2025-05-15T13:23:39-04:00 2024-06-30 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2023-07-01 510103684 CHRISTIANA CARE HEALTH SERVICES INC % SR VP'S OFFICE CHRI 3024282426 4000 NEXUS DRIVE NW3-100 WILMINGTON DE 19803 ROBERT MCMURRAY CFO 3026237202 2025-05-15 true true ANTONIO C RUSSO P00858539 2673303000 2025-05-14 2023 2025-03-06 01:10:19Z JANICE NEVIN MD 4000 NEXUS DRIVE WILMINGTON DE 19803 3853495541 false X WWW.CHRISTIANACARE.ORG X 1965 DE OUR MISSION AS AN ORGANIZATION IS TO SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. 14 10 14540 489 1498234 0 53965055 42127253 2567645527 2755633267 60054269 236160355 16332229 16965085 2697997080 3050885960 516250 1861240 0 0 1555860667 1614928394 0 0 0 1031979043 1050215401 2588355960 2667005035 109641120 383880925 4483979485 4817293499 1106827681 1158781143 3377151804 3658512356 X WE SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. false false 2282840360 1854240 2765367462 AS PART OF ITS MISSION OF SERVICE, THE HOSPITALS AND MEDICAL STAFF OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") OFFER A FULL RANGE OF HEALTH SERVICES TO ADDRESS THE NEEDS OF ITS LOCAL COMMUNITIES. THIS INCLUDES THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES TO RESIDENTS OF THE STATE OF DELAWARE, NORTHERN MARYLAND, SOUTHEASTERN PENNSYLVANIA AND SOUTHERN NEW JERSEY, WITHOUT REGARD TO THE PATIENTS' RACE, GENDER, ETHNICITY, AGE, DISABILITY, RELIGION, OR ABILITY TO PAY. DURING FISCAL 2023, THE HOSPITALS OF CCHS RECORDED 402,555 PATIENT DAYS, 56,359 ADMISSIONS, 192,088 EMERGENCY DEPARTMENT VISITS, AND THE BIRTHS OF 6,325 BABIES. ADDITIONALLY, CCHS'S MEDICAL GROUP ENGAGED WITH PATIENTS DURING A TOTAL OF 292,658 PRIMARY CARE VISITS. DURING THE FISCAL YEAR, CCHS PROVIDED $52,130,184 OF UNCOMPENSATED AND UNREIMBURSED CARE, AND ENGAGED IN A VARIETY OF OTHER ACTIVITIES TO SUPPORT AND ASSIST THE LOCAL COMMUNITIES THAT ARE MORE FULLY DISCUSSED IN SCHEDULE H. 2282840360 true true false true false false false false false true true true false true true false false true false false true false false false true false true true true false true true false false false false false false false false false false true false false false true true true true false false true 366 0 true 14540 true true true false false false false true true false false false false true false X 14 10 false false false false true true true true true false false true true true true true true true true true false PA X SR VP'S OFFICE 3024282441 4000 NEXUS DRIVE AVENUE NORTH WILMINGTON DE 19803 X JANICE E NEVIN MD PRESIDENT & CEO 43.0 2.0 X X 2755490 0 7228 SHARON KURFUERST FORMER COO 0.0 0.0 X 1311367 0 3168 RICHARD CUMING CHIEF OPERATING OFFICER 44.0 1.0 X 1173074 0 68494 RAY A BLACKWELL MD CHIEF OF CARDIAC SURGERY 45.0 0.0 X 1211524 0 20878 RANDALL GABORIAULT CHIEF DIGITAL & INFO. OFFICER 45.0 0.0 X 1125990 0 94186 KENNETH SILVERSTEIN MD FORMER CHIEF PHYSICIAN EXEC 0.0 0.0 X 1126586 0 2850 ROBERT MCMURRAY CFO, TREAS. & ASS'T SECRETARY 36.0 9.0 X 1040419 0 88327 DANIEL ROBB MD PHYSICIAN, CARDIAC SURGEON 45.0 0.0 X 1022687 0 12506 JENNIFER L SCHWARTZ ESQ CORPORATE SECRETARY 35.0 10.0 X 926687 0 80121 NEIL JASANI MD CHIEF PEOPLE OFFICER 45.0 0.0 X 981129 0 20878 KIRK N GARRATT MD MED. DIR. CTR FOR H/V HEALTH 45.0 0.0 X 976760 0 12104 VINAY K GHEYI CHAIR DEPARTMENT RADIOLOGY 45.0 0.0 X 974300 0 13910 KERT ANZILOTTI JR MD INTERIM PRESIDENT 45.0 0.0 X 907418 0 80787 LISA MAXWELL MD PRESIDENT, CC MEDICAL GROUP 45.0 0.0 X 919693 0 20878 NICHOLAS J PETRELLI MD MED. DIR, CCHS CANCER PROGRAM 45.0 0.0 X 909743 0 12506 BETTINA TWEARDY-RIVEROS CHIEF HEALTH EQUITY OFFICER 45.0 0.0 X 780074 0 66272 FREDERIC T HARAD MD DIRECTOR 45.0 0.0 X 752407 0 12506 BARBARA ALBANI MD DIRECTOR - AS OF 01/24 45.0 0.0 X 721170 0 0 VINAY MAHESHWARI MD DIRECTOR 45.0 0.0 X 613808 0 20878 BARRY NIZIOLEK DIRECTOR 1.0 0.0 X 0 0 0 CHRISTINE SAUERS DIRECTOR 1.0 0.0 X 0 0 0 DAVID B STRATTON ESQ CHAIR - THRU 12/23 44.0 1.0 X X 0 0 0 DWIGHT D THOMEY ESQ DIRECTOR - THRU 12/23 1.0 3.0 X X 0 0 0 JULIE TOPKIS NASON DIRECTOR 1.0 0.0 X 0 0 0 KATHY JANVIER DIRECTOR 1.0 1.0 X 0 0 0 LOLITA A LOPEZ CHAIR - AS OF 01/24 1.0 0.0 X X 0 0 0 LOSSIE FREEMAN DIRECTOR 1.0 1.0 X 0 0 0 MORGAN MILLER MLIS DIRECTOR - AS OF 01/24 1.0 0.0 X 0 0 0 PAWAN RASTOGI MD DIRECTOR 1.0 0.0 X 0 0 0 RITA LANDGRAF DIRECTOR - AS OF 01/24 0.0 0.0 X 0 0 0 SALVATORE CHIP ROSSIE DIRECTOR - THRU 12/23 1.0 0.0 X 0 0 0 TOM MOORE VICE CHAIR - AS OF 01/24 1.0 0.0 X X 0 0 0 20230326 0 638477 3518 true true false CERNER CORPORATION PO BOX 959156 ST LOUIS MO 631959156 IT SERVICES 27221920 GENERAL HEALTHCARE RESOURCES 2250 HICKORY ROAD STE 240 PLYMOUTH MEETING PA 19462 TEMP. STAFFING SRVCS 16999659 ANESTHESIA SERVICES PA 100 WEST COMMONS BLVD STE 400 NEW CASTLE DE 19720 ANESTHESIA SERVICES 14349192 CONSTRUCTION SERVICES GROUP LLC 1630 WEST CHESTER PIKE WEST CHESTER PA DE 19382 CONSTRUCTION SRVCS 13698676 ERNST YOUNG LLP PO BOX 640382 PITTSBURGH PA 152640382 CONSULTING SRVCS 10376097 337 9471 141751 2955695 36741376 2278960 142903 42127253 NET PROGRAM SERVICE REVENUES 622110 2686086673 2686086673 0 0 OTHER REVENUES 900099 69546594 63818551 1498234 4229809 2755633267 71219169 71219169 0 0 5508369 5508369 0 5508369 5508369 969203319 -1652552 802609581 166593738 -1652552 164941186 164941186 17738 141751 0 17738 17738 0 0 0 0 0 0 MAINTENANCE FEES 531390 1704783 0 0 1704783 AFFILIATE REVENUES 900099 9734195 9734195 0 0 11438978 3050885960 2759639419 1498234 247621054 1861240 1861240 0 0 0 15178595 12798782 2379813 0 0 1252443799 1056076366 196367433 0 79249174 66823900 12425274 0 179392604 151266100 28126504 0 88664222 74762787 13901435 0 21517461 16855532 4661929 0 6065352 4751245 1314107 0 444513 348206 96307 0 422633 331067 91566 0 0 6434027 6434027 0 44148858 34583657 9565201 0 6703332 5251002 1452330 0 6095872 4775153 1320719 0 75279050 58969245 16309805 0 87447 68501 18946 0 45223456 35425435 9798021 0 3057053 2394718 662335 0 0 1281634 1003958 277676 0 8458612 6951961 1506651 0 0 118544262 88441488 30102774 0 30839123 24157582 6681541 0 MEDICAL SUPPLIES 489757416 489757416 0 0 OTHER SUPPLIES AND SERVICES 185855300 145185019 40670281 0 2667005035 2282840360 384164675 0 X 13272 13272 269688680 295480916 0 0 421401431 537742510 0 0 0 0 0 0 49504179 48445848 27951704 30153319 2870783346 1831759564 1067277741 1039023782 1672961947 1915847561 491444744 437767095 0 0 1015805 1015805 482719982 511803391 4483979485 4817293499 446857675 449538491 0 0 0 0 298936087 291699694 0 0 0 0 0 0 0 0 361033919 417542958 1106827681 1158781143 X 3317366405 3593169230 59785399 65343126 3377151804 3658512356 4483979485 4817293499 X 383880925 85758988 -188279361 X false true X true true true X 80735115 128076121 43095263 53965055 42127253 347998807 0 0 80735115 128076121 43095263 53965055 42127253 347998807 0 347998807 38348773 34285085 42693278 55003321 76727538 247057995 0 1515817 1583245 1524457 1625074 1704783 7953376 603010178 11772482091 0.57710 0.60142 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 422633 false false 422633 false SCHEDULE C, PART II-B, LINE 1(G) DETAIL OF LOBBYING ACTIVITIES CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAY ENGAGE IN LOBBYING ACTIVITIES AS PERMITTED UNDER APPLICABLE FEDERAL AND STATE LAWS, INCLUDING EFFORTS TO INFLUENCE LEGISLATION OR PUBLIC POLICY RELEVANT TO ITS MISSION AND OPERATIONS. IN ADDITION, CCHS IS A MEMBER OF VARIOUS TRADE AND PROFESSIONAL ASSOCIATIONS. ANNUAL MEMBERSHIP DUES ARE PAID TO THESE ORGANIZATIONS, AND IN SOME CASES, A PORTION OF SUCH DUES HAS BEEN DESIGNATED BY THE RESPECTIVE ASSOCIATIONS AS ALLOCABLE TO LOBBYING AND ADVOCACY EFFORTS. THESE AMOUNTS HAVE BEEN IDENTIFIED IN ACCORDANCE WITH INFORMATION PROVIDED BY THE RESPECTIVE ORGANIZATIONS AND ARE NOT DIRECTLY CONTROLLED BY CCHS. 59228178 809537 4928139 0 2256646 0 62709208 58310687 732143 3560384 0 3375036 0 59228178 68569307 669502 -6744573 0 4183549 0 58310687 62232483 993569 9205113 0 3861858 0 68569307 67336850 1520182 2545562 0 9170111 0 62232483 0.35950 0.41590 0.22460 true false 32739798 32739798 1801186301 1024715409 776470892 37457859 14587692 22870167 959029169 760693863 198335306 40370219 31762600 8607619 1039023782 OTHER SECURITIES 437767095 F 437767095 CONSTRUCTION IN PROGRESS 51056920 DUE FROM AFFILIATES 198427340 OTHER ASSETS 121943137 OTHER RECEIVABLES 43689826 SUBSIDIARY INVESTMENT 96686168 511803391 0 PENSION & POST RETIREMENT BENEFIT 192249760 INSURANCE LIABILITIES 14158018 OTHER LIABILITIES 211135180 417542958 FORM 990, SCHEDULE D, PART V, LINE 3A & 4 DETAIL OF ENDOWMENT FUNDS THE ORGANIZATION'S BOARD DESIGNATED ENDOWMENTS ARE INTENDED TO COVER ANNUAL INCREMENTAL OPERATING EXPENSES OF THE HEALTH SERVICES' TRANSITIONAL CANCER RESEARCH, VALUE INSTITUTE, AND INFANT MORTALITY. THE ORGANIZATION'S PERMANENT ENDOWMENT CONSISTS OF APPROXIMATELY TWENTY SEVEN DONOR RESTRICTED ENDOWMENT FUNDS USED FOR A VARIETY OF PURPOSES, INCLUDING SALARY AND PROGRAM SUPPORT. THE ORGANIZATION'S PURPOSE AND TIME RESTRICTED NET ASSETS ARE RESTRICTED FOR INDIGENT CARE, BUILDING AND MAINTENANCE, AND PROGRAM SUPPORT. -------------------- Central America and the Caribbean 0 0 Investments 174876372 0 0 0 0 174876372 174876372 true false true false false false FORM 990, SCHEDULE F, PART I, LINE 2 DETAIL OF SUB-CONTRACTS IN FURTHERANCE OF ITS RESEARCH ACTIVITIES, THE ORGANIZATION MAY MAKE SUB-CONTRACTS TO FOREIGN INSTITUTIONS THAT PERFORM RESEARCH IN CONNECTION WITH RESEARCH GRANTS AWARDED TO THE ORGANIZATION. THE ORGANIZATION DOES NOT CATEGORIZE ANY SUCH SUB-CONTRACTS AS GRANTS FOR FORM 990, SCHEDULE F, PARTS II AND III PURPOSES. FY24 HFGCC 5K 96658 85950 10708 0 0 0 0 0 0 FY25 HFGCC 5K 62832 55802 7030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159490 141752 17738 0 0 0 0 0 0 0 17738 FORM 990, SCHEDULE G, PART II DETAIL OF FUNDRAISING EVENTS EXPENSES RELATED TO THE HFGCC 5K EVENTS WERE RECORDED DIRECTLY BY CHRISTIANA CARE HEALTH SYSTEM, INC., THE SOLE MEMBER OF THIS ORGANIZATION. true true X true X 400. false false false false 16686977 0 16686977 0.00630 342674799 323658624 19016174 0.00710 359361776 323658624 35703151 0.01340 39 17459 17942366 1285784 16656582 0.00620 4 134 100114063 16956329 83157734 0.03120 1 27509 269932838 192828061 77104777 0.02890 1 19256070 17017691 2238379 0.00080 14 292 1775365 0 1775365 0.00070 59 45394 409020702 228087865 180932837 0.06780 59 45394 768382478 551746489 216635988 0.08120 1 14400 0 14400 1 90423 0 90423 1 105000 0 105000 1 14013 0 14013 1 100 238145 0 238145 0.00010 5 100 461981 0 461981 0.00010 true 71170791 493718 532781855 605350289 -72568434 X true true 2 1 CHRISTIANA HOSPITAL 4755 OGLETOWN-STANTON ROAD NEWARK DE 19718 www.christianacare.org LICENSE #HSPTL-002 X X X X X A 2 WILMINGTON HOSPITAL 501 WEST 14TH STREET WILMINGTON DE 19801 www.christianacare.org LICENSE #HSPTL-001 X X X X X A A-CHRISTIANA AND WILMINGTON HOSPITALS 12 false false true X X X X X X X X X 21 true true true true X SEE PART V, SECTION C X true 22 true SEE PART V, SECTION C false true X 400. 0. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X X true X false false PART V, SECTION B, LINE 5 (INPUT FROM COMMUNITY) CHRISTIANACARE WELCOMES THE TASK OF UNDERTAKING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AS IT ALLOWS US ANOTHER OPPORTUNITY TO LEARN FROM OUR NEIGHBORS. THIRTY-FIVE INDIVIDUALS WHO REPRESENTED DELAWARE HEALTH AND SOCIAL SERVICES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTHCARE PROVIDERS, AND SCHOOL SYSTEMS AS WELL AS LOCAL POLICYMAKERS PARTICIPATED IN FOUR VIRTUAL COMMUNITY STAKEHOLDER MEETINGS. AT EACH MEETING, DATA WERE PRESENTED INCLUDING A SUMMARY OF UNFAVORABLE COMMUNITY HEALTH INDICATORS. PARTICIPANTS WERE ASKED TO PROVIDE FEEDBACK ON THE SECONDARY DATA ANALYSIS AND IDENTIFY COMMUNITY HEALTH ISSUES THAT WERE MISSING FROM THE DATA. TO CONCLUDE, ALL PARTICIPANTS WERE ASKED TO COMPLETE AN ONLINE SURVEY AND TO IDENTIFY THREE TO FIVE COMMUNITY HEALTH ISSUES THEY CONSIDER TO BE MOST SIGNIFICANT. 110 STUDENTS AT WILLIAM PENN HIGH SCHOOL IN NEW CASTLE ALSO RECEIVED THE PRESENTATION OF SECONDARY DATA DURING THEIR HEALTH CLASSES AND EACH PARTICIPANT IDENTIFIED THREE TO FIVE HEALTH ISSUES THEY FELT TO BE THE MOST SIGNIFICANT. IN ADDITION TO THE COMMUNITY MEETINGS, INTERVIEWS WITH THE CABINET SECRETARY AND DEPUTY SECRETARY FOR DELAWARE HEALTH AND SOCIAL SERVICES AND THE DIRECTOR FOR THE DELAWARE DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH WERE CONDUCTED TO GAIN THEIR EXPERTISE ON THE HEALTH CHALLENGES OF OUR COMMUNITY. FINALLY, FORTY-FIVE CHRISTIANACARE CAREGIVERS FROM DIVERSE DEPARTMENTS PARTICIPATED IN TWO VIRTUAL MEETINGS. THEIR PERSPECTIVES FROM SERVING THE COMMUNITY ALSO PROVIDED INSIGHT INTO OUR COMMUNITY'S CHALLENGES AND SUCCESSES. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2022 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW, AND ANALYSIS, TO DEVELOP THE CHNA. -------------------- PART V, SECTION B, LINE 6 (JOINT CHNA) CHRISTIANACARE'S TWO HOSPITAL FACILITIES IN DELAWARE, CHRISTIANA HOSPITAL AND WILMINGTON HOSPITAL, JOINTLY CONDUCTED THEIR CHNA. -------------------- PART V, SECTION B, LINE 7 (CHNA PUBLIC AVAILABILITY) YES. CHRISTIANACARE'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-NEEDS-ASSESSMENT/ PAPER COPIES ARE ALSO AVAILABLE UPON REQUEST. -------------------- PART V, LINES 8 AND 9 YES. CHRISTIANACARE ADOPTED ITS COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) ON SEPTEMBER 19, 2022. -------------------- PART V, SECTION B, LINE 10 (IMP. PLAN PUBLIC AVAILABILITY) CHRISTIANACARE'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-IMPLEMENTATION-PLAN/ PAPER COPIES OF THE CHIP ARE ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. ---------------------------------------- PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA) IN CHRISTIANACARE'S 2022 CHNA, THE FOLLOWING WERE IDENTIFIED AS THE COMMUNITY'S MOST SIGNIFICANT NEEDS: . ACCESS TO HEALTH SERVICES . CHRONIC HEALTH CONDITIONS . MATERNAL AND CHILD HEALTH . MENTAL HEALTH AND SUBSTANCE USE DISORDERS . SOCIAL DRIVERS OF HEALTH . VIOLENT CRIME CHRISTIANACARE IS ADDRESSING ALL THESE SIGNIFICANT AREAS OF NEED. AS DESCRIBED PREVIOUSLY, 110 HIGH-SCHOOL AGED STUDENTS ALSO IDENTIFIED THE MOST SIGNIFICANT HEALTH NEEDS OF THEIR COMMUNITY. THE SIGNIFICANT AREAS OF NEED THE STUDENTS IDENTIFIED MIRRORED THE NEEDS SELECTED BY THE PARTICIPATING ADULTS, BUT WITH TWO ADDITIONAL SIGNIFICANT AREAS OF NEED IDENTIFIED BY MANY OF THE STUDENTS: SEXUALLY TRANSMITTED INFECTIONS AND SMOKING, TOBACCO, AND VAPE PRODUCT USE. CHRISTIANACARE ADDRESSES BOTH THESE AREAS IN OUR SCHOOL-BASED HEALTH CENTERS AND ALLIANCE FOR ADOLESCENT PREGNANCY PREVENTION (AAPP) PROGRAMMING. WHILE WE WILL NOT PRIORITIZE THE TWO ADDITIONAL TEEN-IDENTIFIED SIGNIFICANT AREAS OF NEED, WE WILL CONTINUE TO ADDRESS THEM THROUGH DIRECT INTERACTION WITH STUDENTS IN THE SCHOOL-BASED HEALTH CENTERS AND THROUGH AAPP PROGRAMMING. ACCESS TO HEALTH SERVICES: MOBILE HEALTH SERVICES IN JUNE 2022, CHRISTIANACARE INTRODUCED ITS TWO MOBILE HEALTH SERVICES VANS SUPPORTED BY A $1 MILLION INVESTMENT FROM BARCLAYS AS PART OF ITS COVID-19 COMMUNITY AID PACKAGE. CHRISTIANACARE USES THE VANS TO SERVE PATIENTS WHO NEED SAME DAY CARE AND THOSE WITHOUT A DOCTOR. WITHIN THE VANS, PATIENTS MAY RECEIVE ADULT CARE, WOMEN'S HEALTH, PEDIATRICS, VACCINES, AND MORE. RECEIVING CARE IS NOT A ONE-TIME EVENT, BUT THE START OF A PRIMARY AND SPECIALTY CARE RELATIONSHIP. CHRISTIANACARE HAS PARTNERED WITH COMMUNITY ORGANIZATIONS TO LOCATE THE VANS WHERE THEY ARE NEEDED AND ENCOURAGE COMMUNITY MEMBERS TO TAKE ADVANTAGE OF THE SERVICES OFFERED ON THE VANS. INFY2024, WE EXPANDED TO OFFERING MOBILE HEALTH SERVICES AT 7 ACCESS POINTS LOCATED AT THE FOLLOWING ORGANIZATIONS IN WILMINGTON: EZION FAIR BAPTIST CHURCH, CHRISTIAN GROWTH MINISTRY, EMPOWERMENT CENTER, AND KINGSWOOD COMMUNITY CENTER, AS WELL AS ROSE HILL COMMUNITY CENTER IN NEW CASTLE AND THE CLAYMONT COMMUNITY CENTER IN CLAYMONT. EACH OF THOSE ORGANIZATIONS ARE LOCATED WITHIN COMMUNITIES WITH SIGNIFICANT NEEDS. ADDITIONALLY, THE VAN IS ALSO LOCATED EACH WEEK ACROSS FROM CHRISTIANACARE'S WILMINGTON HOSPITAL CAMPUS. ONCE A MONTH, ONE OF THE VANS IS ALSO LOCATED AT AREAS OF NEED DOWNSTATE AT THE MODERN MATURITY CENTER AND FRIENDSHIP HOUSE OF KENT COUNTY IN DOVER AND THE MARKET STREET PARK IN LAUREL. IN FY2024, THERE WERE 364 PATIENTS VISITS ON THE VANS, INCLUDING 78 NEW PATIENTS. THIS WAS MORE THAN DOUBLE THE NUMBER OF PATIENT VISITS ON THE VANS IN FY2023. SCHOOL BASED HEALTH CENTERS CHRISTIANACARE ALSO OPERATES 26 SCHOOL-BASED HEALTH CENTERS (SBHCS) THROUGHOUT NEW CASTLE COUNTY IN ELEMENTARY, MIDDLE, AND HIGH SCHOOLS. IN FY2024, CHRISTIANACARE BEGAN OPERATING AN ADDITIONAL THREE SBHCS. THE CONVENIENCE PROVIDED BY SBHCS ALONG WITH THE OPPORTUNITY TO ADDRESS HEALTH ISSUES AT THE EARLIEST AND MOST PREVENTABLE STAGES NOT ONLY SUPPORTS ACCESS TO CARE, BUT ALSO HEALTH EQUITY. IN FY2024, OUR SBHCS HAD 27,509 STUDENT VISITS. DENTAL SERVICES ACCESSING DENTAL SERVICES IS CHALLENGING FOR MANY COMMUNITY MEMBERS IN NEW CASTLE COUNTY AND THE STATE. FOR DECADES, CHRISTIANACARE'S DENTAL CLINIC HAS PROVIDED COMPREHENSIVE CARE, INCLUDING ORAL SURGERY, RESTORATIVE DENTISTRY, ENDODONTICS, PERIODONTICS, PEDIATRIC DENTISTRY, PROSTHETICS, IMPLANTS, AND ORAL MEDICINE FOR THE UNINSURED AND UNDERINSURED INDIVIDUALS. CHRISTIANACARE IS A REGIONAL REFERRAL CENTER FOR DELAWARE AND SURROUNDING STATES, AS WELL AS A MAJOR PROVIDER OF PRIMARY MEDICAL AND DENTAL CARE. IN ADDITION TO THE GENERAL PRACTICE DENTISTRY RESIDENCY, THE DEPARTMENT ALSO OFFERS A FULLY ACCREDITED ORAL AND MAXILLOFACIAL SURGERY RESIDENCY PROGRAM. EVERY FRIDAY, THE DENTAL CLINIC SERVES UNINSURED AND MEDICAID PEDIATRIC PATIENTS. FEES AT THE CLINIC ARE KEPT AT A REDUCED LEVEL AND ONLY MEDICAID IS ACCEPTED. PATIENTS ARE SEEN AT THIS CLINIC BY DENTAL RESIDENTS AND VOLUNTEER AND EMPLOYED DOCTORS. THE RESIDENTS SERVING THE DENTAL CLINIC ALSO PROVIDE DENTAL SERVICE IN THE COMMUNITY THROUGH ROTATIONS AT AFFILIATED DENTAL CLINICS AT WESTSIDE FAMILY HEALTHCARE, A FEDERALLY QUALIFIED HEALTH CENTER, AND DELAWARE TECHNICAL COMMUNITY COLLEGE. IN FY2024, THERE WERE 12558 VISITS TO THE DENTAL CLINIC AND ORAL SURGERY RESIDENT CLINIC. FURTHER, THE DENTAL CLINIC HAS BEEN FOCUSED ON INTERNAL IMPROVEMENTS TO INCREASE ACCESS AND BETTER SERVE THE COMMUNITY BY ADDING POSITIONS TO SUPPORT CLINIC GROWTH, IMPROVING SCHEDULING TO OPTIMIZE CASE MIX AND APPOINTMENT AVAILABILITY, AND COMMITTING TO SEEING TRAUMA PATIENTS WITHIN SEVEN DAYS. PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.) NEW CASTLE COUNTY HOPE CENTER SINCE 2021, CHRISTIANACARE HAS OPERATED AN ON-SITE PRIMARY CARE OFFICE AT THE NEW CASTLE COUNTY HOPE CENTER, A FORMER HOTEL REPURPOSED TO SERVE AS AN EMERGENCY SHELTER FOR FAMILIES AND INDIVIDUALS EXPERIENCING HOMELESSNESS. SERVICES INCLUDE ACUTE ILLNESS MANAGEMENT, CHRONIC DISEASE MANAGEMENT, PRENATAL CARE, PEDIATRIC AND NEWBORN CARE, AND CONTRACEPTIVE MANAGEMENT. SINCE 2023, CHRISTIANACARE HAS ALSO OPERATED A MEDICAL RESPITE PROGRAM ENCOMPASSING THIRTY-SIX ROOMS AT THE HOPE CENTER FOR PATIENTS WHOSE COMPLEX ILLNESSES MAKE THEM INELIGIBLE FOR RESIDING AT A STANDARD HOUSING SHELTER. THIS PROGRAM ALLOWS PATIENTS WITHOUT STABLE HOUSING TO RECEIVE CARE IN THE COMMUNITY INSTEAD OF REMAINING IN OUR HOSPITAL DUE TO THE LACK OF COMMUNITY OPTIONS FOR THEM. IN FY2024, FORTY-ONE PATIENTS WERE SERVED BY THIS PROGRAM. HEALTH GUIDES HEALTH GUIDES INCREASE ACCESS TO CARE BY CONNECTING PATIENTS TO HEALTH CARE SERVICES AND COMMUNITY RESOURCES AND ASSISTING IN HEALTH INSURANCE AND PRESCRIPTION ASSISTANCE ENROLLMENT AND FINANCIAL ASSISTANCE APPLICATIONS. THE HEALTH GUIDES ARE BASED IN THE WILMINGTON HOSPITAL AND AT TWO CHRISTIANACARE PRIMARY CARE PRACTICES. THE HEALTH GUIDES SERVING THE TWO PRACTICES ARE BI-LINGUAL TO BETTER SERVE THE NEEDS OF THOSE PATIENT POPULATIONS. THE HEALTH GUIDES ALSO ROUTINELY ATTEND COMMUNITY EVENTS TO PROVIDE THEIR SERVICES IN THE COMMUNITY. IN FY2024, THE HEALTH GUIDES HAD 4,273 PATIENT ENCOUNTERS AND ASSISTED PATIENTS IN APPLYING FOR A TOTAL OF $2,007,218 IN FINANCIAL ASSISTANCE. COMMUNITY HEALTH WORKERS (CHWS) CHWS CONNECT PATIENTS TO CARE, THEY WORK TO ADDRESS PATIENTS' SOCIAL NEEDS, AND THEY HELP PATIENTS IDENTIFY AND ACHIEVE PATIENT CENTERED GOALS. ADDITIONALLY, CHRISTIANACARE'S CHWS ATTEND COMMUNITY EVENTS TO PROVIDE INFORMATION ABOUT OUR PROGRAMS, COMPLETE SOCIAL DETERMINANTS OF HEALTH SCREENING, AND PROVIDE REFERRALS TO RESOURCES IN THE COMMUNITY. CHWS ARE VALUABLE MEMBERS OF A PATIENT'S CARE TEAM BECAUSE OUR CAREGIVERS RECOGNIZE THE OUTSIZED ROLE A PATIENT'S SOCIAL NEEDS HAS ON THEIR HEALTH. CHRISTIANACARE UTILIZES CHWS TO ADDRESS EACH OF OUR PRIORITIZED AREAS OF NEED AS WILL BE EXPLAINED IN FURTHER DETAIL IN THE RELEVANT SECTIONS. CHRISTIANACARE HAS EMBEDDED CHWS WITHIN THE NEW CASTLE COUNTY HOPE CENTER AND CHRISTIANACARE SBHCS. THE HOPE CENTER CHW WORKS WITH THE PATIENTS IN THE MEDICAL RESPITE BED PROGRAM (41 PATIENTS IN FY2024) TO CLOSE CARE GAPS AND ADDRESS THE SOCIAL DRIVERS OF HEALTH THAT ARE IMPACTING THOSE PATIENTS' HEALTH AND WELL-BEING. CHRISTIANACARE HAS ALSO EMBEDDED CHWS IN 22 OF OUR SBHC TO SERVE STUDENTS AND THEIR FAMILIES BY CONNECTING THEM TO MEDICAL SERVICES AND COMMUNITY RESOURCES. IN FY2024, 670 STUDENTS WERE ASSISTED BY THE SBHC CHWS. IN FY2024, A SBHC CHW WORKED WITH A HIGH-SCHOOL STUDENT WHO RELOCATED TO DELAWARE FROM ANOTHER COUNTRY. THE CHW CONNECTED THAT STUDENT TO A PRIMARY CARE PROVIDER, EYE CARE, AND MEDICAID. THE STUDENT WAS ALSO INTERESTED IN LEARNING MORE ABOUT COLLEGE AND GETTING A SUMMER JOB. THE CHW PROVIDED THE STUDENT WITH COLLEGE RESOURCES AND INFORMATION AND SHARED A JOB OPPORTUNITY SHE THOUGHT MIGHT BE OF INTEREST TO THE STUDENT. THE STUDENT SUCCESSFULLY APPLIED FOR THE JOB AND WAS THRILLED TO GET IT. WHILE EVERY STUDENT HAS UNIQUE NEEDS, THIS IS AN EXAMPLE OF HOW OUR CHWS PROVIDE COMPREHENSIVE SUPPORT TO HELP INDIVIDUALS MEET ANY GOAL THEY HAVE REGARDLESS OF WHETHER IT IS DIRECTLY RELATED TO HEALTH. CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER DEPLOYS A TEAM OF CHWS TO PROVIDE EDUCATION IN THE COMMUNITY ON CANCER SCREENING AND PREVENTION. THESE CHWS ARE FOCUSED ON PROVIDING EDUCATION IN A CULTURALLY APPROPRIATE WAY AND ENSURING THAT INDIVIDUALS ARE CONNECTED TO AND RECEIVE SCREENING THROUGH RESOURCES LIKE SCREENING FOR LIFE, A STATE SPONSORED PROGRAM WHICH HELPS ELIGIBLE ADULTS PAY FOR CANCER SCREENINGS. IN FY2024, THESE CHWS PROVIDED INFORMATION AND EDUCATION TO OVER 9,000 INDIVIDUALS AT APPROXIMATELY 140 COMMUNITY EVENTS. PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.) CHRONIC HEALTH CONDITIONS: FOOD INSECURITY PROGRAMS FOOD INSECURITY IS ASSOCIATED WITH WORSENING CHRONIC DISEASE OUTCOMES AND DIFFICULTIES ADHERING TO A HEALTHY DIET. TO ADDRESS FOOD INSECURITY AND ITS IMPACT ON CHRONIC DISEASE, CHRISTIANACARE LAUNCHED THE DELAWARE FOOD FARMACY (DFF), A 6-MONTH FOOD AS MEDICINE CHW PROGRAM IN PRIMARY CARE FOR PATIENTS WITH CHRONIC CONDITIONS AND FOOD INSECURITY. PATIENTS RECEIVE WEEKLY MEDICALLY TAILORED GROCERIES, AND CHWS ASSIST PATIENTS WITH GOAL SETTING AND IMPROVING DIETARY KNOWLEDGE AND CULINARY SKILLS. IN FY2024, CHRISTIANACARE ENROLLED 87 PARTICIPANTS IN THE PROGRAM, AND PROVIDED FOOD FOR 224 COMMUNITY MEMBERS AS THE ENTIRE HOUSEHOLDS OF THE PARTICIPANTS ARE PROVIDED FOOD. 63% OF THE PARTICIPANTS LIVE IN THE ZIP CODES WE DEFINED AS HIGH RISK IN OUR 2022 CHNA. IN JANUARY 2024, CHRISTIANACARE EXPANDED THE DFF INTO WOMEN'S HEALTH. THIS PROGRAM WILL BE DISCUSSED IN MORE DETAIL IN THE MATERNAL AND CHILD HEALTH SECTION. CHRISTIANACARE ALSO CREATED THE HEALTHY FOOD DELIVERY PROGRAM AS AN INTERVENTION FOR PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND ARE DIAGNOSED WITH DIABETES, HYPERTENSION, AND/OR CONGESTIVE HEART FAILURE. BI-WEEKLY MEDICALLY TAILORED GROCERIES ARE DELIVERED TO PATIENTS' HOMES BY PARTNERING ORGANIZATION HUNGRY HARVEST. IN FY2024, CHRISTIANACARE ENROLLED 24 PARTICIPANTS AND SERVED 56 COMMUNITY MEMBERS. 67% OF THE PARTICIPANTS LIVE IN THE HIGH-RISK ZIP CODES DEFINED BY OUR 2022 CHNA. IN FY2024, A PATIENT IN HER EARLY 70S AND SUFFERING FROM MULTIPLE CHRONIC CONDITIONS ENROLLED IN CHRISTIANACARE'S PRIMARY CARE DFF. SINCE HER PARTICIPATION IN THE PROGRAM, SHE HAS BEEN EATING HEALTHY FOODS MORE OFTEN AND USING THE DFF RECIPES PROVIDED BY HER CHW. SHE FEELS GOOD ABOUT HOW SHE HAS CHANGED HER DIET AND HAS BECOME MORE CONFIDENT. PRIMARY CARE AND WOMEN'S HEALTH CHW PROGRAMS CHRISTIANACARE CREATED ITS PRIMARY CARE CHW PROGRAM TO SERVE PATIENTS OF CHRISTIANACARE'S PRIMARY PRACTICES WHO HAVE MEDICAID, MEDICARE, OR ARE UNINSURED WITH DIABETES, HYPERTENSION, AND HIGH EMERGENCY DEPARTMENT UTILIZATION OR AT LEAST ONE INPATIENT STAY. THIS SIX-MONTH PROGRAM UTILIZES AN EVIDENCE-BASED APPROACH TO IMPROVE HEALTH OUTCOMES AND INCREASE HEALTH LITERACY. IN FY2024, CHRISTIANACARE ENROLLED 266 PATIENTS IN THIS PROGRAM. CHRISTIANACARE CREATED THE WOMEN'S HEALTH CHW PROGRAM TO TRANSFORM MATERNAL AND INFANT HEALTHCARE WITH A COMMITTED INVESTMENT TO ADDRESS THE SOCIAL DRIVERS OF HEALTH. PREGNANT AND POSTPARTUM PATIENTS WITH MEDICAID OR NO INSURANCE AND A CHRONIC DISEASE, MENTAL HEALTH AND/OR SUBSTANCE USE ISSUE(S), LATE/NO ENTRY TO PRENATAL CARE, HISTORY OF POOR BIRTH OUTCOMES, A BMI AT/ABOVE 30, AND/OR ARE AT-RISK FOR BIRTH DEFECTS ARE ELIGIBLE. IN FY2024, OUR CHWS WORKED WITH 121 PATIENTS WHO GRADUATED FROM THE PROGRAM. THE WOMEN'S HEALTH CHWS HELPED CONNECT THESE PATIENTS TO WIC AND OTHER STATE BENEFITS SUCH AS PURCHASE OF CARE, PROVIDED REFERRALS TO DIAPER BANKS, ASSISTED WITH TRANSPORTATION TO AND FROM MEDICAL APPOINTMENTS, AND HELPED PATIENTS ENGAGE IN WORKFORCE DEVELOPMENT PROGRAMS. WOMEN'S HEALTH CHW PROGRAM: MATERNAL AND CHILD HEALTH DELAWARE'S INFANT MORTALITY RATE HAS IMPROVED CONSIDERABLY IN THE LAST DECADE, BUT UNFORTUNATELY, RACIAL DISPARITIES IN MATERNAL AND INFANT MORTALITY PERSIST. CHRISTIANACARE CONTINUES TO UNDERTAKE AND LEAD TARGETED EFFORTS TO IMPROVE THESE DISPARATE OUTCOMES IN BOTH CLINICAL AND COMMUNITY SETTINGS. WE RECOGNIZE THAT REDUCING MATERNAL AND INFANT MORTALITY RATES, AND THE DISPARITIES WITHIN THOSE RATES, IS ONLY POSSIBLE WITH A COMPREHENSIVE APPROACH THAT CONSIDERS ALL THE NEEDS OF THE INDIVIDUAL. THIS IS WHY MANY OF OUR PROGRAMS FOCUSED ON MATERNAL AND CHILD HEALTH ADDRESS SOCIAL DRIVERS OF HEALTH. IT IS ALSO WHY CHRISTIANACARE UTILIZES DIGITAL TOOLS TO PROVIDE EXPECTANT PARENTS WITH INFORMATION ABOUT HEALTHY PREGNANCIES AND PROVIDES VIRTUAL CARE OPTIONS TO ENSURE INFORMATION, RESOURCES, AND CARE ARE ACCESSIBLE TO ALL PATIENTS. WE KNOW NOT EVERYONE CAN TAKE OFF WORK OR FIND TRANSPORTATION TO AN APPOINTMENT. AS DESCRIBED PREVIOUSLY, CHRISTIANACARE CREATED THE WOMEN'S HEALTH CHW PROGRAM TO TRANSFORM MATERNAL AND INFANT HEALTHCARE. WOMEN'S HEALTH CHWS ARE EMBEDDED THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH SERVICES INCLUDING INPATIENT, OUTPATIENT, OBSTETRICS (OB) TRIAGE, AND THE NEONATAL INTENSIVE CARE UNIT (NICU). THESE CHWS PARTNER WITH PATIENTS TO PROVIDE CONNECTION TO NEEDED SOCIAL AND HEALTH RESOURCES TO ULTIMATELY IMPROVE HEALTH. HEALTHY BEGINNINGS AND HOME VISITING CHW PROGRAMS IN PARTNERSHIP WITH THE DELAWARE DIVISION OF PUBLIC HEALTH, CHRISTIANACARE HAS OFFERED BOTH THE HOME VISITING CHW (FORMERLY HEALTH AMBASSADORS) AND HEALTHY WOMEN HEALTHY BABY (HWHB) PROGRAMS FOR MORE THAN A DECADE. BOTH PROGRAMS WERE CREATED TO ADDRESS DELAWARE'S HIGH INFANT MORTALITY RATE. THE HOME VISITING CHW PROGRAM SERVES PREGNANT WOMEN AND FAMILIES WITH CHILDREN AGED 0 TO 5 IN TARGETED HIGH-RISK ZIP CODES TO CONNECT WOMEN AND YOUNG FAMILIES TO HEALTH CARE, SOCIAL SERVICES, HOME VISITING, AND EDUCATIONAL PROGRAMS. THEY ALSO PROMOTE KEY MATERNAL AND CHILD HEALTH MESSAGES INCLUDING THE BENEFITS OF BREASTFEEDING AND THE IMPORTANCE OF SAFE SLEEP. THE HWHB ENROLLS HIGH RISK WOMEN INTO PRECONCEPTION, PRENATAL, AND INTERCONCEPTION CARE. THIS PROGRAM HAS IMPACTED BIRTH OUTCOMES. HWHB ENROLLED INDIVIDUALS WERE 10% LESS LIKELY TO SMOKE DURING PREGNANCY; WERE 9% LESS LIKELY TO DELIVER A LOW-BIRTH-WEIGHT INFANT; AND WERE 15% LESS LIKELY TO DELIVER A PRETERM INFANT AS COMPARED TO WOMEN WITH SIMILAR RISKS FACTORS NOT ENROLLED WITH HWHB PROGRAMS. THE CURRENT STATE FUNDED PROGRAM, HWHB 3.0 HAS A STRONG EMPHASIS ON THE FOURTH TRIMESTER, THE 12-WEEK PERIOD AFTER THE BIRTH OF A BABY. THE CHRISTIANACARE HWHB HEALTHY BEGINNINGS TEAM IS ADDRESSING THIS CRITICAL AREA OF WOMEN'S HEALTHCARE WITH THE ADDITION OF A BILINGUAL POSTPARTUM HEALTH EDUCATOR. IN FY2024, THE HOME VISITING CHWS SERVED 134 INDIVIDUALS BY PROVIDING THEM WITH A VARIETY OF ESSENTIAL ITEMS NEEDED FOR INFANTS AND CHILDREN SUCH AS CLOTHING, DIAPERS, CAR SEATS, STROLLERS, PACK & PLAYS, AND FORMULA AS WELL AS NEEDED RESOURCES LIKE FOOD AND BUS PASSES AND REFERRALS TO HOME VISITING PROGRAMS. IN FY2024, HEALTHY BEGINNINGS ENROLLED 1,989 PATIENTS. OF THOSE PATIENTS, 59.7% WERE AFRICAN AMERICAN AND 61.3% LIVED IN A HIGH-RISK ZONE (19702, 19703, 19720, 19801, 19802, 19804, 19805, 19809, 19901, 19904, 19933, 19950, 19973). IN FY2024, THE HOME VISITING CHWS HELPED A TEENAGED MOTHER GET ESSENTIAL BABY ITEMS AND ENROLL IN THE NURSE FAMILY PARTNERSHIP, A COMMUNITY HEALTH ORGANIZATION WHICH PARTNERS THE FIRST-TIME MOTHER WITH A SPECIALLY TRAINED NURSE WHO MAKES HOME VISITS BEGINNING IN THE PREGNANCY AND THROUGH THE CHILD'S SECOND BIRTHDAY. THE MOTHER OF THE NEW TEENAGED MOTHER WAS WITHOUT A JOB AS WELL AND SO THE ENTIRE FAMILY WAS APPRECIATIVE OF THE SUPPORT. PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.) WOMEN'S HEALTH DELAWARE FOOD FARMACY IN JANUARY 2024, CHRISTIANACARE EXPANDED ITS DELAWARE FOOD FARMACY (DFF) PROGRAM INTO WOMEN'S HEALTH. THIS 6-TO-8-MONTH FOOD IS MEDICINE PROGRAM IS INTENDED TO IMPROVE HEALTH OUTCOMES AND REDUCE HOSPITAL UTILIZATION, AND TO ALLEVIATE FOOD INSECURITY AND IMPROVE DIETARY BEHAVIORS. LIKE THE PRIMARY CARE DFF, THE WOMEN'S HEALTH DFF PARTNERS WITH COMMUNITY ORGANIZATION, LUTHERAN COMMUNITY SERVICES, TO PROVIDE OUR PREGNANT PATIENTS AND THEIR FAMILY MEMBERS WITH APPROXIMATELY 22-42 WEEKS (DEPENDING ON GESTATIONAL AGE AT PROGRAM ENROLLMENT AND PREGNANCY LENGTH) OF MEDICALLY TAILORED GROCERIES THAT ARE HIGH IN MICRONUTRIENTS CRITICAL FOR A HEALTHY PREGNANCY. CHWS GUIDE PATIENTS AND THEIR FAMILIES THROUGH THE HEALTH, SOCIAL, AND COMMUNITY SERVICES SYSTEMS TO FOSTER HEALTH AND WELL-BEING. PATIENTS IN THE PROGRAM ALSO RECEIVE CULINARY EQUIPMENT AND TRAINING, EDUCATIONAL NUTRITION VIDEOS, AND RECIPES, AND CHWS WILL PROVIDE NUTRITION ASSESSMENT, EDUCATION, AND ONGOING SUPPORT FOR DIETARY BEHAVIOR CHANGES AND ACHIEVING GOALS FOR A HEALTHIER PREGNANCY. IN FY2024, CHRISTIANACARE ENROLLED 60 PARTICIPANTS AND 203 COMMUNITY MEMBERS WERE SERVED. 54% OF THE PARTICIPANTS LIVE IN HIGH-RISK ZIP CODES AS IDENTIFIED BY OUR 2022 CHNA. A TOTAL OF 27,620 MEALS WERE PROVIDED TO THESE PARTICIPANTS AND THEIR FAMILIES IN FY2024. OF THE PROGRAM, ONE PARTICIPANT SAID "I LOVE THIS PROGRAM. I FEEL LIKE IT HAS CHANGED EVERYTHING IN MY LIFE. IT TAUGHT ME HOW TO COOK HEALTHIER FOR MY PREGNANCY THAT WILL FOREVER STICK TO ME." PARTICIPATION IN STATE COALITIONS FOCUSED ON MATERNAL AND INFANT MORTALITY CHRISTIANACARE CAREGIVERS LEAD AND PARTICIPATE IN STATEWIDE COLLABORATIVE EFFORTS TO ADDRESS THE SYSTEMIC ISSUE OF MATERNAL AND INFANT MORTALITY. IN 2023, CHRISTIANACARE PEDIATRICIAN, PRISCILLA MPASI, WAS APPOINTED CHAIR OF THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM (DHMIC) BY THE GOVERNOR. THE MISSION OF DHMIC IS TO PROVIDE STATEWIDE LEADERSHIP AND COORDINATION OF EFFORTS TO REDUCE INFANT MORTALITY, DECREASE PRETERM BIRTH, DECREASE THE MATERNAL MORTALITY RATE, AND DECREASE DISPARITY RATES. CHRISTIANACARE CAREGIVERS ALSO SERVE ON DELAWARE'S MATERNAL MORTALITY REVIEW PANEL AND THE FETAL & INFANT MORTALITY REVIEW (FIMR). BOTH PANELS SERVE TO EXAMINE INDIVIDUAL DEATHS TO CONSIDER THE PUBLIC HEALTH AND CLINICAL INTERVENTIONS AS WELL AS SYSTEMIC CHANGE THAT COULD REDUCE THE NUMBER OF DEATHS. ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION FINALLY, SINCE 1995, THE STATE OF DELAWARE HAS ALSO PROVIDED CHRISTIANACARE WITH A GRANT TO OPERATE THE ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION (AAPP). AAPP PROVIDES DELAWARE YOUTH WITH SKILLS AND INFORMATION TO HELP AVOID OR REDUCE INVOLVEMENT IN HIGH-RISK BEHAVIORS, PARTICULARLY HIGH-RISK SEXUAL BEHAVIORS, AND TO PROMOTE POSITIVE YOUTH DEVELOPMENT. IN FY24, CHRISTIANACARE CAREGIVERS EDUCATED 1,268 YOUTH FROM THIRTY SCHOOLS THROUGHOUT DELAWARE. OF THE YOUTH EDUCATED, MORE THAN 65% WERE FROM HIGH-RISK AREAS AS IDENTIFIED BY OUR 2022 CHNA. CHRISTIANACARE'S AAPP TEAM WAS ALSO ABLE TO PURCHASE AND DISTRIBUTE HYGIENE PRODUCTS TO ALL STUDENTS. MENTAL HEALTH AND SUBSTANCE USE DISORDERS: MENTAL HEALTH AND SUBSTANCE USE DISORDERS HAVE BEEN IDENTIFIED AS A SIGNIFICANT AREA OF NEED BY OUR COMMUNITY IN EVERY CHNA CHRISTIANACARE HAS COMPLETED. OVER THE PAST SEVERAL YEARS, CHRISTIANACARE HAS UNDERTAKEN A VARIETY OF INITIATIVES TO RESPOND TO THAT NEED BY EXPANDING ACCESS TO BEHAVIORAL HEALTH SERVICES IN CLINICAL AND COMMUNITY SETTINGS INCLUDING EMBEDDED BEHAVIORAL HEALTH CARE MODELS. BEHAVIORAL HEALTH CHW PROGRAM CHRISTIANACARE CREATED THE BEHAVIORAL HEALTH CHW PROGRAM TO SERVE ADULTS AND CHILDREN AND ADOLESCENTS PARTICIPATING IN OUTPATIENT BEHAVIORAL HEALTH SERVICES AND PROJECT RECOVERY, AN OUTPATIENT PROGRAM OFFERING TREATMENT FOR SUBSTANCE USE DISORDER. PATIENTS WHO ARE ENGAGED WITH THOSE PRACTICES, RESIDING IN NEW CASTLE COUNTY, AND HAVE DISCUSSED AT LEAST ONE SOCIAL CARE OR COMMUNITY ENGAGEMENT GOAL ARE ELIGIBLE TO PARTICIPATE IN THE PROGRAM. IN FY2024, 118 PATIENTS PARTICIPATED IN THIS PROGRAM INCLUDING 39 FAMILIES OF YOUTH RECEIVING OUTPATIENT BEHAVIORAL HEALTH SERVICES. PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.) PROJECT ENGAGE CHRISTIANACARE'S PROJECT ENGAGE IS AN EARLY INTERVENTION AND REFERRAL TO SUBSTANCE USE DISORDER TREATMENT PROGRAM. PROJECT ENGAGE EMPLOYS PEERS IN RECOVERY TO ENGAGE WITH INPATIENTS AND PATIENTS IN THE EMERGENCY DEPARTMENT WHO ARE STRUGGLING WITH SUBSTANCE USE DISORDER. THE PEERS USE MOTIVATIONAL INTERVIEWING TO EMPOWER EACH PATIENT IN THE DECISION-MAKING PROCESS, ASSISTING THEM TO TAKE THE CRITICAL FIRST STEP TO SEEK HELP FOR THE SUBSTANCE USE DISORDER. PEERS CONNECT THESE PATIENTS TO TREATMENT PROGRAMS AND OTHER COMMUNITY RESOURCES. IN FY24, PROJECT ENGAGE PEERS HAD A TOTAL OF 2,940 ENGAGEMENTS WITH PATIENTS AND MADE 1,781 REFERRALS TO TREATMENT. POLICE DEPARTMENT PARTNERSHIPS SINCE 2021, CHRISTIANACARE'S CENTER FOR COMMUNITY HEALTH AND EMPOWERMENT HAS PARTNERED WITH THE NEW CASTLE COUNTY POLICE DEPARTMENT (NCCPD) TO DIVERT INDIVIDUALS AWAY FROM THE CRIMINAL JUSTICE SYSTEM AND EMERGENCY DEPARTMENTS WHEN APPROPRIATE AND CONNECT INDIVIDUALS TO CARE IN THE COMMUNITY. SERVING WITH THE POLICE IN A CO-RESPONDER MODEL, CHRISTIANACARE MENTAL HEALTH PROFESSIONALS RESPOND TO 911 CALLS AND OFFICER REFERRALS WHEN MENTAL ILLNESS IS BELIEVED TO BE A PRIMARY FACTOR FOR POLICE INVOLVEMENT. ADDITIONAL CHRISTIANACARE CAREGIVERS SUPPORT THE NCCPD'S HERO HELP PROGRAM WHICH ADDRESSES SUBSTANCE USE DISORDER BY SUPPORTING THOSE SEEKING TREATMENT. THESE CAREGIVERS RESPOND TO NON-FATAL OVERDOSES, PROVIDE OUTREACH IN THE COMMUNITY, WORK WITH INDIVIDUALS TO DEVISE A TREATMENT PLAN, OBTAIN TREATMENT, PROVIDE ONGOING MANAGEMENT, AND ADDRESS ANY NEEDS INDIVIDUALS MAY HAVE THAT SERVE AS BARRIERS TO OBTAINING TREATMENT. IN MARCH 2024, CHRISTIANACARE LAUNCHED A NEW POLICE PARTNERSHIP WITH THE WILMINGTON POLICE DEPARTMENT, THE WILMINGTON PARTNERS IN CARE PROGRAM. LIKE THE NCCPD PARTNERSHIP, THIS PROGRAM UTILIZES A CO-RESPONDER MODEL WHICH PAIRS TRAINED MENTAL HEALTH CLINICIANS WITH POLICE OFFICERS WHO RESPOND AS A TEAM TO CALLS FOR SERVICE AND CONDUCT PROACTIVE OUTREACH. IN DECEMBER 2024, CHRISTIANACARE ALSO BEGAN A NEW PARTNERSHIP WITH THE NEWARK POLICE DEPARTMENT. THESE PARTNERSHIPS PROVIDE INTERVENTIONS FOR COMMUNITY MEMBERS WHO MAY NOT HAVE ACCESS TO THE BEHAVIORAL HEALTH SERVICES THEY NEED. IT ALSO PROVIDES MUCH NEEDED SUPPORT TO THE POLICE WHO ARE ROUTINELY CONFRONTED WITH BEHAVIORAL HEALTH NEEDS OF COMMUNITY MEMBERS. COMMUNITY SUBSTANCE OVERDOSE SUPPORT (SOS) CHRISTIANACARE'S COMMUNITY SUBSTANCE OVERDOSE SUPPORT (SOS), CREATED IN PARTNERSHIP WITH NEW CASTLE COUNTY, PROVIDES OUTREACH TO INDIVIDUALS WITH SUBSTANCE USE DISORDER (SUD) LIVING IN NEW CASTLE COUNTY. SOS ACCEPTS SELF-REFERRALS, INTERNAL REFERRALS FOR CHRISTIANACARE PATIENTS, AND NEW CASTLE COUNTY EMS REFERRALS OF INDIVIDUALS THEY HAVE REVIVED WITH NALOXONE, THE OPIOID OVERDOSE REVERSING MEDICATION, AND TAKEN TO ONE OF CHRISTIANACARE'S EMERGENCY DEPARTMENTS. SOS GOES TO INDIVIDUALS' HOMES OR OTHER COMMUNITY LOCATIONS AND USES MOTIVATIONAL INTERVIEWING TECHNIQUES TO ENCOURAGE THE INDIVIDUAL TO ENTER SUBSTANCE USE DISORDER TREATMENT. THE SOS TEAM WILL HELP THE PATIENT ADDRESS ANY BARRIERS TO TREATMENT AND ASSIST THEM WITH ENROLLING IN TREATMENT. IN FY24, THE SOS TEAM SUCCESSFULLY CONTACTED 482 INDIVIDUALS TO OFFER ASSISTANCE IN ENROLLING IN TREATMENT AND ADDRESSING ANY OTHER NEEDS. OF THOSE INDIVIDUALS, 70 AGREED TO TREATMENT, A SUCCESS RATE OF 14.52%. THE SOS TEAM ALSO DISTRIBUTED 20 NARCAN KITS THROUGHOUT THE YEAR. WHILE CONDUCTING COMMUNITY OUTREACH ONE DAY DURING FY2024, THE SOS TEAM ENCOUNTERED AN INDIVIDUAL ON THE STREET WHO WAS EXPERIENCING AN OVERDOSE. THE SOS TEAM SUCCESSFULLY ADMINISTERED NARCAN AND THE EFFECTS OF THE OVERDOSE WERE REVERSED. FINALLY, IN 2024, CHRISTIANACARE'S FAMILY MEDICAL RESIDENCY PROGRAM RECEIVED THE WELLNESS HERO AWARD IN THE 2024 LT. GOVERNOR'S WELLNESS LEADERSHIP CHALLENGE. THE AWARD WAS A RECOGNITION OF THE COMPREHENSIVE PROGRAM CHRISTIANACARE DESIGNED TO ADDRESS THE PRESSING NEED FOR BEHAVIORAL HEALTH SERVICES IN DELAWARE. CHRISTIANACARE'S FAMILY MEDICINE RESIDENCY ESTABLISHED THE SUBSTANCE USE DISORDER TREATMENT PROGRAM IN 2020 TO IDENTIFY AND PROVIDE TARGETED SUBSTANCE ABUSE TREATMENT TO PATIENTS AND TO TRAIN FUTURE PROVIDERS IN THE SPECIFIC AND UNIQUE ISSUES THAT PATIENTS WITH ADDICTION OFTEN FACE IN PRIMARY CARE SETTINGS. PATIENTS IDENTIFIED FOR THE PROGRAM THROUGH CHRISTIANACARE HOSPITALS AND EMERGENCY DEPARTMENTS ARE CONNECTED WITH THE FAMILY MEDICINE DEPARTMENT TO ENCOURAGE THEIR ENROLLMENT INTO PRIMARY CARE. THE PROGRAM ALSO PROVIDES VITAL SOCIAL SUPPORT FOR THESE PATIENTS. THIS PROGRAM HAS LED TO MULTIPLE PATIENTS' CHRONIC MEDICAL CONDITIONS BEING STABILIZED, THE IDENTIFICATION AND TREATMENT OF A PATIENT WITH BLADDER CANCER, AND THE CURE OF 26 CASES OF HEPATITIS C. PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.) VIOLENCE: HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP) IN RECOGNITION OF VIOLENCE AS A PUBLIC HEALTH ISSUE, CHRISTIANACARE LAUNCHED A HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP) IN FEBRUARY 2021 TO SUPPORT PATIENTS IMPACTED BY COMMUNITY VIOLENCE POST-DISCHARGE TO REDUCE RECIDIVISM OF NEW AND RECURRING INJURIES. THE HVIP EMPLOYS CHWS WHO ACTIVELY FOLLOW PATIENTS AND ASSIST IN A MAGNITUDE OF SERVICES POST-DISCHARGE INCLUDING FOLLOW-UP CARE, CONNECTION TO COMMUNITY RESOURCES, ADDRESSING SOCIAL CARE NEEDS, AND IDENTIFYING AND ACHIEVING PATIENT CENTERED GOALS AND OUTCOMES. IN FY2024, CHRISTIANACARE ENROLLED 83 PATIENTS IN HVIP. IN JANUARY 2024, CHRISTIANACARE ALSO ENTERED INTO AN AGREEMENT WITH NEMOURS CHILDREN'S HOSPITAL, DELAWARE TO ALLOW CHILDREN, FOURTEEN YEARS OF AGE AND OLDER, THE OPPORTUNITY TO ALSO PARTICIPATE IN CHRISTIANACARE'S HVIP. THIS COLLABORATION WAS UNDERTAKEN WITH THE GOAL OF PROVIDING THESE CHILDREN, IMPACTED BY VIOLENCE, WITH COMPREHENSIVE CARE AND SUPPORT TO ATTAIN THE MOST POSITIVE OUTCOME POSSIBLE. TRAUMA DEPARTMENT COMMUNITY EDUCATION THE TRAUMA DEPARTMENT IS ALSO ADDRESSING VIOLENCE THROUGH EDUCATION. IN FY2024, THE TRAUMA DEPARTMENT PROVIDED 54 STOP THE BLEED TRAININGS TO 856 INDIVIDUALS AT CHRISTIANACARE CAMPUSES, SCHOOLS, AND COMMUNITY CENTERS THROUGHOUT DELAWARE. STOP THE BLEED IS A NATIONAL AWARENESS CAMPAIGN THAT EMPOWERS BYSTANDERS WITH THE KNOWLEDGE AND TOOLS THEY NEED TO RECOGNIZE AND STOP LIFE-THREATENING BLEEDING. THE TRAUMA DEPARTMENT ALSO MAKES AVAILABLE FREE GUN LOCKS TO PROMOTE THE SAFE STORAGE OF GUNS. CHRISTIANACARE IS THE ONLY ADULT LEVEL 1 TRAUMA CENTER IN DELAWARE AND TREATS OVER 200 GUNSHOT WOUND PATIENTS A YEAR. SOCIAL DRIVERS OF HEALTH: SOCIAL CARE CONNECTION CENTER CHRISTIANACARE IS COMMITTED TO THE STRATEGY OF ADDRESSING SOCIAL DRIVERS OF HEALTH (SDOH) TO IMPROVE HEALTH OUTCOMES. CHRISTIANACARE DEVELOPED AND ADMINISTERS AN SDOH SCREENING INSTRUMENT TO ADMINISTER TO PATIENTS. IT IS HELPFUL TO KNOW THE CHALLENGES OUR PATIENTS FACE TO BETTER SERVE THEM AND WE STRIVE TO ADDRESS THOSE NEEDS THROUGH INTERNAL RESOURCES AND REFERRALS TO COMMUNITY RESOURCES. IN THE SPRING OF 2023, CHRISTIANACARE LAUNCHED THE SOCIAL CARE CONNECTION CENTER WHICH SERVES AS THE UMBRELLA ORGANIZATION FOR OUR MEDICAID ENGAGEMENT CHWS, AMBULATORY CARE CONNECTORS, AND ACUTE CARE CONNECTORS. THE MEDICAID ENGAGEMENT TEAM CONSISTS OF CHWS THAT OUTREACH TO PATIENTS THAT HAVE BEEN NEWLY ASSIGNED OR ATTRIBUTED TO CHRISTIANACARE TO ADDRESS SOCIAL CARE NEEDS AND CONNECT THEM WITH PRIMARY CARE APPOINTMENTS. TO CONNECT WITH PATIENTS, THESE CHWS EMPLOY MULTIPLE METHODS TO ATTEMPT TO ENGAGE PATIENTS INCLUDING GOING TO THE PATIENT'S HOMES. THE CHWS WERE ABLE TO DIRECTLY ENGAGE OR CONFIRM MEMBER ENGAGEMENT WITH THE SYSTEM OF 1039 (53%) OUT OF THE 1964 NEW MEMBERS ASSIGNED OR ATTRIBUTED TO CHRISTIANACARE DURING FY2024. IN FY2024, CHRISTIANACARE SCREENED 12,227 PATIENTS IN PRIMARY CARE PRACTICES THROUGH TONIC, A SELF-ADMINISTERED SDOH SCREENING. OF THOSE, 3587 (29%) INDICATED AT LEAST ONE SOCIAL CARE NEED. POSITIVE SCREENINGS WERE SENT TO THE AMBULATORY CARE CONNECTORS FOR SOCIAL CARE SUPPORT. ACUTE CARE CONNECTORS (ACCS) PERFORM SDOH SCREENING AT THE BEDSIDE AND ADDRESS SOCIAL CARE NEEDS THAT MAY INCREASE THE POSSIBILITY FOR READMISSION. ACCS ARE HIGHLY COLLABORATIVE AND BRIDGE THE CARE PATIENTS RECEIVE IN THE HOSPITAL WITH COMMUNITY SUPPORT AND RESOURCES. ACUTE CARE CONNECTORS SCREENED 12,144 ADMITTED PATIENTS IN OUR TWO HOSPITALS IN DELAWARE. UNITE DELAWARE CHRISTIANACARE PARTNERED WITH UNITE US TO LAUNCH AN ELECTRONIC CARE COORDINATION NETWORK, UNITE DELAWARE, IN 2019. THE UNITE DELAWARE NETWORK CONNECTS SOCIAL SERVICES AND CLINICAL CARE PROVIDERS ACROSS THE STATE. WITH THIS NETWORK, ANY HEALTHCARE PROVIDER OR COMMUNITY ORGANIZATION CAN HELP AN INDIVIDUAL ADDRESS THEIR NEEDS BY SENDING AN ELECTRONIC REFERRAL ON THE PATIENT'S BEHALF TO THE APPROPRIATE ORGANIZATION. THE SENDER OF THAT REFERRAL WILL BE ABLE TO TRACK WHETHER THE NEED WAS MET OR NOT AND TAKE ADDITIONAL ACTION IF NEEDED. CHRISTIANACARE FUNDS THE UNITE DELAWARE PLATFORM TO HELP DELAWAREANS THROUGHOUT THE STATE ADDRESS THEIR NEEDS. THERE IS ALSO NO COST TO THE COMMUNITY-BASED ORGANIZATIONS THAT PARTICIPATE IN THE NETWORK AND SO OUR HOPE IS THAT THE NETWORK ALSO PROVIDES BENEFIT TO THEM. IN FY2024, CHRISTIANACARE CAREGIVERS CONNECTED 3,622 INDIVIDUALS TO THE UNITE DELAWARE PLATFORM AND SENT 8,173 REFERRALS ON THEIR BEHALF TO COMMUNITY ORGANIZATIONS. CHRISTIANACARE DEPARTMENTS AND PROGRAMS RECEIVED 1,402 REFERRALS FOR ASSISTANCE. ROUNDTRIP IN 2020, CHRISTIANACARE PARTNERED WITH ROUNDTRIP TO PROVIDE TRANSPORTATION TO MEDICAL SERVICES FOR PATIENTS WHO HAVE A TRANSPORTATION BARRIER. INITIALLY PILOTED IN TWO DEPARTMENTS, IN FY22, THE DEPARTMENTS UTILIZING ROUNDTRIP EXPANDED CONSIDERABLY AND THERE ARE NOW MORE THAN 20 PARTICIPATING PROGRAMS AND DEPARTMENTS USING ROUNDTRIP TO SERVE PATIENTS WITH TRANSPORTATION BARRIERS. OUR EXPECTATION IS THAT PROVIDING TRANSPORTATION WILL IMPROVE PATIENT HEALTH AND REDUCE HOSPITAL UTILIZATION. IN FY24, 14,273 RIDES WERE PROVIDED TO PATIENTS. PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.) MEDICAL LEGAL PARTNERSHIP SINCE 2015, CHRISTIANACARE HAS PARTNERED WITH THE DELAWARE COMMUNITY LEGAL AID SOCIETY, INC. (CLASI) TO OFFER THE MEDICAL LEGAL PARTNERSHIP (MLP). THE MLP ASSISTS PRIMARY CARE PATIENTS WHO ARE AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL (FPL) WITH THE MITIGATION OF CIVIL LEGAL HARDSHIPS. LAST YEAR, CHRISTIANACARE INCREASED THE INCOME ELIGIBILITY LEVEL FROM 200% OF THE FPL TO ALIGN WITH OUR FINANCIAL ASSISTANCE POLICY. PATIENTS RECEIVE ASSISTANCE FROM THE MLP TO AVOID EVICTION, SUCCESSFULLY REINSTATE BENEFITS, RECEIVE ACCOMMODATION FROM EMPLOYERS AND SCHOOLS, AND FILE PROTECTION FROM ABUSE (PFA) ORDERS AMONG OTHER CIVIL NEEDS. IN FY2024, A TOTAL OF 80 NEW LEGAL MATTERS FOR 62 NEW UNIQUE CLIENTS WERE ADDRESSED. IN FY2024, A PATIENT WHO WAS PREGNANT AND HAVING ISSUES WITH HER EMPLOYER WAS REFERRED TO THE MLP. DUE TO A HEALTH ISSUE DURING HER PREGNANCY, THE PATIENT HAD USED ALL HER PAID LEAVE AND WAS FORCED TO TAKE UNPAID TIME OFF FOR HER MEDICAL APPOINTMENTS AND RECOVERY. THE PATIENT'S EMPLOYER WAS NOT HONORING ANY ACCOMMODATION IN HER NEED FOR TIME AND WAS PLANNING TO DEMOTE THE PATIENT WITH A REDUCTION IN PAY AND BENEFITS. CLASI REPRESENTED THE PATIENT IN OUT-OF-COURT NEGOTIATIONS REGARDING HER EMPLOYMENT AND SUCCESSFULLY ASSERTED HER RIGHTS. THE PATIENT WAS ABLE TO MAINTAIN HER EMPLOYMENT AND BENEFITS INCLUDING A STEP-UP SALARY INCREASE FOR THE NEXT CONTRACT CYCLE AND PAID MATERNITY LEAVE FOR THE BIRTH OF HER CHILD. THE CLASI ATTORNEY ALSO PROVIDED GUIDANCE ON HOW TO DOCUMENT ANY ISSUES THE PATIENT MAY ENCOUNTER UPON HER RETURN TO WORK. COMMUNITY INVESTMENT FUND IN DECEMBER 2019, CHRISTIANACARE LAUNCHED THE COMMUNITY INVESTMENT FUND TO DEEPEN OUR CONNECTION AND INVESTMENT IN OUR COMMUNITIES. SINCE 2019, CHRISTIANACARE'S COMMUNITY INVESTMENT FUND HAS PROVIDED MORE THAN $5.6 MILLION TO 64 ORGANIZATIONS ADDRESSING SOCIAL, BEHAVIORAL, AND ENVIRONMENTAL HEALTH FACTORS SHAPING COMMUNITY HEALTH. IN FY2024, CHRISTIANACARE GAVE OVER $1 MILLION IN COMMUNITY INVESTMENT FUNDS TO 17 COMMUNITY ORGANIZATIONS TO SUPPORT THEIR WORK ADDRESSING FOOD ACCESS, HOUSING INSECURITY, AND ENVIRONMENTAL HEALTH. ADDITIONALLY, CHRISTIANACARE CONTINUED TO PROVIDE FUNDING TO SUPPORT THE DELAWARE COALITION AGAINST DOMESTIC VIOLENCE DOMESTIC VIOLENCE CHW PROGRAM, THE UNITED WAY OF DELAWARE 211 PROGRAM, AND DELAWARE TECHNICAL COMMUNITY COLLEGE FOOD PANTRIES WHICH HELP FEED THEIR FOOD INSECURE STUDENTS. IN FY2024, CHRISTIANACARE ALSO DEVELOPED AND LAUNCHED AN AGING IN PLACE PROGRAM WITH AN INVESTMENT OF $300,000 IN PARTNERSHIP WITH GOOD NEIGHBORS HOME REPAIR AND HABITAT FOR HUMANITY OF NEW CASTLE COUNTY. CHRISTIANACARE CAREGIVERS REFER LOW-INCOME SENIORS AND ADULTS LIVING IN NEW CASTLE COUNTY WITH DISABILITIES TO THESE ORGANIZATIONS TO RECEIVE FREE HOME REPAIR OR MODIFICATION TO PREVENT SLIPS, TRIPS, AND FALLS SO THAT THEY MAY CONTINUE TO LIVE SAFELY IN THEIR HOMES AND AVOID VISITS TO THE EMERGENCY DEPARTMENT. IN-KIND DONATIONS IN ADDITION TO PROVIDING FUNDING TO COMMUNITY ORGANIZATIONS, CHRISTIANACARE ALSO PROVIDES IN-KIND DONATIONS TO ASSIST COMMUNITY ORGANIZATIONS AND REDUCE THE WASTE WE GENERATE. CHRISTIANACARE CAREGIVERS ESTABLISHED A MEDICAL SUPPLY DONATION PROGRAM TO DONATE UNUSED MEDICAL SUPPLIES TO PROJECT C.U.R.E., AN ORGANIZATION THAT PROVIDES MEDICAL SUPPLIES AND EQUIPMENT TO HOSPITALS AND CLINICS IN THE UNDER-DEVELOPED WORLD. EXPIRED SUPPLIES ARE GIVEN TO LOCAL SCHOOLS, LIKE DELAWARE TECHNICAL COMMUNITY COLLEGE TO PROVIDE TRAINING OPPORTUNITIES FOR STUDENTS. IN 2023, CHRISTIANACARE'S SUSTAINABILITY INITIATIVES RESULTED IN THE DIVERSION OF 6,722 POUNDS OF MEDICAL WASTE FROM LANDFILLS. BOTH CAFETERIAS IN OUR NEWARK AND WILMINGTON CAMPUSES ALSO DONATED FOOD TO THE SUNDAY BREAKFAST MISSION, AN EMERGENCY SHELTER FOR MEN, WOMEN, AND CHILDREN IN WILMINGTON. -------------------- PART V, SECTION B, LINE 13 (ELIGIBILITY FOR PROVIDING DISCOUNTED CARE) FEDERAL POVERTY GUIDELINES ARE NOT USED TO DETERMINE DISCOUNTED CARE. A SELF-PAY DISCOUNT OF 15% IS APPLIED TO ALL UNINSURED PATIENT ACCOUNTS REGARDLESS OF INCOME. PATIENTS WITH INCOME IN EXCESS OF 400% OF THE FEDERAL POVERTY LEVEL WILL RECEIVE A 15% DISCOUNT. -------------------- PART V, SECTION B, LINE 16 (FINANCIAL ASSISTANCE POLICY AVAILABILITY) A COPY OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT: https://christianacare.org/US/EN/VISIT-US/FOR-PATIENTS/FINANCIAL-ASSISTANC E-PROGRAM-SUMMARY/FINANCIAL-ASSISTANCE-PROGRAM -------------------- PART V, SECTION B, LINE 20 (ADDITIONAL EFFORTS MADE BEFORE AN ECA) CHRISTIANA CARE HEALTH SERVICES COMMUNICATES IN WRITING ABOUT COLLECTION PLACEMENT AND THE FINANCIAL ASSISTANCE POLICY. -------------------- PART V, SECTION B, LINE 22 (CHARGES FOR FAP-ELIGIBLE INDIVIDUALS) FAP-ELIGIBLE INDIVIDUALS (THOSE WITH INCOME LESS THAN 400% OF FEDERAL POVERTY GUIDELINES) ARE NOT RESPONSIBLE FOR ANY CHARGES. -------------------- PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606). -------------------- PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY) THE AMOUNT OF BAD DEBTS (IMPLICIT PRICE CONCESSIONS) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED UPON THE NUMBER OF PRESUMED CHARITY-CARE ELIGIBLE PATIENTS WHO DID NOT COMPLETE THE FAP PAPERWORK DURING THE YEAR. -------------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. -------------------- PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF CHRISTIANACARE AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, CHRISTIANACARE PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY CHRISTIANACARE TO PROVIDE SUCH SERVICES. AS A RESULT, CHRISTIANA CARE VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. -------------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) CHRISTIANACARE HAS A FINANCIAL ASSISTANCE POLICY THAT IDENTIFIES THE CIRCUMSTANCES FOR WHICH A RESPONSIBLE PARTY WOULD BE EXTENDED A 100% ADJUSTMENT ON ALL MEDICAL BILLS. THE GROSS INCOME THRESHOLD FOR THIS CHARITABLE ADJUSTMENT IS 400% OF THE FEDERAL POVERTY LEVEL AND IT IS BASED ON THE NUMBER OF DEPENDENTS IN THE HOUSEHOLD. THE FINANCIAL ASSISTANCE POLICY FURTHER EXPLAINS THAT ANY UNINSURED PATIENT WHO FAILS TO QUALIFY FOR FINANCIAL ASSISTANCE WOULD BE GRANTED A 15% SELF PAY DISCOUNT. PATIENTS MAY ALSO ESTABLISH INTEREST-FREE MONTHLY PAYMENT ARRANGEMENTS FOR ANY OUTSTANDING BALANCE THAT IS NOT COVERED BY A THIRD PARTY PAYER. AS PART OF THE SELF PAY DUNNING PROCESS, CHRISTIANA CARE MAKES UNINSURED PATIENTS AWARE OF THE FINANCIAL ASSISTANCE PROGRAM WITH THE RELEASE OF OUR FIRST STATEMENT. FOR ALL SUBSEQUENT STATEMENTS, PATIENTS HAVE AN OPPORTUNITY TO CALL OUR CUSTOMER SERVICES DEPARTMENT IF THEY ARE UNABLE TO MAKE PAYMENT IN FULL. IF A PATIENT QUALIFIES FOR A CHARITABLE ADJUSTMENT, THEY ARE EXTENDED THE COURTESY OF AN AUTOMATIC ADJUSTMENT TO THEIR BILLS FOR THE NEXT YEAR AND FOR ONE YEAR PRIOR TO THE DATE A PATIENT'S APPLICATION IS APPROVED. PATIENTS WOULD NEED TO REAPPLY FOR CHARITABLE CONSIDERATION AFTER THE ONE YEAR HAS LAPSED. ALL COLLECTION ACTIONS WOULD CEASE ONCE A PATIENT IS DEEMED ELIGIBLE FOR CHARITY OR ONCE A PATIENT ESTABLISHES AND MAINTAINS A MONTHLY PAYMENT ARRANGEMENT. -------------------- PART VI, LINE 2 (NEEDS ASSESSMENT) MANY OF THE WAYS IN WHICH CHRISTIANACARE ASSESSES THE HEALTH NEEDS OF OUR COMMUNITY HAVE BEEN DESCRIBED. A SYSTEM WIDE SDOH SCREENING INSTRUMENT WAS IMPLEMENTED TO LEARN DIRECTLY FROM OUR PATIENTS ABOUT THEIR CHALLENGES, AND WE PARTNERED WITH UNITE US TO LAUNCH UNITE DELAWARE IN THE STATE TO PROVIDE A TOOL TO ADDRESS OUR PATIENTS' NEEDS AS WELL AS INSIGHT INTO THE NEEDS OF DELAWAREANS. IN FY2024, THE MOST REFERRED NEEDS ON UNITE DELAWARE WERE FOOD ASSISTANCE, HOUSING AND SHELTER, UTILITIES, BENEFITS NAVIGATION, AND TRANSPORTATION. THE PARTNERSHIPS CHRISTIANACARE HAS DEVELOPED WITH COMMUNITY ORGANIZATIONS TO ADDRESS PATIENTS' SOCIAL NEEDS LIKE OUR AGING IN PLACE PROGRAM AND OUR DELAWARE FOOD FARMACY, ALSO OFFER US INSIGHT INTO COMMUNITY CHALLENGES. FURTHER, THE COMMUNITY INVESTMENT FUND PROVIDES US WITH THE OPPORTUNITY TO LEARN FROM COMMUNITY-BASED ORGANIZATIONS. IN FY2024, 74 ORGANIZATIONS APPLIED FOR FUNDING. WHILE NOT EVERY ORGANIZATION WAS AWARDED FUNDING, EVERY APPLICATION WAS REVIEWED AND EACH ONE PROVIDED INFORMATION ABOUT COMMUNITY NEED, THE WAYS IN WHICH ORGANIZATIONS ARE WORKING TO ADDRESS THOSE NEEDS, AND HOW THE NEED MAY SURPASS WHAT IS OFFERED TO ADDRESS IT. PARTICIPATION BY CHRISTIANACARE LEADERS ON COMMUNITY BOARDS AND COMMITTEES ALSO PROVIDES INSIGHT INTO COMMUNITY NEEDS. THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM, THE VISION COALITION OF DELAWARE, THE REACH RIVERSIDE BOARD, THE DELAWARE BUSINESS ROUNDTABLE EDUCATION COMMITTEE, THE WILMINGTON ALLIANCE, AND LITERACY DELAWARE, AMONG OTHER ORGANIZATIONS, ARE ALL SERVED BY CHRISTIANACARE CAREGIVERS. -------------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON OUR WEBSITE: https://christianacare.org/patients/financial-assistance-program/. THE FINANCIAL ASSISTANCE PROGRAM, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE ALSO AVAILABLE IN SPANISH, CANTONESE, AND MANDARIN WHICH ARE THE MOST SPOKEN LANGUAGES BESIDES ENGLISH. THE FINANCIAL ASSISTANCE PROGRAM IS PUBLICIZED THROUGH PAMPHLETS, SIGNAGE, ONLINE NOTICES ON THE CHRISTIANACARE WEBSITE, AND IN-PATIENT SERVICE AREAS. THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED AND WHO INDICATE THEIR INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES AT INTAKE OR DISCHARGE. ALL STATEMENTS INCLUDE VERBIAGE THAT DIRECTS PATIENTS TO OUR WEBSITE OR CUSTOMER SERVICE TO LEARN MORE ABOUT OUR FINANCIAL ASSISTANCE POLICY. TRANSLATION ASSISTANCE BY PHONE TO COMPLETE NECESSARY FORMS FOR ANYONE NOT PROFICIENT IN READING, WRITING, OR SPEAKING ENGLISH IS ALSO AVAILABLE MONDAY THROUGH FRIDAY FROM 9 A.M. TO 4 P.M. PATIENTS MAY ALSO CALL PATIENT FINANCIAL SERVICES TO REQUEST INFORMATION AND AN APPLICATION AND TO TALK CONFIDENTIALLY ABOUT THEIR SITUATION. IF CHRISTIANACARE DETERMINES THAT THE PATIENT MAY QUALIFY FOR OTHER COVERAGE, FINANCIAL COUNSELING IS PROVIDED TO ASSIST PATIENTS TO APPLY FOR THE AVAILABLE COVERAGE. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY WEBPAGE AND PLAIN LANGUAGE SUMMARY ALSO INCLUDES CONTACT INFORMATION OF STATE AND FEDERAL HEALTH INSURANCE RESOURCES FOR THOSE WHO ARE UNINSURED. AS DESCRIBED PREVIOUSLY, CHRISTIANACARE'S HEALTH GUIDES ARE ALSO AVAILABLE TO HELP PATIENTS OVERCOME FINANCIAL BARRIERS. THEY ASSIST PATIENTS IN COMPLETING THE CHRISTIANACARE APPLICATION FOR FINANCIAL ASSISTANCE AS WELL AS ENROLL IN HEALTH INSURANCE OR APPLY FOR PRESCRIPTION ASSISTANCE OR MEDICAID, TO NAME JUST A FEW EXAMPLES. -------------------- PART VI, LINE 4 (COMMUNITY INFORMATION) CHRISTIANACARE IS ONE OF THE LARGEST PROVIDERS IN THE MID-ATLANTIC REGION, SERVING ALL OF DELAWARE AND PARTS OF PENNSYLVANIA, MARYLAND, AND NEW JERSEY. DUE TO THE HIGH PERCENTAGE OF NEW CASTLE COUNTY RESIDENTS AMONG THOSE DISCHARGED FROM CHRISTIANACARE'S TWO DELAWARE HOSPITALS, WE IDENTIFIED NEW CASTLE COUNTY AS OUR SERVICE AREA WITHIN THE 2022 CHNA. IN FY2023, 77.3% OF OUR HOSPITAL DISCHARGES WERE FOR NEW CASTLE COUNTY RESIDENTS. IN 2024, THE POPULATION OF NEW CASTLE COUNTY WAS 581,444 AND IT IS PROJECTED TO GROW BY 3.3% IN THE NEXT DECADE. THE 65 AND OLDER POPULATION IS EXPECTED TO GROW BY 20.2% IN THE NEXT DECADE WHILE AGE GROUPS UNDER 29 YEARS OF AGE ARE EXPECTED TO DECLINE. DUE TO THE CONSIDERABLE VARIATION AMONG SOCIOECONOMIC CONDITIONS IN NEW CASTLE COUNTY, THE 2022 CHNA ASSESSED COMMUNITY HEALTH NEEDS IN TWO GEOGRAPHIC AREAS OF NEW CASTLE COUNTY: "COMMUNITY 1" (ZIP CODES 19801, 19802, 19804, 19805, AND 19720) AND "COMMUNITY 2" (ALL OTHER NEW CASTLE COUNTY ZIP CODES). IN 2023, COMMUNITY 1 ACCOUNTED FOR 30.7% OF CHRISTIANACARE DISCHARGES AND COMMUNITY 2 ACCOUNTED FOR 46.6% OF CHRISTIANACARE DISCHARGES. THE OVERALL POVERTY RATE IN NEW CASTLE COUNTY HAS BEEN BELOW DELAWARE AND U.S. AVERAGES; HOWEVER, RATES FOR BLACK AND FOR HISPANIC COUNTY RESIDENTS HAVE BEEN SUBSTANTIALLY HIGHER THAN RATES FOR WHITE RESIDENTS. THE POVERTY RATE IN COMMUNITY 1 HAS BEEN MORE THAN DOUBLE THE RATE FOR COMMUNITY 2 (16.5% COMPARED TO 8.1%). IN COMMUNITY 1, APPROXIMATELY 44.3% OF THE POPULATION IDENTIFIES AS BLACK; IN COMMUNITY 2, 17.7% OF THE POPULATION IDENTIFIES AS BLACK. APPROXIMATELY 15.9% OF THE OVERALL POPULATION IN COMMUNITY 1 IDENTIFIES AS HISPANIC; IN COMMUNITY 2, 8.8% OF THE POPULATION IDENTIFIES AS BLACK. IN NEW CASTLE COUNTY, LOW-INCOME CENSUS TRACTS AND FOOD DESERTS ARE MOST PREVALENT IN NEWARK, WILMINGTON, AND THROUGHOUT COMMUNITY 1. THE AREA DEPRIVATION INDEX (ADI), WHICH RANKS NEIGHBORHOODS BY SOCIOECONOMIC DISADVANTAGE ALSO RANKS CENSUS TRACTS IN COMMUNITY 1 AS HAVING CONSIDERABLE DISADVANTAGE RELATED TO FACTORS LIKE HOUSING, INCOME, EDUCATION, AND EMPLOYMENT. -------------------- PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, CHRISTIANACARE IS FOCUSED ON MEETING THE NEEDS OF OUR COMMUNITY. CHRISTIANACARE HAS AN EXTENSIVE NETWORK OF PRIMARY CARE AND OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,200 BEDS), A FREESTANDING EMERGENCY DEPARTMENT, A 24/7 PEDIATRIC CARE CENTER, THE ONLY LEVEL I TRAUMA CENTER AND THE ONLY HIGH-RISK DELIVERING HOSPITAL IN DELAWARE OFFERING A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER, REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE, AND WOMEN'S HEALTH, AND THE GENE EDITING INSTITUTE. CHRISTIANACARE IS ALSO ONE OF THE LARGEST COMMUNITY-BASED TEACHING HOSPITALS CONDUCTING RESEARCH IN THE UNITED STATES. CHRISTIANACARE WAS ONE OF THE FIRST HOSPITALS IN THE UNITED STATES TO ESTABLISH AN EMBEDDED RESEARCH INSTITUTE, THE INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH. THIS EMBEDDED RESEARCH INSTITUTE CONDUCTS APPLIED RESEARCH FOCUSED ON ISSUES OF EQUITY AND COMMUNITY HEALTH, POPULATION HEALTH, AND VIRTUAL HEALTH, AS WELL AS TRAINING THE NEXT GENERATION OF CLINICAL SCIENTISTS WITH THE GOAL TO BRIDGE THE GAP BETWEEN CLINICAL AND TRANSLATIONAL RESEARCH, ADVANCEMENTS IN THE QUALITY OF CARE, AND IMPROVED HEALTH OUTCOMES FOR ALL. CHRISTIANACARE IS ALSO COMMITTED TO PROVIDING AFFORDABLE AND VALUE-BASED CARE. CHRISTIANACARE IS A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES 27,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CHRISTIANACARE'S CAREVIO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. CAREVIO HARNESSES AN INFORMATION TECHNOLOGY PLATFORM THAT IDENTIFIES THE PATIENTS WHO ARE AT HIGHEST RISK AND WHO HAVE SIGNIFICANT CARE NEEDS, INCLUDING THOSE WHO DO NOT REGULARLY ACCESS PRIMARY CARE AND PREVENTIVE SERVICES. IN PERFORMANCE YEAR 2023, THE EBRIGHTHEALTH ACO REDUCED HEALTH CARE SPENDING BY APPROXIMATELY $2.4 MILLION AND EARNED A QUALITY SCORE OF 88.4%. THE CUMULATIVE AMOUNT SAVED IS $56 MILLION. IN 2021, CHRISTIANACARE ALSO LAUNCHED ONE OF THE FIRST MEDICAID ACOS IN THE STATE, DELAWARE MEDICAID QUALITY PARTNERS ACO. IN 2023, CHRISTIANACARE'S ACO REDUCED HEALTH CARE SPENDING BY $6.2 MILLION WHILE IMPROVING CARE FOR NEARLY 30,000 MEDICAID BENEFICIARIES IN DELAWARE, INCLUDING APPROXIMATELY 8,000 CHILDREN. THIS SUCCESS IS A DEMONSTRATION THAT WE CAN IMPROVE HEALTH WHILE ALSO HELPING THE STATE REDUCE HEALTH CARE COSTS BY DELIVERING CARE THAT EMPHASIZES PREVENTATIVE CARE AND PROACTIVE MANAGEMENT OF HEALTH CONDITIONS. AS THE LARGEST PRIVATE EMPLOYER IN DELAWARE, CHRISTIANACARE ALSO STRIVES TO BE A LEADER AMONG OTHER BUSINESSES AND ORGANIZATIONS. . CHRISTIANACARE PLEDGED COMMITMENT TO THE WHITE HOUSE/HHS HEALTH SECTOR CLIMATE PLEDGE. CHRISTIANACARE IS TAKING ACTION TO REDUCE ITS GREENHOUSE GAS EMISSIONS BY 50% BY 2030 AND ACHIEVE NET ZERO EMISSIONS BY 2050. . CHRISTIANACARE HAS INSTITUTED A SUPPLIER DIVERSITY PROGRAM TO PROVIDE EQUAL ACCESS TO PROCUREMENT OPPORTUNITIES FOR DIVERSE AND SMALL BUSINESSES TO ASSIST AND MEET OUR HEALTHCARE SYSTEM GOALS. WE PROVIDE RESOURCES AND MENTORSHIP, ASSIST WITH CAPACITY BUILDING, AND OFFER OUTREACH PROGRAMS SO THAT WE CAN WORK WITH COMPANIES THAT HELP CONTRIBUTE TO THE ECONOMY AND COMMUNITIES WE SERVE. . IN 2020, CHRISTIANACARE BEGAN OFFERING 12 WEEKS OF PAID PARENTAL LEAVE FOR ITS CAREGIVERS. . IN 2019, CHRISTIANACARE INCREASED ITS MINIMUM WAGE TO $15 AN HOUR. . IN 2019, CHRISTIANACARE INSTITUTED A COMMUNITY SERVICE BENEFIT TO ITS CAREGIVERS THAT PROVIDES PAID COMMUNITY SERVICE TIME, IN ADDITION TO THEIR PAID TIME OFF, TO VOLUNTEER AT CHARITABLE, NON-PROFIT ORGANIZATIONS. IN FY2024, 1,439 HOURS WERE SPENT IN COMMUNITY SERVICE AT A COST OF APPROXIMATELY $104,000 TO CHRISTIANACARE. AS CHRISTIANACARE CONTINUES TO ADAPT AND INNOVATE TO ENSURE WE ARE EQUIPPED TO OPERATE WITHIN THE EVER-CHANGING LANDSCAPE OF HEALTH CARE, WE WILL ALWAYS BE GUIDED BY OUR MISSION OF SERVICE AND OUR VALUES OF EXCELLENCE AND LOVE. OUR MOST IMPORTANT PARTNERSHIP IS WITH OUR NEIGHBORS WE SERVE. PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) IN JUNE 2024, THE STATE OF DELAWARE SIGNED INTO LAW A REQUIREMENT FOR DELAWARE HOSPITALS TO SUBMIT A COMMUNITY BENEFIT REPORT. A STATE COMMUNITY BENEFIT REPORT IS ALSO FILED IN MARYLAND FOR CHRISTIANACARE'S UNION HOSPITAL LOCATED IN ELKTON, MARYLAND. -------------------- PART II, DESCRIPTION OF TABLE: COMMUNITY BUILDING ACTIVITIES IN FY2024, THE ECONOMIC DEVELOPMENT ACTIVITIES CHRISTIANACARE UNDERTOOK WERE PARTICIPATION ON COMMUNITY ORGANIZATION BOARDS AND LEADERSHIP TEAMS AS WELL AS CASH DONATIONS TO THOSE COMMUNITY ORGANIZATIONS. CHRISTIANACARE'S CHIEF HEALTH EQUITY AND PUBLIC AFFAIRS OFFICER SERVES AS CHAIR OF THE VISION COALITION, A PUBLIC PRIVATE PARTNERSHIP COMPOSED OF A BROAD RANGE OF DELAWAREANS WORKING TOGETHER TO IMPROVE DELAWARE PUBLIC EDUCATION, AND AS A MEMBER OF THE DELAWARE BUSINESS ROUNDTABLE EDUCATION COMMITTEE (DBREC): A NONPROFIT ORGANIZATION THAT AIMS TO IMPROVE PUBLIC EDUCATION BY AGGREGATING AND ALIGNING THE RESOURCES OF ROUNDTABLE MEMBERS AND OTHER BUSINESS LEADERS. CHRISTIANACARE ALSO PROVIDED $40,000 IN FUNDING TO SUPPORT DBREC'S MISSION. CHRISTIANACARE'S WILMINGTON CAMPUS EXECUTIVE DIRECTOR SERVES AS VICE CHAIR ON THE EXECUTIVE BOARD OF THE WILMINGTON ALLIANCE: A NONPROFIT ORGANIZATION THAT PARTNERS WITH COMMUNITY, CIVIC, AND BUSINESS LEADERS TO PRIORITIZE THE CITY'S HIGHEST NEEDS TO DRIVE ECONOMIC OPPORTUNITY AND SOCIAL VITALITY. CHRISTIANACARE ALSO PROVIDED WILMINGTON ALLIANCE WITH $45,000 IN FUNDING TO SUPPORT THEIR MISSION. CHRISTIANACARE'S CEO ALSO SERVED ON THE EXECUTIVE COMMITTEE OF THE DELAWARE BUSINESS ROUNDTABLE BOARD WHOSE MISSION IS TO ENHANCE THE QUALITY OF LIFE IN DELAWARE BY PROMOTING COMMERCE, JOB CREATION, AND SELECT PUBLIC POLICY ISSUES. IN THE COMMUNITY BUILDING CATEGORY OF COMMUNITY SUPPORT, WE REPORTED CHRISTIANACARE'S $105,000 CONTRIBUTION TO DELAWARE COLLEGE SCHOLARS WHICH SERVES TO PREPARE HIGH-ACHIEVING, UNDER-RESOURCED DELAWARE PUBLIC HIGH SCHOOL SCHOLARS ACADEMICALLY AND SOCIALLY FOR SUCCESSFULLY APPLYING TO, SUCCEEDING IN, AND GRADUATING FROM FOUR-YEAR COLLEGES AND UNIVERSITIES. IN THE COMMUNITY BUILDING CATEGORY OF COALITION BUILDING, WE REPORTED THE TIME SPENT BY OUR CHIEF PUBLIC AFFAIRS AND CHIEF HEALTH EQUITY OFFICER PARTICIPATING ON THE PURPOSE-BUILT COMMUNITIES' REACH RIVERSIDE COMMUNITY DEVELOPMENT INITIATIVE BOARD OF DIRECTORS AND AS CHAIR OF THE GOVERNANCE COMMITTEE. IN 2019, CHRISTIANACARE CONTRIBUTED $1 MILLION TO THIS INITIATIVE TO REVITALIZE THE RIVERSIDE NEIGHBORHOOD IN WILMINGTON. IN THE COMMUNITY BUILDING CATEGORY OF HOUSING AND PHYSICAL IMPROVEMENTS, WE REPORTED OUR $14,400 CONTRIBUTION TO THE WILMINGTON NEIGHBORHOOD CONSERVANCY LAND BANK TO PURCHASE UPGRADED SECURITY CAMERAS TO BE PLACED AT NORTH HARRISON STREET IN WILMINGTON. THE CAMERAS ARE INTENDED TO DECREASE CRIMINAL ACTIVITY AND ENABLE RESIDENTS TO FEEL MORE SECURE. SAFETY IS A BASIC NEED THAT CONTRIBUTES TO IMPROVED COMMUNITY HEALTH. FINALLY, CHRISTIANACARE INVESTS CONSIDERABLY IN WORKFORCE DEVELOPMENT. OUR WORKFORCE DEVELOPMENT INITIATIVES SERVE TO BOTH INFLUENCE THE NEXT GENERATION OF HEALTHCARE WORKERS TO UNDERSTAND THE BARRIERS TO GOOD HEALTH PATIENTS MAY FACE AND DEVELOP A WORKFORCE THAT REFLECTS OUR COMMUNITY. CHRISTIANACARE IS IN THE 3RD YEAR OF ITS 5-YEAR COMMITMENT OF $500,000 TO AWARD MERIT-BASED SCHOLARSHIPS OF $12,500 TO TEN SCHOLARS PER YEAR, PER STUDENT, TO ATTEND AN HBCU. THE FOCUS OF THE SCHOLARSHIP PROGRAM ARE MINORITY SCHOLARS PURSUING A FIELD OF STUDY IN HEALTH CARE. THESE SCHOLARS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN AN INTERNSHIP PROGRAM AT CHRISTIANACARE. CHRISTIANACARE'S CENTER FOR COMMUNITY HEALTH AND EMPOWERMENT OFFERS YOUTH PROGRAMMING THAT EXPOSES THE PARTICIPANTS, OR SCHOLARS AS WE REFER TO THEM, TO POTENTIAL CAREERS IN THE HEALTH FIELD AND PROVIDES THEM WITH THE SKILLS AND EXPERIENCE TO SUPPORT THEIR DEVELOPMENT INTO YOUNG ADULTS EVEN IF THEY CHOOSE TO TAKE A DIFFERENT PATH. IN FY2024, THE FOLLOWING PROGRAMS WERE OFFERED: BACK 2 BASICS: BACK 2 BASICS IS A FREE, IMMERSIVE PROGRAM DESIGNED FOR HIGH SCHOOL SCHOLARS, OFFERING THEM A UNIQUE OPPORTUNITY TO EXPLORE HEALTHCARE CAREERS. THROUGH A CASE STUDY APPROACH, PARTICIPANTS WILL GAIN INSIGHT INTO THE PATIENT EXPERIENCE AND UNDERSTAND THE COLLABORATIVE EFFORTS INVOLVED IN PROVIDING CARE. THIS HANDS-ON EXPERIENCE ALLOWS SCHOLARS TO SEE FIRSTHAND HOW VARIOUS HEALTHCARE PROFESSIONALS CONTRIBUTE TO PATIENT WELL-BEING. IN FY2024, THE PROGRAM HAD A TOTAL OF 39 PARTICIPANTS. BRANDYWINE LIFESAVERS PROGRAM: CHRISTIANACARE PARTNERED WITH THE BRANDYWINE LIFESAVERS PROGRAM, DEVELOPED BY BRANDYWINE SCHOOL DISTRICT NURSES, TO CREATE A PIPELINE FOR MIDDLE AND HIGH SCHOOL SCHOLARS TO BE INTRODUCED TO POSSIBLE CAREERS IN HEALTH CARE, SPECIFICALLY NURSING. THE BRANDYWINE LIFESAVERS PROGRAM HOSTED A TOTAL OF 50 MIDDLE AND HIGH SCHOLARS WHO ATTENDED AN INFORMATIONAL SESSION AT CHRISTIANACARE'S NEWARK CAMPUS TO LEARN DIRECTLY FROM NURSES ABOUT THEIR ROLES. CO-OP PROGRAMS: THE CO-OP PROGRAM OFFERS SCHOLARS IN THE NEW CASTLE COUNTY VOCATIONAL TECHNICAL SCHOOL DISTRICT THE OPPORTUNITY TO FULFILL THEIR COOPERATIVE EMPLOYMENT REQUIREMENTS. DESIGNED FOR HIGH SCHOOL SENIORS, THIS PROGRAM PROVIDES A PART-TIME, PAID WORK EXPERIENCE. THE CO-OP PLACEMENTS ARE SPECIFICALLY AVAILABLE TO SCHOLARS ENROLLED IN THE HEALTH SERVICES SHOPS WITHIN THE SCHOOL DISTRICT, GIVING THEM VALUABLE HANDS-ON EXPERIENCE IN THE HEALTHCARE FIELD. IN FY2024, THE PROGRAM HAD A TOTAL OF 15 PARTICIPANTS WHO WORKED IN THE CHRISTIANACARE PATIENT ESCORT SERVICE LINE. HEALTH CAREER COLLABORATIVE: THE HEALTH CAREER COLLABORATIVE PROGRAM, SERVING SCHOLARS FROM WILLIAM PENN HIGH SCHOOL, IS DESIGNED TO SUPPORT YOUTH FROM COMMUNITIES UNDERREPRESENTED IN MEDICINE, HELPING THEM GRADUATE FROM HIGH SCHOOL, PURSUE POST-SECONDARY EDUCATION, IMPROVE HEALTH LITERACY, AND EXPLORE CAREERS IN HEALTHCARE. THROUGH MENTORSHIP, AN ENGAGING HEALTH CURRICULUM, AND EXPOSURE TO VARIOUS HEALTH CAREERS, THE PROGRAM EMPOWERS HIGH SCHOOL SCHOLARS TO IDENTIFY AND ADDRESS THE MOST PRESSING HEALTH NEEDS IN THEIR COMMUNITIES. SCHOLARS ARE ALSO GIVEN THE OPPORTUNITY TO PLAN AND IMPLEMENT COMMUNITY-BASED HEALTH PROMOTION ACTIVITIES, PROVIDING THEM WITH HANDS-ON EXPERIENCE WHILE EXPLORING DIVERSE HEALTH-RELATED CAREER PATHWAYS. IN FY2024, THE PROGRAM HAD A TOTAL OF 12 PARTICIPANTS. HEALTH IMPACTS: THE HEALTH IMPACTS PROGRAM IS DESIGNED TO CONNECT SCHOLARS WITH CAREER OPPORTUNITIES AND PATHWAYS IN HEALTHCARE. THIS 3-PHASE PROGRAM PROVIDES EXPOSURE TO A WIDE RANGE OF HEALTHCARE CAREERS WHILE FOCUSING ON ESSENTIAL SKILLS SUCH AS COMMUNICATION, TIME MANAGEMENT, AND RELATIONSHIP BUILDING. THROUGHOUT THE PROGRAM, SCHOLARS WILL GAIN VALUABLE INSIGHTS INTO THE HEALTHCARE INDUSTRY, WITH A STRONG EMPHASIS ON DEVELOPING EMPLOYABILITY SKILLS. UPON SUCCESSFUL COMPLETION OF PHASE 1, SCHOLARS WILL BE MATCHED WITH A WORK-BASED LEARNING ASSIGNMENT WITHIN THE HEALTH SYSTEM. THE GOAL IS FOR SCHOLARS TO APPLY THE SKILLS THEY'VE ACQUIRED DURING THE PROGRAM TO SECURE AND MAINTAIN A PART-TIME POSITION WITHIN THE HEALTHCARE SYSTEM DURING PHASE 2. PHASE 3 WILL CULMINATE IN AN OFFICIAL JOB OFFER, EITHER FULL-TIME OR PART-TIME, WITHIN THE ORGANIZATION. IN FY2024, A TOTAL OF 27 SCHOLARS WERE REGISTERED IN THE PROGRAM, 9 COMPLETED THE PROGRAM, AND 1 SCHOLAR WAS HIRED BY CHRISTIANACARE. NURSING CAREER COLLABORATIVE: THIS PROGRAM WAS DEVELOPED TO SERVE AS A PATHWAY TO NURSING FOR HIGH SCHOOL SCHOLARS FROM WILLIAM PENN HIGH SCHOOL'S ALLIED HEALTH PROGRAM. THROUGH THE NURSING CAREER COLLABORATIVE, SCHOLARS ARE EDUCATED AND EXPOSED TO THE FIELD AND FUNDAMENTALS OF NURSING. THE PROGRAM IS 6 SESSIONS IN LENGTH- 3 SESSIONS AT WILLIAM PENN HIGH SCHOOL AND 3 SESSIONS AT CHRISTIANACARE'S NEWARK CAMPUS. ON THEIR LAST DAY OF THE PROGRAM, SCHOLARS ALSO HAVE AN OPPORTUNITY TO SHADOW ON A UNIT WITH A NURSE. IN FY2024, 20 SCHOLARS COMPLETED THIS PROGRAM. WORK BASED LEARNING (NURSING/SURGICAL SERVICES): THIS PROGRAM IS DESIGNED TO INCREASE SCHOLAR AWARENESS ABOUT SURGICAL SERVICE CAREERS, THROUGH REAL WORLD WORKPLACE OBSERVATION AND ENGAGEMENT WITH HEALTHCARE PROFESSIONALS. SCHOLARS EXPLORE A VARIETY OF OCCUPATIONS WITHIN THE SURGICAL SETTING, SCOPE OF ROLES/RESPONSIBILITIES, ESSENTIAL SKILLS, AND EDUCATIONAL REQUIREMENTS AND PATHWAYS. PARTICIPANTS ARE SENIORS AT APPOQUINIMINK HIGH SCHOOL AND MIDDLETOWN HIGH SCHOOL AND ENROLLED IN THE SCHOOL OF HEALTH SCIENCE PATHWAY OR ENROLLED IN THE ODESSA HIGH SCHOOL ALLIED HEALTH PROGRAM. SCHOLARS PARTICIPATING IN CHRISTIANACARE'S SURGICAL SERVICE WORK BASED LEARNING EXPERIENCE MUST ATTEND ALL HOSPITAL PROGRAM DATES AND FIVE (5) BACK 2 BASICS VIRTUAL SESSIONS TOTALING 40 HOURS TOWARD THEIR SENIOR CAPSTONE PROJECT. 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PRIOR TO PROVIDING ANY FUNDS, CCHS CONFIRMS THAT THE RECIPIENT ORGANIZATION IS TAX EXEMPT AND REQUIRES THE SUBMISSION OF A PROPOSAL FOR HOW THE FUNDING WILL BE UTILIZED. CCHS RETAINS THE RIGHT TO REQUEST DETAIL REGARDING THE ORGANIZATION'S UTILIZATION OF THE FUNDING. X true true true true false false false false false true false BARBARA ALBANI MD DIRECTOR - AS OF 01/24 598709 0 77522 0 44939 0 0 0 0 0 721170 0 0 0 BETTINA TWEARDY-RIVEROS CHIEF HEALTH EQUITY OFFICER 522965 0 201108 0 56001 0 45394 0 20878 0 846346 0 0 0 DANIEL ROBB MD PHYSICIAN, CARDIAC SURGEON 902520 0 116142 0 4025 0 0 0 12506 0 1035193 0 0 0 FREDERIC T HARAD MD DIRECTOR 597122 0 78318 0 76967 0 0 0 12506 0 764913 0 0 0 JANICE E NEVIN MD PRESIDENT & CEO 1581016 0 725400 0 449074 0 0 0 7228 0 2762718 0 0 0 JENNIFER L SCHWARTZ ESQ CORPORATE SECRETARY 695351 0 207032 0 24304 0 59243 0 20878 0 1006808 0 0 0 KENNETH SILVERSTEIN MD FORMER CHIEF PHYSICIAN EXEC 202031 0 133633 0 790922 0 0 0 2850 0 1129436 0 0 0 KERT ANZILOTTI JR MD INTERIM PRESIDENT 637470 0 147354 0 122594 0 59909 0 20878 0 988205 0 0 0 KIRK N GARRATT MD MED. DIR. CTR FOR H/V HEALTH 822576 0 142607 0 11577 0 0 0 12104 0 988864 0 0 0 LISA MAXWELL MD PRESIDENT, CC MEDICAL GROUP 613121 0 193051 0 113521 0 0 0 20878 0 940571 0 0 0 NEIL JASANI MD CHIEF PEOPLE OFFICER 669573 0 203522 0 108034 0 0 0 20878 0 1002007 0 0 0 NICHOLAS J PETRELLI MD MED. DIR, CCHS CANCER PROGRAM 768565 0 133243 0 7935 0 0 0 12506 0 922249 0 0 0 RANDALL GABORIAULT CHIEF DIGITAL & INFO. OFFICER 703693 0 203327 0 218970 0 73308 0 20878 0 1220176 0 0 0 RAY A BLACKWELL MD CHIEF OF CARDIAC SURGERY 1065357 0 129627 0 16540 0 0 0 20878 0 1232402 0 0 0 RICHARD CUMING CHIEF OPERATING OFFICER 762616 0 246171 0 164287 0 55988 0 12506 0 1241568 0 42001 0 ROBERT MCMURRAY CFO, TREAS. & ASS'T SECRETARY 753010 0 228558 0 58851 0 68103 0 20224 0 1128746 0 23384 0 SHARON KURFUERST FORMER COO 196269 0 129822 0 985276 0 0 0 3168 0 1314535 0 178205 0 VINAY K GHEYI CHAIR DEPARTMENT RADIOLOGY 788000 0 136613 0 49687 0 0 0 13910 0 988210 0 0 0 VINAY MAHESHWARI MD DIRECTOR 521429 0 87628 0 4751 0 0 0 20878 0 634686 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 1A DETAIL REGARDING BENEFITS PROVIDED SOCIAL CLUB DUES CCHS PROVIDES A SOCIAL CLUB MEMBERSHIP TO BE USED BY THE PRESIDENT IN CONNECTION WITH THEIR DUTIES. THE PRESIDENT IS RESPONSIBLE FOR AND TAXED ON ANY PERSONAL USE OF SUCH CLUB MEMBERSHIP. -------------------- FORM 990, SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHOD DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O FOR A DESCRIPTION OF THE COMPENSATION REVIEW AND APPROVAL PROCESS. -------------------- FORM 990, SCHEDULE J, PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS SHARON KURFUERST (FORMER CHIEF OPERATING OFFICER) RECEIVED A SEVERANCE PAYMENT OF $532,730 DURING THE YEAR. KENNETH SILVERSTEIN (FORMER PRESIDENT, CC MEDICAL GROUP) RECEIVED A SEVERANCE PAYMENT OF $548,370 DURING THE YEAR. --------------- FORM 990, SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED PLAN PARTICIPATION CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAINTAINS AN IRC SECTION 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED AND/OR RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: RICHARD CUMING, RN- $64,591 RANDALL GABORIAULT- $67,715 SHARON T. KURFUERST- $263,888 ROBERT MCMURRAY- $30,765 JANICE E. NEVIN, MD- $209,034 KENNETH SILVERSTEIN, MD- $79,136 KERT ANZILOTTI- $54,111 NEIL JASANI- $55,987 VINAY GHEYI- $41,640 LISA C. MAXWELL, MD- NO DISTRIBUTION JENNIFER L. SCHWARTZ, ESQ.- NO DISTRIBUTION BETTINA TWEARDY-RIVEROS- NO DISTRIBUTION -------------------- FORM 990, SCHEDULE J, PART I, LINE 7 PROVISION OF NON-FIXED PAYMENTS CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM") IS THE SOLE MEMBER OF THIS ORGANIZATION. ALL OFFICER/TRUSTEE COMPENSATION ARRANGEMENTS, INCLUDING THE PAYMENT OF DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES, ARE DETERMINED BY THE SYSTEM BOARD. PAYMENTS MADE TO ANY DISQUALIFIED PERSON ARE APPROVED BY THE COMPENSATION COMMITTEE OF SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. -------------------- A DELAWARE HLTH FACILITIES AUTHORITY SERIES 2020A 510272458 246388TQ5 2020-02-11 247255000 REFUND SERIES 2008 & 2010 false false false A 280000 0 305483000 0 0 0 2324976 0 0 145360019 157798005 0 2021 true false true true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false false true false false 0 false 0 false true A true FORM 990, SCHEDULE K, PART I ADDITIONAL INFORMATION REGARDING TAX-EXEMPT BONDS THE DELAWARE HEALTH FACILITIES AUTHORITY SERIES 2020A BOND WAS ISSUED TO CHRISTIANA CARE HEALTH SYSTEM, INC. (EIN:52-1479538), A RELATED IRC SECTION 501(C)(3) ORGANIZATION. SINCE ALL BOND PROCEEDS WERE ALLOCATED TO CHRISTIANA CARE HEALTH SERVICES, INC., THIS BOND HAS BEEN REPORTED ON THIS ORGANIZATION'S FORM 990, SCHEDULE K. HOWEVER, CHRISTIANA CARE HEALTH SYSTEM, INC. REMAINS AS THE PRIMARY OBLIGOR OF THE BOND. -------------------- FORM 990, SCHEDULE K, PART II, LINE 3 ADDITIONAL INFORMATION REGARDING PROCEEDS OF ISSUE FOR DELAWARE HLTH FACILITIES AUTHORITY SERIES 2020A, THE TOTAL PROCEEDS OF THE ISSUE REPORTED INCLUDES INVESTMENT EARNINGS. -------------------- FORM 990, SCHEDULE K, PART II, LINE 5 ADDITIONAL INFORMATION REGARDING CAPITALIZED INTEREST FROM PROCEEDS ALTHOUGH CCHS CAPITALIZES INTEREST FOR BOOK PURPOSES, BOND PROCEEDS ARE NOT USED TO PAY INTEREST AND ARE THEREFORE NOT REPORTED ON PART II, LINE 5. -------------------- FORM 990, SCHEDULE K, PART IV ADDITIONAL INFORMATION REGARDING ARBITRAGE REBATE CCHS RECEIVED ITS 5-YEAR ARBITRAGE COMPLIANCE REPORT ON 2/14/2025. THIS REPORT IS FINAL. X 8 142903 FMV false true false SCHEDULE M, PART I, COLUMN (B) ADDITIONAL INFORMATION REGARDING SECURITIES REPORTED CHRISTIANA CARE HEALTH SERVICES, INC. REPORTS THE NUMBER OF CONTRIBUTIONS IN PART I, COLUMN (B). FORM 990, PART VI, SECTION A, LINES 6 & 7A,7B GOVERNING BODY AND MANAGEMENT CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), A TAX-EXEMPT ORGANIZATION, IS THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). THE SYSTEM BOARD ELECTS DIRECTORS OF CCHS AT ITS ANNUAL MEETING. THE ANNUAL OPERATING BUDGET OF CCHS IS APPROVED BY THE CCHS BOARD, THE SYSTEM FINANCE COMMITTEE, AND THE SYSTEM BOARD. -------------------- FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS INFORMATION RELATED TO CHRISTIANA CARE'S FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PWC US TAX LLP FOR REVIEW. THE FINAL 2023 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2024 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2023 FORM 990 VIA ITS BOARD OF DIRECTOR'S PORTAL. -------------------- FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OUR CONFLICT OF INTEREST ("COI") POLICY IS LOCATED IN THE CAREGIVER RESOURCE CENTER ON THE EMPLOYEE PORTAL. THERE IS AN ANNUAL MANDATORY EDUCATION FOR MANAGERS WHICH INCLUDES AN ELECTRONIC SIGN OFF ACKNOWLEDGING COMPLETION OF THE EDUCATION, REPORTING OF A REAL OR PERCEIVED CONFLICT OR THAT NO CONFLICTS OF INTEREST EXISTS. THE HR/EMPLOYEE RELATIONS TEAM FOLLOWS UP WITH ANYONE WHO HAS A CONFLICT OR PERCEIVED CONFLICT OR DOES NOT COMPLETE THE EDUCATION IN ORDER TO RESOLVE. SEVERAL REPORTING MECHANISMS ALSO EXIST FOR EMPLOYEES TO REPORT CONCERNS. THE BOARD OF DIRECTORS HAS THEIR OWN COI POLICY. COI IS A STANDING AGENDA ITEM ON EACH BOARD OR BOARD COMMITTEE MEETING. BOARD MEMBERS EXPECTATIONS FOR COI ARE CLEARLY COMMUNICATED. -------------------- FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL PROCESS THE BOARD OF DIRECTORS OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") ESTABLISHES CCHS'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE SYSTEM BOARD ENGAGES AN INDEPENDENT THIRD PARTY ANNUALLY WHO ASSESSES DATA FROM SEVERAL MAJOR SURVEYS TO ENSURE TOTAL REMUNERATION IS MARKET COMPETITIVE AND QUALIFIES FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULE, SECTION 4958 OF THE INTERNAL REVENUE CODE. AFTER DELIBERATION, THE ECC DOCUMENTS THEIR DECISIONS IN MEETING MINUTES. -------------------- FORM 990, PART VI, SECTION B, LINE 16B JOINT VENTURE ARRANGEMENTS ALTHOUGH THE ORGANIZATION DOES NOT HAVE A WRITTEN POLICY IN PLACE REGARDING PARTICIPATION IN JOINT VENTURE RELATIONSHIPS, WHEN ANY SUCH RELATIONSHIPS ARE CONSIDERED, THEY ARE FIRST REVIEWED AND EVALUATED BY MANAGEMENT OFFICIALS IN CONJUNCTION WITH PWC US TAX LLP -------------------- FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT, & DISCLOSURE THE GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. -------------------- FORM 990, PART X BALANCE SHEET CERTAIN PRIOR YEAR BALANCES HAVE BEEN RESTATED TO CONFORM TO THE CURRENT YEAR PRESENTATION. -------------------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS CHANGE IN PENSION AND POST RETIREMENT LIABILITIES $ (29,308,906) CHANGE IN NET ASSET OF SYSTEM 261,007 OTHER CHANGES 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