2022-08-18T15:47:21-05:00 2021-09-30 ERNST & YOUNG US LLP 155 N Wacker Drive Chicago IL 60606 990 2020-10-01 362340313 Northwest Community Hospital % CHRISSIE ERDMANN NORT 8476181000 3040 Salt Creek Ln Arlington Heights IL 60005 Christine Erdmann CFO 8476181000 2022-08-15 true Christine Erdmann 999009999 JESSICA WAGENER P01622613 3128792000 2 2020 2022-09-23 18:48:47Z STEPHEN O SCOGNA 800 West Central Road ARLINGTON HEIGHTS IL 60005 541173646 false X NCH.ORG X 1953 IL NCH OPERATES AN ACUTE HOSPITAL IN ARLINGTON HEIGHTS, IL. THE HOSPITAL EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND TO MEET INDIVIDUALS' HEALTHCARE NEEDS. 19 14 4641 434 1528613 0 42495038 4384639 481686137 531877295 -172748 39575 3179999 3378533 527188426 539680042 171378 136498 0 0 251023807 261289092 0 0 0 262386705 263413068 513581890 524838658 13606536 14841384 494027641 476057362 406439672 416176266 87587969 59881096 X NORTHWEST COMMUNITY HOSPITAL EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND TO MEET INDIVIDUALS' HEALTHCARE NEEDS. IT STRIVES TO BE KNOWN FOR ITS SINGULAR FOCUS ON PROVIDING A COMPREHENSIVE, PATIENT-CENTERED SYSTEM OF CARE THAT SURPASSES EVERY EXPECTATION FOR EXCELLENCE (IN QUALITY AND SERVICE). false false 49688443 59177823 CARDIOLOGY NORTHWEST COMMUNITY HOSPITAL'S (HOSPITAL) CARDIAC SERVICE LINE PROVIDED QUALITY, PATIENT CENTERED, COMPASSIONATE CARE, REGARDLESS OF ABILITY TO PAY, TO APPROXIMATELY 50,000 INPATIENT AND OUTPATIENT CASES DURING FY 2021. THE TREATMENT WAS PROVIDED IN HOSPITAL'S STATE-OF-THE-ART DIGITAL CARDIAC CATH LAB SUITES, INCLUSIVE OF ITS HIGH TECH OPERATING ROOMS AND PRIVATE FAMILY CENTERED PATIENT CARE ROOMS ALL AT A COST OF APPROXIMATELY $50,000,000. AN ON-CALL TEAM OF NURSES, RADIOLOGY TECHS, OR TECHS, CARDIOLOGISTS AND SURGEONS WERE READILY AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK, TO PROVIDE EMERGENT CARE TO THOSE WITH CARDIAC DISEASE. THE CARDIAC TEAM WORKS WITH THE EMERGENCY ROOM AND MULTIPLE NEIGHBORING COMMUNITY PARAMEDICS AND EMERGENCY PERSONNEL TO CONSISTENTLY EXCEED THE NATIONAL BENCHMARK OF DOOR TO BALLOON TIME (OR OPEN ARTERY) IN LESS THAN 90 MINUTES FOR PATIENTS PRESENTING IN HOSPITAL'S EMERGENCY ROOM HAVING AN ACUTE MI. NCH HAS BEEN RECOGNIZED AS AN ACCREDITED ECHO LAB BY THE INTERSOCIETAL COMMISSION FOR THE ACCREDITATION OF ECHOCARDIOGRAPHY LABORATORIES (ICAEL) SINCE 2000. NCH PROVIDES THE FULL SCOPE ON NON INVASIVE CARDIAC DIAGNOSTIC TESTING AT MULTIPLE SITES IN THE COMMUNITY INCLUDING THE ATHERTON HEART FAILURE CLINIC WHICH OPENED IN 2014. THE CLINIC PROVIDES A TRANSITIONAL CARE MODEL THAT IS BASED ON PATIENTS WITH HEART FAILURE BEING SEEN IN THE CLINIC BY ADVANCED CARE PRACTITIONERS AND CARDIOLOGISTS WITH 24 HOURS OF HOSPITAL DISCHARGE. THE MULTIDISCIPLINARY TEAM INCLUDING DIETICIANS, SOCIAL WORKERS, PHARMACISTS AND NURSES PROVIDE ONGOING CARE TO PATIENTS AND THEIR FAMILIES IN THE COMMUNITY SETTING ENSURING CARE IS DELIVERED IN THE APPROPRIATE SETTING AND REDUCING AVOIDABLE RE-ADMISSIONS TO THE ACUTE CARE SETTING. NCH HAS EXPERIENCED A SIGNIFICANT DECREASE IN HOSPITAL READMISSIONS FOR BOTH THE HEART FAILURE AND ACUTE MI PATIENT POPULATIONS DIRECTLY RELATED TO STRATEGIES DURING THE HOSPITALIZATION AND IN THE POST ACUTE CARE SETTING. TELEHEALTH MEDICINE AND HOME HEALTH ARE INTEGRAL PARTS OF THE POST ACUTE CARE MODEL NCH HAS IMPLEMENTED FOR CARDIAC PATIENTS. IN ADDITION, NCH HAS ONE OF THE LARGEST CARDIAC AND PULMONARY REHAB PROGRAMS IN THE STATE OF ILLINOIS THAT HAS FURTHER ASSISTED CARDIAC AND PULMONARY PATIENTS IN RETURNING AND MAINTAINING AN OPTIMAL STATE OF HEALTH FOLLOWING A CARDIAC EVENT. IN MAY 2019, NCH OPENED ITS NEW HYBRID CARDIAC CATHETERIZATION LAB, OFFERING STATE OF THE ART COMBINATION CARDIAC CATH LAB AND OPERATING SUITE FOR PERFORMING MINIMALLY INVASIVE ADVANCED CARDIAC PROCEDURES AND ENDOVASCULAR INTERVENTIONS. THE CARDIAC DEPARTMENT ALSO PROVIDES MULTIPLE SCREENING AND EDUCATION PROGRAMS. DURING FY 2021, NCH HOSTED MULTIPLE COMMUNITY EVENTS THAT INCLUDED EDUCATIONAL PRESENTATIONS BY CARDIOLOGISTS AND STAFF, HEALTHY COOKING DEMONSTRATIONS AND HEALTH SCREENINGS. 43599682 41866497 INFECTIOUS DISEASE NORTHWEST COMMUNITY HOSPITAL'S INFECTIOUS DISEASE DEPARTMENT PROVIDED QUALITY, PATIENT CENTERED, COMPASSIONATE CARE, REGARDLESS OF ABILITY TO PAY. IN FY 2021, THE INFECTIOUS DISEASE SERVICE LINE INCURRED APPROXIMATELY 42,000 CASES AT A COST OF APPROXIMATELY 43,600,000. 39081507 41399624 ORTHOPEDICS NORTHWEST COMMUNITY HOSPITAL'S (HOSPITAL) ORTHOPEDIC SERVICE LINE PROVIDES QUALITY, PATIENT CENTERED, COMPASSIONATE CARE FOR PATIENTS, REGARDLESS OF ABILITY TO PAY, WHO ARE IN NEED OF SPECIALIZED ORTHOPEDIC MEDICAL CARE AND SURGICAL PROCEDURES. PATIENTS HAVE ACCESS TO SUPERIOR QUALITY CARE AND BENEFIT FROM THE LATEST TECHNOLOGIES AND ADVANCED PAIN MANAGEMENT TECHNIQUES. PHYSICIANS ARE BOARD CERTIFIED. PREOPERATIVE EDUCATION, CARE PROVISION ON A DEDICATED ORTHOPEDIC UNIT WITH SPECIALTY NURSES AND EXTENSIVE POST SURGICAL REHABILITATION AND HOME CARE SERVICES ARE INCLUDED IN OUR ORTHOPEDIC SERVICES. HOSPITAL'S ORTHOPEDIC SERVICE LINE TEAM IS LED BY AN EXPERT BOARD CERTIFIED ORTHOPEDIC SURGEON. THE ORTHOPEDIC DEPARTMENT PERFORMS GREATER THAN 800 ELECTIVE JOINT PROCEDURES A YEAR. QUALITY CARE, EXCELLENCE IN PATIENT EXPERIENCE AND FAVORABLE OUTCOMES MAKES HOSPITAL A TOP CHOICE IN THE CHICAGO LAND AREA. IN FY 2021, THE ORTHOPEDIC SERVICE LINE INCURRED APPROXIMATELY 26,000 PATIENT CASES AT A COST OF APPROXIMATELY $39,000,000. 315702090 136498 389433351 448071722 true true false true false false false false false true true false true false true true false true false false false false false false false false true true true true true true false false false false false false false false false false false false false false true true true true false false true 324 0 true 4641 true true true false false false false false false false false false true false X 19 14 false false true false true true true true true false false true true true true true true true true false IL X CHRISSIE ERDMANN 8476184606 3040 SALT CREEK LANE Arlington Heights IL 60005 X Stephen O Scogna PRESIDENT/SECRETARY/CEO 34.0 6.0 X X 2866194 0 227462 GERALD P GALLAGHER NS Pres/CEO/ Dir (Beg 1/1/21) 3.0 41.0 X 0 1373606 1001309 Michael C Hartke Executive VP/COO 34.0 6.0 X 1784286 0 106262 Sean O'Grady NS COO/ Director (Beg 1/1/21) 0.0 41.0 X 0 892250 557800 Alan B Loren MD Executive VP - CMO 37.0 3.0 X 1117368 0 92332 Mahalakshmi Halasyamani MD NS CMO/ DIRECTOR (Beg 1/1/21) 1.0 40.0 X 0 678048 196210 John L Skeans CFO/Treasurer 34.0 6.0 X 689151 0 92693 Susan E Nelson MD VP Physician Operations 37.0 3.0 X 561092 0 43180 Eileen Gillespie Executive VP - PT Serv & CNO 40.0 0.0 X 529423 0 66823 TERRY SOLEM VP HUMAN RESOURCES 34.0 6.0 X 496135 0 38712 Glen J Malan VP Info Tech & CIO 37.0 3.0 X 482274 0 32382 RICH CASEY VP HOSPITAL OPERATIONS 37.0 3.0 X 400094 0 62096 RAOUL CHAZARO VP SURGICAL SERVICES 40.0 0.0 X 385518 0 46565 Mary Dano Trm 1019 Exec VP - Chief Legal Counsel 0.0 0.0 X 407913 0 1 Catherine Wood MD Phy & Dir (Beginning 1/1/21) 1.0 39.0 X 0 280011 19534 KENNETH A SPERO MD DIRECTOR 1.0 1.0 X 41400 0 0 E Quinn Regan MD DIRECTOR (Thru 12/31/20) 1.0 1.0 X 20200 0 0 Thomas P MacCarthy Director (THRU 12/31/20) 1.0 1.0 X 0 0 0 Marla F Glabe Director 1.0 1.0 X 0 0 0 Craig E Christell Director (THRU 12/31/20) 1.0 1.0 X 0 0 0 Jay S Cowen MD Director (THRU 12/31/20) 1.0 1.0 X 0 0 0 Guy W Eisenhuth Vice Chairperson 10.0 1.0 X X 0 0 0 Ann K Ford Director 1.0 1.0 X 0 0 0 Diane G Hill Director 1.0 1.0 X 0 0 0 Richard D Hoffman Director (Thru 12/31/20) 1.0 1.0 X 0 0 0 Mary R Sheahen MS RN Chairperson 10.0 1.0 X X 0 0 0 THOMAS G WISCHHUSEN DIRECTOR 1.0 1.0 X 0 0 0 John L Gatta Director 1.0 1.0 X 0 0 0 Susan M Graunke Director 1.0 1.0 X 0 0 0 Michael D Levon Director 1.0 1.0 X 0 0 0 Nimesh S Jhaveri Director 1.0 1.0 X 0 0 0 MUKESH GANGWAL DIRECTOR (Beginning 1/1/21) 1.0 1.0 X 0 0 0 Ricardo Knight MD DIRECTOR (Beginning 1/1/21) 1.0 1.0 X 0 0 0 Maria Thompson DIRECTOR (Beginning 1/1/21) 1.0 1.0 X 0 0 0 9781048 3223915 2583361 439 true true false Sodexo Inc Affiliates PO BOX 360170 PITTSBURGH PA 152516170 Dietary and Biomed 4369956 REHABCARE GROUP EAST INC PO BOX 502096 ST LOUIS MO 63150 PATIENT CARE 3758786 SODEXO CTM INC 7100 COMMERCE WAY STE 280 BRENTWOOD TN 37027 BIOMED SERVICE 3682343 SPACELABS HEALTHCARE LLC 35301 SE CENTER ST SNOQUALMIE WA 98065 IT SERV AND SUPPLY 3558001 ECATALYST CONSULTING 2398 E CAMELBACK RD STE 110 PHOENIX AZ 85016 CONSULTING 2674455 120 2884639 1500000 4384639 NET PATIENT SERVICES 622110 500582096 500582096 0 0 REFERENCE LAB 621511 22386448 21866683 519765 0 CAPITATION REVENUE 622110 6526051 6526051 0 0 HOSPICE REVENUE 622110 450490 450490 0 0 INTERCOMPANY RENTS 532000 1483599 1483599 0 0 448611 448611 0 531877295 0 0 0 1486874 1329728 157146 0 157146 0 0 157146 39575 0 39575 39575 0 0 39575 0 0 0 0 0 0 147793 163876 -16083 0 0 -16083 CAFETERIA 722212 1108492 0 0 1108492 JOINT VENTURE MANAGEMENT FEE 541611 1065853 0 569878 495975 OUTPATIENT PHARMACY 446110 441753 0 438970 2783 621372 0 621372 3237470 539680042 531357530 1528613 2409260 80000 80000 56498 56498 0 0 8089948 8089948 407914 407914 204513527 199244954 5268573 0 6865063 6421390 443673 0 27944243 26138271 1805972 0 13468397 12597966 870431 0 0 1526486 0 1526486 0 0 97574 0 97574 0 0 3097 0 3097 0 39185581 11831926 27353655 0 2669777 0 2669777 0 6083939 4338036 1745903 0 9444660 8834273 610387 0 0 7125540 5360506 1765034 0 136884 13090 123794 0 0 152341 152341 0 0 5961793 5961793 0 0 0 36956120 22707990 14248130 0 13311408 11790616 1520792 0 MEDICAL SUPPLIES 61902038 61902038 0 0 PHARMACEUTICALS 18742631 18742631 0 0 BAD DEBT - PATIENT SERVICES 17422829 17422829 0 0 ILLINOIS PROVIDER TAX 25492131 25492131 0 0 17198239 8982443 8215796 524838658 448071722 76766936 0 38585421 24527929 0 0 0 0 60248983 59426409 0 0 0 0 0 0 9021422 10126040 4719567 4321852 367113996 27520014 363863388 339593982 0 0 0 0 12990867 35970695 2255735 75000 2342258 2015455 494027641 476057362 81121075 81013058 0 0 1500000 0 233939494 235406040 0 0 0 0 0 0 0 0 89879103 99757168 406439672 416176266 X 74597102 46890229 12990867 12990867 87587969 59881096 494027641 476057362 X 14841384 -42548257 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 97574 97574 false Form 990 Schedule C Part II-B, Line 1i NORTHWEST COMMUNITY HOSPITAL PAYS DUES TO CERTAIN HOSPITAL ASSOCIATIONS WHICH USE A PORTION OF THESE DUES FOR LOBBYING. 4796665 20252500 468276 156832 25360609 4435885 250000 261907 151127 4796665 4243431 260000 74854 142400 4435885 3941522 5000 296909 4243431 3504586 5000 431936 3941522 0.86410 0.08870 0.04720 false true true 89072 89072 228617204 5648612 222968592 1523000 387519 1135481 92265478 21275809 70989669 44619242 208074 44411168 339593982 INTEREST NET ASSETS - FND 35970695 F 35970695 0 DUE TO THIRD-PARTY PAYORS 47661371 ASSET RETIREMENT OBLIGATION 905219 PENSION OBLIGATION 36996181 SERP 450000 DUE TO AFFILIATES 10875116 CURRENT PORTION OF OPERATING LEASE LIABILITIES 301208 OPERATING LEASE LIABILITIES 1714247 OTHER LONG TERM LIABLITY 853826 99757168 X Intended use of endowment funds Schedule D, Part V, Line 4 ENDOWMENT FUNDS ARE CREATED ACCORDING TO HOSPITAL NEEDS AND DESIGNATION OR PREFERENCES OF THE DONOR(S) SUPPORTING THE ENDOWMENT FUND. SCHOLARSHIP FUNDS, CONTINUED EDUCATION, OR FUNDS FOR PATIENT CARE IN A HOSPITAL DEPARTMENT DESIGNATED BY THE ENDOWMENT FUND ARE EXAMPLES OF FUND USES. THE ENDOWMENT FUNDS REPORTED ON THE HOSPITAL'S 990 ARE ALSO REPORTED ON NORTHWEST COMMUNITY HOSPITAL FOUNDATION'S FORM 990, SCHEDULE D. SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE NORTHSHORE, FPA, RMI, SWEDISH HOSPITAL, SHF, NCH, NCH HOSPITAL, AND NCH FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). MOST OF THE INCOME RECEIVED BY THE CORPORATION IS EXEMPT FROM TAXATION UNDER SECTION 501(A) OF THE IRC, AS INCOME RELATED TO THE MISSION OF THE ORGANIZATION. ACCORDINGLY, THERE IS NO MATERIAL PROVISION FOR INCOME TAX FOR THESE ENTITIES. SOME OF THE INCOME RECEIVED BY EXEMPT ENTITIES IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. NORTHSHORE AND ITS SUBSIDIARIES FILE FEDERAL INCOME TAX RETURNS AND RETURNS FOR VARIOUS STATES IN THE U.S. ASC 740-10, INCOME TAXES, REQUIRES THAT REALIZATION OF AN UNCERTAIN INCOME TAX POSITION IS MORE LIKELY THAN NOT (I.E., GREATER THAN 50% LIKELIHOOD OF RECEIVING A BENEFIT) BEFORE IT CAN BE RECOGNIZED IN THE FINANCIAL STATEMENTS. FURTHERMORE, THIS INTERPRETATION PRESCRIBES THE BENEFIT TO BE RECORDED IN THE FINANCIAL STATEMENTS AS THE AMOUNT MOST LIKELY TO BE REALIZED ASSUMING A REVIEW BY TAX AUTHORITIES HAVING ALL RELEVANT INFORMATION AND APPLYING CURRENT CONVENTIONS. THIS INTERPRETATION ALSO CLARIFIES THE FINANCIAL STATEMENT CLASSIFICATION OF TAX-RELATED PENALTIES AND INTEREST AND SETS FORTH NEW DISCLOSURES REGARDING UNRECOGNIZED TAX BENEFITS. NO AMOUNT WAS RECORDED FOR THE YEARS ENDED SEPTEMBER 30, 2021 OR 2020. FOR THE YEAR ENDED SEPTEMBER 30, 2021, THE CORPORATION HAS A NET OPERATING LOSS CARRYFORWARD OF $338,941,378, WHICH GENERATED ASSETS OF $95,702,115. THESE ASSETS ARE OFFSET BY A VALUATION ALLOWANCE OF $94,002,288. FOR THE YEAR ENDED SEPTEMBER 30, 2020, THE CORPORATION HAS A NET OPERATING LOSS CARRYFORWARD OF $190,181,510, WHICH GENERATED ASSETS OF $54,211,238. THESE ASSETS ARE OFFSET BYA VALUATION ALLOWANCE OF $52,737,013. true true X true X true X 600. true true true false true true 5448203 0 5448203 0.01070 65408510 51826003 13582507 0.02680 70856713 51826003 19030710 0.03750 43 27439 1467074 241303 1225771 0.00240 22 10599 3281036 360621 2920415 0.00580 1 1376 498040 244508 253532 0.00050 2 0 242292 0 242292 0.00050 8 1247 1054002 0 1054002 0.00210 76 40661 6542444 846432 5696012 0.01130 76 40661 77399157 52672435 24726722 0.04880 1 0 2078 0 2078 0.00000 1 0 4529 0 4529 0.00000 1 0 40633 0 40633 0.00010 2 0 4870 0 4870 0.00000 5 0 52110 0 52110 0.00010 true 4497164 211806231 258579601 -46773370 X true true 1 1 NORTHWEST COMMUNITY HOSPITAL 800 W CENTRAL ROAD ARLINGTON HEIGHTS IL 60005 nch.org 0001701 X X X NORTHWEST COMMUNITY HOSPITAL 1 false false true X X X X X X X X X 20 true false false true X NCH.org X true 20 true NCH.org false true X 200. 600. X X X X X X true true X X X X true X NCH.org X NCH.org X NCH.org X X X X X X true X false X X X X true X false false SCHEDULE H- PART V, SECTION B, LINE 3(E) THE SIGNIFICANT HEALTH NEEDS OF OUR PATIENTS AND COMMUNITY ARE IDENTIFIED THROUGH PRIORITIZED DESCRIPTIONS REFLECTED IN THE CHNA. SCHEDULE H - PART V, SECTION B, LINE 5 AN ONLINE SURVEY WAS IMPLEMENTED AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS SPECIFICALLY TO SOLICIT INPUT FROM KEY INFORMANTS; INDIVIDUALS WHO ARE CONSIDERED EXPERTS IN PUBLIC HEALTH. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE COMMUNITY, INCLUDING THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS SERVED BY THE HOSPITAL. IN JANUARY 2021, 44 POTENTIAL KEY INFORMANTS WERE IDENTIFIED WHICH INCLUDED COMMUNITY/BUSINESS LEADERS, PHYSICIANS, OTHER HEALTH PROVIDERS, PUBLIC HEALTH EXPERTS AND SOCIAL SERVICE AGENCIES. A LETTER WAS SENT FROM THE HOSPITAL'S PRESIDENT AND CEO TO THE KEY INFORMANTS TO EXPLAIN THE PURPOSE OF THE SURVEY AND TO INVITE THEM TO PARTICIPATE. A LINK TO THE ONLINE SURVEY WAS THEN EMAILED TO EACH KEY INFORMANT AND WAS OPEN FROM FEBRUARY 1-10, 2021. A REMINDER EMAIL WAS SENT TO ENCOURAGE PARTICIPATION. THE KEY INFORMANTS WERE ASKED A SERIES OF HEALTH RELATED QUESTIONS, AND TO PROVIDE FEEDBACK ON ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE/HEALTH ISSUES, MODIFIABLE RISK FACTORS AND OTHER CONCERNS. IT ALSO ASKED THEM TO RANK THEIR "TOP THREE HEALTH CONCERNS" FOR THE COMMUNITY. RESULTS FROM THE SURVEY WERE SUMMARIZED IN BOTH A QUANTITATIVE AND QUALITATIVE REPORT AND USED TO IDENTIFY MAJOR HEALTH PROBLEMS, GAPS IN SERVICES AND OTHER FACTORS WHICH MAY CONTRIBUTE TO LESS THAN OPTIMAL HEALTH STATUS FOR THE RESIDENTS OF OUR COMMUNITY. IN ALL, 24 OF THE 44 INVITED PARTICIPANTS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. THROUGH THIS PROCESS, INPUT WAS GATHERED FROM INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME POPULATIONS, MINORITY POPULATIONS (INCLUDING AFRICAN-AMERICANS, ASIANS, EASTERN EUROPEANS, HISPANICS, INDIAN, JAPANESE, POLISH AND RUSSIAN), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (INCLUDING THE DISABLED, THE ELDERLY, THE HOMELESS, MEDICAID/MEDICARE BENEFICIARIES, THE MENTALLY ILL, PREGNANT TEENS, SUBSTANCE ABUSERS, UNDOCUMENTED INDIVIDUALS, UNINSURED/UNDERINSURED RESIDENTS, VETERANS, YOUNG ADULTS AND WOMEN). THE HOSPITAL ALSO SOLICITED INPUT FROM THE COMMUNITY AT LARGE THROUGH AN ONLINE SURVEY. THE SURVEY WAS ANNOUNCED TO THE COMMUNITY THROUGH A PRESS RELEASE, A PAID ADVERTISEMENT IN A LOCAL NEWSPAPER, AND IT WAS FEATURED IN "A HEALTHIER YOU', NCH'S ELECTRONIC COMMUNITY NEWSLETTER. IT WAS ALSO SENT TO VOLUNTEERS, DONORS AND EMPLOYEES ASKING THOSE WHO LIVE IN THE HOSPITAL'S SERVICE AREA TO PARTICIPATE. THE SURVEY LINK WAS ON THE HOSPITAL'S HOME PAGE AND WAS OPEN FROM FEBRUARY 12-22, 2021. MORE THAN 360 PEOPLE PARTICIPATED IN THE SURVEY. THE HOSPITAL ALSO SOLICITED INPUT FROM VULNERABLE POPULATIONS IN THE COMMUNITY THROUGH FOCUS GROUPS. AN INDEPENDENT MODERATOR WAS HIRED TO CONDUCT TWO FOCUS GROUPS IN FEBRUARY 2021: ONE WITH SPANISH-SPEAKING UNDER-RESOURCED COMMUNITY MEMBERS AND ONE WITH ENGLISH-SPEAKING UNDER-RESOURCED COMMUNITY MEMBERS. POTENTIAL PARTICIPANTS WERE GIVEN A SHORT SCREENING QUESTIONNAIRE TO ENSURE THEY LIVED IN THE HOSPITAL'S SERVICE AREA AND SO THAT PARTICIPANTS WOULD VARY IN AGE, GENDER, INSURANCE STATUS, INCOME AND EDUCATIONAL LEVELS. THE FOCUS GROUPS FOLLOWED A GUIDELINE WHICH MIRRORED THE QUESTIONS INCLUDED IN THE COMMUNITY AND KEY INFORMANT SURVEYS SO THAT THE INFORMATION GATHERED COULD BE USED TO COMPARE WITH THE SURVEY RESULTS. THE MODERATOR SUMMARIZED THE RESULTS OF THE FOCUS GROUPS WHICH WERE USED AS ONE OF THE TOOLS IN IDENTIFYING THE MOST PREDOMINANT COMMUNITY NEEDS. NCH ALSO CONDUCTED A FOCUS GROUP IN FEBRUARY 2021 WITH ITS PATIENT FAMILY ADVISORY COUNCIL, WHICH IS COMPRISED OF COMMUNITY MEMBERS WHO USE NCH AS THEIR MEDICAL HOME. THE SAME FORMAT AS THE FOCUS GROUPS DESCRIBED ABOVE WAS USED, AND PROVIDED AN OPPORTUNITY TO GATHER INFORMATION ON THE COMMUNITY'S BELIEFS AND PERCEPTIONS ABOUT THE HEALTH OF ITS COMMUNITY, WHICH SUPPLEMENTED THE DATA COLLECTED IN THE ONLINE COMMUNITY HEALTH SURVEY. SCHEDULE H - PART V, SECTION B, LINE 7A https://www.nch.org/wp-content/uploads/2021-CHNA-2.pdf SCHEDULE H - PART V, SECTION B, LINE 10A https://www.nch.org/wp-content/uploads/2022-2024-Implementation-Plan.pdf SCHEDULE H - PART V, SECTION B, LINE 11 TAKING INTO ACCOUNT HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS AND STRATEGIC PRIORITIES - IT WAS DETERMINED THAT NCH WOULD FOCUS THE MAJORITY OF ITS EFFORTS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE THE FOLLOWING PRIORITY AREAS: BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE), OBESITY, ACCESS TO CARE FOR THE UNDER-RESOURCED, CANCER (INCLUDING TOBACCO) AND CHRONIC DISEASE (DIABETES, HEART DISEASE, STROKE, AND HIGH BLOOD PRESSURE). KEY INDIVIDUALS THROUGHOUT THE HOSPITAL WERE IDENTIFIED TO SERVE ON ISSUE SPECIFIC COMMITTEES TO DEVELOP IMPLEMENTATION STRATEGIES FOR EACH OF THE PRIORITY AREAS FOR THE HOSPITAL'S FISCAL YEARS 2022 THROUGH 2025. THESE INDIVIDUALS ALSO DEVELOPED METRICS TO MEASURE THE SUCCESS OF THE STRATEGIES WHICH WILL BE MONITORED AND UPDATED ANNUALLY. IMPLEMENTATION STRATEGIES FOR BEHAVIORAL HEALTH INCLUDE FREE, IN PERSON MENTAL HEALTH ASSESSMENTS AND A FREE 24/7 RESOURCE AND REFERRAL PHONE LINE TO ASSIST COMMUNITY MEMBERS IN CRISIS. THE HOSPITAL ALSO CONDUCTS FREE BEHAVIORAL HEALTH ASSESSMENTS AND CARE COORDINATION FOR HOSPITALIZED PATIENTS WITH SUBSTANCE ABUSE DISORDERS AND HAS AN OUTPATIENT ADDICTIONS PROGRAM PROVIDING MEDICATION ASSISTED TREATMENT FOR ALCOHOL, OPIOID, AND OTHER SUBSTANCE USE DISORDERS. IT ALSO INCLUDES UTILIZING THE MENTAL HEALTH FIRST AID PROGRAM TO TRAIN COMMUNITY MEMBERS ON IDENTIFYING AND RESPONDING TO BEHAVIORAL HEALTH ISSUES AND AN ED AMBULATORY DETOX PROGRAM. IMPLEMENTATION STRATEGIES FOR OBESITY INCLUDE A COMPREHENSIVE WEIGHT LOSS CLINIC, OUTPATIENT NUTRITION COUNSELING, A COLLABORATIVE COMMUNITY FOOD PANTRY, LOW COST MEMBERSHIPS AT THE NCH WELLNESS CENTER, AND A FOOD INSECURITY INPATIENT SCREENING PROGRAM WITH ONSITE SUPPORT FROM A FOOD PHARMACY. IMPLEMENTATION STRATEGIES FOR ACCESS TO CARE FOR THE UNDER-RESOURCED INCLUDE A COMMUNITY NURSING AND COMMUNITY HEALTH WORKER PROGRAM. THE HOSPITAL'S DEDICATED CASE MANAGEMENT TEAM ALONG WITH TWO COMMUNITY HEALTH NURSES AND A COMMUNITY HEALTH WORKER PROVIDE OUTREACH AND ASSIST VULNERABLE PATIENTS AND COMMUNITY MEMBERS WITH ACCESSING CARE. THE HOSPITAL ALSO FUNDS A CHARITABLE PRESCRIPTION AND FREE TRANSPORTATION PROGRAM TO FURTHER ASSIST THESE INDIVIDUALS. ACCESS TO ORAL HEALTH CARE FOR THE UNDER-RESOURCED IS ADDRESSED THROUGH A COLLABORATIVE MOBILE DENTAL CLINIC PROGRAM THAT IS OPERATED BY THE HOSPITAL WITH SUPPORT FROM FOUR LOCAL TOWNSHIPS, UNIVERSITY OF CHICAGO DENTAL SCHOOL, HARPER COLLEGE, ADVANTAGE AMBULANCE AS WELL AS PROFESSIONAL VOLUNTEERS. IMPLEMENTATION STRATEGIES FOR CANCER INCLUDE THE GIFT-A-MAMMOGRAM PROGRAM WHICH PROVIDES FREE SCREENINGS AND DIAGNOSTIC TESTING FOR UNDER-RESOURCED PATIENTS. THE HOSPITAL ALSO OFFERS LUNG SCREENINGS AND FREE TOBACCO CESSATION COUNSELING AND SUPPORT GROUPS TO AID WITH LUNG CANCER PREVENTION. TEN FREE SUPPORT GROUPS AND ANNUAL CANCER SURVIVOR EVENTS ARE FACILITATED BY THE HOSPITAL. THE HOSPITAL ALSO ADMINISTERS THE CANCER AND LUNG PATIENT FAMILY ASSISTANCE FUND WHICH PROVIDES ASSISTANCE TO CANCER PATIENTS STRUGGLING TO PAY THEIR RENT, UTILITIES AND OTHER LIVING EXPENSES. LASTLY, THE HOSPITAL DEVELOPED IMPLEMENTATION STRATEGIES TO ADDRESS A NUMBER OF CHRONIC DISEASES INCLUDING DIABETES, HEART DISEASE, STROKE AND HIGH BLOOD PRESSURE. THESE INITIATIVES INCLUDE A PATIENT NAVIGATION PROGRAM TO ASSIST CONGESTIVE HEART FAILURE PATIENTS IN THE COMMUNITY AS WELL AS A COMPREHENSIVE OUTPATIENT CLINIC FOR INDIVIDUALS WITH HEART FAILURE OR AFIB. A STROKE SUPPORT GROUP IS OFFERED TO PROMOTE EMOTIONAL HEALING AFTER DIAGNOSIS. STAFF ALSO PROVIDES EDUCATION IN THE COMMUNITY FOCUSED ON EDUCATION AND PREVENTION OF CHRONIC DISEASE. THE KEY PRIORITY AREAS ALONG WITH THE IMPLEMENTATION STRATEGIES AND METRICS CAN BE FOUND ON THE HOSPITAL'S WEBSITE (NCH.ORG). IN ACKNOWLEDGING THE WIDE RANGE OF HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, THE HOSPITAL DETERMINED IT COULD ONLY EFFECTIVELY FOCUS ON THOSE WHICH IT DEEMED MOST PRESSING, MOST UNDER-ADDRESSED, AND MOST WITHIN ITS ABILITY TO INFLUENCE. THE COMMUNITY HEALTH NEEDS THAT THE HOSPITAL IS UNABLE TO ADDRESS ARE: ACCESS TO SPECIALTY AND VISION CARE FOR THE UNDER RESOURCES, CHILD ABUSE, ELDER ABUSE, DOMESTIC VIOLENCE, DEMENTIA/ALZHEIMERS, TEEN SEXUALITY (PREGNANCY AND STD'S), AND SAFE NEIGHBORHOODS/AFFORDABLE HOUSING. THE HOSPITAL BELIEVES ACCESS TO SPECIALTY AND VISION CARE WILL BE ADDRESSED THROUGH REFERRALS FROM PRIMARY CARE PHYSICIANS. THE HOSPITAL COLLABORATES WITH FOUR LOCAL NOT-FOR-PROFIT COMMUNITY AGENCIES (CHILDREN'S ADVOCACY CENTER, NORTHWEST CASA, CATHOLIC CHARITIES AND WINGS) TO ADDRESS CHILD ABUSE, ELDER ABUSE AND DOMESTIC VIOLENCE. THE HOSPITAL BELIEVES THERE ARE SUFFICIENT COMMUNITY RESOURCES INCLUDING PRIMARY CARE PHYSICIANS TO DIAGNOSE AND NURSING HOMES AND MEMORY CARE FACILITIES TO TREAT DEMENTIA AND ALZHEIMERS. THE HOSPITAL PARTNERS WITH LOCAL SCHOOL DISTRICTS THAT PROVIDE SEX EDUCATION AND SUPPORT SERVICES AND WITH LOCAL COMMUNITY CLINICS WHO ADDRESS PREVENTION AND TREATMENT OF PREGNANCY AND STD'S. THE HOSPITAL IS A HEALTHCARE FACILITY AND IS NOT EQUIPPED TO ADDRESS HOUSING ISSUES. NCH RELIES ON ITS LOCAL MUNICIPALITIES TO ADDRESS THESE CONCERNS. THE HOSPITAL SUPPORTS THE EFFORTS OF OTHERS TO ADDRESS THESE AREAS AND WILL FOCUS ITS LIMITED RESOURCES ON THE MORE PREDOMINANT NEEDS IDENTIFIED. FOR A COMPLETE LIST OF NEEDS AND IMPLEMENTATION STRATEGIES VISIT THE HOSPITAL'S WEBSITE (NCH.ORG). SCHEDULE H - PART V, SECTION B, LINE 13H PRESUMED ELIGIBLE PATIENTS RECEIVE 100% FINANCIAL ASSISTANCE FOR THE ACCOUNT BALANCE. A PATIENT MUST PROVIDE DOCUMENTATION LISTING ELIGIBILITY OR QUALIFICATION OR PRINT SCREEN OF WEB PAGE LISTINGS ELIGIBILITY. A PATIENT IS PRESUMED ELIGIBLE IF THEY HAVE ONE OF THE FOLLOWING: - PARTICIPATION IN STATE-FUNDED PRESCRIPTION PROGRAMS; - PARTICIPATION IN WOMEN'S, INFANT'S, AND CHILDREN'S PROGRAMS (WIC); - FOOD STAMP ELIGIBILITY (LINK CARD); - ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAM THAT IS UNFUNDED; - LOW INCOME/SUBSIDIZED HOUSING ARE PROVIDED AS A VALID ADDRESS; - PATIENT IS DECEASED WITH NO KNOWN ESTATE; - AFFILIATION WITH HOMELESS ASSISTANCE ORGANIZATION (I.E. JOURNEYS THE ROAD HOME); - ENROLLED IN SNAP, ILLINOIS FREE BREAKFAST/LUNCH, LOW INCOME HOME ENERGY ASSISTANCE PROGRAM, OR A COMMUNITY-BASED MEDICAL ASSISTANCE PROGRAM WITH LOW-INCOME CRITERIA; - RECEIVING GRANT ASSISTANCE FOR MEDICAL SERVICES; - RECENT PERSONAL BANKRUPTCY, INCARCERATION, RELIGIOUS ORDER AFFILIATION AND VOW OF POVERTY OR ENROLLMENT IN TANF OR IHDA'S RENTAL HOUSING SUPPORT PROGRAM; - A PATIENT WHO HAS BEEN UNRESPONSIVE TO EFFORTS TO APPLY FOR FINANCIAL ASSISTANCE BUT HAS BEEN ASSESSED UNDER THE POST-CARE PROCESS AND MEETS THE CRITERIA; - PATIENT IS MENTALLY OR PHYSICALLY INCAPACITATED AND HAS NO ONE TO ACT ON HIS/HER BEHALF; - PATIENT IS ELIGIBLE FOR SUBSIDIZED SCHOOL LUNCH PROGRAMS; OR - MEDICAID ELIGIBILITY THAT DOES NOT APPLY TO THIS SERVICE (I.E. DHS SOCIAL SERVICES, MOMS AND BABIES). - RELIGIOUS ORDER AFFILIATION AND A VOW OF POVERTY. SCHEDULE H - PART V, SECTION B, LINE 16 https://www.nch.org/billing-insurance/financial-assistance/ 14 NCH Imaging Center 880 W Central Road Arlington Heights IL 60005 Imaging Services NCH Immediate Care & Imaging Center 199 W Rand Road Mount Prospect IL 60056 WALK IN URGENT CARE CENTER, Lab,Imaging,Physical Therapy & Heart Care Services NCH Behavioral Health 901 W Kirchoff Road Arlington Heights IL 60005 Behavioral Health Services NCH Immediate Care & Imaging Center 21481 N Rand road Kildeer IL 60049 Walk in Urgent Care Center, Lab, Imaging, Physical Therapy Services NCH Breast Vein care Weight Management 1410 N Arlington Heights Road ARLINGTON HEIGHTS IL 60004 Breast Center, Vein care & Comprehensive Weight Management Services NCH Immediate Care & Imaging Center 519 S Roselle Road Schaumburg IL 60193 Walk in Urgent Care Center Lab, Imaging, Physical Therapy Services NCH Cardiac Physical Rehabilitation 900 W Central Road Arlington Heights IL 60005 Cardiac & Physical Rehabilitation Services NCH Outpatient Center 3300 Kirchoff Road Rolling Meadows IL 60008 Physical, Occupational, & Speech Therapy Services NCH Home Health 3040 Salt Creek Lane Arlington Heights IL 60005 Home Healthcare Services NCH Immediate Care & Imaging Center 15 S Mchenry Road Buffalo Grove IL 60089 Walk in Urgent Care Center, Lab, Imaging, Physical Therapy Services NCH Imaging Center 1632 W Central Road Arlington Heights IL 60005 Imaging, Cardiac Diagnostic Services NCH Physical Rehabilitation 1200 W Algonquin Rd Bldg M Palatine IL 60067 Physical Therapy Services NCH Physical Rehabilitation 1051 W Rand Road Arlington Heights IL 60004 Physical Therapy Services NCH Diabetes Services 605 W Central Road Arlington Heights IL 60005 Diabetes Services SCHEDULE H - PART I, LINE 3C - CHARITY CARE POLICY THE HOSPITAL PROVIDES EMERGENT AND MEDICALLY NECESSARY SERVICES TO ALL PATIENTS WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. THE WRITTEN CHARITY CARE POLICY IS WIDELY DISTRIBUTED AND COMMUNICATED TO THE COMMUNITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE AMOUNT OF FREE CARE PROVIDED IS DETERMINED BY FINANCIAL NEED AND IS NOT LIMITED BY BUDGETED AMOUNTS. PATIENTS EARNING LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES RECEIVE FREE CARE AND THOSE BETWEEN 200% AND 600% OF THE GUIDELINES RECEIVE DISCOUNTED CARE ON A SLIDING SCALE. THE FINANCIAL ASSISTANCE PROGRAM LOOKS AT THE CURRENT INCOME AND THEN CALCULATES THE POTENTIAL BENEFIT. THE PATIENT'S LIABILITY IS CAPPED AT 25% OF THE FAMILY'S ANNUAL INCOME. PLEASE SEE SCHEDULE H PART V, SECTION B, LINE 13H NARRATIVE FOR MORE DETAIL. SCHEDULE H - PART I, LINE 6A-COMMUNITY BENEFIT REPORT THE HOSPITAL ANNUALLY PRODUCES A COMMUNITY BENEFIT REPORT WHICH HIGHLIGHTS THE COMMUNITY BENEFIT DOLLARS REPORTED IN THE ILLINOIS ATTORNEY GENERAL ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT. THIS INCLUDES CHARITY CARE, LANGUAGE ASSISTANT SERVICES, GOVERNMENT SPONSORED INDIGENT HEALTH CARE, DONATIONS, VOLUNTEER SERVICES, EDUCATION, RESEARCH, SUBSIDIZED HEALTH SERVICES AND OTHER COMMUNITY BENEFITS. IT ALSO HIGHLIGHTS THE MOST PREDOMINANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. COPIES OF THE REPORT ARE PRINTED AND MAILED TO KEY STAKEHOLDERS INCLUDING LOCAL GOVERNMENT, SOCIAL SERVICE AGENCIES, HOSPITAL SUPPORTERS AND MORE. A COPY OF THE REPORT IS ALSO POSTED ON THE HOSPITAL WEBSITE (NCH.ORG) AND IS AVAILABLE IN HARD COPY TO ANYONE WHO REQUESTS ONE. SCHEDULE H - PART I, LINE 7 - FINANCIAL ASSISTANCE THE FOLLOWING METHODOLOGIES WERE USED TO DETERMINE THE AMOUNTS REPORTED IN THE TABLE FOR LINE 7: PART I, LINES 7A - 7D RATIO OF COST TO CHARGES WAS DETERMINED USING WORKSHEET 2 IN THE FORM 990, SCHEDULE H INSTRUCTIONS. PART I, LINES 7E - 7J COSTS WERE DETERMINED USING THE DIRECT AND INDIRECT COSTS FOR SPECIFIC PROGRAMS OR SERVICES. THESE COSTS WERE MAINTAINED/IDENTIFIED IN THE HOSPITAL'S "COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY SOFTWARE" (CBISA). THE INDIRECT PORTION OF THESE COSTS WAS CALCULATED UTILIZING THE INDIRECT COST RATIO FROM THE HOSPITAL'S LATEST AVAILABLE MEDICARE COST REPORT. THE "INDIRECT" RATIOS WERE ENTERED INTO CBISA FOR THE CALCULATION OF INDIRECT COSTS. Part I, Line 7g - SUBSIDIZED HEALTH SERVICES THE HOSPITAL PROVIDES A MOBILE DENTAL CLINIC PROGRAM STAFFED BY A HOSPITAL-EMPLOYED FULL TIME DENTIST, DENTAL ASSISTANT AND PROGRAM MANAGER AND A PART TIME DENTAL HYGIENIST. EVIDENCE BASED RESEARCH DEMONSTRATES THAT GUM DISEASE AND ORAL HEALTH PROBLEMS ARE LINKED TO OTHER SYSTEMIC MEDICAL PROBLEMS SUCH AS CARDIOVASCULAR DISEASE, STROKE, AND BACTERIAL PNEUMONIA, AS WELL AS INCREASED RISK OF DELIVERING PRE-TERM OR LOW BIRTH-WEIGHT BABIES. THE HOSPITAL, WITH FINANCIAL SUPPORT FROM LOCAL TOWNSHIPS AND OTHER DONORS, PROVIDES PREVENTIVE AND RESTORATIVE CARE TO UNINSURED AND UNDERINSURED MEMBERS OF THE COMMUNITY 4-5 DAYS PER WEEK IN A MOBILE DENTAL CLINIC. PART I, LINE 7, Column (F) $17,422,829 of bad debt expense was excluded from total expenses reported on Form 990, Part IX, Line 25, column (A) in the calculation to determine the percentage of net community benefit expenses in relation to total expenses. SCHEDULE H - PART II, COMMUNITY BUILDING ACTIVITIES PART II - LINE 2 - ECONOMIC DEVELOPMENT THE HOSPITAL'S VICE PRESIDENT OF OPERATIONS REPRESENTS THE ORGANIZATION THROUGH PARTICIPATION IN THE ARLINGTON HEIGHTS ECONOMIC ALLIANCE COMMISSION. THE COMMISSION IS MADE UP OF 13 LOCAL BUSINESS OWNERS AND REPRESENTATIVES WHO ARE TASKED WITH IMPROVING THE COMMUNITY'S ECONOMIC CLIMATE BY ADVISING THE VILLAGE BOARD AND STAFF THROUGH A BUSINESS PERSPECTIVE. THE ORGANIZATION ALSO IS A MEMBER OF AND SUPPORTS THE ARLINGTON HEIGHTS CHAMBER OF COMMERCE (AHCC). THE AHCC IS DEDICATED TO FOSTERING BUSINESS GROWTH AND STRENGTHENING THE LOCAL ECONOMY AND COMMUNITY. PART II - LINE 3 - COMMUNITY SUPPORT THE HOSPITAL'S VICE PRESIDENT OF PHYSICIAN OPERATIONS WORKED WITH A LOCAL STATE REPRESENTATIVE TO CREATE INFORMATIONAL PODCASTS FOR COMMUNITY MEMBERS TO LEARN MORE ABOUT THE COVID-19 PANDEMIC, INCLUDING THE IMPORTANCE OF TESTING AND GETTING VACCINATED. FOUR PODCASTS WERE PRODUCED AND AVAILABLE FREE OF CHARGE TO COMMUNITY MEMBERS. PART II - LINE 6 - COALITION BUILDING THE HOSPITAL'S EXECUTIVE DIRECTOR OF COMMUNITY SERVICES REPRESENTS THE ORGANIZATION THROUGH PARTICIPATION IN THE ARLINGTON HEIGHTS ROTARY CLUB IN THE HOSPITAL'S PRIMARY SERVICE AREA. ROTARY CLUB MEMBERS ARE PREDOMINATELY BUSINESS AND PROFESSIONAL LEADERS WHO COME TOGETHER TO SUPPORT ORGANIZATIONS THAT ADDRESS NEED AND DISPARITY IN THE COMMUNITY. AREAS ADDRESSED INCLUDE HUNGER, HOMELESSNESS, MENTAL HEALTH ISSUES, CANCER, TROUBLED YOUTH, DEVELOPMENTALLY DISABLED, DOMESTIC VIOLENCE AND MANY MORE. NOTE THAT THE HOURS/EXPENSES WERE NOT REPORTED IN THE COMMUNITY BUILDING SECTION OF THIS REPORT BECAUSE THE SALARY IS ALREADY CAPTURED IN COMMUNITY BENEFIT OPERATIONS IN PART I, LINE 7J. PART II - LINE 7 - ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT/SAFETY THE HOSPITAL'S VICE PRESIDENT OF OPERATIONS REPRESENTS THE ORGANIZATION THROUGH PARTICIPATION ON THE BOARD OF DIRECTORS FOR HOPEFUL BEGINNINGS/ST. MARY'S SERVICES. THE LOCAL NOT FOR PROFIT ORGANIZATION PROVIDES MATERNITY AND GRIEF COUNSELING AND PARENTING EDUCATION, AS WELL AS GUIDANCE AND SUPPORT FOR FAMILIES SEEKING ADOPTION. THE HOSPITAL'S VICE PRESIDENT AND CHIEF NURSING OFFICER AND VICE PRESIDENT OF HUMAN RESOURCES REPRESENT THE ORGANIZATION ON THE BOARD OF DIRECTORS FOR THE KENNETH YOUNG CENTER (KYC). KYC PARTNERS WITH COMMUNITIES TO PROVIDE SUPPORT FOR PEOPLE OF ALL AGES TO NAVIGATE LIFE'S CHALLENGES THROUGH PERSONALIZED INTERVENTION, TREATMENT AND RECOVERY. SERVICES INCLUDE TREATMENT, RECOVERY AND SUPPORT SERVICES FOR INDIVIDUALS WITH MENTAL ILLNESS AND SERVICE COORDINATION AND IN-HOME SERVICES FOR OLDER ADULTS. THE HOSPITAL'S DIRECTOR OF WOMEN'S AND CHILDREN'S SERVICES REPRESENTS THE ORGANIZATION ON THE BOARD OF DIRECTORS FOR WINGS (WOMEN IN NEED GROWING STRONGER). WINGS PROVIDES A PATHWAY TO INDEPENDENCE FOR ADULTS AND CHILDREN WHO ARE ESCAPING FROM DOMESTIC VIOLENCE AND ABUSE. THEIR GOAL IS TO PROVIDE THE TOOLS AND SUPPORT NECESSARY TO ENSURE THAT VICTIMS CAN ESCAPE THEIR ABUSERS AND BEGIN BUILDING NEW, VIOLENCE-FREE LIVES. PART II - LINE 8 - WORKFORCE DEVELOPMENT THE HOSPITAL HAS A PROGRAM TO ENCOURAGE HIGH SCHOOL STUDENTS TO EXPLORE CAREERS IN HEALTHCARE. THE PROGRAM NORMALLY PROVIDES LOCAL HIGH SCHOOL STUDENTS THE OPPORTUNITY TO SPEND 14 WEEKS IN THE HOSPITAL SHADOWING 14 DIFFERENT DEPARTMENTS. AS THE STUDENTS ROTATE THROUGH THE VARIOUS DEPARTMENTS THEY ARE EXPOSED TO AN ARRAY OF CLINICAL FIELDS, PROVIDING THEM WITH AN IN-DEPTH LOOK AT JUST SOME OF THE MANY CAREER TRACKS THEY COULD PURSUE. DUE TO COVID RESTRICTIONS THE PROGRAM HAD TO BE CONDUCTED VIRTUALLY. HOSPITAL LEADERS FROM DIFFERENT DEPARTMENTS PROVIDED EDUCATION ABOUT THE DEPARTMENT THEY WORK IN AND ANSWERED QUESTIONS ABOUT PURSUING CAREERS. SCHEDULE H - PART III, BAD DEBT, MEDICARE & COLLECTION PRACTICES SECTION A, LINE 2 BAD DEBT EXPENSE WAS REPORTED AT COST USING A COST-TO-CHARGE METHODOLOGY. THE SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES CALCULATED TO REPORT CHARITY CARE ON PART I, LINE 7A WAS MULTIPLIED BY THE COST-TO-CHARGE RATIO TO DETERMINE THE BAD DEBT EXPENSE AT COST. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE EXCLUDED FROM BAD DEBT EXPENSE IN ORDER TO REFLECT THE EXPECTED AMOUNT TO BE PAID. SECTION A, LINE 4 PATIENT ACCOUNTS RECEIVABLE FINANCIAL STATEMENT FOOTNOTE - PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE CORPORATION EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING CARE. PART III, SECTION B, LINE 8 THE MEDICARE SHORTFALL REPORTED IN PART III, LINE 7 REPRESENTS THE EXCESS COST OF PROVIDING SERVICES TO MEDICARE BENEFICIARIES OVER THE PAYMENTS RECEIVED FROM THE MEDICARE PROGRAM. ACCESS TO QUALITY HEALTHCARE IS IMPERATIVE FOR ALL MEDICARE RECIPIENTS, MANY OF WHOM ARE LIVING ON A FIXED INCOME. AS SUCH, THE COSTS ABSORBED BY THE HOSPITAL IN PROVIDING THESE SERVICES IS A BENEFIT TO THE MEMBERS OF THE COMMUNITY WE SERVE. PART III SECTION C. COLLECTION PRACTICES, LINE 9B IT IS THE POLICY OF THE HOSPITAL TO OFFER PATIENTS A PAYMENT PLAN OR FINANCIAL ASSISTANCE WHEN IT BECOMES KNOWN OR SUSPECTED THAT A PATIENT NEEDS SUCH ASSISTANCE. FINANCIAL COUNSELORS CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP DETERMINE IF THERE ARE ANY THIRD PARTY PAYERS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS, SUCH AS MEDICAID, COBRA, WORKERS COMPENSATION, OR SPECIALIZED GRANT PROGRAMS. IF NO THIRD PARTY PROGRAMS ARE IDENTIFIED, THE FINANCIAL COUNSELORS WORK WITH THE PATIENT TO HELP THEM APPLY FOR CHARITY DISCOUNTS OR PAYMENT PLANS. FORMS ARE AVAILABLE IN ENGLISH, SPANISH, RUSSIAN, POLISH, GERMAN, JAPANESE AND TRANSLATION SERVICES ARE PROVIDED IN MANY LANGUAGES. IN ADDITION, ALL PATIENT BILLS AND STATEMENTS INCLUDE INFORMATION ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE AND THE INFORMATION IS ALSO POSTED ON THE HOSPITAL'S WEBSITE (NCH.ORG). COLLECTION ACTIVITY WILL BE SUSPENDED DURING THE CONSIDERATION OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION OR AN APPLICATION FOR OTHER HEALTHCARE BRACKET (I.E., MEDICARE, MEDICAID, ETC.) UNTIL FINANCIAL ASSISTANCE CAN BE DETERMINED. ACCOUNTS IN THE FINANCIAL ASSISTANCE PROCESS WILL BE MONITORED AND, UPON THE DECISION TO APPROVE OR DENY FINANCIAL ASSISTANCE, THE PATIENT'S ACCOUNT WILL BE UPDATED. IF THE FINANCIAL ASSISTANCE APPLICATION IS APPROVED WITH A PERCENTAGE LESS THAN 100% OR DENIED, THE PATIENT'S ACCOUNT WILL BE NOTED AND THE HOSPITAL WILL RESUME THE SELF-PAY COLLECTION ACTIVITY IN COMPLIANCE WITH ITS SELF PAY FOLLOW-UP PROCEDURES. SCHEDULE H - PART VI, LINE 2 - NEEDS ASSESSMENT THE FY 2021 COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED INDEPENDENTLY BY THE HOSPITAL INSTEAD OF BEING OUTSOURCED TO A VENDOR. THE HOSPITAL BELIEVED CONDUCTING ITS OWN ASSESSMENT WOULD YIELD MORE MEANINGFUL RESULTS AND A CLEARER SNAPSHOT OF THE COMMUNITY IT SERVES. THE ASSESSMENT WAS COMPRISED OF DATA COLLECTED FROM QUANTITATIVE, QUALITATIVE OR A COMBINATION OF BOTH RESOURCES. THE HOSPITAL CONTRACTED WITH SG2, AN INDUSTRY LEADER IN HEALTHCARE ANALYTICS AND CONSULTING, FOR QUANTITATIVE DATA. SG2 PROVIDED COMPREHENSIVE DEMOGRAPHIC INFORMATION OF THE HOSPITAL'S SERVICE AREA. THEY ALSO PROVIDED POPULATION GROWTH PROJECTIONS FOR THE COMMUNITY BY TOWN, AGE, GENDER, ETHNICITY/RACE, INCOME AND EDUCATION. IN ADDITION, THEY FORECASTED THE PROJECTED GROWTH OF CHRONIC DISEASE AREAS IN THE OUTPATIENT SETTING FOR THE HOSPITAL'S SERVICE AREA. CHANGES IN COMMUNITY DEMOGRAPHICS HAVE A DIRECT CORRELATION WITH HEALTHCARE NEEDS AND HOW TO ADDRESS THEM. ADDITIONAL QUANTITATIVE DATA WAS COLLECTED THROUGH SPARKMAP (SPARKMAP.ORG), WHICH IS A PRODUCT OF THE CENTER FOR APPLIED RESEARCH AND ENGAGEMENT SYSTEMS AND HOSTED BY THE UNIVERSITY OF MISSOURI. SPARKMAP USES LOCATION-SPECIFIC DATA TO CREATE MAPS AND COMMUNITY ASSESSMENTS THAT INFORM, GUIDE AND TRANSFORM THE WORK OF HEALTHCARE ORGANIZATIONS. THE GOAL OF SPARKMAP IS TO INCREASE THE IMPACT OF THOSE WORKING TOWARD HEALTHY, EQUITABLE AND SUSTAINABLE COMMUNITIES. THE WEB PORTAL ALLOWS ACCESS TO DATA IN MULTIPLE CATEGORIES WHICH CAN BE USED TO EXPLORE COMMUNITY HEALTH. CUSTOM TOOLS ALLOW THE USER TO FILTER DATA BY ZIP CODE AND CREATE A REPORT SPECIFICALLY FOR ITS COMMUNITY. IT ALSO ALLOWS THE USER TO CREATE A CUSTOM REPORT WHICH HIGHLIGHTS ITS COMMUNITIES GREATEST AREAS OF CONCERN. THE LAST SOURCE OF QUANTITATIVE DATA WAS FROM THE 2020 COUNTY HEALTH RANKINGS AND ROADMAPS REPORT (COUNTYHEALTHRANKINGS.ORG), A COLLABORATION BETWEEN THE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE. THE REPORT RANKED U.S. COUNTIES IN EVERY STATE ON VARIOUS HEALTH OUTCOMES, HEALTH FACTORS, SOCIAL AND ECONOMIC CONDITIONS, AND THE PHYSICAL ENVIRONMENT. THE MAJOR GOAL OF THE RANKINGS IS TO RAISE AWARENESS ABOUT THE MANY FACTORS THAT INFLUENCE HEALTH AND THAT HEALTH VARIES FROM PLACE TO PLACE. ALTHOUGH THE RANKINGS PROVIDE VALUABLE COUNTY-WIDE INFORMATION IT DOES NOT EXAMINE DATA AT THE SUB-COUNTY LEVEL. COOK COUNTY IS UNIQUE IN THAT IT IS THE SECOND-MOST POPULOUS COUNTY IN THE UNITED STATES AFTER LOS ANGELES COUNTY, CALIFORNIA. THERE ARE 130 INCORPORATED MUNICIPALITIES PARTIALLY OR WHOLLY WITHIN COOK COUNTY, THE LARGEST OF WHICH IS CHICAGO, WHICH IS HOME TO APPROXIMATELY 54% OF THE POPULATION OF THE COUNTY. THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH RECOGNIZES THE UNIQUENESS OF THE COUNTY AND IDENTIFIED INDICATORS FROM THE RANKINGS FOR WHICH LOCAL DATA EXISTED AND CREATED A REPORT SPECIFICALLY FOR SUBURBAN COOK COUNTY. TWO DIFFERENT SURVEYS WERE DEVELOPED TO COLLECT A COMBINATION OF BOTH QUANTITATIVE AND QUALITATIVE DATA. NCH DEVELOPED A COMPREHENSIVE ONLINE COMMUNITY HEALTH SURVEY IN ORDER TO TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. THE SURVEY ASKED PARTICIPANTS TO SHARE THEIR BELIEFS AND PERCEPTIONS ABOUT ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE/HEALTH ISSUES, MODIFIABLE RISK FACTORS/BEHAVIORS AND OTHER CONCERNS. IT ALSO ASKED THE PARTICIPANTS TO RANK THEIR "TOP THREE HEALTH CONCERNS" FOR THE COMMUNITY. THE COMMUNITY WAS INVITED TO PARTICIPATE IN THE ONLINE SURVEY THROUGH A MEDIA RELEASE AND A PAID ADVERTISEMENT IN A LOCAL NEWSPAPER, THE HOSPITAL'S ELECTRONIC COMMUNITY NEWSLETTER "A HEALTHIER YOU", THE HOSPITAL'S ELECTRONIC VOLUNTEER AND EMPLOYEE NEWSLETTERS, SOCIAL MEDIA AND THROUGH AN EMAIL ANNOUNCEMENT BY THE HOSPITAL'S FOUNDATION TO ALL DONORS. THE SURVEY LINK, LOCATED ON THE HOME PAGE OF THE HOSPITAL'S WEBSITE (NCH.ORG), WAS OPEN FROM FEBRUARY 12 TO 22, 2021 AND 364 PEOPLE RESPONDED. THE MAJORITY OF THE RESPONDENTS WERE CAUCASIAN (99%), FEMALE (71%) AND OLDER ADULTS (15% AGE 55-64, 36% AGE 65-74, AND 32% AGE 75 OR OLDER). THE MAJORITY (73%) HAD ATTAINED A COLLEGE DEGREE (ASSOCIATES OR HIGHER) AND HAD EITHER MEDICARE (63%) OR PRIVATE INSURANCE (34%). THE MAJORITY (72%) LIVE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND THE REMAINDER (28%) LIVE IN THE HOSPITAL'S SECONDARY SERVICE AREA. RESULTS FROM THE SURVEY WERE SUMMARIZED IN A QUANTITATIVE/QUALITATIVE REPORT. IN ADDITION, AN ONLINE SURVEY FOR KEY INFORMANTS WAS CONDUCTED SPECIFICALLY TO SOLICIT INPUT FROM KEY INFORMANTS AS DESCRIBED IN PART V, SECTION B, QUESTION 5. QUALITATIVE DATA WAS PRIMARY COLLECTED THROUGH FOCUS GROUPS. THE HOSPITAL REALIZED THE IMPORTANCE OF GATHERING OPINIONS AND FEEDBACK FROM VULNERABLE POPULATIONS IN THE COMMUNITY WHO HAVE SOME OF THE GREATEST HEALTHCARE NEEDS. AN INDEPENDENT MODERATOR WAS HIRED TO CONDUCT TWO FOCUS GROUPS IN FEBRUARY 2021: ONE WITH SPANISH- SPEAKING UNDER-RESOURCED COMMUNITY MEMBERS AND ONE WITH ENGLISH-SPEAKING UNDER-RESOURCED COMMUNITY MEMBERS. THESE FOCUS GROUPS WERE HELD AT THE COMMUNITY RESOURCE CENTER IN PALATINE, LOCATED IN THE HOSPITAL'S PRIMARY SERVICE AREA. POTENTIAL PARTICIPANTS WERE GIVEN A SHORT SCREENING QUESTIONNAIRE TO ENSURE THEY LIVED IN THE HOSPITAL'S SERVICE AREA AND SO THAT PARTICIPANTS WOULD VARY IN AGE, GENDER, INSURANCE STATUS, INCOME AND EDUCATIONAL LEVELS IF POSSIBLE. THE FOCUS GROUPS FOLLOWED A GUIDELINE WHICH MIRRORED QUESTIONS INCLUDED IN THE COMMUNITY AND KEY INFORMANT SURVEYS SO THAT THE INFORMATION GATHERED COULD BE USED TO COMPARE WITH THE SURVEY RESULTS. THE MODERATOR SUMMARIZED THE RESULTS OF THE FOCUS GROUPS WHICH WERE USED AS ONE OF THE TOOLS IN IDENTIFYING THE MOST PREDOMINANT COMMUNITY NEEDS. THE HOSPITAL ALSO CONDUCTED A FOCUS GROUP VIRTUALLY IN FEBRUARY 2021 WITH ITS PATIENT FAMILY ADVISORY COUNCIL, WHICH IS COMPRISED OF COMMUNITY MEMBERS WHO USE THE HOSPITAL AS THEIR MEDICAL HOME. THE SAME FORMAT AS THE FOCUS GROUPS DESCRIBED ABOVE WAS USED, AND PROVIDED AN OPPORTUNITY TO GATHER ADDITIONAL INFORMATION ON THE COMMUNITY'S BELIEFS AND PERCEPTIONS ABOUT THE HEALTH OF ITS COMMUNITY, WHICH SUPPLEMENTED THE DATA COLLECTED IN THE ONLINE COMMUNITY HEALTH SURVEY. IN MARCH 2021, THE HOSPITAL CONVENED AN INTERNAL, MULTIDISCIPLINARY COMMITTEE THAT MET MULTIPLE TIMES TO REVIEW THE RESULTS OF THE CHNA, AFFIRM AND PRIORITIZE NEEDS AND TO IDENTIFY THE MOST QUALIFIED INTERNAL AND EXTERNAL PERSONS TO DEVELOP IMPLEMENTATION PLANS TO ADDRESS EACH PRIORITY NEED. REPRESENTATIVES FROM THE FOLLOWING HOSPITAL DEPARTMENTS SERVED ON THE COMMITTEE: BEHAVIORAL HEALTH, CARE COORDINATION, COMMUNITY BASED CARE, COMMUNITY SERVICES, COMPLIANCE, DIABETES SERVICES, EMERGENCY DEPARTMENT, EMS, FOUNDATION, GUEST SERVICES, IMMEDIATE CARE CENTERS, MEDICAL GROUP, NURSING EXCELLENCE, PATIENT ACCESS SERVICES, PATIENT EXPERIENCE, AND RESEARCH. IN ADDITION, THE CHAIR OF THE COMMUNITY HEALTH AND OUTREACH COMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS PARTICIPATED IN THE COMMITTEE. THE COMMITTEE MEMBERS WERE PROVIDED WITH AN OVERVIEW OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND RECEIVED A SUMMARY AND COMPARISON DOCUMENT WHICH WAS USED AS A TOOL TO REVIEW ALL OF THE QUANTITATIVE AND QUALITATIVE FINDINGS. THE FINDINGS FROM THE FOCUS GROUPS, COMMUNITY SURVEY AND KEY INFORMANT SURVEY WERE COMPARED AND THE SECONDARY DATA PROVIDED SUPPLEMENTAL INFORMATION. THE MOST COMMON THEMES AND COMMENTS FROM THE NARRATIVE PORTION OF THE SURVEYS WERE ALSO HIGHLIGHTED IN THE DOCUMENT. IN ADDITION, THE COMMITTEE WAS GIVEN WEB ACCESS TO THE COMPLETE SURVEY RESULTS, FOCUS GROUPS SUMMARIES AND ALL SECONDARY DATA. THE COMMITTEE WAS GIVEN TIME TO REVIEW THE SUMMARY AND COMPARISON DOCUMENT AND TO ACCESS THE ADDITIONAL RESOURCES AND THEN RECONVENED TO RANK OR PRIORITIZE THE ISSUES. THE COMMITTEE USED MAGNITUDE, IMPACT/SERIOUSNESS, FEASIBILITY AND CONSEQUENCES OF INACTION AS THE CRITERIA TO IDENTIFY WHICH HEALTH NEEDS WOULD BE ADDRESSED OVER THE NEXT THREE YEARS. TAKING INTO ACCOUNT HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS AND STRATEGIC PRIORITIES - IT WAS DETERMINED THAT NCH WOULD FOCUS THE MAJORITY OF ITS EFFORTS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE THE FOLLOWING PRIORITY AREAS: BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE), OBESITY, ACCESS TO CARE FOR THE UNDER-RESOURCED, CANCER (INCLUDING TOBACCO) AND CHRONIC DISEASE (DIABETES, HEART DISEASE, STROKE, AND HIGH BLOOD PRESSURE). INTERNAL COMMITTEES WERE FORMED TO DEVELOP IMPLEMENTATION PLANS FOR EACH OF THE PRIORITY AREA AS DESCRIBED IN PART V, SECTION C, QUESTION 11. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WAS REVIEWED AND APPROVED BY THE COMMUNITY HEALTH AND OUTREACH COMMITTEE OF THE BOARD ON JUNE 15, 2021 AND PRESENTED TO THE ENTIRE BOARD OF DIRECTORS ON JUNE 28, 2021. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WAS POSTED ON THE HOSPITAL'S WEBSITE, (NCH.ORG) ON SCHEDULE H - PART VI, LINE 3 - PATIENT EDUCATION OF ELIG. FOR ASSISTANCE THE FINANCIAL ASSISTANCE PROGRAM AT THE HOSPITAL IS COMMUNICATED WIDELY TO PATIENTS AND VISITORS IN ENGLISH AND SPANISH USING THE FOLLOWING METHODS: 1. SIGNAGE IN ENGLISH AND SPANISH IS POSTED THROUGHOUT THE ORGANIZATION AT ALL ACCESS POINTS, INCLUDING THE EMERGENCY DEPARTMENT AND OUTPATIENT REGISTRATION AREAS. THESE AREAS ALSO STOCK AND MAKE AVAILABLE A BROCHURE, PRINTED IN ENGLISH AND SPANISH, DESCRIBING THE HOSPITAL'S POLICY. THE HOSPITAL PROVIDES A COMPREHENSIVE LANGUAGE ASSISTANCE PROGRAM WHICH INCLUDES VIDEO REMOTE AND IN-PERSON TRANSLATORS WHO CAN ASSIST THOSE WHO NEED ADDITIONAL INFORMATION ON FINANCIAL ASSISTANCE. 2. IN FY 2021 THE INFORMATION BELOW WAS POSTED ON THE HOSPITAL WEBSITE. "FINANCIAL ASSISTANCEOTHER RELATED TERMS CAN ALSO BE SEARCHED FOR FROM ANY PAGE OF THE HOSPITAL WEBSITE TAKING USERS TO THE INFORMATION INCLUDING APPLICATIONS FOR FINANCIAL ASSISTANCE (AVAILABLE IN ENGLISH, SPANISH, GERMAN, POLISH, JAPANESE, AND RUSSIAN), FINANCIAL ASSISTANCE POLICIES, AND WAYS TO REACH THE NCH FINANCIAL COUNSELOR BY EMAIL, PHONE OR IN PERSON. PATIENT FINANCIAL ASSISTANCE PAGE: TO APPLY FOR PATIENT FINANCIAL ASSISTANCE AT NCH, PLEASE PRINT THE FINANCIAL ASSISTANCE APPLICATION (TAMBIEN DISPONIBLE EN ESPAOL) AND COMPLETE ALL NECESSARY FIELDS. PLEASE BE SURE TO PROVIDE ALL REQUESTED DOCUMENTATION TO BE CONSIDERED FOR FINANCIAL ASSISTANCE. NORTHWEST COMMUNITY HOSPITAL IS A CHARITABLE ORGANIZATION AND PROVIDES FINANCIAL ASSISTANCE TO THOSE WHO ARE ELIGIBLE. THE DAY SURGERY CENTER IS A FOR-PROFIT ORGANIZATION AND ALSO PROVIDES FINANCIAL ASSISTANCE TO THOSE WHO ARE ELIGIBLE. MAIN FEES AND BILL PAYMENT PAGE: FOR FAMILIES WITHOUT INSURANCE WHO NEED HELP WITH MEDICAL BILLS, WE ACCEPT ILLINOIS PUBLIC AID. IN ADDITION, YOU MAY QUALIFY FOR FINANCIAL ASSISTANCE FOR MEDICAL BILLS THROUGH NORTHWEST COMMUNITY HOSPITAL. NORTHWEST COMMUNITY HOSPITAL IS A CHARITABLE ORGANIZATION AND PROVIDES FINANCIAL ASSISTANCE TO THOSE WHO ARE ELIGIBLE. THE DAY SURGERY CENTER IS A FOR-PROFIT ORGANIZATION AND ALSO PROVIDES FINANCIAL ASSISTANCE TO THOSE WHO ARE ELIGIBLE. 3. EACH PATIENT INVOICE OR OTHER SUMMARY OF CHARGES TO A PATIENT SHALL INCLUDE WITH IT OR ON IT A STATEMENT REGARDING HOW A PATIENT MAY APPLY FOR CONSIDERATION UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE PATIENT IS PROVIDED A CONTACT NUMBER FOR FINANCIAL ASSISTANCE AND OUR WEBPAGE TO DOWNLOAD AN APPLICATION. 4. FINANCIAL COUNSELORS PROVIDE FINANCIAL ASSISTANCE INFORMATION TO PATIENTS DURING THEIR REGISTRATION AND WORK WITH PATIENTS IDENTIFIED AT REGISTRATION OR AFTER ADMISSION TO HELP THEM GET THE ASSISTANCE THEY NEED, ANSWER QUESTIONS, SET UP PAYMENT PLANS AND FACILITATE APPLICATIONS FOR GOVERNMENT PROGRAMS SUCH AS MEDICAID. SCHEDULE H - PART VI, LINE 4 - COMMUNITY INFORMATION NORTHWEST COMMUNITY HOSPITAL IS LOCATED IN ARLINGTON HEIGHTS, ILLINOIS, A SUBURB LOCATED APPROXIMATELY 25 MILES NORTHWEST OF CHICAGO. IT'S PRIMARY SERVICE AREA CONSISTS OF ARLINGTON HEIGHTS AND THE SURROUNDING SUBURBS OF MT. PROSPECT, PALATINE, AND ROLLING MEADOWS. THE HOSPITAL'S SECONDARY SERVICE AREA IS COMPRISED OF BARRINGTON, BUFFALO GROVE, DEERFIELD, DES PLAINES, ELK GROVE VILLAGE, HANOVER PARK, HOFFMAN ESTATES, ISLAND LAKE, LAKE ZURICH/KILDEER, MUNDELEIN, NORTHBROOK, PROSPECT HEIGHTS, ROSELLE, ROUND LAKE, SCHAUMBURG, STREAMWOOD, VERNON HILLS, WAUCONDA AND WHEELING. THE POPULATION OF THE HOSPITAL'S TOTAL SERVICE AREA IS APPROXIMATELY 977,610 AND IS PROJECTED TO REMAIN RELATIVELY STABLE WITH A SLIGHT DECLINE IN THE PRIMARY SERVICE AREA (-.06%) AND NO PROJECTED GROWTH IN THE SECONDARY SERVICE AREA. THE HIGHEST UTILIZERS OF HEALTH CARE SERVICES ARE PATIENTS AGED 65 TO 84, AND THIS AGE GROUP IS EXPECTED TO GROW 14.8% IN THE HOSPITAL'S PRIMARY SERVICE AREA AND 18.2% IN THE HOSPITAL'S SECONDARY AREA. THE HOSPITAL'S TOTAL SERVICE AREA IS PREDOMINATELY NON-HISPANIC WHITE (61%), FOLLOWED BY HISPANIC (19%) AND ASIAN (15%). THE NUMBER OF BLACK AND WHITE NON-HISPANIC POPULATION IS PROJECTED TO DECREASE 1.4% AND 5.3% RESPECTIVELY. THE POPULATIONS THAT ARE PROJECTED TO HAVE THE LARGEST GROWTH ARE THE ASIAN/PACIFIC ISLANDERS (10.7%) AND HISPANIC (6.8%) POPULATIONS. HOUSEHOLDS IN THE UPPER INCOME BRACKETS, $200K AND HIGHER, ARE PROJECTED TO INCREASE BY 24.5% WHILE INCOME BRACKETS LESS THAN $100K ARE PROJECTED TO DECREASE BY 5-15.3%. THE MAJORITY, 68.9% OF PERSONS LIVING IN THE HOSPITAL'S SERVICE AREA, HAVE SOME COLLEGE EDUCATION AND THIS IS NOT PROJECTED TO CHANGE SIGNIFICANTLY OVER THE NEXT FIVE YEARS. ALTHOUGH THE HOSPITAL'S SERVICE AREA IS DOMINATED BY COMMERCIAL INSURANCE, THERE ARE STILL A SUBSTANTIAL NUMBER OF INDIVIDUALS ON MEDICAID (24,068) OR UNINSURED (14,420). THE HOSPITAL'S SERVICE AREA PROJECTIONS PREDICT NOTABLE GROWTH IN THE FOLLOWING CHRONIC DISEASES: DIABETES, HYPERTENSION, OSTEOARTHRITIS AND PERSISTENT MOOD DISORDERS BY PERSONS 65 AND OLDER. ALTHOUGH THE HOSPITAL'S SERVICE AREA EXCEEDS STATE AND NATIONAL AVERAGES FOR ANNUAL AVERAGE INCOME, THERE ARE STILL MANY SIGNIFICANT POCKETS OF VULNERABLE POPULATIONS BASED ON INCOME AND ATTAINMENT OF A HIGH SCHOOL DEGREE. IN ADDITION, THE ENTIRE PRIMARY SERVICE AREA AND A SIGNIFICANT PORTION OF THE SECONDARY SERVICE AREA HAVE BEEN DESIGNATED AS A MEDICALLY-UNDERSERVED POPULATION. THE HOSPITAL WORKS CLOSELY WITH TWO FEDERALLY QUALIFIED HEALTH CENTERS AND A COUNTY RUN PRIMARY CARE CLINIC, ALL LOCATED IN THE HOSPITAL'S SERVICE AREA. THERE ARE NO OTHER HOSPITALS IN THE PRIMARY SERVICE AREA AND THREE IN THE SECONDARY SERVICE AREA OF THE HOSPITAL. SCHEDULE H - PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF ITS COMMUNITY IN MANY WAYS AS FOLLOWS: (1) A MAJORITY OF THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO LIVE OR WORK IN THE HOSPITAL'S PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE HOSPITAL, NOR FAMILY MEMBERS. (2) THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. (3) A STANDING COMMUNITY HEALTH AND OUTREACH COMMITTEE OF THE HOSPITAL BOARD REVIEWS THE COMMUNITY HEALTH NEEDS ASSESSMENT AND ENSURES THE IMPLEMENTATION PLAN ADDRESSES IDENTIFIED NEEDS. THE COMMITTEE, COMPRISED OF BOARD MEMBERS, SENIOR EXECUTIVES, PHYSICIANS, COMMUNITY MEMBERS AND STAFF, PROVIDES OVERSIGHT IN MONITORING AND EVALUATING THE EFFECTIVENESS OF STRATEGIES AND INITIATIVES INCLUDED IN THE IMPLEMENTATION PLAN. THE COMMITTEE MONITORS THE AMOUNT OF DOLLARS INVESTED IN COMMUNITY BENEFIT INCLUDING CHARITY CARE, COMMUNITY HEALTH EDUCATION, AND OTHER COMMUNITY HEALTH IMPROVEMENT INITIATIVES. (4) THE PATIENT FAMILY ADVISORY COUNCIL, COMPRISED OF COMMUNITY MEMBERS WHO HAVE UTILIZED THE HOSPITAL'S SERVICES, MEETS MONTHLY TO HELP THE HOSPITAL IDENTIFY AND IMPROVE KEY DRIVERS THAT IMPACT PATIENT EXPERIENCE. THE COMMITTEE REVIEWS CURRENT PROCESSES AND PROPOSED CHANGES AND THEN PROVIDES FEEDBACK, COMMENTS AND SUGGESTIONS. THE COMMITTEE MET VIRTUALLY MULTIPLE TIMES DURING FY 2021 DUE TO THE COVID-19 PANDEMIC. (5) THE HOSPITAL MAINTAINED AN AVERAGE OF 123 DAYS CASH OR CASH EQUIVALENT ON HAND IN THE HOSPITAL ITSELF OR AT NORTHWEST COMMUNITY HEALTHCARE (A 501(C)(3) SUPPORTING ORGANIZATION AND SOLE MEMBER OF THE HOSPITAL) FOR FUNDING CAPITAL IMPROVEMENTS IN TECHNOLOGY, FACILITIES OR PATIENT CARE EQUIPMENT, AND SUPPORTING HOSPITAL OPERATIONS OR COMMUNITY OUTREACH INITIATIVES. (6) THE HOSPITAL HAS DEDICATED STAFF THAT SERVE AS MEMBERS, CHAIRPERSONS, OFFICERS, AND BOARD MEMBERS OF LOCAL AND NATIONAL ORGANIZATIONS DEVOTED TO IMPROVING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS. THESE ORGANIZATIONS INCLUDE: THE CHICAGO DENTAL SOCIETY, HARPER COLLEGE EDUCATIONAL FOUNDATION, KENNETH YOUNG CENTER BOARD OF DIRECTORS, PARTNERS FOR OUR COMMUNITIES BOARD OF DIRECTORS, ST. MARY'S SERVICES HOPEFUL BEGINNINGS BOARD OF DIRECTORS, UNITED PALATINE AND ARLINGTON HEIGHTS ROTARY CLUB. (7) COLLABORATIVE PARTNERSHIPS ARE THE FOUNDATION TO MANY OF THE HOSPITAL'S COMMUNITY HEALTH INITIATIVES AIMED TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. THESE PARTNERSHIPS INCLUDE A COLLABORATION WITH GREATER FAMILY HEALTH AND COOK COUNTY HEALTH AND HOSPITAL SYSTEM TO BRING PRIMARY CARE SERVICES FOR THE UNINSURED AND UNDERINSURED TO THE COMMUNITY. THE HOSPITAL ALSO PARTNERS WITH ELK GROVE, PALATINE, SCHAUMBURG, AND WHEELING TOWNSHIPS ON A MOBILE DENTAL CLINIC PROGRAM WHICH PROVIDED 1,376 PATIENT VISITS IN FY 2021 WITH THE HOSPITAL ABSORBING $94,112 OF THE OPERATING COSTS. NORTHWEST COMMUNITY HEALTHCARE, AN AFFILIATE OF THE HOSPITAL, ALSO PARTNERS WITH PARTNERS FOR OUR COMMUNITIES (POC), A LOCAL 501(C)(3) ORGANIZATION, TO OPERATE AND RUN THE COMMUNITY RESOURCE CENTER WHICH PROVIDES DIRECT SERVICES, REFERRALS, AND OTHER ASSISTANCE TO THE UNDER-RESOURCED. THE HOSPITAL OWNS AND MAINTAINS THE BUILDING AND PROVIDES FREE OR LOW-COST RENT TO LOCAL NOT FOR PROFIT AGENCIES, INCLUDING: ALL SAINTS LUTHERAN CHURCH, ASIAN HUMAN SERVICES, THE CENTER-RESOURCES FOR TEACHING AND LEARNING (ECDEC PROGRAM), COMMUNITY CONSOLIDATED SCHOOL DISTRICT 15, HARPER COLLEGE, HIAS CHICAGO, PALATINE TOWNSHIP SENIOR CITIZENS COUNCIL, PALATINE POLICE DEPARTMENT, PALATINE PARK DISTRICT, PALATINE PUBLIC LIBRARY, PATH (PALATINE ASSISTING THROUGH HOPE), AND WINGS (WOMEN IN NEED GROWING STRONGER). SOME OF THE MANY PROGRAMS AND SERVICES OFFERED AT THE RESOURCE CENTER INCLUDE GED AND CITIZENSHIP CLASSES, HEALTHCARE SERVICES, COMPUTER LITERACY, AFTER-SCHOOL YOUTH PROGRAM, BILINGUAL COUNSELING, PARENTING CLASSES, JOB PLACEMENT, CAREER EDUCATION, RECREATION AND A FOOD AND CLOTHING PANTRY. IN FY 2021, THE COMMUNITY RESOURCE CENTER HAD MORE THAN 125,000 CLIENT VISITS. IN ADDITION TO THE COMMUNITY RESOURCE CENTER, THE HOSPITAL WORKS WITH POC ON MANY COLLABORATIVE HEALTH INITIATIVES INCLUDING THE COMMUNITY HEALTH WORKER (CHW) PROGRAM WHICH PROVIDES HEALTH EDUCATION AND SUPPORT FOR THE LATINO POPULATION. THIS PROGRAM IDENTIFIES LATINA WOMEN WHO DEMONSTRATE THE POTENTIAL TO BECOME LEADERS IN THE COMMUNITY WHO THEN RECEIVE LEADERSHIP TRAINING AND EDUCATION ON SPECIFIC HEALTH TOPICS. THE CHW MEETS PATIENT'S BEDSIDE AND THEN PROVIDES POST DISCHARGE SUPPORT TO HELP THEM UNDERSTAND AND COMPLY WITH DISCHARGE INSTRUCTIONS WHICH CAN OFTEN BE DIFFICULT DUE TO ECONOMIC AND LANGUAGE BARRIERS. IN FY 2021 THE CHW HAD 4,814 CLIENT INTERACTIONS AND THE HOSPITAL PROVIDED $46,109 IN FINANCIAL SUPPORT OF THE PROGRAM. THE HOSPITAL AND SCHAUMBURG TOWNSHIP ALSO COLLABORATIVELY PROVIDE THE SERVICES OF TWO COMMUNITY HEALTH NURSES; ONE OF WHICH IS BILINGUAL IN SPANISH. THESE OUTREACH PROFESSIONALS FOCUS ON HELPING VULNERABLE POPULATIONS (UNDER-RESOURCED AND SENIORS) NAVIGATE HEALTHCARE RESOURCES, PROVIDE HEALTH EDUCATION AND CHRONIC DISEASE MANAGEMENT, AND HELP PATIENTS OBTAIN LOW-COST PRESCRIPTIONS. IN FY 2021, THE TWO PART-TIME COMMUNITY NURSES HAD 4,788 CLIENT INTERACTIONS AND THE HOSPITAL PROVIDED $126,306 IN FINANCIAL SUPPORT OF THE PROGRAM. THE HOSPITAL ALSO DEDICATES RESOURCES TO ENHANCE ITS HEALTH AND WELLNESS OFFERINGS FOR OLDER ADULTS IN THE COMMUNITY. A FULL-TIME SENIOR SERVICES SPECIALIST COORDINATES AND PROMOTES HEALTH AND WELLNESS PROGRAMS HELD ON THE HOSPITAL'S CAMPUS, THE ARLINGTON HEIGHTS SENIOR CENTER AND OTHER LOCATIONS IN THE HOSPITAL'S SERVICE AREA. IN FY 2021 THE HOSPITAL OFFERED 164 PROGRAMS WHICH HAD 2,241 PARTICIPANTS. THE SENIOR SERVICES SPECIALIST SITS ON THE BOARD OF THE PALATINE TOWNSHIP SENIOR CITIZENS COUNCIL AND PARTICIPATES IN VARIOUS COMMITTEES, ALL WHICH ASSIST IN CONTRIBUTING TO THE IMPROVEMENT OF SERVICES AND RELATIONSHIPS WITH SENIORS. THE SENIOR SERVICES SPECIALIST IS ALSO A TRAINED SENIOR HEALTH INSURANCE PROGRAM COUNSELOR (SHIP), AND PROVIDES FREE MEDICARE EDUCATION TO SENIORS. THROUGHOUT THE YEAR THE HOSPITAL OFFERED FREE SHIP MEDICARE COUNSELING TO SENIORS IN THE SURROUNDING COMMUNITIES THROUGH ONE ON ONE COUNSELING EITHER IN-PERSON, VIA EMAIL, OR OVER THE PHONE, BASED ON THE INDIVIDUALS COMFORT LEVEL AND AVAILABILITY TO BE DONE SAFELY. THOSE BECOMING NEWLY ELIGIBLE TO MEDICARE WERE PROVIDED INFORMATION AND TOOLS TO ASSIST THEM IN UNDERSTANDING MEDICARE, AND CURRENT MEDICARE BENEFICIARIES WHERE SHOWN THE OPTIONS THEY HAVE EACH YEAR WHILE KEEPING THEIR INDIVIDUAL NEEDS IN MIND. SHIP COUNSELING WAS OFFERED ON THE HOSPITAL'S CAMPUS AND AT THE ARLINGTON HEIGHTS SENIOR CENTER AND THE LUTHER VILLAGE SENIOR RESIDENTIAL COMMUNITY. IN FY 2021, 368 INDIVIDUALS WERE PROVIDED ONE-ON-ONE SHIP COUNSELING. THE TOTAL COST TO PROVIDE SENIOR PROGRAMMING AND SHIP COUNSELING IN FY 2021 WAS $120,233. (8) THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK AND SERVES ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. (9) THE HOSPITAL PARTICIPATES IN BOTH THE MEDICARE AND MEDICAID GOVERNMENT-SPONSORED HEALTHCARE PROGRAMS. THE HOSPITAL CONTRACTS WITH GREAT LAKES ASSISTANCE PROGRAM TO PROVIDE ASSISTANCE TO PATIENTS, FREE OF CHARGE, THROUGHOUT THE MEDICAID APPLICATION PROCESS WHEN APPLYING FOR MEDICAL COVERAGE THROUGH THE ILLINOIS MEDICAID PROGRAM. THE ASSISTANCE PROVIDED IS INCLUSIVE OF COMPLETING THE APPLICATION, GATHERING ALL OF THE APPROPRIATE ADDITIONAL DOCUMENTS THAT MUST BE SUBMITTED, WORKING WITH THE STATE ON THE PATIENT'S BEHALF AND, IN SOME CASES, WORKING THROUGH AN APPEAL PROCESS. IN FY 2021, 1,271 INDIVIDUALS RECEIVED ASSISTANCE AT A COST OF $162,100. (10) THE HOSPITAL PROVIDES SERVICES FREE OR AT A REDUCED RATE TO INDIVIDUALS WITH LIMITED FINANCIAL RESOURCES WHO ARE UNABLE TO ACCESS ENTITLEMENT PROGRAMS. INDIVIDUALS ARE ELIGIBLE FOR FREE OR DISCOUNTED MEDICALLY NECESSARY HEALTHCARE SERVICES BASED ON ESTABLISHED CRITERIA AND THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS WIDELY DISTRIBUTED AND COMMUNICATED TO THE COMMUNITY. (11) IN JANUARY 2021, THE HOSPITAL JOINED NORTHSHORE UNIVERSITY HEALTHSYSTEM. THE HOSPITAL'S ARLINGTON HEIGHTS CAMPUS FEATURES A 509-BED HOSPITAL WITH A LEVEL II TRAUMA CENTER, LEVEL III NEONATAL INTENSIVE CARE UNIT AND DEDICATED PEDIATRIC EMERGENCY DEPARTMENT. THROUGHOUT THE NORTHWEST SUBURBS, THE HOSPITAL HAS 23 DOCTOR'S OFFICES; FIVE IMMEDIATE CARE CENTERS; SEVEN PHYSICAL REHABILITATION SITES; AND 13 LAB LOCATIONS. HEADQUARTERED IN EVANSTON, NORTHSHORE IS A FULLY INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT INCLUDES 6 HOSPITALS-EVANSTON, GLENBROOK, HIGHLAND PARK, SKOKIE, SWEDISH AND NOW NORTHWEST COMMUNITY HOSPITAL. TOGETHER, THE NORTHSHORE SYSTEM PROVIDES CLINICAL EXCELLENCE AND COMMUNITY-FOCUSED CARE ACROSS CHICAGOLAND. NORTHSHORE CONSISTENTLY RANKS AS A TOP 15 MAJOR TEACHING HOSPITAL IN THE UNITED STATES, WITH AN ESTABLISHED REPUTATION FOR EXCEPT SCHEDULE H - PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM NORTHSHORE UNIVERSITY HEALTHSYSTEM ACQUIRED NORTHWEST COMMUNITY HEALTHCARE AND SUBSIDIARIES ON 1/1/2021. NORTHSHORE UNIVERSITY HEALTHSYSTEM (NORTHSHORE) IS A COMPREHENSIVE, FULLY INTEGRATED, HEALTHCARE DELIVERY SYSTEM THAT INCLUDES FOUR HOSPITALS, AS WELL AS NUMEROUS OUTPATIENT DEPARTMENTS AND CLINICS. IN ADDITION TO THE HOSPITAL ORGANIZATION, THERE ARE THE FOLLOWING AFFILIATES THAT HELP TO MEET THE NEEDS OF THE COMMUNITY: NORTHSHORE UNIVERSITY HEALTHSYSTEM FOUNDATION - THE NORTHSHORE UNIVERSITY HEALTHSYSTEM FOUNDATION (FOUNDATION) SEEKS TO OBTAIN THE PHILANTHROPIC SUPPORT REQUIRED TO ENSURE THAT NORTHSHORE CAN PROVIDE MEDICAL CARE, ADVANCED RESEARCH, AND STATE-OF-THE-ART FACILITIES AND EQUIPMENT. THE FOUNDATION BUILDS RELATIONSHIPS WITH INDIVIDUALS AND THE COMMUNITY TO INCREASE AWARENESS OF NORTHSHORE'S HIGH-QUALITY SERVICES AND GIVING OPPORTUNITIES. NORTHSHORE UNIVERSITY HEALTHSYSTEM RESEARCH INSTITUTE - THE NORTHSHORE UNIVERSITY HEALTHSYSTEM RESEARCH INSTITUTE (RESEARCH INSTITUTE) WAS ORGANIZED IN 1996 TO PROVIDE A MEANS FOR INTEGRATING LEADING-EDGE RESEARCH INTO IMPROVED CLINICAL CARE. THE RESEARCH INSTITUTE ALSO CREATES AN ENVIRONMENT TO RECRUIT AND RETAIN EXTERNALLY-FUNDED RESEARCH LEADERSHIP IN ORDER TO ACHIEVE THE MISSION AND GOALS OF THE ORGANIZATION. THE RESEARCH INSTITUTE NOW HOUSES MORE THAN 210 PRINCIPAL INVESTIGATORS WHO CURRENTLY OCCUPY 95,000 NET SQUARE FEET OF RESEARCH SPACE AND WORK ON 1,200 ACTIVE RESEARCH PROTOCOLS. THE RESEARCH INSTITUTE BUILDS ON NORTHSHORE'S PROMISE TO DELIVER EXCELLENCE IN ALL ASPECTS OF PATIENT CARE. EFFORTS ARE DIRECTED TO RESEARCH INITIATIVES THAT MAKE A DIFFERENCE ACROSS MULTIPLE DISCIPLINES. FROM ONCOLOGY AND NEUROLOGY TO ORTHOPAEDICS AND CARDIOVASCULAR CARE, THE RESEARCH INSTITUTE FOCUSES ON AREAS OF INQUIRY THAT HAVE THE POTENTIAL TO MAKE THE GREATEST IMPACT ON IMPROVING AND SAVING LIVES. NORTHSHORE OFFERS SOME 1,000 ACTIVE CLINICAL TRIALS OF VARIOUS TYPES, FROM INNOVATIVE SURGICAL PROCEDURES TO THE LATEST DRUG THERAPIES. NORTHSHORE'S CLINICAL RESEARCH PORTFOLIO FOCUSES ON A RANGE OF CONDITIONS, INCLUDING CANCER, NEUROLOGIC DISORDERS AND STROKE, CARDIOVASCULAR DISORDERS, AND A WIDE RANGE OF PEDIATRIC AND GYNECOLOGIC CONDITIONS. ADDITIONALLY, MAJOR CLINICAL TRIAL PROGRAMS IN ADVANCED IMAGING AND MEDICAL GENETICS ARE ALSO OFFERED. THE RESEARCH INSTITUTE IS ALSO A MEMBER OF THE ILLINOIS PRECISION MEDICINE CONSORTIUM (IPMC), WHICH IS PART OF A NATIONAL LANDMARK LONGITUDINAL ALL OF US RESEARCH PROGRAM (AOURP) COHORT PROGRAM TO IMPROVE THE ABILITY TO PREVENT AND TREAT DISEASE BASED ON INDIVIDUAL LIFESTYLE, ENVIRONMENT, AND GENETICS. NORTHSHORE WILL ENROLL OVER 9,000 NORTHSHORE PATIENTS IN THE STUDY, AND PARTICIPANTS IN NORTHSHORE'S AOURP WILL BE ASKED TO SHARE A WIDE-RANGE OF HEALTH, ENVIRONMENTAL, AND LIFESTYLE INFORMATION. THE NORTHSHORE PROGRAM FOR PERSONALIZED CANCER CARE (PPCC) IS PIONEERING NEW STRATEGIES IN CANCER CARE. THE PPCC UNIQUELY FOCUSES ON THE GENETIC PATTERN OF AN INDIVIDUAL'S HEREDITARY DNA TO DERIVE A PERSONALIZED CANCER RISK ASSESSMENT PROFILE. BASED ON THE INHERITED RISK OF DEVELOPING A GIVEN CANCER, THE PPCC IS BEGINNING TO IMPLEMENT PERSONALIZED CANCER CARE STRATEGIES THAT ENCOMPASS THE ENTIRE SPECTRUM OF DISEASE. THE PPCC BELIEVES THIS APPROACH WILL LEAD TO MORE EFFICIENT USE OF HEALTH CARE RESOURCES BY TARGETING PREVENTION AND SCREENINGS TOWARD INDIVIDUALS AT GREATER RISK OF DEVELOPING CANCER, EARLIER CANCER DETECTION, AND, ULTIMATELY AND MOST IMPORTANTLY, REDUCED CANCER DEATHS AND SUFFERING. NORTHSHORE UNIVERSITY HEALTH SYSTEM HOME AND HOSPICE SERVICES - NORTHSHORE UNIVERSITY HEALTHSYSTEM HOME AND HOSPICE SERVICES (HOME AND HOSPICE) OFFERS THE FULL SPECTRUM OF HOME AND HOSPICE CARE, INCLUDING SKILLED NURSING, PHYSICAL AND OCCUPATIONAL THERAPY, AND HOME MEDICAL EQUIPMENT. THE HOME AND HOSPICE CAREGIVERS REPRESENT A WIDE RANGE OF MEDICAL SPECIALTIES AND WORK WITH THE PATIENT, FAMILY, AND PHYSICIAN TO TAILOR HOME CARE TO MEET THE INDIVIDUAL NEEDS OF EACH PATIENT. NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES -NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES (FPA) REPRESENTS ABOUT 900 PHYSICIANS WITH OVER 140 OFFICES IN VIRTUALLY EVERY SPECIALTY ALL ON STAFF AT NORTHSHORE HOSPITALS. THE PRIMARY FUNCTION AND ACTIVITY OF FPA IS TO EMPLOY, SUPERVISE, AND CONDUCT EMPLOYMENT-RELATED ACTIVITIES WITH RESPECT TO PHYSICIANS WHO PROVIDE PROFESSIONAL HEALTH CARE SERVICES DIRECTLY FOR NORTHSHORE PATIENTS. FPA PHYSICIANS ALSO CONDUCT MEDICAL EDUCATION AND RESEARCH ACTIVITIES ON BEHALF OF NORTHSHORE. RADIATION MEDICINE INSTITUTE -RADIATION MEDICINE INSTITUTE (RMI) EMPLOYS, SUPERVISES, AND CONDUCTS EMPLOYMENT-RELATED ACTIVITIES WITH RESPECT TO PHYSICIANS WHO PROVIDE PROFESSIONAL HEALTH CARE SERVICES DIRECTLY FOR NORTHSHORE PATIENTS. RMI PHYSICIANS ALSO CONDUCT MEDICAL EDUCATION AND RESEARCH ACTIVITIES ON BEHALF OF NORTHSHORE. NORTHWEST COMMUNITY HEALTHCARE AND SUBSIDIARIES (HEALTHCARE), A NOT-FOR-PROFIT ENTITY, WAS ESTABLISHED TO OWN, OPERATE, CONTROL, AND OTHERWISE COORDINATE THE DELIVERY OF HEALTHCARE WITHIN THE SERVICE AREA OF NORTHWEST COMMUNITY HOSPITAL (THE HOSPITAL), AND COORDINATE THE ACTIVITIES OF THE VARIOUS CORPORATIONS AFFILIATED WITH HEALTHCARE. THE HOSPITAL, LOCATED IN ARLINGTON HEIGHTS, ILLINOIS, IS A 496-BED ACUTE CARE FACILITY PROVIDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES PRIMARILY TO RESIDENTS OF ARLINGTON HEIGHTS AND THE SURROUNDING COMMUNITIES. SUBSIDIARIES OF HEALTHCARE INCLUDE THE HOSPITAL, NORTHWEST COMMUNITY HOSPITAL FOUNDATION (THE FOUNDATION), CENTRAL INSURANCE COMPANY, LTD. (CICL), AND NORTHWEST COMMUNITY HEALTHCARE PHO, LLC (PHO). HEALTHCARE'S OTHER SUBSIDIARIES INCLUDE NORTHWEST COMMUNITY HEALTH SERVICES, INC. (HEALTH SERVICES), NPC-CYBERKNIFE, LLC (CYBERKNIFE), NORTHWEST COMMUNITY DAY SURGERY CENTER II, LLC (DSC-II), NORTHWEST ENDO CENTER LLC (ENDO), NORTHWEST COMMUNITY FOOT AND ANKLE CENTER, LLC (FOOT), AND ENVISION MEDICAL IMAGING, LLC (ENVISION). CICL IS A CAPTIVE INSURANCE COMPANY ESTABLISHED JANUARY 1, 2013, TO PROVIDE GENERAL AND PROFESSIONAL LIABILITY COVERAGE AND WORKERS' COMPENSATION COVERAGE FOR THE RISKS OF HEALTHCARE. CICL IS A FOREIGN CORPORATION ORGANIZED IN THE CAYMAN ISLANDS THAT DOES NOT TAX ITS ACTIVITIES. HEALTH SERVICES OWNS AND OPERATES PHYSICIAN PRACTICES WITHIN THE HOSPITAL'S GEOGRAPHIC AREA. THE NCH MEDICAL GROUP (NCHMG) MULTI-SPECIALTY PHYSICIAN PRACTICE (THAT WAS ESTABLISHED IN 2010) HAS OFFICES IN ARLINGTON HEIGHTS, BUFFALO GROVE, MT. PROSPECT, LAKE ZURICH, PALATINE, AND SCHAUMBURG, ILLINOIS. CYBERKNIFE WAS FORMED IN JUNE 2006 FOR THE PURPOSE OF PURCHASING AND OWNING A STEREOTACTIC RADIOSURGERY SYSTEM AND LEASING IT TO THE HOSPITAL. CYBERKNIFE IS A LIMITED LIABILITY CORPORATION THAT IS OWNED BY HEALTHCARE (74% AT SEPTEMBER 30, 2020 AND 2019) AND PHYSICIAN INVESTORS (26% AT SEPTEMBER 30, 2020 AND 2019). HEALTHCARE CONSOLIDATES CYBERKNIFE, AS HEALTHCARE OWNS A MAJORITY OF THE UNITS OUTSTANDING. DSC-II WAS FORMED IN 2014 FOR THE PURPOSE OF OWNING AND OPERATING AN AMBULATORY SURGERY CENTER. DSC-II IS A LIMITED LIABILITY COMPANY THAT IS OWNED BY HEALTHCARE (57.25% AND 55.75% AT SEPTEMBER 30, 2021 AND 2020, RESPECTIVELY) AND PHYSICIAN INVESTORS (42.75% AND 44.25% AT SEPTEMBER 30, 2021 AND 2020, RESPECTIVELY). HEALTHCARE CONSOLIDATES DSC-II, AS HEALTHCARE OWNS A MAJORITY OF THE UNITS OUTSTANDING. ENDO WAS ESTABLISHED IN DECEMBER 2015 AND BEGAN OPERATIONS IN MARCH 2017. ENDO IS A LIMITED LIABILITY CORPORATION THAT IS OWNED BY HEALTH SERVICES (51% AT SEPTEMBER 30, 2021 AND 2020) AND PHYSICIAN INVESTORS (49% AT SEPTEMBER 30, 2021 AND 2020). HEALTH SERVICES CONSOLIDATES ENDO BECAUSE IT OWNS A CONTROLLING INTEREST. FOOT WAS ESTABLISHED AND BEGAN OPERATIONS IN JULY 2017. FOOT IS A LIMITED LIABILITY CORPORATION THAT IS OWNED BY HEALTH SERVICES (51% AT SEPTEMBER 30, 2021 AND 2020) AND PHYSICIAN INVESTORS (49% AT SEPTEMBER 30, 2021 AND 2020). HEALTH SERVICES CONSOLIDATES FOOT BECAUSE IT OWNS A CONTROLLING INTEREST. ENVISION WAS ESTABLISHED AND BEGAN OPERATIONS IN JULY 2018. ENVISION IS A LIMITED LIABILITY CORPORATION THAT IS OWNED BY HEALTH SERVICES (51% AT SEPTEMBER 30, 2021 AND 2020) AND PHYSICIAN INVESTORS (49% AT SEPTEMBER 30, 2021 AND 2020). HEALTH SERVICES CONSOLIDATES ENVISION BECAUSE IT OWNS A CONTROLLING INTEREST. SCHEDULE H - PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT NORTHWEST COMMUNITY HOSPITAL FILES AN ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT WITH THE ILLINOIS ATTORNEY GENERAL'S OFFICE IN ACCORDANCE WITH ILLINOIS LAW. true WINGS PO BOX 95615 Palatine IL 60095 750800699 501(c)(3) 6750 Sponsor William Rainey Harper College Educational Fnd 1200 W Algonquin Rd Palatine IL 60067 237348228 501(c)(3) 7500 Food Bank and Golf Sponsor Partners for Our Communities 1585 N Rand Rd Palatine IL 60074 363881109 501(c)(3) 6750 Sponsor St Mary's Service 510 N PLUM GROVE RD PALATINE IL 60067 362167889 501(c)(3) 6750 SPONSOR KENNETH YOUNG CENTER 1001 ROHLWING RD ELK GROVE VILLAGE IL 60007 237181444 501(c)(3) 6750 Sponsor 5 Health Initiatives 45 55199 Community Assistance 2 1299 Form 990, Schedule I, Part I, Line 2 - Org. Proc. for Monitoring grants GRANTS IN SUPPORT OF NORTHWEST COMMUNITY HOSPITAL'S (HOSPITAL) MISSION ARE MONITORED BY NORTHWEST COMMUNITY'S FINANCE COMMITTEE AND BOARD OF DIRECTORS AS PART OF THE MONTHLY REVIEW OF HOSPITAL'S FINANCIAL RESULTS. SIGNIFICANT GRANTS TO UNRELATED 501(C)(3) OR GOVERNMENTAL ORGANIZATIONS ARE APPROVED BY HOSPITAL'S COMMUNITY SERVICES DEPARTMENT AND ARE MONITORED THROUGH ONGOING INTERACTIONS WITH OFFICIALS OF THOSE RECIPIENTS REGARDING PROGRAM SERVICES PROVIDED IN HOSPITAL'S SERVICE AREA. true true false false false false false true false Stephen O Scogna PRESIDENT/SECRETARY/CEO 884550 0 1781676 0 199968 0 195382 0 32080 0 3093656 0 145400 0 John L Skeans CFO/Treasurer 430213 0 213924 0 45014 0 63065 0 29628 0 781844 0 24990 0 Michael C Hartke Executive VP/COO 546262 0 1163635 0 74389 0 76325 0 29937 0 1890548 0 53402 0 Alan B Loren MD Executive VP - CMO 499920 0 289097 0 328351 0 74477 0 17855 0 1209700 0 260300 0 Susan E Nelson MD VP Physician Operations 367985 0 160769 0 32338 0 34380 0 8800 0 604272 0 21199 0 Glen J Malan VP Info Tech & CIO 350644 0 99104 0 32526 0 27671 0 4711 0 514656 0 22331 0 TERRY SOLEM VP HUMAN RESOURCES 337465 0 116853 0 41817 0 35208 0 3504 0 534847 0 24391 0 Mary Dano Trm 1019 Exec VP - Chief Legal Counsel 0 0 91641 0 316272 0 0 0 1 0 407914 0 0 0 Eileen Gillespie Executive VP - PT Serv & CNO 325944 0 156941 0 46538 0 47187 0 19636 0 596246 0 36601 0 NANCY ARDELL Exec VP - Chief Legal Counsel 341953 0 107004 0 2351 0 38028 0 28618 0 517954 0 0 0 RICH CASEY VP HOSPITAL OPERATIONS 299287 0 86584 0 14223 0 33623 0 28473 0 462190 0 8667 0 RAOUL CHAZARO VP SURGICAL SERVICES 277077 0 78781 0 29660 0 30134 0 16431 0 432083 0 21421 0 GERALD P GALLAGHER NS Pres/CEO/ Dir (Beg 1/1/21) 0 1363161 0 0 0 10445 0 965602 0 35707 0 2374915 0 0 Mahalakshmi Halasyamani MD NS CMO/ DIRECTOR (Beg 1/1/21) 0 669808 0 0 0 8240 0 192603 0 3607 0 874258 0 0 Sean O'Grady NS COO/ Director (Beg 1/1/21) 0 881106 0 0 0 11144 0 524495 0 33305 0 1450050 0 0 Catherine Wood MD Phy & Dir (Beginning 1/1/21) 0 161167 0 117485 0 1359 0 2666 0 16868 0 299545 0 0 COMPENSATION DETERMINATION PROCESS FOR TOP MANAGEMENT OFFICIALS FORM 990, SCHEDULE J, LINE 3 THE COMPENSATION COMMITTEE OF THE PARENT CORPORATION (HEALTHCARE) ANNUALLY REVIEWS AND MAKES RECOMMENDATIONS TO THE BOARD REGARDING THE COMPENSATION OF THE PRESIDENTS, OTHER VICE PRESIDENTS AND OTHER KEY MANAGEMENT OFFICERS AS DETERMINED BY THE BOARD. AN INDEPENDENT REASONABLENESS OPINION IS OBTAINED ANNUALLY REGARDING THE CHIEF EXECUTIVE OFFICER'S COMPENSATION AND THAT OF OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE. SEVERANCE PAYMENTS FORM 990, SCHEDULE J, LINE 4A IN 2020, THE FOLLOWING INDIVIDUAL RECEIVED a SEVERANCE PAYMENT AS PART OF Their COMPENSATION ARRANGEMENT: Mary Dano $316,272. FORM 990, SCHEDULE J, LINE 4B A SERP PLAN WAS CREATED AND WAS EFFECTIVE ON JANUARY 1, 2014. BENEFITS UNDER THE SERP VEST IN THE AMOUNT CREDITED TO HIS OR HER ACCOUNT BALANCE ON JANUARY 1 OF THE FIFTH PLAN YEAR FOLLOWING THE YEAR FOR WHICH A CONTRIBUTION WAS CREDITED TO THE PARTICIPANT'S ACCOUNT. HOWEVER, PARTICIPANT WILL AUTOMATICALLY VEST IN HIS OR HER ACCOUNT BALANCE IN THE EVENT OF INVOLUNTARY SEPARATION FROM SERVICE OR HIS OR HER ATTAINMENT OF AGE 65 WHILE STILL EMPLOYED BY NCH. PARTICIPANTS WHO VOLUNTARILY RESIGN OR ARE TERMINATED WITH CAUSE BEFORE THE VESTING PERIOD ARE NO LONGER ELIGIBLE FOR THE AMOUNT ACCRUED. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SERP AND HAD VESTED BENEFITS EARNED AND PAID DURING 2020 WHICH ARE REPORTED IN COLUMN (B): STEPHEN O. SCOGNA $ 196,242 MICHAEL C. HARTKE $ 72,075 ALAN B. LOREN, MD $ 322,618 SUSAN E. NELSON, MD $ 28,612 GLEN J. MALAN $ 30,139 TERRY SOLEM $ 36,232 RAOUL CHAZARO $ 24,404 JOHN SKEANS $ 33,729 RICH CASEY $ 11,697 EILEEN GILLESPIE $ 41,012 THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SERP AND EARNED UNVESTED BENEFITS DURING 2020 WHICH ARE REPORTED IN COLUMN (C): STEPHEN O. SCOGNA $ 182,557 JOHN L. SKEANS $ 53,756 MICHAEL C. HARTKE $ 67,050 ALAN B. LOREN, MD $ 61,681 Eileen Gillespie $ 39,437 SUSAN E. NELSON, MD $ 29,939 GLEN J. MALAN $ 27,671 TERRY SOLEM $ 26,586 RAOUL CHAZARO $ 22,010 RICH CASEY $ 24,308 NANCY ARDELL $ 38,028 GERALD P. GALLAGHER $ 799,486 Mahalakshmi Halasyamani,MD $ 122,870 Sean O'Grady $ 423,700 NON-FIXED COMP PAYMENTS FORM 990, SCHEDULE J, LINE 7 THE CEO AND VICE PRESIDENTS OF THE HOSPITAL ARE ELIGIBLE FOR AN ANNUAL INCENTIVE COMPENSATION PAYMENT THAT IS ALIGNED WITH THE STRATEGIC, FINANCIAL AND OPERATIONAL GOALS OF THE ORGANIZATION. THRESHOLD MEASURES, WHICH CONSTITUTE THE MINIMUM REQUIREMENTS, MUST BE ACHIEVED IN ORDER TO HAVE AN INCENTIVE PAYOUT. AWARD OPPORTUNITY LEVELS VARY AS A PERCENT OF BASE SALARY. ACTUAL AMOUNTS AWARDED ARE BASED ON A COMBINATION OF DEFINED TARGETS. MAXIMUM PAYABLE IS 150% OF THE TARGET. AMOUNTS TO BE PAID ARE SUBJECT TO APPROVAL OF THE COMPENSATION COMMITTEE OF NORTHWEST COMMUNITY HEALTHCARE, THE SOLE MEMBER OF THE HOSPITAL. The Compensation Committee retains the discretion to recommend for Board approval adjustments to payouts (either higher or lower) at plan cycle end, to reflect extraordinary performance or unanticipated circumstances. A ILLINOIS FINANCIAL AUTHORITY 861091967 2011-12-01 53100000 SEE PART VI false false false B ILLINOIS FINANCIAL AUTHORITY 861091967 45200FNU9 2008-10-07 86820000 SEE PART VI false false false C ILLINOIS FINANCIAL AUTHORITY 861091967 45204EDN5 2016-06-15 157336237 SEE PART VI false false false A 18100000 0 53100000 0 0 0 434279 0 0 0 52665721 0 2011 true false true true B 39750000 0 86820000 0 0 0 598075 93000 0 86128925 0 0 2008 true false true true C 6805000 0 157336237 0 0 155497835 1838402 0 0 0 0 0 false true false A 0 B 0 false false true C false false false false false 0 false false false true A false false false true false false 0 false 0 false true B false false false true false false 0 0 true C false false false true false false 0 false 0 true A true B true C true Form 990, Part III, Line 4D - Desc. of Other Program Services INCLUDES REVENUE, EXPENSES, AND GRANTS OF $136,498 FROM ALL OTHER PROGRAM SERVICE SPECIALTIES ALONG WITH REFERENCE LAB REVENUE, CAPITATION REVENUE, INTERCOMPANY RENTS AND OTHER RENTAL INCOME NOT DESCRIBED ON FORM 990, PART III, LINES 4A-4C. Form 990, Part VI, Line 4 Significant changes to Organizational Documents NORTHSHORE UNIVERSITY HEALTHSYSTEM BECAME THE SOLE CORPORATE MEMBER OF NORTHWEST COMMUNITY HEALTHCARE (NCH) ON JANUARY 1, 2021. NCH IS THE SOLE CORPORATE MEMBER OF NORTHWEST COMMUNITY HOSPITAL. Form 990, Part VI, Section A. Line 6 - Desc. of Members NORTHWEST COMMUNITY HEALTHCARE (NCH) IS THE SOLE CORPORATE MEMBER OF NORTHWEST COMMUNITY HOSPITAL (HOSPITAL). AS SUCH, IT ELECTS OR APPOINTS THE MEMBERS OF HOSPITAL'S GOVERNING BODY AND APPROVES SIGNIFICANT DECISIONS. Form 990, Part VI, Section A. Line 7a - Power to elect members NCH IS THE SOLE CORPORATE MEMBER OF HOSPITAL. AS SUCH, IT ELECTS OR APPOINTS THE MEMBERS OF THE GOVERNING BODY OF HOSPITAL PERIODICALLY OR AS VACANCIES ARISE. Form 990, Part VI, Section A. Line 7b - Governance Decisions NCH IS THE SOLE CORPORATE MEMBER OF HOSPITAL. AS SUCH, IT MUST APPROVE CERTAIN ACTIONS OF HOSPITAL. ACTION IS TAKEN BY A MAJORITY VOTE OF THE NCH BOARD WITH A QUORUM PRESENT. NCH MUST APPROVE THE FOLLOWING TYPES OF DECISIONS BY HOSPITAL: VOLUNTARY DISSOLUTION, MERGER, CONSOLIDATION OR SALE OR TRANSFER OF 10% OR MORE OF HOSPITAL'S ASSETS; SALE OF REAL PROPERTY OR INTEREST THEREIN; CREATION OF A SUBSIDIARY OR AFFILIATE; ANNUAL AND LONG-TERM CAPITAL AND OPERATING BUDGETS; AMENDMENT, ALTERATION OR REPEAL OF HOSPITAL'S ARTICLES OF INCORPORATION OR BYLAWS; SELECTION OF AUDITORS; APPOINTMENT, REMOVAL AND EVALUATION OF HOSPITAL DIRECTORS; DEBT OR INDEBTEDNESS, GUARANTEES OR BORROWINGS; APPOINTMENT, COMPENSATION, BENEFITS AND EVALUATION OF OFFICERS; APPOINTMENT AND EMPLOYMENT OF THE PRESIDENT; AND ACTIONS TAKEN BY TRUSTEES OF THE NORTHWEST COMMUNITY HOSPITAL EMPLOYEES RETIREMENT PLAN. Form 990, Part VI, Section B. Line 11b - Review of Form 990 A COPY OF FORM 990 WAS MADE AVAILABLE TO THE MEMBERS OF HOSPITAL'S BOARD PRIOR TO FILING. THE BOARD HAS BEEN ASSIGNED THE RESPONSIBILITY OF REVIEWING FORMS 990 FOR ALL AFFILIATES OF NCH. SPECIFIC SECTIONS OF THE TAX RETURN ARE ALSO REVIEWED BY HUMAN RESOURCES, LEGAL, AND COMPLIANCE. Form 990, Part VI, Section B. Line 12c - Conflict of Interest EACH YEAR, THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS SENT TO DIRECTORS, OFFICERS AND KEY EMPLOYEES. EACH RESPONSE IS REVIEWED BY THE GENERAL COUNSEL AND THOSE IN WHICH ANY ACTUAL OR APPARENT CONFLICT WITH THE PRESENT ROLE IS DISCLOSED, ARE REVIEWED BY THE PRESIDENT/CEO AND BOARD CHAIRPERSON. IN THE CASE OF ANY CONFLICT INVOLVING AN ENTITY OR PARTY WITH WHICH HOSPITAL IS DEALING OR COMPETING, THE PERSON WITH THE CONFLICT MAY NOT PARTICIPATE IN ANY DECISIONS REGARDING THAT PARTY. INDIVIDUALS WHO ARE INDEPENDENT CONTRACTORS, OFFICERS, DIRECTORS, OR EMPLOYEES OF OTHER HEALTHCARE FACILITIES IN HOSPITAL'S SERVICE AREA MAY NOT SERVE ON NCH'S OR ANY RELATED ORGANIZATION'S BOARD OR BOARD COMMITTEE. IN ADDITION, THE POLICY INCLUDES A SAMPLE CONFLICT OF INTEREST DISCLOSURE LETTER TO BE USED IF A CONFLICT ARISES AFTER SUBMISSION OF THE ANNUAL QUESTIONNAIRE AND BEFORE SUBMISSION OF THE NEXT ANNUAL QUESTIONNAIRE. SUCH DISCLOSURE LETTERS WOULD BE REVIEWED AS NOTED ABOVE AT THE TIME THEY ARE RECEIVED. Form 990, Part VI, Section B Line 15a & 15b - Comp. Determination The Compensation Committee of the Board of Directors (the "Committee") of Northwest Community Healthcare, which is the parent corporation of Northwest Community Hospital and who has identical board members as Northwest Community Healthcare, is responsible for preparing the total compensation paid to the Organization's senior executives (collectively, "Executives") to ensure that compensation paid to such Executives is reasonable and does not result in excessive and inappropriate benefit to private individuals. The Committee shall, on an annual basis, review and recommend to the Board for approval executive compensation consistent with the process described below. This process is intended to result in compensation decisions that are consistent with the Organization's fulfillment of its mission as set forth in the Organization's Articles of Incorporation, as well as the Organization's compensation philosophy and related principles set forth in this document. The Compensation philosophy is intended to result in the determination and payment of total compensation, including benefits, for Executives based on the following objectives: Compensation that is objectively fair and reasonable compared to similar executives at similar institutions; Compensation that contributes to the attraction and retention of qualified and talented individuals in Executive positions; Compensation that rewards the attainment of performance goals and expectations; and Compensation that reinforces the commitment to the Organization's mission, purpose and values. In assessing the reasonableness of an Executive's total compensation, the Committee shall endeavor to set base salary at or near the market 60th percentile. The Committee shall target total compensation, including but not limited to, salary, any bonus or incentive payments and deferred and noncash compensation, as well as all compensatory benefits such as payments to medical, dental, life, annuity, retirement and disability benefit plans, and any fringe benefits such as housing, automobile, and computer allowances to approximate the market 75th percentile. The Committee shall conduct an annual performance review of the CEO, the results of which shall be used in determining a reasonable total compensation for him or her. The CEO will formulate a compensation recommendation for each Executive who reports to him or her. The CEO will present compensation recommendations based on an evaluation of each Executive's job performance in accordance with criteria established by him or her. When reviewing or assessing the total compensation of any Executive, the Committee shall obtain sufficient information, taking into consideration the knowledge and expertise of its members, to determine whether total compensation of each Executive is reasonable (i.e., whether such compensation is comparable to that of similar executives at similar institutions). To assist in the determination of reasonable compensation, the Committee will select and engage a qualified independent compensation consultant ("Consultant") to annually review and analyze the total compensation, including benefits, of each Executive. The terms of the Consultant's engagement shall provide that the Consultant is to report to the Committee, and that the Consultant shall have no reporting responsibilities to any Executive with respect to any engagement in connection with the executive total compensation program. The Committee shall instruct the Consultant to compile appropriate comparability data, which may include compensation and benefits paid by similarly situated organizations for positions that are functionally comparable to those of each Executive. The Committee shall direct the Consultant to analyze a number of different variables in assessing comparability, including but not limited to organizational size, geographic location, the nature of the services provided, the level of experience and specific responsibilities of the position considered, and the components of the compensation offered. If a Consultant is retained, the Consultant should be directed to provide written analysis and recommendations with respect to a reasonable total compensation for each Executive. The Committee may additionally request that the Consultant be available to present a written analysis and recommendations and to take questions from Board or Committee members. In addition to the reports and analyses of the Consultant, the Committee shall also consider additional comparability data, including but not limited to: the availability of similar services in the geographic area, current compensation surveys compiled by independent firms, and actual written offers from similar institutions competing for services of the applicable Executive. Form 990, Part VI, Section C. Line 19 - Availability of Documents GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE PUBLIC. HOSPITAL'S FINANCIAL STATEMENTS ARE INCLUDED IN THE ANNUAL CONSOLIDATED AUDIT REPORT OF NORTHSHORE UNIVERSITY HEALTHSYSTEM AND SUBSIDIARIES. THESE CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE MUNICIPAL SECURITIES RULEMAKING BOARD'S ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AT WWW.EMMA.MSRB.ORG. Form 990, Part XI, Line 9 RECONCILIATION OF NET ASSETS - OTHER CHANGES IN NET ASSETS TRANSFER FROM AFFILIATES $ 20,000,000 NS ACQUISITION ($ 71,572,860) PERIODIC PENSION COST $ 2,430,620 PENSION EXPENSE $ 2,285,774 NET ASSETS RELEASED FROM TEMP RESTRICTED ($ 1,556,577) CHANGE IN NET ASSETS OF FOUNDATION $ 5,864,786 ____________________________________________________________ TOTAL OTHER CHANGES IN NET ASSETS ($ 42,548,257) NORTHWEST COMMUNITY HEALTHCARE 3040 SALT CREEK LN ARLINGTON HTS IL 60005 363125209 SUPPORT ORG. IL 501(c)(3) 12B NWC Hlthcare false NORTHWEST COMMUNITY HOSPITAL FOUNDATION 3040 SALT CREEK LN ARLINGTON HTS IL 60005 363125193 FUNDRAISING IL 501(c)(3) 7 NWC Hlthcare false NORTHSHORE UNIVERSITY HEALTHSYSTEM 1301 CENTRAL STREET EVANSTON IL 60201 362167060 HOSPITAL IL 501(c)(3) 3 na false NORTHSHORE UNIVERSITY HEALTHSYSTEM FPA 1301 CENTRAL STREET EVANSTON IL 60201 363738206 HEALTHCARE IL 501(C)(3) 12 TYPE I NS UNIV HS false HEALTHCARE FOUNDATION OF HIGHLAND PARK 610 CENTRAL AVE HIGHLAND PARK IL 60035 363196647 FUNDRAISING IL 501(C)(3) 12 TYPE II NA false SWEDISH COVENANT HEALTH 5145 N CALIFORNIA AVE CHICAGO IL 60625 362179813 HOSPITAL IL 501(C)(3) 3 NS UNIV HS false SWEDISH COVENANT HOSPITAL FOUNDATION 5145 N CALIFORNIA AVE CHICAGO IL 60625 205055155 FUNDRAISING IL 501(C)(3) 7 SWEDISH CONV false RADIATION MEDICINE INSTITUTE 1301 CENTRAL STREET EVANSTON IL 60201 363815543 HEALTHCARE IL 501(C)(3) 12 TYPE I NS UNIV HS false NPC-CYBERKNIFE LLC 3040 SALT CREEK LN ARLINGTON HTS IL 60005 204462828 EQUIPMENT LEASING IL na NWC Day Surgery 3040 SALT CREEK LN ARLINGTON HTS IL 60005 300798249 OUTPATIENT CARE IL na NW ENDO CENTER LLC 3040 SALT CREEK LN ARLINGTON HTS IL 60005 812338623 SURGICAL CARE IL na NWC FOOT & ANKLE 3040 SALT CREEK LN ARLINGTON HTS IL 60005 352567039 AMB SRGCAL CNTER IL na ENVISION MED IMG 8930 WAUKEGAN RD STE 130 MORTON GROVE IL 60053 822067179 IMAGING SERVICES IL na RAVINE WAY SURGERY CENTER LLC 24001 RAVINE WAY GLENVIEW IL 60025 201245279 HEALTHCARE IL na NORTHWEST COMMUNITY HEALTH SERVICES INC 800 WEST CENTRAL ROAD ARLINGTON HEIGHTS IL 60005 363312906 HEALTHCARE SERV IL NWC HEALTHCARE C Corp false CENTRAL INSURANCE COMPANY LTD PO Box 10233 Grand Cayman CJ KY1-1002 981109518 INSURANCE CJ NWC Healthcare C Corp false NORTHSHORE PHYSICIAN ASSOCIATES INC 1301 CENTRAL STREET EVANSTON IL 60201 363648026 HEALTHCARE IL NS UNIV HS C Corp false NORTHSHORE PHYSICIAN ASSOCIATES VALUE BA 1301 CENTRAL STREET EVANSTON IL 60201 822268872 HEALTHCARE IL NS FPA C Corp false NORTHSHORE UNIVERSITY HEALTHSYSTEM INSUR GOVERNORS SQUARE BLDG 4 GRAND CAYMAN CJ 980419452 INSURANCE CJ NS UNIV HS C Corp false SWEDISH CONVENANT MGMT SERVICES INC 5145 N CALIFORNIA AVE CHICAGO IL 60625 364073303 PHYS PRACT MGMT IL SWEDISH CONV C CORP false SWEDISH CONVENANT PHYS PARTNERS LTD 5145 N CALIFORNIA AVE CHICAGO IL 60625 363120220 PHYS PRACT MGMT IL SWEDISH CONV C CORP false false false true false false false false false false true true true false true true true true true true