2022-05-14T10:58:32-05:00 2021-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2020-07-01 470757164 ALEGENT CREIGHTON HEALTH ALEG 4023434323 12809 WEST DODGE ROAD OMAHA NE 68154 JEANETTE WOJTALEWICZ CFO 4023434323 2022-05-14 1 JEANETTE WOJTALEWICZ ANGELA NOEL P01051055 3032989100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z EJ KUIPER 12809 WEST DODGE ROAD OMAHA NE 68154 537332102 0 X WWW.CHIHEALTH.COM X 1992 NE THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. 14 10 3346 224 33264481 791599 6452546 12212679 321809089 374750354 4241963 4785117 304376333 136385181 636879931 528133331 117164 207651 0 0 167216290 174606326 0 0 0 456778264 344342856 624111718 519156833 12768213 8976498 938729110 854680490 516452665 358379622 422276445 496300868 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 52051270 31320 51736666 ALEGENT CREIGHTON HEALTH STAFF ARE FOCUSED ON RESTORING PATIENTS' HEALTH BY USING PERSONALIZED CARE AND STATE-OF-THE-ART TECHNOLOGY. THE DIAGNOSTIC CENTER AT THE HOSPITALS ARE EQUIPPED WITH THE LATEST DIGITAL IMAGING TECHNOLOGY. HEALTHCARE PROVIDERS HAVE MEDICAL INFORMATION AT THEIR FINGER TIPS, SO DIAGNOSIS IS QUICKER AND TREATMENT CAN BE STARTED SOONER. EACH DIAGNOSTIC CENTER OFFERS A FULL RANGE OF DIAGNOSTIC IMAGING SERVICES INCLUDING BUT NOT LIMITED TO THE FOLLOWING: MRI, CT SCANNING, PET/CT SCAN, ULTRASOUND, MAMMOGRAMS, NUCLEAR MEDICINE, CLINICAL LABORATORY, X-RAY IMAGING, PULMONARY SERVICES, OUTPATIENT LABORATORY TESTING, ANGIOGRAPHY AND RADIOGRAPHY. 23867184 37418 61809271 AT ALEGENT CREIGHTON HEALTH, OUR TEAM OF BOARD-CERTIFIED SURGEONS PROVIDES A FULL RANGE OF SURGICAL SOLUTIONS. OUR SURGEONS ARE EXCEPTIONALLY SKILLED AND HAVE MANY YEARS OF EXPERIENCE, WHICH ENSURES EVERY PATIENT WILL RECEIVE THE EXPERTISE THEY NEED AND THE COMPASSIONATE CARE THEY DESERVE. WE TAKE PRIDE IN MAKING SURE YOUR EXPERIENCE IS AS CONVENIENT AND COMFORTABLE AS POSSIBLE. EACH PATIENT CAN COUNT ON US FOR AN UNPARALLELED LEVEL OF CARE AND QUALITY SURGICAL OUTCOMES. 13404147 15001 24779723 ALEGENT CREIGHTON HEALTH OFFERS A WIDE RANGE OF COMPREHENSIVE CARDIOVASCULAR SERVICES IN THE REGION, USING A TEAM APPROACH TO ADDRESS THE TOTAL NEEDS OF THE CARDIOVASCULAR PATIENT. CARDIAC SERVICES INCLUDE BUT ARE NOT LIMITED TO: HI-TECH DIAGNOSIS AND INTERVENTION, CARDIAC CATHETERIZATION LAB, ECHOCARDIOGRAPHY, VASCULAR ULTRASOUND, HEART SCANS AND HEART CHECKS, ANGIOPLASTY AND DRUG-ELUTING STENTS. 409721876 123912 204684223 ALEGENT CREIGHTON HEALTH GIVES BACK TO OUR COMMUNITY THROUGH A VARIETY OF MEDICAL SERVICES AND PARTNERSHIPS. ALEGENT HEALTH QUICK CARE PROVIDES URGENT MEDICAL TREATMENTS, SCREENINGS AND ADULT IMMUNIZATIONS FOR PATIENTS 18 MONTHS AND OLDER. THROUGH OUR COLLABORATION WITH OTHER LOCAL COMMUNITY ORGANIZATIONS SUCH AS BOYS TOWN, CREIGHTON UNIVERSITY, OUR HEALTHY COMMUNITY PARTNERSHIP AND ONE WORLD COMMUNITY HEALTH CENTER, ALEGENT CREIGHTON HEALTH IS HELPING TO IDENTIFY AND ADDRESS COMMUNITY HEALTH NEEDS. IN ADDITION, ALEGENT CREIGHTON HEALTH ALSO PROVIDES THE FOLLOWING SERVICES: MATERNITY CARE SERVICES, MENTAL AND BEHAVIORAL HEALTH CARE, ONCOLOGY, PROCEDURE CENTER AND INPATIENT FACILITIES INCLUDING INTENSIVE CARE. 409721876 123912 204684223 499044477 1 1 0 1 0 0 0 0 0 1 1 1 1 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 X 22 0 1 3346 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 0 X JEANETTE WOJTALEWICZ 4023434323 12809 WEST DODGE ROAD OMAHA NE 68154 ANTHONY JONES BOARD MEMBER 1.00 59.00 X 0 2948442 27283 CLIFF ROBERTSON MD BOARD MEMBER/CEO, CHI HEALTH 5.00 45.00 X X 0 2330702 46702 JOHN PETERSDORF BOARD MEMBER 1.00 45.00 X 0 1060100 793557 JEANETTE WOJTALEWICZ BOARD MEMBER/CFO, CHI HEALTH 5.00 45.00 X X 986312 0 50266 KATHY BRESSLER CHIEF OPERATING OFFICER 10.00 40.00 X 975743 0 30868 ANN SCHUMACHER PRESIDENT IMC 0.00 50.00 X 784580 0 47077 LINDA CHASE DIV SVP CNO 10.00 50.00 X 712664 0 15425 CARY WARD MD CHI HEALTH SVP CMO 10.00 50.00 X 642515 0 41571 JAYLEEN CASANO PRESIDENT CUMC-BERGAN MERCY 0.00 50.00 X 621990 0 60943 MICHAEL SCHNIEDERS PRESIDENT GOOD SAMARITAN 0.00 49.00 X 602359 0 35131 ARMAN PAJNIGAR PHYSICIAN INTERNAL MEDICINE 1.00 50.00 X 1493 545842 27376 KEVIN MILLER PRESIDENT - LKS & MDL HOSPITAL 50.00 0.00 X 526301 0 69872 STEVE HOUSTON SVP STRATEGY & BUSINESS DEVELOPMENT 10.00 40.00 X 433805 0 41724 AARON AUSTIN SVP HR CHI HEALTH 10.00 49.00 X 412440 0 36173 HEATHER MORGAN MD BOARD MEMBER 1.00 55.00 X 0 293208 48743 NICK OTOOL INTERIM CFO CHI HEALTH 5.00 45.00 X 212548 0 40111 GREGORY BECKMANN PRESIDENT - PLAINVIEW HOSPITAL 50.00 0.00 X 206909 0 45116 JASON KRUGER MD BOARD MEMBER 1.00 11.00 X 0 143420 41585 FR JAMES CLIFTON SJ SECRETARY 1.00 12.00 X X 525 1825 0 JENNIFER BEATY MD BOARD MEMBER 1.00 11.00 X 0 0 0 RICHARD HERINK BOARD MEMBER 1.00 11.00 X 0 0 0 SUSANNE L HRUZA MD BOARD MEMBER 1.00 11.00 X 0 0 0 ROBERT LANIK TREASURER 1.00 11.00 X X 0 0 0 THOMAS MURRAY PHD BOARD MEMBER 1.00 12.00 X 0 0 0 BARRY SANDSTROM BOARD MEMBER 1.00 11.00 X 0 0 0 SISTER MAURITA SOUKUP BOARD CHAIR 1.00 11.00 X X 0 0 0 BILL YATES BOARD MEMBER 1.00 11.00 X 0 0 0 NADINE HEIMANN OSF BOARD MEMBER 1.00 11.00 X 0 0 0 MARDELL WILSON EDD BOARD MEMBER 1.00 11.00 X 0 0 0 KENT BARNEY BOARD MEMBER 1.00 11.00 X 0 0 0 7120184 7323539 1499523 240 0 1 0 DELOITTE CONSULTING LLP 30 ROCKEFELLER PLAZA NEW YORK NY 10112 CONSULTING SERVICES 4311268 JE DUNN CONSTRUCTION COMPANY 17110 MARCY STE LL01 OMAHA NE 68118 CONSTRUCTION SERVICES 2411493 WALZ TETRICK ADVERTISING INC 5201 JOHNSON DRIVE SUITE 500 MISSION KS 66205 ADVERTISING SERVICES 2346532 BANYAN MEDICAL SYSTEMS LLC 4106 SOUTH 87TH ST OMAHA NE 68127 PROFESSIONAL SERVICES 2129472 AMERITEX SERVICES 1321 SOUTH 20TH ST OMAHA NE 68108 LAUNDRY/LINEN SERVICES 1658912 75 115093 592482 5952748 5552356 4155520 12212679 NET PATIENT SERVICES 900099 244217104 244217104 0 0 PHARMACY SERVICES 446110 122939732 90782311 32157421 0 MANAGEMENT FEES 541610 7065204 6184856 880348 0 MEDICAL SERVICES 621300 528314 472056 56258 0 374750354 2188391 15214 2173177 8304835 6461730 1843105 1843105 53075 1790030 5199401 35191 0 2637866 5199401 -2602675 2596726 2596726 96978 99175 -2197 -2197 REIMBURSEMENT OF EXPEN 900099 128474333 1353556 0 127120777 ACCOUNTABLE CARE REVEN 524298 1525000 0 0 1525000 COMMUNITY HEALTH PROGR 900099 982311 0 29028 953283 3562629 73137 3489492 134544273 528133331 343009883 33264481 139646288 200031 200031 7620 7620 4639592 4407612 231980 136303686 129488502 6815184 6758076 6420172 337904 16919047 16073094 845953 9985925 9486628 499297 54796624 53347609 1449015 2624207 2624207 216859 216859 157691 149806 7885 32286656 30314360 1972296 6413381 6092712 320669 9769524 9281048 488476 7550131 7172625 377506 13393439 12723767 669672 655200 622440 32760 37123 35267 1856 1176617 1176617 5340584 5073555 267029 38957924 37010028 1947896 761321 723255 38066 MEDICAL SUPPLIES 145410400 145410400 0 0 INTERCOMPANY ALLOCATION 16142160 15335052 807108 0 REPAIRS AND MAINTENANCE 6506263 6180950 325313 0 UNRELATED BUSINESS TAXE 764229 764229 0 0 1382523 1330239 52284 519156833 499044477 20112356 0 1063897 647116 0 0 35677309 51201796 0 0 0 10627649 11788926 3828360 4478900 581613340 290577277 292844509 291036063 0 66763986 74103724 48244612 50908361 85074076 85074076 394604712 285441528 938729110 854680490 141185454 245680291 0 4969656 2715397 0 0 0 14786533 14714172 0 355511022 95269762 516452665 358379622 X 422276445 496300868 0 422276445 496300868 938729110 854680490 X 8976498 10893132 1123410 53031383 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 216859 223566 216859 223566 498827618 675103319 499044477 675326885 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 198809 214256 209116 223566 845747 250000 250000 250000 250000 1000000 1500000 4356201 633390 258429 507592 4740428 4375589 572313 -34471 557230 4356201 4158636 660929 35739 479715 4375589 3792434 1037892 17211 688901 4158636 3974504 599535 53758 835363 3792434 0.00000 0.00000 1.00000 0 1 1 33711803 33711803 192865121 49161820 143703301 7927840 3055229 4872611 310533370 234787401 75745969 36575206 3572827 33002379 291036063 CSH OPERATING INVESTMENT POOL 74103724 F 74103724 INVESTMENTS IN UNCONSOLIDATED ORGS - CONTROLLING INTEREST 50908361 F 50908361 ASSETS HELD FOR FUTURE EXPANSION 5018396 INTERCOMPANY RECEIVABLES 228861908 RIGHT-OF-USE OPERATING LEASE 47542600 RIGHT-OF-USE FINANCE LEASE 4018624 285441528 1141 MINIMUM PENSION LIABILITY 37177753 LONG-TERM NOTES PAYABLE 49902 OPERATING LEASE LIABILITY 53662810 FINANCE LEASE LIABILITY 4059057 OTHER LIABILITIES 91105 ENVIRONMENTAL REMEDIATION LIABILITY 227994 95269762 X PART V, LINE 4: ENDOWMENT FUNDS ARE HELD BY CHI HEALTH FOUNDATION TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF ALEGENT CREIGHTON HEALTH. PART X, LINE 2: ALEGENT CREIGHTON HEALTH'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. SUB-SAHARAN AFRICA 1 1 PROGRAM SERVICES SCHOOL OF NURSING 208014 0 1 0 0 0 1 208014 0 208014 0 0 0 0 0 0 PART I, LINE 3: SUB-SAHARAN AFRICA: ACCRUAL ALEGENT CREIGHTON HEALTH HAS ONE DESIGNATED EMPLOYEE WHO IS THE LIAISON FOR THE HOSPITAL LOCATED IN TANZANIA. THE EMPLOYEE ASSISTS WITH THE PROGRAMS, SERVICES, AND ACTIVITIES FOR THE HOUSES FOR HEALTH AND SCHOOL OF NURSING DEPARTMENTS. PART III ACCOUNTING METHOD: 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 0 4431 3945606 0 3945606 0.00760 0 5402 23860054 14376080 9483974 0.01830 0 0 0 0 9833 27805660 14376080 13429580 0.02590 22 3004 434148 7684 426464 0.00080 8 489 263804 0 263804 0.00050 3 0 1520347 859152 661195 0.00130 3 0 12860 0 12860 0.00000 6 647 117545 446 117099 0.00020 42 4140 2348704 867282 1481422 0.00280 42 13973 30154364 15243362 14911002 0.02870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15809 0 15809 0.00000 0 0 0 0 0 0 0 0 0 0 0 0 1 15809 15809 0.00000 1 16388652 0 38833313 55047147 -16213834 X 1 1 1 LAKESIDE AMBULATORY SURGICAL CENTER LLC AMBULATORY SURGICAL CENTER 0.63370 0.00000 0.36630 2 LAKESIDE ENDOSCOPY CENTER LLC AMBULATORY SURGICAL CENTER 0.51020 0.00000 0.48980 3 NEBRASKA SPINE LLC SPINE HOSPITAL 0.51000 0.00000 0.44000 4 BERGAN MERCY SURGICAL CENTER LLC AMBULATORY SURGICAL CENTER 0.63930 0.00000 0.36070 3 1 CHI HEALTH LAKESIDE 16901 LAKESIDE HILLS CT OMAHA NE 68130 WWW.CHIHEALTH.COM H000106 X X X A 2 CHI HEALTH MIDLANDS 11111 S 84TH ST PAPILLION NE 68046 WWW.CHIHEALTH.COM 680001 X X X A 3 CHI HEALTH PLAINVIEW 704 N 3RD ST PLAINVIEW NE 68769 WWW.CHIHEALTH.COM 620002 X X X B FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.CHIHEALTH.COM/CHNA X 1 19 1 WWW.CHIHEALTH.COM/CHNA 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE X WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE X WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 FACILITY REPORTING GROUP - B 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.CHIHEALTH.COM/CHNA X X 1 19 1 WWW.CHIHEALTH.COM/CHNA 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE X WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE X WWW.CHIHEALTH.COM/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 2: CHI HEALTH MIDLANDS, - FACILITY 1: CHI HEALTH LAKESIDE FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: THROUGH THE PRC CHNA PROCESS, INPUT WAS GATHERED FROM A WIDE VARIETY OF INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS (INCLUDING AFRICAN-AMERICAN, AMERICAN INDIAN, ASIAN, ASYLEES, BHUTANESE, BURMESE, CAUCASIAN/WHITE, CHILD WELFARE SYSTEM, CHILDREN, DISABLED, ELDERLY, ESL, HEARING IMPAIRED, HISPANIC, HOMELESS, IMMIGRANTS/REFUGEES, INTERRACIAL FAMILIES, KAREN, LGBT, LOW-INCOME, MEDICAID, MENTALLY ILL, MIDDLE EASTERN, MINORITIES, MUSLIM REFUGEES, NEPALI REFUGEES, NON-ENGLISH SPEAKING, NORTH AND SOUTH OMAHA, RESIDENTS OF THE SUBURBS, RETIRED, RURAL, SINGLE-PARENT FAMILIES, SOMALIAN, SOUTHEAST ASIAN, SUDANESE, TEEN PREGNANCY, UNDERSERVED, UNDOCUMENTED, UNINSURED/UNDERINSURED, VETERANS, VIETNAMESE, WOMEN AND CHILDREN, WORKING PROFESSIONALS), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (INCLUDING AFRICAN-AMERICANS, AIDS/HIV, AUTISTIC, CAUCASIAN/WHITE, CHILDREN (INCLUDING THOSE WITH INCARCERATED PARENTS AND THOSE OF PARENTS WITH MENTAL ILLNESS), DISABLED, DOMESTIC ABUSE AND SEXUAL ASSAULT VICTIMS, ELDERLY, EX-FELONS AND RECENTLY INCARCERATED, HISPANIC, HOMELESS, IMMIGRANTS/REFUGEES, LACK OF TRANSPORTATION, LGBT, LOW-INCOME, MEDICAID/MEDICARE, MENTALLY ILL, MINORITIES, NON-ENGLISH SPEAKING, NORTH AND SOUTH OMAHA, PRENATAL, SUBSTANCE ABUSERS, UNDOCUMENTED, UNINSURED/UNDERINSURED, VETERANS, VICTIMS OF VIOLENCE, WIC CLIENTS, WOMEN AND CHILDREN, YOUNG ADULTS). THIS INPUT WAS GATHERED PRIMARILY THROUGH THE KEY INFORMANT SURVEY AS DESCRIBED IN THE PRC METHODS SECTION OF THE FULL CHNA REPORT. ADDITIONAL COMMUNITY INPUT WAS COLLECTED AT THE LIVE WELL OMAHA CHANGEMAKER SUMMIT ON NOVEMBER 5, 2018, COSPONSORED BY THE LOCAL AREA HOSPITAL SYSTEMS- CHI HEALTH, METHODIST HEALTH SYSTEM, CHILDREN'S HOSPITAL & MEDICAL CENTER AND NEBRASKA MEDICINE- ALONG WITH SEVERAL OTHER PUBLIC HEALTH AND SOCIAL SERVICE ORGANIZATIONS.OVER 160 STAKEHOLDERS PARTICIPATED IN A DATA PRESENTATION FACILITATED BY PRC. THE SUMMIT CONCLUDED WITH A COMMUNITY VOTING SESSION TO DERIVE FOCUSED PRIORITIES FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE CHANGEMAKER SUMMIT COMMUNITY VOTING PRIORITIES ARE LISTED IN THE PRIORITIZATION PROCESS. CHI HEALTH THEN USED THE COMMUNITY INPUT FROM THE CHNA AND CHANGEMAKER SUMMIT TO INFORM TOP PRIORITIES FOR EACH HOSPITAL IMPLEMENTATION PLAN. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: CHI HEALTHNEBRASKA MEDICINEMETHODIST HEALTH SYSTEM FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: DOUGLAS COUNTY HEALTH DEPARTMENTLIVE WELL OMAHAPOTTAWATTAMIE COUNTY PUBLIC HEALTH DEPARTMENTSARPY/CASS COUNTY DEPARTMENT OF HEALTH AND WELLNESSCHARLES DREW HEALTH CENTEROMAHA COMMUNITY FOUNDATIONONE WORLD COMMUNITY HEALTH CENTERS, INC.UNITED WAY OF THE MIDLANDS 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 2018. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON WWW.CHIHEALTH.COM/CHNA. A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED ON BEHALF OF THE FIVE OMAHA METRO CHI HEALTH HOSPITALS (CUMC BERGAN, IMMANUEL, LAKESIDE, MERCY COUNCIL BLUFFS, AND MIDLANDS AND ONE PSYCHIATRIC INPATIENT FACILITY (LASTING HOPE RECOVERY CENTER)), IN PARTNERSHIP WITH THE HEALTH DEPARTMENTS OF DOUGLAS, SARPY/ CASS AND POTTAWATTAMIE AND OTHER LOCAL NON-PROFITS TO SATISFY REGULATORY COMPLIANCE.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH A REVIEW OF PRIMARY DATA COLLECTED VIA THE COMMUNITY HEALTH SURVEY AND KEY INFORMANT SURVEY AND ADDITIONAL COMMUNITY INPUT SESSIONS. A COMPREHENSIVE EXAMINATION OF EXISTING SECONDARY DATA WAS COMPLETED AND REVIEWED DURING THE CHNA PROCESS FOR THE OMAHA METRO AREA BY PRC AT THE DIRECTION OF THE DOUGLAS COUNTY HEALTH DEPARTMENT, SARPY/ CASS DEPARTMENT OF HEALTH AND WELLNESS, POTTAWATTAMIE COUNTY PUBLIC HEALTH DEPARTMENT AND SPONSORING HEALTH CARE ORGANIZATIONS. A LIST OF UTILIZED SOURCES CAN BE FOUND IN THE PRC COMPLETE REPORT IN THE APPENDIX OF THE CHNA. IN ORDER TO ANALYZE DATA AND DETERMINE PRIORITIES, STANDARDIZED DATA WAS USED FOR BENCHMARKING, WHERE APPROPRIATE. THIS WAS ACCOMPLISHED BY REVIEWING TREND DATA PROVIDED BY PRC FROM PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS, NEBRASKA AND IOWA RISK FACTOR DATA, NATIONWIDE RISK FACTOR DATA, AND HEALTHY PEOPLE 2020. TOP HEALTH NEEDS (FROM 2018 CHNA): 1. ACCESS TO HEALTHCARE SERVICES2. CANCER3. DEMENTIA & ALZHEIMER'S DISEASES4. DIABETES5. HEART DISEASE AND STROKE6. INJURY AND VIOLENCE7. MENTAL HEALTH8. NUTRITION, PHYSICAL ACTIVITY & WEIGHT9. RESPIRATORY DISEASES10. SEXUALLY TRANSMITTED DISEASES11. SUBSTANCE ABUSEFOR THIS JOINT IMPLEMENTATION STRATEGY PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS. THEY REPRESENT STRATEGIES THE HOSPITAL WILL EITHER LEAD OR PARTICIPATE IN JOINTLY WITH OTHER CHI HEALTH HOSPITALS, (DESIGNATED AS A 'SYSTEM' STRATEGY BELOW). ONLY STRATEGIES THAT ARE LED OR CO-LED BY CHI HEALTH LAKESIDE OR CHI HEALTH MIDLANDS ARE REPORTED BELOW. PRIORITY HEALTH NEEDS AND STRATEGIES ARE NUMBERED TO ALIGN WITH THE PUBLISHED JOINT IMPLEMENTATION PLAN AT WWW.CHIHEALTH.COM/CHNA:PRIORITY HEALTH NEED #1: BEHAVIORAL HEALTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:- PROVIDE SUPPORT FOR INDIVIDUALS WITH ALZHEIMER'S/ DEMENTIA AND THEIR CAREGIVERS (LAKESIDE/ SYSTEM)- PARTICIPATE IN THE SARPY COUNTY MENTAL HEALTH PROBLEM-SOLVING TASK FORCE (MIDLANDS)- SUPPORT A TOBACCO COALITION AT CHI HEALTH MIDLANDS THAT LEADS POLICY, SYSTEMS AND ENVIRONMENTAL CHANGES THAT REDUCE THE BURDEN OF TOBACCO USAGE IN THE OMAHA METRO- LEAD POLICY/ ADVOCACY EFFORTS THAT EXPAND ACCESS TO BEHAVIORAL HEALTH SERVICES (SYSTEM)- PROVIDE LEADERSHIP AND SUPPORT FOR THE BUILD HEALTH CHALLENGE LED BY HEARTLAND FAMILY SERVICE (SYSTEM)- SUPPORT THE MENTAL HEALTH STIGMA REDUCTION CAMPAIGN COORDINATED BY THE WELLBEING PARTNERSPRIORITY HEALTH NEED #2: SOCIAL DETERMINANTS OF HEALTHTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:- FINANCIAL SUPPORT AND PROMOTION OF DOUBLE UP FOOD BUCKS, A SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) INCENTIVE PROGRAM (SYSTEM)- SIEMBRA SALUD- 'GROW WELLNESS' A BACKYARD GARDEN, HOME VISITING AND EDUCATION PROGRAM DESIGNED TO INCREASE FOOD ACCESS FOR LOW-INCOME LATINO RESIDENTS IN EAST OMAHA (SYSTEM)- SUPPORT FARMER'S MARKETS NUTRITION EDUCATION PROGRAMS (SYSTEM)- PROVIDE FUNDING AND IN-KIND SUPPORT FOR THE IMPLEMENTATION OF THE SHARE OUR TABLE FOOD SECURITY PLAN IN THE OMAHA METRO (SYSTEM)- DEVELOP AND TEST SCREENING AND REFERRAL PROCESSES FOR SOCIAL NEEDS THROUGH UNITE US (SYSTEM)- PARTICIPATE IN INTERNAL AND EXTERNAL WORKFORCE DEVELOPMENT EFFORTS (E.G. STEP UP SUMMER INTERNSHIP PROGRAM, CAREER ACADEMY AND EMPOWERMENT NETWORK FINANCIAL SUPPORT) (SYSTEM)- SUPPORT COMMUNITY LINK PROGRAM AND RELATED EFFORTS TO ADDRESS OUR PATIENTS IDENTIFIED SOCIAL NEEDS THROUGH COMMUNITY ADVOCATES (SYSTEM)PRIORITY HEALTH NEED #3: VIOLENCE PREVENTION & INTERVENTIONTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:- EXPAND THE FORENSIC NURSE EXAMINER PROGRAM (FORMERLY SANE) (SYSTEM) - ALIGN WITH STATE - LEVEL EFFORTS TO IDENTIFY VICTIMS OF HUMAN TRAFFICKING IN HEALTHCARE SETTINGS AND PROVIDE SUPPORT RESOURCES (SYSTEM)- EXPLORE ONGOING OPPORTUNITIES TO PROMOTE TRAUMA INFORMED CARE PRACTICES AND ALIGN WITH TRAUMA INFORMED CITY INITIATIVE (SYSTEM)EXPLORE ONGOING OPPORTUNITIES TO PROMOTE TRAUMA INFORMED CARE PRACTICES AND ALIGN WITH TRAUMA INFORMED CITY INITIATIVE (SYSTEM)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 HAS CONTINUED TO EXPAND ITS PORTFOLIO OF PRIMARY CARE ACCESS POINTS INCLUDING EXTENDED CLINIC HOURS, PRIORITY CARE SERVICES (WALK-IN CARE), QUICK CARE, VIRTUAL CARE, AND PARTNERING WITH MEDEXPRESS FOR URGENT 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, HOPE MEDICAL, FEDERALLY QUALIFIED HEALTH CENTERS- CHARLES DREW AND ONE WORLD COMMUNITY HEALTH CENTER- AND THROUGH FREE HEALTH SCREENINGS AND IMMUNIZATION CLINICS IN THE COMMUNITY. CANCER- CHI HEALTH DID NOT PRIORITIZE CANCER AS A TOP HEALTH NEED IN ORDER TO FOCUS AND MEANINGFULLY IMPACT OTHER AREAS OF NEED. THE PRIORITIZED HEALTH NEEDS ABOVE REPRESENT A CONCERTED EFFORT TO FOCUS ON UPSTREAM EFFORTS THAT MAY IMPACT AN INDIVIDUAL'S CANCER RISK, PARTICULARLY LIFESTYLE FACTORS SUCH AS ALCOHOL AND SUBSTANCE ABUSE. 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. ADDITIONALLY, CHI HEALTH CLINICS ARE WORKING TO INCREASE UTILIZATION OF HPV VACCINATION TO PREVENT CERVICAL CANCER. DEMENTIA AND ALZHEIMER'S DISEASES- THIS NEED WILL BE MET 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. DIABETES- CHI HEALTH DID NOT PRIORITIZE DIABETES 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 NUTRITION, PHYSICAL ACTIVITY & WEIGHT STATUS FOR RELATED ACTIVITIES. 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 HEART AND SOLE/ HEART FAILURE 101 AND OFFERING HEART HEALTHY COOKING CLASSES. CHI HEALTH IS A FINANCIAL SUPPORTER OF THE AMERICAN HEART ASSOCIATION. SEE 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 THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) 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 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 CHI 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 FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 3: CHI HEALTH PLAINVIEW FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS GATHERED THROUGH THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS FACILITATED BY THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT (NCDHD). COMMUNITY INPUT IS AN IMPORTANT ASPECT OF ALL FOUR MAPP ASSESSMENTS, AND ALL FINDINGS WERE VALIDATED THROUGH ADDITIONAL COMMUNITY INPUT. SPECIFIC POPULATIONS AT HIGHER HEALTH RISK OR THAT HAVE POORER HEALTH OUTCOMES WERE IDENTIFIED IN THIS COMMUNITY AS LOW-INCOME, LOW-EDUCATION, HISPANIC, NATIVE AMERICAN, AND ELDERLY RESIDENTS. IN ADDITION TO USING EXISTING RELATIONSHIPS WITH ORGANIZATIONS WHO WORK WITH THESE POPULATIONS TO DISTRIBUTE TARGETED COMMUNITY SURVEYS, REPRESENTATIVES FROM THESE ORGANIZATIONS ALSO PARTICIPATED IN COMMUNITY MEETINGS THROUGHOUT THE ASSESSMENT PROCESS. REPRESENTATIVES OF ALL FOUR SPECIAL POPULATIONS WERE INCLUDED ON INVITATIONS TO EVERY COMMUNITY MEETING. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 6A: ANTELOPE MEMORIAL HOSPITALAVERA CREIGHTON HOSPITALAVERA ST. ANTHONY'S HOSPITALBROWN COUNTY HOSPITALOSMOND GENERAL HOSPITAL FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 6B: THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT (NCDHD) CONDUCTED THE CHNA WHILE OTHER ORGANIZATIONS PARTICIPATED IN THE CHNA PROCESS. PLEASE SEE CHNA REPORT FOR COMPLETE LIST OF PARTICIPATING PARTNERS. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 7D: DATA PROVIDED BY THE NCDHD 2019 CHNA WAS PRESENTED TO CHI HEALTH HOSPITAL ADMINISTRATION, COMMUNITY BENEFIT TEAMS, AND COMMUNITY GROUPS FOR VALIDATION OF NEEDS. ALL PARTIES WHO REVIEWED THE DATA FOUND THE DATA TO ACCURATELY REPRESENT THE NEEDS OF THE COMMUNITY. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 11: THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2018. 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 A MAPP PROCESS. SIX NEEDS WERE ORIGINALLY IDENTIFIED BY NCDHD, AND CHI HEALTH PRIORITIZED THE SAME NEEDS AS THE COMMUNITY BASED ON EXISTING INITIATIVES, POTENTIAL FOR IMPACT, AND THE INTEREST OF THE COMMUNITY. TOP HEALTH NEEDS (FROM 2018 CHNA): 1. AGING2. MENTAL HEALTH 3. NUTRITION, PHYSICAL ACTIVITY, & WEIGHT4. SCREENING FOR CHRONIC DISEASE5. SUBSTANCE ABUSE6. YOUTH BEHAVIORSFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: BEHAVIORAL HEALTH (INCLUDES MENTAL HEALTH AND SUBSTANCE ABUSE)TO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:- SUPPORT INTERNAL AND EXTERNAL EFFORTS TO PROMOTE MENTAL HEALTH SERVICES AND REDUCE SUBSTANCE ABUSE THROUGH EARLY INTERVENTION AND EDUCATION BY SUSTAINING A BEHAVIORAL HEALTH COALITION TO ADDRESS BEHAVIORAL HEALTH ISSUES AND CONNECT SERVICE PROVIDERSPRIORITY HEALTH NEED #2: CHRONIC DISEASE PREVENTION, DETECTION AND MANAGEMENT (INCLUDES NUTRITION, PHYSICAL ACTIVITY & WEIGHT STATUS)TO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN 2019-2021:- EXPAND ACCESS TO HEALTHY FOODS AND RECREATIONAL OPPORTUNITIES AND INCREASE AWARENESS OF RISK FACTORS FOR CHRONIC DISEASE BY ALIGNING HOSPITAL EFFORTS AND FINANCIAL SUPPORT WITH PIERCE COUNTY COMMUNITY PARTNERS.THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS FOR THE FOLLOWING REASONS: IN ACKNOWLEDGING THE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, CHI HEALTH PLAINVIEW PRIORITIZED THE HEALTH ISSUES ABOVE IN ORDER TO MOST EFFECTIVELY FOCUS RESOURCES AND MEANINGFULLY IMPACT THE SELECTED HEALTH ISSUES. THE HOSPITAL TOOK INTO CONSIDERATION EXISTING PARTNERSHIPS, AVAILABLE RESOURCES, THE HOSPITAL'S LEVEL OF EXPERTISE, EXISTING INITIATIVES (OR LACK THEREOF), POTENTIAL FOR IMPACT, AND THE COMMUNITY'S INTEREST IN THE HOSPITAL ENGAGING IN THAT AREA IN ORDER TO SELECT THE PRIORITIES. CHI HEALTH PLAINVIEW SELECTED THE SAME TOP HEALTH NEEDS AS IDENTIFIED BY THE COMMUNITY AND WILL ADDRESS EACH OF THOSE NEEDS AS DESCRIBED IN THE SECTION ABOVE. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) 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 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 CHI 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. FACILITY REPORTING GROUP A, PART V, SECTION B, LINE 11 (CONTINUED): NUTRITION, PHYSICAL ACTIVITY AND WEIGHT- THIS NEED WILL BE ADDRESSED IN PART THROUGH THE FOOD ACCESS STRATEGY UNDER THE SOCIAL DETERMINANTS OF HEALTH PRIORITY. 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, 5-4-3-2-1 GO!, LIVE WELL OMAHA, AND FREE "GET COOKING!" CLASSES OFFERED AT CHI HEALTH LAKESIDE AND CHI HEALTH MIDLANDS. 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, LIVE WELL OMAHA AND THE YMCA. RESPIRATORY DISEASES- CHI HEALTH DID NOT PRIORITIZE RESPIRATORY DISEASES IN ORDER TO FOCUS AND MEANINGFULLY IMPACT OTHER AREAS OF NEED. CHI HEALTH WILL CONTINUE TO PROVIDE THE BREATHE BETTER WITH COPD PROGRAM, FISCAL SPONSORSHIP AND IN- KIND SUPPORT OF TOBACCO EDUCATION AND ADVOCACY OF THE MIDLANDS (TEAM) AND PARTICIPATE IN COMMUNITY HEALTH FAIRS, OFFERING FREE SPIROMETRY TESTING. SEXUALLY TRANSMITTED DISEASES- THERE IS EXTENSIVE EXISTING WORK BY COMMUNITY PARTNERS CURRENTLY TAKING PLACE AROUND SEXUALLY TRANSMITTED DISEASES ACROSS THE OMAHA METRO AREA. 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. 11 1 - ACH-PLAINVIEW RURAL HEALTH CLINIC 704 N 3RD ST PLAINVIEW NE 68769 RURAL HEALTH CLINIC 2 - LAKESIDE ENDOSCOPY CENTER LLC 17001 LAKESIDE HILLS PLAZA OMAHA NE 68130 ENDOSCOPY CENTER 3 - LAKESIDE AMBULATORY SURGICAL CENTER LLC 17031 LAKESIDE HILLS DR OMAHA NE 68130 AMBULATORY SURGICAL CENTER 4 - BERGAN MERCY SURGERY CENTER LLC 7710 MERCY RD OMAHA NE 68124 AMBULATORY SURGICAL CENTER 5 - NEBRASKA SPINE HOSPITAL LLC 6901 N 72ND ST OMAHA NE 68122 SPINE HOSPITAL 6 - CHI HEALTH QUICK CARE LLC 12809 W DODGE RD OMAHA NE 68154 QUICK CARE 7 - CHI HEALTH AMBULATORY SURGERY CTR - MDLS 11111 84TH ST PAPILLION NE 68046 AMBULATORY SURGICAL CENTER 8 - CHI HEALTH CLINIC PLAINVIEW 704 N 3RD ST PLAINVIEW NE 68769 RURAL HEALTH CLINIC 9 - CHI HEALTH LAKESIDE IMAGING CENTER 17201 LAKESIDE HILLS PL STE 107 OMAHA NE 68130 DIAGNOSTIC IMAGING CENTER 10 - CHI HEALTH NURSING HOME NETWORK 12809 W DODGE RD OMAHA NE 68154 HOME CARE AND HOSPICE 11 - CHI HEALTH WEST OMAHA IMAGING CENTER 17201 WRIGHT ST STE 100 OMAHA NE 68130 DIAGNOSTIC IMAGING CENTER 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 THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. * THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG. * THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. * THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. 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 CLINIC; * PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); * FOOD STAMP ELIGIBILITY; * SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; * ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); * LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR * PATIENT IS DECEASED WITH NO KNOWN ESTATE. PART I, LINE 6A: THE 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 HTTP://WWW.CHIHEALTH.COM/COMMUNITY-BENEFIT. PART I, LINE 7: A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS. PART I, LN 7 COL(F): THIS BAD DEBT IS NOT RELATED TO PATIENT CARE. 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. BELOW ARE SPECIFIC EXAMPLES OF WORK THAT FALLS WITHIN THE DEFINITION OF COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE CRITICAL IN HELPING BUILD SOCIAL, HEALTH, AND ECONOMIC OPPORTUNITIES IN OUR COMMUNITY THAT ULTIMATELY DRIVE HEALTH STATUS AND QUALITY OF LIFE FOR OUR RESIDENTS: - WORKFORCE DEVELOPMENT-THE FOLLOWING ACTIVITIES WORK TO STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF OUR RESIDENTS BY DRIVING ENTRY INTO HEALTHCARE CAREERS: * PRESENTATIONS TO HIGH SCHOOL STUDENTS ABOUT HEALTHCARE CAREERS * STAFF TIME SPENT WITH HIGH SCHOOL SHADOW STUDENTS- COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE PART III, LINE 2: COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 45.22%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAYPATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: ALEGENT CREIGHTON HEALTH DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. PART III, LINE 4: ALEGENT CREIGHTON HEALTH DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS ARE PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF THE CHANGE.SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. BAD DEBT EXPENSE FOR 2021 AND 2020 WAS NOT SIGNIFICANT. 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 CREIGHTON HEALTH'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $16,213,834 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. 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. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. PART VI, LINE 2: THE PROCESS OF IDENTIFYING THE COMMUNITY HEALTH NEEDS ACROSS THE OMAHA METRO AREA WAS ACCOMPLISHED BY USING DATA AND COMMUNITY INPUT FROM PROCESSES LED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. * PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC) IS A THIRD-PARTY AGENT CONTRACTED BY LOCAL HEALTH SYSTEMS AND LOCAL HEALTH DEPARTMENTS ( SEE LIST BELOW) TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR A FOUR-COUNTY AREA, REFERRED TO AS THE OMAHA METRO AREA THAT INCLUDES DOUGLAS, SARPY, AND CASS COUNTIES, NEBRASKA, AND POTTAWATTAMIE COUNTY, IOWA. PRC IS A NATIONALLY RECOGNIZED HEALTHCARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING CHNAS ACROSS THE UNITED STATES SINCE 1994. ALONG WITH SEVERAL OTHER COMMUNITY STAKEHOLDERS, CHI HEALTH WAS AN ACTIVE KEY HEALTH PARTNER WORKING WITH PRC TO DESIGN, IMPLEMENT, AND REVIEW THE DATA. THE OMAHA METRO AREA CHNA, CONDUCTED BY PRC, UTILIZED BOTH PRIMARY AND SECONDARY DATA COLLECTED THROUGH THE PRC COMMUNITY HEALTH SURVEY (PRIMARY); ONLINE KEY INFORMANT SURVEY (PRIMARY); AND PUBLIC HEALTH, VITAL STATISTICS, AND OTHER DATA COLLECTION (SECONDARY). PLEASE REFERENCE THE COMPLETE CHNA FOR MORE IN-DEPTH DETAILS REGARDING THE CHNA PROCESS. UNDER THE DIRECTION OF THE NCDHD, THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED FOR THE NINE COUNTIES IN THE NORTH CENTRAL HEALTH DISTRICT. THIS ASSESSMENT WAS CONDUCTED IN PARTNERSHIP WITH MULTIPLE AGENCIES WITHIN THE DISTRICT AND WILL BE THE BASIS FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). IT IS THE GOAL OF THE 2019 NCDHD COMMUNITY HEALTH NEEDS ASSESSMENT TO DESCRIBE THE HEALTH STATUS OF THE POPULATION, IDENTIFY AREAS FOR HEALTH IMPROVEMENT, DETERMINE FACTORS THAT CONTRIBUTE TO HEALTH ISSUES, AND IDENTIFY ASSETS AND RESOURCES THAT CAN BE MOBILIZED TO ADDRESS PUBLIC HEALTH IMPROVEMENT. THE CHNA PROCESS WAS ACCOMPLISHED BY UTILIZING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) STRATEGY LED BY THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT (NCDHD). * NORTH CENTRAL DISTRICT HEALTH DEPARTMENT (NCDHD) IS A STATE-APPROVED DISTRICT HEALTH DEPARTMENT THAT SERVES NINE RURAL NEBRASKA COUNTIES - ANTELOPE, BOYD, BROWN, CHERRY, HOLT, KEYA PAHA, KNOX, PIERCE, AND ROCK (NCHD). NCDHD HAS BEEN STATE-APPROVED AS A MULTI-COUNTY PUBLIC HEALTH DEPARTMENT, A GOVERNMENT BODY AT THE COUNTY LEVEL, SINCE DECEMBER 2001, PROVIDING EDUCATION AND SERVICES TO THE NINE-COUNTY AREA. NCDHD COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR ALL NINE COUNTIES WITHIN THEIR DISTRICT. THIS ASSESSMENT CAN BE FOUND ONLINE AT HTTP://WWW.NCDHD.NE.GOV. * GIS AND HUMAN DIMENSIONS, LLC - NCDHD AND THE PARTNERING DISTRICT HOSPITALS CONTRACTED WITH GIS AND HUMAN DIMENSIONS, LLC, TO ASSEMBLE THIS ASSESSMENT OF PUBLIC HEALTH AND COMMUNITY WELL-BEING UNDER THE PROVISION OF NCDHD, BASED LARGELY UPON DATA COLLECTED THROUGH THE PROCESS OF MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP).THE MAPP PROCESS IS BASED ON FOUR ASSESSMENTS THAT PROVIDE CRITICAL INSIGHT INTO THE HEALTH CHALLENGES AND OPPORTUNITIES CONFRONTING THE COMMUNITY. THE ASSESSMENTS AND THE ISSUES ADDRESSED IN THE ASSESSMENTS ARE LISTED IN THE MAPP METHODS SECTION OF THE 2019 NCDHD COMMUNITY HEALTH NEEDS ASSESSMENT (SEE THE APPENDIX FOR AN EXECUTIVE SUMMARY AND A LINK TO THE FULL REPORT). MAPP WAS CHOSEN, IN PART, BECAUSE THE PROCESS ALLOWS FOR INPUT FROM PARTIES WHO REPRESENT BROAD INTERESTS IN THE COMMUNITIES. INPUT FROM DIVERSE SECTORS INVOLVED IN PUBLIC HEALTH, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND INDIVIDUALS FROM DIVERSE AGE GROUPS, WAS OBTAINED THROUGH SURVEYS AND TARGETED FOCUS GROUPS BY WAY OF INVITATIONS TO COMMUNITY LEADERS AND AGENCIES. PART VI, LINE 3: NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: * CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; * NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND * PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI 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.IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: CHI HEALTH LAKESIDE AND CHI HEALTH MIDLANDS ARE LOCATED IN OMAHA, NE AND AND PAPILLION, NE, RESPECTIVELY. THEY LARGELY SERVE 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." THE OMAHA METRO AREA IS A LARGELY WHITE POPULATION (83.1%, INDEPENDENT OF ETHNICITY) WITH A TOTAL POPULATION OF OVER 800,000 RESIDENTS. A TOTAL OF 10.5% OF METRO AREA RESIDENTS ARE HISPANIC OR LATINO AND 8.3% OF ALL OMAHA METRO AREA RESIDENTS ARE BLACK. 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% OF THE POPULATION IDENTIFYING AS BLACK OR AFRICAN AMERICAN AND 12% IDENTIFYING AS HISPANIC, IT IS LESS DIVERSE THAN THE UNITED STATES OVERALL (13.4% BLACK OR AFRICAN AMERICAN, 18.1% HISPANIC). CASS COUNTY HAS THE LARGEST PERCENTAGE OF THE POPULATION OVER THE AGE OF 65 YEARS (16%).DOUGLAS COUNTY: IDENTIFIED AS THE MOST DIVERSE COUNTY IN THE SERVICE AREA, DOUGLAS COUNTY'S POPULATION LARGELY CONSISTS OF 80.24% NON-HISPANIC WHITE RESIDENTS, 12.0% HISPANIC RESIDENTS, AND 11.17% BLACK OR AFRICAN AMERICAN RESIDENTS. - POPULATION: 543,253 RESIDENTS- 25.88% OF POPULATION IS BELOW 18 YEARS OF AGE AND 11.54% ARE 65 YEARS OR OLDER- MEDIAN HOUSEHOLD INCOME IS $56,003- PERSONS IN POVERTY IS 14%- CHILDREN IN POVERTY IS 15%- UNEMPLOYMENT RATE IS 3.5%- HIGH SCHOOL GRADUATION RATE IS 85% - 72% OF RESIDENTS HAVE SOME COLLEGE EDUCATION- 9% OF THE POPULATION IS UNINSURED, WITH 4.0% OF CHILDREN (UNDER THE AGE OF 19) BEING UNINSUREDSARPY COUNTY: AS THE SECOND MOST POPULATED COUNTY, SARPY COUNTY'S POPULATION LARGELY CONSISTS OF 89.88% NON-HISPANIC WHITE RESIDENTS, 8.41% HISPANIC, AND 4.07% BLACK OR AFRICAN AMERICAN. SARPY COUNTY BOASTS THE HIGHEST MEDIAN HOUSEHOLD INCOME, LOWEST UNEMPLOYMENT RATE, AND THE HIGHEST RATE FOR HIGH SCHOOL GRADUATION. - POPULATION: 172,460 RESIDENTS- 28.14% OF POPULATION IS BELOW 18 YEARS OF AGE AND 10.22% ARE 65 YEARS OR OLDER- MEDIAN HOUSEHOLD INCOME IS $72,269- PERSONS IN POVERTY IS 6.2%- CHILDREN IN POVERTY IS 6%- UNEMPLOYMENT RATE IS 3.0%- HIGH SCHOOL GRADUATION RATE IS 94% - 81% OF RESIDENTS HAVE SOME COLLEGE EDUCATION- 6% OF THE POPULATION IS UNINSURED, WITH 3.7% OF CHILDREN (UNDER THE AGE OF 19) BEING UNINSUREDCASS COUNTY: CASS COUNTY IS THE LEAST DIVERSE OF THE COUNTIES WITH 97.29% OF THE POPULATION BEING NON-HISPANIC WHITE. CASS COUNTY HAS THE SECOND HIGHEST UNEMPLOYMENT RATE, THE SECOND HIGHEST HIGH SCHOOL GRADUATION RATE AND THE HIGHEST PERCENTAGE OF CHILDREN WHO ARE UNINSURED. - POPULATION: 25,463 RESIDENTS- 24.44% OF POPULATION IS BELOW 18 YEARS OF AGE AND 16.0% ARE 65 YEARS OR OLDER- MEDIAN HOUSEHOLD INCOME IS $65,385- PERSONS IN POVERTY IS 7.03%- CHILDREN IN POVERTY IS 10%- UNEMPLOYMENT RATE IS 4.0%- HIGH SCHOOL GRADUATION RATE IS 93% - 73% OF RESIDENTS HAVE SOME COLLEGE EDUCATION- 7% OF THE POPULATION IS UNINSURED, WITH 4.6% OF CHILDREN (UNDER THE AGE OF 19) BEING UNINSUREDPOTTAWATTAMIE COUNTY: THE ONLY COUNTY IN IOWA, POTTAWATTAMIE COUNTY'S POPULATION CONSISTS OF 95.63% OF THE POPULATION BEING NON-HISPANIC WHITE, 7.24% HISPANIC, AND 1.45% BLACK OR AFRICAN AMERICAN. POTTAWATTAMIE HAS THE LOWEST PERCENTAGE OF UNINSURED CHILDREN (2.7%) AND THE LOWEST MEDIAN HOUSEHOLD INCOME OF THE FOUR COUNTIES ($53,260). - POPULATION: 93,198 RESIDENTS- 23.68% OF POPULATION IS BELOW 18 YEARS OF AGE AND 15.7% ARE 65 YEARS OR OLDER- MEDIAN HOUSEHOLD INCOME IS $53,620- PERSONS IN POVERTY IS 11.76%- CHILDREN IN POVERTY IS 15%- UNEMPLOYMENT RATE IS 4.2%- HIGH SCHOOL GRADUATION RATE IS 90% - 63% OF RESIDENTS HAVE SOME COLLEGE EDUCATION- 6% OF THE POPULATION IS UNINSURED, WITH 2.7% OF CHILDREN (UNDER THE AGE OF 19) BEING UNINSUREDCHI HEALTH PLAINVIEW IS LOCATED IN PLAINVIEW, NE AND LARGELY SERVES THE PIERCE COUNTY AREA. PIERCE COUNTY WAS IDENTIFIED AS THE COMMUNITY FOR THIS CHNA, AS IT IS THE PRIMARY SERVICE AREA FOR CHI HEALTH PLAINVIEW.PLAINVIEW, NE IS LOCATED 141 MILES FROM OMAHA, NE AND 100.6 MILES FROM SIOUX CITY, IA. ACCORDING TO THE MOST RECENT CENSUS ESTIMATES, PIERCE COUNTY IS 100% RURAL, ENCOMPASSES 573 SQUARE MILES AND HAS 7,179 RESIDENTS.PIERCE COUNTY:- 24.8% OF RESIDENTS WERE BELOW THE AGE OF 18 IN 2017- 19.1% RESIDENTS WERE OVER THE AGE OF 65 IN 2017- PIERCE COUNTY MEDIAN HOUSEHOLD INCOME: $66,121- HISPANIC POPULATION: ACCORDING TO THE DATA PIERCE COUNTY'S HISPANIC POPULATION ACCOUNTS FOR ONLY 1.6% OF THE POPULATION WHILE NON-HISPANIC WHITE RESIDENTS ACCOUNT FOR 98.4% OF THE POPULATION- 9.5% OF PIERCE COUNTY RESIDENTS LIVE BELOW THE 200% FPL- COUNTY UNEMPLOYMENT RATE IS 2.3%- HIGH SCHOOL GRADUATION RATE IS 93.1%- UNINSURED POPULATION LIVING IN PIERCE COUNTY IS 7.87% PART VI, LINE 5: THE ORGANIZATION'S HOSPITAL FACILITY(IES) PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. THE ORGANIZATION'S HOSPITAL FACILITY(IES) HAVE AN OPEN MEDICAL STAFF. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE FACILITY(IES) TREAT PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT. CHI HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT AND HOSPITAL SPECIFIC COMMUNITY BENEFIT INVESTMENTS TO ADDRESS COMMUNITY HEALTH NEEDS OF THE PARTICULAR SERVICE AREA. EXAMPLES OF HOW CHI HEALTH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY INCLUDE: - FINANCIAL ASSISTANCE AND UNPAID COSTS OF MEDICAID- COMMUNITY HEALTH IMPROVEMENT SERVICES- * COMMUNITY EDUCATION, CLASSES AND PROGRAMS (DEMENTIA, COMMUNITY BEHAVIORAL HEALTH SUPPORT AND EDUCATION, DIABETES, CANCER, PHYSICAL ACTIVITY AND HEALTHY EATING AND COOKING) * SUPPORT GROUPS (BREASTFEEDING, CANCER, BEREAVEMENT, YOUTH, ETC.) * COMMUNITY HEALTH EDUCATION/PROMOTION AND SCREENINGS* SCHOOL BASED HEALTHCARE SERVICES* IMMUNIZATION PROGRAM-PROVIDED STAFF AND FUNDING TO ADMINISTER 450 IMMUNIZATIONS TO 280 UNINSURED AND UNDERINSURED CHILDREN AND ADULTS FROM SARPY AND CASS COUNTIES* MENTAL HEALTH HOTLINE-STAFF AND OPERATE 717-HOPE MENTAL HEALTH HOTLINE FOR ANYONE IN THE COMMUNITY TO ACCESS. THIS PROGRAM AVERAGES OVER 5,000 PHONE CALLS PER MONTH FROM COMMUNITY MEMBERS IN NEED.* PARISH NURSING PROGRAM AND FAITH COMMUNITY HEALTH NETWORK - THE CHI HEALTH FAITH COMMUNITY HEALTH NETWORK PARTNERS WITH CONGREGATIONS OF ALL FAITHS TO BUILD CAPACITY AND SUPPORT THE GROWTH OF HEALTH MINISTRIES WHICH PROMOTE HEALTH, HEALING AND WHOLENESS IN THE COMMUNITIES SERVED.* 5-4-3-2-1GO!- HEALTHY LIFESTYLE CAMPAIGN FOR KIDS; OPERATED IN SCHOOLS, OUT OF SCHOOL SETTINGS, CLINICS, COMMUNITY SETTINGS IN DOUGLAS, SARPY, CASS, AND COLFAX COUNTIES IN NE. INITIAL WORK COMPLETED BY CHI HEALTH IN FY19 AND FOLLOWING CONTRACTOR DEPARTURE, WORK WAS TRANSITIONED THROUGH A GRANT TO LIVE WELL OMAHA FOR THE BROADER OMAHA COMMUNITY STRATEGY IN DOUGLAS COUNTY AS PART OF A 2-YEAR GRANT. * COUNSELING AND ASSISTANCE IN ENROLLING INDIVIDUALS IN MEANS TESTED INSURANCE PROGRAMS TO IMPROVE ACCESS TO CARE.* SUPPORT AND OFFICE SPACE PROVIDED TO THE LEGAL AID OF NEBRASKA TO ASSIST INDIVIDUALS WITH LEGAL MATTERS.* SUPPORT TO HEALTH COALITIONS AND INVESTMENTS IN SOCIAL AND ENVIRONMENTAL IMPROVEMENT STRATEGIES. THESE ARE PROGRAMS, ACTIVITIES AND PARTNERSHIPS THAT IMPROVE THE HEALTH OF PERSONS IN THE COMMUNITY BY ADDRESSING THE DETERMINANTS OF HEALTH, WHICH INCLUDES THE SOCIAL, ECONOMIC AND PHYSICAL ENVIRONMENT. SEE SPECIFIC EXAMPLES BY COMMUNITY BELOW:REGIONAL- NEBRASKA APPLESEED TYPICALLY PROVIDES FUNDS TO SUPPORT HUNGER/FOOD ACCESS EFFORTS; THIS INCLUDES SUMMER MEALS PROGRAM OUTREACH, ENRICHMENT PROGRAMMING AT SUMMER MEALS SITES AND SUPPORT TO LAUNCH STATE'S FIRST SNAP EMPLOYMENT & TRAINING (E&T) THIRD PARTY PARTNERSHIP, WHICH PROVIDES JOB TRAINING FOR SNAP RECIPIENTS. IN THIS RECENT YEAR NEBRASKA APPLESEED PROVIDED SNAP OUTREACH TO NEWLY ELIGIBLE INDIVIDUALS THAT WERE EXPERIENCING ECONOMIC HARDSHIP DUE TO COVID19.- FOOD BANK FOR THE HEARTLAND DONATED FUNDS TO HELP SUPPORT THE INCREASED NEED FOR EMERGENCY FOOD BROUGHT ON BY THE PANDEMIC.- NEBRASKA EXTENSION - PROVIDED FUNDS TO SUPPORT DOUBLE UP FOOD BUCKS IN OMAHA AND LINCOLN; PROGRAM FOR SNAP RECIPIENTS TO RECEIVE AN ADDITIONAL $1 FOR EVERY $1 THEY SPEND (UP TO $20/DAY) ON FRUITS AND VEGETABLES AT PARTICIPATING SITES; NUTRITION/COOKING EDUCATION IS ALSO PROVIDED AT ALL SITES.OMAHA/COUNCIL BLUFFS METRO- HOPE MEDICAL OUTREACH COALITION - PERSONNEL SUPPORT AND ANNUAL OPERATING SUBSIDY. CHI HEALTH HOSPITALS AND PHYSICIANS ARE ONE OF THREE HEALTH SYSTEMS THAT PROVIDE ACCESS FOR THE PATIENTS OF THREE AREA FEDERALLY QUALIFIED HEALTHCARE CENTERS TO SPECIALTY PHYSICIAN SERVICES AND HOSPITAL BASED DIAGNOSTICS AND TREATMENT THAT ARE UNABLE TO AFFORD MEDICAL SERVICES. - COMMUNITY LINK - A PARTNERSHIP WITH COMMONSPIRIT HEALTH TO IMPROVE THE HEALTH AND SOCIOECONOMIC STATUS OF PATIENTS BY ASSESSING AND TREATING THEIR NON-MEDICAL NEEDS AND BARRIERS, WHICH ARE IMPORTANT FACTORS OF THEIR HEALTH.- TOGETHER - GRANT TO LAUNCH A CASE REFERRAL PROGRAM IN PARTNERSHIP WITH CHI HEALTH. TOGETHER WILL PROVIDE AN ON-SITE CASE MANAGER FOR PATENTS IDENTIFIED AS HOMELESS AND DEVELOP HOUSING, COMMUNITY TRANSISTION PLANS, AND SUPPORT FOR POST-DISCHARGE.- SIEMBRA SALUD - A PARTNERSHIP WITH COMMONSPIRIT HEALTH AND LATINO CENTER OF THE MIDLANDS TO ADDRESS FOOD ACCESS FOR LATINO RESIDENTS IN SOUTHEAST OMAHA. THE PROGRAM WAS LAUNCHED IN FY19. CULTIVADORAS WORKED WITH 29 DURING GROWING SEASON TO PLANT FRUITS AND VEGETABLES, IDENTIFY SOCIAL NEEDS AND REFER TO COMMUNITY RESOURCES.- LIVE WELL OMAHA/WELL BEING PARTNERS - LEADS A COALITION OF ORGANIZATIONS THAT ARE COMMITTED TO PRIORITIZING AND IMPROVING LIVING CONDITIONS THAT IMPACT THE HEALTH OF THE COMMUNITY. - 5-4-3-2-1GO!-OPERATES IN AND OUT OF SCHOOLS SETTINGS, CLINICS, AND COMMUNITY SETTINGS IN AND AROUND DOUGLAS COUNTY NE. PROMOTES A HEALTHY LIFESTYLE CAMPAIGN FOR KIDS.- BUILD - PROVIDES SUPPORT FOR UNDERLYING DRIVERS OF POOR MENTAL HEALTH IN AN ECONOMICALLY DISTRESSED NEIGHBORHOOD (NE OMAHA 68111). FUNDED TOGETHER WITH A NATIONAL GRANT, CHI HEALTH, NE MEDICINE, METHODIST, AND CHILDREN'S HOSPITAL AND MEDICAL CENTER.- WHISPERING ROOTS - PARTNERSHIP WITH DOUGLAS COUNTY WIC CLINICS AND SENIOR CENTERS TO OFFER NUTRITIONAL INCENTIVE IN ADDITIONAL TO INCREASE REDEMPTION IN FEDERALLY FUNDED VOUCHER PROGRAMS IN-CONJUNCTION WITH THIS POP UP FARM STAND (PARTNERED WITH BIG GARDENS, DCHD, CDHC, ONE WORLD, AND WENNINGHOFF FARMS.- YOUTURN - PROVIDED FUNDS TO SUPPORT YOUTURN'S HOSPITAL RESPONSE PROGRAM AND YOUTH VIOLENCE PREVENTION EDUCATION AND CASE MANAGEMENT IN NORTHEAST OMAHA.- STOP THE BLEED - ONGOING COMMUNITY TRAINING THAT PROVIDES NECESSARY SKILLS TO HANDLE MASS SHOOTINGS/INJURIES THROUGH FUNDING THAT IS USED TO CREATE KITS CONTAINING NECESSARY SUPPLIES TO TREAT VICTIMS.- OMAHA BRIDGES OUT OF POVERTY - PROVIDED SUPPORT FOR BRIDGES OUT OF POVERTY PROGRAMMING AND TRAINING TO SUPPORT AND TRAIN THOSE IN POVERTY ON RESOURCES AND SKILLS TO BREAK THE CYCLE OF POVERTY IN THEIR FAMILY.- AFRICAN AMERICAN EMPOWERMENT NETWORK - SUPPORT OF THE STEP UP SUMMER JOBS PROGRAM, A WORKFORCE DEVELOPMENT AND VIOLENCE PREVENTION INITIATIVE SERVING A TYPICALLY LOW-INCOME PART OF THE COMMUNITY.- MILLS COUNTY PUBLIC HEALTH - PROVIDED FUNDING FOR FAMILY MATTERS SUBSTANCE ABUSE PREVENTION PROJECT TO SUPPORT FAMILIES DEALING WITH SUBSTANCE ABUSE IN MILLS COUNTY - SUPPORTS FATHERS, MOTHERS, AND CHILDREN SEPARATELY AND AS A WHOLE FAMILY UNIT THROUGH REGULAR GATHERINGS.- BIPOC DOULA PROGRAM - DONATED FUNDS TO SUPPORT THE PILOT PROGRAM TO PROVIDE FREE PERINATAL DOULA SERVICES (BIRTHING EDUCATION, PREGNANCY/LABOR AND POSTPARTUM SUPPORT) TO 10 BLACK, INDIGENOUS, PEOPLE OF COLOR BIRTHING PERSONS TO ADDRESS RACIAL DISPARITIES IN MATERNAL/INFANT HEALTH OUTCOMES.SEE PART VI, LINE 5 DISCLOSURE CONTINUED. 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 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. COMMONSPIRIT HEALTH IS COMPRISED OF MORE THAN 1,500 CARE SITES, CONSISTING OF 140 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. IN FISCAL YEAR 2021, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.5 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 $5.1 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.25 BILLION IN FISCAL YEAR 2021, HAS TOTAL ASSETS OF APPROXIMATELY $54.87 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. PART VI, LINE 5 (CONTINUED): PLAINVIEW:- PLAINVIEW HOSPITAL-FUNDS DONATED TO SUPPORT THE PROVISION OF HYGIENE ESSENTIALS SO LOW INCOME AND AGING INDIVIDUALS.- HEALTH PROFESSIONAL EDUCATION-* CLINICAL PRECEPTORSHIPS AND CLINICAL ROTATIONS FOR HEALTHCARE PROFESSIONALS* ADMINISTRATION AND STUDENT ONBOARDING COSTS FOR NURSING PRECEPTORSHIPS AND CLINICALS* STAFF TIME FACILITATING THE SMALL-GROUP ETHICS CASE DISCUSSIONS WITH MEDICAL STUDENTS* CLINICAL PASTORAL EDUCATION* ACADEMIC AFFILIATION WITH CREIGHTON UNIVERSITY AND ITS HEALTH PROFESSIONS PROGRAMS, INCLUDING THE SCHOOL OF MEDICINE, COLLEGE OF ARTS & SCIENCES, SCHOOL OF DENTISTRY, SCHOOL OF PHARMACY AND HEALTH PROFESSIONS, COLLEGE OF NURSING.* PHYSICIAN RESIDENCY AND FELLOWSHIP PROGRAMS TRAIN MORE THAN 170 RESIDENTS AND FELLOWS ANNUALLY - RESEARCH- * UNFUNDED STAFF SUPPORT OF THE NATIONAL CANCER INSTITUTE COMMUNITY ONCOLOGY RESEARCH PROGRAM (NCORP)* TRAUMA INFORMED CARE-THIS WAS AN IDENTIFIED NEED ON THE COMMUNITY HEALTH IMPROVEMENT PLAN. CHI HEALTH IS PARTNERING TO IMPLEMENT STAFF TRAINING FOR AWARENESS OF TRAUMA AND ITS IMPACT AND COMPLETING A RESEARCH STUDY ON THE EFFECTIVENESS OF THE TRAINING TO HELP BUILD PUBLIC TRAINING AND EDUCATION RESOURCES. - FINANCIAL AND IN-KIND CONTRIBUTIONS-* TANZANIA HEALTH MINISTRY-CHI HEALTH IS A MINISTRY PARTNER WITH THE MACHAME LUTHERAN HOSPITAL IN TANZANIA WHICH PROVIDES FULL SERVICE HEALTH CARE IN A DESPERATELY IMPOVERISHED AREA OF THE COUNTRY INCLUDING A FULL SERVICE HOSPITAL, PHARMACY, HOSPICE OUTREACH, CLINICS, CLINICAL OFFICER SCHOOL, AND THE RECENTLY ESTABLISHED SCHOOL OF NURSING. * STAFF SERVICE ON HEALTH RELATED BOARD AND COALITIONS.* PARTICIPATION IN AND FUNDING OF MATERNAL HEALTH, SUBSTANCE ABUSE, FOOD ACCESS, VIOLENCE PREVENTION, CANCER AND OTHER COMMUNITY HEALTH COALITIONS.* IN-KIND DONATIONS OF SPACE, FOOD AND STAFF TIME PROVIDING STRATEGIC PLANNING, FACILITATION AND CONSULTING SERVICES FOR NOT-FOR-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS.* IN-KIND DONATIONS (STAFF TIME, SPACE, ETC.) SUPPORTING GRANTS FOR BEHAVIORAL HEALTH, VIOLENCE PREVENTION, AND COMMUNITY LINK.* IN-KIND DONATIONS OF MEETING ROOM SPACE AND STAFF TIME FOR NOT-FOR-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS- COMMUNITY BUILDING ACTIVITIES- * PRESENTATIONS TO HIGH SCHOOL STUDENTS ABOUT HEALTHCARE CAREERS.* STAFF TIME SPENT WITH HIGH SCHOOL AND COLLEGE SHADOW STUDENTS.* COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE. 1 NEBRASKA SYNOD ELCA 6757 NEWPORT AVE STE 200 OMAHA NE 68152 363514308 501(C)(3) 46000 GENERAL SUPPORT CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA NE 68154 470648586 501(C)(3) 118531 GENERAL SUPPORT SISTERS OF ST FRANCIS PO BOX 122 MANDERSON SD 57756 460373969 501(C)(3) 10000 GENERAL SUPPORT SISTERS OF MERCY OF THE AMERICAS 7262 MERCY RD OMAHA NE 68124 262400800 501(C)(3) 10000 GENERAL SUPPORT UNITED WAY OF THE MIDLANDS 2201 FARNAM ST SUITE 200 OMAHA NE 68102 470376605 501(C)(3) 15000 GENERAL SUPPORT 5 0 WOW/CARE SUPPORT 100 3300 BOOK PROVIDING NECESSITIES FOR INPATIENTS SCHOLARSHIPS 3 4320 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 OR 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. ALEGENT CREIGHTON HEALTH ONLY DISTRIBUTES FUNDS TO OTHER 501(C)(3) ORGANIZATIONS WITH THE SAME MISSION AND PURPOSE AS THE ALEGENT CREIGHTON HEALTH SYSTEM. THESE DISTRIBUTIONS ARE MONITORED TO ENSURE THEY ARE BEING USED AS SPECIFIED BY THE ORGANIZATION. PART III: LAKESIDE AND MIDLANDS PROVIDED 3 SCHOLARSHIPS DURING FISCAL YEAR 2021 TO STUDENTS INTERESTED IN THE HEALTHCARE INDUSTRY. 1 1 0 0 0 0 0 0 0 ANTHONY JONES BOARD MEMBER 0 1172323 0 1760362 0 15757 0 15734 0 11549 0 2975725 0 0 CLIFF ROBERTSON MD BOARD MEMBER/CEO, CHI HEALTH 0 1011674 0 921351 0 397677 0 16975 0 29727 0 2377404 0 157178 JOHN PETERSDORF BOARD MEMBER 0 509017 0 445500 0 105583 0 729483 0 64074 0 1853657 0 0 JEANETTE WOJTALEWICZ BOARD MEMBER/CFO, CHI HEALTH 553985 0 277663 0 154664 0 17649 0 32617 0 1036578 0 49946 0 KATHY BRESSLER CHIEF OPERATING OFFICER 555720 0 345848 0 74175 0 16975 0 13893 0 1006611 0 0 0 ANN SCHUMACHER PRESIDENT IMC 464376 0 271037 0 49167 0 16984 0 30093 0 831657 0 19702 0 LINDA CHASE DIV SVP CNO 101895 0 68694 0 542075 0 10701 0 4724 0 728089 0 0 0 CARY WARD MD CHI HEALTH SVP CMO 497053 0 139634 0 5828 0 17150 0 24421 0 684086 0 0 0 JAYLEEN CASANO PRESIDENT CUMC-BERGAN MERCY 405427 0 186236 0 30327 0 48793 0 12150 0 682933 0 0 0 MICHAEL SCHNIEDERS PRESIDENT GOOD SAMARITAN 427237 0 141014 0 34108 0 17150 0 17981 0 637490 0 0 0 ARMAN PAJNIGAR PHYSICIAN INTERNAL MEDICINE 1493 544194 0 0 0 1648 0 16172 30 11174 1523 573188 0 0 KEVIN MILLER PRESIDENT - LKS & MDL HOSPITAL 374915 0 129313 0 22073 0 36481 0 33391 0 596173 0 14276 0 STEVE HOUSTON SVP STRATEGY & BUSINESS DEVELOPMENT 333375 0 95069 0 5361 0 16975 0 24749 0 475529 0 0 0 AARON AUSTIN SVP HR CHI HEALTH 321198 0 86513 0 4729 0 16975 0 19198 0 448613 0 0 0 HEATHER MORGAN MD BOARD MEMBER 0 292203 0 0 0 1005 0 17050 0 31693 0 341951 0 0 NICK OTOOL INTERIM CFO CHI HEALTH 185719 0 26478 0 351 0 11109 0 29002 0 252659 0 0 0 GREGORY BECKMANN PRESIDENT - PLAINVIEW HOSPITAL 144763 0 51458 0 10688 0 18698 0 26418 0 252025 0 6988 0 JASON KRUGER MD BOARD MEMBER 0 142625 0 0 0 795 0 13865 0 27720 0 185005 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2020, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING 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. COMPENSATION FOR THE OTHER OFFICERS OF ALEGENT CREIGHTON HEALTH WAS ESTABLISHED BY THE CHI HEALTH CEO AND HUMAN RESOURCES DIRECTOR USING THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION: (1) COMPENSATION SURVEYS OR STUDIES (2) INDEPENDENT COMPENSATION CONSULTANT AND (3) APPROVAL BY THE BOARD COMPENSATION COMMITTEE. PART I, LINES 4A-B SCHEDULE J, PART I, LINE 4A - SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS: FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM ALEGENT CREIGHTON HEALTH DURING THE 2020 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): LINDA CHASE, $538,387. SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DURING THE 2020 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. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: CLIFF ROBERTSON, $186,901; JEANETTE WOJTALEWICZ, $71,692; ANN SCHUMACHER, $19,805; KEVIN MILLER, $14,434; AND GREGORY BECKMANN, $7,887. 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 2020 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 2020, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: CLIFF ROBERTSON, $195,187; JEANETTE WOJTALEWICZ, $77,144; AN ANN SCHUMACHER, $23,533. X 39 4155520 FAIR MARKET VALUE 1 0 1 0 FORM 990, PART V, LINE 1C: PAYMENTS TO VENDORS PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH (CSH) ARE MADE BY CSH. CSH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CSH ON BEHALF OF ALEGENT CREIGHTON HEALTH ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 6 CHI NEBRASKA IS THE SOLE MEMBER OF ALEGENT CREIGHTON HEALTH. 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. 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 CREIGHTON HEALTH BOARD. * AMENDMENT OF THE CORPORATE DOCUMENTS OF ALEGENT CREIGHTON HEALTH. * APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ALEGENT CREIGHTON HEALTH. * ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR ALEGENT CREIGHTON HEALTH. 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 ALEGENT CREIGHTON HEALTH. * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ALEGENT CREIGHTON HEALTH. * APPROVAL OF ISSUANCE OF DEBT BY ALEGENT CREIGHTON HEALTH. * APPROVAL OF PARTICIPATION OF ALEGENT CREIGHTON HEALTH IN A JOINT VENTURE. * APPROVAL OF FORMATION OF A NEW CORPORATION BY ALEGENT CREIGHTON HEALTH. * APPROVAL OF A MERGER INVOLVING ALEGENT CREIGHTON HEALTH. * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF ALEGENT CREIGHTON HEALTH. * TO REQUIRE THE TRANSFER OF ASSETS BY ALEGENT CREIGHTON HEALTH TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'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. 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. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. 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 - 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 THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION THE COMMONSPIRIT HEALTH BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. 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, SECTION B, LINE 16B: ALEGENT CREIGHTON HEALTH 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 XI, LINE 9: BENEFIT PLAN ACCRUAL ADJUSTMENT 12,905,571. MEDICAL STAFF ACTIVITY ADJUSTMENT 15,197. EQUITY CHANGES IN UNCONSOLIDATED ORGS 17,934,497. OTHER CHANGES IN NET ASSETS 951,931. CHP INTERCOMPANY BALANCE ADJUSTMENT 18,522,522. CARES ACT REVENUE REALLOCATION 2,701,665. FORM 990, PART XI, LINE 8 PRIOR PERIOD ADJUSTMENT: CENTRALIZED TRANSACTIONS: TRANSFERS FOR JOURNAL ENTRIES RECORDED CENTRALLY AT COMMONSPIRIT TO STANDARDIZE CONTRACTUAL ALLOWANCE METHODOLOGY ACROSS ALL COMMONSPIRIT AFFILIATES AND SUBSIDIARIES. RECORDED CENTRALLY AT YEAR END AND TRANSFERRED TO FACILITIES IN THE FOLLOWING YEAR. CHI HEALTH QUICK CARE LLC 12809 W DODGE RD OMAHA NE 68154 203437352 EXPRESS CARE CLINIC NE 1134983 676921 ALEGENT CREIGHTON HEALTH CHI HEALTH PARTNERS LLC 12809 W DODGE RD OMAHA NE 68154 900847126 ACCOUNTABLE CARE ORGANIZAION NE 1525000 0 ALEGENT CREIGHTON HEALTH CHI HEALTH CREIGHTON UNIVERSITY MEDICAL CENTER LLC 12809 W DODGE RD OMAHA NE 68154 455517527 VARIOUS MEDICAL SERVICES NE 0 0 ALEGENT CREIGHTON HEALTH ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) LINE 3 ACH 1 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 HOSP OF MO VALLEYIA 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 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