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Banner Health
2901 N CENTRAL AVE Suite 160
Phoenix, AZ 85012
EIN: 450233470
The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more
Individual Facility Details: Banner Payson Medical Center807 S Ponderosa
Payson, AZ 85541
Payson, AZ 85541
30 hospitals in organization:
(click a facility name to update Individual Facility Details panel)
(click a facility name to update Individual Facility Details panel)
| Bed count | 44 | Medicare provider number | 030033 | Member of the Council of Teaching Hospitals | NO | Children's hospital | NO |
Banner HealthDisplay data for year:
Community Benefit Spending- 2017
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
11.16%
Spending by Community Benefit Category- 2017
(as % of total functional expenses)
(as % of total functional expenses)
Community Benefit Spending Compared to Functional Expenses, 2015-2017
Additional data
Community Benefit Expenditures: 2017
All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Operating expenses $ 5,798,241,480 Total amount spent on community benefits as % of operating expenses$ 647,287,402 11.16 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 73,436,286 1.27 %Medicaid as % of operating expenses$ 482,318,961 8.32 %Costs of other means-tested government programs as % of operating expenses$ 0 0 %Health professions education as % of operating expenses$ 45,150,773 0.78 %Subsidized health services as % of operating expenses$ 23,480,568 0.40 %Research as % of operating expenses$ 11,008,207 0.19 %Community health improvement services and community benefit operations*
as % of operating expensesNote: these two community benefit categories are reported together on the Schedule H, part I, line 7e.$ 8,413,293 0.15 %Cash and in-kind contributions for community benefit* as % of operating expenses$ 3,479,314 0.06 %Community building*
as % of operating expenses$ 298,404 0.01 %- * = CBI denoted preventative categories
- Community building activities details:
Did tax-exempt hospital report community building activities? YES Number of activities or programs (optional) 0 Physical improvements and housing 0 Economic development 0 Community support 0 Environmental improvements 0 Leadership development and training for community members 0 Coalition building 0 Community health improvement advocacy 0 Workforce development 0 Other 0 Persons served (optional) 0 Physical improvements and housing 0 Economic development 0 Community support 0 Environmental improvements 0 Leadership development and training for community members 0 Coalition building 0 Community health improvement advocacy 0 Workforce development 0 Other 0 Community building expense
as % of operating expenses$ 298,404 0.01 %Physical improvements and housing as % of community building expenses$ 10,000 3.35 %Economic development as % of community building expenses$ 40,961 13.73 %Community support as % of community building expenses$ 27,251 9.13 %Environmental improvements as % of community building expenses$ 0 0 %Leadership development and training for community members as % of community building expenses$ 5,778 1.94 %Coalition building as % of community building expenses$ 98,951 33.16 %Community health improvement advocacy as % of community building expenses$ 0 0 %Workforce development as % of community building expenses$ 115,463 38.69 %Other as % of community building expenses$ 0 0 %Direct offsetting revenue $ 79,111 Physical improvements and housing $ 0 Economic development $ 0 Community support $ 79,029 Environmental improvements $ 0 Leadership development and training for community members $ 82 Coalition building $ 0 Community health improvement advocacy $ 0 Workforce development $ 0 Other $ 0
Other Useful Tax-exempt Hospital Information: 2017
In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.
Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt
as % of operating expenses$ 60,935,816 1.05 %Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program? NO - Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.
Does the organization have a written financial assistance (charity care) policy? YES Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients? YES Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy
as % of operating expenses$ 36,561,489 60.00 %- Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Reported to credit agency Not available Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid? YES The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines? Not available In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.
Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute? NO
Community Health Needs Assessment Activities: 2017
The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.
Did the tax-exempt hospital report that they had conducted a CHNA? YES Did the CHNA define the community served by the tax-exempt hospital? YES Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital? YES Did the tax-exempt hospital make the CHNA widely available (i.e. post online)? YES Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA? YES
Supplemental Information: 2017
This section presents qualitative information submitted by the hospital, verbatim from the 990H record.
- Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4A (Expenses $ 5174702169 including grants of $ 35347374) (Revenue $ 6121590856) SEE SCHEDULE O
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Facility Information
Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.
SCHEDULE H, PART V, SECTION A, LINES 1, 3-9, 11-13, 15-16, 19-27 A SINGLE SCHEDULE H, PART V, SECTION B WAS COMPLETED FOR FACILITY REPORTING GROUP A. THE HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A ARE LISTED IN SCHEDULE H, PART V, SECTION A. SCHEDULE H, PART V, SECTION A, LINES 2 AND 10 BANNER UNIVERSITY MEDICAL CENTER TUCSON AND BANNER UNIVERSITY MEDICAL CENTER SOUTH, RESPECTIVELY, ARE LISTED SEPARATELY AS FACILITY REPORTING GROUP B BECAUSE THEY conducted their CHNA in partnership WITH PIMA COUNTY HEALTH DEPARTMENT, TUCSON MEDICAL CENTER, CARONDELET HEALTH NETWORK, EL RIO COMMUNITY HEALTH CENTER, NORTHWEST MEDICAL CENTER, THE PASCUA YAQUI TRIBE AND HEALTHY PIMA. SCHEDULE H, PART V, SECTION A, LINES 14 AND 28 BANNER CASA GRANDE MEDICAL CENTER AND BANNER GOLDFIELD MEDICAL CENTER ARE LISTED AS FACILITY REPORTING GROUP C, BECAUSE BOTH ENTITIES HAVE THE SAME REPORTING TIMELINE. SCHEDULE H, PART V, SECTION A, LINE 17 BANNER PAYSON MEDICAL CENTER has the same timeline as BANNER CASA GRANDE MEDICAL CENTER AND BANNER GOLDFIELD MEDICAL CENTER. However, it is listed separately AS FACILITY REPORTING GROUP D because it conducted its own CHNA. As a result, Schedule H, Part V, Section B, Line 6 is answered differently than Reporting Group C. SCHEDULE H, PART V, SECTION A, LINE 18 BANNER LASSEN MEDICAL CENTER IS LISTED SEPARATELY AS FACILITY REPORTING GROUP E BECAUSE THE MEDICAL CENTER'S FPG FAMILY INCOME PERCENTAGE LIMIT FOR ELIGIBILITY FOR FREE CARE (350%) VARIES FROM ALL OTHER BANNER FACILITIES (200%). SCHEDULE H, PART V, SECTION A, LINE 20 Banner Fort Collins Medical Center is listed separately from Facility Reporting Group A because Schedule H, Part VI, Section B, Line 3i is answered differently. Banner Fort Collins conducted a CHNA for the first time in 2016 so there were no previously identified needs to evaluate.
THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 3E APPLIES TO ALL HOSPITAL FACILITIES: The significant health needs of the community identified in each hospital facility's CHNA are presented as a prioritized description. THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 3J APPLIES TO ALL HOSPITAL FACILITIES: THE CHNA REPORT INCLUDES IMPLEMENTATION STRATEGIES, TACTICS AND ANTICIPATED OUTCOMES, AS WELL AS THE NEEDS NOT BEING ADDRESSED.
THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 5 APPLIES TO ALL HOSPITAL FACILITIES: THE FACILITY LEADERSHIP TEAMs, IN COLLABORATION WITH MEMBERS OF BANNER HEALTHS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) STEERING COMMITTEE, CREATED A COMMUNITY ADVISORY COUNCIL (CAC) OF COMMUNITY LEADERS THAT REPRESENTED THE UNDERSERVED, UNINSURED AND MINORITY POPULATIONS. CAC PARTICIPANTS WERE IDENTIFIED BASED ON THEIR ROLE IN THE PUBLIC HEALTH REALM OF THE HOSPITALS SURROUNDING COMMUNITY. EMPHASIS WAS PLACED ON IDENTIFYING POPULATIONS WITHIN THE SERVICE AREA THAT ARE CONSIDERED MINORITY AND/OR UNDERSERVED. INDIVIDUALS THAT REPRESENTED THESE POPULATIONS, INCLUDING THE UNINSURED, UNDERSERVED AND MINORITY POPULATIONS WERE INVITED TO PARTICIPATE IN A FOCUS GROUP TO REVIEW AND VALIDATE THE QUANTITATIVE DATA, PROVIDE ADDITIONAL HEALTH CONCERNS AND FEEDBACK AS TO THE UNDERLYING ISSUES AND POTENTIAL STRATEGIES FOR ADDRESSING SAID CONCERNS. ADDITIONAL DIALOGUE OPPORTUNITIES (EMAIL, TELEPHONE CONVERSATIONS AND IN-PERSON MEETINGS) WERE PROVIDED FOR THOSE PERSONS WHO DESIRED TO PARTICIPATE BUT WERE UNABLE TO PERSONALLY ATTEND A FOCUS GROUP SESSION. THOSE DISCUSSIONS INCLUDED FURTHER REVIEW OF THE DATA, EXISTING RESOURCES AND STRATEGIES FOR ADDRESSING THE SIGNIFICANT HEALTH CONCERNS. GIVEN THE OVERLAP IN PRIMARY SERVICE AREAS IN SOME BANNER SERVICE AREAS, FOCUS GROUPS WERE COMBINED. THE FOCUS GROUP PROVIDED INPUT AND INSIGHTS AND EACH CAC PARTICIPANT WAS VESTED IN THE OVERALL HEALTH OF THE COMMUNITY AND BROUGHT FORTH UNIQUE PERSPECTIVES WITH REGARDS TO THE POPULATIONS HEALTH NEEDS. THE CAC PROVIDED BANNER HEALTH WITH THE OPPORTUNITY TO GATHER VALUABLE INPUT DIRECTLY FROM THE COMMUNITY. THERE WAS ADDITIONAL DIALOGUE (VIA EMAIL, TELEPHONE CONVERSATIONS AND IN-PERSON MEETINGS) WITH LEADERS FROM THE RESPECTIVE COUNTY AND STATE PUBLIC HEALTH DEPARTMENTS (MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH, NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES, PLATTE COUNTY PUBLIC HEALTH DEPARTMENT, ETC). TO FURTHER REVIEW THE DATA, EXISTING RESOURCES AND STRATEGIES FOR ADDRESSING THE SIGNIFICANT HEALTH CONCERNS, INCLUDING OPPORTUNITIES FOR COLLABORATION WITH THOSE DEPARTMENTS AND OTHER GOVERNMENT AND NONPROFIT ORGANIZATIONS. Participants in the CHNA process included members of Banner Healths leadership teams and strategic alignment team, public health experts, community representatives and consultants. The CHNA process utilized a multi-faceted approach to data gathering which included: 1. Data Analytics A collection of secondary or quantitative data from existing data sources and community input or qualitative data from focus groups, health providers, policymakers, and meetings with internal leadership were analyzed. The process was reiterative as both the secondary and primary data were used to help inform each other. The advantage of using this approach was validation of data via cross-verification from a multitude of sources. This data along with prior collaborative efforts was used to initiate discussions among the various parties. 2. Community Health Needs Assessment (CHNA) Steering Committee - This committee, which was commissioned to guide the CHNA process, was comprised of professionals from a variety of disciplines across the organization. This steering committee provided guidance in all aspects of the CHNA process, including development of the process, prioritization of the significant health needs identified and development of the implementation strategies, anticipated outcomes and related measures. 3. Community Advisory Council - Facility leadership teams in collaboration with members of Banner Healths CHNA Steering Committee, created a Community Advisory Council (CAC) of community leaders that represented the underserved, uninsured and minority populations. CAC participants were identified based on their role in the public health realm of the hospitals surrounding community. Emphasis was placed on identifying populations within the service area that are considered minority and/or underserved. Data analytics were also used to analyze access gaps and drive CAC participation. Once gaps in access to health services were identified within the community, the steering committee worked with facility leadership to identify those impacted by a lack of health and related services. Individuals that represented these populations, including the uninsured, underserved and minority populations were invited to participate in a focus group to review and validate the data, provide additional health concerns and feedback as to the underlying issues and potential strategies for addressing. Each CAC participant was vested in the overall health of the community and brought forth a unique perspective with regards to the populations health needs. The CAC provided Banner Health with the opportunity to gather valuable input directly from the community. 4. Community Interests - The broad interests of the community were incorporated through a series of focus groups held with members of minority and underserved populations. All primary data collection efforts were intended to obtain information on the most pressing community concerns, identification of community strengths and assets and areas of opportunity for health improvement strategies. Focus group participants were invited to validate the quantitative data, provide additional health concerns and feedback as to the underlying issues and potential strategies for addressing said concerns. Additional dialogue opportunities (email, telephone conversations and in-person meetings were provided for those persons who desired to participate but were unable to personally attend a focus group session. Given the overlap in primary service areas in some Banner service areas, focus groups were combined. 5. Public Health Agencies - Coordination with and involvement from respective county and state public health departments and agencies(Maricopa County Coordinated Health Needs Assessment (CCHNA) collaborative, the Maricopa County Health Improvement Partnership (HIPMC), Maricopa County Department of Public Health (MCDPH), Nevada Department of Health and Human Services, Platte County Public Health Department etc.) to further review the data, existing resources and strategies for addressing the significant health concerns, including opportunities for collaboration with those departments and other government and nonprofit organizations. Banner also participated in the Pima County Community Health Needs Assessment Advisory Committee which represents a county-wide partnership between the Pima County Health Department, Banner, other Pima County Healthcare systems, the Pascua Yaqui Tribe and Healthy Pima.
THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINES 6A & 6B APPLIES TO ALL HOSPITAL FACILITIES: As noted above, in instances where facilities had joint service areas, focus groups were a combined/joint effort. Everything else was facility specific. APPLIES TO FACILITY GROUP B: IN 2016, BANNER UNIVERSITY MEDICAL CENTER - TUCSON AND BANNER UNIVERSITY MEDICAL CENTER - SOUTH PARTNERED WITH Pima County Health Department, Tucson Medical Center, Carondelet Health Network, El Rio Community Health Center, Northwest Medical Center, the Pascua Yaqui Tribe and Healthy Pima TO CONDUCT ITS CHNA. APPLIES TO FACILITY GROUP C: IN 2017, BANNER CASA GRANDE MEDICAL CENTER AND BANNER GOLDFIELD MEDICAL CENTER PARTNERED WITH SUN LIFE FAMILY HEALTH CENTER (A LOCAL FEDERALLY QUALIFIED HEALTH CENTER) AND PINAL COUNTY TO TO CONDUCT THEIR CHNA. THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 7A APPLIES TO ALL HOSPITAL FACILITIES: Each facility posted CHNA to facility website and made copies available upon demand. COMMUNITY HEALTH NEEDS ASSESSMENTS ARE AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTPS://WWW.BANNERHEALTH.COM/STAYING-WELL/COMMUNITY/HEALTH-NEEDS-ASSESSMEN TS-REPORTS
THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 10A APPLIES TO ALL HOSPITAL FACILITIES: THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGIES CAN BE FOUND AT THE URL LISTED ON SCHEDULE H, PART V, SECTION B, LINE 7A.
THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL HOSPITAL FACILITIES: Banners mission is to make health care easier so that life can be better. While we are guided by our purpose which includes answering Americas health care challenges today and in the future, changing the health care landscape in our communities big and small, taking access and delivery from complex to easy, from costly to affordable and from unpredictable to reliable, resources unfortunately and in some cases expertise to pursue all of the significant health needs identified through the CHNA are limited. The process for prioritization included engagement with both internal stakeholders and CAC partners. A review of current and past data, previous actions taken to improve the community and provide additional health concerns and feedback as to the underlying issues and potential strategies for addressing the issues was conducted and once gaps in access to health services were identified within the community, the steering committee worked with facility leadership to identify those impacted by a lack of health and related services. The CHNA Steering Committee in concert with Banner Health leadership and various local agencies developed a prioritization process and criteria for evaluating the significant health needs identified through the CHNA. This group worked diligently to ensure that those strategies and tactics addressed would be impactful, serve as a foundation for future efforts, and be in alignment with the organizations strengths, mission, vision and strategic plan. The significant health needs identified through the CHNA were prioritized based on the below criteria, which took into account the quantitative data, focus group discussion with the CAC and Banners mission, vision and strategic plan. Each significant health need was evaluated based on the criteria, using a ranking of low (1), medium (3), or high (5) for each criterion; all criteria were equally weighted. The criterion scores for each health need were compiled to determine the overall prioritization. Criteria included: - Data indicates a clear need - Priority within the community - Clear disparities exist - Cost of not addressing is high - Desired outcome can be clearly defined - Measures can be identified - Public would welcome the effort - Banner has the ability to impact - Alignment with Banners mission, vision and strategic plan Also included in the prioritization process was a review of resources potentially available to address identified needs including services and programs available through other hospitals, government agencies, and community based organizations. Resources include access to hospital emergency and acute care services, Federally Qualified Health Centers (FQHC), food banks, homeless shelters, school-based health clinics, faith-based organizations, transportation services, health enrollment navigators, free or low cost medical and dental care, and prevention-based community education. Facility priorities and progress from the last CHNA are as follows: (1) BANNER UNIVERSITY MEDICAL CENTER PHOENIX (A) PRIORITIES 1. ACCESS TO CARE 2. MENTAL/BEHAVIORAL HEALTH 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, heath fairs, blood drives) - Opened two OP clinic buildings providing specialty care - Hired 26 new providers CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Hosted monthly support groups BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults - Implemented Inpatient Consultation process for mental health services - On-boarded two new faculty Attendings (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(2) BANNER UNIVERSITY MEDICAL CENTER TUSCON (A) PRIORITIES 1. Anxiety and depression spectrum disorders (Mental and Behavioral Health) 2. Substance abuse and dependency (Mental and Behavioral Health) 3. Injuries, Accidents and Chronic Pain 4. Diabetes (B) Impact of Actions Taken Since Preceding CHNA This is the first Community Health Needs Assessment completed for Banner-university Medical Centers Tucson and South under Banner ownership and there were no previous actions measured or benchmarks to report against. (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED 1. CARDIOVASCULAR DISEASE 2. CULTURALLY & LINGUISTICALLY APPROPRIATELY SERVICES 3. ORAL / DENTAL HEALTH 4. FINANCIAL HEALTH 5. HOME ENVIRONMENT AS TIED TO HEALTH OUTCOMES 6. ACCESS TO EARLY INTERVENTION 7. DEGENERATIVE DISEASES 8. DIRECT CARE WORKFORCE 9. HEALTH LITERACY 10. LESBIAN, GAY, BISEXUAL AND TRANSGENDER (LGBT) HEALTH
(3) BANNER DESERT/CARDON CHILDRENS (A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(4) BANNER THUNDERBIRD MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. Chronic Disease including Alcohol (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, heaLth fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Added Electroconvulsive Therapy (ECT) - Offered Post-Partum Support Groups - Added 12 Inpatient Behavioral Health beds (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(5) NORTH COLORADO MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website CHRONIC DISEASE: - Develop a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials Mental Health: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes (C) SIGNIFICANT NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Dental: - A lack of dental care was a concern to the group, but they felt that until access to care was addressed there was nothing significant that could be done to positively impact this issue. Specialty Care: - Increased specialty care was a topic that seemed to gain some traction. There was productive discussion on potential affiliations with out of network physicians specifically related to neurology, orthopedics, GI and dermatology. It was ultimately determined that the hospital facilities need to expand access to primary care physicians first, which is something already prioritized. Homelessness: - The cost and impact of homelessness in the Colorado area on healthcare resources was an interesting topic. Though we have not had another facility bring this up, the group felt it was an increasing strain on the already stretched resources within the community. There was discussion about the social services already available in the community and the group felt it was sufficient for the time being.
(6) BANNER BOSWELL MEDICAL CENTER "(A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) - Conducted several health expos concerning preventative breast cancer screenings and low dose lung CT screenings. - Conducted several community lecture events that included heart health prevention (signs & symptoms), Stroke, Aphasia, Diabetes, and Alzheimers. CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials - Comprehensive rehabilitation strategies for the geriatric patient TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Conducted several community lectures concerning ""eating heart healthy"" BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease."
(7) BANNER DEL E WEBB MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials - Provided monthly support groups for Stroke patients and families TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Added 22 adult behavioral beds - Services provided for abuse, depression and grief (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(8) BANNER ESTRELLA MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. Chronic Disease including Alcohol (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Highlighted healthy cafeteria options BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(9) BANNER BAYWOOD MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Highlighted healthy cafeteria options BEHAVIORAL HEALTH: - Create a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(10) BANNER UNIVERSITY MEDICAL CENTER Tucson and South (A) PRIORITIES 1. Anxiety and depression spectrum disorders (Mental and Behavioral Health) 2. Substance abuse and dependency (Mental and Behavioral Health) 3. Injuries, Accidents and Chronic Pain 4. Diabetes (B) Impact of Actions Taken Since Preceding CHNA This is the first Community Health Needs Assessment completed for Banner-University Medical Centers Tucson and South under Banner ownership and there were no previous actions measured or benchmarks to report against. (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED 1. CARDIOVASCULAR DISEASE 2. CULTURALLY & LINGUISTICALLY APPROPRIATELY SERVICES 3. ORAL / DENTAL HEALTH 4. FINANCIAL HEALTH 5. HOME ENVIRONMENT AS TIED TO HEALTH OUTCOMES 6. ACCESS TO EARLY INTERVENTION 7. DEGENERATIVE DISEASES 8. DIRECT CARE WORKFORCE 9. HEALTH LITERACY 10. LESBIAN, GAY, BISEXUAL AND TRANSGENDER (LGBT) HEALTH
(11) BANNER GATEWAY MEDICAL CENTER "(A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials - Added oncology massage therapy TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus - Added a Tobacco Recovery Program OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Added ""Nutrition Basics"" program BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Offered Banner Psychological services in clinics (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease."
(12) BANNER HEART HOSPITAL (A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(13) BANNER MCKEE MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Dental: - A lack of dental care was a concern to the group, but they felt that until access to care was addressed there was nothing significant that could be done to positively impact this issue. Specialty Care: - Increased specialty care was a topic that seemed to gain some traction. There was productive discussion on potential affiliations with out of network physicians specifically related to neurology, orthopedics, GI and dermatology. It was ultimately determined that the hospital facilities need to expand access to primary care physicians first, which is something already prioritized. Homelessness: - The cost and impact of homelessness in the Colorado area on healthcare resources was an interesting topic. Though we have not had another facility bring this up, the group felt it was an increasing strain on the already stretched resources within the community. There was discussion about the social services already available in the community and the group felt it was sufficient for the time being.
(14) BANNER CASA GRANDE MEDICAL CENTER (A) PRIORITIES: 1. Physical Activity and Nutrition 2. Substance Abuse 3. Mental Health (B) NEEDS IDENTIFIED BUT NOT PRIORITIZED: Although there are many important needs in the community, the following are not something the hospital felt could be prioritized at this time due to limited resources. - Hypertension - Diabetes - Accident and Injury Prevention - Oral Health - Lack of Primary Care Providers - Lack of Specialists - Access to Affordable Care - Transportation - Access to Affordable Fresh Fruit & Vegetables
(15) BANNER IRONWOOD MEDICAL CENTER (A) PRIORITIES 1. Behavioral Health/Substance Abuse 2. Access to Care 3. Chronic Disease (B) Impact of Actions Taken Since Preceding CHNA Access to Care: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) Chronic Disease - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials Tobacco/Smoking - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus Behavioral Health - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults Obesity/Nutrition - Sponsorships focused on wellness, healthy eating - Online resources, education, recipes (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Nutrition: Nutrition is an issue mostly because services are not coordinated. Apache Junction food bank, although appreciative of everything they receive, finds that donations are not necessarily the most nutritious. Also, many of the homeless need food that does not need to be cooked. This is something the food bank is taking ownership on. Dental Care: The ratio of patients per dental provider, according to the County Health Rankings & Roadmaps is 3,290:1 which is much higher than the National Benchmark of 1,340:1. The group felt there was adequate need for increased services and providers. Senior Services: There are very few services available for seniors which makes sense considering the predominately young population. No skilled facility is located within 20 miles for the elderly. At one time, fresh meals were delivered but that is no longer happening. Queen Creek has a once a week senior program. Many young families are struggling with taking care of aging parents and it was suggested that churches be looked at to see what type of care they are able to provide. Without significant capital investments, the group felt they didnt have the expertise to address this need. Teen Pregnancy: Although teenaged pregnancy is decreasing, it is still an issue. High schools need help to find support. Pinal County is not that much higher than the U.S. benchmark, but it is significantly higher than the state of Arizona. The high school does address this in health classes though. alcohol abuse is taught to sixth graders but not pregnancy prevention.
(16) STERLING REGIONAL MEDICAL CENTER "(A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website CHRONIC DISEASE: - Develop a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes (C) SIGNIFICANT NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time due to another organization already addressing the need or a lack of expertise and/or financial limitations: Dental Care: - There was concern about many dentists retiring and having difficulty being replaced. Appointments to see a dentist can often be long and there is no after-hours care. However, because a local agency, Salud, started offering dental care it has had a significant impact and there are now 4 dentists in town. There will also be a new program called Virtual Dental where a hygienist will go to a patients home and send results back to the dentist. Though it will take about a month to get an appointment, they will try to get patients in for emergencies that same day. Women and Infant Services: - Though there is currently a program called ""Baby Bear Hugs,"" which guides pregnant, high -risk moms through the healthcare system, there are not enough providers to sustain the program. The CAC discussed the need for more services for infants but it was ultimately realized that until access to care barriers were fixed, such as shortages of primary care and specialty physicians, there was little that could be done. Sexually Transmitted Infections: - With higher rates of sexually transmitted infections, the CAC was concerned about a lack of relevant education in the school system. The public health department reported that they normally see higher rates of STIs in the beginning of the school year and during spring breaks. They are currently working on plan so the CAC did not feel it needed to be prioritized."
(17) BANNER PAYSON MEDICAL CENTER (A) PRIORITIES 1. Behavioral Health, including mental health and substance abuse 2. Access to Care 3. Chronic Disease Management, with a focus on diabetes and heart disease (B) Impact of Actions Taken Since Preceding CHNA This is the first Community Health Needs Assessment completed for BANNER PAYSON MEDICAL CENTER and there were no previous actions measured. C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED Obesity: -The group was concerned about the lack of healthy eating education and wellness programs for the community. While the data shows that Gila County is getting worse in this area, it is only slightly higher than the state and national benchmarks and the group also felt there could be simple solutions to improving access to this education and training. Housing Issues: -While the data shows a higher rate of severe housing problems than the national benchmark, it is still lower than the state and something the group did not feel needed to be addressed at this time as there were few realistic resources to leverage. Adolescent population: -While there was a significant concern about the younger population, especially surrounding teenage pregnancy and STI rates, the data did not support prioritizing that as one of the top unmet needs. This is mostly due to the fact that the majority of the population is over the age of 65.
(18) BANNER LASSEN MEDICAL CENTER CRITICAL ACCESS "(A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participated in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Offered ""Manicures, Massages and Mammograms"" for community members BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Due to limited resources and staffing, there were many needs that came up but were ultimately left out of the priorities as the potential for impact was deemed insignificant or it was already being addressed elsewhere. Suicide among Adults: - Because Lassen is home to two correctional facilities, the high suicide/depression rate of correctional officers is very high. The shortage of officers, exhaustion, turbulent work environment, and difficult population all play a role. There were also high incidences of domestic violence and PTSD in this field. The CAC did not feel they had the resources to address this need. Senior Care: - It was pointed out that Home Health and hospice are not something readily accessible in the community, and for the services that are offered, most are only accepting Medicare. Although there are other Banner facilities that offer this service, Banner Lassen is not one of them and it was discussed that this is something not realistically changing in the near future without a capital investment. The financial implications made this difficult to address. Transportation: - While transportation is tied to access to care, the focus group participants felt it was important enough to stand out on its own. Due to the proximity of specialized care, many patients inside Susanville are not able to afford to take time off of work and drive to Reno, which is the closest area for care not found in Lassen County. Aside from the financial burden this creates, many people are also not well enough to make the trip. The almost 300 miles required to get to Reno is a difficult trek for ill patients. Due to other services provided in the community, the group felt this was being adequately addressed."
(19) BANNER CHURCHILL COMMUNITY HOSPITAL "(A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Appointment scheduling/Promote ""MyBanner"" online portal - Offered educational materials and links via BannerHealth.com - Resources to insurance marketplace - Free community vaccination clinic - 3D mammography tomosynthesis - Direct access endoscopy - Wellness Wednesdays discounted lab services - Community CPR classes - Childbirth classes - Active recruitment of providers CHRONIC DISEASE: - Offered educational materials and links via BannerHealth.com - Physicians facilitating events/media sources - Ladies Night Out - ""Ask the Expert"" - CME courses - Paramedic courtesy visits for high-risk patients - Pursuit of telemedicine capabilities - RN Case Manager Support BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse Creation of on-call mental health team for ED - Expanded telehealth for behavioral and mental health patients - Sought out partnerships with regional health facilities - Paramedic transfer of behavioral patients - CEO participation on Churchill County Board of Health - Promoted expansion of mental health services - Mental health court partnerships TOBACCO/SMOKING: - ""Quitline Nevada"" - 1-800-QUITNOW - Partnership with Churchill County Coalition - Patient discharge instructions/information regarding smoking cessation opportunities from RN OBESITY/NUTRITION: - Sponsor/Support local activities: - Local 5Ks - Fallon Youth Club bike ride - No Hill 100 - ""Healthy Choices Healthy You"" coloring contest - Dietician nutritional consults - BCCH Activities Committee - BCCH walking path for employees/community - BCCH employee Biometrics health screenings - Caf/vending healthy options - Banner Healthy Eating Goals Bannerhealth.com: - Considerations for diet and disease/tips/recipes (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Dental care: - The ratio of patients per dental provider, according to the County Health Rankings & Roadmaps is 1,500:1 which is higher than the National Benchmark of 1,340:1. The group felt there was adequate need for increased services and providers, but that the current access to dental care was enough to get by. Rehabilitation for drug/alcohol addiction: - This was another important topic, but the group felt that addressing behavioral and mental health had to come first before this issue could be dealt with. Also, they did not feel the resources existed as significant costs and infrastructure would be required. Affordability of care: - This was a high priority in our discussions. In fact, this seemed to be the highest ranked issue among our focus group. However, when we dug deeper into the issues, it was realized that until there was proper and sufficient access to services, affording care was less of the problem. This topic is something that can be addressed in the future once reasonable action for improving access to care surfaces."
(20) BANNER FORT COLLINS MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. Behavioral Health, including mental health and substance abuse 3. Chronic Disease Management, with a focus on diabetes and heart disease (B) Impact of Actions Taken Since Preceding CHNA This is the first Community Health Needs Assessment completed for Banner Ft. Collins Medical Center and there were no previous actions measured. (C) SIGNIFICANT NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Dental: - A lack of dental care was a concern to the group, but they felt that until access to care was addressed there was nothing significant that could be done to positively impact this issue. Specialty Care: - Increased specialty care was a topic that seemed to gain some traction. There was productive discussion on potential affiliations with out of network physicians specifically related to neurology, orthopedics, GI and dermatology. It was ultimately determined that the hospital facilities need to expand access to primary care physicians first, which is something already prioritized. Homelessness: - The cost and impact of homelessness in the Colorado area on healthcare resources was an interesting topic. Though we have not had another facility bring this up, the group felt it was an increasing strain on the already stretched resources within the community. There was discussion about the social services already available in the community and the group felt it was sufficient for the time being.
(21) EAST MORGAN HOSPITAL "(A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Extended clinic hours from 7am 8pm CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings, cooking demos, diabetes education and educational materials at Health Fairs MENTAL HEALTH: - Create a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults - Participated in community forums for addressing resource needs TOBACCO/SMOKING: - Created a webpage with information and resources related to mental health and substance abuse - Provider to provider telephone consults OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education and support - Highlighted healthy cafeteria options - Partnered with Kaiser on ""Weigh and Win"" with a total of 800 lbs lost by 600 participants (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Transportation: - While there are Case management teams in the hospital, when they discharge a patient who doesnt have a vehicle or cant drive, they cant get to their follow up appointments and often end up back in the emergency department. It was suggested that if a hospital could add transportation services, patient readmission numbers may decrease. Another problem seen is that some people who come in by ambulance dont have a ride home. This causes strains on resources. Sometimes employees and police officers will take patients home but can only take them so far. The group felt that a long-term strategy would be very difficult to accomplish without financial funding and discussed groups in town already addressing this area. Sexually Transmitted Infections: - With the advances in technology, there have been more sexually transmitted outbreaks. Mobile dating apps that have an anonymous sex focus, could have an impact on increased STIs but its very hard to capture that data unless it is self-reported. The health department thought that these cases had historically been controlled before the mainstream accessibility to ""casual sex."" Legalization of marijuana was seen as having an impact on this as well. Colorado has the second highest rates in country for STIs but the Health Department discussed measures they were taking towards improving this statistic."
(22) BANNER BEHAVIORAL HEALTH HOSPITAL (A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating BEHAVIORAL HEALTH: - Create a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults - Partnered with Banner Psychiatric Center to deploy tele-health services to patients presenting in the Emergency Department with mental health and or substance abuse issues (C) SIGNIFICANT HEALTH NEEDS NOT PRIORITIZED While Banner Health seeks to improve all health and address all needs of our community, it is not feasible or realistic to take an isolated approach to those issues. We have come to realize the value of a community wide collective impact approach. Though we cannot address all the issues identified in the CHNA report, we are being proactive by partnering with the Health Improvement Partnerships of Maricopa County to strategically address issues identified in our CCHNA report and common to other parts of the community. We will be looking at collective impact partnerships in which we agree upon common goals or agendas; agree upon measures; maintain excellent and continuous communications; utilize the continued backbone support of Maricopa County Department of Public Health; and be intentional and reinforcing with the activities and strategies we coordinate. While we will continue to offer programs and services within the hospital to specifically address the top issues found in our report, we will now seek to utilize the power of a community-wide approach to addressing the other issues found in our CHNA report. We are currently in talks with the HIPMC collaborative to design a strategic plan that will address, not only our health needs, but the health needs of all Maricopa County residents. Decreasing Alcohol and Tobacco use is one example of a need identified but not prioritized by Banner Health. This issue was addressed in the previous cycle and because we saw a positive impact in the number of users, we wanted to address one of the more pressing needs in our community. Air quality was another topic of discussion, but we felt the need was better suited to be addressed by another community agency with more experience in that realm. While we know improved air quality can have an impact on chronic diseases, we felt comfortable potentially addressing any areas related to this in the ongoing improvement plans for chronic disease.
(23) COMMUNITY HOSPITAL - TORRINGTON (A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Dental: - Overall health is an indicator of over-all accountability for dental care. Teaching the importance of good dental health doesnt seem to be important to a lot of people. The habit needs to be taught to children early on but if the parents dont value dental health, then the kids learn to not value the habit as well. Though there is already outreach happening in the community, the group would like to see more. The five dental providers in the community try to provide education and outreach so the group felt that was sufficient for the time being. Tobacco: - Though this issue didnt seem to be as important as the last cycle, the CAC pointed out the increase in the use of smokeless tobacco and e-cigarettes. There is currently a lot of support for people who want to quit, and while the hospital supports a smoke free campus, the CAC was pleased to see the rates of smoking decrease since the previous cycle of the CHNA.
(24) WASHAKIE MEDICAL CENTER (A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Senior Care: - The group felt that enough was being done in the community by social services to address the needs of seniors, but they did want to explore better collaboration in engaging this group. Fall prevention and education was discussed as a possible focus area to help prevent re-admissions. Smoking/Tobacco Use: - The data from County Health Rankings show an 11 percent decrease in smoking from 2013-2015. Though the CAC was happy with this rate, they were concerned about the potential that e-cigarettes could negatively impact the numbers as it becomes more and more popular. Injury Deaths: - Due to the farming and heavy machinery used in Washakie, the CAC was mildly concerned about the potential increase in this area. It wasnt something they felt should be addressed at this time, but they wanted to make a note of it for the future.
(25) Page Hospital (A) PRIORITIES 1. ACCESS TO CARE 2. Mental/Behavioral Health 3. CHRONIC DISEASE INCLUDING ALCOHOL (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Offered and participate in free health activities (screenings, health fairs, blood drives) CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Technology: - Page is planning to update the broadband service, however internet, phone and wireless service is a significant problem. With inconsistent access to phone service, patients and providers experiences more difficulty in scheduling and following up on care. Senior care: - The priorities above were so significant that a third priority was hard to choose from the other needs identified. However, senior care did seem to be significant and will be addressed through Access to Care. The community is encouraging Compass to open a nursing home. There are also swing beds coming. Currently there is no assisted living care and the closest nursing home is 130 miles away. There is a lack of long term care and rehab facilities and many of the elderly in town move away because there is no local care available.
(26) PLATTE COUNTY MEMORIAL HOSPITAL (A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website CHRONIC DISEASE: - Developed a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials MENTAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Access to Specialty Care: - The CAC felt that until access to care in general was improved, tackling specialty care would be too challenging. Working on preventative care and expanded education and outreach on maintaining ones health seemed sufficient for the time being. Child Abuse/Elder Abuse: - The CAC felt they were seeing higher rates of child and elder abuse in their community but werent sure that the resources were something we had to address it. The members of the CAC that represented senior citizens said there was training available on how to spot signs of elder abuse but not a lot else. Domestic Violence: - Though there was much conversation about domestic violence, the CAC felt that a lot of it had to do with substance abuse and alcohol abuse and could be addressed in the mental and behavioral health arena.
(27) OGALLALA COMMUNITY HOSPITAL (A) PRIORITIES 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH/SUBSTANCE ABUSE 3. CHRONIC DISEASE (B) Impact of Actions Taken Since Preceding CHNA ACCESS TO CARE: - Promoted participation in MyBanner (online patient portal) - Offered educational materials and links to community resources related to the insurance marketplace - Promoted internal and external community resources that support preventative and maintenance care via the facility website - Hired 2 new providers for the community CHRONIC DISEASE: - Develop a Chronic Disease webpage on the facility website to increase on-line educational opportunities and resource awareness - Expanded Diabetic Education and Nutrition programs - Provided health screenings and educational materials BEHAVIORAL HEALTH: - Created a webpage with information and resources related to Mental Health and Substance Abuse - Provider to provider telephone consults TOBACCO/SMOKING: - Partnered with the State Quit Line to build the Proactive Referral into the Banner Medical Group clinic workflows - Supported a Tobacco Free campus OBESITY/NUTRITION: - Sponsorships focused on wellness, healthy eating - Online education, support and recipes (C) SIGNIFICANT HEALTH NEEDS IDENTIFIED BUT NOT PRIORITIZED Although there are many important needs in the community, the following are not something the CAC felt could be prioritized at this time. Transportation: - This is becoming more significant as people cant get a ride home from hospital if they are outside city limits. They may also have appointments outside the county and cant get to them. While there is a handi-bus outside the city limits which helps people to schedule appointments and shopping, it is not a long term solution as the schedule is limited. Due to increasing support for the handi-bus, it was thought that services may be expanding and the need was going to be addressed. Senior Services: - An aging population affects the need for access to care, preventative care and mental health services. If this was focused on in the future, it could possibly reduce medical costs later on. Lack of long range planning and end of life directives are something that could be impacted by simple education and outreach. Because services for this would require a capital investment, it was not something the CAC felt they could have an impact on and it. Tobacco Use: - Smokeless tobacco is becoming an issue as well as e-cigarettes. Children drinking vapor liquid was mentioned as increasing the number of calls to poison control. Because this is a newer trend, the group wanted to wait and see data in the next cycle of CHNA. Also, the rates of smoking decreased since the previous CHNA and the group agreed it should not be prioritized.
(28) BANNER GOLDFIELD MEDICAL CENTER (A) PRIORITIES: 1. Physical Activity and Nutrition 2. Substance Abuse 3. Mental Health (B) NEEDS IDENTIFIED BUT NOT PRIORITIZED: Although there are many important needs in the community, the following are not something the hospital felt could be prioritized at this time due to limited resources. - Hypertension - Diabetes - Accident and Injury Prevention - Oral Health - Lack of Primary Care Providers - Lack of Specialists - Access to Affordable Care - Transportation - Access to Affordable Fresh Fruit & Vegetab
THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 16A-C APPLIES TO ALL HOSPITAL FACILITIES: THE FAP, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING URL FOR ALL HOSPITAL FACILITIES: WWW.BANNERHEALTH.COM/PATIENTS/BILLING/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16j In addition to all actions noted, Banner offers FAP with each billing statement to the patient/guarantor. THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 18 APPLIES TO ALL HOSPITAL FACILITIES: Banner Health makes reasonable efforts to determine the patient's eligibility under the facility's FAP BEFORE taking any action - up to and including any noted. THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 19 APPLIES TO ALL HOSPITAL FACILITIES: BANNER HEALTH DOES NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS (UP TO AND INCLUDING ANY ACTIONS NOTED IN PART VI, LINE 19), EITHER DIRECTLY OR BY ANY DEBT COLLECTION AGENCY OR OTHER PARTY TO WHICH THE HOSPITAL HAS REFERRED THE PATIENTS DEBT, BEFORE REASONABLE EFFORTS ARE MADE TO DETERMINE WHETHER A RESPONSIBLE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE FAP. THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 22 APPLIES TO ALL HOSPITAL FACILITIES: DURING THE TAX YEAR, FOR ALL UNINSURED PATIENTS WHO HAVE A HOUSEHOLD ANNUAL INCOME OF LESS THAN $125,000, THE MAXIMUM AMOUNT CHARGED FOR INPATIENT SERVICES IS THE AMOUNTS GENERALLY BILLED (AGB) FOR THAT HOSPITAL. HOSPITAL AGB IS THE SUM OF ALL CLAIMS FOR MEDICALLY NECESSARY SERVICES PROVIDED AT SUCH HOSPITAL PAID DURING THE RELEVANT PERIOD BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF CO-PAYS, CO-INSURANCE OR DEDUCTIBLES, BY THE USUAL AND CUSTOMARY CHARGES FOR SUCH MEDICALLY NECESSARY SERVICES.
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Supplemental Information
Schedule H (Form 990) Part VI
SCHEDULE H, PART I, LINE 3A THE FEDERAL POVERTY GUIDELINES (FPG) FAMILY INCOME LIMIT FOR ELIGIBILITY FOR FREE CARE IS 200% FOR HOSPITAL FACILITIES LOCATED IN ARIZONA, COLORADO, NEBRASKA, NEVADA, AND WYOMING. THE FPG FAMILY INCOME LIMIT FOR ELIGIBILITY FOR FREE CARE IS 350% FOR THE HOSPITAL FACILITY LOCATED IN CALIFORNIA. SCHEDULE H, PART I, LINE 3C BANNER HEALTH (BANNER/BH) USES FPG. DEDICATED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS REGARDLESS OF AGE, SEX, RACE, RELIGION, DISABILITY, VETERAN STATUS, NATIONAL ORIGIN AND/OR ABILITY TO PAY DETERMINATIONS ARE MADE BASED UPON BANNERS FINANCIAL ASSISTANCE POLICY. BHS FINANCIAL ASSISTANCE PROGRAM IS INTENDED TO ADDRESS THE DUAL INTERESTS OF PROVIDING ACCESS TO CARE TO THOSE WITHOUT THE ABILITY TO PAY (ECONOMIC INDIGENCE) AND TO OFFER A DISCOUNT FROM BILLED CHARGES FOR THOSE WHO ARE ABLE TO PAY A PORTION OF THE COSTS OF THEIR CARE (MEDICAL INDIGENCE). THIS POLICY ESTABLISHES TWO FINANCIAL ASSISTANCE PROGRAMS, THE BASIC FINANCIAL ASSISTANCE PROGRAM AND THE ENHANCED ASSISTANCE PROGRAM. UNDER THE BASIC FINANCIAL ASSISTANCE PROGRAM, UNINSURED PERSONS HAVING ANNUAL HOUSEHOLD INCOMES OF $125,000 OR LESS WILL QUALIFY FOR FINANCIAL ASSISTANCE IN THE FORM OF DISCOUNTED PRICING COMPARABLE TO THAT AVAILABLE TO COMMERCIAL INSURANCE PAYORS WITHOUT HAVING TO APPLY FOR MEDICAID ASSISTANCE. UNDER THE ENHANCED FINANCIAL ASSISTANCE PROGRAM, UNINSURED PERSONS HAVING HOUSEHOLD INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LINE WILL QUALIFY FOR FINANCIAL ASSISTANCE IN THE FORM OF SUBSTANTIAL DISCOUNTS OR FREE CARE, SUBJECT TO APPLICATION FOR MEDICAID ASSISTANCE. BH MAKES EVERY EFFORT TO COMPLETE A FINANCIAL EVALUATION AT THE EARLIEST POSSIBLE POINT IN THE REGISTRATION/COLLECTION PROCESS FOR ALL PATIENTS INDICATING AN INABILITY TO MEET THEIR FINANCIAL OBLIGATIONS. BANNER WILL PROVIDE A FINANCIAL ASSISTANCE PROGRAM APPLICATION AFTER ALL OTHER OPTIONS FOR REIMBURSEMENT HAVE BEEN EXHAUSTED. SEE PART VI, LINE 3 FOR INFORMATION ON HOW PATIENTS ARE MADE AWARE OF BHS FINANCIAL ASSISTANCE PROGRAM.
SCHEDULE H, PART I, LINE 6A BANNER HEALTH PREPARES AN ANNUAL SYSTEM REPORT OF COMMUNITY BENEFIT ACTIVITIES AS WELL AS AN ELECTRONIC BANNER HEALTH COMMUNITY UPDATE WHICH INCLUDES A COMMUNITY MESSAGE, AND HIGHLIGHTS COMMUNITY LEADERSHIP, AND SUPPORT. Banner Health Community Health Needs Assessments are located at https://www.bannerhealth.com.
SCHEDULE H, PART I, LINE 7 1) FINANCIAL ASSISTANCE AT COST, MEDICAID AND OTHER MEANS TESTED GOVERNMENT PROGRAMS - USING THE COST-TO CHARGE METHODOLOGY DETERMINED BY THE COST ACCOUNTING SYSTEM, THE RATIO OF PATIENT CARE COST TO CHARGES OR RELATIVE VALUE UNITS IS APPLIED TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF FINANCIAL ASSISTANCE. THE COST ACCOUNT SYSTEM ADDRESSES ALL PATIENT SEGMENTS AT THE ACUTE CARE FACILITIES. THE COST ACCOUNTING APPLICATION IS NOT IMPLEMENTED AT THE HEALTH CENTERS, PHYSICIAN PRACTICES, HOME CARE, SURGICAL CENTERS, OR OCCUPATIONAL HEALTH. 2) COMMUNITY HEALTH IMPROVEMENT BANNER USES THE CBISA, COMMUNITY BENEFIT INVENTORY TOOL TO COORDINATE AND ESTIMATE THE COSTS ASSOCIATED WITH COMMUNITY HEALTH IMPROVEMENT INITIATIVES. 3) HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, AND RESEARCH ACTUAL COST LESS REIMBURSEMENTS AS REPORTED IN THE GENERAL LEDGER ARE USED TO VALUE THESE ACTIVITIES, WHICH OPERATED AT A LOSS PROVIDE INVALUABLE SERVICES TO BH COMMUNITIES. 4) CASH AND IN-KIND CONTRIBUTIONS ACTUAL OR FAIR MARKET VALUE IS USED TO VALUE THESE CONTRIBUTIONS OR ACTIVITIES.
SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICES REPORTED IN SECTION 7G INCLUDES, AMONG OTHER THINGS, ALZHEIMER'S MEMORY DISORDER AND RESIDENTIAL TREATMENT PROGRAMS, POISON AND DRUG INFORMATION SERVICES, PALLIATIVE CARE CLINICS, TRAUMA CARE, BURN CLINICS, PRESCRIPTION ASSISTANCE PROGRAMS, BEHAVIORAL HEALTH CARE, FUNDED FOLLOW-UP AND CONTINUING CARE FOR INDIGENTS, SENIOR ADULT DAY CARE, COMMUNITY BASED PRENATAL PROGRAM FOR UNDER/UNINSURED MOTHERS, SCHOOL-BASED CLINIC ACTIVITIES, WOMEN'S AND CHILDREN'S SERVICES, FREE/REDUCED MAMMOGRAMS AND BONE DENSITY TESTS AND PROGRAMS FOR THE CHRONIC INEBRIATE POPULATION. OPERATED AT A LOSS, RESPECTIVE BH COMMUNITIES WOULD BE DEPRIVED OF THESE SERVICES IF NOT FOR THE ORGANIZATION'S INVOLVEMENT.
SCHEDULE H, PART II IN FURTHERANCE OF ITS EXEMPT MISSION, BH PROVIDES A BROAD RANGE OF BENEFITS TO THE COMMUNITIES IT SERVES. THESE ACTIVITIES PROMOTED THE HEALTH, SAFETY AND WELL-BEING OF LOCAL COMMUNITIES BY PROVIDING ADVOCACY SERVICES TO ITS CONSTITUENTS THROUGH PARTICIPATION IN LOCAL AND NATIONAL HEALTH CAMPAIGNS, ENHANCING COMMUNITY WORKFORCE THROUGH RECRUITMENT FOR MEDICALLY UNDERSERVED AREAS, PROVISION OF LEADERS TO DEVELOP LOCAL TALENT, PROVISION OF STAFF FOR COMMUNITY VOLUNTEERISM, RECOGNIZING THE EMPLOYEE VOLUNTEER BASE, PARTICIPATION IN VARIOUS COMMUNITY AWARENESS PROGRAMS, INVOLVEMENT IN COMMUNITY ECONOMIC DEVELOPMENT EFFORTS AND BEING A GOOD CORPORATE CITIZEN. THE RESULTS OF THESE EFFORTS INCLUDE BUT ARE NOT LIMITED TO: -PROMOTING COMMUNITY HEALTH -PROVIDING VOLUNTEER LEADERSHIP TO LOCAL BOARDS AND TASK FORCES THEREBY ALLOWING THE ENTITY TO CHANNEL RESOURCES TO THE COMMUNITY NEED INSTEAD OF SALARIES. -PROVIDING FEDERAL MEDICALLY UNDERSERVED AREAS WITH PHYSICIANS. -PROVIDING DISASTER TRAINING AND EDUCATION TO IMPROVE COMMUNITY SAFETY AND AWARENESS FOR RESIDENTS. -PARTNERING WITH LOCAL BLOOD BANKS TO BLOOD COMBAT SHORTAGES. -PROVIDING MEETING ROOM, ELECTRONIC TELECONFERENCE TECHNOLOGY AND OTHER SPACE FOR VARIOUS COMMUNITY GROUPS. WITHOUT THESE IN-KIND DONATIONS, THESE ORGANIZATIONS WOULD BE REQUIRED TO EXPEND FUNDS, FUNDS NEEDED IN SUPPORT OF THEIR MISSIONS FOR SPACE RENTAL -PARTNERING WITH LOCAL UNITED WAY AGENCIES TO IMPROVE AND ENHANCE COMMUNITY INITIATIVES. -SUPPORT OF COMMUNITY SOCIAL SERVICE NEEDS THROUGH EMPLOYEE FOOD AND CLOTHING INITIATIVES.
SCHEDULE H, PART III, LINE 1 "BH WRITES OFF BAD DEBT AS AN OPERATING EXPENSE (AS OPPOSED TO A REDUCTION IN ALLOWANCE). BAD DEBT RESERVES ARE EVALUATED MONTHLY. THIS METHODOLOGY ALLOWS THE ORGANIZATION TO ARRIVE AT THE SAME POSITION DESCRIBED IN THE HFMA'S STATEMENT 15, ""VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS."" HOWEVER, BH DOES NOT WRITE DOWN SELF-PAY ACCOUNTS USING A CONTRA REVENUE ACCOUNT UNLESS WE HAVE DEEMED IT FINANCIAL ASSISTANCE, WHICH IS A VARIANCE FROM THE STATEMENT (WHICH REQUIRES A WRITE-DOWN OF THE RECEIVABLE TO THE COLLECTIBLE AMOUNT USING A CONTRA REVENUE ACCOUNT)."
SCHEDULE H, PART III, LINE 2 THE PATIENT CARE COST-TO-CHARGES RATIO IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO ACCOUNTS/AMOUNTS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.
SCHEDULE H, PART VI, LINE 6 THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
SCHEDULE H, PART VI, LINE 7 AS REQUIRED BY LAW, BANNER FILES A COMMUNITY BENEFIT REPORT IN CALIFORNIA. BANNER ALSO REPORTS IN THOSE STATES WITH VOLUNTARY HOSPITAL ASSOCIATION REPORTING REQUIREMENTS (COLORADO AND NEBRASKA).
SCHEDULE H, PART III, LINE 3 PREVIOUSLY THE ORGANIZATION ENGAGED A THIRD PARTY TO ASSESS THE VALIDITY OF ACCOUNTS ATTRIBUTABLE TO BAD DEBT AND TO ANALYZE WHAT PERCENT OF BAD DEBT COULD BE/SHOULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD OTHERWISE HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE BH FINANCIAL ASSISTANCE POLICIES. BASED ON THAT STUDY, BH ESTIMATES THAT IN EXCESS OF 60% OF THE PATIENT ACCOUNTS COMPRISING THE ORGANIZATIONS BAD DEBT MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER BH POLICIES. FOLLOWING THIS STUDY, THE ORGANIZATION ENDEAVORED TO ENHANCE EFFORTS TO INFORM PATIENTS OF ITS FINANCIAL ASSISTANCE POLICIES. HOWEVER, IN ORDER TO ENSURE THAT THE ORGANIZATIONS ENHANCED FINANCIAL ASSISTANCE POLICY IS UTILIZED ONLY BY THOSE PERSONS WHO TRULY REQUIRE SUCH ENHANCED ASSISTANCE, THE POLICY REQUIRES THAT PATIENTS MUST FIRST COMPLETE AN APPLICATION, PROVIDE SUPPORTING DOCUMENTATION AND (WITH SOME EXCEPTIONS) APPLY FOR MEDICAID. DESPITE ENCOURAGEMENT BY THE ORGANIZATION, THERE ARE MANY TIMES WHEN THE PATIENT REFUSES OR IS UNABLE TO COMPLETE AN APPLICATION TO BH, PROVIDE INFORMATION TO SUPPORT QUALIFICATION, OR APPLY FOR MEDICAID.
SCHEDULE H, PART III, LINE 4 1) FOOTNOTE PER AUDITED FINANCIAL STATEMENTS (PAGE 13): NET PATIENT ACCOUNTS RECEIVABLE FOOTNOTE: NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICES REVENUES HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. MANAGEMENT ESTIMATES THE PROVISION FOR DOUBTFUL ACCOUNTS AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR EACH MAJOR PAYOR BASED UPON HISTORICAL COLLECTION EXPERIENCE OF EACH FACILITY. BANNER EVALUATES A PATIENTS ABILITY TO PAY FOR SERVICES BASED ON AN ENTITY-WIDE ASSESSMENT, AND AS PART OF THIS ASSESSMENT HAS DETERMINED THAT MANAGEMENT DOES NOT ASSESS THE PATIENTS ABILITY TO PAY FOR THE MAJORITY OF SELF-PAY PATIENTS. ACCORDINGLY, ANY PATIENT ACCOUNT WRITE-OFF IS RECORDED WITHIN THE PROVISION FOR DOUBTFUL ACCOUNTS AS A REDUCTION OF PATIENT SERVICE REVENUE. MANAGEMENT REGULARLY REVIEWS PAYMENT DATA FOR EACH MAJOR PAYOR IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. 2)COSTING METHOLOGY THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.
SCHEDULE H, PART III, LINE 8 The Medicare Cost Reports that hospitals are required to file do not include all of the costs required to treat Medicare patients. Using a financial statement cost-to-charge ratio methodology, the 2017 result is a Medicare surplus of $29.9 M. This situation is not anticipated to continue and a return to a shortfall position is projected as calculations reflected on the Cost Report do not customarily take into account all costs incurred by the organization and differs from the cost reflected on the financial statements. Future Medicare shortfalls should be treated as community benefit because absent this program, many individuals would qualify for financial assistance and other needs-based programs, by accepting payment below cost to treat these individuals, the burdens of the government are relieved, and the amount spent to cover the Medicare shortfall is money not available to cover financial assistance and other community benefit needs.
SCHEDULE H, PART III, LINE 9B BANNER HEALTH'S FINANCIAL ASSISTANCE POLICIES REQUIRE THAT THE ACCOUNTS OF PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE BE WRITTEN OFF EITHER IN FULL OR IN PART, DEPENDING UPON THE LEVEL OF THE FINANCIAL ASSISTANCE FOR WHICH THE PATIENT HAS QUALIFIED. IF THE ACCOUNT IS NOT WRITTEN OFF COMPLETELY, THE REDUCED BALANCE IS TREATED IN THE SAME MANNER AS ACCOUNTS FOR PATIENTS WITHOUT INSURANCE WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. FOR THOSE PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE AND FOR THE PORTION OF THE ACCOUNTS REMAINING AFTER APPLICATION OF THE FINANCIAL ASSISTANCE POLICIES FOR PATIENTS WHO QUALIFY FOR SUCH ASSISTANCE, ACCOUNT COLLECTION PROCESS IS AS FOLLOWS: 1) THE PATIENT OR GUARANTOR WILL RECEIVE 3 STATEMENTS PRIOR TO THE ACCOUNT BEING PLACED WITH AN OUTSIDE AGENCY. THE STATEMENT PROCESS INVOLVES 3 STATEMENT CYCLES FOR EACH ACCOUNT: (A) 1 DAY AFTER FINAL BILL, (B) 36 DAYS AFTER FINAL BILL, AND (C) 71 DAYS AFTER FINAL BILL. THE PROCESS TAKES 105 DAYS TO COMPLETE. THE ACCOUNT IS SENT TO COLLECTIONS 5 DAYS AFTER THE FINAL STATEMENT CYCLE. 2) ATTEMPTS ARE MADE TO VERIFY PHYSICAL LOCATION OF PATIENT AND ALSO TO DETERMINE IF THE PATIENT MAY BE ELIGIBLE FOR AHCCCS/MEDICAID COVERAGE. IN ADDITION AN ATTEMPT IS MADE VIA PHONE BASED ON THE GUARANTORS PROPENSITY TO PAY AND A DETERMINED DOLLAR AMOUNT FOR THE TOP 50% OF OUR CUSTOMERS. 3) ACCOUNTS ARE TURNED OVER TO AN OUTSIDE AGENCY UNDER CONTRACT WITH BH WHEN ALL EFFORTS HAVE BEEN EXHAUSTED. 4) ONCE ASSIGNED TO AN OUTSIDE COLLECTION AGENCY, VARIOUS DEBT COLLECTION PRACTICES ARE UTILIZED IN DIFFERENT STATES, DEPENDING UPON LOCAL CUSTOM AND PRACTICE. IN ALMOST ALL SITUATIONS, THE COLLECTION AGENCY ATTEMPTS TO OBTAIN PAYMENT FROM THE PATIENT BY MEANS OF DIRECT TELEPHONE CONTACT. IF THIS IS UNSUCCESSFUL, FAILURE TO MAKE PAYMENT UPON AN ACCOUNT RESULTS IN A REPORT TO A CREDIT AGENCY. IN CERTAIN STATES, THE COLLECTION AGENCY WILL FILE A COLLECTION LAWSUIT TO OBTAIN A JUDGMENT UPON THE UNPAID ACCOUNT, DEPENDING UPON THE ASSESSMENT OF THE AGENCY AS TO THE POTENTIAL COLLECTABILITY OF THE ACCOUNT. IN THE ORGANIZATIONS PRIMARY STATE, ARIZONA, LAWSUITS ARE RARELY INITIATED, TYPICALLY ONLY WHEN THERE IS REASON TO BELIEVE THAT THE PATIENT HAS SUFFICIENT NET ASSETS TO PAY THE ACCOUNT AND REQUIRE THE PRIOR APPROVAL OF BH.
SCHEDULE H, PART VI, LINE 2 BANNER HEALTH UTILIZES ITS STRATEGY AND PLANNING TEAM TO CONTINUALLY IDENTIFY AREAS IN THE COMMUNITIES BH SERVES WHERE INSTITUTIONAL CLINICAL NEEDS ARE NOT BEING SATISFIED ESPECIALLY FOR THOSE WITHIN UNDERSERVED, UNINSURED AND MINORITY POPULATIONS. IT ALSO LEVERAGES A MULTI-PHASED APPROACH TO UNDERSTANDING GAPS IN SERVICES PROVIDED TO COMMUNITIES SERVED BY HOSPITALS WITHIN THE SYSTEM AS WELL AS COMMUNITY RESOURCES THROUGH A COMBINATION OF POPULATION GROWTH AND CHANGING DEMOGRAPHICS ANALYSIS, DETAILED ANALYSIS OF NATIONAL, STATE AND COUNTY DATA SOURCES, HEALTHCARE SERVICES AVAILABLE THROUGH OTHER HOSPITAL PROVIDERS, PHYSICIAN SUPPLY IN THE BH SERVICE AREAS, NEW AND MORE EFFECTIVE HEALTHCARE SERVICES THAT ARE BECOMING AVAILABLE THAT WOULD ELEVATE THE QUALITY OF HEALTHCARE SERVICES PROVIDED TO BH COMMUNITIES, AND DEMAND PRESSURES EXPERIENCED BY EXISTING BH FACILITIES AND PHYSICIANS. ON A LOCAL BASIS, HOSPITAL MANAGEMENT TEAMS REGULARLY CONSULT WITH COMMUNITY LEADERS AND PARTNERS, LOCAL COMMUNITY-BASED ADVISORY BOARDS, OTHER SERVICE PROVIDERS (INCLUDING FEDERALLY QUALIFIED HEALTH CLINICS) AND BUSINESSES TO IDENTIFY UNMET PHYSICIAN AND HOSPITAL NEEDS. THESE FINDINGS ARE THEN PRIORITIZED BASED ON SYSTEM CAPITAL AND OPERATING RESOURCE AVAILABILITY, FEASIBILITY, AVAILABILITY OF PHYSICIANS TO BE RECRUITED TO THE SERVICE AREA, AND SUSTAINABILITY. BASED UPON THIS PRIORITIZATION, CAPITAL AND OPERATING RESOURCES ARE THEN INTEGRATED INTO THE FACILITY AND SYSTEM BUDGETS AND PLANS.
SCHEDULE H, PART VI, LINE 3 POLICIES AND PROCEDURES EXIST TO EDUCATE OUR PATIENTS ON FINANCIAL ASSISTANCE ELIGIBILITY AND THEY ARE PROVIDED NUMEROUS OPPORTUNITIES FOR EDUCATION ON BANNER HEALTH FINANCIAL ASSISTANCE POLICIES. THE FOLLOWING ARE EXAMPLES OF COMMUNICATION/EDUCATION AVAILABLE TO BH PATIENTS: a. SIGNAGE AND COLLATERAL IN BOTH ENGLISH AND SPANISH ARE POSTED PROMINENTLY IN PATIENT WAITING LOBBIES, INCLUDING THE EMERGENCY DEPARTMENTS, STATING THAT BANNER HAS FINANCIAL ASSISTANCE PROGRAMS FOR THOSE WHO DO NOT HAVE INSURANCE OR MAY BE UNABLE TO PAY FOR THEIR SHARE OF THE COST OF SERVICES. b. A TOLL-FREE NUMBER IS PROVIDED FOR THE PATIENTS/FAMILYS CONVENIENCE. c. AFTER MEDICAL SCREENING, PATIENTS ARE VISITED BY STAFF AND INFORMED OF THE FINANCIAL POLICY. STAFF ALSO ASSISTS POTENTIALLY ELIGIBLE PATIENTS TO APPLY FOR ENROLLMENT FOR MEDICAID/AHCCCS. d. A BRIGHTLY COLORED INSERT IS INCLUDED IN ALL OF OUR BILLING STATEMENT TO PATIENTS. THE INSERT AGAIN INFORMS PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IN BOTH ENGLISH AND SPANISH AND PROVIDES TOLL-FREE ACCESS. e. DEPARTMENT REPRESENTATIVES AGAIN INFORM PATIENTS OF THE FINANCIAL ASSISTANCE POLICIES DURING THE SELF-PAY COLLECTION PROCESS. f. BANNER HEALTH WEBSITE PROVIDES INFORMATION IN BOTH ENGLISH AND SPANISH OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. THROUGHOUT THE PROCESS, STAFF CONTINUES TO ADVISE POTENTIALLY ELIGIBLE PATIENTS OF THE POSSIBILITY OF ENROLLMENT IN MEDICAID/AHCCCS AND OFFER TO ASSIST IN SUCH ENROLLMENT.
SCHEDULE H, PART VI, LINE 5 BH IS GOVERNED BY A COMMUNITY BOARD, DRAWN PRIMARILY FROM THE COMMUNITIES SERVED BY BH. THIS BOARD ESTABLISHES BH PRIORITIES AND ENSURES THAT IT OPERATES IN A MANNER THAT WILL FURTHER ITS CHARITABLE, NONPROFIT PURPOSE TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. AS A NONPROFIT ENTITY, BH EXISTS TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITIES WE SERVE, NOT TO GENERATE PROFITS. TO THAT END, EVERY DOLLAR EARNED IS REINVESTED IN NEW EQUIPMENT, NEW OR EXPANDED PATIENT CARE SERVICES, NEW TECHNOLOGIES, MAINTAINING EXISTING EQUIPMENT AND FACILITIES AND NEW FACILITIES TO MEET MARKET NEEDS OR TO ENSURE THE LONG TERM SUCCESS OF THE ORGANIZATION. FOR EVERY $1 RECEIVED IN PAYMENT FOR PROVIDING CARE TO PATIENTS, WE SPEND, ON AVERAGE $.95 TO PAY OUR EXPENSES. THESE EXPENSES ARE ALLOCATED AS FOLLOWS: -SALARIES AND BENEFITS (.49) -OPERATING EXPENSES SUCH AS UTILITIES, MAINTENANCE, REPAIRS AND INSURANCE (.16) -SUPPLIES (.16) -DEPRECIATION ON CAPITAL INVESTMENTS LIKE EQUIPMENT AND CONSTRUCTION (.05) -INTEREST AND LEASE EXPENSE (.04) -BAD DEBT EXPENSE FOR PATIENTS THAT CANT OR WONT PAY FOR THEIR CARE (.05). IN PARTICULAR, BANNERS HEAVY REINVESTMENT IN CLINICAL SYSTEMS AND HEALTH INFORMATION TECHNOLOGY ENABLES BH TO PROVIDE A UNIFORMLY HIGH QUALITY OF CARE THROUGHOUT THE SYSTEM, INCLUDING BHS SMALL, RURAL, CRITICAL ACCESS HOSPITALS. PHYSICIANS AND STAFF PRACTICING IN THESE SOLE COMMUNITY PROVIDERS HAVE THE SAME ELECTRONIC HEALTH RECORD SYSTEMS AND COMPUTERIZED PHYSICIAN ORDER ENTRY AND DECISION SUPPORT TOOLS AS ARE UTILIZED IN BHS LARGEST TEACHING HOSPITAL. IN ADDITION, BY MEANS OF REMOTE MONITORING AND TELEMEDICINE TECHNOLOGIES, THESE SMALL RURAL HOSPITALS HAVE ACCESS TO THE CLINICAL AND OPERATIONAL SUPPORT OF THE ENTIRE SYSTEM, THEREBY BRINGING A LEVEL OF SOPHISTICATED HEALTH CARE TO THESE COMMUNITIES THAT WOULD NOT OTHERWISE BE POSSIBLE. EXCEPT IN LIMITED CIRCUMSTANCES WHERE NECESSARY TO ENSURE THE AVAILABILITY OF CONSISTENT AND EFFICIENT PHYSICIAN SERVICES, BH UTILIZES AN OPEN MEDICAL STAFF MODEL, THEREBY MAKING THE FACILITIES AVAILABLE TO LOCAL PHYSICIANS TO PROVIDE HIGH QUALITY HOSPITAL SERVICES TO OUR COMMUNITIES. IN ADDITION, BH IS AGGRESSIVELY PURSUING AN INTEGRATION STRATEGY INVOLVING NETWORKS OF EMPLOYED AND INDEPENDENT PHYSICIANS CAPABLE OF PROVIDING EFFICIENT, EVIDENCE-BASED AND HIGH QUALITY CLINICAL CARE WITHIN AN INTEGRATED SYSTEM COVERING THE FULL CONTINUUM OF CARE. THIS WILL ENABLE BH TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES WHILE LIMITING THE COSTS OF PROVIDING SUCH CARE.
SCHEDULE H, PART VI, LINE 4 BH HAD 28 HOSPITALS (AS OF DECEMBER 31, 2017), AND OPERATES OR LEASES NURSING HOMES, PHYSICIAN CLINICS, HOME HEALTH AGENCIES, AMBULATORY FACILITIES, AND DURABLE MEDICAL EQUIPMENT SERVICES IN SIX WESTERN STATES WHICH INCLUDE DEMOGRAPHIC AREAS THAT RANGE FROM METROPOLITAN TO REMOTE RURAL AREAS. THE FOLLOWING SETS FORTH PERTINENT DEMOGRAPHIC INFORMATION WITH RESPECT TO THE COMMUNITIES AND AREAS SERVED BY BH FACILITIES: A. ARIZONA 1) STATE I) POPULATION: 7,016,270 II) MEDIAN HOUSEHOLD INCOME: $51,340 III) POPULATION BELOW POVERTY LEVEL: 16.40% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 11.90% V) UNINSURED ADULTS LIVING IN POVERTY: 12.00% VI) NO COVERAGE AT ANY TIME DURING THE YEAR - ALL AGES: 28.00% VII) UNINSURED NONELDERLY WITH INCOMES BELOW 100% OF FPL: 22.00% VIII) UNINSURED - NONELDERLY INCOMES UP TO 200% OF FPL: 20.00% IX) PERCENT OF POPULATION BELOW 400% OF FPL: 64.00% 2) MARICOPA COUNTY I) POPULATION: 4,307,033 II) MEDIAN HOUSEHOLD INCOME: $55,676 III) POPULATION BELOW POVERTY LEVEL: 15.00% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 11.70% 3) PINAL COUNTY I) POPULATION: 430,237 II) MEDIAN HOUSEHOLD INCOME: $51,190 III) POPULATION BELOW POVERTY LEVEL: 15.40% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 11.30% 4) COCONINO COUNTY I) POPULATION: 140,776 II) MEDIAN HOUSEHOLD INCOME: $51,106 III) POPULATION BELOW POVERTY LEVEL: 17.80% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 13.80% B. CALIFORNIA 1) STATE I) POPULATION: 39,536,653 II) MEDIAN HOUSEHOLD INCOME: $63,783 III) POPULATION BELOW POVERTY LEVEL: 14.30% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 8.30% V) UNINSURED ADULTS LIVING IN POVERTY: 8.00% VI) NO COVERAGE AT ANY TIME DURING THE YEAR - ALL AGES: 17.00% VII) UNINSURED NONELDERLY WITH INCOMES BELOW 100% OF FPL: 14.00% VIII) UNINSURED - NONELDERLY INCOMES UP TO 200% OF FPL: 14.00% IX) PERCENT OF POPULATION BELOW 400% OF FPL: 59.00% 2) LASSEN COUNTY I) POPULATION: 31,163 II) MEDIAN HOUSEHOLD INCOME: $51,457 III) POPULATION BELOW POVERTY LEVEL: 17.60% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 4.90% C. COLORADO 1) STATE I) POPULATION: 5,607,154 II) MEDIAN HOUSEHOLD INCOME: $62,520 III) POPULATION BELOW POVERTY LEVEL: 11.00% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 8.60% V) UNINSURED ESTIMATE OF TOTAL POPULATION: 10.00% VI) UNINSURED ADULTS LIVING IN POVERTY: 27.00% VII) UNINSURED NONELDERLY WITH INCOMES BELOW 100% OF FPL: 21.00% VIII) UNINSURED - NONELDERLY INCOMES UP TO 200% OF FPL: 19.00% IX) PERCENT OF POPULATION BELOW 400% OF FPL: 52.00% 2) LARIMER COUNTY I) POPULATION: 343,976 II) MEDIAN HOUSEHOLD INCOME: $61,942 III) POPULATION BELOW POVERTY LEVEL: 11.20% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 7.30% 3) LOGAN COUNTY I) POPULATION: 21,896 II) MEDIAN HOUSEHOLD INCOME: $43,340 III) POPULATION BELOW POVERTY LEVEL: 16.40% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 10.70% 4) MORGAN COUNTY I) POPULATION: 28,192 II) MEDIAN HOUSEHOLD INCOME: $49,495 III) POPULATION BELOW POVERTY LEVEL: 11.70% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 12.00% 5) WELD COUNTY I) POPULATION: 304,633 II) MEDIAN HOUSEHOLD INCOME: $62,820 III) POPULATION BELOW POVERTY LEVEL: 11.50% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 8.70% D. NEBRASKA 1) STATE I) POPULATION: 1,920,076 II) MEDIAN HOUSEHOLD INCOME: $54,381 III) POPULATION BELOW POVERTY LEVEL: 11.40% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 11.40% V) UNINSURED ESTIMATE OF TOTAL POPULATION: 7.00% VI) UNINSURED ADULTS LIVING IN POVERTY: 27.00% VII) UNINSURED NONELDERLY WITH INCOMES BELOW 100% OF FPL: 20.00% VIII) UNINSURED - NONELDERLY INCOMES UP TO 200% OF FPL: 16.00% IX) PERCENT OF POPULATION BELOW 400% OF FPL: 59.00% 2) KEITH COUNTY I) POPULATION: 8,072 II) MEDIAN HOUSEHOLD INCOME: $43,100 III) POPULATION BELOW POVERTY LEVEL: 12.80% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 10.00% E. NEVADA 1) STATE I) POPULATION: 2,998,039 II) MEDIAN HOUSEHOLD INCOME: $53,094 III) POPULATION BELOW POVERTY LEVEL: 13.80% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 13.10% V) UNINSURED ESTIMATE OF TOTAL POPULATION: 9.00% VI) UNINSURED ADULTS LIVING IN POVERTY: 23.00% VII) UNINSURED NONELDERLY WITH INCOMES BELOW 100% OF FPL: 18.00% VIII) UNINSURED - NONELDERLY INCOMES UP TO 200% OF FPL: 15.00% IX) PERCENT OF POPULATION BELOW 400% OF FPL: 66.00% 2) CHURCHILL COUNTY I) POPULATION: 24,230 II) MEDIAN HOUSEHOLD INCOME: $45,365 III) POPULATION BELOW POVERTY LEVEL: 14.20% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 13.60% F. WYOMING 1) STATE I) POPULATION: 579,315 II) MEDIAN HOUSEHOLD INCOME: $59,143 III) POPULATION BELOW POVERTY LEVEL: 11.30% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 13.40% V) UNINSURED ESTIMATE OF TOTAL POPULATION: 10.00% VI) UNINSURED ADULTS LIVING IN POVERTY: 24.00% VII) UNINSURED NONELDERLY WITH INCOMES BELOW 100% OF FPL: 21.00% VIII) UNINSURED - NONELDERLY INCOMES UP TO 200% OF FPL: 18.00% IX) PERCENT OF POPULATION BELOW 400% OF FPL: 60.00% 2) GOSHEN COUNTY I) POPULATION: 13,378 II) MEDIAN HOUSEHOLD INCOME: $44,883 III) POPULATION BELOW POVERTY LEVEL: 14.60% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 15.40% 3) PLATTE COUNTY I) POPULATION: 8,562 II) MEDIAN HOUSEHOLD INCOME: $41,051 III) POPULATION BELOW POVERTY LEVEL: 12.00 % IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 13.10% 4) WASHAKIE COUNTY I) POPULATION: 8,064 II) MEDIAN HOUSEHOLD INCOME: $46,212 III) POPULATION BELOW POVERTY LEVEL: 13.10% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 16.70% G.BANNER AVERAGE 1) STATE I) POPULATION: 9,609,585 II) MEDIAN HOUSEHOLD INCOME: $57,377 III) POPULATION BELOW POVERTY LEVEL: 13.03% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 10.87% V) UNINSURED ESTIMATE OF TOTAL POPULATION: 9.33% VI) UNINSURED ADULTS LIVING IN POVERTY: 24.33% VII) UNINSURED NONELDERLY WITH INCOMES BELOW 100% OF FPL: 19.33% VIII) UNINSURED - NONELDERLY INCOMES UP TO 200% OF FPL: 17.00% IX) PERCENT OF POPULATION BELOW 400% OF FPL: 60.00% 2) COUNTY I) POPULATION: 408,837 II) MEDIAN HOUSEHOLD INCOME: $49,159 III) POPULATION BELOW POVERTY LEVEL: 14.54% IV) PERSONS W/O HEALTH INSURANCE UNDER AGE 65: 11.69% SOURCES: 2017 U.S. CENSUS BUREAU, KAISER FAMILY FOUNDATION STATE FACTS.
