SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Northwestern Memorial HealthCare Group
 
Employer identification number

36-4724966
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    101,163,352 11,435,003 89,728,349 1.42 %
b Medicaid (from Worksheet 3, column a) . . . . .     560,171,964 317,586,098 242,585,866 3.85 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 661,335,316 329,021,101 332,314,215 5.27 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     5,828,228   5,828,228 0.09 %
f Health professions education (from Worksheet 5) . . .     79,131,866 13,897,797 65,234,069 1.04 %
g Subsidized health services (from Worksheet 6) . . . .     33,286,986   33,286,986 0.53 %
h Research (from Worksheet 7) .     53,954,881   53,954,881 0.86 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     5,167,404   5,167,404 0.08 %
j Total. Other Benefits . . 0 0 177,369,365 13,897,797 163,471,568 2.59 %
k Total. Add lines 7d and 7j . 0 0 838,704,681 342,918,898 495,785,783 7.87 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development     4,918,974   4,918,974 0.08 %
9 Other         0 0 %
10 Total 0 0 4,918,974 0 4,918,974 0.08 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
41,366,926
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
1,472,312,597
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
2,096,377,020
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-624,064,423
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1Kishwaukee Area PHO
  		Credentialing & Managed Care 66.67 %   33.33 %
2Midland Surgical Center
  		Surgery Center 77.5 %   22.5 %
3Lake Forest Managed Care Association
  		Credentialing & Managed Care 50 %   50 %
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?8Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Northwestern Memorial Hospital
251 E Huron
Chicago,IL60611
www.nmh.org
0003251 		X X   X   X X      
2 NORTHWESTERN LAKE FOREST HOSPITAL
1000 N WESTMORELAND ROAD
LAKE FOREST,IL60045
WWW.LFH.ORG
0005660 		X X   X     X      
3 CENTRAL DUPAGE HOSPITAL ASSOCIATION
25 N WINFIELD ROAD
WINFIELD,IL60190
WWW.CADENCEHEALTH.ORG
0005744 		X X   X     X      
4 DELNOR-COMMUNITY HOSPITAL
300 RANDALL ROAD
GENEVA,IL60134
WWW.CADENCEHEALTH.ORG
0005736 		X X   X     X      
5 NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL
1 KISH HOSPITAL DR
DEKALB,IL60115
0005470 		X X         X      
6 Northwestern Medicine Valley West Hospital
1302 N Main Street
Sandwich,IL60548
www.kishhealth.org
0004690 		X X     X   X      
7 Marianjoy Rehabilitation Hospital
26 W 171 Roosevelt Rd
Wheaton,IL60187
www.marianjoy.org
0003228 		X     X         Rehabilitation Svcs  
8 NORTHERN ILLINOIS MEDICAL CENTER
4201 MEDICAL CENTER DRIVE
MCHENRY,IL60050
WWW.NM.ORG
0003889 		X X   X     X      
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Northwestern Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Northwestern Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Northwestern Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Northwestern Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
NORTHWESTERN LAKE FOREST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
NORTHWESTERN LAKE FOREST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
NORTHWESTERN LAKE FOREST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
NORTHWESTERN LAKE FOREST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
CENTRAL DUPAGE HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		3
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
CENTRAL DUPAGE HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
CENTRAL DUPAGE HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
CENTRAL DUPAGE HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DELNOR-COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		4
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
DELNOR-COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
DELNOR-COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
DELNOR-COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		5
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Northwestern Medicine Valley West Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		6
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Northwestern Medicine Valley West Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Northwestern Medicine Valley West Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Northwestern Medicine Valley West Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Marianjoy Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		7
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Marianjoy Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Marianjoy Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Marianjoy Rehabilitation Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
NORTHERN ILLINOIS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		8
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.nm.org/about-us/community-initiatives/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
NORTHERN ILLINOIS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
b
https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
NORTHERN ILLINOIS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
NORTHERN ILLINOIS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - Northwestern Memorial Hospital. The CHNA report also describes Northwestern Memorial Hospital's CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. The hospital facility took into account input from persons who represent the community, including uninsured persons, low-income persons and minority groups, through community input surreys, community focus groups, healthcare and social service provider focus groups, and stakeholder assessments. Community input surveys collected input from 1,593 individuals 18 or older living in the NMH Community Service Area. Surveys were available on paper and online and were disseminated in four different languages. Questions assessed demographics, the health of the community, community strengths, opportunities for improvement and priority health needs. Surveys were targeted at priority populations, those typically underrepresented in assessment processes, including communities of color, immigrants, LGBTQ+ community members, individuals with disabilities and low-income communities. Community focus groups included 36 discussion sessions held within the NMH Community Service Area. Focus groups took place with priority populations, such as veterans, individuals living with mental illness, communities of color, older adults, caregivers, teens and young adults, LGBTQ+ community members, adults and teens experiencing homelessness, families with children, faith communities, adults with disabilities, and children and adults living with chronic conditions such as diabetes and asthma. Healthcare and social service provider focus groups assessed community leaders and healthcare providers, including faith leaders, immigrant service providers and hospitals. Stakeholder assessments evaluated trends, factors and events that currently affect or are anticipated to affect the public health system and included an assessment of the public health system's capacity to advance health equity. To ensure that organizations impacting health in the NMH community service area were meaningfully engaged in interpreting the findings of the CHNA, prioritizing the identified needs, and forming a collaborative plan to address priority needs, the Community Health Council was established and maintained, and the following community stakeholders were formally engaged: 1. Bright Star Community Outreach 2. Chicago Public Library 3. CommunityHealth 4. Erie Family Health Centers 5. Kelly Hall YMCA 6. Near North Health Services Corporation 7. Neighborhood Housing Services 8. Northwestern University's Alliance for Research in Chicagoland Communities 9. Salvation Army Freedom Center 10. West Humboldt Park Development Council
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMH worked in tandem with the Alliance for Health Equity (AHE) which is made up of 37 hospitals and local health departments. Collectively, this group of hospitals worked to collaboratively assess community needs. Specific needs of the NMH Community Service Area were identified and prioritized separately. Hospital facilities included: 1. Advocate Aurora Children's Hospital 2. Advocate Aurora Christ Medical Center 3. Advocate Aurora Illinois Masonic Medical Center 4. Advocate Aurora Lutheran General Hospital 5. Advocate Aurora South Suburban Hospital 6. Advocate Aurora Trinity Hospital 7. AMITA Adventist Medical Center La Grange 8. AMITA Alexian Brothers Medical Center, Elk Grove Village 9. AMITA Holy Family Medical Center 10. AMITA Resurrection Medical Center 11. AMITA St. Alexius Medical Center and Alexian Brothers Behavioral Health Hospital 12. AMITA Saint Francis Hospital 13. AMITA Saint Joseph Hospital 14. AMITA Saints Mary and Elizabeth Medical Center 15. Ann & Robert H. Lurie Children's Hospital of Chicago 16. The Loretto Hospital 17. Loyola Medicine- Gottlieb Memorial Hospital 18. Loyola Medicine- Loyola University Medical Center 19. Loyola Medicine- MacNeal Hospital 20. Mercy Hospital & Medical Center 21. Northwestern Memorial Hospital 22. Norwegian American Hospital 23. Palos Community Hospital 24. Roseland Community Hospital 25. Rush Oak Park 26. Rush University Medical Center 27. Sinai Health System- Holy Cross Hospital 28. Sinai Health System- Mount Sinai Hospital 29. Sinai Health System- Schwab Rehabilitation Hospital 30. South Shore Hospital 31. Swedish Covenant Hospital 32. University of Chicago Medicine 33. University of Chicago Medicine- Ingalls Memorial Hospital 34. Cook County Health- Stroger Hospital 35. Cook County Health- Provident Hospital 36. University of Illinois Hospital and Health Sciences System
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMH worked in tandem with the Alliance for Health Equity (AHE) which is made up of 37 hospitals and local health departments. Collectively, this group of hospitals worked to collaboratively assess community needs. Specific needs of the NMH Community Service Area were identified and prioritized separately. Other organizations included: 1. Chicago Department of Public Health 2. Cook County Department of Public Health 3. Evanston Health and Human Services Department 4. Village of Skokie Health Department
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also shared with the following: 1. Key community organizations 2. Northwestern University Institute of Public Health and Medicine 3. Northwestern Medicine Leadership
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Northwestern Memorial Hospital. Through the tax year 2019-2022 prioritization process and implantation plan, NMH identified four Priority Health Needs: Access to Health Care and Community Resources; Structural Inequities; Violence and Community Safety; and Workforce Development and Economic Vitality. NMH identified health needs that would be best addressed through a coordinated response from a range of healthcare and community resources. Specific ways in which NMH is addressing the significant needs identified in its most recently conducted CHNA are defined as follows: Priority Need 1: Access to Health Care and Community Resources 1.1: Behavioral Health Resources. Improve access to mental and behavioral health resources through the expansion of community-based programs such as Calm Classroom and Mental Health First Aid trainings. As a result of the State of Illinois Coronavirus shut down, all in person educational programs were temporarily paused. Since the State reopened, in-person meetings were severely restricted, and many NMH community partners have not opened external programming. In addition, technology challenges have made it difficult to continue programming, since some community residents do have access to internet or do not know how to use technology platforms such as Zoom. To help address these issues, Northwestern provided a technology grant to Bright Star Community Outreach (BSCO) to help ensure BSCO could continue to offer critical programs in a socially distant and safe manner, NMH provided an emergency grant to upgrade technology and support remote access at BSCO. Technology support enabled BSCO to offer virtual services including counseling and youth programs, especially to those impacted by the Coronavirus pandemic. 1.2: Clinical Community Relationships. Develop a Health System level approach to better serve uninsured and underinsured patients through clinical community relationships. Utilize the identified approach to pilot new opportunities and enhance current relationships in the NMH CSA. During a time when testing resources were scarce, NM provided a critically important mechanism to ensure that high-risk patients received testing and necessary follow-up treatment. Largely through our drive-up testing and other clinical sites, NMH conducted more than 28,000 COVID-19 tests for residents living in high hardship zipcodes. NMH also worked with community partners, including federally qualified health centers, health clinics and other providers, to support testing in the communities we serve, including the provision of test kits for homeless patients on Chicago's West Side. NM also processed COVID-19 specimens from patients of CommunityHealth, a free clinic also on the West Side. Additionally, NM donated critical supplies and PPE, including N95 respirator masks, hand sanitizer, gloves, isolation gowns, surgical facial shields and education for the proper use of PPE to clinical organizations. 1.3: Education-Centered Medical Home (ECMH): Community Engagement Project. Establish a Community Engagement Program together with Northwestern University Feinberg School of Medicine that aligns ECMH community health projects with priority health needs identified through the NMH CHNA. In response to COVID-19, ECMH transitioned to a telehealth model. The use of telehealth aligned with CDC recommendations to protect both providers and patients while still ensuring continuity of care. Additionally, students began making proactive outreach calls to at-risk patients. Each ECMH location created a list of patients that were at high-risk for COVID-19 complications due to age or comorbidities including diabetes or immunosuppressed conditions. Students called these patients once a week to screen for COVID-19 symptoms and to inquire about additional needs including housing and food insecurity. This outreach was a new component of the ECMH program and demonstrates the students' heartfelt consideration for their patients. Medical students who participate in the ECMH program report improved continuity of care experiences, higher satisfaction with their primary care learning climate, more confidence and improved skills. Due to the success of ECMH, the program was expanded to 100 percent of the incoming class of Feinberg medical students in 2020. 1.4: Social Determinants of Health (SDOH) Plan. Implement an electronic tool that is integrated with NMH's electronic medical record (Epic) to capture SDOH for patients, train staff members/advocates to screen and utilize SDOH data, and refer patients to appropriate services in order to address SDOH. NMHC executive leadership identified the implementation of routine SDOH screening as a top organizational priority and included it as a key initiative for the health system. A system wide summit was held in December 2019, which included key physicians, nurses, IT, Quality and other administrative leadership. At the conclusion of the summit, 6 social determinant domains were prioritized to assess and address for patients, including housing, food, medication affordability, transportation, mental health, and social isolation. A review of known surveys used by other health systems was conducted and the determination was made to create a customized survey to screen for social determinants. Additionally, system leadership agreed to use the Epic SDOH tools to store social determinant data collected and visualize patients' needs using Storyboard and SDOH Wheel views in Epic. 1.5: Food Insecurity. Implement food insecurity screening for patients and employees and build a process to link those eligible to appropriate benefits and resources. Collaborate with community partners on food access and nutrition education programming (i.e. healthy cooking on a budget; budgeting food dollars with limited resources, etc). This strategy was not in the original Implementation Plan, but was added to address needs that were elevated or emerged due to Covid-19. NM swiftly responded to hunger in our communities through a combination of food donations, grant funding, food and grocery store vouchers, and transportation services. Economic recession and civil unrest led to the closure of grocery stores in some Chicago neighborhood including Bronzveille. In response, BSCO organized a food drive to distribute groceries to residents. NMH helped support this initiative with grant funding and volunteers. In addition, NMH donated food items to multiple organizations and supported the Lakeview Food Pantry and LaSalle Street Church with grant support to provide immediate food to those who were deeply impacted by the pandemic. NMH and BSCO will continue to collaborate to serve the residents of Bronzeville with future initiatives. NMH also embarked upon a unique collaboration with its delivery vendor MedSpeed and Our Lady of Angels Mission to provide food to those most in need. During Covid-19, the number of people experiencing food insecurity increased, while at the same time, there was a need for community members to shelter in place and limit exposure. In order to meet the food needs of senior citizens and vulnerable populations, this strategy included $27,000 in funding from NMH which supported over 9,000 bags of groceries prepared by Our Lady of Angels and delivered by MedSpeed. There was an average of 90 deliveries per week to over 200 unique addresses/families that benefited from the service. In addition to providing emergency food resources, NM continued its partnership with Near North Health Services Corporation to provide nutrition education to Chicago's most vulnerable. Near North was able to quickly pivot to social media platforms such as Facebook to provide short videos on healthy food preparation on a budget and the nutritional value of those foods.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Northwestern Memorial Hospital. Priority Need 2: Structural Inequities. 2.1: Quality Equity. Analyze patient care and clinical service quality measures to identify disparities and implement improvement strategies. The NMHC Quality Equity Plan was approved by the NMHC Quality Management Committee in June 2020. The plan includes a vision for advancing quality equity for NM patients over the next 5 years with improved infrastructure, programming, and partnership with NU and other community organizations. The FY21 Quality Equity Plan was developed with four categories and a focus in 11 areas. These focus areas and outcomes include: 1) Accessing Care at NM (barriers due to change in insurance status, mitigating barriers for patients with limited English proficiency): a. developed a patient facing document to help patients identify options to continue receiving care at NM if they lost insurance; b. posted on nm.org; c. launched a quality project on interpreter use; 2) Meeting Diverse Needs (HOPE, SDOH): a. Launched HOPE summer work with a focus on patients with chronic conditions including diabetes and hypertension; 3) Focused Clinical Areas (flu vaccine, COVID-19, Diabetes, Maternal Care, Hypertension) a. developed video and written materials for staff to help patients overcome vaccine hesitancy and shared widely; b. provided primary care clinics regular updates on flu vaccination progress, including racial and ethnic disparities in vaccine rates; c. developed a toolkit for practice managers to discuss disparities in vaccination rates with staff and strategize how to reduce disparities; d. developed a playbook for future flu seasons or other vaccination campaigns; e. launched diabetes tune up pathway to connect patients with diabetes to multidisciplinary team for education and resources to better manage diabetes; f. prioritized 4 clinical measures to reduce disparities in; g. identified measures to assess for disparities; 4) Infrastructure (analytics/quality approach to measuring equity with high fidelity data, developing partnership with IPHAM and other research groups at NM/NU): a. standard deck on how to assess for disparities was developed; b. disparity analysis was completed for 6 different clinical measures; c. demographics fields (race, ethnicity, SOGI, language) added as standard fields for all ambulatory quality reports; d. added discrete documentation for disability accommodations; e. updated data logic in Epic for organ specific cancer screenings to align with patients' organs, not their legal sex and/or sex assigned at birth. From May 2020-August 2020, NM launched HOPE (health outreach promoting equity), aimed to contact NM patients to provide education on COVID-19 prevention practices and ensure their health needs are met during the pandemic. Patients in high economic hardship communities that were most at risk of hospitalization if they were to contract COVID-19 were prioritized for this outreach, which included phone calls, text messaging, and paper mail. Outreach included COVID-19 education, reconnection to their established NM PCP, and an SDOH screen and connection to social work when social needs were identified. In total, 1,745 patients were reached by phone and completed an SDOH screen. 15% of patients who completed the screen identified at least one social need and were connected to a social worker who provided connections with community resources. Transportation, social isolation, and housing were the top social risks identified during the outreach calls. The success of the summer outreach work highlighted the need for routine SDOH screening and helped to propel expansion of the work going into FY22. 2.2: Diversity and Inclusion (D&I): Embed D&I values and tactics into employee practices and behaviors. Establish a D&I infrastructure with partnership across the organization to promote, support and activate inclusive strategy, culture and behavior that differentiates NM as an inclusive values-driven organization. Implement implicit bias and cultural competence training to increase awareness and decrease impact of implicit bias. In FY20, NM continued to make significant progress in this strategy. Key milestones include: 1) conducted current state analysis of employee and leadership learning and development programs; 2) embedded D&I content and inclusive language in core programs as appropriate per program review; 3) developed and recommended a prioritized development path for Senior Leader Implicit Bias Journey; 4) developed a D&I learning and development plan for all NM staff and leadership; 5) secured executive sponsors and chairs for Disability and LGBTQ Chapters and finalizing leadership recruitment for both chapters, and launched African Descendants Champion Network; 6) assessed adult and youth talent pipelines for recruitment; 7) completed assessment and recommended initiatives to support development of recruiting, retaining, and developing diverse workforce, including people who live in hardship communities; 8) worked under direction of Inclusive Talent Strategy and Practices to develop plans for all hospitals within the system; and 9) developed a leader toolkit on racial equity and are adding diversity resources to NM's Learning and Perform internal website. 2.3: Community Engagement Plan. Increase engagement with vulnerable populations regarding their experience with structural inequities at NMH. Utilize feedback and input in the strategic planning process. In FY20, NMH conducted a best practice analysis to identify existing frameworks that promote bidirectional communication with the community, including the structures, objectives and operations of community advisory councils. Plans will continue in FY21 to establish a community council. Priority Need 3: Violence and Community Safety. 3.1: Community Violence Prevention. Continue to support Bright Star Community Outreach (BSCO) and The Urban Resilience Network (TURN) model and establish a broader trauma response referral network for NMH patients to receive ongoing trauma support. Collaborate with community partners to launch additional violence prevention strategies, and explore opportunities to expand and increase coordination of existing trauma and violence prevention initiatives. NMH continues to support and provide funding to Bright Star Community Outreach and The Urban Resilience Network. In response to the unanticipated impacts caused by the COVID pandemic, NM provided nearly $200,000 in additional grants to support BSCO's efforts to maintain trauma care support as well as provide remote patient access to mental and behavioral health services in Bronzeville. This funding helped BSCO extend its hours for the trauma helpline, which to-date has served 45,000 individuals in the community. The funding also helped BSCO operate programs on digital platforms during the pandemic through technology updates as well as support for remote access. Additionally, BSCO works with Chicago Public Schools Network 9, the Chicago Police Department (CPD), local funeral staff and other neighborhood entities to build resilience and trauma-informed counseling within the community. In 2019, two NMH key stakeholders from Cease Fire, LeVon Stone and Sheila Regan, launched a new violence interruption organization called Acclivus. Founded in the many of the same principles as Cease Fire, NMH now partners with Acclivus to provide violence interruption services following a violent trauma. Trained "violence interrupters" meet with violent trauma victims and their families at NMH and attempt to defuse feelings of anger as well as discourage victims and their families from retaliating. The violence interrupters work in tandem with violence interrupters in the victim's home community. As violence in Chicago continued to rise, even during the pandemic, it was evident that NMH, needed to examine the feasibility of partnering with other organizations with the goal of developing a trauma referral network. These discussions commenced at the end of FY20 and have evolved into concreted next steps during FY21.
Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - Northwestern Memorial Hospital. 3.2: Trauma-Informed Care. Conduct a current state analysis of practices, gaps and opportunities to address and integrate trauma-informed care into practice, including employee resources for coping with trauma or vicarious trauma. Throughout the Covid-19 pandemic, NMH frontline staff have provided critical, life-saving care to patients in need. Despite the risks and an inordinate rise in emergency department and ICU visits, providers have experienced a never before seen level of medical trauma without a standardized way to cope. In FY20, NMH developed a framework to deploy trauma-informed care practices and resilience tools that included employee staff wellness and staff training for patient-centered care practices. This framework focuses on staff education and training to increase staff competence in handling trauma, employee wellness strategies, and strategies to reinforce a culture of workforce wellness. A team was formed and a charter was developed that aims to use trauma-informed care to improve the patient experience, patient health outcomes and patient safety, and ensure staff have healthy coping mechanisms to better manage vicarious trauma. A current state analysis was conducted to identify existing local efforts and system strategies, and efforts began to link existing trauma-informed care initiatives and confirm support. Priority Need 4: Workforce Development and Economic Vitality. 4.1: Hiring and Workforce Development. Develop and execute a strategic hiring plan to increase hiring of NMH employees from hardship communities within the NMH CSA. Increase youth summer employment, workforce development, and pipeline programs to promote careers in health care and related fields to individuals in underserved communities. NMH is a proud member of U.S. Sen. Dick Durbin's Chicago Hospital Engagement, Action, and Leadership (HEAL) Initiative. Launched in 2018, the HEAL Initiative is a collaboration among 10 Chicago hospitals committed to tangibly impacting violence and trauma, and increasing economic opportunities in Chicago's most underserved neighborhoods. Northwestern Medicine partners with the Chicago Anchors for a Strong Economy (CASE) program to identify opportunities to increase hiring among vulnerable populations and in FY20 hired a manager to oversee recruitment of individuals from HEAL neighborhoods. In 2020, the number of NM hires from the targeted HEAL zip codes increased by 58% over that for 2018. These new hires accounted for nearly 25% of the total number of new hires for NM's Chicago campus, which includes Northwestern Memorial Hospital (NMH), its physician offices and immediate care centers. NM also partnered with BSCO on a virtual job fair to help respond to the loss of jobs as a result of the pandemic. NMH continued to support youth summer employment, workforce development and apprenticeship programs to promote careers in health care field and para-professional roles to students in the target Chicago HEAL zip codes. This includes NMH's longstanding partnership with the Chicago Public Schools and Westinghouse College Prep Academy, as well as the NM Discovery Program. Through these initiatives, 53 high school and collect students participated in comprehensive on-the-job training and youth programs that supported by NM. NMH also continued to support comprehensive internships and fellowships for college students and post-graduates in both clinical and administrative settings. 4.2: Procurement. Establish a procurement plan to increase purchasing of supplies and services from suppliers in the NMH CSA. NM has established a procurement plan and partners with CASE to identify ways to increase spending on supplies and services purchased from companies based in high hardship ZIP codes. In FY20, NM spent more than $3.7 million on supplies and services from companies based in one of the HEAL ZIP codes, promoting economic development. Non-Priority Areas: The CHNA report identified areas of opportunity for health improvement for which NMH and the external steering committee (ESC) determined it would not prepare an implementation plan and strategy. These areas of opportunity and the reasons for not addressing are below. Education and Youth Development: This identified need is addressed within NMH's Workforce development and Economic Vitality strategy. Food Security and Food Access: Although this identified need was not originally prioritized, it was added to the Implementation Plan as the need was elevated due to Covid-19. See priority need 1.5 for additional information. Affordable Housing: This identified need is addressed within NMH's Access to Healthcare and Community Resources strategy. Age-Related Illness: This need is address through the NMH care delivery system. Asthma: The ESC recommended that NMH focus on strengthening and improving access to medical homes, where screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Cancer: NMH provides a comprehensive range of clinical services to treat and screen for cancer. NMH will continue to sustain these services and work to strengthen community-based outreach. The ESC recommended focusing efforts on other health conditions for which NMH could have a greater impact. Diabetes The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Heart Disease The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Obesity The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Maternal and Child Health: NMH provides a comprehensive range of outpatient and inpatient services to expectant women and teens. NMH will continue to sustain these services and work to strengthen community-based medical homes where Maternal and Child Health services can be conveniently accessed. The ESC recommended that NMH focus on strengthening and improving access to medical homes, where access to these services and other prenatal care can be effectively coordinated. Mental Health: This identified need is addressed within NMH's Access to Healthcare and Community Resources strategy. Sexually Transmitted Infections: The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Substance Use Disorder: NMH provides inpatient and outpatient substance abuse counseling. The ESC recommended focusing efforts on other health conditions for which NMH could have a greater impact.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: "insured sliding fee scale assistance" and "insured catastrophic assistance." If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1.Women, Infants and Children Nutrition Program (WIC); 2.Supplemental Nutrition Assistance Program (SNAP); 3.Illinois Free Lunch and Breakfast Program; 4.Low Income Home Energy Assistance Program (LIHEAP); 5.Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services.
Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. The CHNA report also describes Northwestern Lake Forest Hospital's CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. Northwestern Lake Forest Hospital took into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health. Input was collected for the CHNA through a community survey and a focus group, both conducted by the Lake County Health Department and Community Health Center, and through conversations with key stakeholders between April 2018 and October 2018. The survey was randomly distributed to 5,000 Lake County households in early 2018. The focus group was conducted with the Lake County Community Health Worker Partnership, a collaboration between Mano a Mano Family Resource Center and the Waukegan Public Library. Fourteen community health workers who are trained to deliver health education on a myriad of topics ranging chronic disease to mental health to benefit navigation were recruited due to their unique position as utilizers of healthcare services and representatives of LCCHWP. These participants provided diverse geographic representation across the underserved communities of Lake County, with six representing from Waukegan (60085 and 60087), four representing Highwood (60040), two representing North Chicago (60064) and two representing the Round Lake area (60073). The focus group was conducted in Spanish; however, participants could speak in English or Spanish depending on their preference. The facilitator posed all questions provided by NMLFH. They were interviewed about community health strengths, weaknesses, and potential improvement opportunities in their communities. In March 2019, NM LFH also developed a tool to formally solicit input from organizations who are representative of the assessed community area, including those who serve medically underserved, low income and minority populations, to begin the process of ranking priority health needs (defined as health needs that could be impacted the most by the work of NMLFH and partner organizations). The pairwise comparison survey was launched utilizing a process of comparing needs in pairs to judge which need is preferred. Because comparing the needs directly to each other may be subjectively difficult, NMLFH used intervention strategies to address the needs as proxies for the survey comparison. The strategies were selected evidence-based interventions identified by The Community Guide to Preventive Services run by the U.S. Department of Health and Human Services. This led to more realistic results of priorities. NMLFH received over 600 responses to the survey representing over 15 different community organizations.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Northwestern Lake Forest Hospital. A comprehensive CHNA was commissioned on behalf of Northwestern Lake Forest Hospital by the Lake County Health Department and Community Health Center. (LCHD/CHC). LCHD/CHC is a public health accredited, state-certified public health department and a Joint Commission accredited community health center. Specific needs of the NMLFH Community Service Area were identified and prioritized separately.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also shared with the following: 1. Key community organizations 2. Northwestern University Institute of Public Health and Medicine 3. Northwestern Medicine and LFH Leadership
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. Through the tax year 2019-2022 prioritization process and implantation plan, Northwestern Medicine Lake Forest Hospital (NM LFH) identified four priority health to be addressed through collaborative planning and coordinated action with organizations that impact health services in our community: Access to Healthcare, Behavioral Health, Chronic Diseases, and Social Determinants of Health. Priority 1: Access to Healthcare. 1.1: Implement a Transitional Care Clinic (TCC) at NM LFH to medically transition ED patients and inpatients without a medical home. In 2018, nearly 1,900 emergency department (ED) and inpatient patients at NM LFH did not have a primary care physician identified in their electronic health record (EHR). Additionally, 40% of emergency room encounters in FY18 were from Waukegan, North Chicago, Zion and the Round Lake area. The number of patients entering the NM LFH ED who are on Medicaid or are uninsured has continued to rise and many of these patients have multiple barriers preventing entry into the healthcare system. They often utilizing the ED for primary care services and end up receiving a disproportionate amount of care while diverting care from those who may need it more. Additionally, these patients are unable to develop an ongoing relationship with a provider to assist in addressing and managing chronic conditions leaving the patient sicker more often. This can be costly for the health system as patients may have multiple comorbidities and may be uninsured while diverting necessary resources away from other patients. In FY20, NM LFH adapted a model called the Transitional Care (TC) Clinic, a scalable model that links patients who do not have a source of routine care to a primary care physician at Erie HealthReach Waukegan. Through a combination of health education, chronic disease management strategies, and community health outreach, the care team in the TC Clinic receives referrals from NM LFH ED who identify these unattached patients. The TC Clinic serves as a bridge from hospitalization to outpatient management for patients without timely PCP access. The TC Clinic provides a team based approach to medically stabilize patients through intensive management of chronic diseases. The healthcare team addresses complex barriers to care including medication access, building trust to change behavior, and psychosocial education while connecting the patient to a medical home. 1.2: Develop a Health System-level approach to better serve uninsured and underinsured patients through clinical community relationships. In FY20, NM LFH recommitted its support to Erie Waukegan and the Lake County community through a three-year, $1.8 million grant. The grant is aimed at supporting expanded access to medically necessary health care, including primary care, behavioral health care and comprehensive case management. Through this grant support, Erie Waukegan was able to hire additional clinical staff, expand telehealth capabilities, address social determinants of health and improve case management. During a time when testing resources were scarce, NM provided a critically important mechanism to ensure that high-risk patients received testing and necessary follow-up treatment. Largely through our drive-up testing and other clinical sites, NM LFH conducted COVID tests for residents living in high hardship zipcodes. NM LFH also worked with community partners, including federally qualified health centers, health clinics and other providers, to support testing in the communities we serve. Lastly, NM donated critical supplies and PPE, including N95 respirator masks, hand sanitizer, gloves, isolation gowns, surgical facial shields and education for the proper use of PPE to clinical organizations. 1.3: Implement an electronic tool to screen patients for Social Determinants of Health (SDOH) and refer patients to social service organizations as needed. NMHC executive leadership identified the implementation of routine social determinant of health screenings as a top organizational priority and included it as a key initiative for the health system. A system wide summit was held in December 2019, which included key physicians, nurses, IT, Quality and other administrative leadership. At the conclusion of the summit, 6 social determinant domains were prioritized to assess and address for patients: housing, food, medication affordability, transportation, mental health, and social isolation. A review of known surveys used by other health systems was conducted and the determination was made to create a customized survey to screen for SDOHs. Additionally, system leadership agreed to use the Epic SDOH tools to store social determinant data collected and visualize patients' needs using Storyboard and SDOH Wheel views in Epic. From May 2020-August 2020, NM launched HOPE (health outreach promoting equity), aimed to contact NM patients to provide education on COVID-19 prevention practices and ensure their health needs are met during the pandemic. Patients in high economic hardship communities that were most at risk of hospitalization if they were to contract COVID-19 were prioritized for this outreach, which included phone calls, text messaging, and paper mail. Outreach included COVID-19 education, reconnection to their established NM PCP, and an SDOH screen with connection to social work when social needs were identified. In total, 1,745 patients were reached by phone and completed an SDOH screen. 15% of patients who completed the screen identified at least one social need and were connected to a social worker who provided connections with community resources. Transportation, social isolation, and housing were the top social risks identified during the outreach calls. The success of the summer outreach work highlighted the need for routine SDOH screening and helped to propel expansion of the work going into FY21. 1.4: Increase access to social service and community organizations (UW211). In FY20, NM LFH provided support to launch Lake County 211, a free, confidential, 24/7 helpline operated by United Way that guides the public to local, available, and appropriate health and human service resources. It is designed to reduce time and frustration by acting as a central access point to health and human services in Lake County. 211 is Lake County's free, one-stop shop for help: it's a telephone helpline, a texting chatline, and it is searchable online. 211 is available 24 hours a day, every day of the year, always confidential, and always free. 211 helps individuals, families, and providers navigate and connect with a wide range of local health and human services, including: mental health services, crisis counseling, supplemental food programs, shelter and affordable housing options, employment and education support, and financial support. In FY20, 13,417 people made 19,449 requests for assistance through Lake County 211. The vast majority of individuals had their needs met and were able to connect with an organization to assist them.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - NORTHWESTERN LAKE FOREST HOSPITAL. Priority 2: Behavioral Health. 2.1 Expand the use of telehealth for psychiatric services. Since FY16, NM LFH has seen a significant increase in behavioral health inpatient and emergency department patient volume. NM LFH seeks solutions that can be implemented in parallel to system planning, thereby offering patients treatment in the appropriate care settings based on their diagnosis. Telemedicine is the process of providing health care from a distance through technology, often using videoconferencing. Telepsychiatry, a subset of telemedicine, can provide a range of services including psychiatric evaluations, therapy (individual therapy, group therapy, and family therapy), patient education and medication management. In FY20, NM LFH created a pilot to launch telepsychiatry in its emergency departments. During the pilot, 15 people were seen by consult. 2.2 Expand a program to reduce opioid prescribing in the emergency room using the Alternative to Opioids model. Due to COVID-19, NM LFH was unable to expand this program model. 2.3 Increase behavioral health services and capacity in community settings. Due to COVID-19, we were unable to expand this program model. However, activities were planned in FY21 to implement this strategy. 2.4 Implement Calm Classroom, classroom based mindfulness program, in Lake County schools. Calm Classroom is a simple and accessible way to integrate mindfulness into the classroom culture. The daily practice of breathing, stretching, focusing and relaxation exercises cultivates a greater sense of self-awareness, mental focus and emotional resilience within educational spaces. Calm Classroom is the largest provider of school-wide mindfulness programming in the U.S. In 2008 Calm Classroom launched in Chicago Public Schools, and as of 2018 the program has been implemented in thousands of classrooms all over the world. In FY20, NM LFH brought the Calm Classroom curriculum to two underserved school districts, Waukegan School District 60 and Beach Park School District 3, as a way to help students cope with the trauma and every day stressors in their lives. Each school district will be funded for two years then they will commit to sustain funding. This program helped support mindfulness in 27 schools and for over 11,000 students. 2.5: Drug education and prevention programming with students in our local schools, and with parents in our local community through Text-A-Tip. NM LFH supports Lake Forest LEAD, a local non-profit organization dedicated to the promotion of healthy family relationships and the prevention of alcohol, drug use, and other risky behavior by youth. LEAD has served the Lake Forest, Lake Bluff, and Knollwood, IL communities for nearly 30 years. There are a variety of long-term issues that LEAD is seeking to address, including underage drinking and drug abuse; prevention of prescription, over-the-counter and illegal drug abuse by youth and adults; promotion of mental health and wellness; reducing stigma related to depression and other mental health issues; and the prevention of suicide. A significant and successful strategy in the NM LFH and LEAD partnership has been the 24/7 anonymous text crisis line, Text-A-Tip. LEAD has seen a dramatic increase in the number of people who benefit from its programming, both in local Lake Forest and Lake Bluff communities and across the nation. LEAD has conducted trainings, programs and workshops in nearly 20 states over the past two years, and the Text-A-Tip hotline is now accessible to over 7 million people, almost doubling in scope since this time last year, and including the entirety of Lake and McHenry Counties in Illinois. Finally, LEAD's online and social media presence has seen an increase of over 500% in the past 3 years. Text-A-Tip has been able to deliver wellness checks and emergency personnel to teens in crisis, and has led to interventions in suicide and self-harm situations, violence situations, and situations of drug overdose. Aside from the actual lives saved to date, the resource allows students a 24/7 place to turn when they are in need of emotional support. It is safe, anonymous, and always available. Priority 3: Chronic Diseases 3.1 Implement a community blood pressure screening program in high opportunity neighborhoods. Due to COVID-19, NM LFH was unable to expand this program model, but was able to provide increased community health education around myriad of topics including chronic diseases. NM LFH provided support to Mano a Mano, a not-for-profit local immigrant-serving agency that provides a one-stop-shop for health resources and services, educational classes and workshops, and immigration legal services for some of the hardest to reach, most vulnerable families and individuals living in Lake County. Mano a Mano works to empower immigrants and their families living in Lake County, Illinois to become full participants in American life. Mano a Mano conducts multiple initiatives to serve the residents of Lake County, including: the Healthy Families Program (HFP) aimed at expanding health literacy and improving the health of immigrants by helping them integrate into and understand the U.S. healthcare system; the Community Health Workers (CHW) Program, which is a collaboration that focuses on community health needs that have been identified by local research as priorities for low-income and immigrant communities including the health literacy and training priorities including, but not limited to, hypertension, diabetes, prenatal care, insurance benefits, nutrition, and obesity; and expanded access to healthcare and social services through transportation support, among others. The activities supported by NM LFH expanded access to community health education and improved health literacy through the HFP and CHW Program initiatives, as well as access to healthcare and social services through transportation support, for people assisted by Mano a Mano. 3.1 Implement the American Heart Association "Target: BP" program at Northwestern Medicine and Northwestern Medical Group locations. Due to COVID-19, NM LFH was unable to expand this program model. However, community discussions took place, and there are plans to implement this program in FY21. Priority 4: Social Determinants of Health 4.1: Increase youth pipeline opportunities. The Discovery Program is a local effort to expose students to careers in healthcare. Throughout the two year Discovery Program, high school sophomores and juniors are exposed to a broad range of activities designed to encourage their interest in healthcare careers. Topics vary by month and program activities included tours, guest speakers, group discussion, and hands-on projects. In addition, the program fosters character and professional development, cultivates life skills, provides community service and leadership experience, and offers mentorship and networking opportunities. Meetings are held once a month, most often on Saturday mornings, at Lake Forest Hospital and other off-site locations. In FY20, the Discovery program hosted four sessions for 41 students. Half of the students were from underfunded school districts in Lake County, and NM LFH provided transportation to students who were in need.
Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - NORTHWESTERN LAKE FOREST HOSPITAL. 4.2: Create hiring pipelines for youth and adults to connect disparate communities to jobs. NM LFH created a healthcare career pipeline program dedicated to providing a clear path for select graduates from North Chicago Community High School (NCCHS) to receive a post-secondary education followed by employment within the Northwestern Medicine family through a scholarship program called Directing Youth Navigating a Medical Career in the Community or DYNAMIC. The DYNAMIC Scholarship Program was created by the Department of Nursing at Northwestern Medicine Lake Forest Hospital to assist graduates of North Chicago Community High School (NCCHS) obtain a degree in health sciences from the College of Lake County, receive mentoring and guidance throughout their studies, and procure employment at NM LFH upon graduation. Selected students will have tuition paid for at the College of Lake County in one of several pre-approved health science degrees. Throughout the student's tenure at the College, they will be provided professional mentorship by hospital staff and receive exposure to the hospital. Upon graduation, the student will interview and be eligible to be hired by NM. The program was designed and students were recruited in FY20, but due to COVID, NM LFH will select the first student in the program in FY21. In FY20, NM LFH began discussion on the creation of adult pipeline programming for both residents and employees. We are continuing to make significant strides in this area and will have more to report on in FY21. 4.3: Embed diversity and inclusion (D&I) practices. In FY20, NM continued to make significant progress in this strategy. Key milestones include: 1) conducted current state analysis of employee and leadership learning and development programs; 2) embedded D&I content and inclusive language in core programs as appropriate per program review; 3) developed and recommended a prioritized development path for Senior Leader Implicit Bias Journey; 4) developed a D&I learning and development plan for all NM staff and leadership; 5) secured executive sponsors and chairs for Disability and LGBTQ Chapters and finalizing leadership recruitment for both chapters, and launched African Descendants Champion Network; 6) assessed adult and youth talent pipelines for recruitment; 7) completed assessment and recommended initiatives to support development of recruiting, retaining, and developing diverse workforce, including people who live in hardship communities; 8) worked under direction of Inclusive Talent Strategy and Practices to develop plans for all hospitals within the system; and 9) developed a leader toolkit on racial equity and are adding diversity resources to NM's Learning and Perform internal website. 4.4: Implement an integrated quality equity plan. The NMHC Quality Equity Plan was approved by the NMHC Quality Management Committee in June 2020. The plan includes a vision for advancing quality equity for NM patients over the next 5 years with improved infrastructure, programming, and partnership with NU and other community organizations. The FY21 Quality Equity Plan was developed with four categories and a focus in 11 areas. These focus areas and outcomes include: 1) Accessing Care at NM (barriers due to change in insurance status, mitigating barriers for patients with limited English proficiency): a. developed a patient facing document to help patients identify options to continue receiving care at NM if they lost insurance; b. posted on nm.org; c. launched a quality project on interpreter use; 2) Meeting Diverse Needs (HOPE, SDOH): a. Launched HOPE summer work with a focus on patients with chronic conditions including diabetes and hypertension; 3) Focused Clinical Areas (flu vaccine, COVID-19, Diabetes, Maternal Care, Hypertension) a. developed video and written materials for staff to help patients overcome vaccine hesitancy and shared widely; b. provided primary care clinics regular updates on flu vaccination progress, including racial and ethnic disparities in vaccine rates; c. developed a toolkit for practice managers to discuss disparities in vaccination rates with staff and strategize how to reduce disparities; d. developed a playbook for future flu seasons or other vaccination campaigns; e. launched diabetes tune up pathway to connect patients with diabetes to multidisciplinary team for education and resources to better manage diabetes; f. prioritized 4 clinical measures to reduce disparities in; g. identified measures to assess for disparities; 4) Infrastructure (analytics/quality approach to measuring equity with high fidelity data, developing partnership with IPHAM and other research groups at NM/NU): a. standard deck on how to assess for disparities developed; b. disparity analysis completed for 6 different clinical measures; c. demographics fields (race, ethnicity, SOGI, language) added as standard fields for all ambulatory quality reports; d. added discrete documentation for disability accommodations; e. updated data logic in Epic for organ specific cancer screenings to align with patients' organs, not their legal sex and/or sex assigned at birth. 4.5: Improve access to nutritious foods for those who are food insecure. NM LFH joined Lake County CATCH (Community Action to Combat Hunger), a coalition of social service providers, non-profit organizations, community-based organizations, and houses of worship committed to ensuring that everyone in the community has enough food to eat during the COVID-19 pandemic. This group was formed out of the identified need for additional resource support and access points to provide nutritional food distribution to match the increased community needs. Lake County CATCH helps deliver groceries, meal boxes, or hot/cold meals to community members who need to remain at home but don't have access to the resources they need (including seniors, those with underlying health conditions, and those who have tested positive for COVID-19). All CATCH services are free of charge for those who need it and do not impact public charge. CATCH was able to serve 771 families (2,618 individuals) a total of 15,540 meals. 4.6: Support COVID-19 emergency assistance funds. While the global pandemic has touched everyone, its impact has not been evenly felt across the community. Immigrant families have been significantly impacted by the COVID-19 epidemic because of their already low wages, limited savings, little to no access to healthcare, and traditional safety net programs. NM LFH also saw that Latino immigrants in particular, suffered disproportionately from COVID infection and deaths. The existing availability and expansion of public benefits did not adequately cover all community members and families. Immigrants and their families were largely left out of the government's emergency response. With evictions and foreclosures on hold for the duration of the public emergency and people out of work for weeks, most families' primary concern was to cover the basics, including food and health-related expenses such as prescription drugs. To support these community members in this time of crisis, NM LFH supported Mano a Mano in establishing an emergency community fund (a Tanda) that provided direct assistance to community members who were in dire need and unable to get support from government programs. In order to maximize the TANDA benefits, Mano a Mano's case management team set up a formal but low-barrier intake process. For each family, a Mano a Mano case manager gathered information about the community member's family situation, work situation, and food and health needs. The family's eligibility requirements for other types of support that maybe available to other household members such as SNAP assistance was assessed. For food support, Mano a Mano provided community members with gift cards for use at local grocery stores, including local, immigrant-owned stores. Mano a Mano also covered necessary prescription
Schedule H, Part V, Section B, Line 11 Facility , 4 Facility , 4 - NORTHWESTERN LAKE FOREST HOSPITAL. NON-PRIORITY AREAS: The CHNA report identified areas of opportunity for health improvement for which NM LFH and the community health council (CHC) determined it would not prepare an implementation plan and strategy. These areas of opportunity and the reasons for not addressing are below. Cancer: NM LFH provides a comprehensive range of clinical services to treat and screen for cancer. NM LFH will continue to sustain these services and work to strengthen community-based outreach both through the internal oncology department and through community partners. The CHC recommended focusing efforts on other health conditions for which NM LFH could have a greater impact. Immunization & Infectious Diseases: NM LFH provides clinical services to treat pneumonia, asthma, and tuberculosis, as well as other infectious diseases. The CHC recommended that NM LFH focus on strengthening and improving access to medical homes, where preventive care and screening services can be effectively coordinated and access to medically necessary specialty care can be facilitated. Injury & Violence: NM LFH will work to strengthen community-based outreach both through community partnerships to affect injury and violence. The CHC recommended focusing efforts on other determinants for which NM LFH could have a greater impact. Nutrition, Physical Activity & Weight: NM LFH provides clinical services, nutritional counseling, and weight loss programming for patients and will continue to sustain these services. While there is a lot of crossover between these behaviors and those that cause Chronic Disease, the CHC recommended focusing efforts on other health conditions for which NM LFH could have a greater impact. Community work will continue through participation on the various Action Teams as part of the Live Well Lake County Steering Committee. Potentially Disabling Conditions: NM LFH provides comprehensive rehabilitation services including physical, speech, and occupational therapy for patients. The CHC recommended focusing efforts on other health conditions for which NM LFH could have a greater impact. Tobacco Use: NM LFH supports public policies aimed at reducing tobacco use. NM LFH also offers a comprehensive Smoking Cessation Program, facilitated by an American Lung Association certified instructor. The CHC recommended focusing efforts on other health conditions for which NM LFH could have a greater impact.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: "insured sliding fee scale assistance" and "insured catastrophic assistance." If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services.
Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. The CHNA report also describes Central DuPage Hospital's CHNA goals and objectives, public dissemination plan, and the process for the development of the implementation plan.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was implemented as part of the CHNA process. A list of recommended participants was provided by NMCDH; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the population with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Reminder emails were sent as needed to increase participation. In all, 41 community stakeholders took part in the Online Key Informant Survey including representatives of the organizations below: 1. DuPage County Health Department 2. DuPage Federation on Human Services Reform 3. DuPagePads 4. American Cancer Society 5. B.R. Ryall YMCA of Northwestern DuPage County 6. Bartlett Park District 7. Benedictine Public Health Department 8. Breaking Free 9. Catholic Charities Diocese of Joliet 10. DuPage Foundation 11. DuPage Senior Citizens Council 12. DuPage United 13. Educare West DuPage 14. Fox Valley Special Recreation Association 15. NAMI DuPage 16. Northern Illinois Food Bank 17. People's Resource Center 18. Public School District, DuPage County 19. SamaraCare 20. Senior Services Associates, Inc. 21. Warrenville Park District 22. Western DuPage Special Recreation Association 23. West Chicago Public Library District 24. Winfield Park District 25. World Relief DuPage Aurora Through this process, input was gathered from several individuals whose organizations work with low-income, minority populations, or other medically underserved populations. In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such and how these might be better addressed. Findings represent qualitative rather than quantitative data. The Online Key Informant Survey was designed to gather input from participants regarding their opinions and perceptions of the health of the residents in the area. Therefore, these findings are based on perceptions, not facts. To ensure that organizations impacting health in DuPage County were meaningfully engaged in reviewing and interpreting the findings of the CHNA, developing priorities among the identified needs and forming a collaborative plan to address the top priority needs, the External Steering Committee (ESC) was established and maintained.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to the following: 1. Key community organizations and leaders 2. Central DuPage Hospital External Steering Committee 3. Central DuPage Hospital Leadership
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Central DuPage Hospital Association. Through the prioritization process, NMCDH identified three Priority Health Needs: Access to Healthcare Services, Chronic Disease, and Mental Health. NMCDH identified health needs that would be best addressed through a coordinated response from a range of healthcare and community resources. Specific ways in which NMCDH is addressing the significant needs identified in its most recently conducted CHNA are defined as follows: Priority 1: Mental Health. Mental health and physical health are closely connected. Mental health plays an integral role in the ability to maintain physical health. Mental illnesses, such as depression, anxiety and addiction, affect people's ability to participate in health promoting behaviors. Subsequently, the presence of mental health problems can have a serious impact on chronic disease and decrease the ability to participate in treatment and recovery. To address the identified health needs related to Mental Health and Substance Abuse, NMCDH and members of the External Steering Committee plan to collaborate on the following strategies: 1.1 Continue strategic planning efforts to evaluate the demand for hospital-based mental health services and identify appropriate NMCDH resources to address those needs. A comprehensive strategic plan was developed to properly address the mental health needs of the NMCDH and Northwestern Medicine Delnor Hospital service areas. The plan continues to be updated routinely in order to identify the needs and develop strategies to address those needs, including but not limited to expansion of inpatient behavioral health and addiction services and additional capacity in the outpatient mental health service line. 1.2 Provide Community Benefit Grant funding and further solidify relationships with community agencies that can provide outpatient mental health services to the medically underserved residents within the service area. Grants were provided to NAMI DuPage. The following outcomes were reported: 1. 1,868 individuals and family members were served. Due to COVID-19, hospital presentations stopped in March 2020 and have not resumed. 2. 102 individuals attended NAMI education classes. 3. 90% of the individuals and family member reported that they agree or strongly agree that they are now aware of NAMI and community resources that can assist them in their recovery. 4. There were 95 clients served; 651 counseling sessions held. In March 2020, all peer counseling sessions were remote using Zoom. 5. There were 614 clients with a total of 4,427 in attendance for support groups. Support groups also moved to Zoom as of March 2020. 6. 60% of the clients who participated in Peer Counseling reported feeling that they are successfully moving toward their goals. 7. 12 clients attended readiness classes. 8. 41% of the individuals who obtained employment after using NAMI's supported employment program stayed employed after 3 months. 9. 4 - 5 programs were offered each week to NAMI clients; programs were virtual and included bingo, trivia, and book club. 1.3: Participate in and support initiatives within DuPage County that are focused on Mental Health. The DuPage County Health Department is currently developing a Community Health Improvement Plan (CHIP) in collaboration with hospitals and community agencies within the county. One of the identified priorities to be addressed is Mental Health and Substance Abuse. NMCDH will continue to participate in the CHIP Executive Committee and the Mental Health Subgroup to develop and implement the action plan to address the health priority of Mental Health and Substance Abuse. 1.4: Complete the planning phase and implement the Mental Health First Aid Program in the NMCDH service area. The Mental Health First Aid (MHFA) program is designed to teach residents of the community how to take action when a mental illness is suspected or identified. The intent is to reduce the wide reach and economic toll that mental health disorders and crises have on the community. Individuals within NMCDH are currently completing training and the certification process and will begin providing educational sessions to teach parents, family members, caregivers, teachers, school staff, peers and community members how to help an adolescent or adult experiencing a mental health or addiction challenge or crisis. These individuals can then intervene and direct the individual to appropriate resources. The overall goal is to increase awareness and early intervention to those in need of behavioral health services. One NMCDH/NMDH staff was trained to offer the nationally recognized evidence-based Mental Health First Aid program. 1. 7 classes were held; 2. 136 individuals attended the programs; 3. 100% of MHFA participants scored a minimum of 85% on the MHFA course exam. Priority 2: Chronic Disease Chronic conditions are responsible for 70% of deaths and 75% of healthcare spending. Chronic disease is a leading cause of disability and lost income. Chronic disease disproportionally affects low-income and minority populations. In the NMCDH service area, 35% of adults have been told that they have high blood pressure; 30% have been told they have a high cholesterol reading; 23% are obese; and chronic diseases of the heart are the second leading cause of death. To address the identified deficiencies in Chronic Disease, NMCDH and members of the External Steering Committee plan to collaborate on the following strategies: 2.1: Provide resources and tools to patients diagnosed with heart failure in order to improve self-management skills and quality of life. NMCDH continued to provide a post-discharge community-based heart failure program designed to improve the quality of life and decrease readmission rates for patients diagnosed with heart failure. Efforts to improve the coordination of care for heart failure patients were expanded, and a system of referrals for specialty care and social service needs were implemented. A retrospective study of outcomes related to the program was completed to ensure maximum quality is achieved. Key outcomes of this program were: 226 individuals were enrolled in the Community-Based Heart Failure program: (NMCDH/NMDH) 1. 30-day readmission rate for heart failure diagnosis: 4% (markedly below the national rate); 2. 99% of clients demonstrated the ability to identify appropriate action in the event of a worsening of their condition; 3. 94% of clients utilized an effective medication management system; 4. 93% of clients demonstrated compliance with symptom tracking.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Central DuPage Hospital Association. 2.2: Continue to provide and partner in community-based health education, nutrition and activity programs focused on reducing the risk of obesity and chronic disease. NMCDH provided community education in the areas of evidence-based primary interventions (disease prevention, health promotion), secondary interventions (screening) and tertiary interventions (education to individuals affected with a chronic disease, promoting an optimum state of individual wellness). Programmatic venues included CATCH (Coordinated Approach to Child Health), Dinner with the Doc , clinician-led educational offerings, self-help groups, rehabilitation service programs and support programs. A comprehensive plan to increase patient compliance with physician and ancillary staff referrals to smoking cessation resources was developed. Community Benefit Grants were provided to agencies that provide related programming. Key outcomes include: 1. One cardiovascular health educational seminar with 116 individuals in attendance. (NMCDH/NMDH combined data.) 2. Meeting space provided at no charge for 19 support groups. (NMCDH/NMDH) 3. One cancer educational seminar with 93 individuals in attendance (NMCDH/NMDH) 4. Five health education seminars with 574 individuals in attendance. (NMCDH/NMDH) 5. 12 Diabetes Education Services community programs; 90 individuals attended. (NMCDH/NMDH) 6. 226 individuals enrolled in the Community-Based Heart Failure program (NMDH/NMCDH) a) 30-day readmission rate for heart failure diagnosis: 4% (markedly below the national rate); b) 99% of client seen at a home visits within 7 days of discharge; c) 87% of clients able to name two cardiac medications and describe actions. 7. American Cancer Society (NMCDH/NMDH): a) 104 Cancer patients received rides. b) Eight drivers completed training programs which increased the number of drivers to 110 (13% increase from previous year). c) Temporary suspension of services due to COVID-19, but 1,492 rides were provided when service was in operation, which was a ride fulfillment rate increase of 5%. 8. DuPage Pads Medical Respite Program: a) 128 individuals in 73 household were served. Of the 128 individuals served, 89 were adults and 39 were children. b) 100% of participants obtained or maintained benefits. c) 100% of participants received information on the importance of regular physicals relative to age and gender. d) 100% of participants exited the program with medical insurance. e) 75% of participants exited the program with an identified primary care physician. f) 75% of participants exited the program with a follow-up appointment with a primary care physician related to the condition resulting in entry to the Medical Respite Program. g) 47% of individuals served exited into stable housing 9. Almost Home Kids (NMCDH/NMDH): a) 90% of children received an evaluation to determine if Sleep Medicine could provide improve health outcomes by having better sleep patterns. b) 20 sleep studies were conducted based on the child's actual needs. c) 1 to 2 candidates for decannulation annually. 10. COVID grant outcomes (NMCDH/NMDH): a) Educare purchased one Thermoscan system, 200 thermometers for each family to monitor symptoms at home, and 20 infrared thermometers to be used at the school. b) Educare purchased Uniforms for their staff. c) Midwest Shelter for Homeless Veterans utilized the grant money to cover the costs of their Virtual Commissary. (Grant amount: $2,000). d) West Chicago School District 33 purchased 275 infrared thermometers for families to use at home to monitor symptoms and 4 Thermoscan Systems for their schools. 11. The CATCH Program reached over 855 students and teachers. (NMCDH/NMDH) 12. A total of 3 community programs were offered for stroke education; 86 people were reached. (NMCDH/NMDH) 13. 465 page views of Kits for Kids were downloaded for hand washing, bicycle safety and healthy nutrition. (NMCDH/NMDH) 14. 128 individuals participated in smoking cessation programs. 100% self-reported smoking cessation by the end of week 6. (NMCDH/NMDH) 15. Think First Curriculum offered 315 presentations to children from k-12 and 17,301 individuals participated in related events. (NMCDH/NMDH): a) 5,218 children were fitted and received bike helmets (NMCDH/NMDH); b) 261 couples attended child safety classes (NMCDH/NMDH); c) 822 car seats were checked/distributed (NMCDH/NMDH). 16. 31 individuals participated in the National Diabetes Prevention Program, with a total loss of 140 lbs and 426 hours self-reported exercise by the final class. (NMCDH/NMDH) Priority 3: Access to Care. An aging population, coupled with a challenging economy and an increasing prevalence of chronic disease, create access-to-care issues relating to both the affordability and availability of care. NMCDH seeks to promote access through a variety of initiatives identified below. NMCDH will continue to work with individuals and families to promote access to medically necessary services by maintaining an accessible financial assistance program. Additionally, staff and leadership will work collaboratively with key community partners to promote a seamless continuum of care into local medical home settings. 3.1: Strengthen and increase patient affiliation with high-quality patient-centered medical homes. NMCDH and its partners from the External Steering Committee focused efforts on strengthening the care coordination, availability, cultural competency and offerings available at the patient-centered medical homes operated by the Federally Qualified Health Centers and healthcare organizations that are closely aligned with NMCDH. By concentrating efforts on improving the most essential community-based component of the healthcare system - the patient-centered medical home - NMCDH focused on ensuring patients receive timely and appropriate care. NMCDH will implement evidence-based practices to address the health concern related to members of the community receiving age and gender-appropriate screenings and other preventive services, including recommended routine immunizations. 3.2: Investigate innovative ways to connect uninsured members of the community with applicable entitlement programs and available healthcare and social services to improve access to medical care. Patients in need of financial assistance were connected with appropriate resources and assisted in the completion of applications for government assistance programs. 3.3: Improve access to evidence-based preventive services, including age and gender-appropriate screenings and routine immunizations. 1. Over 23,638 individuals received financial assistance at NMCDH and NMDH. 2. $72,881,880 was rendered in financial assistance within the following categories: Presumptive Charity Care: $27,976,088, Approved Financial Assistance: $60,832,071, and Alternate Charity Care: $724,629 (NMCDH/NMDH). 3. 2,227 Medicaid applications were processed through Engage DuPage services. NMCDH leadership and staff participated in various community task forces to further the development of the health and human services safety net. 4. 4,957 individuals were enrolled in the DuPage County Health Safety Net System, resulting in links to 229 primary care providers, 4,728 links to local FQHCs, 2,102 specialty referrals, and 26,464 prescriptions were filled. 5. The Silver Access Premium program provided assistance to 842 individuals. 6. $5,690,537 was rendered to Access DuPage clients for outpatient and other specialty care services. 7. $$2,092,690 was rendered to Access DuPage clients for inpatient care. 8. Funding was provided to Engage DuPage for the provision of Community Access Specialists in the Emergency Room. 9. 247 individuals received breast cancer screening. 10. 58,190 encounters were completed utilizing trained professional healthcare interpreters (NMCDH/NMDH). 11. A formal agreement was executed in December 2016 with VNA Healthcare. Workgroups developed a process for referring patients and there were 106 patients that received care from RMG and NM Hospitals. (NMCDH/NMDH) Non-Priority Areas: The CHNA report identified areas of opportunity for which NMCDH and the ESC determined it would not prepare an implementation plan and strategy, including: Cancer: NMCDH provides a comprehensive range of clinical services to treat and screen for cancer. NMCDH will continue these services and work to strengthen community-based outreach. Immunization and Infectious Disease in Adults: NMCDH provides clinical services to treat pneumonia, asthma and tuberculosis. The ESC recommended that NMCDH focus on strengthening and improving access to medical homes where preventive care and screening services can be effectively coordinated and access to medically necessary specialty care can be facilitated. Vaccine services are provided to children as part of the access to care strategies. Tobacco Use: Tobacco use was incorporated into the chronic disease strategy.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: "insured sliding fee scale assistance" and "insured catastrophic assistance." If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services.
Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - DELNOR-COMMUNITY HOSPITAL. The CHNA report also describes Delnor Hospital's CHNA goals and objectives, public dissemination plan, and the process for the development of the implementation plan.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - DENOR-COMMUNITY HOSPITAL. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THE CHNA PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY NMDH; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATION WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 157 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY INCLUDING REPRESENTATIVES OF THE ORGANIZATIONS BELOW: 1. ADVOCATE SHERMAN HOSPITAL 2. AGENCY ON AGING NORTHEASTERN ILLINOIS 3. ASSOCIATION FOR INDIVIDUAL DEVELOPMENT 4. BATAVIA INTERFAITH FOOD PANTRY AND CLOTHES CLOSET 5. BATAVIA UNITED WAY 6. BENEDICTINE UNIVERSITY 7. BLACKBERRY TOWNSHIP 8. BATAVIA PUBLIC SCHOOL DISTRICT #101 9. CASA KANE COUNTY 10. CATHOLIC SOCIAL SERVICES (CATHOLIC CHARITIES) 11. CENTRO DE INFORMACION 12. CITY OF AURORA 13. COMMUNITY CONTACTS, INC. 14. COMMUNITY FOUNDATION OF THE FOX RIVER VALLEY 15. CONLEY OUTREACH COMMUNITY SERVICES 16. DAYONEPACT 17. ELDERDAY CENTER, INC. 18. ELGIN AREA CHAMBER OF COMMERCE 19. ELGIN PARTNERSHIP FOR EARLY LEARNING 20. ENVIRONMENTAL PROTECTION AGENCY 21. FAMILY SERVICE ASSOCIATION OF GREATER ELGIN AREA 22. FOX VALLEY SPECIAL RECREATION ASSOCIATION 23. GAIL BORDEN LIBRARY 24. GATEWAY FOUNDATION 25. GENEVA PARK DISTRICT 26. GREATER ELGIN FAMILY CARE CENTER 27. HERGET MIDDLE SCHOOL 28. HESED HOUSE 29. HIGHLAND AVENUE CHURCH OF THE BRETHREN 30. HOPE FOR TOMORROW, INC. 31. INC BOARD NFP 32. KANE COUNTY BOARD 33. KANE COUNTY DEVELOPMENT AND COMMUNITY SERVICES DEPARTMENT 34. KANE COUNTY DIVISION OF TRANSPORTATION 35. KANE COUNTY FARM BUREAU 36. KANE COUNTY HEALTH DEPARTMENT 37. KANE COUNTY MEDICAL SOCIETY 38. KANE COUNTY REGIONAL OFFICE OF EDUCATION 39. KANE COUNTY SHERIFF'S OFFICE 40. KANELAND COMMUNITY SCHOOL DISTRICT #302 41. LAO-AMERICAN ORGANIZATION OF ELGIN 42. LAZARUS HOUSE 43. LUTHERAN SOCIAL SERVICES (ELGIN) 44. MARIE WILKINSON FOOD PANTRY 45. MARKLUND HYDE CENTER 46. MUTUAL GROUND 47. NAMI - KANE, DEKALB AND KENDALL COUNTIES 48. NORTHEASTERN ILLINOIS AREA AGENCY ON AGING 49. OPEN DOOR CLINIC OF GREATER ELGIN 50. PADS AT HESED HOUSE 51. PR STRATEGIES AND COMMUNICATIONS/PMS ADVERTISING, INC. 52. PRESENCE MERCY MEDICAL CENTER (AURORA) 53. PRESENCE ST. JOSEPH HOSPITAL (ELGIN) 54. REBUILDING TOGETHER AURORA 55. RENZ ADDICTION COUNSELING CENTER 56. RUSH COPLEY MEDICAL CENTER 57. ST. CHARLES PARK DISTRICT 58. STC UNDERGROUND TEEN CENTER 59. SUICIDE PREVENTION SERVICES 60. SALVATION ARMY OF AURORA 61. TRI CITY FAMILY SERVICES 62. TRI CITY HEALTH PARTNERSHIP 63. U-46 SCHOOL DISTRICT (ELGIN) 64. UNIVERSITY OF ILLINOIS EXTENSION 65. VALLEY INDUSTRIAL ASSOCIATION 66. VILLAGE OF ALGONQUIN 67. VNA HEALTHCARE 68. WAUBONSEE COMMUNITY COLLEGE 69. WAYSIDE CROSS MINISTRIES 70. WELL CHILD CENTER 71. WELLBATAVIA INITIATIVE 72. WEST AURORA SCHOOL DISTRICT #129 73. YWCA ELGIN INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WITH SPECIAL EMPHASIS ON PERSONS WHO WORK WITH OR HAVE SPECIAL KNOWLEDGE ABOUT VULNERABLE POPULATIONS IN CENTRAL KANE COUNTY INCLUDING LOW-INCOME INDIVIDUALS, MINORITY POPULATIONS, THOSE WITH CHRONIC CONDITIONS AND OTHER MEDICALLY UNDERSERVED RESIDENTS. To ensure that organizations impacting health in central Kane County were meaningfully engaged in reviewing and interpreting the findings of the CHNA, developing priorities among the identified needs and forming a collaborative plan to address the top priority needs, the External Steering Committee (ESC) was established and maintained. This multidisciplinary committee was made up of key stakeholders who were selected based on strong collaborative efforts to improve the health of the community, including the medically underserved, minority and low-income populations.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - DELNOR-COMMUNITY HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to the following: 1. Key community organizations and leaders 2. Delnor External Steering Committee 3. Delnor Leadership
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - DELNOR-COMMUNITY HOSPITAL. Through the prioritization process, NMDH identified three Priority Health Needs: Access to Healthcare Services, Chronic Disease, and Mental Health. NMDH identified health needs that would be best addressed through a coordinated response from a range of healthcare and community resources. Specific ways in which NMDH is addressing the significant needs identified in its most recently conducted CHNA are defined as follows: Priority 1: Mental Health Mental health and physical health are closely connected. Mental health plays an integral role in the ability to maintain physical health. Mental illnesses, such as depression, anxiety and addiction, affect people's ability to participate in health promoting behaviors. Subsequently, the presence of mental health problems can have a serious impact on chronic disease and decrease the ability to participate in treatment and recovery. To address the identified health needs related to Mental Health and Substance Abuse, NMDH and members of the External Steering Committee collaborate on the following strategies: 1.1: Continue strategic planning efforts to evaluate the demand for hospital-based mental health services and identify appropriate NMDH resources to address those needs. A comprehensive strategic plan has been developed to properly address the mental health needs of the NMDH and Northwestern Medicine Central DuPage Hospital (NMCDH) service areas. The plan identifies the needs along with strategies to address those needs, including but not limited to expansion of inpatient behavioral health and addiction services and additional capacity in the outpatient mental health service line. 1.2: Provide Community Benefit Grant funding and further solidify relationships with community agencies that can provide outpatient mental health services to the medically underserved residents within the service area. A grant was provided to Tri City Family Services, and the following outcomes were reported: 1. 70% of GAF scale scores and C-GAS scores fell in the 0-5 point improvement range, 16.3% fell in the 6-10 range, 4.9% fell in the 11-15 range, 2.9% of the scores fell in the 16-20 range, and 2.9% fell in the >20 point range. These scores indicate that the majority of clients are improving in their functioning by the end of treatment, as reported by their therapist. 2. 50.6% of identified client goals were in the category of Moods and Emotions, 31.2% were in category of Home/Family/Interpersonal Relations, 5.3% were in the category of School/Work Adjustment, 4.8% were in the category of Behavior Towards Others, and 4.8% were in the category of Thinking. The remaining 4% were divided amongst the categories. 1.3: Participate in and support initiatives within Kane County that are focused on Mental Health. The Kane County Health Department developed a Community Health Improvement Plan (CHIP) in collaboration with the hospitals and community agencies within the county. One of the identified priorities to be addressed is Mental Health and Substance Abuse. NMDH will continue to participate in the CHIP Executive Committee and the Mental Health Subgroup to develop and implement the action plan to address the health priority of Mental Health and Substance Abuse. a. Leadership staff Allison Johnson participated in the Kane County Behavioral Council. The Council coordinate services and assist in making the system more responsive by bringing together provider organizations, mental health authorities, major funders of mental health services, mental health advocacy groups and public officials. b. NMDH leadership participated on the TriCity Family Services advisory council. The goal of the council is to provide support to community service agency that serve the mental health needs of residents. c. NMDH hosted a Drug Takeback Day and 59.2 pounds of medications was collected. NMDH Medication Drug Disposal Kiosk in the ER collected 463 pounds of medication. d. NMDH/NMCDH Behavioral Health Services hosted 5 evidence-based wellness events: d1) Continuing Education programs for mental health and substance use disorder professionals; d2) Naperville Central High School Health Careers Class; d3) Thompson Middle School student support group for mental health; d4) Chamber of Commerce member education topics including helping employees with COVID stress, cannabis legislation, workplace stress management and general anxiety; and d5) Education presentation on mental health and substance abuse. e. Office space was provided at no charge for 12-Step Programs offered Sundays thru Saturdays. (NMCDH/NMDH). A total of 1,530 hours of room usage was recorded. 1.4: Complete the planning phase and implement the Mental Health First Aid Program in the NMDH service area. The Mental Health First Aid (MHFA) program is designed to teach residents of the community how to take action when a mental illness is suspected or identified. The intent is to reduce the wide reach and economic toll that mental health disorders and crises have on the community. Individuals within NMDH completed a training and certification process and provided educational sessions to teach parents, family members, caregivers, teachers, school staff, peers and community members how to help an adolescent or adult experiencing a mental health or addiction challenge or crisis. These individuals can then intervene and direct the individual to appropriate resources. The overall goal is to increase awareness and early intervention to those in need of behavioral health services. a) Three NMDH/NMCDH staff members were trained to offer the nationally recognized evidence-based Mental Health First Aid program virtually; b)7 classes were held; c) 136 individuals (adults and youth) attended the programs; d) 100% of MHFA participants scored a minimum of 100% on the MHFA course exam. Priority 2: Chronic Disease: Chronic conditions are responsible for 70% of deaths and 75% of healthcare spending. Chronic disease is a leading cause of disability and lost income. Chronic disease disproportionally affects low-income and minority populations. In the NMDH service area, 35% of adults have been told that they have high blood pressure; 30% have been told they have a high cholesterol reading; 23% are obese; and chronic diseases of the heart are the second leading cause of death. To address the identified deficiencies in Chronic Disease, NMDH and members of the External Steering Committee plan to collaborate on the following strategies: 2.1: Provide resources and tools to patients diagnosed with heart failure in order to improve self-management skills and quality of life. NMDH continued to provide a post-discharge community-based heart failure program designed to improve the quality of life and decrease readmission rates for patients diagnosed with heart failure. Efforts to improve the coordination of care for heart failure patients were expanded, and a system of referrals for specialty care and social service needs were implemented. A retrospective study of outcomes related to the program was completed to ensure maximum quality is achieved. Key outcomes of this program include: a) 226 individuals were enrolled in the Community-Based Heart Failure program: (NMCDH/NMDH); b) 30-day readmission rate for heart failure diagnosis: 4% (markedly below the national rate); c) 99% of clients demonstrated the ability to identify appropriate action in the event of a worsening of their condition; d) 94% of clients utilized an effective medication management system; e) 93% of clients demonstrated compliance with symptom tracking.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - DELNOR-COMMUNITY HOSPITAL. 2.2: Continue to provide, participate and partner in community-based health education, nutrition and activity programs focused on reducing the risk of obesity and chronic disease. NMDH provided community education related to chronic disease in the areas of evidence-based primary interventions (disease prevention, health promotion), evidence-based secondary interventions (screening) and evidence-based tertiary interventions (education to individuals affected with a chronic disease in an effort to promote an optimum state of individual wellness). Programmatic venues included the CATCH (Coordinated Approach to Child Health) program, the Dinner with the Doc series, clinician-led educational offerings, self-help groups, rehabilitation service programs and support programs. A comprehensive plan to increase patient compliance with physician and ancillary staff referrals to smoking cessation resources was also investigated and developed. Community Benefit Grants were provided to agencies that provide programming related to the priority health need of chronic disease. Key outcomes of these interventions include: 1. One educational seminar was offered for cardiovascular health with 116 individuals in attendance (NMDH/NMCDH); 2. Meeting space provided at no charge for 19 support groups (NMDH/NMCDH); 3. One educational seminar was offered for cancer with 93 individuals in attendance (NMDH/NMCDH); 4. Five additional educational seminars offered with 574 individuals in attendance (NMDH/NMCDH); 5. 12 Diabetes Education Services community programs with 90 individuals in attendance (NMDH/NMCDH); 6. 226 individuals enrolled in the Community-Based Heart Failure program (NMDH/NMCDH); a) 30-day readmission rate for heart failure diagnosis: 4% (markedly below the national rate); b) 99% of client were seen at a home visits within 7 days of discharge; and c) 87% of clients were able to name two cardiac medications and describe actions. 7. American Cancer Society (NMCDH/NMDH): a) 104 Cancer patients received rides; b) 8 drivers completed training which increased the number of drivers to 110 (an increase of 13% from the previous year); c) Temporary suspension of services due to COVID-19: 1,492 rides provided during the time that service was in operation (an increase in ride fulfillment rate of 5%). 8. Almost Home Kids (NMCDH/NMDH): a) 90% of children receive an evaluation to determine if Sleep Medicine could provide improve health outcomes via better sleep patterns; b) 20 sleep studies conducted, based on the child's actual needs; c) 1- 2 candidates for decannulation annually. 9. Marklund Children's Home (NMDH): a) 82% client care KPI average; b) 50% student goals met (on target); c) Students moved to hybrid learning (Covid-19) which impacted the Student Time on Task Goal (61% average compared to 92% goal); d) 78% average attendance. 10. TriCity Health Partnership (NMDH): a) Patient compliance was 54% for follow-up visits; b) All patients in the program met goal to lowering bleeding points by 50% (several reduced by 70%); c) TCHP only able to provide medication refills and tele-medicine options due to Covid-19; accurate diabetic A1C levels not possible. 11. Well Child Center a) 47% of Pediatric Dental Program children completed preventive six month follow-up appointment; b) 67% of PDP children did not have decay; c) 36% of children in the First Tooth Visit Program had a six month preventive care appointment; d) 85% of FTVP children program did not have new decay; e) 95% of the patients/parents reported positive experience with dentists, treatments, and Pediatric Clinic; f) 95% of parent's confidence level increased in preventive dentistry and knowledge of good daily dental care practice, including understanding of ADA recommendations. 12. The CATCH Program reached over 855 students and teachers (NMCDH/NMDH). 13. Three community programs were offered for stroke education with 86 people reached (NMCDH/NMDH). 14. 465 page views of Kits for Kids were downloaded for hand washing, bicycle safety and healthy nutrition (NMCDH/NMDH). 15. 128 individuals participated in smoking cessation programs with 100% self-reported smoking cessation by the end of week six. (NMCDH/NMDH). 16. 315 presentations of Think First Curriculum (children k-12): a) 17,301 individuals participated in TF community events (NMCDH/NMDH): b) 5,218 children fitted and received bike helmets (NMCDH/NMDH); c) 261 couples attended child safety classes (NMCDH/NMDH); d) 822 car seats checked/distributed (NMCDH/NMDH). 17. National Diabetes Prevention Program had 31 participants with a total loss of 140 lbs and 426 self-reported exercise hours. (NMCDH/NMDH). 18. 64 Community Kitchen classes, children/adults, and specialty classes for kids with special needs with 463 attending the healthy eating cooking classes. 19. COVID grant outcomes: a) Batavia School District 101 purchased 1,250 thermometers for families to monitor at home; b) St. Mark's Preschool Covid Grant Purchased Infrared Thermometers, waterbottle fill station, and a portable handwashing program. Priority 3: Access to Care: An aging population, coupled with a challenging economy and an increasing prevalence of chronic disease, create access-to-care issues relating to both the affordability and availability of care. NMDH seeks to promote access through a variety of initiatives identified below. NMDH will continue to work with individuals and families to promote access to medically necessary services by maintaining an accessible financial assistance program. Additionally, staff and leadership will work collaboratively with key community partners to promote a seamless continuum of care into local medical home settings. 3.1: Increase patient affiliation with high-quality patient-centered medical homes. NMDH and its ESC partners focused on strengthening care coordination, availability, cultural competency and offerings available at patient-centered medical homes operated by FQHC and healthcare organizations that closely align with NMDH. By concentrating efforts on improving the most essential community-based component of the healthcare system- the patient-centered medical home- NMDH focused on ensuring patients receive timely and appropriate care. NMDH continued its long-established partnership with Tri City Health Partnership and looked for ways to strengthen the patient-centered medical home. NMDH supported this partnership through grant funding, knowledge sharing, and streamlined access to medically appropriate diagnostic and specialty services at NMDH and within the Northwestern Medicine Regional Medical Group. 148 patients from TCHP received care (at no charge) from Northwestern Medicine facilities. NMDH will implement evidence-based practices to address the health concern related to members of the community receiving age and gender-appropriate screenings and other preventive services, including recommended routine immunizations. 3.2: Investigate innovative ways to connect uninsured members of the community with applicable entitlement programs and available healthcare and social services to improve access to medical care. Patients in need of financial assistance were connected to appropriate resources and NM assisted in the completion of applications for government assistance programs. 3.3: Improve access to evidence-based preventive services, including age and gender-appropriate screenings and routine immunizations. 76 vaccine clinics were provided, and 657 individuals in need received breast cancer screening at no charge. Non-Priority Areas: The CHNA identified areas of opportunity for health improvement for which NMDH and the ESC determined it would not prepare an implementation plan and strategy. These areas of opportunity and the reasons for not addressing are below. Cancer: NMDH provides a comprehensive range of clinical services to treat and screen for cancer. NMDH will continue to sustain these services and work to strengthen community-based outreach. The ESC recommended focusing efforts on other health conditions for which NMDH could have a greater impact (heart failure and nutrition and weight). Immunization and Infectious Disease in Adults: NMDH provides clinical services to treat pneumonia, asthma and tuberculosis. The ESC recommended that NMDH focus on strengthening and improving access to medical homes, where preventive care and screening services can be effectively coordinated and access to medically necessary specialty care can be facilitated. Vaccine services are provided to children as part of the access to care strategies. Tobacco Use: Tobacco use was incorporated into the strategies around chronic disease.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - DELNOR-COMMUNITY HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: "insured sliding fee scale assistance" and "insured catastrophic assistance." If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services.
Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - DELNOR-COMMUNITY HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - KISHWAUKEE HOSPITAL. The CHNA report also describes Kishwaukee Hospital background, charity care, the mission, CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - KISHWAUKEE HOSPITAL. PARTNERING WITH DEKALB COUNTY HEALTH DEPARTMENT, THE CHNA PROCESS INCLUDED A SURVEY ADMINISTERED TO COMMUNITY PARTNERS, THEIR EMPLOYEES, AND CLIENTS, TO ALLOW RESPONSES FROM LOW-INCOME AREAS, MENTAL HEALTH CLINICS, YOUTH ORGANIZATIONS AND FOOD PANTRIES. REPRESENTATIVES OF THE COMMUNITY INCLUDED: 1. ADVENTURE WORKS DEKALB 2. CITY OF DEKALB 3. CITY OF SYCAMORE 4. DEKALB COUNTY NON-PROFIT PARTNERSHIP 5. DEKALB COUNTY BOARD OF HEALTH 6. DEKALB COUNTY COMMUNITY DEVELOPMENT 7. DEKALB COUNTY COMMUNITY FOUNDATION 8. DEKALB COUNTY HEALTH DEPARTMENT 9. DEKALB COUNTY MENTAL HEALTH BOARD AND COMMUNITY ACTION 10. DEKALB CUSD 428 11. FAMILY FIRST PHYSICIANS 12. FOX VALLEY YMCA 13. KISHWAUKEE YMCA FINDINGS REPRESENT QUALITATIVE RATHER THAN QUANTITATIVE DATA. THE KEY INFORMANT SURVEY WAS DESIGNED TO GATHER INPUT FROM PARTICIPANTS REGARDING THEIR OPINIONS AND PERCEPTIONS OF THE HEALTH OF THE RESIDENTS IN THE AREA. THEREFORE, THESE FINDINGS ARE BASED ON PERCEPTIONS, NOT FACTS. AN EXTERNAL STEERING COMMITTEE WAS CONVENED TO PROVIDE OVERSIGHT TO THE DEVELOPMENT OF THE CHNA AND ENGAGE THE COMMUNITY THROUGHOUT THE PROCESS UNDER THE LEADERSHIP AND DIRECTION OF MEMBERS FROM DEKALB COUNTY HEALTH DEPARTMENT, KISHWAUKEE HOSPITAL, AND NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - KISHWAUKEE HOSPITAL. KISHWAUKEE HOSPITAL WORKED IN TANDEM WITH VALLEY WEST HOSPITAL AND SHARED RESPONSIBILITIES ON A JOINT STEERING COMMITTEE. SPECIFIC NEEDS AND CONCERNS OF KISHWAUKEE COMMUNITY HOSPITAL WERE IDENTIFIED AND ADDRESSED SEPARATELY.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - KISHWAUKEE HOSPITAL. KISHWAUKEE HOSPITAL COMPLETED A CHNA IN PARTNERSHIP WITH DEKALB COUNTY HEALTH DEPARTMENT. THE TWO ORGANIZATIONS COLLABORATED UNDER THE NAME "TOGETHER FOR A HEALTHIER DEKALB COUNTY" FOR THE PURPOSE OF THE CHNA. THE TOGETHER FOR A HEALTHIER DEKALB COUNTY STEERING COMMITTEE, MADE UP OF EMPLOYEES FROM BOTH ORGANIZATIONS, UTILIZED THE ASSESSMENT TOOL OF MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) IN JANUARY 2018. MAPP IS A COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - KISHWAUKEE HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to the following: 1. Key Community Organizations & Leaders 2. Internal & External Steering Committee Members 3. Kishwaukee Hospital Leadership
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL. Northwestern Medicine Kishwaukee Hospital (NMKH) completed a comprehensive Community Health Needs Assessment (CHNA) to identify the highest priority health needs of residents within our community, and use this information to guide new and existing efforts to improve the overall health of the populations served. The goals of the CHNA was to implement a structured data driven approach to determine health status, behaviors, and needs of all residents in the NMKH service area. Through this assessment and prioritization process, NMKH identified four health priority needs; adolescent health, behavioral health/mental health, chronic disease (cardiovascular disease and cancer), and maternal child health. Specific ways in which NMKH is addressing the needs identified in the CHNA are defined as follows: Priority 1: Adolescent Health Adolescents (age 10 to 19) make up 16 percent of the DeKalb County population. The behavioral patterns established during these developmental periods can help determine young people's current health status and their risk for developing chronic disease during adulthood. Health and social problems that may start or peak during these years; including; mental disorders, substance use, smoking/nicotine use, nutrition and weight conditions, sexually transmitted infections, teen pregnancy, homelessness, homicide, suicide and motor vehicle collisions. Effective programs and policies that address these issues can provide protective factors during these important stages in a person's life. 1.1: Advocate for use of evidence-based anti-bullying curriculum in schools. NMKH's goal was to decrease the percentage of adolescents reporting being bullied in the past 12 months, as related to name calling, physical threats, hitting, punching, kicking, pushing or cyber bullying. Adolescents who report another student has ever bullied (reported at least 1 type of bullying) in the past 12 months as identified by the IYS includes 48 percent of 8th graders, 35 percent of 10th graders, and 32 percent of 12th graders. Discussions were had with the DeKalb County Health Department to consider requesting funding for money to support an evidence based anti-bullying curriculum. Youth prevention education is delivered to two school districts; DeKalb, and Genoa-Kingston. Skill development is the core of the evidence based curriculum delivered. The program is designed to mitigate risk factors and enhance protective factors related to alcohol, tobacco, and other drug use. The lessons introduce and develop social and emotion skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure. In TY2019, the following students received the curriculum: 154 students in grade 6 at Clinton Rosette Middle School, DeKalb; 111 students in grade 7 at Genoa Kingston Middle School, Genoa; 107 students in grade 7 at Sandwich Middle School; and 93 students in grade 8 in Genoa Middle School. 1.2: Collaborate with schools to address depression and substance use among adolescents utilizing evidence-based interventions and education. Youth prevention education is delivered to two school districts; DeKalb and Genoa-Kingston. Skill development is the core of the evidence-based curriculum delivered. The program is designed to mitigate risk factors and enhance protective factors related to alcohol, tobacco, and other drug (ATOD) use. The lessons introduce and develop social and emotion skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure. In TY2019, 2879 students in local schools received the curriculum. 1.3: Deliver an evidence-based Youth Prevention Program Education model program aimed at reducing alcohol use to an entire grade level of 6-12th grade students. Youth prevention education is delivered to two school districts; DeKalb and Genoa-Kingston. Skill development is the core of the evidence based curriculum delivered. The program is designed to mitigate risk factors and enhance protective factors related to alcohol, tobacco, and other drug (ATOD) use. The lessons introduce and develop social and emotion skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure. In TY2019, 2879 students in local schools received the curriculum. 1.4: Implement a communication campaign addressing the contributing factors related to past 30-day alcohol use. The Illinois Youth Survey (IYS) 2018 data reports past 30-day use of alcohol for DeKalb County as follows: 14% of 8th grade students, 26% of 10th grade students, and 40% of 12th grade students. In partnership DeKalb County High Schools including; Hiawatha, Genoa-Kingston, Indian Creek, Sandwich and Sycamore, a nine-month communication campaign is delivered. During the nine-month campaign, primary messages must be changed every 6 weeks and reach a majority of the student population. Secondary messages are changed every 12 weeks during the campaign. Total number of students impacted by primary and secondary messages was 2879 students (unduplicated population). 1.5: Engage local school districts in DeKalb County to participate in the Illinois Youth Survey. During a non-survey year (current reporting year) engage the districts to review the latest IYS data. To continue to ensure at least an 80% participation rate in the IYS throughout DeKalb County Schools, presentations on the 2019 IYS data were given during a DeKalb County Superintendents Monthly Regional Office of Education meeting; seven school districts leaders were present. Additionally, all DeKalb County schools received communication about the importance of understanding the IYS data and an invitation to have NM staff meet with districts to discuss the findings. 1.6: Provide an evidence-based curriculum focusing on causes and risk factors of brain and spinal cord injury, injury prevention measures and the use of safety habits at an early age. The Think First curriculum was offered to 1,298 children in 20 different schools throughout the county. The program fit and distributed 1,137 bike helmets to students. 1.7: Provide Kids Can Cook classes at the Leishman Center for Culinary Health to promote healthy cooking, using fresh ingredients, healthy eating and appropriate culinary skills to participants. Kids Can Cook classes were offered five times, reaching 52 youth. 1.8: Directly or indirectly support activities related to smoking prevention programs in school age children. Catch My Breath is a prevention program that provides students will skills to resist peer pressure and media influences to try E-Cigarettes. Locally, the program was taught 9 times (3 sessions per class) to 6th grade students in Genoa Kingston Middle School and 178 students were reached through the program. 1.9: Provide evidence-based programs for students in grades 6-8 to be safe when they are home alone or watching younger siblings. In an effort to increase knowledge and skills related to the prevention of unsafe situations, what to do in an emergency, and behaviors that helps students stay in control of themselves and others in their care, the Safe Sitter program was presented four times and 37 students completed the program. 1.10: Provide the evidence-based program Coordinated Approach to Child Health (CATCH) to students to create behavior changes in students to identify healthy foods and increase physical activity. CATCH is a program delivered in collaboration by the DeKalb County Health Department, Kishwaukee Family YMCA, Northern Illinois University (NIU), and NMKH. The program is delivered to Sycamore School District and Genoa Kingston School District. Genoa Kingston grades K-6 receive CATCH lessons (6 lessons per grade level) throughout the school year, impacting 128 students.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL. Priority 2: Behavioral Health and Substance Abuse Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with others and the ability to adapt to change and to cope with challenges. Mental health is essential to personal well-being, family and interpersonal relationships and the ability to contribute to society. Mental disorders are among the most common and costly causes of disability. Mental and physical health are closely connected. Inpatient hospital admission data analysis found the most frequent Medicare Severity Diagnostic Related Groups (MS-DRGs) assigned to DeKalb County residents is psychoses; this is three times higher than the next most frequent MS-DRG. 2.1: Support policy and efforts in becoming Trauma Informed Community. Trauma is highly prevalent and can impact a person at any time during their lifespan and may present as mental health, substance use or physical health conditions. A trauma informed approach includes realizing the widespread impact of trauma and understands potential paths for recovery; recognizing the signs and symptoms of trauma in clients, families, staff, and others involved with the system; responding by fully integrating knowledge about trauma into policies, procedures, and practices; and resisting re-traumatization. NMKH identified key departments involved in trauma-informed efforts, inquired about education and trauma informed practices, and sought opportunities to create a team to discuss feasibility of the project and project charter. 2.2: Support efforts to eliminate the stigma of mental health. NMKH's goal was to increase public education and awareness of the negative attitudes and beliefs regarding behavioral health, and decrease stigma related to mental health by increasing the proportion of DeKalb County organizations that complete a Mental Health First Aid course. In TX2019, additional training was completed which allowed staff to offer the program in a virtual format due to Covid-19. 2.3: Reduce high-risk opioid prescribing through provider education and guidelines. NMKH's goal was to reduce the number of prescribed opiate drugs as measured by the IDPH Opioid Dashboard. The opioid prescribing summary included: a) total opioid prescriptions at NMKH 731; b) average number of pills at discharge 14; percentage on target number of pills at discharge is 73.7%; percentage above target number of pills at discharge is 26.3%. 2.4: Implement a communication campaign addressing alcohol use by teens in local school districts. The Illinois Youth Survey (IYS) 2019 data reports past 30-day use of alcohol for DeKalb County as follows: 14% of 8th grade students, 26% of 10th grade students, and 40% of 12th grade students. In partnership DeKalb County High Schools including; Hiawatha, Genoa-Kingston, Indian Creek, Sandwich and Sycamore, a nine-month communication campaign was delivered. During the campaign, primary messages must be changed every 6 weeks and reach a majority of the student population. Secondary messages are changed every 12 weeks during the campaign. Total number of students impacted by primary and secondary messages was 2879 students (unduplicated population). 2.5: Raise awareness of the drug take back programs in the service area. Working in partnership with the following local law enforcement offices: DeKalb Police Department, DeKalb County Sheriff's Office, Kingston Police Department, Sandwich Police Department and Sycamore Police Department to decrease the opportunity for diversion of non-prescribed prescription drugs and opioids. A total of 796.2 pounds of unwanted, unused, or expired medication was disposed of throughout DeKalb County in either permanent drug take back boxes or during National Drug Take Back Day. 2.6: Increase drug prevention programs in communities and schools targeted at opioid misuse and prescription drug abuse. To educate on the risks of opioid and prescription drug use, a lesson specific to opioid misuse and abuse was delivered as part of the youth prevention education programming taking place at Clinton Rosette Middle School, Genoa Kingston Middle School, and Sandwich Middle School. At Clinton Rosette 148 students received the lesson, at Genoa Kingston 89 students received the lesson, and at Sandwich 91 students received the lesson. 2.7: Participate on the DeKalb County Overdose Prevention Program Taskforce. A group of government leaders, healthcare organizations, and law enforcement staff gather to discuss strategies to reduce the number of fatal opioid related overdoses in DeKalb County. NMKH staff attended three task force scheduled meetings. Because of the taskforce, over 50 people from various organizations have been trained using the train the trainer model on the use of Naloxone and provided a supply for their organization. PRIORITY 3: Chronic Disease - Cancer Cancer remains the second leading cause of mortality in the United States (Center for Disease Control and Prevention, 2012) and of DeKalb County residents. By cancer site, lung cancer is the most common for both genders. The leading male cancer site deaths are lung, colorectal, and prostate, while the leading female cancer site deaths are lung, breast, and colorectal. 3.1: Educate the community on importance of screening for cancer and early detection. Promotion of Low Dose CT Lung Cancer Screening: this screening was promoted at community events and through worksite wellness organizations. 275 community members received the information promoting Low Dose CT Lung Screening. 3.2: Offer free or reduced cost mammograms for targeted populations. The Women Matter program is designed to provide screening mammography services at no cost to women who do not have insurance coverage in DeKalb County. Efforts were made to promote this free and reduced cost program (which is open to women between the ages of 40-64 years who reside within DeKalb County, and have no insurance/underinsured or a high deductible plan). Information about this program is shared at various event throughout the community during the fiscal year. A total of 14 patients were screened through Women Matter and of these two patients required additional follow-up. 3.3: Offer educational programs on smoking cessation in the community. The American Respiratory Associations, Courage to Quit smoking cessation programs are offered throughout the year to the community and businesses to assist with smoking cessation efforts. Smoking cessation programs have proven effective in decreasing the incidence of cancer, heart disease and stroke. Program facilitators provide information, practice skills, and support to help tobacco users reach smoke-free goals. During the fiscal year there were six Courage to Quit classes and two completed referrals to the Illinois Quit Line. 3.4: Promote the availability of smoking cessation classes and the Illinois Quit Line. The American Respiratory Associations, Courage to Quit smoking cessation programs are offered throughout the year to the community and businesses to assist with smoking cessation efforts. Smoking cessation programs have proven effective in decreasing the incidence of cancer, heart disease and stroke. Program facilitators provide information, practice skills, and support to help tobacco users reach smoke-free goals. Additionally, the Illinois Quit Line is an underutilized resource for smoking cessation support. NMKH community health services department worked with the respiratory therapy department to get information related to the IL Quit Line and current Courage to Quit classes in the hands of patients who need this information. During the fiscal year, there were five Courage to Quit classes and four completed referrals to the Illinois Quit Line. There was also a team created for the standardization of smoking cessation effort led by Bluhm Cardiovascular and Community Health Services. 3.5: Directly or indirectly support activities related to smoking prevention programs in school age children. NMKH works to support activities related to smoking prevention programs in school age children through collaboration with local school districts. CATCH My Breath is a prevention program that provides students with skills to resist peer pressure and media influences to try electronic nicotine delivery systems, commonly known as e-cigarettes. Locally this program was taught six times (three lessons per class) to 178 sixth grade students.
Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL. PRIORITY 4: Cardiovascular Disease Cardiovascular Disease, principally heart disease is the leading cause of death in the United States, with stroke following as the third leading cause. Together, heart disease and stroke are among the most widespread and costly health problems facing our nation today, accounting for more than $500 billion in healthcare expenditures. Healthy People 2020 stresses that the risk of Americans developing and dying from cardiovascular disease would be substantially reduced if changes were made in diet, physical activity and management of high blood pressure, cholesterol and smoking. In planning to address this health priority within the community, hospitals can positively impact the health burdens of all chronic disease by addressing the disease across the continuum of lifespan. 4.1: Promote Know Your Numbers, an evidence based approach to community awareness of cardiovascular disease. Better prevention of and the management of high cholesterol, high blood pressure or diabetes to help lower the risk for heart disease is a key component to the Know Your Numbers biometric screening appointments. This screening was designed to provide participants with their individual cardiovascular risk factors including fasting glucose, total cholesterol, Body Mass Index (BMI), blood pressure and waist measurement. Lifestyle changes such as quitting or never smoking, limiting alcohol use, exercising and eating healthy all lower risk for cardiovascular disease and are thoroughly discussed during the screening appointments. Community members have access to this complimentary screening and appointments are available monthly. 158 community members participated in the screening. Additionally, blood pressure checks are offered weekly free of charge for community members and patients at two locations; Kishwaukee Hospital and NM Genoa clinic. The goal of offering the blood pressure checks is to improve awareness of one's own blood pressure number, an indicator used for heart disease risk factors. 1638 people participated in blood pressure screenings during the fiscal year. Of those screened patients with a B/P greater than 120/80 is 87 percent. 4.2: Offer educational sessions for targeted populations to address prevention of cardiovascular disease through healthy diet and cooking programs at the Leishman Center for Culinary Health and through the DASH program to manage high blood pressure. The Leishman Center for Culinary Health offers a variety of natural, whole foods cooking classes designed to help participants make simple changes for a healthier lifestyle. Classes offered in the center include disease specific offerings such as Eat to Beat: Cancer and Eat to Beat: Heart Disease. The philosophy of the Leishman Center is focused around eating real food, which support the mission of the department in tackling chronic illness, disease and obesity. The Leishman Center for Culinary Health reached more than 868 participants through 93 in house classes and external programs. 4.3: Identify and implement a community education program to increase awareness on sodium and promote sodium reduction in the diet. Increase awareness on the daily consumption of sodium and its impact on high blood pressure, which is a leading risk factor for cardiovascular disease. As part of larger community events, NMKH participated in seven community opportunities to share information related to sodium consumption, reading a nutrition label to identify sodium on the label, and helpful tips for reducing sodium in the diet, this evidence based information is from the American Heart Association. The development and implementation of the program called Managing your Blood Pressure with the DASH (Dietary Approaches to Stop Hypertension) Diet was also implemented. The DASH program outcomes and metrics were developed during this fiscal year. The class continues to be offered on a quarterly basis. 4.4: Offer the American Heart Association CPR program. This American Heart Association course is designed for anyone who wants to learn basic CPR. Participants learn how to perform CPR on adults, children, and infants and how to help an adult, child, or infant who is choking. These classes were offered five times with 59 participants in attendance. 4.5: Provide resources and tools to patients diagnosed with heart failure to improve self-management skills and quality of life. Kishwaukee Hospital's Community Based Heart Failure Program started seeing patients in November 2018. In FY2020, 65 patients were enrolled with 98% compliance with system tracker, 100% of patients able to identify action needed for worsening of symptoms, 91% of patients able to identify two cardiac medications, 98% of patients using a medication system, 100% of patients receiving a home visit within 7 days of hospital discharge and 77% of patients followed-up with their physician within 7 days. PRIORITY 5: Maternal Child Health According to the Centers for Disease Control and Prevention, safe motherhood begins before conception with good nutrition and a healthy lifestyle. It continues with appropriate prenatal care with the ideal result being a full-term pregnancy without unnecessary interventions and the delivery of a healthy baby. In addition, it includes a healthy postpartum period in a positive environment that supports the physical and emotional needs of the mother, baby and family. The number of births in DeKalb County for 2016 was 1,093. Notably, there has been a decrease in births over the past three years within DeKalb County. The overall teen birth rate in DeKalb County per 1,000 population is 15.7 5.1: To assess capacity to provide referral systems for smoking cessation among pregnant women and Offer Courage to Quit smoking cessation program. NMKH community wellness continued to offer ongoing sessions of the Respiratory Health Association's Courage to Quit smoking cessation programs to women who are receiving services at the DeKalb County Health Department.
Schedule H, Part V, Section B, Line 11 Facility , 4 Facility , 4 - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL. 5.2: Support messaging related to The Basics of DeKalb County. Staff met with the Basics Coordinator, hired by DeKalb County to lead this initiative. The hospital will stay committed to supporting the mission of The Basics DeKalb County. The health department received funding from NMKH community benefit dollars to support messaging and the creation of a space dedicated to the work of The Basics within the health department waiting area. 5.3: Update childbirth education classes to include messaging on domestic violence and resources available for referral. Programmatic slides updated to include information related to domestic violence resources available in DeKalb County. 5.4: Investigate opportunities to increase referrals to the Breastfeeding Center to WIC clients at the DeKalb County Health Department FY20 a total of 10 prenatal lactation consults. Of those, 4 were WIC clients who had received a referral. A total of 354 initial lactation consults (1st visit to the center) and 520 follow-up lactation consults for a total of 874 one-on-one consults. Of these 874 consults, approximately 8% were WIC clients. 1,021 calls on the warm line. Of those, approximately 40% are WIC clients. Transportation challenges have always contributed to a higher propensity of call vs. in person visits. 3 walk-in consults - these are consults who most often come to the center without a scheduled appointment directly after being seen by the pediatrician. When there is availability to see walk-in patients in the center, the patient is marked as a "walk-in". 90% of walk-in clients were WIC clients. 5.5: Investigate the feasibility of offering a childbirth education class in Spanish. Continue to investigate the feasibility of offering childbirth education in Spanish. Online computer system does offer a program in Spanish. Need to assess need with additional input from the health department and women being seen through their Women, Infant and Children clinic. The CHNA report identified area of opportunity for health improvement for which NMKH and its external committee determined it would not prepare an implementation plan and strategy. These identified areas and the reason for not addressing are listed below: NON-PRIORITY: Access to Health Services. Access to health services ranked as a concern that will be addressed within the health priorities selected through the MAPP process. NON-PRIORITY: Environmental Health. There are programs and initiative available through other organizations within DeKalb County to address Environmental Health. NON-PRIORITY: Health Communication/HIT. NMKH utilizes tools such as the Electronic Medical Record as a way to continue to assist patients and community members with Health Information Technology. NON-PRIORITY: Infectious Disease/STI. There are programs and initiatives available through other organizations within DeKalb County to address infectious disease and STIs. NON-PRIORITY: Injury and Violence. There are programs and initiatives available through other organizations within DeKalb County to address injury and violence. NON-PRIORITY: Social Determinants of Health. Social Determinants of Health ranked as a concern that will be addressed within the health priorities selected through the MAPP process.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - KISHWAUKEE COMMUNITY HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: "insured sliding fee scale assistance" and "insured catastrophic assistance." If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services.
Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - KISHWAUKEE COMMUNITY HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - VALLEY WEST HOSPITAL. The CHNA report also describes Valley West Hospital background, charity care, the mission, CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - VALLEY WEST HOSPITAL. PARTNERING WITH DEKALB COUNTY HEALTH DEPARTMENT, THE CHNA PROCESS INCLUDED A SURVEY ADMINISTERED TO COMMUNITY PARTNERS, THEIR EMPLOYEES, AND CLIENTS, TO ALLOW RESPONSES FROM LOW-INCOME AREAS, MENTAL HEALTH CLINICS, YOUTH ORGANIZATIONS AND FOOD PANTRIES. REPRESENTATIVES OF THE COMMUNITY INCLUDED: 1. ADVENTURE WORKS DEKALB 2. CITY OF DEKALB 3. CITY OF SYCAMORE 4. DEKALB COUNTY NON-PROFIT PARTNERSHIP 5. DEKALB COUNTY BOARD OF HEALTH 6. DEKALB COUNTY COMMUNITY DEVELOPMENT 7. DEKALB COUNTY COMMUNITY FOUNDATION 8. DEKALB COUNTY HEALTH DEPARTMENT 9. DEKALB COUNTY MENTAL HEALTH BOARD AND COMMUNITY ACTION 10. DEKALB CUSD 428 11. FAMILY FIRST PHYSICIANS 12. FOX VALLEY YMCA 13. KISHWAUKEE YMCA FINDINGS REPRESENT QUALITATIVE RATHER THAN QUANTITATIVE DATA. THE KEY INFORMANT SURVEY WAS DESIGNED TO GATHER INPUT FROM PARTICIPANTS REGARDING THEIR OPINIONS AND PERCEPTIONS OF THE HEALTH OF THE RESIDENTS IN THE AREA. THEREFORE, THESE FINDINGS ARE BASED ON PERCEPTIONS, NOT FACTS. AN EXTERNAL STEERING COMMITTEE WAS CONVENED TO PROVIDE OVERSIGHT TO THE DEVELOPMENT OF THE CHNA AND ENGAGE THE COMMUNITY THROUGHOUT THE PROCESS UNDER THE LEADERSHIP AND DIRECTION OF MEMBERS FROM DEKALB COUNTY HEALTH DEPARTMENT, KISHWAUKEE HOSPITAL, AND NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - VALLEY WEST HOSPITAL. VALLEY WEST HOSPITAL WORKED IN TANDEM WITH KISHWAUKEE HOSPITAL AND SHARED RESPONSIBILITIES ON A JOINT STEERING COMMITTEE. SPECIFIC NEEDS AND CONCERNS OF VALLEY WEST HOSPITAL WERE IDENTIFIED AND ADDRESSED SEPARATELY.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - VALLEY WEST HOSPITAL. VALLEY WEST HOSPITAL PARTNERED WITH DEKALB COUNTY HEALTH DEPARTMENT UNDER THE NAME "TOGETHER FOR A HEALTHIER DEKALB COUNTY" AND UTILIZED THE ASSESSMENT TOOL OF MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP). THIS COLLABORATION ENGENDERED BROADER THINKING ABOUT COMMUNITY NEEDS FOR THE VALLEY WEST COMMUNITY.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - VALLEY WEST HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to the following: 1. Key Community Organizations & Leaders 2. NMVWH Internal & External Steering Committee Members 3. Northwestern Medicine Valley West Hospital Leadership
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. Northwestern Medicine Valley West Hospital (NMVW) completed a comprehensive Community Health Needs Assessment (CHNA) to identify the highest priority health needs of residents within our community, and use this information to guide new and existing efforts to improve the overall health of the populations served. The goals of the CHNA was to implement a structured data driven approach to determine health status, behaviors, and needs of all residents in the NMVW service area. Through this assessment and prioritization process NMVW identified four health priority needs; adolescent health, behavioral health/mental health, chronic disease (cardiovascular disease and cancer), and maternal child health. Specific ways in which NMVW is addressing the needs identified in the CHNA are defined as follows: Priority 1: Adolescent Health Adolescents (age 10 to 19) make up 16 percent of the DeKalb County population. The behavioral patterns established during these developmental periods can help determine young people's current health status and their risk for developing chronic disease during adulthood. Health and social problems that may start or peak during these years include mental disorders, substance use, smoking/nicotine use, nutrition and weight conditions, sexually transmitted infections, teen pregnancy, homelessness, homicide, suicide and motor vehicle collisions. Effective programs and policies that address these issues can provide protective factors during these important stages in a person's life. 1.1: Advocate for use of evidence-based anti-bullying curriculum in schools. To decrease the percentage of adolescents reporting being bullied in the past 12 months, as related to name calling, physical threats, hitting, punching, kicking, pushing or cyber bullying. Adolescents who report another student has ever bullied (reported at least 1 type of bullying) in the past 12 months as identified by the IYS: 48 percent of 8th graders, 35 percent of 10th graders, and 32 percent of 12th graders. Discussions with the DeKalb County Health Department to consider requesting funding for money to support an evidence based anti-bullying curriculum. Youth prevention education is delivered to two school districts: DeKalb and Genoa-Kingston. Skill development is the core of the evidence based curriculum delivered. The program is designed to mitigate risk factors and enhance protective factors related to alcohol, tobacco, and other drug use. The lessons introduce and develop social and emotion skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure. In FY2020, 154 students in grade 6 at Clinton Rosette Middle School, DeKalb; and 111 students in grade 7 at at Genoa Kingston Middle School, Genoa; and 107 students in grade 7 at Sandwich Middle School, Sandwich; and 93 students in grade 8 in Genoa Middle School received the curriculum. 1.2: Collaborate with schools to address depression and substance use among adolescents utilizing evidence-based interventions and education. Youth prevention education is delivered to two school districts: DeKalb and Genoa-Kingston. Skill development is the core of the evidence based curriculum delivered. The program is designed to mitigate risk factors and enhance protective factors related to alcohol, tobacco, and other drug use. The lessons introduce and develop social and emotion skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure. In FY2020, 2879 students in local schools received the curriculum. 1.3: Deliver an evidence based Youth Prevention Program Education model program aimed at reducing alcohol use to an entire grade level of 6th - 12th grade students. Youth prevention education is delivered to two school districts: DeKalb and Genoa-Kingston. Skill development is the core of the evidence based curriculum delivered. The program is designed to mitigate risk factors and enhance protective factors related to alcohol, tobacco, and other drug use. The lessons introduce and develop social and emotion skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure. In FY2020, 2879 students in local schools received the curriculum. 1.4: Implement a communication campaign addressing the contributing factors related to past 30-day alcohol use. The Illinois Youth Survey (IYS) 2019 data reports past 30-day use of alcohol for DeKalb County as follows: 14% of 8th grade students, 26% of 10th grade students, and 40% of 12th grade students. In partnership DeKalb County High Schools including; Hiawatha, Genoa-Kingston, Indian Creek, Sandwich and Sycamore a nine-month communication campaign was delivered. During the campaign, primary messages must be changed every 6 weeks and reach a majority of the student population. Secondary messages are changed every 12 weeks during the campaign. Total number of students impacted by primary and secondary messages was 2879 students (unduplicated population). 1.5: Engage local school districts in DeKalb County to participate in the Illinois Youth Survey. During a non-survey year (current reporting year) engage the districts to review the latest IYS data. To continue to ensure at least an 80% participation rate in the IYS throughout DeKalb County Schools, presentations on the 2019 IYS data was given during a DeKalb County Superintendents Monthly Regional Office of Education meeting, seven school districts leaders were present. Additionally, all DeKalb County schools received communication about the importance of understanding the IYS data and an invitation to have NM staff meet with districts to discuss the findings. 1.6: Provide an evidence-based curriculum focusing on causes and risk factors of brain and spinal cord injury, injury prevention measures and the use of safety habits at an early age. The Think First curriculum was offered to 1,298 children in 20 different schools throughout the county. The program fit and distributed 1,137 bike helmets to students. 1.7: Provide Kids Can Cook classes at the Leishman Center for Culinary Health to promote healthy cooking, using fresh ingredients, healthy eating and appropriate culinary skills to participants. Kids Can Cook classes were offered five times, reaching 52 youth. 1.8: Directly or indirectly support activities related to smoking prevention programs in school age children. Catch My Breath is a prevention program that provides students with skills to resist peer pressure and media influences to try E-Cigarettes. Locally, the program was taught 9 times (3 sessions per class) to 6th grade students in Genoa Kingston Middle School and 178 students were reached through the program. 1.9: Provide evidence-based programs for students in grades 6-8 to be safe when they are home alone or watching younger siblings. In an effort to increase knowledge and skills related to prevention of unsafe situations, what to do in an emergency, and manage behavior that helps students stay in control of themselves and other in their care, the Safe Sitter program was presented four times and 37 students completed the program. 1.10: Provide the evidence-based program Coordinated Approach to Child Health (CATCH) to students to create behavior changes in students to identify health foods and increase physical activity. CATCH is a program delivered in collaboration by the DeKalb County Health Department, Kishwaukee Family YMCA, Northern Illinois University (NIU), and NMKH. The program is delivered to Sycamore School District and Genoa Kingston School district. In Genoa Kingston, grades K-6th receive CATCH lessons (6 lessons per grade level) throughout the school year, impacting 128 students.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. Priority 2: Behavioral Health and Substance Abuse Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with others and the ability to adapt to change and to cope with challenges. Mental health is essential to personal well-being, family and interpersonal relationships and the ability to contribute to society. Mental disorders are among the most common and costly causes of disability. Mental and physical health are closely connected. Inpatient hospital admission data analysis found the most frequent Medicare Severity Diagnostic Related Groups (MS-DRGs) assigned to DeKalb County residents is psychoses; this is three times higher than the next most frequent MS-DRG. 2.1: Support policy and efforts in becoming Trauma Informed Community. Trauma is highly prevalent, can impact a person at any time during their lifespan and may present as mental health, substance use or physical health conditions. A trauma informed approach includes realizing the widespread impact of trauma and understanding potential paths for recovery. It also includes recognizing the signs and symptoms of trauma in clients, families, staff, and others involved with the system, and responding by fully integrating knowledge about trauma into policies, procedures, and practices, resists re-traumatization. This strategy focused on identification of key departments, an inquiry of education around trauma informed practices, and the opportunity to create a team to discuss the feasibility of the project and project charter. 2.2: Support efforts to eliminate the stigma of mental health. The goal of this strategy is to educate the public on negative attitudes and beliefs regarding behavioral health by increasing the proportion of DeKalb County organizations that complete a Mental Health First Aid (MHFA) course. MHFA is designed to increase awareness and decrease stigma related to mental health. During FY2020, staff was trained to provide the program in a virtual format due to Covid-19. 2.3: Reduce high-risk opioid prescribing through provider education and guidelines. NMVW's goal was to reduce the number of prescribed opiate drugs as measured by the IDPH Opioid Dashboard. Opioid prescribing summary: a) total opioid prescriptions at NMVW 731; b) average number of pills at discharge 14; c) percentage on target number of pills at discharge was 73.7 percent; and d) percentage above target number of pills at discharge was 26.3 percent. 2.4: Implement a communication campaign addressing alcohol use by teens in local school districts. The Illinois Youth Survey (IYS) 2019 data reports past 30-day use of alcohol for DeKalb County as follows: 14% of 8th grade students, 26% of 10th grade students, and 40% of 12th grade students. In partnership DeKalb County High Schools including; Hiawatha, Genoa-Kingston, Indian Creek, Sandwich and Sycamore a nine-month communication campaign was delivered. During the campaign, primary messages must be changed every 6 weeks and reach a majority of the student population. Secondary messages are changed every 12 weeks during the campaign. Total number of students impacted by primary and secondary messages was 2879 students (unduplicated population). 2.5: Raise awareness of the drug take back programs in the service area. NMVWH worked in partnership with the local law enforcement offices, including DeKalb Police Department, DeKalb County Sheriff's Office, Kingston Police Department, Sandwich Police Department and Sycamore Police Department, to decrease the opportunity for diversion of non-prescribed prescription drugs and opioids. A total of 796.2 pounds of unwanted, unused, or expired medication was disposed of throughout DeKalb County in either permanent drug take back boxes or during National Drug Take Back Day. 2.6: Increase drug prevention programs in communities and schools targeted at opioid misuse and prescription drug abuse. This strategy focused on education of the risks of opioid and prescription drug use. A lesson specific to opioid misuse and abuse was delivered as part of the youth prevention education programming taking place at Clinton Rosette Middle School, Genoa Kingston Middle School, and Sandwich Middle School. At Clinton Rosette 148 students received the lesson, at Genoa Kingston 89 students received the lesson, and at Sandwich 91 students received the lesson. 2.7: Participate on the DeKalb County Overdose Prevention Program Taskforce. A group of government leaders, healthcare organizations, and law enforcement personnel gather to discuss strategies to reduce the number of fatal opioid related overdoses in DeKalb County. NM staff attended three task force scheduled meetings. Because of the taskforce efforts, over 50 people from various organizations have been trained on the proper use of Naloxone and have received a supply of Naloxone for their organization. PRIORITY 3: Chronic Disease - Cancer Cancer remains the second leading cause of mortality in the United States (Center for Disease Control and Prevention, 2012) and of DeKalb County residents. By cancer site, lung cancer is the most common site for both genders. The leading male cancer site deaths are lung, colorectal, and prostate, while the leading female cancer site deaths are lung, breast, and colorectal. 3.1: Educate the community on importance of screening for cancer and early detection. Low Dose CT Lung Cancer Screenings were promoted at community events and worksite wellness organizations. 275 community members received the information promoting Low Dose CT Lung Screening. 3.2: Offer free or reduced cost mammograms for targeted populations. The Women Matter program was designed to provide screening mammography services at no cost to women who do not have insurance coverage in DeKalb County. Efforts are made to promote this program, which is open to women between the ages of 40-64 years, who reside within DeKalb County, and have no insurance, are underinsured or have high deductible plan. Information about this program was shared at various event throughout the community during the fiscal year. A total of 14 patients were screened through Women Matter, and of these, two patients required additional follow-up. 3.3: Offer educational programs on smoking cessation in the community. The American Respiratory Association's Courage to Quit smoking cessation programs are offered throughout the year to the community organizations and businesses to assist with smoking cessation efforts. Smoking cessation programs have proven effective in decreasing the incidence of cancer, heart disease and stroke. Program facilitators provide information, practice skills, and support to help tobacco users reach smoke-free goals. During the fiscal year there were six Courage to Quit classes and two completed referrals to the Illinois Quit Line. 3.4: Promote the availability of smoking cessation classes and the Illinois Quit Line. The Illinois Quit Line is an underutilized resource for smoking cessation support. NM community health services department worked with the respiratory therapy department to get information related to the IL Quit Line and current Courage to Quit classes in the hands of patients who need this information. During the fiscal year, there were five Courage to Quit classes and four completed referrals to the Illinois Quit Line. There was also a team created for the standardization of smoking cessation effort led by Bluhm Cardiovascular and Community Health Services. 3.5: Directly or indirectly support activities related to smoking prevention programs in school age children. NM works to support activities related to smoking prevention programs in school age children through collaboration with local school districts. CATCH My Breath is a prevention program that provides students with skills to resist peer pressure and media influences to try nicotine delivery systems, commonly known as E-Cigarettes. This program was offered locally six times (three lessons per class) to 178 sixth grade students.
Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. Priority 4: Cardiovascular Disease Cardiovascular Disease, principally heart disease, is the leading cause of death in the United States, with stroke following as the third leading cause. Together, heart disease and stroke are among the most widespread and costly health problems facing our nation today, accounting for more than $500 billion in healthcare expenditures. Healthy People 2020 stresses that the risk of Americans developing and dying from cardiovascular disease would be substantially reduced if changes were made in diet, physical activity and management of high blood pressure, cholesterol and smoking. In planning to address this health priority within the community, hospitals can positively impact the health burdens of all chronic disease by addressing the disease across the continuum of lifespan. 4.1: Promote Know Your Numbers, an evidence based approach to community awareness of cardiovascular disease. Better prevention and management of high cholesterol, high blood pressure or diabetes to help lower the risk for heart disease is a key component to the Know Your Numbers biometric screening appointments. The screening was designed to provide a participant with their individual cardiovascular risk factors including fasting glucose, total cholesterol, Body Mass Index (BMI), blood pressure and waist measurement. Lifestyle changes such as quitting or never smoking, limiting alcohol use, exercising and eating healthy all lower risk for cardiovascular disease and are thoroughly discussed during the screening appointments. Community members have access to this complimentary screening and appointments are available monthly. In FY2020, 158 community members participated in the screening. Additionally, blood pressure checks were offered weekly free of charge for community members and patients at two locations: Kishwaukee Hospital and NM Genoa Clinic. The goal of offering blood pressure checks was to improve awareness of one's own blood pressure number, an indicator used for heart disease risk factors. 1638 people participated in blood pressure screenings during the fiscal year. Patients screened with a blood pressure greater than 120/80 was 87 percent. 4.2: Offer educational sessions for targeted populations to address prevention of cardiovascular disease through healthy diet and cooking programs at the Leishman Center for Culinary Health and through the DASH program to manage high blood pressure. The Leishman Center for Culinary Health offers a variety of natural, whole foods cooking classes designed to help participants make simple changes for a healthier lifestyle. Classes offered in the center include disease specific offerings such as Eat to Beat: Cancer and Eat to Beat: Heart Disease. The philosophy of the Leishman Center is focused around eating real food, which support the mission of the department in tackling chronic illness, disease and obesity. The Leishman Center for Culinary Health reached 868 participants through 93 in house classes and external programs. 4.3: Identify and implement a community education program to increase awareness on sodium and promote sodium reduction in the diet. Increase awareness on the daily consumption of sodium and its impact on high blood pressure, which is a leading risk factor for cardiovascular disease. As part of larger community events, NM participated in seven community opportunities to share information related to sodium consumption, reading a nutrition label to identify sodium on the label, and helpful tips for reducing sodium in the diet. This evidence based information is from the American Heart Association. The development and implementation of the program called Managing your Blood Pressure with the DASH (Dietary Approaches to Stop Hypertension) Diet was also implemented. The DASH program outcomes and metrics were developed during this fiscal year. The class continues to be offered on a quarterly basis. 4.4: Offer the American Heart Association CPR program. This American Heart Association course was designed for anyone who wants to learn basic CPR. Participants learn how to perform CPR on adults, children, and infants and how to help an adult, child, or infant who is choking. These classes were offered five times with 59 participants in attendance. 4.5: Provide resources and tools to patients diagnosed with heart failure to improve self-management skills and quality of life. Kishwaukee Hospital's Community Based Heart Failure Program started seeing patients in November 2018. In FY2020, 65 patients were enrolled with 98% compliance with system tracker, 100% of patients able to identify action needed for worsening of symptoms, 91% of patients able to identify two cardiac medications, 98% of patients using a medication system, 100% of patients receiving a home visit within 7 days of hospital discharge and 77% of patients followed-up with their physician within 7 days. Priority 5: Maternal Child Health According to the Centers for Disease Control and Prevention, safe motherhood begins before conception with good nutrition and a healthy lifestyle. It continues with appropriate prenatal care with the ideal result being a full-term pregnancy without unnecessary interventions and the delivery of a healthy baby. In addition, it includes a healthy postpartum period in a positive environment that supports the physical and emotional needs of the mother, baby and family. The number of births in DeKalb County for 2016 was 1,093. Notably, there has been a decrease in births over the past three years within DeKalb County. The overall teen birth rate in DeKalb County per 1,000 population is 15.7 5.1: To assess capacity to provide referral systems for smoking cessation among pregnant women and Offer Courage to Quit smoking cessation program. NM community wellness continued to offer ongoing sessions of the Respiratory Health Association's Courage to Quit smoking cessation programs to women who are receiving services at the DeKalb County Health Department. 5.2: Support messaging related to The Basics of DeKalb County. Staff met with the Basics Coordinator, hired by DeKalb County to lead this initiative. The hospital will stay committed to supporting the mission of The Basics DeKalb County. The health department received funding from NM community benefit dollars to support messaging and the creation of a space dedicated to the work of The Basics within the health department waiting area. 5.3: Update childbirth education classes to include messaging on domestic violence and resources available for referral. Programmatic slides were updated to include information related to domestic violence resources available in DeKalb County. 5.4: Investigate opportunities to increase referrals to the Breastfeeding Center to WIC clients at the DeKalb County Health Department In FY20, there were a total of 10 prenatal lactation consults. Of those consults, 4 were WIC clients who had received a referral. A total of 354 initial lactation consults (1st visit to the center) and 520 follow-up lactation consults were held, for a total of 874 one-on-one consults. Of these 874 consults, approximately 8% were WIC clients. 1,021 calls were received on the warm line. Of those, approximately 40% were WIC clients. Transportation challenges have always contributed to a higher propensity of call vs. in person visits. 3 walk-in consults - these are consults who most often come to the center without a scheduled appointment directly after being seen by the Pediatrician. When there is availability to see walk-in patients in the center, the patient is marked as a "walk-in." 90% of walk-in clients were WIC clients. 5.5: Investigate the feasibility of offering a childbirth education class in Spanish. Continue to investigate the feasibility of offering childbirth education in Spanish. Online computer system does offer a program in Spanish. Need to assess need with additional input from the health department and women being seen through their Women, Infant and Children clinic.
Schedule H, Part V, Section B, Line 11 Facility , 4 Facility , 4 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. The CHNA report identified areas of opportunity for health improvement for which NMVW and its external committee determined it would not prepare an implementation plan and strategy. Identified areas and the reason for not addressing are listed below: NON-PRIORITY: Access to Health Services. Access to health services ranked as a concern that will be addressed within the health priorities selected through the MAPP process. NON-PRIORITY: Environmental Health. There are programs and initiative available through other organizations within DeKalb County to address Environmental Health. NON-PRIORITY: Health Communication/HIT. NMVW utilizes tools such as the Electronic Medical Record as a way to continue to assist patients and community members with Health Information Technology. NON-PRIORITY: Infectious Disease/STI . There are programs and initiatives available through other organizations within DeKalb County to address infectious disease and STIs. NON-PRIORITY: Injury and Violence. There are programs and initiatives available through other organizations within DeKalb County to address injury and violence. NON-PRIORITY: Social Determinants of Health. Social Determinants of Health ranked as a concern that will be addressed within the health priorities selected through the MAPP process.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: "insured sliding fee scale assistance" and "insured catastrophic assistance." If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services.
Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. THE CHNA REPORT ALSO DESCRIBES MARIANJOY REHABILITATION HOSPITAL BACKGROUND, CHARITY CARE, THE MISSION, CHNA GOALS AND OBJECTIVES, PUBLIC DISSEMINATION PLAN, AND DEVELOPMENT OF THE IMPLEMENTATION PLAN.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THE CHNA PROCESS. THE LIST OF PARTICIPANTS WAS PROVIDED BY MARIANJOY REHABILITATION HOSPITAL AND INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATION WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 41 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY INCLUDING REPRESENTATIVES OF THE ORGANIZATIONS BELOW: 1. DUPAGE FOUNDATION 2. DUPAGE SENIOR CITIZENS COUNCIL 3. DUPAGE UNITED 4. EDUCARE WEST DUPAGE 5. FOX VALLEY SPECIAL RECREATION ASSOCIATION 6. NAMI DUPAGE 7. NORTHERN ILLINOIS FOOD BANK 8. PEOPLE'S RESOURCE CENTER 9. SAMARACARE 10. SENIOR SERVICES ASSOCIATES, INC. 11. WARRENVILLE PARK DISTRICT 12. WESTERN DUPAGE SPECIAL RECREATION ASSOCIATION 13. WEST CHICAGO PUBLIC LIBRARY DISTRICT 14. WINFIELD PARK DISTRICT THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. IN THE ONLINE SURVEY, KEY INFORMANTS WERE ASKED TO RATE THE DEGREE TO WHICH VARIOUS HEALTH ISSUES ARE A PROBLEM IN THEIR OWN COMMUNITY. FOLLOW-UP QUESTIONS ASKED THEM TO DESCRIBE WHY THEY IDENTIFIED PROBLEM AREAS AS SUCH AND HOW THESE MIGHT BE BETTER ADDRESSED. FINDING REPRESENT QUALITATIVE RATHER THAN QUANTITATIVE DATA. THE ONLINE KEY INFORMANT SURVEY WAS DESIGNED TO GATHER INPUT FORM PARTICIPANTS REGARDING THEIR OPINIONS AND PERCEPTIONS OF THE HEALTH OF THE RESIDENTS IN THE AREA. THEREFORE, THESE FINDINGS ARE BASED ON PERCEPTIONS, NOT FACTS.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. IN ADDITION TO PROVIDING THE CHNA REPORT ON THE WEBSITE AND MAKING IT AVAILABLE TO THE PUBLIC UPON REQUEST, THE CHNA REPORT WAS ALSO DISTRIBUTED TO THE FOLLOWING: 1. KEY COMMUNITY ORGANIZATIONS & LEADERS 2. MARIANJOY REHABILITATION HOSPITAL INTERNAL & EXTERNAL STEERING COMMITTEE MEMBERS 3. MARIANJOY REHABILITATION HOSPITAL LEADERSHIP
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. Through the prioritization process, Marianjoy Rehabilitation Hospital (MRH) identified four priority health needs: 1. Access to healthcare services 2. Chronic disease management and rehabilitation 3. Promoting Independence in Individuals with Disabilities 4. Injury Prevention MRH identified priority health needs that would be best addressed through a coordinated response from a range of healthcare and community resources. Specific ways in which MRH is addressing the significant needs identified in its most recently conducted CHNA are below. Priority Need 1: Access to healthcare services MRH ensures that residents of our community have access to high quality medically necessary healthcare services in the most appropriate setting. Dedicated to the delivery of physical medicine and rehabilitation, MRH offers specialty programs for adult and pediatric patients recovering from injury or illness in both the inpatient and outpatient settings. MRH is committed to developing and maintaining programs that address the affordability of and accessibility to healthcare services. Additionally, MRH offers a comprehensive financial assistance program to patients who are unable to afford the cost of necessary medical care. MRH seeks to engage and maintain a multicultural workforce of primary care providers, specialists, midlevel practitioners, registered professional nurses and other specialties committed to working in an evidence-based practice setting by providing a clinical site for educational experiences. The development and implementation of the DuPage County Access to Health Services Action Plan is led by the DuPage Health Coalition. Formerly known as Access DuPage, the Coalition is a collaborative effort by thousands of individuals and hundreds of organizations in DuPage County to provide access to medical services to the county's low-income, medically uninsured residents. The DuPage Health Coalition also operates the Silver Access Program, which provides financial help to lower income families purchasing Health Insurance through the Affordable Care Act's Healthcare Marketplace. In early 2017, the DuPage Health Coalition will open the DuPage Dispensary of Hope, a new free pharmacy program in Wheaton, offered in partnership with DuPage County. MRH leadership and staff work collaboratively with the DuPage Coalition to promote affordable access to care for all residents of DuPage County. MRH will continue to support national and local efforts to increase access to care by providing leadership, investing resources and working collaboratively with other community organizations throughout the county. In conjunction with DuPage Health Coalition's Access DuPage program and independent medical providers, MRH will support the maintenance of an efficient and effective continuum of care for individuals with disabilities, offering inpatient and outpatient rehabilitation services to those in need. 1.1: MRH will offer financial assistance policies that are easily accessible, user-friendly, respectful, and meet all regulatory requirements. Marianjoy integrated the promotion and availability of the financial assistance program within registration, billing and all patient financial interactions. 1.2: MRH will continue to provide medically necessary inpatient and outpatient hospital services to uninsured and underinsured patients in accordance with the hospital's financial assistance policies. MRH tracked the number of individuals and the amount of rendered financial assistance annually. In FY20, 133 patients/services provided, in the amount of $919,063 of community care provided. 1.3: MRH will continue to address the needs of individuals identified as potentially eligible for public health insurance by facilitating their application for government-sponsored healthcare coverage via a trained in-person staff who will assist in facilitating enrollment. In FY20, MRH maintained 99% approval rate of applications submitted. 1.4: MRH leadership will continue representation on various task forces and work groups related to the collaborative work occurring on access to care issues. In FY20, MRH continued coordination of monetary support of Access DuPage services. 1.5: MRH will provide low-cost transportation to outpatient appointments. In FY20, MRH provided 8,834 rides through MRH transport services. 1.6: MRH will continue to provide free inpatient and outpatient care to all Access DuPage clients in accordance with presumptive eligibility and existing MRH financial assistance policies. Opportunities to promote coordinated care to needed services for Access DuPage will be evaluated. In FY20, 133 patients/services provided, in the amount of $919,063 of community care provided. 1.7: MRH will serve as a training center for physicians, nursing and other allied health professions. Quantitative data, such as the number and types of internships and staff time commitment, was tracked throughout FY20 and maintained 100% approval rate of applications submitted. 1.8: MRH will provide trained professional healthcare interpreters and offer language assistance programs. In FY20, MRH provided a total of $491,726 in interpreter services for MRH patients, including $414,384 on phone interpretation and the remainder on in-person interpretation. Priority Need 2: Chronic disease management and rehabilitation In general, individuals with disabilities tend to experience higher percentages of health disparities than the larger population. These added challenges can result in further impaired mobility, nutritional deficits and an increased susceptibility to chronic medical conditions. Common precursors of chronic diseases, including physical inactivity, obesity, hypertension and high cholesterol, are more prevalent among persons with disabilities than those without. Despite increased health risks, people with disabilities are rarely targeted by specific health-promotion and disease-prevention efforts. Given the increasing prevalence of disability as the population ages, the need for community health services focusing on the rehabilitation needs of those served will likely increase at a proportional rate. A broad range of intervention exists to address the issue of chronic disease including health education, health screenings, supporting linkages to medical homes, and chronic disease management programs. MRH utilizes a collaborative, evidence-based approach to prevention, screening and chronic disease management aimed at reducing and eliminating many of the prominent contributors to mortality in the United States. Programs such as Access DuPage and Engage DuPage ensure access to routine healthcare, screening, primary care providers, specialists, medications and medical homes. MRH offers a comprehensive financial assistance program to individuals unable to afford the cost of their acute medical care. In addition, the hospital offers a comprehensive array of community education programing and services to support both primary and tertiary interventions. 2.1: MRH will offer evidence-based community health and wellness programming in the areas of chronic disease management and rehabilitation, overcoming the limitations of chronic disabilities. In FY20, MRH staff developed curriculum for the four courses listed below. However, the curriculum was either shortened or not initiated due to Covid-19. 1. Pediatric Oncology 2. Relaxation and Meditation 3. Balance and Fall Risks 4. Behavioral Coaching 2.2: MRH will provide access to the Emerging Fitness Center, including specialty group classes for individuals with specific exercise needs. In FY20, 2,300 sessions were held in the MRH Fitness Center for individuals with disabilities. Many of the participants were prior MRH patients or family members. 2.3: MRH will offer evidence-based support programs in the areas of chronic disease management. Programmatic venues include, but are not limited to, self-help and support groups. In FY20, MRH provided the following support groups (due to Covid-19, total sessions for the year were reduced or cancelled): 1. Amputee (4 sessions; 34 participants) 2. Parkinson's (2 sessions; 14 participants) 3. Caregiver Support (9 sessions; 27 participants) 4. Stroke (3 sessions; 24 participants) 5. ALS (0 sessions; 0 participants) 6. Aphasia (0 sessions; 0 participants) 7. Connections-Peds (3 sessions; 42 participants) 8. High Hopes- BI (2 sessions; 40 participants) 9. Lives in Motion- SCI (5 sessions; 80 participants) 10. MS (3 sessions; 42 participants)
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - MARIANJOY REHABILITATION HOSPITAL. Priority Need 3: Promoting Independence in Individuals with Disabilities The physicians and clinicians at MRH are trained in the provision of specialty treatments and rehabilitation for individuals with disabilities resulting from injuries, accidents, illnesses, or congenital defects. Fitness and wellness programs tailored to people with disabilities and other health issues help ensure these vulnerable populations are engaged in moderate physical activity designed to improve strength and increase flexibility, to protect against further disability and enhance functional independence. The addition of the Marianjoy Fitness Center has opened new opportunities for individuals who may not have felt physically able or comfortable in other exercise settings. Throughout the year, MRH offers a variety of free and public classes and lectures (focused on health and wellness) to support and promote the independence of disabled individuals. Additionally, MRH sponsors a variety of support groups at no cost and open to the public including: amputation, aphasia, brain injury, chronic pain, and stroke. MRH works closely with its community partners to promote independence of disabled individuals. Partners include, but are not limited to the DuPage County Health Department, DuPage Federation on Human Service Reform, local school districts, Office of the Secretary of State, and DuPage Workforce Board. 3.1: MRH will provide aquatic programs in a group class setting for adults and children. In FY20, MRH provided 88 patient sessions. Individual goals were established, and PHI documented towards goal attainment. Aquatic therapy ceased for community groups in March 2020 due to Covid-19. 3.2 MRH will provide services through the Tellabs Center for Neurorehabilitation and Neuroplasticity, an innovative rehab technology designed to support a wide range of patient conditions which benefit from the creation of lasting neuro-pathway changes derived through repetition. In FY20, MRH provided 3,044 scheduled visits using the mobility and upper extremity robotic equipment available in the TCNN. In addition, patients were assessed by therapy experts and individual goals were established. 3.3: The Marianjoy Driver Rehabilitation Program will work with clients utilizing specialized equipment to promote the ability to drive for individuals with disabilities. Participants are provided with a comprehensive appraisal of a person's ability to drive safely. The Driver Rehabilitation Program also provides behind-the-wheel training for students that qualify, and will assist in obtaining the requirements for a driver's license. In FY20, MRH evaluated and/or provided drivers training to 121 students. In addition, a self-reported tracking process was implemented. 3.4: MRH will provide the GoBabyGo program, where therapists and engineers collaborate to retrofit powered toy vehicles to meet the needs of children with disabilities. In FY20, the annual event was postponed due to Covid-19. The program continues to identify community needs for future planning around serving the population to meet these needs. 3.5: MRH will offer evidence-based community health and wellness programming in the areas of chronic disease management and rehabilitation, overcoming the limitations of chronic disabilities, including but not limited to the following topic: Life after an amputation. In FY20, MRH staff developed curriculum for the four courses listed below. However, the curriculum was either shortened or not initiated due to Covid-19. 1. Pediatric Oncology 2. Relaxation and Meditation 3. Balance and fall risks 4. Behavioral Coaching 3.6: MRH will offer evidence-based support programs in the areas of promoting independence in programmatic venues including but not limited to self-help and support groups. In FY20, MRH provided the following support groups (due to Covid-19, total sessions for the year were reduced or cancelled): 1. Amputee (4 sessions; 34 participants) 2. Parkinson's (2 sessions; 14 participants) 3. Caregiver Support (9 sessions; 27 participants) 4. Stroke (3 sessions; 24 participants) 5. ALS (0 sessions; 0 participants) 6. Aphasia (0 sessions; 0 participants) 7. Connections-Peds (3 sessions; 42 participants) 8. High Hopes- BI (2 sessions; 40 participants) 9. Lives in Motion- SCI (5 sessions; 80 participants) 10. MS (3 sessions; 42 participants) Priority Need 4: Injury Prevention MRH offers a variety of programs, both through inpatient and outpatient services, to address injury prevention. Evidence-based, community health and wellness programming are offered by MRH in the areas of chronic disease management and rehabilitation and overcoming the limitations of chronic disabilities. Topics include: Core Yoga to increase strength and balance in individuals with disabilities; Understanding, identifying and preventing running injuries; and how aging affects your balance. These programs address the prevention of injury for both persons with or without disabilities. MRH offers the Police Interaction Course for Drivers with Special Needs program, focusing on enhancing communication between autistic individuals and first responders. MRH works closely with its community partners to address the issue of injury prevention. Partners include, but are not limited to the DuPage County Health Department, Northwestern Memorial Central DuPage Hospital and local school districts. 4.1: MRH will offer evidence-based community health and wellness programming in the areas of chronic disease management and rehabilitation, overcoming the limitations of chronic disabilities. In FY20, MRH developed three courses, but only one was partially implemented due to Covid-19: 1. Yoga (6 five-week sessions were held; 52 participants) 2. Aging and Balance (0 courses; 0 participants) 3. Therapeutic Golf Program (0 adult sessions; 0 participants) 4.2: MRH will offer the Police Interaction Course for Drivers with Special Needs program. Sessions will provide autistic individuals with the skills to respond calmly and communicate effectively during a traffic stop. In FY20, the program was not offered due to multiple changes within the Sheriff's Department and the Covid-19 pandemic. 4.3: MRH will collaborate with Central DuPage Hospital (NMCDH) to offer evidence-based community-based injury prevention programming. In FY20, programs were marketed in the NMCDH shared brochure for the first quarter; however, due to Covid-19, courses were cancelled. Needs that are not being addressed together with the reasons why: The CHNA report identified areas of opportunity for health improvement for which Marianjoy Rehabilitation Hospital and the external steering committee determined it would not prepare an implementation plan and strategy. These areas of opportunity and the reasons for not addressing are below. Mental health and substance abuse: The DuPage behavioral health collaborative was formed in response to the mental health findings and needs noted in the DuPage county IPLAN. The mission of the group is to work collaboratively to identify and implement data-driven strategies that improve access and quality of behavioral health services for all DuPage county residents, advocate for aligning resources and funding, and to educate the community about the signs and symptoms of mental health issues. The collaborative is composed of two teams: the treatment leadership team (behavioral health) and the prevention leadership team (substance abuse). Northwestern Medicine Central DuPage Hospital (NMCDH) leadership and staff serve as integral members of both teams working both independently and collaboratively to address mental health and substance abuse issues in DuPage County. Both teams are comprised of members from local hospitals, public health, private and community sectors and represent a broad cross-section of the community united to respond to both issues. Additionally, the DuPage county health department crisis intervention unit is a mental health support system that deals with mental health emergencies on a 24-hour basis. This unit deals with urgent mental health issues that require immediate attention such as suicidal thoughts, homicidal threats, and symptoms of serious mental illness including depression, schizophrenia, bipolar disorder, anxiety and other issues that may require hospitalization. Individuals can contact the unit at any time and set up an appointment either by phone or in person. The crisis program also has a ten-bed respite unit available for short term stabilization. Psychiatric evaluations and short-term crisis counseling intervention are also available on a scheduled basis as needed.
Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - MARIANJOY REHABILITATION HOSPITAL. In the area of inpatient care, NMCDH offers immediate help, providing short-term psychiatric care for adults and teens (13 years of age and older) in a hospital setting. Short term inpatient care is provided in three secure hospital psychiatric units to help people who pose a risk to themselves or others and those who are unable to care for themselves. Following stabilization, NMCDH offers a full range of treatment including outpatient partial hospitalization, individual and family therapy, group therapy and follow-up services in the community. NMCDH also offers a full range of substance abuse services including inpatient detoxification, residential treatment and rehabilitation services, along with continued counseling to support long-term recovery. Immunization and infectious disease: The DuPage County Health Department is responsible for monitoring the incidence of infectious diseases and providing childhood and adult immunizations. Immunization services are offered at the CPHC (Wheaton), SEPHC (Westmont), and EPHC (Lombard) offices. Childhood immunizations are available for all children who do not have insurance, or have insurance that does not cover immunizations, through the state of Illinois' Vaccines for Children (VFC) program. Additionally, immunizations and selected testing are also offered by the county's Federally Qualified Health Centers (FQHC), thereby assuring multiple opportunities for residents to receive screening and immunizations. Access to health promotion activities: MRH works collaboratively to support the provision of health promotion and health education sessions to clients residing in the community. It is widely recognized that the most effective way to address chronic disease is to address the problem across its lifespan in a coordinated effort. Health education programs are offered by NMCDH and MRH in an effort to focus on health promotion and disease prevention. Local primary care providers and FQHCs provide medical homes and routine care aimed at screening, early detection and prompt treatment of disease and other health concerns. Local hospitals provide immediate and emergently needed acute care. Programs such as access DuPage and engage DuPage ensure access to routine healthcare, screening, primary care providers, specialists, medications and medical homes. Nutrition, physical activity and weight: The problems related to poor nutrition, inadequate physical activity and overweight/obesity are included within the broader category of chronic disease within our Implementation Plan. These factors are considered key root causes of chronic disease and were included in the causal analysis and response. Guided by the ESC, MRH will continue to support and work collaboratively with existing local organizations who are providing affordable primary healthcare to individuals experiencing the remaining healthcare issues noted above as we believe they are best positioned to lead the provision of these services.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Marianjoy Rehabilitation Hospital. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: "insured sliding fee scale assistance" and "insured catastrophic assistance." If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services.
Schedule H, Part V, Section B, Line 2 On September 1, 2018, NMHC became the sole member of Centegra Health System and its subsidiaries. The health system is comprised of Centegra Health System, Northern Illinois Medical Center, Memorial Medical Center, Health Bridge Corporation, NIMED Corporation, and Centegra Health System Foundation. The Illinois Health Facilities and Services Review Board unanimously approved the application for Centegra to join NMHC in June 2018.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. The CHNA report also describes NIMC's CHNA goals, objectives, public dissemination plan, and development of the implementation plan.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. NIMC commissioned Northern Illinois University Center for Governmental Studies to conduct a comprehensive CHNA. The CHNA framework consisted of a systematic, data-driven approach to determine the health status, behaviors and healthcare needs of residents in McHenry County. The assessment provided information to enable NIMC hospital leadership and key community stakeholders to identify health issues of greatest concern among all residents and decide how best to commit the hospitals' resources to those areas, thereby achieving the greatest possible impact on the community's health status. The CHNA incorporated data from both quantitative and qualitative sources and was conducted from September 2019 through April 2020. Prevalent needs were identified across all socioeconomic groups, races, ethnicities, ages and genders. The assessment highlighted health and socioeconomic disparities and needs that disproportionately impact the medically underserved and uninsured. A key component of any comprehensive assessment involves reaching out to members of the community and organizations that interact with them in an effort to better understand the needs and issues that affect the health of its citizens. NMMH, NMHH and NMWH gratefully acknowledges the participation of our community partners and key stakeholders for their input on perceived needs and priorities within the communities we serve. These individuals and organizations work closely with members of our community, including those most in need and those with marginalized access to healthcare services. In all, 76 stakeholders took part in the online key informant survey. Organizations marked with an asterisk denote programs that work with the poor, vulnerable and marginalized in McHenry County. Below is a list of the organizations asked to participate in the online key informant survey. 1. Advocate Aurora Health* 2. American Cancer Society 3. AMITA Health* 4. Association for Individual Development* 5. Cary Police Department 6. Cary School District 26* 7. Clearbrook* 8. Crystal Lake Food Pantry* 9. Epilepsy Foundation of North Central Illinois* 10. Family Health Partnership Clinic* 11. Fox River Fire District 12. Fox River Grove School District 3* 13. Harvard Area Community Health Center* 14. Harvard Community School District 50* 15. Harvard Senior Center* 16. Home of the Sparrow* 17. Huntley Community School District 158* 18. In Sync Systems, Inc. 19. Independence Health & Therapy* 20. Johnsburg School District 12* 21. League of United Latin American Citizens* 22. McHenry County Department of Health* 23. McHenry County Dental Society 24. McHenry County Government 25. McHenry County Housing Authority* 26. McHenry County Mental Health Board* 27. McHenry County Office of Special Projects 28. McHenry County Planning & Development 29. McHenry County School District 15* 30. McHenry County School District 154* 31. McHenry County School District 156* 32. McHenry County Sheriff 33. McHenry County Substance Abuse Coalition* 34. Northern Illinois Special Recreation Association* 35. Northwest Center Against Sexual Assault* 36. Northwestern Medicine McHenry Hospital* 37. Northwestern Medicine Huntley Hospital* 38. Northwestern Medicine Woodstock Hospital* 39. Options and Advocacy* 40. PFLAG* 41. Pioneer Center for Human Services* 42. Prairie Grove School District 46* 43. Riley School District 18* 44. Rosecrance* 45. Sage YMCA* 46. Salvation Army Extension Unit* 47. Senior Care Volunteer Network* 48. Senior Services, Inc.* 49. The Mathers Clinic 50. Turning Point* 51. United Way of Greater McHenry County* 52. Village of Bull Valley 53. Village of Lake in the Hills 54. Village of Port Barrington 55. Village of Spring Grove 56. Volunteer Center of McHenry County* Through this process, input was gathered from several individuals whose organizations work with low-income, minority, or other medically underserved populations. In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such and how these might better be addressed.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. The CHNA was conducted with Advocate Aurora Health.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. The CHNA was conducted with McHenry County Department of Health and McHenry County Mental Health Board.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also shared with the following: 1. Key community organizations 2. Northwestern Medicine Leadership
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. Through a systematic, data-driven approach, NIMC (NMMH, NMHH, and NMWH) has prioritized the below identified Significant Health Needs to address in accordance with IRS regulations. These needs will be referred to as the Priority Health Needs throughout the remainder of the document. NIMC worked collaboratively to develop strategies and identify resources and areas for collaboration, where applicable, to impact each priority health need. 1. Access to Health Care 2. Chronic Disease (including a. cancer, b. diabetes, c. heart disease and stroke, and d. nutrition, physical activity and weight) 3. Mental Health and Substance Abuse Priority 1: Access to Healthcare Services. Access to comprehensive, quality healthcare services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone. It impacts overall physical, social and mental health status; prevention of disease and disability; detection and treatment of health conditions; quality of life; preventable death; and life expectancy. Improving healthcare services includes increasing access to and use of evidence-based preventive services. Clinical preventive services are services that prevent illness by detecting early warning signs or symptoms before they develop into a disease (primary prevention) or detect a disease at an earlier, and often more treatable, stage (secondary prevention). 1.1: Improve access to comprehensive, quality healthcare services. NMMH, NMHH and NMWH will continue to address the needs of individuals identified as potentially eligible for public health insurance by facilitating their application for government-sponsored healthcare coverage. 1. Financial services assists patients in applying for government-sponsored healthcare coverage. 2. Leadership will continue representation on various task forces and workgroups related to the collaborative work occurring on access-to-care issues. 3. Staff will continue to create or participate in programs and initiatives focused on Safety Net objectives to promote access to care. 4. Provide office space and support to the Senior Health Insurance Program (SHIP); The SHIP program will provide seniors Medicare counseling and support to facilitate their use of the healthcare system. 5. During the timeframe of 9/1/2019 to 3/31/20, 500 Medicare beneficiaries received information on insurance options and assistance with enrollment, with 80 individuals receiving assistance with enrollment into various programs. NM provide space for two individuals to meet community members to educate and enroll. 1.2: NM Leadership participates in meetings focused on addressing access to care issues for patients that need assistance. Most patients are referred from Aunt Martha's FQHC and/or The Family Health Partnership Clinic. 1. Provide operational grants to Aunt Martha's and Family Health Partnership Clinic in support of care coordination for patients without insurance. Provision of an operational grant to Aunt Martha's and Family Health Partnership Clinic enable low-income McHenry County residents to afford and receive needed care. 2. Provide low-cost or no-cost inpatient and outpatient care to clients from Aunt Martha's and/or Family Health Partnership Clinic in accordance with presumptive eligibility and existing NM financial assistance policies. Access to free inpatient and outpatient care will enable presumptively eligible, low-income residents to receive needed services in a timely, coordinated and efficient manner. 3. Aunt Martha's received in kind space with a fair market value of $215,597.38 and the Family Health Partnership Clinic received an in-kind cash donation to support programs services in the amount of $30,000. 1.3 Offer financial assistance policies that are accessible, user-friendly and meet regulatory requirements. 1. Conduct internal audits of policies, procedures, materials and signage/web pages. 2. Provide services in accordance with FA policies. Priority 2a: Chronic Disease (Cancer). Continued advances in cancer research, detection and treatment have resulted in a decline in both incidence and death rates for all cancers. More than half of those that develop cancer will be alive in five years. Yet cancer remains a leading cause of death in the United States, second only to heart disease. In McHenry County, cancer is a leading and rising cause of death. Many cancers are preventable by reducing risk factors such as use of tobacco products, physical inactivity and poor nutrition, obesity, and ultraviolet light exposure. Other cancers can be prevented by getting vaccinated against human papillomavirus (HPV) and hepatitis B virus. In the past decade, overweight and obesity have emerged as new risk factors for developing certain cancers, including colorectal, breast, uterine corpus (endometrial) and kidney cancers. The impact of weight trends on cancer incidence will not be known for decades. Continued focus on preventing weight gain will lead to lower rates of cancer and many chronic diseases. Priority 2b: Chronic Disease (Diabetes). The rate of diabetes mellitus continues to increase throughout the world. Due to the steady rise in the number of persons with diabetes mellitus, and possibly earlier onset of Type 2 diabetes mellitus, there is growing concern that this increase might overwhelm existing healthcare systems. Diabetes is a top 10 leading cause of death, and prevalence of the condition has risen over the past decade in McHenry County. Priority 2c: Chronic Disease (Cardiovascular Disease) Heart disease is the leading cause of death in the United States, with stroke following as the third leading cause. Together, heart disease and stroke are among the most widespread and costly health problems facing the nation today, accounting for more than $500 billion in healthcare expenditures and related expenses in 2010 alone. Fortunately, they are also among the most preventable. The risk of Americans developing and dying from cardiovascular disease would be substantially reduced if major improvements were made across the U.S. population in diet and physical activity, control of high blood pressure and cholesterol, smoking cessation and appropriate aspirin use. The burden of cardiovascular disease is disproportionately distributed across the population. Significant disparities exist based on gender, age, race/ethnicity, geographic area and socioeconomic status. Priority 2d: Chronic Disease (Nutrition, Physical Activity and Weight) Strong science exists supporting the health benefits of eating a healthful diet and maintaining a healthy body weight. Efforts to change diet and weight should address individual behaviors, as well as the policies and environments that support these behaviors in settings such as schools, worksites, healthcare organizations, and communities. The goal of promoting healthful diets and healthy weight encompasses increasing household food security and eliminating hunger. Regular physical activity can improve the health and quality of life of Americans of all ages, regardless of the presence of a chronic disease or disability. Personal, social, economic, and environmental factors all play a role in physical activity levels among youth, adults, and older adults. Understanding the barriers to and facilitators of physical activity is important to ensure the effectiveness of interventions and other actions to improve levels of physical activity. 2.1: Strive to improve cardiovascular health and quality of life through prevention, detection and treatment of risk factors for heart attack and stroke. 2.2: Offer early identification and treatment of heart attacks and stroke, through heart age screenings and blood pressure screenings. 1. In partnership with staff from McHenry County Department of Health, NM cardiovascular staff and RNs participated and provided 10 cardiovascular screenings during the reporting time. Monthly events were held for blood pressure, which provided free screenings to 415 individuals in the community. 2.3: Offer education and prevention of repeat cardiovascular events, through education on lifestyle and other measures to prevent heart disease. 2.4: Reduction in deaths from cardiovascular disease education in the community. A series of programs were offered on nutrition and cardiovascular health reaching 722 residents provided by nurses and dietitians for a total of 117 hours. Staff provided 290 hours to educate 1,381 people on CPR education and training.
Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - NORTHERN ILLINOIS MEDICAL CENTER. 2.5: Reduce the disease burden of diabetes mellitus (DM) and improve the quality of life for all persons who are at risk for DM, through blood glucose screenings in the community. 1. Staff provided 11 events to screen the senior population at risk for DM and reached 191 participants; 2. Staff provided 5 screening events in partnership with Northern Illinois Food Pantry locations in which 60 individuals received glucose screening. 2.6: Offer evidence-based community health and wellness programming in skin cancer education and prevention. 1. Due to the pandemic, skin cancer screening, education, and prevention activities were not held in TY2019. 2. In lieu of in-person screenings, information on sun safety was included in the Summer Program Guide with a distribution to 45,000 households in McHenry County 2.7: Offer evidence-based community health and wellness programming for cardiovascular disease, peripheral vascular disease, and diabetes with the goal of increasing participant identification of signs/symptoms of the selected topic, as well as prevention and management strategies. Participants will rate their perceived level of knowledge before and after the program. 1. Staff provided two events to the community, focused on wellness and nutrition with 49 individuals participating and 6 hours of staff time devoted to presentations. 2. 193 individuals received nutrition education through cardiopulmonary rehabilitation, which was a voluntary opportunity for these individuals. 52 staff hours were devoted to providing this education. 2.8: Offer the nationally recognized ThinkFirst Injury Prevention Program. Staff will provide the community with an evidence-based program focusing on bike/helmet safety, child safety classes and car seat safety. 1. During the time period, there were five Bike Safety education and helmet fitting events with 756 participants. Additionally, there was one car seat safety event with 7 participants. 2.9: Support opportunities to promote physical activity in McHenry County, including increased access to physical activity options in school-aged children and encouragement of physical activity to prevent childhood and adult obesity. 1. There were several events held locally that encouraged participation in activities to promote physical activity, such as walks, runs, and gym memberships. 2. Staff provided 20 hours of in-kind support to Girls on the Run, which served 1,450 people and encouraged running to maintain an active lifestyle. 2.10: Foster collaborations among McHenry County Department of Health, Family Health Partnership Clinic and area Farmers Market vendors. Individuals in these agencies will be screened for food insecurity and when positively identified will receive vouchers to purchase fresh fruits and vegetables at area Farmers Markets. (Program goals include increased access to fresh fruits and vegetables for individuals screened positive for food insecurity and encouragement to choose healthy food options to reduce obesity among McHenry County adults.) 1. Funding will support redemption costs for vouchers used at area Farmers Markets. 2. As a result of this program, individuals who screened positive for food insecurity have increased access to fresh fruits and vegetables. The Farmer's Market Coupon Program served 100 people through 40 staff hours. 2.11: Support opportunities to promote physical activity kits to area schools and park districts to promote physical activity for youth, including increased access to physical activity options in school-aged children and funding to support supplying physical activity kits to area schools. 1. Funding will support supplying physical activity kits to area schools through NIMC community partner, McHenry County Department of Health. Priority 3: Mental Health/Substance Abuse Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with challenges. Mental health is essential to personal well-being, family and interpersonal relationships, and the ability to contribute to community or society. Mental health and physical health are closely connected. Mental health plays a major role in people's ability to maintain good physical health. Mental illnesses, such as depression and anxiety, affect people's ability to participate in health-promoting behaviors. In turn, problems with physical health, such as chronic diseases, can have a serious impact on mental health and decrease a person's ability to participate in treatment and recovery. In McHenry County in 2019, there were 176.3 mental health providers for every 100,000 population, below state and U.S rates. Substance abuse has a major impact on individuals, families and communities. The effects of substance abuse are cumulative, significantly contributing to costly social, physical, mental and public health problems. Advances in research have led to the development of evidence-based strategies to effectively address substance abuse. Improvements in brain-imaging technologies and the development of medications that assist in treatment have gradually shifted the research community's perspective on substance abuse. There is now a deeper understanding of substance abuse as a disorder that develops in adolescence and, for some individuals, will develop into a chronic illness that will require lifelong monitoring and care. Half of key informants taking part in the online survey characterized Substance Abuse as a "major problem" in the community. 3.1: Increase awareness of existing mental health and substance abuse services in McHenry County. 1. A train-the-trainer program was held for NMHH OB nurses to train patients in the community on Narcan resources. The program provided sensitivity to treatment to OB nurses that may encounter pregnant women who may be affected by a substance abuse disorder. 3.2: Reduce the overall number of suicide deaths in McHenry County. (Provide the PHQ-9 depression screening tool to patients within the primary care setting and increase in the number of support groups and attendees related to suicide and/or survivors of suicide.) 1. The PHQ-9 screening was not utilized during the TY2019 timeframe. 3.3: Increase in the number of support groups and attendees related to suicide and/or survivors of suicide. (Provide community education on Suicide Prevention to the community at-large to reduce the number of opioid-/heroin-related overdose deaths and adverse events.) 1. The Behavioral Health Services team coordinated the Survivors of Suicide Grief Support Group with 30 staff hours serving 630 people. In addition, the same team provided leadership to the Suicide Prevention Task Force, which included 80 hours of in-kind staff support and 20 people served. Significant Health Needs Not Addressed by NIMC (NMMH, NMHH, and NMWH). Through a systematic, data-driven approach, NIMC determined that it will not address the below identified Significant Health Needs over the next three years. Many of these needs are already being addressed through the comprehensive services and Community Benefits operations offered at the three NM NWR hospitals and throughout NMHC. Specific reasons explaining why an identified Significant Health Need will not be prioritized are outlined below. Oral Health: While the need for improved dental health and access to dental health providers exists, NM leadership does not feel that we possess the expertise to address this health concern. Rather, we will work collaboratively with existing community initiatives to promote programming that will expand access to dental care and improve dental health of community residents. Respiratory Disease: Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Specific methods of detection, intervention and treatment exist that may reduce this burden and promote health. The prevalence of respiratory disease in McHenry County residents is lower than in Illinois and the U.S., so we have chosen not to focus on this Significant Health Need.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. IN ADDITION TO THE DOCUMENTED 200% OF FPG, WE ALSO PROVIDE A SLIDING SCALE DISCOUNT OF 80% FOR THOSE WHO HAVE FPG UP TO 350%. IN ADDITION WE HAVE PRESUMPTIVE CHARITY WHICH ALLOWS FOR CHARITY DISCOUNTS/FINANCIAL ASSISTANCE TO THOSE WHO CURRENTLY MEET MEDICAID ELIGIBILITY OR OTHER STATE PROGRAMS BASED ON FPG WHO MAY NOT HAVE HAD INSURANCE COVERAGE AT THE TIME OF THE SERVICE WE PROVIDED.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured or underinsured. Those who do not qualify for free care will receive a sliding scale discount off the gross charges for their medically necessary services based on their family income as a percent of the Federal Poverty Guidelines. These patients are expected to pay their remaining balance for care, and may work with financial counselors to set up a payment plan based on their financial situation. Patients seeking assistance may first be asked to apply for other external programs (such as Medicaid or insurance through the public marketplace) as appropriate before eligibility under this policy is determined. Additionally, any uninsured patients who are believed to have the financial ability to purchase health insurance may be encouraged to do so to help ensure healthcare accessibility and overall well-being. NMHC will not bill patients who have been deemed eligible for financial assistance coverage for eligible care or services, including care or services that are emergent or medically necessary, more than the amounts generally billed to insured patients. Patients who are uninsured or underinsured and have a household income at or below the thresholds per Federal Poverty Guidelines will receive full or partial discount off their balance. The policy is updated on an annual basis to represent the most current federal poverty guideline levels and the appropriate sliding scale for full and partial discounts. To be considered eligible for financial assistance, patients may be required to cooperate with NMHC to explore alternative means of assistance if necessary, including Medicare and Medicaid. Patients will be required to provide necessary information and documentation when applying for hospital financial assistance or other private or public payment programs. NMHC may seek to determine eligibility for financial assistance prior to rendering non-emergent services. In certain non-emergent circumstances it may be necessary to provide care or evaluation to the patient before eligibility can be determined. When determining patients' eligibility, NMHC does not take into account race, gender, age, sexual orientation, religious affiliation, national origin or social or immigrant status. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Presumptive Homelessness; B. Presumptive Mental incapacitation with no one to act on the patient's behalf; C. Presumptive Scoring when NMHC can utilize publically available information as well as internal payment and documentation history to determine if a patient is eligible for presumptive financial assistance without completion of an application. D. Presumptive Deceased with no estate; E. Presumptive State Program: Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services. F. Presumptive Out of State Program for patients who are eligible for out of state programs based on FPG where NMHC does not participate; G. Additional Presumptive Criteria may also be recommended, including the following: 1. Recent Personal Bankruptcy; 2. Incarceration; 3. Affiliation with a religious order which includes a vow of poverty; 4. Enrollment in temporary assistance for needy families (TANF); or 5. Enrollment in IHDA's Rental Housing Support Program. NMHC also partners with third-parties and other eligibility vendors, to help identify patients who may be eligible for financial assistance, presumptive financial assistance under this policy or through other public and private programs including identifying other sources of third party payment, i.e. health insurance coverage. NMHC may also use previous financial assistance eligibility determinations as a basis for determining eligibility in the event that the patient does not provide sufficient documentation to support an eligibility determination. Financial assistance applications on file at NMHC may be used for a time period of up to six months after the date of submission. All patients presumptively determined to be eligible for less than the most generous amount of assistance available under this policy (free care) will be informed about how the discount amount was calculated and given a reasonable amount of time to submit an application for further financial assistance.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?213
Name and address Type of Facility (describe)
1 Lavin
259 E Erie Street
Chicago,IL60611 		MOB
2 Arkes
676 N St Clair
Chicago,IL60611 		Admin & clinical
3 541 Fairbanks
541 N Fairbanks
Chicago,IL60611 		Admin Bldg
4 Ambulatory Svc Pav
25 N Winfield Road
Winfield,IL60190 		MOB
5 211 Ontario
211 E Ontario
Chicago,IL60611 		Admin Bldg
6 Olson
710 N Fairbanks
Chicago,IL60611 		Clinical
7 Grayslake OutPt- BLDG A
1475 E Belvidere Rd
Grayslake,IL60030 		Admin & clinical
8 Patriot Bldg
2701 Patriot Boulevard
Glenview,IL60026 		Admin & clinical
9 Health Bridge Huntley
10450 Algonquin Road
Huntley,IL60142 		Fitness
10 Delnor 351 MOB
351 Delnor Rd
Geneva,IL60134 		MOB
11 Kish Wellness Center
626 Bethany Rd
Dekalb,IL60115 		Fitness
12 Worcester House
244 E Pearson
Chicago,IL60611 		Patient Housing
13 680 Bldg
680 N Lake Shore Drive
Chicago,IL60611 		Admin
14 NLFH Bays 900 N A Wing
900 N Westmoreland
Lake Forest,IL60045 		Admin & clinical
15 Delnor 302 MOB
302 Randall Rd
Geneva,IL60134 		MOB
16 Cantera Offices
27650 Ferry Road
Warrenville,IL60555 		MOB
17 Delnor Health & Wellness Ctr
296 Randall Rd
Geneva,IL60134 		Fitness
18 1475 E Belvidere (MOB)
1475 E Belvidere Rd
Grayslake,IL60030 		Clinical
19 River North MOB
636 Raymond Drive
Naperville,IL60563 		MOB
20 RMG Dekalb Clinic
1850 Gateway Dr
Sycamore,IL60178 		MOB
21 Keystone MOB
4525 Weaver Parkway
Warrenville,IL60555 		Admin Bldg
22 Huntley ACM
10350 Haligus Rd
Huntley,IL60142 		MOB
23 NLFH Westmoreland Bldg
600 N Westmoreland Road
Lake Forest,IL60045 		Clinical
24 1033 University Place
1033 University Place
Evanston,IL60201 		Admin Bldg
25 St Charles MOB
2900 Foxfield Road
St Charles,IL60174 		MOB
26 Danada MOB
7 Blanchard Circle
Wheaton,IL60187 		MOB
27 Behaviorial Health Bldg
27W350 High Lake Rd
Winfield,IL60190 		MOB
28 1880 Oak Avenue
1880 Oak Avenue
Evanston,IL60201 		Admin Bldg
29 Wheaton Med MOB
1800 N Main Street
Wheaton,IL60187 		MOB
30 Marianjoy MOB (leased)
26W 171 Roosevelt Road
Wheaton,IL60187 		MOB
31 Q CenterWoodlands Office Bldg
1405 North 5th Avenue
St Charles,IL60174 		Admin Bldg
32 446448 Ontario Bldg
446 E Ontario
Chicago,IL60611 		MOB
33 Glen Ellyn MOB
885 Roosevelt Road
Glen Ellyn,IL60137 		MOB
34 Aurora MOB
2635 Church Road
Aurora,IL60502 		MOB
35 MOB-B 4309 Medical Center Drive
4309 Medical Center Drive
McHenry,IL60050 		MOB
36 West Belmont
1325-41 West Belmont
Chicago,IL60657 		Clinical
37 Support Svc Building
371 Schmale Road
Carol Stream,IL60188 		Admin Bldg
38 Stratford South MOB
245 S Gary Avenue
Bloomingdale,IL60108 		MOB
39 360 Station Drive
360 Station Drive
Crystal Lake,IL60014 		MOB
40 Grayslake Prof Bldg
1275 E Belvidere Rd
Grayslake,IL60030 		Admin & clinical
41 NLFH McGaw 800 Bldg
800 N Westmoreland
Lake Forest,IL60045 		Admin & clinical
42 Woodstock MOB2 - 3707 Doty Rd
3707 Doty Road
Woodstock,IL60098 		MOB
43 2507 Richmond Road
2507 Richmond Road
McHenry,IL60050 		MOB
44 Mona Kea Medical Park
501/515/517 Thornhill
Carol Stream,IL60188 		MOB
45 SONO Blackhawk
1460 N Halsted
Chicago,IL60642 		Clinical
46 6155 Grand Ave
6155 Grand Avenue
Gurnee,IL60031 		MOB
47 Snyder Building
27W353 Jewell Road
Winfield,IL60190 		Admin Bldg
48 850 N Milwaukee
850 N Milwaukee
Vernon Hills,IL60061 		Clinical
49 Bartlett MOB
820 S Route 59
Bartlett,IL60103 		MOB
50 Delnor Family Residency Bldg
298 S Randall Rd
Geneva,IL60134 		MOB
51 South Loop
150 W Roosevelt/1135 S Delano Ct
Chicago,IL60605 		Clinical
52 Stratford North MOB
231 S Gary Avenue
Bloomingdale,IL60108 		MOB
53 213 Front Street
213 Front Street
McHenry,IL60050 		Admin Bldg
54 350 Waukegan
350 S Waukegan
Deerfield,IL60015 		Clinical
55 Cornerstone MOB
2001 Wiesbrook Road
Wheaton,IL60187 		MOB
56 Fargo MOB
2425 Fargo Blvd
Geneva,IL60134 		MOB
57 Kishwaukee Prof MOB
8 Health Services Dr
DeKalb,IL60115 		MOB
58 Oakbrook Outpatient (MJ)
17W682 Butterfield Rd
Oakbrook Terrace,IL60523 		MOB
59 South Naperville MOB
101 E 75th Street
Naperville,IL60565 		MOB
60 645 N Michigan
645 N Michigan Ave
Chicago,IL60611 		MOB
61 Valley West MOB
1310 N Main St
Sandwich,IL60548 		Hybrid
62 Church Street Plaza
1704 Maple Avenue
Evanston,IL60021 		Clinical
63 Stratford North 215-235 Gary Ave
215-235 Gary Ave
Bloomingdale,IL60108 		MOB
64 CNS Offices
690 North Avenue
Carol Stream,IL60188 		MOB
65 737 N Michigan
737 N Michigan
Chicago,IL60611 		Clinical
66 St Charles Medical Park
XXX-XX-XXXX N 5th Avenue
St Charles,IL60174 		MOB
67 260 E Congress Parkway
260 E Congress Pkwy
Crystal Lake,IL60014 		MOB
68 MSI building
2111 Midlands Court
Sycamore,IL60178 		MOB
69 Delnor Cancer Resource Ctr (Living Well)
442 Williamsburg Ave
Geneva,IL60134 		MOB
70 MOB A 4309 Medical Center Drive
4309 Medical Center Drive
McHenry,IL60050 		MOB
71 Bucktown
1776 N Milwaukee
Chicago,IL60647 		Clinical
72 Abbott Hall
710 N Lake Shore Drive
Chicago,IL60611 		Admin
73 IT Data Center
2200 Bussee Road
Elk Grove Village,IL60007 		Admin Bldg
74 Health Bridge Crystal Lake
200 Congress Parkway
Crystal Lake,IL60014 		Fitness
75 Plank Road Clinic
165 E Plank Rd
Sycamore,IL60178 		MOB
76 Winfield Town Center
50 Winfield Road
Winfield,IL60190 		Admin Bldg
77 20 S Clark St
20 S Clark St
Chicago,IL60603 		MOB
78 Two Transam Plaza
2 Transam Plaza Drive
Oakbrook Terrace,IL60181 		MOB
79 Gary Medical LLC
2001 Gary Avenue
Wheaton,IL60187 		MOB
80 NLFH Gurnee Tower Court
25 Tower Court
Gurnee,IL60031 		Grounds Building
81 Sage Cancer Center
4305 Medical Center Drive
McHenry,IL60050 		MOB
82 NLFH Dearhaven Bldg
1100 N Westmoreland
Lake Forest,IL60045 		Childcare Center
83 27272729 Sycamore
2727/2729 Sycamore Rd
DeKalb,IL60115 		MOB
84 Elburn MOB
905 N First Street
Elburn,IL60119 		MOB
85 329 W 18th St Archive
329 W 18th Street
Chicago,IL60611 		Storage
86 Rochelle Crossings
450 Coronado Dr
Rochelle,IL61068 		Hybrid
87 Healthtrack Offices
875 Roosevelt Road
Glen Ellyn,IL60137 		MOB
88 150 Bldg
150 E Huron
Chicago,IL60611 		MOB
89 Oak Brook Regency Towers
1415 West 22nd Street Ste 750E
Oak Brook,IL60523 		MOB
90 27332737 Sycamore
2731/2733/2737 Sycamore Rd
DeKalb,IL60115 		MOB
91 American Dental Assoc
211 E Chicago Ave
Chicago,IL60611 		Admin
92 South Elgin - Express Care
542-552 Randall Road
South Elgin,IL60177 		MOB
93 14 Health Services Drive
14 Health Services Dr
Sycamore,IL60115 		MOB
94 4201 Medical Center Drive
4201 Medical Center Drive
McHenry,IL60050 		Childcare Center
95 11650 S Route 47
11650 S Route 47
Huntley,IL60142 		MOB
96 Twin Dialysis Building
306 Randall Road
Geneva,IL60134 		MOB
97 Twin MOB
308 Randall Road
Geneva,IL60134 		MOB
98 NLFH East&West 700 Bldg
700 N Westmoreland
Lake Forest,IL60045 		Admin
99 360 Terra Cotta Road
360 Terra Cotta Road
Crystal Lake,IL60012 		MOB
100 Foxpointe
760 Foxpointe Dr
Sycamore,IL60178 		MOB
101 111 W Washington
111 W Washington
Chicago,IL60602 		MOB
102 25 North Third Street
25 North Third Street
Geneva,IL60134 		MOB
103 Port Clinton Square
600 Central Ave
Highland Park,IL60035 		Clinical
104 BHS Community Support
631 S First St
DeKalb,IL60115 		MOB
105 650 Dakota Street
650 Dakota Street
Crystal Lake,IL60012 		MOB
106 2127 Midland Court
2127 Midland Court
Sycamore,IL60178 		MOB
107 Elgin MOB
1600 Randall Road
Elgin,IL60123 		MOB
108 West Loop ICC
171 N Aberdeen
Chicago,IL60607 		Clinical
109 625 N Michigan
625 N Michigan Avenue Suite 1150
Chicago,IL60611 		Office
110 St Charles Executive Ctr
2570 Foxfield Dr
St Charles,IL60174 		MOB
111 385 Wirtz Drive
385 Wirtz Drive
Dekalb,IL60115 		MOB
112 Lisle MOB (CDPG)
1019 School Street
Lisle,IL60532 		MOB
113 Genoa
599 Pearson Dr
Genoa,IL60135 		MOB
114 635 N Dearborn
635 N Dearborn
Chicago,IL60654 		Clinical
115 527 South Street
527 South Street
Woodstock,IL60098 		MOB
116 KHS Office Annex
2475 Bethany Rd
Sycamore,IL60178 		Admin Bldg
117 Sugar Grove Bldg (The Landings)
414 Division Street
Sugar Grove,IL60554 		MOB
118 1465 Commerce Drive
1465 Commerce Drive
Algonquin,IL60102 		MOB
119 750 E Terra Cotta 60012
750 E Terra Cotta 60012
Crystal Lake,IL60012 		MOB
120 Cantera Medical Bldg
28375 Davis Parkway
Warrenville,IL60555 		MOB
121 Glenbard Medical
444 Park Blvd
Glen Ellyn,IL60137 		MOB
122 Healthcare Providers Bldg
471-473 Army Trail Rd
Bloomingdale,IL60108 		Lab
123 Malta
21193 Malta Rd
Malta,IL60150 		MOB
124 Streeterville ICC
635 Fairbanks Court
Chicago,IL60611 		Clinical
125 RMG Plano
12700 Route 34
Plano,IL60545 		MOB
126 Sycamore MOB
1830 Mediterranean Dr
Sycamore,IL60178 		MOB
127 Kishwaukee Warehouse
2445 W Bethany Rd
Sycamore,IL60178 		Admin Bldg
128 500 Coventry Lane
500 Coventry Lane
Crystal Lake,IL60014 		MOB
129 Woodstock MOB1 3703 Doty Rd
3703 Doty Road
Woodstock,IL60098 		MOB
130 RMG Waterman
10003 US Route 30
Waterman,IL60556 		MOB
131 South Elgin Briargate MOB
472 Briargate Drive
South Elgin,IL60177 		MOB
132 375 E Chicago (Rubloff)
375 E Chicago
Chicago,IL60611 		Clinical
133 NLFH Deerpath House
720 W Deerpath Rd
Lake Forest,IL60045 		Patient Housing
134 880 W Central Rd
880 W Central Rd
Arlington Heights,IL60005 		Storage
135 Silver Cross Hospital
1890 Silver Cross Blvd
New Lenox,IL60451 		MOB
136 Elmhurst Memorial Hosp
1200 York Road
Elmhurst,IL60126 		Clinical
137 RMG Englehart
224 E RailRoad St
Sandwich,IL60548 		MOB
138 BHS Discovery House
220 College Ave
DeKalb,IL60115 		MOB
139 385 Millennium Drive
385 Millennium Drive
Crystal Lake,IL60012 		Admin Bldg
140 3 9555 Gross Point Rd
9555 Gross Point Rd
Skokie,IL60076 		Clinical
141 Kish PT Hampshire
895 S State St
Hampshire,IL60140 		MOB
142 River Forest MOB
7411 Lake Street Suite 2210
River Forest,IL603051886 		MOB
143 Batavia East
1049 E Wilson
Batavia,IL60150 		MOB
144 Chesterton Timeshare
650 Dickinson Road
Chesterton,IN46304 		Clinical
145 4418 W Diversey
4418 W Diversey
Chicago,IL60639 		Office
146 616 35th Ave Healthlab
616 35th Ave
Moline,IL61265 		MOB
147 Hinsdale Lab Building
534 Chestnut
Hinsdale,IL60521 		Lab
148 16151 Weber Road
16151 Weber Road
Crest Hill,IL60403 		Clinical
149 111 N Wabash
111 N Wabash
Chicago,IL60602 		Clinical
150 - 7177 Crimson Ridge - Healthlab
7177 Crimson Ridge Drive Suite 8
Rockford,IL61107 		MOB
151 Rush Copley MOB
2020 Ogden Ave Suite 365
Aurora,IL60504 		MOB
152 RMG St Margarets Health (Baum Peru)
4040 Progress Blvd
Peru,IL61354 		MOB
153 - 555 W Pine - Healthlab
555 West Pine Street
Farmington,MO63640 		MOB
154 2425 W 22nd St
2425 West 22nd Street STE 203B
Oakbrook,IL60523 		Clinical
155 The Sheridan at Green Oaks
29330 N Waukegan Rd
Lake Bluff,IL60044 		Clinical
156 Urbana Timeshare
611 W Park
Urbana,IL61801 		Clinical
157 Evergreen Park MOB
9760 S Kedzie Ave
Evergreen Park,IL60805 		Lab
158 201 N Cummings
201 N Cummings
Washington,IL61571 		Clinical
159 Galleria
1030 N Clark
Chicago,IL60611 		Clinical
160 St John Timeshare
9615 Keilman Street
St John,IN46373 		Clinical
161 Delcom Billing Office
3755 E Main Street
St Charles,IL60174 		Admin Bldg
162 1935 N Capital Avenue
1935 N Capital Avenue
Indianapolis,IN46202 		Lab
163 4350 7th Street
4350 7th Street Suite B
Moline,IL61265 		MOB
164 420 Thatcher
420 Thatcher Avenue
River Forest,IL60305 		Clinical
165 201 E Walton
201 E Walton Place
Chicago,IL60611 		Patient Housing
166 2701 S Western Ave
2701 S Western Ave
Chicago,IL60608 		Storage
167 4732 N Lincoln Ave
4732 N Lincoln Ave
Chicago,IL60625 		MOB
168 2315 Campus Drive
2315 Campus Drive
Evanston,IL60208 		Office
169 10448 South Pulaski Rd
10448 South Pulaski Road Suite 10
Oak Lawn,IL60453 		Office
170 NLFH Grounds Building
660 N Westmoreland
Lake Forest,IL60045 		Grounds Building
171 13000 W Rt 176
13000 W Route 176
Lake Bluff,IL60044 		Office
172 10370 Haligus Road
10370 Haligus Road
Huntley,IL60142 		MOB
173 1122 N Main Street
1122 N Main Street Suite D
Algonquin,IL60102 		MOB
174 333 Front Street
333 Front Street
McHenry,IL60050 		MOB
175 394 Federal Drive
394 Federal Drive
Crystal Lake,IL60014 		MOB
176 201 Throop Street
201 Throop Street
Woodstock,IL60098 		MOB
177 420 N IL RT 31
420 N IL RT 31
Crystal Lake,IL60012 		MOB
178 1925 to 1947 Huntley Road
1925 to 1947 Huntley Road
Dundee,IL60118 		MOB
179 2615 Three Oaks Road
2615 Three Oaks Road Suite 1A
Cary,IL60013 		MOB
180 2615 Three Oaks Road Sub portion of Suite 1B
2615 Three Oaks Road Sub portion of
Suite 1B
Cary,IL60013 		MOB
181 3739 West Elm Street
3739 West Elm Street
McHenry,IL60050 		Thrift Shop
182 305 Front Street
305 Front Street
McHenry,IL60050 		Storage Unit
183 921 Tara Drive (Catulpa Lane)
921 Tara Drive Catulpa Lane
Woodstock,IL60098 		Storage Unit
184 3901 Mercy Drive
3901 Mercy Drive
McHenry,IL60050 		MOB
185 12920 Del Webb
12920 Del Webb
Huntley,IL60142 		Fitness
186 10210 Carrick Lane
1021 Carrick Lane
McHenry,IL60050 		MOB
187 585 Cimmaron Circle
585 Cimmaron Circle
Crystal Lake,IL60012 		Patient Housing
188 HealthLab Buffalo Grove
355 W Dundee Rd
Buffalo Grove,IL60089 		Lab
189 Lifetime Fitness Office
455 Scott Drive
Bloomingdale,IL60108 		Fitness
190 Mirshed Clinic
4255 W 63rd Street
Chicago,IL60629 		Lab
191 BHS Ben Gordon Central Ofc
12 Health Services Dr
DeKalb,IL60115 		MOB
192 Kish Pavillion
5 Kish Hospital Dr
DeKalb,IL60115 		Hybrid
193 Decatur lab office
544 W Pershing Suite B
Decatur,IL62526 		Lab
194 Elmhurst Ortho MOB
300 W Butterfield Rd
Elmhurst,IL60126 		MOB
195 Atrium Professional Center
3100 45th Street
Highland,IN46322 		Lab
196 Soutlake Medical MOB
8127 Merrillville Raod
Merillville,IN46410 		Lab
197 2127 Midlands Court
2127 Midlands Court
Sycamore,IL60178 		MOB
198 Belvidere lab space
2188 N State Street
Belvidere,IL61008 		Lab
199 Rama Place Building
2060 N Shadeland Ave
Indianapolis,IN46219 		Lab
200 RMG Ottawa (Baum)
1209 Starfire Dr
Ottawa,IL61350 		MOB
201 15 W Pleasant Ave
15 W Pleasant Ave
Sandwich,IL60548 		MOB
202 Lab lease Schaumburg
129 S Roselle Rd
Schaumburg,IL60074 		Lab
203 St Louis Lab site
916 Olive Street
St Louis,IL63101 		Lab
204 Vernon Hills Lab Lease
175 E Hawthorn Pkwy
Vernon Hills,IL60061 		Lab
205 Vale Park Medical Ctr
401 Wall Street
Valparaiso,IN46383 		Lab
206 Obstetrical & Gynecological Assoc
85 East HU Hwy 6 Suite 330
Valparaiso,IN46383 		Lab
207 Wheaton Bible Church
27W500 North Ave
West Chicago,IL60185 		MOB
208 West Chicago Warehouse
245 W Roosevelt Rd Unit 70
West Chicago,IL60185 		Warehouse
209 27W405 High Lake Road
27W405 High Lake Road
Winfield,IL60190 		House
210 27W404-406 Jewell Road
27W404-406 Jewell Road
Winfield,IL60190 		House
211 27W375 Jewell Road
27W375 Jewell Road
Winfield,IL60190 		House
212 4885 Hoffman Blvd
4885 Hoffman Blvd
Hoffman Estates,IL60192 		MOB
213 Highland IN Healthlab 2213 Main St
2213 Main Street
Highland,IN46322 		MOB
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Part I, Line 6a COMMUNITY BENEFIT REPORT Northwestern Memorial HealthCare and Subsidiaries (NMHC) submit a community benefit report to the Illinois attorney general according to the requirements for the state of Illinois. Northwestern Memorial Hospital (NMH), Northwestern Lake Forest Hospital (NLFH), Central DuPage Hospital (NWCDH), Delnor Community Hospital (Delnor), Kishwaukee Community Hospital (KCH), Valley West Hospital (VWH), Marianjoy Rehabilitation Hospital and Clinics (MJRH), Northern Illinois Medical Center (NIMC) and all other NMHC non-profit subsidiaries' results are included in this report.
Schedule H, Part I, Line 7g SUBSIDIZED HEALTH SERVICES THE BENEFITS REPORTED ARE PRIMARILY ASSOCIATED WITH OPERATING LOSSES SUPPORTING NMH'S MENTAL HEALTH PROGRAMS. NMHC DOES NOT INCLUDE COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES.
Schedule H, Part I, Line 3c DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE Northwestern Memorial Hospital, Northwestern Lake Forest Hospital, Central DuPage Hospital, Delnor-Community Hospital, Kishwaukee Community Hospital, Valley West Hospital, Marianjoy Rehabilitation Hospital and Clinics, and Northern Illinois Medical Center 09/01/2019 - 08/31/2020 NMH, NLFH, CDH, Delnor, Kishwaukee, Valley West, MJRH, and NIMC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: "uninsured sliding fee scale assistance" and "uninsured catastrophic assistance." If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Illinois Residents. The NIMC policy in place does not reflect a residency requirement. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, "Third-Party Funding Sources"). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance. A. Homelessness B. Deceased with no estate C. Mental incapacitation with no one to act on the patient's behalf D. Medicaid eligibility, but not on date of service for non-covered service E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines; 1. Women, Infants and Children Nutrition Program (WIC) 2. Supplemental Nutrition Assistance Program (SNAP) 3. Illinois Free Lunch and Breakfast Program 4. Low Income Home Energy Assistance Program (LIHEAP) 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial 6. Receipt of grant assistance for medical services
Schedule H, Part VI, Line 2 NEEDS ASSESSMENT, CONTINUED Northwestern Medicine Valley West Hospital: NM Valley West collaborates with diverse organizations to identify a common vision and plan to create a collective impact on the overall health of the community. This includes striving to coordinate efforts focusing on community priorities with community stakeholders including the DeKalb County Health Department, the Kendall County Health Department, Fox Valley Older Adults, and other medical, not-for-profit, community and faith-based organizations. Marianjoy Rehabilitation Hospital: MRH coordinates strategies with community partners and key stakeholders who include, but are not limited to, the DuPage County Health Department, DuPage Federation on Human Services Reform, AbilityLinks, the People's Resource Center, and local school districts and public entities. MRH's Pediatric Community Groups continue to be highly utilized by parents/caregivers to work on achieving functional goals for children with special needs. Northern Illinois Medical Center: NIMC represents the three hospitals of the legacy Centegra Health System (CHS), including Northwestern Medicine McHenry Hospital, Northwestern Medicine Huntley Hospital and Northwestern Medicine Woodstock Hospital. McHeny Hospital works with the Chicago Medical School Internal Medicine Residency program to provide training to the next generation of caregivers. The Woodstock campus is home to Aunt Martha's Woodstock Community Health Center, a federally qualified health center, offering comprehensive primary care and mental health services to the uninsured and underinsured members of the broader McHenry Community.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 172897800
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COST OF CHARITY CARE FOR THE HOSPITALS WAS CALCULATED BY APPLYING THE TOTAL COST-TO-CHARGE RATIO FROM EACH HOSPITAL'S MEDICARE COST REPORT (CMS 2552-96 WORKSHEET C, PART 1, CONSISTENT WITH THE STATE OF ILLINOIS ATTORNEY GENERAL'S OFFICE DEFINITION) TO THE CHARGES ON ACCOUNTS IDENTIFIED AS QUALIFYING FOR CHARITY CARE (AS DEFINED IN THE AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS ACCOUNTING AND AUDITING GUIDE - HEALTHCARE ORGANIZATIONS). THE RESULTANT CALCULATED COST WAS THEN OFFSET BY ANY PAYMENTS RECEIVED THAT WERE DESIGNATED FOR THE PAYMENT OF PATIENT BILLS QUALIFYING FOR A CHARITY CARE DISCOUNT (AS DEFINED IN THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION'S PRINCIPLES AND PRACTICES BOARD STATEMENT 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS). THE PHYSICIAN GROUPS, INCLUDING NMG AND RMG ARE NOT REQUIRED TO FILE A MEDICARE COST REPORT. AN INTERNALLY CALCULATED COST-TO-CHARGE RATIO SPECIFIC TO THE PHYSICIAN GROUPS WAS USED TO DETERMINE THE COST OF CHARITY CARE FOR NMG. THE RESULTANT CALCULATED COST WAS THEN OFFSET BY ANY PAYMENTS, CONSISTENT WITH THE METHODOLOGY FOR THE HOSPITALS. THE UNREIMBURSED COST OF BAD DEBT, MEDICAID, MEDICARE OR ANY OTHER FEDERAL, STATE OR LOCAL INDIGENT HEALTHCARE PROGRAM IS NOT INCLUDED IN THE UNREIMBURSED COST FIGURE FOR CHARITY CARE. THE COSTS OF CHARITY CARE IN THIS REPORT DIFFER FROM NMHC'S NOTES TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR FISCAL YEAR 2020 WHERE THEY WERE CALCULATED BY APPLYING A COST-TO-CHARGE RATIO DEVELOPED PRIOR TO FILING NMH'S, NLFH'S, CDH'S, DELNOR'S, KISH'S, MARIANJOY'S, AND NIMC'S FISCAL YEAR 2020 MEDICARE COST REPORTS TO CHARGES FOREGONE FOR CHARITY CARE. THE FISCAL YEAR 2020 MEDICARE COST REPORTS WERE COMPLETED AFTER THE AUDITED FINANCIAL STATEMENTS WERE ISSUED. THE COSTS OF CHARITY CARE FOR THE HOSPITALS INCLUDED IN THIS REPORT WERE CALCULATED USING THE COST-TO-CHARGE RATIOS FROM NMH'S, NLFH'S, CDH'S, DELNOR'S, KISH'S, MARIANJOY'S, AND NIMC'S COST REPORTS FILED IN MARCH OF 2021 FOR FISCAL YEAR 2020. COMMUNITY HEALTH IMPROVEMENT SERVICES - THE COST OF LANGUAGE ASSISTANCE PROGRAMS INCLUDES BOTH THE COST OF EMPLOYEES AND NONEMPLOYEES TO PROVIDE TRANSLATION SERVICES TO NMHC HOSPITAL PATIENTS AND FAMILY MEMBERS. EDUCATION - UNREIMBURSED EDUCATION COSTS INCLUDE THE COST OF NMHC'S MEDICAL RESIDENCY, FELLOWSHIP AND INTERNSHIP PROGRAMS LESS ANY THIRD-PARTY PAYOR REIMBURSEMENTS AND FEES RECEIVED. SUBSIDIZED HEALTH SERVICES - SUBSIDIZED HEALTH SERVICES INCLUDE THE UNCOMPENSATED COST OF PROVIDING BEHAVIORAL HEALTH SERVICES, HEALTH EDUCATION AND INFORMATION AND PROGRAMS TO POSITIVELY IMPACT THE WELLNESS OF THE COMMUNITY. COSTS CALCULATED WERE OFFSET BY ANY REIMBURSEMENT RECEIVED FOR SERVICES PROVIDED. THE UNREIMBURSED COST FOR BEHAVIORAL HEALTH SERVICES WAS ALSO ADJUSTED TO EXCLUDE THE UNREIMBURSED COST OF CHARITY CARE AND GOVERNMENT SPONSORED INDIGENT HEALTHCARE. RESEARCH - NMHC PROVIDES SUPPORT TO ADVANCE MEDICAL AND SCIENTIFIC RESEARCH AND ACADEMIC PURSUITS. THE REPORTED SUPPORT INCLUDES THE UNREIMBURSED COST OF FUNDS PROVIDED FOR RESEARCH PROJECTS AND UNREIMBURSED OPERATIONAL INFRASTRUCTURE COSTS TO SUPPORT CLINICAL RESEARCH THAT OCCURS AT NMH, NMG, CDH AND MJRH. DONATIONS - DONATIONS INCLUDE THE DOLLAR AMOUNT RECORDED DURING FISCAL YEAR 2020 IN ACCORDANCE WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES AS CONTRIBUTIONS TO CHARITABLE AND OTHER COMMUNITY OR CIVIC ORGANIZATIONS FOR FURTHERANCE OF THEIR CHARITABLE PURPOSES.
Schedule H, Part II Community Building Activities NMHC HOSPITALS PROVIDE A BROAD RANGE OF TRAINING PROGRAMS AND SUPERVISED PATIENT CARE EXPERIENCES TO ENSURE THAT A HIGHLY TRAINED HEALTHCARE WORKFORCE OF ADEQUATE CAPACITY IS IN PLACE TO SERVE THE RESIDENTS OF THE REGION. IMPORTANTLY, THESE PROGRAMS CREATE PATHWAYS FOR AT-RISK MEMBERS OF THE COMMUNITY TO SEEK JOBS WITHIN THE HEALTHCARE SYSTEM AND ALSO ARE IN PLACE FOR YOUNG PEOPLE TO LEARN ABOUT AND POTENTIALLY EXPLORE HEALTHCARE CAREERS. ALLIED HEALTH SCHOOLS AT NMH NMH OPERATES FOUR ACCREDITED ALLIED HEALTH SCHOOLS - DIAGNOSTIC MEDICAL SONOGRAPHY, NUCLEAR MEDICINE TECHNOLOGY, RADIATION THERAPY AND RADIOLOGY - AS WELL AS A HISTOTECHNOLOGY PROGRAM, POST-PRIMARY CT AND MRI PROGRAMS, AND A MEDICAL ASSISTANT PROGRAM. THE 21-MONTH CERTIFICATE PROGRAMS ARE OPEN TO EMPLOYEES AND THE GENERAL PUBLIC. MANY STUDENTS COME FROM THE LOCAL COMMUNITY, AS WELL AS FROM AFFILIATED COLLEGES AND UNIVERSITIES. LEADERS OF THESE PROGRAMS VISIT CITY HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO INTRODUCE VARIOUS MEDICAL FIELDS TO PROSPECTIVE STUDENTS AND INCREASE THEIR GENERAL KNOWLEDGE OF VARIOUS ALLIED HEALTH FIELDS. THE CERTIFICATE PROGRAMS AIM TO ADDRESS THE NEED FOR ALLIED HEALTH PROFESSIONALS IN THE FIELD. IN ADDITION TO TRAINING THE NATION'S FUTURE PHYSICIANS, FEINBERG HAS FURTHER RESPONDED TO THE ANTICIPATED SHORTAGE OF MEDICAL PROVIDERS BY OFFERING A MASTER'S-LEVEL PHYSICIAN ASSISTANT PROGRAM. PHYSICIAN ASSISTANTS ARE HIGHLY EFFECTIVE MEMBERS OF PRIMARY CARE TEAMS THAT INCLUDE MANY LEVELS OF PROVIDERS AND CAN EFFICIENTLY DELIVER THE HIGHEST QUALITY OF CARE TO EXTENDED GROUPS OF PATIENTS. THROUGH FEINBERG'S PROGRAM, PHYSICIAN ASSISTANTS ARE EDUCATED AND TRAINED WITHIN THE MEDICAL SCHOOL SETTING AND GAIN CLINICAL EXPERIENCE AT NMHC HOSPITALS. CLINICAL EXPERIENCE AT NMHC HOSPITALS NMHC HOSPITALS PROVIDE THE IMPORTANT CLINICAL SETTING FOR THE EDUCATION OF THE NEXT GENERATION OF HEALTHCARE WORKERS, INCLUDING PHYSICIANS, NURSES, PHARMACISTS, LABORATORY PROFESSIONALS, ALLIED HEALTH WORKERS AND SKILLED TECHNICIANS. THROUGH CLINICAL AFFILIATIONS WITH TOP REGIONAL UNIVERSITIES AND COLLEGES AND ESTABLISHED CLINICAL ROTATIONS, MENTORING, CLINICIAN SHADOWING, TRADITIONAL DIDACTIC LECTURES AND OTHER TEACHING PROGRAMS, WE PROVIDE CLINICAL SETTINGS FOR THE EDUCATION OF THOUSANDS OF STUDENTS, MANY OF WHOM WILL BECOME PROFESSIONALS IN FIELDS IDENTIFIED AS AREAS OF CURRENT OR FUTURE WORKFORCE SHORTAGE IN THE NATIONAL HEALTHCARE SYSTEM. NMHC PROVIDES EDUCATION TO A WIDE RANGE OF STUDENTS INCLUDING: - UNDERGRADUATE AND GRADUATE NURSING STUDENTS - STUDENTS FROM UNIVERSITY-BASED PHARMACY PROGRAMS - RESPIRATORY THERAPY STUDENTS - GRADUATE SOCIAL WORK INTERNS - PSYCHOLOGY PHD CANDIDATES WITH CLINICAL EMPHASES IN ADULT CLINICAL PSYCHOLOGY, BEHAVIORAL MEDICINE (HEALTH PSYCHOLOGY), CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY AND CLINICAL NEUROPSYCHOLOGY - INTERNS IN BIOMEDICAL ENGINEERING - PASTORAL CARE STUDENTS - PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, SPEECH LANGUAGE PATHOLOGISTS, PHYSICAL THERAPIST ASSISTANTS AND OCCUPATIONAL THERAPY ASSISTANTS THROUGH A MASTER CLINICIAN PROGRAM - PHYSICAL AND OCCUPATIONAL THERAPY ASSISTANT, BACHELOR, MASTERS AND PHD STUDENTS - STUDENTS IN A BROAD ARRAY OF OTHER CLINICAL PROGRAMS ON-THE-JOB TRAINING AND YOUTH EDUCATION PROGRAMS RESEARCH ON THE SOCIAL DETERMINANTS OF HEALTH INDICATES THAT ACCESS TO EDUCATIONAL AND ECONOMIC OPPORTUNITIES IS A KEY FACTOR IMPACTING INDIVIDUALS' QUALITY OF LIFE. NMHC OFFERS A MULTITUDE OF OPPORTUNITIES TO EXPOSE STUDENTS TO POTENTIAL HEALTHCARE CAREERS AND TO FOSTER PROFESSIONAL DEVELOPMENT IN THE FIELD. ONGOING, COMPREHENSIVE, ON-THE-JOB TRAINING AND YOUTH PROGRAMS FOR HIGH SCHOOL, COLLEGE AND POST-GRADUATE STUDENTS ARE OFFERED AT EVERY HOSPITAL IN THE HEALTH SYSTEM IN BOTH CLINICAL AND ADMINISTRATIVE SETTINGS. NM HAS LONG INVESTED IN PROGRAMS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, INCLUDING PROVIDING EDUCATIONAL AND EMPLOYMENT OPPORTUNITIES FOR YOUTH. IN 2011, NMH EMBARKED ON AN EDUCATIONAL PARTNERSHIP WITH WESTINGHOUSE COLLEGE PREPARATORY HIGH SCHOOL (WESTINGHOUSE), A SELECTIVE-ENROLLMENT HIGH SCHOOL ON CHICAGO'S WEST SIDE, TO PROVIDE TALENTED HIGH SCHOOL STUDENTS WITH THE OPPORTUNITY TO LEARN ABOUT AND PURSUE POST-HIGH-SCHOOL EDUCATION IN HEALTHCARE CAREERS. STUDENTS MEET FEINBERG FACULTY AND HOSPITAL EMPLOYEES, AND ARE PROVIDED A BEHIND-THE-SCENES UNDERSTANDING OF CLINICAL AREAS AND POTENTIAL CAREERS. THE PROGRAM ALSO INCLUDES MENTORING, AN INTENSIVE SUMMER PROGRAM, DISTANCE LEARNING, ACT TEST PREPARATION, AND LEADERSHIP AND LIFE SKILLS DEVELOPMENT. THE PROGRAM HAD 20 PARTICIPANTS IN FY20. IN FY20, EXPANDING ON THE LONG-STANDING RELATIONSHIP BETWEEN NMH AND WESTINGHOUSE, THREE ADDITIONAL PROGRAMS WERE OFFERED TO THE WESTINGHOUSE COMMUNITY: - THE COMMUNITY GRAND ROUNDS SESSION PROVIDED THE OPPORTUNITY FOR NM FACULTY TO DIRECTLY SHARE MEDICAL INFORMATION AND KNOWLEDGE. - THE ANATOMY LAB SESSION PROVIDED STUDENTS WITH THEIR FIRST GLANCE OF MEDICAL SCHOOL AND EXPOSURE TO A REAL HUMAN BODY. - THE MEN IN MEDICINE AND SCIENCE (MIMS) PROGRAM EXPOSED WESTINGHOUSE FRESHMAN MALE STUDENTS TO THE WORLD OF MEDICINE AND SCIENCE. AN ADDITIONAL 175 STUDENTS PARTICIPATED IN THESE SUPPLEMENTAL SESSIONS. REFLECTING THE GEOGRAPHICAL EXPANSION OF THE HEALTH SYSTEM, THE NM DISCOVERY PROGRAM, FORMERLY KNOWN AS MEDICAL EXPLORERS, GREW TO FOUR CHAPTERS IN FY20: NM DISCOVERY PROGRAM CENTRAL (54 PARTICIPANTS), NM DISCOVERY PROGRAM WEST (60 PARTICIPANTS), NM DISCOVERY PROGRAM NORTH (41 PARTICIPANTS) AND NM DISCOVERY PROGRAM GREATER DEKALB (15 PARTICIPANTS). THROUGHOUT THE TWO-YEAR PROGRAM, STUDENTS ARE EXPOSED TO A BROAD RANGE OF ACTIVITIES DESIGNED TO ENCOURAGE THEIR INTEREST IN HEALTHCARE CAREERS. IN ADDITION, THE PROGRAM FOSTERS CHARACTER AND PROFESSIONAL DEVELOPMENT, CULTIVATES LIFE SKILLS, PROVIDES COMMUNITY SERVICE AND LEADERSHIP EXPERIENCE, AND OFFERS MENTORSHIP AND NETWORKING OPPORTUNITIES. ONCE-MONTHLY ACTIVITIES INCLUDE TOURS, GUEST SPEAKERS, GROUP DISCUSSION AND HANDS-ON PROJECTS (DUE TO THE COVID-19 PANDEMIC, THE PROGRAM WAS OFFERED VIRTUALLY IN SPRING 2020). SINCE THE PROGRAM BEGAN, MANY PARTICIPANTS HAVE PURSUED CAREERS IN NURSING AND OTHER HEALTHCARE FIELDS, AND SEVERAL ARE NOW EMPLOYED AT NMH. IN FY20, THE HEALTH SYSTEM BEGAN PLANNING FOR THE NEXT CHAPTER OF THE NM DISCOVERY PROGRAM - NM DISCOVERY PROGRAM NORTHWEST CHAPTER - WHICH LAUNCHED IN THE FALL OF 2020. ADDITIONAL EXPANSION OF BOTH THE NM DISCOVERY PROGRAM IS EXPECTED IN COMING YEARS. SINCE 2016, NM HUNTLEY AND NM MCHENRY HOSPITALS HAVE OFFERED THE YOUTH RESIDENCY PROGRAM. WORKING WITH LOCAL HIGH SCHOOLS, THE PROGRAM PROVIDES INTENSIVE JOB SHADOWING AND MENTORSHIP WITH THE GOAL OF SPARKING STUDENTS' INTEREST IN HEALTH CAREERS AND ULTIMATELY RETURNING TO WORK IN THE LOCAL COMMUNITY. FROM LEARNING TO READ A MRI, TO INSPECTING CELL TISSUES FOR TUMORS, STUDENTS ARE IMMERSED IN A PROFESSIONAL MEDICAL ENVIRONMENT IN CONJUNCTION WITH THE HIGH-SCHOOL BASED CURRICULUM. EACH CHAPTER SERVES UP-TO 30 STUDENTS ANNUALLY. NM CDH, NM DELNOR AND NM KISHWAUKEE OFFER PROJECT SEARCH, A PROGRAM FOR STUDENT INTERNS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. PROJECT SEARCH IS AN EMPLOYABILITY SKILLS TRAINING PROGRAM THAT ASSISTS STUDENTS WHO HAVE INTELLECTUAL AND DEVELOPMENTAL DISABILITIES TRANSITION FROM HIGH SCHOOL TO PRODUCTIVE EMPLOYMENT. THE HALLMARK OF PROJECT SEARCH IS TOTAL WORKPLACE IMMERSION, WHICH FACILITATES A SEAMLESS COMBINATION OF CLASSROOM INSTRUCTION, CAREER EXPLORATION AND HANDS-ON TRAINING. DURING THE ONE-YEAR PROGRAM, STUDENTS WHO ARE IN THEIR LAST YEAR OF HIGH SCHOOL PARTICIPATE IN THREE 10-WEEK INTERNSHIPS WITHIN THE HOSPITAL TO EXPLORE THEIR VOCATIONAL SKILLS, ABILITIES AND POTENTIAL CAREER PATHS. THE GOAL OF THE PROGRAM IS TO ACHIEVE 100% EMPLOYMENT AT THE END OF THE INTERNSHIP. PROJECT SEARCH IS CONTINUING TO EXPAND ACROSS THE HEALTH SYSTEM. IN FY20, NM MCHENRY BEGAN PLANNING FOR ITS OWN PROJECT SEARCH PROGRAM - INCLUDING THE CONSTRUCTION OF A DEDICATED CLASSROOM SPACE - WHICH LAUNCHED IN FALL 2020. COMMUNITY HEALTH EDUCATION COMMUNITY-BASED EDUCATION PROGRAMS ARE OFFERED ACROSS THE HEALTH SYSTEM AND IN COORDINATION WITH OUR COMMUNITY PARTNERS. THESE INITIATIVES RANGE FROM DISEASE-SPECIFIC INFORMATION PROGRAMS, TO MENTAL HEALTH AND SUBSTANCE ABUSE COMMUNITY EDUCATION, TO MINDFULNESS TRAINING, AMONG MANY MORE.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount NET PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS, AND NET PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THESE AMOUNTS ARE BASED PRIMARILY ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED WRITE-OFFS AND NET COLLECTIONS, ALONG WITH THE AGING STATUS FOR EACH MAJOR PAYOR SOURCE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BASED ON HISTORICAL EXPERIENCE, A PORTION OF NORTHWESTERN MEMORIAL'S SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, A PROVISION IS RECORDED FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO THESE PATIENTS. AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IN ACCORDANCE WITH NORTHWESTERN MEMORIAL'S POLICIES, ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, NORTHWESTERN MEMORIAL RECORDS AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE ADJUSTED AS NEEDED IN FUTURE PERIODS. BAD DEBTS REPRESENT THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS REPORTED IN NMHC'S FISCAL YEAR 2020 AUDITED FINANCIAL STATEMENTS RELATED TO PATIENT CARE SERVICES ADJUSTED TO COST CONSISTENT WITH THE METHODOLOGY USED TO CALCULATE GOVERNMENT SPONSORED INDIGENT HEALTHCARE.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote NET PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS, AND NET PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THESE AMOUNTS ARE BASED PRIMARILY ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED WRITE-OFFS AND NET COLLECTIONS, ALONG WITH THE AGING STATUS FOR EACH MAJOR PAYOR SOURCE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BASED ON HISTORICAL EXPERIENCE, A PORTION OF NORTHWESTERN MEMORIAL'S SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, A PROVISION IS RECORDED FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO THESE PATIENTS. AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IN ACCORDANCE WITH NORTHWESTERN MEMORIAL'S POLICIES, ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, NORTHWESTERN MEMORIAL RECORDS AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE ADJUSTED AS NEEDED IN FUTURE PERIODS. BAD DEBTS REPRESENT THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS REPORTED IN NMHC'S FISCAL YEAR 2020 AUDITED FINANCIAL STATEMENTS RELATED TO PATIENT CARE SERVICES ADJUSTED TO COST CONSISTENT WITH THE METHODOLOGY USED TO CALCULATE GOVERNMENT SPONSORED INDIGENT HEALTHCARE.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE UNREIMBURSED COST OF MEDICARE IS DEFINED BY THE STATE OF ILLINOIS ATTORNERY GENERAL'S OFFICE ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT AS A COMMUNITY BENEFIT. THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION ALSO VIEWS THE UNREIMBURSED COSTS OF MEDICARE AS PART OF A HOSPITAL'S COMMUNITY BENEFIT PROGRAM. NMHC PROVIDES MEDICAL CARE TO MEDICARE PATIENTS AT A COST HIGHER THAN THE REIMBURSEMENT IT RECEIVES FROM MEDICARE. THE AMOUNTS LISTED FOR PART III, LINE 5 THRU 7, ARE CALCULATED CONSISTENT WITH THE METHODOLOGY DESCRIBED FOR CALCULATING UNREIMBURSED COST OF MEDICAID FOR FISCAL 2020.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance NMHC'S CREDIT AND COLLECTION POLICY CONTAINS A PROVISION FOR FINANCIAL COUNSELING. THE POLICY STATES THAT PATIENTS WITH SELF-PAY BALANCES AND WITHOUT THE RESOURCES TO PAY THEIR OBLIGATIONS WILL BE ASSESSED FOR FREE AND DISCOUNTED CARE ELIGIBILITY BY THE FINANCIAL COUNSELING DEPARTMENTS. THE ASSESSMENT INVOLVES AND EVALUATION OF ALL LEVELS OF ASSISTANCE INCLUDING GOVERNMENTAL ASSISTANCE, EXTENDED PAY ALTERNATIVES, AND FREE OR DISCOUNTED CARE. IF THE PATIENT QUALIFIES FOR FREE CARE, THE ACCOUNT IS ADJUSTED TO ZERO SO NO COLLECTION ACTIVITY OCCURS. IF FINANCIAL ASSISTANCE RESULTS IN A DISCOUNTED OR REDUCED BALANCE, ONLY THE REDUCED BALANCE WILL BE SUBJECT TO THE COLLECTION PROCESS.
Schedule H, Part V, Section B, Line 16a FAP website - Northwestern Memorial Hospital: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN LAKE FOREST HOSPITAL: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - CENTRAL DUPAGE HOSPITAL ASSOCIATION: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - DELNOR-COMMUNITY HOSPITAL: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Northwestern Medicine Valley West Hospital: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Marianjoy Rehabilitation Hospital: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHERN ILLINOIS MEDICAL CENTER: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website - Northwestern Memorial Hospital: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN LAKE FOREST HOSPITAL: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - CENTRAL DUPAGE HOSPITAL ASSOCIATION: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - DELNOR-COMMUNITY HOSPITAL: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Northwestern Medicine Valley West Hospital: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Marianjoy Rehabilitation Hospital: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHERN ILLINOIS MEDICAL CENTER: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Northwestern Memorial Hospital: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN LAKE FOREST HOSPITAL: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - CENTRAL DUPAGE HOSPITAL ASSOCIATION: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - DELNOR-COMMUNITY HOSPITAL: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Northwestern Medicine Valley West Hospital: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Marianjoy Rehabilitation Hospital: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHERN ILLINOIS MEDICAL CENTER: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment NMHC'S MISSION SETS FORTH OUR COMMITMENT TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND TO ADVANCE MEDICAL RESEARCH AND EDUCATION, ONE PATIENT AT A TIME. THE COMMUNITY BENEFITS PLAN DESCRIBES THE BROAD-REACHING GOALS THAT SUPPORT THIS COMMITMENT AND ADDRESS OUR RESPONSIBILITY AS A TAX-EXEMPT ORGANIZATION. THE DEPARTMENT OF EXTERNAL AFFAIRS DEVELOPS AND MAINTAINS A COMMUNITY BENEFITS PLAN FOR THE HEALTH SYSTEM, WHICH IS EXECUTED AT THE HOSPITAL LEVEL TO BEST MEET THE NEEDS OF OUR LOCAL COMMUNITIES. REVIEWED ANNUALLY AND REVISED AS NEEDED, THE OBJECTIVES OF THE COMMUNITY BENEFITS PLAN ARE TO: 1. PROVIDE QUALITY MEDICAL CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 2. HONOR NORTHWESTERN MEDICINE'S MISSION AND COMMITMENT TO THE COMMUNITY. 3. BE RESPONSIVE TO THE ASSESSED NEEDS OF THE LOCAL COMMUNITY SERVED BY EACH HOSPITAL. 4. FORGE RELATIONSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS TO HELP ADDRESS SOCIAL DETERMINANTS OF HEALTH. 5. EVALUATE THE PUBLIC HEALTH IMPACT OF NORTHWESTERN MEDICINE PROGRAMMING, AND REPLICATE BY GEOGRAPHY AND/OR DISEASE STATE WITH SENSITIVITY TO THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITIES WE SERVE. 6. LEVERAGE OUR STRENGTHS AS A PREMIER ACADEMIC HEALTH SYSTEM TO TRAIN THE NEXT GENERATION OF CAREGIVERS AND UTILIZE EVIDENCE-BASED MODELS FOR COMMUNITY HEALTH ENGAGEMENT. 7. LEVERAGE OUR BOND WITH NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE TO BE LEADERS IN QUALITY, ACADEMIC EXCELLENCE, SCIENTIFIC DISCOVERY, PATIENT SAFETY AND RESEARCH-INFORMED TREATMENT. ALIGNED WITH OUR MISSIONS AND COMMUNITY BENEFITS PLAN, AND IN ACCORDANCE WITH THE REQUIREMENTS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA), EACH OF THE HEALTH SYSTEM HOSPITALS WORKS WITH COMMUNITY AND CAMPUS PARTNERS EVERY THREE YEARS TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IDENTIFIES THE HIGHEST PRIORITY HEALTH NEEDS OF RESIDENTS OF ITS COMMUNITY. WITH FEINBERG, NMHC BRINGS TO BEAR THE RESOURCES OF A WORLD-CLASS, INTEGRATED ACADEMIC HEALTH SYSTEM TO ADVANCE OUR COMMUNITY BENEFITS PLAN AND CHNA INITIATIVES IN WAYS THAT COULD NOT BE ACHIEVED AS STAND-ALONE HOSPITALS. PROVIDING BETTER CARE CLOSER TO HOME ALLOWS OUR COMMUNITIES ACCESS TO THE LATEST DEVELOPMENTS IN EDUCATION AND RESEARCH THAT PREVIOUSLY MAY NOT HAVE BEEN AVAILABLE AT THE COMMUNITY LEVEL. THIS INCLUDES: - SEEKING ROOT CAUSES TO HEALTH CONDITIONS, AND COLLABORATING WITH SCIENTISTS AND CLINICIANS TO DEVELOP SOLUTIONS - ENHANCING ACCESS TO HEALTH CARE - IMPROVING CLINICAL QUALITY - ADVANCING MEDICAL INNOVATION - ENSURING THAT A HIGHLY SKILLED HEALTHCARE WORKFORCE IS IN PLACE FOR DECADES TO COME - ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH CHNAS PROVIDE INFORMATION THAT ENABLES HOSPITALS TO IDENTIFY HEALTH ISSUES OF GREATEST CONCERN AMONG RESIDENTS IN THEIR COMMUNITIES AND DECIDE HOW BEST TO COMMIT RESOURCES TO THOSE AREAS, THEREBY MAKING THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS. NMHC EMPLOYS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINE THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE RESIDENTS OF EACH HOSPITAL'S COMMUNITY. EACH CHNA SERVES AS A TOOL TOWARD REACHING THREE GOALS: 1. IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS AND ELEVATE THEIR OVERALL QUALITY OF LIFE. A HEALTHY COMMUNITY IS ONE WHERE ITS RESIDENTS SUFFER LITTLE FROM PHYSICAL AND MENTAL ILLNESS AND ALSO ENJOY A HIGH QUALITY OF LIFE. 2. REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS. BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA, IT IS POSSIBLE TO IDENTIFY POPULATION SEGMENTS THAT ARE MOST AT RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE SEGMENTS MAY THEN BE DEVELOPED TO COMBAT SOME OF THE SOCIOECONOMIC FACTORS THAT HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH. 3. INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES ARE BENEFICIAL IN ACCOMPLISHING THE FIRST GOAL (IMPROVING HEALTH STATUS, INCREASING LIFE SPANS AND ELEVATING THE QUALITY OF LIFE), AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASES RESULTING FROM A LACK OF PREVENTIVE CARE. THE CHNAS AND CORRESPONDING IMPLEMENTATION STRATEGIES WERE DEVELOPED WITH FEEDBACK FROM COMMUNITY HEALTHCARE ORGANIZATIONS AND OTHER SOCIAL SERVICES AND PUBLIC ORGANIZATIONS THAT UNDERSTAND AND HELP REPRESENT THE WIDE-RANGING HEALTHCARE NEEDS OF THE RESIDENTS IN OUR COMMUNITIES. THE CHNA IMPLEMENTATION PLANS ARE GROUNDED IN PUBLIC HEALTH MODELS DEVELOPED WITH OUR COMMUNITY PARTNERS AND FEINBERG FACULTY, IN WHICH RESIDENTS OF OUR COMMUNITIES ARE INFORMED AND ABLE TO MAKE HEALTHY LIFESTYLE CHOICES, MANAGE THEIR CHRONIC HEALTH CONDITIONS AND RECEIVE MEDICALLY NECESSARY HEALTHCARE SERVICES IN THE MOST APPROPRIATE SETTING. WE BELIEVE THAT OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE IS BEST ACCOMPLISHED IN COLLABORATION WITH PARTNERS IN BOTH THE COMMUNITY AND WITHIN THE ORGANIZATIONS THAT COMPRISE NORTHWESTERN MEDICINE, INCLUDING THE HEALTH SYSTEM AND FEINBERG. OUR AFFILIATIONS WITH COMMUNITY-BASED HEALTHCARE AND COMMUNITY PARTNERS ENABLE THE HEALTH SYSTEM'S ORGANIZATIONS TO MEANINGFULLY IMPROVE ACCESS TO HIGH-QUALITY HEALTH CARE AND IMPLEMENT TARGETED PROGRAMS THAT ADDRESS THE HIGHEST-PRIORITY HEALTH NEEDS OF THE COMMUNITY. WE HAVE IMPLEMENTED LARGE-SCALE PROGRAMS THROUGHOUT OUR COMMUNITIES USING THIS FRAMEWORK TO TARGET HIGH-PRIORITY HEALTH CONDITIONS AND WILL CONTINUE TO USE PUBLIC HEALTH MODELS TO ADDRESS PRIORITY HEALTH NEEDS IDENTIFIED THROUGH OUR CHNAS. ONGOING EFFORTS DRAW ON NMHC'S AND FEINBERG'S STRENGTHS IN PUBLIC HEALTH, COMMUNICATION AND EDUCATION, AND INCLUDE PROGRAMS TO ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS IN COMMUNITIES SERVED ACROSS THE HEALTH SYSTEM. OUR HOSPITALS HAVE ENDURING RELATIONSHIPS, OFTEN DECADES OLD, WITH LOCAL HEALTHCARE AND COMMUNITY ORGANIZATIONS. THROUGH THESE PARTNERSHIPS, WE COLLABORATE ON DETERMINING PRIORITY HEALTH NEEDS THROUGH THE CHNA PROCESS AND WORK TOGETHER TO DEVELOP SOLUTIONS THAT RESPECT THE VARIED CULTURAL, SOCIOECONOMIC AND PRACTICAL NEEDS OF OUR DIVERSE COMMUNITIES. NORTHWESTERN MEMORIAL HOSPITAL: NMH COLLABORATES WITH COMMUNITY-BASED HEALTH, EDUCATION AND SOCIAL SERVICE ORGANIZATIONS TO PROVIDE HEALTH EDUCATION, OUTREACH SERVICES AND FOCUSED DISEASE MANAGEMENT PROGRAMS, AND TO ENSURE THAT THE RESIDENTS OF OUR COMMUNITIES HAVE CONVENIENT ACCESS TO HIGH-QUALITY MEDICAL HOMES. NMH HAS FORMAL AND LONGSTANDING AFFILIATIONS WITH TWO FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) BASED IN THE COMMUNITY - NEAR NORTH HEALTH SERVICE CORPORATION AND ERIE FAMILY HEALTH CENTER - AS WELL AS WITH COMMUNITYHEALTH, THE LARGEST FREE HEALTH CLINIC IN ILLINOIS. VITAL COMMUNITY PARTNERSHIPS ARE ALSO IN PLACE AMONG VARIOUS HEALTH AND COMMUNITY PARTNERS, INCLUDING BRIGHT STAR COMMUNITY OUTREACH AND KELLY HALL YMCA, AMONG MANY MORE. NORTHWESTERN MEDICINE LAKE FOREST HOSPITAL: THROUGH CHARITY CARE, OUTREACH SERVICES AND HEALTH EDUCATION PROGRAMS, NM LFH IMPROVES ACCESS TO HEALTHCARE SERVICES AND RESPONDS TO THE PRIORITY HEALTH NEEDS OF THE RESIDENTS OF LAKE COUNTY, ESPECIALLY AMONG THE UNINSURED OR UNDERINSURED. NM LFH HAS DEEP ROOTS IN LAKE COUNTY AND STRONG RELATIONSHIPS WITH COMMUNITY PARTNERS INCLUDING ERIE HEALTHREACH WAUKEGAN HEALTH CENTER AND THE LAKE COUNTY HEALTH DEPARTMENT, AMONG OTHERS. NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL: NM CDH HAS ENDURING RELATIONSHIPS WITH SEVERAL COMMUNITY-LED, COUNTY-WIDE HEALTH COLLABORATIVES, THE DUPAGE COUNTY HEALTH DEPARTMENT, LOCAL SCHOOL DISTRICTS AND SOCIAL SERVICES ORGANIZATIONS. LONGSTANDING COLLABORATIONS INCLUDE THE DUPAGE HEALTH COALITION/ACCESS DUPAGE AND THE VILLAGE OF WINFIELD. THROUGH THESE PARTNERSHIPS, AND MANY MORE, NM CDH PROVIDES HEALTH EDUCATION, NAVIGATION AND OUTREACH SERVICES. NORTHWESTERN MEDICINE DELNOR HOSPITAL: NM DELNOR REGULARLY ENGAGES WITH KANE COUNTY ORGANIZATIONS COMMITTED TO IMPROVING THE HEALTH OF ITS RESIDENTS, INCLUDING THE KANE COUNTY HEALTH DEPARTMENT AND THE TRI CITY HEALTH PARTNERSHIP, AMONG OTHERS. NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL: NM KISHWAUKEE WORKS CLOSELY WITH MANY COMMUNITY PARTNERS INCLUDING THE DEKALB COUNTY COMMUNITY MENTAL HEALTH BOARD, DEKALB COUNTY HEALTH DEPARTMENT, NORTHERN ILLINOIS UNIVERSITY, KISHWAUKEE COLLEGE, AREA SCHOOL DISTRICTS, AND MANY OTHER LOCAL MEDICAL PROVIDERS, NOT-FOR-PROFIT ORGANIZATIONS, AND COMMUNITY GROUPS. TOGETHER, NM KISHWAUKEE COLLABORATES WITH THESE DIVERSE ORGANIZATIONS TO IDENTIFY A COMMON VISION AND PLAN TO CREATE A COLLECTIVE IMPACT ON THE OVERALL HEALTH OF THE COMMUNITY.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THERE ARE MANY WAYS THAT PATIENTS OF THE HOSPITALS ARE INFORMED OR MADE AWARE OF THE AVAILABILITY OF THE HOSPITAL'S VARIOUS FINANCIAL ASSISTANCE PROGRAMS. A. TO INCREASE AWARENESS OF FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITALS HAVE DEVELOPED BROCHURES (IN ENGLISH AND SPANISH) THAT ARE PROVIDED TO PATIENTS UPON ADMISSION AND AVAILABLE AT REGISTRATION POINTS-OF-ENTRY B. ENGLISH- AND SPANISH-LANGUAGE SIGNS NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE ARE PRESENT AT EVERY PATIENT REGISTRATION AREA, INCLUDING THE EMERGENCY DEPARTMENT. C. AS PART OF THE REGISTRATION PROCESS, PATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE INFORMATION BROCHURE WHICH DESCRIBES THE TYPES OF ASSISTANCE AVAILABLE AND HOW TO QUALIFY FOR ONE OR MORE OF THE PROGRAMS. D. THE GENERAL CONSENT FORMS THAT EVERY PATIENT SIGNS CONTAINS INFORMATION ABOUT THE NMHC FINANCIAL ASSISTANCE PROGRAMS, AND IS AVAILABLE IN ENGLISH, SPANISH, RUSSIAN, AND POLISH AT NMH, WHILE NLFH, CDH, DELNOR, KCH, VWH, AND MJRH HAVE PROGRAMS IN ENGLISH AND SPANISH. E. INPATIENTS RECEIVE A PATIENT WELCOME PACKAGE THAT INCLUDES THE FINANCIAL ASSISTANCE INFORMATION. F. PATIENTS CAN LEARN ABOUT AND ASSESS THEIR ELIGIBILITY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAMS WITH THE HELP OF THE HOSPITAL'S TEAM OF FINANCIAL COUNSELING AND PATIENT INQUIRY REPRESENTATIVES. THESE REPRESENTATIVES ARE AVAILABLE ON A WALK-IN BASIS OR THROUGH A TOLL-FREE NUMBER. G. PROCESSES ARE IN PLACE TO LINK PATIENTS WITH FINANCIAL COUNSELORS AND PATIENT INQUIRY REPRESENTATIVES WHEN FINANCIAL HARDSHIP IS IDENTIFIED AS A CONCERN DURING SOCIAL SERVICES ASSESSMENTS. H. THE ENTRY PORTAL TO THE NMHC WEBSITE CONTAIN A PROMINENT LINK TO INFORMATION ABOUT NMHC'S VARIOUS FINANCIAL ASSISTANCE PROGRAMS, THE FINANCIAL ASSISTANCE BROCHURE AND DOWNLOADABLE APPLICATIONS IN MULTIPLE LANGUAGES. I. WORKING IN CONJUNCTION WITH CLINICAL STAFF, FINANCIAL COUNSELORS VISIT INPATIENTS NOT ENROLLED IN GOVERNMENT OR PRIVATE HEALTH PLANS WHILE THEY ARE STILL IN THE HOSPITAL TO ASSIST THEM IN DETERMINING THEIR ELIGIBILITY FOR BOTH GOVERNMENT HEALTH PROGRAMS AND FOR HOSPITAL FREE AND DISCOUNTED CARE PROGRAMS. J. THE HOSPITALS INFORM UNINSURED PATIENTS, AND PATIENTS WITH AN OUTSTANDING BALANCE AFTER INSURANCE, OF THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING THE FREE CARE AND DISCOUNTED CARE PROGRAM, AND THE CATASTROPHIC PROGRAM OFFERED BY THE HOSPITALS, IN WRITTEN CORRESPONDENCE SENT TO THOSE PATIENTS. THIS INFORMATION INCLUDES THE TOLL-FREE PHONE NUMBER TO THE TEAM OF PATIENT ACCOUNT REPRESENTATIVES. K. THE HOSPITALS HAVE ON-SITE PATIENT ACCOUNT STAFF WHO ARE TRAINED AND AVAILABLE TO ASSIST PATIENTS WITH FINANCIAL ASSISTANCE. L. THE HOSPITALS PROVIDE PROACTIVE FINANCIAL COUNSELING FOR SELF-PAY PATIENTS WHO HAVE A SCHEDULED INPATIENT ADMISSION. FINANCIAL COUNSELING INCLUDES ASSESSMENT FOR PUBLICLY OR PRIVATELY FUNDED INSURANCE AND THE HOSPITALS' FINANCIAL ASSISTANCE PROGRAMS. FINANCIAL ASSISTANCE PROGRAMS, INCLUDES THE FREE CARE AND DISCOUNTED CARE PROGRAMS, AND THE CATASTROPHIC PROGRAM OFFERED BY THE HOSPITALS, IN WRITTEN CORRESPONDENCE SENT TO THOSE PATIENTS. THIS INFORMATION INCLUDES THE TOLL-FREE PHONE NUMBER TO THE TEAM OF PATIENT ACCOUNT REPRESENTATIVES.
Schedule H, Part VI, Line 4 Community information The communities served by NMHC hospitals are complex and diverse, encompassing rural, suburban and urban areas, with a range of socioeconomic statuses and social determinants of health that correspond to these demographics. NMHC is committed to providing care that takes into consideration the cultures and environments in which our patients live and is responsive to their needs. NMHC works closely with community partners, including health and social service partners, to identify priority health concerns and jointly develop community-based health initiatives designed to address healthcare disparities. Each NMHC hospital considers a variety of factors when defining its distinctive community. These factors include: geographic area served, principal functions of the hospital, areas of high hardship and the population served, the location of existing NM and community assets, and the service areas of other healthcare providers. By considering each of these factors, each NMHC hospital defined its own Community Service Area (CSA) and is working to meet the unique needs of the community it serves. Northwestern Memorial Hospital Service Area NMH serves a large, complex and diverse area with patients coming from the City of Chicago and surrounding counties. NMH's Hospital Service Area was previously defined as the Cities of Chicago and Evanston. This was re-evaluated to determine a 7-mile radius around the Hospital which maximizes the opportunity to identify and address health needs for communities serviced by the Hospital. The community comprises 34 ZIP codes, 92.30 square miles, or 57% of Chicago's total population. NMH's Hospital Service Area is ethnically and racially diverse with large Black and Hispanic populations as well as large Polish and Spanish-speaking populations. Significantly, 21 percent of families live below the poverty level in NMH's Hospital Service Area. NMH is committed to providing culturally competent care that is responsive to the needs of all our patients, regardless of the ability to pay. NMH works with community health centers in some of Chicago's medically underserved areas to identify priority health concerns and jointly develop community-based health initiatives designed to address healthcare disparities. Northwestern Medicine Lake Forest Hospital Service Area NM LFH primarily serves Lake County, which has a fairly stable population of around 704,000 residents; nearly 73 percent of inpatient admissions at NM LFH are derived from Lake County. While NM LFH's Hospital Service Area population is only expected to grow by 0.7 percent over the next five years, the over-65 population is growing rapidly. Between 2010 and 2017 (the most recent information available), the number of persons in Lake County 65 years and older increased from 8.5 percent of the population to 13.7 percent. A total of 21.9% of Lake County residents are Hispanic or Latino. In looking at race independent of ethnicity, 61.4% of residents of Lake County are White and 6.6% are Black. NM LFH defines its community as Lake County in order to facilitate alignment with the Lake County Health Department (LCHD). Northwestern Medicine Central DuPage Hospital Service Area Located in Winfield, Illinois, NMCDH serves the residents of central and western DuPage County and beyond. NMCDH's Hospital Service Area accounts for 70 percent of inpatient admissions. Age distribution in the County includes 23.8 percent infants, children or adolescents (up 0.4 percent from the 2015 CHNA), 63.3 percent of residents are age 18 to 64 (up 1.1 percent), and the 12.9 percent of age 65 or older (up 0.6 percent). In looking at race independent of ethnicity, 79.4% of residents in DuPage County are White and 4.7% are Black. When considering ethnicity, 13.9% of DuPage residents are Hispanic or Latino. The county has a higher proportion of white residents and a lower proportion of black residents than the state and US. The percentage of Hispanic and Latino residents is also lower than found in the state and US. Northwestern Medicine Delnor Hospital Service Area NMDH primarily serves the residents of Kane County. Kane County is the seventh-youngest county in Illinois and notable for its age distribution. The median age remains 34.5 years as compared to the 2015 current Census Bureau average of 36.7 years. Those aged 18 to 24 comprise 61.1 percent of the population; 27.1 percent are age 0 to 17, and 11.7 percent are age 65 or older. Non-Hispanic whites now constitute 72.5 percent of the total population, an increase from 59 percent in the prior CHNA report, and Hispanics now comprise 31.4 percent of the total population. When compared to Illinois and the US in general, the proportion of Hispanics is double in Kane County, and the county has the largest proportion of Hispanics in the state. Northwestern Medicine Kishwaukee Hospital Service Area NMKH serves a majority of DeKalb County residents; the greater part of the county's residents live in the cities of DeKalb and Sycamore. The median age of DeKalb County residents is significantly lower than that of Illinois overall, at 30.3 years, or seven years less than the median age of an Illinois or US resident. 21.4 percent of residents are aged 20 to 29 years and 16.3 percent are aged from 10 to 19 years. Additionally, 11 percent of the population is aged 30 to 39, 11.8 percent comprises 40 to 49 years, 2.4 percent from 50 to 59 years, and 15.8 percent are over 60 years. The county population is 87 percent white, 8 percent black, 3 percent Asian and 2 percent is two or more races. When considering ethnicity, 11 percent of the population identified as Hispanic or Latino. Northwestern Medicine Valley West Hospital Service Area A critical access hospital in Sandwich, Illinois, NMVW primarily serves residents of DeKalb County, demographics as detailed with NMKH. NMVW's Hospital Service Area accounts for 72 percent of inpatient admissions. NM CDH, NM Delnor, NM Kishwaukee and NM Valley West define their CSA based on their Primary Service Area (PSA). The PSA is a contiguous set of ZIP codes within a defined geographical area that accounts for a majority percentage of inpatient admissions. Marianjoy Rehabilitation Hospital Service Area Located in Wheaton, Illinois, MRH largely serves the residents of DuPage County, demographics as discussed with regards to the NMCDH service area of DuPage County as well. However, due to the specialty nature of the hospital, MRH also serves as a destination hospital receiving patient referrals from surrounding counties including Cook, Will, Kane, Kendall, DeKalb and LaSalle. Due to the unique services offered by MRH, the hospital does not use a PSA to define its community. MRH considers DuPage County its CSA, but also serves as a destination hospital for surrounding counties. Patients often travel from Cook, Will, Kane, Kendall, DeKalb and LaSalle counties, among many more, to receive care at MRH. Northern Illinois Medical Center The hospitals comprising NIMC define their primary service area as McHenry County, the sixth-most populous county in Illinois, estimated at 308,570 residents as of 2018 data. The overall population of the service area increased by 18.7% from 2000 to 2010 Census records, significantly greater than the state or national trends for the same time period. The age distribution of the population was 24.6% aged 0-17, 62.5% aged 18-64, and 12.9% aged 65 and older as of the latest data available in 2017. When looking at race independent of ethnicity, 92.4% of residents are White, 2.7 percent are Asian and 1.3 percent are Black. A total of 12.5% of Hospital service area residents are Hispanic or Latino. McHenry County uninsured rates in 2017 were just 5.5% compared to the state uninsured rate of 7.8%. McHenry County also enjoys a relatively high socioeconomic status in comparison to the state at large, with median household income of $82,230 compared to the average $61,229. Together, the three NM hospitals in Chicago's northwest suburbs - NM McHenry, NM Huntley and NM Woodstock - serve the same CSA of McHenry County, which accounts for a majority of inpatient admissions.
Schedule H, Part VI, Line 5 Promotion of community health As described in earlier sections, NMHC believes that its mission to improve the health of the communities it serves is best accomplished in collaboration with partners in the community. The CHNA process and ongoing input from community partners inform how NMHC hospitals prioritize and address community health needs. Along with our many care locations, our community affiliations help us to provide care to residents near where they live or work, with streamlined pathways to access medically necessary hospital-based care. NMHC also sponsors numerous programs to provide mental health services, promote health and wellness, prevent injury and trauma, and provide healthcare career training, youth mentoring, language assistance and volunteer programs to enhance the quality and accessibility of care. Net unreimbursed cost for these activities for FY20 was more than $44 million.
Schedule H, Part VI, Line 6 Affiliated health care system AS DESCRIBED THROUGHOUT THIS FORM 990, THE SUBORDINATES REPORTED IN THIS GROUP RETURN ARE ALL PART OF NORTHWESTERN MEMORIAL HEALTHCARE. THE COMMUNITY BENEFIT PLAN AND COMMUNITY HEALTH NEEDS ASSESSMENT, DESCRIBED EARLIER IN SCHEDULE H, GIVE DETAILS ABOUT EACH SUBORDINATE'S RESPECTIVE ROLE IN PROMOTING THE HEALTH OF THE COMMUNITIES WE SERVE.
Schedule H, Part VI, Line 7 State filing of community benefit report IL
Schedule H (Form 990) 2019
Additional Data


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