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 Health believes charging a minimal co-pay causes patients to be a full participant in their healthcare plan. For the National Jewish Health Financial Assistance program (FAP) National Jewish Health reviews income and liquid asset levels to determining patient financial need and discounts. Liquid assets (less an allowance based on family size) are added to annualized income (less annual medical expenses) to compare to the FPG. Through this formula National Jewish Health takes into account medical indigence.
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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 Health classifies accounts as bad debt at the end of the collection cycle once contractual adjustments, financial assistance, 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 4
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National Jewish Health does not have a footnote in the financial statements which describes bad debt expense. National Jewish Health is subject to not-for-profit guidelines rather than healthcare guidelines for financial statement reporting as National Jewish Health has historically had non-patient revenues, gains and other support in excess of patient revenue. Patient payments received are netted out of bad debt in the calculation. On the audited financial statements, bad debt is recorded as actual patient charges not collected.
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Schedule H, Part III, Section B, Line 8
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National Jewish Health is committed to providing specialty 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 treatments. 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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National Jewish Health screens for financial assistance policy (FAP) eligibility for 240 days after the first self-pay balance statement. During the first 120 days National Jewish Health collects on all accounts (excluding extraordinary collection practices) - until a patient applies for financial assistance. If they are found eligible, the discount is calculated and applied, the balance due is determined and normal collection practices resume for the remaining balance. During the last 120 days, if a patient applies for National Jewish Health financial assistance, all collection efforts (including any extraordinary collection practices) are suspended. If the patient is determined to be FAP eligible, any extraordinary collection efforts are reversed, the discount is calculated and applied,the balance due calculated, and normal collection efforts are resumed for this balance.
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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 outreach 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 and finance staff to identify and assess programs National Jewish Health has in place specific to identified community health needs.
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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 the locations our 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 diagnosis. We also treat patients with food allergies, mycobacterial infections, bronchiectasis, cystic fibrosis, lung cancer and other respiratory and immune diseases. 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 sates.
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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 120 years ago, when National Jewish Health was a free hospital for the care of indigent TB patients, National Jewish Health has been committed to meeting the medical needs of the under served in the community. National Jewish Health is one of only a handful of outpatient clinics in the area that schedules patients for services on a first come, first served 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 Health spends millions of dollars to conduct the full continuum of research from basic science to clinical application. National Jewish Health 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 Health 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 Health 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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