2022-05-13T10:48:20-05:00 2021-06-30 990 2020-07-01 043398280 THE MERCY HOSPITAL INC MERC 8607144000 114 WOODLAND STREET MS-510358 HARTFORD CT 06105 JENNIFER SCHNEIDER SVP AND REGIONAL CFO 8607144000 2022-05-13 JENNIFER SCHNEIDER 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z SEE SCHEDULE O DEBORAH BITSOLI 114 WOODLAND STREET MS-510358 HARTFORD CT 06105 349737500 0 0928 X WWW.TRINITYHEALTHOFNE.ORG X 1898 MA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 15 12 2469 22 2172555 0 34195497 3983929 301057412 318191596 988355 6952528 25848501 20218271 362089765 349346324 411683 0 0 0 135344581 116980205 0 0 0 216618203 217830690 352374467 334810895 9715298 14535429 542089487 650277258 355044362 453874826 187045125 196402432 X WE, TRINITY HEALTH OF NEW ENGLAND AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. THE MERCY HOSPITAL IS A MEMBER OF TRINITY HEALTH OF NEW ENGLAND AND TRINITY HEALTH. 0 1 314938674 334915007 TTHE MERCY HOSPITAL HAS ESTABLISHED ITSELF AS ONE OF THE LEADING PROVIDERS OF HEALTH CARE SERVICES IN WESTERN MASSACHUSETTS. THE MERCY HOSPITAL IS A FULL-SERVICE ACUTE CARE HOSPITAL LICENSED FOR 182 BEDS PROVIDING SERVICES AND PROGRAMS FOR CARDIAC CARE, MATERNITY SERVICES, CANCER TREATMENT, EMERGENCY CARE, DIAGNOSTIC IMAGING, INTENSIVE CARE, CRITICAL CARE, AND SURGICAL PROCEDURES, IN AN INPATIENT AND OUTPATIENT SETTING. THE MERCY HOSPITAL ALSO PROVIDES A COMPREHENSIVE HOSPITAL-BASED REHABILITATION CENTER. PLEASE SEE SCHEDULE H AND THE WEBSITE AT WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/ FOR ADDITIONAL INFORMATION. 314938674 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 283 0 1 2469 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 MA X DONNA GILBERT 8607149632 114 WOODLAND STREET MS-510358 HARTFORD CT 06105 BENJAMIN CARTER DIRECTOR THR 12/20;TRINITY EVP & COO 1.00 54.00 X 0 1555234 83280 REGINALD EADIE MD DIRECTOR; TH OF NE PRESIDENT & CEO 1.00 54.00 X 0 1012709 231496 DANIEL MOEN FORMER OFFICER; SFMC TREN PRES/CEO 0.00 55.00 X 0 703752 62129 EMILY BROWER DIR AS OF 1/21; TRINITY HEALTH SVP 1.00 49.00 X 0 454700 128414 THOMAS ROBERT FORMER OFFICER; SPHP TREAS & CFO 0.00 50.00 X 0 460637 113339 DEBORAH BITSOLI PRESIDENT 48.00 7.00 X 0 448614 107308 ROBERT ANTHONY SECRETARY; VP MANAGING COUNSEL 1.00 49.00 X 0 435764 100790 JENNIFER SCHNEIDER TREASURER; SVP AND REGIONAL CFO 1.00 49.00 X 0 402744 101726 VIKRAM SONDHI FORMER KEY EMPLOYEE;MEDICAL DIRECTOR 0.00 50.00 X 0 451447 46772 MARK FULCO FORMER OFFICER 0.00 0.00 X 0 450748 14980 STUART ROSENBERG VP OP; PRES, JOHNSON MEMORIAL HOSP 24.00 31.00 X 0 351886 64843 ROBERT ROOSE MD CHIEF MEDICAL OFFICER 49.00 1.00 X 0 365063 45099 GUY DISTEFANO VP FINANCE 23.00 27.00 X 0 370362 39458 DANIEL KEENAN SVP GOVERNMENT RELATIONS 43.00 7.00 X 0 262523 49219 DARLENE CUNHA CHIEF NURSING OFFICER 50.00 0.00 X 0 278944 23692 MARY TARAIL MD PSYCHIATRIST 50.00 0.00 X 283881 0 16997 DOROTA POLUHA MD MEDICAL DIRECTOR 50.00 0.00 X 266593 0 16626 ARI KRIEGSMAN MD MEDICAL DIRECTOR ADDICTION CONSULT 50.00 0.00 X 228304 0 36987 JAMES HARRIS FORMER OFFICER;TH OF NE DIR OF REIMB 0.00 50.00 X 0 192722 44514 CHARLES FLINN FORMER KEY EMPLOYEE 0.00 0.00 X 0 126817 2727 SHERI LEMIEUX ASST SEC; ASST TO TH OF NE PRES/CEO 1.00 39.00 X 0 99573 13706 GWENDOLYN MORASKI MD DIR, SFHMC MED STAFF PRES THR 12/20 1.00 10.00 X 0 68750 0 HARIS ATHAR MD DIR & SFHMC MED STAFF PRES AT 1/21 1.00 10.00 X 0 15000 0 KEVIN O'CONNOR DIRECTOR, CHAIR THROUGH 12/20 1.00 5.00 X X 0 0 0 JAMES SMITH DIR; V CHAIR THR 12/20;CHAIR AT 1/21 1.00 5.00 X X 0 0 0 JOANN PRICE DIRECTOR; VICE CHAIR AS OF 1/21 1.00 5.00 X X 0 0 0 MOST REV JUAN MIGUEL BETANCOURT DIRECTOR 1.00 5.00 X 0 0 0 GREGORY DAVIS DIRECTOR 1.00 5.00 X 0 0 0 NAKIA HALL DIRECTOR 1.00 5.00 X 0 0 0 WALTER HARRISON DIRECTOR 1.00 5.00 X 0 0 0 KARL KRAPEK DIRECTOR AS OF 1/21 1.00 5.00 X 0 0 0 PAUL MANCINONE DIRECTOR 1.00 12.00 X 0 0 0 JOYCE MANDELL DIRECTOR 1.00 5.00 X 0 0 0 ANGELA MATTIE DIRECTOR 1.00 5.00 X 0 0 0 JOSEPH MENGACCI DIRECTOR 1.00 5.00 X 0 0 0 BARBARA MULLEN CSJ DIRECTOR 1.00 5.00 X 0 0 0 778778 8507989 1344102 205 1 1 0 BOSTON MEDICAL CENTER ONE BOSTON MEDICAL CENTER PL BOSTON MA 02118 PHYSICIAN SERVICES 2177134 SC ORTHOPEDICS OF NEW ENGLAND PC 528 8TH STREET NE HICKORY NC 28601 PHYSICIAN SERVICES 1716469 ADFINITAS HEALTH AT MERCY HOSP 7250 PARKWAY DRIVE STE 500 HANOVER MD 21076 PHYSICIAN SERVICES 1697179 SOHO HEALTH 95 WOODLAND ST 4TH FLOOR HARTFORD CT 06105 HEATHCARE SERVICES 1269507 ANGELICA 1061 MARQUETTE RD ROCKMART GA 30153 LAUNDRY SERVICE 1148164 36 60000 1546502 2377427 3983929 NET PATIENT SERVICE REVENUE 622110 311952195 311952195 PHARMACY REVENUE 446110 6239401 4244923 1994478 318191596 2378317 2378317 661226 0 661226 661226 661226 3965387 1000000 0 391176 3965387 608824 4574211 4574211 GOV'T SUBSIDY-DSTI PROGRAM 622110 10805003 10805003 INTERCOMPANY REVENUE 622110 2319701 2319701 CAFETERIA REVENUE 722514 661079 661079 5771262 5593185 178077 19557045 349346324 334915007 2172555 8274833 1317779 1317779 465728 465728 95974879 92155590 3819289 7292669 6918022 374647 4442118 4301477 140641 7487032 6914921 572111 98639 98639 167097 167097 25222637 19076227 6146410 409402 334647 74755 2442518 1758164 684354 19652 18669 983 9232793 8627795 604998 26901 12393 14508 107104 83444 23660 4220173 4220173 12924766 12322844 601922 2523818 2406281 117537 INTERCO PURCHASED SVCS 77979992 74348367 3631625 MEDICAL SUPPLIES 66479544 66479544 BAD DEBT EXPENSE 8715119 8715119 EQUIPMENT MAINTENANCE 3288077 3230396 57681 3972458 3014601 957857 334810895 314938674 19872221 0 3547605 2328098 586123 475833 40761828 41874870 61157 5796192 5798630 716674 835353 286760309 209901864 77546187 76858445 273626397 271196204 105554692 146028725 33892632 104881100 542089487 650277258 35875777 30255270 6314154 23221 295155 227965 312559276 423368370 355044362 453874826 X 184380304 191258912 2664821 5143520 187045125 196402432 542089487 650277258 X 14535429 10914110 -12454894 -3637338 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 1 29261 0 0 0 29261 0 PART II-B, LINE 1: MERCY HOSPITAL HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MERCY HOSPITAL WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 654729 25547 51803 732079 808233 -57904 -7876 87724 654729 871309 8906 71982 808233 2314700 4750 1448141 871309 331917 1968680 43603 29500 2314700 1.00000 0 0 1678762 1678762 99387986 51130388 48257598 2327713 1597192 730521 180359436 157174284 23185152 3006412 3006412 76858445 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 45894742 F HEDGE FUNDS 25033496 F EQUITY METHOD INVESTMENTS 75100487 C 146028725 MISCELLANEOUS RECEIVABLES 15121613 OTHER LONG TERM ASSETS 1165929 INVESTMENT IN UNCONSOL. AFFILIATES 179570 INTERCOMPANY ACCOUNTS RECEIVABLE 59696570 OTHER CURRENT ASSETS 1996136 OTHER INTERCOMPANY ASSETS 26720165 OPERATING LEASE RIGHT-OF-USE ASSETS 1117 104881100 INTERCOMPANY ACCOUNTS PAYABLE 156552571 INTERCOMPANY NOTES PAYABLE 107793436 OTHER CURRENT LIABILITIES 11015603 OPERATING LEASE LIABILITIES 659804 MEDICARE CASH ADVANCES 35306690 LT ASSET RETIREMENT OBLIGATION 895970 OVERDRAFT IN POOLED INVESTMENT 111144296 423368370 PART V, LINE 4: INCOME FROM ENDOWMENT FUNDS ARE USED TO PROVIDE PATIENT CARE. 1 1 X 1 X 1 X 1 0 1 1 6234 2405189 2405189 0.00740 22978 87850583 66993555 20857028 0.06400 29212 90255772 66993555 23262217 0.07140 9 224 243244 113 243131 0.00070 1 178 118921 118921 0.00040 1 6380 1520532 1269551 250981 0.00080 2 181 136584 53816 82768 0.00030 13 6963 2019281 1323480 695801 0.00220 13 36175 92275053 68317035 23958018 0.07360 1 1000 1000 0.00000 1 1000 1000 0.00000 0 8715119 0 80262779 77522271 2740508 X 1 1 1 LIFEPATH PARTNERS LLC LABORATORY SERVICES 0.50000 0.00000 0.50000 1 1 MERCY HOSPITAL INC 271 CAREW ST SPRINGFIELD MA 01104 WWW.TRINITYHEALTHOFNE.ORG STATE LICENSE # VHFO X X X MERCY HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 18 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 MERCY HOSPITAL, INC. PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MERCY HOSPITAL INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTH: - HOUSING NEEDS - BUILT ENVIRONMENT (ACCESS TO HEALTHY FOOD, TRANSPORTATION, AND PLACES TO EXERCISE) - LACK OF RESOURCES TO MEET BASIC NEEDS - EDUCATIONAL ATTAINMENT - VIOLENCE AND TRAUMA - SOCIAL ENVIRONMENT AND SOCIAL ISOLATION - ENVIRONMENTAL EXPOSURES 2. BARRIERS TO ACCESSING QUALITY HEALTH CARE - INSURANCE AND HEALTH CARE RELATED CHALLENGES- LIMITED AVAILABILITY OF PROVIDERS - LACK OF TRANSPORTATION AND NEED FOR FINANCIAL ASSISTANCE - NEED FOR CULTURALLY SENSITIVE CARE - LACK OF CARE COORDINATION - HEALTH LITERACY AND LANGUAGE BARRIERS 3. HEALTH OUTCOMES- MENTAL HEALTH AND SUBSTANCE USE - CHRONIC HEALTH CONDITIONS - PHYSICAL ACTIVITY AND NUTRITION - INFANT AND PERINATAL HEALTH ADDITIONAL DESCRIPTIONS FOR EACH OF THE PRIORITIZED NEEDS AND SUB-NEEDS CAN BE FOUND IN THE HOSPITAL'S CHNA, WHICH IS LOCATED ON THE HOSPITAL'S WEBSITE: WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS MERCY HOSPITAL, INC. PART V, SECTION B, LINE 5: THE INPUT OF THE COMMUNITY AND OTHER IMPORTANT REGIONAL STAKEHOLDERS WAS PRIORITIZED BY THE COALITION AS AN IMPORTANT PART OF THE CHNA PROCESS. BELOW ARE THE PRIMARY MECHANISMS FOR COMMUNITY AND STAKEHOLDER ENGAGEMENT: THE CHNA REGIONAL ADVISORY COMMITTEE (RAC) INCLUDED REPRESENTATIVES FROM EACH HOSPITAL/INSURER COALITION MEMBER AS WELL AS PUBLIC HEALTH AND COMMUNITY STAKEHOLDERS FROM EACH HOSPITAL SERVICE AREA. STAKEHOLDERS ON THE RAC INCLUDED LOCAL AND REGIONAL PUBLIC HEALTH AND HEALTH DEPARTMENT REPRESENTATIVES; REPRESENTATIVES FROM LOCAL AND REGIONAL ORGANIZATIONS SERVING OR REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME OR POPULATIONS OF COLOR; AND INDIVIDUALS FROM ORGANIZATIONS THAT REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY. THE COALITION CONDUCTED A STAKEHOLDER ANALYSIS TO ENSURE GEOGRAPHIC, SECTOR (E.G. SCHOOLS, COMMUNITY SERVICE ORGANIZATIONS, HEALTHCARE PROVIDERS, PUBLIC HEALTH, AND HOUSING), AND RACIAL/ETHNIC DIVERSITY OF RAC. THE RAC MET IN WORKGROUPS (DATA AND REPORTS, ENGAGEMENT AND DISSEMINATION, AND HEALTH EQUITY) TO GUIDE THE CONSULTANTS IN THE PROCESS OF CONDUCTING THE CHNA, AND TO PRIORITIZE COMMUNITY HEALTH NEEDS, CHNA FINDINGS, AND DISSEMINATION OF INFORMATION. ASSESSMENT METHODS AND FINDINGS WERE MODIFIED BASED ON THE STEERING COMMITTEE FEEDBACK. THE RAC CONSISTED OF 31 PEOPLE, INCLUDING COALITION MEMBERS AND CONSULTANTS. THE RAC MET MONTHLY FROM SEPTEMBER 2018 THROUGH JUNE 2019. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED TO BOTH GATHER INFORMATION USED TO IDENTIFY PRIORITY HEALTH NEEDS AND ENGAGE THE COMMUNITY. KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH HEALTH CARE PROVIDERS, HEALTH CARE ADMINISTRATORS, LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS, AND LOCAL LEADERS THAT REPRESENT THE INTERESTS OF THE COMMUNITY OR THAT SERVE MEDICALLY UNDERSERVED, LOW-INCOME, OR POPULATIONS OF COLOR IN THE SERVICE AREA. INTERVIEWS WITH LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS WERE USED TO IDENTIFY PRIORITY HEALTH AREAS AND COMMUNITY FACTORS THAT CONTRIBUTE TO HEALTH NEEDS. FOCUS GROUP PARTICIPANTS INCLUDED COMMUNITY ORGANIZATIONAL REPRESENTATIVES, COMMUNITY MEMBERS (LOW-INCOME, PEOPLE OF COLOR, AND OTHERS), AND OTHER COMMUNITY STAKEHOLDERS. TOPICS AND POPULATIONS INCLUDED: SUBSTANCE USE, TRANSGENDER HEALTH, OLDER ADULTS, YOUTH, MENTAL HEALTH, CANCER CARE, GUN VIOLENCE, AND RURAL FOOD ACCESS. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED FROM FEBRUARY 2019 THROUGH MARCH 2019. FOCUS GROUPS AND KEY INFORMANT INTERVIEWS ENGAGED ABOUT 210 PEOPLE, PRIMARILY IN HAMPDEN COUNTY BUT ALSO ACROSS THE REGION. THIS CHNA ALSO USED QUALITATIVE DATA FROM OTHER HOSPITAL SERVICE AREAS AS APPROPRIATE. THREE COMMUNITY CONVERSATIONS AND APPROXIMATELY 46 COMMUNITY CHATS WERE HELD THAT WERE PERTINENT TO MERCY'S CHNA. COMMUNITY CONVERSATIONS WERE LARGER BIDIRECTIONAL INFORMATION-SHARING MEETINGS THAT WERE CONDUCTED IN THE HOSPITAL'S SERVICE AREA, WITH ONE DONE IN SPANISH IN SPRINGFIELD. FOR COMMUNITY CHATS, RAC MEMBERS SHARED INFORMATION ABOUT THE CHNA AND GATHERED PRIORITIES IN REGULAR MEETINGS OF SERVICE PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, AND GROUPS OF STAFF AND ADMINISTRATORS AT HOSPITALS. CONVERSATIONS AND CHATS WERE HELD FROM JANUARY 2019 THROUGH APRIL 2019 AND ENGAGED APPROXIMATELY 824 PEOPLE IN HAMPDEN COUNTY. COMMUNITY FORUM SESSIONS WERE HELD IN JUNE 2019 UPON COMPLETION OF THE CHNA REPORT. THE COMMUNITY LISTENING SESSIONS INCLUDED INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND COMMUNITY STAKEHOLDERS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE SESSIONS HELPED TO OBTAIN INPUT ON THE PRIORITIZED HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA AND TO GAIN FEEDBACK ON THE NEEDS THAT ARE THE FOCUS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESS. BELOW IS A LIST OF PUBLIC HEALTH AND COMMUNITY REPRESENTATIVES, AND OTHER STAKEHOLDERS INVOLVED IN THE PROCESS, WHICH INCLUDED REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE VULNERABLE POPULATIONS, WHICH INCLUDE CHILDREN, OLDER ADULTS, LATINOS, AFRICAN AMERICANS, AND REFUGEES, WERE REPRESENTED BY: ACO PATIENT FAMILY ADVISORY COUNCIL, ALZHEIMER'S SUPPORT GROUP, ARMBROOK VILLAGE OLDER ADULT COMMUNITY, BAYSTATE COMMUNITY FACULTY HEALTH CARE PROFESSIONALS, BMC PATIENT FAMILY ADVISORY COUNCIL, BOYS AND GIRLS CLUB, BSEP CAREER INTERDISCIPLINARY, C3 MASON SQUARE, C3 SOUTH END, CARSON CENTER, CENTER FOR HUMAN DEVELOPMENT, CITY OF SPRINGFIELD PUBLIC HEALTH DEPARTMENT, COLLABORATIVE FOR EDUCATIONAL SERVICES, COMMUNITY ACTION PIONEER VALLEY, DEAN HIGH SCHOOL YOUTH COMMUNITY, EAST LONGMEADOW BOARD OF HEALTH, FALCETTI TOWERS COMMUNITY, FAMILY ADVOCACY CENTER'S HOMICIDE BEREAVEMENT PROGRAM, GANDAR COMMUNITY, GIRLS INC. SPRINGFIELD YOUTH COMMUNITY, GREATER SPRINGFIELD SENIOR SERVICES, HAMPDEN COUNTY HEALTH COALITION, HAMPDEN COUNTY SHERIFF'S DEPARTMENT, HEALTHY HILL INITIATIVE, HOLYOKE COMMUNITY COLLEGE, INTERFAITH COUNCIL, JEWISH FAMILY SERVICES, KAMP FOR KIDS, MA DEPARTMENT OF PUBLIC HEALTH - BUREAU OF SUBSTANCE USE SERVICES, MA DEPARTMENT OF PUBLIC HEALTH - DIVISION FOR PERINATAL/EARLY CHILDHOOD/SPECIAL NEEDS/CARE COORDINATION, MARTIN LUTHER KING FAMILY SERVICES, MASON SQUARE CAB, MASS IN MOTION, MASS MUTUAL, MASSACHUSETTS COUNCILS ON AGING, MATERNAL AND CHILD HEALTH COMMISSION, MEN OF COLOR HEALTH AWARENESS, MENTAL HEALTH ASSOCIATION, METROCARE OF SPRINGFIELD, MORGAN SCHOOL, NATIONAL ASSOCIATION OF HISPANIC NURSES OF WESTERN MA, NEW NORTH CITIZEN'S COUNCIL, NOBLE COMMUNITY CARE, NOBLE PATIENT FAMILY ADVISORY COUNCIL, OUT NOW YOUTH, PARENT VILLAGES, PATCH SERVICES BEHAVIORAL HEALTH NETWORK, PROJECT COACH YOUTH, SERVICENET, SHRINERS MEDICAL HOME, SPRINGFIELD DEPARTMENT OF HEALTH & HUMAN SERVICES, SQUARE ONE, STAVROS CENTER FOR INDEPENDENT LIVING, UNITY OF PIONEER VALLEY, UMASS SCHOOL OF PUBLIC HEALTH & HEALTH SCIENCES, WESTERN MA BLACK NURSES ASSOCIATION, WESTERN MA HEALTH EQUITY NETWORK, WESTERN MA VETERANS OUTREACH, WESTFIELD SENIOR CENTER, YOUNG CHILDREN'S COUNCIL. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 6A: MERCY HOSPITAL IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS AND COLLABORATED WITH THE FOLLOWING HOSPITALS IN CONDUCTING THE CHNA: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HOSPITAL, AND SHRINERS HOSPITAL FOR CHILDREN. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 6B: MERCY HOSPITAL COLLABORATED WITH HEALTH NEW ENGLAND, A HEALTH INSURANCE PROVIDER, IN CONDUCTING THE CHNA. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 11: MERCY HOSPITAL SUPPORTED INITIATIVES TO IMPROVE THE FOLLOWING SIGNIFICANT HEALTH NEEDS IN FISCAL YEAR 2021: BARRIERS TO ACCESSING QUALITY HEALTH CARE, AND HEALTH OUTCOMES. BARRIERS TO ACCESSING QUALITY HEALTH CARE - A SIGNIFICANT HEALTH NEED WAS FOUND IN REGARD TO HAMPDEN COUNTY RESIDENTS EXPERIENCING CHALLENGES IN ACCESSING CARE DUE TO THE SHORTAGE OF PROVIDERS. FIFTY-FOUR PERCENT OF HAMPDEN COUNTY RESIDENTS LIVE IN A HEALTH CARE PROFESSIONAL SHORTAGE AREA. MERCY HOSPITAL IMPLEMENTED AN INITIATIVE TO IMPROVE HEALTH LITERACY, ALONG WITH ACCESS TO CERVICAL CANCER SCREENINGS AND MAMMOGRAMS FOR HOMELESS WOMEN. THE IMPLEMENTATION STRATEGY'S GOAL WAS TO INCREASE THE NUMBER OF HOMELESS WOMEN WHO PARTICIPATE IN WOMEN'S HEALTH SCREENINGS. TO ACCOMPLISH THIS GOAL, MERCY HOSPITAL CONTINUED TO PERFORM CERVICAL CANCER SCREENINGS, AND ALSO VERIFIED THE CERVICAL SCREENING RECORDS AND MAMMOGRAMS PERFORMED INSIDE AND OUTSIDE OF MERCY HOSPITAL. ADDITIONALLY, MERCY HOSPITAL CONTINUED PROVIDING EDUCATION ON THE HEALTH RISKS PERTAINING TO WOMEN'S HEALTH. HEALTH OUTCOMES - THE SECOND SIGNIFICANT HEALTH NEED WAS FOUND TO BE A NEED TO INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION AMONG AREA RESIDENTS, ESPECIALLY THOSE WITH CHRONIC HEALTH CONDITIONS. MANAGING AND CONTROLLING CHRONIC HEALTH CONDITIONS REMAIN AN AREA OF PRIORITIZED HEALTH NEED FOR HAMPDEN COUNTY RESIDENTS. RESIDENTS CONTINUE TO EXPERIENCE HIGH RATES AND ASSOCIATED MORBIDITY, PARTICULARLY FOR OBESITY, DIABETES, CARDIOVASCULAR DISEASE, CANCER, AND ASTHMA. A HEALTHY DIET AND PHYSICAL ACTIVITY PLAY AN IMPORTANT ROLE IN PREVENTING AND MANAGING CHRONIC DISEASES.IN RESPONSE TO THIS HEALTH NEED, AN INITIATIVE WAS IDENTIFIED AND IMPLEMENTED TO IMPROVE PHYSICAL ACTIVITY AND NUTRITION THROUGH EDUCATION AND SPREADING AWARENESS AMONG DIFFERENT POPULATION GROUPS WITHIN THE COMMUNITY. A COMMUNITY HEALTH CHALLENGE WAS CONDUCTED TO IMPROVE COMMUNITY MEMBER HEALTH, CALLED THE "61 DAY CHALLENGE". IT ENCOMPASSED A VARIETY OF HEALTH AND WELLNESS GOALS INCLUDING HEALTHY EATING AND BETTER PHYSICAL HEALTH. OF THE PEOPLE WHO PARTICIPATED IN THE CHALLENGE, MORE THAN HALF OF THE PARTICIPANTS FELT THEY OBTAINED THEIR GOAL. BESIDES GOALS RELATED TO OBESITY REDUCTION, THE GOALS RELATED TO STRESS REDUCTION AND MENTAL HEALTH WERE ALSO EXTREMELY POPULAR. MERCY HOSPITAL IS COMMITTED TO ADHERING TO ITS MISSION AND REMAINING GOOD STEWARDS OF ITS RESOURCES SO IT CAN CONTINUE TO ENHANCE ITS CLINICAL ACTIVITIES AND TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THE FOLLOWING AREAS HAVE BEEN IDENTIFIED IN THE CHNA AS NEEDS THAT WERE NOT ADDRESSED IN FISCAL YEAR 2021 FOR THE FOLLOWING REASONS: COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTH - MERCY HOSPITAL DID NOT DIRECTLY ADDRESS THIS PARTICULAR NEED BECAUSE MERCY HOSPITAL, ALTHOUGH PLAYING ITS ROLE IN THIS COLLECTIVE EFFORT, IS NOT QUALIFIED TO FULLY ADDRESS THIS NEED IN THE COMMUNITY. MERCY HOSPITAL, HOWEVER, HAS TAKEN STEPS TOWARD ADDRESSING THIS NEED THROUGH ITS VARIOUS COMMUNITY PARTNERS AND WAS AN INSTRUMENTAL PARTNER IN MASSUP SPRINGFIELD COALITION. THIS IS A COLLABORATION BETWEEN MERCY HOSPITAL, THE SPRINGFIELD FOOD POLICY COUNCIL, SQUARE ONE, OPEN PANTRY COMMUNITY SERVICES INC., GARDENING THE COMMUNITY, AND FERTILE GROUND. IT'S A DIVERSE, PLACE-BASED COALITION THAT ADVOCATES FOR ALL SPRINGFIELD RESIDENTS TO ACCESS AND ENJOY HEALTHY FOOD. THE COMMUNITIES OF FOCUS ARE SPRINGFIELD'S NORTH END, SOUTH END, MASON SQUARE, DOWNTOWN AND METRO CENTRAL NEIGHBORHOODS. RACIAL EQUITY AND RESIDENT LEADERSHIP ARE AT THE FOUNDATION OF THIS COALITION'S EFFORTS. MERCY HOSPITAL, INC. PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCY HOSPITAL, INC. - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. THE MERCY HOSPITAL - PART V, SECTION B, LINE 7A WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS THE MERCY HOSPITAL - PART V, SECTION B, LINE 10A: WWW.TRINITYHEALTHOFNE.ORG/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS THE MERCY HOSPITAL - PART V, SECTION B, LINE 16A: WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/ THE MERCY HOSPITAL - PART V, SECTION B, LINE 16B: WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/ THE MERCY HOSPITAL - PART V, SECTION B, LINE 16C: WWW.TRINITYHEALTHOFNE.ORG/FOR-PATIENTS/BILLING-AND-FINANCIAL-RESOURCES/ 2 1 - LIFEPATH PARTNERS LLC 299 CAREW STREET SPRINGFIELD MA 01104 LABORATORY 2 - WESTERN MASS PETCT IMAGING CENTER 271 CAREW STREET SPRINGFIELD MA 01104 IMAGING CENTER PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: MERCY HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT, WHICH IT SUBMITS TO THE STATE OF MASSACHUSETTS. IN ADDITION, MERCY HOSPITAL REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG. IN ADDITION, MERCY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $8,715,119, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART I, LINE 5A: DURING FY21, DUE TO THE COVID-19 PANDEMIC, THE HOSPITAL SUSPENDED ITS TRADITIONAL ANNUAL BUDGET PROCESS AND USED A QUARTERLY PROCESS TO PLAN FOR FREE AND DISCOUNTED CARE UNDER ITS FINANCIAL ASSISTANCE POLICY. THIS CHANGE IN PROCESS DID NOT ALLOW THE HOSPITAL TO BUDGET FOR FINANCIAL ASSISTANCE EXPENSES ON AN ANNUAL BASIS. THE HOSPITAL IMPLEMENTED A NEW ROLLING FORECAST METHOD FOR FINANCIAL PLANNING IN FY22. THE ROLLING FORECAST WILL FACILITATE CONTINUOUS PLANNING, PERFORMANCE ASSESSMENT AND ACCOUNTABILITY. PART II, COMMUNITY BUILDING ACTIVITIES: MERCY HOSPITAL PARTICIPATED IN COMMUNITY BUILDING ACTIVITIES IN FISCAL YEAR 2021, AS DESCRIBED BELOW:COALITION BUILDING: MERCY HOSPITAL HOSTED STEERING COMMITTEE MEETINGS AND WAS ACTIVELY INVOLVED IN THE MASSUP SPRINGFIELD COALITION. THE COALITION WORKED TO CREATE A MORE EFFECTIVE FOOD SYSTEM TO HELP RESIDENTS LEAD HEALTHIER LIVES. THE COALITION SUPPORTS THE FOLLOWING: REDUCE SNAP/HIP GAP, MAKE STATE AND LOCAL ADVOCACY EFFORTS TO INCREASE ACCESS TO HEALTHY AND AFFORDABLE FOODS, ENGAGE AND MOBILIZE NEIGHBORHOOD COUNCILS AND COMMITTEES ADVOCATING FOR HEALTHY FOOD CHOICES, INCREASE SUPPLY OF FRESH FOOD IN CURRENT RETAIL STORES, INCREASE COMMUNITY GARDENS. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: MERCY HOSPITAL USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MERCY HOSPITAL IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MERCY HOSPITAL IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: MERCY HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: "AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED." PART III, LINE 8: MERCY HOSPITAL DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - MERCY HOSPITAL ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES, AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCY HOSPITAL COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. MERCY HOSPITAL OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. MERCY HOSPITAL HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MERCY HOSPITAL MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - THE SERVICE AREA FOR MERCY INCLUDES ALL 23 COMMUNITIES WITHIN HAMPDEN COUNTY WHICH INCLUDES THE THIRD LARGEST CITY IN MASSACHUSETTS - SPRINGFIELD (POPULATION OVER 150,000). THREE ADJACENT CITIES (HOLYOKE, CHICOPEE AND WEST SPRINGFIELD) CREATE A DENSELY POPULATED URBAN CORE THAT INCLUDES OVER HALF OF THE POPULATION OF THE SERVICE AREA (270,000 PEOPLE). SMALLER COMMUNITIES EXIST TO THE EAST AND WEST OF THIS CENTRAL CORE AREA. MANY OF THESE COMMUNITIES HAVE POPULATIONS UNDER 20,000 PEOPLE. THE PIONEER VALLEY TRANSIT AUTHORITY, THE SECOND LARGEST PUBLIC TRANSIT SYSTEM IN THE STATE, SERVES 11 COMMUNITIES IN THE SERVICE AREA, AND CONNECTS SUBURBAN AREAS TO THE CORE CITIES AND SERVICES. THE SERVICE AREA HAS MORE RACIAL AND ETHNIC DIVERSITY THAN MANY OTHER PARTS OF WESTERN MASSACHUSETTS. COUNTY-WIDE, 24% OF THE POPULATION IS LATINO, 8% IS BLACK AND 2% IS ASIAN (AMERICAN COMMUNITY SURVEY [ACS], 2013-2017), THOUGH THIS DIVERSITY IS NOT EQUALLY SPREAD THROUGHOUT THE REGION AND TENDS TO BE CONCENTRATED IN THE URBAN CORE. A SUBSTANTIAL PROPORTION OF THE COUNTY'S POPULATION IS FROM OTHER COUNTRIES. IN 2017, 22% OF THE STATE'S IMMIGRANTS CAME TO WESTERN MASSACHUSETTS. WEST SPRINGFIELD HAS WELCOMED THE HIGHEST PROPORTION IN HAMPDEN COUNTY - 15% OF THE CITY'S POPULATION ARE IMMIGRANTS (US CENSUS, ACS, 2013-2017). ECONOMICALLY, THE MERCY SERVICE AREA IS HOME TO MANY OF THE LARGEST EMPLOYERS IN THE REGION, AS WELL AS NUMEROUS COLLEGES AND UNIVERSITIES, AND PROVIDES A STRONG ECONOMIC ENGINE FOR THE BROADER REGION. THE LARGEST INDUSTRIES AND EMPLOYERS INCLUDE HEALTH CARE, SERVICE, AND WHOLESALE TRADE AND MANUFACTURING. AT THE SAME TIME, THE COUNTY STRUGGLES WITH HIGHER RATES OF UNEMPLOYMENT AND POVERTY, LOWER HOUSEHOLD INCOMES, AND LOWER RATES OF EDUCATIONAL ATTAINMENT. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS ABOUT $52,000 ($22,000 LESS THAN THE STATE), THE POVERTY RATE IS MORE THAN 60% HIGHER THAN STATEWIDE, AND THE CHILD POVERTY RATE IS AN ALARMING 27% - MORE THAN 1 OUT OF EVERY 4 CHILDREN IN HAMPDEN COUNTY IS LIVING IN POVERTY (ACS, 2013-2017). DESPITE BEING AT THE CORE OF THE KNOWLEDGE CORRIDOR REGION, ONLY 27% OF THE POPULATION AGE 25 AND OVER HAS A BACHELOR'S DEGREE, COMPARED TO 43% STATEWIDE. UNEMPLOYMENT IS SOMEWHAT HIGHER THAN THE STATE AVERAGE. THE MEDIAN AGE FOR THE SERVICE AREA IS SIMILAR TO THAT OF MASSACHUSETTS, ALTHOUGH IN SPRINGFIELD THE MEDIAN AGE IS ABOUT 33 YEARS OF AGE COMPARED TO 39 IN HAMPDEN COUNTY. THE POPULATION OVER 45 YEARS OLD IS GROWING AS A PERCENTAGE OF THE TOTAL POPULATION. BETWEEN 2010 AND 2035, THE PROPORTION OF PEOPLE OVER AGE 60 IS PROJECTED TO GROW FROM 20% OF THE POPULATION TO 28% IN HAMPDEN COUNTY, WITH THE NUMBER OF OLDER ADULTS INCREASING FROM APPROXIMATELY 92,000 IN 2010 TO AN ESTIMATED 140,000 IN 2035. IN HAMPDEN COUNTY 16% OF THE POPULATION HAS A DISABILITY COMPARED TO THE STATE AT 12%. IN SPRINGFIELD AND HOLYOKE, DISABILITY RATES ARE HIGH AT ALMOST 20% AND 17%, RESPECTIVELY. IN HAMPDEN COUNTY, 11% OF YOUTH UNDER 18 HAVE A DISABILITY (THE PERCENTAGE FOR THE STATE IS 7%). BY RACE AND ETHNICITY, 6% OF WHITE CHILDREN HAVE A DISABILITY, 10% OF LATINO CHILDREN, AND 6% OF BLACK CHILDREN (ACS, 2013-2017). PEOPLE WITH DISABILITIES TEND TO HAVE HIGHER RATES OF POVERTY AND LOWER LEVELS OF EDUCATION. IN HAMPDEN COUNTY, POVERTY RATES AMONG THOSE WITH A DISABILITY (27%) WERE MORE THAN DOUBLE THOSE AMONG PEOPLE WITHOUT A DISABILITY (12%). SIMILARLY, 30% OF THE POPULATION WITH A DISABILITY DID NOT HAVE A HIGH SCHOOL DIPLOMA, COMPARED TO 11% AMONG THOSE WITHOUT A DISABILITY (US CENSUS, ACS, 2013-2017).HAMPDEN COUNTY CONTAINS SIX ACUTE CARE HOSPITAL FACILITIES. SEVERAL AREAS AND POPULATIONS IN HAMPDEN COUNTY ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA). OVER 54% PERCENT OF HAMPDEN COUNTY RESIDENTS LIVE IN A HPSA. THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS (MUA/MUP) IN HAMPDEN COUNTY ARE PRIMARILY FOUND IN SPRINGFIELD, WEST SPRINGFIELD, WESTFIELD, BLANDFORD, AND CHESTER. MUA AND MUP ARE IDENTIFIED BASED ON AVAILABILITY OF PRIMARY CARE PROVIDERS, INFANT MORTALITY RATE, POVERTY RATE, AND PROPORTION OF OLDER ADULTS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH -MERCY HOSPITAL'S GOVERNING BODY IS ITS BOARD OF DIRECTORS, THE MAJORITY OF WHICH IS COMPRISED OF INDIVIDUALS WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS. THE ORGANIZATION EXTENDS MEDICAL PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ITS DEPARTMENTS AND SPECIALTIES, PROVIDED THESE PHYSICIANS MEET THE QUALIFICATIONS OUTLINED AND CERTIFIED BY THE MEDICAL CREDENTIALING OFFICE. AS A NON-PROFIT ENTITY, ANY AND ALL OF MERCY HOSPITAL'S EXCESS FUNDS ARE USED TO FUND IMPROVEMENTS IN PATIENT CARE AND MEDICAL EDUCATION. MERCY HOSPITAL FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY OFFERING THE FOLLOWING:HEALTH CARE FOR THE HOMELESS (HCH) - MERCY HOSPITAL'S DEPARTMENT OF COMMUNITY HEALTH PROVIDED CARE TO THE COMMUNITY'S HOMELESS POPULATION IN FRANKLIN, HAMPSHIRE, AND HAMPDEN COUNTIES THROUGH PRIMARY CARE SERVICES, HEALTH EDUCATION, CASE MANAGEMENT, MENTAL HEALTH SERVICES, AND FREE CLINICS. MORE THAN 5,000 TOTAL MEDICAL ENCOUNTERS INCLUDING MENTAL HEALTH SERVICES AND COVID-19 TEST AND VACCINE ADMINISTRATION WERE PROVIDED. IN THE ONGOING EFFORT TO IDENTIFY HOMELESS PERSONS IN WESTERN MASSACHUSETTS, THE HCH STAFF (WHICH INCLUDES PHYSICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, MEDICAL HEALTH COUNSELORS, AND MEDICAL ASSISTANTS) ASSESS HOMELESS NEEDS AND RESOURCES, DELIVERS HEALTH AND SOCIAL SERVICES AND EVALUATES THE IMPACT.THE FOLLOWING GRANTS WERE RECEIVED BY THE HCH TEAM TO ADDRESS HOMELESSNESS:ESG GRANT 1 - FUNDING TO HIRE A COMMUNITY OUTREACH NURSE RN AND COMMUNITY HEALTH WORKER. BOTH ROLES WORK IN TANDEM TO PROVIDE OUTREACH SERVICES TO INDIVIDUALS WHO ARE UNWILLING/UNABLE TO SLEEP IN CONGREGATE LIVING SITUATIONS, FOCUSING ON HAMPDEN COUNTY. THEIR OUTREACH SERVICES INCLUDE CASE MANAGEMENT, EMPLOYMENT ASSISTANCE AND JOB TRAINING, LIFE SKILLS TRAINING, MENTAL HEALTH SERVICES AND SUBSTANCE USE TREATMENT. BASIC PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES WILL ALSO BE OFFERED THROUGH REFERRAL TO THE HEALTHCARE FOR THE HOMELESS CLINIC. ESG GRANT 2 - FUNDING TO EXPAND COMMUNITY OUTREACH EFFORTS AND HIRE A SOCIAL WORKER AS WELL AS A SECOND COMMUNITY HEALTH WORKER. THEY WORK IN TANDEM WITH THE ESG 1 TEAM TO PROVIDE OUTREACH SERVICES TO INDIVIDUALS WHO ARE UNWILLING/UNABLE TO SLEEP IN CONGREGATE LIVING SITUATIONS, FOCUSING ON SPRINGFIELD. PVTA TAXI GRANT - FUNDING TO COVER NON-EMERGENCY AND NON-COVID-19 TRAVEL FOR HOMELESS PATIENTS AND SENIORS WHO FACED TRANSPORTATION BARRIERS WHEN MEETING THEIR BASIC NEEDS. COVID-19 EPIDEMIC - BESIDES OFFERING COVID-19 TESTING AND VACCINATION SERVICES TO THE COMMUNITY, MERCY HOSPITAL, AS PART OF THE TRINITY HEALTH OF NEW ENGLAND HEALTH SYSTEM, WAS INVOLVED IN A MULTIFACETED PUBLIC HEALTH AWARENESS MEDIA CAMPAIGN. COMMUNICATIONS ON COVID-19 PREVENTION, TESTING AND TREATMENT ALSO INCLUDED TARGETED MESSAGING FOR DIVERSE COMMUNITIES AS WELL AS TARGETED MESSAGING FOR CHILDREN. THE TRINITY HEALTH "IT STARTS HERE" CAMPAIGN SUPPORTED COVID-19 VACCINE OUTREACH, EDUCATION AND CLINICS BY GRANTING SUBCONTRACTS TO LOCAL COMMUNITY-BASED ORGANIZATIONS WHICH INCLUDED THE PUBLIC HEALTH INSTITUTE OF WESTERN MA, BLACK SPRINGFIELD COVID-19 COALITION, NEW NORTH CITIZENS' COUNCIL, EDUCARE SPRINGFIELD AND OPEN PANTRY COMMUNITY SERVICES, INC. THE COMMUNITIES OF FOCUS WERE COMMUNITIES OF COLOR AND THOSE WHO ARE VULNERABLE LIVING IN SPRINGFIELD. ACTIONS INCLUDED: PROVIDING VACCINES TO COMMUNITY MEMBERS AND HOSTING VACCINE CLINICS AT COMMUNITY EVENTS; HAVING BILINGUAL COMMUNITY OUTREACH CHAMPIONS GO DOOR-TO-DOOR TO ADDRESS CONCERNS AROUND THE VACCINE; ENGAGING LOCAL SOCIAL MEDIA INFLUENCERS AND RADIO STATIONS TO PROMOTE THE "IT STARTS HERE" CAMPAIGN ON THE IMPORTANCE OF BEING VACCINATED. WITH THIS CAMPAIGN, OVER 30,000 PEOPLE WERE REACHED VIA COMMUNITY COVID-19 OUTREACH AND EDUCATION EFFORTS. PART VI, LINE 6: MERCY HOSPITAL IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR THOSE WHO ARE POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE BY CONNECTING SOCIAL AND CLINICAL CARE, ADDRESSING SOCIAL NEEDS, DISMANTLING SYSTEMIC RACISM, AND REDUCING HEALTH INEQUITIES. WE DO THIS BY: 1. INVESTING IN OUR COMMUNITIES 2. ADVANCING SOCIAL CARE3. IMPACTING SOCIAL INFLUENCERS OF HEALTHINVESTING IN OUR COMMUNITIES:TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2021, TRINITY HEALTH INVESTED $1.2 BILLION IN COMMUNITY BENEFIT, SUCH AS INITIATIVES SUPPORTING THOSE WHO ARE POOR AND VULNERABLE, HELPING TO MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, AND MOVING FORWARD POLICY, SYSTEM, AND ENVIRONMENTAL CHANGE. IN RESPONSE TO COVID-19, TRINITY HEALTH MEMBER HOSPITALS REDIRECTED SOME RESOURCES TO ADDRESS THE MOST URGENT SOCIAL AND MEDICAL NEEDS IN OUR COMMUNITIES, INCLUDING FOOD SUPPORT, EDUCATION SUPPORT, AND OUTREACH TO THOSE EXPERIENCING HOMELESSNESS.ADDITIONALLY, THROUGH TRINITY HEALTH'S COMMUNITY HEALTH INSTITUTE, $1.6 MILLION WAS INVESTED IN THE "IT STARTS HERE" COVID-19 VACCINE CAMPAIGN, COUPLING COMMUNITY ENGAGEMENT STRATEGIES AND SOCIAL MEDIA INFLUENCERS. THIS EFFORT DISTRIBUTED $1.1 MILLION IN CHWB GRANTS TO MEMBER HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS IN SUPPORT OF COMMUNITY ENGAGEMENT STRATEGIES FOCUSED IN COMMUNITIES OF COLOR. OVER 80% OF DOLLARS AWARDED SUPPORTED PRIORITIZED COMMUNITIES, DEFINED AS 40% OF THE COMMUNITY BEING BLACK/LATINX AND/OR NATIVE AMERICAN. IT STARTS HERE LAUNCHED IN FEBRUARY, AND IN JUST UNDER FIVE MONTHS, MEMBER HOSPITALS AND THEIR COMMUNITY PARTNERS REACHED NEARLY 615,000 PEOPLE THROUGH OUTREACH AND EDUCATION, ENGAGED OVER 1,150 COMMUNITY CHAMPIONS, AND HELD OVER 700 VACCINE CLINICS THAT PROVIDED OVER 152,000 VACCINATIONS. IN ADDITION TO COMMUNITY EFFORTS, IT STARTS HERE FUNDED SOCIAL MEDIA CAMPAIGNS TO IMPROVE ACCESS TO COVID-19 VACCINATION INFORMATION BY ENGAGING LOCAL SOCIAL MEDIA INFLUENCERS WHO REPRESENT THE CULTURE AND ETHNICITY OF OUR LOCAL COMMUNITIES.BEYOND COVID-19 EFFORTS, TRINITY HEALTH COMMITTED MORE THAN $46 MILLION IN LOANS TO 31 NOT-FOR-PROFIT ORGANIZATIONS FOCUSING ON IMPROVING COMMUNITY CONDITIONS AROUND HOUSING, FACILITIES, EDUCATION, AND ECONOMIC DEVELOPMENT THROUGH OUR COMMUNITY INVESTING PROGRAM. THE PROGRAM MAKES LOW-INTEREST RATE LOANS TO SELECT COMMUNITY PARTNERS AND INTERMEDIARIES TO POSITIVELY IMPACT SOCIAL INFLUENCERS THAT DRIVE HEALTHY OUTCOMES FOR FAMILIES AND RESIDENTS LIVING IN THE COMMUNITIES WE SERVE. ADVANCING SOCIAL CARE:TRINITY HEALTH'S SOCIAL CARE PROGRAM WAS DEVELOPED TO PROMOTE HEALTHY BEHAVIORS WHILE HELPING PATIENTS, COLLEAGUES AND MEMBERS ACCESS ESSENTIAL NEEDS, SUCH AS TRANSPORTATION, CHILDCARE, OR AFFORDABLE MEDICATIONS. COMMUNITY HEALTH WORKERS ARE A KEY COMPONENT OF SOCIAL CARE AND SERVE AS LIAISONS BETWEEN HEALTH AND SOCIAL SERVICES AND THE COMMUNITY TO ADDRESS PATIENTS' SOCIAL NEEDS AND MITIGATE BARRIERS. TRINITY HEALTH'S COMMUNITY HEALTH WORKER HUB DRIVES INTEGRATION AND ASSIGNMENT OF COMMUNITY HEALTH WORKERS THROUGHOUT THE HEALTH SYSTEM. IT INCLUDES A NETWORK OF COMMUNITY HEALTH WORKERS AND COMMUNITY-BASED ORGANIZATIONS THAT TOGETHER, HELP SUPPORT INDIVIDUALS AND FAMILIES IN NEED. BECAUSE OF THEIR LIVED EXPERIENCES, COMMUNITY HEALTH WORKERS ARE TRUSTED MEMBERS OF THE COMMUNITY AND WORK CLOSELY WITH A PATIENT BY ASSESSING THEIR SOCIAL NEEDS, HOME ENVIRONMENT AND OTHER SOCIAL RISK FACTORS, AND ULTIMATELY CONNECT THE INDIVIDUAL TO SERVICES WITHIN THE COMMUNITY. IN FISCAL YEAR 2021, TRINITY HEALTH GREW ITS NETWORK OF COMMUNITY HEALTH WORKERS BY 15%, OVER 90 COMMUNITY HEALTH WORKERS, SPANNING NEARLY EVERY MEMBER HOSPITAL.ADDITIONALLY, WE CREATED THE TRINITY HEALTH COMMUNITY RESOURCE DIRECTORY, WHICH IS AN ONLINE PORTAL CONNECTING THOSE IN NEED TO FREE OR REDUCED-COST HEALTH AND SOCIAL SERVICE RESOURCES WITHIN THE COMMUNITY AND ACROSS ALL TRINITY HEALTH LOCATIONS. IN FISCAL YEAR 2021, THE COMMUNITY RESOURCE DIRECTORY YIELDED NEARLY 50,000 SEARCHES, OVER 1,000 REFERRALS, OVER 70 KEY ORGANIZATIONS CLAIMED THEIR PROGRAMS, AND OVER 900 SOCIAL NEEDS ASSESSMENTS WERE COMPLETED.TRINITY HEALTH CONTINUES TO EXPAND THE NATIONAL DIABETES PREVENTION PROGRAM THROUGH THE SUPPORT OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. EPIC, TRINITY HEALTH'S ELECTRONIC HEALTH RECORD, IDENTIFIED THE DIABETES PREVENTION PROGRAM AS A BEST PRACTICE FOR IDENTIFICATION OF AT-RISK PATIENTS, REFERRAL, AND BI-DIRECTIONAL COMMUNICATION. ADDITIONALLY, THE AMERICAN MEDICAL ASSOCIATION PRESENTED TRINITY HEALTH'S DIABETES PREVENTION PROGRAM APPROACH TO THEIR BOARD OF DIRECTORS AS A BEST PRACTICE FOR A POPULATION HEALTH, DATA-DRIVEN STRATEGY TO PREVENT DIABETES.IMPACTING SOCIAL INFLUENCERS OF HEALTH:IN PARTNERSHIP WITH THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY, THE INVESTOR ENVIRONMENTAL HEALTH NETWORK AND INVESTORS FOR OPIOID AND PHARMACEUTICAL ACCOUNTABILITY, TRINITY HEALTH USES ITS OWNERSHIP OF SHARES OF STOCK IN CORPORATIONS TO INFLUENCE CORPORATIONS' POLICIES AND PRACTICES THAT AFFECT SOCIAL INFLUENCERS OF HEALTH, THE LIVING CONDITIONS THAT CAN AFFECT THE HEALTH OF A COMMUNITY, SUCH AS HOUSING, FOOD, EDUCATION, HEALTH CARE, AND ECONOMICS. TRINITY HEALTH TAKES ACTION BY WRITING LETTERS TO COMPANIES, MEETING WITH CORPORATE MANAGEMENT, AND SUBMITTING AND SUPPORTING SHAREHOLDER RESOLUTIONS AS AGENDA ITEMS FOR COMPANIES' ANNUAL MEETINGS OF SHAREHOLDERS.FISCAL YEAR 2021 YIELDED MANY POSITIVE OUTCOMES IN ITS 180 COMPANY ENGAGEMENTS, INCLUDING 50 COMPANY DIALOGUES AND 16 FILED RESOLUTIONS LEADING TO CHANGES IN POLICIES AND PRACTICES AT 18 CORPORATIONS. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES MA 1 1 0 0 0 0 0 0 0 BENJAMIN CARTER DIRECTOR THR 12/20;TRINITY EVP & COO 0 1254721 0 0 0 300513 0 12825 0 70455 0 1638514 0 0 REGINALD EADIE MD DIRECTOR; TH OF NE PRESIDENT & CEO 0 992914 0 0 0 19795 0 191213 0 40283 0 1244205 0 0 DANIEL MOEN FORMER OFFICER; SFMC TREN PRES/CEO 0 672485 0 0 0 31267 0 12825 0 49304 0 765881 0 0 EMILY BROWER DIR AS OF 1/21; TRINITY HEALTH SVP 0 436906 0 0 0 17794 0 91538 0 36876 0 583114 0 0 THOMAS ROBERT FORMER OFFICER; SPHP TREAS & CFO 0 448775 0 0 0 11862 0 78203 0 35136 0 573976 0 0 DEBORAH BITSOLI PRESIDENT 0 435981 0 0 0 12633 0 70950 0 36358 0 555922 0 0 ROBERT ANTHONY SECRETARY; VP MANAGING COUNSEL 0 424547 0 0 0 11217 0 68200 0 32590 0 536554 0 0 JENNIFER SCHNEIDER TREASURER; SVP AND REGIONAL CFO 0 391138 0 0 0 11606 0 67100 0 34626 0 504470 0 0 VIKRAM SONDHI FORMER KEY EMPLOYEE;MEDICAL DIRECTOR 0 450957 0 0 0 490 0 17100 0 29672 0 498219 0 0 MARK FULCO FORMER OFFICER 0 0 0 0 0 450748 0 0 0 14980 0 465728 0 377549 STUART ROSENBERG VP OP; PRES, JOHNSON MEMORIAL HOSP 0 335417 0 0 0 16469 0 21375 0 43468 0 416729 0 0 ROBERT ROOSE MD CHIEF MEDICAL OFFICER 0 359115 0 0 0 5948 0 12825 0 32274 0 410162 0 0 GUY DISTEFANO VP FINANCE 0 254718 0 0 0 115644 0 9135 0 30323 0 409820 0 0 DANIEL KEENAN SVP GOVERNMENT RELATIONS 0 257838 0 0 0 4685 0 16018 0 33201 0 311742 0 0 DARLENE CUNHA CHIEF NURSING OFFICER 0 274021 0 0 0 4923 0 12423 0 11269 0 302636 0 0 MARY TARAIL MD PSYCHIATRIST 263881 0 20000 0 0 0 16997 0 0 0 300878 0 0 0 DOROTA POLUHA MD MEDICAL DIRECTOR 265486 0 0 0 1107 0 11989 0 4637 0 283219 0 0 0 ARI KRIEGSMAN MD MEDICAL DIRECTOR ADDICTION CONSULT 227107 0 0 0 1197 0 8093 0 28894 0 265291 0 0 0 JAMES HARRIS FORMER OFFICER;TH OF NE DIR OF REIMB 0 191479 0 0 0 1243 0 15162 0 29352 0 237236 0 0 CHARLES FLINN FORMER KEY EMPLOYEE 0 0 0 0 0 126817 0 0 0 2727 0 129544 0 126817 PART I, LINE 3 THE MERCY HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. THE MERCY HOSPITAL'S PRESIDENT WAS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE MERCY HOSPITAL'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2020. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CHARLES FLINN - $123,696 MARK FULCO - $377,549 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2020. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2020, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2020. THE FOLLOWING PAYOUTS FOR 2020 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: BENJAMIN CARTER - $260,058 MARK FULCO - $57,258 THE FOLLOWING ACCRUALS FOR 2020 ARE INCLUDED IN COLUMN C OF SCHUEDLE J, PART II: ROBERT ANTHONY - $55,375 DEBORAH BITSOLI - $58,125 EMILY BROWER - $78,713 REGINALD EADIE - $178,388 THOMAS ROBERT - $56,828 JENNIFER SCHNEIDER - $50,000 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($285,000 IN 2020). THE FOLLOWING PAYOUTS FOR 2020 FOR THIS PLAN ARE INCLUDED IN COLUMN B (III) OF SCHEDULE J, PART II: DANIEL KEENAN - $777 DANIEL MOEN - $11,348 ROBERT ROOSE - $4,004 STUART ROSENBERG - $4,165 JENNIFER SCHNEIDER - $2,946 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 416160 DONOR PROVIDED GOODS/SERVICES TO THE MERCY HOSPITAL 0 FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCY MEDICAL CENTER PROVIDENCE BEHAVORIAL HEALTH HOSPITAL SR. MARY CARITAS CANCER CENTER @ MERCY MEDICAL CENTER HEALTHCARE FOR THE HOMELESS @ MERCY MEDICAL CENTER SISTERS OF PROVIDENCE HEALTH SYSTEM FORM 990, PART III, LINE 3 THE MERCY HOSPITAL SOLD ITS BEHAVIORAL HEALTH SERVICE, PROVIDENCE BEHAVIORAL HEALTH HOSPITAL IN APRIL 2021 AND ALL THE PROGRAMS CONDUCTED AT PROVIDENCE HOSPITAL CEASED. THESE PROGRAMS INCLUDED INPATIENT SERVICES FOR DETOX AND CLINCIAL STABILIZATION AND OUTPATIENT SERVICES FOR METHADONE (BOTH DOSING AND COUNSELING) AND OTHER OUTPATIENT COUNSELING PROGRAMS RELATED TO BEHAVIORAL HEALTH. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE MERCY HOSPITAL IS TRINITY HEALTH OF NEW ENGLAND CORPORATION (TRINITY HEALTH OF NEW ENGLAND). SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH OF NEW ENGLAND IS THE SOLE MEMBER OF THE MERCY HOSPITAL. TRINITY HEALTH OF NEW ENGLAND HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF THE MERCY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH OF NEW ENGLAND MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH OF NEW ENGLAND MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. AS THE PARENT OF THE NATIONAL TRINITY HEALTH SYSTEM, CERTAIN POWERS ARE RESERVED TO TRINITY HEALTH CORPORATION. THESE INCLUDE THE AUTHORITY TO ADOPT OR MODIFY THE ORGANIZATION'S GOVERNING DOCUMENTS, TO APPROVE MAJOR CHANGES SUCH AS A MERGER OR DISSOLUTION, AND TO APPROVE SIGNIFICANT FINANCE MATTERS IN EXCESS OF CERTAIN LIMITS ESTABLISHED BY TRINITY HEALTH CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT AND COMPLIANCE COMMITTEE OF TRINITY HEALTH OF NEW ENGLAND HAS THE RESPONSIBILITY FOR OVERSEEING THE REVIEW OF THE FORM 990, INCLUDING ENSURING APPROPRIATE DIRECTORS AND/OR MANAGEMENT PERSONNEL HAVE REVIEWED AND ANY ISSUES ARE COMMUNICATED TO THIS COMMITTEE PRIOR TO FILING. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE MERCY HOSPITAL HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF THE MERCY HOSPITAL, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF THE MERCY HOSPITAL AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF THE MERCY HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO THE MERCY HOSPITAL OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF THE MERCY HOSPITAL (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF THE MERCY HOSPITAL. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF THE MERCY HOSPITAL WAS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING PRESIDENT AND VICE PRESIDENT FINANCE COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE PRESIDENT AND VICE PRESIDENT FINANCE OF THE MERCY HOSPITAL ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR OTHER EXECUTIVES WHO ARE NOT PART OF THE REBUTTABLE PRESUMPTION PROCESS, TRINITY HEALTH USES A MARKET ANALYSIS TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE MERCY HOSPITAL IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, THE MERCY HOSPITAL INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. THE MERCY HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY GAIN IN UNCONSOLIDATED AFFILIATES 473,672. EQUITY TRANSFERS TO AFFILIATES -7,285,277. PARTNERSHIP AND STOCKHOLDERS EQUITY ACTIVITY 174,267. GAIN ON DIVESTITURES 3,000,000. FORM 990, PART XII, LINE 2: THE MERCY HOSPITAL'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY21 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH OF NEW ENGLAND AND TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. MERCY CARE ALLIANCE LLC 1221 MAIN ST STE 213 HOLYOKE MA 01040 471561725 ACCOUNTABLE CARE ORGANIZATION MA 0 14039 THE MERCY HOSPITAL INC MERCY HEALTH ACCOUNTABLE CARE ORGANIZATION 1221 MAIN ST STE 213 HOLYOKE MA 01040 821007572 ACCOUNTABLE CARE ORGANIZATION MA 3609674 289030 THE MERCY HOSPITAL INC ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS 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