2019-03-15T10:54:44-05:00 2018-04-30 KPMG LLP 1212 North 96th Street Suite 300 OMAHA NE 68114 990 2017-05-01 470542043 Columbus Community Hospital Inc % Jennifer Weick COLU 4025623357 PO Box 1800 Columbus NE 68602 CHAD VAN CLEAVE CFO 2019-03-15 true DONALD NEAL JR P00798244 4023481450 167.68.102.5 47006120190745000009 2019-03-15 P 55718AD0153E791F3315D72D27656E543FED7AC8 55718AD0153E791F3315D72D27656E543FED7AC8 2017 2019-02-21 02:37:17Z Chad Van Cleave 4600 38th Street Columbus NE 68601 105720479 false X www.columbushosp.org X 1972 NE Our mission is to improve the health of the communities we serve. 11 11 817 228 191419 -119946 166412 672544 92297270 101377066 476260 1278055 1793461 2131847 94733403 105459512 1127833 1690878 0 0 44490247 48766021 0 0 0 37097142 40405078 82715222 90861977 12018181 14597535 127571692 141605032 7824117 6980848 119747575 134624184 X Our mission is to improve the health of the communities we serve. false false 86625293 176738 101508358 See Schedule O 1514140 1514140 0 See Schedule O 88139433 true true false true false false false false false true true false false false false true false true false false false false false false false false true true true true true false false false false false false false false false false false false false true true true true false true 83 0 true 817 true true true false false false false false false false false false X 11 11 false false false false false false false true true false false true true true true true true true true false X Jennifer Weick 4025623362 4600 38th Street Columbus NE 68601 X Clark Lehr Chairman 1.0 0.0 X X 0 0 0 Brett Bonwell Vice Chairman 1.0 0.0 X X 0 0 0 Jeff Gokie Treasurer 1.0 0.0 X X 0 0 0 Brian Schmidt Director 1.0 0.0 X 0 0 0 Beth Przymus Director 1.0 0.0 X 0 0 0 Julie Haney Director 1.0 0.0 X 0 0 0 Dale Zaruba MD Director 1.0 0.0 X 0 0 0 Jeffrey Gotschall MD Director 1.0 0.0 X 0 0 0 Bonnie McPhillips Director 1.0 0.0 X 0 0 0 Stan Emerson Director 1.0 0.0 X 0 0 0 Tim Tooley Director 1.0 0.0 X 0 0 0 Amy Blaser VP Business Development 40.0 0.0 X 164275 0 43540 Chad Van Cleave VP Finance 40.0 0.0 X 161976 0 44102 Scott Messersmith VP Operations 40.0 0.0 X 156339 0 42950 Linda Walline VP Nursing (Thru May 2017) 40.0 0.0 X 122793 0 14105 Dorothy Bybee VP Nursing (Begin May 2017) 40.0 0.0 X 124060 0 17838 Michael Hansen President/CEO/Secretary 39.0 1.0 X 477724 0 79092 Dustin Volkmer MD Physician 40.0 0.0 X 606876 0 36566 Edward Fehringer MD Physician 40.0 0.0 X 758721 0 36566 Michael McGuire MD Physician 40.0 0.0 X 501284 0 36566 Richard Cimpl MD Physician 40.0 0.0 X 696166 0 36566 Ian Crabb MD Physician 40.0 0.0 X 574493 0 25766 4344707 0 413657 52 false true false McKesson Technologies Inc PO Box 98347 Chicago IL 60693 IT Consulting 1375082 Inpatient Physician Associates 3200 Pine Lake Rd Suite A Lincoln NE 68516 Hospitalist Svcs 1096717 B-D Construction Inc 2154 East 32nd Ave Columbus NE 68601 Construction 963467 Focusone Solutions PO Box 3037 Omaha NE 68103 Contract Labor 391304 Renovo Solutions LLC 4 Executive Circle Suite 185 Irvine CA 92614 Equipment Maint 223118 9 647873 24671 672544 Net Patient Service Revenue 621110 101377066 101377066 101377066 985334 985334 0 0 399872 260967 138905 0 138905 138905 292721 292721 292721 292721 0 0 0 0 0 0 0 0 0 Meals on Wheels 900099 66532 66532 Cafeteria 900099 330907 330907 Health Watch 900099 64760 64760 1530743 191419 1339324 1992942 105459512 101508358 191419 3087191 176738 176738 1514140 1514140 0 0 1448794 1448794 0 36942648 36942648 1269463 1269463 6601975 6601975 2503141 2503141 0 123639 123639 243680 243680 6446 6446 0 29895 29895 3898838 3898838 381483 381483 12905800 12782203 123597 2226933 2226933 0 1551979 1551979 245230 245230 0 149675 149675 0 0 6906052 6906052 292399 292399 Provision for Bad Debts 4841393 4841393 0 0 Minor Equip & Financing AGR 2551153 2551153 Purchased Services 2767254 2767254 Recruiting 577424 577424 705805 705805 90861977 88139433 2722544 0 11776546 11711800 0 0 0 0 10954395 7497208 0 0 0 0 644121 648169 1826002 2312992 2130291 1783886 122700871 69937921 53578639 52762950 46390805 64540522 0 0 0 0 0 0 270893 347505 127571692 141605032 7824117 6980848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7824117 6980848 X 119747575 134624184 0 0 0 0 119747575 134624184 127571692 141605032 X 14597535 73939 205135 X false true X true false X false false false false false false true false true 6446 6446 false Schedule C, Part II-B, Line 1g DIRECT CONTACT WITH STATE AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENT OFFICIALS. WE HAVE ADVOCATED FOR RURAL HEALTHCARE LEGISLATION (E.G. RURAL HOSPITAL DEMONSTRATION PROGRAM). Schedule C, Part II-B, Line 1i Dues paid to American Hospital Association allocated to lobbying $3,033 and dues paid to Nebraska Hospital Association allocated to lobbying $3,413. 1846405 17400 1863805 1832057 14348 1846405 1806283 25774 1832057 1798246 8037 1806283 1742125 56121 1798246 1.00000 false true true 1152275 1152275 68332500 30240138 38092362 44662868 36449181 8213687 8553228 3248602 5304626 52762950 0 0 X Schedule D, Part V, Line 4 Endowment funds are held and maintained by Columbus Community Hospital Foundation. The endowment funds exist in support of improved health services by Columbus Community Hospital. Schedule D, Part X, Line 2 The Hospital adopted Financial Accounting Standards Board (FASB) Interpretation No. 48, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No, 109. FIN 48 provides specific guidance on how to address uncertainty in accounting for income tax assets and liabilities, prescribing recognition thresholds and measurement attributes. The adoption of FIN 48 by Columbus Community Hospital did not have a material impact on the Hospital's financial position, results of operations, or cash flows. In fiscal years ending 2018 and 2017, management determined that there are no income tax positions requiring recognition in the financial statements. true true X true X 130. true X true true false true true 753890 753890 0.00880 5589130 1149372 4439758 0.05160 6343020 1149372 5193648 0.06040 86954 261795 2000 259795 0.00300 301 693855 693855 0.00810 448 448 0.00000 6233 6233 0.00010 25854 25854 0.00030 87255 988185 2000 986185 0.01150 87255 7331205 1151372 6179833 0.07190 800 873830 873830 0.01000 5000 5000 0.00010 300 13944 10725 3219 0.00000 30 31 31 0.00000 1130 892805 10725 882080 0.01010 false 4841393 22290095 28013618 -5723523 X true true HealthPark LLC Property management 0.27586 0.72414 ZARZ LLC Property management 0.1 0.9 1 1 Columbus Community Hospital Inc 4600 38th Street Columbus NE 686011800 www.columbushosp.org License #630001 X X X 47 Bed Acute Care Hospital w/ 24 hr ER Services Columbus Community Hospital Inc 1 false false true X X X X X X X X X 15 true true true true X See Section C X true 15 true See Section C false true X 130. 200. X X true true X X X X true X See Section C X See Section C X See Section C X X X X X X true X false X X X X true X false false Schedule H, Part V, Line 5 MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) PROCESS WAS DEVELOPED BY AND IS RECOMMENDED FOR COMMUNITY ASSESSMENT BY THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS (NACCHO) AND CENTER FOR DISEASE CONTROL (CDC). MAPP WAS ALSO A RECOMMENDED COMMUNITY ASSESSMENT BY THE NEBRASKA RURAL HEALTH ASSOCIATION IN ITS COMMUNITY HEALTH ASSESSMENT COLLABORATIVE PRELIMINARY RECOMMENDATIONS FOR NEBRASKA'S COMMUNITY, NONPROFIT HOSPITALS TO COMPLY WITH NEW REQUIREMENTS FOR TAX EXEMPT STATUS ENACTED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (SEPTEMBER OF 2011). MAPP ALLOWS FOR INPUT FROM PARTIES WHO REPRESENT BROAD INTERESTS IN THE COMMUNITIES. INPUT FROM DIVERSE SECTORS INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND INDIVIDUALS FROM DIVERSE AGE GROUPS WAS OBTAINED THROUGH SURVEYS, TARGETED FOCUS GROUPS, OPEN PUBLIC MEETINGS AND TARGET INVITATIONS TO COMMUNITY LEADERS AND AGENCIES. THE HOSPITAL'S PARTICIPATION IN THE CURRENT MAPP ASSESSMENT IS THE MOST THOROUGH TO DATE WITH OVER 100 INDIVIDUALS IN THE DISTRICT PARTICIPATING IN THE PROCESS. THIS DOES NOT COUNT THE 1,000 INDIVIDUAL SURVEYS OR FOCUS GROUP PARTICIPANTS. Schedule H, Part V, Line 6a - CHI Health, Schuyler - Genoa Community Hospital - Boone County Health Center Schedule H, Part V, Line 6b - East Central District Health Department - Good Neighbor Community Health Center Schedule H, Part V, Line 7a The detailed assessment and related components are available via link on https://www.columbushosp.org/news_events/community_health_needs_assessment _chna.aspx or available on request and available for review at Columbus Community Hospital. Schedule H, Part V, Line 10a THE IMPLEMENTATION STRATEGY IS AVAILABLE VIA LINK ON HTTPS://WWW.COLUMBUSHOSP.ORG/NEWS_EVENTS/CHIP_IMPLEMENTATION_PLAN.ASPX Schedule H, Part V, Line 11 CHNA IDENTIFIED HEALTH CARE NEEDS THE FOLLOWING "HEALTH PRIORITIES" WERE IDENTIFIED AS RECOMMENDED AREAS OF INTERVENTION UNDER THE CHNA CONDUCTED IN COLLABORATION WITH THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT (CONTRACTING WITH SCHMEEKLE RESEARCH, INC.), COVERING THE COUNTIES OF PLATTE (WHERE CCH IS LOCATED), BOONE, COLFAX AND NANCE: - ACCESS TO HEALTH CARE - OBESITY - FAMILY SUPPORT - SUBSTANCE ABUSE - BEHAVIORAL HEALTH CCH WILL WORK HAND-IN-HAND WITH THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT AND OTHER HEALTH AND BUSINESS-RELATED AGENCIES TO ADDRESS THESE NEEDS. SPECIFICALLY, CCH WILL TAKE THE LEAD IN ADDRESSING THE IDENTIFIED NEEDS OF ACCESS TO HEALTH CARE AND FAMILY HEALTH AND WELLNESS BY CONDUCTING THE ACTIVITIES DESCRIBED BELOW. IT WILL SUPPORT THE IDENTIFIED NEEDS OF FAMILY SUPPORT, SUBSTANCE ABUSE AND BEHAVIORAL HEALTH AS REQUESTED BY OTHER PARTICIPANTS OF THE CHNA THAT HAVE AGREED TO TAKE THE LEAD IN THESE AREAS. THESE PARTICIPANTS ALREADY HAVE PROGRAMS IN PLACE AND EXPERTISE IN THESE AREAS. THE ALLOCATION OF DUTIES IN ADDRESSING THESE IDENTIFIED HEALTH CARE NEEDS, PROMOTES PROGRAM EFFECTIVENESS AND SUPPORTS THE EFFICIENT ALLOCATION OF LIMITED HEALTH CARE DOLLARS. IMPLEMENTATION STRATEGY ACCESS TO HEALTH CARE: OBJECTIVE: UPDATE OUR FACILITIES TO OFFER OUR PATIENTS THE MOST COMPREHENSIVE, HIGH-QUALITY CARE. ACTION STEP: CCH ANNOUNCED PLANS FOR A $35-MILLION RENOVATION PROJECT THAT WILL PRIMARILY IMPACT SURGICAL SERVICES, MATERNAL CHILD HEALTH AND RADIOLOGY. THE CONSTRUCTION IS EXPECTED TO BEGIN IN 2019, WITH THE ENTIRE PROJECT COMPLETED BY 2021. OBJECTIVE: REIMAGINE AND IMPROVE HOW CCH TREATS JOINT REPLACEMENT PATIENTS. ACTION STEP: CCH LAUNCHED THE SURGE CENTER IN APRIL 2018. THE GOAL OF THE PROGRAM IS TO PROVIDE COMPREHENSIVE EDUCATION, SUPPORT AND CARE FOR PEOPLE WHO ELECT TO UNDERGO HIP, KNEE OR SHOULDER REPLACEMENT SURGERY. OBJECTIVE: EXPAND CANCER CARE OFFERINGS IN THE COMMUNITY. ACTION STEP: TO BETTER SERVE AREA RESIDENTS WHO HAVE BEEN DIAGNOSED WITH CANCER, CCH DEVELOPED A PATIENT NAVIGATION PROGRAM AND CREATED THE POSITIONS OF ONCOLOGY NURSE NAVIGATOR AND ONCOLOGY SOCIAL WORKER. IN FALL 2018, ADRIAN TASA, RN, BSN, OCN, WAS HIRED AS CCHS FIRST ONCOLOGY NURSE NAVIGATOR AND SHELBY CZARNICK, CMSW, LIMHP, WAS HIRED AS CCHS FIRST ONCOLOGY SOCIAL WORKER. THESE POSITIONS WERE CREATED TO HELP BETTER EDUCATE AND PREPARE PATIENTS FOR CANCER TREATMENT. TASA AND CZARNICK WILL CONNECT WITH PATIENTS SOON AFTER THEIR CANCER DIAGNOSIS AND GUIDE THEM THROUGH THE ENTIRE PROCESS OF THEIR CANCER TREATMENT. OBJECTIVE: RECRUIT QUALITY PHYSICIANS TO MEET THE GROWING NEEDS OF THE COMMUNITIES WE SERVE. ACTION STEP: IN THE 2018 CALENDAR YEAR, 13 HEALTH CARE PROVIDERS WERE SUCCESSFULLY RECRUITED INCLUDING FULL-TIME, MIDLEVEL AND SATELLITE PROVIDERS IN AREAS SUCH AS OPTHALMOLOGY, FAMILY PRACTICE, ED, AND PAIN MANAGEMENT, AMONG OTHERS. OBJECTIVE: ENHANCE HEALTH CARE OFFERINGS BY EXPANDING TELEHEALTH SERVICES. ACTION STEP: STARTED THE TELESTROKE PROGRAM, E-MENTAL HEALTH TRIAGE AND THE TELESTEWARDSHIP PROGRAM, AS WELL AS TELEHEALTH BEHAVIORAL HEALTH ASSESSMENT OUT OF THE EMERGENCY DEPARTMENT. THESE PROGRAMS ALLOW CCH PATIENTS TO INTERACT WITH HEALTH SPECIALISTS IN LARGER COMMUNITIES. FOR EXAMPLE, TELESTROKE ALLOWS CCH PATIENTS TO CONSULT WITH A NEBRASKA MEDICINE NEUROLOGIST WITHOUT HAVING TO LEAVE COLUMBUS. OBJECTIVE: INCREASE ACCESS TO CANCER SCREENINGS. ACTION STEP: IN APRIL 2018, COLUMBUS COMMUNITY HOSPITAL'S COLUMBUS OTOLARYNGOLOGY CLINIC OFFERED FREE ORAL, HEAD AND NECK CANCER SCREENINGS. ALSO IN 2018, CCH OFFERED LOW-DOSE CT LUNG SCREENINGS TO QUALIFYING PATIENTS WHO WERE REFERRED BY THEIR DOCTOR. THE SCREENINGS WERE OFFERED AT A REDUCED COST OF $250 EACH. OVER THE PAST YEAR, CCH PERFORMED MORE THAN 110 SCREENINGS FOR QUALIFYING PATIENTS. OBJECTIVE: MAKE THE EHEALTH LIBRARY ON THE CCH WEBSITE A GOOD RESOURCE FOR THE PUBLIC. ACTION STEP: THE EHEALTH LIBRARY AND THE CCH WEBSITE CONTINUE TO BE UPDATED WITH THE NEWEST INFORMATION ON SERVICE LINES AND RESOURCES. THE EHEALTH LIBRARY HAS BEEN ACCESSED MORE EACH YEAR. IT CONTINUES TO BE A REPUTABLE RESOURCE FOR ALL. OBJECTIVE: EXPAND THE VISITING PHYSICIANS CLINIC TO INCREASE OFFICE HOURS AS WELL AS INCREASE PHYSICIAN RECRUITMENT FOR MULTIPLE SPECIALTIES AND LOCAL PRIMARY CARD LINICS. ACTION STEP: CONTINUED PHYSICIAN RECRUITMENT AND OFFERED INCREASED ACCESS TO THE VISITING PHYSICIANS CLINIC. OBJECTIVE: BRING ADDITIONAL MEDICAL SERVICES TO THE COMMUNITY BY OPENING NEW CLINICS. OBJECTIVE: EXPAND THE EXISTING HOSPITALIST PROGRAM TO BETTER SERVE ALL CCH PATIENTS. ACTION STEP: CCH ADDED AN ON-CALL PEDIATRIC HOSPITALIST PROGRAM TO PROVIDE CARE TO INPATIENT AND OBSERVATION PATIENTS WHO ARE NEWBORN UP TO 18 YEARS OLD. OBJECTIVE: OFFER EXPANDED SERVICES THROUGH CCHS REHABILITATIVE SERVICES DEPARTMENT. ACTION STEP: CCH OCCUPATIONAL THERAPIST, JILL JAKUB, MOTR/L, CLT, CHT, OCCUPATIONAL THERAPIST, RECEIVED HER NATIONAL HAND THERAPY CERTIFICATION, ALLOWING HER TO DO ADVANCED TREATMENT OF MEDICAL CONDITIONS OF THE HAND, WRIST, ELBOW AND SHOULDER THROUGH CCHS REHAB SERVICES. OBJECTIVE: WORK TO CONTINUALLY IMPROVE PATIENTS ACCESS TO HEALTH CARE AND THE QUALITY OF HEALTH CARE THEY RECEIVE. ACTION STEP: CCH ADOPTED A PATIENT-CENTERED METHODOLOGY CALLED LEAN HEALTHCARE. THE ULTIMATE GOAL BEHIND LEAN IS TO ELIMINATE WASTE, IMPROVE PROCESSES AND INCREASE OVERALL PATIENT SATISFACTION. CCH HAS BEEN WORKING TO CREATE A CULTURE SURROUNDING THESE SIMPLE GOALS. EMPLOYEES ARE ENCOURAGED TO TAKE PART IN THE PRACTICE AND SHARE ANY IDEAS THEY HAVE TO IMPROVE QUALITY OF CARE IN THE FACILITY. THE HOPE IS TO IMPROVE PATIENT CARE, PATIENT SATISFACTION, STAFF SATISFACTION AND REGULATORY COMPLIANCE, AS WELL AS REDUCE INVENTORY, COSTS, MORTALITY RATES AND MORBIDITY RATES. OBJECTIVE: OFFER COMMUNITY EVENTS THAT PROVIDE HEALTH EDUCATION AND AFFORDABLE HEALTH SCREENINGS. ACTION STEP: OFFERED EVENTS THAT PROVIDED COMMUNITY MEMBERS WITH AN OPPORTUNITY TO RECEIVE HEALTH EDUCATION AND HEALTH SCREENINGS, INCLUDING: - CCH HELD ITS 14TH ANNUAL TUNE-UP FOR LIFE ON SEPTEMBER 9, 2017. THE EVENT FEATURED FREE HEALTH SCREENINGS FOR BLOOD PRESSURE, BODY COMPOSITION, BONE MINERAL DENSITY, AS WELL AS TESTS ON FLEXIBILITY, STRENGTH, HEARING AND VISION. AT THE EVENT, ATTENDEES COULD ALSO GET DISCOUNTED HEALTH SCREENINGS, SEASONAL FLU SHOTS AND THE PNEUMONIA VACCINE. - ON SEPTEMBER 26, 2017 CCH HELD A SENIOR LIVING FESTIVAL WHICH EDUCATED SENIORS ON SKIN LESIONS AND CCHS NEW SURGE JOINT REPLACEMENT CENTER. THE EVENT ALSO GAVE PARTICIPANTS THE CHANCE TO GET FREE BONE MINERAL DENSITY AND BLOOD PRESSURE SCREENINGS, AS WELL AS FLU SHOTS AND PNEUMONIA VACCINATIONS. CCH STAFF WERE ALSO ON HAND TO ANSWER QUESTIONS ABOUT THE HOSPITALS SERVICES AND A DIABETES EDUCATOR WAS ON-SITE AS WELL. - CCH HELD ITS 14TH ANNUAL DIABETES AWARENESS DAY ON OCTOBER 10, 2017. THE EVENT ALLOWED AREA RESIDENTS TO LEARN MORE ABOUT DIABETES AND CCH STAFF WERE ON HAND TO PROVIDE HEALTH SCREENINGS. ATTENDEES COULD ALSO VISIT NUMEROUS INFORMATIONAL BOOTHS, LISTEN TO SPEAKERS AND ATTEND A HEALTHY COOKING DEMONSTRATION. - CCH'S REHABILITATIVE SERVICES DEPARTMENT, IN COLLABORATION WITH THE COLUMBUS FAMILY YMCA TOGETHERHOOD GROUP, CONTINUED TO OFFER A WELLNESS GARDEN THAT TEACHES COMMUNITY MEMBERS ABOUT NUTRITION WHILE PROVIDING PATIENTS WITH LIMITED MOBILITY AN OPPORTUNITY TO EXPAND THEIR SKILLS WHILE LANDSCAPING AND GARDENING. OBJECTIVE: TO OFFER LONG-TERM, RECURRING HEALTH EDUCATION EVENTS THAT GIVE COMMUNITY MEMBERS AN OPPORTUNITY TO LEARN MORE ABOUT THEIR HEALTH AND HOW TO MANAGE IT. ACTION STEP: OFFERED A VARIETY OF LONG-TERM, RECURRING EVENTS THAT HELP COMMUNITY MEMBERS LEARN MORE ABOUT THEIR HEALTH, INCLUDING: - LUNCH AND LEARN EVENTS THAT PROVIDED COMMUNITY MEMBERS WITH INFORMATION ABOUT TOPICS INCLUDING: MINDFUL EATING, THE IMPORTANCE OF SLEEP AND EAT MORE, WEIGH LESS: RATIONAL SUCCESSFUL WEIGHT LOSS. - SPINE FIT CLASSES WERE HELD TO HELP COMMUNITY MEMBERS IMPROVE THEIR MOBILITY, STABILITY AND THE HEALTH OF THEIR NECKS, BACKS AND UPPER AND LOWER EXTREMITIES. OBJECTIVE: EXPAND PATIENT TRANSPORTATION FOR CCH CLIENTS IN ORDER TO SERVICE OUR CLIENTS SAFELY, EFFICIENTLY AND ENSURE THEY HAVE A SAFE RIDE HOME. ACTION STEP: CONTRACTED WITH CHECKER CAB COMPANY TO PROVIDE 24/7 ACCESS CAB SERVICE AVAILABLE FOR PATIENTS UP TO A 150-MILE DISPOSITION RADIUS. OBJECTIVE: OFFER LONG-TERM PROGRAMS AND SUPPORT TO COMMUNITY MEMBERS WITH CHRONIC HEALTH ISSUES. ACTION PLAN: CONTINUED TO OFFER SUPPORT GROUPS AND ACTIVITIES, INCLUDING THE FOLLOWING: - DIABETES ACTIVITY GROUP, COMPREHENSIVE DIABETES GROUP, ADVANCED CARBOHYDRATE COUNTING CLASS, CONTROL DIABETES FOR LIFE, LOUD CROWD EXERCISE GROUP, TBI/STROKE SUPPORT GROUP AND THE AMERICAN CANCER SOCIETY'S LOOK GOOD - FEEL BETTER PROGRAM. (continued) Schedule H, Part V, Line 11 (continued) IMPLEMENTATION STRATEGY OBESITY: OBJECTIVE: OFFER SPECIAL EVENTS TO ENCOURAGE COMMUNITY MEMBERS TO INCREASE THEIR PHYSICAL ACTIVITY, AND THEREFORE, IMPROVE THEIR OVERALL HEALTH. ACTION STEP: PROMOTED INCREASED PHYSICAL ACTIVITY THROUGH A VARIETY OF PROGRAMS AND SPECIAL EVENTS, INCLUDING: - ON OCTOBER 7, 2017 CCH AGAIN HELD ITS ANNUAL WE CAN RUN, WALK AND ROLL EVENT IN WHICH PARTICIPANTS COULD CHOOSE TO COMPETE IN A 5K (3.1 MILES) OR 1-MILE RACE. PROCEEDS FROM THE EVENT WENT TOWARD PURCHASING AMTRYKES FOR INDIVIDUALS AND FAMILIES IN THE COMMUNITY. AMTRYKES ARE ADAPTIVE TRICYCLES THAT ALLOW DIFFERENTLY-ABLED INDIVIDUALS TO PARTICIPATE MORE FULLY IN HEALTH AND WELLNESS ACTIVITIES. - HELD A S.N.A.P. CAMP (S - SAFETY, N - NUTRITION, A - AWARENESS, P - PHYSICAL ACTIVITY) CAMP ON AUGUST 7, 2017 FOR CHILDREN TO HELP THEM MAKE HEALTHY CHOICES IN NUTRITION, EXERCISE AND SAFETY. THE CAMP WAS FOR CHILDREN ENTERING GRADES 4, 5 AND 6. OBJECTIVE: IMPROVE COMMUNITY MEMBERS' HEALTH AND NUTRITION THROUGH THE USE OF EDUCATIONAL PROGRAMS AND EVENTS. ACTION STEP: OFFERED A VARIETY OF PROGRAMS AND EVENTS TO TEACH COMMUNITY MEMBERS HOW TO IMPROVE THEIR NUTRITION AND THEREFORE THEIR OVERALL HEALTH, INCLUDING: - HEALTHY COOKING DEMONSTRATION CLASSES, LED BY CCH DIETITIANS ARE OFFERED MONTHLY. IN THIS LOW-COST PROGRAM, COMMUNITY MEMBERS CAN SEE A DEMONSTRATION AND OBTAIN A COLLECTION OF EASY AND HEALTHY RECIPES. - ASK THE DIETITIAN SESSIONS, ALSO LED BY CCH DIETITIANS, ARE HELD WEEKLY. THESE FREE, EDUCATIONAL EVENTS GIVE COMMUNITY MEMBERS THE OPPORTUNITY TO GET ONE-ON-ONE TIME WITH A DIETITIAN TO GET THEIR HEALTH AND NUTRITION QUESTIONS ANSWERED. - STARTING IN JANUARY 2018, A FOOD, FITNESS & FUN PROGRAM WAS OFFERED FOR CHILDREN IN FIRST THROUGH SIXTH GRADE. THE FREE, EIGHT-WEEK AFTERSCHOOL PROGRAM TAUGHT KIDS ABOUT NUTRITION AND HEALTHY LIFESTYLE CHOICES. - THE NATIONAL DIABETES PREVENTION PROGRAM IS ALSO OFFERED THROUGH CCH. IN THIS YEARLONG PROGRAM, PARTICIPANTS WORK WITH A TRAINED LIFESTYLE COACH TO MAKE HEALTHY CHANGES TO THEIR LIFESTYLE. CCH HAS PROVIDED THE PROGRAM SINCE 2017 AND PARTICIPANTS HAVE LOST AN AVERAGE OF FIVE TO SIX PERCENT OF THEIR BODY WEIGHT AND AVERAGED MORE THAN 200 MINUTES OF ACTIVITY EACH WEEK. THE PROGRAM RECEIVED NATIONAL RECOGNITION IN 2018. - CONTINUED TO OFFER THE CHIP PROGRAM TO PROMOTE EVIDENCE-BASED MEDICAL GUIDELINES TO HELP COMMUNITY MEMBERS LIVE A HEALTHY LIFESTYLE. THE CHIP PROGRAM CONTINUES TO GROW AND EXPAND. THE PROGRAM IS OFFERED TO PHYSICIAN-REFERRED CLIENTS AND HAS BEEN EXPANDED TO THE GENERAL PUBLIC. AS OF AUGUST 2018, MORE THAN 15 SESSIONS OF CHIP HAD BEEN COMPLETED THROUGH CCH WITH PARTICIPANTS SEEING MARKED REDUCTIONS IN THEIR CHOLESTORAL LEVELS AND EXCESS WEIGHT. IMPLEMENTATION STRATEGY FAMILY SUPPORT: CCH OPENED THE 13,000-SQUARE-FOOT COLUMBUS COMMUNITY HOSPITAL CHILD CARE CENTER IN FALL 2017. IT HAS THE CAPACITY TO CARE FOR 105 INFANTS AND CHILDREN FROM SIX WEEKS TO 13 YEARS OF AGE. CCH CONTINUED ITS HEALTHY FAMILIES NETWORK, A HOME VISITATION PROGRAM THAT WORKS WITH YOUNG, AT-RISK FAMILIES IN PLATTE, COLFAX, BOONE AND NANCE COUNTIES. IT HELPS YOUNG FAMILIES WHO NEED SUPPORT AND EDUCATION, AND TEACHES PARENTS ABOUT THE IMPORTANCE OF THE FIRST FOUR YEARS OF A CHILDS LIFE. IT OFFERS HOME VISITS TO MOTHERS, STARTING IN THE SECOND TRIMESTER AND THOSE SERVICES CONTINUE UNTIL THE CHILDREN ARE THREE YEARS OLD. THE PROGRAM IS OFFERED TO THE COMMUNITY AT NO CHARGE TO THE FAMILIES. CCH ALSO CONTINUED ITS BABY CARE AND BREASTFEEDING CLASSES AND IN MAY 2018, CCH INTRODUCED ITS BUMP AND BEYOND SERIES OF CLASSES FOR EXPECTING PARENTS. IN THE CLASSES, EXPERTS TEACH PARENTS ABOUT LABOR AND DELIVERY, COMFORT TECHNIQUES AND MEDICAL PROCEDURES, ALONG WITH NEWBORN AND POSTPARTUM CARE. CLASSES ARE HELD MONTHLY. THE COST IS $30 PER COUPLE FOR EACH SERIES OF CLASSES. SPANISH INTERPRETERS ARE AVAILABLE FOR THE CLASSES UPON REQUEST. IN 2018, CCH STARTED WORKING WITH THE BRIGGS AND BARRETT PROJECT, AN INITIATIVE THAT HELPS EDUCATE PARENTS ON SIDS AND SUDDEN UNEXPECTED INFANT DEATH (SUID). AS PART OF THE PROJECT, ALL NEW PARENTS WHO DELIVER AT CCH WILL RECEIVE A HALO SLEEP SACK AND A COPY OF THE BOOK SLEEP BABY: SAFE AND SNUG. THESE MATERIALS ARE MEANT TO PROMOTE SAFE SLEEP PRACTICES FROM DAY ONE. IN SEPTEMBER 2017, CCH PARTICIPATED IN KIDS SAFETY DAY, WHERE AREA FAMILIES COULD LEARN SAFETY TIPS FROM LOCAL EXPERTS. THE EVENT INCLUDED DEMONSTRATIONS AND DISPLAYS THAT ALLOWED CHILDREN AND TEENS TO LEARN ABOUT FIRE, SEATBELT AND POWERLINE SAFETY, AMONG OTHER IMPORTANT TOPICS. ATTENDEES COULD ALSO PARTICIPATE IN VARIOUS DRAWINGS, INCLUDING THE CHANCE TO WIN A FREE BICYCLE. IN 2018, CCH STARTED OFFERING LEGAL SERVICES THROUGH LEGAL AID, A NON-PROFIT LAW FIRM THAT HELPS LOW -INCOME NEBRASKANS WITH CIVIL LEGAL CHALLENGES. LEGAL AID OFFERS FREE CIVIL LEGAL SERVICES TO THOSE WHO QUALIFY. LEGAL AID ASSISTS WITH LEGAL ISSUES INCLUDING GUARDIANSHIPS, SNAP (FOOD STAMP) DENIALS, MEDICAID/MEDICARE ISSUES, FMLA AND EMPLOYMENT RIGHTS AND MORE. TO IMPROVE THE STABILITY, HEALTH AND WELL-BEING OF WOMEN, INFANTS, CHILDREN AND FAMILIES THROUGH EFFECTIVE USE OF COMMUNITY RESOURCES, THE CHILD WELL-BEING GROUP (CWB) THROUGH THEIR ZERO2EIGHT INITIATIVES AND ACTIVITIES LED THE WAY IN IDENTIFYING AND ADDRESSING SOCIAL-EMOTIONAL FAMILY NEEDS. THE PLATTE COLFAX ZERO2EIGHT CHILD WELL-BEING (CWB) COALITION'S LEADERSHIP TEAM IS MANAGING THE COMMUNITY-BASED CHILD ABUSE PREVENTION (CBCAP), PROMOTING SAFE AND STABLE FAMILIES (PSSF), NEBRASKA CHILD ABUSE PREVENTION (NCAP), SCOTT FOUNDATION AND IV-E GRANTS TO IMPROVE ACCESS TO ENHANCED SOCIAL, EMOTIONAL, FAMILY SUPPORT, AND SCHOOL AND COMMUNITY CHILD WELL-BEING PROGRAMS IN THE SERVICE AREA WITHIN PLATTE AND COLFAX COUNTIES. EAST CENTRAL DISTRICT HEALTH DEPARTMENT (ECDHD) SERVES AS ADMINISTRATIVE LEAD AND FISCAL AGENT FOR THE CWB INITIATIVE IN PLATTE/COLFAX COUNTIES, MANAGING ALL GRANT FUNDING FOR THE INITIATIVES OF THE COALITION. THE ENTIRE COALITION MEETS BIMONTHLY TO REVIEW PROGRESS OF PARTNERSHIPS, ACTIVITIES AND THE RESULTS OF WORK TO ENHANCE EARLY CHILDHOOD SOCIAL-EMOTIONAL DEVELOPMENT AS DEFINED IN THIS AGREEMENT. LATE 2018 THE PREVIOUS LEADERSHIP GROUP MADE UP OF EIGHT INDIVIDUALS FROM DIFFERENT AGENCIES FILED FOR A 501(C)(3) NOT FOR PROFIT, FOR THE ORGANIZATION. AT THAT TIME A NAME CHANGE WAS COMPLETED FOR THE ORGANIZATION "COMMUNITY AND FAMILY PARTNERSHIP" (CFP). THE ENTIRE MEMBERSHIP MEETS BI-MONTHLY AND THE LEADERSHIP GROUP WHICH IS NOW THE BOARD OF DIRECTORS MEETS MONTHLY. THE BOARD GUIDES THE DIRECTION OF THE COMMUNITY AND FAMILY PARTNERSHIP AND OFFERS ASSISTANCE TO INDIVIDUAL WORKGROUPS AS NEEDED. IT IS EXPECTED THAT IT WILL TAKE THE REST OF 2019 TO FULLY IMPLEMENT THE 501(C)(3) AND OPERATE AS AN INDEPENDENT ORGANIZATION. THIS WAS DONE IN ORDER TO ALLOW THE ORGANIZATION TO APPLY FOR ADDITIONAL GRANT FUNDS. PRESENTLY, THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT REMAINS AS CONTRACTED FOR THE FISCAL AND ADMINISTRATIVE LEAD FOR THE COMMUNITY AND FAMILY PARTNERSHIP. COMMUNITY PARTNERS/STAKEHOLDERS IN THE CWB COALITION INCLUDE, BUT ARE NOT LIMITED TO: BEFRIEND MENTORING, BOYS TOWN, COLUMBUS AREA UNITED WAY, CENTRAL NEBRASKA COMMUNITY ACTION PARTNERSHIP, CENTER FOR SURVIVORS, COLUMBUS COMMUNITY HOSPITAL, COLUMBUS PUBLIC SCHOOLS, COLUMBUS CHILD ABUSE PREVENTION COUNCIL, EAST CENTRAL DISTRICT HEALTH DEPARTMENT, EDUCATIONAL SERVICE UNIT 7, PLATTE COUNTY JUVENILE SERVICES, ROYAL FAMILY KIDS, SAVE THE CHILDREN, SCHUYLER COMMUNITY SCHOOLS AND YOUTH FOR CHRIST. - COMMUNITY BASED CHILD ABUSE PREVENTION (CBCAP) FUND: THE CBCAP FUNDING PRIMARILY PROVIDES FOR THE ADMINISTRATIVE NEEDS OF THE COALITION, INCLUDING PERSONNEL COMPENSATION, OPERATIONAL EXPENSES, TRAVEL AND TRAINING OF THE COORDINATOR AND LEADERSHIP TEAM MEMBERS, ADVERTISING AND MARKETING AND ONE-TIME EVENTS SUCH AS HEALTH FAIRS TO CONNECT WITH PARENTS AND FAMILIES. - PROMOTING SAFE AND STABLE FAMILIES (PSSF) FUND: THE PSSF FUNDING WILL BE UTILIZED TO IMPLEMENT OR CONTINUE THE FOLLOWING STRATEGIES: - CONTINUE ELEMENTARY LEVEL ATTENDANCE MONITOR WITH COLUMBUS PUBLIC SCHOOLS. AN ATTENDANCE MONITOR IS WORKING WITH GRADE SCHOOL STUDENTS AND FAMILIES WHO ARE HAVING ATTENDANCE ISSUES AT SCHOOL. AFTER THREE TO FIVE ABSENCES, A REFERRAL IS MADE TO THE ATTENDANCE MONITOR, WHO THEN COMMUNICATES WITH FAMILIES. IF A BROADER CONCERN IS DISCOVERED, THE FAMILY WILL BE REFERRED TO GET HELP. THE ATTENDANCE MONITOR WILL SERVE AS A LIAISON BETWEEN THEM, THE SCHOOL AND OTHER SERVICES AS NEEDED. THE PURPOSE OF THE ATTENDANCE MONITOR IS TO HELP THE FAMILIES ADDRESS CONCERNS THAT ARE KEEPING THEIR CHILDREN FROM ATTENDING SCHOOL. ALSO, THE ATTENDANCE MONITOR'S PURPOSE IS TO INTERVENE BEFORE THE CONCERN GROWS INTO ONE REQUIRING ATTENTION FROM CHILD PROTECTIVE SERVICES OR OTHER HIGHER INTENSITY SYSTEMS, AS WELL AS BEFORE THE CHILD IS SIGNIFICANTLY AFFECTED ACADEMICALLY DUE TO THE SCHOOL ABSENCES. (continued) Schedule H, Part V, Line 11 (continued) - A SIMILAR PROGRAM HAS BEEN IMPLEMENTED SUCCESSFULLY AT THE LOCAL HIGH SCHOOL LEVEL IN COLUMBUS. IT IS NECESSARY TO STRESS THE IMPORTANCE OF SCHOOL ATTENDANCE AT AN EARLY AGE. GOOD ATTENDANCE WILL HELP ALL STUDENTS ACHIEVE SUCCESS AT BOTH THEIR CURRENT ACADEMIC LEVEL AND LATER IN THEIR SCHOOL CAREERS. - SIZZLING SUMMER ENRICHMENT PROGRAM (SSEP) FOCUSES ON READING WITH THE INTENTION OF MAKING AN IMPACT ON THE "SUMMER SLIDE" STUDENTS EXPERIENCE WHEN OUT OF SCHOOL FOR SUMMER BREAK. RESEARCH HAS SHOWN THAT STUDENTS' FUTURE SUCCESS CAN BE PREDICTED BY WHETHER THEIR READING SKILLS ARE AT, OR ABOVE, GRADE LEVEL BY THIRD GRADE, MEANING IT IS CRITICAL FOR CHILDREN IN GRADES K-2 TO HAVE OPPORTUNITIES TO KEEP THOSE SKILLS STRONG EVEN DURING NON-SCHOOL TIMES. ENRICHMENT ACTIVITIES, INCLUDING SEVERAL SCIENCE, TECHNOLOGY, ENGINEERING AND MATH (STEM) ACTIVITIES, ART PROJECTS, ORGANIZED PHYSICAL ACTIVITIES AND LOCAL FIELD TRIPS ARE INCLUDED IN THE PROGRAM. - ROYAL FAMILY KIDS MENTORING PROGRAM: ROYAL FAMILY KIDS PROVIDES SUPPORT FOR KIDS IN THE FOSTER CARE SYSTEM THROUGH THEIR ANNUAL SUMMER CAMP, AND HAS EXPANDED ITS REACH TO HELP SUPPORT THOSE CHILDREN YEAR-ROUND WITH AN AFTER-SCHOOL MENTORING PROGRAM. TRAINED VOLUNTEER MENTORS HELP THESE CHILDREN NAVIGATE CHALLENGES AND ENCOURAGE "NORMALCY" FOR KIDS WHOSE LIVES HAVE BEEN COMPLICATED BY BEING PART OF THE FOSTER CARE SYSTEM. - EARLY CHILDHOOD PROVIDER TRAINING AND PROGRAM SUPPORT. TRAINING LOCAL HOME-BASED CHILDCARE PROVIDERS IN THE AL'S CARING PALS CURRICULUM. FOURTEEN PROVIDERS HAVE SUCCESSFULLY COMPLETED THE TRAINING AND IMPLEMENTED THIS SOCIAL EMOTIONAL CURRICULUM IN THEIR PROGRAMS, UTILIZING SONGS, PUPPETS AND OTHER TOOLS TO TEACH CHILDREN ABOUT WAYS TO EXPRESS THEIR EMOTIONS AND RECOGNIZE OTHERS' FEELINGS, ULTIMATELY LEADING TO HEALTHIER PARENT-CHILD AND PEER RELATIONSHIPS AND BETTER SCHOOL READINESS SKILLS. - ZERO2EIGHT WILL HELP PROVIDE TRAINING AND SUPPORT FOR CHILDCARE PROVIDERS TO MEET AND EXCEED LICENSING REQUIREMENTS, INCLUDING POTENTIALLY EXPANDING THE AVAILABLE CURRICULUM TO ACCOMMODATE SPANISH-SPEAKING PROVIDERS WITH RESOURCES TO ENSURE ALL PROVIDERS ARE USING BEST PRACTICES FOR THE DEVELOPMENT OF THE YOUNG CHILDREN IN THEIR CARE. WE RECOGNIZE THAT WHEN PROVIDERS ARE WELL TRAINED AND SUPPORTED IN THEIR DESIRE TO BRING QUALITY CARE TO THE COMMUNITY, PARENTS ARE MORE SECURE IN THE SAFETY AND WELL-BEING OF THEIR CHILDREN AND MORE WILLING TO SEEK OUT HELP IF THE CHALLENGES OF PARENTING BECOME OVERWHELMING. - MENTAL/BEHAVIORAL HEALTH SUPPORT VOUCHERS. FOR MANY UNINSURED OR UNDERINSURED FAMILIES IN OUR COMMUNITIES, OBTAINING MENTAL AND BEHAVIORAL HEALTH SERVICES HAS BEEN CHALLENGING. IN MANY CASES, THIS HAS MEANT THAT YOUTH IN NEED OF THERAPY HAVE GONE UNSERVED. TO HELP ALLEVIATE THIS, ZERO2EIGHT HAS ESTABLISHED A VOUCHER-BASED REIMBURSEMENT PROGRAM WITH LOCAL SCHOOLS AND JUVENILE SERVICES. SCHOOL PERSONNEL CAN REFER STUDENTS AND THEIR FAMILIES TO THIS VOUCHER PROGRAM. LOCAL THERAPISTS ARE WILLING TO ACCEPT PAYMENT FROM THE VOUCHER PROGRAM AND WORK WITH PARENTS TO OBTAIN FURTHER FUNDING FOR COUNSELING BEYOND WHAT THE VOUCHERS CAN PROVIDE. (continued) Schedule H, Part V, Line 11 (continued) IMPLEMENTATION STRATEGY SUBSTANCE ABUSE: IN NOVEMBER 2017, CCH CREATED THE PAIN MANAGEMENT TASK FORCE WHICH WAS CONVENED AT THE DIRECTION OF THE MEDICAL EXECUTIVE COMMITTEE. ITS GOAL WAS TO DELIVER SAFE, COMPASSIONATE, EVIDENCE-BASED PAIN MANAGEMENT TO THE COMMUNITY OF COLUMBUS. THESE EFFORTS WERE DESIGNED TO CHANGE THE WAY PROVIDERS AND PATIENTS THINK ABOUT PAIN MANAGEMENT, REDUCE THE NUMBER OF OPIOID PILLS WHICH BECOME UNCONTROLLED AND MAKE MEDICATION EDUCATION EASILY ACCESSIBLE TO EVERYONE. - THE TASK FORCE DEVELOPED GUIDELINES FOR PAIN MANAGEMENT AND THE DISPENSING OF OPIOIDS. IT ALSO ADDED NON-NARCOTIC PAIN OPTIONS TO THE PHARMACY FORMULARY AND DEVELOPED A NON-MEDICATION COMFORT MENU FOR PATIENTS, AMONG OTHER ACCOMPLISHMENTS. TO FURTHER ENHANCE MEDICATION SAFETY, CCH AND LOCAL HEALTH CARE PROVIDERS URGED COMMUNITY MEMBERS TO THINK ABOUT MEDICATION SAFETY. TO THIS END, THE TEAM PRODUCED AND PROMOTED UPDATED MEDICATION LISTS. THESE ARE LISTS PEOPLE CAN CARRY WITH THEM IN CASE OF AN EMERGENCY OR TAKE TO A DOCTORS APPOINTMENT. THEY HELP PROVIDERS IN OUR COMMUNITY MAKE BETTER INFORMED DECISIONS ABOUT THEIR PATIENTS SO PATIENTS CAN RECEIVE BETTER QUALITY CARE. THE MEDICATION LISTS, POCKETS AND BROCHURES HAVE BEEN WELL RECEIVED BY NURSING HOMES, ASSISTED LIVING FACILITIES, PHARMACIES, HOME HEALTH CARE AGENCIES, EMERGENCY SERVICES, PHYSICIANS CLINICS, AND THE HOSPITAL. TO DECREASE THE USE AND ABUSE OF OPIOIDS, CCH EXPLORED NON-OPIOID TREATMENT OPTIONS. THE CCH ANESTHESIA DEPARTMENT IS NOW DOING MORE THAN A DOZEN DIFFERENT NERVE BLOCKS TO HELP PROVIDE POSTOPERATIVE PAIN RELIEF. THIS INCLUDES NERVE BLOCKS FOR GENERAL, OBSTETRIC AND ORTHOPEDIC PATIENTS. CCHS CERTIFIED REGISTERED NURSE ANESTHETISTS (CRNAS) ARE ALSO UTILIZING ENHANCED RECOVERY AFTER SURGERY (ERAS). IOVERA WAS ANOTHER ONE OF THE NON-OPIOID OPTIONS USED TO TREAT PAIN. THE IOVERA TREATMENT IS A CLINICALLY PROVEN, NON-OPIOID, LONG-LASTING PAIN MANAGEMENT SOLUTION THAT USES THE BODYS NATURAL RESPONSE TO COLD TO RELIEVE PAIN. THE IOVERA TREATMENT IS BASED UPON THE WELL-ESTABLISHED PRINCIPLES OF CRYONEUROLYSIS. THE IOVERA SYSTEM USES AN INNOVATIVE PROCESS TO FORM A TARGETED COLD ZONE SURROUNDING PERIPHERAL NERVE TISSUE TO IMMEDIATELY BLOCK THE NERVE FROM SENDING PAIN SIGNALS. THE SYSTEM IS SPECIFICALLY DESIGNED TO CREATE A TEMPORARY, REVERSIBLE NERVE BLOCK THROUGH A PROCESS CALLED WALLERIAN DEGENERATION THAT IS FOLLOWED BY PREDICTABLE REGENERATION OF THE NERVES. IMPLEMENTATION STRATEGY BEHAVIORAL HEALTH OBJECTIVE: CONTINUE TO ENHANCE THE BEHAVIORAL HEALTH SERVICE LINE WITHIN THE COMMUNITY. ACTION STEPS: - EXPANDED TELEHEALTH SERVICES TO INCLUDE: ACCESS TO PSYCHIATRY, GERIATRIC PSYCHIATRY AND STARTED THE E-MENTAL HEALTH TRIAGE PROGRAM AS WELL AS TELEHEALTH BEHAVIORAL HEALTH ASSESSMENT OUT OF THE EMERGENCY DEPARTMENT. THESE PROGRAMS ALLOW PATIENTS TO INTERACT WITH HEALTH SPECIALISTS IN LARGER COMMUNITIES. - CREATED A LIST OF THE TARGET POPULATION IN THE COMMUNITY TO EXPAND MENTAL HEALTH EDUCATION AND PROVIDE TRAININGS. - CREATED A WAY FOR COMMUNITY AGENCIES TO GET TOGETHER TO LEARN WHAT OTHER AGENCIES HAVE TO OFFER AND CREATE COMMUNICATION BETWEEN AGENCIES. - EXPANDED THE KNOWLEDGE OF THE NAMI SUPPORT GROUP FOR INDIVIDUALS WITH MENTAL HEALTH ISSUES AND THEIR FAMILY OR FRIENDS. - SCHUYLER SCHOOL SYSTEM HAS ADDED A THERAPIST TO THEIR TEAM FOR MENTAL HEALTH SERVICES IN THE SCHOOLS TO BEGIN THIS FALL. THIS IS AVAILABLE THROUGH THE BEHAVIORAL HEALTH PROVIDERS FROM THE GOOD NEIGHBOR COMMUNITY HEALTH CENTER. - MEETING WITH THE TARGET POPULATIONS IN THE COMMUNITY TO PROVIDE MENTAL HEALTH FIRST AID TRAINING. - LOBBY FOR THE PASSAGE OF LEGISLATIVE BILLS TO CHANGE THE PROCESS FOR INDIVIDUALS PLACED UNDER EMERGENCY PROTECTIVE CUSTODY. - TRANSITION OF THE RAINBOW CENTER TO GOODWILL INDUSTRIES IN MAY OF 2017 TO SERVE THE POPULATION. GOODWILL INDUSTRIES ARE PROVIDING MULTIPLE SERVICES INCLUDING EMPLOYMENT SERVICES, COMMUNITY SERVICES, TRANSPORTATION AS WELL AS THEIR DAY BEHAVIORAL HEALTH SERVICES PROGRAM LOCATED AT THE FAMILY RESOURCE CENTER. - DISPERSE THE MENTAL HEALTH DATA COLLECTION CHART TO OTHER COMMUNITY AGENCIES TO COLLECT LOCAL DATA. - COORDINATING SERVICES WITH RICHARD YOUNG HOSPITAL, KEARNEY NE., ON EMERGENCY PROTECTIVE CUSTODY CASES (EPC) WHICH IS ONE OF THE TWO LOCATIONS FOR OUR REION IV EPC'S. - DEVELOPING PREVENTATIVE HEALTH SERVICES AND SCREENINGS WITHIN THE PUBLIC SCHOOL SYSTEM. - PARTNERED WITH OTHER COMMUNITY AGENCIES TO ESTABLISH WORKFLOW PROCESS AMONG AGENCIES THAT GUIDES PARENTS AND CAREGIVERS OF JUVENILES THROUGH THE BEHAVIORAL HEALTH SYSTEM. - CONTINUED WORK WITH THE STATE ON SECURING MORE BEDS IN LINCOLN REGIONAL CENTER. - CCH SUCCESSFULLY RECRUITED A PHYCIATRIST TO BEGIN WORKING AND LIVING IN THE COMMUNITY BEGINNING IN AUGUST 2019, WILL SHARE TIME BETWEEN THE GOOD NEIGHBOR COMMUNITY HEALTH CENTER AND A PRIVATE OUTPATIENT CLINIC. - CCH WILL BEGIN AN OPIOD SCREENING CLINIC IN THE SPRING OF 2019. Schedule H, Part V, Line 16a https://www.columbushosp.org/for_patients_visitors/patients_financial_info rmation/discount_charity_care_programs.aspx Schedule H, Part V, Line 16b https://www.columbushosp.org/sites/www/Uploads/Charity-Financial%20Assista nce%20Application%20-%20English.pdf Schedule H, Part V, Line 16c HTTPS://WWW.COLUMBUSHOSP.ORG/SITES/WWW/UPLOADS/FILES/CCHFINANCIALASSISTANC EPOLICYSUMMARY.PDF 5 Humphrey Clinic of CCH 3003 Main Street Humphrey NE 686423155 Clinic in small town to offer medical services to residents Hospice of Columbus Community Hospital 3005-19th St Suite 600 Columbus NE 686014248 Hospice Services Home Health of Columbus Community Hosp 3005-16th St Suite 600 Columbus NE 686014248 Home Health Services Columbus Orthopedic & Sports Med Clinic 4508 38th St Suite 133 Columbus NE 686011668 Free Standing Clinic Columbus Otolaryngology Clinic 4508 38th St Suite 152 Columbus NE 68601 Free Standing Clinic Schedule H, Part I, Line 3c N/A Schedule H, Part I, Line 6a A COMMUNITY BENEFIT REPORT IS INCLUDED EACH YEAR IN THE HOSPITAL'S QUARTERLY NEWSLETTER HOUSECALL WITH AN ELECTRONIC VERSION OF THE NEWSLETTER HOUSED ON THE HOSPITAL'S WEBSITE. A SEPARATE LANDING PAGE ON THE WEBSITE WAS ALSO CREATED FOR THE REPORT TO PROVIDE EASY ACCESS TO THE REPORT. Schedule H, Part I, Line 7b THE REVENUE GENERATED BY MEDICAID PATIENTS IS MULTIPLIED BY THE COST TO CHARGE RATIO DEVELOPED IN WORKSHEET 2. THE REMAINING PRODUCT IS THE CALCULATED COST ASSOCIATED WITH THE CHARGES FROM MEDICAID PATIENTS. THESE COSTS ARE REDUCED BY THE REIMBURSEMENTS COLLECTED FOR THE MEDICAID CHARGES. THE REMAINING NUMBER IS THE NET COMMUNITY BENEFIT EXPENSE. Schedule H, PART I, LINE 7E EXPENSES REPRESENT WAGES ALONG WITH SERVICES AND SUPPLIES PURCHASED BY THE HOSPITAL. DIRECT OFFSETTING REVENUES REPRESENT CASH COLLECTED FOR THESE SERVICES. Schedule H, PART I, LINE 7I CASH DONATIONS MADE TO EAST CENTRAL HEALTH DEPARTMENT (ECHD) AND THE GOOD NEIGHBOR COMMUNITY HEALTH CENTER REPRESENT THE MAJORITY OF THESE DONATIONS. Schedule H, PART I, LINE 7, COLUMN (F) THE AMOUNT OF 86,020,584 USED AS THE DENOMINATOR TO COMPUTE COLUMN (F) IS CALCULATED BY TAKING TOTAL FUNCTIONAL EXPENSES OF 90,861,977 MINUS BAD DEBT EXPENSE OF 4,841,393. Schedule H, Part II Community Building Activities Columbus Community Hospital (CCH) continues to collaborate with the local Chamber of Commerce to recruit skilled professionals to fill job openings in the community. The Hospital also provides support and staff time to assist in highlighting the health care community, offering specific department or Hospital tours in order to recruit skilled professionals to live and work in Columbus. On Hospital-donated land, the City of Columbus created a twelve acre urban lake and, on the same property, an additional 20 acres designated as the future site of a fire station. A handicap/stroller-accessible dock on the urban lake allows access for fishing or to watch water fowl rest in the area as they migrate through Columbus. The urban lake provides a community space within the city limits for people of all ages. The Hospital continues to partner with our local public health department and community health center (CHC) on several projects and community disease prevention initiatives, providing financial support and professional staff time as liaisons to these community partnerships throughout the year. Working together with these agencies, some of the chronic disease and accident prevention strategies addressed include: Type II Diabetes, hypertension and heart disease, pre and postnatal newborn care, physical activity and exercise, colon cancer prevention and early detection, and community preparedness for natural and man-made disasters. These programs reach countless members of the community each year, making a difference in the lives of people living with chronic health issues. Other hospital-driven community health initiatives include: free flu shots for residents at the shelter for the homeless and participation in numerous community health fairs/events each year providing medical screenings and free health information/education. To encourage entry into the medical profession, Columbus Community Hospital partners with local day care facilities, area schools and colleges, offering its medical professionals as guest speakers or instructors at hands-on learning events. To help in recruitment of health care professionals and also to relieve the daycare shortage in Columbus, the Hospital Board has also approved the construction of an on-site daycare and pre-school for Hospital employees. In August 2017, Columbus Community Hospital opened the Child Care Center northeast of the hospital. The Child Care Center has capacity to care for 105 children from infants to age 12. In an ongoing commitment as an employer and community partner, Columbus Community Hospital strives to provide a better life for the families in our community and to help alleviate the child care shortage in Columbus. Columbus Community Hospital has an independent Board of Directors, consisting of community leaders with diverse backgrounds. The CCH Board approved the construction of a $21 million, 85,723 square foot community wellness facility that opened on October 27, 2015. The Columbus Family YMCA leased, below fair market value, 62,397 square feet of the facility that is available for use by the entire community and includes: 2 gyms, 3 pools, and weight and exercise equipment. Classes for wellness and fitness are provided by health care professionals from the Hospital and YMCA staff. In separate areas, the facility also houses the Hospitals adult and pediatric therapies. As a way to celebrate the two-year anniversary of Columbus Community Hospital Rehabilitative Services relocating to the Columbus Wellness Center, Columbus Community Hospital hosted an open house for all patients both past and present. Held at the Columbus Wellness Center, coffee, apple cider, hors doeurves, door prizes were all welcomed features of the event. Musicians including cello, piano and flute brought a relaxing and beautiful atmosphere as physical, occupational and speech therapists shared memories with their patients. The event also acknowledged the exponential growth the Hospitals Rehabilitative Services department and the Columbus Wellness Center have seen since it was completed in 2015. Schedule H, Part III, Line 2 The methodology used to estimate bad debt expense is to take the private pay write-offs for the year and divide them by the total revenue generated from self-pay patients and multiply the product by the self-pay accounts receivable. This gives the amount of reserve necessary to cover the potential bad debt in current self-pay accounts receivable. Bad debt expense for the fiscal year is the amount of additional expense necessary to bring that reserve account to the calculated (estimated) balance. Schedule H, Part III, Line 3 N/A Schedule H, Part III, Line 4 Financial statements do not include any text for bad debt. The amount in Line 2 is the book bad debt amount. Schedule H, Part III, Line 8 In accordance with 42 CFR 413.24, Columbus Community Hospital uses the step-down method as its costing methodology. Departments within a provider are usually divided into two types: 1) Those that produce patient care revenue (e.g., routing services, radiology), and 2) Those that do not directly generate patient care revenue, but are utilized as a service by other departments (e.g., laundry and linen, dietary). The two types of departments are commonly referred to as revenue-producing cost centers and nonrevenue-producing cost centers. Although nonrevenue-producing cost center do not directly produce patient care revenue, they contribute indirectly to patient care revenue generated by serving as a service to the revenue-producing centers and also to other nonrevenue-producing centers. Therefore, for the purpose of proper matching of revenue and expenses, the cost of the revenue-producing centers should include both its direct expenses and its proportionate share of the costs of each nonrevenue-producing center (indirect costs) based on the amount of services received. The process of allocating the cost of a particular nonrevenue-producing center to other nonrevenue-producing centers and revenue-producing centers is performed by utilizing a set of statistics (e.g. pounds of laundry for allocating laundry and linen costs, square feet for allocating depreciation building costs). Every nonrevenue-producing cost center has the potential of being allocated to every other nonrevenue-producing cost center in addition to the revenue-producing cost centers. This precludes a simple allocation of the direct expense of the nonrevenue-producing cost center because the indirect costs derived from allocation of other nonrevenue-producing cost centers must be computed in determining the full cost (direct and indirect costs) of the nonrevenue-producing cost center being allocated. The step-down method recognizes that services furnished by certain nonrevenue-producing departments are utilized by certain other nonrevenue-producing centers as well as by the revenue-producing centers. All costs of nonrevenue-producing centers are allocated to all centers that they serve, regardless of whether or not these centers produce revenue. The cost of the nonrevenue-producing center servicing the greatest number of other centers, while receiving benefits from the least number of centers, is apportioned first. Following the apportionment of the cost of the non-revenue-producing center, that center will be considered closed and no further costs are apportioned to that center. This applies even though it may have received some service from a center whose cost is apportioned later. Generally, if two centers furnish services to an equal number of centers while receiving benefits from an equal number, that center which has the greatest amount of expense should be allocated first. Schedule H, Part III, Line 9b The purpose of our Financial Assistance/Charity Program is to further the charitable mission of CCH by providing financially disadvantaged and other qualified patients with an avenue to apply for and receive free or discounted care consistent with the requirements of the Internal Revenue Code and implementing regulations under Section 501(r). CCH's Financial Assistance Policy reflects the mission, vision and values of CCH. It is intended to assist low income, uninsured and underinsured individuals whose financial status, under the hospital's qualification criteria, makes it impractical or impossible to pay for medically necessary and emergency care. Our financial assistance program has an implied and presumptive avenue, as well as medical indigence. This Program provides a fair and comprehensive system of distributing free or discounted medical care to poor and financially disadvantaged patients within the available resources of CCH. This Policy addresses: Eligibility criteria for financial assistance, The extent to which financial assistance includes free and discounted care, and medically indigent care, The basis for calculating amounts charged to eligible patients (the calculation of amounts generaly billed), The method for applying for assistance and application period, Actions that may be taken by CCH in the event of nonpayment, and Measures to widely publicize the Policy. CCH recognizes the individual's right to obtain quality health care regardless of age, sex, race, disability, national origin, marital status, sexual orientation, personal beliefs or their ability to pay. CCH has a fiduciary responsibility to seek payment for services from those who can pay. Schedule H, Part VI, Line 2 Needs Assessment In 2010, Columbus Community Hospital began implementing a five year strategic plan. The plan includes a thorough assessment of the organization's external environment in terms of opportunities and threats, as well as an assessment of the organization's internal strengths and weaknesses. The plan also includes strategic issues, goals and related strategies for future organizational effectiveness. Six organizational pillars were identified: Quality, Culture, People, Service, Facilities and Finance. 1) Quality: Quality efforts have been focused on Evidence-Based Processes (EBP) and educating staff on the importance of using and integrating these processes in daily operations. CCH has implemented an electronic medical record to afford ease of information access and communication across the continuum of care. The clinical leadership groups for nursing and respiratory therapy have initiated a review of how to integrate EBP into the clinical areas and will be starting classes to educate staff within and outside nursing. 2) Culture: In an effort to achieve a high performance organization, CCH is in the process of implementing a 4-part culture improvement initiative that includes: TeamSTEPPS, Just Culture, Student and Lean/Six Sigma Process Improvement. The Hospital continues to work with the Studer Group to hardwire appropriate tools, focusing on improving patient outcomes and create a culture/environment, making CCH an employer of choice, and where physicians want to bring their patients for care. 3) People: CCH has continued to be aggressive in its recruitment efforts to attract and retain the workforce needed to support strategic growth initiatives across all service lines. CCH is initiating a new on-boarding process for new employees. In addition, nursing has updated their orientation program and has trained preceptors and nurse mentors/coaches. 4) Services: CCH performs an annual comprehensive program review of existing and new services and has ranked priority service line development in the areas of hospital medicine, orthopedics, cardiology, cancer and rehab services. 5) Facilities: CCH has developed a comprehensive master facilities plan that can adapt to current and future patient care needs. An Emergency Department expansion was completed in 2012 with a new Medical Office Building recently completed to house visiting physicians and the Wound, Ostomy, and Continence Care (W.O.C.) Clinic. 6) Finance: CCH is working diligently to maintain financial stability. Our approach includes: work to extend the Demonstration Project with an alternate plan in place if the program is discontinued. The Hospital maintains a conservative successful investment strategy and continue growth in the CCH Foundation. Schedule H,Part VI, Line 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE ON THE HOSPITAL'S WEBSITE, INCLUDING LINKS TO ADDITIONAL, IN-DEPTH INFORMATION. CCH HAS TAKEN MEASURES TO WIDELY PUBLICIZE THE FINANCIAL ASSISTANCE POLICY. Patient Charity/Financial Assistance Program: A) Monthly Payment Option 1) If you are unable to pay your balance in full, please call the Patient accounts department to set up an acceptable payment arrangement. B)Patient Charity/Financial Assistance Program: 1) If patients feel their income is not sufficient to pay for services at Columbus Community Hospital, they are encouraged to contact the Patient Accounts Department and/or Social Workers for information regarding charity/financial assistance. 2) Further information about Medicare/Medicaid/Charity Care is provided in both English and Spanish on our website. The State has Medicaid applications available online. Our Patient Accounts and Social Services staff can provide patients with financial/charity applications in either English or Spanish. 3) Additionally, signage is posted to include the Financial Assistance Policy Summary in English and Spanish directing patients to call or come in as needed for financial help and employees are encouraged at the earliest possible point to refer individuals to Patient Accounts or Social Services who will see patients individually and counsel on specific circumstances. We have implemented measures to widely publicize the Financial Assistance Program. 4) Monthly statements include the following information: a. Payment plans b. Charity/Financial Assistance Program c. 24/7 online Business Office access, which includes information on payment plans, charity/financial assistance and applications for financial/charity assistant available in both English and Spanish that can be downloaded from our website. d. The phone number of Patient Accounts and the on-line hospital website. 5) All registration areas have signage posted in English and Spanish of the Financial Assistance Policy Summary, brochures which address financial assistance, CCH affiliates and non-affiliates (independent physicians and other independents). 6) The CCH Website in English and Spanish Charity/Financial Assistance application, Financial Assistance Policy Summary, Financial Aid/Charity Program Policy, calculations of amounts generally billed (AGB) which is revised annually, Columbus Community Hospital and CCH-Employed Physicians, practitioners and clinics and independent community physicians and other independents (which are revised quarterly). Schedule H, Part VI, Line 4 Community Information The Local Economy Columbus Community Hospital is located in Columbus, Nebraska, which has a population of approximately 22,000. It is the county seat and the largest city in Platte County, which has a population of approximately 32,800. Almost 70 percent of Platte County's residents live in Columbus. The average unemployment rate in Platte County over the past five years is 3.2 percent. This is compared to the natioinal average unemployment rate of 3.7 percent which was reported in September 2018. This was the lowest national unemployment rate reported in the past 50 years. Platte County has been recognized as the third best place to find a job by CNN/Money Magazine and the average per capita income in the county is about $38,000. The estimated average wage in Platte County, as reported in 2016, was about $18/hour or $730/week. Columbus has also been recognized by Money Magazine as one of "The Top 100 Best Small Towns to Live". According to the Nebraska Department of Labor, Columbus is considered a major hub for the manufacturing industry and has a greater share of manufacturing employment than other Nebraska metropolitan area. The Columbus and area economy is based on agriculture and manufacturing, with many industrial companies attracted by plentiful, low-priced hydroelectric power. A hardworking, well-educated workforce, low evergy costs and a local environment friendly to business, provide encouragement for strong economic and industrial development within our area. Among the major employers are Archer Daniels Midland (ADM), an ethanol manufacturing company; FLEXCON; Central Confinement Services; Pillen Family Farms; Vishay; two BD Medical Plants which are medical equipment companies; Behlen Manufcaturing, which manufactures steel buildings and Nebraska Public Power, whose headquarters is in Columbus. These business opportunities have led to an influx of single people and young families moving into the Columbus-area seeking employment. This growth of Columbus, Platte County and the surrounding communities has, in turn, led to an increase in admissions at CCH. As reported in the 2017-2018 CCH annual report, the hospital had about 2,700 inpatient admissions; 11,900 emergency visits; 3,600 outpatient procedures and 700 inpatient procedures in the preceding year. Service Capacity Columbus Community Hospital (CCH) is a community-owned, not-for-profit hospital, located on 60 acres in the northwest part of Columbus, Nebraska. It is a 47-bed acute care facility that is certified for swing beds, with four skilled nursing beds and 14 ambulatory outpatient beds. CCH moved to its current location more than 5 years ago. Since 2002, the community has grown and the hospital's services have followed suit. To keep up with increased demand for health care offerings in the area, CCH is in the process of a $35-million renovation project. The renovation will primarily impact CCH's Surgical Services, Maternal Child Health and Radiology departments and will cause several structural and departmental adjustments within the hospital. Construction is expected to begin in 2019, with the entire project slated for completion by 2021. CCH offers comprehensive care, including 24-hour emergency care, intensive care, medical-surgical care, inpatient and outpatient care, as well as general, ENT, urology podiatry and orthopedic surgical procedures. Other ancillary services include: respiratory care, wound care, diabetes education, endoscopy and cardiopulmonary rehabilitation. The hospital also offers comprehensive outpatient laboratory, radiology and rehabilitative services as well as free, 24/7 interpreter services. The hospital's Healthpark Medical Office Building currently houses a visiting physicians' clinic and the CCH laboratory, along with Columbus Otolaryngology Clinic, Columbus Orthopedic & Sports Medicine Clinic and Columbus General Surgery. Additionally, CCH has a second campus, which houses medical outreach services such as Home Health and Hospice, Healthy Families and Occupational Health Services. The hospital has more than 740 employees and an active medical staff of 48 physicians who represent 14 medical specialties. An additional 20 specialty services are brought to the community on an intermittent basis by visitng physicians. CCH is committed to actively recruiting and developing long-term relationships with physicians to meet the growing needs of the communities it serves. In the 2017 calendar year, a total of 27 providers were successfully recruited by CCH. This includes full-time, midlevel and satellite providers in areas such as family practice, neurology, radiology and cardiology, among other specialties. To better serve the needs of its community, CCH added an on-call pediatric hospitalist program which is available 24/7 and 365 days a year. This service provides care to inpatient and observation patients who are newborn up to 18 years old. The pediatric hospitalist's job is to help stabilize and improve a patient's health as quickly as possible. Pediatric hospitalists are availble by request. once a pediatric hospitalist has been requested, the hospitalist will follow the patient until discharge. Recently, CCH also added several new telehealth services, including the Telstroke Program, e-Mental Health Triage and the Telestewardship Program. Each program gives CCH's physicians access to specialists in larger communities without leaving Columbus. These expanded telehelath services increase access to psychiatry and geriatric psychiatry services, as well as services for stroke patients. e-Mental Health Triage allows for behavioral health assessments out of CCH's Emergency Department and the Telstroke program allows CCH stroke patients and their physicians to immediately connect and consult with expert Nebraska medicine neurologists. In May 2017, CCH joined forces with Columbus Otolaryngology Clinic to provide a wide range of high-quality otolaryngology services to Columbus residents. Through the clinic, Dr. Nila Novotny, along with Dr. James Weekly, Dr. Paul Sherrerd and a support staff of nine others, provide a full range of otolaryngology services. The clinic is located in the Healthpark Medical Office Building next to the hospital. CCH's commitment to the community extends beyond its health care services. The hospital also strives to provide a better life for families in its community. With that in mind, CCH built a child care center to help alleviate a child care shortage in the area. In August 2017, CCH opened the CCH Child Care Center northeast of the hospital. The Child Care Center has the capacity to care for more than 100 children from infants to age 12. It provides an additional benefit to CCH employees and to the community as a whole, since it is open to the public. In April 2018, CCH expanded its joint replacement offerings with the launch of the Surge Center, a comprehensive joint replacement program. The goal of the program is to provide quality outcomes for people who elect to undergo hip, knee or shoulder replacement surgery. The program starts with education before surgery. After their procedure, patients are taken to the Surge Center where they receive assistance from nurses and other staff members who specialize in joint care. They also participate in group activities with other joint replacement patients, including physical therapy. CCH expanded its service offerings further in May 2018 by merging with Columbus General Surgery. The surgeons at Columbus General Surgery evaluate and treat the following: gastrointestinal pathology, breast pathology, skin lesions, thyroid nodules and varicose veins. Columbus General Surgery also provides colon cancer screenings. To further improve patient experiences, CCH also adopted a patient-centered methodology called Lean Healthcare. The ultimate goal behind Lean is to eliminate waste, improve processes and increase overall patient satisfaction. CCH has been working to create a culture surrounding these simple goals. Employees are encouraged to take part in the practice and share any ideas they have to improve quality of care in the facility. The hope is to improve patient care, patient satisfaction, staff satisfaction and regulatory compliance, as well as reduce inventory, costs, mortality rates and morbidity rates. Over the past several months, the hospital has also improved its services through the purchase of new equipment including a Wide Bore MRI, which allows larger-sized patients or those with claustrophobia to receive scans in Columbus which are of the same quality, or better, than those done in larger cities in Nebraska. Additionally, the new MRI is quieter, faster and produces superior images than those from CCH's previous equipment. Schedule H, Part VI, Line 5 Promotion of Community Health CCH's mission is to improve the health of the communities it serves. Each year, the hospital strives to provide the best care to its patients, while also providing wellness events and activities that are easily accessible to community members. In accordance with these goals, CCH holds various community health and wellness events, and organizes health and safety initiatives. In August 2017, CCH held a S.N.A.P. Camp (S - Safety, N - Nutrition, A - Awareness, P - Physical Activity) camp for children to help them make healthy choices in nutrition, exercise and safety. The camp was for children entering grades 4, 5 and 6. CCH held two community health events in September 2017. The 14th annual Tune Up for Life Community Health Fair was held Saturday, September 9, 2017. The health fair featured free health screenings for blood pressure, body composition, bone mineral density, colorectal cancer, flexibility, hearing, strength and vision. Discounted health tests and vaccines were also available, including artrial fibrillation, abdominal aortic ultrasound, peripheral arterial disease, carotid artery ultrasound, seasonal flu shots, pneumonia vaccinations and much more. On September 26, 2017, CCH held a Senior Living Festival that provided local seniors with information on the latest innovations in hearing and balance, as well as information on medication safety. CCH offered medical services such as blood pressure and bone mineral density screenings free of charge. Flu shots and pneumonia vaccinations were also available for attendees. To promote community wellness, CCH held its 7th annual We Can Run, Walk & Roll event on October 7, 2017. The event is desinged to celebrate the abilities of individuals with disabilities and to promote health and well-being in the community. Proceeds from We Can Run, Walk & Roll are used to purchase AmTrykes for those in the community who need the adapted tricycles and would not otherwise be able to purchase them. CCH held the 14th Annual Diabetes Awareness Day on October 10, 2017 that offered community members the chance to learn about a variety of diabetes-related topics, attend a healthy cooking demonstration, and do a variety of health screenings, as well as receive immunizations and vaccines. In November 2017, CCH created the Pain Management Task Force with the goal of delivering safe, compassionate, evidence-based pain management to the community of Columbus. During the fiscal year, the task force developed guidelines for pain management and the dispensing of opioids. It also added non-narcotic pain options to the pharmacy formulary and developed a non-medication comfort menu for patients, among other accomplishments. These efforts were designed to change the way providers and patients think about pain management, reduce the number of opiod pills which become uncontroleld and make education easily assessable to everyone. To address the health of the children in its community, CCH started offering the Food, Fitness & Fun program in January 2018. The free, eight-week afterschool program taught kids in grades one through six about nutrition and healthy lifestyle choices. In April 2018, CCH's Columbus otolaryngology Clinic offered free oral, head and neck cancer screenings. Also in 2018, CCH offered low-dose CT lung screenings to qualifying patients who were referred by their doctors. The screenings were offered at a reduced cost of $250 each. Over the past year, CCH performed more than 110 screenings for qualifying patients. To further enhance medication safety, CCH and local health care providers urged community members to think about medication safety. To this end, the team produced and promoted updated medication lists. These are lists people can carry with them in case of an emergency or take to a doctor's appointment. They help providers in our community make better informed decisions about their patients so patients can receive better quality care. The medication lists, pockets and brochures have been well received by nursing homes, assisted living facilities, pharmacies, home health care agencies, emergency services, physician's clinics and the hospital. The Complete Health Improvement Program (CHIP) is another program CCH implemented to improve the health of its community. The program initially began as a pilot program for employees in June 2016 but was expanded in later years to be open to the public. CHIP is an affordable, evidence-based, intensive lifestyle enrichment program desinged to reduce disease risk factors through the adoption of better health habits and appropriate lifestyle modifications. The goal of the program is to lower blood cholesterol, hypertension and blood sugar levels and reduce excess weight by improving dietary choices, enhancing daily exercise, increasing support systems and decreasing stress, thus aiding in the prevention and reduction of disease. As of August 2018, more than 15 sessions of CHIP have been completed. The following are the average results per session: - 5.1 reduction in blood glucose - 10.1 reduction in triglycerides - 12.0 LDL cholesterol reduction - 4.8 HDL cholesterol reduction - 18.4 total cholesterol reduction - 6.0 diastolic blood pressure reduction - 11.3 systolic blood pressure reduction - 136.9 pounds lost Participants have reported feeling better overall in addition to having increased energy. They've also reported reduced inflammation and joint pain, and increased range of motion. Several participants who had previously been taking prescription medicaion under their physician's guidance, have had their dosage reduced or been able to be completly taken off the medication. In addition to CHIP, CCH offers several ongoing programs that educate the community about nutrition and healthy eating. This includes monthly cooking classes and a program called Ask the Dietician. The Healthy Cooking Classes are held the third Tuesday of each month. For $15, community members can learn a collection of easy and healthy recipes. Dieticians also give participants advice on how to cut down on unhealthy ingredients like fat and sodium. CCH dieticians also offer free Ask the Dietitian sessions which give community members the opportunity to get one-on-one time with a dietician every week. Each session includes an educational discussion, followed by a question and answer segment. CCH dietitians can answer questions about diabetes, weight loss, heart health, healthy cooking and much more. CCH held its 14th annual Tune-Up for Life on September 9, 2017. The event featured free halth screenings for blood pressure, body composition, bone mineral density, as well as tests on flexibility, strenth, hearing and vision. At the event, attendees could also get discounted health screenings, and seasonal flu shots and the pneumonia vaccine. Also in September 2017, CCH participated in Kids Safety Day, where area families could learn safety trips from local experts. The event included demonstrations and displays that allowed children and teens to learn about fire, seatbelt and powerline safety, among other important topics. Attendees could also participate in various drawings, including the chance to win a free bicycle. On September 26, 2017 CCH held a Senior Living Festival which educated seniors on skin lesions and CCH's new Surge Joint Replacement Center. The event also gave participants the chance to get free bone mineral density and blood pressure screenings, as well as flu shots and pneumonia vaccinations. CCH staff were also on hand to answer questions about the hospital's services and a diabetes educator was on-site as well. On October 7, 2017 CCH again held its annual We Can Run, Walk and Roll event in which participants could choose to complete in a 5K (3.1 miles) or 1-mile race. Proceeds from the event went toward purchasing AmTrykes for individuals and familites in the community. AmTrykes are adaptive tricycles that allow differently-abled individuals to participate more fully in health and wellness activities. CCH held its 14th Annual Diabetes Awareness Day on October 10, 2017. The event allowed area residents to learn more about diabetes and CCH staff were on hand to provide health screenings. Attendees could also visit numerous informational booths, listen to speakers and attend a health cooking demonstration. Schedule H, Part VI, Line 6 Affiliated Health Care System N/A Schedule H, Part VI, Line 7 State Filing of Community Benefit Report The Community Benefit information from the 2017-2018 annual report can be found at: https://www.columbushosp.org/sites/www/Uploads/AnnualReport0818web.pdf true COLUMBUS COMMUNITY FOUNDATION 4600 38TH STREET COLUMBUS NE 68601 470836747 501(C)(3) 176738 PROGRAM SUPPORT 1 0 Charity Care to Patients 735 1514140 Book write-off of med exp Schedule I, Part I, Line 2 Columbus Community Hospital does not typically give out donations, but occasionally a request is brought forward and the Board determines that it is in the best interest of the community to provide a particular grant. Prior to providing the grant, the Hospital determines that the organization it gives to is a 501(C)(3) organization or a government agency. The Hospital will also make grants to these related organizations as necessary to support their exempt purpose. X true true X X X X X X false true false false false true false false false Amy Blaser VP Business Development 143938 0 13734 0 6603 0 17774 0 27722 0 209771 0 0 0 Chad Van Cleave VP Finance 141722 0 14048 0 6206 0 18336 0 27767 0 208079 0 6206 0 Scott Messersmith VP Operations 134477 0 13040 0 8822 0 17184 0 27623 0 201146 0 0 0 Michael Hansen President/CEO/Secretary 403258 0 50625 0 23841 0 53326 0 29771 0 560821 0 18000 0 Dustin Volkmer MD Physician 455229 0 151647 0 0 0 10800 0 29714 0 647390 0 0 0 Edward Fehringer MD Physician 547851 0 192870 0 18000 0 10800 0 29714 0 799235 0 18000 0 Michael McGuire MD Physician 486753 0 14531 0 0 0 10800 0 29545 0 541629 0 0 0 Richard Cimpl MD Physician 570986 0 107180 0 18000 0 10800 0 29648 0 736614 0 18000 0 Ian Crabb MD Physician 556493 0 0 0 18000 0 0 0 29771 0 604264 0 18000 0 Schedule J, Part I, Line 1a The Organization paid for social and health club dues as part of the CEO's employment agreement. These amounts were reflected on the CEO's W-2. Schedule J, Part I, Line 4b The following reportable individuals participated in a supplemental nonqualified retirement plan during the 2017 calendar year. Amounts deferred from the plan were included in Column C of the Schedule J: Michael Hansen - $42,526 Amy Blaser - $11,274 Scott Messersmith - $10,901 Chad Van Cleave - $11,913 Schedule J, Part I, Line 4c The Hospital's Executive Compensation Committee, made up of independent Hospital Board members, reviews the CEO's compensation annually. The wage range is compared to information provided by third party consultants. Decisions are documented. Schedule J, Part I, Line 6a With the assistance of Towers-Watson, executive compensation consultants, the Board authorized paying an incentive to the executives for meeting specific Board-Established Directives. The Board authorized paying up to 25% of base compensation for Michael Hansen and up to 20% for the following VPs: - Linda Walline - Amy Blaser - Chad Van Cleave The incentive is based on goals established by the Board which are now reviewed annually. One of the goals is the Hospital's operating margin. The Board determines the associated metrics for each individual goal. Each of the goals is then assigned a weight based on the level of importance, as determined by the Board. The results are entered and the metric is tabulated. That number is multiplied by the corresponding weight. Once weighted, the figures are added in total to establish a score between 1 and 5. No incentive is paid if the Hospital's operating margin falls below 7.0%, regardless of the outcomes of the other measures. Any physician bonuses are based on productivity. The incentives were paid in this fiscal year for work done in the previous fiscal year. The bonuses paid were: - Michael Hansen - $50,625 - Edward Fehringer, MD - $192,870 - Dustin Volkmer - $151,647 - Michael McGuire, MD - $14,531 - Linda Walline - $17,412 - Amy Blaser - $13,734 - Chad Van Cleave - $14,048 - Scott Messersmith - $13,040 - Richard Cimpl - $107,180 Form 990, Part III, Line 4a Columbus Community Hospital (CCH) is a 47 bed acute care hospital which currently employs over 650 people. It is a significant, positive economic force for the Columbus area, returning dollars into the economy through local purchases by the organization and salaries that return to the community. It is an asset for the local communities where patients can obtain quality health care without the need to drive over 50 miles for care. CCH offers a variety of services that provide necessary care for area residents. Below is a brief summary of services offered by Columbus Community Hospital: - All 47 beds of the Hospital's acute care services are also certified as swing beds. - CCH provides certified, dedicated medical interpreters to assist non-English speaking patients. The interpreters are available in-house or on-call 24/7 and serve as a liaison between the care providers and the patient. - The Hospital provides ICU, medical surgical, OB and orthopedic services, along with a variety of complimentary ancillary services. These ancillary services include wound care, diabetic education and cardiac rehab and also include clinical pharmacy services. To enhance patient safety, CCH uses bar-coded medication administration, smart pumps and computerized physician order entry. - So that area residents can receive care close to home, CCH offers rehabilitative services that include physical therapy, speech therapy, occupational therapy as well as specialized multidisciplinary therapy programs such as thrive cancer rehabiliation care, parkinson wellness program, concussion management team, complete decongestive lymphedema therapy clinic, a driver's rehabiliation program, visual and vestibular rehab, aquatic therapy program, and pelvic floor dysfunction (male/female urinary incontinence and pelvic pain) program. The Hospital's Wiggles and Giggles Therapy for Kids offers pediatric physical, occupational and speech for children ranging in age from infants to adolescents. In November 2015, outpatient therapy services moved into first floor space with greater access for patients at the new columbus wellness center and now patients are integrated and transitioned into medical wellness programs after discharge such as the parkinson's exercise group, the loud crowd voice exercise group, TBI, & stroke support group, spinefit exercise classes, aquatic exercise classes, and tai chi for better balance classes. - Nurses in the Hospital's Same Day Services (SDS) Department prepare patients for surgery and care for patients in both the inpatient and outpatient setting. The Department oversees several outpatient procedures, including an average of 80 endoscopy procedures each month. SDS nurses also administer blood transfusions and chemotherapy infusions. - CCH offers some of the most advanced imaging services including MRI, CT, Digital Mammography and ultrasound. Radiologists are on campus and/or available 24/7. All images are digital, and the dictation used by radiologists is voice recognized and becomes part of the digital image. - The Hospital's laboratory performs an average of 13,000 tests per month for both inpatients and outpatients. - The CCH Emergency Department (ED) employs highly trained emergency physicians and nurses, offering 24/7 care. Other Hospital departments providing support in the ED include Respiratory Care, Social Work, Laboratory, Medical Interpreters and Diagnostic Imaging. In May, 2006, the CCH Emergency Department was designated as a Level III Trauma Center. The Medical Staff and personnel in the Trauma Center have received specialized training to resuscitate and stabilize trauma patients. The Trauma Program provides systematic review of trauma care and participates in injury prevention activities throughout the community. - CCH opened wound care services in August, 2008, offering clinic hours one day per week. The identified service area includes a 45-mile radius around Columbus. By January 2009, a second day was added to support the demand. The program has exceeded the anticipated demand and provides a much needed service close to home. The clinic sees about 100 patients per month for wound care. - For services located in facilities off-site, the larger services are Home Health and Hospice. Home Health provides skilled health services for patients at their place of residence. The program is medically directed and must be ordered by the attending physician. Home Health is Medicare and Medicaid Certified and meets the requirements of the Joint Commission. Services provided within the program are: - Supervision and administration of medications - Intravenous therapy - Instructing patients in diabetic management - Nutritional assessments - Home Health aides - Personal care services - Occupational, speech and physical therapies - Hospice services are provided to persons who are no longer receiving curative treatment and whose life expectancy is six months or less. Care is provided by an interdisciplinary team which consists of the physician, nurse, social worker, therapist, Home Health aide, spiritual advisor, volunteer and other health professionals. - Our local Healthy Family Nebraska Program (HFN) targets young, primarily single, pregnant mothers and their families. Our voluntary HFN home visitation program targets the most vulnerable young women and their families by offering them intense, in-home education, support and resources. This home visiting program covers families in a four county area. The HFN requires each mother/family to actively participate in building an individualized family plan. This strength-based approach promotes self-improvement and enhances self-esteem and independence for our young parents that will help them make better decisions and break out of destructive cycles. - The CCH Sleep Lab offers complete polysomnographic sleep testing by trained and licensed sleep technicians for the purpose of diagnosing obstructive/central sleep apnea. Both daytime and night sleep studies are performed. - Occupational Health Services (OHS) offers a menu of health care services designed to prevent and treat injuries in the workplace. Partnering with employers in more than 800 companies and with other health care professions, OHS provides the Columbus and regional area businesses and industry with a comprehensive range of services designed to support and maintain a healthy, safe workforce while assisting them in meeting OSHA and DOT compliance regulations. Their full range of services include: - A comprehensive testing procedure called Physical Capacity Profile (PCP) that matches employees to the job and is designed to accommodate individuals with handicaps. The PCP system was developed by an orthopedic physician. Through use of this testing, musculoskeletal imbalances are detected which helps employers place employees in the appropriate job to minimize the potential of injury. - 24/7 drug and alcohol testing services - Pre-employment/post job offer physical assessments - On-site nursing services - Hearing/vision testing - Hearing conservation program management - Respiratory fit testing - Respiratory evaluation services - Flu shots and immunization programs - Wellness programs - Lifeline, an in-home emergency response program, provides the vital safety net that many people need to continue living at home in familiar and comforting surroundings. The program is completely focused on ensuring the patient's independence, safety and well-being in their home. It operates with a bracelet worn by the patient with a button that can be pressed if help is needed. Pre-determined responders are summoned to their home or emergency transfer can be called if needed. - Meals on Wheels are prepared by the Nutrition Services Department and are delivered by community volunteers. Seniors and physically handicapped adults qualify for the program. Special diets can also be accommodated. Financial assistance is available through the Nebraska Department of Social Services. (continued) Form 990, Part III, Line 4a (continued) - The Hospital also participates in and has hosted county-wide natural disaster and pandemic drills. As a member of a larger preparedness team, RROMRS, CCH can assist or receive assistance from this region's Medicare providers. Through these drills and exercises, the Hospital is well-prepared to handle a natural disaster or pandemic should one arise. - To better service our community, Columbus Community Hospital has partnered with Columbus Children's Healthcare to create the Columbus Community Hospital Pediatric Hospitalist Program in May of 2017. This service is applicable to inpatient and observation care only to patients ages newborn to age 18. Pediatric Hospitalists routinely complete rounds in morning and evenings, and as census and acuity demands. Physicians from other communities who are not currently credentialed at Columbus Community Hospital may refer to the Pediatric Hospitalist group for admission. Hospitalists routinely complete rounds in morning and evenings, and as census and acuity demands. Physicians from other communities who are not currently credentialed at Columbus Community Hospital may refer to the Pediatric Hospitalist group for admission. Form 990, Part III, Line 4b PROVIDE UNCOMPENSATED SERVICES TO PEOPLE WHO ARE UNABLE TO PAY. CCH CHARITY/FINANCIAL AID POLICY REFLECTS THE MISSION, VISION AND VALUES OF CCH. IT IS INTENDED TO ASSIST LOW-INCOME, UNDERINSURED, AND UNINSURED INDIVIDUALS WHOSE FINANCIAL STATUS, UNDER THE HOSPITAL'S QUALIFICATION CRITERIA, MAKES IT IMPRACTICAL OR IMPOSSIBLE TO PAY FOR NECESSARY MEDICAL SERVICES. CCH HAS A FIDUCIARY RESPONSIBILITY TO SEEK PAYMENT FOR SERVICES FROM THOSE WHO CAN PAY, AND EVERY EFFORT WILL BE MADE TO APPLY CONSISTENT, FAIR AND EQUITABLE FINANCIAL AID PRACTICES IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. CCH FOLLOWS THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE BOTH ELIGIBILITY FOR FREE CARE, 100% OF FPG, AND DISCOUNTED CARE, 200% FPG. CCH ALSO OFFERS CATASTROPHIC CHARITY ASSISTANCE. IF THE APPLICANT QUALIFIES FOR PARTIAL CHARITY/FINANCIAL ASSISTANCE AND THE TOTAL BALANCE AFTER ALL WRITE-OFF'S IS GREATER THAN $1,200, AN ADDITIONAL WRITE-OFF WILL BE DONE AS OUTLINED BELOW: - REDUCE TO $1,200 - ADJUSTMENTS WILL BE DONE FROM OLDEST TO NEWEST. Form 990, Part VI, Line 11b The Form 990 will be available for all the Members of the Finance Committee to review. Upon Committee review, the 990 will then be submitted to the full Board for review and the Board will make any corrections if applicable. Form 990, Part VI, Line 12c Columbus Community Hospital monitors any conflict of interest based on their Conflict of Interest Policy. Employees and Volunteers are required to fully disclose any conflict of interest that may exist or appears to exist. Hospital reviews any of these conflicts and works with the Vice President or CEO to determine if a conflict exists. If one does exist, the Hospital initiates actions to manage, reduce, or eliminate the conflict. Form 990, Part VI, Line 15a The Hospital's Executive Compensation Committee, made up of independent Hospital Board Members, reviews the CEO's compensation annually. The wage range is compared to information provided by third party consultants. Decisions are documented. Form 990, Part VI, Line 15b The Hospital's CEO and Director of Human Resources, review the VP's and other highly compensated employee's compensation annually. The wage range is compared to information provided by third party consultants. Decisions are documented. Form 990, Part VI, Line 19 At Columbus Community Hospital, a 3-ring binder exists in the Executive Assistant's office labeled for public disclosure which includes the most current of the following: A) Governing Documents which are the Hospital's Bylaws B) Conflict of Interest Policy C) Audited Financial Statements D) Forms 990 and 990-T Form 990, Part XI, Line 9 Other changes: A) HealthPark, LLC separate 990 income - $205,135 Columbus Community Hospital Foundation 4600 38th Street Columbus NE 68601 470836747 Fundraising NE 501(C)(3) Line 12, I CCH true Healthpark Title Company 4600 38th Street Columbus NE 68601 470830945 Holding Co NE 501(C)(2) N/A CCH true ZARZ LLC PO Box 1800 Columbus NE 68602 273676428 Property Mgmt NE Hlthpk Title Co Related 0 0 false 0 true 0.10000 HealthPark LLC PO Box 1800 Columbus NE 68602 470836733 Property Mgmt NE Hlthpk Title Co Related 0 0 false 0 true 0.22760 Platte Valley Physician Hospital Org PO Box 1800 Columbus NE 68602 470790385 HEALTH ADMIN NE CCH Nonprofit Corp 3450 6191 1.00000 true false true true false true false false false false false true false true true true false true false false Columbus Community Hospital Foundation b 176738 Cash Columbus Community Hospital Foundation c 647873 Cash Healthpark Title Company K 16401 Book