STATE OF ILLINOIS HEALTH FACILITIES AND SERVICES …. 13-062 Alexian... · STATE OF ILLINOIS HEALTH FACILITIES AND SERVICES ... Hartgrove Hospital Chicago 150 29 ... the same time

  STATE OF ILLINOIS

HEALTH FACILITIES AND SERVICES REVIEW BOARD

525 WEST JEFFERSON ST.   SPRINGFIELD, ILL INOIS 62761 (217) 782-3516 FAX: (217) 785-4111

DOCKET NO:

H-08

BOARD MEETING:

December 17, 2013

PROJECT NO:

13-062

PROJECT COST:

Original: $1,281,000

FACILITY NAME:

Alexian Brothers Medical Center

CITY:

Elk Grove Village

TYPE OF PROJECT: Substantive HSA: VII

PROJECT DESCRIPTION: The applicants (Alexian Brothers Medical Center, Alexian Brothers Health System, and Ascension Health) propose the establishment of an acute mental illness (AMI) category of service at Alexian Brothers Medical Center. The estimated project cost is $1,281,000. The anticipated project completion date is June 30, 2014.

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EXECUTIVE SUMMARY

PROJECT DESCRIPTION:

The applicants (Alexian Brothers Medical Center, Alexian Brothers Health System Ascension Health) propose the establishment of an acute mental illness (AMI) category of service at Alexian Brothers Medical Center. The estimated project cost is $1,281,000. The anticipated project completion date is June 30, 2014.

The applicants view this proposal of adding beds to Alexian Brothers Medical Center as the less costly alternative than adding a new addition to Alexian Brothers Behavioral Health Hospital.

WHY THE PROJECT IS BEFORE THE STATE BOARD:

This project is before the State Board because the project proposes the establishment of a category of service as defined by the State Board.

PURPOSE OF THE PROJECT:

According to the applicants “The proposed establishment of an inpatient AMI- unit addresses two existing problems, and does so in a cost effective manner. The first problem is that demand for inpatient services at ABBHH consistently exceeds the hospital's physical capacity to admit patients. During 2012, Alexian Brothers Behavioral Health Hospital (ABBHH) was ·forced to '"re-direct" 1,201 patients to other hospitals, due to a lack of an appropriate bed. In addition, the hospital typically maintains a waiting list of approximately ten patients, those being patients that have been evaluated by ABBHH staff, and having the ability to delay admission for up to two weeks, until an appropriate bed is available. Like most psychiatric hospitals, ABBHH operates age group-specific units and programming-children, adolescents/young adults, adults, and older adult geropsychiatry and limits admissions to units, accordingly.

The second problem to be addressed through the development of an AMI unit at Alexian Brothers Medical Center (ABMC) is some (primarily) geropsychiatry patients' need for medical services that cannot be provided in a psychiatric hospital. Currently, such ABBHH patients must be discharged, transported to St. Alexius Medical Center for services typically provided on an outpatient basis, transported back to ABBHH, and readmitted. This process is stressful, cumbersome, disruptive to therapy, and costly. The proposed AMI unit at ABMC will have an older adult geropsychiatry focus, adopt the clinical programs used by ABBHH, operate as an extension of ABBHH, and be managed by ABBHH. Admission to the proposed AMI unit, however, will not be limited to a specific age group. With the establishment of the proposed unit at ABMC, a portion of ABBHH's bed complement allocated to older adults will be re-designated for other age groups, resulting in a reduced number of "re-directs" in those age groups.” The primary goal of the project is to reduce the number of patients "re-directed" to facilities not operated by ABBHH and to reduce or eliminate ABBHH's waiting list. Success will be immediately measurable.”

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NEED FOR THE PROJECT:

There is a calculated excess of 122 acute mental illness beds in the HSA-7 A-7 Acute Mental Illness Planning Area.

There are 14 facilities within 30 minutes. Of these 14 facilities 7 facilities are operating at less than the target occupancy of 85%.

Facilities within 30 minutes of the proposed site

Name City AMI Beds

Time Occupancy Met Occupancy

Target?

Northwest Community Hospital Arlington Heights 32 14.95 76.30% No

Adventist Glen Oaks Hospital Glendale Height 61 16.1 89.20% Yes

Streamwood Behavioral Health Systems Streamwood 162 18.4 65.60% No

Alexian Brothers Behavioral Health Hospital Hoffman Estates 141 20.7 92.60% Yes

Advocate Good Samaritan Hospital Downers Grove 41 23 67.60% No

Maryville Academy / Scott A. Nolan Center Des Plaines 125 24.15 39.20% No

Riveredge Hospital Forest Park 210 25.3 55.30% No

Advocate Lutheran General Hospital Park Ridge 55 25.3 52.50% No

VHS Westlake Hospital Melrose Park 33 26.45 85.80% Yes

Gottlieb Memorial Hospital Melrose Park 12 26.45 88.50% Yes

Adventist Hinsdale Hospital Hinsdale 17 27.6 87.10% Yes

Central DuPage Hospital Winfield 15 28.75 100.20% Yes

Loretto Hospital Chicago 76 28.75 43.20% No

Hartgrove Hospital Chicago 150 29.9 74.80% Yes

Travel time adjusted per 1100.510 (d) Occupancy taken from 2012 Hospital Profiles. Table sorted by time Note Streamwood Behavioral Health Systems and Maryville Academy serve adolscents only.

BACKGROUND/COMPLIANCE ISSUES:

The applicants do not have outstanding compliance issues with the State Board.

PUBLIC HEARING/COMMENTS:

No public hearing was requested and no letters of opposition have been received by the State Board Staff. Support letters have been received by the State Board Staff. State Representative Martin Moylan stated in support “I am writing in support of a project that I believe will help Alexian Brothers Health System serve more mental health patients in the

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Northwest Suburbs. Alexian Brothers Behavioral Health hospital offers our community excellent psychiatric services, and is the leading provider of psychiatric services in this region; however, they are often unable to take admissions due to high utilization. To provide more services, Alexian Brothers Medical Center will open a psychiatric unit managed by Alexian Brothers Behavioral Health Hospital. This plan will address the need for more high quality psychiatric programs without having the expense of building for additional beds. This common sense approach saves time, money while providing the clinical expertise of a world class psychiatric facility.” " . Brian Gross Administrator Manor Care stated in support “I am writing this letter in support of the above planned project at Alexian Brothers Medical Center to operate a Psychiatric Unit within the hospital. As an operator of a 190 bed Skilled Nursing Facility within three miles of the hospital, my patients have experienced frequent delays in accessing inpatient mental health programming within this community, including the Alexian Brothers Behavioral Health Hospital (ABBHH), primarily due to limited bed capacity. There have been many occasions where patients suffering from acute or emergency mental health conditions within my facility have had to wait for a psychiatric bed to become available in order to access appropriate care. Having a Psychiatric unit within the confines of the Alexian Brothers Medical Center would expedite mental health services for patients whom are first transported to the emergency room and then later to a psychiatric hospital when a bed does become available. Frequently, patients have had to wait in the emergency room or on a medical unit until a bed becomes available. The reputation of Alexian Brothers Behavior Health Hospital is superb. I speak from personal experience where a family member utilized and benefited from, the professional and caring environment at ABBHH. There is a tremendous need for high quality inpatient psychiatric programs within this community. Based upon my professional and personal experience with the care and services currently being provided by the Alexian Brothers Health System, I believe the community would benefit greatly if this project were approved.”

Scott Burgess Executive Director Alexian Brothers Behavioral Health Hospital stated in support “I write with pleasure to support the Alexian Brothers Medical Center Project to open a much needed psychiatric unit at ABMC in Elk Grove Village, Illinois. As you are already aware, Illinois has decreased its state-operated psychiatric inpatient capacity from over 35,000 beds in the 1960's to approximately 1,000 beds currently. Additionally, due to poor reimbursement structures, the Illinois Hospital Association has reported, licensed psychiatric beds have decreased from 5,350 in 1991 to 3,869 in 2010 (a 28% reduction). As a community mental health provider for over 51 years, we are seeing firsthand the challenges and struggles clients and family members go through as they seek a local inpatient bed for a psychiatric condition. Sadly, due to the shrinkage in state and local hospital inpatient capacity, local hospitals are often full. When this happens, individuals may be transferred to the only available bed, perhaps many towns away. This inhibits the ability for a local response and regular family involvement. In so doing, it inhibits the success of treatment. At the same time inpatient hospital options have shrunk and the need for mental health services has increased, the community mental health system "safety-net" has been financially decimated and hit disproportionately hard by state budget cuts resulting in individuals not being able to attain treatment until they are in crisis. According to recent IHA data, between 2009 and 2012, emergency room visits for the uninsured with primary mental illness or behavioral health disorders increased by 17%, rising from 48,820 visits to 57,003. It was noted that ED visits grew at a rate 10.6% higher than those with general medical emergencies. It is clear there is a significant, unmet demand for acute mental health

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services, including increased access to psychiatric inpatient services: The Alexian Brothers Health System has long been recognized, in our community and nationally, as a leader in behavioral health care. The Alexian Brothers Order, having provided psychiatric services for roughly four centuries throughout the world and for almost 150 years in America, has demonstrated a heritage and commitment in a manner almost unprecedented in healthcare. I respectfully encourage the Illinois Health Facilities and Services Review Board to approve the Alexian Brothers Medical Center request to add a psychiatric unit to assist in meeting the local community's desperate need for more psychiatric resources.”

FINANCIAL AND ECONOMIC FEASIBILITY

The entirety of the project will be funded through internal sources (Cash and Securities/Fair Market Value of the Leases. A review of the audited financial statements indicates that sufficient cash is available to fund the project.

CONCLUSIONS:

The applicants addressed a total of 14 criteria and have not met the following:

State Board Criteria Not Met Criteria 1110.730(b) – Planning Area Need There is an calculated excess of 122 AMI

beds in the HSA-7 A-7 Acute Mental Illness Planning Area

Criteria 1110.730(c) Duplication of Service There are 14 facilities within 30 minutes of the proposed facility. 7 of the 14 facilities are not operating at the target occupancy of 85%.

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STATE BOARD STAFF REPORT Alexian Brothers Medical Center

Elk Grove Village Project #13-062

APPLICATION SUMMARY

Applicants Alexian Brothers Medical Center, Alexian Brothers Health System, Ascension

Health Facility Name Alexian Brothers Medical Center

Application Received September 24, 2013 Application Deemed Complete September 24, 2013

Review Period Ends November 24, 2013 Applicant Request a Deferral Yes

I. Project Description

The applicants (Alexian Brothers Medical Center, Alexian Brothers Health System and Ascension Health) propose the establishment of an acute mental illness (AMI) category of service at Alexian Brothers Medical Center. The patient care unit will be developed through the renovation of existing space; and will operate under the clinical direction of Alexian Brothers Behavioral Health Hospital (ABBHH). ABMC and ABBHH are located in the same IDPH-designated Health Service Area and Health Planning Area, approximately 12.6 miles/18 minutes apart. The anticipated project completion date is June 30, 2014.

II. Summary of Findings

A. The State Board Staff finds the proposed project DOES NOT appear to be in conformance with the provisions of Part 1110.

B. The State Board Staff finds the proposed project appears to be in

conformance with the provisions of Part 1120. III. General Information

The applicants are Alexian Brothers Medical Center, Alexian Brothers Health System and Ascension Health. Alexian Brothers Medical Center is located at 800 Biesterfield Road, Elk Grove Village, Illinois in HSA 7 and the A-07 Acute Mental Illness Planning Area. The operating entity/licensee and the owner of the site is Alexian Brothers Medical Center. The A-07 Acute Mental Illness Planning Area has a calculated excess of 122 acute mental illness beds by CY 2015.

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This is a substantive project subject to 1110 and 1120 review. Project Obligation will occur after permit issuance. At the conclusion of this report are the 2012 Hospital Profile for Alexian Brothers Medical Center and Alexian Brothers Behavioral Health Hospital.

IV. Public Comment

A public hearing was offered on this project but no hearing was requested. Letter of support were received by the State Board Staff. No letters of opposition were received.

V. Project Costs

The project is being funded with cash and securities of $1,281,000. The applicants project start up costs of $100,000.

TABLE ONE

Project Uses and Sources of Funds Uses of Funds Clinical Total

Preplanning Costs $15,000 $15,000

Modernization Costs $754,000 $754,000

Contingencies $75,000 $75,000

Architectural & Engineering Fees $91,000 $91,000

Consulting and Other Fees $60,000 $60,000

Movable or Other Equipment $286,000 $286,000

Total Uses of Funds $1,281,000 $1,281,000 Cash and Securities $1,281,000 $1,281,000

Total Sources of Funds $1,281,000 $1,281,000

VI. Cost Space Requirements

The applicants are proposing 8,870 GSF of clinical space for the new AMI unit.

TABLE TWO Cost Space Requirements

Department Cost Existing New Construction

Modernization Vacated

AMI $1,281,000 8,870 0 8,870 0 Total $1,281,000 8,870 0 8,870 0

VII. Safety Net Impact Statement

Alexian Brothers Medical Center (ABMC), as is the case with Alexian Brothers Health System's (ABHS) other hospitals and programs; is a safety net provider. Despite its suburban location, ABMC provided services to nearly 3,000 patients without any charge in 2012, and provided services to an additional 55,400 Medicaid recipients. Patients are

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not turned away due to a lack of financial resources. Somewhat unique to ABHS is the manner in which it develops and supports community based facilities, programs and services, consistent with the Alexian Brothers values of compassion, dignity of the person, care of the poor, holism and partnership. These programs, none of which are self-sufficient, are subsidized by ABMC and ABHS's other two hospitals through ABHS, and provide services throughout the metropolitan Chicago area. Examples of the safety net programs that are subsidized are: Bonaventure House and The Harbor Bonaventure House was founded in the 1980s in Chicago's Lakeview community, and The Harbor was established in Waukegan in 1998. These two residential facilities are the only two state licensed recovery homes for men and women living with HIV/AIDS. The facilities offer 24/7 staffing, case management services, occupational therapy, holistic spiritual care, after care, and recovery care for those in need of assistance in maintaining sobriety. Requirements for residency include a diagnosis of HIV/AIDS, homelessness or a risk of becoming homeless, and 90 days of maintained sobriety with a commitment to remain sober. Bettendorf Place Bettendorf Place is located on the South side of Chicago, and provides semi-permanent supportive housing for men and women with qualifying disabilities. The facility provides 23 furnished studio apartments, common meeting and laundry spaces, counseling offices, and a technology learning center. The requirements for Bettendorf Place residency are the presence of a qualifying chronic disease, and some source of limited income. The expected outcome for all residents is that they will transition into permanent housing with stable health. Case management, occupational therapy, holistic spiritual care and access to the computer lab/technology learning center are made available to community residents, as well as those living in Bettendorf Place.

Alexian Center for Mental Health A community mental health center, providing outpatient services to the residents of the northwest suburbs has been in operation since 1962. The center, which was publically funded and operated under a number of names as it evolved, was on the brink of closing in 1997 due to insufficient funding. Understanding the need for the center's programming, and particularly the need presented by the lower income component of the area's population, ABHS acquired the center and in 2004 centralized services in Arlington Heights. Since assuming responsibility for the community-based center, ABHS has expanded the center's programmatic base and received JCAHO accreditation. Among the programs offered through the center are: partial/day hospitalization, age group-specific outpatient therapy, psychosocial rehabilitation, case management, and a transitional housing program.

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TABLE THREE Safety Net Information

2010 2011 2012

Net Patient Revenue $403,268,639 $417,752,000 $438,858,000

Amount of Charity Care (charges) $39,170,934 $44,245,378 $37,949,509

Cost of Charity Care $7,362,312 $8,316,485 $7,133,313

Charity

Charity (# of patients)

Inpatient 472 554 556

Outpatient 1,917 1,990 2,424

Total 2,389 2,544 2,980Charity (cost in dollars)

Inpatient $4,441,227 $5,183,200 $4,158,489

Outpatient $2,921,085 $3,133,285 $2,974,824

Total $7,362,312 $8,316,485 $7,133,313

% of Charity Care to Net Revenue 1.83% 1.99% 1.63%

Medicaid

Medicaid (# of patients)

Inpatient 2,570 2,542 2,476

Outpatient 37,908 42,751 52,913

Total 40,478 45,293 55,389Medicaid (revenue)

Inpatient $7,108,711 $7,991,484 $12,102,180

Outpatient $6,018,556 $5,051,710 $5,310,083

Total $13,127,267 $13,043,194 $17,412,263

% of Medicaid to Net Revenue 3.26% 3.12% 3.97%

VIII. Project Purpose, Background and Alternatives A) Criterion 1110.230 - Background of Applicant – Information Requirements

1) An applicant must demonstrate that it is fit, willing and able, and has the qualifications, background and character, to adequately provide a proper standard of health care service for the community. [20 ILCS 3960/6] In evaluating the qualifications, background and character of the applicant, HFPB shall consider whether adverse action has been taken against the applicant, or against any health care facility owned or operated by the applicant, directly or indirectly, within three years preceding the filing of the application. A health care facility is considered "owned or operated" by every person or entity that owns, directly or indirectly, an ownership interest. If any person or entity owns any option to acquire stock, the stock shall be considered to be

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owned by such person or entity (refer to 77 Ill. Adm. Code 1100 and 1130 for definitions of terms such as "adverse action", "ownership interest" and "principal shareholder").

Alexian Brothers Health System ('"ABHS") has not had any adverse actions against any Illinois health care facility owned or operated by ABHS during the three (3) year period prior to the filing of this application. ABHS authorizes the State Board and Agency access to information to verify documentation or information submitted in response to the requirements of Review Criterion 1130.230 or to obtain any documentation or information which the State Board or Agency finds pertinent to this CON application:

B) Criterion 1110.230 - Purpose of the Project – Information Requirements

The applicant shall document that the project will provide health services that improve the health care or well-being of the market area population to be served. The applicant shall define the planning area or market area, or other, per the applicant's definition.

The applicants’ state the following regarding the purpose of the project. “The purpose of the proposed project is to improve the ability of area residents to access the acute mental illness inpatient services long provided by Alexian Brothers Health System (ABHS). As a result, the service population's health status and well being will be improved.

The proposed establishment of an inpatient AMI- unit addresses two existing

problems, and does so in a cost effective manner. The first problem is that demand for inpatient services at ABBHH consistently exceeds the hospital's physical capacity to admit patients. During 2012, ABBHH was ·forced to '"re-direct" 1,201 patients to other hospitals, due to a lack of an appropriate bed. In addition, the hospital typically maintains a waiting list of approximately ten patients, those being patients that have been evaluated by ABBHH staff, and having the ability to delay admission for up to two weeks, until an appropriate bed is available. Like most psychiatric hospitals, ABBHH operates age group-specific units and programming-children, adolescents/young adults, adults, and older adult geropsychiatry and limits admissions to units, accordingly.

The second problem to be addressed through the development of an AMI unit at ABMC is some (primarily) geropsychiatry patients' need for medical services that cannot be provided in a psychiatric hospital. Currently, such ABBHH patients must be discharged, transported to St. Alexius Medical Center for services typically provided on an outpatient basis, transported back to ABBHH, and readmitted. This process is stressful, cumbersome, disruptive to therapy, and costly. The proposed AMI unit at ABMC will have an older adult geropsychiatry focus, adopt the clinical programs used by ABBHH, operate as an extension of ABBHH, and be managed by ABBHH. Admission to the proposed AMI unit,

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however, will not be limited to a specific age group. With the establishment of the proposed unit at ABMC, a portion of ABBHH's bed complement allocated to older adults will be re-designated for other age groups, resulting in a reduced number of "re-directs" in those age groups.” The primary goal of the project is to reduce the number of patients "re-directed" to facilities not operated by ABBHH and to reduce or eliminate ABBHH's waiting list. Success will be immediately measurable.

C) Alternatives to the Proposed Project – Information Requirements

The applicant shall document that the proposed project is the most effective or least costly alternative for meeting the health care needs of the population to be served by the project.

The primary purpose of the proposed project is to increase the access of area residents to the acute mental illness inpatient services provided through Alexian Brothers Health System (ABHS) and Alexian Brothers Behavioral Health Hospital (ABBHH). Given that purpose and goal, only one viable alternative to the proposed project is available to the applicants. That alternative involves the construction of an addition to Alexian Brothers Behavioral Health Hospital, to allow an expanding of the hospital's bed capacity. That alternative was dismissed due to the capital cost associated with the required new construction, and the availability of suitable space at Alexian Brothers Medical Center (ABMC). A preliminary estimate of the alternative identified a construction-related cost of approximately $7.5M. One of the benefits of developing an AMI service at ABMC is the direct access to medical services required by some patients, which cannot be provided in the psychiatric hospital setting. General accessibility to AMI services, because ABBHH and ABMC are in close proximity to one another, would be identical, regardless of where the beds are to be developed. Ongoing staffing costs would also be very similar. Because of the intent to have the proposed ABMC unit managed by ABBHH, and for the unit to duplicate ABBHH's programs, it is anticipated that the quality of care will be identical. Given the construction cost associated with the identified alternative to the proposed project, the alternative was deemed by the applicants to be inferior to the proposed project.

IX. Project Scope and Size

A) Criterion 1110.234(a) - Size of Project 1) The applicant shall document that the physical space proposed for the

project is necessary and appropriate. The proposed square footage (SF) cannot deviate from the SF range indicated in Appendix B, or exceed the SF standard in Appendix B if the standard is a single number, unless SF can be justified by documenting, as described in subsection (a)(2).

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The applicants are proposing 8,870 GSF of modernized space for the 25 bed unit which is 355 GSF per bed. This is in compliance with the State Board Standard of 440-560 GSF per bed.

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE SIZE OF THE PROJECT CRITERION (77 IAC 1110.234 (a)).

B) Criterion 1110.234 (b) - Project Services Utilization The applicant shall document that, by the end of the second year of operation, the annual utilization of the clinical service areas or equipment shall meet or exceed the utilization standards specified in Appendix B.

The applicants have documented by the end of the second year of operation the annual utilization of the AMI unit will meet or exceed the target occupancy of 85%.

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE PROJECT SERVICES UTILIZATION CRITERION (77 IAC 1110.234 (a)).

X. Need for the Project

Section 1110.730 - Acute Mental Illness

A) Criterion 1110.730 (b) - Planning Area Need The applicant shall document that the number of beds to be established or added is necessary to serve the planning area's population. 1) 77 Ill. Adm. Code 1100 (formula calculation)

A) The number of beds to be established for each category of

service is in conformance with the projected bed deficit specified in 77 Ill. Adm. Code 1100, as reflected in the latest updates to the Inventory.

B) The number of beds proposed shall not exceed the number of

the projected deficit, to meet the health care needs of the population served, in compliance with the occupancy standard specified in 77 Ill. Adm. Code 1100.

2) Service to Planning Area Residents

A) Applicants proposing to establish or add beds shall document

that the primary purpose of the project will be to provide necessary health care to the residents of the area in which the

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proposed project will be physically located (i.e., the planning or geographical service area, as applicable), for each category of service included in the project.

3) Service Demand – Establishment of AMI and/or CMI

The number of beds proposed to establish a new AMI and/or CMI service is necessary to accommodate the service demand experienced by the existing applicant facility over the latest two-year period, as evidenced by historical and projected referrals, or, if the applicant proposes to establish a new hospital, the applicant shall submit projected referrals.

4) Service Accessibility

The number of beds being established or added for each category of service is necessary to improve access for planning area residents.

The applicants state the following regarding this criterion: “The proposed establishment of a 25-bed acute mental illness unit at Alexian Brothers Medical Center ("ABMC") will allow Alexian Brothers Health System (ABBS) and Alexian Brothers Behavioral Health Hospital ("ABBHH") to better serve those area residents requiring inpatient acute mental illness ('"AMI") services and seeking those services from ABBHH/ABHS The demand for inpatient AMI services, as provided by ABBHH, is so great, that the "need" for the proposed 25-bed unit at ABMC is supported in this application is consistent with IHFSRB expectations, and without going outside of Alexian Brothers Health System. Specifically,

ABBHH has, since 2009, operated above the IHFSRB target occupancy level, and will "redirect" approximately 523 appropriate patients annually to the proposed unit

ABMC's Emergency Department transferred 480 patients to inpatient AMI programs in 2012. Had AMI beds been available at ABMC, 142 of those patients would have been admitted to the ABMC unit. Those patients will be admitted to the proposed unit; and

St. Alexius Medical Center's Emergency Department transferred 1,993 patients to inpatient AMI programs during the 12-month period ending June 30, 2013. Had AMI beds been available at ABMC, 371 of those patients would have been transferred to the ABMC unit.

The three sources identified above will result in approximately 1,036 patients being admitted to the proposed ABMC unit. Because only the three in-System sources are being used to support the proposed unit, projected utilization is viewed as being very conservative. In addition routinely, and with great regularity, ABBHH must turn away prospective inpatients, "deflecting" them to

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another hospital, due to a lack of available beds. While the hospital does not keep records of such occurrences, Dr. Gregory Teas, ABBHH's Medical Director, estimates that approximately 1,200 patients are "deflected" annually. Because sufficient patient-specific data is not recorded to meet the requirements of Section 1110.730(b) (3), these patients have not been used to justify the proposed 25-bed unit. The applicants acknowledge, that while ABBHH has historically experienced an extraordinary demand for its services, and a resultant occupancy rate that consistently surpasses the IDPH's target rate, other providers in Planning Area A-07 have not experienced that demand. The applicants believe that this disparity is largely the result of the programmatic reputation that ABBHH has developed, both within the provider/referral source community and the community, in general. Of note is the fact that during the first six months of2013, Northwest Community Hospital referred 51 patients to ABBHH and Advocate Lutheran General Hospital referred 22 patients to ABBHH. The AMI census at both of these Planning Area A-07 hospitals is below the IDPH's target level. While clearly a larger unit could be justified, the number of beds being proposed is limited by the physical constraints of the nursing unit to be renovated for use as the AMI unit. As discussed elsewhere in this application, the ABMC Unit will be managed by Alexian Brothers Behavioral Health Hospital, and provide services consistent with ABBHH treatment protocols. ABBHH's average length of stay is 7.5 days, suggesting that the 1,036 patients identified above will require 7,770 patient days of care, resulting in an average daily census of 21.3 patients, supporting a "need" for the proposed 25 beds.”

There is an excess of 122 AMI beds in the Acute Mental Illness A-07 Planning Area. There is no absence of the proposed service within the planning area, nor access limitations due to payor status of patients, nor restrictive admission policies at existing providers. In addition it does not appear that the area population and existing care system exhibit indicators of medical care problems. There appears to be sufficient demand for the additional beds at this facility, however there is excess capacity within the planning area.

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT DOES NOT APPEAR TO BE IN CONFORMANCE WITH THE PLANNING AREA NEED CRITERION (77 IAC 1110.730 (b)).

B) Criterion 1110.730 (c) - Unnecessary Duplication/Maldistribution

1) The applicant shall document that the project will not result in an

unnecessary duplication. The applicant shall provide the following information: A) A list of all zip code areas that is located, in total or in part,

within 30 minutes normal travel time of the project's site;

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B) The total population of the identified zip code areas (based upon the most recent population numbers available for the State of Illinois population); and

C) The names and locations of all existing or approved health care

facilities located within 30 minutes normal travel time from the project site that provide the categories of bed service that are proposed by the project.

2) The applicant shall document that the project will not result in

maldistribution of services. Maldistribution exists when the identified area (within the planning area) has an excess supply of facilities, bed and services characterized by such factors as, but not limited to: A) A ratio of beds to population that exceeds one and one-half

times the State average; B) Historical utilization (for the latest 12-month period prior to

submission of the application) for existing facilities and services that is below the occupancy standard established pursuant to 77 Ill. Adm. Code 1100; or

C) Insufficient population to provide the volume or caseload

necessary to utilize the services proposed by the project at or above occupancy standards.

3) The applicant shall document that, within 24 months after project

completion, the proposed project: A) Will not lower the utilization of other area providers below the

occupancy standards specified in 77 Ill. Adm. Code 1100; and B) Will not lower, to a further extent, the utilization of other area

hospitals that are currently (during the latest 12-month period) operating below the occupancy standards.

The applicants provided the necessary documentation as required. There are 14 facilities within 30 minutes normal drive time of the proposed facility. 7 (50%) of the 14 facilities are operating at less than the target occupancy of 85%. It appears that a duplication of service will result with the establishment of this program. The applicants stated the following:

“As identified in the IDPH's Inventory, AMI Planning Area A-07 consists of five hospital providers: Advocate Lutheran General Hospital, Alexian Brothers Behavioral Health Hospital (ABBHH), Scott A Nolan Center, Northwest

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Community Hospital and Streamwood Behavioral Health Center. All five of these programs are fully-matured and have been in operation for many years. When evaluating the five programs, two facts standout 1) the Alexian Brothers program is the only program that has traditionally operated at an occupancy level exceeding the IDPH target; and 2) two of the programs (Nolan and Streamwood) do not provide services to adults. Referral patterns for AMI services within the northwestern suburbs have evolved over the years, and are well-established. The ABBHH program's high utilization and documented need to turn away one hundred patients a month due to a lack of beds confirms that demand exists for the programs offered by ABBHH, and that admission to the other area providers is often made on a "second choice" basis, as a referral from ABBHH. Also of note is the reliance of other hospitals, including those providing AMI services on ABBHH. ABBHH tracked direct referrals from other hospitals during the first six months of 2013. On an annualized basis, in 2013 ABBHH will admit 294 patients from other hospitals providing AMI services in the metropolitan Chicago area, including a projected 146 patients referred from Advocate Lutheran General Hospital and Northwest Community Hospital, both of which are located in ABBHH's IDPH-designated service area, and both of which provide AMI services, themselves. It is also anticipated, based on the historical data, that an additional 208 patients will be referred to ABBHH from the Advocate hospitals in Barrington and Libertyville neither of which provide AMI services. A significant portion of the proposed Alexian Brothers Medical Center (ABMC) program's patient population will consist of patients currently being admitted to Alexian Brothers Behavioral Health Hospital, and will allow ABBHH the flexibility to operate at the IDPH target occupancy rate of 85%. As a result, the establishment of an AMI program at ABMC (which will be clinically managed by ABBHH) will not cause the only area provider operating in excess of the IDPH target occupancy rate to drop below that target”

TABLE FOUR

Facilities within 30 minutes of the proposed site Name City AMI

BedsTime Occupancy Met

Occupancy Target?

Northwest Community Hospital Arlington Heights 32 14.95 76.30% No

Adventist Glen Oaks Hospital Glendale Height 61 16.1 89.20% Yes

Streamwood Behavioral Health Systems Streamwood 162 18.4 65.60% No

Alexian Brothers Behavioral Health Hospital Hoffman Estates 141 20.7 92.60% Yes

Advocate Good Samaritan Hospital Downers Grove 41 23 67.60% No

Maryville Academy / Scott A. Nolan Center Des Plaines 125 24.15 39.20% No

Riveredge Hospital Forest Park 210 25.3 55.30% No

Advocate Lutheran General Hospital Park Ridge 55 25.3 52.50% No

VHS Westlake Hospital Melrose Park 33 26.45 85.80% Yes

Gottlieb Memorial Hospital Melrose Park 12 26.45 88.50% Yes

 Page17

TABLE FOUR Facilities within 30 minutes of the proposed site

Name City AMI Beds

Time Occupancy Met Occupancy

Target?

Adventist Hinsdale Hospital Hinsdale 17 27.6 87.10% Yes

Central DuPage Hospital Winfield 15 28.75 100.20% Yes

Loretto Hospital Chicago 76 28.75 43.20% No

Hartgrove Hospital Chicago 150 29.9 74.80% Yes

Travel time adjusted per 1100.510 (d) Occupancy taken from 2012 Hospital Profiles. Table sorted by time

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT DOES NOT APPEAR TO BE IN CONFORMANCE WITH THE MALDISTRIBUTION/UNNECESSARY DUPLICATION OF SERVICE CRITERION (77 IAC 1110.730 (c)).

C) Criterion 1110.730 (e) - Staffing Availability The applicant shall document that relevant clinical and professional staffing needs for the proposed project were considered and that licensure and JCAHO staffing requirements can be met. In addition, the applicant shall document that necessary staffing is available by providing letters of interest from prospective staff members, completed applications for employment, or a narrative explanation of how the proposed staffing will be achieved. The applicants state the following: “The proposed acute mental illness (AMJ) unit will meet or exceed all licensure, JCAHO and industry staffing-related standards. A Board-Certified psychiatrist will be named to the position of Medical Director. The initial Medical Director will be named approximately three months prior to the unit's opening, and will lead the process of adapting as necessary Alexian Brothers Behavioral Health Hospital's clinical policies and treatment protocols for use in the AMI unit setting. The nursing and therapy staff will include experienced registered nurses and therapists, many of which will have either worked at ABBHH, or completed an orientation process at that facility. All personnel will undergo a unit orientation process, led by the Medical Director and members of the clinical leadership team. Positions will initially be made available to Alexian Brothers Health System employees, including those working at ABBHH. Subsequent to the initial internal posting of available positions, normal recruitment means, such as advertisements in local newspapers and professional publications will be used to attract and hire qualified staff. “ The applicants have provided the necessary narrative and have met the requirements of this criterion. (Application page 68)

 Page18

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE STAFFING AVAILABILITY CRITERION (77 IAC 1110.730 (e)).

D) Criterion 1110.730 (f) - Performance Requirements

1) The minimum unit size for a new AMI unit within an MSA is 20 beds.

2) The minimum unit size for a new AMI unit outside an MSA is 10 beds.

The applicants are proposing a 25 bed AMI Unit. This meets the minimum unit size of 20 beds for a facility located in an MSA. The applicants have met this criterion. (Application page 69)

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE PERFORMANCE REQUIREMENTS CRITERION (77 IAC 1110.730 (f)).

E) Criterion 1110.730 (g) - Assurances The applicant representative who signs the CON application shall submit a signed and dated statement attesting to the applicant's understanding that, by the second year of operation after the project completion, the applicant will achieve and maintain the occupancy standards specified in 77 Ill. Adm. Code 1100 for each category of service involved in the proposal.

The applicants provided the necessary assurance as required by this criterion. (Application page 70) THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE ASSURANCES CRITERION (77 IAC 1110.730 (g)).

XI. Availability of Funds

A. Criterion 1120.120 (a) Availability of Funds The applicant shall document that financial resources shall be available and be equal to or exceed the estimated total project cost plus any related project costs by providing evidence of sufficient financial resources. The cost of the project is $1,281,000. All project costs will be funded from internal sources of cash. The applicants have furnished audited financial statements that documented sufficient cash to fund the project. The applicants have met the requirements of this criterion.

 Page19

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE AVAILABILITY OF FUNDS CRITERION (77 IAC 1120.120).

XII. Financial Viability

A) Criterion 1120.130 (a) - Financial Viability Waiver The applicant is NOT required to submit financial viability ratios if:

1) all project capital expenditures, including capital expended through a

lease, are completely funded through internal resources (cash, securities or received pledges); or

HFSRB NOTE: Documentation of internal resources availability shall be available as of the date the application is deemed complete.

2) the applicant's current debt financing or projected debt financing is

insured or anticipated to be insured by Municipal Bond Insurance Association Inc. (MBIA), or its equivalent; or

HFSRB NOTE: MBIA Inc is a holding company whose subsidiaries provide financial guarantee insurance for municipal bonds and structured financial projects. MBIA coverage is used to promote credit enhancement as MBIA would pay the debt (both principal and interest) in case of the bond issuer's default.

3) the applicant provides a third-party surety bond or performance

bond letter of credit from an A rated guarantor (insurance company, bank or investing firm) guaranteeing project completion within the approved financial and project criteria

The cost of the project is $1,281,000. All project costs will be funded from internal sources of cash. The applicants have met the requirements of this criterion. THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE FINANCIAL VIABILITY CRITERION (77 IAC 1120.130).

XIII. Economic Feasibility

A) Criterion 1120.140 (a) - Reasonableness of Financing Arrangements

No debt financing is being used for this project.

 Page20

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE REASONABLENESS OF FINANCING ARRANGEMENTS CRITERION (77 IAC 1120.140 (a)).

B) Criterion 1120.140 (b) - Conditions of Debt Financing No debt financing is being used for this project.

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE REASONABLENESS OF FINANCING ARRANGEMENTS CRITERION (77 IAC 1120.140 (b)).

C) Criterion 1120.140 (c) - Reasonableness of Project and Related Costs The applicant shall document that the estimated project costs are reasonable and shall document compliance with the State Board Standards. Preplanning Costs - These costs are $15,000 or 1.77% of modernization contingencies and equipment costs. This appears reasonable when compared to the State Board Standard of 1.8%. Modernization Costs and Contingencies These costs are $769,000 or $87.88 GSF. This appears reasonable when compared to the State Board Standard of $267 per GSF. Contingencies - These costs are $75,000 and are 9.94% of modernization. This appears reasonable when compared to the State Board Standard of 10-15%.

Architectural and Engineering Fees - These costs are $91,000 or 11.83% of modernization and contingency costs. This appears reasonable when compared to the State Board Standard of 7.76-11.66%.

Consulting and Other Fees – These costs are $60,000. The State Board does not have a standard for these costs Movable or Other Equipment – These costs are $286,000. The State Board does not have a standard for these costs. THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE REASONABLENESS OF PROJECT COSTS CRITERION (77 IAC 1120.140 (c)).

D) Criterion 1120.140 (d) - Projected Operating Costs The applicant shall provide the projected direct annual operating costs (in current dollars per equivalent patient day or unit of service) for the first full fiscal year at target utilization but no more than two years following project completion. Direct cost means the fully allocated costs of salaries, benefits and supplies for the service.

 Page21

The projected operating costs are $2179.13 per adjusted patient day. The State Board does not have a standard for these costs.

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE PROJECTED OPERATING COSTS CRITERION (77 IAC 1120.140 (d)).

E) Total Effect of the Project on Capital Costs

The applicant shall provide the total projected annual capital costs (in current dollars per equivalent patient day) for the first full fiscal year at target utilization but no more than two years following project completion.

The capital costs per adjusted patient day are $26.13. The State Board does not have a standard for these costs.

THE STATE BOARD STAFF FINDS THE PROPOSED PROJECT APPEARS TO BE IN CONFORMANCE WITH THE TOTAL EFFECT OF THE PROJECT ON CAPITAL COSTS CRITERION (77 IAC 1120.140 (e)).

Copyright © and (P) 1988–2006 Microsoft Corporation and/or its suppliers. All rights reserved. http://www.microsoft.com/mappoint/Portions © 1990–2005 InstallShield Software Corporation. All rights reserved. Certain mapping and direction data © 2005 NAVTEQ. All rights reserved. The Data for areas of Canada includes information taken with permission from Canadian authorities, including: © Her Majesty the Queen in Right of Canada, © Queen's Printer for Ontario. NAVTEQ and NAVTEQ ON BOARD are trademarks of NAVTEQ. © 2005 Tele Atlas North America, Inc. All rights reserved. Tele Atlas and Tele Atlas North America are trademarks of Tele Atlas, Inc.

13-062 Alexian Brothers Medical Center

0 mi 2 4 6 8

IDPH Number: 5009

HSA 7

HPA A-07

COUNTY: Suburban Cook County

OWNERSHIP: Alexian Brothers Behavioral Health Hospital

OPERATOR: Alexian Brothers Behavioral Health Hospital

Ownership, Management and General Information Patients by Race

White #####

Black ###

American Indian #

Asian ##

Hawaiian/ Pacific #

Hispanic or Latino: ###

Not Hispanic or Latino:#####

Unknown: #####

71.5%

2.8%

0.0%

1.4%

0.0%

24.1%

4.7%

76.5%

18.8%

Page 1Hospital Profile - CY 2012 Alexian Brothers Behavioral Health Hospital Hoffman EstatesPatients by Ethnicity

(Not Answered)

1650 Moon Lake BoulevardADDRESS

Church-RelatedMANAGEMENT:

CERTIFICATION:

Hoffman EstatesCITY:

ADMINISTRATOR NAME: Clayton Ciha

ADMINSTRATOR PHONE 847-882-1600 ext 8001

Birthing Data

Number of Total Births: 0

Number of Live Births: 0

Birthing Rooms: 0

Labor Rooms: 0

Delivery Rooms: 0

Labor-Delivery-Recovery Rooms: 0

Labor-Delivery-Recovery-Postpartum Rooms: 0

Level 1 Patient Days 0

Level 2 Patient Days 0

Level 2+ Patient Day 0

C-Section Rooms: 0

Newborn Nursery Utilization

Total Nursery Patientdays 0

CSections Performed: 0

Inpatient Studies 0

Outpatient Studies 0

Laboratory Studies

Kidney: 0

Heart: 0

Lung: 0

Heart/Lung: 0

Pancreas: 0

Liver: 0

Organ Transplantation

Total: 0

Studies Performed Under Contract 51,177

FACILITY DESIGNATION: Psychiatric Hospital

Unknown

0

0

0

0

0

0

0

141

Clinical Service

Peak Beds

Setup and

Staffed Admissions

Inpatient

Days

Average

Length

of Stay

Average

Daily

Census

Staffed Bed

Occupancy

Rate %

Medical/Surgical

Pediatric

Intensive Care

Obstetric/Gynecology

Long Term Care

Swing Beds

Neonatal

Acute Mental Illness

Rehabilitation

0

0

0

0

0

141

0

0

0 0 0

0 0 0

0 0 0

0 0 0

0 0

0 0 0

6,355 47,671 0

0 0

0 0 0

0

Observation

Days

0.0 0.0 0.0 0.0

0.0 0.0 0.0

0.0 0.0 0.0 0.0

0.0

0.0 0.0 0.0 0.0

0.0 0.0

0.0 0.0 0.0 0.0

0.0 0.0 0.0 0.0

0.0 0.0 0.0 0.0

7.5 130.6 92.6 92.6

Medicare Medicaid Charity CareOther Public Private Insurance Private Pay

Inpatients and Outpatients Served by Payor Source

Totals

1464 399 38 4335 15104

Facility Utilization Data by Category of Service

Authorized

CON Beds

12/31/2012

Peak

Census

Dedcated Observation

0

0

0

0

0

139

0

0

0 0

0 0

0 0

0

0 0

0

0-14 Years

15-44 Years

45-64 Years

65-74 Years

75 Years +

0

0

0Direct Admission

Transfers

Maternity

Clean Gynecology 0 0

0 0

0 0

0

(Includes ICU Direct Admissions Only)

Facility Utilization 6,355 47,671 0141 7.5 130.6

Inpatients

Outpatients

6,355

3814 1366 0 16232 0993 22,405

23.0% 6.3% 0.6% 68.2% 1.6% 0.2%

17.0% 6.1% 0.0% 72.4% 4.4% 0.0%

92.6

14,630,666 1,164,891 0 21,517,584 675,023 613,32837,988,164

564,7411,947,083 111,436 21,558,202 2,155,953 26,337,415 0

7.4% 2.1% 0.4% 81.9% 8.2%

38.5% 3.1% 0.0% 56.6% 1.8%

Inpatient and Outpatient Net Revenue by Payor Source

Inpatient

Revenue ( $)

Outpatient

Revenue ( $)

100.0%

100.0%

613,328

1.0%

Medicare Medicaid

Charity Care

ExpenseOther Public Private Insurance Private Pay Totals

Total Charity Care as % of Net Revenue

7/1/2011 6/30/2012Financial Year Reported: to Total Charity Care Expense

CON

Occupancy

Rate %

Long-Term Acute Care 0 0.0 0.00 00 00 0.0 0.0

Page 2Alexian Brothers Behavioral Health Hospital Hoffman Estates

Source: 2012 Annual Hospital Questionnaire, Illinois Department of Public Health, Health Systems Development.

Emergency/Trauma Care

Persons Treated by Emergency Services: 0

Patients Admitted from Emergency: 0

Stand-ByEmergency Service Type:

Level of Trauma Service

Operating Rooms Dedicated for Trauma Care 0

Patients Admitted from Trauma 0

Number of Trauma Visits: 0

Level 1

(Not Answered)

Level 2

(Not Answered)

Total ED Visits (Emergency+Trauma): 0

Outpatient Visits at the Hospital/ Campus: 57,348

Outpatient Service Data

Total Outpatient Visits 142,247

Outpatient Visits Offsite/off campus 84,899

Cardiac Catheterization Labs

Total Cath Labs (Dedicated+Nondedicated labs): 0

Dedicated Interventional Catheterization Labs 0

Interventional Catheterizations (0-14): 0

EP Catheterizations (15+) 0

Interventional Catheterization (15+) 0

Cardiac Surgery Data

Pediatric (0 - 14 Years): 0

Adult (15 Years and Older): 0

Coronary Artery Bypass Grafts (CABGs) performed of total Cardiac Cases : 0

Total Cardiac Surgery Cases: 0

Diagnostic Catheterizations (15+) 0

Dedicated EP Catheterization Labs 0

Cath Labs used for Angiography procedures 0

Dedicated Diagnostic Catheterization Lab 0

Diagnostic Catheterizations (0-14) 0

Cardiac Catheterization Utilization

Total Cardiac Cath Procedures: 0

Number of Emergency Room Stations 0

Certified Trauma Center No

Hospital Profile - CY 2012

General Radiography/Fluoroscopy 0 0 0

Diagnostic/Interventional

Equipment

0 0 0Nuclear Medicine

Mammography

Ultrasound

Diagnostic Angiography

Positron Emission Tomography (PET)

Computerized Axial Tomography (CAT)

Magnetic Resonance Imaging

Lithotripsy

0 0 0

0 0 0

0 0

0 0 0

0 0 0

0 0 0

Owned Contract Inpatient Outpt

Linear Accelerator 0 0

0

0

0

0

0

0

0

0

Therapies/

Treatments

00Interventional Angiography

0 0 0Proton Beam Therapy

Gamma Knife 0 0 0

Cyber knife 0 0 0

0 0 0

Radiation Equipment

Owned Contract

Examinations

0

0

0 0 0

Image Guided Rad Therapy

Intensity Modulated Rad Thrp

High Dose Brachytherapy

0 0

0 0

0 0Angiography

Contract

0

0

0

0

0

0

0

0

0

Dedicated and Non-Dedicated Procedure Room Utilzation

Procedure Type

Gastrointestinal

Laser Eye Procedures

Pain Management

0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0

Cystoscopy 0 0 0 0 0 0 0 0 0

Multipurpose Non-Dedicated Rooms

Inpatient Outpatient

Hours per Case

0.0 0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

Inpatient Outpatient Combined Total

Procedure Rooms

Inpatient Outpatient

Surgical Cases

Inpatient Total HoursOutpatient

Surgical Hours

0 0 0 0 0 0 0 0 0 0.0 0.0

0 0 00 0 0 0 0

Surgical Specialty

Inpatient Outpatient Combined Total Inpatient Inpatient Total HoursOutpatient Outpatient

0Cardiovascular

0 0 00 0 0 0 0 0Dermatology

0 0 00 0 0 0 0 0General

Gastroenterology

Neurology

OB/Gynecology

Oral/Maxillofacial

Ophthalmology

Orthopedic

Otolaryngology

Plastic Surgery

Podiatry

Thoracic

Urology

Totals

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

0 0 00 0 0 0 0 0

Stage 1 Recovery Stations 0 Stage 2 Recovery Stations 0SURGICAL RECOVERY STATIONS

Operating Rooms Surgical Cases Surgical Hours

0.0 0.0

Inpatient Outpatient

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

0.0 0.0

Hours per Case

Surgery and Operating Room Utilization

IDPH Number: 2238

HSA 7

HPA A-07

COUNTY: Suburban Cook County

OWNERSHIP: Alexian Brothers Health System

OPERATOR: Alexian Brothers Health System

Ownership, Management and General Information Patients by Race

White ######

Black ###

American Indian #

Asian #####

Hawaiian/ Pacific #

Hispanic or Latino:#####

Not Hispanic or Latino:######

Unknown: ###

86.4%

2.7%

0.0%

5.8%

0.0%

5.0%

8.0%

89.4%

2.6%

Page 1Hospital Profile - CY 2012 Alexian Brothers Medical Center Elk Grove VillagePatients by Ethnicity

(Not Answered)

800 Biesterfield RoadADDRESS

Church-RelatedMANAGEMENT:

CERTIFICATION:

Elk Grove VillageCITY:

ADMINISTRATOR NAME: John Werrbach

ADMINSTRATOR PHONE (847) 981-5774

Birthing Data

Number of Total Births: 2,309

Number of Live Births: 2,301

Birthing Rooms: 0

Labor Rooms: 0

Delivery Rooms: 0

Labor-Delivery-Recovery Rooms: 10

Labor-Delivery-Recovery-Postpartum Rooms: 0

Level 1 Patient Days 4,515

Level 2 Patient Days 1,482

Level 2+ Patient Day 387

C-Section Rooms: 2

Newborn Nursery Utilization

Total Nursery Patientdays 6,384

CSections Performed: 819

Inpatient Studies 703,042

Outpatient Studies 939,542

Laboratory Studies

Kidney: 0

Heart: 0

Lung: 0

Heart/Lung: 0

Pancreas: 0

Liver: 0

Organ Transplantation

Total: 0

Studies Performed Under Contract 26,237

FACILITY DESIGNATION: General Hospital

Unknown

241

36

16

28

0

0

66

0

Clinical Service

Peak Beds

Setup and

Staffed Admissions

Inpatient

Days

Average

Length

of Stay

Average

Daily

Census

Staffed Bed

Occupancy

Rate %

Medical/Surgical

Pediatric

Intensive Care

Obstetric/Gynecology

Long Term Care

Swing Beds

Neonatal

Acute Mental Illness

Rehabilitation

229

36

16

0

66

0

0

28

13,146 64,337 5,569

2,606 8,361 33

0 0 0

0 0 0

0 0

1,459 21,545 0

0 0 0

7,196 165

0 0 0

2,765

Observation

Days

0.0 0.0 0.0 0.0

5.3 191.5 79.5

3.2 23.0 63.9 63.9

83.6

2.7 20.2 72.0 72.0

0.0 0.0

0.0 0.0 0.0 0.0

0.0 0.0 0.0 0.0

14.8 59.0 89.4 89.4

0.0 0.0 0.0 0.0

Medicare Medicaid Charity CareOther Public Private Insurance Private Pay

Inpatients and Outpatients Served by Payor Source

Totals

9260 2476 43 7236 556106

Facility Utilization Data by Category of Service

Authorized

CON Beds

12/31/2012

Peak

Census

Dedcated Observation

241

34

0

0

64

0

0

28

1,586 5,886

338 1,257

4,529 25,084

17,643

2,762 14,467

3,931

0-14 Years

15-44 Years

45-64 Years

65-74 Years

75 Years +

7,404

957

2,307Direct Admission

Transfers

Maternity

Clean Gynecology 345 1,115

2,420 6,081

0 0

299

(Includes ICU Direct Admissions Only)

Facility Utilization 19,677 101,439 5,767387 5.4 293.7

Inpatients

Outpatients

19,677

112977 52913 793 233809 24244108 407,024

47.1% 12.6% 0.2% 36.8% 0.5% 2.8%

27.8% 13.0% 0.2% 57.4% 1.0% 0.6%

75.9

105,609,694 12,102,180 298,415 95,825,242 2,149,469 4,158,489215,985,000

7,058,48142,703,008 436,355 168,354,820 4,320,336 222,873,000 2,974,824

19.2% 3.2% 0.2% 75.5% 1.9%

48.9% 5.6% 0.1% 44.4% 1.0%

Inpatient and Outpatient Net Revenue by Payor Source

Inpatient

Revenue ( $)

Outpatient

Revenue ( $)

100.0%

100.0%

7,133,313

1.6%

Medicare Medicaid

Charity Care

ExpenseOther Public Private Insurance Private Pay Totals

Total Charity Care as % of Net Revenue

7/1/2011 6/30/2012Financial Year Reported: to Total Charity Care Expense

CON

Occupancy

Rate %

Long-Term Acute Care 0 0.0 0.00 00 00 0.0 0.0

Page 2Alexian Brothers Medical Center Elk Grove Village

Source: 2012 Annual Hospital Questionnaire, Illinois Department of Public Health, Health Systems Development.

Emergency/Trauma Care

Persons Treated by Emergency Services: 48,749

Patients Admitted from Emergency: 10,966

ComprehensiveEmergency Service Type:

Level of Trauma Service

Operating Rooms Dedicated for Trauma Care 1

Patients Admitted from Trauma 976

Number of Trauma Visits: 1,224

Level 1

(Not Answered)

Level 2

Adult

Total ED Visits (Emergency+Trauma): 49,973

Outpatient Visits at the Hospital/ Campus: 400,765

Outpatient Service Data

Total Outpatient Visits 407,024

Outpatient Visits Offsite/off campus 6,259

Cardiac Catheterization Labs

Total Cath Labs (Dedicated+Nondedicated labs): 4

Dedicated Interventional Catheterization Labs 0

Interventional Catheterizations (0-14): 0

EP Catheterizations (15+) 394

Interventional Catheterization (15+) 814

Cardiac Surgery Data

Pediatric (0 - 14 Years): 0

Adult (15 Years and Older): 198

Coronary Artery Bypass Grafts (CABGs) performed of total Cardiac Cases : 124

Total Cardiac Surgery Cases: 198

Diagnostic Catheterizations (15+) 933

Dedicated EP Catheterization Labs 1

Cath Labs used for Angiography procedures 0

Dedicated Diagnostic Catheterization Lab 0

Diagnostic Catheterizations (0-14) 0

Cardiac Catheterization Utilization

Total Cardiac Cath Procedures: 2,141

Number of Emergency Room Stations 34

Certified Trauma Center Yes

Hospital Profile - CY 2012

General Radiography/Fluoroscopy 26 30,791 46,024

Diagnostic/Interventional

Equipment

4 2,184 2,546Nuclear Medicine

Mammography

Ultrasound

Diagnostic Angiography

Positron Emission Tomography (PET)

Computerized Axial Tomography (CAT)

Magnetic Resonance Imaging

Lithotripsy

5 44 21,567

10 8,246 17,380

0 0

1 12 1,056

6 12,404 19,667

4 3,634 8,690

Owned Contract Inpatient Outpt

Linear Accelerator 2 9,120

0

0

0

0

0

0

0

0

Therapies/

Treatments

1,0502,076Interventional Angiography

0 0 0Proton Beam Therapy

Gamma Knife 1 0 212

Cyber knife 0 0 0

0 0 0

Radiation Equipment

Owned Contract

Examinations

2,298

2,269

1 0 248

Image Guided Rad Therapy

Intensity Modulated Rad Thrp

High Dose Brachytherapy

0 0

0 0

2 0Angiography

Contract

0

0

0

0

0

0

0

0

0

Dedicated and Non-Dedicated Procedure Room Utilzation

Procedure Type

Gastrointestinal

Laser Eye Procedures

Pain Management

0 0 7 7 2166 7481 3491 12024 15515

0 0 1 1 0 67 0 7 7

0 0 1 1 20 642 20 642 662

0 0 6 6 100 1213 128 1200 1328

0 0 0 0 0 0 0 0 0

Cystoscopy 0 0 1 1 2 53 1 26 27

Multipurpose Non-Dedicated Rooms

Minor

Inpatient Outpatient

Hours per Case

1.6 1.6

0.0

1.0

0.5

1.3

0.0

0.1

1.0

0.5

1.0

0.0

Inpatient Outpatient Combined Total

Procedure Rooms

Inpatient Outpatient

Surgical Cases

Inpatient Total HoursOutpatient

Surgical Hours

0 0 0 0 0 0 0 0 0 0.0 0.0

1425 9 14340 2 2 292 5

Surgical Specialty

Inpatient Outpatient Combined Total Inpatient Inpatient Total HoursOutpatient Outpatient

0Cardiovascular

0 0 00 0 0 0 0 0Dermatology

2542 2466 50080 0 12 12 1465 2011General

Gastroenterology

Neurology

OB/Gynecology

Oral/Maxillofacial

Ophthalmology

Orthopedic

Otolaryngology

Plastic Surgery

Podiatry

Thoracic

Urology

Totals

1 1 20 0 0 0 1 1

1163 238 14010 0 0 0 340 116

493 957 14500 0 0 0 232 863

21 118 1390 0 0 0 10 72

3928 3689 76170 0 0 0 1547 2353

166 777 9430 0 0 0 60 448

62 504 5660 0 0 0 38 317

201 1088 12890 0 0 0 130 649

355 57 4120 0 0 0 137 48

688 717 14050 0 1 1 382 741

4 80 840 0 0 0 3 58

11049 10701 217500 0 15 15 4637 7682

Stage 1 Recovery Stations 15 Stage 2 Recovery Stations 30SURGICAL RECOVERY STATIONS

Operating Rooms Surgical Cases Surgical Hours

4.9 1.8

Inpatient Outpatient

0.0 0.0

1.7 1.2

1.0 1.0

3.4 2.1

2.1 1.1

2.1 1.6

2.5 1.6

2.8 1.7

1.6 1.6

1.5 1.7

2.6 1.2

1.8 1.0

1.3 1.4

2.4 1.4

Hours per Case

Surgery and Operating Room Utilization