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Community Health Network Inc

7330 Shadeland Station 200
Indianapolis, IN 46256
EIN: 350983617
The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more
Individual Facility Details: Community Hospital Of Indiana Inc
7150 Clearvista Drive
Indianapolis, IN 46256
3 hospitals in organization:
(click a facility name to update Individual Facility Details panel)
Bed count298Medicare provider number150169Member of the Council of Teaching HospitalsNOChildren's hospitalNO

Community Health Network IncDisplay data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
6.45%
Spending by Community Benefit Category- 2021
(as % of total functional expenses)
* = CBI denoted preventative categories
Community Benefit Spending Compared to Functional Expenses, 2010-2021
Additional data

Community Benefit Expenditures: 2021

  • All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.

    • Operating expenses$ 1,441,918,394
      Total amount spent on community benefits
      as % of operating expenses
      		$ 93,041,068
      6.45 %
  • Amount spent in the following IRS community benefit categories:
      • Financial Assistance at cost
        as % of operating expenses
        		$ 3,611,959
        0.25 %
        Medicaid
        as % of operating expenses
        		$ 22,871,458
        1.59 %
        Costs of other means-tested government programs
        as % of operating expenses
        		$ 0
        0 %
        Health professions education
        as % of operating expenses
        		$ 18,399,850
        1.28 %
        Subsidized health services
        as % of operating expenses
        		$ 42,810
        0.00 %
        Research
        as % of operating expenses
        		$ 4,479,717
        0.31 %
        Community health improvement services and community benefit operations*
        as % of operating expenses
        Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.
        		$ 43,044,479
        2.99 %
        Cash and in-kind contributions for community benefit*
        as % of operating expenses
        		$ 590,795
        0.04 %
        Community building*
        as % of operating expenses        		$ 5,330,145
        0.37 %
    • * = CBI denoted preventative categories
    • Community building activities details:
        • Did tax-exempt hospital report community building activities?YES
          Number of activities or programs (optional)10
          Physical improvements and housing0
          Economic development2
          Community support1
          Environmental improvements0
          Leadership development and training for community members1
          Coalition building0
          Community health improvement advocacy5
          Workforce development1
          Other0
          Persons served (optional)0
          Physical improvements and housing0
          Economic development0
          Community support0
          Environmental improvements0
          Leadership development and training for community members0
          Coalition building0
          Community health improvement advocacy0
          Workforce development0
          Other0
          Community building expense
          as % of operating expenses          		$ 5,330,145
          0.37 %
          Physical improvements and housing
          as % of community building expenses
          		$ 0
          0 %
          Economic development
          as % of community building expenses
          		$ 482,054
          9.04 %
          Community support
          as % of community building expenses
          		$ 1,210
          0.02 %
          Environmental improvements
          as % of community building expenses
          		$ 0
          0 %
          Leadership development and training for community members
          as % of community building expenses
          		$ 280,715
          5.27 %
          Coalition building
          as % of community building expenses
          		$ 0
          0 %
          Community health improvement advocacy
          as % of community building expenses
          		$ 1,349,364
          25.32 %
          Workforce development
          as % of community building expenses
          		$ 3,216,802
          60.35 %
          Other
          as % of community building expenses
          		$ 0
          0 %
          Direct offsetting revenue$ 389,731
          Physical improvements and housing$ 0
          Economic development$ 0
          Community support$ 0
          Environmental improvements$ 0
          Leadership development and training for community members$ 52,210
          Coalition building$ 0
          Community health improvement advocacy$ 237,307
          Workforce development$ 100,214
          Other$ 0

    Other Useful Tax-exempt Hospital Information: 2021

    • In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

      • Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt
        as % of operating expenses        		$ 11,313,912
        0.78 %
        Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?NO
    • Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy

      The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

      • Does the organization have a written financial assistance (charity care) policy?YES
        Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?YES
        Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy
        as % of operating expenses        		$ 9,750,070
        86.18 %
    • Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
      • Reported to credit agencyNot available

    • Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.

      • After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid?YES

    • The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.

      • If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines?Not available

    • In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

      • Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute?YES

    Community Health Needs Assessment Activities: 2021

    • The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

      • Did the tax-exempt hospital report that they had conducted a CHNA?YES
        Did the CHNA define the community served by the tax-exempt hospital?YES
        Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?YES
        Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?YES
        Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?YES

    Supplemental Information: 2021

    This section presents qualitative information submitted by the hospital, verbatim from the 990H record.
    • Statement of Program Service Accomplishments
      Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
      • 4A (Expenses $ 872847216 including grants of $ 4569023) (Revenue $ 1776564262)
COMMUNITY HEALTH NETWORK, INC. OPERATES THREE ACUTE CARE FULL SERVICE HOSPITALS IN INDIANAPOLIS, INDIANA WITH 1,085 STAFFED BEDS. IN 2021, THE HOSPITALS SERVED 37,937 INPATIENTS FOR A TOTAL OF 192,797 INPATIENT DAYS OF SERVICE. THE HOSPITALS ALSO PROVIDED 1,309,223 OUTPATIENT VISITS, WHICH INCLUDED 150,257 EMERGENCY VISITS AND 594,885 MENTAL HEALTH VISITS. THE HOSPITALS OFFER MANY PATIENT FOCUSED HEALTHCARE SERVICES THAT INCLUDE WOMEN AND CHILDREN SERVICES, PEDIATRICS, ONCOLOGY, MENTAL HEALTH SERVICES, NEUROSCIENCES, ORTHOPEDICS, JOINT REPLACEMENT, BREAST CARE SERVICES, SURGERY SERVICES, REHABILITATION SERVICES, HEALTH PROMOTION SERVICES, EMERGENCY SERVICES, AND TRAINING AND EDUCATION FOR HEALTH CARE PROFESSIONALS.
      4B (Expenses $ 59929728 including grants of $ 0) (Revenue $ 6892733)
COMMUNITY HEALTH NETWORK, INC. PROVIDES SHARED SERVICES TO THE RELATED ORGANIZATIONS COLLECTIVELY REFERRED TO AS THE COMMUNITY HEALTH NETWORK. THESE SERVICES INCLUDE FINANCE AND ACCOUNTING, MATERIALS MANAGEMENT, PATIENT ACCOUNTING, TRANSCRIPTION SERVICES, MEDICAL RECORDS, LEGAL, HUMAN RESOURCES, INFORMATION TECHNOLOGY, AND BUSINESS DEVELOPMENT.
      Facility Information
      Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.
      PART V, SECTION A:
PART V, SECTION B, LINE 7A:HTTPS://WWW.ECOMMUNITY.COM/COMMUNITY-BENEFIT/ARCHIVED-REPORTSPART V, SECTION B, LINE 10A:HTTPS://WWW.ECOMMUNITY.COM/COMMUNITY-BENEFIT/ARCHIVED-REPORTS
      PART V, SECTION B
FACILITY REPORTING GROUP A
      FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: COMMUNITY HOSPITAL NORTH, - FACILITY 2: INDIANA HEART HOSPITAL, LLC, - FACILITY 3: COMMUNITY HOSPITAL EAST
      GROUP A-FACILITY 1 -- COMMUNITY HOSPITAL NORTH PART V, SECTION B, LINE 5:
IN 2021, COMMUNITY HEALTH NETWORK CONDUCTED A CHNA TO UNDERSTAND THE GREATEST HEALTH NEEDS IN THE COMMUNITIES SERVED. THE HOSPITALS TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROADER NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE CHNA ALSO INCLUDED ORGANIZATIONS OTHER THAN HOSPITALS. COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY COLLECTING AND ANALYZING DATA FROM MULTIPLE SOURCES. STATISTICS FOR NUMEROUS COMMUNITY HEALTH STATUS, HEALTH CARE ACCESS, AND RELATED INDICATORS WERE ANALYZED, INCLUDING DATA PROVIDED BY LOCAL, STATE, AND FEDERAL GOVERNMENT AGENCIES, LOCAL COMMUNITY SERVICE ORGANIZATIONS, AND COMMUNITY HEALTH NETWORK. COMPARISONS TO BENCHMARKS WERE MADE WHERE POSSIBLE. FINDINGS FROM RECENT ASSESSMENTS OF THE COMMUNITY'S HEALTH NEEDS CONDUCTED BY OTHER ORGANIZATIONS (E.G., LOCAL HEALTH DEPARTMENTS) WERE REVIEWED AS WELL.INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS CONSIDERED THROUGH KEY INFORMANT INTERVIEWS AND COMMUNITY MEETINGS. STAKEHOLDERS INCLUDED: INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; LOCAL PUBLIC HEALTH DEPARTMENTS; HOSPITAL STAFF AND PROVIDERS; REPRESENTATIVES OF SOCIAL SERVICE ORGANIZATIONS; REPRESENTATIVES OF FAITH-BASED ORGANIZATIONS; REPRESENTATIVES OF LOCAL UNIVERSITIES AND SCHOOLS; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. VIRTUAL COMMUNITY INPUT SESSIONS WERE HELD BETWEEN MAY AND JULY OF 2021. INVITATIONS AND PRESENTATIONS FOR THESE VIRTUAL SESSIONS WERE ORGANIZED BY COUNTY TO ENSURE WE COULD HEAR FROM THOUGHT-LEADERS SERVING IN THE SPECIFIC COMMUNITY. FOR A COMPLETE LIST OF PARTICIPANTS, PLEASE SEE THE ATTACHED COMMUNITY BENEFIT REPORT.
      GROUP A-FACILITY 1 -- COMMUNITY HOSPITAL NORTH PART V, SECTION B, LINE 6A:
THE CHNA FOR COMMUNITY HEALTH NETWORK WAS A COLLABORATIVE EFFORT WITH ALL FIVE HOSPITALS WITHIN COMMUNITY HEALTH NETWORK. IN ADDITION TO THE NETWORK HOSPITALS, COMMUNITY HEALTH NETWORK ALSO COLLABORATED WITH OTHER INDIANA HEALTH SYSTEMS TO COLLECT PRIMARY DATA THROUGH ONLINE COMMUNITY MEETINGS AND KEY STAKEHOLDER INTERVIEWS. THESE HEALTH SYSTEMS INCLUDE ASCENSION ST. VINCENT'S INDIANA, IU HEALTH, AND RIVERVIEW HEALTH.
      GROUP A-FACILITY 1 -- COMMUNITY HOSPITAL NORTH PART V, SECTION B, LINE 6B:
COMMUNITY HEALTH NETWORK WORKED WITH VERITE HEALTHCARE CONSULTING, LLC (VERITE) TO COMPLETE THE CHNA.
      GROUP A-FACILITY 1 -- COMMUNITY HOSPITAL NORTH PART V, SECTION B, LINE 11:
"COMMUNITY HEALTH NEEDS WERE DETERMINED TO BE ""SIGNIFICANT"" IF THEY WERE IDENTIFIED AS PROBLEMATIC IN AT LEAST TWO OF THE FOLLOWING THREE DATA SOURCES: 1) THE MOST RECENTLY AVAILABLE SECONDARY DATA REGARDING THE COMMUNITY'S HEALTH, 2) RECENT ASSESSMENTS DEVELOPED BY THE STATE AND LOCAL ORGANIZATIONS, AND 3) INPUT FROM COMMUNITY STAKEHOLDERS WHO PARTICIPATED IN THE COMMUNITY MEETING, KEY INFORMANT INTERVIEW PROCESS, AND STAFF SURVEYS. THE IMPLEMENTATION STRATEGIES WERE DRAFTED FOR EACH REGION AND DESCRIBE HOW THE HOSPITALS PLAN TO ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED. THE HOSPITALS REVIEWED THE CHNA FINDINGS AND APPLIED THE FOLLOWING CRITERIA TO DETERMINE THE MOST APPROPRIATE NEEDS FOR THE REGIONS TO ADDRESS: 1) THE EXTENT TO WHICH THE HOSPITAL HAS RESOURCES AND COMPETENCIES TO ADDRESS THE NEED 2) THE IMPACT THAT THE HOSPITAL COULD HAVE ON THE NEED (I.E. THE NUMBER OF LIVES THE HOSPITAL CAN IMPACT)3) THE FREQUENCY WITH WHICH STAKEHOLDERS IDENTIFIED THE NEEDS AS A SIGNIFICANT PRIORITY4) THE EXTENT OF COMMUNITY SUPPORT FOR THE HOSPITAL TO ADDRESS THE ISSUE AND POTENTIAL FOR PARTNERSHIPS TO ADDRESS THE ISSUE.COMMUNITY HEALTH NETWORK WILL ADDRESS ALL OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2021 CHNA, THESE INCLUDE: MENTAL HEALTH/SUBSTANCE USE, CHRONIC DISEASE, SOCIAL DETERMINANTS OF HEALTH (SDOH), COVID-19 AND MATERNAL/INFANT HEALTH. COMMUNITY HEALTH NETWORK (""CHNW"") IS ADDRESSING THE NEEDS IDENTIFIED IN THE FOLLOWING WAYS:MENTAL HEALTH/SUBSTANCE USECHNW OPIOID STEWARDSHIP PROGRAM: CHNW HAS DEDICATED RESOURCES TO THE PREVENTION OF OPIOID USE DISORDER AND OVERDOSE DEATHS. THE OPIOID STEWARDSHIP PROGRAM INCLUDES SAFE OPIOID PRESCRIBING TRAINING FOR PRIMARY CARE AND SPECIALTY CARE PRACTITIONERS. BY PARTNERING WITH BOSTON UNIVERSITY SCHOOL OF MEDICINE, A LONGSTANDING LEADER IN EDUCATIONAL EXCELLENCE, WE BROUGHT AWARD WINNING CURRICULUM TO CHNW TO EDUCATE OUR PRACTITIONERS HOW TO SAFELY AND EFFECTIVELY MANAGE PATIENTS ACUTE AND/OR CHRONIC PAIN INCLUDING SAFE OPIOID PRESCRIBING MEASURES WHEN OPIOIDS ARE MEDICALLY NECESSARY. NARCAN PROGRAM: CHNW IS DEDICATED TO THE PREVENTION OF OVERDOSE DEATHS THROUGH OUR NARCAN PROGRAM. NARCAN IS THE DRUG THAT CAN REVERSE THE EFFECTS OF OPIOIDS SUCH AS HEROIN, METHADONE AND OXYCODONE. OUR PROGRAM PROVIDES A NARCAN KIT TO PATIENTS AND THEIR FAMILIES WHO ARE AT RISK FOR AN OPIOID OVERDOSE WHEN THEY HAVE BEEN DISCHARGED FROM AN EMERGENCY DEPARTMENT OR THE BEHAVIORAL HEALTH PAVILION. THROUGH PARTNERSHIPS WITH COMMUNITY NONPROFIT ORGANIZATIONS SUCH AS OVERDOSE LIFELINE AND THE BEECH GROVE COMPREHENSIVE DRUG FREE COALITION WE PROVIDED OPIOID OVERDOSE AWARENESS TRAINING AND FREE NARCAN KITS TO THE COMMUNITIES WE SERVE. IN 2021, 738 NARCAN KITS WERE DISTRIBUTED.SCHOOL-BASED BEHAVIORAL CARE SERVICES: CHNW'S SCHOOL-BASED CARE SERVICES PROVIDES COORDINATED, MULTI-SERVICE 'ON THE SPOT' CARE DIRECTLY IN SCHOOLS TO STUDENTS IN NEED BY WAY OF AN EMBEDDED COORDINATED TEAM OF SCHOOL NURSES, SCHOOL BEHAVIORAL HEALTH PROFESSIONALS, SCHOOL SPORTS MEDICINE & ATHLETIC TRAINING PROFESSIONALS, AND VIRTUAL CARE PROVIDERS. THE PROGRAM ALSO AIMS TO HELP KEEP SCHOOL TEACHERS, STAFF, EMPLOYEES, AND ADMINISTRATORS HEALTHY AND AVAILABLE TO SUPPORT KIDS IN SCHOOLS BY WAY OF ONSITE HEALTH & WELLNESS CLINICS AND EAP SERVICES FOR SCHOOL EMPLOYEES AND THEIR DEPENDENTS. CHNW PROVIDES OVER 170 BEHAVIORAL STAFF EMPLOYEES TO 143 SCHOOLS THROUGHOUT CENTRAL INDIANA. THESE ON-SITE BEHAVIORAL HEALTH SPECIALISTS PROVIDE SERVICES SUCH AS, COUNSELING, LIFE-SKILLS TRAINING, CRISIS RESPONSE, TRAUMA AND DEPRESSION SCREENINGS, STAFF EDUCATION AND TRAINING, TESTING, FAMILY SERVICES AND MORE. CHNW SCHOOL-BASED BEHAVIORAL HEALTH CAREGIVERS HAD 245,365 ENCOUNTERS WITH STUDENTS, FAMILIES AND STAFF DURING THE 2021/2022 ACADEMIC YEAR.CHRONIC DISEASEDIABETES EDUCATION CLASSES: CHNW PROVIDES FREE VIRTUAL DIABETES EDUCATION AND SUPPORT COURSES FOR PATIENTS AND COMMUNITY MEMBERS. EACH COURSE CONSISTS OF TWO CLASSES. COURSES ARE HELD AT VARIOUS TIMES THROUGHOUT THE MONTH TO ENSURE ACCESS FOR ALL WHO ARE INTERESTED. IN 2021, 42 COURSES WERE HELD.PRODUCE RX PROGRAM: CHNW COMPLETED 2 ROUNDS IN 2021 OF THE PRODUCE PRESCRIPTION NUTRITION INCENTIVE PROGRAM WHERE HIGH-RISK PARTICIPANTS FROM CHNW'S REACH CLINIC (RESOURCES TO EVALUATE AND ADVANCE COMMUNITY HEALTH LOCATED AT 2920 N. ARLINGTON AVE, SUITE B, INDIANAPOLIS, IN 46218) WERE ENROLLED INTO FREE CHRONIC DISEASE FOCUSED NUTRITION EDUCATION CLASSES PROVIDED BY THE AMBULATORY DIETITIAN TEAM. EACH PARTICIPANT RECEIVED FINANCIAL INCENTIVES PROVIDED BY CHNW COMMUNITY BENEFIT THAT WERE REDEEMABLE FOR FRUITS AND VEGETABLES AT LOCAL RETAIL LOCATIONS FOR ATTENDING.FAITH HEALTH INITIATIVE PROGRAM: TRAINS AND SUPPORTS A NETWORK OF FAITH COMMUNITY NURSES (FCNS) WHO CAN CREATE SUSTAINABLE ENGAGED HEALTH MINISTRIES AND ACTIVITIES IN THEIR RESPECTIVE FAITH COMMUNITIES. THESE FCNS PROVIDE CHRONIC DISEASE MANAGEMENT SUPPORT, MENTAL HEALTH SUPPORT THROUGH HEALTH MINISTRIES WITHIN THEIR CONGREGATIONS.SOCIAL DETERMINANTS OF HEALTH (SDOH)MEDICAL LEGAL PARTNERSHIP (MLP): THE PURPOSE OF A MLP IS TO IMPROVE HEALTH OUTCOMES FOR PATIENTS THROUGH THE PROVISION OF LEGAL SERVICES THAT IMPACT SOCIAL DETERMINANTS OF HEALTH. HOSPITALS OFTEN SEE PATIENTS WHO ARE SUFFERING FROM ACUTE AND CHRONIC MEDICAL CONDITIONS CAUSED OR AGGRAVATED BY CONDITIONS IN PATIENTS' HOMES, ISSUES IN THE PATIENTS' RELATIONSHIPS, OR PATIENTS' LACK OF INCOME AND OTHER RESOURCES. EMBEDDING AN MLP ATTORNEY IN THE HOSPITAL ALLOWS THE HOSPITAL AND THE MLP TO WORK TOGETHER AS A TEAM TO ADDRESS HABITABILITY ISSUES IN A PATIENT'S HOME AND PROVIDE PATIENTS WITH THE MEDICAL CARE AND LEGAL SERVICES THEY NEED TO BECOME HEALTHY AND STAY HEALTHY.WELLFUND: THE WELLFUND EXISTS TO HELP PATIENTS NAVIGATE HEALTHCARE COVERAGE OPTIONS, INCLUDING INITIAL ENROLLMENT AND ONGOING MAINTENANCE OF COVERAGE. PATIENTS HAVE DIRECT ACCESS TO WELLFUND PATIENT ADVOCATES DURING PRE-SERVICE, ADMISSION AND POST-DISCHARGE FOR QUESTIONS AND DETERMINING WHICH PLAN BEST MEETS THEIR NEEDS. IN 2021, WELLFUND PATIENT ADVOCATES ASSISTED OVER 29,000 INDIVIDUALS WITH ENROLLMENT ASSISTANCE. THE ADVOCATES ARE AVAILABLE TO MEET WITH PATIENTS IN PERSON OR OVER THE PHONE TO HELP WITH ENROLLMENT.SDOH SCREENING: A NETWORK-WIDE SDOH SCREENING PROGRAM WAS ROLLED OUT IN Q1 OF 2021. UTILIZING THE EPIC SDOH SCREENING TOOL, PATIENTS ADMITTED TO CHNW HOSPITALS, OB PATIENTS AND PRIMARY CARE PATIENTS ARE PROVIDED A COMPREHENSIVE SDOH SCREENING TO IDENTIFY ANY NEEDS THAT COULD IMPACT THE OVERALL HEALTH AND WELL-BEING OF THE PATIENT. CAREGIVERS ARE TRAINED ON HOW TO PROVIDE REFERRAL RESOURCES TO ASSIST THE PATIENT IN ADDRESSING THEIR IDENTIFIED NEED. PATIENTS NEEDING ADDITIONAL FOLLOW-UP ARE REFERRED FOR ADDITIONAL ASSISTANCE BY A CASE MANAGER OR HEALTH ADVOCATE. IN 2021, 70,939 PATIENTS WERE SCREENED.MATERNAL/INFANT HEALTHNURSE-FAMILY PARTNERSHIP (NFP): GOODWILL OF CENTRAL & SOUTHERN INDIANA IMPLEMENTED THE NFP, A NURSE HOME-VISITING PROGRAM SERVING LOW-INCOME MOTHERS AND BABIES.MILK FOR HEALTHY BABIES - THE MILK BANK: FOUR COMMUNITY HOSPITALS ARE HOME TO AN INDIANA MOTHERS' MILK BANK MILK DEPOT. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. WHEN A MOTHER'S OWN MILK IS NOT AVAILABLE, PASTEURIZED DONOR HUMAN MILK IS DISPERSED BY PRESCRIPTION OR HOSPITAL ORDER PRIMARILY TO PREMATURE INFANTS IN HOSPITAL NEONATAL INTENSIVE CARE UNITS. COMMUNITY HOSPITAL NORTH, COMMUNITY HOSPITAL SOUTH, COMMUNITY HOWARD REGIONAL HEALTH AND COMMUNITY HOSPITAL ANDERSON PARTICIPATE IN THE MILK BANK PROGRAM. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. BABE STORE: AN INCENTIVE PROGRAM TO HELP ENCOURAGE REGULAR PRENATAL CARE AND SUPPORT SERVICES. PARENTS RECEIVE COUPONS FOR ATTENDING SCHEDULED PRENATAL CARE VISITS AND SOCIAL SERVICE APPOINTMENTS. COUPONS CAN BE USED TO PURCHASE NEEDED BABY ITEMS SUCH AS DIAPERS AND BABY CARE ITEMS.FACILITY 1, COMMUNITY HOSPITAL NORTH - PART V, LINE 16AECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 1, COMMUNITY HOSPITAL NORTH - PART V, LINE 16BECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 1, COMMUNITY HOSPITAL NORTH - PART V, LINE 16CECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICY"
      GROUP A-FACILITY 2 -- INDIANA HEART HOSPITAL, LLC PART V, SECTION B, LINE 5:
IN 2021, COMMUNITY HEALTH NETWORK CONDUCTED A CHNA TO UNDERSTAND THE GREATEST HEALTH NEEDS IN THE COMMUNITIES SERVED. THE HOSPITALS TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROADER NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE CHNA ALSO INCLUDED ORGANIZATIONS OTHER THAN HOSPITALS. COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY COLLECTING AND ANALYZING DATA FROM MULTIPLE SOURCES. STATISTICS FOR NUMEROUS COMMUNITY HEALTH STATUS, HEALTH CARE ACCESS, AND RELATED INDICATORS WERE ANALYZED, INCLUDING DATA PROVIDED BY LOCAL, STATE, AND FEDERAL GOVERNMENT AGENCIES, LOCAL COMMUNITY SERVICE ORGANIZATIONS, AND COMMUNITY HEALTH NETWORK. COMPARISONS TO BENCHMARKS WERE MADE WHERE POSSIBLE. FINDINGS FROM RECENT ASSESSMENTS OF THE COMMUNITY'S HEALTH NEEDS CONDUCTED BY OTHER ORGANIZATIONS (E.G., LOCAL HEALTH DEPARTMENTS) WERE REVIEWED AS WELL.INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS CONSIDERED THROUGH KEY INFORMANT INTERVIEWS AND COMMUNITY MEETINGS. STAKEHOLDERS INCLUDED: INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; LOCAL PUBLIC HEALTH DEPARTMENTS; HOSPITAL STAFF AND PROVIDERS; REPRESENTATIVES OF SOCIAL SERVICE ORGANIZATIONS; REPRESENTATIVES OF FAITH-BASED ORGANIZATIONS; REPRESENTATIVES OF LOCAL UNIVERSITIES AND SCHOOLS; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. VIRTUAL COMMUNITY INPUT SESSIONS WERE HELD BETWEEN MAY AND JULY OF 2021. INVITATIONS AND PRESENTATIONS FOR THESE VIRTUAL SESSIONS WERE ORGANIZED BY COUNTY TO ENSURE WE COULD HEAR FROM THOUGHT-LEADERS SERVING IN THE SPECIFIC COMMUNITY. FOR A COMPLETE LIST OF PARTICIPANTS, PLEASE SEE THE ATTACHED COMMUNITY BENEFIT REPORT.
      GROUP A-FACILITY 2 -- INDIANA HEART HOSPITAL, LLC PART V, SECTION B, LINE 6A:
THE CHNA FOR COMMUNITY HEALTH NETWORK WAS A COLLABORATIVE EFFORT WITH ALL FIVE HOSPITALS WITHIN COMMUNITY HEALTH NETWORK. IN ADDITION TO THE NETWORK HOSPITALS, COMMUNITY HEALTH NETWORK ALSO COLLABORATED WITH OTHER INDIANA HEALTH SYSTEMS TO COLLECT PRIMARY DATA THROUGH ONLINE COMMUNITY MEETINGS AND KEY STAKEHOLDER INTERVIEWS. THESE HEALTH SYSTEMS INCLUDE ASCENSION ST. VINCENT'S INDIANA, IU HEALTH, AND RIVERVIEW HEALTH.
      GROUP A-FACILITY 2 -- INDIANA HEART HOSPITAL, LLC PART V, SECTION B, LINE 6B:
COMMUNITY HEALTH NETWORK WORKED WITH VERITE HEALTHCARE CONSULTING, LLC (VERITE) TO COMPLETE THE CHNA.
      GROUP A-FACILITY 2 -- INDIANA HEART HOSPITAL, LLC PART V, SECTION B, LINE 11:
"COMMUNITY HEALTH NEEDS WERE DETERMINED TO BE ""SIGNIFICANT"" IF THEY WERE IDENTIFIED AS PROBLEMATIC IN AT LEAST TWO OF THE FOLLOWING THREE DATA SOURCES: 1) THE MOST RECENTLY AVAILABLE SECONDARY DATA REGARDING THE COMMUNITY'S HEALTH, 2) RECENT ASSESSMENTS DEVELOPED BY THE STATE AND LOCAL ORGANIZATIONS, AND 3) INPUT FROM COMMUNITY STAKEHOLDERS WHO PARTICIPATED IN THE COMMUNITY MEETING, KEY INFORMANT INTERVIEW PROCESS, AND STAFF SURVEYS. THE IMPLEMENTATION STRATEGIES WERE DRAFTED FOR EACH REGION AND DESCRIBE HOW THE HOSPITALS PLAN TO ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED. THE HOSPITALS REVIEWED THE CHNA FINDINGS AND APPLIED THE FOLLOWING CRITERIA TO DETERMINE THE MOST APPROPRIATE NEEDS FOR THE REGIONS TO ADDRESS: 1) THE EXTENT TO WHICH THE HOSPITAL HAS RESOURCES AND COMPETENCIES TO ADDRESS THE NEED 2) THE IMPACT THAT THE HOSPITAL COULD HAVE ON THE NEED (I.E. THE NUMBER OF LIVES THE HOSPITAL CAN IMPACT)3) THE FREQUENCY WITH WHICH STAKEHOLDERS IDENTIFIED THE NEEDS AS A SIGNIFICANT PRIORITY4) THE EXTENT OF COMMUNITY SUPPORT FOR THE HOSPITAL TO ADDRESS THE ISSUE AND POTENTIAL FOR PARTNERSHIPS TO ADDRESS THE ISSUE.COMMUNITY HEALTH NETWORK WILL ADDRESS ALL OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2021 CHNA, THESE INCLUDE: MENTAL HEALTH/SUBSTANCE USE, CHRONIC DISEASE, SOCIAL DETERMINANTS OF HEALTH (SDOH), COVID-19 AND MATERNAL/INFANT HEALTH. COMMUNITY HEALTH NETWORK (""CHNW"") IS ADDRESSING THE NEEDS IDENTIFIED IN THE FOLLOWING WAYS:MENTAL HEALTH/SUBSTANCE USECHNW OPIOID STEWARDSHIP PROGRAM: CHNW HAS DEDICATED RESOURCES TO THE PREVENTION OF OPIOID USE DISORDER AND OVERDOSE DEATHS. THE OPIOID STEWARDSHIP PROGRAM INCLUDES SAFE OPIOID PRESCRIBING TRAINING FOR PRIMARY CARE AND SPECIALTY CARE PRACTITIONERS. BY PARTNERING WITH BOSTON UNIVERSITY SCHOOL OF MEDICINE, A LONGSTANDING LEADER IN EDUCATIONAL EXCELLENCE, WE BROUGHT AWARD WINNING CURRICULUM TO CHNW TO EDUCATE OUR PRACTITIONERS HOW TO SAFELY AND EFFECTIVELY MANAGE PATIENTS ACUTE AND/OR CHRONIC PAIN INCLUDING SAFE OPIOID PRESCRIBING MEASURES WHEN OPIOIDS ARE MEDICALLY NECESSARY. NARCAN PROGRAM: CHNW IS DEDICATED TO THE PREVENTION OF OVERDOSE DEATHS THROUGH OUR NARCAN PROGRAM. NARCAN IS THE DRUG THAT CAN REVERSE THE EFFECTS OF OPIOIDS SUCH AS HEROIN, METHADONE AND OXYCODONE. OUR PROGRAM PROVIDES A NARCAN KIT TO PATIENTS AND THEIR FAMILIES WHO ARE AT RISK FOR AN OPIOID OVERDOSE WHEN THEY HAVE BEEN DISCHARGED FROM AN EMERGENCY DEPARTMENT OR THE BEHAVIORAL HEALTH PAVILION. THROUGH PARTNERSHIPS WITH COMMUNITY NONPROFIT ORGANIZATIONS SUCH AS OVERDOSE LIFELINE AND THE BEECH GROVE COMPREHENSIVE DRUG FREE COALITION WE PROVIDED OPIOID OVERDOSE AWARENESS TRAINING AND FREE NARCAN KITS TO THE COMMUNITIES WE SERVE. IN 2021, 738 NARCAN KITS WERE DISTRIBUTED.SCHOOL-BASED BEHAVIORAL CARE SERVICES: CHNW'S SCHOOL-BASED CARE SERVICES PROVIDES COORDINATED, MULTI-SERVICE 'ON THE SPOT' CARE DIRECTLY IN SCHOOLS TO STUDENTS IN NEED BY WAY OF AN EMBEDDED COORDINATED TEAM OF SCHOOL NURSES, SCHOOL BEHAVIORAL HEALTH PROFESSIONALS, SCHOOL SPORTS MEDICINE & ATHLETIC TRAINING PROFESSIONALS, AND VIRTUAL CARE PROVIDERS. THE PROGRAM ALSO AIMS TO HELP KEEP SCHOOL TEACHERS, STAFF, EMPLOYEES, AND ADMINISTRATORS HEALTHY AND AVAILABLE TO SUPPORT KIDS IN SCHOOLS BY WAY OF ONSITE HEALTH & WELLNESS CLINICS AND EAP SERVICES FOR SCHOOL EMPLOYEES AND THEIR DEPENDENTS. CHNW PROVIDES OVER 170 BEHAVIORAL STAFF EMPLOYEES TO 143 SCHOOLS THROUGHOUT CENTRAL INDIANA. THESE ON-SITE BEHAVIORAL HEALTH SPECIALISTS PROVIDE SERVICES SUCH AS, COUNSELING, LIFE-SKILLS TRAINING, CRISIS RESPONSE, TRAUMA AND DEPRESSION SCREENINGS, STAFF EDUCATION AND TRAINING, TESTING, FAMILY SERVICES AND MORE. CHNW SCHOOL-BASED BEHAVIORAL HEALTH CAREGIVERS HAD 245,365 ENCOUNTERS WITH STUDENTS, FAMILIES AND STAFF DURING THE 2021/2022 ACADEMIC YEAR.CHRONIC DISEASEDIABETES EDUCATION CLASSES: CHNW PROVIDES FREE VIRTUAL DIABETES EDUCATION AND SUPPORT COURSES FOR PATIENTS AND COMMUNITY MEMBERS. EACH COURSE CONSISTS OF TWO CLASSES. COURSES ARE HELD AT VARIOUS TIMES THROUGHOUT THE MONTH TO ENSURE ACCESS FOR ALL WHO ARE INTERESTED. IN 2021, 42 COURSES WERE HELD.PRODUCE RX PROGRAM: CHNW COMPLETED 2 ROUNDS IN 2021 OF THE PRODUCE PRESCRIPTION NUTRITION INCENTIVE PROGRAM WHERE HIGH-RISK PARTICIPANTS FROM CHNW'S REACH CLINIC (RESOURCES TO EVALUATE AND ADVANCE COMMUNITY HEALTH LOCATED AT 2920 N. ARLINGTON AVE, SUITE B, INDIANAPOLIS, IN 46218) WERE ENROLLED INTO FREE CHRONIC DISEASE FOCUSED NUTRITION EDUCATION CLASSES PROVIDED BY THE AMBULATORY DIETITIAN TEAM. EACH PARTICIPANT RECEIVED FINANCIAL INCENTIVES PROVIDED BY CHNW COMMUNITY BENEFIT THAT WERE REDEEMABLE FOR FRUITS AND VEGETABLES AT LOCAL RETAIL LOCATIONS FOR ATTENDING.FAITH HEALTH INITIATIVE PROGRAM: TRAINS AND SUPPORTS A NETWORK OF FAITH COMMUNITY NURSES (FCNS) WHO CAN CREATE SUSTAINABLE ENGAGED HEALTH MINISTRIES AND ACTIVITIES IN THEIR RESPECTIVE FAITH COMMUNITIES. THESE FCNS PROVIDE CHRONIC DISEASE MANAGEMENT SUPPORT, MENTAL HEALTH SUPPORT THROUGH HEALTH MINISTRIES WITHIN THEIR CONGREGATIONS.SOCIAL DETERMINANTS OF HEALTH (SDOH)MEDICAL LEGAL PARTNERSHIP (MLP): THE PURPOSE OF A MLP IS TO IMPROVE HEALTH OUTCOMES FOR PATIENTS THROUGH THE PROVISION OF LEGAL SERVICES THAT IMPACT SOCIAL DETERMINANTS OF HEALTH. HOSPITALS OFTEN SEE PATIENTS WHO ARE SUFFERING FROM ACUTE AND CHRONIC MEDICAL CONDITIONS CAUSED OR AGGRAVATED BY CONDITIONS IN PATIENTS' HOMES, ISSUES IN THE PATIENTS' RELATIONSHIPS, OR PATIENTS' LACK OF INCOME AND OTHER RESOURCES. EMBEDDING AN MLP ATTORNEY IN THE HOSPITAL ALLOWS THE HOSPITAL AND THE MLP TO WORK TOGETHER AS A TEAM TO ADDRESS HABITABILITY ISSUES IN A PATIENT'S HOME AND PROVIDE PATIENTS WITH THE MEDICAL CARE AND LEGAL SERVICES THEY NEED TO BECOME HEALTHY AND STAY HEALTHY.WELLFUND: THE WELLFUND EXISTS TO HELP PATIENTS NAVIGATE HEALTHCARE COVERAGE OPTIONS, INCLUDING INITIAL ENROLLMENT AND ONGOING MAINTENANCE OF COVERAGE. PATIENTS HAVE DIRECT ACCESS TO WELLFUND PATIENT ADVOCATES DURING PRE-SERVICE, ADMISSION AND POST-DISCHARGE FOR QUESTIONS AND DETERMINING WHICH PLAN BEST MEETS THEIR NEEDS. IN 2021, WELLFUND PATIENT ADVOCATES ASSISTED OVER 29,000 INDIVIDUALS WITH ENROLLMENT ASSISTANCE. THE ADVOCATES ARE AVAILABLE TO MEET WITH PATIENTS IN PERSON OR OVER THE PHONE TO HELP WITH ENROLLMENT.SDOH SCREENING: A NETWORK-WIDE SDOH SCREENING PROGRAM WAS ROLLED OUT IN Q1 OF 2021. UTILIZING THE EPIC SDOH SCREENING TOOL, PATIENTS ADMITTED TO CHNW HOSPITALS, OB PATIENTS AND PRIMARY CARE PATIENTS ARE PROVIDED A COMPREHENSIVE SDOH SCREENING TO IDENTIFY ANY NEEDS THAT COULD IMPACT THE OVERALL HEALTH AND WELL-BEING OF THE PATIENT. CAREGIVERS ARE TRAINED ON HOW TO PROVIDE REFERRAL RESOURCES TO ASSIST THE PATIENT IN ADDRESSING THEIR IDENTIFIED NEED. PATIENTS NEEDING ADDITIONAL FOLLOW-UP ARE REFERRED FOR ADDITIONAL ASSISTANCE BY A CASE MANAGER OR HEALTH ADVOCATE. IN 2021, 70,939 PATIENTS WERE SCREENED.MATERNAL/INFANT HEALTHNURSE-FAMILY PARTNERSHIP (NFP): GOODWILL OF CENTRAL & SOUTHERN INDIANA IMPLEMENTED THE NFP, A NURSE HOME-VISITING PROGRAM SERVING LOW-INCOME MOTHERS AND BABIES.MILK FOR HEALTHY BABIES - THE MILK BANK: FOUR COMMUNITY HOSPITALS ARE HOME TO AN INDIANA MOTHERS' MILK BANK MILK DEPOT. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. WHEN A MOTHER'S OWN MILK IS NOT AVAILABLE, PASTEURIZED DONOR HUMAN MILK IS DISPERSED BY PRESCRIPTION OR HOSPITAL ORDER PRIMARILY TO PREMATURE INFANTS IN HOSPITAL NEONATAL INTENSIVE CARE UNITS. COMMUNITY HOSPITAL NORTH, COMMUNITY HOSPITAL SOUTH, COMMUNITY HOWARD REGIONAL HEALTH AND COMMUNITY HOSPITAL ANDERSON PARTICIPATE IN THE MILK BANK PROGRAM. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. BABE STORE: AN INCENTIVE PROGRAM TO HELP ENCOURAGE REGULAR PRENATAL CARE AND SUPPORT SERVICES. PARENTS RECEIVE COUPONS FOR ATTENDING SCHEDULED PRENATAL CARE VISITS AND SOCIAL SERVICE APPOINTMENTS. COUPONS CAN BE USED TO PURCHASE NEEDED BABY ITEMS SUCH AS DIAPERS AND BABY CARE ITEMS.FACILITY 2, INDIANA HEART HOSPITAL LLC - PART V, LINE 16AECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 2, INDIANA HEART HOSPITAL, LLC - PART V, LINE 16BECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 2, INDIANA HEART HOSPITAL, LLC - PART V, LINE 16CECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICY"
      GROUP A-FACILITY 3 -- COMMUNITY HOSPITAL EAST PART V, SECTION B, LINE 5:
IN 2021, COMMUNITY HEALTH NETWORK CONDUCTED A CHNA TO UNDERSTAND THE GREATEST HEALTH NEEDS IN THE COMMUNITIES SERVED. THE HOSPITALS TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROADER NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THE CHNA ALSO INCLUDED ORGANIZATIONS OTHER THAN HOSPITALS. COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY COLLECTING AND ANALYZING DATA FROM MULTIPLE SOURCES. STATISTICS FOR NUMEROUS COMMUNITY HEALTH STATUS, HEALTH CARE ACCESS, AND RELATED INDICATORS WERE ANALYZED, INCLUDING DATA PROVIDED BY LOCAL, STATE, AND FEDERAL GOVERNMENT AGENCIES, LOCAL COMMUNITY SERVICE ORGANIZATIONS, AND COMMUNITY HEALTH NETWORK. COMPARISONS TO BENCHMARKS WERE MADE WHERE POSSIBLE. FINDINGS FROM RECENT ASSESSMENTS OF THE COMMUNITY'S HEALTH NEEDS CONDUCTED BY OTHER ORGANIZATIONS (E.G., LOCAL HEALTH DEPARTMENTS) WERE REVIEWED AS WELL.INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS CONSIDERED THROUGH KEY INFORMANT INTERVIEWS AND COMMUNITY MEETINGS. STAKEHOLDERS INCLUDED: INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; LOCAL PUBLIC HEALTH DEPARTMENTS; HOSPITAL STAFF AND PROVIDERS; REPRESENTATIVES OF SOCIAL SERVICE ORGANIZATIONS; REPRESENTATIVES OF FAITH-BASED ORGANIZATIONS; REPRESENTATIVES OF LOCAL UNIVERSITIES AND SCHOOLS; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. VIRTUAL COMMUNITY INPUT SESSIONS WERE HELD BETWEEN MAY AND JULY OF 2021. INVITATIONS AND PRESENTATIONS FOR THESE VIRTUAL SESSIONS WERE ORGANIZED BY COUNTY TO ENSURE WE COULD HEAR FROM THOUGHT-LEADERS SERVING IN THE SPECIFIC COMMUNITY. FOR A COMPLETE LIST OF PARTICIPANTS, PLEASE SEE THE ATTACHED COMMUNITY BENEFIT REPORT.
      GROUP A-FACILITY 3 -- COMMUNITY HOSPITAL EAST PART V, SECTION B, LINE 6A:
THE CHNA FOR COMMUNITY HEALTH NETWORK WAS A COLLABORATIVE EFFORT WITH ALL FIVE HOSPITALS WITHIN COMMUNITY HEALTH NETWORK. IN ADDITION TO THE NETWORK HOSPITALS, COMMUNITY HEALTH NETWORK ALSO COLLABORATED WITH OTHER INDIANA HEALTH SYSTEMS TO COLLECT PRIMARY DATA THROUGH ONLINE COMMUNITY MEETINGS AND KEY STAKEHOLDER INTERVIEWS. THESE HEALTH SYSTEMS INCLUDE ASCENSION ST. VINCENT'S INDIANA, IU HEALTH, AND RIVERVIEW HEALTH.
      GROUP A-FACILITY 3 -- COMMUNITY HOSPITAL EAST PART V, SECTION B, LINE 6B:
COMMUNITY HEALTH NETWORK WORKED WITH VERITE HEALTHCARE CONSULTING, LLC (VERITE) TO COMPLETE THE CHNA.
      GROUP A-FACILITY 3 -- COMMUNITY HOSPITAL EAST PART V, SECTION B, LINE 11:
"COMMUNITY HEALTH NEEDS WERE DETERMINED TO BE ""SIGNIFICANT"" IF THEY WERE IDENTIFIED AS PROBLEMATIC IN AT LEAST TWO OF THE FOLLOWING THREE DATA SOURCES: 1) THE MOST RECENTLY AVAILABLE SECONDARY DATA REGARDING THE COMMUNITY'S HEALTH, 2) RECENT ASSESSMENTS DEVELOPED BY THE STATE AND LOCAL ORGANIZATIONS, AND 3) INPUT FROM COMMUNITY STAKEHOLDERS WHO PARTICIPATED IN THE COMMUNITY MEETING, KEY INFORMANT INTERVIEW PROCESS, AND STAFF SURVEYS. THE IMPLEMENTATION STRATEGIES WERE DRAFTED FOR EACH REGION AND DESCRIBE HOW THE HOSPITALS PLAN TO ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED. THE HOSPITALS REVIEWED THE CHNA FINDINGS AND APPLIED THE FOLLOWING CRITERIA TO DETERMINE THE MOST APPROPRIATE NEEDS FOR THE REGIONS TO ADDRESS: 1) THE EXTENT TO WHICH THE HOSPITAL HAS RESOURCES AND COMPETENCIES TO ADDRESS THE NEED 2) THE IMPACT THAT THE HOSPITAL COULD HAVE ON THE NEED (I.E. THE NUMBER OF LIVES THE HOSPITAL CAN IMPACT)3) THE FREQUENCY WITH WHICH STAKEHOLDERS IDENTIFIED THE NEEDS AS A SIGNIFICANT PRIORITY4) THE EXTENT OF COMMUNITY SUPPORT FOR THE HOSPITAL TO ADDRESS THE ISSUE AND POTENTIAL FOR PARTNERSHIPS TO ADDRESS THE ISSUE.COMMUNITY HEALTH NETWORK WILL ADDRESS ALL OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2021 CHNA, THESE INCLUDE: MENTAL HEALTH/SUBSTANCE USE, CHRONIC DISEASE, SOCIAL DETERMINANTS OF HEALTH (SDOH), COVID-19 AND MATERNAL/INFANT HEALTH. COMMUNITY HEALTH NETWORK (""CHNW"") IS ADDRESSING THE NEEDS IDENTIFIED IN THE FOLLOWING WAYS:MENTAL HEALTH/SUBSTANCE USECHNW OPIOID STEWARDSHIP PROGRAM: CHNW HAS DEDICATED RESOURCES TO THE PREVENTION OF OPIOID USE DISORDER AND OVERDOSE DEATHS. THE OPIOID STEWARDSHIP PROGRAM INCLUDES SAFE OPIOID PRESCRIBING TRAINING FOR PRIMARY CARE AND SPECIALTY CARE PRACTITIONERS. BY PARTNERING WITH BOSTON UNIVERSITY SCHOOL OF MEDICINE, A LONGSTANDING LEADER IN EDUCATIONAL EXCELLENCE, WE BROUGHT AWARD WINNING CURRICULUM TO CHNW TO EDUCATE OUR PRACTITIONERS HOW TO SAFELY AND EFFECTIVELY MANAGE PATIENTS ACUTE AND/OR CHRONIC PAIN INCLUDING SAFE OPIOID PRESCRIBING MEASURES WHEN OPIOIDS ARE MEDICALLY NECESSARY. NARCAN PROGRAM: CHNW IS DEDICATED TO THE PREVENTION OF OVERDOSE DEATHS THROUGH OUR NARCAN PROGRAM. NARCAN IS THE DRUG THAT CAN REVERSE THE EFFECTS OF OPIOIDS SUCH AS HEROIN, METHADONE AND OXYCODONE. OUR PROGRAM PROVIDES A NARCAN KIT TO PATIENTS AND THEIR FAMILIES WHO ARE AT RISK FOR AN OPIOID OVERDOSE WHEN THEY HAVE BEEN DISCHARGED FROM AN EMERGENCY DEPARTMENT OR THE BEHAVIORAL HEALTH PAVILION. THROUGH PARTNERSHIPS WITH COMMUNITY NONPROFIT ORGANIZATIONS SUCH AS OVERDOSE LIFELINE AND THE BEECH GROVE COMPREHENSIVE DRUG FREE COALITION WE PROVIDED OPIOID OVERDOSE AWARENESS TRAINING AND FREE NARCAN KITS TO THE COMMUNITIES WE SERVE. IN 2021, 738 NARCAN KITS WERE DISTRIBUTED.SCHOOL-BASED BEHAVIORAL CARE SERVICES: CHNW'S SCHOOL-BASED CARE SERVICES PROVIDES COORDINATED, MULTI-SERVICE 'ON THE SPOT' CARE DIRECTLY IN SCHOOLS TO STUDENTS IN NEED BY WAY OF AN EMBEDDED COORDINATED TEAM OF SCHOOL NURSES, SCHOOL BEHAVIORAL HEALTH PROFESSIONALS, SCHOOL SPORTS MEDICINE & ATHLETIC TRAINING PROFESSIONALS, AND VIRTUAL CARE PROVIDERS. THE PROGRAM ALSO AIMS TO HELP KEEP SCHOOL TEACHERS, STAFF, EMPLOYEES, AND ADMINISTRATORS HEALTHY AND AVAILABLE TO SUPPORT KIDS IN SCHOOLS BY WAY OF ONSITE HEALTH & WELLNESS CLINICS AND EAP SERVICES FOR SCHOOL EMPLOYEES AND THEIR DEPENDENTS. CHNW PROVIDES OVER 170 BEHAVIORAL STAFF EMPLOYEES TO 143 SCHOOLS THROUGHOUT CENTRAL INDIANA. THESE ON-SITE BEHAVIORAL HEALTH SPECIALISTS PROVIDE SERVICES SUCH AS, COUNSELING, LIFE-SKILLS TRAINING, CRISIS RESPONSE, TRAUMA AND DEPRESSION SCREENINGS, STAFF EDUCATION AND TRAINING, TESTING, FAMILY SERVICES AND MORE. CHNW SCHOOL-BASED BEHAVIORAL HEALTH CAREGIVERS HAD 245,365 ENCOUNTERS WITH STUDENTS, FAMILIES AND STAFF DURING THE 2021/2022 ACADEMIC YEAR.CHRONIC DISEASEDIABETES EDUCATION CLASSES: CHNW PROVIDES FREE VIRTUAL DIABETES EDUCATION AND SUPPORT COURSES FOR PATIENTS AND COMMUNITY MEMBERS. EACH COURSE CONSISTS OF TWO CLASSES. COURSES ARE HELD AT VARIOUS TIMES THROUGHOUT THE MONTH TO ENSURE ACCESS FOR ALL WHO ARE INTERESTED. IN 2021, 42 COURSES WERE HELD.PRODUCE RX PROGRAM: CHNW COMPLETED 2 ROUNDS IN 2021 OF THE PRODUCE PRESCRIPTION NUTRITION INCENTIVE PROGRAM WHERE HIGH-RISK PARTICIPANTS FROM CHNW'S REACH CLINIC (RESOURCES TO EVALUATE AND ADVANCE COMMUNITY HEALTH LOCATED AT 2920 N. ARLINGTON AVE, SUITE B, INDIANAPOLIS, IN 46218) WERE ENROLLED INTO FREE CHRONIC DISEASE FOCUSED NUTRITION EDUCATION CLASSES PROVIDED BY THE AMBULATORY DIETITIAN TEAM. EACH PARTICIPANT RECEIVED FINANCIAL INCENTIVES PROVIDED BY CHNW COMMUNITY BENEFIT THAT WERE REDEEMABLE FOR FRUITS AND VEGETABLES AT LOCAL RETAIL LOCATIONS FOR ATTENDING.FAITH HEALTH INITIATIVE PROGRAM: TRAINS AND SUPPORTS A NETWORK OF FAITH COMMUNITY NURSES (FCNS) WHO CAN CREATE SUSTAINABLE ENGAGED HEALTH MINISTRIES AND ACTIVITIES IN THEIR RESPECTIVE FAITH COMMUNITIES. THESE FCNS PROVIDE CHRONIC DISEASE MANAGEMENT SUPPORT, MENTAL HEALTH SUPPORT THROUGH HEALTH MINISTRIES WITHIN THEIR CONGREGATIONS.SOCIAL DETERMINANTS OF HEALTH (SDOH)MEDICAL LEGAL PARTNERSHIP (MLP): THE PURPOSE OF A MLP IS TO IMPROVE HEALTH OUTCOMES FOR PATIENTS THROUGH THE PROVISION OF LEGAL SERVICES THAT IMPACT SOCIAL DETERMINANTS OF HEALTH. HOSPITALS OFTEN SEE PATIENTS WHO ARE SUFFERING FROM ACUTE AND CHRONIC MEDICAL CONDITIONS CAUSED OR AGGRAVATED BY CONDITIONS IN PATIENTS' HOMES, ISSUES IN THE PATIENTS' RELATIONSHIPS, OR PATIENTS' LACK OF INCOME AND OTHER RESOURCES. EMBEDDING AN MLP ATTORNEY IN THE HOSPITAL ALLOWS THE HOSPITAL AND THE MLP TO WORK TOGETHER AS A TEAM TO ADDRESS HABITABILITY ISSUES IN A PATIENT'S HOME AND PROVIDE PATIENTS WITH THE MEDICAL CARE AND LEGAL SERVICES THEY NEED TO BECOME HEALTHY AND STAY HEALTHY.WELLFUND: THE WELLFUND EXISTS TO HELP PATIENTS NAVIGATE HEALTHCARE COVERAGE OPTIONS, INCLUDING INITIAL ENROLLMENT AND ONGOING MAINTENANCE OF COVERAGE. PATIENTS HAVE DIRECT ACCESS TO WELLFUND PATIENT ADVOCATES DURING PRE-SERVICE, ADMISSION AND POST-DISCHARGE FOR QUESTIONS AND DETERMINING WHICH PLAN BEST MEETS THEIR NEEDS. IN 2021, WELLFUND PATIENT ADVOCATES ASSISTED OVER 29,000 INDIVIDUALS WITH ENROLLMENT ASSISTANCE. THE ADVOCATES ARE AVAILABLE TO MEET WITH PATIENTS IN PERSON OR OVER THE PHONE TO HELP WITH ENROLLMENT.SDOH SCREENING: A NETWORK-WIDE SDOH SCREENING PROGRAM WAS ROLLED OUT IN Q1 OF 2021. UTILIZING THE EPIC SDOH SCREENING TOOL, PATIENTS ADMITTED TO CHNW HOSPITALS, OB PATIENTS AND PRIMARY CARE PATIENTS ARE PROVIDED A COMPREHENSIVE SDOH SCREENING TO IDENTIFY ANY NEEDS THAT COULD IMPACT THE OVERALL HEALTH AND WELL-BEING OF THE PATIENT. CAREGIVERS ARE TRAINED ON HOW TO PROVIDE REFERRAL RESOURCES TO ASSIST THE PATIENT IN ADDRESSING THEIR IDENTIFIED NEED. PATIENTS NEEDING ADDITIONAL FOLLOW-UP ARE REFERRED FOR ADDITIONAL ASSISTANCE BY A CASE MANAGER OR HEALTH ADVOCATE. IN 2021, 70,939 PATIENTS WERE SCREENED.MATERNAL/INFANT HEALTHNURSE-FAMILY PARTNERSHIP (NFP): GOODWILL OF CENTRAL & SOUTHERN INDIANA IMPLEMENTED THE NFP, A NURSE HOME-VISITING PROGRAM SERVING LOW-INCOME MOTHERS AND BABIES.MILK FOR HEALTHY BABIES - THE MILK BANK: FOUR COMMUNITY HOSPITALS ARE HOME TO AN INDIANA MOTHERS' MILK BANK MILK DEPOT. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. WHEN A MOTHER'S OWN MILK IS NOT AVAILABLE, PASTEURIZED DONOR HUMAN MILK IS DISPERSED BY PRESCRIPTION OR HOSPITAL ORDER PRIMARILY TO PREMATURE INFANTS IN HOSPITAL NEONATAL INTENSIVE CARE UNITS. COMMUNITY HOSPITAL NORTH, COMMUNITY HOSPITAL SOUTH, COMMUNITY HOWARD REGIONAL HEALTH AND COMMUNITY HOSPITAL ANDERSON PARTICIPATE IN THE MILK BANK PROGRAM. BREAST MILK DONORS CAN DROP OFF THEIR MILK AT THESE LOCATIONS. BABE STORE: AN INCENTIVE PROGRAM TO HELP ENCOURAGE REGULAR PRENATAL CARE AND SUPPORT SERVICES. PARENTS RECEIVE COUPONS FOR ATTENDING SCHEDULED PRENATAL CARE VISITS AND SOCIAL SERVICE APPOINTMENTS. COUPONS CAN BE USED TO PURCHASE NEEDED BABY ITEMS SUCH AS DIAPERS AND BABY CARE ITEMS.FACILITY 3, COMMUNITY HOSPITAL EAST - PART V, LINE 16AECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 3, COMMUNITY HOSPITAL EAST - PART V, LINE 16BECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICYFACILITY 3, COMMUNITY HOSPITAL EAST - PART V, LINE 16CECOMMUNITY.COM/FINANCIAL-ASSISTANCE-POLICY"
      Supplemental Information
      Schedule H (Form 990) Part VI
      PART I, LINE 3C:
OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARECHNW ALSO CONSIDERS THE PATIENT'S MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY WHEN CONSIDERING THE PATIENT FOR FINANCIAL ASSISTANCE.
      PART I, LINE 6A:
RELATED ORGANIZATION INFORMATIONA COMMUNITY BENEFIT REPORT IS COMPLETED FOR THE COMMUNITY HEALTH NETWORK INCLUDING COMMUNITY HEALTH NETWORK, INC. AND OTHER TAX-EXEMPT AFFILIATES OF THE NETWORK.
      PART I, LINE 7:
COSTING METHODOLOGY EXPLANATIONA COST TO CHARGE RATIO WAS UTILIZED TO DETERMINE COSTS FOR LINES A THROUGH C IN THE TABLE. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. LINES E THROUGH I OF THE TABLE ARE BASED ON ACTUAL INCURRED EXPENSES.PART II - COMMUNITY BUILDING ACTIVITIESSEE THE ATTACHED IRS SCHEDULE H SUPPLEMENTAL INFORMATION REPORT
      PART III, LINE 2:
"BAD DEBT EXPENSE METHODOLOGYTHE COST TO CHARGE RATIO UTILIZED FOR PURPOSES OF REPORTING BAD DEBT COSTS WAS DERIVED FROM WORKSHEET 2 AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS.ADDITIONALLY, COMMUNITY HEALTH NETWORK ADOPTED A NEW STANDARD RELATED TO REVENUE RECOGNITION AND CODIFIED IN THE FASB ACCOUNTING STANDARDS CODIFICATION (""ASC"") AS TOPIC 606 (""ASC 606"") IN FISCAL YEAR 2018. BECAUSE OF THE ADOPTION OF THIS STANDARD FROM AN ACCOUNTING PRESENTATION STANDPOINT, THE NETWORK NO LONGER EXPLICITLY REPORTS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. HOWEVER, THE NETWORK STILL DOES INCUR A SIGNIFICANT AMOUNT OF ADJUSTMENTS TO PATIENT'S ACCOUNTS FOR THOSE WHO DO NOT PAY THEIR PATIENT BALANCE WHICH RESULTS IN A SIGNIFICANT AND MATERIAL COST TO THE NETWORK. AS SUCH THE NETWORK WILL CONTINUE TO REPORT IN LINE 2 THE AMOUNT OF ADJUSTMENTS RELATED TO ADJUSTMENTS PREVIOUSLY IDENTIFIED AS BAD DEBT."
      PART III, LINE 3:
BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE:THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED UTILIZING THE HISTORICAL LEVEL OF PATIENTS THAT WERE DETERMINED AS ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON A PRESUMPTIVE ELIGIBILITY PROCESS AND APPLYING THIS RATIO TO THE REPORTED BAD DEBT EXPENSE ON THE FINANCIAL STATEMENTS. THE PORTION OF THE BAD DEBT THAT IS ASSOCIATED WITH PATIENTS WHO MEET THE CHARITY CARE GUIDELINES, BUT WHO DID NOT APPLY FOR FINANCIAL ASSISTANCE IS CONSIDERED COMMUNITY BENEFIT SERVICES.
      PART III, LINE 4:
THE AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING WITHIN THE FOOTNOTES: PATIENT ACCOUNTS RECEIVABLE AT DECEMBER 31, 2021 AND 2020, ARE REPORTED AT THE AMOUNTS THAT REFLECTS THE CONSIDERATION WHICH THE NETWORK EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDIDNG PATIENT CARE, AS FURTHER DESCRIBED IN NOTE 2. THE COLLECTION OF OUTSTANDING RECEIVABLES FOR MEDICARE, MEDICAID, MANAGED CARE AND COMMERCIAL INSURANCE PAYERS, AND PATIENTS IS THE NETWORK'S PRIMARY SOURCE OF CASH AND IS CRITICAL TO THE NETWORK'S OPERATING PERFORMANCE. THE PRIMARY COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE CARRIER HAS PAID THE AMOUNTS COVERED BY THE APPLICABLE AGREEMENT, BUT PATIENT RESPONSIBILITY AMOUNTS (DEDUCTIBLES AND COINSURANCE) REMAIN OUTSTANDING. THE NETWORK GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYER AGREEMENTS. THE CONCENTRATION OF NET RECEIVABLES BY PAYER CLASS FOR BOTH PATIENTS AND THIRD-PARTY PAYERS AT DECEMBER 31, 2021 AND 2020 IS AS FOLLOWS. NET RECEIVABLE FOR PATIENTS INCLUDES UNINSURED BALANCES WHICH ARE THE RESPONSIBILITY OF THE PATIENT ASSOCIATED WITH THIRD-PARTY PAYERS LISTED BELOW: 2021 2020MEDICARE 23% 22%MEDICAID 10% 11%MANAGED CARE AND COMMERCIAL INSURANCE 59% 58%PATIENTS 8% 9% 100% 100%CHARITY CARETHE NETWORK MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE NETWORK PROVIDES 100% CHARITY CARE TO PATIENTS WHOSE INCOME LEVEL IS EQUAL TO OR BELOW 200% OF THE FEDERAL POVERTY LINE. PATIENTS WITH INCOME LEVELS RANGING FROM 200%-300% OF THE CURRENT YEAR'S FEDERAL POVERTY LEVEL WILL QUALIFY FOR PARTIAL ASSISTANCE DETERMINED BY A SLIDING SCALE. THE NETWORK USES COST AS THE MEASUREMENT BASIS FOR CHARITY CARE DISCLOSURE PURPOSES WITH THE COST BEING IDENTIFIED AS THE DIRECT AND INDIRECT COSTS OF PROVIDING THE CHARITY CARE. CHARITY CARE AT COST WAS $7,029(000) AND $9,005(000) FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, RESPECTIVELY. CHARITY CARE COST WAS ESTIMATED ON THE APPLICATION OF THE ASSOCIATED COST-TO-CHARGE RATIOS.PATIENT SERVICE REVENUETHE NETWORK'S REVENUES GENERALLY RELATE TO CONTRACTS WITH PATIENTS IN WHICH THE NETWORK'S PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO THE PATIENTS. PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE NETWORK EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYERS (INCLUDING GOVERNMENT PROGRAMS AND MANAGED CARE AND COMMERCIAL INSURANCE COMPANIES) AND INCLUDE VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE NETWORK BILLS THE PATIENTS AND THIRD-PARTY PAYERS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED OR THE PATIENT IS DISCHARGED FROM THE FACILITY. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. THE NETWORK DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYERS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE NETWORK'S POLICY, AND IMPLICIT PRICE CONCESSIONS.PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE NETWORK. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED OR ACTUAL CHARGES. THE NETWORK BELIEVES THAT THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS IN OUR HOSPITALS RECEIVING INPATIENT ACUTE CARE SERVICES. THE NETWORK MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED AT A POINT IN TIME, WHICH INCLUDES OUTPATIENT SERVICES, IS GENERALLY RECOGNIZED WHEN SERVICES ARE PROVIDED TO OUR PATIENTS AND THE NETWORK DOES NOT BELIEVE IT IS REQUIRED TO PROVIDE ADDITIONAL SERVICES TO THE PATIENT.BECAUSE ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, THE NETWORK HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION PROVIDED IN FASB ASC 606-10-50-14A AND, THEREFORE, IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OBLIGATIONS REFERRED TO PREVIOUSLY ARE PRIMARILY RELATED TO INPATIENT ACUTE CARE SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN THE PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD.THE NETWORK DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. MANAGEMENT CONTINUALLY REVIEWS THE CONTRACTUAL ESTIMATION PROCESS TO CONSIDER AND INCORPORATE UPDATES TO LAWS AND REGULATIONS AND THE FREQUENT CHANGES IN MANAGED CARE CONTRACTUAL TERMS RESULTING FROM CONTRACT RENEGOTIATIONS AND RENEWALS. ESTIMATES OF CONTRACTUAL ADJUSTMENTS UNDER MANAGED CARE AND COMMERCIAL INSURANCE PLANS ARE BASED UPON THE PAYMENT TERMS SPECIFIED IN THE RELATED CONTRACTUAL AGREEMENTS. THE PAYMENT ARRANGEMENTS WITH THIRD-PARTY PAYERS PROVIDE FOR PAYMENTS TO THE NETWORK AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYERS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE NETWORK ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. AT DECEMBER 31, 2021 AND 2020, ESTIMATED IMPLICIT PRICE CONCESSIONS OF $710,244(000) AND $633,819(000), RESPECTIVELY, WERE RECORDED TO ADJUST REVENUES TO THE ESTIMATED AMOUNTS COLLECTIBLE.ESTIMATED IMPLICIT PRICE CONCESSIONS ARE RECORDED FOR ALL UNINSURED ACCOUNTS, WHICH INCLUDES UNINSURED PATIENTS AND UNINSURED COPAYMENT AND DEDUCTIBLE AMOUNTS FOR PATIENTS WHO HAVE HEALTH CARE COVERAGE, REGARDLESS OF THE AGING OF THOSE ACCOUNTS. THE ESTIMATES FOR IMPLICIT PRICE CONCESSIONS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL WRITE-OFFS AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL, STATE AND PRIVATE EMPLOYER HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS AS A PRIMARY SOURCE OF INFORMATION IN ESTIMATING THE COLLECTABILITY OF OUR ACCOUNTS RECEIVABLE. THE NETWORK PERFORMS A HINDSIGHT ANALYSIS QUARTERLY, UTILIZING HISTORICAL ACCOUNTS RECEIVABLE COLLECTION AND WRITE-OFF DATA. THE NETWORK BELIEVES ITS QUARTERLY UPDATES TO THE ESTIMATED IMPLICIT PRICE CONCESSION AMOUNTS AT EACH OF ITS HOSPITAL FACILITIES PROVIDE REASONABLE VALUATION ESTIMATES OF THE NETWORK'S REVENUES AND ACCOUNTS RECEIVABLE.BEGINNING JUNE 2012, THE STATE OF INDIANA OFFERED VOLUNTARY PARTICIPATION IN THE STATE OF INDIANA'S HAF PROGRAM. THE STATE OF INDIANA IMPLEMENTED THIS PROGRAM TO UTILIZE SUPPLEMENTAL REIMBURSEMENT PROGRAMS FOR THE PURPOSE OF PROVIDING REIMBURSEMENT TO PROVIDERS TO OFFSET A PORTION OF THE COST OF PROVIDING CARE TO MEDICAID AND INDIGENT PATIENTS. THIS PROGRAM IS DESIGNED WITH INPUT FROM CMS AND IS FUNDED WITH A COMBINATION OF STATE AND FEDERAL RESOURCES, INCLUDING FEES OR TAXES LEVIED ON THE PROVIDERS.REIMBURSEMENT UNDER THE PROGRAM IS REFLECTED WITHIN PATIENT SERVICE REVENUE AND THE FEES PAID FOR PARTICIPATION IN THE HAF PROGRAM ARE RECORDED IN SUPPLIES AND OTHER EXPENSES WITHIN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. THE FEES AND REIMBURSEMENTS ARE SETTLED MONTHLY. REVENUE RECOGNIZED RELATED TO THE HAF PROGRAM WAS $289,191(000) AND $261,379(000) FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, RESPECTIVELY. EXPENSE FOR FEES RELATED TO THE HAF PROGRAM WAS $92,317(000) AND $85,504(000) FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, RESPECTIVELY.
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MEDICARE EXPLANATIONPER THE 990 INSTRUCTIONS THE MEDICARE COST REPORT WAS UTILIZED TO DETERMINE THE MEDICARE SHORTFALL. HOWEVER, THE MEDICARE COST REPORT IS NOT REFLECTIVE OF ALL COSTS ASSOCIATED WITH MEDICARE PROGRAMS SUCH AS PHYSICIAN SERVICES AND SERVICES BILLED VIA FREE STANDING CLINICS. FURTHER THE MEDICARE COST REPORT EXCLUDES REVENUES AND COSTS OF MEDICARE PARTS C AND D. THE MEDICARE SHORTFALL ATTRIBUTED TO THOSE AREAS NOT INCLUDED ON THE MEDICARE COST REPORT IS $56,142,790. AS SUCH, THE TOTAL MEDICARE SHORTFALL FOR ALL MEDICARE PROGRAMS IS $81,532,654. MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS COMMUNITY BENEFIT BECAUSE MEDICARE REPRESENTS 48.62% OF THE OVERALL PAYER MIX FOR THIS ORGANIZATION.
      PART III, LINE 9B:
COLLECTION PRACTICES EXPLANATIONNOTWITHSTANDING ANY OTHER PROVISION OF ANY OTHER POLICY AT COMMUNITY REGARDING BILLING AND COLLECTION MATTERS, COMMUNITY WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS BEFORE IT MAKES REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL WHO HAS AN UNPAID BILL FROM COMMUNITY IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. THE ACTIONS COMMUNITY MAY TAKE IN THE EVENT OF NONPAYMENT AND THE PROCESS AND TIME FRAMES FOR TAKING THESE ACTIONS ARE MORE FULLY DESCRIBED IN COMMUNITY'S BILLING AND COLLECTIONS POLICY.
      PART VI, LINE 2 - NEEDS ASSESSMENT
IN ADDITION TO THE TRIENNIAL CHNA, COMMUNITY HEALTH NETWORK CONTINUALLY ASSESSES THE NEEDS OF OUR PATIENTS AND THE COMMUNITY SERVED. COMMUNITY HEALTH NETWORK WORKS COLLABORATIVELY WITH OUR PEER HEALTH SYSTEM TO DISCUSS TRENDS AND WAYS IN WHICH THE HEALTH SYSTEMS CAN WORK TOGETHER TO ADDRESS THE NEEDS OF THE COMMUNITY. COMMUNITY HEALTH NETWORK ASSESSES THE SDOH NEEDS OF OUR PATIENTS BY EVALUATING DATA FROM THE COMMUNITY CONNECTIONS PLATFORM, A FREE SEARCH ENGINE THAT ALLOWS COMMUNITY MEMBERS TO ANONYMOUSLY SEARCH FOR SOCIAL CARE RESOURCES. INTERNALLY, CHNW HAS ACCESS TO A ROBUST DATA ANALYTICS TEAM AND TOOLS WHICH DEVELOP DASHBOARDS TO HELP TRACK AND MONITOR THE HEALTH NEEDS OF THOSE SERVED.
      PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
COMMUNITY WILL UNDERTAKE THE FOLLOWING EFFORTS TO WIDELY PUBLICIZE ITS FINANCIAL ASSISTANCE POLICY:1. WRITTEN NOTIFICATION - A PLAIN LANGUAGE SUMMARY WILL BE POSTED IN EACH PATIENT REGISTRATION AND WAITING AREA AND AVAILABLE ONLINE AT ECOMMUNITY.COM. IN THE CASE OF SERVICES RENDERED IN THE HOME, THE FINANCIAL ASSISTANCE SUMMARY WILL BE PROVIDED TO THE RESPONSIBLE PARTY DURING THE FIRST IN-HOME VISIT. ALL PUBLICATIONS AND INFORMATIONAL MATERIALS RELATED TO THE FINANCIAL ASSISTANCE PROGRAM WILL BE TRANSLATED INTO LANGUAGES APPROPRIATE TO THE POPULATION IN THE SERVICE AREA.2. ORAL NOTIFICATION - ALL POINTS OF ACCESS WILL MAKE EVERY EFFORT TO INFORM EACH RESPONSIBLE PARTY ABOUT THE EXISTENCE OF COMMUNITY'S FINANCIAL ASSISTANCE PROGRAM IN THE APPROPRIATE LANGUAGE DURING ANY PRE-ADMISSION, REGISTRATION, ADMISSION, OR DISCHARGE PROCESS. ADDITIONALLY, THE POST-SERVICE COLLECTION PROCESS WILL INTEGRATE NOTIFICATION OF THE AVAILABILITY OF ASSISTANCE INTO THE STANDARD PROCESS WHEN COLLECTION EFFORTS FAIL.3. STATEMENT NOTIFICATION - STATEMENTS WILL PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM.4. ABOUT YOUR BILL: FREQUENTLY ASKED QUESTIONS - COPIES OF THESE DOCUMENTS WILL BE AVAILABLE IN PATIENT REGISTRATION AREAS, THROUGH THE BUSINESS OFFICES AND PATIENT FINANCIAL COUNSELORS.5. COMMUNITY WILL MAKE REASONABLE EFFORTS TO INFORM AND NOTIFY RESIDENTS OF THE COMMUNITY SERVED ABOUT THE FINANCIAL ASSISTANCE POLICY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. MODES OF DELIVERY OF THIS INFORMATION MAY INCLUDE NEWSLETTERS, BROCHURES AND/OR THE PROVISION OF ONLINE ACCESS.
      PART VI, LINE 4 - COMMUNITY INFORMATION
THE POPULATION SERVED BY COMMUNITY HEALTH NETWORK IS EXPECTED TO REMAIN STABLE WITH JUST OVER 11.6% GROWTH PROJECTED OVER THE NEXT 5 YEARS. CURRENT POPULATION IS 523,201. THE RACIAL AND ETHNIC MAKE-UP OF THE COMMUNITY IS, 55.2% WHITE, 27.5% BLACK, 10.4% HISPANIC AND 6.7% OTHER. THE FASTEST GROWING AGE GROUP IS THOSE AGED 65+. 17.8% OF THE RESIDENTS IN MARION COUNTY AND 4.6% OF THE RESIDENTS IN HAMILTON COUNTY LIVE IN POVERTY.
      PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH
A MAJORITY OF COMMUNITY HEALTH NETWORK'S (COMMUNITY) BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO RESIDE IN COMMUNITY'S PRIMARY SERVICES AREAS. COMMUNITY EXTENDS MEDICAL PRIVILEGES TO ALL PHYSICIANS WHO MEET THE CREDENTIALING QUALIFICATIONS NECESSARY FOR APPOINTMENT TO ITS MEDICAL STAFF. COMMUNITY DOES NOT DENY APPOINTMENT BASED ON GENDER, RACE, CREED, OR NATIONAL ORIGIN. COMMUNITY, IN COLLABORATION WITH MARIAN UNIVERSITY OSTEOPATHIC SCHOOL OF MEDICINE, TRAINS THE NEXT GENERATION OF PHYSICIANS IN A LEARNING ENVIRONMENT. COMMUNITY APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH.
      PART VI, LINE 6:
"AFFILIATED HEALTH CARE SYSTEM: COMMUNITY HEALTH NETWORK, INC. (""CHNW"") IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. SEE THE ATTACHED IRS 990 SCHEDULE H SUPPLEMENTAL INFORMATION REPORT FOR HOW CHNW IS INVOLVED IN PROMOTING THE HEALTH OF THE COMMUNITY IT SERVES."
      PART VI, LINE 7:
STATE FILING OF COMMUNITY BENEFIT REPORT - INDIANA