2020-06-03T13:55:30-05:00 2019-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2018-07-01 510103684 CHRISTIANA CARE HEALTH SERVICES INC % SR VICE PRESIDENT'S OFFICE CHRI 3026237201 PO BOX 2653 WILMINGTON DE 198050653 ROBERT M MCMURRAY CFO 3026237202 2020-06-03 true ANTONIO C RUSSO P00858539 2673303000 2020-06-03 155.201.35.117 23522320201555000003 2020-06-03 P CFCED273F45E15359E1AD418F281705A5641D1F2 1165BB5F41A71AB0D781DA876A823BF1466164C1 2018 2020-11-06 18:47:13Z JANICE NEVIN MD 4755 OGLETOWN-STANTON ROAD NEWARK DE 19718 2472196143 false X WWW.CHRISTIANACARE.ORG X 1965 DE OUR MISSION AS AN ORGANIZATION IS TO SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. 20 17 12638 1048 4794053 0 22698446 24577838 1371432728 2003698183 62409870 81965865 227054451 1841287 1683595495 2112083173 0 0 0 0 1101167332 1197510102 0 0 0 415593042 714773175 1516760374 1912283277 166835121 199799896 3230957055 3539982993 652910048 794893093 2578047007 2745089900 X WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH, IN THE COMMUNITY, IN OUR PHYSICIAN PRACTICES AND IN OUR HOSPITALS. WE SERVE TOGETHER AS ONE TEAM, GUIDED BY OUR VALUES, EXCELLENCE AND LOVE, TO BE A CATALYST FOR A HEALTHIER COMMUNITY. WE SHARE A COMMITMENT TO EXCELLENCE AT CHRISTIANA CARE. false false 495859395 0 347157766 PROVISION OF PROFESSIONAL PATIENT CARE FOR THE HOSPITALS OF CHRISTIANA CARE. APPROXIMATELY 2,667 FULL TIME EQUIVALENT ("FTE") NURSES ARE EMPLOYED WITH 305,124 PATIENT DAYS RECORDED DURING FISCAL 2019. THE HOSPITALS OFFER A FULL SCOPE OF SERVICES WITH THE NEEDS OF THE POPULATION SERVED WITHOUT REGARD TO AGE, RACE OR ECONOMIC CIRCUMSTANCES. 184390104 0 315400460 PHARMACY-PROVIDED PHARMACY SERVICES FOR BOTH INPATIENTS AND OUTPATIENTS. DURING FISCAL 2019, 6,563,795 DOSES WERE PERFORMED WITH AN APPROXIMATE FTE COUNT OF 235. 261601597 0 380199241 OPERATING ROOM-PROVIDED BOTH INPATIENT AND OUTPATIENT SURGICAL PROCEDURES. 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THE ORGANIZATION'S ENDOWMENT CONSISTS OF APPROXIMATELY TWENTY-THREE DONOR RESTRICTED ENDOWMENT FUNDS USED FOR A VARIETY OF PURPOSES, INCLUDING SALARY AND PROGRAM SUPPORT. THE ORGANIZATION'S PURPOSE AND TIME RESTRICTED NET ASSETS ARE RESTRICTED FOR INDIGENT CARE, BUILDING AND MAINTENANCE, AND PROGRAM SUPPORT. -------------------- Central America and the Caribbean Investments 75851973 75851973 75851973 true false true false false false SCHEDULE F, PART II DETAIL OF SUB-CONTRACTS IN FURTHERANCE OF ITS RESEARCH ACTIVITIES, THE ORGANIZATION MAY MAKE SUB-CONTRACTS TO FOREIGN INSTITUTIONS THAT PERFORM RESEARCH IN CONNECTION WITH RESEARCH GRANTS AWARDED TO THE ORGANIZATION. THE ORGANIZATION DOES NOT CATEGORIZE ANY SUCH SUB-CONTRACTS AS GRANTS FOR FORM 990, SCHEDULE F, PARTS II AND III PURPOSES. EVENING OF HOPE 156715 134315 22400 0 156715 134315 22400 22400 FORM 990, SCHEDULE G, PART II, EVENT #1 DETAIL OF FUNDRAISING EVENTS THE EXPENSES ASSOCIATED WITH THE EVENING OF HOPE FUNDRAISING EVENT WERE RECORDED DIRECTLY BY A RELATED PARTY. -------------------- true true X true X false false true false true true 15134519 15134519 0.00790 258388746 241406576 16982170 0.00890 273523265 241406576 32116689 0.01680 58 66480 9461092 2257133 7203895 0.00380 5 10 79698938 11759808 67939130 0.03550 1 19353576 13850355 5503221 0.00290 6 413149 413149 0.00020 70 66490 108926755 27867296 81059395 0.04240 70 66490 382450020 269273872 113176084 0.05920 2 320376 320376 0.00020 1 60000 60000 3 1033261 1033261 0.00060 3 93091 93091 9 1506728 1506728 0.00080 true 62680662 8789324 489040997 591145063 -102104066 X true true 2 1 CHRISTIANA HOSPITAL 4755 OGLETOWN-STANTON ROAD NEWARK DE 19718 www.christianacare.org LICENSE #HSPTL-002 X X X X X A 2 WILMINGTON HOSPITAL 501 WEST 14TH STREET WILMINGTON DE 19801 www.christianacare.org LICENSE #HSPTL-001 X X X X X A A-CHRISTIANA AND WILMINGTON HOSPITALS 12 false false true X X X X X X X X X 18 true true true true X SEE PART V, SECTION C X true 19 true SEE PART V, SECTION C false true X 200. 0. X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false PART V, SECTION B LINE 5 (INPUT FROM COMMUNITY) TO LEARN FROM THE COMMUNITIES WE SERVE, CHRISTIANACARE HELD A SERIES OF COMMUNITY MEETINGS: FOUR MEETINGS OF 98 COMMUNITY STAKEHOLDERS; SIX MEETINGS OF 53 LOCAL TEENAGERS; AND TWO INTERNAL MEETINGS OF 13 CHRISTIANACARE STAFF MEMBERS. THE COMMUNITY STAKEHOLDERS REPRESENTED LOCAL HEALTH DEPARTMENTS, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTH CARE PROVIDERS, LOCAL POLICYMAKERS, PARKS AND RECREATION DEPARTMENTS, AND SCHOOL SYSTEMS; THE CHRISTIANACARE STAFF MEMBERS WERE THOSE WHO WORKED DIRECTLY WITH PATIENTS; AND THE TEENAGERS REPRESENTED SEVERAL AREAS ACROSS NEW CASTLE COUNTY, INCLUDING NEWARK, NEW CASTLE, WILMINGTON AND CLAYMONT. CHRISTIANACARE WAS PURPOSEFUL IN THE INCLUSION OF A BROAD ARRAY OF COMMUNITY VOICES AT THESE MEETINGS TO ENSURE A DIVERSITY OF VIEWPOINTS. THESE MEETINGS ALL BEGAN WITH A PRESENTATION OF PRELIMINARY SECONDARY COMMUNITY HEALTH DATA. PARTICIPANTS THEN WERE ASKED (A) TO IDENTIFY COMMUNITY HEALTH ISSUES THAT MAY NOT HAVE BEEN WELL MEASURED BY SECONDARY DATA AND (B) THROUGH A VOTING PROCESS, TO IDENTIFY WHICH NEEDS THEY BELIEVED WERE MOST SIGNIFICANT IN NEW CASTLE COUNTY. IN ADDITION TO THE ABOVE MEETINGS, AN INTERVIEW WAS CONDUCTED WITH AN ASSOCIATE DEPUTY DIRECTOR WITHIN THE DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES. DURING THAT INTERVIEW, SECONDARY DATA FINDINGS AND SIGNIFICANT NEEDS ALSO WERE DISCUSSED TO GET THE ASSOCIATE DEPUTY DIRECTOR'S PERSPECTIVE. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2019 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW AND ANALYSIS, TO DEVELOP THE CHNA. -------------------- PART V, SECTION B, LINE 6 (JOINT CHNA) CHRISTIANACARE'S TWO HOSPITAL FACILITIES, CHRISTIANA AND WILMINGTON HOSPITALS, JOINTLY CONDUCTED THEIR CHNA. -------------------- PART V, SECTION B, LINE 7 & 10 (CHNA & IMP. STRATEGY PUBLIC AVAILABILITY) CHRISTIANACARE'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-NEEDS-ASSESSMENT/ CHRISTIANACARE'S CHNA IS ALSO AVAILABLE IN PAPER COPY TO THE PUBLIC UPON REQUEST. CHRISTIANACARE'S COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WAS ADOPTED ON OR BEFORE THE 15TH DAY OF THE 5TH MONTH AFTER JUNE 30, 2019, AS ALLOWED UNDER THE IRS SECTION 501(R) REGULATIONS. CHRISTIANACARE'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ A PAPER COPY OF THE CHIP IS ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. -------------------- PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) IN THE MOST RECENT CHNA, FINALIZED IN JUNE 2019, CHRISTIANACARE IDENTIFIED THE COMMUNITY'S MOST SIGNIFICANT NEEDS AS: 1. SOCIAL DETERMINANTS OF HEALTH INCLUDING POVERTY, FOOD INSECURITY, HOUSING, AFFORDABILITY OF CARE, EDUCATION, AND EMPLOYMENT/JOB SECURITY 2. MENTAL HEALTH AND SUBSTANCE USE DISORDER 3. VIOLENCE AND PUBLIC SAFETY 4. MATERNAL AND CHILD HEALTH ESPECIALLY INFANT MORTALITY 5. ACCESS TO DENTAL AND PRIMARY CARE UNSURPRISINGLY, ALL BUT ACCESS TO DENTAL AND PRIMARY CARE WERE IDENTIFIED AS SIGNIFICANT HEALTH NEEDS IN THE 2018 CHNA. ISSUES LIKE POVERTY, VIOLENCE, AND INFANT MORTALITY ARE NOT ONES THAT CAN BE RESOLVED QUICKLY. IN THE 2018 CHNA, CHRISTIANACARE ALSO IDENTIFIED TRANSPORTATION, HOUSING, AND EMPLOYMENT AS SIGNIFICANT NEEDS, BUT DETERMINED THAT IT WAS NOT ABLE TO ADDRESS THESE NEEDS GIVEN A LACK OF EXPERTISE AND INFRASTRUCTURE. WHILE WE CONTINUE TO ACKNOWLEDGE THAT ADDRESSING SOCIAL DETERMINANTS OF HEALTH IS TO SOME EXTENT OUTSIDE OF OUR SCOPE OF EXPERTISE; WE HAVE ADVANCED OUR ORGANIZATIONAL CAPACITY TO SUPPORT A SOCIAL CARE FRAMEWORK AND MADE A COMMITMENT TO PARTNERING WITH COMMUNITY ORGANIZATIONS THAT DO ADDRESS THESE AREAS. IN SUPPORT OF THAT COMMITMENT, CHRISTIANACARE'S OFFICE OF HEALTH EQUITY DESIGNED THE COMMUNITY INVESTMENT FUND IN PARTNERSHIP WITH CHRISTIANACARE'S FINANCE DEPARTMENT IN FY 2019. THE FUND SUPPORTS PARTNERSHIPS TO BUILD THE COMMUNITY'S COLLECTIVE CAPACITY TO ADDRESS SOCIAL, BEHAVIORAL AND ENVIRONMENTAL FACTORS THAT IMPACT HEALTH. RECIPIENT COMMUNITY ORGANIZATIONS ARE SELECTED BASED ON THE QUALITY OF THEIR PROPOSALS AND IMPLEMENTATION PLANS, AND ON THE ALIGNMENT OF THEIR PROPOSALS WITH THE KEY PRIORITIES OF CHRISTIANACARE'S COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLAN. IN FY 2020, NEARLY $2,000,000 IN FUNDING WAS GIVEN TO 32 COMMUNITY ORGANIZATIONS ACROSS THE STATE. THE FOLLOWING ARE BRIEF HIGHLIGHTS OF SOME KEY PROGRAMS AND INITIATIVES THAT CHRISTIANACARE HAS UNDERTAKEN TO ADDRESS THE AREAS OF NEED IDENTIFIED IN THE CHNA. PLEASE SEE THE CHRISTIANACARE CHIP AT HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ FOR A COMPLETE DESCRIPTION OF HOW CHRISTIANACARE IS ADDRESSING THE IDENTIFIED AREAS OF NEED. 1. SOCIAL DETERMINANTS OF HEALTH CHRISTIANACARE UNDERTOOK EXCITING AND INNOVATIVE PARTNERSHIPS TO ADDRESS POVERTY AND SOCIAL DETERMINANTS OF HEALTH DURING THIS FISCAL YEAR. IN MARCH 2019, CHRISTIANACARE GAVE A GIFT OF $1,000,000 TO PURPOSE BUILT COMMUNITIES' REACH RIVERSIDE COMMUNITY DEVELOPMENT INITIATIVE. THIS INITIATIVE IS A COMMUNITY-LED REVITALIZATION PROJECT IN ONE OF WILMINGTON'S OLDEST AND MOST UNDERSERVED NEIGHBORHOODS. CHRISTIANACARE'S GIFT WILL FUND COMMUNITY HEALTH AND WELLNESS OUTREACH AND EDUCATION, FACILITIES AND RESOURCES FOR TEEN PROGRAMS AND ACTIVITIES, SUPPORT FOR SENIORS AND CHILDREN, TRANSPORTATION, AND PROGRAMS TO SUPPORT ECONOMIC OPPORTUNITY AND MOBILITY THROUGH WORKFORCE DEVELOPMENT AND FINANCIAL HEALTH PROGRAMS. CHRISTIANACARE'S CHIEF HEALTH EQUITY OFFICER, BETTINA TWEARDY RIVEROS, ALSO SERVES ON THE REACH RIVERSIDE BOARD OF DIRECTORS, AND CO-CHAIRS THE HEALTH, WELLNESS & SAFETY COMMITTEE ENSURING THAT CHRISTIANACARE WILL SERVE THIS COMMUNITY AS A PARTNER IN ITS HEALTH. CHRISTIANACARE ALSO ENGAGED UNITE US TO DEVELOP A CARE-COORDINATION NETWORK, UNITE DELAWARE, THAT CONNECTS SOCIAL SERVICES AND CLINICAL CARE PROVIDERS ACROSS THE STATE. WITH THIS ONLINE NETWORK, ANY HEALTH CARE PROVIDER OR SOCIAL SERVICE AGENCY CAN HELP AN INDIVIDUAL ADDRESS THE DIVERSE NEEDS THEY MAY HAVE. THIS TOOL HAS THE POTENTIAL TO REVOLUTIONIZE THE WAY SOCIAL SERVICE AND HEALTH CARE ORGANIZATIONS WORK TOGETHER IN DELAWARE. IT ENABLES OUR COMMUNITY TO TAKE ADVANTAGE OF EXISTING RESOURCES AND BETTER UNDERSTAND AREAS THAT NEED ADDITIONAL RESOURCES OR INVESTMENT. WE ARE INVESTING IN THIS NETWORK BECAUSE WE EXPECT THIS NETWORK TO IMPROVE COORDINATION AMONG COMMUNITY ORGANIZATIONS AND HEALTH CARE PROVIDERS, AND BECAUSE IT WILL PROVIDE VALUABLE INFORMATION ABOUT HOW THE NEEDS OF DELAWAREANS ARE BEING MET OR UNMET WHICH WILL ALSO SERVE TO INFORM OUR COMMUNITY INVESTMENT. ANOTHER COMPREHENSIVE WAY IN WHICH CHRISTIANACARE ADDRESSES SOCIAL DETERMINANTS OF HEALTH IS THE DELAWARE MEDICAL LEGAL PARTNERSHIP (MLP) CREATED IN PARTNERSHIP WITH DELAWARE'S COMMUNITY LEGAL AID SOCIETY, INC. ("CLASI"). THE MLP PROVIDES FREE, CIVIL LEGAL SERVICES TO LOW-INCOME PATIENTS, ADULTS AND CHILDREN, WHO ARE FACING LEGAL MATTERS OR NEEDS THAT MAY NEGATIVELY IMPACT THEIR HEALTH OR LEGAL MATTERS OR NEEDS WHICH MAY HAVE BEEN CREATED OR AGGRAVATED BY A PERSON'S HEALTH ISSUES. SOME OF THE MATTERS ADDRESSED THROUGH THIS PROGRAM ARE SAFE HOUSING, PREVENTION OF SUBSIDIZED AND PUBLIC HOUSING EVICTIONS, ASSISTANCE OBTAINING OR PRESERVING INCOME MAINTENANCE AND GOVERNMENT BENEFITS, ACCESS TO SOCIAL SERVICES, APPROPRIATE EDUCATIONAL SERVICES, HEALTH INSURANCE AND ACCESS TO HEALTH CARE. CLASI ATTORNEYS ARE LOCATED ON-SITE AT THE WILMINGTON HOSPITAL AND ARE INTEGRATED INTO HEALTH CARE TEAMS. DURING THIS FISCAL YEAR, THE OFFICE OF HEALTH EQUITY AGGRESSIVELY PROMOTED THIS PROGRAM THROUGHOUT THE SYSTEM TO ENSURE THAT STAFF WERE AWARE OF THIS PROGRAM AND COULD REFER INDIVIDUALS IN NEED THIS SERVICE. THE NUMBER OF THOSE REFERRED INCREASED BY OVER 50% DUE TO THOSE EFFORTS. CHRISTIANACARE IS ALSO ADDRESSING SOCIAL DETERMINANTS OF HEALTH THROUGH ITS COMMITMENT TO A COMMUNITY HEALTH WORKERS (CHW) PROGRAM. AS RECENTLY AS 2017, CHRISTIANA CARE DID NOT EMPLOY ANY CHWS AND BY THE TIME OF THIS WRITING, THERE ARE 16 FULL-TIME CHWS, AND WE EXPECT THAT NUMBER TO INCREASE TO 20. CHWS ARE TRAINED LAYPEOPLE WHO HELP PATIENTS ADDRESS THEIR SOCIAL NEEDS WITH THE EXPECTATION THAT IF SOCIAL NEEDS ARE MET, PATIENTS CAN MORE EFFECTIVELY ADDRESS THEIR HEALTH NEEDS. THEY ARE EMBEDDED IN THE FOLLOWING LOCATIONS THROUGHOUT THE CHRISTIANACARE SYSTEM: WOMEN'S HEALTH, SCHOOL-BASED HEALTH CENTERS, PRIMARY CARE AND OUR CARE-COORDINATION COMMUNITY TEAM. THERE IS ALSO A CHW COMMITTED TO HELPING PATIENTS ADDRESS FOOD INSECURITY. FOOD INSECURITY CHRISTIANACARE ADDRESSES FOOD INSECURITY WITH ITS PRODUCE RX PROGRAM CREATED IN 2017 IN PARTNERSHIP WITH URBAN ACRES PRODUCE, A COMMUNITY RUN LLC FOUNDED TO ADDRESS THE LACK OF CONVENIENT ACCESS TO HEALTHY FOODS IN LOW INCOME SECTIONS OF WILMINGTON. ELIGIBLE PREGNANT AND POST-PARTUM WOMEN AS WELL AS INDIVIDUALS DIAGNOSED WITH HYPERTENSION OR DIABETES ARE GIVEN "PRESCRIPTIONSVOUCHERS WHICH THEY EXCHANGE FOR PRODUCE AT ONE OF THE URBAN ACRES PRODUCE FARM STANDS. WITH CHRISTIANACARE SUPPORT, URBAN ACRES PRODUCE OPERATES FARM STANDS AT SIX LOCATIONS THROUGHOUT WILMINGTON INCLUDING A SENIOR CENTER, WESTSIDE FAMILY HEALTHCARE CENTER, AND THE WILMINGTON HOSPITAL. AN ADDITIONAL FARM STAND IS LOCATED AT THE CHRISTIANA HOSPITAL. THESE FARM STANDS ARE PRESENT IN EACH LOCATION FOR A SET NUMBER OF HOURS ON A SET DAY, AND ANYONE, NOT ONLY THOSE WITH PRESCRIPTIONS, IS ABLE TO VISIT THE FARM STANDS AND PURCHASE AFFORDABLE PRODUCE. CHRISTIANACARE'S PARTNERSHIP WITH URBAN ACRES PRODUCE DEMONSTRATES ITS COMMITMENT TO COMPREHENSIVE COMMUNITY EFFORTS. URBAN ACRES PRODUCE WORKS TO NOT ONLY ENSURE COMMUNITIES HAVE ACCESS TO AFFORDABLE PRODUCE, IT ALSO STRIVES TO DO SO IN A WAY THAT CREATES JOB OPPORTUNITIES. ANOTHER FOOD INSECURITY INITIATIVE CHRISTIANACARE UNDERTOOK THIS FISCAL YEAR WAS THE ESTABLISHMENT OF THE WILMINGTON HOSPITAL FOOD PANTRY IN EARLY 2019 IN PARTNERSHIP WITH THE FOOD BANK OF DELAWARE. THIS FOOD PANTRY SERVES OUTPATIENTS OF WILMINGTON HOSPITAL, THE CENTER FOR SPECIAL HEALTH CARE NEEDS, INDEPENDENCE AT HOME, AND CAREVIO COMMUNITY. IF A PATIENT IS FOOD INSECURE, THEY WILL BE PROVIDED WITH A BOX OF NON-PERISHABLE FOOD IMMEDIATELY. THESE PATIENTS ALSO RECEIVE INFORMATION ABOUT COMMUNITY-BASED FOOD OPTIONS FOR CONTINUING SUPPORT. AFTER ONE YEAR OF OPERATION, DATA-INFORMED DETERMINATIONS WILL BE MADE ABOUT ANY NEEDED CHANGES TO THE PROGRAM, AND THE INFORMATION SECURED FROM THIS PROGRAM WILL ALSO BE USED TO INFORM OTHER FOOD INSECURITY INITIATIVES WHICH WE EXPECT TO DEVELOP DURING FISCAL YEAR 2020. HOUSING DURING FISCAL YEAR 2019, CHRISTIANACARE FOCUSED ON RESEARCHING TRANSITIONAL HOUSING MODELS THAT PROVIDE WRAPAROUND SERVICES FOR PEOPLE WITH COMPLEX HEALTH NEEDS. CHRISTIANACARE ENTERED INTO PARTNERSHIPS WITH FRIENDSHIP HOUSE AND ATTACK ADDICTION RESPECTIVELY TO PROVIDE FINANCIAL SUPPORT FOR THESE ORGANIZATIONS' TRANSITIONAL HOUSING FOR HOMELESS INDIVIDUALS AND INDIVIDUALS SUFFERING FROM SUBSTANCE USE DISORDER. IN FISCAL YEAR 2020, WE ALSO EXPECT TO DEVELOP A PROCESS FOR REFERRING APPROPRIATE PATIENTS TO THESE ORGANIZATIONS FOR TRANSITIONAL HOUSING. CHRISTIANACARE ALSO ENTERED INTO THE EARLY STAGES OF A PARTNERSHIP WITH HABITAT FOR HUMANITY NEW CASTLE COUNTY TO PROVIDE CRITICAL REPAIRS AND SAFETY MODIFICATIONS TO LOW-INCOME PATIENTS THAT ARE HOMEOWNERS RETURNING FROM THE HOSPITAL. CHRISTIANACARE'S INDEPENDENCE AT HOME PROGRAM AND GOOD NEIGHBORS HOME REPAIR ALSO BEGAN WO PART V, SECTION B, LINE 13 (ELIGIBILITY FOR PROVIDING DISCOUNTED CARE) FEDERAL POVERTY GUIDELINES ARE NOT USED TO DETERMINE DISCOUNTED CARE. A SELF-PAY DISCOUNT OF 15% IS APPLIED TO ALL UNINSURED PATIENT ACCOUNTS REGARDLESS OF INCOME. PATIENTS WITH INCOME IN EXCESS OF 200% WILL ONLY RECEIVE A 15% DISCOUNT. -------------------- PART V, SECTION B, LINE 16 (FINANCIAL ASSISTANCE POLICY AVAILABILITY) A COPY OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT: HTTPS://CHRISTIANACARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL -ASSISTANCE/ -------------------- PART V, SECTION B, LINE 20 (ADDITIONAL EFFORTS MADE BEFORE AN ECA) CHRISTIANA CARE HEALTH SERVICES COMMUNICATES IN WRITING ABOUT COLLECTION PLACEMENT AND THE FINANCIAL ASSISTANCE POLICY. -------------------- PART V, SECTION B, LINE 22 (CHARGES FOR FAP-ELIGIBLE INDIVIDUALS) FAP-ELIGIBLE INDIVIDUALS (THOSE WITH INCOME LESS THAN 200% OF FEDERAL POVERTY GUIDELINES) ARE NOT RESPONSIBLE FOR ANY CHARGES. -------------------- PART I, LINE 3C (DES. OF ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CARE) CHRISTIANA CARE HEALTH SERVICES, INC.("CHRISTIANACARE") HAS A SELF PAY DISCOUNT PERCENTAGE OF 15% THAT IS APPLIED TO ALL UNINSURED PATIENTS' ACCOUNTS, REGARDLESS OF THE PERSON'S ABILITY TO PAY. THIS DISCOUNT PERCENTAGE IS COMPARABLE TO THAT WHICH IS EXTENDED TO OUR MANAGED CARE COMPANIES. -------------------- PART I, LINE 6A (COMMUNITY BENEFIT ANNUAL REPORT INFORMATION) CHRISTIANACARE HEALTH SYSTEM (CCHS) DID PREPARE A COMMUNITY HEALTH NEEDS ASSESSMENT AND A COMMUNITY HEALTH IMPLEMENTATION PLAN DURING THE FY2019 TAX YEAR. BOTH DOCUMENTS ARE AVAILABLE AT THE FOLLOWING LINK ON THE CCHS WEBSITE: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ -------------------- PART I, LINE 7 (COSTING METHODOLOGY USED) THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. -------------------- PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER NEW ACCOUNTING PRONOUNCEMENT ASC 606). -------------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. -------------------- PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF CHRISTIANACARE AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, CHRISTIANACARE PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY CHRISTIANACARE TO PROVIDE SUCH SERVICES. AS A RESULT, CHRISTIANA CARE VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. -------------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) CHRISTIANACARE HAS A FINANCIAL ASSISTANCE POLICY THAT IDENTIFIES THE CIRCUMSTANCES FOR WHICH A RESPONSIBLE PARTY WOULD BE EXTENDED A 100% ADJUSTMENT ON ALL MEDICAL BILLS. THE INCOME THRESHOLD FOR THIS CHARITABLE ADJUSTMENT IS 200% OF THE FEDERAL POVERTY LEVEL AND IT IS BASED ON THE NUMBER OF DEPENDENTS IN THE HOUSEHOLD. THE FINANCIAL ASSISTANCE POLICY FURTHER EXPLAINS THAT ANY UNINSURED PATIENT WHO FAILS TO QUALIFY FOR FINANCIAL ASSISTANCE WOULD BE GRANTED A 15% SELF PAY DISCOUNT. IT ALSO REVEALS A PATIENT'S ABILITY TO ESTABLISH INTEREST-FREE MONTHLY PAYMENT ARRANGEMENTS FOR ANY OUTSTANDING BALANCE THAT IS NOT COVERED BY A THIRD PARTY PAYER. AS PART OF THE SELF PAY DUNNING PROCESS, CHRISTIANA CARE MAKES UNINSURED PATIENTS AWARE OF THE FINANCIAL ASSISTANCE PROGRAM WITH THE RELEASE OF OUR FIRST STATEMENT. ALL SUBSEQUENT STATEMENTS PROVIDE THE PATIENTS WITH AN OPPORTUNITY TO CALL OUR CUSTOMER SERVICES DEPARTMENT IF THEY ARE UNABLE TO MAKE PAYMENT IN FULL. IF A PATIENT QUALIFIES FOR A CHARITABLE ADJUSTMENT, THEY ARE EXTENDED THE COURTESY OF AN AUTOMATIC ADJUSTMENT TO THEIR BILLS FOR THE NEXT YEAR AND FOR ONE YEAR PRIOR TO THE DATE A PATIENT'S APPLICATION IS APPROVED. PATIENTS WOULD NEED TO REAPPLY FOR CHARITABLE CONSIDERATION AFTER THE ONE YEAR HAS LAPSED. ALL COLLECTION ACTIONS WOULD CEASE ONCE A PATIENT IS DEEMED ELIGIBLE FOR CHARITY OR ONCE A PATIENT ESTABLISHES AND MAINTAINS A MONTHLY PAYMENT ARRANGEMENT. -------------------- PART VI, LINE 2 (NEEDS ASSESSMENT) AT CHRISTIANACARE, WE ABIDE BY THE CHRISTIANACARE WAY: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. CHRISTIANACARE IS GUIDED BY ITS COMMITMENT TO PARTNERING WITH OUR NEIGHBORS TO BETTER UNDERSTAND THEIR NEEDS AND GOALS FOR HEALTH. UNDERTAKING THE 2019 CHNA WAS NOT SIMPLY AN IRS REQUIREMENT FOR US, INSTEAD, WE VIEWED IT AS AN OPPORTUNITY TO LISTEN TO OUR NEIGHBORS. OUR NEIGHBORS ARE IN THE BEST POSITION TO TELL US WHAT THEIR HEALTH NEEDS ARE AND HOW WE CAN ASSIST THEM IN MEETING THOSE NEEDS. DURING THIS REPORTING YEAR, OUR COMMITMENT TO LISTENING TO OUR PATIENTS AND COMMUNITIES HAS BEEN MADE EVIDENT THROUGH THE INITIATIVES WE HAVE UNDERTAKEN SUCH AS THE COMMUNITY HEALTH WORKER PROGRAM, THE REACH RIVERSIDE INITIATIVE, AND UNITE DELAWARE. THESE INITIATIVES WILL NOT SUCCEED IF WE DO NOT ENGAGE WITH OUR PATIENTS AND COMMUNITY MEMBERS TO UNDERSTAND THEIR NEEDS AND THE IMPACT OF THOSE NEEDS ON THEIR HEALTH. IF, FOR EXAMPLE, A PATIENT TELLS THEIR COMMUNITY HEALTH WORKER THAT THEY CANNOT THINK ABOUT MAKING CHANGES TO THEIR DIET UNTIL THEY RESUME THEIR SOCIAL SECURITY BENEFITS, THEN THE COMMUNITY HEALTH WORKER WILL WORK WITH THEM TO RESUME THOSE BENEFITS AND ADDRESS THEIR DIET WHEN THAT IS RESOLVED AND THE PATIENT IS READY. THROUGH THIS MODEL, WE ARE NOT SIMPLY PRESCRIBING, WE ARE WORKING CLOSELY WITH THE PATIENT TO ADDRESS THE BARRIERS THEY IDENTIFY AS BEING IN THE WAY OF GOOD HEALTH THEREBY SETTING THEM UP FOR MORE SUCCESS. THE REACH RIVERSIDE INITIATIVE RELIES ON RESIDENT ENGAGEMENT TO REVITALIZE THE RIVERSIDE NEIGHBORHOOD. WE INVESTED BECAUSE WE BELIEVE THE COMMUNITY SHOULD DETERMINE ITS FUTURE, AND WE WANTED TO HELP EMPOWER THEM TO DO SO BY PARTNERING AROUND THEIR HEALTH NEEDS. FINALLY, THE USE OF UNITE DELAWARE REQUIRES COMMUNICATION AMONG COMMUNITY ORGANIZATIONS AND COMMUNITY MEMBERS. THROUGH UNITE DELAWARE, CHRISTIANACARE HAS ACCESS TO DATA ON WHAT SOCIAL SERVICES ARE THE MOST REQUESTED WITHIN OUR COMMUNITIES, AND OF THOSE, WHICH ONES ARE MET OR UNMET. THIS DATA REPRESENTS THE VOICE OF OUR COMMUNITIES, AN EXPRESSION OF THEIR NEEDS. UNDERSTANDING THOSE GAPS WILL HELP GUIDE OUR COMMUNITY INVESTMENT. CHRISTIANACARE'S GREATER WILMINGTON COMMUNITY PARTNERSHIP AND THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL WERE FORMED TO HAVE DIRECT CONTACT WITH COMMUNITY LEADERS AND STAKEHOLDERS TO GAIN PERSPECTIVE AND GUIDANCE FROM THEM REGARDING OUR COMMUNITIES' NEEDS. CHRISTIANACARE ALSO COLLABORATES WITH PARTNERS TO BETTER UNDERSTAND AND ADDRESS PRESSING HEALTH CONCERNS IN OUR STATE. AS DESCRIBED IN THE PREVIOUS SECTION, CHRISTIANACARE PARTICIPATES IN THE FETAL INFANT MORTALITY REVIEW AND THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM TO DECREASE THE INFANT MORTALITY RATE. CHRISTIANA CARE'S VICE PRESIDENT OF COMMUNITY HEALTH AND ENGAGEMENT ALSO CO-CHAIRS THE DRUG OVERDOSE FATALITY REVIEW COMMISSION WHICH IS OF VITAL IMPORTANCE IN OUR STATE. IN 2018, DELAWARE MOVED INTO THE POSITION OF HAVING THE SECOND HIGHEST OVERDOSE DEATH RATE AMONG THE STATES. MEMBERS OF THE TRAUMA TEAM ALSO PARTICIPATE IN THE DELAWARE COALITION FOR INJURY PREVENTION, SAFE KIDS DELAWARE, AND SAFE KIDS NEW CASTLE COUNTY TO CREATE PARTNERSHIPS AND INITIATIVES TO PREVENT INJURY AND UNDERSTAND THE NEEDS STATEWIDE. CHRISTIANACARE ALSO CREATED THE SCHOOL-BASED HEALTH CENTER COMMUNITY ADVISORY BOARD (SBHC CAB) TO PROVIDE GUIDANCE AND INPUT ON INCREASING THE VALUE AND REACH OF CHRISTIANA CARE'S 18 SBHCS ACROSS NEW CASTLE COUNTY, WHILE ALSO BUILDING AWARENESS TO THE VARIETY OF SERVICES EACH CENTER PROVIDES FOR ADOLESCENTS IN A HIGH SCHOOL SETTING. A GROUP OF STAKEHOLDERS WERE ASKED TO SERVE ON THE SBHC CAB INCLUDING PARENTS/GUARDIANS, TEACHERS AND SCHOOL ADMINISTRATION, CLINICIANS, COMMUNITY PROVIDERS, AND RESEARCHERS. THE SBHC CAB MEETINGS WERE DESIGNED TO GIVE THESE STAKEHOLDERS A PLATFORM FOR EQUAL INPUT. THROUGH A COMMUNITY-BASED PARTICIPATORY RESEARCH FRAMEWORK, THIS PROJECT WAS RESPONSIBLE FOR IDENTIFYING CRITICAL BARRIERS TO CARE - FOR BOTH IN-SCHOOL AND OUT-OF-SCHOOL SETTINGS. BECAUSE SOCIAL DETERMINANTS OF HEALTH (SDOH) WERE IDENTIFIED AS AN AREA OF NEED IN OUR 2016 AND 2019 CHNAS, WE ARE UNDERTAKING A NUMBER OF INITIATIVES, DESCRIBED IN THE PREVIOUS SECTION, TO ADDRESS THEM. WE ALSO RECOGNIZE THAT IN ORDER TO IMPROVE PATIENT HEALTH THERE IS A NEED TO IDENTIFY AND ADDRESS INDIVIDUAL PATIENTS' SDOH. FOR EXAMPLE, A PATIENT'S FREQUENT VISITS TO THE EMERGENCY DEPARTMENT FOR HYPERGLYCEMIA REFLECTS POORLY MANAGED DIABETES. IT COULD BE ASSUMED THIS IS DUE TO WILLFUL NONCOMPLIANCE, BUT IT MIGHT INSTEAD BE DUE TO FOOD INSECURITY THAT LIMITS THE PATIENTS' ABILITY TO CONSISTENTLY OBTAIN APPROPRIATE FOODS TO CONTROL THEIR DIABETES. THIS IS IMPORTANT TO KNOW AS IT WILL GUIDE THE INTERVENTION TO IMPROVE THE PATIENT'S HEALTH. ADDRESSING PATIENTS' SOCIAL NEEDS IN ADDITION TO PROVIDING CLINICAL CARE HAS BECOME A MAJOR PUBLIC HEALTH INITIATIVE AND IS A KEY COMPONENT OF OUR WORK AT CHRISTIANACARE TO CREATE AN INTEGRATED CLINICAL AND SOCIAL CARE FRAMEWORK. AN IMPORTANT FIRST STEP TO ADDRESSING PATIENTS' SDOH IS TO SCREEN PATIENTS FOR THESE SOCIAL NEEDS IN CLINICAL SETTINGS. CHRISTIANACARE DEVELOPED ITS SYSTEMWIDE STANDARDIZED SDOH SCREENING TOOL BY HAVING KEY STAKEHOLDERS ACROSS THE HEALTH SYSTEM, FROM PROVIDERS AND NURSES, TO INFORMATION TECHNOLOGY ANALYSTS, EPIDEMIOLOGISTS AND RESEARCHES, REVIEW THE EXISTING AND VALIDATED SCREENING TOOLS. AFTER WORKGROUP MEETINGS AND IN-DEPTH DISCUSSIONS, THE STAKEHOLDERS IDENTIFIED SIX PRIORITY DOMAINS: 1) PERSONAL FINANCE, 2) FOOD INSECURITY, 3) HOUSING INSTABILITY, 4) TRANSPORTATION, 5) INTERPERSONAL VIOLENCE, AND 6) HEALTH LITERACY. THE CHRISTIANACARE SDOH WORKING GROUP THEN COMPILED A LIST OF VALIDATED QUESTIONS FROM THE VARIOUS EXISTING TOOLS AND CAME TO A CONSENSUS ON 9 RECOMMENDED SDOH SCREENING QUESTIONS AND ONE EXTRA QUESTION ADDRESSING URGENT NEEDS. DURING THE END OF THIS REPORTING PERIOD, SELECTED DEPARTMENTS WITHIN CHRISTIANACARE BEGAN A TARGETED USE OF THE SDOH SCREENING TOOL. THE UTILIZATION OF THE SDOH SCREENING TOOL IS A CLEAR DEMONSTRATION OF OUR DESIRE TO GIVE OUR PATIENTS THE OPPORTUNITY TO TELL US WHAT THEIR NEEDS ARE. MOST IMPORTANTLY, IF THEY STATE A NEED, THAT NEED WILL BE ADDRESSED BY CONNECTING THE PATIENT TO THE APPROPRIATE COMMUNITY RESOURCES. LEARNING THE PATIENTS' SOCIAL NEEDS PROVIDES DATA THAT WILL INFORM INVESTMENT AND INITIATIVES, BUT THE SDOH WORKING GROUP FELT STRONGLY THAT IF PATIENTS ARE GOING TO BE ASKED PERSONAL QUESTIONS AND DEMONSTRATE THEIR TRUST IN US BY ANSWERING THEM HONESTLY, WE HAD TO PROVIDE SOME ASSISTANCE ADDRESSING THESE NEEDS OR WE SHOULD NOT ASK THE QUESTION. THESE ARE JUST SOME OF THE PARTNERSHIPS AND INITIATIVES CHRISTIANACARE HAS UNDERTAKEN TO LEARN FROM ITS COMMUNITY ABOUT ITS HEALTH NEEDS. WE EXPECT TO CONTINUE TO LEARN FROM OUR NEIGHBORS AND ALWAYS SEEK NEW WAYS TO CONNECT WITH THEM. -------------------- PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) CHRISTIANACARE FULFILLS ITS MISSION OF SERVING ITS NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON CHRISTIANACARE'S WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL -ASSISTANCE/, AND IN PAMPHLETS THROUGHOUT CHRISTIANACARE FACILITIES, INCLUDING CHRISTIANACARE'S OUTPATIENT PRACTICES. FINANCIAL ASSISTANCE APPLICATIONS ARE ALSO AVAILABLE IN SPANISH, CANTONESE, AND MANDARIN WHICH ARE THE LANGUAGES MOST SPOKEN IN CHRISTIANACARE'S SERVICE AREA BESIDES ENGLISH. TRANSLATION ASSISTANCE TO COMPLETE THE NECESSARY FORMS IS AVAILABLE FOR ANYONE NOT PROFICIENT IN READING, WRITING, OR SPEAKING ENGLISH. A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM IS ALSO AVAILABLE ON OUR WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/PATIENTS/FINANCIAL-ASSISTANCE-PROGRAM/FINANCIAL -ASSISTANCE/. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY APPLIES TO ALL MEDICALLY NECESSARY SERVICES, INCLUDING THE HOSPITAL INPATIENT, OUTPATIENT, AND EMERGENCY DEPARTMENT SERVICES THAT ARE BILLED BY CHRISTIANACARE, AS WELL AS ALL SERVICES RENDERED BY CHRISTIANACARE PHYSICIANS - INCLUDING DENTAL SERVICES THAT REQUIRE HOSPITALIZATION. MEDICALLY NECESSARY SERVICES ARE PROVIDED AT NO CHARGE TO INDIVIDUALS WHOSE HOUSEHOLD INCOME IS LESS THAN 200% OF THE FEDERAL POVERTY LEVEL AND WHO MEET OTHER FINANCIAL ASSISTANCE PROGRAM REQUIREMENTS FOR ELIGIBILITY. UNINSURED INDIVIDUALS WITH A HOUSEHOLD INCOME GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR A STANDARD DISCOUNT OF 15%. IF AN INDIVIDUAL NEEDS ASSISTANCE IN OBTAINING FINANCIAL ASSISTANCE, BESIDES PATIENT FINANCIAL SERVICES REPRESENTATIVES, THE HEALTH GUIDES ARE ALSO AVAILABLE TO PROVIDE INFORMATION AND ASSIST. -------------------- PART VI, LINE 4 (COMMUNITY INFORMATION) NEARLY 80% OF WILMINGTON AND CHRISTIANA HOSPITAL DISCHARGES ARE TO NEW CASTLE COUNTY, DELAWARE, AND SO WE CONSIDER THE CHRISTIANACARE COMMUNITY TO BE PRIMARILY NEW CASTLE COUNTY. THE POPULATION OF NEW CASTLE COUNTY REPRESENTS CONSIDERABLE VARIATION IN SOCIOECONOMIC STATUS. FOR EXAMPLE, THE POVERTY RATE IN ZIP CODE 19801 (WHERE WILMINGTON HOSPITAL IS LOCATED) IS APPROXIMATELY 37% AND THE POVERTY RATE IN ZIP CODE 19701 IS UNDER 5%. BECAUSE OF THAT VARIATION, THE 2019 CHNA ASSESSED COMMUNITY HEALTH NEEDS IN TWO GEOGRAPHIC AREAS: "COMMUNITY 1" (ZIP CODES 19801, 19802, 19804, 19805, AND 19720) AND "COMMUNITY 2" (ALL OTHER ZIP CODES). THE DISTINCTION WAS MADE BETWEEN THESE TWO COMMUNITIES TO ENSURE THAT THE BARRIERS TO HEALTH FACED BY COMMUNITY 1 WOULD NOT BE OVERLOOKED WHEN CONSIDERING NEW CASTLE COUNTY AS A WHOLE. THE TOTAL POPULATION OF NEW CASTLE COUNTY IN 2018 WAS APPROXIMATELY 556,000 PERSONS, WITH COMMUNITY 1 COMPRISED OF APPROXIMATELY 162,000 PERSONS, AND COMMUNITY 2 COMPRISED OF 394,000 PERSONS. THE COUNTY'S POPULATION IS EXPECTED TO GROW 3.4 PERCENT FROM 2018 TO 2023; EVERY ZIP CODE IN NEW CASTLE COUNTY IS PROJECTED TO INCREASE IN POPULATION. THE POPULATION 65 YEARS OF AGE AND OLDER IS ANTICIPATED TO GROW AT A MUCH HIGHER RATE OF 19.2 PERCENT. NOTABLE DIFFERENCES BETWEEN COMMUNITY 1 AND COMMUNITY 2 INCLUDE THE FOLLOWING: - COMMUNITY 1 HAS A MUCH HIGHER "PERCENT RACIAL/ETHNIC MINORITY" THAN COMMUNITY 2. - THE PERCENT OF RESIDENTS IN POVERTY AND CONSIDERED LOW INCOME IN COMMUNITY 1 IS ABOUT DOUBLE THE PERCENT FOR COMMUNITY 2. - RESIDENTS OF COMMUNITY 1 ARE MORE LIKELY TO BE UNINSURED AND TO HAVE LIMITED ENGLISH PROFICIENCY. - HIGH SCHOOL GRADUATION RATES ALSO HAVE BEEN MUCH LOWER IN COMMUNITY 1 THAN IN COMMUNITY 2. MORE DETAILED INFORMATION ON THE DEMOGRAPHICS OF CHRISTIANA CARE'S SERVICE AREA POPULATION CAN BE FOUND WITHIN ITS CHNA AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-NEEDS-ASSESSMENT/. -------------------- PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANACARE'S MISSION IS TO SERVE OUR NEIGHBORS AS RESPECTFUL, CARING, PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, AFFORDABLE, SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. WE ARE COMMITTED TO FULFILLING OUR MISSION OF SERVICE TO OUR NEIGHBORS, AND AS THE LARGEST HEALTH CARE PROVIDER IN A STATE THAT HAS NO SAFETY NET OR PUBLIC HOSPITAL; WE SERVE A SIGNIFICANT PORTION OF THE COMMUNITY'S UNINSURED AND UNDERINSURED POPULATION ALONG WITH A SUBSTANTIAL PORTION OF THE STATE'S MEDICAID POPULATION. IN DEMONSTRATION OF OUR COMMITMENT TO SERVING OUR NEIGHBORS, IN JULY 2019, CHRISTIANACARE ENTERED INTO AGREEMENTS WITH DELAWARE'S TWO LARGEST MEDICAID PAYORS TO WORK WITH BENEFICIARIES IN POPULATION HEALTH CONTRACTS. AT CHRISTIANACARE, WE ARE KEENLY AWARE OF THE IMPORTANCE OF OUR COMMITMENT TO THE HEALTH OF OUR COMMUNITIES. EACH YEAR, CHRISTIANACARE'S WILMINGTON HOSPITAL HEALTH CENTER ATTRACTS APPROXIMATELY 75,000 PATIENT VISITS. A SIGNIFICANT NUMBER WHEN YOU CONSIDER THE ENTIRE POPULATION OF NEW CASTLE COUNTY IS 556,000 INDIVIDUALS. CHRISTIANACARE ALSO PROVIDES SERVICES THAT DELAWAREANS CANNOT FIND ELSEWHERE IN THE STATE SUCH AS KIDNEY TRANSPLANT, AN EPILEPSY MONITORING UNIT, AND A COMPREHENSIVE PAIN CENTER, LAUNCHED DURING THIS REPORTING PERIOD, WHICH OFFERS EFFECTIVE, NON-OPIOID PAIN TREATMENT STRATEGIES FOR INDIVIDUALS WITH ACUTE AND CHRONIC PAIN. CHRISTIANACARE'S CENTER FOR SPECIAL HEALTH CARE NEEDS, BASED IN THE WILMINGTON HOSPITAL, IS THE ONLY CENTER IN THE AREA DEDICATED TO CARING FOR ADULTS AGED 18 AND OLDER WITH COMPLEX MEDICAL AND SOCIAL CONDITIONS WHICH ORIGINATED IN CHILDHOOD SUCH AS CYSTIC FIBROSIS, HEMOPHILIA, AND INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. THE CENTER FOR SPECIAL HEALTH CARE NEEDS HELPS PATIENTS AND THEIR FAMILIES WITH THE TRANSITION BETWEEN PEDIATRIC AND ADULT CARE BY PROVIDING THEM WITH ACCESSIBLE AND CONVENIENT CARE AND BY CONNECTING THEM WITH RESOURCES IN THE COMMUNITY. ENSURING THAT PATIENTS HAVE A POSITIVE TRANSITION FROM PEDIATRIC TO ADULT CARE IS IMPORTANT AS STUDIES HAVE SHOWN DECLINES IN HEALTH FOR CERTAIN DISEASES ONCE A PATIENT AGES OUT OF PEDIATRIC CARE. MUCH LIKE THE CENTER FOR SPECIAL HEALTH CARE NEEDS, THE NEWLY CREATED CENTER FOR HOPE AND HEALING ALSO SEEKS TO SERVE PATIENTS WITH COMPLEX NEEDS IN A COMPREHENSIVE MANNER, WITH A FOCUS ON MENTAL HEALTH NEEDS AS A PRIMARY DIAGNOSIS. INDIVIDUALS AT THE CENTER FOR HOPE AND HEALING HAVE A TEAM OF SUPPORT THAT HELPS GET INDIVIDUALS STABILIZED AND THEN ADDRESS THEIR PHYSICAL, MENTAL, AND SOCIAL NEEDS. SIGNIFICANT RESEARCH IS ALSO HAPPENING ON THE CHRISTIANACARE CAMPUS. DURING THIS REPORTING PERIOD, CHRISTIANACARE SCIENTISTS IN THE HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE FOUND THAT THE CRISPR-CAS9 GENE EDITING SYSTEM MAY BE ABLE TO DELETE A GENE IN CANCER TUMORS THAT LEADS TO THE TUMOR DEVELOPING A RESISTANCE TO CHEMOTHERAPIES USED TO TREAT LUNG CANCER. THE FOCUS OF THIS STUDY WAS TO DETERMINE HOW CRISPR AND CHEMOTHERAPY CAN BE USED TOGETHER TO EFFECTIVELY COMBAT CANCER. CHRISTIANACARE'S CENTER FOR TRANSLATIONAL CANCER RESEARCH ALSO RECEIVED A NEARLY $1 MILLION GRANT FROM THE LISA DEAN MOSELEY FOUNDATION IN EARLY 2019 TO FURTHER STEM CELL RESEARCH INTO THE ORIGINS OF COLON CANCER. WITH THIS THREE-YEAR GRANT, CHRISTIANACARE SCIENTISTS WILL BUILD ON THEIR DISCOVERY THAT STEM CELL OVERPOPULATION DRIVES CANCER DEVELOPMENT AND GROWTH IN THE COLON. OUR EXPECTATION IS THAT THIS WORK WILL CONTRIBUTE TO THE DEVELOPMENT OF TARGETED AND MORE EFFECTIVE CANCER TREATMENT STRATEGIES. THESE ARE BUT TWO EXAMPLES OF THE EXCITING AND INNOVATIVE WORK HAPPENING AT CHRISTIANACARE TO SERVE ITS PATIENTS, AND THE BROADER POPULATION, WITH POTENTIAL BREAKTHROUGHS AND MODELS TO BE EMULATED. CHRISTIANACARE IS ALSO PROUD OF ITS VALUE INSTITUTE WHICH CONDUCTS REAL-WORLD RESEARCH ON PRESSING HEALTH CARE ISSUES. THE MISSION OF THE VALUE INSTITUTE IS TO DEVELOP, DELIVER AND EVALUATE INNOVATIVE PRACTICE AND POLICY SOLUTIONS THAT IMPROVE THE EXPERIENCE, EFFICIENCY AND EFFECTIVENESS OF HEALTH CARE FOR PATIENTS AND PROVIDERS ALIKE. CHRISTIANACARE'S GOVERNING BODY, ITS BOARD OF DIRECTORS, IS COMPRISED OF PERSONS WHO RESIDE IN ITS PRIMARY SERVICE AREA, AND MOST OF THE BOARD MEMBERS ARE NOT EMPLOYEES, INDEPENDENT CONTRACTORS, OR FAMILY MEMBERS OF CHRISTIANACARE. AS DESCRIBED IN THE CHNA AND CHIP, CHRISTIANACARE FINANCIALLY SUPPORTS IMPROVEMENTS IN ACCESSING CARE, COMMUNITY OUTREACH, IMPROVING THE CARE AND OVERALL HEALTH OF OUR NEIGHBORS, AND CONTINUING TO SUPPORT MEDICAL EDUCATION AND RESEARCH. CHRISTIANACARE INNOVATIVELY SERVES ITS COMMUNITY THROUGH CAREVIO, A CARE MANAGEMENT PROGRAM WHICH CURRENTLY MANAGES MORE THAN 100,000 LIVES. CAREVIO IS A ROBUST INFORMATION TECHNOLOGY PLATFORM THAT HARNESSES REAL-TIME HEALTH DATA FROM ALL AVAILABLE SOURCES. IT USES A PREDICTION ANALYTICS ENGINE TO COORDINATE CARE, IDENTIFY POPULATIONS MOST AT-RISK AND HELP PREVENT THE NEED FOR HOSPITALIZATIONS AND EMERGENCY DEPARTMENT VISITS THROUGH PREVENTIVE CARE AND, WHEN APPROPRIATE, HOME CARE. CAREVIO HAS MORE THAN 50 NURSE CARE COORDINATORS, SOCIAL WORKERS, CLINICAL PHARMACISTS, RESPIRATORY THERAPISTS AND MEDICAL DIRECTORS WHO CONNECT WITH PATIENTS BY PHONE, VIDEO, IN-PERSON VISITS, SECURE TEXTING AND E-MAIL TO HELP THEM MANAGE THEIR HEALTH CARE. CAREVIO'S COMMUNITY TEAM, A SMALL GROUP OF DOCTORS, PHARMACISTS, NURSE CARE COORDINATORS AND SOCIAL WORKERS, FOCUSES ON REDUCING HOSPITAL AND EMERGENCY DEPARTMENT USE FOR PEOPLE WHO STRUGGLE WITH A COMBINATION OF SOCIAL BARRIERS TO HEALTH AND AT LEAST ONE POORLY CONTROLLED MEDICAL DIAGNOSIS. SINCE JANUARY 2016, THE COMMUNITY TEAM HAS ASSISTED MORE THAN 900 PEOPLE, WITH OVER 9,200 PERSONAL INTERVENTIONS. THEY ACHIEVED A 35% REDUCTION IN EMERGENCY DEPARTMENT USE AND A 25% REDUCTION IN HOSPITAL STAYS. CHRISTIANACARE IS ALSO A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES MORE THAN 45,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CAREVIO ALSO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. EACH DAY, CHRISTIANACARE CONNECTS WITH ITS NEIGHBORS IN THEIR NEIGHBORHOODS AT PLAY STREETS WILMINGTON EVENTS, AT CHAT & CHEWS HELD IN COMMUNITY CENTERS WHERE PARENTS ARE OFFERED PARENTING EDUCATION AND LUNCH, IN THEIR HOMES FOLLOWING AN OPIOID OVERDOSE WITH ENCOURAGEMENT TO SEEK TREATMENT, IN CLASSROOMS THROUGHOUT THE STATE WHERE STUDENTS ARE TAUGHT HOW TO PREVENT INJURIES AND THE REAL IMPACT OF VIOLENCE, AND AT FARM STANDS THROUGHOUT THE CITY OF WILMINGTON. CHRISTIANACARE IS FOCUSED ON PROVIDING THE RIGHT CARE, AT THE RIGHT TIME, IN THE RIGHT PLACE. WE ARE COMMITTED TO MAKING GOOD HEALTH ACCESSIBLE FOR EVERYONE, AND WE KNOW THIS MEANS MEETING PEOPLE WHERE THEY ARE WHICH IS OFTEN OUT IN THE COMMUNITY, OUTSIDE OF THE HOSPITAL OR THE PRIMARY CARE OFFICE. CHRISTIANACARE ALSO WORKS TO IMPROVE THE HEALTH OF ITS COMMUNITIES BY DIRECTLY ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THROUGH THE HARRINGTON VALUE INSTITUTE PARTNERSHIP COMMUNITY FUND WHICH WAS ESTABLISHED IN 2015 TO FOSTER PARTNERSHIPS BETWEEN THE COMMUNITY, CHRISTIANACARE, AND CHRISTIANACARE'S VALUE INSTITUTE. THE PURPOSE OF THE HARRINGTON VALUE INSTITUTE COMMUNITY PARTNERSHIP FUND IS TO SUPPORT RESEARCH AND PROGRAM DEVELOPMENT IN THE AREAS OF POPULATION HEALTH TO ADDRESS COMMUNITY NEEDS, SUCH AS PROVIDING CARE FOR THE DISADVANTAGED OR UNDERSERVED AND REDUCING DISPARITIES IN HEALTH. THE HARRINGTON VALUE INSTITUTE COMMUNITY PARTNERSHIP FUND WILL SUPPORT PROJECTS ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH AND CLINICAL OUTCOMES. THE DELAWARE MEDICAL LEGAL PARTNERSHIP AND THE SCHOOL-BASED HEALTH CENTER COMMUNITY ADVISORY BOARD DISCUSSED IN PREVIOUS SECTIONS WERE HARRINGTON FUND AWARDEES. IN FISCAL YEAR 2020, EIGHT ORGANIZATIONS RECEIVED GRANTS THROUGH THE HARRINGTON VALUE INSTITUTE COMMUNITY PARTNERSHIP FUND. COMBINED GRANT FUNDS WERE APPROXIMATELY $375,000. THE HARRINGTON VALUE INSTITUTE COMMUNITY PARTNERSHIP FUND ALSO OFFERS A 12-MONTH EXPERIENTIAL TRAINING PROGRAM DESIGNED TO SUPPORT UNDER-REPRESENTED MINORITY, PRE-MED STUDENTS FROM DELAWARE WHO HAVE GRADUATED FROM COLLEGE AND ARE INTERESTED IN PURSUING CLINICAL AND TRANSLATIONAL RESEARCH CAREERS. CHRISTIANACARE SUPPORTS THE FIRST STATE SCHOOL LOCATED IN ITS WILMINGTON HOSPITAL IN PARTNERSHIP WITH THE RED CLAY CONSOLIDATED SCHOOL DISTRICT AND THE DELAWARE DEPARTMENT OF EDUCATION. CHILDREN AND ADOLESCENTS IN KINDERGARTEN THROUGH HIGH SCHOOL, WHO WOULD TYPICALLY BE HOMEBOUND WITH SERIOUS ILLNESSES LIKE DIABETES, SICKLE-CELL ANEMIA, SEVERE ASTHMA, CANCER, AND OTHER ILLNESSES HAVE THE OPPORTUNITY TO ATTEND SCHOOL WITH THEIR PEERS WHILE RECEIVING NEEDED MEDICAL TREATMENT. THIS PROGRAM IS ONLY ONE OF THREE IN OPERATION NATIONWIDE, AND IT HAS BEEN A STAPLE OF CHRISTIANACARE'S COMMUNITY PROGRAMS SINCE IT BEGAN SERVING ADOLESCENTS IN 1985 AND EXPANDED TO SERVE ELEMENTARY STUDENTS IN 1991. CHRISTIANACARE IS ALSO A MAJOR TEACHING HOSPITAL WITH TWO CAMPUSES AND MORE THAN 260 MEDICAL-DENTAL RESI PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) CHRISTIANA CARE IS A MAJOR TEACHING HEALTH SYSTEM WITH MORE THAN 1,600 MEDICAL-STAFF MEMBERS AND 260 MEDICAL-DENTAL RESIDENTS AND FELLOWS. MAJOR FACILITIES INCLUDE: - CHRISTIANA HOSPITAL-STANTON CAMPUS: LOCATED IN NEWARK, DELAWARE, THIS CAMPUS IS HOME TO THE 906 LICENSED BED CHRISTIANA HOSPITAL, THE CHRISTIANA CARE CENTER FOR HEART & VASCULAR HEALTH, THE HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE, THE CHRISTIANA CARE BREAST CENTER, THE CHRISTIANA SURGICENTER, AND THE JOHN H. AMMON MEDICAL EDUCATION CENTER. CHRISTIANA HOSPITAL IS ALSO THE STATE'S ONLY HIGH RISK DELIVERY HOSPITAL FEATURING A LEVEL III NEONATAL INTENSIVE CARE UNIT. CHRISTIANA HOSPITAL IS ALSO A LEVEL I TRAUMA CENTER. - WILMINGTON HOSPITAL CAMPUS: LOCATED IN THE HEART OF THE CITY OF WILMINGTON, THIS CAMPUS IS THE CORPORATE HEADQUARTERS FOR THE HEALTH SYSTEM AND INCLUDES THE 321 LICENSED BED WILMINGTON HOSPITAL, THE ROCCO A. ABESSINIO FAMILY WILMINGTON HOSPITAL HEALTH CENTER, THE CENTER FOR REHABILITATION, THE CENTER FOR ADVANCED JOINT REPLACEMENT, THE WILMINGTON ANNEX, THE SWANK MEMORY CENTER, THE FIRST STATE SCHOOL, AND THE ROXANA CANNON ARSHT SURGICENTER. WILMINGTON HOSPITAL IS A LEVEL III TRAUMA CENTER. - MIDDLETOWN EMERGENCY DEPARTMENT: CHRISTIANA CARE FACILITIES ALSO INCLUDE AN EMERGENCY DEPARTMENT FACILITY IN MIDDLETOWN, DELAWARE, THAT SERVES THE MIDDLETOWN, ODESSA AND TOWNSEND, DELAWARE POPULATIONS ON A 24-7 BASIS. THE FACILITY CONTAINS 18 TREATMENT ROOMS, AND IS AVAILABLE TO SERVE MANY OF THE FREQUENT EMERGENCY CARE NEEDS OF THE LOCAL COMMUNITY. -------------------- PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) DELAWARE DOES NOT REQUIRE THE FILING OF A COMMUNITY BENEFIT REPORT. IN THE INTEREST OF SHARING INFORMATION ABOUT ITS COMMUNITY BENEFIT WITH ITS NEIGHBORS, CHRISTIANACARE HAS ESTABLISHED A COMMUNITY BENEFIT DEDICATED SECTION ON ITS WEBSITE WHERE THE CHNA AND CHIP CAN BE FOUND, ALONG WITH ARTICLES ABOUT CHRISTIANACARE'S COMMUNITY BENEFIT INITIATIVES AND STORIES. THIS GROWING COLLECTION OF STORIES CAN BE ACCESSED AT: HTTPS://NEWS.CHRISTIANACARE.ORG/CATEGORY/IN-THE-COMMUNITY/. -------------------- X true true X X X X X true true false false false false false true false THOMAS L CORRIGAN FORMER EXECUTIVE VP AND CFO 375782 0 244258 0 271856 0 27211 0 8927 0 928034 0 0 0 JAMES HOPKINS MD MEMBER 421096 0 85000 0 12000 0 27211 0 9134 0 554441 0 0 0 BRENDA K PIERCE ESQ FORMER SECRETARY OF CORP 162761 0 80000 0 214181 0 24349 0 3707 0 484998 0 0 0 AUDREY VAN LUVEN FORMER SR VP&CHIEF HR OFFICER 0 0 262129 0 197305 0 7961 0 0 0 467395 0 0 0 JANICE E NEVIN MD PRESIDENT & CEO 1084695 0 606867 0 61229 0 172471 0 10734 0 1935996 0 0 0 PAUL DAVIS PHYSICIAN 745991 0 112650 0 0 0 25836 0 15956 0 900433 0 0 0 KENNETH SILVERSTEIN EXECUTIVE VICE PRESIDENT 636806 0 223684 0 0 0 87917 0 15956 0 964363 0 0 0 KIRK GARRATT MEDICAL DIRECTOR HVIS 594866 0 138457 0 58177 0 24461 0 5456 0 821417 0 0 0 RAY BLACKWELL CHIEF CARDIAC SURGERY 694674 0 88576 0 0 0 27211 0 15956 0 826417 0 0 0 RICHARD CUMING CHIEF NURSING EXECUTIVE 417393 0 148055 0 0 0 66462 0 9134 0 641044 0 0 0 MICHAEL EPPEHIMER CHIEF OP. OFFICER - MED GROUP 328385 0 91375 0 4819 0 45277 0 15956 0 485812 0 0 0 SHARON KURFUERST CHIEF OP. OFFICER - HEALTH SVC 332113 0 90917 0 0 0 59451 0 15956 0 498437 0 0 0 JOSEPH BENNETT MD MEMBER 464658 0 33303 0 38500 0 24461 0 14180 0 575102 0 0 0 BRIAN GALINAT MD CHIEF ORTHOPAEDIC SURGERY 319626 0 92336 0 365399 0 27211 0 8398 0 812970 0 0 0 NICHOLAS PETRELLI MD MEDICAL DIRECTOR, CANCER 579243 0 162037 0 32130 0 27211 0 9134 0 809755 0 0 0 NEIL JASANI CHIEF PEOPLE OFFICER 432504 0 156193 0 0 0 69335 0 15956 0 673988 0 0 0 JENNIFER L SCHWARTZ ESQ SECRETARY OF CORP 184761 0 85000 0 0 0 18374 0 8260 0 296395 0 0 0 ROB MCMURRAY CFO, TREASURER & ASS'T SEC'Y 333074 0 62299 0 8817 0 50594 0 15956 0 470740 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 1A DETAIL REGARDING BENEFITS PROVIDED SOCIAL CLUB DUES CCHS PROVIDES A SOCIAL CLUB MEMBERSHIP TO BE USED BY THE PRESIDENT IN CONNECTION WITH THEIR DUTIES. THE PRESIDENT IS RESPONSIBLE FOR AND TAXED ON ANY PERSONAL USE OF SUCH CLUB MEMBERSHIP. -------------------- FORM 990, SCHEDULE J, PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS AUDREY VAN LUVEN RECEIVED A SEVERANCE DISTRIBUTION OF $197,305 DURING THE 2018 CALENDAR YEAR. BRIAN GALINAT RECEIVED A SEVERANCE DISTRIBUTION OF $142,056 DURING THE 2018 CALENDAR YEAR. -------------------- FORM 990, SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED PLAN PARTICIPATION CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAINTAINS AN IRC SECTION 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED AND/OR RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: THOMAS L. CORRIGAN- $69,293 BRIAN GALINAT- $27,701 KIRK GARRATT, MD- $35,758 JANICE E. NEVIN, MD- NO DISTRIBUTION NICHOLAS PETRELLI- $34,476 BRENDA PIERCE- $27,701 -------------------- FORM 990, SCHEDULE J, PART I, LINE 7 PROVISION OF NON-FIXED PAYMENTS CCHS PROVIDES DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE CCHS COMPENSATION COMMITTEE THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. A DELAWARE HLTH FACILITIES AUTHORITY SERIES 2008 510272458 246388NVO 2008-11-20 80000000 REFINANCE SERIES 2004 & MED BLDG false false false B DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010A 510272458 246388EQ5 2010-11-04 74491341 CONSTRUCTION OF HOSPITAL false false false C DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010 510272458 246388QPO 2010-11-04 127295000 CONSTRUCTION OF HOSPITAL false false false A 7210000 0 80000000 0 0 0 774850 0 0 19062025 60163125 0 2006 true false true true B 15360000 0 74956804 0 0 0 879197 0 0 74077607 0 0 2014 false false true true C 16620000 0 128314967 0 0 0 684318 0 0 127630649 0 0 2014 false false true true A false false false true true 0 false false false true B false false false true true 0 false false false true C false false false true true 0 false false false true A false true true false 0 false 0 false true B false true false false 0 false 0 false true C false true true false 0 false 0 false true A true B true C true FORM 990, SCHEDULE K, PART II, LINE 3 FOR DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010A, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $465,463 IN INVESTMENT EARNINGS. FOR DELAWARE HLTH FACILITIES AUTHORITY SERIES 2010, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $1,119,967 IN INVESTMENT EARNINGS. -------------------- FORM 990, SCHEDULE K, PART IV, LINE 2C, COLUMNS A, B, AND C AN ARBITRAGE REBATE AND YIELD RESTRICTION COMPLIANCE ANALYSIS WAS COMPLETED BY THE PFM GROUP FOR THE DELAWARE HEALTH FACILITIES AUTHORITY 2008 BONDS ON NOVEMBER 19, 2018 AND THE DELAWARE HEALTH FACILITIES AUTHORITY 2010 BONDS ON NOVEMBER 4, 2015. FORM 990, PART III, LINE 4D DETAIL OF OTHER PROGRAM SERVICES CHRISTIANACARE HEALTH SERVICES ("CCHS"), HEADQUARTERED IN WILMINGTON, DELAWARE, IS ONE OF THE COUNTRY'S LARGEST HEALTH CARE PROVIDERS AND IS A MAJOR TEACHING HOSPITAL WITH TWO CAMPUSES AND MORE THAN 260 MEDICAL-DENTAL RESIDENTS AND FELLOWS. CHRISTIANACARE IS RECOGNIZED AS A REGIONAL CENTER FOR EXCELLENCE IN CARDIOLOGY, CANCER AND WOMEN'S HEALTH SERVICES. THE SYSTEM FEATURES A LEVEL 3 NEONATAL INTENSIVE CARE UNIT, THE ONLY DELIVERING HOSPITAL IN THE STATE TO OFFER THIS LEVEL OF CARE FOR NEWBORNS. CHRISTIANA CARE HEALTH SERVICES IS ALSO HOME TO DELAWARE'S ONLY LEVEL 1 TRAUMA CENTER, THE ONLY OF ITS KIND BETWEEN PHILADELPHIA AND BALTIMORE. A NOT-FOR-PROFIT, NON-SECTARIAN HEALTH SYSTEM, CHRISTIANACARE INCLUDES TWO HOSPITALS WITH MORE THAN 1,200 PATIENT BEDS, PREVENTIVE MEDICINE, REHABILITATION SERVICES, A NETWORK OF PRIMARY CARE PHYSICIANS AND AN EXTENSIVE RANGE OF OUTPATIENT SERVICES. WITH MORE THAN 11,300 EMPLOYEES, CHRISTIANACARE IS THE LARGEST PRIVATE EMPLOYER IN DELAWARE AND ONE OF THE LARGEST EMPLOYERS IN THE PHILADELPHIA REGION. -------------------- FORM 990, PART VI, SECTION A, LINE 2 FAMILY AND BUSINESS RELATIONSHIPS GEORGE FOUTRAKIS, TRUSTEE, AND PAUL KANIEFSKI, TRUSTEE, HAVE A BUSINESS RELATIONSHIP. -------------------- FORM 990, PART VI, SECTION A, LINE 7A,B GOVERNING BODY AND MANAGEMENT THE BOARD OF DIRECTORS OF CHRISTIANACARE HEALTH SYSTEM, INC. ("SYSTEM"), SOLE MEMBER OF CHRISTIANACARE HEALTH SERVICES, INC. ("CCHS"), AT IT'S ANNUAL MEETING IN NOVEMBER, ELECTS DIRECTORS OF CHRISTIANACARE. THE ANNUAL OPERATING BUDGET OF CHRISTIANACARE IS APPROVED BY THE CHRISTIANACARE BOARD, THE SYSTEM FINANCE COMMITTEE AND THE SYSTEM BOARD. -------------------- FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS INFORMATION RELATED TO CHRISTIANACARE'S FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP FOR REVIEW. THE FINAL 2018 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2019 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2018 FORM 990 VIA ITS BOARD OF DIRECTOR'S PORTAL. ------------------ FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OUR CONFLICT OF INTEREST ("COI") POLICY IS LOCATED IN THE CAREGIVER RESOURCE CENTER ON THE EMPLOYEE PORTAL. THERE IS AN ANNUAL MANDATORY EDUCATION FOR MANAGERS WHICH INCLUDES AN ELECTRONIC SIGN OFF ACKNOWLEDGING COMPLETION OF THE EDUCATION, REPORTING OF A REAL OR PERCEIVED CONFLICT OR THAT NO CONFLICTS OF INTEREST EXISTS. THE HR/EMPLOYEE RELATIONS TEAM FOLLOWS UP WITH ANYONE WHO HAS A CONFLICT OR PERCEIVED CONFLICT OR DOES NOT COMPLETE THE EDUCATION IN ORDER TO RESOLVE. THE EMPLOYEE HANDBOOK SETS EXPECTATIONS FOR EMPLOYEE CONFLICTS OF INTEREST. SEVERAL REPORTING MECHANISMS ALSO EXIST FOR EMPLOYEES TO REPORT CONCERNS. THE BOARD OF DIRECTORS HAS THEIR OWN COI POLICY. COI IS A STANDING AGENDA ITEM ON EACH BOARD OR BOARD COMMITTEE MEETING. BOARD MEMBERS EXPECTATIONS FOR COI ARE CLEARLY COMMUNICATED. -------------------- FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL PROCESS THE BOARD OF DIRECTORS ESTABLISHES CHRISTIANACARE'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE BOARD ENGAGES AN INDEPENDENT THIRD PARTY ANNUALLY WHO ASSESSES DATA FROM SEVERAL MAJOR SURVEYS TO ENSURE TOTAL REMUNERATION IS MARKET COMPETITIVE AND QUALIFIES FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULE, SECTION 4958 OF THE INTERNAL REVENUE CODE. AFTER DELIBERATION, THE ECC DOCUMENTS THEIR DECISIONS IN MEETING MINUTES. -------------------- FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT, & DISCLOSURE THE FORM 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF CHRISTIANACARE ARE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE WEB THROUGH DIGITAL ASSURANCE CERTIFICATION ("DAC"). -------------------- FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS CHANGE IN PENSION AND POSTRETIREMENT LIABILITIES $ (55,800,442) CHANGE IN NET ASSETS OF THE SYSTEM 2,046,972 OTHER 326,788 ----------- TOTAL $ (53,426,682) =========== CHRISTIANA CARE CAMPUS REALTY LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE 0 0 CCHS CHRISTIANA CARE QUALITY PARTNERS LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -212391 0 CCHS CHRISTIANA CARE QUALITY PARTNERS ACOLLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -1365073 906 CCHS CHRISTIANA CARE CARE LINK LLC 501 WEST 14TH STREET WILMINGTON DE 19801 510103684 SUPPORT SRVCS DE -4037204 334044 CCHS CHRISTIANA CARE HEALTH SYSTEM INC 501 WEST 14TH STREET WILMINGTON DE 19801 521479538 FUNDRAISING DE 501(c)(3) 7 NA false CHRISTIANA CARE HLTH INITIATIVES INC 200 HYGEIA DRIVE SUITE 2300 NEWARK DE 19713 510295186 OUTPATIENT SV DE 501(c)(3) 10 CCHS SYSTEM false CHRISTIANA CARE HOME HEALTH & COM SRVCS 1 READS WAY NEW CASTLE DE 19720 510064334 HOME HLTHCARE DE 501(c)(3) 7 CCHS SYSTEM false THE DE CTR FOR MAT FETAL MED OF CC INC 200 HYGEIA DRIVE NEWARK DE 19713 205891272 HEALTHCARE DE CCHS C CORP 45187 2751756 1.00000 true CHRISTIANA CARE HEALTH PLANS 200 HYGEIA DRIVE OFFICE 2524 NEWARK DE 19713 510352728 INSURANCE DE CCHS SYSTEM C CORP false CHRISTIANA CARE DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 816359549 DEF COMP PLAN DE CC HEALTH SRVCS TRUST true CHRISTIANA CARE EXEC DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048822 DEF COMP PLAN DE CC HEALTH SRVCS TRUST true CARE ASSOCIATES DEFERRED COMP PLAN 4755 OGLETOWN STANTON RD NEWARK DE 19718 357048714 DEF COMP PLAN DE CC HEALTH SRVCS TRUST true CHRISTIANA CARE INSURANCE CO LTD PO BOX 1159 878 W BAY RD GRAND CAYMAN CJ KY1-1102 981489490 SELF-INSURANCE CJ CC HEALTH SRVCS C-CORP -8388 52297605 1.00000 true true false true false false false false false false true false false true true true true true true true THE DE CTR FOR MAT FETAL MED OF CC INC A,O 514255 FMV CHRISTIANA CARE INSURANCE CO LTD R 36534378 FMV CHRISTIANA CARE HEALTH SYSTEM CJMNO 7987631 FMV DIRECT OTHER LOBBYING EXEMPT PURPOSE NAME OF ELECTING ORGANIZATION EXPENDITURES EXPENDITURES __________________________________ ____________ _______________ CHRISTIANA CARE HEALTH SYSTEM $ NONE $ 3,441,481 CHRISTIANA CARE HEALTH SERVICES 218,022 1,912,065,255 CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES NONE 47,145,997 CHRISTIANA CARE HEALTH INITIATIVES NONE 6,290,453 ------------ -------------- TOTAL $ 218,022 $ 1,968,943,188 THE ORGANIZATION HAS MADE THE LOBBYING ELECTION UNDER I.R.C. SECTION 501(H) FOR THE TAX YEAR ENDED JUNE 30, 2019. THIS ELECTION HAS NOT BEEN REVOKED BEFORE THE START OF THE ORGANIZATION'S TAX YEAR THAT BEGAN IN 2018.