2025-05-13T14:10:23-05:00 2024-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2023-07-01 470376615 ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ALEG 4023434323 6901 NORTH 72ND STREET OMAHA NE 68122 NICK O'TOOL MARKET CFO 4023434323 2025-05-13 1 1 HEATHER ADKINS P01725376 3032989100 2023 2025-03-06 01:10:19Z TIM BRICKER 12809 WEST DODGE ROAD OMAHA NE 68154 235813419 0 X WWW.CHIHEALTH.COM X 1904 NE THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. 15 10 1835 142 55309 28077 2507023 762019 191296353 218237464 3764588 7152332 3205676 4421411 200773640 230573226 78066 121535 0 0 81032126 98572695 0 0 0 118410413 124425143 199520605 223119373 1253035 7453853 770711717 805829267 11559127 24725570 759152590 781103697 X AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 24840014 25395 45601387 ALEGENT HEALTH-IMMANUEL MEDICAL CENTER REHABILITATION CENTER PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT PROGRAMS FOR INDIVIDUALS OF ALL AGES. THE REHABILITATION CENTER IS THE REGION'S MOST COMPREHENSIVE CENTER FOR PHYSICAL MEDICINE AND REHABILITATION, OFFERING PATIENTS SOME OF THE MOST ADVANCED REHABILITATIVE TECHNOLOGY. IMMANUEL REHABILITATION CENTER HAS RECEIVED THE HIGHEST LEVEL OF ACCREDITATION AWARDED BY THE JOINT COMMISSION AND BY THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF). AT EVERY LEVEL OF CARE, A TEAM OF LICENSED AND CERTIFIED REHABILITATION PROFESSIONALS ARE AVAILABLE. EACH ONE OF THE REHABILITATION PROGRAMS ARE DESIGNED TO MAXIMIZE INDEPENDENCE AND QUALITY OF LIFE. 20779602 13352 23975040 ALEGENT HEALTH-IMMANUEL MEDICAL CENTER OFFERS COMPREHENSIVE CARDIAC SERVICES THROUGH THE CHI HEALTH CLINIC HEART INSTITUTE AND ITS PHYSICIANS. THESE SERVICES OFFERED AT ALEGENT HEALTH-IMMANUEL MEDICAL CENTER INCLUDE BUT ARE NOT LIMITED TO: GENERAL CARDIOLOGY, INTERVENTIONAL CARDIOLOGY, ELECTROPHYSIOLOGY, VASCULAR SURGERY, CARDIOVASCULAR SURGERY AND THORACIC SURGERY. IN ADDITION, ALEGENT HEALTH-IMMANUEL MEDICAL CENTER IS ONE OF SIX CHI HEALTH HOSPITALS TO BE ACCREDITED FOR CHEST PAIN AND HEART FAILURE AND CERTIFIED IN ATRIAL FIBRILLATION BY THE SOCIETY OF CARDIOVASCULAR PATIENT CARE. WHETHER IT'S THE LATEST RECOMMENDATIONS FOR DISEASE PREVENTION OR A BREAKTHROUGH TREATMENT, ALEGENT HEALTH-IMMANUEL MEDICAL CENTER'S CARDIAC TEAM IS ALWAYS MOVING FORWARD FOR YOU AND YOUR HEALTH. 14735029 11850 21278462 ALEGENT HEALTH-IMMANUEL MEDICAL CENTER MENTAL HEALTH PHYSICIANS ARE UNIQUE IN THEIR CARE-GIVING APPROACH TO EMOTIONAL AND BEHAVIORAL PROBLEMS OF CHILDREN, ADOLESCENTS, ADULTS AND SENIORS. PHYSICIANS PROVIDE THE MOST APPROPRIATE CARE AT THE LEVEL OF SERVICE THAT EACH PATIENT NEEDS. OUTPATIENT AND INPATIENT BEHAVIORAL SERVICE PROGRAMS ARE PROVIDED. RECENTLY, IMMANUEL MEDICAL CENTER BUILT THE RESIDENTIAL TREATMENT CENTER. THIS NEW STATE OF THE ART FACILITY FEATURES 20 PRIVATE ROOMS FOR BOYS AND GIRLS BETWEEN THE AGES OF SIX AND EIGHTEEN YEARS OF AGE. 152451369 70938 127382575 ALEGENT HEALTH-IMMANUEL MEDICAL CENTER PROVIDES ADDITIONAL SERVICES INCLUDING BUT NOT LIMITED TO: WEIGHT MANAGEMENT, A 24 HOUR EMERGENCY DEPARTMENT, INPATIENT HOSPITAL FACILITIES, PROCEDURE CENTER, ORTHOPEDIC SERVICES, DIGESTIVE HEALTH CENTER, FAMILY LIFE CENTER, RADIOLOGY, UROLOGY, DIAGNOSTIC SERVICES AND PHYSICAL THERAPY. PATIENTS ARE AT THE CENTER OF EVERYTHING DONE AT ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. 152451369 70938 127382575 212806014 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 1 0 1 1835 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 0 X NICK O'TOOL 4023434323 12809 WEST DODGE ROAD OMAHA NE 68154 JOHN PETERSDORF BOARD MEMBER 1.00 49.00 X 0 2089747 992820 EVERT KUIPER FORMER PRESIDENT & CEO CHI HEALTH 0.00 0.00 X 0 2787233 48534 TIM BRICKER EX-OFFICIO BM/REGIONAL PRESIDENT 5.00 45.00 X X 0 2499192 116526 JEANETTE WOJTALEWICZ FORMER CFO, CHI HEALTH 0.00 0.00 X 0 1344835 12367 ANN SCHUMACHER PRESIDENT - IMC (TERMED 3/31/24) 50.00 0.00 X 0 524574 45252 NICK O'TOOL MARKET CFO 5.00 45.00 X 0 349020 50949 KIRTIBALA GUPTA MD BOARD MEMBER/PHYSICIAN 1.00 49.00 X 0 346502 47524 HEATHER MORGAN MD BOARD MEMBER/PHYSICIAN 1.00 49.00 X 0 320425 58377 CY XAYARATH TRAVELER RN 5.00 45.00 X 16958 297788 55767 BRENDA WALLINGFORD PEDIATRIC NURSE PRACTITIONER 1.00 49.00 X 387 279993 36780 MATTHEW BOGARD PHYSICIAN EMERGENCY MEDICINE 0.00 50.00 X 0 270110 40400 MARK CIPOLLA SENIOR PHYSICIST 1.00 49.00 X 1951 250522 49648 COLVILLE OSBORNE PHYSICIST CHIEF 0.00 50.00 X 0 254089 46571 BARBARA DAMRATOWSKI TRAVELER RN 50.00 0.00 X 261805 5055 26166 HEIDI SAUNDERS TRAVELER RN 50.00 0.00 X 248791 7892 33899 MATTHEW WALTERS SENIOR PHYSICIST 0.00 50.00 X 0 265135 15861 ANTHONY ASHBY INTERIM PRESIDENT - IMC 40.00 10.00 X 179077 33641 40040 KENT BARNEY TREASURER 1.00 11.00 X X 0 0 0 SISTER MAURITA SOUKUP BOARD CHAIR 1.00 11.00 X X 0 0 0 LG SEARCEY BOARD MEMBER 1.00 11.00 X 0 0 0 KEVIN FITZGERALD PHD SECRETARY 1.00 11.00 X X 0 0 0 KELLY BACON BOARD MEMBER 1.00 11.00 X 0 0 0 DAVE TAYLOR BOARD MEMBER 1.00 11.00 X 0 0 0 BILL YATES VICE CHAIR 1.00 11.00 X X 0 0 0 SISTER NADINE HEIMANN OSF BOARD MEMBER 1.00 40.00 X 0 0 0 MARDELL WILSON EDD BOARD MEMBER 1.00 11.00 X 0 0 0 CYNTHIA ALLOWAY BOARD MEMBER 1.00 11.00 X 0 0 0 KATE CUTLER BOARD MEMBER 1.00 11.00 X 0 0 0 708969 11925753 1717481 159 1 1 0 7ER GROUP PO BOX 241072 OMAHA NE 68124 CONSTRUCTION SERVICES 945485 MCCARTHY BUILDING COMPANIES 14217 DAYTON CIRCLE SUITE 8 OMAHA NE 68137 CONSTRUCTION SERVICES 482335 EMERGENCY CLINICIANS ASSOC LLC 6901 N 72ND ST OMAHA NE 68122 MEDICAL SERVICES 390281 MILLER ELECTRIC COMPANY 2501 SAINT MARYS AVENUE OMAHA NE 68105 ELECTRICAL SERVICES 319093 MMC MECHANICAL CONTRACTORS 9751 S 142ND STREET OMAHA NE 68138 CONSTRUCTION SERVICES 258696 10 55800 670219 36000 762019 NET PATIENT SERVICES 900099 216132620 216132620 0 0 MEDICAL SERVICES 621300 1765700 1765700 0 0 LABORATORY SERVICES 621500 236825 236825 0 0 PHARMACY SERVICES 446110 102319 102319 0 0 218237464 2812658 2812658 6111054 4983015 1128039 1128039 1128039 4385559 0 45885 4385559 -45885 4339674 4339674 292762 211293 81469 81469 INSURANCE 524298 1383286 0 0 1383286 ADMINISTRATIVE REVENUE 561000 928437 0 0 928437 CAFETERIA 722100 553627 0 0 553627 346553 55309 291244 3211903 230573226 218237464 55309 11518434 X 114535 114535 7000 7000 198811 159049 39762 77853212 73990373 3862839 3618440 3437518 180922 11344849 10777607 567242 5557383 5279514 277869 4449489 4227015 222474 174948 174948 9794 9794 623098 591943 31155 40610057 38340107 2269950 2219 2108 111 3711213 3525652 185561 9465776 8992487 473289 7183867 6824674 359193 66117 62811 3306 16477 15653 824 198031 198031 7653713 7271027 382686 9819308 9328343 490965 1011855 961262 50593 MEDICAL SUPPLIES 24868503 24868503 0 0 INTERCOMPANY ALLOCATION 10651397 10118827 532570 0 REPAIRS AND MAINTENANCE 3568115 3389709 178406 0 DUES & SUBSCRIPTIONS 149325 141859 7466 0 191841 180407 11434 223119373 212806014 10313359 0 3376 3190 2805064 2164435 0 31478851 34348529 0 0 0 5392437 5263050 222277 4244 187711203 99541105 74055506 88170098 0 151886971 167333038 18946620 23531733 0 485920615 485010950 770711717 805829267 6343678 9844507 0 60813 60813 0 0 0 0 0 5154636 14820250 11559127 24725570 X 759059265 781010372 93325 93325 759152590 781103697 770711717 805829267 X 7453853 9575452 4921802 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 9794 326001 9794 326001 212806015 664318832 212815809 664644833 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 223566 281919 304849 326001 1136335 250000 250000 250000 250000 1000000 1500000 SCHEDULE C, PART II-A, COLUMN A, LINE 1C THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: NEBRASKA HOSPITAL ASSOCIATION - $3,851 AMERICAN HOSPITAL ASSOCIATION - $4,014 CATHOLIC HEALTH ASSOCIATION - $1,732 340B - $197 8668670 308786 89094 504179 79255 8483116 8444479 447954 29152 252915 8668670 9026882 238613 95861 916877 8444479 8831339 346807 110162 261426 9026882 8772255 123107 72627 136650 8831339 0.41471 0.58529 0 1 1 17002007 17002007 114687721 54136257 60551464 500578 490733 9845 49953964 40927387 9026577 5566933 3986728 1580205 88170098 CSH OPERATING INVESTMENT POOL 167333038 F 167333038 INTERCOMPANY RECEIVABLES 483962587 RIGHT-OF-USE OPERATING LEASE 1045863 OTHER ASSETS 2500 485010950 INTERCOMPANY PAYABLES 13319649 OPERATING LEASE LIABILITY 952548 ENVIRONMENTAL REMEDIATION LIABILITY 543285 OTHER CURRENT LIABILITIES 4768 14820250 X PART V, LINE 4: ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. PART X, LINE 2: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 0 1 1 4906 3416072 0 3416072 0.01530 26811 51445556 38731848 12713708 0.05700 0 0 31717 54861628 38731848 16129780 0.07230 9 2023 345550 2052 343498 0.00150 5 1087 4870223 637871 4232352 0.01900 0 0 1 0 3 0 3 0.00000 7 1 178897 0 178897 0.00080 22 3111 5394673 639923 4754750 0.02130 22 34828 60256301 39371771 20884530 0.09360 1 14636247 0 32325945 36582949 -4257004 X 1 1 2 1 CHI HEALTH IMMANUEL 6901 N 72ND STREET OMAHA NE 68122 WWW.CHIHEALTH.COM NE 260002 & MHSU010 X X X A 2 CHI HEALTH PSYCH RES TREATMENT FACILITY 6845 N 68TH PLAZA OMAHA NE 68122 WWW.CHIHEALTH.COM NE MHSU010 X MENTAL HEALTH SUBSTANCE ABUSE A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.CHIHEALTH.COM/CHNA X X 1 22 1 WWW.CHIHEALTH.COM/CHNA 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.CHIHEALTH.COM/EN/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE.HTML X HTTPS://WWW.CHIHEALTH.COM/EN/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE.HTML X HTTPS://WWW.CHIHEALTH.COM/EN/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE.HTML X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: CHI HEALTH IMMANUEL, - FACILITY 2: CHI HEALTH PSYCH. RES. TREATMENT FACILITY FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, CHI HEALTH IMMANUEL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. IN THIS CYCLE OF CHNA PROCESS, PROFESSIONAL RESEARCH CONSULTANTS (PRC), A THIRD-PARTY NATIONAL HEALTHCARE RESEARCH FIRM, CONTRACTED BY LOCAL HEALTH SYSTEMS (INCLUDING CHI HEALTH) AND HEALTH DEPARTMENTS. THE ASSESSMENT CONDUCTED ENCOMPASSED A FOUR-COUNTY AREA, INCLUDING POTTAWATTAMIE COUNTY, IOWA AND DOUGLAS, SARPY, AND CASS COUNTIES, NEBRASKA. THE ASSESSMENT WAS COMPOSED OF A SECONDARY DATA ANALYSIS, COMMUNITY HEALTH SURVEY, ONLINE KEY INFORMANT, AND COMMUNITY PRESENTATION. BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), ALONG WITH OTHER PUBLIC HEALTH SURVEYS, AND CUSTOMIZED TO ADDRESS GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION, DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES, THE PRC COMMUNITY HEALTH SURVEY WAS DEVELOPED BY THE SPONSORING ORGANIZATIONS AND PRC. THE SURVEY WAS KEPT SIMILAR TO A PREVIOUS SURVEY USED IN THE REGION IN 2011, 2015, AND 2018 TO ALLOW FOR TREND ANALYSIS. THE PRC COMMUNITY HEALTH SURVEY WAS COMPLETED BY 2,527 RESIDENTS VIA MIXED MODE METHODOLOGY, INCLUDING A TELEPHONE SURVEY WHICH INCORPORATED BOTH LANDLINE AND CELL PHONE INTERVIEWS, AS WELL AS THROUGH ONLINE QUESTIONNAIRES, AND UTILIZED A STRATIFIED RANDOM SAMPLE OF INDIVIDUALS AGE 18 AND OVER ACROSS THE METRO AREA. THE HIGHER DOUGLAS COUNTY SAMPLE REFLECTS A TARGET OF 50 SURVEYS PER ZIP CODE WITHIN THE COUNTY (ALTHOUGH SOME LESSER-POPULATED ZIP CODES DID NOT REACH THIS THRESHOLD). ONCE THE INTERVIEWS WERE COMPLETED, THESE WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION SO AS TO APPROPRIATELY REPRESENT THE METRO AREA AS A WHOLE. PARTICIPANTS IN THE KEY INFORMANT SURVEY WERE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY AND WERE IDENTIFIED THROUGH THE SPONSORING ORGANIZATIONS. THE LIST INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS WHO THE SPONSORS FELT WERE ABLE TO IDENTIFY PRIMARY CONCERNS WITHIN THE POPULATIONS THEY SERVE, AS WELL AS THE COMMUNITY AS A WHOLE. KEY INFORMANTS WERE CONTACTED VIA EMAIL TO INTRODUCE THE PURPOSE OF THE SURVEY AND WERE PROVIDED A LINK TO COMPLETE THE SURVEY ONLINE. A TOTAL OF 150 KEY INFORMANTS COMPLETED THE SURVEY. DATA PRESENTATION AND DISCUSSION WAS IMPLEMENTED AT THE WELLBEING PARTNERS XCHANGE SUMMIT. COMMUNITY INPUT WAS COLLECTED AT THE XCHANGE SUMMIT ON OCT 6, 2021, CO-SPONSORED BY THE LOCAL AREA HOSPITAL SYSTEMS- CHI HEALTH, METHODIST HEALTH SYSTEM, CHILDREN'S HOSPITAL & MEDICAL CENTER AND NEBRASKA MEDICINE- ALONG WITH SEVERAL OTHER NON-GOVERNMENTAL HEALTH AND SOCIAL SERVICE ORGANIZATIONS. OVER 94 INDIVIDUALS REPRESENTING HEALTHCARE, PUBLIC HEALTH, SOCIAL SERVICES AND OTHERS ENGAGED IN A COMMUNITY CONVERSATION TO DIVE DEEPER INTO RESOURCES AND GAPS IN OUR REGIONAL APPROACH TO MENTAL HEALTH. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: - CHI HEALTH CREIGHTON UNIVERSITY MEDICAL CENTER BERGAN MERCY- CHI HEALTH IMMANUEL- CHI HEALTH LAKESIDE- CHI HEALTH MERCY COUNCIL BLUFFS- CHI HEALTH MIDLANDS- LASTING HOPE RECOVERY CENTER- NEBRASKA SPINE HOSPITAL (A JOINT VENTURE)- NEBRASKA MEDICINE (BELLEVUE MEDICAL CENTER AND NEBRASKA MEDICAL CENTER)- METHODIST HEALTH SYSTEM (METHODIST HOSPITAL, METHODIST JENNIE EDMUNDSON HOSPITAL, AND METHODIST WOMEN'S HOSPITAL) FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: - DOUGLAS COUNTY HEALTH DEPARTMENT- POTTAWATTAMIE COUNTY PUBLIC HEALTH- SARPY/CASS HEALTH DEPARTMENT- OMAHA COMMUNITY FOUNDATION- CHARLES DREW HEALTH CENTER, INC.- ONE WORLD COMMUNITY HEALTH CENTERS, INC.- THE WELLBEING PARTNERS FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 7D: THIS CHNA WAS COMPLETED IN PARTNERSHIP WITH THE HEALTH DEPARTMENT AND HEALTH SYSTEMS, IN ADDITION PRESENTATIONS WERE MADE TO REGIONAL HEALTH COUNCIL ON APRIL 12TH, 2022, CHI CUMC BERGAN MERCY COMMUNITY BOARD ON MAY 12TH, 2022, CHI IMMANUEL COMMUNITY BOARD ON MAY 19TH, 2022, CHI LAKESIDE COMMUNITY BOARD ON JUNE 2ND, 2022, AND CHI MIDLANDS COMMUNITY BOARD ON JUNE 7TH, 2022. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2022. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON WWW.CHIHEALTH.COM/CHNA. THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY AND SECONDARY DATA REVIEW INCLUDING A COMMUNITY SURVEY, AND KEY INFORMANT INTERVIEWS.TOP HEALTH NEEDS (FROM 2022 CHNA): 1. MENTAL HEALTH2. NUTRITION, PHYSICAL ACTIVITY & WEIGHT3. SUBSTANCE ABUSE4. DIABETES5. SEXUAL HEALTH6. INJURY & VIOLENCE7. HEART DISEASE & STROKE8. TOBACCO USE9. INFANT HEALTH & FAMILY PLANNING10. POTENTIALLY DISABLING CONDITIONS11. ORAL HEALTH12. ACCESS TO HEALTH CARE SERVICES13. RESPIRATORY DISEASE14. CANCERFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: BEHAVIORAL HEALTH (MENTAL HEALTH/SUBSTANCE MISUSE)TO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025:1.1 EXPAND ACCESS TO MENTAL HEALTH SERVICES FOR YOUTH* 1.1.1 OPERATE AN INTEGRATED SCHOOL-BASED MENTAL HEALTH PROGRAMFY24 ACTIONS AND IMPACT:MAINTAINED AND INTEGRATED SCHOOL-BASED MENTAL HEALTH PROGRAM IN THE DC WEST SCHOOL SYSTEM IN VALLEY, NE. THE PROGRAM SERVES STUDENTS AND THEIR FAMILIES IN GRADES K-12.MEASURES:STUDENTS SERVED (NOT UNDUPLICATED): 41AVERAGE NUMBER OF STUDENTS SERVED IN SCHOOL-BASED AND VIRTUAL PROGRAMS: 26NEW STUDENT REFERRALS: 26BILLABLE OFFICE VISITS: 5331.2 EXPAND ACCESS TO RESOURCES FOR INDIVIDUALS LIVING WITH ALZHEIMERS AND DEMENTIA-RELATED DISEASES (ADRD)* 1.2.1 PROVIDE SUPPORT FOR INDIVIDUALS WITH ALZHEIMER'S/ DEMENTIA AND THEIR CAREGIVERS (SYSTEM)FY24 ACTIONS AND IMPACT: NOT AVAILABLE AT TIME OF REPORTING. MEASURES: NO MEASURES TO REPORT. 1.3 EXPAND ACCESS TO BEHAVIORAL HEALTH SERVICES FOR ADULTS IN CRISIS* 1.3.1 CONTINUE TO PROVIDE ACCESS TO OUTPATIENT BEHAVIORAL HEALTH SERVICES AND REDUCE BEHAVIORAL HEALTH READMISSIONS THROUGH LASTING HOPE RECOVERY CENTER OUTPATIENT CLINICFY24 ACTIONS AND IMPACT:EXPANDED SERVICES OFFERED AT LASTING HOPE, INCLUDING AN INTENSIVE OUTPATIENT PROGRAM.MEASURES:LASTING HOPE OUTPATIENT CLINIC VISITS: 7,644* 1.3.2 INVEST IN NONPROFITS ADDRESSING OUR PRIORITY HEALTH NEED OF BEHAVIORAL HEALTH FY24 ACTIONS AND IMPACT:FUNDED FOUR NONPROFITS THROUGH COMMUNITY HEALTH IMPROVEMENT GRANTS (CHIG): IMMIGRANT LEGAL CENTER + REFUGEE EMPOWERMENT CENTER, LATINO CENTER OF THE MIDLANDS, COMUNIDAD MAYA PIXAN IXIM, RISE ACADEMY.MEASURES:CHIG FUNDS AWARDED (1/1/24-12/31/24): $190,000* 1.3.3 DEVELOP AND PILOT AN INTEGRATED PEER SUPPORT SPECIALIST (PSS) PROGRAM ACROSS ALL AREAS OF BEHAVIORAL HEALTH FY24 ACTIONS AND IMPACT:THE HEALTHY COMMUNITIES TEAM SUPPORTED THIS STRATEGY THROUGH A FY24-25 MISSION AND MINISTRY COMMUNITY HEALTH & WELLBEING PROJECT GRANT. THROUGHOUT FY24:HIRED AND TRAINED AN FTE FOR AN OUTPATIENT POSITION, A 0.6 FTE FOR PARTIAL CARE, AND A 0.4 FTE FOR YOUTH RESIDENTIAL. THESE STAFF RECEIVED TRAINING IN THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION'S (SAMHSA) TAKING ACTION FOR WHOLE HEALTH AND WELLBEING PROGRAM IN JUNE 2024. AN ADVISORY COUNCIL FIRST MET ON DECEMBER 18, 2023. THE COUNCIL CREATED A WORK GROUP TO IDENTIFY EXISTING RELEVANT QUALITY MEASURES FOR PERFORMANCE MANAGEMENT. EACH DEPARTMENT TO WHICH A PSS IS ASSIGNED WILL TAKE ON THE COST OF THE PSS. FUTURE WORK WILL EXPLORE HOW TO STRUCTURE SERVICE DELIVERY AND/OR ADVOCATE FOR MEDICAID/MEDICARE REIMBURSEMENT OF EXISTING SERVICE DELIVERY.1.4 ADVOCATE FOR POLICY CHANGE* 1.4.1 LEAD POLICY AND ADVOCACY EFFORTS THAT EXPAND ACCESS TO BEHAVIORAL HEALTH SERVICES FY24 ACTIONS AND IMPACT:THROUGH THE NEBRASKA HOSPITAL ASSOCIATION, CHI HEALTH SUPPORTED ADVOCACY EFFORTS THAT CULMINATED IN THE PASSAGE OF SEVERAL LAWS THAT PRESERVE ACCESS AND SUSTAINABILITY OF BEHAVIORAL HEALTH SERVICES, SUCH AS:LBB896- CHANGE PROVISIONS RELATING TO TELEHEALTH CONSULTATIONS INCLUDED IN HEALTH AND HUMAN SERVICES COMMITTEE PRIORITY LEGISLATION ELIMINATES THE REQUIREMENT TO COLLECT A SIGNED CONSENT STATEMENT FOR A TELEHEALTH CONSULTATION IF VERBAL CONSENT HAS ALREADY BEEN GIVEN. THE BILL REMOVES THE FOLLOWING LANGUAGE: "THE SIGNED STATEMENT MAY BE COLLECTED BY PAPER OR ELECTRONIC SIGNATURE AND SHALL BECOME A PART OF THE PATIENT'S MEDICAL RECORD. IF THE PATIENT GIVES VERBAL CONSENT DURING THE INITIAL TELEHEALTH CONSULTATION, THE SIGNED STATEMENT SHALL BE COLLECTED WITHIN TEN DAYS AFTER SUCH TELEHEALTH CONSULTATION."LB62 COVERAGE OF TRANSLATION AND INTERPRETATION SERVICES UNDER MEDICAID REQUIRES THE STATE TO PROVIDE COVERAGE FOR ALL NECESSARY TRANSLATION AND INTERPRETATION SERVICES FOR INDIVIDUALS WHO RECEIVE MEDICAID. IT REQUIRES THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE THE COVERAGE, AS WELL AS REIMBURSEMENT FOR PROVIDERS, AND TO "TAKE ALL ACTIONS NECESSARY" TO MAXIMIZE FEDERAL FUNDING TO DO SO. LB857 CREATES THE NEBRASKA PRENATAL PLUS PROGRAM, PROVIDE FOR USE OF THE MEDICAID MANAGED CARE EXCESS PROFIT FUND, AND CHANGE PROVISIONS RELATING TO COVERAGE OF GLUCOSE MONITORS UNDER THE MEDICAL ASSISTANCE ACT. LB857 CREATES THE NEBRASKA PRENATAL PLUS PROGRAM AT DHHS FOR WOMEN ELIGIBLE FOR MEDICAID OR THE CHILDREN'S HEALTH INSURANCE PROGRAM TO REDUCE THE INCIDENCE OF LOW BIRTH WEIGHT, PRE-TERM BIRTH, AND ADVERSE BIRTH OUTCOMES WHILE ALSO ADDRESSING OTHER LIFESTYLE, BEHAVIORAL, AND NONMEDICAL ASPECTS OF AN AT-RISK MOTHER'S LIFE THAT MAY AFFECT THE HEALTH AND WELL-BEING OF THE MOTHER OR THE CHILD. SERVICES ELIGIBLE FOR REIMBURSEMENT FOR AT-RISK MOTHERS INCLUDE NUTRITION COUNSELING, PSYCHOSOCIAL COUNSELING AND SUPPORT, GENERAL CLIENT EDUCATION AND HEALTH PROMOTION, BREASTFEEDING SUPPORT, AND TARGETED CASE MANAGEMENT. LB857 LIMITS ELIGIBILITY FOR AT-RISK MOTHERS OTHERWISE ELIGIBLE FOR MEDICAID WHILE PREGNANT, REMOVES CHIP ELIGIBILITY AND POSTPARTUM COVERAGE. IT ALSO LIMITS NUTRITION COUNSELING TO 6 OR FEWER SESSIONS.LB905 REQUIRE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO SUBMIT A MEDICAID WAIVER OR STATE PLAN AMENDMENT FOR MEDICAL RESPITE CARE, CHANGE THE DEFINITION OF RESPITE CARE, AND CHANGE PROVISIONS RELATING TO THE MEDICAID MANAGED CARE EXCESS PROFIT FUND. LB905 REQUIRES DHHS TO SUBMIT A MEDICAID WAIVER OR STATE PLAN AMENDMENT TO DESIGNATE TWO MEDICAL RESPITE FACILITIES TO REIMBURSE FOR SERVICES PROVIDED TO AN INDIVIDUAL WHO IS HOMELESS AND AN ADULT IN THE EXPANSION POPULATION NO LATER THAN JAN. 1, 2025. LB1355 PROVIDE FOR RELEASE OF CERTAIN PATIENT DATA BY AN EMERGENCY MEDICAL SERVICE, CHANGE PROVISIONS OF THE OPIOID PREVENTION AND TREATMENT ACT, AND PROVIDE FOR STATE AID, RESEARCH, FIRST RESPONDER TRAINING, AND OVERDOSE FATALITY REVIEW. LB1355 REQUIRES THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE GRANTS TO LOCAL PUBLIC HEALTH DEPARTMENTS, LAW ENFORCEMENT AGENCIES, AND HEALTH CARE FACILITIES, TO AID PROGRAMS TO FACILITATE OPIOID OVERDOSE PREVENTION EFFORTS, EDUCATION AND TRAINING, RECOVERY, PROBLEM-SOLVING COURTS, AND DATA TRACKING. THE BILL INCLUDES THE INTENT OF THE LEGISLATURE TO APPROPRIATE $4,000,000 ANNUALLY FROM THE NEBRASKA OPIOID RECOVERY FUND BEGINNING IN FY2024-25 FOR GRANTS UNDER THE OPIOID PREVENTION AND TREATMENT ACT. WOULD PROVIDE $500,000 EACH TO A LOCAL PUBLIC HEALTH DEPARTMENT, A LAW ENFORCEMENT AGENCY APPLICANT, AND TO A HEALTH CARE FACILITY APPLICANT. LB1355 ALLOWS PHARMACISTS TO SELL, AND PUBLIC HEALTH DEPARTMENTS TO DISTRIBUTE, FENTANYL TEST STRIPS.MEASURES:BEHAVIORAL HEALTH BILLS APPROVED (OF THOSE SUPPORTED BY NHA AND/OR CHI HEALTH): 5* 1.4.2 SUPPORT SARPY/CASS TOBACCO COALITION FY24 ACTIONS AND IMPACT:TOBACCO EDUCATION & ADVOCACY OF THE MIDLANDS (TEAM) CONTINUED TO WORK WITH BUSINESSES, SCHOOL DISTRICTS, PUBLIC HOUSING PROGRAMS AND CITY PARKS TO IMPLEMENT SMOKE-FREE/ VAPE-FREE/ TOBACCO- FREE POLICIES. CONTINUED WORKING ON NEW INITIATIVES TO DECREASE THE NUMBER OF TOBACCO RETAILERS AND INCREASE THE NUMBER OF CESSATION ASSESSMENT AND REFERRAL SYSTEM POLICIES WITHIN HEALTH CARE, SOCIAL SERVICE, AND EDUCATION AGENCIES.MEASURES:TEAM COALITIONMEMBERS: 116NEW MEMBERS: 9MULTI-FAMILY BUILDINGS THAT ADOPTED 100% SMOKE-FREE/VAPE-FREE OR TOBACCO-FREE IN SARPY/CASS COUNTY: 10CESSATION ASSESSMENT AND REFERRAL SYSTEM POLICIES WITHIN HEALTH CARE, SOCIAL SERVICE, AND EDUCATION AGENCIES IN SARPY/CASS COUNTY: 8SEE PART V, SECTION B, LINE 11 DISCLOSURE CONTINUED FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. PART V, SECTION B, LINE 11 (CONTINUED 1): 1.5 DECREASE BEHAVIORAL HEALTH WORKFORCE SHORTAGE THROUGH EDUCATIONAL PARTNERSHIPS* 1.5.1 DEVELOP, IMPLEMENT AND EVALUATE BEHAVIORAL HEALTH WORKFORCE RECRUITMENT AND RETENTION STRATEGIESCONTINUED TO IMPLEMENT RETENTION STRATEGIES. UTILIZED FUNDING FOR QUARTERLY RECOGNITION OF PRECEPTORS, SUPERVISORS, AND MENTORS AND FOR SPONSORING CONFERENCES AND CONTINUING EDUCATION. RELOCATED THE CREIGHTON PSYCHIATRIC RESIDENCY PROGRAM TO IMMANUEL TO ACCOMMODATE ADDITIONAL THERAPISTS AT LASTING HOPE.ADDED A NEW INTENSIVE OUTPATIENT PROGRAM FOR CHEMICAL DEPENDENCY AT LASTING HOPE. MEASURES:HIRED:PSYCHIATRISTS: 4PSYCHIATRIC NURSE PRACTITIONERS: 6CHEMICAL DEPENDENCY PROGRAMTHERAPISTS: 2NURSE: 1ADDICTION PSYCHIATRIST: 1VACANCY RATES AS OF JULY 2024 IMMANUEL: 18.98% (23.67% IN JUNE 2024)LASTING HOPE: 30.34% (39.33% IN JUNE 2024)1.6 REDUCE MENTAL HEALTH STIGMA* 1.6.1 SUPPORT INTERNAL/COMMUNITY MENTAL HEALTH STIGMA REDUCTION CAMPAIGNSFY24 ACTIONS AND IMPACT:IMPLEMENTED THE AMERICAN HOSPITAL ASSOCIATION'S PEOPLE MATTER WORDS MATTER CAMPAIGN BY DISTRIBUTING MONTHLY POSTERS AND COMMUNICATIONS AND ENSURING THAT ALL ORGANIZATION LEADERS KNEW HOW TO ORDER PROMOTIONAL MATERIALS.MEASURES: NO MEASURES TO REPORT.1.7 EARLY DETECTION OF DEPRESSION AND CONNECTION TO MENTAL HEALTH SERVICES AMONG PREGNANT PEOPLE* 1.7.1 CONDUCT PERINATAL DEPRESSION SCREENING DURING PRENATAL VISIT, WHILE INPATIENT FOR DELIVERY AND AT POSTPARTUM VISITFY24 ACTIONS AND IMPACT:CONTINUED TO IMPLEMENT INPATIENT DEPRESSION SCREENING.MEASURES:CUMC - BERGAN MERCY: 30,000IMMANUEL: 504LAKESIDE: 9231.8 PREVENT SUICIDE* 1.8.1 EXPLORE LOCAL SCHOOL NEEDS REGARDING SUICIDE PREVENTION SUICIDE AND PROVIDE TRAINING AND FINANCIAL RESOURCES (E.G. QUESTION. PERSUADE. RESPOND (QPR), MENTAL HEALTH FIRST AID, ETC.)FY24 ACTIONS AND IMPACT: NO ACTIONS TO REPORT. MEASURES: NO MEASURES TO REPORT. PART V, SECTION B, LINE 11 (CONTINUED 2): PRIORITY HEALTH NEED #2: HEALTH-RELATED SOCIAL NEEDSTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025:- HEALTHY FOOD ACCESS* 2.1.1 IMPLEMENT AND EVALUATE A FOOD PRESCRIPTION PROGRAM PILOT FY24 ACTIONS AND IMPACT:CONTINUED TO SUPPORT THE CURA PROJECT.MEASURES:# OF PARTICIPANTS: 105PARTICIPANT A1C: AVERAGE BASELINE A1C: 8.1% BASELINE A1C <7%: 32.4% (N = 34)BASELINE A1C 7-8.9%: 32.4% (N = 34)BASELINE A1C>9%: 35.2% (N = 37)OVERALL RETENTION RATE FOR THE 18-MONTH PROGRAM: 72.7% * 2.1.2 PROVIDE FINANCIAL SUPPORT AND PROMOTION OF DOUBLE UP FOOD BUCKS, A SNAP INCENTIVE PROGRAMFY24 ACTIONS AND IMPACT:CONTINUED TO SUPPORT THE DOUBLE UP FOOD BUCKS (DUFB) PROGRAM STATEWIDE. PARTICIPANTS ENGAGED WITH DUFB AT PARTICIPATING RETAIL SITES [GROCERY STORES, FARMERS MARKETS, AND COMMUNITY SUPPORTED AGRICULTURE (CSAS)] THROUGH FOOD DEMONSTRATIONS, PROGRAM USE, AND PROGRAM PROMOTION/OUTREACH.MEASURES:VALUE OF QUALIFYING SNAP PURCHASES OF FRESH FRUITS AND VEGETABLES: $351,715.72DOUBLE UP FOOD BUCKS REDEEMED: >$192,800DOUBLE UP FOOD BUCKS PURCHASES: $16,321 UNDUPLICATED DOUBLE UP FOOD BUCKS CUSTOMERS: 5,869* 2.1.3 PROVIDE FINANCIAL SUPPORT TO ORGANIZATIONS ADDRESSING FOOD SECURITY, SUCH AS SAVING GRACEFY24 ACTIONS AND IMPACT:DONATED FUNDS TO SAVING GRACE PERISHABLE FOOD RESCUE.MEASURES:FUNDS DONATED: $1,000* 2.1.4 SUPPORT A SENIOR AND WIC FARMERS MARKET VOUCHER REDEMPTION PROGRAM AND POP UP FARM STANDS FY24 ACTIONS AND IMPACT:CONTINUED TO PARTNER WITH BIG GARDENS AND WHISPERING ROOTS TO OFFER POP-UP FARM STANDS AT FIVE WOMEN, INFANT AND CHILDREN (WIC) CLINICS AND TWO SENIOR CENTERS IN DOUGLAS AND SARPY COUNTY. THESE SITES WERE SELECTED TO ACCOMMODATE INDIVIDUALS PARTICIPATING IN THE WIC AND SENIOR FARMER'S MARKET VOUCHER PROGRAM IN A SAFER, SMALLER MARKET ENVIRONMENT AND TO IMPROVE ACCESS (TRANSPORTATION WAS CITED AS A BARRIER CONTRIBUTING TO HISTORICALLY LOW REDEMPTION RATES IN THE WIC FARMER'S MARKET VOUCHER PROGRAM IN NE).THE STATE OF NEBRASKA ELIMINATED WIC VOUCHERS IN 2022, SO WHISPERING ROOTS, RATHER THAN ACCEPTING AND MATCHING THE VOUCHERS, BEGAN DISTRIBUTING MONTHLY TOKENS TO WIC AND OTHER LOW-INCOME FAMILIES TO SPEND ON FRESH PRODUCE. MEASURES:PARTICIPATING SITES: 7FARM STAND CUSTOMERS SERVED: 616VALUE OF FREE PRODUCE DISTRIBUTED TO WIC AND OTHER LOW-INCOME FAMILIES: $52,566VALUE OF SENIOR FARMER'S MARKET VOUCHERS REDEEMED: $4,371 (1,457 VOUCHERS)VALUE OF SENIOR PRODUCE MATCH PROVIDED TO VOUCHERS RECIPIENTS TO 'DOUBLE UP': $5,754TOTAL OF ALL PURCHASES OF FRESH, LOCAL PRODUCE: $63,8802.2 FINANCIAL LITERACY* 2.2.1 PROVIDE FINANCIAL SUPPORT AND PROMOTION OF THE BRIDGES OUT OF POVERTY FINANCIAL LITERACY PROGRAMFY24 ACTIONS AND IMPACT:AWARDED A COMMUNITY HEALTH IMPROVEMENT GRANT (CHIG) TO BRIDGES OUT OF POVERTY.MEASURES:CHIG FUNDS AWARDED (1/1/24-12/31/24): $50,000GETTING AHEAD PROGRAMGRADUATION RATE: 91% (416/441)PARTICIPANT DEMOGRAPHICS:AFRICAN-AMERICAN: 25.34%ASIAN: 2.45%CAUCASIAN: 25.61%HISPANIC: 40.33%MIDDLE EASTERN: 0.27%NATIVE AMERICAN: 2.45%OTHER: 3.54%3 MONTHS POST GRADUATION ASSESSMENT:AVERAGE MONTHLY INCOME INCREASE: $1,500AVERAGE MONTHLY BILL REDUCTION: $580AVERAGE INCREASE IN ASSETS: $7,500AVERAGE REDUCTION IN MONTHLY PUBLIC BENEFITS USAGE: $124AVERAGE DECREASE IN DEBT TO INCOME RATIO: 50%2.3 SUPPORT EFFORTS TO ADDRESS HOUSING STABILITY* 2.3.1 IMPLEMENT AND SUSTAIN A MEDICAL RESPITE PROGRAM FY24 ACTIONS AND IMPACT:MEDICAL RESPITE GUESTS RECEIVE CASE MANAGEMENT, ACCESS TO MEDICAL CARE, DAILY MEALS, AND CLOTHING. COMMUNITY PARTNERS, SUCH AS UNITED HEALTHCARE, AND NEBRASKA TOTAL CARE, COMMUNITY ALLIANCE (PEER SUPPORT AND SOAR), HOUSING NAVIGATION AND DIVERSION ARE ALSO AVAILABLE AT THE SHELTER FOR GUESTS.MEASURES:PATIENTS DISCHARGED INTO MEDICAL RESPITE CARE: 28GENDERMALE: 22FEMALE: 6AGE35-44: 645-54: 655-64: 11 65+: 5RACE/ETHNICITY: BLACK OR AFRICAN AMERICAN: 9WHITE: 17MULTIPLE RACES: 1HISPANIC/LATINO: 1PATIENTS CONNECTED TO ADDITIONAL WRAPAROUND SERVICES IN MEDICAL RESPITE: 100%PATIENTS IN MEDICAL RESPITE REFERRED TO A PRIMARY CARE PROVIDER: 100%PATIENTS SCREENED FOR BEHAVIORAL HEALTH CARE AND SUBSTANCE USE NEEDS: 100%PATIENTS CONNECTED TO PERMANENT HOUSING: 2* 2.3.2 SUPPORT A HEALTH AND HOUSING COALITION FY24 ACTIONS AND IMPACT:THE HEALTH & HOUSING COALITION CONTINUES TO MEET AND DISCUSS: THE PURPOSE OF THE COALITION AND THE ROLE OF PARTICIPANTS, THE INTERSECTION OF CLINICAL CARE AND HOUSING NEEDS, IMPLEMENTATION OF THE MEDICAL RESPITE PILOT, UPDATES FROM THRESHOLD CONTINUUM OF CARE (FORMERLY METRO AREA CONTINUUM OF CARE), NEWS FROM THE CITY OF OMAHA'S HOMELESS SERVICES COORDINATOR, HEALTH SYSTEM IMPLEMENTATION OF SOCIAL NEEDS SCREENGINGS, AND HOUSING LEGISLATION.THE MEDICAL RESPITE STEERING COMMITTEE CONTINUED TO MEET (BIWEEKLY). THE HIGH UTILIZERS OF EMERGENCY SERVICES COMMITTEE TRANSITIONED TO A FREQUENT USERS SYSTEMS ENGAGEMENT (FUSE) COMMITTEE. MEASURES:COALITION MEETING ATTENDANCE:AUGUST 29, 2023: 43 PEOPLE REPRESENTING 27 ORGANIZATIONS SEPTEMBER 14, 2023: 15 PEOPLE REPRESENTING 21 ORGANIZATIONSNOVEMBER 14, 2023: 42 PEOPLE REPRESENTING 25 ORGANIZATIONSJANUARY 30, 2024: 39 PEOPLE REPRESENTING 26 ORGANIZATIONSAPRIL 30, 2024: 40 PEOPLE REPRESENTING 27 ORGANIZATIONS* 2.3.3 EVALUATE AND SUSTAIN AN INPATIENT HOUSING CASE MANAGEMENT PROGRAM FY24 ACTIONS AND IMPACT:CONTINUED TO IMPROVE THE PROCESS OF IDENTIFYING AND REFERRING PATIENTS WITH HOUSING INSTABILITY ADMITTED TO CUMC-BERGAN MERCY TO TOGETHER FOR ONSITE HOUSING PROBLEM SOLVING AND CASE MANAGEMENT.MEASURES:REFERRALS MADE TO TOGETHER FOR HOUSING CASE MANAGEMENT: 67INTERVENTIONS:PREVENTION: 44DIVERSION: 13GENERAL INFORMATION: 2UTILITIES: 1FINANCIAL INTERVENTIONS TO PREVENT HOMELESSNESS OR ACHIEVE STABLE HOUSING: $87,382.472.4 ADDRESS TRANSPORTATION BARRIERS TO ACCESSING HEALTHCARE SERVICES* 2.4.1 CONVENE AN INTERNAL WORKING GROUP TO EXPLORE OPPORTUNITIES TO MEET PATIENT TRANSPORTATION NEEDSFY24 ACTIONS AND IMPACT: NO UPDATES TO REPORT. MEASURES: NO MEASURES TO REPORT. 2.5 SOCIAL NEEDS INTEGRATION* 2.5.1 DEVELOP AND TEST REFERRAL PROCESSES FOR SOCIAL NEEDS THROUGH UNITE US FY24 ACTIONS AND IMPACT:INTEGRATED UNITE US WITHIN THE ELECTRONIC HEALTH RECORD SYSTEM, EPIC, IN MAY 2024. LAUNCHED UNIVERSAL HEALTH-RELATED SOCIAL NEEDS SCREENING OF ALL ADULT INPATIENT ADMISSIONS IN APRIL 2024.MEASURES:CHI HEALTH CUMC - BERGAN MERCYPATIENTS IMPACTED BY UNITE US REFERRALS: 20REFERRALS: 37CHI HEALTH IMMANUELPATIENTS IMPACTED BY UNITE US REFERRALS: 20REFERRALS: 50*NOTE: COUNTS MAY BE SKEWED. REFERRAL TRACKING WAS BROKEN OUT BY HOSPITAL BEGINNING IN MAY 2024. PREVIOUSLY, ALL TRACKING WAS CENTRALIZED UNDER ONE HOSPITAL/CLINIC REPORTING ORGANIZATION.* 2.5.2 LEVERAGE COMMUNITY HEALTH WORKERS TO IMPROVE PATIENT OUTCOMES AND REDUCE HEALTH DISPARITIES FY24 ACTIONS AND IMPACT:COMMUNITY LINK MAINTAINED COMMUNITY HEALTH WORKERS (CHWS) IN FOUR AMBULATORY CLINICS, BUT RECEIVED SOCIAL WORK REFERRALS FROM A TOTAL OF 28 OMAHA METRO CHI HEALTH CLINICS. FOUR COMMUNITY LINK CHWS COMPLETED HRSA-FUNDED COMMUNITY HEALTH WORKER TRAINING PROGRAMS DURING WHICH THEY COMPLETED APPRENTICESHIPS IN THEIR CURRENT ROLES. SEVERAL COMMUNITY LINK CHWS SHARED THEIR TIME AND EXPERTISE WITH THE NEBRASKA CHW CONSULTANT-TRAINER CADRE TO SUPPORT CHW WORKFORCE DEVELOPMENT. COMMUNITY LINK SERVED AS A CONSULTANT TO THE NEBRASKA ASSOCIATION OF LOCAL HEALTH DIRECTORS (NALHD) AS THEY DEVELOPED CHW TRAINING MODULES. CHI INTEGRATED THE UNITE US RESOURCE AND REFERRAL PLATFORM INTO THE ELECTRONIC HEALTH RECORD SYSTEM. COMMUNITY LINK CONTINUED TO USE UNITE US TO SEND REFERRALS THAT DID NOT REQUIRE IMMEDIATE RESPONSE.COMMUNITY LINK CONTINUED TO COLLABORATE ON A MIDWEST CHW COMMUNITY OF PRACTICE CALL THAT INCLUDES ALL THE CHW TEAMS FROM THE UPPER AND LOWER CENTRAL REGION (INCLUDING NE/IA/ND/MN).MEASURES:REFERRALS RECEIVED: 3,627BARRIERS IDENTIFIED: 4,895 (TOP 5 INCLUDE FINANCIAL, INSURANCE, TRANSPORTATION, FOOD, AND HOUSING)BARRIERS ADDRESSED: 7,657INTERVENTIONS PROVIDED: 9,337 PART V, SECTION B, LINE 11 (CONTINUED 3): * 2.5.3 SUPPORT THE IMPLEMENTATION OF PATHWAYS COMMUNITY HUB TO SUSTAIN A COMMUNITY HEALTH WORKER (CHW) WORKFORCE IN THE OMAHA METRO AND REDUCE DISPARATE MATERNAL AND INFANT HEALTH OUTCOMES FY24 ACTIONS AND IMPACT: AWARDED A COMMUNITY HEALTH IMPROVEMENT GRANT (CHIG) TO OMAHA PATHWAYS COMMUNITY HUB TO SERVE PREGNANT PEOPLE AT RISK FOR POOR BIRTH OUTCOMES DUE TO SOCIAL, MEDICAL AND BEHAVIORAL RESOURCES WITH 1) A FOCUS ON SERVING INDIVIDUALS EAST OF 72ND ST. IN DOUGLAS AND SARPY COUNTIES IN NEBRASKA AND 2) A PRIORITY TO SERVE BLACK PREGNANT INDIVIDUALS.MEASURES:CHIG FUNDS AWARDED (1/1/24-12/31/24): $50,000PATHWAYS COMMUNITY HUB METRICS (MARCH 1, 2024-JUNE 30, 2024):PREGNANT PEOPLE SERVED (MEANING AT LEAST ONE NEED SUCCESSFULLY ADDRESSED): 38REFERRED INDIVIDUALS ENROLLED IN THE PROGRAM: 70% (47/63)PATHWAYS CLOSED: 98; ACROSS 12 NEED AREASSOCIAL SERVICE REFERRAL: 58PREGNANCY: 13FOOD SECURITY: 5FAMILY PLANNING: 4POSTPARTUM: 4EMPLOYMENT: 3HEALTHCARE COVERAGE: 3MEDICAL REFERRAL: 3ORAL HEALTH: 2TRANSPORTATION: 1MEDICAL HOME: 1HOUSING: 1HEALTH EDUCATION MODULES DELIVERED: 77* 2.5.4 INVEST IN NONPROFITS ADDRESSING OUR PRIORITY HEALTH NEED OF HEALTH RELATED SOCIAL NEEDS FY24 ACTIONS AND IMPACT:FUNDED FIVE NONPROFITS THROUGH COMMUNITY HEALTH IMPROVEMENT GRANTS (CHIG): OMAHA COMMUNITY FOUNDATION, NO MORE EMPTY POTS, OMAHA BRIDGES OUT OF POVERTY, INCOMMON COMMUNITY, TOGETHER.MEASURES:CHIG FUNDS AWARDED (1/1/24-12/31/24): $247,0862.6 INCREASE THE NUMBER AND DIVERSITY OF YOUTH INTERESTED IN HEALTH CARE CAREERS* 2.6.1 CREATE A HEALTH CARE CAREER PIPELINE FOR STUDENTS FY24 ACTIONS AND IMPACT:HOSTED A MEDICAL ACADEMY FOR HIGH SCHOOL STUDENTS INTERESTED IN A HEALTH CARE CAREER. MEASURES:NO MEASURES TO REPORT. * 2.6.2 SUPPORT SIEMBRA SALUD, HEALTH CAREER LADDER PROGRAMFY24 ACTIONS AND IMPACT:CONTINUED TO SUPPORT THE SIEMBRA SALUD INTERNSHIP PROGRAM. INTERNS SPLIT THEIR TIME BETWEEN URBAN AGRICULTURE OR PROFESSIONAL DEVELOPMENT LEARNING AND CAREER EXPLORATION ACTIVITIES. THEY COMPLETED MENTAL HEALTH FIRST AID, (MHFA); CPR; QUESTION, PERSUADE, REFER (QPR); AND STOP THE BLEED TRAININGS. THE CNA TRAINING AND LICENSURE PROGRAM RECRUITED STUDENTS FROM TWO HUBSTHE LATINO CENTER OF THE MIDLANDS AND BRYAN HIGH SCHOOL. STUDENTS RECEIVED THEIR TRAINING AT METROPOLITAN COMMUNITY COLLEGE OR FULTON HOMES. PARTNERED WITH MCC TO SUPPORT STUDENTS AND PILOT AN INSTRUCTIONAL RESTRUCTURING. MEASURES:SIEMBRA SALUDAPPLICATIONS RECEIVED: 37APPLICATIONS ACCEPTED: 12INTERNS: 14HEALTH CAREER EXPERIENCES: 5HOSPITAL: 2CLINIC: 1CAREER PANEL PRESENTATIONS: 2TRAININGS AND CERTIFICATIONS: 15FAMILIES REACHED THROUGH HOME GARDENING PROGRAM: 50 CNA LICENSURE AND TRAINING PROGRAMAPPLICATIONS RECEIVED: 49ENROLLEES: 5GRADUATES: 4HIRED BY CHI: 22.7 HEALTH EQUITY TRANSFORMATION ASSESSMENT (HETA)* 2.7.1 COLLECT RACE, ETHNICITY AND LANGUAGE DATA FOR PATIENTS AND STAFF. ASSESS DATA AND IDENTIFY STRATEGIES TO RECRUIT/ RETAIN A HEALTHCARE WORKFORCE REFLECTIVE OF THE RACIAL, ETHNIC AND LINGUISTIC DIVERSITY OF OUR PATIENTS AND COMMUNITY.FY24 ACTIONS AND IMPACT:COMPLETED THE AMERICAN HOSPITAL ASSOCIATION'S HEALTH EQUITY TRANSFORMATION ASSESSMENT. CREATED A HEALTH EQUITY ACTION PLAN AND FORMED A COMMITTEE TO ADVANCE THE WORK. WILL FOCUS ON UNDERSTANDING DRIVERS OF PREVENTABLE READMISSIONS (INCLUDING UNMET SOCIAL NEEDS) IN FY25.MEASURES: NO MEASURES TO REPORT. PART V, SECTION B, LINE 11 (CONTINUED 4): PRIORITY HEALTH NEED #3: VIOLENCE PREVENTION & INTERVENTIONTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025:3.1 PROVIDE RESOURCES AND SUPPORT TO VICTIMS OF VIOLENCE* 3.1.1 SUPPORT AND EXPAND THE FORENSIC NURSE EXAMINER PROGRAM FY24 ACTIONS AND IMPACT:THE FORENSIC NURSE EXAMINER (FNE) PROGRAM MARKET MANAGER PROVIDED ONGOING EDUCATION ON INTIMATE PARTNER VIOLENCE (IPV), SEXUAL ASSAULT (SA), AND HUMAN TRAFFICKING (HT) IDENTIFICATION TO EMERGENCY DEPARTMENTS.MEASURES:FNES: 18IDENTIFIED IPV, SA, AND/OR HT CASES FOR WHICH FNES WERE CALLED TO PROVIDE SUPPORT (AS OF NOVEMBER 13, 2024): 434# OF SURVIVORS OF DOMESTIC VIOLENCE, SEXUAL ASSAULT AND HUMAN TRAFFICKING SERVED THROUGH THE FORENSIC NURSE EXAMINER PROGRAM: 547* 3.1.2 SUPPORT TRAUMA RESPONSE, INCLUDING INPATIENT CASE MANAGEMENT AND COMMUNITY-BASED VIOLENCE INTERVENTION EFFORTS FY24 ACTIONS AND IMPACT:CONTINUED TO PARTNER WITH YOUTURN. MEASURES:HOSPITAL TRAUMA RESPONSES: 0 (IN-PERSON RESPONSE PAUSED DUE TO COVID-19) CURRENTLY PLANNING TO REINSTATE TRAUMA RESPONSE FOR FY25FACILITATED ENCOUNTERS WITH HIGH SCHOOL STUDENTS: 4,428TRAINING PROVIDED TO HIGHEST RISK YOUTH: 78DIRECT CONTACT WITH HIGHEST RISK YOUTH HOUSED AT DOUGLAS COUNTY YOUTH CENTER: 745CASE MANAGEMENT FOR ADOLESCENT AND YOUNG ADULTS: 137COMMUNITY-BASED REFERRALS: 875PUBLIC EDUCATION MATERIALS DISTRIBUTED: 3,852COMMUNITY MEMBERS REACHED THROUGH VIOLENCE PREVENTION EVENTS: 10,253 3.2 PREVENT VIOLENCE AND INTERVENE WHEN IT IS SUSPECTED* 3.2.1 INCREASE HEALTH SYSTEM AND COMMUNITY CAPACITY TO IDENTIFY VICTIMS OF HUMAN TRAFFICKING AND RESPOND APPROPRIATELYFY24 ACTIONS AND IMPACT:THE HEALTHY COMMUNITIES TEAM SUPPORTED THIS STRATEGY THROUGH A FY22-24 MISSION AND MINISTRY UNITED AGAINST VIOLENCE GRANT. THROUGHOUT FY24:THE FORENSIC NURSE EXAMINER (FNE) PROGRAM MARKET MANAGER PROVIDED ONGOING EDUCATION ON INTIMATE PARTNER VIOLENCE (IPV), SEXUAL ASSAULT (SA), AND HUMAN TRAFFICKING (HT) IDENTIFICATION TO EMERGENCY DEPARTMENTS.CHI HEALTH AWARDED HUMAN TRAFFICKING AND VIOLENCE PREVENTION MINI-GRANTS TO SUPPORT COMMUNITY ORGANIZATIONS SERVING VICTIMS AND SURVIVORS IN THE OMAHA METRO AREA; AWARDEES: RESTORED WINGS (FY23 + FY24), HEARTLAND FAMILY SERVICE (FY23 + FY24), AND MEN AGAINST DOMESTIC VIOLENCE ACTION COALITION (FY24).SUPPORTED COMMUNITY TRAINING/EDUCATION FACILITATED BY THE WOMEN'S CENTER FOR ADVANCEMENT (WCA), AN ADVOCACY ORGANIZATION PROVIDING DIRECT SUPPORT TO VICTIMS/SURVIVORS OF VIOLENCE.THE INTERNAL EDUCATION AND AWARENESS INITIATIVES BECAME SELF-SUSTAINED/AUTONOMOUS AND NO LONGER REQUIRED THE OVERSIGHT OF THE HOSPITAL-BASED OMAHA METRO HUMAN TRAFFICKING/VIOLENCE PREVENTION TASK FORCE, SO THE TASK FORCE TRANSITIONED TO A BI-MONTHLY "ADVISORY COUNCIL." THE ADVISORY COUNCIL REGULARLY ATTENDED THE NEBRASKA HUMAN TRAFFICKING TASK FORCE MEETINGS LED BY THE NEBRASKA ATTORNEY GENERAL'S OFFICE, AND REGULARLY CONNECTED WITH VARIOUS MULTIDISCIPLINARY TASK FORCES/RESPONSE GROUPS IN THE OMAHA METRO COMMUNITIES. HOSTED, IN COLLABORATION WITH CREIGHTON UNIVERSITY'S OFFICE OF CONTINUING EDUCATION AND 11 COMMUNITY/STATE ORGANIZATIONS, INCLUDING WILLOW RISING, CATHOLIC CHARITIES, OMAHA POLICE DEPARTMENT, AND THE DOUGLAS COUNTY SHERIFF'S DEPARTMENT, THE SECOND ANNUAL MIDWEST REGIONAL ANTI-HUMAN TRAFFICKING CONFERENCE ON NOVEMBER 8, 2023 IN OMAHA, NE. CONFERENCE ATTENDEES RECEIVED ALL RESOURCES SUCH AS POWERPOINTS AND HANDOUTS VIA THE VIRTUAL EVENT APP. REQUIRED HUMAN TRAFFICKING 101, PEARR (TRAUMA-INFORMED APPROACH TO VICTIM ASSISTANCE IN HEALTH CARE SETTINGS), AND TRAUMA INFORMED CARE STAFF TRAINING VIA PATHWAYS. THE DIVISION RELEASES THESE TRAININGS ANNUALLY ON OCTOBER 1ST AND REQUIRES THEIR COMPLETION BY DECEMBER 31ST.MEASURES:FNES: 18IDENTIFIED IPV, SA, AND/OR HT CASES FOR WHICH FNES WERE CALLED TO PROVIDE SUPPORT (AS OF NOVEMBER 13, 2024): 434FY24 VIOLENCE PREVENTION/TRAUMA RESPONSE MINI-GRANTS: $21,500ESTHETICIANS AND TATTOO ARTISTS TRAINED ON IDENTIFYING IPV/ HUMAN TRAFFICKING: 100MIDWEST REGIONAL ANTI-HUMAN TRAFFICKING CONFERENCE REGISTRANTS: 377LIVE ATTENDEES: 161 VIRTUAL AND 77 IN-PERSON FROM 22 DIFFERENT STATESCEUS: 786.5 CLAIMED BY 143 ELIGIBLE PROFESSIONALSSTAFF PATHWAYS TRAININGS (NEBRASKA AND IOWA COMPLETION RATES AS OF JANUARY 2024)HUMAN TRAFFICKING 101: 85% (11,194/13,128)PEARR TOOL: 90% (6893/7686**ASSIGNED TO DEFINED CLINICAL STAFF ONLY.TRAUMA-INFORMED CARE: 90% (7089/7854)* 3.2.2 INVEST IN COMMUNITY ORGANIZATION ADDRESSING OUR PRIORITY HEALTH NEED OF VIOLENCE PREVENTION & INTERVENTION FY24 ACTIONS AND IMPACT:FUNDED ONE NONPROFIT THROUGH COMMUNITY HEALTH IMPROVEMENT GRANTS (CHIG): RISE ACADEMY.FUNDED THREE NONPROFITS THROUGH HUMAN TRAFFICKING AND VIOLENCE PREVENTION MISSION AND MINISTRY FUND (MMF) MINI GRANTS: HEARTLAND FAMILY SERVICE, RESTORED WINGS, AND MEN AGAINST DOMESTIC VIOLENCE ACTION COALITION (MADVAC).NEBRASKA SPINE DONATED TO THE OMAHA POLICE AND FIRE DEPARTMENTS TO SUPPORT THEIR COMMUNITY OUTREACH EVENTS AND EDUCATION.MEASURES:CHIG FUNDS AWARDED (1/1/24-12/31/24): $40,000HUMAN TRAFFICKING AND VIOLENCE PREVENTION MMF MINI GRANT FUNDS AWARDED: $21,500FUNDS DONATED TO THE OMAHA POLICE AND FIRE DEPARTMENTS: $2,0003.3 PROVIDE TRAUMA-INFORMED CARE FOR PATIENTS* 3.3.1 EXPLORE ONGOING OPPORTUNITIES TO PROMOTE TRAUMA-INFORMED CARE PRACTICES WITHIN THE BEHAVIORAL HEALTH SERVICE LINE FY24 ACTIONS AND IMPACT: ALL STAFF RECEIVE ANNUAL TRAUMA INFORMED CARE TRAINING. MEASURES: NO MEASURES TO REPORT. 3.4 SUPPORT SCHOOL-BASED PROGRAMMING TO INCREASE PROTECTIVE FACTORS AND REDUCE RISK FACTORS FOR VIOLENCE* 3.4.1 PROVIDE FUNDING TO COMMUNITY-BASED ORGANIZATIONS DELIVERING EDUCATION AND TRAINING TO LOCAL SCHOOLS F24 ACTIONS AND IMPACT: NO UPDATES TO REPORT. MEASURES: NO MEASURES TO REPORT. PART V, SECTION B, LINE 11 (CONTINUED 5): THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS FOR THE FOLLOWING REASONS: ACCESS TO HEALTHCARE SERVICES. ACCESS TO CARE IS A FUNDAMENTAL COMPONENT OF CHI HEALTH'S MISSION AND STRATEGY. THIS ISSUE WAS NOT ELEVATED TO A PRIORITY FOR THIS PARTICULAR PLAN BECAUSE THE INTENT WAS TO IDENTIFY ADDITIONAL STRATEGIES AND INITIATIVES THAT REACH ABOVE AND BEYOND CHI HEALTH'S TYPICAL BUSINESS. FOR EXAMPLE, CHI HEALTH CONTINUES TO OFFER A WIDE ARRAY OF PRIMARY CARE ACCESS POINTS INCLUDING: EXTENDED CLINIC HOURS, PRIORITY CARE SERVICES (WALK-IN CARE), QUICK CARE AND VIRTUAL CARE. ADDITIONAL PROGRAMS LIKE MD SAVE, WHICH ALLOWS PATIENTS TO PRE-PURCHASE CERTAIN SERVICES AT A DISCOUNTED PRICE, AND THE MEDICATION ACCESS PROGRAM (A PRESCRIPTION MEDICATION FINANCIAL ASSISTANCE PROGRAM), ARE WORKING TO LOWER THE COST OF CARE TO THE CONSUMER. IN ADDITION TO PROVIDING THE MAJORITY OF CARE TO THE UNINSURED AND UNDERINSURED IN THE OMAHA METRO AREA, CHI HEALTH WILL CONTINUE TO ADDRESS ACCESS TO HEALTHCARE SERVICES THROUGH FINANCIAL SUPPORT PROVIDED TO THE MAGIS CLINIC ANDHOPE MEDICAL, AS WELL AS THROUGH FREE HEALTH SCREENINGS AND IMMUNIZATION CLINICS IN THE COMMUNITY.CANCER. CHI HEALTH DID NOT PRIORITIZE CANCER AS A TOP HEALTH NEED BASED ON THE CONSIDERATIONS ABOVE AND IN ORDER TO FOCUS AND MEANINGFULLY IMPACT OTHER AREAS OF NEED. CHI HEALTH WILL CONTINUE TO PERFORM EXISTING CANCER OUTREACH THROUGHOUT THE COMMUNITY AND FINANCIALLY SUPPORT COMMUNITY PARTNERS SUCH AS THE AMERICAN CANCER SOCIETY, THE NEBRASKA CANCER COALITION AND PROJECT PINK'D. CHI HEALTH PARTICIPATES IN THE EVERY WOMAN MATTERS AND NEBRASKA COLON CANCER SCREENING PROGRAMS TO PROVIDE TESTING AND DIAGNOSTIC SERVICES FOR THE MEDICALLY UNDERSERVED IN NEBRASKA. ADDITIONALLY, CHI HEALTH CLINICS ARE WORKING TO INCREASE UTILIZATION OF HPV VACCINATION TO PREVENT CERVICAL CANCER.DIABETES. CHI HEALTH DID NOT PRIORITIZE DIABETES BASED ON THE CONSIDERATIONS ABOVE AND IN ORDER TO FOCUS AND MEANINGFULLY IMPACT OTHER AREAS OF NEED. CHI HEALTH WILL CONTINUE PERFORMING DIABETES OUTREACH AND EDUCATION ACROSS THE OMAHA METRO AREA, INCLUDING THROUGH THE INTEGRATION OF CERTIFIED DIABETES EDUCATORS INTO PRIMARY CARE CLINICS. SEE ALSO HEALTH RELATED SOCIAL NEEDS FOR RELATED ACTIVITIES, SUCH AS THE CURA PROJECT/ PRODUCE PRESCRIPTION PROGRAM FOR LOW- INCOME, DIABETIC PATIENTS.HEART DISEASE AND STROKE. WHILE THIS NEED WAS NOT PRIORITIZED SPECIFICALLY, THE FOCUS ON SUBSTANCE ABUSE THROUGH THE BEHAVIORAL HEALTH PRIORITY WILL HAVE AN IMPACT ON BEHAVIORAL RISK FACTORS FOR HEART DISEASE AND STROKE, SUCH AS ALCOHOL AND SUBSTANCE ABUSE. ADDITIONALLY, CHI HEALTH OFFERS PROGRAMMING DESIGNED TO MITIGATE RISK FACTORS FOR HEART DISEASE AND STROKE THROUGH CHI HEALTH HEART CARE CLASSES INCLUDING HEALTHY COOKING CLASSES. CHI HEALTH IS A FINANCIAL SUPPORTER OF THE AMERICAN HEART ASSOCIATION.INFANT HEALTH & FAMILY PLANNING. WHILE THIS NEED WAS NOT PRIORITIZED SPECIFICALLY, IT IS ANTICIPATED THAT THE PRIORITY FOCUS AREAS WILL HAVE AN IMPACT ON INFANT HEALTH & FAMILY PLANNING, PARTICULARLY THROUGH THE PATHWAYS COMMUNITY HUB PROGRAM, PERINATAL DEPRESSION SCREENING, BLACK, INDIGENOUS, PEOPLE OF COLOR (BIPOC) DOULA PROGRAM AND CENTERING PREGNANCY. REPRESENTATIVES FROM CHI HEALTH PARTICIPATE IN THE DOUGLAS COUNTY HEALTH DEPARTMENT- LED BABY BLOSSOMS COLLABORATIVE. IN ADDITION, CHI SUPPORTS ORGANIZATIONS FOCUSED ON IMPROVING CHILD AND MATERNAL HEALTH OUTCOMES AND REDUCING RACIAL/ ETHNIC DISPARITIES, SUCH AS I BE BLACK GIRL AND MARCH OF DIMES. NUTRITION, PHYSICAL ACTIVITY AND WEIGHT.- THIS NEED WILL BE ADDRESSED IN PART THROUGH THE FOOD ACCESS STRATEGIES UNDER THE HEALTH RELATED SOCIAL NEEDS PRIORITY, INCLUDING PROVIDING FINANCIAL SUPPORT FOR DOUBLE UP FOOD BUCKS AND THE WOMEN, INFANT & CHILDREN (WIC)/ SENIOR FARMER'S MARKET VOUCHER PROGRAM. THERE IS SIGNIFICANT EXISTING WORK WITHIN CHI HEALTH AND THE COMMUNITY TO ADDRESS NUTRITION, PHYSICAL ACTIVITY AND WEIGHT STATUS, SUCH AS THE HEALTHY FAMILIES PROGRAM, AND 5-4-3-2-1 GO! CAMPAIGN. ADDITIONALLY, CHI HEALTH PROVIDES FINANCIAL SUPPORT AND IN-KIND CONTRIBUTIONS TO ORGANIZATIONS COMMITTED TO THIS WORK, SUCH AS: CITY SPROUTS, BIG GARDEN/ "GATHER" MOBILE KITCHEN CLASSROOM, SAVING GRACE AND WHISPERING ROOTS.RESPIRATORY DISEASES. CHI HEALTH DID NOT PRIORITIZE RESPIRATORY DISEASES BASED ON THE CONSIDERATIONS ABOVE AND IN ORDER TO FOCUS AND MEANINGFULLY IMPACT OTHER AREAS OF NEED. CHI HEALTH WILL CONTINUE TO PROVIDE FISCAL SPONSORSHIP, PROVIDE IN- KIND SUPPORT OF TOBACCO EDUCATION AND ADVOCACY OF THE MIDLANDS (TEAM). ORAL HEALTH. CHI HEALTH DID NOT PRIORITIZE ORAL HEALTH BASED ON THE CONSIDERATIONS ABOVE AND IN ORDER TO FOCUS AND MEANINGFULLY IMPACT OTHER AREAS OF NEED. OTHER COMMUNITY PARTNERS ARE ADDRESSING THIS NEED SUCH AS CHARLES DREW HEALTH CENTER DENTAL CLINIC, ONE WORLD COMMUNITY HEALTH CENTER AND FAMILY INC.POTENTIALLY DISABLING CONDITIONS. THIS NEED WILL BE MET IN PART THROUGH THE BEHAVIORAL HEALTH PRIORITY, WHICH IDENTIFIES, "PROVIDING SUPPORT FOR INDIVIDUALS WITH ALZHEIMER'S/ DEMENTIA AND THEIR CAREGIVERS" AS A KEY ACTIVITY. IN ADDITION, CHI HEALTH IMMANUEL OPERATES AN INPATIENT AND OUTPATIENT GERIATRIC PSYCHIATRY PROGRAM AND RECENTLY OPENED A NEUROLOGICAL INSTITUTE. CHI HEALTH PROVIDES FINANCIAL SUPPORT TO THE NEBRASKA ALZHEIMER'S ASSOCIATION FOR FREE CARE CONSULTATION FOR FAMILIES WITH A LOVED ONE WHO HAS RECENTLY RECEIVED A DEMENTIA/ ALZHEIMER'S DIAGNOSIS.SEXUAL HEALTH. THERE IS EXTENSIVE EXISTING WORK CURRENTLY TAKING PLACE AROUND SEXUALLY TRANSMITTED DISEASES ACROSS THE OMAHA METRO AREA LED BY COMMUNITY PARTNERS, SUCH AS THE DOUGLAS COUNTY HEALTH DEPARTMENT, WOMEN'S FUND AND THE FEDERALLY QUALIFIED HEALTH CENTERS. THEREFORE, THIS IS NOT AN AREA THAT CHI HEALTH PRIORITIZED. HOWEVER, AS MENTIONED IN THE CANCER SECTION ABOVE, CHI HEALTH CLINICS ARE FOCUSING ON HPV VACCINATION FOR THE PREVENTION OF CERVICAL CANCER. PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:- THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.- THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS.- THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:- RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;- HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC;- PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);- FOOD STAMP ELIGIBILITY;- ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID);- LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR- PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE. PART I, LINE 6A: CHI HEALTH SYSTEM PRODUCES AN ANNUAL PUBLIC COMMUNITY BENEFIT REPORT THAT IS MAILED TO A CORE CONSTITUENCY, PLACED IN KEY PLACES THROUGHOUT THE ORGANIZATION AND DISTRIBUTED IN COMMUNITY MEETINGS. IT IS ALSO AVAILABLE ON THE COMPANY'S INTRANET SITE AND ON ITS PUBLIC WEBSITE AT HTTPS://WWW.CHIHEALTH.COM/ABOUT-US/MISSION-VALUES/COMMUNITY-BENEFIT. PART I, LINE 7: COMMONSPIRIT HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY ("CBISA") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS. PART II, COMMUNITY BUILDING ACTIVITIES: CHI HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT INVESTMENTS, AS WELL AS HOSPITAL SPECIFIC INVESTMENTS THAT ADDRESS COMMUNITY HEALTH NEEDS WHICH INCLUDE SUPPORT OF LOCAL HEALTH COALITIONS, INVESTMENTS IN PARTNERSHIPS AND PROGRAMS THAT ADDRESS TOP COMMUNITY HEALTH NEEDS, PARTICIPATION IN LOCAL COMMITTEES AND BOARDS TIED TO TOP HEALTH NEEDS, AND INVESTMENTS IN MANY OTHER WAYS AS DESCRIBED IN OTHER AREAS OF THE SCHEDULE H NARRATIVE. PART III, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR ADDITIONAL DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. ALEGENT HEALTH-IMMANUEL MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ALSO ALSO UTILIZES A WAYSTAR SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. WAYSTAR USES A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, ALEGENT HEALTH-IMMANUEL MEDICAL CENTER DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2024, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 11-12."PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES." PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. ALEGENT HEALTH-IMMANUEL MEDICAL CENTER'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $4,257,004 MILLION REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT. PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. PART VI, LINE 4: CHI HEALTH IMMANUEL IS LOCATED IN OMAHA, NE AND LARGELY SERVES THE OMAHA METRO AREA THAT CONSISTS OF DOUGLAS, SARPY, AND CASS COUNTIES IN NEBRASKA AND POTTAWATTAMIE COUNTY IN IOWA. THESE FOUR COUNTIES WERE IDENTIFIED AS THE COMMUNITY FOR THIS CHNA, AS THEY ENCOMPASS THE PRIMARY SERVICE FOR CHI HEALTH HOSPITALS LOCATED IN THE OMAHA METRO AREA, THUS COVERING BETWEEN 75% AND 90% OF PATIENTS SERVED. THESE COUNTIES ARE CONSIDERED TO BE AND REFERRED TO AS THE "OMAHA METRO AREA." FOR THE PURPOSES OF THE CHNA DOUGLAS, SARPY, AND CASS COUNTIES IN NEBRASKA AND POTTAWATTAMIE COUNTY IN IOWA WERE IDENTIFIED AS THE COMMUNITY FOR THIS CHNA. WITH A TOTAL POPULATION OF OVER 800,000 IN THE FOUR COUNTY AREA, THE DATA SHOW A LARGELY NON-HISPANIC WHITE POPULATION ACROSS THE FOUR COUNTIES WITH GREATER DIVERSITY OBSERVED IN DOUGLAS COUNTY AND TO A LESSER EXTENT, SARPY COUNTY, BOTH OF WHICH ARE THE MOST URBAN COUNTIES IN THE OMAHA METRO AREA. WHILE DOUGLAS COUNTY IS THE MOST DIVERSE OF THE FOUR COUNTIES, WITH 11.5% OF THE POPULATION IDENTIFYING AS BLACK OR AFRICAN AMERICAN AND 12.9% IDENTIFYING AS HISPANIC, IT IS LESS DIVERSE THAN THE UNITED STATES OVERALL (13.4% BLACK OR AFRICAN AMERICAN, 18.5% HISPANIC). CASS COUNTY HAS THE LARGEST PERCENTAGE OF THE POPULATION OVER THE AGE OF 65 YEARS (16%), INDICATING UNIQUE HEALTH NEEDS SPECIFIC TO THE AGING POPULATION. DOUGLAS COUNTY HAS THE HIGHEST PERCENTAGE OF UNINSURED RESIDENTS OVERALL AND UNINSURED CHILDREN (UNDER THE AGE OF 19). THE AVERAGE INCOME FOR THE FOUR COUNTY AREA IS AS FOLLOWS DOUGLAS ($66,600), SARPY ($83,051), CASS ($73,683) AND POTTAWATTAMIE ($60,065). SARPY COUNTY HAS THE HIGHEST MEDIAN INCOME IN THE FOUR COUNTY AREA (DOUGLAS: $66,600, SARPY $83,051, CASS: $73,683, POTTAWATTAMIE: $60,065). DOUGLAS COUNTY HAS THE HIGHEST PERCENTAGE OF PEOPLE LIVING IN POVERTY IN THE FOUR COUNTY AREA (DOUGLAS: 9.8%, SARPY: 4.9%, CASS 5.9%, POTTAWATTAMIE: 9.2%). THE PERCENTAGE OF PERSONS WITHOUT HEALTH INSURANCE UNDER 65 IS 10.3% IN DOUGLAS COUNTY, 5.7% IN SARPY COUNTY, 6.6% IN CASS COUNTY, AND 6% IN POTTAWATTAMIE COUNTY. THE FOUR COUNTY SERVICE AREA HAS 26 DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) INCLUDING PRIMARY CARE, DENTAL HEALTH, MENTAL HEALTH DISCIPLINES. THE 26 DESIGNATED HPSA HAVE SCORES THAT RANGE FROM NINE TO 25 WHERE THE SCORE RANGE IS ZERO TO 26 (HIGHER SCORES INDICATE AN INCREASINGLY GREATER HEALTH PROFESSIONAL SHORTAGE). THE FOUR COUNTY SERVICE AREA HAS EIGHT DESIGNATED MEDICALLY UNDERSERVED AREAS (MUA) INCLUDING PRIMARY CARE. THE EIGHT DESIGNATED MUA'S HAVE SCORES THAT RANGE FROM 44.9 - 64.3 IN WHICH THE LOWEST SCORE (HIGHEST NEED) IS ZERO; THE HIGHEST SCORE (LOWEST NEED) IS 100. THE FOLLOWING ORGANIZATIONS REPRESENT HOSPITALS AND OTHER HEALTHCARE SYSTEMS DELIVERING HEALTHCARE SERVICES IN THE OMAHA COUNCIL BLUFFS METROPOLITAN AREA:FEDERALLY QUALIFIED HEALTH CENTERS: * ALL CARE HEALTH CENTER * CHARLES DREW HEALTH CENTER * ONE WORLD COMMUNITY HEALTH CENTERS, INC. * COUNCIL BLUFFS COMMUNITY HEALTH CENTER * FRED LEROY HEALTH & WELLNESS CENTERHEALTH DEPARTMENTS: * DOUGLAS COUNTY HEALTH DEPARTMENT * POTTAWATTAMIE COUNTY PUBLIC HEALTH DEPARTMENT * SARPY CASS DEPARTMENT OF HEALTH & WELLNESSHEALTH SYSTEMS (HOSPITALS/ CLINICS): * CHI HEALTH CLINICS * CHILDREN'S HOSPITAL & MEDICAL CENTER * METHODIST HEALTH SYSTEM * NEBRASKA MEDICINE * VA NEBRASKA-WESTERN IOWA HEALTH CARE SYSTEM PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. PART VI, LINE 6: THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 24 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS. COMMONSPIRIT HEALTH AND SUBSTANTIALLY ALL OF ITS DIRECT AFFILIATES AND SUBSIDIARIES HAVE BEEN GRANTED EXEMPTIONS FROM FEDERAL INCOME TAX AS CHARITABLE ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF SEPTEMBER 25, 2024, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,300 CARE SITES, CONSISTING OF 137 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. AN ADDITIONAL 21 HOSPITALS ARE OPERATED THROUGH UNCONSOLIDATED JOINT VENTURES. IN FISCAL YEAR 2024, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.574 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.22 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $37.5 BILLION IN FISCAL YEAR 2024, HAS TOTAL ASSETS OF APPROXIMATELY $54.73 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. 1 CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 501(C)(3) 17295 0 GENERAL SUPPORT IMMIGRANT LEGAL CENTER 4223 CENTER STREET OMAHA NE 68105 743195841 501(C)(3) 50000 0 GENERAL SUPPORT OMAHA COMMUNITY FOUNDATION 1120 S 101ST ST STE 320 OMAHA NE 68124 470645958 501(C)(3) 39839 0 GENERAL SUPPORT 3 0 SCHOLARSHIPS 4 7000 PART I, LINE 2: MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS. PART III: SCHOLARSHIPS ARE PROVIDED BY THE IMMANUEL MEDICAL CENTER AUXILIARY TO PROVIDE CONTINUING EDUCATION FOR ALEGENT HEALTH - IMMANUEL MEDICAL CENTER EMPLOYEES FOR THEIR PERSONAL GROWTH AND/OR PROFESSIONAL DEVELOPMENT. ALL PERMANENT, FULL-TIME AND PART-TIME EMPLOYEES IN GOOD STANDING WHO HAVE SIX MONTHS OR MORE OF SERVICE WITH ALEGENT HEALTH - IMMANUEL MEDICAL CENTER MAY APPLY FOR THE SCHOLARSHIPS. PAYMENT FOR TUITION, LAB FEES, BOOKS, AND REGISTRATION EXPENSES WILL BE MADE DIRECTLY TO THE INSTITUTION UPON RECEIPT OF A STATEMENT OF COSTS FROM THE INSTITUTION. THE AWARDING OF THE SISTER INGEBORG BLOMBERG SCHOLARSHIP SHALL BE SUBJECT TO THE FOLLOWING CRITERIA: 1 APPLICATION IS MADE PRIOR TO MAKING A COMMITMENT TO THE SCHOOL 2. THE SCHOOL AND COURSE ARE OF RECOGNIZED STANDING 3. THE EMPLOYEE CONTINUES TO MAINTAIN HIS/HER REGULARLY SCHEDULED WORKING HOURS 4. THE EMPLOYEE SHALL SIGN AN AUTHORIZATION ALLOWING THE AUXILIARY TO RECEIVE WRITTEN CERTIFICATION OF PERFORMANCE FROM THE INSTITUTION 5. IT IS EVIDENT THAT THE COURSE, OR COURSES ARE MUTUALLY BENEFICIAL TO THE EMPLOYEE AND TO ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6. THE EMPLOYEE IS EXPECTED TO REMAIN EMPLOYED AT ALEGENT HEALTH - IMMANUEL MEDICAL CENTER FOR AT LEAST ONE YEAR AFTER RECEIVING THE SISTER INGEBORG BLOMBERG SCHOLARSHIP. ALEGENT HEALTH - IMMANUEL MEDICAL CENTER OCCASIONALLY DISTRIBUTES FUNDS TO OTHER 501(C)(3) ORGANIZATIONS. THESE DISTRIBUTIONS ARE MONITORED TO ENSURE THEY ARE BEING USED AS SPECIFIED BY THE ORGANIZATION. 1 1 0 0 0 0 0 0 0 JOHN PETERSDORF BOARD MEMBER 0 645040 0 716812 0 727895 0 923913 0 68907 0 3082567 0 713173 EVERT KUIPER FORMER PRESIDENT & CEO CHI HEALTH 0 749566 0 0 0 2037667 0 20045 0 28489 0 2835767 0 0 TIM BRICKER EX-OFFICIO BM/REGIONAL PRESIDENT 0 876719 0 1582430 0 40043 0 82634 0 33892 0 2615718 0 0 JEANETTE WOJTALEWICZ FORMER CFO, CHI HEALTH 0 128679 0 132479 0 1083677 0 9698 0 2669 0 1357202 0 0 ANN SCHUMACHER PRESIDENT - IMC (TERMED 3/31/24) 0 493561 0 0 0 31013 0 19350 0 25902 0 569826 0 0 NICK O'TOOL MARKET CFO 0 252554 0 96047 0 419 0 16660 0 34289 0 399969 0 0 KIRTIBALA GUPTA MD BOARD MEMBER/PHYSICIAN 0 342890 0 0 0 3612 0 18825 0 28699 0 394026 0 0 HEATHER MORGAN MD BOARD MEMBER/PHYSICIAN 0 319514 0 0 0 911 0 18500 0 39877 0 378802 0 0 CY XAYARATH TRAVELER RN 14457 247894 0 800 2501 49094 0 18317 663 36787 17621 352892 0 0 BRENDA WALLINGFORD PEDIATRIC NURSE PRACTITIONER 387 277509 0 800 0 1684 0 16596 3 20181 390 316770 0 0 MATTHEW BOGARD PHYSICIAN EMERGENCY MEDICINE 0 255259 0 0 0 14851 0 19000 0 21400 0 310510 0 0 MARK CIPOLLA SENIOR PHYSICIST 1909 248211 0 800 42 1511 0 15483 102 34063 2053 300068 0 0 COLVILLE OSBORNE PHYSICIST CHIEF 0 247854 0 800 0 5435 0 16452 0 30119 0 300660 0 0 BARBARA DAMRATOWSKI TRAVELER RN 221582 3235 0 800 40223 1020 15123 0 11005 38 287933 5093 0 0 HEIDI SAUNDERS TRAVELER RN 221040 7031 0 800 27751 61 13846 0 19719 334 282356 8226 0 0 MATTHEW WALTERS SENIOR PHYSICIST 0 263742 0 800 0 593 0 15239 0 622 0 280996 0 0 ANTHONY ASHBY INTERIM PRESIDENT - IMC 134547 33641 44239 0 291 0 0 11585 8691 19764 187768 64990 0 0 PART I, LINE 3: DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH, USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. PART I, LINE 4A: CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2023 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): EVERT KUIPER, $2,025,542; JEANETTE WOJTALEWICZ, $1,083,464. IN ACCORDANCE WITH AN EXECUTIVE SEVERANCE POLICY, DIGNITY HEALTH'S LISTED PERSONS ARE PROVIDED WITH MARKET-STANDARD COMPENSATION RANGING FROM PAYMENTS OF 9-24 MONTHS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION. PART I, LINE 4B: DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2023, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: ANN SCHUMACHER, $25,394. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE. THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS FOR ONE BOARD MEMBERS/OFFICER, FOUR KEY EMPLOYEES, ONE HIGHEST COMPENSATED EMPLOYEE AND ONE FORMER KEY EMPLOYEE OCCURRED DURING 2023 INCLUDE J. PETERSDORF, $713,173. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH SUPPLEMENTAL EXECUTIVE RETENTION/RETIREMENT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN WHICH IN 2002 WAS OFFERED TO MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM BY THE DIGNITY HEALTH BOARD OF DIRECTORS AND WOULD BE PAID ONLY IF THE EXECUTIVES STAYED WITH THE ORGANIZATION FOR A SPECIFIED NUMBER OF YEARS AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION AND RETIREMENT OF THE PARTICIPANTS. THE EXECUTIVE MANAGEMENT TEAM IS RECRUITED FROM STABLE CAREERS IN ORGANIZATIONS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES. DUTIES ARE BOTH EXTENSIVE AND COMPLEX AND REQUIRE SUBSTANTIAL AND DIVERSE EXPERIENCE AND SKILL SETS TO EXECUTE THEIR ROLES SUCCESSFULLY. THE CALCULATION FOR THE PAYMENTS TO EACH EXECUTIVE ARE BASED ON THE VALUE OF A FINAL AVERAGE PAY ANNUITY BENEFIT BASED ON RETIREMENT AGE AND SERVICE YEARS TO THE ORGANIZATION. DISTRIBUTION OCCURS EACH JULY 1 IF THE PLAN FORMULA WARRANTS A PAYMENT. NO PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT OCCURRED DURING 2023. PART II: ALEGENT HEALTH - IMMANUEL MEDICAL CENTER FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023. FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF ALEGENT HEALTH-IMMANEUL MEDICAL CENTER ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 2 KEVIN FITZGERALD AND MARDELL WILSON - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 CHI NEBRASKA IS THE SOLE MEMBER OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S CORPORATE MEMBER IS CHI NEBRASKA. PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, BOTH CHI NEBRASKA AND COMMONSPIRIT HEALTH HAVE RESERVED POWERS AS OUTLINED IN THE COMMONSPIRIT HEALTH GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE CHI NEBRASKA'S BOARD: *APPROVE MEMBERS OF THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER BOARD. *AMENDMENT OF THE CORPORATE DOCUMENTS OF THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *APPROVAL OF ISSUANCE OF DEBT BY ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *APPROVAL OF PARTICIPATION OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER IN A JOINT VENTURE. *APPROVAL OF FORMATION OF A NEW CORPORATION BY ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *APPROVAL OF A MERGER INVOLVING THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. *TO REQUIRE THE TRANSFER OF ASSETS BY THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI NEBRASKA OR COMMONSPIRIT HEALTH MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION B, LINE 11B FOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF COMMONSPIRIT HEALTH (CSH), A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE CSH TAX DIRECTOR AND THE LOCAL CHIEF FINANCIAL OFFICER. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW AND ARE ABLE TO ASK THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON CHIEF FINANCIAL OFFICER APPROVAL AND SIGNATURE, THE TAX ANALYST FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD AND FINANCE COMMITTEE, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15B COMMONSPIRIT'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PRACTICES FOR CERTAIN EXECUTIVES WITHIN ORGANIZATION. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE IN DETERMINING VARIABLE COMPENSATION. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AND FINANCIAL LEGAL COUNSEL TO VALIDATE THE ORGANIZATION'S BENCHMARKING APPROACH AND REASONABLENESS OF THE TOTAL COMPENSATION AND BENEFITS PACKAGES FOR CERTAIN EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED BY THE COMMONSPIRIT HEALTH COMPENSATION DEPARTMENT FROM INDEPENDENT THIRD-PARTY SALARY SURVEYS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES) FOR ALL OTHER STAFF AND LEADERSHIP ROLES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATION DEPARTMENT. IN ADDITION, THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE NEBRASKA SECRETARY OF STATE WEBSITE AT WWW.SOS.NE.GOV/BUSINESS. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. FORM 990, PART VI, LINE 16B: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; AND (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 15,328,516. MANAGEMENT AND GENERAL EXPENSES 806,764. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,135,280. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,587,485. MANAGEMENT AND GENERAL EXPENSES 504,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,092,089. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 7,884,406. MANAGEMENT AND GENERAL EXPENSES 414,969. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,299,375. CONSULTING: PROGRAM SERVICE EXPENSES 41,525. MANAGEMENT AND GENERAL EXPENSES 2,186. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,711. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 5,498,175. MANAGEMENT AND GENERAL EXPENSES 541,427. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,039,602. FORM 990, PART XI, LINE 9: EQUITY CHANGES IN UNCONSOLIDATED ORGS 4,922,014. OTHER CHANGES -212. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMM MEM HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) LINE 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) LINE 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) LINE 3 BSLHV 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) LINE 12A, I CSH 0 BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON TX 77566 800240261 PHYSICIANS TX 501(C)(3) LINE 3 TCHB 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(C)(3) LINE 3 SLH-CO 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 REHABILITATION TX 501(C)(3) LINE 10 SJSC 0 CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840405257 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL AVE CENTENNIAL CO 80112 840902211 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CHIC 0 CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 12A, I CSH 0 CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 TELEHEALTH CO 501(C)(3) LINE 12A, I CSH 0 CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 SURGERY CENTER OR 501(C)(3) LINE 10 MMC - ROSEBURG 0 CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD CA 93311 844171789 CLINIC CA 501(C)(3) LINE 3 DCC 0 CENTRAL KANSAS MEDICAL CENTER 9100 E MINERAL CIRCLE CENTENNIAL CO 80112 480543724 INACTIVE KS 501(C)(3) LINE 3 CSH 0 CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO ND 58104 271966847 SENIOR LIVING MN 501(C)(3) LINE 10 CSH 0 CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 ACH 0 CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER KY 41018 202741651 INVESTMENTS KY 501(C)(3) LINE 12A, I CSH 0 CHI LIVING COMMUNITIES 930 S WYNN ROAD OREGON OH 43616 341892096 SENIOR LIVING OH 501(C)(3) LINE 12A, I SFH-OH 0 CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 822748395 HOSPITAL GA 501(C)(3) LINE 3 MHCS 0 CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA NE 68510 363233121 HOLDING CO NE 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER PA 17602 232342997 HEALTHCARE PA 501(C)(3) LINE 12A, I CSH 0 CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE NM 87102 710897107 COMMUNITY NM 501(C)(3) LINE 12A, I CSH 0 CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 710236913 HOSPITAL AR 501(C)(3) LINE 3 CHI-SVHS 0 CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125064 HOLDING CO AR 501(C)(3) LINE 12A, I SVIMC 0 CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS AR 71913 261125131 PHYSICIANS AR 501(C)(3) LINE 3 CHI-SVHS 0 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 470617373 HEALTHCARE CO 501(C)(3) LINE 12A, I N/A 0 COMMONSPIRIT HEALTH FOUNDATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 853374038 FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CSH 0 COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC 185 BERRY STREET STE 200 SAN FRANCISCO CA 94107 850919176 OPERATING INVESTMENTS DE 501(C)(3) LINE 12A, I CSH 0 COMMONSPIRIT HEALTH RESEARCH INSTITUTE 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 271050565 RESEARCH CO 501(C)(3) LINE 12A, I CSH 0 COMMONSPIRIT MOUNTAIN REGION 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 841335382 MANAGEMENT COMPANY CO 501(C)(3) LINE 12A, I CHIC 0 COMMUNITY HOSPITAL OF SAN BERNARDINO 1805 MEDICAL CENTER DRIVE SAN BERNARDINO CA 92411 951643373 HOSPITAL CA 501(C)(3) LINE 3 DCC 0 COMMUNITY LIMITED CARE DIALYSIS CENTER 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 237419853 HOLDING CO OH 501(C)(2) GSH 0 COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY IA 51555 421294399 FUNDRAISING FOUNDATION IA 501(C)(3) LINE 12A, I AH-CMHMV 0 CONTINUING CARE HOSPITAL ONE SAINT JOSEPH DRIVE LEXINGTON KY 40504 611400619 HOSPITAL KY 501(C)(3) LINE 3 SJHS 0 DIGNITY COMMUNITY CARE 185 BERRY STREET STE 200 SAN FRANCISCO CA 94107 815009488 HOSPITAL CO 501(C)(3) LINE 3 CSH 0 DIGNITY HEALTH 185 BERRY STREET STE 200 SAN 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FOUNDATION CA 501(C)(3) LINE 12A, I DH 0 DOMINICAN OAKS CORPORATION 1555 SOQUEL DRIVE SANTA CRUZ CA 95065 770127719 OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS CA 501(C)(3) LINE 10 DHS 0 ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW WA 98022 910715805 HOSPITAL WA 501(C)(3) LINE 3 FHS 0 FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 611345363 HOSPITAL KY 501(C)(3) LINE 3 KOH 0 FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN KY 40004 562351341 FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I FH 0 FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO OH 43623 341931806 HEALTHCARE OH 501(C)(3) LINE 10 CHILC 0 FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA WA 98405 911145592 FUNDRAISING FOUNDATION WA 501(C)(3) LINE 10 FHS 0 FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA WA 98405 910564491 HOSPITAL WA 501(C)(3) LINE 3 CSH 0 FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA WA 98402 911939739 PHYSICIANS WA 501(C)(3) LINE 10 FHS 0 FRENCH HOSPITAL MEDICAL CENTER FOUNDATION 1911 JOHNSON AVENUE SAN LUIS OBISPO CA 93401 203256125 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON ND 58540 450227752 HOSPITAL ND 501(C)(3) LINE 3 SAMC 0 GLENDALE MEMORIAL HEALTH FOUNDATION 1420 SOUTH CENTRAL AVENUE GLENDALE CA 91204 953625651 FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DCC 0 GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 201536108 INACTIVE CO 501(C)(3) LINE 12A, I CSH 0 GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311778403 EDUCATION OH 501(C)(3) LINE 2 GSH 0 GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY NE 68848 470379755 HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA 0 GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY NE 68847 470659443 FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 GSH-KN 0 GOOD SAMARITAN HOSPITAL FOUNDATION OF 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