2024-05-14T09:04:50-05:00 2023-06-30 990 2022-07-01 520738041 HOLY CROSS HEALTH INC HOLY 3017547000 1500 FOREST GLEN ROAD SILVER SPRING MD 209101484 JULIE KEESE VICE PRESIDENT AND CFO 3017547000 2024-05-14 JULIE KEESE 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O DOUGLAS STRONG 1500 FOREST GLEN ROAD SILVER SPRING MD 209101484 681972745 0 X WWW.HOLYCROSSHEALTH.ORG X 1959 MD TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 15 12 4843 466 2413182 25086 6192841 8548299 658452314 648850197 21183721 13756810 11382145 10429910 697211021 681585216 385590 391779 0 0 352818794 364118051 0 0 0 331932221 331328936 685136605 695838766 12074416 -14253550 1062516102 1084380152 506977734 514770284 555538368 569609868 X WE, HOLY CROSS HEALTH AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. WE CARRY OUT THIS MISSION IN OUR COMMUNITIES THROUGH OUR COMMITMENT TO BE THE MOST TRUSTED PROVIDER OF HEALTH CARE SERVICES. 0 0 610439225 391779 651328083 HOLY CROSS HEALTH IS A NOT-FOR-PROFIT HEALTH SYSTEM IN MONTGOMERY COUNTY, MD., DEDICATED TO IMPROVING THE HEALTH OF ITS COMMUNITY FOR MORE THAN 60 YEARS. HOLY CROSS SERVES OVER 160,000 PATIENTS EACH YEAR THROUGH A FULL RANGE OF INPATIENT, OUTPATIENT AND INNOVATIVE COMMUNITY-BASED SERVICES. HOLY CROSS HAS GROWN FROM A SINGLE HOSPITAL LOCATED IN SILVER SPRING, MD., INTO A SYSTEM OF HOSPITALS AND HEALTH CENTERS IN LOCATIONS THROUGHOUT THE COMMUNITY. HOLY CROSS GERMANTOWN HOSPITAL OPENED OCTOBER 1, 2014 AND IS THE FIRST HOSPITAL IN THE NATION TO BE LOCATED ON A COLLEGE CAMPUS. CARE IS ENHANCED BY AN EDUCATIONAL PARTNERSHIP, AND INCLUDES HIGH-QUALITY MEDICAL, SURGICAL, OBSTETRIC, EMERGENCY, AND BEHAVIORAL HEALTH SERVICES. HOLY CROSS HEALTH CENTERS ARE LOCATED IN SILVER SPRING, GAITHERSBURG, GERMANTOWN AND ASPEN HILL.FOR MORE INFORMATION SEE SCHEDULE H AND THE HOSPITAL WEBSITE: WWW.HOLYCROSSHEALTH.ORG. 610439225 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 473 0 1 4843 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 1 1 MD X JULIE KEESE - VP AND CFO 3017547201 1500 FOREST GLEN RD SILVER SPRING MD 20910 NORVELL COOTS MD DIRECTOR; PRESIDENT & CEO 54.00 1.00 X X 0 929927 43070 DOUG RYDER FORMER OFFICER 0.00 0.00 X 0 484254 344322 GREG JOLISSAINT VP MILITARY & VET HEALTH THR 8/22 50.00 0.00 X 0 450025 247534 LOUIS DAMIANO MD PRESIDENT OF HCH & HCGH 55.00 0.00 X 0 627506 57323 TINA WEATHERWAX-GRANT DIR; TH SVP PUBLIC POLICY & ADVOCACY 1.00 49.00 X 0 526695 142670 KRISTIN FELICIANO VP CHIEF STRATEGY OFFICER THR 10/22 50.00 0.00 X 0 376364 290837 RINY KARRAS MD THORACIC SURGEON 50.00 0.00 X 514639 0 20829 GRIFFIN DAVIS MD CHIEF CLINICAL OFFICER 50.00 0.00 X 0 478148 53559 ANNICE CODY PRESIDENT HCH NETWORK 50.00 0.00 X 0 414409 57371 ANN BURKE HCH VP MEDICAL AFFAIRS THROUGH 12/22 50.00 0.00 X 429673 0 41356 ELIZABETH SIMPSON ASST SECRETARY; VP MANAGING COUNSEL 49.00 1.00 X 0 387261 47670 ANNE GILLIS ASSISTANT TREASURER & CFO 49.00 1.00 X 0 380718 49745 RHONIQUE SHIELDS HCH NETWORK VP MEDICAL AFFAIRS 50.00 0.00 X 392648 0 34793 DOUGLAS MURPHY MD DIRECTOR, ON CALL PHYSICIAN 5.00 0.00 X 100200 0 0 THOMAS MCELROY DIRECTOR & CHAIR THROUGH 12/22 1.00 0.00 X X 0 0 0 AJAY GUPTA DIR;V CHAIR THR 12/22;CHAIR AT 1/23 1.00 0.00 X X 0 0 0 CARMEN LARSEN DIRECTOR; TREASURER 1.00 0.00 X X 0 0 0 ELSBETH MULVANEY CSC DIR; SEC THR 12/22;V CHAIR AT 1/23 1.00 0.00 X X 0 0 0 UMA AHLUWALIA DIRECTOR 1.00 0.00 X 0 0 0 ROSE BLACKBURNE MD DIRECTOR AS OF 1/23 1.00 0.00 X 0 0 0 SHARON FRIEDMAN DIRECTOR THROUGH 12/22 1.00 0.00 X 0 0 0 DAVID ANTHONY HILL DIRECTOR 1.00 0.00 X 0 0 0 MARGARETIA JACKSON DIRECTOR AS OF 1/23 1.00 0.00 X 0 0 0 ROBIN MADDEN MD DIRECTOR 1.00 0.00 X 0 0 0 MARC POTASH DIRECTOR 1.00 0.00 X 0 0 0 ERIC SCHOOMAKER MD DIRECTOR 1.00 0.00 X 0 0 0 SHARLET WAGNER CSC DIRECTOR 1.00 0.00 X 0 0 0 JACQUELINE WATSON DO DIRECTOR 1.00 0.00 X 0 0 0 1437160 5055307 1431079 980 1 1 0 HALLMARK HEALTH CARE SOLUTIONS INC PO BOX 22937 NEW YORK NY 10087 TEMPORARY MEDICAL STAFFING SERVICES 24185711 WHITING TURNER CONTRACTING CO PO BOX 17596 BALTIMORE MD 21297 CONSTRUCTION SERVICES 12288404 KAISER PERMANENTE 1 KAISER PLAZA OAKLAND CA 94612 HEALTH CARE SERVICES 4507378 DIAGNOSTIC MED IMAGING PO BOX 3507 SILVER SPRING MD 209183507 CLINICAL SERVICES 2308114 CHILDRENS NATL MED 12211 PLUM ORCHARD DR STE 200 SILVER SPRING MD 20904 CLINICAL SERVICES 2241118 149 1402345 6892880 253074 8548299 NET PATIENT SERVICE REVENUE 622110 648850197 646437015 2413182 648850197 8554673 8554673 1241345 0 1241345 1241345 1241345 5013531 576135 0 387529 5013531 188606 5202137 5202137 CAFETERIA REVENUE 722514 2884527 2884527 RADIATION TREATMENT CENTER 622110 2314165 2314165 PARKING 812930 1412970 1412970 2576903 2576903 9188565 681585216 651328083 2413182 19295652 X 266196 266196 125583 125583 3626907 100200 3526707 502878 502878 298858794 281337032 17521762 14727390 13801052 926338 24733447 23196093 1537354 21668635 20426999 1241636 2098767 2098767 224075 224075 91751 91751 75000 75000 657229 657229 78768044 68665737 10102307 1131918 23206 1108712 3452581 2139864 1312717 25899530 20612245 5287285 16685390 14666039 2019351 670016 664616 5400 183971 177625 6346 15156576 15156576 32110330 15607234 16503096 7604958 344875 7260083 MEDICAL SUPPLIES 91557731 91557731 BAD DEBT EXPENSE 27562267 27562267 INTERCO PURCHASED SVCS 15487433 3446252 12041181 EQUIPMENT MAINTENANCE 7941063 7893672 47391 3970306 569364 3400942 695838766 610439225 85399541 0 154356 70080 58677 55495 98798447 86810856 13378650 12937303 3108798 2473963 834392143 421958832 411126744 412433311 252483837 243264522 167376883 187249409 739513 8509665 115290197 130575548 1062516102 1084380152 78663081 81585066 5597519 2798011 2362763 2442226 420354371 427944981 506977734 514770284 X 555438323 569529336 100045 80532 555538368 569609868 1062516102 1084380152 X -14253550 17877875 10447175 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 31070 1 75000 0 0 106070 0 PART II-B, LINE 1: HOLY CROSS HEALTH HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED HOLY CROSS HEALTH WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. MARYLAND HOSPITAL ASSOCIATION - $8,263 CATHOLIC HOSPITAL ASSOCIATION - $4,866 AMERICAN HOSPITAL ASSOCIATION - $2,913 PROFESSIONAL ORGANIZATIONS - $15,028 TOTAL - $31,070 ORGANIZATION EMPLOYEES ALSO ENGAGE IN ADVOCACY ON ISSUES RELATED TO HEALTH CARE AND HEALTH CARE PROVIDERS. SUCH ACTIVITIES CONSIST OF WRITTEN AND VERBAL COMMUNICATIONS WITH FEDERAL, STATE AND LOCAL ELECTED OFFICIALS AND GOVERNMENT AGENCIES. HOLY CROSS HEALTH ALSO PAID A THIRD PARTY LOBBYING FIRM DURING THE YEAR TO LOBBY FOR OR AGAINST LEGISLATION DETERMINED TO BE OF INTEREST TO HOLY CROSS HEALTH. 100045 -19513 80532 83951 16094 100045 54184 29767 83951 59668 -5484 54184 58397 1271 59668 1.00000 0 0 493418 493418 636479736 281176664 355303072 25292 2845 22447 192797841 140779323 52018518 4595856 4595856 412433311 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 35564533 F EQUITY METHOD INVESTMENTS 124261622 C HEDGE FUNDS 27423254 F 187249409 MISCELLANEOUS RECEIVABLES 1035539 INTERCOMPANY ACCOUNTS RECEIVABLE 15172128 INVESTMENT IN UNCONSOL. AFFILIATES 61938682 INTERCOMPANY OTHER LT ASSETS 37837024 OPERATING LEASE RIGHT-OF-USE ASSETS 7798524 OTHER LONG TERM ASSETS 6793651 130575548 INTERCOMPANY ACCOUNTS PAYABLE 18925266 DEFERRED COMPENSATION LIABILITY 1945048 ASSET RETIREMENT OBLIGATION (ASC 410) 412886 OTHER LIABILITIES 13572538 INTERCOMPANY NOTES PAYABLE 365525102 GUARANTEES 13502915 LEASE LIABILITIES 14061226 427944981 PART V, LINE 4: THE PURPOSE OF THE LOUIS GALDIERI, M.D. MEMORIAL FUND ENDOWMENT IS TO PROVIDE AN AWARD TO A STUDENT(S) OF THE HOLY CROSS HOSPITAL SCHOOL OF RADIOLOGIC TECHNOLOGY WHO EXEMPLIFIES THE VALUES OF THE SCHOOL THROUGH TEAMWORK, INITIATIVE, CONCERN FOR OTHERS AND SCIENTIFIC CURIOSITY. 1 1 X 1 X 1 X 1 1 0 1 1 38092082 18587384 19504698 0.02920 153018708 151381225 1637483 0.00250 191110790 169968609 21142181 0.03170 55 157496 7285823 891033 6394790 0.00960 2 785 3452031 3452031 0.00520 12 89673 14341915 1813349 12528566 0.01870 2 730 246145 15525 230620 0.00030 2 185646 154160 31486 0.00000 73 248684 25511560 2874067 22637493 0.03380 73 248684 216622350 172842676 43779674 0.06550 1 27562267 0 130791945 131111160 -319215 X 1 1 2 1 HOLY CROSS HOSPITAL 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 WWW.HOLYCROSSHEALTH.ORG MARYLAND LICENSE # 15-016 X X X X 2 HOLY CROSS GERMANTOWN HOSPITAL 19801 OBSERVATION DRIVE GERMANTOWN MD 20876 WWW.HOLYCROSSHEALTH.ORG MARYLAND LICENSE #015-080 X X X X HOLY CROSS HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 22 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 HOLY CROSS GERMANTOWN HOSPITAL 2 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 22 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 HOLY CROSS HOSPITAL PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: HOLY CROSS HOSPITAL (HCH) INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. ACCESS TO CARE (MENTAL HEALTH PROVIDERS; PRIMARY CARE PROVIDERS; AND LACK OF INSURANCE)2. HEALTHY BEHAVIORS (FOOD INSECURITY; ADULT OBESITY; AND PHYSICAL INACTIVITY)3. EDUCATION, INCOME, JOB, AND ENVIRONMENT (WORKFORCE/LABOR SHORTAGES; INCOME INEQUALITY; AND HOUSING COST BURDEN) HOLY CROSS GERMANTOWN HOSPITAL PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: HOLY CROSS GERMANTOWN HOSPITAL (HCGH) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. ACCESS TO CARE (MENTAL HEALTH PROVIDERS; PRIMARY CARE PROVIDERS; AND LACK OF INSURANCE)2. HEALTHY BEHAVIORS (FOOD INSECURITY; ADULT OBESITY; AND PHYSICAL INACTIVITY)3. EDUCATION, INCOME, JOB, AND ENVIRONMENT (WORKFORCE/LABOR SHORTAGES; INCOME INEQUALITY; AND HOUSING COST BURDEN) HOLY CROSS HOSPITAL PART V, SECTION B, LINE 5: HCH AND HCGH AGAIN COLLABORATED WITH OTHER HEALTH CARE PROVIDERS TO SUPPORT HEALTHY MONTGOMERY, MONTGOMERY COUNTY'S COMMUNITY HEALTH IMPROVEMENT PROCESS. GUIDANCE WAS PROVIDED FROM A PANEL OF EXTERNAL PARTICIPANTS WITH EXPERTISE IN PUBLIC HEALTH AND INSIGHT INTO THE NEEDS OF OUR COMMUNITY. IN 2015, THROUGH HEALTHY MONTGOMERY, THE MONTGOMERY COUNTY HEALTH SYSTEMS/HOSPITALS (ADVENTIST HEALTHCARE, HOLY CROSS HEALTH, MEDSTAR HEALTH, AND SUBURBAN HOSPITAL) BEGAN MEETING AS A SUBGROUP TO LEVERAGE COMMUNITY BENEFIT RESOURCES, IDENTIFY OVERLAPPING IMPLEMENTATION STRATEGIES, AND DECREASE DUPLICATION OF EFFORTS. IN 2021, THE MONTGOMERY COUNTY HOSPITALS, THROUGH THE MONTGOMERY COUNTY HOSPITAL COLLABORATIVE (MCHC), FURTHER ADVANCED THEIR DEDICATION TO COLLECTIVE IMPACT BY BEGINNING THE DEVELOPMENT OF A JOINT CHNA AND IMPLEMENTATION STRATEGY.THE 2022 MCHC CHNA RELIED ON MULTIPLE RESOURCES TO IDENTIFY THE UNMET HEALTH NEEDS OF THE PEOPLE WE SERVE, INCLUDING: FEDERAL, STATE, AND LOCAL HEALTH SURVEILLANCE DATA SETS; EXTERNAL ADVISORY GROUPS COMPRISING OF OFFICERS FROM STATE AND LOCAL GOVERNMENT AGENCIES AND LEADERS FROM COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, FAITH-BASED ORGANIZATIONS, COLLEGES, COALITIONS, AND ASSOCIATIONS; A 19-QUESTION CHNA SURVEY COMPLETED IN 2021; COMMUNITY CONVERSATIONS AND KEY INFORMANT INTERVIEWS; AND EXISTING NEEDS ASSESSMENTS FROM LOCAL HEALTH INITIATIVES, GOVERNMENT AGENCIES, AND NON-PROFIT COMMUNITY HEALTH ORGANIZATIONS.A QUESTIONNAIRE WAS DESIGNED TO SEEK INPUT FROM THE COMMUNITY FOR THE 2022 CHNA AND UNDERSTAND THE HEALTH PRIORITIES, BARRIERS TO CARE, AND HEALTH BEHAVIOR PREVALENCE IN THE MCHC DEFINED COMMUNITY BENEFIT SERVICE AREA (CBSA). DUE TO COVID-19 RESTRICTIONS AND TO HELP WIDEN OUR REACH, THE QUESTIONNAIRE WAS AVAILABLE ELECTRONICALLY IN BOTH ENGLISH AND SPANISH FROM OCTOBER 2021 TO MARCH 2022. TO REACH COMMUNITY STAKEHOLDERS, THE MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, THE QUESTIONNAIRE WAS DISTRIBUTED VIA VARIOUS CHANNELS, INCLUDING COMMUNITY CLASSES, HOSPITAL'S COMMUNITY NEWSLETTERS, VACCINATION AND SAFETY-NET CLINICS, AND MORE THAN 80 COMMUNITY PARTNERS. A TOTAL OF 488 ADULTS WHO RESIDE IN THE 2022 CHNA CBSA RESPONDED TO THE SURVEY. RESPONDENTS SELF-IDENTIFIED AS NON-HISPANIC WHITE (63%), WOMEN (82%), AND OVER THE AGE OF 55 (65%). ETHNIC AND RACIAL MINORITIES ACCOUNTED FOR 38% OF THE ELIGIBLE RESPONSES. AFRICAN AMERICANS/BLACKS (14%) WERE THE SECOND MOST COMMON GROUP TO PARTICIPATE IN THE SURVEY. LATINOS/HISPANICS ACCOUNTED FOR 13% OF RESPONDENTS AND ASIANS FOR 7%. THE LATINO/HISPANIC RESPONDENTS MOST OFTEN REPORTED THEIR RACE AS WHITE (53%), OTHER (27%), OR PREFERRED NOT TO ANSWER (11%). IN ADDITION TO THE COMMUNITY SURVEY, HCH AND HCGH OBTAINED ADVICE FROM EXTERNAL PARTICIPANTS THAT REPRESENT THE INTERESTS OF THE COMMUNITIES WE SERVE. THIS EXTERNAL REVIEW COMMITTEE REVIEWS OUR COMMUNITY BENEFIT PLAN, ANNUAL WORK PLAN, FOUNDATION/KEY BACKGROUND MATERIAL, AND DATA SUPPLEMENTS TO ADVISE US ON PRIORITY COMMUNITY NEEDS AND THE DIRECTION TO TAKE FOR THE FOLLOWING YEAR. EXTERNAL GROUP PARTICIPANTS INCLUDE THE PUBLIC HEALTH OFFICER AND THE DIRECTOR OF THE MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES; A VARIETY OF INDIVIDUALS FROM LOCAL AND STATE GOVERNMENTAL AGENCIES; AND LEADERS FROM COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES, COALITIONS, AND ASSOCIATIONS. THESE PARTICIPANTS ARE EXPERTS IN A RANGE OF AREAS, INCLUDING PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, SOCIAL DETERMINANTS OF HEALTH, HEALTH CARE, AND SOCIAL SERVICES. ON JUNE 2, 2022, THE EXTERNAL REVIEW COMMITTEE MET TO PROVIDE INPUT ON EXISTING AND EMERGING COMMUNITY NEEDS FOR THE CURRENT CHNA. ORGANIZATIONS REPRESENTING MULTIPLE LOW-INCOME, MINORITY, MEDICALLY UNDERSERVED, AND SENIOR COMMUNITIES WITHIN OUR CBSA WERE SOLICITED FOR INPUT INCLUDING: THE MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE MONTGOMERY COUNTY DEPARTMENT OF RECREATION, THE GAITHERSBURG-GERMANTOWN CHAMBER OF COMMERCE, UNITED WAY OF THE NATIONAL CAPITAL AREA, IMPACT SILVER SPRING, MONTGOMERY COLLEGE, UNIVERSITY OF MARYLAND SCHOOL OF PUBLIC HEALTH, AND CROSS COMMUNITY. HOLY CROSS GERMANTOWN HOSPITAL PART V, SECTION B, LINE 5: HCH AND HCGH AGAIN COLLABORATED WITH OTHER HEALTH CARE PROVIDERS TO SUPPORT HEALTHY MONTGOMERY, MONTGOMERY COUNTY'S COMMUNITY HEALTH IMPROVEMENT PROCESS. GUIDANCE WAS PROVIDED FROM A PANEL OF EXTERNAL PARTICIPANTS WITH EXPERTISE IN PUBLIC HEALTH AND INSIGHT INTO THE NEEDS OF OUR COMMUNITY. IN 2015, THROUGH HEALTHY MONTGOMERY, THE MONTGOMERY COUNTY HEALTH SYSTEMS/HOSPITALS (ADVENTIST HEALTHCARE, HOLY CROSS HEALTH, MEDSTAR HEALTH, AND SUBURBAN HOSPITAL) BEGAN MEETING AS A SUBGROUP TO LEVERAGE COMMUNITY BENEFIT RESOURCES, IDENTIFY OVERLAPPING IMPLEMENTATION STRATEGIES, AND DECREASE DUPLICATION OF EFFORTS. IN 2021, THE MONTGOMERY COUNTY HOSPITALS, THROUGH THE MONTGOMERY COUNTY HOSPITAL COLLABORATIVE (MCHC), FURTHER ADVANCED THEIR DEDICATION TO COLLECTIVE IMPACT BY BEGINNING THE DEVELOPMENT OF A JOINT CHNA AND IMPLEMENTATION STRATEGY.THE 2022 MCHC CHNA RELIED ON MULTIPLE RESOURCES TO IDENTIFY THE UNMET HEALTH NEEDS OF THE PEOPLE WE SERVE, INCLUDING: FEDERAL, STATE, AND LOCAL HEALTH SURVEILLANCE DATA SETS; EXTERNAL ADVISORY GROUPS COMPRISING OF OFFICERS FROM STATE AND LOCAL GOVERNMENT AGENCIES AND LEADERS FROM COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, FAITH-BASED ORGANIZATIONS, COLLEGES, COALITIONS, AND ASSOCIATIONS; A 19-QUESTION CHNA SURVEY COMPLETED IN 2021; COMMUNITY CONVERSATIONS AND KEY INFORMANT INTERVIEWS; AND EXISTING NEEDS ASSESSMENTS FROM LOCAL HEALTH INITIATIVES, GOVERNMENT AGENCIES, AND NON-PROFIT COMMUNITY HEALTH ORGANIZATIONS.A QUESTIONNAIRE WAS DESIGNED TO SEEK INPUT FROM THE COMMUNITY FOR THE 2022 CHNA AND UNDERSTAND THE HEALTH PRIORITIES, BARRIERS TO CARE, AND HEALTH BEHAVIOR PREVALENCE IN THE MCHC DEFINED CBSA. DUE TO COVID-19 RESTRICTIONS AND TO HELP WIDEN OUR REACH, THE QUESTIONNAIRE WAS AVAILABLE ELECTRONICALLY IN BOTH ENGLISH AND SPANISH FROM OCTOBER 2021 TO MARCH 2022. TO REACH COMMUNITY STAKEHOLDERS, THE MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, THE QUESTIONNAIRE WAS DISTRIBUTED VIA VARIOUS CHANNELS, INCLUDING COMMUNITY CLASSES, HOSPITAL'S COMMUNITY NEWSLETTERS, VACCINATION AND SAFETY-NET CLINICS, AND MORE THAN 80 COMMUNITY PARTNERS. A TOTAL OF 488 ADULTS WHO RESIDE IN THE 2022 CHNA CBSA RESPONDED TO THE SURVEY. RESPONDENTS SELF-IDENTIFIED AS NON-HISPANIC WHITE (63%), WOMEN (82%), AND OVER THE AGE OF 55 (65%). ETHNIC AND RACIAL MINORITIES ACCOUNTED FOR 38% OF THE ELIGIBLE RESPONSES. AFRICAN AMERICANS/BLACKS (14%) WERE THE SECOND MOST COMMON GROUP TO PARTICIPATE IN THE SURVEY. LATINOS/HISPANICS ACCOUNTED FOR 13% OF RESPONDENTS AND ASIANS FOR 7%. THE LATINO/HISPANIC RESPONDENTS MOST OFTEN REPORTED THEIR RACE AS WHITE (53%), OTHER (27%), OR PREFERRED NOT TO ANSWER (11%). IN ADDITION TO THE COMMUNITY SURVEY, HCH AND HCGH OBTAINED ADVICE FROM EXTERNAL PARTICIPANTS THAT REPRESENT THE INTERESTS OF THE COMMUNITIES WE SERVE. THIS EXTERNAL REVIEW COMMITTEE REVIEWS OUR COMMUNITY BENEFIT PLAN, ANNUAL WORK PLAN, FOUNDATION/KEY BACKGROUND MATERIAL, AND DATA SUPPLEMENTS TO ADVISE US ON PRIORITY COMMUNITY NEEDS AND THE DIRECTION TO TAKE FOR THE FOLLOWING YEAR. EXTERNAL GROUP PARTICIPANTS INCLUDE THE PUBLIC HEALTH OFFICER AND THE DIRECTOR OF THE MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES; A VARIETY OF INDIVIDUALS FROM LOCAL AND STATE GOVERNMENTAL AGENCIES; AND LEADERS FROM COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES, COALITIONS, AND ASSOCIATIONS. THESE PARTICIPANTS ARE EXPERTS IN A RANGE OF AREAS, INCLUDING PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, SOCIAL DETERMINANTS OF HEALTH, HEALTH CARE, AND SOCIAL SERVICES. ON JUNE 2, 2022, THE EXTERNAL REVIEW COMMITTEE MET TO PROVIDE INPUT ON EXISTING AND EMERGING COMMUNITY NEEDS FOR THE CURRENT CHNA. ORGANIZATIONS REPRESENTING MULTIPLE LOW-INCOME, MINORITY, MEDICALLY UNDERSERVED, AND SENIOR COMMUNITIES WITHIN OUR CBSA WERE SOLICITED FOR INPUT INCLUDING: THE MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE MONTGOMERY COUNTY DEPARTMENT OF RECREATION, THE GAITHERSBURG-GERMANTOWN CHAMBER OF COMMERCE, UNITED WAY OF THE NATIONAL CAPITAL AREA, IMPACT SILVER SPRING, MONTGOMERY COLLEGE, UNIVERSITY OF MARYLAND SCHOOL OF PUBLIC HEALTH, AND CROSS COMMUNITY. HOLY CROSS HOSPITAL PART V, SECTION B, LINE 6A: HOLY CROSS HOSPITAL CONDUCTED ITS CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: HOLY CROSS GERMANTOWN HOSPITAL, SUBURBAN HOSPITAL, MEDSTAR MONTGOMERY MEDICAL CENTER, ADVENTIST HEALTHCARE WHITE OAK MEDICAL CENTER (FORMERLY WASHINGTON ADVENTIST HOSPITAL), AND SHADY GROVE ADVENTIST HOSPITAL. HOLY CROSS GERMANTOWN HOSPITAL PART V, SECTION B, LINE 6A: HOLY CROSS GERMANTOWN HOSPITAL CONDUCTED ITS CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: HOLY CROSS HOSPITAL, SUBURBAN HOSPITAL, MEDSTAR MONTGOMERY MEDICAL CENTER, ADVENTIST HEALTHCARE WHITE OAK MEDICAL CENTER (FORMERLY WASHINGTON ADVENTIST HOSPITAL), AND SHADY GROVE ADVENTIST HOSPITAL. HOLY CROSS HOSPITAL PART V, SECTION B, LINE 6B: AS MEMBERS OF HEALTHY MONTGOMERY, MONTGOMERY COUNTY'S COMMUNITY HEALTH IMPROVEMENT PROCESS, HCH COLLABORATED WITH THE FOLLOWING ORGANIZATIONS TO CONDUCT THEIR CHNA: MANNA FOOD SERVICES, MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, PRIMARY CARE COALITION OF MONTGOMERY COUNTY, MONTGOMERY COUNTY DEPARTMENT OF PLANNING, AFRICAN AMERICAN HEALTH PROGRAM, ASIAN AMERICAN HEALTH INITIATIVE, LATINO HEALTH INITIATIVE, MONTGOMERY COUNTY PUBLIC SCHOOLS, MONTGOMERY COUNTY RECREATION DEPARTMENT, MONTGOMERY COUNTY DEPARTMENT OF TRANSPORTATION, MONTGOMERY PARKS, MONTGOMERY COUNTY COLLABORATION, COMMISSION ON HEALTH, AND UNITEDHEALTH CARE COMMUNITY PLAN MCO. HOLY CROSS GERMANTOWN HOSPITAL PART V, SECTION B, LINE 6B: AS MEMBERS OF HEALTHY MONTGOMERY, MONTGOMERY COUNTY'S COMMUNITY HEALTH IMPROVEMENT PROCESS, HCGH COLLABORATED WITH THE FOLLOWING ORGANIZATIONS TO CONDUCT THEIR CHNA: MANNA FOOD SERVICES, MONTGOMERY COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, PRIMARY CARE COALITION OF MONTGOMERY COUNTY, MONTGOMERY COUNTY DEPARTMENT OF PLANNING, AFRICAN AMERICAN HEALTH PROGRAM, ASIAN AMERICAN HEALTH INITIATIVE, LATINO HEALTH INITIATIVE, MONTGOMERY COUNTY PUBLIC SCHOOLS, MONTGOMERY COUNTY RECREATION DEPARTMENT, MONTGOMERY COUNTY DEPARTMENT OF TRANSPORTATION, MONTGOMERY PARKS, MONTGOMERY COUNTY COLLABORATION, COMMISSION ON HEALTH, AND UNITEDHEALTH CARE COMMUNITY PLAN MCO. HOLY CROSS HOSPITAL PART V, SECTION B, LINE 11: HOLY CROSS HEALTH INCLUDES TWO HOSPITAL FACILITIES, HOLY CROSS HOSPITAL AND HOLY CROSS GERMANTOWN HOSPITAL. BOTH HOSPITALS WORK TOGETHER TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA. HOLY CROSS HEALTH ADDRESSES THE UNMET NEEDS OF OUR COMMUNITY IN ACCORDANCE WITH OUR MISSION AND IN ALIGNMENT WITH THE FINDINGS OF OUR CHNA AND THE PRIORITIES OF HEALTHY MONTGOMERY. KEY FINDINGS FROM ALL DATA SOURCES WERE REVIEWED, AND THE MOST PRESSING NEEDS WERE INCORPORATED INTO A MULTI-YEAR IMPLEMENTATION STRATEGY, ADDRESSING THE NEEDS OF THE MOST VULNERABLE AND UNDERSERVED INDIVIDUALS AND FAMILIES.WE ALSO SCREEN PATIENTS AND COMMUNITY MEMBERS FOR SOCIAL NEEDS AND DEVELOP PROGRAMS TO ADDRESS IDENTIFIED TOP NEEDS. THE ACCOUNTABLE HEALTHY COMMUNITIES PROGRAM, WHICH RAN FROM JULY 2022 THROUGH JANUARY 2023, PROVIDED SOCIAL NEEDS SCREENINGS TO 2,324 PATIENTS AND FOLLOWED UP WITH 316 PATIENTS WITH SOCIAL NEEDS. THE HEALTH CENTERS PROVIDED SOCIAL NEEDS SCREENINGS TO 73% OF HEALTH CENTER PATIENTS, A 57% IMPROVEMENT FROM THE BEGINNING OF THE FISCAL YEAR. THROUGH THE NEXUS CONNECT PROGRAM, A TELEHEALTH NAVIGATOR ADDRESSED SOCIAL NEEDS FOR 90 COMMUNITY MEMBERS REFERRED TO THE HEALTH CENTER. IN THE COMMUNITY, THE ROAD TO HEALTH PROGRAM REFERRED 80 COMMUNITY MEMBERS TO PRIMARY CARE AND PROVIDED LINKS TO ADDITIONAL COMMUNITY RESOURCES. THE HOLY CROSS HEALTH COLLEAGUE SOCIAL NEEDS PROGRAM CONNECTED COLLEAGUES IN NEED OF HEALTH CARE SERVICES AND WORKED WITH COLLEAGUES WHO NEEDED TO SEE A PHYSICIAN BUT COULD NOT.BELOW ARE THREE PROGRAM EXAMPLES FOR EACH CHNA PRIORITY AREA:ACCESS TO CARE:MENTAL HEALTH PROVIDERS - HOLY CROSS HEALTH CENTER BEHAVIORAL HEALTH SERVICES WERE ESTABLISHED TO MEET THE GROWING NEED FOR MENTAL HEALTH PROVIDERS, 57.6% (781/1335) OF HOLY CROSS HEALTH CENTER PATIENTS AND 83.2% (3664/4405) OF HOLY CROSS HEALTH PARTNER PATIENTS RECEIVED DEPRESSION SCREENINGS DURING THEIR PRIMARY CARE VISITS; 98 PATIENTS WERE REFERRED TO MINDOULA. PRIMARY CARE PROVIDERS - HOLY CROSS HEALTH CENTERS AND OB/GYN CLINICS PROVIDE PRIMARY CARE SERVICES TO LOW-INCOME PATIENTS WHO ARE UNINSURED OR ENROLLED IN MARYLAND PHYSICIANS CARE AND OPERATE ON A SLIDING SCALE (FOR PATIENTS UNDER 250% FEDERAL POVERTY LEVEL (FPL) THE FEE IS $30, FROM 251%-300% FPL THE FEE IS $45, AND OVER 301% FPL THE FEE IS $60). IN FISCAL YEAR 2023 (FY23), THERE WERE 35,418 TOTAL PATIENTS AT THE HOLY CROSS HEALTH CENTERS AND 67 NEW PATIENT NEWBORN VISITS AT HOLY CROSS HEALTH CENTER IN GAITHERSBURG. IN FY23, THROUGH THE MONTGOMERY COUNTY MATERNITY PARTNERSHIP PROGRAM, 1,143 UNINSURED, LOW-INCOME PREGNANT WOMEN RECEIVED PRENATAL CARE WITH 48.6% OF PATIENTS RECEIVING EARLY PRENATAL CARE. LACK OF INSURANCE ADVOCACY - HOLY CROSS HEALTH ADVOCATED FOR ADEQUATE REIMBURSEMENT, TO PROTECT 340B DRUG PRICING PROGRAM, TO ADVANCE VIRTUAL CARE AND TELEHEALTH PERMANENCY, EXPAND MEDICAID, ACCELERATE TOTAL COST OF CARE MODELS, REFORM INSURER PRACTICES, AND EXPAND PACE. HEALTHY BEHAVIORS:FOOD INSECURITY - HOLY CROSS HEALTH IMPLEMENTED MONTHLY MOBILE MARKETS BETWEEN JANUARY AND JUNE 2023 AT ITS HOSPITALS, DISTRIBUTING FRESH PRODUCE, SHELF-STABLE ITEMS, AND PROTEINS TO 825 UNDUPLICATED PARTICIPANTS/3,076 HOUSEHOLD MEMBERS AND 940 UNDUPLICATED PARTICIPANTS/3,800 HOUSEHOLD MEMBERS, RESPECTIVELY. ADULT OBESITY; DIABETES MANAGEMENT AND PREVENTION - THERE WERE 1,872 DIABETES EDUCATION CLASS VISITS, SIX CDC-RECOGNIZED DIABETES PREVENTION PROGRAM COHORTS WITH 50 UNDUPLICATED PARTICIPANTS. AND 28 PARTICIPANTS IN A SIX-WEEK LIFESTYLE MEDICINE PROGRAM. HOLY CROSS HEALTH ALSO HELD NINE COHORTS FOR THE DIABETES SELF-MANAGEMENT (DSMP) AND CHRONIC DISEASE SELF-MANAGEMENT (CDSMP) PROGRAMS WITH A TOTAL OF 540 ENCOUNTERS AND A COMPLETION RATE OF 72% AND 59%, RESPECTIVELY. PHYSICAL INACTIVITY - SENIOR FIT, AN EVIDENCE-BASED PHYSICAL ACTIVITY PROGRAM FOR PEOPLE AGE 55+, WAS HELD BOTH VIRTUALLY AND IN-PERSON. IN FY23, THERE WERE 2,440 SENIOR FIT CLASSES HELD WITH 79,834 ENCOUNTERS.EDUCATION, INCOME, JOB & ENVIRONMENT: WORKFORCE/LABOR SHORTAGES - HOLY CROSS HEALTH IMPLEMENTED THE CAREER PATHWAYS PROGRAM IN JANUARY 2023, PROVIDING COLLEAGUES IN POSITIONS REQUIRING ONLY A HIGH SCHOOL DIPLOMA OR GED AN OPPORTUNITY TO ADVANCE AT HOLY CROSS HEALTH BY COMPLETING A CERTIFICATION PROGRAM. ADDITIONALLY, HOLY CROSS HEALTH NETWORK PROVIDED EDUCATIONAL EXPERIENCES TO 12 INTERNS IN COMMUNITY HEALTH, AND A TEAM OF SIX STUDENTS COMPLETED A CAPSTONE PROJECT FROM GEORGE WASHINGTON UNIVERSITY'S MHA PROGRAM AT OUR HEALTH CENTERS. THE HEALTH CENTERS ALSO PROVIDED CLINICAL ROTATIONS TO MEDICAL ASSISTANT STUDENTS, RESIDENTS, COMMUNITY HEALTH WORKER STUDENTS, AND NURSING STUDENTS AT MEDICAL ADULT DAY CENTER.INCOME INEQUALITY - HOLY CROSS HEALTH ADDRESSES INCOME INEQUALITY THROUGH PROGRAMS SUCH AS THE CAREER PATHWAYS PROGRAM, PREVIOUSLY MENTIONED AND THE PATHWAYS TO INDEPENDENT EMPLOYMENT (PIE), WHICH WAS RE-ESTABLISHED IN FY23. PIE PROVIDES GAINFUL EMPLOYMENT TO HARD-TO-HIRE INDIVIDUALS, SUCH AS THOSE WHO HAVE BEEN PREVIOUSLY INCARCERATED, AGING OUT OF THE FOSTER CARE SYSTEM, OR TEENAGE PARENTS. IN FY23, NINE PIE PARTICIPANTS WERE HIRED, SURPASSING THE TARGET OF EIGHT COLLEAGUES. HOUSING COST BURDEN - IN FY23, HOLY CROSS HEALTH BEGAN WORKING WITH DEVELOPERS AND COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS TO ESTABLISH WORKFORCE HOUSING IN UPPER MONTGOMERY COUNTY. HOLY CROSS GERMANTOWN HOSPITAL PART V, SECTION B, LINE 11: HOLY CROSS HEALTH INCLUDES TWO HOSPITAL FACILITIES, HOLY CROSS HOSPITAL AND HOLY CROSS GERMANTOWN HOSPITAL. BOTH HOSPITALS WORK TOGETHER TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA. HOLY CROSS HEALTH ADDRESSES THE UNMET NEEDS OF OUR COMMUNITY IN ACCORDANCE WITH OUR MISSION AND IN ALIGNMENT WITH THE FINDINGS OF OUR CHNA AND THE PRIORITIES OF HEALTHY MONTGOMERY. KEY FINDINGS FROM ALL DATA SOURCES WERE REVIEWED, AND THE MOST PRESSING NEEDS WERE INCORPORATED INTO A MULTI-YEAR IMPLEMENTATION STRATEGY, ADDRESSING THE NEEDS OF THE MOST VULNERABLE AND UNDERSERVED INDIVIDUALS AND FAMILIES.WE ALSO SCREEN PATIENTS AND COMMUNITY MEMBERS FOR SOCIAL NEEDS AND DEVELOP PROGRAMS TO ADDRESS IDENTIFIED TOP NEEDS. THE ACCOUNTABLE HEALTHY COMMUNITIES PROGRAM, WHICH RAN FROM JULY 2022 THROUGH JANUARY 2023, PROVIDED SOCIAL NEEDS SCREENINGS TO 2,324 PATIENTS AND FOLLOWED UP WITH 316 PATIENTS WITH SOCIAL NEEDS. THE HEALTH CENTERS PROVIDED SOCIAL NEEDS SCREENINGS TO 73% OF HEALTH CENTER PATIENTS, A 57% IMPROVEMENT FROM THE BEGINNING OF THE FISCAL YEAR. THROUGH THE NEXUS CONNECT PROGRAM, A TELEHEALTH NAVIGATOR ADDRESSED SOCIAL NEEDS FOR 90 COMMUNITY MEMBERS REFERRED TO THE HEALTH CENTER. IN THE COMMUNITY, THE ROAD TO HEALTH PROGRAM REFERRED 80 COMMUNITY MEMBERS TO PRIMARY CARE AND PROVIDED LINKS TO ADDITIONAL COMMUNITY RESOURCES. THE HOLY CROSS HEALTH COLLEAGUE SOCIAL NEEDS PROGRAM CONNECTED COLLEAGUES IN NEED OF HEALTH CARE SERVICES AND WORKED WITH COLLEAGUES WHO NEEDED TO SEE A PHYSICIAN BUT COULD NOT.BELOW ARE THREE PROGRAM EXAMPLES FOR EACH CHNA PRIORITY AREA:ACCESS TO CARE:MENTAL HEALTH PROVIDERS - HOLY CROSS HEALTH CENTER BEHAVIORAL HEALTH SERVICES WERE ESTABLISHED TO MEET THE GROWING NEED FOR MENTAL HEALTH PROVIDERS, 57.6% (781/1335) OF HOLY CROSS HEALTH CENTER PATIENTS AND 83.2% (3664/4405) OF HOLY CROSS HEALTH PARTNER PATIENTS RECEIVED DEPRESSION SCREENINGS DURING THEIR PRIMARY CARE VISITS; 98 PATIENTS WERE REFERRED TO MINDOULA. PRIMARY CARE PROVIDERS - HOLY CROSS HEALTH CENTERS AND OB/GYN CLINICS PROVIDE PRIMARY CARE SERVICES TO LOW-INCOME PATIENTS WHO ARE UNINSURED OR ENROLLED IN MARYLAND PHYSICIANS CARE AND OPERATE ON A SLIDING SCALE (FOR PATIENTS UNDER 250% FEDERAL POVERTY LEVEL (FPL) THE FEE IS $30, FROM 251%-300% FPL THE FEE IS $45, AND OVER 301% FPL THE FEE IS $60). IN FISCAL YEAR 2023 (FY23), THERE WERE 35,418 TOTAL PATIENTS AT THE HOLY CROSS HEALTH CENTERS AND 67 NEW PATIENT NEWBORN VISITS AT HOLY CROSS HEALTH CENTER IN GAITHERSBURG. IN FY23, THROUGH THE MONTGOMERY COUNTY MATERNITY PARTNERSHIP PROGRAM, 1,143 UNINSURED, LOW-INCOME PREGNANT WOMEN RECEIVED PRENATAL CARE WITH 48.6% OF PATIENTS RECEIVING EARLY PRENATAL CARE. LACK OF INSURANCE ADVOCACY - HOLY CROSS HEALTH ADVOCATED FOR ADEQUATE REIMBURSEMENT, TO PROTECT 340B DRUG PRICING PROGRAM, TO ADVANCE VIRTUAL CARE AND TELEHEALTH PERMANENCY, EXPAND MEDICAID, ACCELERATE TOTAL COST OF CARE MODELS, REFORM INSURER PRACTICES, AND EXPAND PACE. HEALTHY BEHAVIORS:FOOD INSECURITY - HOLY CROSS HEALTH IMPLEMENTED MONTHLY MOBILE MARKETS BETWEEN JANUARY AND JUNE 2023 AT ITS HOSPITALS, DISTRIBUTING FRESH PRODUCE, SHELF-STABLE ITEMS, AND PROTEINS TO 825 UNDUPLICATED PARTICIPANTS/3,076 HOUSEHOLD MEMBERS AND 940 UNDUPLICATED PARTICIPANTS/3,800 HOUSEHOLD MEMBERS, RESPECTIVELY. ADULT OBESITY; DIABETES MANAGEMENT AND PREVENTION - THERE WERE 1,872 DIABETES EDUCATION CLASS VISITS, SIX CDC-RECOGNIZED DIABETES PREVENTION PROGRAM COHORTS WITH 50 UNDUPLICATED PARTICIPANTS. AND 28 PARTICIPANTS IN A SIX-WEEK LIFESTYLE MEDICINE PROGRAM. HOLY CROSS HEALTH ALSO HELD NINE COHORTS FOR THE DIABETES SELF-MANAGEMENT (DSMP) AND CHRONIC DISEASE SELF-MANAGEMENT (CDSMP) PROGRAMS WITH A TOTAL OF 540 ENCOUNTERS AND A COMPLETION RATE OF 72% AND 59%, RESPECTIVELY. PHYSICAL INACTIVITY - SENIOR FIT, AN EVIDENCE-BASED PHYSICAL ACTIVITY PROGRAM FOR PEOPLE AGE 55+, WAS HELD BOTH VIRTUALLY AND IN-PERSON. IN FY23, THERE WERE 2,440 SENIOR FIT CLASSES HELD WITH 79,834 ENCOUNTERS.EDUCATION, INCOME, JOB & ENVIRONMENT: WORKFORCE/LABOR SHORTAGES - HOLY CROSS HEALTH IMPLEMENTED THE CAREER PATHWAYS PROGRAM IN JANUARY 2023, PROVIDING COLLEAGUES IN POSITIONS REQUIRING ONLY A HIGH SCHOOL DIPLOMA OR GED AN OPPORTUNITY TO ADVANCE AT HOLY CROSS HEALTH BY COMPLETING A CERTIFICATION PROGRAM. ADDITIONALLY, HOLY CROSS HEALTH NETWORK PROVIDED EDUCATIONAL EXPERIENCES TO 12 INTERNS IN COMMUNITY HEALTH, AND A TEAM OF SIX STUDENTS COMPLETED A CAPSTONE PROJECT FROM GEORGE WASHINGTON UNIVERSITY'S MHA PROGRAM AT OUR HEALTH CENTERS. THE HEALTH CENTERS ALSO PROVIDED CLINICAL ROTATIONS TO MEDICAL ASSISTANT STUDENTS, RESIDENTS, COMMUNITY HEALTH WORKER STUDENTS, AND NURSING STUDENTS AT MEDICAL ADULT DAY CENTER.INCOME INEQUALITY - HOLY CROSS HEALTH ADDRESSES INCOME INEQUALITY THROUGH PROGRAMS SUCH AS THE CAREER PATHWAYS PROGRAM, PREVIOUSLY MENTIONED AND THE PATHWAYS TO INDEPENDENT EMPLOYMENT (PIE), WHICH WAS RE-ESTABLISHED IN FY23. PIE PROVIDES GAINFUL EMPLOYMENT TO HARD-TO-HIRE INDIVIDUALS, SUCH AS THOSE WHO HAVE BEEN PREVIOUSLY INCARCERATED, AGING OUT OF THE FOSTER CARE SYSTEM, OR TEENAGE PARENTS. IN FY23, NINE PIE PARTICIPANTS WERE HIRED, SURPASSING THE TARGET OF EIGHT COLLEAGUES. HOUSING COST BURDEN - IN FY23, HOLY CROSS HEALTH BEGAN WORKING WITH DEVELOPERS AND COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS TO ESTABLISH WORKFORCE HOUSING IN UPPER MONTGOMERY COUNTY. HOLY CROSS HOSPITAL PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. HOLY CROSS GERMANTOWN HOSPITAL PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. HOLY CROSS HOSPITAL - PART V, SECTION B, LINE 7A: WWW.HOLYCROSSHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFIT-PLANNING/COMMUNITY-HEALTH-NEEDS-ASSESSMENT HOLY CROSS GERMANTOWN HOSPITAL - PART V, SECTION B, LINE 7A: WWW.HOLYCROSSHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFIT-PLANNING/COMMUNITY-HEALTH-NEEDS-ASSESSMENT HOLY CROSS HOSPITAL - PART V, SECTION B, LINE 10A: WWW.HOLYCROSSHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFIT-PLANNING/IMPLEMENTATION-PLAN HOLY CROSS GERMANTOWN HOSPITAL - PART V, SECTION B, LINE 10A: WWW.HOLYCROSSHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFIT-PLANNING/IMPLEMENTATION-PLAN HOLY CROSS HOSPITAL - PART V, SECTION B, LINE 16A: WWW.HOLYCROSSHEALTH.ORG/FOR-PATIENTS/BILLING-FINANCIAL-ASSISTANCE-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM HOLY CROSS GERMANTOWN HOSPITAL - PART V, SECTION B, LINE 16A: WWW.HOLYCROSSHEALTH.ORG/FOR-PATIENTS/BILLING-FINANCIAL-ASSISTANCE-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM HOLY CROSS HOSPITAL - PART V, SECTION B, LINE 16B: WWW.HOLYCROSSHEALTH.ORG/FOR-PATIENTS/BILLING-FINANCIAL-ASSISTANCE-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM HOLY CROSS GERMANTOWN HOSPITAL - PART V, SECTION B, LINE 16B: WWW.HOLYCROSSHEALTH.ORG/FOR-PATIENTS/BILLING-FINANCIAL-ASSISTANCE-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM HOLY CROSS HOSPITAL - PART V, SECTION B, LINE 16C: WWW.HOLYCROSSHEALTH.ORG/FOR-PATIENTS/BILLING-FINANCIAL-ASSISTANCE-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM HOLY CROSS GERMANTOWN HOSPITAL - PART V, SECTION B, LINE 16C: WWW.HOLYCROSSHEALTH.ORG/FOR-PATIENTS/BILLING-FINANCIAL-ASSISTANCE-AND-INSURANCE/FINANCIAL-ASSISTANCE-PROGRAM 14 1 - CHESAPEAKE POTOMAC REGIONAL CANCER CT 11340 PEMBROOKE SQ SUITE 201 WALDORF MD 20603 CANCER TREATMENT 2 - CHESAPEAKE POTOMAC REGIONAL CANCER CT 30077 BUSINESS CENTER DR CHARLOTTE HALL MD 20622 CANCER TREATMENT 3 - DOCTORS REGIONAL CANCER CENTER 8116 GOOD LUCK RD SUITE 005 LANHAM MD 20706 CANCER TREATMENT 4 - DOCTORS REGIONAL CANCER CENTER 4901 TELSA DR SUITE A BOWIE MD 20715 CANCER TREATMENT 5 - HOLY CROSS RADIATION TREATMENT CENTER 2121 MEDICAL PARK DR SUITE 4 SILVER SPRING MD 20902 CANCER TREATMENT 6 - HOLY CROSS HEALTH CTR - GAITHERSBURG 220 PERRY PARKWAY UNIT 5 GAITHERSBURG MD 20877 HEALTH CLINIC 7 - HC HEALTH PARTNERS IN KENSINGTON 3720 FARRAGUT AVE 2ND FLOOR KENSINGTON MD 20895 PRIMARY CARE 8 - HOLY CROSS HEALTH CENTER - ASPEN HILL 13415 CONNECTICUT AVE 100 SILVER SPRING MD 20906 HEALTH CLINIC 9 - HOLY CROSS HEALTH PARTNERS AT ASBURY 201 RUSSELL AVE GAITHERSBURG MD 20877 PRIMARY CARE 10 - HOLY CROSS DIALYSIS CTR AT WOODMORE 11721 WOODMORE RD SUITE 190 MITCHELLVILLE MD 20721 DIALYSIS TREATMENT 11 - HC HLTH PARTNERS PROGRESSIVE MED CARE 18530 OFFICE PARK DR MONTGOMERY VILLAGE MD 20886 PRIMARY CARE 12 - HOLY CROSS HEALTH CTR - SILVER SPRING 7987 GEORGIA AVE SILVER SPRING MD 20910 HEALTH CLINIC 13 - HOLY CROSS RESOURCE CENTER 9805 DAMERON DR SILVER SPRING MD 20902 ADULT DAY CARE 14 - HOLY CROSS HEALTH CENTER - GERMANTOWN 12800 MIDDLEBROOK RD SUITE 206 GERMANTOWN MD 20874 HEALTH CLINIC PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: HOLY CROSS HEALTH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT FOR HOLY CROSS HOSPITAL AND HOLY CROSS GERMANTOWN HOSPITAL, WHICH IT SUBMITS TO THE STATE OF MARYLAND. DUE TO MARYLAND'S UNIQUE ALL PAYER SYSTEM, THE VALUES REPORTED ON PART I, LINE 7B ARE DIFFERENT FROM THOSE REPORTED TO THE STATE OF MARYLAND. SEE PART I, LINE 7B BELOW. IN ADDITION, HOLY CROSS HEALTH REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.HOLY CROSS HEALTH ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.PART I, LINE 7A: MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYERS, INCLUDING GOVERNMENTAL PAYERS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL PAYER SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYERS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAK OUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE.PART I, LINE 7B: THE VALUES REPORTED ARE DIFFERENT FROM THOSE REPORTED TO THE STATE OF MARYLAND. MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE SETTING PROCESS AND ALL PAYERS, INCLUDING GOVERNMENTAL PAYERS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. COMMUNITY BENEFIT EXPENSES ARE EQUAL TO MEDICAID REVENUES IN MARYLAND, AS SUCH, THE NET EFFECT IS ZERO. THE EXCEPTION TO THIS IS THE IMPACT ON THE HOSPITAL OF ITS SHARE OF THE MEDICAID ASSESSMENT. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE SETTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $27,562,267, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: HOLY CROSS HEALTH USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, HOLY CROSS HEALTH IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, HOLY CROSS HEALTH IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: HOLY CROSS HEALTH IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: "AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED." PART III, LINE 8: HOLY CROSS HEALTH DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - HEALTHY MONTGOMERY, MONTGOMERY COUNTY'S COMMUNITY HEALTH IMPROVEMENT PROCESS, IS SUPPORTED FINANCIALLY BY ALL SIX HOSPITALS IN THE COUNTY AND SERVES AS THE BASE FOR HCH AND HCGH'S JOINT NEEDS ASSESSMENT. THE HEALTHY MONTGOMERY STEERING COMMITTEE IS COMPRISED OF GOVERNMENT AGENCIES, HOSPITAL SYSTEMS, MINORITY HEALTH PROGRAMS/INITIATIVES, ADVOCACY GROUPS, ACADEMIC INSTITUTIONS, COMMUNITY-BASED SERVICE PROVIDERS, AND OTHER STAKEHOLDERS. IN ADDITION TO HEALTHY MONTGOMERY, WE USE EXISTING NEEDS ASSESSMENTS FROM LOCAL HEALTH INITIATIVES, GOVERNMENT AGENCIES, AND NON-PROFIT COMMUNITY HEALTH ORGANIZATIONS TO IDENTIFY UNMET NEEDS, ESPECIALLY FOR UNDERSERVED MINORITIES, SENIORS, AND WOMEN AND CHILDREN. HOLY CROSS HEALTH REGULARLY PARTICIPATES IN A VARIETY OF COALITIONS, COMMISSIONS, COMMITTEES, PARTNERSHIPS AND PANELS, AND OUR COMMUNITY HEALTH WORKERS SPEND TIME IN THE COMMUNITY AS COMMUNITY PARTICIPANTS AND BRING BACK FIRST-HAND KNOWLEDGE OF COMMUNITY NEEDS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - HOLY CROSS HEALTH COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOLY CROSS HEALTH OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. NOTIFICATION ABOUT FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. PART VI, LINE 4: COMMUNITY INFORMATION -THE HOSPITALS WITHIN THE MONTGOMERY COUNTY HOSPITAL COLLABORATIVE (MCHC) SERVE PORTIONS OF MONTGOMERY, PRINCE GEORGE'S, FREDERICK, CARROLL, AND HOWARD COUNTIES AND THE DISTRICT OF COLUMBIA, SPANNING 86 ZIP CODES WITH A POPULATION OF ALMOST 2.3 MILLION PEOPLE. THE MCHC CHNA IDENTIFIES AND PRIORITIZES COMMUNITIES OF FOCUS FOR MEANINGFUL ENGAGEMENT. TO DO THIS, THE MCHC IDENTIFIED ZIP CODES IN EACH HOSPITAL'S PRIMARY SERVICE AREA AS THE COLLECTIVE COMMUNITY BENEFIT SERVICE AREA (CBSA), COMPRISED OF 38 ZIP CODES SPANNING 388 SQUARE MILES OF MONTGOMERY COUNTY AND NORTHERN PRINCE GEORGE'S COUNTY, WITH A TOTAL POPULATION OF 1,250,503. THE POPULATION DENSITY FOR THIS AREA (3,218 PERSONS PER SQ. MI.) IS GREATER THAN MONTGOMERY COUNTY (2,116 PERSONS PER SQ. MI.), PRINCE GEORGE'S COUNTY (1,883 PERSONS PER SQ. MI.), AND THE STATE (620 PERSONS PER SQ. MI.). THE LARGEST POPULATIONS BY RACE/ETHNICITY WITHIN THE SERVICE AREA ARE NON-HISPANIC WHITES (37.3%), NON-HISPANIC BLACKS (22.6%), HISPANIC/LATINO (22.5%), AND NON-HISPANIC ASIAN (13.5%).OF THE MCHC CBSA POPULATION, 33% ARE OF FOREIGN BIRTH COMPARED TO MONTGOMERY COUNTY (32%), PRINCE GEORGE'S COUNTY (23%), AND MARYLAND (15.2%). LIMITED ENGLISH PROFICIENCY (LEP), OR THE INABILITY TO SPEAK ENGLISH WELL, CREATES BARRIERS TO HEALTH CARE ACCESS, PROVIDER COMMUNICATIONS, AND HEALTH LITERACY/EDUCATION. OF THE CBSA POPULATION AGED 5 AND OLDER, 16.5% SPEAK ENGLISH "LESS THAN VERY WELL" COMPARED TO MARYLAND (7%), WITH SPANISH BEING THE HIGHEST PERCENTAGE OF LANGUAGE SPOKEN IN THE HOME.POPULATIONS EXPERIENCING VULNERABILITY ARE GROUPS AND COMMUNITIES AT A HIGHER RISK FOR POOR HEALTH OUTCOMES BECAUSE OF THE BARRIERS THEY EXPERIENCE AND THE STRUCTURAL AND SOCIETAL FACTORS THEY FACE, SUCH AS SYSTEMIC RACISM, DISCRIMINATION, STIGMA, AND POVERTY. - LOW-INCOME AND POVERTY ARE LINKED TO POOR HEALTH OUTCOMES DUE TO THEIR CORRELATION WITH ADVERSE CONDITIONS (SUBSTANDARD HOUSING, HOMELESSNESS, FOOD INSECURITY, INADEQUATE CHILDCARE, LACK OF ACCESS TO HEALTH CARE, UNSAFE NEIGHBORHOODS, AND UNDER-RESOURCED SCHOOLS). WITHIN THE MCHC CBSA, 20.4% (250,418 INDIVIDUALS) LIVE IN HOUSEHOLDS WITH INCOMES BELOW 200% OF FPL. - MINORITIES OFTEN EXPERIENCE HIGHER RATES OF ILLNESS AND DEATH ACROSS A RANGE OF HEALTH CONDITIONS (DIABETES, HYPERTENSION, OBESITY, ASTHMA, AND HEART DISEASE) WHEN COMPARED TO THEIR WHITE COUNTERPARTS. IN THE CBSA, MORE THAN 40% OF THE POPULATION IS NON-HISPANIC, NON-WHITE AND 22.5% ARE HISPANIC.- THE LACK OF HEALTH INSURANCE IS CONSIDERED A KEY DRIVER OF HEALTH STATUS. IN THE CBSA, 9.1% OF THE TOTAL POPULATION IS WITHOUT HEALTH INSURANCE COVERAGE, GREATER THAN THE STATE OF MARYLAND (6.1%).- OF THE ESTIMATED 1,250,503 TOTAL POPULATION COVERED IN THE CBSA, AN ESTIMATED 177,072 (14.2%) ARE AGED 65 AND OLDER, COMPARABLE TO MONTGOMERY COUNTY AND SLIGHTLY HIGHER THAN PRINCE GEORGE'S COUNTY. THE POPULATION OF ADULTS AGED 60 AND GREATER IS ESTIMATED TO INCREASE BY 40%, FROM 1.2 TO 1.7 MILLION BETWEEN 2015 AND 2030 (2017-2020 STATE PLAN ON AGING FOR MARYLAND). HEALTH STATUS, COGNITIVE ABILITY, AND SOCIAL NETWORK ARE RISK FACTORS THAT CAN CONTRIBUTE TO VULNERABILITY IN OLDER ADULTS. - HOMELESSNESS INCLUDES PEOPLE LIVING ON THE STREETS OR OTHER PLACES NOT INTENDED FOR HUMAN HABITATION; LIVING IN SHELTERS; LACKING A FIXED, REGULAR, AND ADEQUATE NIGHTTIME RESIDENCE; TEMPORARILY STAYING WITH FRIENDS AND RELATIVES; AND EVEN THOSE AT RISK FOR HOMELESSNESS. MONTGOMERY COUNTY'S POINT-IN-TIME COUNT FOR HOMELESSNESS HAD A 35% DECREASE BETWEEN 2017 AND 2021. OUT OF THE 187,380 STUDENTS ENROLLED IN SCHOOL DURING THE 2019-2020 SCHOOL YEAR, 1,499 (0.8%) WERE HOMELESS.- COMPARED WITH INDIVIDUALS WITHOUT DISABILITIES, INDIVIDUALS WITH DISABILITIES ARE LESS LIKELY TO RECEIVE RECOMMENDED PREVENTIVE HEALTH CARE SERVICES, AT HIGHER RISK FOR POOR HEALTH OUTCOMES, AND ARE MORE LIKELY TO ENGAGE IN UNHEALTHY BEHAVIORS THAT PUT THEIR HEALTH AT RISK. WITHIN THE CBSA, 8% (99,809) OF THE TOTAL POPULATION HAS ONE OR MORE DISABILITIES. PART VI, LINE 5: OTHER INFORMATION - HOLY CROSS HEALTH, COMPRISED OF HOLY CROSS HOSPITAL AND HOLY CROSS GERMANTOWN HOSPITAL, HAS A 15-MEMBER COMMUNITY BOARD COMPRISED OF A MAJORITY OF COMMUNITY MEMBERS THAT PROVIDE GOVERNANCE FOR BOTH HOSPITALS, AS WELL AS HOLY CROSS HEALTH NETWORK. TWO OF THE 15 BOARD MEMBERS ARE EMPLOYED BY TRINITY HEALTH, HOLY CROSS HEALTH'S PARENT CORPORATION. TWO BOARD MEMBERS LIVE OUTSIDE HOLY CROSS HEALTH'S LOCAL AREA, AND TWO SISTERS OF THE HOLY CROSS ARE BOARD MEMBERS.HOLY CROSS HEALTH HAS A VERY LARGE, DIVERSE MEDICAL STAFF OF NEARLY 2,000 MEMBERS. THE MEDICAL STAFF OF HOLY CROSS HEALTH ARE ORGANIZED IN THE PUBLIC INTEREST, AND MEDICAL STAFF PRIVILEGES AT THE TWO HOSPITALS ARE OPEN AND AVAILABLE TO ALL QUALIFIED PHYSICIANS AND PROVIDERS. HOLY CROSS HOSPITAL IS THE LARGEST HOSPITAL EMERGENCY SERVICES PROVIDER IN MONTGOMERY AND PRINCE GEORGE'S COUNTIES. OVER 87,000 ACUTELY ILL PATIENTS ARE TREATED ANNUALLY, AND THE CENTER PROVIDES A WIDE RANGE OF EMERGENCY SERVICES 24/7/365, INCLUDING SEVERAL HIGHLY REGARDED SPECIALIZED EMERGENCY SERVICES THAT HAVE EARNED THE HOSPITAL A REPUTATION AS A PIONEER IN EMERGENCY CARE.THE HOLY CROSS GERMANTOWN HOSPITAL EMERGENCY ROOM IS THE ONLY FULL-SERVICE EMERGENCY ROOM IN GERMANTOWN, MD. THE HOSPITAL'S EMERGENCY ROOM IS STAFFED BY A TEAM OF BOARD-CERTIFIED EMERGENCY MEDICINE PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, REGISTERED NURSES, AND PATIENT CARE TECHNICIANS. IT FEATURES AN ARRAY OF ACUTE EMERGENCY SERVICES, AS WELL AS SPECIALIZED EMERGENCY SERVICES.HOLY CROSS HEALTH HAS PARTNERED WITH THE THREE OTHER HEALTH SYSTEMS IN MONTGOMERY COUNTY AND A NETWORK OF COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT NEXUS MONTGOMERY, A POPULATION HEALTH IMPROVEMENT PLAN DESIGNED TO IMPROVE THE HEALTH STATUS OF THOSE MOST AT RISK OF AVOIDABLE HOSPITAL USE.THREE COLLEAGUES IN THE COMMUNITY HEALTH DEPARTMENT JOINED THE LEADERS IN EQUITY AND DIVERSITY (LEAD) COLLABORATIVE WHICH SUPPORTS IMPLEMENTING STRATEGIES THAT ADDRESS HEALTH DISPARITIES IN DIVERSE AND AGING POPULATIONS. THE GOAL OF THE WORKFORCE DEVELOPMENT PROGRAM IS TO IMPROVE INCOME INEQUALITY FOR 75% OF PARTICIPANTS BY DECEMBER 31, 2023. THE PROGRAM HAS BEEN HIGHLIGHTED THROUGHOUT LEAD AS A BEST PRACTICE AND PRESENTED AT THE NATIONAL CHA CONFERENCE AND THE TRINITY HEALTH ADVANCING TOGETHER WEBINAR SERIES. HOLY CROSS HEALTH CONTINUED TO EXPAND SELF-CARE PROGRAMS IN THE COMMUNITY:- PROVIDED 26 EVIDENCE-BASED (STANFORD) WORKSHOPS FOR THE COMMUNITY WITH 1,319 ENCOUNTERS.- RECEIVED RENEWED CDC RECOGNITION OF THE DIABETES PREVENTION PROGRAM FOR ANOTHER FIVE YEARS; IMPLEMENTED SIX COHORTS WITH APPROXIMATELY 50 PARTICIPANTS WITH FUNDING SUPPORT FROM TRINITY HEALTH AND NEXUS MONTGOMERY REGIONAL PARTNERSHIP (NMRP). - WITH MINORITY OFFICE FOR TECHNICAL ASSISTANCE (MOTA) STATE FUNDING, IMPLEMENTED 11 ROAD TO HEALTH COHORTS REACHING 186 COMMUNITY MEMBERS; OF WHOM 26% REDUCED BODY WEIGHT, AND 70% COMPLETED 150 MINUTES OF PHYSICAL ACTIVITY PER WEEK BY THE END OF SIX-WEEK CLASS; APPROXIMATELY 38% OF PROGRAM PARTICIPANTS ATTEND FOLLOW-UP SESSIONS; AND MORE THAN 4,000 COMMUNITY OUTREACH ENCOUNTERS. - HOLY CROSS HEALTH RECEIVED $123,000 FROM THREE SEPARATE DONORS TO DEVELOP AND IMPLEMENT OUR EQUITABLE WELLNESS INITIATIVE (EWI) TO ADDRESS DIABETES PREVENTION, DIABETES MANAGEMENT, AND LUNG HEALTH AMONG BLACK AND LATINX POPULATIONS WITH LOW LITERACY LEVELS AND/OR LOW EDUCATIONAL ATTAINMENT. 135 EWI VIRTUAL AND IN-PERSON WORKSHOPS WERE HELD, REACHING 984 UNDUPLICATED INDIVIDUALS THROUGH 2,300 ENCOUNTERS. TRAINED STAFF HAVE ALSO CONDUCTED MORE THAN 370 SOCIAL NEEDS ASSESSMENTS AND MADE REFERRALS TO RESOURCES TO ADDRESS IDENTIFIED NEEDS.- DEVELOPED CURRICULUM AND DELIVERED A SIX-WEEK NUTRITION, MOVEMENT AND MENTAL HEALTH LIFESTYLE MEDICINE PROGRAM TO 25-30 PARTICIPANTS PER CLASS. PARTNERSHIPS: THROUGH TRINITY HEALTH'S COMMUNITY GRANTS AND THE HOLY CROSS HEALTH FOUNDATION KEVIN J. SEXTON FUND, HOLY CROSS HEALTH OFFERED FUNDING OPPORTUNITIES TO COMMUNITY PARTNERS WHO DIRECTLY ALIGN WITH INTERVENTIONS AND NEEDS IDENTIFIED IN OUR MOST CURRENT CHNA TO ADVANCE THE CHNA IMPLEMENTATION STRATEGY AND/OR EMERGING NEED. IN FY23, THE FUNDS SUPPORTED COMMUNITY HEALTH WORKER CAPACITY BUILDING FOR CROSS COMMUNITY, INC. AND PARTNERED WITH CAREERCATCHERS TO IDENTIFY AND SUPPORT HARD TO HIRE COMMUNITY MEMBERS THROUGH THE HOLY CROSS HEALTH HIRING PROCESS TO OBTAIN GAINFUL EMPLOYMENT. COMMUNITY HEALTH ALSO SECURED TRINITY HEALTH FUNDING TO SUPPORT FOOD SECURITY WORK BY THREE PARTNERS: COMMUNITY FARM SHARE, MONTGOMERY COUNTY FOOD COUNCIL, AND KINGDOM FELLOWSHIP. HOLY CROSS HEALTH INCREASED COMMUNITY ENGAGEMENT THROUGH HEALTH EDUCATION, ADDRESSING SOCIAL NEEDS, AND WORKFORCE DEVELOPMENT: IMPLEMENTED THREE WORKFORCE DEVELOPMENT PROGRAMS: PIE PROGRAM, PATHWAYS PROGRAM, AND NMRP'S WORKSOURCE MONTGOMERY PROGRAM; SECURED SUB-CONTRACT WITH MONTGOMERY COUNTY FOOD COUNCIL FOR SNAP ENROLLMENT; RECEIVED FUNDING FROM KAISER PERMANENTE TO IMPLEMENT KIDS FIT; AND RECEIVED MOTA FUNDING TO IMPLEMENT ROAD TO HEALTH.SOCIAL CARE: REALIZING THAT CLINICAL CARE ONLY ACCOUNTS FOR ABOUT 20% OF HEALTH OUTCOMES, IN FY23, HOLY CROSS HEALTH HAD 5,427 SOCIAL CARE ENCOUNTERS ASSESSING OR CONNECTING INDIVIDUALS TO SOCIAL SERVICES.- HOLY CROSS HEALTH RECEIVED FUNDING FOR THE HEART PAYMENT PROGRAM WHICH PROVIDES ADDITIONAL SUPPORT TO MARYLAND PRIMARY CARE PROGRAM PARTICIPANTS AND PROMOTES THE STATE'S AND CMS' GOAL TO ADVANCE HEALTH EQUITY. IN FY23, 231 OUTREACH CALLS WERE MADE, WITH 135 PATIENTS RECEIVING BENEFICIARY-LEVEL SERVICES IN FOOD, SOCIAL ISOLATION, HOME AIDE, TRANSPORTATION, ETC.- COLLEAGUE SOCIAL NEEDS ASSESSMENTS WERE COMPLETED BY 174 COLLEAGUES, WITH 116 COLLEAGUES BEING REFERRED FOR ASSISTANCE WITH AT LEAST ONE NEED. HOLY CROSS HEALTH ADVANCED TRINITY HEALTH ADVOCACY AGENDA AND POLICIES TO ADDRESS CHNA-IDENTIFIED PRIORITIES (ACCESS TO CARE AND INSURANCE, FOOD SECURITY, OBESITY, PHYSICAL ACTIVITY, WORKFORCE, INCOME INEQUALITY, AND HOUSING)- SECURED PUBLIC FUNDING, INCLUDING $3.2 MILLION FROM THE COUNTY FOR STAFFING; 34% INCREASE IN MONTGOMERY CARES FUNDING; $15,000 TO ESTABLISH COMMUNITY PHARMACY PROGRAM FOR OB/GYN CLINIC; $2 MILLION FROM STATE FOR CANCER CENTER AND RECOMMENDATION BY SENATORS FOR $428K IN FEDERAL EARMARK FUNDING FOR THE "EQUITABLY AGING IN PLACE" PROGRAM TO PROVIDE SCHOLARSHIPS TO MADC FOR LOW-INCOME PARTICIPANTS AND TO INCREASE BREADTH OF SERVICES TO INCLUDE MUSIC AND ART THERAPY.- SUPPORTED UNIVERSAL ACCESS TO SCHOOL MEALS, PROVIDED DATA AND INSIGHT TO LEGISLATIVE DISCUSSIONS RELATED TO PEDIATRIC DENTISTRY AND IN-HOME DELIVERIES FOR VBAC (VAGINAL BIRTH AFTER CESAREAN DELIVERY) PATIENTS. PRESENTED ON COMMUNITY BENEFIT REPORTING IN AN HSCRC WEBINAR. ADVOCATED TO HSCRC REGARDING POPULATION HEALTH TARGETS FOR DIABETES MANAGEMENT.HOLY CROSS HEALTH MAINTAINED THE FOLLOWING STRATEGIC PARTNERSHIPS: - MONTGOMERY COLLEGE - SUPPORT ROTATIONS AND RECRUITMENT- KAISER PERMANENTE - COMPLETED FISCAL YEAR 2024 (FY24) OPERATING PLAN RELATED TO HEALTH DISPARITIES, CARE WITHOUT DELAY, AND COMPASSIONATE CARE FOR SERIOUSLY ILL; ADDRESSED SHARED SOCIAL DETERMINANTS OF HEALTH PRIORITIES RELATED TO FOOD SECURITY; CONTINUED HOSPITAL OPERATIONS WORKGROUP TO ADDRESS READMISSIONS, AND BED AVAILABILITY.- MARYLAND PHYSICIAN CARE (MPC) - SECURED $50K GRANT TO SUPPORT PATHWAYS PROGRAM, CONTINUE TO SUPPORT MARKETING AND WORK WITH MPC ON PATIENT ACTIVATION AND QUALITY PERFORMANCE.- NEXUS MONTGOMERY REGIONAL PARTNERSHIP - SECURED TWO WORKFORCE DEVELOPMENT GRANTS AND INITIATED WORKFORCE COMMITTEE, CONTINUED TO SUPPORT DEVELOPMENT OF BEHAVIORAL HEALTH RESTORATION CENTER, RE-ENGAGED SNF ALLIANCE, CONTINUED TO IMPLEMENT NEXUS CONNECT AND ESTABLISHED NEW FOCUS ON ADVOCACY AS A COMPONENT OF ALL INITIATIVES. SECURED $1.3 MILLION IN WORKFORCE DEVELOPMENT FUNDING WHICH WILL BE DISBURSED IN EARLY FY24. IMPLEMENTED $100K WORKSOURCE MONTGOMERY CERTIFICATION-TRAINING GRANT.- COLLABORATIVE HEALTH SYSTEMS - GENERATED SAVINGS OF $1.277 MILLION (OFFSET BY STATEWIDE SAVINGS FOR NET GAIN OF $165K).- CAREFIRST - CONTINUED ENGAGEMENT RELATED TO MATERNAL HEALTH AND SOCIAL DETERMINANTS. PART VI, LINE 6: HOLY CROSS HEALTH IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE - EMPHASIZING THE NECESSITY TO INTEGRATE SOCIAL AND CLINICAL CARE. WE DO THIS BY: 1. ADDRESSING PATIENT SOCIAL NEEDS, 2. INVESTING IN OUR COMMUNITIES, AND 3. STRENGTHENING THE IMPACT OF OUR COMMUNITY BENEFIT. TRINITY HEALTH CHWB TEAMS LEAD THE DEVELOPMENT AND IMPLEMENTATION OF TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES AND FOCUS INTENTIONALLY ON ENGAGING COMMUNITIES AND RESIDENTS EXPERIENCING POVERTY AND OTHER VULNERABILITIES. WE BELIEVE THAT COMMUNITY MEMBERS AND COMMUNITIES THAT ARE THE MOST IMPACTED BY RACISM AND OTHER FORMS OF DISCRIMINATION EXPERIENCE THE GREATEST DISPARITIES AND INEQUITIES IN HEALTH OUTCOMES AND SHOULD BE INCLUSIVELY ENGAGED IN ALL COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT EFFORTS. THROUGHOUT OUR WORK, WE DISMANTLE OPPRESSIVE SYSTEMS, AND BUILD COMMUNITY CAPACITY AND PARTNERSHIPS.TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2023 (FY23), TRINITY HEALTH CONTRIBUTED $1.47 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. IN ADDITION TO ANNUAL COMMUNITY BENEFIT SPENDING, TRINITY HEALTH IMPLEMENTS A SOCIALLY RESPONSIBLE INVESTING PROGRAM. AS OF THE END OF FY23, $62.7 MILLION (INCLUDING $7.0 MILLION IN NEW LENDING) WAS ALLOCATED IN THE FOLLOWING AREAS:- HOUSING: BUILDING AFFORDABLE HOUSING; IMPROVING ACCESS TO SENIOR HOUSING; AND COMBATTING HOMELESSNESS ($35.5 MILLION)- EDUCATION: SUPPORTING STUDENTS ENTERING THE HEALTH PROFESSIONS ($10.1 MILLION)- FACILITIES: BUILDING COMMUNITY FACILITIES FOR NONPROFITS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS ($9.7 MILLION)- ECONOMIC DEVELOPMENT: ENCOURAGING SMALL BUSINESS DEVELOPMENT, CREATING LOCAL JOBS AND SUPPORTING ACCESS TO HEALTHY FOODS; QUALITY CHILDCARE; AND OTHER COMMUNITY SERVICES ($7.4 MILLION)ACROSS THE SYSTEM, NEARLY 700,000 OF PATIENTS SEEN IN PRIMARY CARE SETTINGS WERE SCREENED FOR SOCIAL NEEDS. FOR ABOUT 30% OF THOSE PATIENTS, AT LEAST ONE SOCIAL NEED WAS IDENTIFIED. TOGETHERCARE - TRINITY HEALTH'S ELECTRONIC HEALTH RECORD, POWERED BY EPIC - HAS MADE IT POSSIBLE FOR TRINITY HEALTH TO STANDARDIZE SCREENING FOR SOCIAL NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES THROUGH THE COMMUNITY RESOURCE DIRECTORY (COMMUNITYRESOURCES.TRINITY-HEALTH.ORG). COMMUNITY HEALTH WORKERS (CHW'S) SERVE AS LIAISONS BETWEEN HEALTH AND SOCIAL SERVICES. TRINITY HEALTH CHW'S PARTNERED WITH POPULATION HEALTH NURSES AND SOCIAL WORK CARE MANAGERS TO SERVE MEDICARE PATIENTS AT RISK FOR PREVENTABLE HOSPITALIZATIONS, RESULTING IN A DECREASE IN PREVENTABLE HOSPITALIZATIONS FOR THE MEDICARE POPULATION OVERALL, AND ALSO FOR LOW-INCOME PATIENTS DUALLY ENROLLED IN MEDICARE AND MEDICAID. CHW'S ADVANCE SOCIAL AND CLINICAL CARE INTEGRATION BY ASSESSING AND ADDRESSING A PATIENT'S SOCIAL NEEDS, HOME ENVIRONMENT AND OTHER SOCIAL RISK FACTORS, AND ULTIMATELY CONNECTING THE PATIENT (AND THEIR FAMILY) TO SERVICES WITHIN THE COMMUNITY. TRINITY HEALTH PROVIDES A 40+ HOUR FOUNDATIONAL CHW AND CHRONIC DISEASE-SPECIFIC TRAINING TO TRINITY HEALTH-EMPLOYED CHW'S AND ALSO TO COMMUNITY PARTNERS THAT EMPLOY CHW'S. IN 2017, TRINITY HEALTH RECEIVED A SIX-YEAR, $8.5 MILLION GRANT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION TO INCREASE THE NUMBER OF NATIONAL DIABETES PREVENTION PROGRAM (DPP) DELIVERY SITES, INCREASE PROGRAM ENROLLMENT, MAINTAIN PARTICIPATION RATES, AND INCREASE BENEFIT COVERAGE. IN ADDITION, THE GRANT WAS USED TO STANDARDIZE CLINICAL SCREENING AND DETECTION OF DIABETES. DURING THE GRANT PERIOD, TRINITY HEALTH BUILT THE NATIONAL DPP INTO ITS ELECTRONIC HEALTH RECORD SYSTEM TO MAKE IDENTIFYING PATIENTS AND ENROLLING THEM IN THE PROGRAM EASIER. SINCE SEPTEMBER 2017, OVER 6,000 PARTICIPANTS HAVE ENROLLED IN A TRINITY HEALTH NATIONAL DPP AND HAVE COLLECTIVELY LOST A TOTAL OF OVER 51,000 POUNDS.LASTLY, TRINITY HEALTH'S FY23 SHAREHOLDER ADVOCACY PRIORITIES FOCUSED ON IMPROVING CORPORATE POLICIES AND PRACTICES THAT IMPACT COMMUNITIES, WITH THE AIM OF REDUCING STRUCTURAL RACISM AND HEALTH INEQUITIES. TRINITY HEALTH, IN COLLABORATION WITH ITS PARTNERS THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY AND THE INVESTOR ENVIRONMENTAL HEALTH NETWORK, FILED SHAREHOLDER PROPOSALS AT 20 COMPANIES. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES MD 1 SISTERS OF THE HOLY CROSS FINANCIAL SERVICES ST MARYS LOURDES HALL NOTRE DAME IN 465565014 350868159 501(C)(3) 156600 0 SUPPORT FOR THE FORMAL MINISTRIES OF THE SISTERS OF THE HOLY CROSS MONTGOMERY COUNTY FOOD COUNCIL INC PO BOX 34412 BETHESDA MD 20827 824630058 501(C)(3) 50000 0 IMPROVING COMMUNITY HEALTH COMMUNITY FARMSHARE 14975 SUGARLAND RD POOLESVILLE MD 20837 861311884 501(C)(3) 59596 0 PRODUCE PRESCRIPTION PROGRAM 3 0 TRANSPORTATION FOR PATIENTS 135 6894 SPECIALTY CARE FOR PATIENTS SUCH AS SONOGRAMS ETC. 90 18681 FOOD PROGRAMS 376 16767 PATIENT PERSONAL NEEDS 47 6927 SUPPORT FOR FAMILIES OF PATIENTS 528 58734 COLLEAGUE ASSISTANCE 3 5821 ADULT DAYCARE PATIENT SCHOLARSHIP 2 4780 HOUSING AND UTILITIES ASSISTANCE TO PATIENT AND COLLEAGUES 7 6979 PART I, LINE 2: DONATIONS MADE BY HOLY CROSS HEALTH TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 1 1 0 0 0 0 0 0 0 NORVELL COOTS MD DIRECTOR; PRESIDENT & CEO 0 573168 0 199500 0 157259 0 13725 0 29345 0 972997 0 0 DOUG RYDER FORMER OFFICER 0 172306 0 103988 0 207960 0 329863 0 14459 0 828576 0 0 GREG JOLISSAINT VP MILITARY & VET HEALTH THR 8/22 0 227560 0 87205 0 135260 0 232661 0 14873 0 697559 0 0 LOUIS DAMIANO MD PRESIDENT OF HCH & HCGH 0 442509 0 104043 0 80954 0 13725 0 43598 0 684829 0 0 TINA WEATHERWAX-GRANT DIR; TH SVP PUBLIC POLICY & ADVOCACY 0 348364 0 159131 0 19200 0 110198 0 32472 0 669365 0 0 KRISTIN FELICIANO VP CHIEF STRATEGY OFFICER THR 10/22 0 244923 0 61875 0 69566 0 261968 0 28869 0 667201 0 0 RINY KARRAS MD THORACIC SURGEON 513796 0 0 0 843 0 13725 0 7104 0 535468 0 0 0 GRIFFIN DAVIS MD CHIEF CLINICAL OFFICER 0 402137 0 73000 0 3011 0 19144 0 34415 0 531707 0 0 ANNICE CODY PRESIDENT HCH NETWORK 0 338063 0 68769 0 7577 0 22875 0 34496 0 471780 0 0 ANN BURKE HCH VP MEDICAL AFFAIRS THROUGH 12/22 356309 0 70936 0 2428 0 18300 0 23056 0 471029 0 0 0 ELIZABETH SIMPSON ASST SECRETARY; VP MANAGING COUNSEL 0 299490 0 75528 0 12243 0 18300 0 29370 0 434931 0 0 ANNE GILLIS ASSISTANT TREASURER & CFO 0 308613 0 62550 0 9555 0 22875 0 26870 0 430463 0 0 RHONIQUE SHIELDS HCH NETWORK VP MEDICAL AFFAIRS 320979 0 64705 0 6964 0 13725 0 21068 0 427441 0 0 0 PART I, LINE 3 HOLY CROSS HEALTH IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. HOLY CROSS HEALTH'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF HOLY CROSS HEALTH'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2022. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KRISTIN FELICIANO - $61,284 GREG JOLISSAINT - $120,751 DOUG RYDER - $123,422 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNTS, WHICH WERE UNPAID AS OF 12/31/22: KRISTIN FELICIANO - $257,393 (PAID IN 2023) GREG JOLISSAINT - $228,086 (PAID IN 2023) DOUG RYDER - $325,698 ($297,128 PAID IN 2023 AND $28,570 TO BE PAID IN 2024) THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2022, AND THEIR NON-VESTED BENEFITS FOR 2022 WERE ACCRUED. THE FOLLOWING PAYOUTS FOR 2022 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: NORVELL COOTS - $131,001 LOUIS DAMIANO - $64,467 DOUG RYDER - $69,662 THE FOLLOWING ACCRUAL FOR 2022 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: TINA WEATHERWAX-GRANT - $91,898 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($305,000 FOR 2022). THE FOLLOWING PAYOUTS FOR 2022 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: ANNICE CODY - $3,399 GRIFFIN DAVIS - $0 KRISTIN FELICIANO - $2,227 ANNE GILLIS - $2,346 TINA WEATHERWAX-GRANT - $4,554 GREG JOLISSAINT - $4,082 ELIZABETH SIMPSON - $2,370 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 209700 DONOR PROVIDED GOODS/SERVICES TO HOLY CROSS HEALTH 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 845169 DONOR PROVIDED GOODS/SERVICES TO HOLY CROSS HEALTH 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF HOLY CROSS HEALTH IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF HOLY CROSS HEALTH. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF HOLY CROSS HEALTH. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION A, LINE 8B LINE 8B IS ANSWERED "NO" BECAUSE HOLY CROSS HEALTH HAD NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR HOLY CROSS HEALTH IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE AS WELL AS THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C HOLY CROSS HEALTH HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF HOLY CROSS HEALTH, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, AND KEY EMPLOYEES. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF HOLY CROSS HEALTH AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF HOLY CROSS HEALTH ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO HOLY CROSS HEALTH OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF HOLY CROSS HEALTH IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF HOLY CROSS HEALTH. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR HOLY CROSS HEALTH'S CEO, OFFICERS AND KEY MANAGEMENT OFFICIALS IS ESTABLISHED AND PAID BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO, HOSPITAL PRESIDENT AND CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO, HOSPITAL PRESIDENT AND CFO OF HOLY CROSS HEALTH ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR OTHER EXECUTIVES WHO ARE NOT PART OF THE REBUTTABLE PRESUMPTION PROCESS, TRINITY HEALTH USES A MARKET ANALYSIS TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 HOLY CROSS HEALTH IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, HOLY CROSS HEALTH INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. HOLY CROSS HEALTH'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 39,528,048. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,528,048. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 386,684. MANAGEMENT AND GENERAL EXPENSES 741,773. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,128,457. BILLING SERVICES: PROGRAM SERVICE EXPENSES 146,385. MANAGEMENT AND GENERAL EXPENSES 2,001,832. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,148,217. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,763,217. MANAGEMENT AND GENERAL EXPENSES 6,913,453. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,676,670. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,178,031. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,178,031. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 3,356. MANAGEMENT AND GENERAL EXPENSES 445,249. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 448,605. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 15,985,359. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,985,359. LAUNDRY AND LINEN SERVICES: PROGRAM SERVICE EXPENSES 1,674,657. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,674,657. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFILIATES -4,150,930. EQUITY GAIN IN UNCONSOL. AFFILIATES 14,598,105. FORM 990, PART XII, LINE 2: HOLY CROSS HEALTH'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY23 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, PART C, DOING BUSINESS AS NAMES: HOLY CROSS HOSPITAL HOLY CROSS GERMANTOWN HOSPITAL HOLY CROSS HEALTH NETWORK HOLY CROSS DIALYSIS CENTER AT WOODMORE HOLY CROSS HEALTH CENTER HOLY CROSS HOSPITAL DIALYSIS HOLY CROSS HEALTH PARTNERS PROFESSIONAL SERVICES OF HOLY CROSS SENIOR FIT HOLY CROSS HEALTH CENTERS LLC 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 822340203 PHYSICIAN NETWORK MD 0 2035356 HOLY CROSS HEALTH INC HOLY CROSS HEALTH PARTNERS LLC 1500 FOREST GLEN ROAD SILVER SPRING MD 20910 822391212 PHYSICIAN NETWORK MD 347001 1255432 HOLY CROSS HEALTH INC ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD CT 06105 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL HEALTH FOUNDATION-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 521025476 FOUNDATION NJ 501(C)(3) LINE 7 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH LIFE INC 7500 K JOHNSON BOULEVARD BORDENTOWN NJ 08505 222797282 PACE PROGRAM NJ 501(C)(3) LINE 10 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH MEDICAL GROUP-EAST TRENTON PA 601 HAMILTON AVENUE TRENTON NJ 08629 832199054 HEALTH CARE SERVICES NJ 501(C)(3) LINE 3 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 223431049 HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA STREET COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP 5315 ELLIOTT DR 102 YPSILANTI MI 48197 382507173 HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVENUE DES MOINES IA 50314 420680448 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST SW ELKADER IA 52043 420818642 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY COMMUNITY HOSPITAL GROUP LLC 1 COVENANT FOUNDATION INC 3421 WEST NINTH STREET WATERLOO IA 50702 421295784 FOUNDATION IA 501(C)(3) LINE 7 COVENANT MEDICAL CENTER INC 1 COVENANT MEDICAL CENTER INC 3421 WEST NINTH STREET WATERLOO IA 50702 421264647 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 WHEATON FRANCISCAN HEALTHCARE-IOWA INC 1 DILEY RIDGE MEDICAL CENTER 3100 EASTON SQUARE PL STE 300 COLUMBUS OH 43219 342032340 HEALTH CARE AND HOSPITAL SERVICES OH 501(C)(3) LINE 3 MOUNT CARMEL HEALTH SYSTEM 1 DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE IA 52001 262227941 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 FOUNDATION IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 EDDY LICENSED HOME CARE AGENCY 433 RIVER ST SUITE 3000 TROY NY 12180 141818568 HOME HEALTH SERVICES NY 501(C)(3) LINE 3 LTC (EDDY) INC 1 EMBRACING AGE INC 333 BUTTERNUT DRIVE DEWITT NY 13214 461051881 PACE PROGRAM NY 501(C)(3) LINE 12B, II ST JOSEPH'S HEALTH INC 1 EMPIRE HOME INFUSION SERVICE INC 10 BLACKSMITH DRIVE MALTA NY 12020 141795732 HOME HEALTH SERVICES NY 501(C)(3) LINE 10 HOME AIDE SERVICE OF EASTERN NEW YORK INC 1 FARREN CARE CENTER INC PO BOX 9184 FARMINGTON HILLS MI 48333 042501711 LONG TERM CARE MA 501(C)(3) LINE 3 TRINITY CONTINUING CARE SERVICES 1 FRANCISCAN ELDERCARE CORPORATION PO BOX 2500 WILMINGTON DE 19805 223008680 LONG TERM CARE (INACTIVE) DE 501(C)(3) LINE 10 ST FRANCIS HOSPITAL INC 1 GENESIS HEALTH SERVICES FOUNDATION 1227 E RUSHOLME STREET DAVENPORT IA 52803 421421670 FOUNDATION IA 501(C)(3) LINE 7 GENESIS HEALTH SYSTEM 1 GENESIS HEALTH SYSTEM 1227 E RUSHOLME STREET DAVENPORT IA 52803 421418847 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 GENESIS HEALTH SYSTEM (IL) 801 ILLINI DRIVE SILVIS IL 61282 363616314 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST 1227 E RUSHOLME STREET DAVENPORT IA 52803 391905171 EMPLOYEE BENEFIT TRUST IA 501(C)(3) LINE 12A, I GENESIS HEALTH SYSTEM 1 GENESIS MEDICAL CENTER ALEDO 409 NW 9TH AVENUE ALEDO IL 61231 454475683 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 GENESIS HEALTH SYSTEM (IL) 1 GLACIER HILLS FOUNDATION 1200 EARHART RD ANN ARBOR MI 48105 208072723 FOUNDATION MI 501(C)(3) LINE 12A, I GLACIER HILLS INC 1 GLACIER HILLS INC 1200 EARHART RD ANN ARBOR MI 48105 381891500 SENIOR LIVING COMMUNITY MI 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 GLEN EDDY INC 1 GLEN EDDY DRIVE NISKAYUNA NY 12309 141794150 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 TRINITY HEALTH GEORGIA INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GOTTLIEB MEMORIAL FOUNDATION 701 WEST NORTH AVENUE MELROSE PARK IL 60160 743260011 FOUNDATION IL 501(C)(3) LINE 12D, III-O N/A 0 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160 362379649 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH NY 12061 800102840 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HEARTWOOD LODGE TRINITY HEALTH (FKA NORTH OTTAWA CARE CENTER) 18525 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