CHRISTIANA CARE HEALTH SERVICES INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: CHRISTIANA CARE HEALTH SERVICES INC (EIN 51-0103684)
Tax period: 2021-07-01 to 2022-06-30
Filed: 2023-05-15
IRS object ID: 202311359349305831
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule G
Schedule H
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R
Affiliated Group Attachment

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-05-15T11:04:12-05:00	ReturnTs
Tax Period End	2022-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	PricewaterhouseCoopers LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	2001 MARKET ST SUITE 1800	AddressLine1Txt
City	PHILADELPHIA	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	19103	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	510103684	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHRISTIANA CARE HEALTH SERVICES INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% SR VP'S OFFICE	InCareOfNm
Business Name Control	CHRI	BusinessNameControlTxt
Phone	3024282426	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4000 NEXUS DRIVE NW3-100	AddressLine1Txt
City	WILMINGTON	CityNm
State Abbreviation	DE	StateAbbreviationCd
ZIP	19803	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ROBERT MCMURRAY	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	3026237202	PhoneNum
Signature	2023-05-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	ROBERT	PersonFirstNm
Person Last	MCMURRAY	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ANTONIO C RUSSO	PreparerPersonNm
PTIN	P00858539	PTIN
Phone	2673303000	PhoneNum
Preparation	2023-05-09	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Principal Officer	JANICE NEVIN MD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4000 NEXUS DRIVE	AddressLine1Txt
City	WILMINGTON	CityNm
State Abbreviation	DE	StateAbbreviationCd
ZIP	19803	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$3,102,526,470	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CHRISTIANACARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1965	FormationYr
Legal Domicile State	DE	LegalDomicileStateCd
Activity Or Mission	OUR MISSION AS AN ORGANIZATION IS TO SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	13804	TotalEmployeeCnt
Total Volunteers	538	TotalVolunteersCnt
Total Gross UBI	$1,391,208	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$128,076,121	PYContributionsGrantsAmt
CY Contributions Grants	$43,095,263	CYContributionsGrantsAmt
PY Program Service Revenue	$2,187,692,532	PYProgramServiceRevenueAmt
CY Program Service Revenue	$2,339,408,720	CYProgramServiceRevenueAmt
PY Investment Income	$199,105,805	PYInvestmentIncomeAmt
CY Investment Income	$205,839,630	CYInvestmentIncomeAmt
PY Other Revenue	$18,852,326	PYOtherRevenueAmt
CY Other Revenue	$16,410,989	CYOtherRevenueAmt
PY Total Revenue	$2,533,726,784	PYTotalRevenueAmt
CY Total Revenue	$2,604,754,602	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,317,604,659	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$1,432,780,622	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$829,007,353	PYOtherExpensesAmt
CY Other Expenses	$986,479,046	CYOtherExpensesAmt
PY Total Expenses	$2,146,612,012	PYTotalExpensesAmt
CY Total Expenses	$2,419,259,668	CYTotalExpensesAmt
PY Revenues Less Expenses	$387,114,772	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$185,494,934	CYRevenuesLessExpensesAmt
Total Assets BOY	$4,818,599,325	TotalAssetsBOYAmt
Total Assets EOY	$4,236,219,870	TotalAssetsEOYAmt
Total Liabilities BOY	$1,336,477,794	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,095,605,855	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$3,482,121,531	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$3,140,614,015	NetAssetsOrFundBalancesEOYAmt
Mission	WE SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$2,046,596,178	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$2,351,033,382	RevenueAmt
Desc	AS PART OF ITS MISSION OF SERVICE, THE HOSPITALS AND MEDICAL STAFF OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") OFFER A FULL RANGE OF HEALTH SERVICES TO ADDRESS THE NEEDS OF ITS LOCAL COMMUNITIES. THIS INCLUDES THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES TO RESIDENTS OF THE STATE OF DELAWARE, NORTHERN MARYLAND, SOUTHEASTERN PENNSYLVANIA AND SOUTHERN NEW JERSEY, WITHOUT REGARD TO THE PATIENTS' RACE, GENDER, ETHNICITY, AGE, DISABILITY, RELIGION, OR ABILITY TO PAY. DURING FISCAL 2022, THE HOSPITALS OF CCHS RECORDED 428,698 PATIENT DAYS, 60,094 ADMISSIONS, 220,800 EMERGENCY DEPARTMENT VISITS, AND THE BIRTHS OF 6,829 BABIES. ADDITIONALLY, CCHS'S MEDICAL GROUP ENGAGED WITH PATIENTS DURING A TOTAL OF 286,992 PRIMARY CARE VISITS. DURING THE FISCAL YEAR, CCHS PROVIDED $65,232,695 OF UNCOMPENSATED AND UNREIMBURSED CARE, AND ENGAGED IN A VARIETY OF OTHER ACTIVITIES TO SUPPORT AND ASSIST THE LOCAL COMMUNITIES THAT ARE MORE FULLY DISCUSSED IN SCHEDULE H.	Desc
Total Program Service Expenses	$2,046,596,178	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (true)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	356	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	13804	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (true)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	false	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	SR VP'S OFFICE	PersonNm
Phone	3024282441	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4000 NEXUS DRIVE AVENUE NORTH	AddressLine1Txt
City	WILMINGTON	CityNm
State Abbreviation	DE	StateAbbreviationCd
ZIP	19803	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Key EmployeeKeyEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JANICE E NEVIN MD
PRESIDENT & CEO	44.0	1.0	Yes (X)	Yes (X)	$2,224,542	$0	$71,161
KENNETH SILVERSTEIN MD
CHIEF PHYSICIAN EXECUTIVE	45.0	0.0		Yes (X)	$1,543,930	$0	$41,860
RAY A BLACKWELL MD
CHIEF CARDIAC SURGERY	45.0	0.0			$1,026,665	$0	$43,310	Yes (X)
RANDALL GABORIAULT
CHIEF DIGITAL & INFO OFFICER	45.0	0.0			$981,874	$0	$44,350		Yes (X)
KIRK N GARRATT MD
MEDICAL DIRECTOR - HEART/VASC	45.0	0.0			$979,910	$0	$26,689	Yes (X)
KERT ANZILOTTI
CHIEF MEDICAL OFFICER	45.0	0.0			$929,510	$0	$41,860	Yes (X)
VINAY K GHEYI
DEPARTMENT CHAIR - RADIOLOGY	45.0	0.0			$926,957	$0	$35,523	Yes (X)
SHARON T KURFUERST
CHIEF OPERATING OFFICER	43.0	2.0			$909,862	$0	$36,778		Yes (X)
PAUL K DAVIS MD
CARDIAC SURGEON	45.0	0.0			$890,648	$0	$42,900	Yes (X)
ROBERT MCMURRAY
TREASURER AND ASS'T SECRETARY	38.0	7.0		Yes (X)	$849,222	$0	$43,310
NEIL JASANI MD
CHIEF PEOPLE OFFICER	45.0	0.0			$738,148	$0	$43,310		Yes (X)
FREDERIC T HARAD MD
MEMBER	45.0	0.0	Yes (X)		$720,906	$0	$41,152
JENNIFER L SCHWARTZ ESQ
CORPORATE SECRETARY	37.0	8.0		Yes (X)	$720,571	$0	$39,853
RIC CUMING RN
CHIEF NURSING EXECUTIVE	45.0	0.0			$698,589	$0	$32,129		Yes (X)
LISA C MAXWELL MD
PRESIDENT, MEDICAL GROUP	45.0	0.0			$662,384	$0	$59,877		Yes (X)
JOSEPH BENNETT MD
MEMBER (THROUGH 12/31/21)	45.0	0.0	Yes (X)		$659,734	$0	$40,410
MICHAEL EPPEHIMER MD
FORMER PRES. MED GROUP	0.0	0.0			$290,433	$0	$1,624			Yes (X)
CHRISTINE SAUERS
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0
DAVID B STRATTON ESQ
MEMBER, CHAIR	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
DWIGHT D THOMEY ESQ
MEMBER	1.0	3.0	Yes (X)		$0	$0	$0
ERIC T JOHNSON MD
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0
GEORGE FOUTRAKIS
MEMBER (THROUGH 12/31/21)	1.0	1.0	Yes (X)		$0	$0	$0
LOLITA A LOPEZ
MEMBER, VICE CHAIR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
LOSSIE FREEMAN
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0
PAULA K MAXWELL
MEMBER (THROUGH 12/31/21)	1.0	1.0	Yes (X)		$0	$0	$0
PENELOPE T SARIDAKIS
MEMBER (THROUGH 12/31/21)	1.0	0.0	Yes (X)		$0	$0	$0
SALVATORE CHIP ROSSI
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0
THEODORE G PLUSH
MEMBER (THROUGH 3/2022)	1.0	0.0	Yes (X)		$0	$0	$0
TOM MOORE
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0
JULIE TOPKIS NASON
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0
BARRY NIZIOLEK
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0
PAWAN RASTOGI MD
MEMBER	1.0	0.0	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$15,753,885	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$686,096	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2316	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
GENERAL HEALTHCARE RESOURCES
2250 HICKORY ROAD SUITE 240	PLYMOUTH MEETING	PA	19462	STAFFING SERVICES	$47,884,042
MICROSOFT SERVICES
PO BOX 844510	DALLAS	TX	752844510	IT SERVICES	$7,213,310
CERNER CORPORATION
PO BOX 959156	ST LOUIS	MO	631959156	IT SERVICES	$29,739,608
CONSTRUCTION SERVICES GROUP LLC
1630 WEST CHESTER PIKE	WEST CHESTER	PA	19382	CONSTRUCTION SRVCS	$14,514,971
DISABATINO CONSTRUCTION CO
1 SOUTH CLEVELAND AVE	WILMINGTON	DE	19805	CONSTRUCTION SRVCS	$5,845,951

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	270	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$16,784	FederatedCampaignsAmt
Fundraising	$188,983	FundraisingAmt
Related Organizations	$4,876,002	RelatedOrganizationsAmt
Government Grants	$35,672,389	GovernmentGrantsAmt
All Other Contributions	$2,341,105	AllOtherContributionsAmt
Noncash Contributions	$70,440	NoncashContributionsAmt
Total Contributions	$43,095,263	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
NET PROGRAM SERVICE REVENUES	622110	$2,298,378,209	$2,298,378,209	$0	$0
OTHER REVENUES	900099	$41,030,511	$36,557,233	$1,391,208	$3,082,070

Field	Value	IRS element (for citing)
Total Program Service Revenue	$2,339,408,720	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$39,431,408	TotalRevenueColumnAmt
Exclusion	$39,431,408	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,261,870	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$3,261,870	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,261,870	TotalRevenueColumnAmt
Exclusion	$3,261,870	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$658,239,375	SecuritiesAmt
Other	$5,940,715	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$497,771,868	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$160,467,507	SecuritiesAmt
Other	$5,940,715	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$166,408,222	TotalRevenueColumnAmt
Exclusion	$166,408,222	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$188,983	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
MAINTENANCE FEES	531390	$1,524,457	$0	$0	$1,524,457
AFFILIATE REVENUES	900099	$11,624,662	$11,624,662	$0	$0

Field	Value	IRS element (for citing)
Other Revenue Total	$13,149,119	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,604,754,602	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,346,560,104	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,391,208	UnrelatedBusinessRevenueAmt
Exclusion	$213,708,027	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$10,610,922	TotalAmt
Program Services	$8,913,175	ProgramServicesAmt
Management And General	$1,697,747	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,103,156,058	TotalAmt
Program Services	$925,445,517	ProgramServicesAmt
Management And General	$177,710,541	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$74,647,438	TotalAmt
Program Services	$62,703,848	ProgramServicesAmt
Management And General	$11,943,590	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$168,324,411	TotalAmt
Program Services	$141,392,505	ProgramServicesAmt
Management And General	$26,931,906	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$76,041,793	TotalAmt
Program Services	$63,792,069	ProgramServicesAmt
Management And General	$12,249,724	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,243,673	TotalAmt
Program Services	$2,499,317	ProgramServicesAmt
Management And General	$744,356	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$393,660	TotalAmt
Program Services	$303,323	ProgramServicesAmt
Management And General	$90,337	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$249,595	TotalAmt
Program Services	$192,318	ProgramServicesAmt
Management And General	$57,277	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$7,134,471	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$7,134,471	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$130,628,957	TotalAmt
Program Services	$100,652,308	ProgramServicesAmt
Management And General	$29,976,649	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$6,675,303	TotalAmt
Program Services	$5,143,459	ProgramServicesAmt
Management And General	$1,531,844	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,241,870	TotalAmt
Program Services	$5,580,010	ProgramServicesAmt
Management And General	$1,661,860	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$66,340,795	TotalAmt
Program Services	$51,116,952	ProgramServicesAmt
Management And General	$15,223,843	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$32,715,864	TotalAmt
Program Services	$25,208,249	ProgramServicesAmt
Management And General	$7,507,615	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,773,596	TotalAmt
Program Services	$1,366,592	ProgramServicesAmt
Management And General	$407,004	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$4,960,010	TotalAmt
Program Services	$3,821,790	ProgramServicesAmt
Management And General	$1,138,220	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$10,353,749	TotalAmt
Program Services	$8,555,095	ProgramServicesAmt
Management And General	$1,798,654	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$116,353,679	TotalAmt
Program Services	$82,840,809	ProgramServicesAmt
Management And General	$33,512,870	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$24,254,484	TotalAmt
Program Services	$18,688,581	ProgramServicesAmt
Management And General	$5,565,903	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$418,245,187	$418,245,187	$0	$0
OTHER SUPPLIES AND SERVICES	$155,914,153	$120,135,074	$35,779,079	$0

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,419,259,668	TotalAmt
Program Services	$2,046,596,178	ProgramServicesAmt
Management And General	$372,663,490	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part X	Yes (X)	InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$440,619,940	BOYAmt
EOY	$141,444,726	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$191,331,183	BOYAmt
EOY	$191,508,175	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$313,356,780	BOYAmt
EOY	$370,268,568	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$37,414,184	BOYAmt
EOY	$46,112,024	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$17,267,840	BOYAmt
EOY	$28,837,684	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$2,664,299,520	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,616,455,217	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,106,742,213	BOYAmt
EOY	$1,047,844,303	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,780,366,763	BOYAmt
EOY	$1,522,391,684	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$571,984,820	BOYAmt
EOY	$419,786,225	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,015,805	BOYAmt
EOY	$1,015,805	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$358,499,797	BOYAmt
EOY	$467,010,676	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,818,599,325	BOYAmt
EOY	$4,236,219,870	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$394,195,384	BOYAmt
EOY	$431,963,789	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$312,855,885	BOYAmt
EOY	$305,985,527	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$629,426,525	BOYAmt
EOY	$357,656,539	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,336,477,794	BOYAmt
EOY	$1,095,605,855	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,414,358,021	BOYAmt
EOY	$3,083,488,363	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$67,763,510	BOYAmt
EOY	$57,125,652	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,482,121,531	BOYAmt
EOY	$3,140,614,015	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,818,599,325	BOYAmt
EOY	$4,236,219,870	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$185,494,934	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$590,214,088	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$63,211,638	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$22,698,446	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$24,577,838	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$80,735,115	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$128,076,121	CurrentTaxYearMinus1YearAmt
Current Tax Year	$43,095,263	CurrentTaxYearAmt
Total	$299,182,783	TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$22,698,446	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$24,577,838	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$80,735,115	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$128,076,121	CurrentTaxYearMinus1YearAmt
Current Tax Year	$43,095,263	CurrentTaxYearAmt
Total	$299,182,783	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$0	SubstantialContributorsTotAmt
Public Support Total170	$299,182,783	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$32,254,956	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$40,934,424	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$38,348,773	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$34,285,085	CurrentTaxYearMinus1YearAmt
Current Tax Year	$42,693,278	CurrentTaxYearAmt
Total	$188,516,516	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,686,211	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,481,357	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,515,817	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$1,583,245	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,524,457	CurrentTaxYearAmt
Total	$7,791,087	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$495,490,386	TotalSupportAmt
Gross Receipts Rltd Activities	$10,320,134,708	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.60381	PublicSupportCY170Pct
Public Support PY170	0.61799	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Organization Belongs Afflt Grp	Yes (X)	OrganizationBelongsAffltGrpInd

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$0	FilingOrganizationsTotalAmt
Affiliated Group Total	$0	AffiliatedGroupTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$249,595	FilingOrganizationsTotalAmt
Affiliated Group Total	$249,595	AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$249,595	FilingOrganizationsTotalAmt
Affiliated Group Total	$249,595	AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$2,419,010,073	FilingOrganizationsTotalAmt
Affiliated Group Total	$2,475,653,591	AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$2,419,259,668	FilingOrganizationsTotalAmt
Affiliated Group Total	$2,475,903,186	AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$1,000,000	AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt
Affiliated Group Total	$250,000	AffiliatedGroupTotalAmt

Field	Value	IRS element (for citing)
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$1,000,000	CurrentYearMinus3Amt
Current Year Minus2	$1,000,000	CurrentYearMinus2Amt
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$4,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$6,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$218,022	CurrentYearMinus3Amt
Current Year Minus2	$230,460	CurrentYearMinus2Amt
Current Year Minus1	$249,926	CurrentYearMinus1Amt
Current Year	$249,595	CurrentYearAmt
Total	$948,003	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$250,000	CurrentYearMinus3Amt
Current Year Minus2	$250,000	CurrentYearMinus2Amt
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$1,500,000	GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$0	CurrentYearMinus3Amt
Current Year Minus2	$0	CurrentYearMinus2Amt
Current Year Minus1	$0	CurrentYearMinus1Amt
Current Year	$0	CurrentYearAmt
Total	$0	TotalAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$68,569,307	BeginningYearBalanceAmt
Contributions	$669,502	ContributionsAmt
Investment Earnings Or Losses	-$6,744,573	InvestmentEarningsOrLossesAmt
Other Expenditures	$4,183,549	OtherExpendituresAmt
End Year Balance	$58,310,687	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$62,232,483	BeginningYearBalanceAmt
Contributions	$993,569	ContributionsAmt
Investment Earnings Or Losses	$9,205,113	InvestmentEarningsOrLossesAmt
Other Expenditures	$3,861,858	OtherExpendituresAmt
End Year Balance	$68,569,307	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$67,336,850	BeginningYearBalanceAmt
Contributions	$1,520,182	ContributionsAmt
Investment Earnings Or Losses	$2,545,562	InvestmentEarningsOrLossesAmt
Other Expenditures	$9,170,111	OtherExpendituresAmt
End Year Balance	$62,232,483	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$69,132,135	BeginningYearBalanceAmt
Contributions	$518,673	ContributionsAmt
Investment Earnings Or Losses	$1,845,561	InvestmentEarningsOrLossesAmt
Other Expenditures	$4,159,519	OtherExpendituresAmt
End Year Balance	$67,336,850	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$102,737,030	BeginningYearBalanceAmt
Contributions	$1,197,900	ContributionsAmt
Investment Earnings Or Losses	$7,177,549	InvestmentEarningsOrLossesAmt
Other Expenditures	$41,980,344	OtherExpendituresAmt
End Year Balance	$69,132,135	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.40820	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.42080	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.17100	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (true)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$32,350,503	OtherCostOrOtherBasisAmt
Book Value	$32,350,503	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,691,701,572	OtherCostOrOtherBasisAmt
Depreciation	$903,641,632	DepreciationAmt
Book Value	$788,059,940	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$34,348,921	OtherCostOrOtherBasisAmt
Depreciation	$9,742,149	DepreciationAmt
Book Value	$24,606,772	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$866,992,551	OtherCostOrOtherBasisAmt
Depreciation	$674,566,865	DepreciationAmt
Book Value	$192,425,686	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$38,905,973	OtherCostOrOtherBasisAmt
Depreciation	$28,504,571	DepreciationAmt
Book Value	$10,401,402	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,047,844,303	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	OTHER SECURITIES	Desc
Book Value	$419,786,225	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$419,786,225	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDesc	Book ValueBookValueAmt
CONSTRUCTION IN PROGRESS	$90,373,706
DUE FROM AFFILIATES	$83,439,429
OTHER ASSETS	$166,603,469
OTHER RECEIVABLES	$30,705,904
ASSETS LIMITED TO USE	$0
SUBSIDIARY INVESTMENT	$95,888,168

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$467,010,676	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
PENSION AND POST RETIREMENT BE	$101,343,222
INSURANCE LIABILITIES	$14,526,586
OTHER LIABILITIES	$195,217,061
ADVANCES FROM THIRD PARTY PAYO	$46,569,670

Field	Value	IRS element (for citing)
Total Liability	$357,656,539	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE D, PART V, LINE 3A & 4	FormAndLineReferenceDesc
Explanation	DETAIL OF ENDOWMENT FUNDS 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 FIVE 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 MAINTENANCE, AND PROGRAM SUPPORT. --------------------	ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Type Of Activities Conducted	Investments	TypeOfActivitiesConductedTxt
Region Total Expenditures	$144,280,871	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Spent	$144,280,871	SubtotalSpentAmt
Total Spent	$144,280,871	TotalSpentAmt
Transfer To Foreign Corp	Yes (true)	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE F, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	FRIENDS HFGCC5K	Event1Nm
Gross Receipts Event1	$188,983	GrossReceiptsEvent1Amt
Charitable Contri Event1	$188,983	CharitableContriEvent1Amt
Cash Prizes Event1	$0	CashPrizesEvent1Amt
Non Cash Prizes Event1	$0	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$0	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$0	FoodAndBeverageEvent1Amt
Entertainment Event1	$0	EntertainmentEvent1Amt
Other Direct Expenses Event1	$0	OtherDirectExpensesEvent1Amt
Event2	NONE	Event2Nm
Gross Receipts Event2	$0	GrossReceiptsEvent2Amt
Charitable Contri Event2	$0	CharitableContriEvent2Amt
Gross Revenue Event2	$0	GrossRevenueEvent2Amt
Cash Prizes Event2	$0	CashPrizesEvent2Amt
Non Cash Prizes Event2	$0	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$0	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$0	FoodAndBeverageEvent2Amt
Entertainment Event2	$0	EntertainmentEvent2Amt
Other Direct Expenses Event2	$0	OtherDirectExpensesEvent2Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Other Events	$0	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$0	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$0	GrossRevenueOtherEventsAmt
Cash Prizes Other Events	$0	CashPrizesOtherEventsAmt
Non Cash Prizes Other Events	$0	NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events	$0	RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events	$0	FoodAndBeverageOtherEventsAmt
Entertainment Other Events	$0	EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events	$0	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$188,983	GrossReceiptsTotalAmt
Charitable Contributions Tot	$188,983	CharitableContributionsTotAmt
Cash Prizes Total Events	$0	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$0	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$0	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$0	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$0	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$0	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$0	DirectExpenseSummaryEventsAmt
Net Income Summary	$0	NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE G, PART II	FormAndLineReferenceDesc
Explanation	DETAIL OF FUNDRAISING EVENTS EXPENSES RELATED WITH THE FRIENDS HFGCC 5K AND THE GOLF CLASSIC EVENT WERE RECORDED DIRECTLY BY CHRISTIANA CARE HEALTH SYSTEM, INC. THE SOLE MEMBER OF THE ORGANIZATION.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	false	FreeCareMedicallyIndigentInd
Financial Assistance Budget	false	FinancialAssistanceBudgetInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,352,059	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,352,059	NetCommunityBenefitExpnsAmt
Total Expense	0.00510	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$330,715,188	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$279,072,889	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$51,642,299	NetCommunityBenefitExpnsAmt
Total Expense	0.02140	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$343,067,247	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$279,072,889	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$63,994,358	NetCommunityBenefitExpnsAmt
Total Expense	0.02650	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	47	ActivitiesOrProgramsCnt
Persons Served	54089	PersonsServedCnt
Total Community Benefit Expns	$13,247,640	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,495,300	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,752,340	NetCommunityBenefitExpnsAmt
Total Expense	0.00400	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Persons Served	1184	PersonsServedCnt
Total Community Benefit Expns	$77,095,486	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,670,295	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$63,425,191	NetCommunityBenefitExpnsAmt
Total Expense	0.02620	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$19,249,661	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,552,330	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,697,331	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$1,567,905	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,567,905	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	63	ActivitiesOrProgramsCnt
Persons Served	55273	PersonsServedCnt
Total Community Benefit Expns	$111,160,692	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$32,717,925	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$78,442,767	NetCommunityBenefitExpnsAmt
Total Expense	0.03240	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	63	ActivitiesOrProgramsCnt
Persons Served	55273	PersonsServedCnt
Total Community Benefit Expns	$454,227,939	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$311,790,814	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$142,437,125	NetCommunityBenefitExpnsAmt
Total Expense	0.05890	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$85,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$85,000	NetCommunityBenefitExpnsAmt

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$42,363	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$42,363	NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$105,374	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$105,374	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$5,672	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,672	NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$212,410	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$212,410	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$450,819	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$450,819	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$19,560,265	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,084,122	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$518,092,905	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$628,301,557	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$110,208,652	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd
CHRISTIANA HOSPITAL
1	4755 OGLETOWN-STANTON ROAD	NEWARK	DE	19718	www.christianacare.org	LICENSE #HSPTL-002	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
WILMINGTON HOSPITAL
2	501 WEST 14TH STREET	WILMINGTON	DE	19801	www.christianacare.org	LICENSE #HSPTL-001	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A-CHRISTIANA AND WILMINGTON HOSPITALS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	12	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B, LINE 5 (INPUT FROM COMMUNITY)	CHRISTIANACARE'S OFFICE OF HEALTH EQUITY SOUGHT THE PARTICIPATION OF A BROAD ARRAY OF INDIVIDUALS TO INFORM THE 2022 CHNA. THIS WAS AN IMPORTANT ASPECT OF THE CHNA PROCESS THAT ALLOWED US TO EXEMPLIFY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE, AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. EFFECTIVELY SERVING OUR COMMUNITIES REQUIRES US TO LISTEN AND LEARN SO THAT WE CAN PROVIDE OUR COMMUNITIES WITH WHAT IS IMPORTANT TO THEM. THE CHNA IS A WELCOME OPPORTUNITY TO EXAMINE WHETHER WE ARE MEETING THE NEEDS OF THOSE WE SERVE. WHEN COMPLETING THIS AND PRIOR CHNAS, OUR INTENTION WAS TO HEAR DIRECTLY FROM COMMUNITY MEMBERS AND STAKEHOLDERS. WHILE UNDERTAKING THE 2022 CHNA, COVID-19 CASES WERE REACHING A NEW PEAK IN OUR STATE AND CHRISTIANACARE WAS FORCED TO ISSUE CRISIS STANDARDS OF CARE FOR THE FIRST TIME IN ITS HISTORY. BECAUSE OF THIS, WE DECIDED TO HOST VIRTUAL COMMUNITY MEETINGS TO RECEIVE COMMUNITY INPUT TO PREVENT INCREASED COMMUNITY TRANSMISSION OF COVID-19. OUR PREFERRED FORMAT WOULD HAVE BEEN MEETINGS HELD IN THE COMMUNITY AT ACCESSIBLE LOCATIONS TO PROMOTE COMMUNITY PARTICIPATION, BUT SAFETY HAD TO BE PRIORITIZED. IN ADDITION TO THE COMMUNITY MEETINGS, WE ALSO CONDUCTED INTERVIEWS WITH THE CABINET SECRETARY AND DEPUTY SECRETARY FOR DELAWARE HEALTH AND SOCIAL SERVICES AND THE DIRECTOR FOR THE DELAWARE DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH TO GAIN THEIR PERSPECTIVES ON THE HEALTH OF OUR COMMUNITIES. WE ARE GRATEFUL FOR THE PARTICIPATION OF ALL THOSE WHO SHARED THEIR EXPERIENCE AND PROVIDED INPUT. ALL COMMUNITY MEETINGS FOLLOWED THE SAME FORMAT. SECONDARY DATA WERE PRESENTED INCLUDING A SUMMARY OF UNFAVORABLE COMMUNITY HEALTH INDICATORS. PARTICIPANTS WERE ASKED TO PROVIDE FEEDBACK ON THE SECONDARY DATA ANALYSIS AND IDENTIFY COMMUNITY HEALTH ISSUES THAT WERE MISSING FROM THE DATA. TO CONCLUDE, ALL PARTICIPANTS WERE ASKED TO COMPLETE AN ONLINE SURVEY AND TO IDENTIFY THREE TO FIVE COMMUNITY HEALTH ISSUES THEY CONSIDER TO BE MOST SIGNIFICANT. IN TOTAL, 35 INDIVIDUALS WHO REPRESENTED ORGANIZATIONS INCLUDING DELAWARE HEALTH AND SOCIAL SERVICES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTHCARE PROVIDERS, LOCAL POLICYMAKERS, AND SCHOOL SYSTEMS PARTICIPATED IN FOUR VIRTUAL COMMUNITY STAKEHOLDER MEETINGS. THE 2022 CHNA ALSO INCLUDED THE INPUT OF YOUNG DELAWAREANS. CHRISTIANACARE CAREGIVERS WHO PROVIDE REPRODUCTIVE HEALTH EDUCATION TO ADOLESCENTS IN SCHOOLS THROUGHOUT THE STATE PROVIDED THE SECONDARY DATA PRESENTATION TO 110 STUDENTS PARTICIPATING IN THEIR CLASSES AT WILLIAM PENN HIGH SCHOOL IN NEW CASTLE. WE SOUGHT INPUT FROM AND WANTED TO HEAR FROM YOUNG PEOPLE BECAUSE THEY MAKE UP A SIGNIFICANT PART OF OUR COMMUNITY. FINALLY, 45 CHRISTIANACARE CAREGIVERS WHO REPRESENTED ADMINISTRATION, NURSING, CASE MANAGEMENT, SOCIAL SERVICES, PROJECT MANAGEMENT, AND HEALTH EQUITY DEPARTMENTS PARTICIPATED IN AN ADDITIONAL TWO VIRTUAL MEETINGS. WE PROVIDED THEM WITH INFORMATION ABOUT THE CHALLENGES OUR COMMUNITY IS FACING AND GAINED THEIR PERSPECTIVE BASED ON THEIR EXPERIENCES SERVING OUR COMMUNITY. AT CHRISTIANACARE, ALL EMPLOYEES ARE REFERRED TO AS CAREGIVERS REGARDLESS OF THEIR POSITION. THROUGHOUT THIS SECTION, WE WILL REFER TO CAREGIVERS AS OPPOSED TO EMPLOYEES OR STAFF. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2022 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 IN DELAWARE, CHRISTIANA HOSPITAL AND WILMINGTON HOSPITAL, JOINTLY CONDUCTED THEIR CHNA. -------------------- PART V, SECTION B, LINE 7 (CHNA PUBLIC AVAILABILITY) CHRISTIANACARE'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/ A PAPER COPY OF THE CHNA IS ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. -------------------- PART V, SECTION B, LINE 10 (IMP. PLAN PUBLIC AVAILABILITY) CHRISTIANACARE'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-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 IN JUNE 2022, CHRISTIANACARE IDENTIFIED THE FOLLOWING AS THE COMMUNITY'S MOST SIGNIFICANT NEEDS: - ACCESS TO HEALTH SERVICES - CHRONIC HEALTH CONDITIONS - MATERNAL AND CHILD HEALTH - MENTAL HEALTH AND SUBSTANCE USE DISORDERS - SOCIAL DETERMINANTS OF HEALTH - VIOLENT CRIME CHRISTIANACARE WILL ADDRESS ALL THESE SIGNIFICANT AREAS OF NEED. EXCEPT FOR THE NEWLY ADDED CHRONIC HEALTH CONDITIONS, THESE NEEDS WERE ALSO PRIORITIZED IN 2019. WE WILL CONTINUE TO ADDRESS THESE NEEDS THROUGH PROGRAMMING WE HAVE CREATED, ADAPTED, AND EXPANDED SINCE OUR 2019 CHNA. WHILE UNDERTAKING THIS CHNA, WE WERE FORTUNATE TO LEARN FROM MANY HIGH SCHOOL STUDENTS ABOUT WHAT THEY CONSIDERED TO BE SIGNIFICANT AREAS OF NEED. THE SIGNIFICANT AREAS OF NEED THAT THEY SELECTED MIRRORED THE SELECTIONS OF THE ADULTS WHO PARTICIPATED, WITH TWO ADDITIONAL SIGNIFICANT AREAS OF NEED IDENTIFIED BY MANY OF THE STUDENTS: SEXUALLY TRANSMITTED INFECTIONS AND SMOKING, TOBACCO, AND VAPE PRODUCT USE. CHRISTIANACARE ADDRESSES BOTH THESE AREAS IN ITS SCHOOL-BASED HEALTH CENTERS AND SINCE 1995 HAS BEEN THE RECIPIENT OF A STATE GRANT TO OPERATE THE ALLIANCE FOR ADOLESCENT PREGNANCY PREVENTION (AAPP). AAPP PROVIDES EDUCATION TO STUDENTS THROUGHOUT DELAWARE TO REDUCE THE NUMBER OF TEENS WHO ARE SEXUALLY ACTIVE, CONTRACT AND SPREAD SEXUALLY TRANSMITTED INFECTIONS, BECOME PREGNANT AND BECOME TEEN PARENTS. WHILE WE WILL NOT PRIORITIZE THESE ADDITIONAL AREAS OF NEED IDENTIFIED BY THE TEENS, WE WILL CONTINUE TO ADDRESS THEM THROUGH DIRECT INTERACTION WITH STUDENTS IN THE SCHOOL-BASED HEALTH CENTERS AND THROUGH AAPP PROGRAMMING. ACCESS TO HEALTH SERVICES ON JUNE 2, 2022, THE CHRISTIANACARE BOARD APPROVED A NEW 5-YEAR STRATEGIC PLAN FOR IMPLEMENTATION, WHICH IDENTIFIES OUR ASPIRATIONS, GOALS AND IMPERATIVES. ONE OF THE ASPIRATIONS IS TO RADICALLY SIMPLIFY ACCESS. TO ACCOMPLISH THIS, WE WILL LOOK TO DIGITAL SOLUTIONS TO EASE ACCESS AND REDUCE ADMINISTRATIVE BURDEN AND WORK TOWARDS DEVELOPING A PLAN TO REDUCE ACCESS BARRIERS RELATED TO OUT-OF-POCKET EXPENSE BY USING AUTOMATED PROCESSES. WE ARE COMMITTED TO MAKING CARE MORE CONVENIENT AND AFFORDABLE FOR OUR PATIENTS WHICH WE EXPECT TO IMPROVE ACCESS. WE ALSO RECOGNIZE THAT DIGITAL SOLUTIONS ALONE WILL NOT IMPROVE ACCESS FOR ALL. COMMUNITY-BASED SERVICES REMAIN VITAL TO THE HEALTH OF OUR COMMUNITIES ALONG WITH FINDING INNOVATIVE WAYS TO DELIVER THESE SERVICES. THROUGHOUT THIS NARRATIVE, WE WILL SHARE THE INNOVATIVE WAYS WE ARE SERVING OUR COMMUNITY BY PROVIDING RADICALLY CONVENIENT SERVICE. IN JUNE 2022, CHRISTIANACARE INTRODUCED ITS TWO MOBILE HEALTH SERVICES VANS IN A RIBBON CUTTING CEREMONY IN WILMINGTON'S SOUTHBRIDGE NEIGHBORHOOD. SOUTHBRIDGE IS LOCATED IN THE 19801 ZIP CODE, AN AREA OF HIGH NEED, AND A NEIGHBORHOOD THAT WE INTEND TO CONTINUE TO SERVE THROUGH MOBILE HEALTH SERVICES. THE VANS ARE SUPPORTED BY BARCLAYS WITH A $1 MILLION INVESTMENT AS PART OF ITS COVID-19 COMMUNITY AID PACKAGE. MOBILE HEALTH SERVICES WILL ALLOW US TO BRING CARE TO OUR NEIGHBORS WHO MAY HAVE DIFFICULTY ACCESSING CARE OTHERWISE. IMPORTANTLY, RECEIVING CARE ON THE VAN WILL NOT BE A ONE-TIME EVENT, BUT THE START OF A RELATIONSHIP THAT WILL HELP AN INDIVIDUAL IMPROVE THEIR HEALTH AND WELLNESS. IN SERVICE TO THAT EXPECTATION, WE ARE BEING INTENTIONAL ABOUT WHERE WE PROVIDE MOBILE HEALTH SERVICES. WHILE WE EXPECT TO PROVIDE ONE-TIME SERVICES LIKE VACCINATIONS AND SCREENINGS ON THE VANS, WE WILL ALSO SELECT COMMUNITY LOCATIONS WHERE THE VANS WILL BE REGULARLY STATIONED TO PROVIDE ONGOING PRIMARY CARE AND ACCESS TO SPECIALTY CARE FOR OUR NEIGHBORS. THE COMPLEX CARE AND COMMUNITY MEDICINE DEPARTMENT IS WORKING CLOSELY WITH THE COMMUNITY HEALTH DEPARTMENT TO IDENTIFY AREAS IN THE COMMUNITY WHERE THE VANS SHOULD GO AND THE COMMUNITY ORGANIZATIONS THAT CAN BE PARTNERED WITH TO HOST THE VANS. COMMUNITY PARTNERSHIPS ARE NECESSARY TO ENSURE WE ARE BRINGING SERVICES TO THE COMMUNITY THAT ARE WANTED, NEEDED, AND USED. IT IS ALSO OUR FIRMLY HELD BELIEF THAT COMMUNITY PARTNERSHIPS WILL ENABLE US AND OUR PARTNERS TO BETTER ADDRESS THE VARIED NEEDS OF THOSE WE SERVE. FOR MOST OF FY2022, THE VANS WERE BEING OUTFITTED TO SERVE AS PRACTICES ON WHEELS. IN THE EARLY MONTHS OF FY2023, THE FOCUS HAS BEEN ON DETERMINING WHERE THE VANS SHOULD BE IN THE COMMUNITY AND AT WHAT CADENCE. THE VANS HAVE PROVIDED SERVICES AT A HANDFUL OF COMMUNITY LOCATIONS OVER THE LAST SEVERAL MONTHS AND SINCE NOVEMBER 2022, ONE VAN HAS BEEN ROUTINELY STATIONED OUTSIDE OF THE WILMINGTON HOSPITAL, ALSO LOCATED IN THE HIGH-NEED 19801 ZIP CODE. THIS HAS SERVED AS A FIRST OPPORTUNITY TO PROVIDE PRIMARY CARE SERVICES ON THE VAN. TWO PRIMARY CARE PRACTICES LOCATED IN WILMINGTON HOSPITAL HAVE BEEN SENDING OVERFLOW PATIENTS TO THE VAN WHEN NECESSARY TO ENSURE ACUTE PATIENTS ARE SEEN. WE ARE ALSO PLEASED TO REPORT THAT ON A FEW OCCASIONS, INDIVIDUALS WALKING PAST THE VAN, WITH NO INTENTION OF SEEING A PHYSICIAN, HAVE ENDED UP RECEIVING SERVICES IN THE VAN BECAUSE THEY STOPPED TO TALK WITH THE CAREGIVERS, SHARED HEALTH CONCERNS, AND WERE GIVEN THE OPPORTUNITY TO BE SEEN RIGHT THEN AND THERE. THIS IS EXACTLY THE TYPE OF CONVENIENCE AND MOTIVATION TO ADDRESS HEALTH CONCERNS WE WANT TO PROVIDE OUR NEIGHBORS THROUGH OUR MOBILE HEALTH SERVICES.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	IN ANOTHER EXAMPLE OF PROVIDING RADICAL CONVENIENCE, CHRISTIANACARE OPERATES 23 SCHOOL-BASED HEALTH CENTERS (SBHCS) THROUGHOUT NEW CASTLE COUNTY IN ELEMENTARY, MIDDLE, AND HIGH SCHOOLS. SBHCS OFFER CONVENIENT ACCESS TO HEALTH CARE FOR STUDENTS AND PROVIDE THE OPPORTUNITY TO ADDRESS HEALTH ISSUES AT THE EARLIEST AND MOST PREVENTABLE STAGES. BY VIRTUE OF THEIR ACCESSIBILITY, SBHCS ALSO ADVANCE HEALTH EQUITY IN THE COMMUNITY. IN FY2022, OUR SBHCS SERVED 29,890 STUDENTS AND WE EXPECT THIS NUMBER TO INCREASE AS CHRISTIANACARE HAS OPENED TWO NEW SBHCS IN KUUMBA ACADEMY CHARTER SCHOOL IN WILMINGTON AND ODESSA HIGH SCHOOL IN SOUTHERN NEW CASTLE COUNTY. INACCESSIBLE OR NON-EXISTENT MENTAL HEALTH SERVICES IS A NATIONAL CONCERN THAT IS ALSO HELD AMONG DELAWAREANS. BOTH ADULT AND TEENAGE PARTICIPANTS IN THE 2022 CHNA COMMUNITY MEETINGS IDENTIFIED MENTAL HEALTH AS THE MOST SIGNIFICANT AREA OF NEED IN NEW CASTLE COUNTY. IN RESPONSE TO THE NEED WE ARE SEEING IN THE COMMUNITY, PARTICULARLY AMONG OUR YOUTH, CHRISTIANACARE HAS PRIORITIZED EXPANDING BEHAVIORAL HEALTH SERVICES IN SBHCS IN FY2023. PROVIDING YOUTH WITH THE SERVICES AND THE TOOLS TO ADDRESS THEIR MENTAL HEALTH NEEDS EARLY WILL HELP PREVENT MORE SIGNIFICANT MENTAL HEALTH ISSUES AS THEY GROW OLDER. NEARLY A DECADE AGO, CHRISTIANACARE RECEIVED A GRANT TO HIRE MARKETPLACE GUIDES WHO WOULD ASSIST UNINSURED INDIVIDUALS IN ENROLLING IN THE HEALTH INSURANCE MARKETPLACE. IN THE YEARS SINCE, THAT WORK HAS TRANSFORMED INTO OUR HEALTH GUIDE PROGRAM BASED IN THE WILMINGTON HOSPITAL. THE HEALTH GUIDES CONNECT PATIENTS TO HEALTH CARE SERVICES AND COMMUNITY RESOURCES, AS WELL AS ASSIST WITH HEALTH INSURANCE ENROLLMENT AND PRESCRIPTION ASSISTANCE. IN FY2022, CHRISTIANACARE EXPANDED THE HEALTH GUIDE PROGRAM BY HIRING TWO NEW BILINGUAL HEALTH GUIDES TO SERVE ON-SITE AT TWO ADDITIONAL CHRISTIANACARE PRIMARY CARE PRACTICES, CHRISTIANACARE'S SU CENTRO DE SALUD, WITH PRIMARY CARE AT KIRKWOOD LOCATED IN WILMINGTON AND THE MEDICAL ARTS PAVILION (MAP) LOCATED ON THE NEWARK CAMPUS. THESE ADDITIONAL HEALTH GUIDES WILL ENSURE MORE INDIVIDUALS ARE HELPED IN ACCESSING NEEDED RESOURCES TO RECEIVE CARE AND THAT THOSE WHOSE PRIMARY LANGUAGE IS SPANISH WILL HAVE AN EASIER TIME ACCESSING THOSE SERVICES. IN FY2022, 1,433 INDIVIDUALS RECEIVED ASSISTANCE FROM THE HEALTH GUIDES. THE HEALTH GUIDES ALSO CONNECT PATIENTS TO THE MEDICAL LEGAL PARTNERSHIP (MLP), A COLLABORATION WITH THE DELAWARE COMMUNITY LEGAL AID SOCIETY, INC. (CLASI) WHICH ASSISTS PATIENTS WITH THE MITIGATION OF CIVIL LEGAL HARDSHIPS. CHRISTIANACARE HAS CONTRACTED WITH CLASI SINCE 2015 TO HELP PATIENTS ADDRESS THEIR CIVIL LEGAL NEEDS IN AREAS SUCH AS 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. UNDERSTANDABLY, THESE ISSUES PREVENT PATIENTS FROM BEING ABLE TO OBTAIN OR FOCUS ON THEIR HEALTHCARE. WITH THE RESOLUTION OF THESE BARRIERS, PATIENTS CAN PRIORITIZE THEIR HEALTH. THIS PARTNERSHIP HAS BECOME EVEN MORE CRUCIAL SINCE THE PANDEMIC, WHICH HAS EXACERBATED THE INEQUITIES ALREADY FELT BY LOW-INCOME COMMUNITIES IN THE AREAS THE MLP IS ABLE TO REMEDIATE. IN FY2022, 153 PRIMARY CARE PATIENTS WERE REFERRED TO THE MLP WITH 172 DISCRETE LEGAL MATTERS. MOST OF THESE PATIENTS WERE FEMALE WITH CLOSE TO HALF IDENTIFYING AS BLACK OR HISPANIC. THE AVERAGE INCOME OF REFERRED PATIENTS WAS AT 65 PERCENT OF THE FEDERAL POVERTY LEVEL AND ALMOST 50 PERCENT OF THE REFERRED PATIENTS LIVED IN THE CITY OF WILMINGTON. CHRISTIANACARE CONTINUES TO PARTNER WITH CLASI TO PROVIDE THIS SERVICE TO PATIENTS. THE COMMUNITY HEALTH WORKER (CHW) PROGRAM, LIKE THE HEALTH GUIDES AND THE MLP, IS COMMITTED TO HELPING PATIENTS OVERCOME BARRIERS TO GOOD HEALTH. EVEN WHEN PATIENTS ARE CONNECTED TO CARE, OTHER HARDSHIPS IN THEIR LIVES OR CHALLENGES IN COORDINATING COMPLEX MEDICAL CARE CAN DETER ACCESS. THE CHWS SERVE TO PROVIDE THE EMOTIONAL AND INSTRUMENTAL SUPPORT TO HELP PATIENTS OVERCOME THOSE CHALLENGES. CHWS MEET PATIENTS IN THEIR HOMES TO HELP THEM ORGANIZE THEIR MEDICATION OR LEARN A RECIPE; AT THE GYM TO WORK OUT; OR AT THE SOCIAL SECURITY OFFICE TO FILL OUT FORMS. CHWS PROMOTE ACCESS TO HEALTH SERVICES NOT ONLY BY HELPING PATIENTS ADDRESS THEIR HEALTH NEEDS, BUT ALSO BY VIRTUE OF THEIR ACCESSIBILITY. CHRISTIANACARE CHWS SERVE DIFFERENT POPULATIONS WITH AN EVIDENCE-BASED APPROACH. ALL CHWS RECEIVE TRAINING THROUGH PENN MEDICINE'S IMPACT (INDIVIDUALIZED MANAGEMENT FOR PATIENT CENTERED TARGET) MODEL. THE CHWS WORK TO IMPROVE HEALTH OUTCOMES BY ADDRESSING SOCIAL NEEDS, HELPING PATIENTS TO IDENTIFY AND ACHIEVE PATIENT-CENTERED GOALS, AND CONNECTING PATIENTS TO CARE. SUMMARIES OF THE CHW PROGRAMS WILL BE PROVIDED IN THIS SECTION, AND AS WILL BE DEMONSTRATED, OUR CHW INITIATIVE ALSO ADDRESSES OTHER PRIORITIZED AREAS OF NEED. CHRISTIANACARE'S CHWS ARE A BEDROCK OF THE STRATEGY WE EMPLOY TO SUPPORT OUR COMMUNITY. IT EXEMPLIFIES OUR COMMITMENT TO RADICAL ACCESS AND PARTNERING WITH OUR PATIENTS. IN FY2022, OUR CHW INITIATIVE GREW CONSIDERABLY WITH THE ADDITION OF BEHAVIORAL HEALTH, MEDICAID ENGAGEMENT, AND SOCIAL DETERMINANTS OF HEALTH CHWS. BEHAVIORAL HEALTH CHWS CHRISTIANACARE LAUNCHED THE BEHAVIORAL HEALTH CHW PROGRAM IN OCTOBER 2021, WHICH ASSISTS PATIENTS IN INCREASING THEIR INDEPENDENCE AND RESILIENCE. THE 4 BEHAVIORAL HEALTH CHWS ARE EMBEDDED WITHIN CHRISTIANACARE OUTPATIENT BEHAVIORAL HEALTH PRACTICES TO SUPPORT CHILDREN AND ADOLESCENTS AS WELL AS ADULTS WITH MENTAL HEALTH AND/OR SUBSTANCE USE DIAGNOSES FOR UP TO 6 MONTHS. IN FY22, 137 PATIENTS, INCLUDING 40 CHILDREN/ADOLESCENTS, WORKED WITH THESE CHWS.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	EMERGENCY DEPARTMENT CHWS CHRISTIANACARE'S EMERGENCY DEPARTMENT CHW PROGRAM LAUNCHED IN FEBRUARY 2021. EMBEDDED IN THE WILMINGTON HOSPITAL'S EMERGENCY DEPARTMENT, THIS 3-MONTH PROGRAM DELIVERS EPISODIC CARE TO THOSE PATIENTS THAT FREQUENT THE EMERGENCY DEPARTMENT (2 OR MORE VISITS IN THE PRIOR 90 DAYS). THE 2 EMERGENCY DEPARTMENT CHWS MEET PATIENTS AT BEDSIDE AND IN THE COMMUNITY TO CONNECT THE PATIENTS WITH RESOURCES AND PRIMARY CARE AND LONG-TERM SUPPORT. IN FY2022, THIS PROGRAM SERVED 60 INDIVIDUALS. MEDICAID ENGAGEMENT CHWS LAUNCHED IN JUNE 2021, MEDICAID ENGAGEMENT AIMS TO REACH PATIENTS THROUGHOUT THE STATE WHO ARE NEWLY ENROLLED IN DELAWARE MEDICAID TO CONNECT THEM TO PRIMARY CARE SERVICES AND COMMUNITY RESOURCES THAT ADDRESS THEIR SOCIAL DETERMINANTS OF HEALTH. IN FY22, 4 MEDICAID ENGAGEMENT CHWS ATTEMPTED OUTREACH TO 746 PATIENTS. OF THOSE, 98 PATIENTS SCHEDULED A PRIMARY CARE APPOINTMENT, AND 19 PATIENTS UPDATED THEIR PAYER. PRIMARY CARE CHWS CHRISTIANACARE'S PRIMARY CARE CHWS ENGAGE PATIENTS WITH DIABETES, HYPERTENSION, AND/OR HIGH EMERGENCY DEPARTMENT UTILIZATION IN PRIMARY CARE SERVICES. THE 7 PRIMARY CARE CHWS ARE EMBEDDED WITHIN 6 PRIMARY CARE PRACTICES TO DELIVER SERVICES IN A 6-MONTH PROGRAM TO ADULTS WITH MEDICAID INSURANCE. IN FY2022, A PRIMARY CARE CHW BEGAN SERVING A NEW CHRISTIANACARE PRACTICE, SU CENTRO DE SALUD, WITH PRIMARY CARE AT KIRKWOOD AND A SECOND CHW WAS HIRED FOR THE WILMINGTON ADULT MEDICINE PRACTICE TO MEET PATIENT NEED MORE ADEQUATELY. CHWS WERE ALSO TRAINED TO ASSIST PATIENTS WITH SELF-MONITORED BLOOD PRESSURE READINGS. IN TOTAL, 240 PATIENTS WERE SERVED BY THE PRIMARY CARE CHWS IN FY2022. SOCIAL DETERMINANTS OF HEALTH CHWS CHRISTIANACARE'S SOCIAL DETERMINANTS OF HEALTH (SDOH) CHW PROGRAM LAUNCHED IN NOVEMBER 2021. IT WAS DESIGNED TO IMPROVE HEALTH OUTCOMES AND REDUCE LONGSTANDING DISPARITIES IN HEALTH. THIS PROGRAM INCLUDES A?FOCUS ON SCREENING FOR SOCIAL DETERMINANTS OF HEALTH TO IDENTIFY AND ADDRESS THE BARRIERS TO HEALTHCARE. AFTER STEADY EXPANSION DURING FY2022, THERE ARE NOW 4 SDOH CHWS EMBEDDED AT FOUR PRIMARY CARE PRACTICES. THE SDOH CHWS CONDUCT IN-DEPTH PATIENT INTERVIEWS AND SCREENINGS AT PRIMARY PRACTICES FOR PRE-APPOINTMENT PREPARATION AND ANNUAL APPOINTMENTS. THEY IDENTIFY SOCIAL CARE NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES. IN FY2022, 120 PATIENTS WERE SCREENED USING CHRISTIANACARE'S SDOH SCREENING TOOL AND 120 PATIENTS WERE ENROLLED INTO THE SDOH CHW PROGRAM. WOMEN'S HEALTH CHWS CHRISTIANACARE'S WOMEN'S HEALTH CHWS SEEK TO REMOVE BARRIERS TO CARE AND CONNECT PATIENTS TO RESOURCES TO PROMOTE POSITIVE MATERNAL AND INFANT BIRTH OUTCOMES. FIVE WOMEN'S HEALTH CHWS ARE EMBEDDED THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH SERVICES INCLUDING INPATIENT, OUTPATIENT, OBSTETRICS (OB) TRIAGE, AND THE NEONATAL INTENSIVE CARE UNIT (NICU). WOMEN'S HEALTH CHWS SERVE PATIENTS OF ALL AGES THROUGHOUT NEW CASTLE AND KENT COUNTY THAT ARE UNINSURED, INSURED WITH MEDICAID, OR ARE MEDICAID-ELIGIBLE WITH ONE OR MORE OF THE FOLLOWING CONDITIONS: CHRONIC DISEASE, MENTAL HEALTH AND/OR SUBSTANCE USE ISSUE(S), LATE OR NO ENTRY TO PRENATAL CARE, HISTORY OF POOR BIRTH OUTCOMES, BMI AT/ABOVE 30, OR ARE AT-RISK FOR BIRTH DEFECTS. SERVICE DELIVERY CONSISTS OF EPISODIC AND LONGITUDINAL CARE DURING THE PERINATAL PERIOD. IN FY2022, THE PROGRAM EXPANDED TO SERVE THE NICU AND OB TRIAGE SERVICES. IN TOTAL, 126 PATIENTS WERE SERVED IN FY2022. SCHOOL-BASED HEALTH CENTER CHWS SEVEN CHWS ARE EMBEDDED WITHIN 21 SCHOOL-BASED HEALTH CENTERS (SBHC) OPERATED BY CHRISTIANACARE. THE CHWS SERVED 1073 STUDENTS IN FY2022 BY CONNECTING THEM AND THEIR FAMILY TO NEEDED RESOURCES SUCH AS CLOTHING, FOOD, TRANSPORTATION, AND UTILITY ASSISTANCE. THEY ALSO ASSISTED STUDENTS IN MEETING THEIR HEALTH NEEDS THROUGH CONNECTION TO PRIMARY CARE PRACTICES, DENTAL SERVICES, AND EYE CARE AS WELL AS HELPING TO ENROLL THEM IN HEALTH INSURANCE. OBTAINING HEALTH INSURANCE WAS THE MOST PROVIDED SERVICE FOLLOWED BY CONNECTION TO A PRIMARY CARE PROVIDER. PEDIATRIC CARE CENTER CHRISTIANACARE ALSO MADE A SIGNIFICANT INVESTMENT TO BETTER SERVE CHILDREN AND THEIR FAMILIES BY OPENING A NEW 14 BED PEDIATRIC CARE CENTER LOCATED IN THE NEWARK CAMPUS. LAUNCHED IN OCTOBER 2021, THE CENTER PROVIDES 24/7 COMBINED SHORT-STAY INPATIENT AND EMERGENCY CARE FOR CHILDREN AND TEENS. THE PEDIATRIC CARE CENTER WILL SIGNIFICANTLY IMPROVE ACCESS TO CARE FOR CHILDREN IN NEW CASTLE COUNTY. DENTAL SERVICES ACCESSING DENTAL SERVICES IS ALSO CHALLENGING FOR MANY COMMUNITY MEMBERS AND CHRISTIANACARE HAS LONG WORKED TO ADDRESS THIS NEED. IN JANUARY 2021, CHRISTIANACARE COMPLETED A TWO-YEAR RENOVATION PROJECT THAT INCREASED THE CLINICAL CAPACITY OF OUR DENTISTRY AND ORAL-MAXILLOFACIAL SURGERY PRACTICES. THE SUCCESS OF THIS EXPANSION WAS SHOWN IN FY2022 WITH A RECORD HIGH NUMBER OF VISITS. CHRISTIANACARE'S DENTAL CLINIC HAS PROVIDED COMPREHENSIVE CARE, INCLUDING ORAL SURGERY, FOR UNINSURED AND UNDERINSURED INDIVIDUALS THROUGHOUT DELAWARE FOR OVER SIXTY YEARS. EVERY FRIDAY, THE DENTAL CLINIC SERVES UNINSURED PEDIATRIC PATIENTS. FEES AT THE CLINIC ARE KEPT AT A REDUCED LEVEL AND ONLY MEDICAID IS ACCEPTED. ANNUALLY, 11,000 PATIENTS ARE SEEN AT THIS CLINIC BY DENTAL RESIDENTS AND VOLUNTEER AND EMPLOYED DOCTORS. THE RESIDENTS SERVING THE DENTAL CLINIC ALSO PROVIDE DENTAL SERVICE IN THE COMMUNITY THROUGH ROTATIONS AT AFFILIATED DENTAL CLINICS AT WESTSIDE FAMILY HEALTHCARE AND DELAWARE TECHNICAL COMMUNITY COLLEGE. CHRISTIANACARE DENTAL RESIDENTS ALSO PROVIDE COMMUNITY OUTREACH. IN APRIL 2022, DENTAL RESIDENTS PROVIDED MOUTH AND THROAT CANCER SCREENINGS ON TWO SEPARATE OCCASIONS AT THE SUNDAY BREAKFAST MISSION. THE SUNDAY BREAKFAST MISSION, LOCATED IN WILMINGTON IN THE 19801 ZIP CODE, PROVIDES EMERGENCY SHELTER TO MEN, WOMEN, AND CHILDREN. CHRISTIANACARE ROUTINELY PARTNERS WITH THIS ORGANIZATION TO PROVIDE SERVICES TO ITS GUESTS. IN APRIL 2022, 53 INDIVIDUALS WERE SCREENED AND FOR THOSE THAT REQUIRED FOLLOW-UP, AN APPOINTMENT WAS SCHEDULED FOR THEM AT THE DENTAL CLINIC.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	CHRONIC HEALTH CONDITIONS IN OUR 5-YEAR STRATEGIC PLAN, CHRISTIANACARE ADOPTED THE ASPIRATION OF ENDING DISPARITIES IN ACCESS, EXPERIENCE, CARE DELIVERY, AND HEALTH OUTCOMES. TO EVEN BEGIN THE WORK OF ENDING DISPARITIES, WE MUST FIRST IDENTIFY DISPARITIES AND THEN DEVELOP EFFECTIVE STRATEGIES TO REDUCE THEM. IN FY2023, WE WILL BUILD SYSTEMS AND PROCESSES TO IDENTIFY AND REDUCE DISPARITIES IN QUALITY MEASURES AND HEALTH OUTCOMES WITH A FOCUS ON CHRONIC DISEASE, CANCER, AND MATERNAL/INFANT HEALTH OUTCOMES. OUR EXPECTATION IS THAT REDUCING DISPARITIES IN THESE AREAS WILL ULTIMATELY IMPROVE HEALTH OUTCOMES. AS DESCRIBED PREVIOUSLY, CHRONIC CONDITIONS ARE AN ELIGIBILITY REQUIREMENT TO PARTICIPATE IN THE PRIMARY CARE AND WOMEN'S HEALTH CHW PROGRAMS. THE CHW WORKS WITH THE PATIENTS TO IMPROVE SELF-MANAGEMENT OF THEIR CHRONIC CONDITIONS. WHILE CHRONIC CONDITIONS ARE NOT A REQUIREMENT TO PARTICIPATE IN EACH CHW PROGRAM, IF A PATIENT HAS A CHRONIC CONDITION, IT WILL BE ADDRESSED BY ANY OF THE CHWS WHO HAVE THE SHARED GOAL OF IMPROVING HEALTH. TO ADDRESS CHRONIC DISEASE OUTCOMES AND FOOD INSECURITY AMONG OUR LOW-INCOME PATIENTS, WE LAUNCHED THE DELAWARE FOOD FARMACY (DFF) IN PARTNERSHIP WITH LUTHERAN COMMUNITY SERVICES IN FEBRUARY 2021. THIS 6-MONTH COMPREHENSIVE FOOD PHARMACY SERVES PRIMARY CARE PATIENTS WITH UNCONTROLLED?HYPERTENSION, DIABETES, AND/OR CONGESTIVE HEART FAILURE. PARTICIPANTS IN THIS PROGRAM RECEIVE WEEKLY MEDICALLY TAILORED GROCERY BOXES DELIVERED TO THEIR HOMES BY LUTHERAN COMMUNITY SERVICES. THE BOXES CONTAIN ENOUGH FOOD FOR THE PATIENT AND THEIR FAMILY MEMBERS TO PREPARE ABOUT 10 MEALS. THE FOOD PROVISIONS ARE GUIDED BY AN EVIDENCE-BASED EATING PLAN. ALONG WITH THE FOOD, PARTICIPANTS MEET EACH WEEK WITH A DFF CHW, WHO ASSISTS THEM WITH GOAL SETTING AND IMPROVING DIETARY KNOWLEDGE AND CULINARY SKILLS. PARTICIPANTS ALSO RECEIVE ADDITIONAL SUPPORT FROM CHRISTIANACARE PHARMACISTS, REGISTERED DIETITIANS, AND BEHAVIORAL HEALTH CONSULTANTS AS WELL AS BLOOD PRESSURE CUFFS, GLUCOSE MONITORS, AND SCALES FOR SELF-MONITORING. THE DFF INCLUDES AN ONGOING ROBUST EVALUATION THAT EXAMINES PRE-TO-POST ENROLLMENT CHANGES IN FOOD INSECURITY AND NUTRITIONAL AND CHRONIC DISEASE OUTCOMES. TWENTY-FOUR HOUR DIETARY RECALLS, PATIENT SURVEYS, AND MEDICAL RECORD DATA ARE BEING USED TO DOCUMENT PROGRAM PROCESS AND OUTCOMES. IN FY2022, 79 PATIENTS PARTICIPATED, AND 198 COMMUNITY MEMBERS WERE FED THROUGH THE DFF. OF THE DFF PARTICIPANTS, 75% WERE FOOD INSECURE, AND THE MAJORITY HAD ONE OR MORE CHRONIC CONDITIONS. A LITTLE MORE THAN HALF OF THE PARTICIPANTS WERE FEMALE AND MOST PARTICIPANTS WERE BLACK/AFRICAN-AMERICAN (70%) WITH ANOTHER 14% IDENTIFYING AS HISPANIC. DEMONSTRATING THE EFFECTIVENESS OF THE PROGRAM, 90% OF THESE PARTICIPANTS LOST WEIGHT. OUTCOMES OF EARLIER DFF PARTICIPANTS, THERE HAVE BEEN A TOTAL OF 95, HAVE ALSO BEEN PROMISING WITH PATIENTS SHOWING INCREASED CALCIUM AND FIBER INTAKE, DECREASES IN HBA1C AND BLOOD PRESSURE, WEIGHT LOSS, AND DECREASES IN ANXIETY AND DEPRESSION. OUR PARTNERSHIP WITH LUTHERAN COMMUNITY SERVICES HAS BEEN A KEY COMPONENT OF THIS PROGRAM'S SUCCESS AND WE LOOK FORWARD TO EXPANDING OUR SUCCESS WITH THEM OVER THE NEXT SEVERAL MONTHS. CHRISTIANACARE IS ACTIVELY ENGAGED IN DEVELOPING A CULTURALLY CENTERED DFF TO OFFER TO OUR SPANISH-SPEAKING PATIENTS. IN THE UPCOMING YEAR, CHRISTIANACARE WILL FURTHER EXPAND THE DFF TO SERVE A TARGETED SUBSET OF PATIENTS IN OUR WOMEN'S HEALTH PRACTICES. THE DFF OPERATES OUT OF CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT, BUT THE PARTICIPATION OF MULTIPLE DEPARTMENTS MAKES THIS PROGRAM AND ITS EXPANSION POSSIBLE. THE DFF DEMONSTRATES CHRISTIANACARE'S COMPREHENSIVE APPROACH TO PROVIDING HOLISTIC AND CONVENIENT CARE THAT RECOGNIZES THE PATIENT AS A WHOLE PERSON. WITH LONG TERM COMMUNITY PARTNER, URBAN ACRES, CHRISTIANACARE ALSO OPERATES A PRODUCE DELIVERY PROGRAM. ADULT PATIENTS LIVING IN NEW CASTLE COUNTY WHO ARE ON MEDICAID OR ARE MEDICAID ELIGIBLE AND HAVE DIABETES, HYPERTENSION, AND/OR NEED FOOD ASSISTANCE ARE ELIGIBLE. THIS 3-TO-6-MONTH WEEKLY DELIVERY PROGRAM IS DESIGNED TO INCREASE PATIENT ACCESS TO THE FRESH PRODUCE NECESSARY TO LIVE A HEALTHIER LIFE. ALONG WITH A BAG OF PRODUCE CONSISTING OF 1 LEAFY GREEN, 2-3 ADDITIONAL VEGETABLES, AND 2-3 FRUITS, PATIENTS ARE ALSO CONNECTED TO SUSTAINABLE FOOD ASSISTANCE PROGRAMS AND RECEIVE EDUCATIONAL MATERIALS ON THE HEALTH BENEFITS OF FRUITS AND VEGETABLES. IN FY2022, 178 PATIENTS WERE SERVED. OF THOSE PATIENTS, 65% WERE FEMALE, 54% WERE BLACK/AFRICAN AMERICAN, AND 19% WERE HISPANIC. THE MEAN AGE OF THESE PATIENTS WAS 57.54.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	MATERNAL AND CHILD HEALTH IN 2015, DELAWARE HAD THE SECOND HIGHEST INFANT MORTALITY RATE AMONG ALL STATES. IN 2020, DELAWARE WAS RANKED 31ST HIGHEST INFANT MORTALITY RATE AMONG THE STATES. THIS IMPROVEMENT WAS THE RESULT OF CONCENTRATED EFFORTS BY STATE AND COMMUNITY AGENCIES AS WELL AS HEALTH SYSTEMS LIKE CHRISTIANACARE WHICH HAS TAKEN A LEADING ROLE IN THIS EFFORT. THE SIGNIFICANT DECREASE IN THE INFANT MORTALITY RATE IS AN ACCOMPLISHMENT TO BE CELEBRATED, BUT THERE IS STILL WORK TO BE DONE TO IMPROVE MATERNAL AND INFANT OUTCOMES, PARTICULARLY DISPARATE OUTCOMES ACROSS RACE AND ETHNICITY. CHRISTIANACARE CONTINUES TO ADDRESS MATERNAL AND CHILD HEALTH WITH EXCEPTIONAL AND INNOVATIVE CLINICAL CARE COMBINED WITH COMMUNITY SUPPORTS LIKE THE HEALTH AMBASSADORS WHICH WILL BE DESCRIBED IN FURTHER DETAIL IN THIS SECTION. WE ALSO ADDRESS SOCIAL DETERMINANTS OF HEALTH BECAUSE WE BELIEVE THAT PROVIDING OUR COMMUNITIES AND NEIGHBORS WITH LIFE RESOURCES WILL HAVE A POSITIVE EFFECT ON HEALTH OUTCOMES INCLUDING THE LONG-TERM IMPACT OF IMPROVING MATERNAL AND INFANT OUTCOMES. AS HAS BEEN DEMONSTRATED THROUGHOUT THIS NARRATIVE, CHRISTIANACARE IS COMMITTED TO REDUCING DISPARITIES, PROVIDING RADICAL CONVENIENCE, AND IMPLEMENTING INNOVATIVE STRATEGIES TO IMPROVE HEALTH OUTCOMES. OVER THE LAST SEVERAL YEARS, CHRISTIANACARE'S WOMEN'S HEALTH DEPARTMENT HAS SUCCESSFULLY IMPLEMENTED THESE OBJECTIVES TO SIGNIFICANTLY IMPROVE MATERNAL AND INFANT HEALTH. POST-PARTUM HYPERTENSION MONITORING--REDUCTION OF DISPARITIES CHRISTIANACARE CLINICAL LEADERS DESIGNED AND IMPLEMENTED A POST-PARTUM HYPERTENSION MONITORING PROGRAM FROM FEBRUARY 2019 THROUGH MAY 2020 TO IMPROVE EARLY DETECTION OF POSTPARTUM HYPERTENSION BY OVERCOMING LOW ATTENDANCE FOR FOLLOW-UP OFFICE VISITS. WOMEN WITH HIGH BLOOD PRESSURE COMPRISED MOST POSTPARTUM READMISSIONS, WITH BLACK WOMEN READMITTED TWICE AS OFTEN AS WHITE WOMEN, BUT ONLY 30% OF PATIENTS ATTENDED POSTPARTUM OFFICE VISITS. THE STUDY TEAM EVALUATED HISTORICAL DATA TO LEARN ABOUT THE BARRIERS ASSOCIATED WITH THE POOR POSTPARTUM OFFICE VISIT RATE. PATIENTS REPORTED CHALLENGES WITH THE TIME AND RESOURCES REQUIRED TO TRAVEL TO APPOINTMENTS, THE EXERTION ASSOCIATED WITH THE EFFORT, AND THE PERCEIVED LOW BENEFIT FROM THE VISIT. TO ADDRESS THESE BARRIERS, CHRISTIANACARE CONNECTED A TARGETED POPULATION OF NEW MOTHERS PRIOR TO HOSPITAL DISCHARGE WITH TWISTLE, A REMOTE PATIENT MONITORING PLATFORM. PATIENTS WHO CONSENTED TO PARTICIPATE IN THE PROGRAM RECEIVED A BRIEF OVERVIEW OF THE PLATFORM AND TUTORIAL ON THE MONITORING EQUIPMENT PRIOR TO HOSPITAL DISCHARGE. THE PROGRAM INCLUDED SENDING EDUCATIONAL MATERIALS AND ASSESSMENT FORMS AUTOMATICALLY TO PATIENTS' CELL PHONES ON A PRESCRIBED SCHEDULE. PATIENTS WITH BLOOD PRESSURE IN THE NORMAL RANGE RECEIVED AUTOMATED REPLIES THAT OFFERED IMMEDIATE REASSURANCE. ABNORMAL READINGS WERE PROMPTLY ROUTED TO THE CARE TEAM FOR FOLLOW-UP. THIS PROCESS PROVIDED AN OPPORTUNITY FOR THE CARE TEAM TO PROACTIVELY TITRATE MEDICATION AND AVOID PATIENTS REQUIRING READMISSION FOR HYPERTENSIVE CRISIS. THIS PROGRAM SUCCESSFULLY REDUCED POSTPARTUM HYPERTENSION READMISSION RATES AND ELIMINATED A LONGSTANDING RACIAL DISPARITY. NOTABLY, 91% OF NEW MOTHERS SUBMITTED AT LEAST ONE BLOOD PRESSURE READING IN THE REMOTE MONITORING PROGRAM, AND 70% OF PATIENTS ENGAGED IN THE FULL 10-DAY PROTOCOL. THE PROGRAM SUCCESSFULLY REDUCED OVERALL POSTPARTUM PATIENT READMISSIONS BY 55%. AMONG BLACK MOTHERS, THE READMISSION RATE DROPPED FROM 61% TO 31%. THIS PROGRAM HAS NOW BECOME STANDARD PRACTICE THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH PRACTICES. BASED ON PATIENT FEEDBACK, THE DURATION OF THE MONITORING PROGRAM WAS EXTENDED FROM 10 DAYS TO 42 DAYS. THE ADDITIONAL TIME SUPPORTS EACH PATIENT'S CARE TRANSITION TO THEIR PRIMARY PHYSICIAN OR THE IDENTIFICATION OF A PRIMARY CARE PROVIDER FOR THOSE WITHOUT ONE. PRENATAL AND POSTPARTUM DIABETES MONITORING-REDUCTION OF DISPARITIES WOMEN'S HEALTH CLINICAL LEADERS TACKLED POOR COMPLIANCE WITH POSTPARTUM DIABETES TESTING IN THE SAME MANNER. WOMEN WITH GESTATIONAL DIABETES ARE ASKED TO COMPLETE 2-HOUR GLUCOSE TOLERANCE TEST 6-12 WEEKS POST-DELIVERY. WHILE GESTATIONAL DIABETES RESOLVES AFTER DELIVERY FOR MOST WOMEN, SOME DEVELOP TYPE 2 DIABETES. AS WITH THE PREVIOUSLY DESCRIBED PATIENTS, THE LOGISTICS OF GETTING TO THE DIABETES SCREENING APPOINTMENT PRESENTED MANY CHALLENGES, ESPECIALLY FOR WOMEN FROM LOW-INCOME AND MINORITY COMMUNITIES. TO OVERCOME THOSE BARRIERS, PATIENTS WERE ASKED TO SUBMIT THREE FASTING BLOOD SUGARS AT HOME AND TEXT THE RESULTS. PATIENTS WITH ABNORMAL RESULTS COMPLETED THE 2-HOUR GLUCOSE TOLERANCE TEST AND WERE CONNECTED TO PRIMARY CARE. TEXT-BASED SCREENING FOR POSTPARTUM DIABETES TESTING ACHIEVED IMPROVED COMPLIANCE WITH A 92% INCREASE IN COMPLIANCE RATES COMPARED TO STANDARD SCREENING (25% VERSUS 48%) AND A 213% INCREASE IN THE DETECTION OF TYPE 2 DIABETES (5.4% IN THE STANDARD SCREENING GROUP COMPARED TO 16.9% IN TEXT-BASED SCREENING). ENGAGEMENT WITH TEXT-BASED SCREENING NARROWED THE RACIAL GAP IN CARE WITH A 211% INCREASE IN COMPLIANCE AMONG BLACK WOMEN. IMPROVEMENTS IN COMPLIANCE WITH TEXT-BASED CARE LED TO A 180% HIGHER DIABETES DETECTION AMONG NON-BLACK WOMEN AND A 577% INCREASE AMONG BLACK WOMEN. THESE PROGRAMS DEMONSTRATE HOW DISPARITIES CAN BE EFFECTIVELY ADDRESSED. THESE SUCCESSES WILL INFORM THE WOMEN'S HEALTH DEPARTMENT AS IT PARTNERS WITH THE DELAWARE FOOD FARMACY TO USE FOOD AS MEDICINE TO SERVE HIGH-RISK OBESE PREGNANT PATIENTS. WE LOOK FORWARD TO SHARING INFORMATION ABOUT THIS PROGRAM AS IT PROGRESSES.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	BIRTHING COMPANION CERTIFICATE PARTNERSHIP WITH UNIVERSITY OF DELAWARE CHRISTIANACARE IS ALSO ADDRESSING DISPARITIES IN MATERNAL AND CHILD HEALTH THROUGH ITS COLLABORATION WITH UNIVERSITY OF DELAWARE'S DIVISION OF PROFESSIONAL AND CONTINUING STUDIES AND SCHOOL OF NURSING TO CREATE A BIRTHING COMPANION CERTIFICATE IN THE FALL OF 2021. BIRTH COMPANIONS SUPPORT AND ADVOCATE FOR WOMEN DURING THEIR PREGNANCY, LABOR AND BIRTH, AND AFTER DELIVERY. NURSING STUDENTS PARTICIPATING IN THIS COURSE PROGRAM ARE PROVIDED WITH THE SKILLS THEY NEED TO PURSUE THE REQUIREMENTS OF BECOMING A DOULA. THIS PROGRAM SERVES THE DUAL PURPOSE OF HELPING THE PATIENT AND PROVIDING THE NURSING STUDENT WITH CLINICAL EXPERIENCE AND THE OPPORTUNITY TO WORK CLOSELY WITH PATIENTS WHO MAY BE IN VERY DIFFERENT CIRCUMSTANCES THAN THEIR OWN. THIS WILL GIVE THE PARTICIPATING STUDENTS AN EARLY LESSON IN THE IMPORTANCE OF RECOGNIZING PATIENTS AS A WHOLE PERSON. COMMUNITY HEALTH WORKERS, HEALTHY BEGINNINGS, AND OTHER PROGRAMS TO ADDRESS INFANT MORTALITY AND DISPARITIES CHRISTIANACARE HAS SEVERAL PROGRAMS DESIGNED TO PROMOTE MATERNAL AND CHILDREN'S HEALTH IN A HOLISTIC MANNER. AS DESCRIBED PREVIOUSLY, WOMEN'S HEALTH CHWS ARE EMBEDDED THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH SERVICES INCLUDING INPATIENT, OUTPATIENT, OBSTETRICS (OB) TRIAGE, AND THE NEONATAL INTENSIVE CARE UNIT (NICU). THESE CHWS PARTNER WITH PATIENTS TO PROVIDE CONNECTION TO NEEDED SOCIAL AND HEALTH RESOURCES TO ULTIMATELY IMPROVE HEALTH. IN PARTNERSHIP WITH THE DELAWARE DIVISION OF PUBLIC HEALTH, CHRISTIANACARE HAS OFFERED HEALTHY BEGINNINGS FOR OVER A DECADE. CREATED TO ADDRESS DELAWARE'S HIGH INFANT MORTALITY RATE, THIS PROGRAM PROVIDES PRECONCEPTION CARE TO IDENTIFY AND ADDRESS RISKS TO FUTURE PREGNANCY, PREGNANCY PLANNING TO SET THE STAGE FOR A HEALTHY PREGNANCY, AND PRENATAL CARE FROM CONCEPTION TO CHILDBIRTH. HEALTHY BEGINNINGS OFFERS A MULTIDISCIPLINARY TEAM OF DOCTORS, NURSE PRACTITIONERS, NURSE EDUCATORS, SOCIAL WORKERS, RESOURCE MOTHERS, DIETICIANS, AND CASE MANAGERS TO ENSURE THE PATIENT HAS THE CLINICAL AND SOCIAL RESOURCES NEEDED TO ACHIEVE POSITIVE OUTCOMES FOR MOTHER AND BABY AND REDUCE DISPARATE OUTCOMES. IN FY2022, PATIENTS IN THIS PROGRAM RECEIVED THE FOLLOWING SERVICES TO SUPPORT THEIR HEALTH: PERSONAL HEALTH AND WELLNESS, WEIGHT MANAGEMENT, STRESS MANAGEMENT, EMOTIONAL HEALTH TREATMENT, FAMILY PLANNING, CONTRACEPTION, DOMESTIC ABUSE SCREENING, TOBACCO CESSATION, AND HYPERTENSION SCREENING AND TREATMENT. IN FY2022, 1,148 PATIENTS WERE ENROLLED IN HEALTHY BEGINNINGS, OF THOSE, 80.8% WERE BLACK AND 73.9% LIVED-IN HIGH-RISK ZONES (19703, 19720, 19801, 19802, 19804, 19805, 19809). HEALTH AMBASSADORS FOR THE LAST DECADE, THE STATE OF DELAWARE HAS AWARDED CHRISTIANACARE GRANT FUNDING TO SUPPORT ITS HEALTH AMBASSADORS PROGRAM. LIKE THE HEALTHY BEGINNINGS PROGRAM, THE HEALTH AMBASSADORS PROGRAM WAS CREATED IN RESPONSE TO THE HIGH INFANT MORTALITY RATE. HEALTH AMBASSADORS GUIDE FAMILIES ON THE PATH TO GOOD HEALTH. THEY SERVE PREGNANT WOMEN AND FAMILIES WITH CHILDREN AGED 0 TO 5 IN TARGETED HIGH-RISK ZIP CODES TO CONNECT WOMEN AND YOUNG FAMILIES TO HEALTH CARE, SOCIAL SERVICES, HOME VISITING, AND EDUCATIONAL PROGRAMS. THE HEALTH AMBASSADORS ALSO PROMOTE KEY MATERNAL AND CHILD HEALTH MESSAGES INCLUDING THE BENEFITS OF BREASTFEEDING AND THE IMPORTANCE OF SAFE SLEEP. IN FY2022, THE HEALTH AMBASSADORS EXPANDED THEIR REACH BY HIRING A SECOND BILINGUAL HEALTH AMBASSADOR IN JUNE 2022 TO SERVE THE SPANISH SPEAKING COMMUNITY, AS WELL AS PREGNANT AND PARENTING WOMEN WITH SUBSTANCE USE DISORDER RECEIVING TREATMENT AT A SUBSTANCE USE DISORDER TREATMENT CLINIC IN CLAYMONT. FROM JUNE TO NOVEMBER 2022, THE HEALTH AMBASSADORS HAD AN INCREASE IN SERVICES FOR SPANISH SPEAKING FAMILIES BY 40% COMPARED TO THE SAME PERIOD THE PREVIOUS YEAR. THE HEALTH AMBASSADORS WERE ALSO AT THE FOREFRONT OF PROVIDING RELIEF TO FAMILIES IMPACTED BY THE INFANT FORMULA SHORTAGE. THE HEALTH AMBASSADORS PARTNERED WITH THE STATE AND OTHER COMMUNITY ORGANIZATIONS TO COLLECT BABY FOOD AND FORMULA AND HOST A BABY FOOD AND FORMULA DRIVE IN JUNE 2022 FOR FAMILIES IN NEED. WHILE THE CRISIS OF THE INFANT FORMULA SHORTAGE DID ABATE TOWARDS THE END OF 2022, FINDING FORMULA CONTINUES TO BE A CHALLENGE FOR SOME FAMILIES AND THE HEALTH AMBASSADORS PROVIDE THE NEEDED SUPPORT FOR THESE FAMILIES. THE HEALTH AMBASSADORS ALSO PROVIDED FAMILIES WITH 2,882 ESSENTIAL ITEMS SUCH AS FOOD BOXES (227), CAR SEATS (179), PACKAGES OF DIAPERS (640), STROLLERS (27), CLOTHING (160), AND MORE. IN MOST CASES, THE HEALTH AMBASSADORS DELIVERED THESE ITEMS TO THE FAMILY'S HOME. THE HEALTH AMBASSADORS ALSO PROVIDED 625 REFERRALS FOR FAMILIES TO RECEIVE SERVICES SUCH AS HOME VISITING, HOUSING, AND HEALTH INSURANCE. WHILE THERE WAS ALWAYS FREQUENT COMMUNICATION BETWEEN THE WOMEN'S HEALTH CHWS, HEALTH AMBASSADORS, AND HEALTHY BEGINNINGS, IN FY2022, THESE GROUPS BEGAN A WEEKLY HUDDLE TO ENSURE THE HIGH NEEDS PATIENTS THEY SERVE ARE RECEIVING THE MOST EFFECTIVE CARE AND THE NEEDED RESOURCES FOR FAMILIES FROM PRECONCEPTION TO RAISING YOUNG CHILDREN.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION (AAPP) SINCE 1995, THE STATE OF DELAWARE HAS ALSO PROVIDED CHRISTIANACARE WITH A GRANT TO OPERATE THE ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION (AAPP). AAPP 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. IN FY2022, CHRISTIANACARE'S AAPP TEAM PROVIDED 500 ADOLESCENTS WITH EDUCATION. AAPP OFFERS THREE COURSES: 1. BE PROUD! BE RESPONSIBLE: A SIX-MODULE CURRICULUM THAT PROVIDES ADOLESCENTS, AGES 13 TO 18, WITH THE KNOWLEDGE, MOTIVATION, AND SKILLS NECESSARY TO CHANGE THEIR BEHAVIORS IN WAYS THAT WILL REDUCE THEIR RISK OF CONTRACTING HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS. 2. MAKING PROUD CHOICES: AN EIGHT-MODULE CURRICULUM THAT PROVIDES YOUNG ADOLESCENTS, AGES 11 TO 13, WITH THE KNOWLEDGE, CONFIDENCE, AND SKILLS NECESSARY TO REDUCE THEIR RISK OF SEXUALLY TRANSMITTED INFECTIONS (STIS), HIV, AND PREGNANCY. 3. WISE GUYS: A TEN-MODULE PROGRAM DESIGNED TO PREVENT ADOLESCENT PREGNANCY, EMPOWER YOUNG MEN TO RECOGNIZE CHALLENGES THEY MAY FACE IN LIFE, AND GIVE THEM THE TOOLS TO OVERCOME THESE CHALLENGES. SELF-REPORTED PRE-TEST AND POST-TEST KNOWLEDGE, ATTITUDE, AND BEHAVIOR MEASURES BETWEEN SEPTEMBER 2021 AND APRIL 2022 DEMONSTRATED STUDENTS' INCREASED KNOWLEDGE AFTER PARTICIPATING IN BE PROUD! BE RESPONSIBLE! AND MAKING PROUD CHOICES COURSES. DATA FOR WISE GUYS WAS INCOMPLETE, BUT WE EXPECT TO SEE POSITIVE RESULTS IN FY2023. IMPORTANTLY, EVERY STUDENT WAS PROVIDED A SATISFACTION SURVEY AT THE END OF THEIR COURSE AND 94% RATED THE AAPP SERIES AS "EXCELLENT"GOOD6% RATED IT AS "FAIR". 100% OF RESPONDENTS ANSWERED "YES" TO THE QUESTION OF WHETHER THEIR EDUCATOR EXPLAINED THE PROGRAM IN A WAY THEY COULD UNDERSTAND. DELAWARE HEALTHY MOTHER & INFANT CONSORTIUM (DHMIC) CHRISTIANACARE CAREGIVERS ARE ALSO SERVING THE STATE THROUGH COLLABORATIVE EFFORTS SUCH AS THE DELAWARE HEALTHY MOTHER & INFANT CONSORTIUM (DHMIC). DR. DAVID PAUL, CHRISTIANACARE CHAIR OF PEDIATRICS, AGAIN SERVED AS CO-CHAIR OF DHMIC IN FY2022. THE MISSION OF DHMIC IS TO PROVIDE STATEWIDE LEADERSHIP AND COORDINATION OF EFFORTS TO PREVENT INFANT MORTALITY AND TO IMPROVE THE HEALTH OF WOMEN OF CHILDBEARING AGE AND INFANTS THROUGHOUT DELAWARE. CHRISTIANACARE CAREGIVERS ALSO SERVE ON THE DELAWARE MATERNAL MORTALITY REVIEW PANEL WHICH REVIEWS MATERNAL DEATHS AND RECOMMENDS TERTIARY AND SYSTEMIC CHANGES TO REDUCE MORTALITY RATES. MENTAL HEALTH AND SUBSTANCE USE DISORDERS EVEN BEFORE THE CORONAVIRUS PANDEMIC EXACERBATED THE ISSUES OF ACCESS TO BEHAVIORAL HEALTH SERVICES AND BROUGHT INCREASED ATTENTION TO THE BEHAVIORAL HEALTH NEEDS OF VULNERABLE POPULATIONS, OUR COMMUNITY HAD LONG IDENTIFIED MENTAL HEALTH AND SUBSTANCE USE DISORDERS AS A SIGNIFICANT AREA OF NEED. TO ADDRESS THIS AREA OF NEED, CHRISTIANACARE IS WORKING TO PROVIDE MORE ACCESS BY HIRING ADDITIONAL CAREGIVERS AND DEVELOPING AND EXPANDING PROGRAMS. CHRISTIANACARE'S BEHAVIORAL HEALTH TEAM WORKED TOWARDS A GOAL OF HIRING 71 NEW CAREGIVERS IN BOTH CLINICAL AND NON-CLINICAL ROLES TO ADDRESS BEHAVIORAL HEALTH BY THE END OF FISCAL YEAR 2023. IT HAS BEEN A CHALLENGE IN OUR STATE AND NATIONALLY TO FILL BEHAVIORAL HEALTH POSITIONS. CHRISTIANACARE IS NOT IMMUNE TO THOSE CHALLENGES, BUT WE ARE ENCOURAGED BY THE PROGRESS WE HAVE ALREADY MADE. CHRISTIANACARE LAUNCHED A GENDER WELLNESS CLINIC IN OCTOBER 2021 WHICH SERVES ANYONE AGE 13 OR OLDER EXPLORING THEIR GENDER IDENTITY, EXPERIENCING GENDER DYSPHORIA, OR WHO NEEDS EDUCATION AND SUPPORT AROUND SOCIAL AND MEDICAL TRANSITION. A NEW GERIATRIC MENTAL HEALTH PROGRAM IS IN DEVELOPMENT IN COLLABORATION WITH CHRISTIANACARE'S SWANK MEMORY CENTER. THIS PROGRAM WILL BE COMPRISED OF TWO NEW SENIOR PSYCH SOCIAL WORKERS AND A GERIATRIC PSYCHIATRIST. ALSO SET TO LAUNCH THIS YEAR IS THE FIRST EPISODE CLINIC, AN EARLY INTERVENTION MODEL DESIGNED TO CONNECT PATIENTS WITH RESOURCES TO REDUCE INAPPROPRIATE ED VISITS AND READMISSION TO INPATIENT FLOORS. FINALLY, NOW THAT COVID-19 RESTRICTIONS HAVE EASED, WE ARE VERY PLEASED TO RETURN TO OFFERING GROUP THERAPY PROGRAMS FOR ADULTS AND CHILDREN. WE ARE ALSO WORKING TO EXPAND OUR SUBSTANCE USE AND EMBEDDED BEHAVIORAL HEALTH CARE MODELS. EMBEDDED BEHAVIORAL HEALTH CARE INCREASES ACCESS AND EARLY PREVENTION AS WELL AS ENABLES US TO SERVE THE PATIENT HOLISTICALLY BY ADDRESSING THE CONNECTION BETWEEN PHYSICAL AND MENTAL HEALTH. AN ADVANCED PRACTICE CLINICIAN IS NOW EMBEDDED WITHIN PROJECT RECOVERY, CHRISTIANACARE'S OUTPATIENT SUBSTANCE USE DISORDER TREATMENT PROGRAM. WITH THE ADDITION OF TWO NEW BEHAVIORAL HEALTH CONSULTANTS (BHC), SIX WOMEN'S HEALTH PRACTICES ARE NOW SERVED BY BHCS. WE INTEND TO EXPAND EMBEDDED BEHAVIORAL HEALTH INTO NEW PRACTICES THIS YEAR AND WILL BE ABLE TO SHARE THAT PROGRESS NEXT YEAR. IN FY2022, CHRISTIANACARE ALSO LAUNCHED THE BEHAVIORAL HEALTH CHW PROGRAM, AS DESCRIBED IN THE ACCESS TO CARE SECTION. THROUGH THIS PROGRAM, CHWS ARE EMBEDDED IN CHRISTIANACARE'S OUTPATIENT BEHAVIORAL HEALTH SERVICES TO SUPPORT CHILDREN, ADOLESCENTS, AND ADULTS WITH MENTAL HEALTH AND/OR SUBSTANCE USE DIAGNOSES FOR UP TO 6 MONTHS.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	ANOTHER PROGRAM CHRISTIANACARE HAS OPERATED TO ADDRESS SUBSTANCE USE DISORDER IS PROJECT ENGAGE, AN EARLY INTERVENTION AND REFERRAL TO SUBSTANCE USE DISORDER TREATMENT PROGRAM. PEERS IN SUBSTANCE USE DISORDER RECOVERY ENGAGE WITH INPATIENTS AND PATIENTS IN THE EMERGENCY DEPARTMENT WHO ARE STRUGGLING WITH SUBSTANCE USE DISORDER. THE PEERS USE MOTIVATIONAL INTERVIEWING TO EMPOWER EACH PATIENT IN THE DECISION-MAKING PROCESS, ASSISTING THEM TO TAKE THE CRITICAL FIRST STEP TO SEEK HELP FOR THE SUBSTANCE USE DISORDER. PEERS WILL CONNECT THESE PATIENTS TO TREATMENT PROGRAMS AND OTHER COMMUNITY RESOURCES. IN FY2022, PROJECT ENGAGE PEERS HAD A TOTAL OF 2061 ENGAGEMENTS WITH PATIENTS AND MADE 977 REFERRALS TO TREATMENT. CHRISTIANACARE'S PROVISION OF BEHAVIORAL HEALTH SERVICES IN SCHOOL-BASED HEALTH CENTERS IS NOT THE ONLY COMMUNITY-BASED EFFORT BEING UNDERTAKEN TO PROVIDE RADICALLY CONVENIENT SERVICE TO OUR NEIGHBORS. SINCE 2020, CHRISTIANACARE HAS PARTNERED WITH THE NEW CASTLE COUNTY POLICE DEPARTMENT (NCCPD) TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE DISORDER IN THE COMMUNITY. SUPPORTED BY FEDERAL AND STATE GRANT FUNDING, THE UNDERLYING GOALS OF THIS PARTNERSHIP ARE TO DIVERT INDIVIDUALS AWAY FROM THE CRIMINAL JUSTICE SYSTEM AND EMERGENCY DEPARTMENTS WHEN APPROPRIATE AND WORK TO CONNECT INDIVIDUALS TO CARE IN THE COMMUNITY. THREE CHRISTIANACARE CAREGIVERS, TWO MENTAL HEALTH PROFESSIONALS AND A CASE MANAGER, ARE EMBEDDED IN THE POLICE DEPARTMENT'S BEHAVIORAL HEALTH UNIT (BHU) TO ADDRESS MENTAL HEALTH NEEDS IN THE COMMUNITY. SERVING WITH THE POLICE IN A CO-RESPONDER MODEL, THE MENTAL HEALTH PROFESSIONALS RESPOND TO 911 CALLS AND OFFICER REFERRALS WHEN MENTAL ILLNESS IS BELIEVED TO BE A PRIMARY FACTOR FOR POLICE INVOLVEMENT. THEY PROVIDE SUPPORT TO THE COMMUNITY MEMBER AT A TIME OF CRISIS AS WELL AS EDUCATION TO THE OFFICERS ON HOW TO IDENTIFY MENTAL ILLNESS AND PROVIDE ESSENTIAL DE-ESCALATION TACTICS. ONCE THE INITIAL CRISIS HAS BEEN ABATED, THE CASE MANAGER CONTINUES TO WORK TO CONNECT THESE INDIVIDUALS TO THE APPROPRIATE COMMUNITY TREATMENT AND TO ADDRESS ANY SOCIAL NEEDS. IN FY2022, CHRISTIANACARE RECEIVED ADDITIONAL GRANT FUNDING TO EMPLOY ANOTHER MENTAL HEALTH PROFESSIONAL TO BETTER MEET THE NEEDS THE POLICE ARE EXPERIENCING IN THE COMMUNITY. THREE ADDITIONAL CHRISTIANACARE CAREGIVERS SUPPORT THE NCCPD'S HERO HELP PROGRAM WHICH ADDRESSES SUBSTANCE USE DISORDER BY SUPPORTING THOSE SEEKING TREATMENT. THESE CAREGIVERS RESPOND TO NON-FATAL OVERDOSES, PROVIDE OUTREACH IN THE COMMUNITY, WORK WITH INDIVIDUALS TO DEVISE A TREATMENT PLAN AND OBTAIN TREATMENT, PROVIDE ONGOING CASE MANAGEMENT, AND ADDRESS ANY NEEDS INDIVIDUALS MAY HAVE THAT SERVE AS BARRIERS TO OBTAINING TREATMENT. THE INITIAL GRANT FUNDING WHICH ENABLED US TO BEGIN OUR PARTNERSHIP WITH THE POLICE WILL EXPIRE IN OCTOBER 2023. CHRISTIANACARE WILL SEEK ADDITIONAL SUPPORT TO CONTINUE THIS PARTNERSHIP - AND EXPAND IT WITH MORE CAREGIVERS EMBEDDED IN THE NCCPD. THIS PROGRAM ADDRESSES A SIGNIFICANT NEED IN THE COMMUNITY AND ENABLES US TO SERVE OUR COMMUNITY AND THE POLICE. THE NCCPD RECOGNIZES THAT SUBSTANCE USE DISORDER AND MENTAL HEALTH ISSUES ARE OFTEN THE DRIVING FACTORS LEADING TO INVOLVEMENT WITH POLICE. OUR PARTNERSHIP PROVIDES THEM WITH THE SUPPORT TO RESPOND APPROPRIATELY AND IT ALLOWS CHRISTIANACARE TO PROVIDE MORE SERVICES IN THE COMMUNITY. CHRISTIANACARE'S COMMUNITY SUBSTANCE OVERDOSE SUPPORT (SOS), CREATED IN PARTNERSHIP WITH NEW CASTLE COUNTY, PROVIDES OUTREACH TO INDIVIDUALS WITH SUBSTANCE USE DISORDER (SUD) LIVING IN NEW CASTLE COUNTY. SOS ACCEPTS SELF-REFERRALS, INTERNAL REFERRALS FOR CHRISTIANACARE PATIENTS, AND NEW CASTLE COUNTY EMS REFERRALS OF INDIVIDUALS THEY HAVE REVIVED WITH NALOXONE, THE OPIOID OVERDOSE REVERSING MEDICATION, AND TAKEN TO ONE OF CHRISTIANACARE'S EMERGENCY DEPARTMENTS. SOS GOES TO INDIVIDUALS' HOMES OR OTHER COMMUNITY LOCATIONS AND USES MOTIVATIONAL INTERVIEWING TECHNIQUES TO ENCOURAGE THE INDIVIDUAL TO ENTER SUBSTANCE USE DISORDER TREATMENT. IF NEEDED, SOS WILL HELP THE PATIENT ADDRESS ANY BARRIERS TO TREATMENT AND ASSIST THEM WITH ENROLLING IN TREATMENT. SOS ALSO PROVIDES NALOXONE AND TRAINING ON ITS USE AS WELL AS OTHER HARM REDUCTION EDUCATION IN THE COMMUNITY. IN FY2022, SOS DISTRIBUTED 290 NALOXONE KITS OF WHICH 132 WERE REFILLS. THIS DEMONSTRATES THE LIKELIHOOD OF THE NALOXONE BEING USED AS A LIFESAVING MEASURE. SOS ALSO RECEIVED A TOTAL OF 669 REFERRALS. THEY WERE ABLE TO SUCCESSFULLY CONTACT 38% OF THOSE REFERRALS, AND OF THOSE, 9% AGREED TO TREATMENT. IF AN INDIVIDUAL WAS UNWILLING TO GO TO TREATMENT, THEY WERE OFFERED HARM REDUCTION EDUCATION AND NALOXONE AND ENCOURAGED TO CONTACT SOS ONCE THEY WERE READY TO PURSUE TREATMENT. VIOLENCE IN RECOGNITION OF VIOLENCE AS A PUBLIC HEALTH ISSUE, CHRISTIANACARE LAUNCHED A HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP), EMPOWERING VICTIMS OF LIVED VIOLENCE (EVOLV), IN FEBRUARY 2021. EVOLV IS DESIGNED TO CREATE A SINGLE CARE TEAM USING EVIDENCE BASED SYNERGISTIC STRATEGIES. EVOLV AIMS TO ADDRESS VIOLENCE AND SUPPORT PATIENTS IMPACTED BY COMMUNITY VIOLENCE IN EFFORTS TO IMPROVE HEALTH AND WELL-BEING AND REDUCE RECIDIVISM OF NEW AND RECURRING INJURIES. 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 ARE ELIGIBLE TO PARTICIPATE IN EVOLV. THE LENGTH OF THE PROGRAM IS THREE MONTHS AND PROVIDES THE PATIENT WITH ACCESS TO A DEDICATED SOCIAL WORKER AND COMMUNITY HEALTH WORKER (CHW). EVOLV ASSISTS PATIENTS IN MANY SERVICES POST-DISCHARGE INCLUDING FOLLOW-UP CARE, EDUCATION, EMPLOYMENT, SOCIAL SUPPORT, CONNECTION TO COMMUNITY RESOURCES, LEGAL SUPPORTS, AND IDENTIFYING AND ACHIEVING PATIENT CENTERED GOALS AND OUTCOMES. IN FY2022, EVOLV SERVED 82 PATIENTS AND CONTINUED TO WORK CLOSELY WITH THE TRAUMA DEPARTMENT. FURTHER STRENGTHENING THIS RELATIONSHIP WAS THE COMPLETION OF EVOLV'S INTEGRATION INTO CHRISTIANACARE'S ELECTRONIC HEALTH RECORD. THIS WILL IMPROVE COMMUNICATION BETWEEN EVOLV AND CLINICIANS AS WELL AS DATA TRACKING. EVOLV CLINICAL AND PROGRAM LEADS ALSO SUBMITTED A GRANT PROPOSAL FOR FEDERAL AND STATE FUNDING TO EXPAND THE PROGRAM WITH ADDITIONAL CHWS. AS THEY HAVE DONE SINCE EVOLV WAS BEING DESIGNED, THE EVOLV TEAM CONTINUES TO ENGAGE WITH GOVERNMENT AND COMMUNITY ORGANIZATIONS ADDRESSING VIOLENCE TO ENSURE COHESION IN THEIR EFFORTS TO REDUCE VIOLENCE IN OUR COMMUNITIES, ESPECIALLY IN WILMINGTON. THE TRAUMA DEPARTMENT IS ALSO ADDRESSING VIOLENCE THROUGH EDUCATION. THROUGHOUT THE YEAR, TRAUMA DEPARTMENT CAREGIVERS PROVIDED STOP THE BLEED TRAINING TO COMMUNITY GROUPS AND STUDENTS. STOP THE BLEED IS A NATIONAL AWARENESS CAMPAIGN THAT EMPOWERS BYSTANDERS WITH THE KNOWLEDGE AND TOOLS THEY NEED TO RECOGNIZE AND STOP LIFE-THREATENING BLEEDING. THE TRAUMA DEPARTMENT ALSO REVAMPED STUDENT PROGRAMS ADDRESSING VIOLENCE IT HAD PREVIOUSLY OFFERED TO CREATE A NEW OFFERING FOR STUDENTS THAT REFRAMES GUN VIOLENCE AS A PUBLIC HEALTH ISSUE. STUDENTS DISCUSS THE INDIVIDUAL AND COMMUNITY FACTORS THAT PUT PEOPLE AT RISK FOR GUN VIOLENCE AS WELL AS THE PHYSICAL AND EMOTIONAL IMPACTS OF GUN VIOLENCE. STUDENTS ARE ALSO EMPOWERED WITH INFORMATION TO HELP THEM IDENTIFY THE WARNING SIGNS OF GUN VIOLENCE. STUDENTS IN MIDDLE AND HIGH SCHOOLS THROUGHOUT NEW CASTLE COUNTY RECEIVED THIS EDUCATION.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	SOCIAL DETERMINANTS OF HEALTH CHRISTIANACARE IS COMMITTED TO THE STRATEGY OF ADDRESSING SOCIAL DETERMINANTS OF HEALTH (SDOH) TO IMPROVE HEALTH OUTCOMES. THE CHWS, THE HEALTH GUIDES, THE HEALTH AMBASSADORS, AND THE PEERS WHO COMPRISE THE SOS OUTREACH TEAM ADDRESS CHRISTIANACARE'S DIFFERENT IDENTIFIED AREAS OF NEED, BUT THEY SHARE THE SAME OBJECTIVE OF HELPING INDIVIDUALS OVERCOME THEIR SOCIAL BARRIERS TO GOOD HEALTH. THE DELAWARE FOOD FARMACY AND THE PRODUCE DELIVERY PROGRAM WERE DESIGNED TO SERVE FOOD INSECURE PATIENTS, AND TEXT-BASED BLOOD PRESSURE MONITORING AND SCREENING FOR DIABETES WAS IMPLEMENTED IN WOMEN'S HEALTH TO OVERCOME PATIENT BARRIERS SUCH AS TRANSPORTATION. IN ADDITION TO THE INDIVIDUAL PROGRAMS THAT DIRECTLY ADDRESS SOCIAL DETERMINANTS OF HEALTH, CHRISTIANACARE IS ALSO ADDRESSING SDOH ON A SYSTEMWIDE SCALE. CHRISTIANACARE DESIGNED AND IMPLEMENTED ONE SDOH SCREENING INSTRUMENT TO ADMINISTER TO PATIENTS. TO IMPROVE THE FACILITATION OF THE SDOH SCREENING INSTRUMENT, WE RECENTLY INTRODUCED PATIENT SELF-ADMINISTRATION OF THE SDOH SCREENING INSTRUMENT. ALLOWING PATIENTS TO COMPLETE THE SCREENING ON THEIR OWN WILL INCREASE THE NUMBER OF SDOH SCREENS COMPLETED, IMPROVE EFFICIENCY, AND PROVIDE A BETTER PATIENT EXPERIENCE, AS PATIENTS MAY FEEL MORE COMFORTABLE ENTERING ANSWERS TO QUESTIONS THAT CAN FEEL INVASIVE. WE PUT A GREAT DEAL OF TIME AND RESOURCES INTO CREATING AND OPERATIONALIZING THE SDOH SCREENING INSTRUMENT BECAUSE WE MUST UNDERSTAND THE OBSTACLES THAT STAND IN THE WAY OF OUR PATIENTS IMPROVING THEIR HEALTH. THE SDOH SCREENING WILL ALSO PROVIDE US WITH A BROADER PICTURE OF THE CHALLENGES OUR COMMUNITIES FACE SO THAT WE CAN RESPOND APPROPRIATELY WITH INTERNAL PROGRAMMING AND STRATEGIES THAT ADDRESS THOSE NEEDS AS WELL AS THROUGH COMMUNITY PARTNERSHIPS. IN OUR FY2023 ANNUAL OPERATING PLAN, WE SET THE GOAL OF INCREASING BY 25%, THE PERCENTAGE OF PATIENTS WITH COMPLETE SDOH SCREENS FROM HIGH-RISK COMMUNITIES AS DEFINED IN THE CHNA (HIGH-RISK COMMUNITIES ARE THOSE IN THE 19801, 19802, 19804, 19805, AND 19720 ZIP-CODES). WE WOULD NOT PURSUE SCREENING OUR PATIENTS FOR THEIR SOCIAL NEEDS AS AGGRESSIVELY AS WE HAVE IF WE HAD NO TOOLS TO HELP THEM ADDRESS THOSE NEEDS. TO THAT END, WE PARTNERED WITH UNITE US TO LAUNCH AN ELECTRONIC CARE COORDINATION NETWORK, UNITE DELAWARE, IN LATE 2019. THE UNITE DELAWARE NETWORK CONNECTS SOCIAL SERVICES AND CLINICAL CARE PROVIDERS ACROSS THE STATE. WITH THIS NETWORK, ANY HEALTHCARE PROVIDER OR SOCIAL SERVICE AGENCY CAN HELP AN INDIVIDUAL ADDRESS THE DIVERSE ARRAY OF NEEDS THEY MAY HAVE BY SENDING AN ELECTRONIC REFERRAL ON BEHALF OF THE PATIENT TO THE APPROPRIATE ORGANIZATION. THE SENDER OF THAT REFERRAL WILL BE ABLE TO TRACK WHETHER THAT NEED WAS MET OR NOT AND TAKE ADDITIONAL ACTION IF NEEDED TO HELP THE PATIENT MEET THEIR NEED. UNITE DELAWARE NOW INCLUDES TWO OTHER DELAWARE HOSPITALS AND OVER 200 COMMUNITY-BASED ORGANIZATIONS. CHRISTIANACARE FUNDS THE UNITE DELAWARE PLATFORM BECAUSE WE BELIEVE IT CAN HELP DELAWAREANS THROUGHOUT THE STATE ADDRESS THEIR NEEDS AND IT ALSO PROVIDES BENEFITS AT NO COST TO THE PARTICIPATING COMMUNITY-BASED ORGANIZATIONS THAT PARTICIPATE IN THE NETWORK. IN MAY 2022, UNITE DELAWARE WAS INTEGRATED INTO CHRISTIANACARE'S MEDICAL HEALTH RECORD TO ENABLE EASIER OPERABILITY FOR PROVIDERS TO SEND A REFERRAL IN A CLINICAL SETTING AND SO THE PATIENT'S ENTIRE CARE TEAM CAN HAVE INSIGHT INTO THEIR SOCIAL NEEDS. ANOTHER GOAL OF CHRISTIANACARE'S FY2023 ANNUAL OPERATING PLAN IS TO INCREASE BY 25% THE NUMBER OF REFERRALS CAREGIVERS SEND THROUGH THE UNITE DELAWARE NETWORK ON BEHALF OF PATIENTS IN THE HIGH-RISK COMMUNITIES AS DEFINED IN THE CHNA. HALFWAY INTO FY2023, WE ARE ON TRACK TO MEET BOTH ANNUAL OPERATING PLAN GOALS FOR INCREASED SDOH SCREENING AND UNITE DELAWARE REFERRALS. TRANSPORTATION HAS ROUTINELY BEEN IDENTIFIED AS A BARRIER TO CARE. TO ADDRESS THAT NEED, CHRISTIANACARE PARTNERED WITH ROUNDTRIP TO PROVIDE TRANSPORTATION TO MEDICAL SERVICES FOR ELIGIBLE PATIENTS WHO HAVE A TRANSPORTATION BARRIER. IN 2020, CHRISTIANACARE PILOTED THIS PROGRAM IN TWO DEPARTMENTS AND IN FY2022, WE UNDERTOOK A CONSIDERABLE EXPANSION. THERE ARE NOW EIGHTEEN PARTICIPATING PROGRAMS AND DEPARTMENTS USING ROUNDTRIP TO SERVE PATIENTS WITH TRANSPORTATION BARRIERS. OUR EXPECTATION IS THAT PATIENTS' HEALTH WILL IMPROVE WHEN THE TRANSPORTATION BARRIER IS REMOVED, AND WE EXPECT TO DESIGN AND IMPLEMENT AN EVALUATION TO DEMONSTRATE THAT IN THE COMING MONTHS. IN FY2022, JUST OVER 9,000 RIDES WERE PROVIDED TO PATIENTS THROUGH ROUNDTRIP. AS A HEALTH SYSTEM, WE BELIEVE IT IS NECESSARY TO IDENTIFY AND ADDRESS THE SOCIAL NEEDS OF OUR PATIENTS BECAUSE THE BEST CLINICAL CARE WILL NOT, FOR EXAMPLE, OVERCOME THE POOR HEALTH OUTCOMES OF A DIABETIC PATIENT WHO LIVES IN A FOOD DESERT. THROUGHOUT THIS DOCUMENT, WE HAVE SHARED SUCCESSFUL STRATEGIES WE HAVE EMPLOYED TO ADDRESS SOCIAL NEEDS, AND WE KNOW THAT COMMUNITY PARTNERSHIPS ARE A REQUIREMENT FOR BUILDING UPON THAT SUCCESS. TO SUPPORT COMMUNITY-BASED ORGANIZATIONS WE LAUNCHED THE COMMUNITY INVESTMENT FUND IN DECEMBER 2019. THAT YEAR, WE AWARDED NEARLY $2 MILLION IN FUNDING TO 32 COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE AREAS OF NEED PRIORITIZED IN THE 2019 CHNA. WE WERE UNABLE TO PROVIDE THIS FUNDING IN FY2021 DUE TO THE FINANCIAL UNCERTAINLY CAUSED BY THE PANDEMIC, BUT IN FY2022, WE PROVIDED 13 ORGANIZATIONS WITH OVER $1 MILLION IN FUNDING TO ADDRESS FOOD INSECURITY AND HOUSING. IN ADDITION TO THE COMMUNITY INVESTMENT FUND, CHRISTIANACARE ALSO PROVIDED A COMBINED $310,000 IN FUNDING TO: - THE DELAWARE COALITION AGAINST DOMESTIC VIOLENCE TO SUPPORT A CHW PROGRAM SERVING SURVIVORS OF DOMESTIC VIOLENCE. - THE WEST END NEIGHBORHOOD HOUSE TO SUPPORT ITS DROP-IN CENTER WHICH SERVES UNACCOMPANIED HOMELESS YOUTH, AGED 18-23, INCLUDING THOSE WHO EXPERIENCED THE FOSTER CARE SYSTEM AND/OR IDENTIFY AS LGBTQ+. - THE WILMINGTON NEIGHBORHOOD CONSERVANCY LAND BANK IN SUPPORT OF ITS LOWER HILLTOP AFFORDABLE HOUSING INITIATIVE TO PROVIDE MORE AFFORDABLE HOUSING OPTIONS TO THE COMMUNITY. - THE ARC OF DELAWARE TO SUPPORT THE DEVELOPMENT OF A STATEWIDE WEBSITE THAT CAN SERVE AS A REPOSITORY OF THE EXISTING SOCIAL AND RECREATIONAL PROGRAMS FOR ADULTS WITH DISABILITIES AND BE THE STARTING POINT OF A COORDINATED EFFORT TO DETERMINE WHAT ADDITIONAL PROGRAMMING IS NEEDED STATEWIDE TO MEET UNADDRESSED NEEDS FOR THIS POPULATION. - DELAWARE TECH COMMUNITY COLLEGE TO ENHANCE THE OFFERINGS OF THE FOUR FOOD CLOSETS OPERATED AT EACH OF ITS CAMPUSES THROUGHOUT DELAWARE FOR THEIR FOOD INSECURE STUDENTS.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA)	THE ABOVE IS NOT AN EXHAUSTIVE LIST OF THE FUNDING CONTRIBUTED TO COMMUNITY ORGANIZATIONS IN FY2022, BUT IT DEMONSTRATES OUR COMMITMENT TO SUPPORTING THE DIVERSE EFFORTS OF OUR COMMUNITY PARTNERS TO MEET THE NEED OF OUR COMMUNITIES. CHRISTIANACARE IS ALSO INVESTING IN WORKFORCE DEVELOPMENT. FOR THE NEXT FOUR YEARS, CHRISTIANACARE WILL AWARD TEN STUDENTS MERIT-BASED SCHOLARSHIPS OF $12,500 PER YEAR, PER STUDENT, TO ATTEND AN HBCU. THE FOCUS OF THE SCHOLARSHIP PROGRAM WILL BE MINORITY STUDENTS WHO ARE PURSUING A FIELD OF STUDY IN HEALTH CARE. THESE STUDENTS WILL ALSO BE INVITED TO PARTICIPATE IN AN INTERNSHIP PROGRAM AT CHRISTIANACARE. WE MADE THIS COMMITMENT BECAUSE WE RECOGNIZE THE IMPORTANCE OF DIVERSITY IN THE HEALTH CARE FIELD TO IMPROVE PATIENT CARE. CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT ALSO OFFERS YOUTH PROGRAMMING THAT EXPOSES THE PARTICIPANTS, OR SCHOLARS AS WE REFER TO THEM, TO POTENTIAL CAREERS IN THE HEALTH FIELD AND PROVIDES THEM WITH THE SKILLS AND EXPERIENCE TO SUPPORT THEIR DEVELOPMENT INTO YOUNG ADULTS EVEN IF THEY CHOOSE TO TAKE A DIFFERENT PATH. IN FY2022, THE FOLLOWING PROGRAMS WERE OFFERED: BACK 2 BASICS 2.0: THIS PROGRAM, OFFERED IN PARTNERSHIP WITH JOBS FOR DELAWARE GRADS, A SCHOOL-TO-WORK TRANSITIONAL PROGRAM DEDICATED TO HELPING YOUTH REACH ACADEMIC AND ECONOMIC SUCCESS, WAS CREATED IN RESPONSE TO THE CORONAVIRUS PANDEMIC. IT PROVIDES HIGH SCHOOL SCHOLARS WITH THE OPPORTUNITY TO PARTICIPATE IN 12 IMMERSIVE SESSIONS THROUGH A CASE STUDY APPROACH. IN FY2022, 21 SCHOLARS ENROLLED IN THIS PROGRAM. NURSING CAREER COLLABORATIVE: THIS PROGRAM WAS DEVELOPED TO SERVE AS A PATHWAY TO NURSING FOR HIGH SCHOOL SCHOLARS FROM WILLIAM PENN HIGH SCHOOL AND FREIRE CHARTER SCHOOL. THROUGH THE NURSING CAREER COLLABORATIVE, SCHOLARS ARE EDUCATED AND EXPOSED TO THE FIELD AND FUNDAMENTALS OF NURSING. ON THEIR LAST DAY OF THE PROGRAM, SCHOLARS ALSO HAD AN OPPORTUNITY TO SHADOW ON A UNIT WITH A NURSE. IN FY2022, 9 SCHOLARS PARTICIPATED. CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT ALSO OFFERED THE CAMP FRESH PROGRAM FOR THE 15TH YEAR. CAMP FRESH IS AN 8-WEEK SUMMER PROGRAM THAT EXPLORES HEALTH AND WELLNESS WITH 11-18-YEAR OLD YOUTH. CAMP FRESH PROMOTES IMPROVED NUTRITION, MENTAL WELLNESS, INCREASED PHYSICAL ACTIVITY, AWARENESS OF REPRODUCTIVE HEALTH AND IDENTIFYING OPPORTUNITIES FOR PERSONAL, ACADEMIC, AND PROFESSIONAL GROWTH. CAMP FRESH SERVES DELAWARE YOUTH, MOST LIVING IN FEDERALLY RECOGNIZED HIGH-RISK ZIP CODES. YOUTH ARE ELIGIBLE TO ATTEND IF THEIR FAMILY RECEIVES OR IS ELIGIBLE TO RECEIVE MEDICAID. IN THE SUMMER OF 2021, CAMP FRESH TRANSFORMED THE DISRUPTION CAUSED BY THE CORONAVIRUS PANDEMIC INTO AN OPPORTUNITY TO TRY SOMETHING NEW IN THE FORM OF AN 8-WEEK LEADERSHIP PROGRAM, THE CAMP FRESH INFLUENCERS. THE CAMP FRESH INFLUENCER PROGRAM WAS DESIGNED TO PROVIDE YOUTH WITH LEADERSHIP SKILLS AS WELL AS IMPROVE CAMP FRESH THROUGH THEIR PARTNERSHIP. INFLUENCERS PROVIDED THEIR OPINIONS ABOUT CAMP FRESH PROGRAMMING AND MADE RECOMMENDATIONS FOR IMPROVEMENT AND ADVANCEMENT. A TOTAL OF 8 INFLUENCERS COMPLETED THIS PROGRAM. FROM JUNE TO AUGUST 2022, CHRISTIANACARE HOSTED A CAMP FRESH PROGRAM THAT INCORPORATED LESSONS LEARNED FROM THE INFLUENCERS. THERE WERE 24 PARTICIPANTS AND BASED ON FEEDBACK RECEIVED FROM THE INFLUENCERS, THIS WAS THE FIRST TIME THAT CAMPERS AS YOUNG AS 11 YEARS OLD WERE ABLE TO PARTICIPATE. THIS SUMMER ALSO SAW THE EMPLOYMENT OF THE FIRST JUNIOR COUNSELOR WHO HAD BEEN A PREVIOUS CAMP FRESH CAMPER. OTHER FIRSTS WERE STATE RECOGNITION OF CAMP FRESH AS AN EXEMPT SUMMER CAMP PROVIDER AND THE CERTIFICATION OF ALL CAMP FRESH CAREGIVERS IN "SERVSAFE" TO PARTICIPATE IN FOOD PREPARATION AS CAMP FRESH PROVIDES LUNCH, SNACK, AND DINNER FOR ALL CAMPERS. OUTSIDE OF THE SUMMER MONTHS, CAMPERS ARE OFFERED CAMP FRESH 360. PARTICIPANTS OF CAMP FRESH 360 COME TOGETHER TWICE PER MONTH WITH ADDITIONAL HEALTH EDUCATION SESSIONS THAT ARE OFFERED TO YOUTH, THEIR PARENTS/GUARDIANS, FAMILY MEMBERS AND FRIENDS. CHRISTIANACARE ALSO PARTNERS WITH COMMUNITY ORGANIZATIONS OFFERING YOUTH PROGRAMMING TO PROVIDE EXPOSURE TO THE HEALTH CARE FIELD. IN FY 2022, 9 MEDICAL ASSISTANT TRACT SCHOLARS FROM DELCASTLE AND ST. GEORGES TECHNICAL HIGH SCHOOLS CAME TO CHRISTIANACARE FOR THE CO-OP EXPERIENCE. IN APRIL 2022, ABOUT 30 MIDDLE SCHOOL SCHOLARS WHO PARTICIPATE IN THE BRANDYWINE LIFESAVERS CAME TO CHRISTIANACARE'S NEWARK CAMPUS FOR A CAREER EXPO THAT EXPOSED THEM TO VARIOUS NURSING SPECIALTIES. CAREGIVERS SPOKE WITH STUDENTS ABOUT THEIR WORK AND PROVIDED DEMONSTRATIONS. BRANDYWINE SCHOOL DISTRICT NURSES DEVELOPED THE LIFESAVERS PROGRAM TO CREATE A PIPELINE WITH YOUNGER STUDENTS TO GIVE THEM TIME TO LEARN ABOUT POSSIBLE CAREERS IN HEALTH CARE. THE PROGRAM ALSO FOCUSES ITS ATTENTION ON STUDENTS FROM BACKGROUNDS NOT REPRESENTED IN THE NURSING PROFESSION. NURSING STUDENTS FROM THE UNIVERSITY OF DELAWARE ALSO SHADOWED CAREGIVERS IN THE COMMUNITY HEALTH DEPARTMENT TO GAIN EXPOSURE TO THE SOCIAL DETERMINANTS OF HEALTH AND CHRISTIANACARE'S COMMUNITY WORK. THE EXPECTATION IS THAT THIS WILL PROVIDE THESE FUTURE NURSES WITH THE UNDERSTANDING OF THE CHALLENGES THEIR PATIENTS FACE. --------------------
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% OF THE FEDERAL POVERTY LEVEL WILL 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/US/EN/VISIT-US/FOR-PATIENTS/FINANCIAL-ASSISTANC E-PROGRAM-SUMMARY/FINANCIAL-ASSISTANCE-PROGRAM --------------------
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. --------------------

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 FY2022 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. PATIENTS MAY ALSO 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 EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE, AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. WE PARTNER WITH OUR NEIGHBORS TO PROVIDE THEM WITH SYSTEMS OF CARE THAT THEY VALUE. TO EFFECTIVELY DO THIS, WE MUST LISTEN TO AND LEARN FROM OUR COMMUNITIES CONSISTENTLY. A NEEDS ASSESSMENT CANNOT REPLACE ONGOING TRUSTED PARTNERSHIPS AND A WILLINGNESS TO LISTEN ACTIVELY AND SEEK NEW KNOWLEDGE, TWO OF THE BEHAVIORS THAT GUIDE CHRISTIANACARE CAREGIVERS. MANY OF THE WAYS IN WHICH CHRISTIANACARE ASSESSES THE HEALTH NEEDS OF OUR COMMUNITY HAVE BEEN DESCRIBED IN EARLIER SECTIONS. WE IMPLEMENTED A SYSTEM WIDE SDOH SCREENING INSTRUMENT TO LEARN DIRECTLY FROM OUR PATIENTS ABOUT THEIR CHALLENGES, AND WE PARTNERED WITH UNITE US TO LAUNCH UNITE DELAWARE IN THE STATE WHICH PROVIDES A TOOL TO ADDRESS OUR PATIENTS' NEEDS AS WELL AS INSIGHT INTO THE NEEDS OF DELAWAREANS. FOR EXAMPLE, USE OF THE NETWORK HAS SHOWN THAT HOUSING AND FOOD INSECURITY ARE CONSISTENTLY THE MOST REFERRED NEEDS. THE COMMUNITY INVESTMENT FUND PROVIDES US WITH THE OPPORTUNITY TO LEARN FROM COMMUNITY-BASED ORGANIZATIONS (FOR FY2022, THERE WERE MORE THAN 60 APPLICANTS) ABOUT THE CHALLENGES THEIR COMMUNITIES FACE AND HOW THEY THINK BEST TO ADDRESS THEM. DIRECTLY PARTNERING WITH COMMUNITY ORGANIZATIONS SUCH AS URBAN ACRES, LUTHERAN COMMUNITY SERVICES, AND THE NEW CASTLE COUNTY POLICE DEPARTMENT ALSO PROVIDES INSIGHT INTO OUR COMMUNITY. CHRISTIANACARE ALSO PARTNERED WITH COMMUNITY STAKEHOLDERS AND ORGANIZATIONS TO CREATE SEVERAL GROUPS WHICH PROVIDE US WITH A DIRECT LINE OF CONTACT INTO OUR COMMUNITIES. THE GREATER WILMINGTON COMMUNITY PARTNERSHIP WAS FORMED WITH COMMUNITY PARTNERS IN 2012. INITIALLY CREATED IN PARTNERSHIP WITH HOMELESS SHELTER PROVIDERS TO COLLABORATIVELY ADDRESS THE NEEDS OF HOMELESS INDIVIDUALS, THIS GROUP HAS CONTINUED TO MEET MONTHLY FOR INFORMATION AND RESOURCE SHARING AND THE OPPORTUNITY TO DISCUSS COMMUNITY CHALLENGES. PARTICIPANTS INCLUDE THOSE FROM FAITH-BASED, NON-PROFIT, AND GOVERNMENT ORGANIZATIONS. CHRISTIANACARE CAREGIVERS PLAN AND HOST THE MEETINGS WITH INPUT FROM PARTICIPANTS. THE DELAWARE HEALTH MATERNAL AND INFANT CONSORTIUM CREATED THE WILMINGTON CONSORTIUM TO EDUCATE PROFESSIONALS WORKING WITH FAMILIES WITH CHILDREN FROM BIRTH TO AGE 5. LIKE THE GREATER WILMINGTON COMMUNITY PARTNERSHIP, THE PURPOSE OF THE GROUP IS TO SHARE RESOURCES AND DISCUSS COMMUNITY ISSUES AS THEY RELATE TO FAMILIES WITH YOUNG CHILDREN. CHRISTIANACARE CAREGIVERS CO-CHAIR THE GROUP WHICH MEETS BI-MONTHLY AND PROVIDE THE ADMINISTRATIVE SUPPORT FOR IT TO OPERATE. MEMBERS ARE ALSO ABLE TO SHARE COMMUNITY EVENTS AND RESOURCES WHICH ARE SENT OUT TO ALL MEMBERS IN A WEEKLY EMAIL. THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL, CO-CHAIRED BY CHRISTIANACARE'S CHIEF HEALTH EQUITY OFFICER, WAS FORMED TO PROVIDE CHRISTIANACARE WITH DIRECT CONTACT WITH COMMUNITY LEADERS AND STAKEHOLDERS TO GAIN THEIR PERSPECTIVE ON COMMUNITY NEEDS AND IDENTIFY OPPORTUNITIES IN WHICH BOTH THE COMMUNITY AND CHRISTIANACARE CAN BENEFIT FROM WORKING TOGETHER TOWARDS MUTUAL GOALS. PARTICIPATION BY CHRISTIANACARE LEADERS ON COMMUNITY BOARDS AND COMMITTEES ALSO PROVIDES INSIGHT INTO COMMUNITY NEEDS. THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM, THE VISION COALITION OF DELAWARE, THE DELAWARE BUSINESS ROUNDTABLE, THE DRUG OVERDOSE FATALITY REVIEW COMMISSION, AND AIDS DELAWARE ARE ALL CHAIRED AND CO-CHAIRED BY CHRISTIANACARE CAREGIVERS. CHRISTIANACARE'S PATIENT & FAMILY HEALTH EDUCATION TEAM HAS ALSO BEEN INVOLVED IN A MULTI-YEAR PARTNERSHIP WITH THE UNIVERSITY OF DELAWARE PARTNERSHIP FOR HEALTHY COMMUNITIES AND THE DELAWARE DIVISION OF PUBLIC HEALTH TO CREATE A STRATEGIC PLAN FOR HEALTH LITERACY IN OUR STATE. THIS EFFORT BRINGS TOGETHER EXISTING NETWORKS FROM THROUGHOUT THE STATE IN THE HEALTH, EDUCATION, AND GOVERNMENTAL SECTORS AS WELL AS A CONTRACTED PROJECT WITH PMG CONSULTING TO ASSESS THE BASELINE NEEDS IN THE STATE AND TO GENERATE A STRATEGIC PLAN FOR ONGOING WORK. THIS PARTNERSHIP WILL SERVE TO MAKE CHRISTIANACARE A MORE HEALTH LITERATE ORGANIZATION AS WELL AS BENEFIT ALL DELAWAREANS. OUR PARTICIPATION ALSO ALLOWS US MORE INSIGHT INTO THE CHALLENGES WITHIN OUR COMMUNITY AND THROUGHOUT DELAWARE, AND HOW OUR PARTNERS ARE RESPONDING. --------------------
PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE)	FOR FY22 UNINSURED INDIVIDUALS WITH A HOUSEHOLD INCOME GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL WERE ELIGIBLE FOR A STANDARD DISCOUNT OF 15%. EFFECTIVE FEBRUARY 1, 2023, CHRISTIANACARE WILL UPDATE ITS FINANCIAL ASSISTANCE POLICY TO MAKE IT AVAILABLE FOR MORE PATIENTS. THE FINANCIAL ASSISTANCE ELIGIBILITY THRESHOLD WILL BE INCREASED FROM 200% TO 400% OF THE FEDERAL POVERTY LEVEL. PATIENTS FACING CATASTROPHIC COSTS, WHERE THE MEDICAL EXPENSES FOR AN EPISODE OF CARE EXCEED 20% OF THEIR ANNUAL INCOME, CAN NOW APPLY FOR FINANCIAL ASSISTANCE AS WELL. CHRISTIANACARE'S PRESUMPTIVE ELIGIBILITY PROCESS WAS ALSO UPDATED AND CLARIFIED IN THE FINANCIAL ASSISTANCE POLICY TO REDUCE THE BURDEN ON PATIENTS TO SUPPLY SUPPORTING DOCUMENTATION. THE PROCESS FOR CHRISTIANACARE REPRESENTATIVES TO MAKE IMMEDIATE CASE-BY-CASE DETERMINATIONS OF INDIVIDUAL ELIGIBILITY AND ACCEPT ALTERNATIVE QUALIFYING DOCUMENTATION FOR FINANCIAL ASSISTANCE WAS ALSO UPDATED AND STREAMLINED. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY, ALONG WITH THE FOLLOWING MATERIALS ARE ALSO AVAILABLE ON OUR WEBSITE: HTTPS://CHRISTIANACARE.ORG/US/EN/VISIT-US/FOR-PATIENTS/FINANCIAL-ASSISTANC E-PROGRAM-SUMMARY/FINANCIAL-ASSISTANCE-PROGRAM IN ENGLISH, SPANISH, AND MANDARIN: - A PLAIN LANGUAGE SUMMARY, - THE FINANCIAL ASSISTANCE APPLICATION, - A DESCRIPTION OF THE APPLICATION PROCESS, - THE INCOME SCALES, - THE FINANCIAL ASSISTANCE SERVICE AREA, AND - A LIST OF PARTICIPATING AND NON-PARTICIPATING PROVIDERS. THE FINANCIAL ASSISTANCE PROGRAM IS PUBLICIZED THROUGH PAMPHLETS, SIGNAGE, ONLINE NOTICES ON THE CHRISTIANACARE WEBSITE, AND IN-PATIENT SERVICE AREAS. THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED AND WHO INDICATE THEIR INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES AT INTAKE OR DISCHARGE. BECAUSE THEY ARE THE MOST SPOKEN LANGUAGES BESIDES ENGLISH, APPLICATIONS AND SUPPORTING DOCUMENTS SUCH AS THE PLAIN LANGUAGE SUMMARY ARE ALSO AVAILABLE IN SPANISH, MANDARIN, AND CANTONESE. TRANSLATION ASSISTANCE BY PHONE TO COMPLETE NECESSARY FORMS FOR ANYONE NOT PROFICIENT IN READING, WRITING, OR SPEAKING ENGLISH IS ALSO AVAILABLE MONDAY THROUGH FRIDAY FROM 9 A.M. TO 4 P.M. PATIENTS MAY ALSO CALL PATIENT FINANCIAL SERVICES TO REQUEST INFORMATION AND AN APPLICATION AND TO TALK CONFIDENTIALLY ABOUT THEIR SITUATION. IF CHRISTIANACARE DETERMINES THAT THE PATIENT MAY QUALIFY FOR OTHER COVERAGE, FINANCIAL COUNSELING WILL BE PROVIDED TO ASSIST PATIENTS TO APPLY FOR THE AVAILABLE COVERAGE. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY WEBPAGE AND PLAIN LANGUAGE SUMMARY ALSO INCLUDES CONTACT INFORMATION OF STATE AND FEDERAL HEALTH INSURANCE RESOURCES FOR THOSE WHO ARE UNINSURED. CHRISTIANACARE'S HEALTH GUIDES ARE ALSO AVAILABLE TO HELP PATIENTS OVERCOME FINANCIAL BARRIERS. THEY ASSIST PATIENTS IN COMPLETING THE CHRISTIANACARE'S APPLICATION FOR FINANCIAL ASSISTANCE AS WELL AS ENROLL IN HEALTH INSURANCE OR APPLY FOR PRESCRIPTION ASSISTANCE OR MEDICAID TO NAME JUST A FEW EXAMPLES. IN FY2022, THE HEALTH GUIDES ASSISTED 50 PATIENTS IN SUBMITTING REQUESTS FOR ADJUSTMENTS TO THEIR MEDICAL BILLS RECEIVED FROM MULTIPLE SOURCES FOR A TOTAL OF $305,141. --------------------
PART VI, LINE 4 (COMMUNITY INFORMATION)	WHILE CHRISTIANACARE PROVIDES SERVICES IN FOUR STATES, THE 2022 CHNA DEFINED CHRISTIANACARE'S COMMUNITY AS NEW CASTLE COUNTY, DELAWARE BECAUSE OF THE HIGH PERCENTAGE OF NEW CASTLE COUNTY RESIDENTS AMONG THOSE DISCHARGED FROM CHRISTIANACARE'S TWO DELAWARE HOSPITALS. IN FY2021, 77% OF CHRISTIANA HOSPITAL'S DISCHARGES AND 91% OF WILMINGTON HOSPITAL'S DISCHARGES WERE NEW CASTLE COUNTY RESIDENTS. THE TOTAL POPULATION OF NEW CASTLE COUNTY IN 2021 WAS APPROXIMATELY 553,500 PERSONS. THIS POPULATION IS EXPECTED TO GROW 2.6% FROM 2020 TO 2030. THE POPULATION 65 YEARS OF AGE AND OLDER IS ANTICIPATED TO GROW BY 30.5% DURING THAT TIME. THERE IS CONSIDERABLE VARIATION AMONG SOCIOECONOMIC CONDITIONS IN NEW CASTLE COUNTY. TO ENSURE THESE VARIATIONS WERE NOT OVERLOOKED, THE 2022 CHNA ASSESSED COMMUNITY HEALTH NEEDS IN TWO GEOGRAPHIC AREAS OF NEW CASTLE COUNTY: "COMMUNITY 1" (ZIP CODES 19801, 19802, 19804, 19805, AND 19720) AND "COMMUNITY 2" (ALL OTHER NEW CASTLE COUNTY ZIP CODES). COMMUNITY 1 ACCOUNTED FOR 28% OF CHRISTIANACARE DISCHARGES IN 2021 AND COMMUNITY 2 ACCOUNTED FOR 52% OF CHRISTIANACARE DISCHARGES. IN COMMUNITY 1, APPROXIMATELY 48% OF THE POPULATION IDENTIFIES AS BLACK; IN COMMUNITY 2, THIS STATISTIC IS 17%. APPROXIMATELY 15% OF THE OVERALL POPULATION IN COMMUNITY 1 IDENTIFIES AS HISPANIC; IN COMMUNITY 2, THIS STATISTIC IS ABOUT 8%. THE OVERALL POVERTY RATE IN NEW CASTLE COUNTY HAS BEEN BELOW DELAWARE AND U.S. AVERAGES; HOWEVER, RATES FOR BLACK AND FOR HISPANIC COUNTY RESIDENTS HAVE BEEN SUBSTANTIALLY HIGHER THAN RATES FOR WHITE RESIDENTS. THE POVERTY RATE IN COMMUNITY 1 HAS BEEN MORE THAN DOUBLE THE RATE FOR COMMUNITY 2 (16.8% COMPARED TO 8.3%). LOW-INCOME CENSUS TRACTS ARE MOST PREVALENT IN NEWARK, WILMINGTON AND THROUGHOUT COMMUNITY 1. IN MANY OF THESE CENSUS TRACTS, MORE THAN ONE-HALF OF HOUSEHOLDS ARE "RENT BURDENED," ARE CATEGORIZED AS "HIGH NEED" BY THE DIGNITY HEALTH COMMUNITY NEED INDEXTM (CNI) AND ARE IN THE TOP QUARTILE NATIONALLY FOR "SOCIAL VULNERABILITY" ACCORDING TO THE CENTERS FOR DISEASE CONTROL'S SOCIAL VULNERABILITY INDEX. BECAUSE OF THESE DISPARITIES AMONG NEW CASTLE COUNTY COMMUNITIES, WE HAVE COMMITTED TO HELPING PATIENTS LIVING IN THE HIGH-NEEDS COMMUNITIES OF COMMUNITY 1 ADDRESS THEIR SOCIAL NEEDS THROUGH INCREASED SDOH SCREENING AND RESOURCE REFERRALS THROUGH UNITE DELAWARE. WHILE THE DATA DEMONSTRATE THAT COMMUNITY 2 RESIDENTS ARE NOT AS LIKELY TO HAVE POOR SOCIAL DETERMINANTS OF HEALTH, WE RECOGNIZE THAT THERE ARE CERTAINLY INDIVIDUALS IN THIS AREA FACING CHALLENGES AS WELL. OUR COMMITMENT TO SDOH SCREENING AMONG ALL PATIENTS WILL ENSURE THOSE PATIENTS ARE NOT OVERLOOKED. --------------------
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, AND EQUITABLE 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 LICENSED 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 265 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)	CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, CHRISTIANACARE HAS GROWN, AND CONTINUES TO GROW, TO MEET THE NEEDS OF OUR COMMUNITY. CHRISTIANACARE HAS AN EXTENSIVE NETWORK OF PRIMARY CARE AND OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,435 LICENSED BEDS), A FREESTANDING 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. CHRISTIANACARE 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, ADULT KIDNEY TRANSPLANT, AND A LEVEL 2 PEDIATRIC EMERGENCY CARE FACILITY. CHRISTIANACARE IS ALSO ONE OF THE LARGEST COMMUNITY-BASED TEACHING HOSPITALS CONDUCTING RESEARCH IN THE UNITED STATES. WE ARE COMMITTED TO ADVANCING HEALTH AND HEALTH EQUITY THROUGH RESEARCH AND INNOVATION AS DEMONSTRATED THROUGHOUT THIS NARRATIVE AND AS SHOWN BY OUR INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH. THIS EMBEDDED RESEARCH INSTITUTE CONDUCTS APPLIED RESEARCH FOCUSED ON ISSUES OF EQUITY AND COMMUNITY HEALTH, POPULATION HEALTH, AND VIRTUAL HEALTH, AS WELL AS TRAINING THE NEXT GENERATION OF CLINICAL SCIENTISTS WITH THE GOAL TO BRIDGE THE GAP BETWEEN CLINICAL AND TRANSLATIONAL RESEARCH, ADVANCEMENTS IN THE QUALITY OF CARE, AND IMPROVED HEALTH OUTCOMES FOR ALL. ALONG WITH SERVING OUR PATIENTS AND COMMUNITY THROUGH EXCEPTIONAL CLINICAL SERVICES, TRAINING THE NEXT GENERATION OF HEALTHCARE WORKERS, CONDUCTING ROBUST RESEARCH TO ADVANCE HEALTH OUTCOMES, AND AN UNWAVERING COMMITMENT TO EQUITY, WE ARE ALSO COMMITTED TO PROVIDING AFFORDABLE AND VALUE-BASED CARE. CHRISTIANACARE IS A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES APPROXIMATELY 30,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CHRISTIANACARE'S CAREVIO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. CAREVIO IS ANOTHER EXAMPLE OF CHRISTIANACARE'S AWARD WINNING INNOVATION TO BETTER SERVE INDIVIDUALS. CAREVIO HARNESSES AN INFORMATION TECHNOLOGY PLATFORM THAT IDENTIFIES THE PATIENTS WHO ARE AT HIGHEST RISK AND WHO HAVE SIGNIFICANT CARE NEEDS, INCLUDING THOSE WHO DO NOT REGULARLY ACCESS PRIMARY CARE AND PREVENTIVE SERVICES. UNDERSTANDING WHO IS AT RISK FOR POOR HEALTH ENABLES CLINICIANS TO PROACTIVELY CONTACT THE INDIVIDUAL TO CONNECT THEM TO THE HEALTH SERVICES THEY NEED. IN PERFORMANCE YEAR 2021, THE EBRIGHTHEALTH ACO REDUCED HEALTH CARE SPENDING BY $7 MILLION AND EARNED A QUALITY SCORE OF 82.1%. THIS MARKS THE SIXTH CONSECUTIVE YEAR THAT EBRIGHTHEALTH ACO HAS REDUCED HEALTH CARE COSTS FOR ITS ATTRIBUTED BENEFICIARIES, BRINGING THE CUMULATIVE AMOUNT SAVED TO MORE THAN $44.5 MILLION. CHRISTIANACARE ALSO LAUNCHED ONE OF THE FIRST MEDICAID ACOS IN THE STATE, DELAWARE MEDICAID QUALITY PARTNERS ACO ON JULY 1, 2021. THIS ACO SERVES MORE THAN 18,000 MEDICAID PATIENTS AND LIKE THE EBRIGHTHEALTH ACO, IT WILL ALSO BE SUPPORTED BY CAREVIO. HEALTH EQUITY, CARE STANDARDIZATION, AND SOCIAL DETERMINANTS OF HEALTH ARE AREAS OF FOCUS FOR THIS ACO TO ENSURE PATIENTS ARE SET UP FOR SUCCESS IN ACHIEVING POSITIVE HEALTH OUTCOMES. CHRISTIANACARE'S LEADERSHIP IN THE AREAS OF CLINICAL CARE, INNOVATION, AND RESEARCH CONTRIBUTE TO NATIONAL RECOGNITION. THE FOLLOWING ARE TWO AWARDS WE RECENTLY RECEIVED AMONG MANY. FOR THE 7TH YEAR IN A ROW, THE COLLEGE OF HEALTHCARE INFORMATION MANAGEMENT EXECUTIVES (CHIME) HAS GIVEN CHRISTIANACARE THE "MOST WIRED" DESIGNATION. AMONG THE MORE THAN 38,000 ORGANIZATIONS SURVEYED BY CHIME, CHRISTIANACARE RANKED ABOVE ITS PEERS IN THE CATEGORIES OF ANALYTICS AND DATA MANAGEMENT, POPULATION HEALTH, INFRASTRUCTURE, AND PATIENT ENGAGEMENT. FOR THE 3RD YEAR IN A ROW, HEALTHGRADES NAMED CHRISTIANACARE AS ONE OF AMERICA'S 50 BEST HOSPITALS. CHRISTIANACARE IS AMONG THE TOP 1% OF MORE THAN 4,500 HOSPITALS ASSESSED NATIONWIDE FOR CONSISTENT, YEAR-OVER-YEAR SUPERIOR CLINICAL PERFORMANCE. AS THE LARGEST PRIVATE EMPLOYER IN THE STATE OF DELAWARE, CHRISTIANACARE ALSO STRIVES TO BE A LEADER AMONG OTHER BUSINESSES AND ORGANIZATIONS. IN EARLY 2019, CHRISTIANACARE INCREASED ITS MINIMUM WAGE TO $15 AN HOUR, AND BEGINNING IN JULY 2020, CHRISTIANACARE BEGAN OFFERING 12 WEEKS OF PAID PARENTAL LEAVE FOR ITS CAREGIVERS. IN HONOR OF MARTIN LUTHER KING DAY IN JANUARY 2019, CHRISTIANACARE ALSO PROVIDED A COMMUNITY SERVICE BENEFIT TO ITS CAREGIVERS WHICH PROVIDES THEM WITH PAID COMMUNITY SERVICE TIME, IN ADDITION TO THEIR PAID TIME OFF, TO VOLUNTEER AT CHARITABLE, NON-PROFIT ORGANIZATIONS. IN FY2022, 425 HOURS WERE SPENT IN COMMUNITY SERVICE AT A COST OF OVER $24,000 TO CHRISTIANACARE. FINALLY, CHRISTIANACARE HAS ALSO COMMITTED TO BEING AN ANTI-RACISM ORGANIZATION. THAT COMMITMENT CAN BE FOUND HERE: ANTI-RACISM COMMITMENT - CHRISTIANACARE. CHRISTIANACARE'S CONTINUED GROWTH, ADAPTATION, AND INNOVATION WILL ALWAYS BE DRIVEN BY OUR FOUNDATION OF SERVICE TO OUR COMMUNITY AND ADDRESSING THE NEEDS THEY IDENTIFY. OUR MOST IMPORTANT PARTNERSHIP WILL ALWAYS BE WITH OUR NEIGHBORS. --------------------
PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT)	THERE IS NO PRESENT STATE OF DELAWARE REQUIREMENT FOR CHRISTIANACARE TO FILE A COMMUNITY BENEFIT REPORT. 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 CAN BE ACCESSED AT: https://christianacare.org/us/en/about-us/who-we-are/community-benefit --------------------

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
FREDERIC T HARAD MD
MEMBER	$573,656	$0	$108,750	$0	$38,500	$0	$18,804	$0	$22,348	$0	$762,058	$0	$0	$0
JANICE E NEVIN MD
PRESIDENT & CEO	$1,395,891	$0	$828,651	$0	$0	$0	$60,660	$0	$10,501	$0	$2,295,703	$0	$0	$0
JENNIFER L SCHWARTZ ESQ
CORPORATE SECRETARY	$504,545	$0	$216,026	$0	$0	$0	$16,843	$0	$23,010	$0	$760,424	$0	$0	$0
JOSEPH BENNETT MD
MEMBER (THROUGH 12/31/21)	$547,436	$0	$101,298	$0	$11,000	$0	$17,400	$0	$23,010	$0	$700,144	$0	$0	$0
KENNETH SILVERSTEIN MD
CHIEF PHYSICIAN EXECUTIVE	$1,227,165	$0	$316,765	$0	$0	$0	$18,850	$0	$23,010	$0	$1,585,790	$0	$0	$0
KIRK N GARRATT MD
MEDICAL DIRECTOR - HEART/VASC	$743,932	$0	$235,978	$0	$0	$0	$18,850	$0	$7,839	$0	$1,006,599	$0	$0	$0
LISA C MAXWELL MD
PRESIDENT, MEDICAL GROUP	$487,510	$0	$174,874	$0	$0	$0	$36,867	$0	$23,010	$0	$722,261	$0	$0	$0
MICHAEL EPPEHIMER MD
FORMER PRES. MED GROUP	$290,433	$0	$0	$0	$0	$0	$0	$0	$1,624	$0	$292,057	$0	$0	$0
NEIL JASANI MD
CHIEF PEOPLE OFFICER	$529,312	$0	$208,836	$0	$0	$0	$20,300	$0	$23,010	$0	$781,458	$0	$0	$0
PAUL K DAVIS MD
CARDIAC SURGEON	$749,835	$0	$140,813	$0	$0	$0	$18,850	$0	$24,050	$0	$933,548	$0	$0	$0
RANDALL GABORIAULT
CHIEF DIGITAL & INFO OFFICER	$721,909	$0	$259,965	$0	$0	$0	$20,300	$0	$24,050	$0	$1,026,224	$0	$0	$0
RAY A BLACKWELL MD
CHIEF CARDIAC SURGERY	$852,819	$0	$173,846	$0	$0	$0	$20,300	$0	$23,010	$0	$1,069,975	$0	$0	$0
RIC CUMING RN
CHIEF NURSING EXECUTIVE	$486,094	$0	$212,495	$0	$0	$0	$17,400	$0	$14,729	$0	$730,718	$0	$0	$0
ROBERT MCMURRAY
TREASURER AND ASS'T SECRETARY	$600,633	$0	$248,589	$0	$0	$0	$20,300	$0	$23,010	$0	$892,532	$0	$0	$0
SHARON T KURFUERST
CHIEF OPERATING OFFICER	$654,345	$0	$255,517	$0	$0	$0	$20,300	$0	$16,478	$0	$946,640	$0	$0	$0
KERT ANZILOTTI
CHIEF MEDICAL OFFICER	$739,637	$0	$189,873	$0	$0	$0	$18,850	$0	$23,010	$0	$971,370	$0	$0	$0
VINAY K GHEYI
DEPARTMENT CHAIR - RADIOLOGY	$706,300	$0	$220,657	$0	$0	$0	$20,300	$0	$15,233	$0	$962,490	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 3 TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHOD DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O FOR A DESCRIPTION OF THE COMPENSATION REVIEW AND APPROVAL PROCESS. --------------------
FORM 990, SCHEDULE J, PART I, LINE 4A	DETAIL OF SEVERANCE PAYMENTS MICHAEL EPPEHIMER, MD (FORMER PRESIDENT MED GROUP) RECEIVED A SEVERANCE PAYMENT OF $283,184 DURING THE 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: KERT ANZILOTTI- $135,455 RIC CUMING, RN- NO DISTRIBUTION RANDALL GABORIAULT- $117,198 KIRK N. GARRATT, MD- $20,140 VINAY K. GHEYI- $19,294 NEIL JASANI, MD- $31,244 SHARON T. KURFUERST- $23,571 LISA C. MAXWELL, MD- NO DISTRIBUTION ROBERT MCMURRAY- NO DISTRIBUTION JANICE E. NEVIN, MD- $165,126 JENNIFER L. SCHWARTZ, ESQ.- NO DISTRIBUTION KENNETH SILVERSTEIN, MD- NO DISTRIBUTION --------------------
FORM 990, SCHEDULE J, PART I, LINE 7	PROVISION OF NON-FIXED PAYMENTS CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM") IS THE SOLE MEMBER OF THIS ORGANIZATION. ALL OFFICER/TRUSTEE COMPENSATION ARRANGEMENTS, INCLUDING THE PAYMENT OF DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES, ARE DETERMINED BY THE SYSTEM BOARD. PAYMENTS MADE TO ANY DISQUALIFIED PERSON ARE APPROVED BY THE COMPENSATION COMMITTEE OF SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. --------------------

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	DELAWARE HLTH FACILITIES AUTHORITY SERIES 2020A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	510272458	BondIssuerEIN
CUSIP	246388Tq5	CUSIPNum
Bond Issued	2020-02-11	BondIssuedDt
Issue Price	$247,255,000	IssuePriceAmt
Purpose	REFUND SERIES 2008 & 2010	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$0	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$305,483,000	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$2,324,976	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$145,360,019	CapitalExpendituresAmt
Other Spent Proceeds	$157,798,005	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2021	SubstantialCompletionYr
Refunding Tax Exempt Bonds	Yes (true)	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	false	RefundingTaxableBondsInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Change In Use Bond Financed Prop	0.00000	ChangeInUseBondFinancedPropPct
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	false	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	Yes (true)	NoRebateDueInd
Variable Rate Issue	false	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE K, PART I	FormAndLineReferenceDesc
Explanation	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. -------------------- FORM 990, SCHEDULE K, PART II, LINE 5 ADDITIONAL INFORMATION REGARDING CAPITALIZED INTEREST FROM PROCEEDS ALTHOUGH CCHS CAPITALIZES INTEREST FOR BOOK PURPOSES, BOND PROCEEDS ARE NOT USED TO PAY INTEREST AND ARE THEREFORE NOT REPORTED ON PART II, LINE 5. --------------------	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
ERIN KURFUERST
DAUGHTER OF KEY EMPLOYEE	$62,749	EMPLOYMENT	false
WL GORE ASSOCIATES INC
TRUSTEE IS AN OFFICER	$2,481,977	PURCHASE OF MEDICAL SUPPLIES	false
NEUROSCIENCES II EXTRA SPACE LLC
TRUSTEE IS > 35% OWNER	$195,127	PROPERTY LEASE	false

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArtGrp
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp
Clothing And Household Goods		ClothingAndHouseholdGoodsGrp
Cars And Other Vehicles		CarsAndOtherVehiclesGrp
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	7	ContributionCnt
Noncash Contributions Rpt F990	$175,080	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp
Real Estate Commercial		RealEstateCommercialGrp
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE M, PART I, COLUMN (B)	FormAndLineReferenceDesc
Explanation	ADDITIONAL INFORMATION REGARDING SECURITIES REPORTED CHRISTIANA CARE HEALTH SERVICES, INC. REPORTS THE NUMBER OF CONTRIBUTIONS IN PART I, COLUMN (B).	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINES 6 & 7A,7B	GOVERNING BODY AND MANAGEMENT CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), A TAX-EXEMPT ORGANIZATION, IS THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). THE SYSTEM BOARD ELECTS DIRECTORS OF CCHS AT ITS ANNUAL MEETING. 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 CHRISTIANA CARE'S FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW. THE FINAL 2021 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2022 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2021 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 OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") ESTABLISHES CCHS'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE SYSTEM 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 $ 76,125,946 CHANGE IN NET ASSET OF SYSTEM (2,507,283) OTHER CHANGES (10,407,025) ----------- TOTAL $ 63,211,638

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CHRISTIANA CARE CAMPUS REALTY LLC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	510103684	SUPPORT SRVCS	DE	$0	$0	CCH SERVICES
CHRISTIANA CARE QUALITY PARTNERS LLC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	510103684	SUPPORT SRVCS	DE	-$258,911	$4,553,320	CCH SERVICES
CHRISTIANA CARE QUALITY PARTNERS ACOLLC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	510103684	SUPPORT SRVCS	DE	$1,364,861	$0	CCH SERVICES
CHRISTIANA CARE CARE LINK LLC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	510103684	SUPPORT SRVCS	DE	-$9,307,615	$8,108,607	CCH SERVICES
CHRISTIANA CARE CTR FOR VIRTUAL HLTH LLC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	862155365	SUPPORT SRVCS	DE	-$4,901,241	$2,360,150	CCH SERVICES

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CHRISTIANA CARE HEALTH SYSTEM
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	521479538	FUNDRAISING	DE	501(C)(3)	7	NA	false
CHRISTIANA CARE HEALTH INITIATIVES
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	510295186	OUTPATIENT SV	DE	501(C)(3)	10	CCH SYSTEM	false
CHRISTIANA CARE HOME HEALTH & COM SRVCS
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	510064334	HOME HLTHCARE	DE	501(C)(3)	7	CCH SYSTEM	false
UNION HOSPITAL OF CECIL COUNTY FDN
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	521794552	FUNDRAISING	MD	501(C)(3)	7	AFFINITY	false
UNION HOSPITAL OF CECIL COUNTY INC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	520607945	HLTHCARE SVCS	MD	501(C)(3)	3	AFFINITY	false
UNION HOSPITAL OF CECIL COUNTY HLTH SVCS
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	521794553	PROPERTY MGMT	MD	501(C)(3)	10	AFFINITY	false
UNION HOSPITAL OF CECIL COUNTY ONCOLOGY
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	812662359	HEALTHCARE	MD	501(C)(3)	3	AFFINITY	false
AFFINITY HEALTH ALLIANCE INC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	521794697	MANAGEMENT	DE	501(C)(3)	12B, II	CCH SERVICES	Yes (true)
CHRISTIANA CARE WEST GROVE INC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	883155785	HEALTHCARE	PA	501(C)(3)	12C,III-FI	CCH SERVICES	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
CHRISTIANA CARE GO HEALTH URGENT CARE L
5555 GLENRIDGE CONNECTOR SUITE 700	ATLANTA	GA	30342	844061485	URGENT CARE SRVCS	DE	CCH SERVICES	RELATED	-$2,680,257	$18,027,420	false	$0	false	0.50100
CHRISTIANACARE VALUE HEALTH JV LLC
11221 ROE AVENUE	LEAWOOD	KS	66211	851100149	AMBULATORY SRVCS	DE	CCH SERVICES	RELATED	$0	$25,500	false	$0	Yes (true)	0.51000
CLINERGY LLC
4755 OGLETOWN STANTON RD	NEWARK	DE	19718	852698063	GROUP PURCHASING	DE	CCH SERVICES	RELATED	-$410,647	$333,403	false	$0	false	0.79800
LEEWARD HEALTH LLC
4000 NEXUS DRIVE STE C3-300	WILMINGTON	DE	19803	883132477	MED ADV RISK	DE	CCH SYSTEM				false		false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
THE DE CTR FOR MAT FETAL MED OF CC INC
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	205891272	HEALTHCARE	DE	CCH SERVICES	C CORP	$196,509	$4,847,681	1.00000	Yes (true)
CHRISTIANA CARE HEALTH PLANS
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	510352728	INSURANCE	DE	CCH SYSTEM	C CORP			1.00000	false
CHRISTIANA CARE DEFERRED COMP PLAN
4755 OGLETOWN STANTON RD	NEWARK	DE	19718	816359549	DEF COMP PLAN	DE	CCH SERVICES	TRUST	$0	$0	1.00000	Yes (true)
CHRISTIANA CARE EXEC DEFERRED COMP PLAN
4755 OGLETOWN STANTON RD	NEWARK	DE	19718	357048822	DEF COMP PLAN	DE	CCH SERVICES	TRUST	$0	$0	1.00000	Yes (true)
CARE ASSOCIATES DEFERRED COMP PLAN
4755 OGLETWON STANTON RD	NEWARK	DE	19718	357048714	DEF COMP PLAN	DE	CCH SERVICES	TRUST	$0	$0	1.00000	Yes (true)
CHRISTIANA CARE INSURANCE CO LTD
				981489490	SELF-INSURANCE		CCH SERVICES	C CORP	-$3,413,621	$71,448,076	1.00000	Yes (true)	PO BOX 1159 878 W BAY RD	GRAND CAYMAN	CJ	KY1-1102	CJ
CHRISTIANA CARE STRATEGIC INVESTMENTS
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	853348300	STRATEGY	DE	CCH SYSTEM	C CORP				false
UNION HOSPITAL OF CECIL COUNTY VENTURES
4000 NEXUS DR NW3-100	WILMINGTON	DE	19803	521793691	MEDICAL SERVICES	MD	AFFINITY	C CORP				false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
UNION HOSPITAL OF CECIL COUNTY INC
ADOQR	$35,526,124	FMV
CHRISTIANA CARE GO HEALTH URGENT CARE LLC
ADJPR	$25,126,630	FMV
THE DE CTR FOR MAT FETAL MED OF CC INC
K,O	$936,747	FMV
CHRISTIANA CARE INSURANCE CO LTD
Q,R	$38,582,984	FMV
AFFINITY HEALTH ALLIANCE INC
ADOQR	$2,074,946	FMV
CLINERGY LLC
O	$629,581	FMV
CHRISTIANA CARE HOME HEALTH & COMM SERVICES
ADOQR	$5,157,651	FMV

Affiliated Group Attachment AffiliatedGroupAttachment

Field	Value	IRS element (for citing)
Meduim Explanation	DIRECT OTHER LOBBYING EXEMPT PURPOSE NAME OF ELECTING ORGANIZATION EXPENDITURES EXPENDITURES __________________________________ ____________ _______________ CHRISTIANA CARE HEALTH SYSTEM $ NONE $ 3,994,382 CHRISTIANA CARE HEALTH SERVICES 249,595 2,419,010,073 CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES NONE 43,668,856 CHRISTIANA CARE HEALTH INITIATIVES NONE 8,980,280 ------------ -------------- TOTAL $ 249,595 $2,475,653,591 THE ORGANIZATION HAS MADE THE LOBBYING ELECTION UNDER I.R.C. SECTION 501(H) FOR THE TAX YEAR ENDED JUNE 30, 2022. THIS ELECTION WAS NOT REVOKED BEFORE THE START OF THE ORGANIZATION'S TAX YEAR THAT BEGAN IN 2021.	MeduimExplanationTxt