Mercy Medical Center Redding. Community Benefit 2015 Report and 2016 Plan

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Community Benefit 2015 Report and 2016 Plan

A message from Mark Korth, President and CEO of, and Douglas Hatter, M.D., Chair of the Dignity Health North State Service Area Community Board. The Hello humankindness campaign launched by Dignity Health is a movement ignited by and based on the proven idea that human connection, be it physical, verbal, or otherwise, leads to better health. Dignity Health s comprehensive approach to community health improvement includes multi pronged initiatives directed at significant health needs, partnering with others in the community working to improve health, and investing in efforts that address social determinants of health. shares a commitment to improve the health of our community, and delivers programs and services to achieve that goal. The Community Benefit 2015 Report and 2016 Plan describes much of this work. This report meets requirements of not for profit hospitals in the Patient Protection and Affordable Care Act to adopt a community health Implementation Strategy at least every three years, and in California state law (Senate Bill 697) to produce an annual community benefit report and plan. Dignity Health complies with both mandates in all of its hospitals, including those in Arizona and Nevada. We are proud of the outstanding programs, services and other community benefits our hospital delivers, and are pleased to report to our community. In fiscal year 2015 (FY15), provided $18,187,858 in patient financial assistance, unreimbursed costs of Medicaid, community health improvement services, and other community benefits. Including the unreimbursed costs of caring for patients covered by Medicare, the hospital s total community benefit expense was $45,132,914. Dignity Health s North State Service Area Community Board reviewed, approved and adopted the Community Benefit 2015 Report and 2016 Plan at its October 8, 2015 meeting. Thank you for taking the time to review our report and plan. If you have any questions, please contact us at 530.225.6000 1

TABLE OF CONTENTS Executive Summary 3 Mission, Vision, and Values 4 Our Hospital and Our Commitment 5 Description of the Community Served 6 Community Benefit Planning Process Community Health Needs Assessment Process 8 CHNA Significant Health Needs 9 Community Benefit Plan Development Process 9 Planning for the Uninsured/Underinsured Patient Population 10 2015 Report and 2016 Plan Summary, Anticipated Impact, and Planned Collaboration 11 Program Digests 13 Economic Value of Community Benefit 18 Appendices Appendix A: Community Board and Committee Rosters 19 Appendix B: Other Programs and Non Quantifiable Benefits 21 2

EXECUTIVE SUMMARY is a member hospital of Dignity Health. The Hospital is located at the tip of the Sacramento River Valley in Redding, California and serves as a regional referral center for far Northern California. The Hospital offers major medical services including a Level II Trauma Center with a dedicated Orthopedic Traumatologist, Level III Neonatal Intensive Care Unit, Cardiovascular Services, and Oncology Services. is also the sole provider of obstetrical services in its primary service area. is licensed for 267 beds and has approximately 1,679 employees. In addition to the key services listed above, also offers a wide array of specialty and surgical services including but not limited to: Pediatric Care Surgical Inpatient and Outpatient Care Center for Joint and Spine Health Joint Venture with 21 st Century Oncology Mercy Regional Cancer Center in Redding o Ida C. Emerson Oncology Unit o Outpatient Chemotherapy Services o Floyd Morgan Family Cancer Resource Center & Medical Library Mercy Heart Center Mercy Stroke Center Mercy Home Health & Hospice Services Mercy Family Medicine Residency Program Mercy Family Health Center A clinic associated with the Mercy Family Practice Residency Program. The clinic serves Medi Cal and Medicare patients as well as un /under insured individuals, under the direction of the Mercy Family Practice Residency faculty. Mercy Maternity Clinic This Clinic helps mothers and babies achieve a healthy start, by offering comprehensive prenatal care for low income mothers and high risk pregnancies. Wound Healing and Hyperbaric Medicine Center This freestanding service cares for individuals with hard to heal wounds. An 11 room hospitality house for families of patients who reside outside of the greater Redding area and must travel to for trauma, cardiac or cancer care. These families are often unable to sustain this unforeseen financial burden and these rooms are provided at a low nightly rate or at no cost for those who cannot afford to pay. A dedicated campus for senior services. Named Mercy Oaks, this campus currently features a senior housing complex operated by Mercy Housing, a comprehensive senior nutrition and transportation program and a myriad of social services dedicated to seniors and people who have disabilities. During the fiscal year ending June 30, 2015, provided over $18 million (excluding shortfall from Medicare) in serving the poor and broader community. This amount includes the hospital s reinvestment through community grants and other gifts/sponsorships to help improve community health. maintains its strong, mission based commitment to caring for Medi Cal enrollees and all members of the community. The hospital served 54,678 Medi Cal patients in FY15, compared to 46,199 in FY14, an 18% percent increase. This report and plan is publicly available at www.dignityhealth.org. 3

MISSION, VISION AND VALUES Our Mission We are committed to furthering the healing ministry of Jesus. We dedicate our resources to: Delivering compassionate, high quality, affordable health services; Serving and advocating for our sisters and brothers who are poor and disenfranchised; and Partnering with others in the community to improve the quality of life. Our Vision A vibrant, national health care system known for service, chosen for clinical excellence, standing in partnership with patients, employees, and physicians to improve the health of all communities served. Our Values Dignity Health is committed to providing high quality, affordable healthcare to the communities we serve. Above all else we value: Dignity Respecting the inherent value and worth of each person. Collaboration Working together with people who support common values and vision to achieve shared goals. Justice Advocating for social change and acting in ways that promote respect for all persons. Stewardship Cultivating the resources entrusted to us to promote healing and wholeness. Excellence Exceeding expectations through teamwork and innovation. Hello humankindness After more than a century of experience, we ve learned that modern medicine is more effective when it s delivered with compassion. Stress levels go down. People heal faster. They have more confidence in their health care professionals. We are successful because we know that the word care is what makes health care work. At Dignity Health, we unleash the healing power of humanity through the work we do every day, in the hospital and in the community. Hello humankindness tells people what we stand for: health care with humanity at its core. Through our common humanity as a healing tool, we can make a true difference, one person at a time. 4

OUR HOSPITAL AND OUR COMMITMENT is a member hospital of Dignity Health. As part of Dignity Health, Mercy Medical Center Redding plays a lead role in caring for the community and partnering with others to help make Redding and the surrounding areas a healthier place. In living out the mission, Mercy Redding is particularly attentive to the needs of the poor, disadvantaged and vulnerable. Rooted in Dignity Health s mission, vision and values, is dedicated to delivering community benefit with the engagement of its management team and Community Board. The board is composed of community members who provide stewardship and direction for the hospital as a community resource. Community benefit is also integrated into the strategic planning process at Mercy Medical Center Redding and is demonstrated at multiple levels throughout the organization. The community benefit planning process is a joint effort that engages the Dignity Health North State Board, Mercy Redding s President and Leadership Team, and Mercy Redding s Advisory Council. The Dignity Health North State Board has overall responsibility for community benefit activities for Mercy Medical Center Redding to ensure that the activities support the mission, policies and strategic plan of the organization, as well as, address the priority needs of the community. In addition to the involvement and oversight of the Dignity Health North State Board, developed a subcommittee of the Advisory Council to provide a community perspective to help prioritize the health opportunities for the organization. The 24 member Council represents a broad range of community organizations and needs. The North State Service Area Vice President of Business Development & Strategy is the individual responsible for the implementation and facilitation of Community Benefit activities. Membership on the Dignity Health North State Board and Advisory Council include community stakeholders, Sisters of Mercy, senior hospital leadership, physicians, and Mission Integration leadership (rosters for the Dignity Health North State Board and Mercy Redding s Advisory Council are listed in Appendix A). Responsibilities of the Board and the Advisory Council include: Review and approval of the annual community benefit report and plan to ensure it is aligned with s mission and strategy, is focused on the priority needs identified through the community health assessment and/or by hospital leadership, and fulfills responsibilities as a charitable organization. Provide oversight for the Dignity Health Grants Program, including the identification of grant funding priorities and selection of grant review committee members. Serve as advocates in the community that further s mission and help foster strategic partnerships to improve community health. s community benefit program includes financial assistance provided to those who are unable to pay the cost of their care, unreimbursed costs of Medicaid, subsidized health services that meet a community need, and community health improvement services. Our community benefit also includes monetary grants we provide to not for profit organizations that are working together to improve health on significant needs identified in our Community Health Needs Assessment. Many of these programs and initiatives are described in this report. 5

DESCRIPTION OF THE COMMUNITY SERVED Dignity Health hospitals define service areas as the zip codes that represent the geographic area served by the hospital based on approximately 80% of hospital discharges. (MMCR) serves a primary service area comprised of ten zip codes in Redding and surrounding communities in Shasta, Tehama and Trinity County. Portions of Shasta County and all of Trinity County are federally designated as Medically Underserved Areas and Populations. A summary description of the community is below, and additional community facts and details can be found in the CHNA report online. Total Population: 205,186 Hispanic or Latino: 10.7% Race: 79.9% White, 0.9% Black/African American, 2.6% Asian, 2.2% American Indian/Alaska Native, & Native Hawaiian or Other Pacific Islander, 0.1% Other, 3.6% Two or More Races Median Income: $46,270 Uninsured: 9.8% Unemployment: 7.4% No HS Diploma: 12.1% CNI Score: 3.6 Medicaid Population: 27.2% Other Area Hospitals: 1 Medically Underserved Areas or Populations: Yes Most of the communities in our primary service area are considered to have disproportionate unmet health care needs. In fact, the median CNI score for our primary service area is 3.6 indicating a high level of need. The most current CNI map can be found below. This is a major challenge for us as we plan and implement our community benefit programs and services. It is imperative that we provide a leadership role in building local capacity with our community partners in our efforts to create healthy communities. 6

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COMMUNITY BENEFIT PLANNING PROCESS The hospital engages in multiple activities to conduct its community benefit and community health improvement planning process. These include, but are not limited to: conducting a Community Health Needs Assessment with community input at least every three years; using five core principles to guide planning and program decisions; measuring and tracking program indicators; and engaging key stakeholders in the development and annual updating of the community benefit plan. Community Health Needs Assessment Process MMCR is committed to involving and informing the residents of Shasta County in a Community Needs Assessment Survey process. A community health needs assessment (CHNA) is a systematic process involving the community, to identify and analyze community health needs in order to prioritize, plan and act upon unmet community health needs. An assessment is conducted every three years, most recently in 2014, and identifies the health needs of residents by acknowledging ongoing health concerns within the community. Through surveys and the evaluation of existing health related data, community benefit staff compiled a report inventorying community health priorities and provided recommendations for areas of intervention. MMCR conducted the 2014 CHNA at the facility level using community benefit staff to oversee the process. By conducting the CHNA at the facility level, the Hospital was able to gain a better insight into the needs of the community. MMCR took into consideration available internal and external resources and partnered with outside individuals and organizations as appropriate throughout the CHNA process. Based on this assessment, issues of greatest concern were identified and the Hospital determined the areas to commit resources to, thereby focusing outreach efforts to continually improve the health status of the community we serve. The CHNA process incorporated data from primary sources (survey) and secondary data research (vital statistics and other existing health related data) relating to a wide array of community health indicators. Primary data was collected by using paper surveys and an identical web based survey via Survey Monkey.com. We looked to our community partners to represent their respective communities in the survey process. The final survey instrument was developed by and Public Health and is similar to the previous surveys used in the region. The surveys were used to collect information from community members, stakeholders and providers for the purpose of understanding community perception of needs. The surveys were emailed to approximately 1,000 emails through a distribution list that the Hospital compiled and uses to disseminate health education materials. The Hospital distributed surveys to zip codes within the primary service area, including zip codes with disproportionate unmet health needs. There were 168 surveys completed for a return rate of approximately 16.8%. The following partners assisted the hospital in conducting the needs assessment: Advisory Council This group of active community members represent all of the communities in our primary service area. They completed the survey in addition to participating in the priority setting process once the data was compiled. Shasta County Public Health In addition to providing assistance with the survey design, Public Health representatives distributed the surveys to their employees and clients. 8

Secondary data was used to validate the information obtained from the surveys and was provided through the free web based platform CHNA.org. This web based tool was designed to assist hospitals in completing the CHNA at the local level in order to help reduce the costs incurred by Hospitals. The data provided through CHNA.org has aggregated data available from 7,000 public data sources, including the Centers for Disease Control and Prevention and the National Center for Chronic Disease Prevention and Health promotion. Once the primary and secondary data were collected and compiled, MMCR community benefit staff analyzed the data and compared it to prior assessments to determine which information from the previous assessments would be useful in building upon for the health of the community. The results revealed a list of top perceived health risks and behaviors from the community s perspective, many of which overlap. CHNA Significant Health Needs The top areas of opportunity for the current assessment are listed below: Health Concerns: mental health problems, obesity, cancers, domestic violence, child abuse/neglect, aging problems, diabetes, heart disease and/or stroke. Health Risk Behaviors: drug abuse, being overweight, alcohol abuse, poor eating habits, tobacco use, and lack of exercise. A formal community asset assessment has not been conducted at this time, and may be addressed in the future in partnership with the Shasta County Public Health Services Agency. Community Benefit Plan Development Process An essential component of the CHNA is to prioritize the health opportunities that are identified through the assessment process. MMCR carefully considered how to prioritize various community benefit initiatives. After the health opportunities were identified, they were ranked by a small committee comprised of a representative from a local community health collaborative and a representative of Shasta County Public Health. The ranking tool contained seven criteria with which to rank each health opportunity. Each criterion was assigned a specific weighted value. Definitions of the criteria used are listed below: High Incidence or Prevalence Is the local rate/percent higher than the state or national rate/percent? Consider absolute numbers directly affected by the problem, as well as disproportionate rates among special populations (subgroups of age, sex, race/ethnicity, geographic region). Trending What are the trends? Is the rate/percent increasing or decreasing over time? Severity of Problem/Consequences Consider the degree to which the problem leads to death, disability or impairs one s quality of life. Also consider the risk of exacerbating the problem by not addressing at the earliest opportunity. Amenable to Intervention Consider how likely it is that interventions will be successful in preventing or reducing the consequences of a problem. Keep in mind all types of intentions (e.g., community education, policy and/or organizational changes, etc.), the potential to reach populations at greatest risk, and the ability of the community at large to mobilize to support the intervention. In other words can we make a difference? Resources Available Consider what programs are currently in place to address the problem, and consider the ability of organizations to reasonably impact the issue, given available resources. 9

Costliness of Treatment of Problem/Consequences Consider the financial costs of treating the problem; what costs might be saved by preventing or reducing the severity of the problem? Acceptability Considering what the community feels is important, as it can mean greater community support later on. After the participants ranked each of the areas of opportunity, the results were then calculated and further discussion ensued to select the areas that should be the focus for the next community benefit planning cycle (FY2015 FY2018). As a result of the ranking and prioritization process by the ranking committee, and taking into account that the hospital has limited financial resources, the will be addressing the following health areas: Mental health Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits Lack of exercise Substance Abuse Tobacco Use Some, if not all, of the health needs listed above will be addressed in part through the Chronic Disease Self Management Program (CDSMP). CDSMP is designed to educate participants and promote selfmanagement of any chronic disease. After completion of a workshop series, participants are able to improve their understanding of their condition and be able to better self manage symptoms of their disease. As a result of this evidence based chronic disease self management program, participants are empowered to better self care; and as a result of partnerships established in support of a healthcare continuum, community residents have access to vital support services. In addition to the CDSMP program, the Hospital will also continue to provide other community health education programs including the tobacco cessation program and diabetes management classes. While the health needs and risks of domestic violence and child abuse/neglect were also identified in the Community Health Assessment, the Hospital has limited resources and ability to effect sustainable change. MMCR will support local non profit organizations that address those needs through donations, sponsorships, and the community grants program as appropriate. Planning for the Uninsured/Underinsured Patient Population In keeping with its mission, the hospital offers patient financial assistance (also called charity care) to those who have health care needs and are uninsured, underinsured, ineligible for a government program or otherwise unable to pay. The hospital strives to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. The amount of financial assistance provided in FY15 is listed in the Economic Value of Community Benefit section of this report. 10

2015 REPORT AND 2016 PLAN This section presents programs and initiatives the hospital is delivering, funding or on which it is collaborating with others to address significant community health needs. It includes both a report on activities for FY15 and planned programs with measurable objectives for FY16. SUMMARY As a matter of Dignity Health policy, the hospital s community benefit programs are guided by five core principles. All of our initiatives relate to one or more of these principles: Disproportionate Unmet Health Related Needs: Seek to address the needs of communities with disproportionate unmet health related needs. Primary Prevention: Address the underlying causes of persistent health problems through health promotion, disease prevention, and health protection. Seamless Continuum of Care: Emphasize evidence based approaches by establishing operational linkages between clinical services and community health improvement activities. Community Capacity: Target charitable resources to mobilize and build the capacity of existing community assets. Collaborative Governance: Engage diverse community stakeholders in the selection, design, implementation, and evaluation of program activities. Below are community benefit and community health programs and initiatives operated or substantially supported by the hospital FY15, and those planned to be delivered in FY16. Programs that the hospital plans to deliver in 2016 are denoted by *. Physical Activity & Fitness and Nutrition & Overweight Mercy is a founding partner of Healthy Shasta and continues to be a major annual supporter with financial and in kind support*. Scholarships for Health Professions Education Shasta College Sponsor Scholarship opportunities for the Advanced Nursing*. Simpson University Sponsor Scholarship opportunities for the RN to BSN program*. also offers scholarships to graduating high school seniors that are pursuing a healthcare related major*. Cancer Deaths/Skin Cancers/Prostate Exams Continued free tobacco cessation classes Quit for Good *. Provider of Every Women Counts State Program*. Chronic Disease Offered two, six week workshops of the Stanford based Chronic Disease Self Management Program (CDSMP) titled Healthier Living, as well as trained community members to become workshop leaders*. Continued offering diabetes classes every other month throughout FY2015. 11

Anticipated Impact The anticipated impacts of specific program initiatives, including goals and objectives, are stated in the Program Digests on the following pages. Overall, the hospital anticipates that actions taken to address significant health needs will: improve health knowledge, behaviors, and status; increase access to care; and help create conditions that support good health. The hospital is committed to monitoring key initiatives to assess and improve impact. Hospital executive leadership, Community Board, and Dignity Health receive and review program updates. In addition, the hospital evaluates impact and sets priorities for its community benefit program by conducting Community Health Needs Assessments every three years. This community benefit plan specifies significant community health needs that the hospital plans to address in whole or in part, in ways consistent with its mission and capabilities. The hospital may amend the plan as circumstances warrant. For instance, changes in significant community health needs or in other community assets and resources directed to those needs may merit refocusing the hospital s limited resources to best serve the community. The following pages include Program Digests describing key programs and initiatives that address one or more significant health needs in the most recent CHNA report. 12

PROGRAM DIGESTS Healthier Living Chronic Disease Self Management Significant Health Needs Mental Health Addressed Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits, Lack of exercise Program Emphasis Disproportionate Unmet Health Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description The Healthier Living workshop is for adults who have a chronic health condition or who live with someone with a chronic health condition. Healthier Living workshop participants learn how to manage stress, fight fatigue and pain, learn how to communicate with their doctor and family members and set goals and learn problem solving techniques. Planned Collaboration None Community Benefit Category A Community Health Improvement Services FY 2015 Report Program Goal / Enhance proactive community benefit programming targeted to expand the continuum of care Anticipated Impact for community members living with chronic disease, enhancing quality of life by preventing or reducing unnecessary admissions to the Hospital. Measurable Objective(s) Monitor program participants and demonstrate a decrease in or avoidance of admission 90 days with Indicator(s) post intervention among participants of the program through self reported utilization. Baseline / Needs Summary Primary and secondary data from the community health assessment indicated a need for interventions that address the following conditions: Mental health, Obesity, Cancers, Aging problems, Diabetes, Heart disease and/or stroke, Poor eating habits, Lack of exercise Intervention Actions Conduct two Healthier Living workshops during the next fiscal year. for Achieving Goal Explore the ability to offer more specialized areas of this program e.g. diabetes, mental health and pain management. Host a leader trainer during FY15 to train more leaders for community programs. Program Performance / Outcome Two Healthier Living workshops were conducted in FY15. A total of 11 community members attended the six week workshops. Due to staffing changes and limited resources, the Hospital decided to postpone offering additional Stanford health management modules. However, these modules will be explored again in FY16 as staffing and resources are reallocated. A leader training was also conducted in early FY15 and a total of 12 leaders were trained. Leader trainings enhance partnerships and create sustainability for the Healthier Living program within the community. Hospital s Contribution / Program $5,600 Expense FY 2016 Plan Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Enhance proactive community benefit programming targeted to expand the continuum of care for community members living with chronic disease, enhancing quality of life by preventing or reducing unnecessary admissions to the Hospital. Monitor program participants and demonstrate a decrease in or avoidance of admission 90 days post intervention among participants of the program through self reported utilization. Primary and secondary data from the community health assessment indicated a need for 13

Intervention Actions for Achieving Goal interventions that address the following conditions: Mental health, Obesity, Cancers, Aging problems, Diabetes, Heart disease and/or stroke, Poor eating habits, Lack of exercise Conduct two Healthier Living workshops during the next fiscal year. Host a leader trainer during FY16 to train more leaders for community programs Cancer Programs Significant Health Needs Mental Health Addressed Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits, Lack of exercise Program Emphasis Disproportionate Unmet Health Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description Provide services/programs that respond to the identified community need listed above to help improve community health. Planned Collaboration None Community Benefit Category A Community Health Improvement Services FY 2015 Report Program Goal / Enhance proactive community benefit programming targeted to expand the continuum of care Anticipated Impact for patients and enhance quality of life by reducing unnecessary readmissions to the hospital. Measurable Objective(s) Monitor quit rate of participants in Quit for Good tobacco cessation classes as well as monitor with Indicator(s) participants in the Healthier Living Workshops to identify improvement in self management of their chronic conditions. Baseline / Needs Summary PRC community health assessment indicates that COPD death rates are worse than both the California and US averages; and the prevalence of lung cancer disease is increasing in Shasta County. Tobacco use rates are statistically unchanged in Shasta County since 2007 and this contributes to both COPD and Lung Cancer. Intervention Actions Continue to offer and promote the Quit for Good tobacco cessation classes throughout for Achieving Goal FY2015. Refer community members to the Healthier Living Workshops as appropriate to help community members self manage their condition (i.e. COPD). Program Performance / Outcome Tobacco cessation classes were continued and offered throughout FY14. The correlation between tobacco use, lung cancer and COPD is covered in the curriculum. In addition to the Quit for Good classes and Mercy Redding also supported the Youth Violence Prevention Council with a community grant to help the organization provide substance use treatment and tobacco cessation programs for teens aged 12 18. Community members were referred to the Healthier Living workshop as appropriate. Hospital s Contribution / Program $27,000 Expense FY 2016 Plan Program Goal / Enhance proactive community benefit programming targeted to expand the continuum of care Anticipated Impact for patients and enhance quality of life by reducing unnecessary readmissions to the hospital. Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Monitor quit rate of participants in Quit for Good tobacco cessation classes as well as monitor participants in the Healthier Living Workshops to identify improvement in self management of their chronic conditions. PRC community health assessment indicates that COPD death rates are worse than both the 14

Intervention Actions for Achieving Goal California and US averages; and the prevalence of lung cancer disease is increasing in Shasta County. Tobacco use rates are statistically unchanged in Shasta County since 2007 and this contributes to both COPD and Lung Cancer. Continue to offer and promote the Quit for Good tobacco cessation classes throughout FY2016. Refer community members to the Healthier Living Workshops as appropriate to help community members self manage their condition (i.e. COPD). Chronic Pain, Substance Abuse, and Mental Health Programs Significant Health Needs Mental Health Addressed Obesity Cancers Aging problems Diabetes Heart disease and/or stroke Poor eating habits, Lack of exercise Program Emphasis Disproportionate Unmet Health Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description Develop and implement an educational campaign and support investments to increase awareness and early identification of risk factors that can contribute to unhealthy behaviors. Planned Collaboration None Community Benefit Category A Community Health Improvement Services FY 2015 Report Program Goal / Enhance proactive community benefit programming targeted to expand the continuum of care Anticipated Impact for community members living with chronic disease, enhancing quality of life by preventing or reducing unnecessary admissions to the Hospital. Measurable Objective(s) Monitor program participants and demonstrate a decrease in or avoidance of admission 90 days with Indicator(s) post intervention among participants of the program through self reported utilization. Baseline / Needs Summary Primary and secondary data from the community health assessment indicated a need for interventions that address the following conditions: Mental health, Obesity, Cancers, Aging problems, Diabetes, Heart disease and/or stroke, Poor eating habits, Lack of exercise Intervention Actions Explore the ability to offer a more specialized area of this program e.g. mental health and for Achieving Goal pain management. Refer community members to the Healthier Living Workshops as appropriate to help community members self manage their condition Program Performance / Outcome Due to staffing changes and limited resources, the Hospital decided to postpone offering additional Stanford health management modules. However, these modules will be explored again in FY16 as staffing and resources are reallocated. Community members were still referred to the CDSMP version of Healthier Living as appropriate. In addition to referring community members to the CDSMP program, the Hospital provided a community grants to Empire Recovery Center for their detox program that provides detox services for homeless and indigent addicts. Hospital s Contribution / Program $25,000 Expense FY 2016 Plan Program Goal / Anticipated Impact Enhance proactive community benefit programming targeted to expand the continuum of care for community members living with chronic disease, enhancing quality of life by preventing or reducing unnecessary admissions to the Hospital. 15

Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal Monitor program participants and demonstrate a decrease in or avoidance of admission 90 days post intervention among participants of the program through self reported utilization. Primary and secondary data from the community health assessment indicated a need for interventions that address the following conditions: Mental health, Obesity, Cancers, Aging problems, Diabetes, Heart disease and/or stroke, Poor eating habits, Lack of exercise Explore the ability to offer a more specialized area of this program e.g. mental health and pain management. Refer community members to the Healthier Living Workshops as appropriate to help community members self manage their condition Dignity Health Community Grants Program Significant Health Needs Access to Healthcare Addressed Cancer Disability & Chronic Pain Heart Disease & Stroke Injury & Violence Mental Health & Mental Disorders Nutrition, Physical Activity & Overweight Respiratory Disease Substance Abuse Tobacco Use Program Emphasis Disproportionate Unmet Health Related Needs Primary Prevention Seamless Continuum of Care Build Community Capacity Collaborative Governance Program Description Providing funding to support community based organizations who will provide services to underserved populations to improve the quality of life. The objective of the Community Grants Program is to award grants to organizations whose proposals respond to the priorities identified in the most recent Community Health Needs Assessment (CHNA). Planned Collaboration None Community Benefit Category Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal Program Performance / Outcome E Cash and In Kind Contributions FY 2015 Report To build community capacity by identifying community organizations and funding programs that are in alignment with the needs identified in the most recent CHNA. Funding will be awarded to organizations whose programs respond to a need identified in the most recent CHNA and align with at least one of the five core principles (listed in the Program Emphasis above). Respond to the priority health needs in Shasta County and provide grant funds to be used to provide services to underserved populations (economically poor; women & children; mentally or physically disabled; or other disenfranchised populations). Prioritize grant applications that address the target areas. Community Grants were provided to seven local non profit organizations, totaling $215,317. Organizations receiving grants were: Northern California Center for Family Awareness $30,000 for divorce education workshops. Shingletown Medical Center $10,000 for the chronic disease self management program (CDSMP) titled Healthier Living. Youth Violence Prevention Council $25,000 for a substance and tobacco cessation program for teens. United Way $30,000 for the 2 1 1 Shasta resources referral program. 16

Hospital s Contribution / Program Expense Program Goal / Anticipated Impact Measurable Objective(s) with Indicator(s) Baseline / Needs Summary Intervention Actions for Achieving Goal Shasta County Chemical People $30,000 for a peer mentoring program for youth. Empire Recovery Center $25,000 for their substance abuse detox program for the homeless/indigent. Mountain Valleys Health Centers $65,317 for a transportation services program $215,317 FY 2016 Plan To build community capacity by identifying community organizations and funding programs that are in alignment with the needs identified in the most recent CHNA. Funding will be awarded to organizations whose programs respond to a need identified in the most recent CHNA and align with at least one of the five core principles (listed in the Program Emphasis above). Respond to the priority health needs in Shasta County and provide grant funds to be used to provide services to underserved populations (economically poor; women & children; mentally or physically disabled; or other disenfranchised populations). Prioritize grant applications that address the target areas. 17

ECONOMIC VALUE OF COMMUNITY BENEFIT uses a cost accounting methodology for calculating costs for community benefit. Classified Summary Including Non Community Benefit (Medicare) 7/1/2014 through 6/30/2015 Total Offsetting Net % of Organization Persons Expense Revenue Benefit Expenses Revenues Benefits for Living in Poverty Financial Assistance 3,338 4,109,640 0 4,109,640 1.0 0.9 Medicaid 64,678 138,494,079 129,583,736 8,910,343 2.1 2.0 Means Tested Programs 6 1,104,62 50,441 60,021 0.0 0.0 Community Services: Comm. Benefit Operations 0 107,843 0 107,843 0.0 0.0 Comm. Health Improvement Svcs. 1,216 91,427 0 91,427 0.0 0.0 Financial and In Kind Contributions 2,181 1,389,639 31,775 1,357,864 0.3 0.3 Totals for Community Services 3,397 15,888,909 31,775 1,557,134 0.4 0.3 Totals for Living in Poverty 61,419 144,303,090 129,665,952 14,637,138 3.5 3.2 Benefits for Broader Community Community Services: Comm. Health Improvement Svcs. 1,755 20,411 0 20,411 0.0 0.0 Financial and In Kind Contributions 419 472,565 0 472,565 0.1 0.1 Health Professions Education 72 4,008,967 954,805 3,054,162 0.7 0.7 Subsidized Health Services 3 3,582 0 3,582 0.0 0.0 Totals for Community Services 2,249 4,505,525 954,805 3,550,720 0.9 0.8 Totals for Broader Community 2,249 4,505,525 954,805 3,550,720 0.9 0.8 Totals for Community Benefit 63,668 148,808,615 130,620,757 18,187,858 4.4 4.0 Medicare 42,183 160,086,647 133,141,591 26,945,056 6.5 5.9 Totals with Medicare 105,851 308,895,262 263,762,348 45,132,914 10.8 9.9 18

APPENDIX A: COMMUNITY BOARD AND COMMITTEE ROSTERS FY 2016 DIGNITY HEALTH NORTH STATE SERVICE AREA COMMUNITY BOARD MEMBERS Douglas Hatter, M.D., Chairperson Jim Cross, Secretary Mark Korth, North State Service Area President Fernando Alvarez, M.D. Diane Brickell LeRoy Crye Sister Nora Mary Curtin Sister Clare Marie Dalton Ryan Denham Sandra Dole Alan Foley Todd Guthrie, M.D. Patrick Quintal, M.D. Any communications to Board Members should be made in writing and directed to: Lynn Strack, Executive Assistant Dignity Health North State P.O. Box 496009 Redding, CA 96049 6009 (530) 225 6103 (530) 225 6118 fax 7/1/15 19

MERCY MEDICAL CENTER REDDING ADVISORY COUNCIL MEMBERS 2015 MEMBER TERM REAPPTD Jason Parker, Chairperson (Morgan Stanley Financial) 6/2008 to 12/2015 to 12/2012 Mike Mangas (KRCR Channel 7) 6/2008 to 12/2015 to 12/2012 Marion Nebergall (Community Member) 6/2008 to 12/2015 to 12/2012 Janice Cunningham, (Cox Real Estate) 6/2008 to 12/2015 to 12/2012 Janet Applegarth (Anderson Chamber of Commerce) 1/2011 to 12/2016 to 12/2013 Tracey Moore, Vice Chairperson (Sierra Pacific Industries) 1/2012 to 12/2017 to 12/2013 Robert Paoletti (Redding Police Department) 1/2012 to 12/2017 to 12/2013 Jim Cloney (Shasta Unified School District) 1/2013 to 12/2018 to 12/2014 Donnell Ewert (Shasta County Public Health) 1/2013 to 12/2018 to 12/2014 Stacey Carman (Redding Rancheria) 1/2013 to 12/2018 to 12/2014 Jean King (One SAFE Place) 1/2014 to 12/2019 to 12/2015 Scott Putnam, Secretary (Apex Technology Management Inc.) 1/2014 to 12/2019 to 12/2015 Laura Redwine (City of Shasta Lake) 1/2014 to 12/2019 to 12/2015 Joe Wyse (Shasta College) 1/2014 to 12/2019 to 12/2015 April LaFrance (Woodstone Construction) 1/2015 to 12/2020 to 12/2016 Jonathan Anderson (Good News Rescue Mission) 1/2015 to 12/2020 to 12/2016 Kim Niemer (City of Redding) 1/2015 to 12/2020 to 12/2016 Les Baugh (Shasta County Board of Supervisors) 1/2015 to 12/2020 to 12/2016 Gordon Flinn (Simpson University) 1/2015 to 12/2020 to 12/2016 Mark Rincon (FIT Physical Therapy) 1/2015 to 12/2020 to 12/2016 20

APPENDIX B: OTHER PROGRAMS AND NON QUANTIFIABLE BENEFITS The hospital delivers a number of community programs and non quantifiable benefits in addition to those described elsewhere in this report. Like those programs and initiatives, the ones below are a reflection of the hospital s mission and its commitment to improving community health and well being. Non Quantifiable Benefits Mercy Redding gives to the community in many ways that are difficult to measure. Through leadership and advocacy efforts, the Hospital works collaboratively with many local organizations to enhance communitybuilding activities and programs to help address the root causes of health problems. During FY2015, MMCR provided expertise and/or hospital resources to help strengthen the following community partnerships: American Cancer Society Economic Development Council Good News Rescue Mission Leadership Redding Northern Valley Catholic Social Services North State Symphony Redding Chamber of Commerce Redding Rancheria Shasta County Public Health Simpson University St. Joseph Parish School Turtle Bay Exploration Park YMCA 21