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2022Community Health NeedsAssessment

2 I Community Health Needs AssessmentTABLE OF CONTENTSINTRODUCTION.......................................................................................................................................5-8Executive Summary..............................................................................................................................................7-10Background...............................................................................................................................................................10-13Faireld Memorial Hospital Services......................................................................................................14-16Local Impact of COVID.......................................................................................................................................16-17ESTABLISHING THE CHNA INFRASTRUCTURE AND PARTNERSHIPS.........................19 DATA COLLECTION............................................................................................................................19-23Secondary Data.....................................................................................................................................................19-21Primary Data............................................................................................................................................................21-23DATA ANALYSIS...................................................................................................................................25-80Demographics.......................................................................................................................................................25-28Social Determinants of Health...................................................................................................................29-53Health and Wellness Indicators...............................................................................................................40-79- Chronic Illness....................................................................................................................................................58-74- Substance Use..........................................................................................................................................................75- Mental and Behavioral Health...............................................................................................................76-79Emergency Preparedness...................................................................................................................................80Copyright ©2022 by the Illinois Critical Access Network (ICAHN). All rights reserved. The contents of this publication may not be copied, reproduced, replaced, distributed, published, displayed, modied, or transferred in any form or by any means except with the prior permission of ICAHN. Copyright infringement is a violation of federal law subject to criminal and civil penalties.

Faireld Memorial Hospital I 3IDENTIFICATION AND PRIORITIZATION OF NEEDS.........................................................83-84Process................................................................................................................................................................................83Description of the Community Health Needs Identied...............................................................84 RESOURCES AVAILABLE TO MEET PRIORITY HEALTH NEEDS........................................87Hospital Resources....................................................................................................................................................87Healthcare Partners or other Resources including Telemedicine.........................................87Community Resources...........................................................................................................................................87DOCUMENTING AND COMMUNICATING RESULTS................................................................89 IMPLEMENTATION STRATEGY...................................................................................................90-96Planning Process.........................................................................................................................................................90Implementation Strategy..............................................................................................................................92-96REFERENCES AND APPENDIX....................................................................................................97-98

Faireld Memorial Hospital I 5INTRODUCTIONFaireld Memorial Hospital has been serving the healthcare needs of the surrounding area since 1950. Upon its opening, Faireld Memorial Hospital was equipped with 84 beds and was staed with six resident physicians and 24 registered nurses. In 1966, Faireld Memorial Hospital announced its expansion project, which consisted of attached oces adjoining the hospital, now known as the Mattie B. Rinard Building. In 1975, Faireld Memorial Hospital opened its Intensive Care Unit.In 1998, Faireld Memorial Hospital completed a $4.1 million expansion project. This expansion included, but was not limited to, a new surgical and emergency department, along with expansion of the laboratory and imaging departments. Additionally, the entire second oor was converted to all-private rooms. In August 2008, FMH opened Horizon Healthcare, a certied hospital based-rural health clinic, in a temporary building until the construction of the new FMH Medical Arts Complex was complete. In May 2011, FMH opened the Medical Arts Complex, a 25,468 square foot facility, which includes Horizon Healthcare, specialist suites, board room, and community/education rooms.In February of 2020, Faireld Memorial Hospital broke ground on its $21 million expansion project which includes a new Emergency Department with two dedicated psychiatric beds and an additional four exam rooms.AdolescentsAdultsSeniorsEarly Childhood AdolescentsAdultsSeniors

6 I Community Health Needs AssessmentToday, Faireld Memorial Hospital provides numerous services including a 30-bed Skilled Care Unit, Home Health services, 24-hour emergency care, Intensive Care Unit, Urgent Care, designated Comfort Care rooms, surgical services, diagnostic imaging (CT scanning, ultrasound, 3-Digital Mammography, PET-CT, nuclear medicine, bone density, MRI, general x-ray procedures), cardiac rehabilitation, 24-hour laboratory services, diabetes education, sleep studies, physical therapy, occupational therapy, speech language pathology, hydrotherapy, industrial rehabilitation, pulmonary rehabilitation, and respiratory therapy. Faireld Memorial Hospital’s acute care and intensive care units have all-private rooms, and the Skilled Care Unit has both private and semi-private rooms. Services provided in the Mattie B. Rinard Building and FMH Medical Arts Complex include DaVita dialysis, FMH Senior Life Solutions (intensive outpatient geriatric psychiatric services), heart care, cancer care specialists, podiatry, orthopedics, and urology care. Faireld Memorial Hospital is a critical access hospital in southern Illinois. In addition to the hospital and Horizon Health Care in Faireld, there are clinics in Cisne, Grayville and Carmi.Faireld Memorial Hospital’s commitment – and impact – is seen in the growth and progress they are experiencing that is very dierent from national rural health trends.

Faireld Memorial Hospital I 7Provisions in the Aordable Care Act (ACA) require charitable hospitals to conduct a Community Health Needs Assessment (CHNA). The CHNA is a systematic process involving the community to identify and analyze community health needs as well as community assets and resources in order to plan and act upon priority community health needs. This assessment process results in a CHNA report which assists the hospital in planning, implementing, and evaluating hospital strategies and community benet activities. The Community Health Needs Assessment was developed and conducted, in partnership with representatives from the community, by a consultant provided through the Illinois Critical Access Hospital Network (ICAHN). ICAHN is a not-for-prot 501(c)(3) corporation established in 2003 for the purposes of sharing resources, education, promoting operational eciencies, and improving healthcare services for member critical access and rural hospitals and their communities.ICAHN, with 57 member hospitals, is an independent network governed by a nine-member board of directors, with standing and project development committees facilitating the overall activities of the network. ICAHN continually strives to strengthen the capacity and viability of its members and rural health providers. This Community Health Needs Assessment will serve as a guide for planning and implementation of healthcare initiatives that will allow the hospital and its partners to best serve the emerging health needs of Faireld and the surrounding area. The CHNA process was coordinated by the Executive Assistant/Sta Accountant.Two focus groups met to discuss the state of overall health and wellness in the Faireld Memorial Hospital service area and to identify health concerns and needs in the delivery of healthcare and health services in order to improve wellness and reduce chronic illness for all residents. The focus groups included representation of healthcare providers, community leaders, community services providers, schools, a community college, faith-based organizations, local elected ocials, public health and others. Some members of these groups provided services to underserved and unserved persons as all or part of their roles.EXECUTIVE SUMMARY

8 I Community Health Needs AssessmentThe ndings of the focus groups were presented, along with secondary data analyzed by the consultant, to a third group for identication and prioritization of the signicant health needs facing the community. The group consisted of representatives of public health, community leaders, healthcare providers, and community services providers.IDENTIFICATION AND PRIORITIZATION ADDRESSING THE NEED At the conclusion of their review and discussion, the identication and prioritization group advanced the following needs:1. The group rst identied and prioritized availability of mental healthand substance abuse services, including:– Improved access for transportation (local and distant) for personswith mental health and substance use disorders– Access to a local psychiatrist– Improved access to social workers, licensed counselors, and certied peer counselors– Increased education for parents and youth about mental healthand substance use issues2. The group next prioritized transportation– Strengthen local ambulance services– Improved access to reliable, exible transportation to and from medical appointments and careAvailability of Mental Health and Substance Abuse ServicesTransportation Access toPhysical Therapy

Faireld Memorial Hospital I 93. The third prioritized need was improved access to physical therapyand local opportunities for recreation and education.– Improve access to physical therapy services at Faireld MemorialHospital– Improved community access to opportunities for recreation and exercise for all ages in all seasonsThe results of the assessment process were then presented to senior sta at Faireld Memorial Hospital through a facilitated discussion for development of a plan to address the identied and prioritized needs. ADDRESSING THE NEED CREATING THE PLANThe group addressed the needs with the following strategies:• Faireld Memorial Hospital will explore partnerships to develop additional mental health and substance use resources.• Faireld Memorial Hospital will explore the potential to recruit a local psychiatrist.• Faireld Memorial Hospital will explore recruitment of social workers, licensed clinical counselors, and certied peer counselors.• Faireld Memorial Hospital will collaborate with local agencies and providers as appropriate to address unmet mental health and substance use services and education needs, including transportation.• Faireld Memorial Hospital will explore opportunities for Mental Health First Aid training for adults and adults involved with youth and other appropriate community outreach programs.• Faireld Memorial Hospital will explore providing education to local ambulance services on nancial management.• Faireld Memorial Hospital will explore collaboration with local ambulance services, as may be reasonable and appropriate, to improve operations and provide education.

10 I Community Health Needs Assessment• Faireld Memorial Hospital will explore collaboration with RIDES Mass Transit to address transportation opportunities.• Faireld Memorial Hospital will explore opportunities for expanding therapy services.• Faireld Memorial Hospital will explore with community partners the need and operational feasibility of an indoor facility for recreation, exercise, and education located at FMH.BACKGROUNDThe Community Health Needs Process is conducted every three years. In response to issues identied and prioritized and the implementation strategy developed to address them, Faireld Memorial Hospital has taken the following steps since the last CHNA.Additionally, the Community Health Needs Process identied needs common to the world of healthcare. The process prioritized those needs based on primary and secondary data gathered into the four needs statements below. The logic model addresses these needs and sub-issues: 1. REDUCE OBESITYLong-term objective:Faireld Memorial Hospital will explore providing community education programs from the nutritionist. Faireld Memorial Hospital will explore youth education and awareness programs. Faireld Memorial Hospital will re-establish a weight loss clinic.Year One Activities:• Each month the FMH Dietitian shares a healthy recipe with sta that is also shared with the public via the hospital’s Facebook page for social media.

Faireld Memorial Hospital I 11• Plans for working with the public during educational programs was put on hold in March 2020 as the COVID pandemic took the forefront for all activities. Social distancing rules and regulations were put into place that did not allow for hospital sta to enter into the schools.Year Two Activities:• It was determined to focus eorts on the ongoing pandemic, and the decision was made to not establish a weight loss clinic due to social distancing requirements. Each month, the dietitian shares a healthy menu through social media. Healthy options are available in the FMH Cafe.2. ADDRESS SUBSTANCE ABUSE THROUGH EXPANDED PREVENTION EDUCATION AT YOUNG AGESLong-term objective:Faireld Memorial Hospital will explore formation of a SADD (Students Against Drunk Driving) program or similar youth prevention eort with high school students. Faireld Memorial Hospital will collaborate with schools to bring appropriate substance abuse prevention programs to students.Year One Activities:• Plans for working with the students to develop a SADD program was put on hold in March 2020 as the COVID pandemic took the forefront for all activities. Social distancing rules and regulations were put into place that did not allow for hospital sta to enter into the schools.Year Two Activities:• Plans will be developed to work with schools as soon as regulations allow. Will look into the possibility of starting in the fall of 2022 school year, if pandemic rules and regulations allow for use of a demonstration room that shows parents signs to look for in their child’s room as an indicator they may be using drugs.

12 I Community Health Needs Assessment3. EXPANDED ACCESS TO DETOXIFICATIONLong-term objective:Faireld Memorial Hospital will explore the feasibility of local inpatient detoxication. Faireld Memorial Hospital will explore available partners for a detoxication center for transfers.Year One Activities:• The COVID pandemic took the forefront for all activities in the past year, starting in March 2020. The feasibility of local inpatient detoxication is not a possibility now with so many resources directed at dealing with the pandemic.• A list of detoxication centers for transfers is available for crisis interventionists and nursing sta.Year Two Activities:• Will continue to work on gathering a list of resources for patients needing detoxication as more information becomes available. 4. EXPANDED LOCAL SERVICES FOR SUICIDE AND OTHER MENTAL CRISESLong-term objective:Faireld Memorial Hospital will build a new Emergency Room with two dedicated psychiatric use rooms. Faireld Memorial Hospital will hire a crisis interventionist.Year One Activities:• Faireld Memorial Hospital broke ground on its $21 million dollar expansion project in February 2020. In this expansion, the hospital will be expanding its Emergency Department to include an additional four exam rooms to bring the Emergency Department to a total of nine beds. Two of the rooms in the new addition will be designated for mental illness beds, including drug abuse patients. The two mental illness rooms are designed to have doors that will close over the wall of equipment and supplies at the touch of a button to stop any patient from accessing supplies or any other item which could result in injury. Work on the expansion project is projected to be completed in 2022.

Faireld Memorial Hospital I 13• Four full-time crisis interventionists were added to the Faireld Memorial Hospital sta to assist with the growing emergent mental health needs of its patients and community.• Faireld Memorial Hospital employs three full-time behavioral health therapists who see patients in the Faireld and Carmi clinics. Year Two Activities:• Work will continue on the expansion project throughout 2022 and 2023 as Faireld Memorial Hospital progresses through Phases I, II, and III.Faireld Memorial Hospital’s executive sta will evaluate achievement of activities and meeting the appropriate specied outcomes on an annual basis and will report their ndings regarding the progress of the Implementation Strategy to the Board of Directors for appropriate response or action and for use in reporting progress to regulators as required.

14 I Community Health Needs AssessmentFor the purpose of this CHNA, Faireld Memorial Hospital has dened its primary service area and populations as the general population within the geographic area in and surrounding Faireld, dened in detail below. The hospital’s patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. A total of 43,534 people live in the 1,482.71 square mile service area dened for this assessment, according to the U.S. Census Bureau American Community Survey 2015-2019 5-year estimates. The population density for this area, estimated at 29 persons per square mile, is less than the national average population density of 92 persons per square mile. The service area consists of all or portions of the following rural counties: Clay, Edwards, Gallatin, Hamilton, Saline, Wabash, Wayne, and White.Including the following communities: Faireld, Carmi, Cisne, Albion, Barnhill, Ellery, Golden Gate, Ge, Burnt Prairie, Mills Shoals, Simms, Mt. Erie, Grayville, Wayne City, Eneld, Crossville, Johnsonville, Norris City, Rinard, Springerton, Flora, Clay City, and West Salem.AREA SERVED BY FAIRFIELD MEMORIAL HOSPITALFairfield Memorial Hospital Service Area 2022February 21, 2022©2022 Esri Page 1 of 1

Faireld Memorial Hospital I 15Faireld Memorial Service Area - Key Facts20 ZIP Codes Prepared by Esri62446 (Mount Erie) et al. Geography: ZIP Code KEY FACTS33,665Population45.4Median Age2.3AverageHousehold Size$51,325Median HouseholdIncomeEDUCATION10%No High SchoolDiploma36%High SchoolGraduate38%Some College16%Bachelor's/Grad/Prof DegreeBUSINESS1,304Total Businesses11,107Total EmployeesEMPLOYMENT54%White Collar36%Blue Collar10%Services4.0%UnemploymentRateINCOME$51,325Median HouseholdIncome$28,012Per Capita Income$152,582Median Net WorthHouseholds By IncomeThe largest group: $50,000 - $74,999 (20.6%)The smallest group: $200,000+ (2.2%)Indicator▲Value Diff<$15,000 11.4% +1.7%$15,000 - $24,999 11.0% +0.8%$25,000 - $34,999 10.9% -0.9%$35,000 - $49,999 15.1% -0.5%$50,000 - $74,999 20.6% +2.6%$75,000 - $99,999 13.4% -2.9%$100,000 - $149,999 12.2% -0.7%$150,000 - $199,999 3.2% 0$200,000+ 2.2% -0.1%Bars show deviation from Edwards CountyThis infographic contains data provided by Esri, Esri and Data Axle. The vintage of the data is 2021, 2026. © 2022 EsriThe infographic above highlights some of the key facts of that data and provides a snapshot of the population served by Faireld Memorial Hospital. The data on the following pages will take a deep dive into the demographics of Faireld Memorial Hospital’s service area and will oer insight to both the commonality and complexity of the Faireld Memorial Hospital audience. The average household size in the area, at 2.5, is lower than both Illinois (3.0) and the same as the U.S. (2.5) overall average. Median age is 41 years, which is higher than Illinois and the U.S. benchmark. The largest level of education is some college, followed by high school graduate.Faireld Memorial Hospital Service Area – Key Facts

16 I Community Health Needs AssessmentNote: This indicator is compared to the state average. Data Source: Johns Hopkins University. Accessed via ESRI. Additional data analysis by CARES. 2021. Source geography: CountyConrmed COVID-19 CasesLOCAL IMPACT OF COVIDCOVID-19 Conrmed Cases and MortalitiesThe COVID-19 epidemic has overshadowed many local health functions during 2020 and 2021. It has dramatically impacted overall health of the communities and the delivery of healthcare and health-related services. The broad impact has been seen throughout the communities, changing the way people work, shop, learn and communicate. The mortality rate related to COVID-19 in the service area of Faireld Memorial Hospital has generally exceeded the rate of the state of Illinois. In the service area, there have been 4,744 conrmed cases of COVID-19. The rate of conrmed cases is 35,795.67 per 100,000 population, which is grater than the state average of 24,704.25. Data are current as of 5/3/2022.The area’s unemployment rate of 4.8% is lower than statewide and slightly higher than the national average. Also, as is the case in much of rural Illinois, median family household income in the service area is lower than the statewide average.

Faireld Memorial Hospital I 17COVID-19 MortalitiesNote: This indicator is compared to the state average. Data Source: Johns Hopkins University. Accessed via ESRI. Additional data analysis by CARES. 2021. Source geography: CountyIn the service area, there have been 69 total deaths among patients with conrmed cases of the coronavirus disease COVID-19. Data are current as of 5/3/2022.

Faireld Memorial Hospital I 19Data Collection QuantitativeQualitativeData AnalysisESTABLISHING THE CHNA INFRASTRUCTURE AND PARTNERSHIPSData CollectionDescription of Data Sources – QuantitativeQuantitative (secondary) data is collected from many resources including, but not restricted to, the following:Source DescriptionBehavioral Risk Factor Surveillance SystemThe BRFSS is the largest, continuously conducted telephone health survey in the world. It enables the Center for Disease Control and Prevention (CDC), state health departments, and other health agencies to monitor modiable risk factors for chronic diseases and other leading causes of death.SparkMap SparkMapis an online mapping and reporting platform powered by the Center for Applied Research and Engagement Systems (CARES) at the University of Missouri. US Census National census data is collected by the US Census Bureau every 10 years.Centers for Disease ControlThrough the CDC’s National Vital Statistics System, states col-lect and disseminate vital statistics as part of the US’s oldest and most successful intergovernmental public health data sharing system.SECONDARY DATA

20 I Community Health Needs AssessmentSource DescriptionCounty Health RankingsEach year, the overall health of each county in all 50 states is assessed and ranked using the latest publicly available data through a collaboration of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.American Communities SurveyTheAmerican Community Survey(ACS), a product of the U.S. Census Bureau, helps local ocials, community leaders, and businesses understand the changes taking place in their communities. It is the premier source for detailed population and housing information about our nation.Illinois Department of Employment SafetyThe Illinois Department of Employment Security is the state’s employment agency. It collects and analyzes employment information.National CancerInstituteThe National Cancer Institute coordinates the National Cancer Program, which conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients, and the families of cancer patients. Illinois Department of Public HealthThe Illinois Department of Public Health is the state agencyresponsible for preventing and controlling disease and injury, regulating medical practitioners, and promoting sanitation.HRSA The Health Resources and Services Administration of the US Department of Health and Human Services develops health professional shortage criteria for the nation and uses that data to determine the location of Health Professional Shortage Areas and Medically Underserved Areas and Populations.Local IPLANS The Illinois Project for Local Assessment of Needs (IPLAN) is a communityhealth assessment and planning process that is conducted every ve years by local health jurisdictions in Illinois.ESRI ESRI (Environmental Systems Research Institute) is an international supplier ofGeographic Information System (GIS) software, web GIS and geodatabasemanagement applications. ESRI allows for specialized inquiries at the zip code, or other dened, level.Illinois State Board of EducationThe Illinois State Board of Education administers public education in the state of Illinois. Each year, it releases school “report cards” which analyze the makeup, needs, and performance of local schools.USDA USDA, among its many functions, collects and analyzes information related to nutrition and local production and food availability.

Faireld Memorial Hospital I 21Secondary data is initially collected through the SparkMap and/or ESRI systems and then reviewed. Questions raised by the data reported from those sources are compared with other federal, state and local data sources in order to resolve or reconcile potential issues with reported data. Two focus groups were convened at Faireld Memorial Hospital on March 31, 2022. The groups included representation of healthcare providers, community leaders, community services providers, schools, faith-based organizations, local elected ocials, law enforcement, and others on November 14, 2021. Several members of these groups provided services to underserved and unserved persons as all or part of their roles. In response to a request to identify positive developments in health and healthcare in the service area of Faireld Memorial Hospital, the groups put forward the following: Focus Group One – Community LeadersThe group was rst asked to identify positive developments since the last CHNA:• Faireld Memorial Hospital provides local orthopedic services• There has been signicant expansion of available local mental health services• Job development at Faireld Memorial Hospital has positively impacted the local economy• Faireld Memorial Hospital opened urgent care services• Faireld Memorial Hospital’s role as a community leader and partner has expanded greatly• Physical therapy services at Faireld Memorial Hospital have expanded, resulting in excellent local physical therapy opportunities• A strong partnership exists between Faireld Memorial Hospital and Frontier Community College• Faireld Memorial Hospital cooperates with area Shriners to provide clinicsPRIMARY DATA

22 I Community Health Needs Assessment• Faireld Memorial Hospital cooperates with area schools to provide sports physicals and other services• Faireld Memorial Hospital oers local urology services The group was then asked to identify needs that continue to exist in the areas of health, wellness, and the delivery of healthcare and health services for all residents of the service area. The group identied:• Address emotional trauma among youth by improving access to services and by identication and mitigation of root causes including substance use at home, domestic violence, childhood trauma, food insecurity, and other circumstances that prevent youth from feeling safe, healthy, and happy.• Access to aordable housing• Improve collaboration with schools for services for sports and other needs• An indoor health and recreation facility that could provide a public pool that can serve the community in general and provide opportunities for aqua-therapy, and a track and exercise equipment for recreation, exercise, and therapy for all seasons• Obstetrics services• Stability of ambulance services county-wide• Reasonable access to residential broadband throughout the service area Focus Group Two – Medical Professionals and PartnersThe group was rst asked to identify positive developments since the last CHNA:• Access to mental health services has improved as a result of developments at Faireld Memorial Hospital• Faireld Memorial Hospital has increased access to care away from the hospital campus through the addition of three satellite locations and traveling specialty services, including mental health• New dentist in the community• Addition of orthopedic services at Faireld Memorial Hospital• Faireld Memorial Hospital has recruited primary care providers

Faireld Memorial Hospital I 23• Faireld Memorial Hospital has expanded mid-level providers• Urgent care at Faireld Memorial Hospital• Bobcat Gym has opened at the community college and is oering Silver Sneakers• Frontier Community College oers a Certied Medical Assistant program, a Medical Laboratory Technician program, and several other healthcare degrees and certicates• Advanced Practice Residents at Faireld Memorial Hospital are able to observe mental health servicesThe group was then asked to identify needs that continue to exist in the areas of health, wellness, and the delivery of healthcare and health services for all residents of the service area. The group identied:• Local access to a psychiatrist for medical management of complex patients• Better access for opportunities for recreation and exercise for seniors• Better access to information about Medicare for providers and seniors• A community center with a track, gym, pool, and child care to provide a single location for recreation, exercise, and therapy• Reliable, exible public transportation• Local and distant transportation for mental health and substance use disorder patients• Expand education to parents about youth mental health and substance use issues and local services• Expand education to youth about mental health and substance use• Community programs like Pathways to Purpose and Village, Inc.• Outdoor opportunities for recreation and exercise• Better access to childcare, daycare, and after-school care• Better access to healthy foods for youth and adults and nutrition information• Address gaps in assessment and services for youth• Availability of case management services for non-Medicare patients

Faireld Memorial Hospital I 25Age Group EthnicityRaceDisabilityDATA ANALYSISTotal Population by Age GroupData Source: US Census Bureau, American Community Survey. 2016‐-20. Source Geography: TractDEMOGRAPHICS

26 I Community Health Needs AssessmentTotal Population by EthnicityData Source: US Census Bureau, American Community Survey. 2016-‐20. Source geography: TractTotal Population by Age Groups, Faireld Memorial Hospital Service Area

Faireld Memorial Hospital I 27Total Population by Race AloneData Source: US Census Bureau, American Community Survey. 2016‐-20. Source geography: TractTotal Population by Race Alone, Faireld Memorial Hospital Service Area

28 I Community Health Needs AssessmentPopulation with any DisabilityThis indicator reports the percentage of the total civilian non-institutionalized population with a disability. The report area has a total population of 43,002 for whom disability status has been determined, of which 7,850 or 18.25% have any disability. This indicator is relevant because disabled individuals comprise a vulnerable population that requires targeted services and outreach by providers.Data Source: US Census Bureau, American Community Survey. 2016-‐20. Source geography: Tract

Faireld Memorial Hospital I 29
SOCIAL DETERMINANTS OF HEALTHThe data and discussion on the following pages will take a look into the socialdeterminants in the Faireld Memorial Hospital service area and will oer insightinto the complexity of circumstances that impact physical and mental wellness forthe Faireld Memorial Hospital audience. The infographic on Page 31 provides asnapshot of the at-risk population served by Faireld Memorial Hospital.The CDC describes social determinants of health as conditions in the places wherepeople live, learn, work, and play that aect a wide range of health and quality oflife risks and outcomes. Healthy People 2030 uses a place-based framework thatoutlines ve key areas of SDoH:• Healthcare access and quality, including: - Access to healthcare- Access to primary care - Health insurance coverage- Health literacy• Education access and quality, including: - High school graduation- Enrollment in higher education- Educational attainment in general- Language and literacy- Early childhood education and development• Social and community context – within which people live, learn work  and play, including: - Civic participation - Civic cohesiveness- Discrimination - Conditions within the workplace• Economic stability, including: - Income- Cost of living - Socioeconomic status- Poverty

30 I Community Health Needs Assessment• - Employment - Food security - Housing stability• Neighborhood and built environment, including: - Quality of housing - Access to transportation - Availability of healthy food - Air and water quality - Crime and violenceSome of the social determinant indicators reected in the data include:• 5,015 households with disability• 2,052 households below the poverty level• Median household income is $51,325, which is lower than both Illinois and the U.S.• 2,966 or 8.79% of the 33,750 population of the service area (age 18 and older) are veterans.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: Tract

Faireld Memorial Hospital I 31AT RISK POPULATION PROFILEGeography: CountyFaireld Memorial Servce Area - At Risk Population20 ZIP Codes Prepared by Esri62446 (Mount Erie) et al. Geography: ZIP Code Version 1.8© 2022 EsriSource: Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey (ACS) Data,AT RISK POPULATION PROFILE20 ZIP CodesGeography: ZIP Code33,665Population14,590Households2.27Avg SizeHousehold45.4MedianAge$51,325MedianHousehold Income$94,316MedianHome Value62WealthIndex302HousingAffordability10DiversityIndexAT RISK POPULATION5,015Households WithDisability8,073Population 65+1,097HouseholdsWithout VehiclePOVERTY AND LANGUAGE14%Households Belowthe Poverty Level2,052Households Belowthe Poverty Level6Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES32,964DaytimePopulation1,304TotalBusinesses11,107TotalEmployeesPOPULATION BY AGE20,00016,00012,0008,0004,0000Aged65+18to65Under186,7177,59619,352Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 5,482 18,387 7,111 30,980Spanish 14 262 25 301Spanish & English Well 10 117 9 136Spanish & English Not Well 4 109 10 123Spanish & No English 0 37 6 43Indo-European 67 231 34 332Indo-European & English Well 48 199 34 281Indo-European & English Not Well 0 31 0 31Indo-European & No English 19 0 0 19Asian-Pacic Island 7 75 7 89Asian-Pacic Isl & English Well 7 72 7 86Asian-Pacic Isl & English Not Well 0 3 0 3Asian-Pacic Isl & No English 0 0 0 0Other Language 0 13 8 21Other Language & English Well 0 13 8 21Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Faireld Memorial Servce Area - At Risk Population20 ZIP Codes Prepared by Esri62446 (Mount Erie) et al. Geography: ZIP Code Version 1.8© 2022 EsriSource: Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey (ACS) Data,AT RISK POPULATION PROFILE20 ZIP CodesGeography: ZIP Code33,665Population14,590Households2.27Avg SizeHousehold45.4MedianAge$51,325MedianHousehold Income$94,316MedianHome Value62WealthIndex302HousingAffordability10DiversityIndexAT RISK POPULATION5,015Households WithDisability8,073Population 65+1,097HouseholdsWithout VehiclePOVERTY AND LANGUAGE14%Households Belowthe Poverty Level2,052Households Belowthe Poverty Level6Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES32,964DaytimePopulation1,304TotalBusinesses11,107TotalEmployeesPOPULATION BY AGE20,00016,00012,0008,0004,0000Aged65+18to65Under186,7177,59619,352Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 5,482 18,387 7,111 30,980Spanish 14 262 25 301Spanish & English Well 10 117 9 136Spanish & English Not Well 4 109 10 123Spanish & No English 0 37 6 43Indo-European 67 231 34 332Indo-European & English Well 48 199 34 281Indo-European & English Not Well 0 31 0 31Indo-European & No English 19 0 0 19Asian-Pacic Island 7 75 7 89Asian-Pacic Isl & English Well 7 72 7 86Asian-Pacic Isl & English Not Well 0 3 0 3Asian-Pacic Isl & No English 0 0 0 0Other Language 0 13 8 21Other Language & English Well 0 13 8 21Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Faireld Memorial Servce Area - At Risk Population20 ZIP Codes Prepared by Esri62446 (Mount Erie) et al. Geography: ZIP Code Version 1.8© 2022 EsriSource: Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey (ACS) Data,AT RISK POPULATION PROFILE20 ZIP CodesGeography: ZIP Code33,665Population14,590Households2.27Avg SizeHousehold45.4MedianAge$51,325MedianHousehold Income$94,316MedianHome Value62WealthIndex302HousingAffordability10DiversityIndexAT RISK POPULATION5,015Households WithDisability8,073Population 65+1,097HouseholdsWithout VehiclePOVERTY AND LANGUAGE14%Households Belowthe Poverty Level2,052Households Belowthe Poverty Level6Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES32,964DaytimePopulation1,304TotalBusinesses11,107TotalEmployeesPOPULATION BY AGE20,00016,00012,0008,0004,0000Aged65+18to65Under186,7177,59619,352Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 5,482 18,387 7,111 30,980Spanish 14 262 25 301Spanish & English Well 10 117 9 136Spanish & English Not Well 4 109 10 123Spanish & No English 0 37 6 43Indo-European 67 231 34 332Indo-European & English Well 48 199 34 281Indo-European & English Not Well 0 31 0 31Indo-European & No English 19 0 0 19Asian-Pacic Island 7 75 7 89Asian-Pacic Isl & English Well 7 72 7 86Asian-Pacic Isl & English Not Well 0 3 0 3Asian-Pacic Isl & No English 0 0 0 0Other Language 0 13 8 21Other Language & English Well 0 13 8 21Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Faireld Memorial Hospital Service Area

32 I Community Health Needs AssessmentEconomic Stability – Income and Economics Economic and social insecurity often are associated with poor health. Poverty, unemployment, and lack of educational achievement aect access to care and a community’s ability to engage in healthy behaviors. Without a network of support and a safe community, families cannot thrive. Ensuring access to social and economic resources provides a foundation for a healthy community.Employment – Unemployment Rate Total unemployment in the service area for the current month equals 808 or 4.5% of the civilian, non-institutionalized population age 16 and older (non-seasonally adjusted). This indicator is relevant because unemployment creates nancial instability and barriers to access including insurance coverage, health services, healthy food, and other necessities that contribute to poor health status.Note: This indicator is compared to the state average.Data Source: US Department of Labor, Bureau of Labor Statistics, 2022-February. Source geography: County

Faireld Memorial Hospital I 33Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: TractIncome – Median Household IncomeThis indicator reports median household income based on the latest 5-year American Community Survey estimates. This includes the income of the householder and all other individuals 15 years old and over in the household, whether they are related to the householder or not. Because many households consist of only one person, average household income is usually less than average *

34 I Community Health Needs AssessmentPoverty – Population Below 100% FPLPoverty is considered a key driver of health status. Within the service area, 13.63% or 5,783 individuals are living in households with income below the Federal Poverty Level (FPL). This indicator is relevant because poverty creates barriers to access including health services, health food, and other necessities that contribute to poor health status.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: Tract

Faireld Memorial Hospital I 35Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: TractPoverty – Children Below 100% FPLIn the service area, 19.81% or 1,898 children aged 0-17 are living in households with income below the Federal Poverty Level (FPL). This indicator is relevant because poverty creates barriers to access including health services, healthy food, and other necessities that contribute to poor health status.

36 I Community Health Needs AssessmentEducational AttainmentEducational attainment shows the distribution of the highest level of education achieved in the service area and helps schools and businesses to understand the needs of adults, whether it be workforce training or the ability to develop science, technology, engineering, and mathematics opportunities. Educational attainment is calculated for persons over 25 and is an estimated average for the period from 2014-2019.These indicators are important because education is closely tied to health outcomes and economic opportunity. For the selected area, 10.8% have at least a college bachelor’s degree, while 36.2% stopped their formal education attainment after high school.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: Tract

Faireld Memorial Hospital I 37Housing and FamiliesThis category contains indicators that describe the structure of housing and families and the condition and quality of housing units and residential neighborhoods. These indicators are important because housing issues like overcrowding and aordability have been linked to multiple health outcomes including infectious disease, injuries, and mental disorders. Furthermore, housing metrics like home-ownership rates and housing prices are key for economic analysis.Aordable HousingThis indicator reports the number and percentage of housing units aordable at various income levels. Aordability is dened by assuming that housing costs should not exceed 30% of total household income. Income levels are expressed as a percentage of each county’s area median household income (AMI).Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: Tract

38 I Community Health Needs AssessmentAordable Renter-Occupied Units, Percent Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: Tract

Faireld Memorial Hospital I 39Other Social and Economic FactorsEconomic and social insecurity often are associated with poor health. Poverty, unemployment, and lack of educational achievement aect access to care and a community’s ability to engage in healthy behaviors. Without a network of support and a safe community, families cannot thrive. Ensuring access to social and economic resources provides a foundation for a healthy community. Area Deprivation IndexThis indicator reports the average (population weighted) Area Deprivation Index (ADI) for the selected area. The Area Deprivation Index ranks neighborhoods and communities relative to all neighborhoods across the nation (national percentile) or relative to other neighborhoods within just one state (state percentile). The ADI is calculated based on 17 measures related to four primary domains (education, income and employment, housing, and household characteristics). The overall scores are measured on a scale of 1 to 100, where 1 indicates the lowest level of deprivation (least disadvantages) and 100 is the highest level of deprivation (most disadvantaged).Note: This indicator is compared to the state average. Data Source: University of Wisconsin-Madison School of Medicine and Public Health, Neighborhood Atlas, 2021. Source geography: Block group

40 I Community Health Needs AssessmentFood Insecurity RateThis indicator reports the estimated percentage of the population that experienced food insecurity at some point during the report year. Food insecurity is the household-level economic and social condition of limited or uncertain access to adequate food.Note: This indicator is compared to the state average.Data Source: Feeding America, 2017. Source geography: CountyHEALTH AND WELLNESS INDICATORS

Faireld Memorial Hospital I 41Food Insecurity – Food Insecure ChildrenThis indicator reports the estimated percentage of the population under age 18 that experienced food insecurity at some point during the report year. Food insecurity is the household-level economic and social condition of limited or uncertain access to adequate food.Food Environment – Food Desert Census TractThis indicator reports the number of neighborhoods in the service area that are within food deserts. The USDA Food Access Research Atlas denes a food desert as any neighborhood that lacks healthy food sources due to income level, distance to supermarkets, or vehicle access. The service area has a population of 8,616 living in food deserts and a total of three census tracts classied as food deserts by the USDA.

42 I Community Health Needs AssessmentFood Environment – Low Food AccessThis indicator reports the percentage of the population with low food access. Low food access is dened as living more than one-half mile from the nearest supermarket, supercenter, or large grocery store. Data are from the April 2021 Food Access Research Atlas dataset. This indicator is relevant because it highlights populations and geographies facing food insecurity. Within the service area, 14.78% of the total population have low food access. The total population in the service area with low food access is 6,644.Note: This indicator is compared to the state average. Data Source: U.S. Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas, 2019. Source geography: Tract.

Faireld Memorial Hospital I 43Food Environment – Low Income and Low Food AccessThis indicator reports the percentage of the low income population with low food access. Low food access is dened as living more than one-half mile from the nearest supermarket, supercenter, or large grocery store. Data are from the April 2021 Food Access Research Atlas dataset. This indicator is relevant because it highlights populations and geographies facing food insecurity. Within the service area, 14.14% of the total low income population have low food access. The total low income population in the service area with low food access is 2,251.Note: This indicator is compared to the state average. Data Source: U.S. Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas, 2019. Source geography: Tract.

44 I Community Health Needs AssessmentHomeless Children and YouthThis indicator reports the number of homeless children and youth enrolled in the public school system during the school year 2019-2020. According to the data source denitions, homelessness is dened as lacking a xed, regular, and adequate nighttime residence. Those who are homeless may be sharing the housing of other persons, living in motels, hotels, or camping grounds, in emergency transitional shelters, or may be unsheltered. Data are aggregated to the service area level based on school district summaries where three or more homeless children are counted. In the service area, of all the 6,231 students enrolled during the school year 2019-2020, there were 483 or 1.2% homeless students, which is lower than the statewide rate of 2.6%. Note: Data are available for 100.0% of school districts in the report area, representing 100.0% of the public school student population.Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, County Business Patterns, Additional data analysis by CARES, 2019. Source geography: County

Faireld Memorial Hospital I 45Insurance – Insurance Population and Provider TypeHealth insurance coverage is considered a key driver of health status. In the service area, 40,569 total civilians have some form of health insurance coverage. Of those, 69.62% have private insurance (e.g. insurance purchased through an employer or union), through direct purchase (e.g. on a health exchange) or have Tricare or other military health insurance. In addition, 48.09% have a form of public health insurance. Public health insurance includes the federal programs: Medicare, Medicaid, and VA Health Care (provided through the Department of Veterans Aairs) as well as the Children’s Health Insurance Program (CHIP). This indicator is relevant because insurance provides access to healthcare including regular primary care, specialty care, and other health services that prevent poor health status. Note: Percentages may exceed 100% as individuals may have more than one form of health insurance.Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, American Community Survey, 2018-2019. Source geography: County

46 I Community Health Needs AssessmentPhysical EnvironmentA community’s health is also aected by the physical environment. A safe, clean environment that provides access to healthy food and recreational opportunities is important to maintaining and improving community health. Built Environment – Broadband AccessThis indicator reports the percentage of population with access to high-speed internet. Data are based on the reported service area of providers oering download speeds of 25 MBPS or more and upload speeds of 3 MBPS or more. This data represent both wireline and xed/terrestrial wireless internet providers. Cellular internet providers are not included.Note: This indicator is compared to the state average. Data Source: National Broadband Map, December 2020. Source geography: Tract

Faireld Memorial Hospital I 47Built Environment – Households With No ComputerThis indicator reports the percentage of households who don’t own or use any types of computers including desktop or laptop, smartphone, tablet, or other portable wireless computer, or some other type of computer, based on the 2014-2019 American Community Survey estimates. Of the 18,829 total households in the service area, 3,090 or 16.41% are without a computer.Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, American Community Survey, 2015-2019. Source geography: Tract

48 I Community Health Needs AssessmentHouseholds With No or Slow InternetThis indicator reports the percentage of households who either use dial-up as their only way of internet connection, have internet access but do not pay for their service, or have no internet access in their home, based on the 2015-2019 American Community Survey estimates. Of the 18,829 total households in the service area, 4,748 or 25.22% have no or slow internet.Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, American Community Survey, 2015-2019. Source geography: Tract

Faireld Memorial Hospital I 49Clinical Care and PreventionA lack of access to care presents barriers to good health. Supply of facilities and physicians, the rate of uninsurance, nancial hardship, transportation barriers, cultural competency, and coverage limitations aect access. Rates of morbidity, mortality, and emergency hospitalizations can be reduced if community residents access services such as health screenings, routine tests, and vaccinations. Prevention indicators can call attention to a lack of access or knowledge regarding one or more health issues and can inform program interventions. Prevention – Core Prevention Services for MenThis indicator reports the percentage of males age 65 years and older who report that they are up-to-date on a core set of clinical preventive services. Services include: an inuenza vaccination in the past year, a pneumococcal vaccination (PPV) ever, and either a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past ve years and a FOBT within the past three years, or a colonoscopy within the past 10 years. Within the service area, there are 35.9% men 65 and older who had core preventative services in the last one to 10 years of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2018. Source geography: Tract

50 I Community Health Needs AssessmentPrevention – Core Prevention Services for WomenThis indicator reports the percentage of females age 65 years and older who report that they are up-to-date on a core set of clinical preventive services. Services include: an inuenza vaccination in the past year, a pneumococcal vaccination (PPV) ever, and either a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past ve years and a FOBT within the past three years, or a colonoscopy within the past 10 years, and a mammogram in the past two years. Within the service area, there are 25.4% women 65 and older who had core preventative services in the last one to 10 years of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2018. Source geography: Tract

Faireld Memorial Hospital I 51Health BehaviorsHealth behaviors such as poor diet, a lack of exercise, and substance abuse contribute to poor health status. Alcohol – Heavy Alcohol ConsumptionIn the service area, 2,815 or 21.24% adults self-report excessive drinking in the last 30 days, which is less than the state rate of 21.54%. Data for this indicator were based on survey responses to the 2018 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and are used for the 2021 County Health Rankings. Excessive drinking is dened as the percentage of the population who report at least one binge drinking episode involving ve or more drinks for men and four or more for women over the past 30 days, or heavy drinking involving more than two drinks per day for men and more than one per day for women, over the same time period. Alcohol use is a behavioral health issue that is also a risk factor for a number of negative health outcomes, including: physical injuries related to motor vehicle accidents, stroke, chronic diseases such as heart disease and cancer, and mental health conditions such as depression and suicide. There are a number of evidence-based interventions that may reduce excessive/binge drinking; examples include raising taxes on alcoholic beverages, restricting access to alcohol by limiting days and hours of retail sales, and screening and counseling for alcohol abuse (Centers for Disease Control and Prevention, Preventing Excessive Alcohol Use, 2020).

52 I Community Health Needs AssessmentPhysical InactivityWithin the service area, 6,822 or 19.7% of adults and older self-report no active leisure time, based on the question: “During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?” This indicator is relevant because current behaviors are determinants of future health, and this indicator may illustrate a cause of signicant health issues, such as obesity and poor cardiovascular health. Note: In 2021, the CDC updated the methodology used to produce estimates for this indicator. Estimated values for prior years (2004-2007) have been updated in this platform to allow comparison across years. Use caution when comparing with saved assessments generated prior to November 10, 2021.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2019. Source geography: County

Faireld Memorial Hospital I 53Tobacco Usage – Current SmokersThis indicator reports the percentage of adults age 18 and older who report having smoked at least 100 cigarettes in their lifetime and currently smoke every day or some days. Within the service area, there are 20.3% adults who have smoked or currently smoke of the total population. Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract*

54 I Community Health Needs AssessmentHealthcare WorkforceA lack of access to care presents barriers to good health. The supply and accessibility of facilities and physicians, the rate of uninsurance, nancial hardship, transportation barriers, cultural competency, and coverage limitations aect access. Rates of morbidity, mortality, and emergency hospitalizations can be reduced if community residents access services such as health screenings, routine tests, and vaccinations. Prevention indicators can call attention to a lack of access or knowledge regarding one or more health issues and can inform program interventions.Access to Care – Dental HealthThis indicator reports the number of dentists per 100,000 population. This indicator includes all dentists qualied as having a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), who are licensed by the state to practice dentistry and who are practicing within the scope of that license. Within the service area, there are 16 dentists. This represents 37.62 dentists per 100,000 total population.Note: This indicator is compared to the state average. Data Source: U.S. Department of Health & Human Services, Health Resources and Services Administration, HRSA - Area Health Resource File. Accessed via County Health Rankings, 2017. Source geography: County

Faireld Memorial Hospital I 55Access to Care – Mental HealthThis indicator reports the number of mental health providers in the service areaas a rate per 100,000 total area population. Mental health providers includepsychiatrists, psychologists, clinical social workers, counselors, marriage andfamily therapists, and mental health providers that treat alcohol and other drugabuse as well as advanced practice nurses specializing in mental healthcare.Data from the 2020 Centers for Medicare and Medicaid Services (CMS) NationalProvider Identier (NPI) downloadable le are used in the 2021 County HealthRankings. Within the service area, there are 17 mental health providers with a CMSNational Provider Identier (NPI). This represents 128.9 providers per 100,000 totalpopulation. Note: Data are suppressed for counties with population greater than 1,000 and 0 mental health provide
Note: This indicator is compared to the state average. Data Source: Centers for Medicare and Medicaid Services, CMS - National Planand Provider Enumeration System (NPPES), Accessed via County Health Rankings, 2020. Source geography: County* *

56 I Community Health Needs AssessmentAccess to Care – Primary CareThis indicator reports the number of primary care physicians per 100,000 population. Doctors classied as “primary care physicians” by the AMA include: General Family Medicine MDs and Dos, General Practice MDs and DOs, General Internal Medicine MDs and General Pediatrics MDs. Physicians age 75 and over and physicians practicing subspecialties within the listed specialties are excluded. This indicator is relevant because a shortage of health professionals contributes to access and health status issues. Within the service area, there are 11 primary care physicians. This represents 27.61 providers per 100,000 total population.Note: This indicator is compared to the state average. Data Source: U.S. Department of Health & Human Services, Health Resources and Services Administration, HRSA - Area Health Resource File. Accessed via County Health Rankings, 2017. Source geography: County

Faireld Memorial Hospital I 57Access to Care – Nurse PractitionersThis indicator reports the number of nurses with a CMS National Provider Identier (NPI). Nurses counted for this indicator include all advanced practice registered nurses (APRNs) and nurse practitioners, regardless of sub-specialty. Data are from the latest Centers for Medicare and Medicaid Services (CMS) National Provider Identier (NPI) downloadable le.Note: This indicator is compared to the state average. Data Source: Centers for Medicare and Medicaid Services, CMS - National Plan and Provider Enumeration System (NPPES), 2021. Source geography: Address43,221 27.76

58 I Community Health Needs AssessmentHealth OutcomesMeasuring morbidity and mortality rates allows assessing linkages between social determinants of health and outcomes. By comparing, for example, the prevalence of certain chronic diseases to indicators in other categories (e.g., poor diet and exercise) with outcomes (e.g., high rates of obesity and diabetes), various causal relationships may emerge, allowing a better understanding of how certain community health needs may be addressed.Cancer Incidence – All SitesThis indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of cancer (all sites) adjusted to 2000 U.S. standard population age groups (under age 1, 1-4, 5-9, ..., 80-84, 85 and older). Within the service area, there were 311 new cases of cancer reported. This means there is a rate of 486.9 for every 100,000 total population.Note: This indicator is compared to the state average. Data Source: State Cancer Proles, 2014-2018. Source geography: CountyCHRONIC ILLNESS

Faireld Memorial Hospital I 59Top Five Most Commonly Diagnosed CancersThe table below shows counts and age-adjusted incidence rates of the ve most common newly diagnosed cancers by site for the ve-year period of 2014-2018.* ** ** ** *

60 I Community Health Needs AssessmentTop Five Most Commonly Diagnosed Cancers continued

Faireld Memorial Hospital I 61Chronic Conditions – Chronic Obstructive Pulmonary Disease (Adult)This indicator reports the percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they had chronic obstructive pulmonary disease (COPD), emphysema, or chronic bronchitis. Within the service area, there were 9.3% of adults 18 and older who reported having chronic obstructive pulmonary disease of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract

62 I Community Health Needs AssessmentChronic Conditions – Diabetes (Adult)This indicator reports the number and percentage of adults age 20 and older who have ever been told by a doctor that they have diabetes. This indicator is relevant because diabetes is a prevalent problem in the U.S. It may indicate an unhealthy lifestyle and puts individuals at risk for further health issues. Within the service area, 3,089 of adults age 20 and older have diabetes. This represents 7.5% of the total survey population. Note: In 2021, the CDC updated the methodology used to produce estimates for this indicator. Estimated values for prior years (2004-2017) have been updated in this platform to allow comparison across years. Use caution when comparing with saved assessments generated prior to November 10, 2021.

Faireld Memorial Hospital I 63Chronic Conditions – Kidney Disease (Adult)This indicator reports the number and percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they have kidney disease.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract

64 I Community Health Needs AssessmentChronic Conditions – Coronary Heart Disease (Adult)This indicator reports the percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they had angina or coronary heart disease. Within the service area, there were 8.0% of adults 18 and older who reported having coronary heart disease of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract*

Faireld Memorial Hospital I 65Chronic Conditions – High Blood Pressure (Adult)This indicator reports the percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they have high blood pressure. Women who were told high blood pressure only during pregnancy and those who were told they had borderline hypertension were not included. Within the service area, there were 36.7% of adults 18 and older who reported having high blood pressure of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract

66 I Community Health Needs AssessmentChronic Conditions – High Cholesterol (Adult)This indicator reports the percentage of adults age 18 and older who report having been told by a doctor, nurse, or other health professional that they had high cholesterol. Within the service area, there were 35.6% of adults age 18 and older who reported having high cholesterol of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract

Faireld Memorial Hospital I 67Stroke (Adult)This indicator reports the number and percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they have had a stroke. Within the service area, there were 4.1% of adults age 18 and older who reported having a stroke of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract*

68 I Community Health Needs AssessmentObesityThis indicator reports the number and percentage of adults age 20 and older who self-report having a Body Mass Index (BMI) greater than 30.0 (obese). Respondents were considered obese if their Body Mass Index was 30 or greater. Body Mass Index (weight [kg]/height [m]2) was derived from self-report of height and weight. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues. Note: In 2021, the CDC updated the methodology used to produce estimates for this indicator. Estimated values for prior years (2004-2017) have been updated in this platform to allow comparison across years. Use caution when comparing with saved assessments generated prior to November 10, 2021.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2019. Source geography: County*

Faireld Memorial Hospital I 69Teeth LossThis indicator reports the number and percentage of adults age 18 and older who report having lost all of their natural teeth because of tooth decay or gum disease. Within the service area, there were 15.4% of adults 18 and older who reported losing all natural teeth of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract*

70 I Community Health Needs AssessmentPoor or Fair HealthIn this service area, the estimated prevalence of fair or poor health among adults aged 18 years and older was 20.5%. This value is based on the crude number of adults who self-report their general health status as “fair” or “poor.”Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract*

Faireld Memorial Hospital I 71Poor Physical HealthThis indicator reports the percentage of adults age 18 and older who report 14 or more days during the past 30 days during which their physical health was not good. Dara were from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) annual survey. Within the service area, there were 15.0% of adults 18 and older who reported poor physical health in the past month of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract*

72 I Community Health Needs AssessmentPoor Physical Health – DaysThis indicator reports the average number of self-reported physically unhealthy days in the past 30 days among adults. Figures are reported as crude rates, and as rates age-adjusted to year 2000 standard. Data were from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and area used for the 2021 County Health Rankings. Within the service area, there are a total of 4.3 average days of poor physical health days per month among adults 18 and older.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2018. Source geography: County

Faireld Memorial Hospital I 73Deaths of Despair (Suicide + Drug/Alcohol Poisoning)This indicator reports average rate of death due to intentional self-harm (suicide), alcohol-related disease, and drug overdose, also known as “deaths of despair” per 100,000 population. Figures are reported as crude rates, and as rates age-adjusted to year 2000 standard. Rates are resummarized for report area from county level data, only where data is available. This indicator is relevant because death of despair is an indicator of poor mental health. Within the service area, there were 114 deaths of despair. This represents an age-adjusted death rate of 54.0 per every 100,000 total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, CDC - National Vital Statistics System, Accessed via CDC WONDER, 2016-2020. Source geography: CountySUBSTANCE USE* ** ** ** **

74 I Community Health Needs AssessmentPoor Mental HealthThis indicator reports the percentage of adults age 18 and older who report 14 or more days during the past 30 days during which their mental health was not good. Data were from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) annual survey. Within the report area, there were 15.5% of adults 18 and older who reported poor mental health in the past month of the total population. Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention: Behavioral Risk Factor Surveillance System. Accessed via the 500 Cities Data Portal, 2019. Source geography: TractMENTAL AND BEHAVIORAL HEALTH*

Faireld Memorial Hospital I 75Poor Mental Health – DaysThis indicator reports the average number of self-reported mentally unhealthy days in the past 30 days among adults (age adjusted to the 2000 standard). Data were from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and are used for the 2021 County Health Rankings. Of the 3,007 total adults in the service area, the average poor mental health days is 4.7 per month, which is greater than the state’s monthly average of 4.1.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention: Behavioral Risk Factor Surveillance System, Accessed via County Health Rankings, 2018. Source geography: County

76 I Community Health Needs AssessmentPoor Mental Health – Mental Health and Substance Use ConditionsThis indicator reports the rate of diagnoses for mental health and substance use conditions among the Medicare population. Figures are reported as age-adjusted to year 2000 standard. Rates are resummarized for report areas from county level data, only where data is available. This indicator is relevant because mental health and substance use is an indicator of poor health.Note: This indicator is compared to the state average. Data Source: Centers for Medicare and Medicaid Services, Mapping Medicare Disparities Tool, 2019. Source geography: County

Faireld Memorial Hospital I 77Mortality – SuicideThis indicator reports the 2016-2020 ve-year average rate of death due to intentional self-harm (suicide) per 100,000 population. Figures are reported as crude rates, and as rates age-adjusted to year 2000 standard. Rates are summarized fore service areas from county level data, only where data is available. This indicator is relevant because suicide is an indicator of poor mental health. Note: Data are suppressed for counties with fewer than 20 deaths in the timeframe.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention: National Vital Statistics System. Accessed via CDC WONDER: 2016-2020. Source geography: County*******************

78 I Community Health Needs AssessmentFaireld Memorial Hospital works with the US-HHS ASPR, the Illinois Departmentof Public Health, county health departments, the Illinois Emergency Management Agency, and other state, regional, and local partners to plan, exercise, and equipfor emergency preparedness and to ensure the ability to address a wide rangeof potential emergencies, ranging from disasters of all causes to pandemics andterrorism.EMERGENCY PREPAREDNESS

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Faireld Memorial Hospital I 81SECONDARY DATAThe steering group, comprised of representatives from both focus groups – including a local public health department and schools – including members serving persons likely to be unserved, underserved or otherwise experiencing unmet needs, met on April 14, 2022 to identify and prioritize signicant health needs. The group reviewed notes from the focus groups and summaries of data reviewed by the consultant which included SparkMaps, ESRI, Illinois Department of Public Health, CDC, USDA, Illinois Department of Labor, HRSA, County Health Rankings and Roadmaps, National Cancer Institute and other resources. Following the review, the group identied and then prioritized the following as being the signicant health needs facing the Faireld Memorial Hospital service area.PROCESSIDENTIFICATION AND PRIORITIZATION OF NEEDSAvailability of Mental Health and Substance Abuse ServicesTransportation Access toPhysical Therapy

82 I Community Health Needs AssessmentAt the conclusion of their review and discussion, the identication and prioritization group advanced the following needs:1. Mental health and substance abuse services, including:– Improved access for transportation (local and distant) for personswith mental health and substance use disorders– Access to a local psychiatrist– Improved access to social workers, licensed counselors, and certied peer counselors– Increased education for parents and youth about mental healthand substance use issues2. Transportation– Strengthen local ambulance services– Improved access to reliable, exible transportation to and from medical appointments and care3. Physical therapy and local opportunities for recreation and education– Improve access to physical therapy services at Faireld MemorialHospital– Improved community access to opportunities for recreation and exercise for all ages in all seasonsDESCRIPTION OF THE COMMUNITY HEALTH NEEDS IDENTIFIED

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Faireld Memorial Hospital I 85Resources PartnersVolunteersGovernment
Services at Faireld Memorial Hospital•  Administration• Appropriate individual staHOSPITAL RESOURCES RESOURCES AVAILABLE TO MEET PRIORITY HEALTH NEEDS• Public health• Local ambulance servicesHEALTHCARE PARTNERS OR OTHER RESOURCES, INCLUDING TELEMEDICINECOMMUNITY RESOURCES• Schools• Frontier Community College• RIDES Mass Transit• Other transportation companies• City of Faireld• Wayne County Board• Senior Citizens Center• Other interested groups of individuals

Faireld Memorial Hospital I 87Documentation Online PresenceCommentsImplementationSECONDARY DATAThis CHNA Report will be available to the community on the hospital’s public website, www.faireldmemorial.org. A hard copy may be reviewed at the hospital by inquiring at the information desk at the main entrance. No written comments were received concerning the hospital facility’s most recently conducted CHNA nor on the most recently adopted Implementation Strategy. A method for retaining written public comments and responses exists,but none were received.Clarication of Asterisk (*) in several of the tablesTables indicate “No data” or “Suppressed” for a variety of reasons related to how the table is constructed from varying data sources of sometimes dierent age (period of data collection) or area and reect lack of sucient data to complete computations or report numbers without risking possibility of identication of individuals in small areas.DOCUMENTING AND COMMUNICATING RESULTS

Faireld Memorial Hospital I 89The Implementation Strategy was developed through a facilitated meetinginvolving key administrative sta at Faireld Memorial Hospital on April 14, 2022.The group reviewed the needs assessment process completed to that pointand considered the prioritized signicant needs and supporting documents.They discussed steps taken to address the previous Community Health NeedsAssessment. They also considered internal and external resources potentiallyavailable to address the current prioritized needs.The group then considered each of the prioritized needs. For each of the threecategories, actions the hospital intends to take were identied along with theanticipated impact of the actions, the resources the hospital intends to commit  to the actions, and the external collaborators the hospital plans to cooperate  with to address the need.The plan will be evaluated by periodic review of measurable outcome indicators  in conjunction with annual review and reporting.PLANNING PROCESSIMPLEMENTATION STRATEGYAvailability of MentalHealth and SubstanceAbuse ServicesTransportation Access toPhysical Therapy

90 I Community Health Needs AssessmentThe group addressed the needs with the following strategies:1. Mental health and substance abuse services, including:– Improved access for transportation (local and distant) for personswith mental health and substance use disorders– Access to a local psychiatrist– Improved access to social workers, licensed counselors, and certied peer counselors– Increased education for parents and youth about mental healthand substance use issuesActions the hospital intends to take to address the health need:• Faireld Memorial Hospital will explore partnerships to develop additional mental health and substance use resources• Faireld Memorial Hospital will explore the potential to recruit a local psychiatrist• Faireld Memorial Hospital will explore recruitment of social workers, licensed clinical counselors, and certied peer counselors• Faireld Memorial Hospital will collaborate with local agencies and providers as appropriate to address unmet health and substance use services and education needs, including transportation• Faireld Memorial Hospital will expand Mental Health First Aid training for adults and adults involved with youth and other appropriate community outreach programsAnticipated impacts of these actions: Faireld Memorial Hospital anticipates that the steps set out above will address the identied needs at levels relying, in part, on availability of resources beyond the control of the hospital. IMPLEMENTATION STRATEGY

Faireld Memorial Hospital I 91Programs and resources the hospital plans to commit to address health need:• Administration• Appropriate individual staPlanned collaboration between the hospital and other facilities:• RIDES Mass Transit• Other transportation companies• Egyptian Health Department• Area schools• Frontier Community College2. Transportation– Strengthen local ambulance services– Improved access to reliable, exible transportation to and from medical appointments and careActions the hospital intends to take to address the health need:• Faireld Memorial Hospital will explore providing education to local ambulance services on nancial management• Faireld Memorial Hospital will explore collaboration with local ambulance services, as may be reasonable and appropriate, to improve operations and provide education• Faireld Memorial Hospital will explore collaboration with RIDES Mass Transit to address transportation opportunitiesAnticipated impacts of these actions:Faireld Memorial Hospital anticipates that the steps above, if successful, will help to address each of the needs raised and improve the overall transportation situation, emergency and non-emergency, throughout the service area.

92 I Community Health Needs AssessmentPrograms and resources the hospital plans to commit to address health need: • Administration • Select staPlanned collaboration between the hospital and other facilities:• Local ambulance services• RIDES Mass Transit3. Physical therapy and local opportunities for recreation and education– Improve access to physical therapy services at Faireld MemorialHospital– Improved community access to opportunities for recreation and exercise for all ages in all seasonsActions the hospital intends to take to address the health need: • Faireld Memorial Hospital will explore opportunities for expanding therapy services• Faireld Memorial Hospital will explore use of existing space at the hospital to expand therapy services • Faireld Memorial Hospital will explore with community partners, the need and operational feasibility of an indoor facility for recreation, exercise, and education located at FMHAnticipated impacts of these actions: Faireld Memorial Hospital anticipates that the steps above have the potential for short- and long-term solutions to the identied needs.

Faireld Memorial Hospital I 93Programs and resources the hospital plans to commit to address health need: • Administration• Applicable individual sta membersPlanned collaboration between the hospital and other facilities:• City of Faireld• Faireld civic groups• Wayne County Board• Senior Citizens Center• Frontier Community College• Schools• Other interested groups or individuals

Faireld Memorial Hospital I 95Focus Groups AdministrationOrganizationsBusinessFocus Group One – Community LeadersDarlene Zurliene, School AdministratorPaul Bruinsma, Frontier Community CollegeMike Dreith, Mayor, City of FaireldLibby Lingafelter, Executive Director, Chamber of CommerceTyler Lampley, Alderman, City of FaireldKatherine Bunting, CEO, Faireld Memorial HospitalFocus Group Two – Medical Professionals and PartnersJennifer Bowers, Physical Therapy AssistantLance Endsley, PharmacistHollie Barrett, Director of Physician Practices, Faireld Memorial HospitalDana Taylor, COO, Faireld Memorial HospitalMarla Lakes, MDREFERENCES AND APPENDIX

96 I Community Health Needs AssessmentIdentication and Prioritization GroupDana Taylor, COO, Faireld Memorial HospitalJe Wise, Plant Operations Director, Faireld Memorial Hospital, and also serves as a rural reghter, representing emergency respondersShauna Williams, Marketing Director, Faireld Memorial Hospital, and also serves on the Faireld Chamber of CommercePat Kenshalo, community representativeAmy Marsh, CFO, Faireld Memorial HospitalHollie Barrett, Director of Physician Practices, Faireld Memorial HospitalImplementation Planning and Strategy Group Dana Taylor, COO, Faireld Memorial Hospital Mary Knight, Executive Assistant/Sta Accountant, Faireld Memorial Hospital Amy Marsh, CFO, Faireld Memorial Hospital Hazel Vest, CNO, Faireld Memorial HospitalKatherine Bunting, CEO, Faireld Memorial Hospital

Faireld Memorial Hospital I 97NOTES

98 I Community Health Needs AssessmentNOTES

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303 NW 11th Street, Faireld, IL 62837 618.842.2611 • faireldmemorial.org