2022-05-14T11:45:29-05:00 2021-06-30 135565207 KPMG LLP 1225 17TH ST SUITE 800 DENVER CO 80202 990 2020-07-01 300752920 TRINITY HEALTH SYSTEM GROUP TRIN 7402837000 380 SUMMIT AVENUE STEUBENVILLE OH 43952 DAVE WERKIN CFO 7402837000 2022-05-14 1 DAVE WERKIN 999009999 MARK SHELTON P01203482 3032962323 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MATT GRIMSHAW 380 SUMMIT AVENUE STEUBENVILLE OH 43952 276048727 1 1 5388 X WWW.TRINITYHEALTH.COM X 1996 OH A COMMUNITY PARTNER DEDICATED TO EXCELLENCE IN SERVING THE HEALTH NEEDS OF THE TRI-STATE AREA. 15 11 2273 50 554871 330144 5524164 3441229 217130131 254207246 7561074 14532421 6221638 3867831 236437007 276048727 3300 6306 0 0 127239919 135485926 0 0 0 108248428 120334369 235491647 255826601 945360 20222126 322194187 371217232 74626121 75421448 247568066 295795784 X AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 156197674 4284 172347377 OUTPATIENT SERVICES:THROUGH JUNE 2021, THE CENTER REALIZED 6,847 ACUTE ADMISSIONS AND 289,965 OUTPATIENT VISITS. IN LINE WITH TRINITY HEALTH SYSTEM'S VALUES, SERVICE, REVERENCE AND STEWARDSHIP, THE TONY TERAMANA CANCER CENTER CAN MEET THE NEEDS OF CANCER PATIENTS THROUGH A HOLISTIC APPROACH WHICH INCLUDES COMPASSION, CONCERN, DIGNITY AND RESPECT. TRINITY HEALTH SYSTEM'S CARDIAC REHABILITATION PROGRAM IS DESIGNED TO EFFECT LIFESTYLE CHANGE IN PATIENTS ENROLLED. THESE CHANGES ARE ACHIEVED THROUGH SAFE PHYSICAL CONDITIONING, SOUND EDUCATIONAL SESSIONS, AND GROUP SUPPORT, WHICH EMPHASIZE THE UNDERSTANDING OF RISK FACTORS ASSOCIATED WITH HEART DISEASE. THE PROGRAM'S GOAL IS TO ENHANCE THE QUALITY OF LIFE FOR THE PATIENT. AGE IS NOT A FACTOR. OUR SPECIALLY TRAINED STAFF WORK WITH PATIENTS, THEIR FAMILIES, AND PHYSICIANS TO DEVELOP A PERSONALIZED PROGRAM OF HEALTH AND WELLNESS. THE GOALS OF THE CARDIAC REHAB PROGRAM ARE INCREASED UNDERSTANDING OF HEART DISEASE, INCREASED ENDURANCE, DECREASED HEART RATE AND BLOOD PRESSURE, INCREASED MUSCULAR FITNESS, REDUCED CHOLESTEROL/TRIGLYCERIDE LEVELS, DECREASED BODY FAT, BETTER NUTRITION MANAGEMENT AND IMPROVED SENSE OF WELL-BEING. AN INTEGRAL PART OF THE OVERALL PROGRAM, EDUCATION, INCREASES A PATIENT'S UNDERSTANDING OF THEIR ILLNESS AND HELPS THEM TO IDENTIFY CURRENT HABITS THAT CAN NEGATIVELY AFFECT THEIR CARDIAC CONDITION. WE COVER ISSUES LIKE RISK FACTOR REDUCTION, ANGINA, HEART ATTACK, MEDICATION, DIETARY AND EXERCISE GUIDELINES, SMOKING, AND BREATHING AND RELAXATION METHODS. INDIVIDUALS ENROLLED IN THIS PHASE ARE REFERRED BY THEIR PHYSICIAN. AFTER AN ASSESSMENT OF CONDITION IS MADE, A PATIENT IS SCHEDULED FOR EXERCISE TRAINING WITH MONITORING. RISK FACTORS, DIET, AND LIFESTYLE CHANGES ARE ALSO DISCUSSED. CONVENIENT SESSIONS ARE SCHEDULED THREE TIMES PER WEEK AND LAST APPROXIMATELY ONE HOUR. ONCE THE OUTPATIENT PROGRAM IS CONCLUDED, PATIENTS MAY CONTINUE THIS PHASE IN ORDER TO INSURE THEIR QUALITY OF LIFE. THEIR ONGOING PARTICIPATION IN THE PROGRAM CAN OFFER THEM INCREASED ENDURANCE, DECREASED HEART RATE AND BLOOD PRESSURE, AND INCREASED MUSCULAR FITNESS. TRINITY WORKCARE IS THE OCCUPATIONAL HEALTH DEPARTMENT OF TRINITY HEALTH SYSTEM AND PROVIDES A COMPREHENSIVE OCCUPATIONAL HEALTH SERVICE TO THE BUSINESS COMMUNITY. OUR PROGRAM IS DESIGNED TO ASSIST THE CLIENT COMPANY DECREASE LOST WORK TIME, MEDICAL EXPENSES, INSURANCE PREMIUMS ANDMAINTAIN COMPLIANCE WITH COMPANY AND GOVERNMENT REGULATIONS. WORKCARE SERVICES INCLUDE MEDICAL SURVEILLANCE, SUBSTANCE ABUSE TESTING, INJURY TREATMENT AND CASE MANAGEMENT, PHYSICAL THERAPY, WELLNESS PROMOTION AND EMPLOYEE ASSISTANCE PROGRAM. THROUGH JUNE 2021, THERE WERE 7,278 VISITS TO WORKCARE. OUTPATIENT OCCUPATIONAL THERAPY AT TRINITY IS PROVIDED BOTH AS AN EXTENSION OF SERVICES RECEIVED AS AN INPATIENT OR YOU CAN RECEIVE SERVICES AS A NEW PATIENT. WE ARE STAFFED TO PROVIDE EXPERTISE WITH ALL NEUROLOGICAL AND ORTHOPEDIC DISORDERS AND SPECIALIZE IN THE AREA OF HAND DISORDERS. WE PROVIDE EXERCISE, MODALITIES (PARAFFIN, ULTRASOUND, IONTOPHORESIS, FLUIDOTHERAPY AND E-STIM), FUNCTIONAL ACTIVITIES, SPLINTING/BRACING AND ADL TRAINING. PHYSICAL THERAPY ASSESSES YOUR MOVEMENT, STRENGTH AND ENDURANCE AND WILL HELP TO RESTORE QUALITY OF MUSCLE TONE, COORDINATION, BALANCE, STRENGTH, ENDURANCE, JOINT FLEXIBILITY AND FUNCTIONAL MOBILITY. OUR DEPARTMENT IS FULLY EQUIPPED TO ALLOW FOR PRIVATE TREATMENT. ADDITIONALLY A MODERN GYM IS UTILIZED FOR YOUR EXERCISE NEEDS. WE PROVIDE SPECIALIZED PROGRAMS IN EXERCISE, FUNCTIONAL ACTIVITIES AND MODALITIES. OUR SPEECH PATHOLOGY DEPARTMENT IS EQUIPPED TO RENDER A BROAD SPECTRUM OF DIAGNOSTIC AND REHABILITATIVE SERVICES TO CHILDREN, ADOLESCENTS AND ADULTS WITH DISORDERS ASSOCIATED WITH DECREASED COGNITIVE SKILLS, APHASIA, APRAXIA, DYSARTHRIA, VOICE, AND DELAYED SPEECH AND LANGUAGE. WE ALSO SPECIALIZE IN DIAGNOSTIC AND THERAPEUTIC INTERVENTIONS FOR PATIENTS WITH SWALLOWING DISORDERS. TO SUPPORT SENIORS THROUGH TRYING TIMES, WE PROUDLY OFFER THE TRINITY SENIOR PROGRAM, A THERAPEUTIC PROGRAM DESIGNED TO MEET THE EMOTIONAL AND PSYCHOLOGICAL NEEDS OF OLDER ADULTS. WE SEE PATIENTS 55 YEARS OR OLDER THAT ARE EXPERIENCING EMOTIONAL DIFFICULTIES SUCH AS DEPRESSION, ANXIETY, GRIEF, ANGER AND OTHER EMOTIONAL ISSUES. THE SHORT TERM OUTPATIENT PROGRAM INCLUDES SUPPORT GROUPS, OCCUPATIONAL AND RECREATIONAL GROUPS, AND HEALTH/MEDICATION EDUCATION. TRINITY HOME HEALTH IS SPECIAL HOME CARE FOR SPECIAL PEOPLE. THE DISCIPLINES OFFERED ARE SKILLED NURSING CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, MEDICAL SOCIAL SERVICES (OHIO) AND HOME HEALTH AIDES. THROUGH JUNE 2021, THE HOME HEALTH DEPARTMENT REALIZED 17,717 HOME VISITS. 58198013 1596 64215264 INPATIENT SERVICES:IN EASTERN OHIO, THE HOSPITAL INCLUDES TRINITY EAST AND TRINITY WEST WHICH HAS A COMBINED CAPACITY OF OVER 500 BEDS. TRINITY EAST OFFERS A VARIETY OF SERVICES INCLUDING SKILLED CARE, LONG-TERM CARE, INPATIENT PHYSICAL REHABILITATION AND BEHAVIORAL MEDICINE SERVICES (MENTAL HEALTH & ADDICTION RECOVERY). TRINITY WEST IS A FULL SERVICE ACUTE CARE FACILITY OFFERING 24-HOUR EMERGENCY CARE, KIDNEY DIALYSIS, LITHOTRIPSY, ENDOSCOPY AND RELATED SERVICES, SURGERY AND MEDICAL SURGICAL INPATIENT UNITS, COMPREHENSIVE CARDIAC CARE, PEDIATRICS, WOMEN'S HEALTH, INPATIENT/OUTPATIENT SURGICAL SERVICES, WOUND CLINIC, OCCUPATIONAL MEDICINE AND A FULL ARRAY OF DIAGNOSTIC CAPABILITIES. THE TRINITY SKILLED CARE CENTER, A HOSPITAL-BASED SKILLED AND LONG TERM CARE NURSING FACILITY, IS FULLY CERTIFIED FOR 50 BEDS AND WAS DEVELOPED TO MEET THE NEEDS OF PATIENTS WHO REQUIRE ADDITIONAL SKILLED CARE BEYOND THE ACUTE PHASE OF ILLNESS OR INJURY. THROUGH JUNE 2021, TRINITY SKILLED CARE CENTER HAD 314 ADMISSIONS AND 6,106 PATIENT DAYS. THE SKILLED CARE CENTER ALSO HAS AN ONGOING ACTIVITY PROGRAM. PATIENTS ARE ENCOURAGED TO PARTICIPATE IN THESE ENJOYABLE ACTIVITIES AS A GROUP OR INDIVIDUALLY. THE ATMOSPHERE IS INFORMAL AND RELAXING TO AID IN THE EMOTIONAL WELL-BEING OF EACH PATIENT. DISCHARGE PLANNING BEGINS ON ADMISSION TO TRINITY SKILLED CARE CENTER. INDIVIDUALIZED GOALS ARE ESTABLISHED WITH THE PATIENT, THE PATIENT'S FAMILY AND A HIGHLY QUALIFIED TEAM OF PROFESSIONALS. THIS TEAM INCLUDES: THE ATTENDING PHYSICIAN, NURSE, SOCIAL SERVICES, DIETITIAN, PHYSICAL THERAPIST, OCCUPATIONAL THERAPIST AND SPEECH THERAPIST. THIS PROCESS ASSURES THE CONTINUITY OF CARE UPON DISCHARGE. TRINITY'S REHABILITATION CENTER PROVIDES AN INTEGRATED AND INTERDISCIPLINARY TEAM APPROACH TO HELP PATIENTS WHO HAVE PHYSICAL IMPAIRMENTS. PROGRAMS ARE AVAILABLE FOR PATIENTS WITH STROKES AND OTHER NEUROLOGICAL DISORDERS, ARTHRITIS, AMPUTATIONS, JOINT REPLACEMENTS AND OTHER ORTHOPEDIC PROBLEMS, BRAIN INJURY, AND SPINAL CORD INJURY. THE CENTER HAS 20 PRIVATE ROOMS, EACH SPECIALLY DESIGNED FOR REHABILITATION. PATIENTS ALSO UTILIZE A HOME-LIKE APARTMENT TO REGAIN SKILLS SUCH AS COOKING, BATHING AND DRESSING. PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH-LANGUAGE PATHOLOGY AREAS HAVE STATE-OF-THE-ART EQUIPMENT, AND THE THERAPISTS ARE HIGHLY TRAINED REHABILITATION SPECIALISTS. A VAN IS AVAILABLE FOR COMMUNITY OUTINGS AND HOME VISITS. THESE TRIPS PROVIDE OPPORTUNITIES FOR PATIENTS TO PRACTICE THEIR SKILLS IN THEIR COMMUNITY, HOME AND WORK PLACE WHEN APPROPRIATE. WITH A TEAM APPROACH TO TREATMENT, A PERSONALIZED REHABILITATION PROGRAM IS DESIGNED TO MEET THE UNIQUE NEEDS AND GOALS OF EACH PATIENT. THE TEAM CONSISTS OF THE PATIENT, HIS/HER FAMILY, PHYSICIANS, REHABILITATION NURSES, PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, SPEECH LANGUAGE PATHOLOGISTS, PSYCHOLOGISTS, SOCIAL WORKERS, THERAPEUTIC RECREATIONAL SPECIALISTS, DIETITIANS, RESPIRATORY THERAPISTS, CASE COORDINATORS AND VOCATIONAL COUNSELORS. THROUGH A POSITIVE, PERSONALIZED AND INTERDISCIPLINARY APPROACH, THE TEAM HELPS PATIENTS REGAIN PHYSICAL, EMOTIONAL, SOCIAL AND VERBAL SKILLS. THROUGH JUNE 2021, THE REHAB CENTER HAD 196 ADMISSIONS AND 2,065 PATIENT DAYS. THE WOMEN'S HEALTH & BIRTH CENTER IS PROUD TO OFFER TOTAL MATERNITY CARE. OUR SPECIALLY QUALIFIED STAFF OF DEDICATED NURSES AND PHYSICIANS GUIDES YOU AND YOUR FAMILY THROUGH A COMPREHENSIVE EDUCATION EXPERIENCE AND THE CHILDBIRTH EXPERIENCE. AT THE WOMEN'S HEALTH & BIRTH CENTER YOU DELIVER YOUR BABY IN A SPECIALLY DESIGNED CHILDBEARING ROOM FOR YOUR ENTIRE HOSPITAL STAY: ADMISSION PROCEDURES, LABOR, DELIVERY, AND RECOVERY. YOUR POSTPARTUM STAY IS IN A SPECIALLY DESIGNED ROOM THAT MAKES THE FAMILY EXPERIENCE ONE YOU WILL ALWAYS REMEMBER. OUR PRIVATE CHILDBEARING ROOMS ARE EQUIPPED FOR THE ENTIRE BIRTH EXPERIENCE. ALL FORMS OF PAIN RELIEF EXCEPT GENERAL ANESTHESIA MAY BE PROVIDED IN THIS ROOM. CESAREAN DELIVERIES ARE PERFORMED IN THE WOMEN'S HEALTH & BIRTH CENTER IN A MODERN, STATE OF THE ART SURGICAL SUITE, WITH LABOR AND POSTPARTUM CARE PROVIDED IN A WOMEN'S HEALTH & BIRTH CENTER SUITE. THE SURGICAL SUITE MAY ALSO BE USED BY THOSE WISHING A MORE TRADITIONAL BIRTH EXPERIENCE. FATHERS ARE ENCOURAGED TO STAY AT THE HOSPITAL; SLEEPING ACCOMMODATIONS ARE PROVIDED AT NO EXTRA CHARGE. AT THE WOMEN'S HEALTH & BIRTH CENTER, ROOMING-IN IS FLEXIBLE AND DESIGNED TO MEET YOUR INDIVIDUAL NEEDS. YOU AND YOUR FAMILY ARE PARTNERS WITH US IN THE CARE OF YOUR BABY. IF YOU WANT TO REST OR HAVE TIME ALONE WE CAN CARE FOR YOUR BABY IN OUR WELLEQUIPPED NURSERY NEAR YOUR ROOM. IN THE WOMEN'S HEALTH & BIRTH CENTER, A SPECIALLY TRAINED PERINATAL NURSE IS ASSIGNED TO EACH MOTHER AND BABY TO PROVIDE PERSONAL, INDIVIDUALIZED CARE. EXTRA TIME AND TEACHING ARE INTEGRAL PARTS OF THE ATTENTION WEGIVE ALL FAMILIES. AFTER DISCHARGE, WE KNOW THAT QUESTIONS OFTEN ARISE AND IT IS GOOD TO HAVE SOMEONE WITH WHOM YOU CAN TALK. BUT EVEN MORE, WE ARE INTERESTED IN YOU AND WE WANT TO PROVIDE AS MUCH CARE AND ASSISTANCE AS WE CAN DURING THIS SPECIAL TIME IN YOUR LIFE. ONCE HOME, A PERINATAL NURSE FROM THE WOMEN'S HEALTH & BIRTHING CENTER IS AVAILABLE FOR CONSULTATION THROUGH TELEPHONE CALLS TO ALL PATIENTS. SIMPLY CALL AT ANY TIME OF THE DAY OR NIGHT IF YOU NEED ASSISTANCE OR INFORMATION. THROUGH JUNE 2021, THE WOMEN'S HEALTH & BIRTH CENTER DELIVERED 313 BABIES. 15521746 426 17126582 EMERGENCY ROOM:THE EMERGENCY SERVICES OF TRINITY HEALTH SYSTEM ARE AVAILABLE AT TRINITY MEDICAL CENTER WEST. THE ER HAS BEEN REMODELED AND EXPANDED TO ACCOMMODATE PATIENTS REQUIRING TREATMENT - IT HAS DOUBLED IN SIZE AND NOW HAS TWICE AS MANY TREATMENT BEDS AVAILABLE AND MORE PHYSICIAN, PROFESSIONAL AND SUPPORT STAFF HAVE BEEN ADDED TO PROVIDE CARE. A DEDICATED X-RAY ROOM, HAS BEEN CONSTRUCTED ADJACENT TO THE ER AND SPECIAL TREATMENT AREAS HAVE BEEN CONSTRUCTED FOR CARDIAC EMERGENCIES, TRAUMA, PEDIATRIC EMERGENCIES, OBSTETRICAL EMERGENCIES, SUTURING AND FRACTURES. THE ER IS OPEN 24 HOURS / 7 DAYS A WEEK FOR ALL LEVELS OF EMERGENCY AND URGENT CARE. THROUGH JUNE 2021, WE HAD 32,251 EMERGENCY ROOM VISITS. 229917433 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 89 0 1 2273 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 11 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X JAMES DUMPMAN 7402837000 380 SUMMIT AVENUE STEUBENVILLE OH 43952 LARRY SCHUMACHER BOARD MEMBER 2.00 45.00 X 0 1962777 220294 RAMANA MURTY MD PHYSICIAN 40.00 0.00 X 1328530 0 25275 RAFAEL SCHMULEVICH MD PHYSICIAN 40.00 0.00 X 1099923 0 29863 SATHISH MAGGE MD PHYSICIAN 40.00 0.00 X 1058467 0 23618 KUMAR AMIN MD PHYSICIAN 40.00 0.00 X 1035582 0 28621 BALDEV SEKHON MD PHYSICIAN 40.00 0.00 X 926489 0 26650 MATT GRIMSHAW PRESIDENT & CEO 5.00 45.00 X X 651707 29299 43267 RICK GRECO DO PRESIDENT, MEDICAL GROUP ENTERPRISE 5.00 45.00 X 399573 0 21935 DAVE WERKIN CFO 5.00 45.00 X 304583 0 28579 BRENT MALLEK VP OF HR 50.00 2.00 X 264294 0 22395 JIM MIDDLETON DIRECTOR OF NURSING 50.00 2.00 X 255327 0 13699 PAUL WHEELER VP OF OPERATIONS / COO 5.00 45.00 X 195119 0 22517 JIM MIRASOLA VP OF MEDICAL GROUP ENTERPRISE 50.00 2.00 X 181591 0 12215 FRED BROWER FORMER PRESIDENT & CEO 0.00 0.00 X 147768 0 0 JOHN COLUMBUS MD BOARD MEMBER 2.00 3.00 X 9825 0 0 MATTHEW COLFLESH MD BOARD MEMBER 2.00 3.00 X 4575 0 0 MICHAEL BIASI BOARD MEMBER 2.00 3.00 X 0 0 0 DAN DAILY BOARD MEMBER 2.00 3.00 X 0 0 0 SISTER DIANA LYNN ECKEL BOARD MEMBER 2.00 3.00 X 0 0 0 ERIC EXLEY SECRETARY 2.00 3.00 X X 0 0 0 SHEILA HENDRICKS BOARD MEMBER 2.00 3.00 X 0 0 0 MARK MORELLI BOARD MEMBER 2.00 3.00 X 0 0 0 JAMES PADDEN CHAIRMAN 2.00 3.00 X X 0 0 0 DOUGLAS SCHAEFER VICE CHAIRMAN 2.00 3.00 X X 0 0 0 DAVID SKIVIAT SR TREASURER 2.00 3.00 X X 0 0 0 DENNIS WOLTERS BOARD MEMBER 2.00 3.00 X 0 0 0 AARON PROVENZANO DO BOARD MEMBER 2.00 3.00 X 0 0 0 7863353 1992076 518928 127 1 1 0 UPMC CANCER CENTER PO BOX 223270 PITTSBURGH PA 15251 ONCOLOGISTS 5197537 STEEL VALLEY HOSPITALISTS 2720 SUNSET BLVD STEUBENVILLE OH 43952 HOSPITALISTS 2370450 MAXIM HEALTHCARE SERVICES 12558 COLLECTIONS CTR DR CHICAGO IL 60693 HEALTHCARE STAFFING 2171461 WASHINGTON HEALTHCARE STRATEGIES PO BOX 463 BRIDGEVILLE PA 15017 ANESTHESIOLOGISTS 1767362 GUARDIAN HEALTHCARE PROVIDERS PO BOX 306098 NASHVILLE TN 37230 HEALTHCARE STAFFING 1326214 37 445870 2916461 78898 3441229 PATIENT SERVICES 900099 254207246 253689223 518023 0 254207246 2520661 36848 2483813 201212 0 201212 201212 201212 12011760 0 12011760 12011760 12011760 PHARMACY SERVICES 446110 1672790 0 0 1672790 TUITION 611600 634573 0 0 634573 MANAGEMENT FEES 541610 546559 0 0 546559 812697 812697 3666619 276048727 253689223 554871 18363404 X 6306 6306 2158374 2158374 104231284 88596591 15634693 1878137 1596417 281720 20426579 17362592 3063987 6791552 5772819 1018733 399353 379385 19968 8038 8038 36374163 34373191 2000972 935365 888597 46768 4313880 4098186 215694 587858 558465 29393 6037545 5735668 301877 279000 265050 13950 7431120 7059564 371556 4656717 4423881 232836 2204014 2093813 110201 MEDICAL SUPPLIES 49099173 49099173 0 0 STATE PROVIDER TAX 3586721 3407385 179336 0 REPAIRS AND MAINTENANCE 3072011 2918410 153601 0 MISCELLANEOUS EXPENSES 549271 521807 27464 0 800140 760133 40007 255826601 229917433 25909168 0 64713 2647933 37262711 13438004 0 30997388 39900363 0 0 0 0 0 0 3538691 4513409 1301993 1955457 116715449 31226884 68297780 85488565 1198169 1433704 151935792 191371645 0 210000 210000 27386950 30258152 322194187 371217232 56620241 57796498 0 0 43013 572558 0 0 0 0 0 0 0 0 0 17962867 17052392 74626121 75421448 X 246467955 294695671 1100111 1100113 247568066 295795784 322194187 371217232 X 20222126 25416051 2589541 X 0 1 X 1 1 1 X 2 TRINITY HEALTH SYSTEM - TRINITY EAST 340714474 3 1 0 0 TRINITY HEALTH SYSTEM - TRINITY WEST 340875691 3 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 SCHEDULE A, PART IV, LINE 1 TRINITY HOSPITAL HOLDING COMPANY (EIN: 34-1842025) IS THE SOLE MEMBER OF TRINITY EAST (EIN: 34- 0714474) AND TRINITY WEST (EIN: 34-0875691). TRINITY HOSPITAL HOLDING COMPANY, TRINITY EAST AND TRINITY WEST ARE INCLUDED IN THE GROUP RETURN FOR TRINITY HEALTH SYSTEM GROUP. THE SUBORDINATES OF THE TRINITY HOSPITAL HOLDING COMPANY DO NOT HAVE THE SAME PUBLIC CHARITY STATUS. TRINITY HOSPITAL HOLDING COMPANY IS A TYPE II SUPPORTING ORGANIZATION PURSUANT TO IRC 509(A)(3). TRINITY EAST AND TRINITY WEST ARE IRC 170(B)(1)(A)(III) HOSPITAL ORGANIZATIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8038 8038 0 SCHEDULE C, PART II-B, LINE 1 THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION- $2,668 CATHOLIC HEALTH ASSOCIATION- $1,430 OHIO HOSPITAL ASSOCIATION - $3,920 1077000 249417 249417 1077000 1077000 75497 75497 1077000 1077000 19150 19150 1077000 1077000 34568 34568 1077000 1077000 17315 17315 1077000 1.00000 0 0 7810022 7810022 27330170 14304465 13025705 53367 43100 10267 26160752 16503323 9657429 55361138 375996 54985142 85488565 CSH OPERATING INVESTMENT POOL 191371645 F 191371645 INTERCOMPANY RECEIVABLES 10312093 UNCONSOLIDATED CONTROLLING INT 1156175 DEPOSITS 1800 ROU OPERATING LEASE 15817050 OTHER ASSETS 2971034 30258152 OTHER CURRENT LIABILITIES 17475 OPERATING LEASE LIABILITY 16137363 INTERCOMPANY PAYABLES 317984 UNCLAIMED PROPERTY 208819 POST EMPLOYMENT BENEFITS 370751 17052392 X PART V, LINE 4: THE INTEREST IS UNRESTRICTED AND USED FOR HOSPITAL OPERATIONS. THE PRINCIPAL IS RESTRICTED AND NOT USED. PART X, LINE 2: TRINITY HEALTH SYSTEM GROUP'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 52150 2184063 3670538 0 0.00000 45696311 35961992 9734319 0.03810 52150 47880374 39632530 9734319 0.03810 5 1433 32696 32696 0.00010 3 40 112182 112182 0.00040 1 3094486 2060728 1033758 0.00400 2 500 29286 29286 0.00010 11 1973 3268650 2060728 1207922 0.00460 11 54123 51149024 41693258 10942241 0.04270 0 0 0 0 0 0 0 0 0 1 7078892 118000 58137777 49028640 9109137 X 1 1 1 VALLEY SURGICAL CENTER LTD AMBULATORY SURGERY 0.36950 0.36950 2 1 TRINITY MEDICAL CENTER WEST 4000 JOHNSON ROAD STEUBENVILLE OH 43952 HTTP://WWW.TRINITYHEALTH.COM 1208AHR X X X A 2 TRINITY MEDICAL CENTER EAST 380 SUMMIT AVENUE STEUBENVILLE OH 43952 HTTP://WWW.TRINITYHEALTH.COM 1208AHR X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTP://WWW.TRINITYHEALTH.COM/ X WWW.OHIO.GOV X 1 19 1 HTTP://WWW.TRINITYHEALTH.COM/ 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.TRINITYHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRINITYHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRINITYHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 SCHEDULE H, PART V, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, LINE 5 THE TRINITY STEERING COMMITTEE IDENTIFIED TARGET STAKEHOLDERS TO BE INTERVIEWED. STRATEGY SOLUTIONS, INC. DEVELOPED THE STAKEHOLDER INTERVIEW GUIDE AND CREATED ALL DATA COLLECTION TOOLS. STRATEGY SOLUTIONS, INC. STAFF SCHEDULED AND CONDUCTED NINE (9) INTERVIEWS AND ENTERED DATA INTO THE COLLECTION TOOLS. INTERVIEW QUESTIONS INCLUDED THE FOLLOWING TOPICS: TOP COMMUNITY HEALTH NEEDS, ENVIRONMENTAL FACTORS DRIVING THE NEEDS, EFFORTS CURRENTLY UNDERWAY TO ADDRESS NEEDS, AND ADVICE FOR THE STEERING COMMITTEE. THE PRIMARY DATA COLLECTION PROCESS ALSO INCLUDED CONDUCTING A COMMUNITY SURVEY FROM MARCH 1, 2019 TO APRIL 1, 2019, UTILIZING A MIXED-METHODOLOGY CONVENIENCE SAMPLE, WITH DATA COLLECTION COMPLETED VIA PAPER AND THE INTERNET. TRINITY PUT A LINK TO THE SURVEY ON THEIR FACEBOOK PAGE AND DISTRIBUTED VIA EMAIL TO ALL INTERNAL AND EXTERNAL STAKEHOLDERS. INDIVIDUALS HAD THE OPTION TO PRINT A PAPER VERSION IF THEY PREFERRED TO COMPLETE THE SURVEY VIA THAT MODALITY. A TOTAL OF 190 SURVEYS WERE COMPLETED BY THE RESIDENTS OF THE TRINITY SERVICE AREA.TRINITY HEALTH COLLABORATED WITH OTHER LOCAL ORGANIZATIONS AND PROVIDERS TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. REPRESENTATIVES INCLUDED A DIVERSE MIX OF INDIVIDUALS FROM THE CITY OF STEUBENVILLE HEALTH DEPARTMENT, JEFFERSON COUNTY HEALTH DEPARTMENT AND REPRESENTATIVE MEMBERS OF OTHER COMMUNITY AGENCIES INCLUDING THE AREA UNITED WAY, PUBLIC SENIOR HOUSING, THE YMCA AND PRIME TIME SERVICES. SCHEDULE H, PART V, LINE 11 THE HOSPITAL FACILITY IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY PROMOTING WELL-BEING AND PREVENTING MENTAL HEALTH AND SUBSTANCE USE DISORDERS FOCUSING ON DEPRESSION, SUICIDE, DRUG DEPENDENCY/ABUSE AND DRUG OVERDOSE DEATHS. IT IS DONE BY OFFERING IP, OP AND INTENSIVE OP SERVICES, SCREENINGS AND REFERRALS FOR DEPRESSION, OFFERING THERAPISTS IN THE SCHOOLS AND PSYCHIATRISTS IN PROVIDER OFFICES, SCREENING FOR AND PLACING PATIENTS WITH CO-OCCURRING DIAGNOSES, AND CONTINUING TO OFFER SAFETALK TRAINING. TRINITY ALSO OFFERS IP AND OP DETOX PROGRAMS AND COUNSELING AND A DETOX RESIDENTIAL SUPPORT UNIT PROGRAM AND PROVIDE SUPPORT GROUPS FOR SUBSTANCE USE DEPENDENCY AS WELL AS LOSS AND GRIEF FROM DRUG OVERDOSE DEATHS. TRINITY PROMOTES CHRONIC DISEASE MANAGEMENT ACROSS THE CONTINUUM OF CARE, INCLUDING CARDIOVASCULAR DISEASE, DIABETES, AND OVERWEIGHT/OBESITY BY THEIR OUTREACH PROGRAMS TO THE COMMUNITY THROUGH HEALTH FAIRS, SCREENINGS, EDUCATION, AND PROGRAMS. TRINITY ALSO PROVIDES RESEARCH PROTOCOL FOR REFERRALS FROM HOSPITAL TO AGENCIES FOR EXERCISE/NUTRITION. THE HOSPITAL ALSO PARTNERS WITH LOCAL FOOD BANKS TO FOCUS OFFERINGS ON FRESH FRUITS, VEGETABLES AND PROTEIN. WOMEN AND INFANT HEALTH STRATEGIES AND PROGRAMS THAT TRINITY ADDRESSES FOCUS ON OUTREACH TO THE COMMUNITY THROUGH PROGRAMS, SERVICES AND REFERRALS TO EDUCATE ON PRE-TERM BIRTHS, HOW TO REDUCE LOW BIRTH WEIGHT BABIES, AND INFANT MORTALITY THROUGH THE HELP ME GROW PROGRAM, CRIBS FOR KIDS PROGRAM AND OPSFF PROGRAM. TRINITY ALSO CONTINUES TO ASSIST THOSE PATIENTS UNINSURED OR UNDERINSURED TO RECEIVE COVERAGE AND INCREASE ACCESS TO CARE THROUGH MORE PROVIDERS AND INCREASE TO ACCESSIBILITY. TRINITY PARTNERS WITH A CARING PLACE CHILD ADVOCACY CENTER, AIM WOMEN'S CENTER, CHANGE, INC., JEFFERSON BEHAVIORAL HEALTH SYSTEM, JEFFERSON COUNTY GENERAL HEALTH DISTRICT, JEFFERSON COUNTY PREVENTION AND RECOVERY, OHIO VALLEY HEALTH CENTER, URBAN MISSION, WOMEN'S HEALTH CENTER, AND YMCA. BY ADDRESSING THE HEALTH NEEDS ASSESSMENT AREAS AND IMPLEMENTING PROGRAMS AND PROCESSES, TRINITY ANTICIPATES IMPROVING HEALTHCARE OUTCOMES, CREATING STABILITY IN A PERSON'S LIFE, ENSURING THAT EVERYONE IS WELL AND RECEIVING THE SERVICES THEY NEED AND FOCUSING NOT ONLY ON THE INDIVIDUAL, BUT THEIR ENTIRE FAMILY AS WELL. SCHEDULE H, PART V, LINE 13H THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A CHI HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. SCHEDULE H, PART I, LINE 3C UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: *THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. *THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG. *THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. *THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: *RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; *HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC; *PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); *FOOD STAMP ELIGIBILITY; *SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; *ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); *LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR *PATIENT IS DECEASED WITH NO KNOWN ESTATE. SCHEDULE H, PART I, LINE 7 THE ONLY SERVICE INCLUDED IN SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G IS BEHAVIORAL MEDICINE. SCHEDULE H, PART I, LINE 7 A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS ON LINES 7A AND 7B; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. WORKSHEET 2 WAS UTILIZED TO COMPUTE THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/21 USING THE FOLLOWING FORMULA: OPERATING EXPENSE (LESS NON-PATIENT CARE ACTIVITIES, MEDICARE PROVIDER TAXES, COMMUNITY BENEFIT EXPENSE AND COMMUNITY BUILDING EXPENSE) DIVIDED BY GROSS PATIENT REVENUE (LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS). BASED ON THAT FORMULA, $237,627,006 / $797,083,449 RESULTS IN A 29.81% COST-TO-CHARGE RATIO. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE OTHER BENEFITS SECTION (LINE 7E - 7I) SCHEDULE H, PART III, LINE 2 COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 29.81%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 4 TRINITY HEALTH SYSTEM GROUP DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS ARE PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF THE CHANGE.SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. BAD DEBT EXPENSE FOR 2021 AND 2020 WAS NOT SIGNIFICANT. SCHEDULE H, PART III, LINE 8 USING ESSENTIALLY THE SAME MEDICARE COST REPORT PRINCIPLES AS TO THE ALLOCATION OF GENERAL SERVICES COSTS AND "APPORTIONMENT" METHODS, THE "CHI WORKBOOK" CALCULATES A PAYERS' GROSS ALLOWABLE COSTS BY SERVICE (SO AS TO FACILITATE A CORRESPONDING COMPARISON BETWEEN GROSS ALLOWABLE COSTS AND ULTIMATE PAYMENTS RECEIVED). THE TERM "GROSS ALLOWABLE COSTS" MEANS COSTS BEFORE ANY DEDUCTIBLES OR CO-INSURANCE ARE SUBTRACTED. TRINITY HEALTH SYSTEM GROUP'S ULTIMATE REIMBURSEMENT WILL BE REDUCED BY ANY APPLICABLE COPAYMENT/ DEDUCTIBLE. WHERE MEDICARE IS THE SECONDARY INSURER, AMOUNTS DUE FROM THE INSURED'S PRIMARY PAYER WERE NOT SUBTRACTED FROM MEDICARE ALLOWABLE COSTS BECAUSE THE AMOUNTS ARE TYPICALLY IMMATERIAL. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE-SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY:TOTAL MEDICARE REVENUE: $58,137,777TOTAL MEDICARE COSTS: $49,028,640SURPLUS OR SHORTFALL: $9,109,137TRINITY HEALTH SYSTEM GROUP BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENTS AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS. SCHEDULE H, PART III, SECTION C, LINE 9B THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. SCHEDULE H, PART III, LINE 3 TRINITY HEALTH SYSTEM GROUP BELIEVES THAT A SMALL PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. PART VI, LINE 2: TRINITY HEALTH SYSTEM PROVIDES CARE TO A SERVICE AREA OF JUST OVER 200,000 INDIVIDUALS. TRINITY IS ACCREDITED BY THE JOINT COMMISSION ON THE ACCREDITATION OF HOSPITALS, A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, VOLUNTARY HOSPITALS OF AMERICA AND THE CATHOLIC HOSPITAL ASSOCIATION. THE SYSTEM OFFERS A FULL ARRAY OF ACUTE AND OUTPATIENT SERVICES ON TWO CAMPUSES. TRINITY ALSO MAINTAINS PHYSICIAN OFFICES, WALK-IN LAB DRAW FACILITIES, THE TONY TERAMANA CANCER CENTER, WORKCARE AND THE DIGESTIVE AND NUTRITION CENTER THROUGHOUT THE TRI-STATE AREA. ADDITIONALLY, AT TRINITY WE UNDERSTAND PATIENT EDUCATION IS A VITAL ROLE IN MAINTAINING A HEALTHY COMMUNITY. OUR STAFF PARTICIPATES IN NUMEROUS HEALTH FAIRS AND BLOOD SCREENING PROGRAMS THROUGHOUT THE YEAR. TRINITY HEALTH SYSTEM IS PART OF COMMONSPIRIT HEALTH, A NONPROFIT, CATHOLIC HEALTH SYSTEM DEDICATED TO ADVANCING HEALTH FOR ALL PEOPLE. IT WAS CREATED IN FEBRUARY 2019 THROUGH THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH. COMMONSPIRIT HEALTH IS COMMITTED TO CREATING HEALTHIER COMMUNITIES, DELIVERING EXCEPTIONAL PATIENT CARE, AND ENSURING EVERY PERSON HAS ACCESS TO QUALITY HEALTH CARE. OUR MISSION: AS COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. OUR CORE VALUES AND QUALITY PRINCIPLES REVERENCE: PROFOUND RESPECT AND AWE FOR ALL OF CREATION, THE FOUNDATION THAT SHAPES SPIRITUALITY, OUR RELATIONSHIPS WITH OTHERS AND OUR JOURNEY TO GOD. INTEGRITY: MORAL WHOLENESS, SOUNDNESS, FIDELITY, TRUST, TRUTHFULNESS IN ALL WE DO. COMPASSION: SOLIDARITY WITH ONE ANOTHER, CAPACITY TO ENTER INTO ANOTHER'S JOY AND SORROW. EXCELLENCE: PREEMINENT PERFORMANCE, BECOMING THE BENCHMARK, PUTTING FORTH OUR PERSONAL AND PROFESSIONAL BEST. TRINITY HEALTH HAS DEVELOPED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE FOLLOWING FACILITIES: O TRINITY MEDICAL CENTER EAST O TRINITY MEDICAL CENTER WEST TRINITY HEALTH SYSTEM, A MEMBER OF CATHOLIC HEALTH INITIATIVES AND COMMONSPIRIT HEALTH IS PROUD TO PRESENT ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT. THIS REPORT SUMMARIZES A COMPREHENSIVE REVIEW AND ANALYSIS OF HEALTH STATUS INDICATORS, PUBLIC HEALTH, SOCIOECONOMIC, DEMOGRAPHIC AND OTHER QUALITATIVE AND QUANTITATIVE DATA FROM THE PRIMARY SERVICE AREA OF TRINITY HEALTH SYSTEM. THIS REPORT ALSO INCLUDES SECONDARY DISEASE INCIDENCE AND PREVALENCE DATA FROM JEFFERSON COUNTY, THE PRIMARY SERVICE AREA OF THE HOSPITAL. IN ADDITIONAL SECONDARY DATA IS PROVIDED, WHERE AVAILABLE, FOR COLUMBIANA AND HARRISON COUNTIES IN OHIO AND BROOKE AND HANCOCK COUNTIES IN WEST VIRGINIA, THE SECONDARY SERVICE AREA OF THE HOSPITAL. THE DATA WAS REVIEWED AND ANALYZED TO DETERMINE THE TOP PRIORITY NEEDS AND ISSUES FACING THE REGION OVERALL. THE PRIMARY PURPOSE OF THIS ASSESSMENT WAS TO IDENTIFY THE HEALTH NEEDS AND ISSUES OF THE JEFFERSON COUNTY COMMUNITY DEFINED AS THE PRIMARY SERVICE AREA OF TRINITY HEALTH SYSTEM. ADDITIONALLY, TRINITY IS INTERESTED IN IDENTIFYING THE NEEDS AND ISSUES OF THE SECONDARY SERVICE AREA WHICH INCLUDES COLUMBIANA AND HARRISON COUNTIES IN OHIO AND BROOKE AND HANCOCK COUNTIES IN WEST VIRGINIA. THE CHNA ALSO PROVIDES USEFUL INFORMATION FOR PUBLIC HEALTH AND HEALTH CARE PROVIDERS, POLICY MAKERS, SOCIAL SERVICE AGENCIES, COMMUNITY GROUPS AND ORGANIZATIONS, RELIGIOUS INSTITUTIONS, BUSINESSES, AND CONSUMERS WHO ARE INTERESTED IN IMPROVING THE HEALTH STATUS OF THE COMMUNITY AND REGION. THE RESULTS ENABLE THE HOSPITAL, AS WELL AS OTHER COMMUNITY PROVIDERS, TO MORE STRATEGICALLY IDENTIFY COMMUNITY HEALTH PRIORITIES, DEVELOP INTERVENTIONS, AND COMMIT RESOURCES TO IMPROVE THE HEALTH STATUS OF THE REGION. IMPROVING THE HEALTH OF THE COMMUNITY IS THE FOUNDATION OF THE MISSION OF TRINITY HEALTH SYSTEM, AND AN IMPORTANT FOCUS FOR EVERYONE IN THE SERVICE REGION, INDIVIDUALLY AND COLLECTIVELY. IN ADDITION TO THE EDUCATION, PATIENT CARE, AND PROGRAM INTERVENTIONS PROVIDED THROUGH THE HOSPITAL, WE HOPE THAT THE INFORMATION IN THIS CHNA WILL ENCOURAGE ADDITIONAL ACTIVITIES AND COLLABORATIVE EFFORTS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY THAT TRINITY HEALTH SYSTEM SERVES. TRINITY HEALTH COLLABORATED WITH OTHER LOCAL ORGANIZATIONS AND PROVIDERS TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. REPRESENTATIVES INCLUDED A DIVERSE MIX OF INDIVIDUALS FROM THE CITY OF STEUBENVILLE HEALTH DEPARTMENT, JEFFERSON COUNTY HEALTH DEPARTMENT AND REPRESENTATIVE MEMBERS OF OTHER COMMUNITY AGENCIES INCLUDING THE AREA UNITED WAY, PUBLIC SENIOR HOUSING, THE YMCA AND PRIME TIME SERVICES. "THE 2019 TRINITY CHNA WAS CONDUCTED TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS, AND HEALTH NEEDS TO PROVIDE CRITICAL INFORMATION TO THOSE IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ENABLE COMMUNITY MEMBERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF PEOPLE LIVING IN THE COMMUNITY." PART VI, LINE 4: THE POPULATION IN JEFFERSON COUNTY IS PROJECTED TO DECREASE FROM 65,632 IN 2019 TO 64,251 IN 2024. THERE WERE SLIGHTLY MORE FEMALES (51.5%) THAN MALES (48.5%). THE POPULATION WAS PREDOMINANTLY CAUCASIAN (91.1%). THE MEDIAN AGE WAS 44.6 AND WAS PROJECTED TO REMAIN STEADY. JUST UNDER ONE-THIRD (30.7%) OF RESIDENTS HAD NEVER BEEN MARRIED, WHILE 42.5% WERE MARRIED, 3.7% WERE SEPARATED, 14.9% WERE DIVORCED AND 8.3% WERE WIDOWED. JUST OVER ONE IN TEN RESIDENTS (11.0%) DID NOT COMPLETE HIGH SCHOOL, WHILE 43.1% WERE A HIGH SCHOOL GRADUATE, 10.6% HAD A BACHELOR'S DEGREE AND 5.4% HAD AN ADVANCED DEGREE. THE AVERAGE HOUSEHOLD INCOME WAS $59,124, WITH 11.8% OF FAMILIES LIVING IN POVERTY. MOST (93.5%) OF THE LABOR FORCE WAS EMPLOYED. DEMOGRAPHICS JEFFERSON COUNTY GENDER: 48.5% MALE, 51.5% FEMALE ETHNICITY: WHITE/NON-HISPANIC - 91.1%, BLACK/AFRICAN AMERICAN - 5.4%, HISPANIC/LATINO ORIGIN - 1.6%, ASIAN -0.4% AGE: MEDIAN AGE IS 44.6 MARITAL STATUS: MARRIED - 42.5%, NEVER MARRIED - 30.7%, DIVORCED - 14.9%, WIDOWED - 8.3%, SEPARATED - 3.7% HOUSEHOLD INCOME: AVERAGE - $59,124. MEDIAN - $45,609. FAMILIES LIVING IN POVERTY - 11.8% EDUCATION: DID NOT COMPLETE HIGH SCHOOL - 11%. HIGH SCHOOL GRAD/GED - 43.1%. BACHELOR'S DEGREE - 10.6%. ADVANCED DEGREE - 5.4%. EMPLOYMENT: EMPLOYED - 93.5%. AGE 16 OR OVER EMPLOYED - 49.4%. AGE 16 OR OVER UNEMPLOYED - 3.4%. HOLD WHITE COLLAR OCCUPATIONS - 52.8% OVERALL, THE SERVICE AREA OF THE SYSTEM HAS A LOWER AVERAGE HOUSEHOLD INCOME THAN THE STATE OF OHIO AND A HIGHER UNEMPLOYMENT RATE. JEFFERSON COUNTY IS ECONOMICALLY DEPRESSED WITH A PER-CAPITA INCOME LOWER THAN STATE AVERAGES. ALL 3 COUNTIES IN THE SYSTEM'S IMMEDIATE SERVICE AREA HAVE A HIGH PROPORTION OF THE POPULATION AT OR BELOW THE POVERTY LEVEL. THE ECONOMIC CONDITIONS OF THE AREA HAVE HINDERED THE GROWTH OF THE HOSPITAL AND MORE SELF-PAY PATIENTS HAVE TAKEN ADVANTAGE OF THE HOSPITAL'S SERVICES. CHARITY CARE AND BAD DEBT ACCOUNTS HAVE INCREASED EACH YEAR FOR THE LAST FEW YEARS. AS RECENTLY UNEMPLOYED RESIDENTS LOSE THEIR HEALTH BENEFITS, WE EXPECT HIGHER CHARITY CARE LEVELS. THE PAYER MIX AT THS IS HEAVILY WEIGHTED TO THE GOVERNMENTAL PAYERS, WITH AROUND 40% OF THE REVENUE GENERATED FROM MEDICARE AND 11% GENERATED FROM THE MEDICAID PROGRAM. WITH THE 2 PROGRAMS RECORDING SIGNIFICANT SHORTFALLS BETWEEN PAYMENT TO HOSPITALS AND HOSPITAL COSTS, THE ECONOMIC CHALLENGES FOR THS ARE GREAT. SCHEDULE H, PART VI, LINE 3 NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: -CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; -NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND -PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 6 THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. COMMONSPIRIT HEALTH IS COMPRISED OF MORE THAN 1,500 CARE SITES, CONSISTING OF 140 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2021, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.5 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $5.1 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.25 BILLION IN FISCAL YEAR 2021, HAS TOTAL ASSETS OF APPROXIMATELY $54.87 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. SCHEDULE H, PART VI, LINE 7 OH PART VI, LINE 5 THE ORGANIZATION'S HOSPITAL FACILITY(IES) PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. THE ORGANIZATION'S HOSPITAL FACILITY(IES) HAVE AN OPEN MEDICAL STAFF. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE FACILITY(IES) TREAT PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT. X X X 0 1 0 0 0 0 0 0 0 LARRY SCHUMACHER BOARD MEMBER 0 1053841 0 748629 0 160307 0 197895 0 22399 0 2183071 0 0 RAMANA MURTY MD PHYSICIAN 992952 0 312962 0 22616 0 0 0 25275 0 1353805 0 0 0 RAFAEL SCHMULEVICH MD PHYSICIAN 872740 0 209683 0 17500 0 0 0 29863 0 1129786 0 0 0 SATHISH MAGGE MD PHYSICIAN 1034219 0 17094 0 7154 0 0 0 23618 0 1082085 0 0 0 KUMAR AMIN MD PHYSICIAN 880332 0 150000 0 5250 0 0 0 28621 0 1064203 0 0 0 BALDEV SEKHON MD PHYSICIAN 833321 0 49712 0 43456 0 0 0 26650 0 953139 0 0 0 MATT GRIMSHAW PRESIDENT & CEO 440703 0 211004 0 0 29299 0 16158 27109 0 678816 45457 0 0 RICK GRECO DO PRESIDENT, MEDICAL GROUP ENTERPRISE 365198 0 34375 0 0 0 0 0 21935 0 421508 0 0 0 DAVE WERKIN CFO 254533 0 50050 0 0 0 0 0 28579 0 333162 0 0 0 BRENT MALLEK VP OF HR 233383 0 30911 0 0 0 0 0 22395 0 286689 0 0 0 JIM MIDDLETON DIRECTOR OF NURSING 208886 0 46441 0 0 0 0 0 13699 0 269026 0 0 0 PAUL WHEELER VP OF OPERATIONS / COO 170454 0 24665 0 0 0 0 0 22517 0 217636 0 0 0 JIM MIRASOLA VP OF MEDICAL GROUP ENTERPRISE 144905 0 20901 0 15785 0 0 0 12215 0 193806 0 0 0 FRED BROWER FORMER PRESIDENT & CEO 0 0 0 0 147768 0 0 0 0 0 147768 0 0 0 SCHEDULE J, PART I, LINE 4A FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. SCHEDULE J, PART I, LINE 4B DURING THE 2020 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/HOSPITAL PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: LAWRENCE P. SCHUMACHER, $142,712. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2020 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2020, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: MATTHEW GRIMSHAW, $29,299. SCHEDULE J, PART I, LINE 4B TRINITY HEALTH SYSTEM GROUP MAINTAINS A NONQUALIFIED RETIREMENT PLAN FOR FRED BROWER. THE PLAN IS A SERP AND THE INCREASE IN BENEFITS IS CALCULATED ANNUALLY BASED ON THE TERMS OF THE AGREEMENT. DURING 2020 THE FOLLOWING PAYMENTS WERE MADE BY TRINITY HEALTH SYSTEM FROM THE DEFERRED COMPENSATION PLAN: FRED BROWER: $147,768. LISA A BIASI FAMILY MEMBER OF TRUSTEE 24240 EMPLOYMENT 0 FRANK CONFORTI FAMILY MEMBER OF TRUSTEE 135314 EMPLOYMENT 0 CAROL ANTONELLI-GRECO FAMILY MEMBER OF TRUSTEE 102128 EMPLOYMENT 0 FORM 990, PART V, LINE 3B TRINITY HEALTH SYSTEM - TRINITY EAST (EIN 34-0714474), TRINITY HEALTH SYSTEM - TRINITY WEST (EIN 34-0875691), AND TRINITY HOSPITAL HOLDING COMPANY (EIN 34-1842025) ARE SUBORDINATE ORGANIZATIONS OF TRINITY HEALTH SYSTEM GROUP. EACH OF THE SUBORDINATES FILES ITS OWN 990-T, WHEN REQUIRED. FORM 990, PART VI, SECTION A, LINE 1 PURSUANT TO ARTICLE V, SECTION 7 OF THE CODE OF REGULATIONS OF TRINITY HEALTH SYSTEM GROUP, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, AND THE PRESIDENT, EACH OF WHOM SHALL SERVE AS A VOTING MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO APPENDIX A OF THE CORPORATION'S CODE OF REGULATIONS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE CODE OF REGULATIONS OF TRINITY HEALTH SYSTEM GROUP, THE ENTITY'S SOLE MEMBER IS TRINITY HEALTH SYSTEM, AN OHIO NONPROFIT ORGANIZATION. THE MEMBERS OF THE SOLE MEMBER ARE SYLVANIA FRANCISCAN HEALTH, AN OHIO NONPROFIT ORGANIZATION AND COMMONSPIRIT HEALTH, A COLORADO NONPROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE GOVERNING BODY SHALL CONSIST OF THE MEMBERS OF THE CORPORATE MEMBER'S GOVERNING BODY. DIRECTORS OF THE CORPORATE MEMBER, AND THEREFORE OF THE FILING ORGANIZATION, SHALL BE APPOINTED BY THE PARENT CORPORATION NO LATER THAN JUNE 30 OF EACH YEAR. PRIOR TO EACH ANNUAL MEETING OF THE PARENT CORPORATION, OR SUCH OTHER MEETING CALLED FOR THE PURPOSE OF APPOINTING DIRECTORS OF THE CORPORATION, THE GOVERNANCE COMMITTEE SHALL SELECT AND SUBMIT TO THE BOARD A SLATE OF NOMINEES QUALIFIED TO SERVE ON THE BOARD. THE BOARD SHALL REVIEW THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ON THE RECOMMENDED SLATE AND SHALL VOTE TO ACCEPT OR REFUSE EACH NOMINEE. THE NAMES AND QUALIFICATION OF EACH INDIVIDUAL ACCEPTED BY THE BOARD SHALL THEN BE SUBMITTED TO THE PARENT CORPORATION, WHO SHALL THEN APPOINT OR REFUSE EACH NOMINEE WITH THE RECOMMENDATION OF THE PRESIDENT HEALTH SYSTEM DELIVERY AND CHIEF OPERATING OFFICER OR OTHER DESIGNEE. NOTWITHSTANDING ANYTHING IN THIS CODE OF REGULATIONS TO THE CONTRARY, THE PARENT CORPORATION MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD SHOULD THE BOARD FAIL TO FURNISH THE PARENT CORPORATION WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD IN ACCORDANCE WITH THIS SECTION. FORM 990, PART VI, SECTION A, LINE 7B TRINITY HEALTH SYSTEM GROUP HAS ONE CORPORATE MEMBER, TRINITY HEALTH SYSTEM. TRINITY HEALTH SYSTEM MUST APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES AS A CONDITION BEFORE THEY BECOME EFFECTIVE: 1) MERGER, CONSOLIDATION, OR SUBSTANTIAL SALE 2) CREATION OF SUBSIDIARIES OF AFFILIATION WITH OTHER ENTITIES 3) CONVEYANCING REAL PROPERTY OR CREATING LIENS THEREON 4) TRANSFER OF PERSONAL PROPERTY, INCURRING OR GUARANTEEING INDEBTEDNESS OR GRANTING LIENS IN EXCESS OF AN AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBERS 5) APPROVAL OF CORPORATION OR SUBSIDIARY TRUSTEES AND DIRECTORS BASED ON AGREED UPON CRITERIA 6) CAPITAL EXPENDITURES OR GRANTS IN EXCESS OF AN AMOUNT PRESCRIBED FROM TIME TO TIME BY THE MEMBERS 7) ADDITION OR TERMINATION OF SERVICES 8) APPROVAL OF SELECTION OF THE SLATE OF CANDIDATES FOR THE OFFICE OF CEO OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES PROVIDED, HOWEVER, THAT A REPRESENTATIVE OF EACH MEMBER WILL SERVE ON THE SELECTION COMMITTEE 9) APPROVAL OF THE ANNUAL BUDGET AND STRATEGIC PLAN FOR THE CORPORATION AND ITS SUBSIDIARIES. FORM 990, PART VI, SECTION B, LINE 11B ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER. SUBSEQUENT TO THE CFO'S REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE CFO. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15 AN EXTERNAL COMPENSATION CONSULTANT REVIEWS ANNUALLY THE BASE SALARY, TOTAL CASH, AND TOTAL REMUNERATION, AS COMPARED TO MARKET, FOR THOSE IDENTIFIED AS OFFICERS/KEY EMPLOYEES. THIS REVIEW IS TO DETERMINE REASONABLENESS OF THE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 8,100,102. MANAGEMENT AND GENERAL EXPENSES 418,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,518,385. CONSULTING: PROGRAM SERVICE EXPENSES 498,619. MANAGEMENT AND GENERAL EXPENSES 26,243. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 524,862. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 3,418,203. MANAGEMENT AND GENERAL EXPENSES 379,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,798,003. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 8,833,251. MANAGEMENT AND GENERAL EXPENSES 464,908. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,298,159. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,523,016. MANAGEMENT AND GENERAL EXPENSES 711,738. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,234,754. FORM 990, PART XI, LINE 9: PENSION VALUATION 735,876. REALLOCATION OF CARES ACT FUNDS 6,473,559. PENSION PLAN CONTRIBUTION -4,619,894. 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