2022-05-13T15:54:56-05:00 2021-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2020-07-01 510103684 CHRISTIANA CARE HEALTH SERVICES INC % SR VP'S OFFICE CHRI 3024282426 PO BOX 2653 WILMINGTON DE 198050653 ROBERT M MCMURRAY CFO 3026237202 2022-05-13 true ROBERT M MCMURRAY 999009999 ANTONIO C RUSSO P00858539 2673303000 2022-05-12 2 2020 2022-09-23 18:48:47Z JANICE NEVIN MD 4000 NEXUS DRIVE WILMINGTON DE 19803 3027040520 false X WWW.CHRISTIANACARE.ORG X 1965 DE OUR MISSION AS AN ORGANIZATION IS TO SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. 14 11 13069 404 5074808 0 80735115 128076121 1885207044 2187692532 102844109 199105805 13395684 18852326 2082181952 2533726784 0 0 0 0 1255954196 1317604659 0 0 0 747739423 829007353 2003693619 2146612012 78488333 387114772 4179624084 4818599325 1298158505 1336477794 2881465579 3482121531 X WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. false false 426338075 0 644993608 PROVISION OF PROFESSIONAL PATIENT CARE FOR THE HOSPITALS OF CHRISTIANA CARE - DURING THE FISCAL YEAR, RECORDED 343,601 PATIENT DAYS WITH AN APPROXIMATE FTE COUNT OF 3080. THE HOSPITALS OFFER A FULL SCOPE OF SERVICES WITH THE NEED OF THE POPULATION SERVED WITHOUT REGARD TO AGE, RACE OR ECONOMIC CIRCUMSTANCES. 172970145 0 387857553 PHARMACY - PROVIDED PHARMACY SERVICES FOR BOTH INPATIENTS AND OUTPATIENTS. DURING FISCAL 2021, 6,825,386 DOSES WERE ADMINISTERED WITH AN APPROXIMATE FTE COUNT OF 241. 188398566 0 334563447 OPERATING ROOM - PROVIDED BOTH INPATIENT AND OUTPATIENT SURGICAL PROCEDURES. IN FISCAL 2021, 34,200 CASES WERE PERFORMED, REQUIRING AN APPORXIMATE FTE COUNT OF 610. 976782126 0 834286065 1764488912 true true false true false false false false true true true false true true false false true false false true false false false true false true true false false true true false false false false false false false true true true true false false false true true true true false false true 368 0 true 13069 true true true false false false false false false false false false true false X 14 11 true false true false false true true true true false false true true true true true true true true true false PA X SR VP'S OFFICE 3024282426 4000 NEXUS DR STE NW3-117 WILMINGTON DE 19803 JANICE E NEVIN MD PRESIDENT & CEO 44.0 1.0 X X 1788006 0 191920 KENNETH SILVERSTEIN MD CHIEF PHYSICIAN EXECUTIVE 42.0 3.0 X 903548 0 108459 PAUL K DAVIS MD CARDIAC SURGEON 45.0 0.0 X 860383 0 38394 KIRK N GARRATT MD MEDICAL DIRECTOR, HEART/VASC 45.0 0.0 X 855018 0 25377 RAY A BLACKWELL MD CHIEF CARDIAC SURGERY 45.0 0.0 X 830502 0 39819 ROBERT MCMURRAY CFO, TREASURER & ASS'T SEC'Y 43.0 2.0 X 772585 0 94804 FREDERIC T HARAD MD MEMBER 44.0 1.0 X 803674 0 38394 RANDALL GABORIAULT CHIEF INFORMATION OFFICER 45.0 0.0 X 735647 0 97545 RAAFAT ABDEL-MISIH MD ONCOLOGY SURGEON 45.0 0.0 X 793608 0 31797 NICHOLAS J PETRELLI MD MEDICAL DIRECTOR, CANCER 45.0 0.0 X 790800 0 31797 NEIL JASANI MD CHIEF PEOPLE OFFICER 45.0 0.0 X 663354 0 84587 SHARON KURFUERST SYSTEM CHIEF OPERATING OFFICER 45.0 0.0 X 621153 0 78108 RICHARD CUMING CHIEF NURSING EXECUTIVE 44.0 1.0 X 617460 0 75849 JENNIFER L SCHWARTZ ESQ CORPORATE SECRETARY 40.0 5.0 X 590868 0 82750 JOSEPH BENNETT MD MEMBER 44.0 1.0 X 625037 0 36969 MICHAEL EPPEHIMER MD PRES. MED GROUP (THRU 10/2020) 45.0 0.0 X 624336 0 35301 LISA MAXWELL MD PRESIDENT, MEDICAL GROUP 45.0 0.0 X 449912 0 39919 ANDREW M LUBIN MEMBER (THRU 12/31/20) 1.0 1.0 X 0 0 0 BETTY J CAFFO PHD MBR,VICE CHAIR (THRU 12/31/20) 1.0 3.0 X X 0 0 0 CHRISTINE SAUERS MEMBER (AS OS 1/1/21) 1.0 0.0 X 0 0 0 DAVID B STRATTON ESQ MEMBER, CHAIR (AS OF 1/1/21) 1.0 2.0 X X 0 0 0 DONEENE DAMON ESQ MEMBER, CHAIR (THRU 12/31/20) 1.0 1.0 X X 0 0 0 DWIGHT D THOMEY ESQ MEMBER (AS OF 1/1/21) 1.0 3.0 X 0 0 0 ERIC T JOHNSON MD MEMBER 1.0 0.0 X 0 0 0 GEORGE FOUTRAKIS MEMBER 1.0 1.0 X 0 0 0 KATHLEEN F MCDONOUGH ESQ MEMBER (THRU 12/31/20) 1.0 1.0 X 0 0 0 LOLITA A LOPEZ MEMBER, VICE CHAIR(AS OF 1/21) 1.0 1.0 X X 0 0 0 LOSSIE FREEMAN MEMBER (AS OF 1/1/21) 1.0 0.0 X 0 0 0 MARK TURNER MEMBER (THRU 12/31/20) 1.0 1.0 X 0 0 0 MEGAN GREENBERG ESQ MEMBER (THRU 12/31/20) 1.0 1.0 X 0 0 0 NICHOLAS M MARSINI JR MEMBER (THRU 12/31/20) 1.0 1.0 X 0 0 0 PAUL KANIEFSKI MEMBER (THRU 12/31/20) 1.0 1.0 X 0 0 0 PAULA K MAXWELL MEMBER (AS 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THE ORGANIZATION'S BOARD DESIGNATED ENDOWMENTS ARE INTENDED TO COVER ANNUAL INCREMENTAL OPERATING EXPENSES OF THE HEALTH SERVICES' TRANSITIONAL CANCER RESEARCH, VALUE INSTITUTE, AND INFANT MORTALITY. THE ORGANIZATION'S PERMANENT ENDOWMENT CONSISTS OF APPROXIMATELY TWENTY FOUR DONOR RESTRICTED ENDOWMENT FUNDS USED FOR A VARIETY OF PURPOSES, INCLUDING SALARY AND PROGRAM SUPPORT. THE ORGANIZATION'S PURPOSE AND TIME RESTRICTED NET ASSETS ARE RESTRICTED FOR INDIGENT CARE, BUILDING AND MAINTANCE, AND PROGRAM SUPPORT. -------------------- Central America and the Caribbean Investments 140942557 140942557 140942557 true false true false false false FORM 990, SCHEDULE F, PART I, LINE 2 DETAIL OF SUB-CONTRACTS IN FURTHERANCE OF ITS RESEARCH ACTIVITIES, THE ORGANIZATION MAY MAKE SUB-CONTRACTS TO FOREIGN INSTITUTIONS THAT PERFORM RESEARCH IN CONNECTION WITH RESEARCH GRANTS AWARDED TO THE ORGANIZATION. THE ORGANIZATION DOES NOT CATEGORIZE ANY SUCH SUB-CONTRACTS AS GRANTS FOR FORM 990, SCHEDULE F, PARTS II AND III PURPOSES. GOLF CLASSIC 99940 83940 16000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99940 83940 16000 0 0 0 0 0 0 0 16000 FORM 990, SCHEDULE G, PART II DETAIL OF FUNDRAISING EVENTS EXPENSES ASSOCIATED WITH THE GOLF CLASSIC EVENT WERE RECORDED DIRECTLY BY A RELATED PARTY. true true X true X false false false false 16212173 0 16212173 0.00760 283941307 268312691 15628616 0.00730 300153480 268312691 31840789 0.01490 47 60025 11465346 2811168 8654178 0.00400 5 15 86474344 12391813 74082531 0.03450 1 20447813 18059517 2388296 0.00110 4 152806 0 152806 0.00010 57 60040 118540309 33262498 85277811 0.03970 57 60040 418693789 301575189 117118600 0.05460 1 50000 50000 2 278957 278957 0.00010 1 101255 101255 1 15540 15540 3 35740 35740 1 400 420 420 1 83742 83742 10 400 565654 565654 0.00030 true 56558325 2371974 500543745 611972581 -111428836 X true true 2 1 CHRISTIANA HOSPITAL 4755 OGLETOWN-STANTON ROAD NEWARK DE 19718 www.christianacare.org LICENSE #HSPTL-002 X X X X X A 2 WILMINGTON HOSPITAL 501 WEST 14TH STREET WILMINGTON DE 19801 www.christianacare.org LICENSE #HSPTL-001 X X X X X A A-CHRISTIANA AND WILMINGTON HOSPITALS 12 false false true X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X true 19 true SEE PART V, SECTION C false true X 200. 0. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false PART V, SECTION B LINE 5 (INPUT FROM COMMUNITY) AT CHRISTIANACARE, ONE OF OUR CORE VALUES IS LISTENING ACTIVELY AND SEEKING TO UNDERSTAND, AND WE HONOR THAT COMMITMENT IN HOW WE CONDUCT OUR CHNA. WE DO NOT CONSIDER THE ASSESSMENT JUST A REQUIREMENT TO BE COMPLETED, BUT RATHER A KEY OPPORTUNITY TO LISTEN TO THE VOICE OF THE COMMUNITY, SEEK TO UNDERSTAND THE COMMUNITY'S NEEDS, BUILD TRUST, AND ENSURE THAT WE ARE MEETING THOSE NEEDS. IN JANUARY 2019, CHRISTIANACARE HELD A SERIES OF COMMUNITY MEETINGS TO INFORM THE LAST NEEDS ASSESSMENTS: FOUR MEETINGS OF 98 COMMUNITY STAKEHOLDERS; SIX MEETINGS OF 53 LOCAL TEENAGERS; AND TWO INTERNAL MEETINGS OF 13 CHRISTIANACARE STAFF MEMBERS. THE COMMUNITY STAKEHOLDERS REPRESENTED LOCAL HEALTH DEPARTMENTS, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTH CARE PROVIDERS, LOCAL POLICYMAKERS, PARKS AND RECREATION DEPARTMENTS, AND SCHOOL SYSTEMS. THE CHRISTIANACARE STAFF MEMBERS WERE THOSE WHO WORKED DIRECTLY WITH PATIENTS. THE TEENAGERS REPRESENTED SEVERAL AREAS ACROSS NEW CASTLE COUNTY, INCLUDING NEWARK, NEW CASTLE, WILMINGTON AND CLAYMONT. CHRISTIANACARE WAS PURPOSEFUL IN THE INCLUSION OF A BROAD ARRAY OF COMMUNITY VOICES AT THESE MEETINGS TO ENSURE A DIVERSITY OF VIEWPOINTS. THE COMMUNITY MEETINGS WERE ALSO HELD IN DIFFERENT AREAS OF NEW CASTLE COUNTY TO ENSURE THAT WE WERE MEETING COMMUNITY MEMBERS IN THEIR OWN COMMUNITIES. THE MEETINGS BEGAN WITH A PRESENTATION OF PRELIMINARY SECONDARY COMMUNITY HEALTH DATA. PARTICIPANTS THEN WERE ASKED (A) TO IDENTIFY COMMUNITY HEALTH ISSUES THAT MAY NOT HAVE BEEN WELL MEASURED BY SECONDARY DATA AND (B) THROUGH A VOTING PROCESS, TO IDENTIFY WHICH NEEDS THEY BELIEVED WERE MOST SIGNIFICANT IN NEW CASTLE COUNTY. IN ADDITION TO THE ABOVE MEETINGS, AN INTERVIEW WAS CONDUCTED WITH AN ASSOCIATE DEPUTY DIRECTOR WITHIN THE DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES. DURING THAT INTERVIEW, SECONDARY DATA FINDINGS AND SIGNIFICANT NEEDS ALSO WERE DISCUSSED TO GET THE ASSOCIATE DEPUTY DIRECTOR'S PERSPECTIVE. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2019 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW, AND ANALYSIS, TO DEVELOP THE CHNA. -------------------- PART V, SECTION B, LINE 6 (JOINT CHNA) CHRISTIANACARE'S TWO HOSPITAL FACILITIES, CHRISTIANA AND WILMINGTON HOSPITALS, JOINTLY CONDUCTED THEIR CHNA. -------------------- PART V, SECTION B, LINE 7 & 10 (CHNA & IMP. STRATEGY PUBLIC AVAILABILITY) CHRISTIANACARE'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/ CHRISTIANACARE'S CHNA IS ALSO AVAILABLE IN PAPER COPY TO THE PUBLIC UPON REQUEST. CHRISTIANACARE'S COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ A PAPER COPY OF THE CHIP IS ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. -------------------- PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) IN THE MOST RECENT CHNA, FINALIZED 0N JUNE 2019, CHRISTIANACARE IDENTIFIED THE COMMUNITY'S MOST SIGNIFICANT NEEDS AS: 1. SOCIAL DETERMINANTS OF HEALTH INCLUDING POVERTY, FOOD INSECURITY, HOUSING, AFFORDABILITY OF CARE, EDUCATION, AND EMPLOYMENT/JOB SECURITY 2. MENTAL HEALTH AND SUBSTANCE USE DISORDER 3. VIOLENCE AND PUBLIC SAFETY 4. MATERNAL AND CHILD HEALTH ESPECIALLY INFANT MORTALITY 5. ACCESS TO DENTAL AND PRIMARY CARE ALL EXCEPT ACCESS TO DENTAL AND PRIMARY CARE WERE ALSO IDENTIFIED AS SIGNIFICANT HEALTH NEEDS IN THE 2016 CHNA. THIS IS UNSURPRISING GIVEN THE COMPLEXITY OF ADDRESSING ISSUES SUCH AS POVERTY AND INFANT MORTALITY. IN THE 2016 CHNA, CHRISTIANACARE ALSO IDENTIFIED TRANSPORTATION, HOUSING, AND EMPLOYMENT AS SIGNIFICANT NEEDS, BUT DETERMINED THAT IT WAS NOT ABLE TO ADDRESS THESE NEEDS AT THAT TIME GIVEN A LACK OF EXPERTISE AND INFRASTRUCTURE. ADDRESSING SOCIAL DETERMINANTS OF HEALTH IS ESSENTIAL TO IMPROVING THE HEALTH OF OUR COMMUNITY, SO WE HAVE ADVANCED OUR ORGANIZATIONAL CAPACITY TO SUPPORT A SOCIAL CARE FRAMEWORK THAT INTEGRATES INTERNAL AND EXTERNAL RESOURCES AS WE WORK TO ADDRESS THESE ISSUES. IN FY21, THE PANDEMIC CONTINUED TO DOMINATE OUR ACTIVITIES INSIDE AND OUTSIDE OF CLINICAL SPACES. IN FY20, WE COLLABORATED WITH THE LATIN AMERICAN COMMUNITY CENTER (LACC) AND KINGSWOOD COMMUNITY CENTER (KCC) TO OFFER COVID-19 TESTING CENTRALLY LOCATED IN WILMINGTON TO PROVIDE ACCESS TO HISTORICALLY UNDERSERVED MINORITY COMMUNITIES. FOR THOSE TESTING POSITIVE, CONTINUED MONITORING WAS OFFERED IN THEIR PREFERRED LANGUAGE. TESTING BEGAN IN APRIL 2020 AT BOTH LACC AND KCC AND IT CONTINUED AT LACC UNTIL APRIL 2021, AT WHICH TIME THE LACC RESUMED ITS OWN PROGRAMMING IN THAT SPACE. DURING THE PERIOD FROM JULY 2020 TO APRIL 2021, CHRISTIANACARE SAW 497 PATIENTS AT THE LACC TESTING SITE AND TESTED 477 PATIENTS. COVID-19 TESTING CONTINUES TO BE OFFERED AT THE KINGSWOOD COMMUNITY CENTER, NOW WITHIN A NEWLY DEVELOPED PRIMARY CARE PRACTICE THAT BEGAN OPERATING IN APRIL 2021. AT THE KINGSWOOD COMMUNITY CENTER, PATIENTS CAN CONNECT TO CHRISTIANACARE VIRTUAL HEALTH FOR A VIRTUAL APPOINTMENT WITH A PRIMARY CARE PROVIDER OR A MEMBER OF THEIR CARE TEAM, AND RECEIVE ACCESS TO MEDICAL SERVICES SUCH AS VACCINES, BLOOD PRESSURE CHECKS, AND IN-PERSON EXAMS. IN PERSON HELP WITH THE VIRTUAL CARE TECHNOLOGY IS ALSO AVAILABLE IF NEEDED. ONE OF THE MOST REWARDING THINGS CHRISTIANACARE WAS ABLE TO DO FOR ITS NEIGHBORS DURING FY21 WAS TO OFFER COVID-19 VACCINATIONS. BETWEEN JANUARY 16, 2021 AND JUNE 11, 2021, CHRISTIANACARE HELD 28 VACCINATION EVENTS AT ITS NEWARK CAMPUS AND ADMINISTRATIVE LOCATION IN WILMINGTON, AVENUE NORTH. A TOTAL OF 22,362 FIRST AND SECOND DOSES WERE PROVIDED TO COMMUNITY MEMBERS. CHRISTIANACARE'S OFFICE OF HEALTH EQUITY ALSO ORGANIZED EIGHT FIRST AND SECOND DOSE VACCINATION EVENTS IN COMMUNITY LOCATIONS THROUGHOUT NEW CASTLE COUNTY BETWEEN FEBRUARY AND JUNE 2021. AT THESE EVENTS, 2,810 1ST DOSES AND 2,616 2ND DOSES WERE PROVIDED. INDIVIDUALS WHO RECEIVED A 1ST DOSE WERE INVITED TO RETURN TO THE SAME LOCATION TO RECEIVE THEIR SECOND DOSE AND SENT REMINDERS AS WELL. THE GOAL OF HOLDING VACCINATION CLINICS IN COMMUNITIES WAS TO BRING THE VACCINE TO THOSE COMMUNITIES THAT MAY NOT HAVE OTHERWISE HAD EASY ACCESS. THE OFFICE OF HEALTH EQUITY WORKED VERY CLOSELY WITH TRUSTED COMMUNITY PARTNERS TO ORGANIZE THESE EVENTS AND PROMOTE THEM TO COMMUNITY MEMBERS. WE WERE PARTICULARLY FOCUSED ON USING THESE VACCINATIONS EVENTS TO ADDRESS DISPARATE VACCINATION RATES WE WERE SEEING IN OUR COMMUNITIES AND NATIONALLY. THE STATISTICS REFLECTING THOSE WE VACCINATED DEMONSTRATE OUR SUCCESS. AT THE FIRST VACCINATION EVENT IN THE COMMUNITY EDUCATION BUILDING IN WILMINGTON, 71% OF THOSE VACCINATED WERE BLACK OR AFRICAN AMERICAN. AT ONE OF THE FINAL VACCINATION EVENTS IN NEWPORT, 82% OF THOSE VACCINATED IDENTIFIED AS HISPANIC OR LATINO. THE VACCINATION CLINICS TOOK A GREAT AMOUNT OF TIME AND EFFORT TO ORGANIZE. EACH EVENT AT THE HOSPITAL REQUIRED 40 - 50 CAREGIVERS TO VOLUNTEER DURING THEIR PERSONAL TIME OR TO STEP AWAY FROM THEIR OTHER DUTIES TO PERFORM EVERYTHING FROM ADMINISTERING THE VACCINE TO GREETING COMMUNITY MEMBERS. THE PHARMACY TEAM SUPPORTED EVERY EVENT AND WERE IN CONSTANT COMMUNICATION WITH THE SITE SUPERVISORS TO ENSURE VACCINE SUPPLY AND DELIVERY WAS SEAMLESS. ALL OUR EVENTS HAD THE SUPPORT AND PRESENCE OF THE EXECUTIVE LEADERSHIP TEAM WHO GREETED AND GUIDED COMMUNITY MEMBERS, PROVIDED VACCINATIONS, AND SCRIBED ALONG WITH OTHER VOLUNTEERS. THE CORE VACCINATION TEAM WAS CONTINUOUSLY IMPROVING EACH EVENT TO ENSURE WE COULD SEE AS MANY COMMUNITY MEMBERS AS VACCINE SUPPLY ALLOWED. WE ALSO CONSISTENTLY ADAPTED TO CDC AND STATE GUIDANCE ON VACCINATION GUIDELINES AND VACCINE SUPPLY CHALLENGES. WE ARE PARTICULARLY PROUD OF THE WORK OUR CAREGIVERS IN INFORMATION TECHNOLOGY (IT) PUT INTO THIS EFFORT. THE IT TEAM CREATED A HOMEGROWN INTERNAL VACCINATION SOFTWARE SOLUTION TO CAPTURE COMMUNITY MEMBER INTAKE AND VACCINE INFORMATION. THEY CREATED REPORTS TO SHARE INTERNALLY AND WITH THE STATE. THE SOFTWARE SYSTEM ALSO ALLOWED THE IT TEAM TO SHARE VACCINE DATA WITH THE STATE FOR THE STATE'S VACCINE REGISTRY. IN FY21, CHRISTIANACARE WAS ALSO ABLE TO BEGIN PROVIDING MONOCLONAL ANTIBODY TREATMENTS TO INDIVIDUALS TO ENSURE THEY DID NOT FACE SEVERE ILLNESS OR HOSPITALIZATION DUE TO COVID-19. TO DATE, 2,395 INDIVIDUALS HAVE RECEIVED THIS TREATMENT SINCE IT WAS FIRST OFFERED IN DECEMBER 2020. TO ENSURE THAT TRANSPORTATION BARRIERS WOULD NOT PREVENT SOMEONE FROM RECEIVING THIS LIFE-SAVING TREATMENT, CHRISTIANACARE'S CENTER FOR VIRTUAL HEALTH AND COMMUNITY HEALTH DEPARTMENT WORKED TOGETHER TO CREATE A PIPELINE TO PROVIDE TRANSPORTATION THROUGH ROUNDTRIP FOR THOSE RECEIVING THESE TREATMENTS. IN FY21, 27 INDIVIDUALS RECEIVED FREE TRANSPORTATION FROM THEIR HOMES TO THE NEWARK CAMPUS TO RECEIVE MONOCLONAL ANTIBODY TREATMENTS. ALONG WITH TESTING, VACCINATION, AND TREATMENT, OUR COMMUNITY TEAMS CONTINUE TO PROVIDE EDUCATION IN THE COMMUNITY REGARDING COVID-19. WE EXPECT TO CONTINUE TO ADAPT AS NEEDED TO BEST SERVE OUR PATIENTS AND COMMUNITIES AS WE CONTINUE TO RESPOND TO THE HEALTH NEEDS OF THE COMMUNITY WHILE THE COVID-19 PANDEMIC CONTINUES. MORE HIGHLIGHTS FROM THIS FISCAL YEAR THAT CHRISTIANACARE HAS UNDERTAKEN TO ADDRESS THE AREAS OF NEED IDENTIFIED IN THE CHNA ARE DESCRIBED BELOW. PLEASE SEE THE CHRISTIANACARE CHIP AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-IMPLEMENTATION-PLAN/ FOR A COMPLETE DESCRIPTION OF HOW CHRISTIANACARE IS ADDRESSING THE IDENTIFIED AREAS OF NEED. 1. SOCIAL DETERMINANTS OF HEALTH IN FY19, CHRISTIANACARE'S OFFICE OF HEALTH EQUITY DESIGNED THE COMMUNITY INVESTMENT FUND IN PARTNERSHIP WITH CHRISTIANACARE'S FINANCE DEPARTMENT. IN THE 2020 FISCAL YEAR, CHRISTIANACARE GAVE NEARLY $2,000,000 IN COMMUNITY INVESTMENT FUNDING TO 32 COMMUNITY ORGANIZATIONS ACROSS THE STATE. DUE TO THE DISRUPTION AND FINANCIAL UNCERTAINTY CAUSED BY THE PANDEMIC, THE OFFICE OF HEALTH EQUITY WAS UNABLE TO PROVIDE COMMUNITY INVESTMENT FUNDING IN FY21, BUT AS OF THIS WRITING, CHRISTIANACARE HAS SELECTED THE SECOND ROUND OF COMMUNITY ORGANIZATIONS TO RECEIVE FY22 COMMUNITY INVESTMENT FUNDING, WHICH WE LOOK FORWARD TO REPORTING ON IN OUR NEXT FILING. CHRISTIANACARE HAS CONTINUED ITS INVOLVEMENT IN THE PURPOSE BUILT COMMUNITIES' REACH RIVERSIDE COMMUNITY DEVELOPMENT INITIATIVE. IN MARCH 2019, CHRISTIANACARE MADE A GIFT OF $1,000,000 TO THE INITIATIVE IN SUPPORT OF COMMUNITY HEALTH AND YOUTH DEVELOPMENT PROGRAMS IN RIVERSIDE, ONE OF WILMINGTON'S OLDEST AND MOST UNDERSERVED COMMUNITIES. IN FY20, CHRISTIANACARE'S CHIEF HEALTH EQUITY OFFICER, BETTINA TWEARDY RIVEROS, SERVED AS A MEMBER ON THE REACH RIVERSIDE BOARD AND AS A CO-CHAIR OF THE HEALTH, WELLNESS, AND SAFETY COMMITTEE. IN FY21, THE CHIEF HEALTH EQUITY OFFICER CONTINUED SERVING AND AS DESCRIBED ABOVE, CHRISTIANACARE NOW HAS A VIRTUAL HEALTH PRIMARY CARE PRACTICE LOCATED AT KINGSWOOD COMMUNITY CENTER. BRINGING EASILY ACCESSIBLE HEALTHCARE INTO THE COMMUNITY WAS ONE OF THE GOALS OF THE INITIATIVE THAT WE WERE EAGER TO HELP THE COMMUNITY MEET. PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) THE OFFICE OF HEALTH EQUITY LAUNCHED UNITE DELAWARE IN NOVEMBER 2019. UNITE DELAWARE IS A COORDINATED CARE NETWORK OF HEALTH AND SOCIAL SERVICE PROVIDERS CONNECTED THROUGH A SHARED TECHNOLOGY PLATFORM, UNITE US, WHICH ENABLES ALL ORGANIZATIONS ON THE PLATFORM TO SEND AND RECEIVE REFERRALS TO ADDRESS INDIVIDUALS' SOCIAL AND HEALTH NEEDS. THERE ARE CURRENTLY 156 PARTICIPATING ORGANIZATIONS FROM THROUGHOUT THE STATE OF DELAWARE ON THE PLATFORM THAT CAN ADDRESS A VARIETY OF SOCIAL AND HEALTH NEEDS. IN FY21, CHRISTIANACARE PARTNERED WITH DELAWARE 211 TO BRING THEM ONBOARD THE UNITE US PLATFORM TO ADDRESS ANY NEED THAT MAY NOT BE MET BY THE CURRENT PARTICIPATING PARTNER. THE DELAWARE 211 PARTNERSHIP ENSURES THAT NO DELAWAREAN WHO SEEKS HELP THROUGH UNITE DELAWARE WILL LEAVE EMPTY HANDED. IN FY21, CHRISTIANACARE ALSO BEGAN WORKING WITH UNITE US TO INTEGRATE THE PLATFORM INTO THE ELECTRONIC HEALTH RECORD TO ENSURE EASIER ACCESS TO ADDRESS PATIENTS' NEEDS IN CLINICAL SETTINGS. ANOTHER COMPREHENSIVE WAY IN WHICH CHRISTIANACARE ADDRESSES SOCIAL DETERMINANTS OF HEALTH IS THE DELAWARE MEDICAL LEGAL PARTNERSHIP (MLP) CREATED IN PARTNERSHIP WITH DELAWARE'S COMMUNITY LEGAL AID SOCIETY, INC. ("CLASI"). THE MLP PROVIDES FREE, CIVIL LEGAL SERVICES TO LOW-INCOME PATIENTS, ADULTS, AND CHILDREN WHO ARE FACING LEGAL MATTERS OR NEEDS THAT MAY NEGATIVELY IMPACT THEIR HEALTH OR LEGAL MATTERS OR NEEDS WHICH MAY HAVE BEEN CREATED OR AGGRAVATED BY A PERSON'S HEALTH ISSUES. SOME OF THE MATTERS ADDRESSED THROUGH THIS PROGRAM ARE SAFE HOUSING, PREVENTION OF SUBSIDIZED AND PUBLIC HOUSING EVICTIONS, ASSISTANCE OBTAINING OR PRESERVING INCOME MAINTENANCE AND GOVERNMENT BENEFITS, ACCESS TO SOCIAL SERVICES, APPROPRIATE EDUCATIONAL SERVICES, HEALTH INSURANCE, AND ACCESS TO HEALTH CARE. IN ANTICIPATION THAT THE PANDEMIC WOULD EXACERBATE EXISTING LEGAL NEEDS IN THE AREAS OF HOUSING, UNEMPLOYMENT, DOMESTIC VIOLENCE, AND OTHER AREAS FOR ALREADY VULNERABLE POPULATIONS, CHRISTIANACARE EXPANDED ITS CONTRACT WITH CLASI. WE SERVED 274 INDIVIDUALS IN THE MLP PROGRAM IN FY21, MORE THAN DOUBLE THE NUMBER THAT WERE SERVED IN THE PRIOR FISCAL YEAR. CHRISTIANACARE CONTINUES TO ADDRESS SOCIAL DETERMINANTS OF HEALTH THROUGH ITS COMMITMENT TO A COMMUNITY HEALTH WORKERS (CHW) PROGRAM. AS DELAWARE TRANSITIONS FROM VOLUME TO VALUE, WE ARE TAKING ADVANTAGE OF THE OPPORTUNITY TO DEVELOP A STANDARDIZED, SCALABLE, SUSTAINABLE CHW PROGRAM. CHRISTIANACARE CONTINUES TO PARTNER WITH UNIVERSITY OF PENNSYLVANIA'S CENTER FOR COMMUNITY HEALTH WORKERS' IMPACT TEAM TO ENSURE ADHERENCE TO THE MODEL AND CONTINUED SUCCESS. EMERGENCY DEPARTMENT CHW PROGRAM CHRISTIANACARE'S EMERGENCY DEPARTMENT'S CHW PROGRAM LAUNCHED ON FEBRUARY 1, 2021 AND PROVIDES THREE MONTHS OF LONGITUDINAL SUPPORT TO HIGH ED UTILIZERS AT THE WILMINGTON HOSPITAL IN ORDER TO ASSESS AND ADDRESS THEIR SOCIAL AND ENVIRONMENTAL BARRIERS TO HEALTH. THE TEAM CONSISTS OF TWO COMMUNITY HEALTH WORKERS WHO AIM TO MEET ED PATIENTS AT BEDSIDE, WHEN POSSIBLE, AND CONNECT THEM WITH PRIMARY CARE AND LONG-TERM SUPPORT. THE GOAL OF THE TEAM IS TO INCREASE PATIENTS' ACCESS TO CARE WHILE IDENTIFYING AND ACHIEVING THEIR PERSONAL GOALS AND SOCIAL NEEDS. ELIGIBILITY CRITERIA: - 2 OR MORE ED VISITS WITHIN THE LAST 90 DAYS AT THE WILMINGTON HOSPITAL DURING THIS FISCAL YEAR THE OBJECTIVES OF THE EMERGENCY DEPARTMENT'S CHW PROGRAM WERE TO REACH OUR MOST VULNERABLE PATIENTS FREQUENTING THE ED, ASSESS AND ADDRESS THEIR SOCIAL DETERMINANTS OF HEALTH, IDENTIFY AND ACHIEVE PATIENTS' PERSONAL GOALS, INCREASE THEIR ACCESS TO PRIMARY CARE AND POST HOSPITAL FOLLOW-UP VISITS, IMPROVE PATIENTS' CHRONIC CONDITION LIKE DIABETES AND HYPERTENSION, AND REDUCE 30-DAY READMISSION RATES AND ED UTILIZATION. THE EMERGENCY DEPARTMENT'S CHW PROGRAM IS IN ITS EARLY STAGES AND CURRENTLY HAS SUCCESSFULLY ENROLLED APPROXIMATELY 30 PATIENTS. ENROLLMENT OF THIS PATIENT POPULATION IS UNDERSTANDABLY DIFFICULT DUE TO SEVERE MENTAL HEALTH DIAGNOSES AND THE FACT THAT MANY ELIGIBLE PATIENTS ARE HOMELESS. OVER THE NEXT FISCAL YEAR, THE EMERGENCY DEPARTMENT'S CHW PROGRAM IS GOING TO FOCUS ON ITS OPERATIONAL PROCESSES, SPECIFICALLY TRANSITIONING PROGRAM DOCUMENTATION INTO THE HEALTHECARE PLATFORM. ADDITIONALLY, A ROBUST EVALUATION PLAN WILL BE DEVELOPED TO ASSESS THE PROGRAM'S IMPACT ON PATIENT EXPERIENCE, PATIENT CENTERED GOALS, SOCIAL DETERMINANTS OF HEALTH, ACCESS TO CARE, CHRONIC DISEASE MANAGEMENT, AND HOSPITAL UTILIZATION. PRIMARY CARE CHW PROGRAM CHWS ADDRESS THE SOCIAL DETERMINANTS THAT AFFECT A PATIENT'S OVERALL HEALTH AND TREATMENT OUTCOMES BY CONNECTING THEM TO RESOURCES AND WRAPAROUND SUPPORT WITHIN THEIR COMMUNITY. THE PRIMARY CARE CHWS WORK WITH ELIGIBLE PATIENTS FOR SIX MONTHS AT CHRISTIANACARE'S MAP 2, SMYRNA, FAMILY COMMUNITY MEDICINE AND WILMINGTON ADULT MEDICINE PRACTICES. ELIGIBILITY CRITERIA: - MEDICAID OR MEDICAID ELIGIBLE - HYPERTENSION OR DIABETES - OR HIGH ED UTILIZATION (2 OR MORE ED VISITS IN THE PAST 90 DAYS) DURING THIS FISCAL YEAR THE PROGRAM OBJECTIVES WERE TO REACH OUR MEDICAID PATIENT POPULATION DIAGNOSED WITH HYPERTENSION AND DIABETES, ASSESS AND ADDRESS THEIR SOCIAL DETERMINANTS OF HEALTH, IDENTIFY AND ACHIEVE PATIENTS' PERSONAL GOALS, DECREASE NO SHOW PRIMARY CARE APPOINTMENT RATES, IMPROVE PATIENTS' SELF-MANAGEMENT OF CHRONIC CONDITION, AND REDUCE 30-DAY READMISSION RATES AND ED UTILIZATION. FROM JULY 2020 THROUGH JUNE 2021 THE PRIMARY CARE CHW PROGRAM ENROLLED 231 NEW PATIENTS, 69 OF WHOM HAVE SUCCESSFULLY GRADUATED FROM THE PROGRAM. THESE PATIENTS ARE 55 YEARS OLD ON AVERAGE; 70% BLACK/AFRICAN AMERICAN, 27% WHITE AND 3% OTHER. SIXTY-SEVEN PERCENT ARE FEMALES, AND 92% ARE NON-HISPANIC/NON-LATINO. SCHOOL-BASED HEALTH CENTERS CHW PROGRAM THE SCHOOL-BASED HEALTH CENTERS (SBHC) ARE A PARTNERSHIP BETWEEN CHRISTIANACARE, THE RESPECTIVE SCHOOL DISTRICTS, AND THE DELAWARE DIVISION OF PUBLIC HEALTH. HEALTHCARE IN THE SBHC IS PROVIDED BY A MULTI-DISCIPLINARY TEAM. A NURSE PRACTITIONER, A LICENSED CLINICAL SOCIAL WORKER/ LICENSED PROFESSIONAL COUNSELOR OF MENTAL HEALTH, AND A REGISTERED DIETITIAN PROVIDE CARE TO STUDENTS DURING SCHOOL HOURS. THERE ARE 21 CHRISTIANACARE OPERATED SBHCS. IN FY21, 9 SCHOOLS RECEIVED CHW SERVICES 1-2 DAYS A WEEK, INCLUDING MCKEAN, HOWARD, WILLIAM PENN, CHRISTIANA, HODGSON, NEWARK, GLASGOW, SHORTLIDGE, AND WARNER. THESE SCHOOLS WERE SELECTED TO HAVE A CHW BASED ON HIGH NEEDS, DISPARITIES, AND LOW INSURANCE ENROLLMENT. SBHCS ARE AN ESSENTIAL ACCESS POINT FOR MEDICAL AND BEHAVIORAL HEALTH CARE FOR STUDENTS WHO MAY NOT OTHERWISE BE ABLE TO RECEIVE TREATMENT, DUE TO A VARIETY OF FACTORS INCLUDING PARENT WORK SCHEDULES, TRANSPORTATION, AND COVERAGE. FOR THOSE WITH AN EXISTING PROVIDER, SBHCS DO NOT TAKE THE PLACE OF THE STUDENT'S PEDIATRICIAN OR FAMILY DOCTOR, AND SBHC DOCTORS AND NURSES WILL WORK WITH THE STUDENT'S PRIMARY CARE PROVIDER TO CARE FOR THE STUDENT. WHEN APPLICABLE AND APPROPRIATE, AND WITH PARENT/GUARDIAN PERMISSION, THE SBHC WILL WORK TO SHARE MEDICAL INFORMATION WITH STUDENTS' PRIMARY CARE PROVIDERS TO PREVENT ANY DUPLICATION OF HEALTH CARE SERVICE. ELIGIBILITY CRITERIA: - STUDENT AT ONE OF THE SCHOOLS WITH A SBHC - STUDENTS' PARENT(S)/GUARDIAN(S) COMPLETES REGISTRATION, CONSENT, AND HEALTH HISTORY FORMS - UP-TO-DATE INSURANCE INFORMATION IS NEEDED IF THE STUDENT IS INSURED, HOWEVER, INSURANCE IS NOT REQUIRED. NO CO-PAY, CO-INSURANCE OR DEDUCTIBLE WILL BE CHARGED, AND NO ONE WILL BE TURNED AWAY BASED ON ABILITY TO PAY. DURING THIS FISCAL YEAR THE PRIMARY OBJECTIVES OF THE SBHC CHWS WAS SLIGHTLY DIFFERENT THAN PREVIOUS YEARS DUE TO COVID19. IN ADDITION TO HELPING STUDENTS AND THEIR FAMILIES IDENTIFY FINANCIAL BARRIERS TO HEALTHCARE, CONNECTING THEM TO HEALTHCARE SERVICES, SUBMITTING SOCIAL NEED REFERRALS, PROVIDING RESOURCES, AND HELPING WITH SCHOOL TRANSITIONS, SBHC CHWS PROVIDED SUPPORT FOR COMMUNITY HEALTH PROGRAMS, COVID19 TESTING SITES, AND VACCINATION EVENTS. IN OCTOBER 2020, SBHC CHWS RETURNED TO THEIR ASSIGNED SCHOOL SITES. DURING THIS TIME CHRISTIANACARE STAFF MADE IMPROVEMENTS TO PREVIOUS WORKFLOWS AND IMPLEMENTED NEW POLICIES AND PROCEDURES TO ENSURE COVID19 SAFETY. OUTREACH EFFORTS CONTINUED TO INCREASE AS WELL AS OPPORTUNITIES FOR COLLABORATION. REFERRALS FILTERED IN AT A STEADY PACE AND THE TEAM WAS EQUIPPED WITH THE NECESSARY TOOLS TO SUPPORT THE NEEDS OF STUDENTS AND FAMILIES. THROUGHOUT THE SCHOOL YEAR THE SBHC CHWS SERVED 1,193 UNIQUE STUDENTS AND THEIR FAMILIES. CHWS HELPED THEM COMBAT FINANCIAL BARRIERS TO HEALTHCARE BY CONNECTING 21% TO HEALTH INSURANCE. CHWS IDENTIFIED STUDENTS THAT DID NOT HAVE A PRIMARY CARE PROVIDER (17%) AND CONNECTED THEM WITH A PCP. THEY ALSO PROVIDED 27% OF THE STUDENTS WITH FOOD ASSISTANCE, 10% WITH SCHOOL TRANSITION SUPPORT, 5% WITH CAREER SUPPORT, AND 4% WITH TRANSPORTATION TO HEALTHCARE APPOINTMENTS. PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) THIS UPCOMING SCHOOL YEAR, THE SBHC CHW PROGRAM WILL BE IMPLEMENTING THE ADAPTED IMPACT PENN MEDICINE MODEL. CHWS WILL PROACTIVELY SEEK STUDENTS TO ENROLL IN THE PROGRAM FOR EITHER 3 OR 6 MONTHS MAINTAINING A CASE LOAD OF AT LEAST 6 STUDENTS PER SCHOOL (3 SCHOOLS PER CHW). CHWS WILL CONTINUE TO ACCEPT REFERRALS FOR STUDENTS WITH ONE-TIME NEEDS THAT DO NOT MEET THE CRITERIA FOR ENROLLMENT. THE SBHC CHW PROGRAM WILL ALSO BE GAINING 2 NEW FTES TO EXPAND THIS WORK TO 6 MORE SCHOOLS (A.I. DUPONT, BRANDYWINE, CONCORD, DELCASTLE, MCKEAN, AND MOUNT PLEASANT) LEAVING ONLY 5 SITES WITHOUT AN ASSIGNED CHW. CONTINUED ADJUSTMENTS AND IMPROVEMENTS TO THE PROGRAM WILL BE MADE AS NEEDED. WOMEN'S HEALTH CHW PROGRAM MATERNAL HEALTH CAN BECOME A HEALTH ISSUE NOT ONLY FOR BABY, BUT FOR THE EXPECTING MOTHER AS WELL. CHRISTIANACARE IS POISED TO TRANSFORM HEALTHCARE FOR MOTHERS AND BABIES IN DELAWARE WITH A COMMITTED INVESTMENT TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH THROUGH WRAP AROUND SERVICES. WOMEN'S HEALTH CHWS WORK WITH OUTPATIENT MOTHERS AT SUITE 1900 WOMEN'S HEALTH AND WILMINGTON WOMEN'S HEALTH, AND WITH CHRISTIANACARE INPATIENT MOTHERS TO SUPPORT THEM DURING AND AFTER PREGNANCY. ELIGIBILITY CRITERIA: - MEDICAID OR MEDICAID ELIGIBLE - LIVES IN ONE OF THE FOLLOWING ZIP CODES: 19701, 19702, 19711, 19713, 19720, 19801, 19802, 19804, 19805, 19977 - AND MEETS AT LEAST ONE OF THE FOLLOWING CRITERIA: - A HISTORY OF POOR BIRTH OUTCOMES (E.G., LOW BIRTH WEIGHT DELIVERY, PREMATURE BIRTH, INFANT DEATH, FETAL DEATH/STILLBIRTH) - A CHRONIC DISEASE (E.G., DIABETES, HIGH BLOOD PRESSURE). - LATE ENTRY INTO PRENATAL CARE - NO PRENATAL CARE - RISK FOR BIRTH DEFECTS - EXPOSURE OR FAMILY HISTORY - MENTAL ILLNESS - BMI AT OR ABOVE 30. DURING THIS FISCAL YEAR THE OBJECTIVES OF THE WOMEN'S HEALTH CHW PROGRAM WERE TO REACH OUR HIGH-RISK PREGNANT PATIENT POPULATION, ASSESS AND ADDRESS THEIR SOCIAL DETERMINANTS OF HEALTH, IDENTIFY AND ACHIEVE PATIENTS' PERSONAL GOALS, INCREASE POST-PARTUM FOLLOW-UP VISITS, IMPROVE THE USAGE OF LONG-TERM CONTRACEPTION, AND REDUCE 42-DAY READMISSIONS POST-DELIVERY DISCHARGE. FROM JULY 2020 THROUGH JUNE 2021 THE WOMEN'S HEALTH CHW PROGRAM ENROLLED 128 PATIENTS, 86 OF WHICH HAVE SUCCESSFULLY GRADUATED FROM THE PROGRAM. THESE PATIENTS ARE 29 YEARS OLD ON AVERAGE, 48% BLACK/AFRICAN AMERICAN, 25% WHITE, 27% OTHER AND 57% NON-HISPANIC/NON-LATINO. FOOD INSECURITY AS THE LARGEST PRIVATE EMPLOYER IN DELAWARE, WE RECOGNIZE THAT OUR CAREGIVERS REPRESENT OUR COMMUNITIES. BASED ON STATE STATISTICS, NEARLY 1,900 OF OUR MORE THAN 13,000 CHRISTIANACARE CAREGIVERS COULD BE FACING FOOD INSECURITY. ON MAY 17, 2021, CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT IN THE OFFICE OF HEALTH EQUITY RELAUNCHED THE EMPLOYEE FOOD PANTRIES AT BOTH OUR CHRISTIANACARE NEWARK AND WILMINGTON CAMPUSES. THESE ANONYMOUS FOOD PANTRIES, AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK, ARE AVAILABLE TO ALL EMPLOYEES IN NEED OF FOOD ASSISTANCE. TO BEST SERVE AND MEET THE NEEDS AND PREFERENCES OF OUR CAREGIVERS, WE REQUESTED FEEDBACK ON THE TYPES OF NON-PERISHABLE FOODS INCLUDED IN THE FOOD BOXES. THE FOOD BOXES WERE VETTED BY OUR CHRISTIANACARE REGISTERED DIETICIANS TO ENSURE THEY WERE NUTRITIONALLY BALANCED. FOOD ITEMS IN A SINGLE BOX INCLUDE: - PACKAGED TUNA, CANNED CHICKEN, QUICK OATS, WHOLE WHEAT SPAGHETTI, SPAGHETTI SAUCE, MACARONI AND CHEESE, EVAPORATED MILK, YELLOW RICE, BLACK BEANS, JALAPENOS, CARROTS, CORN, GREEN BEANS, PEACHES, PINEAPPLES, UNSWEETENED APPLESAUCE, PEANUT BUTTER, JELLY, DRIED CRANBERRIES IN ADDITION TO THE FOOD, THE BOXES INCLUDE A PACKET WITH COMMUNITY RESOURCE INFORMATION, ALONG WITH HEALTHY RECIPES THAT USE INGREDIENTS PROVIDED IN THE BOX. RECIPES INCLUDE CANNED CHICKEN ENCHILADAS, TUNA FISH CASSEROLE, VEGETABLE RICE, AND OATMEAL MUFFINS WITH DRIED CRANBERRIES. FROM MAY 2021 THROUGH JULY 2021, CHRISTIANACARE PROVIDED 125 FOOD BOXES, WITH AN AVERAGE COST OF $21 PER BOX, TO OUR CAREGIVERS. CHRISTIANACARE IS ALSO CONTINUING ITS LONG-STANDING PARTNERSHIP WITH URBAN ACRES TO SUPPORT PRODUCE DELIVERY. THROUGH THIS PARTNERSHIP, FROM JULY 2020 THROUGH JUNE 2021 WE PROVIDED 190 AT-RISK, FOOD INSECURE, PATIENTS WITH FRESH, LOCAL PRODUCE ON A WEEKLY BASIS FOR A MINIMUM OF 6 MONTHS. - PATIENTS RECEIVE A $10 BAG OF PRODUCE APPROXIMATELY 50/50 FRUITS AND VEGETABLES - THE VARIETY OF FRUITS AND VEGETABLES VARIED SEASONALLY. HOUSEHOLDS OF 5 OR MORE RECEIVE 2 BAGS. THE MAJORITY OF PROGRAM PARTICIPANTS WERE FEMALES (81%) AND NON-HISPANIC (68%). HALF OUR PATIENTS WERE BLACK OR AFRICAN AMERICAN (51%), 24% WERE WHITE AND THE REMAINING QUARTER IDENTIFIED AS OTHER. - NINETY PERCENT OF PROGRAM PARTICIPANTS WERE VERY SATISFIED OR SATISFIED WITH THE PROGRAM AND THE MAJORITY RATED THE QUALITY OF PRODUCE AS EXCELLENT OR VERY GOOD (78%). - NEARLY ALL THE PATIENTS FELT THEY ATE HEALTHIER FOODS BECAUSE OF THE PROGRAM (95%) AND 65% OF PATIENTS WOULD NOT HAVE HAD ENOUGH FOOD TO EAT EACH WEEK WITHOUT THE DELIVERED PRODUCE. - 81% OF PARTICIPANTS CONSUMED ALL THE PRODUCE THAT WAS PROVIDED. THOSE WHO DID NOT EAT ALL THE PRODUCE SAID IT WAS BECAUSE THEY: 1) DID NOT KNOW HOW TO PREPARE IT, 2) DID NOT HAVE THE APPROPRIATE EQUIPMENT, 3) DID NOT LIKE THE TASTE, 4) IT WAS TOO MUCH FOOD. - 50% OF PATIENTS WERE NOT ENROLLED IN SNAP AND 81% OF THOSE UNENROLLED REQUESTED AND RECEIVED ENROLLMENT ASSISTANCE FROM OUR CHWS. PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, COMMUNITY HEALTH DEPARTMENT, LAUNCHED THE DELAWARE FOOD FARMACY (DFF) IN COLLABORATION WITH PRIMARY CARE, NUTRITION SERVICES, BEHAVIORAL HEALTH, AND IREACH (CHRISTIANACARE INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH). CHRISTIANACARE PARTNERED WITH LUTHERAN COMMUNITY SERVICES TO DEVELOP AND LAUNCH THE DFF, A PROGRAM THAT ADDRESSES HEALTHCARE INEQUITIES BY PROVIDING HOLISTIC CARE WITH RADICAL CONVENIENCE. DFF IS DESIGNED TO HELP MEDICAID AT-RISK PATIENTS WITH UNCONTROLLED DIABETES, HYPERTENSION AND/OR HEART FAILURE SELF-MANAGE THEIR CHRONIC CONDITION THROUGH A NUTRITION-BASED COMPREHENSIVE CARE MODEL - TREATING THE "WHOLE PERSON." - THE SIX-MONTH PROGRAM PROVIDES PATIENT WITH PERSONALIZED DISEASE MANAGEMENT, NUTRITIONAL EDUCATION, HEALTH PSYCHOLOGY, SOCIAL CARE ASSISTANCE, AND MEDICALLY TAILORED FOOD BOXES. - FOOD BOXES ARE DELIVERED WEEKLY TO PATIENTS' HOME. THE FOOD PROVIDED IN THESE BOXES CONSISTS OF THE FOLLOWING DASH EATING PLAN FOOD GROUPS: FRESH VEGETABLES, FRESH FRUITS, WHOLE GRAINS, LOW-FAT DAIRY, LEAN MEATS/POULTRY/FISH, AND NUTS/SEEDS/LEGUMES. - EACH WEEK, PATIENTS RECEIVED ENOUGH FOOD TO FEED THEM AND THEIR FAMILIES FOR 10 MEALS. FOR EXAMPLE, A FAMILY OF 4 WOULD RECEIVE ENOUGH FOOD EACH WEEK TO MAKE 40 SEPARATE MEALS. FROM MARCH 2021 THROUGH JUNE 2021 DFF HAS SERVED 13 PATIENTS AND A TOTAL OF 38 COMMUNITY MEMBERS, PROVIDING ENOUGH FOOD FOR OVER 1,800 MEALS. ADDITIONALLY, EACH ENROLLED PARTICIPANT RECEIVED A $200 DFF WELCOME KIT. KIT ITEMS INCLUDE: MEDIUM NON-STICK POT AND PAN, CHEF'S KNIFE, CUTTING BOARD SET, MIXING BOWL SET, MEASURING SPOONS, MEASURING CUPS, STRAINER, OVEN MITTS, VEGETABLE PEELER, CAN OPENER, TONGS, SPATULA, TUPPERWARE, STARTER SPICE KIT, AND A BASIC COOKING 101 COOKBOOK. OVER HALF OF PROGRAM PARTICIPANTS WERE FEMALES (61%), NEARLY ALL WERE NON-HISPANIC (92%), 62% OF PATIENTS WERE BLACK OR AFRICAN AMERICAN, APPROXIMATELY A QUARTER WERE WHITE (23%), AND THE REMAINING 15% IDENTIFIED AS OTHER. SEVENTY-SEVEN PERCENT OF PATIENTS HAD POORLY CONTROLLED DIABETES, 70% WERE DIAGNOSED WITH POORLY CONTROLLED HYPERTENSION AND 7% HAD CONGESTIVE HEART FAILURE, WITH OVER HALF EXPERIENCING COMORBIDITIES (56%). MOST PATIENTS ENROLLED (88%) WERE IDENTIFIED AS BEING FOOD INSECURE HOUSING THIS YEAR, CHRISTIANACARE PROVIDED $50,000 IN FUNDING TO HOUSING ALLIANCE DELAWARE, A STATEWIDE NON-PROFIT ORGANIZATION THAT ADDRESSES AFFORDABLE HOUSING NEEDS AND HOMELESSNESS, TO CONTINUE ITS PROGRAM THAT WILL SERVE CHRONICALLY HOMELESS INDIVIDUALS AT RISK OF POOR HEALTH OUTCOMES BY OFFERING FINANCIAL ASSISTANCE TO REDUCE ECONOMIC BARRIERS TO EXITING HOMELESSNESS AND ENGINEERING A MORE EFFICIENT AND COMPREHENSIVE PROCESS TO ENSURE HOSPITALIZED HOMELESS INDIVIDUALS ARE CONNECTED TO THE HEALTH AND HOUSING SERVICES THEY NEED. A QUALITATIVE ASSESSMENT TO ALLOW THOSE EXPERIENCING CHRONIC HOMELESSNESS TO SHARE THEIR BARRIERS TO RECEIVING BEHAVIORAL, MEDICAL, AND SOCIAL NEEDS IS ALSO CONDUCTED THROUGH THIS PROGRAM. THIS IS THE SECOND YEAR OF FUNDING THIS PROGRAM. PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) IN DECEMBER 2020, NEW CASTLE COUNTY GOVERNMENT PURCHASED A HOTEL ALONG I-95 AND RAPIDLY TRANSFORMED IT INTO AN EMERGENCY HOMELESS SHELTER. CHRISTIANACARE SERVED AS A PARTNER TO THE COUNTY DURING THIS PROCESS AND IS NOW ON-SITE PROVIDING MEDICAL CARE TO THE RESIDENTS. WHILE THE IMPACT OF THE PANDEMIC DID NOT ALLOW CHRISTIANACARE TO FUND HOUSING AT THE SAME LEVEL IT DID IN FY20, HOUSING INITIATIVES IN FY22 ARE ALREADY BEING FUNDED. AFFORDABILITY OF CARE CHRISTIANACARE'S FINANCIAL ASSISTANCE PROGRAM ALLOWS ELIGIBLE INDIVIDUALS TO RECEIVE MEDICALLY NECESSARY SERVICES AT NO COST OR AT A 15% STANDARD DISCOUNT. CHRISTIANACARE ALSO OFFERS THE HEALTH GUIDES PROGRAM. HEALTH GUIDES FUNCTION AS COLLABORATIVE, INTERDEPENDENT MEMBERS OF THE PRIMARY CARE PRACTICES AND ADVOCATES OF THEIR COMMUNITY BY SEEKING TO SUPPORT PRIMARILY UNINSURED, UNDERINSURED, AND UNDERREPRESENTED DELAWAREANS IN ALL ASPECTS OF HEALTH CARE. SERVING AS THE "BRIDGE" BETWEEN THE COMMUNITY AND HEALTH CARE PROVIDERS, HEALTH GUIDES PROVIDE ASSISTANCE WITH ACCESSING APPROPRIATE HEALTH CARE SERVICES, CONNECTING TO HEALTH INSURANCE AND FINANCIAL ASSISTANCE OPPORTUNITIES AS WELL AS TO COMMUNITY RESOURCES OUTSIDE THE HEALTH SYSTEM, AND PROVIDING HEALTH AND WELLNESS INFORMATION WITH A FOCUS ON PREVENTION. DURING THIS FISCAL YEAR THERE HAVE BEEN THREE PRIMARY OBJECTIVES FOR THE HEALTH GUIDE PROGRAM. FIRST, IDENTIFY FINANCIAL BARRIERS TO HEALTHCARE. THIS MAY INCLUDE CONNECTION TO MEDICAID, THE MARKETPLACE OR FINANCIAL ASSISTANCE PROGRAMS. SECOND, CONNECT TO HEALTHCARE SERVICES. THIS INCLUDES ANYTHING FROM FINDING A DOCTOR OR SPECIALTY SERVICE, TO HELPING SCHEDULE APPOINTMENTS. THREE, REFER PATIENTS TO COMMUNITY-BASED RESOURCES SUCH AS SOCIAL SUPPORT SERVICES, COMMUNITY-BASED PROGRAMMING, AND EDUCATION TO IMPROVE HEALTH AND WELLNESS. CHRISTIANACARE ALSO COLLECTED DEMOGRAPHIC DATA OF PATIENTS THAT HEALTH GUIDES SERVE TO BETTER UNDERSTAND THE POPULATION AND IDENTIFY NEEDS WITHIN SPECIFIC COMMUNITIES. THROUGHOUT THE PAST FISCAL YEAR, THE HEALTH GUIDES SERVED 1,964 UNIQUE PATIENTS. PATIENTS WERE 53 YEARS OLD ON AVERAGE; 41% WHITE, 31% BLACK/AFRICAN AMERICAN, 4% ASIAN/ASIAN AMERICAN, 13% IDENTIFIED AS OTHER RACE AND 11% EITHER DIDN'T KNOW THEIR RACE OR PREFERRED NOT TO DISCLOSE. THE MAJORITY WERE NON-HISPANIC (81%) AND FEMALE (57%). THE HEALTH GUIDES IDENTIFIED PATIENTS WITH FINANCIAL BARRIERS AND CONNECTED 35% OF PATIENTS TO HEALTH INSURANCE AND 20% TO FINANCIAL ASSISTANCE PROGRAMS. FOURTEEN PERCENT OF PATIENTS WERE CONNECTED TO HEALTHCARE SERVICES LIKE A PRIMARY CARE PROVIDER OR SPECIALTY CARE. FOR PATIENTS UNABLE TO PAY FOR THEIR MEDICATION (34%), HEALTH GUIDES ENROLLED THEM INTO PRESCRIPTION SAVINGS PROGRAMS. THE HEALTH GUIDES ALSO ASSISTED WITH CONNECTING PATIENTS TO HEALTH AND FINANCIAL EDUCATION 7%, FOOD PROGRAMING, 6% AND TRANSPORTATION, 1%. EDUCATION IN FY 21, CHIEF HEALTH EQUITY OFFICER BETTINA TWEARDY RIVEROS CONTINUED TO SERVE AS A BOARD MEMBER ON THE DELAWARE BUSINESS ROUNDTABLE EDUCATION COMMITTEE (DBREC) AND DBREC'S EXECUTIVE COMMITTEE, WHICH SEEKS TO IMPROVE PUBLIC EDUCATION IN DELAWARE BY AGGREGATING AND ALIGNING THE RESOURCES OF ROUNDTABLE MEMBERS AND OTHER BUSINESS LEADERS. SHE ALSO ASSUMED THE ROLE AS CHAIR OF THE VISION COALITION TEAM LEADERSHIP TEAM. THE VISION COALITION IS A PUBLIC-PRIVATE PARTNERSHIP COMPOSED OF A BROAD RANGE OF DELAWAREANS WORKING TOGETHER TO IMPROVE DELAWARE'S PUBLIC EDUCATION. CHRISTIANACARE FIRMLY BELIEVES THAT TO BE READY TO LEARN AND EXCEL IN SCHOOL, CHILDREN NEED TO BE HEALTHY, AND THAT REQUIRES ACCESS TO HEALTH CARE, PREVENTION, TREATMENT, AND EDUCATION. CHRISTIANACARE OPERATES 21 SCHOOL-BASED HEALTH CENTERS THROUGHOUT THE STATE. IN 2018, CHRISTIANACARE OPENED ITS FIRST SCHOOL-BASED HEALTH CENTER AT AN ELEMENTARY SCHOOL, WARNER ELEMENTARY IN THE CITY OF WILMINGTON. IN FY20, CHRISTIANACARE OPENED A SECOND SCHOOL-BASED HEALTH CENTER AT WARNER'S SISTER SCHOOL, SHORTLIDGE ELEMENTARY (K-2ND). BOTH SCHOOLS SERVE HIGH-NEED STUDENTS IN THE HEART OF WILMINGTON. THE STATE DOES NOT REIMBURSE FOR THE COSTS OF OPERATING THESE ELEMENTARY SCHOOL-BASED HEALTH CENTERS, AS IT DOES FOR HIGH SCHOOL SBHCS, BUT CHRISTIANACARE DETERMINED THAT THE COMMUNITY NEED WAS SIGNIFICANT AND IS OPERATING BOTH WARNER AND SHORTLIDGE SBHCS BASED ON OUR COMMITMENT TO MEET THAT COMMUNITY NEED. DURING THIS REPORTING YEAR, CHRISTIANACARE'S SCHOOL-BASED HEALTH CENTERS SERVED 13,636 STUDENTS. PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) CHRISTIANACARE'S WORKFORCE PROGRAM AIMS TO EXPOSE HIGH SCHOOL SCHOLARS TO CAREERS IN HEALTH CARE. TYPICALLY, SCHOLARS ARE MISTAKEN IN THINKING THAT THE HEALTH SYSTEM IS PRIMARILY MADE UP OF PROFESSIONALS WEARING WHITE COATS AND/OR SCRUBS. THE PROGRAMMING PROVIDED BY WORK FORCE DEVELOPMENT SETS OUT TO CONFIRM THAT THOSE WEARING WHITE COATS AND SCRUBS ARE NOT THE ONLY PROFESSIONALS IN HEALTHCARE. THE WORK FORCE DEVELOPMENT PROGRAMMING EXPLORES CAREERS IN HEALTH CARE, AIMINGS TO BUILD SUCCESSFUL PARTNERSHIPS AND REDUCE ACHIEVEMENT GAPS. WE EXTEND OUR REACH TO HIGH SCHOOL STUDENTS, SPECIFICALLY THE SYSTEMICALLY OVERLOOKED MEMBERS OF OUR COMMUNITY, TO DEVELOP A PIPELINE FOR A WORKFORCE OF CAREGIVERS THAT REFLECT THE COMMUNITIES WE SERVE. THE WORKFORCE DEVELOPMENT PROGRAM HAS ESTABLISHED MEANINGFUL, LASTING PARTNERSHIPS IN THE COMMUNITY, INCLUDING BUT NOT LIMITED TO WILLIAM PENN HIGH SCHOOL, JOBS FOR DELAWARE GRADS, DELAWARE BIO, THE DEPARTMENT OF EDUCATION, COMMUNITIES IN SCHOOLS, THE DEPARTMENT OF LABOR/TEEN WAREHOUSE, AND THE NATIONAL HEALTH CAREER COLLABORATIVE. DURING FY21, THE WORKFORCE DEVELOPMENT PROGRAM HAS HAD CONSIDERABLE SUCCESSES DESPITE OPERATING DURING THE PANDEMIC. SOME HIGHLIGHTS WERE: - HOSTED THE BACK 2 BASICS VIRTUAL SESSION. THE PANDEMIC PUT A PAUSE ON CHRISTIANACARE'S IN-PERSON JOB SHADOWING OPPORTUNITIES, BUT BECAUSE CAREER PIPELINES AND PATHWAYS REMAIN THE FOUNDATION OF WORKFORCE DEVELOPMENT, WE CREATED VIRTUAL BACK 2 BASICS PROGRAMMING. VIRTUAL SESSIONS WERE HELD TWICE PER MONTH AND SCHOLARS WERE ABLE TO ATTEND A VIRTUAL CAREER FAIR WITH OPPORTUNITY TO ENGAGE AND HAVE ONE-ON-ONE GROUP DIALOGUE WITH HEALTH CARE PROFESSIONALS. - THE WINTER SESSION OF THE HEALTH CAREER COLLABORATIVE WENT VIRTUAL AND WAS COMPLETED IN MARCH 2021. A TOTAL OF 26 WILLIAM PENN HIGH SCHOOL ALLIED HEALTH STUDENTS ENROLLED INTO THE PROGRAM WITH 24 COMPLETING THE WINTER SERIES. - THE WORKFORCE DEVELOPMENT PROGRAM CREATED A MONTHLY NEWSLETTER. THE NEWSLETTER WAS DESIGNED TO KEEP SCHOLARS IN THE KNOW ABOUT COMMUNITY HAPPENINGS, INTRODUCE THEM TO A FEATURED HEALTH CARE PROFESSIONAL, SHARE POETRY, ART AND DESIGN AND PROVIDE A SPACE FOR THEM TO SHARE THEIR TALENTS AS WELL. WE HAD THE PRIVILEGE OF HAVING A PREVIOUS HEALTH CAREER COLLABORATIVE SCHOLAR (WHO WAS IN HIS FIRST YEAR OF COLLEGE AT THE UNIVERSITY OF PENNSYLVANIA) WRITE AN ARTICLE FOR THE NEWSLETTER. - IN OCTOBER 2020, WORKFORCE DEVELOPMENT COLLABORATED WITH THE TEEN WAREHOUSE FOR THE LEARNING FOR CAREERS GRANT FUNDED BY THE DEPARTMENT OF LABOR. CHRISTIANACARE IS PART OF THE EMPLOYEE GROUP FOR THE GRANT. THE GRANT WILL GIVE SCHOLARS AN OPPORTUNITY TO LEARN ABOUT CODING, HTML AND JAVA SCRIPT AND THEN VIRTUALLY SHADOW CHRISTIANACARE'S INNOVATION CENTER. THE SCHOLARS WILL WORK WITH CAREGIVERS AT THE INNOVATION CENTER TO SOLVE A TECHNICAL PROBLEM WITHIN THE HEALTH SYSTEM. OVER THE COURSE OF FY21, 93 STUDENTS WERE ENGAGED BY THE WORKFORCE DEVELOPMENT PROGRAM. WE ARE ALSO PROUD THAT 80 SCHOLARS IN THE FIRST ROUND OF THE WORK FORCE DEVELOPMENT PROGRAMMING HAVE STARTED THEIR FIRST YEAR OF COLLEGE AT SCHOOLS INCLUDING UNIVERSITY OF PENNSYLVANIA, NEUMANN UNIVERSITY AND DEL TECH. TRANSPORTATION IN THE 2016 CHNA, CHRISTIANACARE DECIDED NOT TO ADDRESS TRANSPORTATION AS A COMMUNITY NEED AS WE DID NOT HAVE THE ABILITY TO DO SO. IN 2020, WE BEGAN TO ADDRESS TRANSPORTATION NEEDS BY PARTNERING WITH ROUNDTRIP HEALTH TO PROVIDE CONVENIENT AND FREE TRANSPORTATION TO AND FROM MEDICAL SERVICES FOR THOSE PATIENTS WITH TRANSPORTATION BARRIERS. DURING FY21, THE USE OF ROUNDTRIP WAS SO SUCCESSFUL FOR THE PATIENTS AND CAREGIVERS THAT WE DECIDED TO EXPAND IT TO OTHER AREAS IN FY22. BETWEEN JULY 1, 2020 AND JUNE 30, 2021, 1,493 RIDES WERE GIVEN TO 206 UNIQUE PATIENTS. 2. MENTAL HEALTH AND SUBSTANCE USE DISORDER CHRISTIANACARE STRIVES TO PROVIDE PERSONALIZED AND EFFECTIVE TREATMENT FOR MENTAL HEALTH ILLNESSES AND SUBSTANCE USE DISORDERS. BELOW ARE BRIEF DESCRIPTIONS OF THE BEHAVIORAL HEALTH SERVICES OFFERED AT CHRISTIANACARE. PROJECT ENGAGE: AN EARLY INTERVENTION AND REFERRAL TO SUBSTANCE USE DISORDER TREATMENT PROGRAM DESIGNED TO HELP HOSPITAL PATIENTS WHO MAY BE STRUGGLING WITH ALCOHOL OR DRUG USE. PROJECT ENGAGE COLLABORATES WITH HOSPITAL STAFF TO IDENTIFY AND CONNECT PATIENTS WITH COMMUNITY-BASED TREATMENT PROGRAMS AND OTHER RESOURCES. PROJECT ENGAGE INTEGRATES PEERS IN RECOVERY INTO THE CLINICAL SETTING IN THE HOSPITAL TO MEET WITH PATIENTS AT THEIR BEDSIDE. ALONG WITH THE PATIENT AND HOSPITAL CLINICAL TEAM, PROJECT ENGAGE ALSO WORKS WITH TREATMENT PROVIDERS AND ENSURES TO HELP DEVELOP A DISCHARGE PLAN FOR EACH PATIENT. IN FY 21, PROJECT ENGAGE CONDUCTED 1,614 PATIENT ENGAGEMENTS. PROJECT RECOVERY: PROJECT RECOVERY OFFERS PROFESSIONAL TREATMENT FOR SUBSTANCE USE AND CO-OCCURRING DISORDERS. THE TEAM INCLUDES A PSYCHIATRIST, COUNSELORS, AND A SOCIAL WORKER WHO PERFORM A COMPLETE ASSESSMENT OF HEALTH AND SUBSTANCE USE. TOGETHER WITH THE PATIENT, A COMPREHENSIVE TREATMENT PLAN IS DEVELOPED THAT PUTS THEM ON THE PATH TO A SUBSTANCE-FREE LIFE. PROJECT RECOVERY OFFERS: INDIVIDUAL, GROUP, AND FAMILY THERAPY; MEDICATION-ASSISTED TREATMENT IN AN OFFICE-BASED SETTING; CASE MANAGEMENT; ONGOING CONSULTATION AND COORDINATION WITH DOCTORS OR OTHER PROVIDERS; AND SMOKING CESSATION. ADULT BRIDGE PROGRAM: OUR ADULT BRIDGE PROGRAM GIVES ADULTS RAPID ACCESS TO INDIVIDUALIZED EVALUATION, CARE PLANNING, AND THERAPY. WHEN APPROPRIATE, PATIENTS TRANSFER TO COMMUNITY BASED OR PRIMARY CARE PROVIDERS. EMBEDDED BEHAVIORAL HEALTH CONSULTANTS: CHRISTIANACARE'S INTEGRATED MODEL OF CARE EMBEDS MENTAL HEALTH PROFESSIONALS IN PRIMARY CARE PRACTICES. THIS PRACTICE ENABLES GREATER FOCUS ON WELLNESS, PREVENTION AND WHOLE PERSON CARE. CENTER FOR HOPE AND HEALING: THE CENTER FOR HOPE AND HEALING OFFERS SUPPORT TO PEOPLE IN OUR COMMUNITIES WHO ARE STRUGGLING WITH MENTAL, MEDICAL, AND SOCIAL HEALTH PROBLEMS. THE GOAL OF THE CENTER IS TO GIVE PATIENTS ACCESS TO PROVIDERS WHO CAN HELP STABILIZE THEIR HEALTH AND THEIR LIVES. SPECIALISTS WORK TOGETHER TO QUICKLY STABILIZE PATIENTS' HEALTH AND THEN PUT LONG-TERM SUPPORT IN PLACE WITH OTHER PROVIDERS AND PROGRAMS. THE CENTER OFFERS FLEXIBLE, RESPONSIVE CARE IN A RESPECTFUL, CARING, AND SUPPORTIVE SETTING. THIS FISCAL YEAR, THE CENTER FOR HOPE AND HEALING OPENED A SECOND LOCATION IN WILMINGTON. THIS NEW LOCATION INCORPORATES A PRIMARY CARE PRACTICE FOR THIS PATIENT POPULATION. BEHAVIORAL HEALTH UNIT: IN LATE 2018, CHRISTIANACARE REPLACED ITS INPATIENT BEHAVIORAL HEALTH UNIT AT WILMINGTON HOSPITAL WITH A NEW, EXPANDED FACILITY THAT PROVIDES STATE-OF-THE-ART MEDICAL AND BEHAVIORAL HEALTH CARE. THE NEW BEHAVIORAL HEALTH UNIT IS MORE THAN DOUBLE THE SIZE OF THE OLD SPACE AND INCLUDES FOUR PODS TO ADDRESS SPECIFIC NEEDS: GERIATRIC BEHAVIORAL HEALTH ISSUES, ACUTE BEHAVIORAL HEALTH ISSUES, A DUAL DIAGNOSIS OF BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER, AND BEHAVIORAL HEALTH/MEDICAL ISSUES. EACH POD HAS SELF-CONTAINED PROGRAMMING AND A DEDICATED NURSING STATION. COMPREHENSIVE PAIN CENTER: THE PAIN MANAGEMENT CENTER IS FOCUSED ON TREATING PAIN WITHOUT PRESCRIBING OPIOIDS. PROVIDERS ARE COMMITTED TO OFFERING THERAPIES FOCUSED ON ALLEVIATING PAIN WHILE SUPPORTING CHRISTIANACARE'S MISSION TO REDUCE DEPENDENCIES ON OPIOID MEDICATIONS. A MULTIMODAL, MULTIDISCIPLINARY PAIN TREATMENT STRATEGY FOCUSED ON IMPROVING FUNCTION IS UTILIZED. OPIOID WITHDRAWAL CLINICAL PATHWAY: CHRISTIANACARE'S OPIOID WITHDRAWAL CLINICAL PATHWAY WAS LAUNCHED IN NOVEMBER 2017 AND PROVIDES A MEDICAL ROADMAP TO HELP THE HOSPITAL CARE TEAM TO BETTER IDENTIFY PATIENTS AT RISK FOR OPIOID ADDICTION AND GUIDE THEM INTO EFFECTIVE TREATMENT. ALL PATIENTS ADMITTED TO THE HOSPITAL ARE SCREENED FOR POSSIBLE OPIOID WITHDRAWAL AND EVALUATED FOR APPROPRIATE DISCHARGE PLANNING TO A COMMUNITY PROVIDER. PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) ADDICTION CONSULT SERVICE: INDIVIDUALS ADMITTED TO A CHRISTIANACARE HOSPITAL WITH COMPLEX COMORBIDITIES ARE PROVIDED WITH EXPERT CLINICAL INTERVENTION BY A TEAM OF MEDICAL PROFESSIONALS WITH SPECIALTIES IN ADDICTION MEDICINE. INDIVIDUALS ALSO RECEIVE TRAUMA FOCUSED PSYCHOLOGY SERVICES AT BEDSIDE. PSYCHIATRIC CRISIS TEAM: A GROUP OF SPECIALTY-TRAINED REGISTERED NURSES, PSYCHIATRIC SOCIAL WORKERS AND BEHAVIORAL HEALTH SPECIALISTS ARE AVAILABLE 24 HOURS A DAY FOR EMERGENCY RESPONSE TO THE MEDICAL UNITS. THE TEAM OFFERS IMMEDIATE INTERVENTION FOR THOSE IN CRISIS BECAUSE OF PSYCHIATRIC ILLNESS. CHRISTIANA CARE PSYCHIATRIC EMERGENCY SERVICES: CHRISTIANA CARE PSYCHIATRIC EMERGENCY SERVICES PROVIDES INTEGRATED MEDICAL AND PSYCHIATRIC EMERGENCY CARE THAT INCLUDES AN ASSESSMENT BY A MULTIDISCIPLINARY TEAM, CRISIS INTERVENTION AND OTHER URGENT MENTAL HEALTH SERVICES ON A 24-HOUR BASIS, SEVEN DAYS A WEEK. THE 10-BED PSYCHIATRIC EMERGENCY SERVICES AREA IS LOCATED ADJACENT TO THE EMERGENCY DEPARTMENT AT WILMINGTON HOSPITAL. AT CHRISTIANA HOSPITAL, PATIENTS RECEIVE THE SAME LEVEL OF EXCEPTIONAL CARE IN A 3-BED AREA, LOCATED WITHIN THE EMERGENCY DEPARTMENT AS WELL AS A 5-BED CO-MANAGED MEDICAL PSYCHIATRIC POD. CHRISTIANACARE ALSO CONTINUES TO ADDRESS BEHAVIORAL HEALTH NEEDS IN THE COMMUNITY. CHRISTIANACARE'S COMMUNITY SUBSTANCE OVERDOSE SUPPORT (SOS), EMPLOYS PEER ENGAGEMENT SPECIALISTS WHO ARE IN RECOVERY TO ENGAGE WITH INDIVIDUALS IN THEIR HOMES OR COMMUNITIES AFTER THEY HAVE BEEN BROUGHT TO THE HOSPITAL FOLLOWING A SUSPECTED OVERDOSE. THEY BEGIN A RELATIONSHIP WITH THESE INDIVIDUALS WITH THE GOAL OF GETTING THEM TO TREATMENT. COMMUNITY SOS ALSO OFFERS HARM REDUCTION EDUCATION TO THOSE WHO ARE NOT YET READY TO ENTER TREATMENT AND PROVIDES NALOXONE AND TRAINING ON ITS USE TO THOSE WITH SUBSTANCE USE DISORDER AND THEIR FRIENDS AND FAMILY. IN FY21, COMMUNITY SOS GAVE OUT 325 NALOXONE KITS TO INDIVIDUALS. COMMUNITY SOS PROVIDED INDIVIDUALS WITH NALOXONE KITS AFTER TRAINING THEM ON ITS USE WHILE STATIONED AT THE LATIN AMERICAN COMMUNITY CENTER AND KINGSWOOD COMMUNITY CENTER DURING THE COVID-19 TESTING WINDOWS. IN NOVEMBER 2021, CHRISTIANACARE LAUNCHED A PARTNERSHIP WITH NEW CASTLE COUNTY, WITH SIX CAREGIVERS WORKING AS EMBEDDED RESOURCES WITHIN THE NEW CASTLE COUNTY POLICE DEPARTMENT'S BEHAVIORAL HEALTH UNIT. FOUR OF THESE CAREGIVERS ENGAGE IN THE COMMUNITY WITH INDIVIDUALS WHO SUFFERED A NON-FATAL OVERDOSE AND PROVIDE THEM WITH A TREATMENT PLAN AND ONGOING CASE MANAGEMENT. THE OTHER TWO CAREGIVERS ACCOMPANY COUNTY POLICE WHEN RESPONDING TO 911 CALLS WHEN MENTAL HEALTH IS THOUGHT TO BE AN ISSUE. THE CAREGIVERS WILL ENSURE THE INDIVIDUAL'S MENTAL HEALTH NEEDS ARE ADDRESSED AS WELL AS PROVIDE THEM WITH CONNECTION TO CARE. 3. VIOLENCE AND PUBLIC SAFETY CHRISTIANACARE RECOGNIZES THAT VIOLENCE IS A PUBLIC HEALTH ISSUE AND DETERMINED THAT AS A HEALTH SYSTEM, IT WAS NECESSARY TO ADDRESS VIOLENCE HEAD ON BY IMPLEMENTING A HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP). THE HVIP WAS RENAMED "EMPOWERING VICTIMS OF LIVED VIOLENCE" (EVOLV) PRIOR TO ITS LAUNCH ON FEBRUARY 15, 2021. EVOLV WORKS WITH PATIENTS WHO HAVE SUFFERED A GUNSHOT WOUND, STAB WOUND, OR VIOLENT BLUNT ASSAULT, ARE RESIDENTS OF NEW CASTLE COUNTY, AND AGED 13 YEARS OR OLDER. EVOLV'S INITIAL FOCUS INCLUDED PATIENTS ADMITTED IN THE TRAUMA DEPARTMENT FOR A COMPLEX INJURY. THE EVOLV SOCIAL WORKER APPROACHED PATIENTS AT THE HOSPITAL TO INTRODUCE THE PROGRAM GOALS AND EXPLANATION OF SUPPORT. THE SOCIAL WORKER ENROLLS HOSPITALIZED PATIENTS AND PROVIDES A WARM HAND-OFF TO THE EVOLV COMMUNITY HEALTH WORKER (CHW) TO START THE RAPPORT BUILDING PROCESS AND PREPARE FOR THE COMMUNITY ENGAGEMENT PRIOR TO DISCHARGE. THE CHW ACTIVELY FOLLOWS PATIENTS AND SUPPORTS THEM BY PROVIDING THEM WITH ACCESS TO CARE, ADDRESSING ANY SOCIAL DETERMINANTS, AND IDENTIFYING AND ACHIEVING PATIENT CENTERED GOALS AND OUTCOMES. THE LENGTH OF ENGAGEMENT IS THREE MONTHS. CHRISTIANACARE COLLABORATED WITH THE STATE OF DELAWARE DURING FY21 AROUND THE ISSUE OF VIOLENCE. AS PART OF THIS COLLABORATIVE, EVOLV BEGAN ENGAGING WITH COMMUNITY ORGANIZATIONS THAT FOCUS ON VIOLENCE SUCH AS SOCIAL CONTRACT, COMMUNITY INTERVENTION TEAM (CIT), AND GROUP VIOLENCE INTERVENTION (GVI) WHICH EACH HAVE THEIR OWN UNIQUE APPROACH TO ADDRESSING THE GUN VIOLENCE ISSUE IN DELAWARE. CIT AND GVI ARE BOTH WILMINGTON BASED ORGANIZATIONS WITH A MIX OF COMMUNITY AND GOVERNMENTAL SUPPORT. IN FY21, CHRISTIANACARE CONTINUED TO PROVIDE EDUCATION TO YOUTH THROUGHOUT DELAWARE ABOUT VIOLENCE PREVENTION WITH THE CHOICE ROAD PROGRAM, WHICH URGES STUDENTS TO CONSIDER THE CHOICES THEY MAKE, AND A NEW PROGRAM THAT INTRODUCES STUDENTS TO THE CONCEPT OF GUN VIOLENCE AS A PUBLIC HEALTH ISSUE. IN ADDITION TO VIOLENCE PREVENTION, CHRISTIANACARE ALSO EDUCATES ADOLESCENTS AND ADULTS ABOUT SAFE CHOICES TO PREVENT INJURIES. THE TRAUMA TEAM ADAPTED TO HOLD MANY OF THESE SESSIONS VIRTUALLY AND CONTINUED TO BE A PRESENCE IN SCHOOLS AND SENIOR CENTERS DESPITE THE PANDEMIC. 4. MATERNAL AND CHILD HEALTH ESPECIALLY INFANT MORTALITY CHRISTIANACARE IS NOT ONLY WORKING TO IMPROVE THE INFANT MORTALITY RATE THROUGH PROGRAMS AIMED AT PREGNANT WOMEN SUCH AS HEALTHY BEGINNINGS, THE EMBEDDED CHWS IN WOMEN'S HEALTH DESCRIBED PREVIOUSLY, AND HEALTH AMBASSADORS, BUT ALSO BY ADDRESSING SOCIAL DETERMINANTS OF HEALTH. IN 2005, THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM (DHMIC) WAS FOUNDED BY THEN-GOVERNOR RUTH ANN MINNER TO IMPLEMENT RECOMMENDATIONS TO REDUCE INFANT MORTALITY AND RACIAL DISPARITIES THROUGHOUT THE STATE. CHRISTIANACARE HAS REMAINED A LEADER IN DHMIC AND IN THE COMMUNITY TO ADDRESS MATERNAL AND CHILD HEALTH. DR. DAVID PAUL, CHAIR OF PEDIATRICS, SERVES AS DHMIC'S CHAIR. CHRISTIANACARE REPRESENTATIVES ALSO SERVE ON THE FETAL INFANT MORTALITY REVIEW WHICH MEETS EACH YEAR TO CONDUCT A RESPECTIVE REVIEW OF THE HISTORY AND CIRCUMSTANCES SURROUNDING EACH CHILD'S DEATH OR NEAR DEATH IN DELAWARE. THE STATE OF DELAWARE CONTINUES TO DEMONSTRATE ITS CONFIDENCE IN CHRISTIANACARE BY AWARDING IT A GRANT TO SUPPORT THE HEALTH AMBASSADORS PROGRAM SINCE 2012. THE PROGRAM IS DESIGNED TO IMPROVE MATERNAL AND CHILD MORBIDITY AND MORTALITY THROUGH THE PROMOTION OF HEALTH BEFORE, DURING, AND AFTER PREGNANCY. IN FY 21, THE HEALTH AMBASSADORS ASSISTED AND WERE ABLE TO SUCCESSFULLY MEET THE NEEDS OF 3,212 INDIVIDUALS. THE STATE OF DELAWARE HAS ALSO PROVIDED CHRISTIANACARE WITH A GRANT TO OPERATE THE ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION (AAPP) SINCE 1995. AAPP, WHICH OPERATES OUT OF CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT, WORKS TO REDUCE THE NUMBER OF TEENS WHO ARE SEXUALLY ACTIVE, BECOME PREGNANT, AND BECOME TEEN PARENTS THROUGH EDUCATIONAL PROGRAMMING OFFERED TO TEENS AND THEIR PARENTS. AAPP PROGRAMMING IS OFFERED THROUGHOUT THE STATE. AAPP OFFERED SIGNIFICANT CHALLENGES THIS YEAR DUE TO SCHOOL CLOSURES AND REMOTE LEARNING. NEVERTHELESS, IN FY21, AAPP PROVIDED EDUCATION TO 163 STUDENTS. PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) SINCE 2018, CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT IN THE OFFICE OF HEALTH EQUITY HAS ALSO PROVIDED BOOT CAMP FOR NEW DADS (BCND) AND BOOT CAMP FOR NEW MOMS (BCNM). BCND PROVIDES COMMUNITY-BASED WORKSHOPS TO HELP NEW AND SOON TO BE DADS BECOME CONFIDENT IN THEIR ABILITY TO CARE FOR THEIR INFANTS, SUPPORT THEIR PARTNER, AND SUCCESSFULLY BECOME CAPABLE DADS. THESE WORKSHOPS ARE FOR DADS OF ALL AGES, CULTURES, AND ECONOMIC LEVELS. THE WORKSHOPS ARE CO-FACILITATED BY LOCAL DADS WHO WERE RECRUITED AND TRAINED BY CHRISTIANACARE. BCNM SEEKS TO PROVIDE INFORMATION ABOUT WHAT HAPPENS AFTER PREGNANCY, LABOR, AND DELIVERY. BCNM IS FOCUSED ON HELPING NEW MOMS HANDLE THE CHANGES IN HER LIFE AND THE RELATIONSHIP WITH HER PARTNER ONCE HER BABY HAS BEEN BORN. IN THIS REPORTING YEAR, 6 VIRTUAL SESSIONS WERE HELD FOR MOMS AND DADS. IN PARTNERSHIP WITH THE DELAWARE DIVISION OF PUBLIC HEALTH, CHRISTIANACARE'S HEALTHY BEGINNINGS PROGRAM BRINGS TOGETHER PRECONCEPTION CARE (WHICH IDENTIFIES AND ADDRESSES POTENTIAL RISKS TO FUTURE PREGNANCIES), PREGNANCY PLANNING (WHICH GUIDES THE WOMAN THROUGH THE FIRST STEPS THAT LAY THE GROUNDWORK FOR A HEALTHY PREGNANCY), AND PRENATAL CARE (WHICH ENSURES THE GOOD HEALTH OF MOTHER AND BABY FROM CONCEPTION TO BIRTH). THIS HOLISTIC APPROACH IS UNDERTAKEN BY A TEAM THAT INCLUDES DOCTORS, NURSE PRACTITIONERS, SOCIAL WORKERS, CASE WORKERS, RESOURCE MOTHERS, AND DIETICIANS, WORKING WITH THE MOTHER TO ASSIST HER IN HAVING A HEALTHY PREGNANCY AND INFANT. THE CHRISTIANACARE HEALTHY BEGINNINGS PROGRAM IS ALSO UTILIZING ROUNDTRIP TRANSPORTATION SERVICES TO ENSURE PATIENTS CAN ATTEND THEIR MEDICAL APPOINTMENTS. 5. ACCESS TO DENTAL AND PRIMARY CARE CHRISTIANACARE SUCCESSFULLY EXPANDED DENTAL SERVICES AT WILMINGTON HOSPITAL WITH THE COMPLETION OF A TWO-YEAR RENOVATION PROJECT IN FY20 THAT INCREASED THE CLINICAL CAPACITY OF OUR DENTISTRY AND ORAL-MAXILLOFACIAL SURGERY PRACTICES. THIS INCREASE ENABLES MORE THAN 5,000 ADDITIONAL VISITS PER YEAR AT ONE OF THE FEW ACCESS POINTS IN THE COMMUNITY FOR DENTAL CARE. CHRISTIANACARE IS EXPANDING PRIMARY CARE SERVICES TO SUPPORT IMPROVED ACCESS TO THE PREVENTIVE CARE AND CHRONIC DISEASE MANAGEMENT THAT HELPS PATIENTS TO BE HEALTHY AND AVOID COSTLY UNNECESSARY EMERGENCY ROOM VISITS AND HOSPITAL ADMISSIONS. CHRISTIANACARE WILL CONTINUE TO SEEK OPPORTUNITIES TO PLACE PROVIDERS AND STAFF IN COMMUNITY SETTINGS TO MEET PATIENT NEEDS AT CONVENIENT ACCESS POINTS. THIS IS NECESSARY BECAUSE THERE ARE BARRIERS TO ACCESSING CARE CAUSED BY TRANSPORTATION AND WORK SCHEDULES. WE AIM TO MEET THE NEEDS OF OUR NEIGHBORS IN THE COMMUNITY WHERE THEY LIVE, WORK, AND PLAY AS DEMONSTRATED BY OUR PREVIOUSLY DESCRIBED NEWLY ESTABLISHED PRACTICE AT KINGSWOOD COMMUNITY CENTER AND THE NEW CENTER FOR HOPE AND HEALING PRACTICE. IN FY 21, CHRISTIANACARE ALSO LAUNCHED A PRIMARY CARE PRACTICE EMBEDDED IN THE HELEN F. GRAHAM CANCER CENTER AND RESEARCH INSTITUTE. CHRISTIANACARE IS ONE OF THE FIRST CANCER PROGRAMS IN THE NATION TO OFFER PATIENTS UNDERGOING CANCER TREATMENTS THE OPPORTUNITY TO SEE A PRIMARY CARE PROVIDER ON-SITE. IN FY 21, CHRISTIANACARE ALSO ACQUIRED A PRACTICE, SU CENTRO DE SALUD WITH PRIMARY CARE AT KIRKWOOD , WHICH SERVES PATIENTS WITH SPANISH SPEAKING AND CULTURALLY COMPETENT PROVIDERS AND STAFF TO ENSURE THE HEALTH NEEDS OF HISPANIC COMMUNITY CAN BE MET. -------------------- PART V, SECTION B, LINE 13 (ELIGIBILITY FOR PROVIDING DISCOUNTED CARE) FEDERAL POVERTY GUIDELINES ARE NOT USED TO DETERMINE DISCOUNTED CARE. A SELF-PAY DISCOUNT OF 15% IS APPLIED TO ALL UNINSURED PATIENT ACCOUNTS REGARDLESS OF INCOME. PATIENTS WITH INCOME IN EXCESS OF 200% WILL ONLY RECEIVE A 15% DISCOUNT. -------------------- PART V, SECTION B, LINE 16 (FINANCIAL ASSISTANCE POLICY AVAILABILITY) A COPY OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT: HTTPS://CHRISTIANACARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL -ASSISTANCE/ -------------------- PART V, SECTION B, LINE 20 (ADDITIONAL EFFORTS MADE BEFORE AN ECA) CHRISTIANA CARE HEALTH SERVICES COMMUNICATES IN WRITING ABOUT COLLECTION PLACEMENT AND THE FINANCIAL ASSISTANCE POLICY. -------------------- PART V, SECTION B, LINE 22 (CHARGES FOR FAP-ELIGIBLE INDIVIDUALS) FAP-ELIGIBLE INDIVIDUALS (THOSE WITH INCOME LESS THAN 200% OF FEDERAL POVERTY GUIDELINES) ARE NOT RESPONSIBLE FOR ANY CHARGES. -------------------- PART I, LINE 3C (DES. OF ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CARE) CHRISTIANA CARE HEALTH SERVICES, INC.("CHRISTIANACARE") HAS A SELF PAY DISCOUNT PERCENTAGE OF 15% THAT IS APPLIED TO ALL UNINSURED PATIENTS' ACCOUNTS, REGARDLESS OF THE PERSON'S ABILITY TO PAY. THIS DISCOUNT PERCENTAGE IS COMPARABLE TO THAT WHICH IS EXTENDED TO OUR MANAGED CARE COMPANIES. -------------------- PART I, LINE 6A (COMMUNITY BENEFIT ANNUAL REPORT INFORMATION) CHRISTIANACARE HEALTH PREPARED A COMMUNITY HEALTH NEEDS ASSESSMENT AND A COMMUNITY HEALTH IMPLEMENTATION PLAN DURING THE FY2019 TAX YEAR. BOTH DOCUMENTS ARE AVAILABLE AT THE FOLLOWING LINK ON THE CCHS WEBSITE: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ -------------------- PART I, LINE 7 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED) IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. AS A RESULT, THERE ARE NO BAD DEBT EXPENSES INCLUDED ON FORM 990, PART IX THAT NEED TO BE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES LISTED. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. -------------------- PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606). -------------------- PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY) THE AMOUNT OF BAD DEBTS (IMPLICIT PRICE CONCESSIONS) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED UPON THE NUMBER OF PRESUMED CHARITY-CARE ELIGIBLE PATIENTS WHO DID NOT COMPLETE THE FAP PAPERWORK DURING THE YEAR. -------------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGE 15 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. -------------------- PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF CHRISTIANACARE AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, CHRISTIANACARE PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY CHRISTIANACARE TO PROVIDE SUCH SERVICES. AS A RESULT, CHRISTIANA CARE VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. -------------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) CHRISTIANACARE HAS A FINANCIAL ASSISTANCE POLICY THAT IDENTIFIES THE CIRCUMSTANCES FOR WHICH A RESPONSIBLE PARTY WOULD BE EXTENDED A 100% ADJUSTMENT ON ALL MEDICAL BILLS. THE GROSS INCOME THRESHOLD FOR THIS CHARITABLE ADJUSTMENT IS 200% OF THE FEDERAL POVERTY LEVEL AND IT IS BASED ON THE NUMBER OF DEPENDENTS IN THE HOUSEHOLD. THE FINANCIAL ASSISTANCE POLICY FURTHER EXPLAINS THAT ANY UNINSURED PATIENT WHO FAILS TO QUALIFY FOR FINANCIAL ASSISTANCE WOULD BE GRANTED A 15% SELF PAY DISCOUNT. IT ALSO REVEALS A PATIENT'S ABILITY TO ESTABLISH INTEREST-FREE MONTHLY PAYMENT ARRANGEMENTS FOR ANY OUTSTANDING BALANCE THAT IS NOT COVERED BY A THIRD PARTY PAYER. AS PART OF THE SELF PAY DUNNING PROCESS, CHRISTIANA CARE MAKES UNINSURED PATIENTS AWARE OF THE FINANCIAL ASSISTANCE PROGRAM WITH THE RELEASE OF OUR FIRST STATEMENT. FOR ALL SUBSEQUENT STATEMENTS, PATIENTS HAVE AN OPPORTUNITY TO CALL OUR CUSTOMER SERVICES DEPARTMENT IF THEY ARE UNABLE TO MAKE PAYMENT IN FULL. IF A PATIENT QUALIFIES FOR A CHARITABLE ADJUSTMENT, THEY ARE EXTENDED THE COURTESY OF AN AUTOMATIC ADJUSTMENT TO THEIR BILLS FOR THE NEXT YEAR AND FOR ONE YEAR PRIOR TO THE DATE A PATIENT'S APPLICATION IS APPROVED. PATIENTS WOULD NEED TO REAPPLY FOR CHARITABLE CONSIDERATION AFTER THE ONE YEAR HAS LAPSED. ALL COLLECTION ACTIONS WOULD CEASE ONCE A PATIENT IS DEEMED ELIGIBLE FOR CHARITY OR ONCE A PATIENT ESTABLISHES AND MAINTAINS A MONTHLY PAYMENT ARRANGEMENT. -------------------- PART VI, LINE 2 (NEEDS ASSESSMENT) AT CHRISTIANACARE, WE ABIDE BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. CHRISTIANACARE IS GUIDED BY ITS COMMITMENT TO PARTNERING WITH OUR NEIGHBORS TO BETTER UNDERSTAND THEIR NEEDS AND GOALS FOR HEALTH. UNDERTAKING THE 2019 CHNA WAS NOT SIMPLY AN IRS REQUIREMENT FOR US, BUT RATHER AN OPPORTUNITY TO LISTEN TO OUR NEIGHBORS. OUR NEIGHBORS ARE IN THE BEST POSITION TO TELL US WHAT THEIR HEALTH NEEDS ARE AND HOW WE CAN ASSIST THEM IN MEETING THOSE NEEDS. OUR ASSESSMENT AND OUR IMPLEMENTATION PLAN WERE BUILT UPON THIS FOUNDATION. OUR ACTIONS MUST BE DIRECTED BY THE NEEDS OF THE COMMUNITY AND WHAT THEY WANT AS OPPOSED TO WHAT WE THINK THEY NEED OR WANT. LISTENING TO OUR NEIGHBORS AND PARTNERING WITH THEM TO ADDRESS THEIR CHALLENGES ARE STRATEGIES THAT CHRISTIANACARE WILL ALWAYS EMPLOY. THESE UNDERPIN ALL SUCCESSFUL INTERVENTIONS TO IMPROVE HEALTH, AND WE HOPE THAT OUR WORK AND PARTNERSHIPS IN FY21 DEMONSTRATED THIS COMMITMENT TO OUR NEIGHBORS. CHRISTIANACARE'S GREATER WILMINGTON COMMUNITY PARTNERSHIP, THE WILMINGTON CONSORTIUM, AND THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL WERE FORMED TO HAVE DIRECT CONTACT WITH COMMUNITY LEADERS AND STAKEHOLDERS TO GAIN PERSPECTIVE AND GUIDANCE FROM THEM REGARDING OUR COMMUNITIES' NEEDS. CHRISTIANACARE ALSO COLLABORATES WITH PARTNERS TO BETTER UNDERSTAND AND ADDRESS PRESSING HEALTH CONCERNS IN OUR STATE. AS DESCRIBED IN THE PREVIOUS SECTION, CHRISTIANACARE PARTICIPATES IN THE FETAL INFANT MORTALITY REVIEW AND THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM TO DECREASE THE INFANT MORTALITY RATE. CHRISTIANACARE'S CHIEF HEALTH EQUITY OFFICER CO-CHAIRS THE REACH RIVERSIDE HEALTH, WELLNESS, AND SAFETY COMMITTEE. CHRISTIANACARE'S VICE PRESIDENT OF BEHAVIORAL HEALTH AND SOCIAL CARE INTEGRATION ALSO CO-CHAIRS THE DRUG OVERDOSE FATALITY REVIEW COMMISSION. AS DESCRIBED PREVIOUSLY, CHRISTIANACARE HAS ALSO TAKEN THE INNOVATIVE APPROACH TO PARTNER DIRECTLY WITH OUR COUNTY POLICE DEPARTMENT TO DIVERT INDIVIDUALS IN OUR COMMUNITIES SUFFERING FROM BEHAVIORAL HEALTH ISSUES FROM THE CRIMINAL JUSTICE SYSTEM AND INTO THE APPROPRIATE TREATMENT. MEMBERS OF THE TRAUMA TEAM ALSO PARTICIPATE IN THE DELAWARE COALITION FOR INJURY PREVENTION, SAFE KIDS DELAWARE, AND SAFE KIDS NEW CASTLE COUNTY, WHILE MEMBERS OF PARENT EDUCATION ALSO PARTICIPATE IN THE BLACK MATERNAL HEALTH AND BREASTFEEDING COALITIONS. WE ALSO RECOGNIZE THAT TO IMPROVE PATIENT HEALTH THERE IS A NEED TO IDENTIFY AND ADDRESS INDIVIDUAL PATIENTS' SDOH. ADDRESSING PATIENTS' SOCIAL NEEDS IN ADDITION TO PROVIDING CLINICAL CARE HAS BECOME A MAJOR PUBLIC HEALTH INITIATIVE AND IS A KEY COMPONENT OF OUR WORK AT CHRISTIANACARE TO CREATE AN INTEGRATED CLINICAL AND SOCIAL CARE FRAMEWORK. CHRISTIANACARE DEVELOPED ITS SYSTEMWIDE STANDARDIZED SDOH SCREENING TOOL THAT IS BEING UNIVERSALLY IMPLEMENTED THROUGHOUT CHRISTIANACARE. AS USE OF THE SCREENING TOOL IS EXPANDING, CHRISTIANACARE INTERNAL ACCESS TO UNITE DELAWARE IS ALSO INCREASING THROUGH INTEGRATION IN THE ELECTRONIC HEALTH RECORD. THESE ARE TWO VITALLY CONNECTED INITIATIVES BECAUSE WE FEEL STRONGLY THAT IF A PATIENT DISCLOSES A NEED, WE MUST BE PREPARED TO HELP THEM ADDRESS IT. UNITE DELAWARE ALLOWS US TO DO EXACTLY THAT THROUGH SOCIAL SERVICE REFERRALS TO A PLATFORM OF COMMUNITY-BASED ORGANIZATIONS. THESE ARE JUST SOME OF THE PARTNERSHIPS AND INITIATIVES CHRISTIANACARE HAS UNDERTAKEN TO LEARN FROM ITS COMMUNITY ABOUT ITS NEEDS. LISTENING TO OUR NEIGHBORS WILL BE AN ONGOING PRIVILEGE AND A COMMITMENT. -------------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) CHRISTIANACARE FULFILLS ITS MISSION OF SERVING ITS NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH REGARDLESS OF A PATIENT'S ABILITY TO PAY. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO PROVIDE RELIEF TO INDIVIDUALS IMPACTED BY THE HIGH COST OF HEALTHCARE. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON CHRISTIANACARE'S WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL -ASSISTANCE/, AND IN PAMPHLETS THROUGHOUT CHRISTIANACARE FACILITIES, INCLUDING CHRISTIANACARE'S OUTPATIENT PRACTICES. FINANCIAL ASSISTANCE APPLICATIONS ARE ALSO AVAILABLE IN SPANISH, CANTONESE, AND MANDARIN WHICH ARE THE LANGUAGES MOST SPOKEN IN CHRISTIANACARE'S SERVICE AREA BESIDES ENGLISH. TRANSLATION ASSISTANCE TO COMPLETE THE NECESSARY FORMS IS AVAILABLE FOR ANYONE NOT PROFICIENT IN READING, WRITING, OR SPEAKING ENGLISH. A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM IS ALSO AVAILABLE ON OUR WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY APPLIES TO ALL MEDICALLY NECESSARY SERVICES, INCLUDING THE HOSPITAL INPATIENT, OUTPATIENT, AND EMERGENCY DEPARTMENT SERVICES THAT ARE BILLED BY CHRISTIANACARE, AS WELL AS ALL SERVICES RENDERED BY CHRISTIANACARE PHYSICIANS - INCLUDING DENTAL SERVICES THAT REQUIRE HOSPITALIZATION. MEDICALLY NECESSARY SERVICES ARE PROVIDED AT NO CHARGE TO INDIVIDUALS WHOSE HOUSEHOLD INCOME IS LESS THAN 200% OF THE FEDERAL POVERTY LEVEL AND WHO MEET OTHER FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY REQUIREMENTS. UNINSURED INDIVIDUALS WITH A HOUSEHOLD INCOME GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR A STANDARD DISCOUNT OF 15%. IF AN INDIVIDUAL NEEDS ASSISTANCE IN OBTAINING FINANCIAL ASSISTANCE, BESIDES PATIENT FINANCIAL SERVICES REPRESENTATIVES, THE HEALTH GUIDES ARE ALSO AVAILABLE TO PROVIDE INFORMATION AND ASSIST. -------------------- PART VI, LINE 4 (COMMUNITY INFORMATION) WHILE CHRISTIANACARE PROVIDES SERVICES IN FOUR STATES, NEARLY 80% OF WILMINGTON AND CHRISTIANA HOSPITAL DISCHARGES ARE TO NEW CASTLE COUNTY, DELAWARE, AND SO WE CONSIDER THE CHRISTIANACARE COMMUNITY TO BE PRIMARILY NEW CASTLE COUNTY. THE POPULATION OF NEW CASTLE COUNTY REPRESENTS CONSIDERABLE VARIATION IN SOCIOECONOMIC STATUS. FOR EXAMPLE, THE POVERTY RATE IN ZIP CODE 19801 (WHERE WILMINGTON HOSPITAL IS LOCATED) IS APPROXIMATELY 37% WHILE THE POVERTY RATE IN ZIP CODE 19701 IS UNDER 5%. BECAUSE OF THAT VARIATION, THE 2019 CHNA ASSESSED COMMUNITY HEALTH NEEDS IN TWO GEOGRAPHIC AREAS: "COMMUNITY 1" (ZIP CODES 19801, 19802, 19804, 19805, AND 19720) AND "COMMUNITY 2" (ALL OTHER ZIP CODES). THE DISTINCTION WAS MADE BETWEEN THESE TWO COMMUNITIES TO ENSURE THAT THE BARRIERS TO HEALTH FACED BY COMMUNITY 1 WOULD NOT BE OVERLOOKED WHEN CONSIDERING NEW CASTLE COUNTY AS A WHOLE. THE TOTAL POPULATION OF NEW CASTLE COUNTY IN 2018 WAS APPROXIMATELY 556,000 PERSONS, WITH COMMUNITY 1 COMPRISED OF APPROXIMATELY 162,000 PERSONS, AND COMMUNITY 2 COMPRISED OF 394,000 PERSONS. THE COUNTY'S POPULATION IS EXPECTED TO GROW 3.4 PERCENT FROM 2018 TO 2023; EVERY ZIP CODE IN NEW CASTLE COUNTY IS PROJECTED TO INCREASE IN POPULATION. THE POPULATION 65 YEARS OF AGE AND OLDER IS ANTICIPATED TO GROW AT A MUCH HIGHER RATE OF 19.2 PERCENT. NOTABLE DIFFERENCES BETWEEN COMMUNITY 1 AND COMMUNITY 2 INCLUDE THE FOLLOWING: - COMMUNITY 1 HAS A MUCH HIGHER "PERCENT RACIAL/ETHNIC MINORITY" THAN COMMUNITY 2. - THE PERCENT OF RESIDENTS IN POVERTY AND CONSIDERED LOW INCOME IN COMMUNITY 1 IS ABOUT DOUBLE THE PERCENT FOR COMMUNITY 2. - RESIDENTS OF COMMUNITY 1 ARE MORE LIKELY TO BE UNINSURED AND TO HAVE LIMITED ENGLISH PROFICIENCY. - HIGH SCHOOL GRADUATION RATES ALSO HAVE BEEN MUCH LOWER IN COMMUNITY 1 THAN IN COMMUNITY 2. MORE DETAILED INFORMATION ON THE DEMOGRAPHICS OF CHRISTIANA CARE'S SERVICE AREA POPULATION CAN BE FOUND WITHIN ITS CHNA AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-NEEDS-ASSESSMENT/ -------------------- -------------------- PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANACARE'S MISSION IS TO SERVE OUR NEIGHBORS AS EXPERT, CARING, PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE AFFORDABLE, SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. WE ARE COMMITTED TO FULFILLING OUR MISSION OF SERVICE TO OUR NEIGHBORS. AS THE LARGEST HEALTH CARE PROVIDER IN A STATE THAT HAS NO SAFETY NET OR PUBLIC HOSPITAL, WE SERVE A SIGNIFICANT PORTION OF THE COMMUNITY'S UNINSURED AND UNDERINSURED POPULATION ALONG WITH A SUBSTANTIAL PORTION OF THE STATE'S MEDICAID POPULATION. IN DEMONSTRATION OF OUR COMMITMENT TO SERVING OUR NEIGHBORS, IN JULY 2019, CHRISTIANACARE ENTERED INTO AGREEMENTS WITH DELAWARE'S TWO LARGEST MEDICAID PAYORS TO WORK WITH BENEFICIARIES IN POPULATION HEALTH CONTRACTS. IN APRIL 2021, CHRISTIANACARE AND HIGHMARK HEALTH ANNOUNCED A JOINT VENTURE THAT WILL CREATE A NEW MODEL OF VALUE-BASED CARE THAT IS CONTINUOUS, AND DATA AND TECHNOLOGY LED. THIS IS PROBLEM-SOLVING DESIGNED TO TAKE COST AND INEFFICIENCIES OUT OF THE SYSTEM. CHRISTIANACARE INCLUDES AN EXTENSIVE NETWORK OF OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,435 BEDS), FREE-STANDING EMERGENCY DEPARTMENT, A LEVEL I TRAUMA CENTER AND A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER AND REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE AND WOMEN'S HEALTH. IT ALSO INCLUDES THE PIONEERING GENE EDITING INSTITUTE. CHRISTIANACARE IS A NONPROFIT TEACHING HEALTH SYSTEM WITH MORE THAN 260 RESIDENTS AND FELLOWS. WE ARE CONTINUALLY RANKED BY US NEWS & WORLD REPORT AS A BEST HOSPITAL AND THIS FISCAL YEAR, RANKED BY FORBES AS THE 5TH BEST HEALTH SYSTEM TO WORK FOR IN THE UNITED STATES. WITH OUR UNIQUE, DATA-POWERED CARE COORDINATION SERVICE CAREVIOTM AND A FOCUS ON POPULATION HEALTH AND VALUE-BASED CARE, AS DEMONSTRATED THROUGH OUR JOINT VENTURE WITH HIGHMARK, CHRISTIANACARE IS SHAPING THE FUTURE OF HEALTH CARE. CHRISTIANACARE ALSO PROVIDES SERVICES THAT DELAWAREANS CANNOT FIND ELSEWHERE IN THE STATE SUCH AS AN EPILEPSY MONITORING UNIT, A COMPREHENSIVE PAIN CENTER (WHICH OFFERS EFFECTIVE, NON-OPIOID PAIN TREATMENT STRATEGIES FOR INDIVIDUALS WITH ACUTE AND CHRONIC PAIN), KIDNEY TRANSPLANTS, A LEVEL 2 PEDIATRIC EMERGENCY CARE FACILITY, CAR-T CELL THERAPY, A NEW BREAKTHROUGH TREATMENT FOR HIGHLY RESISTANT B-CELL BLOOD CANCERS, AND PROSTATE EMBOLIZATION (A MINIMALLY INVASIVE OUTPATIENT PROCEDURE PERFORMED BY VASCULAR INTERVENTIONAL RADIOLOGISTS). CHRISTIANACARE ALSO LAUNCHED THE FIRST YOUNG ADULT SURVIVORSHIP TRANSITION PROGRAM IN DELAWARE TO HELP ADOLESCENT AND YOUNG ADULT CANCER SURVIVORS AGED 18 TO 39 TO STAY HEALTHY AFTER CHILDHOOD CANCER. MANY CANCER SURVIVORS HAVE UNMET HEALTH NEEDS BECAUSE OF THEIR TREATMENTS. SIGNIFICANT AND DIVERSE RESEARCH IS ALSO HAPPENING AT CHRISTIANACARE. DURING THE COVID-19 PANDEMIC IN 2020, THERE WAS A 34% INCREASE IN ALCOHOL WITHDRAWAL RATES AMONG HOSPITALIZED PATIENTS AT CHRISTIANACARE, ACCORDING TO A RESEARCH LETTER PUBLISHED IN THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. THIS STUDY IS BELIEVED TO BE THE FIRST TO QUANTIFY THE IMPACT OF THE COVID-19 PANDEMIC ON ALCOHOL WITHDRAWAL AMONG HOSPITALIZED PATIENTS. IN BREAKTHROUGH COLON CANCER RESEARCH, SCIENTISTS AT CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE HAVE DISCOVERED A LINK BETWEEN TWO KEY SIGNALING PATHWAYS CRUCIAL TO THE DEVELOPMENT AND GROWTH OF COLON CANCER. THE STUDY IS PUBLISHED IN THE JOURNAL PLOS ONE. CHRISTIANACARE IS ALSO PROUD OF ITS INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH (IREACH), AN EMBEDDED HEALTH RESEARCH INSTITUTE THAT CONDUCTS APPLIED RESEARCH FOCUSED ON ISSUES OF EQUITY AND COMMUNITY HEALTH, POPULATION HEALTH, AND VIRTUAL HEALTH, AND ALSO TRAINS THE NEXT GENERATION OF CLINICAL SCIENTISTS. THE GOAL IS TO BRIDGE THE GAP BETWEEN CLINICAL AND TRANSLATIONAL RESEARCH, ADVANCEMENTS IN THE QUALITY OF CARE, AND IMPROVED POPULATION HEALTH OUTCOMES FOR ALL. CHRISTIANACARE INNOVATIVELY SERVES ITS COMMUNITY THROUGH CAREVIO, AN AWARD-WINNING CARE MANAGEMENT ORGANIZATION SERVING INDIVIDUALS WITH ACUTE, CHRONIC AND COMPLEX HEALTH CARE NEEDS. CAREVIO EARNED ACCREDITATION IN TWO AREAS - CASE MANAGEMENT AND POPULATION HEALTH PROGRAM - THIS FISCAL YEAR FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA), A PRIVATE, NONPROFIT ORGANIZATION DEDICATED TO IMPROVING HEALTH CARE QUALITY. CAREVIO IS THE FIRST NON-HEALTH-PLAN POPULATION HEALTH MANAGEMENT ORGANIZATION IN DELAWARE TO RECEIVE NCQA ACCREDITATION FOR CASE MANAGEMENT AND POPULATION HEALTH. CAREVIO IS A ROBUST INFORMATION TECHNOLOGY PLATFORM THAT HARNESSES REAL-TIME HEALTH DATA FROM ALL AVAILABLE SOURCES. IT USES A PREDICTION ANALYTICS ENGINE TO COORDINATE CARE, IDENTIFY POPULATIONS MOST AT-RISK AND HELP PREVENT THE NEED FOR HOSPITALIZATIONS AND EMERGENCY DEPARTMENT VISITS THROUGH PREVENTIVE CARE AND HOME CARE. CAREVIO HAS NURSE CARE COORDINATORS, SOCIAL WORKERS, CLINICAL PHARMACISTS, RESPIRATORY THERAPISTS, AND MEDICAL DIRECTORS WHO CONNECT WITH PATIENTS BY PHONE, VIDEO, IN-PERSON VISITS, SECURE TEXTS AND E-MAIL TO HELP THEM MANAGE THEIR HEALTH CARE. CHRISTIANACARE IS A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES APPROXIMATELY 50,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CAREVIO ALSO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. CHRISTIANACARE SUPPORTS THE FIRST STATE SCHOOL LOCATED AT WILMINGTON HOSPITAL IN PARTNERSHIP WITH THE RED CLAY CONSOLIDATED SCHOOL DISTRICT AND THE DELAWARE DEPARTMENT OF EDUCATION. CHILDREN AND ADOLESCENTS FROM KINDERGARTEN THROUGH HIGH SCHOOL, WHO WOULD TYPICALLY BE HOMEBOUND WITH SERIOUS ILLNESSES SUCH AS DIABETES, SICKLE-CELL ANEMIA, SEVERE ASTHMA, CANCER, AND ILLNESSES ATTEND SCHOOL WITH THEIR PEERS WHILE RECEIVING NEEDED MEDICAL TREATMENT. THIS PROGRAM IS ONLY ONE OF THREE IN OPERATION NATIONWIDE, AND IT HAS BEEN A STAPLE OF CHRISTIANACARE'S COMMUNITY PROGRAMS SINCE IT BEGAN SERVING ADOLESCENTS IN 1985 AND EXPANDED TO SERVE ELEMENTARY STUDENTS IN 1991. CHRISTIANACARE IS ALSO A MAJOR TEACHING HOSPITAL. CHRISTIANACARE PARTNERS WITH LEADING COLLEGES AND UNIVERSITIES IN THE REGION TO OFFER A ROBUST NURSING EDUCATION PROGRAM AND WITH LOCAL TECHNICAL COLLEGES TO PROVIDE CLINICAL TRAINING FOR TECHNICAL HEALTHCARE CAREERS. CHRISTIANACARE IS COMMITTED TO INSTILLING IN THE STUDENTS IT TEACHES AND MENTORS THE IMPORTANCE OF OUR COMMUNITY'S HEALTH AND WELL-BEING, AND THE NEED TO CONSIDER THE SOCIAL DETERMINANTS OF HEALTH IN ALL WE DO. FINALLY, CHRISTIANACARE IS CONSISTENTLY RECOGNIZED FOR ITS GOOD WORKS THROUGH THE RECEIPT OF NUMEROUS NATIONAL AWARDS. DURING THIS REPORTING PERIOD: - CHRISTIANACARE WAS RECOGNIZED FOR THE 3RD YEAR IN A ROW AMONG THE WORLD'S BEST HOSPITALS BY NEWSWEEK. THE AMERICAN HOSPITAL ASSOCIATION'S INSTITUTE FOR DIVERSITY AND HEALTH EQUITY ALSO NAMED CHRISTIANACARE A 2021 CAROLYN BOONE LEWIS EQUITY OF CARE AWARD HONOREE. THE CAROLYN BOONE LEWIS EQUITY OF CARE AWARD IS AN ANNUAL RECOGNITION OF OUTSTANDING EFFORTS AMONG HOSPITALS AND HEALTH CARE SYSTEMS TO ADVANCE EQUITY OF CARE TO ALL PATIENTS AND TO SPREAD LESSONS LEARNED AND PROGRESS TOWARD DIVERSITY, INCLUSION, AND HEALTH EQUITY. - FORBES MAGAZINE ALSO RANKED CHRISTIANACARE AS ONE OF THE BEST EMPLOYERS FOR DIVERSITY AND INCLUSION IN THE UNITED STATES IN ITS LIST OF BEST EMPLOYERS FOR DIVERSITY 2021. - FOR ITS OUTSTANDING PATIENT PARTICIPATION RATE IN CANCER CLINICAL TRIALS, CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER AND RESEARCH INSTITUTE HAS EARNED TOP NATIONAL RANKINGS FROM SEVERAL ORGANIZATIONS OF THE NATIONAL CANCER INSTITUTE. CHRISTIANACARE'S PATIENT PARTICIPATION RATE INTO CANCER CLINICAL TRIALS EACH YEAR IS NEARLY 30% - MORE THAN SEVEN TIMES THE NATIONAL AVERAGE OF 4%. - CHRISTIANACARE EARNED HEALTHGRADES 2021 AMERICA'S 50 BEST HOSPITALS AWARDT AND IS AMONG THE TOP 1 PERCENT OF MORE THAN 4,500 HOSPITALS ASSESSED NATIONWIDE FOR ITS CONSISTENT, YEAR-OVER-YEAR SUPERIOR CLINICAL PERFORMANCE. - CHRISTIANACARE HAS BEEN HONORED AS ONE OF ONLY 89 INSTITUTIONS OUT OF 722 BY THE AMERICAN COLLEGE OF SURGEONS (ACS) CLINICAL CONGRESS FOR ACHIEVING "MERITORIOUS" OUTCOMES IN SURGICAL PATIENT CARE. CHRISTIANACARE'S GOVERNING BODY, ITS BOARD OF DIRECTORS, IS COMPRISED PRIMARILY OF PERSONS WHO RESIDE IN ITS PRIMARY SERVICE AREA, AND MOST OF THE BOARD MEMBERS ARE NOT EMPLOYEES, FAMILY MEMBERS OF EMPLOYEES, OR INDEPENDENT CONTRACTORS OF CHRISTIANACARE. AS DESCRIBED IN THE CHNA AND CHIP, CHRISTIANACARE FINANCIALLY SUPPORTS IMPROVEMENTS IN ACCESSING CARE, COMMUNITY OUTREACH, IMPROVING THE CARE AND OVERALL HEALTH OF OUR NEIGHBORS, AND CONTINUING TO SUPPORT MEDICAL EDUCATION AND RESEARCH. -------------------- PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) CHRISTIANA CARE IS A MAJOR TEACHING HEALTH SYSTEM WITH MORE THAN 1,600 MEDICAL-STAFF MEMBERS AND 260 MEDICAL-DENTAL RESIDENTS AND FELLOWS. MAJOR FACILITIES INCLUDE: - CHRISTIANA HOSPITAL-STANTON CAMPUS: LOCATED IN NEWARK, DELAWARE, THIS CAMPUS IS HOME TO THE 1039 LICENSED BED CHRISTIANA HOSPITAL, THE CHRISTIANA CARE CENTER FOR HEART & VASCULAR HEALTH, THE HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE, THE CHRISTIANA CARE BREAST CENTER, THE CHRISTIANA SURGICENTER, AND THE JOHN H. AMMON MEDICAL EDUCATION CENTER. CHRISTIANA HOSPITAL IS ALSO THE STATE'S ONLY HIGH RISK DELIVERY HOSPITAL FEATURING A LEVEL III NEONATAL INTENSIVE CARE UNIT. CHRISTIANA HOSPITAL IS ALSO A LEVEL I TRAUMA CENTER. - WILMINGTON HOSPITAL CAMPUS: LOCATED IN THE HEART OF THE CITY OF WILMINGTON, THIS CAMPUS INCLUDES THE 321 LICENSED BED WILMINGTON HOSPITAL, THE ROCCO A. ABESSINIO FAMILY WILMINGTON HOSPITAL HEALTH CENTER, THE CENTER FOR REHABILITATION, THE CENTER FOR ADVANCED JOINT REPLACEMENT, THE WILMINGTON ANNEX, THE SWANK MEMORY CENTER, THE FIRST STATE SCHOOL, AND THE ROXANA CANNON ARSHT SURGICENTER. WILMINGTON HOSPITAL IS A LEVEL III TRAUMA CENTER. - MIDDLETOWN EMERGENCY DEPARTMENT: CHRISTIANA CARE FACILITIES ALSO INCLUDE AN EMERGENCY DEPARTMENT FACILITY IN MIDDLETOWN, DELAWARE, THAT SERVES THE MIDDLETOWN, ODESSA AND TOWNSEND, DELAWARE POPULATIONS ON A 24-7 BASIS. THE FACILITY CONTAINS 18 TREATMENT ROOMS, AND IS AVAILABLE TO SERVE MANY OF THE FREQUENT EMERGENCY CARE NEEDS OF THE LOCAL COMMUNITY. - AFFINITY HEALTH ALLIANCE, INC. IS AN AFFILIATED HEALTH CARE SYSTEM WHICH INCLUDES A NUMBER OF HEALTHCARE RELATED ENTITIES, INCLUDING: UNION HOSPITAL OF CECIL COUNTY, INC., UNION HOSPITAL OF CECIL COUNTY FOUNDATION, INC., UNION HOSPITAL OF CECIL COUNTY HEALTH SERVICES, INC., AND UNION HOSPITAL OF CECIL COUNTY ONCOLOGY, INC. -------------------- PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) DELAWARE DOES NOT REQUIRE THE FILING OF A COMMUNITY BENEFIT REPORT. IN THE INTEREST OF SHARING INFORMATION ABOUT ITS COMMUNITY BENEFIT WITH ITS NEIGHBORS, CHRISTIANACARE HAS ESTABLISHED A COMMUNITY BENEFIT DEDICATED SECTION ON ITS WEBSITE WHERE THE CHNA AND CHIP CAN BE FOUND, ALONG WITH ARTICLES ABOUT CHRISTIANACARE'S COMMUNITY BENEFIT INITIATIVES AND STORIES. THIS GROWING COLLECTION OF STORIES CAN BE ACCESSED AT: https://news.christianacare.org/category/in-the-community/community-benefi t. -------------------- X true true X X X X X true true false false false false false true false FREDERIC T HARAD MD MEMBER 696424 0 65250 0 42000 0 18525 0 19869 0 842068 0 0 0 JANICE E NEVIN MD PRESIDENT & CEO 1219968 0 411174 0 156864 0 178646 0 13274 0 1979926 0 152113 0 JENNIFER L SCHWARTZ ESQ CORPORATE SECRETARY 476416 0 114452 0 0 0 62881 0 19869 0 673618 0 0 0 JOSEPH BENNETT MD MEMBER 553258 0 60779 0 11000 0 17100 0 19869 0 662006 0 0 0 KENNETH SILVERSTEIN MD CHIEF PHYSICIAN EXECUTIVE 727596 0 175162 0 790 0 88590 0 19869 0 1012007 0 0 0 KIRK N GARRATT MD MEDICAL DIRECTOR, HEART/VASC 677549 0 130491 0 46978 0 18525 0 6852 0 880395 0 0 0 LISA MAXWELL MD PRESIDENT, MEDICAL GROUP 373713 0 76199 0 0 0 20050 0 19869 0 489831 0 0 0 MICHAEL EPPEHIMER MD PRES. MED GROUP (THRU 10/2020) 440725 0 77097 0 106514 0 19950 0 15351 0 659637 0 91107 0 NEIL JASANI MD CHIEF PEOPLE OFFICER 524109 0 115482 0 23763 0 64718 0 19869 0 747941 0 27686 0 NICHOLAS J PETRELLI MD MEDICAL DIRECTOR, CANCER 633053 0 121921 0 35826 0 20050 0 11747 0 822597 0 0 0 PAUL K DAVIS MD CARDIAC SURGEON 775895 0 84488 0 0 0 18525 0 19869 0 898777 0 0 0 RAAFAT ABDEL-MISIH MD ONCOLOGY SURGEON 715176 0 77478 0 954 0 20050 0 11747 0 825405 0 0 0 RANDALL GABORIAULT CHIEF INFORMATION OFFICER 591893 0 143754 0 0 0 77452 0 20093 0 833192 0 0 0 RAY A BLACKWELL MD CHIEF CARDIAC SURGERY 743981 0 86521 0 0 0 19950 0 19869 0 870321 0 0 0 RICHARD CUMING CHIEF NURSING EXECUTIVE 499955 0 117505 0 0 0 64102 0 11747 0 693309 0 0 0 ROBERT MCMURRAY CFO, TREASURER & ASS'T SEC'Y 635123 0 137462 0 0 0 74935 0 19869 0 867389 0 0 0 SHARON KURFUERST SYSTEM CHIEF OPERATING OFFICER 514901 0 106252 0 0 0 58239 0 19869 0 699261 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 1A DETAIL REGARDING BENEFITS PROVIDED SOCIAL CLUB DUES CCHS PROVIDES A SOCIAL CLUB MEMBERSHIP TO BE USED BY THE PRESIDENT IN CONNECTION WITH THEIR DUTIES. THE PRESIDENT IS RESPONSIBLE FOR AND TAXED ON ANY PERSONAL USE OF SUCH CLUB MEMBERSHIP. -------------------- FORM 990, SCHEDULE J, PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS MICHAEL EPPEHIMER, MD WAS PAID $88,958 IN SEVERANCE DURING CALENDAR YEAR 2020. -------------------- FORM 990, SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED PLAN PARTICIPATION CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAINTAINS AN IRC SECTION 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED AND/OR RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: NICHOLAS J. PETRELLI, MD - $ 36,576 KIRK N. GARRATT, MD - $ 39,147 MICHAEL EPPEHIMER, MD - $ 114,236 KENNETH SILVERSTEIN, MD - $ 70,065 NEIL JASANI, MD - $ 73,878 JANICE NEVIN, MD - $ 310,709 RICHARD CUMING - $ 47,002 ROBERT MCMURRAY - $ 54,985 SHARON KURFUERST - $ 38,289 RANDALL GABORIAULT - $ 57,502 JENNIFER L. SCHWARTZ, ESQ. - $ 45,781 LISA MAXWELL, MD - $ 19,777 -------------------- FORM 990, SCHEDULE J, PART I, LINE 7 PROVISION OF NON-FIXED PAYMENTS CCHS PROVIDES DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE CCHS COMPENSATION COMMITTEE THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. A DELAWARE HLTH FACILITIES AUTHORITY SERIES 2020A 510272458 246388Tq5 2020-02-11 247255000 REFUND SERIES 2008 & 2010 false false false A 0 157570000 305482979 0 0 0 2324976 0 0 144825092 227984 534927 true false true true A false false false false 0 false false false true A false false false true false false 0 false 0 false true A true FORM 990, SCHEDULE K, PART I ADDITIONAL INFORMATION REGARDING TAX-EXEMPT BONDS THE DELAWARE HEALTH FACILITIES AUTHORITY SERIES 2020A BOND WAS ISSUED TO CHRISTIANA CARE HEALTH SYSTEM, INC. (EIN:52-1479538), A RELATED IRC SECTION 501(C)(3) ORGANIZATION. SINCE ALL BOND PROCEEDS WERE ALLOCATED TO CHRISTIANA CARE HEALTH SERVICES, INC., THIS BOND HAS BEEN REPORTED ON THIS ORGANIZATION'S FORM 990, SCHEDULE K. HOWEVER, CHRISTIANA CARE HEALTH SYSTEM, INC. REMAINS AS THE PRIMARY OBLIGOR OF THE BOND. -------------------- FORM 990, SCHEDULE K, PART II, LINE 3 ADDITIONAL INFORMATION REGARDING PROCEEDS OF ISSUE FOR DELAWARE HLTH FACILITIES AUTHORITY SERIES 2020A, THE TOTAL PROCEEDS OF THE ISSUE REPORTED INCLUDES INVESTMENT EARNINGS. -------------------- NEUROSCIENCES II EXTRA SPACE LLC TRUSTEE IS > 35% OWNER 194097 PROPERTY LEASE false WL GORE ASSOCIATES INC TRUSTEE IS AN OFFICER 2310410 PURCHASE OF MEDICAL SUPPLIES false ERIN KURFUERST DAUGHTER OF KEY EMPLOYEE 19564 EMPLOYMENT false X 13 175080 FMV false true false SCHEDULE M, PART I, COLUMN (B) ADDITIONAL INFORMATION REGARDING SECURITIES REPORTED CHRISTIANA CARE HEALTH SERVICES, INC. REPORTS THE NUMBER OF CONTRIBUTIONS IN PART I, COLUMN (B). FORM 990, PART III, LINE 4(D) DETAIL OF OTHER PROGRAM SERVICES CHRISTIANACARE HEALTH SERVICES ("CCHS"), HEADQUARTERED IN WILMINGTON, DELAWARE, IS ONE OF THE COUNTRY'S LARGEST HEALTH CARE PROVIDERS AND IS A MAJOR TEACHING HOSPITAL WITH TWO CAMPUSES AND MORE THAN 259 MEDICAL-DENTAL RESIDENTS AND FELLOWS. CHRISTIANACARE IS RECOGNIZED AS A REGIONAL CENTER FOR EXCELLENCE IN CARDIOLOGY, CANCER AND WOMEN'S HEALTH SERVICES. THE SYSTEM FEATURES A LEVEL 3 NEONATAL INTENSIVE CARE UNIT, THE ONLY DELIVERING HOSPITAL IN THE STATE TO OFFER THIS LEVEL OF CARE FOR NEWBORNS. CHRISTIANA CARE HEALTH SERVICES IS ALSO HOME TO DELAWARE'S ONLY LEVEL 1 TRAUMA CENTER, THE ONLY OF ITS KIND BETWEEN PHILADELPHIA AND BALTIMORE. A NOT-FOR-PROFIT, NON-SECTARIAN HEALTH SYSTEM, CHRISTIANACARE INCLUDES TWO HOSPITALS WITH MORE THAN 1,200 PATIENT BEDS, PREVENTIVE MEDICINE, REHABILITATION SERVICES, A NETWORK OF PRIMARY CARE PHYSICIANS AND AN EXTENSIVE RANGE OF OUTPATIENT SERVICES. WITH MORE THAN 13,000 EMPLOYEES, CHRISTIANACARE IS THE LARGEST PRIVATE EMPLOYER IN DELAWARE AND ONE OF THE LARGEST EMPLOYERS IN THE PHILADELPHIA REGION. -------------------- FORM 990, PART VI, SECTION A, LINE 2 FAMILY AND BUSINESS RELATIONSHIPS GEORGE FOUTRAKIS, TRUSTEE, AND PAUL KANIEFSKI, TRUSTEE, HAVE A BUSINESS RELATIONSHIP. -------------------- FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO GOVERNING DOCUMENTS EFFECTIVE JANUARY 1, 2021, THE BOARD OF DIRECTORS OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("HEALTH SYSTEM") BECAME THE CORPORATE MEMBERS OF THE HEALTH SYSTEM IN REPLACE OF THE TRUSTEES WHO WERE PREVIOUSLY THE CORPORATE MEMBERS. THIS WAS A MEMBERSHIP SUBSTITUTION. ADDITIONALLY, IT WAS APPROVED TO SEPARATE WHAT WAS PREVIOUSLY A "MIRROR BOARD" FOR THE HEALTH SYSTEM AND CHRISTIANA CARE HEALTH SERVICES, INC. ("HEALTH SERVICES") IN OTHER WORDS, THE SAME DIRECTORS SERVED AS DIRECTORS FOR BOTH HEALTH SYSTEM AND HEALTH SERVICES. THESE BOARDS WERE SEPARATED EFFECTIVE JANUARY 1, 2021 SUCH THAT THERE IS NOW A SEPARATE BOARD FOR HEALTH SYSTEM AND A SEPARATE BOARD FOR HEALTH SERVICES. THIS ALSO RESULTED IN A REORGANIZATION OF THE COMMITTEES TIED TO EACH BOARD. -------------------- FORM 990, PART VI, SECTION A, LINE 7A,B GOVERNING BODY AND MANAGEMENT THE BOARD OF DIRECTORS OF CHRISTIANACARE HEALTH SYSTEM, INC. ("SYSTEM"), SOLE MEMBER OF CHRISTIANACARE HEALTH SERVICES, INC. ("CCHS"), AT IT'S ANNUAL MEETING IN NOVEMBER, ELECTS DIRECTORS OF CHRISTIANACARE. THE ANNUAL OPERATING BUDGET OF CHRISTIANACARE IS APPROVED BY THE CHRISTIANACARE BOARD, THE SYSTEM FINANCE COMMITTEE AND THE SYSTEM BOARD. -------------------- FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS INFORMATION RELATED TO CHRISTIANA CARE'S FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW. THE FINAL 2020 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2021 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2020 FORM 990 VIA ITS BOARD OF DIRECTOR'S PORTAL. ------------------ FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OUR CONFLICT OF INTEREST ("COI") POLICY IS LOCATED IN THE CAREGIVER RESOURCE CENTER ON THE EMPLOYEE PORTAL. THERE IS AN ANNUAL MANDATORY EDUCATION FOR MANAGERS WHICH INCLUDES AN ELECTRONIC SIGN OFF ACKNOWLEDGING COMPLETION OF THE EDUCATION, REPORTING OF A REAL OR PERCEIVED CONFLICT OR THAT NO CONFLICTS OF INTEREST EXISTS. THE HR/EMPLOYEE RELATIONS TEAM FOLLOWS UP WITH ANYONE WHO HAS A CONFLICT OR PERCEIVED CONFLICT OR DOES NOT COMPLETE THE EDUCATION IN ORDER TO RESOLVE. SEVERAL REPORTING MECHANISMS ALSO EXIST FOR EMPLOYEES TO REPORT CONCERNS. THE BOARD OF DIRECTORS HAS THEIR OWN COI POLICY. COI IS A STANDING AGENDA ITEM ON EACH BOARD OR BOARD COMMITTEE MEETING. BOARD MEMBERS EXPECTATIONS FOR COI ARE CLEARLY COMMUNICATED. -------------------- FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL PROCESS THE BOARD OF DIRECTORS ESTABLISHES CHRISTIANACARE'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE BOARD ENGAGES AN INDEPENDENT THIRD PARTY ANNUALLY WHO ASSESSES DATA FROM SEVERAL MAJOR SURVEYS TO ENSURE TOTAL REMUNERATION IS MARKET COMPETITIVE AND QUALIFIES FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULE, SECTION 4958 OF THE INTERNAL REVENUE CODE. AFTER DELIBERATION, THE ECC DOCUMENTS THEIR DECISIONS IN MEETING MINUTES. -------------------- FORM 990, PART VI, SECTION B, LINE 16B JOINT VENTURE ARRANGEMENTS ALTHOUGH THE ORGANIZATION DOES NOT HAVE A WRITTEN POLICY IN PLACE REGARDING PARTICIPATION IN JOINT VENTURE RELATIONSHIPS, WHEN ANY SUCH RELATIONSHIPS ARE CONSIDERED, THEY ARE FIRST REVIEWED AND EVALUATED BY MANAGEMENT OFFICIALS IN CONJUNCTION WITH PRICEWATERHOUSECOOPERS LLP. -------------------- FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT, & DISCLOSURE THE FORM 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF CCHS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE WEB THROUGH DIGITAL ASSURANCE CERTIFICATION ("DAC"). -------------------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS CHANGE IN PENSION AND POST RETIREMENT LIABILITIES $(96,618,358) CHANGE IN NET ASSET OF SYSTEM (2,470,907) ----------- TOTAL $ (99,089,265) =========== CHRISTIANA CARE CAMPUS REALTY LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE 0 0 CCH SERVICES CHRISTIANA CARE QUALITY PARTNERS LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -702790 0 CCH SERVICES CHRISTIANA CARE QUALITY PARTNERS ACOLLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -1456772 0 CCH SERVICES CHRISTIANA CARE CARE LINK LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -4023434 0 CCH SERVICES CHRISTIANA CARE HEALTH SYSTEM 501 WEST 14TH STREET WILMINGTON DE 19801 521479538 FUNDRAISING DE 501(C)(3) 7 NA false CHRISTIANA CARE HEALTH INITIATIVES 200 HYGEIA DRIVE SUITE 2300 NEWARK DE 19713 510295186 OUTPATIENT SV DE 501(C)(3) 10 CCH SYSTEM false CHRISTIANA CARE HOME HEALTH & COM SRVCS 1 READS WAY NEW CASTLE DE 19720 510064334 HOME HLTHCARE DE 501(C)(3) 7 CCH SYSTEM false UNION HOSPITAL OF CECIL COUNTY FOUNDATIO 106 BOW STREET ELKTON MD 21921 521794552 FUNDRAISING MD 501(C)(3) 7 AFFINITY false UNION HOSPITAL OF CECIL COUNTY INC 106 BOW STREET ELKTON MD 21921 520607945 HLTHCARE SVCS MD 501(C)(3) 3 AFFINITY false UNION HOSPITAL OF CECIL COUNTY HLTH SVCS 106 BOW STREET ELKTON MD 21921 521794553 PROPERTY MGMT MD 501(C)(3) 10 AFFINITY false UNION HOSPITAL OF CECIL COUNTY ONCOLOGY 106 BOW STREET ELKTON MD 21921 812662359 HEALTHCARE MD 501(C)(3) 3 AFFINITY false AFFINITY HEALTH ALLIANCE INC 106 BOW STREET ELKTON MD 21921 521794697 MANAGEMENT MD 501(C)(3) 12B, II CCH SERVICES true CHRISTIANA CARE GO HEALTH URGENT CARE L 5555 GLENRIDGE CONNECTOR SUITE 700 ATLANTA GA 30342 844061485 URGENT CARE SRVCS DE CCH SERVICES RELATED -2657422 1204086 false 0 false 0.50100 CHRISTIANACARE VALUE HEALTH JV LLC 11221 ROE AVENUE LEAWOOD KS 66211 851100149 AMBULATORY SRVCS DE CCH SERVICES RELATED 0 25500 false 0 true 0.51000 CLINERGY LLC 4755 OGLETOWN STANTON RD NEWARK DE 19718 852698063 GROUP PURCHASING DE CCH SERVICES RELATED 0 0 false 0 false 0.79800 LEEWARD HEALTH LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON DE 19803 MED ADV RISK SHAR DE CCH SYSTEM false THE DE CTR FOR MAT FETAL MED OF CC INC 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 205891272 HEALTHCARE DE CCH SERVICES C CORP -38074 5719667 1.00000 true CHRISTIANA CARE HEALTH PLANS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 510352728 INSURANCE DE CCH SYSTEM C CORP false CHRISTIANA CARE DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 816359549 DEF COMP PLAN DE CCH SERVICES TRUST true CHRISTIANA CARE EXEC DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048822 DEF COMP PLAN DE CCH SERVICES TRUST true CARE ASSOCIATES DEFERRED COMP PLAN 4755 OGLETWON STANTON RD NEWARK DE 19718 357048714 DEF COMP PLAN DE CCH SERVICES TRUST true CHRISTIANA CARE INSURANCE CO LTD PO BOX 1159 878 W BAY RD GRAND CAYMAN CJ KY1-1102 981489490 SELF-INSURANCE CJ CCH SERVICES C CORP 2554951 74589881 1.00000 true CHRISTIANA CARE STRATEGIC INVESTMENTS 4000 NEXUS DR STE NW3-100 WILMINGTON DE 19803 853348300 STRATEGY DE CCH SYSTEM C CORP false UNION HOSPITAL OF CECIL COUNTY VENTURES 106 BOW STREET ELKTON MD 21921 521793691 MEDICAL SERVICES MD AFFINITY C CORP false CENTER FOR VIRTUAL HEALTH LLC 4000 NEXUS DR STE C3-300 WILMINGTON DE 19803 862155365 MNGMT & SUPPORT DE CCH SERVICES C CORP 0 0 1.00000 false CENTER FOR VIRTUAL HEALTH PRACTICE PA 4000 NEXUS DR STE C3-300 WILMINGTON DE 19803 862158927 VIRTUAL PRIM CARE DE CNTR VIRTUAL C CORP false true true true true false false false false false true true true false true true true true true true UNION HOSPITAL OF CECIL COUNTY INC O 7770021 FMV CHRISTIANA CARE GO HEALTH URGENT CARE LLC J,P,R 9463182 FMV THE DE CTR FOR MAT FETAL MED OF CC INC K,O 641018 FMV CHRISTIANA CARE INSURANCE CO LTD Q,R 29809654 FMV CHRISTIANA CARE GO HEALTH URGENT CARE LLC A,D 39390783 FMV CLINERGY LLC O 12493 FMV DIRECT OTHER LOBBYING EXEMPT PURPOSE NAME OF ELECTING ORGANIZATION EXPENDITURES EXPENDITURES __________________________________ ____________ _______________ CHRISTIANA CARE HEALTH SYSTEM $ NONE $ 4,670,129 CHRISTIANA CARE HEALTH SERVICES 249,926 2,146,254,538 CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES NONE 45,878,225 CHRISTIANA CARE HEALTH INITIATIVES NONE 8,087,165 ------------ -------------- TOTAL $ 249,926 $2,204,890,087 THE ORGANIZATION HAS MADE THE LOBBYING ELECTION UNDER I.R.C. SECTION 501(H) FOR THE TAX YEAR ENDED JUNE 30, 2021. THIS ELECTION HAS NOT BEEN REVOKED BEFORE THE START OF THE ORGANIZATION'S TAX YEAR THAT BEGAN IN 2020.