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 determine 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 take 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 allocated 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 2
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The bad debt on line 2 is calculated at a cost to charge ratio, so is listed at an estimated cost lost. All accounts written off for private pay or underinsured patients who are determined to be uncollectible are considered implicit price concessions since we accept patients regardless of their ability to pay. The amount listed in line 2 is actually a reduction to gross revenue on our audited financial statements- as a price concession to reach net revenue. The note discussing Patient Revenue includes all related information and in footnote 3 of the audited financial statements.
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Schedule H, Part III, Section A, Line 4
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Consistent with FASB 605 and 606, revenue is recorded net of price concession, including bad debt. Bad debt is not reported on the financial statements, except when financial positions change for patients after their date of service. Financial Bad Debt was -0- for FY22 so as such there was no footnote.
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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 scrutinized published health data, held community input sessions, surveyed community health providers and consulted with our own faculty, who have extensive contacts and experience with the community, to understand the outstanding health needs of residents in our community.
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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 on 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 focused on respiratory, cardiac, immune, and related diseases, National Jewish Health serves a very diverse community. The main National Jewish Health campus is located in central Denver neighborhood at 1400 Jackson Street. Adult and pediatric patients come to National Jewish Health from the local community as well as from throughout the State of Colorado and nationally. Since tobacco addiction is a significant contributor to the disease burden of our patients, National Jewish Health operates tobacco cessation programs for the Denver community and in 21 other states.
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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 medial needs of the under served in the community. National Jewish Health is only one of 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 Took Kit program for the western slope and a free asthma care and teaching program in the lower income communities of Colorado. National Jewish Health has created a comprehensive multi-disciplinary ALS (amyotrophic lateral sclerosis or Lou Gehrig's disease) program to meet the needs of patients in Colorado and Rocky Mountain Region who suffer from this very rare but severely debilitating condition. The care of these patients is exceptionally challenging and requires the coordinated input of physicians and other health care providers with specific expertise in ALS from multi-specialties including Neurology, Pulmonology, Palliative Care, Rehabilitation Services, Speech and Swallow Therapy, Gastroenterology, Nutrition and Nursing. National Jewish hosts one of only a handful of such programs in the Rocky Mountain region and invests hundreds of thousands of dollars in this critical community need annually. 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". The Colorado House and Senate unanimously recognized National Jewish Health for our vital role in serving the health needs of Colorado citizens. Throughout the COVID-19 pandemic, National Jewish Health kept its outpatient clinics open, provided testing to patients and the general public, and provided COVID-19 specific clinical programs for children and adults to treat both actively infected and recovering patients, including monoclonal antibody therapies. National Jewish Health quickly set up operations to provide vaccinations following the state's prioritization phases as soon as it received its first doses of the COVID-19 vaccine in December 2020. To facilitate the needs of the community and the general public, National Jewish Health set up a drive-thru vaccination site on its campus parking lot and partnered with a local university for high volume vaccination events. National Jewish Health also collaborated with groups in underserved communities and set up a site at a local church for several vaccination events. Through June 2021, National Jewish Health provided over 59,700 doses of the vaccine. National Jewish Health continues to fous on post-COVID recovery efforts in specialized clinics. There continues to be a demand for National Jewish Health's COVID-19 testing, both PCR molecular and antibody testing, by public health departments and for several large employer groups and school systems. Our researchers were highly focused on COVID-19. Over the course of the pandemic, our researchers participated in multiple clinical trials of experimental therapies as well as implemented research programs designed to better understand the mechanisms and potential novel treatments for the virus.
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