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Schedule H, Part V, Section B, Line 3E
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THE NEEDS IDENTIFIED IN THE CHNA WERE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY, AS PRIORITIZED BY THE COMMUNITY LEADERS.
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Schedule H, Part V, Section B, Line 5 Facility A, 1
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Facility A, 1 - OCHSNER CLINIC FOUNDATION FACILITY REPORTING GROUP A. INFORMATION FROM THE PUBLIC WAS SOLICITED IN TWO WAYS: INTERVIEW OF KEY COMMUNITY STAKEHOLDERS AND SURVEYS HEALTH PROVIDERS. THE HOSPITAL IDENTIFIED KEY COMMUNITY STAKEHOLDERS, LEADERS FROM ORGANIZATIONS THAT HAVE SPECIAL KNOWLEDGE AND/OR EXPERTISE IN PUBLIC HEALTH, AGENCIES WITH INFORMATION RELATIVE TO THE HEALTH NEEDS OF THE COMMUNITY AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY. SUCH PERSONS WERE INTERVIEWED, PARTICIPATED IN FOCUS GROUPS AND/OR WERE SURVEYED AS PART OF THE NEEDS ASSESSMENT PLANNING PROCESS. AS PART OF THE CHNA PHASE, TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY STAKEHOLDERS IN THE SERVICE AREA TO BETTER UNDERSTAND THE CHANGING COMMUNITY HEALTH ENVIRONMENT. THE INTERVIEWS OFFERED COMMUNITY LEADERS AN OPPORTUNITY TO PROVIDE FEEDBACK ON THE NEEDS OF THE COMMUNITY, SUGGESTIONS ON SECONDARY DATA RESOURCES TO REVIEW AND EXAMINE, AND OTHER INFORMATION RELEVANT TO THE STUDY. AS PART OF THE CHNA PROJECT, TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY STAKEHOLDERS TO BETTER UNDERSTAND THE CHANGING COMMUNITY HEALTH ENVIRONMENT. COMMUNITY STAKEHOLDER INTERVIEWS WERE CONDUCTED IN FEBRUARY 2018 AND CONTINUED THROUGH APRIL 2018. COMMUNITY STAKEHOLDERS TARGETED FOR INTERVIEWS ENCOMPASSED A WIDE VARIETY OF PROFESSIONAL BACKGROUNDS INCLUDING: 1) PUBLIC HEALTH EXPERTS, 2) PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH-RELATED DATA, 3) REPRESENTATIVES OF UNDERSERVED POPULATIONS, 4) GOVERNMENT LEADERS, AND 5) RELIGIOUS LEADERS. TOP COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED BY COMMUNITY LEADERS DURING A REGIONAL COMMUNITY HEALTH NEEDS IDENTIFICATION FORUM HELD IN JUL 2018. CONSULTANTS PRESENTED TO COMMUNITY LEADERS THE CHNA FINDINGS FROM ANALYZING SECONDARY DATA, KEY STAKEHOLDER INTERVIEWS, AND SURVEYS. COMMUNITY LEADERS DISCUSSED THE DATA PRESENTED, SHARED THEIR VISIONS AND PLANS FOR COMMUNITY HEALTH IMPROVEMENT IN THEIR COMMUNITIES, AND IDENTIFIED AND PRIORITIZED THE TOP COMMUNITY HEALTH NEEDS IN THE COMMUNITY. THE FOLLOWING IS A LIST OF COMMUNITY ORGANIZATIONS THAT PARTICIPATED IN THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS: 504HEALTHNET, ACCESS HEALTH LOUISIANA, AGENDA FOR CHILDREN, AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION, ANDREA'S RESTAURANT, BACKYARD GARDENERS NETWORK, BATON ROUGE HEALTH DISTRICT, BELLE CHASSE YMCA, BOYS & GIRLS CLUBS WEST BANK, BROAD COMMUNITY CONNECTIONS, BRYAN BELL METROPOLITAN LEADERSHIP FORUM, BUREAU OF CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION, BUREAU OF FAMILY HEALTH, CAFE HOPE, CAFFIN AVENUE SDA CHURCH, CAPITAL AREA HUMAN SERVICES, CCOSJ, CENTRAL CHAMBER OF COMMERCE, CENTRAL LAFAYETTE HIGH SCHOOL, CHILDREN'S BUREAU NEW ORLEANS, CITY OF BATON ROUGE, CITY OF COVINGTON, CITY OF KENNER, CITY OF MANDEVILLE, CITY OF NEW ORLEANS EMERGENCY MEDICAL SERVICES, CITY OF SLIDELL, CIVIC COALITION WEST BANK, COUNCIL ON AGING OF ST, COVENANT HOUSE NEW ORLEANS, COVINGTON FOOD BANK, CRESCENT DENTAL, DAUGHTERS OF CHARITY, EAST JEFFERSON GENERAL HOSPITAL, EAST ST, EXCELTH FAMILY HEALTH CENTER, FIFTH DISTRICT SAVINGS BANK, FRIENDS OF LAFITTE GREENWAY, GHEENS NEEDY FAMILY, GIN WEALTH MANAGEMENT PARTNERS, GOOD SAMARITAN FOOD BANK, GULF COAST BANK & TRUST COMPANY, HEALTH GUARDIANS OF CATHOLIC CHARITIES ARCHDIOCESE OF NEW ORLEANS, HOSPITAL SERVICE DISTRICT, HUB INTERNATIONAL GULF SOUTH, HUMANA, HUMANA BOLD GOAL, JEFFCAP, JEFFERSON CHAMBER OF COMMERCE, JEFFERSON PARISH COUNCIL ON AGING, JEFFERSON PARISH PUBLIC SCHOOL SYSTEM, JEWISH FAMILY SERVICES, JOHN J, JUNIOR LEAGUE OF NEW ORLEANS, KENNER DISCOVERY HEALTH SCIENCES ACADEMY, KINGSLEY HOUSE, LAFOURCHE BEHAVIORAL HEALTH CENTER, LAFOURCHE FIRE DEPARTMENT DISTRICT #1, LAFOURCHE HOSPITAL SERVICE DISTRICT #2, LAFOURCHE PARISH GOVERNMENT, LAFOURCHE PARISH SCHOOL BOARD, LAFOURCHE PARISH SHERIFF'S OFFICE, LAKEVIEW REGIONAL MEDICAL CENTER, LCMC HEALTH, LCMC HEALTH - CHILDREN'S HOSPITAL, LCMC HEALTH - NEW ORLEANS EAST HOSPITAL, LCMC HEALTH - TOURO INFIRMARY, LCMC HEALTH - UNIVERSITY MEDICAL CENTER, LCMC HEALTH - WEST JEFFERSON MEDICAL CENTER, LIMB UP, LOCKPORT CITY COUNCIL, LOUISIANA CHILDREN'S RESEARCH CENTER FOR DEVELOPMENT AND LEARNING, LOUISIANA DEPARTMENT OF HEALTH, LOUISIANA ORGAN PROCUREMENT AGENCY, LOUISIANA POLICY INSTITUTE FOR CHILDREN, LOUISIANA PUBLIC HEALTH INSTITUTE, LOUISIANA PUBLIC HEALTH INSTITUTE, LOUISIANA STATE UNIVERSITY AGRICULTURAL CENTER, LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER, LOUISIANA STATE UNIVERSITY/UNIVERSITY MEDICAL CENTER, MARKET UMBRELLA, MARTIN LUTHER KING, JR, METHODIST HEALTH SYSTEM FOUNDATION, INC, METROPOLITAN HUMAN SERVICES DISTRICT, NEW ORLEANS CHAMBER OF COMMERCE, NEW ORLEANS COUNCIL ON AGING, NEW ORLEANS EMERGENCY MEDICINE, NEW ORLEANS HEALTH DEPARTMENT, NEW ORLEANS MISSION/GIVING HOPE RETREAT, NEW PATHWAYS NEW ORLEANS, NEWMAN, MATHIS, BRADY & SPEDALE, NOLA BUSINESS ALLIANCE, NORTHSHORE COMMUNITY FOUNDATION, NORTHSHORE HEALTHCARE ALLIANCE, NURSE FAMILY PARTNERSHIP, OCHSNER BAPTIST MEDICAL CENTER, OCHSNER HEALTH SYSTEM, OCHSNER HEALTH SYSTEM BOARD OF TRUSTEES, OCHSNER MEDICAL CENTER - BATON ROUGE, OCHSNER MEDICAL CENTER - KENNER, OCHSNER MEDICAL CENTER - KENNER HOSPITAL BOARD, OCHSNER MEDICAL CENTER - NORTH SHORE, OCHSNER MEDICAL CENTER - WEST BANK, OCHSNER REHABILITATION HOSPITAL IN PARTNERSHIP WITH SELECT MEDICAL, OCHSNER ST, ONE HAVEN INC, PEOPLE'S HEALTH, RAINBOW CHILD CARE CENTER, INC, READY RESPONDERS, REGINA COELI CHILD DEVELOPMENT CENTER, RIVER PARISH BEHAVIORAL CENTER, RIVER PLACE BEHAVIORAL HEALTH A SERVICE OF OCHSNER HEALTH SYSTEM, SAIRP, SALVATION CHRISTIAN FELLOWSHIP, SECOND BAPTIST CHURCH, SECOND HARVEST FOOD BANK, SLIDELL MEMORIAL HOSPITAL, SOUTH CENTRAL PLANNING & DEVELOPMENT COMMISSION (SCPDC), ST. JOHN COUNCIL, ST. JOHN VOLUNTEER CITIZEN, ST. TAMMANY CORONER'S OFFICE, ST. TAMMANY DEPARTMENT OF HEALTH & HUMAN SERVICES, ST. TAMMANY PARISH CLERK OF COURT; 22ND JUDICIAL DISTRICT COURT, ST. TAMMANY PARISH GOVERNMENT HEALTH & HUMAN SERVICES, ST. TAMMANY PARISH HOSPITAL, ST. THOMAS HEALTH CENTER, SUSAN G KOMEN, THE BLOOD CENTER, THE HAVEN, THE LOUISIANA CAMPAIGN FOR TOBACCO-FREE LIVING, THE METROPOLITAN HOSPITAL COUNCIL OF NEW ORLEANS, THE NATIONAL ALLIANCE ON MENTAL ILLNESS, TPRC, TULANE LAKESIDE HOSPITAL FOR WOMEN AND CHILDREN, TULANE MEDICAL CENTER, US HOUSE OF REPRESENTATIVES, UMCNO FORENSICS, UNITED HEALTHCARE, UNITED WAY, UNITED WAY FOR GREATER NEW ORLEANS, UNITED WAY OF SOUTHEAST LOUISIANA, UNITY OF GREATER NEW ORLEANS, VACHERIE GHEENS COMMUNITY CENTER, VIET, VOLUNTEERS OF AMERICA, WELL-AHEAD LOUISIANA REGION 9, WEST JEFFERSON MEDICAL CENTER, WEST JEFFERSON MEDICAL CENTER FOUNDATION DIRECTOR, WEST JEFFERSON MEDICAL CENTER; AUXILIARY THE CHNA WAS DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED IN DECEMBER 29, 2014. THE CHNA WAS APPROVED BY THE BOARD OF DIRECTORS IN OCTOBER 2018 AND THE CHNA IMPLEMENTATION STRATEGY WAS APPROVED BY THE BOARD OF DIRECTORS IN APRIL 2019.
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Schedule H, Part V, Section B, Line 6a Facility A, 1
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Facility A, 1 - OCHSNER CLINIC FOUNDATION FACILITY REPORTING GROUP A. THE CHNA WAS CONDUCTED WITH A NUMBER OF OTHER HOSPITAL FACILITIES. * OCHSNER MEDICAL CENTER KENNER * ST. CHARLES PARISH HOSPITAL * CHILDREN'S HOSPITAL OF NEW ORLEANS * TOURO INFIRMARY * UNIVERSITY MEDICAL CENTER NEW ORLEANS * EAST JEFFERSON GENERAL HOSPITAL * WEST JEFFERSON MEDICAL CENTER * SLIDELL MEMORIAL HOSPITAL * ST. TAMMANY PARISH HOSPITAL
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Schedule H, Part V, Section B, Line 11 Facility A, 1
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Facility A, 1 - A-1 OCHSNER MEDICAL CENTER (INCLUDING SATELLITE LOCATIONS). 2020 UPDATE ON 2018 COMMUNITY HEALTH NEEDS ASSESSMENT Behavioral Health/Mental Health/Substance Abuse For decades, Ochsner has applied excellence, innovation, research, and education to the delivery of psychiatry and behavioral health services. Ochsner offers a breadth of services and specialty treatment programs including short-term outpatient counseling, group therapy, hospital inpatient and day treatment programs. In 2020, 24 providers and expanded new behavioral health services were added to Ochsner facilities in Louisiana's Northshore, South shore, Baton Rouge, and Bayou regions. There was a 20% growth in unique patients served across outpatient clinics for behavioral health and addictive disorders. During the COVID-19 pandemic, the Ochsner system conducted 90% of behavioral health visits virtually, seeing 10,780 patients through the MyOchsner patient portal. Additionally, the Office of Professional Well-Being led the COVID-19 Staff Support and Wellness Initiative, providing on-demand access to a crisis phone line and psychiatric consultation, twice-daily virtual mindfulness groups, and decompression groups for high-stress units. In order to meet the behavioral health, mental health, and substance abuse needs of our community, we have focused on increasing access to care for all ages. The Boh Center for Child Development is one of the largest multi-disciplinary child focused centers in the Gulf South utilizing interdisciplinary team evaluations, integrated treatment protocols and supports parents within the school setting to navigate special education services and provide family centered treatment plans. The system-wide Opioid Stewardship Committee continues to develop best-practices in decreasing the use of opioids. Ochsner launched the iCare program with the Lambeth House to offer telehealth services for dementia and Alzheimer's care to allow these patients to stay at home while receiving proactive and continuing care. In 2018, Ochsner Health partnered with Acadia Healthcare to open River Place Behavioral Health, an 82-bed inpatient facility that treats patients starting at age 12. Access to Care Ochsner continues to provide medical services in neighborhoods across the Greater New Orleans Region, including opening the first of 15 planned Ochsner Community Health Centers, the Ochsner Community Health Brees Family Center, in New Orleans East. A cornerstone of Ochsner's Healthy State by 2030 initiative, these centers will be located in underserved neighborhoods across Louisiana, including areas with low access to care. In 2020, Ochsner Health deepened that commitment with a new, five-year pledge of $1 million to Son of a Saint, a nonprofit organization dedicated to transforming the lives of fatherless boys in New Orleans while also inspiring mentorship, which will fund critical programmatic staff and enhance the organization's services to promote the whole person - mind, body, and spirit - through healthcare educators, social workers and mental health providers. To increase access to care for students, Ochsner sponsors two school-based health centers within Jefferson Parish Public School System's (JPPSS) two largest high schools. JPPSS is the largest public school system in the state of Louisiana with 81,000 students and an economically disadvantaged school population of 85%. Through this sponsorship, Ochsner covers the complete cost of the Nurse Practitioners, all student wellness programs, and the rotation of Ochsner Clinical School Medical Students. Ochsner also provides for the Medical Directors for these school clinics. The Ochsner Sports Medicine Institute partnered with local schools throughout southeast Louisiana to provide low or no-cost Athletic Training services for their student athletes, including pre-sports physicals to keep student-athletes healthy. Ochsner is a recognized leader in digital medicine. Over 15,000 patients participated in Ochsner Digital Medicine for chronic disease. The program is available in 15 states and will expand in 2021 to serve patients, employers, payors, and health systems nationally. One of our most impactful initiatives is the Connected MOM program, which allows expectant mothers to stay connected to their Ochsner care team from the comfort of home through digital monitoring. Policymakers have taken notice of this Ochsner initiative, recognizing that maternal and infant mortality rates are far too high, especially within underserved communities, by initiating the Connected Maternal Online Monitoring Services (MOM) Act which requires the Centers for Medicare and Medicaid (CMS) to provide coverage recommendations for remote devices to check blood pressure, blood glucose, and pulse rates. UniteUs is a community resource referral platform that allows Ochsner team members to connect patients with community-based resources that can assist with providing services and closing gaps of patients' non-clinical needs. Considering the long term need to continue to grow the pipeline of healthcare providers, Ochsner has made significant investments in K-12 and Healthcare Education. Over 13,200 K-12 students and teachers were engaged in Ochsner's K-12 STEM Education Program Teacher Professional Development programs that span across the state of Louisiana and into Mississippi. Our Workforce Development programs worked with Louisiana Community and Technical Colleges throughout Louisiana to host incumbent training and workforce development programs. The programs in Greater New Orleans, Northshore, Lake Charles, Bayou and Baton Rouge trained 411 unemployed or underemployed adults at no cost to the student, with a 100% graduation rate and 100% employment upon graduation rate in roles as Medical Assistant, Pharmacy Tech, Coding, and Patient Care Technician. Health Education & Health Literacy Ochsner is focused on the need to provide opportunities for community members and patients to learn about their health and how to improve or maintain it by empowering them with education and learning opportunities. The Ochsner Eat Fit program makes it easy for community members to make the right decisions for their health through collaborative work with local restaurants, schools, and sports arenas in New Orleans, Northshore, Baton Rouge, Shreveport, and Acadiana. Ochsner provides 6 Registered Dieticians to partner with 336 restaurant partners to review their menus and certify approved "Eat Fit" options. Ochsner provides the "CHOP" After-School cooking program at schools and community centers in the Greater New Orleans, Baton Rouge, Northshore, and Hancock Mississippi regions. This no-cost, 8-week program gives young people the opportunity to learn hands-on cooking skills through health education and healthy recipes. The Ochsner Corporate Wellness team provided over 3,500 no-cost health screenings to community members, teachers, and local organizations across regions. Ochsner Tobacco Cessation and Education programs educate local students through interactive tobacco prevention programs. Additionally, the Tobacco Control & Prevention program offers 23 cessation clinic sites that provide free tobacco cessation services to patients who are eligible for the tobacco trust program. Over 15,000 people have participated since the start of the program which has a 12-month quit rate of 30%. System wide, over 10,400 unique patients demonstrated a 29.8% quit rate. Cessation clinics are located in the Greater New Orleans Area, Baton Rouge, and the Northshore. At Ochsner's Westbank and Baptist campuses, over 100 educational programs and community outreach events occurred. Ochsner Westbank hosted regular car seat inspections, baby basics, and breastfeeding classes, and facilitated the John Ehret High School Wellness Council. Ochsner Baptist hosted delivery, sibling, Babies R Us Basics, breastfeeding, newborn care, postpartum, baby safety, grandparents, and Happiest Baby on Block classes taught by Ochsner Nurses and Professionals. ALL IDENTIFIED SIGNIFICANT NEEDS WERE ADDRESSED.
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Schedule H, Part V, Section B, Line 11 Facility A, 2
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Facility A, 2 - A-2 OCHSNER MEDICAL CENTER - BATON ROUGE (OMC - BR). 2020 UPDATE ON 2018 COMMUNITY HEALTH NEEDS ASSESSMENT Access to Care Ochsner's decades long commitment to serving the Baton Rouge community added another chapter in 2020 with the opening of Ochsner Health Center - Bluebonnet South. The new facility offers a full array of primary care, general pediatrics, obstetrics, & women's services. The area is also home to Ochsner Medical Center - Baton Rouge, Ochsner Medical Complex -The Grove, Ochsner Medical Complex - Iberville, & Ochsner Cancer Center - Baton Rouge, as well as 12 additional Ochsner health centers, three therapy & wellness centers, & two urgent care centers. Patients are served by more than 2,000 Ochsner team members dedicated to outstanding patient care. Additionally, OMC - BR has implemented Telemedicine services & Virtual Hospital Medicine (only at Ochsner - Iberville.) In response to COVID-19, rapid COVID-19 & Influenza point of care testing has been added. Both Emergency Departments have introduced ED Paramedics & is the first hospital to do so in the Baton Rouge Region. Ochsner is a recognized leader in digital medicine. Over 15,000 patients participated in Ochsner Digital Medicine for chronic disease. The program is available in 15 states & will expand to serve patients, employers, payors, & health systems nationally. One of our most impactful initiatives is the Connected MOM program, which allows expectant mothers to stay connected to their Ochsner care team from home through digital monitoring. Policymakers have taken notice of this Ochsner initiative, recognizing that maternal & infant mortality rates are far too high, especially within underserved communities, by initiating the Connected Maternal Online Monitoring Services (MOM) Act. UniteUs is a community resource referral platform that allows Ochsner team members to connect patients with community-based resources that can assist with providing services & closing gaps of patients' non-clinical needs. Considering the long term need of healthcare providers, Ochsner has made significant investments in K-12 & Healthcare Education. Over 13,200 K-12 students & teachers were engaged in Ochsner's K-12 STEM Education Program Teacher Professional Development programs that span across the state of LA & into MS. Our Workforce Development programs worked with Louisiana Community & Technical Colleges throughout LA to host incumbent training & workforce development programs. The programs trained 411 unemployed or underemployed adults at no cost to the student, with a 100% graduation rate & 100% employment upon graduation rate in roles as Medical Assistant, Pharmacy Tech, Coding, & Patient Care Technician. Behavioral Health/Mental Health/Substance Abuse OMC - BR, in addition to adult psychiatric services, now provides pediatric & adolescent psychiatry & psychology. Behavioral Health services are now available at three new locations along the I-12 corridor, providing patients ease of access to a location of their choice. Virtual appointments are also available & have increased to 48%, allowing further ease of access to Behavioral Health services across the state. For decades, Ochsner has applied excellence, innovation, research, & education to the delivery of psychiatry & behavioral health services. Ochsner offers a breadth of services & specialty treatment programs including short-term outpatient counseling, group therapy, hospital inpatient, & day treatment programs. In 2020, 24 providers & expanded new behavioral health services were added to Ochsner facilities. There was a 20% growth in unique patients served across outpatient clinics for behavioral health & addictive disorders. During the COVID-19 pandemic, the Ochsner system conducted 90% of behavioral health visits virtually, seeing 10,780 patients through the MyOchsner patient portal. Additionally, the Office of Professional Well-Being led the COVID-19 Staff Support & Wellness Initiative, providing on-demand access to a crisis phone line & psychiatric consultation, twice-daily virtual mindfulness groups, & decompression groups for high-stress units. OMC - BR participated in the I Care Council, a Drug/Alcohol/Violence prevention program through East Baton Rouge Parish School System. The system-wide Opioid Stewardship Committee continues to develop best-practices in decreasing the use of opioids. Ochsner launched the iCare program with the Lambeth House to offer telehealth services for dementia & Alzheimer's care to allow these patients to stay at home while receiving proactive & continuing care. Healthy Living Ochsner is focused on the need to provide opportunities for community members & patients to learn about their health & how to improve or maintain it by empowering them with education & learning opportunities. The Ochsner Eat Fit program makes it easy for community members to make the right decisions for their health through collaborative work with local restaurants, schools, & sports arenas. Ochsner provides 6 Registered Dieticians to partner with 336 restaurant partners to review their menus & certify approved "Eat Fit" options. Ochsner provides the "CHOP" After-School cooking program at schools & community centers. This no-cost, 8-week program gives young people the opportunity to learn hands-on cooking skills through health education & healthy recipes. The Ochsner Corporate Wellness team provided over 3,500 no-cost health screenings to community members, teachers, & local organizations across regions. The Ochsner Sports Medicine Institute partnered with local schools throughout southeast LA to provide low or no-cost Athletic Training services for their student athletes, including pre-sports physicals to keep student-athletes healthy. Ochsner Tobacco Cessation & Education programs educate local students through interactive tobacco prevention programs. Additionally, the Tobacco Control & Prevention program offers 23 cessation clinic sites that provide free tobacco cessation services to patients who are eligible for the tobacco trust program. Over 15,000 people have participated since the start of the program which has a 12-month quit rate of 30%. System wide, over 10,400 unique patients demonstrated a 29.8% quit rate. OMC - Baton Rouge participates in the Mayor's Healthy Baton Rouge Coalition with other hospitals in the region to work together to improve health outcomes. In 2020, OMC - BR worked with Healthy Baton Rouge to drive COVID response & healthy citizens initiatives & the Mayor's Health BR CHNA process. Additionally, OMC - BR hosted "Safe Return to Business" informational webinars open for all businesses in the Baton Rouge & surrounding areas. STIs Ochsner - Baton Rouge's Infection Control nurses routinely work with OPH regarding communicable diseases in the local population. In an effort to eliminate HIV & HCV, OMC - Baton Rouge & Ochsner Medical Complex - Iberville implemented the opt-out HIV/HCV testing in the Emergency Departments to all qualifying patients in early 2019. Baton Rouge was the first region within Ochsner Health to accomplish this. Since then, other locations now offer opt-out HIV/HCV testing option to all qualifying patients who come to the ED. The key to this initiative is the LPN Care Coordinator housed in the Baton Rouge ED. This LPN Coordinator connects patients to care & coordinates education for frontline staff. Care Coordinators work closely with all tested patients to ensure that they receive their results in a timely manner & are linked to a care provider as efficiently as possible to review their care options. These Care Coordinators work with Rapid Start Navigators, employed by the State, to ensure patients are seen by a provider as quickly as possible. A virtual series, Project ECHO, was offered to all Emergency Department nurses to create further awareness of the need to reduce stigma of persons who use drugs &/or persons living with HIV or HCV. Handouts were made to educate patients who inject drugs on the risks involved, the proper use & disposal of needles & syringes, the importance of knowing one's status, & options available for those who are HIV/HCV positive. ALL IDENTIFIED SIGNIFICANT NEEDS WERE ADDRESSED.
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Schedule H, Part V, Section B, Line 11 Facility A, 3
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Facility A, 3 - A-3 OCHSNER MEDICAL CENTER - KENNER, LLC (OMC - KENNER). 2020 UPDATE ON 2018 COMMUNITY HEALTH NEEDS ASSESSMENT Education Understanding that access to high quality education in a safe and supportive environment is a critical beginning step in improving health outcomes, in 2019, Ochsner received approval from the Jefferson Parish Public School System (JPPSS) to enter into a community partnership with Discovery Schools Foundation. Through this partnership, Ochsner financed and managed the construction of a new school facility to house a PreK-8th grade, open enrollment, public charter school in an underserved neighborhood. JPPSS is the largest public-school system in the state of Louisiana with 81,000 students and an economically disadvantaged school population of 85%. Discovery Schools Foundation operates the Kenner Discovery Health Sciences Academy adjacent to the Ochsner Medical Center - Kenner campus allowing for a close partnership for student and teacher programming. Considering the long-term need to continue to grow the pipeline of healthcare providers, Ochsner has made significant investments in K-12 and Healthcare Education. Over 13,200 K-12 students and teachers were engaged in Ochsner's K-12 STEM Education Program Teacher Professional Development programs that span across the state of Louisiana and into Mississippi. OMC - Kenner hosted job shadow and tours for students and career days at local high schools in early 2020 before the COVID pandemic. Ochsner also supports the LSUHSC Family Practice and Internal Medicine Graduate Medical Education residency programs at OMC - Kenner. Behavioral Health/Mental Health/Substance Abuse For decades, Ochsner has applied excellence, innovation, research, and education to the delivery of psychiatry and behavioral health services. Ochsner offers a breadth of services and specialty treatment programs including short-term outpatient counseling, group therapy, hospital inpatient and day treatment programs. In 2020, 24 providers and expanded new behavioral health services were added to Ochsner facilities in Louisiana's Northshore, South shore, Baton Rouge, and Bayou regions. There was a 20% growth in unique patients served across outpatient clinics for behavioral health and addictive disorders. During the COVID-19 pandemic, the Ochsner system conducted 90% of behavioral health visits virtually, seeing 10,780 patients through the MyOchsner patient portal. Additionally, the Office of Professional Well-Being led the COVID-19 Staff Support and Wellness Initiative, providing on-demand access to a crisis phone line and psychiatric consultation, twice-daily virtual mindfulness groups, and decompression groups for high-stress units. In order to meet the behavioral health, mental health, and substance abuse needs of our community, we have focused on increasing access to care for all ages. The Boh Center for Child Development is one of the largest multi-disciplinary child focused centers in the Gulf South utilizing interdisciplinary team evaluations, integrated treatment protocols and supports parents within the school setting to navigate special education services and provide family centered treatment plans. We continue to provide inpatient psychiatric services at our flagship hospital, Ochsner Medical Center, outpatient mental health services and clinical psychiatric services. The system-wide Opioid Stewardship Committee continues to develop best-practices in decreasing the use of opioids. Ochsner launched the iCare program with the Lambeth House to offer telehealth services for dementia and Alzheimer's care to allow these patients to stay at home while receiving proactive and continuing care. In 2018, Ochsner Health partnered with Acadia Healthcare to open River Place Behavioral Health, an 82-bed inpatient facility that treats patients starting at age 12. Access to Care Ochsner - Kenner opened a second catheterization lab further expanding is capacity to serve cardiovascular patients. OMC - Kenner has hosted Hispanic Health Fairs and provided free screenings to community members. Additionally, free blood pressure screenings, nurse consultations, and wellness services were provided at community events offered through the year in Kenner. Ochsner continues to provide medical services in neighborhoods across the Greater New Orleans Region, including opening the first of 15 planned Ochsner Community Health Centers, the Ochsner Community Health Brees Family Center. A cornerstone of Ochsner's Healthy State by 2030 initiative, these centers will be located in underserved neighborhoods across Louisiana, including areas with low access to care. To increase access to care for students, Ochsner sponsors two school-based health centers within Jefferson Parish Public School System's two largest high schools. JPPSS is the largest public school system in the state of Louisiana with 81,000 students and an economically disadvantaged school population of 85%. Through this sponsorship, Ochsner covers the complete cost of the Nurse Practitioners, all student wellness programs, and the rotation of Ochsner Clinical School Medical Students. Ochsner also provides for the Medical Directors for these school clinics. The Ochsner Sports Medicine Institute partnered with local schools throughout southeast Louisiana to provide low or no-cost Athletic Training services for their student athletes, including pre-sports physicals to keep student-athletes healthy. Ochsner is a recognized leader in digital medicine. Over 15,000 patients participated in Ochsner Digital Medicine for chronic disease. The program is available in 15 states and will expand in 2021 to serve patients, employers, payors, and health systems nationally. One of our most impactful initiatives is the Connected MOM program, which allows expectant mothers to stay connected to their Ochsner care team from the comfort of home through digital monitoring. Policymakers have taken notice of this Ochsner initiative, recognizing that maternal and infant mortality rates are far too high, especially within underserved communities, by initiating the Connected Maternal Online Monitoring Services (MOM) Act which requires the Centers for Medicare and Medicaid (CMS) to provide coverage recommendations for remote devices to check blood pressure, blood glucose, and pulse rates. UniteUs is a community resource referral platform that allows Ochsner team members to connect patients with community-based resources that can assist with providing services and closing gaps of patients' non-clinical needs. ALL IDENTIFIED SIGNIFICANT NEEDS WERE ADDRESSED.
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Schedule H, Part V, Section B, Line 11 Facility A, 4
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Facility A, 4 - A-4 OCHSNER MEDICAL CENTER - NORTHSHORE, LLC. 2020 UPDATE ON 2018 COMMUNITY HEALTH NEEDS ASSESSMENT Behavioral Health/Mental Health/Substance Abuse Ochsners' Northshore region partnered with Safe Haven, a collaborative healing environment for citizens struggling with mental illness and substance abuse. Safe Haven provides a single point of entry into the behavioral health continuum for law enforcement, the judiciary, and local hospitals. Ochsner partnership with Safe Haven education, training, advisory-expertise, and collaborative partnership programming. Ochsners' Northshore region also maintains a close partnership with NAMI, collaborating on and hosting support groups and other events throughout the year. For decades, Ochsner has applied excellence, innovation, research, and education to the delivery of psychiatry and behavioral health services. Ochsner offers a breadth of services and specialty treatment programs including short-term outpatient counseling, group therapy, hospital inpatient, and day treatment programs. In 2020, 24 providers and expanded new behavioral health services were added to Ochsner facilities in Louisiana's Northshore, South shore, Baton Rouge, and Bayou regions. There was a 20% growth in unique patients served across outpatient clinics for behavioral health and addictive disorders. During the COVID-19 pandemic, the Ochsner system conducted 90% of behavioral health visits virtually, seeing 10,780 patients through the MyOchsner patient portal. Additionally, the Office of Professional Well-Being led the COVID-19 Staff Support and Wellness Initiative, providing on-demand access to a crisis phone line and psychiatric consultation, twice-daily virtual mindfulness groups, and decompression groups for high-stress units. In order to meet the behavioral health, mental health, and substance abuse needs of our community, we have focused on increasing access to care for all ages. The Boh Center for Child Development is one of the largest multi-disciplinary child focused centers in the Gulf South utilizing interdisciplinary team evaluations, integrated treatment protocols, and supports parents within the school setting to navigate special education services and provide family centered treatment plans. We continue to provide inpatient psychiatric services at our flagship hospital, Ochsner Medical Center, outpatient mental health services and clinical psychiatric services. The system-wide Opioid Stewardship Committee continues to develop best-practices in decreasing the use of opioids. Ochsner launched the iCare program with the Lambeth House to offer telehealth services for dementia and Alzheimer's care to allow these patients to stay at home while receiving proactive and continuing care. In 2018, Ochsner Health partnered with Acadia Healthcare to open River Place Behavioral Health, an 82-bed inpatient facility that treats patients starting at age 12. Health Education Ochsner is focused on the need to provide opportunities for community members and patients to learn about their health and how to improve or maintain it by empowering them with education and learning opportunities. The Ochsner Eat Fit program makes it easy for community members to make the right decisions for their health through collaborative work with local restaurants, schools, and sports arenas in New Orleans, Northshore, Baton Rouge, Shreveport, and Acadiana. Ochsner provides 6 Registered Dieticians to partner with 336 restaurant partners to review their menus and certify approved "Eat Fit" options. Ochsner provides the "CHOP" After-School cooking program at schools and community centers in the Greater New Orleans, Baton Rouge, Northshore, and Hancock Mississippi regions. This no-cost, 8-week program gives young people the opportunity to learn hands-on cooking skills through health education and healthy recipes. The Ochsner Corporate Wellness team provided over 3,500 no-cost health screenings to community members, teachers, and local organizations across regions. OMC - Northshore partnered with Slidell Memorial Hospital to offer the CHOP program to local Boys & Girls Club. Additionally, OMC - Northshore partnered with the American Heart Association to sponsor Kids Cook with Heart, a healthy eating program that teaches kids cooking skills and healthy habits. The Ochsner Sports Medicine Institute partnered with local schools throughout southeast Louisiana to provide low or no-cost Athletic Training services for their student athletes, including pre-sports physicals to keep student-athletes healthy. Ochsner Tobacco Cessation and Education programs educate local students through interactive tobacco prevention programs. Additionally, the Tobacco Control & Prevention program offers 23 cessation clinic sites that provide free tobacco cessation services to patients who are eligible for the tobacco trust program. Over 15,000 people have participated since the start of the program which has a 12-month quit rate of 30%. System wide, over 10,400 unique patients demonstrated a 29.8% quit rate. Cessation clinics are located in the Greater New Orleans Area, Baton Rouge, and the Northshore. OMC - Northshore co-founded Healthier Northshore to promote healthier lifestyles, preventative screenings, and health education. Chronic Disease Ochsner's digital medicine programs change the way patients manage chronic diseases like hypertension and diabetes through wearable technology that monitors levels and alerts care providers. 71% of participants in the hypertension digital medicine program achieved control within 90 days of entering the program. Diabetes digital medicine program allows diabetic patients to measure blood sugar levels anywhere and automatically transmit the information to their care teams. Care teams use information to adjust treatment plans, medications and provide lifestyle guidance resulting in significant improvements in blood sugar control, patient activation, and completing important health maintenance measures. The Ochsner InnovationHub opened in 2019 as a way for community members to have access to learn about digital medicine options to manage chronic disease, explore healthy lifestyle education, and have interactive experiences centered around healthcare. In community centers, churches, schools, and businesses throughout Ochsner communities, we provide expert speakers that cover topics centered around managing chronic diseases, prevention strategies, and a host of other health topics for community members. All Ochsner campuses provide support groups for a variety of topics including, managing chronic health conditions, transplant support, mental health, pre- and post-natal, sibling classes, geriatric, and women's health. Ochsner - Northshore provided a full-time Nurse Practitioner to St. Tammany Parish Public School System to manage the schools COVID-19 response beginning 9/17/2020 to present time. This full-time provider was provided at no cost to the school system. In addition, from 8/27/2020 - 10/3/2020 a full-time Medical Assistant was provided at no cost to the school system. ALL IDENTIFIED SIGNIFICANT NEEDS WERE ADDRESSED.
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Schedule H, Part V, Section B, Line 11 Facility A, 5
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Facility A, 5 - A-5 OCHSNER ST. ANNE GENERAL HOSPITAL. 2020 UPDATE ON 2018 COMMUNITY HEALTH NEEDS ASSESSMENT Access to Care Ochsner continues to provide medical services in neighborhoods across the Bayou region. Ochsner has significantly increased access and availability to Urgent Care services throughout the community with 19 locations in 8 parishes across Louisiana. Ochsner is a recognized leader in digital medicine. Over 15,000 patients participated in Ochsner Digital Medicine for chronic disease. The program is available in 15 states and will expand in 2021 to serve patients, employers, payors, and health systems nationally. One of our most impactful initiatives is the Connected MOM program, which allows expectant mothers to stay connected to their Ochsner care team from the comfort of home through digital monitoring. Policymakers have taken notice of this Ochsner initiative, recognizing that maternal and infant mortality rates are far too high, especially within underserved communities, by initiating the Connected Maternal Online Monitoring Services (MOM) Act which requires the Centers for Medicare and Medicaid (CMS) to provide coverage recommendations for remote devices to check blood pressure, blood glucose, and pulse rates. UniteUs is a community resource referral platform that allows Ochsner team members to connect patients with community-based resources that can assist with providing services and closing gaps of patients' non-clinical needs. Considering the long term need to continue to grow the pipeline of healthcare providers, Ochsner has made significant investments in K-12 and Healthcare Education. Over 13,200 K-12 students and teachers were engaged in Ochsner's K-12 STEM Education Program Teacher Professional Development programs that span across the state of Louisiana and into Mississippi. Our Workforce Development programs worked with Louisiana Community and Technical Colleges throughout Louisiana to host incumbent training and workforce development programs. The programs in Greater New Orleans, Northshore, Lake Charles, Bayou, and Baton Rouge trained 411 unemployed or underemployed adults at no cost to the student, with a 100% graduation rate and 100% employment upon graduation rate in roles as Medical Assistant, Pharmacy Tech, Coding, and Patient Care Technician. Behavioral Health/Mental Health/Substance Abuse For decades, Ochsner has applied excellence, innovation, research, and education to the delivery of psychiatry and behavioral health services. Ochsner offers a breadth of services and specialty treatment programs including short-term outpatient counseling, group therapy, hospital inpatient, and day treatment programs. In 2020, 24 providers and expanded new behavioral health services were added to Ochsner facilities in Louisiana's Northshore, South shore, Baton Rouge, and Bayou regions. There was a 20% growth in unique patients served across outpatient clinics for behavioral health and addictive disorders. During the COVID-19 pandemic, the Ochsner system conducted 90% of behavioral health visits virtually, seeing 10,780 patients through the MyOchsner patient portal. Additionally, the Office of Professional Well-Being led the COVID-19 Staff Support and Wellness Initiative, providing on-demand access to a crisis phone line and psychiatric consultation, twice-daily virtual mindfulness groups, and decompression groups for high-stress units. In order to meet the behavioral health, mental health, and substance abuse needs of our community, we have focused on increasing access to care for all ages. The Boh Center for Child Development is one of the largest multi-disciplinary child focused centers in the Gulf South utilizing interdisciplinary team evaluations, integrated treatment protocols, and supports parents within the school setting to navigate special education services and provide family centered treatment plans. We continue to provide inpatient psychiatric services at our flagship hospital, Ochsner Medical Center, outpatient mental health services and clinical psychiatric services. The system-wide Opioid Stewardship Committee continues to develop best-practices in decreasing the use of opioids. Ochsner launched the iCare program with the Lambeth House to offer telehealth services for dementia and Alzheimer's care to allow these patients to stay at home while receiving proactive and continuing care. In 2018, Ochsner Health partnered with Acadia Healthcare to open River Place Behavioral Health, an 82-bed inpatient facility that treats patients starting at age 12. Chronic Disease Ochsner's digital medicine programs changes the way patients manage chronic diseases like hypertension and diabetes through wearable technology that monitors levels and alerts care providers. 71% of participants in the hypertension digital medicine program achieved control within 90 days of entering the program. Diabetes digital medicine program allows diabetic patients to measure blood sugar levels anywhere and automatically transmit the information to their care teams. Care teams use information to adjust treatment plans, medications and provide lifestyle guidance resulting in significant improvements in blood sugar control, patient activation and completing important health maintenance measures. The Ochsner InnovationHub opened in 2019 as a way for community members to have access to learn about digital medicine options to manage chronic disease, explore healthy lifestyle education, and have interactive experiences centered around healthcare. In community centers, churches, schools, and businesses throughout Ochsner communities, we provide expert speakers that cover topics centered around managing chronic diseases, prevention strategies, and a host of other health topics for community members. All Ochsner campuses provide support groups for a variety of topics including, managing chronic health conditions, transplant support, mental health, pre- and post-natal, sibling classes, geriatric, and women's health. ALL IDENTIFIED SIGNIFICANT NEEDS WERE ADDRESSED.
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Schedule H, Part V, Section B, Line 13 Facility A, 1
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Facility A, 1 - OCHSNER CLINIC FOUNDATION FACILITY REPORTING GROUP A. PATIENTS WHOSE FAMILY INCOME EXCEEDS 200% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, FOR EXAMPLE CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF OCHSNER MANAGEMENT.
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Schedule H, Part V, Section B, Line 15 Facility A, 1
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Facility A, 1 - OCHSNER CLINIC FOUNDATION FACILITY REPORTING GROUP A. The FAP application is provided to the patient or their representative immediately upon request.
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Schedule H, Part V, Section B, Line 16 Facility A, 1
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Facility A, 1 - OCHSNER CLINIC FOUNDATION FACILITY REPORTING GROUP A. THE POLICY IS INCLUDED IN PATIENT BILLING STATEMENTS.
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Schedule H, Part V, Section B, Line 3E
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THE NEEDS IDENTIFIED IN THE CHNA WERE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY, AS PRIORITIZED BY THE COMMUNITY LEADERS.
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Schedule H, Part V, Section B, Line 5 Facility B, 1
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Facility B, 1 - OCHSNER MEDICAL CENTER - HANCOCK FACILITY REPORTING GROUP B. INFORMATION FROM THE PUBLIC WAS SOLICITED IN TWO WAYS: INTERVIEW OF KEY COMMUNITY STAKEHOLDERS AND SURVEYS HEALTH PROVIDERS. THE HOSPITAL IDENTIFIED KEY COMMUNITY STAKEHOLDERS, LEADERS FROM ORGANIZATIONS THAT HAVE SPECIAL KNOWLEDGE AND/OR EXPERTISE IN PUBLIC HEALTH, AGENCIES WITH INFORMATION RELATIVE TO THE HEALTH NEEDS OF THE COMMUNITY AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY. SUCH PERSONS WERE INTERVIEWED, PARTICIPATED IN FOCUS GROUPS AND/OR WERE SURVEYED AS PART OF THE NEEDS ASSESSMENT PLANNING PROCESS. AS PART OF THE CHNA PHASE, TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY STAKEHOLDERS IN THE SERVICE AREA TO BETTER UNDERSTAND THE CHANGING COMMUNITY HEALTH ENVIRONMENT. THE INTERVIEWS OFFERED COMMUNITY LEADERS AN OPPORTUNITY TO PROVIDE FEEDBACK ON THE NEEDS OF THE COMMUNITY, SUGGESTIONS ON SECONDARY DATA RESOURCES TO REVIEW AND EXAMINE, AND OTHER INFORMATION RELEVANT TO THE STUDY. AS PART OF THE CHNA PROJECT, TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY STAKEHOLDERS TO BETTER UNDERSTAND THE CHANGING COMMUNITY HEALTH ENVIRONMENT. COMMUNITY STAKEHOLDER INTERVIEWS WERE CONDUCTED IN FEBRUARY 2019 AND CONTINUED THROUGH APRIL 2019. COMMUNITY STAKEHOLDERS TARGETED FOR INTERVIEWS ENCOMPASSED A WIDE VARIETY OF PROFESSIONAL BACKGROUNDS INCLUDING: 1) PUBLIC HEALTH EXPERTS, 2) PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH-RELATED DATA, 3) REPRESENTATIVES OF UNDERSERVED POPULATIONS, 4) GOVERNMENT LEADERS, AND 5) RELIGIOUS LEADERS. TOP COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED BY COMMUNITY LEADERS DURING A REGIONAL COMMUNITY HEALTH NEEDS IDENTIFICATION FORUM HELD IN JUL 2019. CONSULTANTS PRESENTED TO COMMUNITY LEADERS THE CHNA FINDINGS FROM ANALYZING SECONDARY DATA, KEY STAKEHOLDER INTERVIEWS, AND SURVEYS. COMMUNITY LEADERS DISCUSSED THE DATA PRESENTED, SHARED THEIR VISIONS AND PLANS FOR COMMUNITY HEALTH IMPROVEMENT IN THEIR COMMUNITIES, AND IDENTIFIED AND PRIORITIZED THE TOP COMMUNITY HEALTH NEEDS IN THE COMMUNITY. Examples of organizations and populations represented by participants included: Coastal Family Health Center, Gulf Coast Women's Center for Non-Violence, Mississippi Department of Health, Gulf Coast Health Communities Collaborative, Mississippi Youth Court, United Health Care, low-income mothers and families, those experiencing homelessness, families involved in the court system, and families experiencing domestic violence. THE CHNA WAS DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED IN DECEMBER 29, 2014. THE CHNA WAS APPROVED BY THE BOARD OF DIRECTORS IN DECEMBER 2019 AND THE CHNA IMPLEMENTATION STRATEGY WAS APPROVED BY THE BOARD OF DIRECTORS IN MAY 2020.
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Schedule H, Part V, Section B, Line 11 Facility B, 1
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Facility B, 1 - OCHSNER MEDICAL CENTER - HANCOCK FACILITY REPORTING GROUP B. 2020 UPDATE ON 2019 COMMUNITY HEALTH NEEDS ASSESSMENT Disease Management Over 15,000 patients participated in Ochsner Digital Medicine for chronic disease. The program is available in 15 states and will expand in 2021 to serve patients, employers, payors, and health systems nationally. Ochsner increased number of patients with chronic conditions cared for by Digital Medicine by 67%. Ochsner's Digital Medicine Net Promoter Score (a patient's willingness to recommend a product or service) is 87.5, exceeding industry best practices and those of consumer services like Netflix and Amazon. Early Detection & Screenings Ochsner urged patients to complete vaccinations and cancer screenings despite the pandemic, completing more than 178,000 screenings for breast, colon, cervical, and other cancers, and 3,381 HPV vaccinations that help protect against certain cancers. Access to Care Ochsner is at the forefront in new digital innovations that improve health and benefit patients and healthcare providers wherever they are. Our innovative telemedicine and consumer-focused digital solutions increase access to specialized care for adult and pediatric patients from home, on the road, and in an array of healthcare settings. Provider-to-provider virtual consultations increased to 96,067 in 2020, a 60% increase over 2019. 260 unique partners participated in Ochsner's telemedicine programs in 2020, a 115% year-over-year jump. UniteUs is a community resource referral platform that allows Ochsner team members to connect patients with community-based resources that can assist with providing services and closing gaps of patients' non-clinical needs. Considering the long term need to continue to grow the pipeline of healthcare providers, Ochsner has made significant investments in K-12 and Healthcare Education. Over 13,200 K-12 students and teachers were engaged in Ochsner's K-12 STEM Education Program Teacher Professional Development programs that span across the state of Louisiana and into Mississippi. The Ochsner Clinical School and Graduate Medical Education Programs brought over 800 students through medical training programs in 2019 and we continued to partner with the Chamberlain School of Nursing at Ochsner to prepare the next generation of nurses. Our Workforce Development programs worked with Louisiana Community and Technical Colleges throughout Louisiana to host incumbent training and workforce development programs. The programs in Greater New Orleans, Northshore, Lake Charles, Bayou, and Baton Rouge trained 411 unemployed or underemployed adults at no cost to the student, with a 100% graduation rate and 100% employment upon graduation rate in roles as Medical Assistant, Pharmacy Tech, Coding, and Patient Care Technician. Community Education Ochsner is focused on the need to provide opportunities for community members and patients to learn about their health and how to improve or maintain it by empowering them with education and learning opportunities. The Ochsner Eat Fit program makes it easy for community members to make the right decisions for their health through collaborative work with local restaurants, schools, and sports arenas in New Orleans, Northshore, Baton Rouge, Shreveport, and Acadiana. Ochsner provides 6 Registered Dieticians to partner with 336 restaurant partners to review their menus and certify approved "Eat Fit" options. Ochsner provides the "CHOP" After-School cooking program at schools and community centers in the Greater New Orleans, Baton Rouge, Northshore, and Hancock Mississippi regions. This no-cost, 8-week program gives young people the opportunity to learn hands-on cooking skills through health education and healthy recipes. The Ochsner Corporate Wellness team provided over 3,500 no-cost health screenings to community members, teachers, and local organizations across regions. Ochsner Tobacco Cessation and Education programs educate local students through interactive tobacco prevention programs. Additionally, the Tobacco Control & Prevention program offers 23 cessation clinic sites that provide free tobacco cessation services to patients who are eligible for the tobacco trust program. Over 15,000 people have participated since the start of the program which has a 12-month quit rate of 30%. System wide, over 10,400 unique patients demonstrated a 29.8% quit rate. Cessation clinics are located in the Greater New Orleans Area, Baton Rouge, and the Northshore. ALL IDENTIFIED SIGNIFICANT NEEDS WERE ADDRESSED.
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Schedule H, Part V, Section B, Line 13 Facility B, 1
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Facility B, 1 - OCHSNER MEDICAL CENTER - HANCOCK FACILITY REPORTING GROUP B. PATIENTS WHOSE FAMILY INCOME EXCEEDS 200% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, FOR EXAMPLE CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF OCHSNER MANAGEMENT.
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Schedule H, Part V, Section B, Line 15 Facility B, 1
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Facility B, 1 - OCHSNER MEDICAL CENTER - HANCOCK FACILITY REPORTING GROUP B. The FAP application is provided to the patient or their representative immediately upon request.
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Schedule H, Part V, Section B, Line 16 Facility B, 1
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Facility B, 1 - OCHSNER MEDICAL CENTER - HANCOCK FACILITY REPORTING GROUP B. THE POLICY IS INCLUDED IN PATIENT BILLING STATEMENTS.
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Schedule H, Part V, Section B, Line 3E
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The needs identified in the CHNA were a prioritized description of the significant health needs in the community, as prioritized by the community leaders.
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Schedule H, Part V, Section B, Line 5 Facility C, 1
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Facility C, 1 - OCHSNER REHABILITATION HOSPITAL FACILITY REPORTING GROUP C. INFORMATION FROM THE PUBLIC WAS SOLICITED IN TWO WAYS: INTERVIEW OF KEY COMMUNITY STAKEHOLDERS AND SURVEYS HEALTH PROVIDERS. THE HOSPITAL IDENTIFIED KEY COMMUNITY STAKEHOLDERS, LEADERS FROM ORGANIZATIONS THAT HAVE SPECIAL KNOWLEDGE AND/OR EXPERTISE IN PUBLIC HEALTH, AGENCIES WITH INFORMATION RELATIVE TO THE HEALTH NEEDS OF THE COMMUNITY AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY. SUCH PERSONS WERE INTERVIEWED, PARTICIPATED IN FOCUS GROUPS AND/OR WERE SURVEYED AS PART OF THE NEEDS ASSESSMENT PLANNING PROCESS. AS PART OF THE CHNA PHASE, TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY STAKEHOLDERS IN THE SERVICE AREA TO BETTER UNDERSTAND THE CHANGING COMMUNITY HEALTH ENVIRONMENT. THE INTERVIEWS OFFERED COMMUNITY LEADERS AN OPPORTUNITY TO PROVIDE FEEDBACK ON THE NEEDS OF THE COMMUNITY, SUGGESTIONS ON SECONDARY DATA RESOURCES TO REVIEW AND EXAMINE, AND OTHER INFORMATION RELEVANT TO THE STUDY. AS PART OF THE CHNA PROJECT, TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY STAKEHOLDERS TO BETTER UNDERSTAND THE CHANGING COMMUNITY HEALTH ENVIRONMENT. COMMUNITY STAKEHOLDER INTERVIEWS WERE CONDUCTED IN FEBRUARY 2018 AND CONTINUED THROUGH APRIL 2018. COMMUNITY STAKEHOLDERS TARGETED FOR INTERVIEWS ENCOMPASSED A WIDE VARIETY OF PROFESSIONAL BACKGROUNDS INCLUDING: 1) PUBLIC HEALTH EXPERTS, 2) PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH-RELATED DATA, 3) REPRESENTATIVES OF UNDERSERVED POPULATIONS, 4) GOVERNMENT LEADERS, AND 5) RELIGIOUS LEADERS. TOP COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED BY COMMUNITY LEADERS DURING A REGIONAL COMMUNITY HEALTH NEEDS IDENTIFICATION FORUM HELD IN JUL 2018. CONSULTANTS PRESENTED TO COMMUNITY LEADERS THE CHNA FINDINGS FROM ANALYZING SECONDARY DATA, KEY STAKEHOLDER INTERVIEWS, AND SURVEYS. COMMUNITY LEADERS DISCUSSED THE DATA PRESENTED, SHARED THEIR VISIONS AND PLANS FOR COMMUNITY HEALTH IMPROVEMENT IN THEIR COMMUNITIES, AND IDENTIFIED AND PRIORITIZED THE TOP COMMUNITY HEALTH NEEDS IN THE COMMUNITY. THE FOLLOWING IS A LIST OF COMMUNITY ORGANIZATIONS THAT PARTICIPATED IN THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS: 504HEALTHNET, ACCESS HEALTH LOUISIANA, AGENDA FOR CHILDREN, AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION, ANDREA'S RESTAURANT, BACKYARD GARDENERS NETWORK, BATON ROUGE HEALTH DISTRICT, BELLE CHASSE YMCA, BOYS & GIRLS CLUBS WEST BANK, BROAD COMMUNITY CONNECTIONS, BRYAN BELL METROPOLITAN LEADERSHIP FORUM, BUREAU OF CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION, BUREAU OF FAMILY HEALTH, CAFE HOPE, CAFFIN AVENUE SDA CHURCH, CAPITAL AREA HUMAN SERVICES, CCOSJ, CENTRAL CHAMBER OF COMMERCE, CENTRAL LAFAYETTE HIGH SCHOOL, CHILDREN'S BUREAU NEW ORLEANS, CITY OF BATON ROUGE, CITY OF COVINGTON, CITY OF KENNER, CITY OF MANDEVILLE, CITY OF NEW ORLEANS EMERGENCY MEDICAL SERVICES, CITY OF SLIDELL, CIVIC COALITION WEST BANK, COUNCIL ON AGING OF ST, COVENANT HOUSE NEW ORLEANS, COVINGTON FOOD BANK, CRESCENT DENTAL, DAUGHTERS OF CHARITY, EAST JEFFERSON GENERAL HOSPITAL, EAST ST, EXCELTH FAMILY HEALTH CENTER, FIFTH DISTRICT SAVINGS BANK, FRIENDS OF LAFITTE GREENWAY, GHEENS NEEDY FAMILY, GIN WEALTH MANAGEMENT PARTNERS, GOOD SAMARITAN FOOD BANK, GULF COAST BANK & TRUST COMPANY, HEALTH GUARDIANS OF CATHOLIC CHARITIES ARCHDIOCESE OF NEW ORLEANS, HOSPITAL SERVICE DISTRICT, HUB INTERNATIONAL GULF SOUTH, HUMANA, HUMANA BOLD GOAL, JEFFCAP, JEFFERSON CHAMBER OF COMMERCE, JEFFERSON PARISH COUNCIL ON AGING, JEFFERSON PARISH PUBLIC SCHOOL SYSTEM, JEWISH FAMILY SERVICES, JOHN J, JUNIOR LEAGUE OF NEW ORLEANS, KENNER DISCOVERY HEALTH SCIENCES ACADEMY, KINGSLEY HOUSE, LAFOURCHE BEHAVIORAL HEALTH CENTER, LAFOURCHE FIRE DEPARTMENT DISTRICT #1, LAFOURCHE HOSPITAL SERVICE DISTRICT #2, LAFOURCHE PARISH GOVERNMENT, LAFOURCHE PARISH SCHOOL BOARD, LAFOURCHE PARISH SHERIFF'S OFFICE, LAKEVIEW REGIONAL MEDICAL CENTER, LCMC HEALTH, LCMC HEALTH - CHILDREN'S HOSPITAL, LCMC HEALTH - NEW ORLEANS EAST HOSPITAL, LCMC HEALTH - TOURO INFIRMARY, LCMC HEALTH - UNIVERSITY MEDICAL CENTER, LCMC HEALTH - WEST JEFFERSON MEDICAL CENTER, LIMB UP, LOCKPORT CITY COUNCIL, LOUISIANA CHILDREN'S RESEARCH CENTER FOR DEVELOPMENT AND LEARNING, LOUISIANA DEPARTMENT OF HEALTH, LOUISIANA ORGAN PROCUREMENT AGENCY, LOUISIANA POLICY INSTITUTE FOR CHILDREN, LOUISIANA PUBLIC HEALTH INSTITUTE, LOUISIANA PUBLIC HEALTH INSTITUTE, LOUISIANA STATE UNIVERSITY AGRICULTURAL CENTER, LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER, LOUISIANA STATE UNIVERSITY/UNIVERSITY MEDICAL CENTER, MARKET UMBRELLA, MARTIN LUTHER KING, JR, METHODIST HEALTH SYSTEM FOUNDATION, INC, METROPOLITAN HUMAN SERVICES DISTRICT, NEW ORLEANS CHAMBER OF COMMERCE, NEW ORLEANS COUNCIL ON AGING, NEW ORLEANS EMERGENCY MEDICINE, NEW ORLEANS HEALTH DEPARTMENT, NEW ORLEANS MISSION/GIVING HOPE RETREAT, NEW PATHWAYS NEW ORLEANS, NEWMAN, MATHIS, BRADY & SPEDALE, NOLA BUSINESS ALLIANCE, NORTHSHORE COMMUNITY FOUNDATION, NORTHSHORE HEALTHCARE ALLIANCE, NURSE FAMILY PARTNERSHIP, OCHSNER BAPTIST MEDICAL CENTER, OCHSNER HEALTH SYSTEM, OCHSNER HEALTH SYSTEM BOARD OF TRUSTEES, OCHSNER MEDICAL CENTER - BATON ROUGE, OCHSNER MEDICAL CENTER - KENNER, OCHSNER MEDICAL CENTER - KENNER HOSPITAL BOARD, OCHSNER MEDICAL CENTER - NORTH SHORE, OCHSNER MEDICAL CENTER - WEST BANK, OCHSNER REHABILITATION HOSPITAL IN PARTNERSHIP WITH SELECT MEDICAL, OCHSNER ST, ONE HAVEN INC, PEOPLE'S HEALTH, RAINBOW CHILD CARE CENTER, INC, READY RESPONDERS, REGINA COELI CHILD DEVELOPMENT CENTER, RIVER PARISH BEHAVIORAL CENTER, RIVER PLACE BEHAVIORAL HEALTH A SERVICE OF OCHSNER HEALTH SYSTEM, SAIRP, SALVATION CHRISTIAN FELLOWSHIP, SECOND BAPTIST CHURCH, SECOND HARVEST FOOD BANK, SLIDELL MEMORIAL HOSPITAL, SOUTH CENTRAL PLANNING & DEVELOPMENT COMMISSION (SCPDC), ST. JOHN COUNCIL, ST. JOHN VOLUNTEER CITIZEN, ST. TAMMANY CORONER'S OFFICE, ST. TAMMANY DEPARTMENT OF HEALTH & HUMAN SERVICES, ST. TAMMANY PARISH CLERK OF COURT; 22ND JUDICIAL DISTRICT COURT, ST. TAMMANY PARISH GOVERNMENT HEALTH & HUMAN SERVICES, ST. TAMMANY PARISH HOSPITAL, ST. THOMAS HEALTH CENTER, SUSAN G KOMEN, THE BLOOD CENTER, THE HAVEN, THE LOUISIANA CAMPAIGN FOR TOBACCO-FREE LIVING, THE METROPOLITAN HOSPITAL COUNCIL OF NEW ORLEANS, THE NATIONAL ALLIANCE ON MENTAL ILLNESS, TPRC, TULANE LAKESIDE HOSPITAL FOR WOMEN AND CHILDREN, TULANE MEDICAL CENTER, US HOUSE OF REPRESENTATIVES, UMCNO FORENSICS, UNITED HEALTHCARE, UNITED WAY, UNITED WAY FOR GREATER NEW ORLEANS, UNITED WAY OF SOUTHEAST LOUISIANA, UNITY OF GREATER NEW ORLEANS, VACHERIE GHEENS COMMUNITY CENTER, VIET, VOLUNTEERS OF AMERICA, WELL-AHEAD LOUISIANA REGION 9, WEST JEFFERSON MEDICAL CENTER, WEST JEFFERSON MEDICAL CENTER FOUNDATION DIRECTOR, WEST JEFFERSON MEDICAL CENTER; AUXILIARY THE CHNA WAS DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED IN DECEMBER 29, 2014. THE CHNA WAS APPROVED BY THE BOARD OF DIRECTORS IN OCTOBER 2018 AND THE CHNA IMPLEMENTATION STRATEGY WAS APPROVED BY THE BOARD OF DIRECTORS IN APRIL 2019.
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Schedule H, Part V, Section B, Line 11 Facility C, 1
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Facility C, 1 - OCHSNER REHABILITATION HOSPITAL FACILITY REPORTING GROUP C. 2020 UPDATE ON 2018 COMMUNITY HEALTH NEEDS ASSESSMENT Behavioral Health/Mental Health/Substance Abuse Ochsner for decades has applied excellence, innovation, research, and education to the delivery of psychiatry and behavioral health services. Ochsner offers a breadth of services and specialty treatment programs including short-term outpatient counseling, group therapy, hospital inpatient, and day treatment programs. In 2020, 24 providers and expanded new behavioral health services were added to Ochsner facilities in Louisiana's Northshore, South shore, Baton Rouge, and Bayou regions. There was a 20% growth in unique patients served across outpatient clinics for behavioral health and addictive disorders. During the COVID-19 pandemic, the Ochsner system conducted 90% of behavioral health visits virtually, seeing 10,780 patients through the MyOchsner patient portal. Additionally, the Office of Professional Well-Being led the COVID-19 Staff Support and Wellness Initiative, providing on-demand access to a crisis phone line and psychiatric consultation, twice-daily virtual mindfulness groups, and decompression groups for high-stress units. In order to meet the behavioral health, mental health, and substance abuse needs of our community, we have focused on increasing access to care for all ages. The Boh Center for Child Development is one of the largest multi-disciplinary child focused centers in the Gulf South utilizing interdisciplinary team evaluations, integrated treatment protocols, and supports parents within the school setting to navigate special education services and provide family centered treatment plans. We continue to provide inpatient psychiatric services at our flagship hospital, Ochsner Medical Center, outpatient mental health services and clinical psychiatric services. The system-wide Opioid Stewardship Committee continues to develop best-practices in decreasing the use of opioids. Ochsner launched the iCare program with the Lambeth House to offer telehealth services for dementia and Alzheimer's care to allow these patients to stay at home while receiving proactive and continuing care. In 2018, Ochsner Health partnered with Acadia Healthcare to open River Place Behavioral Health, an 82-bed inpatient facility that treats patients starting at age 12. Access to Care Ochsner continues to provide medical services in neighborhoods across the Greater New Orleans Region, including opening the first of 15 planned Ochsner Community Health Centers, the Ochsner Community Health Brees Family Center, in New Orleans East. A cornerstone of Ochsner's Healthy State by 2030 initiative, these centers will be located in underserved neighborhoods across Louisiana, including areas with low access to care. In 2020, Ochsner Health deepened that commitment with a new, five-year pledge of $1 million to Son of a Saint, a nonprofit organization dedicated to transforming the lives of fatherless boys in New Orleans while also inspiring mentorship, which will fund critical programmatic staff and enhance the organization's services to promote the whole person - mind, body, and spirit - through healthcare educators, social workers, and mental health providers. To increase access to care for students, Ochsner sponsors two school-based health centers within Jefferson Parish Public School System's (JPPSS) two largest high schools. JPPSS is the largest public school system in the state of Louisiana with 81,000 students and an economically disadvantaged school population of 85%. Through this sponsorship, Ochsner covers the complete cost of the Nurse Practitioners, all student wellness programs, and the rotation of Ochsner Clinical School Medical Students. Ochsner also provides for the Medical Directors for these school clinics. The Ochsner Sports Medicine Institute partnered with local schools throughout southeast Louisiana to provide low or no-cost Athletic Training services for their student athletes, including pre-sports physicals to keep student-athletes healthy. Ochsner is a recognized leader in digital medicine. Over 15,000 patients participated in Ochsner Digital Medicine for chronic disease. The program is available in 15 states and will expand in 2021 to serve patients, employers, payors, and health systems nationally. One of our most impactful initiatives is the Connected MOM program, which allows expectant mothers to stay connected to their Ochsner care team from the comfort of home through digital monitoring. Policymakers have taken notice of this Ochsner initiative, recognizing that maternal and infant mortality rates are far too high, especially within underserved communities, by initiating the Connected Maternal Online Monitoring Services (MOM) Act which requires the Centers for Medicare and Medicaid (CMS) to provide coverage recommendations for remote devices to check blood pressure, blood glucose, and pulse rates. UniteUs is a community resource referral platform that allows Ochsner team members to connect patients with community-based resources that can assist with providing services and closing gaps of patients' non-clinical needs. Considering the long term need to continue to grow the pipeline of healthcare providers, Ochsner has made significant investments in K-12 and Healthcare Education. Over 13,200 K-12 students and teachers were engaged in Ochsner's K-12 STEM Education Program Teacher Professional Development programs that span across the state of Louisiana and into Mississippi. Our Workforce Development programs worked with Louisiana Community and Technical Colleges throughout Louisiana to host incumbent training and workforce development programs. The programs in Greater New Orleans, Northshore, Lake Charles, Bayou, and Baton Rouge trained 411 unemployed or underemployed adults at no cost to the student, with a 100% graduation rate and 100% employment upon graduation rate in roles as Medical Assistant, Pharmacy Tech, Coding, and Patient Care Technician. Health Education & Health Literacy Ochsner is focused on the need to provide opportunities for community members and patients to learn about their health and how to improve or maintain it by empowering them with education and learning opportunities. The Ochsner Eat Fit program makes it easy for community members to make the right decisions for their health through collaborative work with local restaurants, schools, and sports arenas in New Orleans, Northshore, Baton Rouge, Shreveport, and Acadiana. Ochsner provides 6 Registered Dieticians to partner with 336 restaurant partners to review their menus and certify approved "Eat Fit" options. Ochsner provides the "CHOP" After-School cooking program at schools and community centers in the Greater New Orleans, Baton Rouge, Northshore, and Hancock Mississippi regions. This no-cost, 8-week program gives young people the opportunity to learn hands-on cooking skills through health education and healthy recipes. The Ochsner Corporate Wellness team provided over 3,500 no-cost health screenings to community members, teachers, and local organizations across regions. Ochsner Tobacco Cessation and Education programs educate local students through interactive tobacco prevention programs. Additionally, the Tobacco Control & Prevention program offers 23 cessation clinic sites that provide free tobacco cessation services to patients who are eligible for the tobacco trust program. Over 15,000 people have participated since the start of the program which has a 12-month quit rate of 30%. System wide, over 10,400 unique patients demonstrated a 29.8% quit rate. Cessation clinics are located in the Greater New Orleans Area, Baton Rouge, and the Northshore. ALL IDENTIFIED SIGNIFICANT NEEDS WERE ADDRESSED.
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Schedule H, Part V, Section B, Line 13 Facility C, 1
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Facility C, 1 - OCHSNER REHABILITATION HOSPITAL FACILITY REPORTING GROUP C. PATIENTS WHOSE FAMILY INCOME EXCEEDS 200% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, FOR EXAMPLE CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF MANAGEMENT.
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Schedule H, Part V, Section B, Line 2
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Ochsner St. Mary WAS ACQUIRED AS OF 10/01/2019.
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Schedule H, Part V, Section B, Line 13 Facility D, 1
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Facility D, 1 - OCHSNER ST. MARY FACILITY REPORTING GROUP D. PATIENTS WHOSE FAMILY INCOME EXCEEDS 200% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, FOR EXAMPLE CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF OCHSNER MANAGEMENT.
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Schedule H, Part V, Section B, Line 15 Facility D, 1
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Facility D, 1 - OCHSNER ST. MARY FACILITY REPORTING GROUP D. The FAP application is provided to the patient or their representative immediately upon request.
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Schedule H, Part V, Section B, Line 16 Facility D, 1
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Facility D, 1 - OCHSNER ST. MARY FACILITY REPORTING GROUP D. The policy is included in patient billing statements.
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Schedule H, Part V, Section B, Line 13 Facility E, 1
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Facility E, 1 - North Shore Rehabilitation Hospital FACILITY REPORTING GROUP E. PATIENTS WHOSE FAMILY INCOME EXCEEDS 200% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, FOR EXAMPLE CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF MANAGEMENT.
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