2019-05-14T08:20:20-05:00 2018-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2017-07-01 510103684 CHRISTIANA CARE HEALTH SERVICES INC % VICE PRESIDENT'S OFFICE CHRI 3026237201 PO BOX 2653 WILMINGTON DE 198050653 ROBERT M MCMURRAY CFO 3026237202 2019-05-09 true ANTONIO C RUSSO P00858539 2673303000 2019-05-09 155.201.188.33 23522320191345000020 2019-05-14 P CFCED273F45E15359E1AD418F281705A5641D1F2 CFCED273F45E15359E1AD418F281705A5641D1F2 2017 2019-02-21 02:37:17Z JANICE NEVIN MD 4755 OGLETOWN-STANTON ROAD NEWARK DE 19718 2196906965 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. 19 17 11139 1145 3836153 1055505 35304559 22698446 1396421550 1371432728 71183909 62409870 294090298 227054451 1797000316 1683595495 0 0 0 0 1044935974 1101167332 0 0 0 538565296 415593042 1583501270 1516760374 213499046 166835121 2946500848 3230957055 615628909 652910048 2330871939 2578047007 X WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH, IN THE COMMUNITY, IN OUR PHYSICIAN PRACTICES AND IN OUR HOSPITALS. 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THE ORGANIZATION'S PERMANENT ENDOWMENT CONSISTS OF APPROXIMATELY NINETEEN DONOR RESTRICTED ENDOWMENT FUNDS USED FOR A VARIETY OF PURPOSES, INCLUDING SALARY AND PROGRAM SUPPORT. THE ORGANIZATION'S TEMPORARILY RESTRICTED ENDOWMENT REPRESENTS TEMPORARILY RESTRICTED NET ASSETS WHICH ARE RESTRICTED FOR INDIGENT CARE, BUILDING AND MAINTENANCE AND PROGRAM SUPPORT. -------------------- CELEBRATE HOPE 101646 75271 26375 0 0 0 0 0 0 NONE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101646 75271 26375 0 0 0 0 0 0 0 26375 FORM 990, SCHEDULE G, PART II, EVENT #1 DETAIL OF FUNDRAISING EVENTS THE EXPENSES ASSOCIATED WITH THE CELEBRATION OF HOPE FUNDRAISING EVENT WERE RECORDED DIRECTLY BY A RELATED PARTY. true true X true X false false true false false 22771338 22771338 0.01500 257348078 231060992 26287086 0.01730 280119416 231060992 49058424 0.03230 58 68767 11794542 4038774 7755768 0.00510 5 11 60572470 11628905 48943565 0.03230 2 16359626 14905490 1454136 0.00100 4 878173 878173 0.00060 69 68778 89604811 30573169 59031642 0.03900 69 68778 369724227 261634161 108090066 0.07130 1 192 192 1 200665 200665 0.00010 2 44448 44448 2 17173 17173 6 262478 262478 0.00010 true 50250831 5025083 479504541 580057798 -100553257 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 15 true true true true X SEE PART V, SECTION C X true 15 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 true X false false PART V, SECTION B LINE 5 (INPUT FROM COMMUNITY) CHRISTIANA CARE HEALTH SYSTEM (CHRISTIANA CARE) CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN FISCAL 2016 TO IMPROVE ITS UNDERSTANDING OF THE NEEDS OF RESIDENTS IN ITS SERVICE AREA IN ORDER TO BETTER SERVE THEM. TO COMPLETE THE CHNA, CHRISTIANA CARE CONTRACTED WITH COMMUNITY HEALTH ADVISORS, LLC (CHA). CHA CONDUCTED RESEARCH, INTERVIEWS, AND A COMMUNITY HEALTH SURVEY TO OBTAIN AND ANALYZE PRIMARY AND SECONDARY DATA. AS WAS DETAILED IN THE CHRISTIANA CARE CHNA, PRIMARY DATA COLLECTION EFFORTS INCLUDED INTERVIEWS WITH KEY STAKEHOLDERS AND COMMUNITY LEADERS, ALONG WITH A BRIEF COMMUNITY HEALTH SURVEY COMPLETED BY AREA RESIDENTS. THIRTY-FOUR STAKEHOLDERS AND COMMUNITY LEADERS WERE INTERVIEWED. SOME OF THOSE INTERVIEWED, SUCH AS DR. KARYL RATTAY, DIRECTOR OF THE DELAWARE DIVISION OF PUBLIC HEALTH, HAD EXPERTISE IN PUBLIC HEALTH, WHILE OTHERS, LIKE MARIA MATOS, PRESIDENT AND CEO OF THE LATIN AMERICAN COMMUNITY CENTER, HAD SPECIAL KNOWLEDGE ABOUT THE COMMUNITIES WE SERVE. THE STAKEHOLDERS AND COMMUNITY LEADERS INTERVIEWED SERVE A DIVERSE CROSS-SECTION OF THE COMMUNITY AND HAVE BROAD UNDERSTANDINGS OF THE DIFFERENT FACTORS THAT PLAY INTO COMMUNITY HEALTH NEEDS. THIS DIVERSITY OF KNOWLEDGE WAS IMPORTANT TO CHRISTIANA CARE AS IT SOUGHT TO ENSURE THE CHNA WOULD BE TRULY REPRESENTATIVE OF THE COMMUNITY IT SERVES. THE STAKEHOLDERS INTERVIEWED WERE THE FOLLOWING: 1. LINDA BRITTINGHAM, CHRISTIANA CARE DIRECTOR OF SOCIAL WORK 2. KATHY CANNATELLI, EUGENE DU PONT PREVENTATIVE MEDICINE & REHABILITATION INSTITUTE & CENTER FOR COMMUNITY HEALTH 3. PAUL CALISTRO, WEST END NEIGHBORHOOD HOUSE 4. DR. CHRIS CANNON, ARSHT CANNON FOUNDATION 5. REVEREND TAMIKA COBB, BEAUTIFUL GATES OUTREACH CENTER 6. VICKY COOKE, DELAWARE BREAST COALITION 7. CHIEF BOBBY CUMMINGS, CITY OF WILMINGTON POLICE 8. PASTOR GERDTS, FIRST AND CENTRAL PRESBYTERIAN CHURCH IN WILMINGTON 9. SUSAN GETMAN, WILMINGTON SENIOR CENTER 10. ALLISON GILL, AMERICAN CANCER SOCIETY 11. JIM GRANT, DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES 12. RICH HEFFRON, DELAWARE STATE CHAMBER OF COMMERCE 13. JUDITH HERRMAN, UNIVERSITY OF DELAWARE SCHOOL OF NURSING 14. JOE HICKEY, ST PATRICKS CENTER 15. PASTOR ANDY JACOB, HANOVER PRESBYTERIAN CHURCH 16. LYNN JONES, CHRISTIANA CARE VISITING NURSE ASSOCIATION 17. TYRONE JONES, UNITED WAY OF DELAWARE 18. NORA KATURAKES, CHRISTIANA CARE CANCER OUTREACH AND EDUCATION 19. OMAR KHAN, M.D., EUGENE DUPONT PREVENTIVE MEDICINE & REHABILITATION INSTITUTE, AND CENTER FOR COMMUNITY HEALTH 20. JIM LAFFERTY, MENTAL HEALTH SOCIETY 21. SECRETARY RITA LANDGRAF, DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES 22. REVEREND TOM LAYMAN, SUNDAY BREAKFAST MISSION 23. LOLITA LOPEZ, WESTSIDE FAMILY HEALTH 24. MARIA MATOS, LATIN AMERICAN COMMUNITY CENTER 25. DR. KARYL RATTAY, DIRECTOR OF THE DELAWARE DIVISION OF PUBLIC HEALTH 26. JILL ROGERS, DELAWARE DIVISION OF DEVELOPMENTAL DISABILITIES 27. COLONEL ELMER SETTING, NEW CASTLE POLICE 28. HANIFA SHABAZZ, WILMINGTON CITY COUNCILWOMAN 29. EILEEN SPARLING, UD CENTER FOR DISABILITIES STUDIES 30. MICHELLE TAYLOR, UNITED WAY OF DELAWARE 31. LAVAIDA WHITE, RETIRED PUBLIC HEALTH NURSE AND ACTIVE COMMUNITY RESIDENT 32. EMILY VERA, MENTAL HEALTH SOCIETY 33. TWO MEMBERS OF THE CHRISTIANA CARE PATIENT ADVISORY COMMITTEES THE KEY STAKEHOLDERS SHARED SIGNIFICANT INFORMATION ABOUT OUR COMMUNITIES AND THE CHALLENGES THEY FACE, BUT CHRISTIANA CARE THOUGHT IT WAS NECESSARY TO ALSO GET COMMUNITY MEMBERS DIRECT INPUT ON THE TOP HEALTH AND HEALTH-RELATED ISSUES IN THEIR COMMUNITIES TO ENSURE COMMUNITY MEMBERS ALSO HAD A VOICE IN THE CHNA. A BRIEF COMMUNITY HEALTH SURVEY WAS CREATED TO RETAIN COMMUNITY MEMBER INPUT, AND FIFTY-FIVE INDIVIDUALS VISITING THE NEW CASTLE FARMERS MARKET COMPLETED THIS SURVEY IDENTIFYING THE TOP HEALTH ISSUES IN THE COMMUNITY SUCH AS DIABETES AND THE TOP HEALTH-RELATED ISSUES IN THE COMMUNITY SUCH AS AFFORDABLE CARE. ALTHOUGH THE 2016 CHNA AND CHIP WERE COMPLETED, CHRISTIANA CARE CONTINUES TO PRIORITIZE COMMUNICATION WITH COMMUNITY MEMBERS AND STAKEHOLDERS TO ENSURE COMMUNITIES NEEDS ARE KNOWN AND ADDRESSED. THE GREATER WILMINGTON COMMUNITY PARTNERSHIP IS AN EXAMPLE OF OUR COMMITMENT TO COMMUNITY COLLABORATION. THIS PARTNERSHIP CAME TOGETHER IN 2012 WHEN CHRISTIANA CARE AND REPRESENTATIVES FROM DIFFERENT SHELTERS MET TO DISCUSS INDIVIDUALS WHO WERE GOING TO THE WILMINGTON EMERGENCY DEPARTMENT FOR NON-MEDICAL NEEDS, WHEN A SHELTER MAY HAVE SERVED THEM BETTER. IT WAS RECOGNIZED THAT THE SHELTERS ALL KEPT THE SAME HOURS, WHILE THE EMERGENCY DEPARTMENT, OPEN SEVEN DAYS A WEEK FOR TWENTY-FOUR HOURS A DAY, WAS ALWAYS ABLE TO PROVIDE SHELTER. AS A RESULT, THE SHELTERS WORKED ON EXPANDING THEIR HOURS IN COORDINATION WITH EACH OTHER SO THE EMERGENCY DEPARTMENT WOULD NOT BE THE ONLY OPTION FOR INDIVIDUALS WHO NEEDED SHELTER. MORE THAN SIXTY ORGANIZATIONS INCLUDING SHELTERS, FOOD AND CLOTHING BANKS, FAITH-BASED AGENCIES, AND CITY AND STATE SERVICE AGENCIES ARE NOW REPRESENTED IN THE PARTNERSHIP. CHRISTIANA CARE HOSTS THESE MONTHLY MEETINGS IN ITS WILMINGTON HOSPITAL, AND THE MEETINGS SERVE TO KEEP CHRISTIANA CARE AND ITS COMMUNITY PARTNERS AWARE OF WHAT IS HAPPENING IN COMMUNITIES AND ENABLES THE SUCCESSFUL COMMUNITY COLLABORATION THAT LED TO ITS DEVELOPMENT TO CONTINUE. CHRISTIANA CARE ALSO CREATED THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL WHICH SEEKS TO ASSIST CHRISTIANA CARE IN IMPROVING THE HEALTH OF COMMUNITY MEMBERS AND COMMUNITIES BY ADVISING CHRISTIANA CARE, SHARING INSIGHTS ON COMMUNITY NEEDS, IDENTIFYING COMMUNITY RESOURCES TO LEVERAGE THAT WILL STRENGTHEN CHRISTIANA CARES WORK WITHIN COMMUNITIES, AND SERVING AS AN OPEN CHANNEL OF COMMUNICATION BETWEEN CHRISTIANA CARE AND THE COMMUNITY. THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL SUPPORTS CHRISTIANA CARE AS IT SEEKS TRANSFORMATIVE RELATIONSHIPS WITH COMMUNITIES THAT WILL ALLOW BOTH THE COMMUNITY AND CHRISTIANA CARE TO BENEFIT FROM WORKING TOGETHER TOWARDS MUTUAL GOALS. THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL INCLUDES APPROXIMATELY TWENTY INDIVIDUALS FROM DIFFERENT COMMUNITY AGENCIES SUCH AS THE CENTRAL BAPTIST COMMUNITY DEVELOPMENT CORPORATION AND URBAN PROMISE WILMINGTON. CHRISTIANA CARE ALSO CONTINUES TO LEARN FROM ITS COMMUNITY MEMBERS BY ROUTINELY PARTICIPATING IN HEALTH FAIRS AND COMMUNITY EVENTS AND INITIATIVES. CHRISTIANA CARE ALSO MONITORS NATIONAL DATA AND TRENDS IN HEALTHCARE TO PREPARE FOR ISSUES THAT MAY HAVE AN IMPACT IN DELAWARE, AND TO DETERMINE IF THERE ARE PROGRAMS IN OTHER STATES OR COMMUNITIES THAT WOULD BE HELPFUL WITHIN THE COMMUNITIES WE SERVE. AN EXAMPLE OF CHRISTIANA CARE LISTENING TO ITS COMMUNITIES AND ADOPTING A NATIONAL PROGRAM WOULD BE ITS SUPPORT OF THE PLAY STREETS WILMINGTON INITIATIVE. THE DELAWARE CENTER FOR HEALTH INNOVATIONS HEALTHY NEIGHBORHOODS CHRONIC DISEASE/HEALTHY LIFESTYLES TASKFORCE RECOMMENDED BRINGING PLAY STREETS TO WILMINGTON NEIGHBORHOODS TO INCREASE COMMUNITY COHESION AND PROVIDE A SAFE SPACE FOR HEALTHY RECREATION FOR FAMILIES. PLAY STREETS HAS BEEN ADOPTED BY COMMUNITIES ACROSS THE COUNTRY, AND CHRISTIANA CARE IS A MAJOR SPONSOR AND ORGANIZING PARTNER OF PLAY STREETS WILMINGTON WHICH SERVED EIGHT NEIGHBORHOODS THROUGHOUT THE SUMMER OF 2018 AND WILL BEGIN AGAIN IN JUNE 2019. -------------------- PART V, SECTION B, LINE 6 (JOINT CHNA) CHRISTIANA CARES TWO HOSPITAL FACILITIES, CHRISTIANA AND WILMINGTON HOSPITALS, JOINTLY CONDUCTED THEIR CHNA. -------------------- PART V, SECTION B, LINE 7-10 (CHNA & IMPLEMENTATION PLAN PUBLIC AVAILABILITY) CHRISTIANA CARES CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/. CHRISTIANA CARES CHNA IS ALSO AVAILABLE TO THE PUBLIC UPON REQUEST. CHRISTIANA CARE'S COMMUNITY HEALTH IMPLEMENTATION PLAN ("CHIP") WAS ADOPTED ON OR BEFORE THE 15TH DAY OF THE 5TH MONTH AFTER JUNE 30, 2016, AS ALLOWED UNDER THE IRS SECTION 501(R) REGULATIONS. THE TAX YEAR THE HOSPITAL FACILITY LAST ADOPTED AN IMPLEMENTATION STRATEGY WAS 2015. CHRISTIANA CARES 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) CHRISTIANA CARE CONTINUES TO ADDRESS THE FOUR AREAS OF NEED IDENTIFIED IN THE 2016 CHNA: POVERTY, MENTAL HEALTH AND SUBSTANCE USE DISORDER, VIOLENCE AND PUBLIC SAFETY, AND WOMEN AND CHILDRENS HEALTH. THERE WAS ALSO SIGNIFICANT NEED IDENTIFIED IN THE CHNA IN THE AREAS OF TRANSPORTATION, HOUSING, AND EMPLOYMENT WHICH ARE SOCIAL DETERMINANTS OF HEALTH THAT CHRISTIANA CARE WAS NOT YET ABLE TO ADDRESS THROUGH ITS OWN INITIATIVES GIVEN A LACK OF EXPERTISE AND INFRASTRUCTURE. GENERALLY, ADDRESSING SOCIAL DETERMINANTS OF HEALTH IS NOT THE TRADITIONAL WORK OF HOSPITALS, BUT CHRISTIANA CARE HAS SOUGHT TO ADDRESS THESE AREAS OF NEED THROUGH COMMUNITY PARTNERSHIPS. CHRISTIANA CARE IS A PARTNER WITH DELAWARE PATHWAYS, A STATE-WIDE INITIATIVE LED BY THE DEPARTMENTS OF LABOR AND EDUCATION WHICH SEEKS TO ENGAGE YOUTH IN CAREER EXPLORATION AND TRAINING THROUGH INDUSTRY-BASED CAREER PATHWAYS, AND WITH JOBS FOR DELAWARE GRADUATES WHICH IS ANOTHER STATE-WIDE INITIATIVE AND NATIONALLY REPLICATED MODEL THAT WORKS TO SIMULTANEOUSLY ADDRESS DELAWARES UNEMPLOYMENT AND DROPOUT RATES. NOT ONLY ARE THESE PARTNERSHIPS IMPORTANT BECAUSE COMMUNITY MEMBERS HAVE IDENTIFIED EMPLOYMENT AS AN AREA OF NEED, BUT ALSO BECAUSE AS THE LARGEST EMPLOYER IN THE STATE OF DELAWARE, CHRISTIANA CARE BELIEVES IT HAS A RESPONSIBILITY TO ACT AS A LEADER AND DEMONSTRATE THE NECESSITY OF TAKING A ROLE IN IMPROVING COMMUNITIES. ANOTHER EXAMPLE OF THE WAY IN WHICH CHRISTIANA CARE SEEKS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH IS THROUGH ITS PARTNERSHIP WITH THE COMMUNITY LEGAL AID SOCIETY, INC. (CLASI). CHRISTIANA CARE AND CLASI CREATED THE MEDICAL LEGAL PARTNERSHIP TO INTEGRATE LAWYERS INTO HEALTH CARE TEAMS TO HELP ADDRESS LEGAL MATTERS OR NEEDS THAT HAVE AN IMPACT ON CLIENTS HEALTH OR ARE CREATED OR AGGRAVATED BY THE CLIENTS HEALTH ISSUES. CLASI PROVIDES FREE, CIVIL LEGAL SERVICES TO THOSE INDIVIDUALS WHO MEET CERTAIN ELIGIBILITY CRITERIA AND WHO NEED AN ADVOCATE WHEN FACING ISSUES LIKE THE TERMINATION OF PUBLIC BENEFITS SUCH AS MEDICAID OR SOCIAL SECURITY; EVICTIONS; UTILITY SHUT-OFFS; AND OBTAINING REASONABLE ACCOMMODATIONS FROM EMPLOYERS. THE FOLLOWING ARE BRIEF HIGHLIGHTS OF SOME KEY PROGRAMS AND INITIATIVES THAT CHRISTIANA CARE HAS UNDERTAKEN TO ADDRESS THE AREAS OF NEED IDENTIFIED IN THE CHNA. PLEASE SEE THE CHRISTIANA CARE CHIP AT HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ FOR A COMPLETE DESCRIPTION OF HOW CHRISTIANA CARE IS ADDRESSING THE IDENTIFIED AREAS OF NEED. 1. PREVALENCE OF POVERTY CHRISTIANA CARES INITIATIVES IN THIS AREA OF NEED SEEK TO ADDRESS THE FOLLOWING: POVERTY AND SOCIAL DETERMINANTS OF HEALTH, FOOD INSECURITY, AFFORDABILITY OF CARE, AND HOUSING, EMPLOYMENT, AND JOB SECURITY. PROGRAMS AND INITIATIVES INCLUDE THE FOLLOWING: CAMP FRESH (FRESH RESOURCES EVERYONE SHOULD HAVE): CAMP FRESH SERVES YOUTH WHO ATTEND A NUMBER OF HIGH SCHOOLS ACROSS NEW CASTLE COUNTY. THE MAJORITY OF THE TEENS IN THE PROGRAM ARE LIVING IN FEDERALLY RECOGNIZED HIGH-RISK ZIP CODES, INCLUDING 19801, 19802, 19805 AND 19720. THE CAMP, WHICH WAS CREATED IN JUNE OF 2007, IS A YEAR-ROUND HEALTH EDUCATION AND ADVOCACY PROGRAM, AND IT PROVIDES A VARIETY OF WELLNESS AND LEARNING-DRIVEN OPPORTUNITIES FOR YOUNG PEOPLE WHO ARE ENROLLED IN MEDICAID. CAMP FRESH PROMOTES IMPROVED NUTRITION AND MENTAL HEALTH, INCREASED PHYSICAL ACTIVITY, AWARENESS OF SEXUAL HEALTH RISKS AND IDENTIFYING OPPORTUNITIES FOR PERSONAL, ACADEMIC AND PROFESSIONAL GROWTH. CAMP FRESH ALSO HOLDS EVENTS SUCH AS PARENT RESOURCE NIGHT, STRESS MANAGEMENT, AND THE CAMP FRESH FINALE. DURING THIS REPORTING YEAR, MORE THAN 450 PEOPLE ATTENDED THESE EVENTS AND 42 TEENS, ALL ENROLLED IN MEDICAID, PARTICIPATED IN THE SUMMER CAMP. PRODUCE RX PROGRAM: IN THE SUMMER OF 2017, CHRISTIANA CARE PARTNERED WITH WESTSIDE FAMILY HEALTHCARE AND URBAN ACRES PRODUCE, A COMMUNITY-OWNED FARM STAND, TO ESTABLISH THE FRESH PRODUCE PRESCRIPTION PILOT PROGRAM. THIS PILOT PROGRAM PROVIDED WEEKLY FARMERS MARKETS AT TWO WESTSIDE FAMILY HEALTHCARE LOCATIONS IN WILMINGTON DURING THE SUMMER, AND SOUGHT TO ADDRESS FOOD INSECURITY AMONG A COHORT OF WESTSIDE FAMILY HEALTHCARE PATIENTS WHO WERE PRE-DIABETIC OR PRENATAL WOMEN LIVING WITHIN THE 19801, 19802 AND 19805 ZIP CODES. THIS INITIATIVE ENDED IN OCTOBER 2017, AND CHRISTIANA CARE EXPANDED UPON THOSE EFFORTS IN CONTINUED PARTNERSHIP WITH URBAN ACRES PRODUCE THE FOLLOWING SPRING AND SUMMER. WITH CHRISTIANA CARE SUPPORT, URBAN ACRES PRODUCE WAS ABLE TO OPERATE FARM STANDS IN SIX LOCATIONS THROUGHOUT THE CITY OF WILMINGTON INCLUDING A STAND AT THE WILMINGTON HOSPITAL AND CONTINUING THE TWO STANDS AT WESTSIDE FAMILY HEALTHCARE LOCATIONS THAT WERE ESTABLISHED IN THE PRIOR PILOT. THE STANDS WERE IN OPERATION FROM MAY 1ST TO SEPTEMBER 30TH, 2018. ANYONE WAS WELCOME TO PURCHASE AFFORDABLE PRODUCE FROM THE STANDS, BUT PREGNANT AND POST-PARTUM WOMEN WHO LIVED IN HIGH RISK ZIP CODES AND WERE ENROLLED IN HEALTHY BEGINNINGS, A CHRISTIANA CARE PROGRAM DESIGNED TO REDUCE INFANT MORTALITY, WERE ELIGIBLE TO RECEIVE "PRESCRIPTIONSVOUCHERS FROM THE HEALTHY BEGINNINGS STAFF FOR USE ANY OF THE PRODUCE STANDS. 173 PATIENTS WERE ENROLLED IN THIS PROGRAM. AT EACH PRODUCE STAND, A CHRISTIANA CARE COMMUNITY HEALTH WORKER OR HEALTH GUIDE PROVIDED HELPFUL INFORMATION ABOUT ACCESSING HEALTHCARE, AND A DIETICIAN WAS ALSO PRESENT WITH SAMPLES OF HEALTHY FOODS AND RECIPES TO SHARE WHICH IS IMPORTANT BECAUSE MAKING PRODUCE ACCESSIBLE IS ONLY HELPFUL IF INDIVIDUALS KNOW HOW TO PREPARE IT IN WAYS THEY WANT TO EAT. CHRISTIANA CARE HAS BEEN INTERVIEWING PARTICIPANTS AND ANALYZING EVALUATION RESPONSES TO DETERMINE HOW THE PROGRAM CAN BE IMPROVED WHEN IT BEGINS AGAIN IN THE SPRING OF 2019 TO ENSURE THOSE PROVIDED A PRESCRIPTION TAKE FULL ADVANTAGE OF ITS OFFERINGS AND THAT A POSITIVE IMPACT ON HEALTH OCCURS. CHRISTIANA CARE LOOKS FORWARD TO CONTINUING THIS INITIATIVE WITH URBAN ACRES PRODUCE BECAUSE THIS PARTNERSHIP COMBINES A CLINICAL AND COMMUNITY BASED APPROACH TO HEALTH, AND BECAUSE IT ALSO SUPPORTS COMMUNITY ECONOMIC DEVELOPMENT. URBAN ACRES PRODUCE IS A WILMINGTON BASED FARM STAND WHICH NOT ONLY SEEKS TO PROVIDE ITS COMMUNITY WITH ACCESS TO AFFORDABLE FRESH PRODUCE, BUT ALSO HIGH LEVEL JOBS AND THE ESTABLISHMENT OF A LOCAL-FOCUSED DISTRIBUTION NETWORK. DELAWARE MEDICAL LEGAL PARTNERSHIP: SINCE 2015 CHRISTIANA CARE HAS PARTNERED WITH DELAWARE'S COMMUNITY LEGAL AID SOCEITY, INC. ("CLASI") TO PROVIDE 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 PERSONS 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. CLASI ATTORNEYS ARE LOCATED ON-SITE AT THE WILMINGTON HOSPITAL AND ARE INTEGRATED INTO HEALTH CARE TEAMS. HEALTH GUIDES: HEALTH GUIDES PROVIDE UNINSURED PATIENTS WITH LINKAGES TO QUALITY, AFFORDABLE HEALTHCARE. CHRISTIANA CARE'S HEALTH GUIDES ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE PROCESS AND HELP PATIENTS NAVIGATE THE HEALTHCARE SYSTEM THROUGH PERSONAL INTERACTION, HEALTH RISK ASSESSMENT, AND IDENTIFICATION OF BARRIERS TO CARE. HEALTH GUIDES ALSO HOST EDUCATION SESSIONS TO EDUCATE THE COMMUNITY ON HOW TO USE THEIR INSURANCE. DURING THIS REPORTING YEAR, HEALTH GUIDES ASSISTED 2,160 INDIVIDUALS. COMMUNITY HEALTH WORKERS: A COMMUNITY HEALTH WORKER (CHW) IS A MEMBER OF THE HEALTH CARE TEAM WHO WORKS DIRECTLY WITH INDIVIDUALS AND FAMILIES TO ASSIST THEM IN ADDRESSING THEIR NON-CLINICAL HEALTH AND SOCIAL SERVICE NEEDS IN A CULTURALLY COMPETENT WAY TO ACHIEVE BETTER HEALTH OUTCOMES AND HEALTH EQUITY IN THE COMMUNITIES THEY SERVE. IN JUNE 2017, HEALTH MANAGEMENT ASSOCIATES IN PARTNERSHIP WITH THE DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES AND THE DELAWARE CENTER FOR HEALTH INNOVATION, PRODUCED A REPORT, DEVELOPMENT AND DEPLOYMENT OF COMMUNITY HEALTH WORKERS IN DELAWARE:ESTABLISHING A CERTIFICATION PROGRAM AND REIMBURSEMENT MECHANISM" WHICH ADDRESSED THE WAYS IN WHICH CHWS CAN BE ESTABLISHED AND UTLIZED IN DELAWARE TO IMPROVE POPULATION HEALTH. CHRISTIANA CARE RESPONDED TO THIS REPORT BY DEVELOPING A STANDARDIZED CURRICULUM, TRAINING, AND CERTIFICATION PROGRAM FOR CHWS IN ALIGNMENT WITH THE REPORT RECOMMENDATIONS. IN JANUARY 2018, CHRISTIANA CARES FIRST CHW TRAINING WAS LAUNCHED WITH A SIX WEEK PROGRAM THAT 16 PARTICIPANTS SUCCESSFULLY COMPLETED. CHRISTIANA CARE ALSO DEVELOPED A ROBUST CHW TRAINING EVALUATION, WITH THE ASSISTANCE OF ITS VALUE INSTITUTE, TO SUPPORT CONTINUOUS PROGRAM IMPROVEMENT. QUARTERLY MEETINGS WILL BE HELD FOR THE CHWS TO PROVIDE OPPORTUNITIES FOR NETWORKING, GROUP COHESION, QUALITATIVE DATA COLLECTION AND ADDITIONAL EDUCATION 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/ -------------------- PART V, SECTION B, LINE 22D, OTHER (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.("CHRISTIANA CARE"HEALTH SERVICES") 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) CHRISTIANA CARE HEALTH SYSTEM (CCHS) DID PREPARE A COMMUNITY HEALTH NEEDS ASSESSMENT AND A COMMUNITY HEALTH IMPLEMENTATION PLAN DURING THE FY2016 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 (COSTING METHODOLOGY USED) 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 (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). -------------------- PART III, SECTION A, LINE 4 (BAD DEBT EXPENSE FOOTNOTE) THE TEXT OF THE ORGANIZATION'S BAD DEBT EXPENSE FOOTNOTE CAN BE FOUND ON PAGE 26 (FOOTNOTE #13) OF THE ELECTRONICALLY ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CHRISTIANA CARE HEALTH SERVICES, INC. -------------------- 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 CHRISTIANA CARE AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, CHRISTIANA CARE 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 CHRISTIANA CARE 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) CHRISTIANA CARE 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 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. ALL SUBSEQUENT STATEMENTS PROVIDE THE PATIENTS WITH 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. 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) CHRISTIANA CARE CONDUCTED ITS CHNA IN FISCAL YEAR 2016 IN ACCORDANCE WITH THE REQUIREMENTS OF THE AFFORDABLE CARE ACT AND SECTION 501(R) OF THE INTERNAL REVENUE CODE. THE CHNA INFORMED THE DEVELOPMENT OF CHRISTIANA CARES 2017-2019 COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP). BOTH THE CHNA AND THE CHIP ARE AVAILABLE ON CHRISTIANA CARES WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/. CHRISTIANA CARE CONTRACTED WITH COMMUNITY HEALTH ADVISORS, LLC (CHA) TO ASSIST WITH CONDUCTING THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW AND ANALYSIS, TO DEVELOP THE CHNA. CHRISTIANA CARE ALSO CONSIDERED SEVERAL SECONDARY DATA SOURCES, IDENTIFIED IN THE CHNA, TO ENSURE KEY DEMOGRAPHIC TRENDS AND DATA ON SOCIAL DETERMINANTS OF HEALTH FURTHER INFORMED OUR FINDINGS. CHRISTIANA CARES COMMITMENT TO COMMUNITY ENGAGEMENT IS REFLECTED IN THE CHNA THROUGH ITS COLLECTION AND REVIEW OF PRIMARY DATA. CHRISTIANA CARE CONDUCTED INTERVIEWS WITH THIRTY-FOUR COMMUNITY STAKEHOLDERS AND LEADERS (THE LIST OF THESE INDIVIDUALS IS INCLUDED IN THE CHNA). IN ADDITION TO THOSE INTERVIEWS, CHRISTIANA CARE ALSO CONDUCTED A SURVEY OF FIFTY-FIVE COMMUNITY MEMBERS IN FEBRUARY 2016 AT THE NEW CASTLE COUNTY FARMERS MARKET. THE SURVEY ASKED FOR COMMUNITY MEMBER INPUT ON THE TOP FIVE "HEALTH ISSUES" FACING THE COMMUNITY AND THE TOP FIVE "HEALTH-RELATED ISSUES" FACING THE COMMUNITY. ONCE THE INITIAL DATA COLLECTION, SURVEYS, AND INTERVIEWS WERE COMPLETED, CHRISTIANA CARE ASKED KEY COMMUNITY STAKEHOLDERS AND MEMBERS OF THE CHRISTIANA CARE LEADERSHIP TEAM TO PRIORITIZE THE SIGNIFICANT HEALTH NEEDS BASED ON THE ISSUES IDENTIFIED IN THE COMMUNITY SURVEYS. AS A RESULT, THE FOLLOWING WERE IDENTIFIED IN THE CHNA AS "PRIORITIZED SIGNIFICANT HEALTH NEEDS": 1. PREVALENCE OF POVERTY AND OTHER FACTORS INCLUDING FOOD INSECURITY, HOUSING, AFFORDABILITY OF CARE, AND EMPLOYMENT/JOB SECURITY 2. MENTAL HEALTH AND SUBSTANCE USE DISORDER 3. VIOLENCE AND PUBLIC SAFETY 4. WOMEN AND CHILDRENS HEALTH, ESPECIALLY, PRECONCEPTION HEALTH, PRENATAL CARE, AND INFANT MORTALITY THE CHNA REVIEWED THE EXISTING CHRISTIANA CARE PROGRAMS AND OTHER COMMUNITY RESOURCES THAT ADDRESSED THE FOUR AREAS OF PRIORITY HEALTH NEEDS, AND IT ALSO DISCUSSED THE ACTIONS CHRISTIANA CARE HAD UNDERTAKEN TO ADDRESS THE PREVIOUSLY REPORTED PRIORITY HEALTH NEEDS WHICH INCLUDED NEW MODELS OF CARE AND ENHANCED MENTAL HEALTH SERVICES. THE CHRISTIANA CARE BOARD OF DIRECTORS APPROVED THE CHNA IN ITS MAY 2016 BOARD MEETING. THE CHNA AND THE IDENTIFIED AREAS OF PRIORITY HEALTH NEEDS INFORMED THE DEVELOPMENT OF CHRISTIANA CARES 2017-2019 CHIP. THE FOLLOWING IS A BRIEF SUMMARY OF THE ACTION ITEMS OUTLINED IN THE CHIP, AND AVAILABLE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/. PREVALENCE OF POVERTY: CHRISTIANA CARE WILL CONTINUE TO SUPPORT COLLABORATION ACROSS SECTORS AND WITH OTHER HEALTH SYSTEMS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. CHRISTIANA CARE WILL ALSO CONTINUE TO UTILIZE HEALTH GUIDES, HEALTH AMBASSADORS, AND COMMUNITY HEALTH WORKERS TO CONNECT WITH COMMUNITY MEMBERS AND PROVIDE THEM WITH INFORMATION ABOUT ACCESSING HEALTH AND SOCIAL SERVICES RESOURCES. MENTAL HEALTH AND SUBSTANCE USE DISORDER: CHRISTIANA CARE WILL CONTINUE ITS ONGOING BEHAVIORAL HEALTH AND PRIMARY CARE INTEGRATION EFFORTS AND CONTINUE TO SUPPORT IMPROVED ACCESS TO BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT AND PREVENTION SERVICES. VIOLENCE AND PUBLIC SAFETY: CHRISTIANA CARE WILL CONTINUE TO PARTNER WITH COMMUNITY ORGANIZATIONS AND GOVERNMENT ENTITIES AT ALL LEVELS TO ADDRESS THE VIOLENCE AND PUBLIC SAFETY ISSUES FACING DELAWARE, WITH A PARTICULAR FOCUS ON THE EPIDEMIC OF GUN VIOLENCE IN THE CITY OF WILMINGTON. CHRISTIANA CARE WILL USE ITS OUTREACH PROGRAMS THAT INCORPORATE INNOVATIVE EDUCATIONAL TOOLS TO WORK TO PREVENT VIOLENCE. WOMENS AND CHILDRENS HEALTH: CHRISTIANA CARE WILL INCREASE PRECONCEPTION HEALTH AND PRE-NATAL CARE FOR PREGNANT WOMEN, ATTEMPT TO REDUCE THE UNINTENDED PREGNANCY AND PREMATURE BIRTH RATES, AND SEEK TO REDUCE INFANT MORTALITY. ADDITIONAL PROGRAM INFORMATION IS AVAILABLE IN THE CHNA AND CHIP, AS WELL AS IN PART V OF THIS SCHEDULE H. CHRISTIANA CARE IS COMMITTED TO LISTENING TO THE COMMUNITY IT SERVES AND LEARNING ABOUT THE NEEDS OF COMMUNITY MEMBERS. THE GREATER WILMINGTON COMMUNITY PARTNERSHIP AND THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL, TWO GROUPS CHRISTIANA CARE FORMED TO HAVE DIRECT CONTACT WITH COMMUNITY LEADERS AND STAKEHOLDERS, ARE EXAMPLES OF THIS COMMITMENT. CHRISTIANA CARE PARTICIPATION IN GROUPS LIKE THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM, DESCRIBED PREVIOUSLY IN PART V, AND HEALTHY NEIGHBORHOODS, A DELAWARE CENTER FOR HEALTH INNOVATION INITIATIVE TO ADDRESS POPULATION HEALTH CHALLENGES, ARE OTHER EXAMPLES OF ITS COMMITMENT TO LEARNING ABOUT AND ADDRESSING THE HEALTH NEEDS OF ITS COMMUNITY IN PARTNERSHIP WITH STAKEHOLDERS THROUGHOUT THE STATE. -------------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) CHRISTIANA CARE FULFILLS ITS MISSION OF SERVING ITS NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH REGARDLESS OF ABILITY TO PAY. IN KEEPING WITH THAT MISSION, AND AS STATED IN CHRISTIANA CARES CHIP, CHRISTIANA CARE REVISED ITS FINANCIAL ASSISTANCE POLICY TO PROVIDE RELIEF TO INDIVIDUALS IMPACTED BY THE HIGH COST OF HEALTHCARE. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON CHRISTIANA CARES WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL -ASSISTANCE/, AND IN PAMPHLETS THROUGHOUT CHRISTIANA CARE FACILITIES, INCLUDING CHRISTIANA CARES OUTPATIENT PRACTICES. FINANCIAL ASSISTANCE APPLICATIONS ARE ALSO AVAILABLE IN SPANISH, CANTONESE, AND MANDARIN WHICH ARE THE LANGUAGES MOST SPOKEN IN OUR 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/. CHRISTIANA CARES FINANCIAL ASSISTANCE POLICY APPLIES TO ALL MEDICALLY NECESSARY SERVICES, INCLUDING THE HOSPITAL INPATIENT, OUTPATIENT, AND EMERGENCY DEPARTMENT SERVICES THAT ARE BILLED BY CHRISTIANA CARE, AS WELL AS ALL SERVICES RENDERED BY CHRISTIANA CARE 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 REQUIREMENTS FOR ELIGIBILITY. UNINSURED INDIVIDUALS WITH A HOUSEHOLD INCOME GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR A STANDARD DISCOUNT OF 15%. -------------------- PART VI, LINE 4 (COMMUNITY INFORMATION) CHRISTIANA CARES PRIMARY SERVICE AREA IS IN NEW CASTLE COUNTY, DELAWARE. THE MAJORITY OF CHRISTIANA CARES PATIENTS, APPROXIMATELY 80%, RESIDE IN NEW CASTLE COUNTY. ACCORDING TO THE U.S. CENSUS AMERICAN COMMUNITY SURVEY, DELAWARE WAS ONE OF ONLY TWO STATES TO HAVE A RISE IN ITS POVERTY RATE BETWEEN 2016 AND 2017 WITH THE STATE POVERTY RATE RISING TO 13.6%. THE POVERTY RATE IN NEW CASTLE COUNTY IS 11%, LOWER THAN THE STATE AND NATIONAL AVERAGE, BUT WITHIN NEW CASTLE COUNTY THERE IS GREAT VARIATION IN POVERTY LEVELS. IN THE CITY OF WILMINGTON, 26% OF RESIDENTS ARE LIVING AT OR BELOW THE POVERTY LEVEL. THE RACIAL/ETHNIC COMPOSITION OF NEW CASTLE COUNTY IS PREDOMINATELY WHITE/CAUCASIAN WITH 23.4% OF ITS SERVICE POPULATION AS AFRICAN-AMERICAN NON-HISPANIC, 9.7% AS HISPANIC, 5.1% ASIAN, AND 2.5% AS ALL OTHERS. MORE DETAILED INFORMATION ON THE DEMOGRAPHICS OF CHRISTIANA CARES SERVICE AREA POPULATION CAN BE FOUND WITHIN ITS CHNA AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/. -------------------- PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANA CARES MISSION IS TO SERVE OUR NEIGHBORS AS RESPECTFUL, CARING, PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, AFFORDABLE, SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. WE ARE COMMITTED TO FULFILLING OUR MISSION OF SERVICE TO OUR NEIGHBORS, AND AS THE LARGEST HEALTH CARE PROVIDER IN A STATE THAT HAS NO SAFETY NET OR PUBLIC HOSPITAL; WE SERVE A SIGNIFICANT PORTION OF THE COMMUNITYS UNINSURED AND UNDERINSURED POPULATION ALONG WITH A SUBSTANTIAL PORTION OF THE STATES MEDICAID POPULATION. CHRISTIANA CARE IS KEENLY AWARE OF THE IMPORTANCE OF THE COMMITMENT WE HAVE TO THE HEALTH OF OUR COMMUNITIES. EACH YEAR, CHRISTIANA CARES WILMINGTON HOSPITAL HEALTH CENTER ATTRACTS APPROXIMATELY 67,500 PATIENT VISITS. A SIGNIFICANT NUMBER WHEN YOU CONSIDER THE ENTIRE POPULATION OF NEW CASTLE COUNTY WHICH IS APPROXIMATELY 550,000. CHRISTIANA CARE ALSO PROVIDES SERVICES THAT DELAWAREANS CANNOT FIND ELSEWHERE IN THE STATE. CHRISTIANA CARES KIDNEY TRANSPLANT PROGRAM IS DELAWARES ONLY ADULT TRANSPLANT PROGRAM. MORE THAN 300 PATIENTS HAVE BEEN TRANSPLANTED IN THE DECADE THE PROGRAM HAS BEEN IN OPERATION AND EVERY YEAR, MORE THAN 1,000 PATIENTS RELY ON THE KIDNEY TRANSPLANT TEAM FOR KIDNEY FAILURE CARE. IN THIS REPORTING PERIOD, CHRISTIANA CARE ALSO OPENED DELAWARES FIRST EPILEPSY MONITORING UNIT (EMU). THE EMU IS PART OF A LARGER EFFORT TO ESTABLISH AN EPILEPSY CENTER OF EXCELLENCE, UNDER THE GUIDELINES OF THE NATIONAL ASSOCIATION OF EPILEPSY CENTERS, SO ADULTS OF ANY AGE CAN RECEIVE THE HIGHEST QUALITY ROUTINE AND SPECIALTY CARE FOR SEIZURE DISORDERS. PATIENT COMFORT AND SAFETY WAS A PARAMOUNT CONCERN WHEN CREATING THIS EMU AND IT IS ONE OF THE FEW EMUS IN THE COUNTRY THAT USES A PATIENT LIFT TO ALLOW PATIENTS TO MOVE SAFELY AROUND THEIR ROOM AND NOT FEAR FALLS. CHRISTIANA CARES CENTER FOR SPECIAL HEALTH CARE NEEDS, BASED IN THE WILMINGTON HOSPITAL, IS ALSO NEW THIS REPORTING PERIOD, AND IS THE ONLY CENTER IN THE AREA DEDICATED TO CARING FOR ADULTS AGED 18 AND OLDER WITH COMPLEX MEDICAL AND SOCIAL CONDITIONS WHICH ORIGINATED IN CHILDHOOD SUCH AS CYSTIC FIBROSIS, HEMOPHILIA, AND INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. THE CENTER STRIVES TO HELP PATIENTS AND THEIR FAMILIES TRANSITION SEAMLESSLY BETWEEN PEDIATRIC AND ADULT CARE BY PROVIDING THEM WITH ACCESSIBLE AND CONVENIENT CARE AND BY CONNECTING THEM WITH RESOURCES IN THE COMMUNITY. ENSURING THAT PATIENTS HAVE A POSITIVE TRANSITION FROM PEDIATRIC TO ADULT CARE IS IMPORTANT AS STUDIES HAVE SHOWN DECLINES IN HEALTH FOR CERTAIN DISEASES ONCE A PATIENT AGES OUT OF PEDIATRIC CARE. SIGNIFICANT RESEARCH IS ALSO HAPPENING ON THE CHRISTIANA CARE CAMPUS. LAST YEAR, WE REPORTED ON CHRISTIANA CARES GENE EDITING INSTITUTE, WHICH IS A PART OF THE HELEN F. GRAHAM CANCER CENTER AND RESEARCH INSTITUTE, AND ITS DEVELOPMENT OF A POTENTIALLY BREAKTHROUGH CRISPR GENE-EDITING TOOL WHICH COULD ALLOW FOR A MORE TARGETED TREATMENT STRATEGY FOR INDIVIDUAL PATIENTS. THIS YEAR, CHRISTIANA CARE SCIENTISTS IN THE HELEN F. GRAHAM CANCER CENTER AND RESEARCH INSTITUTES CENTER FOR TRANSLATIONAL CANCER RESEARCH DISCOVERED THAT THE OVEREXPRESSION OF HOXA4 AND HOXA9 GENES IN COLON CANCER STEM CELLS PROMOTES CELL REPLICATION AND CONTRIBUTES TO THE OVERPOPULATION OF STEM CELLS THAT DRIVES THE DEVELOPMENT OF COLON CANCER. FINDINGS SUGGEST TREATMENT WITH VITAMIN A DERIVATIVES, CALLED RETINOID DRUGS, COULD PROVIDE A THERAPEUTIC STRATEGY FOR DECREASING THE EXPRESSION OF HOX GENES AND TARGETING HIGHLY RESISTANT CANCER STEM CELLS. CHRISTIANA CARE IS ALSO PARTICIPATING IN THE ASPIRIN TRIAL, THE LARGEST EVER TRIAL LOOKING AT THE ROLE OF ASPIRIN IN PREVENTING PRETERM BIRTH, A LEADING FACTOR IN INFANT MORTALITY. STUDIES HAVE SUGGESTED THAT LOW-DOSE ASPIRIN GIVEN EARLY IN PREGNANCY MAY LOWER THE RISK OF PRETERM BIRTH BY 20% OR MORE. IF THIS STUDY SUPPORTS THAT, ASPIRIN COULD BE AN ACCESSIBLE LOW-COST TREATMENT FOR EXPECTANT WOMEN LIVING IN POVERTY. THESE ARE JUST A FEW EXAMPLES OF THE RESEARCH CHRISTIANA CARE IS UNDERTAKING TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES THAT WILL HAVE IMPLICATIONS FOR THE BROADER POPULATION. CHRISTIANA CARES GOVERNING BODY, ITS BOARD OF DIRECTORS, IS COMPRISED OF PERSONS WHO RESIDE IN ITS PRIMARY SERVICE AREA, AND MOST OF THE BOARD MEMBERS ARE NOT EMPLOYEES, INDEPENDENT CONTRACTORS, OR FAMILY MEMBERS OF CHRISTIANA CARE. CHRISTIANA CARE HAS ALSO ESTABLISHED THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL TO SUPPORT OPEN DIALOGUE ON THE NEEDS OF THE COMMUNITY. AS DESCRIBED IN THE CHNA AND CHIP, CHRISTIANA CARE FINANCIALLY SUPPORTS IMPROVEMENTS IN ACCESS TO CARE, COMMUNITY OUTREACH, IMPROVING THE CARE AND OVERALL HEALTH OF OUR NEIGHBORS, AND CONTINUING TO SUPPORT MEDICAL EDUCATION AND RESEARCH. ONE OF THE MOST SIGNIFICANT AND INNOVATIVE WAYS CHRISTIANA CARE IS SERVING ITS COMMUNITY IS THROUGH CARELINK CARE NOW, A PATIENT-CENTERED CARE COORDINATION SERVICE. CHRISTIANA CARE PARTNERS WITH APPROXIMATELY 300 PRIMARY CARE PHYSICIANS TO CHANGE THE WAY CARE IS DELIVERED TO 104,000 MEDICARE BENEFICIARIES AND HEALTH PLAN MEMBERS. CARELINK CARE NOW STRIVES TO ACHIEVE BETTER QUALITY AND CARE AT A LOWER COST TO THE PATIENT THROUGH HARNESSING AN INFORMATION TECHNOLOGY PLATFORM THAT INTEGRATES ALL AVAILABLE SOURCES OF A PERSONS HEALTH DATA ADMISSIONS AND EMERGENCY DEPARTMENT VISIT INFORMATION, LAB RESULTS, PHARMACEUTICAL USE DATA AND PHYSICIAN VISITS INTO CARE COORDINATION SOFTWARE THAT SUPPORTS AN INTERDISCIPLINARY TEAM IN PROVIDING COORDINATED CARE SERVICES TO PROVIDERS AND THEIR PATIENTS. CARELINK CARE NOW IS ABLE TO IDENTIFY THE HIGHEST RISK POPULATIONS THROUGH ITS PREDICTIVE ANALYTIC CAPABILITIES AND REACH OUT TO INDIVIDUALS IN REAL TIME TO ENSURE THEY GET THE HEALTH SERVICES THEY NEED. CHRISTIANA CARE IS ALSO A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES 50,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CARELINK CARE NOW IS ALSO PART OF THIS INITIATIVE. IN ITS FIRST TWO YEARS OF OPERATION, EBRIGHTHEALTH ACO HAS IMPROVED QUALITY OF CARE AND ACHIEVED COST SAVINGS OF NEARLY $2 MILLION. EVERY DAY, CHRISTIANA CARE REACHES OUT TO ITS NEIGHBORS IN THEIR COMMUNITIES THROUGH OUR HEALTH GUIDES, WHO PROVIDE LINKS TO QUALITY AFFORDABLE HEALTHCARE TO UNINSURED PATIENTS; OUR HEALTH AMBASSADORS WHO CONNECT WITH WOMEN IN COMMUNITIES WHERE THERE IS A HIGH RISK FOR INFANT MORTALITY TO ENSURE THEY RECEIVE CARE AND ACCESS TO RESOURCES; OUR PEER ENGAGEMENT SPECIALISTS WHO SEEK A REACHABLE MOMENT WITH THOSE RECOVERING FROM AN OVERDOSE WITHIN THE HOSPITAL TO ENCOURAGE THEM TO TAKE THE FIRST STEPS TOWARDS CONFRONTING THEIR SUBSTANCE USE DISORDER; OUR VIOLENCE PREVENTION COORDINATOR, WHO TALKS WITH TEENS ABOUT THE REAL IMPACT OF VIOLENCE ON THEM AND THEIR FAMILIES; AND OUR COMMUNITY EDUCATORS WHO ENCOURAGE ADOLESCENTS TO MAKE RESPONSIBLE AND SAFE CHOICES WHEN IT COMES TO THEIR SEXUAL HEALTH. THESE ARE BUT A FEW EXAMPLES OF HOW CHRISTIANA SERVES ITS NEIGHBORS. OTHER EXAMPLES OF THE INNOVATIVE WAYS IN WHICH CHRISTIANA CARE WORKS TO IMPROVE THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY ARE DESCRIBED IN MORE DETAIL IN THE CHNA AND CHIP, AS WELL AS IN SECTIONS B AND C OF THIS NARRATIVE. CHRISTIANA CARE ALSO WORKS TO IMPROVE THE HEALTH OF ITS COMMUNITIES BY DIRECTLY ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THROUGH THE CHARLES J. HARRINGTON FUND WHICH WAS MADE POSSIBLE THROUGH A $13 MILLION BEQUEST TO ADVANCE SCHOLARSHIP AND SUPPORT INNOVATIVE PROJECTS THAT HELP REDUCE HEALTH CARE DISPARITIES FOR THE UNDERSERVED AND DISADVANTAGED POPULATIONS THROUGHOUT OUR SERVICE AREA. ONE COMPONENT OF THE FUND, KNOWN AS THE HARRINGTON VALUE INSTITUTE COMMUNITY PARTNERSHIP FUND (HARRINGTON FUND), SUPPORTS NEW OR EXISTING INNOVATIVE COMMUNITY PROGRAMS THAT TARGET ONE OR MORE SOCIAL DETERMINANTS OF HEALTH AND INCLUDE BOTH A COMMUNITY FOCUS AND A CLINICAL OUTCOME. IN JUNE 2017, CHRISTIANA CARE ANNOUNCED HARRINGTON FUND AWARDS TO FOUR PROJECTS. THESE PROJECTS WERE: 1. READING INTERVENTION READING CORPS PROGRAM: A CONTINUING PROJECT, THE WILMINGTON BASED READING ASSIST INSTITUTE PROVIDES EARLY INTERVENTION FOR FIRST THROUGH THIRD GRADE STUDENTS IN LOW-INCOME AND LOW-PERFORMING PUBLIC ELEMENTARY SCHOOLS WHO SUFFER FROM LANGUAGE-BASED LEARNING DISABILITIES, AND WHO ARE READING AT OR BELOW THE 25TH PERCENTILE. WE KNOW THAT NOT BEING ABLE TO READ WILL HAVE A SIGNIFICANTLY NEGATIVE IMPACT ON AN INDIVIDUALS LIFE AND HEALTH. NOT BEING ABLE TO READ A PRESCRIPTION OR CARE INSTRUCTIONS AFTER SURGERY WILL HAVE AN OBVIOUS IMPACT ON HEALTH, BUT ILLITERACY IS ALSO LIKELY TO HINDER A PERSONS EMPLOYABILITY CAN ALSO HAVE A NEGATIVE IMPACT ON HEALTH. 2. HEALTHY LATINA FAMILIES: IMPROVING ACCESS AND CARE: A CONTINUING PROJECT, LAUNCHED IN 2012, THE PROMOTORAS FOR HEALTHY FAMILY PROGRAM STRATEGICALLY EMBEDS SPECIALLY TRAINED HISPANIC, SPANISH-SPEAKING HEALTH ADVOCATES AND RESOURCES KNOWN AS PROMOTORAS THROUGHOUT LATINA COMMUNITIES TO PROVIDE HEALTH OUTREACH AND EDUCATION, ELIMINATE BARRIERS TO CARE, AND PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) CHRISTIANA CARE IS A MAJOR TEACHING HEALTH SYSTEM WITH A 1,514 MEMBER MEDICAL-DENTAL STAFF AND MORE THAN 260 MEDICAL-DENTAL RESIDENTS AND FELLOWS. MAJOR FACILITIES INCLUDE: - CHRISTIANA HOSPITAL-STANTON CAMPUS: LOCATED IN NEWARK, DELAWARE, THIS CAMPUS IS HOME TO THE 906 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 STATES 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 IS THE CORPORATE HEADQUARTERS FOR THE HEALTH SYSTEM AND 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. -------------------- PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) DELAWARE DOES NOT REQUIRE THE FILING OF A COMMUNITY BENEFIT REPORT. NEVERTHELESS, CHRISTIANA CARE HAS ESTABLISHED A COMMUNITY BENEFIT DEDICATED SECTION ON ITS WEBSITE WHERE THE CHNA AND CHIP CAN BE FOUND, ALONG WITH ARTICLES ABOUT CHRISTIANA CARES COMMUNITY BENEFIT INITIATIVES AND STORES. THIS GROWING COLLECTION OF STORIES CAN BE ACCESSED AT: HTTPS://NEWS.CHRISTIANACARE.ORG/CATEGORY/IN-THE-COMMUNITY/COMMUNITY- BENEFIT/. X true true X X X X X true true false false false false false true false THOMAS L CORRIGAN EXECUTIVE VP AND CFO 651536 0 235464 0 138589 0 26786 0 17927 0 1070302 0 0 0 ROBERT LASKOWSKI FORMER PRESIDENT & CEO 0 0 0 0 2128925 0 7886 0 0 0 2136811 0 0 0 JAMES HOPKINS MD MEMBER 408364 0 85000 0 37000 0 25436 0 11180 0 566980 0 0 0 BRENDA K PIERCE ESQ SECRETARY OF CORP- THRU 6/18 311164 0 86428 0 20950 0 45256 0 11180 0 474978 0 0 0 AUDREY VAN LUVEN SR VP&CHIEF HR OFF. THRU 7/17 379995 0 132998 0 89775 0 26736 0 3595 0 633099 0 0 0 JANICE E NEVIN MD PRESIDENT & CEO 1038734 0 502250 0 60707 0 137436 0 11973 0 1751100 0 0 0 TIMOTHY GARDNER MD MEDICAL DIRECTOR, HVIS 655274 0 182006 0 40638 0 26736 0 11180 0 915834 0 0 0 VIRGINIA COLLIER PHYSICIAN 523432 0 73280 0 275213 0 26736 0 261 0 898922 0 0 0 PAUL DAVIS PHYSICIAN 716479 0 103501 0 0 0 24086 0 19812 0 863878 0 0 0 KENNETH SILVERSTEIN CHIEF CLINICAL OFFICER 609589 0 211520 0 0 0 84520 0 17927 0 923556 0 0 0 RICHARD CUMING CHIEF NURSING EXECUTIVE 399178 0 140002 0 0 0 64086 0 0 0 603266 0 0 0 MICHAEL EPPEHIMER CHIEF OP. OFFICER - MED GROUP 299550 0 84005 0 150000 0 43437 0 17927 0 594919 0 0 0 SHARON KURFUERST CHIEF OP. OFFICER - HEALTH SVC 305530 0 84005 0 157231 0 44788 0 17927 0 609481 0 0 0 NICHOLAS PETRELLI MD MEDICAL DIRECTOR, CANCER 562364 0 156200 0 33261 0 26736 0 12289 0 790850 0 0 0 MARK BOROWSKY PHYSCIAN 580592 0 150000 0 0 0 26786 0 17927 0 775305 0 0 0 NEIL JASANI CHIEF PEOPLE OFFICER 401776 0 111829 0 0 0 24086 0 17927 0 555618 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 AUDREY VAN LUVEN RECEIVED A SEVERANCE DISTRIBUTION OF $175,382 DURING THE 2017 CALENDAR YEAR. VIRGINIA COLLIER RECEIVED A SEVERANCE DISTRIBUTION OF $503,300 DURING THE 2017 CALENDAR YEAR. -------------------- 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: THOMAS L. CORRIGAN- $67,276 TIMOTHY GARDNER, MD- $39,001 NICHOLAS PETRELLI- $33,471 -------------------- 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 2008 510272458 246388NVO 2008-11-20 80000000 REFINANCE SERIES 2004 & MED BLDG false false false B DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010A 510272458 246388EQ5 2010-11-04 74491341 CONSTRUCTION OF HOSPITAL false false false C DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010 510272458 246388QPO 2010-11-04 127295000 CONSTRUCTION OF HOSPITAL false false false A 4725000 0 80000000 0 0 0 774850 0 0 19062025 60163125 0 2006 true false true true B 15360000 0 74956804 0 0 0 879197 0 0 74077607 0 0 2014 false false true true C 10955000 0 128314967 0 0 0 684318 0 0 127630649 0 0 2014 false false true true A false false false true true 0 false false false true B false false false true true 0 false false false true C false false false true true 0 false false false true A false true true false 0 false 0 false true B false true false false 0 false 0 false true C false true true false 0 false 0 false true A true B true C true FORM 990, SCHEDULE K, PART II, LINE 3 FOR DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010A, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $465,463 IN INVESTMENT EARNINGS. FOR DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $1,119,967 IN INVESTMENT EARNINGS. -------------------- FORM 990, SCHEDULE K, PART IV, LINE 2C, COLUMNS A, B, AND C AN ARBITRAGE REBATE AND YIELD RESTRICTION COMPLIANCE ANALYSIS WAS COMPLETED BY THE PFM GROUP FOR THE DELAWARE HEALTH FACILITIES AUTHORITY 2008 BONDS ON NOVEMBER 19, 2018 AND THE DELAWARE HEALTH FACILITIES AUTHORITY 2010 BONDS ON NOVEMBER 4, 2015. FORM 990, PART III, LINE 4D DETAIL OF OTHER PROGRAM SERVICES CHRISTIANA CARE 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 260 MEDICAL-DENTAL RESIDENTS AND FELLOWS. CHRISTIANA CARE 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, CHRISTIANA CARE 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 11,800 EMPLOYEES, CHRISTIANA CARE IS THE LARGEST PRIVATE EMPLOYER IN DELAWARE AND ONE OF THE LARGEST EMPLOYERS IN THE PHILADELPHIA REGION. -------------------- FORM 990, PART IV, LINE 21 DETAIL OF SUBAWARDS IN FURTHERANCE OF ITS MEDICAL RESEARCH ACTIVITIES, CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAKES SUB-AWARDS TO OTHER INSTITUTIONS THAT PERFORM RESEARCH IN CONNECTION WITH RESEARCH GRANTS AWARDED TO CCHS. CCHS DOES NOT CATEGORIZE THESE SUB-AWARDS AS GRANTS OR ASSISTANCE FOR FORM 990 REPORTING, SINCE THE RECIPIENT ORGANIZATIONS PERFORM RESEARCH SERVICES FOR CCHS AND ARE CONSIDERED INDEPENDENT CONTRACTORS WHICH SERVE THE DIRECT NEEDS OF CCHS. DURING THE YEAR ENDED JUNE 30, 2018, CCHS MADE SUB-AWARD PAYMENTS TO 3 RECIPIENTS TOTALING $81,669. -------------------- FORM 990, PART VI, SECTION A, LINE 7A,B GOVERNING BODY AND MANAGEMENT THE BOARD OF DIRECTORS OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"), AT IT'S ANNUAL MEETING IN NOVEMBER, ELECTS DIRECTORS OF CCHS. THE ANNUAL OPERATING BUDGET OF CCHS IS APPROVED BY THE CCHS BOARD, THE SYSTEM FINANCE COMMITTEE AND THE SYSTEM BOARD. -------------------- FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS INFORMATION RELATED TO CCHS' FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW. THE FINAL 2017 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2018 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2017 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 SUPERVISORY POLICY MANUAL. 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. THE EMPLOYEE HANDBOOK SETS EXPECTATIONS FOR EMPLOYEE CONFLICTS OF INTEREST AND EXPECTATIONS. 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 CHRISTIANA CARE'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 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 POSTRETIREMENT LIABILITIES $ (8,631,474) BENEFICIAL INTEREST IN SYSTEM (8,887) OTHER 610,289 ----------- TOTAL $ (8,030,072) ============ CHRISTIANA CARE CAMPUS REALTY LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE 0 0 CCHS CHRISTIANA CARE QUALITY PARTNERS LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -53796 10695 CCHS CHRISTIANA CARE QUALITY PARTNERS ACOLLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -1071933 10698 CCHS CHRISTIANA CARE CARE LINK LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -3001833 10703 CCHS CHRISTIANA CARE HEALTH SYSTEM INC 501 WEST 14TH STREET WILMINGTON DE 19801 521479538 FUNDRAISING DE 501(c)(3) 7 NA false CHRISTIANA CARE HLTH INITIATIVES INC 200 HYGEIA DRIVE SUITE 2300 NEWARK DE 19713 510295186 OUTPATIENT SV DE 501(c)(3) 10 CCHS SYSTEM false CHRISTIANA CARE HOME HEALTH & COM SRVCS 1 READS WAY NEW CASTLE DE 19720 510064334 HOME HLTHCARE DE 501(c)(3) 7 CCHS SYSTEM false THE DE CTR FOR MAT FETAL MED OF CC INC 200 HYGEIA DRIVE NEWARK DE 19713 205891272 HEALTHCARE DE CCHS C CORP 169857 1876479 1.00000 true CHRISTIANA CARE HEALTH PLANS 200 HYGEIA DRIVE OFFICE 2524 NEWARK DE 19713 510352728 INSURANCE DE CCHS SYSTEM C CORP false true false true false false false false false false true false false true true true true true true false THE DE CTR FOR MAT FETAL MED OF CC INC A,O 563912 FMV DIRECT OTHER LOBBYING EXEMPT PURPOSE NAME OF ELECTING ORGANIZATION EXPENDITURES EXPENDITURES __________________________________ ____________ _______________ CHRISTIANA CARE HEALTH SYSTEM $ NONE $ 3,269,336 CHRISTIANA CARE HEALTH SERVICES 198,652 1,516,561,722 CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES NONE 45,376,090 CHRISTIANA CARE HEALTH INITIATIVES NONE 2,187,646 ------------ -------------- TOTAL $ 198,652 $ 1,567,394,794 THE ORGANIZATION HAS MADE THE LOBBYING ELECTION UNDER I.R.C. SECTION 501(H) FOR THE TAX YEAR ENDED JUNE 30, 2018. THIS ELECTION HAS NOT BEEN REVOKED BEFORE THE START OF THE ORGANIZATION'S TAX YEAR THAT BEGAN IN 2017.