Health + Wellbeing LOOKING AHEAD Community Health Needs Assessment Implementation Strategy for 2017 Nutrition & Physical Activity Goal:

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COMMU N I TY B E N E F I T ANNU A L R E P O RT 2016

Improving Health + Wellbeing Augusta Health completed its most recent Community Health Needs Assessment in 2016 for the areas of Staunton, Augusta County and Waynesboro (SAW). Performed every three years, the Community Health Needs Assessment (CHNA) is a systematic, data driven approach to determining health status, behaviors and the areas of greatest health need in the local community. It provides information so the health issues of greatest concern can be identified, and resources allocated. Areas of opportunity were determined following the review of national benchmark data, number of residents affected and the potential impact on community health and wellness. 1 Nutrition, Physical Activity and Weight 2 Diabetes 3 Mental Health 4 Heart Disease and Stroke 5 Access to Healthcare Services 6 Cancer 7 Substance Abuse 8 Dementia, including Alzheimer s Disease 9 Respiratory Diseases 10 Tobacco 11 Chronic Kidney Disease 12 Injury and Violence 13 Oral Health

IDENTIFY From these 13 areas of opportunity, three significant health issues were identified by Augusta Health as priorities to address based on two important criteria: 1 Scope and Severity, and 2 Ability for the Hospital to Impact The following three priority issues were identified from the CHNA data. 1 Nutrition & Physical Activity 6.5% of the SAW population have low food access, meaning they do not live near a large grocery store. Nutrition. The Office of Disease Prevention and Health Promotion supports the health benefits of eating a healthful diet and maintaining a healthy body weight. 19.1% of SAW adults find it very or somewhat difficult to access affordable, fresh fruits and vegetables. Physical Activity. Regular physical activity can improve the health and quality of life of Americans, as well as lower the risk of chronic diseases. Adults should do two hours and 30 minutes a week or moderate-intensity (such as walking) or one hour and 15 minutes a week of vigorous intensity aerobic physical activity (such as jogging). The guidelines also recommend that all adults do muscle-strengthening activities (such as push-ups) on two or more days per week. Children and adolescents should do 60 minutes or more of physical activity each day. In 2013, there were 9.3 recreation/ fitness facilities for every 100,000 population in SAW. This is below the state average. 51.8% of SAW adults are found to be insufficiently active or inactive based on reported physical activity intensity, frequency and duration over the past month, 39.2% of SAW adults report eating five or more servings of fruits and/or vegetables per day. Among SAW children age 2 to 17, 66.8% are reported to have had 60 minutes of physical activity on each of the seven days preceding the interview. 15.6% of SAW adults regularly participate in adequate levels of both aerobic and strengthening activities (meeting physical activity recommendations). This is less favorable then state and national findings. 2 Diabetes 3 Mental Health 13.9% of SAW adults report having been diagnosed with diabetes. This is higher than the state average. Diabetes. Diabetes occurs when the body cannot produce or respond appropriately to insulin. Diabetes lowers life expectancy, increases the risk of heart disease and is the leading cause of kidney failure. The rate of diabetes continues to increase in the United States and around the world, however, lifestyle changes have been proven effective in preventing or delaying onset in high-risk individuals. Mental Health. Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with others and the ability to cope with challenges. Mental disorders are that health conditions characterized by alterations in thinking, mood and/or behavior that are associated with distress and/or impaired functioning. Mental health plays a major role in people s ability to maintain good physical health. 21.8% of SAW adults have experienced symptoms of chronic depression. Between 2012-2014, there was an annual average ageadjusted suicide rate of 18.9 deaths per 100,000 population in SAW. This is much higher than the state and national rates. Another 5.7% of adults report that they have been diagnosed with pre-diabetes. 14.9% of SAW adults are currently taking medication or receiving treatment from a doctor or other health professional for some type of mental health condition.

ADDRESS Community Health Education Programs Educational and community-based programs play a key role in preventing disease, improving health and enhancing quality of life. I credit the Lunch and Learn program with providing lifesaving information and education. I would not have known I was having a heart attack, and my wife and I would not have responded appropriately to the signs and symptoms. Community member Al Swicegood on the monthly Lunch and Learn health education series 47 % 34 24 Tobacco cessation class participants quit smoking through the Gain Independence From Tobacco program Participants taught lifesaving skills of CPR and AED in Family and Friends CPR Middle schools students exposed to healthcare professions in the Augusta Career Explorers Camps Community Benefit by the Numbers Community health improvement and community benefit activities were provided by Augusta Health to members of our community. These include screenings, health presentations and free tests. 94 Blood pressures measured through the Big Squeeze program 26,500,026 Steps taken in Walk with a Doc walking initiative 954 Screenings and Health Fair Attendees 104 Referred from screening or health fair for follow-up care $1,000 Dick Graham Scholarship awarded to the child of an employee for tuition at an educational institution above high school level, in honor of Augusta Health s first CEO 491 Speakers Bureau Attendees 619 Lunch and Learn Attendees Faith Community Nurse Network A new initiative for 2016, the Augusta Health Faith Community Nurse (FCN) Network, provides hands-on screenings and education to members of faith communities. 5 Faith Communities in the FCN Network 7 Registered Nurses completed the FCN Course 3,742 Parishioners were served by the FCN Network

IMPACT Community Benefit The Community Partnership Committee of the Augusta Health Board of Directors provides oversight of all Community Benefit activities of the health system. The Internal Revenue Service requires all US nonprofit hospitals and health systems to engage in and provide community benefit activities. These activities include projects and programs implemented by Augusta Health to improve the health needs of the community, as identified in the organization s 2016 Community Health Needs Assessment. In 2016, Augusta Health provided $23,337,100 in support to the region. This support includes financial assistance to those who cannot afford care, subsidized patient services that operate at a loss, community health improvement programs, funding to nonprofit organizations with programs aimed at improving the health of the community and health professions education. Community Benefit Services (at cost) $ 8,726,600 Charity Care $ 6,186,700 Bad Debt $ 4,502,400 Medicaid Shortfall $ 2,063,900 Subsidized Community Services $ 1,343,500 Community Health Improvement Programs $ 407,100 Cash, Grants and In-kind Contributions $ 106,900 Health Professions Education 2016 Funding Recipients Funding by CHNA Areas of Opportunity* 49% Access to Care 36% Mental Health 13% Oral Health 1% Dementia, including Alzheimer s Disease 1% Nutrition and Physical Activity *Community Health Needs Assessment Report Uncompensated Services (at market value) $ 31,134,000 Charity Care $ 22,071,600 Bad Debt Alzheimer s Association Augusta Regional Dental Clinic Augusta-Staunton Health Department Blue Ridge Court Services Central Shenandoah EMS Council City of Staunton Crossroads to Brain Injury Recovery Greater Augusta Wellness Partnership Mary Baldwin College Valley Area Community Support Valley Hope Counseling Center Valley Mission Virginia Regional Transportation Association Waynesboro YMCA SOURCE: 2016 SCHEDULE H, IRS FORM 990 For more information or to access a copy of this Annual Report, visit our website at www.augustahealth.com

78 MEDICAL CENTER DR FISHERSVILLE, VA 22939 PRESORT FIRST CLASS POSTAGE & FEES PAID AUGUSTA HEALTH Firstname Lastname Street Address City, ST Zipcode LOOKING AHEAD Community Health Needs Assessment Implementation Strategy for 2017 A written plan with goals, objectives and outcome measures to describe how each priority need is being addressed. 1 2 3 Nutrition & Physical Activity Goal: To improve the wellbeing of Staunton, Augusta County and Waynesboro residents through increased knowledge about and access to healthy foods and participation in physical activity programs. Diabetes Goal: To decrease prevalence of prediabetes and improve diabetes management by expanding education offerings and access to services. Mental Health Goal: To increase the number of residents who are connected to the appropriate mental health service at the correct level of care by expanding screenings, improving access and working with community partners to determine additional mental health services needed in Staunton, Augusta County and Waynesboro. Augusta Health Community Partnership Committee is a committee appointed by the Augusta Health Board of Directors. The committee improves the health of the community by providing input and oversight on Augusta Health s Community Benefit initiatives, collaborative partnerships and strategic funding, and ensures alignment with the priority areas identified in the Community Health Needs Assessment. Back Row: (left to right) John Peterson, Chairman, Augusta Health Board of Directors; Tami Radecke, Vice President of Community Partnerships, Augusta Health; David Metz; Rich Evans, MD; Thomas Jennings; Margaret Hersh; William L. Vaughn; Mark LaRosa, Vice President of Business Development/Chief Strategy Officer, Augusta Health; Stephen Howlett, MD; Robin G. Crowder, EdD; Burnie Powers, Chairman, Community Partnership Committee; Krystal Moyers, Community Outreach Manager, Augusta Health Front Row: (left to right) Laura Kornegay, MD; Arona E. Richard; Mary Mannix, FACHE, President/CEO, Augusta Health; Mimi Elrod, PhD Not Pictured: Ronald W. Denney; Kurt Gottschalk; David Pastors