Schedule H, Part I, Line 3c
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National Jewish Health is a voluntary participant in the Colorado Indigent Care Program (CICP) and has modeled their Financial Assistance Policy after the program. Pursuant to CICP guidelines, patients pay a minimal co-pay for care. National Jewish believes charging a minimal co-pay causes patients to be a full participant in their healthcare plan. National Jewish reviews income level, asset level, medical indigence, insurance status, uninsured discount and state regulation when determining patient financial need.
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Schedule H, Part I, Line 6a
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National Jewish was in the middle of implementing a new website in June and July and failed to post the completed CHNA on the hospital website as of June 30, 2016. This was discovered August 31, 2016 and the CHNA was completed and posted on the website September 2, 2016. The CHNA was also reviewed by the institution's audit firm who made additional recommendations to the CHNA which are in the process of being implemented and the new CHNA will be posted in April 2017. Per Section 4959 of 501(r)(3), National Jewish paid the $50,000 excise tax before the 990 was filed.
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Schedule H, Part I, Line 7
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National Jewish Health conducts an annual study to determine the costs of all major programs. Through this study, which allocates specific costs across major programs, we determine the cost of clinical care. This ratio is multiplied by the total bad debt charges to determine cost. It is the same methodology used to determine cost of free and reduced care. National Jewish classifies accounts as bad debt at the end of the collection cycle once contractual adjustments and payments have been applied. An account is considered bad debt after all reasonable collection efforts have been made.
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Schedule H, Part III, Section A, Line 2
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Bad debt costs are estimated by multiplying actual bad debt write-offs for the fiscal year by the cost-to-charge ratio calculated from W/S C (grouping of total cost and charge) of the Medicare Cost report. 1,917,000 * .626=1,200,242. Patient payments received are netted out of bad debt in the calculation.
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Schedule H, Part III, Section A, Line 4
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National Jewish Health does not have a footnote in the financial statements which describes bad debt expense. National Jewish is subject to not-for-profit guidelines rather than healthcare guidelines for financial statement reporting as National Jewish has historically had non-patient revenues, gains and other support in excess of patient revenue.
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Schedule H, Part III, Section B, Line 8
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National Jewish Health is committed to providing speciality care to seniors. Patients benefit from extensive time with their healthcare providers, multi-specialty care focused on the whole patient, comprehensive patient education, rehabilitation and thorough diagnostic work-ups and treatment. This care is expensive and many aspects of it are not reimbursed adequately from Medicare. Many patients come to us as a last resort. The ability to access our care without regard to the limitations of insurance is an important benefit to these patients and to their community.
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Schedule H, Part III, Section C, Line 9b
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An account cannot go to bad debt collection until full and complete pre-collection efforts have been exhausted. When a patient expresses hardship, they are screened, eligibility is established and the account is adjusted to the eligibility rating in the Financial Assistance Policy.
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Schedule H, Part VI, Line 2
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National Jewish Health assembled a team from within the institution to conduct the community health needs assessment. The team reviewed the Proposed Rules for the Community Health Needs Assessments for Charitable Hospitals and organized the review to create this summary. The group sought key information about the community demographics and health needs from various governmental and non-governmental sources. The group then used its own knowledge of the institution and communicated with other people throughout National Jewish Health, including grant administrators, individual researchers, professional education, community outreach and finance staff to identify and assess programs National Jewish Health has in place specific to identified community health needs. National Jewish was in the middle of implementing a new website in June and July and failed to post the completed CHNA on the hospital website as of June 30, 2016. This was discovered August 31, 2016 and the CHNA was completed and posted on the website September 2, 2016.
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Schedule H, Part VI, Line 3
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National Jewish Health maintains a financial counseling department designed to help patients obtain needed assistance. The counselors inquire about financial need and educate patients on the various assistance programs available to them, including National Jewish's own financial assistance program and the Colorado Indigent Care Program. The counselors are available to assist patients in applying for need based programs and in establishing payment plans and options.
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Schedule H, Part VI, Line 4
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As a specialty hospital, National Jewish Health serves a community defined both by geography and by disease. The community was determined primarily by determining where patients came from and what types of illnesses have been treated. The main National Jewish Health campus is located in central Denver at 1400 Jackson St. As a nationally recognized specialty care center for respiratory, immune and related diseases, National Jewish Health serves both a local and national community. As a specialty hospital focused on respiratory, immune and related diseases, National Jewish Health serves a community defined by those diseases. Asthma represents the most common diagnosis among our patients, accounting for about 14,000 patient encounters. Chronic Obstructive Pulmonary Disease, COPD, represents the second most common diagnosis, accounting for about 6,500 patient encounters. Cough, shortness of breath, pulmonary fibrosis, allergic rhinitis, food allergy and rheumatoid arthritis are other common diagnoses. We also treat patients with food allergies, mycobacterial infections, bronchiectasis, cystic fibrosis, lung cancer and other respiratory and immune diseases. Tobacco Addiction. Tobacco use contributes to many respiratory diseases, especially lung cancer and chronic obstructive pulmonary disease. Thus, tobacco addiction is an important contributor to the disease burden of our patients. National Jewish Health operates tobacco cessation programs for the Denver community and for 16 other states. Obesity. Obesity is a national epidemic, which contributes to worsening asthma, COPD and respiratory diseases in general. National Jewish Health operates a weight management program, FitLogix, for corporate clients and health insurers.
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Schedule H, Part VI, Line 5
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National Jewish Health invests significant resources in meeting the healthcare needs of our community. Since our founding over 117 years ago, when National Jewish was a free hospital for the care of indigent TB patients, National Jewish has been committed to meeting the medical needs of the under served in the community. National Jewish is one of only a handful of outpatient clinics in the area that schedules patients for services on a first come, first serve basis regardless of ability to pay. All patients are provided a full scope of diagnostic and therapeutic services without regard to the patient's financial need. Our clinicians serve at multiple locations throughout the state in order to ease access to our services. As a teaching institution, our faculty educates and trains tomorrow's doctors, nurses and other healthcare staff. Every year, National Jewish spends millions of dollars to conduct the full continuum of research from basic science to clinical application. National Jewish operates a K-8 school on our campus exclusively for chronically ill children with special medical needs. To our knowledge, it is the only school of its kind on a healthcare campus in the country. Overwhelmingly, the students at the school live in poverty and qualify for free or reduced lunches. National Jewish offers free lung testing around the country. We subsidize programs throughout the community including an inner city asthma program in the Denver Public Schools, an Asthma Tool Kit program for the western slope and a free asthma care and teaching program in lower income communities in Colorado. As a not-for-profit institution our Board of Directors, all of whom are community leaders, are heavily involved in the direction and strategies of furthering our mission 'to heal, to discover and to educate.' On April 8th, 2010, National Jewish was unanimously recognized by the Colorado House and Senate for our vital role in serving the health needs of Colorado citizens.
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