2021-07-28T13:28:01-05:00 2020-09-30 ERNST & YOUNG US LLP 155 N Wacker Drive Chicago IL 60606 990 2019-10-01 362340313 Northwest Community Hospital % CHRISSIE ERDMANN NORT 8476181000 3040 Salt Creek Ln Arlington Heights IL 60005 JOHN SKEANS CFO 8476181000 2021-07-28 true JESSICA WAGENER P01622613 3128792000 2019 2022-09-23 18:48:47Z STEPHEN O SCOGNA 800 West Central Road ARLINGTON HEIGHTS IL 60005 528960196 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. 17 15 4924 560 1010167 0 4541954 42495038 534283597 481686137 34283 -172748 5434226 3179999 544294060 527188426 167419 171378 0 0 250304309 251023807 0 0 0 261422797 262386705 511894525 513581890 32399535 13606536 509146585 494027641 380747168 406439672 128399417 87587969 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 49443768 0 54038616 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 2020. 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 2020, NCH HOSTED MULTIPLE COMMUNITY EVENTS THAT INCLUDED EDUCATIONAL PRESENTATIONS BY CARDIOLOGISTS AND STAFF, HEALTHY COOKING DEMONSTRATIONS AND HEALTH SCREENINGS. 42949375 0 52826972 GASTROENTEROLOGY NORTHWEST COMMUNITY HOSPITAL'S GASTROENTEROLOGY(GI) SERVICE LINE PROVIDES QUALITY, PATIENT CENTERED, COMPASSIONATE CARE FOR PATIENTS, REGARDLESS OF ABILITY TO PAY, WHO ARE IN NEED OF DIAGNOSTIC AND THERAPEUTIC ENDOSCOPIC PROCEDURES. THE HOSPITAL'S GI CENTER HAS BECOME A REGIONAL REFERRAL CENTER FOR PATIENTS IN NEED OF INTERVENTIONAL PROCEDURES INCLUDING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ENDOSCOPIC ULTRASOUND. A STATE-OF-THE-ART INTERVENTIONAL SUITE OFFERS PATIENTS ACCESS TO SUPERIOR QUALITY CARE BY PROVIDING DIGITAL IMAGING. HOSPITAL'S INTERVENTIONAL TEAM IS LED BY AN EXPERT INTERVENTIONAL PHYSICIAN. THIS TEAM PROVIDES SAME-DAY CARE FOR PATIENTS IN AND BEYOND HOSPITAL'S SERVICE AREA WHO ARE IN NEED OF INTERVENTIONAL PROCEDURES. IN FY 2020, THE GASTROENTEROLOGY SERVICE LINE INCURRED APPROXIMATELY 26,500 PATIENT CASES AT A COST OF APPROXIMATELY $43,000,000. 35855016 0 37198068 INFECTIOUS DISEASE NORTHWEST COMMUNITY HOSPITAL'S INFECTIOUS DISEASE DEPARTMENT PROVIDED QUALITY, PATIENT CENTERED, COMPASSIONATE CARE, REGARDLESS OF ABILITY TO PAY. IN FY 2020, THE INFECTIOUS DISEASE SERVICE LINE INCURRED APPROXIMATELY 38,000 CASES AT A COST OF APPROXIMATELY 36,000,000. 307717605 171378 337622481 435965764 true true false true false false false false false true true false false false true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true false false true 305 0 true 4924 true true true false false false false false false false false false true false X 17 15 false false false 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 10.0 30.0 X X 1151149 0 210136 Michael C Hartke Executive VP/COO 30.0 10.0 X 605775 0 103129 Alan B Loren MD Executive VP - CMO 30.0 10.0 X 552485 0 85862 John L Skeans CFO/Treasurer 30.0 10.0 X 472299 0 91614 TERRY SOLEM VP HUMAN RESOURCES 30.0 10.0 X 466892 0 40182 Mary Dano Trm 1019 Exec VP - Chief Legal Counsel 30.0 10.0 X 478065 0 14601 Susan E Nelson MD VP Physician Operations 30.0 10.0 X 414938 0 41448 Glen J Malan VP Info Tech & CIO 40.0 0.0 X 356628 0 42979 John Mathai Chief Medical Physicist 40.0 0.0 X 349632 0 38266 Eileen Gillespie Executive VP - PT Serv & CNO 40.0 0.0 X 312201 0 67045 Bradford Buxton Trm 319 VP Strategy & Business Dev. 40.0 0.0 X 301239 0 5602 Kimberly Nagy Trm 918 Executive VP - PT Serv & CNO 0.0 0.0 X 305532 0 0 KENNETH A SPERO MD DIRECTOR 1.0 1.0 X 23400 0 0 E Quinn Regan MD DIRECTOR 1.0 1.0 X 9725 0 0 Thomas P MacCarthy Director 1.0 1.0 X 0 0 0 Marla F Glabe Director 1.0 1.0 X 0 0 0 Craig E Christell Director 1.0 1.0 X 0 0 0 Jay S Cowen MD Director 1.0 1.0 X 0 0 0 Guy W Eisenhuth Dir/Vice Chair (Beg 1/1/20) 10.0 1.0 X X 0 0 0 Ann K Ford Director 1.0 1.0 X 0 0 0 Diane G Hill Chair (End 12/31/19)/Director 10.0 1.0 X X 0 0 0 Richard D Hoffman Director 1.0 1.0 X 0 0 0 Mary R Sheahen MS RN Vice Chair/Chair (beg 1/1/20) 10.0 1.0 X X 0 0 0 Nhat Q Tran Director (Through 12/31/19) 1.0 1.0 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 (Beginning 1/1/2020) 1.0 1.0 X 0 0 0 Michael D Levon Director (Beginning 1/1/2020) 1.0 1.0 X 0 0 0 Nimesh S Jhaveri Director (Beginning 1/1/2020) 1.0 1.0 X 0 0 0 5799960 0 740864 339 true true false LEOPARDO COMPANIES INC 5200 PRAIRIE STONE PKWY HOFFMAN ESTATES IL 60192 CONSTRUCTION 5533937 Sodexo Inc Affiliates PO BOX 360170 PITTSBURGH PA 152516170 Dietary and Biomed 4569986 REHABCARE GROUP EAST INC PO BOX 502096 ST LOUIS MO 63150 PATIENT CARE 3358487 SODEXO CTM INC 7100 COMMERCE WAY STE 280 BRENTWOOD TN 37027 BIOMED SERVICE 3144882 ECATALYST CONSULTING 2398 E CAMELBACK RD STE 110 PHOENIX AZ 85016 CONSULTING 2457202 119 2968090 39526948 42495038 NET PATIENT SERVICES 622110 461390240 461390240 REFERENCE LAB 621511 13714559 13345340 369219 CAPITATION REVENUE 622110 2923901 2923901 OTHER RENT INCOME 532000 1681079 1681079 INTERCOMPANY RENTS 532000 1195729 1195729 780629 780629 481686137 0 0 0 1681079 1325582 355497 0 355497 355497 47000 219748 -172748 -172748 -172748 0 0 0 0 0 0 183106 226440 -43334 -43334 CAFETERIA 722212 1324348 1324348 JOINT VENTURE MANAGEMENT FEE 541611 822638 443848 378790 OUTPATIENT PHARMACY 446110 198349 197100 1249 522501 522501 2867836 527188426 481316918 1010167 2366303 171378 171378 0 0 0 3838829 3838829 305532 305532 202048657 193413804 8634853 4654111 4365663 288448 25942031 24334223 1607808 14234647 13352427 882220 0 1812017 0 1812017 304300 0 304300 38157 0 38157 0 1480 1480 0 38961883 11097452 27864431 3205217 0 3205217 7562487 5956795 1605692 9740721 9137021 603700 0 7251136 5441874 1809262 276028 40031 235997 0 133619 133619 0 7546876 7546876 0 0 38923870 23138199 15785671 10385467 9936598 448869 MEDICAL SUPPLIES 57996428 57996428 0 PHARMACEUTICALS 17378791 17378791 0 BAD DEBT - PATIENT SERVICES 17896442 17896442 0 ILLINOIS PROVIDER TAX 22984494 22984494 0 19987292 11642169 8345123 513581890 435965764 77616126 0 0 38585421 3620875 0 0 0 68621830 60248983 0 0 0 0 0 0 9163195 9021422 3955419 4719567 853429465 489566077 377126852 363863388 0 0 0 0 23808908 12990867 3061000 2255735 19788506 2342258 509146585 494027641 58932821 81121075 0 0 206187 1500000 242961630 233939494 0 0 0 0 0 0 0 0 78646530 89879103 380747168 406439672 X 115631285 74597102 12768132 12990867 128399417 87587969 509146585 494027641 X 13606536 -54417984 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 38157 38157 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. 4435885 250000 261907 151127 4796665 4243431 260000 74854 142400 4435885 3941522 5000 296909 4243431 3504586 5000 431936 3941522 4068523 5820 -462764 106993 3504586 0.42490 0.49110 0.08400 false true true 0 89072 89072 0 319679187 166046236 153632951 3287882 2484510 803372 501010086 308093548 192916538 29363238 12941783 16421455 363863388 0 DUE TO THIRD-PARTY PAYORS 37845468 ASSET RETIREMENT OBLIGATION 883066 PENSION OBLIGATION 24017414 INSURANCE LIABILITY 8909280 SERP 2200000 DUE TO AFFILIATES 13681617 CURRENT PORTION OF OPERATING LEASE LIABILITIES 326803 OPERATING LEASE LIABILITIES 2015455 89879103 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. true true X true X 300. true X 600. true true true false true true 6806261 6806261 0.01370 59033578 50428647 8604931 0.01740 65839839 50428647 15411192 0.03110 43 38075 1424974 178125 1246849 0.00250 21 14645 2758534 418543 2339991 0.00470 1 1301 409689 211449 198240 0.00040 2 0 230384 0 230384 0.00050 8 1451 424969 0 424969 0.00090 75 55472 5248550 808117 4440433 0.00900 75 55472 71088389 51236764 19851625 0.04010 2 0 7606 0 7606 1 0 31048 0 31048 0.00010 3 111 5567 0 5567 6 111 44221 0 44221 0.00010 false 17896442 189628045 202749539 -13121494 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 17 true false false true X NCH.org X true 17 true NCH.org false true X 300. 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 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 FEBRUARY 2018, 30 POTENTIAL KEY INFORMANTS WERE IDENTIFIED WHICH INCLUDED GOVERNMENT OFFICIALS, 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 12-26, 2018. A REMINDER EMAIL WAS SENT TO ENCOURAGE PARTICIPATION. THE KEY INFORMANTS WERE ASKED A SERIES OF HEALTH RELATED QUESTIONS, ASKED TO "GRADE" THEIR COMMUNITIES OVERALL HEALTH AND PROVIDE FEEDBACK ON ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE/HEALTH ISSUES, FAMILY ISSUES AND MODIFIABLE RISK FACTORS. IT ALSO ASKED THEM TO RANK THEIR "TOP FIVE 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, 18 OF THE 30 INVITED PARTICIPANTS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS COMPLETED THE ONLINE SURVEY: ARLINGTON HEIGHTS HEALTH DEPARTMENT, ASIAN HUMAN SERVICES, BRIDGE YOUTH AND FAMILY SERVICES, COOK COUNTY HEALTH AND HOSPITAL SYSTEM, ELK GROVE TOWNSHIP, HEARTLAND, LINDEN OAKS, JOURNEYS THE ROAD HOME, NORTHWEST COMMUNITY HEALTHCARE, SCHAUMBURG TOWNSHIP, ST. MARY'S SERVICES, AND WHEELING TOWNSHIP. 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 AND AN ADVERTISEMENT IN A LOCAL NEWSPAPER. IT WAS ALSO SENT TO VOLUNTEERS, DONORS AND EMPLOYEES ASKING THOSE WHO LIVE IN THE HOSPITAL'S SERVICE AREA TO PARTICIPATE. THE LINK WAS OPEN FROM FEBRUARY 21 THROUGH MARCH 14, 2018. MORE THAN 300 PEOPLE PARTICIPATED IN THE SURVEY. THE HOSPITAL ALSO SOLICITED INPUT FROM VULNERABLE POPULATIONS IN THE COMMUNITY THROUGH FOCUS GROUPS. A PROFESSIONAL MODERATOR WAS HIRED TO CONDUCT THREE FOCUS GROUPS IN FEBRUARY 2018: ONE WITH SENIORS; 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 COMMUNTIY NEEDS. SCHEDULE H - PART V, SECTION B, LINE 7A https://www.nch.org/wp-content/uploads/NCH_CHNA_Summary_2018.pdf SCHEDULE H - PART V, SECTION B, LINE 10A https://www.nch.org/wp-content/uploads/2019-2021-Implementation-Plan-FY20. 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: ACCESS TO CARE FOR THE UNDER-RESOURCED, BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE), OBESITY/PHYSICAL ACTIVITY/NUTRITION, CANCER (SMOKING/TOBACCO) AND CHRONIC DISEASE (DIABETES, HEART DISEASE, STROKE, AND RESPIRATORY). KEY INDIVIDUALS WERE IDENTIFIED TO SERVE ON ISSUE SPECIFIC COMMITTEES TO DEVELOP IMPLEMENTATION STRATEGIES FOR EACH OF THE PRIORITY AREAS FOR THE HOSPITALS FISCAL YEARS 2019 THROUGH 2021. THESE INDIVIDUALS ALSO DEVELOPED METRICS TO MEASURE THE SUCCESS OF THE STRATEGIES WHICH WILL BE MONITORED AND UPDATED ANNUALLY. 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 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 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. IMPLEMENTATION STRATEGIES FOR OBESITY, NUTRITION AND PHYSICAL ACTIVITY INCLUDE A COMPREHENSIVE WEIGHT LOSS CLINIC, A COLLABORATIVE COMMUNITY FOOD PANTRY, LOW COST MEMBERSHIPS AT THE NCH WELLNESS CENTER, FINANCIAL SUPPORT OF SUMMER NUTRITION PROGRAMS FOR UNDER-RESOURCED STUDENTS AND THE LAUNCH OF A FOOD INSECURITY INPATIENT SCREENING PROGRAM WITH ONSITE SUPPORT FROM A FOOD PHARMACY. IMPLEMENTATION STRATEGIES FOR CANCER INCLUDE A MULTI-DISCIPLINARY CANCER CLINIC TO HELP PATIENTS NEWLY DIAGNOSED WITH BREAST OR LUNG CANCER. TEN SUPPORT GROUPS AND ANNUAL CANCER SURVIVOR EVENTS ARE FACILITATED BY THE HOSPITAL. THE GIFT-A-MAMMOGRAM PROGRAM 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. LASTLY, THE HOSPITAL DEVELOPED IMPLEMENTATION STRATEGIES TO ADDRESS A NUMBER OF CHRONIC DISEASES INCLUDING DIABETES, HEART DISEASE, STROKE AND RESPIRATORY. THESE INITIATIVES INCLUDE A COMPREHENSIVE OUTPATIENT CLINIC FOR INDIVIDUALS WITH HEART FAILURE OR AFIB, SUPPORT GROUPS AND FREE STROKE RISK ASSESSMENTS. STAFF ALSO PROVIDES EDUCATION IN THE COMMUNITY FOCUSED ON PREVENTION AND PLANS TO LAUNCH A MOBILE INTEGRATED HEALTH PILOT IN PARTNERSHIP WITH LOCAL MUNICIPALITIES IN 2020. THE KEY PRIORITY AREAS ALONG WITH THE IMPLEMENTATION STRATEGIES AND METRICS CAN BE FOUND ON THE HOSPITALS 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, CHRONIC KIDNEY DISEASE, DEMENTIA/ALZHEIMERS, CHILD ABUSE AND DOMESTIC VIOLENCE. THE HOSPITAL BELIEVES ACCESS TO SPECIALTY AND VISION CARE WILL BE ADDRESSED THROUGH REFERRALS FROM PRIMARY CARE PHYSICIANS. THE HOSPITAL BELIEVES THAT CHRONIC KIDNEY DISEASE WILL BE ADDRESSED THROUGH THE HEART FAILURE AND DIABETES INITIATIVES THAT WERE DEVELOPED. 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 COLLABORATES WITH THREE LOCAL NOT-FOR-PROFIT COMMUNITY AGENCIES (CHILDREN'S ADVOCACY CENTER, NORTHWEST CASA AND WINGS) TO ADDRESS CHILD ABUSE AND DOMESTIC VIOLENCE. 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 AT 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/wp-content/uploads/2018_Financial_Assistance_Policy_En glish.pdf 16 NCH Imaging Center 880 W Central Road Arlington Heights IL 60005 Imaging Services NCH Behavioral Health 901 W Kirchoff Road Arlington Heights IL 60005 Behavioral Health 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 Immediate Care & Imaging Center 21481 N Rand road Kildeer IL 60049 Walk in Urgent Care Center, Lab, Imaging, Physical Therapy Services NCH Immediate Care & Imaging Center 519 S Roselle Road Schaumburg IL 60193 Walk in Urgent Care Center Lab, Imaging, Physical Therapy Services NCH Imaging Center 1450 Busch Parkway Buffalo Grove IL 60089 Imaging Services NCH Outpatient Center 3300 Kirchoff Road Rolling Meadows IL 60008 Physical, Occupational, & Speech 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 Cardiac Physical Rehabilitation 900 W Central Road Arlington Heights IL 60005 Cardiac & Physical Rehabilitation 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 455 S Roselle Road Schaumburg IL 60193 Physical Therapy Services NCH Physical Rehabilitation 1051 W Rand Road Arlington Heights IL 60005 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 300% OF THE FEDERAL POVERTY GUIDELINES RECEIVE FREE CARE AND THOSE BETWEEN 300% 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 - 7I 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) $17,896,442 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 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 PRESIDENT AND CEO REPRESENTS THE ORGANIZATION THROUGH PARTICIPATION ON THE BOARD OF DIRECTORS FOR THE ILLINOIS HOSPITAL ASSOCIATION (IHA). THE IHA WORKS WITH OVER 200 HOSPITALS AND 50 HEALTH CARE SYSTEMS TO IMPROVE THE HEALTH AND WELL-BEING OF PATIENTS AND COMMUNITIES. 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 SERVES 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. PART II - LINE 8 - WORKFORCE DEVELOPMENT THE HOSPITAL HAS A PROGRAM TO ENCOURAGE HIGH SCHOOL STUDENTS TO EXPLORE CAREERS IN HEALTHCARE. THE PROGRAM 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. THE HOSPITAL ALSO PARTICIPATES IN VOCATIONAL FAIRS AT LOCAL HIGH SCHOOLS AND COMMUNITY COLLEGES AND HOSTS OTHER ONE-TIME EVENTS FOR STUDENTS TO VISIT THE HOSPITAL, HEAR PRESENTATIONS FROM DIFFERENT DEPARTMENTS AND ASK QUESTIONS AS A WAY TO EXPLORE DIFFERENT CAREERS IN HEALTHCARE. UNFORTUNATELY THE HIGH SCHOOL PROGRAM WAS TEMPORARILY HALTED AND EDUCATION WAS LIMITED DUE TO COVID RESTRICTIONS AND SCHOOL CLOSURES. SCHEDULE H - PART III, BAD DEBT, MEDICARE & COLLECTION PRACTICES SECTION A, LINE 2, 3, 4 UNCOLLECTIBLE ACCOUNTS ARE DETERMINED BASED UPON THE FOLLOWING METHODOLOGY. (NCH) ANALYSES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS MONTHLY USING A HINDSIGHT CALCULATION THAT UTILIZES WRITE-OFF DATA FOR ALL PAYER CLASSES DURING THE LATEST 18-MONTH PERIOD, WITH WRITE-OFF ACTIVITY TO ESTIMATE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AT A POINT IN TIME. THE PERCENTAGES USED IN THE COMPUTATION OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS CHANGE EACH MONTH GIVEN CHANGES IN TRENDS FROM THESE ANALYSES OR POLICY CHANGES. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. WRITE-OFFS ARE SHOWN NET OF CONTRACTUALS AND DISCOUNTS. THE HOSPITAL'S BAD DEBT EXPENSE AS REPORTED ON LINE 2 IS REPORTED AT THE REMAINING CHARGES. FOR FY 2020, THE HOSPITAL RECORDED PROVISIONS FOR BAD DEBT EXPENSE OF $17,896,442. IN 2013, THE HOSPITAL BEGAN USING A FINANCIAL TOOL TO DETERMINE "PRESUMPTIVE ELIGIBILITY" FOR CHARITY CARE WRITE-OFFS. THIS TOOL UTILIZES VARIOUS CRITERIA TO HELP DETERMINE PATIENTS THAT WOULD BE ELIGIBLE FOR FINANCIAL ASSISTANCE EVEN IF THOSE PATIENTS HAVE NOT COMPLETED A FINANCIAL ASSISTANCE APPLICATION. IT IS BELIEVED THAT ALL PATIENTS WHO WOULD QUALIFY FOR CHARITY HAVE BEEN IDENTIFIED AND THAT LITTLE TO NONE OF THE AMOUNTS WRITTEN OFF AS BAD DEBT COULD BE CLASSIFIED AS CHARITY AS A RESULT OF THE USE OF THIS NEW FINANCIAL TOOL. 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 2018 COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED INDEPENDENTLY BY THE HOSPITAL INSTEAD OF BEING OUTSOURCED TO A VENDOR. THE HOSPITAL BELIEVED DOING 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 HOSPITALS 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 BY BOTH INPATIENT AND OUTPATIENT FOR THE HOSPITALS SERVICE AREA. CHANGES IN COMMUNITY DEMOGRAPHICS HAVE A DIRECT CORRELATION WITH HEALTHCARE NEEDS AND HOW TO ADDRESS THEM. ADDITIONAL QUANTITATIVE DATA WAS COLLECTED THROUGH COMMUNITY COMMONS, A WEB PORTAL (COMMUNITYCOMMONS.ORG) THAT ALLOWS ACCESS TO DATA IN MULTIPLE CATEGORIES WHICH CAN BE USED TO EXPLORE COMMUNITY HEALTH. THESE CATEGORIES INCLUDE DEMOGRAPHICS, SOCIAL AND ECONOMIC FACTORS, PHYSICAL ENVIRONMENT, CLINICAL CARE, HEALTH BEHAVIORS AND HEALTH OUTCOMES. THE GOAL OF COMMUNITY COMMONS IS TO INCREASE THE IMPACT OF THOSE WORKING TOWARD HEALTHY, EQUITABLE, AND SUSTAINABLE COMMUNITIES. CUSTOM TOOLS ALLOWED THE HOSPITAL TO FILTER DATA BY ZIP CODE AND CREATE A REPORT SPECIFICALLY FOR ITS COMMUNITY. IT ALSO ALLOWED THE HOSPITAL TO CREATE A CUSTOM REPORT WHICH HIGHLIGHTS ITS COMMUNITY'S GREATEST AREAS OF CONCERN. THE LAST SOURCE OF QUANTITATIVE DATA WAS THE 2018 COUNTY HEALTH RANKINGS AND ROADMAPS REPORT (COUNTYHEALTHRANKINGS.ORG), COLLABORATION BETWEEN THE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE. THIS REPORT RANKS 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. BECAUSE THE COUNTY WHERE THE HOSPITAL IS LOCATED (COOK) IS SO LARGE AND DIVERSE, THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH RECOGNIZED THE UNIQUENESS AND IDENTIFIED INDICATORS FROM THE RANKINGS FOR WHICH LOCAL DATA EXISTED AND CREATED A REPORT SPECIFICALLY FOR SUBURBAN COOK COUNTY. THE HOSPITAL UTILIZED THIS REPORT AS WELL. 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. A PROFESSIONAL MODERATOR WAS HIRED TO CONDUCT THREE FOCUS GROUPS IN FEBRUARY 2018: ONE WITH SENIORS; 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 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. TWO DIFFERENT SURVEYS WERE DEVELOPED TO COLLECT A COMBINATION OF BOTH QUANTITATIVE AND QUALITATIVE DATA. A COMPREHENSIVE ONLINE COMMUNITY HEALTH SURVEY WAS CONDUCTED 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 "GRADE" THEIR COMMUNITIES OVERALL HEALTH AND PROVIDE FEEDBACK ON ACCESS TO CARE, BEHAVIORAL HEALTH, CHRONIC DISEASE/HEALTH ISSUES, FAMILY ISSUES AND MODIFIABLE RISK FACTORS. IT ALSO ASKED THE PARTICIPANTS TO RANK THEIR "TOP FIVE 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 AND THROUGH SOCIAL MEDIA. THE SURVEY LINK, LOCATED ON THE HOME PAGE OF THE HOSPITAL'S WEBSITE (NCH.ORG), WAS OPEN FROM FEBRUARY 21 TO MARCH 14, 2018 AND 414 PEOPLE RESPONDED. 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. IN APRIL 2018, THE HOSPITAL CONVENED AN INTERNAL, MULTIDISCIPLINARY COMMITTEE WHICH MET MULTIPLE TIMES TO REVIEW THE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, 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 DEPARTMENTS SERVED ON THE COMMITTEE: BEHAVIORAL HEALTH, CARE COORDINATION, COMMUNITY SERVICES, COMPLIANCE, DECISION SUPPORT, DIABETES SERVICES, EMERGENCY DEPARTMENT, EMS, FOUNDATION, GUEST SERVICES, IMMEDIATE CARE CENTERS, MARKETING, MEDICAL GROUP, NURSING, PATIENT ACCESS SERVICES, RESEARCH, AND PATIENT EXPERIENCE. IN ADDITION, THE CHAIRMAN OF THE NCH BOARD OF DIRECTORS AND THE EXECUTIVE VICE PRESIDENT CHIEF LEGAL COUNSEL PARTICIPATED IN THE COMMITTEE. THE COMMITTEE MEMBERS 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 TWO WEEKS 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: ACCESS TO CARE FOR THE UNDER-RESOURCED, BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE), OBESITY/PHYSICAL ACTIVITY/WEIGHT, CANCER (SMOKING/TOBACCO) AND CHRONIC DISEASE (DIABETES, HEART DISEASE, STROKE, RESPIRATORY). 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 13, 2018 AND PRESENTED TO THE ENTIRE BOARD OF DIRECTORS ON JUNE 25, 2018. IT WAS ALSO PRESENTED FOR APPROVAL TO THE COMMUNITY BENEFIT REGULATORY COMMITTEE, A COMMITTEE THAT ENSURES THE HOSPITAL IS MEETING ALL OF THE MANDATED REGULATORY REQUIREMENTS ON JUNE 12, 2018. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WAS POSTED ON THE HOSPITAL'S WEBSITE, (NCH.ORG) IN JULY 2018 WHICH THE COMMUNITY WAS MADE AWARE OF THROUGH PRESS RELEASES. THE IMPLEMENTATION PLAN IS ASSESSED AND UPDATED ON THE HOSPITAL'S WEBSITE ON AN ANNUAL BASIS. THE WEBSITE ALSO HAS A LINK WHICH PROVIDES THE COMMUNITY WITH THE OPPORTUNITY TO OFFER COMMENTS AND FEEDBACK ABOUT THE ASSESSMENT AND/OR IMPLEMENTATION PLAN. NO COMMENTS HAVE BEEN RECEIVED SINCE THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WERE POSTED. THE HOSPITAL WILL PROVIDE ANY INDIVIDUAL REQUESTING A COPY OF THE WRITTEN REPORT WITH THE DIRECT WEBSITE ADDRESS, OR URL, WHERE THE DOCUMENT CAN BE ACCESSED. NCH WILL ALSO MAINTAIN AT ITS FACILITIES A HARD COPY OF THE REPORTS THAT MAY BE VIEWED BY ANY WHO REQUEST IT. AS MENTIONED PREVIOUSLY, THE HOSPITAL MAINTAINS A FULL TIME COMMUNITY SERVICES DEPARTMENT THAT IS IN CONSTANT COLLABORATION WITH COMMUNITY ORGANIZATIONS, LOCAL GOVERNMENT, SCHOOLS, CHURCHES AND SOCIAL SERVICE AGENCIES TO IDENTIFY AND ADDRESS UNMET NEEDS. THE EXECUTIVE DIRECTOR OF THE COMMUNITY SERVICES DEPARTMENT IS ON THE BOARD OF DIRECTORS OF PARTNERS FOR OUR COMMUNITIES (POC), A LOCAL NOT FOR PROFIT THAT HELPS THE HOSPITAL RUN A COMMUNITY RESOURCE CENTER IN THE HOSPITALS PRIMARY SERVICE AREA. THE RESOURCE CENTER HOUSES ELEVEN NOT FOR PROFIT AGENCIES INCLUDING COMMUNITY CARES, A FOOD AND CLOTHING PANTRY FOR UNDER-RESOURCED MEMBERS OF THE COMMUNITY. PROVIDERS AT THIS CE SCHEDULE H - PART VI, LINE 3 - PATIENT EDUCATION OF ELIG. FOR ASSISTANCE THE FINANCIAL ASSISTANCE PROGRAM AT NORTHWEST COMMUNITY 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 2020 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 AND OVER, 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 HOSPITAL HAS A COMMUNITY BENEFIT REGULATORY COMMITTEE COMPRISED OF STAFF FROM COMMUNITY SERVICES, FINANCE, LEGAL, COMPLIANCE AND PATIENT ACCESS SERVICES. THIS COMMITTEE REVIEWS THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THE DEVELOPMENT OF THE IMPLEMENTATION PLAN AND THE ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT FOR THE STATE OF ILLINOIS TO ENSURE ALL REGULATORY REQUIREMENTS ARE BEING MET. (5) 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 (6) THE HOSPITAL MAINTAINED AN AVERAGE OF 268 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. (7) 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 WELL-BEING OF COMMUNITY MEMBERS. THESE ORGANIZATIONS INCLUDE: THE CHICAGO DENTAL SOCIETY, HARPER COLLEGE LEARNING AND CAREER CENTER ADVISORY COMMITTEE, 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 BOARD OF DIRECTORS. (8) 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 ELGIN FAMILY CARE CENTER 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 1,301 PATIENT VISITS IN FY 2020 WITH THE HOSPITAL ABSORBING $198,240 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 2020, THE COMMUNITY RESOURCE CENTER HAD MORE THAN 200,000 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 2020 THE CHW HAD 4,128 CLIENT INTERACTIONS AND THE HOSPITAL PROVIDED $49,580 IN FINANCIAL SUPPORT OF THE PROGRAM. THE HOSPITAL, POC 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 2020, THE TWO PART-TIME COMMUNITY NURSES HAD 4,181 CLIENT INTERACTIONS AND THE HOSPITAL PROVIDED $59,600 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, DEDICATED SENIOR SERVICES LIAISON SCHEDULES AND OVERSEES LECTURES, PROGRAMS AND SCREENINGS AT LOCAL SENIOR CENTERS AND OTHER COMMUNITY LOCATIONS THAT SERVE OLDER ADULTS. IN FY 2020, DUE TO THE PANDEMIC, PROGRAMMING WAS SIGNIFIGANTLY DECREASED. THE HOSPITAL WAS HOWEVER, STILL ABLE TO PROVIDE MORE THAN 100 HEALTH AND WELLNESS PROGRAMS AND SUPPORT GROUPS WITH 1,538 ENCOUNTERS AT THE ARLINGTON HEIGHTS SENIOR CENTER ALONE. THE "ASK-THE-NURSE" PROGRAM AT THE SENIOR CENTER PROVIDES SENIORS WITH THE OPPORTUNITY TO ASK HEALTHCARE QUESTIONS AND SHARE CONCERNS. QUESTIONS FOR THE MAJORITY OF FY 2020 FOCUSING ON COVID-19 SIGNS AND SYMPTOMS, TESTING AND VACCINE SAFETY AND AVAILABILITY. IN ADDITION TO QUESTIONS REGARDING MEDICATIONS, TREATMENT PLANS AND UPCOMING TESTS AND PROCEDURES. A NURSE ALSO PROVIDES FREE BLOOD PRESSURE CHECKS AND OFFERS HELP WITH CHRONIC DISEASE MANAGEMENT FOR DIABETES AND OTHER ILLNESSES. WHEN IT WAS SAFE TO DO SO THE HOSPITAL ALSO PROVIDED OTHER OFFERINGS SUCH AS PHYSICIAN LECTURES, SCREENINGS, WALKERS CLUB AND PARKINSON'S PROGRAMS. SENIORS FROM THE COMMUNITY RECEIVED CUTTING EDGE HEALTH INFORMATION FROM PHYSICIANS AND STAFF ON VARIOUS HEALTH TOPICS SUCH AS DIABETES, CARING FOR AGING TEETH, SENSIBLE SUPPLEMENTING FOR SENIORS, INNOVATIONS IN REHABILITATION TECHNOLOGY, BALANCE AND FALL RISK, MENTAL HEALTH AND MORE. THE SENIOR SERVICES SPECIALIST IS ALSO A TRAINED SENIOR HEALTH INSURANCE PROGRAM COUNSELOR (SHIP), WHICH PROVIDES FREE MEDICARE EDUCATION TO SENIORS. IN FY 2020, 247 SENIORS WERE PROVIDED ASSISTANCE WITH THEIR MEDICARE QUESTIONS AND CONCERNS. (9) THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK AND SERVES ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. (10) 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 2020, 1,153 INDIVIDUALS RECEIVED ASSISTANCE AT A COST OF $143,522. (11) 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. (12) NCH IS AN INDEPENDENT COMMUNITY HOSPITAL THAT PROVIDES ACUTE CARE AND IS RECOGNIZED FOR THE FOLLOWING OUTSTANDING DISTINCTIONS: 2020 HEALTHGRADES AMERICA'S 250 BEST HOSPITALS AWARD; 2020 HEALTHGRADES AMERICA'S 100 BEST HOSPITALS AWARD FOR CARDIAC CARE, CRITICAL CARE, PULMONARY CARE AND STROKE CARE; 2020 HEALTHGRADES CORONARY INTERVENTION EXCELLENCE AWARD; 20 SCHEDULE H - PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM 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). NORTHWEST COMMUNITY PHYSICIANS ASSOCIATION, LLC (NCPA) IS AN INACTIVE, NOT-FOR-PROFIT SUBSIDIARY OF THE HOSPITAL. 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 (55.25% AND 51.75% AT SEPTEMBER 30, 2020 AND 2019, RESPECTIVELY) AND PHYSICIAN INVESTORS (44.75% AND 48.25% AT SEPTEMBER 30, 2020 AND 2019, 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, 2020 AND 2019) AND PHYSICIAN INVESTORS (49% AT SEPTEMBER 30, 2020 AND 2019). 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, 2020 AND 2019) AND PHYSICIAN INVESTORS (49% AT SEPTEMBER 30, 2019 AND 2018). 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, 2020 AND 2019) AND PHYSICIAN INVESTORS (49% AT SEPTEMBER 30, 2020 AND 2019). 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 Shelter Inc 1616 N ARLINGTON HTS RD ARLINGTON HEIGHTS IL 60004 237399596 501(c)(3) 10000 Sponsor WINGS PO BOX 95615 Palatine IL 60095 750800699 501(c)(3) 8000 Sponsor Partners for Our Communities 1585 N Rand Rd Palatine IL 60074 363881109 501(c)(3) 8000 Sponsor St Mary's Service 510 N PLUM GROVE RD PALATINE IL 60067 362167889 501(c)(3) 7500 SPONSOR ARLINGTON HEIGHTS PARK DISTRICT 1200 S DUNTON ARLINGTON HEIGHTS IL 60005 366003283 LOCAL GOV 5417 Sponsor KENNETH YOUNG CENTER 1001 ROHLWING RD ELK GROVE VILLAGE IL 60007 237181444 501(c)(3) 8000 Sponsor CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO 1717 Rand Rd Des Plaines IL 60016 362170821 501(c)(3) 7000 Sponsor 7 0 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 797866 0 176346 0 176937 0 180086 0 30050 0 1361285 0 136203 0 John L Skeans CFO/Treasurer 405387 0 63702 0 3210 0 62490 0 29124 0 563913 0 0 0 Michael C Hartke Executive VP/COO 482779 0 77104 0 45892 0 74114 0 29015 0 708904 0 48842 0 Kimberly Nagy Trm 918 Executive VP - PT Serv & CNO 12338 0 52595 0 240599 0 0 0 0 0 305532 0 0 0 Alan B Loren MD Executive VP - CMO 465923 0 82662 0 3900 0 69189 0 16673 0 638347 0 12301 0 Susan E Nelson MD VP Physician Operations 318975 0 92375 0 3588 0 32489 0 8959 0 456386 0 19433 0 Bradford Buxton Trm 319 VP Strategy & Business Dev. 72518 0 60271 0 168450 0 5602 0 0 0 306841 0 139901 0 Glen J Malan VP Info Tech & CIO 297306 0 29239 0 30083 0 38281 0 4698 0 399607 0 22001 0 John Mathai Chief Medical Physicist 345161 0 4171 0 300 0 8948 0 29318 0 387898 0 0 0 TERRY SOLEM VP HUMAN RESOURCES 276218 0 127214 0 63460 0 36991 0 3191 0 507074 0 66355 0 Mary Dano Trm 1019 Exec VP - Chief Legal Counsel 283867 0 44884 0 149314 0 12039 0 2562 0 492666 0 88683 0 Eileen Gillespie Executive VP - PT Serv & CNO 297222 0 10000 0 4979 0 47707 0 19338 0 379246 0 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 2019, THE FOLLOWING INDIVIDUALS RECEIVED a SEVERANCE PAYMENT AS PART OF Their COMPENSATION ARRANGEMENT: Mary Dano $71,880; Kimberly Nagy $240,599. 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. FOR EXAMPLE, A JANUARY 1, 2014 CONTRIBUTION, A PARTICIPANT WILL VEST IN THAT CONTRIBUTION, AS ADJUSTED FOR EARNINGS AND LOSSES, ON JANUARY 1, 2019. 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 2019 WHICH ARE REPORTED IN COLUMN (B): STEPHEN O. SCOGNA $ 173,181 MICHAEL C. HARTKE $ 62,102 ALAN B. LOREN, MD $ 15,641 MARY DANO $ 88,683 SUSAN E. NELSON, MD $ 24,709 GLEN J. MALAN $ 27,975 TERRY SOLEM $ 73,875 BRADFORD BUXTON $ 167,150 THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SERP AND EARNED UNVESTED BENEFITS DURING 2019 WHICH ARE REPORTED IN COLUMN (C): STEPHEN O. SCOGNA $ 167,486 JOHN L. SKEANS $ 49,890 MICHAEL C. HARTKE $ 61,514 ALAN B. LOREN, MD $ 56,589 Eileen Gillespie $ 36,601 SUSAN E. NELSON, MD $ 26,857 GLEN J. MALAN $ 25,681 TERRY SOLEM $ 24,391 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 2008-10-17 86820000 SEE PART VI false false false C ILLINOIS FINANCIAL AUTHORITY 861091967 45204EDN5 2016-06-15 157336237 SEE PART VI false false false A 15800000 0 53100000 0 0 0 434279 0 0 0 52665721 0 2011 true false true true B 36170000 0 86820000 0 0 0 598075 93000 0 86128925 0 0 2008 true false true true C 4415000 0 157336237 0 0 155497835 1838402 0 0 0 0 0 false true false false A 0 B 0 false false true C false false false false 0 false false false true A false true false false false false 0 false 0 false true B false false true false false false 0 false 0 true C false true false false false false 0 false 0 false true A true B true C true Form 990, Part III, Line 4D - Desc. of Other Program Services INCLUDES REVENUE, EXPENSES, AND GRANTS OF $171,378 FROM ALL OTHER PROGRAM SERVICE SPECIALITIES 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, 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 AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD HAS BEEN ASSIGNED THE RESPONSIBILITY OF REVIEWING FORMS 990 FOR ALL AFFILIATES OF NCH. THIS COMMITTEE REVIEWED FORM 990 PRIOR TO DISTRIBUTION TO THE FULL BOARD. 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 NCH 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 TO AFFILIATES ($ 43,000,000) PERIODIC PENSION COST ($ 9,482,217) PENSION EXPENSE ($ 4,095,301) NET ASSETS RELEASED FROM UNRESTRICTED $ 1,936,800 NET ASSETS RELEASED FROM TEMP RESTRICTED ($ 2,517,579) CHANGE IN NET ASSETS OF FOUNDATION $ 2,740,313 ____________________________________________________________ TOTAL OTHER CHANGES IN NET ASSETS ($ 54,417,984) NORTHWEST COMMUNITY PHYSICIANS ASSN LLC 3040 SALT CREEK LN ARLINGTON HTS IL 60005 510457240 TRM 7/15/20 IL 0 0 NWC Hospital NORTHWEST COMMUNITY HEALTHCARE 3040 SALT CREEK LN ARLINGTON HEIGHTS IL 60005 363125209 SUPPORT ORG. IL 501(c)(3) 12B NWC Hlthcare false NORTHWEST COMMUNITY HOSPITAL FOUNDATION 3040 SALT CREEK LN ARLINGTON HEIGHTS IL 60005 363125193 FUNDRAISING IL 501(c)(3) 7 NWC Hlthcare false NPC-CYBERKNIFE LLC 3040 SALT CREEK LN ARLINGTON HTS IL 60005 204462828 EQUIPMENT LEASING IL NWC HEALTHCARE NWC Day Surgery 3040 SALT CREEK LN ARLINGTON HTS IL 60005 300798249 OUTPATIENT CARE IL NWC HEALTHCARE NW ENDO CENTER LLC 3040 SALT CREEK LN ARLINGTON HTS IL 60005 812338623 SURGICAL CARE IL NWC HEALTHCARE NWC FOOT & ANKLE 3040 SALT CREEK LN ARLINGTON HTS IL 60005 352567039 AMB SRGCAL CNTER IL NWC HEALTHCARE ENVISION MED IMG 8930 WAUKEGAN RD STE 130 MORTON GROVE IL 60053 822067179 IMAGING SERVICES IL NWC HEALTHCARE NORTHWEST COMMUNITY HEALTH SERVICES INC 800 WEST CENTRAL ROAD ARLINGTON HEIGHTS IL 60005 363312906 HEALTHCARE SERV IL NWC HEALTHCARE C Corp CENTRAL INSURANCE COMPANY LTD PO Box 10233 Grand Cayman CJ KY1-1002 981109518 INSURANCE CJ NWC Healthcare C Corp false false true false false false false false false true true true false true true true true true true