2021-11-12T15:07:42-06:00 2020-12-31 990 2020-01-01 344428256 THE TOLEDO HOSPITAL TOLE 4192525772 100 MADISON AVE ATTN TAX DEPARTM TOLEDO OH 43604 STEVEN M CAVANAUGH TREASURER 4192525772 2021-11-11 0 STEVEN CAVANAUGH 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z STEVEN M CAVANAUGH 100 MADISON AVE ATTN TAX DEPARTMENT TOLEDO OH 43604 1792168295 0 X WWW.PROMEDICA.ORG X 1907 OH THE TOLEDO HOSPITAL IS AN ACUTE CARE FACILITY AND THE ADULT TERTIARY FACILITY OF PROMEDICA HEALTH SYSTEM, INC. PROVIDING INPATIENT AND OUTPATIENT HEALTH SERVICES TO THE GENERAL PUBLIC OF NORTHWEST OHIO AND SOUTHEAST MICHIGAN. 27 20 7576 374 -68366 1014148 10483296 52682314 1099736358 1110165661 18237309 -18491763 13973515 8271724 1142430478 1152627936 881659 774334 0 0 452501743 479150594 0 0 0 631052942 667352019 1084436344 1147276947 57994134 5350989 1926315453 2740360333 2546895303 2783305295 -620579850 -42944962 X AS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WE ARE A VALUABLE COMMUNITY RESOURCE PROVIDING COMPREHENSIVE HEALTH SERVICES WITH EXPERTISE AND COMPASSION, AND IMPROVING THE HEALTH OF THOSE WE SERVE THROUGH PREVENTION, EDUCATION, AND SUPERIOR SERVICE. 0 0 998524821 774334 1102418273 THE TOLEDO HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O. 642340 709174 THE TOLEDO HOSPITAL OPERATES A HEALTH CLUB FACILITY. - SEE SCHEDULE O. 999167161 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 339 0 1 7576 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 27 20 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 1 0 X ROBERT SHARON 5675855652 100 MADISON AVE TOLEDO OH 43604 RANDALL OOSTRA PHS PRES. & CEO 1.00 55.00 X 0 3971638 136986 STEVEN M CAVANAUGH TREASURER 1.00 55.00 X 0 2048174 105065 JEFFREY C KUHN SECRETARY 1.00 55.00 X 0 1123411 62157 KEVIN C WEBB PHD CHIEF ACUTE & POST ACUTE OFF 1.00 42.00 X 0 1049317 51281 AARON A BUERK MD TRUSTEE 1.00 40.00 X 77345 885275 23803 MATTHEW KANG EX OFFICIO 1.00 40.00 X 0 720559 41724 DAWN M BUSKEY PRES., TRUSTEE 1.00 40.00 X X 0 589773 43229 GARY W AKENBERGER COO, ACUTE CARE & SVP, DIAG 0.00 40.00 X 0 483424 41276 RAVI K ADUSUMILLI MD TRUSTEE 1.00 0.00 X 0 475853 25740 DEANA SIEVERT SR VP, PAT CARE/CNO, SYSTEM 0.00 40.00 X 0 402381 35116 NEERAJ K KANWAL MD FORMER OFFICER 0.00 40.00 X 0 263236 74245 QIN-SHENG CHEN SR. MEDICAL PHYSICIST 40.00 0.00 X 292558 0 23203 ALAN M SATTLER FORMER OFFICER 0.00 40.00 X 0 249480 36266 JAMES BINGLE TRUSTEE 1.00 40.00 X 0 281808 2388 JAMES BURNS SR. MEDICAL PHYSICIST 40.00 0.00 X 253121 0 29568 FEDOR LURIE ASSOC DIR RESEARCH ED VASC 40.00 0.00 X 227751 0 23503 JOSHUA OVENS RN CRITICAL CARE TRANSPORT 40.00 0.00 X 217801 0 30362 BETH ESTEP VP PATIENT CARE SERVICES/ASSO 4.00 36.00 X 16136 203872 1695 THOMAS GEORGE PADANILAM MD TRUSTEE 1.00 0.00 X 0 46485 0 WILLIAM R MCDONNELL CHAIRMAN 1.00 1.00 X X 0 0 0 ADRIENNE J GREEN TRUSTEE 1.00 0.00 X 0 0 0 ALANA GRACE HATCHER TRUSTEE (PARTIAL YEAR) 1.00 0.00 X 0 0 0 AMIR A KHAN TRUSTEE 1.00 0.00 X 0 0 0 BRADLEY J TOFT TRUSTEE 1.00 0.00 X 0 0 0 CHARLES A PARCHER TRUSTEE 1.00 0.00 X 0 0 0 CHARLES MICHAEL SMITH TRUSTEE 1.00 0.00 X 0 0 0 ERICH L WEINLANDER TRUSTEE 1.00 0.00 X 0 0 0 JACQUELINE HYLANT BERENWEIG TRUSTEE 1.00 0.00 X 0 0 0 JAMES H BRENNAN JR EX OFFICIO 1.00 1.00 X 0 0 0 JOAN UHL-BROWNE TRUSTEE 1.00 0.00 X 0 0 0 MARGARET G RESSNER EX OFFICIO 1.00 0.00 X 0 0 0 MARLON P KISER TRUSTEE 1.00 0.00 X 0 0 0 MARTIN P SUTTER TRUSTEE 1.00 0.00 X 0 0 0 RICHARD D LANTZ TRUSTEE 1.00 0.00 X 0 0 0 ROBERT P SCHLATTER TRUSTEE 1.00 0.00 X 0 0 0 RODNEY L EASON JR TRUSTEE 1.00 0.00 X 0 0 0 SARA M SWISHER TRUSTEE 1.00 0.00 X 0 0 0 SARAH A MCHUGH TRUSTEE 1.00 0.00 X 0 0 0 SUSAN K STAELIN TRUSTEE 1.00 0.00 X 0 0 0 TIMOTHY M HUSTED MD TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM J LANGE TRUSTEE 1.00 0.00 X 0 0 0 1084712 12794686 787607 268 1 1 0 UNIVERSITY OF TOLEDO 2801 W BANCROFT TOLEDO OH 43606 EDUCATION 14363605 AMN HEALTHCARE INC 12400 HIGH BLUFF DR SAN DIEGO CA 92130 STAFFING AGENCY 10775376 METRO AVIATION INC PO BOX 7008 SHREVEPORT LA 711377008 AVIATION SERVICE 5568621 LATHROP COMPANY INC 28 N ST CLAIR ST SUITE 200 TOLEDO OH 43604 CONSTRUCTION GENERAL 4228849 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 LAB TESTING 3790484 65 6154978 44775275 1752061 52682314 NET PATIENT SERVICES 622110 1096006272 1094562386 1443886 AFFIL. ORG. RENT REV. 531120 13450215 13450215 MEMBERSHIP REVENUE 713940 709174 709174 1110165661 -32245994 -1580123 -30665871 2648009 2614406 33603 33603 33603 636610740 13691090 629709714 6837885 6901026 6853205 13754231 13754231 11211 25068 -13857 -13857 681506 353286 328220 328220 DIETARY 722514 2736187 2736187 PHARMACY 446110 1566740 1566740 EDUCATION 611710 355491 355491 3265340 3197469 67871 7923758 1152627936 1103127447 -68366 -3113459 X 774334 774334 77345 77345 393925032 304603239 89321793 14186363 9015076 5171287 39614950 31446772 8168178 31346904 25264100 6082804 40270 40270 3894345 855350 3038995 28603 28603 1702269 1702269 160743837 158126228 2617609 5184640 596318 4588322 9429982 5512337 3917645 726026 14521 711505 21149533 19400376 1749157 917718 451714 466004 33107754 33107754 93280291 73876679 19403612 5686370 5226919 459451 MEDICAL SUPPLIES 121812589 121812589 0 UBI TAXES 511939 511939 0 DRUGS 88318220 88318220 0 INTERCOMPANY SERVICES 67693685 67693685 0 53123948 52559011 564937 1147276947 999167161 148109786 0 20321054 185104121 6296891 6422335 159110574 159235222 1621628 7109391 11657639 21333257 1993032 4387951 1750838019 904888335 895169911 845949684 73987027 837644957 28469248 9007034 28106112 28610457 699582337 635555924 1926315453 2740360333 97092068 242296631 1000000 780990851 780439191 1520293668 1513550926 148518716 246018547 2546895303 2783305295 X -874519670 -326484394 253939820 283539432 -620579850 -42944962 1926315453 2740360333 X 5350989 68383585 522608 503377706 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 28603 28603 0 PART II-B, LINE 1: THE TOLEDO HOSPITAL PAYS DUES TO THE AMERICAN HOSPITAL ASSOCATION AND THE OHIO HOSPITAL ASSOCATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATIONS. 32425291 2000 890305 33317596 28747861 8000 3669430 32425291 10674678 21592265 -3519082 28747861 9839115 835563 10674678 9891715 -19454 -33146 9839115 1.00000 1 1 1 52410744 52410744 1236245117 574774602 661470515 3764798 3753465 11333 398564434 292366554 106197880 59852926 33993714 25859212 845949684 DUE FROM AFFILIATES 118488799 OTHER RECEIVABLES 2408034 BENEFICIAL INTEREST IN FOUNDATION 283539432 OTHER SEGREGATED INVESTMENTS 13017912 INTERCOMPANY DEBT FROM RELATED ENTITIES 218101747 635555924 DUE TO AFFILIATES 161296485 ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE 11397547 ASSET REMEDIATION OBLIGATION 10081847 DEFERRED COMPENSATION 4319325 PENSION PLAN LIABILITY 275804 OPERATING LEASE LIABILITY 8190216 OTHER LIABILITIES 50457323 246018547 PART V, LINE 4: THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT THE TOLEDO HOSPITAL CONSISTENT WITH DONOR INTENT. 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 6802485 0 6802485 0.00590 243169102 176470348 66698754 0.05810 183764 161737 22027 0.00000 250155351 176632085 73523266 0.06400 15711459 2093849 13617610 0.01190 48232265 20640271 27591994 0.02400 24703533 7626087 17077446 0.01490 223763 223763 0.00020 1436828 1436828 0.00130 90307848 30360207 59947641 0.05230 340463199 206992292 133470907 0.11630 8000 8000 0.00000 1000 1000 0.00000 25000 25000 0.00000 529965 529965 0.00050 563965 563965 0.00050 1 58085234 7707217 176337230 204225748 -27888518 X 1 1 1 PROMEDICA ORTHOPEDIC CO-MANAGEMENT CO LLC PHYSICIAN SERVICES 0.35000 0.06000 0.51000 2 PROMEDICA SURGICAL SERVICES CO-MANAGEMENT PHYSICIAN SERVICES 0.44030 0.00920 0.47710 3 REYNOLD ROAD SURGICAL CENTER LLC SURGICAL CENTER 0.63000 0.04990 0.32010 4 NORTHWEST OHIO DEDICATED BREAST MRI LLC MEDICAL DIAGNOSTIC 0.50000 0.00000 0.47900 5 WEST CENTRAL SURGICAL CENTER LLC SURGICAL CENTER 0.50000 0.00000 0.15000 4 1 THE TOLEDO HOSPITAL 2142 NORTH COVE BLVD TOLEDO OH 43606 WWW.PROMEDICA.ORG 1226 X X X X X X A 2 FLOWER HOSPITAL 5200 HARROUN RD SYLVANIA OH 43560 WWW.PROMEDICA.ORG 1227 X X X X A 3 WILDWOOD ORTHOPAEDIC HOSPITAL 2901 N REYNOLDS RD TOLEDO OH 43615 WWW.PROMEDICA.ORG 1501 X X A 4 ARROWHEAD BEHAVIORAL HEALTH 1725 TIMBERLINE RD MAUMEE OH 43537 WWW.ARROWHEADBEHAVIORAL.COM 1543 X PSYCHIATRIC/ SUBSTANCE ABUSE FACILITY B REPORTING GROUP A 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE PART V, SECTION C X 1 19 1 SEE PART V, SECTION C 0 1 X 200.000000000000 600.000000000000 X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 REPORTING GROUP B 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE PART V, SECTION C X 1 19 1 SEE PART V, SECTION C 0 1 X 200.000000000000 600.000000000000 X 1 1 X X 1 X X X X X 1 X 0 X X 0 X X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: THE TOLEDO HOSPITAL, - FACILITY 2: FLOWER HOSPITAL, - FACILITY 3: WILDWOOD ORTHOPAEDIC HOSPITAL GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL, FLOWER HOSPITAL, & ARROWHEAD BEHAVIORAL HEALTH. GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 11: THE TOLEDO HOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - TRAUMA- EDUCATION - MENTAL HEALTH/SUBSTANCE ABUSE THIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022. THE TOLEDO HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN, INCLUDE: ADULT HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS,YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH VIOLENCE; YOUTH PERCEPTIONS, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD (AGES 0-5), MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2020 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. TOLEDO HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2020 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019: HEALTH NEED IDENTIFIED: TRAUMA EDUCATION STRATEGY #1 - PROVIDE AT LEAST FOUR (4) FREE, "STOP THE BLEED" TRAININGS AND EDUCATION SESSIONS TO COMMUNITY ORGANIZATIONS PER YEAR.ACTIONS TAKEN: - IN 2020, FOUR (4) "STOP THE BLEED" TRAININGS SESSIONS WERE CONDUCTED, WITH 15 KITS DISTRIBUTED AND 62 TOTAL PARTICIPANTS.STRATEGY #2 - PROVIDE AT LEAST TEN FREE CONTINUING MEDICAL EDUCATION SESSIONS TO LOCAL EMERGENCY MEDICAL SERVICES PROVIDERS PER YEARACTIONS TAKEN:- IN 2020, 27 FREE CONTINUING MEDICAL EDUCATION SESSIONS WERE PROVIDE TO 404 LOCAL EMERGENCY MEDICAL SERVICES PROVIDERS TO IMPROVE MEDICAL CARE AT THE SCENE OF INJURY.STRATEGY #3 - ASSESS INDIVIDUALS FOR FALL PREVENTION AND PROVIDE CONNECTIONS TO RESOURCES IN THE COMMUNITY.ACTIONS TAKEN: - 4,900 INDIVIDUALS WERE ASSESSED FOR FALL RISK AND WERE PROVIDED EDUCATION IN THE TOLEDO HOSPITAL EMERGENCY DEPARTMENT (ED).- REFERRALS TO COMMUNITY RESOURCES PROCESS WILL START IN 2021 WITH EDUCATIONAL MATERIAL COVERING COMMUNITY ORGANIZATIONS THAT PROVIDE THIS SERVICE.- THE PERCENTAGE OF COMPLIANCE OF FALL RISK ASSESSMENTS IN THE ED WAS 65%. THE PLAN TO IMPROVE THIS COMPLIANCE PERCENTAGE INCLUDES NURSING AND PROVIDER EDUCATION, AS WELL AS INCLUDING INPATIENT NURSING AND CARE COORDINATION TEAM. HEALTH NEED IDENTIFIED: MENTAL HEALTH/SUBSTANCE ABUSE STRATEGY #1 - DEPLOYMENT OF FREE NARCAN KITS TO PATIENTS AND FAMILIES IN THE EMERGENCY DEPARTMENT (ED) WHO ARE AT RISK FOR OVERDOSEACTIONS TAKEN:- WORKING WITHIN AN ESTABLISHED PROTOCOL, 338 FREE NARCAN KITS WERE DISTRIBUTED TO PATIENTS AND FAMILIES IN THE ED WHO WERE AT RISK FOR OVERDOSE.STRATEGY #2 - PROVIDE AT LEAST TWO FREE EDUCATIONAL CLASSES IN THE COMMUNITY ON MOCK HEROIN OVERDOSE. ACTIONS TAKEN: - ONE MOCK HEROIN OVERDOSE SESSION WAS OFFERED, WITH 25 TOTAL PARTICIPANTS. TOLEDO CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11:PROMEDICA RUSSELL J. EBEID CHLDREN'S HOPSITAL (ECH), FOMERLY TOLEDO CHILDREN'S HOSPITAL (OPERATING WITHIN AND AS PART OF THE TOLEDO HOSPITAL), CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- MENTAL HEALTH/SUBSTANCE ABUSE- INFANT MORTALITY/MATERNAL HEALTH- INJURY PREVENTION/SAFETY- CHRONIC DISEASE ASTHMA AND FOOD INSECURITY- INCREASE SCHOOL READINESSTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS, 2020-2022. RUSSELL EBEID CHILDREN'S HOSPITAL (ECH), DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS INTHE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2019 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: ADULT HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, ADULT MENTAL HEALTH, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, ENVIRONMENTAL CONDITIONS, YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR, YOUTH DRUG USE, YOUTH SEXUAL BEHAVIOR, YOUTH VIOLENCE, CHILD HEALTH AND FUNCTION STATUS, MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2020 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. RUSSELL J. EBEID CHILDREN'S HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2020 WITH RESPECT TO ITS MOST RECEMT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: MENTAL HEALTH/SUBSTANCE ABUSESTRATEGY #1 - CONDUCT EPIC AUDIT OF SCREENS COMPLETED AND % WITH APPROPRIATE FOLLOW THROUGH. SCREENS WILL BE AUDITED TO DETERMINE HOW MANY WERE COMPLETED AND HANDLED APPROPRIATELY ACCORDING TO RISK LEVEL. CULLEN CENTER WILL SCREEN ALL CLIENTS FOR SUICIDE RISK AND REFER AS APPROPRIATE.ACTIONS TAKEN: - 1295 PATIENTS ADMITTED SINCE JANUARY 1, 2020 (AGES 6 AND UP) WERE SCREENED - 93% SCREENING CORRECTLY, WITH 77 INDIVIDUALS FOUND AT HIGH RISK.- 107 PATIENTS DID NOT HAVE THE SCREEN COMPLETED CORRECTLY, STAFF EDUCATION IN JUNE AND SEPTEMBER OF 2020 IMPROVED THIS MEASURE.- 98.7% HAD APPROPRIATE REFERRALS FOR FOLLOW-UP. THIS WILL CONTINUE TO BE MONITORED.STRATEGY #2 IMPROVE YOUTH MENTAL HEALTH THROUGH:1. PROVIDE TRAUMA AND TRAUMA INFORMED TRAININGS TO RUSSELL J. EBEID CHILDREN'S HOSPITAL STAFF, PROFESSIONALS, AND COMMUNITY MEMBERS AT LARGE TO HELP THEM PROVIDE APPROPRIATE TRAUMA INFORMED SERVICES TO YOUTH WHO HAVE HISTORIES OF TRAUMA.2. PROVIDE TRAUMA INFORMED PARENTING GROUPS TO PARENTS OF CHILDREN WITH HISTORIES OF TRAUMA.3. PROVIDE RISK PREVENTION PROGRAM, HIP HOP HEALTH, TO AT-RISK TEENS, AND, ALSO PROVIDE EDUCATION FOR OTHER PROVIDERS WHO PROVIDE PREVENTION PROGRAMS FOR AT-RISK YOUTH.CONTINUED BELOW: GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: TOLEDO HOSPITAL, WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL, & ARROWHEAD BEHAVIORAL HEALTH. GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO GROUP A-FACILITY 2 -- FLOWER HOSPITAL PART V, SECTION B, LINE 11: FLOWER HOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- MENTAL HEALTH- CANCERTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022.FLOWER HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN, INCLUDE: ADULT HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT ALCOHOL CONSUMPTION, ADULT DRUG USE, ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS,YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH DRUG USE, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH VIOLENCE; YOUTH PERCEPTIONS, MATERNAL AND INFANT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD (AGES 0-5), MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2020 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. FLOWER HOSPITAL TOOK THE FOLLOWING ACTIONS DURING TAX YEAR 2020 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: MENTAL HEALTHSTRATEGY #1 - ADVOCACY & CAPACITY BUILDINGA. SPONSOR A BI-ANNUAL CONFERENCE TO HELP PROVIDERS BETTER SERVE PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS.ACTIONS TAKEN: - ONE (1) CONFERENCE WAS HELD ON NOVEMBER 6, 2020, THE 24TH ANNUAL PSYCHIATRIC SYMPOSIUM AND 128 PARTICIPANTS ATTENDED.B. JOIN OR CREATE THREE ADVOCACY ACTIVITIES EACH YEAR THAT SUPPORT LOCAL, STATE, OR NATIONAL EFFORTS TO HELP PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS.ACTIONS TAKEN: - FLOWER HOSPITAL JOINED IN, OR CREATED, 12 ADVOCACY ACTIVITIES WITH THE HELP OF THE PROMEDICA-FUNDED NATIONAL ALLIANCE FOR MENTAL ILLNESS (NAMI) FAMILY NAVIGATOR EMPLOYEE, INCLUDING THE NAMI WALK IN WHICH 60 EMPLOYEES PARTICIPATED AND RAISED MORE THAN $2.000. THESE FUNDS WILL GO NAMI TOLEDO CHAPTER TO HELP SUPPORT THE COMMUNITY INITIATIVE OF MENTAL HEALTH EDUCATION AND SUPPORT FOR PATIENTS AND FAMILIES.- THE FLOWER HOSPITAL DIRECTOR OF INPATIENT PSYCHIATRY ATTENDED QUARTERLY MEETINGS FOR THE OHIO HEALTH ASSOCIATION BEHAVIORAL HEALTH CARE WORKGROUP TO CREATE INFORMATION AND REFERRAL RESOURCES FOR PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS.STRATEGY #2 - PROGRAMMINGA. DEVELOP AND MAINTAIN A FAMILY SUPPORT GROUP FOR PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSISACTIONS TAKEN:- A TOTAL OF 38 MEETINGS/EVENTS WERE HELD AND 311 PARTICIPANTS SERVED THROUGHOUT 2020, IN SESSIONS FACILITATED BY THE PROMEDICA-FUNDED, NAMI FAMILY NAVIGATOR, TO SUPPORT PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS. IN JUNE 2020, AS PART OF THE ABOVE NUMBERS, A FAMILY SUPPORT GROUP WAS HELD TWO MONDAYS WITH TOTAL OF 22 PARTICIPANTS, AND IN JULY A FAMILY SUPPORT GROUP WAS HELD EACH MONDAY, WITH TOTAL OF 25 PARTICIPANTS. DUE TO COVID-19, THE FAMILY SUPPORT GROUP MEETINGS WERE HELD SPORADICALLY AT DIFFERENT VENUES (BOTH IN PERSON AND VIRTUAL) AND DID NOT HAVE THE SAME STEADY PARTICIPANTS AS ORIGINALLY INTENDED.B. PARTNER WITH COMMUNITY GROUPS TO INCREASE COMMUNITY ORGANIZATION'S STAFFING THAT PROVIDES SYSTEM AND RESOURCE NAVIGATION SUPPORT TO PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSISACTIONS TAKEN:- PROMEDICA-FUNDED A PART TIME FAMILY NAVIGATOR IN COLLABORATION WITH THE NATIONAL ALLIANCE FOR MENTAL ILLNESS (NAMI) WHO WORKED 1040 HOURS (BASELINE 2019 0 HOURS).C. PARTNER WITH COMMUNITY GROUPS TO CREATE INFORMATION AND REFERRAL RESOURCES FOR PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS. ACTIONS TAKEN: - THE DIRECTOR OF FLOWER HOSPITAL'S PSYCHIATRY DEPARTMENT AND THE NAMI TEAM UPDATED THE NORTHWEST OHIO MENTAL HEALTH RESOURCE GUIDE. THIS RESOURCE GUIDE IS AVAILABLE FREE ONLINE FOR PRINTING, SOCIAL MEDIA/WEB SUPPORT, ETC. AVAILABLE ONLINE: HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/NW_OHIO_MENTAL_HEALTH_RESOURCE.PDF AND IN PRINT THROUGH PROMEDICA, (THESE BOOKLETS ARE DISTRIBUTED TO THE COMMUNITY AT HEALTH FAIRS, ETC.).STRATEGY #3 - EDUCATION: HOLD FIVE EDUCATIONAL SESSIONS EACH YEAR THAT PROVIDE EDUCATION AND INFORMATION ON VARIOUS TOPICS AND ISSUES THAT ARE IMPORTANT TO PARENTS AND FAMILIES WHOSE CHILDREN HAVE A MENTAL HEALTH DIAGNOSIS. ACTIONS TAKEN: - A TOTAL OF 50 EDUCATIONAL SESSIONS WERE HELD, WITH 211 PARTICIPANTS.HEALTH NEED IDENTIFIED: CANCERSTRATEGY #1 - ADVOCACY & CAPACITY BUILDING: WORK WITH SALONS AND BARBERSHOP OWNERS TO PROVIDE EDUCATION AND RESOURCES TO INCREASE HEALTH EQUITY IN THE COMMUNITIES THEY SERVE.ACTIONS TAKEN: - FIRST QUARTER 2020, 42 BARBERS. WORKING OUT OF SIX (6) BARBERSHOPS, WERE TRAINED IN THE USE OF AUTOMATED EXTERNAL DEFIBRILLATOR (AED) MACHINES. EACH PARTICIPATING SHOPS RECEIVED AN AED MACHINE WHICH WAS INSTALLED IN THOSE SHOPS. - SECOND QUARTER OF 2020, 40 BARBERS AND STYLISTS RECEIVED NO-TOUCH FOREHEAD THERMOMETERS TO MONITOR CLIENTS TEMPERATURE AT BEGINNING OF COVID PANDEMIC. 500 PERSONAL HAND-SANITIZERS WERE ALSO DISTRIBUTED TO CLIENTS IN BARBERSHOPS AND SALONS ALONG WITH 500 COPIES OF AMERICAN CANCER SOCIETY CANCER SCREENING GUIDELINES.- THIRD QUARTER OF 2020, PROMEDICA PROVIDED A $20,000 SPONSORSHIP FOR THE VIRTUAL SUSAN G. KOMEN RACE FOR THE CURE, NORTHWEST OHIO TO RAISE AWARENESS OF SCREENING FOR BREAST CANCER. - 3000 PROMEDICA-PRODUCED BREAST CANCER EDUCATION BOOKMARKS WERE DISTRIBUTED THROUGH SUSAN G. KOMEN, TO MAINTAIN BREAST CANCER SCREENING AWARENESS. - FLOWER HOSPITAL STAFF CO-CHAIRED OHIO PARTNERS FOR CANCER CONTROL PROSTATE WORK GROUP TO CREATE HEALTH EQUITY IN PROSTATE CANCER SCREENING GUIDELINES.- FOURTH QUARTER OF 2020, 50 PERSONAL HAND SANITIZERS ATTACHED TO AMERICAN CANCER SOCIETY SCREENING GUIDELINES AND INSTRUCTIONS FOR "EARLY DETECTION SAVES LIVES" WERE DELIVERED TO PARTICIPATING BARBERSHOPS AND SALONS. - FOR 2020, THE TOTAL NUMBER OF COMMUNITY OUTREACH INITIATIVES (ABOVE) INCLUDING NUMBER OF EDUCATIONAL MATERIALS HANDED OUT, AND PARTICIPANTS: 4,682STRATEGY #2 - PROGRAMMING: EDUCATE THE COMMUNITY ON EARLY DETECTION OF BREAST AND PROSTATE CANCER THROUGH AT LEAST TWO EDUCATIONAL PROGRAMS PER YEAR.ACTIONS TAKEN:- 46 WOMEN ATTENDED THE "WOMEN'S SEXUAL HEALTH AFTER CANCER" EDUCATION PROGRAM.- CERTIFIED TOBACCO TREATMENT SPECIALIST PROVIDED TOBACCO PREVENTION EDUCATION TO APPROXIMATELY 1545 MIDDLE AND HIGH SCHOOL STUDENTS IN 2020.STRATEGY #3 - EDUCATION: PROVIDE EDUCATION ON HEALTH TOPICS TO REDUCE THE INCIDENCE OF LATE TERM CANCER DIAGNOSIS. ACTIONS TAKEN:- 12 BARBERS ATTENDED A BARBERSHOP PROGRAM ON TOBACCO TREATMENT OPTIONS (OHIO QUIT LINE) AND THE IMPORTANCE OF HAVING A LOW DOSE LUNG CT TO DETECT LUNG CANCER EARLY. THE ATTENDING BARBERS WERE GIVEN THE TOBACCO TREATMENT/LOW DOSE LUNG CT INFORMATION TO DISPENSE TO THEIR CLIENTS WHO ARE TOBACCO USERS. 50 PIECES OF PROGRAM INFORMATION WERE DISPENSED BY THE BARBERS TO THEIR CLIENTS.- FOUR (4) SALONS RECEIVED 200 WOMEN'S WELLNESS AND EDUCATION PACKAGES. EACH KIT CONTAINED ONE (1) EACH; REUSABLE BAG, STRESS BALL, EMORY BOARD, HAND SANITIZER, LIP BALM, BREAST CANCER EDUCATION BOOKMARK, COLORECTAL CANCER SCREENING INFORMATION AND AMERICAN CANCER SOCIETY TAKING CHARGE OF YOUR HEALTH PAMPHLETS.- TOTAL NUMBER OF AMERICAN CANCER SOCIETY CANCER PREVENTION RESOURCE GUIDES DISTRIBUTED IN BOTH IN EDUCATIONAL SESSIONS ABOVE WERE APPROXIMATELY 1,500. GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: THE TOLEDO HOSPITAL, FLOWER HOSPITAL, & ARROWHEAD BEHAVIORAL HEALTH. GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO GROUP A-FACILITY 3 -- WILDWOOD ORTHOPAEDIC HOSPITAL PART V, SECTION B, LINE 11: WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL CONDUCTED AND ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- HUNGER- OBESITYTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2020-2022.WILDWOOD HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN, INCLUDE: ADULT HEALTH CARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT TOBACCO USE, ADULT DRUG USE, ADULT ALCOHOL CONSUMPTION, ADULT SEXUAL BEHAVIOR, ADULT MENTAL HEALTH, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, ENVIRONMENTAL CONDITIONS, YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH ALCOHOL CONSUMPTION, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH VIOLENCE; YOUTH PERCEPTIONS, MATERNAL AND INFANT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD (AGES 0-5), MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2020 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2020 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: HUNGERSTRATEGY #1 - SCREEN INPATIENTS ON ADMISSION FOR FOOD INSECURITY, AND PROVIDE FOOD TO TAKE HOME AT DISCHARGE, IF FOOD INSECURITY IS IDENTIFIED.ACTIONS TAKEN:- IN 2020, AT TOLEDO HOSPITAL, 553 INPATIENTS SCREENED POSITIVE FOR FOOD INSECURITY, AND 72 FOOD AT DISCHARGE BOXES WERE PROVIDED. PATIENTS HAVE THE OPTION OF DECLINING THE FOOD BOX.STRATEGY #2 - SCREEN OUTPATIENTS IN SPECIFIC PROMEDICA PRIMARY CARE OFFICES FOR FOOD INSECURITY AND PROVIDE A REFERRAL TO A PROMEDICA FOOD PHARMACY AND/OR PROVIDE A LISTING OF FOOD AGENCIES TO ASSIST PATIENTS WITH FOOD ACCESS.ACTIONS TAKEN:- 1,103 UNIQUE HOUSEHOLDS WITHOUT CHILDREN (2,053 ADULTS/SENIORS) WERE SERVED BY THE CENTER FOR HEALTH SERVICES AND PROMEDICA HEALTH AND WELLNESS CENTER FOOD CLINICS IN 2020. PATIENTS ARE REFERRED BY THEIR PROMEDICA PRIMARY CARE PROVIDER AND MAY VISIT THE FOOD CLINICS ONCE A MONTH FOR 2-3 DAYS OF HEALTHY FOOD.HEALTH NEED IDENTIFIED: OBESITYSTRATEGY #1 - PROVIDE FREE COOKING MATTERS PROGRAMMING TO PARENTS AND FAMILIES THROUGHOUT THE COMMUNITY. COOKING MATTERS IS A 6-WEEK HEALTHY EATING AND COOKING CLASS FOR LOW-INCOME FAMILIES, WHICH WILL BE OFFERED AT THE PROMEDICA EBEID CENTER'S TEACHING KITCHEN.ACTIONS TAKEN:- THROUGH THE EBEID NEIGHBORHOOD PROMISE, ONE COOKING MATTERS CLASS WAS COMPLETED IN 2020, WITH 10 PARTICIPANTS AT THE EBEID CENTER. - IN PARTNERSHIP WITH TOLEDO PUBLIC SCHOOLS, STAFF OFFERED A GARDEN TO PLATE COOKING CLASS, WHICH EMPHASIZED THE IMPORTANCE OF FRESH AND HEALTHY VEGETABLES AND HOW TO COOK A MEAL.STRATEGY #2 - PROVIDE FREE COOKING MATTERS AT THE STORE PROGRAMMING TO PARENTS AND FAMILIES. COOKING MATTERS AT THE STORE IS A ONE-TIME, EDUCATIONAL GROCERY STORE TOUR TEACHING HEALTHY EATING ON A BUDGET.ACTIONS TAKEN:- THROUGH THE EBEID CENTER, ONLINE COOKING VIDEOS WERE PROVIDED THROUGH THE MARKET ON THE GREEN AND THE EBEID CENTER FACEBOOK GROUPS, IN LIEU OF IN PERSON PROGRAMS.STRATEGY #3 - PROVIDE PHYSICAL ACTIVITY EDUCATION AS PART OF THE PROGRAMMING AT THE EBEID CENTER.ACTIONS TAKEN:- THROUGH THE EBEID NEIGHBORHOOD PROMISE PROGRAM, ONE UPTOWN WALK AND ROLL EVENT WAS HELD WITH A TOTAL OF 175 PARTICIPANTS, TO INCREASE PHYSICAL ACTIVITY IN THE NEIGHBORHOOD.- 600 EDUCATIONAL FLYERS, ON PHYSICAL ACTIVITY WERE SENT TO MARKET ON THE GREEN FOR DISTRIBUTION TO THEIR CUSTOMERS. PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 4: ARROWHEAD BEHAVIORAL HEALTH GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT PROCESS, PROMEDICA STAFF JOINED MULTIPLE COMMUNITY ORGANIZATIONS TO COLLABORATE TO DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR LUCAS COUNTY.IN 2019, PROMEDICA TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE, AND ARROWHEAD BEHAVIORAL HOSPITALS CONVENED CHNA COMMITTEES TO REVIEW THE MOST RECENT LUCAS COUNTY CHA AND CHIP, TAKING INTO ACCOUNT THE GAP AND RESOURCE ASSESSMENTS. THE COMMITTEE THEN SELECTED AND PRIORITIZED KEY INDICATORS FOR THEIR DEFINED COMMUNITY, IDENTIFIED RESOURCES AND GAPS IN THESE AREAS, AND DEVELOPED IMPLEMENTATION PLANS TO ADDRESS THESE PRIORITY HEALTH NEEDS IN THE COMMUNITY OVER THE NEXT THREE YEARS, TAKING INTO ACCOUNT THE NEEDS OF MINORITY AND UNDERSERVED POPULATIONS. THE HOSPITALS RECEIVED FEEDBACK ON THE CHNA AND PLAN FROM THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TO CONFIRM THESE NEEDS FROM A COMMUNITY HEALTH EXPERT PERSPECTIVE.THE LUCAS COUNTY CHA AND CHIP PROCESSES INCLUDED INPUT FROM ORGANIZATIONS AND PERSONS WHO REPRESENT THE COMMUNITY. COLLABORATING ORGANIZATIONS INCLUDED: ADELANTE, ADVOCATES FOR BASIC LEGAL EQUALITY, INC. (ABLE), AMERICAN CANCER SOCIETY, AREA OFFICE ON AGING OF NORTHWESTERN OHIO, CENTER FOR HEALTH AND SUCCESSFUL LIVING - UNIVERSITY OF TOLEDO, CENTRAL STATE UNIVERSITY, CWA LOCAL 4319/NAACP 3204, FAMILY AND CHILD ABUSE PREVENTION CENTER, FREDRICK DOUGLASS CENTER, HEALTHY LUCAS COUNTY, HOSPITAL COUNCIL OF NORTHWEST OHIO, LAKE ERIE TRAFFIC SAFETY, LUCAS COUNTY FAMILY COUNCIL, LUCAS COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES, MERCY HEALTH, MENTAL HEALTH & RECOVERY SERVICES BOARD OF LUCAS COUNTY, NEW CONCEPTS, NEIGHBORHOOD HEALTH ASSOCIATION, OTTAWA HILLS SCHOOLS, OHIO STATE UNIVERSITY EXTENSION, PARAMOUNT INSURANCE, PROMEDICA, ST. LUKE'S HOSPITAL, TOLEDO FIRE AND RESCUE, TOLEDO/LUCAS COUNTY CARENET, TOLEDO LUCAS COUNTY COMMISSION ON MINORITY HEALTH, TOLEDO LUCAS COUNTY HEALTH DEPARTMENT, TOLEDO MUSEUM OF ART, TOLEDO PUBLIC SCHOOLS, TOLEDO PUBLIC SCHOOLS HEAD START, THE UNIVERSITY OF TOLEDO, UNIVERSITY OF TOLEDO MEDICAL CENTER, UNITED WAY OF GREATER TOLEDO/LIVE WELL TOLEDO, UNITED PASTORS FOR SOCIAL EMPOWERMENT, YMCA OF GREATER TOLEDO, YWCA OF NORTHWEST OHIO GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: THE TOLEDO HOSPITAL, FLOWER HOSPITAL, & WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL. GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2019 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 11: ARROWHEAD BEHAVIORAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS, 2020-2022.- SUBSTANCE ABUSE- MENTAL HEALTHARROWHEAD BEHAVIORAL HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2019 SIGNIFICANT COUNTY HEALTH NEEDS IDENTIFIED, AND SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2019 IMPLEMENTATION PLAN INCLUDE: ADULT HEALTHCARE COVERAGE/ACCESS/UTILIZATION, PREVENTIVE MEDICINE, WOMEN'S HEALTH, MEN'S HEALTH, ORAL HEALTH, HEALTH STATUS PERCEPTIONS, ADULT WEIGHT STATUS, ADULT TOBACCO USE, ADULT SEXUAL BEHAVIOR, CARDIOVASCULAR HEALTH, CANCER, ARTHRITIS, ASTHMA, DIABETES, QUALITY OF LIFE, SOCIAL DETERMINANTS OF HEALTH, ENVIRONMENTAL CONDITIONS; YOUTH WEIGHT STATUS, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH VIOLENCE, YOUTH PERCEPTION, MATERNAL AND INFANT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD (AGES 0-5), MIDDLE CHILDHOOD (AGES 6-11), FAMILY AND COMMUNITY CHARACTERISTICS, AND PARENT HEALTH. MINORITY HEALTH COMPARISONS WERE ALSO INCLUDED IN THE COUNTY HEALTH ASSESSMENT.DUE TO RESTRICTIONS AND REGULATIONS PUT IN PLACE DUE TO THE COVID-19 PANDEMIC, MANY OF THE STRATEGIES MEANT TO BE IMPLEMENTED HAD TO BE DELAYED. LISTED HERE ARE THE STRATEGIES THAT WERE ABLE TO BE MAINTAINED WHILE FOLLOWING PROPER PUBLIC HEALTH GUIDELINES IN PLACE AT THE TIME. ITEMS UNABLE TO BE ADDRESSED IN 2020 WILL BE ADDRESSED IN THE SUBSEQUENT YEAR. ARROWHEAD BEHAVIORAL HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2020 WITH RESPECT TO ITS MOST RECENT CHNA, CONDUCTED IN 2019:HEALTH NEED IDENTIFIED: SUBSTANCE ABUSESTRATEGY #1 FREE TRANSPORTATION FOR OUTPATIENT SERVICES AND INPATIENT DISCHARGES/ADMISSIONS (WHEN NEEDED).ACTIONS TAKEN: - NO COST TRANSPORTATION FOR OUTPATIENT SERVICES AND INPATIENT DISCHARGES/ADMISSIONS WERE PROVIDED, WHEN NEEDED.STRATEGY #2 - COLLABORATION WITH TOLEDO-LUCAS COUNTY HEALTH DEPARTMENT TO PROVIDE NO COST HEPATITIS A VACCINATIONS TO INDIVIDUALS IN HIGH RISK POPULATIONS.STRATEGY #3 - PARTICIPATE IN COMMUNITY AWARENESS/EDUCATION ACTIVITIES, INCLUDING: RELAPSE PREVENTION, ALCOHOLICS ANONYMOUS AND NAMI FAMILY TO FAMILY. ACTIONS TAKEN:- 36 RELAPSE PREVENTION SESSIONS WERE HELD WITH 488 TOTAL PARTICIPANTS- 12 ALCOHOLICS ANONYMOUS SESSIONS WERE HELD WITH 360 PARTICIPANTSHEALTH NEED IDENTIFIED: MENTAL HEALTHSTRATEGY #1 PARTICIPATE IN COMMUNITY AWARENESS/EDUCATION ACTIVITIES TO INCREASE EDUCATON AND AWARENESS TO THE COMMUNITY ABOUT MENTAL HEALTH AND MENTAL HEALTH RESOURCES.ACTIONS TAKEN: - PARTICIPATED IN TEN (10) COMMUNITY AWARENESS/EDUCATION SESSIONS IN 2020, WITH APPROXIMATELY 300 PARTICIPANTS.- 2,716 INDIVIDUALS SCREENED DURING ONSITE ASSESSMENTS TO DETERMINE IF ARROWHEAD BEHAVIORAL HOSPITAL HAD PROGRAMS TO MEET THEIR INDIVIDUAL NEEDS. GROUP B-FACILITY 4 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 20E: PRIOR TO PURSUING COLLECTION ACTIONS, THE HOSPITAL FACILITY INITIATED THE FOLLOWING ACTIONS:- PATIENTS ARE OFFERED PAYMENT PLANS TO WORK WITH THE HOSPITAL FACILITYTO PAY THEIR OUTSTANDING BALANCES WITH COMMUNICATION MADE TO THEPATIENT ON A MONTHLY BASIS VIA PAPER INVOICES AND PHONE CALLS- PATIENT ACCOUNTS WILL NOT GO TO BAD DEBT COLLECTION IF THE PATIENTMAKES MONTHLY PAYMENTS AS AGREED TO WITH THE HOSPITAL FACILITY OR IFTHE PATIENT COMMUNICATES THEIR INABILITY TO MAKE PAYMENTS TIMELY- PATIENT ACCOUNTS WILL GO TO BAD DEBT COLLECTION IF THE PATIENT DOESNOT COMMUNICATE WITH THE HOSPITAL FACILITY OR RESPOND TO PAPER INVOICESAND PHONE CALLS FOR MULTIPLE MONTHS PART V, SECTION B, LINE 7A THE 2019 CHNA FOR TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE AND ARROWHEAD BEHAVIORAL HOSPITALS CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-FLOWER-WILDWOOD-AND-ARROWHEAD-HOSPITALS-2019-JOINT-CHNA.PDFTHE 2019 CHNA FOR PROMEDICA TOLEDO CHILDREN'S HOSPITAL CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-CHILDRENS-HOSPITAL-2019-CHNA.PDF PART V, SECTION B, LINE 10A THE 2020-2020 CHNA IMPLEMENTATION PLAN FOR TOLEDO, FLOWER, WILDWOOD ORTHOPAEDIC & SPINE AND ARROWHEAD BEHAVIORAL HOSPITALS CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-FLOWER-WILDWOOD-AND-ARROWHEAD-BEHAVIORAL-HOSPITALS-2019-JOINT-CHNA-IMPLEMENTATION-PLAN-2020-2022-(1).PDFTHE 2020-2020 CHNA IMPLEMENTATION PLAN FOR PROMEDICA TOLEDO CHILDREN'S HOSPITAL CAN BE FOUND AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/CHNA/PROMEDICA-TOLEDO-CHILDRENS-HOSPITAL-2019-CHNA-IMPLEMENTATION-PLAN-2020-2022.PDF PART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/UNINSURED_DISCOUNT_POLICY.PDF PART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/FINANCIAL_ASSISTANCE_APPLICATION.PDF PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/ASSETS/DOCUMENTS/PATIENT-RESOURCES/PLAIN_LANGUAGE_FINANCIAL_ASSISTANCE.PDF TOLEDO CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11 CONTINUED: ACTIONS TAKEN: - 33 COMMUNITY AND HOSPITAL TRAININGS WERE PROVIDED, WITH OVER 443 PARTICIPANTS TRAINED- ASSESSED KNOWLEDGE LEARNED THROUGH POST EVALUATION. 96% REPORTING AN INCREASE IN KNOWLEDGE AFTER THE TRAINING; 38% INDICATED THEY WERE TRAUMA INFORMED PRIOR TO THE TRAINING AND 93% INDICATED THEY WERE HIGHLY INFORMED AFTER THE TRAINING-TWO 6-WEEK LONG TRAUMA INFORMED PARENTING GROUPS WERE HELD FOR 14 CAREGIVERS (TOTALING 24 HOURS). 100% OF THE ATTENDEES WERE SATISFIED WITH THE TRAINING AND 94% INDICATED AN INCREASE IN THEIR KNOWLEDGE- "HIP HOP HEALS" GROUP OF AT RISK TEENS WERE PROVIDED EDUCATION INCLUDING TWO GROUPS OF 16 STUDENTS, WITH CLASSES HELD FOR 6 WEEKS. UNABLE TO ADMINISTER END OF YEAR SURVEY TO DETERMINE OUTCOME DUE TO COVID RELATED SCHOOL CLOSURES. PLANS ARE TO RESUME IN 2021.- ONE LEARNING COMMUNITY ESTABLISHED WITH 22 PROVIDERS PARTICIPATING IN A PREVENTION GROUP FOR AT-RISK YOUTH, IN THEIR OWN COMMUNITIES. STRATEGY #3 - PROVIDE PEER-LED BULLYING/VIOLENCE PREVENTION AWARENESS EDUCATION TO ELEMENTARY AND MIDDLE SCHOOL AGED KIDS. HAVE A POSITIVE IMPACT ON PEER BULLYING BY PROVIDING EDUCATION TO SCHOOLS (Y1-500 YOUTH, Y2-750 YOUTH, Y3-1000 YOUTH).ACTIONS TAKEN: - THE 2020 OBJECTIVE OF 500 YOUTH EDUCATED, WAS MET IN 1ST AND 2ND QUARTERS. - 76 STUDENT LEADERS RECEIVED MULTI-SESSION TRAININGS ON BYSTANDER INTERVENTION IN FALL OF 2020; THE NUMBER OF STUDENT LEADERS WERE REDUCED DUE TO COVID RELATED SCHOOL CLOSURES AND TPS MORATORIUM ON SERVICES DURING 2020.- 588 STUDENTS RECEIVED PEER LED EDUCATION ON HOW THEY CAN REDUCE BULLYING IN THEIR SCHOOLS.-TRAINED PEER LEADERS WERE NOT ABLE TO DO CLASSROOM PRESENTATIONS AND HAVE ONLY BEEN ABLE TO EDUCATE PEERS VIA SOCIAL MEDIA MESSAGING CAMPAIGNS CENTERED AROUND BYSTANDER INTERVENTION, BULLYING PREVENTION, INCREASING KINDNESS, MENTAL HEALTH AWARENESS AND DE-STIGMATIZATIONSTRATEGY #4 - DEMONSTRATE CHANGE AS EVIDENCED BY PARTICIPANT RETROSPECTIVE TESTING. INCREASE CONFIDENCE LEVEL "YOUR PEERS ARE MAKING FUN OF A CLASSMATE. HOW CONFIDENT ARE YOU THAT YOU WOULD STAND UP FOR THE PERSON EVEN IF YOU DID NOT KNOW THEM?" (Y1-10%, Y2-15%, Y3-20%).ACTIONS TAKEN:- TRACKED CONFIDENCE LEVEL OF TEENS. IN 2020 (YEAR 1) TEEN LEADERS DEMONSTRATED A 72% OVERALL INCREASE IN THEIR CONFIDENCE LEVEL FOR INTERVENING (BYSTANDER INTERVENTION). DATA COLLECTED ONCE ANNUALLY AT CONCLUSION OF SCHOOL YEAR MAY/JUNE.STRATEGY #5: 1. PROVIDE ANTENATAL EDUCATION BY NEONATAL NURSE PRACTITIONER FROM NEONATAL INTENSIVE CARE UNIT (NICU) ABOUT MATERNAL BONDING AND THE USE OF NON-PHARMACOLOGICAL BUNDLE ITEMS TO DECREASE THE NEED FOR PHARMACOLOGICAL TREATMENT FOR NEONATAL ABSTINENCE SYNDROME (NAS) STRESSING THE IMPORTANCE OF THE USE OF MATERNAL BREAST MILK IN THE NAS POPULATION. 2. CONTINUE CONSULTS AT CENTER FOR HEALTH SERVICES (CHS) AS ORDERED BY PRIMARY CARE PROVIDER/OBSTETRICIAN.3. CONTINUE PARTICIPATION AT THE MONTHLY "MOM'S GROUP" MEETINGS AT ZEPF CENTER.ACTIONS TAKEN: -16 NEONATAL ABSTINENCE SYNDROME (NAS) CONSULTS WERE COMPLETED AT CHS IN 2020 A NEONATAL NURSE PRACTITIONER FROM NEONATAL INTENSIVE CARE UNIT (NICU) INSTRUCTED NEW MOTHERS ABOUT MATERNAL BONDING AND THE USE OF NON-PHARMACOLOGICAL BUNDLE ITEMS TO DECREASE THE NEED FOR PHARMACOLOGICAL TREATMENT FOR NAS. THE IMPORTANCE OF THE USE OF MATERNAL BREAST MILK IN THE NAS POPULATION WAS ALSO STRESSED.-A LICENSED THERAPIST EDUCATED APPROXIMATELY 8-10 INDIVIDUALS AT MOM'S GROUP AT ZEPF MENTAL HEALTH CENTER IN JANUARY AND FEBRUARY. DUE TO COVID RESTRICTIONS ADDITIONAL MEETINGS WERE UNABLE TO HELD IN THE REMAINING MONTHS. (10-12 HOURS IN 2020 MEETING TIME). ATTEMPTED ZOOM MEETING FOR "MOM'S GROUP" AT THE ZEPF CENTER, BUT DUE TO MULTIPLE FACTORS WAS NOT SUCCESSFUL- HAD ACCESS TO NEW MOTHERS SEEN AT THE CENTER FOR HEALTH SERVICES CLINIC, SAW 16 NEW MOTHERS FOR RELATED CONSULTS AND EDUCATION. -DUE TO THE INCREASE IN NAS BABIES AND DECREASE IN ACCESSING HEALTH CARE FOR THESE MOMS PRIOR TO BIRTH, THE LOS (LENGTH OF STAY) AND LOTX (LENGTH OF TREATMENT) FOR BOTH GROUPS SHOWED NO STATISTICAL DIFFERENCE. HOWEVER, THE 12 BABIES WHO HAD CONSULTS SHOWED BETTER BIRTH WEIGHT, HEAD CIRCUMFERENCE AND GESTATIONAL AGE AT DELIVERY. ALSO OF NOTE; THE CONSULT GROUP OF MOMS HAD A MUCH LOWER USAGE OF MARIJUANA WHILE PREGNANT. HEALTH NEED IDENTIFIED: INFANT MORTALITY/MATERNAL HEALTHSTRATEGY #1 SAFE SLEEP1. PROVIDE ACCESS TO SAFE SLEEP EDUCATION TO LOW INCOME CAREGIVERS WITH CHILDREN LESS THAN 12 MONTHS OF AGE, AND REFER PARENTS TO CLASSES AS APPROPRIATE. PROVIDE ASSESSMENTS TO FAMILIES RECEIVING PORTABLE CRIB TO ENSURE SAFE SLEEP PRACTICES AND USE OF CRIB.2. PROVIDE SAFE SLEEP SACKS AND SAFE SLEEP EDUCATION TO LOW INCOME CAREGIVERS WITH NEWBORN INFANTS WHEN APPROPRIATE.3. EXPAND AS POSSIBLE BASED ON FUNDING AVAILABILITY.ACTIONS TAKEN:-SAFE SLEEP EDUCATION WAS PROVIDED TO 463 FAMILIES. -156 REFERRALS OF ELIGIBLE PATIENTS WERE MADE TO THE SAFE SLEEP CRIB PROGRAM AT THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT TO RECEIVE A PORTABLE CRIB FOR HELP ME GROW (HMG) AND PATHWAYS PARTICIPANTS. -151 FAMILIES WERE REFERRED TO TOLEDO HEALTH DEPARTMENT AND ASSESSED FOR FOLLOW-UP CRIBS FOR KIDS (SAFE SLEEP) CLASSES, WITH 30 DAY FOLLOW-UP FOR COMPLIANCE.-153 NUMBER OF SLEEP SACKS WERE DISTRIBUTED. -215 REPRODUCTIVE LIFE PLAN ASSESSMENTS WERE COMPLETED.STRATEGY #2 BREASTFEEDING 1. TH/ECH WOMEN, INFANT AND CHILDREN SUPPLEMENTAL FOOD PROGRAM (WIC) DIETITIANS AND SUPPORT STAFF DISCUSS BREASTFEEDING WITH EACH PREGNANT/BREASTFEEDING WOMAN, ENROLLED IN THE TH/ECH WIC PROGRAM, AND ENCOURAGE ATTENDANCE TO THE FREE, UNLIMITED, BREASTFEEDING EDUCATION CLASSES. 2. OFFER BREASTFEEDING EDUCATION CLASSES TO EACH PREGNANT/BREASTFEEDING WOMAN ENROLLED IN THE WIC PROGRAM.3. MAKE REFERRALS TO WIC LACTATION CONSULTANT AND WIC BREASTFEEDING STAFF.4. WIC PEER BREASTFEEDING COUNSELOR CONTACTS THE TH/ECH BREASTFEEDING MOMS TO OFFER SUPPORT AND ANSWER BREASTFEEDING QUESTIONS.5. EDUCATE PREGNANT WOMEN PARTICIPATING IN PATHWAYS AND HMG HOME VISITING PROGRAMS REGARDING BREASTFEEDING AND/OR FEEDING BREASTMILK DURING HOME VISITS AND USE LACTATION CONSULTANTS IF NEEDED TO SUSTAIN INFANTS RECEIVING BREASTMILK UNTIL AT LEAST 5 WEEKS OLD. INCORPORATE THE ODH BREASTFEEDING/BREAST MILK INITIATIVE MATERIALS. ACTIONS TAKEN:- THE NUMBER OF PREGNANT/BREASTFEEDING WOMEN ENROLLED IN TH/E- CH WIC PROGRAM WAS 161, IN 2020.- ECH PROVIDED BREASTFEEDING CLASSES THROUGH WIC TWO TIMES A MONTH WITH 80 CLASSES HELD VIRTUALLY IN 2020, WITH A TOTAL OF 193 WOMEN ATTENDING IN 2020. - ECH WAS UNABLE TO MONITOR QUARTERLY BREASTFEEDING RATES DUE TO STATE CHANGES IN DATABASE ACCESS.-TH/ECH WIC PEER BREASTFEEDING COUNSELOR CONTACTS, TO EDUCATE AND ENCOURAGE, BREASTFEEDING MOMS (VIA TEXTS, IN PERSON, PHONE CALLS) INCLUDED 4,105 TEXT MESSAGES, 385 VISITS IN PERSON, AND 1,194 CALLS, IN 2020.- PROMOTED BREASTFEEDING THROUGH EDUCATION AND SUPPORT OF 100% PARTICIPANTS OF PATHWAYS AND HELP ME GROW PROGRAM FOR A TOTAL OF 123 PARTICANTS FOR HALF OF THE YEAR. STATISTICS FROM FIRST HALF OF THE YEAR WERE UNABLE TO BE SUBSTANTIATED DUE TO STAFF TURNOVER.- THE ECH CERTIFIED LACTATION COUNSELOR REFERRED 104 PATIENTS TO HEALTH DEPARTMENT LACTATION CONSULTANT.- THE NUMBER OF INFANTS RECEIVING BREASTMILK, WHOSE MOTHERS WERE ENROLLED IN PATHWAYS AND HELP ME GROW, WAS 168, IN 2020. - FOR THE SECOND HALF OF 2020 THE NUMBER OF NEWBORNS FED BREASTMILK IN THEIR FIRST 6 WEEKS AFTER DELIVERY WAS 65 (DUE TO MOTHERS NOT CONTINUING BREASTFEEDING AFTER A CERTAIN POINT WITHIN THE SIX WEEKS). HEALTH NEED IDENTIFIED: INJURY PREVENTION STRATEGY #11. KIDS IN SAFE SEATS (KISS) AND OHIO BUCKLES BUCKEYES (OBB) PROGRAMS WILL EDUCATE PARENTS AND CAREGIVERS ON THE IMPORTANCE OF PROPER CAR SEAT USE AT RUSSELL J. EBEID CHILDREN'S HOSPITAL FITTING STATIONS AND COMMUNITY CAR SEAT CHECK EVENTS.2. PROVIDE OPPORTUNITIES FOR PARENTS AND CAREGIVERS TO RECEIVE CAR SEAT INFORMATION (Y1-40, Y2-50, Y3-60).3. KISS AND OBB PROGRAMS WILL PROVIDE ACCESS TO CAR SEATS AND BOOSTER SEATS TO LOW INCOME FAMILIES AT RUSSELL J. EBEID CHILDREN'S HOSPITAL CAR SEAT FITTING STATION AND COMMUNITY EVENTS AND WE WILL DISTRIBUTE TO LOW INCOME FAMILIES.4. PROMOTE AND FACILITATE AT LEAST 2 TRAININGS PER YEAR TO INCREASE THE NUMBER OF CHILD SAFETY TECHNICIANS TRAINED (Y1-16, Y2-18, Y3-20).ACTIONS TAKEN: -ECH STAFF EDUCATED INDIVIDUALS ON CAR SEAT SAFETY THROUGH 8 EVENTS WITH 83 FITTING STATIONS, AND 210 CAR SEATS CHECKED. -ECH STAFF PROVIDED 19 CAR SEAT PRESENTATIONS WITH 187 PARTICIPANTS-240 NO COST OR GRANT FUNDED CAR SEATS WERE DISTRIBUTED TO FAMILIES.- ECH STAFF PROVIDED CHILD PASSENGER SAFETY TRAINING (CPST) AT ONE (1) CPST TRAINING AND ONE (1) SPECIAL NEEDS TRANSPORTATION TRAINING, WITH 21 PEOPLE TRAINED. TOLEDO CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11 CONTINUED: STRATEGY #2 INCREASE AWARENESS OF DISTRACTED DRIVING DANGERS.1. PROMOTE AND FACILITATE DISTRACTED DRIVING PRESENTATIONS FOR LOCAL HIGH SCHOOLS AND COMMUNITY LOCATIONS THROUGHOUT NORTHWEST OHIO.2. CONDUCT DISTRACTED DRIVING PROGRAMMING FOR AT LEAST HIGH SCHOOLS (Y1-3, Y2-5, Y3-6) AND AT COMMUNITY LOCATIONS (Y1-1, Y2-2, Y3-3).ACTIONS TAKEN:-AT THE TOLEDO AUTO SHOW IN FEBRUARY 2020, APPROXIMATELY 60 PEOPLE USED DISTRACTED DRIVING SIMULATOR-IN LIEU OF ONSITE HIGH SCHOOL DISTRACTED DRIVING PROGRAMMING, SOCIAL MEDIA OUTREACH INCLUDED 25 POSTS WITH 2969 PEOPLE REACHED (NO IN-PERSON PROGRAMS FROM MARCH-DECEMBER DUE TO COVID SCHOOL RESTRICTIONS).STRATEGY #3 INCREASE ACCESS TO SAFETY ITEMS, PROVIDE EDCUATION ON CHILD/HOME SAFETY. 1. RUSSELL J. EBEID CHILDREN'S HOSPITAL (ECH) TRAUMA DEPT. AND SAFE KIDS GREATER TOLEDO WILL EDUCATE PARENTS/CAREGIVERS AND THE COMMUNITY ON CONCUSSION PREVENTION AND SPORTS RELATED INJURIES AT EVENTS, COACHES TRAININGS, CONCUSSIONS CLINIC, AND AREA SCHOOLS. 2. EDUCATE AT LEAST 50 PARTICIPANTS AT PRESENTATIONS AND EVENTS (Y1-50 Y2, 3-75).3. ECH COMMUNITY OUTREACH/SAFE KIDS GREATER TOLEDO AND TOLEDO HEALTHY TOMORROWS WILL EDUCATE PARENTS, CAREGIVERS, AND THE COMMUNITY ON HOME SAFETY ISSUES INCLUDING ACCIDENTAL POISONINGS, MEDICATION SAFETY, WATER SAFETY, FALLS, FIRE, BURN, ETC.4. DIRECTLY EDUCATE INDIVIDUALS (Y1-150, Y2-175, Y3-185) THROUGH PRESENTATIONS AND EDUCATIONAL SESSIONS; INDIRECTLY EDUCATE THOUSANDS MORE THROUGH AT SOCIAL MEDIA POSTS, TRADITIONAL MEDIA AND BROCHURES (Y1-5, Y2-10, Y3-15).ACTIONS TAKEN:-ECH PROVIDED HOME SAFETY ITEMS/KITS TO 47 HOUSEHOLDS, WITH 124 ITEMS DISTRIBUTED.-ECH EDUCATED 312 INDIVIDUALS AT 21 SAFETY PRESENTATIONS.- IN LIEU OF IN PERSON EDUCATION, DUE TO COVID RESTRICTIONS, 137 HOME SAFETY SOCIAL MEDIA POSTS WERE MADE, WITH 29,742 PEOPLE REACHED. - NOTE: NUMBER ONE (#1) STRATEGY ABOVE IS A DUPLICATE STRATEGY TO STRATEGY 5, (#1) ON NEXT PAGE, AND IS REPORTED THERE.STRATEGY #4 - IMPROVE SAFETY OF CHILDREN WHO WALK OR BIKE TO SCHOOL.1. COMMUNITY OUTREACH/SAFE KIDS GREATER TOLEDO AND SAFE ROUTES TO SCHOOL (PROGRAMS) WILL EDUCATE STUDENTS AND THE COMMUNITY ON THE FACILITATE WALK TO SCHOOL DAY AND BIKE TO SCHOOL DAY WITH LOCAL SCHOOLS AND EDUCATE ON SAFE WALKING/BIKE PRACTICES AND BENEFITS OF GOING TO SCHOOL IN GROUPS (Y1&2-50 CHILDREN, Y3-60 CHILDREN).ACTIONS TAKEN:- TO IMPROVE SAFETY OF CHILDREN BIKING TO SCHOOL, ECH DID THE FOLLOWING: BIKE HELMET FITTINGS FOR 275 PARTICIPANTS, AND ONE PEDESTRIAN SAFETY EVENT WAS PROVIDED TO APPROXIMATELY 3000 PARTICIPANTS ATTENDING "BOO AT THE ZOO". STRATEGY #5 - INCREASE AWARENESS OF CONCUSSION PREVENTION AND SPORTS RELATED INJURIES.1. RUSSELL J. EBEID CHILDREN'S HOSPITAL TRAUMA DEPT. AND SAFE KIDS GREATER TOLEDO WILL EDUCATE PARENTS/CAREGIVERS AND THE COMMUNITY ON CONCUSSION PREVENTION AND SPORTS RELATED INJURIES AT EVENTS, COACHES TRAININGS, CONCUSSIONS CLINIC, AND AREA SCHOOLS (Y1-AT LEAST 50 PARTICIPANTS, Y2&3-AT LEAST 75 PARTICIPANTS).2. RUSSELL J. EBEID CHILDREN'S HOSPITAL TRAUMA DEPT. WILL ASSIST SCHOOLS AND MEDICAL PROFESSIONALS WITH RETURN2PLAY AND RETURN TO LEARN POLICY AND PROCEDURE ADOPTION BY PROVIDING EDUCATIONAL MATERIALS AND SESSIONS (Y1-AT LEAST 4 SCHOOLS OR MEDICAL PROFESSIONALS, Y2-5, Y3-6).ACTIONS TAKEN: -EBEID CHILDREN'S HOSPITAL TRAUMA DEPARTMENT HELD FOUR (4) EDUCATIONAL SESSIONS ON VARIOUS TRAUMA RELATED CHILD INJURIES, WITH A TOTAL OF 416 PARTICIPANTS. THREE (3) EVENTS WERE HELD AT CAMP MIAKONDA, A BOY SCOUTS OF AMERICA LOCATION, AND ONE (1) EVENT WAS HELD AT THE 180TH NATIONAL GUARD. DUE TO SCHOOL CLOSURES DUE TO COVID RESTRICTIONS, NO EVENTS WERE HOSTED IN SCHOOLS IN 2020.-NO MEDICAL PROFESSIONALS (SCHOOL REGISTERED NURSES) WERE PRESENT AS THEY EDUCATED COMMUNITY MEMBERS AND PARENTS/CAREGIVERS OF CHILDREN, OUTSIDE OF THE SCHOOL SETTING, DUE TO COVID RESTRICTIONS.STRATEGY #6 - DEVELOP AND IMPLEMENT SAFETY EDUCATION FOR CHILDREN AND PARENTS OF CHILDREN WITH AUTISM (YEAR 1-AT LEAST 2 EVENTS, YEAR 2-4 EVENTS, YEAR 3-6 EVENTS).ACTIONS TAKEN:-ECH PROVIDED EDUCATION AT TWO (2) EVENTS, WITH 22 PEOPLE EDUCATED AT THESE EVENTS. IN PERSON EVENTS WERE DIFFICULT TO SCHEDULE DUE TO COVID GROUP RESTRICTIONS.HEALTH NEED IDENTIFIED: CHRONIC DISEASE/ASTHMA/FOOD INSECURITYSTRATEGY #1 - PROMEDICA RUSSELL J. EBEID CHILDREN'S HOSPITAL WILL PROVIDE NURSE COVERAGE IN COLLABORATION WITH THE LUCAS COUNTY HEALTH DEPARTMENT "SHOTS FOR TOTS" PROGRAM TO PROVIDE IMMUNIZATIONS TO CHILDREN.ACTIONS TAKEN: - ECH WAS UNABLE TO DELIVER AND PARTICIPATE IN COMMUNITY "SHOTS FOR TOTS" PROGRAM DUE TO COVID RESTRICTIONS. *NOTE: THE PEDIATRIC CLINIC AT CHS ADMINISTERED 16,207 VACCINES DURING NORMAL MEDICAL CARE APPOINTMENTS THAT ARE REIMBURSED BY INSURANCE. IF NOT COVERED BY THEIR INSURANCE, THEY ARE PROVIDED FREE OF CHARGE. STRATEGY # 2 - INCREASE ACCESS TO ASTHMA EDUCATIONAL PROGRAMS AND INTERVENTIONAL HEALTHCARE. IMPROVE ASTHMA MANAGEMENT FOR CHILDREN. INCREASE UTILIZATION OF CARE FOR HIGHER RISK CHILDREN WITH ASTHMA.1. UTILIZE EVIDENCE BASED ASTHMA DISEASE MANAGEMENT PROGRAM UTILIZED AT PROMEDICA RUSSELL J. EBEID CHILDREN'S HOSPITAL FOR ASTHMA EDUCATION AT THE PEDIATRIC AMBULATORY DEPARTMENT.2. UTILIZE RESPIRATORY THERAPISTS TRAINED TO PROVIDE CONSISTENT ASTHMA EDUCATION TO PARENTS AND CHILDREN WITH ASTHMA AND PROVIDE ACTION PLANS.3. PROVIDE ASTHMA EDUCATION 2 DAYS PER WEEK TO ALL PARENTS OF ASTHMATIC CHILDREN SEEN IN THE PEDIATRIC AMBULATORY DEPARTMENT AND PROVIDE ASTHMA INSTRUCTION BOOKLET TO THOSE RECEIVING EDUCATION. 4. SURVEY PARENTS/PATIENTS AFTER ASTHMA EDUCATION TO ASSESS PERCEPTION OF CARE.5. UTILIZE HOME CARE NURSES TO PROVIDE HOME EVALUATIONS AND FOLLOW UP CARE FOR ASSESSMENT OF PATIENT/FAMILY UNDERSTANDING OF ASTHMA EDUCATION, IMPLEMENTATION OF MANAGEMENT SKILLS AND UNDERSTANDING OF NEED TO TAKE MEDICATIONS AS ORDERED. WILL MAKE HOME HEALTH REFERRAL IF PATIENT ANSWERS YES TO HOSPITALIZATION IN LAST YEAR.ACTIONS TAKEN: - EVIDENCE BASED ASTHMA EDUCATION CLASSES PROVIDED IN THE PEDIATRIC AND PEDIATRIC PULMONARY AMBULATORY DEPARTMENTS, WITH 2,082 PARTICIPANTS. THESE ARE FREE EDUCATIONAL SESSIONS AT PATIENTS AND FAMILY ONE ON ONE APPOINTMENT. 57 PATIENTS WITH POSITIVE HIGH RISK ASTHMA SCREEN WERE REFERRED FOR ASTHMA EDUCATION. FREE SCREENING; NO CHARGE. -1,865 ACTION PLANS WERE PROVIDED WITHOUT CHARGE TO PARENTS OF CHILDREN IN THE PEDIATRIC AND PEDIATRIC PULMONARY AMBULATORY DEPARTMENTS WITH AN ASTHMA DIAGNOSIS. -PATIENTS RECEIVE EDUCATION AT EVERY VISIT. ADDITIONAL EDUCATIONAL OPPORTUNITES WERE OFFERED BUT NO PATIENTS RETURNED FOR EDUCATION OR SOUGHT CLASS INSTRUCTION. -FOR BOTH PEDIATRIC (PEDS) CLINIC AND PEDIATRIC PULMONARY (PULM) DEPARTMENTS, SURVEY RESULTS WERE:-98.5% (COMBINED - 99% PEDS PULM; 98% PEDS CLINIC) PERCENT OF PARENTS ANSWERED "YES" ON WHETHER THERE WAS ENOUGH TIME GIVEN WITH EDUCATOR TO GET QUESTIONS ANSWERED. -97.5% (COMBINED - 97% PEDS PULM; 98% PEDS CLINIC) PERCENT OF PATIENTS INDICATED "NO", THEY HAD NO DIFFICULTY MAKING APPOINTMENT. -97.5% COMBINED (97% PEDS PULM; 98% PEDS CLINIC) NO PATIENTS WERE REFERRED FOR ASTHMA TO HOME HEALTH BASED ON HOSPITALIZED IN THE LAST YEAR IN BOTH PEDS PULM AND PEDS CLINIC. THIS INDICATES PATIENTS ARE COMPLIANT WITH MEDICATION REGIMEN.STRATEGY #3 - DECREASE ASTHMA-RELATED HOSPITAL ADMISSIONS AND ED VISITS BY IMPROVED FAMILY/CHILD KNOWLEDGE AND APPROPRIATE MANAGEMENT OF CHILD'S ASTHMA.1. PROMEDICA RUSSELL J. EBEID CHILDREN'S HOSPITAL AND OUTPATIENT PRACTICES HAVE BEEN CERTIFIED BY THE JOINT COMMISSION FOR PEDIATRIC ASTHMA DISEASE MANAGEMENT AND IS THE ONLY HOSPITAL IN OHIO WITH THIS DISTINCTION. THIS TEAM MEETS REGULARLY TO EVALUATE PROGRESS BASED ON TARGET GOALS.2. PROVIDE EVIDENCED BASED EDUCATION TO PATIENTS USING QUALITY MEASURES TO DETERMINE SUCCESS. A. UTILIZE ASTHMA ORDER SETS IN PEDIATRIC EMERGENCY DEPARTMENT.B. UTILIZE ASTHMA ORDER SETS IN PEDIATRIC INPATIENT UNITC. UTILIZE ASTHMA ORDER SETS AT PULMONARY CLINIC AT PEDS AMBULATORY CLINIC (MEANT TO STATE PEDIATRIC ICU)3. PROVIDE ASTHMA INSTRUCTION BOOKLETS TO THOSE RECEIVING PARENT EDUCATION AND CONDUCT EVALUATIONS. 4. PROVIDE ASTHMA ACTION PLAN TO ALL PATIENTS AND FAMILIES WITH ASTHMA DIAGNOSIS FROM PROMEDICA RUSSELL J. EBEID CHILDRENS HOSPITAL AND MONITOR NUMBER OF PATIENTS SEEN IN ED WITHIN 7 OR 30 DAYS FROM LAST ED VISIT. TOLEDO CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11 CONTINUED: ACTIONS TAKEN:- ECH IS THE ONLY HOPSITAL IN OHIO CERTIFIED BY THE JOINT COMMISSION FOR PEDIATRIC ASTHMA DISEASE MANAGEMENT. THIS TEAM MEETS REGULARLY TO EVALUATE PROGRESS BASED ON TARGET GOALS, AND REVIEWS AND EDUCATES STAFF TO CONTINUALLY IMPROVE ON ALL ASPECTS BELOW.-MONITORED ORDER SET SCREENING STATISTICS AS A PERCENTAGE OF ALL PATIENTS SEEN WITH ASTHMA, THE PERCENT OF PATIENTS RECEIVING THE FOLLOWING IS: PERCENT OF ORDER SETS USED IN ED: 85.1%, GOAL 100% PERCENT OF ORDER SETS USED IN PEDIATRIC INPATIENT UNIT: 4%, GOAL 100% PERCENT OF ORDER SETS USED IN PEDIATRIC INTENSIVE CARE (PICU). 85.4%, GOAL 100% REVIEW AND EDUCATE STAFF TO CONTINUALLY IMPROVE.-ALL (100%) PATIENTS RECEIVE INSTRUCTION BOOKLETS 100%. -MONITORED ASTHMA ACTION PLAN AND READMISSION RATES: CONDUCTED QUALITY PHONE CALL TO PATIENTS AT FIVE DAYS POST DISCHARGE OCCURS. PATIENTS WERE ASKED "WERE ALL YOUR QUESTIONS ANSWERED, DID YOU OR DID THE PARENT HELP TO DEVELOP ASTHMA ACTION PLAN (AAP)? " PERCENTAGE: 98.7%, GOAL 100% OUTPATIENT ASTHMA ACTION PLAN (AAP) MATCHES VISIT MEDICATIONS: 63.6%, GOAL 75% PER CERTIFICATION GUIDELINES. 7 DAY READMISSIONS INPATIENTS 2% 2020, 1% 2019. NO TARGET. DID NOT IMPROVE OVER 2019. 30 DAY READMISSIONS INPATIENTS 1.25% 2020, 4% 2019. NO TARGET. IMPROVED OVER 2019. MONITORED ED REVISITS FOR RETURN TO HOSPITAL ED FOLLOWING LAST ED VISIT: 3-DAY PERCENTAGE 1.17%; (NO LONGER COLLECT 7-DAY, 30-DAY, OR 180-DAY PERCENTAGE DUE TO 3-DAY BEING THE BETTER INDICATOR FOR CARE.) NO TARGET SET BY JOINT COMMISSION FOR PEDIATRIC ASTHMA DISEASE MANAGEMENT. STRATEGY #4 - ASSESS FOOD INSECURITY FOR EACH WIC PARTICIPANT DURING ALL WIC CERTIFICATION APPOINTMENTS. YEAR 1 (2020)1. REVIEW ALL HEALTH HISTORY FORMS AT EACH WIC CERTIFICATION APPOINTMENT AND ADDRESS THE QUESTION THAT INDICATES FOOD INSECURITY.2. DISCUSS THE PROMEDICA HEALTH SYSTEM FOOD CLINIC WITH EACH FOOD INSECURE FAMILY. MANY TIMES WE PHYSICALLY WALK OUR WIC PATIENTS DOWN TO THE CHS FOOD CLINIC. IF THE FOOD CLINIC IS CLOSED, WE OFFER HOURS OF OPERATION AND SUGGEST THAT ALL PROMEDICA HEALTH SYSTEM PATIENTS OBTAIN A REFERRAL TO THE FOOD CLINIC FROM THEIR PHYSICIAN.3. YEAR 2 AND 3 (2021-2022) EVALUATE PROGRAM TO DETERMINE ANY CHANGES NEEDED.ACTIONS TAKEN:- NUMBER OF PATIENTS WITH POSITIVE/AT RISK RESPONSES TO FOOD INSECUITY QUESTIONS ASKED AT WIC CERTIFICATION APPOINTMENT WERE 101. THE NUMBER OF PATIENTS REFERRED TO THE PROMEDICA FOOD CLINIC WAS 64 BASED ON PATIENT FEEDBACK, THE REMAINDER OF THE PATIENTS DECLINED A REFERRAL DUE TO THE COVID RELATED INCREASE IN FOOD STAMP/SNAP BENEFITS, AND FREE UNIVERSAL BREAKFAST AND LUNCH AT SCHOOLS. IN RESPONSE TO PANDEMIC FOOD BENEFITS, FOOD INSECURITY NEED IN WIC CLINIC DECREASED.STRATEGY #5 PROMEDICA ECH AMBULATORY PEDIATRIC PRACTICES WILL CONTINUE TO SCREEN ALL PATIENTS FOR FOOD INSECURITY AND REFER PATIENTS TO THE PROMEDICA FOOD CLINIC. THE FOOD CLINIC PROVIDES ACCESS TO HEALTHY FOOD AND NUTRITION EDUCATION FOR PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY. THE FOOD CLINIC WILL PROVIDE CONTINUED EDUCATION/TRAINING TO PRACTICES ON ADDRESSING FOOD INSECURITY. ALL PATIENTS REFERRED TO THE FOOD CLINIC WILL BE OFFERED NUTRITION COUNSELING AND NUTRITION RESOURCES.1. THE FOOD CLINIC WILL EXPLORE WAYS TO INCREASE EDUCATION THROUGH IMPROVED COMMUNICATION WITH PROVIDERS AND INCREASED EDUCATION OPPORTUNITIES. 2. YEARS 2 AND 3 (2021-2022) EVALUATE FOOD CLINIC PROGRAM EXPANSION TO PROVIDE SERVICES TO ADDITIONAL PRACTICES AND PATIENTS. REFINE NUTRITION EDUCATION OPPORTUNITIES PROVIDED THROUGH THE FOOD CLINIC. 3. YEARS 2 AND 3 (2021-2022) ALL PATIENTS/FAMILIES AT ECH WILL BE SCREENED FOR FOOD INSECURITY PRI - OR TO DISCHARGE AND WILL BE OFFERED AN EMERGENCY FOOD BAG UPON DISCHARGE.4. YEAR 1 (2020) - CONTINUE TO PROVIDE FOOD BAGS AT DISCHARGE FOR PATIENTS IDENTIFIED AS FOOD INSECURE. YEARS 2 AND 3 (2021-2022) - EVALUATE FOOD SECURITY SCREENING RATES TO DETERMINE NEED FOR ADDITIONAL TRAINING ACROSS ECH STAFF. ACTIONS TAKEN:- TRAINING IS ONGOING, NEW PROVIDERS AND STAFF ARE REGULARLY TRAINED. FOOD CLINIC TRAINING MATERIALS PROVIDED TO THREE (3) PRACTICES IN 2020. - 15,192 FOOD INSECURITY SCREENS WERE CONDUCTED AT CHS PEDIATRIC PRACTICE IN 2020- 1,298 REFERRALS WERE WRITTEN TO THE FOOD CLINIC FROM CHS PEDIATRIC PRACTICES IN 2020.- 1,607 UNIQUE HOUSEHOLDS WITH CHILDREN (6,792 INDIVIDUALS) WERE SERVED BY THE CHS AND PROMEDICA HEALTH AND WELLNESS FOOD CLINICS IN 2020- IN 2020, 12 HOUSEHOLDS WITH CHILDREN RECEIVED NUTRITION COUNSELING, 117 HOUSEHOLDS WITH CHILDREN RECEIVED HEALTHY RECIPES, 298 HOUSEHOLDS WITH CHILDREN RECEIVED HEALTHY NUTRITION HANDOUTS - 74 FOOD AT DISCHARGE FOOD BAGS WERE PROVIDED TO FOOD INSECURE FAMILIES AT ECH IN 2020.HEALTH NEED IDENTIFIED: INCREASE SCHOOL READINESS1. EDUCATE LOW INCOME PARENTS ABOUT PARENTING AND BENEFITS OF READING TO THEIR CHILDREN DURING HOME VISITS AND PROVIDE FREE CHILDREN'S BOOKS TO HOMES.A. YEAR 1 (2020) - TOLEDO HEALTHY TOMORROWS (THT)/HELP ME GROW (HMG) HOME VISITORS PROVIDE LITERACY EDUCATION AND BOOKS TO FAMILIES.B. YEAR 2 THRU 3 (2021-2022) - CONTINUE EDUCATION AND BOOK DISTRIBUTION WITH FAMILIES ENROLLED IN THT PROGRAMS AND PROVIDE RESOURCES FOR FAMILIES TO CONTINUE LITERACY ACTIVITIES AFTER DISCHARGED FROM THT PROGRAMS.2. PROVIDE AGE SPECIFIC DEVELOPMENTAL SCREENING FROM BIRTH TO AGE 3 FOR CHILDREN ENROLLED IN THT/HMG PROGRAMS.3. YEARS 1 THRU 3 (2020-2022)SCREEN ALL INFANTS AND CHILDREN TO AGE 3 YEARS OLD WITH AGE APPROPRIATE AGES AND STAGES, THIRD EDITION AND REFER ALL CHILDREN TO EARLY INTERVENTION THROUGH ESTABLISHED PROCEDURE IF SCREENING DETERMINES NEED FOR EVALUATION.ACTIONS TAKEN: -PROVIDED EDUCATION ABOUT READING AND DISTRIBUTED BOOKS DURING HOME VISITS: BETWEEN THE TWO (THT/HMG) PROGRAMS, 250 FAMILIES EDUCATED. NUMBER OF BOOKS DISTRIBUTED: 382.- SCREENED CHILDREN ENROLLED IN THT/HMG PROGRAM WITH AGES AND STAGES: 245 - NUMBER OF REFERRALS MADE TO EARLY INTERVENTION MADE THROUGH THESE HOME VISITS: 41 52 1 - PROMEDICA HICKMAN CANCER CENTER 5300 HARROUN RD STE 010 SYLVANIA OH 435602182 ONCOLOGY 2 - PARKWAY SURGERY CENTER 2120 W CENTRAL AVE TOLEDO OH 436063834 SURGERY/LAB 3 - PROMEDICA MAUMEE ONCOLOGY 5805 MONCLOVA RD MAUMEE OH 435371839 ONCOLOGY 4 - ENDOSCOPY CENTER 5700 MONROE ST UNIT 102 SYLVANIA OH 435602767 ENDOSCOPY 5 - PROMEDICA HEALTH & WELLNESS CENTER 5700 MONROE ST SYLVANIA OH 435602779 LAB & RADIOLOGY 6 - HARRIS-MCINTOSH RADIOLOGYEBEID CHILDRENS 2121 HUGHES DR TOLEDO OH 436063845 RADIOLOGY/CARDIOLOGY/PULMONARY 7 - NORTHWEST OHIO CARDIOLOGY 2940 N MCCORD RD TOLEDO OH 436151753 CARDIOLOGY 8 - PROMEDICA LABS 2130 W CENTRAL AVE STE 300 TOLEDO OH 436062920 LAB 9 - PROMEDICA NEUROSCIENCE CENTER 2130 W CENTRAL AVE TOLEDO OH 436063818 NEUROSCIENCE 10 - CENTER FOR HEALTH SVCSREHABRADIOLOGYWOM 2150 W CENTRAL AVENUE ROOM H TOLEDO OH 436063859 LAB 11 - SPORTSCARE AT WILDWOOD MEDICAL CTR 2865 N REYNOLDS RD STE 110 TOLEDO OH 436152069 PHYSICAL THERAPY 12 - PROMEDICA WILDWOODTOTAL REHAB WILDWOOD 2865 N REYNOLDS RD SUITE 150 TOLEDO OH 436152069 LAB & RADIOLOGY 13 - TOTAL REHAB PEDIATRICS 4041 W SYLVANIA AVE STE 100 TOLEDO OH 436234465 PHYSICAL THERAPY 14 - PERRYSBURG MEDICAL CTR 1601 BRIGHAM DR 180 PERRYSBURG OH 435517118 LAB/RADIOLOGY 15 - FLOWER MOB LAB 5308 HARROUN RD STE 0050 SYLVANIA OH 435602193 LAB 16 - PROMEDICA HEALTH CTR ARROWHEAD 660 BEAVER CREEK CIR STE 120 MAUMEE OH 435371745 LAB/RADIOLOGY/PT 17 - JOBST VASCULAR VASCULAR INSTITUTE 2109 HUGHES DR STE 500 TOLEDO OH 436063856 VASCULAR 18 - MONROE CARDIOLOGY TESTING CENTER 730 N MACOMB ST 429 MONROE MI 481622904 CARDIOLOGY 19 - TOTAL REHAB AT PERRYSBURG 1601 BRIGHAM DR 100 PERRYSBURG OH 435517121 PHYSICAL THERAPY 20 - TOLEDO HOSP AT CONRAD JOBST TOWER 2109 HUGHES DR STE 130 TOLEDO OH 436063856 LAB 21 - PROMEDICA HEMATOLOGYONCOLOGY ASSOC 5308 HARROUN RD STE 0055 SYLVANIA OH 435602174 CANCER CARE 22 - PROMEDICA VASCULAR LAB - SYLVANIA 5700 MONROE ST UNIT 309 SYLVANIA OH 435602767 VASCULAR 23 - PMV CARDIOVASCULAR 5705 MONCLOVA RD STE 201 MAUMEE OH 435371877 CARDIAC TESTING 24 - TOLEDO HOSPITAL CARDIAC TESTING CENTER 1601 BRIGHAM DR 120 PERRYSBURG OH 435517121 PHYSICAL THERAPY/CARDIOLOGY/VASCULAR 25 - SPORTSCARE AT PROFESSIONAL PARK 4848 N HOLLAND SYLVANIA RD STE 202 SYLVANIA OH 435602148 PHYSICAL THERAPY 26 - TOTAL REHAB AT BEDFORD 2000 W DEAN RD TEMPERANCE MI 481829427 PHYSICAL THERAPY 27 - TOTAL REHAB AT SPRING MEADOWS 6855 SPRING VALLEY DR STE 155 HOLLAND OH 435289374 PHYSICAL THERAPY 28 - TOTAL REHAB AT MAUMEE ARROWHEAD 660 BEAVER CREEK CIR STE 210 MAUMEE OH 435371745 PHYSICAL THERAPY 29 - PROMEDICA HEARING CTR 5300 HARROUN RD SUITE 218 SYLVANIA OH 435602168 AUDIOLOGY 30 - CENTER FOR WOUND CARE OF NW OHIO 3110 W CENTRAL AVENUE SUITE A TOLEDO OH 436062956 WOUND CARE 31 - PROMEDICA LABS MCCORD RD 3020 N MCCORD RD 101 TOLEDO OH 436151701 LAB 32 - PROMEDICA HEALTH CENTER - EAST 3156 DUSTIN RD STE102 OREGON OH 436164342 LAB 33 - PROMEDICA SECOR RD LAB 7300 SECOR RD STE 6 LAMBERTVILLE MI 481449360 LAB 34 - JOBST ANTICOAGULATION - TOLEDO 2109 HUGHES DR STE 550 TOLEDO OH 436065103 ANTICOAGULATION CLINIC 35 - PROMEDICA WELLNESS CENTER - PULMONARY FUNC 5700 MONROE ST STE 307 SYLVANIA OH 435602768 PULMONARY 36 - TFL METRO PAT CLINIC 5300 HARROUN RD STE 202 226 SYLVANIA OH 435602146 LAB 37 - PROMEDICA HEALTH CTR SWANTON 22 TURTLE CREEK CIR STE E SWANTON OH 435588591 LAB 38 - PROMEDICA LAB - POINT PLACE 4805 SUDER RD TOLEDO OH 436111800 LAB 39 - PROMEDICA LAB - TOLEDO HOSPITAL MEDICAL 2100 W CENTRAL AVE STE 130 TOLEDO OH 436063800 LAB 40 - PROMEDICA ROSSFORD 1215 GRASSY LANE ROSSFORD OH 434601525 LAB 41 - PROMEDICA MEDICAL CENTER 445 W 4TH STREET FOSTORIA OH 448301849 LAB 42 - PROMEDICA MARY ELLEN FALZONE DIABETES 2100 W CENTRAL AVE STE 120 TOLEDO OH 436063800 DIABETES CARE 43 - PROMEDICA HEALTH CTR LAMBERTVILLE 7579 SECOR RD LAMBERTVILLE MI 481449624 LAB 44 - PROMEDICA PHYSICIANS GENERAL SURGERY 5700 MONROE ST SYLVANIA OH 435602767 BARIATRIC 45 - PCJ HEART FAILURE CLINIC 2109 HUGHES DR TOLEDO OH 436063856 HEART FAILURE CLINIC 46 - PROMEDICA TRANSPORTATION NETWORK 2142 NORTH COVE BLVD TOLEDO OH 436063895 GROUND AND AIR TRANSPORT 47 - TOTAL REHAB- PROMEDICA OWENS CORNING 1 OWENS CORNING PARKWAY TOLEDO OH 436591000 PHYSICAL THERAPY 48 - PROMEDICA NORTHWEST OHIO HEMOPHILIA CENT 2109 HUGHES DR STE 860 TOLEDO OH 436065114 HEMOPHILIA 49 - PROMEDICA PHYSICIANS GYNOONCOLOGY 2109 HUGHES DR STE 820 TOLEDO OH 436065113 WOMENS CARE 50 - PROMEDICA WELLNESS SERVICES-MAUMEE 1789 INDIAN WOOD CIRCLE STE 210 MAUMEE OH 435374022 COMMUNITY EDUCATION 51 - CHS OCCUHEALTH 2142 NORTH COVE BLVD TOLEDO OH 436063895 CHECK LAB OR RAD 52 - RENAL CARE GROUP DIALYSIS 3100 W CENTRAL AVE STE 100 TOLEDO OH 436062924 DIALYSIS PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS, UNDERINSURANCE STATUS AND RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: THE TOLEDO HOSPITAL REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT. PART I, LINE 7: THE TOLEDO HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS. PART II, COMMUNITY BUILDING ACTIVITIES: THE TOLEDO HOSPITAL PROMOTED THE HEALTH OF ITS COMMUNITY BY SUPPORTING LOCAL ORGANIZATIONS AND ACTIVITIES THAT ENGAGE IN COMMUNITY BUILDING ACTIVITIES. PART III, LINE 2: THE TOLEDO HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY. PART III, LINE 3: THE TOLEDO HOSPITAL ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT. PART III, LINE 4: PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGE 18 AND 19 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION. PART III, LINE 8: MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM. - THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS. - MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER. - MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.THE TOLEDO HOSPITAL USED THE MEDICARE ALLOWABLE COSTS PER ITS 2020 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. PART III, LINE 9B: FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING. PART VI, LINE 2: PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE. PART VI, LINE 3: THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS. PART VI, LINE 4: THE TOLEDO HOSPITAL, WITH LOCATIONS IN THE TOLEDO, OHIO METROPOLITAN AREA, SERVES AN AREA PRIMARILY AROUND LUCAS COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 650,000. APPROXIMATELY, 18% OF THE SERVICE AREA IS AGE 65 OR OVER; 37% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $61,000; 74% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 50% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. LUCAS COUNTY HAS A POPULATION OF APPROXIMATELY 428,000 WITH APPROXIMATELY 18% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 32% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 8% OF LUCAS COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR LUCAS COUNTY IN 2020 WAS 6% THE LEADING CAUSES OF DEATH IN LUCAS COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, CANCER, UNINTENTIONAL INJURIES/ACCIDENTS, LUNG DISEASE, ALZHEIMER'S, STROKE, AND DIABETES. ACCORDING TO 2020 COUNTY HEALTH RANKINGS, LUCAS COUNTY RANKED 76 OF 88 COUNTIES FOR HEALTH OUTCOMES, 67 OF 88 FOR LENGTH OF LIFE, AND 76 OF 88 FOR QUALITY OF LIFE. THERE ARE THIRTEEN HOSPITALS WITHIN A 30-MILE RADIUS OF THE TOLEDO HOSPITAL: ST. ANNE MERCY HOSPITAL, ST. VINCENT MERCY MEDICAL CENTER, UNIVERSITY OF TOLEDO MEDICAL CENTER, FLOWER HOSPITAL, ST. CHARLES MERCY HOSPITAL, BAY PARK COMMUNITY HOSPITAL, ST. LUKE'S HOSPITAL, MERCY MEMORIAL HOSPITAL CORPORATION, WOOD COUNTY HOSPITAL, EMMA L. BIXBY MEDICAL CENTER, HERRICK MEMORIAL HOSPITAL, INC., MONROE REGIONAL HOSPITAL, AND FULTON COUNTY HEALTH CENTER. PART VI, LINE 5: THE TOLEDO HOSPITAL IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. IN 2020:- THERE WERE APPROXIMATELY 313 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), SERVING ON MORE THAN 25 DIFFERENT BOARDS, COMMITTEES, COUNCILS AND FOUNDATIONS. OF THOSE BOARD MEMBERS, MOST LIVE WITHIN PROMEDICA'S OHIO AND MICHIGAN ACUTE CARE SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN THE GREATER TOLEDO AREA WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. BOARD MEMBERS INCLUDED 63 PHYSICIANS WITH A BALANCE OF 190 MEN AND 140 WOMEN. - PROMEDICA NON-PARENT BOARD MEMBERS' DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, WERE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES WERE EXTENDED TO ALL QUALIFIED PHYSICIANS AT OUR METRO TOLEDO AND REGIONAL HOSPITALS. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MET THOSE QUALIFICATIONS WAS GRANTED PRIVILEGES, UPON THEIR REQUEST.- AS PART OF PROMEDICA'S ELECTRONIC HEALTH RECORD (EHR) JOURNEY, THE INFORMATION TECHNOLOGY SERVICES TEAM COMPLETED TWO SYSTEM-WIDE UPGRADES TO THE EPIC PLATFORM. THE UPGRADES ALLOW PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON USER INPUT.- PROMEDICA PRIMARY CARE PROVIDERS CONTINUED SCREENING PATIENTS FOR RISK FACTORS OF SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREENED POSITIVE FOR ANY OF THE FACTORS WERE CONNECTED TO COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE.- PROMEDICA CANCER INSTITUTE (PCI) COMPLETED MORE THAN 2,300 LUNG CANCER SCREENINGS AT ITS LUNG CLINICS, EXPANDED ITS GENETICS COUNSELING PROGRAM TO INCLUDE VIRTUAL OPTIONS DURING THE PANDEMIC, AND ESTABLISHED A NEW SEXUAL HEALTH PROGRAM FOR CANCER PATIENTS BY HOSTING TWO WEBINARS. ADDITIONALLY, PCI WAS INSTRUMENTAL IN HELPING PROMEDICA IMPLEMENT MONOCLONAL ANTIBODY TREATMENT AT ITS INFUSION CENTERS FOR COVID-19 PATIENTS TO IMPROVE SYMPTOM MANAGEMENT.- APPROXIMATELY 700 ATTENDEES PARTICIPATED IN THE ANNUAL PROMEDICA BARBERSHOP INITIATIVE, ART OF THE CUT, WHICH CELEBRATED THE ROLE OF LOCAL BARBERS AS ARTISTS, MEN'S HEALTH ADVOCATES, AND COMMUNITY LEADERS WHILE EXAMINING THE INTERSECTION OF ART AND WELLNESS. AS PART OF THE BARBERSHOP INITIATIVE, MORE THAN 30 METRO TOLEDO BARBERS RECEIVED TRAINING IN THE USE OF AUTOMATED EXTERNAL DEFIBRILLATORS (AED) AND UNITS WERE INSTALLED IN SIX BLACK-OWNED BARBERSHOPS. ADDITIONALLY, MORE THAN 1,200 HEALTH AND WELLNESS BAGS AND MORE THAN 2,000 CANCER SCREENING EDUCATIONAL MATERIALS WERE PROVIDED TO BARBERSHOPS AND SALONS IN LUCAS AND LENAWEE COUNTIES TO SHARE IMPORTANT HEALTH AND SCREENING INFORMATION WITH TRADITIONALLY UNDERSERVED COMMUNITIES.- PROMEDICA'S FOUNDATIONS RAISED FUNDS FOR PHILANTHROPY IN SUPPORT OF PROMEDICA'S MISSION TO IMPROVE HEALTH AND WELL-BEING. THIS INCLUDED A COVID-19 EMERGENCY EMPLOYEE COMPASSION FUND, WHICH PROVIDED $250 EMERGENCY GRANTS TO EMPLOYEES ACROSS THE COUNTRY WHO FOUND THEMSELVES IN IMMEDIATE FINANCIAL STRAIN DUE TO THE PANDEMIC. NEARLY 10,000 GRANTS WERE GIVEN TO HELP WITH FOOD, HOUSING, CHILDCARE, AND OTHER EXPENSES. THE PROMEDICA FOUNDATION ALSO ESTABLISHED THE PROMEDICA IMPACT FUND TO RAISE $1 BILLION IN THE NEXT EIGHT YEARS TO ACCELERATE NATIONWIDE EFFORTS AROUND THE SOCIAL DETERMINANTS OF HEALTH (SDOH). THESE EFFORTS INCLUDE ADDRESSING HUNGER, AFFORDABLE HOUSING, WORKFORCE DEVELOPMENT, AND EDUCATION. PART VI, LINE 6: PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A NATIONWIDE, MISSION-BASED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2020 PROMEDICA WAS COMPRISED OF MORE THAN 45,000 EMPLOYEES, APPROXIMATELY 1,200 VOLUNTEERS AND MORE THAN 2,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERSINCLUDING APPROXIMATELY 1,100 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP ('PPG")WHO FORM A PROVIDER NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO ENSURE COMMUNITY MEMBERS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. IN 2020:- PROMEDICA MEMBERS AND AFFILIATE HOSPITALS INCLUDED: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL,; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; AND COMMUNITY HEALTH CENTER OF BRANCH COUNTY D/B/A PROMEDICA COLDWATER REGIONAL HOSPITAL. PROMEDICA ALSO INCLUDES PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION AS WELL AS HUNDREDS OF SKILLED NURSING AND REHABILITATION CENTERS, ASSISTED LIVING FACILITIES AND MEMORY CARE COMMUNITIES, ALL UNDER THE PROMEDICA SENIOR CARE/HCR MANORCARE UMBRELLA. - PROMEDICA MANAGED APPROXIMATELY 1.85 MILLION PPG EMPLOYED PROVIDER ENCOUNTERS, 50,400 SURGERIES, 6,700 BIRTHS, AND MORE THAN 226,500 EMERGENCY ROOM VISITS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $319,240,000 MILLION.- PROMEDICA CONTINUED TO OPERATE THREE COMMUNITY FOOD CLINICS, LOCATED AT PROMEDICA BAY PARK HOSPITAL, THE PROMEDICA HEALTH AND WELLNESS CENTER AND PROMEDICA'S CENTER FOR HEALTH SERVICES, TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEMSELVES AND THEIR FAMILY FROM ONE OF THESE FOOD CLINICS. AS PART OF THE PROGRAM, PATIENTS CAN RECEIVE TWO TO THREE DAYS OF SUPPLEMENTAL FOOD. THROUGH DECEMBER 2020, MORE THAN 8,357 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 2,860 UNIQUE HOUSEHOLDS, FURTHERED PROMEDICA'S EFFORTS TO REDUCE FOOD INSECURITY. THIS TRANSLATES TO ABOUT 67,535 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 202,605 MEALS.- FOR ITS MICHIGAN PATIENTS, PROMEDICA OFFERED VEGGIE MOBILE VOUCHERS TO PATIENTS WHO SCREENED POSITIVE FOR FOOD INSECURITY. PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL PROVIDE THE $5 VOUCHERS SO PATIENTS CAN REDEEM FRESH PRODUCE FROM THE VEGGIE MOBILE THAT IS SOURCED FROM PROMEDICA FARMS, LOCAL GROWERS, AND A WHOLESALER. IN 2020, NEARLY 1,848 POUNDS OF PRODUCE WAS GROWN AT PROMEDICA FARMS, 44 PATIENTS IDENTIFIED AS FOOD INSECURE REDEEMED A VOUCHER ISSUED BY A PHYSICIAN OR DISCHARGE PLANNING, AND AN ADDITIONAL 18 PATIENTS WERE PROVIDED A FOOD BOX AND VEGGIE VOUCHER UPON DISCHARGE. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDED BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD. ADDITIONALLY, TWO NEW FINANCIAL OPPORTUNITY CENTERS (FOC) WERE OPENED IN FREMONT AND DEFIANCE, OHIO. MUCH LIKE THE FOC LOCATED IN UPTOWN TOLEDO, THE NEW LOCATIONS OFFER SERVICES AND ASSIST LOW TO MODERATE-INCOME FAMILIES WITH SECURING LIVING WAGE JOBS, BUILDING CREDIT, REDUCING DEBT, AND GAINING WEALTH. THE FOC ALSO HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING AS WELL AS FREE TAX PREPARATION. 1 PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO OH 43604 341517672 501(C)(3) 761972 OPERATING GRANT NW OHIO MILITARY FRIENDS PO BOX 204 OTTAWA MI 49267 421744630 501(C)(3) 12362 DONATION 2 0 PART I, LINE 2: AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES. X 0 0 1 0 0 0 0 0 0 0 0 RANDALL OOSTRA PHS PRES. & CEO 0 1973076 0 1805059 0 193503 0 117599 0 19387 0 4108624 0 0 STEVEN M CAVANAUGH TREASURER 0 1330912 0 710821 0 6441 0 82144 0 22921 0 2153239 0 0 JEFFREY C KUHN SECRETARY 0 716660 0 391346 0 15405 0 44915 0 17242 0 1185568 0 0 KEVIN C WEBB PHD CHIEF ACUTE & POST ACUTE OFF 0 663831 0 370658 0 14828 0 31704 0 19577 0 1100598 0 0 AARON A BUERK MD TRUSTEE 77345 884061 0 0 0 1214 0 0 0 23803 77345 909078 0 0 MATTHEW KANG EX OFFICIO 0 567352 0 149936 0 3271 0 18186 0 23538 0 762283 0 0 DAWN M BUSKEY PRES., TRUSTEE 0 491636 0 95763 0 2374 0 23800 0 19429 0 633002 0 0 GARY W AKENBERGER COO, ACUTE CARE & SVP, DIAG 0 390451 0 88180 0 4793 0 19393 0 21883 0 524700 0 0 RAVI K ADUSUMILLI MD TRUSTEE 0 473253 0 0 0 2600 0 0 0 25740 0 501593 0 0 DEANA SIEVERT SR VP, PAT CARE/CNO, SYSTEM 0 327015 0 72423 0 2943 0 8160 0 26956 0 437497 0 0 NEERAJ K KANWAL MD FORMER OFFICER 0 17612 0 79954 0 165670 0 0 0 74245 0 337481 0 0 QIN-SHENG CHEN SR. MEDICAL PHYSICIST 278093 0 400 0 14065 0 5700 0 17503 0 315761 0 0 0 ALAN M SATTLER FORMER OFFICER 0 210691 0 35926 0 2863 0 10110 0 26156 0 285746 0 0 JAMES BINGLE TRUSTEE 0 241135 0 33750 0 6923 0 0 0 2388 0 284196 0 0 JAMES BURNS SR. MEDICAL PHYSICIST 240495 0 400 0 12226 0 10328 0 19240 0 282689 0 0 0 FEDOR LURIE ASSOC DIR RESEARCH ED VASC 227751 0 0 0 0 0 3541 0 19962 0 251254 0 0 0 JOSHUA OVENS RN CRITICAL CARE TRANSPORT 210626 0 7076 0 99 0 5630 0 24732 0 248163 0 0 0 BETH ESTEP VP PATIENT CARE SERVICES/ASSO 16113 163204 0 14516 23 26152 0 0 130 1565 16266 205437 0 0 PART I, LINE 1A CHARTER TRAVEL: 2 OFFICERS- NOT INCLUDED IN TAXABLE COMPENSATION PART I, LINE 1B DUE TO EXTENUATING CIRCUMSTANCES RELATED TO THE COVID-19 PANDEMIC THAT LIMITED FLIGHT SCHEDULES AND ABILITY TO TRAVEL, CHARTERED FLIGHT SERVICES WERE UTILIZED WHEN NECESSARY AS THE ONLY FEASIBLE TRAVEL SOLUTION DURING TAX YEAR 2020. THIS WAS NECESSARY IN ORDER TO ENABLE EXECUTIVES TO BE ABLE TO CONTINUE TO CONDUCT BUSINESS WHEN COMMERCIAL FLIGHTS WERE NOT AVAILABLE TO MEET SCHEDULED MEETINGS AND DUE TO SCHEDULE CONSTRAINTS. DURING 2020 THERE WAS NOT A POLICY GOVERNING THIS TYPE OF TRAVEL IN PLACE AS IT WAS NOT FORESEEN IT WOULD BE NECESSARY. CURRENTLY A POLICY IS BEING DRAFTED TO ENSURE PROPER COMPLIANCE AND GOVERNANCE OF THESE EXPENDITURES IN THE FUTURE. PART I, LINE 3 PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF THE TOLEDO HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4A UNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: NEERAJ K. KANWAL, M.D. $165,297.60 ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. SCHEDULE J, SUPPLEMENTAL INFORMATION: IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR. A COUNTY OF LUCAS OHIO 346400806 549310VL1 2015-09-30 45586125 SEE PART VI 0 0 0 B SERIES 2011 A & B BONDS - SEE PART VI 549310UL2 2011-02-09 197051617 SEE PART VI 1 0 0 C SERIES 2011 D & E BONDS - SEE PART VI 549310VD9 2011-12-01 152004328 SEE PART VI 1 0 0 D COUNTY OF LUCAS OHIO 346400806 000000000 2017-12-29 299500000 SEE PART VI 0 0 0 A 45598957 11 586084 45012873 2018 0 0 1 1 B 3120000 193935000 199572288 2337157 127520671 69714460 2014 1 0 1 1 C 16860000 40300000 152004328 1505879 150498449 1 0 1 1 D 220004636 4263 93424370 0 1 1 1 A 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 D 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 PART I: SERIES 2015 BOND DETAIL ISSUER NAME: 2015 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VL1 DATE ISSUED: 09/30/2015 ISSUE PRICE: $45,586,125 PURPOSE: FINANCE THE CONSTRUCTION AND EQUIPPING OF A 302 BED PATIENT TOWER ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2045 SERIES 2011 BOND DETAIL ISSUER NAME: 2011 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310UL2 & 549310UJ7 DATE ISSUED: 02/09/2011 ISSUE PRICE: $180,148,535 PURPOSE: REFINANCE THE PROMEDICA HEALTHCARE 2008B BONDS ISSUED 05/15/2008. FINANCE THE COST OF THE ACQUISITION, CONSTRUCTION, RENOVATION, AND EQUIPPING OF CERTAIN OTHER OHIO HEALTHCARE FACILITIES OF THE MEMBERS OF THE OBLIGATED GROUP. MATURITY: 11/15/2041 ISSUER NAME: 2011 SERIES B - COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY ISSUER EIN: 38-6005798 CUSIP#: 52601PBE7 DATE ISSUED: 02/09/2011 ISSUE PRICE: $16,903,082 PURPOSE: REFINANCE THE REDEMPTION OF THE PROMEDICA HEALTH CARE OBLIGATED GROUP SERIES 2008C BONDS ISSUED 05/15/2008. MATURITY: 11/15/2035 ISSUER NAME: 2011 SERIES D - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VD9 DATE ISSUED: 12/01/2011 ISSUE PRICE: $142,575,271 PURPOSE: TO FINANCE THE EARLY OPTIONAL REDEMPTION OF THE REMAINING OUTSTANDING MATURITIES OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 1999 BONDS ISSUED 04/01/1999 AND 07/26/1999. MATURITY: 11/15/2030 ISSUER NAME: 2011 SERIES E - COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY ISSUER EIN: 38-6005798 CUSIP#: 52601PB56 DATE ISSUED: 12/01/2011 ISSUE PRICE: $9,429,057 PURPOSE: REFINANCE THE EARLY OPTIONAL REDEMPTION OF THE LENAWEE HEALTH ALLIANCE OBLIGATED GROUP SERIES 1999A BONDS ISSUED 04/01/1999 AND 07/26/1999. MATURITY: 11/15/2028 SERIES 2017 BOND DETAIL ISSUER NAME: 2017 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $54,710,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008D BONDS ISSUED 05/15/2008. MATURITY: 11/15/2040 ISSUER NAME: 2017 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $120,010,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES C - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $84,980,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES D - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $39,800,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011. MATURITY: 11/15/2029 ISSUER NAME: 2017 SERIES F AND G - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VM9 DATE ISSUED: 12/29/2017 ISSUE PRICE: $142,500,000 PURPOSE: TO REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008A BONDS ISSUED 05/15/2008 AND TO FINANCE THE CONSTRUCTION AND EQUIPPING OF A REPLACEMENT HOSPITAL ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2034 ISSUER NAME: 2017 SERIES H - COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY ISSUER EIN: 38-6005798 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $24,945,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011B & 2011E BONDS ISSUED 02/09/2011 & 12/01/2011. FORM 8038 FOR THIS ISSUE ERRONEOUSLY REPORTS THAT THE BONDS ALSO REFUNDED SERIES 2008D ISSUED 05/15/2008, BUT THAT REPORTING WAS IN ERROR. MATURITY: 11/15/2035 SERIES 2018 BOND DETAIL ISSUER NAME: 2018 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310WE6 DATE ISSUED: 10/25/2018 ISSUE PRICE: $261,485,311 PURPOSE: REFINANCING THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011C BONDS ISSUED 05/25/2011 & 2017G BONDS ISSUED 12/29/2017 AND FINANCE THE CONSTRUCTION AND EQUIPPING OF REPLACEMENT HOSPITAL CAMPUS ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2048 PART I, LINE C OF ENTITY 2, COLUMN (C): ENTERED HERE IS THE CUSIP FOR THE LATEST MATURITY; THIS INFORMATION WAS INADVERTENTLY OMITTED FROM THE FORM 8038 FOR THE ISSUE. PART I, COLUMN (E): DIFFERENCE BETWEEN THE ISSUE PRICES SHOWN IN PART I, COLUMN (E) AND TOTAL PROCEEDS SHOWN IN PART II, LINE 3 ARE DUE TO INVESTMENT EARNINGS. PART III, COLUMN (C), SERIES 2011 D & E BONDS: PART III HAS NOT BEEN COMPLETED WITH RESPECT TO THE SERIES 2011 D & E BONDS, SINCE SUCH BONDS REFUNDED PRE-2003 BOND ISSUES. PART IV, COLUMN (A), SERIES 2015 B BONDS: DATE THE REBATE COMPUTATION WAS PERFORMED: 10/10/2020 PART IV, COLUMN (B), LINE 2C, SERIES 2011 A & B BONDS: DATE THE REBATE COMPUTATION WAS PERFORMED: 02/22/2016. PART IV, LINE 6: CERTAIN OF THESE BOND ISSUES CONSITUTE ADVANCE REFUNDING ISSUES. FOR SUCH ISSUES, THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. A COUNTY OF LUCAS OHIO 346400806 549310VM9 2017-12-29 142500000 SEE PART VI 0 0 0 B COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY 386005798 000000000 2017-12-29 24945000 SEE PART VI 0 0 0 C COUNTY OF LUCAS OHIO 346400806 549310WE6 2018-10-25 261485311 SEE PART VI 0 0 0 A 80000000 62500000 80000000 62500000 1 0 1 1 B 24945000 22595814 3872 3708807 0 1 1 1 C 262545834 1559890 839544 170995519 89150881 1 0 1 1 A 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 LISA TOFT FAMILY MEMBER OF BRADLEY J. TOFT (TRUSTEE) 48479 EMPLOYMENT 0 FORM 990, PART III, LINE 4 THE TOLEDO HOSPITAL - PROGRAM SERVICE ACCOMPLISHMENTS THE TOLEDO HOSPITAL (D/B/A PROMEDICA TOLEDO HOSPITAL) IS THE ADULT TERTIARY HOSPITAL OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. FOR MORE THAN 130 YEARS, PROMEDICA TOLEDO HOSPITAL (TH) HAS SERVED METROPOLITAN TOLEDO AND SURROUNDING COMMUNITIES WITH STATE-OF-THE-ART EMERGENCY, MEDICAL, DIAGNOSTIC, AND SURGICAL SERVICES. THE 794-BED HOSPITAL OFFERS ACCESS TO THE AREA'S LARGEST BOARD-CERTIFIED MEDICAL STAFF, WITH MORE THAN 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS AS WELL AS ADVANCE PRACTICE PROVIDERS, OFFERING THE LARGEST BOARD-CERTIFIED MEDICAL STAFF IN THE AREA. ADDITIONALLY, TH OFFERS A NUMBER OF KEY SERVICES TO THE METRO-TOLEDO AREA, SUCH AS THE CENTER FOR WOMEN'S HEALTH, WHICH INCLUDES MATERNAL-FETAL MEDICINE FOR HIGH-RISK PREGNANCIES AND A LEVEL III PERINATAL UNIT; JOBST VASCULAR INSTITUTE; PROMEDICA BREAST CARE; AND A LEVEL I TRAUMA CENTER. OTHER PROGRAMS AND SERVICES INCLUDE WELL-ESTABLISHED NEUROSCIENCES, CARDIOVASCULAR AND ORTHOPAEDIC DEPARTMENTS, A NATIONALLY RECOGNIZED BARIATRIC PROGRAM, A CERTIFIED COMPREHENSIVE STROKE CENTER, AND AN EMERGENCY CENTER THAT TREATS MORE THAN 100,000 PATIENTS ANNUALLY. ALL SERVICES ARE FULLY BACKED BY ACCREDITED ANCILLARY SERVICES, SUCH AS LABORATORY, RADIOLOGY, AS WELL AS PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES. PROMEDICA TOLEDO CHILDREN'S HOSPITAL (TCH) WAS RENAMED PROMEDICA RUSSELL J. EBEID CHILDREN'S HOSPITAL (ECH) IN 2020 IN HONOR OF THE LIFE, LEGACY AND GENEROSITY OF COMMUNITY PHILANTHROPIST RUSSELL EBEID. THE NAME CHANGE COINCIDED WITH EXTENSIVE RENOVATIONS TO THE EIGHTH FLOOR OF THE RENAISSANCE TOWER TO PROVIDE A NEW LOCATION FOR THE PEDIATRIC INTENSIVE CARE UNIT AND GENERAL PEDIATRICS UNIT. ECH OPERATES AS PART OF TH, PROVIDING PEDIATRIC TERTIARY CARE. ECH EXCLUSIVELY SERVES THE HEALTHCARE NEEDS OF CHILDREN AND ADOLESCENTS UNDER THE AGE OF 18. ECH'S MEDICAL STAFF INCLUDES BOARD-CERTIFIED PHYSICIANS AND ADVANCE PRACTICE PROVIDERS, WHILE A NEWBORN INTENSIVE CARE UNIT INCLUDES A NEONATAL PHYSICIAN AND PEDIATRIC HOSPITALIST WHO ARE ON DUTY 24 HOURS A DAY. OTHER ECH SPECIALTY SERVICES INCLUDE A PEDIATRIC CANCER CENTER, ASTHMA TREATMENT AND EDUCATION SERVICES, PEDIATRIC PSYCHIATRY, AND A DEDICATED LEVEL II PEDIATRIC TRAUMA CENTER. IN 2020, PROMEDICA TOLEDO HOSPITAL WAS NAMED ONE OF AMERICA'S 50 BEST HOSPITALS FOR THE THIRD YEAR IN A ROW. THE AWARD RECOGNIZES THE TOP 2% OF HOSPITALS IN THE NATION FOR EXHIBITING CLINICAL EXCELLENCE FOR AT LEAST FOUR CONSECUTIVE YEARS. TH ALSO WAS RATED THE NUMBER 1 HOSPITAL IN THE METRO TOLEDO AREA BY U.S. NEWS AND WORLD REPORT AND WAS RECOGNIZED BY BECKER'S HOSPITAL REVIEW AS ONE OF THE "100 GREATEST HOSPITALS IN AMERICA" FOR 2020. IN 2020, PROMEDICA TOLEDO HOSPITAL BROKE GROUND ON A NEW FREESTANDING EMERGENCY DEPARTMENT AND URGENT CARE CLINIC IN MAUMEE, OHIO THAT IS SCHEDULED TO OPEN IN LATE 2021 TO MEET THE NEEDS OF THAT COMMUNITY'S RESIDENTS. PROMEDICA FLOWER HOSPITAL (FH), A DIVISION OF TH, IS A 311-BED FACILITY IN SYLVANIA, OHIO, WHICH PROVIDES EXTENSIVE HEALTHCARE SERVICES INCLUDING EMERGENCY MEDICINE, INPATIENT REHABILITATION, SURGICAL SERVICES, CARDIAC AND PULMONARY REHABILITATION, LABOR AND DELIVERY, INPATIENT ONCOLOGY CARE, OUTPATIENT ONCOLOGY SERVICES THROUGH THE HICKMAN CANCER CENTER, AND A FULL RANGE OF DIAGNOSTIC, LABORATORY AND RADIOLOGY SERVICES. FH ALSO HOUSES THE LARGEST ADULT INPATIENT PSYCHIATRIC UNIT IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. IN 2020, FH'S CARDIAC REHAB DEPARTMENT EARNED THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR_ CERTIFICATION. A PEER REVIEW ACCREDITATION PROCESS, AACVPR-CERTIFIED PROGRAMS ARE LEADERS IN CARDIAC AND PULMONARY REHABILITATION BECAUSE THEY OFFER THE MOST ADVANCED PRACTICES AVAILABLE AND HAVE A PROVEN TRACK RECORD OF HIGH QUALITY PATIENT CARE. FH ALSO RECEIVED THE GET WITH THE GUIDELINES STROKE GOLD PLUS HONOR ROLL AS RECOGNITION OF THE HOSPITAL'S COMMITMENT TO ENSURING STROKE PATIENTS RECEIVE THE MOST APPROPRIATE TREATMENT ACCORDING TO NATIONALLY RECOGNIZED BEST PRACTICES. PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (WOSH), ALSO A DIVISION OF TH, IS AN ALL-DIGITAL, 42-BED ACUTE CARE FACILITY THAT PROVIDES INPATIENT AND OUTPATIENT ORTHOPAEDIC SURGERY TO ADDRESS THE NEEDS OF AGING BABY BOOMERS AND OTHERS WHO EXPERIENCE CHRONIC PAIN FROM JOINT DISEASE. THIS UNIQUE, FREE-STANDING HOSPITAL SERVES ONLY ORTHOPAEDIC AND SPINE PATIENTS, OFFERING DIAGNOSTIC, SURGICAL AND REHABILITATION SERVICES ALL IN ONE CONVENIENT AND EASILY ACCESSIBLE LOCATION. IN 2020, WOSH RECEIVED NATIONAL RECOGNITION WITH THE PRESS GANEY GUARDIAN OF EXCELLENCE AWARD, PRESENTED TO ORGANIZATIONS SCORING IN THE 95TH PERCENTILE OR HIGHER FOR PATIENT EXPERIENCE METRICS. THIS MARKS THE EIGHTH CONSECUTIVE YEAR THAT THE HOSPITAL HAS RECEIVED THIS RECOGNITION. IN 2020, TH SERVED 49,780 INPATIENTS; 638,459 OUTPATIENTS; AND 99,378 EMERGENCY CENTER PATIENTS. TH CONTRIBUTED $133,471,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH ACTIVITIES, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, TH CONTRIBUTED $59,948,000 TO THE COMMUNITY DURING 2020. INCLUDED IN THIS FIGURE ARE PROGRAMS SUCH AS: - THE COME TO THE TABLE INITIATIVE THAT PROVIDES 24 HOURS' WORTH OF FOOD TO PATIENTS WHO QUALIFY FOR FOOD INSECURITY BY COMPLETING A QUESTIONNAIRE UPON DISCHARGE FOLLOWING AN INPATIENT STAY. - THE AUTISM COLLABORATIVE A COLLABORATION BETWEEN ECH AND LOCAL AUTISM ORGANIZATIONS AND UNIVERSITIES TO PROVIDE EXPERT KNOWLEDGE AND SERVICES UNDER ONE UMBRELLA ORGANIZATION, ALLOWING THOSE WITH AUTISM AND THEIR FAMILIES TO RESEARCH AND FIND THE BEST POSSIBLE CARE. - SUPPORT GROUPS FOR PATIENTS' FAMILIES TO ASSIST WITH MANAGING CHRONIC DISEASE AND TO OFFER SOCIAL SERVICES INFORMATION. - WITH THE GOAL OF IMPROVING INFANT MORTALITY RATES IN OUR REGION, A NURSING MOTHERS SUPPORT GROUP IS OFFERED AT NO CHARGE THROUGHOUT THE YEAR. - THE TEEN PEP (PEERS EDUCATING PEERS) PROGRAM EXTENDS CARE AND EDUCATION OUTSIDE THE HOSPITAL, IN MORE NONTRADITIONAL WAYS, BY ENCOURAGING TEENS TO TALK WITH THEIR PEERS ABOUT IMPORTANT TOPICS SUCH AS TEEN RELATIONSHIPS, BULLYING, MENTAL HEALTH, AND PHYSICAL AND EMOTIONAL ABUSE. - VIRTUAL PREPARATION FOR PARENTHOOD CLASSES THAT HELP PREPARE EXPECTANT PARENTS FOR A HEALTHY LABOR AND DELIVERY, AND OFFER INFANT SAFETY TIPS, AS WELL AS NEW MOTHER CARE AND HEALTHY BABY EDUCATION. - FREE SCREENING MAMMOGRAMS AND BREAST CARE EDUCATION THAT EMPHASIZES THE IMPORTANCE OF ROUTINE SELF-BREAST EXAMS FOR UNINSURED AND UNDERINSURED WOMEN IN THE TOLEDO AREA. - IN-KIND DONATIONS AND GENERAL CONTRIBUTIONS, WHICH SUPPORT LOCAL NON-PROFIT ORGANIZATIONS WITH SIMILAR VALUES. TH ALSO PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2020, OF WHICH $6,802,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DID NOT PAY THEIR BILLS. TH'S COST OF BAD DEBT FOR 2020 WAS $11,431,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT TOTAL OF $133,471,000 INDICATED ABOVE. FURTHER, TH PROVIDED $66,721,000 OF COMMUNITY BENEFIT THROUGH COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. ALSO, IN 2020, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT- FOR TREATING MEDICARE PATIENTS WAS $86,828,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $133,471,000 NOTED ABOVE. DURING 2020 TH EXPENDED $254,296,000 IN NET PAYROLL, PROVIDING 7,576 JOBS IN NORTHWEST OHIO. A TOTAL OF $14,925,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, TH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. FORM 990, PART VI, SECTION A, LINE 6 AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF THE TOLEDO HOSPITAL. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF THE TOLEDO HOSPITAL AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 RETURNS OF PROMEDICA HEALTH SYSTEM, INC. (PHS) AND ITS SUBSIDIARIES ARE PREPARED BY THE PHS TAX DEPARTMENT WITH THE ASSISTANCE OF FINANCE. THE RETURNS ARE REVIEWED BY THE AVP OF TAX BEFORE BEING PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES PRIOR TO FILING. ANY COMMENTS OR QUESTIONS FROM THE BOARD ARE REVIEWED AND INCORPORATED INTO THE RETURN IF APPROPRIATE. FINAL RETURNS ARE PROVIDED TO A PRINCIPAL OFFICER FOR SIGNATURE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL BONUS-ELIGIBLE SENIOR LEADERSHIP AND SPECIFICALLY IDENTIFIED ADDITIONAL EMPLOYEES, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. ADDITIONALLY, AS PART OF THE ANNUAL MANDATORY COMPLIANCE TRAINING ASSIGNED TO ALL PROMEDICA EMPLOYEES, EACH EMPLOYEE IS REQUIRED TO ELECTRONICALLY ACKNOWLEDGE THAT THEY HAVE RECEIVED A COPY OF THE PROMEDICA STANDARDS OF CONDUCT, THAT THEY UNDERSTAND HOW THE STANDARDS APPLY TO THEM, ACKNOWLEDGE THEIR OBLIGATION TO FOLLOW THEM, THEIR OBLIGATION TO REPORT VIOLATIONS OF THE STANDARDS OR REQUESTS THAT WOULD RESULT IN VIOLATIONS OF THE STANDARDS TO APPROPRIATE COMPANY OFFICERS AND THAT THEY HAVE REPORTED ALL VIOLATIONS KNOWN TO THEM AS REQUIRED BY THE STANDARDS. IN ADDITION THE ATTESTATION STATES ANY CONFLICTS OF INTEREST OR OTHER MATTERS FOR WHICH THE STANDARDS REQUIRE WRITTEN DISCLOSURE TO THE COMPANY HAVE BEEN SO DISCLOSED BY THE EMPLOYEE AND THEY UNDERSTAND AND ACKNOWLEDGE THAT TO THE EXTENT THEY ARE AN AT-WILL EMPLOYEE, THE STANDARDS DO NOT AFFECT THE AT-WILL NATURE OF MY EMPLOYMENT RELATIONSHIP WITH THE COMPANY. EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER FOR PROMEDICA PHYSICIAN GROUP (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER OR THEIR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PHYSICIAN AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PROMEDICA HEALTH SYSTEM, INC. WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. FORM 990, PART VI, SECTION B, LINE 15 THE TOLEDO HOSPITAL'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF PROMEDICA FOUNDATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 16B: JOINT VENTURE OPERATING AGREEMENTS INVOLVING PROMEDICA HEALTH SYSTEM, INC. OR ITS SUBSIDIARIES (COLLECTIVELY, PHS) INCLUDE PROVISIONS TO PROTECT PHS'S TAX-EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. PHS CONTINUALLY ENSURES THAT ITS TAX-EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL PHS JOINT VENTURES. FORM 990, PART IX, LINE 11G GENERAL FEES: PROGRAM SERVICE EXPENSES 48,704,617. MANAGEMENT AND GENERAL EXPENSES 993,971. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,698,588. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 53,431,012. MANAGEMENT AND GENERAL EXPENSES 1,090,428. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,521,440. NON-PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 34,300. MANAGEMENT AND GENERAL EXPENSES 700. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,000. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 8,768,086. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,768,086. SERVICE CONTRACTOR FEES: PROGRAM SERVICE EXPENSES 10,447,001. MANAGEMENT AND GENERAL EXPENSES 213,204. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,660,205. LAUNDRY FEES: PROGRAM SERVICE EXPENSES 4,526,202. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,526,202. TEMP AGENCY FEES: PROGRAM SERVICE EXPENSES 15,645,971. MANAGEMENT AND GENERAL EXPENSES 319,306. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,965,277. TESTING FEES: PROGRAM SERVICE EXPENSES 16,569,039. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,569,039. FORM 990, PART IX, LINE 24E PROVIDER TAXES: PROGRAM SERVICE EXPENSES 24,481,208. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,481,208. SUPPLIES - GENERAL: PROGRAM SERVICE EXPENSES 12,029,812. MANAGEMENT AND GENERAL EXPENSES 245,506. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,275,318. FOOD: PROGRAM SERVICE EXPENSES 4,104,285. MANAGEMENT AND GENERAL EXPENSES 83,761. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,188,046. OTHER: PROGRAM SERVICE EXPENSES 3,772,021. MANAGEMENT AND GENERAL EXPENSES 76,980. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,849,001. EQUIPMENT RENTAL: PROGRAM SERVICE EXPENSES 2,714,388. MANAGEMENT AND GENERAL EXPENSES 55,396. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,769,784. MINOR EQUIPMENT: PROGRAM SERVICE EXPENSES 2,599,299. MANAGEMENT AND GENERAL EXPENSES 53,047. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,652,346. DUES & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 1,580,775. MANAGEMENT AND GENERAL EXPENSES 32,261. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,613,036. VEHICLE EXPENSE: PROGRAM SERVICE EXPENSES 628,448. MANAGEMENT AND GENERAL EXPENSES 12,825. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 641,273. COMMUNITY PROGRAM: PROGRAM SERVICE EXPENSES 394,038. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 394,038. LICENSES & FEES: PROGRAM SERVICE EXPENSES 187,112. MANAGEMENT AND GENERAL EXPENSES 3,819. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 190,931. STATE PREMIUM TAX: PROGRAM SERVICE EXPENSES 65,750. MANAGEMENT AND GENERAL EXPENSES 1,342. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,092. TAXES: PROGRAM SERVICE EXPENSES 1,875. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,875. FORM 990, PART XI, LINE 9: PENSION EXPENSE ADJUSTMENT -160,756. BENEFICIAL INTEREST IN FOUNDATION 29,413,548. TRANSFERS BETWEEN RELATED ENTITIES -72,271,677. TRANSFER OF SECURITIES FROM COMMUNITY HEALTH CENTER OF BRANCH COUNTY 14,188,114. TRANSFER OF SECURITIES FROM PROMEDICA HEALTH SYSTEM, INC. 8,174,307. TRANSFER OF SECURITIES FROM MEMORIAL HOSPITAL 48,679,074. TRANSFER OF SECURITIES FROM DEFIANCE HOSPITAL, INC. 99,962,298. TRANSFER OF SECURITIES FROM VISITING NURSE HOSPICE & HEALTH CARE 9,657,246. TRANSFER OF SECURITIES FROM PROMEDICA CONTINUING CARE SERVICES CORPORATION 8,666,356. TRANSFER OF SECURITIES FROM EMMA L. BIXBY MEDICAL CENTER 93,933,975. TRANSFER OF SECURITIES FROM HERRICK MEMORIAL HOSPITAL 38,683,938. TRANSFER OF SECURITIES FROM FOSTORIA HOSPITAL ASSOCIATION 43,035,884. TRANSFER OF SECURITIES FROM BAY PARK COMMUNITY HOSPITAL 14,763,551. TRANSFER OF SECURITIES FROM HCR MANORCARE, INC. 50,710,848. TRANSFER OF CASH FROM HCR MANORCARE, INC 115,941,000. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT YET BEEN COMPLETED. PLANS HAVE BEEN MADE TO HAVE THE REQUIRED SINGLE AUDIT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26. PROMEDICA HICKMAN CANCER CENTER PHARMACY LLC 100 MADISON AVE TOLEDO OH 43604 PHARMACY OH 106430559 THE TOLEDO HOSPITAL PHS INVESTMENTS LLC 100 MADISON AVE TOLEDO OH 43604 INVESTMENT COMPANY OH -4199215 18248493 THE TOLEDO HOSPITAL BAY PARK COMMUNITY HOSPITAL 100 MADISON AVE TOLEDO OH 43604 341883132 HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 COMMUNITY HEALTH CENTER OF BRANCH COUNTY 100 MADISON AVE TOLEDO OH 43604 386108110 HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 DEFIANCE HOSPITAL AUXILIARY 1200 RALSTON DEFIANCE OH 43512 510173779 HOSPITAL / FOUNDATION SUPPORT OH 501(C)(3) 10 DEFIANCE HOSPITAL INC 1 DEFIANCE HOSPITAL INC 100 MADISON AVE TOLEDO OH 43604 344446484 HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 EMMA L BIXBY MEDICAL CENTER 100 MADISON AVE TOLEDO OH 43604 382796005 HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 EMMA L BIXBY MEDICAL CENTER AUXILIARY 818 RIVERSIDE AVE ADRIAN MI 43604 382149602 HOSPITAL / FOUNDATION SUPPORT MI 501(C)(3) 12B, II EMMA L BIXBY MEDICAL CENTER 1 FOSTORIA HOSPITAL ASSOCIATION 100 MADISON AVE TOLEDO OH 43604 340898745 HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 FOSTORIA HOSPITAL AUXILIARY PO BOX 907 FOSTORIA OH 44830 346517634 HOSPITAL / FOUNDATION SUPPORT OH 501(C)(3) 10 FOSTORIA HOSPITAL ASSOCIATION 1 HCR MANORCARE FOUNDATION INC 444 N SUMMIT ST TOLEDO OH 43604 522031975 FOUNDATION OH 501(C)(3) 12B, II PROMEDICA FOUNDATION 1 HCR MANORCARE INC PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 825373223 SKILLED NURSING FACILITIES OH 501(C)(3) 10 PROMEDICA HEALTH SYSTEM INC 1 HEARTLAND HOSPICE MEMORIAL FUND INC 444 N SUMMIT ST TOLEDO OH 43604 270497199 FOUNDATION OH 501(C)(3) 12B, II PROMEDICA FOUNDATION 1 HERRICK MEDICAL CENTER AUXILIARY 500 E POTTAWATAMIE ST TECUMSEH MI 49286 383076105 HOSPITAL / FOUNDATION SUPPORT MI 501(C)(3) 12B, II HERRICK MEMORIAL HOSPITAL INC 1 HERRICK MEMORIAL HOSPITAL INC 100 MADISON AVE TOLEDO OH 43604 383049015 HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 KAITLYN'S COTTAGE INC 100 MADISON AVE TOLEDO OH 43604 454781053 RESPITE CARE OH 501(C)(3) 10 DEFIANCE HOSPITAL INC 1 LENAWEE LONG TERM CARE PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 382879330 LONG TERM CARE MI 501(C)(3) 10 HCR MANORCARE INC 1 MANOR CARE OF GIG HARBOR WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 260624719 SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC 1 MANOR CARE OF LACEY WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 260624391 SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC 1 MANOR CARE OF LYNNWOOD WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 260624675 SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC 1 MANOR CARE OF SALMON CREEK WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 260624375 SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC 1 MANOR CARE OF SPOKANE WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 260624687 SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC 1 MANOR CARE OF TACOMA WA ASSOCIATION PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 260624696 SKILLED NURSING FACILITY DE 501(C)(3) 10 HCR MANORCARE INC 1 MEMORIAL HOSPITAL 100 MADISON AVE TOLEDO OH 43604 344430849 HOSPITAL OH 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 MEMORIAL PROFESSIONAL SERVICES 100 MADISON AVE TOLEDO OH 43604 273763993 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 MERCY MEMORIAL HOSPITAL CORPORATION 100 MADISON AVE TOLEDO OH 43604 381984289 HOSPITAL MI 501(C)(3) 3 PROMEDICA HEALTH SYSTEM INC 1 MONROE COMMUNITY HEALTH SERVICES PO BOX 10086 ATTN TAX-5 TOLEDO OH 43699 382934134 LONG TERM CARE MI 501(C)(3) 10 HCR MANORCARE INC 1 PARAMOUNT ADVANTAGE 1901 INDIAN WOOD CIR MAUMEE OH 43537 203376102 HEALTH INSURANCE OH 501(C)(3) 10 PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES 1 PROMEDICA AT HOME INC 100 MADISON AVE TOLEDO OH 43604 852320857 PHYSICIAN SUPPORT MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA CENTRAL PHYSICIANS 100 MADISON AVE TOLEDO OH 43604 341881137 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA CHILDRENS SPECIALISTS 100 MADISON AVE TOLEDO OH 43604 208734161 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA CONTINUING CARE SERVICES CORP 100 MADISON AVE TOLEDO OH 43604 344492440 LONG TERM AND HOME HEALTH CARE OH 501(C)(3) 10 PROMEDICA CONTINUUM SERVICES 1 PROMEDICA CONTINUUM SERVICES 100 MADISON AVE TOLEDO OH 43604 341880767 PHYSICIAN MANAGEMENT SERVICES OH 501(C)(3) 12B, II PROMEDICA HEALTH SYSTEM INC 1 PROMEDICA COURIER SERVICES INC 100 MADISON AVE TOLEDO OH 43604 260324790 COURIER SERVICE OH 501(C)(3) 12B, II PROMEDICA CONTINUUM SERVICES 1 PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO OH 43604 341517672 FOUNDATION OH 501(C)(3) 12B, II PROMEDICA HEALTH SYSTEM INC 1 PROMEDICA GENITO-URINARY SURGEONS 100 MADISON AVE TOLEDO OH 43604 461120436 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA HEALTH SYSTEM INC 100 MADISON AVE TOLEDO OH 43604 341517671 PARENT COMPANY OF HEALTH SYSTEM OH 501(C)(3) 12B, II N/A 0 PROMEDICA INDEMNITY CORP ONE CHURCH ST 5TH FLOOR BURLINGTON VT 05401 341931936 PROFESSIONAL & GENERAL LIABILITY VT 501(C)(3) 12B, II PROMEDICA HEALTH SYSTEM INC 1 PROMEDICA MONROE CARDIOLOGY 100 MADISON AVE TOLEDO OH 43604 272920342 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA MONROE PHYSICIANS 100 MADISON AVE TOLEDO OH 43604 461111822 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA NORTHWEST OHIO CARDIOLOGY CONSULTANTS 100 MADISON AVE TOLEDO OH 43604 263888045 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA PHYSICIAN GROUP INC 100 MADISON AVE TOLEDO OH 43604 341899439 PHYSICIAN HEALTH CARE SERVICES OH 501(C)(3) 10 PROMEDICA HEALTH SYSTEM INC 1 PROMEDICA PHYSICIANS AT HOME INC 100 MADISON AVE TOLEDO OH 43604 852181349 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 PROMEDICA PRIMARY CARE PROVIDERS 100 MADISON AVE TOLEDO OH 43604 831731861 PHYSICIAN HEALTH CARE SERVICES MI 501(C)(3) 10 PROMEDICA PHYSICIAN GROUP INC 1 THE HUG FUND 444 N SUMMIT ST TOLEDO OH 43604 202272848 FOUNDATION OH 501(C)(3) 12B, II PROMEDICA FOUNDATION 1 VISITING NURSE HOSPICE AND HEALTH CARE 100 MADISON AVE TOLEDO OH 43604 341831624 HOSPICE HOME CARE OH 501(C)(3) 10 HCR MANORCARE INC 1 EAST-WEST HOLDINGS LTD 715 SOUTH TAFT AVE FREMONT OH 43420 204066818 REAL ESTATE OH N/A 0 0 MERCYMANOR PARTNERSHIP PO BOX 10086 ATTN TAX-5 TOLEDO OH 43604 521931012 SKILLED NURSING PA N/A 0 1 NORMAN SPECIALTY HOSPITAL LLC PO BOX 10086 ATTN TAX-5 TOLEDO OH 43604 421627672 HEALTH CARE DE N/A 0 1 NORTHWEST OHIO DEDICATED BREAST MRI LLC 100 MADISON AVE TOLEDO OH 43604 260679898 MEDICAL DIAGNOSTICS OH THE TOLEDO HOSPITAL RELATED 64076 382761 0 0 0.50000 PROMEDICA DOWNTOWN CAMPUS LANDLORD LLC 100 MADISON AVE TOLEDO OH 43604 473163945 REAL ESTATE OH N/A 0 1 PROMEDICA MASTER TENANT LLC 100 MADISON AVE TOLEDO OH 43604 475288490 REAL ESTATE OH N/A 0 1 PROMEDICA PATHOLOGY LABORATORIES LLC 2130 W CENTRAL AVE STE 300 TOLEDO OH 43606 831022842 CLINICAL LABORATORY DE THE TOLEDO HOSPITAL RELATED -2487043 60436374 0 0 0.51000 PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC 100 MADISON AVE TOLEDO OH 43604 461989695 PHYSICIAN MANAGEMENT SERVICES OH N/A 0 0 REYNOLDS ROAD SURGICAL CENTER LTD 2865 N REYNOLDS RD TOLEDO OH 43615 311569454 FREESTANDING AMBULATORY SURGICAL CENTER OH THE TOLEDO HOSPITAL RELATED 149542 1401787 0 0 0.63000 ROCKET VENTURE FUND II LLC 2865 N REYNOLDS RD STE 220 TOLEDO OH 43615 475603627 INVESTMENT FUND OH N/A 0 0 THE SURGICAL INSTITUTE OF MONROE AMBULATORY SURGERY CENTER LLC 1051 S TELEGRAPH RD MONROE MI 48161 270843485 AMBULATORY SURGICAL CENTER MI N/A 0 0 WEST CENTRAL SURGICAL CENTER LLC 7055 W CENTRAL TOLEDO OH 43617 200088459 AMBULATORY SURGICAL CENTER OH THE TOLEDO HOSPITAL RELATED 761604 1708974 0 1 0.50000 HERRICK MEMORIAL DEVELOPMENT CORP 500 E POTTAWATAMIE TR ADRIAN MI 49221 383146907 FACILITY LEASING MI N/A C 0 HERRICK MEMORIAL OFFICE PLAZA CONDOMINIUM ASSOCIATION 818 RIVERSIDE AVE ADRIAN MI 49221 383639616 FACILITY MANAGEMENT MI N/A C 0 MONROE HEALTH VENTURES INC 718 N MACOMB MONROE MI 48164 382704426 PHARMACY MI N/A C 0 PROMEDICA CENTRAL CORPORATION OF MICHIGAN 100 MADISON AVE TOLEDO OH 43604 383322278 PHYSICIAN HEALTH CARE SERVICES OH N/A C 0 PROMEDICA HEALTH NETWORK INC 100 MADISON AVE TOLEDO OH 43604 474006496 PHYSICIAN MANAGEMENT SERVICES OH N/A C 0 PROMEDICA INNOVATIONS LLC 100 MADISON AVE TOLEDO OH 43604 301221601 INVESTMENT COMPANY OH N/A C 0 PROMEDICA INSURANCE CORP INC AND SUBSIDIARIES 1901 INDIAN WOOD CIR MAUMEE OH 43537 341570675 HEALTH CARE INSURANCE OH N/A C 0 PROMEDICA MANAGER MEMBER LLC 100 MADISON AVE TOLEDO OH 43604 475168737 REAL ESTATE OH N/A C 0 PROMEDICA NORTH PHYSICIAN CORPORATION 100 MADISON AVE TOLEDO OH 43604 383482148 PHYSICIAN HEALTH CARE SERVICES OH N/A C 0 PROMEDICA RETAIL GROUP INC 3890 MONROE ST TOLEDO OH 43606 341159928 FLORIST OH N/A C 0 1 1 1 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 REYNOLDS ROAD SURGICAL CENTER LLC A 379877 FMV