SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Trinity Health System Group
 
Employer identification number

30-0752920
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		  47,993 1,570,768 1,570,948 0 0 %
b Medicaid (from Worksheet 3, column a) . . . . .     41,431,975 25,549,562 15,882,413 6.740 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .   47,993 43,002,743 27,120,510 15,882,413 6.740 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 5 2,629 140,965   140,965 0.060 %
f Health professions education (from Worksheet 5) . . . 2 25 113,887   113,887 0.050 %
g Subsidized health services (from Worksheet 6) . . . . 1   3,314,005 1,661,753 1,652,252 0.700 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 2   50,001   50,001 0.020 %
j Total. Other Benefits . . 10 2,654 3,618,858 1,661,753 1,957,105 0.830 %
k Total. Add lines 7d and 7j . 10 50,647 46,621,601 28,782,263 17,839,518 7.570 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
12,101,694
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
202,000
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
57,049,287
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
57,005,190
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
44,097
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1VALLEY SURGERY CTR
  		AMBULATORY SURGERY 34 % 0 % 34 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 TRINITY MEDICAL CENTER WEST
4000 JOHNSON ROAD
STEUBENVILLE,OH43952
HTTP://WWW.TRINITYHEALTH.COM/
1208AHR 		X X         X     A
2 TRINITY MEDICAL CENTER EAST
380 SUMMIT AVENUE
STEUBENVILLE,OH43952
HTTP://WWW.TRINITYHEALTH.COM/
1208AHR 		X X               A
Schedule H (Form 990) 2019
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Schedule H (Form 990) 2019
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		12
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take 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? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
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Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
(SEE STATEMENT)
b
(SEE STATEMENT)
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
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Schedule H (Form 990) 2019
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Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
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Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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Schedule H (Form 990) 2019
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Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION A TRINITY MEDICAL CENTER WEST - EIN: 34-0875691 TRINITY MEDICAL CENTER EAST - EIN: 34-0714474 SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS ARE INCLUDED IN A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY NAME: A DESCRIPTION: TRINITY HEALTH COLLABORATED WITH OTHER LOCAL ORGANIZATIONS AND PROVIDERS TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. REPRESENTATIVES INCLUDED A DIVERSE MIX OF INDIVIDUALS FROM THE CITY OF STEUBENVILLE HEALTH DEPARTMENT, JEFFERSON COUNTY HEALTH DEPARTMENT AND REPRESENTATIVE MEMBERS OF OTHER COMMUNITY AGENCIES INCLUDING THE TRINITY STEERING COMMITTEE IDENTIFIED TARGET STAKEHOLDERS TO BE INTERVIEWED. STRATEGY SOLUTIONS, INC. DEVELOPED THE STAKEHOLDER INTERVIEW GUIDE AND CREATED ALL DATA COLLECTION TOOLS. STRATEGY SOLUTIONS, INC. STAFF SCHEDULED AND CONDUCTED NINE (9) INTERVIEWS AND ENTERED DATA INTO THE COLLECTION TOOLS. INTERVIEW QUESTIONS INCLUDED THE FOLLOWING TOPICS: TOP COMMUNITY HEALTH NEEDS, ENVIRONMENTAL FACTORS DRIVING THE NEEDS, EFFORTS CURRENTLY UNDERWAY TO ADDRESS NEEDS, AND ADVICE FOR THE STEERING COMMITTEE. THE PRIMARY DATA COLLECTION PROCESS ALSO INCLUDED CONDUCTING A COMMUNITY SURVEY FROM MARCH 1, 2019 TO APRIL 1, 2019, UTILIZING A MIXED-METHODOLOGY CONVENIENCE SAMPLE, WITH DATA COLLECTION COMPLETED VIA PAPER AND THE INTERNET. TRINITY PUT A LINK TO THE SURVEY ON THEIR FACEBOOK PAGE AND DISTRIBUTED VIA EMAIL TO ALL INTERNAL AND EXTERNAL STAKEHOLDERS. INDIVIDUALS HAD THE OPTION TO PRINT A PAPER VERSION IF THEY PREFERRED TO COMPLETE THE SURVEY VIA THAT MODALITY. A TOTAL OF 190 SURVEYS WERE COMPLETED BY THE RESIDENTS OF THE TRINITY SERVICE AREA.
SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY NAME: A DESCRIPTION: THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN TAX YEAR 2019 THAT ARE BEING ADDRESSED ARE: MENTAL HEALTH/SUBSTANCE ABUSE, CHRONIC DISEASE, MATERNALAND INFANT HEALTH, ACCESS TO QUALITY HEALTHCARE, INFECTIOUS DISEASE, PHYSICAL ACTIVITY AND NUTRITION, TOBACCO USE AND INJURY. THE MAJORITY (94.0%) OF FOCUS GROUP PARTICIPANTS IDENTIFIED MENTAL HEALTH AS A TOP COMMUNITY HEALTH PROBLEM, WHILE 85.5% OF COMMUNITY SURVEY RESPONDENTS IDENTIFIED IT AS A TOP ISSUE. JUST UNDER ONE THIRD OF STAKEHOLDERS (30.0%) IDENTIFIED THE NEED FOR MORE MENTAL HEALTH PROVIDERS. FEWER THAN ONE IN FIVE COMMUNITY SURVEY RESPONDENTS AGREE THAT THERE IS A SUFFICIENT NUMBER AND RANGE OF MENTAL/BEHAVIORAL HEALTH PROVIDERS IN THE AREA (18.9%) OR SUBSTANCE USE PROVIDERS (16.2%). FURTHERMORE, ONLY ONE IN TEN COMMUNITY SURVEY RESPONDENTS AGREE THAT COMMUNITY MEMBERS KNOW HOW TO ACCESS MENTAL HEALTH SERVICES (10.4%) OR SUBSTANCE USE SERVICES (10.4%). MOST COMMUNITY SURVEY RESPONDENTS THINK MENTAL HEALTH (86.1%), DEPRESSION (85.5%), ALCOHOL ABUSE (88.4%) AND ILLEGAL DRUG ABUSE (97.0%) ARE PROBLEMS IN THE COMMUNITY. FOCUS GROUP PARTICIPANTS DISCUSSED THE NEED FOR MORE BEHAVIORAL HEALTH SERVICES IN THE COMMUNITY. THEY EMPHASIZED THE NEED FOR MORE SERVICES FOR CHILDREN AS WELL AS LONG TERM AND STEP-DOWN FACILITIES. PARTICIPANTS ALSO TALKED ABOUT THE NEED FOR DETOX AND REHABILITATION PROGRAMS IN THE COMMUNITY. GIVEN THE RURAL NATURE OF THE COMMUNITY A FEW GROUPS SUGGESTED THE NEED FOR MOBILE OR TELE TREATMENT OPTIONS. THE IMPACT OF TRAUMA AND DRUG USE ON CHILDREN WAS ALSO NOTED BY A FEW GROUPS. STAKEHOLDERS TALKED ABOUT THE NEED FOR ADDITIONAL BEHAVIORAL HEALTH SERVICES, INDICATING A HIGH NEED IN THE COMMUNITY. THEY DISCUSSED THE NEED FOR VARYING LEVELS OF TREATMENT AS WELL AS THE IMPORTANCE OF EDUCATING THE COMMUNITY ABOUT BEHAVIORAL HEALTH. A FEW TALKED ABOUT THE CHALLENGES WHEN INDIVIDUALS ARE EXPERIENCING BOTH A MENTAL HEALTH CONCERN AS WELL AS STRUGGLING WITH ADDICTION AS TREATMENT OPTIONS ARE VERY LIMITED. THERE ARE ALSO A LIMITED AMOUNT OF CRISIS OR 24/7 OPTIONS IN THE COMMUNITY TO GET PEOPLE THEY HELP THEY NEED WHEN THEY NEED IT. THE COST OF CARE AND LACK OF COORDINATION AMONG PROVIDERS WERE MENTIONED AS BARRIERS TO TREATMENT. COMMUNITY SURVEY RESPONDENTS IDENTIFIED THE FOLLOWING AS PROBLEMS IN THE COMMUNITY: * OBESITY (98.8%) * OVERWEIGHT (98.2%) * CANCER (91.6%) * DIABETES (88.5%) * HEART DISEASE (86.1%) * HIGH BLOOD PRESSURE (83.7%) * ASTHMA/COPD (83.4%) * STROKE (81.2%) VERY FEW FOCUS GROUP PARTICIPANTS TALKED ABOUT CHRONIC DISEASE. THE FEW THAT DID NOTED THAT THESE CHRONIC CONDITIONS IMPACT ONE'S OVERALL HEALTH AND THAT THERE IS A NEED FOR PREVENTION AS WELL AS DISEASE MANAGEMENT. THE SCHOOL GROUP NOTED AN INCREASE IN DIABETES AND ASTHMA IN CHILDREN IN RECENT YEARS. ONE STAKEHOLDER INDICATED THAT THERE ARE HIGH RATES OF CANCER IN THE AREA. ANOTHER TALKED ABOUT THE NEED FOR MORE PREVENTATIVE CARE NOTING PEOPLE DO NOT GO FOR ROUTINE SCREENINGS AND CHECK-UPS SO MANY CONDITIONS COULD BE CAUGHT AND MANAGED SOONER. A FEW DISCUSSED THAT GIVEN THE AGING POPULATION OF THE COMMUNITY THERE ARE LIKELY CHRONIC CONDITIONS ASSOCIATED WITH THAT POPULATION. THE PERCENTAGE OF ADULTS WITHOUT HEALTH INSURANCE IN JEFFERSON COUNTY HAS BEEN DECREASING SINCE 2011 (18.2%) AND IN 2016 WAS 5.7%, WHICH IS LOWER WHEN COMPARED TO OHIO (7.7%) AND THE NATION (12.0%). THE PERCENTAGE HAS ALSO BEEN DECREASING IN COLUMBIANA COUNTY SINCE 2013 (20.6%) AND IN 2016 (7.1%) WAS COMPARABLE TO THE STATE AND BELOW THE NATION. THE PERCENTAGE OF ADULTS WITHOUT HEALTH INSURANCE IN HARRISON COUNTY HAS BEEN DECREASING SINCE 2008-2012 (17.8%) AND IN 2012-2016 (13.7%) WAS JUST ABOVE THE STATE (11.9%) AND BELOW THE NATION (16.4%). THE PERCENTAGE OF DISABLED INDIVIDUALS IN JEFFERSON COUNTY WITHOUT HEALTH INSURANCE HAS DECREASED FROM 17.9% IN 2009 TO 2.1% IN 2016, WHICH IS LOWER WHEN COMPARED TO OHIO (6.8%) AND THE NATION (9.8%) AND FALLS SHORT OF THE HEALTHY PEOPLE 2020 GOAL TO HAVE 100% OF INDIVIDUALS HAVE HEALTH INSURANCE. THE PERCENTAGE OF UNINSURED ADULTS IN BROOKE AND HANCOCK COUNTIES HAS DECREASED SINCE 2013 (20.2%, 20.0% RESPECTIVELY) AND IN 2019 (6.2%, 7.4%) ARE BOTH BELOW WEST VIRGINIA (8.0%). THE PERCENTAGE OF UNINSURED CHILDREN HAS ALSO BEEN DECREASING SINCE 2013 IN BROOKE (4.6%) AND HANCOCK (4.5%) COUNTIES AND IN 2019 (2.2% FOR BOTH) BOTH COUNTIES ARE COMPARABLE TO WEST VIRGINIA (2.4%). FOCUS GROUP PARTICIPANTS WERE ASKED TO RATE THE OVERALL HEALTH STATUS OF THE COMMUNITY. COMMUNITY SURVEY RESPONDENTS AND FOCUS GROUP PARTICIPANTS EXPERIENCE BOTH IDENTIFIED LIMITED FINANCIAL RESOURCES, TRANSPORTATION, AND LITERACY/EDUCATION LEVEL AS BARRIERS TO CARE. IN ADDITION, COMMUNITY SURVEY RESPONDENTS INDICATED THE LACK OF A SUPPORT SYSTEM, QUALITY CHILD CARE AND DISCRIMINATION AS BARRIERS. FOCUS GROUP PARTICIPANTS ALSO MENTIONED FAMILY CHALLENGES, LACK OF AWARENESS OF AVAILABLE SERVICES AND LIMITED PROVIDERS AS BARRIERS. STAKEHOLDERS TALKED ABOUT THE FACT THAT MANY RESIDENTS DO NOT KNOW WHERE TO GO FOR CARE AND OFTEN END UP IN THE ER BECAUSE THEY DO NOT KNOW WHERE ELSE TO GO. THE LACK OF PROVIDERS AND FREE CLINICS WERE ALSO NOTED AS NEEDED SERVICES IN THE COMMUNITY. STAKEHOLDERS ALSO TALKED ABOUT THE LACK OF TRANSPORTATION AS A BARRIER TO ACCESSING THE NEEDED CARE. STRATEGY BY HEALTH NEED BELOW ARE STRATEGIES AND PROGRAM ACTIVITIES THE HOSPITAL INTENDS TO DELIVER TO HELP ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA REPORT. THEY ARE ORGANIZED BY HEALTH NEED AND INCLUDE STATEMENTS OF THE STRATEGIES' ANTICIPATED IMPACT AND ANY PLANNED COLLABORATION WITH OTHER ORGANIZATIONS IN OUR COMMUNITY. HEALTH NEED: MENTAL HEALTH AND SUBSTANCE USE DISORDER TRINITY HEALTH SYSTEM MENTAL HEALTH PROGRAM: PROVIDE DEPRESSION SCREENINGS AND REFERRALS IN THE ED AND DIRECT ADMISSIONS. PROVIDE SCREENINGS AND PLACEMENT FOR PATIENTS WITH CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER DIAGNOSES. RESEARCH THE FEASIBILITY WITH CMS OF INCREASING THE NUMBER OF LICENSED MENTAL HEALTH BEDS JEFFERSON BEHAVIORAL HEALTH OUTPATIENT MENTAL HEALTH PROGRAM. PROVIDE PSYCHIATRISTS TO BE LOCATED WITHIN PROVIDER OFFICES. PROVIDE THERAPISTS TO SCHOOLS FOR STUDENTS' SAFETALK TRAINING PROGRAM. SUICIDE ALERTNESS FOR EVERYONE (SAFETALK) IS A HALF-DAY TRAINING PROGRAM THAT TEACHES PARTICIPANTS TO RECOGNIZE AND ENGAGE PERSONS WHO MIGHT BE HAVING THOUGHTS OF SUICIDE AND TO CONNECT THEM WITH COMMUNITY RESOURCES TRAINED IN SUICIDE INTERVENTION. SAFETALK STRESSES SAFETY WHILE CHALLENGING TABOOS THAT INHIBIT OPEN TALK ABOUT SUICIDE. OFFER MAT AND VIVITROL PROGRAMS DEPRESSION SCREENINGS VARIOUS PROVIDERS AND AGENCIES SCREEN FOR DEPRESSION AND SUICIDE AND MAKE REFERRALS AS NEEDED. TRINITY HEALTH SYSTEM BEHAVIORAL MEDICINE ADDICTION RECOVERY PROGRAM: PROVIDE SCREENINGS AND PLACEMENT FOR PATIENTS WITH CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER DIAGNOSES. OFFER A DETOX RESIDENTIAL SUPPORT UNIT PROGRAM FOR TEEN MOMS. PROVIDE DETOX PROGRAMS, COUNSELING OR REFERRALS - ALL AGES - BOTH INPATIENT AND OUTPATIENT. JEFFERSON BEHAVIORAL HEALTH OUTPATIENT ADDICTION RECOVERY PROGRAM: PROVIDES A SYSTEM OF QUALITY SERVICES INCLUDING INTERVENTION, AND RECOVERY TO ALL CLIENTS AFFECTED BY ADDICTION. PROVIDE LOSS AND GRIEF SUPPORT GROUPS FOR THOSE LOSING A LOVED ONE TO A DRUG OVERDOSE. PROJECT DAWN: PROJECT DAWN (DEATHS AVOIDED WITH NALOXONE) IS A STATE PROGRAM FOCUSING ON NALOXONE ADMINISTERING TRAINING AND THE HANDING OUT OF NALOXONE KITS. MEDICATED ASSISTED TREATMENT (MAT) PROGRAM: MAT IS A TREATMENT RESOURCE FOR THOSE BATTLING CHEMICAL DEPENDENCY. UTILIZES SPECIFIC FDA-APPROVED MEDICATIONS TO HELP PATIENTS REDUCE CRAVINGS AND MITIGATE THEIR WITHDRAWAL SYMPTOMS. ANTICIPATED IMPACT: THE HOSPITAL'S AND PARTNERS' INITIATIVES TO ADDRESS DEPRESSION, SUICIDE, DRUG DEPENDENCY AND OVERDOSE DEATHS ARE ANTICIPATED TO RESULT IN IMPROVED HEALTH CARE OUTCOMES, IMPROVED PATIENT LINKAGES TO INPATIENT AND OUTPATIENT MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES, PROVIDE A SEAMLESS TRANSITION OF CARE, AND IMPROVE CARE COORDINATION TO ENSURE INDIVIDUALS ARE CONNECTED TO APPROPRIATE CARE AND CAN ACCESS SERVICES, AND CREATE A DRUG-FREE COMMUNITY. PLANNED COLLABORATION: THE HOSPITAL WILL PARTNER WITH LOCAL CHURCHES, PROVIDERS, FIRST RESPONDERS AND LAW ENFORCEMENT, A CARING PLACE CHILD ADVOCACY CENTER, COLEMAN PROFESSIONAL SERVICES, COMMUNITY ACTION COUNSEL, FAMILY RECOVERY CENTER, JEFFERSON BEHAVIORAL HEALTH SYSTEM, JEFFERSON COUNTY GENERAL HEALTH DISTRICT, JEFFERSON COUNTY PREVENTION AND RECOVERY, JEFFERSON COUNTY SCHOOL DISTRICT, OHIO VALLEY HEALTH CENTER PASTORAL CARE, URBAN MISSION, VILLAGE NETWORK, WOMEN'S HEALTH CENTER AND YMCA. FACILITY NAME: A DESCRIPTION: HEALTH NEED: CHRONIC DISEASE CHRONIC DISEASE COMMUNITY OUTREACH: OUTREACH TO COMMUNITY THROUGH HOSPITAL PARTICIPATION IN HEALTH FAIRS, SCREENINGS, EDUCATION, PROGRAMS. RESEARCH THE FEASIBILITY OF HAVING THE CAFETERIA FLAG MENU OPTIONS THAT ARE HEART HEALTHY OR
SCHEDULE H, PART V, SECTION B, LINE 13H FACILITY NAME: A DESCRIPTION: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A CHI HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.
SCHEDULE H, PART V, SECTION B, LINE 16A HTTP://WWW.TRINITYHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16B HTTP://WWW.TRINITYHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16C HTTP://WWW.TRINITYHEALTH.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
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Schedule H (Form 990) 2019
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2019
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Schedule H (Form 990) 2019
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART I, LINE 3C UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: -THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. -THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG. -THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. -THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: -RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; -HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC; -PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); -FOOD STAMP ELIGIBILITY; -SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; -ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); -LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR -PATIENT IS DECEASED WITH NO KNOWN ESTATE. SCHEDULE H, PART I, LINE 7G THE ONLY SERVICE INCLUDED IN SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G IS BEHAVIORAL MEDICINE. SCHEDULE H, PART I, LINE 7 TABLE A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS ON LINES 7A AND 7B; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. WORKSHEET 2 WAS UTILIZED TO COMPUTE THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/20 USING THE FOLLOWING FORMULA: OPERATING EXPENSE (LESS NON-PATIENT CARE ACTIVITIES, MEDICARE PROVIDER TAXES, COMMUNITY BENEFIT EXPENSE AND COMMUNITY BUILDING EXPENSE) DIVIDED BY GROSS PATIENT REVENUE (LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS). BASED ON THAT FORMULA, $220,917,915 / $724,158,160 RESULTS IN A 30.51% COST-TO-CHARGE RATIO. THE HOSPITAL'S COST ACCOUNTING RECORDS WERE USED TO COMPLETE THE OTHER BENEFITS SECTION (LINE 7E - 7I). SCHEDULE H, PART III, LINE 2 COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 30.51%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 TRINITY HEALTH SYSTEM GROUP BELIEVES THAT A SMALL PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. SCHEDULE H, PART III, LINE 4 TRINITY HEALTH SYSTEM GROUP DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS IS PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGE IN NET ASSETS. BAD DEBT EXPENSE FOR 2020 WAS NOT SIGNIFICANT. SCHEDULE H, PART III, LINE 8 USING ESSENTIALLY THE SAME MEDICARE COST REPORT PRINCIPLES AS TO THE ALLOCATION OF GENERAL SERVICES COSTS AND "APPORTIONMENT" METHODS, THE "CHI WORKBOOK" CALCULATES A PAYERS' GROSS ALLOWABLE COSTS BY SERVICE (SO AS TO FACILITATE A CORRESPONDING COMPARISON BETWEEN GROSS ALLOWABLE COSTS AND ULTIMATE PAYMENTS RECEIVED). THE TERM "GROSS ALLOWABLE COSTS" MEANS COSTS BEFORE ANY DEDUCTIBLES OR CO-INSURANCE ARE SUBTRACTED. TRINITY HEALTH SYSTEM GROUP'S ULTIMATE REIMBURSEMENT WILL BE REDUCED BY ANY APPLICABLE COPAYMENT/ DEDUCTIBLE. WHERE MEDICARE IS THE SECONDARY INSURER, AMOUNTS DUE FROM THE INSURED'S PRIMARY PAYER WERE NOT SUBTRACTED FROM MEDICARE ALLOWABLE COSTS BECAUSE THE AMOUNTS ARE TYPICALLY IMMATERIAL. ALTHOUGH NOT PRESENTED ON THE MEDICARE COST REPORT, IN ORDER TO FACILITATE A MORE ACCURATE UNDERSTANDING OF THE "TRUE" COST OF SERVICES (FOR "SHORTFALL" PURPOSES) THE CHI WORKBOOK ALLOWS A HEALTH CARE FACILITY NOT TO OFFSET COSTS THAT MEDICARE CONSIDERS TO BE NON-ALLOWABLE, BUT FOR WHICH THE FACILITY CAN LEGITIMATELY ARGUE ARE RELATED TO THE CARE OF THE FACILITY'S PATIENTS. IN ADDITION, ALTHOUGH NOT REPORTABLE ON THE MEDICARE COST REPORT, THE CHI WORKBOOK INCLUDES THE COST OF SERVICES THAT ARE PAID VIA A SET FEE SCHEDULE RATHER THAN BEING REIMBURSED BASED ON COSTS (E.G. OUTPATIENT CLINICAL LABORATORY). FINALLY, THE CHI WORKBOOK ALLOWS A FACILITY TO INCLUDE OTHER HEALTH CARE SERVICES PERFORMED BY A SEPARATE FACILITY (SUCH AS A PHYSICIAN PRACTICE) THAT ARE MAINTAINED ON SEPARATE BOOKS AND RECORDS (AS OPPOSED TO THE MAIN FACILITY'S BOOKS AND RECORDS WHICH HAS ITS COSTS OF SERVICE INCLUDED WITHIN A COST REPORT). TRUE COSTS OF MEDICARE COMPUTED USING THIS METHODOLOGY: TOTAL MEDICARE REVENUE: $57,049,287 TOTAL MEDICARE COSTS: $57,005,190 SURPLUS OR SHORTFALL: $44,097 TRINITY HEALTH SYSTEM GROUP BELIEVES THAT EXCLUDING MEDICARE LOSSES FROM COMMUNITY BENEFIT MAKES THE OVERALL COMMUNITY BENEFIT REPORT MORE CREDIBLE FOR THESE REASONS: UNLIKE SUBSIDIZED AREAS SUCH AS BURN UNITS OR BEHAVIORAL-HEALTH SERVICES, MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS. IN FACT, FOR-PROFIT HOSPITALS FOCUS ON ATTRACTING PATIENTS WITH MEDICARE COVERAGE, ESPECIALLY IN THE CASE OF WELL-PAID SERVICES THAT INCLUDE CARDIAC AND ORTHOPEDICS. SIGNIFICANT EFFORT AND RESOURCES ARE DEVOTED TO ENSURING THAT HOSPITALS ARE REIMBURSED APPROPRIATELY BY THE MEDICARE PROGRAM. THE MEDICARE PAYMENT ADVISORY COMMISSION (MEDPAC), AN INDEPENDENT CONGRESSIONAL AGENCY, CAREFULLY STUDIES MEDICARE PAYMENT AND THE ACCESS TO CARE THAT MEDICARE BENEFICIARIES RECEIVE. THE COMMISSION RECOMMENDS PAYMENT ADJUSTMENTS TO CONGRESS ACCORDINGLY. THOUGH MEDICARE LOSSES ARE NOT INCLUDED BY CATHOLIC HOSPITALS AS COMMUNITY BENEFIT, THE CATHOLIC HEALTH ASSOCIATION GUIDELINES ALLOW HOSPITALS TO COUNT AS COMMUNITY BENEFIT SOME PROGRAMS THAT SPECIFICALLY SERVE THE MEDICARE POPULATION. FOR INSTANCE, IF HOSPITALS OPERATE PROGRAMS FOR PATIENTS WITH MEDICARE BENEFITS THAT RESPOND TO IDENTIFIED COMMUNITY NEEDS, GENERATE LOSSES FOR THE HOSPITAL, AND MEET OTHER CRITERIA, THESE PROGRAMS CAN BE INCLUDED IN THE CHA FRAMEWORK IN CATEGORY C AS "SUBSIDIZED HEALTH SERVICES." MEDICARE LOSSES ARE DIFFERENT FROM MEDICAID LOSSES, WHICH ARE COUNTED IN THE CHA COMMUNITY BENEFIT FRAMEWORK, BECAUSE MEDICAID REIMBURSEMENTS GENERALLY DO NOT RECEIVE THE LEVEL OF ATTENTION PAID TO MEDICARE REIMBURSEMENT. MEDICAID PAYMENT IS LARGELY DRIVEN BY WHAT STATES CAN AFFORD TO PAY, AND IS TYPICALLY SUBSTANTIALLY LESS THAN WHAT MEDICARE PAYS. SCHEDULE H, PART III, SECTION C, LINE 9B THE HEALTH SYSTEM IS COMMITTED TO SERVE EVERYONE, ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF THE HEALTH SYSTEM. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. IN ASSESSING A PATIENT'S ABILITY TO PAY, THE HEALTH SYSTEM UTILIZES THE GENERALLY RECOGNIZED POVERTY INCOME LEVELS ESTABLISHED BY THE FEDERAL GOVERNMENT, BUT ALSO INCLUDES CERTAIN CASES WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO PATIENT INCOME AND RESOURCES. THE HEALTH SYSTEM'S POLICY PROVIDES CHARITY CARE TO PATIENTS UP TO 200% OF THE FEDERAL POVERTY LEVEL. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECOGNIZED THESE AMOUNTS AS CHARITY CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. THROUGH JUNE 2020, CHARITY CARE APPROXIMATED $5,118,962. TO EDUCATE AND INFORM OUR PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER OUR CHARITY CARE POLICY, SELF-PAY INPATIENTS ARE INTERVIEWED BY THE ORGANIZATION'S
SCHEDULE H, PART VI, LINE 2 TRINITY HEALTH SYSTEM PROVIDES CARE TO A SERVICE AREA OF JUST OVER 200,000 INDIVIDUALS. TRINITY IS ACCREDITED BY THE JOINT COMMISSION ON THE ACCREDITATION OF HOSPITALS, A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, VOLUNTARY HOSPITALS OF AMERICA AND THE CATHOLIC HOSPITAL ASSOCIATION. THE SYSTEM OFFERS A FULL ARRAY OF ACUTE AND OUTPATIENT SERVICES ON TWO CAMPUSES. TRINITY ALSO MAINTAINS PHYSICIAN OFFICES, WALK-IN LAB DRAW FACILITIES, THE TONY TERAMANA CANCER CENTER, WORKCARE AND THE DIGESTIVE AND NUTRITION CENTER THROUGHOUT THE TRI-STATE AREA. ADDITIONALLY, AT TRINITY WE UNDERSTAND PATIENT EDUCATION IS A VITAL ROLE IN MAINTAINING A HEALTHY COMMUNITY. OUR STAFF PARTICIPATES IN NUMEROUS HEALTH FAIRS AND BLOOD SCREENING PROGRAMS THROUGHOUT THE YEAR. TRINITY HEALTH SYSTEM IS PART OF COMMONSPIRIT HEALTH, A NONPROFIT, CATHOLIC HEALTH SYSTEM DEDICATED TO ADVANCING HEALTH FOR ALL PEOPLE. IT WAS CREATED IN FEBRUARY 2019 THROUGH THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH. COMMONSPIRIT HEALTH IS COMMITTED TO CREATING HEALTHIER COMMUNITIES, DELIVERING EXCEPTIONAL PATIENT CARE, AND ENSURING EVERY PERSON HAS ACCESS TO QUALITY HEALTH CARE. OUR MISSION THE MISSION OF CATHOLIC HEALTH INITIATIVES IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE CREATE HEALTHIER COMMUNITIES. OUR CORE VALUES AND QUALITY PRINCIPLES REVERENCE: PROFOUND RESPECT AND AWE FOR ALL OF CREATION, THE FOUNDATION THAT SHAPES SPIRITUALITY, OUR RELATIONSHIPS WITH OTHERS AND OUR JOURNEY TO GOD. INTEGRITY: MORAL WHOLENESS, SOUNDNESS, FIDELITY, TRUST, TRUTHFULNESS IN ALL WE DO. COMPASSION: SOLIDARITY WITH ONE ANOTHER, CAPACITY TO ENTER INTO ANOTHER'S JOY AND SORROW. EXCELLENCE: PREEMINENT PERFORMANCE, BECOMING THE BENCHMARK, PUTTING FORTH OUR PERSONAL AND PROFESSIONAL BEST. TRINITY HEALTH HAS DEVELOPED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE FOLLOWING FACILITIES: O TRINITY MEDICAL CENTER EAST O TRINITY MEDICAL CENTER WEST TRINITY HEALTH SYSTEM, A MEMBER OF CATHOLIC HEALTH INITIATIVES AND COMMONSPIRIT HEALTH IS PROUD TO PRESENT ITS 2020 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT. THIS REPORT SUMMARIZES A COMPREHENSIVE REVIEW AND ANALYSIS OF HEALTH STATUS INDICATORS, PUBLIC HEALTH, SOCIOECONOMIC, DEMOGRAPHIC AND OTHER QUALITATIVE AND QUANTITATIVE DATA FROM THE PRIMARY SERVICE AREA OF TRINITY HEALTH SYSTEM. THIS REPORT ALSO INCLUDES SECONDARY/DISEASE INCIDENCE AND PREVALENCE DATA FROM JEFFERSON COUNTY, THE PRIMARY SERVICE AREA OF THE HOSPITAL. IN ADDITIONAL SECONDARY DATA IS PROVIDED, WHERE AVAILABLE, FOR COLUMBIANA AND HARRISON COUNTIES IN OHIO AND BROOKE AND HANCOCK COUNTIES IN WEST VIRGINIA, THE SECONDARY SERVICE AREA OF THE HOSPITAL. THE DATA WAS REVIEWED AND ANALYZED TO DETERMINE THE TOP PRIORITY NEEDS AND ISSUES FACING THE REGION OVERALL. THE PRIMARY PURPOSE OF THIS ASSESSMENT WAS TO IDENTIFY THE HEALTH NEEDS AND ISSUES OF THE JEFFERSON COUNTY COMMUNITY DEFINED AS THE PRIMARY SERVICE AREA OF TRINITY HEALTH SYSTEM. ADDITIONALLY, TRINITY IS INTERESTED IN IDENTIFYING THE NEEDS AND ISSUES OF THE SECONDARY SERVICE AREA WHICH INCLUDES COLUMBIANA AND HARRISON COUNTIES IN OHIO AND BROOKE AND HANCOCK COUNTIES IN WEST VIRGINIA. THE CHNA ALSO PROVIDES USEFUL INFORMATION FOR PUBLIC HEALTH AND HEALTH CARE PROVIDERS, POLICY MAKERS, SOCIAL SERVICE AGENCIES, COMMUNITY GROUPS AND ORGANIZATIONS, RELIGIOUS INSTITUTIONS, BUSINESSES, AND CONSUMERS WHO ARE INTERESTED IN IMPROVING THE HEALTH STATUS OF THE COMMUNITY AND REGION. THE RESULTS ENABLE THE HOSPITAL, AS WELL AS OTHER COMMUNITY PROVIDERS, TO MORE STRATEGICALLY IDENTIFY COMMUNITY HEALTH PRIORITIES, DEVELOP INTERVENTIONS, AND COMMIT RESOURCES TO IMPROVE THE HEALTH STATUS OF THE REGION. IMPROVING THE HEALTH OF THE COMMUNITY IS THE FOUNDATION OF THE MISSION OF TRINITY HEALTH SYSTEM, AND AN IMPORTANT FOCUS FOR EVERYONE IN THE SERVICE REGION, INDIVIDUALLY AND COLLECTIVELY. IN ADDITION TO THE EDUCATION, PATIENT CARE, AND PROGRAM INTERVENTIONS PROVIDED THROUGH THE HOSPITAL, WE HOPE THAT THE INFORMATION IN THIS CHNA WILL ENCOURAGE ADDITIONAL ACTIVITIES AND COLLABORATIVE EFFORTS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY THAT TRINITY HEALTH SYSTEM SERVES. TRINITY HEALTH COLLABORATED WITH OTHER LOCAL ORGANIZATIONS AND PROVIDERS TO TAKE INTO ACCOUNT THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. REPRESENTATIVES INCLUDED A DIVERSE MIX OF INDIVIDUALS FROM THE CITY OF STEUBENVILLE HEALTH DEPARTMENT, JEFFERSON COUNTY HEALTH DEPARTMENT AND REPRESENTATIVE MEMBERS OF OTHER COMMUNITY AGENCIES INCLUDING THE AREA UNITED WAY, PUBLIC SENIOR HOUSING, THE YMCA AND PRIME TIME SERVICES. "THE 2019 TRINITY CHNA WAS CONDUCTED TO IDENTIFY PRIMARY HEALTH ISSUES, CURRENT HEALTH STATUS, AND HEALTH NEEDS TO PROVIDE CRITICAL INFORMATION TO THOSE IN A POSITION TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE REGION'S RESIDENTS. THE RESULTS ENABLE COMMUNITY MEMBERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF PEOPLE LIVING IN THE COMMUNITY."
SCHEDULE H, PART VI, LINE 3 NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: - CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; - NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND - PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE, WWW.CATHOLICHEALTH.NET, AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES. HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART VI, LINE 4 THE POPULATION IN JEFFERSON COUNTY IS PROJECTED TO DECREASE FROM 65,632 IN 2019 TO 64,251 IN 2024. THERE WERE SLIGHTLY MORE FEMALES (51.5%) THAN MALES (48.5%). THE POPULATION WAS PREDOMINANTLY CAUCASIAN (91.1%). THE MEDIAN AGE WAS 44.6 AND WAS PROJECTED TO REMAIN STEADY. JUST UNDER ONE-THIRD (30.7%) OF RESIDENTS HAD NEVER BEEN MARRIED, WHILE 42.5% WERE MARRIED, 3.7% WERE SEPARATED, 14.9% WERE DIVORCED AND 8.3% WERE WIDOWED. JUST OVER ONE IN TEN RESIDENTS (11.0%) DID NOT COMPLETE HIGH SCHOOL, WHILE 43.1% WERE A HIGH SCHOOL GRADUATE, 10.6% HAD A BACHELOR'S DEGREE AND 5.4% HAD AN ADVANCED DEGREE. THE AVERAGE HOUSEHOLD INCOME WAS $59,124, WITH 11.8% OF FAMILIES LIVING IN POVERTY. MOST (93.5%) OF THE LABOR FORCE WAS EMPLOYED. DEMOGRAPHICS JEFFERSON COUNTY GENDER: 48.5% MALE, 51.5% FEMALE ETHNICITY: WHITE/NON-HISPANIC - 91.1%, BLACK/AFRICAN AMERICAN - 5.4%, HISPANIC/LATINO ORIGIN - 1.6%, ASAIN - 0.4% AGE: MEDIAN AGE IS 44.6 MARITAL STATUS: MARRIED - 42.5%, NEVER MARRIED - 30.7%, DIVORCED - 14.9%, WIDOWED - 8.3%, SEPARATED - 3.7% HOUSEHOLD INCOME: AVERAGE - $59,124. MEDIAN - $45,609. FAMILIES LIVING IN POVERTY - 11.8% EDUCATION: DID NOT COMPLETE HIGH SCHOOL - 11%. HIGH SCHOOL GRAD/GED - 43.1%. BACHELOR'S DEGREE - 10.6%. ADVANCED DEGREE - 5.4%. EMPLOYMENT: EMPLOYED - 93.5%. AGE 16 OR OVER EMPLOYED - 49.4%. AGE 16 OR OVER UNEMPLOYED - 3.4%. HOLD WHITE COLLAR OCCUPATIONS - 52.8% OVERALL, THE SERVICE AREA OF THE SYSTEM HAS A LOWER AVERAGE HOUSEHOLD INCOME THAN THE STATE OF OHIO AND A HIGHER UNEMPLOYMENT RATE. JEFFERSON COUNTY IS ECONOMICALLY DEPRESSED WITH A PER-CAPITA INCOME LOWER THAN STATE AVERAGES. ALL 3 COUNTIES IN THE SYSTEM'S IMMEDIATE SERVICE AREA HAVE A HIGH PROPORTION OF THE POPULATION AT OR BELOW THE POVERTY LEVEL. THE ECONOMIC CONDITIONS OF THE AREA HAVE HINDERED THE GROWTH OF THE HOSPITAL AND MORE SELF-PAY PATIENTS HAVE TAKEN ADVANTAGE OF THE HOSPITAL'S SERVICES. CHARITY CARE AND BAD DEBT ACCOUNTS HAVE INCREASED EACH YEAR FOR THE LAST FEW YEARS. AS RECENTLY UNEMPLOYED RESIDENTS LOSE THEIR HEALTH BENEFITS, WE EXPECT HIGHER CHARITY CARE LEVELS. THE PAYER MIX AT THS IS HEAVILY WEIGHTED TO THE GOVERNMENTAL PAYERS, WITH AROUND 40% OF THE REVENUE GENERATED FROM MEDICARE AND 11% GENERATED FROM THE MEDICAID PROGRAM. WITH THE 2 PROGRAMS RECORDING SIGNIFICANT SHORTFALLS BETWEEN PAYMENT TO HOSPITALS AND HOSPITAL COSTS, THE ECONOMIC CHALLENGES FOR THS ARE GREAT.
SCHEDULE H, PART VI, LINE 5 THE ORGANIZATION'S HOSPITAL FACILITY(IES) PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. THE ORGANIZATION'S HOSPITAL FACILITY(IES) HAVE AN OPEN MEDICAL STAFF. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE FACILITY(IES) TREAT PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT.
SCHEDULE H, PART VI, LINE 6 THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH AS A SINGLE MINISTRY IN EARLY 2020. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN - BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND COMPRISES 142 HOSPITALS, INCLUDING THREE ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS AS WELL AS 31 CRITICAL-ACCESS FACILITIES; COMMUNITY HEALTH SERVICES ORGANIZATIONS; ACCREDITED NURSING COLLEGES; HOME HEALTH AGENCIES; LIVING COMMUNITIES; A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS; AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2020, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.01 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.59 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $29.58 BILLION IN FISCAL YEAR 2020, HAS TOTAL ASSETS OF APPROXIMATELY $46.77 BILLION. COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED "SHARE SERVICES" FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY.
SCHEDULE H, PART VI, LINE 7 OH
Schedule H (Form 990) 2019
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