2020-11-13T14:16:44-06:00 2019-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2019-01-01 814791043 ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC STJO 7075255300 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 PATTI PILGRIM REGIONAL CFO 7075255300 2020-11-13 1 EVA NITTA P01286320 4158948000 2020-11-06 152.169.64.19 2020-11-13 09:52:28 US P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 8C6B038D826617A351DA504230A10C8935A538B8 2019 2021-01-29 14:40:06Z X KEVIN KLOCKENGA 1165 MONTGOMERY DRIVE SANTA ROSA CA 95405 1267389859 0 X WWW.STJOSEPHHEALTH.ORG X 2016 CA SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 6 6 5270 557 202827 57174 14377534 14189723 938430441 1235158954 13835074 17166498 1845742 708910 968488791 1267224085 7081600 6108600 0 0 0 455397350 0 0 4462964 838654870 772630114 845736470 1234136064 122752321 33088021 1280829488 1359575117 512096145 517210669 768733343 842364448 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 1161925588 6108600 1235993338 SEE SCHEDULE OPROVIDENCEON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT TO FORM PROVIDENCE ST. JOSEPH HEALTH (PROVIDENCE). BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK, TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA.PROGRAM SERVICE ACCOMPLISHMENTS:CARE NETWORK:CARE (CARE MANAGEMENT, ADVOCACY, RESOURCES, AND EDUCATION) NETWORK IS A NATIONALLY RECOGNIZED, AWARD WINNING COMMUNITY-BASED PROGRAM THAT PROMOTES CHRONIC DISEASE SELF-MANAGEMENT UTILIZING AN INTERDISCIPLINARY RN, SOCIAL WORK, BEHAVIORAL AND SPIRITUAL APPROACH. SERVICES ARE PROVIDED IN THE CLIENT'S HOME OR AS NEEDED IN A HEALTH PROVIDER OFFICE OR OTHER COMMUNITY SERVICE LOCATION. THE PROGRAM IS AIMED AT CARE COORDINATION AND IMPROVING DISEASE MANAGEMENT AND QUALITY OF LIFE WHILE REDUCING OVERALL GOVERNMENT BURDEN OF HEALTHCARE COSTS. CARE NETWORK SERVED OVER 8,000 PATIENTS PROVIDING OVER 15,000 ENCOUNTERS.CONTINUUM OF ORAL HEALTH SERVICES:ST. JOSEPH HEALTH NORTHERN CALIFORNIA OFFERS A CONTINUUM OF ORAL HEALTH SERVICES TO ITS COMMUNITIES. THIS INCLUDES A FIXED SITE DENTAL CLINIC LOCATED IN SANTA ROSA, MOBILE DENTAL CLINICS IN BOTH SONOMA COUNTY AND NAPA COUNTY, THE MIGHTY MOUTH SCHOOL-BASED DENTAL DISEASE PREVENTION PROGRAM, AND MOMMY AND ME, WHICH TEACHES GOOD DENTAL HEALTH PRACTICES TO VERY YOUNG CHILDREN ZERO TO FIVE YEARS OLD AND THEIR MOTHERS. THE CLINICS PRIORITIZE SERVICE TO CHILDREN AGES 0-16 YEARS, BUT ALSO SERVE ADULTS WITH URGENT NEEDS. THEY PROVIDE BASIC, PREVENTIVE, EMERGENCY AND COMPREHENSIVE DENTAL CARE WITH A STRONG FOCUS ON PREVENTION AND EDUCATION. MOBILE MEDICAL CLINIC:OUR MOBILE MEDICAL CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. THE MOBILE HEALTH TEAM ALSO SERVED SEVERAL LOCAL HOMELESS SHELTERS, PROVIDING DIRECT PATIENT CARE IN THE SHELTERS. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, PLEASE VISITWWW.STJOSEPHHEALTH.ORGFOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISITWWW.STJHS.ORGFOR MORE INFORMATION ABOUT PROVIDENCE ST. 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JOSEPH HEALTH NORTHERN CALIFORNIA, LLC. 1446786 8019532 955593 36816 10385095 1440138 6648 1446786 1.00000 0 0 24604425 24604425 674282245 293598185 380684060 131874805 79151452 52723353 431195480 357656318 73539162 163145591 163145591 694696591 HOSPITAL FEE/PROVIDER TAX RECEIVABLE 60914848 OTHER ASSETS 40908425 101823273 TAX-EXEMPT BOND LIABILITIES 351460815 OTHER CURRENT AND LT LIABILITIES 27250792 HOSPITAL FEE/PROVIDER TAX LIABILITY 17671141 DUE TO THIRD PARTY 11614605 ACCRUED RETIREMENT COMPENSATION 3634084 DUE TO AFFILIATES 2146149 413777586 PART V, LINE 4: INTENDED USE OF ENDOWMENT FUNDS THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS INCLUDES SCHOLARSHIPS FOR EMPLOYEES WHO WISH TO RETURN TO SCHOOL TO BECOME NURSES AND MEET THE CRITICAL NEEDS OF THE HOSPITAL, AS WELL AS THE COMMUNITY'S NEEDIEST INDIVIDUALS. KEEGAN LEADERS 94812 80912 13900 0 0 0 17677 5963 7767 GALA 583323 556923 26400 0 26400 8000 44768 5500 49699 678135 637835 40300 26400 8000 62445 11463 57466 165774 -125474 1 1 X 1 X 1 X 500.000000000000 1 1 0 1 1 12549563 0 12549563 0.01240 287029027 297532722 0 0.00000 9500243 5671204 3829039 0.00380 309078833 303203926 16378602 0.01620 19281686 2399017 16882669 0.01670 570844 0 570844 0.00080 3783662 2597705 1185957 0.00120 0 0 0.00000 6041427 620644 5420783 0.00540 29677619 5617366 24060253 0.02410 338756452 308821292 40438855 0.04030 34374 0 34374 0.00000 34374 34374 0.00000 0 408654839 489854396 -81199557 X 1 1 2 CENTER MATERNAL & CHILD HEALTH CLINICAL HOSPITAL SERVICES 0.50000 0.50000 4 1 SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DRIVE SANTA ROSA CA 95405 WWW.STJOESONOMA.ORG 6933475 X X X DESIGNATED TRAUMA CENTER, LEVEL II A 2 QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS STREET NAPA CA 94558 WWW.THEQUEEN.ORG 110000060 X X X DESIGNATED TRAUMA CENTER, LEVEL III 3 REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA CA 95540 WWW.STJOEHUMBOLDT.ORG D-0295172 X X X X A 4 ST JOSEPH HOSPITAL OF EUREKA 2700 DOLBEER STREET EUREKA CA 95501 WWW.STJOEHUMBOLDT.ORG D-0189726 X X X A GROUP A - 1 3 & 4 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 17 1 SEE PART V, SECTION C 0 1 X 200.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 QUEEN OF THE VALLEY MEDICAL CENTER (2) 2 0 0 1 X X X X X X X X X 19 1 0 1 1 X SEE PART V, SECTION C X 1 17 1 SEE PART V, SECTION C 0 1 X 200.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALOVERVIEW AND SUMMARY OF THE HEALTH FRAMEWORK GUIDING THE CHNA:THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS WAS GUIDED BY THE FUNDAMENTAL UNDERSTANDING THAT MUCH OF A PERSON AND COMMUNITY'S HEALTH IS DETERMINED BY THE CONDITIONS IN WHICH THEY LIVE, WORK, PLAY AND PRAY. IN GATHERING INFORMATION ON THE COMMUNITIES WE SERVED BY THE HOSPITAL, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, HEALTH BEHAVIORS, AND THE AVAILABILITY OF CLINICAL CARE. THIS FRAMEWORK FOCUSES ATTENTION ON THE SOCIAL DETERMINANTS OF HEALTH TO LEARN MORE ABOUT OPPORTUNITIES FOR INTERVENTION THAT WILL HELP PEOPLE BECOME AND STAY HEALTH WITHIN THEIR COMMUNITY.IN ADDITION, WE RECOGNIZED THAT WHERE PEOPLE LIVE TELLS US A LOT ABOUT THEIR HEALTH AND HEALTH NEEDS, AND THAT THERE CAN BE POCKETS WITHIN COUNTIES AND CITIES WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE SUBSTANTIALLY WORSE THAN NEARBY AREAS. WHEN DATA WAS PUBLICLY AVAILABLE, IT WAS COLLECTED AT THE ZIP CODE LEVEL TO SHOW THE DISPARITIES IN HEALTH AND THE SOCIAL DETERMINANTS OF HEALTH THAT OCCUR WITHIN THE HOSPITAL SERVICE AREA.THE OLIN GROUP IS A SOCIALLY CONSCIOUS CONSULTING FIRM WORKING ACROSS NONPROFIT, PUBLIC, PRIVATE, AND PHILANTHROPIC SECTORS TO BRING ABOUT COMMUNITY TRANSFORMATION. BASED IN SANTA ANA, CALIFORNIA, THE OLIN GROUP HAS 15 YEARS OF EXPERIENCE WORKING ON EVALUATION, PLANNING, ASSESSMENT, FUNDRAISING, COMMUNICATION, AND OTHER SERVICES FOR NONPROFIT ORGANIZATIONS, AND HAD PREVIOUSLY SUPPORTED THE CHNA PROCESS OF MULTIPLE HOSPITALS IN THE ST. JOSEPH HEALTH SYSTEM. THE OLIN GROUP SERVED AS THE LEAD CONSULTANT IN THE CHNA PROCESSES AND ASSISTING IN THE PRIORITIZATION AND SELECTION OF HEALTH NEEDS.COMMUNITY INPUT:THE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS: COMMUNITY RESIDENT FOCUS GROUPS, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND A COMMUNITY FORUM. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTED KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY OUR MINISTRY. IN ADDITION, THE FINDINGS FROM THE RECENT SONOMA COUNTY COLLABORATIVE CHNA CONDUCTED IN 2016 AND FROM THE ONGOING COMMUNITY BUILDING INITIATIVE IN THE ROSELAND NEIGHBORHOOD OF SOUTHWEST SANTA ROSA WERE CONSIDERED AS ADDITIONAL SOURCES.RESIDENT FOCUS GROUPS:FOR COMMUNITY RESIDENT GROUPS, HOSPITAL COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMUNITY BENEFIT COMMITTEES AND THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIPS DEPARTMENT, IDENTIFIED GEOGRAPHIC AREAS WHERE DATA SUGGESTED THERE WERE SIGNIFICANT HEALTH, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC CONCERNS. THIS PROCESS ALSO IDENTIFIED THE LANGUAGE NEEDS OF THE COMMUNITY, WHICH DETERMINED THE LANGUAGE IN WHICH EACH FOCUS GROUP WAS CONDUCTED. COMMUNITY BENEFIT STAFF THEN PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THOSE AREAS TO RECRUIT FOR AND HOST THE FOCUS GROUPS. THE COMMUNITY-BASED ORGANIZATION DEVELOPED AN INVITATION LIST USING THEIR CONTACTS AND KNOWLEDGE OF THE AREA, AND PARTICIPANTS WERE PROMISED A SMALL INCENTIVE FOR THEIR TIME. TWO CONSULTANTS STAFFED EACH FOCUS GROUP, SERVING AS FACILITATORS AND NOTE TAKERS. THESE CONSULTANTS WERE NOT DIRECTLY AFFILIATED WITH THE MINISTRY TO ENSURE CANDOR FROM THEIR PARTICIPANTS.NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP:FOR THE NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, COMMUNITY BENEFIT STAFF DEVELOPED A LIST OF LEADERS FORM ORGANIZATIONS THAT SERVE DIVERSE CONSTITUENCIES WITHIN THE HOSPITAL'S SERVICE AREA. MINISTRY STAFF SOUGHT TO INVITE ORGANIZATIONS WITH WHICH THEY HAD EXISTING RELATIONSHIPS, BUT ALSO USED THE FOCUS GROUP AS AN OPPORTUNITY TO BUILD NEW RELATIONSHIPS WITH STAKEHOLDERS. PARTICIPANTS WERE NOT GIVEN A MONETARY INCENTIVE FOR ATTENDANCE. AS WITH THE RESIDENT FOCUS GROUPS, THIS GROUP WAS FACILITATED BY OUTSIDE CONSULTANTS WITHOUT A DIRECT LINK TO ST. JOSEPH HEALTH.RESIDENT COMMUNITY FORUM:RECRUITMENT FOR THE COMMUNITY RESIDENT FORUM WAS MUCH BROADER TO ENCOURAGE AS MANY PEOPLE AS POSSIBLE TO ATTEND THE SESSION. COMMUNITY BENEFIT STAFF PUBLICIZED THE EVENT THROUGH FLYERS AND EMAILS USING THEIR EXISTING OUTREACH NETWORKS, AND ALSO ASKED THEIR PARTNER ORGANIZATIONS TO INVITE AND RECRUIT PARTICIPANTS. NO FORMAL INVITATION LIST WAS USED FOR THE FORUM AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUM WAS CONDUCTED BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT. WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUM FOLLOWED A DIFFERENT PROCESS. THE LEAD FACILITATOR SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR AND ASKED THE PARTICIPANTS TO COMMENT ON THEM AND ADD ANY OTHER CONCERNS. ONCE THE DISCUSSION WAS COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS PROCESS, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS.COMMUNITY BUILDING INITIATIVE: ROSELAND:IN 2016, THE MINISTRY COLLABORATED WITH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND IN A PROCESS TO IDENTIFY PRESSING COMMUNITY NEEDS IN THE ROSELAND NEIGHBORHOOD OF SANTA ROSA. BECAUSE THIS PROCESS ALSO INVOLVED COMMUNITY MEETINGS, THE HOSPITAL INCORPORATED THE COMMUNITY INPUT FROM THIS PROCESS INTO THE OVERALL DATA CONSIDERATION FOR THIS CHNA.DATA LIMITATIONS AND INFORMATION GAPS:WHILE CARE WAS TAKEN TO SELECT AND GATHER DATA THAT WOULD TELL THE STORY OF THE HOSPITAL'S SERVICE AREA, IT IS IMPORTANT TO RECOGNIZE THE LIMITATIONS AND GAPS IN INFORMATION THAT NATURALLY OCCUR.- NOT ALL DESIRED HEALTH-RELATED DATA WAS AVAILABLE. AS A RESULT PROXY MEASURES WERE USED WHEN AVAILABLE. FOR EXAMPLE, THERE IS LIMITED COMMUNITY OR ZIP CODE LEVEL DATA ON THE INCIDENCE OF MENTAL HEALTH, OR MANY HEALTH BEHAVIORS SUCH AS SUBSTANCE ABUSE.- DATA THAT IS GATHERED THROUGH INTERVIEWS AND SURVEYS MAY BE BIASED DEPENDING ON WHO IS WILLING TO RESPOND TO THE QUESTIONS AND WHETHER THEY ARE REPRESENTATIVE OF THE POPULATION AS A WHOLE.- THE ACCURACY OF DATA GATHERED THROUGH INTERVIEWS AND SURVEYS DEPENDS ON HOW CONSISTENTLY THE QUESTIONS ARE INTERPRETED ACROSS ALL RESPONDENTS AND HOW HONEST PEOPLE ARE IN PROVIDING THEIR ANSWERS.- WHILE MOST INDICATORS ARE RELATIVELY CONSISTENT FROM YEAR TO YEAR, OTHER INDICATORS ARE CHANGING QUICKLY (SUCH AS RATES OF UNINSURED) AND THE MOST RECENT DATA AVAILABLE IS NOT A GOOD REFLECTION OF THE CURRENT STATE.- ZIP CODE AREAS ARE THE SMALLEST GEOGRAPHIC REGIONS FOR WHICH MANY HEALTH OUTCOMES AND HEALTH BEHAVIOR INDICATORS ARE PUBLICLY AVAILABLE. IT IS RECOGNIZED THAT EVEN WITHIN ZIP CODES, THERE CAN BE POPULATIONS THAT ARE DISPROPORTIONATELY WORSE OFF. FOR EXAMPLE, WITHIN SMALLER GEOGRAPHIC AREAS, SUCH AS CENSUS TRACTS, SOCIO-ECONOMIC DATA PROVIDES A MORE GRANULAR UNDERSTANDING OF DISPARITY AT THE NEIGHBORHOOD LEVEL. AS PREVIOUSLY MENTIONED, CENSUS TRACT HEALTH OUTCOME AND HEALTH BEHAVIOR DATA WAS NOT PUBLICLY AVAILABLE TO PAINT A COMPLETE PICTURE OF COMMUNITY LEVEL NEED.- DATA FOR ZIP CODES WITH SMALL POPULATIONS (BELOW 2,000) IS OFTEN UNRELIABLE, ESPECIALLY WHEN THE DATA IS ESTIMATED FROM A SMALL SAMPLE OF THE POPULATION. IN THE TOTAL SERVICE AREA, ANNAPOLIS, BODEGA, BODEGA BAY, CAZADERO, FULTON, GEYSERVILLE, GRATON, HOPLAND, JENNER, KENWOOD, MONTE RIO, OCCIDENTAL, POINT AREA, STEWARTS POINT, AND THE SEA RACH EACH HAD FEWER THAN 2,000 PEOPLE.- INFORMATION GATHER DURING FOCUS GROUPS AND COMMUNITY FORUMS IS DEPENDENT ON WHO WAS INVITED AND WHO SHOWED UP FOR THE EVENT. EFFORTS WERE MADE TO INCLUDE PEOPLE WHO COULD REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AND/OR WERE MEMBERS OF COMMUNITIES OF GREATEST NEED.- FEARS ABOUT DEPORTATION KEPT MANY UNDOCUMENTED IMMIGRANTS FROM PARTICIPATING IN THE FOCUS GROUPS AND COMMUNITY FORUM AND MADE IT MORE DIFFICULT FOR THEIR VOICE TO BE HEARD.QUEEN OF THE VALLEY MEDICAL CENTERCOMMUNITY INPUTTHE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS: COMMUNITY RESIDENT FOCUS GROUP, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND A COMMUNITY FORUM. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTED KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY QUEEN OF THE VALLEY MEDICAL CENTER. WE DEVELOPED A PROTOCOL (NOTED IN APPENDIX 3B OF THE CHNA) FOR EACH GROUP TO ENSURE CONSISTENCY ACROSS INDIVIDUAL FOCUS GROUPS, ALTHOUGH THE FACILITATORS HAD SOME DISCRETION ON ASKING FOLLOW-UP QUESTIONS OR PROBES AS THEY SAW FIT. INVITATION AND RECRUITMENT PROCEDURES VARIED FOR EACH TYPE OF GROUP. APPENDIX 3 OF THE CHNA INCLUDES A FULL REPORT OF THE COMMUNITY INPUT PROCESS AND FINDINGS ALONG WITH DESCRIPTIONS OF THE PARTICIPANTS. SCHEDULE H, PART V, SECTION B, LINE 5 (CONTINUED) RESIDENT FOCUS GROUPSFOR COMMUNITY RESIDENT GROUPS, COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMITTEES AND THE SYSTEM OFFICE, IDENTIFIED GEOGRAPHIC AREAS WHERE DATA SUGGESTED THERE WERE SIGNIFICANT HEALTH, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC CONCERNS. THIS PROCESS ALSO IDENTIFIED THE LANGUAGE NEEDS OF THE COMMUNITY, WHICH DETERMINED THE LANGUAGE IN WHICH EACH FOCUS GROUP WAS CONDUCTED. COMMUNITY BENEFIT STAFF THEN PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THOSE AREAS TO RECRUIT FOR AND HOST THE FOCUS GROUPS. THE COMMUNITY BASED ORGANIZATION DEVELOPED AN INVITATION LIST USING THEIR CONTACTS AND KNOWLEDGE OF THE AREA, AND PARTICIPANTS WERE PROMISED A SMALL INCENTIVE FOR THEIR TIME. TWO CONSULTANTS STAFFED EACH FOCUS GROUP, SERVING AS FACILITATORS AND NOTE TAKERS. THESE CONSULTANTS WERE NOT DIRECTLY AFFILIATED WITH THE MINISTRY TO ENSURE CANDOR FROM THE PARTICIPANTS. TWO RESIDENT FOCUS GROUPS WERE CONDUCTED, ONE CONDUCTED ON 3/16/17 IN THE CITY OF SONOMA IN SPANISH WITH 20 PARTICIPANTS AND THE OTHER CONDUCTED ON 3/22/17 IN THE CITY OF AMERICAN CANYON WITH 16 PARTICIPANTS. THE COMMUNITY RESIDENT FOCUS GROUP ATTENDEES WERE 83% FEMALE AND 17% MALE. 70% OF ATTENDEES IDENTIFIED AS HISPANIC/LATINO, 13% AS NON-LATINO WHITE, 10% AS FILIPINO, AND 7% AS BLACK/AFRICAN-AMERICAN. OF THOSE WHO RESPONDED, 45% SAID THEY EARNED LESS THAN $35,000 ANNUALLY; THE AMERICAN CANYON GROUP WAS CONSIDERABLY MORE AFFLUENT THAN THE GROUP IN SONOMA. MORE DETAILED DEMOGRAPHIC INFORMATION IS LISTED IN APPENDIX 3A OF THE CHNA.NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUPFOR THE NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, COMMUNITY BENEFIT STAFF DEVELOPED A LIST OF LEADERS FROM ORGANIZATIONS THAT SERVE DIVERSE CONSTITUENCIES WITHIN THE HOSPITAL'S SERVICE AREA. MINISTRY STAFF SOUGHT TO INVITE ORGANIZATIONS WITH WHICH THEY HAD EXISTING RELATIONSHIPS, BUT ALSO USED THE FOCUS GROUP AS AN OPPORTUNITY TO BUILD NEW RELATIONSHIPS WITH STAKEHOLDERS. THE GROUP WAS CONDUCTED ON 3/23/17. PARTICIPANTS WERE NOT GIVEN A MONETARY INCENTIVE FOR ATTENDANCE. AS WITH THE RESIDENT FOCUS GROUPS, THIS GROUP WAS FACILITATED BY OUTSIDE CONSULTANTS WITHOUT A DIRECT LINK TO ST. JOSEPH HEALTH. THE GROUP INCLUDED 21 PARTICIPANTS REPRESENTING DIVERSE POPULATIONS INCLUDING LOW INCOME, CHRONICALLY ILL, MEDICALLY UNDERSERVED, LATINO AND FILIPINO POPULATIONS. A FULL LIST OF PARTICIPANTS AND ORGANIZATIONS IS IN APPENDIX 3B OF THE CHNA.RESIDENT COMMUNITY FORUMRECRUITMENT FOR THE COMMUNITY RESIDENT FORUM WAS MUCH BROADER TO ENCOURAGE AS MANY PEOPLE AS POSSIBLE TO ATTEND THE SESSION. COMMUNITY BENEFIT STAFF PUBLICIZED THE EVENT THROUGH FLYERS AND EMAILS USING THEIR EXISTING OUTREACH NETWORKS, AND ALSO ASKED THEIR PARTNER ORGANIZATIONS TO INVITE AND RECRUIT PARTICIPANTS. NO FORMAL INVITATION LIST WAS USED FOR THE FORUM AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUM WAS CONDUCTED ON 3/27/17 BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT. WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUM FOLLOWED A DIFFERENT PROCESS. THE LEAD FACILITATOR SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR AND ASKED THE PARTICIPANTS TO COMMENT ON THEM AND ADD ANY OTHER CONCERNS. ONCE THE DISCUSSION WAS COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS PROCESS, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALCOLLECTING COMMUNITY INPUT IS AN INTEGRAL PART OF THE NEEDS ASSESSMENT PROCESS. QUANTITATIVE DATA ONLY TELLS PART OF THE STORY, BUT HEARING DIRECTLY FROM RESIDENTS AND STAKEHOLDERS WORKING IN HEALTH-RELATED FIELDS PROVIDES CONTEXT AND FIRST-HAND EXPERIENCE OF THE NEEDS OCCURRING WHERE PEOPLE LIVE, WORK AND PLAY.OVER A TWO WEEK PERIOD IN FEBRUARY 2017 WE HELD THREE RESIDENT FOCUS GROUPS IN DIFFERENT GEOGRAPHIC LOCATIONS OF OUR SERVICE AREA AND WITH POPULATIONS WHO HAVE KNOWN HEALTH DISPARITIES. IN TOTAL, MORE THAN 30 PEOPLE PARTICIPATED. THE FOCUS GROUPS WERE HELD IN FORTUNA AND EUREKA AND INCLUDED SENIORS LIVING IN THE EEL RIVER VALLEY AS WELL AS ELDERS FROM THE TABLE BLUFF RANCHERIA, LOW-INCOME FAMILIES AND SPANISH-SPEAKING COMMUNITY MEMBERS.A FOURTH FOCUS GROUP WITH GOVERNMENT AND NON-PROFIT STAKEHOLDERS WAS ALSO HELD IN EUREKA. ELEVEN REPRESENTATIVES FROM NINE ENTITIES ATTENDED. AT EACH FOCUS GROUP PARTICIPANTS WERE PROVIDED WITH SUMMARY SECONDARY AND PUBLICALLY AVAILABLE DATA HIGHLIGHTING AREAS OF NEED AND ASKED TO PROVIDE FEEDBACK. FOR CONSISTENCY PURPOSES, THE SAME QUESTIONS WERE ASKED AT EACH OF THE FOCUS GROUPS BUT PARTICIPANTS WERE ENCOURAGED TO SHARE THEIR PERSONAL EXPERIENCES ABOUT THE VARIOUS FACTORS INFLUENCING THEIR HEALTH AND THE HEALTH OF THEIR COMMUNITY. THEY WERE ALSO ASKED TO IDENTIFY ANY GAPS OR MISSING INFORMATION.AFTER GATHERING INPUT FROM FOCUS GROUPS, A RESIDENT COMMUNITY FORUM WAS HELD AT THE SEQUOIA CONFERENCE CENTER IN EUREKA. THE FORUM WAS OPEN TO ALL COMMUNITY MEMBERS. CALIFORNIA CENTER FOR RURAL POLICY FACILITATED THE FORUM AND SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR. AFTER ROBUST DISCUSSION, PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS DESIGN, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKACOLLECTING COMMUNITY INPUT IS AN INTEGRAL PART OF THE NEEDS ASSESSMENT PROCESS. QUANTITATIVE DATA ONLY TELLS PART OF THE STORY, BUT HEARING DIRECTLY FROM RESIDENTS AND STAKEHOLDERS WORKING IN HEALTH-RELATED FIELDS PROVIDES CONTEXT AND FIRST-HAND EXPERIENCE OF THE NEEDS OCCURRING WHERE PEOPLE LIVE, WORK AND PLAY.OVER A TWO WEEK PERIOD IN FEBRUARY 2017 WE HELD THREE RESIDENT FOCUS GROUPS IN DIFFERENT GEOGRAPHIC LOCATIONS OF OUR SERVICE AREA AND WITH POPULATIONS WHO HAVE KNOWN HEALTH DISPARITIES. IN TOTAL, MORE THAN 30 PEOPLE PARTICIPATED. THE FOCUS GROUPS WERE HELD IN FORTUNA AND EUREKA AND INCLUDED SENIORS LIVING IN THE EEL RIVER VALLEY AS WELL AS ELDERS FROM THE TABLE BLUFF RANCHERIA, LOW-INCOME FAMILIES AND SPANISH-SPEAKING COMMUNITY MEMBERS.A FOURTH FOCUS GROUP WITH GOVERNMENT AND NON-PROFIT STAKEHOLDERS WAS ALSO HELD IN EUREKA. ELEVEN REPRESENTATIVES FROM NINE ENTITIES ATTENDED. AT EACH FOCUS GROUP PARTICIPANTS WERE PROVIDED WITH SUMMARY SECONDARY AND PUBLICALLY AVAILABLE DATA HIGHLIGHTING AREAS OF NEED AND ASKED TO PROVIDE FEEDBACK. FOR CONSISTENCY PURPOSES, THE SAME QUESTIONS WERE ASKED AT EACH OF THE FOCUS GROUPS BUT PARTICIPANTS WERE ENCOURAGED TO SHARE THEIR PERSONAL EXPERIENCES ABOUT THE VARIOUS FACTORS INFLUENCING THEIR HEALTH AND THE HEALTH OF THEIR COMMUNITY. THEY WERE ALSO ASKED TO IDENTIFY ANY GAPS OR MISSING INFORMATION.AFTER GATHERING INPUT FROM FOCUS GROUPS, A RESIDENT COMMUNITY FORUM WAS HELD AT THE SEQUOIA CONFERENCE CENTER IN EUREKA. THE FORUM WAS OPEN TO ALL COMMUNITY MEMBERS. CALIFORNIA CENTER FOR RURAL POLICY FACILITATED THE FORUM AND SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR. AFTER ROBUST DISCUSSION, PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS DESIGN, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALCHNA OTHER HOSPITAL FACILITIES:- SUTTER HEALTH- KAISER PERMANENTE- SONOMA WEST MEDICAL CENTERFACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALCHNA OTHER HOSPITAL FACILITIES:ST. JOSEPH HOSPITAL OF EUREKAFACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKACHNA OTHER HOSPITAL FACILITIES:REDWOOD MEMORIAL HOSPITAL SCHEDULE H, PART V, SECTION B, LINE 6B FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALMANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:- SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES- COMMUNITY CHILD CARE COUNCIL (4CS) OF SONOMA COUNTY- FIRST 5 SONOMA COUNTY- BURBANK HOUSING- COMMUNITY FOUNDATION SONOMA COUNTY- SONOMA COUNTY SHERIFF'S OFFICE- CITY OF SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP- COMMUNITY ACTION PARTNERSHIP OF SONOMA- SONOMA COUNTY ACES CONNECTION- SONOMA COUNTY ECONOMIC DEVELOPMENT BOARD- SONOMA COUNTY PERMIT & RESOURCE MANAGEMENT DEPARTMENT- SONOMA COUNTY ENVIRONMENTAL HEALTH & SAFETY- BUCKELEW PROGRAMS- SONOMA COUNTY OFFICE OF EDUCATION- SONOMA COUNTY COMMUNITY DEVELOPMENT COMMISSION- LA LUZ COMMUNITY CENTER- PETALUMA PEOPLE SERVICES CENTER- SANTA ROSA COMMUNITY HEALTH CENTERS- WEST COUNTY HEALTH CENTERS- PETALUMA HEALTH CARE DISTRICT- PETALUMA HEALTH CENTER- ALLIANCE MEDICAL CENTER- PALM DRIVE HEALTH CARE DISTRICT- NORTH SONOMA COUNTY HEALTH CARE DISTRICT- SONOMA VALLEY HEALTH CARE DISTRICT- RUSSIAN RIVER ARE RESOURCES AND ADVOCATES- COMMUNITY HEALTH INITIATIVE OF THE PETALUMA AREA- LATINO SERVICE PROVIDERS- SONOMA COUNTY HUMAN SERVICES DEPARTMENT- SONOMA COUNTY TASK FORCE ON THE HOMELESS- SONOMA COUNTY HEALTH CARE FOR THE HOMELESS COALITION- MENDOCINO COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES- HEALTH MENDOCINOQUEEN OF THE VALEEY MEDICAL CENTERQUEEN OF THE VALLEY MEDICAL CENTER COLLABORATED WITH ON THE MOVE BAY AREA IN THE CHNA PROCESS.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALCHNA OTHER ORGANIZATIONS INCLUDING COLLABORATIVE AND COMMUNITY PARTNERS:- THE OLIN GROUP- CALIFORNIA CENTER FOR RURAL POLICY- HUMBOLDT COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, PUBLIC HEALTH BRANCH- LIVE WELL HUMBOLDT, COMMUNITY STRATEGIES TEAM- MULTIGENERATIONAL CENTER AND THE FORTUNA SENIOR CENTER- BETTY KWAN CHINN HOMELESS FOUNDATION AND DAY CENTER- ENGLISH EXPRESS- HUMBOLDT COUNTY OFFICE OF EDUCATION- HUMBOLDT SENIOR RESOURCE CENTER- FORTUNA SENIOR CENTER- WESTSIDE COMMUNITY IMPROVEMENT ASSOCIATION AND THE JEFFERSON COMMUNITY CENTER- HUMBOLDT DEL-NORTE MEDICAL SOCIETY- LATINONET AND HUMBOLDT PROMOTORES DE SALUD- REDWOOD COMMUNITY ACTION AGENCY- ALCOHOL AND DRUG CARE SERVICES- EUREKA RESCUE MISSIONFACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAST. JOSEPH HOSPITAL EUREKA, ALONG WITH REDWOOD MEMORIAL HOSPITAL, COLLOBORATED ON THE CHNA PROCESS WITH THE FOLLOWING ORGANIZATIONS:- THE OLIN GROUP- CALIFORNIA CENTER FOR RURAL POLICY- HUMBOLDT COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, PUBLIC HEALTH BRANCH- LIVE WELL HUMBOLDT, COMMUNITY STRATEGIES TEAM- MULTIGENERATIONAL CENTER AND THE FORTUNA SENIOR CENTER- BETTY KWAN CHINN HOMELESS FOUNDATION AND DAY CENTER- ENGLIGH EXPRESS- HUMBOLDT COUNTY OFFICE OF EDUCATION- HUMBOLDT SENIOR RESOURCE CENTER- FORTUNA SENIOR CENTER- WESTSIDE COMMUNITY IMPROVEMENT ASSOCIATION AND THE JEFFERSON COMMUNITY CENTER- HUMBOLDT DEL-NORTE MEDICAL SOCIETY- LATINONET AND HUMBOLDT PROMOTORES DE SALUD- REDWOOD COMMUNITY ACTION AGENCY- ALCOHOL AND DRUG CARE SERVICES- EUREKA RESCUE MISSION SCHEDULE H, PART V, SECTION B, LINE 7A CHNA WEBSITEFACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALHTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/QUEEN OF THE VALLEY MEDICAL CENTERHTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALHTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAHTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITEFACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALHTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/QUEEN OF THE VALLEY MEDICAL CENTERHTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALHTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAHTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALCOMMUNITY HEALTH NEEDS PRIORITIZED:ACCESS TO RESOURCES:ENSURING ACCESS TO AFFORDABLE, QUALITY HEALTH CARE SERVICES IS IMPORTANT TO PROTECTING BOTH INDIVIDUAL AND POPULATION HEALTH, ELIMINATING HEALTH DISPARITIES AND PROMOTING OVERALL QUALITY OF LIFE IN THE COMMUNITY. THIS INCLUDES MOST BARRIERS TO ACCESSING HEALTH CARE SERVICES AND OTHER NECESSARY RESOURCES, SUCH AS INCOME, LACK OF ADEQUATE INSURANCE, IMMIGRATION STATUS, TRANSPORTATION, A SHORTAGE OF PROVIDERS AND SPECIALISTS, LANGUAGE BARRIERS, AND RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS.THE COMMUNITY BENEFIT COMMITTEE (CBC) NOTED THAT WHILE MANY ADULTS IN SONOMA COUNTY ARE ABLE TO OBTAIN INSURANCE COVERAGE AND ACCESS REGULAR HEALTHCARE IN THE WAKE OF THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT (ACA), DISPARITIES PERSIST. SPECIFICALLY, LOWER INCOME RESIDENTS HAVE DIFFICULTY ACCESSING CARE, AS MANY REMAIN UNINSURED DUE TO HIGH PREMIUM COSTS AND THOSE WITH PUBLIC INSURANCE FACE BARRIERS TO FINDING PROVIDERS WHO ACCEPT MEDI-CAL.FOREIGN-BORN RESIDENTS WHO ARE NOT U.S. CITIZENS ALSO FACE STARK BARRIERS IN OBTAINING INSURANCE COVERAGE AND ACCESSING CARE. AMONG THOSE WHO DO HAVE INSURANCE COVERAGE, PRIMARY DATA IDENTIFIED OTHER BARRIERS TO ACCESSING CARE INCLUDING THAT THERE ARE NOT ENOUGH PRIMARY HEALTHCARE PROVIDERS IN SONOMA COUNTY TO MEET THE HIGH DEMAND. THE CBC RECOGNIZES THIS IS AN ONGOING, HIGH-PRIORITY NEED, AND ONE WHICH, GIVEN THE EXISTING SRMH COMMUNITY BENEFIT PROGRAMS (MOBILE HEALTH AND DENTAL CLINICS, FIXED-SITE DENTAL CLINIC, AND IN-HOME CARE), WE ARE UNIQUELY QUALIFIED WITH APPROPRIATE CAPACITY TO ADDRESS.CARE NETWORK, OUR NEWEST PROGRAM, PROVIDES A COMPREHENSIVE TEAM APPROACH TO PROVIDE MEDICAL CARE, CARE COORDINATION, SOCIAL WORK SUPPORTS, AND RESOURCE NAVIGATION TO THE MOST VULNERABLE PATIENT POPULATION. WE ALSO BEGAN TO STRENGTHEN OUR PARTNERSHIPS WITH SANTA ROSA COMMUNITY HEALTH, CATHOLIC CHARITIES, REDWOOD GOSPEL MISSION, THE PALMS AND SAM JONES SHELTER TO PROVIDE SUPPORT SERVICES IN THE COMMUNITY FOR OUR MOST VULNERABLE PATIENTS. THE PROGRAM HAS ALSO INTEGRATED WITH PSYCHIATRIC LIAISONS IN THE EMERGENCY DEPARTMENT TO PROVIDE SERVICES TO BEHAVIORAL HEALTH PATIENTS REQUIRING PSYCHIATRIC CARE OR REFERRALS TO CARE.HOMELESSNESS AND HOUSING CONCERNS:THESE TWO NEEDS WERE COMBINED BY THE CBC IN RECOGNITION OF THE FACT THAT THE TWO ISSUES, WHILE IDENTIFIED SEPARATELY IN THE DATA COLLECTION PROCESS, ARE INEXTRICABLE LINKED AND CANNOT BE EFFECTIVELY ADDRESSED SEPARATELY, AND THAT WHILE HOMELESSNESS IS THE MORE VISIBLE PROBLEM, THE STRESS OF HOUSING INSECURITY AND THE THREAT OF HOMELESSNESS ARE EQUALLY INJURIOUS TO COMMUNITY AND INDIVIDUAL HEALTH. HOUSING IS CONSIDERED A PRIMARY SOCIAL DETERMINANT OF HEALTH, AND THE LACK OF HOUSING OR AFFORDABLE HOUSING CONTRIBUTES TO AND EXACERBATES MULTIPLE ADVERSE HEALTH CONDITIONS.STAKEHOLDERS NOTED THAT 2,835 HOMELESS PERSONS WERE FOUND DURING THE JANUARY 26, 2017 SONOMA COUNTY HOMELESS COUNT. WHILE THIS NUMBER REFLECTS A DECLINING TREND IN HOMELESSNESS IN SONOMA COUNTY OVER THE PAST FIVE YEARS, THE NUMBER IS STILL VERY LARGE. ON ANY GIVEN NIGHT, 5.6 PEOPLE OUT OF EVERY 1,000 RESIDENTS ARE HOMELESS, AND MANY OF THEM IN MUCH MORE VISIBLE LOCATIONS THAN IN PREVIOUS YEARS' COUNTS. THE CBC BELIEVES IT IS IMPERATIVE THAT WE JOIN IN OUR COMMUNITY'S EFFORTS TO COMBAT THESE TRENDS AS WE SEE THIS AS THE MOST PROMINENT SOCIAL DETERMINANT OF HEALTH THAT WE MUST ADDRESS. OUR PRIMARY FOCUS IS ON THE CONDITION OF HOMELESSNESS, INCLUDING THE DEVELOPMENT OF PERMANENT SUPPORTIVE HOUSING, PROVIDING HEALTHCARE TO HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. WE CONTINUED TO PARTNER WITH OTHER COMMUNITY ORGANIZATIONS TO ADDRESS ISSUES OF HOUSING AFFORDABILITY, AVAILABILITY, OVERCROWDING, AND QUALITY.OUR INTERSECTIONS COALITION LAUNCHED THIS YEAR AND WILL FOCUS ON THE ISSUE OF HOUSING EQUITY. IT CONTAINS AN IMPORTANT COMMUNITY ENGAGEMENT ELEMENT THAT WILL INCLUDE RECRUITMENT AND LEADERSHIP DEVELOPMENT FOR RESIDENTS OF THE MOST VULNERABLE NEIGHBORHOODS IN OUR COMMUNITY. ONE OF THE PRIMARY FOCI OF THE COALITION IS ADVOCACY BY THESE RESIDENTS FOR HOUSING POLICIES THAT WILL PROMOTE EQUITY. WE ARE ALSO A LEADING MEMBER OF THE HEALTH CARE FOR THE HOMELESS COLLABORATIVE FOCUSED ON COORDINATING EXISTING SERVICES AND DEVELOPING NEW HOMELESS HEALTH CARE SERVICES. OUR MOBILE HEALTH CLINIC TEAM HAS ADDED SANTA ROSA HOMELESS SHELTERS TO THEIR ROSTER AND BEGAN PROVIDING SERVICES INSIDE THE SHELTERS, CONTRIBUTING TO A REDUCTION IN UNNECESSARY ER VISITS. WE HAVE ALSO PROVIDED FUNDING TO THE COMMITTEE ON THE SHELTERLESS FOR THE CREATION OF 11 PERMANENT SUPPORTIVE HOUSING UNITS IN THE MARY ISAAC CENTER IN PETALUMA AND PROVIDED FUNDING TO SANTA ROSA COMMUNITY HEALTH IN SUPPORT OF THEIR HOMELESS CARE TRANSITIONS PROGRAM WHICH CONNECTS PATIENTS WITH NEEDED SOCIAL SERVICES.BEHAVIORAL HEALTH:MENTAL HEALTH AND SUBSTANCE USE WERE COMBINED BY THE CBC IN RECOGNITION OF THE FACT THAT MENTAL HEALTH AND SUBSTANCE USE DISORDERS OFTEN GO HAND-IN-HAND AND MORE MANY PATIENTS ARE CO-OCCURRING CONDITIONS. WE PREFER THE TERM BEHAVIORAL HEALTH TO REFER TO THESE CONDITIONS COLLECTIVELY. IN ADDITION, THE CBC NOTED THAT AT THE CONCLUSION OF STEP 3 OF THE PRIORITIZATION PROCESS, THESE WERE THE FIRST AND SECOND HIGHEST RANKED CONCERNS. BOTH CONCERNS WERE RAISED THROUGHOUT THE COMMUNITY INPUT PROCESS AND RECEIVED A HIGH NUMBER OF VOTES AT THE COMMUNITY FORUM.ALTHOUGH THE DATA SHOWS A BETTER RATIO OF POPULATION TO MENTAL HEALTH PROVIDERS IN SONOMA AND MENDOCINO COUNTIES THAT THE STATE, FOCUS GROUP PARTICIPANTS SPOKE OF SHORTAGES OF PROVIDERS AND SERVICES FOR MENTAL HEALTH AND SUBSTANCE USE. IN SONOMA COUNTY, FOR INSTANCE, MANY LOW-INCOME INDIVIDUALS WITH MENTAL HEALTH CONCERNS DO NOT HAVE ACCESS TO THE TREATMENT THEY NEED. INSUFFICIENT PRIVATE INSURANCE COVERAGE FOR MENTAL HEALTH SERVICES AND INSUFFICIENT AVAILABILITY OF PUBLICLY FUNDED TREATMENT SERVICES ARE SIGNIFICANT BARRIERS FOR MANY. FURTHERMORE, LIMITED INTEGRATION OF MENTAL HEALTH SERVICES WITHIN THE HEALTH CARE SYSTEM ALSO LEADS TO MISSED OPPORTUNITIES FOR EARLY PROBLEM IDENTIFICATION AND PREVENTION. MENTAL HEALTH INCLUDES EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING. POOR MENTAL HEALTH, INCLUDING THE PRESENCE OF CHRONIC TOXIC STRESS OR PSYCHOLOGICAL CONDITIONS SUCH AS ANXIETY, DEPRESSION OR POST-TRAUMATIC STRESS DISORDER, HAS PROFOUND CONSEQUENCES ON HEALTH BEHAVIOR CHOICES AND PHYSICAL HEALTH. AS A RESULT, THE CBC FELT THAT THE FOCUS ON MENTAL HEALTH AND SUBSTANCE USE, I.E. BEHAVIORAL HEALTH, WITH A PARTICULAR FOCUS ON TRAUMA-INFORMED COMMUNITY-BASED PREVENTION AND RESILIENCE IN THE FACE OF ADVERSE COMMUNITY EXPERIENCES, WAS OF PARAMOUNT IMPORTANCE TO OUR MINISTRY AND OUR COMMUNITY.WE ARE A LEADING MEMBER OF THE BEHAVIORAL HEALTH COALITION FOCUSED ON IDENTIFYING, DEVELOPING AND IMPLEMENTING POLICIES AND PRACTICES TO IMPROVE THE COUNTYWIDE BEHAVIORAL HEALTH SYSTEM OF CARE, SOMETHING THAT WAS IDENTIFIED BY SRMH AS THE MOST PRESSING NEED IN THE LOCAL BEHAVIORAL HEALTH COMMUNITY. OUR HEALTHY FOR LIFE PROGRAM IS PARTNERING WITH SCOE, THE SCHOOL DISTRICTS AND OTHER COMMUNITY GROUPS TO PLAN AND IMPLEMENT MORE EXPLICITLY BEHAVIORAL HEALTH ELEMENTS INTO ITS CURRICULA, IN ADDITION TO CONTINUING ITS PHYSICAL FITNESS AND MINDFULNESS EDUCATION. WE ALSO PROVIDED FUNDING TO SANTA ROSA COMMUNITY HEALTH IN SUPPORT OF MENTAL HEALTH SERVICES FOR THEIR LOW-INCOME PATIENTS.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE RECOGNIZE THAT IN CHOOSING TO FOCUS ON THE NEEDS WE HAVE PRIORITIZED, WE WILL NOT BE DIRECTLY ADDRESSING OTHER NEEDS THAT ARE ALSO IMPORTANT IN OUR COMMUNITY. FOR INSTANCE, WE RECOGNIZE THAT CARDIOVASCULAR DISEASE IS THE LEADING CAUSE OF DEATH IN OUR COMMUNITY, AND THAT HEART DISEASE, OBESITY, AND DIABETES WERE ALL AMONG THE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN OUR CHNA PROCESS. IN NOT SELECTING ANY OF THESE CHRONIC CONDITIONS AS ONE OF OUR COMMUNITY BENEFIT PRIORITY AREAS, WE ARE AWARE THAT OTHER ONGOING PROGRAMS IN OUR MINISTRY AND IN OUR COMMUNITY ARE FULLY ENGAGED IN ADDRESSING THEM. WE ARE COMMITTED TO CONTINUE OUR INVOLVEMENT WITH COMMUNITY INITIATIVES SUCH AS HEARTS OF SONOMA AND THE CALIFORNIA ACCOUNTABLE COMMUNITIES FOR HEALTH INITIATIVE, FINANCIAL SUPPORT FOR NONPROFIT ORGANIZATIONS SUCH AS THE NORTHERN CALIFORNIA CENTER FOR WELL-BEING, AND THE HEART WORKS CARDIAC REHAB PROGRAM. SCHEDULE H, PART V, SECTION B, LINE 11 (CONTINUED) WITH RESPECT TO SOME OF THE OTHER NEEDS IDENTIFIED IN THE CHNA PROCESS THAT WERE NOT PRIORITIZED FOR ACTION THROUGH THIS PLAN, WE INTEND TO REMAIN ENGAGED IN ADDRESSING: ORAL HEALTH NEEDS THROUGH OUR ONGOING ST. JOSEPH HEALTH COMMUNITY DENTAL CLINIC AND MOBILE DENTAL CLINIC; CRIME AND SAFETY THROUGH OUR CONTINUED INVOLVEMENT ON THE SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP; AND INSURANCE AND COST OF CARE THROUGH OUR CONTINUED INVOLVEMENT ON THE COVERED SONOMA AND SONOMA HEALTH ACTION COMMUNITY HEALTH IMPROVEMENT COMMITTEES. WE ALSO INTEND TO INCORPORATE OTHER ISSUES SUCH AS EARLY CHILDHOOD DEVELOPMENT IN OUR BEHAVIORAL HEALTH STRATEGY AS IT IS SUCH A FUNDAMENTAL DETERMINANT OF MENTAL HEALTH LATER IN LIFE AND ECONOMIC INSECURITY IN OUR HOUSING CONCERNS STRATEGY AS IT IS A NECESSARY INGREDIENT IN HOUSING AFFORDABILITY. SIMILARLY, WITH RESPECT TO IMMIGRATION, WE LACK APPROPRIATE EXPERTISE OR COMPETENCY TO OFFER A PROGRAM, BUT WE INTEND TO DEVELOP A MEDICAL LEGAL PARTNERSHIP WITH A LOCAL LEGAL AID ORGANIZATION THAT WILL ASSIST RESIDENTS AND PATIENTS WITH IMMIGRATION ISSUES, AMONG OTHERS. AND WHILE FOOD AND NUTRITION IS NOT TO BE DIRECTLY ADDRESSED BY OUR OWN PROGRAMMING, WE ANTICIPATE THAT OUR ONGOING SUPPORT OF LOCAL INITIATIVES AND ORGANIZATIONS INVOLVED IN CARDIOVASCULAR DISEASE PREVENTION WILL INCLUDES A CONSIDERATION AND INCLUSION OF STRATEGIES TO ADDRESS THIS NEED. FURTHERMORE, WE WILL CONTINUE FUNDING OTHER LOCAL NONPROFIT ORGANIZATIONS THROUGH GRANTS FROM OUR CARE FOR THE POOR PROGRAM MANAGED BY THE SRMH COMMUNITY BENEFIT DEPARTMENT, AND WE WILL ENCOURAGE AND ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT THE SRMH SERVICE AREAS.QUEEN OF THE VALLEY MEDICAL CENTERQUEEN OF THE VALLEY IS WORKING BOTH INTERNALLY AND WITH COMMUNITY PARTNERS TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED BY THE FY17 COMMUNITY HEALTH NEEDS ASSESSMENT. QUEEN OF THE VALLEY'S FY18-FY20 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON THREE BROAD CATEGORIES OF HEALTH NEEDS: MENTAL HEALTH, SUBSTANCE ABUSE, AND SOCIAL DETERMINANTS OF HEALTH WHICH INCLUDE HOUSING, ECONOMIC ISSUES AND ACCESS TO HEALTH CARE.MENTAL HEALTH: THIS INITIATIVE IS FOCUSED ON IMPROVING MENTAL HEALTH AND WELLBEING OF 200 VULNERABLE LOW-INCOME OLDER ADULTS, INDIVIDUALS WITH ACUTE MEDICAL CONDITIONS AND PREGNANT AND POSTPARTUM WOMEN ANNUALLY. ACCESS TO MENTAL HEALTH SERVICES FOR LOW-INCOME INDIVIDUALS IS LIMITED. OLDER ADULTS, POSTPARTUM WOMEN AND THOSE WITH COMPLEX MEDICAL CONDITIONS ARE MORE LIKELY TO SUFFER FROM DEPRESSION THAT CAN CONTRIBUTE TO POOR QUALITY OF LIFE AND PLACE THEM AT HIGHER RISK FOR SUICIDE. GOAL: REDUCE DEPRESSION AND IMPROVE QUALITY OF LIFE AMONG 200 LOW-INCOME OLDER ADULTS, INDIVIDUALS WITH ACUTE MEDICAL CONDITIONS AND PREGNANT AND POSTPARTUM WOMEN ANNUALLY. THE OUTCOME MEASURE IS PERCENTAGE OF CLIENTS THAT IMPROVE DEPRESSION INDICTORS AS MEASURED THROUGH VALIDATED TOOLS (PHQ9).SUBSTANCE ABUSE: PERINATAL SUBSTANCE USE HAS SERIOUS CONSEQUENCES FOR BOTH MOTHER AND CHILD. OBSTETRICAL COMPLICATIONS FROM SUBSTANCE USE INCLUDE AN INCREASED RISK OF MISCARRIAGE, INTRAUTERINE GROWTH RESTRICTION, PREMATURE LABOR, AND EVEN FETAL DEMISE. RISKS EXTEND BEYOND PREGNANCY TO THE NEWBORN. ALCOHOL USE CAN LEAD TO FETAL ALCOHOL SPECTRUM DISORDER (FASD) ASSOCIATED WITH NUMEROUS DISABILITIES. OPIOID USE IS ASSOCIATED WITH NEONATAL WITHDRAWAL SYNDROME (NAS). RECENT ESTIMATES IDENTIFIED AN INCREASE IN THE RATE OF NEONATAL INTENSIVE CARE UNIT (NICU) ADMISSIONS IN THE UNITED STATES FOR NAS FROM 7 CASES TO 27 CASES PER 1000 ADMISSIONS LEADING TO AN INCREASE FROM 0.6% TO 4% OF ALL NICU DAYS BEING ATTRIBUTED TO NAS. INTERVENING WITH HIGH RISK WOMEN CAN ALSO PREVENT CHILDHOOD TRAUMA ASSOCIATED WITH PARENTAL SUBSTANCE ABUSE. IN NAPA, A SCREENING PILOT CONDUCTED FROM OCTOBER 2015-MAY 2017 USING THE VALIDATED 4PS PLUS TOOL TO ASSESS USE OF ALCOHOL, TOBACCO AND OTHER DRUGS BY PREGNANT WOMEN IN NAPA HAD THE FOLLOWING RESULTS: WITH A TOTAL OF 1,094 WOMEN SCREENED, THERE WERE A TOTAL OF 369 POSITIVE SCREENS FOR SUBSTANCE USE, OR ABOUT 33.7% OF THE TOTAL NUMBER OF SCREENS. GOAL: PREVENT ADVERSE CHILDHOOD EXPERIENCES THROUGH A COMPREHENSIVE SET OF ACTIVITIES TO REDUCE PERINATAL SUBSTANCE USE AND ABUSE SERVING APPROXIMATELY 500 WOMEN ANNUALLY. OUTCOME MEASURE: TO BE DEVELOPED BASED ON PLANNING COALITION RESEARCH OF APPROPRIATE MEASURES. ACTIVITIES INCLUDE DEVELOPING A BROAD BASED COALITION OF COMMUNITY AND PUBLIC AGENCY PARTNERS TO ADDRESS ISSUES OF PERINATAL SUBSTANCE USE AND ABUSE, EDUCATION PROFESSIONALS AND THE PUBLIC ON PERINATAL SUBSTANCE ABUSE IMPACTS AND SERVICES AVAILABLE, IMPLEMENT INTEGRATED PATIENT EDUCATION, SCREENING AND INTERVENTION TO CHANGE PATIENT SUBSTANCE ABUSE BEHAVIORS.SOCIAL DETERMINANTS OF HEALTH: THIS INITIATIVE ADDRESSES THE GAP IN HOUSING THAT IS AVAILABLE AND AFFORDABLE FOR CHRONICALLY HOMELESS AND LOW INCOME COMMUNITY MEMBERS, IMPROVING ECONOMIC STABILITY FOR LOW INCOME VULNERABLE ADULTS, AND ENSURING ACCESS TO QUALITY ORAL HEALTH CARE FOR LOW INCOME CHILDREN. GOALS INCLUDE SUPPORTING SUSTAINABLE, COLLECTIVE EFFORTS TO REDUCE HOMELESSNESS AND IMPROVE AVAILABILITY AND ACCESSIBILITY OF HOUSING THAT IS AFFORDABLE FOR LOW INCOME AND OTHER VULNERABLE POPULATIONS, ENSURE ACCESS TO BASIC NEEDS AND HEALTH MANAGEMENT OF LOW INCOME VULNERABLE ADULTS WITH COMPLEX MEDICAL AND SOCIO-ECONOMIC CONDITIONS INCLUDING HOMELESSNESS AND LACK OF ACCESS TO ESSENTIAL MEDICAL AND SOCIAL SERVICE RESOURCES, AND TO REDUCE THE ECONOMIC BURDEN ON FAMILIES AND IMPROVE ORAL HEALTH STATUS OF CHILDREN 6 MONTHS TO 26 YEARS OF AGE WHO ARE UNINSURED OR UNDERINSURED. OUTCOME MEASURES FOR THE SOCIAL DETERMINANTS OF HEALTH INITIATIVE INCLUDE COMMUNITY-WIDE COLLABORATIVE EFFORTS EXPANDING NUMBER OF INDIVIDUALS (TBD) HOUSED WHO WERE HOMELESS OR PRECARIOUSLY HOUSED, PERCENTAGE IMPROVEMENT IN QUALITY OF LIFE MEASURES ON VALIDATED SF12 SURVEY FROM ENROLLMENT TO DISCHARGE OF LOW INCOME, VULNERABLE CLIENTS, AND PERCENTAGE OF LOW INCOME PATIENTS WHO DEMONSTRATE ORAL HEALTH STATUS IMPROVEMENT AT RECALL VISIT BASED ON A SET OF CLINICAL CRITERIA. FOR MORE INFORMATION ON THE KEY STRATEGIES FOR ADDRESSING THESE HEALTH NEEDS GO TO THE QUEEN OF THE VALLEY MEDICAL CENTER FY18-FY20 CB PLAN LOCATED AVAILABLE ONLINE AT HTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/ NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH QUEEN OF THE VALLEY AND BY FUNDING OTHER NON-PROFITS THROUGH OUR CARE FOR THE POOR PROGRAM MANAGED BY THE QUEEN OF THE VALLEY.FURTHERMORE, QUEEN OF THE VALLEY WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT QUEEN OF THE VALLEY SERVICE AREAS. SCHEDULE H, PART V, SECTION B, LINE 11 (CONTINUED) HE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED WITH THE FOLLOWING EXPLANATION: SJH QUEEN OF THE VALLEY DOES NOT DIRECTLY ADDRESS IMMIGRATION STATUS. HOWEVER, COMMUNITY BENEFIT SERVICES ARE PROVIDED WITHOUT CONSIDERATION OF IMMIGRATION STATUS AND THE MEDICAL CENTER PROVIDES CHARITY MEDICAL CARE. IN ADDITION, QUEEN OF THE VALLEY MEDICAL CENTER AND COMMUNITY BENEFIT PROGRAMS PARTNERS WITH MULTIPLE COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE NEEDS OF THE UNDOCUMENTED. WHILE CANCER, HEART DISEASE, DIABETES AND ASTHMA ARE NOT A PRIMARY FOCUS OF THE PLAN, THE SERVICE AREA INCLUDES QUEEN OF THE VALLEY MEDICAL CENTER, ST. HELENA HOSPITAL, KAISER CLINIC AND OLE HEALTH THAT PROVIDE MEDICAL SERVICES TO INDIVIDUALS WITH THESE CONDITIONS. ALSO, QUEEN OF THE VALLEY'S CARE NETWORK PROVIDES CARE COORDINATION AND CARE MANAGEMENT FOR LOW INCOME PERSONS WITH COMPLEX MEDICAL CONDITIONS INCLUDING CHRONIC DISEASES SUCH AS THESE. SJH QUEEN OF THE VALLEY DOES NOT DIRECTLY ADDRESS ISSUES OF TRANSPORTATION AND TRAFFIC. AS A PARTNER IN LIVE HEALTHY NAPA COUNTY, QUEEN OF THE VALLEY PARTNERS WITH THE COMMUNITY TO IMPROVE CONDITIONS THROUGH ADVOCACY AND PARTNERSHIPS. IN ADDITION, TRANSPORTATION SUPPORT IS PROVIDED TO QUEEN OF THE VALLEY CARE NETWORK CLIENTS. WHILE ACCESS TO FOOD IS NOT A PRIMARY FOCUS OF THE IMPLEMENTATION STRATEGY, SJH QUEEN OF THE VALLEY COMMUNITY BENEFIT PROVIDES FUNDING SUPPORT TO LOCAL SAFETY FOOD NET ORGANIZATIONS, WORKS DIRECTLY WITH COMMUNITY PARTNERS SUCH AS THE FOOD BANK AND LIVE HEALTHY NAPA COUNTY TO EXPAND ACCESS, AND DIRECTLY ASSISTS LOW-INCOME CHRONICALLY ILL CARE NETWORK CLIENTS WITH FOOD ACCESS. IN ADDITION, QUEEN OF THE VALLEY WILL COLLABORATE WITH PUBLIC AGENCIES AND COMMUNITY-BASED ORGANIZATIONS THAT ADDRESS LANGUAGE BARRIERS AND AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALAS A RESULT OF THE FINDINGS OF OUR FY17 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THROUGH A PRIORITIZATION PROCESS ALIGNED WITH OUR MISSION, RESOURCES AND HOSPITAL STRATEGIC PLAN, REDWOOD MEMORIAL HOSPITAL WILL FOCUS ON THE FOLLOWING AREAS FOR ITS FY18-FY20 COMMUNITY BENEFIT FFORTS:- HOUSING- MENTAL HEALTH & SUBSTANCE ABUSE- FOOD AND NUTRITIONCOLLABORATING ORGANIZATIONSREDWOOD MEMORIAL HOSPITAL BELIEVES IN WORKING COLLABORATIVELY TO SOLVE COMMUNITY AND HEALTH-RELATED PROBLEMS. THE SOCIAL AND HEALTH PROBLEMS OUR COMMUNITIES FACE ARE SIGNIFICANT AND COMPLEX; THEY ARE BIGGER THAN ANY ONE ORGANIZATION ALONE. THEREFORE, REDWOOD MEMORIAL HOSPITAL WILL PARTNER WITH GOVERNMENT ENTITIES, NON-PROFIT ORGANIZATIONS, SCHOOLS, THE INTERFAITH COMMUNITY AND THE BUSINESS COMMUNITY IN ORDER TO ACHIEVE THE GOALS AND STRATEGIES OUTLINED IN THIS PLAN.FLEXIBLE APPROACHDUE TO THE FAST PACE AT WHICH THE COMMUNITY AND HEALTH CARE INDUSTRY CHANGE, REDWOOD MEMORIAL HOSPITAL ANTICIPATES THAT IMPLEMENTATION STRATEGIES MAY EVOLVE AND THEREFORE, A FLEXIBLE APPROACH IS BEST SUITED FOR THE DEVELOPMENT OF ITS RESPONSE TO THE REDWOOD MEMORIAL HOSPITAL CHNA. ON AN ANNUAL BASIS REDWOOD MEMORIAL HOSPITAL EVALUATES ITS CB PLAN, SPECIFICALLY ITS STRATEGIES AND RESOURCES; AND MAKES ADJUSTMENTS AS NEEDED TO ACHIEVE ITS GOALS/OUTCOME MEASURES, AND TO ADAPT TO CHANGES IN RESOURCE AVAILABILITY.FOR DETAILED INFORMATION ON HOW REDWOOD MEMORIAL HOSPITAL IS ADDRESSING THE SIGNIFICANT NEED IDENTIFIED IN OUT FY17 CHNA, PLEASE SEE OUR CB IMPLEMENTATION PLAN POSTED TO OUR WEBSITE.HTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH CORE COMMUNITY BENEFIT PROGRAMING (CARE TRANSITIONS, COMMUNITY RESOURCE CENTERS, PASO A PASO AND HEALTHY KIDS HUMBOLDT) AND BY FUNDING OTHER NON-PROFITS THROUGH OUR CARE FOR THE POOR COMMUNITY GRANTS PROGRAM MANAGED BY THE REDWOOD MEMORIAL HOSPITAL COMMUNITY BENEFIT DEPARTMENT. FURTHERMORE, REDWOOD MEMORIAL HOSPITAL WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT REDWOOD MEMORIAL HOSPITAL SERVICE AREAS.THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW:WHILE WE COULD NOT PRIORITIZE ALL OF THE NEEDS IDENTIFIED, WE WILL BE ABLE TO EFFECT MANY OF THE NEEDS BY WORKING ON ROOT CAUSE. FOR EXAMPLE, HEART DISEASE IS NOT A PRIORITY NEED, BUT WE WILL IMPACT THIS HEALTH OUTCOME BY FOCUSING OUR EFFORTS ON PROMOTING GOOD NUTRITION AND FOOD SECURITY. DENTAL CARE IS NOT A PRIORITIZED NEED BUT REDWOOD MEMORIAL HOSPITAL IS COMMITTED TO WORKING WITH PARTNERS ON THE MULTI-YEAR DENTAL TRANSFORMATION GRANT OUR PUBLIC HEALTH DEPARTMENT RECEIVED FROM THE CA DEPARTMENT OF HEALTH CARE SERVICES. ADDITIONALLY, REDWOOD MEMORIAL HOSPITAL DOES NOT HAVE A PROGRAM IN PLACE TO DIRECTLY PREVENT ASTHMA OCCURRENCE IN OUR SERVICE AREA; HOWEVER, WE PARTNER WITH SEVERAL ENTITIES, INCLUDING THE PUBLIC HEALTH DEPARTMENT THAT DO ADDRESS ASTHMA PREVENTION. FURTHERMORE, OUR EFFORTS TO IMPROVE THE QUALITY OF HOUSING IN OUR SERVICE HAS THE POTENTIAL TO IMPACT ASTHMA OCCURRENCE.IN ADDITION, REDWOOD MEMORIAL HOSPITAL WILL COLLABORATE WITH LOCAL ORGANIZATION(S) THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAAS A RESULT OF THE FINDINGS OF OUR FY17 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THROUGH A PRIORITIZATION PROCESS ALIGNED WITH OUR MISSION, RESOURCES AND HOSPITAL STRATEGIC PLAN, ST. JOSEPH HOSPITAL OF EUREKA WILL FOCUS ON THE FOLLOWING AREAS FOR ITS FY18-FY20 COMMUNITY BENEFIT EFFORTS:- HOUSING- MENTAL HEALTH & SUBSTANCE ABUSE- FOOD AND NUTRITIONCOLLABORATING ORGANIZATIONSST. JOSEPH HOSPITAL OF EUREKA BELIEVES IN WORKING COLLABORATIVELY TO SOLVE COMMUNITY AND HEALTH-RELATED PROBLEMS. THE SOCIAL AND HEALTH PROBLEMS OUR COMMUNITIES FACE ARE SIGNIFICANT AND COMPLEX; THEY ARE BIGGER THAN ANY ONE ORGANIZATION ALONE. THEREFORE, ST. JOSEPH HOSPITAL OF EUREKA WILL PARTNER WITH GOVERNMENT ENTITIES, NON-PROFIT ORGANIZATIONS, SCHOOLS, THE INTERFAITH COMMUNITY AND THE BUSINESS COMMUNITY IN ORDER TO ACHIEVE THE GOALS AND STRATEGIES OUTLINED IN THIS PLAN.FLEXIBLE APPROACHDUE TO THE FAST PACE AT WHICH THE COMMUNITY AND HEALTH CARE INDUSTRY CHANGE, ST. JOSEPH HOSPITAL OF EUREKA ANTICIPATES THAT IMPLEMENTATION STRATEGIES MAY EVOLVE AND THEREFORE, A FLEXIBLE APPROACH IS BEST SUITED FOR THE DEVELOPMENT OF ITS RESPONSE TO THE ST. JOSEPH HOSPITAL OF EUREKA CHNA. ON AN ANNUAL BASIS ST. JOSEPH HOSPITAL OF EUREKA EVALUATES ITS CB PLAN, SPECIFICALLY ITS STRATEGIES AND RESOURCES, AND MAKES ADJUSTMENTS AS NEEDED TO ACHIEVE ITS GOALS/OUTCOME MEASURES, AND TO ADAPT TO CHANGES IN RESOURCE AVAILABILITY.FOR DETAILED INFORMATION ON HOW ST. JOSEPH HOSPITAL OF EUREKA IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN OUT FY17 CHNA, PLEASE SEE OUR CB IMPLEMENTATION PLAN POSTED TO OUR WEBSITE.HTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUING OUR MISSION THROUGH CORE COMMUNITY BENEFIT PROGRAMING (CARE TRANSITIONS, EVERGREEN LODGE, COMMUNITY RESOURCE CENTERS, PASO A PASO AND HEALTHY KIDS HUMBOLDT) AND BY FUNDING OTHER NON-PROFITS THROUGH OUR CARE FOR THE POOR COMMUNITY GRANTS PROGRAM MANAGED BY THE ST. JOSEPH HOSPITAL OF EUREKA COMMUNITY BENEFIT DEPARTMENT.FURTHERMORE, ST. JOSEPH HOSPITAL OF EUREKA WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT ST. JOSEPH HOSPITAL OF EUREKA SERVICEAREAS.THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW: SCHEDULE H, PART V, SECTION B, LINE 11 (CONTINUED) WHILE WE COULD NOT PRIORITIZE ALL OF THE NEEDS IDENTIFIED, WE WILL BE ABLE TO EFFECT MANY OF THE NEEDS BY WORKING ON ROOT CAUSE. FOR EXAMPLE, HEART DISEASE IS NOT A PRIORITY NEED, BUT WE WILL IMPACT THIS HEALTH OUTCOME BY FOCUSING OUR EFFORTS ON PROMOTING GOOD NUTRITION AND FOOD SECURITY. DENTAL CARE IS NOT A PRIORITIZED NEED BUT ST. JOSEPH HOSPITAL OF EUREKA IS COMMITTED TO WORKING WITH PARTNERS ON THE MULTI-YEAR DENTAL TRANSFORMATION GRANT OUR PUBLIC HEALTH DEPARTMENT RECEIVED FROM THE CA DEPARTMENT OF HEALTH CARE SERVICES. ADDITIONALLY, ST. JOSEPH HOSPITAL OF EUREKA DOES NOT HAVE A PROGRAM IN PLACE TO DIRECTLY PREVENT ASTHMA OCCURRENCE IN OUR SERVICE AREA; HOWEVER, WE PARTNER WITH SEVERAL ENTITIES, INCLUDING THE PUBLIC HEALTH DEPARTMENT THAT DO ADDRESS ASTHMA PREVENTION. FURTHERMORE, OUR EFFORTS TO IMPROVE THE QUALITY OF HOUSING IN OUR SERVICE HAS THE POTENTIAL TO IMPACT ASTHMA OCCURRENCE.IN ADDITION, ST. JOSEPH HOSPITAL OF EUREKA WILL COLLABORATE WITH LOCAL ORGANIZATION(S) THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS. SCHEDULE H, PART V, SECTION B, LINE 13H FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALTHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.QUEEN OF THE VALLEY MEDICAL CENTERBASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALTHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKATHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 16A FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALFINANCIAL ASSISTANCE POLICYHTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/QUEEN OF THE VALLEY MEDICAL CENTERFINANCIAL ASSISTANCE POLICYHTTPS://WWW.THEQUEEN.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIALASSISTANCE/FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALFINANCIAL ASSISTANCE POLICYHTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAFINANCIAL ASSISTANCE POLICYHTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16B FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/QUEEN OF THE VALLEY MEDICAL CENTERFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.THEQUEEN.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIALASSISTANCE/FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINAN CIAL-ASSISTANCE/FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16C FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALPLAIN LANGUAGE SUMMARYHTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/QUEEN OF THE VALLEY MEDICAL CENTERPLAIN LANGUAGE SUMMARYHTTPS://WWW.THEQUEEN.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIALASSISTANCE/FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALPLAIN LANGUAGE SUMMARYHTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAPLAIN LANGUAGE SUMMARYHTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 16J FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALTHE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.ADDITIONALLY, A PATIENT INFORMATION BROCHURE THAT DESCRIBES THE FEATURES OF THE SJH FINANCIAL ASSISTANCE PROGRAM WILL BE MADE AVAILABLE TO PATIENT AND MEMBERS OF THE GENERAL PUBLIC.QUEEN OF THE VALLEY MEDICAL CENTERTHE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.ADDITIONALLY, A PATIENT INFORMATION BROCHURE THAT DESCRIBES THE FEATURES OF THE SJH FINANCIAL ASSISTANCE PROGRAM WILL BE MADE AVAILABLE TO PATIENT AND MEMBERS OF THE GENERAL PUBLIC.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALTHE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS TO PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON REQUEST. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.ADDITIONALLY, A PATIENT INFORMATION BROCHURE THAT DESCRIBES THE FEATURES OF THE SJH FINANCIAL ASSISTANCE PROGRAM WILL BE MADE AVAILABLE TO PATIENT AND MEMBERS OF THE GENERAL PUBLIC.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKATHE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.ADDITIONALLY, A PATIENT INFORMATION BROCHURE THAT DESCRIBES THE FEATURES OF THE SJH FINANCIAL ASSISTANCE PROGRAM WILL BE MADE AVAILABLE TO PATIENT AND MEMBERS OF THE GENERAL PUBLIC. SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINES 4 AND 8 THE FILING ORGANIZATION COMPLETED A CHNA PRIOR TO ITS JUNE 30, 2017 YEAR END. DURING 2017, THE FILING ORGANIZATION CHANGED ITS TAX YEAR END FROM JUNE 30 TO DECEMBER 31 IN 2017. AS A RESULT OF THIS CHANGE, A SHORT PERIOD TAX RETURN WAS FILED FOR THE PERIOD JULY 1, 2017 TO DECEMBER 31, 2017. THE FILING ORGANIZATION ADOPTED A CHNA FOR TAX YEAR 2019 AND WHILE ALL OF THE STEPS WERE COMPLETED PRIOR TO THE FILING OF THIS RETURN, THEY WERE NOT COMPLETED BY DECEMBER 31, 2019. THE COMPLETION OF THE CHNA AFTER DECEMBER 31, 2019 IS NOT AN IRC 501(R) FAILURE PURSUANT TO SECTION 1.501(R)-2(B) OF THE REGULATIONS BECAUSE IT WAS MINOR, INADVERTENT AND DUE TO REASONABLE CAUSE, AND HAS BEEN CORRECTED. IT WAS MINOR BECAUSE IT WAS A SINGLE TIMING ERROR BY A FILING ORGANIZATION OTHERWISE COMPLIANT WITH SECTION 501(R). IT WAS INADVERTENT AND DUE TO REASONABLE CAUSE BECAUSE THE SAME ERROR HAS NOT BEEN MADE PREVIOUSLY AND THE FILING ORGANIZATION HAS AN ESTABLISHED PROCESS FOR COMPLETING CHNAS. THE FILING ORGANIZATION IS AFFILIATED WITH A LARGE HEALTH SYSTEM WHERE THE COMPLETION OF THE CHNA IS COORDINATED ON A SYSTEM-WIDE LEVEL BY A TEAM DEDICATED TO COMMUNITY HEALTH IMPROVEMENT. IT HAS BEEN CORRECTED THROUGH THE COMPLETION OF THE CHNA PRIOR TO FILING THE 2019 FORM 990 AND BY MAKING THE RESULTS OF THE 2019 CHNA WIDELY AVAILABLE. 27 1 - REDWOOD REGIONAL MEDICAL GROUP INC 3555 ROUND BARN CIRCLE SANTA ROSA CA 95403 ONCOLOGY SERVICES 2 - SANTA ROSA AMBULATORY SURGERY CENTER 525 DOYLE PARK DRIVE SANTA ROSA CA 95401 AMBULATORY SURGERY CENTER 3 - OUTPATIENT ONCOLOGY SERVICES 110 LYNCH CREEK WAY SUITE A PETALUMA CA 94594 ONCOLOGY SERVICES 4 - OUTPATIENT IMAGING CENTER 121 SOTOYOME STREET SANTA ROSA CA 95405 IMAGING SERVICES 5 - ADVANCED SURGERY INSTITUTE 1739 4TH STREET SANTA ROSA CA 95404 SURGERY CENTER 6 - OUTPATIENT IMAGING CENTER 2330 BUHNE STREET EUREKA CA 95501 IMAGING CENTER 7 - NORTHCOAST SURGERY CENTER 2705 HARRIS AVENUE EUREKA CA 95501 SURGERY CENTER 8 - SANTA ROSA MEMORIAL OUTPATIENT LAB 500 DOYLE PARK DRIVE SANTA ROSA CA 95405 LABORATORY SERVICES 9 - BEHAVIORAL HEALTH 405 W COLLEGE AVE SUITE F SANTA ROSA CA 95405 BEHAVIORAL HEALTH SERVICES 10 - HUMBOLDT HOME INFUSION PROGRAM 2612 HARRISON AVE EUREKA CA 95501 AMBULATORY HOME INFUSION 11 - PHYSICAL THERAPY 131 STONY CIRCLE SUITE 2000 SANTA ROSA CA 95401 PHYSICAL THERAPY 12 - SYNERGY HEALTH CLUB 1201 REDWOOD HWY PETALUMA CA 94954 HEALTH CLUB 13 - SLEEP DISORDERS CENTER 2367 23RD STREET EUREKA CA 95501 SLEEP CLINIC 14 - OUTPATIENT REHABILITATION CENTER 2024 HARRISON AVENUE EUREKA CA 95501 REHABILITATION CENTER 15 - URGENT CARE - SANTA ROSA 925 CORPORATE CENTER PARKWAY DR STE A SANTA ROSA CA 95409 URGENT CARE 16 - SYNERGY HEALTH CLUB 3421 VILLA LANE NAPA CA 94558 REHABILITATION CENTER 17 - WEST COUNTY HAND & PT 968 GRAVENSTEIN HWY S SEBASTOPOL CA 94572 PHYSICAL THERAPY 18 - SLEEP MEDICINE INSTITUTE 585 W COLLEGE AVE SANTA ROSA CA 95401 SLEEP CLINIC 19 - SLEEP MEDICINE INSTITUTE 1476 PROFESSIONAL DR PETALUMA CA 94954 SLEEP CLINIC 20 - URGENT CARE - ROHNERT PARK 1450 MEDICAL CENTER DRIVE ROHNERT PARK CA 94928 URGENT CARE 21 - WOUND CARE CLINIC 500 DOYLE PARK DRIVE SANTA ROSA CA 95405 WOUND CARE 22 - NAPA PROMPT CARE 1621 W IMOLA AVE NAPA CA 94559 URGENT CARE 23 - LAB DRAW STATION 980 TRANCAS STREET SUITE 11 NAPA CA 94558 LABORATORY SERVICES 24 - URGENT CARE - WINDSOR 6580 HEMBREE LANE SUITE 270 WINDSOR CA 95492 URGENT CARE 25 - ORTHOPEDIC PHYSICAL THERAPY 1255 NORTH DUTTON AVE SUITE B SANTA ROSA CA 95401 PHYSICAL THERAPY 26 - SANTA ROSA MEMORIAL HOSPITAL ANNEX 151 SOTOYOME STREET SANTA ROSA CA 95405 STEP-DOWN UNIT 27 - ST JOSEPH DENTAL CLINICMOBILE VAN 1450 MEDICAL CENTER DRIVE SUITE 1 ROHNERT PARK CA 94928 DENTAL SERVICES SCHEDULE H, PART I, LINE 3C FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALIN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.QUEEN OF THE VALLEY MEDICAL CENTERIN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALIN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAIN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. SCHEDULE H, PART I, LINE 6A FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALSANTA ROSA MEMORIAL HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/QUEEN OF THE VALLEY MEDICAL CENTERQUEEN OF THE VALLEY MEDICAL CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALREDWOOD MEMORIAL HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT:HTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAST. JOSEPH HOSPITAL OF EUREKA PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: HTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ SCHEDULE H, PART I, LINE 7A-7I FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALTHE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.QUEEN OF THE VALLEY MEDICAL CENTERTHE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITAL THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING WORKSHEET 2, A COST-TO-CHARGE RATIO AND GENERAL LEDGER.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKATHE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. SCHEDULE H, PART I, LINE 7, COLUMN (F) FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALTHE PROPORTIONATE SHARE OF THE ORGANIZATION'S JOINT VENTURE EXPENSES HAVE BEEN INCLUDED IN THE CALCULATION OF THE COMMUNITY BENEFIT EXPENSE PERCENTAGES. SCHEDULE H, PART I, LINE 7G FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALNO COSTS ATTRIBUTED TO PHYSICIAN CLINICS WERE INCLUDED.QUEEN OF THE VALLEY MEDICAL CENTERNO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALNO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKANO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. SCHEDULE H, PART II FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALCOMMUNITY BUILDING ACTIVITIES:NEIGHBORHOOD CARE STAFF (NCS) PROGRAM SERVES AS THE COMMUNITY OUTREACH AND ENGAGEMENT ARM OF THE COMMUNITY BENEFIT DEPARTMENT. NCS STAFF ENGAGE COMMUNITY RESIDENT LEADERS AND AGENCY PARTNERS TO ADDRESS LOCAL COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES, FACILITATE COMMUNITY CONVERSATIONS AND PLANNING, SUPPORT COLLABORATIVE INITIATIVES, AND DRIVE POLICY AND PROGRAM DEVELOPMENTS EMERGING FROM THESE EFFORTS. OUR NCS STAFF ALSO WORK IN TARGET COMMUNITIES OF NEED THROUGHOUT THE COUNTY, ORGANIZING COMMUNITY ENGAGEMENT BY RESIDENTS AT THE NEIGHBORHOOD LEVEL. THESE EFFORTS INCLUDED THE ONGOING COLLECTION OF RESIDENT FEEDBACK IDENTIFYING ISSUES OF CONCERN AND NEED FOR THEM IN THEIR NEIGHBORHOODS AND DEVELOPING STRATEGIES FOR CREATING AND ADVOCATING FOR SOLUTIONS.IN CLOVERDALE, THE "FAMILIAS EN ACCION POSITIVA", THROUGH SUPPORT PROVIDED BY OUR NCS ORGANIZERS, FORMALIZED ITSELF AS AN ONGOING COMMUNITY RESIDENT GROUP WITH AN ESTABLISHED LEADERSHIP STRUCTURE AND BEGAN PARTNERING WITH THE CLOVERDALE COMMUNITY PARTNERSHIP TO FORM A SONOMA COUNTY HEALTH ACTION CHAPTER. IN GUERNEVILLE, THE NCS ORGANIZER HAS ORGANIZED AN ONGOING POETRY GROUP AT WEST COUNTY COMMUNITY SERVICES EMPOWERMENT CENTER, A DROP-IN SITE FOR LOCAL HOMELESS AND MENTALLY ILL RESIDENTS. BUILDING ON THIS, THE LOCAL COMMUNITY HEALTH CENTER HAS PARTNERED WITH THE GROUP IN ORGANIZING AN OPIOID ADDICITON PROJECT.NCS ALSO PROVIDES BILINGUAL LEADERSHIP AND ADVOCACY TRAINING TO COMMUNITY LEADERS IN VULNERABLE NEIGHBORHOODS IN SONOMA COUNTY, AS WELL AS TO MEMBERS OF COMMUNITY GROUPS, LOCAL ORGANIZATIONS, AND ASSOCIATIONS THROUGH THEIR A.C.T.I.O.N. (AGENTS OF CHANGE TRAINING IN OUR NEIGHBORHOODS) TRAINING. THIS INITIATIVE WORKS TO ENGAGE AND TRAIN COMMUNITY LEADERS TO PROACTIVELY RESPOND TO THE NEEDS OF THEIR COMMUNITY.WE ARE ALSO FUNDERS OF A LATINO LEADERSHIP DEVELOPMENT PROGRAM KNOWN AS "ON THE VERGE." THIS IS A YEAR-LONG COHORT MODEL LEADERSHIP DEVELOPMENT PROGRAM AIMED AT EARLY CAREER LATINO PROFESSIONALS. NOW IN ITS SECOND YEAR, THE INITIAL COHORT IS DEVELOPING A BILINGUAL MENTAL HEALTH DROP-IN CENTER OFFERING CULTURALLY APPROPRIATE COUNSELING AND SUPPORT SERVICES. FURTHER SUPPORT FOR THE DEVELOPMENT OF THIS CENTER WILL ALSO INCLUDE LEADERSHIP DEVELOPMENT OPPORTUNITIES FOR LATINO RESIDENTS, PRIMARILY YOUTH.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKACOMMUNITY BUILDING ACTIVITIESTHE ORGANIZATION PURCHASED PRODUCE AND GRASS FED BEEF FROM LOCAL FARMERS AND RANCHERS THUS REDUCING ITS CARBON FOOTPRINT AND SUPPORTING THE LOCAL AG ECONOMY. THE ORGANIZATION ALSO INVESTED STAFF TIME IN CREATING A HEALTH CAREERS SUMMER INSTITUTE FOR LOCAL HIGH SCHOOL STUDENTS INTERESTED IN HEALTH CAREERS IN PARTNERSHIP WITH THE HUMBOLDT COUNTY OFFICE OF EDUCATION AND LOCAL AREA HIGH SCHOOLS. SCHEDULE H, PART III, SECTION A, LINE 2 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALMETHODOLOGY FOR CALCULATING BAD DEBTTHE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE.QUEEN OF THE VALLEY MEDICAL CENTERMETHODOLOGY FOR CALCULATING BAD DEBTTHE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALMETHODOLOGY FOR CALCULATING BAD DEBTTHE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAMETHODOLOGY FOR CALCULATING BAD DEBTTHE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 3 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALTHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY.QUEEN OF THE VALLEY MEDICAL CENTERTHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTICY AND QUALICY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALCRITERIA USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKATHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, SECTION A, LINE 4 SANTA ROSA MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, REDWOOD MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL OF EUREKAFOOTNOTE FROM THE PROVIDENCE ST. JOSEPH HEALTH COMBINED FINANCIAL STATEMENTS FOR YEAR ENDED 12/31/19AS A RESULT OF ADOPTING ASU 2014-09 , THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019.THE HEALTH SYSTEM PROVIDES FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS. THERE ARE VARIOUS FACTORS THAT CAN IMPACT THE COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF COPAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE COVERAGE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS USED BY THE HEALTH SYSTEM. THE HEALTH SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF PAST EXPERIENCE, WHICH HAS HISTORICALLY INDICATED THAT MANY PATIENTS ARE UNRESPONSIVE OR ARE OTHERWISE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. SCHEDULE H, PART III, SECTION B, LINE 8 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALCOMMUNITY BENEFITSTHE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.QUEEN OF THE VALLEY MEDICAL CENTERCOMMUNITY BENEFITSTHE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALCOMMUNITY BENEFITS THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKACOMMUNITY BENEFITSTHE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION C, LINE 9B FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALCOLLECTION ACTIVITYPATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTICY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.QUEEN OF THE VALLEY MEDICAL CENTERCOLLECTION ACTIVITYPATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTICY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALCOLLECTION ACTIVITYPATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTICY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKACOLLECTION ACTIVITYPATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTICY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. SCHEDULE H, PART VI, LINE 2 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALNEEDS ASSESSMENT:THE GOAL OF THE CHNA DATA DEVELOPMENT PROCESS WAS TO GATHER, ANALYZE, AND SUMMARIZE CURRENT LOCAL DATA ON THE RESIDENTS OF SONOMA COUNTY, THEIR HEALTH STATUS AND THE VARIETY OF FEATURES AND CONDITIONS WHICH IMPACT THEIR HEALTH, HEALTHY DEVELOPMENT AND QUALITY OF LIFE. TO ACCOMPLISH THIS, THE CHNA PARTNERS DEVELOPED AND UTILIZED BOTH PRIMARY AND SECONDARY DATA SOURCES. THE PARTNERS CONDUCTED THE FOLLOWING ACTIVITIES TO CREATE THE FY17 SONOMA COUNTY CHNA:- DEMOGRAPHIC SUMMARY: DEVELOPED A DEMOGRAPHIC SUMMARY OF SONOMA COUNTY'S CURRENT POPULATION ALONG WITH POPULATION GROWTH PROJECTIONS WHEN AVAILABLE. INFORMATION IS PROVIDED ON A VARIETY OF DEMOGRAPHIC INDICATORS INCLUDING POPULATION DISTRIBUTION, AGE, ETHNICITY, INCOME, HEALTHCARE COVERAGE, EDUCATION AND EMPLOYMENT.- SECONDARY SOURCES: ASSEMBLED SUMMARY DATA FROM A VARIETY OF SECONDARY SOURCES IDENTIFYING HEALTH BEHAVIORS AND CONDITIONS THAT COMPROMISE THE HEALTH AND HEALTHY DEVELOPMENT OF CHILDREN AND CONTRIBUTE MOST PROMINENTLY TO ILLNESS AND INJURY, DISABILITY AND DEATH FOR SONOMA COUNTY ADULTS AND CHILDREN. WHERE KNOWN, INFORMATION ON CONTRIBUTING FACTORS IS PRESENTED ALONG WITH EACH HEALTH INDICATOR. HEALTH DISPARITIES ARE HIGHLIGHTED.- KEY INFORMANT INTERVIEWS AND FOCUS GROUPS: CONDUCTED KEY INFORMANT INTERVIEWS, COMMUNITY-BASED FOCUS GROUPS AND A COUNTRYWIDE RANDOM TELEPHONE SURVEY TO GATHER DATA ON HEALTH STATUS AND ELICIT INFORMATION ON COMMUNITY HEALTH ISSUES OF GREATEST CONCERN AND PERSPECTIVES ON LOCAL OPPORTUNITIES TO IMPROVE POPULATION HEALTH AND/OR THE HEALTHCARE DELIVERY SYSTEM.PRIORITY COMMUNITY HEALTH NEEDS:THE PRIORITIZED COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE FY17 CHNA PROCESS INCLUDE THE FOLLOWING.1. HEALTHY EATING AND PHYSICAL FITNESS2. GAPS IN ACCESS TO PRIMARY CARE3. ACCESS TO SERVICES FOR SUBSTANCE USE DISORDERS4. BARRIERS TO HEALTHY AGING5. ACCESS TO MENTAL HEALTH SERVICES6. DISPARITIES IN EDUCATIONAL ATTAINMENT7. CARDIOVASCULAR DISEASE8. ADVERSE CHILDHOOD EXPERIENCES OR EXPOSURE TO STRESS (ACES)9. ACCESS TO HEALTH CARE COVERAGE10. TOBACCO USE11. COORDINATION AND INTEGRATION OF LOCAL HEALTH CARE SYSTEM12. DISPARITIES IN ORAL HEALTH13. LUNG, BREAST, AND COLORECTAL CANCERNEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH COMMUNITY BENEFIT PROGRAMMING AND BY FUNDING OTHER NONPROFIT ORGANIZATIONS THROUGH OUR CARE FOR THE POOR PROGRAM MANAGED BY SRMH.FURTHERMORE, SANTA ROSA MEMORIAL HOSPITAL WILL ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES, RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGH ST. JOSEPH HEALTH COMMUNITIES.QUEEN OF THE VALLEY MEDICAL CENTERNEEDS ASSESSMENTIN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, QUEEN OF THE VALLEY COMMUNITY BENEFIT STAFF ARE MEMBERS OF LIVE HEALTHY NAPA COUNTY (LHNC). NAPA COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LHNC, AND THIS THE PUBLIC PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 40 AGENCIES. LHNC MEETS REGULARLY, HAS A WEB SITE AND SENDS ELECTRONIC NEWSLETTERS AND UPDATES FOR ANY URGENT COMMUNITY NEEDS THAT ARISE BETWEEN MEETINGS. IN ADDITION TO LHNC, QUEEN OF THE VALLEY STRATEGIC SERVICES CONDUCT ANALYSIS AND REPORT ON COMMUNITY NEEDS AND TRENDS.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALNEEDS ASSESSMENTIN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, REDWOOD MEMORIAL HOSPITAL COMMUNITY BENEFIT STAFF ARE CORE MEMBERS OF MULTIPLE CROSS-SECTOR COLLABORATIVES INCLUDING LIVE WELL HUMBOLDT (LWH). HUMBOLDT COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LWH, AND THIS PUBLIC AND PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 20 AGENCIES.FRONTLINE CB CAREGIVERS ALSO PROVIDE ONGOING INFORMATION AND FEEDBACK ABOUT NEEDS THEIR CLIENTS FACE IN REAL TIME. THE ORGANIZATION ALSO PARTNERS WITH HUMBOLDT STATE UNIVERSITY AND OTHER NONPROFITS TO CONDUCT SURVEYS OF VULNERABLE POPULATIONS. IN ADDITION TO LWH, REDWOOD MEMORIAL HOSPITAL STRATEGIC SERVICES CONDUCT ANALYSIS AND REPORT ON COMMUNITY NEEDS AND TRENDS.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKANEEDS ASSESSMENTIN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, ST. JOSEPH HOSPITAL COMMUNITY BENEFIT STAFF ARE CORE MEMBERS OF MULTIPLE CROSS-SECTOR COLLABORATIVES INCLUDING LIVE WELL HUMBOLDT (LWH). HUMBOLDT COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LWH, AND THIS PUBLIC AND PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 20 AGENCIES. FRONTLINE CB CAREGIVERS ALSO PROVIDE ONGOING INFORMATION AND FEEDBACK ABOUT NEEDS THEIR CLIENTS FACE IN REAL TIME. THE ORGANIZATION ALSO PARTNERS WITH HUMBOLDT STATE UNIVERSITY AND OTHER NONPROFITS TO CONDUCT SURVEYS OF VULNERABLE POPULATIONS. IN ADDITION TO LWH, ST. JOSEPH HOSPITAL STRATEGIC SERVICES CONDUCT ANALYSIS AND REPORT ON COMMUNITY NEEDS AND TRENDS. SCHEDULE H, PART VI, LINE 3 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ONE WAY SRMH INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ONE WAY RMH INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEONE WAY SJHE INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. SCHEDULE H, PART VI, LINE 4 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALCOMMUNITY INFORMATION:SANTA ROSA MEMORIAL HOSPITAL (SRMH), FOUNDED BY THE SISTERS OF ST. JOSEPH OF ORANGE, HAS BEEN SERVING THE HEALTHCARE NEEDS OF FAMILIES IN THE COMMUNITY FOR MORE THAN 60 YEARS. DURING THIS TIME, ITS MISSION HAS REMAINED THE SAME: TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES SERVED. PART OF A LARGER HEALTHCARE SYSTEM KNOWN AS PROVIDENCE ST. JOSEPH HEALTH (PSJH), SRMH IS PART OF A COUNTYWIDE MINISTRY THAT INCLUDES TWO HOSPITALS, URGENT CARE FACILITIES, HOSPICE, HOME HEALTH SERVICES, AND OTHER FACILITIES FOR TREATING THE HEALTHCARE NEEDS OF THE COMMUNITY IN SONOMA COUNTY AND THE REGION. THE MINISTRY'S CORE FACILITIES ARE PETALUMA VALLEY HOSPITAL (PVH), AN 80-BED ACUTE CARE HOSPITAL, AND SRMH, A FULL SERVICE, STATE OF THE ART 330-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER. MAJOR PROGRAMS AND SERVICES INCLUDE CRITICAL CARE, CARDIOVASCULAR CARE, STROKE CARE, WOMEN'S AND CHILDREN'S SERVICES, CANCER CARE, AND ORTHOPEDICS. SRMH IS HOME TO THE NORMA & EVERT PERSON HEART & VASCULAR INSTITUTE AND THE UCSF NEONATAL INTENSIVE CARE NURSERY.SRMH PROVIDES SOUTHERN MENDOCINO, NORTHERN MARIN, AND SONOMA COUNTIES' COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM UKIAH IN THE NORTH, MARSHALL IN THE SOUTH, SONOMA VALLEY IN THE EAST AND BODEGA BAY IN THE WEST. SRMH'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF SANTA ROSA, PETALUMA, SEBASTOPOL, WINDSOR, HEALDSBURG, ROHNERT PARK, COTATI, SONOMA, CLOVERDALE, UKIAH, AND POINT ARENA.DEFINING THE COMMUNITY:SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE COUNTY'S TOTAL POPULATION WAS ESTIMATED AT 487,011 AT THE TIME OF THE CHNA. SINCE 2006, THE COUNTY POPULATION HAS GROWN AT AN OVERALL RATE OF 1.8% WITH THE CITIES OF SONOMA, SANTA ROSA AND WINDSOR EXPERIENCING THE FASTEST GROWTH RATES. ACCORDING TO PROJECTIONS FROM THE CALIFORNIA DEPARTMENT OF FINANCE, THE COUNTY POPULATION IS PROJECTED TO GROW BY 8.3% TO 546,204 IN 2020. THIS RATE OF GROWTH IS LESS THAN THAT PROJECTED FOR CALIFORNIA AS A WHOLE (10.1%).THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION ESTIMATED TO BE NEARLY 171,000 IN 2012 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. AT LEAST PART OF SONOMA COUNTY, CALIFORNIA, IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). THE AREA IS 0.8 SQUARE MILES AND IS LOCATED NEAR DOWNTOWN SANTA ROSA. THE CLOVERDALE AREA IN SONOMA COUNTY IS A DESIGNATED PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (PC-HSPA). THERE ARE 6,888 CIVILIAN RESIDENTS IN THIS AREA, WHICH IS 307.5 TOTAL SQUARE MILES.SRMH PROVIDES SONOMA COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL IS LOCATED IN DOWNTOWN SANTA ROSA, ABOUT 55 MILES NORTH OF SAN FRANCISCO JUST OFF THE HIGHWAY 101 CORRIDOR IN CENTRAL SONOMA COUNTY. SRMH'S PRIMARY SERVICE AREA IS LIMITED TO A TIGHT RADIUS, BUT ITS SECONDARY SERVICE AREA COMPRISES THE ENTIRE COUNTY, PLUS NORTHERN MARIN COUNTY AND SOUTHERN MENDOCINO COUNTY. THE CHNA PROCESS AND DATA GATHERING ADDRESSES SONOMA COUNTY. FOR A COMPLETE COPY OF THE 2017 SRMH CHNA SEE: HTTPS://WWW.STJOESONOMA.ORG/DOCUMENTS/COMMUNITY-BENEFIT/SRMH-CHNA-FY17.PDFSONOMA COUNTY'S UNINCORPORATED AREAS ARE HOME TO 146,739 RESIDENTS, 30.1% OF THE TOTAL POPULATION. A SIGNIFICANT NUMBER OF THESE INDIVIDUALS LIVE IN LOCATIONS THAT ARE VERY RURAL AND GEOGRAPHICALLY REMOTE. RESIDENTS OF THESE AREAS MAY EXPERIENCE SOCIAL ISOLATION AND SIGNIFICANT BARRIERS IN ACCESSING BASIC SERVICES AND SUPPORTS SUCH AS TRANSPORTATION, HEALTH CARE, NUTRITIOUS FOOD AND OPPORTUNITIES TO SOCIALIZE. LOW INCOME AND SENIOR POPULATIONS LIVING IN REMOTE AREAS MAY FACE SPECIAL CHALLENGES IN MAINTAINING HEALTH AND QUALITY OF LIFE. OF THE COUNTY'S TOTAL SENIOR POPULATION, AGE 60 AND OLDER, 12,144 (12%) ARE CONSIDERED "GEOGRAPHICALLY ISOLATED" AS DEFINED BY THE OLDER AMERICANS ACT.SRMH TOTAL SERVICE AREA:THE COMMUNITY SERVED BY SRMH IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF SRMH'S INPATIENTS. THE SRMH TOTAL SERVICE AREA IS COMPRISED OF BOTH THE PRIMARY SERVICE AREA (PSA) AS WELL AS THE SECONDARY SERVICE AREA (SSA) AND IS ESTABLISHED BASED ON THE FOLLOWING CRITERIA:- PSA: 70% OF DISCHARGES (EXCLUDING NORMAL NEWBORNS)- SSA: 71%-85% OF DISCHARGES (DRAW RATES PER ZIP CODE ARE CONSIDERED AND PSA/SSA ARE MODIFIED ACCORDINGLY)- INCLUDES ZIP CODES FOR CONTINUITY- NATURAL BOUNDARIES ARE CONSIDERED (I.E., FREEWAYS, MOUNTAIN RANGES, ETC.)- CITIES ARE PLACED IN PSA OR SSA, BUT NOT BOTH.THE PSA IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF SRMH'S PATIENTS ORIGINATE. THE CITIES AND TOWNS IN THE SRMH PSA INCLUDE SANTA ROSA, SEBASTOPOL, WINDSOR, FORESTVILLE, ROHNERT PARK AND COTATI/PENNGROVE. THE SSA IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE SSA INCLUDES ALL OF SONOMA COUNTY, UKIAH TO THE NORTH IN MENDOCINO COUNTY, AND NORTHERN MARIN COUNTY TO THE SOUTH. THE POPULATION OF THE SERVICE AREA IS 835,741, OF WHICH 328,005 ARE IN THE PSA AND 507,736 RESIDE IN THE SSA.COMMUNITY NEED INDEX (ZIP CODE LEVEL) BASED ON NATIONAL NEED:THE COMMUNITY NEED INDEX (CNI) WAS DEVELOPED BY DIGNITY HEALTH AND TRUVEN HEALTH ANALYTICS. THE CNI IDENTIFIES THE SEVERITY OF HEALTH DISPARITY FOR EVERY ZIP CODE IN THE UNITED STATES AND DEMONSTRATES THE LINK BETWEEN COMMUNITY NEED, ACCESS TO CARE, AND PREVENTABLE HOSPITALIZATIONS.CNI AGGREGATES FIVE SOCIOECONOMIC INDICATORS THAT CONTRIBUTE TO HEALTH DISPARITY (ALSO KNOWN AS BARRIERS):- INCOME BARRIERS (ELDER POVERTY, CHILD POVERTY AND SINGLE PARENT POVERTY)- CULTURE BARRIERS (NON-CAUCASIAN LIMITED ENGLISH);- EDUCATIONAL BARRIERS (% POPULATION WITHOUT HS DIPLOMA);- INSURANCE BARRIERS (INSURANCE, UNEMPLOYED AND UNINSURED);- HOUSING BARRIERS (HOUSING, RENTING PERCENTAGE).THIS OBJECTIVE MEASURE IS THE COMBINED EFFECT OF FIVE SOCIOECONOMIC BARRIERS (INCOME, CULTURE, EDUCATION, INSURANCE AND HOUSING). A SCORE OF 1.0 INDICATES A ZIP CODE WITH THE FEWEST SOCIOECONOMIC BARRIERS, WHILE A SCORE OF 5.0 REPRESENTS A ZIP CODE WITH THE MOST SOCIOECONOMIC BARRIERS. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATIONS FOR MANAGEABLE CONDITIONS SUCH AS EAR INFECTIONS, PNEUMONIA OR CONGESTIVE HEART FAILURE COMPARED TO COMMUNITIES WITH THE LOWEST CNI SCORES. (REF ROTH R, BARSI E., HEALTH PROG. 2005 JUL-AUG; 86(4):32-8.) THE CNI IS USED TO A DRAW ATTENTION TO AREAS THAT NEED ADDITIONAL INVESTIGATION SO THAT HEALTH POLICY AND PLANNING EXPERTS CAN MORE STRATEGICALLY ALLOCATE RESOURCES.FOR EXAMPLE, THE ZIP CODE 95407 ON THE CNI MAP IS SCORED 4.2, MAKING IT A HIGH NEED COMMUNITY.THE MINISTRY'S SERVICE AREA IS ALSO SERVED BY SUTTER SANTA ROSA REGIONAL HOSPITAL AND KAISER PERMANENTE SANTA ROSA MEDICAL CENTER AND MEDICAL OFFICES.QUEEN OF THE VALLEY MEDICAL CENTERCOMMUNITY INFORMATIONQUEEN OF THE VALLEY MEDICAL CENTER'S TOTAL HOSPITAL SERVICE AREA (TSA) INCLUDES APPROXIMATELY 167,000 PEOPLE AND PORTIONS OF NAPA AND SONOMA COUNTIES. THE PRIMARY SERVICE AREA (PSA) CONSISTS OF THE ZIP CODES FOR THE CITIES OF NAPA AND YOUNTVILLE, AND THE SECONDARY SERVICE AREA CONSISTS OF THE CITIES OF AMERICAN CANYON, ST. HELENA, AND BOYES HOT SPRINGS IN SONOMA. OVER 75% OF THE POPULATION OF THE TSA IS IN NAPA COUNTY, AND APPROXIMATELY 90% OF NAPA COUNTY'S POPULATION IS WITHIN THE TSA.A PREMIUM WINE PRODUCING REGION, THERE IS A LARGE AGRICULTURE AND HOSPITALITY INDUSTRY. ALTHOUGH OFTEN VIEWED AS A COMMUNITY OF WEALTH, THE LARGE NUMBER OF LOW WAGE EARNERS IN THESE INDUSTRIES COMBINED WITH THE HIGH COST OF LIVING LEND TO POCKETS OF POVERTY AND INDIVIDUALS AND FAMILIES HAVING DIFFICULTY MEETING BASIC NEEDS.ETHNIC DIVERSITY OF THE TSA INCLUDE 33.5% LATINO, 54.8% NON-LATINO WHITE WITH 7.2% ASIAN/PACIFIC ISLANDER AND 1.7% BLACK. 16.2% OF THE TSA DO NOT SPEAK ENGLISH "VERY WELL".THE MEDIAN HOUSEHOLD INCOME IS $68,468 WITH 22.1% HOUSEOLDS BELOW 200% OF THE FPL AND 7.6% LIVING BELOW 100% FPL. SCHEDULE H, PART VI, LINE 4 (CONTINUED) 15.4% OF CHILDREN AND 7.1% OF OLDER ADULTS LIVE 100% BELOW FPL. QUEEN OF THE VALLEY'S TSA HAS A HIGHER PERCENTAGE OF OLDER ADULTS (18.5%) THAN THE MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED.MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE". MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. QUEEN OF THE VALLEY, ALONG WITH THE MAJORITY OF THE TSA IS LOCATED IN A MEDICALLY UNDERSERVED POPULATIONS AREA, SIGNIFYING THE IMPORTANCE OF THE MEDICAL CENTER TO THE COMMUNITY IT SERVES STATE.THERE IS ONE OTHER HOSPITAL IN THE COMMUNITY: ST. HELENA HOSPITAL.HEALTH PROFESSIONS SHORTAGE AREA - MENTAL, DENTAL, OTHER THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS).ALTHOUGH QUEEN OF THE VALLEY IS NOT LOCATED IN A HEALTH PROFESSIONS SHORTAGE AREA, LARGE PORTIONS OF THE SERVICE AREA TO THE WEST AND NORTH ARE DESIGNATED SHORTAGE AREAS. FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALCOMMUNITY INFORMATIONREDWOOD MEMORIAL HOSPITAL PROVIDES THE RURAL NORTH COAST AND EEL RIVER VALLEY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM EUREKA IN THE NORTH, REDWAY IN THE SOUTH, BRIDGEVILLE IN THE EAST AND IS BORDERED BY THE PACIFIC OCEAN IN THE WEST. OUR HOSPITAL TOTAL SERVICE AREA INCLUDES THE CITIES OF EUREKA, FORTUNA, FERNDALE, RIO DELL AND THE UNINCORPORATED COMMUNITIES OF LOLETA, HYDESVILLE, CARLOTTA, BRIDGEVILLE, SCOTIA, REDCREST, MYERS FLAT, MIRANDA AND REDWAY. THIS INCLUDES A POPULATION OF APPROXIMATELY 78,428 PEOPLE.HOSPITAL TOTAL SERVICE AREA:THE COMMUNITY SERVED BY THE HOSPITAL IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF THE HOSPITAL'S INPATIENTS. THE HOSPITAL TOTAL SERVICE AREA IS THE COMPRISED OF BOTH THE PRIMARY SERVICE AREA (PSA) AS WELL AS THE SECONDARY SERVICE AREA (SSA) AND IS ESTABLISHED BASED ON THE FOLLOWINGCRITERIA:- PSA: 70% OF DISCHARGES (EXCLUDING NORMAL NEWBORNS)- SSA: 71%-85% OF DISCHARGES (DRAW RATES PER ZIP CODE ARE CONSIDERED AND PSA/SSA ARE MODIFIED ACCORDINGLY)- INCLUDES ZIP CODES FOR CONTINUITY- NATURAL BOUNDARIES ARE CONSIDERED (I.E., FREEWAYS, MOUNTAIN RANGES, ETC.)- CITIES ARE PLACED IN PSA OR SSA, BUT NOT BOTHTHE PRIMARY SERVICE AREA ("PSA") IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF THE HOSPITAL'S PATIENTS ORIGINATE. THE SECONDARY SERVICE AREA ("SSA") IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE PSA IS COMPRISED OF FORTUNA, RIO DELL, EUREKA, FERNDALE AND LOLETA. THE SSA IS COMPRISED OF HYDESVILLE, SCOTIA, CARLOTTA, REDWAY, MYERS FLAT, BRIDGEVILLE, MIRANDA AND REDCREST.THE TOTAL SERVICE AREA (TSA) OF REDWOOD MEMORIAL HOSPITAL INCLUDES APPROXIMATELY 78,000 PEOPLE, OF WHICH 91% IS IN THE PRIMARY SERVICE AREA (PSA). THE SECONDARY SERVICE AREA CONSISTS ENTIRELY OF SMALLER INLAND COMMUNITIES. THE TSA COMPRISES 57% OF THE POPULATION OF HUMBOLDT COUNTY, INCLUDING THE POPULATION CENTERS OF EUREKA AND FORTUNA, BUT EXCLUDING ARCATA AND MCKINLEYVILLE. THERE ARE NOT SUBSTANTIAL DIFFERENCES BETWEEN THE TSA AND COUNTY, BUT THERE ARE MANY COMPARED TO THE STATE. THE TSA IS WORSE THAN CALIFORNIA ON MEDIAN INCOME, $41,192, BUT SIMILAR TO OR SLIGHTLY BETTER ON POVERTY METRICS. THIS MAY INDICATE THAT REVENUE IS MORE EVENLY DISTRIBUTED ACROSS THE SERVICE AREA. THERE ARE HIGHER PERCENTAGES OF OLDER ADULTS, LOWER PERCENTAGES OF CHILDREN, AND FAR MORE NON-LATINO WHITES IN THE SERVICE AREA THAN IN CALIFORNIA (74% IN HUMBOLDT COUNTY COMPARED TO 37% ACROSS CALIFORNIA).THE RACE/ETHNICTY DATA FOR THE TSA IS PRIMARILY NON-LATINO WHITE AT 74.4%. 12.8% ARE LATINO AND 3.1% ARE AMERICAN INDIAN. THE TSA HAS 9 FEDERALLY RECOGNIZED TRIBAL ENTITIES.THE TSA HAS MANY POCKETS OF HIGH NEED AS IDENTIFIED AS A COMMUNITY NEEDS INDEX SCORE OF BETWEEN 4.2 AND 5.0. THE COMMUNITIES OF EUREKA 95501 AND 95503, RIO DELL 95562, LOLETA 95551, AND FORTUNA 95540 ARE ALL IN THIS HIGHEST NEED CATEGORY.OTHER HOSPITALS IN HUMBOLDT COUNTY INCLUDE ST. JOSEPH HOSPITAL IN EUREKA, MAD RIVER COMMUNITY HOSPITAL IN ARCATA AND JEROLD PHELPS COMMUNITY HOSPITAL IN GARBERVILLE.HEALTH PROFESSIONS SHORTAGE AREA - PRIMARY, MENTAL, AND OTHER:THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). REDWOOD MEMORIAL HOSPITAL AND ITS SERVICE AREA ARE BOTH LOCATED IN A PRIMARY AND MENTAL HEALTHCARE SHORTAGE AREA.MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA:MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE." MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY.ALTHOUGH REDWOOD MEMORIAL HOSPITAL IS NOT LOCATED IN A MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATIONS AREA, LARGE PORTIONS OF THE SERVICE AREA TO THE NORTH, SOUTH AND WEST OF REDWOOD MEMORIAL HOSPITAL ARE DESIGNATED AS SHORTAGE AREAS; AND THERE ARE ALSO 14 FEDERALLY QUALIFIED HEALTH CENTERS WITHIN A 50 MILE RADIUS OF REDWOOD MEMORIAL HOSPITAL.FEDERALLY QUALIFIED HEALTH CENTERS ARE HEALTH CLINICS THAT QUALIFY FOR ENHANCED REIMBURSEMENT FROM MEDICARE AND MEDICAID. THEY MUST PROVIDE PRIMARY CARE SERVICES TO AN UNDERSERVED AREA OR POPULATION, OFFER A SLIDING FEE SCALE, HAVE AN ONGOING QUALITY ASSURANCE PROGRAM, AND HAVE A GOVERNING BOARD OF DIRECTORS. THE ACA INCLUDED PROVISIONS THAT INCREASED FEDERAL FUNDING TO FEDERALLY QUALIFIED HEATH CENTERS TO HELP MEET THE ANTICIPATED DEMAND FOR HEALTHCARE SERVICES BY THOSE INDIVIDUALS WHO GAINED HEALTHCARE COVERAGE THROUGH THE VARIOUS HEALTH EXCHANGES. A LARGE PERCENTAGE OF AREA RESIDENTS DEPEND ON THE FEDERALLY QUALIFIED HEALTH CENTERS TO RECEIVE THEIR HEALTHCARE SERVICES. ADDITIONALLY, MANY OF THE FEDERALLY QUALIFIED HEALTH CENTERS' PATIENTS UTILIZE THE SERVICES OF REDWOOD MEMORIAL HOSPITAL. ALTHOUGH REDWOOD MEMORIAL HOSPITAL IS NOT LOCATED IN A MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATIONS AREA, LARGE PORTIONS OF THE SERVICE AREA TO THE NORTH, SOUTH AND WEST OF REDWOOD MEMORIAL HOSPITAL ARE DESIGNATED AS SHORTAGE AREAS; AND THERE ARE ALSO 14 FEDERALLY QUALIFIED HEALTH CENTERS WITHIN A 50 MILE RADIUS OF REDWOOD MEMORIAL HOSPITAL.FEDERALLY QUALIFIED HEALTH CENTERS ARE HEALTH CLINICS THAT QUALIFY FOR ENHANCED REIMBURSEMENT FROM MEDICARE AND MEDICAID. THEY MUST PROVIDE PRIMARY CARE SERVICES TO AN UNDERSERVED AREA OR POPULATION, OFFER A SLIDING FEE SCALE, HAVE AN ONGOING QUALITY ASSURANCE PROGRAM, AND HAVE A GOVERNING BOARD OF DIRECTORS. THE ACA INCLUDED PROVISIONS THAT INCREASED FEDERAL FUNDING TO FEDERALLY QUALIFIED HEATH CENTERS TO HELP MEET THE ANTICIPATED DEMAND FOR HEALTHCARE SERVICES BY THOSE INDIVIDUALS WHO GAINED HEALTHCARE COVERAGE THROUGH THE VARIOUS HEALTH EXCHANGES. A LARGE PERCENTAGE OF AREA RESIDENTS DEPEND ON THE FEDERALLY QUALIFIED HEALTH CENTERS TO RECEIVE THEIR HEALTHCARE SERVICES. ADDITIONALLY, MANY OF THE FEDERALLY QUALIFIED HEALTH CENTERS' PATIENTS UTILIZE THE SERVICES OF REDWOOD MEMORIAL HOSPITAL. SCHEDULE H, PART VI, LINE 4 (CONTINUED) FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKACOMMUNITY INFORMATIONST. JOSEPH HOSPITAL EUREKA PROVIDES RURAL NORTH COAST COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM CRESCENT CITY IN THE NORTH, RIO DELL IN THE SOUTH, WILLOW CREEK/ HOOPA IN THE EAST AND IS BORDERED BY THE PACIFIC OCEAN IN THE WEST. OUR HOSPITAL TOTAL SERVICE AREA INCLUDES THE CITIES AND OF EUREKA, ARCATA, FORTUNA, TRINIDAD, BLUE LAKE, FERNDALE, RIO DELL, CRESCENT CITY AND THE UNINCORPORATED COMMUNITIES OF MCKINLEYVILLE, FIELDS LANDING, BAYSIDE, SAMOA, HOOPA, WILLOW CREEK, LOLETA, KLAMATH, ORICK AND KNEELAND; AS WELL AS NINE FEDERALLY RECOGNIZED TRIBES: RESIGHINI RANCHERIA, BEAR RIVER BAND OF ROHNERVILLE RANCHERIA, BIG LAGOON RANCHERIA, BLUE LAKE RANCHERIA, HOOPA VALLEY TRIBE, KARUK TRIBE, TABLE BLUFF RANCHERIA, TRINIDAD RANCHERIA AND THE YUROK TRIBE. THIS INCLUDES A POPULATION OF APPROXIMATELY 148,828 PEOPLE.HOSPITAL TOTAL SERVICE AREA:THE COMMUNITY SERVED BY THE HOSPITAL IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF THE HOSPITAL'S INPATIENTS. THE HOSPITAL TOTAL SERVICE AREA IS THE COMPRISED OF BOTH THE PRIMARY SERVICE AREA (PSA) AS WELL AS THE SECONDARY SERVICE AREA (SSA) AND IS ESTABLISHED BASED ON THE FOLLOWINGCRITERIA:- PSA: 70% OF DISCHARGES (EXCLUDING NORMAL NEWBORNS)- SSA: 71%-85% OF DISCHARGES (DRAW RATES PER ZIP CODE ARE CONSIDERED AND PSA/SSA ARE MODIFIED ACCORDINGLY)- INCLUDES ZIP CODES FOR CONTINUITY- NATURAL BOUNDARIES ARE CONSIDERED (I.E., FREEWAYS, MOUNTAIN RANGES, ETC.)- CITIES ARE PLACED IN PSA OR SSA, BUT NOT BOTHTHE PRIMARY SERVICE AREA ("PSA") IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF THE HOSPITAL'S PATIENTS ORIGINATE. THE SECONDARY SERVICE AREA ("SSA") IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE PSA IS COMPRISED OF EUREKA, ARCATA, MCKINLEYVILLE, BAYSIDE, SAMOA, FIELDS LANDING, AND FORTUNA. THE SSA IS COMPRISED OF CRESCENT CITY, KLAMATH, ORICK, HOOPA, WILLOW CREEK, TRINIDAD, BLUE LAKE, KNEELAND, LOLETA, FERNDALE AND RIO DELL.THE TOTAL SERVICE AREA (TSA) OF ST. JOSEPH HOSPITAL EUREKA INCLUDES APPROXIMATELY 150,000 PEOPLE, WITH ABOUT 124,000 (84%) IN HUMBOLDT COUNTY. 90% OF THE POPULATION OF BOTH HUMBOLDT AND DEL NORTE COUNTIES LIVE IN THE TSA, SO COMPARISONS TO COUNTY DATA ARE ONLY OF LIMITED UTILITY. THE TSA HAS A MEDIAN HOUSEHOLD INCOME OF $40,053, 31.3% OF THIS POPULATION HAS A HOUSEHOLD INCOME BELOW 200% OF FEDERAL POVERTY LEVEL, AND 25.0% OF CHILDREN AND 7.4% OF OLDER ADULTS LIVE BELOW 100% OF FPL.THE RACE/ETHNICTY DATA FOR THE TSA IS PRIMARILY NON-LATINO WHITE AT 71.6%. 12.9% ARE LATINO AND 5.5% ARE AMERICAN INDIAN. THE TSA HAS 9 FEDERALLY RECOGNIZED TRIBAL ENTITIES.THE TSA HAS MANY POCKETS OF HIGH NEED AS IDENTIFIED AS A COMMUNITY NEEDS INDEX SCORE OF BETWEEN 4.2 AND 5.0. THE COMMUNITIES OF EUREKA 95501 AND 95503, HOOPA 95546, ORICK 95555 AND ARCATA 95521 ARE ALL IN THIS HIGHEST NEED CATEGORY.OTHER HOSPITALS IN HUMBOLDT COUNTY INCLUDE REDWOOD MEMORIAL IN FORTUNA AND MAD RIVER COMMUNITY HOSPITAL IN ARCATA.HEALTH PROFESSIONS SHORTAGE AREA - PRIMARY, MENTAL, AND OTHER:THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). ST. JOSEPH HOSPITAL AND ITS SERVICE AREA ARE BOTH LOCATED IN A PRIMARY AND MENTAL HEALTHCARE SHORTAGE AREA.MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA:MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE". MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. THE MAP BELOW DEPICTS THE MEDICALLY UNDERSERVED AREAS/MEDICALLY UNDERSERVED WITHIN A 50 MILE RADIUS FROM ST. JOSEPH HOSPITAL.ALTHOUGH ST. JOSEPH HOSPITAL IS NOT LOCATED IN A MEDICALLY UNDERSERVED AREA/ MEDICALLY UNDERSERVED POPULATIONS AREA, LARGE PORTIONS OF THE SERVICE AREA TO THE NORTH, SOUTH AND WEST OF ST. JOSEPH HOSPITAL ARE DESIGNATED AS SHORTAGE AREAS; AND THERE ARE ALSO 14 FEDERALLY QUALIFIED HEALTH CENTERS WITHIN A 50 MILE RADIUS OF ST. JOSEPH HOSPITAL EUREKA.FEDERALLY QUALIFIED HEALTH CENTERS ARE HEALTH CLINICS THAT QUALIFY FOR ENHANCED REIMBURSEMENT FROM MEDICARE AND MEDICAID. THEY MUST PROVIDE PRIMARY CARE SERVICES TO AN UNDERSERVED AREA OR POPULATION, OFFER A SLIDING FEE SCALE, HAVE AN ONGOING QUALITY ASSURANCE PROGRAM, AND HAVE A GOVERNING BOARD OF DIRECTORS. THE ACA INCLUDED PROVISIONS THAT INCREASED FEDERAL FUNDING TO FEDERALLY QUALIFIED HEATH CENTERS TO HELP MEET THE ANTICIPATED DEMAND FOR HEALTHCARE SERVICES BY THOSE INDIVIDUALS WHO GAINED HEALTHCARE COVERAGE THROUGH THE VARIOUS HEALTH EXCHANGES. A LARGE PERCENTAGE OF AREA RESIDENTS DEPEND ON THE FEDERALLY QUALIFIED HEALTH CENTERS TO RECEIVE THEIR HEALTHCARE SERVICES. ADDITIONALLY, MANY OF THE FEDERALLY QUALIFIED HEALTH CENTERS' PATIENTS UTILIZE THE SERVICES OF ST. JOSEPH HOSPITAL-EUREKA.JOSEPH HOSPITAL-EUREKA. SCHEDULE H, PART VI, LINE 5 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALPROMOTION OF COMMUNITY HEALTHSANTA ROSA MEMORIAL HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. SANTA ROSA MEMORIAL HOSPITAL IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.QUEEN OF THE VALLEY MEDICAL CENTERPROMOTION OF COMMUNITY HEALTHQUEEN OF THE VALLEY MEDICAL CENTER PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. QUEEN OF THE VALLEY IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES.2) OPEN MEDICAL STAFF.3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. FACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALPROMOTION OF COMMUNITY HEALTHREDWOOD MEMORIAL HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. REDWOOD MEMORIAL HOSPITAL IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.FACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKAPROMOTION OF COMMUNITY HEALTHST. JOSEPH HOSPITAL, EUREKA PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. ST. JOSEPH HOSPITAL, EUREKA IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEMON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST.TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS AND 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. SCHEDULE H, PART VI, LINE 7 FACILITY REPORTING GROUP ASANTA ROSA MEMORIAL HOSPITALSTATE FILING OF COMMUNITY BENEFIT REPORTCALIFORNIAQUEEN OF THE VALLEY MEDICAL CENTERSTATE FILING OF COMMUNITY BENEFIT REPORTCALIFORNIAFACILITY REPORTING GROUP AREDWOOD MEMORIAL HOSPITALSTATE FILING OF COMMUNITY BENEFIT REPORTCALIFORNIAFACILITY REPORTING GROUP AST. JOSEPH HOSPITAL OF EUREKASTATE FILING OF COMMUNITY BENEFIT REPORTCALIFORNIA 1 ST JOSEPH HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW RENTON WA 980579016 330143024 501(C)(3) 6108600 CARE FOR THE POOR 1 0 PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. X 1 1 1 1 0 0 0 0 0 1 0 KEVIN KLOCKENGA REGIONAL CHIEF EXECUTIVE - NO CA 0 696204 0 440231 0 7603 0 195574 0 35643 0 1375255 0 0 ROBERTA LUSKIN-HAWK MD CHIEF EXEC EUREKA 0 451632 0 171999 0 50362 0 150331 0 31324 0 855648 0 33339 LARRY COOMES CHIEF EXEC QVMC 0 434385 0 207928 0 6027 0 148141 0 51657 0 848138 0 0 CHAD KRILICH CMO-CHIEF MEDICAL OFFICER 423655 0 121137 0 5161 0 11200 0 44867 0 606020 0 0 0 CAROL KOEBLE CHIEF MEDICAL OFFICER - N. CA REGION 429315 0 127344 0 10134 0 75596 0 6215 0 648604 0 0 0 OLUYEMI ADEYANJU ESQ GENERAL COUNSEL 0 352516 0 187551 0 3976 0 88287 0 13684 0 646014 0 0 WILLIAM PARKS CHIEF MEDICAL AFFAIRS/CMO 390272 0 114250 0 14816 0 11200 0 45421 0 575959 0 0 0 KIM BROWN SIMS CHIEF NURSING OFFICER (PART YEAR) 180186 0 91047 0 265527 0 7443 0 14125 0 558328 0 40458 0 VICKI WHITE CNO-CHIEF NURSING OFCR 326585 0 90611 0 76932 0 11200 0 26492 0 531820 0 64688 0 TYLER HEDDEN CEO-CHIEF EXEC OFFICER-SONOMA 383463 0 92056 0 4229 0 11200 0 34598 0 525546 0 0 0 PART I, LINE 1A PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: TRAVEL FOR COMPANIONS SPOUSE OR COMPANION TRAVEL. TRAVEL EXPENSES INCURRED BY A PROVIDENCE EMPLOYEE'S SPOUSE OR COMPANION WILL NOT BE REIMBURSED BY PROVIDENCE UNLESS THE SPOUSE OR COMPANION IS REQUIRED TO, OR INVITED TO ATTEND A PROVIDENCE SYSTEM-SPONSORED MEETING, OR FOR TRAVEL RELATED TO RELOCATION. RELOCATION-RELATED VISITS SHOULD NOT EXCEED TWO RELOCATION-RELATED VISITS, UNLESS APPROVED BY THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE. REIMBURSEMENT OF THESE EXPENSES IS LIMITED AND MAY BE CONSIDERED A TAXABLE BENEFIT BY THE IRS AND IF SO, ARE INCLUDED ON THE EMPLOYEE'S FORM W- 2. ROBERTA LUSKIN-HAWK, MD - $2,565 LARRY COOMES - $2,565 PART I, LINE 3 DESCRIPTION OF PROCESS TO REVIEW COMOPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT IN 2019: KIM BROWN SIMS - $220,299 NON-QUALIFIED RETIREMENT PLAN ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: ROBERTA LUSKIN-HAWK, M.D. - $33,339 KIM BOWN SIMS - $40,458 VICKI WHITE - $64,688 PART I, LINE 7 NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. FORM 990, PART V, LINE 1 ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC FROM ITS SHARED SERVICES. SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. FORM 990, PART V, LINE 15 INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATIONS SECTION 4960 TAX ANALYSIS AND REPORTING. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBER RESERVES THE RIGHT TO APPOINT TRUSTEES TO THE ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE REGULARLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE'S LEGAL ENTITIES. PROVIDENCE ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. FORM 990, PART IX, LINE 11G AGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 29,265,309. MANAGEMENT AND GENERAL EXPENSES 2,117,362. FUNDRAISING EXPENSES 72,595. TOTAL EXPENSES 31,455,266. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 32,273,879. MANAGEMENT AND GENERAL EXPENSES 1,519,216. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,793,095. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 42,284,353. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 276,894. TOTAL EXPENSES 42,561,247. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 74,411,105. MANAGEMENT AND GENERAL EXPENSES 964,474. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,375,579. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 7,648,451. MANAGEMENT AND GENERAL EXPENSES 73,352. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,721,803. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS -2,770,859. CHANGE IN EQUITY RELATED TO INVESTMENTS 63,710. OTHER 2,500,444. COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 611573313 HEALTHCARE TX 501(C)(3) 12,I CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 461259908 HEALTHCARE CA 501(C)(3) 12,III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 463516417 HEALTHCARE TX 501(C)(3) 12,I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752897026 HEALTHCARE TX 501(C)(3) 7 CHS 1 COVENANT HOSPITAL HOBBS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 844273963 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 822913146 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752743883 HEALTHCARE TX 501(C)(3) 3 CHS 1 E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911082119 UNEMPLOYMENT WA 501(C)(3) 12,I PHS WA 1 EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANS. CARE WA 501(C)(3) 10 N/A 0 FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 954322584 SUPPORT CA 501(C)(3) 7 PHS SOCAL 1 GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 201910170 SUPPORT WA 501(C)(3) 7 PHS WA 1 GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC WA 98188 273133200 HEALTHCARE WA 501(C)(3) 7 SHS 1 GRACE CLINIC OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 203856995 HEALTHCARE TX 501(C)(3) 3 CHS 1 HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(C)(3) 12,I HMHP 1 HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(C)(3) 7 HHF 1 HOAG CLINIC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92658 330676831 HEALTHCARE CA 501(C)(3) 10 HMHP 1 HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 HMHP 1 HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH CA 92663 951643327 HEALTHCARE CA 501(C)(3) 3 CHN 1 HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752133781 HEALTHCARE TX 501(C)(3) 10 CHS 1 INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911307555 HEALTHCARE WA 501(C)(3) 3 PHS WA 1 INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 814260130 HEALTHCARE WA 501(C)(3) 7 PHS SJHS 1 INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 912003593 HEALTHCARE WA 501(C)(3) 7 WHC 1 JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 954291515 HEALTHCARE CA 501(C)(3) 4 PSJHC 1 KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 916033089 SUPPORT WA 501(C)(3) 12,III KRMC 1 KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 237005501 SUPPORT WA 501(C)(3) 7 KRMC 1 KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 910655392 HEALTHCARE WA 501(C)(3) 3 WHC 1 LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 330844408 IMAGING SVCS CA 501(C)(3) 10 PHS SOCAL 1 LUBBOCK HERITAGE HOSPITAL LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 264021016 HEALTHCARE TX 501(C)(3) 3 CHS 1 LUBBOCK METHODIST HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752220963 HEALTHCARE TX 501(C)(3) 7 CHS 1 LUNDBERG ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911562797 SUPPORT OR 501(C)(3) 7 PHS OR 1 MARSHA RIVKIN CENTER FOR OVARIAN CANCER RESEARCH 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 912054035 RESEARCH WA 501(C)(3) 7 SHS 1 METHODIST CHILDREN'S HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752428911 HEALTHCARE TX 501(C)(3) 3 CHS 1 METHODIST HOSPITAL LEVELLAND 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752246348 HEALTHCARE TX 501(C)(3) 3 CHS 1 METHODIST HOSPITAL PLAINVIEW 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752426010 HEALTHCARE TX 501(C)(3) 3 CHS 1 MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 951643360 HEALTHCARE CA 501(C)(3) 3 CHN 1 NORTHWEST HOPE & HEALING FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 200799737 SUPPORT WA 501(C)(3) 12,I SHS 1 PACMED CLINICS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 562290878 HEALTHCARE WA 501(C)(3) 10 WHC 1 PH&S FOUNDATIONSFVSA & SCVSA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 953544877 HEALTHCARE CA 501(C)(3) 7 PHS SOCAL 1 PROVIDENCE ALASKA FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 920093565 HEALTHCARE AK 501(C)(3) 7 PHS WA 1 PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911940286 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911789266 SUPPORT WA 501(C)(3) 7 PHS WA 1 PROVIDENCE CHILDREN'S HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930800140 SUPPORT OR 501(C)(3) 7 PHS OR 1 PROVIDENCE COMMUNITY HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930692907 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE DETHMAN HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 473385506 SUPPORT WA 501(C)(3) 7 N/A 0 PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 311744654 SUPPORT WA 501(C)(3) 7 PHS WA 1 PROVIDENCE HEALTH & SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911549796 HEALTHCARE WA 501(C)(3) 12,II PSJH 0 PROVIDENCE HEALTH & SERVICES - MONTANA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 810231793 HEALTHCARE MT 501(C)(3) 3 PHS WA 1 PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 510216587 HEALTHCARE OR 501(C)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 510216586 HEALTHCARE WA 501(C)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911303277 HEALTHCARE WA 501(C)(3) 3 PMWHC 1 PROVIDENCE HEALTH ASSURANCE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 550828701 MEDICAID OR 501(C)(4) N/A PHP 1 PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 320014330 HEALTHCARE WA 501(C)(3) 7 PHS WA 1 PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA) 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911433382 HEALTHCARE WA 501(C)(3) 7 PHS W WA 1 PROVIDENCE HEALTH PLAN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930863097 HEALTHCARE OR 501(C)(4) N/A PPP 1 PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 510216589 HEALTHCARE CA 501(C)(3) 3 PHS 1 PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930921990 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE HOSPICE AND HOME CARE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 272552749 HEALTHCARE WA 501(C)(3) 7 PHS W WA 1 PROVIDENCE HOSPICE OF SEATTLE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 912077378 HEALTHCARE WA 501(C)(3) 7 PHS W WA 1 PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 510224944 HEALTHCARE CA 501(C)(3) 7 PHS SOCAL 1 PROVIDENCE MARIANWOOD FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 931554288 HEALTHCARE WA 501(C)(3) 7 PHS W WA 1 PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 330283773 HEALTHCARE CA 501(C)(3) 12,I PHS SOCAL 1 PROVIDENCE MILWAUKIE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 943079515 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE MINISTRIES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 RELIGIOUS ORG WA 501(C)(3) 1 N/A 0 PROVIDENCE MOUNT ST VINCENT FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911188119 HEALTHCARE WA 501(C)(3) 7 PHS WA 1 PROVIDENCE NEWBERG HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930889144 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 311629656 SUPPORT WA 501(C)(3) 7 PHS WA 1 PROVIDENCE PLAN PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911861964 HEALTHCARE WA 501(C)(4) N/A PHS OR 1 PROVIDENCE PORTLAND MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 931231494 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE ROSSI ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 311584166 SUPPORT WA 501(C)(3) 10 PHS WA 1 PROVIDENCE SAINT JOHN'S HEALTH CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 951684082 HEALTHCARE CA 501(C)(3) 3 PHS SOCAL 1 PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 814542216 HEALTHCARE CA 501(C)(3) 3 PHS SOCAL 1 PROVIDENCE SEASIDE HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930927320 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 912171539 SUPPORT WA 501(C)(3) 7 PHS WA 1 PROVIDENCE ST FRANCIS ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 943244854 SUPPORT WA 501(C)(3) 7 PHS WA 1 PROVIDENCE ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 811244422 HEALTHCARE WA 501(C)(3) 12,III N/A 0 PROVIDENCE ST JOSEPH HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 943078543 HEALTHCARE WA 501(C)(3) 7 PHS WA 1 PROVIDENCE ST JOSEPH MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 810463482 HEALTHCARE MT 501(C)(3) 3 PHS WA 1 PROVIDENCE ST MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 452841492 HEALTHCARE WA 501(C)(3) 7 PHS WA 1 PROVIDENCE ST PETER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911097056 SUPPORT WA 501(C)(3) 7 PHS W WA 1 PROVIDENCE ST VINCENT MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930575982 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE TRINITYCARE HOSPICE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 953264139 HEALTHCARE CA 501(C)(3) 10 PHS SOCAL 1 PROVIDENCE 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