4A (Expenses $ 6129794483 including grants of $ 23991724) (Revenue $ 8169595327)
"THE NMHC GROUP RETURN REFLECTS THE COMBINED INFORMATION AND OPERATIONS OF EIGHTEEN TAX EXEMPT ORGANIZATIONS. THIS INCLUDES NINE HOSPITAL FACILITIES, TWO MEDICAL GROUPS, ONE FOUNDATION, AND VARIOUS OTHER RELATED ENTITIES SUPPORTING THE HEALTHCARE MISSION OF THE SYSTEM. NORTHWESTERN MEMORIAL HOSPITAL (EIN: 37-0960170) (""NMH"") FOR MORE THAN 150 YEARS, NMH AND ITS PREDECESSOR INSTITUTIONS, PASSAVANT MEMORIAL AND WESLEY MEMORIAL HOSPITALS, HAVE SERVED THE RESIDENTS OF CHICAGO. THE COMMITMENT TO PROVIDE HEALTHCARE, REGARDLESS OF THE PATIENTS' ABILITY TO PAY, REACHES BACK TO THE FOUNDING PRINCIPLES OF PASSAVANT AND WESLEY AND CONTINUES TO BE INTEGRAL TO OUR MISSION TO PUT PATIENTS FIRST. NMH IS AN ACADEMIC MEDICAL CENTER (AMC) HOSPITAL AND SERVES AS THE PRIMARY TEACHING HOSPITAL FOR THE NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE (""FEINBERG""), WITH MORE THAN 2,228 PHYSICIANS ON THE MEDICAL STAFF, THE MAJORITY OF WHOM HAVE FACULTY APPOINTMENTS AT FEINBERG. NMH IS AMONG THE LIMITED NUMBER OF HOSPITALS IN THE UNITED STATES TO BE DESIGNATED AS A MAJOR TEACHING HOSPITAL BY THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC). ACCORDING TO THE AAMC, WHILE MAJOR TEACHING HOSPITALS REPRESENT ONLY 5 PERCENT OF ALL HOSPITALS, THEY ACCOUNT FOR 25 PERCENT AND 20 PERCENT OF ALL MEDICAID AND MEDICARE DISCHARGES, RESPECTIVELY, AS WELL AS PROVIDE 35 PERCENT OF THE COUNTRY'S CHARITY CARE. IN AGGREGATE, MAJOR TEACHING HOSPITALS SERVE A HIGHER PROPORTION OF LOW-INCOME, DUAL-ELIGIBLE, DISABLED AND MINORITY PATIENTS THAN OTHER HOSPITALS. AS AMCS SERVE AS MAJOR REFERRAL CENTERS AND HAVE VERY SPECIALIZED EXPERTISE, THEY PROVIDE CARE TO THOSE PATIENTS WHO ARE UNABLE TO SEEK NECESSARY CARE ELSEWHERE AND THEREFORE HAVE A PATIENT POPULATION THAT IS OFTEN MORE COMPLEX, SICKER AND MORE VULNERABLE THAN THE GENERAL PATIENT POPULATION. NMH IS A 943-BED, ADULT ACUTE CARE HOSPITAL LOCATED IN CHICAGO'S GROWING DOWNTOWN AREA AND SAW MORE THAN 43,900 ADULTS ADMITTED AS INPATIENTS IN FISCAL YEAR 2022. AS AN ADULT LEVEL I TRAUMA CENTER IN DOWNTOWN CHICAGO WITH 24/7 SERVICE, NMH HAD NEARLY 83,000 EMERGENCY DEPARTMENT (ED) VISITS IN FISCAL YEAR 2022. NMH IS ALSO THE ONLY AMC HOSPITAL IN CHICAGO PARTICIPATING IN BOTH CITY AND STATE LEVEL I TRAUMA NETWORKS AND AS A LEVEL III NEONATAL INTENSIVE CARE UNIT, ALLOWING US TO PROVIDE LIFESAVING CARE AND TREATMENT TO THE MOST SERIOUSLY INJURED ADULTS AND PREMATURE AND SICK INFANTS. NMH HAS THE LARGEST BIRTHING CENTER IN ILLINOIS, WITH NEARLY 12,000 DELIVERIES IN FISCAL YEAR 2022. NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL (EIN: 36-2513909) (""CDH"") CDH HAS A RICH HISTORY OF CARING FOR ITS COMMUNITY. THE 408-BED, TERTIARY-CARE FACILITY LOCATED IN WINFIELD, ILLINOIS OFFERS EMERGENCY, INPATIENT AND OUTPATIENT CARE IN MEDICAL AND SURGICAL SERVICES, OBSTETRICS, PEDIATRICS, BEHAVIORAL HEALTH, CARDIOLOGY, NEUROLOGY AND ONCOLOGY TO RESIDENTS OF DUPAGE COUNTY AND SURROUNDING AREAS. CDH IS DESIGNATED AS A LEVEL II TRAUMA CENTER AND PROVIDES LEVEL III NEONATAL INTENSIVE CARE; CDH EMS SERVES AS A STATE-DESIGNATED RESOURCE HOSPITAL. IT IS ALSO A REGIONAL DESTINATION FOR ONCOLOGY, ORTHOPEDIC, PEDIATRIC AND CARDIOLOGY CARE. CANCER PATIENTS ARE OFFERED HIGHLY ADVANCED TREATMENT AT THE STATE'S FIRST AND ONLY PROTON THERAPY CENTER. MORE THAN 1,300 PHYSICIANS ARE ON THE MEDICAL STAFF AND ARE TRAINED IN MORE THAN 90 SPECIALTY AREAS. IN FISCAL YEAR 2022, CDH HAD MORE THAN 21,500 INPATIENT ADMISSIONS. CDH'S ED HAD MORE THAN 70,500 VISITS IN FISCAL YEAR 2022. NORTHWESTERN LAKE FOREST HOSPITAL (EIN: 36-2179779) (""LFH"") WITH ROOTS IN THE NORTHERN CHICAGO REGION, LFH WAS FOUNDED IN 1899 AS ALICE HOME ON THE CAMPUS OF LAKE FOREST COLLEGE. SINCE ITS FOUNDING, LFH HAS UPHELD THE PROMISE TO PROVIDE LAKE COUNTY RESIDENTS WITH CONVENIENT ACCESS TO QUALITY CARE SUPPORTED BY ADVANCED DIAGNOSTICS AND TECHNOLOGY. THE CURRENT LAKE FOREST HOSPITAL INCLUDES 114 PRIVATE INPATIENT ROOMS, 72 OUTPATIENT CARE SPACES, EIGHT OPERATING ROOMS AND 483,500 SQUARE FEET OF NEW CONSTRUCTION ON ITS 160-ACRE CAMPUS, OPENED IN FISCAL YEAR 2018. LFH SERVES THE LAKE COUNTY, ILLLINOIS AND KENOSHA COUNTY, WISCONSIN AREA. 992 PHYSICIANS OFFER LAKE COUNTY RESIDENTS CONVENIENT ACCESS TO ADVANCED DIAGNOSTIC AND SPECIALTY SERVICES. CARE IS PROVIDED THROUGH THE MAIN HOSPITAL CAMPUS IN SUBURBAN LAKE FOREST, ABOUT 30 MILES NORTH OF DOWNTOWN CHICAGO, AT LARGE OUTPATIENT FACILITIES IN GRAYSLAKE, ILLINOIS AND GLENVIEW, ILLINOIS AND AT IMMEDIATE CARE CENTERS. IN FISCAL YEAR 2022, LFH PROVIDED CARE FOR OVER 10,600 INPATIENT ADMISSIONS. LFH'S BOARD-CERTIFIED EMERGENCY PHYSICIANS AND TRAUMA-TRAINED NURSES PROVIDE TRAUMA AND EMERGENCY CARE TO PATIENTS THROUGH THE LEVEL II TRAUMA CENTER AT LFH AND A FREE-STANDING EMERGENCY ROOM AT THE GRAYSLAKE OUTPATIENT CENTER, WHICH TOGETHER HAD MORE THAN 64,300 EMERGENCY VISITS IN FISCAL YEAR 2022. LAUNCHED IN 2015, LFH SERVES AS THE HOME SITE FOR THE NORTHWESTERN MCGAW FAMILY MEDICINE RESIDENCY PROGRAM WITH 24 RESIDENTS IN FISCAL YEAR 2022. DURING FISCAL YEAR 2020, LFH LAUNCHED ITS TRANSITIONAL CARE CLINIC TO PROVIDE MEDICAL AND PSYCHOSOCIAL SUPPORT TO PATIENTS WHO DO NOT HAVE A PRIMARY CARE PHYSICIAN AND FACE COMPLEX CHALLENGES NAVIGATING THE HEALTHCARE SYSTEM FOLLOWING AN INPATIENT OR EMERGENCY HEALTH EPISODE AND THE CLINIC HAS TREATED MORE THAN 500 PATIENTS SINCE ITS LAUNCH. NORTHWESTERN MEMORIAL FOUNDATION (EIN: 35-3155315) (""NMF"") NMF IS THE FUNDRAISING ARM OF THE HEALTH SYSTEM AND REPRESENTS THE COMBINED LEGACY OF THE HOSPITALS COMPRISING THE GROUP. NMF PROVIDES SUPPORT SYSTEMWIDE THROUGH THE CONTRIBUTIONS IT COLLECTS. NORTHWESTERN MEDICAL FACULTY FOUNDATION D/B/A NORTHWESTERN MEDICAL GROUP (EIN: 36-3097297) (""NMG"") NORTHWESTERN MEDICAL GROUP IS A MULTISPECIALTY AND PRIMARY CARE PHYSICIAN PRACTICE WITH MORE THAN 1,300 PHYSICIANS AND 360 ADVANCED PRACTICE PROVIDERS WITH EXPERTISE IN MORE THAN 90 MEDICAL SPECIALTIES. SERVING ON THE FACULTY OF FEINBERG, PHYSICIANS CONTRIBUTE TO RESEARCH AND EDUCATION, AS WELL AS PROVIDE CLINICAL CARE. CENTRAL DUPAGE PHYSICIAN GROUP D/B/A NORTHWESTERN MEDICINE REGIONAL MEDICAL GROUP (EIN: 36-3149833) (""RMG or ""CDPG"") CENTRAL DUPAGE PHYSICIAN GROUP IS A MULTI-SPECIALTY AND PRIMARY CARE NETWORK WITH MORE THAN 400 PHYSICIANS, INCLUDING 335 SPECIALISTS, WITH EXPERTISE IN OVER 60 SPECIALTIES. RMG OFFERS MORE THAN 90 PRACTICES IN 36 LOCATIONS THROUGHOUT CHICAGO'S WESTERN SUBURBS. DELNOR-COMMUNITY HOSPITAL (EIN: 36-3484281) (""DCH"") DCH OPENED 75 YEARS AGO AS THE RESULT OF A COMMUNITY-LED EFFORT TO BUILD A FACILITY TO MEET THE GROWING HEALTHCARE NEEDS OF RESIDENTS OF KANE COUNTY. NOW A 159-BED ACUTE CARE FACILITY, DCH IS A RECOGNIZED LEADER IN CLINICAL QUALITY AND PATIENT-CENTERED CARE LOCATED 37 MILES WEST OF DOWNTOWN CHICAGO IN GENEVA, ILLINOIS. THE DCH MEDICAL STAFF INCLUDES 700 PHYSICIANS IN 80 SPECIALTIES, PROVIDING COMPREHENSIVE MEDICAL CARE FOR ITS SURROUNDING COMMUNITIES. IN FISCAL YEAR 2022, DCH HAD MORE THAN 9,700 INPATIENT ADMISSIONS AND ITS ED HAD NEARLY 40,000 VISITS. DCH SERVES AS THE HOME SITE FOR THE NORTHWESTERN MCGAW FAMILY MEDICINE RESIDENCY AT DELNOR,WITH 24 RESIDENTS IN FISCAL YEAR 2022. DCH IS ALSO THE SITE OF THE PHARMACY RESIDENCY PROGRAM, THE ONLY PROGRAM OF ITS KIND WITHIN 25 MILES OF THE HOSPITAL. KISHWAUKEE COMMUNITY HOSPITAL (EIN: 23-7087041) (""KCH"") KCH IS LOCATED IN DEKALB, ILLINOIS AND SERVES AS AN ACUTE-CARE, 98-BED COMMUNITY HOSPITAL WITH AN ENDURING COMMITMENT TO THE RESIDENTS OF DEKALB COUNTY. THE HOSPITAL PROVIDES CARE THROUGH A BROAD RANGE OF SPECIALTIES AND UNIQUE SERVICES, INCLUDING THROUGH ITS INNOVATIVE BREASTFEEDING CENTER AND ITS NEW, STATE-OF-THE-ART HEALTH AND WELLNESS CENTER THAT OPENED IN 2018. THE KISHWAUKEE MEDICAL STAFF IS COMPOSED OF 380 PHYSICIANS WHO TREATED MORE THAN 5,300 INPATIENT ADMISSIONS AND MORE THAN 35,400 ED VISITS IN FISCAL YEAR 2022. VALLEY WEST COMMUNITY HOSPITAL (EIN: 36-4244337) (""VWCH"") VWCH IS A CRITICAL-ACCESS, 25-BED HOSPITAL IN SANDWICH, ILLINOIS, SERVING THE FOX VALLEY COMMUNITY FOR MORE THAN 70 YEARS. MORE THAN 200 PHYSICIANS ARE ON STAFF WITH VALLEY WEST, REPRESENTING A WIDE RANGE OF SPECIALTIES. DURING FISCAL YEAR 2022, VALLEY WEST HAD MORE THAN 760 INPATIENT ADMISSIONS AND MORE THAN 8,800 ED VISITS. AS A CRITICAL-ACCESS HOSPITAL WITHIN THE NORTHWESTERN MEDICINE SYSTEM, VALLEY WEST CREATES A SEAMLESS PATHWAY TO SPECIALTY CARE ACROSS THE SYSTEM AND GREATLY EXPANDING ACCESS TO CARE FOR THE RURAL COMMUNITY. IN FISCAL YEAR 2020, VWCH LAUNCHED THE HOMEWARD HEALING PROGRAM FOR PATIENTS WHO NEED SHORT-TERM, COMPREHENSIVE, SKILLED HEALTHCARE SERVICES AFTER AN ACUTE STAY IN THE HOSPITAL. THIS ALLOWS FOR ADDITIONAL CARE THAT CANNOT BE PROVIDED AT HOME AND WITHOUT HAVING TO BE TRANSFERRED TO A SKILLED NURSING FACILITY."

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - Northwestern Memorial Hospital. The CHNA report also describes Northwestern Memorial Hospital's CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. The hospital facility took into account input from persons who represent the community, including uninsured persons, low-income persons and minority groups, through community input surveys, community focus groups, healthcare and social service provider focus groups, and stakeholder assessments. Community input surveys collected input from 3,722 individuals 18 or older living in the NMH Community Service Area. Surveys were available on paper and online and were disseminated in two different languages. Questions assessed demographics, the health of the community, community strengths, opportunities for improvement and priority health needs. Surveys were targeted at priority populations, those typically underrepresented in assessment processes, including communities of color, immigrants, LGBTQ+ community members, individuals with disabilities and low-income communities. Community focus groups included 21 sessions held within the NMH Community Service Area. Focus groups took place with priority populations, such as veterans, individuals living with mental illness, communities of color, older adults, caregivers, teens and young adults, LGBTQ+ community members, adults and teens experiencing homelessness, families with children, faith communities, adults with disabilities, and children and adults living with chronic conditions such as diabetes and asthma. Stakeholder assessments evaluated trends, factors and events that currently effect or are anticipated to affect the public health system and included an assessment of the public health system's capacity to advance health equity. To ensure that organizations impacting health in the NMH community service area were meaningfully engaged in interpreting and prioritizing the identified needs, as well as the development of a collaborative plan to address priority needs, the external Community Engagement Council was engaged, which is made up of representatives of the following organizations: 1. Bright Star Community Outreach 2. Center for Housing and Health 3. Chatham Work Force and Education Center 4. Connections for Abused Women and their Children 5. Erie Family Health Centers 6. Greater Chicago Food Depository 7. Howard Brown Health 8. National Able Network 9. Near North Health 10. Thresholds 11. West Humboldt Park Development Council 12. Inner City Muslim Action Network

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMH worked in tandem with the Alliance for Health Equity (AHE) which is made up of 33 hospitals and local health departments. This group worked collaboratively to assess community needs. Specific needs of the NMH Community Service Area were identified and prioritized separately. Hospital facilities included: 1. Advocate Aurora Children's Hospital 2. Advocate Aurora Christ Medical Center 3. Advocate Aurora Illinois Masonic Medical Center 4. Advocate Aurora Lutheran General Hospital 5. Advocate Aurora South Suburban Hospital 6. Advocate Aurora Trinity Hospital 7. Advent Health Medical Center La Grange 8. Ascension Alexian Brothers Medical Center, Elk Grove Village 9. Ascension Holy Family Medical Center 10. Ascension Resurrection Medical Center 11. Ascension St. Alexius Medical Center and Alexian Brothers Behavioral Health Hospital 12. Ascension Saint Francis Hospital 13. Ascension Saint Joseph Hospital 14. Ascension Saints Mary and Elizabeth Medical Center 15. Ann Robert H. Lurie Children's Hospital of Chicago 16. Humboldt Park Health 17. Jackson Park Hospital 18. The Loretto Hospital 19. Loyola Medicine- Gottlieb Memorial Hospital 20. Loyola Medicine- Loyola University Medical Center 21. Loyola Medicine- MacNeal Hospital 22. Northwestern Memorial Hospital 23. Northwestern Palos Community Hospital 24. OSF Little Company of Mary Medical Center 25. Roseland Community Hospital 26. Rush Oak Park 27. Rush University Medical Center 28. Sinai Health System- Holy Cross Hospital 29. Sinai Health System- Mount Sinai Hospital 30. Sinai Health System- Schwab Rehabilitation Hospital 31. South Shore Hospital 32. Swedish Hospital 33. University of Illinois Hospital and Health Sciences System

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMH worked in tandem with the Alliance for Health Equity (AHE) which is made up of multiple hospitals and local health departments. This group worked collaboratively to assess community needs. Specific needs of the NMH Community Service Area were identified and prioritized separately. Other organizations included: 1. Chicago Department of Public Health 2. Cook County Department of Public Health 3. Cook County Health

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. Section C: In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also intentionally shared with the following: 1. Key community organizations 2. Northwestern University Institute of Public Health and Medicine 3. Northwestern Medicine Leadership

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - Northwestern Memorial Hospital. NMH adopted a new implementation strategy in FY2023 (TY2022) in alignment with the most recent CHNA. For Line 11, NMH is reporting on the FY2019 (TY2018) implementation strategies, as this is the most recent outcomes data available at the time of this report. In FY2019 (TY2018), NMH identified four Priority Health Needs: Access to Health Care and Community Resources; Structural Inequities; Violence and Community Safety; and Workforce Development and Economic Vitality. Specific ways in which NMH addressed significant needs are defined as follows: Priority Need 1: Access to Health Care and Community Resources 1.1: Behavioral Health Resources. Improve access to mental and behavioral health resources through the expansion of community-based programs such as Calm Classroom and Mental Health First Aid trainings. In FY22, NMH provided three Mental Health First Aid Trainings to 31 individuals who work with high-risk adult and youth populations. 1.2: Clinical Community Relationships. Develop a Health System level approach to better serve uninsured and underinsured patients through clinical community relationships. Utilize the identified approach to pilot new opportunities and enhance current relationships in the NMH CSA. In the Fall, 2021, NMH launched a new relationship with the Inner-City Muslim Action Network (IMAN)-- a community organization that fosters health, wellness and healing in the inner-city by organizing for social change, cultivating the arts, and operating a holistic health center. Located in the Southwest side of Chicago, IMAN has an FQHC that serves over 2300 patients annually. In launching the partnership, the following tasks were accomplished: 1) Executed partnership assessment to identify metrics to be tracked and collected; determine if there are hospital-specific report additions (i.e. CHIPs, local hospital strategy, foundation support, etc.) to inform data package, identified key metrics to be collected and tracked and defined methodology for data collection; 2) Identified NM team members from the following departments to form an internal working group with the goal of ensuring a seamless patient referral process. Patient Registration/Scheduling--Ensure referred patients are registered accurately in NM ordering system, Patient Financial Services--conducted Financial Assistance Application trainings to ensure sliding fee workflows are adhered; NM Physician Group--Communicated new relationships with providers and staff; NM EMR Team--Ensured IMAN is listed as a new referral agency and providers ae uploaded into system; conducted EMR trainings with IMAN; Medical Records-ensure new provider information have been added to NM medical record system; 3) Identified one point of contact at NM FQHC who will triage and manage patient referral challenges/concerns and 4) Determined standard meeting date/time to discuss workflows. After successful completion of the above tasks, at the end of FY22, NMH received 22 outpatient referrals, 12 inpatient and 21 ED patients from IMAN. 1.3: Education-Centered Medical Home (ECMH): Community Engagement Project. Establish a Community Engagement Program together with Northwestern University Feinberg School of Medicine that aligns ECMH community health projects with priority health needs identified through the NMH CHNA. Although COVID continues to disrupt clinical and group learning opportunities, ECMH was able to launch the first iteration of our Community Health Advocacy Initiative (CHAI) projects. Addressing social determinants of health is a primary strategy to attaining health equity and cannot be addressed by a single clinician working alone in the office setting. The goal of CHAI is to provide medical students with the knowledge and skills needed to improve the health of patients in the context of their larger community. The knowledge learning objectives include understanding the impact of the social environment, built environment, access to care, and forces and systems on patient health and understanding the role of hospitals in improving community health. The skill learning objectives include being able to locate sources of community health data, perform a patient social needs assessment, identify community resources to address patient's identified social needs, learning how to partner with other to improve community health, acquiring advocacy skills to improve health at the individual, community, and policy levels, and to apply knowledge and skills to improve community health through experiential learning. These learning objectives were accomplished by 4 asynchronous lectures and explanatory modules using a socioecological approach to organize: 1. Health of Chicago, 2.Assessing and Addressing social Need (individual) 3. The Role of Hospitals in Community Health (community) 4. Advocating for Change (policy). The long-term goal is for each ECMH to implement an authentic, meaningful community project. Each student developed a CHAI Project Proposal and the ECMH group then chose one of the 4 individual project ideas for next year's efforts. Once they coalesced around a topic, the group followed a step wise plan. They first identified and analyzed sources of community health data for planning CHAI project, then created a plan to address the community health problems, and lastly developed an evaluation plan to address the community health problem. The groups have been successful in the first iteration of their projects. Example project topics include ""Increasing Medicaid enrollment among newly-eligible immigrant seniors"", ""Improving dietary self-management for patients with diabetes"", and ""Decreasing accidental firearm injuries"" Each ECMH is in the midst of these plans. Once completed they will be assessed, and we will gather feedback from the students and ECMH sites to refine the process for future years. 1.4: Social Determinants of Health (SDOH) Plan. Implement an electronic tool that is integrated with NMH's electronic medical record (Epic) to capture SDOH for patients, train staff members/advocates to screen and utilize SDOH data, and refer patients to appropriate services in order to address SDOH. In 2020, a COVID response team contacted primary care patients at high risk and conducted an SDOH screen. An expanded pilot followed in various clinical settings and regions. In November 2021, the program launched in the inpatient setting where the screening is completed by the bedside nurse. The results populate an integrated EHR tool and are visible to care teams during the hospital stay, and if the patient requests assistance, they are connected to a social worker. Community resource referrals are generated, discussed with the patient and included in discharge instructions. As of December 2022, 143,290 patients were screened (~80%) and 6.4% (9,112) requested assistance. Further scale and spread occurred in the summer 2022, where the program expanded in the ambulatory setting. The patient is screened before or during the clinic visit and if the patient requests assistance their care team is notified, community resources are auto-generated and the patient is connected to the NM Outreach team. In hospitals, 15.2% (21,475) patients have identified needs. The most common are primary medical home (63%), transportation (20.2%), and medication affordability (17.6%). Domains that have the highest rate requesting assistance include mental health (79.5%) and food insecurity (67.3%). In ambulatory practices, 11.2% (8,029) patients have identified needs. The most common are mental health access (39.2%), primary medical home (35.1%), and medication affordability (17.5%). Domains with the highest rate requesting assistance include mental health access (70.5%) and food insecurity (59.4%). The NM Outreach team has contacted over 7,600 patients with an engagement rate of 62%. Outreach has identified that patients living in under resourced communities need further assistance (35%) than patients living in a non- under resourced community (31%). Although there's no national standard or best practice, we have yet to find a health system that has taken an approach as disciplined, comprehensive and systematic as NM, screening over 20,000 patients per month. 1.5: Food Insecurity. A comprehensive review of current activities related to food security within the Northwestern Medicine system was conducted during FY22. A review of SDOH screening data was completed, including mapping of patients that responded to being food insecure and in a current food emergency state. Utilizing CHNA data as well as internal SDOH screening data, a plan was developed to address food security needs within the patient population, the NM workforce as well as within the community."

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - Northwestern Memorial Hospital. Workgroups were developed to focus on the following projects: food vouchers, partnership with the Greater Chicago Food Depository, engagement with the Alliance for Health Equity food security efforts, providing nutrition education focusing on budget-friendly meals, and leveraging community gardens. Work within these groups was started in late FY22. In the NMH CSA, the NM Leishman Center conducted virtual cooking classes which had 494 registrants in FY22. NM employee volunteer projects were also launched to address food security, leveraging our Team NM program. In FY22, 42 events were coordinated to focus on feeding and clothing the hungry community, with 378 volunteers serving 945 hours. In FY22, NMH continued to provide funding to support the unique also embarked upon a unique collaboration with its delivery vendor MedSpeed and Our Lady of Angels Mission to provide food to those most in need. There were 2400 bags of groceries delivered to 50 unique addresses. NM continued its partnership with Near North Health Services Corporation to provide nutrition education to Chicago's most vulnerable. We conducted our 4 week class series twice and also held two one day classes for a total 10 classes. These classes resulted in a total number of 76 attendees. The focus of the classes was on using more culturally relevant foods for adults living around the Kelly Hall YMCA in order to demonstrate basic nutrition topics: macronutrients, fiber, etc. Those who attended the class demonstrated a better understanding of basic nutrition topics. Priority Need 2: Structural Inequities. 2.1: Quality Equity. Analyze patient care and clinical service quality measures to identify disparities and implement improvement strategies. The NMHC Quality Equity Plan was approved by the NMHC Quality Management Committee in June 2021. The plan includes a vision for advancing quality equity for NM patients over the next 5 years with improved infrastructure, programming, and partnership with NU and other community organizations. The FY22 Quality Equity Plan was developed with four categories and a focus in 11 areas. These focus areas and outcomes include: 1) Accessing Care at NM (barriers due to change in insurance status, mitigating barriers for patients with limited English proficiency): a. worked with NU student group to identify options to improve access for patients with limited English proficiency; 2) Meeting Diverse Needs (SDOH, NM Outreach Team): a. launched a universal SDOH screening and follow-up program in 11 hospitals and two medical groups with over 130 clinic sites in primary care and select specialties (including OBGYN, pediatrics); b. integrated a community resource referral database in the electronic health record for easy activation and automated systems to provide resources near the patients home; c. developed a follow-up pathway for the primary care patients with a need and requesting assistance. The NM Outreach includes community health workers, social work, and nurses to contact the patients and ensure resources are adequate; 3) Focused Clinical Areas (flu vaccine, COVID-19, Diabetes, Maternal Care, Hypertension) a. updated multimedia materials for staff to help patients overcome vaccine hesitancy and shared widely; b. expanded the diabetes tune up pathway to connect patients with diabetes to multidisciplinary team for education and resources to better manage diabetes including connection with the NM outreach team; c. prioritized clinical measures to focus on key drivers and reduce disparities in; 4) Infrastructure (analytics/quality approach to measuring equity with high fidelity data, expanding partnership with IPHAM and other academic groups at NM/NU): a. standard method on how to assess for disparities was tested; b. disparity analysis was completed for 6 different clinical measures; c. a quality project focused on the fidelity of race/ethnicity data collection and expanded fields were added with culturally responsive training for the access team; d. Equity Grand Rounds program launched, four sessions in FY22 averaging over 400+ participants; e. Developed the inaugural SDOH youth pipeline program for seven undergraduate interns dedicated to the SDOH program; f. demographics fields (race, ethnicity, SOGI, language, zip code) added as targeted fields for all quality reports. 2.2: Diversity and Inclusion (DI): Embed DI values and tactics into employee practices and behaviors. Establish a DI infrastructure with partnership across the organization to promote, support and activate inclusive strategy, culture and behavior that differentiates NM as an inclusive values-driven organization. Implement implicit bias and cultural competence training to increase awareness and decrease impact of implicit bias. In FY22, NM continued to make significant progress in this strategy. Key milestones include: 1) updated New Leader Orientation Training coursework to include eight hours of DEI content 2) created a Leadership Workshop for Mitigating Implicit Bias and D+I toolkits and e-learnings (e.g., Inclusive Recruitment and Equitable Hiring Toolkit, Microaggressions) 3) created toolkits and playlists - Implicit Bias, Equity, Ally and Disability Sensitivity Playlist 4) expanded NM Champion Network by two chapters - Asian American and Pacific Islander and Latinx 5) partnered with Recruitment and Community Service Manager to attended community events 6) opened PCT school focused on current employees with several other hiring pilots in flight. We are working closely with community hiring and talent acquisition to publicize these opportunities for career development at NM. 2.3: Community Engagement Plan. Increase engagement with vulnerable populations regarding their experience with structural inequities at NMH. Utilize feedback and input in the strategic planning process. In FY20, NMH conducted a best practice analysis to identify existing frameworks that promote bidirectional communication with the community, including the structures, objectives and operations of community advisory councils. Plans will continue in FY21 to establish a community council. In FY22, NMH established the external Community Engagement Council to increase community voice in the CHNA process. This council was responsible for reviewing assessment findings, validating data, prioritizing community needs and helping to identify potential solutions. Council members represented organizations from faith based organizations such as Bright Star Community Outreach, FQHCs such as Erie Family Health Centers, Howard Brown Health, Near North Health, Inner City Muslim Action Network, housing such as Center for Housing and Health, workforce development such as Chatham Work Force and Education Center, National Able Network, behavioral health centers such as Thresholds, intimate partner violence agencies such as Connections for Abused Women and their Children, food banks such as Greater Chicago Food Depository, and neighborhood development agency such as West Humboldt Park Development Council. By bringing together individuals from various community organizations, including public health agencies, community groups and healthcare providers, the council provided valuable insights into the unique health challenges and priorities of the community. The collaborative effort helped the hospital to identify areas where it can have the most meaningful impact, and develop strategies to address these needs through targeted programs and initiatives. By engaging with the community in this way, a hospital can build stronger relationships and trust, and ultimately improve the health and well-being of the people it serves. Priority Need 3: Violence and Community Safety. 3.1: Community Violence Prevention. Continue to support Bright Star Community Outreach (BSCO) and The Urban Resilience Network (TURN) model and establish a broader trauma response referral network for NMH patients to receive ongoing trauma support. Collaborate with community partners to launch additional violence prevention strategies, and explore opportunities to expand and increase coordination of existing trauma and violence prevention initiatives. NMH continues to support and provide funding to Bright Star Community Outreach and The Urban Resilience Network. NMH has provided $1.0 million dollars to Bright Start Community Outreach to support trauma counseling, job placement and food insecurity programs. BSCO's trauma services consist of a trauma helpline, Caring and Resilient Environment Rooms (C.A.R.E.) and community ambassadors and advocates. The helpline is a toll-free number that interacts with clients who are currently in crisis or have been affected by trauma and/or violence.

Schedule H, Part V, Section B, Line 11 Facility , 3
Facility , 3 - Northwestern Memorial Hospital. The helpline utilizes trained faith and community leaders as paraprofessionals who set up regular calls to walk callers from brokenness to wholeness. There is no length of time for services and no cost to participants. This year the helpline received 678 calls. The ambassador component of the program works in concert with the helpline to help make the Greater Bronzeville community and beyond better informed about trauma. This is accomplished by conducting seminars and training that vary from days to weeks depending on the needs of the client. The ambassadors have successfully engaged 11,630 individuals this fiscal year. In FY22, NMH received philanthropic support to build a hospital-based violence interruption mode that will enable NMH to provide in-house case management to the victims of interpersonal violence who present to Northwestern Memorial Hospital. We engaged The Health Alliance for Violence Intervention (HAVI), a leading authority on hospital-based violence interruption programs, to help NMH design a model that will work for our staff, patients and community. To date, NMH has been able to achieve the following successes: 1) improved streamlined workflows and communication with social work, trauma staff and Acclivus, 2) support up to fifteen patients per month to address health inequities and provide vital resources to patients in need, 3) created a new coordinator role that will help manage the program and our relationships with community organizations such as Acclivus, IMAN, BSCO and other violence interruption agencies 4) began the interviewing process for the role 5) supported the development of an outpatient mechanism to help screen patients for social determinants of health and connect them with primary care physicians in the NMH Transitional Care Clinic to connect patients to a medical home. 3.2: Trauma-Informed Care. Conduct a current state analysis of practices, gaps and opportunities to address and integrate trauma-informed care into practice, including employee resources for coping with trauma or vicarious trauma. In FY20, NMH developed a framework to deploy trauma-informed care practices and resilience tools that included employee staff wellness and staff training for patient-centered care practices. This framework focuses on staff education and training to increase staff competence in handling trauma, employee wellness strategies, and strategies to reinforce a culture of workforce wellness. A team was formed and a charter was developed that aims to use trauma-informed care to improve the patient experience, patient health outcomes and patient safety, and ensure staff have healthy coping mechanisms to better manage vicarious trauma. A current state analysis was conducted to identify existing local efforts and system strategies, and efforts began to link existing trauma-informed care initiatives and confirm support. In FY22, there were 17 Trauma Informed Care seminars and/or activies attended by 272 participants. In addition, NM has created and implemented a Peer to Peer (P2P) Support Network- a confidential service that provides acute, emotional, and psychological first aid to all NM physicians, nurses, and Advanced Practice Providers (APPs) involved in adverse clinical events, medical errors, near misses, or distressful patient situations. NM physician, nurse, and APP peer supporters receive training on providing acute, emotional first aid to colleagues through confidential, one-on-one conversations. This training includes an overview of trauma informed approach to patient care and how to apply the six trauma informed core principles with peers during peer support conversations. The training content uses SAMHSA's Concept of Trauma and Guidance for a Trauma Informed Approach. There are now almost 100 trained peer supporters across NM. Priority Need 4: Workforce Development and Economic Vitality. 4.1: Hiring and Workforce Development. Develop and execute a strategic hiring plan to increase hiring of NMH employees from hardship communities within the NMH CSA. Increase youth summer employment, workforce development, and pipeline programs to promote careers in health care and related fields to individuals in underserved communities. NMH is a proud member of U.S. Sen. Dick Durbin's Chicago Hospital Engagement, Action, and Leadership (HEAL) Initiative. Launched in 2018, the HEAL Initiative is a collaboration among 10 Chicago hospitals committed to tangibly impacting violence and trauma, and increasing economic opportunities in Chicago's most underserved neighborhoods. In 2022, the number of NM hires from the targeted HEAL zip codes increased by 55% over that for 2021. These new hires accounted for nearly 28% of the total number of new hires for NM's Chicago campus, which includes Northwestern Memorial Hospital (NMH), its physician offices and immediate care centers. NM also partnered with BSCO on a virtual job fair to help respond to the loss of jobs as a result of the pandemic. Additionally, NM had an approximate 200% increase in the number of job offers made to individuals referred by our community partners from FY21 (59) to FY22 (over 170). Of the 170+ job offers extended in FY22, approximately 140 resulted in successful hires. Also, in FY22, Northwestern Medicine launched the NM Work-based Learning Program. The NM Work-based Learning Program mitigates the skills and/or work experience gap(s) between job seekers and their NM job(s) of interest. Through this program, participants receive paid on-the-job training as well as employment retention support if hired at Northwestern Medicine. The program supported four NM roles in FY22 and will expand to support five additional NM roles (nine total) in FY23. To date, 15 individuals were hired at NM via the program. See program details below. NM Work-based Learning Program (# of participants since October 2021) o Expanded to now support nine NM roles. Assistant Imaging Technician* Breast Center Assistant* Housekeeping/Environmental Services Medical Assistant* Patient Access Specialist (7) Patient Care Technician* Patient Escort (7) Patient Service Representative* Sterile Processing Technician (1) *Indicates a new role added in FY23 Finally, NMH continued to support youth summer employment, workforce development and apprenticeship programs to promote careers in the healthcare field and para-professional roles to students in the target Chicago HEAL zip codes. This includes NMH's longstanding partnership with the Chicago Public Schools and Westinghouse College Prep Academy, as well as the NM Discovery Program, Cristo Rey and Urban Alliance partnerships, and the NM Undergraduate Administrative Internship Program. Through these initiatives, 74 high school and college students residing in HEAL zip codes participated in comprehensive on-the-job training and youth programs supported by NM. NMH also continued to support comprehensive internships and fellowships for college students and post-graduates in both clinical and administrative settings. 4.2: Procurement. Establish a procurement plan to increase purchasing of supplies and services from suppliers in the NMH CSA. NMHC is committed to establishing a Supply Chain Supplier Diversity Program to increase purchasing of supplies and services from the communities served by NMHC hospitals. Through this commitment, NMHC will increase our annual spend with diverse certified vendors, increase the number of vendors from local communities that we do business with, and increase our annual spend with businesses owned by women and by people in racial and ethnic minority groups. In FY22, NM spent $1.2M on supplies and services from companies based in one of the HEAL ZIP codes, promoting economic development. Non-Priority Areas: The FY2019 (TY2018) CHNA identified areas of opportunity for health improvement for which NMH determined it would not prepare an implementation strategy. These needs and the reasons for not addressing are below. Education and Youth Development: This identified need is addressed within NMH's Workforce development and Economic Vitality strategy. Food Security and Food Access: Although this identified need was not originally prioritized, it was added to the Implementation Plan as the need was elevated due to Covid-19. See priority need 1.5 for additional information. Affordable Housing: This identified need is addressed within NMH's Access to Healthcare and Community Resources strategy. Age-Related Illness: This need is address through the NMH care delivery system.

Schedule H, Part V, Section B, Line 11 Facility , 4
Facility , 4 - Northwestern Memorial Hospital. Asthma: The External Steering Committee (ESC) recommended that NMH focus on strengthening and improving access to medical homes, where screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Cancer: NMH provides a comprehensive range of clinical services to treat and screen for cancer. NMH will continue to sustain these services and work to strengthen community-based outreach. Diabetes The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Heart Disease The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Obesity The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Maternal and Child Health: NMH provides a comprehensive range of outpatient and inpatient services to expectant women and teens. NMH will continue to sustain these services and work to strengthen community-based medical homes where Maternal and Child Health services can be conveniently accessed. The ESC recommended that NMH focus on strengthening and improving access to medical homes, where access to these services and other prenatal care can be effectively coordinated. Mental Health: This identified need is addressed within NMH's Access to Healthcare and Community Resources strategy. Sexually Transmitted Infections: The ESC recommended that NMH focus on strengthening and improving access to medical homes, where counseling on prevention and screening for disease can be effectively coordinated and access to medically necessary specialty care can be facilitated. Substance Use Disorder: NMH provides inpatient and outpatient substance abuse counseling. The ESC recommended focusing efforts on other health conditions for which NMH could have a greater impact.

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: ""insured sliding fee scale assistance and ""insured catastrophic assistance."" If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1.Women, Infants and Children Nutrition Program (WIC); 2.Supplemental Nutrition Assistance Program (SNAP); 3.Illinois Free Lunch and Breakfast Program; 4.Low Income Home Energy Assistance Program (LIHEAP); 5.Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services."

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - NORTHWESTERN MEMORIAL HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. The CHNA also describes the NMLFH CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. The hospital facility took into account input from persons who represent the broad interests of the community, including those with lived experience and those with special knowledge of or expertise in public health. NMLFH gathered input through community input surveys and key informant interviews. To ensure that organizations impacting health in the NMLFH community service area were meaningfully engaged in interpreting and prioritizing the identified needs, as well as the development of a collaborative plan to address priority needs, the external Community Engagement Council was engaged, which is made up of representatives of the following organizations: 1. Erie HealthReach Waukegan 2. Lake County Health Department 3. College of Lake County 4. Waukegan Public Library 5. Northeastern Illinois Food Bank 6. United Way of Lake County 7. Josselyn Center 8. Mano a Mano 9. Catholic Charities

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. NMLFH collaborated with Advocate Condell Medical Center to conduct the CHNA.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - Northwestern Lake Forest Hospital. A comprehensive CHNA was commissioned on behalf of Northwestern Lake Forest Hospital by the Lake County Health Department and Community Health Center. (LCHD/CHC). LCHD/CHC is a public health accredited, state-certified public health department and a Joint Commission accredited community health center. Specific needs of the NMLFH Community Service Area were identified and prioritized separately.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public at the hospital facility, the CHNA report was also shared with the following: 1. Key community organizations 2. Northwestern Medicine Lake Forest Hospital Leadership

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. NMLFH adopted a new implementation strategy in FY2023 (TY2022) in alignment with the most recent CHNA. For Line 11, NMLFH is reporting on the FY2019 (TY2018) implementation strategies, as this is the most recent outcomes data available at the time of this report. In FY2019 (TY2018), NMLFH identified four Priority Health Needs: Access to Health Care, Behavioral Health, Chronic Diseases, and Social Determinants of Health. Specific ways in which NMH addressed significant needs are defined as follows: Priority 1: Access to Health Care. 1.1: Implement a Transitional Care Clinic (TCC) at NM LFH to medically transition ED patients and inpatients without a medical home. In 2018, nearly 1,900 emergency department (ED) and inpatient patients at NM LFH did not have a primary care physician identified in their electronic health record (EHR). Additionally, 40% of emergency room encounters in FY18 were from Waukegan, North Chicago, Zion and the Round Lake area, where many residents are covered by Medicaid plans or are lack insurance. When patients utilize the ED for primary care and treatment of chronic conditions - services that would be better provided in the primary care setting - they use care resources that could be provided to more acute patients. Additionally, those with chronic conditions have better health outcomes when they receive ongoing care within the context of an ongoing relationship with a primary care provider. Since February 2020, NM LFH opened its Transitional Care Clinic (TCC) to provide comprehensive services through a series of appointments to medically and psychosocially stabilize patients following discharge from the ED or inpatient, then links patients who do not have a source of routine care to a primary care physician at Erie HealthReach Waukegan or other medical home. The TCC team also addresses complex barriers to care including medication access, health literacy, insurance, and transportation while connecting the patient to a medical home. In FY21, the TCC provided care to 244 patients through 929 patient visits. 1.2: Implement an electronic tool to screen patients for Social Determinants of Health (SDOH) and refer patients to social service organizations as needed. In 2021, a pilot was conducted among multiple settings and regions of a screening tool that evaluated 6 social determinant domains: housing, food, medication affordability, transportation, mental health, and social isolation. The tool was integrated into the Epic electronic medical record for data collection and to enable visualization of the patients' needs using Storyboard and SDOH Wheel views in Epic. As of August, 2022, more than 9230 patients who live in Lake County ZIP codes had been screened, with 2944 of those patients reporting from a high hardship zip code. An additional pilot was designed in partnership with Mano a Mano Family Resource Center targeting Spanish speaking Latino patients in the NM Grayslake Family Medicine Clinic. The goal is to link patients and community residents to resources to address social needs in a timely, efficient, culturally appropriate that is in or near their neighborhood through referrals directly to a Mano a Mano community health worker. This pilot launched in FY22 created more than 20 direct referrals to a community health worker at Mano a Mano, all who accepted help and received additional education regarding relevant medical conditions. Priority 2: Behavioral Health. 2.1 Expand the use of telehealth for psychiatric services throughout the NM LFH CSA. The need for behavioral health services has risen in recent years, surging during and following the pandemic. For patients seeking care for behavioral health in the Emergency Department at NM LFH, limited access to in-person psychiatric consults can create delays in moving to the next setting for care, whether inpatient or ambulatory. NM LFH implemented telepsychiatry in 2020, which allows for psychiatrists to use a specialized platform and videoconferencing technology to perform comprehensive evaluations in the ED in a timely manner from a remote location. In FY2021, 141 patients were provided telepsychiatry consults. 2.2 Expand a program to reduce opioid prescribing in the emergency department using the Alternatives to Opioids model. Due to COVID-19, NMLFH was unable to expand this program model. 2.3 Increase behavioral health services and capacity in community settings. In FY21 NM LFH developed a partnership with The Josselyn Center, a longstanding behavioral health provider who opened a new location in NM LFH's service area in 2020. Through the partnership, NM LFH provided funding for operational capacity and to support a new role, a Behavioral Health Care Coordinator, to create an immediate connection with patients being discharged from NM LFH settings and establishing care at The Josselyn Center. Through August, 2022 384 patients were referred for assessment and care. In addition, NM LFH provides grant funding to provide timely access and expand capacity for behavioral health services at Erie HealthReach Waukegan, an FQHC serving nearly 10,000 patients in Lake County. In partnership with the Waukegan Public Library, NM LFH launched a pilot to reduce barriers to behavioral health services in the community. NM LFH provided funding for the library to contract two social workers with the Josselyn Center, one Spanish speaking, and one African American. These social workers were available to Library patrons for 30-60-minute appointments with access to the Library's community health workers as well. By bringing social workers to a community setting, we worked to address barriers to cost and access. 2.4 Implement Calm Classroom, a classroom-based mindfulness program, in Lake County schools. Calm Classroom is a simple and accessible way to integrate mindfulness into the classroom culture. The daily practice of breathing, stretching, focusing and relaxation exercises cultivates a greater sense of self-awareness, mental focus and emotional resilience within educational spaces. Calm Classroom is the largest provider of school-wide mindfulness programming in the U.S. In 2008 Calm Classroom launched in Chicago Public Schools, and as of 2018 the program has been implemented in thousands of classrooms all over the world. Each school district was funded for two years and committed to sustain funding. Through NM LFH funding, Calm Classroom became available to over 25,000 students. Priority 3: Chronic Disease 3.1 Implement a community blood pressure screening program in high opportunity neighborhoods, educate residents about hypertension and connect them to a quality medical home. NM LFH provided blood pressure clinics, initiating 70 referrals to a Primary Care Provider and 72 referrals to a community partner to address other social determinants of health. In addition to screening NM LFH supported community organizations which further provided health education and health resources. NM LFH provided funding support to Mano a Mano, a not-for-profit local immigrant-serving agency that provides a one-stop-shop for health resources and services, educational classes and workshops, and immigration legal services for some of the hardest to reach, most vulnerable families and individuals living in Lake County. Mano a Mano works to empower immigrants and their families living in Lake County, Illinois to become full participants in American life. Mano a Mano conducts multiple initiatives to serve the residents of Lake County, including: the Healthy Families Program (HFP) aimed at expanding health literacy and improving the health of immigrants by helping them integrate into and understand the U.S. healthcare system; the Community Health Workers (CHW) Program, which is a collaboration that focuses on community health needs that have been identified by local research as priorities for low-income and immigrant communities including the health literacy and training priorities including, but not limited to, hypertension, diabetes, prenatal care, insurance benefits, nutrition, and obesity; and expanded access to healthcare and social services through transportation support, among others. The activities supported by NM LFH expanded access to community health education and improved health literacy through the HFP and CHW Program initiatives, as well as access to healthcare and social services through transportation support, for people assisted by Mano a Mano.

Schedule H, Part V, Section B, Line 11 Facility , 2
"Facility , 2 - NORTHWESTERN LAKE FOREST HOSPITAL. NM LFH also supported the Functional Health Literacy Program and the Community Health Worker Program at Waukegan Public Library. Through this program, the Waukegan Public library will expand its capacity to provide health education to members of the African American and English-speaking community in Waukegan and its surrounding communities. The goal is to increase understanding of how to prevent and manage chronic diseases, increase healthy behaviors, and access medical providers among the underserved African Americans in the area. Its long-term goal is to reduce health inequities through health literacy and service navigation for a community especially impacted by educational, cultural, and social barriers to accessing health services. Additionally, NM LFH supported the Roberti Community House, a not-for-profit local community organization who provided support to the residents of the community through programming to support healthier lifestyle, weekly produce boxes and daily emergency lunch support. 3.2 Implement the American Heart Association ""Target: BP"" program at Northwestern Medicine and Northwestern Medical Group locations and within local federally qualified health center partners. Due to COVID-19, NM LFH was unable to expand this program model. However, community discussions took place, and there are plans to implement this program in post-pandemic years. The community programming team was still able to lead several blood pressure screening clinics, screening more than 700 patients in the community. Priority 4: Social Determinants of Health 4.1: Increase youth pipeline opportunities by engaging North Chicago Community High School via their Healthcare Careers Pathway program and expose students to healthcare-related careers through presentations, internships and curriculum development. In FY21 the Healthcare Careers Pathway program did not take place a NCCHS. However, NMLFH provided support to career counselors and will continue to do so in FY22 as the Pathway program returns. 4.2: Create hiring pipelines for youth and adults to connect disparate communities to jobs through training programs, targeted outreach and partnerships, and inclusive local hiring practices. The NM Discovery Program is a local effort to expose students to careers in healthcare. Throughout the NM Discovery Program, high school sophomores and juniors are exposed to a broad range of activities designed to encourage their interest in healthcare careers. Topics vary by month and program activities included tours, guest speakers, group discussion, and hands-on projects. In addition, the program fosters character and professional development, cultivates life skills, provides community service and leadership experience, and offers mentorship and networking opportunities. Meetings are held once a month, most often on Saturday mornings, at Lake Forest Hospital and other off-site locations. During the pandemic, most sessions were held remotely. In FY21, the Discovery program hosted a cohort of 30 students for 6 sessions. Half of the students were from underfunded school districts in Lake County. NM LFH created a healthcare career pipeline program dedicated to providing a clear path for select graduates from North Chicago Community High School (NCCHS) to receive a post-secondary education followed by employment within the Northwestern Medicine family through a scholarship program called Directing Youth Navigating a Medical Career in the Community or DYNAMIC. The DYNAMIC Scholarship Program was created by the Department of Nursing at Northwestern Medicine Lake Forest Hospital to assist graduates of North Chicago Community High School (NCCHS) obtain a degree in health sciences from the College of Lake County, receive mentoring and guidance throughout their studies, and procure employment at NM LFH upon graduation. Selected students will have tuition paid for at the College of Lake County in one of several pre-approved health science degrees, or use the scholarship funds to cover other education-related expenses. Throughout the student's tenure at the College, they will be provided professional mentorship by hospital staff and receive exposure to the hospital setting. Upon graduation, the student will interview and be eligible to be hired by NM. The program was continued in FY22, with three students enrolled as scholarship recipients. Mentors at NM LFH were identified for the scholarship recipients and met with students minimally on a quarterly basis. 4.3: Embed diversity and inclusion (DI) practices and behaviors into what employees do each day by establishing a DI infrastructure with partnerships across the organization. These partnerships will promote, support and activate inclusive strategy culture and behavior that differentiates NM as an inclusive values-driven organization. Implement implicit bias and cultural competence training to increase awareness and decrease impact of implicit bias. In FY21, NM continued to make significant progress in this strategy in improving access to care at NM, meeting our patients diverse needs and improving overall equity for patients, the community and workforce. NM hosted 4 equity grand round, averaging 400+ participants, partnered with newly established community engagement councils, and continued the Equity Key Initiatives. The NM Diversity and Inclusion program seeks to embed Diversity, Equity and Inclusion (DEI) practices and behaviors into what employees do each day. This will foster engagement, mitigate bias, engender a day-to-day sense of belonging in the workplace, and create an internal environment that reflects the communities we serve. In FY21, 8,679 employees and 1,217 leaders from across NM participated in DEI training programs. Demonstrating NM's appreciation of diverse talents at all levels of the organization, we also support a network of five workforce-led resource groups that together form the NM Champion Network. Each of the five chapters is comprised of individuals that either identify as members or are allies of historically underrepresented communities. The chapters are: * African Descendants * Asian American Pacific Islander * Disability * Latinx * LGBTQ The groups are employee-led, and discuss workforce enhancements at NM, develop activities, awareness events, community outreach, support cultural responsiveness education opportunities, and participate in a variety of other approaches to promote diversity, equity and inclusion and engender a sense of community and belonging at NM. Participation in NM Champion network groups grew by 44% in FY21, and now more than 1,200 employees participate as member system-wide. NON-PRIORITY AREAS: The CHNA report identified areas of opportunity for health improvement for which NMLFH determined it would not prepare an implementation plan. These areas of opportunity and the reasons for not addressing are below. Accidents and Unintentional Injuries: Need was assessed by community as a relatively low priority and conditions are addressed through the NMLFH care delivery system. Cancer: Condition is addressed through the NMLFH care delivery system. Diabetes: Condition is addressed through the NMLFH care delivery system. Healthy Pregnancies: Need was assessed by community as a relatively low priority and is addressed through the NMLFH care delivery system. Infectious Diseases: Condition is addressed through the NMLFH care delivery system. Obesity: Condition is addressed through the NMLFH care delivery system. Pulmonary Disease (including tobacco use): Condition is addressed through the NMLFH care delivery system."

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: ""insured sliding fee scale assistance and ""insured catastrophic assistance."" If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services."

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - NORTHWESTERN LAKE FOREST HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. The CHNA report also describes Central DuPage Hospital's CHNA goals and objectives, public dissemination plan, and the process for the development of the implementation plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was implemented as part of the CHNA process. A list of recommended participants was provided by NMCDH; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the population with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online. Reminder emails were sent as needed to increase participation. In all, 41 community stakeholders took part in the Online Key Informant Survey including representatives of the organizations below: 1. Batavia Park district 2. Family shelter services 3. Common threads organization 4. DuPage County Health Department 5. Nami DuPage 6. VNA Health Care 7. DuPage Community Foundation 8. West Chicago Library 9. Senior Services Association 10. Secretary of State 11. DuPage Pads, Inc. 12. Carol Stream Police Department 13. St. Charles Park District 14. Association for Individual Development 15. B.R. Ryall of Northwestern DuPage County 16. Winfield in Action 17. Winfield Township 18. Benedictine University 19. Edward Hines VA Hospital 20. Humanitarian Service Projects 21. West Chicago Park District 22. Northern Illinois Food Bank 23. Wheaton Park District 24. Glen Ellyn Park District 25. Western DuPage Special Recreation Association 26. Donka, Inc. 27. World Relief 28. CASA of DuPage County 29. DuPage Senior Citizens Council 30. Winfield Park District 31. West Chicago YMCA 32. Mutual Ground 33. Meier Clinics 34. Kensington International 35. ProActive Kids 36. Warrenville Park District 37. SPR Consulting 38. Almost Home Kids 39. Bartlett Police Department 40. DuPage Easter Seal 41. People's Resource Center 42. DuPage Health Coalition 43. Samara Care Through this process, input was gathered from several individuals whose organizations work with low-income, minority populations, or other medically underserved populations. In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such and how these might be better addressed. Findings represent qualitative rather than quantitative data. The Online Key Informant Survey was designed to gather input from participants regarding their opinions and perceptions of the health of the residents in the area. Therefore, these findings are based on perceptions, not facts. To ensure that organizations impacting health in DuPage County were meaningfully engaged in reviewing and interpreting the findings of the CHNA, developing priorities among the identified needs and forming a collaborative plan to address the top priority needs, the External Steering Committee (ESC) was established.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to Central DuPage Hospital Leadership.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - Central DuPage Hospital Association. Through the FY2021 prioritization process, NMCDH identified four Priority Health Needs: Access to Healthcare Services, Chronic Disease, Mental Health and Substance Use Disorders, and Social Determinants of Health. Specific ways in which NMCDH is addressing the priority needs identified in the CHNA are defined as follows: Priority 1: Access to Healthcare Services 1.1: Community Engagement: Support efforts that increase access to healthcare services and community resources by investing in resources and collaborating with community-based organizations. Through an organized community engagement approach, a number of community organizations were contacted to learn more about the services they provide and identify opportunities to support access to health care issues. Through these efforts, NM was able to increase programs and initiatives focused on promoting access to care, especially with low-income and under-resourced communities. The following organizations having received educational resources and staff time: Access DuPage, Silver Access, DuPage Senior Council, Healthy West Chicago DuPage Pads, Mercy Housing and Spectrios Institute for Low Vision. In addition, a collaboration was formed with Age Guide to assist individuals aged 60 and older. Their goal is to coordinate their current services with NM by providing wrap around resources for the DuPage Senior community. 1.2: Federally Qualified Health Center (FQHC) and Clinical Community Collaboration: Align with the system-level approach to better serve the uninsured and underinsured populations through clinical community relationships. Utilizing a third-party software, NMCDH, in collaboration with Federally Qualified Health Centers (FQHCs) and Free and Charitable Clinics, assessed patients that seek medical care in the NMKH emergency department (ED) and in-patient settings. During the time frame, 46 self-identified patients from Aunt Martha's received care in the ED. Also, 6 of those patients were admitted in-patient at NMCDH. Additionally, 3,010 self-identified patients from the Visiting Nurse Association (VNA) utilized the NMKH ED, and 240 VNA patients were admitted as in-patients. This information helps ensure that our most vulnerable patients receive adequate and timely care. NMCDH provided a proportion of funding to support FQHC and other clinical community partners in a shared grant during the time period. VNA also received a grant in the amount of $50,000 to provide diabetes medical care and education to 521 individuals with limited or no insurance. The funds ensured that these individuals had access to the Step-by-Step Wellness program offered by VNA which focused on diabetes management and provided participants with access to fresh fruits and vegetables. 1.3: Health Screenings: Support efforts that increase access to health screenings by investing in resources and collaborating with community-based organizations such as the Why Wait program. Unfortunately, the Why Wait program was discontinued during the reporting time frame. In lieu of the Why Wait program, NMCDH provided health education related to Breast Health through three community sessions with a total of 10 attendees. 1.4: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address access to healthcare services. Midwestern University benefitted from support from NMCHDH to its College of Dental Medicine program. The Midwestern University's Dental Institute aims to assist veterans who are unable to afford dental care. Veterans referred by nonprofit agencies, including the Veterans Smile Program, will receive care including dental exams, tooth extractions, x-rays and dentures if needed. Priority 2: Chronic Disease 2.1: Health Screenings: Provide no-cost biometric screenings and educational sessions to the community. Provide no-cost blood pressure screenings and education about cardiovascular disease. Offer strategies to help people eat healthier, maintain a healthy weight and increase physical activity. NMCDH offered health education materials, screening supplies, and staffing expertise to the community. During the time frame, NMCDH implemented 4 blood pressure clinics which provided screening and education services at no cost to 131 participants. Of those individuals screened, 80.8% were identified as high risk. 2.2: Community Health and Wellness Programming: Promote health and reduce chronic disease through prevention, detection and addressing risk factors. Collaborate with early-childhood schools and child care centers to review polices and curricula, and increase efforts that promote nutrition and moderate to vigorous physical activity. NMCDH promoted wellness through chronic disease education, prevention, and early detection programs. Education centered around identifying and addressing risk factors. The Coordinated Approach to Child Health (CATCH) program was offered to community organizations. As a result, 15 classrooms comprised of 409 individuals benefitted from increased knowledge of disease prevention and wellness promotion methods. 2.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address chronic disease. NMCDH provided funding through the NM Community Benefit donations and grants process to organizations that address chronic disease. One example was the Warrenville Park District, which utilized funding to support a community-wide race emphasizing physical activity to prevent chronic disease. Priority 3: Mental Health and Substance Use Disorders 3.1: Community Engagement: Support mental health efforts by collaborating with community-based organizations. NMCDH supported initiatives within DuPage County focused on Mental Health. This included participating in the development of the DuPage County Health Department Community Health Improvement Plan (CHIP) in collaboration with other local hospitals and community agencies. NMCDH provided staff support to the DuPage County Prevention Leadership Team (PLT) whose goal was to reduce substance use disorders and increase mental health awareness for youth 18 years and younger. This collaborative met monthly and NMCDH staff participation totaled over 18 hours of time devoted to these efforts. NMCDH also participated in CCSD93 Interconnected Mental Health Support program by devoting 9 hours of staff time and expertise. This work aimed to build an interconnected system of mental health support for the community unit school district which serves Bloomingdale, Carol stream and Hanover Park. 3.2: Mental Health Training and Education: Educate the community on how to identify, understand and respond to the signs of mental illnesses and substance use disorders. Increase awareness of negative attitudes and beliefs around mental health. The Mental Health First Aid (MHFA) program was designed to teach community members how to identify and take action to address mental health concerns. In addition to supporting those experiencing a mental health issue, the program aims to reduce the wide reach and economic toll of mental health disorders and crises in the community. Sessions aim to increase awareness and early intervention for those in need of behavioral health services. Select NMCDH staff are completing the training and certification process which will enable them to teach community members (including parents, family members, caregivers, teachers, school staff, and peers) how to help an adolescent or adult experiencing a mental health or addiction challenge or crisis. These individuals can then intervene and direct individual to appropriate resources. To-date, one NMCDH/NMDH staff has been trained to offer the nationally recognized evidence-based MHFA program. In fiscal year 2022, five MHFA sessions were offered in the NMCDH community service area and 77 participants completed the program.

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - Central DuPage Hospital Association. 3.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address mental health and substance use disorders. NMCDH provided community benefit grant funding and further solidified relationships with community agencies that provide outpatient mental health and substance use disorder services to the medically underserved residents in the service area. During the time period indicated, $5,000 was allocated in the form of a donation and/or grant to two community organizations on behalf of NMCDH. These organizations include the following: Bridge Communities: The majority of Bridge clients have undergone many forms of trauma including experiencing homelessness, coping with systemic racism, and witnessing or being a victim of abuse or neglect. Over the past two years, many parents have lost jobs and several families have been sick with COVID-19. In addition, some parents work in frontline industries. Despite the toxic stress they have experienced, parents and children have little or no engagement in mental health services. NMCDH funding will support access to ongoing mental health counseling with the goals of reversing the impacts of trauma, racism, and toxic stress; preventing similar experiences from occurring again; building resiliency; and positively impacting long-term behavioral and physical health. Bridge assesses all clients on their mental health needs and symptoms, refers them to trauma-informed counseling as necessary, and consistently monitors their mental health throughout their involvement in the two-year program. The Carlton Center (TCC) is a non-profit family development center serving teens and families. TCC works to normalize and de-stigmatize mental health to the underserved community. NMCDH funding will support counseling services and youth programs, including summer internships. This programs aims to teach youth new skills in a safe environment while decreasing the opportunity to engage in delinquent behavior. As a minority run organization, TCC understands the needs of Black, Indigenous, and people of color and offers services accordingly. Priority 4: Social Determinants of Health 4.1: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address SDOH. During the time period indicated, $151,000 was allocated in the form of a donation and/or grant to several community organizations on behalf of NMCDH. Recipient organizations include, but are not limited to: Choose DuPage, DuPage Habitat for Humanity and Chicago South Suburbs, People Made Visible, Inc., and People's Resource Center. With funding support from NMCDH, DuPage Pads provided emergency services to assist their clients in achieving housing stability in a safe and efficient manner. DuPage Pads was able to assist 329 individuals in transitioning from homelessness to housing stability. Non-Priority Areas The CHNA identified areas of opportunity for health improvement for which NMCDH determined it would not prepare an implementation plan. These areas of opportunity and the reasons for not addressing are below. Cancer: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Coronavirus/COVID-19: This need is addressed through the NMCDH care delivery system. Diabetes: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Heart disease and stroke: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Injury and violence: This need is better addressed through external community agencies who provide services to address it. Nutrition, physical activity and weight: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Potentially disabling conditions: This need is better addressed through external community agencies who provide services to address them. Tobacco use: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy.

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: ""insured sliding fee scale assistance and ""insured catastrophic assistance."" If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services."

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - CENTRAL DUPAGE HOSPITAL ASSOCIATION. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - DELNOR-COMMUNITY HOSPITAL. The CHNA report also describes the NMDH CHNA goals and objectives, public dissemination plan, and the process for the development of the implementation plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - DENOR-COMMUNITY HOSPITAL. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THE CHNA PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY NMDH; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATION WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 157 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY INCLUDING REPRESENTATIVES OF THE ORGANIZATIONS BELOW: 1. Ravenswood Health and Wellness Center and Advance Performance Pain 7 Wellness Center 2. Rush Copley Medical Center 3. American Cancer Society 4. Nutrition And Wellness Educator at University of Illinois 5. Professor, Health Studies, Nutrition and Dietetics, Northern Illinois University 6. Kane County Department of Transportation 7. Northern Illinois Food Bank 8. Visiting Nurse Association 9. Kane County Health Department 10. Aunt Martha's Youth Services 11. Greater Family Health 12. Amita Health, Provena Mercy Medical Center 13. Elgin Community College 14. Amita Health 15. KDOT Planning and Programming 16. Waubonsee Community College 17. Association For Individual Development 18. Active Medical Center 19. Community Harvest Educational Foundation 20. Advocate Health 21. American Heart Association 22. Fox Valley Park Districts 23. Kane County Bicycle and Pedestrian Coordinator 24. Center For Diabetic Wellness, Amita Health 25. Northern Illinois University 26. Upward Bound 27. Pads Program, Elgin To ensure that organizations impacting health in central Kane County were meaningfully engaged in reviewing and interpreting the findings of the CHNA, developing priorities among the identified needs and forming a collaborative plan to address the top priority needs, the External Steering Committee (ESC) was established and maintained. This multidisciplinary committee was made up of key stakeholders who were selected based on strong collaborative efforts to improve the health of the community, including the medically underserved, minority and low-income populations.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - DELNOR-COMMUNITY HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to Delnor Leadership.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - DELNOR-COMMUNITY HOSPITAL. Through the FY2021 prioritization process, NMDH identified four Priority Health Needs: Access to Healthcare Services, Chronic Disease, Mental Health and Substance Use Disorders, and Social Determinants of Health. Specific ways in which NMDH is addressing the priority needs identified in the CHNA are defined as follows: Priority 1: Access to Health Care and Community Resources 1.1: Community Engagement: Support efforts that increase access to healthcare services and community resources by investing in resources and collaborating with community-based organizations. NMDH provided staff time and educational resources to support efforts that increase access to healthcare services and community resources with its participation in workgroup activities and to promote programs and initiatives to address access to health care issues and community resources. NM CDH provided 18 hours of staff to support the Kane County Health Department's Access to Health Services Action Team. As part of these efforts, a planned approach to increase programs and initiatives focused on promoting access to care, especially with low-income and under-resourced communities was addressed as a key component of the workplan. 1.2: Federally Qualified Health Center (FQHC) and Clinical Community Collaboration: Align with the system-level approach to better serve the uninsured and underinsured populations through clinical community relationships. Utilizing a third-party software, NMDH, in collaboration with Federally Qualified Health Centers (FQHCs) and Free and Charitable Clinics, are able to assess a number of patients that seek medical care in the NMKH Emergency Department and In-Patient setting. During the time frame it was identified that there were 43 self-identified patients from Aunt Martha's that received care in the ED. Also, 4 of those patients were admitted In-Patient at NMDH. Additionally, there 2,336 self-identified patients from VNA that utilized NMDH ED. VNA patients that were admitted In-Patient equated to 139. Having this information is helpful to ensure that our most vulnerable patients receive adequate and timely care. NMDH was able to provide a proportion of funding to support Tri City Health in the form of a grant in the amount of $20,000 during the time period. 1.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address access to healthcare services and community resources. NMDH provided funding through the Community Benefit donations and grants process to support strategies and organizations that address access to healthcare services and community resources. During the time period indicated there was $121,000 provided to a number of community organizations in the form of a donation and/or grants of community organizations on behalf of NMDH. Elgin Well Child Conference and Referral Service, was one organization that supported the most vulnerable clients served at WCC, funding was allocated for the purchase of two refurbished Symphony Breast Pumps to support the Women, Infant, and Children (WIC) breastfeeding participants through the WCC breast pump loaner program. Premature infants and newborns greatly benefit from this program as it has been proven that the nutrition an infant receives through breastmilk can greatly improve overall wellbeing and health, a core focus of the Well Child Center's mission to help families raise healthy children. Priority 2: Chronic Disease 2.1: Health Screenings: Provide no-cost biometric screenings and educational sessions to the community. Provide no-cost blood pressure screenings and education about cardiovascular disease. Offer strategies to help people eat healthier, maintain a healthy weight and increase physical activity. List outcomes In addition to the screenings, NMDH staff provided 19.5 hours of support to the Nutrition Exercise and Weight collaborative that focuses on increasing awareness, providing education and provides community resources to contribute to a healthy lifestyle. 2.2: Community Health and Wellness Programming: Promote health and reduce chronic disease through prevention, detection and addressing risk factors. Collaborate with early-childhood schools and child care centers to review polices and curricula, and increase efforts that promote nutrition and moderate to vigorous physical activity. NMDH provided staff, health education tools and materials for screening and education. During the time NMDH staff provided 2 blood pressure clinics which provided this free service and education to 37 participants. Of those individuals screened 63.2% were identified as high risk. 2.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address chronic disease. NMDH provided funding through the Community Benefit donations and grants process to support strategies and organizations that address chronic disease. Aurora Interfaith Food Pantry, a new partner with NMDH, provided nutritious food relief to the community to prevent chronic disease and promote health. Priority 3: Mental Health and Substance Use Disorders 3.1: Community Engagement: Support mental health efforts by collaborating with community-based organizations. Continue strategic planning efforts to evaluate the demand for hospital-based mental health services and identify appropriate NMDH resources to address those needs. NMDH staff participated this past year on the Kane County Health Department Tobacco Coalition approximately 2 hours to address tobacco education and prevention efforts. Additionally, NMDH staff participated with Kane County Health Department Behavioral Health Council on their collaborative focused on mental health and substance abuse for health care professionals. 3.2: Mental Health Training and Education: Educate the community on how to identify, understand and respond to the signs of mental illnesses and substance use disorders. Increase awareness of negative attitudes and beliefs around mental health. Mental Health First Aid course was offered to the NMDH community service area in an attempt to increase awareness and decrease stigma related to mental health. In FY22, we offered one course which resulted in 13 participants. 3.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address mental health and substance use disorders. As a result of funding, Kane County State's Attorney Office offered the Pre-Arrest Diversion (PAD) program. Individuals in Pre-Arrest Diversion have presented problematically in the community due to their untreated mental illness, substance use, or lack of resources. Providing them with the things they need on the most basic level, gives them a chance to start moving in a more positive direction where they either stop showing up problematically or at least less frequently. Addressing their needs helps to improve public health and public safety, so all in our community benefit. Priority 4: Social Determinants of Health 4.1: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address SDOH. Every week, the Aurora Food Pantry distributes about 80 pounds of food per visitor. Since the receipt of the grant funds from NMDH, approximately 50,000 people benefitted from the program. Neighbors needing food assistance come to the pantry and can shop in the marketplace just like a grocery store. This gives them the opportunity to select the foods that their families will eat. Additionally, by giving them choices, they are able to select foods that are healthy and nutritious. These foods include fresh produce, frozen meats of all kinds, cereal, rice, beans, shelf-stable foods and of course dairy products. Non-Priority Areas The CHNA identified areas of opportunity for health improvement for which NMDH determined it would not prepare an implementation plan. These areas of opportunity and the reasons for not addressing are below. Education: This need is better addressed through external community agencies who provide these services. Environment: This need is better addressed through external community agencies who provide services to address this. Exercise, nutrition and weight: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Immunizations and infectious diseases: This need was assessed by the community as a relatively low priority as measured by the NMDH prioritization tool.

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - DELNOR-COMMUNITY HOSPITAL. Maternal, fetal and infant health: This need was assessed by the community as a relatively low priority as measured by the NMDH prioritization tool. Older adults and aging: This need was assessed by the community as a relatively low priority as measured by the NMDH prioritization tool. Other chronic diseases (defined as osteoporosis, rheumatoid arthritis, osteoarthritis and chronic kidney disease): This need was assessed by the community as a relatively low priority as measured by the NMDH prioritization tool. Public safety: This need is better addressed through external community agencies who provide services to address this. Teen and adolescent health: This need was assessed by the community as a relatively low priority as measured by the NMDH prioritization tool. Transportation: This need is better addressed through external community agencies who provide these services.

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - DELNOR-COMMUNITY HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: ""insured sliding fee scale assistance and ""insured catastrophic assistance."" If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services."

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - DELNOR-COMMUNITY HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - KISHWAUKEE HOSPITAL. The CHNA report also describes Kishwaukee Hospital background, charity care, the mission, CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - KISHWAUKEE HOSPITAL. Partnering with DeKalb County health department, the CHNA process included a survey administered to community partners, their employees, and clients, to allow responses from low-income areas, mental health clinics, youth organizations and food pantries. Representatives of the community included: 1. Adventure Works 2. Black, Liberated, Leadership and Community Kinmanship (B.L.L.A.C.K.) 3. Casa Dekalb County 4. Dekalb County Community Foundation 5. Dekalb County Community Gardens 6. Dekalb County Mental Health Board 7. Dekalb County Health Department 8. Dekalb County Regional Office of Education 9. Dekalb County Sheriff's Office 10. Dekalb County States Attorney's Office 11. Dekalb County Youth Service Bureau 12. Dekalb Police Department 13. Family Service Agency of Dekalb County 14. Fox Valley Community Services 15. Fox Valley YMCA 16. Greater Family Health 17. Hope Haven 18. Housing Authority of The County of Dekalb 19. Kendall County Health Department 20. Kishwaukee College 21. Kishwaukee Family YMCA 22. Kishwaukee United Way 23. New Hope Missionary Baptist Church 24. Open Door Rehabilitation Center 25. Opportunity House Plano Community School District 88 26. Safe Passage 27. Sandwich Community Unity School District 430 28. Sandwich Police Department 29. State Representative Jeff Keicher, District 70 30. Voluntary Action Center The key informant survey was designed to gather input from participants regarding their opinions and perceptions of the health of the residents in the area. Therefore, these findings are based on perceptions, not facts. An external steering committee was convened to provide oversight to the development of the CHNA and engage the community throughout the process under the leadership and direction of members from Northwestern Medicine Kishwaukee Hospital and Northwestern Medicine Valley West Hospital.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - KISHWAUKEE HOSPITAL. KISHWAUKEE HOSPITAL WORKED IN TANDEM WITH VALLEY WEST HOSPITAL AND SHARED RESPONSIBILITIES ON A JOINT STEERING COMMITTEE. SPECIFIC NEEDS AND CONCERNS OF KISHWAUKEE COMMUNITY HOSPITAL WERE IDENTIFIED AND ADDRESSED SEPARATELY.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - KISHWAUKEE HOSPITAL. KISHWAUKEE HOSPITAL COLLABORATED WITH HCI FOR ITS 2021 CHNA.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - KISHWAUKEE HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to Kishwaukee Hospital Leadership.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL. Through the FY2021 prioritization process, NMKH identified three Priority Health Needs: Access to Health Care and Community Resources, Chronic Disease, and Mental Health and Substance Use Disorders. Specific ways in which NMKH is addressing the needs identified in the CHNA are defined as follows: Priority 1: Access to Health Care and Community Resources 1.1: Community Engagement: Support efforts that increase access to healthcare services and community resources by investing in resources and collaborating with community-based organizations. Support efforts that increase access to healthcare services and community resources by investing in resources and collaborating with community-based organizations. Through an organized approach to connect with community organizations a number of agencies were contacted to learn more about the services provided and share knowledge in order to identify and support access to health care issues. Additionally, there was a planned approach to increase programs and initiatives focused on promoting access to care, especially with low-income and under-resourced communities. As a result of those efforts the identified the following organizations including, but not limited to have received support in the form of staff time as part of those efforts: Safe Passage, University Village Collaborative, Opportunity House and Hope Haven. 1.2: Federally Qualified Health Center (FQHC) and Clinical Community Collaboration: Align with the system-level approach to better serve the uninsured and underinsured populations through clinical community relationships. Utilizing a third-party software, NMKH, in collaboration with Federally Qualified Health Centers (FQHCs) and Free and Charitable Clinics, are able to assess a number of patients that seek medical care in the NMKH Emergency Department and In-Patient setting. During the time frame it was identified that there were 103 self-identified patients from Aunt Martha's that received care in the ED. Additionally, there 849 self-identified patients from VNA that utilized NMKH ED. VNA patients that were admitted In-Patient equated to 39. Having this information is helpful to ensure that our most vulnerable patients receive adequate and timely care. 1.3: Health Screenings: Support efforts to increase access to health screenings by investing in resources and collaborating with community-based organizations such as the Women Matter program . 1.4: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address access to healthcare services and community resources. NMKH provided funding through the Community Benefit donations and grants process to support strategies and organizations that address access to healthcare services and community resources. During the time period indicated NMKH awarded Voluntary Action Center with an NM Community Grant during the specified time period. Voluntary Action Center (VAC) has provided transportation and nutrition services to DeKalb County residents for over 45 years. Grant funding awarded to VAC supports transportation services through their TransVAC and MedVAC programs, and meals to homebound and senior populations through Meals on Wheels. Priority 2: Chronic Disease 2.1: Health Screenings: Provide no-cost biometric screenings and educational sessions to the community. Provide no-cost blood pressure screenings and education about cardiovascular disease. Offer strategies to help people eat healthier, maintain a healthy weight and increase physical activity. Better prevention of and the management of high cholesterol, high blood pressure or diabetes to help lower the risk for heart disease is a key component to the Know Your Numbers biometric screening appointments. A screening designed to provide a participant with their individual cardiovascular risk factors including fasting glucose, total cholesterol, Body Mass Index (BMI), blood pressure and waist measurement. Community members have access to this complimentary screening and appointments are available monthly. Unfortunately, due to changes in medical director leadership and oversight to the CLIA requirements, the program was not offered during this time period. Blood pressure checks were offered throughout the NMH community service area. The goal of offering the blood pressure checks is to improve awareness of one's own blood pressure number, an indicator used for heart disease risk factors. There were 16 clinics offered and 403 people participated in blood pressure screenings during the timeframe. Of those screened patients with a B/P greater than 120/80 is 63.8 percent. 2.2: Leishman Center for Culinary Health: Expand access to educational and behavioral modification programs (such as healthy diet and cooking programs) to reduce the risk of chronic disease. The Leishman Center for Culinary Health offers a variety of natural, whole foods cooking classes designed to help participants make simple changes for a healthier lifestyle. The philosophy of the Leishman Center is focused around eating real food, which support the mission of the department in tackling chronic illness, disease and obesity. The Leishman Center for Culinary Health reached more than 110 participants through 175 class offerings. 2.3: Food Security and Access: Farmers Market Coupon Program: Foster collaborations with community-based organizations to increase access to fresh fruits and vegetables. This program was discontinued during the timeframe due to lack of participations and access to vendors willing to support the program. In lieu of this program NMKH pivoted to provide additional funding to support DCCG or Barb Food Mart. 2.4: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address chronic disease. NMKH provided funding through the Community Benefit donations and grants process to strategies and organizations that address chronic disease. Sycamore Park District benefitted from a donation to continue to provide high-quality, accessible programming to address physical activity and prevention of chronic disease. Their programs strived to engage community members around increased awareness and wellness resources. Priority 3: Mental Health and Substance Use Disorders 3.1: Ben Gordon Center: The Living Room: Provide a calm and safe environment in which guests can resolve crises without intensive intervention. NMKH partnered with NM Behavioral Health Services to provide a calm and safe environment in which guests can resolve crises without intensive intervention. At The Living Room visitors can speak with a trained peer recovery support specialist. There is no cost and no appointment needed for this service, and it is available to any DeKalb County resident age 18 or older. As a result of this program, there were 565 individuals that visited the Living Room. 3.2: Mental Health Training and Education: Educate the community on how to identify, understand and respond to the signs of mental illnesses and substance use disorders. Increase awareness of negative attitudes and beliefs around mental health. Mental Health First Aid course was offered to the NMKH community service area in an attempt to increase awareness and decrease stigma related to mental health. In FY22, the number of sessions delivered was 7 with 38 participants. 3.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address mental health or substance use disorders. CASA DeKalb County serves as the voice for children in DeKalb County who have experienced abuse or neglect and are involved in the court system through no fault of their own. The funding from NMKH was utilized for recruitment costs, training costs and staff support for the summer and fall 2022 pre-service training classes for new advocates and continuing education classes for current advocates. It costs approximately $2,500 to train and support an advocate. 3.4: Drug Education and Safety Services: Raise awareness and educate the community about the potential for abuse of medications while providing a safe, convenient and responsible way of disposing of prescription drugs.

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL. NNMKH raised awareness of the drug take back programs in the service area. Working in partnership with the following local law enforcement offices: DeKalb Police Department, DeKalb County Sheriff's Office, Kingston Police Department, Sandwich Police Department and Sycamore Police Department to decrease the opportunity for diversion of non-prescribed prescription drugs and opioids. A total of 144.75 pounds of unwanted, unused, or expired medication was disposed of throughout DeKalb County in either permanent drug takeback boxes or during National Drug Take Back Day. 3.5: Tobacco Cessation Education and Resources: Offer educational programs and referral services (such as Courage to Quit and referrals to the Illinois Quitline) to encourage tobacco cessation. NMKH offered educational programs and referral services (such as Courage to Quit and referrals to the Illinois Quitline) to encourage tobacco cessation. During the time period, there were 170 individuals that participated in smoking cessation programs and two referred to the IL Tobacco Quitline. Non-Priority Areas The CHNA report identified area of opportunity for health improvement for which NMKH determined it would not prepare an implementation plan. These identified areas and the reason for not addressing are listed below: Cancer: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Environment: This need is better addressed through external community agencies who provide services to address this. Exercise, nutrition and weight: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Immunizations and infectious disease: This need was assessed by the community as a relatively low priority as measured by the NMKH prioritization tool. Other chronic diseases (defined as chronic pain, autoimmune diseases, osteoporosis, rheumatoid arthritis, osteoarthritis and chronic kidney disease): This need was assessed by the community as a relatively low priority as measured by the NMKH prioritization tool. Public Safety: This need is better addressed through external community agencies who provide services to address this. Transportation: This need is better addressed through external community agencies who provide these services. Women's Health: This need was assessed by the community as a relatively low priority as measured by the NMKH prioritization tool.

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - KISHWAUKEE COMMUNITY HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: ""insured sliding fee scale assistance and ""insured catastrophic assistance."" If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services."

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - KISHWAUKEE COMMUNITY HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - VALLEY WEST HOSPITAL. The CHNA report also describes Valley West Hospital background, charity care, the mission, CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - VALLEY WEST HOSPITAL. Partnering with DeKalb County health department, the CHNA process included a survey administered to community partners, their employees, and clients, to allow responses from low-income areas, mental health clinics, youth organizations and food pantries. Representatives of the community included: 1. Adventure Works 2. Black, Liberated, Leadership and Community Kinmanship (B.L.L.A.C.K.) 3. Casa Dekalb County 4. Dekalb County Community Foundation 5. Dekalb County Community Gardens 6. Dekalb County Mental Health Board 7. Dekalb County Health Department 8. Dekalb County Regional Office of Education 9. Dekalb County Sheriff's Office 10. Dekalb County States Attorney's Office 11. Dekalb County Youth Service Bureau 12. Dekalb Police Department 13. Family Service Agency of Dekalb County 14. Fox Valley Community Services 15. Fox Valley YMCA 16. Greater Family Health 17. Hope Haven 18. Housing Authority of The County of Dekalb 19. Kendall County Health Department 20. Kishwaukee College 21. Kishwaukee Family YMCA 22. Kishwaukee United Way 23. New Hope Missionary Baptist Church 24. Open Door Rehabilitation Center 25. Opportunity House Plano Community School District 88 26. Safe Passage 27. Sandwich Community Unity School District 430 28. Sandwich Police Department 29. State Representative Jeff Keicher, District 70 30. Voluntary Action Center The key informant survey was designed to gather input from participants regarding their opinions and perceptions of the health of the residents in the area. Therefore, these findings are based on perceptions, not facts. An external steering committee was convened to provide oversight to the development of the CHNA and engage the community throughout the process under the leadership and direction of members from northwestern medicine Kishwaukee Hospital, and Northwestern Medicine Valley West Hospital.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - VALLEY WEST HOSPITAL. VALLEY WEST HOSPITAL WORKED IN TANDEM WITH KISHWAUKEE HOSPITAL AND SHARED RESPONSIBILITIES ON A JOINT STEERING COMMITTEE. SPECIFIC NEEDS AND CONCERNS OF VALLEY WEST HOSPITAL WERE IDENTIFIED AND ADDRESSED SEPARATELY.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - VALLEY WEST HOSPITAL. VALLEY WEST HOSPITAL PARTNERED WITH HCI.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - VALLEY WEST HOSPITAL. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also distributed to Northwestern Medicine Valley West Hospital Leadership.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. Through the FY2021 prioritization process, NMVWH identified four Priority Health Needs: Access to Health Care and Community Resources, Chronic Disease, Mental Health and Substance Use Disorders, and Older Adults and Aging. Specific ways in which NMVWH is addressing the needs identified in the CHNA are defined as follows: Priority 1: Access to Health Care and Community Resources 1.1: Community Engagement: Support efforts that increase access to healthcare services and community resources by investing in resources and collaborating with community-based organizations. NMVWH supported efforts that increase access to healthcare services and community resources by investing in resources and collaborating with community-based organizations. Through an organized approach to connect with community organizations a number of agencies were contacted to learn more about the services provided and share knowledge in order to identify and support access to health care issues. Additionally, there was a planned approach to increase programs and initiatives focused on promoting access to care, especially with low-income and under-resourced communities. As a result of those efforts the identified the following organizations having received educational resources and staff time as part of those efforts. Sone organizations that we engaged with included but are not limited to were: Equine Dreams, Fox Valley YMCA, Sandwich Education Foundation and United Way of DeKalb County. 1.2: Federally Qualified Health Center (FQHC) and Clinical Community Collaboration: Align with the system-level approach to better serve the uninsured and underinsured populations through clinical community relationships. Utilizing a third-party software, NMVWH, in collaboration with Federally Qualified Health Centers (FQHCs) and Free and Charitable Clinics, are able to assess a number of patients that seek medical care in the NMKH Emergency Department and In-Patient setting. During the time frame it was identified that there were 16 self-identified patients from Aunt Martha's that received care in the ED. Additionally, there were 467 self-identified patients from VNA that utilized NMKH ED. VNA patients that were admitted In-Patient equated to 8. Having this information is helpful to ensure that our most vulnerable patients receive adequate and timely care. 1.3: Health Screenings: Support efforts to increase access to health screenings by investing in resources and collaborating with community-based organizations such as the Women Matter program. The NMVWH CHNA also indicated that the age-adjusted death rate due to breast cancer in DeKalb County is higher than state and national values. Further, the county value of 28.4 deaths per 100,000 female patients does not meet the Healthy People 2020 target of 20.7 deaths per 100,000, and the rate is increasing significantly. Offering people with little or no insurance coverage access to no-cost or reduced-cost mammograms will help increase screening rates. As a result of these efforts there were five women that received free mammograms through the Women Matter program. 1.4: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address access to healthcare services and community resources. Open Door Rehabilitation provides unrivaled services for adults with intellectual and developmental disabilities which enrich their quality of life. Open Door carries out this mission by providing day program, residential, and intermittent services. Our client population struggles with physical health due to their disabilities, so we design our programs around helping them make healthier choices and giving them more opportunities for activities that improve their health. Funding support to this organization enabled these individuals to access and participate in a number of outings and activities in the community. Priority 2: Chronic Disease 2.1: Health Screenings: Provide no-cost biometric screenings and educational sessions to the community. Provide no-cost blood pressure screenings and education about cardiovascular disease. Offer strategies to help people eat healthier, maintain a healthy weight and increase physical activity. Know Your Numbers, an evidence-based approach to community awareness of cardiovascular disease. Better prevention of and the management of high cholesterol, high blood pressure or diabetes to help lower the risk for heart disease is a key component to the Know Your Numbers biometric screening appointments. Unfortunately, due to changes in leadership and oversight to the CLIA requirements, the program was not offered during this time period. There were 4 blood pressure clinics offered in the NMVWH service area with 62 participants that were screened. The goal of offering the blood pressure checks is to improve awareness of one's own blood pressure number, an indicator used for heart disease risk factors. Of those screened patients with a B/P greater than 120/80 is 40 percent. 2.2: Leishman Center for Culinary Health: Expand access to educational and behavioral modification programs (such as healthy diet and cooking programs) to reduce the risk of chronic disease. The Leishman Center for Culinary Health offers a variety of natural, whole foods cooking classes designed to help participants make simple changes for a healthier lifestyle. The philosophy of the Leishman Center is focused around eating real food, which support the mission of the department in tackling chronic illness, disease and obesity. The Leishman Center for Culinary Health reached more than 35 participants through 56 virtual classes. 2.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address chronic disease. Provided funding through the Community Benefit donations and grants process to support strategies and organizations that address access to healthcare services and community resources. NMVW Hospital provided DeKalb County Community Gardens with a Community Donation in FY22. This organization's mission is to provide access to healthy and sustainable foods, and address food security in the county. Funding supported the more than 15 acres of garden space maintained by the organization where produce is grown and distributed to community members through the Grow Mobile, a mobile food pantry program. Priority 3: Mental Health and Substance Use Disorders 3.1: Mental Health Training and Education: Educate the community on how to identify, understand and respond to the signs of mental illnesses and substance use disorders. Increase awareness of negative attitudes and beliefs around mental health. Educated the public on negative attitudes and beliefs regarding behavioral health by increasing the proportion of DeKalb County organizations to complete Mental Health First Aid course to increase awareness and decrease stigma related to mental health. During the time period, the number of sessions delivered was 7 with 38 participants. 3.2: Drug Education and Safety Services: Raise awareness and educate the community about the potential for abuse of medications while providing a safe, convenient and responsible way of disposing of prescription drugs. Raised awareness of the drug take back programs in the service area. Working in partnership with the following local law enforcement offices: DeKalb Police Department, DeKalb County Sheriff's Office, Kingston Police Department, Sandwich Police Department and Sycamore Police Department to decrease the opportunity for diversion of non-prescribed prescription drugs and opioids. A total of 204.75 pounds of unwanted, unused, or expired medication was disposed of throughout DeKalb County in either permanent drug takeback boxes or during National Drug Take Back Day. 3.3: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address mental health or substance use disorders. Sandwich Police Department was a recipient of funding from NMVWH to support their D.A.R.E. program. The D.A.R.E. program is a 5th grade classroom-based teaching opportunity between the students and the Sandwich Police Department that empowers students to respect others and choose to lead lives free from violence, substance use, and other dangerous behaviors. The program provides this valuable education to roughly 300 students.

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. Priority 4: Older Adults and Aging 4.1: Community Benefit Donations and Grants: Provide funding through the Community Benefit donations and grants process to strategies and organizations that address the needs of older adults and aging. NMVWH provided funding to support organizations whose primary focus is on older adults and aging by providing funding support to the following organizations. NM Valley West Hospital collaborated with Fox Valley Community Services, located in Sandwich, IL, to provide nutrition programming developed and lead by staff from NM's Leishman Center for Culinary Health. Educators delivered two virtual programs in June 2022 to clients of Fox Valley Community Services, a long-standing partner of NM Valley West Hospital whose mission is to provide programs and services that encourage seniors to continue living independent lives. Non-Priority Areas The CHNA report identified area of opportunity for health improvement for which NMVWH determined it would not prepare an implementation plan. These identified areas and the reason for not addressing are listed below: Cancer: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Environment: This need is better addressed through external community agencies who provide services to address this. Exercise, nutrition and weight: Although not individually called out as a priority, this need is being addressed through the Chronic Disease strategy. Immunizations and infectious disease: This need was assessed by the community as a relatively low priority as measured by the NMVWH prioritization tool. Other chronic diseases (defined as chronic pain, autoimmune diseases, osteoporosis, rheumatoid arthritis, osteoarthritis and chronic kidney disease): This need was assessed by the community as a relatively low priority as measured by the NMVWH prioritization tool. Public Safety: This need is better addressed through external community agencies who provide services to address this. Transportation: This need is better addressed through external community agencies who provide these services. Women's Health: This need was assessed by the community as a relatively low priority as measured by the NMVWH prioritization tool.

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: ""insured sliding fee scale assistance and ""insured catastrophic assistance."" If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services."

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. THE CHNA REPORT ALSO DESCRIBES MARIANJOY REHABILITATION HOSPITAL BACKGROUND, CHARITY CARE, MISSION, CHNA GOALS AND OBJECTIVES, PUBLIC DISSEMINATION PLAN, AND DEVELOPMENT OF THE IMPLEMENTATION PLAN.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THE CHNA PROCESS. THE LIST OF PARTICIPANTS WAS PROVIDED BY MARIANJOY REHABILITATION HOSPITAL AND INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATION WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 41 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY INCLUDING REPRESENTATIVES OF THE ORGANIZATIONS BELOW: 1. DUPAGE FOUNDATION 2. DUPAGE SENIOR CITIZENS COUNCIL 3. DUPAGE UNITED 4. EDUCARE WEST DUPAGE 5. FOX VALLEY SPECIAL RECREATION ASSOCIATION 6. NAMI DUPAGE 7. NORTHERN ILLINOIS FOOD BANK 8. PEOPLE'S RESOURCE CENTER 9. SAMARACARE 10. SENIOR SERVICES ASSOCIATES, INC. 11. WARRENVILLE PARK DISTRICT 12. WESTERN DUPAGE SPECIAL RECREATION ASSOCIATION 13. WEST CHICAGO PUBLIC LIBRARY DISTRICT 14. WINFIELD PARK DISTRICT THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. IN THE ONLINE SURVEY, KEY INFORMANTS WERE ASKED TO RATE THE DEGREE TO WHICH VARIOUS HEALTH ISSUES ARE A PROBLEM IN THEIR OWN COMMUNITY. FOLLOW-UP QUESTIONS ASKED THEM TO DESCRIBE WHY THEY IDENTIFIED PROBLEM AREAS AS SUCH AND HOW THESE MIGHT BE BETTER ADDRESSED. FINDING REPRESENT QUALITATIVE RATHER THAN QUANTITATIVE DATA. THE ONLINE KEY INFORMANT SURVEY WAS DESIGNED TO GATHER INPUT FORM PARTICIPANTS REGARDING THEIR OPINIONS AND PERCEPTIONS OF THE HEALTH OF THE RESIDENTS IN THE AREA. THEREFORE, THESE FINDINGS ARE BASED ON PERCEPTIONS, NOT FACTS.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. IN ADDITION TO PROVIDING THE CHNA REPORT ON THE WEBSITE AND MAKING IT AVAILABLE TO THE PUBLIC UPON REQUEST, THE CHNA REPORT WAS ALSO DISTRIBUTED TO THE FOLLOWING: * KEY COMMUNITY ORGANIZATIONS LEADERS * MARIANJOY REHABILITATION HOSPITAL INTERNAL EXTERNAL STEERING COMMITTEE MEMBERS * MARIANJOY REHABILITATION HOSPITAL LEADERSHIP

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - MARIANJOY REHABILITATION HOSPITAL. Through the FY2021 prioritization process, MRH identified four Priority Health Needs: Access to Health Care and Community Resources, Promoting Independence and Activity, Promoting Wellness and Preventing Disease, and Social Determinants of Health. Specific ways in which MRH is addressing the priority needs identified in the CHNA are defined as follows: Priority 1: Access to Health Care and Community Resources 1.1: Community Engagement: Support efforts that increase access to healthcare services and community resources by investing in resources and collaborating with community-based organizations. Through an organized approach to connect with community organizations a number of agencies were contacted to learn more about the services provided and share knowledge in order to identify and support access to health care issues. Organizations that NMMRH connected with during the specified time period, include, but is not limited to Access DuPage, Spectrios Institute for Low Vision, School Association for Special Education in DuPage County (SASED), Clare Woods Academy and Cupertino Home, Clearbrook, Ray Graham Association for People with Disabilities, and Marklund Philip Center and Day School As part of the outreach effort, Clare Woods Academy and Cupertino Home was interested in understanding what NMMRH resources may be available to assist individuals with learning and behavior disabilities aged between 5 to 21. Their goal is to coordinate their current services with NM by providing wrap around resources for the disability community. 1.2: Outpatient Transportation: Provide transportation services for outpatients in need of medical or therapy appointments, utilizing non-emergency transportation resources. During this time period, outpatient transportation has not been implemented. Leadership is aware that transportation continues to be a top barrier for patients and a plan to address this barrier is being taken under advisement. Priority 2: Promoting Independence and Activity 2.1: MRH Fitness Center: Provide access to classes and trainings at MRH Fitness Center that focus on increasing independence and activity. The Emerging Fitness Center at Northwestern Medicine Marianjoy Rehabilitation Hospital provides a place where people of all fitness and ability levels can exercise. Members can have their exercises modified based on their needs. Group exercise classes, personal training, and therapy-related classes for children with developmental disabilities were accessible to members. Through a planned approach to increase awareness of the Fitness Center, efforts were taken to identify community organizations that focus on outreach to those in the disability, chronic disease/movement disorder, and senior communities. As a result of those efforts, a community partnership list was developed and the next steps will be to engage those partners. Additionally, there was a planned approach to identify opportunities to track the impact on individual participants. During this time period, a SMART Goals dashboard was developed and will be implemented in the next year. 2.2: Safe Drivers Education: Provide community education for teenagers and older adults on safe driving. The NM MRH Driver Rehabilitation program has specially trained occupational therapists that assess participants with disabilities or health issues that hinder safe driving. The purpose of the Safe Driver program is to help participants understand their challenges and to identify and implement solutions to help them drive safely. NM MRH Safer Driver education team identified and provided a new evaluation to 350 adults/teens. 2.3: Aphasia Center: Provide services and interactions among individuals with communication disorders (aphasia). Support families and caregivers as part of outreach efforts. The NM MRH Aphasia Center is designed for people experiencing aphasia who would like to improve their communication skills. A speech-language pathologist with expertise in language disorders leads small group sessions. Within this time period, 89 unique clients were seen and 526 registrations were collected. Priority 3: Promoting Wellness and Preventing Disease 3.1: Community Programming: Offer evidence-based community health and wellness programming for chronic disease management, rehabilitation, and overcoming the limitations of chronic disabilities. NMMRH strived to promote and reduce chronic disease through community outreach and education. Efforts included offering programs to community organizations focused on healthy eating. As a result of those program offerings in Culinary Health at the Leishman Center, NMMRH was able to offer 133 classes where 187 participants within the NMMRH area participated. 3.2: Support Programs: Offer evidence-based support programs, including but not limited to self-help and support groups. NM MRH provides support and resource groups free at cost and they are open to caregivers and family members. Groups that NM MRH extended support program offerings include: Lives in Motion (Spinal Injury Cord) Support Group, Teen and Young Adult Brain Injury Support Group, Stroke Support Group, MS Support Group, ALS Support Group, and High Hopes (Adult Brain Injury) Support Group. Due to Covid-19, all groups were held virtually. 3.3: Injury Prevention: Offer injury prevention programming, including child passenger safety interventions. Implement programming with content provided by the ThinkFirst National Injury Prevention Foundation. During the time period indicated, The ThinkFirst team held 423 school presentations and reached 21,338 participants. The Injury Prevention team reached 4931 participants in Community Events, donated 5,595 helmets, checked 786 car seats, donated 625 car seats. Priority 4: Social Determinants of Health 4.1: NM Disability Employee Resource Group: Leverage the NM Disability Employee Resource Group to promote NM employment opportunities to people with disabilities. Northwestern Medicine and the NM Disability Chapter promotes a workplace environment that fosters a culture of inclusion and focuses on disability cultural responsiveness. Collaboration between the NM Disability Chapter, NM Talent Acquisition, and NM Human Resources, opportunities are underway to identify a planned approach towards increasing awareness of NM employment through targeted outreach. The goal of this collaboration is to increase the number of people with disabilities who work at NM. At this time, plan metrics are being identified and will be implemented in the following year. 4.2: Pipeline Programs: Evaluate and determine the role of MRH in job preparedness programs (such as NM Project Search) that can be implemented for young adults and adults with disabilities. At Project SEARCH the goal for each program participant (intern) is competitive employment by providing real-life work experience combined with training in employability and independent-living skills. During the FY22 time period, 11 students received training and all gained employment upon completion of their school year. Non-Priority Areas The CHNA identified areas of opportunity for health improvement for which MRH determined it would not prepare an implementation plan. These areas of opportunity and the reasons for not addressing are below. Cancer: Although not individually called out as a priority, this need is being addressed through the Promoting Wellness and Preventing Disease strategy. COVID-19: This need is addressed through the MRH care delivery system. Diabetes: Although not individually called out as a priority, this need is being addressed through the Promoting Wellness and Preventing Disease strategy. Heart disease: Although not individually called out as a priority, this need is being addressed through the Promoting Wellness and Preventing Disease strategy. Mental health: This need is addressed through the MRH care delivery system. Nutrition, physical activity and weight: Although not individually called out as a priority, this need is being addressed through the Promoting Wellness and Preventing Disease strategy. Substance use disorders: This need is better addressed through external community agencies who provide services to address it. Tobacco use: This need is addressed through the MRH care delivery system. Oral health: This need is better addressed through external community agencies who provide services to address it.

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - Marianjoy Rehabilitation Hospital. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Legal Illinois Residents. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. NMHC provides Free Care and Discounted Care to eligible Insured Patients through two methods: ""insured sliding fee scale assistance and ""insured catastrophic assistance."" If the Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. If there is reason to believe that an Applicant may have assets in amounts in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Homelessness; B. Deceased with no estate; C. Mental incapacitation with no one to act on the patient's behalf; D. Medicaid eligibility, but not on date of service for non-covered service; or E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services."

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - MARIANJOY REHABILIATION HOSPITAL. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. The CHNA report also describes NIMC's CHNA goals, objectives, public dissemination plan, and development of the implementation plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. NIMC commissioned Northern Illinois University Center for Governmental Studies to conduct a comprehensive CHNA. The CHNA framework consisted of a systematic, data-driven approach to determine the health status, behaviors and healthcare needs of residents in McHenry County. The assessment provided information to enable NIMC hospital leadership and key community stakeholders to identify health issues of greatest concern among all residents and decide how best to commit the hospitals' resources to those areas, thereby achieving the greatest possible impact on the community's health status. The CHNA incorporated data from both quantitative and qualitative sources and was conducted from September 2019 through April 2020. Prevalent needs were identified across all socioeconomic groups, races, ethnicities, ages and genders. The assessment highlighted health and socioeconomic disparities and needs that disproportionately impact the medically underserved and uninsured. A key component of any comprehensive assessment involves reaching out to members of the community and organizations that interact with them in an effort to better understand the needs and issues that affect the health of its citizens. NMMH, NMHH and NMWH gratefully acknowledges the participation of our community partners and key stakeholders for their input on perceived needs and priorities within the communities we serve. These individuals and organizations work closely with members of our community, including those most in need and those with marginalized access to healthcare services. In all, 76 stakeholders took part in the online key informant survey. Organizations marked with an asterisk denote programs that work with the poor, vulnerable and marginalized in McHenry County. Below is a list of the organizations asked to participate in the online key informant survey. 1. Advocate Aurora Health* 2. American Cancer Society 3. AMITA Health* 4. Association for Individual Development* 5. Cary Police Department 6. Cary School District 26* 7. Clearbrook* 8. Crystal Lake Food Pantry* 9. Epilepsy Foundation of North Central Illinois* 10. Family Health Partnership Clinic* 11. Fox River Fire District 12. Fox River Grove School District 3* 13. Harvard Area Community Health Center* 14. Harvard Community School District 50* 15. Harvard Senior Center* 16. Home of the Sparrow* 17. Huntley Community School District 158* 18. In Sync Systems, Inc. 19. Independence Health Therapy* 20. Johnsburg School District 12* 21. League of United Latin American Citizens* 22. McHenry County Department of Health* 23. McHenry County Dental Society 24. McHenry County Government 25. McHenry County Housing Authority* 26. McHenry County Mental Health Board* 27. McHenry County Office of Special Projects 28. McHenry County Planning Development 29. McHenry County School District 15* 30. McHenry County School District 154* 31. McHenry County School District 156* 32. McHenry County Sheriff 33. McHenry County Substance Abuse Coalition* 34. Northern Illinois Special Recreation Association* 35. Northwest Center Against Sexual Assault* 36. Northwestern Medicine McHenry Hospital* 37. Northwestern Medicine Huntley Hospital* 38. Northwestern Medicine Woodstock Hospital* 39. Options and Advocacy* 40. PFLAG* 41. Pioneer Center for Human Services* 42. Prairie Grove School District 46* 43. Riley School District 18* 44. Rosecrance* 45. Sage YMCA* 46. Salvation Army Extension Unit* 47. Senior Care Volunteer Network* 48. Senior Services, Inc.* 49. The Mathers Clinic 50. Turning Point* 51. United Way of Greater McHenry County* 52. Village of Bull Valley 53. Village of Lake in the Hills 54. Village of Port Barrington 55. Village of Spring Grove 56. Volunteer Center of McHenry County* Through this process, input was gathered from several individuals whose organizations work with low-income, minority, or other medically underserved populations. In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such and how these might better be addressed.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. The CHNA was conducted with Advocate Aurora Health.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. The CHNA was conducted with McHenry County Department of Health and McHenry County Mental Health Board.

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also shared with the following: 1. Key community organizations 2. Northwestern Medicine Leadership

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. Through a systematic, data-driven approach, NMMH, NMHH, and NMWH prioritized Significant Health Needs to address in accordance with IRS regulations. These needs will be referred to as Priority Health Needs throughout the remainder of the document. NMMH, NMHH, and NMWH worked collaboratively to develop strategies and identify resources and areas for collaboration, where applicable, to impact each priority health need. Priority 1: Access to Healthcare. 1.1: NMMH, NMHH and NMWH will adapt a health system-level approach to better serve uninsured and underinsured patients through clinical community relationships. NMMH, NMHH and NMWH will pilot new opportunities and enhance current relationships in the service area. NMMH, NMHH and NMWH have established relationships with Aunt Martha's, a Federally Qualified Health Center, and with Family Health Partnership Clinic, a Free and Charitable Health Clinic. Through these relationships, patients who have received care at NM facilities in McHenry County can receive primary and preventive services at these local clinical sites. NM supports these partnerships through regular communication, as well as through financial and in-kind support. 1.2: The Regional Medical Group (RMG) Residency Clinic will expand with Rosalind Franklin University to increase access to follow-up care for patients who are discharged from NMMH, NMHH and NMWH. Providing access to care, especially for patients discharged from hospital emergency departments and from inpatient stay, is essential to coordinating care and optimizing health of patients recovering from injury or illness. This is acutely important for patients who do not have an established relationship with a primary care provider. Adequate capacity among physicians accepting patients regardless of ability to pay is needed to ensure that follow up appointments can be provided in a timely manner and primary care relationships are established. Currently NM partners with Rosalind Franklin University Chicago Medical School to address this need in McHenry County. Residents are licensed physicians who graduated from medical school with a degree of Medical Doctor (MD) or Doctor of Osteopathy (DO). Residents have met all the requirements to continue their graduate medical training in order to become board certified physicians. Residents work with an attending NM physician to provide care to patients seeking follow up care post discharge from the hospital and/or to those that are in need of a primary care provider, regardless of insurance status. In FY21, the RMG Residency Clinic continued to grow access, providing 533 new patient visits, and grew the number of patients with established primary care providers by more than 33% to 1,347 patients. 1.3: NMMH, NMHH and NMWH will provide information sessions on healthy weight and nutrition through community lectures and programs. Nearly 35% of McHenry County residents were identified as obese in the most recently conducted CHNA. NMMH, NMHH and NMWH have implemented a number of strategies to improve understanding of diet, and provide motivation to lose weight, including the ""New Dimension"" weight loss challenge program. This program offers an individualized action plan for success, and focuses on each dimension of health (emotional, environmental, intellectual, occupation, physical, social, spiritual, and financial) to provide a comprehensive approach to change and goal attainment. It has helped people lose weight and embrace healthy habits for more than 30 years. In FY21, 272 individuals participated in 22 healthy weight and nutrition programs. 92 participants began the New Dimension program, and the number that successfully completed increased from 65% to 73% compared to FY20. In addition, NM began offering healthy cooking classes virtually through the Leishman Center for Culinary Health, a facility to educate participants on choosing healthy living through food. Located at Northwestern Medicine Kishwaukee Hospital, the Leishman Center offers a variety of natural, plant-based cooking classes designed to promote a healthier lifestyle through better food choices. Many of the classes are directed toward clinical conditions that can be improved with healthier eating, including reducing obesity, managing diabetes and hypertension. These are offered free of charge to the public. In FY21, 347 residents of McHenry County signed up to participate, of which 167 registrations were for health condition-specific classes. On average, 62.4% of registrants attend classes, yielding 217 attendees, 105 of whom participated in learning about cooking to improve specific disease conditions. 1.4: NMMH, NMHH and NMWH will provide information and education on diabetes through community lectures and screenings and diabetes support groups. The McHenry County Healthy Community Study showed that 53% of McHenry County residents have not had a blood sugar test in the past three years. The study also showed that 11.8% of McHenry County residents have been diagnosed with diabetes. Through screenings conducted at various settings throughout the community, 2,815 people had glucose finger sticks and education on diabetes in FY21. Managing diabetes for one's self or helping a loved one manage diabetes can be complex and overwhelming. To help those living with diabetes, NM grew the number of support groups from 9 to 11 in McHenry County in FY21. The number of attendees grew by 13% from the prior year. 1.5: NMMH, NMHH and NMWH will provide information on cardiovascular disease and hypertension through community lectures, screenings and individual training. Cardiovascular disease is the third leading cause of death in the United States and is the second leading cause of death in McHenry County. Fortunately, deaths from cardiovascular disease are preventable, especially if intervention is provided across the lifespan of the disease-from early education, prevention and screening to early diagnosis, prompt treatment and comprehensive aftercare. NMHH, NMMH and NMWH provided 2,984 blood pressure screenings to members of the community. Of the screenings conducted in community settings, 37.1% of participants were found to be at high risk based on their blood pressure reading. These participants were referred to their primary care provider for follow-up, or if not aligned with a primary care provider, were referred to a community health care provider. A number of other programs and presentations were offered to the community to educate on cardiovascular health. These included a Health Coaching Program, which offered lectures on mental health, nutrition and exercise over a 4- week period. Twenty-one people participated in this offering during FY21. Additionally, 52 people attended two community educational presentations on atrial fibrillation and ""Guilt Free Grill Out,"" which provided healthier grilling options. For a more in-depth screening service, patients can elect heart related screenings such as EKG, Vascular Ultrasound, and Echocardiograms performed by Northwestern Medicine Imaging Technicians and interpreted by Northwestern Medicine Cardiologists/Radiologists. The goal of these noninvasive screenings is to identify risk for heart disease and stroke so action can be taken early for a healthier future. EKGs can be performed on patients as young at 13 years old in partnership with Lurie Children's. Thirty-two participants received heart-related screenings (i.e., EKG, vascular ultrasound, echocardiograms) in FY21. Priority 2: Behavioral health. 2.1: NMMH, NMHH and NMWH will address and integrate trauma-informed care into practice, including providing employee resources for coping with trauma or vicarious trauma. Trauma does not discriminate. It can affect anyone, and nearly 70% of the population reports experiencing some type of trauma in their lifetime. Whether the trauma results from a single event, a series of events, or a set of physically or emotionally harmful circumstances, it can have serious implications on well-being, social functioning, physical and mental health, and life expectancy. In addition, the more an individual is exposed to stressful or traumatic experiences, the greater the risk for chronic health conditions. Trauma-informed care acknowledges that understanding a patient's life experiences is key to delivering effective care and improving health outcomes. Trauma informed care is the open-mindedness and compassion that all patients deserve, because anyone can have a history that affects their encounter with the health system. Additionally, trauma-informed care raises sensitivity to trauma that may be part of a caregiver's background."

Schedule H, Part V, Section B, Line 11 Facility , 2
Facility , 2 - NORTHERN ILLINOIS MEDICAL CENTER. 2.2: NMMH, NMHH and NMWH will improve access to mental health resources through patient care programs, support groups and community lectures. NMMH, NMHH and NMWH will promote behavioral health partnerships with high-quality community-based organizations and providers. Mental health is essential to personal well-being, family and interpersonal relationships, and the ability to contribute to community or society. Mental disorders are health conditions that are characterized by alterations in thinking, mood, and/or behavior that are associated with distress and/or impaired functioning. Mental illness is the term that refers collectively to all diagnosable mental disorders. The resulting disease burden of mental illness is among the highest of all diseases. Mental health and physical health are closely connected. Mental health plays a major role in people's ability to maintain good physical health. Mental illnesses, such as depression and anxiety, affect people's ability to participate in health-promoting behaviors. (Source: Healthy People 2020) NMMH, NMHH and NMWH will provide the following programs to address mental behavioral health issues in its respective service areas. * Psychiatric Emergency Services provides assessment, disposition, and referral for patients presenting to the Emergency Departments within the Northwest Region. Referrals include service levels ranging from outpatient programming all the way up through behavioral health inpatient programming. During the last year, psychiatric behavioral health services experienced a total of 2,541 referrals in the following populations: 430 Individuals aged 0-17, 728 individuals aged 18-29, 672 individuals aged 30-44, 551 individuals 45-64, 95 individuals aged 65-74, and 65 individuals age 75+. * Partial Hospital and Intensive Outpatient Hospital Programming provides outpatient level services to patients that do not meet criteria for an inpatient stay, but need increased support to prevent the next level of treatment or as a step down from an inpatient level of care. This program offers a variety of services to address mental health and substance use disorders. During the last year, the program the program provided these services to a total of 340 individuals, including 128 individuals aged 18-29, 99 individuals aged 30-44, 86 individuals aged 45-64, 18 individuals aged 65-74 and 9 individuals aged 75+. * The Behavioral Health Unit provides a safe, intensive level of care for patients that are not able to maintain their safety in the community. Through the use of evidence-based therapies, psychiatric and nursing interventions and groups, patients are stabilized to transition to a lower level of care. During the last year, the program the program provided these services to a total of 1,064 individuals, including 363 individuals aged 18-29, 320 individuals aged 30-44, 323 individuals aged 45-64, 43 individuals aged 65-74 and to 15 individuals aged 75+. * Our Behavioral Health Community Navigator (BHCN) links our patients seen in all three areas to long-term services that are appropriate to their needs and fills in gaps between internal services provided to successful linkages in the community. Total referrals for the BHCN was 649. 2.3: NMMH, NMHH and NMWH will improve access to substance use treatment resources through patient care programs, support groups and community lectures. NMMH, NMHH and NMWH will promote behavioral health and substance use partnerships with high-quality community-based organizations and providers. Substance abuse disorder refers to a set of related conditions associated with the consumption of mind-and behavior-altering substances that have negative behavioral and health outcomes. Social attitudes and political and legal responses to the consumption of alcohol and illicit drugs make substance abuse one of the most complex public health issues. In addition to the considerable health implications, substance abuse has been a flash point in the criminal justice system and a major focal point in discussions about social values; people argue over whether substance abuse is a disease with genetic and biological foundations or a matter of personal choice. Improved evaluation of community-level prevention has enhanced researchers' understanding of environmental and social factors that contribute to the initiation and abuse of alcohol and illicit drugs, leading to a more sophisticated understanding of how to implement evidence-based strategies in specific social and cultural settings. (Source: Healthy People 2020) NMMH, NMHH and NMWH provided support, educational and training and programs to address substance abuse in it service areas by: * Substance Use Nurse serves as the chair of the Substance Abuse Coalition Education Committee This committee is creating education for the community around substance use, effects of substances, consequences and laws, addiction information, vaping, and resources to a variety of audiences including middle-school aged children, high school aged adolescents, parents and other community members. The nurse also attends the McHenry County Substance Abuse Coalition meetings to interface with other substance use resources in the county and to participate in community awareness focused events. * Substance Use Nurse participates in action planning for community overdose alerts, and substance abuse community event planning. * Substance Use Nurse also participates on the McHenry Suicide Prevention Task Force. Priority 3: Social determinants of health. 3.1: NMMH, NMHH and NMWH will implement an electronic tool that is integrated with NM's electronic medical record (EMR) system to capture SDOH for patients, train staff members and advocates to screen and use SDOH data, and refer patients to appropriate services to address SDOH. NMMH, NMHH and NMWH will partner with community-based organizations that are able to screen individuals for SDOH. Health starts in our homes, schools, workplaces, neighborhoods and communities. Taking care of ourselves by eating well, staying active and making regular visits to the doctor influence our health. Our health is also determined in part by access to social and economic opportunities, community resources, quality education, workplace safety and environmental factors. The condition in which we live explain, in part, why some are healthier than others. Disparities in community conditions, including income, poverty, employability, food access and housing have been identified as health concerns in McHenry County. A NM system-wide approach was developed around assessing and collecting SDOH on patients in order to treat the whole patient. Patients who screen positive for a SDOH are offered assistance, and when accepted, are referred to community-based agencies and organizations that can provide assistance with SDOH. In FY21, a total of 19,009 SDOH screens were conducted at NM facilities in the NMHH, NMMH and NMWH service area. Of these, 2,783 (14.6%) screened positive for one or more SDOH, and 1,145 (6.0%) requested assistance. The most frequently cited concern was having a medical home (1,499 patients with this concern). A total of 513 patients expressed concerns about transportation, 432 about mental health, 417 about medication affordability, and 264 about safe housing. 251 patients expressed concern about food or money. Those screening positive for mental health concerns were most likely to request assistance, with 79.2% requesting help. 3.2: NMMH, NMHH and NMWH will increase youth pipeline opportunities by introducing students to healthcare-related careers through presentations and internship experiences. NMMH, NMHH and NMWH will create hiring pipelines for youth and adults in hardship communities to connect to jobs through training programs, targeted outreach and partnerships, and inclusive, local hiring practices. NM will work with internal and external stakeholders and community partners to advocate for reduced barriers to educational attainment and for support to fill workforce gaps. The Project SEARCH Transition-to-Work Program is a unique, business-led, one-year employment preparation program for individuals with developmental disabilities, which takes place entirely at the workplace. Total workplace immersion facilitates a seamless combination of classroom instruction, career exploration, and hands-on training through worksite rotations. The program culminates in individualized job development.

Schedule H, Part V, Section B, Line 11 Facility , 3
"Facility , 3 - NORTHERN ILLINOIS MEDICAL CENTER. The goal for each program participant is competitive employment. To reach that goal, the program provides real-life work experience combined with training in employability and independent-living skills to help young people with significant disabilities make successful transitions to productive adult life. The Project SEARCH model involves an extensive period of skills training and career exploration, innovative adaptations, long-term job coaching, and continuous feedback from teachers, skills trainers, and employers. As a result, at the completion of the training program, students with significant intellectual disabilities are employed in complex and rewarding jobs. In addition, the presence of a Project SEARCH program can bring about long-term changes in business culture that have far-reaching positive effects on attitudes about hiring people with disabilities and the range of jobs in which they can be successful. The Project SEARCH program graduated five participants in FY21, and Northwestern Medicine hired one individual. The NM Discovery Program creates a pathway for the next generation of NM leaders by drawing on the talents of our incredible team of health care professionals to provide STEM career exposure. Throughout the Program, students are exposed to a broad range of health care careers through activities including tours, guest speakers, group discussion, and hands-on projects. In addition, the program fosters character and professional development, cultivates life skills, provides community service and leadership experience, and offers mentorship and networking opportunities. The Discovery Program Northwest Chapter is open to high school students who meet the below eligibility criteria. Meetings are held once a month at Northwestern Medicine Huntley Hospital. First Year Applicants must: * Be at least 15 years of age. * Be a resident of McHenry County. * Be entering sophomore, junior or senior year of high school. * Have an academic GPA of at least 3.0 on a 4.0 GPA scale or 3.8 on a 5.0 GPA scale. * Commit to the school year-long program, including attendance at all Discovery Program meetings and community service activities. No more than two excused absences are permitted per year. Thirty students participated in the program in FY21, with 29 completing the entire year. Of these, five were from low-income backgrounds. In FY21, a Northwest Chapter NM Discovery Summer Internship was piloted at NMWH. Through a competitive application process, two students were chosen to participate for the paid experience, and were given rotations through four different departments. They also participated in ""lunch and learn"" sessions with local leaders to learn about careers and potential pathways. In partnership with McHenry High School (MHS) and Huntley High School (HHS), the Youth Residency Program provides high school students in the fourth year of their respective health sciences track with the opportunity to gain an authentic experience by shadowing alongside medical professionals in numerous healthcare settings. The program follows a blended format that allows students the flexibility to substitute time typically spent in the classroom with time at Northwestern Medicine (NM) healthcare facilities. During the first month of the school year, students spend time in the classroom completing orientation and learning prerequisite knowledge and skills before rotations begin. Students then typically schedule and attend one two-hour rotation per week. There are about 21 medical rotations in total ranging from Cath Lab to Wound Care. Independent time and in-class time are spent researching in preparation for rotations, reflecting on learning experiences, and deepening understanding of the science behind various procedures and technologies observed. During the pandemic, it was necessary for the students to participate in virtual education when community transmission levels were high and/or patient census and staffing shortages due to exposure reduced the hospitals' ability to host students. Each program is open to up to 30 students. 3.3: NMMH, NMHH and NMWH will establish a diversity and inclusion infrastructure with partnerships across the organization to promote, support, and activate inclusive strategy, culture and behavior that differentiates NM as an inclusive values-driven organization. The NM Diversity and Inclusion program seeks to embed Diversity, Equity and Inclusion (DEI) practices and behaviors into what employees do each day. This will foster engagement, mitigate bias, engender a day-to-day sense of belonging in the workplace, and create an internal environment that reflects the communities we serve. In FY21, 8,679 employees and 1,217 leaders from across NM participated in DEI training programs. Demonstrating NM's appreciation of diverse talents at all levels of the organization, we also support a network of five workforce-led resource groups that together form the NM Champion Network. Each of the five chapters is comprised of individuals that either identify as members or are allies of historically underrepresented communities. The chapters are: * African Descendants * Asian American Pacific Islander * Disability * Latinx * LGBTQ The groups are employee-led, and discuss workforce enhancements at NM, develop activities, awareness events, community outreach, support cultural responsiveness education opportunities, and participate in a variety of other approaches to promote diversity, equity and inclusion and engender a sense of community and belonging at NM. Participation in NM Champion network groups grew by 44% in FY21, and now more than 1,200 employees participate as member system-wide. 3.4: NMMH, NMHH and NMWH will foster collaborations with community-based organizations. Individuals interacting with these agencies will be screened for income-based programs or food insecurity and, when positively identified, will receive vouchers to purchase fresh fruits and vegetables at area farmers' markets. NMMH, NMHH and NMWH have established relationships with local food pantries, food distribution partners and other local support systems to help residents of McHenry County who are subject to food insecurity. In addition to referring patients who screen positive for food insecurity to area food sources, NMMH, NMHH and NMWH also provide grant funding to regional food banks and organizations that facilitate delivery of food. In FY21, NM provided $5,000 to Northern Illinois Food Bank, in addition to $75,000 granted from NM's West Region hospitals. NM also provided $3,000 to the Senior Care Volunteer Network, to support their work in delivering groceries to individuals and households that could not access food pantries due to physical/mobility or transportation limitations. To further improve access to food, NMMH, NMHH and NMWH organized mobile food pantries at identified locations of high need throughout the county, and provided fresh food to 446 families with 1,498 individuals in FY21. 3.5 NMMH, NMHH and NMWH will foster collaborations with community-based organizations that address housing instability. Housing instability encompasses a number of challenges, such as trouble paying rent, overcrowding, moving frequently, staying with relatives, or spending of household income on housing expenses. Households are considered cost burdened if they spend more than 30 percent of their income on housing and severely burdened if they spend more than 50 percent of their income on housing. Cost-burdened households have little left over each month to spend on other necessities, such as food, clothing, utilities and health care. NMMH, NMHH and NMWH provided donations to local organizations that are regularly engaged in supporting individuals facing housing instability, including $10,000 to Home of the Sparrow, $5,000 to Habitat for Humanity, $2,000 for Refuge for Women, and $250 for Senior Services Associates in FY21. NON-PRIORITY AREAS: The CHNA identified areas of opportunity for health improvement for which NMMH, NMHH, and NMWH determined it would not prepare an implementation plan. These areas of opportunity and the reasons for not addressing are below. Arthritis: This condition is addressed through the NM care delivery system. Asthma: This condition is addressed through the NM care delivery system. Caregiver Support: This need was assessed by the community as a relatively low priority and is better addressed through external community agencies who provide these services. e-Cigarette and tobacco use: This need was assessed by the community as a relatively low priority and is address through the NM care delivery system."

Schedule H, Part V, Section B, Line 11 Facility , 4
Facility , 4 - NORTHERN ILLINOIS MEDICAL CENTER. Transportation: This need was assessed by the community as a relatively low priority and is address through the NM NWR care delivery system along with other community agencies.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. IN ADDITION TO THE DOCUMENTED 200% OF FPG, WE ALSO PROVIDE A SLIDING SCALE DISCOUNT OF 80% FOR THOSE WHO HAVE FPG UP TO 350%. IN ADDITION WE HAVE PRESUMPTIVE CHARITY WHICH ALLOWS FOR CHARITY DISCOUNTS/FINANCIAL ASSISTANCE TO THOSE WHO CURRENTLY MEET MEDICAID ELIGIBILITY OR OTHER STATE PROGRAMS BASED ON FPG WHO MAY NOT HAVE HAD INSURANCE COVERAGE AT THE TIME OF THE SERVICE WE PROVIDED.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. NMHC shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured or underinsured. Those who do not qualify for free care will receive a sliding scale discount off the gross charges for their medically necessary services based on their family income as a percent of the Federal Poverty Guidelines. These patients are expected to pay their remaining balance for care, and may work with financial counselors to set up a payment plan based on their financial situation. Patients seeking assistance may first be asked to apply for other external programs (such as Medicaid or insurance through the public marketplace) as appropriate before eligibility under this policy is determined. Additionally, any uninsured patients who are believed to have the financial ability to purchase health insurance may be encouraged to do so to help ensure healthcare accessibility and overall well-being. NMHC will not bill patients who have been deemed eligible for financial assistance coverage for eligible care or services, including care or services that are emergent or medically necessary, more than the amounts generally billed to insured patients. Patients who are uninsured or underinsured and have a household income at or below the thresholds per Federal Poverty Guidelines will receive full or partial discount off their balance. The policy is updated on an annual basis to represent the most current federal poverty guideline levels and the appropriate sliding scale for full and partial discounts. To be considered eligible for financial assistance, patients may be required to cooperate with NMHC to explore alternative means of assistance if necessary, including Medicare and Medicaid. Patients will be required to provide necessary information and documentation when applying for hospital financial assistance or other private or public payment programs. NMHC may seek to determine eligibility for financial assistance prior to rendering non-emergent services. In certain non-emergent circumstances it may be necessary to provide care or evaluation to the patient before eligibility can be determined. When determining patients' eligibility, NMHC does not take into account race, gender, age, sexual orientation, religious affiliation, national origin or social or immigrant status. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance: A. Presumptive Homelessness; B. Presumptive Mental incapacitation with no one to act on the patient's behalf; C. Presumptive Scoring when NMHC can utilize publically available information as well as internal payment and documentation history to determine if a patient is eligible for presumptive financial assistance without completion of an application. D. Presumptive Deceased with no estate; E. Presumptive State Program: Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines: 1. Women, Infants and Children Nutrition Program (WIC); 2. Supplemental Nutrition Assistance Program (SNAP); 3. Illinois Free Lunch and Breakfast Program; 4. Low Income Home Energy Assistance Program (LIHEAP); 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial; or 6. Receipt of grant assistance for medical services. F. Presumptive Out of State Program for patients who are eligible for out of state programs based on FPG where NMHC does not participate; G. Additional Presumptive Criteria may also be recommended, including the following: 1. Recent Personal Bankruptcy; 2. Incarceration; 3. Affiliation with a religious order which includes a vow of poverty; 4. Enrollment in temporary assistance for needy families (TANF); or 5. Enrollment in IHDA's Rental Housing Support Program. NMHC also partners with third-parties and other eligibility vendors, to help identify patients who may be eligible for financial assistance, presumptive financial assistance under this policy or through other public and private programs including identifying other sources of third party payment, i.e. health insurance coverage. NMHC may also use previous financial assistance eligibility determinations as a basis for determining eligibility in the event that the patient does not provide sufficient documentation to support an eligibility determination. Financial assistance applications on file at NMHC may be used for a time period of up to six months after the date of submission. All patients presumptively determined to be eligible for less than the most generous amount of assistance available under this policy (free care) will be informed about how the discount amount was calculated and given a reasonable amount of time to submit an application for further financial assistance.

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - NORTHERN ILLINOIS MEDICAL CENTER. NMHC's Financial Counseling Department is responsible for assisting Applicants applying for Financial Assistance prior to or during the course of treatment. Areas within NMHC handling billing inquiry, customer service, and self-pay follow-up shall assist Applicants after services have been provided. The determination of an Applicant's eligibility for Financial Assistance should be made as early as possible. In cases where the Patient is seeking services other than Emergency Services, determination shall be made prior to the scheduling and/or rendering of services, whenever possible. Pursuant to the Illinois Fair Patient Billing Act, Patients shall be instructed to apply for Financial Assistance within sixty (60) days after discharge or the receipt of outpatient care, whichever is longer, and NMHC shall not send bills to Uninsured Patients until such sixty (60) day period has passed. While NMHC may bill Patients after the sixty (60) day period, it shall, nevertheless, process Applications received at any time during the Application Period. The Application Period shall be the 240 day period provided by IRS guidance, starting from the date care is provided. Unless eligibility has been previously determined or unless otherwise provided within this policy, the Patient or Guarantor is required to complete an Application for Financial Assistance and provide supporting documentation, which provides, in accordance with law, information about the Applicant's financial position (including, as applicable, information about the Applicant's family) and other information which is necessary in making a determination of eligibility for Financial Assistance. The Application shall be available on a form provided by NMHC and consistent with the provisions of the Illinois Hospital Uninsured Patient Discount Act and other applicable law. Unless otherwise provided herein or in an appendix, Applications will only be accepted from individuals who have had a previously existing relationship with NMHC during the last 12 months or an upcoming appointment or admission. Patients shall complete one (1) Application which shall be recognized by all NMHC Affiliates. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. The Financial Assistance application described the primary and supplementary information required of an individual to provide as part of his or her application. This was documented on the 'Financial Assistance Required Supporting Documents' page included with the Financial Assistance application. Contact information of hospital facility staff who can provide an individual with information about the Financial Assistance Policy and application process was also provided.

Schedule H, Part V, Section B, Line 2
ON JANUARY 1, 2021, NMHC BECAME THE SOLE MEMBER OF PALOS COMMUNITY HOSPITAL. THE ILLINOIS HEALTH FACILITIES AND SERVICES REVIEW BOARD UNANIMOUSLY APPROVED THE APPLICATION FOR PALOS TO JOIN NMHC IN NOVEMBER 2020.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - Northwestern Medicine Palos Hospital. The CHNA report also describes NMPH CHNA goals and objectives, public dissemination plan, and development of the Implementation Plan.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - Northwestern Medicine Palos Hospital. The hospital facility took into account input from persons who represent the community, including uninsured persons, low-income persons and minority groups, through community input surveys, community focus groups, healthcare and social service provider focus groups, and stakeholder assessments. Community input surveys collected input from 526 individuals 18 or older living in the NMPH Community Service Area. Surveys were available on paper and online and were disseminated in two different languages. Questions assessed demographics, the health of the community, community strengths, opportunities for improvement and priority health needs. Surveys were targeted at priority populations, those typically underrepresented in assessment processes, including communities of color, immigrants, LGBTQ+ community members, individuals with disabilities and low-income communities. Community focus groups included 8 sessions held within the NMPH Community Service Area. Focus groups took place with priority populations, such as veterans, individuals living with mental illness, communities of color, older adults, caregivers, teens and young adults, LGBTQ+ community members, adults and teens experiencing homelessness, families with children, faith communities, adults with disabilities, and children and adults living with chronic conditions such as diabetes and asthma. Stakeholder assessments evaluated trends, factors and events that currently effect or are anticipated to affect the public health system and included an assessment of the public health system's capacity to advance health equity. To ensure that organizations impacting health in the NMPH community service area were meaningfully engaged in interpreting and prioritizing the identified needs, as well as the development of a collaborative plan to address priority needs, the external Community Engagement Council was engaged, which is made up of representatives of the following organizations: 1. Arab American Family Services 2. Sertoma Centre 3. Pillars Community Health (bilingual - Spanish) 4. Community health workers from west/southwest suburbs 5. Immigrant and refugee service providers 6. People who identify as LGBTQIA+ 7. NAMI Chicago, individuals with mental health conditions 8. NAMI Chicago, family members of individuals with mental health conditions

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - Northwestern Medicine Palos Hospital. NMPH worked in tandem with the Alliance for Health Equity (AHE) which is made up of 36 hospitals and local health departments. This group worked collaboratively to assess community needs. Specific needs of the NMPH Community Service Area were identified and prioritized separately. Hospital facilities included : 1. Advocate Aurora Children's Hospital 2. Advocate Aurora Christ Medical Center 3. Advocate Aurora Illinois Masonic Medical Center 4. Advocate Aurora Lutheran General Hospital 5. Advocate Aurora South Suburban Hospital 6. Advocate Aurora Trinity Hospital 7. AMITA Adventist Medical Center La Grange 8. AMITA Alexian Brothers Medical Center, Elk Grove Village 9. AMITA Holy Family Medical Center 10. AMITA Resurrection Medical Center 11. AMITA St. Alexius Medical Center and Alexian Brothers Behavioral Health Hospital 12. AMITA Saint Francis Hospital 13. AMITA Saint Joseph Hospital 14. AMITA Saints Mary and Elizabeth Medical Center 15. Ann Robert H. Lurie Children's Hospital of Chicago 16. The Loretto Hospital 17. Loyola Medicine- Gottlieb Memorial Hospital 18. Loyola Medicine- Loyola University Medical Center 19. Loyola Medicine- MacNeal Hospital 20. Mercy Hospital Medical Center 21. Northwestern Medicine Palos Hospital 22. Northwestern Memorial Hospital 23. Norwegian American Hospital 24. Roseland Community Hospital 25. Rush Oak Park 26. Rush University Medical Center 27. Sinai Health System- Holy Cross Hospital 28. Sinai Health System- Mount Sinai Hospital 29. Sinai Health System- Schwab Rehabilitation Hospital 30. South Shore Hospital 31. Swedish Covenant Hospital 32. University of Chicago Medicine 33. University of Chicago Medicine- Ingalls Memorial Hospital 34. Cook County Health- Stroger Hospital 35. Cook County Health- Provident Hospital 36. University of Illinois Hospital and Health Sciences System

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - Northwestern Medicine Palos Hospital. NMPH worked in tandem with the Alliance for Health Equity (AHE) which is made up of multiple hospitals and local health departments. This group worked collaboratively to assess community needs. Specific needs of the NMPH Community Service Area were identified and prioritized separately. Other organizations included: 1. Chicago Department of Public Health 2. Cook County Department of Public Health 3. Cook County Health

Schedule H, Part V, Section B, Line 7 Facility , 1
Facility , 1 - Northwestern Medicine Palos Hospital. In addition to providing the CHNA report on the website and making it available to the public upon request, the CHNA report was also shared with the following: 1. Key community organizations 2. Northwestern Medicine Leadership

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - Northwestern Medicine Palos Hospital. NMPH adopted a new implementation strategy in FY2023 (TY2022) in alignment with the most recent CHNA. For Line 11, NMPH is reporting on the FY2022 (TY2021) implementation strategies, as this is the most recent outcomes data available at the time of this report. In FY2022 (TY2021), NMPH identified three Priority Health Needs: Access to Healthcare Services; Heart Disease and Stroke; and Mental Health and Substance Use Disorders. Specific ways in which NMH addressed significant needs are defined as follows: Priority Need 1: Access to Healthcare Services 1.1: Community Engagement: Identify and develop relationships with community organizations. Pilot a community engagement council. Assess SDOH resources in the electronic system to best address patients' social needs. List outcomes As a newly integrated hospital to the NMHC system, much of fiscal year 22 was spent establishing relationships with community organizations addressing a variety of needs in the NMPH CSA such as Sertoma Centre, the Bridge Teen Center, Crisis Center for South Suburbia, Catholic Charities and more. In effort to give community a voice in the CHNA process in addition to the surveys and focus groups, NMPH established a Community Engagement Council (CEC) with the goal of gathering input from key informants representing organizations working with the local community. The CEC for the CHNA that took place in 2022. Organizations represented include: Bremen High School District 228, Crisis Center for South Suburbia, Moraine Valley Community College, National Alliance on Mental Illness, Pathlights, Sertoma Centre, Inc. and Together We Cope. This group of informants provided input on prioritized health needs as well as the community health implementation plan. NMPH conducted an audit on existing database of community resources addressing social determinants of health in preparation of the launch of an updated electronic health information management system. Slated for use in October 2022, the new system will allow for referrals to be given to patients that identify a need and ask for assistance. 1.2: Federally Qualified Health Center (FQHC) and Clinical Community Collaboration: Align with the system-level approach to better serve the uninsured and underinsured populations through clinical community relationships. The NMPH CSA is lacking an FQHC. During the pandemic, an FQHC located outside the service received a grant from Cook County to provide COVID vaccinations in the service area. NMPH established a relationship with the FQHC leadership team to determine interest in opening a clinical space with in the CSA. While interested, the FQHC is researching affordable office space conducive to delivering care. 1.3: Enhance Healthcare Services Available in the Community: Improve access to specialty care to address the health needs of the community where they live. In FY22, NM opened a new multi-specialty clinic in in the Orland Park outpatient center with services including neurology, esophageal (gastroenterology) and hepatology care. Through seamless integration with the Health System, the new clinic provides access to academic medicine and NMH's top-ranked subspecialty programs for patients in south suburban communities. Priority Need 2: Heart Disease and Stroke 2.1: Virtual Cooking Classes: Host virtual cooking classes targeted at a broader audience or specific community organization or group such as employees, volunteers or the general public. Provide trusted health education materials along with the class. After introducing Northwestern Medicine and explaining how NM can work with community partners, four virtual cooking demonstrations were provided with a total of 110 attendees though community partners. In these programs, participants learned how to cook with healthy ingredients. In addition to classes available through community partners, NM hosted virtual cooking demonstrations focused on nutrition to address/manage chronic conditions. Fifteen attendees from the NMPH CSA learned how to cook more healthfully. 2.2: Health Screenings: Support efforts to increase access to health screenings by investing resources and collaborating with community-based organizations. NM Palos Hospital spent much of FY22 building relationships with local community agencies that would be a good partner for on-site blood pressure screenings and one-on-one education. One blood pressure screening was provided with 25 participants with 68% of the participants presenting with levels that were high. Registered nurses spent time individually educating participants on how steps to manage blood pressure levels. Additionally, NM Palos Hospital awarded Sertoma Centre a grant to hire a health educator allowing the organization to increase integrated healthcare services such as health education, health screenings, and linkage to medical resources and specialists. With the grant funding, Sertoma Centre provides education and proactively identifies and monitors health conditions in people diagnosed with severe mental illnesses to reduce the impact of medical comorbidities like diabetes, high blood pressure, COPD, nicotine use disorder, obesity and other chronic illnesses in this population. Priority Need 3: Mental Health and Substance Use Disorders 3.1: Mental Health Training and Education: Improve access to mental and behavioral health resources through the expansion of community-based programs such as Mental Health First Aid trainings. The ability to offer a variety of programs to community was new in FY22 for NM Palos Hospital. Much of FY22 was spent developing relationships with local organizations and building trust. A couple of organizations shared that they are trained to provide Mental Health First Aid or they have received this education from another entity. For example, Moraine Valley Community College and Sertoma Centre have team members trained to deliver this education. The Bridge Teen Center staff received this education from Sertoma Centre. Mental Health First Aid education was provided to twelve staff members at Pathlights, a community organization that services a senior population and their caregivers. 3.2: Youth Mental Health Support: Collaborate with local schools and organizations to evaluate assets and needs for youth mental health support. Conduct a readiness assessment for a school-based mindfulness and mental health promotion curriculum. During FY22, NM Palos Hospital conducted outreach with school districts within the Community Service Area. Many of the school districts indicated that they already had resources to support the mental health of their students. A few programs have taken place with one school district located in an under resourced community in FY23. Non-Priority Areas: The NMPH FY2022 (TY2021) Community Health Implementation Plan identified areas of opportunity for health improvement for which NMPH determined it would not prepare an implementation plan. These areas of opportunity and the reasons for not addressing are below. Cancer: This need is addressed through the NMPH care delivery system. Respiratory disease: This need is addressed through the NMPH care delivery system. Nutrition, physical activity and weight: These needs are better addressed through external community agencies who provide services to address them. Tobacco use: Although not individually called out as a priority, this need is being addressed through the Heart Disease and Stroke strategy. Potentially disabling conditions: This need was assessed by the community as a relatively low priority as measured by NMPH prioritization tool. Oral health: This need is better addressed through external community agencies who provide services to address it.

Schedule H, Part I, Line 6a COMMUNITY BENEFIT REPORT
Northwestern Memorial HealthCare and Subsidiaries (NMHC) submit a community benefit report to the Illinois attorney general according to the requirements for the state of Illinois. Northwestern Memorial Hospital (NMH), Northwestern Lake Forest Hospital (NLFH), Central DuPage Hospital (NWCDH), Delnor Community Hospital (Delnor), Kishwaukee Community Hospital (KCH), Valley West Hospital (VWH), Marianjoy Rehabilitation Hospital and Clinics (MJRH), Northern Illinois Medical Center (NIMC), Palos Community Hospital (PCH) and all other NMHC non-profit subsidiaries' results are included in this report.

Schedule H, Part I, Line 7g SUBSIDIZED HEALTH SERVICES
THE BENEFITS REPORTED ARE PRIMARILY ASSOCIATED WITH OPERATING LOSSES SUPPORTING NMH'S MENTAL HEALTH PROGRAMS. NMHC DOES NOT INCLUDE COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES.

Schedule H, Part I, Line 3c DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE
"Northwestern Memorial Hospital, Northwestern Lake Forest Hospital, Central DuPage Hospital, Delnor-Community Hospital, Kishwaukee Community Hospital, Valley West Hospital, Marianjoy Rehabilitation Hospital and Clinics, Northern Illinois Medical Center, and Palos Community Hospital 09/01/2021 - 08/31/2022 NMH, NLFH, CDH, Delnor, Kishwaukee, Valley West, MJRH, NIMC, and PCH shall, in accordance with Illinois Hospital Uninsured Patient Discount Act, provide Free Care and Discounted Care to Uninsured Patients. As of 9/1/2021, the combined NMHC policy applies to all entities excepting PCH. In accordance with Illinois regulations, the PCH Financial Assistance Policy will remain in effect for two years following the Palos affiliation with NM as of January 1, 2021. NMHC provides Free Care and Discounted Care to eligible Applicants who are uninsured through two methods: ""uninsured sliding fee scale assistance and ""uninsured catastrophic assistance."" If an Applicant qualifies under both methods, NMHC will apply the method that is most beneficial to the Applicant. Despite qualification under either method, if there is reason to believe that an Applicant may have assets in excess of 600% of the then current Federal Poverty Guideline applicable to the Applicant's Family Size and that are available to pay for medical services, NMHC may require the Applicant to provide information about such assets, and the Free Care Committee may consider those assets in deciding whether, and to what extent, to extend Free Care or Discounted Care. Free Care and Discounted Care shall be available for those Uninsured Patients who are Illinois Residents. The separate PCH policy in place similarly reflects a residency requirement. Non-Residents who are Uninsured Patients are not eligible for Free Care or Discounted Care. Notwithstanding the foregoing, there shall be no residency requirement for Uninsured Applicants receiving Emergency Services. Financial Assistance will only be applied to self-pay balances, after all third-party benefits/resources are reasonably exhausted, including, but not limited to, benefits from insurance carriers (e.g., health, home, auto liability, worker's compensation, or employer funded health reimbursement accounts), government programs (e.g., Medicare, Medicaid or other federal, state, or local programs), or proceeds from litigation, settlements, and/or private fundraising efforts (collectively, ""Third-Party Funding Sources""). Patients receiving Financial Assistance and who require Medically Necessary care (other than Emergency Services) must, whenever possible, be screened for eligibility for Medicaid, Health Insurance Exchange, or other available payment programs and, if found eligible, the Patient must fully cooperate with enrollment requirements prior to the procedure being scheduled and/or services being rendered. Eligible Patients who fail or refuse to enroll in available Medicaid, Health Insurance Exchange, or other available payment programs may be ineligible for Financial Assistance. NMHC (or its agent), at its discretion, may assess a Patient's or Guarantor's Financial Assistance eligibility by means other than a completed Application. In such instances, eligibility determinations may include the use of information provided by credit reporting agencies, public records, or other objective and reasonably accurate means of assessing a Patient's or Guarantor's Program eligibility. An uninsured Patient demonstrating eligibility under one or more of the following programs shall be deemed eligible for NMHC's Free and Discounted Care program and will not be required to provide additional supporting documentation for financial assistance. A. Homelessness B. Deceased with no estate C. Mental incapacitation with no one to act on the patient's behalf D. Medicaid eligibility, but not on date of service for non-covered service E. Enrollment in the following assistance programs for low-income individuals having eligibility criteria at or below 200% of the federal poverty income guidelines; 1. Women, Infants and Children Nutrition Program (WIC) 2. Supplemental Nutrition Assistance Program (SNAP) 3. Illinois Free Lunch and Breakfast Program 4. Low Income Home Energy Assistance Program (LIHEAP) 5. Enrollment in an organized community-based program providing access to medical care that assess and documents limited low income financial 6. Receipt of grant assistance for medical services"

Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation
148431089

Schedule H, Part III, Line 8 Community benefit methodology for determining medicare costs
THE UNREIMBURSED COST OF MEDICARE IS DEFINED BY THE STATE OF ILLINOIS ATTORNERY GENERAL'S OFFICE ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT AS A COMMUNITY BENEFIT. THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION ALSO VIEWS THE UNREIMBURSED COSTS OF MEDICARE AS PART OF A HOSPITAL'S COMMUNITY BENEFIT PROGRAM. NMHC PROVIDES MEDICAL CARE TO MEDICARE PATIENTS AT A COST HIGHER THAN THE REIMBURSEMENT IT RECEIVES FROM MEDICARE. THE AMOUNTS LISTED FOR PART III, LINE 5 THRU 7, ARE CALCULATED CONSISTENT WITH THE METHODOLOGY DESCRIBED FOR CALCULATING UNREIMBURSED COST OF MEDICAID FOR FISCAL 2022.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
NMHC'S CREDIT AND COLLECTION POLICY CONTAINS A PROVISION FOR FINANCIAL COUNSELING. THE POLICY STATES THAT PATIENTS WITH SELF-PAY BALANCES AND WITHOUT THE RESOURCES TO PAY THEIR OBLIGATIONS WILL BE ASSESSED FOR FREE AND DISCOUNTED CARE ELIGIBILITY BY THE FINANCIAL COUNSELING DEPARTMENTS. THE ASSESSMENT INVOLVES AND EVALUATION OF ALL LEVELS OF ASSISTANCE INCLUDING GOVERNMENTAL ASSISTANCE, EXTENDED PAY ALTERNATIVES, AND FREE OR DISCOUNTED CARE. IF THE PATIENT QUALIFIES FOR FREE CARE, THE ACCOUNT IS ADJUSTED TO ZERO SO NO COLLECTION ACTIVITY OCCURS. IF FINANCIAL ASSISTANCE RESULTS IN A DISCOUNTED OR REDUCED BALANCE, ONLY THE REDUCED BALANCE WILL BE SUBJECT TO THE COLLECTION PROCESS.

Schedule H, Part VI, Line 2 Needs assessment
NMHC'S MISSION SETS FORTH OUR COMMITMENT TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND TO ADVANCE MEDICAL RESEARCH AND EDUCATION, ONE PATIENT AT A TIME. THE COMMUNITY BENEFITS PLAN DESCRIBES THE BROAD-REACHING GOALS THAT SUPPORT THIS COMMITMENT AND ADDRESS OUR RESPONSIBILITY AS A TAX-EXEMPT ORGANIZATION. THE DEPARTMENT OF EXTERNAL AFFAIRS DEVELOPS AND MAINTAINS A COMMUNITY BENEFITS PLAN FOR THE HEALTH SYSTEM, WHICH IS EXECUTED AT THE HOSPITAL LEVEL TO BEST MEET THE NEEDS OF OUR LOCAL COMMUNITIES. REVIEWED ANNUALLY AND REVISED AS NEEDED, THE OBJECTIVES OF THE COMMUNITY BENEFITS PLAN ARE TO: 1. PROVIDE QUALITY MEDICAL CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 2. HONOR NORTHWESTERN MEDICINE'S MISSION AND COMMITMENT TO THE COMMUNITY. 3. BE RESPONSIVE TO THE ASSESSED NEEDS OF THE LOCAL COMMUNITY SERVED BY EACH HOSPITAL. 4. FORGE RELATIONSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS TO HELP ADDRESS SOCIAL DETERMINANTS OF HEALTH. 5. EVALUATE THE PUBLIC HEALTH IMPACT OF NORTHWESTERN MEDICINE PROGRAMMING, AND REPLICATE BY GEOGRAPHY AND/OR DISEASE STATE WITH SENSITIVITY TO THE INDIVIDUAL NEEDS OF OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITIES WE SERVE. 6. LEVERAGE OUR STRENGTHS AS A PREMIER ACADEMIC HEALTH SYSTEM TO TRAIN THE NEXT GENERATION OF CAREGIVERS AND UTILIZE EVIDENCE-BASED MODELS FOR COMMUNITY HEALTH ENGAGEMENT. 7. LEVERAGE OUR BOND WITH NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE TO BE LEADERS IN QUALITY, ACADEMIC EXCELLENCE, SCIENTIFIC DISCOVERY, PATIENT SAFETY AND RESEARCH-INFORMED TREATMENT. ALIGNED WITH OUR MISSIONS AND COMMUNITY BENEFITS PLAN, AND IN ACCORDANCE WITH THE REQUIREMENTS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA), EACH OF THE HEALTH SYSTEM HOSPITALS WORKS WITH COMMUNITY AND CAMPUS PARTNERS EVERY THREE YEARS TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IDENTIFIES THE HIGHEST PRIORITY HEALTH NEEDS OF RESIDENTS OF ITS COMMUNITY. WITH FEINBERG, NMHC BRINGS TO BEAR THE RESOURCES OF A WORLD-CLASS, INTEGRATED ACADEMIC HEALTH SYSTEM TO ADVANCE OUR COMMUNITY BENEFITS PLAN AND CHNA INITIATIVES IN WAYS THAT COULD NOT BE ACHIEVED AS STAND-ALONE HOSPITALS. PROVIDING BETTER CARE CLOSER TO HOME ALLOWS OUR COMMUNITIES ACCESS TO THE LATEST DEVELOPMENTS IN EDUCATION AND RESEARCH THAT PREVIOUSLY MAY NOT HAVE BEEN AVAILABLE AT THE COMMUNITY LEVEL. THIS INCLUDES: - SEEKING ROOT CAUSES TO HEALTH CONDITIONS, AND COLLABORATING WITH SCIENTISTS AND CLINICIANS TO DEVELOP SOLUTIONS - ENHANCING ACCESS TO HEALTH CARE - IMPROVING CLINICAL QUALITY - ADVANCING MEDICAL INNOVATION - ENSURING THAT A HIGHLY SKILLED HEALTHCARE WORKFORCE IS IN PLACE FOR DECADES TO COME - ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH CHNAS PROVIDE INFORMATION THAT ENABLES HOSPITALS TO IDENTIFY HEALTH ISSUES OF GREATEST CONCERN AMONG RESIDENTS IN THEIR COMMUNITIES AND DECIDE HOW BEST TO COMMIT RESOURCES TO THOSE AREAS, THEREBY MAKING THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS. NMHC EMPLOYS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINE THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE RESIDENTS OF EACH HOSPITAL'S COMMUNITY. EACH CHNA SERVES AS A TOOL TOWARD REACHING THREE GOALS: 1. IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS AND ELEVATE THEIR OVERALL QUALITY OF LIFE. A HEALTHY COMMUNITY IS ONE WHERE ITS RESIDENTS SUFFER LITTLE FROM PHYSICAL AND MENTAL ILLNESS AND ALSO ENJOY A HIGH QUALITY OF LIFE. 2. REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS. BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA, IT IS POSSIBLE TO IDENTIFY POPULATION SEGMENTS THAT ARE MOST AT RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE SEGMENTS MAY THEN BE DEVELOPED TO COMBAT SOME OF THE SOCIOECONOMIC FACTORS THAT HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH. 3. INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES ARE BENEFICIAL IN ACCOMPLISHING THE FIRST GOAL (IMPROVING HEALTH STATUS, INCREASING LIFE SPANS AND ELEVATING THE QUALITY OF LIFE), AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASES RESULTING FROM A LACK OF PREVENTIVE CARE. THE CHNAS AND CORRESPONDING IMPLEMENTATION STRATEGIES WERE DEVELOPED WITH FEEDBACK FROM COMMUNITY HEALTHCARE ORGANIZATIONS AND OTHER SOCIAL SERVICES AND PUBLIC ORGANIZATIONS THAT UNDERSTAND AND HELP REPRESENT THE WIDE-RANGING HEALTHCARE NEEDS OF THE RESIDENTS IN OUR COMMUNITIES. THE CHNA IMPLEMENTATION PLANS ARE GROUNDED IN PUBLIC HEALTH MODELS DEVELOPED WITH OUR COMMUNITY PARTNERS AND FEINBERG FACULTY, IN WHICH RESIDENTS OF OUR COMMUNITIES ARE INFORMED AND ABLE TO MAKE HEALTHY LIFESTYLE CHOICES, MANAGE THEIR CHRONIC HEALTH CONDITIONS AND RECEIVE MEDICALLY NECESSARY HEALTHCARE SERVICES IN THE MOST APPROPRIATE SETTING. WE BELIEVE THAT OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE IS BEST ACCOMPLISHED IN COLLABORATION WITH PARTNERS IN BOTH THE COMMUNITY AND WITHIN THE ORGANIZATIONS THAT COMPRISE NORTHWESTERN MEDICINE, INCLUDING THE HEALTH SYSTEM AND FEINBERG. OUR AFFILIATIONS WITH COMMUNITY-BASED HEALTHCARE AND COMMUNITY PARTNERS ENABLE THE HEALTH SYSTEM'S ORGANIZATIONS TO MEANINGFULLY IMPROVE ACCESS TO HIGH-QUALITY HEALTH CARE AND IMPLEMENT TARGETED PROGRAMS THAT ADDRESS THE HIGHEST-PRIORITY HEALTH NEEDS OF THE COMMUNITY. WE HAVE IMPLEMENTED LARGE-SCALE PROGRAMS THROUGHOUT OUR COMMUNITIES USING THIS FRAMEWORK TO TARGET HIGH-PRIORITY HEALTH CONDITIONS AND WILL CONTINUE TO USE PUBLIC HEALTH MODELS TO ADDRESS PRIORITY HEALTH NEEDS IDENTIFIED THROUGH OUR CHNAS. ONGOING EFFORTS DRAW ON NMHC'S AND FEINBERG'S STRENGTHS IN PUBLIC HEALTH, COMMUNICATION AND EDUCATION, AND INCLUDE PROGRAMS TO ADDRESS IDENTIFIED PRIORITY HEALTH NEEDS IN COMMUNITIES SERVED ACROSS THE HEALTH SYSTEM. OUR HOSPITALS HAVE ENDURING RELATIONSHIPS, OFTEN DECADES OLD, WITH LOCAL HEALTHCARE AND COMMUNITY ORGANIZATIONS. THROUGH THESE PARTNERSHIPS, WE COLLABORATE ON DETERMINING PRIORITY HEALTH NEEDS THROUGH THE CHNA PROCESS AND WORK TOGETHER TO DEVELOP SOLUTIONS THAT RESPECT THE VARIED CULTURAL, SOCIOECONOMIC AND PRACTICAL NEEDS OF OUR DIVERSE COMMUNITIES. NORTHWESTERN MEMORIAL HOSPITAL: NMH COLLABORATES WITH COMMUNITY-BASED HEALTH, EDUCATION AND SOCIAL SERVICE ORGANIZATIONS TO PROVIDE HEALTH EDUCATION, OUTREACH SERVICES AND FOCUSED DISEASE MANAGEMENT PROGRAMS, AND TO ENSURE THAT THE RESIDENTS OF OUR COMMUNITIES HAVE CONVENIENT ACCESS TO HIGH-QUALITY MEDICAL HOMES. NMH HAS FORMAL AND LONGSTANDING AFFILIATIONS WITH TWO FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) BASED IN THE COMMUNITY - NEAR NORTH HEALTH SERVICE CORPORATION AND ERIE FAMILY HEALTH CENTER - AS WELL AS WITH COMMUNITYHEALTH, THE LARGEST FREE HEALTH CLINIC IN ILLINOIS. VITAL COMMUNITY PARTNERSHIPS ARE ALSO IN PLACE AMONG VARIOUS HEALTH AND COMMUNITY PARTNERS, INCLUDING BRIGHT STAR COMMUNITY OUTREACH AND KELLY HALL YMCA, AMONG MANY MORE. NORTHWESTERN MEDICINE LAKE FOREST HOSPITAL: THROUGH CHARITY CARE, OUTREACH SERVICES AND HEALTH EDUCATION PROGRAMS, NM LFH IMPROVES ACCESS TO HEALTHCARE SERVICES AND RESPONDS TO THE PRIORITY HEALTH NEEDS OF THE RESIDENTS OF LAKE COUNTY, ESPECIALLY AMONG THE UNINSURED OR UNDERINSURED. NM LFH HAS DEEP ROOTS IN LAKE COUNTY AND STRONG RELATIONSHIPS WITH COMMUNITY PARTNERS INCLUDING ERIE HEALTHREACH WAUKEGAN HEALTH CENTER AND THE LAKE COUNTY HEALTH DEPARTMENT, AMONG OTHERS. NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL: NM CDH HAS ENDURING RELATIONSHIPS WITH SEVERAL COMMUNITY-LED, COUNTY-WIDE HEALTH COLLABORATIVES, THE DUPAGE COUNTY HEALTH DEPARTMENT, LOCAL SCHOOL DISTRICTS AND SOCIAL SERVICES ORGANIZATIONS. LONGSTANDING COLLABORATIONS INCLUDE THE DUPAGE HEALTH COALITION/ACCESS DUPAGE AND THE VILLAGE OF WINFIELD. THROUGH THESE PARTNERSHIPS, AND MANY MORE, NM CDH PROVIDES HEALTH EDUCATION, NAVIGATION AND OUTREACH SERVICES. NORTHWESTERN MEDICINE DELNOR HOSPITAL: NM DELNOR REGULARLY ENGAGES WITH KANE COUNTY ORGANIZATIONS COMMITTED TO IMPROVING THE HEALTH OF ITS RESIDENTS, INCLUDING THE KANE COUNTY HEALTH DEPARTMENT AND THE TRI CITY HEALTH PARTNERSHIP, AMONG OTHERS. NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL: NM KISHWAUKEE WORKS CLOSELY WITH MANY COMMUNITY PARTNERS INCLUDING THE DEKALB COUNTY COMMUNITY MENTAL HEALTH BOARD, DEKALB COUNTY HEALTH DEPARTMENT, NORTHERN ILLINOIS UNIVERSITY, KISHWAUKEE COLLEGE, AREA SCHOOL DISTRICTS, AND MANY OTHER LOCAL MEDICAL PROVIDERS, NOT-FOR-PROFIT ORGANIZATIONS, AND COMMUNITY GROUPS. TOGETHER, NM KISHWAUKEE COLLABORATES WITH THESE DIVERSE ORGANIZATIONS TO IDENTIFY A COMMON VISION AND PLAN TO CREATE A COLLECTIVE IMPACT ON THE OVERALL HEALTH OF THE COMMUNITY.

Schedule H, Part VI, Line 4 Community information
The communities served by NMHC hospitals are complex and diverse, encompassing rural, suburban and urban areas, with a range of socioeconomic statuses and social determinants of health that correspond to these demographics. NMHC is committed to providing care that takes into consideration the cultures and environments in which our patients live and is responsive to their needs. NMHC works closely with community partners, including health and social service partners, to identify priority health concerns and jointly develop community-based health initiatives designed to address healthcare disparities. Each NMHC hospital considers a variety of factors when defining its distinctive community. These factors include: geographic area served, principal functions of the hospital, areas of high hardship and the population served, the location of existing NM and community assets, and the service areas of other healthcare providers. By considering each of these factors, each NMHC hospital defined its own Community Service Area (CSA) and is working to meet the unique needs of the community it serves. Northwestern Memorial Hospital Service Area NMH serves a large, complex and diverse area with patients coming from the City of Chicago and surrounding counties. NMH's Hospital Service Area was previously defined as the Cities of Chicago and Evanston. This was re-evaluated to determine a 7-mile radius around the Hospital which maximizes the opportunity to identify and address health needs for communities serviced by the Hospital. The community comprises 34 ZIP codes, 92.30 square miles, or 56% of Chicago's total population. NMH's Hospital Service Area is ethnically and racially diverse with large Black and Hispanic populations as well as large Polish and Spanish-speaking populations. Significantly, more than 30 percent of families live below the poverty level in NMH's Hospital Service Area. NMH is committed to providing culturally competent care that is responsive to the needs of all our patients, regardless of the ability to pay. NMH works with community health centers in some of Chicago's medically underserved areas to identify priority health concerns and jointly develop community-based health initiatives designed to address healthcare disparities. Northwestern Medicine Lake Forest Hospital Service Area NM LFH primarily serves Lake County, which has a fairly stable population of around 725,000 residents. While NM LFH's Hospital Service Area population is only expected to grow by 0.7 percent over the next five years, the over-65 population is growing rapidly. According to the 2020 census results (the most recent information available), the number of persons in Lake County 65 years and older comprises 14.5 percent of the total population. A total of 21.5% of Lake County residents are Hispanic or Latino. In looking at race independent of ethnicity, 60.9% of residents of Lake County are White and 6.4% are Black. NM LFH defines its community as Lake County in order to facilitate alignment with the Lake County Health Department (LCHD). Northwestern Medicine Central DuPage Hospital Service Area Located in Winfield, Illinois, NMCDH serves over 931,000 residents of central and western DuPage County and beyond. Age distribution in the County includes 23.1 percent infants, children or adolescents, 62.5 percent of residents are age 18 to 64, and the 14.5 percent of age 65 or older. In looking at race independent of ethnicity, 77.5% of residents in DuPage County are White and 4.8% are Black. When considering ethnicity, 14.2% of DuPage residents are Hispanic or Latino. The county has a higher proportion of white residents and a lower proportion of black residents than the state and US. The percentage of Hispanic and Latino residents is also lower than found in the state and US. Northwestern Medicine Delnor Hospital Service Area NMDH primarily serves 235,000 residents of Kane County. Kane County is the seventh-youngest county in Illinois and notable for its age distribution. Those aged 0 to 17 comprise 22.3 percent of the population; 61.5 percent are age 18 to 64, and 16.2 percent are age 65 or older. The service area population is 82.4 percent white, 4.7 percent black, 3.5 percent Asian and 9.4 percent is some other race or two or more races. When considering ethnicity, 17.6 percent of the service area population identified as Hispanic or Latino. Northwestern Medicine Kishwaukee Hospital Service Area NMKH serves a majority of DeKalb County residents with an approximate population of 92,000 individuals; the greater part of the county's residents live in the cities of DeKalb and Sycamore. 21.5 percent of residents are aged 0 to 17 years and 65.9 percent are aged from 18 to 64 years. Additionally, 12.6 percent of the population is aged 65 years and older. The service area population is 80.6 percent white, 9 percent black, 2.9 percent Asian and 7.5 percent is some other race or two or more races. When considering ethnicity, 11.8 percent of the service area population identified as Hispanic or Latino. Northwestern Medicine Valley West Hospital Service Area A critical access hospital in Sandwich, Illinois, NMVW primarily serves residents of DeKalb County, demographics as detailed with NMKH. Most of the estimated population of 41,460 residents is centered in the cities of Plano, Sandwich and Somonauk. 22.3 percent of the population is aged 0 to 17, 63.1 percent aged 18 to 64, and 14.6 percent of the residents are age 65 and older. The population is predominantly white with 83.9 percent of the population, followed by 6.5 percent Black and the remaining 9.6 percent is another race or two or more races. Among the population, 16.4 percent identifies as Hispanic or Latino. Marianjoy Rehabilitation Hospital Service Area Located in Wheaton, Illinois, MRH largely serves the residents of DuPage County, demographics as discussed with regards to the NMCDH service area of DuPage County as well. However, due to the specialty nature of the hospital, MRH also serves as a destination hospital receiving patient referrals from surrounding counties including Cook, Will, Kane, Kendall, DeKalb and LaSalle. Due to the unique services offered by MRH, the hospital does not use a PSA to define its community. MRH considers DuPage County its CSA, but also serves as a destination hospital for surrounding counties. Patients often travel from Cook, Will, Kane, Kendall, DeKalb and LaSalle counties, among many more, to receive care at MRH. Care is provided for all persons across the life span, including but not limited to adults, children, women, seniors and disabled people. Special consideration is given to underserved and disproportionately affected populations. Northern Illinois Medical Center The hospitals comprising NIMC define their primary service area as McHenry County, the sixth-most populous county in Illinois, estimated at 308,570 residents as of 2018 data. The age distribution of the population was 24.6% aged 0-17, 62.5% aged 18-64, and 12.9% aged 65 and older as of the latest data available in 2017. When looking at race independent of ethnicity, 92.4% of residents are White, 2.7 percent are Asian and 1.3 percent are Black. A total of 12.5% of Hospital service area residents are Hispanic or Latino. McHenry County uninsured rates in 2017 were just 5.5% compared to the state uninsured rate of 7.8%. McHenry County also enjoys a relatively high socioeconomic status in comparison to the state at large, with median household income of $82,230 compared to the average $61,229. Together, the three NM hospitals in Chicago's northwest suburbs - NM McHenry, NM Huntley and NM Woodstock - serve the same CSA of McHenry County, which accounts for a majority of inpatient admissions. Palos Community Hospital PCH serves the areas surrounding its campus in Palos Heights, Illinois and includes 26 residential ZIP codes in southwest Cook County and northeast Will County. Over 622,000 residents reside in this service area, with a change in population of 0.93% between the 2010 and 2020 census results. Cook County age distribution indicates 21.8% of the population to be aged 0-17, 63.5% aged 18-64, and 14.7% aged 65 and older. Reviewing for race independent of ethnicity, 76% of residents are non-Hispanic White, 13.3% of residents are Hispanic, 5.9% are non-Hispanic Black, 4.7% are among other races and ethnicities. A total of 23.4% of service area respondents believe their overall health is fair or poor and 28.3% of respondents have received a diagnosis of a depressive disorder.

Schedule H, Part VI, Line 6 Affiliated health care system
AS DESCRIBED THROUGHOUT THIS FORM 990, THE SUBORDINATES REPORTED IN THIS GROUP RETURN ARE ALL PART OF NORTHWESTERN MEMORIAL HEALTHCARE. THE COMMUNITY BENEFIT PLAN AND COMMUNITY HEALTH NEEDS ASSESSMENT, DESCRIBED EARLIER IN SCHEDULE H, GIVE DETAILS ABOUT EACH SUBORDINATE'S RESPECTIVE ROLE IN PROMOTING THE HEALTH OF THE COMMUNITIES WE SERVE.

Schedule H, Part VI, Line 2 NEEDS ASSESSMENT, CONTINUED
Northwestern Medicine Valley West Hospital: NM Valley West collaborates with diverse organizations to identify a common vision and plan to create a collective impact on the overall health of the community. This includes striving to coordinate efforts focusing on community priorities with community stakeholders including the DeKalb County Health Department, the Kendall County Health Department, Fox Valley Older Adults, and other medical, not-for-profit, community and faith-based organizations. Marianjoy Rehabilitation Hospital: MRH coordinates strategies with community partners and key stakeholders who include, but are not limited to, the DuPage County Health Department, DuPage Federation on Human Services Reform, AbilityLinks, the People's Resource Center, and local school districts and public entities. MRH's Pediatric Community Groups continue to be highly utilized by parents/caregivers to work on achieving functional goals for children with special needs. Northern Illinois Medical Center: NIMC represents the three hospitals of the legacy Centegra Health System (CHS), including Northwestern Medicine McHenry Hospital, Northwestern Medicine Huntley Hospital and Northwestern Medicine Woodstock Hospital. McHeny Hospital works with the Chicago Medical School Internal Medicine Residency program to provide training to the next generation of caregivers. The Woodstock campus is home to Aunt Martha's Woodstock Community Health Center, a federally qualified health center, offering comprehensive primary care and mental health services to the uninsured and underinsured members of the broader McHenry Community. Palos Community Hospital: PCH is situated in the South Suburbs of Chicago, including the Palos Heights and Orland Park communities. PCH has worked with partners and stakeholders from that area including, but not limited to, the City of Palos Heights, the Villages of Chicago Ridge, Crestwood, Midlothian, Orland Park, Palos Park, and Worth, as well as local school districts and public entities.

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
THE COST OF CHARITY CARE FOR THE HOSPITALS WAS CALCULATED BY APPLYING THE TOTAL COST-TO-CHARGE RATIO FROM EACH HOSPITAL'S MEDICARE COST REPORT (CMS 2552-96 WORKSHEET C, PART 1, CONSISTENT WITH THE STATE OF ILLINOIS ATTORNEY GENERAL'S OFFICE DEFINITION) TO THE CHARGES ON ACCOUNTS IDENTIFIED AS QUALIFYING FOR CHARITY CARE (AS DEFINED IN THE AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS ACCOUNTING AND AUDITING GUIDE - HEALTHCARE ORGANIZATIONS). THE RESULTANT CALCULATED COST WAS THEN OFFSET BY ANY PAYMENTS RECEIVED THAT WERE DESIGNATED FOR THE PAYMENT OF PATIENT BILLS QUALIFYING FOR A CHARITY CARE DISCOUNT (AS DEFINED IN THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION'S PRINCIPLES AND PRACTICES BOARD STATEMENT 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS). THE PHYSICIAN GROUPS, INCLUDING NMG AND RMG ARE NOT REQUIRED TO FILE A MEDICARE COST REPORT. AN INTERNALLY CALCULATED COST-TO-CHARGE RATIO SPECIFIC TO THE PHYSICIAN GROUPS WAS USED TO DETERMINE THE COST OF CHARITY CARE FOR NMG. THE RESULTANT CALCULATED COST WAS THEN OFFSET BY ANY PAYMENTS, CONSISTENT WITH THE METHODOLOGY FOR THE HOSPITALS. THE UNREIMBURSED COST OF BAD DEBT, MEDICAID, MEDICARE OR ANY OTHER FEDERAL, STATE OR LOCAL INDIGENT HEALTHCARE PROGRAM IS NOT INCLUDED IN THE UNREIMBURSED COST FIGURE FOR CHARITY CARE. THE COSTS OF CHARITY CARE IN THIS REPORT DIFFER FROM NMHC'S NOTES TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR FISCAL YEAR 2022 WHERE THEY WERE CALCULATED BY APPLYING A COST-TO-CHARGE RATIO DEVELOPED PRIOR TO FILING NMH'S, NLFH'S, CDH'S, DELNOR'S, KISH'S, MARIANJOY'S, NIMC'S, AND PCH'S FISCAL YEAR 2022 MEDICARE COST REPORTS TO CHARGES FOREGONE FOR CHARITY CARE. THE FISCAL YEAR 2022 MEDICARE COST REPORTS WERE COMPLETED AFTER THE AUDITED FINANCIAL STATEMENTS WERE ISSUED. THE COSTS OF CHARITY CARE FOR THE HOSPITALS INCLUDED IN THIS REPORT WERE CALCULATED USING THE COST-TO-CHARGE RATIOS FROM NMH'S, NLFH'S, CDH'S, DELNOR'S, KISH'S, MARIANJOY'S, NIMC'S, AND PCH'S COST REPORTS FILED IN MARCH OF 2023 FOR FISCAL YEAR 2022. COMMUNITY HEALTH IMPROVEMENT SERVICES - THE COST OF LANGUAGE ASSISTANCE PROGRAMS INCLUDES BOTH THE COST OF EMPLOYEES AND NONEMPLOYEES TO PROVIDE TRANSLATION SERVICES TO NMHC HOSPITAL PATIENTS AND FAMILY MEMBERS. EDUCATION - UNREIMBURSED EDUCATION COSTS INCLUDE THE COST OF NMHC'S MEDICAL RESIDENCY, FELLOWSHIP AND INTERNSHIP PROGRAMS LESS ANY THIRD-PARTY PAYOR REIMBURSEMENTS AND FEES RECEIVED. SUBSIDIZED HEALTH SERVICES - SUBSIDIZED HEALTH SERVICES INCLUDE THE UNCOMPENSATED COST OF PROVIDING BEHAVIORAL HEALTH SERVICES, HEALTH EDUCATION AND INFORMATION AND PROGRAMS TO POSITIVELY IMPACT THE WELLNESS OF THE COMMUNITY. COSTS CALCULATED WERE OFFSET BY ANY REIMBURSEMENT RECEIVED FOR SERVICES PROVIDED. THE UNREIMBURSED COST FOR BEHAVIORAL HEALTH SERVICES WAS ALSO ADJUSTED TO EXCLUDE THE UNREIMBURSED COST OF CHARITY CARE AND GOVERNMENT SPONSORED INDIGENT HEALTHCARE. RESEARCH - NMHC PROVIDES SUPPORT TO ADVANCE MEDICAL AND SCIENTIFIC RESEARCH AND ACADEMIC PURSUITS. THE REPORTED SUPPORT INCLUDES THE UNREIMBURSED COST OF FUNDS PROVIDED FOR RESEARCH PROJECTS AND UNREIMBURSED OPERATIONAL INFRASTRUCTURE COSTS TO SUPPORT CLINICAL RESEARCH THAT OCCURS AT NMH, NMG, CDH AND MJRH. DONATIONS - DONATIONS INCLUDE THE DOLLAR AMOUNT RECORDED DURING FISCAL YEAR 2022 IN ACCORDANCE WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES AS CONTRIBUTIONS TO CHARITABLE AND OTHER COMMUNITY OR CIVIC ORGANIZATIONS FOR FURTHERANCE OF THEIR CHARITABLE PURPOSES.

Schedule H, Part VI, Line 7 State filing of community benefit report
IL

Schedule H, Part II Community Building Activities
NMHC HOSPITALS PROVIDE A BROAD RANGE OF TRAINING PROGRAMS AND SUPERVISED PATIENT CARE EXPERIENCES TO ENSURE THAT A HIGHLY TRAINED HEALTHCARE WORKFORCE OF ADEQUATE CAPACITY IS IN PLACE TO SERVE THE RESIDENTS OF THE REGION. IMPORTANTLY, THESE PROGRAMS CREATE PATHWAYS FOR AT-RISK MEMBERS OF THE COMMUNITY TO SEEK JOBS WITHIN THE HEALTHCARE SYSTEM AND ALSO ARE IN PLACE FOR YOUNG PEOPLE TO LEARN ABOUT AND POTENTIALLY EXPLORE HEALTHCARE CAREERS. ALLIED HEALTH SCHOOLS AT NMH NMH OPERATES FOUR ACCREDITED ALLIED HEALTH SCHOOLS - DIAGNOSTIC MEDICAL SONOGRAPHY, NUCLEAR MEDICINE TECHNOLOGY, RADIATION THERAPY AND RADIOLOGY - AS WELL AS A HISTOTECHNOLOGY PROGRAM, POST-PRIMARY CT AND MRI PROGRAMS, AND A MEDICAL ASSISTANT PROGRAM. THE 21-MONTH CERTIFICATE PROGRAMS ARE OPEN TO EMPLOYEES AND THE GENERAL PUBLIC. MANY STUDENTS COME FROM THE LOCAL COMMUNITY, AS WELL AS FROM AFFILIATED COLLEGES AND UNIVERSITIES. LEADERS OF THESE PROGRAMS VISIT CITY HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO INTRODUCE VARIOUS MEDICAL FIELDS TO PROSPECTIVE STUDENTS AND INCREASE THEIR GENERAL KNOWLEDGE OF VARIOUS ALLIED HEALTH FIELDS. THE CERTIFICATE PROGRAMS AIM TO ADDRESS THE NEED FOR ALLIED HEALTH PROFESSIONALS IN THE FIELD. IN ADDITION TO TRAINING THE NATION'S FUTURE PHYSICIANS, FEINBERG HAS FURTHER RESPONDED TO THE ANTICIPATED SHORTAGE OF MEDICAL PROVIDERS BY OFFERING A MASTER'S-LEVEL PHYSICIAN ASSISTANT PROGRAM. PHYSICIAN ASSISTANTS ARE HIGHLY EFFECTIVE MEMBERS OF PRIMARY CARE TEAMS THAT INCLUDE MANY LEVELS OF PROVIDERS AND CAN EFFICIENTLY DELIVER THE HIGHEST QUALITY OF CARE TO EXTENDED GROUPS OF PATIENTS. THROUGH FEINBERG'S PROGRAM, PHYSICIAN ASSISTANTS ARE EDUCATED AND TRAINED WITHIN THE MEDICAL SCHOOL SETTING AND GAIN CLINICAL EXPERIENCE AT NMHC HOSPITALS. CLINICAL EXPERIENCE AT NMHC HOSPITALS NMHC HOSPITALS PROVIDE THE IMPORTANT CLINICAL SETTING FOR THE EDUCATION OF THE NEXT GENERATION OF HEALTHCARE WORKERS, INCLUDING PHYSICIANS, NURSES, PHARMACISTS, LABORATORY PROFESSIONALS, ALLIED HEALTH WORKERS AND SKILLED TECHNICIANS. THROUGH CLINICAL AFFILIATIONS WITH TOP REGIONAL UNIVERSITIES AND COLLEGES AND ESTABLISHED CLINICAL ROTATIONS, MENTORING, CLINICIAN SHADOWING, TRADITIONAL DIDACTIC LECTURES AND OTHER TEACHING PROGRAMS, WE PROVIDE CLINICAL SETTINGS FOR THE EDUCATION OF THOUSANDS OF STUDENTS, MANY OF WHOM WILL BECOME PROFESSIONALS IN FIELDS IDENTIFIED AS AREAS OF CURRENT OR FUTURE WORKFORCE SHORTAGE IN THE NATIONAL HEALTHCARE SYSTEM. NMHC PROVIDES EDUCATION TO A WIDE RANGE OF STUDENTS INCLUDING: - UNDERGRADUATE AND GRADUATE NURSING STUDENTS - STUDENTS FROM UNIVERSITY-BASED PHARMACY PROGRAMS - RESPIRATORY THERAPY STUDENTS - GRADUATE SOCIAL WORK INTERNS - PSYCHOLOGY PHD CANDIDATES WITH CLINICAL EMPHASES IN ADULT CLINICAL PSYCHOLOGY, BEHAVIORAL MEDICINE (HEALTH PSYCHOLOGY), CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY AND CLINICAL NEUROPSYCHOLOGY - INTERNS IN BIOMEDICAL ENGINEERING - PASTORAL CARE STUDENTS - PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, SPEECH LANGUAGE PATHOLOGISTS, PHYSICAL THERAPIST ASSISTANTS AND OCCUPATIONAL THERAPY ASSISTANTS THROUGH A MASTER CLINICIAN PROGRAM - PHYSICAL AND OCCUPATIONAL THERAPY ASSISTANT, BACHELOR, MASTERS AND PHD STUDENTS - STUDENTS IN A BROAD ARRAY OF OTHER CLINICAL PROGRAMS ON-THE-JOB TRAINING AND YOUTH EDUCATION PROGRAMS RESEARCH ON THE SOCIAL DETERMINANTS OF HEALTH INDICATES THAT ACCESS TO EDUCATIONAL AND ECONOMIC OPPORTUNITIES IS A KEY FACTOR IMPACTING INDIVIDUALS' QUALITY OF LIFE. NMHC OFFERS A MULTITUDE OF OPPORTUNITIES TO EXPOSE STUDENTS TO POTENTIAL HEALTHCARE CAREERS AND TO FOSTER PROFESSIONAL DEVELOPMENT IN THE FIELD. ONGOING, COMPREHENSIVE, ON-THE-JOB TRAINING AND YOUTH PROGRAMS FOR HIGH SCHOOL, COLLEGE AND POST-GRADUATE STUDENTS ARE OFFERED AT EVERY HOSPITAL IN THE HEALTH SYSTEM IN BOTH CLINICAL AND ADMINISTRATIVE SETTINGS. NM HAS LONG INVESTED IN PROGRAMS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, INCLUDING PROVIDING EDUCATIONAL AND EMPLOYMENT OPPORTUNITIES FOR YOUTH. IN 2011, NMH EMBARKED ON AN EDUCATIONAL PARTNERSHIP WITH WESTINGHOUSE COLLEGE PREPARATORY HIGH SCHOOL (WESTINGHOUSE), A SELECTIVE-ENROLLMENT HIGH SCHOOL ON CHICAGO'S WEST SIDE, TO PROVIDE TALENTED HIGH SCHOOL STUDENTS WITH THE OPPORTUNITY TO LEARN ABOUT AND PURSUE POST-HIGH-SCHOOL EDUCATION IN HEALTHCARE CAREERS. STUDENTS MEET FEINBERG FACULTY AND HOSPITAL EMPLOYEES, AND ARE PROVIDED A BEHIND-THE-SCENES UNDERSTANDING OF CLINICAL AREAS AND POTENTIAL CAREERS. THE PROGRAM ALSO INCLUDES MENTORING, AN INTENSIVE SUMMER PROGRAM, DISTANCE LEARNING, ACT TEST PREPARATION, AND LEADERSHIP AND LIFE SKILLS DEVELOPMENT. THE PROGRAM HAD 21 PARTICIPANTS IN FY22 AND 54 STUDENTS HAVE GRADUATED FROM THE PROGRAM TO DATE. IN FY22, THE OFFERED PROGRAMS TO THE WESTINGHOUSE COMMUNITY INCLUDED: - THE COMMUNITY GRAND ROUNDS SESSION PROVIDED THE OPPORTUNITY FOR NM FACULTY TO DIRECTLY SHARE MEDICAL INFORMATION AND KNOWLEDGE. - THE ANATOMY LAB SESSION PROVIDED STUDENTS WITH THEIR FIRST GLANCE OF MEDICAL SCHOOL AND EXPOSURE TO A REAL HUMAN BODY. - THE MEN IN MEDICINE AND SCIENCE (MIMS) PROGRAM EXPOSED WESTINGHOUSE FRESHMAN MALE STUDENTS TO THE WORLD OF MEDICINE AND SCIENCE. REFLECTING THE GEOGRAPHICAL EXPANSION OF THE HEALTH SYSTEM, THE NM DISCOVERY PROGRAM, FORMERLY KNOWN AS MEDICAL EXPLORERS, GREW TO SIX CHAPTERS IN FY22 WITH OVER 150 STUDENT PARTICIPANTS AT: NM DISCOVERY PROGRAM CENTRAL, NM DISCOVERY PROGRAM WEST, NM DISCOVERY PROGRAM NORTH, NM DISCOVERY PROGRAM GREATER DEKALB, NM DISCOVERY PROGRAM NORTHWEST, AND NM DISCOVERY PROGRAM SOUTH. THROUGHOUT THE TWO-YEAR PROGRAM, STUDENTS ARE EXPOSED TO A BROAD RANGE OF ACTIVITIES DESIGNED TO ENCOURAGE THEIR INTEREST IN HEALTHCARE CAREERS. IN ADDITION, THE PROGRAM FOSTERS CHARACTER AND PROFESSIONAL DEVELOPMENT, CULTIVATES LIFE SKILLS, PROVIDES COMMUNITY SERVICE AND LEADERSHIP EXPERIENCE, AND OFFERS MENTORSHIP AND NETWORKING OPPORTUNITIES. ONCE-MONTHLY ACTIVITIES INCLUDE TOURS, GUEST SPEAKERS, GROUP DISCUSSION AND HANDS-ON PROJECTS. SINCE THE PROGRAM BEGAN, MANY PARTICIPANTS HAVE PURSUED CAREERS IN NURSING AND OTHER HEALTHCARE FIELDS, AND SEVERAL ARE NOW EMPLOYED AT NMH. ADDITIONAL EXPANSION OF BOTH THE NM DISCOVERY PROGRAM IS EXPECTED IN COMING YEARS. SINCE 2016, NM HUNTLEY AND NM MCHENRY HOSPITALS HAVE OFFERED THE YOUTH RESIDENCY PROGRAM. WORKING WITH LOCAL HIGH SCHOOLS, THE PROGRAM PROVIDES INTENSIVE JOB SHADOWING AND MENTORSHIP WITH THE GOAL OF SPARKING STUDENTS' INTEREST IN HEALTH CAREERS AND ULTIMATELY RETURNING TO WORK IN THE LOCAL COMMUNITY. FROM LEARNING TO READ AN MRI, TO INSPECTING CELL TISSUES FOR TUMORS, STUDENTS ARE IMMERSED IN A PROFESSIONAL MEDICAL ENVIRONMENT IN CONJUNCTION WITH THE HIGH-SCHOOL BASED CURRICULUM. EACH CHAPTER SERVES UP-TO 30 STUDENTS ANNUALLY. NM CDH, NM DELNOR, NM KISHWAUKEE, AND NM WOODSTOCK OFFER PROJECT SEARCH, A PROGRAM FOR STUDENT INTERNS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. PROJECT SEARCH IS AN EMPLOYABILITY SKILLS TRAINING PROGRAM THAT ASSISTS STUDENTS WHO HAVE INTELLECTUAL AND DEVELOPMENTAL DISABILITIES TRANSITION FROM HIGH SCHOOL TO PRODUCTIVE EMPLOYMENT. THE HALLMARK OF PROJECT SEARCH IS TOTAL WORKPLACE IMMERSION, WHICH FACILITATES A SEAMLESS COMBINATION OF CLASSROOM INSTRUCTION, CAREER EXPLORATION AND HANDS-ON TRAINING. DURING THE ONE-YEAR PROGRAM, STUDENTS WHO ARE IN THEIR LAST YEAR OF HIGH SCHOOL PARTICIPATE IN THREE 10-WEEK INTERNSHIPS WITHIN THE HOSPITAL TO EXPLORE THEIR VOCATIONAL SKILLS, ABILITIES AND POTENTIAL CAREER PATHS. THE GOAL OF THE PROGRAM IS TO ACHIEVE 100% EMPLOYMENT AT THE END OF THE INTERNSHIP. PROJECT SEARCH IS CONTINUING TO EXPAND ACROSS THE HEALTH SYSTEM. PROJECT SEARCH HAD 40 PARTICIPANTS DURING FY22, AND 100% ACHIEVED EMPLOYMENT AT THE END OF THEIR INTERNSHIP; EIGHT GRADUATES OF THE PROGRAM ARE NOW EMPLOYED BY THE HEALTH SYSTEM. COMMUNITY HEALTH EDUCATION COMMUNITY-BASED EDUCATION PROGRAMS ARE OFFERED ACROSS THE HEALTH SYSTEM AND IN COORDINATION WITH OUR COMMUNITY PARTNERS. THESE INITIATIVES RANGE FROM DISEASE-SPECIFIC INFORMATION PROGRAMS, TO MENTAL HEALTH AND SUBSTANCE ABUSE COMMUNITY EDUCATION, TO MINDFULNESS TRAINING, AMONG MANY MORE.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
NET PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS, AND NET PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THESE AMOUNTS ARE BASED PRIMARILY ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED WRITE-OFFS AND NET COLLECTIONS, ALONG WITH THE AGING STATUS FOR EACH MAJOR PAYOR SOURCE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BASED ON HISTORICAL EXPERIENCE, A PORTION OF NORTHWESTERN MEMORIAL'S SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, A PROVISION IS RECORDED FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO THESE PATIENTS. AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IN ACCORDANCE WITH NORTHWESTERN MEMORIAL'S POLICIES, ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, NORTHWESTERN MEMORIAL RECORDS AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE ADJUSTED AS NEEDED IN FUTURE PERIODS. BAD DEBTS REPRESENT THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS REPORTED IN NMHC'S FISCAL YEAR 2022 AUDITED FINANCIAL STATEMENTS RELATED TO PATIENT CARE SERVICES ADJUSTED TO COST CONSISTENT WITH THE METHODOLOGY USED TO CALCULATE GOVERNMENT SPONSORED INDIGENT HEALTHCARE.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
NET PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS, AND NET PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THESE AMOUNTS ARE BASED PRIMARILY ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED WRITE-OFFS AND NET COLLECTIONS, ALONG WITH THE AGING STATUS FOR EACH MAJOR PAYOR SOURCE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. BASED ON HISTORICAL EXPERIENCE, A PORTION OF NORTHWESTERN MEMORIAL'S SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, A PROVISION IS RECORDED FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO THESE PATIENTS. AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IN ACCORDANCE WITH NORTHWESTERN MEMORIAL'S POLICIES, ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, NORTHWESTERN MEMORIAL RECORDS AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE ADJUSTED AS NEEDED IN FUTURE PERIODS. BAD DEBTS REPRESENT THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS REPORTED IN NMHC'S FISCAL YEAR 2022 AUDITED FINANCIAL STATEMENTS RELATED TO PATIENT CARE SERVICES ADJUSTED TO COST CONSISTENT WITH THE METHODOLOGY USED TO CALCULATE GOVERNMENT SPONSORED INDIGENT HEALTHCARE.

Schedule H, Part V, Section B, Line 16a FAP website
- Northwestern Memorial Hospital: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN LAKE FOREST HOSPITAL: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - CENTRAL DUPAGE HOSPITAL ASSOCIATION: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - DELNOR-COMMUNITY HOSPITAL: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Northwestern Medicine Valley West Hospital: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Marianjoy Rehabilitation Hospital: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHERN ILLINOIS MEDICAL CENTER: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - PALOS COMMUNITY HOSPITAL: Line 16a URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- Northwestern Memorial Hospital: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN LAKE FOREST HOSPITAL: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - CENTRAL DUPAGE HOSPITAL ASSOCIATION: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - DELNOR-COMMUNITY HOSPITAL: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Northwestern Medicine Valley West Hospital: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Marianjoy Rehabilitation Hospital: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHERN ILLINOIS MEDICAL CENTER: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - PALOS COMMUNITY HOSPITAL: Line 16b URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- Northwestern Memorial Hospital: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN LAKE FOREST HOSPITAL: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - CENTRAL DUPAGE HOSPITAL ASSOCIATION: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - DELNOR-COMMUNITY HOSPITAL: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHWESTERN MEDICINE KISHWAUKEE COMMUNITY HOSPITAL: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Northwestern Medicine Valley West Hospital: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - Marianjoy Rehabilitation Hospital: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - NORTHERN ILLINOIS MEDICAL CENTER: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance; - PALOS COMMUNITY HOSPITAL: Line 16c URL: https://www.nm.org/patients-and-visitors/billing-and-insurance/financial-assistance;

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
THERE ARE MANY WAYS THAT PATIENTS OF THE HOSPITALS ARE INFORMED OR MADE AWARE OF THE AVAILABILITY OF THE HOSPITAL'S VARIOUS FINANCIAL ASSISTANCE PROGRAMS. A. TO INCREASE AWARENESS OF FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITALS HAVE DEVELOPED BROCHURES (IN ENGLISH AND SPANISH) THAT ARE PROVIDED TO PATIENTS UPON ADMISSION AND AVAILABLE AT REGISTRATION POINTS-OF-ENTRY B. MULTI-LANGUAGE SIGNS NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE ARE PRESENT AT EVERY PATIENT REGISTRATION AREA, INCLUDING THE EMERGENCY DEPARTMENT. SIGNS ARE POSTED IN ENGLISH, SPANISH, ARABIC, BOSNIAN, CHINESE (SIMPLIFIED AND TRADITIONAL), HINDI, KOREAN, POLISH, RUSSIAN, URDU, AND VIETNAMESE. C. AS PART OF THE REGISTRATION PROCESS, PATIENTS ARE PROVIDED WITH A FINANCIAL ASSISTANCE INFORMATION BROCHURE WHICH DESCRIBES THE TYPES OF ASSISTANCE AVAILABLE AND HOW TO QUALIFY FOR ONE OR MORE OF THE PROGRAMS. D. THE GENERAL CONSENT FORMS THAT EVERY PATIENT SIGNS CONTAINS INFORMATION ABOUT THE NMHC FINANCIAL ASSISTANCE PROGRAMS, AND IS AVAILABLE IN ENGLISH, SPANISH, RUSSIAN, AND POLISH AT NMH, WHILE NLFH, CDH, DELNOR, KCH, VWH, AND MJRH HAVE PROGRAMS IN ENGLISH AND SPANISH. E. INPATIENTS RECEIVE A PATIENT WELCOME PACKAGE THAT INCLUDES THE FINANCIAL ASSISTANCE INFORMATION. F. PATIENTS CAN LEARN ABOUT AND ASSESS THEIR ELIGIBILITY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAMS WITH THE HELP OF THE HOSPITAL'S TEAM OF FINANCIAL COUNSELING AND PATIENT INQUIRY REPRESENTATIVES. THESE REPRESENTATIVES ARE AVAILABLE ON A WALK-IN BASIS OR THROUGH A TOLL-FREE NUMBER. G. PROCESSES ARE IN PLACE TO LINK PATIENTS WITH FINANCIAL COUNSELORS AND PATIENT INQUIRY REPRESENTATIVES WHEN FINANCIAL HARDSHIP IS IDENTIFIED AS A CONCERN DURING SOCIAL SERVICES ASSESSMENTS. H. THE ENTRY PORTAL TO THE NMHC WEBSITE CONTAIN A PROMINENT LINK TO INFORMATION ABOUT NMHC'S VARIOUS FINANCIAL ASSISTANCE PROGRAMS, THE FINANCIAL ASSISTANCE BROCHURE AND DOWNLOADABLE APPLICATIONS IN MULTIPLE LANGUAGES. I. WORKING IN CONJUNCTION WITH CLINICAL STAFF, FINANCIAL COUNSELORS VISIT INPATIENTS NOT ENROLLED IN GOVERNMENT OR PRIVATE HEALTH PLANS WHILE THEY ARE STILL IN THE HOSPITAL TO ASSIST THEM IN DETERMINING THEIR ELIGIBILITY FOR BOTH GOVERNMENT HEALTH PROGRAMS AND FOR HOSPITAL FREE AND DISCOUNTED CARE PROGRAMS. J. THE HOSPITALS INFORM UNINSURED PATIENTS, AND PATIENTS WITH AN OUTSTANDING BALANCE AFTER INSURANCE, OF THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING THE FREE CARE AND DISCOUNTED CARE PROGRAM, AND THE CATASTROPHIC PROGRAM OFFERED BY THE HOSPITALS, IN WRITTEN CORRESPONDENCE SENT TO THOSE PATIENTS. THIS INFORMATION INCLUDES THE TOLL-FREE PHONE NUMBER TO THE TEAM OF PATIENT ACCOUNT REPRESENTATIVES. K. THE HOSPITALS HAVE ON-SITE PATIENT ACCOUNT STAFF WHO ARE TRAINED AND AVAILABLE TO ASSIST PATIENTS WITH FINANCIAL ASSISTANCE. L. THE HOSPITALS PROVIDE PROACTIVE FINANCIAL COUNSELING FOR SELF-PAY PATIENTS WHO HAVE A SCHEDULED INPATIENT ADMISSION. FINANCIAL COUNSELING INCLUDES ASSESSMENT FOR PUBLICLY OR PRIVATELY FUNDED INSURANCE AND THE HOSPITALS' FINANCIAL ASSISTANCE PROGRAMS. FINANCIAL ASSISTANCE PROGRAMS, INCLUDES THE FREE CARE AND DISCOUNTED CARE PROGRAMS, AND THE CATASTROPHIC PROGRAM OFFERED BY THE HOSPITALS, IN WRITTEN CORRESPONDENCE SENT TO THOSE PATIENTS. THIS INFORMATION INCLUDES THE TOLL-FREE PHONE NUMBER TO THE TEAM OF PATIENT ACCOUNT REPRESENTATIVES.

Schedule H, Part VI, Line 5 Promotion of community health
As described in earlier sections, NMHC believes that its mission to improve the health of the communities it serves is best accomplished in collaboration with partners in the community. The CHNA process and ongoing input from community partners inform how NMHC hospitals prioritize and address community health needs. Along with our many care locations, our community affiliations help us to provide care to residents near where they live or work, with streamlined pathways to access medically necessary hospital-based care. NMHC also sponsors numerous programs to provide mental health services, promote health and wellness, prevent injury and trauma, and provide healthcare career training, youth mentoring, language assistance and volunteer programs to enhance the quality and accessibility of care. Net unreimbursed cost for these activities for FY22 was over $67 million.