK FORCES PROPOSED SIMILAR PROGRAMS TO EXPAND COMMUNICATION AND PROMOTE EXISTING RESOURCES. ALL HAVE AGREED TO CONTINUE TO MEET AND ENGAGE NEW PARTNERS OVER THE THREE YEARS OF THIS PLAN TO ENCOURAGE DIALOGUE AMONG THEMSELVES AND CONTINUE TO STREAMLINE AND STRENGTHEN EACH OTHER'S COMMUNITY EFFORTS. ADDITIONALLY, EACH TASK FORCE PLANS TO COMPILE AN INVENTORY OF COMMUNITY RESOURCES THAT ARE CURRENTLY AVAILABLE TO NOT ONLY INCREASE AWARENESS AMONG THE GROUP BUT ALSO TO ADVERTISE TO COMMUNITY MEMBERS. NOT KNOWING WHAT RESOURCES ARE AVAILABLE AND HOW TO ACCESS THEM WAS A CLEAR MESSAGE HEARD DURING OUR CHNA PROCESS. THROUGH KEY PARTNERSHIPS WITH ORGANIZATIONS LISTED AT THE END OF THIS IMPLEMENTATION PLAN DOCUMENT, THE PLAN IS TO MAKE THESE RESOURCES MORE WELL-KNOWN - THROUGH THE PROGRAM PA 211: GET CONNECTED (PA 211), FOR EXAMPLE, A FREE AND CONFIDENTIAL SERVICE THAT HELPS PEOPLE FIND THE LOCAL RESOURCES THEY NEED 24/7. OUR PROJECTS FOCUS HEAVILY ON COMMUNITY EDUCATION, ANOTHER MESSAGE WE HEARD THROUGH OUR CHNA PROCESS. IN ADDITION, MANY OF OUR PROJECTS WILL SERVE MORE THAN ONE OF OUR IDENTIFIED COMMUNITY NEEDS. FOR EXAMPLE, INCREASING OUR OUTREACH AND PROGRAMMING TO MORE FOOD PANTRIES ACROSS OUR SERVICE AREA FURTHERS OUR WORK IN THE AREAS OF HEALTH EQUITY, WELLNESS AND DISEASE PREVENTION AND NUTRITION AND FOOD ACCESS. WITHIN EACH PRIORITY AREA, WE WILL BE FOCUSING OUR EFFORTS ON COMMUNITIES IDENTIFIED WITH THE HIGHEST NEED. THESE MIGHT BE AREAS WITH LARGER MINORITY POPULATIONS, LOWER LIFE EXPECTANCY AND OTHER HIGH-RISK GROUPS. THE FOLLOWING ACTIONS WILL ADDRESS OUR PRIORITIZED HEALTH NEEDS OVER THE NEXT THREE YEARS, AS WELL AS THE SPECIFIC HOSPITAL ADDRESSING EACH NEED. ALL NEEDS WILL BE ADDRESSED IN THIS PLAN. STRATEGIES INCLUDED ARE EVIDENCE-BASED, OR STRATEGIES THAT WILL BE EVALUATED, TO ENSURE THE MOST EFFECTIVE USE OF COMMUNITY AND HOSPITAL RESOURCES. ALL OUTCOMES WILL BE TRACKED AND ANY NECESSARY ADJUSTMENTS TO THIS PLAN WILL BE SHARED IN ANNUAL REPORTS THAT WILL BE COMMUNICATED PUBLICLY ON OUR WEBSITES. PRIORITY 1) MENTAL HEALTH RESPONSIBLE PARTY: PENNSYLVANIA PSYCHIATRIC INSTITUTE, PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER AND PENN STATE HEALTH HAMPDEN MEDICAL CENTER GOAL: IMPROVE MENTAL HEALTH THROUGH PREVENTION, INTERVENTION AND SUPPORT. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS:-REDUCE THE NUMBER OF POOR MENTAL HEALTH DAYS REPORTED BY ADULTS IN THE PAST 30 DAYS.-DECREASE THE PERCENTAGE OF CHILDREN REPORTING FEELING SAD OR DEPRESSED MOST DAYS IN THE PAST YEAR. -DECREASE THE NUMBER OF DRUG OVERDOSE DEATHS PER 100,000 POPULATION. PROGRAM 1. BEHAVIORAL HEALTH EDUCATION AND PREVENTION - EXPAND AND INCREASE BEHAVIORAL HEALTH TRAINING AND EDUCATION. SHORT TERM OBJECTIVES (YEAR 1)1. OFFER MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS.-5 TO TEACHERS-3 TO LAW ENFORCEMENT-2 TO COMMUNITY HEALTH WORKERS (CHWS)-COLLABORATE WITH THE DAUPHIN COUNTY DISTRICT ATTORNEY'S OFFICE TO OFFER 3 CIT TRAININGS.2. PROVIDE SUBSTANCE USE EDUCATION VIA 15 LECTURES, TRAININGS, WEBINARS OR HEALTH FAIRS.3. DISTRIBUTE NALOXONE, LOCK BOXES AND SAFE DISPOSAL POUCHES AT 2 HEALTH FAIRS IN OUR SERVICE AREA. MEDIUM-TERM OBJECTIVES (YEAR 2)1. OFFER MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS.-USE TRAIN-THE-TRAINER TO EDUCATE 3 CHWS ON OFFERING MENTAL HEALTH SIGNS/SYMPTOMS TRAINING.-OFFER 3 MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS TO STUDENTS IN GRADES 7 AND HIGHER.2. EXPAND SUBSTANCE USE EDUCATION VIA LECTURES, TRAININGS, WEBINARS OR HEALTH FAIRS IN 2 ADDITIONAL COUNTIES AND WITHIN THE BUREAU OF PRISONS.3. DISTRIBUTE NALOXONE, LOCK BOXES AND SAFE DISPOSAL POUCHES AT 2 ADDITIONAL HEALTH FAIRS IN OUR SERVICE AREA. LONG-TERM OBJECTIVES (YEAR 3) 1. OFFER MENTAL HEALTH SIGNS/SYMPTOMS TRAININGS.-BY THE END OF THE 3RD YEAR, OVER 800 INDIVIDUALS WILL HAVE RECEIVED MENTAL HEALTH SIGNS/SYMPTOMS TRAINING.2. PROVIDE SUBSTANCE USE EDUCATION VIA 15 LECTURES, TRAININGS, WEBINARS OR HEALTH FAIRS AMONG 2 ADDITIONAL POPULATIONS (LGBTQ+, RELIGIOUS, PEOPLE OF COLOR, ETC.).3. DISTRIBUTE NALOXONE, LOCK BOXES AND SAFE DISPOSAL POUCHES AT 2 ADDITIONAL HEALTH FAIRS IN OUR SERVICE AREA. PROGRAM 2. BEHAVIORAL HEALTH RESOURCES, SUPPORT AND COLLABORATION - COLLABORATE WITH OTHER ORGANIZATIONS TO DEVELOP AN INVENTORY OF BEHAVIORAL HEALTH RESOURCES AND SUPPORT SYSTEMS. SHORT TERM OBJECTIVES (YEAR 1)1. DEVELOP OPPORTUNITIES TO COLLABORATE-JOIN A COLLABORATIVE ALREADY IN PLACE, SUCH AS THE HEAL PA INITIATIVE.-APPLY FOR PSH COMMUNITY RELATIONS AND ASSOCIATION FOR FACULTY AND FRIENDS GRANTS.-GATHER AND CREATE AN INVENTORY OF MENTAL HEALTH AND SUBSTANCE USE RESOURCES.2. BUILD RELATIONSHIPS WITH 3 SUPERINTENDENTS TO DISCUSS MENTAL HEALTH RESOURCE PROMOTION.3. COLLABORATE WITH PA 211 TO INCREASE AWARENESS OF MENTAL HEALTH RESOURCES.-OBTAIN BASELINE STATISTICS ON PA 211 MENTAL HEALTH RESOURCE USAGE.4. PSH GOVERNMENT RELATIONS WILL MEET WITH PSH LEADERSHIP TO REVIEW AND ASSESS MENTAL HEALTH PRIORITIES AND NEEDS FOR THE NEXT 2 YEARS.5. RECRUIT ADDITIONAL PROVIDERS.-RECRUIT 5 PHYSICIANS FOCUSED ON ADDICTION TO THE AIR PROGRAM.-RECRUIT 2 FELLOWS TO THE ADDICTION MEDICINE FELLOWSHIP AND OBTAIN A BASELINE NUMBER OF PATIENTS SEEN IN CLINICS AT PPI.6. INITIATE 1 SMART RECOVERY SUPPORT GROUP. MEDIUM-TERM OBJECTIVES (YEAR 2)1. MAINTAIN AND EXPAND THE INVENTORY OF MENTAL HEALTH AND SUBSTANCE USE RESOURCES.2. COLLABORATE WITH 3 SCHOOL DISTRICTS TO ADD PA 211 AND 741741 AS RESOURCES IN STUDENTS' AGENDA BOOKS.3. DETERMINE INCREASE IN PA 211 MENTAL HEALTH RESOURCE USE DURING YEAR 1 AND INCREASE BY 10%.4. PSH GOVERNMENT RELATIONS WILL WORK ON ADDRESSING THE MENTAL HEALTH PRIORITY AREAS IDENTIFIED IN YEAR 1.5. INCREASE THE NUMBER OF PATIENTS RECEIVING METHADONE OR BUPRENORPHINE TREATMENT AT PPI CLINICS BY 45%.6. INITIATE 1 SMART RECOVERY FRIENDS AND FAMILY SUPPORT GROUP. LONG-TERM OBJECTIVES (YEAR 3) 1. MAINTAIN AND EXPAND THE INVENTORY OF MENTAL HEALTH AND SUBSTANCE USE RESOURCES.2. CONTINUE COLLABORATING WITH SCHOOL DISTRICTS TO PROMOTE MENTAL HEALTH RESOURCES.3. MEET OR EXCEED TARGET OF 10% INCREASE IN USE OF PA 211 MENTAL HEALTH RESOURCES.4. PSH GOVERNMENT RELATIONS WILL CONTINUE TO WORK ON ADDRESSING THE MENTAL HEALTH PRIORITY AREAS IDENTIFIED IN YEARS 1 AND 2.5. MAINTAIN THE NUMBER OF PATIENTS RECEIVING METHADONE OR BUPRENORPHINE TREATMENT AT PPI CLINICS.6. CONTINUE TO OFFER 2 SMART RECOVERY SUPPORT GROUPS. PRIORITY 2) HEALTH EQUITY RESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENN STATE HEALTH HAMPDEN MEDICAL CENTER, PENNSYLVANIA PSYCHIATRIC INSTITUTE PENN STATE HEALTH REHABILITATION HOSPITAL AND PENN STATE HEALTH LANCASTER MEDICAL CENTER. GOALS: - BRIDGE SYSTEMIC GAPS IN CARE BY EXPANDING COMMUNITY ACCESS AND NAVIGATION POINTS IN COLLABORATION WITH COMMUNITY PARTNERS. - EXPAND LANGUAGE AND PRACTICES THAT ARE SENSITIVE TO ISSUES LIKE SOCIAL DETERMINANTS OF HEALTH, RACISM AND LGBTQ+ DISCRIMINATION BY PROMOTING TRAUMA-INFORMED CARE (TIC). OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS: - REDUCE DISPARITIES IN LIFE EXPECTANCY WITHIN OUR SERVICE AREA. - INCREASE THE PERCENTAGE OF ADULTS WITH A ROUTINE CHECKUP IN THE PAST YEAR. - DECREASE THE AVERAGE SCORES OF THE COMMUNITY NEED INDEX, SOCIAL VULNERABILITY INDEX OR AREA DEPRIVATION INDEX. PROGRAM 1. COMMUNITY ACCESS POINTS - COLLABORATE WITH FORMAL AND INFORMAL COMMUNITY LEADERS TO FIND COMMUNITY ACCESS AND NAVIGATION POINTS TO ENHANCE HEALTH OUTREACH. SHORT TERM OBJECTIVES (YEAR 1)1. COLLABORATE TO CREATE AND MAINTAIN AN INVENTORY OF COMMUNITY HEALTH CARE ACCESS POINTS IN HIGHEST NEED AREAS, FOCUSING ON HEALTH NEEDS SPECIFIC TO COMMUNITY.2. UPLIFT PARTNERSHIP WITH UNITED WAY:- SUPPORT PROMOTION OF PA 211 PROGRAM.- RUN PSH UNITED WAY CAMPAIGN.- HIRE CONTACT TO CARE CHW TO IMPLEMENT CHW PROGRAM FOR PSH IN CUMBERLAND, DAUPHIN AND PERRY COUNTIES. MEDIUM-TERM OBJECTIVES (YEAR 2)1. MAINTAIN AND UPDATE INVENTORY OF COMMUNITY HEALTH CARE ACCESS AND NAVIGATION POINTS, AND INCREASE NUMBER OF COMMUNITY ACCESS POINTS BY 6 LOCATIONS/EVENTS.2. CONTINUE PARTNERSHIP WITH UNITED WAY:- CONTINUE SUPPORTING PROMOTION OF PA 211 PROGRAM.- RUN PSH UNITED WAY CAMPAIGN, INCREASING DONATIONS BY 3%.- DEVELOP PSH CONTACT TO CARE CHW PROGRAM FOR CUMBERLAND, PERRY AND DAUPHIN COUNTIES. LONG-TERM OBJECTIVES (YEAR 3) 1. MAINTAIN AND UPDATE INVENTORY OF COMMUNITY HEALTH CARE ACCESS AND NAVIGATION POINTS, INCREASE NUMBER OF COMMUNITY ACCESS POINTS BY 12 LOCATIONS/EVENTS AND ASSESS THE COMMUNITY IMPACT.2. CONTINUE PARTNERSHIP WITH UNITED WAY:- CONTINUE SUPPORTING PROMOTION OF PA 211.- RUN UNITED WAY CAMPAIGN, INCREASING EMPLOYEE CONTRIBUTIONS BY 3%.- ASSESS UNITED WAY CHW PROGRAM. PROGRAM 2. TRAUMA INFORMED COMMUNITIES - EXPAND TRAUMA-INFORMED AND HEALING-CENTERED PRACTICES ACROSS THE SERVICE AREA. SHORT TERM OBJECTIVES (YEAR 1)1. COLLABORATE TO CREATE AND MAINTAIN AN INVENTORY OF COMMUNITY ORGANIZATIONS ALREADY PROMOTING TRAUMA INFORMED PRACTICES.2. PARTNER WITH COMMUNITY ORGANIZATIONS TO IDENTIFY EXISTING TIC TRAINING OPTIONS FOR PSH STAFF. MEDIUM-TERM OBJECTIVES (YEAR 2)1. INCREASE PSH INVOLVEMENT IN STATEWIDE TRAUMA-INFORMED CARE WORK BY:- SERVING ON THREE TASK FORCES- EXPANDING OCCUPATIONAL THERAPY EDUCATION ON SENSORY NEEDS OF CHILDREN TO 2 COUNTIES2. IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, OFFER 2 TIC TRAININGS TO PSH STAFF THAT ARE ALSO OPEN TO THE COMMUNITY TO PARTICIPATE. LONG-TERM OBJECTIVES (YEAR 3) 1. BEGIN TO EDUCATE AT THE STATE LEVEL ON HOW TO IMPLEMENT TRAUMA-INFORMED PROCESSES. 2. IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, OFFER 2 TIC TRAININGS TO PSH STAFF THAT ARE ALSO OPEN TO THE COMMUNITY TO PARTICIPATE. PRIORITY 3) WELLNESS AND DISEASE PREVENTION ELEMENT 1. CHRONIC DISEASE AND RISK FACTOR PREVENTION RESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENN STATE HEALTH HAMPDEN MEDICAL CENTER AND PENN STATE HEALTH REHABILITATION HOSPITAL GOAL: IMPROVE CHRONIC DISEASE PREVENTION BY PROVIDING SCREENINGS AND EDUCATIONAL SESSIONS IN IDENTIFIED HIGH-NEED COMMUNITIES. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS - INCREASE THE NUMBER OF HEALTH SCREENINGS PROVIDED IN HIGH-NEED COMMUNITY LOCATIONS THAT RESULT IN EDUCATION AND/OR REFERRALS FOR FOLLOW-UP CARE. - PARTICIPANTS SHOW IMPROVED KNOWLEDGE OF CHRONIC DISEASE RISK FACTOR PREVENTION AFTER EDUCATIONAL SESSIONS. - INCREASE THE PERCENTAGE OF FEMALE MEDICARE ENROLLEES AGES 65 TO 74 WHO RECEIVED AN ANNUAL MAMMOGRAPHY SCREENING. PROGRAM 1. COLLABORATE TO INCREASE OPPORTUNITIES FOR CHRONIC DISEASE EDUCATION AND SCREENINGS, WITH A FOCUS ON UNDERSERVED COMMUNITIES AS IDENTIFIED BY CHNA AND COMMITTEE INPUT. SHORT TERM OBJECTIVES (YEAR 1)1. COLLABORATE ON PROVIDING EDUCATION AND SCREENINGS AT 4 LARGE OPPORTUNITIES.- FORM AND HOLD REGULAR TASK FORCE MEETINGS TO ENHANCE COMMUNICATION BETWEEN PSH HOSPITALS AND COMMUNITY PARTNERS ACROSS THE 6-COUNTY REGION.- DEVELOP AND PROMOTE AN INVENTORY OF EVENTS, ACTIVITIES AND PROGRAMS ALREADY BEING OFFERED IN UNDERSERVED COMMUNITIES.- IDENTIFY GAPS AND DEVELOP ONE NEW OPPORTUNITY WHERE NEEDED. MEDIUM-TERM OBJECTIVES (YEAR 2)1. COLLABORATE ON PROVIDING EDUCATION AND SCREENINGS AT 6 LARGE OPPORTUNITIES.- SUMMARIZE AND EVALUATE COMMUNITY OPPORTUNITIES ATTENDED IN YEAR 1 TO DETERMINE BEST FIT FOR MEETING HIGH-NEED COMMUNITIES. LONG-TERM OBJECTIVES (YEAR 3) 1. COLLABORATE ON PROVIDING EDUCATION AND SCREENINGS AT 8 LARGE OPPORTUNITIES.- SUMMARIZE AND EVALUATE COMMUNITY OPPORTUNITIES ATTENDED IN YEAR 2 TO DETERMINE BEST FIT FOR MEETING HIGH-NEED COMMUNITIES.PROGRAM 2. EVALUATE EDUCATIONAL PROGRAMS TO DEMONSTRATE IMPROVED UNDERSTANDING OF CHRONIC DISEASE RISK FACTOR PREVENTION. SHORT TERM OBJECTIVES (YEAR 1)1. CREATE AN EVALUATION SURVEY TO IMPLEMENT AT EACH EDUCATIONAL PROGRAM. MEDIUM-TERM OBJECTIVES (YEAR 2)1. COLLABORATE WITH COMMUNITY PARTNERS TO OFFER 6 EDUCATIONAL SESSIONS, AND MEASURE IMPROVED UNDERSTANDING OF CHRONIC DISEASE RISK FACTOR PREVENTION. LONG-TERM OBJECTIVES (YEAR 3) 1. COLLABORATE WITH COMMUNITY PARTNERS TO OFFER 8 EDUCATIONAL SESSIONS, AND MEASURE IMPROVED UNDERSTANDING OF CHRONIC DISEASE RISK FACTOR PREVENTION. ELEMENT 2. NUTRITION AND FOOD ACCESS RESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER AND PENN STATE HEALTH HAMPDEN MEDICAL CENTER GOAL: ADDRESS ISSUES RELATED TO OBESITY AND FOOD INSECURITY BY PROMOTING ACCESS TO AND CONSUMPTION OF HEALTHFUL DIETS, AND DETERMINE THE IMPACT OF NUTRITION EDUCATION AND IMPROVED ACCESS. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS: - REDUCE OBESITY RATES IN BERKS, LEBANON AND DAUPHIN COUNTIES. - REDUCE THE PERCENTAGE OF RESIDENTS WITH LOW ACCESS TO FOOD IN BERKS, LEBANON AND DAUPHIN COUNTIES. - INCREASE THE REACH OF NUTRITION EDUCATION AND FOOD ACCESS TO RESIDENTS OF BERKS, CUMBERLAND, DAUPHIN, LANCASTER, LEBANON AND PERRY COUNTIES. PROGRAM 1. FOOD BUCKS / VEGGIE RX EXPANSION - EXPAND REACH OF NUTRITION AND FOOD ACCESS PROGRAMS. SHORT TERM OBJECTIVES (YEAR 1)1. BEGIN PROGRAM PLANNING AND DEVELOPMENT OF VEGGIE RX INTO LEBANON.- IDENTIFY KEY PARTNERS AND REQUIRED RESOURCES.- DETERMINE GOALS, OBJECTIVES AND MEASURABLE OUTCOMES.- DETERMINE REFERRAL PROCESS AND ELIGIBILITY.- CREATE NEEDS ASSESSMENT OF COMMUNITY PARTICIPANTS.2. ENGAGE AT LEAST 10,000 PARTICIPANTS ACROSS ALL NUTRITION AND FOOD ACCESS PROGRAMS (FOOD BOX INITIATIVE, COMMUNITY GARDEN, FARMERS MARKETS, WELLNESS ON WHEELS, FARM STAND, VEGGIE RX AND DOWNTOWN HEALTHY FOOD PANTRY).3. DEVELOP A PRE-/POST EVALUATION PLAN FOR NUTRITION EDUCATION FOR CURRENT VEGGIE RX PROGRAM. MEDIUM-TERM OBJECTIVES (YEAR 2)1. START NEW SITE LOCATION IN LEBANON.- ENROLLMENT OF 30 INDIVIDUALS AT NEW SITE LOCATION.- DETERMINE PROCESS-EVALUATION METHODS.- MONITOR PROGRESS TOWARD THE PROGRAM'S GOALS.2. ENGAGE AT LEAST 12,000 PARTICIPANTS ACROSS ALL NUTRITION AND FOOD ACCESS PROGRAMS (FOOD BOX INITIATIVE, COMMUNITY GARDEN, FARMERS MARKETS, WELLNESS ON WHEELS, FARM STAND, VEGGIE RX AND DOWNTOWN HEALTHY FOOD PANTRY).3. IMPLEMENT THE PRE-/POST-EVALUATION OF EDUCATIONAL OFFERINGS FOR PARTICIPANTS. LONG-TERM OBJECTIVES (YEAR 3) 1. ENROLL 40 INDIVIDUALS IN THE PROGRAM.- UTILIZE AN EVALUATION TOOL.- EXPAND THE NETWORK OF FOOD RETAIL PARTNERS.2. ENGAGE AT LEAST 14,000 PARTICIPANTS ACROSS ALL NUTRITION AND FOOD ACCESS PROGRAMS (FOOD BOX INITIATIVE, COMMUNITY GARDEN, FARMERS MARKETS, WELLNESS ON WHEELS, FARM STAND, VEGGIE RX AND DOWNTOWN HEALTHY FOOD PANTRY).3. EVALUATE THE PRE-/POST-DATA FOR NUTRITION EDUCATION. PROGRAM 2. REGIONAL COLLABORATIVE AND STANDARDIZED NUTRITION AND FOOD ACCESS RESOURCE GUIDE - DEVELOP A REGIONAL 6-COUNTY COLLABORATIVE TO INCREASE COMMUNICATION AND DEVELOP A NUTRITION/FOOD ACCESS RESOURCE GUIDE. SHORT TERM OBJECTIVES (YEAR 1)1. ESTABLISH A MEETING SCHEDULE FOR THE COLLABORATIVE AND IDENTIFY PARTNERS TO INCLUDE.2. IDENTIFY PROGRAMS THAT WILL BE INCLUDED IN THE RESOURCE GUIDE.- CATEGORIZE THE RESOURCE GUIDE BASED ON NEED AND COUNTY.- FINALIZE METHODS OF DISSEMINATION AND DISTRIBUTE THE RESOURCE GUIDE THROUGH AT LEAST 5 OUTLETS.MEDIUM-TERM OBJECTIVES (YEAR 2)1. MAINTAIN THE MEETING SCHEDULE FOR THE COLLABORATIVE.2. MAINTAIN AND DISTRIBUTE THE RESOURCE GUIDE THROUGH AT LEAST 10 COMMUNITY OPPORTUNITIES IN UNDERSERVED COMMUNITIES. LONG-TERM OBJECTIVES (YEAR 3) 1. MAINTAIN THE MEETING SCHEDULE FOR THE COLLABORATIVE.- DEVELOP AND IMPLEMENT A POST-SURVEY TO ASSESS THE EFFECTIVENESS OF THE COLLABORATIVE.2. MAINTAIN AND DISTRIBUTE THE RESOURCE GUIDE THROUGH AT LEAST 15 COMMUNITY OPPORTUNITIES IN UNDERSERVED COMMUNITIES. PROGRAM 3. COMMUNITY GARDEN INITIATIVE - IMPROVE ACCESS TO FRUITS, VEGETABLES AND NUTRITION EDUCATION WITHIN THE SERVICE AREA. SHORT TERM OBJECTIVES (YEAR 1)1. PLANT AT LEAST 2 COMMUNITY/SENSORY GARDENS IN THE SERVICE AREA.- ENGAGE LOCAL PARTNERS AND COMMUNITY MEMBERS.- COMPLETE A FOOD INSECURITY SURVEY, IDENTIFYING BARRIERS TO ACCESSING FOOD. MEDIUM-TERM OBJECTIVES (YEAR 2)1. OFFER 3 NUTRITION AND GARDENING EDUCATION PROGRAMS AT COMMUNITY GARDENS. LONG-TERM OBJECTIVES (YEAR 3)1. OFFER 6 NUTRITION AND GARDENING EDUCATION PROGRAMS AT COMMUNITY GARDENS. ELEMENT 3. PHYSICAL ACTIVITY RESPONSIBLE PARTY: PENN STATE HEALTH MILTON S. HERSHEY MEDICAL CENTER, PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER, PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER, PENN STATE HEALTH HAMPDEN MEDICAL CENTER, PENN STATE HEALTH REHABILITATION HOSPITAL AND PENN STATE HEALTH LANCASTER MEDICAL CENTER. GOAL: IMPROVE HEALTH, FITNESS AND QUALITY OF LIFE THROUGH DAILY PHYSICAL ACTIVITY. OVERARCHING INDICATORS/MEASUREMENTS FOR SUCCESS: - INCREASE THE NUMBER OF FREE EXERCISE OPPORTUNITIES FOR ALL AGES IN ZIP CODES IDENTIFIED BY OUR CHNA AND COMMUNITY PARTNERS AS HAVING THE GREATEST RISK FACTORS FOR POOR HEALTH. - REDUCE THE PERCENTAGE OF ADULTS WHO DO NOT ENGAGE IN LEISURE-TIME PHYSICAL ACTIVITY. PROGRAM 1. COMMUNITY PHYSICAL ACTIVITY PROGRAMS AND INFRASTRUCTURE - 1. COLLABORATE TO SHARE OPPORTUNITIES FOR SAFE, COMMUNITY EXERCISE PROGRAMS.2. ENHANCE POLICIES AND INFRASTRUCTURE TO INCREASE OPPORTUNITIES FOR PHYSICAL ACTIVITY. SHORT TERM OBJECTIVES (YEAR 1)1. CREATE AN INVENTORY OF FREE COMMUNITY EXERCISE PROGRAMS.2. JOIN COMMUNITY COLLABORATIVES ALREADY IN PLACE TO INCREASE PHYSICAL ACTIVITY.3. INVESTIGATE OPPORTUNITIES WITH LOCAL, COUNTY AND STATEWIDE PARKS AND RECREATION SYSTEMS IN ALL 6 COUNTIES; ESTABLISH A PARTNERSHIP WITH 1.4. INVESTIGATE OPPORTUNITIES TO FOSTER PHYSICAL ACTIVITY AT ALL PSH HOSPITAL LOCATIONS AND EXTENDING INTO LOCAL COMMUNITIES.5. COLLABORATE WITH 1 SCHOOL DISTRICT OR COMMUNITY ORGANIZATION TO IDENTIFY WAYS TO ENHANCE THE BUILT ENVIRONMENT FOR YOUTH PHYSICAL ACTIVITY. MEDIUM-TERM OBJECTIVES (YEAR 2)1. PROMOTE AND SHARE THE INVENTORY OF FREE COMMUNITY PROGRAMS THROUGH 5 OPPORTUNITIES.2. COLLABORATE ON ENHANCING 1 EXISTING COMMUNITY PHYSICAL ACTIVITY OPPORTUNITY IN 3 OF OUR 6 COUNTIES.3. ESTABLISH 1 ADDITIONAL PARTNERSHIP WITH A LOCAL, COUNTY OR STATEWIDE PARKS AND RECREATION SYSTEM.4. INCREASE/ENHANCE 2 OPPORTUNITIES FOR PHYSICAL ACTIVITY AT PSH HOSPITAL LOCATIONS AND EXTENDED INTO LOCAL COMMUNITIES.5. COLLABORATE WITH 1 ADDITIONAL SCHOOL DISTRICT OR COMMUNITY ORGANIZATION TO IDENTIFY WAYS TO ENHANCE THE BUILT ENVIRONMENT FOR YOUTH PHYSICAL ACTIVITY LONG-TERM OBJECTIVES (YEAR 3)1. PROMOTE AND SHARE THE INVENTORY OF FREE COMMUNITY PROGRAMS THROUGH 5 NEW OPPORTUNITIES.2. COLLABORATE ON ENHANCING ONE EXISTING COMMUNITY PHYSICAL ACTIVITY OPPORTUNITY IN ALL 6 OF OUR COUNTIES.3. ESTABLISH 1 ADDITIONAL PARTNERSHIP WITH A LOCAL, COUNTY OR STATEWIDE PARKS AND RECREATION SYSTEM.4. INCREASE/ENHANCE 2 OPPORTUNITIES FOR PHYSICAL ACTIVITY AT PSH HOSPITAL LOCATIONS AND EXTENDED INTO LOCAL COMMUNITIES.5. COLLABORATE WITH 1 ADDITIONAL SCHOOL DISTRICT OR COMMUNITY ORGANIZATION TO IDENTIFY WAYS TO ENHANCE THE BUILT ENVIRONMENT FOR YOUTH PHYSICAL ACTIVITY.COMMUNITY GRANTS AND CHARITABLE PURPOSE SPONSORSHIPS:IN ORDER TO ALSO PARTNER WITH COMMUNITY ORGANIZATIONS TO ADDRESS PRIORITIZED HEALTH NEEDS, GRANTS AND SPONSORSHIPS ARE PROVIDED ON AN ANNUAL BASIS. CALENDAR YEAR 2023 IS THE EIGHTH YEAR OF THESE GRANTS AND, OVER THIS TIME FRAME, 105 PROJECT TEAMS WERE FUNDED BY $396,750. THIS SUCCESSFUL ENDEAVOR ENGAGES EMPLOYEES FROM ALL PSH HOSPITALS TO PARTNER WITH COMMUNITY ORGANIZATIONS TO START A PROGRAM ADDRESSING AT LEAST ONE OF THE HEALTH NEED PRIORITIES NAMED IN THE CHNA. PRIORITY IS GIVEN TO SUSTAINABLE START-UP PROJECTS THAT WILL HAVE A POSITIVE HEALTH IMPACT ON OUR COMMUNITY. APPLICATIONS MAY ALSO BE SUBMITTED TO SUPPORT PREEXISTING PROGRAMS AND CONTINUE THEIR EXCELLENT WORK. NOT ONLY DO THESE GRANTS PROVIDE LOCAL HEALTH PROGRAMMING, BUT THEY ALSO 1) ENGAGE EMPLOYEE TALENT IN COMMUNITY OUTREACH, 2) HELP DEVELOP AN ORGANIZATIONAL CULTURE OF COMMUNITY HEALTH IMPROVEMENT AND 3) PROVIDE OUR EMPLOYEES AND STUDENTS WITH THE OPPORTUNITY TO LEARN FROM COMMUNITY PARTNERS AND BETTER UNDERSTAND THE SOCIAL INFLUENCES ON HEALTH THAT EXIST OUTSIDE OF OUR HOSPITAL WALLS. CHNA IMPLEMENTATION PLAN 2022-2025 YEAR ONE ACCOMPLISHMENTS: DURING FISCAL YEAR 2023, PSH HOSPITALS CONTINUED FIVE TASK FORCES TO CARRY OUT THE FIRST YEAR OF THE CHNA IMPLEMENTATION PLAN. THESE TASK FORCES ARE COMPRISED OF PSH EMPLOYEES AND COMMUNITY PARTNERS AND MEMBERS WHO ALL FOCUS ON THE PRIORITIES IDENTIFIED IN THE CHNA: MENTAL HEALTH, HEALTH EQUITY AND CHRONIC DISEASE AND RISK FACTOR PREVENTION (SPLIT INTO THREE TASK FORCES: CHRONIC DISEASE AND RISK FACTOR PREVENTION, NUTRITION AND FOOD ACCESS, AND PHYSICAL ACTIVITY.) THE FOLLOWING SECTION WILL DESCRIBE KEY ACCOMPLISHMENTS PER PRIORITY AREA AND TASK FORCE. 100% OF THE OBJECTIVES SET IN YEAR ONE OF THE PLAN WERE MET. ALSO DURING THIS FISCAL YEAR, PSH CONTINUED TO EXPAND AND LANCASTER MEDICAL CENTER OPENED. ANTICIPATING THIS, LANCASTER COUNTY WAS INCLUDED IN THE 2021 CHNA, THEY JUMPED RIGHT ON BOARD THE COMMUNITY OUTREACH EFFORTS AND A LYON SOFTWARE CBISA CONTRACT WAS INITIATED TO TRACK THEIR COMMUNITY BENEFIT. ALL OTHER HOSPITALS CONTINUED TO EXPAND AND ACHIEVED INCREASES IN COMMUNITY HEALTH DOLLARS CONTRIBUTED AS WELL AS PERSONS SERVED IN THE COMMUNITY. NEW THIS YEAR, PSH DEVELOPED A MORE FORMAL ANNUAL COMMUNITY BENEFIT REPORT INSTEAD OF THE ANNUAL CHNA REPORT CARD. THE CHNA, IMPLEMENTATION PLAN AND COMMUNITY BENEFIT REPORT CAN BE FOUND AT: HTTPS://WWW.PENNSTATEHEALTH.ORG/COMMUNITY. MENTAL HEALTH:SEE YEAR 1 GOALS AND OBJECTIVES ABOVE. YEAR 1 ACCOMPLISHMENTS:OFFER MENTAL HEALTH SIGNS AND SYMPTOMS TRAININGS: - TRAINED 418 INDIVIDUALS ON MENTAL HEALTH SIGNS AND SYMPTOMS IN PARTNERSHIP WITH THE FOLLOWING ORGANIZATIONS: CIT DAUPHIN COUNTY LAW ENFORCEMENT, PA STATE POLICE ACADEMY CADETS, BEACON CLINIC, ERG GROUP AT PHS, DAUPHIN COUNTY DISTRICT ATTORNEY'S OFFICE CIT, INTERNATIONAL SERVICE CENTER, COMMUNITY HEALTH WORKERS. - PROVIDED SUBSTANCE USE EDUCATION VIA 18 LECTURES, TRAININGS, WEBINARS OR HEALTH FAIRS. - DISTRIBUTED NALOXONE, LOCK BOXES AND SAFE DISPOSAL POUCHES AT 4 HEALTH FAIRS. - COLLABORATED ON A COMMUNITY HEALTH VENDING MACHINE PROJECT TO DISPENSE NALOXONE, DRUG CHECKING KITS, AND OTHER HEALTH NECESSITIES. - OFFERED DRUG TAKE BACK DAY COLLECTING OVER 1000 POUNDS OF UNWANTED, UNNEEDED, OR EXPIRED MEDICATIONS, AS WELL AS 20 SHARPS CONTAINERS. DEVELOP OPPORTUNITIES TO COLLABORATE: - JOINED HEAL PA INITIATIVE. - RECEIVED A COMMUNITY RELATIONS GRANT TO BEGIN SENSORY REGULATION WORKSHOPS GEARED TOWARDS CHILDREN, TEENS AND YOUTH. - CREATED AND MAINTAIN THE COMMUNITY NETWORK DIRECTORY TO SERVE AS AN INVENTORY OF MENTAL HEALTH AND SUBSTANCE USE RESOURCES. - MADE CONNECTIONS WITH MULTIPLE SCHOOL DISTRICT SUPERINTENDENTS AND PARTNERED WITH STEELTON HIGHSPIRE SCHOOL DISTRICT. - PARTNERED WITH THE HEALTH EQUITY TASK FORCE, PA 211 AND THE UNITED WAY OF THE CAPITAL REGION ON A VIDEO TO PROMOTE 211 USAGE. - PSH GOVERNMENT RELATIONS MET WITH LEADERSHIP TO REVIEW AND ASSESS MENTAL HEALTH PRIORITIES AND NEEDS FOR THE NEXT 2 YEARS. - INITIATED UNITED WAY OF THE CAPITAL REGION CONTACT TO CARE AND ROAD TO SUCCESS INITIATIVES AND EMPLOY A COMMUNITY HEALTH WORKER (CHW) AT PPI. - RECRUITED 2 FELLOWS TO THE ADDICTION MEDICINE FELLOWSHIP AND MONITOR NUMBER OF PATIENTS SEEN AT PPI. - LEADER WAS TRAINED TO INITIATE THE SMART RECOVERY SUPPORT GROUP. - PPI INITIATED ADULT AND CHILD SUPPORT GROUPS. - THROUGH THE USE OF FUNDS FROM A COMMUNITY RELATIONS GRANT, THE LANCASTER HARM REDUCTION PROJECT WAS ABLE TO TEMPORARILY INCREASE HOURS AT THEIR HARRISBURG AND LANCASTER LOCATIONS FOR 6 MONTHS. - A COMMUNITY RELATIONS GRANT ALLOWED THE PARTNERSHIP WITH AN OUTREACH SPECIALIST IN THE COMMUNITY TO EXPAND OUR EDUCATIONAL OFFERINGS TO PROVIDE FREE HIGH QUALITY, EVIDENCE-BASED, TRAUMA-SENSITIVE TRAINING ON SUBSTANCE USE, HARM REDUCTION, AND MENTAL HEALTH TOPICS TO MEMBERS OF THE COMMUNITY. HEALTH EQUITY:SEE YEAR 1 GOALS AND OBJECTIVES ABOVE. YEAR 1 ACCOMPLISHMENTS:COLLABORATE TO CREATE AND MAINTAIN AN INVENTORY OF COMMUNITY HEALTH ACCESS POINTS AND ORGANIZATIONS PROMOTING TRAUMA INFORMED CARE PRACTICES: - CHNA NETWORKING DRIVE UPDATED WITH CURRENT COMMUNITY ACCESS POINTS AND TRAUMA INFORMED ORGANIZATIONS. UPLIFT PARTNERSHIP WITH THE UNITED WAY: - PA 211 CAMPAIGN VIDEO CREATED AND PROVIDED TO COMMUNITY PARTNERS AND JOINT SOCIAL MEDIA CAMPAIGN RAN IN JULY 2022. - PA 211 INFORMATION EMBEDDED IN PSH DISCHARGE INSTRUCTIONS JUNE 2023. - UNITED WAY 2022 CAMPAIGN SUCCESSFULLY RAN AND PLANNING FOR 2023 HAS STARTED. - UNITED WAY CONTACT TO CARE CHW HIRED DECEMBER 2022. PARTNER WITH COMMUNITY ORGANIZATION ON TRAUMA INFORMED CARE TRAININGS: - TRAUMA INFORMED CARE STAFF TRAINING OFFERED IN SEPTEMBER 2022. - FIFTEEN COMMUNITY PARTNER EDUCATION SESSIONS PROVIDED. - EVALUATION RESULTS: 486 PRE-SURVEYS AND 340 POST-SURVEYS HAVE BEEN COMPLETED TO EVALUATE THE TRAINING PROGRAM. PARTICIPANT RESPONSES HAVE SHOWN A STATISTICALLY SIGNIFICANT IMPROVEMENT IN THEIR 'KNOWLEDGE AND 'UNDERSTANDING' OF TRAUMA. NINETY-EIGHT PERCENT OF OPEN-ENDED RESPONSES HAVE BEEN POSITIVE, WITH MANY STATING THAT THE TRAINING IS "EYE-OPENING AND "INFORMATIVE." ADDITIONAL YEAR 1 HIGHLIGHTS: - EXPANDED WORK AT THE RACETRACK TO ASSIST OTHER POPULATIONS IN PARTNERSHIP WITH HOLY SPIRIT MEDICAL CENTER OUTREACH CLINIC. - PARTNERSHIP WITH CARDIOVASCULAR SERVICE LINE TO INCREASE ASCVD SCREENING IN THE COMMUNITY AND THE NUMBER OF SCREENINGS WAS DOUBLED WITHIN THE FIRST QUARTER. - PARTNERSHIP WITH LION CARE TO OFFER HEALTH FAIR WITH THE ISGH MOSQUE IN STEELTON. - IMPLEMENTED NURSE COMMUNITY PARTNERSHIP REFERRAL PROGRAM. - BEGAN HEALTHCARE SCREENINGS AT CORNER STORES IN READING. - BEGAN TRACKING COMMUNITY HEALTH NURSE AND CHW PARTICIPANT HEALTH DATA IN REDCAP SO WE CAN BEGIN EVALUATING EFFORTS. - THE PSH SYSTEM-WIDE HEALTH EQUITY STRATEGY WAS STARTED, AND THIS CHNA HEALTH EQUITY TASK FORCE CONTRIBUTES AS THE COMMUNITY PILLAR. - THE HEALTH EQUITY TASK FORCE PARTICIPATED IN A TEAM OUTREACH EVENT AND PACKED FOOD BOXES AT THE CENTRAL PENNSYLVANIA FOOD BANK. CHRONIC DISEASE AND RISK FACTOR PREVENTION:SEE YEAR 1 GOALS AND OBJECTIVES ABOVE. YEAR 1 ACCOMPLISHMENTS:COLLABORATE TO INCREASE OPPORTUNITIES FOR CHRONIC DISEASE EDUCATION AND TRAININGS WITH A FOCUS ON UNDERSERVED COMMUNITIES: - TASK FORCE MEETINGS HAVE FOSTERED COLLABORATION TO EXTEND OUR REACH, AND WE HAVE HEARD ABOUT EXCELLENT PROGRAMS FROM MANY PRESENTERS. - THE COMMUNITY NETWORK DIRECTORY WAS CREATED AND IS BEING USED BY ALL TASK FORCES FOR NETWORKING AND COLLABORATION. - COLLABORATED AT MANY LARGE COMMUNITY EVENTS ACROSS OUR SIX COUNTIES, EXAMPLES: NATIONAL NIGHT OUT, RECFEST, YMCA HEALTH EQUITY TOUR, BERKS GUTS AND GLORY EVENT, AMERICAN HEART WALK, CULTURAL DIVERSITY FESTIVAL IN DOWNTOWN READING, CANCER SURVIVORSHIP CONFERENCE, PENN STATE HEALTH BLUE WHITE GAME, DIABETES FAIRS, FLU SHOT EVENTS, REACH EVENTS, AND WALK WITH A DOC TO PROVIDE STROKE AND DIABETES EDUCATION. - COMMUNITY HEALTH NURSES PROVIDING EDUCATION AND SCREENINGS AT THE DOWNTOWN READING FARMSTAND AND IN COLLABORATION WITH THE READING CORNER STORE INITIATIVE; ALSO NEW THIS YEAR, A FAIR WAS HELD AT THE STEELTON MOSQUE. - STROKE PROGRAM COLLABORATED WITH THE PANTRIES AND WELLNESS SUPPORT (PAWS) PROGRAM, AND PROVIDED BRAIN AND STROKE EDUCATION AT PAXTONIA ELEMENTARY SCHOOL. THE STROKE TEAM ALSO IDENTIFIED A GAP AND PARTNERED WITH LEADER CENTER FOR ACTIVE LIFE TO PROVIDE LUNCH-AND-LEARN OPPORTUNITIES ON PREVENTION SCREENINGS AND MESSAGES. CREATE AN EVALUATION SURVEY TO IMPLEMENT AT COMMUNITY EDUCATIONAL EVENTS TO DEMONSTRATE IMPROVED UNDERSTANDING OF CHRONIC DISEASE RISK FACTOR PREVENTION: - EVALUATION FRAMEWORK AND SURVEYS CREATED. SHORT AND LONG (INCLUDES DEMOGRAPHIC QUESTIONS) VERSIONS AVAILABLE IN ENGLISH AND SPANISH VIA PDFS, REDCAP LINKS, AND A POWERPOINT SLIDE AND FLIER WITH QR CODES. - SURVEYS ARE BEING USED BY COMMUNITY HEALTH AND OTHER TASK FORCES TOO AND HAVE BEEN COMPLETED VIRTUALLY AND AT HERSHEY PLAZA, LHACC, SALVATION ARMY, MORNING STAR, CUMBERLAND COUNTY HOUSING AND THE INTERNATIONAL SERVICE CENTER. - EDUCATIONAL TOPICS EVALUATED INCLUDE: LET'S GET EDUCATED AGAINST CANCER, BREAST BINGO: CANCER EDUCATION, HELLO (END OF LIFE PLANNING), KNOW YOUR NUMBERS, MENTAL HEALTH SIGNS & SYMPTOMS, CAUTION (CANCER EDUCATION), PREVENTATIVE HEALTH, URINARY HEALTH, OSTEOPOROSIS, AND STROKE. - WORKING WITH THE STROKE TEAM TO DEVELOP A PRE-POST SURVEY SPECIFICALLY FOR THEM AS WELL AS A PRE-POST SURVEY FOR USE WITH THE SENSORY TRAINING GRANT. - EVALUATION RESULTS: 173 EVALUATION SURVEYS WERE COMPLETED, WITH THE SHORT, ENGLISH SURVEY BEING THE FORMAT MOST OFTEN USED. RESULTS SHOWED THAT THE MOST USEFUL METHOD OF LEARNING WAS THROUGH A PRESENTATION FORMAT AND THAT THE MAJORITY OF RESPONDENTS PREFERRED TO RECEIVE EDUCATIONAL INFORMATION IN PERSON. ABOUT ONE HUNDRED PERCENT OF ALL RESPONDENTS SAID THEY EITHER 'STRONGLY AGREE OR 'AGREE' THAT THEY HAD LEARNED SOMETHING NEW DURING THEIR EVENT THAT THEY CAN USE IN THEIR WORK / LIFE. THE EVALUATION ALSO SHOWED THAT THE MAJORITY OF PARTICIPANTS PLAN TO EITHER USE THE INFORMATION THEY LEARNED TO IMPROVE THEIR OWN HEALTH OR DISCUSS IT WITH A FRIEND/FAMILY MEMBER/COLLEAGUE/ PROVIDER, SHOWING HOW EDUCATIONAL EVENTS CAN IMPACT THE HEALTH OF EVEN THOSE IN THE COMMUNITY WHO DID NOT ATTEND THE EVENT THEMSELVES. NUTRITION AND FOOD ACCESS:SEE YEAR 1 GOALS AND OBJECTIVES ABOVE. YEAR 1 ACCOMPLISHMENTS:EXPAND REACH OF NUTRITION AND FOOD ACCESS PROGRAMS: - VEGGIE RX CONTINUES TO DEMONSTRATE GREAT SUCCESS IN BERKS COUNTY. 75 PATIENTS WERE ENROLLED SINCE JULY 1, 2022. THIS NUMBER DOES NOT REFLECT THE TOTAL NUMBER OF FAMILY MEMBERS POSITIVELY IMPACTED BY THE PATIENT'S PARTICIPATION IN THE PROGRAM. IN TOTAL, WE ENROLLED 154 PATIENTS IN VEGGIE RX 2.0; 81% HISPANIC, 70% FEMALE, 59.5% LESS THAN HIGH SCHOOL EDUCATION, 58.8% RECEIVING SNAP, AND 90.0% ON MEDICAID/MEDICARE. COMPARED TO BASELINE, AT 7 MONTHS POST-PROGRAM A1C DECREASED SIGNIFICANTLY (-0.4%, P = .04) AND THERE WAS NO PRE-POST CHANGE IN BMI (P=.78). THE OVERALL VOUCHER REDEMPTION RATE WAS 85% (13,848 REDEEMED/16,196 GIVEN). - VEGGIE RX EXPANDED TO LEBANON AND LANCASTER COUNTIES: > FOR LEBANON COUNTY VEGGIE RX, THERE WAS 39 PEOPLE ENROLLED AND 19 COMPLETED THE PROGRAM. 68% SHOWED A DECREASE IN THEIR A1C AFTER THE 6-WEEK PROGRAM. > FOR LANCASTER VEGGIE RX, 16 ENROLLED AND 13 COMPLETED THE PROGRAM. > CREATED PRE/POST ASSESSMENTS FOR THE PROGRAM AND EACH EDUCATIONAL SESSION. - OVERALL, NUTRITION AND FOOD ACCESS INITIATIVES REACHED OVER 30,000 PEOPLE IN YEAR ONE. DEVELOP A REGIONAL COLLABORATIVE TO INCREASE COMMUNICATION AND DEVELOP A NUTRITION / FOOD ACCESS RESOURCE: - DEVELOPED GEOCODING MAP TO SHOW ALL OF PENN STATE HEALTH FOOD ACCESS LOCATIONS AND FOOD DESSERTS. INCLUDES OVER 80 LOCATIONS THAT HIGHLIGHT DIFFERENT FOOD ACCESS WORK SUCH AS THE VEGGIE RX PROGRAMS, FARM STAND, COMMUNITY GARDENS, FOOD BOXES, COMMUNITY FRIDGES, PANTRIES AND WELLNESS SUPPORT (PAWS), ETC. - DEVELOPED COMMUNITY NETWORKING DIRECTORY TO HOUSE RECURRING NUTRITION RELATED PROGRAMS AND EVENTS. - CREATED FACT SHEETS HIGHLIGHTING MANY OF THESE SERVICES. IMPROVE ACCESS TO FRUITS AND VEGETABLES, AND NUTRITION EDUCATION WITH OUR SERVICE AREA: - PAWS PROGRAM PROVIDED HEALTH SCREENINGS AND EDUCATION AT 10 FOOD PANTRIES AND ALSO PROVIDED NURSING OUTREACH AT OTHER LOCATIONS SUCH AS THE RACETRACK, ANCHOR LANCASTER, LANCASTER LIBRARIES, AND WITH THE CORNER STORE INITIATIVE IN READING. - COMMUNITY GARDEN EXPANSION: IN ADDITION TO OUR CAMPUS GARDEN, RITE AID HEALTHY FUTURES HAS GRACIOUSLY PROVIDED FUNDING TO CONSTRUCT MULTIPLE COMMUNITY GARDENS ACROSS OUR SERVICE AREA. THE FIRST GARDEN WAS THE CHESTNUT STREET COMMUNITY CENTER GARDEN IN LEBANON. DURING THE FIRST YEAR OF OUR PLAN WE EXPANDED TO 14 GARDENS TOTAL IN BERKS, DAUPHIN, LANCASTER, LEBANON AND PERRY COUNTIES. - THIS YEAR THE GARDENS HAVE REACHED OVER 5,000 COMMUNITY MEMBERS. - THE GARDENS CREATE A SPACE FOR FAMILIES TO HARVEST VARIOUS VEGETABLES, BRING THE COMMUNITY TOGETHER, AND PROVIDE NUTRITION EDUCATION. - WE PROVIDED PROGRAMMING TO 150 PEOPLE ABOUT CONTAINER GARDENING AT EIGHT LOCATIONS AND SERVED 58 PEOPLE FOR THE COOKING CLASSES IN FOUR OF THE GARDENS. - TWELVE AEROGARDENS WERE PROVIDED TO THE LEBANON SCHOOL DISTRICT TO TEACH STUDENTS IN ALL GRADES GARDENING TECHNIQUES AND HOW TO GROW THEIR OWN HEALTHY FOODS WHILE INCREASING CONSUMPTION. EVALUATION PRE AND POST SURVEYS WERE DEVELOPED AND UTILIZED. ADDITIONAL SUPPLIES WERE USED TO CREATE AN AQUAPONICS PROGRAM FOR 5TH GRADERS. - PENN STATE REACH PARTNERED WITH BELL & EVENS ON A DIABETES PREVENTION PROGRAM INCENTIVIZE PARTICIPANTS WITH WEEKLY CSI VEGETABLE BOXES FOR PARTICIPATING IN AN ON-LINE EDUCATIONAL PROGRAM. PHYSICAL ACTIVITY: SEE YEAR 1 GOALS AND OBJECTIVES ABOVE. YEAR 1 ACCOMPLISHMENTS: - OUR CHNA COMMUNITY MEMBER SURVEY SHOWED THAT LESS THAN 30% OF THOSE SURVEYED MET THE NATIONAL PHYSICAL ACTIVITY GUIDELINE OF AT LEAST 150 MINUTES OF MODERATE-INTENSITY, AEROBIC PHYSICAL ACTIVITY EACH WEEK OR THE EQUIVALENT OF 30 MINUTES ON AT LEAST FIVE DAYS PER WEEK. 1/5 REPORTED NO DAYS OF PHYSICAL ACTIVITY IN THE PAST MONTH. GOOD NEWS: 2023 COUNTY HEALTH RANKINGS SHOWED A DECREASE IN THE PERCENTAGE OF ADULTS WHO REPORT NO LEISURE TIME PHYSICAL ACTIVITY IN ALL SIX COUNTIES! COLLABORATE MORE TO SHARE OPPORTUNITIES FOR COMMUNITY PHYSICAL ACTIVITY PROGRAMS: - CREATED AND MAINTAIN PHYSICAL ACTIVITY SECTION OF THE COMMUNITY NETWORK DIRECTORY BEING USED BY ALL TASK FORCES. - HOLD MEETINGS EVERY OTHER MONTH TO HIGHLIGHT UPCOMING EVENTS ACROSS OUR SIX COUNTIES. - INVITE PRESENTERS TO SHARE ABOUT PHYSICAL ACTIVITY PROGRAMS TO HELP PROMOTE AND POSSIBLY REPLICATE IN OTHER AREAS TO EXPAND PHYSICAL ACTIVITY OPPORTUNITIES AND INFRASTRUCTURE: THE COMMON WHEEL, COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY LEBANON VALLEY CALENDAR, PENNSYLVANIA PARKS & FORESTS FOUNDATION, THE ASPEN INSTITUTE PROJECT PLAY, PENN STATE PRO WELLNESS, AHEC - HEALTH EQUITY TOOL KIT, BETTER TOGETHER LEBANON SUMMERFEST, GIRLS RUGBY, INC., GIRLS ON THE RUN, JCWK DANCE LAB, HARRISBURG BICYCLE CLUB SMART CYCLING CLASS, REACH PHYSICAL ACTIVITY PROJECTS, PENN STATE REHABILITATION RECFEST - CONTINUE TO PARTNER WITH DAUPHIN COUNTY PARKS AND RECREATION ON THEIR PARKS RX WALK WITH A DOC PROGRAM. PSH PHYSICIANS SHARE A KEY MESSAGE AND THEN WALK WITH PARTICIPANTS TO ANSWER QUESTIONS. DCPR ALSO OPENED A FIRST DISC GOLF COURSE IN NORTHERN DAUPHIN COUNTY. - SHARED AND PARTICIPATED IN HARRISBURG PARKS AND RECREATION DESIGN UPDATE MEETINGS. - TASK FORCE MEMBERS PARTICIPATE ON THE PA STATE HEALTH IMPROVEMENT PLAN DEVELOPMENT COMMITTEE FOR PHYSICAL ACTIVITY AND NUTRITION. ENHANCE POLICIES AND INFRASTRUCTURE TO INCREASE OPPORTUNITIES FOR PHYSICAL ACTIVITY: - WORKED WITH PHYSICAL ACTIVITY INFRASTRUCTURE AND INITIATIVES IN ALL 6 COUNTIES. BIKE SHARE PROGRAM ON REGIONAL BIKE SHARE PLANNING COMMITTEE AND NEW BIKE RACK PLACED IN HUMMELSTOWN. - PROVIDED COUNTING DEVICES TO THE SAMBA TRAILS AND WILL CONTINUE TO SUPPORT THESE TRAILS. - PROMOTED AND PARTICIPATED IN MEETINGS FOR THE TRI-COUNTY REGIONAL PLANNING COMMISSION (TCRPC) AND HARRISBURG AREA TRANSPORTATION STUDY (HATS) REGIONAL ACTIVE TRANSPORTATION PLAN FOR CUMBERLAND, DAUPHIN, AND PERRY COUNTIES. - PROVIDED COMMUNITY RELATIONS GRANTS TO THE JOY OF SPORTS FOUNDATION PLAY FIT PROGRAM IN DERRY TOWNSHIP, LEBANON BICYCLE RECYCLE, BRINGING BALANCE TO OLDER ADULTS THROUGH A MATTER OF BALANCE - PSH ST. JOSEPH'S DOWNTOWN CENTER IN READING AND REACH OFFERED AND EVALUATED A WALK WITH A DOC PROGRAM. - REACH WORKS TO INCREASE PHYSICAL ACTIVITY THROUGH THE BUILT ENVIRONMENT AND VARIOUS PHYSICAL ACTIVITY INITIATIVES IN LEBANON AND BERKS COUNTIES: LEBANON: TRAFFIC GARDEN, LIBERTY TRAIL IMPROVEMENTS, PUMPTRACK, SAMBA TRAILS AND BASKETBALL COURT IMPROVEMENTS AT COLEMAN PARK, LEBANON BICYCLE RECYCLE, RAIL TRAIL SPUR PROJECTS. READING: ACTIVE TRANSPORTATION PLAN IN DOWNTOWN READING AND BILINGUAL AND INCLUSIVE WALKING GUIDES AND TOURS, WALK WORKS IN BOTH LEBANON AND READING. SUPPORT LEBANON PHYSICAL ACTIVITY TASK FORCE AND COMMUNITY EVENTS LIKE HEALTHY KIDS DAY, SUMMERFEST, LEBANON VALLEY TENNIS EVENTS, LEBANON VALLEY MOUNTAIN BIKE TEAM, ETC. - PENN STATE PRO WELLNESS PROVIDES ONGOING SUPPORT TO SCHOOLS FOR WALK TO SCHOOL DAY AND MOVE IT OUTSIDE. - RECFEST 2023 HELD AT SPOOKY NOOK IN LANCASTER ADAPTIVE SPORTS RECREATION AND EXERCISE EXPO FOR ALL AGES AND ABILITIES TO INTRODUCE HOW TO USE AND ACCESS ADAPTIVE EQUIPMENT. - NATIONAL NIGHT OUT WAS HELD ON AUGUST 1ST AT 10 LOCATIONS ACROSS OUR SIX COUNTIES; IN PERRY COUNTY THE MESSAGE FOCUSED ON BACK TO SCHOOL SAFETY DEVELOPED BY PSH PEDIATRIC TRAUMA AND INJURY PREVENTION INCLUDING TRANSPORTATION SAFETY, AND REFLECTORS FOR USE ON BACKPACKS, KEYCHAINS, ETC. WERE DISTRIBUTED.PART V, SECTION B, LINE 16THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING WEBSITE: WWW.PENNSTATEHEALTH.ORG/PATIENTS-VISITORS/BILLING-MEDICAL-RECORDS/FINANCIAL-ASSISTANCE PART I, LINE 3C: NOT APPLICABLE PART I, LINE 6A: COMMUNITY BENEFIT REPORT: PENN STATE HEALTH LANCASTER MEDICAL CENTER PREPARES A COMMUNITY BENEFIT REPORT AND MAKES IT AVAILABLE TO THE PUBLIC. PART I, LINE 7: COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE: A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. BASED ON THAT FORMULA, (28,428,542/68,087,837) RESULTS IN A 41.8% COST-TO-CHARGE RATIO. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES: THERE ARE NO PHYSICIAN PRACTICES INCLUDED IN SUBSIDIZED HEALTH SERVICES. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES: EACH HOSPITAL WITHIN THE PENN STATE HEALTH SYSTEM ENGAGED IN ACTIVITIES TO PROTECT AND IMPROVE EACH OF ITS COMMUNITY'S HEALTH AND SAFETY. OVERALL, FOR FY 2023, THE PENN STATE HEALTH SYSTEM SERVED 972,301 COMMUNITY MEMBERS WITH 126,400 EMPLOYEE HOURS AND 43,337 VOLUNTEER HOURS, RESULTING IN $7,291,934 IN COMMUNITY HEALTH SERVICES PROVIDED TO THE COMMUNITIES. COMMUNITY HEALTH IMPROVEMENT SERVICES IS PRESENTED IN PART I, LINE 7. PART III, LINE 2: THE INITIAL IMPLICIT PRICE CONCESSIONS (BAD DEBT) RESERVE IS DETERMINED BASED ON THE DIFFERENCE BETWEEN THE 18 MONTH AND THE 6 MONTH ZERO BALANCE CLAIMS RATE. IF A NEGATIVE IMPLICIT RATE IS CALCULATED, NO IMPLICIT RATE IS APPLIED BASED ON THE RESULTS OF THE PRIOR YEAR LOOKBACK. ADDITIONAL IMPLICIT PRICE CONCESSION ESTIMATES ARE CONSIDERED TO ACCOUNT FOR (1) SELF-PAY AFTER INSURANCE BALANCES THAT HAVE NOT YET TRANSFERRED FROM AN INSURANCE BALANCE TO PATIENT BALANCE DUE TO TIMING OF THE REVENUE CYCLE PROCESS, AND (2) UNCOLLECTIBLE AMOUNTS THAT OCCUR ON A PATIENT ACCOUNT GREATER THAN 18 MONTHS. PART III, LINE 3: PATIENTS' ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND ARE RECLASSIFIED TO CHARITY CARE (100% DISCOUNTED CARE) WHENEVER A PATIENT BECOMES ELIGIBLE UNDER THE HOSPITAL'S UNCOMPENSATED OR CHARITY CARE POLICY. PART III, LINE 4: PAGE 12, FOOTNOTE FOR NET PATIENT SERVICE REVENUE PART III, LINE 8: THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND THE COST OF BAD DEBT ARE COMMUNITY BENEFIT AND SHOULD BE INCLUDED ON FORM 990, SCHEDULE H, PART I. THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND IS CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER THE INTERNAL REVENUE CODE ("IRC") 501(C)(3). SATISFYING THE "COMMUNITY BENEFIT STANDARD," AS ARTICULATED BY THE INTERNAL REVENUE SERVICE (IRS) IN REVENUE RULING 69-545, IS CURRENTLY REQUIRED FOR A HOSPITAL TO BE RECOGNIZED AS A CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (IRC) 501(C)(3). AS DEVELOPED IN REVENUE RULING 69-545, UNDER THE COMMUNITY BENEFIT STANDARD, HOSPITALS WERE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO THOSE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER FACTORS THAT DEMONSTRATED COMMUNITY BENEFIT INCLUDED: SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND FACILITIES AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; AND IT WAS CONTROLLED BY A BOARD OF DIRECTORS THAT CONSISTED OF INDEPENDENT CIVIC LEADERS. PENNSYLVANIA REQUIRES NON-PROFIT HOSPITALS TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO STATE GUIDANCE AND CASE LAW, THE UNREIMBURSED COST OF MEDICARE AND BAD DEBT IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES. PART III, LINE 9B: THE MEDICAL CENTER'S DEBT COLLECTION POLICY PROVIDES THAT THE MEDICAL CENTER WILL PERFORM A REASONABLE REVIEW OF EACH INPATIENT ACCOUNT PRIOR TO TURNING AN ACCOUNT FOR TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (E.G. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE MEDICAL CENTER'S COMMUNITY ASSISTANCE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY PATIENT ACCOUNT THAT IS SUBSEQUENTLY DETERMINED TO MEET THE MEDICAL CENTER COMMUNITY ASSISTANCE POLICY IS REQUIRED TO BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT TO THE MEDICAL CENTER FOR APPROPRIATE FOLLOW-UP. THE MEDICAL CENTER REQUIRES ITS THIRD-PARTY COLLECTION AGENTS TO INCLUDE A MESSAGE ON ALL STATEMENTS INDICATING THAT IF A PATIENT OR PATIENT GUARANTOR MEETS CERTAIN STIPULATED INCOME REQUIREMENTS, THE PATIENT OR PATIENT GUARANTOR MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE MEDICAL CENTER'S CONTRACTS WITH THIRD PARTY COLLECTION AGENCIES INCLUDE THE FOLLOWING STANDARDS: - NEITHER THE MEDICAL CENTER NOR THEIR COLLECTION AGENCIES WILL REQUEST BENCH OR ARREST WARRANTS AS A RESULT OF NON-PAYMENT; - NEITHER THE MEDICAL CENTER NOR THEIR COLLECTION AGENCIES WILL SEEK LIENS THAT WOULD REQUIRE THE SALE OR FORECLOSURE OF A PRIMARY RESIDENCE; - NO COLLECTION AGENCY MAY SEEK COURT ACTION WITHOUT HOSPITAL APPROVAL. FINALLY, COLLECTION AGENCIES ARE TRAINED ON THE MEDICAL CENTER'S MISSION, CORE VALUES AND STANDARD OF CONDUCT TO MAKE SURE ALL PATIENTS ARE TREATED WITH DIGNITY AND RESPECT. PART VI, LINE 2: COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA):SEE CHNA INFORMATION. OCCASIONALLY ADDITIONAL ASSESSMENTS ARE CONDUCTED BY DISEASE SPECIFIC DEPARTMENTS, INSTITUTES, AND PROGRAMS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEWE BELIEVE THAT RECEIVING HEALTHCARE IS A BASIC HUMAN RIGHT. PENN STATE HEALTH LANCASTER MEDICAL CENTER PARTICIPATES IN THE WIDEST NUMBER OF INSURANCE PROGRAMS OF THE HOSPITALS IN THE REGION. WE REALIZE THAT MANY PEOPLE EITHER CANNOT AFFORD HEALTH INSURANCE OR DO NOT HAVE ENOUGH INSURANCE TO COVER THEIR BILLS. THOSE ARE THE REASONS FOR OUR PAYMENT OPTIONS AND FINANCIAL ASSISTANCE PROGRAM, WHICH IS PUBLICLY POSTED ON THE HOSPITAL WEBSITE: HTTPS://WWW.PENNSTATEHEALTH.ORG/PATIENTS-VISITORS/BILLING-MEDICAL-RECORDS/FINANCIAL-ASSISTANCE. A PRICE ESTIMATOR ALSO WAS ADDED IN ORDER TO FURTHER CREATE PRICE AND COST TRANSPARENCY. WE UNDERSTAND THAT THE NEED FOR HEALTH CARE AND HOSPITAL SERVICES IS OFTEN UNPLANNED, AND SOME PATIENTS MAY NOT HAVE SUFFICIENT INSURANCE, OR MAY BE UNABLE TO PAY THEIR ENTIRE BILL RIGHT AWAY. WE ASSURE PATIENTS THAT ADMISSION TO PENN STATE HEALTH LANCASTER MEDICAL CENTER IS A MEDICAL, NOT A FINANCIAL, DECISION. FOR THOSE WHO NEED TO TAKE ADVANTAGE OF OUR FINANCIAL ASSISTANCE PROGRAMS, WE PROVIDE THE NECESSARY ASSISTANCE IN COMPLETING APPLICATIONS THAT HELP TO DETERMINE ELIGIBILITY FOR FEDERAL, STATE OR COUNTY GOVERNMENT HEALTH CARE ASSISTANCE. WE ALSO OFFER PENN STATE HEALTH LANCASTER MEDICAL CENTER'S OWN ASSISTANCE PLAN THAT CAN PAY ALL OR A SIGNIFICANT PORTION OF HOSPITAL BILLS. PART VI, LINE 4: COMMUNITY INFORMATIONTHE SERVICE AREA DEFINED FOR PURPOSES OF THE CHNA ENCOMPASSES 225 ZIP CODES IN SIX PENNSYLVANIA COUNTIES: BERKS, CUMBERLAND, DAUPHIN, LANCASTER, LEBANON AND PERRY. THESE SIX FOCUS COUNTIES REPRESENT THE COMMUNITY WHERE HEALTH CARE RESOURCES ARE AVAILABLE AND PROVIDED BY THE PARTNERING PENN STATE HEALTH ORGANIZATIONS. THE COUNTIES ARE ALSO HOME TO THE MAJORITY OF PENN STATE HEALTH'S PATIENT POPULATION. TOTAL POPULATION OF THESE SIX COUNTIES: 1,707,543. FOR ADDITIONAL DEMOGRAPHIC INFORMATION SEE FULL CHNA REPORT PAGE 2 AND STARTING ON PAGE 17. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHPENN STATE HEALTH HAS COMPLETED FIVE CYCLES OF COMMUNITY HEALTH NEEDS ASSESSMENTS AND HAS ESTABLISHED A LONG LEGACY OF COMMUNITY HEALTH PROGRAMMING. MANY PROGRAMS IDENTIFIED IN OUR CURRENT PLAN WILL CARRY FORWARD INTO THE NEW PLAN AND BE FURTHER DEVELOPED AND ENHANCED; INCLUDING THOSE COLLABORATED ON WITH MANY PROGRAMS AND PROJECTS WITHIN THE PENN STATE COLLEGE OF MEDICINE: - PENN STATE CANCER INSTITUTE CANCER NAVIGATION AND SURVIVORSHIP NETWORK - PENN STATE ADDICTION CENTER FOR TRANSLATION - PENN STATE CENTER FOR THE PROTECTION OF CHILDREN - PENN STATE REACH (RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH) PROGRAM - PENN STATE PRO WELLNESS - PENN STATE PROJECT ECHO (EXTENSION FOR COMMUNITY HEALTHCARE OUTCOMES)- MEDICAL STUDENT PROGRAMS, INCLUDING THE HEALTH SYSTEMS SCIENCE PATIENT NAVIGATION AND CULINARY MEDICINE COURSES AND THE STUDENT-RUN AND COLLABORATIVE OUTREACH PROGRAM FOR HEALTH EQUITY (SCOPE). - PENN STATE HEALTH OFFICE FOR DIVERSITY, EQUITY AND INCLUSION PIPELINE PROGRAMS - PENN STATE COLLEGE OF MEDICINE DEPARTMENT OF PUBLIC HEALTH SCIENCES - COMMUNITY HEALTH EQUITY & ENGAGEMENT IN RESEARCH (CHEER) PROGRAM - PENN STATE COLLEGE OF NURSING - ASERT COMMUNITY OUTREACH LANCASTER MEDICAL CENTER OPENED AND IMMEDIATELY BEGAN COMMUNITY HEALTH OUTREACH. STAFF MEMBERS JOINED THE CHNA HEALTH EQUITY AND PHYSICAL ACTIVITY TASK FORCES. SPECIFIC COMMUNITY HEALTH PROGRAMMING EXECUTED ON BY PENN STATE HEALTH LANCASTER MEDICAL CENTER IS AS FOLLOWS:- LANCASTER COUNTY NAACP FREEDOM FUND COMMITTEE- UNITED WAY CAMPAIGN, UNITED WAY DAY OF CARING AND STUFF THE BUS EVENT- CHARITABLE PURPOSE SPONSORSHIPS- COMMUNITY MEDICAL GROUP PROVIDING MEDICAL SERVICES AT WATER STREET MINISTRIES CLINIC- GIVING TREE EVENT- COMMUNITY GARDENS - DECA- COMMUNITY FAIRS AND EVENTS: LANCASTER REC CAREER DAY, EMS WEEK FISHING DERBY, MOTHER'S DAY TRUCK CONVOY AND CARNIVAL- COMMUNITY HEALTH NURSING OUTREACH AT THE DUKE STREET AND EWELL PLAZA LIBRARIES- ANCHOR LANCASTER COMMUNITY HEALTH NURSING OUTREACH- DIVERSITY EDUCATION AND CULTURAL COMPETENCY AT THE LANCASTER AND LITITZ PRIDE FESTIVALS- ELIZABETHTOWN COMMUNITY CUPBOARD FOOD PANTRY HEALTH EDUCATION AND SCREENINGS- FACILITIES TRANSPORTATION INFRASTRUCTURE EFFORTS TO SUPPORT LOCAL COMMUNITY AND IMPROVE ACCESS TO CARE AND BASIC NEEDS- LIFE LION EMS COMMUNITY OUTREACH AT 24 LOCAL COMMUNITY EVENTS TO PREVENT BURDEN ON THE LOCAL HOSPITAL EMERGENCY DEPARTMENTS AND PROVIDE EDUCATION, CPR AND STOP THE BLEED TRAINING.- STUDENT SHADOWING AND MENTORING FOR HACC AND PA COLLEGE OF HEALTH SCIENCES STUDENTS- LANCASTER VEGGIE RX PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMPENN STATE HEALTH LANCASTER MEDICAL CENTER IS A MEMBER OF THE PENN STATE HEALTH SYSTEM. EACH HOSPITAL IN THE SYSTEM HAS A ROLE IN ADDRESSING COMMUNITY HEALTH NEEDS; THESE ROLES ARE DISCUSSED IN THE CHNA AND THE IMPLEMENTATION PLAN. ADDITIONALLY, WE ENCOURAGE READING EACH HOSPITAL'S OWN FEDERAL FORM 990, SCHEDULE H TO HEAR MORE ABOUT PROGRAMS OFFERED IN ITS COMMUNITIES. PART VI, LINE 7: COMMUNITY BENEFIT REPORT STATE FILINGSNOT APPLICABLE IN THE STATE OF PENNSYLVANIA. 1 PENN STATE HEALTH COMMUNITY MEDICAL GROUP 100 CRYSTAL DRIVE MC CA210 HERSHEY PA 17033 300976099 501(C)(3) 6196056 0 PHYSICIAN PRACTICES EAST HEMPFIELD TOWNSHIP 1700 NISSLEY ROAD LANDISVILLE PA 17538 236000356 GOV 56667 0 PROGRAM SUPPORT 2 0 PART I, LINE 2: IF A REQUEST FOR A CHARITABLE CONTRIBUTION OR GRANT IS APPROVED, THE COMMUNITY RELATIONS DEPARTMENT SENDS AN EMAIL WITH THE FOLLOWING DETAILS: -RECIPIENT IS ASKED TO PROVIDE AN INVOICE FOR PAYMENT, PROVIDING THE EXACT AMOUNT REQUESTED AND DETAILS FOR WHAT IT WILL BE SPENT ON. -THE APPROPRIATE LOGOS AND BRANDING ELEMENTS ARE PROVIDED FOR ANY MESSAGING. -THE FOLLOWING STATEMENT IS INCLUDED: "PENN STATE HEALTH (OR ITS AFFILIATE) IS PROUD TO SPONSOR PROGRAMS THAT SERVE OUR COMMUNITY. THIS ACTIVITY IS CONSISTENT WITH, AND SUPPORTIVE OF, OUR MISSION BY PROVIDING COMMUNITY BENEFIT WITHIN THE COMMUNITIES WE SERVE. ACCORDINGLY, YOU SHOULD CONSIDER THIS DONATION TO BE RESTRICTED TO ITS INTENDED PURPOSE. WE APPRECIATE YOUR SERVICE AND ARE EXCITED TO SUPPORT YOU IN THIS EFFORT!" THE SPONSORSHIPS ARE MONITORED BY THE ORGANIZATION'S COMMUNITY RELATIONS PERSONNEL TO ENSURE THE FUNDS ARE SPENT AS INTENDED AND THE ORGANIZATION MAY REQUEST WRITTEN DOCUMENTATION AND RECEIPTS AS SUBSTANTIATION. ORGANIZATION PERSONNEL ATTEND MANY OF THE EVENTS/CAUSES WE SPONSOR, WORK/ENGAGE ACTIVELY WITH THESE NON-PROFIT ORGANIZATIONS THROUGHOUT THE YEAR, AND TYPICALLY RECEIVE CONFIRMATION LETTERS FROM THE ORGANIZATIONS AS WAYS TO ASSURE OUR CONTRIBUTIONS ARE USED FOR THEIR INTENDED PURPOSES. 0 1 0 0 0 0 0 1 0 STEPHEN MASSINI DIR & CHAIR / PSH CEO 0 1319391 0 75000 0 205466 0 38400 0 23245 0 1661502 0 0 DEBORAH ADDO DIRECTOR / PSH COO 0 788301 0 88462 0 44000 0 39593 0 9259 0 969615 0 0 PAULA TINCH DIRECTOR / PSH CFO & EVP 0 740070 0 64231 0 4181 0 102173 0 17690 0 928345 0 0 JUDITH HLAFCSAK DIRECTOR / PSH CHIEF OF STAFF 0 379734 0 40000 0 151205 0 61630 0 9259 0 641828 0 0 JOSEPH FRANK DIRECTOR / PRESIDENT 458658 0 50000 0 17598 0 69316 0 9005 0 604577 0 0 0 CLAIRE MOONEY SVP AND CHIEF OPERATING OFFICER 255965 0 83849 0 2496 0 37771 0 23213 0 403294 0 0 0 NICOLE LEHMAN INTERIM SEC. (PSU EMP) 0 261742 0 15000 0 0 0 70490 0 26766 0 373998 0 0 EDWARD CHABALOWSKI TREASURER / VP & CFO 0 287853 0 19712 0 5922 0 33897 0 17311 0 364695 0 0 ROSS DARROW VICE PRESIDENT, TREASURER 0 262516 0 25000 0 14362 0 38400 0 23219 0 363497 0 0 BARBARA ZUPPA VP, CHIEF NURSING OFFICER 189215 0 20577 0 4509 0 16463 0 14844 0 245608 0 0 0 MARK JAROWENKO VP OF MEDICAL AFFAIRS 180839 0 0 0 1860 0 10990 0 3968 0 197657 0 0 0 CHANHAK BINSANN STAFF PHARMACIST 117797 0 26062 0 800 0 17788 0 24138 0 186585 0 0 0 KIMBERLEE YOUNG PHARMACIST 148839 0 5440 0 2417 0 14047 0 3860 0 174603 0 0 0 BISRAT MULUGETA ACUTE CARE CLINICAL PHARMACIST 122620 0 20102 0 1366 0 15707 0 8565 0 168360 0 0 0 LISA HOWELL DIRECTOR OF SURGICAL SERVICES 137366 0 10635 0 1264 0 10945 0 7477 0 167687 0 0 0 ANNEMARIE BOYAN FMR SEC/PSH GC (PSU EMP) (THRU 2/22) 0 142089 0 0 0 0 0 7383 0 5311 0 154783 0 0 PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE CEO'S COMPENSATION: COMPENSATION FOR THE CEO (PRESIDENT) IS ESTABLISHED AND PAID BY A RELATED ORGANIZATION. THAT ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B DURING THE CALENDAR YEAR ENDING WITHIN THIS FISCAL YEAR ENDED JUNE 30, 2023, AN OFFICER PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE BELOW LISTED INDIVIDUAL VESTED IN THE PLAN IN A PRIOR YEAR; THEREFORE, CURRENT YEAR CONTRIBUTIONS ARE TAXABLE AND REPORTED ON SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION. - STEPHEN MASSINI - $165,523 DURING THE CALENDAR YEAR ENDING WITHIN THIS FISCAL YEAR ENDED JUNE 30, 2023, CERTAIN DIRECTORS AND OFFICERS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE BELOW LISTED INDIVIDUALS' CONTRIBUTIONS HAVE NOT YET VESTED; UNVESTED CONTRIBUTIONS ARE REPORTED ON SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION. - DEBORAH ADDO - $1,193 - PAULA TINCH - $63,773 - JUDITH HLAFCSAK - $23,230 - JOSEPH FRANK - $30,916 PART I, LINE 7 BONUSES, PAID BY THE FILING ORGANIZATION OR A RELATED ORGANIZATION THAT EMPLOYS THE INDIVIDUALS, ARE BASED ON A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOAL ACHIEVEMENTS AS WELL AS ORGANIZATION OPERATION ACHIEVEMENTS. THE FINAL DETERMINATION OF THE BONUS AMOUNT IS DETERMINED AND APPROVED BY THE APPLICABLE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF THE OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED. FORM 990, PART V, LINE 1A: FORMS 1096: FORM 1096 FOR THE FILING ORGANIZATION IS PROCESSED AND REPORTED BY ITS RELATED ORGANIZATION PENN STATE HEALTH (EIN: 47-3769205). FORM 990, PART VI, SECTION A, LINE 2 CERTAIN LISTED OFFICERS AND BOARD MEMBERS ALSO SERVE AS OFFICERS AND BOARD MEMBERS OF A TAXABLE ENTITY. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: THE FILING ORGANIZATION'S SOLE MEMBER IS PENN STATE HEALTH, A PENNSYLVANIA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ELECTING MEMBERS OF GOVERNING BODY: DIRECTORS SHALL BE ELECTED BY THE SOLE MEMBER. PURSUANT TO SPECIFICATIONS DEFINED IN THE BYLAWS, THE SOLE MEMBER MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS: PURSUANT TO SPECIFICATIONS DEFINED IN THE BYLAWS THE CORPORATE MEMBERS HAVE RESERVED POWERS. NOTWITHSTANDING ANY OTHER PROVISIONS OF THESE BYLAWS, THE SOLE MEMBER MUST APPROVE THE FOLLOWING ITEMS, AS APPLICABLE, BEFORE THEY MAY BE IMPLEMENTED BY THIS CORPORATION. THE SOLE MEMBER SHALL HAVE THE AUTHORITY: (A) TO DETERMINE THE NUMBER OF AND TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION; (B) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, AND TO DETERMINE THE COMPENSATION OF, THE PRESIDENT; (C) TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR AND VICE CHAIR OF THE BOARD, THE SECRETARY (INCLUDING ANY ASSISTANT OR ASSOCIATE SECRETARY), AND THE TREASURER (INCLUDING ANY ASSISTANT TREASURER); (D) TO APPROVE ANY AND ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (E) TO ADOPT OR MODIFY THE MISSION, VISION, OR OBJECTIVES OF THE CORPORATION; (F) TO ADOPT ALL LONG-RANGE AND STRATEGIC PLANS; (G) TO APPROVE ALL OPERATING AND CAPITAL BUDGETS; (H) TO APPROVE ALL UNBUDGETED CAPITAL EXPENDITURES AND ALL UNBUDGETED OPERATING EXPENDITURES IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER; (I) TO APPROVE THE INCURRENCE OF DEBT OR GUARANTEE OF INDEBTEDNESS FOR BORROWED MONEY, OR THE PLEDGE OR MORTGAGE OF ASSETS TO SECURE THE SAME AND TO ESTABLISH AN OBLIGATED GROUP FOR FINANCING PURPOSES; (J) TO DETERMINE ANNUAL DISTRIBUTIONS TO BE MADE TO OR FOR THE BENEFIT OF THE PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE AS ACADEMIC SUPPORT PAYMENTS; (K) TO REQUIRE THE CORPORATION TO PARTICIPATE IN A CENTRALIZED FINANCIAL AND CASH MANAGEMENT SYSTEM FOR PENN STATE HEALTH AND ONE OR MORE OF ITS CONTROLLED AFFILIATES (THE "SYSTEM"); (L) TO APPROVE ANY DONATION OR TRANSFER OF THE CORPORATION'S ASSETS IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER, OTHER THAN DONATIONS OR TRANSFERS TO THE SOLE MEMBER OR ANOTHER ENTITY IN THE SYSTEM, UNLESS AUTHORIZED IN THE CORPORATION'S APPROVED BUDGET; (M) TO APPROVE AND AUTHORIZE ADDITIONS AND ELIMINATIONS OF CLINICAL SERVICES OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF CLINICAL AND SUPPORT SERVICES ACROSS THE SYSTEM; (N) TO APPROVE THE CREATION OR DISSOLUTION OF, INVESTMENT IN, OR DISPOSITION OF ANY SUBSIDIARY OR JOINT VENTURE AND TO APPROVE ANY OTHER STRATEGIC ALIGNMENT OR FUNDAMENTAL CHANGE TRANSACTION, INCLUDING (I) JOINT OPERATING AGREEMENTS OR MANAGEMENT AGREEMENTS, (II) ACQUISITIONS, DISPOSITIONS OR TRANSFERS OF MATERIAL OPERATIONS, (III) CLOSURE OF FACILITIES, (IV) MERGERS, CONSOLIDATIONS, AND DIVISIONS, (V) THE SALE, PLEDGING, LEASING OR TRANSFER OF ASSETS WITH A VALUE IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER, AND (VI) THE LIQUIDATION OR DISSOLUTION OF THE CORPORATION; (O) TO ADOPT EMPLOYEE BENEFIT PLANS; (P) TO ADOPT OR APPROVE THE INVESTMENT POLICIES OF THE CORPORATION; (Q) TO SELECT AND APPOINT AUDITORS FOR, AND TO DESIGNATE THE FISCAL YEAR OF, THE CORPORATION; (R) TO RETAIN COUNSEL ON BEHALF OF AND SETTLE ANY LITIGATION AGAINST THE CORPORATION; (S) TO ENTER INTO SYSTEM-WIDE AGREEMENTS ON BEHALF OF THE CORPORATION; (T) TO ELECT TO EXERCISE, IN ITS DISCRETION, THE POWERS RESERVED TO THE CORPORATION BY ITS SUBSIDIARIES OR HELD BY THE CORPORATION AND/OR ITS SUBSIDIARIES WITH RESPECT TO JOINT VENTURES, IN WHICH CASE THE ACTION OF THE SOLE MEMBER SHALL TAKE PRECEDENCE OVER ANY ACTION OF THE BOARD OF DIRECTORS OF THIS CORPORATION; AND (U) EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, TO GIVE SUCH APPROVALS AND TAKE SUCH OTHER ACTIONS AS ARE SPECIFICALLY RESERVED TO THE MEMBERS OF A PENNSYLVANIA NONPROFIT CORPORATION UNDER THE PENNSYLVANIA NONPROFIT CORPORATION LAW OF 1988, AS AMENDED (THE "PENNSYLVANIA NONPROFIT CORPORATION LAW"). FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY: THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTING FIRM; IT IS REVIEWED BY ACCOUNTING/FINANCE DEPARTMENT PERSONNEL AND THE CHIEF FINANCIAL OFFICER, AND THEN DISTRIBUTED TO ALL MEMBERS OF THE BOARD FOR REVIEW AND COMMENT BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: THE FILING ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST (COI) POLICIES FOR OFFICERS, DIRECTORS, AND KEY EMPLOYEES (COVERED PERSONS). PER THE POLICY, NO COVERED PERSONS MAY ENGAGE IN ANY TRANSACTION OR ARRANGEMENT OR UNDERTAKE POSITIONS WITH OTHER ORGANIZATIONS THAT INVOLVE A CONFLICT OF INTEREST, EXCEPT IN COMPLIANCE WITH THE POLICY. EVERY COVERED PERSON SHALL DISCLOSE ALL ACTUAL AND POTENTIAL CONFLICTS THROUGH AN ANNUAL ONLINE DISCLOSURE STATEMENT AND AS MATTERS INVOLVING AN ACTUAL OR POTENTIAL CONFLICT ARISE. THE BOARD WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION OR ARRANGEMENT GIVING RISE TO THE POTENTIAL CONFLICT TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION OR ARRANGEMENT. A COVERED PERSON WHO HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH THE BOARD OF DIRECTORS OR A COMMITTEE IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE PRESENTATION TO THE BOARD OR COMMITTEE TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. THE FILING ORGANIZATION MAY ENTER INTO A TRANSACTION OR ARRANGEMENT IN WHICH A COVERED PERSON HAS AN ACTUAL CONFLICT OF INTEREST IF A MAJORITY OF DIRECTORS WHO HAVE NO INTEREST IN THE TRANSACTION OR ARRANGEMENT APPROVE THE TRANSACTION OR ARRANGEMENT AT A BOARD OR COMMITTEE MEETING AFTER DETERMINING THAT THE TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO THE CORPORATION, ANY COVERED PERSON WHO HAS A CONFLICT WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING SUCH TRANSACTION OR ARRANGEMENT (EXCEPT THAT THE COVERED PERSON MAY APPEAR AT A MEETING TO ANSWER QUESTIONS), AND IF THE TRANSACTION OR ARRANGEMENT INVOLVES COMPENSATION OR OTHER FINANCIAL BENEFIT TO THE COVERED PERSON, THE BOARD RELIES ON APPROPRIATE COMPARABILITY DATA TO DETERMINE REASONABLENESS. THE FILING ORGANIZATION WILL DOCUMENT THE FOREGOING IN THE MINUTES OF BOARD AND COMMITTEE MEETINGS, AS APPLICABLE. EACH COVERED PERSON MUST SIGN A STATEMENT THAT AFFIRMS THAT HE OR SHE HAS RECEIVED A COPY OF THE COI POLICY, HAS READ AND UNDERSTANDS IT, AND HAS AGREED TO COMPLY WITH IT. IF THE BOARD OF DIRECTORS HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO COMPLY WITH THE POLICY, THE BOARD MAY COUNSEL THE COVERED PERSON REGARDING SUCH FAILURE AND, IF THE ISSUE IS NOT RESOLVED TO THE BOARD'S SATISFACTION, MAY CONSIDER ADDITIONAL CORRECTIVE ACTION, INCLUDING REMOVAL FROM THE BOARD OF DIRECTORS OR OTHER POSITION WITH THE FILING ORGANIZATION, AS APPROPRIATE. FORM 990, PART VI, LINES 13 & 14: WHISTLEBLOWER POLICY AND DOCUMENT RETENTION/DESTRUCTION POLICY: THE FILING ORGANIZATION FOLLOWS THE WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY OF A RELATED ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15B PROCESS USED TO ESTABLISH COMPENSATION OF CEO, OFFICERS, AND KEY EMPLOYEES: THE FILING ORGANIZATION IS PART OF A MULTI-ENTITY HEALTH SYSTEM AND MAY OR MAY NOT DESIGNATE ONE OR MORE OF ITS EMPLOYEES AS A CEO (OR PRESIDENT), OFFICER, OR KEY EMPLOYEE. IF THE FILING ORGANIZATION DOES NOT DESIGNATE INDIVIDUALS TO THESE ROLES, THE ROLE IS HANDLED BY AN INDIVIDUAL FROM THE PARENT ENTITY, PENN STATE HEALTH, OR AN AFFILITATE. PENN STATE HEALTH HAS ESTABLISHED A SYSTEM-WIDE PROCESS FOR ESTABLISHING COMPENSATION AS FOLLOWS: ANNUALLY, THE COMPENSATION COMMITTEE OF THE PARENT BOARD ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT A COMPENSATION ANALYSIS FOR THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER (CEO), OFFICERS, AND KEY EMPLOYEES. AS PART OF THE ANALYSIS, THE INDEPENDENT COMPENSATION CONSULTANT IDENTIFIES, GATHERS, AND ANALYZES APPROPRIATE COMPARABILITY DATA UPON WHICH THE COMMITTEE AND THE FULL BOARD WILL RELY TO ASSESS THE REASONABLENESS OF THE TOTAL PROPOSED COMPENSATION (INCLUDING BENEFITS) OF THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION ANALYSIS IS COMPLETE AND DOCUMENTED IN REPORTS, THE REPORTS ARE PROVIDED TO THE BOARD FOR REVIEW AND CONSIDERATION, TOGETHER WITH WRITTEN OPINIONS FROM THE COMPENSATION CONSULTANT THAT THE PROPOSED COMPENSATION ARRANGEMENTS FOR THE CEO, OFFICERS, AND KEY EMPLOYEES ARE REASONABLE WITHIN THE MEANING OF TREASURY REGULATION 53.4958-4(B)(1)(II)(A). WITH INPUT FROM THE COMPENSATION COMMITTEE, THE FULL BOARD MAKES ANNUAL DECISIONS WITH RESPECT TO COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES BASED UPON THE DATA IN THE REPORT AND THE OPINION OF THE COMPENSATION CONSULTANT THAT THE PROPOSED COMPENSATION IS REASONABLE. THESE DECISIONS, THE BASIS FOR THESE DECISIONS, THE BOARD MEMBERS' NAMES WHO VOTE ON COMPENSATION, AND THAT NONE OF THE BOARD MEMBERS HAVE A CONFLICT OF INTEREST WITH RESPECT TO THESE COMPENSATION ARRANGEMENTS IS ALL CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF THE PENNSYLVANIA STATE UNIVERSITY AND ITS SUBSIDIARIES (WHICH INCLUDES PENN STATE HEALTH AND ITS AFFILIATES) ARE AVAILABLE AT WWW.PSU.EDU. FORM 990, PART VII: PART VII AND SCHEDULE J REFLECT CERTAIN DIRECTORS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THAT REMUNERATION FOR DIRECTORS WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF A RELATED ORGANIZATION, NOT FOR SERVICES RENDERED AS DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 4,035,690. MANAGEMENT AND GENERAL EXPENSES 492,450. TOTAL EXPENSES 4,528,140. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,805,407. MANAGEMENT AND GENERAL EXPENSES 586,118. TOTAL EXPENSES 3,391,525. CLINICAL SERVICES: PROGRAM SERVICE EXPENSES 7,621. TOTAL EXPENSES 7,621. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,346,467. MANAGEMENT AND GENERAL EXPENSES 6,278,951. TOTAL EXPENSES 7,625,418. CONSULTING FEES: PROGRAM SERVICE EXPENSES 53,531. MANAGEMENT AND GENERAL EXPENSES 191,131. TOTAL EXPENSES 244,662. ST JOSEPH REGIONAL HEALTH NETWORK 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 231352211 HEALTHCARE PA 501(C)(3) LINE 3 PSH 0 ST JOSEPH MEDICAL CENTER FOUNDATION 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 232649362 FUNDRAISING PA 501(C)(3) LINE 12A, I SJRHN 0 ST JOSEPH MEDICAL GROUP 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 208544021 HEALTHCARE PA 501(C)(3) LINE 10 PSH 0 THE PENNSYLVANIA STATE UNIVERSITY ONE OLD MAIN UNIVERSITY PARK PA 16802 246000376 EDUCATION PA 115 N/A 0 PENN STATE HEALTH 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 473769205 HEALTHCARE PA 501(C)(3) LINE 12A, I PSU 0 THE MILTON S HERSHEY MEDICAL CENTER 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 251854772 HEALTHCARE PA 115 PSH 0 PENN STATE HEALTH HAMPDEN MEDICAL CENTER 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 851608328 HEALTHCARE PA 501(C)(3) LINE 3 PSH 0 PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 231512747 HEALTHCARE PA 501(C)(3) LINE 3 PSH 0 HOLY SPIRIT CORPORATION 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 232214540 REAL ESTATE PA 501(C)(2) PSHHSMC 0 SPIRIT PHYSICIAN SERVICES INC 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 251766971 PHYSICIAN SERVICES PA 501(C)(3) LINE 10 PSH 0 HERSHEY OUTPATIENT SURGERY CENTER LP 15305 DALLAS PKWY ADDISON TX 75001 HEALTHCARE PA NITTANY HLTH 0 0 NITTANY HEALTH - VALUEHEALTH JOINT 11221 ROE AVE LEAWOOD KS 66211 851154159 HEALTHCARE PA NITTANY HLTH 0 0 NITTANY HEALTH INC 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 251769611 HOMECARE INTEGRTN PA N/A C 0 CGH REALTY CO INC 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 232326801 REAL ESTATE PA N/A C 0 HOLY SPIRIT VENTURES INC 100 CRYSTAL A DRIVE MC CA210 HERSHEY PA 17033 232407709 REAL ESTATE PA N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 SUPPLEMENTAL INFORMATION: SCHEDULE R LISTS ONLY THOSE RELATED ORGANIZATIONS THAT RELATE TO THE HEALTH CARE OPERATIONS UNDER THE COMMON CONTROL OF THE PENNSYLVANIA STATE UNIVERSITY.