TY 2023 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JANICE E NEVIN MD...................................................................... PRESIDENT & CEO	43.0 ................. 2.0	X	X				2,755,490	7,228
(2) SHARON KURFUERST...................................................................... FORMER COO	0.0 ................. 0.0					X	1,311,367	3,168
(3) RICHARD CUMING...................................................................... CHIEF OPERATING OFFICER	44.0 ................. 1.0			X			1,173,074	68,494
(4) RAY A BLACKWELL MD...................................................................... CHIEF OF CARDIAC SURGERY	45.0 ................. 0.0				X		1,211,524	20,878
(5) RANDALL GABORIAULT...................................................................... CHIEF DIGITAL & INFO. OFFICER	45.0 ................. 0.0			X			1,125,990	94,186
(6) KENNETH SILVERSTEIN MD...................................................................... FORMER CHIEF PHYSICIAN EXEC	0.0 ................. 0.0					X	1,126,586	2,850
(7) ROBERT MCMURRAY...................................................................... CFO, TREAS. & ASS'T SECRETARY	36.0 ................. 9.0		X				1,040,419	88,327
(8) DANIEL ROBB MD...................................................................... PHYSICIAN, CARDIAC SURGEON	45.0 ................. 0.0				X		1,022,687	12,506
(9) JENNIFER L SCHWARTZ ESQ...................................................................... CORPORATE SECRETARY	35.0 ................. 10.0		X				926,687	80,121
(10) NEIL JASANI MD...................................................................... CHIEF PEOPLE OFFICER	45.0 ................. 0.0			X			981,129	20,878
(11) KIRK N GARRATT MD...................................................................... MED. DIR. CTR FOR H/V HEALTH	45.0 ................. 0.0				X		976,760	12,104
(12) VINAY K GHEYI...................................................................... CHAIR DEPARTMENT RADIOLOGY	45.0 ................. 0.0				X		974,300	13,910
(13) KERT ANZILOTTI JR MD...................................................................... INTERIM PRESIDENT	45.0 ................. 0.0			X			907,418	80,787
(14) LISA MAXWELL MD...................................................................... PRESIDENT, CC MEDICAL GROUP	45.0 ................. 0.0			X			919,693	20,878
(15) NICHOLAS J PETRELLI MD...................................................................... MED. DIR, CCHS CANCER PROGRAM	45.0 ................. 0.0				X		909,743	12,506
(16) BETTINA TWEARDY-RIVEROS...................................................................... CHIEF HEALTH EQUITY OFFICER	45.0 ................. 0.0			X			780,074	66,272
(17) FREDERIC T HARAD MD...................................................................... DIRECTOR	45.0 ................. 0.0	X					752,407	12,506

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) BARBARA ALBANI MD........................................................................ DIRECTOR - AS OF 01/24	45.0 .......................0.0	X		721,170	0
(19) VINAY MAHESHWARI MD........................................................................ DIRECTOR	45.0 .......................0.0	X		613,808	20,878
(20) BARRY NIZIOLEK........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0
(21) CHRISTINE SAUERS........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0
(22) DAVID B STRATTON ESQ........................................................................ CHAIR - THRU 12/23	44.0 .......................1.0	X	X	0	0
(23) DWIGHT D THOMEY ESQ........................................................................ DIRECTOR - THRU 12/23	1.0 .......................3.0	X	X	0	0
(24) JULIE TOPKIS NASON........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0
(25) KATHY JANVIER........................................................................ DIRECTOR	1.0 .......................1.0	X		0	0
(26) LOLITA A LOPEZ........................................................................ CHAIR - AS OF 01/24	1.0 .......................0.0	X	X	0	0
(27) LOSSIE FREEMAN........................................................................ DIRECTOR	1.0 .......................1.0	X		0	0
(28) MORGAN MILLER MLIS........................................................................ DIRECTOR - AS OF 01/24	1.0 .......................0.0	X		0	0
(29) PAWAN RASTOGI MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0
(30) RITA LANDGRAF........................................................................ DIRECTOR - AS OF 01/24	0.0 .......................0.0	X		0	0
(31) SALVATORE CHIP ROSSIE........................................................................ DIRECTOR - THRU 12/23	1.0 .......................0.0	X		0	0
(32) TOM MOORE........................................................................ VICE CHAIR - AS OF 01/24	1.0 .......................0.0	X	X	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
CERNER CORPORATION, PO BOX 959156 ST LOUIS,MO631959156	IT SERVICES	27,221,920
GENERAL HEALTHCARE RESOURCES, 2250 HICKORY ROAD STE 240 PLYMOUTH MEETING,PA19462	TEMP. STAFFING SRVCS	16,999,659
ANESTHESIA SERVICES PA, 100 WEST COMMONS BLVD STE 400 NEW CASTLE,DE19720	ANESTHESIA SERVICES	14,349,192
CONSTRUCTION SERVICES GROUP LLC, 1630 WEST CHESTER PIKE WEST CHESTER PA,DE19382	CONSTRUCTION SRVCS	13,698,676
ERNST YOUNG LLP, PO BOX 640382 PITTSBURGH,PA152640382	CONSULTING SRVCS	10,376,097
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 337

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	80,735,115	128,076,121	43,095,263	53,965,055	42,127,253	347,998,807
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	80,735,115	128,076,121	43,095,263	53,965,055	42,127,253	347,998,807
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.						347,998,807

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..	80,735,115	128,076,121	43,095,263	53,965,055	42,127,253	347,998,807
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	38,348,773	34,285,085	42,693,278	55,003,321	76,727,538	247,057,995
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.)..	1,515,817	1,583,245	1,524,457	1,625,074	1,704,783	7,953,376
11	Total support. Add lines 7 through 10						603,010,178

Gross receipts from related activities, etc. (see instructions) ..................

11,772,482,091

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

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

57.710 %

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

60.142 %

16a

33 1/3% support test—2023. 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

33 1/3% support test—2022. 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—2023. 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

10%-facts-and-circumstances test—2022. 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

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) 2023

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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.)..

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

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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

33 1/3 % support tests—2022. 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

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) 2023

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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

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.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described on 11a above?

11b

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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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.

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.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

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

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization CHRISTIANA CARE HEALTH SERVICES INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

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) (2023)

Schedule B (Form 990) (2023)

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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

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

right arrow

Complete if the organization is described below. 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

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.

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

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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) 2022

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 right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	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) .................................................
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? ...................................................................................................................	Yes No

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

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

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

422,633

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

422,633

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

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, PART II-B, LINE 1(G)	DETAIL OF LOBBYING ACTIVITIES CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAY ENGAGE IN LOBBYING ACTIVITIES AS PERMITTED UNDER APPLICABLE FEDERAL AND STATE LAWS, INCLUDING EFFORTS TO INFLUENCE LEGISLATION OR PUBLIC POLICY RELEVANT TO ITS MISSION AND OPERATIONS. IN ADDITION, CCHS IS A MEMBER OF VARIOUS TRADE AND PROFESSIONAL ASSOCIATIONS. ANNUAL MEMBERSHIP DUES ARE PAID TO THESE ORGANIZATIONS, AND IN SOME CASES, A PORTION OF SUCH DUES HAS BEEN DESIGNATED BY THE RESPECTIVE ASSOCIATIONS AS ALLOCABLE TO LOBBYING AND ADVOCACY EFFORTS. THESE AMOUNTS HAVE BEEN IDENTIFIED IN ACCORDANCE WITH INFORMATION PROVIDED BY THE RESPECTIVE ORGANIZATIONS AND ARE NOT DIRECTLY CONTROLLED BY CCHS.

Return Reference

Explanation

SCHEDULE C, PART II-B, LINE 1(G)

DETAIL OF LOBBYING ACTIVITIES CHRISTIANA CARE HEALTH SERVICES, INC. ("CCHS") MAY ENGAGE IN LOBBYING ACTIVITIES AS PERMITTED UNDER APPLICABLE FEDERAL AND STATE LAWS, INCLUDING EFFORTS TO INFLUENCE LEGISLATION OR PUBLIC POLICY RELEVANT TO ITS MISSION AND OPERATIONS. IN ADDITION, CCHS IS A MEMBER OF VARIOUS TRADE AND PROFESSIONAL ASSOCIATIONS. ANNUAL MEMBERSHIP DUES ARE PAID TO THESE ORGANIZATIONS, AND IN SOME CASES, A PORTION OF SUCH DUES HAS BEEN DESIGNATED BY THE RESPECTIVE ASSOCIATIONS AS ALLOCABLE TO LOBBYING AND ADVOCACY EFFORTS. THESE AMOUNTS HAVE BEEN IDENTIFIED IN ACCORDANCE WITH INFORMATION PROVIDED BY THE RESPECTIVE ORGANIZATIONS AND ARE NOT DIRECTLY CONTROLLED BY CCHS.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
right arrow

Attach to Form 990.
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

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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)? .............................

Yes No

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.

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.

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	59,228,178	58,310,687	68,569,307	62,232,483	67,336,850
b	Contributions ...	809,537	732,143	669,502	993,569	1,520,182
c	Net investment earnings, gains, and losses	4,928,139	3,560,384	-6,744,573	9,205,113	2,545,562
d	Grants or scholarships ...	0	0	0	0	0
e	Other expenditures for facilities and programs ...	2,256,646	3,375,036	4,183,549	3,861,858	9,170,111
f	Administrative expenses ....	0	0	0	0	0
g	End of year balance ......	62,709,208	59,228,178	58,310,687	68,569,307	62,232,483

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

35.950 %

Permanent endowment right arrow

41.590 %

Term endowment right arrow

22.460 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

Yes

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 ....	1,801,186,301	1,024,715,409	776,470,892
c	Leasehold improvements	37,457,859	14,587,692	22,870,167
d	Equipment ....	959,029,169	760,693,863	198,335,306
e	Other .....	40,370,219	31,762,600	8,607,619
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,039,023,782

Schedule D (Form 990) 2022

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	437,767,095	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	437,767,095

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.)

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				51,056,920
(2)DUE FROM AFFILIATES				198,427,340
(3)OTHER ASSETS				121,943,137
(4)OTHER RECEIVABLES				43,689,826
(5)SUBSIDIARY INVESTMENT				96,686,168
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				511,803,391

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
PENSION & POST RETIREMENT BENEFIT	192,249,760
INSURANCE LIABILITIES	14,158,018
OTHER LIABILITIES	211,135,180






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	417,542,958
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) 2022

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 SEVEN 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) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right arrow

Attach to Form 990. Right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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.

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? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

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)	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	0	0	Investments	174,876,372
















3a	Sub-total ....	0	0		174,876,372
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0		174,876,372

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2023

Schedule F (Form 990) 2023Page 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) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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

2023

Open to Public Inspection

Name of the organization
CHRISTIANA CARE HEALTH SERVICES INC

Employer identification number

51-0103684

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 FY24 HFGCC 5K (event type)	(b) Event #2 FY25 HFGCC 5K (event type)	(c) Other events 0 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	96,658	62,832	0	159,490
2	Less: Contributions . . . .	85,950	55,802	0	141,752
3	Gross income (line 1 minus line 2) . . . . . .	10,708	7,030	0	17,738

4	Cash prizes . . . . .	0	0	0	0
5	Noncash prizes . . . .	0	0	0	0
6	Rent/facility costs . . . .	0	0	0	0
7	Food and beverages . . .	0	0	0	0
8	Entertainment . . . .	0	0	0	0
9	Other direct expenses . . .	0	0	0	0
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				0
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				17,738

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation
FORM 990, SCHEDULE G, PART II	DETAIL OF FUNDRAISING EVENTS EXPENSES RELATED TO THE HFGCC 5K EVENTS WERE RECORDED DIRECTLY BY CHRISTIANA CARE HEALTH SYSTEM, INC., THE SOLE MEMBER OF THIS ORGANIZATION.

Schedule G (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

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

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 400 %

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: . . . . . . . .

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) . . .			16,686,977	0	16,686,977	0.630 %
b	Medicaid (from Worksheet 3, column a) . . . . .			342,674,799	323,658,624	19,016,174	0.710 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			359,361,776	323,658,624	35,703,151	1.340 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	39	17,459	17,942,366	1,285,784	16,656,582	0.620 %
f	Health professions education (from Worksheet 5) . . .	4	134	100,114,063	16,956,329	83,157,734	3.120 %
g	Subsidized health services (from Worksheet 6) . . . .	1	27,509	269,932,838	192,828,061	77,104,777	2.890 %
h	Research (from Worksheet 7) .	1		19,256,070	17,017,691	2,238,379	0.080 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	14	292	1,775,365	0	1,775,365	0.070 %
j	Total. Other Benefits . .	59	45,394	409,020,702	228,087,865	180,932,837	6.780 %
k	Total. Add lines 7d and 7j .	59	45,394	768,382,478	551,746,489	216,635,988	8.120 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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	1		14,400	0	14,400
2	Economic development	1		90,423	0	90,423
3	Community support	1		105,000	0	105,000
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1		14,013	0	14,013
7	Community health improvement advocacy
8	Workforce development	1	100	238,145	0	238,145	0.010 %
9	Other
10	Total	5	100	461,981	0	461,981	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

71,170,791

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. ......

493,718

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

Enter total revenue received from Medicare (including DSH and IME).....

532,781,855

Enter Medicare allowable costs of care relating to payments on line 5.....

605,350,289

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-72,568,434

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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) 2023

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)							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) 2023

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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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 .................

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..................................

Yes

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. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2023

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

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 400.%
and FPG family income limit for eligibility for discounted care of 0.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

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

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

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

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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)	CHRISTIANACARE WELCOMES THE TASK OF UNDERTAKING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AS IT ALLOWS US ANOTHER OPPORTUNITY TO LEARN FROM OUR NEIGHBORS. THIRTY-FIVE INDIVIDUALS WHO REPRESENTED DELAWARE HEALTH AND SOCIAL SERVICES, NON-PROFIT ORGANIZATIONS, LOCAL BUSINESSES, HEALTHCARE PROVIDERS, AND SCHOOL SYSTEMS AS WELL AS LOCAL POLICYMAKERS PARTICIPATED IN FOUR VIRTUAL COMMUNITY STAKEHOLDER MEETINGS. AT EACH MEETING, 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 CONSIDER TO BE MOST SIGNIFICANT. 110 STUDENTS AT WILLIAM PENN HIGH SCHOOL IN NEW CASTLE ALSO RECEIVED THE PRESENTATION OF SECONDARY DATA DURING THEIR HEALTH CLASSES AND EACH PARTICIPANT IDENTIFIED THREE TO FIVE HEALTH ISSUES THEY FELT TO BE THE MOST SIGNIFICANT. IN ADDITION TO THE COMMUNITY MEETINGS, 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 WERE CONDUCTED TO GAIN THEIR EXPERTISE ON THE HEALTH CHALLENGES OF OUR COMMUNITY. FINALLY, FORTY-FIVE CHRISTIANACARE CAREGIVERS FROM DIVERSE DEPARTMENTS PARTICIPATED IN TWO VIRTUAL MEETINGS. THEIR PERSPECTIVES FROM SERVING THE COMMUNITY ALSO PROVIDED INSIGHT INTO OUR COMMUNITY'S CHALLENGES AND SUCCESSES. 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) YES. CHRISTIANACARE'S CHNA IS AVAILABLE ON ITS WEBSITE AT: HTTPS://CHRISTIANACARE.ORG/ABOUT/WHOWEARE/COMMUNITYBENEFIT/COMMUNITY-HEALT H-NEEDS-ASSESSMENT/ PAPER COPIES ARE ALSO AVAILABLE UPON REQUEST. -------------------- PART V, LINES 8 AND 9 YES. CHRISTIANACARE ADOPTED ITS COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) ON SEPTEMBER 19, 2022. -------------------- 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/ PAPER COPIES OF THE CHIP ARE ALSO AVAILABLE TO MEMBERS OF THE PUBLIC UPON REQUEST. ----------------------------------------
PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA)	IN CHRISTIANACARE'S 2022 CHNA, THE FOLLOWING WERE IDENTIFIED 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 DRIVERS OF HEALTH . VIOLENT CRIME CHRISTIANACARE IS ADDRESSING ALL THESE SIGNIFICANT AREAS OF NEED. AS DESCRIBED PREVIOUSLY, 110 HIGH-SCHOOL AGED STUDENTS ALSO IDENTIFIED THE MOST SIGNIFICANT HEALTH NEEDS OF THEIR COMMUNITY. THE SIGNIFICANT AREAS OF NEED THE STUDENTS IDENTIFIED MIRRORED THE NEEDS SELECTED BY THE PARTICIPATING ADULTS, 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 OUR SCHOOL-BASED HEALTH CENTERS AND ALLIANCE FOR ADOLESCENT PREGNANCY PREVENTION (AAPP) PROGRAMMING. WHILE WE WILL NOT PRIORITIZE THE TWO ADDITIONAL TEEN-IDENTIFIED SIGNIFICANT AREAS OF NEED, 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: MOBILE HEALTH SERVICES IN JUNE 2022, CHRISTIANACARE INTRODUCED ITS TWO MOBILE HEALTH SERVICES VANS SUPPORTED BY A $1 MILLION INVESTMENT FROM BARCLAYS AS PART OF ITS COVID-19 COMMUNITY AID PACKAGE. CHRISTIANACARE USES THE VANS TO SERVE PATIENTS WHO NEED SAME DAY CARE AND THOSE WITHOUT A DOCTOR. WITHIN THE VANS, PATIENTS MAY RECEIVE ADULT CARE, WOMEN'S HEALTH, PEDIATRICS, VACCINES, AND MORE. RECEIVING CARE IS NOT A ONE-TIME EVENT, BUT THE START OF A PRIMARY AND SPECIALTY CARE RELATIONSHIP. CHRISTIANACARE HAS PARTNERED WITH COMMUNITY ORGANIZATIONS TO LOCATE THE VANS WHERE THEY ARE NEEDED AND ENCOURAGE COMMUNITY MEMBERS TO TAKE ADVANTAGE OF THE SERVICES OFFERED ON THE VANS. INFY2024, WE EXPANDED TO OFFERING MOBILE HEALTH SERVICES AT 7 ACCESS POINTS LOCATED AT THE FOLLOWING ORGANIZATIONS IN WILMINGTON: EZION FAIR BAPTIST CHURCH, CHRISTIAN GROWTH MINISTRY, EMPOWERMENT CENTER, AND KINGSWOOD COMMUNITY CENTER, AS WELL AS ROSE HILL COMMUNITY CENTER IN NEW CASTLE AND THE CLAYMONT COMMUNITY CENTER IN CLAYMONT. EACH OF THOSE ORGANIZATIONS ARE LOCATED WITHIN COMMUNITIES WITH SIGNIFICANT NEEDS. ADDITIONALLY, THE VAN IS ALSO LOCATED EACH WEEK ACROSS FROM CHRISTIANACARE'S WILMINGTON HOSPITAL CAMPUS. ONCE A MONTH, ONE OF THE VANS IS ALSO LOCATED AT AREAS OF NEED DOWNSTATE AT THE MODERN MATURITY CENTER AND FRIENDSHIP HOUSE OF KENT COUNTY IN DOVER AND THE MARKET STREET PARK IN LAUREL. IN FY2024, THERE WERE 364 PATIENTS VISITS ON THE VANS, INCLUDING 78 NEW PATIENTS. THIS WAS MORE THAN DOUBLE THE NUMBER OF PATIENT VISITS ON THE VANS IN FY2023. SCHOOL BASED HEALTH CENTERS CHRISTIANACARE ALSO OPERATES 26 SCHOOL-BASED HEALTH CENTERS (SBHCS) THROUGHOUT NEW CASTLE COUNTY IN ELEMENTARY, MIDDLE, AND HIGH SCHOOLS. IN FY2024, CHRISTIANACARE BEGAN OPERATING AN ADDITIONAL THREE SBHCS. THE CONVENIENCE PROVIDED BY SBHCS ALONG WITH THE OPPORTUNITY TO ADDRESS HEALTH ISSUES AT THE EARLIEST AND MOST PREVENTABLE STAGES NOT ONLY SUPPORTS ACCESS TO CARE, BUT ALSO HEALTH EQUITY. IN FY2024, OUR SBHCS HAD 27,509 STUDENT VISITS. DENTAL SERVICES ACCESSING DENTAL SERVICES IS CHALLENGING FOR MANY COMMUNITY MEMBERS IN NEW CASTLE COUNTY AND THE STATE. FOR DECADES, CHRISTIANACARE'S DENTAL CLINIC HAS PROVIDED COMPREHENSIVE CARE, INCLUDING ORAL SURGERY, RESTORATIVE DENTISTRY, ENDODONTICS, PERIODONTICS, PEDIATRIC DENTISTRY, PROSTHETICS, IMPLANTS, AND ORAL MEDICINE FOR THE UNINSURED AND UNDERINSURED INDIVIDUALS. CHRISTIANACARE IS A REGIONAL REFERRAL CENTER FOR DELAWARE AND SURROUNDING STATES, AS WELL AS A MAJOR PROVIDER OF PRIMARY MEDICAL AND DENTAL CARE. IN ADDITION TO THE GENERAL PRACTICE DENTISTRY RESIDENCY, THE DEPARTMENT ALSO OFFERS A FULLY ACCREDITED ORAL AND MAXILLOFACIAL SURGERY RESIDENCY PROGRAM. EVERY FRIDAY, THE DENTAL CLINIC SERVES UNINSURED AND MEDICAID 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. IN FY2024, THERE WERE 12558 VISITS TO THE DENTAL CLINIC AND ORAL SURGERY RESIDENT CLINIC. FURTHER, THE DENTAL CLINIC HAS BEEN FOCUSED ON INTERNAL IMPROVEMENTS TO INCREASE ACCESS AND BETTER SERVE THE COMMUNITY BY ADDING POSITIONS TO SUPPORT CLINIC GROWTH, IMPROVING SCHEDULING TO OPTIMIZE CASE MIX AND APPOINTMENT AVAILABILITY, AND COMMITTING TO SEEING TRAUMA PATIENTS WITHIN SEVEN DAYS.
PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.)	NEW CASTLE COUNTY HOPE CENTER SINCE 2021, CHRISTIANACARE HAS OPERATED AN ON-SITE PRIMARY CARE OFFICE AT THE NEW CASTLE COUNTY HOPE CENTER, A FORMER HOTEL REPURPOSED TO SERVE AS AN EMERGENCY SHELTER FOR FAMILIES AND INDIVIDUALS EXPERIENCING HOMELESSNESS. SERVICES INCLUDE ACUTE ILLNESS MANAGEMENT, CHRONIC DISEASE MANAGEMENT, PRENATAL CARE, PEDIATRIC AND NEWBORN CARE, AND CONTRACEPTIVE MANAGEMENT. SINCE 2023, CHRISTIANACARE HAS ALSO OPERATED A MEDICAL RESPITE PROGRAM ENCOMPASSING THIRTY-SIX ROOMS AT THE HOPE CENTER FOR PATIENTS WHOSE COMPLEX ILLNESSES MAKE THEM INELIGIBLE FOR RESIDING AT A STANDARD HOUSING SHELTER. THIS PROGRAM ALLOWS PATIENTS WITHOUT STABLE HOUSING TO RECEIVE CARE IN THE COMMUNITY INSTEAD OF REMAINING IN OUR HOSPITAL DUE TO THE LACK OF COMMUNITY OPTIONS FOR THEM. IN FY2024, FORTY-ONE PATIENTS WERE SERVED BY THIS PROGRAM. HEALTH GUIDES HEALTH GUIDES INCREASE ACCESS TO CARE BY CONNECTING PATIENTS TO HEALTH CARE SERVICES AND COMMUNITY RESOURCES AND ASSISTING IN HEALTH INSURANCE AND PRESCRIPTION ASSISTANCE ENROLLMENT AND FINANCIAL ASSISTANCE APPLICATIONS. THE HEALTH GUIDES ARE BASED IN THE WILMINGTON HOSPITAL AND AT TWO CHRISTIANACARE PRIMARY CARE PRACTICES. THE HEALTH GUIDES SERVING THE TWO PRACTICES ARE BI-LINGUAL TO BETTER SERVE THE NEEDS OF THOSE PATIENT POPULATIONS. THE HEALTH GUIDES ALSO ROUTINELY ATTEND COMMUNITY EVENTS TO PROVIDE THEIR SERVICES IN THE COMMUNITY. IN FY2024, THE HEALTH GUIDES HAD 4,273 PATIENT ENCOUNTERS AND ASSISTED PATIENTS IN APPLYING FOR A TOTAL OF $2,007,218 IN FINANCIAL ASSISTANCE. COMMUNITY HEALTH WORKERS (CHWS) CHWS CONNECT PATIENTS TO CARE, THEY WORK TO ADDRESS PATIENTS' SOCIAL NEEDS, AND THEY HELP PATIENTS IDENTIFY AND ACHIEVE PATIENT CENTERED GOALS. ADDITIONALLY, CHRISTIANACARE'S CHWS ATTEND COMMUNITY EVENTS TO PROVIDE INFORMATION ABOUT OUR PROGRAMS, COMPLETE SOCIAL DETERMINANTS OF HEALTH SCREENING, AND PROVIDE REFERRALS TO RESOURCES IN THE COMMUNITY. CHWS ARE VALUABLE MEMBERS OF A PATIENT'S CARE TEAM BECAUSE OUR CAREGIVERS RECOGNIZE THE OUTSIZED ROLE A PATIENT'S SOCIAL NEEDS HAS ON THEIR HEALTH. CHRISTIANACARE UTILIZES CHWS TO ADDRESS EACH OF OUR PRIORITIZED AREAS OF NEED AS WILL BE EXPLAINED IN FURTHER DETAIL IN THE RELEVANT SECTIONS. CHRISTIANACARE HAS EMBEDDED CHWS WITHIN THE NEW CASTLE COUNTY HOPE CENTER AND CHRISTIANACARE SBHCS. THE HOPE CENTER CHW WORKS WITH THE PATIENTS IN THE MEDICAL RESPITE BED PROGRAM (41 PATIENTS IN FY2024) TO CLOSE CARE GAPS AND ADDRESS THE SOCIAL DRIVERS OF HEALTH THAT ARE IMPACTING THOSE PATIENTS' HEALTH AND WELL-BEING. CHRISTIANACARE HAS ALSO EMBEDDED CHWS IN 22 OF OUR SBHC TO SERVE STUDENTS AND THEIR FAMILIES BY CONNECTING THEM TO MEDICAL SERVICES AND COMMUNITY RESOURCES. IN FY2024, 670 STUDENTS WERE ASSISTED BY THE SBHC CHWS. IN FY2024, A SBHC CHW WORKED WITH A HIGH-SCHOOL STUDENT WHO RELOCATED TO DELAWARE FROM ANOTHER COUNTRY. THE CHW CONNECTED THAT STUDENT TO A PRIMARY CARE PROVIDER, EYE CARE, AND MEDICAID. THE STUDENT WAS ALSO INTERESTED IN LEARNING MORE ABOUT COLLEGE AND GETTING A SUMMER JOB. THE CHW PROVIDED THE STUDENT WITH COLLEGE RESOURCES AND INFORMATION AND SHARED A JOB OPPORTUNITY SHE THOUGHT MIGHT BE OF INTEREST TO THE STUDENT. THE STUDENT SUCCESSFULLY APPLIED FOR THE JOB AND WAS THRILLED TO GET IT. WHILE EVERY STUDENT HAS UNIQUE NEEDS, THIS IS AN EXAMPLE OF HOW OUR CHWS PROVIDE COMPREHENSIVE SUPPORT TO HELP INDIVIDUALS MEET ANY GOAL THEY HAVE REGARDLESS OF WHETHER IT IS DIRECTLY RELATED TO HEALTH. CHRISTIANACARE'S HELEN F. GRAHAM CANCER CENTER DEPLOYS A TEAM OF CHWS TO PROVIDE EDUCATION IN THE COMMUNITY ON CANCER SCREENING AND PREVENTION. THESE CHWS ARE FOCUSED ON PROVIDING EDUCATION IN A CULTURALLY APPROPRIATE WAY AND ENSURING THAT INDIVIDUALS ARE CONNECTED TO AND RECEIVE SCREENING THROUGH RESOURCES LIKE SCREENING FOR LIFE, A STATE SPONSORED PROGRAM WHICH HELPS ELIGIBLE ADULTS PAY FOR CANCER SCREENINGS. IN FY2024, THESE CHWS PROVIDED INFORMATION AND EDUCATION TO OVER 9,000 INDIVIDUALS AT APPROXIMATELY 140 COMMUNITY EVENTS.
PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.)	CHRONIC HEALTH CONDITIONS: FOOD INSECURITY PROGRAMS FOOD INSECURITY IS ASSOCIATED WITH WORSENING CHRONIC DISEASE OUTCOMES AND DIFFICULTIES ADHERING TO A HEALTHY DIET. TO ADDRESS FOOD INSECURITY AND ITS IMPACT ON CHRONIC DISEASE, CHRISTIANACARE LAUNCHED THE DELAWARE FOOD FARMACY (DFF), A 6-MONTH FOOD AS MEDICINE CHW PROGRAM IN PRIMARY CARE FOR PATIENTS WITH CHRONIC CONDITIONS AND FOOD INSECURITY. PATIENTS RECEIVE WEEKLY MEDICALLY TAILORED GROCERIES, AND CHWS ASSIST PATIENTS WITH GOAL SETTING AND IMPROVING DIETARY KNOWLEDGE AND CULINARY SKILLS. IN FY2024, CHRISTIANACARE ENROLLED 87 PARTICIPANTS IN THE PROGRAM, AND PROVIDED FOOD FOR 224 COMMUNITY MEMBERS AS THE ENTIRE HOUSEHOLDS OF THE PARTICIPANTS ARE PROVIDED FOOD. 63% OF THE PARTICIPANTS LIVE IN THE ZIP CODES WE DEFINED AS HIGH RISK IN OUR 2022 CHNA. IN JANUARY 2024, CHRISTIANACARE EXPANDED THE DFF INTO WOMEN'S HEALTH. THIS PROGRAM WILL BE DISCUSSED IN MORE DETAIL IN THE MATERNAL AND CHILD HEALTH SECTION. CHRISTIANACARE ALSO CREATED THE HEALTHY FOOD DELIVERY PROGRAM AS AN INTERVENTION FOR PATIENTS WHO SCREEN POSITIVE FOR FOOD INSECURITY AND ARE DIAGNOSED WITH DIABETES, HYPERTENSION, AND/OR CONGESTIVE HEART FAILURE. BI-WEEKLY MEDICALLY TAILORED GROCERIES ARE DELIVERED TO PATIENTS' HOMES BY PARTNERING ORGANIZATION HUNGRY HARVEST. IN FY2024, CHRISTIANACARE ENROLLED 24 PARTICIPANTS AND SERVED 56 COMMUNITY MEMBERS. 67% OF THE PARTICIPANTS LIVE IN THE HIGH-RISK ZIP CODES DEFINED BY OUR 2022 CHNA. IN FY2024, A PATIENT IN HER EARLY 70S AND SUFFERING FROM MULTIPLE CHRONIC CONDITIONS ENROLLED IN CHRISTIANACARE'S PRIMARY CARE DFF. SINCE HER PARTICIPATION IN THE PROGRAM, SHE HAS BEEN EATING HEALTHY FOODS MORE OFTEN AND USING THE DFF RECIPES PROVIDED BY HER CHW. SHE FEELS GOOD ABOUT HOW SHE HAS CHANGED HER DIET AND HAS BECOME MORE CONFIDENT. PRIMARY CARE AND WOMEN'S HEALTH CHW PROGRAMS CHRISTIANACARE CREATED ITS PRIMARY CARE CHW PROGRAM TO SERVE PATIENTS OF CHRISTIANACARE'S PRIMARY PRACTICES WHO HAVE MEDICAID, MEDICARE, OR ARE UNINSURED WITH DIABETES, HYPERTENSION, AND HIGH EMERGENCY DEPARTMENT UTILIZATION OR AT LEAST ONE INPATIENT STAY. THIS SIX-MONTH PROGRAM UTILIZES AN EVIDENCE-BASED APPROACH TO IMPROVE HEALTH OUTCOMES AND INCREASE HEALTH LITERACY. IN FY2024, CHRISTIANACARE ENROLLED 266 PATIENTS IN THIS PROGRAM. CHRISTIANACARE CREATED THE WOMEN'S HEALTH CHW PROGRAM TO TRANSFORM MATERNAL AND INFANT HEALTHCARE WITH A COMMITTED INVESTMENT TO ADDRESS THE SOCIAL DRIVERS OF HEALTH. PREGNANT AND POSTPARTUM PATIENTS WITH MEDICAID OR NO INSURANCE AND 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 ARE ELIGIBLE. IN FY2024, OUR CHWS WORKED WITH 121 PATIENTS WHO GRADUATED FROM THE PROGRAM. THE WOMEN'S HEALTH CHWS HELPED CONNECT THESE PATIENTS TO WIC AND OTHER STATE BENEFITS SUCH AS PURCHASE OF CARE, PROVIDED REFERRALS TO DIAPER BANKS, ASSISTED WITH TRANSPORTATION TO AND FROM MEDICAL APPOINTMENTS, AND HELPED PATIENTS ENGAGE IN WORKFORCE DEVELOPMENT PROGRAMS. WOMEN'S HEALTH CHW PROGRAM: MATERNAL AND CHILD HEALTH DELAWARE'S INFANT MORTALITY RATE HAS IMPROVED CONSIDERABLY IN THE LAST DECADE, BUT UNFORTUNATELY, RACIAL DISPARITIES IN MATERNAL AND INFANT MORTALITY PERSIST. CHRISTIANACARE CONTINUES TO UNDERTAKE AND LEAD TARGETED EFFORTS TO IMPROVE THESE DISPARATE OUTCOMES IN BOTH CLINICAL AND COMMUNITY SETTINGS. WE RECOGNIZE THAT REDUCING MATERNAL AND INFANT MORTALITY RATES, AND THE DISPARITIES WITHIN THOSE RATES, IS ONLY POSSIBLE WITH A COMPREHENSIVE APPROACH THAT CONSIDERS ALL THE NEEDS OF THE INDIVIDUAL. THIS IS WHY MANY OF OUR PROGRAMS FOCUSED ON MATERNAL AND CHILD HEALTH ADDRESS SOCIAL DRIVERS OF HEALTH. IT IS ALSO WHY CHRISTIANACARE UTILIZES DIGITAL TOOLS TO PROVIDE EXPECTANT PARENTS WITH INFORMATION ABOUT HEALTHY PREGNANCIES AND PROVIDES VIRTUAL CARE OPTIONS TO ENSURE INFORMATION, RESOURCES, AND CARE ARE ACCESSIBLE TO ALL PATIENTS. WE KNOW NOT EVERYONE CAN TAKE OFF WORK OR FIND TRANSPORTATION TO AN APPOINTMENT. AS DESCRIBED PREVIOUSLY, CHRISTIANACARE CREATED THE WOMEN'S HEALTH CHW PROGRAM TO TRANSFORM MATERNAL AND INFANT HEALTHCARE. WOMEN'S HEALTH CHWS 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. HEALTHY BEGINNINGS AND HOME VISITING CHW PROGRAMS IN PARTNERSHIP WITH THE DELAWARE DIVISION OF PUBLIC HEALTH, CHRISTIANACARE HAS OFFERED BOTH THE HOME VISITING CHW (FORMERLY HEALTH AMBASSADORS) AND HEALTHY WOMEN HEALTHY BABY (HWHB) PROGRAMS FOR MORE THAN A DECADE. BOTH PROGRAMS WERE CREATED TO ADDRESS DELAWARE'S HIGH INFANT MORTALITY RATE. THE HOME VISITING CHW 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. THE HWHB ENROLLS HIGH RISK WOMEN INTO PRECONCEPTION, PRENATAL, AND INTERCONCEPTION CARE. THIS PROGRAM HAS IMPACTED BIRTH OUTCOMES. HWHB ENROLLED INDIVIDUALS WERE 10% LESS LIKELY TO SMOKE DURING PREGNANCY; WERE 9% LESS LIKELY TO DELIVER A LOW-BIRTH-WEIGHT INFANT; AND WERE 15% LESS LIKELY TO DELIVER A PRETERM INFANT AS COMPARED TO WOMEN WITH SIMILAR RISKS FACTORS NOT ENROLLED WITH HWHB PROGRAMS. THE CURRENT STATE FUNDED PROGRAM, HWHB 3.0 HAS A STRONG EMPHASIS ON THE FOURTH TRIMESTER, THE 12-WEEK PERIOD AFTER THE BIRTH OF A BABY. THE CHRISTIANACARE HWHB HEALTHY BEGINNINGS TEAM IS ADDRESSING THIS CRITICAL AREA OF WOMEN'S HEALTHCARE WITH THE ADDITION OF A BILINGUAL POSTPARTUM HEALTH EDUCATOR. IN FY2024, THE HOME VISITING CHWS SERVED 134 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 AND REFERRALS TO HOME VISITING PROGRAMS. IN FY2024, HEALTHY BEGINNINGS ENROLLED 1,989 PATIENTS. OF THOSE PATIENTS, 59.7% WERE AFRICAN AMERICAN AND 61.3% LIVED IN A HIGH-RISK ZONE (19702, 19703, 19720, 19801, 19802, 19804, 19805, 19809, 19901, 19904, 19933, 19950, 19973). IN FY2024, THE HOME VISITING CHWS HELPED A TEENAGED MOTHER GET ESSENTIAL BABY ITEMS AND ENROLL IN THE NURSE FAMILY PARTNERSHIP, A COMMUNITY HEALTH ORGANIZATION WHICH PARTNERS THE FIRST-TIME MOTHER WITH A SPECIALLY TRAINED NURSE WHO MAKES HOME VISITS BEGINNING IN THE PREGNANCY AND THROUGH THE CHILD'S SECOND BIRTHDAY. THE MOTHER OF THE NEW TEENAGED MOTHER WAS WITHOUT A JOB AS WELL AND SO THE ENTIRE FAMILY WAS APPRECIATIVE OF THE SUPPORT.
PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.)	WOMEN'S HEALTH DELAWARE FOOD FARMACY IN JANUARY 2024, CHRISTIANACARE EXPANDED ITS DELAWARE FOOD FARMACY (DFF) PROGRAM INTO WOMEN'S HEALTH. THIS 6-TO-8-MONTH FOOD IS MEDICINE PROGRAM IS INTENDED TO IMPROVE HEALTH OUTCOMES AND REDUCE HOSPITAL UTILIZATION, AND TO ALLEVIATE FOOD INSECURITY AND IMPROVE DIETARY BEHAVIORS. LIKE THE PRIMARY CARE DFF, THE WOMEN'S HEALTH DFF PARTNERS WITH COMMUNITY ORGANIZATION, LUTHERAN COMMUNITY SERVICES, TO PROVIDE OUR PREGNANT PATIENTS AND THEIR FAMILY MEMBERS WITH APPROXIMATELY 22-42 WEEKS (DEPENDING ON GESTATIONAL AGE AT PROGRAM ENROLLMENT AND PREGNANCY LENGTH) OF MEDICALLY TAILORED GROCERIES THAT ARE HIGH IN MICRONUTRIENTS CRITICAL FOR A HEALTHY PREGNANCY. CHWS GUIDE PATIENTS AND THEIR FAMILIES THROUGH THE HEALTH, SOCIAL, AND COMMUNITY SERVICES SYSTEMS TO FOSTER HEALTH AND WELL-BEING. PATIENTS IN THE PROGRAM ALSO RECEIVE CULINARY EQUIPMENT AND TRAINING, EDUCATIONAL NUTRITION VIDEOS, AND RECIPES, AND CHWS WILL PROVIDE NUTRITION ASSESSMENT, EDUCATION, AND ONGOING SUPPORT FOR DIETARY BEHAVIOR CHANGES AND ACHIEVING GOALS FOR A HEALTHIER PREGNANCY. IN FY2024, CHRISTIANACARE ENROLLED 60 PARTICIPANTS AND 203 COMMUNITY MEMBERS WERE SERVED. 54% OF THE PARTICIPANTS LIVE IN HIGH-RISK ZIP CODES AS IDENTIFIED BY OUR 2022 CHNA. A TOTAL OF 27,620 MEALS WERE PROVIDED TO THESE PARTICIPANTS AND THEIR FAMILIES IN FY2024. OF THE PROGRAM, ONE PARTICIPANT SAID "I LOVE THIS PROGRAM. I FEEL LIKE IT HAS CHANGED EVERYTHING IN MY LIFE. IT TAUGHT ME HOW TO COOK HEALTHIER FOR MY PREGNANCY THAT WILL FOREVER STICK TO ME." PARTICIPATION IN STATE COALITIONS FOCUSED ON MATERNAL AND INFANT MORTALITY CHRISTIANACARE CAREGIVERS LEAD AND PARTICIPATE IN STATEWIDE COLLABORATIVE EFFORTS TO ADDRESS THE SYSTEMIC ISSUE OF MATERNAL AND INFANT MORTALITY. IN 2023, CHRISTIANACARE PEDIATRICIAN, PRISCILLA MPASI, WAS APPOINTED CHAIR OF THE DELAWARE HEALTHY MOTHER AND INFANT CONSORTIUM (DHMIC) BY THE GOVERNOR. 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 CHANGE THAT COULD REDUCE THE NUMBER OF DEATHS. ALLIANCE FOR ADOLESCENTS PREGNANCY PREVENTION 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 FY24, CHRISTIANACARE CAREGIVERS EDUCATED 1,268 YOUTH FROM THIRTY SCHOOLS THROUGHOUT DELAWARE. OF THE YOUTH EDUCATED, MORE THAN 65% WERE FROM HIGH-RISK AREAS AS IDENTIFIED BY OUR 2022 CHNA. CHRISTIANACARE'S AAPP TEAM WAS ALSO ABLE TO PURCHASE AND DISTRIBUTE HYGIENE PRODUCTS TO ALL STUDENTS. MENTAL HEALTH AND SUBSTANCE USE DISORDERS: MENTAL HEALTH AND SUBSTANCE USE DISORDERS HAVE BEEN IDENTIFIED AS A SIGNIFICANT AREA OF NEED BY OUR COMMUNITY IN EVERY CHNA CHRISTIANACARE HAS COMPLETED. OVER THE PAST SEVERAL YEARS, CHRISTIANACARE HAS UNDERTAKEN A VARIETY OF INITIATIVES TO RESPOND TO THAT NEED BY EXPANDING ACCESS TO BEHAVIORAL HEALTH SERVICES IN CLINICAL AND COMMUNITY SETTINGS INCLUDING EMBEDDED BEHAVIORAL HEALTH CARE MODELS. BEHAVIORAL HEALTH CHW PROGRAM CHRISTIANACARE CREATED THE BEHAVIORAL HEALTH CHW PROGRAM TO SERVE ADULTS AND CHILDREN AND ADOLESCENTS PARTICIPATING IN OUTPATIENT BEHAVIORAL HEALTH SERVICES AND PROJECT RECOVERY, AN OUTPATIENT PROGRAM OFFERING TREATMENT FOR SUBSTANCE USE DISORDER. PATIENTS WHO ARE ENGAGED WITH THOSE PRACTICES, RESIDING IN NEW CASTLE COUNTY, AND HAVE DISCUSSED AT LEAST ONE SOCIAL CARE OR COMMUNITY ENGAGEMENT GOAL ARE ELIGIBLE TO PARTICIPATE IN THE PROGRAM. IN FY2024, 118 PATIENTS PARTICIPATED IN THIS PROGRAM INCLUDING 39 FAMILIES OF YOUTH RECEIVING OUTPATIENT BEHAVIORAL HEALTH SERVICES.
PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.)	PROJECT ENGAGE CHRISTIANACARE'S PROJECT ENGAGE IS AN EARLY INTERVENTION AND REFERRAL TO SUBSTANCE USE DISORDER TREATMENT PROGRAM. PROJECT ENGAGE EMPLOYS PEERS IN RECOVERY TO 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 CONNECT THESE PATIENTS TO TREATMENT PROGRAMS AND OTHER COMMUNITY RESOURCES. IN FY24, PROJECT ENGAGE PEERS HAD A TOTAL OF 2,940 ENGAGEMENTS WITH PATIENTS AND MADE 1,781 REFERRALS TO TREATMENT. POLICE DEPARTMENT PARTNERSHIPS SINCE 2021, CHRISTIANACARE'S CENTER FOR COMMUNITY HEALTH AND EMPOWERMENT HAS PARTNERED WITH THE NEW CASTLE COUNTY POLICE DEPARTMENT (NCCPD) TO DIVERT INDIVIDUALS AWAY FROM THE CRIMINAL JUSTICE SYSTEM AND EMERGENCY DEPARTMENTS WHEN APPROPRIATE AND CONNECT INDIVIDUALS TO CARE IN THE COMMUNITY. SERVING WITH THE POLICE IN A CO-RESPONDER MODEL, CHRISTIANACARE MENTAL HEALTH PROFESSIONALS RESPOND TO 911 CALLS AND OFFICER REFERRALS WHEN MENTAL ILLNESS IS BELIEVED TO BE A PRIMARY FACTOR FOR POLICE INVOLVEMENT. 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 MARCH 2024, CHRISTIANACARE LAUNCHED A NEW POLICE PARTNERSHIP WITH THE WILMINGTON POLICE DEPARTMENT, THE WILMINGTON PARTNERS IN CARE PROGRAM. LIKE THE NCCPD PARTNERSHIP, THIS PROGRAM UTILIZES A CO-RESPONDER MODEL WHICH PAIRS TRAINED MENTAL HEALTH CLINICIANS WITH POLICE OFFICERS WHO RESPOND AS A TEAM TO CALLS FOR SERVICE AND CONDUCT PROACTIVE OUTREACH. IN DECEMBER 2024, CHRISTIANACARE ALSO BEGAN A NEW PARTNERSHIP WITH THE NEWARK POLICE DEPARTMENT. THESE PARTNERSHIPS PROVIDE INTERVENTIONS FOR COMMUNITY MEMBERS WHO MAY 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 COMMUNITY MEMBERS. COMMUNITY SUBSTANCE OVERDOSE SUPPORT (SOS) 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. THE SOS TEAM WILL HELP THE PATIENT ADDRESS ANY BARRIERS TO TREATMENT AND ASSIST THEM WITH ENROLLING IN TREATMENT. IN FY24, THE SOS TEAM SUCCESSFULLY CONTACTED 482 INDIVIDUALS TO OFFER ASSISTANCE IN ENROLLING IN TREATMENT AND ADDRESSING ANY OTHER NEEDS. OF THOSE INDIVIDUALS, 70 AGREED TO TREATMENT, A SUCCESS RATE OF 14.52%. THE SOS TEAM ALSO DISTRIBUTED 20 NARCAN KITS THROUGHOUT THE YEAR. WHILE CONDUCTING COMMUNITY OUTREACH ONE DAY DURING FY2024, THE SOS TEAM ENCOUNTERED AN INDIVIDUAL ON THE STREET WHO WAS EXPERIENCING AN OVERDOSE. THE SOS TEAM SUCCESSFULLY ADMINISTERED NARCAN AND THE EFFECTS OF THE OVERDOSE WERE REVERSED. FINALLY, IN 2024, CHRISTIANACARE'S FAMILY MEDICAL RESIDENCY PROGRAM RECEIVED THE WELLNESS HERO AWARD IN THE 2024 LT. GOVERNOR'S WELLNESS LEADERSHIP CHALLENGE. THE AWARD WAS A RECOGNITION OF THE COMPREHENSIVE PROGRAM CHRISTIANACARE DESIGNED TO ADDRESS THE PRESSING NEED FOR BEHAVIORAL HEALTH SERVICES IN DELAWARE. CHRISTIANACARE'S FAMILY MEDICINE RESIDENCY ESTABLISHED THE SUBSTANCE USE DISORDER TREATMENT PROGRAM IN 2020 TO IDENTIFY AND PROVIDE TARGETED SUBSTANCE ABUSE TREATMENT TO PATIENTS AND TO TRAIN FUTURE PROVIDERS IN THE SPECIFIC AND UNIQUE ISSUES THAT PATIENTS WITH ADDICTION OFTEN FACE IN PRIMARY CARE SETTINGS. PATIENTS IDENTIFIED FOR THE PROGRAM THROUGH CHRISTIANACARE HOSPITALS AND EMERGENCY DEPARTMENTS ARE CONNECTED WITH THE FAMILY MEDICINE DEPARTMENT TO ENCOURAGE THEIR ENROLLMENT INTO PRIMARY CARE. THE PROGRAM ALSO PROVIDES VITAL SOCIAL SUPPORT FOR THESE PATIENTS. THIS PROGRAM HAS LED TO MULTIPLE PATIENTS' CHRONIC MEDICAL CONDITIONS BEING STABILIZED, THE IDENTIFICATION AND TREATMENT OF A PATIENT WITH BLADDER CANCER, AND THE CURE OF 26 CASES OF HEPATITIS C.
PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.)	VIOLENCE: HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP) IN RECOGNITION OF VIOLENCE AS A PUBLIC HEALTH ISSUE, CHRISTIANACARE LAUNCHED A HOSPITAL BASED VIOLENCE INTERVENTION PROGRAM (HVIP) IN FEBRUARY 2021 TO SUPPORT PATIENTS IMPACTED BY COMMUNITY VIOLENCE POST-DISCHARGE TO REDUCE RECIDIVISM OF NEW AND RECURRING INJURIES. THE HVIP EMPLOYS 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. IN FY2024, CHRISTIANACARE ENROLLED 83 PATIENTS IN HVIP. IN JANUARY 2024, CHRISTIANACARE ALSO ENTERED INTO AN AGREEMENT WITH NEMOURS CHILDREN'S HOSPITAL, DELAWARE TO ALLOW CHILDREN, FOURTEEN YEARS OF AGE AND OLDER, THE OPPORTUNITY TO ALSO PARTICIPATE IN CHRISTIANACARE'S HVIP. THIS COLLABORATION WAS UNDERTAKEN WITH THE GOAL OF PROVIDING THESE CHILDREN, IMPACTED BY VIOLENCE, WITH COMPREHENSIVE CARE AND SUPPORT TO ATTAIN THE MOST POSITIVE OUTCOME POSSIBLE. TRAUMA DEPARTMENT COMMUNITY EDUCATION THE TRAUMA DEPARTMENT IS ALSO ADDRESSING VIOLENCE THROUGH EDUCATION. IN FY2024, THE TRAUMA DEPARTMENT PROVIDED 54 STOP THE BLEED TRAININGS TO 856 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 MAKES AVAILABLE FREE GUN LOCKS TO PROMOTE THE SAFE STORAGE OF GUNS. CHRISTIANACARE IS THE ONLY ADULT LEVEL 1 TRAUMA CENTER IN DELAWARE AND TREATS OVER 200 GUNSHOT WOUND PATIENTS A YEAR. SOCIAL DRIVERS OF HEALTH: SOCIAL CARE CONNECTION CENTER CHRISTIANACARE IS COMMITTED TO THE STRATEGY OF ADDRESSING SOCIAL DRIVERS OF HEALTH (SDOH) TO IMPROVE HEALTH OUTCOMES. CHRISTIANACARE DEVELOPED AND ADMINISTERS AN SDOH SCREENING INSTRUMENT TO ADMINISTER TO PATIENTS. IT IS HELPFUL TO KNOW THE CHALLENGES OUR PATIENTS FACE TO BETTER SERVE THEM AND WE STRIVE TO ADDRESS THOSE NEEDS THROUGH INTERNAL RESOURCES AND REFERRALS TO COMMUNITY RESOURCES. IN THE SPRING OF 2023, CHRISTIANACARE LAUNCHED THE SOCIAL CARE CONNECTION CENTER WHICH SERVES AS THE UMBRELLA ORGANIZATION FOR OUR MEDICAID ENGAGEMENT CHWS, AMBULATORY CARE CONNECTORS, AND ACUTE CARE CONNECTORS. THE MEDICAID ENGAGEMENT TEAM CONSISTS OF CHWS THAT OUTREACH TO PATIENTS THAT HAVE BEEN NEWLY ASSIGNED OR ATTRIBUTED TO CHRISTIANACARE TO ADDRESS SOCIAL CARE NEEDS AND CONNECT THEM WITH PRIMARY CARE APPOINTMENTS. TO CONNECT WITH PATIENTS, THESE CHWS EMPLOY MULTIPLE METHODS TO ATTEMPT TO ENGAGE PATIENTS INCLUDING GOING TO THE PATIENT'S HOMES. THE CHWS WERE ABLE TO DIRECTLY ENGAGE OR CONFIRM MEMBER ENGAGEMENT WITH THE SYSTEM OF 1039 (53%) OUT OF THE 1964 NEW MEMBERS ASSIGNED OR ATTRIBUTED TO CHRISTIANACARE DURING FY2024. IN FY2024, CHRISTIANACARE SCREENED 12,227 PATIENTS IN PRIMARY CARE PRACTICES THROUGH TONIC, A SELF-ADMINISTERED SDOH SCREENING. OF THOSE, 3587 (29%) INDICATED AT LEAST ONE SOCIAL CARE NEED. POSITIVE SCREENINGS WERE SENT TO THE AMBULATORY CARE CONNECTORS FOR SOCIAL CARE SUPPORT. ACUTE CARE CONNECTORS (ACCS) PERFORM SDOH SCREENING AT THE BEDSIDE AND 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. ACUTE CARE CONNECTORS SCREENED 12,144 ADMITTED PATIENTS IN OUR TWO HOSPITALS IN DELAWARE. UNITE DELAWARE CHRISTIANACARE PARTNERED WITH UNITE US TO LAUNCH AN ELECTRONIC CARE COORDINATION NETWORK, UNITE DELAWARE, IN 2019. THE UNITE DELAWARE NETWORK CONNECTS SOCIAL SERVICES AND CLINICAL CARE PROVIDERS ACROSS THE STATE. WITH THIS NETWORK, ANY HEALTHCARE PROVIDER OR COMMUNITY ORGANIZATION CAN HELP AN INDIVIDUAL ADDRESS THEIR NEEDS BY SENDING AN ELECTRONIC REFERRAL ON THE PATIENT'S BEHALF TO THE APPROPRIATE ORGANIZATION. THE SENDER OF THAT REFERRAL WILL BE ABLE TO TRACK WHETHER THE NEED WAS MET OR NOT AND TAKE ADDITIONAL ACTION IF NEEDED. CHRISTIANACARE FUNDS THE UNITE DELAWARE PLATFORM TO 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 FY2024, CHRISTIANACARE CAREGIVERS CONNECTED 3,622 INDIVIDUALS TO THE UNITE DELAWARE PLATFORM AND SENT 8,173 REFERRALS ON THEIR BEHALF TO COMMUNITY ORGANIZATIONS. CHRISTIANACARE DEPARTMENTS AND PROGRAMS RECEIVED 1,402 REFERRALS FOR ASSISTANCE. ROUNDTRIP IN 2020, CHRISTIANACARE PARTNERED WITH ROUNDTRIP TO PROVIDE TRANSPORTATION TO MEDICAL SERVICES FOR PATIENTS WHO HAVE A TRANSPORTATION BARRIER. INITIALLY PILOTED IN TWO DEPARTMENTS, IN FY22, THE DEPARTMENTS UTILIZING ROUNDTRIP EXPANDED CONSIDERABLY AND THERE ARE NOW MORE THAN 20 PARTICIPATING PROGRAMS AND DEPARTMENTS USING ROUNDTRIP TO SERVE PATIENTS WITH TRANSPORTATION BARRIERS. OUR EXPECTATION IS THAT PROVIDING TRANSPORTATION WILL IMPROVE PATIENT HEALTH AND REDUCE HOSPITAL UTILIZATION. IN FY24, 14,273 RIDES WERE PROVIDED TO PATIENTS.
PART V, SECTION B, LINE 11 (ADDRESSING NEEDS IDENTIFIED IN THE CHNA-CONT.)	MEDICAL LEGAL PARTNERSHIP SINCE 2015, CHRISTIANACARE HAS PARTNERED WITH THE DELAWARE COMMUNITY LEGAL AID SOCIETY, INC. (CLASI) TO OFFER THE MEDICAL LEGAL PARTNERSHIP (MLP). THE MLP ASSISTS PRIMARY CARE PATIENTS WHO ARE AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL (FPL) WITH THE MITIGATION OF CIVIL LEGAL HARDSHIPS. LAST YEAR, CHRISTIANACARE INCREASED THE INCOME ELIGIBILITY LEVEL FROM 200% OF THE FPL TO ALIGN WITH OUR FINANCIAL ASSISTANCE POLICY. PATIENTS RECEIVE ASSISTANCE FROM THE MLP TO AVOID EVICTION, SUCCESSFULLY REINSTATE BENEFITS, RECEIVE ACCOMMODATION FROM EMPLOYERS AND SCHOOLS, AND FILE PROTECTION FROM ABUSE (PFA) ORDERS AMONG OTHER CIVIL NEEDS. IN FY2024, A TOTAL OF 80 NEW LEGAL MATTERS FOR 62 NEW UNIQUE CLIENTS WERE ADDRESSED. IN FY2024, A PATIENT WHO WAS PREGNANT AND HAVING ISSUES WITH HER EMPLOYER WAS REFERRED TO THE MLP. DUE TO A HEALTH ISSUE DURING HER PREGNANCY, THE PATIENT HAD USED ALL HER PAID LEAVE AND WAS FORCED TO TAKE UNPAID TIME OFF FOR HER MEDICAL APPOINTMENTS AND RECOVERY. THE PATIENT'S EMPLOYER WAS NOT HONORING ANY ACCOMMODATION IN HER NEED FOR TIME AND WAS PLANNING TO DEMOTE THE PATIENT WITH A REDUCTION IN PAY AND BENEFITS. CLASI REPRESENTED THE PATIENT IN OUT-OF-COURT NEGOTIATIONS REGARDING HER EMPLOYMENT AND SUCCESSFULLY ASSERTED HER RIGHTS. THE PATIENT WAS ABLE TO MAINTAIN HER EMPLOYMENT AND BENEFITS INCLUDING A STEP-UP SALARY INCREASE FOR THE NEXT CONTRACT CYCLE AND PAID MATERNITY LEAVE FOR THE BIRTH OF HER CHILD. THE CLASI ATTORNEY ALSO PROVIDED GUIDANCE ON HOW TO DOCUMENT ANY ISSUES THE PATIENT MAY ENCOUNTER UPON HER RETURN TO WORK. COMMUNITY INVESTMENT FUND IN DECEMBER 2019, CHRISTIANACARE LAUNCHED THE COMMUNITY INVESTMENT FUND TO DEEPEN OUR CONNECTION AND INVESTMENT IN OUR COMMUNITIES. SINCE 2019, CHRISTIANACARE'S COMMUNITY INVESTMENT FUND HAS PROVIDED MORE THAN $5.6 MILLION TO 64 ORGANIZATIONS ADDRESSING SOCIAL, BEHAVIORAL, AND ENVIRONMENTAL HEALTH FACTORS SHAPING COMMUNITY HEALTH. IN FY2024, CHRISTIANACARE GAVE OVER $1 MILLION IN COMMUNITY INVESTMENT FUNDS TO 17 COMMUNITY ORGANIZATIONS TO SUPPORT THEIR WORK ADDRESSING FOOD ACCESS, HOUSING INSECURITY, AND ENVIRONMENTAL HEALTH. ADDITIONALLY, CHRISTIANACARE CONTINUED TO PROVIDE FUNDING TO SUPPORT THE DELAWARE COALITION AGAINST DOMESTIC VIOLENCE DOMESTIC VIOLENCE CHW PROGRAM, THE UNITED WAY OF DELAWARE 211 PROGRAM, AND DELAWARE TECHNICAL COMMUNITY COLLEGE FOOD PANTRIES WHICH HELP FEED THEIR FOOD INSECURE STUDENTS. IN FY2024, CHRISTIANACARE ALSO DEVELOPED AND LAUNCHED AN AGING IN PLACE PROGRAM WITH AN INVESTMENT OF $300,000 IN PARTNERSHIP WITH GOOD NEIGHBORS HOME REPAIR AND HABITAT FOR HUMANITY OF NEW CASTLE COUNTY. CHRISTIANACARE CAREGIVERS REFER LOW-INCOME SENIORS AND ADULTS LIVING IN NEW CASTLE COUNTY WITH DISABILITIES TO THESE ORGANIZATIONS TO RECEIVE FREE HOME REPAIR OR MODIFICATION TO PREVENT SLIPS, TRIPS, AND FALLS SO THAT THEY MAY CONTINUE TO LIVE SAFELY IN THEIR HOMES AND AVOID VISITS TO THE EMERGENCY DEPARTMENT. IN-KIND DONATIONS IN ADDITION TO PROVIDING FUNDING TO COMMUNITY ORGANIZATIONS, CHRISTIANACARE ALSO PROVIDES IN-KIND DONATIONS TO ASSIST COMMUNITY ORGANIZATIONS AND REDUCE THE WASTE WE GENERATE. CHRISTIANACARE CAREGIVERS ESTABLISHED A MEDICAL SUPPLY DONATION PROGRAM TO DONATE UNUSED MEDICAL SUPPLIES TO PROJECT C.U.R.E., AN ORGANIZATION THAT PROVIDES MEDICAL SUPPLIES AND EQUIPMENT TO HOSPITALS AND CLINICS IN THE UNDER-DEVELOPED WORLD. EXPIRED SUPPLIES ARE GIVEN TO LOCAL SCHOOLS, LIKE DELAWARE TECHNICAL COMMUNITY COLLEGE TO PROVIDE TRAINING OPPORTUNITIES FOR STUDENTS. IN 2023, CHRISTIANACARE'S SUSTAINABILITY INITIATIVES RESULTED IN THE DIVERSION OF 6,722 POUNDS OF MEDICAL WASTE FROM LANDFILLS. BOTH CAFETERIAS IN OUR NEWARK AND WILMINGTON CAMPUSES ALSO DONATED FOOD TO THE SUNDAY BREAKFAST MISSION, AN EMERGENCY SHELTER FOR MEN, WOMEN, AND CHILDREN IN WILMINGTON. --------------------
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 400% 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 400% OF FEDERAL POVERTY GUIDELINES) ARE NOT RESPONSIBLE FOR ANY CHARGES. --------------------

Schedule H (Form 990) 2023

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) 2023

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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 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 400% 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)	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 FY2024, THE MOST REFERRED NEEDS ON UNITE DELAWARE WERE FOOD ASSISTANCE, HOUSING AND SHELTER, UTILITIES, BENEFITS NAVIGATION, AND TRANSPORTATION. THE PARTNERSHIPS CHRISTIANACARE HAS DEVELOPED WITH COMMUNITY ORGANIZATIONS TO ADDRESS PATIENTS' SOCIAL NEEDS LIKE OUR AGING IN PLACE PROGRAM AND OUR DELAWARE FOOD FARMACY, ALSO OFFER US INSIGHT INTO COMMUNITY CHALLENGES. FURTHER, THE COMMUNITY INVESTMENT FUND PROVIDES US WITH THE OPPORTUNITY TO LEARN FROM COMMUNITY-BASED ORGANIZATIONS. IN FY2024, 74 ORGANIZATIONS APPLIED FOR FUNDING. WHILE NOT EVERY ORGANIZATION WAS AWARDED FUNDING, EVERY APPLICATION WAS REVIEWED AND EACH ONE PROVIDED INFORMATION ABOUT COMMUNITY NEED, THE WAYS IN WHICH ORGANIZATIONS ARE WORKING TO ADDRESS THOSE NEEDS, AND HOW THE NEED MAY SURPASS WHAT IS OFFERED TO ADDRESS IT. 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 EDUCATION COMMITTEE, THE WILMINGTON ALLIANCE, AND LITERACY DELAWARE, AMONG OTHER ORGANIZATIONS, ARE ALL SERVED BY CHRISTIANACARE CAREGIVERS. --------------------
PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE)	CHRISTIANACARE'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON OUR WEBSITE: https://christianacare.org/patients/financial-assistance-program/. THE FINANCIAL ASSISTANCE PROGRAM, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE ALSO AVAILABLE IN SPANISH, CANTONESE, AND MANDARIN WHICH ARE THE MOST SPOKEN LANGUAGES BESIDES ENGLISH. 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. ALL STATEMENTS INCLUDE VERBIAGE THAT DIRECTS PATIENTS TO OUR WEBSITE OR CUSTOMER SERVICE TO LEARN MORE ABOUT OUR FINANCIAL ASSISTANCE POLICY. 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. --------------------
PART VI, LINE 4 (COMMUNITY INFORMATION)	CHRISTIANACARE IS ONE OF THE LARGEST PROVIDERS IN THE MID-ATLANTIC REGION, SERVING ALL OF DELAWARE AND PARTS OF PENNSYLVANIA, MARYLAND, AND NEW JERSEY. 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 WITHIN THE 2022 CHNA. IN FY2023, 77.3% OF OUR HOSPITAL DISCHARGES WERE FOR NEW CASTLE COUNTY RESIDENTS. IN 2024, THE POPULATION OF NEW CASTLE COUNTY WAS 581,444 AND IT IS PROJECTED TO GROW BY 3.3% IN THE NEXT DECADE. THE 65 AND OLDER POPULATION IS EXPECTED TO GROW BY 20.2% IN THE NEXT DECADE WHILE AGE GROUPS UNDER 29 YEARS OF AGE ARE EXPECTED TO DECLINE. 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). IN 2023, COMMUNITY 1 ACCOUNTED FOR 30.7% OF CHRISTIANACARE DISCHARGES AND COMMUNITY 2 ACCOUNTED FOR 46.6% 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 (16.5% COMPARED TO 8.1%). IN COMMUNITY 1, APPROXIMATELY 44.3% OF THE POPULATION IDENTIFIES AS BLACK; IN COMMUNITY 2, 17.7% OF THE POPULATION IDENTIFIES AS BLACK. APPROXIMATELY 15.9% OF THE OVERALL POPULATION IN COMMUNITY 1 IDENTIFIES AS HISPANIC; IN COMMUNITY 2, 8.8% OF THE POPULATION IDENTIFIES AS BLACK. IN NEW CASTLE COUNTY, LOW-INCOME CENSUS TRACTS AND FOOD DESERTS ARE MOST PREVALENT IN NEWARK, WILMINGTON, AND THROUGHOUT COMMUNITY 1. THE AREA DEPRIVATION INDEX (ADI), WHICH RANKS NEIGHBORHOODS BY SOCIOECONOMIC DISADVANTAGE ALSO RANKS CENSUS TRACTS IN COMMUNITY 1 AS HAVING CONSIDERABLE DISADVANTAGE RELATED TO FACTORS LIKE HOUSING, INCOME, EDUCATION, AND EMPLOYMENT. --------------------
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. CHRISTIANACARE WAS ONE OF THE FIRST HOSPITALS IN THE UNITED STATES 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. 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 27,000 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. IN PERFORMANCE YEAR 2023, THE EBRIGHTHEALTH ACO REDUCED HEALTH CARE SPENDING BY APPROXIMATELY $2.4 MILLION AND EARNED A QUALITY SCORE OF 88.4%. THE CUMULATIVE AMOUNT SAVED IS $56 MILLION. IN 2021, CHRISTIANACARE ALSO LAUNCHED ONE OF THE FIRST MEDICAID ACOS IN THE STATE, DELAWARE MEDICAID QUALITY PARTNERS ACO. IN 2023, CHRISTIANACARE'S ACO REDUCED HEALTH CARE SPENDING BY $6.2 MILLION WHILE IMPROVING CARE FOR NEARLY 30,000 MEDICAID BENEFICIARIES IN DELAWARE, INCLUDING APPROXIMATELY 8,000 CHILDREN. THIS SUCCESS IS A DEMONSTRATION THAT WE CAN IMPROVE HEALTH WHILE ALSO HELPING THE STATE REDUCE HEALTH CARE COSTS BY DELIVERING CARE THAT EMPHASIZES PREVENTATIVE CARE AND PROACTIVE MANAGEMENT OF HEALTH CONDITIONS. AS THE LARGEST PRIVATE EMPLOYER IN DELAWARE, CHRISTIANACARE ALSO STRIVES TO BE A LEADER AMONG OTHER BUSINESSES AND ORGANIZATIONS. . 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 FY2024, 1,439 HOURS WERE SPENT IN COMMUNITY SERVICE AT A COST OF APPROXIMATELY $104,000 TO CHRISTIANACARE. AS CHRISTIANACARE CONTINUES TO ADAPT AND INNOVATE TO ENSURE WE ARE EQUIPPED TO OPERATE WITHIN THE EVER-CHANGING LANDSCAPE OF HEALTH CARE, WE WILL ALWAYS BE GUIDED BY OUR MISSION OF SERVICE AND OUR VALUES OF EXCELLENCE AND LOVE. OUR MOST IMPORTANT PARTNERSHIP IS WITH OUR NEIGHBORS WE SERVE.
PART VI, LINE 7 (STATES FILING OF COMMUNITY BENEFIT REPORT)	IN JUNE 2024, THE STATE OF DELAWARE SIGNED INTO LAW A REQUIREMENT FOR DELAWARE HOSPITALS TO SUBMIT A COMMUNITY BENEFIT REPORT. A STATE COMMUNITY BENEFIT REPORT IS ALSO FILED IN MARYLAND FOR CHRISTIANACARE'S UNION HOSPITAL LOCATED IN ELKTON, MARYLAND. --------------------
PART II, DESCRIPTION OF TABLE: COMMUNITY BUILDING ACTIVITIES	IN FY2024, THE ECONOMIC DEVELOPMENT ACTIVITIES CHRISTIANACARE UNDERTOOK WERE PARTICIPATION ON COMMUNITY ORGANIZATION BOARDS AND LEADERSHIP TEAMS AS WELL AS CASH DONATIONS TO THOSE COMMUNITY ORGANIZATIONS. CHRISTIANACARE'S CHIEF HEALTH EQUITY AND PUBLIC AFFAIRS OFFICER SERVES AS CHAIR OF THE VISION COALITION, A PUBLIC PRIVATE PARTNERSHIP COMPOSED OF A BROAD RANGE OF DELAWAREANS WORKING TOGETHER TO IMPROVE DELAWARE PUBLIC EDUCATION, AND AS A MEMBER OF THE DELAWARE BUSINESS ROUNDTABLE EDUCATION COMMITTEE (DBREC): A NONPROFIT ORGANIZATION THAT AIMS TO IMPROVE PUBLIC EDUCATION BY AGGREGATING AND ALIGNING THE RESOURCES OF ROUNDTABLE MEMBERS AND OTHER BUSINESS LEADERS. CHRISTIANACARE ALSO PROVIDED $40,000 IN FUNDING TO SUPPORT DBREC'S MISSION. CHRISTIANACARE'S WILMINGTON CAMPUS EXECUTIVE DIRECTOR SERVES AS VICE CHAIR ON THE EXECUTIVE BOARD OF THE 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. CHRISTIANACARE ALSO PROVIDED WILMINGTON ALLIANCE WITH $45,000 IN FUNDING TO SUPPORT THEIR MISSION. CHRISTIANACARE'S CEO ALSO SERVED ON THE EXECUTIVE COMMITTEE OF THE DELAWARE BUSINESS ROUNDTABLE BOARD WHOSE MISSION IS TO ENHANCE THE QUALITY OF LIFE IN DELAWARE BY PROMOTING COMMERCE, JOB CREATION, AND SELECT PUBLIC POLICY ISSUES. IN THE COMMUNITY BUILDING CATEGORY OF COMMUNITY SUPPORT, WE REPORTED CHRISTIANACARE'S $105,000 CONTRIBUTION TO DELAWARE COLLEGE SCHOLARS WHICH SERVES TO PREPARE HIGH-ACHIEVING, UNDER-RESOURCED DELAWARE PUBLIC HIGH SCHOOL SCHOLARS ACADEMICALLY AND SOCIALLY 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 AND AS CHAIR OF THE GOVERNANCE COMMITTEE. IN 2019, CHRISTIANACARE CONTRIBUTED $1 MILLION TO THIS INITIATIVE TO REVITALIZE THE RIVERSIDE NEIGHBORHOOD IN WILMINGTON. IN THE COMMUNITY BUILDING CATEGORY OF HOUSING AND PHYSICAL IMPROVEMENTS, WE REPORTED OUR $14,400 CONTRIBUTION TO THE WILMINGTON NEIGHBORHOOD CONSERVANCY LAND BANK TO PURCHASE UPGRADED SECURITY CAMERAS TO BE PLACED AT NORTH HARRISON STREET IN WILMINGTON. THE CAMERAS ARE INTENDED TO DECREASE CRIMINAL ACTIVITY AND ENABLE RESIDENTS TO FEEL MORE SECURE. SAFETY IS A BASIC NEED THAT CONTRIBUTES TO IMPROVED COMMUNITY HEALTH. 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 3RD YEAR OF ITS 5-YEAR COMMITMENT OF $500,000 TO AWARD MERIT-BASED SCHOLARSHIPS OF $12,500 TO TEN SCHOLARS PER YEAR, PER STUDENT, TO ATTEND AN HBCU. THE FOCUS OF THE SCHOLARSHIP PROGRAM ARE MINORITY SCHOLARS PURSUING A FIELD OF STUDY IN HEALTH CARE. THESE SCHOLARS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN AN INTERNSHIP PROGRAM AT CHRISTIANACARE. CHRISTIANACARE'S CENTER FOR COMMUNITY HEALTH AND EMPOWERMENT 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 FY2024, THE FOLLOWING PROGRAMS WERE OFFERED: BACK 2 BASICS: BACK 2 BASICS IS A FREE, IMMERSIVE PROGRAM DESIGNED FOR HIGH SCHOOL SCHOLARS, OFFERING THEM A UNIQUE OPPORTUNITY TO EXPLORE HEALTHCARE CAREERS. THROUGH A CASE STUDY APPROACH, PARTICIPANTS WILL GAIN INSIGHT INTO THE PATIENT EXPERIENCE AND UNDERSTAND THE COLLABORATIVE EFFORTS INVOLVED IN PROVIDING CARE. THIS HANDS-ON EXPERIENCE ALLOWS SCHOLARS TO SEE FIRSTHAND HOW VARIOUS HEALTHCARE PROFESSIONALS CONTRIBUTE TO PATIENT WELL-BEING. IN FY2024, THE PROGRAM HAD A TOTAL OF 39 PARTICIPANTS. BRANDYWINE LIFESAVERS PROGRAM: CHRISTIANACARE PARTNERED WITH THE BRANDYWINE LIFESAVERS PROGRAM, DEVELOPED BY BRANDYWINE SCHOOL DISTRICT NURSES, TO CREATE A PIPELINE FOR MIDDLE AND HIGH SCHOOL SCHOLARS TO BE INTRODUCED TO POSSIBLE CAREERS IN HEALTH CARE, SPECIFICALLY NURSING. THE BRANDYWINE LIFESAVERS PROGRAM HOSTED A TOTAL OF 50 MIDDLE AND HIGH SCHOLARS WHO ATTENDED AN INFORMATIONAL SESSION AT CHRISTIANACARE'S NEWARK CAMPUS TO LEARN DIRECTLY FROM NURSES ABOUT THEIR ROLES. CO-OP PROGRAMS: THE CO-OP PROGRAM OFFERS SCHOLARS IN THE NEW CASTLE COUNTY VOCATIONAL TECHNICAL SCHOOL DISTRICT THE OPPORTUNITY TO FULFILL THEIR COOPERATIVE EMPLOYMENT REQUIREMENTS. DESIGNED FOR HIGH SCHOOL SENIORS, THIS PROGRAM PROVIDES A PART-TIME, PAID WORK EXPERIENCE. THE CO-OP PLACEMENTS ARE SPECIFICALLY AVAILABLE TO SCHOLARS ENROLLED IN THE HEALTH SERVICES SHOPS WITHIN THE SCHOOL DISTRICT, GIVING THEM VALUABLE HANDS-ON EXPERIENCE IN THE HEALTHCARE FIELD. IN FY2024, THE PROGRAM HAD A TOTAL OF 15 PARTICIPANTS WHO WORKED IN THE CHRISTIANACARE PATIENT ESCORT SERVICE LINE. HEALTH CAREER COLLABORATIVE: THE HEALTH CAREER COLLABORATIVE PROGRAM, SERVING SCHOLARS FROM WILLIAM PENN HIGH SCHOOL, IS DESIGNED TO SUPPORT YOUTH FROM COMMUNITIES UNDERREPRESENTED IN MEDICINE, HELPING THEM GRADUATE FROM HIGH SCHOOL, PURSUE POST-SECONDARY EDUCATION, IMPROVE HEALTH LITERACY, AND EXPLORE CAREERS IN HEALTHCARE. THROUGH MENTORSHIP, AN ENGAGING HEALTH CURRICULUM, AND EXPOSURE TO VARIOUS HEALTH CAREERS, THE PROGRAM EMPOWERS HIGH SCHOOL SCHOLARS TO IDENTIFY AND ADDRESS THE MOST PRESSING HEALTH NEEDS IN THEIR COMMUNITIES. SCHOLARS ARE ALSO GIVEN THE OPPORTUNITY TO PLAN AND IMPLEMENT COMMUNITY-BASED HEALTH PROMOTION ACTIVITIES, PROVIDING THEM WITH HANDS-ON EXPERIENCE WHILE EXPLORING DIVERSE HEALTH-RELATED CAREER PATHWAYS. IN FY2024, THE PROGRAM HAD A TOTAL OF 12 PARTICIPANTS. HEALTH IMPACTS: THE HEALTH IMPACTS PROGRAM IS DESIGNED TO CONNECT SCHOLARS WITH CAREER OPPORTUNITIES AND PATHWAYS IN HEALTHCARE. THIS 3-PHASE PROGRAM PROVIDES EXPOSURE TO A WIDE RANGE OF HEALTHCARE CAREERS WHILE FOCUSING ON ESSENTIAL SKILLS SUCH AS COMMUNICATION, TIME MANAGEMENT, AND RELATIONSHIP BUILDING. THROUGHOUT THE PROGRAM, SCHOLARS WILL GAIN VALUABLE INSIGHTS INTO THE HEALTHCARE INDUSTRY, WITH A STRONG EMPHASIS ON DEVELOPING EMPLOYABILITY SKILLS. UPON SUCCESSFUL COMPLETION OF PHASE 1, SCHOLARS WILL BE MATCHED WITH A WORK-BASED LEARNING ASSIGNMENT WITHIN THE HEALTH SYSTEM. THE GOAL IS FOR SCHOLARS TO APPLY THE SKILLS THEY'VE ACQUIRED DURING THE PROGRAM TO SECURE AND MAINTAIN A PART-TIME POSITION WITHIN THE HEALTHCARE SYSTEM DURING PHASE 2. PHASE 3 WILL CULMINATE IN AN OFFICIAL JOB OFFER, EITHER FULL-TIME OR PART-TIME, WITHIN THE ORGANIZATION. IN FY2024, A TOTAL OF 27 SCHOLARS WERE REGISTERED IN THE PROGRAM, 9 COMPLETED THE PROGRAM, AND 1 SCHOLAR WAS HIRED BY CHRISTIANACARE. NURSING CAREER COLLABORATIVE: THIS PROGRAM WAS DEVELOPED TO SERVE AS A PATHWAY TO NURSING FOR HIGH SCHOOL SCHOLARS FROM WILLIAM PENN HIGH SCHOOL'S ALLIED HEALTH PROGRAM. THROUGH THE NURSING CAREER COLLABORATIVE, SCHOLARS ARE EDUCATED AND EXPOSED TO THE FIELD AND FUNDAMENTALS OF NURSING. THE PROGRAM IS 6 SESSIONS IN LENGTH- 3 SESSIONS AT WILLIAM PENN HIGH SCHOOL AND 3 SESSIONS AT CHRISTIANACARE'S NEWARK CAMPUS. ON THEIR LAST DAY OF THE PROGRAM, SCHOLARS ALSO HAVE AN OPPORTUNITY TO SHADOW ON A UNIT WITH A NURSE. IN FY2024, 20 SCHOLARS COMPLETED THIS PROGRAM. WORK BASED LEARNING (NURSING/SURGICAL SERVICES): THIS PROGRAM IS DESIGNED TO INCREASE SCHOLAR AWARENESS ABOUT 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 ROLES/RESPONSIBILITIES, ESSENTIAL SKILLS, AND EDUCATIONAL REQUIREMENTS AND PATHWAYS. PARTICIPANTS ARE SENIORS AT APPOQUINIMINK HIGH SCHOOL AND MIDDLETOWN HIGH SCHOOL AND ENROLLED IN THE SCHOOL OF HEALTH SCIENCE PATHWAY OR ENROLLED IN THE ODESSA HIGH SCHOOL ALLIED HEALTH PROGRAM. SCHOLARS PARTICIPATING IN CHRISTIANACARE'S SURGICAL SERVICE WORK BASED LEARNING EXPERIENCE MUST ATTEND ALL HOSPITAL PROGRAM DATES AND FIVE (5) BACK 2 BASICS VIRTUAL SESSIONS TOTALING 40 HOURS TOWARD THEIR SENIOR CAPSTONE PROJECT. IN FY2024, 6 SCHOLARS COMPLETED THIS PROGRAM.

Schedule H (Form 990) 2023

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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

2023

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

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? ........................

Yes No

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	(h) Purpose of grant or assistance
(1) DCF HEALTHY COMMUNITIES DELAWARE LLC 100 W 10TH ST WILMINGTON,DE19801	85-4094666	501(c)(3)	25,000	GENERAL SUPPORT
(2) HABITAT FOR HUMANITY OF NEW CASTLE COUNTY 1920 HUTTON ST WILMINGTON,DE19802	51-0294138	501(c)(3)	200,000	GENERAL SUPPORT
(3) DELAWARE HUMANITIES COUNCIL INC 100 W 10TH ST WILMINGTON,DE19801	51-0212681	501(c)(3)	13,761	GENERAL SUPPORT
(4) DELAWARE CENTER FOR JUSTICE 100 W 10TH ST WILMINGTON,DE19801	51-0064323	501(c)(3)	75,000	GENERAL SUPPORT
(5) THE RESURRECTION CENTER 3301 N MARKET ST WILMINGTON,DE19802	23-7317318	501(c)(3)	21,532	GENERAL SUPPORT
(6) HEALTHY FOOD FOR HEALTHY KIDS INC 221 W 10TH ST WILMINGTON,DE19801	30-0444914	501(c)(3)	24,465	GENERAL SUPPORT
(7) CORNERSTONE WEST COMMUNITY DEVELOPMENT CORPORATION 710 N LINCOLN ST WILMINGTON,DE19805	51-0387484	501(c)(3)	66,500	GENERAL SUPPORT
(8) BAYSIDE COMMUNITY NETWORK INC 1290 W PULASKI HIGHWAY ELKTON,MD21921	52-1139792	501(c)(3)	70,000	GENERAL SUPPORT
(9) PROJECT NEW START INC 4601 CONCORD PIKE WILMINGTON,DE19803	47-2300080	501(c)(3)	75,000	GENERAL SUPPORT
(10) AIDS DELAWARE INC 100 W 10TH ST WILMINGTON,DE19801	22-2805481	501(c)(3)	25,000	GENERAL SUPPORT
(11) YWCA DELAWARE INC 100 W 10TH ST WILMINGTON,DE19801	51-0064344	501(c)(3)	70,310	GENERAL SUPPORT
(12) ST PATRICK'S CENTER INC 107 E 14TH ST WILMINGTON,DE19801	51-0120169	501(c)(3)	75,000	GENERAL SUPPORT
(13) SUSSEX COUNTY HABITAT FOR HUMANITY PO BOX 759 GEORGETOWN,DE19947	51-0334057	501(c)(3)	75,000	GENERAL SUPPORT
(14) GOOD NEIGHBORS INC 224 E STREET RD KENNETT SQUARE,PA19348	11-3839742	501(c)(3)	75,000	GENERAL SUPPORT
(15) DELAWARE INTERFAITH POWER & LIGHT PO BOX 7881 WILMINGTON,DE19803	45-3593450	501(c)(3)	55,900	GENERAL SUPPORT
(16) YMCA OF DELAWARE 100 W 1OTH ST WILMINGTON,DE19801	51-0065748	501(c)(3)	75,000	GENERAL SUPPORT
(17) DEEP ROOTS INC PO BOX 113 EARLEVILLE,MD21919	45-5115992	501(c)(3)	69,747	GENERAL SUPPORT
(18) GREEN BERET PROJECT INC 494 FAWN HAVEN WALK DOVER,DE19901	82-1215032	501(c)(3)	75,000	GENERAL SUPPORT
(19) CHILDREN & FAMILIES FIRST 555 JUSTISON ST WILMINGTON,DE19801	51-0065731	501(c)(3)	75,000	GENERAL SUPPORT
(20) DELAWARE BUSINESS ROUNDTABLE EDUCATION COMMITTEE 100 W 10TH ST WILMINGTON,DE19801	56-2364584	501(c)(3)	40,000	GENERAL SUPPORT
(21) DELAWARE COALITION AGAINST DOMESTIC VIOLENCE 100 W 10TH ST WILMINGTON,DE19801	51-0354794	501(c)(3)	100,000	GENERAL SUPPORT
(22) WILMINGTON NEIGHBORHOOD CONSERVANCY LAND BANK 321 E 11TH STREET WILMINGTON,DE19801	81-1773249	501(c)(3)	14,400	GENERAL SUPPORT
(23) DELAWARE COLLEGE SCHOLARS PO BOX 392 WILMINGTON,DE19801	82-4608572	501(c)(3)	105,000	GENERAL SUPPORT
(24) WILMINGTON ALLIANCE INC 100 W 10TH ST WILMINGTON,DE19801	51-0347680	501(c)(3)	45,000	GENERAL SUPPORT
(25) HBCU WEEK FOUNDATION INC 1022 COLEMAN STREET WILMINGTON,DE19805	85-1276996	501(c)(3)	132,625	GENERAL SUPPORT
(26) UNITED WAY OF DELAWARE 625 N ORANGE STREET WILMINGTON,DE19801	51-0073399	501(c)(3)	100,000	GENERAL SUPPORT
(27) DELAWARE TECHNICAL & COMMUNITY COLLEGE 300 N ORANGE STREET WILMINGTON,DE19801	51-0246178	501(c)(3)	75,000	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

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) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CHRISTIANA CARE HEALTH SERVICES INC

Employer identification number

51-0103684

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .....

Yes

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? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

Yes

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1BARBARA ALBANI MD DIRECTOR - AS OF 01/24	(i) (ii)	598,709 ------------- 0	77,522 ------------- 0	44,939 ------------- 0	0 ------------- 0	0 ------------- 0	721,170 ------------- 0	0 ------------- 0
2BETTINA TWEARDY-RIVEROS CHIEF HEALTH EQUITY OFFICER	(i) (ii)	522,965 ------------- 0	201,108 ------------- 0	56,001 ------------- 0	45,394 ------------- 0	20,878 ------------- 0	846,346 ------------- 0	0 ------------- 0
3DANIEL ROBB MD PHYSICIAN, CARDIAC SURGEON	(i) (ii)	902,520 ------------- 0	116,142 ------------- 0	4,025 ------------- 0	0 ------------- 0	12,506 ------------- 0	1,035,193 ------------- 0	0 ------------- 0
4FREDERIC T HARAD MD DIRECTOR	(i) (ii)	597,122 ------------- 0	78,318 ------------- 0	76,967 ------------- 0	0 ------------- 0	12,506 ------------- 0	764,913 ------------- 0	0 ------------- 0
5JANICE E NEVIN MD PRESIDENT & CEO	(i) (ii)	1,581,016 ------------- 0	725,400 ------------- 0	449,074 ------------- 0	0 ------------- 0	7,228 ------------- 0	2,762,718 ------------- 0	0 ------------- 0
6JENNIFER L SCHWARTZ ESQ CORPORATE SECRETARY	(i) (ii)	695,351 ------------- 0	207,032 ------------- 0	24,304 ------------- 0	59,243 ------------- 0	20,878 ------------- 0	1,006,808 ------------- 0	0 ------------- 0
7KENNETH SILVERSTEIN MD FORMER CHIEF PHYSICIAN EXEC	(i) (ii)	202,031 ------------- 0	133,633 ------------- 0	790,922 ------------- 0	0 ------------- 0	2,850 ------------- 0	1,129,436 ------------- 0	0 ------------- 0
8KERT ANZILOTTI JR MD INTERIM PRESIDENT	(i) (ii)	637,470 ------------- 0	147,354 ------------- 0	122,594 ------------- 0	59,909 ------------- 0	20,878 ------------- 0	988,205 ------------- 0	0 ------------- 0
9KIRK N GARRATT MD MED. DIR. CTR FOR H/V HEALTH	(i) (ii)	822,576 ------------- 0	142,607 ------------- 0	11,577 ------------- 0	0 ------------- 0	12,104 ------------- 0	988,864 ------------- 0	0 ------------- 0
10LISA MAXWELL MD PRESIDENT, CC MEDICAL GROUP	(i) (ii)	613,121 ------------- 0	193,051 ------------- 0	113,521 ------------- 0	0 ------------- 0	20,878 ------------- 0	940,571 ------------- 0	0 ------------- 0
11NEIL JASANI MD CHIEF PEOPLE OFFICER	(i) (ii)	669,573 ------------- 0	203,522 ------------- 0	108,034 ------------- 0	0 ------------- 0	20,878 ------------- 0	1,002,007 ------------- 0	0 ------------- 0
12NICHOLAS J PETRELLI MD MED. DIR, CCHS CANCER PROGRAM	(i) (ii)	768,565 ------------- 0	133,243 ------------- 0	7,935 ------------- 0	0 ------------- 0	12,506 ------------- 0	922,249 ------------- 0	0 ------------- 0
13RANDALL GABORIAULT CHIEF DIGITAL & INFO. OFFICER	(i) (ii)	703,693 ------------- 0	203,327 ------------- 0	218,970 ------------- 0	73,308 ------------- 0	20,878 ------------- 0	1,220,176 ------------- 0	0 ------------- 0
14RAY A BLACKWELL MD CHIEF OF CARDIAC SURGERY	(i) (ii)	1,065,357 ------------- 0	129,627 ------------- 0	16,540 ------------- 0	0 ------------- 0	20,878 ------------- 0	1,232,402 ------------- 0	0 ------------- 0
15RICHARD CUMING CHIEF OPERATING OFFICER	(i) (ii)	762,616 ------------- 0	246,171 ------------- 0	164,287 ------------- 0	55,988 ------------- 0	12,506 ------------- 0	1,241,568 ------------- 0	42,001 ------------- 0
16ROBERT MCMURRAY CFO, TREAS. & ASS'T SECRETARY	(i) (ii)	753,010 ------------- 0	228,558 ------------- 0	58,851 ------------- 0	68,103 ------------- 0	20,224 ------------- 0	1,128,746 ------------- 0	23,384 ------------- 0
17SHARON KURFUERST FORMER COO	(i) (ii)	196,269 ------------- 0	129,822 ------------- 0	985,276 ------------- 0	0 ------------- 0	3,168 ------------- 0	1,314,535 ------------- 0	178,205 ------------- 0
18VINAY K GHEYI CHAIR DEPARTMENT RADIOLOGY	(i) (ii)	788,000 ------------- 0	136,613 ------------- 0	49,687 ------------- 0	0 ------------- 0	13,910 ------------- 0	988,210 ------------- 0	0 ------------- 0
19VINAY MAHESHWARI MD DIRECTOR	(i) (ii)	521,429 ------------- 0	87,628 ------------- 0	4,751 ------------- 0	0 ------------- 0	20,878 ------------- 0	634,686 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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 $532,730 DURING THE YEAR. KENNETH SILVERSTEIN (FORMER PRESIDENT, CC MEDICAL GROUP) RECEIVED A SEVERANCE PAYMENT OF $548,370 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- $64,591 RANDALL GABORIAULT- $67,715 SHARON T. KURFUERST- $263,888 ROBERT MCMURRAY- $30,765 JANICE E. NEVIN, MD- $209,034 KENNETH SILVERSTEIN, MD- $79,136 KERT ANZILOTTI- $54,111 NEIL JASANI- $55,987 VINAY GHEYI- $41,640 LISA C. MAXWELL, MD- NO DISTRIBUTION JENNIFER L. SCHWARTZ, ESQ.- NO DISTRIBUTION BETTINA TWEARDY-RIVEROS- NO DISTRIBUTION --------------------
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) 2023

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	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 ..................	280,000
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) 2023

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 ....	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 .........	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) 2023

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. --------------------

FORM 990, SCHEDULE K, PART IV

ADDITIONAL INFORMATION REGARDING ARBITRAGE REBATE CCHS RECEIVED ITS 5-YEAR ARBITRAGE COMPLIANCE REPORT ON 2/14/2025. THIS REPORT IS FINAL.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

2023

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	142,903	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 ( )
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

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

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

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) (2023)

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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

CHRISTIANA CARE HEALTH SERVICES INC

Employer identification number

51-0103684

Return Reference	Explanation
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 2023 FORM 990 FOR THE FISCAL YEAR ENDING JUNE 30, 2024 WAS REVIEWED AND APPROVED BY VARIOUS SENIOR MANAGEMENT OFFICIALS. THE ORGANIZATION'S GOVERNING BOARD WAS ALSO PROVIDED ACCESS TO THE APPROVED 2023 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 $ (29,308,906) CHANGE IN NET ASSET OF SYSTEM 261,007 OTHER CHANGES (159,231,462) ----------- TOTAL $ (188,279,361)

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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 ACOLLC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 47-4102953	SUPPORT SRVCS	DE	1,978,118	2,274,319	CCH SERVICES
(3) CHRISTIANA CARE CARE LINK LLC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0103684	SUPPORT SRVCS	DE	5,747,066	9,420,404	CCH SERVICES
(4) CHRISTIANA CARE CTR FOR VIRTUAL HLTH LLC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 86-2155365	SUPPORT SRVCS	DE	330,192	6,982,398	CCH SERVICES
(5) CHRISTIANA CARE NEIGHBORHOOD HOSPITALS 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0103684	HLTHCARE SVCS	DE	-137,805	357,510	CCH SERVICES
(6) CHRISTIANA CARE AMBULATORY SURG CTR LLC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0103684	AMB SURG CTR	DE	-19,638	600	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?
(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	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	Yes
(4)UNION HOSPITAL OF CECIL COUNTY FDN 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-1794552	FUNDRAISING	MD	501(C)(3)	7	AFFINITY	Yes
(5)UNION HOSPITAL OF CECIL COUNTY INC 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-0607945	HLTHCARE SVCS	MD	501(C)(3)	3	AFFINITY	Yes
(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	Yes
(7)UNION HOSPITAL OF CECIL COUNTY ONCOLOGY 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 81-2662359	HEALTHCARE	MD	501(C)(3)	3	AFFINITY	Yes
(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)	12A, 1	CCH SERVICES	Yes
(10)CHRISTIANA CARE GENE EDITING INSTITUTE 40000 NEXUS DR NW3-100 WILMINGTON,DE19803 88-3110655	HEALTHCARE	DE	501(C)(3)	PENDING	CCH SYSTEM		No
(11)CHRISTIANA CARE PENNSYLVANIA INC 400O NEXUS DRIVE NW3-100 WILMINGTON,DE19803 99-2607716	HEALTHCARE	PA	501(C)(3)	PENDING	CCH SYSTEM		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) CHRISTIANA CARE GO HEALTH URGENT CARE L 5555 GLENRIDGE CONNECTOR SUITE 700 ATLANTA,GA30342 84-3657727	URGENT CARE SRVCS	DE	CCH SERVICES	RELATED	68,377	20,472,583		No	0		No	50.100 %
(2) CLINERGY LLC 4755 OGLETOWN STANTON RD NEWARK,DE19718 85-2698063	GROUP PURCHASING	DE	CCH SERVICES	RELATED	114,228	543,224		No	0		No	79.800 %
(3) LEEWARD HEALTH LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON,DE19803 88-3132477	MED ADV RISK SHAR	DE	CCH SYSTEM								No
(4) CHRISTIANA CARE EMERGENCY PHYSICIANS LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON,DE19803 93-3393372	HEALTH SRVCS	DE	CCH SERVICES	RELATED	-5,400,769	-5,400,769		No	0		No	85.000 %
(5) CHRISTIANA CARE EMERUS LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON,DE19803 93-4258269	HEALTH SRVCS	DE	CCH SERVICES	RELATED	0	0		No	0		No	51.000 %
(6) CHRISTIANA CARE EMERUS NEIGHBORHOOD HOSP 4000 NEXUS DRIVE STE C3-300 WILMINGTON,DE19803	HEALTH SRVCS	DE	CC EMERUS LLC								No
(7) CHRISTIANACARE ATLAS JV LLC 4000 NEXUS DRIVE STE C3-300 WILMINGTON,DE19803	HEALTH SRVCS	DE	CC AMB SURG CTR								No
(8) SOUTHERN CHESTER COUNTY MOB I 1015 W BALTIMORE PIKE WEST GROVE,PA19390 23-2200841	MOB	PA	CC WEST GROVE								No
(9) SOUTHERN CHESTER COUNTY MED II 1015 W BALTIMORE PIKE WEST GROVE,PA19390 23-2468569	MOB	PA	CC WEST GROVE								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?
(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	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	-35,350	7,312,673	100.000 %		No
(2) CHRISTIANA CARE HEALTH PLANS 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 51-0352728	INSURANCE	DE	CCH SYSTEM	C CORP	-11,646	79,004	100.000 %		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	3,124,398	100,788,035	100.000 %	Yes
(7) UNION HOSPITAL OF CECIL COUNTY VENTURES 4000 NEXUS DR NW3-100 WILMINGTON,DE19803 52-1793691	MEDICAL SERVICES	MD	AFFINITY	C CORP	2,180,430	6,298,265	100.000 %		No

Schedule R (Form 990) 2023

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

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 .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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	37,841,545	FMV
(2) CHRISTIANA CARE GO HEALTH URGENT CARE LLC	ADJPQ	40,043,740	FMV
(3) THE DE CTR FOR MAT FETAL MED OF CC INC	J,M,O	1,036,484	FMV
(4) CHRISTIANA CARE INSURANCE CO LTD	Q,R	52,237,661	FMV
(5) AFFINITY HEALTH ALLIANCE INC	R,S	2,801,313	FMV
(6) CHRISTIANA CARE HOME HEALTH & COMM SERVICES	ADOQR	4,892,589	FMV
(7) CHRISTIANA CARE WEST GROVE	O	4,656,805	FMV
(8) CHRISTIANA CARE EMERGENCY PHYSICIANS	N,O,Q	4,204,380	FMV

Schedule R (Form 990) 2023

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

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
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	10
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	14,540
6	Total number of volunteers (estimate if necessary) .............	6	489
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,498,234
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	53,965,055	42,127,253
9	Program service revenue (Part VIII, line 2g) .........	2,567,645,527	2,755,633,267
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	60,054,269	236,160,355
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	16,332,229	16,965,085
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,697,997,080	3,050,885,960
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	516,250	1,861,240
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)	1,555,860,667	1,614,928,394
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,031,979,043	1,050,215,401
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,588,355,960	2,667,005,035
19	Revenue less expenses. Subtract line 18 from line 12.......	109,641,120	383,880,925
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	4,483,979,485	4,817,293,499
21	Total liabilities (Part X, line 26).............	1,106,827,681	1,158,781,143
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,377,151,804	3,658,512,356

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,282,840,360 including grants of $ 1,854,240 ) (Revenue $ 2,765,367,462 )
	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 expenses2,282,840,360

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	20,230,326	0	638,477

1a	Federated campaigns..		1a	9,471
b	Membership dues..		1b
c	Fundraising events..		1c	141,751
d	Related organizations		1d	2,955,695
e	Government grants (contributions)		1e	36,741,376

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,278,960

g	Noncash contributions included in lines 1a - 1f:$		1g	142,903

h Total. Add lines 1a-1f.......		42,127,253

		Business Code
2a	NET PROGRAM SERVICE REVENUES	622110	2,686,086,673	2,686,086,673	0	0
b	OTHER REVENUES	900099	69,546,594	63,818,551	1,498,234	4,229,809
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		2,755,633,267

3 Investment income (including dividends, interest, and othersimilar amounts) ......			71,219,169			71,219,169
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
			(i) Real	(ii) Personal
6a	Gross rents	6a	5,508,369
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	5,508,369	0
d	Net rental income or (loss).......			5,508,369			5,508,369
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	969,203,319	-1,652,552
b	Less: cost or other basis and sales expenses	7b	802,609,581
c	Gain or (loss)	7c	166,593,738	-1,652,552
d	Net gain or (loss).........			164,941,186			164,941,186
8a	Gross income from fundraising events (not including $ 141,751of contributions reported on line 1c). See Part IV, line 18 ....
			8a	17,738
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			17,738			17,738
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..			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..			0

Business Code
11a	MAINTENANCE FEES		531390	1,704,783	0	0	1,704,783
b	AFFILIATE REVENUES		900099	9,734,195	9,734,195	0	0
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			11,438,978
12	Total revenue. See instructions.....			3,050,885,960	2,759,639,419	1,498,234	247,621,054

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,861,240	1,861,240
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 ...........	15,178,595	12,798,782	2,379,813	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........	1,252,443,799	1,056,076,366	196,367,433	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	79,249,174	66,823,900	12,425,274	0
9	Other employee benefits .......	179,392,604	151,266,100	28,126,504	0
10	Payroll taxes ...........	88,664,222	74,762,787	13,901,435	0
11	Fees for services (non-employees):
a	Management ......	21,517,461	16,855,532	4,661,929	0
b	Legal .........	6,065,352	4,751,245	1,314,107	0
c	Accounting ...........	444,513	348,206	96,307	0
d	Lobbying ...........	422,633	331,067	91,566	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	6,434,027		6,434,027	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	44,148,858	34,583,657	9,565,201	0
12	Advertising and promotion ....	6,703,332	5,251,002	1,452,330	0
13	Office expenses .......	6,095,872	4,775,153	1,320,719	0
14	Information technology ......	75,279,050	58,969,245	16,309,805	0
15	Royalties ..	87,447	68,501	18,946	0
16	Occupancy ...........	45,223,456	35,425,435	9,798,021	0
17	Travel ............	3,057,053	2,394,718	662,335	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	1,281,634	1,003,958	277,676	0
20	Interest ...........	8,458,612	6,951,961	1,506,651	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	118,544,262	88,441,488	30,102,774	0
23	Insurance ...	30,839,123	24,157,582	6,681,541	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	489,757,416	489,757,416	0	0
b	OTHER SUPPLIES AND SERVICES	185,855,300	145,185,019	40,670,281	0
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	2,667,005,035	2,282,840,360	384,164,675	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			13,272	1	13,272
2	Savings and temporary cash investments .........			269,688,680	2	295,480,916
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			421,401,431	4	537,742,510
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 ............			49,504,179	8	48,445,848
9	Prepaid expenses and deferred charges ......			27,951,704	9	30,153,319
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,870,783,346
b	Less: accumulated depreciation	10b	1,831,759,564	1,067,277,741	10c	1,039,023,782
11	Investments—publicly traded securities .			1,672,961,947	11	1,915,847,561
12	Investments—other securities. See Part IV, line 11 .....			491,444,744	12	437,767,095
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 ...........			482,719,982	15	511,803,391
16	Total assets. Add lines 1 through 15 (must equal line 33)...			4,483,979,485	16	4,817,293,499

17	Accounts payable and accrued expenses .....	446,857,675	17	449,538,491
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	298,936,087	20	291,699,694
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	361,033,919	25	417,542,958
26	Total liabilities. Add lines 17 through 25..	1,106,827,681	26	1,158,781,143

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	3,317,366,405	27	3,593,169,230
28	Net assets with donor restrictions ...........	59,785,399	28	65,343,126
	Organizations that do not follow FASB ASC 958, check here 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 ...........	3,377,151,804	32	3,658,512,356
33	Total liabilities and net assets/fund balances ........	4,483,979,485	33	4,817,293,499

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No