2018-11-15T14:26:14-06:00 2017-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE STE 4200 INDIANAPOLIS IN 462045108 990 2017-01-01 344428256 THE TOLEDO HOSPITAL TOLE 5675853830 2142 N COVE BLVD TOLEDO OH 43606 MICHAEL P BROWNING TREASURER 5675858505 2018-11-15 1 SAMANTHA BOKORI P01057347 3174648600 12.203.115.26 2018-11-15 14:23:06 CS P 8CEDF576CA043CC62ABB75A2273520B055B15DFF 2B300E1FC09CCA321063079848B1E489E0A7BF4B 2017 2019-02-21 02:37:17Z PROMEDICA TOLEDO HOSPITAL MICHAEL P BROWNING 100 MADISON AVE TOLEDO OH 43604 1297344519 0 X WWW.PROMEDICA.ORG X 1907 OH THE TOLEDO HOSPITAL IS AN ACUTE CARE FACILITY AND THE ADULT TERTIARY FACILITY OF PROMEDICA HEALTH SYSTEM, INC. PROVIDING INPATIENT AND OUTPATIENT HEALTH SERVICES TO THE GENERAL PUBLIC OF NORTHWEST OHIO AND SOUTHEAST MICHIGAN. 27 17 5702 245 3555275 1257709 55620401 15767287 767588153 792287580 37445095 29743899 16623887 16637311 877277536 854436077 176377422 140635397 0 0 352481625 344776858 0 0 0 438000519 484855195 966859566 970267450 -89582030 -115831373 1442478118 1438331354 1002560783 1110030755 439917335 328300599 X AS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WE ARE A VALUABLE COMMUNITY RESOURCE PROVIDING COMPREHENSIVE HEALTH SERVICES WITH EXPERTISE AND COMPASSION, AND IMPROVING THE HEALTH OF THOSE WE SERVE THROUGH PREVENTION, EDUCATION AND SUPERIOR SERVICE. 0 0 751674851 140635397 765203899 THE TOLEDO HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO THE GENERAL PUBLIC. - SEE SCHEDULE O. 58904069 0 CONSISTENT WITH OUR MISSION, THE TOLEDO HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY. - SEE SCHEDULE O. 52472300 27997331 CONSISTENT WITH OUR MISSION, THE TOLEDO HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT, INCLUDING COMMUNITY HEALTH IMPROVEMENT SERVICES, SUBSIDIZED HEALTH SERVICES, AND HEALTH PROFESSIONS EDUCATION. - SEE SCHEDULE O. 1684409 1998536 OPERATES A HEALTH CLUB FACILITY. 1684409 1998536 864735629 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 312 0 1 5702 1 1 1 0 0 0 0 0 0 0 0 0 X 27 17 1 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 1 0 X STANTON E RISSER 5675853618 100 MADISON AVE TOLEDO OH 43604 ADRIENNE J GREEN TRUSTEE 1.00 2.00 X 0 0 0 AHED T NAHHAS MD TRUSTEE 1.00 2.00 X 5206 19959 0 ALANA GRACE HATCHER TRUSTEE 1.00 2.00 X 0 0 0 ARTURO POLIZZI PRESIDENT, EX OFFICIO 40.00 2.50 X X 0 635788 264600 BRADLEY J TOFT TRUSTEE 1.00 2.00 X 0 0 0 CHARLES A PARCHER TRUSTEE 1.00 2.00 X 0 0 0 CHARLES MICHAEL SMITH TRUSTEE 1.00 2.00 X 0 0 0 CHRISTOPHER H JACKSON TRUSTEE 1.00 2.00 X 0 0 0 DAVID SCOTT MIERZWIAK MD TRUSTEE 40.00 3.00 X 0 386739 72216 DEBORAH A GUNTSCH MD TRUSTEE 1.00 42.00 X 8125 336164 19533 HENRY H NADDAF MD TRUSTEE 1.00 2.00 X 0 37500 0 JAMES F WEBER TRUSTEE 1.00 2.00 X 0 0 0 JAY P MORGAN TRUSTEE 1.00 2.00 X 0 0 0 JOSEPH D NAPOLI TRUSTEE 1.00 9.00 X 0 0 0 KEVIN C WEBB PHD EX OFFICIO 1.00 52.50 X 0 655627 240675 MARLON P KISER TRUSTEE 1.00 2.00 X 0 0 0 MARTIN P SUTTER TRUSTEE 1.00 2.00 X 0 0 0 NANCY PARIS KABAT CHAIRPERSON 1.00 3.00 X X 487 0 0 RAVI K ADUSUMILLI MD TRUSTEE 1.00 42.00 X 0 660798 43269 RICHARD D LANTZ TRUSTEE 1.00 2.00 X 0 0 0 RICHARD L MUNK MD TRUSTEE 1.00 42.00 X 15509 108093 11301 RICHARD S SWEENEY TRUSTEE 1.00 2.00 X 0 0 0 ROBERT F WOOD MD TRUSTEE 1.00 2.00 X 0 0 0 ROBERT P SCHLATTER TRUSTEE 1.00 2.00 X 0 0 0 SUSAN K STAELIN TRUSTEE 1.00 2.00 X 0 0 0 THOMAS GEORGE PADANILAM MD TRUSTEE 1.00 2.00 X 0 0 0 TIMOTHY M HUSTED MD TRUSTEE 1.00 2.00 X 0 0 0 WILLIAM C NOWICKI VICE-CHAIR 1.00 2.00 X X 0 0 0 WILLIAM R MCDONNELL TRUSTEE 1.00 2.00 X 0 0 0 JEFFREY C KUHN SECRETARY 0.50 52.00 X 0 616424 244159 MICHAEL P BROWNING TREASURER 0.50 50.50 X 0 697115 246414 RANDALL OOSTRA PHS PRES & CEO, EX OFFICIO 0.50 54.50 X 0 1749816 483218 ALISON S AVENDT VP, OPERATIONS TTH & PRES, PTN 40.00 0.00 X 0 181379 23546 DARRIN M ARQUETTE SR. VP, NEURO, HEART AND VASC 40.00 6.00 X 0 335318 46341 DAWN BUSKEY COO, METRO REGION ACUTE CARE 40.00 1.50 X 0 360870 75823 DEANA L SIEVERT SR. VP, PAT CARE/CNO, SYSTEM 0.50 41.00 X 0 240993 65731 GARY W AKENBERGER SR. VP DIAG, FACILITIES & SEC 40.00 4.50 X 0 379804 91320 LORI FERGUSON VP, PATIENT CARE, TTH 40.00 0.00 X 0 247349 183377 PAULA L GRIEB VP, PAT CARE/ASSOC CNO, METRO 40.00 1.00 X 0 190606 21252 SCOTT FOUGHT VP, FINANCE, ACUTE CARE OPS 40.00 5.00 X 0 281158 46283 THADIUS L WADSWORTH VP SURGICAL SERVICES, METRO 40.00 1.00 X 67582 91703 16424 FEDOR LURIE ASSOC. DIR. RESEARCH ED. VASC. 40.00 0.00 X 210405 0 28200 JACKLYN KIEFER ASSOC. DIR. ED. FAMILY PRACTICE 40.00 0.00 X 195641 0 18228 JEFFREY LEWIS ASSOC. DIR. ED. FAMILY PRACTICE 40.00 0.00 X 193482 0 53164 JOSHUA OVENS RN, CRITICAL CARE TRANSPORT 40.00 0.00 X 244261 0 41121 LOUITO EDJE DIR. ED. FAMILY PRACTICE 40.00 0.00 X 219941 0 29940 ALAN M SATTLER FORMER OFFICER 0.00 40.00 X 0 389038 80933 KATHLEEN S HANLEY FORMER OFFICER 0.00 0.00 X 0 571790 1351 JOSEPH SFERRA FORMER KEY EMPLOYEE 40.00 0.00 X 0 677903 44857 KHURRAM KAMRAN FORMER KEY EMPLOYEE 0.00 0.00 X 0 155843 5263 NEERAJ K KANWAL MD FORMER KEY EMPLOYEE 0.00 42.50 X 0 377036 56450 1160639 10384813 2554989 123 1 1 0 LATHROP COMPANY INC 460 WEST DUSSEL DR MAUMEE OH 435374205 GENERAL CONTRACTING 115647669 RUDOLPH LIBBE INC 6494 LATCHA RD WALBRIDGE OH 43465 GENERAL CONTRACTING 28390808 UNIVERSITY OF TOLEDO DEPT L674 COLUMBUS OH 43260 EDUCATION & PHYSICIANS 7763214 METRO AVIATION INC PO BOX 7008 SHREVEPORT LA 71137 AVIATION SERVICES 4632926 HKS INC 1919 MCKINNEY AVE DALLAS TX 75201 ARCHITECTURAL DESIGN 4051999 63 10143 12061602 1909309 1786233 14069 15767287 NET PATIENT SERVICES 622110 780204479 777138161 3066318 AFFIL. ORG. RENT REV. 531120 10623451 10623451 MEMBERSHIP REVENUE 713940 1459650 1459650 792287580 3807249 3807249 3409758 3465404 -55646 -55646 101734 -157380 461629342 3057065 436284103 2465654 25345239 591411 25936650 591411 25345239 18830 10143 10473 8357 8357 969641 682808 286833 286833 DIETARY 722514 3446900 3446900 PHARMACY 446110 3345868 3345096 772 AFF TRANS SUPPORT SVCS 900099 2940792 2940792 6664207 6277756 386451 16397767 854436077 795199766 3555275 39913749 140635397 140635397 97753 55841 41912 282789593 209264299 73525294 5958054 4408960 1549094 34616485 25628416 8988069 21314973 15773080 5541893 24895 24895 867478 867478 1058733 1058733 28184 28184 692526 692526 72036704 63799983 8236721 1572250 1257800 314450 6812465 6812465 19507883 19507883 18285024 14628019 3657005 1507294 691342 815952 7806 7806 20699342 20699342 62559793 62559793 6237057 4989646 1247411 MEDICAL SUPPLIES 115920689 115920689 DRUGS 53098528 53098528 INTERCOMPANY SERVICES 49553322 49079282 474040 UBI TAXES 300000 300000 54085222 54039965 45257 970267450 864735629 105531821 0 32236257 77009694 6050299 6118446 131736355 153280893 13599 11059227 7547300 2834289 1732593 1313461225 613198919 554554186 700262306 246824919 5285717 11187926 11644645 18201744 18113172 427779317 457336588 1442478118 1438331354 60928969 75439050 938945 10252000 509355608 623714672 351092277 332601744 80244984 68023289 1002560783 1110030755 X 261276443 132454119 168801778 185171803 9839114 10674677 439917335 328300599 1442478118 1438331354 X -115831373 -12641344 16855981 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 28184 28184 0 PART II-B, LINE 1: THE TOLEDO HOSPITAL PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION - A PORTION OF WHICH IS ALLOCABLE TO LOBBYING BY THE ASSOCIATIONS. 9839115 835563 10674678 9891715 -19454 -33146 9839115 10484815 1188 -594288 9891715 10560195 4397 -79777 10484815 10062050 558860 -60715 10560195 1.00000 1 1 1 2307790 63481835 65789625 678276754 379649949 298626805 6965528 6943565 21963 297513450 207685670 89827780 264915868 18919735 245996133 700262306 DUE FROM AFFILIATES 2591716 OTHER RECEIVABLES 3848672 BENEFICIAL INTEREST IN FOUNDATION 193866311 RESEARCH FUNDS 1980170 OTHER SEGREGATED INVESTMENTS 29893431 INTERCOMPANY DEBT FROM RELATED ENTITIES 221769578 ESTIMATED THIRD PARTY RECEIVABLE 3386710 457336588 DUE TO AFFILIATES 33060012 ESTIMATED THIRD PARTY SETTLEMENTS PAYABLE 7039651 INTEREST RATE SWAP 14957621 ASBESTOS REMEDIATION 8061545 DEFERRED COMPENSATION 4277578 PLEDGES PAYABLE 100000 PENSION PLAN LIABILITY 319932 DEFERRED INCOME TAXES 206950 68023289 PART V, LINE 4: THE ENDOWMENT FUNDS ARE INVESTED TO GENERATE INCOME TO BE USED TO SUPPORT THE TOLEDO HOSPITAL CONSISTENT WITH DONOR INTENT. PTN BOWLING FUNDRAISER 9743 6827 2916 2213 PTN GOLF FUNDRAISER 11720 3316 8404 8176 1 7510 0 7510 84 28973 10143 18830 10473 10473 8357 1 1 X 1 X 1 X 1 1 1 0 1 1 7929068 7929068 0.00810 181234256 130265981 50968275 0.05200 44715 37989 6726 0.00000 189208039 130303970 58904069 0.06010 3841556 1157589 2683967 0.00270 27763472 14878899 12884573 0.01320 20867272 11960843 8906429 0.00910 52472300 27997331 24474969 0.02500 241680339 158301301 83379038 0.08510 1 38436185 6373865 135870834 152981727 -17110893 X 1 1 1 PROMEDICA ORTHOPEDIC CO-MANAGEMENT CO LLC PHYSICIAN SERVICES 0.23590 0.02830 0.56600 2 PROMEDICA SURGICAL SERVICES CO-MANAGEMENT CO LLC PHYSICIAN SERVICES 0.30910 0.01000 0.37270 3 REYNOLDS ROAD SURGICAL CENTER LLC SURGICAL CENTER 0.67210 0.03220 0.29570 4 NORTHWEST OHIO DEDICATED BREAST MRI LLC MEDICAL DIAGNOSTIC 0.50000 0.50000 5 WEST CENTRAL SURGICAL CENTER LLC SURGICAL CENTER 0.50000 0.50000 3 1 THE TOLEDO HOSPITAL 2142 NORTH COVE BLVD TOLEDO OH 43606 WWW.PROMEDICA.ORG 1226 X X X X X X A 2 WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL 2901 N REYNOLDS RD TOLEDO OH 43615 WWW.PROMEDICA.ORG 1501 X X A 3 ARROWHEAD BEHAVIORAL HEALTH 1725 TIMBERLINE ROAD MAUMEE OH 43537 WWW.ARROWHEADBEHAVIORAL.COM 1543 X PSYCHIATRIC / SUBSTANCE ABUSE FACILITY B FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/DEFAULT.ASPX X 1 16 0 1 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 FACILITY REPORTING GROUP - B 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTP://WWW.ARROWHEADBEHAVIORAL.COM/CHNA/ X SEE PART V, SECTION C X 1 16 0 1 0 1 X 200.000000000000 500.000000000000 X 1 1 X X 1 X X X X X 1 X 0 X X 0 X X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: THE TOLEDO HOSPITAL, - FACILITY 2: WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT SURVEY PROCESSES, LUCAS COUNTY CONDUCTED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS TO DEVELOP A COUNTY STRATEGIC PLAN, UTILIZING THE MAPP PROCESS THAT INCLUDES FOUR ASSESSMENTS: COMMUNITY THEMES & STRENGTHS, FORCES OF CHANGE, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND THE COMMUNITY HEALTH STATUS ASSESSMENT. THESE FOUR ASSESSMENTS WERE USED BY THE RESPECTIVE COUNTY CHIP COMMITTEES TO PRIORITIZE SPECIFIC HEALTH ISSUES AND POPULATION GROUPS WHICH ARE THE FOUNDATION OF THE PLAN. A RESOURCE ASSESSMENT AND GAP ANALYSIS WAS PART OF THIS FORMAL PROCESS. THE FINAL CHIP PLANS WERE APPROVED BY THE RESPECTIVE COUNTY CHIP STRATEGIC PLANNING COMMITTEES. THE HOSPITAL THEN UTILIZED THESE DATA AND PLANS TO DEVELOP THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN. FEEDBACK FROM THE LOCAL HEALTH DEPARTMENT WAS REQUESTED AFTER THE HOSPITAL PLAN WAS DRAFTED. PERSONS WHO REPRESENTED THE LUCAS COUNTY COMMUNITY THROUGH THESE PROCESSES INCLUDED: TOLEDO FIRE AND RESCUE DEPARTMENT, TOLEDO-LUCAS COUNTY HEALTH DEPARTMENT, LUCAS COUNTY JUVENILE COURT, UNIVERSITY OF TOLEDO, TOLEDO PUBLIC SCHOOLS, SPRINGFIELD TOWNSHIP FIRE, LIVE WELL TOLEDO, CITY OF TOLEDO, DEPARTMENT OF NEIGHBORHOODS, HOSPITAL COUNCIL OF NORTHWEST OHIO, LUCAS COUNTY CHILDREN SERVICES, WHITEHOUSE, PROMEDICA, LUCAS COUNTY EMA, CENTER FOR HOPE, NEIGHBORHOOD HEALTH ASSOCIATION, HARBOR BEHAVIORAL HEALTH, BOWLING GREEN STATE UNIVERSITY, HEALTHY LUCAS COUNTY, ADELANTE, SYLVANIA TOWNSHIP FIRE DEPARTMENT, MERCY HEALTH, LOURDES UNIVERSITY, ASPIRE, UNITED WAY OF GREATER TOLEDO, MOBILE CARE GROUP, CARENET, TOLEDO COMMUNITY FOUNDATION, OREGON CITY, ST. LUKE'S HOSPITAL, UT MPH INTERNS, MENTAL HEALTH AND RECOVERY SERVICES BOARD, JERUSALEM TOWNSHIP FIRE, BRIGHTSIDE, THE ZEPF CENTER, SWANTON AREA COMMUNITY COALITION, ANTHONY WAYNE SCHOOLS, OTTAWA HILLS LOCAL SCHOOLS, SYLVANIA SCHOOLS, PROMEDICA (ALL LUCAS COUNTY HOSPITALS), MERCY, MERCY PEDIATRICIAN, YWCA CHILDCARE, EARLY CHILDHOOD COORDINATING COMMITTEE (EC3), LUCAS COUNTY FAMILY COUNCIL, AND LUCAS COUNTY FAMILY FIRST COUNCIL. GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL, FLOWER HOSPITAL, AND ARROWHEAD BEHAVIORAL HEALTH. GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO. GROUP A-FACILITY 2 -- WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT SURVEY PROCESSES, LUCAS COUNTY CONDUCTED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS TO DEVELOP A COUNTY STRATEGIC PLAN, UTILIZING THE MAPP PROCESS THAT INCLUDES FOUR ASSESSMENTS: COMMUNITY THEMES & STRENGTHS, FORCES OF CHANGE, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND THE COMMUNITY HEALTH STATUS ASSESSMENT. THESE FOUR ASSESSMENTS WERE USED BY THE RESPECTIVE COUNTY CHIP COMMITTEES TO PRIORITIZE SPECIFIC HEALTH ISSUES AND POPULATION GROUPS WHICH ARE THE FOUNDATION OF THE PLAN. A RESOURCE ASSESSMENT AND GAP ANALYSIS WAS PART OF THIS FORMAL PROCESS. THE FINAL CHIP PLANS WERE APPROVED BY THE RESPECTIVE COUNTY CHIP STRATEGIC PLANNING COMMITTEES. THE HOSPITAL THEN UTILIZED THESE DATA AND PLANS TO DEVELOP THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN. FEEDBACK FROM THE LOCAL HEALTH DEPARTMENT WAS REQUESTED AFTER THE HOSPITAL PLAN WAS DRAFTED. PERSONS WHO REPRESENTED THE LUCAS COUNTY COMMUNITY THROUGH THESE PROCESSES INCLUDED: TOLEDO FIRE AND RESCUE DEPARTMENT, TOLEDO-LUCAS COUNTY HEALTH DEPARTMENT, LUCAS COUNTY JUVENILE COURT, UNIVERSITY OF TOLEDO, TOLEDO PUBLIC SCHOOLS, SPRINGFIELD TOWNSHIP FIRE, LIVE WELL TOLEDO, CITY OF TOLEDO - DEPARTMENT OF NEIGHBORHOODS, HOSPITAL COUNCIL OF NORTHWEST OHIO, LUCAS COUNTY CHILDREN SERVICES, WHITEHOUSE, PROMEDICA, LUCAS COUNTY EMA, CENTER FOR HOPE, NEIGHBORHOOD HEALTH ASSOCIATION, HARBOR BEHAVIORAL HEALTH, BOWLING GREEN STATE UNIVERSITY, HEALTHY LUCAS COUNTY, ADELANTE, SYLVANIA TOWNSHIP FIRE DEPARTMENT, MERCY HEALTH, LOURDES UNIVERSITY, ASPIRE, UNITED WAY OF GREATER TOLEDO, MOBILE CARE GROUP, CARENET, TOLEDO COMMUNITY FOUNDATION, OREGON CITY, ST. LUKE'S HOSPITAL, UT MPH INTERNS, MENTAL HEALTH AND RECOVERY SERVICES BOARD, JERUSALEM TOWNSHIP FIRE, BRIGHTSIDE, AND THE ZEPF CENTER. GROUP A-FACILITY 2 -- WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: THE TOLEDO HOSPITAL, FLOWER HOSPITAL, AND ARROWHEAD BEHAVIORAL HEALTH. GROUP A-FACILITY 2 -- WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO. PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 3: ARROWHEAD BEHAVIORAL HEALTH GROUP B-FACILITY 3 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. FOLLOWING THE FORMAL COUNTY HEALTH ASSESSMENT SURVEY PROCESSES, LUCAS COUNTY CONDUCTED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS TO DEVELOP A COUNTY STRATEGIC PLAN, UTILIZING THE MAPP PROCESS THAT INCLUDES FOUR ASSESSMENTS: COMMUNITY THEMES & STRENGTHS, FORCES OF CHANGE, THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND THE COMMUNITY HEALTH STATUS ASSESSMENT. THESE FOUR ASSESSMENTS WERE USED BY THE RESPECTIVE COUNTY CHIP COMMITTEES TO PRIORITIZE SPECIFIC HEALTH ISSUES AND POPULATION GROUPS WHICH ARE THE FOUNDATION OF THE PLAN. A RESOURCE ASSESSMENT AND GAP ANALYSIS WAS PART OF THIS FORMAL PROCESS. THE FINAL CHIP PLANS WERE APPROVED BY THE RESPECTIVE COUNTY CHIP STRATEGIC PLANNING COMMITTEES. THE HOSPITAL THEN UTILIZED THESE DATA AND PLANS TO DEVELOP THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN. FEEDBACK FROM THE LOCAL HEALTH DEPARTMENT WAS REQUESTED AFTER THE HOSPITAL PLAN WAS DRAFTED. PERSONS WHO REPRESENTED THE LUCAS COUNTY COMMUNITY THROUGH THESE PROCESSES INCLUDED: TOLEDO FIRE AND RESCUE DEPARTMENT, TOLEDO-LUCAS COUNTY HEALTH DEPARTMENT, LUCAS COUNTY JUVENILE COURT, UNIVERSITY OF TOLEDO, TOLEDO PUBLIC SCHOOLS, SPRINGFIELD TOWNSHIP FIRE, LIVE WELL TOLEDO, CITY OF TOLEDO - DEPARTMENT OF NEIGHBORHOODS, HOSPITAL COUNCIL OF NORTHWEST OHIO, LUCAS COUNTY CHILDREN SERVICES, WHITEHOUSE, PROMEDICA, LUCAS COUNTY EMA, CENTER FOR HOPE, NEIGHBORHOOD HEALTH ASSOCIATION, HARBOR BEHAVIORAL HEALTH, BOWLING GREEN STATE UNIVERSITY, HEALTHY LUCAS COUNTY, ADELANTE, SYLVANIA TOWNSHIP FIRE DEPARTMENT, MERCY HEALTH, LOURDES UNIVERSITY, ASPIRE, UNITED WAY OF GREATER TOLEDO, MOBILE CARE GROUP, CARENET, TOLEDO COMMUNITY FOUNDATION, OREGON CITY, ST. LUKE'S HOSPITAL, UT MPH INTERNS, MENTAL HEALTH AND RECOVERY SERVICES BOARD, JERUSALEM TOWNSHIP FIRE, BRIGHTSIDE, AND THE ZEPF CENTER. GROUP B-FACILITY 3 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 6A: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE FOLLOWING HOSPITAL FACILITIES: THE TOLEDO HOSPITAL, FLOWER HOSPITAL, AND WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL. GROUP B-FACILITY 3 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 6B: THE HOSPITAL FACILITY CONDUCTED ITS 2016 CHNA WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO. GROUP A-FACILITY 1 -- THE TOLEDO HOSPITAL PART V, SECTION B, LINE 11: THE TOLEDO HOSPITAL CONDUCTED AND ADOPTED ITS SECOND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2016 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- TRAUMA - EDUCATION AND FALL PREVENTION- CARDIOVASCULAR DISEASETHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2016; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2017-2019.THE TOLEDO HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2016 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2016 IMPLEMENTATION PLAN INCLUDE: HEALTH STATUS PERCEPTIONS, HEALTH CARE COVERAGE/ACCESS/UTILIZATION, CANCER, DIABETES, ARTHRITIS, ASTHMA AND OTHER RESPIRATORY DISEASES, WEIGHT STATUS/OBESITY, TOBACCO USE, ALCOHOL CONSUMPTION, DRUG USE, WOMEN'S HEALTH, MEN'S HEALTH, PREVENTIVE HEALTH AND SCREENINGS, SEXUAL BEHAVIOR AND PREGNANCY OUTCOMES, ADULT SEXUAL BEHAVIOR, ADULT PREGNANCY, QUALITY OF LIFE, SOCIAL ISSUES, SOCIAL CONTEXT AND SAFETY, MENTAL HEALTH AND SUICIDE, ORAL HEALTH, MINORITY HEALTH, YOUTH WEIGHT, YOUTH TOBACCO USE, YOUTH ALCOHOL AND DRUG USE, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH SAFETY AND VIOLENCE, CHILDREN HEALTH STATUS, CHILDREN DIAGNOSED WITH ASTHMA, CHILDREN DIAGNOSED WITH ADHD/ADD, CHILDREN DIAGNOSED WITH VISION PROBLEMS THAT CANNOT BE CORRECTED, CHILDREN'S HEALTH ACCESS, EARLY CHILDHOOD HEALTH, MIDDLE CHILDHOOD HEALTH, FAMILY FUNCTIONING/NEIGHBORHOODS, AND PARENT HEALTH.THE TOLEDO HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2017 WITH RESPECT TO ITS MOST RECENTLY CONDUCTED CHNA IN 2016:HEALTH NEED IDENTIFIED: TRAUMA - EDUCATION AND FALL PREVENTIONSTRATEGY #1 - PROVIDE FREE CONTINUING MEDICAL EDUCATION, IN VARIOUS CATEGORIES, TO EMS (EMERGENCY MEDICAL SERVICES) PROVIDERS TO IMPROVE THE CARE PROVIDED TO PATIENT AT THE SCENE PRIOR TO TRANSPORTATION TO A HOSPITAL.ACTIONS TAKEN: - OVER 48 SESSIONS WITH 566 PARTICIPANTS PROVIDED IN FREE COMMUNITY EDUCATION. SOME TOPICS INCLUDE NARCOTIC OVERDOSE, TRAUMA TRIAGE, CIRCADIAN RHYTHM, PEDIATRIC TRAUMA, HEART FAILURE, INTERPRETING VITAL SIGNS (ADULT AND PEDIATRIC), PEDIATRIC BEHAVIORAL, EMERGENCY PREPAREDNESS, PEDIATRIC BEHAVIORAL EMERGENCIES, BACK TO THE BASICS, STROKE, 12 LEAD CLASS, PARAMEDIC REFRESHER, EVOC, NOVFA FIRE SCHOOL, GERIATRIC EMERGENCIES.STRATEGY #2 - PROVIDE MATTER OF BALANCE AND OTHER FALL PREVENTION EDUCATION IN THE COMMUNITY.ACTIONS TAKEN: - PROMEDICA HOME HEALTH CARE COMMUNITY OUTREACH ACTIVITIES PROVIDED AT LOCAL VENUES. 37 COMMUNITY OUTREACH PROGRAMS CONDUCTED AND OVER 6,000 COMMUNITY MEMBERS ATTENDED. EVENTS INCLUDED, BUT NOT LIMITED TO: ST. CATHERINE'S CHURCH FALL PREVENTION EDUCATION, HEART OF MATTER PROGRAM, SENIOR EXPO AT THE TAM-O-SHANTER, OREGON HEALTH FAIR, NATIONAL FALLS PREVENTION AWARENESS DAY, SENIOR SAFETY DAY, AND GO RED LUNCHEON.STRATEGY #3 - PROVIDE HOME SAFETY ASSESSMENTS FOR ALL PROMEDICA HOME CARE PATIENTS.ACTIONS TAKEN: - PROMEDICA HOME CARE PROVIDED HOME SAFETY ASSESSMENTS AND BASIC FALL PREVENTION EDUCATION, FREE OF CHARGE, FOR ALL PROMEDICA HOME HEALTH CARE ADMISSIONS IN 2017, WITH 12,828 HOME ASSESSMENTS PERFORMED.HEALTH NEED IDENTIFIED: CARDIOVASCULAR DISEASESTRATEGY #1 - PROVIDE FREE HANDS ONLY CPR (CARDIOPULMONARY RESUSCITATION) EDUCATION TO THE PUBLIC DURING AT LEAST FOUR COMMUNITY EVENTS EACH YEAR.ACTIONS TAKEN:- PROVIDED HANDS ONLY CPR AT: FREMONT ROTARY (19 PARTICIPANTS); HEALTHY HEART FAIR (NINE PARTICIPANTS); HEART OF THE MATTER (57 PARTICIPANTS); LATINO ART FESTIVAL (14 PARTICIPANTS); WORLD HEART DAY (30 PARTICIPANTS); AND BLACK WELLNESS DAY (EIGHT PARTICIPANTS). PROVIDED HANDS ONLY CPR AT LUCAS COUNTY FAIR (25 PARTICIPANTS) WITH CONTINUOUS FILM EDUCATION, AUTOMATIC EXTERNAL DEFIBRILLATOR (AED) DEMO, BLOOD PRESSURE CHECKS AND HEALTHY LIFESTYLE TEACHING, AND PROVIDED BROCHURES ON THE IMPORTANCE OF RECOGNIZING SIGNS OF HEART ATTACK AND CALLING 9-1-1. STRATEGY #2 - PROVIDE FREE CONSULTATION TO HIGH SCHOOLS, UPON REQUEST, TO MEET NEW FEDERAL STANDARD THAT ALL STUDENTS WILL HAVE CPR EDUCATION PRIOR TO HIGH SCHOOL GRADUATION.ACTIONS TAKEN:- TEN (10) TOLEDO PUBLIC SCHOOLS WERE ASSISTED IN MEETING CPR REQUIREMENT, WITH 25 EMPLOYEES TRAINED.TOLEDO CHILDREN'S HOSPITAL (OPERATING WITHIN AND AS PART OF THE TOLEDO HOSPITAL) CONDUCTED AND ADOPTED ITS SECOND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2016 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY: - DECREASE INFANT MORTALITY- DECREASE YOUTH MENTAL HEALTH ISSUES AND BULLYING- DECREASE HEART DISEASE AND OTHER CHRONIC DISEASES - ASTHMA- INCREASE HEALTHY WEIGHT STATUS- INJURY PREVENTION/SAFETY- INCREASE SCHOOL READINESSTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2016; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2017-2019. TOLEDO CHILDREN'S HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2016 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2016 IMPLEMENTATION PLAN INCLUDE: TOBACCO USE, ALCOHOL CONSUMPTION, MARIJUANA AND OTHER DRUG USE, VIOLENCE ISSUES, YOUTH PERCEPTIONS, CHILD HEALTH AND FUNCTIONAL STATUS, FAMILY FUNCTIONING/NEIGHBORHOOD & COMMUNITY CHARACTERISTICS, AND PARENT HEALTH.TOLEDO CHILDREN'S HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2017 WITH RESPECT TO ITS MOST RECENTLY CONDUCTED CHNA IN 2016:HEALTH NEED IDENTIFIED: DECREASE INFANT MORTALITYSTRATEGY #1 - REFER APPROPRIATE PATIENTS TO THE SAFE SLEEP CRIB PROGRAM AT THE TOLEDO LUCAS COUNTY HEALTH DEPARTMENT TO RECEIVE A PORTABLE CRIB FOR HELP ME GROW AND PATHWAYS PARTICIPANTS. PROVIDE ACCESS TO SAFE SLEEP EDUCATION TO LOW INCOME CAREGIVERS WITH CHILDREN LESS THAN 12 MONTHS OF AGE. PROVIDE FOLLOW UP ASSESSMENT TO FAMILIES RECEIVING A PORTABLE CRIB TO ENSURE SAFE SLEEP PRACTICES AND USE OF THE CRIB.ACTIONS TAKEN:- 181 SAFE SLEEP CRIB REFERRALS WERE MADE TO HELP ME GROW/PATHWAYS PROGRAM.- 139 FOLLOW UP ASSESSMENTS WERE COMPLETED ON PARTICIPANTS REFERRED TO CLASSES.STRATEGY #2 - PROVIDE SAFE SLEEP SACKS AND EDUCATION ON USE TO LOW INCOME CAREGIVERS WITH NEWBORN INFANTS WHEN APPROPRIATE. ACTIONS TAKEN: - 92 SLEEP SACKS WERE PROVIDED FOR INFANTS WITHOUT A SLEEP SACK. STRATEGY #3 - PROVIDE ASSESSMENT USING THE REPRODUCTIVE LIFE PLAN AND EDUCATION ON BIRTH SPACING (INFANT MORTALITY IS REDUCED IF BIRTH SPACING OF AT LEAST 18 MONTHS BETWEEN CHILDREN PLANNING TAKES PLACE) FOR ALL WOMEN ENROLLED IN TOLEDO HEALTHY TOMORROWS (THT) OB PATHWAYS PROGRAM.ACTIONS TAKEN:- 520 REPRODUCTIVE LIFE PLAN BIRTH SPACING ASSESSMENTS WERE COMPLETED.STRATEGY #4 - EDUCATE PREGNANT WOMEN IN THE BENEFITS OF BRESTFEEDING THEIR NEWBORN AND SUPPORT THEIR DECISION IF CHOOSING TO BREASTFEED.A) EXPAND TRAINING FOR TOLEDO HEALTHY TOMORROWS (THT) PATHWAYS AND HELP ME GROW STAFF IN THE BENEFITS OF BREASTFEEDING, ESPECIALLY WITH AFRICAN AMERICAN MOTHERS AT LEAST UNTIL THEIR NEWBORN IS 6 WEEKS OLD. B) PROMOTE BREASTFEEDING THROUGH EDUCATION AND SUPPORT OF PARTICIPANTS OF THT PATHWAYS AND ADD THE THT/HELP ME GROW PROGRAMS.C) INCREASE THE NUMBER OF INFANTS BEING BREASTFED WHOSE MOTHERS ARE ENROLLED IN THT PATHWAYS AND HELP ME GROW.D) CONTINUE TO OFFER AT LEAST 4 BREASTFEEDING EDUCATION CLASSES EACH MONTH THROUGH WOMENS, INFANTS AND CHILDREN (WIC).E) MAKE REFERRALS TO WIC LACTATION CONSULTANT AND WIC BREASTFEEDING STAFF.F) DISCUSS BREASTFEEDING WITH EACH PREGNANT WIC PARTICIPANT AND ENCOURAGE ATTENDANCE AT THE BREASTFEEDING EDUCATION CLASS.G) CONTACT BREASTFEEDING MOTHERS AND OFFER SUPPORT AS WELL AS TO ANSWER BREASTFEEDING QUESTIONS.ACTIONS TAKEN:- STAFF CONTINUING CURRENT EDUCATION TO PREGNANT WOMEN WITH AN EXPANDED PROGRAM BEING DEVELOPED BY HOSPITAL COUNCIL OF NORTHWEST OHIO (HCNO) BUT NOT AVAILABLE IN 2017. THIS EDUCATION WILL OCCUR IN 2018.- 274 PREGNANT WOMEN RECEIVED BREASTFEEDING PROMOTION EDUCATION THAT WAS PROVIDED DURING HOME VISITING TO PROGRAM PARTICIPANTS.- 165 NEWBORNS WERE BREASTFED IN THEIR FIRST 6 WEEKS AFTER DELIVERY.- 77 INFANTS WERE BREASTFED BEYOND 6 WEEKS AFTER DELIVERY.- 643 CONTACTS WERE MADE TO PREGNANT AND BREASTFEEDING MOTHERS BY LACTATION CONSULTANTS. (54 BREASTFEEDING EDUCATION CLASSES WERE OFFERED; 204 ATTENDED; 364 INDIVIDUALLY SEEN BY CONSULTANTS; 75 ATTENDED BABIES-R-US CLASS).- 34% OF WOMEN RECEIVING WIC (WOMEN, INFANT AND CHILDREN PROGRAM) THROUGH TOLEDO AND TOLEDO CHILDREN'S HOSPITALS ARE BREASTFEEDING. ALL WOMEN RECEIVING WIC ARE ENCOURAGED TO ATTEND THE BREASTFEEDING EDUCATION CLASS.HEALTH NEED IDENTIFIED: DECREASE YOUTH MENTAL HEALTH ISSUES AND BULLYINGSTRATEGY #1 - DECREASE BULLYING, SUICIDE, AND DATING VIOLENCE THROUGH AWARENESS AND PREVENTION PROGRAMS IN YOUTHS 12-18 YEARS.A. EACH SCHOOL YEAR THE TEEN PEERS EDUCATING PEERS (PEP) PROGRAM WILL BE OFFERED TO 12 CORE SCHOOLS IN LUCAS COUNTY. THE PROGRAM ADDRESSES TEEN DATING VIOLENCE, SEXUAL ASSAULT AND BULLYING PREVENTION.B. ONE ADDITIONAL SCHOOL WILL BE ADDED EACH YEAR PER GRANT FUNDING. PRIORITY WILL BE GIVEN TO ELEMENTARY SCHOOL INCLUSION AND REACHING YOUNGER STUDENTS VIA IMPLEMENTATION IN ELEMENTARY SCHOOL OR DELIVERING OLDER PEER LED EDUCATION (HIGH SCHOOL TO ELEMENTARY STUDENTS).C. PROGRAM LEAD WILL AS CO-CHAIR, COLLABORATE WITH THE LUCAS COUNTY SUICIDE PREVENTION COALITION (OTHER PARTNERS IN THE COALITION INCLUDE MERCY OUTREACH, THE UNIVERSITY OF TOLEDO, NAMI OF GREATER TOLEDO, LUCAS COUNTY MENTAL HEALTH AND RECOVERY SERVICES BOARD) TO DESIGN AND IMPLEMENT A TEEN AMBASSADOR PROGRAM WHICH WILL TRAIN AND UTILIZE SEVERAL STUDENTS FROM EACH PARTICIPATING SCHOOL TO PROMOTE SOCIAL MEDIA CAMPAIGNS AND AWARENESS ABOUT DEPRESSION AND SUICIDE PREVENTION, THUS REDUCING MENTAL HEALTH/SUICIDE STIGMA IN THEIR SCHOOLS. LUCAS COUNTY SUICIDE PREVENTION COALITION COORDINATOR (EMPLOYEE CONTRACTED THROUGH NAMI) WILL PROVIDE ONGOING OVERSIGHT, MANAGEMENT AND CONSULTATION TO SCHOOLS AND/OR STUDENTS PARTICIPATING IN NEWLY CREATED TEEN AMBASSADOR PROGRAM.D. PROGRAM LEAD WILL SERVE ON BRAVE (BULLYING RESOURCES AND ANTI-VIOLENCE EDUCATION) COMMITTEE, WHICH WAS CREATED BASED ON THE CHIP. BRAVE PARTNERING AGENCIES INCLUDE UT, TPS AND NAMI; COMMITTEE MISSION IS TO EXPAND COORDINATED ANTI-BULLYING EDUCATION AS WELL AS SUICIDE PREVENTION AND THREAT ASSESSMENT EDUCATION TO COMMUNITY SCHOOLS AND AGENCIES, PARENT GROUPS AND TEENS.E. NO LOCAL INITIATIVE/COALITION OR STRATEGIC PLAN EXISTS TO ADDRESS TEEN SEXUAL OR DATING VIOLENCE SPECIFICALLY. PROGRAM STAFF WILL PARTICIPATE IN CREATING A COMMUNITY COLLABORATIVE GROUP TO ADDRESS TEEN DATING VIOLENCE AND TEEN SEXUAL ASSAULT.ACTIONS TAKEN:- TEEN PEP FUNDED BY OHIO DEPARTMENT OF HEALTH (ODH). ODH FUNDED PROGRAMS RECEIVE OUTCOME MEASUREMENT EVALUATION GUIDANCE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION EMPOWERMENT EVALUATION CONTRACTOR DR. SANDRA ORTEGA FOR ALL PROGRAM OUTCOME MEASURES. RESULTS INCLUDED: 18 SCHOOLS PARTICIPATED; 176 TEEN PEER LEADERS WERE TRAINED; AND 2,082 CLASSROOM PARTICIPANTS GRADES 9-12 PARTICIPATED.- ADDITIONALLY, WHITTIER K-8 ELEMENTARY SCHOOL WAS ADDED PER GRANT FUNDING (ODH DECREASING FUNDING IN 2018).- THE NUMBER OF LCSPC (LUCAS COUNTY SUICIDE PREVENTION COALITION) TEEN AMBASSADOR PROGRAMS FOR 2017 WAS 10 SCHOOLS.- BRAVE COALITION DISBANDED PRIMARILY BECAUSE THE ORIGINAL OBJECTIVES OF THE COALITION/3-YEAR STRATEGIC GOALS HAD BEEN MET, AND MEMBERS OF THE COALITION WENT ON TO CONTINUE THE MISSION EITHER ON THEIR OWN OR THROUGH OTHER LIKE-MINDED COALITIONS SUCH AS THE LUCAS COUNTY SUICIDE PREVENTION COALITION AND TEEN PEP.- AS A LOCAL INITIATIVE, THE LUCAS COUNTY YOUTH SEXUAL AND INTIMATE PARTNER VIOLENCE COALITION WAS CREATED IN RESPONSE TO AN IDENTIFIED GAP FOR SUCH COMMUNITY COLLABORATION SURROUNDING TWO VERY IMPORTANT NEEDS IN THE TOLEDO AREA. THE COALITION HAS NOT DEVELOPED A FORMAL STRATEGIC PLAN, OPTING INSTEAD TO FOCUS ON PROMOTING YOUTH CULTURE CHANGE VIA SOCIAL MEDIA. YOUTH SPEND MUCH OF THEIR TIME ON VARIOUS SOCIAL MEDIA OUTLETS AND THIS WAS IDENTIFIED AS THE BEST WAY TO BOTH REACH LOCAL YOUTH AND IMPACT THEIR IDEAS AND KNOWLEDGE ABOUT SEXUAL ASSAULT AND TEEN DATING VIOLENCE. IN 2017, ITS THIRD YEAR, THE COALITION HAS HOSTED 3 TEEN FOCUS GROUPS IN THE TOLEDO AREA WITH VARIOUS YOUTH FROM DIVERSE POPULATIONS WITH THE GOAL OF INVOLVING YOUTH IN THE CREATION OF SEXUAL AND INTIMATE PARTNER VIOLENCE PREVENTION MESSAGING. FROM THESE FOCUS GROUPS, THE COALITION HAS SUCCESSFULLY STARTED UP BOTH A FACEBOOK AND INSTAGRAM PAGE THAT HIGHLIGHT AND PROMOTE PREVENTION MESSAGING SURROUNDING THESE TOPICS.STRATEGY #2 - EACH YEAR UP TO FOUR ELEMENTARY SCHOOLS WILL BE GIVEN BULLYING PREVENTION EDUCATION VIA OLDER TRAINED PEER LEADERS (HIGH SCHOOL TEAMS) OR FROM 7TH/8TH GRADE TRAINED TEEN LEADERS IN THEIR BUILDING. MEASUREMENT TO INCLUDE:A. NUMBER OF ELEMENTARY/MIDDLE SCHOOLS THAT HIGH SCHOOL LEADERS PRESENT TO.B. NUMBER OF TRAINED YOUTH LEADERS IN NEWLY ADDED ELEMENTARY SCHOOLS (WHERE APPLICABLE).C. NUMBER OF ELEMENTARY STUDENTS RECEIVING PEER LED EDUCATION.ACTIONS TAKEN:- OHIO DEPARTMENT OF HEALTH CONTRACTOR FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION GUIDES EMPOWERMENT EVALUATION FOR ALL PROGRAM OUTCOME MEASURES. 2017 RESULTS INCLUDE SEVEN (7) SCHOOLS PARTICIPATING.- 22 NUMBER OF TEEN PEER LEADERS WERE TRAINED. - 1,484 CLASSROOM PARTICIPANTS GRADES 1-6 PARTICIPATED.- ONE (1) ADDITIONAL SCHOOL WAS ADDED IN 2017, PER GRANT FUNDING (ODH DECREASING FUNDS IN 2018).STRATEGY #3 - PROVIDE TRAUMA-INFORMED TRAINING TO PROMEDICA TOLEDO CHILDREN HOSPITAL STAFF THAT PROVIDES CARE TO YOUTH (0-18 YEARS). THIS WILL HELP ENHANCE PATIENT-CENTERED CARE, WHICH WILL POSITIVELY IMPACT YOUTH MENTAL HEALTH. DEVELOP TRAUMA-INFORMED TRAININGS (BASED ON SAMHSA CURRICULUM) FOR DIFFERENT HOSPITAL STAFF/PROVIDER GROUPS.ACTIONS TAKEN:- GENERAL TRAUMA INFORMED CARE TRAINING WAS DEVELOPED TO EDUCATE MENTAL HEALTH PROFESSIONALS IN THE COMMUNITY PARTICIPATING.- PRE AND POST TEST DATA SHOWED INCREASED KNOWLEDGE OF DEPRESSION AND SUICIDE MARKERS, INDICATORS OF WHEN TO REFER FOR MENTAL HEALTH, INDICATORS OF TRAUMA, AND HOW TO BE A MORE TRAUMA-INFORMED STAFF MEMBER. STRATEGY #4 - THE LUCAS COUNTY TRAUMA INFORMED CARE COALITION (LCTIC) CREATED IN LATE 2014, IS A COUNTY WIDE COALITION WHOSE MISSION IS TO INCREASE AWARENESS AND PRACTICE OF TRAUMA INFORMED CARE (TIC) IN THE COMMUNITY. MEMBERSHIP INCLUDES STAFF FROM TOLEDO CHILDREN'S HOSPITAL, COMMUNITY MENTAL HEALTH CENTERS, THE LUCAS COUNTY MENTAL HEALTH RECOVERY SERVICES BOARD, DOMESTIC VIOLENCE SHELTERS, UNIVERSITY OF TOLEDO, UTMC, TOLEDO POLICE DEPARTMENT AND EMS, NAMI, UNITED WAY, AND MANY OTHERS. THE WORK OF THE LCTIC WILL HELP TO IMPROVE YOUTH MENTAL HEALTH THROUGH:A) EDUCATING MENTAL HEALTH PROFESSIONALS HOW TO PROVIDE MORE APPROPRIATE TRAUMA INFORMED SERVICES TO YOUTH WHO HAVE TRAUMA HISTORIES.B) EMPOWERING CONSUMERS, PARENTS, AND COMMUNITY MEMBERS TO BETTER UNDERSTAND HOW TO ACCESS APPROPRIATE TRAUMA INFORMED SERVICES FOR YOUTH WHO HAVE EXPERIENCED TRAUMA.C) ASSESS LEARNING DURING TRAUMA PRESENTATIONS BY DEVELOPING A BRIEF PRE AND POST TRAUMA KNOWLEDGE MEASURE TO GIVE TO ALL ATTENDEES OF THE TRAUMA PRESENTATIONS.D) COLLECTING AND PROVIDING DATA ON THE OTHER ACTIVITIES OF THE TRAUMA COALITION AND ITS IMPACT ON SPREADING TRAUMA INFORMED KNOWLEDGE TO THE COMMUNITY.E) BUILDING A TRAUMA COALITION COUNTY WEBSITE. DEVELOP AND FIND VETTED TRAUMA RESOURCES TO LINK TO THE WEBSITE AND/OR TO DISSEMINATE TO THE COMMUNITY.ACTIONS TAKEN: - 48 PROFESSIONALS IN THE COMMUNITY WERE TRAINED IN TRAUMA INFORMED CARE (TIC).- TRAUMA COALITION WEBSITE DEVELOPED AND RUNNING. VETTED TRAUMA RESOURCES WERE PLACED ON THE WEBSITE EMPOWERING VISITORS (I.E. CONSUMERS, PARENTS AND COMMUNITY MEMBERS) TO OBTAIN APPROPRIATE TRAUMA INFORMED SERVICES.- PRE AND POST ASSESSMENT OF TRAUMA INFORMED CARE PROVIDED TO THE 48 MENTAL HEALTH PROFESSIONALS TRAINED.- OVER 90% OF PARTICIPANTS AGREED/STRONGLY AGREED THEY UNDERSTOOD THE: DEFINITION OF TRAUMA, THREE E'S OF TRAUMA, PREVALENCE OF TRAUMA, FOUR R'S OF A TRAUMA INFORMED HOSPITAL; EFFECTS OF TRAUMA; WAYS THEY COULD BE MORE TRAUMA-INFORMED.- 70% OF PARTICIPANTS AGREED/STRONGLY AGREED THAT THEY UNDERSTOOD SAMHSA'S 6 PRINCIPLES IN TIC. RESULTS WERE PROVIDED TO THE TRAUMA COALITION.HEALTH NEED IDENTIFIED: DECREASE HEART DISEASE AND OTHER CHRONIC DISEASES - ASTHMASTRATEGY #1 - IMPROVE PATIENT/FAMILY KNOWLEDGE OF ASTHMA MANAGEMENT AND INCREASE THEIR PARTICIPATION IN SELF-CARE THROUGH EDUCATION.A) IMPLEMENT EVIDENCE BASED ASTHMA DISEASE MANAGEMENT PROGRAM UTILIZED AT PROMEDICA TOLEDO CHILDREN'S HOSPITAL FOR ASTHMA EDUCATION AT THE PEDIATRIC AMBULATORY DEPARTMENT.B) UTILIZE RESPIRATORY THERAPISTS TRAINED TO PROVIDE CONSISTENT ASTHMA EDUCATION TO PARENTS AND CHILDREN WITH ASTHMA.C) PROVIDE ASTHMA EDUCATION 2 DAYS PER WEEK TO ALL PARENTS OF ASTHMATIC CHILDREN SEEN IN THE PEDIATRIC AMBULATORY DEPARTMENT.D) PROVIDE THE ASTHMA INSTRUCTION BOOKLET TO PARENTS RECEIVING EDUCATION.E) PROVIDE AN ASTHMA ACTION PLAN TO ALL PARENTS OF CHILDREN SEEN IN THE PEDIATRIC AMBULATORY DEPARTMENT WITH A DIAGNOSIS OF ASTHMA.F) MONITOR CHILDREN WHO RECEIVE EDUCATION FOR FREQUENCY OF ASTHMA RELATED HOSPITALIZATIONS AND/OR ED VISITS DURING THIS INITIAL YEAR.G) PROMOTE PEDIATRIC AMBULATORY ASTHMA EDUCATION & MANAGEMENT AS A MODEL TO OTHER PEDIATRIC OFFICES TO INCREASE ASTHMA MANAGEMENT ACCESS FOR ALL CHILDREN WITH ASTHMA.ACTIONS TAKEN:- ASTHMA EDUCATION WAS PROVIDED TO 672 PATIENTS IN THE PEDIATRIC AMBULATORY DEPARTMENTS.- ACTION PLANS WERE GIVEN TO 518 PARENTS OF CHILDREN IN THE PEDIATRIC AMBULATORY DEPARTMENT WITH AN ASTHMA DIAGNOSIS.- 72 PATIENTS RETURNED FOR EDUCATION OR TO SEEK CLASS INSTRUCTION.STRATEGY #2 - DECREASE ASTHMA RELATED HOSPITAL ADMISSIONS AND EMERGENCY DEPARTMENT (ED) VISITS.A) WILL MONITOR ALL TOLEDO CHILDREN'S PEDIATRIC PRIMARY PATIENTS WHO RECEIVE ASTHMA EDUCATION FOR FREQUENCY OF ASTHMA RELATED HOSPITALIZATIONS AND/OR ED VISITS.B) EDUCATION WILL CONSIST OF TEACHING AND PRACTICING HEALTHY BEHAVIORS TO INCREASE NUMBER OF ASTHMA PATIENTS RETURNING FOR FOLLOW UP CARE AND MEDICATION REFILLS ON ROUTINE BASIS.C) UTILIZE HOME CARE NURSES TO PROVIDE HOME EVALUATIONS AND FOLLOW UP CARE FOR ASSESSMENT OF PATIENT/FAMILY UNDERSTANDING OF ASTHMA EDUCATION, IMPLEMENTATION OF MANAGEMENT SKILLS AND UNDERSTANDING OF NEED TO TAKE MEDICATIONS AS ORDERED.D) PATIENTS WILL FOLLOW UP IN PEDIATRIC AMBULATORY OFFICE FOR FOLLOW UP AS NEEDED WITH RESPIRATORY THERAPIST ASTHMA EDUCATOR FOR MONITORING FAMILY/CHILD'S UNDERSTANDING AND ONGOING MANAGEMENT OF EDUCATION. RESPIRATORY THERAPIST WILL RE-EDUCATE AS NEEDED.ACTIONS TAKEN: - MONITORED NUMBER OF ASTHMA HOSPITALIZATIONS/ED VISITS FROM 2017. THE < 30 DAY READMISSION RATE HAS DECREASED FROM 2.25% IN 2016 TO 1.5% IN 2017. THE PERCENTAGE OF < 30 AND < 60 DAY REVISITS TO THE ED HAVE REMAINED VIRTUALLY UNCHANGED BETWEEN 1Q17 AND 1Q18. THE % OF < 7 DAY REVISITS HAS INCREASED FROM 1.8% TO AVERAGE OF 2.95% ; THE < 7 DAY READMISSION RATE IS 0.5% FOR SAMPLED PATIENT POPULATION.- DEVELOPED MEASURES TO IDENTIFY NUMBER OF PATIENTS PARTICIPATION IN ASTHMA EDUCATION IN 2017. DEVELOPED MEASURES TO IDENTIFY IF INCREASING ASTHMA RECHECKS IN 2018. IDENTIFIED THAT PRIMARY CARE PHYSICIANS WERE NOT REFERRING ASTHMA PATIENTS TO HOME CARE CONSISTENTLY FOR HOME CARE NURSING FOLLOW UP PER NAEEP GUIDELINES 2007 REPORT. RE-EDUCATION HAS OCCURRED IN 2018 AND THEN ANNUALLY FOR UTILIZATION OF HOME CARE. ASTHMA EDUCATORS ARE TO PROVIDE FEEDBACK TO NURSES/PCP OF FAMILIES THAT WOULD BENEFIT FROM FOLLOW UP ASSESSMENT OF PATIENT/FAMILY UNDERSTANDING OF ASTHMA EDUCATION AND HOME ASTHMA MANAGEMENT SKILLS AND MEDICATION USAGE.- THE OFFICE HAS REDESIGNED THE SCHEDULING OF ASTHMA PATIENTS TO COINCIDE WITH THE DAYS THE RESPIRATORY THERAPISTS ARE AVAILABLE. - INCREASED NUMBER OF ASTHMA PATIENTS RETURNING FOR ASTHMA RECHECKS PER YEAR RESULTING IN CAPTURING ASTHMA PATIENTS WHILE IN OFFICE AND ABLE TO SCHEDULE NEXT APPOINTMENT BEFORE LEAVING. STRATEGY #3 - IMPROVE MANAGEMENT OF ASTHMA FOR CHILDREN AT PROMEDICA TOLEDO CHILDREN'S HOSPITAL AND ASSOCIATED OUTPATIENT AREAS.A) PROMEDICA TOLEDO CHILDREN'S HOSPITAL HAS BEEN ACCREDITED BY THE JOINT COMMISSION FOR ASTHMA DISEASE MANAGEMENT AND IS THE ONLY HOSPITAL IN OHIO WITH THIS DISTINCTION. THIS IS AN EVIDENCED BASED PROGRAM USING QUALITY MEASURES TO DETERMINE SUCCESS. THIS TEAM MEETS REGULARLY TO EVALUATE PROGRESS BASED ON TARGET GOALS.B) UTILIZE EVIDENCED BASED ASTHMA ORDER SETS DESIGNED FOR THE CHILDREN'S EMERGENCY DEPARTMENT, THE CHILDREN'S HOSPITAL PEDIATRIC UNIT AND PEDIATRIC INTENSIVE CARE UNIT (PICU).C) PROVIDE ASTHMA EDUCATION TO PATIENTS AND THEIR FAMILIES ADMITTED TO PROMEDICA TOLEDO CHILDREN'S HOSPITAL THAT MEET THE DIAGNOSIS CRITERIA FOR ASTHMA.D) PROVIDE STANDARDIZED ASTHMA EDUCATION TO PATIENTS AND THEIR FAMILIES SEEN IN CENTER FOR HEALTH SERVICES OR PULMONARY CLINIC THAT MEET THE CRITERIA FOR ASTHMA.E) PROVIDE THE ASTHMA INSTRUCTION BOOKLET TO THOSE PARENTS RECEIVING EDUCATION.F) PROVIDE AN ASTHMA ACTION PLAN TO ALL PATIENTS AND FAMILIES DISCHARGED WITH AN ASTHMA DIAGNOSIS FROM PROMEDICA TOLEDO CHILDREN'S HOSPITAL OR PEDIATRIC EMERGENCY DEPARTMENT.ACTIONS TAKEN:- TCH MAINTAINS ACCREDITATION BY THE JOINT COMMISSION FOR ASTHMA DISEASE MANAGEMENT PROVIDING THE HIGHEST LEVEL OF CARE.- 90% USE OF ASTHMA ORDER SETS COMPLETED IN PEDIATRIC EMERGENCY DEPARTMENT.- 98.5% USE OF ASTHMA ORDER SETS COMPLETED IN PEDIATRIC INPATIENT UNIT.- 100% USE OF ASTHMA ORDER SETS COMPLETED IN PEDIATRIC ICU.- 94% USE OF ASTHMA HOME MANAGEMENT PLAN OF CARE COMPLETED WITH PATIENTS AND THEIR FAMILIES AT TIME OF DISCHARGE; 97% HIGH RISK ASTHMA SCREENING COMPLETED WITH INPATIENTS.- 100% PATIENTS/FAMILIES CORRECTLY ANSWERED ASTHMA EDUCATION EVALUATIONS.- 0.5% PATIENTS WERE SEEN IN EMERGENCY DEPARTMENT WITHIN 7 DAYS; 1.7% WITHIN 30 DAYS FROM LAST EMERGENCY DEPARTMENT VISIT, (DECREASING NUMBER FROM PREVIOUS YEAR).STRATEGY #4 - IMPROVE ACCESS TO PEDIATRIC PRIMARY CARE PHYSICIANS AT THE PROMEDICA TOLEDO CHILDREN'S HOSPITAL CLINIC.A) INCREASE PEDIATRIC PHYSICIAN HOURS AS NEEDED.B) OFFER SAME DAY APPOINTMENTS FOR SICK NEW PATIENTS.C) MONITOR ACCESS TO CARE REPORT TO DETERMINE LENGTH OF TIME NEW PATIENTS MUST WAIT FOR APPOINTMENT AND ADD AVAILABLE PHYSICIAN HOURS AS NEEDED.ACTIONS TAKEN:- 1,433 NEW PATIENTS ATTENDED THE PROMEDICA TOLEDO CHILDREN'S HOSPITAL PRIMARY CARE CLINIC IN 2017. SAME DAY APPOINTMENTS ARE OFFERED FOR SICK, NEW PATIENTS.- ACCESS TO CARE REPORT COMPILED QUARTERLY TO MONITOR ACCESS TO CARE AND MODIFY, AS NEEDED, TO IMPROVE ACCESS TO CARE. STRATEGY #5 - INCREASE CHILDHOOD IMMUNIZATION RATES A) PROMEDICA TOLEDO CHILDREN'S HOSPITAL (TCH) WILL PROVIDE NURSE COVERAGE IN COLLABORATION WITH THE LUCAS COUNTY HEALTH DEPARTMENT "SHOTS FOR TOTS" PROGRAM TO PROVIDE IMMUNIZATIONS TO CHILDREN.B) THE PROMEDICA TOLEDO CHILDREN'S HOSPITAL PRIMARY CARE CLINIC WILL CONTINUE TO OFFER FREE "VACCINES FOR KIDS" PER THE STATE GUIDELINES TO ALL ELIGIBLE CHILDREN. THE STATE REGISTRY WILL BE UPDATED AT EACH VISIT WHERE SHOTS ARE GIVEN.C) THE PROMEDICA TOLEDO CHILDREN'S HOSPITAL PRIMARY CARE CLINIC WILL CONTINUE TO TAKE EVERY OPPORTUNITY AT VISITS TO UPDATE CHILDREN'S IMMUNIZATIONS.ACTIONS TAKEN:- TCH PROVIDED 122 NURSING HOURS TO SHOTS FOR TOTS PROGRAM IN THE COMMUNITY.- FREE VACCINES WERE OFFERED THROUGH THE "VACCINES FOR KIDS" PROGRAM.- 72% OF CHILDREN WERE IMMUNIZED BY AGE 2 IN THE PROMEDICA TOLEDO CHILDREN'S HOSPITAL PRIMARY CARE CLINIC.HEALTH NEED IDENTIFIED: INCREASE HEALTHY WEIGHT STATUSSTRATEGY #1 - INCREASE THE NUTRITION EDUCATION OFFERINGS TO CHILDREN AND PARENTS IN PROMEDICA TOLEDO CHILDREN'S HOSPITAL SERVICE AREA. DISTRIBUTE NUTREXITY BOARD GAMES TO ALL SURROUNDING ELEMENTARY SCHOOLS AND AFTER-SCHOOL PROGRAMS. NUTREXITY IS A BOARD GAME FOCUSED ON TEACHING HEALTHY EATING BASICS, INCLUDING NUTRITION, EXERCISE AND BEING A HEALTH PART OF THE COMMUNITY, TO 2ND-5TH GRADERS.ACTIONS TAKEN:- NUTREXITY GAMES WERE DONATED TO SCHOOLS AND COMMUNITY ORGANIZATIONS IN 2015 AND 2016 TO PROVIDE CONTINUOUS ACCESS TO THIS EDUCATIONAL PROGRAM AT THE SCHOOLS. IN LIEU OF PROVIDING THAT PROGRAM, COMMUNITY MEMBERS WERE EDUCATED THROUGH ALTERNATIVE PROGRAMS, INCLUDING: TWO (2) HEALTHY EATING PRESENTATIONS WITH STUDENTS AT CHRIST THE KING, AND FIVE (5) COOKING MATTERS AT THE STORE HEALTHY GROCERY STORE TOURS COMPLETED IN 2017 WITH 36 TOTAL PARTICIPANTS. STRATEGY #2 - ADDRESS FOOD INSECURITY AMONG PATIENTSA) ADDITIONAL PROMEDICA PRACTICES WILL BE TRAINED TO REFER FOOD INSECURE PATIENTS TO PROMEDICA'S FOOD PHARMACY, WHICH PROVIDES HEALTHY FOOD ON A MONTHLY BASIS TO PATIENTS.B) ALL PATIENTS AT TCH WILL BE SCREENED FOR FOOD INSECURITY PRIOR TO DISCHARGE AND WERE OFFERED AN EMERGENCY FOOD BAG UPON DISCHARGE.C) STARTING IN 2016, TOLEDO HOSPITAL/TOLEDO CHILDREN'S HOSPITAL WILL TAKE PART IN THE SUMMER FOOD SERVICE PROGRAM AS A SUMMER MEAL SITE PROVIDING FREE MEALS FOR CHILDREN AGES 1-18.ACTIONS TAKEN:- EIGHT (8) ADDITIONAL PROMEDICA PRACTICES WERE TRAINED IN 2017 TO REFER FOOD INSECURE PATIENTS TO PROMEDICA'S FOOD PHARMACY, WHICH PROVIDES HEALTHY FOOD ON A MONTHLY BASIS TO PATIENTS. - 1,896 FAMILIES WITH CHILDREN WERE SERVED BY THE PROMEDICA FOOD PHARMACY.- RESULTS FROM FOOD PHARMACY STUDY AND EMR DATA RESEARCH WERE COMPLETED IN 2017 SHOWING INSIGNIFICANT CHANGE IN FOOD INSECURITY LEVEL, QUALITY OF LIFE, AND MENTAL HEALTH OUTCOMES. ADDITIONAL RESULTS WILL BE AVAILABLE IN 2018. PRELIMINARY RESULTS FROM POPULATION HEALTH ANALYSIS OF THE SYSTEM FOOD CLINIC PROGRAM INDICATED A 3% REDUCTION IN ED USAGE; 53% REDUCTION IN ALL CAUSE READMISSION RATES, AND 4% INCREASE IN PRIMARY CARE USAGE FOR PATIENTS AFTER UTILIZING THE FOOD CLINIC PROGRAM. - ALL TCH PATIENTS WERE SCREENED FOR FOOD INSECURITY WITH 64 EMERGENCY FOOD BAGS PROVIDED TO TCH PATIENTS AT DISCHARGE.- 306 MEALS WERE SERVED AT TOLEDO HOSPITAL'S SUMMER MEALS PROGRAM.STRATEGY #3 - PROVIDE EDUCATION AND AWARENESS TO CHILDREN AND FAMILIES ON CHILD OBESITY AND HEALTHY SUPPLEMENTAL FOODS THROUGH THE PROMEDICA TOLEDO CHILDREN'S HOSPITAL WIC PROGRAM.A. CONDUCT INDIVIDUAL NUTRITION ASSESSMENTS FOR WIC PARTICIPANTS. TAILOR INDIVIDUAL WIC FOOD PACKAGE TO BEST MEET EACH PARTICIPANT'S INDIVIDUAL NUTRITION NEEDS AND/OR GOALS.B. MAKE REFERRALS TO PHYSICIAN, AS INDICATED BY WIC POLICIES AND PROCEDURES.C. PROVIDE BREASTFEEDING EDUCATION CLASSES.D. EDUCATE ON LIMITING JUICE AND EMPTY CALORIE FOODS AND REPLACE WITH ECONOMICAL HEALTHY FOODS.E. EDUCATE PARENT/CAREGIVER ON HOW TO EXTEND FOOD DOLLARS AND OFFERS HEALTHY, INEXPENSIVE MEAL IDEAS.F. PROVIDE FARMER MARKET COUPONS, TO ELIGIBLE WIC PARTICIPANTS, (JULY THROUGH SEPTEMBER) TO HELP INCREASE FRESH FRUIT AND VEGETABLE INTAKE.ACTIONS TAKEN:- 10,372 CHILDREN AND CAREGIVERS WERE ASSESSED AND EDUCATED THROUGH WIC PROGRAM.- ALL WIC PATIENTS ARE REQUIRED TO HAVE DIET ASSESSMENTS TWICE A YEAR, AND BASED ON THIS ASSESSMENT PHYSICIAN REFERRALS ARE MADE.- 54 BREAST FEEDING EDUCATION CLASSES WERE PROVIDED THROUGH THE CHS (CENTER FOR HEALTH SERVICES) CLINIC BASED WIC PROGRAM.- ALL WIC PATIENTS ARE REQUIRED TO HAVE DIET ASSESSMENTS TWICE A YEAR, AND BASED ON THIS ASSESSMENT, FAMILIES ARE EDUCATED ON LIMITING JUICE AND EMPTY CALORIE FOODS AND REPLACE WITH ECONOMICAL HEALTH FOODS.- ALL WIC PATIENTS ARE REQUIRED TO HAVE DIET ASSESSMENTS TWICE A YEAR, AND BASED ON THIS ASSESSMENT PARENTS/CAREGIVERS ARE EDUCATED ON HOW TO EXTEND FOOD DOLLARS AND OFFERED HEALTHY, INEXPENSIVE MEAL IDEAS.- 643 PARTICIPANTS PARTICIPATED IN THE CHS CLINIC BASED BREAST FEEDING CLASSES THROUGH THE WIC PROGRAM.- 1,044 FARMER MARKET COUPONS WERE GIVEN TO ELIGIBLE WIC PARTICIPANTS THROUGH THE WIC PROGRAM.HEALTH NEED IDENTIFIED: INJURY PREVENTION/SAFETYSTRATEGY #1 - PROMEDICA TOLEDO CHILDREN'S HOSPITAL IN PARTNERSHIP WITH STATE FARM WILL CONDUCT A DISTRACTED DRIVING PROGRAM THAT WILL EDUCATE HIGH SCHOOL STUDENTS AND THE COMMUNITY ON THE DANGERS OF DISTRACTED DRIVING AND THE IMPORTANCE TO SPEAK UP IF FEELING UNSAFE WITH OTHER DRIVERS (BASED ON FUNDING AVAILABILITY). CONDUCT DISTRACTED DRIVING PROGRAM FOR AT LEAST 3 HIGH SCHOOLS AND AT LEAST 1 COMMUNITY LOCATION.ACTIONS TAKEN:- PROMOTED AND FACILITATE DISTRACTED DRIVING PRESENTATIONS FOR EIGHT (8) HIGH SCHOOLS IN LUCAS COUNTY AND GREATER TOLEDO AREA, RESULTING IN EIGHT (8) SCHOOLS PARTICIPATING, 3,250 PARTICIPANTS WERE EDUCATED AT PRESENTATIONS, AND 320 PARTICIPANTS USED THE DISTRACTED DRIVER SIMULATOR.- DISTRACTED DRIVING EDUCATION PROVIDED AT COMMUNITY LOCATIONS IN 2017: TOLEDO AUTO SHOW (4 DAYS), TOLEDO HOSPITAL EMPLOYEE HEALTH FAIR, TOLEDO HOSPITAL CAFETERIA, SWANTON CORN FESTIVAL, OWENS CORNING EMPLOYEE HEALTH FAIR, LUCAS COUNTY EDUCATIONAL SERVICE CENTER (SOLAR ECLIPSE COMMUNITY VIEWING EVENT), AND PROMEDICA GO RED EVENT. APPROXIMATELY 250 TEENS AND ADULTS USING THE DISTRACTED DRIVING SIMULATOR AND OVER 1,500 PEOPLE REACHED THROUGH IN-DIRECT EDUCATION AT THESE EVENTS.STRATEGY #2 - KISS (KIDS IN SAFE SEATS)/OBB (OHIO BUCKLES BUCKEYES)/SAFE KIDS BUCKLE UP CAR SEAT PROGRAMS WILL EDUCATE PARENTS AND CAREGIVERS ON THE IMPORTANCE OF PROPER CAR SEAT USE AT TOLEDO CHILDREN'S HOSPITAL CAR SEAT FITTING STATION AND SAFE KIDS BUCKLE UP COMMUNITY EVENTS. PROVIDE AT LEAST 40 OPPORTUNITIES FOR PARENTS AND CAREGIVERS TO RECEIVE CAR SEAT INFORMATION.ACTIONS TAKEN:- CONDUCTED 57 CAR SEAT CHECKUP EVENTS THROUGHOUT THE GREATER TOLEDO AREA.STRATEGY #3 - KISS/OBB/SAFE KIDS BUCKLE UP WILL PROVIDE ACCESS TO CAR SEATS AND BOOSTER SEATS TO LOW-INCOME FAMILIES AT TOLEDO CHILDREN'S HOSPITAL CAR SEAT FITTING STATION AND SAFE KIDS BUCKLE UP COMMUNITY EVENTS. DISTRIBUTE AT LEAST 100 CAR SEATS TO LOW-INCOME FAMILIES.ACTIONS TAKEN:- 10 KISS/OBB/SAFE KIDS "BUCKLE UP" PRESENTATIONS WERE HELD.- 268 CAR SEATS AND BOOSTER SEATS WERE PROVIDED TO LOW INCOME FAMILIES.- 332 CAR SEATS WERE CHECKED FOR SAFE INSTALLATION.STRATEGY #4 - SAFE ROUTES TO SCHOOL PROGRAM WILL EDUCATE STUDENTS AND THE COMMUNITY ON THE BENEFITS OF WALKING AND BICYCLING TO SCHOOL IN GROUPS AS A WAY TO HAVE A SAFER NEIGHBORHOOD. ACTIONS TAKEN: - PRESENTED TO 17 CLASSROOMS ON PEDESTRIAN AND BICYCLE SAFETY. THE TOTAL NUMBER OF CHILDREN RECEIVING THIS EDUCATION WAS 425.STRATEGY #5 - SAFE KIDS GREATER TOLEDO WILL EDUCATE STUDENTS AND THE COMMUNITY ON THE BENEFITS OF WALKING AND BICYCLING TO SCHOOL IN GROUPS AS A WAY TO HAVE A SAFER NEIGHBORHOOD. PROMOTE INTERNATIONAL WALK TO SCHOOL DAY WITH AT LEAST ONE SCHOOL IN LUCAS COUNTY.ACTIONS TAKEN:- PROMOTED INTERNATIONAL WALK TO SCHOOL (82 PARTICIPANTS; 2 SCHOOLS; 2 PRESENTATIONS) WITH MORE FOCUS ON BIKE TO SCHOOL DAY (680 PARTICIPANTS; 13 SCHOOLS), AND PRESENTED 13 CLASSROOM PRESENTATIONS ON PEDESTRIAN AND BICYCLE SAFETY. STRATEGY #6 - PROMEDICA TOLEDO CHILDREN'S HOSPITAL COMMUNITY OUTREACH/SAFE KIDS HOME SAFETY AND TOLEDO HEALTHY TOMORROWS HELP ME GROW PROGRAMS WILL EDUCATE PARENTS, CAREGIVERS AND THE COMMUNITY ON HOME SAFETY ISSUES INCLUDING ACCIDENTAL POISONINGS SAFETY, MEDICATION SAFETY, WATER SAFETY, FALLS, FIRE, BURN, ETC. DIRECTLY EDUCATE AT LEAST 150 INDIVIDUALS THROUGH PRESENTATIONS AND EDUCATIONAL SESSIONS; INDIRECTLY EDUCATE THOUSANDS MORE THROUGH SOCIAL MEDIA, TRADITIONAL MEDIA AND BROCHURES.ACTIONS TAKEN:- CONDUCTED EDUCATIONAL PRESENTATIONS TO PARENTS/CAREGIVERS AND OTHER PROFESSIONALS WITH 187 PARTICIPANTS.STRATEGY #7 - TCH COMMUNITY OUTREACH/SAFE KIDS HOME SAFETY AND TOLEDO HEALTHY TOMORROWS HELP ME GROW PROGRAMS WILL PROVIDE SAFETY ITEMS AND EDUCATIONAL MATERIALS TO LOW-INCOME FAMILIES TO REDUCE OR PREVENT HOME-RELATED INJURIES. PROVIDE HOME SAFETY ITEMS/KITS TO AT LEAST 30 LOW-INCOME HOUSEHOLDS.ACTIONS TAKEN:- TOLEDO HEALTHY TOMORROWS HELP ME GROW AND PATHWAYS PROGRAMS PROVIDED HOME SAFETY ASSESSMENTS, ITEMS AND/OR EDUCATION TO 172 LOW INCOME FAMILIES IN 2017.STRATEGY #8 - ASSESS AND PROVIDE SAFETY ITEMS TO HOMES LACKING SMOKE/CARBON MONOXIDE (CO) DETECTORS, FIRE EXTINGUISHERS, CHILD SAFETY GATES, DOOR LOCKS, ETC. PARTNER WITH AMERICAN RED CROSS TO REQUEST AND INSTALL SMOKE/CO DETECTORS IN HOMES WITHOUT THEM. FOLLOW UP WITH POST ASSESSMENT TO ENSURE ITEMS ARE BEING USED AND INSTALLED/USED CORRECTLY. COMPLETE WRITTEN ASSESSMENT OF HOME AND NEED FOR SAFETY ITEMS. DISTRIBUTE NEEDED SAFETY ITEMS AND EDUCATE ON USE. COMPLETE WRITTEN FOLLOW UP ASSESSMENT ON INSTALLATION AND CORRECT USE OF SAFETY ITEMS PROVIDED.ACTIONS TAKEN:- PROVIDED SAFETY ITEMS SUCH AS BABY GATES, WINDOW GUARDS, CABINET LOCKS, APPLIANCE LOCKS, FIRE EXTINGUISHERS, CO DETECTORS, OUTLET COVERS, BATH THERMOMETERS, ETC. RESULTING IN 193 ITEMS DISTRIBUTED TO 105 HOUSEHOLDS.- CHILD/HOME SAFETY ASSESSMENTS WERE COMPLETED, WITH 172 COMPLETED ASSESSMENTS FOR HOME SAFETY ITEMS, 15 SMOKE/CO DETECTORS PROVIDED BY THE AMERICAN RED CROSS, AND 165 FOLLOW UP ASSESSMENTS COMPLETED.STRATEGY #9 - SAFE KIDS SPORTS SAFETY AND TOLEDO CHILDREN'S HOSPITAL TRAUMA DEPARTMENT WILL EDUCATE PARENTS/CAREGIVERS AND THE COMMUNITY ON CONCUSSION PREVENTION AND SPORTS-RELATED INJURIES AT EVENTS, COACHES TRAININGS, CONCUSSION CLINIC AND AREA SCHOOLS. EDUCATE AT LEAST 50 PARTICIPANTS AT PRESENTATIONS AND EVENTS.ACTIONS TAKEN:- CONDUCTED EDUCATIONAL PRESENTATIONS TO PARENTS/CAREGIVERS AND OTHER PROFESSIONALS ON SPORTS SAFETY ISSUES, WITH 19 EDUCATIONAL PRESENTATIONS AND 530 TOTAL PARTICIPANTS.STRATEGY #10 - TOLEDO CHILDREN'S HOSPITAL TRAUMA DEPARTMENT WILL ASSIST SCHOOLS AND MEDICAL PROFESSIONALS WITH "RETURN TO PLAY AND "RETURN TO LEARN" POLICY AND PROCEDURE ADOPTION BY PROVIDING EDUCATIONAL MATERIALS AND SESSIONS. PROVIDE INFORMATION TO AT LEAST FOUR SCHOOLS OR MEDICAL PROFESSIONALS.ACTIONS TAKEN:- PROVIDED "RETURN TO PLAY AND "RETURN TO LEARN" MATERIALS AND EDUCATIONAL SESSIONS, WITH 20 SCHOOLS AND 180 MEDICAL AND/OR SCHOOL PROFESSIONALS.HEALTH NEED IDENTIFIED: INCREASE SCHOOL READINESSSTRATEGY #1 - PROMOTE READING TO YOUNG CHILDREN THROUGH THE TOLEDO HEALTHY TOMORROWS/HELP ME GROW PROGRAM ON AN ONGOING BASIS. EDUCATE YOUNG LOW INCOME PARENTS ABOUT PARENTING AND THE BENEFITS OF READING TO THEIR CHILDREN DURING HOME VISITS. PROVIDE FREE CHILDREN'S BOOKS AT HOME VISIT. TOLEDO HEALTHY TOMORROWS (THT)/ HELP ME GROW HOME VISITORS PROVIDED LITERACY EDUCATION AND BOOKS TO FAMILIES.ACTIONS TAKEN:- EDUCATION PROVIDED TO 237 YOUNG LOW INCOME PARENTS AND 385 BOOKS WERE PROVIDED.STRATEGY #2 - PROVIDE AGE SPECIFIC DEVELOPMENTAL SCREENING FROM BIRTH TO AGE 3 FOR CHILDREN ENROLLED IN THT/HELP ME GROW PROGRAM. SCREEN ALL INFANTS AND CHILDREN TO AGE 3 YEARS WITH AGE APPROPRIATE AGES AND STAGES, THIRD EDITION. REFER ALL CHILDREN TO EARLY INTERVENTION THROUGH ESTABLISHED PROCEDURE IF SCREENING DETERMINES NEED FOR EVALUATION.ACTIONS TAKEN:- 618 SCREENINGS WERE COMPLETED AND 15 REFERRALS WERE MADE TO EARLY INTERVENTION.GROUP A-FACILITY 1 -- THE TOLEDO HOSPITALPART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXGROUP A-FACILITY 1 -- THE TOLEDO HOSPITALPART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXGROUP A-FACILITY 1 -- THE TOLEDO HOSPITALPART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX GROUP A-FACILITY 2 -- WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL PART V, SECTION B, LINE 11: WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL CONDUCTED AND ADOPTED ITS SECOND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2016 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- HUNGER- OBESITYTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2016; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2017-2019. WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY, TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS. THE 2016 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2016 IMPLEMENTATION PLAN INCLUDE: HEALTH CARE COVERAGE PERCEPTIONS, HEALTH CARE ACCESS AND UTILIZATION, CARDIOVASCULAR HEALTH, CANCER, DIABETES, ARTHRITIS, ASTHMA, TOBACCO USE, ALCOHOL CONSUMPTION AND DRUG USE, WOMEN'S HEALTH, MEN'S HEALTH, PREVENTIVE MEDICINE AND HEALTH SCREENINGS, ADULT SEXUAL BEHAVIOR, ADULT PREGNANCY OUTCOMES, QUALITY OF LIFE, SOCIAL CONTEXT AND SAFETY, SOCIAL ISSUES (EXCEPT HUNGER), MENTAL HEALTH AND SUICIDE, ORAL HEALTH, MINORITY HEALTH, HEALTH ISSUES SPECIFIC TO YOUTH AND CHILDREN, YOUTH WEIGHT, YOUTH TOBACCO USE, YOUTH ALCOHOL AND DRUG USE, YOUTH SEXUAL BEHAVIOR, YOUTH MENTAL HEALTH, YOUTH SAFETY AND VIOLENCE, CHILDREN HEALTH STATUS, CHILDREN DIAGNOSED WITH ASTHMA, CHILDREN DIAGNOSED WITH ADHD/ADD, CHILDREN DIAGNOSED WITH VISION PROBLEMS THAT CANNOT BE CORRECTED, CHILDREN'S HEALTH ACCESS, EARLY CHILDHOOD HEALTH, MIDDLE CHILDHOOD HEALTH, FAMILY FUNCTIONING/NEIGHBORHOODS, AND PARENT HEALTH.WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2017 WITH RESPECT TO ITS MOST RECENTLY CONDUCTED CHNA IN 2016:HEALTH NEED IDENTIFIED: HUNGERSTRATEGY #1 - SCREEN INPATIENTS ON ADMISSION FOR FOOD INSECURITY, AND PROVIDE FOOD TO TAKE HOME AT DISCHARGE IF FOOD INSECURITY IS IDENTIFIED.ACTIONS TAKEN:- ZERO PATIENTS AT WILDWOOD SCREENED POSITIVE FOR FOOD INSECURITY IN 2017. A TOTAL OF 480 PATIENTS AT TOLEDO HOSPITAL (THAT WILDWOOD OPERATES UNDER) WERE PROVIDED WITH EMERGENCY FOOD BOXES AT DISCHARGE IN 2017. STRATEGY #2 - SCREEN OUTPATIENTS IN SPECIFIC PROMEDICA PRIMARY CARE OFFICES FOR FOOD INSECURITY, AND PROVIDE A REFERRAL TO A PROMEDICA FOOD PHARMACY AND/OR PROVIDE A LISTING OF FOOD AGENCIES TO ASSIST PATIENTS WITH FOOD ACCESS.ACTIONS TAKEN:- 1,364 UNIQUE HOUSEHOLDS, WITH NO CHILDREN, WERE SERVED AT THE PROMEDICA FOOD CLINIC (PHARMACY) IN 2017.HEALTH NEED IDENTIFIED: OBESITYSTRATEGY #1 - PROVIDE FREE COOKING MATTERS PROGRAMMING TO PARENTS AND FAMILIES THROUGHOUT THE COMMUNITY. COOKING MATTERS IS A 6-WEEK HEALTHY EATING AND COOKING CLASS FOR LOW-INCOME FAMILIES, WHICH WILL BE OFFERED AT THE PROMEDICA EBEID INSTITUTE'S TEACHING KITCHEN.ACTIONS TAKEN:- SIX (6) EDUCATIONAL SESSIONS WERE PROVIDED IN 2017.- 82 PARTICIPANTS PARTICIPATED IN EDUCATIONAL SESSIONS.STRATEGY #2 - PROVIDE FREE COOKING MATTERS AT THE STORE PROGRAMMING TO PARENTS AND FAMILIES. COOKING MATTERS AT THE STORE IS A ONE-TIME, EDUCATIONAL GROCERY STORE TOUR TEACHING HEALTHY EATING ON A BUDGET.ACTIONS TAKEN:- FIVE (5) EDUCATIONAL SESSIONS WERE PROVIDED IN 2017.- 36 PARTICIPANTS PARTICIPATED IN EDUCATIONAL SESSIONS.STRATEGY #3 - PROVIDE PHYSICAL ACTIVITY EDUCATION AS PART OF THE PROGRAMMING AT THE EBEID INSTITUTE FOR POPULATION HEALTH.ACTIONS TAKEN:- 12 EDUCATIONAL SESSIONS WERE PROVIDED IN 2017.- 600 PARTICIPANTS PARTICIPATED IN EDUCATIONAL SESSIONS.GROUP A-FACILITY 2 -- WILDWOOD ORTHOPAEDIC & SPINE HOSPITALPART V, SECTION B, LINE 16A: THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXGROUP A-FACILITY 2 -- WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL HEADINGPART V, SECTION B, LINE 16B: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPXGROUP A-FACILITY 2 -- WILDWOOD ORTHOPAEDIC & SPINE HOSPITAL HEADINGPART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE AT THE FOLLOWING URL:WWW.PROMEDICA.ORG/PAGES/PATIENT-RESOURCES/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/DEFAULT.ASPX GROUP B-FACILITY 3 -- ARROWHEAD BEHAVIORAL HEALTH PART V, SECTION B, LINE 7B: THE CHNA REPORT WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL:HTTPS://WWW.PROMEDICA.ORG/FLOWER-HOSPITAL/DOCUMENTS/PROMEDICA%20TOLEDO%20FLOWER%20WILDWOOD%20AND%20ARROWHEAD%20BEHAVIORAL%20HOSPITALS%202016%20JOINT%20COMMUNITY%20HEALTH%20NEEDS%20ASSESSMENT.PDFGROUP B-FACILITY 3 -- ARROWHEAD BEHAVIORAL HEALTHPART V, SECTION B, LINE 11: ARROWHEAD BEHAVIORAL HOSPITAL CONDUCTED AND ADOPTED ITS SECOND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING TAX YEAR 2016 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:- SUBSTANCE ABUSE- MENTAL HEALTHTHIS CHNA WAS CONDUCTED AND ADOPTED AT THE END OF TAX YEAR 2016; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE THREE TAX YEARS, 2017-2019. ARROWHEAD BEHAVIORAL HOSPITAL DOES NOT INTEND TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT GIVEN THAT SOME OF THE IDENTIFIED HEALTH NEEDS ARE EITHER BEING ADDRESSED DURING PHYSICIAN VISITS, GO BEYOND THE SCOPE OF THE HOSPITAL, OR ARE BEING ADDRESSED BY, OR WITH, OTHER ORGANIZATIONS IN THE COMMUNITY. TO SOME EXTENT, RESOURCE RESTRICTIONS DO NOT ALLOW THE HOSPITAL TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED THROUGH THE HEALTH NEEDS ASSESSMENT, BUT MOST IMPORTANTLY TO PREVENT DUPLICATION OF EFFORTS AND INEFFICIENT USE OF RESOURCES, MANY OF THESE ISSUES ARE ADDRESSED BY, AND WITH, OTHER COMMUNITY ORGANIZATIONS AND COALITIONS.THE 2016 SIGNIFICANT HEALTH NEEDS IDENTIFIED, BUT SPECIFICALLY NOT ADDRESSED BY THE HOSPITAL IN ITS 2016 IMPLEMENTATION PLAN INCLUDE: HEALTH CARE PERCEPTIONS/COVERAGE/ACCESS/UTILIZATION, CARDIOVASCULAR HEALTH, DIABETES, CANCER, ARTHRITIS, ASTHMA AND OTHER RESPIRATORY DISEASES, WEIGHT STATUS, TOBACCAO USE, ALCOHOL AND DRUG USE, ORAL HEALTH, WOMEN'S HEALTH, MEN'S HEALTH, PREVENTIVE MEDICINE AND ENVIRONMENTAL HEALTH, ADULT SEXUAL BEHAVIOR AND PREGNANCY OUTCOMES, ADULT MENTAL HEALTH, QUALITY OF LIFE, SOCIAL CONTEXT AND SAFETY, MENTAL HEALTH AND SUICIDE, YOUTH HEALTH OR CHILD HEALTH, YOUTH WEIGHT CONTROL, YOUTH TOBACCO USE, YOUTH SEXUAL BEHAVIOR AND TEEN PREGNANCY OUTCOMES, YOUTH PERSONAL HEALTH AND SAFETY, YOUTH PERCEPTIONS, MATERNAL INFANT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD CARE HEALTH ACCESS, EARLY CHILDHOOD, MIDDLE CHILDHOOD, FAMILY AND COMMUNITY CHARACTERISTICS, PARENT HEALTH, CHILD HEALTH AND FUNCTION STATUS, CHILD HEALTH CARE ACCESS, EARLY CHILDHOOD, MIDDLE CHILDHOOD, FAMILY AND COMMUNITY CHARACTERISTICS, PARENT HEALTH.ARROWHEAD BEHAVIORAL HOSPITAL DID TAKE THE FOLLOWING ACTIONS DURING TAX YEAR 2017 WITH RESPECT TO ITS MOST RECENTLY CONDUCTED CHNA IN 2016:HEALTH NEED IDENTIFIED: SUBSTANCE ABUSESTRATEGY #1 - PROVIDE DRUG/ALCOHOL SCREENINGS VIA MOBILE ASSESSMENTS AT LOCAL EMERGENCY ROOMS, LUCAS COUNTY JAIL, SKILLED NURSING FACILITIES AND MEDICAL REHAB CENTERS.ACTIONS TAKEN:- PROVIDED SIX (6) DRUG/ALCOHOL SCREENINGS VIA MOBILE ASSESSSMENTS AT LOCAL EMERGENCY ROOMS, LUCAS COUNTY JAIL, SKILLED NURSING FACILITIES AND MEDICAL REHAB CENTERS.STRATEGY #2 - TRANSPORTATION FOR OUTPATIENT SERVICES AND INPATIENT DISCHARGES/ADMISSIONS (WHEN NEEDED).ACTIONS TAKEN:- PROVIDED FREE TRANSPORTATION FOR OUTPATIENT SERVICES AND INPATIENT DISCHARGES/ADMISSIONS (WHEN NEEDED). STRATEGY #3 - ONGOING COLLABORATION WITH LUCAS COUNTY DART (DRUG ABUSE RESPONSE TEAM).ACTIONS TAKEN:- HAD ONGOING COLLABORATION WITH LUCAS COUNTY DART PROGRAM THROUGHOUT 2017 THROUGH COMMUNITY LIAISON PARTICIPATION.STRATEGY #4 - PARTICIPATE IN COMMUNITY AWARENESS/EDUCATION ACTIVITIES, INCLUDING: RELAPSE PREVENTION, ALCOHOLICS ANONYMOUS AND NAMI FAMILY TO FAMILY.ACTIONS TAKEN:- 30 EDUCATIONAL SESSIONS WERE PROVIDED IN 2017.- UNKNOWN (NUMEROUS) PARTICIPANTS WERE IN EDUCATIONAL SESSIONS IN 2017.HEALTH NEED IDENTIFIED: MENTAL HEALTHSTRATEGY #1 - PARTICIPATE IN COMMUNITY AWARENESS/EDUCATION ACTIVITIES.ACTIONS TAKEN: - PARTICIPATED IN 30 COMMUNITY AWARENESS/EDUCATION ACTIVITIES IN 2017.STRATEGY #2 - CONTINUE TO PROVIDE INPATIENT CARE TO UNINSURED PATIENTS REGARDLESS OF ABILITY TO PAY.ACTIONS TAKEN:- PROVIDED INPATIENT CARE TO 32 OF UNINSURED PATIENTS IN 2017.STRATEGY #3 - CONTINUE SCREENING, EDUCATION AND WORKFORCE DEVELOPMENT OFFERED TO THE COMMUNITY TOGETHER WITH PROMEDICA FLOWER HOSPITAL PSYCHIATRIC SERVICES.ACTIONS TAKEN: - ARROWHEAD BEHAVIORAL HOSPITAL STAFF PARTICIPATED IN MULTIPLE NAMI (NATIONAL ALLIANCE FOR MENTAL ILLNESS) EVENTS, INCLUDING DONATION OF $2,500 FOR A SPONSORSHIP FOR THE NAMI WALK.GROUP B-FACILITY 3 -- ARROWHEAD BEHAVIORAL HEALTHPART V, SECTION B, LINE 20E: PRIOR TO PURSUING COLLECTION ACTIONS, THE HOSPITAL FACILITY INITIATED THE FOLLOWING ACTIONS: - PATIENTS ARE OFFERED PAYMENT PLANS TO WORK WITH THE HOSPITAL FACILITY TO PAY THEIR OUTSTANDING BALANCES WITH COMMUNICATION MADE TO THE PATIENT ON A MONTHLY BASIS VIA PAPER INVOICES AND PHONE CALLS- PATIENT ACCOUNTS WILL NOT GO TO BAD DEBT COLLECTION IF THE PATIENT MAKES MONTHLY PAYMENTS AS AGREED TO WITH THE HOSPITAL FACILITY OR IF THE PATIENT COMMUNICATES THEIR INABILITY TO MAKE PAYMENTS TIMELY- PATIENT ACCOUNTS WILL GO TO BAD DEBT COLLECTION IF THE PATIENT DOES NOT COMMUNICATE WITH THE HOSPITAL FACILITY OR RESPOND TO PAPER INVOICES AND PHONE CALLS FOR MULTIPLE MONTHS 57 1 - PARKWAY SURGERY CENTER 3500 EXECUTIVE PARKWAY TOLEDO OH 43606 SURGICAL CENTER/LAB 2 - PROMEDICA TRANSPORTATION NETWORK 2142 NORTH COVE BLVD TOLEDO OH 43606 GROUND AND AIR TRANSPORT 3 - ENDOSCOPY CENTER 3439 GRANITE CIRCLE TOLEDO OH 43617 ENDOSCOPY 4 - NORTHWEST OHIO CARDIOLOGY 2940 N MCCORD RD TOLEDO OH 43615 CARDIOLOGY 5 - HARRIS MCINTOSH RADIOLOGY 2121 HUGHES DR TOLEDO OH 43623 RADIOLOGY 6 - PROMEDICA LABS 2141 GIANT ST TOLEDO OH 43606 LAB 7 - PROMEDICA HEALTH & WELLNESS CENTER 5700 MONROE ST SUITE 109 SYLVANIA OH 43560 RADIOLOGY 8 - PROMEDICA HEALTH & WELLNESS CENTER 5700 MONROE ST SUITE 109 SYLVANIA OH 43560 LAB 9 - TOLEDO CHILDRENS HEART CENTER 2121 HUGHES DR TOLEDO OH 43606 CARDIOLOGY 10 - TOTAL REHAB PEDIATRICS 4041 W SYLVANIA AVE SUITE 100 TOLEDO OH 43623 PHYSICAL THERAPY 11 - SPORTSCARE AT WILDWOOD MEDICAL CENTER 2865 N REYNOLDS RD SUITE 110 TOLEDO OH 43615 PHYSICAL THERAPY 12 - CENTER FOR WOUND CARE OF NW OHIO 3110 W CENTRAL AVE SUITE A TOLEDO OH 43606 WOUND CARE 13 - TOTAL REHAB WILDWOOD 2865 N REYNOLDS RD SUITE 101 TOLEDO OH 43615 PHYSICAL THERAPY 14 - JOBST VASCULAR INSTITUTE - TOLEDO 2109 HUGHES DR TOLEDO OH 43606 VASCULAR 15 - PROMEDICA WILDWOOD 2865 N REYNOLDS RD SUITE 130 TOLEDO OH 43615 RADIOLOGY 16 - MONROE CARDIOLOGY TESTING CENTER 730 N MACOMB ST MONROE MI 48162 CARDIOLOGY 17 - PROMEDICA HEALTH CENTER ARROWHEAD 660 BEAVER CREEK CIRCLE SUITE 120 MAUMEE OH 43537 LAB 18 - REYNOLDS ROAD SURGICAL CENTER 2865 N REYNOLDS RD TOLEDO OH 43615 SURGERY CENTER 19 - PROMEDICA VASCULAR LAB - SYLVANIA 5700 MONROE ST SYLVANIA OH 43560 VASCULAR 20 - TOLEDO HOSPITAL TOTAL REHAB AT CTR 2150 W CENTRAL AVE TOLEDO OH 43606 PHYSICAL THERAPY 21 - CENTER FOR HEALTH SVCS 2150 W CENTRAL AVE TOLEDO OH 43606 LAB 22 - HARRIS MCINTOSH RADIOLOGY 2121 HUGHES DR TOLEDO OH 43623 PULMONARY 23 - PERRYSBURG MEDICAL CTR 1601 BRIGHAM DR SUITE 180 PERRYSBURG OH 43551 LAB 24 - TOLEDO HOSPITAL AT CONRAD JOBST TOWER 2109 HUGHES DR SUITE 130 TOLEDO OH 43606 LAB 25 - PROMEDICA HEALTH CENTER ARROWHEAD 660 BEAVER CREEK CIRCLE SUITE 120 MAUMEE OH 43537 RADIOLOGY 26 - TOLEDO HOSPITAL CARDIAC TESTING CTR 1601 BRIGHAM DR PERRYSBURG OH 43551 CARDIOLOGY 27 - TOTAL REHAB AT PERRYSBURG 1601 BRIGHAM DR SUITE 100 PERRYSBURG OH 43551 PHYSICAL THERAPY 28 - WEST CENTRAL SURGICAL CENTER 7055 W CENTRAL AVE TOLEDO OH 43617 SURGERY CENTER 29 - CHS WOMENS 2150 W CENTRAL TOLEDO OH 43606 WOMENS CARE 30 - TOTAL REHAB OF MAUMEE ARROWHEAD 650 BEAVER CREEK CIRCLE SUITE 210 MAUMEE OH 43537 PHYSICAL THERAPY 31 - PROMEDICA PERRYSBURG 1601 BRIGHAM DR SUITE 180 PERRYSBURG OH 43551 RADIOLOGY 32 - CHS PEDIATRICS 2150 W CENTRAL AVE 2ND FLOOR TOLEDO OH 43606 PEDIATRICS 33 - PROMEDICA HEALTH CTR LAMBERTVILLE 7579 SECOR RD LAMBERTVILLE MI 48114 LAB 34 - PROMEDICA LABS MCCORD RD 3020 N MCCORD RD SUITE 101 TOLEDO OH 43615 LAB 35 - PROMEDICA WILDWOOD 2865 N REYNOLDS RD SUITE 130 TOLEDO OH 43615 LAB 36 - TOLEDO HOSPITAL FAMILY RESIDENCY 2100 W CENTRAL AVE STE 200 TOLEDO OH 43606 FAMILY MEDICINE CENTER 37 - PROMEDICA LABS POINT PLACE 4805 SUDER RD TOLEDO OH 43611 LAB 38 - PROMEDICA HEALTH CTR SWANTON 22 TURTLE CREEK CIRCLE SWANTON OH 43558 LAB 39 - NWO BREAST MRI 2121 HUGHES DR SUITE 300 TOLEDO OH 43606 RADIOLOGY 40 - PROMEDICA LAB - TOLEDO HOSPITAL 2100 W CENTRAL AVE TOLEDO OH 43606 LAB 41 - PROMEDICA ROSSFORD 1209 DIXIE HWY ROSSFORD OH 43460 LAB 42 - JOBST ANTICOAGULATION - TOLEDO 2109 HUGHES DR SUITE 550 TOLEDO OH 43606 ANTICOAGULATION THERAPY 43 - PROMEDICA HEALTH CTR EAST 3156 DUSTIN RD SUITE 101 OREGON OH 43616 LAB 44 - PROMEDICA PERRYSBURG VASCULAR 1601 BRIGHAM DR SUITE 180 PERRYSBURG OH 43551 VASCULAR 45 - PROMEDICA MARY ELLEN FALZONE DIABETES 2100 W CENTRAL AVE TOLEDO OH 43606 DIABETES CARE 46 - PROMEDICA PHYSICIANS GENERAL SURGERY 5700 MONROE ST SYLVANIA OH 43560 BARIATRIC 47 - PROMEDICA PHYSICIANS GYNOONCOLOGY 2109 HUGHES DR STE 820 TOLEDO OH 43606 WOMENS CARE 48 - TOTAL REHAB - PROMEDICA OWENS CORNING 1 OWENS CORNING PARKWAY TOLEDO OH 43659 PHYSICAL THERAPY 49 - CHS HEMOPHILIA 2150 W CENTRAL AVE TOLEDO OH 43606 HEMOPHILIA 50 - PROMEDICA HEALTH & WELLNESS CENTER 5700 MONROE ST SUITE 109 SYLVANIA OH 43560 PULMONARY FUNCTION 51 - CENTER FOR WOUND CARE OF NW OHIO 2751 BAY PARK DR OREGON OH 43616 WOUND CARE 52 - CHS OCCUHEALTH 2142 NORTH COVE BLVD TOLEDO OH 43606 LAB 53 - TOLEDO HOSPITAL AT CONRAD JOBST TOWER 2109 HUGHES DR SUITE 130 TOLEDO OH 43606 RADIOLOGY 54 - CENTER FOR HEALTH SVCS 2150 W CENTRAL TOLEDO OH 43606 RADIOLOGY 55 - JULIE MILLER DO 2150 W CENTRAL AVE TOLEDO OH 43606 PHYSICAL MEDICINE 56 - CHS INTERNAL MEDICINE 2150 W CENTRAL AVE TOLEDO OH 43606 INTERNAL MEDICINE 57 - PROMEDICA CHILDREN'S AUTISM CENTER 2040 W CENTRAL TOLEDO OH 43606 AUTISM CENTER PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES RESIDENCY STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: THE TOLEDO HOSPITAL REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE PROMEDICA HEALTH SYSTEM, INC. ANNUAL COMMUNITY BENEFIT REPORT. PART I, LINE 7: THE TOLEDO HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. OTHER BENEFITS AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. AN INDIRECT COST ALLOCATION FACTOR FOR SHARED SERVICES IS ALSO CALCULATED AND INCLUDED IN APPLICABLE PROGRAMS LISTED IN OTHER BENEFITS. PART III, LINE 2: THE TOLEDO HOSPITAL'S ANALYSIS AND ASSESSMENT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND RELATED BAD DEBT EXPENSE USES A RECEIPTS "LOOK-BACK" METHOD UTILIZING HISTORICAL PAYMENT DATA ON ACCOUNTS, INCLUDING CONTRACTUAL ADJUSTMENTS FOR PAYER DISCOUNTS, AS WELL AS PATIENT PAYMENTS, SUCH AS CO-PAYS AND DEDUCTIBLES, TO ESTABLISH ANTICIPATED COLLECTABILITY RATES FOR ACCOUNTS RECEIVABLE WITHIN EACH PAYER CATEGORY. PART III, LINE 3: THE TOLEDO HOSPITAL ESTIMATED THE POSSIBLE AMOUNT OF FINANCIAL ASSISTANCE WITHIN BAD DEBT EXPENSE BY REVIEWING ACCOUNTS THAT WERE INTERNALLY CODED AS HAVING BEEN PROVIDED A FINANCIAL ASSISTANCE APPLICATION, BUT THAT WAS NOT ADEQUATELY COMPLETED BY THE PATIENT OR GUARANTOR, IN WHICH THE ACCOUNT WAS SUBSEQUENTLY WRITTEN OFF TO BAD DEBT. PART III, LINE 4: PROVISION FOR BAD DEBTS AND ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE DISCUSSED ON PAGES 12 AND 13 OF THE ATTACHED PROMEDICA HEALTH SYSTEM AND SUBSIDIARIES CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTAL INFORMATION. PART III, LINE 8: MEDICARE SHORTFALL, WHICH IS THE EXCESS OF COSTS TO TREAT MEDICARE PATIENTS OVER THE REIMBURSEMENT RECEIVED FROM THE FEDERAL GOVERNMENT, SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:- THE MEDICARE SHORTFALL REPRESENTS THE RELIEF OF A FINANCIAL BURDEN THAT WOULD OTHERWISE BE BORNE BY A GOVERNMENT PROGRAM.- THE MEDICARE SHORTFALL REPRESENTS A SOCIETAL BENEFIT INSOFAR AS MANY OF THE PROGRAMS AND SERVICES WOULD NOT BE PROVIDED TO THE COMMUNITY, IF THE DECISION TO PROVIDE SUCH SERVICES WAS MADE ON A FINANCIAL BASIS.- MEDICARE IS A SOCIETAL BENEFIT, PROVIDED BY THE FEDERAL GOVERNMENT, FOR THOSE WHO WOULD OTHERWISE BE UNINSURED AFTER AGING OUT OF TRADITIONAL MEANS OF HEALTH INSURANCE, SUCH AS INSURANCE PROVIDED BY AN EMPLOYER.- MEDICARE IS NOT A TRUE MARKET PAYER, AS COMPARED TO COMMERCIAL PAYERS, WHEREBY REIMBURSEMENT RATES CAN BE NEGOTIATED AND ADJUSTED IN ORDER TO REDUCE INCURRED LOSSES.THE TOLEDO HOSPITAL USED THE MEDICARE ALLOWABLE COSTS PER ITS 2017 AS-FILED MEDICARE COST REPORTS, LESS ANY ADJUSTMENTS FOR SUBSIDIZED HEALTH SERVICES AND HEALTH PROFESSIONS EDUCATION, IF APPLICABLE. ALLOWABLE COSTS ARE CALCULATED BY ALLOCATING TOTAL FACILITY COSTS TO REVENUE GENERATING UNITS WITHIN THE HOSPITAL. THE MEDICARE COST REPORT DOES NOT REFLECT ALL OF THE COSTS ASSOCIATED WITH MEDICARE PROGRAMS. PART III, LINE 9B: FINANCIAL ASSISTANCE DISCOUNTS ARE GRANTED FOR MEDICALLY NECESSARY SERVICES WHEN IT IS DETERMINED THAT THE PATIENT AND FAMILY INCOME MEETS THE CRITERIA ESTABLISHED. PATIENTS WHO HAVE INSURANCE COVERAGE OR WHO ARE ENTITLED TO GOVERNMENTAL ASSISTANCE ARE IDENTIFIED IN ORDER FOR REIMBURSEMENT TO BE OBTAINED. ALL PATIENTS WITH SELF-PAY BALANCES AFTER INSURANCE MAY OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS IF THEY PROVIDE APPROPRIATE DOCUMENTATION THAT THEY SATISFY THE INCOME GUIDELINES. VERIFICATION OF FINANCIAL ASSISTANCE IS PURSUED THROUGHOUT THE INTERNAL COLLECTION PROCESS UNTIL ALL OPTIONS HAVE BEEN EXHAUSTED. ALL PATIENTS, THAT HAVE A SELF-PAY BALANCE, INCLUDING PATIENTS THAT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, RECEIVE BILLING STATEMENTS AND PAYMENT REMINDERS. THESE STATEMENTS INFORM ALL PATIENTS OF THE OPPORTUNITY TO SEEK A FINANCIAL ASSISTANCE ADJUSTMENT FOR MEDICALLY NECESSARY SERVICES, THE ELIGIBILITY CRITERIA, AND THE METHOD TO APPLY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN COMPLETED AND/OR REQUESTED INCOME VERIFICATION HAS NOT BEEN RECEIVED FROM A PATIENT WHO COULD POTENTIALLY QUALIFY, THE PATIENT WILL CONTINUE TO RECEIVE BILLING STATEMENTS THROUGH THE NORMAL COLLECTION PROCESS. IF A PATIENT DOES NOT HAVE INSURANCE, A PRESUMPTIVE CHARITY DETERMINATION (WHICH USES PUBLICLY AVAILABLE DATA SUCH AS DEMOGRAPHIC INFORMATION, CREDIT HISTORY, ETC.) MAY BE MADE TO ASSIST WITH QUALIFYING FOR FINANCIAL ASSISTANCE. ONCE IT HAS BEEN DETERMINED THAT A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, AN ADJUSTMENT IS PROCESSED. THE PATIENT ACCOUNT ANALYST WILL DETERMINE PATIENT ELIGIBILITY AND CALCULATE THE ADJUSTMENT BASED ON POLICY GUIDELINES. AN ADJUSTMENT FORM IS PREPARED AND APPROVED PER POLICY. UNINSURED PATIENTS MAY BE REQUIRED TO COMPLETE AN APPLICATION AND PROVIDE REQUIRED DOCUMENTATION, INCLUDING ANY DOCUMENTATION REQUIRED TO DETERMINE ELIGIBILITY. UNINSURED PATIENTS ARE NOTIFIED IN WRITING WHETHER OR NOT THEY QUALIFY FOR ANY FINANCIAL ASSISTANCE ADJUSTMENT FOR WHICH THEY HAVE SUBMITTED AN APPLICATION, AND OF ANY REMAINING BALANCE OWED. THE ADJUSTMENT IS THEN APPLIED TO THE PATIENT'S ACCOUNT.PATIENTS MAY BE OFFERED PAYMENT PLANS WHEN APPROPRIATE BASED ON DOCUMENTED FINANCIAL NEED AND CIRCUMSTANCES. LONGER PAYMENT PLANS MAY BE OFFERED ON AN EXCEPTION BASIS FOR CASES WITH UNUSUALLY HIGH BALANCES OR SPECIAL CIRCUMSTANCES DEMONSTRATING AN INABILITY TO PAY. ONCE THE INTERNAL COLLECTION PROCESS HAS BEEN COMPLETED, PATIENT ACCOUNTS MAY BE REFERRED TO AN EXTERNAL COLLECTION AGENCY IF THE PATIENT HAS NOT CONTACTED US REGARDING THEIR DESIRE TO APPLY FOR FINANCIAL ASSISTANCE, SENT IN A FINANCIAL ASSISTANCE APPLICATION, RESPONDED TO REQUESTS FOR ADDITIONAL INFORMATION, OR WE ARE UNABLE TO MAKE A PRESUMPTIVE CHARITY DETERMINATION. IT IS THE EXPECTATION OF THE EXTERNAL COLLECTION AGENCY AS THEY WORK ACCOUNTS TO OFFER FINANCIAL ASSISTANCE WHEN APPLICABLE. THROUGHOUT THE COLLECTION PROCESS, THE COLLECTION AGENCY WILL INFORM UNINSURED PATIENTS OF THE CRITERIA TO OBTAIN FINANCIAL ASSISTANCE ADJUSTMENTS BASED ON FAMILY INCOME AND FAMILY SIZE, AND WILL FORWARD APPLICATIONS FOR PATIENTS WHO SUBMIT THE REQUIRED DOCUMENTATION TO THE CENTRAL BUSINESS OFFICE FOR PROCESSING. PART VI, LINE 2: PROMEDICA HEALTH SYSTEM AND HOSPITALS DEMONSTRATE A COMMITMENT TO THE COMMUNITIES IT SERVES AND THEREFORE, BELIEVES IT IS CRITICAL TO UNDERSTAND THE HEALTH CARE NEEDS OF ITS PRIMARY SERVICE AREA. TO THAT END, PROMEDICA HOSPITALS CONDUCT NEEDS ASSESSMENTS IN ITS PRIMARY SERVICE AREAS USING A VARIETY OF METHODOLOGIES TO ASSESS EACH COUNTY'S HEALTH CARE DATA, IDENTIFY GAPS IN HEALTH CARE INITIATIVES, AND MAKE RECOMMENDATIONS FOR THE BETTERMENT OF THE GENERAL COMMUNITY HEALTH. ANALYSIS OF PUBLISHED COUNTY HEALTH DATA, INTERVIEWS WITH KEY STAKEHOLDERS, AND REVIEW OF HISTORICAL AND EXISTING PROMEDICA COMMUNITY ASSESSMENTS ARE ALL MEANS BY WHICH RECOMMENDATIONS FOR THE PROMEDICA COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLANS ARE DEVELOPED. INFORMATION IS REVIEWED AND APPROVED BY HOSPITAL GOVERNANCE LEADERSHIP TO ASSURE THAT PLANS ARE DEVELOPED TO MEET THE NEEDS OF THE COMMUNITY. PUBLISHED COUNTY HEALTH DATACOUNTY HEALTH DATA WERE OBTAINED FROM SEVERAL SOURCES, INCLUDING THE OHIO DEPARTMENT OF HEALTH DATA WAREHOUSE, THE MICHIGAN DEPARTMENT OF HEALTH, AND FORMAL COUNTY ASSESSMENTS CONDUCTED WITHIN THE INDIVIDUAL COUNTIES. ALTHOUGH MOST COUNTIES CONDUCTING A FORMAL ASSESSMENT UTILIZE THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AS THE BASIS OF THE COUNTY QUESTIONNAIRE, COUNTY COMMITTEES TYPICALLY ADD AND/OR CHANGE QUESTIONS TO MEET THE COUNTY'S PERCEIVED NEEDS. PROMEDICA'S COMMUNITY GOALS ARE SET BASED ON THESE DATA.PROMEDICA COMMUNITY HEALTH PLANOVERALL, EMPHASIS IS PLACED ON CLINICAL PROGRAMS FOCUSED ON LEADING CAUSES OF DEATH: CHRONIC DISEASES, MENTAL HEALTH, AND HUNGER/OBESITY DUE TO THE LARGE NUMBERS OF INDIVIDUALS AFFECTED BY THESE DISEASES. THE PRIMARY FOCUS FOR COMMUNITY HEALTH ACTIVITIES ARE RELATED TO EDUCATION, SCREENING, AND PREVENTION OF CHRONIC DISEASES, MENTAL HEALTH ISSUES, AND HUNGER/OBESITY; AND IMPROVING RELATED CONDITIONS THAT RESULT IN HIGH MORBIDITY AND MORTALITY IN OUR COMMUNITIES, WITH SPECIAL EMPHASIS PLACED ON SERVING UNDERSERVED POPULATIONS. AS A SYSTEM, WE ARE ALSO COMMITTED TO WORKING BEYOND OUR FOUR WALLS, ON THE SOCIAL AND ECONOMIC ISSUES THAT IMPACT HEALTH. IN ADDITION, PROMEDICA STRATEGIC PLANNING CONTINUES TO DEVELOP PATIENT-CENTERED, INTEGRATED CLINICAL SERVICE LINES INCLUDING CANCER, CARDIOVASCULAR, BEHAVIORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND MATERNAL FETAL MEDICINE. PART VI, LINE 3: THE OPPORTUNITY FOR FINANCIAL ASSISTANCE ADJUSTMENTS IS COMMUNICATED TO PATIENTS AT PROMEDICA HEALTH SYSTEM HOSPITALS THROUGH THE FOLLOWING METHODS:A. DURING THE PRE-REGISTRATION PROCESS FOR SCHEDULED INPATIENTS AND HIGH-DOLLAR OUTPATIENT CASES, THE CENTRALIZED PRE-REGISTRATION STAFF WILL NOTIFY A PATIENT FINANCIAL ADVOCATE TO CONTACT THE PATIENT PRIOR TO SERVICE TO DISCUSS POTENTIAL ELIGIBILITY FOR GOVERNMENT PROGRAMS AND FINANCIAL ASSISTANCE. THE PRE-SERVICE FUNCTION INCLUDES ACCOUNT REGISTRATION, INSURANCE VERIFICATION, PRE-CERTIFICATION AND FINANCIAL COUNSELING.B. ADMITTING LOCATIONS WILL HAVE FINANCIAL ASSISTANCE FORMS AVAILABLE FOR SELF-PAY PATIENTS TO COMPLETE WHEN REGISTERED AS UNINSURED. AT ADMITTING, UNINSURED PATIENTS ARE INFORMED OF THE OPPORTUNITY TO SEEK FINANCIAL ASSISTANCE. C. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE AT THE HOSPITALS TO ASSIST UNINSURED PATIENTS IN COMPLETING THE FORMS. PATIENT FINANCIAL ADVOCATES ATTEMPT TO MEET WITH IN-HOUSE PATIENTS TO ASSESS ELIGIBILITY AND TO ASSIST WITH APPLICATION FOR GOVERNMENT ASSISTANCE PROGRAMS, TO EXPLAIN PATIENT LIABILITY FOR CHARGES, TO PROVIDE AN ESTIMATE OF CHARGES WHEN FEASIBLE, TO EXPLAIN THE OPPORTUNITY FOR FINANCIAL ASSISTANCE, INCLUDING THE CRITERIA AND THE METHOD FOR APPLYING, AND TO EXPLAIN PAYMENT OPTIONS.D. A MESSAGE IS PRINTED ON THE PATIENT BILLING STATEMENTS TO NOTIFY THE UNINSURED PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE, TO EXPLAIN THE ELIGIBILITY CRITERIA, AND TO DESCRIBE THE METHOD TO APPLY.E. A SUMMARY OF THE POLICY FOR UNINSURED PATIENTS IS INCLUDED IN THE STATEMENTS OF UNINSURED PATIENT, AVAILABLE VIA THE PROMEDICA WEB SITE, AVAILABLE AT HOSPITAL REGISTRATION LOCATIONS, OR BY CALLING THE PROMEDICA CUSTOMER SERVICE DEPARTMENT. BUSINESS OFFICE PERSONNEL ALSO NOTIFY UNINSURED PATIENTS OF THE FINANCIAL ADJUSTMENT POLICY THROUGH THE CUSTOMER SERVICE AND COLLECTION DEPARTMENTS. PART VI, LINE 4: THE TOLEDO HOSPITAL, LOCATED IN TOLEDO, OHIO, SERVES AN AREA PRIMARILY AROUND LUCAS COUNTY AND HAS A SERVICE AREA POPULATION OF APPROXIMATELY 803,000. APPROXIMATELY, 17% OF THE SERVICE AREA IS AGE 65 OR OVER; 38% IS BETWEEN AGE 35 AND 64; MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $54,000; 44% OF THE ADULT POPULATION AGED 25+ HAS A HIGH SCHOOL DEGREE OR LOWER; 49% OF HOUSEHOLDS HAVE AN INCOME OF $50,000 OR LESS. LUCAS COUNTY HAS A POPULATION OF APPROXIMATELY 440,000 WITH APPROXIMATELY 11% OF FAMILIES BELOW THE POVERTY LEVEL AND AN APPROXIMATE 33% MEDICAID ELIGIBLE RATE. APPROXIMATELY, 16% OF LUCAS COUNTY IS UNINSURED. THE AVERAGE UNEMPLOYMENT RATE FOR LUCAS COUNTY IN 2017 WAS 5.3%. THE LEADING CAUSES OF DEATH IN LUCAS COUNTY, BASED ON AGE ADJUSTED MORTALITY RATES ARE HEART DISEASE, LUNG DISEASE, STROKE, DIABETES, CANCER, ALZHEIMER'S AND UNINTENTIONAL INJURIES/ACCIDENTS. ACCORDING TO 2017 COUNTY HEALTH RANKINGS, LUCAS COUNTY RANKED 69 OF 88 COUNTIES FOR HEALTH OUTCOMES, 65 OF 88 FOR LENGTH OF LIFE, AND 73 OF 88 FOR QUALITY OF LIFE. THERE ARE TWELVE HOSPITALS WITHIN A 30-MILE RADIUS OF THE TOLEDO HOSPITAL: ST. ANNE MERCY HOSPITAL, ST. VINCENT MERCY MEDICAL CENTER, UNIVERSITY OF TOLEDO MEDICAL CENTER, FLOWER HOSPITAL, ST. CHARLES MERCY HOSPITAL, BAY PARK COMMUNITY HOSPITAL, ST. LUKE'S HOSPITAL, MERCY MEMORIAL HOSPITAL CORPORATION, WOOD COUNTY HOSPITAL, EMMA L. BIXBY MEDICAL CENTER, HERRICK MEMORIAL HOSPITAL, INC., AND FULTON COUNTY HEALTH CENTER. PART VI, LINE 5: THE TOLEDO HOSPITAL IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC. WHICH PROMOTES THE HEALTH OF THE COMMUNITY AS AN INTEGRATED DELIVERY SYSTEM. - IN 2017, THERE WERE 450 BOARD MEMBERS FOR PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), INCLUDING ITS SUBSIDIARIES. OF THESE, 99% LIVED WITHIN PROMEDICA'S 27-COUNTY SERVICE AREA, WITH THE MAJORITY RESIDING WITHIN METRO TOLEDO WHERE PROMEDICA'S ADULT AND PEDIATRIC TERTIARY HOSPITALS (THE TOLEDO HOSPITAL AND TOLEDO CHILDREN'S HOSPITAL) ARE LOCATED. TRUSTEE REPRESENTATION IS COMPRISED OF DIVERSE MEMBERS, INCLUDING 75 PHYSICIANS, FROM NORTHWEST OHIO AND SOUTHEAST MICHIGAN. ADDITIONALLY, PROMEDICA BOARD MEMBERS INCLUDED 151 WOMEN AND 58 RACIAL/ETHNIC MINORITIES.- BOARD MEMBERS ARE NOT COMPENSATED BY PROMEDICA FOR THEIR SERVICE TO OUR HOSPITALS AND OTHER BUSINESS UNITS; THEIR DONATION OF TIME AND EXPERTISE, INCLUDING ATTENDING BOARD MEETINGS, RETREATS AND OTHER ACTIVITIES, ARE PERFORMED ON A VOLUNTEER BASIS. - PROMEDICA'S MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITIES WHICH PROMEDICA SERVES. QUALIFICATION MAY VARY BY HOSPITAL, BUT ANY PHYSICIAN WHO MEETS THOSE QUALIFICATIONS MAY BE GRANTED PRIVILEGES.- IN 2017, PROMEDICA INVESTED SIGNIFICANT TIME AND FINANCIAL RESOURCES TO COMPLETING THE ROLL OUT OF ITS ELECTRONIC HEALTH RECORD (EHR), EPIC. GO-LIVES TOOK PLACE IN MAY AT PROMEDICA BIXBY AND HERRICK, MONROE REGIONAL, AND MEMORIAL HOSPITALS, AS WELL AS THE 30 PROMEDICA PHYSICIANS OFFICES THAT SUPPORT THESE FACILITIES IN MICHIGAN AND FREMONT. THE FINAL GO-LIVES WERE FOLLOWED IN THE FALL WITH A SYSTEM-WIDE UPGRADE TO THE LATEST OPERATING PLATFORM FOR EPIC, FURTHER ENABLING ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF SERVICE ACROSS PROMEDICA.- PROMEDICA PROVIDED NEARLY 18,000 HEALTH SCREENINGS TO COMMUNITY MEMBERS THROUGHOUT 2017, INCLUDING BLOOD PRESSURE, BLOOD GLUCOSE AND BODY MASS INDEX SCREENINGS AT NUMEROUS HEALTH FAIRS AND SPORTING EVENTS. ADDITIONALLY, FREE SCREENING MAMMOGRAMS, AS WELL AS SKIN CANCER AND LUNG CANCER SCREENINGS AND COLORECTAL CANCER EDUCATION WERE PROVIDED FOR EARLY DETECTION. PROSTATE CANCER SCREENING EDUCATION AND NUTRITIONAL PROGRAMS WERE DEVELOPED TO KEEP PEOPLE HEALTHY.- PROMEDICA'S FOUNDATION RAISES FUNDS FOR PHILANTHROPY IN SUPPORT OF PROMEDICA'S MISSION TO IMPROVE HEALTH AND WELL-BEING. ANNUAL DONOR PROGRAMS, CAPITAL CAMPAIGNS, PLANNED GIVING, AND EVENT FUNDRAISING ACTIVITIES ARE CONDUCTED TO RAISE FUNDS THAT SUPPORT PATIENTS AND FAMILIES, AS WELL AS LOCAL COMMUNITIES, THROUGH HEALTH-RELATED PROGRAMS, SERVICES, EQUIPMENT, AND FACILITY CONSTRUCTION/RENOVATION THAT HAVE BEEN IDENTIFIED, IN PART, THROUGH A COMMUNITY NEEDS ASSESSMENT. PART VI, LINE 6: PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT WAS FORMED IN TOLEDO, OHIO IN 1986. IN 2017 PROMEDICA WAS COMPRISED OF MORE THAN 17,000 EMPLOYEES, APPROXIMATELY 2,500 VOLUNTEERS AND MORE THAN 2,000 HEALTHCARE PROVIDERS, INCLUDING APPROXIMATELY 900 PROVIDERS EMPLOYED BY PROMEDICA PHYSICIAN GROUP, WHO HAVE JOINED TOGETHER TO FORM A NETWORK ACROSS 27 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN. AS AN INTEGRATED DELIVERY SYSTEM, PROMEDICA PROVIDERS SHARE RESOURCES SUCH AS ADVANCED TECHNOLOGY, QUALITY STANDARDS, SAFETY PRACTICES, MEDICAL EXPERTISE, AND SPECIALTY SERVICES TO HELP ENSURE AREA RESIDENTS HAVE READY ACCESS TO HIGH-QUALITY CARE IN THE MOST APPROPRIATE SETTING IN ORDER TO PROVIDE COST-EFFICIENT SERVICES. - PROMEDICA MEMBERS INCLUDE: THE TOLEDO HOSPITAL D/B/A PROMEDICA TOLEDO HOSPITAL; PROMEDICA TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF PROMEDICA TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL, A DIVISION OF PROMEDICA TOLEDO HOSPITAL; FLOWER HOSPITAL D/B/A PROMEDICA FLOWER HOSPITAL; BAY PARK COMMUNITY HOSPITAL D/B/A PROMEDICA BAY PARK HOSPITAL; EMMA L. BIXBY MEDICAL CENTER D/B/A PROMEDICA BIXBY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC. D/B/A PROMEDICA HERRICK HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION D/B/A PROMEDICA FOSTORIA COMMUNITY HOSPITAL; DEFIANCE HOSPITAL, INC. D/B/A PROMEDICA DEFIANCE REGIONAL HOSPITAL; MERCY MEMORIAL HOSPITAL CORPORATION D/B/A PROMEDICA MONROE REGIONAL HOSPITAL; MEMORIAL HOSPITAL D/B/A PROMEDICA MEMORIAL HOSPITAL; PROMEDICA INSURANCE CORPORATION; PROMEDICA PHYSICIAN GROUP, A NETWORK OF SYSTEM-EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS; AND PROMEDICA CONTINUING CARE SERVICES CORPORATION, WITH SERVICES SUCH AS SENIOR CARE, HOSPICE, REHABILITATION SERVICES, AND HOME CARE.- IN 2017, PROMEDICA MANAGED APPROXIMATELY 4.1 MILLION PATIENT ENCOUNTERS AND CONTRIBUTED A TOTAL COMMUNITY BENEFIT OF OVER $191 MILLION, WHICH INCLUDED FREE HEALTH SCREENINGS AND PARTICIPATION IN PUBLIC HEALTH FAIRS TO MEDICAL LECTURES AT AREA SENIOR CENTERS AND NUTRITION EDUCATION IN ELEMENTARY SCHOOLS, PLUS MUCH MORE. - PROMEDICA CONTINUES TO OPERATE TWO FOOD CLINICS - ONE AT THE PROMEDICA HEALTH AND WELLNESS CENTER AND THE OTHER AT PROMEDICA'S CENTER FOR HEALTH SERVICES - TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEM AND THEIR FAMILY FROM THIS LOCATION OR THE ORIGINAL FOOD PHARMACY LOCATED AT PROMEDICA'S CENTER FOR HEALTH SERVICES. AS PART OF THE PROGRAM, EACH PATIENT RECEIVES TWO TO THREE DAYS OF SUPPLEMENTAL FOOD FOR THEIR FAMILY. THROUGH DECEMBER 2017, THERE WERE MORE THAN 9,700 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 3,200 UNIQUE HOUSEHOLDS. THIS TRANSLATES TO ABOUT 74,520 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 223,560 MEALS. - PROMEDICA EBEID INSTITUTE'S MARKET ON THE GREEN PROVIDES BETTER ACCESS TO HEALTHY FOODS IN A DESIGNATED FOOD DESERT, AS WELL AS JOB TRAINING OPPORTUNITIES FOR RESIDENTS IN THE UPTOWN TOLEDO NEIGHBORHOOD, AND A FINANCIAL OPPORTUNITY CENTER TO PROVIDE FINANCIAL COUNSELING FOR RESIDENTS.- IN 2017, PROMEDICA ESTABLISHED THE EBEID PROMISE, A 10-YEAR, $50 MILLION COMMUNITY REVITALIZATION INITIATIVE THANKS TO A GENEROUS $28.5 MILLION GIFT FROM THE FAMILY OF PHILANTHROPIST AND FORMER BOARD MEMBER RUSSELL J. EBEID. THE EBEID PROMISE WILL EXPAND THE SCOPE AND PURPOSE OF THE EBEID INSTITUTE WITH A KEY FOCUS ON THE SOCIAL DETERMINANTS OF HEALTH - HEALTH, NUTRITION, EDUCATION, JOB CREATION, AND FAMILY STABILITY. THIS LONG-TERM INVESTMENT WILL START WITH THE UPTOWN TOLEDO NEIGHBORHOOD AND BE EXPANDED TO TOLEDO'S MONROE STREET CORRIDOR, NEAR PROMEDICA TOLEDO HOSPITAL. PLANS INCLUDE REPLICATING THIS CONCEPT IN COMMUNITIES ACROSS PROMEDICA'S SERVICE AREA IN COMING YEARS.- WITH REGARD TO HEALTH PROFESSIONS EDUCATION, BIWEEKLY, MONTHLY AND ANNUAL PROGRAMS WERE OFFERED THROUGHOUT 2017 FOR CONTINUING MEDICAL EDUCATION CREDIT. MORE THAN 1,500 CREDIT HOURS OF PHYSICIAN EDUCATION WERE OFFERED TO EMPLOYED PROMEDICA PHYSICIANS AND MEDICAL STAFF MEMBERS AS WELL AS NURSES AND OTHER ALLIED HEALTH PROFESSIONALS. 1 PROMEDICA CONTINUING CARE SERVICES CORPORATION 100 MADISON AVE TOLEDO OH 43604 344492440 501(C)(3) 27679770 OPERATING GRANT PROMEDICA HEALTH SYSTEM INC 100 MADISON AVE TOLEDO OH 43604 341517671 501(C)(3) 56000000 OPERATING GRANT PROMEDICA PHYSICIAN GROUP 100 MADISON AVE TOLEDO OH 43604 341899439 501(C)(3) 54318940 OPERATING GRANT PROMEDICA FOUNDATION 444 N SUMMIT ST TOLEDO OH 43604 341517672 501(C)(3) 2628058 OPERATING GRANT THE ARMS FORCES PO BOX 981 MAUMEE OH 43537 270889821 501(C)(3) 7529 CHARITABLE DONATION 5 0 PART I, LINE 2: AS AN AFFILIATE OF PROMEDICA HEALTH SYSTEM, INC. (PHS), CORPORATE TREASURY, WITH THE APPROVAL AND OVERSIGHT OF THE FINANCE COMMITTEE, ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO PHS'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE TREASURY POLICIES AND PROCEDURES. X 1 1 1 1 0 0 0 0 0 0 0 ARTURO POLIZZI PRESIDENT, EX OFFICIO 0 473390 0 147815 0 14583 0 238803 0 25797 0 900388 0 0 DAVID SCOTT MIERZWIAK MD TRUSTEE 0 322334 0 40392 0 24013 0 48247 0 23969 0 458955 0 0 DEBORAH A GUNTSCH MD TRUSTEE 8125 230323 0 102508 0 3333 0 6942 0 12591 8125 355697 0 0 KEVIN C WEBB PHD EX OFFICIO 0 510025 0 135703 0 9899 0 226149 0 14526 0 896302 0 0 RAVI K ADUSUMILLI MD TRUSTEE 0 562540 0 60896 0 37362 0 8100 0 35169 0 704067 0 0 JEFFREY C KUHN SECRETARY 0 479712 0 108013 0 28699 0 229520 0 14639 0 860583 0 0 MICHAEL P BROWNING TREASURER 0 586938 0 70000 0 40177 0 222483 0 23931 0 943529 0 0 RANDALL OOSTRA PHS PRES & CEO, EX OFFICIO 0 1086659 0 577159 0 85998 0 468579 0 14639 0 2233034 0 159048 ALISON S AVENDT VP, OPERATIONS TTH & PRES, PTN 0 163849 0 16091 0 1439 0 21458 0 2088 0 204925 0 0 DARRIN M ARQUETTE SR. VP, NEURO, HEART AND VASC 0 215123 0 92356 0 27839 0 20942 0 25399 0 381659 0 0 DAWN BUSKEY COO, METRO REGION ACUTE CARE 0 286085 0 49036 0 25749 0 60823 0 15000 0 436693 0 0 DEANA L SIEVERT SR. VP, PAT CARE/CNO, SYSTEM 0 209341 0 24440 0 7212 0 39867 0 25864 0 306724 0 0 GARY W AKENBERGER SR. VP DIAG, FACILITIES & SEC 0 322399 0 48208 0 9197 0 71258 0 20062 0 471124 0 0 LORI FERGUSON VP, PATIENT CARE, TTH 0 28537 0 89640 0 129172 0 162707 0 20670 0 430726 0 0 PAULA L GRIEB VP, PAT CARE/ASSOC CNO, METRO 0 173478 0 16328 0 800 0 14809 0 6443 0 211858 0 0 SCOTT FOUGHT VP, FINANCE, ACUTE CARE OPS 0 258000 0 21808 0 1350 0 23604 0 22679 0 327441 0 0 THADIUS L WADSWORTH VP SURGICAL SERVICES, METRO 64956 80861 2000 0 626 10842 0 8821 844 6759 68426 107283 0 0 FEDOR LURIE ASSOC. DIR. RESEARCH ED. VASC. 209091 0 0 0 1314 0 10314 0 17886 0 238605 0 0 0 JACKLYN KIEFER ASSOC. DIR. ED. FAMILY PRACTICE 194992 0 0 0 649 0 12159 0 6069 0 213869 0 0 0 JEFFREY LEWIS ASSOC. DIR. ED. FAMILY PRACTICE 190332 0 0 0 3150 0 33672 0 19492 0 246646 0 0 0 JOSHUA OVENS RN, CRITICAL CARE TRANSPORT 240907 0 0 0 3354 0 16936 0 24185 0 285382 0 0 0 LOUITO EDJE DIR. ED. FAMILY PRACTICE 218816 0 0 0 1125 0 13658 0 16282 0 249881 0 0 0 ALAN M SATTLER FORMER OFFICER 0 381523 0 0 0 7515 0 54182 0 26751 0 469971 0 0 KATHLEEN S HANLEY FORMER OFFICER 0 0 0 0 0 571790 0 0 0 1351 0 573141 0 258776 JOSEPH SFERRA FORMER KEY EMPLOYEE 0 674774 0 0 0 3129 0 42061 0 2796 0 722760 0 0 KHURRAM KAMRAN FORMER KEY EMPLOYEE 0 0 0 12762 0 143081 0 1416 0 3847 0 161106 0 143395 NEERAJ K KANWAL MD FORMER KEY EMPLOYEE 0 324821 0 48616 0 3599 0 31366 0 25084 0 433486 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS 2 HIGHEST COMPENSATED EMPLOYEES INCLUDED IN TAXABLE COMPENSATION PART I, LINE 3 PROMEDICA HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION OF THE TOLEDO HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4A: UNDER A VOLUNTARY TERMINATION AGREEMENT ENTERED INTO BY THE EMPLOYEE AND THE ORGANIZATION OR UPON A QUALIFYING TERMINATION DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE, THE EMPLOYEE IS ENTITLED TO SEVERANCE PAY BASED UPON YEARS OF SERVICE. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRE THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM PROMEDICA. SEVERANCE PAYMENTS WERE MADE DURING THE YEAR TO THE FOLLOWING LISTED PERSONS IN PART VII: KATHLEEN S. HANLEY $258,776 KHURRAM KAMRAN $143,395 LORI FERGUSON $103,952 PART I, LINE 4B: ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. IN ADDITION, THE ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR. A COUNTY OF LUCAS OHIO 346400806 549310VL1 2015-09-30 45586125 SEE PART VI 0 0 0 B SERIES 2011 A & B BONDS - SEE PART VI 549310UL2 2011-02-09 197051617 SEE PART VI 1 0 0 C COUNTY OF LUCAS OHIO 346400806 000000000 2011-05-25 29645000 SEE PART VI 0 0 0 D SERIES 2011 D & E BONDS - SEE PART VI 549310VD9 2011-12-01 152004328 SEE PART VI 1 0 0 A 45598957 586084 45012873 0 0 0 1 B 650000 193935000 199572288 2337157 127520671 69714460 2014 1 0 1 1 C 20655000 29645000 263825 29381175 1 0 1 1 D 7150000 40300000 152004328 1505879 150498449 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, SUPPLEMENTAL INFORMATION: PART I: SERIES 2015 BOND DETAIL ISSUER NAME: 2015 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VL1 DATE ISSUED: 09/30/2015 ISSUE PRICE: $45,586,125 PURPOSE: FINANCE THE CONSTRUCTION AND EQUIPPING OF A 302 BED PATIENT TOWER ON THE CAMPUS OF THE TOLEDO HOSPITAL. MATURITY: 11/15/2045 SERIES 2011 BOND DETAIL ISSUER NAME: 2011 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310UL2 & 549310UJ7 DATE ISSUED: 02/09/2011 ISSUE PRICE: $180,148,535 PURPOSE: REFINANCE THE PROMEDICA HEALTHCARE 2008B BONDS ISSUED 05/15/2008. FINANCE THE COST OF ACQUISITION, CONSTRUCTION, RENOVATION AND EQUIPPING OF CERTAIN OTHER OHIO HEALTHCARE FACILITIES OF THE MEMBERS OF THE OBLIGATED GROUP. MATURITY: 11/15/2041 ISSUER NAME: 2011 SERIES B - COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY ISSUER EIN: 38-6005798 CUSIP#: 52601PBE7 DATE ISSUED: 02/09/2011 ISSUE PRICE: $16,903,082 PURPOSE: REFINANCE THE REDEMPTION OF THE PROMEDICA HEALTH CARE OBLIGATED GROUP SERIES 2008C BONDS ISSUED 05/15/2008. MATURITY: 11/15/2035 ISSUER NAME: 2011 SERIES C - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 05/25/2011 ISSUE PRICE: $29,645,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 1999 BONDS ISSUED 07/01/1999. MATURITY: 11/15/2019 ISSUER NAME: 2011 SERIES D - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: 549310VD9 DATE ISSUED: 12/01/2011 ISSUE PRICE: $142,575,271 PURPOSE: TO FINANCE THE EARLY OPTIONAL REDEMPTION OF THE REMAINING OUTSTANDING MATURITIES OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 1999 BONDS ISSUED 04/01/1999 AND 07/26/1999. MATURITY: 11/15/2030 ISSUER NAME: 2011 SERIES E - COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY ISSUER EIN: 38-6005798 CUSIP#: 52601PB56 DATE ISSUED: 12/01/2011 ISSUE PRICE: $9,429,057 PURPOSE: REFINANCE THE EARLY OPTIONAL REDEMPTION OF THE LENAWEE HEALTH ALLIANCE OBLIGATED GROUP SERIES 1999A BONDS ISSUED 04/01/1999 AND 07/26/1999. MATURITY: 11/15/2028 SERIES 2017 BOND DETAIL ISSUER NAME: 2017 SERIES A - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP #: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $54,710,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008D BONDS ISSUED 05/15/2008. MATURITY: 11/15/2040 ISSUER NAME: 2017 SERIES B - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP#: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $120,010,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES C - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP #: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $84,980,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011A BONDS ISSUED 02/09/2011. MATURITY: 11/15/2041 ISSUER NAME: 2017 SERIES D - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP #: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $39,800,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011D BONDS ISSUED 12/01/2011. MATURITY: 11/15/2029 ISSUER NAME: 2017 SERIES F - COUNTY OF LUCAS OHIO ISSUER EIN: 34-6400806 CUSIP #: N/A DATE ISSUED: 5/15/2018 CONVERTED 3/31/2011 CONVERTED 12/29/2017 ISSUE PRICE: $62,500,000 PURPOSE: TO REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2008A BOND ISSUED 05/15/2008. MATURITY: 11/15/2034 ISSUER NAME: 2017 SERIES G - COUNTY OF LUCAS OHIO ISSUER EIN : 34-6400806 CUSIP #: 549310VM9 DATE ISSUED: 12/29/2017 ISSUE PRICE: $80,000,000 PURPOSE: FINANCE THE CONSTRUCTION AND EQUIPPING OF REPLACEMENT HOSPITAL ON THE CAMPUS OF THE TOELDO HOSPITAL. MATURITY: 11/15/2048 ISSUER NAME: 2017 SERIES H - COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY ISSUER EIN : 38-6005798 CUSIP #: N/A DATE ISSUED: 12/29/2017 ISSUE PRICE: $29,945,000 PURPOSE: REFINANCE A PORTION OF THE EARLY OPTIONAL REDEMPTION OF THE PROMEDICA HEALTHCARE OBLIGATED GROUP SERIES 2011B & 2011E BONDS ISSUED 02/09/2011 & 12/01/2011. FORM 8038 FOR THIS ISSUE ERRONEOUSLY REPORTS THAT THE BONDS ALSO REFUNDED SERIES 2008D ISSUED 5/15/2008, BUT THAT REPORTING WAS IN ERROR. MATURITY: 11/15/2035 PART I, COLUMN (E): DIFFERENCES BETWEEN THE ISSUE PRICES SHOWN IN PART I, COLUMN (E) AND TOTAL PROCEEDS SHOWN IN PART II, LINE 3 ARE DUE TO INVESTMENT EARNINGS. PART III, COLUMN (C), COUNTY OF LUCAS, OHIO BONDS: PART III HAS NOT BEEN COMPLETED WITH RESPECT TO THE COUNTY OF LUCAS, OHIO BONDS, SINCE SUCH BONDS REFUNDED PRE-2003 BOND ISSUES. PART III, COLUMN (D), SERIES 2011 D & E BONDS: PART III HAS NOT BEEN COMPLETED WITH RESPECT TO THE SERIES 2011 D & E BONDS, SINCE SUCH BONDS REFUNDED PRE-2003 BOND ISSUES. PART IV, COLUMN (B), LINE 2C, SERIES 2011 A & B BONDS: DATE THE REBATE COMPUTATION WAS PERFORMED: 02/22/2016. PART IV, LINE 6: CERTAIN OF THESE BOND ISSUES CONSTITUTE ADVANCE REFUNDING ISSUES. FOR SUCH ISSUES, THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. A COUNTY OF LUCAS OHIO 346400806 000000000 2017-12-29 299500000 SEE PART VI 0 0 0 B COUNTY OF LUCAS OHIO 346400806 549310VM9 2017-12-29 142500000 SEE PART VI 0 0 0 C COUNTY OF LENAWEE HOSPITAL FINANCE AUTHORITY 386005798 000000000 2017-12-29 24945000 SEE PART VI 0 0 0 A 299500000 299495737 4263 0 1 1 1 B 142500000 80000000 62500000 1 0 1 1 C 24945000 24941128 3872 0 1 1 1 A 0 1 1 1 1 1 0.00010 0.00000 0.00010 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 1 1 0.00010 0.00000 0.00010 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 SEE PART V SEE PART V 59964 SEE PART V 0 SEE PART V SEE PART V 38416 SEE PART V 0 SEE PART V SEE PART V 51403 SEE PART V 0 SEE PART V SEE PART V 42698 SEE PART V 0 SEE PART V SEE PART V 1317551 SEE PART V 0 SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: KATELYN WELEVER(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: KATELYN WELEVER IS A FAMILY MEMBER OF ALISON AVENDT (KEY EMPLOYEE).(C) AMOUNT OF TRANSACTION: $59,964(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: CHRISTINE WEBER(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: CHRISTINE WEBER IS A FAMILY MEMBER OF JAMES F. WEBER (TRUSTEE).(C) AMOUNT OF TRANSACTION: $38,416(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: FAITH SUTTER(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: FAITH SUTTER IS A FAMILY MEMBER OF MARTIN P. SUTTER (TRUSTEE).(C) AMOUNT OF TRANSACTION: $51,403(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: LISA TOFT(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: LISA TOFT IS A FAMILY MEMBER OF BRADLEY J. TOFT (TRUSTEE).(C) AMOUNT OF TRANSACTION: $42,698(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: SUBSTANTIAL CONTRIBUTOR(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: SUBSTANTIAL CONTRIBUTOR(C) AMOUNT OF TRANSACTION: $1,317,551(D) DESCRIPTION OF TRANSACTION: MEDICAL SUPPLIES(E) SHARING OF ORGANIZATION REVENUES? = NO FORM 990, PART VI, SECTION A, LINE 2 THOMAS GEORGE PADANILAM, MD AND DAWN BUSKEY HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 AS AN OHIO NON-PROFIT ORGANIZATION, THIS CORPORATION HAS A CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROMEDICA HEALTH SYSTEM, INC. (PHS) IS THE PARENT CORPORATION AND SOLE MEMBER OF THE TOLEDO HOSPITAL. AS THE MEMBER, PHS HAS THE RIGHT TO (A) ELECT AND REMOVE THE MEMBERS OF THE BOARD OF TRUSTEES OF THE TOLEDO HOSPITAL, AND (B) FILL ANY VACANCY ON THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B WHILE THE BOARD OF TRUSTEES OF EACH BUSINESS UNIT IS GRANTED CERTAIN POWERS WITH RESPECT TO SUCH BUSINESS UNIT'S OPERATIONS, AS THE MEMBER, PROMEDICA HEALTH SYSTEM, INC. RETAINS APPROVAL RIGHTS WITH RESPECT TO CERTAIN CORPORATE ACTIONS SUCH AS (I) ADOPTION OF THE BUSINESS UNIT'S STRATEGIC PLANS AND FINANCIAL PLANS, (II) EXPENDITURES FOR NON-BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (III) EXPENDITURES FOR ITEMS WHICH ARE INCLUDED IN THE BUSINESS UNIT'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER, (IV) INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS, (V) SALE, LEASE OR OTHER DISPOSITION OF REAL PROPERTY OR ASSETS WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (VI) ANY MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION OR LIQUIDATION. FORM 990, PART VI, SECTION B, LINE 11B UNDER THE GUIDANCE OF PROMEDICA HEALTH SYSTEM, INC.'S (PHS) TAX CONSULTANTS, FORM 990S ARE PREPARED BY THE RESPECTIVE ACCOUNTING DEPARTMENT OF EACH AFFILIATE AND REVIEWED BY THE AFFILIATE'S FINANCE LEADERSHIP. AFTER AFFILIATE'S FINANCE LEADERSHIP APPROVAL, COPIES OF THE FORM 990 FOR PHS AND THEIR SUBSIDIARIES ARE PROVIDED TO THE RESPECTIVE COMPANY'S BOARD OF TRUSTEES AND ARE REVIEWED AND SIGNED BY A PRINCIPAL OFFICER PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C PROMEDICA HEALTH SYSTEM, INC. AND AFFILIATES (PHS) HAVE STANDARDS OF CONDUCT THAT APPLY TO ALL PHS BOARD MEMBERS AND EMPLOYEES. BOARD MEMBERS AND EMPLOYEES ARE EXPECTED TO CERTIFY THEIR COMPLIANCE WITH THE APPLICABLE STANDARDS PRIOR TO ELECTION/APPOINTMENT OR PRIOR TO BEGINNING EMPLOYMENT. BOARD MEMBERS ANNUALLY (OR IMMEDIATELY IF NEW POTENTIAL CONFLICTS OF INTEREST ARISE), ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND RETURN THE BOARD MEMBER SOC SURVEY WITHIN 30 DAYS OF DISSEMINATION. BOARD MEMBER SOC SURVEYS ARE REVIEWED BY THE V.P., AUDIT & COMPLIANCE/CHIEF COMPLIANCE OFFICER (CCO). SUMMARIZED INFORMATION IS FORWARDED FOR REVIEW TO THE CHIEF FINANCIAL OFFICER, GENERAL COUNSEL, BUSINESS UNIT PRESIDENTS AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (PRESIDENT/CEO), BASED UPON THEIR RESPECTIVE KNOWLEDGE OF THE BOARD MEMBERS. THE PURPOSE OF THIS REVIEW IS TO BOTH INFORM MANAGEMENT OF THE DISCLOSED CONFLICTS AND TO ALLOW THEM TO IDENTIFY TO THE V.P., AUDIT & COMPLIANCE, ANY POTENTIAL UNDISCLOSED CONFLICTS. THE AUDIT & COMPLIANCE DEPARTMENT THEN CONDUCTS AN AUDIT OF ALL BOARD MEMBER SOC SURVEYS (ALONG WITH ANY RELATIONSHIPS NOTED THROUGH THE ABOVE REVIEW) TO IDENTIFY ANY POSITIONAL CONFLICTS OF INTEREST AND TO TEST MATERIAL TRANSACTIONS WITH BOARD MEMBERS/THEIR AFFILIATES FOR FAIR MARKET VALUE. THE RESULTS OF THE AUDIT ARE REPORTED DIRECTLY TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE WITH A COPY TO THE PRESIDENT/CEO. THE REPORT INCLUDES A SUMMARY OF THE AUDIT PROCEDURES PERFORMED, ANY SIGNIFICANT CONCERNS IDENTIFIED, AND THEIR RESOLUTION. ANY UNRESOLVED CONFLICTS ARE ADDRESSED BY THE AUDIT COMMITTEE WITH RECOMMENDATIONS TO THE FULL BOARD AS NEEDED. FAILURE TO COMPLETE THE SURVEY OR THE SUBMISSION OF A FALSE OR INCOMPLETE SURVEY, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE BOARD MEMBER'S SURVEY RESULTS OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION BY THE BOARD OF TRUSTEES UP TO AND INCLUDING REMOVAL FROM THE BOARD/COMMITTEE/COUNCIL. EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL SALARIED EMPLOYEES AND SPECIFICALLY IDENTIFIED HOURLY EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC EMPLOYEE CERTIFICATION QUESTIONNAIRE BY AN ESTABLISHED DEADLINE THAT IS COMMUNICATED TO THE EMPLOYEE. THE HUMAN RESOURCES DEPARTMENT ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND PROVIDES NOTIFICATION TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL EMPLOYEE CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT. ALL NEW EMPLOYEES, EXCLUDING EMPLOYED PHYSICIANS, ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYEE STANDARD OF CONDUCT AND THE EMPLOYEE CERTIFICATION STATEMENT WHICH THE NEW EMPLOYEE IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. THE AUDIT & COMPLIANCE DEPARTMENT HAS ACCESS TO A REPORT THAT IDENTIFIES ALL NEW HIRES. A SAMPLE OF EMPLOYEES IS IDENTIFIED AND AN AUDIT IS CONDUCTED TO ENSURE THAT REQUIRED DOCUMENTATION IS ON FILE. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE V.P., AUDIT & COMPLIANCE AND IF NECESSARY DISCUSSED WITH THE BUSINESS UNIT PRESIDENT IN WHICH THE EMPLOYEE WORKS, THE CHIEF HUMAN RESOURCE OFFICER, AND GENERAL COUNSEL. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL OF THE PHS PRESIDENT/CEO. RESULTS OF THE EMPLOYEE PROCESS AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. FAILURE TO COMPLETE THE CERTIFICATION QUESTIONNAIRE, OR THE COMPLETION OF A FALSE OR INCOMPLETE CERTIFICATION QUESTIONNAIRE, OR FAILURE TO DISCLOSE IMMEDIATELY ANY NEW CONFLICTS OF INTEREST THAT MAY ARISE, OR FAILURE TO COOPERATE WITHOUT CONDITION, HONESTLY AND COMPLETELY WITH ANY INVESTIGATION OR REVIEW OF THE EMPLOYEE'S CERTIFICATION QUESTIONNAIRE OR HIS/HER ACTIONS OR CIRCUMSTANCES SHALL BE GROUNDS FOR SANCTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. EMPLOYED PHYSICIANS ANNUALLY (OR IMMEDIATELY IF NEW CONFLICTS OF INTEREST ARISE), ALL EMPLOYED PHYSICIANS ARE REQUIRED TO COMPLETE AND SUBMIT AN ELECTRONIC PHYSICIAN CERTIFICATION QUESTIONNAIRE BY THE ESTABLISHED AND COMMUNICATED DEADLINE. THE OFFICE OF THE PRESIDENT/CHIEF MEDICAL OFFICER AND THE CHIEF OPERATING OFFICER FOR PROMEDICA PHYSICIAN GROUP (PPG) ENSURES THAT ALL QUESTIONNAIRES, WHICH ARE STORED ELECTRONICALLY, ARE COMPLETED AND REVIEWED AND ENSURES NOTIFICATION IS PROVIDED TO THE V.P., AUDIT & COMPLIANCE OF THE NUMBER OF ANNUAL PHYSICIAN CERTIFICATION QUESTIONNAIRES SENT AND RECEIVED AND ALSO ENSURES COPIES OF ANY QUESTIONNAIRES CONTAINING DISCLOSURES THAT WARRANT FURTHER REVIEW BY THE AUDIT & COMPLIANCE DEPARTMENT ARE FORWARDED ACCORDINGLY. ALL NEW EMPLOYED PHYSICIANS ARE PROVIDED EITHER AN ELECTRONIC OR PAPER COPY OF THE EMPLOYED PHYSICIAN STANDARD OF CONDUCT AND THE PHYSICIAN CERTIFICATION STATEMENT WHICH THE NEW PHYSICIAN IS REQUIRED TO COMPLETE PRIOR TO BEGINNING EMPLOYMENT. IDENTIFIED CONFLICTS ARE INITIALLY REVIEWED BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER OR THEIR DESIGNEE, AND IF APPROPRIATE, ARE SUBSEQUENTLY REPORTED TO THE OFFICE OF THE V.P., AUDIT & COMPLIANCE. IF THE CONFLICT IS CONSIDERED A SIGNIFICANT EXPOSURE RISK FOR PHS, A RECOMMENDATION WILL BE PREPARED FOR FINAL APPROVAL BY THE PHS PRESIDENT/CHIEF EXECUTIVE OFFICER. RESULTS OF THE EMPLOYED PHYSICIAN AUDIT ARE INCLUDED IN THE ABOVE REPORT TO THE CHAIR OF THE AUDIT & COMPLIANCE COMMITTEE. ANY ITEMS THAT MEET CRITERIA FOR PUBLIC DISCLOSURE WILL BE COMMUNICATED TO THE APPROPRIATE PHYSICIAN BY THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE IN ADVANCE OF THE POSTING. THE PPG PRESIDENT/CHIEF MEDICAL OFFICER OR DESIGNEE WILL PROVIDE THE PHYSICIAN-INDUSTRY RELATIONSHIP DISCLOSURES TO THE APPLICABLE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. THE PUBLIC DISCLOSURE WILL BE POSTED ON THE PROMEDICA HEALTH SYSTEM, INC. WEBSITE (HTTPS://WWW.PROMEDICA.ORG/PAGES/ABOUT-US/INDUSTRY-RELATIONSHIPS.ASPX) DATABASE BY THE PHS MARKETING/COMMUNICATIONS REPRESENTATIVE. FORM 990, PART VI, SECTION B, LINE 15 THE TOLEDO HOSPITAL'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BY PROMEDICA HEALTH SYSTEM, INC. (PHS), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION DETERMINATIONS OF THE TOLEDO HOSPITAL'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE MADE BY A COMPENSATION COMMITTEE OF PHS. EACH YEAR INDEPENDENT CONSULTANTS CONDUCT AN ANNUAL SURVEY AND RECOMMEND EXECUTIVE PAYROLL BASE SALARY RANGES BASED UPON THE MARKET. THE DATA IS REVIEWED AND APPROVED BY THE PROMEDICA HEALTH SYSTEM COMPENSATION COMMITTEE EVERY OCTOBER. SALARY ADJUSTMENTS ARE DETERMINED AT THE DECEMBER MEETING OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES OTHER FORMS OF COMPENSATION BASED UPON THE PRIOR YEAR PERFORMANCE AT THE JANUARY MEETING EACH YEAR. FORM 990, PART VI, SECTION C, LINE 19 PROMEDICA HEALTH SYSTEM, INC. AND SUBSIDIARIES PROVIDE ANY DOCUMENT OPEN TO PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 16B: JOINT VENTURE OPERATING AGREEMENTS INVOLVING PROMEDICA HEALTH SYSTEM, INC. OR ITS SUBSIDIARIES (COLLECTIVELY, PHS) INCLUDE PROVISIONS TO PROTECT PHS'S TAX EXEMPT STATUS. EACH AGREEMENT CONTAINS SPECIFIC LANGUAGE RELATED TO THE PROVISION OF HEALTH CARE SERVICES WITH FOCUS ON COMMUNITY HEALTH BENEFIT AND MUST FOLLOW A FORMAL REVIEW PROCESS PRIOR TO CONTRACT EXECUTION. PHS CONTINUALLY ENSURES THAT ITS TAX EXEMPT STATUS IS PROTECTED BY ACTIVELY PARTICIPATING IN THE GOVERNANCE OF ALL PHS JOINT VENTURES. FORM 990, PART XI, LINE 9: PENSION/POST-RETIREMENT EXPENSE ADJUSTMENT -105,171. BENEFICIAL INTEREST IN FOUNDATION 17,171,280. SECTION 337(D) GAIN -210,128. FORM 990, PART III, LINE 4: PROMEDICA HEALTH SYSTEM, INC. - PROGRAM SERVICE ACCOMPLISHMENTS ESTABLISHED IN 1986, PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA) IS A MISSION-BASED, LOCALLY OWNED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN CUTTING-EDGE TECHNOLOGY, INNOVATIVE PROGRAMS AND FAMILY-CENTERED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF A PATIENT'S ABILITY TO PAY. BASED ON NEEDS THAT WE HAVE ASSESSED WITHIN THE COMMUNITIES WE SERVE, PROMEDICA LAUNCHED NEW SERVICES AND PROGRAMS IN 2017 TO HELP MEET THE GROWING DEMANDS OF LOCAL CONSUMERS ACROSS ALL SPECTRUMS OF LIFE, INCLUDING THOSE INDIVIDUALS WHO ARE OFTEN THE MOST VULNERABLE WHEN IT COMES TO HEALTH CARE: THE ELDERLY, POOR AND UNDERSERVED. PROMEDICA'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE SERVE. THIS IS REFLECTED IN OUR FOUR CORE VALUES, INCLUDING: COMPASSION - WE TREAT OUR PATIENTS AND EACH OTHER WITH RESPECT, INTEGRITY AND DIGNITY; INNOVATION - WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; TEAMWORK - WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; AND EXCELLENCE - WE STRIVE TO BE THE BEST IN ALL WE DO. PROMEDICA AND ITS AFFILIATES COMPRISE 220 SITES, MORE THAN 2,000 PHYSICIANS AND APPROXIMATELY 17,000 EMPLOYEES AND VOLUNTEERS. DURING 2017, PROMEDICA DISCHARGED 66,395 INPATIENTS AND SERVED 1,195,393 OUTPATIENTS, WHILE HANDLING 286,408 EMERGENCY VISITS SYSTEM-WIDE AS WELL AS 77,180 URGENT CARE VISITS AND MORE THAN 800 VIRTUAL VISITS THROUGH PROMEDICA ONDEMAND. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2017, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 27 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $4.0 BILLION. WE ALSO CREATE A DIRECT ECONOMIC IMPACT WITH OUR REVENUE, PAYROLL AND EMPLOYMENT. ADDITIONALLY, SPENDING ON SERVICES AND MATERIALS WITH VENDORS IN OUR REGION CREATES AN INDIRECT ECONOMIC BENEFIT. OUR PHYSICIANS AND PROVIDERS, LEADERSHIP TEAM MEMBERS, PHYSICIANS AND RESIDENTS, AND EMPLOYEES INDIVIDUALLY CONTRIBUTE PERSONAL RESOURCES TO THE COMMUNITY IN NUMEROUS WAYS - SUCH AS THROUGH TUTORING ELEMENTARY STUDENTS IN READING AND OTHER LIFE SKILLS, PROVIDING MONTHLY HEALTH LECTURES AT LOCAL SENIOR CENTERS, GENEROUSLY CONTRIBUTING TO COMMUNITY FUNDRAISING CAMPAIGNS SUCH AS UNITED WAY, PARTICIPATING IN MEDICAL MISSIONS, SERVING ON LOCAL NOT-FOR-PROFIT BOARDS, AND DONATING NONPERISHABLE FOODS AND CLOTHING ITEMS TO NUMEROUS LOCAL COMMUNITY ORGANIZATIONS AND CHURCHES - UNDERSCORING A KEY BENEFIT OF PROMEDICA BEING LOCALLY OWNED AND OPERATED. PROMEDICA'S MEMBER AND AFFILIATE HOSPITALS INCLUDE: THE TOLEDO HOSPITAL; TOLEDO CHILDREN'S HOSPITAL (OPERATING AS PART OF THE TOLEDO HOSPITAL); PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (A DIVISION OF THE TOLEDO HOSPITAL); FLOWER HOSPITAL; FOSTORIA HOSPITAL ASSOCIATION; DEFIANCE HOSPITAL, INC.; BAY PARK COMMUNITY HOSPITAL; HERRICK MEMORIAL HOSPITAL, INC.; EMMA L. BIXBY MEDICAL CENTER; MEMORIAL HOSPITAL; AND MERCY MEMORIAL HOSPITAL CORPORATION. IN 2017 PROMEDICA ALSO PROVIDED INTEGRATED SERVICES, COMPRISED OF: - PROMEDICA CONTINUING CARE SERVICES CORPORATION, PROVIDING REHABILITATION, HOSPICE, HOME CARE, AMBULATORY AND SENIOR SERVICES, COMMUNITY HEALTH, MEDICAL TRANSPORTATION SERVICES, AND CARE COORDINATION. - PROMEDICA PHYSICIAN GROUP (PROMEDICA PHYSICIANS), WITH APPROXIMATELY 900 HEALTHCARE PROVIDERS, INCLUDING PRIMARY CARE, OBSTETRICS AND SPECIALTY PHYSICIANS, AS WELL AS ADVANCED PRACTICE PROVIDERS. TOGETHER, THIS GROUP HELPS PROMEDICA BROADEN THE CARE WE OFFER TO AREA RESIDENTS, INCLUDING IN SMALLER, OUTLYING COMMUNITIES. - PROMEDICA INSURANCE CORPORATION, THE LARGEST HEALTH MAINTENANCE ORGANIZATION PHYSICALLY LOCATED IN NORTHWEST OHIO. IN 2017, PARAMOUNT ADVANTAGE PROVIDED MEDICAID COVERAGE TO MORE THAN 238,000 MEMBERS ACROSS ALL OF OHIO'S 88 COUNTIES. - PROMEDICA INDEMNITY CORPORATION, PROVIDING MEDICAL PROFESSIONAL AND COMPREHENSIVE GENERAL LIABILITY COVERAGE FOR PROMEDICA, INCLUDING IN OUTLYING AREAS WHERE PRIMARY-CARE PHYSICIAN RECRUITMENT IS DIFFICULT. - TWELVE CONTROLLED FOUNDATIONS THAT SERVE AS FUNDRAISING ENTITIES FOR THEIR RESPECTIVE HOSPITALS/BUSINESS UNITS AND FACILITIES, SUCH AS THE EBEID HOSPICE RESIDENCE ON THE PROMEDICA FLOWER HOSPITAL CAMPUS AND THE MARY ELLEN FALZONE DIABETES CENTER ON THE CAMPUS OF PROMEDICA TOLEDO HOSPITAL. PROMEDICA'S SPECIALIZED CARE INCLUDES ONCOLOGY, ORTHOPAEDICS, HEART AND VASCULAR, NEUROLOGY, REHABILITATIVE, AND BEHAVIORAL MEDICINE, AS WELL AS WOMEN'S AND PEDIATRIC CARE. A FUNDAMENTAL PART OF OUR MISSION IS THAT OUR SERVICES ARE TAILORED TO THE NEEDS OF OUR COMMUNITIES AND THEY ARE AVAILABLE TO EVERYONE IN OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION TO BEING A STRONG ADVOCATE FOR THE HEALTH AND WELL-BEING OF OTHERS, PROMEDICA PROVIDES AND PROMOTES COMMUNITY WELLNESS, COLLABORATING WITH APPROXIMATELY 300 NONPROFIT AGENCIES AND ORGANIZATIONS ACROSS OUR REGION IN 2017 THAT HAD VALUES AND MISSIONS SIMILAR TO OUR OWN. PROMEDICA IS CONTINUALLY IMPROVING ITS SERVICES, FACILITIES, TECHNOLOGIES, AND OUTREACH EFFORTS TO MEET THE EVER-CHANGING NEEDS OF ITS DIVERSE POPULATIONS. IN DIRECT RESPONSE TO COMMUNITY NEEDS, A FEW EXAMPLES FROM 2017 INCLUDE THE FOLLOWING: - IN 2017, PROMEDICA ESTABLISHED THE EBEID PROMISE, A 10-YEAR, $50 MILLION COMMUNITY REVITALIZATION INITIATIVE THANKS TO A GENEROUS $28.5 MILLION GIFT FROM THE FAMILY OF PHILANTHROPIST AND FORMER BOARD MEMBER RUSSELL J. EBEID. THE EBEID PROMISE WILL EXPAND THE SCOPE AND PURPOSE OF THE EBEID INSTITUTE WITH A KEY FOCUS ON THE SOCIAL DETERMINANTS OF HEALTH - HEALTH, NUTRITION, EDUCATION, JOB CREATION, AND FAMILY STABILITY. THIS LONG-TERM INVESTMENT WILL START WITH THE UPTOWN TOLEDO NEIGHBORHOOD AND BE EXPANDED TO TOLEDO'S MONROE STREET CORRIDOR, NEAR PROMEDICA TOLEDO HOSPITAL. PLANS INCLUDE REPLICATING THIS CONCEPT IN COMMUNITIES ACROSS PROMEDICA'S SERVICE AREA IN COMING YEARS. - PROMEDICA ALSO ESTABLISHED A NATIONAL RESEARCH CENTER DEVOTED TO STUDYING THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON INDIVIDUALS AND COMMUNITIES. THE CENTER IS BEING DEVELOPED IN COOPERATION WITH THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCES. IT WILL BE ONE OF THE FIRST OF ITS KIND IN THE NATION AND USES A MULTIDISCIPLINARY APPROACH TO UNDERSTAND AND PROPOSE SOLUTIONS TO ADDRESS THE CONDITIONS IN WHICH PEOPLE ARE BORN, LIVE, WORK AND AGE THAT AFFECT THEIR HEALTH AND WELL-BEING. - THREE PROMEDICA HOSPITALS RECEIVED A 5-STAR RATING FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) IN ITS MOST RECENT COMPARISON OF ACUTE CARE QUALITY. THE THREE HOSPITALS ARE PROMEDICA BAY PARK, MEMORIAL AND TOLEDO HOSPITALS. THE CMS STAR RATING SYSTEM IS A WAY OF SUMMARIZING AND COMPARING HOSPITALS ACROSS THE NATION BASED ON A STANDARDIZED SET OF METRICS AND DEFINITIONS. THE STAR RATING EXAMINES MORE THAN 50 INPATIENT AND OUTPATIENT MEASURES THAT INDICATE GOOD PATIENT OUTCOMES SUCH AS 30-DAY MORTALITY (HEART ATTACK, HEART FAILURE, PNEUMONIA), 30-DAY READMISSIONS, INPATIENT SATISFACTION, HOSPITAL ACQUIRED INFECTIONS, AND MORE. - PROMEDICA CONTINUES TO EMPHASIZE A CULTURE OF SAFETY ACROSS ITS HOSPITALS AND OUTPATIENT SERVICES. THE YEAR-END SERIOUS SAFETY EVENT RATE (SSER) WAS 0.65, REFLECTING A 20% DECREASE IN SERIOUS SAFETY EVENTS. - IN 2017, PROMEDICA OPENED ITS NEW HEADQUARTERS IN DOWNTOWN TOLEDO, OHIO, BRINGING NEARLY 1,000 EMPLOYEES TO THE AREA AND SUPPORTING DOWNTOWN REVITALIZATION AND ECONOMIC GROWTH. - IN 2017, PROMEDICA WELCOMED 130 RESIDENTS/FELLOWS AND 460 MEDICAL STUDENTS FROM THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCES AS PART OF THE ACADEMIC AFFILIATION CREATED IN 2015. THE COLLABORATION IS HELPING TO ADVANCE MEDICAL EDUCATION AND CLINICAL RESEARCH IN NORTHWEST OHIO, BUILDING A LEGACY MODEL OF HEALTH CARE THAT WILL BENEFIT COMMUNITY MEMBERS ACROSS THE REGION FOR GENERATIONS TO COME. - PROMEDICA BROKE GROUND FOR ITS NEW LENAWEE COUNTY HOSPITAL IN MICHIGAN, TO BE NAMED THE PROMEDICA CHARLES AND VIRGINIA HICKMAN HOSPITAL. THE HICKMAN FAMILY GIFT IS THE LARGEST DONATION IN THE HISTORY OF PROMEDICA AND WILL ALLOW FOR THE CONSOLIDATION OF THE PROMEDICA BIXBY AND HERRICK HOSPITALS INTO ONE LOCATION TO BETTER SERVE THE LENAWEE COUNTY COMMUNITY. - PROMEDICA COMPLETED THE ROLL OUT OF ITS NEW ELECTRONIC HEALTH RECORD (EHR), EPIC, IN 2017 AND UPGRADED THE ENTIRE SYSTEM TO THE MOST RECENT VERSION OF EPIC. THE UPGRADED VERSION ALLOWS PROMEDICA TO TAKE ADVANTAGE OF SOME OF THE MANY ENHANCEMENTS THAT EPIC HAS MADE TO ITS SOFTWARE BASED ON INPUT FROM CUSTOMERS. EPIC FURTHER ENABLES ONE PATIENT, ONE RECORD, AND ONE BILL FOR PATIENTS REGARDLESS OF SERVICE PROVIDED OR THE LOCATION OF SERVICE ACROSS PROMEDICA. - PARAMOUNT IMPLEMENTED THE FINAL PHASE OF ITS NEW TRUCARE CARE MANAGEMENT SYSTEM. THE TRUCARE SYSTEM MOVES PARAMOUNT TO A STATE-OF-THE-ART CARE MANAGEMENT SYSTEM AND PROVIDES MANY OPERATIONAL EFFICIENCIES THAT ALLOW PARAMOUNT TO MEET THE RIGOROUS CARE MANAGEMENT DEMANDS THAT ARE REQUIRED TO SERVE THE MEDICAID POPULATION IN OHIO. - PROMEDICA PHYSICIANS LAUNCHED A NEW EDUCATION PROGRAM INTENDED TO HELP BRING AN END TO OHIO'S OPIOID EPIDEMIC. TO DO THIS, PROMEDICA PARTNERED WITH THE OHIO STATE MEDICAL ASSOCIATION TO OFFER SMART RX - SAFE MEDICINE AND RESPONSIBLE TREATMENT PROGRAM. SMART RX IS AN HOUR-LONG ONLINE TRAINING PROGRAM AND PUBLIC AWARENESS CAMPAIGN THAT BRINGS MEDICAL PROFESSIONALS UP-TO-DATE ON OHIO'S OPIOID PRESCRIBING RULES AND REGULATIONS AS WELL AS BEST PRACTICES FOR TREATING PAIN, AND TIPS FOR PATIENTS ON HOW TO APPROPRIATELY HANDLE AND DISPOSE OF POTENTIALLY ADDICTIVE PRESCRIPTION MEDICINES. - PROMEDICA OPENED FOUR ADDITIONAL URGENT CARE CENTERS IN THE METRO-TOLEDO AREA, TO SERVE PATIENTS WHO HAVE MEDICAL CONCERNS THAT DO NOT REQUIRE AN EMERGENCY CENTER. A TOTAL OF NINE URGENT CARE CENTERS ARE NOW OPEN 8 A.M. TO 8 P.M., 365 DAYS PER YEAR, AND ARE STAFFED BY HIGHLY-TRAINED CERTIFIED NURSE PRACTITIONERS. - PROMEDICA OPENED A NEW SPECIALTY PHARMACY TO AID PATIENTS WHO ARE LIVING WITH CHRONIC AND COMPLEX HEALTH CONDITIONS AND NEED SPECIALIZED THERAPIES OR PERSONALIZED CARE. THE PHARMACY PROVIDES DISPENSING FOR SPECIALTY MEDICATIONS USED TO TREAT CHRONIC HEALTH CONDITIONS, INCLUDING CYSTIC FIBROSIS, ULCERATIVE COLITIS AND CHRON'S DISEASE, HEPATITIS C, MULTIPLE SCLEROSIS, AUTOIMMUNE DISEASE, CANCER, AND MUCH MORE. THE NEW PHARMACY IS ABLE TO SHIP MEDICATIONS DIRECTLY TO THE PATIENT FOR IMPROVED ACCESS TO CARE. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS ACROSS THE REGION THAT INCLUDED FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - PROMEDICA CANCER INSTITUTE'S (PCI) COMMUNITY OUTREACH INCLUDED CANCER SCREENINGS AND EDUCATION TO THE MOST VULNERABLE IN OUR COMMUNITY. FREE SCREENING MAMMOGRAMS AS WELL AS LUNG CANCER SCREENINGS WERE PROVIDED FOR EARLY DETECTION. COLORECTAL CANCER EDUCATION AND NUTRITIONAL PROGRAMS WERE DEVELOPED TO KEEP PEOPLE HEALTHY, WHILE SUN SAFETY EDUCATION WAS PROVIDED TO ELEMENTARY SCHOOL CHILDREN TO HELP PREVENT FUTURE CASES OF SKIN CANCER. PCI ALSO HOSTED ANNUAL CANCER SURVIVOR CELEBRATIONS FOR SURVIVORS, FRIENDS AND CAREGIVERS ACROSS THE REGION AND SPONSORED COMMUNITY EVENTS INCLUDING THE ANNUAL NW OHIO SUSAN G. KOMEN, RACE FOR THE CURE AND AMERICAN CANCER SOCIETY RELAY FOR LIFE IN LUCAS COUNTY. - PROMEDICA CONTINUES TO OPERATE TWO FOOD CLINICS - ONE AT THE PROMEDICA HEALTH AND WELLNESS CENTER AND THE OTHER AT PROMEDICA'S CENTER FOR HEALTH SERVICES - TO SERVE PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND HAVE A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. PATIENTS ARE ABLE TO RECEIVE FOOD FOR THEM AND THEIR FAMILY FROM THIS LOCATION OR THE ORIGINAL FOOD PHARMACY LOCATED AT PROMEDICA'S CENTER FOR HEALTH SERVICES. AS PART OF THE PROGRAM, EACH PATIENT RECEIVES TWO TO THREE DAYS OF SUPPLEMENTAL FOOD FOR THEIR FAMILY. THROUGH DECEMBER 2017, THERE HAVE BEEN MORE THAN 9,700 VISITS TO THE FOOD CLINIC, IMPACTING MORE THAN 3,200 UNIQUE HOUSEHOLDS. THIS TRANSLATES TO ABOUT 74,520 DAYS' WORTH OF FOOD PROVIDED TO PATIENTS AND FAMILIES, THE EQUIVALENT OF 223,560 MEALS. - PROMEDICA ALSO OFFERS ITS PRESCRIPTION FOR HEALTH PROGRAM IN THE ADRIAN, MICHIGAN, COMMUNITY. THROUGH THIS PROGRAM, PROMEDICA PROVIDERS ARE ABLE TO WRITE A PRESCRIPTION FOR FOOD FOR ELIGIBLE PATIENTS, WHICH ALLOWS THE INDIVIDUAL TO REDEEM TOKENS FOR THE PURCHASE OF FRESH FRUITS AND VEGETABLES AT THE ADRIAN FARMERS MARKET. THE PROGRAM IS DESIGNED FOR PATIENTS AGE 55 AND OLDER, OR LESS THAN 55 YEARS WITH CHILDREN LIVING IN THE HOUSEHOLD, WHO HAVE A DIAGNOSIS OF HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, OBESITY, PREDIABETES OR DIABETES. - PROMEDICA'S FINANCIAL OPPORTUNITY CENTER (FOC), PROVIDED EDUCATION AND COUNSELING TO NEARLY 1,000 INDIVIDUALS. HOUSED IN THE EBEID INSTITUTE, FOC HELPS INDIVIDUALS NEEDING INCOME SUPPORT (PUBLIC BENEFITS) AND EMPLOYMENT COACHING AND COUNSELING, AS WELL AS FREE TAX PREPARATION THROUGH THE OHIO BENEFIT BANK. FOC ALSO OFFERS A DIGITAL LITERACY SERIES TO ASSIST INDIVIDUALS WISHING TO IMPROVE THEIR COMPUTER LITERACY AND SKILLS TO BE MORE MARKETABLE TO PROSPECTIVE EMPLOYERS. - IN 2017, PROMEDICA PRIMARY CARE PROVIDERS BEGAN SCREENING PATIENTS FOR SOCIAL DETERMINANTS OF HEALTH BY ASKING QUESTIONS RELATED TO EDUCATION, EMPLOYMENT, FOOD SECURITY, HOUSING, TRANSPORTATION, AND VIOLENCE. PATIENTS WHO SCREEN POSITIVE FOR ANY OF THE FACTORS ARE CONNECTED TO NECESSARY COMMUNITY PROGRAMS AND RESOURCES FOR ASSISTANCE. - PROMEDICA TOLEDO HOSPITAL BECAME THE FIRST HOSPITAL IN OHIO TO ACQUIRE SYNAPTIVE MEDICAL'S BRIGHTMATTER TECHNOLOGY, WHICH COMBINES ADVANCED IMAGING, PLANNING, NAVIGATION AND ROBOTIC VISUALIZATION WITH A DIGITAL MICROSCOPE FOR COMPLEX BRAIN TUMOR AND SPINAL SURGERY. THE NEW TECHNOLOGY ALLOWS FOR BETTER SURGICAL ERGONOMICS, FACILITATES COLLABORATION AMONG OPERATING ROOM STAFF, AND CONSUMES LESS SURGICAL TIME, ALL FACTORS THAT COULD LEAD TO IMPROVED PATIENT OUTCOMES. - PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 40 CENTRAL-CITY TEENS AGES 16 - 19 WITH MENTORS IN DEPARTMENTS SUCH AS HUMAN RESOURCES, RADIOLOGY, DIETARY, AND INFORMATION TECHNOLOGY TO LEARN SKILLS INCLUDING CUSTOMER SERVICE, PUNCTUALITY AND BEING ACCOUNTABLE TO OTHERS. - PROMEDICA INNOVATION'S BUSINESS INCUBATOR ALLOWS CLIENT COMPANIES IN THE HEALTHCARE FIELD TO ACCELERATE DEVELOPMENT AND COMMERCIALIZATION OF MEDICAL DEVICES AND HEALTH INFORMATION TECHNOLOGY TO IMPROVE PATIENT CARE LOCALLY AND NATIONALLY. - ADDITIONALLY, IN 2017, PROMEDICA INNOVATIONS FORMED A COLLABORATIVE ORGANIZATION CALLED NEXTTECH WITH THE UNIVERSITY OF TOLEDO, BOWLING GREEN STATE UNIVERSITY, AND MERCY HEALTH. NEXTTECH RECEIVED THE OHIO THIRD FRONTIER GRANT OF $8.7 MILLION TO SERVE AS THE ENTREPRENEURIAL SERVICES PROVIDER (ESP) FOR 18 COUNTIES IN NORTHWEST OHIO. THE ESP OFFERS A NETWORK OF ENTREPRENEURIAL SERVICES AND CAPITAL TO ACCELERATE THE GROWTH OF EARLY STAGE OHIO TECHNOLOGY COMPANIES. IN 2017, PROMEDICA CONTRIBUTED $191,681,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THESE NUMBERS NOT ONLY INDICATE PROMEDICA'S LONG-STANDING COMMITMENT TO THE COMMUNITY, BUT ALSO FULFILL OUR NOT-FOR-PROFIT STATUS BY IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS IN THE COMMUNITIES WE SERVE. SPECIFICALLY, THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, CASH AND IN-KIND CONTRIBUTIONS, AND OTHER COMMUNITY BENEFIT OPERATIONS, PROMEDICA CONTRIBUTED $50,124,000 IN 2017. THESE PROGRAMS INCLUDED FREE COMMUNITY HEALTH SCREENINGS, SUCH AS DIABETES TESTING, BLOOD PRESSURE, BONE DENSITY, BODY MASS, AND CANCER CHECKUPS; MAMMOGRAM SCREENINGS FOR LOW-INCOME AND UNINSURED WOMEN; CHILDHOOD IMMUNIZATIONS; REDUCED-COST SCHOOL-ATHLETIC PHYSICALS; FIRST-AID COVERAGE AT COMMUNITY EVENTS; VOLUNTEER ELEMENTARY SCHOOL MENTORS; PUBLIC HEALTH EDUCATION LECTURES AND SEMINARS; A CHILDHOOD OBESITY PROGRAM; AND MANY OTHER COMMUNITY-BASED INITIATIVES. PROMEDICA ALSO CONTRIBUTED $11,054,000 IN FINANCIAL ASSISTANCE FOR PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. THIS AMOUNT REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DO NOT PAY THEIR BILLS. IN ADDITION, PROMEDICA'S COST OF BAD DEBT FOR 2017 WAS $28,737,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $191,681,000 NOTED ABOVE. FURTHER, PROMEDICA CONTINUES TO BE A LEADING PARTICIPANT IN THE LUCAS COUNTY CARENET INITIATIVE - A COLLABORATIVE EFFORT AMONG PROMEDICA, MERCY HEALTH PARTNERS, THE UNIVERSITY OF TOLEDO MEDICAL CENTER, THE CITY OF TOLEDO, AND OTHERS. CARENET WAS CREATED TO PROVIDE FREE OR LOWER-COST HEALTH CARE FOR LOW-INCOME LUCAS COUNTY RESIDENTS. ESTABLISHED IN 2003, CARENET BRIDGES THE GAP BETWEEN ADULTS WITHOUT HEALTH INSURANCE AND NEEDED HEALTHCARE SERVICES. WHILE SOME INDIVIDUALS MAY QUALIFY FOR GOVERNMENTAL INSURANCE PROGRAMS SUCH AS MEDICAID, OTHERS DO NOT; IT IS FOR THESE INDIVIDUALS THAT CARENET WAS ESTABLISHED. ADDITIONALLY DURING 2017, PROMEDICA PROVIDED $130,504,000 OF COMMUNITY BENEFIT THROUGH THE COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. PROMEDICA'S TOTAL COST - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS DURING 2017 WAS $139,149,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $191,681,000 NOTED ABOVE. INDEED, PROMEDICA GOES BEYOND INDUSTRY STANDARDS IN MEETING THE GOAL OF PROVIDING CARE TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE HOSPITAL CARE FREE-OF-CHARGE TO ALL FAMILIES WITHOUT INSURANCE WITH INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO FREE CARE FOR THOSE FAMILIES UNDER THIS FEDERAL POVERTY LEVEL, PROMEDICA HOSPITALS PROVIDE SIGNIFICANT DISCOUNTS TO FAMILIES WITH INCOMES OF UP TO 400% OF THE FEDERAL POVERTY LEVEL. IN MANY SITUATIONS, OTHER FUNDING SOURCES ARE SECURED AND ACCOMMODATIONS MADE. PROMEDICA'S POLICIES ARE POSTED AND AVAILABLE IN WRITING IN ALL PROMEDICA FACILITIES. ALSO, FINANCIAL ADVOCATES ARE AVAILABLE TO HELP PATIENTS BY EXPLAINING OUR FREE CARE AND DISCOUNT PROGRAMS, AND TO ASSIST WITH THE PAPERWORK NECESSARY TO QUALIFY FOR GOVERNMENT FUNDING. PATIENT BILLS PROVIDE CLEAR EXPLANATIONS, QUALIFICATIONS AND REMINDERS OF THESE PROGRAMS. IN SUMMARY, PROMEDICA DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. THE TOLEDO HOSPITAL - PROGRAM SERVICE ACCOMPLISHMENTS THE TOLEDO HOSPITAL (D/B/A PROMEDICA TOLEDO HOSPITAL) IS THE ADULT TERTIARY HOSPITAL OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION HIGHLY FOCUSED ON ACHIEVING CORE VALUES. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA SERVES 28 COUNTIES IN NORTHWEST OHIO AND SOUTHEAST MICHIGAN, AND IS ONE OF THE REGION'S LEADING HEALTHCARE PROVIDERS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. FOR MORE THAN 130 YEARS, PROMEDICA TOLEDO HOSPITAL (TH) HAS SERVED METROPOLITAN TOLEDO AND SURROUNDING COMMUNITIES WITH STATE-OF-THE-ART EMERGENCY, MEDICAL, DIAGNOSTIC, AND SURGICAL SERVICES. THE 794-BED HOSPITAL OFFERS ACCESS TO THE AREA'S LARGEST BOARD-CERTIFIED MEDICAL STAFF, WITH MORE THAN 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS AS WELL AS ADVANCE PRACTICE PROVIDERS. ADDITIONALLY, TH OFFERS A NUMBER OF KEY SERVICES TO THE METRO-TOLEDO AREA, SUCH AS THE CENTER FOR WOMEN'S HEALTH, WHICH INCLUDES MATERNAL-FETAL MEDICINE AND A LEVEL III PERINATAL UNIT; JOBST VASCULAR INSTITUTE; PROMEDICA BREAST CARE; AND A LEVEL I TRAUMA CENTER. OTHER PROGRAMS AND SERVICES INCLUDE WELL-ESTABLISHED NEUROSCIENCES, CARDIOVASCULAR AND ORTHOPAEDIC DEPARTMENTS, A NATIONALLY RECOGNIZED BARIATRIC PROGRAM, A CERTIFIED COMPREHENSIVE STROKE CENTER, AND AN EMERGENCY CENTER THAT TREATS MORE THAN 100,000 PATIENTS ANNUALLY. ALL SERVICES ARE FULLY BACKED BY ACCREDITED ANCILLARY SERVICES, SUCH AS LABORATORY, RADIOLOGY, AS WELL AS PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES. PROMEDICA TOLEDO CHILDREN'S HOSPITAL (TCH), OPERATING AS PART OF TH, PROVIDES PEDIATRIC TERTIARY CARE. TCH EXCLUSIVELY SERVES THE HEALTHCARE NEEDS OF CHILDREN AND ADOLESCENTS UNDER THE AGE OF 18. TCH'S MEDICAL STAFF INCLUDES BOARD-CERTIFIED PHYSICIANS AND ADVANCE PRACTICE PROVIDERS, WHILE A NEWBORN INTENSIVE CARE UNIT INCLUDES A NEONATAL PHYSICIAN AND PEDIATRIC HOSPITALIST WHO ARE ON DUTY 24 HOURS A DAY. OTHER TCH SPECIALTY SERVICES INCLUDE A PEDIATRIC CANCER CENTER, ASTHMA TREATMENT AND EDUCATION SERVICES, PEDIATRIC PSYCHIATRY, AND A DEDICATED LEVEL II PEDIATRIC TRAUMA CENTER. IN 2017, TH CONTINUED CONSTRUCTION OF ITS NEW GENERATIONS BED TOWER. THE NEW FACILITY WILL BE 13 STORIES TALL WITH MORE 300 PATIENT BEDS AND WILL OFFER IMPROVED ACCESS FOR PATIENTS WHILE PROVIDING THE LATEST TECHNOLOGY AND PROCESSES TO ENSURE A SAFE, HIGH QUALITY ENVIRONMENT FOR PATIENT CARE AND HEALING. THE GENERATIONS TOWER IS EXPECTED TO OPEN FOR PATIENT CARE BY THE END OF 2019. IN 2017, TH WAS NAMED ONE OF THE BEST 100 HOSPITALS IN THE NATION BY HEALTHGRADES AMERICA'S 100 BEST HOSPITALS FOR THE THIRD YEAR IN A ROW. THE AWARD RECOGNIZES THE TOP 2% OF HOSPITALS IN THE NATION FOR EXHIBITING CLINICAL EXCELLENCE FOR AT LEAST FOUR CONSECUTIVE YEARS. TH ALSO WAS RECOGNIZED BY U.S. NEWS AND WORLD REPORT AS ONE OF THE BEST HOSPITALS IN OHIO, WITH A NUMBER 8 RANKING. ADDITIONALLY, BECKER'S NAMED TH TO ITS LIST OF 100 HOSPITALS AND HEALTH SYSTEMS WITH GREAT HEART PROGRAMS, AND TRUVEN HEALTH ANALYTICS RECOGNIZED TH AS ONE OF THE COUNTRY'S 50 TOP CARDIOVASCULAR HOSPITALS. THIS RANKING PUTS TH IN THE TOP 5% OF HOSPITALS NATIONWIDE FOR CARDIOVASCULAR OUTCOMES. A DIVISION OF TH, PROMEDICA WILDWOOD ORTHOPAEDIC AND SPINE HOSPITAL (WOSH) IS AN ALL-DIGITAL, ACUTE CARE FACILITY THAT PROVIDES INPATIENT AND OUTPATIENT ORTHOPAEDIC SURGERY TO ADDRESS THE NEEDS OF AGING BABY BOOMERS AND OTHERS WHO EXPERIENCE CHRONIC PAIN FROM JOINT DISEASE. THIS UNIQUE, FREE-STANDING HOSPITAL SERVES ONLY ORTHOPAEDIC AND SPINE PATIENTS, OFFERING DIAGNOSTIC, SURGICAL AND REHABILITATION SERVICES ALL IN ONE CONVENIENT AND EASILY ACCESSIBLE LOCATION. WOSH RECEIVED NATIONAL RECOGNITION WITH THE PRESS GANEY GUARDIAN OF EXCELLENCE AWARD, PRESENTED TO ORGANIZATIONS SCORING IN THE 95TH PERCENTILE OR HIGHER FOR PATIENT EXPERIENCE METRICS. IN 2017, TH SERVED 35,920 INPATIENTS; 520,587 OUTPATIENTS; AND 95,861 EMERGENCY CENTER PATIENTS. TH CONTRIBUTED $83,379,000 IN COMMUNITY BENEFIT THROUGH COMMUNITY BENEFIT EXPENDITURES, FINANCIAL ASSISTANCE AND GOVERNMENT-SPONSORED, MEANS-TESTED HEALTH CARE. THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND OTHER COMMUNITY BENEFIT OPERATIONS, TH CONTRIBUTED $24,475,000 TO THE COMMUNITY DURING 2017. INCLUDED IN THIS FIGURE ARE PROGRAMS SUCH AS: - THE COME TO THE TABLE INITIATIVE THAT PROVIDES 24 HOURS' WORTH OF FOOD TO PATIENTS WHO QUALIFY FOR FOOD INSECURITY BY COMPLETING A QUESTIONNAIRE. - THE AUTISM COLLABORATIVE - A COLLABORATION BETWEEN TCH AND LOCAL AUTISM ORGANIZATIONS AND UNIVERSITIES - TO PROVIDE EXPERT KNOWLEDGE AND SERVICES UNDER ONE UMBRELLA ORGANIZATION, ALLOWING THOSE WITH AUTISM AND THEIR FAMILIES TO RESEARCH AND FIND THE BEST POSSIBLE CARE. - SUPPORT GROUPS FOR PATIENTS' FAMILIES TO ASSIST WITH MANAGING CHRONIC DISEASE AND TO OFFER SOCIAL SERVICES INFORMATION. - WITH THE GOAL OF IMPROVING INFANT MORTALITY RATES IN OUR REGION, A NURSING MOTHERS SUPPORT GROUP IS OFFERED AT NO CHARGE THROUGHOUT THE YEAR. - THE TEEN PEP (PEERS EDUCATING PEERS) PROGRAM EXTENDS CARE AND EDUCATION OUTSIDE THE HOSPITAL, IN MORE NONTRADITIONAL WAYS, BY ENCOURAGING TEENS TO TALK WITH THEIR PEERS ABOUT IMPORTANT TOPICS SUCH AS TEEN RELATIONSHIPS, BULLYING, AND PHYSICAL AND EMOTIONAL ABUSE. - FREE AND LOW-COST OUTPATIENT CLINICS THAT OFFER A WIDE ARRAY OF HEALTH SERVICES INCLUDING IMMUNIZATIONS, VASCULAR SCREENINGS AND TREATMENT OF MINOR ILLNESSES THAT MIGHT NOT REQUIRE AN EMERGENCY CENTER VISIT BUT STILL REQUIRE MEDICAL ATTENTION. - PREPARATION FOR PARENTHOOD CLASSES THAT HELP PREPARE EXPECTANT PARENTS FOR A HEALTHY LABOR AND DELIVERY, AND OFFER INFANT SAFETY TIPS, AS WELL AS NEW MOTHER CARE AND HEALTHY BABY EDUCATION. - FREE SCREENING MAMMOGRAMS AND BREAST CARE EDUCATION THAT EMPHASIZES THE IMPORTANCE OF ROUTINE SELF-BREAST EXAMS FOR UNINSURED AND UNDERINSURED WOMEN IN THE TOLEDO AREA - IN-KIND DONATIONS AND GENERAL CONTRIBUTIONS, WHICH SUPPORT LOCAL NON-PROFIT ORGANIZATIONS WITH SIMILAR VALUES. TH ALSO PROVIDED A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO THE COMMUNITY DURING 2017, OF WHICH $7,929,000 REPRESENTED UNCOMPENSATED AMOUNTS FOR TREATMENT TO THOSE PATIENTS WHO DID NOT HAVE THE FINANCIAL RESOURCES TO PAY FOR HOSPITAL SERVICES. FINANCIAL ASSISTANCE REPRESENTS THE COST TO PROVIDE SERVICE AND DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS WHO DID NOT PAY THEIR BILLS. TH'S COST OF BAD DEBT FOR 2017 WAS $7,706,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT TOTAL OF $83,379,000 INDICATED ABOVE. TH PROVIDED $50,975,000 OF COMMUNITY SUPPORT WHICH REPRESENTS THE COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICAID AND OTHER MEANS-TESTED PATIENTS. IN 2017, THE TOTAL COSTS - NOT REIMBURSED BY THE GOVERNMENT - FOR TREATING MEDICARE PATIENTS WAS $46,905,000 AND IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $83,379,000 NOTED ABOVE. DURING 2017, TH EXPENDED $176,011,000 IN NET PAYROLL, PROVIDING 4,708 JOBS IN NORTHWEST OHIO. A TOTAL OF $11,249,000 WAS WITHHELD FROM HOSPITAL EMPLOYEES IN STATE AND LOCAL TAXES. IN SUMMARY, TH DEMONSTRATES PROMEDICA'S MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. AND, WE RECOGNIZE THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL CARE. THEREFORE, WE PROVIDE THESE HEALTHCARE SERVICES; RECRUIT AND TRAIN HEALTHCARE PROFESSIONALS TO SERVE THE BROADER COMMUNITY; PROVIDE APPROPRIATE FINANCIAL ASSISTANCE; OFFER SERVICES AND CONTRIBUTIONS TO OTHER NONPROFIT ORGANIZATIONS THAT ALLOW THEM TO PROVIDE KEY SERVICES TO THEIR CONSTITUENTS; AND PRESENT FREE EDUCATIONAL CLASSES, HEALTH FAIRS AND OTHER ACTIVITIES TO OUR LOCAL COMMUNITY TO HELP ENSURE ALL MEMBERS HAVE EQUAL ACCESS TO CARE. COMMUNITY BENEFIT DEFINITIONS PROMEDICA HEALTH SYSTEM, INC. AND ITS SUBSIDIARIES (PROMEDICA) PREPARES ITS COMMUNITY BENEFIT REPORTS CONSISTENT WITH GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES AND CONSISTENT WITH FORM 990, SCHEDULE H, HOSPITALS, REPORTING. COMMUNITY BENEFITS ARE PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY BENEFITS REPORTED BY PROMEDICA RESPOND TO IDENTIFIED COMMUNITY NEEDS AND MEET AT LEAST ONE OF THE FOLLOWING CRITERIA: - IMPROVE ACCESS TO HEALTHCARE SERVICE. - ENHANCE THE HEALTH OF THE COMMUNITY. - ADVANCE HEALTHCARE KNOWLEDGE. - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. FINANCIAL ASSISTANCE CONSISTENT WITH ITS MISSION, PROMEDICA PROVIDES A SIGNIFICANT AMOUNT OF FINANCIAL ASSISTANCE TO PATIENTS WITH LIMITED OR NO ABILITY TO PAY THEIR BILL. PROMEDICA HOSPITALS PROVIDE FREE CARE TO THOSE UNINSURED PATIENTS WITH INCOMES UP TO 200% OF THE FEDERAL POVERTY LEVEL. SIGNIFICANT DISCOUNTS ARE ALSO PROVIDED ON A SLIDING SCALE TO UNINSURED PATIENTS UP TO 400% OF THE FEDERAL POVERTY LEVEL. FINANCIAL ASSISTANCE IS REPORTED IN THE FORM OF COST TO PROVIDE SERVICES AND HAS BEEN REDUCED TO REFLECT REIMBURSEMENT RECEIVED FROM STATE PROGRAMS DESIGNED TO RELIEVE THE BURDEN OF PROVIDING FINANCIAL ASSISTANCE. THE COST OF FINANCIAL ASSISTANCE DOES NOT INCLUDE THE COSTS FOR ACCOUNTS THAT ARE WRITTEN OFF TO BAD DEBT FOR PATIENTS THAT DO NOT PAY THEIR BILL. GOVERNMENT-SPONSORED HEALTH CARE GOVERNMENT-SPONSORED HEALTH CARE INCLUDE SERVICES THAT ARE REIMBURSED OR PARTIALLY REIMBURSED THROUGH GOVERNMENT MEANS-TESTED PROGRAMS SUCH AS MEDICAID. PROMEDICA INCLUDES THE UNPAID COSTS OF THESE PUBLIC PROGRAMS TO THE EXTENT THAT PAYMENTS RECEIVED ARE LESS THAN THE COSTS OF PROVIDING SERVICES. THE UNPAID COSTS OF TREATING MEDICARE PATIENTS IS REPORTED SEPARATELY AND IS NOT INCLUDED IN PROMEDICA'S COMMUNITY BENEFIT REPORT. ADDITIONALLY, THE COST OF FINANCIAL ASSISTANCE HAS BEEN ELIMINATED FROM ANY AMOUNTS REPORTED IN THIS CATEGORY. COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE ACTIVITIES CARRIED OUT FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE ACTIVITIES GENERALLY DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS AS THEY EXTEND BEYOND PATIENT CARE ACTIVITIES AND ARE SUBSIDIZED BY PROMEDICA. COMMUNITY BENEFIT OPERATIONS INCLUDE COSTS ASSOCIATED WITH DEDICATED STAFF, COMMUNITY HEALTH NEED AND/OR ASSESSMENT, AND OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT PLANNING AND ADMINISTRATION. HEALTH PROFESSIONS EDUCATION HEALTH PROFESSIONS EDUCATION INCLUDE COSTS FOR ALL EDUCATIONAL PROGRAMS PROMEDICA IS INVOLVED WITH, THE PROVISION OF A CLINICAL SETTING FOR TRAINING FOR HEALTHCARE STUDENTS OUTSIDE THE ORGANIZATION, AND FUNDING FOR HEALTHCARE EDUCATION. SUBSIDIZED HEALTH SERVICES SUBSIDIZED HEALTH SERVICES ARE SERVICES PROVIDED TO THE COMMUNITY DESPITE A FINANCIAL LOSS. THESE SERVICES GENERATE A BILL FOR REIMBURSEMENT, AND INCLUDE CLINICAL PATIENT CARE SERVICES THAT ARE PROVIDED BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND OTHER PROVIDERS ARE UNWILLING, OR UNABLE, TO PROVIDE THE SERVICES, OR THE SERVICES OTHERWISE WOULD NOT BE AVAILABLE TO MEET COMMUNITY NEEDS. RESEARCH RESEARCH ACTIVITIES INCLUDE CLINICAL AND COMMUNITY HEALTH RESEARCH, AS WELL AS STUDIES ON HEALTHCARE DELIVERY. THE AMOUNT REPORTED FOR PROMEDICA IS REDUCED BY ANY EXTERNAL SUBSIDIES, SUCH AS GRANTS. CASH AND IN-KIND CONTRIBUTIONS CASH AND IN-KIND CONTRIBUTIONS INCLUDE FUNDS AND IN-KIND SERVICES DONATED TO COMMUNITY ORGANIZATIONS AND THE COMMUNITY AT LARGE. IN-KIND SERVICES INCLUDE HOURS DONATED BY STAFF FOR COMMUNITY NEEDS WHILE ON WORK TIME; AS WELL AS DONATIONS OF FOOD, EQUIPMENT AND SUPPLIES. 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