Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 07-01-2022 , and ending 06-30-2023
BCheck if applicable:
CName of organization
CHRISTIANA CARE HEALTH SERVICES INC
 
% SR VP'S OFFICE
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4000 NEXUS DRIVE NW3-100
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WILMINGTON, DE19803
D Employer identification number

51-0103684
E Telephone number

G Gross receipts $ 3,169,010,325
F Name and address of principal officer:
JANICE NEVIN MD
4000 NEXUS DRIVE
WILMINGTON,DE19803
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHRISTIANACARE.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1965
M State of legal domicile: DE
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: OUR MISSION AS AN ORGANIZATION IS TO SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 11
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 12,272
6 Total number of volunteers (estimate if necessary) ............. 6 569
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,680,328
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 43,095,263 53,965,055
9 Program service revenue (Part VIII, line 2g) ......... 2,339,408,720 2,567,645,527
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 205,839,630 60,054,269
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 16,410,989 16,332,229
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,604,754,602 2,697,997,080
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 516,250
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,432,780,622 1,555,860,667
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 986,479,046 1,031,979,043
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,419,259,668 2,588,355,960
19 Revenue less expenses. Subtract line 18 from line 12....... 185,494,934 109,641,120
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 4,231,902,873 4,483,979,485
21 Total liabilities (Part X, line 26)............. 1,096,190,099 1,106,827,681
22 Net assets or fund balances. Subtract line 21 from line 20..... 3,135,712,774 3,377,151,804
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: WE SERVE OUR NEIGHBORS AS EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe 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 (Code:   ) (Expenses $ 2,210,804,304 including grants of $ 516,250 ) (Revenue $ 2,578,197,043 )
AS PART OF ITS MISSION OF SERVICE, THE HOSPITALS AND MEDICAL STAFF OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") OFFER A FULL RANGE OF HEALTH SERVICES TO ADDRESS THE NEEDS OF ITS LOCAL COMMUNITIES. THIS INCLUDES THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES TO RESIDENTS OF THE STATE OF DELAWARE, NORTHERN MARYLAND, SOUTHEASTERN PENNSYLVANIA AND SOUTHERN NEW JERSEY, WITHOUT REGARD TO THE PATIENTS' RACE, GENDER, ETHNICITY, AGE, DISABILITY, RELIGION, OR ABILITY TO PAY. DURING FISCAL 2023, THE HOSPITALS OF CCHS RECORDED 402,555 PATIENT DAYS, 56,359 ADMISSIONS, 192,088 EMERGENCY DEPARTMENT VISITS, AND THE BIRTHS OF 6,325 BABIES. ADDITIONALLY, CCHS'S MEDICAL GROUP ENGAGED WITH PATIENTS DURING A TOTAL OF 292,658 PRIMARY CARE VISITS. DURING THE FISCAL YEAR, CCHS PROVIDED $52,130,184 OF UNCOMPENSATED AND UNREIMBURSED CARE, AND ENGAGED IN A VARIETY OF OTHER ACTIVITIES TO SUPPORT AND ASSIST THE LOCAL COMMUNITIES THAT ARE MORE FULLY DISCUSSED IN SCHEDULE H.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet2,210,804,304
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment
List of Attached Documents:
// Content
......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
List of Attached Documents:
// Content
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
List of Attached Documents:
// Content
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
List of Attached Documents:
// Content
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
List of Attached Documents:
// Content
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
List of Attached Documents:
// Content
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
List of Attached Documents:
// Content
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
List of Attached Documents:
// Content
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
352
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
12,272
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletSR VP'S OFFICE4000 NEXUS DRIVE AVENUE NORTH   WILMINGTON,DE19803 (302) 428-2441
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) JANICE E NEVIN MD......................................................................
PRESIDENT & CEO
 43.0
.................
2.0 		X   X       2,944,902 0 9,778
(2) KENNETH SILVERSTEIN MD......................................................................
CHIEF PHYS. EXEC- THRU 1/23
 44.0
.................
1.0 		    X       1,177,731 0 17,648
(3) RAY A BLACKWELL MD......................................................................
CHIEF OF CARDIAC SURGERY
 45.0
.................
0.0 		        X   1,057,088 0 20,501
(4) RANDALL GABORIAULT......................................................................
CHIEF DIGITAL & INFO. OFFICER
 45.0
.................
0.0 		      X     983,750 0 90,042
(5) SHARON KURFUERST......................................................................
COO- THRU 1/23
 0.0
.................
0.0 		      X     967,304 0 84,880
(6) KIRK N GARRATT MD......................................................................
MED. DIR. CTR FOR H/V HEALTH
 45.0
.................
0.0 		        X   967,643 0 7,085
(7) NEIL JASANI MD......................................................................
CHIEF PEOPLE OFFICER
 45.0
.................
0.0 		      X     939,001 0 20,501
(8) ROBERT MCMURRAY......................................................................
CFO, TREAS. & ASS'T SECRETARY
 36.0
.................
9.0 		    X       857,940 0 86,827
(9) VINAY K GHEYI......................................................................
CHAIR DEPARTMENT RADIOLOGY
 45.0
.................
0.0 		        X   922,721 0 13,663
(10) NICHOLAS J PETRELLI MD......................................................................
MED. DIR, CCHS CANCER PROGRAM
 45.0
.................
0.0 		        X   901,292 0 12,272
(11) PAUL K DAVIS MD......................................................................
PHYSICIAN - CARDIAC SURGEON
 45.0
.................
0.0 		        X   873,870 0 20,501
(12) RICHARD CUMING......................................................................
CHIEF OPERATING OFFICER
 44.0
.................
1.0 		      X     799,573 0 68,418
(13) JENNIFER L SCHWARTZ ESQ......................................................................
CORPORATE SECRETARY
 35.0
.................
10.0 		    X       745,416 0 78,435
(14) LISA MAXWELL MD......................................................................
PRESIDENT, CC MEDICAL GROUP
 45.0
.................
0.0 		      X     703,655 0 71,570
(15) FREDERIC T HARAD MD......................................................................
DIRECTOR
 45.0
.................
0.0 		X           761,349 0 12,272
(16) BETTINA TWEARDY-RIVEROS......................................................................
CHIEF PUBLIC AFFAIRS OFFICER
 45.0
.................
0.0 		      X     653,726 0 62,382
(17) VINAY MAHESHWARI MD......................................................................
DIRECTOR- AS OF 1/1/23
 45.0
.................
0.0 		X           607,271 0 91
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) DAVID B STRATTON ESQ........................................................................
CHAIR
 44.0
.......................1.0 		X   X       0 0 0
(19) LOSSIE FREEMAN........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(20) KATHY JANVIER........................................................................
DIRECTOR- AS OF 1/1/23
 1.0
.......................1.0 		X           0 0 0
(21) ERIC T JOHNSON MD........................................................................
DIRECTOR- THRU 12/31/22
 1.0
.......................0.0 		X           0 0 0
(22) LOLITA A LOPEZ........................................................................
VICE CHAIR
 1.0
.......................0.0 		X   X       0 0 0
(23) TOM MOORE........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(24) JULIE TOPKIS NASON........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(25) BARRY NIZIOLEK........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(26) PAWAN RASTOGI MD........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(27) SALVATORE CHIP ROSSIE........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(28) CHRISTINE SAUERS........................................................................
DIRECTOR
 1.0
.......................0.0 		X           0 0 0
(29) DWIGHT D THOMEY ESQ........................................................................
DIRECTOR
 1.0
.......................3.0 		X           0 0 0


1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 16,864,232 0 676,866
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet3,325
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
GENERAL HEALTHCARE RESOURCES,
2250 HICKORY ROAD SUITE 240
PLYMOUTH MEETING,PA19462 		TEMPORARY STAFFING 94,190,860
CERNER CORPORATION,
PO BOX 959156
ST LOUIS,MO631959156 		IT SERVICES 27,015,449
CONSTRUCTION SERVICES GROUP LLC,
1630 WEST CHESTER PIKE
WEST CHESTER,PA19382 		CONSTRUCTION SRVCS 22,524,820
DELOITTE CONSULTING LLP,
PO BOX 844717
DALLAS,TX75284 		CONSULTING SERVICES 8,285,423
MILESTONE CONSULTING COMPANY INC,
4 MILL PARK COURT
NEWARK,DE19713 		CONSULTING SERVICES 7,166,396
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet334
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a 8,554
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 2,702,461
e Government grants (contributions)1e 48,131,330
f All other contributions, gifts, grants, and similar amounts not included above1f 3,122,710
g Noncash contributions included in lines 1a - 1f:$ 1g 171,862
h Total. Add lines 1a-1f.......MediumBullet 53,965,055
Program Service RevenueAmt Business Code
2a NET PROGRAM SERVICE REVENUES 622110 2,505,720,793 2,505,720,793 0 0
b OTHER REVENUES 900099 61,924,734 56,535,877 1,680,328 3,708,529
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 2,567,645,527
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 50,847,682     50,847,682
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents 0 4,155,639 6a
b Less: rental expenses     6b
c Rental income or (loss) 0 4,155,639 6c
d Net rental income or (loss).......MediumBullet 4,155,639     4,155,639
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 6,170,067 474,049,765 7a
b Less: cost or other basis and sales expenses   471,013,245 7b
c Gain or (loss) 6,170,067 3,036,520 7c
d Net gain or (loss).........MediumBullet 9,206,587     9,206,587
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a MAINTENANCE FEES 531390 1,625,074 0 0 1,625,074
b AFFILIATE REVENUES 900099 10,551,516 10,551,516 0 0
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 12,176,590
12 Total revenue. See instructions.....MediumBullet 2,697,997,080 2,572,808,186 1,680,328 69,543,511
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 516,250 516,250
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 13,854,988 11,802,284 2,052,704 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 0      
7 Other salaries and wages........ 1,207,600,869 1,028,687,167 178,913,702 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 72,859,901 62,065,246 10,794,655 0
9 Other employee benefits ....... 177,399,734 151,116,842 26,282,892 0
10 Payroll taxes ........... 84,145,175 71,678,535 12,466,640 0
11 Fees for services (non-employees):        
a Management ...... 17,464,911 13,278,657 4,186,254 0
b Legal ......... 1,679,939 1,277,266 402,673 0
c Accounting ........... 567,461 431,443 136,018 0
d Lobbying ........... 325,798 251,034 74,764  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 5,889,729 0 5,889,729 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 69,367,073 52,740,125 16,626,948 0
12 Advertising and promotion .... 5,410,127 4,113,346 1,296,781 0
13 Office expenses ....... 7,817,528 5,943,705 1,873,823 0
14 Information technology ...... 72,005,540 54,746,164 17,259,376 0
15 Royalties .. 45,612 34,679 10,933 0
16 Occupancy ........... 41,493,376 31,547,617 9,945,759 0
17 Travel ............ 2,412,007 1,833,861 578,146 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 4,877,538 3,708,416 1,169,122 0
20 Interest ........... 5,815,440 4,788,426 1,027,014 0
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 116,787,364 85,036,341 31,751,023 0
23 Insurance ... 24,877,551 18,914,524 5,963,027 0
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 451,872,980 451,872,980 0 0
b OTHER SUPPLIES AND SERVICES 203,269,069 154,419,396 48,849,673 0
c
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 2,588,355,960 2,210,804,304 377,551,656 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 141,444,726 1 181,844,123
2 Savings and temporary cash investments ......... 191,567,741 2 87,857,829
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 370,268,568 4 421,401,431
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 46,112,024 8 49,504,179
9 Prepaid expenses and deferred charges ...... 28,837,684 9 27,951,704
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,796,158,166
b Less: accumulated depreciation 10b 1,728,880,425 1,047,844,303 10c 1,067,277,741
11 Investments—publicly traded securities . 1,522,391,684 11 1,672,961,947
12 Investments—other securities. See Part IV, line 11 ..... 419,786,225 12 491,444,744
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 1,015,805 14 1,015,805
15 Other assets. See Part IV, line 11 ........... 462,634,113 15 482,719,982
16 Total assets. Add lines 1 through 15 (must equal line 33)... 4,231,902,873 16 4,483,979,485
Liabilities 17 Accounts payable and accrued expenses ..... 432,548,032 17 446,857,675
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 305,985,527 20 298,936,087
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 357,656,540 25 361,033,919
26 Total liabilities. Add lines 17 through 25.. 1,096,190,099 26 1,106,827,681
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 3,078,587,122 27 3,317,366,405
28 Net assets with donor restrictions ........... 57,125,652 28 59,785,399
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 3,135,712,774 32 3,377,151,804
33 Total liabilities and net assets/fund balances ........ 4,231,902,873 33 4,483,979,485
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,697,997,080
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,588,355,960
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
109,641,120
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
3,135,712,774
5
Net unrealized gains (losses) on investments ...............
5
175,474,040
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-43,676,130
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
3,377,151,804
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. 24,577,838 80,735,115 128,076,121 43,095,263 53,965,055 330,449,392
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....           0
3 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
4 Total. Add lines 1 through 3 24,577,838 80,735,115 128,076,121 43,095,263 53,965,055 330,449,392
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. 0
6 Public support. Subtract line 5 from line 4. 330,449,392
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
7 Amounts from line 4.. 24,577,838 80,735,115 128,076,121 43,095,263 53,965,055 330,449,392
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... 40,934,424 38,348,773 34,285,085 42,693,278 55,003,321 211,264,881
9 Net income from unrelated business activities, whether or not the business is regularly carried on..           0
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. 1,481,357 1,515,817 1,583,245 1,524,457 1,625,074 7,729,950
11 Total support. Add lines 7 through 10 549,444,223
12
12
10,986,419,663
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
60.142 %
15
15
60.381 %
16a
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity 		2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions 		8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2022 		(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions. 		 
6 Remaining underdistributions for 2022. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions. 		 
7 Excess distributions carryover to 2023. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990) 2022


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990) (2022)
Schedule B (Form 990) (2022) Page 2
Name of organization
CHRISTIANA CARE HEALTH SERVICES INC
  		Employer identification number
51-0103684
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 3
Name of organization
CHRISTIANA CARE HEALTH SERVICES INC
  		Employer identification number

51-0103684
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I 		(b)
Description of noncash property given 		(c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 4
Name of organization
CHRISTIANA CARE HEALTH SERVICES INC
  		Employer identification number

51-0103684
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2022)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).Click to see attachment
List of Attached Documents:
// Content

B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...................... 0 0
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................ 325,798 325,798
c Total lobbying expenditures (add lines 1a and 1b) ............................................................ 325,798 325,798
d Other exempt purpose expenditures ............................................................................... 2,588,030,162 2,644,027,194
e Total exempt purpose expenditures (add lines 1c and 1d) .................................................. 2,588,355,960 2,644,352,992
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 1,000,000
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ................................................. 250,000 250,000
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) Total
2a Lobbying nontaxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		6,000,000
c Total lobbying expenditures 230,460 249,926 249,595 325,798 1,055,779
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))		 1,500,000
f Grassroots lobbying expenditures 0 0 0 0 0
Schedule C (Form 990) 2021


Schedule C (Form 990) 2021
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
 
c
Media advertisements? ...................................................................................................
 
 
 
d
Mailings to members, legislators, or the public? .............................................................................
 
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
 
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
 
 
i
Other activities? ...................................................................................................................
 
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C (Form 990) 2021


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 58,310,687 68,569,307 62,232,483 67,336,850 69,132,135
b Contributions ... 732,143 669,502 993,569 1,520,182 518,673
c Net investment earnings, gains, and losses 3,560,384 -6,744,573 9,205,113 2,545,562 1,845,561
d Grants or scholarships ...         9,170,111
e Other expenditures for facilities
and programs ... 		3,375,036 4,183,549 3,861,858 9,170,111 4,159,519
f Administrative expenses ....          
g End of year balance ...... 59,228,178 58,310,687 68,569,307 62,232,483 58,166,739
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet38.110 %
b
Permanent endowment SchDMd Bullet42.660 %
c
Term endowment SchDMd Bullet19.230 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
Yes
 
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   32,739,798 32,739,798
b Buildings ....   1,775,133,156 966,643,543 808,489,613
c Leasehold improvements   36,581,801 11,990,592 24,591,209
d Equipment ....   911,562,797 720,091,126 191,471,671
e Other .....   40,140,614 30,155,164 9,985,450
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,067,277,741
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) OTHER SECURITIES		 491,444,744 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 491,444,744
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)CONSTRUCTION IN PROGRESS 49,128,727
(2)DUE FROM AFFILIATES 131,257,960
(3)OTHER ASSETS 173,871,029
(4)OTHER RECEIVABLES 31,776,098
(5)SUBSIDIARY INVESTMENT 96,686,168
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 482,719,982
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 361,033,919
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
FORM 990, SCHEDULE D, PART V, LINE 3A & 4 DETAIL OF ENDOWMENT FUNDS THE ORGANIZATION'S BOARD DESIGNATED ENDOWMENTS ARE INTENDED TO COVER ANNUAL INCREMENTAL OPERATING EXPENSES OF THE HEALTH SERVICES' TRANSITIONAL CANCER RESEARCH, VALUE INSTITUTE, AND INFANT MORTALITY. THE ORGANIZATION'S PERMANENT ENDOWMENT CONSISTS OF APPROXIMATELY TWENTY SIX DONOR RESTRICTED ENDOWMENT FUNDS USED FOR A VARIETY OF PURPOSES, INCLUDING SALARY AND PROGRAM SUPPORT. THE ORGANIZATION'S PURPOSE AND TIME RESTRICTED NET ASSETS ARE RESTRICTED FOR INDIGENT CARE, BUILDING AND MAINTENANCE, AND PROGRAM SUPPORT. --------------------
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region		 (f) Total expenditures
for and investments
in the region
Central America and the Caribbean     Investments   152,526,933
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ....     152,526,933
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     152,526,933
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of noncash
assistance 		(h) Description
of noncash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
FORM 990, SCHEDULE F, PART I, LINE 2 DETAIL OF SUB-CONTRACTS IN FURTHERANCE OF ITS RESEARCH ACTIVITIES, THE ORGANIZATION MAY MAKE SUB-CONTRACTS TO FOREIGN INSTITUTIONS THAT PERFORM RESEARCH IN CONNECTION WITH RESEARCH GRANTS AWARDED TO THE ORGANIZATION. THE ORGANIZATION DOES NOT CATEGORIZE ANY SUCH SUB-CONTRACTS AS GRANTS FOR FORM 990, SCHEDULE F, PARTS II AND III PURPOSES.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2022
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

 

No
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		  26 15,959,789 0 15,959,789 0.620 %
b Medicaid (from Worksheet 3, column a) . . . . .     369,199,405 345,431,411 23,767,994 0.920 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .   26 385,159,194 345,431,411 39,727,783 1.540 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 42 31,259 9,798,101 69,808 9,728,293 0.380 %
f Health professions education (from Worksheet 5) . . . 4 6 88,619,385 14,687,410 73,931,975 2.860 %
g Subsidized health services (from Worksheet 6) . . . . 1 30,892 7,459,254 4,048,903 3,410,351 0.130 %
h Research (from Worksheet 7) . 1   21,380,857 18,927,053 2,453,804 0.090 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 14 1,111 289,911 0 289,911 0.010 %
j Total. Other Benefits . . 62 63,268 127,547,508 37,733,174 89,814,334 3.470 %
k Total. Add lines 7d and 7j . 62 63,294 512,706,702 383,164,585 129,542,117 5.010 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 2   109,634 0 109,634  
3 Community support 1   152,130 0 152,130 0.010 %
4 Environmental improvements 1   1,315 0 1,315  
5 Leadership development and
training for community members		            
6 Coalition building 1   7,065 0 7,065  
7 Community health improvement advocacy 1   833 0 833  
8 Workforce development 1   223,800 0 223,800 0.010 %
9 Other            
10 Total 7   494,777 0 494,777 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
63,038,043
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
762,517
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
526,982,585
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
613,284,601
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-86,302,016
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 CHRISTIANA HOSPITAL
4755 OGLETOWN-STANTON ROAD
NEWARK,DE19718
www.christianacare.org
LICENSE #HSPTL-002 		X X   X   X X     A
2 WILMINGTON HOSPITAL
501 WEST 14TH STREET
WILMINGTON,DE19801
www.christianacare.org
LICENSE #HSPTL-001 		X X   X   X X     A
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A-CHRISTIANA AND WILMINGTON HOSPITALS
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		12
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A-CHRISTIANA AND WILMINGTON HOSPITALS
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
A-CHRISTIANA AND WILMINGTON HOSPITALS
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A-CHRISTIANA AND WILMINGTON HOSPITALS
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B, LINE 5 (INPUT FROM COMMUNITY) AS DEMONSTRATED BY OUR MISSION: WE SERVE OUR NEIGHBORS AS RESPECTFUL, EXPERT, CARING PARTNERS IN THEIR HEALTH. WE DO THIS BY CREATING INNOVATIVE, EFFECTIVE, AFFORDABLE, AND EQUITABLE SYSTEMS OF CARE THAT OUR NEIGHBORS VALUE. CHRISTIANACARE IS GUIDED BY ITS COMMITMENT TO PARTNERING WITH THOSE WE SERVE AND PROVIDING THEM WITH WHAT THEY VALUE. BECAUSE OF THIS, WE WELCOME THE TASK OF UNDERTAKING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT RELIES UPON COMMUNITY INPUT AS ANOTHER OPPORTUNITY TO LEARN FROM OUR NEIGHBORS. IN 2022, CHRISTIANACARE ISSUED CRISIS STANDARDS OF CARE FOR THE FIRST TIME IN ITS HISTORY AS COVID-19 CASES WERE REACHING NEW PEAKS IN OUR STATE. DUE TO THIS ENVIRONMENT, WE DECIDED TO GATHER INPUT THROUGH VIRTUAL COMMUNITY MEETINGS. IN-PERSON MEETINGS HELD AT ACCESSIBLE COMMUNITY LOCATIONS IS OUR PREFERENCE AS THIS ENABLED THE PARTICIPATION OF NEARLY 100 COMMUNITY MEMBERS IN OUR PRIOR CHNA, BUT WE HAD TO PRIORITIZE SAFETY. 35 INDIVIDUALS WHO REPRESENTED ORGANIZATIONS INCLUDING DELAWARE HEALTH AND SOCIAL SERVICES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTHCARE PROVIDERS, SCHOOL SYSTEMS, AND LOCAL POLICYMAKERS PARTICIPATED IN FOUR VIRTUAL COMMUNITY STAKEHOLDER MEETINGS. ALL COMMUNITY MEETINGS FOLLOWED THE SAME FORMAT. SECONDARY DATA WERE PRESENTED INCLUDING A SUMMARY OF UNFAVORABLE COMMUNITY HEALTH INDICATORS. PARTICIPANTS WERE ASKED TO PROVIDE FEEDBACK ON THE SECONDARY DATA ANALYSIS AND IDENTIFY COMMUNITY HEALTH ISSUES THAT WERE MISSING FROM THE DATA. TO CONCLUDE, ALL PARTICIPANTS WERE ASKED TO COMPLETE AN ONLINE SURVEY AND TO IDENTIFY THREE TO FIVE COMMUNITY HEALTH ISSUES THEY CONSIDERED TO BE MOST SIGNIFICANT. CHRISTIANACARE CAREGIVERS WHO PROVIDE REPRODUCTIVE HEALTH EDUCATION TO ADOLESCENTS IN SCHOOLS ALSO PROVIDED THE SECONDARY DATA PRESENTATION TO 110 STUDENTS AT WILLIAM PENN HIGH SCHOOL IN NEW CASTLE DURING THEIR HEALTH CLASSES. YOUNG PEOPLE ARE A SIGNIFICANT PART OF OUR COMMUNITY AND SO WE BELIEVE IT IS IMPORTANT TO HEAR FROM THEM TOO. IN ADDITION TO THE COMMUNITY MEETINGS, WE ALSO CONDUCTED INTERVIEWS WITH THE CABINET SECRETARY AND DEPUTY SECRETARY FOR DELAWARE HEALTH AND SOCIAL SERVICES AND THE DIRECTOR FOR THE DELAWARE DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH TO GAIN THEIR PERSPECTIVES ON THE HEALTH OF OUR COMMUNITIES. FINALLY, 45 CHRISTIANACARE CAREGIVERS FROM DIVERSE DEPARTMENTS PARTICIPATED IN TWO ADDITIONAL VIRTUAL MEETINGS SO THAT WE COULD GAIN THEIR PERSPECTIVE BASED ON THEIR EXPERIENCES SERVING OUR COMMUNITY. CHRISTIANACARE CONTRACTED WITH VERIT HEALTHCARE CONSULTING, LLC (VERIT) TO COMPLETE ITS 2022 CHNA. IN COOPERATION WITH CHRISTIANACARE'S OFFICE OF HEALTH EQUITY, VERIT CONDUCTED THE RESEARCH, PRIMARY AND SECONDARY DATA COLLECTION, REVIEW, AND ANALYSIS, TO DEVELOP THE CHNA. -------------------- PART V, SECTION B, LINE 6 (JOINT CHNA) CHRISTIANACARE'S TWO HOSPITAL FACILITIES IN DELAWARE, CHRISTIANA HOSPITAL AND WILMINGTON HOSPITAL, JOINTLY CONDUCTED THEIR CHNA. -------------------- PART V, SECTION B, LINE 7 (CHNA PUBLIC AVAILABILITY) CHRISTIANACARE'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-NEEDS-ASSESSMENT/ A PAPER COPY OF THE CHNA IS ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. -------------------- PART V, SECTION B, LINE 10 (IMP. PLAN PUBLIC AVAILABILITY) CHRISTIANACARE'S CHIP IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-IMPLEMENTATION-PLAN/ A PAPER COPY OF THE CHIP IS ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. --------------------
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) CHRISTIANACARE IDENTIFIED THE FOLLOWING AS THE COMMUNITY'S MOST SIGNIFICANT NEEDS: . ACCESS TO HEALTH SERVICES . CHRONIC HEALTH CONDITIONS . MATERNAL AND CHILD HEALTH . MENTAL HEALTH AND SUBSTANCE USE DISORDERS . SOCIAL DETERMINANTS OF HEALTH . VIOLENT CRIME CHRISTIANACARE WILL ADDRESS ALL OF THESE SIGNIFICANT AREAS OF NEED. EXCEPT FOR THE NEWLY ADDED CHRONIC CONDITIONS AREA OF NEED, THESE NEEDS WERE ALSO PRIORITIZED IN 2019. WE WILL CONTINUE TO ADDRESS THESE NEEDS THROUGH PROGRAMMING WE HAVE CREATED, ADAPTED, AND EXPANDED SINCE OUR 2019 CHNA. TO COMPLETE THIS CHNA, WE WERE FORTUNATE TO LEARN FROM MANY HIGH SCHOOL STUDENTS ABOUT WHAT THEY CONSIDERED TO BE SIGNIFICANT AREAS OF NEED. THE SIGNIFICANT AREAS OF NEED THE STUDENTS IDENTIFIED MIRRORED THE SELECTIONS OF THE ADULTS WHO PARTICIPATED, BUT WITH TWO ADDITIONAL SIGNIFICANT AREAS OF NEED IDENTIFIED BY MANY OF THE STUDENTS: SEXUALLY TRANSMITTED INFECTIONS AND SMOKING, TOBACCO, AND VAPE PRODUCT USE. CHRISTIANACARE ADDRESSES BOTH THESE AREAS IN ITS SCHOOL-BASED HEALTH CENTERS AND ITS ALLIANCE FOR ADOLESCENT PREGNANCY PREVENTION (AAPP) PROGRAMMING. SINCE 1995 CHRISTIANACARE HAS BEEN THE RECIPIENT OF A STATE GRANT TO OPERATE AAPP WHICH PROVIDES EDUCATION TO STUDENTS THROUGHOUT DELAWARE TO REDUCE THE NUMBER OF TEENS WHO ARE SEXUALLY ACTIVE, CONTRACT AND SPREAD SEXUALLY TRANSMITTED INFECTIONS, BECOME PREGNANT AND BECOME TEEN PARENTS. CHRISTIANACARE WILL NOT PRIORITIZE THE TEEN-IDENTIFIED SIGNIFICANT AREAS OF NEED, BUT WE WILL CONTINUE TO ADDRESS THEM THROUGH DIRECT INTERACTION WITH STUDENTS IN THE SCHOOL-BASED HEALTH CENTERS AND THROUGH AAPP PROGRAMMING. ACCESS TO HEALTH SERVICES CHRISTIANACARE IS COMMITTED TO RADICALLY SIMPLIFYING ACCESS, THROUGH BOTH DIGITAL AND IN-PERSON MEANS. IN FY23, SUCCESSFUL EFFORTS WERE UNDERTAKEN TO PROVIDE PATIENTS WITH MEANINGFUL ACCESS TO THEIR CARE TEAM OUTSIDE OF A VISIT, THE ABILITY TO SCHEDULE THEIR APPOINTMENTS ONLINE IN MORE PRACTICES AND SPECIALTIES, AND THE OPPORTUNITY TO COMPLETE A PAPERLESS INTAKE PROCESS. THE TURNAROUND TIME FOR RESOLVING A CLINICAL CONSULT FOR A PATIENT REFERRAL ALSO IMPROVED DURING FY23. BY CONSULTING WITH THE PATIENT QUICKLY AFTER A REFERRAL AND UNDERSTANDING THEIR NEEDS, THIS PROCESS ENSURES PATIENTS GET THE RIGHT CARE, AVOIDING UNNECESSARY APPOINTMENTS. THESE ACTIVITIES DEMONSTRATE OUR COMMITMENT TO ENSURING BOTH CURRENT PATIENTS AND NEW PATIENTS HAVE INCREASED ACCESS TO THE CARE THEY NEED. WE ARE ALSO UTILIZING COMMUNITY PARTNERSHIPS AND INNOVATIVE PROGRAMS TO PROVIDE ACCESS TO CARE WITHIN OUR COMMUNITY. IN JUNE 2022, CHRISTIANACARE INTRODUCED ITS TWO MOBILE HEALTH SERVICES VANS IN A RIBBON CUTTING CEREMONY IN WILMINGTON'S SOUTHBRIDGE NEIGHBORHOOD. THESE VANS ARE SUPPORTED BY A $1 MILLION INVESTMENT FROM BARCLAYS AS PART OF ITS COVID-19 COMMUNITY AID PACKAGE. MOBILE HEALTH SERVICES ALLOW US TO BRING CARE TO OUR NEIGHBORS WHO MAY HAVE DIFFICULTY ACCESSING CARE OTHERWISE. AS WE REPORTED IN FY22, RECEIVING CARE ON THE VAN IS NOT A ONE-TIME EVENT, BUT THE START OF A PRIMARY AND SPECIALTY CARE RELATIONSHIP THAT WILL HELP EACH INDIVIDUAL IMPROVE THEIR HEALTH AND WELLNESS. IN SERVICE TO THAT EXPECTATION, TIME WAS SPENT IN FY23 DETERMINING HOW BEST TO UTILIZE THE VAN SERVING OUR COMMUNITY WITHIN NEW CASTLE COUNTY. CHRISTIANACARE'S COMPLEX CARE AND COMMUNITY MEDICINE DEPARTMENT WORKED WITH CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT TO IDENTIFY THE AREAS IN THE COMMUNITY WHERE MOBILE HEALTH SERVICES WERE NEEDED AND THE COMMUNITY ORGANIZATIONS THAT COULD BE PARTNERED WITH TO HOST AND PROMOTE THE VANS TO BEST SERVE THE COMMUNITY.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) BEGINNING IN 2023, A VAN IS PARKED ACROSS FROM THE WILMINGTON HOSPITAL EMERGENCY DEPARTMENT EVERY MONDAY MORNING. ON AN ALTERNATING SCHEDULE ON WEDNESDAYS, THE VAN IS STATIONED AT EZION FAIR BAPTIST CHURCH IN THE MORNING AND KINGSWOOD COMMUNITY CENTER IN THE AFTERNOON, AND THE EMPOWERMENT CENTER ON THE FOLLOWING WEDNESDAY MORNING AND THE ROSE HILL COMMUNITY CENTER IN THE AFTERNOON. IN FY23, THERE WERE 180 MOBILE VAN VISITS. THESE LOCATIONS ARE ALL WITHIN AREAS CHRISTIANACARE HIGHLIGHTED IN OUR CHNA AS HAVING CONSIDERABLE CHALLENGES IN COMPARISON TO THE REST OF OUR SERVICE AREA OF NEW CASTLE COUNTY. BRINGING CARE TO THESE COMMUNITIES IS A WAY IN WHICH WE CAN ADDRESS SOME OF THAT NEED. THE VANS SERVE CHRISTIANACARE PATIENTS WHO NEED SAME DAY CARE AND SERVE PATIENTS WHO DON'T HAVE A DOCTOR. THE VANS PROVIDE FULL-SERVICE MEDICINE INCLUDING ADULT CARE, WOMEN'S HEALTH, PEDIATRICS, VACCINES, AND MORE. IN THE SOUTHERN PORTION OF OUR STATE, OUR SECOND VAN IS LOCATED ONCE A MONTH AT THE FOLLOWING LOCATIONS: THE DELAWARE MARKET STREET PARK IN LAUREL, THE MODERN MATURITY CENTER IN DOVER, AND THE FRIENDSHIP HOUSE OF KENT COUNTY IN DOVER. OUR MOBILE PRESENCE AT THESE LOCATIONS PROVIDES ACCESS TO HEALTH SERVICES FOR COMMUNITIES THAT OTHERWISE MAY NOT BE ABLE TO ACCESS SUCH SERVICES. ANOTHER SIGNIFICANT POINT OF ACCESS FOR HEALTH CARE SERVICES CHRISTIANACARE PROVIDES TO OUR COMMUNITY IS THROUGH OUR SCHOOL-BASED HEALTH CENTERS (SBHCS). WE OPERATE 23 SCHOOL-BASED HEALTH CENTERS (SBHC) THROUGHOUT NEW CASTLE COUNTY IN ELEMENTARY, MIDDLE, AND HIGH SCHOOLS. SBHCS OFFER CONVENIENT ACCESS TO HEALTH CARE FOR STUDENTS AND PROVIDE THE OPPORTUNITY TO ADDRESS HEALTH ISSUES AT THE EARLIEST AND MOST PREVENTABLE STAGES. IN FY2023, OUR SBHCS HAD 30,892 STUDENT VISITS. FOR OVER A DECADE CHRISTIANACARE'S HEALTH GUIDES HAVE BEEN WORKING TO CONNECT PATIENTS TO HEALTH CARE SERVICES AND COMMUNITY RESOURCES AND ASSIST IN HEALTH INSURANCE ENROLLMENT AND PRESCRIPTION ASSISTANCE. LOCATED IN THE WILMINGTON HOSPITAL, IN FY2022, WE IDENTIFIED AN OPPORTUNITY TO EXPAND THE PROGRAM AND SERVE MORE PEOPLE BY HIRING TWO NEW BILINGUAL HEALTH GUIDES TO WORK ON-SITE AT TWO CHRISTIANACARE PRIMARY CARE PRACTICES. THIS EXPANSION ACHIEVED OUR GOAL OF SERVING MORE MEMBERS OF OUR COMMUNITY. IN FY23, 2,089 INDIVIDUALS WERE SERVED BY THE HEALTH GUIDES IN 4,848 PATIENT ENCOUNTERS, REPRESENTING AN INCREASE OF 656 PATIENTS FROM FY22. MANY PATIENTS HAD MULTIPLE NEEDS THAT THE HEALTH GUIDES WERE ABLE TO HELP THE PATIENT ADDRESS. IN FY23, THE HEALTH GUIDES PLAYED A CRUCIAL ROLE IN SERVING OUR COMMUNITY BY MAKING PATIENTS AWARE OF THE MEDICAID REDETERMINATION PROCESS, PROVIDING THEM WITH INFORMATION ON THE PROCESS, AND PROVIDING GUIDANCE ON HOW TO MAINTAIN THEIR COVERAGE. THE HEALTH GUIDES ALSO ASSISTED PATIENTS IN APPLYING FOR A TOTAL OF $2,652,177.68 IN FINANCIAL ASSISTANCE. ANOTHER STRATEGY CHRISTIANACARE EMPLOYS TO HELP PATIENTS OVERCOME BARRIERS TO GOOD HEALTH IS THE COMMUNITY HEALTH WORKER (CHW) PROGRAM. CHWS PROVIDE EMOTIONAL AND INSTRUMENTAL SUPPORT TO HELP PATIENTS OVERCOME HARDSHIPS IN THEIR LIVES OR CHALLENGES IN COORDINATING COMPLEX MEDICAL CARE THAT CAN DETER ACCESS. CHWS ARE LOCATED ON-SITE IN PRACTICES AND MEET PATIENTS IN THEIR HOMES AND AT OTHER COMMUNITY SITES TO PROVIDE THE MOST IMPACTFUL SUPPORT. ALL CHWS RECEIVE TRAINING THROUGH PENN MEDICINE'S IMPACT (INDIVIDUALIZED MANAGEMENT FOR PATIENT CENTERED TARGET) EVIDENCE-BASED MODEL. THE CHWS WORK TO IMPROVE HEALTH OUTCOMES BY ADDRESSING SOCIAL NEEDS, HELPING PATIENTS TO IDENTIFY AND ACHIEVE PATIENT CENTERED GOALS, AND CONNECTING PATIENTS TO CARE. CHWS SERVE OUR PATIENTS IN WAYS THAT ARE MORE FULLY DISCUSSED BELOW, BUT THE CHWS ADDRESS EACH OF OUR PRIORITIZED AREAS OF NEED AND ALSO WILL BE INCLUDED THROUGHOUT OUR DESCRIPTIONS OF HOW WE ARE ADDRESSING THOSE NEEDS. IN ADDITION, CHRISTIANACARE'S CHWS ARE REGULAR ATTENDEES AT COMMUNITY EVENTS TO PROVIDE INFORMATION ABOUT OUR PROGRAMS, COMPLETE SOCIAL DETERMINANTS OF HEALTH SCREENING, AND PROVIDE REFERRALS TO RESOURCES IN THE COMMUNITY. IN FY23, THE PRIMARY CARE AND EMERGENCY DEPARTMENT CHWS PROVIDED FURTHER SERVICE TO OUR COMMUNITY BY HOSTING A BACKPACK DRIVE THAT PROVIDED 30 BACKPACKS TO INDIVIDUALS WITHOUT HOUSING TO STORE THEIR BELONGINGS AND VOLUNTEERED AT THE KNOLLWOOD COMMUNITY CENTER IN CLAYMONT TO HELP CLEAN THE NEIGHBORHOOD.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) BEHAVIORAL HEALTH CHWS LAUNCHED IN OCTOBER 2021, THE BEHAVIORAL HEALTH CHWS SUPPORT PATIENTS RECEIVING OUTPATIENT BEHAVIORAL HEALTH AND SUBSTANCE USE SERVICES IN EFFORTS TO ASSIST PATIENTS IN INCREASING INDEPENDENCE AND RESILIENCE. THERE ARE 4 BEHAVIORAL HEALTH CHWS SERVING PATIENTS OF CHRISTIANACARE'S OUTPATIENT BEHAVIORAL HEALTH PRACTICES. THEY PROVIDE SERVICE DELIVERY TO CHILDREN/ADOLESCENTS AND ADULTS WITH MENTAL HEALTH AND/OR SUBSTANCE USE DIAGNOSES FOR UP TO 6 MONTHS. IN FY23, 141 PATIENTS WERE SERVED WITH 75% OF THOSE GRADUATING FROM THE PROGRAM. ADDITIONALLY, 96% OF THESE PATIENTS WERE SCREENED FOR SOCIAL DETERMINANTS OF HEALTH AND OFF THOSE, 88% HAD A POSITIVE SCREENING. EMERGENCY DEPARTMENT CHWS THE EMERGENCY DEPARTMENT (ED) CHW PROGRAM LAUNCHED IN FEBRUARY OF 2021. THIS 3-MONTH PROGRAM UTILIZES AN EVIDENCE-BASED APPROACH TO IMPROVE HEALTH OUTCOMES, INCREASE HEALTH LITERACY, AND DIRECT HIGH ED UTILIZERS (2 OR MORE VISITS TO THE ED IN 90 DAYS) TO PRIMARY CARE AND LONG-TERM SUPPORT. THERE ARE 2 CHWS SERVING PATIENTS OF WILMINGTON HOSPITAL'S ED. IN FY23, THE ED CHWS FOCUSED EFFORTS TO IMPROVE PATIENTS' TRANSITIONS TO CARE FROM THE ED TO CHRISTIANACARE'S CENTER FOR SPECIAL HEALTHCARE NEEDS (PARTICULARLY PATIENTS WITH SICKLE CELL DISEASE) AND PRIMARY CARE PRACTICES. THE ED CHW PROGRAM ALSO EXPANDED THE ELIGIBILITY CRITERIA TO ACCEPT PATIENTS WITH MEDICARE INSURANCE. IN FY23, THIS PROGRAM SERVED 70 PATIENTS WITH 56% OF THOSE GRADUATING. OF THE 81% OF PARTICIPATING PATIENTS WHO WERE SCREENED FOR SOCIAL DETERMINANTS OF HEALTH, 98% SCREENED POSITIVE. NEW CASTLE COUNTY HOPE CENTER CHWS IN MAY 2023, CHRISTIANACARE'S CHW SERVICES EXPANDED TO THE NEW CASTLE COUNTY HOPE CENTER TO SERVE CHRISTIANACARE PATIENTS THAT REQUIRE RESPITE BEDS. THERE IS ONE CHW SERVING THESE PATIENTS. THE CHW ASSISTS PATIENTS IN WORKING TOWARDS OPTIMAL HEALTH BY CLOSING CARE GAPS AND ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT IMPACT HEALTH AND WELL-BEING. DURING FY23, 20 PATIENTS WERE SERVED. MEDICAID ENGAGEMENT CHWS THE MEDICAID ENGAGEMENT TEAM CONSISTS OF FOUR CHWS THAT OUTREACH PATIENTS THAT HAVE BEEN NEWLY CONNECTED TO CHRISTIANACARE AND CONNECT THEM WITH PRIMARY CARE APPOINTMENTS. THESE CHWS EMPLOY MULTIPLE METHODS TO ATTEMPT TO ENGAGE PATIENTS, INCLUDING GOING TO THE PATIENTS' HOMES. IN FY23, 231 PATIENTS WERE SUCCESSFULLY ENGAGED. PRIMARY CARE CHWS THE PRIMARY CARE CHW PROGRAM WAS ONE OF THE FIRST CHW PROGRAMS CHRISTIANACARE DEPLOYED IN FY20. IT IS A 6-MONTH PROGRAM THAT UTILIZES AN EVIDENCE-BASED APPROACH TO IMPROVE HEALTH OUTCOMES, INCREASE HEALTH LITERACY, AND ENGAGE PATIENTS WITH DIABETES, HYPERTENSION, AND/OR HIGH EMERGENCY DEPARTMENT UTILIZATION IN PRIMARY CARE SERVICES. THE PRIMARY CARE CHW PROGRAM HAS 7 CHWS SERVING PATIENTS OF CHRISTIANACARE'S PRIMARY PRACTICES THROUGHOUT NEW CASTLE COUNTY AND KENT COUNTY TO DELIVER SERVICES TO ADULTS 18+ WITH MEDICAID, MEDICARE, AND NO INSURANCE. SERVICE DELIVERY OCCURS THROUGH THE SPAN OF 6-MONTHS. IN FY23, THE PRIMARY CARE CHW PROGRAM EXPANDED ITS ELIGIBILITY CRITERIA TO SERVE PATIENTS WITH MEDICARE INSURANCE. A PRIMARY CARE CHW ALSO BEGAN SERVING PATIENTS WITH SUBSTANCE USE DISORDERS AT CHRISTIANACARE'S FAMILY MEDICINE CENTER. THE PRIMARY CARE CHW PROGRAM ALSO IMPLEMENTED A SELF-MEASURED BLOOD PRESSURE READING (SMBP) PROGRAM FOR PATIENTS DIAGNOSED WITH HYPERTENSION. THE SMBP PROGRAM PROVIDES EDUCATION, TRAINING, AND RESOURCES ON BLOOD PRESSURE MONITORING AS WELL AS BLOOD PRESSURE CUFFS TO PATIENTS FOR AT-HOME MONITORING. IN FY23, THIS PROGRAM SERVED 298 PATIENTS WITH 69% OF THOSE GRADUATING. 95% OF THESE PATIENTS WERE SCREENED FOR SOCIAL DETERMINANTS OF HEALTH. OF THOSE, 77% SCREENED POSITIVE. SCHOOL BASED HEALTH CENTER CHWS IN ADDITION TO THE CLINICAL ACCESS PROVIDED AT SBHCS PREVIOUSLY DESCRIBED, CHRISTIANACARE HAS ALSO EMBEDDED EIGHT COMMUNITY HEALTH WORKERS (CHWS) WITHIN 21 OF CHRISTIANACARE'S SBHCS. JUST AS ALL THE OTHER CHWS DO, THESE CHWS ALSO WORK IN PARTNERSHIP WITH THE STUDENTS TO ADDRESS THEIR HEALTH AND SOCIAL NEEDS. THE SBHC CHWS SERVED 728 STUDENTS IN FY23 BY CONNECTING THEM AND THEIR FAMILIES TO NEEDED RESOURCES SUCH AS CLOTHING, FOOD, TRANSPORTATION, AND UTILITY ASSISTANCE. STUDENTS WERE ALSO CONNECTED TO PRIMARY CARE PRACTICES, DENTAL SERVICES, AND EYE CARE AND HELPED TO ENROLL THEM IN HEALTH INSURANCE. WOMEN'S HEALTH CHWS ONE OF THE INITIAL CHW PROGRAMS LAUNCHED IN FY20, THE WOMEN'S HEALTH CHW PROGRAM WAS DESIGNED TO TRANSFORM MATERNAL AND INFANT HEALTHCARE WITH A COMMITTED INVESTMENT TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH THAT NEGATIVELY IMPACT HEALTH AND WELL-BEING FOR MOTHERS AND THEIR FAMILIES. THE WOMEN'S HEALTH CHW PROGRAM HAS 5 CHWS SERVING PATIENTS OF CHRISTIANACARE'S WOMEN'S HEALTH SERVICES INCLUDING INPATIENT, OUTPATIENT, OB TRIAGE, AND THE NEONATAL INTENSIVE CARE UNIT (NICU). WOMEN'S HEALTH CHWS SERVE PATIENTS OF ALL AGES THROUGHOUT NEW CASTLE AND KENT COUNTY WITH MEDICAID OR THAT ARE UNINSURED WITH A CHRONIC DISEASE, MENTAL HEALTH AND/OR SUBSTANCE USE ISSUE(S), LATE/NO ENTRY TO PRENATAL CARE, HISTORY OF POOR BIRTH OUTCOMES, A BMI AT/ABOVE 30, AND/OR ARE AT-RISK FOR BIRTH DEFECTS. SERVICE DELIVERY CONSISTS OF EPISODIC AND LONGITUDINAL CARE DURING THE PERINATAL PERIOD. IN FY23, THE WOMEN'S HEALTH CHWS SERVED 140 PATIENTS WITH 84% OF THOSE GRADUATING. ADDITIONALLY, 73% OF PATIENTS WERE SCREENED FOR SOCIAL DETERMINANTS OF HEALTH AND OFF THOSE, 70% SCREENED POSITIVE. IN OCTOBER 2022, CHRISTIANACARE OPENED A 14 BED PEDIATRIC CARE CENTER ON THE NEWARK CAMPUS. THE CENTER PROVIDES 24/7 COMBINED SHORT-STAY INPATIENT AND EMERGENCY CARE FOR INFANTS TO 18-YEAR-OLDS. IN THE UNITED STATES, THERE IS ONLY 1 PEDIATRIC HOSPITAL FOR EVERY 20 ADULT HOSPITALS AND PEDIATRIC HOSPITALS SERVE ONLY 15-20% OF PEDIATRIC EMERGENCY PATIENTS. CHRISTIANACARE'S PEDIATRIC CARE CENTER PLAYS A PIVOTAL ROLE IN PROVIDING FAMILIES WITH AN OPTION TO RECEIVE PEDIATRIC-CENTERED CARE IN THEIR COMMUNITY. IN ITS FIRST YEAR OF OPERATION, THE PEDIATRIC CARE CENTER SERVED OVER 7,500 PATIENTS. FURTHER, THE FOCUS HAS BEEN ON CONTINUOUSLY WORKING TO IMPROVE PATIENTS' CARE WHICH HAS BEEN DEMONSTRATED BY THE LENGTH OF STAY FOR THE BEHAVIORAL HEALTH POPULATION GOING FROM 36% DISCHARGED WITHIN 48 HOURS IN FY22 TO 58% DISCHARGED WITHIN 48 HOURS IN FY23. FURTHERMORE, 95% OF ADMITTED PATIENTS WERE ALSO RETAINED WHICH MINIMIZED DIRECT AND INDIRECT COSTS FOR FAMILIES.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) DENTAL SERVICES ACCESSING DENTAL SERVICES IS ALSO CHALLENGING FOR MANY COMMUNITY MEMBERS AND CHRISTIANACARE HAS LONG WORKED TO ADDRESS THIS NEED FOR NOT ONLY OUR NEIGHBORS IN NEW CASTLE COUNTY, BUT FOR INDIVIDUALS THROUGHOUT THE STATE WHO CANNOT ACCESS AFFORDABLE DENTAL CARE. IN JANUARY 2021, CHRISTIANACARE COMPLETED A TWO-YEAR RENOVATION PROJECT THAT INCREASED THE CLINICAL CAPACITY OF OUR DENTISTRY AND ORAL-MAXILLOFACIAL SURGERY PRACTICES. IN FY23, THERE WERE 11,809 PATIENT VISITS TO OUR DENTAL CLINIC. FOR OVER 60 YEARS, OUR DENTAL CLINIC HAS PROVIDED COMPREHENSIVE CARE, INCLUDING ORAL SURGERY, FOR UNINSURED AND UNDERINSURED INDIVIDUALS. EVERY FRIDAY, THE DENTAL CLINIC SERVES UNINSURED PEDIATRIC PATIENTS. FEES AT THE CLINIC ARE KEPT AT A REDUCED LEVEL AND ONLY MEDICAID IS ACCEPTED. PATIENTS ARE SEEN AT THIS CLINIC BY DENTAL RESIDENTS AND VOLUNTEER AND EMPLOYED DOCTORS. THE RESIDENTS SERVING THE DENTAL CLINIC ALSO PROVIDE DENTAL SERVICE IN THE COMMUNITY THROUGH ROTATIONS AT AFFILIATED DENTAL CLINICS AT WESTSIDE FAMILY HEALTHCARE, A FEDERALLY QUALIFIED HEALTH CENTER, AND DELAWARE TECHNICAL COMMUNITY COLLEGE. NEW CASTLE COUNTY HOPE CENTER THE NEW CASTLE COUNTY HOPE CENTER, WHICH IS LOCATED IN A FORMER HOTEL PURCHASED BY NEW CASTLE COUNTY IN 2020, PROVIDES EMERGENCY SHELTER FOR FAMILIES AND INDIVIDUALS EXPERIENCING HOMELESSNESS. THE HOPE CENTER PROVIDES SHELTER, RESOURCES, AND SUPPORT FOR ITS RESIDENTS WITH THE GOAL OF TRANSITIONING THEM INTO PERMANENT HOUSING. CHRISTIANACARE HAS PARTNERED WITH NEW CASTLE COUNTY TO SHARE EXPERTISE ON HEALTH AND PROVIDE SERVICES AT THE HOPE CENTER. SINCE 2021, CHRISTIANACARE HAS OPERATED AN ON-SITE PRIMARY CARE OFFICE THAT SERVES PATIENTS RESIDING IN THE HOPE CENTER. SERVICES INCLUDE ACUTE ILLNESS MANAGEMENT, CHRONIC DISEASE MANAGEMENT, PRENATAL CARE, PEDIATRIC AND NEWBORN CARE, AND CONTRACEPTIVE MANAGEMENT. IN ADDITION TO THE PRIMARY CARE PRACTICE, IN JANUARY 2023, CHRISTIANACARE ALSO ESTABLISHED A MEDICAL RESPITE PROGRAM ENCOMPASSING 36 ROOMS AT THE HOPE CENTER FOR PATIENTS WHOSE COMPLEX ILLNESSES MAKE THEM INELIGIBLE FOR RESIDING AT A STANDARD HOUSING SHELTER. THESE PATIENTS ARE REFERRED THROUGH CHRISTIANACARE DEPARTMENTS/PROGRAMS AND COMMUNITY PARTNERS. THIS PROGRAM ALLOWS PATIENTS WITHOUT STABLE HOUSING TO RECEIVE CARE IN THE COMMUNITY INSTEAD OF REMAINING UNNECESSARILY IN THE HOSPITAL DUE TO THE LACK OF COMMUNITY OPTIONS FOR THEM. TO DATE, 72 PATIENTS HAVE BEEN ABLE TO RECEIVE RESPITE CARE IN THE COMMUNITY AT THE HOPE CENTER. FINALLY, RECEIVING QUALITY HEALTH CARE SERVICES IS FUNDAMENTAL TO ACHIEVING OPTIMAL HEALTH. HOWEVER, ACCESS TO QUALITY HEALTH SERVICES WILL ONLY LEAD TO QUALITY HEALTH OUTCOMES IF PATIENTS AND FAMILIES UNDERSTAND THEIR HEALTH INFORMATION. IN FY23, CHRISTIANACARE LED STATE EFFORTS TO STRENGTHEN HEALTH LITERACY FOR ALL DELAWAREANS. WITH STATE AND COMMUNITY PARTNERS, CHRISTIANACARE ORGANIZED COMMUNITY MEMBERS TO CREATE THE HEALTH LITERACY COUNCIL OF DELAWARE (HLCD) THAT WILL PROMOTE AND ENCULTURATE HEALTH LITERACY BEST PRACTICES TO BENEFIT POPULATION HEALTH IN OUR STATE. WE ALSO SUCCESSFULLY APPLIED FOR AN $80,000 GRANT FROM HIGHMARK BLUE CROSS BLUE SHIELD TO SUPPORT THE HLCD AND PROVIDE EDUCATION IN THE COMMUNITY TO SUPPORT INCREASED HEALTH LITERACY AND ENABLE INDIVIDUALS TO MAKE INFORMED HEALTHY CHOICES. THAT GRANT WORK WILL BEGIN IN FY24. AT CHRISTIANACARE, WE ARE WORKING TO REFINE OUR OPERATIONS TO IMPROVE HEALTH LITERACY AMONG OUR PATIENTS IN A VARIETY OF WAYS. AMONG OTHER EFFORTS, WE INTEGRATED HEALTH LITERATE MEDICATION PATIENT EDUCATION INTO THE ELECTRONIC HEALTH RECORD FOR A MORE CONSISTENT AND STREAMLINED APPROACH, AND WE CONDUCTED RESEARCH ON ENGAGING AND EMPOWERING PATIENTS AND CAREGIVERS TO BE ACTIVE PARTICIPANTS IN UNDERSTANDING THEIR HEALTH. WE WILL CONTINUE OUR EFFORTS TO PROMOTE HEALTH LITERACY AMONG OUR PATIENTS AND IN OUR COMMUNITY AS IT IS A BUILDING BLOCK FOR HEALTH EQUITY.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) CHRONIC HEALTH CONDITIONS IN OUR 5-YEAR STRATEGIC PLAN, CHRISTIANACARE ADOPTED THE ASPIRATION OF ENDING DISPARITIES IN ACCESS, EXPERIENCE, CARE DELIVERY, AND HEALTH OUTCOMES. IN THE AREA OF CHRONIC DISEASE, WE ARE FOCUSED ON REDUCING RACIAL DISPARITIES IN UNCONTROLLED HYPERTENSION. IN FY24, WE WILL DESIGN AND IMPLEMENT INTERVENTIONS TO REDUCE THOSE DISPARITIES. FOOD INSECURITY IS ONE OF THE MOST PREVALENT SOCIAL NEEDS NATIONWIDE AND IS ASSOCIATED WITH WORSENING CHRONIC DISEASE OUTCOMES AND DIFFICULTIES ADHERING TO A HEALTHY DIET. RESEARCH HAS SHOWN THAT CHWS ARE VITAL TO BRIDGING THE GAPS BETWEEN COMMUNITY MEMBERS AND HEALTH AND SOCIAL SERVICES, ULTIMATELY IMPROVING FOOD INSECURITY AND HEALTH OUTCOMES. IN 2021, CHRISTIANACARE LAUNCHED DELAWARE FOOD FARMACY (DFF), A 6-MONTH "FOOD AS MEDICINE" CHW PROGRAM, IN PARTNERSHIP WITH LUTHERAN COMMUNITY SERVICES FOR PATIENTS WITH CHRONIC CONDITIONS. PATIENTS RECEIVE WEEKLY MEDICALLY TAILORED GROCERIES, AND CHWS ASSIST PATIENTS WITH GOAL SETTING AND IMPROVING DIETARY KNOWLEDGE AND CULINARY SKILLS. SINCE PROGRAM LAUNCH, 396,710 MEALS HAVE BEEN PROVIDED. IN FY23, 98 PATIENTS PARTICIPATED, AND 240 COMMUNITY MEMBERS (PARTICIPANTS AND HOUSEHOLD) WERE FED THROUGH THE DFF. ENOUGH FOOD IS PROVIDED FOR THE ENTIRE FAMILY AS A FOOD INSECURE PARENT COULD NOT BE EXPECTED TO EAT THE FOOD PROVIDED FOR THEM WITHOUT SHARING WITH THEIR FAMILY. 80% OF THE PARTICIPANTS LIVED IN THE HIGH-RISK ZIP CODES CHRISTIANACARE IDENTIFIED IN ITS LAST TWO CHNAS. 48,700 MEALS WERE PROVIDED IN FY23. ON AVERAGE, PATIENTS DEVELOPED 2-3 PERSONAL GOALS AND 77% OF THE GOALS WERE COMPLETED UPON GRADUATION. PRELIMINARY OUTCOME ANALYSES DEMONSTRATE PERCENTAGE OF PATIENTS WHO IDENTIFIED AS FOOD INSECURE DECREASED 26%, HEMOGLOBIN A1C DECREASED 0.7 POINTS, BODY MASS INDEX DECREASED 3.6 KG/M2, AND ANXIETY AND DEPRESSION DECREASED 18% AND 11%, RESPECTIVELY. IN FY23, WE CONDUCTED AN ITERATIVE FORMATIVE EVALUATION TO ENSURE DFF IS CULTURALLY RESPONSIVE TO SPANISH SPEAKING PATIENTS. AS A RESULT, DFF MADE MENU CHANGES AND IS COLLABORATING WITH CHRISTIANACARE'S LANGUAGE SERVICES/LANGUAGE LINE TO HAVE DOCUMENTS AND RECIPES TRANSLATED, AS WELL AS TO HAVE DFF COOKING VIDEOS CLOSED CAPTIONED/DUBBED OVER TO SUPPORT OUR SPANISH SPEAKING COMMUNITY. IN PARTNERSHIP WITH URBAN ACRES, CHRISTIANACARE ALSO OPERATED A PRODUCE DELIVERY PROGRAM DESIGNED TO INCREASE PATIENT ACCESS TO THE FRESH PRODUCE NECESSARY TO LIVE A HEALTHIER LIFE. ADULT PATIENTS LIVING IN NEW CASTLE COUNTY WHO ARE ON MEDICAID OR ARE MEDICAID ELIGIBLE AND HAVE DIABETES, HYPERTENSION, AND/OR NEED FOOD ASSISTANCE ARE ELIGIBLE. THEY RECEIVE A $10 WHOLESALE BAG OF PRODUCE (50/50 FRUITS & VEGETABLES) DELIVERED TO THEIR HOMES EVERY WEEK FOR A MINIMUM OF 3 MONTHS. IN FY23, CHRISTIANACARE ENROLLED 137 PARTICIPANTS AND SERVED 376 COMMUNITY MEMBERS (INCLUDING PARTICIPANTS AND THEIR HOUSEHOLD MEMBERS). OF THE PARTICIPANTS, 67% LIVED IN THE HIGH-RISK ZIP CODES IDENTIFIED IN CHRISTIANACARE'S TWO PRIOR CHNAS. AS DESCRIBED PREVIOUSLY, THE PRIMARY CARE AND WOMEN'S HEALTH CHW PROGRAMS INCLUDE CHRONIC CONDITIONS AS AN ELIGIBILITY REQUIREMENT. CHWS WORK WITH THE PATIENTS TO IMPROVE SELF-MANAGEMENT OF THEIR CHRONIC CONDITIONS. WHILE CHRONIC CONDITIONS ARE NOT A REQUIREMENT TO PARTICIPATE IN THE OTHER CHW PROGRAMS, CHRONIC CONDITION MANAGEMENT WILL CERTAINLY BE ADDRESSED IF A PATIENT HAS THAT NEED. MATERNAL AND CHILD HEALTH IN 2010, DELAWARE HAD THE HIGHEST RATE OF UNINTENDED PREGNANCIES IN THE NATION AND BY 2017, THAT RATE WAS DOWN BY NEARLY 20%. THIS WAS THE RESULT OF STATEWIDE COLLABORATION AND PARTICIPATION BY STATE AND COMMUNITY AGENCIES AND PROVIDERS, INCLUDING CHRISTIANACARE, IN PROJECT UPSTREAM, AN EFFORT TO MAKE IUDS AND IMPLANTS IMMEDIATELY AVAILABLE IN ONE OFFICE VISIT OR AFTER A DELIVERY, MISCARRIAGE, OR ABORTION. IN 2015, DELAWARE'S INFANT MORTALITY RATE WAS THE SECOND WORST IN THE NATION AT 9.13 DEATHS PER 1,000 BIRTHS. IN 2021, OUR STATE'S INFANT MORTALITY RATE HAD DECREASED BY NEARLY HALF TO 4.77 PER 1,000 BIRTHS. AS WITH UNINTENDED PREGNANCIES, THIS DECREASE WAS THE RESULT OF CONCERTED EFFORT AMONG PROVIDERS AND STATE AND COMMUNITY AGENCIES. AS WILL BE DESCRIBED IN THIS SECTION, CHRISTIANACARE HAS CREATED, LED, AND PARTICIPATED IN MANY OF THE INITIATIVES THAT HAVE HELPED DECREASE INFANT MORTALITY. WHILE THE REDUCTION IN INFANT MORTALITY IS CERTAINLY AN ACCOMPLISHMENT TO BE CELEBRATED, UNFORTUNATELY, THOSE GAINS HAVE NOT BEEN EQUITABLE. RACIAL DISPARITIES IN MATERNAL AND INFANT MORTALITY PERSIST. IN 2020, DELAWARE'S 5-YEAR BLACK INFANT MORTALITY RATE WAS 3 TIMES THAT OF WHITE INFANT MORTALITY. DESPITE REPRESENTING ONLY 28% OF LIVE BIRTHS IN DELAWARE IN THE 2017 - 2021 PERIOD, BLACK WOMEN REPRESENTED 78% OF PREGNANCY-RELATED DEATHS. CHRISTIANACARE CONTINUES TO UNDERTAKE AND LEAD TARGETED EFFORTS TO IMPROVE THESE DISPARATE OUTCOMES IN BOTH CLINICAL AND COMMUNITY SETTINGS. AS WILL BE DEMONSTRATED THROUGH THE PROGRAMS AND INITIATIVES DESCRIBED BELOW, CHRISTIANACARE RECOGNIZES THAT REDUCING MATERNAL AND INFANT MORTALITY RATES, AND ESPECIALLY THE DISPARITIES WITHIN THOSE RATES, IS ONLY POSSIBLE WITH A HOLISTIC APPROACH THAT CONSIDERS ALL THE NEEDS OF THE INDIVIDUAL, WHETHER THOSE ARE HEALTH RELATED OR SOCIAL. CHRISTIANACARE CAREGIVERS HAVE LONG LED AND PARTICIPATED IN STATEWIDE COLLABORATIVE EFFORTS TO ADDRESS THE SYSTEMIC MATERNAL AND INFANT MORTALITY. FROM 2005 TO 2023, DR. DAVID PAUL, CHRISTIANACARE CHAIR OF PEDIATRICS HAS SERVED AS THE GOVERNOR APPOINTED CHAIR OF THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM (DHMIC). THE MISSION OF DHMIC IS TO PROVIDE STATEWIDE LEADERSHIP AND COORDINATION OF EFFORTS TO REDUCE INFANT MORTALITY, DECREASE PRETERM BIRTH, DECREASE THE MATERNAL MORTALITY RATE, AND DECREASE DISPARITY RATES. CHRISTIANACARE CAREGIVERS ALSO SERVE ON DELAWARE'S MATERNAL MORTALITY REVIEW PANEL AND THE FETAL & INFANT MORTALITY REVIEW (FIMR). BOTH PANELS SERVE TO EXAMINE INDIVIDUAL DEATHS TO CONSIDER THE PUBLIC HEALTH AND CLINICAL INTERVENTIONS AS WELL AS SYSTEMIC CHANGES THAT COULD REDUCE THE NUMBER OF DEATHS.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) AS REPORTED LAST YEAR, CHRISTIANACARE HAS ALSO UNDERTAKEN SEVERAL INITIATIVES TO ADDRESS DISPARITIES AMONG PREGNANT AND POSTPARTUM WOMEN. IMPLEMENTING A REMOTE PATIENT MONITORING PLATFORM SUCCESSFULLY REDUCED OVERALL POSTPARTUM PATIENT READMISSIONS FOR HIGH BLOOD PRESSURE BY 55% AND ELIMINATED A LONGSTANDING RACIAL DISPARITY. AMONG BLACK MOTHERS, THE READMISSION RATE DROPPED FROM 61% TO 31%. LIKEWISE, ENABLING PATIENTS TO UNDERTAKE FASTING BLOOD SUGAR TESTS AT HOME AND TEXT THEIR RESULTS ALSO LED TO IMPROVED COMPLIANCE RATES OVERALL AND A NARROWING OF THE RACIAL GAP IN CARE WITH A 180% HIGHER DIABETES DETECTION AMONG NON-BLACK WOMEN AND A 577% INCREASE AMONG BLACK WOMEN. THESE REDUCTIONS IN RACIAL DISPARITIES WERE MADE POSSIBLE BECAUSE IN BOTH EFFORTS, THE SOLUTION WAS ESSENTIALLY PROVIDED BY THE PATIENTS. THE RESEARCH TEAM CONSIDERED WHY COMPLIANCE WITH POSTPARTUM OFFICE VISITS AMONG BLACK WOMEN WAS LOW. BARRIERS SUCH AS LACK OF TRANSPORTATION AND THE TIME OF THE APPOINTMENT WERE SOME OF THE DIFFICULTIES REPORTED SO THOSE BARRIERS WERE REMOVED THROUGH THE IMPLEMENTATION OF HOME MONITORING AND TESTING. THE POSITIVE RESULTS EXEMPLIFY WHY PATIENTS MUST BE TREATED AS PARTNERS. CHRISTIANACARE HAS ALSO SET THE TARGET OF REDUCING RACIAL DISPARITIES IN PREECLAMPSIA AT 34 WEEKS. IN FY24, WE EXPECT TO DESIGN AND IMPLEMENT INTERVENTIONS, LEARNING FROM PRIOR EXPERIENCE, TO MEET THIS GOAL. AS DESCRIBED PREVIOUSLY, CHRISTIANACARE EMPLOYS WOMEN'S HEALTH CHWS WHO ARE EMBEDDED THROUGHOUT CHRISTIANACARE'S WOMEN'S HEALTH SERVICES INCLUDING INPATIENT, OUTPATIENT, OBSTETRICS (OB) TRIAGE, AND THE NEONATAL INTENSIVE CARE UNIT (NICU). THESE CHWS PARTNER WITH PATIENTS TO PROVIDE CONNECTION TO NEEDED SOCIAL AND HEALTH RESOURCES TO ULTIMATELY IMPROVE HEALTH. CHWS ARE VALUABLE MEMBERS OF A PATIENT'S CARE TEAM WHICH IS POSSIBLE BECAUSE OUR CAREGIVERS RECOGNIZE THE OUTSIZED ROLE A PATIENT'S SOCIAL NEEDS HAS ON THEIR HEALTH. IN PARTNERSHIP WITH THE DELAWARE DIVISION OF PUBLIC HEALTH, CHRISTIANACARE HAS OFFERED BOTH THE HEALTHY BEGINNINGS AND HEALTH AMBASSADORS PROGRAMS FOR OVER A DECADE. BOTH PROGRAMS WERE CREATED TO ADDRESS DELAWARE'S HIGH INFANT MORTALITY RATE. HEALTHY BEGINNINGS FOCUSES ON PRECONCEPTION CARE TO IDENTIFY AND ADDRESS RISKS TO FUTURE PREGNANCY, PREGNANCY PLANNING TO SET THE STAGE FOR A HEALTHY PREGNANCY, AND PRENATAL CARE FROM CONCEPTION TO CHILDBIRTH. THE GOAL IS TO REDUCE DISPARATE BIRTH OUTCOMES AND SAVE THE LIVES OF INFANTS AND THEIR MOTHERS. THE HEALTH AMBASSADORS PROGRAM SERVES PREGNANT WOMEN AND FAMILIES WITH CHILDREN AGED 0 TO 5 IN TARGETED HIGH-RISK ZIP CODES TO CONNECT WOMEN AND YOUNG FAMILIES TO HEALTH CARE, SOCIAL SERVICES, HOME VISITING, AND EDUCATIONAL PROGRAMS. THEY ALSO PROMOTE KEY MATERNAL AND CHILD HEALTH MESSAGES INCLUDING THE BENEFITS OF BREASTFEEDING AND THE IMPORTANCE OF SAFE SLEEP. IN FY23, HEALTHY BEGINNINGS ENROLLED 2,036 PATIENTS. OF THOSE PATIENTS, 1,249 (61.3%) WERE AFRICAN AMERICAN AND 1,201 (58.9%) LIVED IN A HIGH-RISK ZONE (19702, 19703, 19720, 19801, 19802, 19804, 19805, 19809, 19901, 19904, 19933, 19950, 19973). TO BETTER SERVE THEIR PATIENTS, HEALTHY BEGINNINGS PARTNERS WITH DELAWARE COALITION AGAINST DOMESTIC VIOLENCE, UNIVERSITY OF DELAWARE DEPARTMENT OF BEHAVIORAL HEALTH AND NUTRITION, DELAWARE COMMUNITY LEGAL AID SOCIETY, INC., CHILDREN & FAMILIES FIRST, QUALITY INSIGHTS, FOOD BANK OF DELAWARE, DELAWARE WOMEN, INFANT AND CHILDREN (WIC) AND DELAWARE CENTER FOR MATERNAL-FETAL MEDICINE. SERVICES PROVIDED TO PATIENTS INCLUDE PERSONAL HEALTH AND WELLNESS, WEIGHT MANAGEMENT, STRESS MANAGEMENT, EMOTIONAL HEALTH TREATMENT, FAMILY PLANNING, CONTRACEPTION, DOMESTIC ABUSE SCREENING, TOBACCO CESSATION SERVICES AND HYPERTENSION SCREENING AND TREATMENT. IN FY23, THE HEALTH AMBASSADORS SERVED 1,279 INDIVIDUALS BY PROVIDING THEM WITH A VARIETY OF ESSENTIAL ITEMS NEEDED FOR INFANTS AND CHILDREN SUCH AS CLOTHING, DIAPERS, CAR SEATS, STROLLERS, PACK & PLAYS, AND FORMULA AS WELL AS NEEDED RESOURCES LIKE FOOD AND BUS PASSES. EVERY DAY THE HEALTH AMBASSADORS ALSO CONNECTED INDIVIDUALS TO COMMUNITY RESOURCES TO ADDRESS FOOD AND HOUSING INSECURITY, DOMESTIC VIOLENCE, PARENTING EDUCATION NEEDS, AMONG OTHER SOCIAL NEEDS. THE HEALTH AMBASSADORS ALSO HOSTED SEVERAL COMMUNITY EVENTS THROUGHOUT THE YEAR. IN SEPTEMBER 2022, CHRISTIANACARE HELD A LATINX BABY SHOWER TO PROVIDE PREGNANT SPANISH SPEAKING MOTHERS WITH INFORMATION ABOUT HEALTHY DEVELOPMENT AND THE IMPORTANCE OF MATERNAL HEALTH FOR THEIR BABIES' HEALTH AND 120 FAMILIES ATTENDED. IN JANUARY 2023, WE ORGANIZED A WINTER WONDERLAND BABY SHOWER TO PROVIDE EDUCATION ON SAFE SLEEP PRACTICES AND 178 MOTHERS RECEIVED THIS EDUCATION. FINALLY, CHRISTIANACARE HELD A LATINX CHAT & CHEW IN JUNE 2023. THIS 4-SESSION WORKSHOP CONSISTED OF MINI EDUCATIONAL SESSIONS ON HEALTHY RELATIONSHIPS, BREASTFEEDING, NUTRITION DURING PREGNANCY, INFORMATION ON HOME VISITING PROGRAMS, AND HELP WITH INSURANCE NEEDS FOR FAMILIES. EACH SESSION HAD 10-15 WOMEN ATTENDING. WE ARE ALSO EXPANDING THE CHRISTIANACARE COMMUNITY HEALTH DEPARTMENT'S DELAWARE FOOD FARMACY (DFF) PROGRAM INTO WOMEN'S HEALTH. THE WOMEN'S HEALTH DFF IS A 6-TO-9-MONTH PROGRAM THAT WILL PROVIDE PREGNANT MOTHERS WITH THE HOLISTIC CARE NECESSARY KEEP BOTH MOM AND BABY HEALTHY. PARTICIPANTS WILL HAVE DELIVERED TO THEIR HOMES MEDICALLY TAILORED FOOD FOR THEM AND THEIR FAMILIES TO PREPARE 10 MEALS PER WEEK, PER PERSON IN THE HOME. LIKE OUR CURRENT SUCCESSFUL DFF PROGRAM DESCRIBED PREVIOUSLY, CHRISTIANACARE WILL PROVIDE CULINARY EQUIPMENT AND SKILLS TRAINING AND RECIPES, AND CHWS, REGISTERED DIETICIANS (RD'S), AND PROVIDERS WILL PROVIDE NUTRITION ASSESSMENT, EDUCATION AND ONGOING SUPPORT FOR DIETARY BEHAVIOR CHANGES AND ACHIEVING GOALS FOR A HEALTHIER PREGNANCY. ADDITIONALLY, EVIDENCE-BASED BEHAVIOR-CHANGE STRATEGIES SUCH AS MOTIVATIONAL INTERVIEWING, INCREMENTAL SMART GOAL SETTING, REMINDERS/CUES/PROMPTS, MOBILE TECHNOLOGY AND ONGOING SOCIAL SUPPORT WILL BE EMPLOYED IN THIS EXPANSION OF THE DFF PROGRAM TO WOMEN'S HEALTH. A COMMUNITY-ENGAGED APPROACH, INCLUDING AN ADVISORY BOARD OF LOCAL LEADERS AND ORGANIZATIONS, WILL BE USED TO IDENTIFY CULTURALLY RESPONSIVE FOODS AND RECIPES AND DEVELOP EDUCATIONAL MATERIALS APPROPRIATE FOR OUR LARGELY AFRICAN AMERICAN AND HISPANIC PARTICIPANTS AND THEIR FAMILY MEMBERS. TO GAUGE SUCCESS OF THE PROGRAM, WE WILL MEASURE CHANGES IN KEY PROJECT OUTCOMES, SUCH AS CHANGES IN DIETARY BEHAVIORS, FOOD SECURITY AS WELL AS OBSTETRICAL OUTCOMES (I.E., GESTATIONAL DIABETES, NICU DAYS AND CESAREAN DELIVERY). TO BE ELIGIBLE, INDIVIDUALS MUST BE A CHRISTIANACARE WOMEN'S HEALTH PATIENT WHO RESIDES IN NEW CASTLE COUNTY, HAVE MEDICAID OR BE MEDICAID ELIGIBLE, HAVE A BMI OF 30 OR HIGHER, HAVE A SINGLETON PREGNANCY, AND BE BETWEEN 4 AND 14 WEEKS PREGNANT.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) WE ARE AIMING TO LAUNCH THIS PROGRAM IN DECEMBER 2023 AND MUCH OF FY23 WAS SPENT APPLYING FOR THE FEDERAL FUNDING THAT WILL SUPPORT THIS EXPANSION AND PREPARING FOR LAUNCH. A SERIES OF COOKING AND PREGNANCY CARE VIDEOS WERE CREATED FOR THIS EXPANSION, AND TO ENSURE THEIR UTILITY, THE COMMUNITY HEALTH DEPARTMENT ALSO SURVEYED PATIENTS AND COLLECTED QUANTITATIVE AND QUALITATIVE DATA PERTAINING TO THE VIDEOS AND RECIPES THAT WILL BE USED. COMMUNITY HEALTH ALSO HELD FOCUS GROUPS WITH VARIOUS WOMEN'S HEALTH DEPARTMENTS AND PROGRAMS TO DETERMINE HOW BEST TO PROVIDE COLLABORATIVE CARE ON BEHALF OF THESE MOTHERS TO ENSURE THIS PROGRAM WILL SUCCESSFULLY SERVE PATIENTS. CHRISTIANACARE IS ALSO WORKING TO IMPROVE BIRTH OUTCOMES THROUGH ITS COLLABORATION WITH UNIVERSITY OF DELAWARE'S DIVISION OF PROFESSIONAL AND CONTINUING STUDIES AND SCHOOL OF NURSING TO OFFER A BIRTHING COMPANION CERTIFICATE. BIRTH COMPANIONS SUPPORT AND ADVOCATE FOR WOMEN DURING THEIR PREGNANCY, LABOR AND BIRTH, AND AFTER DELIVERY. NURSING STUDENTS PARTICIPATING IN THIS COURSE PROGRAM ARE PROVIDED WITH THE SKILLS NEEDED TO PURSUE THE REQUIREMENTS OF BECOMING A DOULA. THIS PROGRAM SERVES THE DUAL PURPOSE OF HELPING THE PATIENT AND PROVIDING THE NURSING STUDENT WITH CLINICAL EXPERIENCE ALONG WITH THE OPPORTUNITY TO WORK CLOSELY WITH PATIENTS WHO MAY BE IN VERY DIFFERENT CIRCUMSTANCES THAN THEIR OWN. AS A COMMUNITY-BASED TEACHING HOSPITAL, IT IS OUR DUTY TO ENSURE THE NEXT GENERATION OF HEALTH CARE WORKERS RECOGNIZE AND CAN ADDRESS POTENTIAL BARRIERS TO HEALTH THAT MAY RESULT IN HEALTH DISPARITIES. IT IS ALSO OUR COMMITMENT TO ENSURE THE NEXT GENERATION OF HEALTH CARE WORKERS RECOGNIZE AND RESPECT PATIENTS AS WHOLE PEOPLE WHO MAY HAVE VERY DIFFERENT PERSPECTIVES AND EXPERIENCES. FINALLY, SINCE 1995, THE STATE OF DELAWARE HAS ALSO PROVIDED CHRISTIANACARE WITH A GRANT TO OPERATE THE ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION (AAPP). AAPP PROVIDES DELAWARE YOUTH WITH SKILLS AND INFORMATION TO HELP AVOID OR REDUCE INVOLVEMENT IN HIGH-RISK BEHAVIORS, PARTICULARLY HIGH-RISK SEXUAL BEHAVIORS, AND TO PROMOTE POSITIVE YOUTH DEVELOPMENT. IN FY23, CHRISTIANACARE'S 536 STUDENTS PARTICIPATED IN ONE OF THE THREE CORE COURSES AAPP OFFERS: 1. BE PROUD! BE RESPONSIBLE: A SIX-MODULE CURRICULUM THAT PROVIDES ADOLESCENTS, AGES 13 TO 18, WITH THE KNOWLEDGE, MOTIVATION, AND SKILLS NECESSARY TO CHANGE THEIR BEHAVIORS IN WAYS THAT WILL REDUCE THEIR RISK OF CONTRACTING HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS. 2. MAKING PROUD CHOICES: AN EIGHT-MODULE CURRICULUM THAT PROVIDES YOUNG ADOLESCENTS, AGES 11 TO 13, WITH THE KNOWLEDGE, CONFIDENCE, AND SKILLS NECESSARY TO REDUCE THEIR RISK OF SEXUALLY TRANSMITTED INFECTIONS (STIS), HIV, AND PREGNANCY. 3. WISE GUYS: A TEN-MODULE PROGRAM DESIGNED TO PREVENT ADOLESCENT PREGNANCY, EMPOWER YOUNG MEN TO RECOGNIZE CHALLENGES THEY MAY FACE IN LIFE, AND GIVE THEM THE TOOLS TO OVERCOME THESE CHALLENGES. IN EACH OF THE 3 CORE COURSES, SELF-REPORTED PRE-TEST AND POST-TEST KNOWLEDGE, ATTITUDE, AND BEHAVIOR MEASURES BETWEEN SEPTEMBER 2022 AND JUNE 2023 DEMONSTRATED STUDENTS' INCREASED KNOWLEDGE AFTER THEIR PARTICIPATION. AT THE END OF THE COURSE, EVERY STUDENT WAS PROVIDED A SATISFACTION SURVEY AND WAS ASKED TO RATE THE AAPP SERIES THEY ATTENDED. 97% RATED THE AAPP SERIES AS "EXCELLENT"GOOD," 2% RATED IT AS "FAIR,1% RATED IT AS "POOR." IN FY23, THE AAPP TEAM ALSO WORKED TO DEVELOPED WISE GUYS FOR KIDS, A PROGRAM FOR 9-11-YEAR-OLDS. THIS PROGRAM WILL BE PILOTED DURING THE 2023-2024 SCHOOL YEAR. AAPP ALSO OFFERED WISE GUYS: MALE RESPONSIBILITY NEXT LEVEL FOR PARTICIPANTS OVER THE AGE OF 18. IN FY23, 28 INDIVIDUALS RECEIVED THIS EDUCATION. IMPORTANTLY, DESPITE OFFERING THESE COURSES FOR OVER 30 YEARS, THE AAPP TEAM CONTINUALLY LOOKS FOR WAYS TO ENSURE THEIR LESSONS ARE EFFECTIVE AND RESONATE WITH THE STUDENTS. MENTAL HEALTH AND SUBSTANCE USE DISORDERS OUR COMMUNITY HAS LONG IDENTIFIED MENTAL HEALTH AND SUBSTANCE USE DISORDERS AS A SIGNIFICANT AREA OF NEED. OVER THE PAST SEVERAL YEARS, CHRISTIANACARE HAS UNDERTAKEN A VARIETY OF INITIATIVES TO EXPAND ACCESS TO BEHAVIORAL HEALTH SERVICES IN CLINICAL AND COMMUNITY SETTINGS INCLUDING EMBEDDED BEHAVIORAL HEALTH CARE MODELS. EMBEDDING BEHAVIORAL HEALTH SERVICES INCREASES ACCESS AND EARLY PREVENTION AS WELL AS ENABLES US TO SERVE THE PATIENT HOLISTICALLY BY ADDRESSING THE CONNECTION BETWEEN PHYSICAL AND MENTAL HEALTH. CHRISTIANACARE'S BEHAVIORAL HEALTH TEAM SET THE GOAL OF HIRING 71 NEW CAREGIVERS IN BOTH CLINICAL AND NON-CLINICAL ROLES TO ADDRESS BEHAVIORAL HEALTH BY THE END OF FISCAL YEAR 2023. ULTIMATELY, DESPITE A CHALLENGING WORKFORCE ENVIRONMENT, 65 CAREGIVERS WERE HIRED TO ADDRESS BEHAVIORAL HEALTH NEEDS. IN FY23, PSYCHOLOGISTS WERE ALSO EMBEDDED IN CHRISTIANACARE'S PAIN CENTER, PALLIATIVE CARE, AND THE SLEEP CENTER. AS DESCRIBED PREVIOUSLY, CHRISTIANACARE EMPLOYS BEHAVIORAL HEALTH CHWS WHO ARE EMBEDDED IN CHRISTIANACARE'S OUTPATIENT BEHAVIORAL HEALTH SERVICES TO SUPPORT CHILDREN, ADOLESCENTS, AND ADULTS WITH MENTAL HEALTH AND/OR SUBSTANCE USE DIAGNOSES FOR UP TO 6 MONTHS. THESE CHWS ALSO PARTICIPATE IN COMMUNITY EVENTS AND CAN TRAIN COMMUNITY MEMBERS ON THE USE OF NARCAN, AN OPIOID ANTAGONIST DESIGNED TO REVERSE OVERDOSE. IN FY23, DUE TO THE DEMONSTRATED NEED AT THE WILMINGTON FAMILY CENTER PRACTICE, THE EMBEDDED CHW NOW SERVES PATIENTS WITH SUBSTANCE USE DISORDER AS WELL. FOR 15 YEARS, CHRISTIANACARE HAS OPERATED PROJECT ENGAGE, AN EARLY INTERVENTION AND REFERRAL TO SUBSTANCE USE DISORDER TREATMENT PROGRAM. PEERS IN RECOVERY ENGAGE WITH INPATIENTS AND PATIENTS IN THE EMERGENCY DEPARTMENT WHO ARE STRUGGLING WITH SUBSTANCE USE DISORDER. THE PEERS USE MOTIVATIONAL INTERVIEWING TO EMPOWER EACH PATIENT IN THE DECISION-MAKING PROCESS, ASSISTING THEM TO TAKE THE CRITICAL FIRST STEP TO SEEK HELP FOR THE SUBSTANCE USE DISORDER. PEERS WILL CONNECT THESE PATIENTS TO TREATMENT PROGRAMS AND OTHER COMMUNITY RESOURCES. IN FY23, PROJECT ENGAGE PEERS HAD A TOTAL OF 2,468 ENGAGEMENTS WITH PATIENTS AND MADE 1,323 REFERRALS TO TREATMENT. IN APRIL 2023, CHRISTIANACARE'S EMERGENCY DEPARTMENT ALSO BEGAN PRESCRIBING MEDICATIONS FOR OPIOID USE DISORDER (MOUD) TO ELIGIBLE PATIENTS WITH OPIOID USE DISORDER (OUD) SO THAT PATIENTS WHO WANT TO TREAT THEIR OUD CAN TAKE THAT STEP IMMEDIATELY. PROJECT ENGAGE ASSISTS THESE PATIENTS IN MAKING REFERRALS TO TREATMENT TO ENSURE THEY CONTINUE TO RECEIVE MOUD IN THE COMMUNITY AFTER DISCHARGE. AS OVERDOSE DEATHS CONTINUE TO RISE IN DELAWARE, PROVIDING IMMEDIATE ACCESS TO TREATMENT IS CRUCIAL PARTICULARLY AS THE 2021 ANNUAL REPORT ON DELAWARE'S OVERDOSE FATALITIES FOUND THAT 4 OUT OF 5 OF THOSE WHO DIED FROM AN OVERDOSE INTERACTED WITH A HEALTH SYSTEM IN THE YEAR PRIOR TO THEIR DEATH. CHRISTIANACARE ALSO OPERATES SEVERAL BEHAVIORAL HEALTH PROGRAMS IN THE COMMUNITY TO ENSURE OUR NEIGHBORS HAVE ACCESS. IN 2021, CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT RECEIVED STATE AND FEDERAL FUNDING TO PARTNER WITH THE NEW CASTLE COUNTY POLICE DEPARTMENT TO DIVERT INDIVIDUALS AWAY FROM THE CRIMINAL JUSTICE SYSTEM AND EMERGENCY DEPARTMENTS WHEN APPROPRIATE AND WORK TO CONNECT INDIVIDUALS TO CARE IN THE COMMUNITY.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) THREE CHRISTIANACARE CAREGIVERS, TWO MENTAL HEALTH PROFESSIONALS AND A CASE MANAGER, ARE EMBEDDED IN THE POLICE DEPARTMENT'S BEHAVIORAL HEALTH UNIT (BHU) TO ADDRESS MENTAL HEALTH NEEDS IN THE COMMUNITY. SERVING WITH THE POLICE IN A CO-RESPONDER MODEL, THE MENTAL HEALTH PROFESSIONALS RESPOND TO 911 CALLS AND OFFICER REFERRALS WHEN MENTAL ILLNESS IS BELIEVED TO BE A PRIMARY FACTOR FOR POLICE INVOLVEMENT. THEY PROVIDE SUPPORT TO THE COMMUNITY MEMBER AT A TIME OF CRISIS AS WELL AS EDUCATION TO THE OFFICERS ON HOW TO IDENTIFY MENTAL ILLNESS AND PROVIDE ESSENTIAL DE-ESCALATION TACTICS. ONCE THE INITIAL CRISIS HAS BEEN ABATED, THE CASE MANAGER CONTINUES TO WORK TO CONNECT THESE INDIVIDUALS TO THE APPROPRIATE COMMUNITY TREATMENT AND TO ADDRESS ANY SOCIAL NEEDS. SIX ADDITIONAL CHRISTIANACARE CAREGIVERS SUPPORT THE NCCPD'S HERO HELP PROGRAM WHICH ADDRESSES SUBSTANCE USE DISORDER BY SUPPORTING THOSE SEEKING TREATMENT. THESE CAREGIVERS RESPOND TO NON-FATAL OVERDOSES, PROVIDE OUTREACH IN THE COMMUNITY, WORK WITH INDIVIDUALS TO DEVISE A TREATMENT PLAN, OBTAIN TREATMENT, PROVIDE ONGOING MANAGEMENT, AND ADDRESS ANY NEEDS INDIVIDUALS MAY HAVE THAT SERVE AS BARRIERS TO OBTAINING TREATMENT. IN FY23, CHRISTIANACARE AND THE NCCPD SUCCESSFULLY APPLIED FOR FEDERAL FUNDING TO DOUBLE THE NUMBER OF CAREGIVERS SERVING THE HERO HELP PROGRAM INCLUDING THE HIRING OF TWO POSITIONS SERVED BY PEERS. THIS PARTNERSHIP ALLOWS FOR EFFECTIVE INTERVENTIONS FOR COMMUNITY MEMBERS WHO MAY OTHERWISE NOT HAVE ACCESS TO THE BEHAVIORAL HEALTH SERVICES THEY NEED. IT ALSO PROVIDES MUCH NEEDED SUPPORT TO THE POLICE WHO ARE ROUTINELY CONFRONTED WITH BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY MEMBERS. CHRISTIANACARE'S COMMUNITY SUBSTANCE OVERDOSE SUPPORT (SOS), CREATED IN PARTNERSHIP WITH NEW CASTLE COUNTY, PROVIDES OUTREACH TO INDIVIDUALS WITH SUBSTANCE USE DISORDER (SUD) LIVING IN NEW CASTLE COUNTY. SOS ACCEPTS SELF-REFERRALS, INTERNAL REFERRALS FOR CHRISTIANACARE PATIENTS, AND NEW CASTLE COUNTY EMS REFERRALS OF INDIVIDUALS THEY HAVE REVIVED WITH NALOXONE, THE OPIOID OVERDOSE REVERSING MEDICATION, AND TAKEN TO ONE OF CHRISTIANACARE'S EMERGENCY DEPARTMENTS. SOS GOES TO INDIVIDUALS' HOMES OR OTHER COMMUNITY LOCATIONS AND USES MOTIVATIONAL INTERVIEWING TECHNIQUES TO ENCOURAGE THE INDIVIDUAL TO ENTER SUBSTANCE USE DISORDER TREATMENT. IF NEEDED, SOS WILL HELP THE PATIENT ADDRESS ANY BARRIERS TO TREATMENT AND ASSIST THEM WITH ENROLLING IN TREATMENT. SOS ALSO PROVIDES NALOXONE AND TRAINING ON ITS USE AS WELL AS OTHER HARM REDUCTION EDUCATION IN THE COMMUNITY. IN FY23, SOS DISTRIBUTED 314 NALOXONE KITS IN THE ZIP CODES WE IDENTIFIED AS HIGH NEED IN OUR 2 MOST RECENT CHNAS. SOS ALSO RECEIVED A TOTAL OF 797 REFERRALS. THEY WERE ABLE TO SUCCESSFULLY CONTACT 45% OF THOSE REFERRALS, AND OF THOSE, 12% AGREED TO TREATMENT WHICH IS A STRONG RESULT FOR THIS POPULATION. IF AN INDIVIDUAL WAS UNWILLING TO GO TO TREATMENT, THEY WERE OFFERED HARM REDUCTION EDUCATION AND NALOXONE AND ENCOURAGED TO CONTACT SOS ONCE THEY WERE READY TO PURSUE TREATMENT. IN FY23, SOS ALSO BEGAN WORKING WITH THE WILMINGTON POLICE DEPARTMENT (WPD) TO DEVELOP A PARTNERSHIP THAT WOULD ALLOW THE SOS TEAM TO SERVE THOSE WITH SUBSTANCE USE DISORDER REFERRED BY THE WPD. THIS IS ANOTHER EFFORT AIMED AT PROVIDING EFFECTIVE SUPPORT TO THE POLICE IN ADDRESSING THESE PATIENT NEEDS AND CRITICAL RESOURCES TO OUR COMMUNITY. FINALLY, IN RESPONSE TO SPECIFIC COMMUNITY CONCERNS ABOUT ADOLESCENT MENTAL HEALTH IN EARLY 2023, CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT COLLABORATED WITH NEW CASTLE COUNTY'S POLICE DEPARTMENT TO ORGANIZE TWO YOUTH MENTAL HEALTH FAIRS. THE 68 ATTENDEES WERE ABLE TO RECEIVE INFORMATION FROM COMMUNITY BASED MENTAL HEALTH SERVICES AND RESOURCES FROM OVER 25 PROVIDERS. THESE EVENTS WERE HELD IN FEBRUARY 2023 AT THE POLICE ATHLETIC LEAGUE OF WILMINGTON AND THE GREATER NEWARK BOYS & GIRLS CLUB. VIOLENCE IN RECOGNITION OF VIOLENCE AS A PUBLIC HEALTH ISSUE, CHRISTIANACARE LAUNCHED A HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP), EMPOWERING VICTIMS OF LIVED VIOLENCE (EVOLV), IN FEBRUARY 2021. EVOLV IS A COLLABORATION OF CHRISTIANACARE'S TRAUMA AND COMMUNITY HEALTH DEPARTMENTS TO CREATE A SINGLE CARE TEAM USING EVIDENCE-BASED SYNERGISTIC STRATEGIES. EVOLV AIMS TO ADDRESS VIOLENCE AND PROVIDE CARE NAVIGATION AND SUPPORT TO PATIENTS IMPACTED BY COMMUNITY VIOLENCE POST-DISCHARGE TO REDUCE RECIDIVISM OF NEW AND RECURRING INJURIES. EVOLV EMPLOYS TWO CHWS WHO ACTIVELY FOLLOW PATIENTS AND ASSIST IN A MAGNITUDE OF SERVICES POST-DISCHARGE INCLUDING FOLLOW-UP CARE, CONNECTION TO COMMUNITY RESOURCES, ADDRESSING SOCIAL CARE NEEDS, AND IDENTIFYING AND ACHIEVING PATIENT CENTERED GOALS AND OUTCOMES. THE EVOLV PROGRAM HAS A DIRECT CONNECTION TO CHRISTIANACARE'S MISSION AND GOALS TO END DISPARITIES AND RADICALLY SIMPLIFY ACCESS TO CARE. ELIGIBLE PATIENTS ARE THOSE AGES 13+ THROUGHOUT THE STATE OF DELAWARE WHO ARE TREATED AT CHRISTIANACARE'S TRAUMA DEPARTMENT OR EMERGENCY DEPARTMENT FOR A GUNSHOT WOUND, STAB WOUND, AND/OR VIOLENT BLUNT ASSAULT FROM COMMUNITY VIOLENCE. SERVICES ARE EPISODIC AND UP TO 6-MONTHS. IN FY23, THE EVOLV PROGRAM SUCCESSFULLY APPLIED FOR A 2-YEAR GRANT OF $200,000 FROM DELAWARE'S CRIMINAL JUSTICE COUNCIL (CJC). WITH THIS FUNDING, AN ADDITIONAL FRONT-LINE WORKER (CHW) WAS HIRED IN AUGUST OF 2023. EVOLV CONTINUES TO DEVELOP PARTNERSHIPS WITH COMMUNITY AGENCIES SUCH AS THE CENTER FOR STRUCTURAL EQUITY (CFSE), DEPARTMENT OF HEALTH AND SOCIAL SERVICES (DHSS)/GROUP VIOLENCE INTERVENTION (GVI), AND THE OFFICE OF VICTIM'S SERVICES (OVS). THE PARTNERSHIP WITH OVS WILL ALLOW EVOLV TO BETTER ASSIST PATIENTS AND FAMILIES WITH ACCESS TO SERVICES INCLUDING THE VICTIM'S COMPENSATION ASSISTANCE PROGRAM. IN FY23, 39 PATIENTS WERE SERVED WITH 64% OF THOSE GRADUATING. 95% OF PARTICIPATING PATIENTS WERE SCREENED FOR SOCIAL DETERMINANTS OF HEALTH. OF THOSE, 98% SCREENED POSITIVE. THE TRAUMA DEPARTMENT IS ALSO ADDRESSING VIOLENCE THROUGH EDUCATION. IN FY23, THE TRAUMA DEPARTMENT CAREGIVERS PROVIDED 101 STOP THE BLEED TRAININGS TO 1,236 INDIVIDUALS AT CHRISTIANACARE CAMPUSES, SCHOOLS, AND COMMUNITY CENTERS THROUGHOUT DELAWARE. STOP THE BLEED IS A NATIONAL AWARENESS CAMPAIGN THAT EMPOWERS BYSTANDERS WITH THE KNOWLEDGE AND TOOLS THEY NEED TO RECOGNIZE AND STOP LIFE-THREATENING BLEEDING. THE TRAUMA DEPARTMENT ALSO OFFERED EDUCATION FOR STUDENTS THAT REFRAMES GUN VIOLENCE AS A PUBLIC HEALTH ISSUE. STUDENTS DISCUSS THE INDIVIDUAL AND COMMUNITY FACTORS THAT PUT PEOPLE AT RISK FOR GUN VIOLENCE AS WELL AS THE PHYSICAL AND EMOTIONAL IMPACTS OF GUN VIOLENCE. STUDENTS ARE EMPOWERED WITH INFORMATION TO HELP THEM IDENTIFY THE WARNING SIGNS OF GUN VIOLENCE. IN FY23, 60 STUDENTS FROM LAS AMERICAS ASPIRA ACADEMY IN NEWARK PARTICIPATED IN THIS PROGRAM.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) SOCIAL DETERMINANTS OF HEALTH CHRISTIANACARE IS COMMITTED TO THE STRATEGY OF ADDRESSING SOCIAL DETERMINANTS OF HEALTH (SDOH) TO IMPROVE HEALTH OUTCOMES. EVERY PROGRAM PREVIOUSLY DESCRIBED ADDRESSES INDIVIDUALS' SOCIAL NEEDS AND WE ARE ALSO ADDRESSING SDOH ON A SYSTEMWIDE SCALE. CHRISTIANACARE DESIGNED AND IMPLEMENTED ONE SDOH SCREENING INSTRUMENT TO ADMINISTER TO PATIENTS AND IN FY22, INTRODUCED PATIENT SELF-ADMINISTRATION OF THE SDOH SCREENING INSTRUMENT TO INCREASE THE NUMBER OF SDOH SCREENS COMPLETED, IMPROVE EFFICIENCY, AND PROVIDE A BETTER PATIENT EXPERIENCE. THE SDOH SCREEN IS NOT JUST AN EXERCISE TO COLLECT DATA. KNOWING THE CHALLENGES OUR PATIENTS FACE ENABLES US TO BETTER DESIGN CLINICAL AND COMMUNITY INTERVENTIONS TO ADDRESS THEM, AND WE ALSO STRIVE TO ADDRESS THOSE NEEDS THROUGH INTERNAL RESOURCES AND REFERRALS TO COMMUNITY RESOURCES. IN LATE FY23, CHRISTIANACARE LAUNCHED THE SOCIAL CARE CONNECTION CENTER WHICH ESSENTIALLY SERVES AS A HUB TO ADDRESS POSITIVE RESPONSES ON PATIENTS' SDOH SCREENS. DEPENDING ON THE LEVEL OF NEED, A CHW OR SOCIAL WORKER WILL WORK WITH THE PATIENT TO ADDRESS THEIR NEEDS. IN APRIL 2023, CHRISTIANACARE ALSO DEPLOYED TWO ACUTE CARE CONNECTORS (ACCS) TO TWO FLOORS AT WILMINGTON HOSPITAL. THE ACCS PERFORM SDOH SCREENING AT THE BEDSIDE AND SEEK TO ADDRESS SOCIAL CARE NEEDS THAT MAY INCREASE THE POSSIBILITY FOR READMISSION. ACCS ARE HIGHLY COLLABORATIVE AND BRIDGE THE CARE PATIENTS RECEIVE IN THE HOSPITAL WITH COMMUNITY SUPPORT AND RESOURCES. A SIGNIFICANT WAY IN WHICH CHRISTIANACARE ADDRESSES SOCIAL NEED IS THROUGH UNITE DELAWARE. IN 2019, CHRISTIANACARE PARTNERED WITH UNITE US TO LAUNCH AN ELECTRONIC CARE COORDINATION NETWORK, UNITE DELAWARE. THE UNITE DELAWARE NETWORK CONNECTS SOCIAL SERVICES AND CLINICAL CARE PROVIDERS ACROSS THE STATE. WITH THIS NETWORK, ANY HEALTHCARE PROVIDER OR SOCIAL SERVICE AGENCY CAN HELP AN INDIVIDUAL ADDRESS THE DIVERSE ARRAY OF NEEDS THEY MAY HAVE BY SENDING AN ELECTRONIC REFERRAL ON BEHALF OF THE PATIENT TO THE APPROPRIATE ORGANIZATION. THE SENDER OF THAT REFERRAL WILL BE ABLE TO TRACK WHETHER THAT NEED WAS MET OR NOT AND TAKE ADDITIONAL ACTION IF NEEDED TO HELP THE PATIENT MEET THEIR NEED. UNITE DELAWARE NOW INCLUDES TWO OTHER DELAWARE HOSPITALS AND OVER 200 COMMUNITY-BASED ORGANIZATIONS. CHRISTIANACARE FUNDS THE UNITE DELAWARE PLATFORM BECAUSE WE BELIEVE IT CAN HELP DELAWAREANS THROUGHOUT THE STATE ADDRESS THEIR NEEDS. THERE IS ALSO NO COST TO THE COMMUNITY-BASED ORGANIZATIONS THAT PARTICIPATE IN THE NETWORK AND SO OUR HOPE IS THAT THE NETWORK ALSO PROVIDES BENEFIT TO THEM. IN MAY 2022, UNITE DELAWARE WAS INTEGRATED INTO CHRISTIANACARE'S MEDICAL HEALTH RECORD TO ENABLE EASIER OPERABILITY FOR PROVIDERS TO SEND A REFERRAL IN A CLINICAL SETTING, AND SO THE PATIENT'S ENTIRE CARE TEAM CAN HAVE INSIGHT INTO THEIR SOCIAL NEEDS. IN OUR FY2023 ANNUAL OPERATING PLAN, IN SERVICE TO CHRISTIANACARE'S ASPIRATION OF ENDING DISPARITIES, WE SET THE GOAL OF INCREASING BY 25% THE PERCENTAGE OF PATIENTS WITH COMPLETE SDOH SCREENS FROM HIGH-RISK COMMUNITIES AS DEFINED IN THE CHNA AND INCREASING BY 25% THE NUMBER OF REFERRALS CAREGIVERS SEND THROUGH THE UNITE DELAWARE NETWORK ON BEHALF OF PATIENTS IN THE CHNA DEFINED HIGH-RISK ZIP CODES. WE FAR EXCEEDED THESE TARGETS IN FY23. IN FY23, CHRISTIANACARE'S PROGRAMS AND DEPARTMENTS THAT PARTICIPATE ON UNITE US CONNECTED 972 INDIVIDUALS TO THE UNITE DELAWARE PLATFORM AND SENT 2,194 REFERRALS TO PARTICIPATING COMMUNITY ORGANIZATIONS ON THEIR BEHALF. SOME OF CHRISTIANACARE'S PARTICIPATING DEPARTMENTS AND PROGRAMS ALSO ACCEPT REFERRALS THROUGH THE PLATFORM, AND IN FY23, WE MANAGED 1,201 REFERRALS FROM COMMUNITY PARTNERS. IN 2020, CHRISTIANACARE PARTNERED WITH ROUNDTRIP TO PROVIDE TRANSPORTATION TO MEDICAL SERVICES FOR ELIGIBLE PATIENTS WHO HAVE A TRANSPORTATION BARRIER. INITIALLY PILOTED IN TWO DEPARTMENTS, IN FY22, WE UNDERTOOK A CONSIDERABLE EXPANSION AND THERE ARE NOW MORE THAN 20 PARTICIPATING PROGRAMS AND DEPARTMENTS USING ROUNDTRIP TO SERVE PATIENTS WITH TRANSPORTATION BARRIERS. OUR EXPECTATION IS THAT PATIENTS' HEALTH WILL IMPROVE WHEN THE TRANSPORTATION BARRIER IS REMOVED. IN FY23, 19,552 RIDES WERE PROVIDED TO PATIENTS WHICH IS MORE THAN DOUBLE THE NUMBER OF RIDES PROVIDED IN FY22. THE HEALTH GUIDES ALSO CONTINUED TO CONNECT PATIENTS TO THE MEDICAL LEGAL PARTNERSHIP (MLP), CHRISTIANACARE'S COLLABORATION WITH THE DELAWARE COMMUNITY LEGAL AID SOCIETY, INC. (CLASI). THE MLP ASSISTS PRIMARY CARE PATIENTS WHO ARE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL WITH THE MITIGATION OF CIVIL LEGAL HARDSHIPS. CHRISTIANACARE HAS CONTRACTED WITH CLASI SINCE 2015 TO PROVIDE THIS SERVICE. IN FY23, LEGAL SERVICES WERE PROVIDED TO 123 PATIENTS ON A TOTAL OF 146 NEW OPEN LEGAL CASES. SOME PATIENTS HAD MULTIPLE CIVIL LEGAL NEEDS AND SO COMPANION CASES WERE OPENED WHEN NEEDED. IN FY23, THE FOLLOWING LEGAL MATTERS WERE ADDRESSED ON BEHALF OF THE PATIENTS: . 36% HOUSING AND UTILITIES . 35% PERSONAL AND FAMILY STABILITY . 19% INCOME AND INSURANCE . 5% EDUCATION AND EMPLOYMENT . 5% LEGAL IMMIGRATION STATUS MOST OF THE PATIENTS (86) IDENTIFIED AS FEMALE AND 63% REPORTED AN INCOME AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. FOR THE 2ND YEAR, CHRISTIANACARE'S HEALTH DEPARTMENT ALSO PROVIDED SHADOWING OPPORTUNITIES FOR UNIVERSITY OF DELAWARE NURSING STUDENTS. THIS EXPERIENCE PROVIDES EXPOSURE TO THE CHALLENGES PATIENTS MAY FACE AND HOW CHRISTIANACARE PARTNERS WITH PATIENTS TO ADDRESS THEM. IT IS ANOTHER OPPORTUNITY FOR THE NEXT GENERATION OF HEALTHCARE WORKERS TO RECOGNIZE THE IMPORTANCE OF HOLISTIC CARE. DURING THE 2022-2023 SCHOOL YEAR, 40 NURSING STUDENTS FROM THE UNIVERSITY OF DELAWARE MET AND SHADOWED CAREGIVERS IN THE COMMUNITY HEALTH DEPARTMENT.
PART V, SECTION B, LINE 11 (ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA) TO SUCCESSFULLY ADDRESS SOCIAL NEEDS, PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS ARE VITAL. THROUGHOUT THIS SECTION WE HAVE DESCRIBED SOME OF THE PARTNERSHIPS WE HAVE DEVELOPED TO BETTER SERVE OUR COMMUNITY. WE ARE ALSO COMMITTED TO SUPPORTING COMMUNITY-BASED ORGANIZATIONS THROUGH FUNDING. IN DECEMBER 2019, WE LAUNCHED CHRISTIANACARE'S COMMUNITY INVESTMENT FUND WITH THE AWARD OF OVER $2 MILLION IN FUNDING TO 32 COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE AREAS OF NEED PRIORITIZED IN THE 2019 CHNA. DUE TO THE FINANCIAL UNCERTAINLY CAUSED BY THE PANDEMIC, WE WERE UNABLE TO AWARD ANY FUNDS IN FY21. IN FY22, WE PROVIDED 13 ORGANIZATIONS WITH OVER $1 MILLION IN FUNDING TO ADDRESS FOOD INSECURITY AND HOUSING. IN MAY 2023, WE ANNOUNCED A NEW ROUND OF THE COMMUNITY INVESTMENT FUND THAT WOULD AWARD COMMUNITY-BASED ORGANIZATIONS WITH UP TO $75,000 TO ADDRESS FOOD INSECURITY, HOUSING, AND/OR ENVIRONMENTAL HEALTH. 17 ORGANIZATIONS WERE SELECTED TO RECEIVE A TOTAL OF JUST OVER $1 MILLION IN EARLY FY24. IN FY23, CHRISTIANACARE PROVIDED FUNDING TO THE FOLLOWING ORGANIZATIONS: . FRIENDSHIP HOUSE' TRANSITIONAL HOUSING PROGRAM TO SUPPORT THEIR CASE MANAGEMENT AND OTHER EFFORTS TO HELP RESIDENTS GAIN LONG TERM HOUSING. . THE DELAWARE COLLEGE SCHOLARS PROGRAM WHICH PREPARES HIGH-ACHIEVING UNDER-RESOURCED DELAWARE PUBLIC HIGH SCHOOL STUDENTS ACADEMICALLY AND SOCIALLY FOR SUCCESSFULLY APPLYING TO, SUCCEEDING IN, AND GRADUATING FROM FOUR-YEAR COLLEGES AND UNIVERSITIES. . THE RYSHEEMA J. DIXON FOUNDATION TO SUPPORT WILMINGTON PLAYSTREETS SUMMER 2023. THE PRIMARY GOAL OF WHICH IS TO PROMOTE HEALTHY COMMUNITIES BY PROVIDING GREATER ACCESS TO COMMUNITY RESOURCES AND CLOSE 1-2 NEIGHBORHOOD BLOCKS TO ALLOW TIME FOR PLAY IN AN ENCLOSED AND SAFE ENVIRONMENT, ENCOURAGING INTERACTIONS WITH COMMUNITIES. THE ABOVE IS NOT AN EXHAUSTIVE LIST OF THE FUNDING CONTRIBUTED TO COMMUNITY ORGANIZATIONS IN FY23, BUT IT DEMONSTRATES OUR COMMITMENT TO SUPPORTING THE DIVERSE EFFORTS OF OUR COMMUNITY PARTNERS TO MEET THE NEED OF OUR COMMUNITIES. IN ADDITION TO PROVIDING FUNDING TO COMMUNITY ORGANIZATIONS, CHRISTIANACARE ALSO PROVIDES IN-KIND DONATIONS TO ASSIST COMMUNITY ORGANIZATIONS AND REDUCE WASTE. IN FY23, THE WILMINGTON CAMPUS CAFETERIA DONATED 34,095 POUNDS OF FOOD TO THE SUNDAY BREAKFAST MISSION. THE SUNDAY BREAKFAST MISSION IN WILMINGTON PROVIDES EMERGENCY SHELTER AND MEALS TO MEN, WOMEN, AND CHILDREN. --------------------
PART V, SECTION B, LINE 13 (ELIGIBILITY FOR PROVIDING DISCOUNTED CARE) FEDERAL POVERTY GUIDELINES ARE NOT USED TO DETERMINE DISCOUNTED CARE. A SELF-PAY DISCOUNT OF 15% IS APPLIED TO ALL UNINSURED PATIENT ACCOUNTS REGARDLESS OF INCOME. PATIENTS WITH INCOME IN EXCESS OF 200% OF THE FEDERAL POVERTY LEVEL WILL RECEIVE A 15% DISCOUNT. --------------------
PART V, SECTION B, LINE 16 (FINANCIAL ASSISTANCE POLICY AVAILABILITY) A COPY OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT: https://christianacare.org/US/EN/VISIT-US/FOR-PATIENTS/FINANCIAL-ASSISTANC E-PROGRAM-SUMMARY/FINANCIAL-ASSISTANCE-PROGRAM --------------------
PART V, SECTION B, LINE 20 (ADDITIONAL EFFORTS MADE BEFORE AN ECA) CHRISTIANA CARE HEALTH SERVICES COMMUNICATES IN WRITING ABOUT COLLECTION PLACEMENT AND THE FINANCIAL ASSISTANCE POLICY. --------------------
PART V, SECTION B, LINE 22 (CHARGES FOR FAP-ELIGIBLE INDIVIDUALS) FAP-ELIGIBLE INDIVIDUALS (THOSE WITH INCOME LESS THAN 200% OF FEDERAL POVERTY GUIDELINES) ARE NOT RESPONSIBLE FOR ANY CHARGES. --------------------
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C (DES. OF ELIGIBILITY CRITERIA FOR FREE OR DISCOUNTED CARE) CHRISTIANA CARE HEALTH SERVICES, INC.("CHRISTIANACARE") HAS A SELF PAY DISCOUNT PERCENTAGE OF 15% THAT IS APPLIED TO ALL UNINSURED PATIENTS' ACCOUNTS, REGARDLESS OF THE PERSON'S ABILITY TO PAY. THIS DISCOUNT PERCENTAGE IS COMPARABLE TO THAT WHICH IS EXTENDED TO OUR MANAGED CARE COMPANIES. -------------------- PART I, LINE 6A (COMMUNITY BENEFIT ANNUAL REPORT INFORMATION) CHRISTIANACARE HEALTH PREPARED A COMMUNITY HEALTH NEEDS ASSESSMENT AND A COMMUNITY HEALTH IMPLEMENTATION PLAN DURING THE FY2022 TAX YEAR. BOTH DOCUMENTS ARE AVAILABLE AT THE FOLLOWING LINK ON THE CCHS WEBSITE: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY- HEALTH-IMPLEMENTATION-PLAN/ -------------------- PART I, LINE 7 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED) IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. AS A RESULT, THERE ARE NO BAD DEBT EXPENSES INCLUDED ON FORM 990, PART IX THAT NEED TO BE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES LISTED. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. -------------------- PART II (COMMUNITY BUILDING ACTIVITIES) IN FY23, THE ECONOMIC DEVELOPMENT ACTIVITIES CHRISTIANACARE UNDERTOOK WERE PARTICIPATION ON THE FOLLOWING COMMUNITY ORGANIZATION BOARDS AND LEADERSHIP TEAMS: VISION COALITION OF DELAWARE: A PUBLIC PRIVATE PARTNERSHIP COMPOSED OF A BROAD RANGE OF DELAWARE WORKING TOGETHER TO IMPROVE DELAWARE PUBLIC EDUCATION. CHRISTIANACARE'S CHIEF HEALTH EQUITY AND PUBLIC AFFAIRS OFFICER SERVES AS CHAIR OF THE VISION COALITION. SENIOR LEADERSHIP SERVES ON THE DELAWARE BUSINESS ROUNDTABLE EDUCATION COMMITTEE: A NONPROFIT ORGANIZATION THAT AIMS TO IMPROVE PUBLIC EDUCATION BY AGGREGATING AND ALIGNING THE RESOURCES OF ROUNDTABLE MEMBERS AND OTHER BUSINESS LEADERS. WILMINGTON ALLIANCE: A NONPROFIT ORGANIZATION THAT PARTNERS WITH COMMUNITY, CIVIC, AND BUSINESS LEADERS TO PRIORITIZE THE CITY'S HIGHEST NEEDS TO DRIVE ECONOMIC OPPORTUNITY AND SOCIAL VITALITY. IN ADDITION TO OUR WILMINGTON HOSPITAL'S CAMPUS EXECUTIVE DIRECTOR'S PARTICIPATION ON THE WILMINGTON ALLIANCE EXECUTIVE BOARD, AS VICE CHAIR, CHRISTIANACARE ALSO PROVIDED WILMINGTON ALLIANCE WITH $90,000 IN FUNDING TO SUPPORT THEIR MISSION. OUR PARTICIPATION IN THE HEALTHCARE ANCHOR NETWORK, AN ORGANIZATION DEVOTED TO HELPING HEALTHCARE SYSTEMS BUILD MORE INCLUSIVE AND SUSTAINABLE LOCAL COMMUNITIES, IS ALSO INCLUDED IN THIS CATEGORY. IN THE COMMUNITY BUILDING CATEGORY OF COMMUNITY SUPPORT, WE REPORTED CHRISTIANACARE'S $150,000 CONTRIBUTION TO DELAWARE COLLEGE SCHOLARS WHICH SERVES TO ACADEMICALLY AND SOCIALLY PREPARE HIGH-ACHIEVING, UNDER-RESOURCED DELAWARE PUBLIC HIGH SCHOOL STUDENTS FOR SUCCESSFULLY APPLYING TO, SUCCEEDING IN, AND GRADUATING FROM FOUR-YEAR COLLEGES AND UNIVERSITIES. IN THE COMMUNITY BUILDING CATEGORY OF COALITION BUILDING, WE REPORTED THE TIME SPENT BY OUR CHIEF PUBLIC AFFAIRS AND CHIEF HEALTH EQUITY OFFICER PARTICIPATING ON THE PURPOSE-BUILT COMMUNITIES' REACH RIVERSIDE COMMUNITY DEVELOPMENT INITIATIVE BOARD OF DIRECTORS. IN 2019, CHRISTIANACARE CONTRIBUTED $1 MILLION TO THIS INITIATIVE TO REVITALIZE THE RIVERSIDE NEIGHBORHOOD IN WILMINGTON AND OUR CHIEF PUBLIC AFFAIRS OFFICER AND CHIEF HEALTH EQUITY OFFICER HAS CONTINUED TO SUPPORT THIS INITIATIVE. IN THE COMMUNITY BUILDING CATEGORY OF ENVIRONMENTAL IMPROVEMENTS, WE REPORTED EXPENSES RELATED TO THE ENVIRONMENTAL HEALTH ROUNDTABLE WE ORGANIZED IN MAY 2023. THE SMALL, BUT MEANINGFUL, EVENT WAS HELD AT THE TEEN WAREHOUSE LOCATED IN A NEIGHBORHOOD THAT HAS SUFFERED FROM THE IMPACT OF FLOODING RECENTLY AND THROUGHOUT ITS HISTORY. COMMUNITY STAKEHOLDERS SUCH AS THE CHIEF EXECUTIVE OFFICER OF REACH RIVERSIDE, DELAWARE NATURAL RESOURCES AND ENVIRONMENTAL CONTROL SECRETARY, CHIEF EXECUTIVE OFFICER OF THE DELAWARE NATURE SOCIETY CEO, AND STATE REPRESENTATIVES CONVENED TO DISCUSS WITH CHRISTIANACARE LEADERS ENVIRONMENTAL EFFORTS THEY ARE UNDERTAKING AND OPPORTUNITIES FOR COLLABORATION. THIS WORK WILL BE ONGOING AS CHRISTIANACARE STRIVES TO BE A LEADER IN ENVIRONMENTAL STEWARDSHIP. FINALLY, CHRISTIANACARE INVESTS CONSIDERABLY IN WORKFORCE DEVELOPMENT. OUR WORKFORCE DEVELOPMENT INITIATIVES SERVE TO BOTH INFLUENCE THE NEXT GENERATION OF HEALTHCARE WORKERS TO UNDERSTAND THE BARRIERS TO GOOD HEALTH PATIENTS MAY FACE AND DEVELOP A WORKFORCE THAT REFLECTS OUR COMMUNITY. CHRISTIANACARE IS IN THE 2ND YEAR OF ITS 5-YEAR COMMITMENT OF $500,000 TO AWARD MERIT-BASED SCHOLARSHIPS OF $12,500 TO TEN STUDENTS PER YEAR, PER STUDENT, TO ATTEND AN HBCU. THE FOCUS OF THE SCHOLARSHIP PROGRAM ARE MINORITY STUDENTS WHO ARE PURSUING A FIELD OF STUDY IN HEALTH CARE. THESE STUDENTS ALSO PARTICIPATED IN AN INTERNSHIP PROGRAM AT CHRISTIANACARE. CHRISTIANACARE'S COMMUNITY HEALTH DEPARTMENT ALSO OFFERS YOUTH PROGRAMMING THAT EXPOSES THE PARTICIPANTS, OR SCHOLARS AS WE REFER TO THEM, TO POTENTIAL CAREERS IN THE HEALTH FIELD AND PROVIDES THEM WITH THE SKILLS AND EXPERIENCE TO SUPPORT THEIR DEVELOPMENT INTO YOUNG ADULTS EVEN IF THEY CHOOSE TO TAKE A DIFFERENT PATH. IN FY23, THE FOLLOWING PROGRAMS WERE OFFERED: BACK 2 BASICS 2.0: THIS PROGRAM, OFFERED IN PARTNERSHIP WITH JOBS FOR DELAWARE GRADS, A SCHOOL-TO-WORK TRANSITIONAL PROGRAM DEDICATED TO HELPING YOUTH REACH ACADEMIC AND ECONOMIC SUCCESS, WAS CREATED IN RESPONSE TO THE CORONAVIRUS PANDEMIC. IT PROVIDES HIGH SCHOOL SCHOLARS WITH THE OPPORTUNITY TO PARTICIPATE IN 12 IMMERSIVE SESSIONS THROUGH A CASE STUDY APPROACH. IN FY23, 64 SCHOLARS PARTICIPATED IN THIS PROGRAM. WORK BASED LEARNING (NURSING/SURGICAL SERVICES): THIS PROGRAM, INTRODUCED IN FY23, IS DESIGNED TO INCREASE SCHOLAR AWARENESS OF POTENTIAL SURGICAL SERVICE CAREERS, THROUGH REAL WORLD WORKPLACE OBSERVATION AND ENGAGEMENT WITH HEALTHCARE PROFESSIONALS. SCHOLARS EXPLORE A VARIETY OF OCCUPATIONS WITHIN THE SURGICAL SETTING, SCOPE OF ROLE/RESPONSIBILITIES, ESSENTIAL SKILLS, AND EDUCATIONAL REQUIREMENTS AND PATHWAYS. PARTICIPANTS ARE SENIORS AT APPOQUINIMINK HIGH SCHOOL OR MIDDLETOWN HIGH SCHOOL AND ENROLLED IN THE SCHOOL OF HEALTH SCIENCE PATHWAY. SCHOLARS PARTICIPATING IN CHRISTIANACARE'S SURGICAL SERVICE WORK BASED LEARNING EXPERIENCE MUST ATTEND ALL HOSPITAL PROGRAM DATES AND BACK 2 BASICS VIRTUAL SESSIONS. IN FY23, 5 SCHOLARS COMPLETED THIS PROGRAM. NURSING CAREER COLLABORATIVE: THIS PROGRAM WAS DEVELOPED TO SERVE AS A PATHWAY TO NURSING FOR HIGH SCHOOL SCHOLARS FROM WILLIAM PENN HIGH SCHOOL AND FREIRE CHARTER SCHOOL. THROUGH THE NURSING CAREER COLLABORATIVE, SCHOLARS ARE EDUCATED AND EXPOSED TO THE FIELD AND FUNDAMENTALS OF NURSING. ON THEIR LAST DAY OF THE PROGRAM, SCHOLARS ALSO HAD AN OPPORTUNITY TO SHADOW ON A UNIT WITH A NURSE. IN FY23, 20 SCHOLARS PARTICIPATED. MEDICAL ASSISTANT CO-OP: IN FY 23, 9 MEDICAL ASSISTANT TRACT SCHOLARS FROM DELCASTLE AND ST. GEORGES TECHNICAL HIGH SCHOOLS CAME TO CHRISTIANACARE FOR THE CO-OP EXPERIENCE. UPON COMPLETION OF THE ACADEMIC SCHOOL YEAR IN JUNE 2023, 2 OF THE SCHOLARS WERE HIRED ON AS MEDICAL ASSISTANCES. BRANDYWINE LIFESAVERS PROGRAM: IN FY23, CHRISTIANACARE AGAIN PARTNERED WITH THE BRANDYWINE LIFESAVERS PROGRAM WHICH WAS DEVELOPED BY BRANDYWINE SCHOOL DISTRICT NURSES TO CREATE A PIPELINE FOR YOUNGER STUDENTS TO BE INTRODUCED TO POSSIBLE CAREERS IN HEALTH CARE. THE PROGRAM ALSO FOCUSES ITS ATTENTION ON STUDENTS FROM BACKGROUNDS NOT REPRESENTED IN THE NURSING PROFESSION. 60 MIDDLE AND HIGH SCHOOL SCHOLARS FROM THE BRANDYWINE SCHOOL DISTRICT VISITED CHRISTIANACARE'S NEWARK CAMPUS IN MARCH AND APRIL 2023 TO LEARN ABOUT DIFFERENT SPECIALTY STATIONS AND TOUR A PATIENT CARE UNIT. THE TOPICS OF MENTAL HEALTH AND THE IMPORTANCE OF SELF-CARE AND MENTORSHIP WERE ALSO DISCUSSED WITH THE SCHOLARS. --------------------
PART III, SECTION A, LINE 2 (IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606). -------------------- PART III, SECTION A, LINE 3 (IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY) THE AMOUNT OF BAD DEBTS (IMPLICIT PRICE CONCESSIONS) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ITS FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED UPON THE NUMBER OF PRESUMED CHARITY-CARE ELIGIBLE PATIENTS WHO DID NOT COMPLETE THE FAP PAPERWORK DURING THE YEAR. -------------------- PART III, SECTION A, LINE 4 (IMPLICIT PRICE CONCESSION FOOTNOTE) THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. --------------------
PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF CHRISTIANACARE AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, CHRISTIANACARE PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY CHRISTIANACARE TO PROVIDE SUCH SERVICES. AS A RESULT, CHRISTIANA CARE VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. -------------------- PART III, SECTION B, LINE 9B (COLLECTION PRACTICES) CHRISTIANACARE HAS A FINANCIAL ASSISTANCE POLICY THAT IDENTIFIES THE CIRCUMSTANCES FOR WHICH A RESPONSIBLE PARTY WOULD BE EXTENDED A 100% ADJUSTMENT ON ALL MEDICAL BILLS. THE GROSS INCOME THRESHOLD FOR THIS CHARITABLE ADJUSTMENT IS 200% OF THE FEDERAL POVERTY LEVEL AND IT IS BASED ON THE NUMBER OF DEPENDENTS IN THE HOUSEHOLD. THE FINANCIAL ASSISTANCE POLICY FURTHER EXPLAINS THAT ANY UNINSURED PATIENT WHO FAILS TO QUALIFY FOR FINANCIAL ASSISTANCE WOULD BE GRANTED A 15% SELF PAY DISCOUNT. PATIENTS MAY ALSO ESTABLISH INTEREST-FREE MONTHLY PAYMENT ARRANGEMENTS FOR ANY OUTSTANDING BALANCE THAT IS NOT COVERED BY A THIRD PARTY PAYER. AS PART OF THE SELF PAY DUNNING PROCESS, CHRISTIANA CARE MAKES UNINSURED PATIENTS AWARE OF THE FINANCIAL ASSISTANCE PROGRAM WITH THE RELEASE OF OUR FIRST STATEMENT. FOR ALL SUBSEQUENT STATEMENTS, PATIENTS HAVE AN OPPORTUNITY TO CALL OUR CUSTOMER SERVICES DEPARTMENT IF THEY ARE UNABLE TO MAKE PAYMENT IN FULL. IF A PATIENT QUALIFIES FOR A CHARITABLE ADJUSTMENT, THEY ARE EXTENDED THE COURTESY OF AN AUTOMATIC ADJUSTMENT TO THEIR BILLS FOR THE NEXT YEAR AND FOR ONE YEAR PRIOR TO THE DATE A PATIENT'S APPLICATION IS APPROVED. PATIENTS WOULD NEED TO REAPPLY FOR CHARITABLE CONSIDERATION AFTER THE ONE YEAR HAS LAPSED. ALL COLLECTION ACTIONS WOULD CEASE ONCE A PATIENT IS DEEMED ELIGIBLE FOR CHARITY OR ONCE A PATIENT ESTABLISHES AND MAINTAINS A MONTHLY PAYMENT ARRANGEMENT. --------------------
PART VI, LINE 2 (NEEDS ASSESSMENT) AT CHRISTIANACARE, WE PARTNER WITH OUR NEIGHBORS TO PROVIDE THEM WITH SYSTEMS OF CARE THAT THEY VALUE. KNOWING WHAT OUR NEIGHBORS VALUE IS ONLY POSSIBLE THROUGH COMMUNICATION. TWO OF THE BEHAVIORS THAT GUIDE CHRISTIANACARE CAREGIVERS ARE A WILLINGNESS TO LISTEN ACTIVELY AND SEEK NEW KNOWLEDGE AND IT IS WITH THIS MINDSET THAT WE APPROACH OUR PARTNERSHIPS IN THE COMMUNITY AND OUR SERVICE TO OUR PATIENTS. MANY OF THE WAYS IN WHICH CHRISTIANACARE ASSESSES THE HEALTH NEEDS OF OUR COMMUNITY HAVE BEEN DESCRIBED. A SYSTEM WIDE SDOH SCREENING INSTRUMENT WAS IMPLEMENTED TO LEARN DIRECTLY FROM OUR PATIENTS ABOUT THEIR CHALLENGES, AND WE PARTNERED WITH UNITE US TO LAUNCH UNITE DELAWARE IN THE STATE TO PROVIDE A TOOL TO ADDRESS OUR PATIENTS' NEEDS AS WELL AS INSIGHT INTO THE NEEDS OF DELAWAREANS. IN FY23, THE TOP NEEDS REFERRED TO IN UNITE DELAWARE WERE HOUSING & SHELTER, UTILITIES, FOOD ASSISTANCE, CLOTHING & HOUSEHOLD GOODS, AND INCOME SUPPORT. THE COMMUNITY INVESTMENT FUND ALSO PROVIDES US WITH THE OPPORTUNITY TO LEARN FROM COMMUNITY-BASED ORGANIZATIONS ABOUT THE CHALLENGES THEIR COMMUNITIES FACE AND HOW THEY THINK BEST TO ADDRESS THEM. 72 ORGANIZATIONS APPLIED FOR OUR MOST RECENT ROUND OF FUNDING. DIRECTLY PARTNERING WITH COMMUNITY ORGANIZATIONS ALSO PROVIDES INSIGHT INTO OUR COMMUNITY. THE GREATER WILMINGTON COMMUNITY PARTNERSHIP WAS FORMED WITH COMMUNITY PARTNERS IN 2012 TO ADDRESS THE NEEDS OF HOMELESS INDIVIDUALS. THE FOCUS HAS SINCE EXPANDED TO SOCIAL DETERMINANTS OF HEALTH BROADLY, AND IT CONTINUES TO BE HOSTED BY CHRISTIANACARE. MONTHLY MEETINGS PROVIDE INFORMATION AND RESOURCE SHARING AND THE OPPORTUNITY TO DISCUSS COMMUNITY CHALLENGES. PARTICIPANTS INCLUDE THOSE FROM FAITH-BASED, NON-PROFIT, AND GOVERNMENT ORGANIZATIONS. CHAIRED BY A CHRISTIANACARE PROVIDER, THE WILMINGTON CONSORTIUM SERVES TO EDUCATE PROFESSIONALS WORKING WITH FAMILIES WITH CHILDREN FROM BIRTH TO AGE 5. LIKE THE GREATER WILMINGTON COMMUNITY PARTNERSHIP, THE PURPOSE OF THE GROUP IS TO SHARE RESOURCES AND DISCUSS COMMUNITY ISSUES AS THEY RELATE TO FAMILIES WITH YOUNG CHILDREN. MEMBERS ARE ALSO ABLE TO SHARE COMMUNITY EVENTS AND RESOURCES WHICH ARE EMAILED TO ALL MEMBERS. THE COMMUNITY ENGAGEMENT ADVISORY COUNCIL, CO-CHAIRED BY CHRISTIANACARE'S CHIEF HEALTH EQUITY OFFICER, WAS FORMED TO PROVIDE CHRISTIANACARE WITH A DIRECT CONNECTION TO COMMUNITY LEADERS AND STAKEHOLDERS TO GAIN THEIR PERSPECTIVE ON COMMUNITY NEEDS AND IDENTIFY OPPORTUNITIES IN WHICH BOTH THE COMMUNITY AND CHRISTIANACARE CAN BENEFIT FROM WORKING TOGETHER TOWARDS MUTUAL GOALS. CHRISTIANACARE'S PATIENT & FAMILY HEALTH EDUCATION TEAM HAS ALSO PARTNERED WITH THE UNIVERSITY OF DELAWARE PARTNERSHIP FOR HEALTHY COMMUNITIES AND THE DELAWARE DIVISION OF PUBLIC HEALTH TO IMPROVE HEALTH LITERACY IN OUR STATE. SOME OF THEIR SUCCESSFUL EFFORTS, WHICH INCLUDED THE DEVELOPMENT OF AND PARTICIPATION ON THE HEALTH LITERACY COUNCIL OF DELAWARE, WERE DESCRIBED PREVIOUSLY AS A WAY IN WHICH WE ARE ALSO PROMOTING ACCESS TO CARE. PARTICIPATION BY CHRISTIANACARE LEADERS ON COMMUNITY BOARDS AND COMMITTEES ALSO PROVIDES INSIGHT INTO COMMUNITY NEEDS. THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM, THE VISION COALITION OF DELAWARE, THE REACH RIVERSIDE BOARD, THE DELAWARE BUSINESS ROUNDTABLE, THE WILMINGTON ALLIANCE, AND AIDS DELAWARE, AMONG OTHER ORGANIZATIONS, ARE ALL SERVED BY CHRISTIANACARE CAREGIVERS. --------------------
PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) ON FEBRUARY 1, 2023, CHRISTIANACARE MADE SEVERAL CHANGES TO ITS FINANCIAL ASSISTANCE POLICY TO MAKE IT AVAILABLE TO MORE OF OUR NEIGHBORS. THE FINANCIAL ASSISTANCE ELIGIBILITY THRESHOLD WAS RAISED FROM 200% TO 400% OF THE FEDERAL POVERTY LEVEL AND PATIENTS FACING CATASTROPHIC COSTS, WHERE THE MEDICAL EXPENSES FOR AN EPISODE OF CARE EXCEED 20% OF THEIR ANNUAL INCOME, CAN NOW APPLY FOR FINANCIAL ASSISTANCE AS WELL. CHRISTIANACARE'S PRESUMPTIVE ELIGIBILITY PROCESS WAS ALSO UPDATED AND CLARIFIED IN THE FINANCIAL ASSISTANCE POLICY TO REDUCE THE BURDEN ON PATIENTS TO SUPPLY SUPPORTING DOCUMENTATION. THE PROCESS FOR CHRISTIANACARE REPRESENTATIVES TO MAKE IMMEDIATE CASE-BY-CASE DETERMINATIONS OF INDIVIDUAL ELIGIBILITY AND ACCEPT ALTERNATIVE QUALIFYING DOCUMENTATION FOR FINANCIAL ASSISTANCE WAS ALSO UPDATED AND STREAMLINED. THOSE WHO ARE UNINSURED WITH HOUSEHOLD INCOMES GREATER THAN 400% OF THE FPL ARE ELIGIBLE FOR A STANDARD DISCOUNT OF 15%. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON OUR WEBSITE: FINANCIAL ASSISTANCE PROGRAM SUMMARY - CHRISTIANACARE ALONG WITH THE FOLLOWING MATERIALS IN ENGLISH, SPANISH, CANTONESE, AND MANDARIN WHICH ARE THE MOST SPOKEN LANGUAGES BESIDES ENGLISH: . A PLAIN LANGUAGE SUMMARY, . THE FINANCIAL ASSISTANCE APPLICATION, . A DESCRIPTION OF THE APPLICATION PROCESS, . THE INCOME SCALES, . THE FINANCIAL ASSISTANCE SERVICE AREA, AND . A LIST OF PARTICIPATING AND NON-PARTICIPATING PROVIDERS. THE FINANCIAL ASSISTANCE PROGRAM IS PUBLICIZED THROUGH PAMPHLETS, SIGNAGE, ONLINE NOTICES ON THE CHRISTIANACARE WEBSITE, AND IN-PATIENT SERVICE AREAS. THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED AND WHO INDICATE THEIR INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES AT INTAKE OR DISCHARGE. TRANSLATION ASSISTANCE BY PHONE TO COMPLETE NECESSARY FORMS FOR ANYONE NOT PROFICIENT IN READING, WRITING, OR SPEAKING ENGLISH IS ALSO AVAILABLE MONDAY THROUGH FRIDAY FROM 9 A.M. TO 4 P.M. PATIENTS MAY ALSO CALL PATIENT FINANCIAL SERVICES TO REQUEST INFORMATION AND AN APPLICATION AND TO TALK CONFIDENTIALLY ABOUT THEIR SITUATION. IF CHRISTIANACARE DETERMINES THAT THE PATIENT MAY QUALIFY FOR OTHER COVERAGE, FINANCIAL COUNSELING IS PROVIDED TO ASSIST PATIENTS TO APPLY FOR THE AVAILABLE COVERAGE. CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY WEBPAGE AND PLAIN LANGUAGE SUMMARY ALSO INCLUDES CONTACT INFORMATION OF STATE AND FEDERAL HEALTH INSURANCE RESOURCES FOR THOSE WHO ARE UNINSURED. AS DESCRIBED PREVIOUSLY, CHRISTIANACARE'S HEALTH GUIDES ARE ALSO AVAILABLE TO HELP PATIENTS OVERCOME FINANCIAL BARRIERS. THEY ASSIST PATIENTS IN COMPLETING THE CHRISTIANACARE APPLICATION FOR FINANCIAL ASSISTANCE AS WELL AS ENROLL IN HEALTH INSURANCE OR APPLY FOR PRESCRIPTION ASSISTANCE OR MEDICAID, TO NAME JUST A FEW EXAMPLES. IN FY23, THE HEALTH GUIDES ASSISTED PATIENTS IN APPLYING FOR $2,652.177.67 IN CHRISTIANACARE FINANCIAL ASSISTANCE. --------------------
PART VI, LINE 4 (COMMUNITY INFORMATION) CHRISTIANACARE PROVIDES SERVICES IN FOUR STATES, BUT DUE TO THE HIGH PERCENTAGE OF NEW CASTLE COUNTY RESIDENTS AMONG THOSE DISCHARGED FROM CHRISTIANACARE'S TWO DELAWARE HOSPITALS, WE IDENTIFIED NEW CASTLE COUNTY AS OUR SERVICE AREA. IN FY2021, 77% OF CHRISTIANA HOSPITAL'S DISCHARGES AND 91% OF WILMINGTON HOSPITAL'S DISCHARGES WERE FOR NEW CASTLE COUNTY RESIDENTS. THE TOTAL POPULATION OF NEW CASTLE COUNTY IN 2021 WAS APPROXIMATELY 553,500 PERSONS. THIS POPULATION IS EXPECTED TO GROW 2.6% FROM 2020 TO 2030. THE POPULATION 65 YEARS OF AGE AND OLDER IS ANTICIPATED TO GROW BY 30.5% DURING THAT TIME. DUE TO THE CONSIDERABLE VARIATION AMONG SOCIOECONOMIC CONDITIONS IN NEW CASTLE COUNTY, THE 2022 CHNA ASSESSED COMMUNITY HEALTH NEEDS IN TWO GEOGRAPHIC AREAS OF NEW CASTLE COUNTY: "COMMUNITY 1" (ZIP CODES 19801, 19802, 19804, 19805, AND 19720) AND "COMMUNITY 2" (ALL OTHER NEW CASTLE COUNTY ZIP CODES). COMMUNITY 1 ACCOUNTED FOR 28% OF CHRISTIANACARE DISCHARGES IN 2021 AND COMMUNITY 2 ACCOUNTED FOR 52% OF CHRISTIANACARE DISCHARGES. THE OVERALL POVERTY RATE IN NEW CASTLE COUNTY HAS BEEN BELOW DELAWARE AND U.S. AVERAGES; HOWEVER, RATES FOR BLACK AND FOR HISPANIC COUNTY RESIDENTS HAVE BEEN SUBSTANTIALLY HIGHER THAN RATES FOR WHITE RESIDENTS. THE POVERTY RATE IN COMMUNITY 1 HAS BEEN MORE THAN DOUBLE THE RATE FOR COMMUNITY 2 (16.8% COMPARED TO 8.3%). IN COMMUNITY 1, APPROXIMATELY 48% OF THE POPULATION IDENTIFIES AS BLACK; IN COMMUNITY 2, THIS STATISTIC IS 17%. APPROXIMATELY 15% OF THE OVERALL POPULATION IN COMMUNITY 1 IDENTIFIES AS HISPANIC; IN COMMUNITY 2, THIS STATISTIC IS ABOUT 8%. LOW-INCOME CENSUS TRACTS ARE MOST PREVALENT IN NEWARK, WILMINGTON AND THROUGHOUT COMMUNITY 1. IN MANY OF THESE CENSUS TRACTS, MORE THAN ONE-HALF OF HOUSEHOLDS ARE "RENT BURDENED,CATEGORIZED AS "HIGH NEED" BY THE DIGNITY HEALTH COMMUNITY NEED INDEXTM (CNI) AND ARE IN THE TOP QUARTILE NATIONALLY FOR "SOCIAL VULNERABILITY" ACCORDING TO THE CENTERS FOR DISEASE CONTROL'S SOCIAL VULNERABILITY INDEX. BECAUSE OF THESE DISPARITIES AMONG NEW CASTLE COUNTY COMMUNITIES, WE SET THE FY23 AOP GOALS OF INCREASED SDOH SCREENING AND RESOURCE REFERRALS THROUGH UNITE DELAWARE FOR PATIENTS LIVING IN COMMUNITY 1. OUR COMMITMENT TO SDOH SCREENING AMONG ALL PATIENTS WILL ENSURE PATIENTS OUTSIDE OF COMMUNITY 1 ARE ALSO RECOGNIZED THROUGH OUR UNIVERSAL SCREENING. --------------------
PART VI, LINE 5 (INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH) CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, CHRISTIANACARE IS FOCUSED ON MEETING THE NEEDS OF OUR COMMUNITY. CHRISTIANACARE HAS AN EXTENSIVE NETWORK OF PRIMARY CARE AND OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,200 BEDS), A FREESTANDING EMERGENCY DEPARTMENT, A 24/7 PEDIATRIC CARE CENTER, THE ONLY LEVEL I TRAUMA CENTER AND THE ONLY HIGH-RISK DELIVERING HOSPITAL IN DELAWARE OFFERING A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER, REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE, AND WOMEN'S HEALTH, AND THE GENE EDITING INSTITUTE. CHRISTIANACARE IS ALSO ONE OF THE LARGEST COMMUNITY-BASED TEACHING HOSPITALS CONDUCTING RESEARCH IN THE UNITED STATES. AS DEMONSTRATED THROUGHOUT OUR RESPONSES, WE ARE COMMITTED TO ENSURING OUR NEXT GENERATION OF HEALTHCARE PROFESSIONALS ARE PREPARED TO SERVE OUR COMMUNITY. CHRISTIANACARE WAS ONE OF THE FIRST HOSPITALS IN THE NATION TO ESTABLISH AN EMBEDDED RESEARCH INSTITUTE, THE INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH. THIS EMBEDDED RESEARCH INSTITUTE CONDUCTS APPLIED RESEARCH FOCUSED ON ISSUES OF EQUITY AND COMMUNITY HEALTH, POPULATION HEALTH, AND VIRTUAL HEALTH, AS WELL AS TRAINING THE NEXT GENERATION OF CLINICAL SCIENTISTS WITH THE GOAL TO BRIDGE THE GAP BETWEEN CLINICAL AND TRANSLATIONAL RESEARCH, ADVANCEMENTS IN THE QUALITY OF CARE, AND IMPROVED HEALTH OUTCOMES FOR ALL. AN EXAMPLE OF THEIR WORK IS A 2021 STUDY THAT SHOWED DISPROPORTIONATELY HIGHER COUNTS OF CONVENIENCE STORE TOBACCO RETAILERS LOCATED IN MEDIUM AND HIGH-DENSITY RESIDENTIAL ZONES IN PREDOMINATELY AFRICAN AMERICAN AND LATINX NEIGHBORHOODS WITHIN THE CITY OF WILMINGTON RELATIVE TO THE SURROUNDING COUNTY. THE AUTHORS PROPOSED ZONING SOLUTIONS AS A TOOL TO FIGHT TOBACCO USE. CHRISTIANACARE IS ALSO COMMITTED TO PROVIDING AFFORDABLE AND VALUE-BASED CARE. CHRISTIANACARE IS A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES APPROXIMATELY 30,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CHRISTIANACARE'S CAREVIO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. CAREVIO HARNESSES AN INFORMATION TECHNOLOGY PLATFORM THAT IDENTIFIES THE PATIENTS WHO ARE AT HIGHEST RISK AND WHO HAVE SIGNIFICANT CARE NEEDS, INCLUDING THOSE WHO DO NOT REGULARLY ACCESS PRIMARY CARE AND PREVENTIVE SERVICES. UNDERSTANDING WHO IS AT RISK FOR POOR HEALTH ENABLES CLINICIANS TO PROACTIVELY CONTACT THE INDIVIDUAL TO CONNECT THEM TO THE HEALTH SERVICES THEY NEED. IN PERFORMANCE YEAR 2022, THE EBRIGHTHEALTH ACO REDUCED HEALTH CARE SPENDING BY APPROXIMATELY $9.5 MILLION AND EARNED A QUALITY SCORE OF 86.7%. THIS IS THE THIRD CONSECUTIVE YEAR THE ACO HAS ACHIEVED SHARED SAVINGS AND THE SEVENTH CONSECUTIVE YEAR THAT EBRIGHTHEALTH ACO HAS REDUCED HEALTH CARE COSTS FOR ITS ATTRIBUTED BENEFICIARIES. THE CUMULATIVE AMOUNT SAVED IS $54 MILLION. IN 2021, CHRISTIANACARE ALSO LAUNCHED ONE OF THE FIRST MEDICAID ACOS IN THE STATE, DELAWARE MEDICAID QUALITY PARTNERS ACO. THIS ACO SERVES MORE THAN 18,000 MEDICAID PATIENTS AND IS ALSO SUPPORTED BY CAREVIO. THIS ACO WILL FOCUS ON HEALTH EQUITY, CARE STANDARDIZATION, AND SOCIAL DETERMINANTS OF HEALTH TO ENSURE PATIENTS ARE SET UP FOR SUCCESS IN ACHIEVING POSITIVE HEALTH OUTCOMES. CHRISTIANACARE ALSO STRIVES TO BE A LEADER AMONG OTHER BUSINESSES AND ORGANIZATIONS. . IN 2022, CHRISTIANACARE PLEDGED COMMITMENT TO THE WHITE HOUSE/HHS HEALTH SECTOR CLIMATE PLEDGE. CHRISTIANACARE IS TAKING ACTION TO REDUCE ITS GREENHOUSE GAS EMISSIONS BY 50% BY 2030 AND ACHIEVE NET ZERO EMISSIONS BY 2050. . CHRISTIANACARE HAS INSTITUTED A SUPPLIER DIVERSITY PROGRAM TO PROVIDE EQUAL ACCESS TO PROCUREMENT OPPORTUNITIES FOR DIVERSE AND SMALL BUSINESSES TO ASSIST AND MEET OUR HEALTHCARE SYSTEM GOALS. WE PROVIDE RESOURCES AND MENTORSHIP, ASSIST WITH CAPACITY BUILDING, AND OFFER OUTREACH PROGRAMS SO THAT WE CAN WORK WITH COMPANIES THAT HELP CONTRIBUTE TO THE ECONOMY AND COMMUNITIES WE SERVE. . IN 2020, CHRISTIANACARE BEGAN OFFERING 12 WEEKS OF PAID PARENTAL LEAVE FOR ITS CAREGIVERS. . IN 2019, CHRISTIANACARE INCREASED ITS MINIMUM WAGE TO $15 AN HOUR. . IN 2019, CHRISTIANACARE INSTITUTED A COMMUNITY SERVICE BENEFIT TO ITS CAREGIVERS THAT PROVIDES PAID COMMUNITY SERVICE TIME, IN ADDITION TO THEIR PAID TIME OFF, TO VOLUNTEER AT CHARITABLE, NON-PROFIT ORGANIZATIONS. IN FY23, 1,325 HOURS WERE SPENT IN COMMUNITY SERVICE AT A COST OF OVER $64,000 TO CHRISTIANACARE. AS CHRISTIANACARE CONTINUES TO ADAPT, INNOVATE, AND GROW, WE WILL ALWAYS BE GUIDED BY OUR MISSION OF SERVICE AND OUR VALUES OF EXCELLENCE AND LOVE. OUR MOST IMPORTANT PARTNERSHIP IS WITH THE PEOPLE IN ALL THE COMMUNITIES WE SERVE.
PART VI, LINE 6 (AFFILIATED HEALTHCARE SYSTEM INFORMATION) CHRISTIANACARE IS CENTERED ON IMPROVING HEALTH OUTCOMES, MAKING HIGH-QUALITY CARE MORE ACCESSIBLE, AND LOWERING HEALTH CARE COSTS. GUIDED BY OUR VALUES, LOVE AND EXCELLENCE, CHRISTIANACARE HAS GROWN, AND CONTINUES TO GROW, TO MEET THE NEEDS OF OUR COMMUNITY. CHRISTIANACARE HAS AN EXTENSIVE NETWORK OF PRIMARY CARE AND OUTPATIENT SERVICES, HOME HEALTH CARE, URGENT CARE CENTERS, THREE HOSPITALS (1,435 LICENSED BEDS), A FREESTANDING EMERGENCY DEPARTMENT, A LEVEL I TRAUMA CENTER AND A LEVEL III NEONATAL INTENSIVE CARE UNIT, A COMPREHENSIVE STROKE CENTER, AND REGIONAL CENTERS OF EXCELLENCE IN HEART AND VASCULAR CARE, CANCER CARE, AND WOMEN'S HEALTH. CHRISTIANACARE PROVIDES SERVICES THAT DELAWAREANS CANNOT FIND ELSEWHERE IN THE STATE SUCH AS AN EPILEPSY MONITORING UNIT, A COMPREHENSIVE PAIN CENTER, WHICH OFFERS EFFECTIVE, NON-OPIOID PAIN TREATMENT STRATEGIES FOR INDIVIDUALS WITH ACUTE AND CHRONIC PAIN, ADULT KIDNEY TRANSPLANT, AND A LEVEL 2 PEDIATRIC EMERGENCY CARE FACILITY. CHRISTIANACARE IS ALSO ONE OF THE LARGEST COMMUNITY-BASED TEACHING HOSPITALS CONDUCTING RESEARCH IN THE UNITED STATES. WE ARE COMMITTED TO ADVANCING HEALTH AND HEALTH EQUITY THROUGH RESEARCH AND INNOVATION AS DEMONSTRATED THROUGHOUT THIS NARRATIVE AND AS SHOWN BY OUR INSTITUTE FOR RESEARCH ON EQUITY AND COMMUNITY HEALTH. THIS EMBEDDED RESEARCH INSTITUTE CONDUCTS APPLIED RESEARCH FOCUSED ON ISSUES OF EQUITY AND COMMUNITY HEALTH, POPULATION HEALTH, AND VIRTUAL HEALTH, AS WELL AS TRAINING THE NEXT GENERATION OF CLINICAL SCIENTISTS WITH THE GOAL TO BRIDGE THE GAP BETWEEN CLINICAL AND TRANSLATIONAL RESEARCH, ADVANCEMENTS IN THE QUALITY OF CARE, AND IMPROVED HEALTH OUTCOMES FOR ALL. ALONG WITH SERVING OUR PATIENTS AND COMMUNITY THROUGH EXCEPTIONAL CLINICAL SERVICES, TRAINING THE NEXT GENERATION OF HEALTHCARE WORKERS, CONDUCTING ROBUST RESEARCH TO ADVANCE HEALTH OUTCOMES, AND AN UNWAVERING COMMITMENT TO EQUITY, WE ARE ALSO COMMITTED TO PROVIDING AFFORDABLE AND VALUE-BASED CARE. CHRISTIANACARE IS A FOUNDING PARTNER IN EBRIGHTHEALTH ACO, AN ACCOUNTABLE CARE ORGANIZATION THAT SERVES APPROXIMATELY 30,000 REGIONAL MEDICARE BENEFICIARIES FROM DELAWARE, PENNSYLVANIA, AND MARYLAND. CHRISTIANACARE'S CAREVIO PROVIDES THE CARE COORDINATION FOR THIS INITIATIVE. CAREVIO IS ANOTHER EXAMPLE OF CHRISTIANACARE'S AWARD WINNING INNOVATION TO BETTER SERVE INDIVIDUALS. CAREVIO HARNESSES AN INFORMATION TECHNOLOGY PLATFORM THAT IDENTIFIES THE PATIENTS WHO ARE AT HIGHEST RISK AND WHO HAVE SIGNIFICANT CARE NEEDS, INCLUDING THOSE WHO DO NOT REGULARLY ACCESS PRIMARY CARE AND PREVENTIVE SERVICES. UNDERSTANDING WHO IS AT RISK FOR POOR HEALTH ENABLES CLINICIANS TO PROACTIVELY CONTACT THE INDIVIDUAL TO CONNECT THEM TO THE HEALTH SERVICES THEY NEED. IN PERFORMANCE YEAR 2021, THE EBRIGHTHEALTH ACO REDUCED HEALTH CARE SPENDING BY $7 MILLION AND EARNED A QUALITY SCORE OF 82.1%. THIS MARKS THE SIXTH CONSECUTIVE YEAR THAT EBRIGHTHEALTH ACO HAS REDUCED HEALTH CARE COSTS FOR ITS ATTRIBUTED BENEFICIARIES, BRINGING THE CUMULATIVE AMOUNT SAVED TO MORE THAN $44.5 MILLION. CHRISTIANACARE ALSO LAUNCHED ONE OF THE FIRST MEDICAID ACOS IN THE STATE, DELAWARE MEDICAID QUALITY PARTNERS ACO ON JULY 1, 2021. THIS ACO SERVES MORE THAN 18,000 MEDICAID PATIENTS AND LIKE THE EBRIGHTHEALTH ACO, IT WILL ALSO BE SUPPORTED BY CAREVIO. HEALTH EQUITY, CARE STANDARDIZATION, AND SOCIAL DETERMINANTS OF HEALTH ARE AREAS OF FOCUS FOR THIS ACO TO ENSURE PATIENTS ARE SET UP FOR SUCCESS IN ACHIEVING POSITIVE HEALTH OUTCOMES. CHRISTIANACARE'S LEADERSHIP IN THE AREAS OF CLINICAL CARE, INNOVATION, AND RESEARCH CONTRIBUTE TO NATIONAL RECOGNITION. THE FOLLOWING ARE TWO AWARDS WE RECENTLY RECEIVED AMONG MANY. FOR THE 7TH YEAR IN A ROW, THE COLLEGE OF HEALTHCARE INFORMATION MANAGEMENT EXECUTIVES (CHIME) HAS GIVEN CHRISTIANACARE THE "MOST WIRED" DESIGNATION. AMONG THE MORE THAN 38,000 ORGANIZATIONS SURVEYED BY CHIME, CHRISTIANACARE RANKED ABOVE ITS PEERS IN THE CATEGORIES OF ANALYTICS AND DATA MANAGEMENT, POPULATION HEALTH, INFRASTRUCTURE, AND PATIENT ENGAGEMENT. FOR THE 3RD YEAR IN A ROW, HEALTHGRADES NAMED CHRISTIANACARE AS ONE OF AMERICA'S 50 BEST HOSPITALS. CHRISTIANACARE IS AMONG THE TOP 1% OF MORE THAN 4,500 HOSPITALS ASSESSED NATIONWIDE FOR CONSISTENT, YEAR-OVER-YEAR SUPERIOR CLINICAL PERFORMANCE. AS THE LARGEST PRIVATE EMPLOYER IN THE STATE OF DELAWARE, CHRISTIANACARE ALSO STRIVES TO BE A LEADER AMONG OTHER BUSINESSES AND ORGANIZATIONS. IN EARLY 2019, CHRISTIANACARE INCREASED ITS MINIMUM WAGE TO $15 AN HOUR, AND BEGINNING IN JULY 2020, CHRISTIANACARE BEGAN OFFERING 12 WEEKS OF PAID PARENTAL LEAVE FOR ITS CAREGIVERS. IN HONOR OF MARTIN LUTHER KING DAY IN JANUARY 2019, CHRISTIANACARE ALSO PROVIDED A COMMUNITY SERVICE BENEFIT TO ITS CAREGIVERS WHICH PROVIDES THEM WITH PAID COMMUNITY SERVICE TIME, IN ADDITION TO THEIR PAID TIME OFF, TO VOLUNTEER AT CHARITABLE, NON-PROFIT ORGANIZATIONS. IN FY2022, 425 HOURS WERE SPENT IN COMMUNITY SERVICE AT A COST OF OVER $24,000 TO CHRISTIANACARE. FINALLY, CHRISTIANACARE HAS ALSO COMMITTED TO BEING AN ANTI-RACISM ORGANIZATION. THAT COMMITMENT CAN BE FOUND HERE: ANTI-RACISM COMMITMENT - CHRISTIANACARE. CHRISTIANACARE'S CONTINUED GROWTH, ADAPTATION, AND INNOVATION WILL ALWAYS BE DRIVEN BY OUR FOUNDATION OF SERVICE TO OUR COMMUNITY AND ADDRESSING THE NEEDS THEY IDENTIFY. OUR MOST IMPORTANT PARTNERSHIP WILL ALWAYS BE WITH OUR NEIGHBORS. --------------------
PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT) THERE IS NO PRESENT STATE OF DELAWARE REQUIREMENT FOR CHRISTIANACARE TO FILE A COMMUNITY BENEFIT REPORT. CHRISTIANACARE HAS ESTABLISHED A COMMUNITY BENEFIT DEDICATED SECTION ON ITS WEBSITE WHERE THE CHNA AND CHIP CAN BE FOUND, ALONG WITH ARTICLES ABOUT CHRISTIANACARE'S COMMUNITY BENEFIT INITIATIVES AND STORIES. THIS CAN BE ACCESSED AT: https://christianacare.org/us/en/about-us/who-we-are/community-benefit --------------------
Schedule H (Form 990) 2022
Additional Data


Software ID:  
Software Version:  

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number
51-0103684
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) DELAWARE COLLEGE SCHOLARS
PO BOX 392
WILMINGTON,DE19801 		82-4608572 501(C)(3) 150,000       GENERAL SUPPORT
(2) HBCU WEEK FOUNDATION INC
1022 COLEMAN STREET
WILMINGTON,DE19805 		85-1276996 501(C)(3) 136,250       GENERAL SUPPORT
(3) FRIENDSHIP HOUSE INC
PO BOX 1517
WILMINGTON,DE19899 		51-0306759 501(C)(3) 100,000       GENERAL SUPPORT
(4) WILMINGTON ALLIANCE INC
100 W 10TH ST
SUITE 206
WILMINGTON,DE19801 		51-0347680 501(C)(3) 90,000       GENERAL SUPPORT
(5) RYSHEEMA J DIXON FOUNDATION
903 RUE MADORA
BEAR,DE19701 		92-1122189 501(C)(3) 40,000       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
5
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022

Schedule I (Form 990) 2022
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
FORM 990, SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS ALL FUNDING REQUIRES APPROVAL. PRIOR TO PROVIDING ANY FUNDS, CCHS CONFIRMS THAT THE RECIPIENT ORGANIZATION IS TAX EXEMPT AND REQUIRES THE SUBMISSION OF A PROPOSAL FOR HOW THE FUNDING WILL BE UTILIZED. CCHS RETAINS THE RIGHT TO REQUEST DETAIL REGARDING THE ORGANIZATION'S UTILIZATION OF THE FUNDING.
Schedule I (Form 990) 2022



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1RAY A BLACKWELL MD
CHIEF OF CARDIAC SURGERY 		(i)

(ii)		 892,906
-------------
0 		155,636
-------------
0 		8,546
-------------
0 		0
-------------
0 		20,501
-------------
0 		1,077,589
-------------
0 		0
-------------
0
2RICHARD CUMING
CHIEF OPERATING OFFICER 		(i)

(ii)		 514,222
-------------
0 		185,622
-------------
0 		99,729
-------------
0 		56,146
-------------
0 		12,272
-------------
0 		867,991
-------------
0 		40,000
-------------
0
3PAUL K DAVIS MD
PHYSICIAN - CARDIAC SURGEON 		(i)

(ii)		 745,228
-------------
0 		112,651
-------------
0 		15,991
-------------
0 		0
-------------
0 		20,501
-------------
0 		894,371
-------------
0 		0
-------------
0
4RANDALL GABORIAULT
CHIEF DIGITAL & INFO. OFFICER 		(i)

(ii)		 672,226
-------------
0 		244,128
-------------
0 		67,396
-------------
0 		69,541
-------------
0 		20,501
-------------
0 		1,073,792
-------------
0 		0
-------------
0
5KIRK N GARRATT MD
MED. DIR. CTR FOR H/V HEALTH 		(i)

(ii)		 785,789
-------------
0 		171,222
-------------
0 		10,632
-------------
0 		0
-------------
0 		7,085
-------------
0 		974,728
-------------
0 		0
-------------
0
6VINAY K GHEYI
CHAIR DEPARTMENT RADIOLOGY 		(i)

(ii)		 752,758
-------------
0 		164,024
-------------
0 		5,939
-------------
0 		0
-------------
0 		13,663
-------------
0 		936,384
-------------
0 		0
-------------
0
7NEIL JASANI MD
CHIEF PEOPLE OFFICER 		(i)

(ii)		 515,438
-------------
0 		184,394
-------------
0 		239,169
-------------
0 		0
-------------
0 		20,501
-------------
0 		959,502
-------------
0 		159,456
-------------
0
8SHARON KURFUERST
COO- THRU 1/23 		(i)

(ii)		 691,616
-------------
0 		248,907
-------------
0 		26,781
-------------
0 		71,217
-------------
0 		13,663
-------------
0 		1,052,184
-------------
0 		0
-------------
0
9LISA MAXWELL MD
PRESIDENT, CC MEDICAL GROUP 		(i)

(ii)		 515,436
-------------
0 		184,371
-------------
0 		3,848
-------------
0 		51,069
-------------
0 		20,501
-------------
0 		775,225
-------------
0 		0
-------------
0
10ROBERT MCMURRAY
CFO, TREAS. & ASS'T SECRETARY 		(i)

(ii)		 624,494
-------------
0 		226,794
-------------
0 		6,652
-------------
0 		66,326
-------------
0 		20,501
-------------
0 		944,767
-------------
0 		0
-------------
0
11JANICE E NEVIN MD
PRESIDENT & CEO 		(i)

(ii)		 1,347,992
-------------
0 		742,346
-------------
0 		854,564
-------------
0 		0
-------------
0 		9,778
-------------
0 		2,954,680
-------------
0 		564,176
-------------
0
12NICHOLAS J PETRELLI MD
MED. DIR, CCHS CANCER PROGRAM 		(i)

(ii)		 734,231
-------------
0 		159,979
-------------
0 		7,082
-------------
0 		0
-------------
0 		12,272
-------------
0 		913,564
-------------
0 		0
-------------
0
13JENNIFER L SCHWARTZ ESQ
CORPORATE SECRETARY 		(i)

(ii)		 543,248
-------------
0 		197,288
-------------
0 		4,880
-------------
0 		57,934
-------------
0 		20,501
-------------
0 		823,851
-------------
0 		0
-------------
0
14KENNETH SILVERSTEIN MD
CHIEF PHYS. EXEC- THRU 1/23 		(i)

(ii)		 725,662
-------------
0 		263,534
-------------
0 		188,535
-------------
0 		0
-------------
0 		17,648
-------------
0 		1,195,379
-------------
0 		0
-------------
0
15BETTINA TWEARDY-RIVEROS
CHIEF PUBLIC AFFAIRS OFFICER 		(i)

(ii)		 461,660
-------------
0 		151,168
-------------
0 		40,898
-------------
0 		41,881
-------------
0 		20,501
-------------
0 		716,108
-------------
0 		0
-------------
0
16FREDERIC T HARAD MD
DIRECTOR 		(i)

(ii)		 599,122
-------------
0 		78,318
-------------
0 		83,909
-------------
0 		0
-------------
0 		12,272
-------------
0 		773,621
-------------
0 		0
-------------
0
17VINAY MAHESHWARI MD
DIRECTOR- AS OF 1/1/23 		(i)

(ii)		 498,145
-------------
0 		105,211
-------------
0 		3,915
-------------
0 		0
-------------
0 		91
-------------
0 		607,362
-------------
0 		0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
FORM 990, SCHEDULE J, PART I, LINE 1A DETAIL REGARDING BENEFITS PROVIDED SOCIAL CLUB DUES CCHS PROVIDES A SOCIAL CLUB MEMBERSHIP TO BE USED BY THE PRESIDENT IN CONNECTION WITH THEIR DUTIES. THE PRESIDENT IS RESPONSIBLE FOR AND TAXED ON ANY PERSONAL USE OF SUCH CLUB MEMBERSHIP. -------------------- FORM 990, SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHOD DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O FOR A DESCRIPTION OF THE COMPENSATION REVIEW AND APPROVAL PROCESS. --------------------
FORM 990, SCHEDULE J, PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS SHARON KURFUERST (FORMER CHIEF OPERATING OFFICER) RECEIVED A SEVERANCE PAYMENT OF $168,230 DURING THE YEAR. KENNETH SILVERSTEIN (FORMER PRESIDENT, CC MEDICAL GROUP) RECEIVED A SEVERANCE PAYMENT OF $173,170 DURING THE YEAR. ---------------
FORM 990, SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED PLAN PARTICIPATION CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAINTAINS AN IRC SECTION 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED AND/OR RECEIVED DISTRIBUTIONS FROM THE 457(F) PLAN DURING THE YEAR: RICHARD CUMING, RN- $58,402 RANDALL GABORIAULT- $61,829 NEIL JASANI, MD- $232,282 SHARON T. KURFUERST- $21,575 LISA C. MAXWELL, MD- NO DISTRIBUTION ROBERT MCMURRAY- NO DISTRIBUTION JANICE E. NEVIN, MD- $843,088 JENNIFER L. SCHWARTZ, ESQ.- NO DISTRIBUTION KENNETH SILVERSTEIN, MD- $82,817 BETTINA TWEARDY-RIVEROS- $36,502 --------------------
FORM 990, SCHEDULE J, PART I, LINE 7 PROVISION OF NON-FIXED PAYMENTS CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM") IS THE SOLE MEMBER OF THIS ORGANIZATION. ALL OFFICER/TRUSTEE COMPENSATION ARRANGEMENTS, INCLUDING THE PAYMENT OF DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES, ARE DETERMINED BY THE SYSTEM BOARD. PAYMENTS MADE TO ANY DISQUALIFIED PERSON ARE APPROVED BY THE COMPENSATION COMMITTEE OF SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. --------------------
Schedule J (Form 990) 2022

Additional Data


Software ID:  
Software Version:  

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number
51-0103684
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A DELAWARE HLTH FACILITIES AUTHORITY SERIES 2020A
  		51-0272458 246388TQ5 02-11-2020 247,255,000 REFUND SERIES 2008 & 2010   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 0      
2 Amount of bonds legally defeased .............. 0      
3 Total proceeds of issue .................. 305,483,000      
4 Gross proceeds in reserve funds ............. 0      
5 Capitalized interest from proceeds ............. 0      
6 Proceeds in refunding escrows ............... 0      
7 Issuance costs from proceeds ............... 2,324,976      
8 Credit enhancement from proceeds ............. 0      
9 Working capital expenditures from proceeds ............. 0      
10 Capital expenditures from proceeds ............. 145,360,019      
11 Other spent proceeds ............. 157,798,005      
12 Other unspent proceeds ............. 0      
13 Year of substantial completion ............. 2021
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		X              
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........ 		  X            
16 Has the final allocation of proceeds been made? .......... X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X            
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X            
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X            
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 %      
6 Total of lines 4 and 5 ............. 0 %      
7 Does the bond issue meet the private security or payment test? ...   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 %      
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X            
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X              
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X            
b Exception to rebate? ........ X              
c No rebate due? .........   X            
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X            
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider .......... 0
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider .......... 0
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ... X              
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X              
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
FORM 990, SCHEDULE K, PART I ADDITIONAL INFORMATION REGARDING TAX-EXEMPT BONDS THE DELAWARE HEALTH FACILITIES AUTHORITY SERIES 2020A BOND WAS ISSUED TO CHRISTIANA CARE HEALTH SYSTEM, INC. (EIN:52-1479538), A RELATED IRC SECTION 501(C)(3) ORGANIZATION. SINCE ALL BOND PROCEEDS WERE ALLOCATED TO CHRISTIANA CARE HEALTH SERVICES, INC., THIS BOND HAS BEEN REPORTED ON THIS ORGANIZATION'S FORM 990, SCHEDULE K. HOWEVER, CHRISTIANA CARE HEALTH SYSTEM, INC. REMAINS AS THE PRIMARY OBLIGOR OF THE BOND. -------------------- FORM 990, SCHEDULE K, PART II, LINE 3 ADDITIONAL INFORMATION REGARDING PROCEEDS OF ISSUE FOR DELAWARE HLTH FACILITIES AUTHORITY SERIES 2020A, THE TOTAL PROCEEDS OF THE ISSUE REPORTED INCLUDES INVESTMENT EARNINGS. -------------------- FORM 990, SCHEDULE K, PART II, LINE 5 ADDITIONAL INFORMATION REGARDING CAPITALIZED INTEREST FROM PROCEEDS ALTHOUGH CCHS CAPITALIZES INTEREST FOR BOOK PURPOSES, BOND PROCEEDS ARE NOT USED TO PAY INTEREST AND ARE THEREFORE NOT REPORTED ON PART II, LINE 5. --------------------
Schedule K (Form 990) 2021

Additional Data


Software ID:  
Software Version:  

SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large image Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large image Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 8 171,862 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2022)
Schedule M (Form 990) (2022)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE M, PART I, COLUMN (B) ADDITIONAL INFORMATION REGARDING SECURITIES REPORTED CHRISTIANA CARE HEALTH SERVICES, INC. REPORTS THE NUMBER OF CONTRIBUTIONS IN PART I, COLUMN (B).
Schedule M (Form 990) (2022)

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Return Reference Explanation
FORM 990, HEADER, ITEM B AMENDED FORM 990 THE ORGANIZATION'S JUNE 30, 2023 FORM 990 IS BEING AMENDED IN ORDER TO CORRECT CERTAIN COMPENSATION INFORMATION THAT WAS PREVIOUSLY INADVERTENTLY REPORTED AS A COMPONENT OF FORM 990, PART VII, SECTION A, COLUMN (F) AND FORM 990, SCHEDULE J, PART II, COLUMN (C) COMPENSATION. THIS INFORMATION HAS NOW BEEN MORE PROPERLY REPORTED AS A COMPONENT OF FORM 990, SCHEDULE J, PART II, COLUMN (F) COMPENSATION FOR THE AFFECTED INDIVIDUALS. THE SUPPLEMENTAL DISCLOSURE FOR FORM 990, SCHEDULE J, PART I, LINE 4B HAS ALSO BEEN REVISED. --------------------
FORM 990, PART VI, SECTION A, LINES 6 & 7A,7B GOVERNING BODY AND MANAGEMENT CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), A TAX-EXEMPT ORGANIZATION, IS THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS"). THE SYSTEM BOARD ELECTS DIRECTORS OF CCHS AT ITS ANNUAL MEETING. THE ANNUAL OPERATING BUDGET OF CCHS IS APPROVED BY THE CCHS BOARD, THE SYSTEM FINANCE COMMITTEE, AND THE SYSTEM BOARD. --------------------
FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS INFORMATION RELATED TO CHRISTIANA CARE'S FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO PWC US TAX LLP FOR REVIEW. THE FINAL 2022 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2023 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2022 FORM 990 VIA ITS BOARD OF DIRECTOR'S PORTAL. --------------------
FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OUR CONFLICT OF INTEREST ("COI") POLICY IS LOCATED IN THE CAREGIVER RESOURCE CENTER ON THE EMPLOYEE PORTAL. THERE IS AN ANNUAL MANDATORY EDUCATION FOR MANAGERS WHICH INCLUDES AN ELECTRONIC SIGN OFF ACKNOWLEDGING COMPLETION OF THE EDUCATION, REPORTING OF A REAL OR PERCEIVED CONFLICT OR THAT NO CONFLICTS OF INTEREST EXISTS. THE HR/EMPLOYEE RELATIONS TEAM FOLLOWS UP WITH ANYONE WHO HAS A CONFLICT OR PERCEIVED CONFLICT OR DOES NOT COMPLETE THE EDUCATION IN ORDER TO RESOLVE. SEVERAL REPORTING MECHANISMS ALSO EXIST FOR EMPLOYEES TO REPORT CONCERNS. THE BOARD OF DIRECTORS HAS THEIR OWN COI POLICY. COI IS A STANDING AGENDA ITEM ON EACH BOARD OR BOARD COMMITTEE MEETING. BOARD MEMBERS EXPECTATIONS FOR COI ARE CLEARLY COMMUNICATED. --------------------
FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL PROCESS THE BOARD OF DIRECTORS OF CHRISTIANA CARE HEALTH SYSTEM, INC. ("SYSTEM"), THE SOLE MEMBER OF CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") ESTABLISHES CCHS'S COMPETITIVE TOTAL COMPENSATION POLICY AND PRACTICE. THE EXECUTIVE COMPENSATION COMMITTEE ("ECC") OF THE SYSTEM BOARD ENGAGES AN INDEPENDENT THIRD PARTY ANNUALLY WHO ASSESSES DATA FROM SEVERAL MAJOR SURVEYS TO ENSURE TOTAL REMUNERATION IS MARKET COMPETITIVE AND QUALIFIES FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULE, SECTION 4958 OF THE INTERNAL REVENUE CODE. AFTER DELIBERATION, THE ECC DOCUMENTS THEIR DECISIONS IN MEETING MINUTES. --------------------
FORM 990, PART VI, SECTION B, LINE 16B JOINT VENTURE ARRANGEMENTS ALTHOUGH THE ORGANIZATION DOES NOT HAVE A WRITTEN POLICY IN PLACE REGARDING PARTICIPATION IN JOINT VENTURE RELATIONSHIPS, WHEN ANY SUCH RELATIONSHIPS ARE CONSIDERED, THEY ARE FIRST REVIEWED AND EVALUATED BY MANAGEMENT OFFICIALS IN CONJUNCTION WITH PWC US TAX LLP. --------------------
FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT, & DISCLOSURE THE GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. --------------------
FORM 990, PART X BALANCE SHEET CERTAIN PRIOR YEAR BALANCES HAVE BEEN RESTATED TO CONFORM TO THE CURRENT YEAR PRESENTATION. --------------------
FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS CHANGE IN PENSION AND POST RETIREMENT LIABILITIES $(43,856,239) CHANGE IN NET ASSET OF SYSTEM 230,334 OTHER CHANGES (50,225) ----------- TOTAL $(43,676,130)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC
 
Employer identification number

51-0103684
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) CHRISTIANA CARE CAMPUS REALTY LLC
4000 NEXUS DR NW3-100
WILMINGTON,DE19803
51-0103684 		SUPPORT SRVCS DE 0 0 CCH SERVICES
 
(2) CHRISTIANA CARE QUALITY PARTNERS LLC
4000 NEXUS DR NW3-100
WILMINGTON,DE19803
84-4061485 		SUPPORT SRVCS DE -227,515 3,723,127 CCH SERVICES
 
(3) CHRISTIANA CARE QUALITY PARTNERS ACOLLC
4000 NEXUS DR NW3-100
WILMINGTON,DE19803
47-4102953 		SUPPORT SRVCS DE -1,383,606 101,994 CCH SERVICES
 
(4) CHRISTIANA CARE CARE LINK LLC
4000 NEXUS DR NW3-100
WILMINGTON,DE19803
51-0103684 		SUPPORT SRVCS DE -10,934,575 3,050,461 CCH SERVICES
 
(5) CHRISTIANA CARE CTR FOR VIRTUAL HLTH LLC
4000 NEXUS DR NW3-100
WILMINGTON,DE19803
86-2155365 		SUPPORT SRVCS DE -4,782,702 4,996,050 CCH SERVICES
 


Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)CHRISTIANA CARE HEALTH SYSTEM
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
52-1479538 		FUNDRAISING DE 501(C)(3) 7 NA
 
 
No
(2)CHRISTIANA CARE HEALTH INITIATIVES
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
51-0295186 		OUTPATIENT SV DE 501(C)(3) 10 CCH SYSTEM
 
 
No
(3)CHRISTIANA CARE HOME HEALTH & COM SRVCS
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
51-0064334 		HOME HLTHCARE DE 501(C)(3) 7 CCH SYSTEM
 
 
No
(4)UNION HOSPITAL OF CECIL COUNTY FDN
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
52-1794552 		FUNDRAISING MD 501(C)(3) 7 AFFINITY
 
 
No
(5)UNION HOSPITAL OF CECIL COUNTY INC
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
52-0607945 		HLTHCARE SVCS MD 501(C)(3) 3 AFFINITY
 
 
No
(6)UNION HOSPITAL OF CECIL COUNTY HLTH SVCS
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
52-1794553 		PROPERTY MGMT MD 501(C)(3) 10 AFFINITY
 
 
No
(7)UNION HOSPITAL OF CECIL COUNTY ONCOLOGY
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
81-2662359 		HEALTHCARE MD 501(C)(3) 3 AFFINITY
 
 
No
(8)AFFINITY HEALTH ALLIANCE INC
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
52-1794697 		MANAGEMENT DE 501(C)(3) 12B, II CCH SERVICES
 
Yes
 
(9)CHRISTIANA CARE WEST GROVE INC
4000 NEXUS DR NW3-100

WILMINGTON,DE19803
88-3155785 		HEALTHCARE PA 501(C)(3) PENDING CCH SERVICES
 
Yes
 
(10)CHRISTIANA CAREGENE EDITING INSTITUTE
40000 NEXUS DR NW3-100

WILMINGTON,DE19803
88-3110655 		HEALTHCARE DE 501(C)(3) PENDING CCH SYSTEM
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) CHRISTIANA CARE GO HEALTH URGENT CARE L

5555 GLENRIDGE CONNECTOR SUITE 700
ATLANTA,GA30342
84-3657727 		URGENT CARE SRVCS DE CCH SERVICES
  		RELATED 0 0   No 0   No 50.100 %
(2) CHRISTIANACARE VALUE HEALTH JV LLC

11221 ROE AVENUE
LEAWOOD,KS66211
85-1100149 		AMBULATORY SRVCS DE CCH SERVICES
  		RELATED 0 25,500   No 0 Yes   51.000 %
(3) CLINERGY LLC

4755 OGLETOWN STANTON RD
NEWARK,DE19718
85-2698063 		GROUP PURCHASING DE CCH SERVICES
  		RELATED -41,020 428,997   No 0   No 79.800 %
(4) LEEWARD HEALTH LLC

4000 NEXUS DRIVE STE C3-300
WILMINGTON,DE19803
88-3132477 		MED ADV RISK DE CCH SYSTEM
  		        No     No  






Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) THE DE CTR FOR MAT FETAL MED OF CC INC

4000 NEXUS DR NW3-100
WILMINGTON,DE19803
20-5891272 		HEALTHCARE DE CCH SERVICES
  		C CORP 35,582 5,971,632 100.000 % Yes  
(2) CHRISTIANA CARE HEALTH PLANS

4000 NEXUS DR NW3-100
WILMINGTON,DE19803
51-0352728 		INSURANCE DE CCH SYSTEM
  		C CORP         No
(3) CHRISTIANA CARE DEFERRED COMP PLAN

4755 OGLETOWN STANTON RD
NEWARK,DE19718
81-6359549 		DEF COMP PLAN DE CCH SERVICES
  		TRUST 0 0 100.000 % Yes  
(4) CHRISTIANA CARE EXEC DEFERRED COMP PLAN

4755 OGLETOWN STANTON RD
NEWARK,DE19718
35-7048822 		DEF COMP PLAN DE CCH SERVICES
  		TRUST 0 0 100.000 % Yes  
(5) CARE ASSOCIATES DEFERRED COMP PLAN

4755 OGLETWON STANTON RD
NEWARK,DE19718
35-7048714 		DEF COMP PLAN DE CCH SERVICES
  		TRUST 0 0 100.000 % Yes  
(6) CHRISTIANA CARE INSURANCE CO LTD

PO BOX 1159 878 W BAY RD
  GRAND CAYMANKY1-1102
CJ
98-1489490 		SELF-INSURANCE CJ CCH SERVICES
  		C CORP 2,009,422 75,736,485 100.000 % Yes  
(7) CHRISTIANA CARE STRATEGIC INVESTMENTS

4000 NEXUS DR NW3-100
WILMINGTON,DE19803
85-3348300 		STRATEGY DE CCH SYSTEM
  		C CORP         No
(8) UNION HOSPITAL OF CECIL COUNTY VENTURES

4000 NEXUS DR NW3-100
WILMINGTON,DE19803
52-1793691 		MEDICAL SERVICES MD AFFINITY
  		C CORP         No
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) UNION HOSPITAL OF CECIL COUNTY INC

 ADOQR 38,223,329 FMV
(2) CHRISTIANA CARE GO HEALTH URGENT CARE LLC

 ADJPR 34,661,291 FMV
(3) THE DE CTR FOR MAT FETAL MED OF CC INC

 J,K,O 1,134,931 FMV
(4) CHRISTIANA CARE INSURANCE CO LTD

 Q,R 41,304,662 FMV
(5) AFFINITY HEALTH ALLIANCE INC

 R,S 2,556,997 FMV
(6) CLINERGY LLC

 O 890,297 FMV
(7) CHRISTIANA CARE HOME HEALTH & COMM SERVICES

 ADOQR 9,575,854 FMV
(8) UNION HOSPITAL OF CECIL COUNTY ONCOLOGY INC

 J,K,O 665,802 FMV
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


Software ID:  
Software Version:  






TY 2022 AffiliatedGroupAttachment
Name:
CHRISTIANA CARE HEALTH SERVICES INC
EIN:
51-0103684
Explanation:
DIRECT OTHER LOBBYING EXEMPT PURPOSE NAME OF ELECTING ORGANIZATION EXPENDITURES EXPENDITURES __________________________________ ____________ _______________ CHRISTIANA CARE HEALTH SYSTEM $ NONE $ 2,870,161 CHRISTIANA CARE HEALTH SERVICES 325,798 2,588,030,162 CHRISTIANA CARE HOME HEALTH AND COMMUNITY SERVICES NONE 42,543,018 CHRISTIANA CARE HEALTH INITIATIVES NONE 10,583,853 ----------- -------------- TOTAL $ 325,798 $2,644,027,194 THE ORGANIZATION HAS MADE THE LOBBYING ELECTION UNDER I.R.C. SECTION 501(H) FOR THE TAX YEAR ENDED JUNE 30, 2023. THIS ELECTION HAS NOT BEEN REVOKED BEFORE THE START OF THE ORGANIZATION'S TAX YEAR THAT BEGAN IN 2022.