Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
A For the 2020 calendar year, or tax year beginning 01-01-2020 , and ending 12-31-2020
BCheck if applicable:
CName of organization
Adventist Health SystemSunbelt Inc
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
900 Hope Way
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Altamonte Springs, FL32714
D Employer identification number

59-1479658
E Telephone number

G Gross receipts $ 4,834,488,128
F Name and address of principal officer:
Terry Shaw
900 Hope Way
Altamonte Springs,FL32714
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.adventhealth.com
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet1071
K Form of organization:  
L Year of formation: 1973
M State of legal domicile: FL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Operation of 11 acute-care hospitals & related healthcare services.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 22
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 16
5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ...... 5 31,944
6 Total number of volunteers (estimate if necessary) ............. 6 2,331
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 15,945,467
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 257,396
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 31,146,379 213,695,716
9 Program service revenue (Part VIII, line 2g) ......... 4,523,075,663 4,562,883,817
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 118,616,621 33,458,778
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 21,068,685 16,434,372
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 4,693,907,348 4,826,472,683
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 23,069,970 23,860,271
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,799,684,813 1,863,860,613
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 2,176,601,308 2,562,510,999
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,999,356,091 4,450,231,883
19 Revenue less expenses. Subtract line 18 from line 12....... 694,551,257 376,240,800
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 8,921,698,765 9,561,434,235
21 Total liabilities (Part X, line 26)............. 4,010,328,109 4,198,376,273
22 Net assets or fund balances. Subtract line 21 from line 20..... 4,911,370,656 5,363,057,962
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2020)
Form 990 (2020)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: Adventist Health System Sunbelt Healthcare Corporation and all its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ. The hospital and healthcare system whose parent is Adventist Health System Sunbelt Healthcare Corporation is known as AdventHealth. AdventHealth seeks to be widely respected as a consumer-focused organization that engages individuals in their health by delivering wholistic, best practice care across a connected, comprehensive continuum of services. With Christ as our example, AdventHealth cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 4,053,421,963 including grants of $ 23,860,271 ) (Revenue $ 4,562,023,014 )
Operation of 11 acute care hospitals with 139,632 patient admissions, 755,751 patient days and 1,247,836 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet4,053,421,963
Form 990 (2020)
Form 990 (2020)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
Yes
 
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2020)
Form 990 (2020)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
31,944
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2020)
Form 990 (2020)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
22
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
16
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletPaul Rathbun900 Hope Way   Altamonte Springs,FL32714 (407) 357-2419
Form 990 (2020)
Form 990 (2020)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Rathbun Paul C......................................................................
Dir(end 9/20)/AdventHealth CFO
1.00
.................
50.00
X   X       0 4,358,321 210,783
(2) Shaw Terry D......................................................................
Dir/President/AdventHealth CEO
1.00
.................
50.00
X   X       0 2,994,533 203,959
(3) Tol Daryl......................................................................
Dir(end 9/20)/CEO AH Central FL Div
1.00
.................
50.00
    X       0 1,986,560 203,471
(4) Silvestry MD Scott......................................................................
Phy/Dir AH Thoracic Transplant
75.00
.................
0.00
        X   1,861,106 0 43,107
(5) Banks David......................................................................
Former Key Emp - SEVP/CSO
0.00
.................
50.00
          X 0 1,490,148 186,218
(6) Moorhead MD David......................................................................
Former Key Emp - SEO/CCO
0.00
.................
50.00
          X 0 1,585,029 28,788
(7) Accola MD Kevin......................................................................
Exec Med Dir/Cardio Surgery & Structual Heart Prog
55.38
.................
0.00
        X   1,570,134 0 38,477
(8) Goodman Todd A......................................................................
CFO AH Central FL Division
1.00
.................
50.00
    X       0 1,387,075 180,479
(9) Palmer MD George......................................................................
Med Dir/ AH Celebration Cardio Surgery Prog
46.15
.................
0.00
        X   1,384,314 0 36,152
(10) Soler Eddie......................................................................
Former Key Emp - EVP/SFO
0.00
.................
50.00
          X 0 1,210,478 187,520
(11) Stevens Eric A......................................................................
Former Key Emp/CEO CFD So Acute Care Srvs
0.00
.................
0.00
          X 0 1,243,941 43,082
(12) Davis JR MD Robert......................................................................
Phy/Dir AH Cardovascular
70.00
.................
0.00
        X   1,202,484 0 24,481
(13) Botta MD Donald......................................................................
Phy/Dir AH Heart Transplant
40.00
.................
0.00
        X   1,032,515 0 36,081
(14) Finkler Neil......................................................................
CMO AH CFD So Acute Care Srvs
50.00
.................
0.00
      X     0 840,582 117,695
(15) Thompson Michael J......................................................................
CEO AH CFD Integrated Hlth Srvs
40.00
.................
10.00
      X     0 795,081 120,318
(16) Hilliard Douglas W......................................................................
CFO AH CFD South Region
50.00
.................
0.00
      X     0 783,979 109,918
(17) Wandersleben Jennifer J......................................................................
CEO AH CFD So Acute Care Srvs
50.00
.................
0.00
      X     0 701,360 142,144
Form 990 (2020)
Form 990 (2020)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Owen Terry R........................................................................
Former Key Emp/SVP Partnering Strategy
0.00
.......................50.00
          X 0 795,875 45,284
(19) Cook Timothy W........................................................................
CEO AH Alt & Seminole Mkt
50.00
.......................0.00
      X     0 693,864 106,224
(20) Spenst Brett........................................................................
CEO AH Orlando (end 11/20)
50.00
.......................0.00
      X     0 683,757 98,097
(21) Harcombe Douglas W........................................................................
CEO AH Celebration & Osecola Mkt
50.00
.......................0.00
      X     0 621,167 112,728
(22) Zbaraschuk Amy L........................................................................
CFO AH CFD Integrated Hlth Srvs
50.00
.......................0.00
      X     0 622,263 106,676
(23) Hagensicker Janice K........................................................................
Former Key Emp/Sr Fin Off AH Orl SW
0.00
.......................50.00
          X 0 656,866 40,454
(24) Moorhead Sheryl D........................................................................
AH CFD Chief People Officer
50.00
.......................0.00
      X     0 642,669 29,471
(25) Deininger Robert........................................................................
CEO AH Orlando (beg 11/20)
50.00
.......................0.00
      X     0 552,840 107,708
(26) Villanueva Jeffrey........................................................................
CEO AH E Orl & E Orange Mkt
50.00
.......................0.00
      X     0 486,926 96,115
(27) Jernigan PhD Donald L........................................................................
Dir/CEO Emeritus (end 3/20)
1.00
.......................1.00
X           0 443,591 5,635
(28) Reed MD Monica P........................................................................
Former Key Employee
0.00
.......................0.00
          X 8,280 366,974 25,227
(29) Bradley Kenneth W........................................................................
Former Kep Emp/AH Dir Emerging Leadership
0.00
.......................50.00
          X 0 182,976 33,011
(30) Bigalke John T........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 33,482 0
(31) Cherry MD Robert A........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 10,790 0
(32) Johnson Tidjani Michelle........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 8,924 0
(33) Tikker Blair........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 8,924 0
(34) Freedman David........................................................................
Director
1.00
.......................1.00
X           0 4,464 0
(35) Page John M........................................................................
Director (end 9/20)
1.00
.......................1.00
X           0 4,281 0
(36) Moore MDiv Larry R........................................................................
Vice Chairman/Sec/Dir
1.00
.......................2.00
X           0 4,176 0
(37) Thurber Gary F........................................................................
Vice Chairman/Director
2.00
.......................2.00
X           0 4,161 0
(38) Smith DMin PhD Ron C........................................................................
Chairman/Director
2.00
.......................2.00
X           0 4,159 0
(39) Poenitz Steven N........................................................................
Director (end 9/20)
1.00
.......................1.00
X           0 4,104 0
(40) Griffith Jr Buford........................................................................
Director
1.00
.......................2.00
X           0 4,081 0
(41) Valentine II MDiv Maurice R........................................................................
Vice Chairman/Director
2.00
.......................2.00
X           0 4,072 0
(42) Peoples Troy K........................................................................
Director (end 9/20)
1.00
.......................2.00
X           0 4,002 0
(43) Scott Glynn CW........................................................................
Director
1.00
.......................2.00
X           0 3,974 0
(44) Werner Thomas L........................................................................
Director
1.00
.......................3.00
X           0 3,954 0
(45) Webb Gil........................................................................
Director (end 12/20)
1.00
.......................1.00
X           0 3,854 0
(46) Davidson James R........................................................................
Director (end 9/20)
1.00
.......................1.00
X           0 3,849 0
(47) Shaw EdD Kenneth........................................................................
Director
1.00
.......................2.00
X           0 2,852 0
(48) Aguilera Ronald........................................................................
Director (end 9/20)
1.00
.......................2.00
X           0 2,851 0
(49) Barnett D Edward........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 2,749 0
(50) Lyons Justin C........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 2,731 0
(51) Van Schaik Vic........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 2,731 0
(52) Bernard Roger A........................................................................
Director (beg 9/20)
1.00
.......................2.00
X           0 2,715 0
(53) Carlson Ronald........................................................................
Director (end 9/20)
1.00
.......................4.00
X           0 2,656 0
(54) Craig Carlos J........................................................................
Director (end 9/20)
1.00
.......................1.00
X           0 2,624 0
(55) Machado Allan........................................................................
Director
1.00
.......................2.00
X           0 2,424 0
(56) Johnson MD Mark........................................................................
Director (end 9/20)
1.00
.......................1.00
X           0 1,837 0
(57) Brown-Fraser PhD RD Sherine R........................................................................
Director (end 9/20)
1.00
.......................1.00
X           0 1,801 0
(58) Devore Susan D........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 0 0
(59) Morgan William H........................................................................
Director (beg 9/20)
1.00
.......................1.00
X           0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 7,058,833 26,270,077 2,719,303
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet2,160
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Brasfield & Gorrie LLC

941 West Morse Blvd Suite 200
Winter Park,FL32789
Design and Construction Services 111,407,994
Engie Insight Services Inc

1313 N Atlantic St Suite 5000
Spokane,WA99201
Professional Services (Energy Strategy) 37,932,038
AMN Healthcare Inc

1950 Sawtelle Blvd Suite 120
Los Angeles,CA90025
Healthcare Staffing Services 25,032,907
Trane US Inc

PO Box 406469
Atlanta,GA30384
Construction/Energy Services 19,485,802
Batson-Cook Company

2859 Paces Ferry SE Suite 200
Atlanta,GA30339
Design and Construction Services 14,996,881
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet505
Form 990 (2020)
Form 990 (2020)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 6,611,327
e Government grants (contributions)1e 199,794,276
f All other contributions, gifts, grants, and similar amounts not included above1f 7,290,113
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 213,695,716
 Program Service RevenueAmt Business Code
2a Patient Revenue 622110 4,504,937,879 4,491,429,392 13,508,487  
b Rent from Exempt Affiliates 622110 19,827,618 19,827,618    
c Cafeteria/Vending Rev. 622110 11,872,826 11,787,571 85,255  
d Laundry 622110 7,595,248 7,511,743 83,505  
e Gift Shop 622110 5,412,418 5,403,855 8,563  
f All other program service revenue. 13,237,828 11,116,396 2,121,432  
g Total. Add lines 2a–2f .....MediumBullet 4,562,883,817
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 33,477,104     33,477,104
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 139,812     139,812
(ii) Personal (i) Real
6a Gross rents 44,449 3,007,635 6a
b Less: rental expenses 12,356 1,691,607 6b
c Rental income or (loss) 32,093 1,316,028 6c
d Net rental income or (loss).......MediumBullet 1,348,121   138,225 1,209,896
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 6,292,426 730 7a
b Less: cost or other basis and sales expenses 5,217,716 1,093,766 7b
c Gain or (loss) 1,074,710 -1,093,036 7c
d Net gain or (loss).........MediumBullet -18,326     -18,326
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a Equity earnings from related enti 622110 10,416,428 10,416,428    
b Investment in Subs 622110 4,530,011 4,530,011    
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 14,946,439
12 Total revenue. See instructions.....MediumBullet 4,826,472,683 4,562,023,014 15,945,467 34,808,486
Form 990 (2020)
Form 990 (2020)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 22,529,137 22,529,137
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 1,331,134 1,331,134
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 12,329,164   12,329,164  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 1,371,379,475 1,351,140,066 20,239,409  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 57,256,751 56,010,412 1,246,339  
9 Other employee benefits ....... 317,701,143 305,792,112 11,909,031  
10 Payroll taxes ........... 105,194,080 102,875,451 2,318,629  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 5,494,735   5,494,735  
c Accounting ........... 878,214   878,214  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 5,902,507   5,902,507  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 630,328,500 504,448,727 125,879,773  
12 Advertising and promotion .... 61,260,188   61,260,188  
13 Office expenses ....... 184,485,776 153,652,856 30,832,920  
14 Information technology ...... 173,232,072 159,298,875 13,933,197  
15 Royalties ..        
16 Occupancy ........... 105,642,343 105,642,343    
17 Travel ............ 3,695,815 127,412 3,568,403  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 671,599   671,599  
20 Interest ........... 27,656,448 27,656,448    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 233,374,957 233,374,957    
23 Insurance ... 33,751,700 33,086,735 664,965  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 793,050,390 793,050,390    
b Assessments 93,597,878 93,597,878    
c Repairs/Maintenance 93,079,131 93,079,131    
d UBI Tax 278,641   278,641  
e All other expenses 116,130,105 16,727,899 99,402,206  
25 Total functional expenses. Add lines 1 through 24e 4,450,231,883 4,053,421,963 396,809,920 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2020)
Form 990 (2020)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 91,546 1 93,806
2 Savings and temporary cash investments ......... 2,917,094,143 2 3,085,669,421
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 652,396,165 4 692,175,855
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 109,133,897 8 181,578,520
9 Prepaid expenses and deferred charges ...... 39,071,767 9 39,503,014
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 5,396,576,477
b Less: accumulated depreciation 10b 2,408,623,707 2,777,298,055 10c 2,987,952,770
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 7,172,830 12 11,702,841
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 28,585,967 14 25,490,949
15 Other assets. See Part IV, line 11 ........... 2,390,854,395 15 2,537,267,059
16 Total assets. Add lines 1 through 15 (must equal line 33)... 8,921,698,765 16 9,561,434,235
Liabilities 17 Accounts payable and accrued expenses ..... 330,251,271 17 371,315,945
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 3,356,609,779 20 3,251,968,063
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 323,467,059 25 575,092,265
26 Total liabilities. Add lines 17 through 25.. 4,010,328,109 26 4,198,376,273
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 4,909,860,928 27 5,362,777,186
28 Net assets with donor restrictions ........... 1,509,728 28 280,776
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 4,911,370,656 32 5,363,057,962
33 Total liabilities and net assets/fund balances ........ 8,921,698,765 33 9,561,434,235
Form 990 (2020)
Form 990 (2020)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
4,826,472,683
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
4,450,231,883
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
376,240,800
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
4,911,370,656
5
Net unrealized gains (losses) on investments ...............
5
46,747,524
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
28,698,982
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
5,363,057,962
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2020)
Form 990 (2020)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in 11a above?
11b
 
 
c
A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2020 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2020
(iii)
Distributable
Amount for 2020
1 Distributable amount for 2020 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2020:
a From 2015.......  
b From 2016.......  
c From 2017.......  
d From 2018.......  
e From 2019.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2020 distributable amount  
i Carryover from 2015 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2020 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2020 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2020, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2020. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2021. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2016.....  
b Excess from 2017.....  
c Excess from 2018.....  
d Excess from 2019.....  
e Excess from 2020.....  
Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
Name of organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 3
Name of organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 4
Name of organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2020

Schedule C (Form 990 or 990-EZ) 2020
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2020


Schedule C (Form 990 or 990-EZ) 2020
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
173,050
j
Total. Add lines 1c through 1i ....................................................................................................
173,050
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: The corporation paid dues to the American Hospital Association, Florida Hospital Association, Texas Hospital Association, and Association of Organ Procurement who use a portion of the dues to conduct lobbying activities.
Schedule C (Form 990 or 990EZ) 2020


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 20,731,829 20,471,913 19,274,406 19,390,999 19,118,543
b Contributions ... 50,000 50,000 100,000 166,685 568,450
c Net investment earnings, gains, and losses 1,197,926 1,196,289 1,099,218 1,051,467 277,615
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
632,443 526,694 1,711 9,029 573,609
f Administrative expenses ....          
g End of year balance ...... 21,347,312 21,191,508 20,471,913 20,600,122 19,390,999
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet92.350 %
b
Permanent endowment SchDMd Bullet7.650 %
c
Term endowment SchDMd Bullet0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .......................
3a(i)
 
No
(ii) Related organizations .......................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   264,206,155 264,206,155
b Buildings ....   1,950,189,591 739,051,523 1,211,138,068
c Leasehold improvements        
d Equipment ....   2,779,403,491 1,613,592,922 1,165,810,569
e Other .....   402,777,240 55,979,262 346,797,978
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 2,987,952,770
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)Due From Related/Affiliated Entities 17,390,431
(2)Long-term Investments 189,853,153
(3)Other Non-Current Assets 225,388,247
(4)Receivable - Interco Alloc of Tax-Exempt Bond Proceeds 1,915,960,358
(5)Receivable from Third Party 59,362,902
(6)Board Designated Funds 100
(7)Other Current Receivables 129,311,868
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 2,537,267,059
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 575,092,265
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Part V, Line 4: All endowment funds are held by related 501(c)(3) exempt foundations. These endowment funds have been established for a variety of purposes in support of related tax-exempt hospitals. All of the foundation's permanently restricted endowment funds are required to be retained permanently either by explicit donor stipulation or by the Florida Uniform Prudent Management of Institutional Funds Act. Part V, line 1a, column (a) Current year - Explanation for change in opening balance: During 2021 it was determined that endowments in the amount of $459,679, received prior to 2020, should be excluded as these funds do not represent endowments held for the benefit of the filing organization. As a result, the filing organization restated the beginning endowment fund balance in its 2020 tax year. Part V, line 1a, column (c) Two years back - Explanation for change in opening balance: During 2018, it was determined that an Endowment in the amount of $1,325,716 received prior to 2018 should be reclassified from permanent endowment to a temporarily restricted asset.
Part X, Line 2: The filing organization is a subsidiary organization within AdventHealth. The consolidated financial statements of AdventHealth contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2020 and 2019. NAHS also has temporary deductible differences of approximately $41,800 and $46,500 at December 31, 2020 and 2019, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2020, NAHS had net operating loss carryforwards of approximately $43,500, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $10,200 and $11,400 at December 31, 2020 and 2019, respectively. NAHS remeasured its deferred tax assets and liabilities based on the rates at which they are expected to reverse in the future, which is generally 21%. A full valuation allowance has been provided at December 31, 2020 and 2019 to offset the deferred tax asset since Healthcare Corporation has determined that it is more likely than not that the benefit of the net operating loss carryforwards will not be realized in future years. The Income Taxes Topic of the Accounting Standards Codification (ASC) (ASC 740) prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken, or expected to be taken, in a tax return. There were no material uncertain tax positions as of December 31, 2020 and 2019. On December 22, 2017, the United States enacted tax reform legislation commonly known as the Tax Cuts and Jobs Act (Act), resulting in significant modifications to existing law. Certain provisions impact tax-exempt organizations, including revisions to taxes on unrelated business activities, excise taxes on compensation of certain employees, and various other provisions. The impact of these provisions on the consolidated financial statements is not, and is not expected, to be significant.
Schedule D (Form 990) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
Central America and the Caribbean     Grantmaking   839,162
Central America and the Caribbean     Program Services Mission Trips, Wheelchair Fitting, etc. 36,547
East Asia and the Pacific     Grantmaking   24,940
East Asia and the Pacific     Program Services Mission Trips 22,957
Europe (including Iceland and Greenland)     Meetings   6,795
Middle East and North Africa     Meetings   1,476
Middle East and North Africa     Grantmaking   34,444
North America (which includes Canada and Mexico, but not the U.S.)     Grantmaking   39,128
North America (which includes Canada and Mexico, but not the U.S.)     Meetings   892
North America (which includes Canada and Mexico, but not the U.S.)     Program Services Mission Trips, Cleft Clinic 15,352
South America     Grantmaking   217,420
South America     Meetings   2,386
South America     Program Services Travel for Global Mission 3,899
Sub-Saharan Africa     Grantmaking   178,352
Sub-Saharan Africa     Program Services Mission Trips 2,035
South Asia     Grantmaking   17,500
South Asia     Program Services   935
3a Sub-total .... 0 0 1,005,449
b Total from continuation sheets to Part I ... 0 0 438,771
c Totals (add lines 3a and 3b) 0 0 1,444,220
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2020
Schedule F (Form 990) 2020
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
Central America and the Caribbean Medical Supplies or Equipment     13,500 Medical Supplies Other
East Asia and the Pacific Medical Supplies or Equipment 16,800       Book
Central America and the Caribbean Medical Supplies or Equipment     20,600 Medical Supplies Other
Middle East and North Africa Medical Supplies or Equipment     15,766 Medical Supplies Other
Middle East and North Africa Medical Supplies or Equipment     18,678 Medical Supplies Other
Central America and the Caribbean Medical Supplies or Equipment     9,907 Medical Supplies Book
Central America and the Caribbean Medical Supplies or Equipment     44,542 Medical Supplies Other
South America Medical Supplies or Equipment 149,398       Book
South America Other     9,530 Other Other
South America Medical Supplies or Equipment 26,887       Book
Sub-Saharan Africa Medical Supplies or Equipment     6,243 Medical Supplies Other
South Asia General Support 17,500       Book
South America Medical Supplies or Equipment     11,006 Medical Equipment Other
Central America and the Caribbean Medical Supplies or Equipment     66,988 Medical Supplies Other
Central America and the Caribbean Other 362,199       Book
Central America and the Caribbean Medical Supplies or Equipment     205,444 Medical Supplies Other
North America (which includes Canada and Mexico, but not the U.S.) Medical Supplies or Equipment     23,219 Medical Supplies Other
North America (which includes Canada and Mexico, but not the U.S.) Medical Supplies or Equipment     5,832 Medical Supplies Book
South America Medical Supplies or Equipment     14,430 Medical Supplies Other
Sub-Saharan Africa School Construction 156,958       Book
Sub-Saharan Africa Medical Supplies or Equipment     13,211 Medical Supplies Other
Central America and the Caribbean Medical Supplies or Equipment     46,340 Medical Supplies Other
East Asia and the Pacific Medical Supplies or Equipment     7,550 Medical Supplies Other
Central America and the Caribbean Medical Supplies or Equipment     54,819 Medical Supplies Other
Central America and the Caribbean Medical Supplies or Equipment 8,000   0   Book
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
25
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2020
Schedule F (Form 990) 2020Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
General Support North America 1 5,788 Cash Payment     Book
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2020
Schedule F (Form 990) 2020
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2020
Schedule F (Form 990) 2020
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Part I, Line 2: Foreign grants are generally non-cash donations of medical equipment and supplies to assist foreign health care providers in fulfilling their mission of providing health care services to the populations they serve. The foreign health care providers are often hospitals and/or clinics operated and/or sponsored by or affiliated with the Seventh-Day Adventist Church. The foreign hospitals/clinics may be located in remote and/or underserved villages and townships of developing countries. Grants are typically made to other U.S. charitable organizations or foreign entities recognized as charitable by the foreign country in which they are located. As a result of the nature of the grants as non-cash medical equipment and supplies and the fact that most grants are made indirectly through other U.S. or foreign charitable organizations, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States.
Part III Accounting Method:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2020
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
No
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    204,271,827   204,271,827 4.590 %
b Medicaid (from Worksheet 3, column a) . . . . .     658,506,131 340,719,244 317,786,887 7.140 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     862,777,958 340,719,244 522,058,714 11.730 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     26,145,000 22,282 26,122,718 0.590 %
f Health professions education (from Worksheet 5) . . .     46,658,203 9,985,227 36,672,976 0.820 %
g Subsidized health services (from Worksheet 6) . . . .     12,511,016 11,519,513 991,503 0.020 %
h Research (from Worksheet 7) .     5,476,241 4,153,681 1,322,560 0.030 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     22,582,465   22,582,465 0.510 %
j Total. Other Benefits . .     113,372,925 25,680,703 87,692,222 1.970 %
k Total. Add lines 7d and 7j .     976,150,883 366,399,947 609,750,936 13.700 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy     34,047,796 7,178,281 26,869,515 0.600 %
8 Workforce development     150,628 100 150,528 0 %
9 Other     53,582   53,582 0 %
10 Total     34,252,006 7,178,381 27,073,625 0.600 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
188,833,913
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
16,279,137
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
718,961,591
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
845,518,321
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-126,556,730
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
11 San Marcos MRI LP
 
Imaging Center 60.000 % 0 % 40.000 %
22 Central Texas Ambulatory Endoscopy
 
Endoscopy Center 18.800 % 0 % 81.200 %
33 Surgery Management Associates of Kissimmee LLC
 
Management/Admin 30.000 % 0 % 70.000 %
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?11Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 AdventHealth Orlando
601 E Rollins Street
Orlando,FL32803
www.adventhealth.com/hospital/adventh
4369
X X X X   X X   Therapy Center, EPS Cath Lab, 4 Off-site EDs A
2 AdventHealth Celebration
400 Celebration Place
Celebration,FL34747
www.adventhealth.com/hospital/adventh
4369
X X   X     X   Therapy Center A
3 AdventHealth Altamonte Springs
601 E Altamonte Drive
Altamonte Springs,FL32701
www.adventhealth.com/hospital/adventh
4369
X X   X     X   Cancer Center, Therapy A
4 AdventHealth East Orlando
7727 Lake Underhill Road
Orlando,FL32822
www.adventhealth.com/hospital/adventh
4369
X X   X     X     A
5 AdventHealth Winter Park
200 N Lakemont Avenue
Winter Park,FL32792
www.adventhealth.com/hospital/adventh
4369
X X   X     X     A
6 AdventHealth Kissimmee
2450 North Orange Blossom Trail
Kissimmee,FL34744
www.adventhealth.com/hospital/adventh
4369
X X   X     X     A
7 AdventHealth Sebring
4200 Sun N Lake Blvd
Sebring,FL33825
www.adventhealth.com/hospital/adventh
4171
X X         X     B
8 AdventHealth Apopka
2100 Ocoee-Apopka Road
Apopka,FL32703
www.adventhealth.com/hospital/adventh
4369
X X   X     X     A
9 AdventHealth Lake Placid
1210 US Highway 27 North
Lake Placid,FL33852
www.adventhealth.com/hospital/adventh
4171
X X         X   Senior Behavioral Unit, Outpatient Physical Therapy B
10 AdventHealth Wauchula
735 S 5th Avenue
Wauchula,FL33873
www.adventhealth.com/hospital/adventh
4239
X X     X   X   Skilled Nursing A
11 Central Texas Medical Center (through
04/01/20 1301 Wonder World Drive
San Marcos,TX78666
www.ctmc.org
000556
X X         X     A
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Part V, Page 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Part V, Page 8
b
See Part V, Page 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Part V, Page 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Part V, Page 8
b
See Part V, Page 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Part V, Section B Facility Reporting Group A
Facility Reporting Group A consists of: - Facility 1: AdventHealth Orlando, - Facility 2: AdventHealth Celebration, - Facility 3: AdventHealth Altamonte Springs, - Facility 4: AdventHealth East Orlando, - Facility 5: AdventHealth Winter Park, - Facility 6: AdventHealth Kissimmee, - Facility 8: AdventHealth Apopka, - Facility 10: AdventHealth Wauchula, - Facility 11: Central Texas Medical Center (through
Facility Reporting Group - A Part V, Section B, line 5: See Line 5 footnote below.
Facility Reporting Group - A Part V, Section B, line 7d: See Line 7d footnote below.
Facility Reporting Group - A Part V, Section B, line 11: See Line 11 footnote below.
Facility Reporting Group - A Part V, Section B, line 13h: See Line 13h footnote below.
Part V, Section B Facility Reporting Group B
Facility Reporting Group B consists of: - Facility 7: AdventHealth Sebring, - Facility 9: AdventHealth Lake Placid
Facility Reporting Group - B Part V, Section B, line 5: See Line 5 footnote below.
Facility Reporting Group - B Part V, Section B, line 6a: See Line 6a footnote below.
Facility Reporting Group - B Part V, Section B, line 7d: See Line 7d footnote below.
Facility Reporting Group - B Part V, Section B, line 11: See Line 11 footnote below.
Facility Reporting Group - B Part V, Section B, line 13h: See Line 13h footnote below.
Part V, Section B, Line 5 Footnote Group A-Facility 1 -- AdventHealth OrlandoAdventHealth Orlando (AHO or the Hospital) is the flagship hospital of the seven hospital campuses that operate under a single hospital license. The seven campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHO is located in and serves the residents of Orange County. AHO has become one of the most trusted and comprehensive hospitals in the region. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHO was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHO had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHO's community/service area. The following organizations participated in AHO's CHNAC and specifically represented low-income, minority and other medically underserved populations:Second Harvest Food Bank - a non-profit organization that operates a food bank throughout the six counties that make up most of Central Florida and provides a workforce development program for populations at risk for food insecurity;Grace Medical Home - a patient-centered medical home that focuses on serving the clinically underserved through the provision of continuous and comprehensive primary care;Juvenile Diabetes Research Foundation;Ronald McDonald House;United Against Poverty;Healthy Start Coalition of Orange County;Mother's Milk Bank of Central Florida; andOrange County Public Health Department.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents.Group A-Facility 2 -- AdventHealth CelebrationAdventHealth (AHC or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHC is located in Osceola County and it primarily serves residents from Osceola County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHC was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHC had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHC's community/service area. The following organizations participated in AHC's CHNAC and specifically represented low-income, minority and other medically underserved populations:Osceola Council of Aging - a non-profit organization with a focus on providing care and essential social services to seniors and families; Community Vision of Osceola County - a community planning non-profit that works to convene regional stakeholders to create a shared vision for a healthy and prosperous Osceola County; Hope Community Center - a social service non-profit that works to connect socioeconomically disadvantaged families to essential services with the goal of helping them to become self-sustaining; The Osceola County Health Department;Celebration Foundation;The City of Kissimmee;Osceola Community Health Services; Park Place Behavioral Health; REACH Marketing; andSecond Harvest Food Bank.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 289 surveys were completed by Osceola County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of nine focus groups were held which included representatives from organizations that serve underrepresented populations in Osceola County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Ninety-seven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, nine intercept surveys were conducted with patients at a local federally qualified health center. Group A-Facility 3 -- AdventHealth AltamonteAdventHealth Altamonte Springs (AHAlt or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHAlt is located in Seminole County and its primary service area encompasses all of Seminole County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. **see continuation of footnote
Part V, Section B, Line 5 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteThe 2019 CHNA conducted for AHAlt was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHAlt had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHAlt's community/service area. The following organizations participated in AHAlt's CHNAC and specifically represented low-income, minority and other medically underserved populations:Community Health Centers - an organization providing medical services and representing low-income, minority, and other underrepresented populations;Second Harvest Food Bank; Shepherd's Hope - a primary care clinic serving low-income, minority, and other underrepresented populations; Hope Community Center - an organization that provides education, immigration services, youth and family services and other community programs to low-income, minority, and other underrepresented populations; and The Department of Health in Seminole County. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 523 surveys were completed by Seminole County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 10 focus groups were held which included representatives from organizations that serve underrepresented populations in Seminole County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Eighty-three key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, fourteen intercept surveys were conducted with patients at a local federally qualified health center. Group A-Facility 4 -- AdventHealth East OrlandoAdventHealth East Orlando (AHEO or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHEO is located in and serves the residents of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHEO was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHEO had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHEO's community/service area. The following organizations participated in AHEO's CHNAC and specifically represented low-income, minority and other medically underserved populations:True Health - a multi-county Federally Qualified Health Center that provides access to care for low-income, uninsured, underinsured and underserved populations in Seminole and Orange Counties regardless of ability to pay;United Global Outreach;Orange County Government; and Second Harvest Food Bank. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents. Group A-Facility 5 -- AdventHealth Winter ParkAdventHealth Winter Park (AHWP or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHWP is located in and primarily serves the residents of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHWP was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHWP had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHWP's community/service area. The following organizations participated in AHWP's CHNAC and specifically represented low-income, minority and other medically underserved populations:Second Harvest Food Bank;Seniors First, Inc.;Fleet Farming; andOrange County Health Department. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers.**see continuation
Part V, Section B, Line 5 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkA total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents.Group A-Facility 7 -- AdventHealth KissimmeeAdventHealth Kissimmee (AHK or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHK is located in and serves the residents of Osceola County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHK was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHK had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHK's community/service area. The following organizations participated in AHK's CHNAC and specifically represented low-income, minority and other medically underserved populations:Osceola Council of Aging - a non-profit organization with a focus on providing care and essential social services to seniors and families; Community Vision of Osceola County - a community planning non-profit that works to convene regional stakeholders to create a shared vision for a healthy and prosperous Osceola County; Hope Community Center - a social service non-profit that works to connect socioeconomically disadvantaged families to essential services with the goal of helping them to become self-sustaining; The Osceola County Health Department;Celebration Foundation;The City of Kissimmee;Osceola Community Health Services; Park Place Behavioral Health; REACH Marketing; andSecond Harvest Food Bank.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 289 surveys were completed by Osceola County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of nine focus groups were held which included representatives from organizations that serve underrepresented populations in Osceola County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Ninety-seven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, nine intercept surveys were conducted with patients at a local federally qualified health center.Group A-Facility 8 -- AdventHealth ApopkaAdventHealth Apopka (AHApk or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHApk is located in Orange County and its primary service area encompasses all of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHApk was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHApk had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHApk's community/service area. The following organizations participated in AHApk's CHNAC and specifically represented low-income, minority and other medically underserved populations:Community Health Centers - a federally qualified health center serving Central Florida residents;Seminole County Department of Health;Second Harvest Food Bank; Shepherd's Hope - a free and charitable clinic that provides care to the underinsured and uninsured; andHope Community Center.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents. **see continuation of footnote
Part V, Section B, Line 5 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaAdventHealth Wauchula is a 25-bed hospital located in Wauchula, Florida in Hardee County. It serves the same communities as its sister hospitals, AdventHealth Sebring and AdventHealth Lake Placid. AdventHealth Wauchula is designated by the state of Florida as a Critical Access Hospital. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews. AH Wauchula formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of AH Wauchula. Key members of the CHNAC included representatives from the following organizations:Drug Free Hardee;MV Transportation - an organization involved in helping to meet transportation needs of those living in disadvantaged communities;Peace River Center - a domestic violence center;Healthy Start Coalition of Hardee, Highlands, and Polk Counties;Highlands County Board of County Commissioners;Nu-Hope Elder Care Services, Inc.;Heartland Regional Transportation Planning Organization;Florida Department of Health in Hardee County;Samaritan's Touch Care Center;Heartland Rural Health Network;Hardee Help Center; RCMA - an organization that provides child-care and child and parent education for migrant and other low-income families; and Central Florida Health Care - a federally qualified health center.Community surveys were completed on-line and in person by participants in community settings. Local community organizations assisted in survey participation efforts by providing access to a computer at community events. Community surveys were also made available at local clinics, community events, department of motor vehicle locations, and the community locations. A total of 578 residents participated in the Community Health Needs Assessment survey. AH Wauchula also gathered primary data through stakeholder interviews. Interviews were conducted on-line by members of the CHNAC. Group A-Facility 11 -- Central Texas Medical CenterCentral Texas Medical Center (CTMC or the Hospital) is a 170-bed hospital located in San Marcos, Texas. The Hospital's service area consists of Hays and Caldwell counties. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews.Central Texas Medical Center formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of Central Texas Medical Center. Key members of the CHNAC included representatives from the following organizations:Texas State Student Health Center;Women, Infants and Children (WIC);Community Action, Inc.;San Marcos - Hays County EMS;San Marcos Consolidated Independent School District;Scheib Mental Health;Hays County Commission; andCommuniCare Health Centers. CTMC also gathered primary data through focus groups, interviews, and an online survey. Focus groups were conducted at the Dr. Eugene Clark Central Library, the Hays County Library, WIC Programs Center of Caldwell County and Hays County Community Action, Inc. One-hundred and twenty-two online surveys were completed by community residents.
Part V, Section B, Line 5 Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidAdventHealth Sebring (AH Sebring) and AdventHealth Lake Placid (AH Lake Placid) are both located in Highlands County Florida and operate under a single hospital license. AH Sebring and AH Lake Placid share the same service area which includes Highlands County and portions of adjacent Hardee County. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews. AH Sebring and AH Lake Placid formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of AH Sebring and AH Lake Placid. Key members of the CHNAC included representatives from the following organizations:Drug Free Highlands;Highlands County Sheriff's Office;MV Transportation - an organization involved in helping to meet transportation needs of those living in disadvantaged communities;Peace River Center - a domestic violence center;Healthy Start Coalition of Hardee, Highlands, and Polk Counties; Highlands County Board of County Commissioners;Nu-Hope Elder Care Services, Inc.;Highway Park Neighborhood Council;Heartland Regional Transportation Planning Organization;Florida Department of Health in Highland County;Samaritan's Touch Care Center;Wings of Faith Christian Worship Center;Heartland Rural Health Network;Highlands County Veteran Services Office;RCMA - an organization that provides child-care and child and parent education for migrant and other low-income families; and Central Florida Health Care - a federally qualified health center.Community surveys were completed on-line and in person by participants in community settings. Local community organizations assisted in survey participation efforts by providing access to a computer at community events. Community surveys were also made available at local clinics, community events, department of motor vehicle locations, and the community locations. A total of 578 residents from Highlands County participated in the Community Health Needs Assessment survey. AH Sebring and AH Lake Placid also gathered primary data through stakeholder interviews. Interviews were conducted on-line by members of the CHNAC.
Part V, Section B, Line 6a Footnote Facility Reporting Group - BAdventHealth Sebring and AdventHealth Lake Placid collaborated in conducting their Community Health Needs Assessments (CHNA) in 2019.
Part V, Section B, Line 7a Each hospital facility's CHNA report was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlandohttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/community-health-needs-assessmentsFacility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/community-health-needs-assessmentsFacility 5 -- AdventHealth Winter Parkhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/community-health-needs-assessmentsFacility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/community-health-needs-assessments Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments Facility 11 -- Central Texas Medical Centerhttps://www.adventhealth.com/community-health-needs-assessments Part V, Section B, Line 10aEach hospital facility's most recently adopted implementation strategy was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlandohttps://www.adventhealth.com/community-health-needs-assessments Facility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/community-health-needs-assessments Facility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/community-health-needs-assessments Facility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/community-health-needs-assessments Facility 5 -- AdventHealth Winter Parkhttps://www.adventhealth.com/community-health-needs-assessments Facility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/community-health-needs-assessments Facility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/community-health-needs-assessments Facility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/community-health-needs-assessments Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments Facility 11 -- Central Texas Medical CenterThe 2020-2022 Implementation Plan is posted on the website of the 501(c)(3) unrelated successor organization.
Part V, Section B, Line 7d Footnote Facility Reporting Group - AThe Hospital facilities have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospitals' websites at least until the date the hospital facilities have made widely available on its websites its two subsequent Community Health Needs Assessment Reports. The Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facilities have made available for public inspection its two subsequent Community Health Needs Assessment Reports.
Part V, Section B, Line 7d Footnote Facility Reporting Group - BThe Hospital facilities have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospitals' websites at least until the date the hospital facility has made widely available on its websites its two subsequent Community Health Needs Assessment Reports. The Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facilities have made available for public inspection its two subsequent Community Health Needs Assessment Reports.
Part V, Section B, Line 11 Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant NeedsAdventist Health System/Sunbelt Inc. d/b/a AdventHealth Orlando will be referred to in this document as AdventHealth Orlando or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Orlando is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Orlando's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Orlando worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Orlando chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. AdventHealth intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Orlando Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective, to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, providing financial support of at least $455,000 and annual board service over the next three years throughout the tri-county region. The tri-county region is defined as Orange, Osceola, and Seminole counties. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each AdventHealth Central Florida Division hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest Food Bank to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 4,945 pounds of food or 4,121 meals towards the larger Divisional goal. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedThe second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County, and Seminole County. The reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroot efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the board of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.The reporting Hospital provided representation to serve on two boards within their primary service area. The first is on the board of the UP (United Against Poverty) Orlando, a local nonprofit that serves those in poverty by providing crisis case management, transformative education, food and household subsidies, job training and placement, personal empowerment training and referrals to other collaborative social service providers. The reporting Hospital also provides representation on the board of the Heart of Florida, a local nonprofit that provides education, health, and financial stability for every person in Central Florida.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and education to the community at large. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse, to provide additional fresh produce in Orange County, the county of the reporting Hospital. These partnerships increased the amount of healthy food available to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity. In 2020, the Division provided representation on behalf of the Hospital to participate in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Orlando identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care, and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke. 2020 Update: The AdventHealth Orlando Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, residency rotations, and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging, volunteer services, etc. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County. The Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported by the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County, and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County, and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedPriority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health, and substance use were all identified as top community needs by stakeholders, key informants, and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as the local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness. 2020 Update: The AdventHealth Orlando Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, the Division serves on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Orlando primary service area that were identified as hot spots; and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to AdventHealth Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Orlando primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedThe second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting AdventHealth Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:There were over 1,500 individuals experiencing homelessness in Orange County in 2018. When individuals are experiencing homelessness, it is more difficult to access health care and manage chronicphysical and mental conditions. The AdventHealth Central Florida Division is heavily invested in addressing homelessness and is involved with partners such as: Christian Service Center, Coalition for the Homeless of Central Florida, Dave's House, Family Promise of Greater Orlando, Homeless Services Network of Central Florida and others.2020 Update: The AdventHealth Orlando Community Health Plan has one desired goal statement under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless populationGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide annual financial and in-kind support, including board service and employee volunteers to support community partners and increase the capacity to care for our homeless population. This objective is funded and managed at the Divisional level; outcomes reported for this objective are for the Division and not specific to the reporting Hospital. The first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric by providing financial support of $48,900 to three organizations in the Hospital's primary service area. Family Promise of Greater Orlando was given $18,000 to support their work to help individuals experiencing homelessness sustain housing and self-sufficiency and increase the program's capacity. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing and diversion received $5,000. Dave's House received $25,900 to further provide supportive housing for individuals with serious mental illness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The reporting Hospital progressed on this metric with in-kind services, including service on three boards. Boards served on include Christian Service Center, The Sharing Center, and Samaritan Resource Center. All of these organizations work to address the immediate and/or long-term needs of those experiencing homelessness. Due to COVID-19, volunteer efforts were delayed. The reporting Hospital pivoted where necessary to address the immediate needs of the community during the pandemic and will continue to do so. The Hospital will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Community Needs Not Chosen by AdventHealth OrlandoThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Community Resources Group: Although there is a multitude of resources available in the community, many community members may not know of these services or how to access them. To optimize utilization of available resources, the local CHNAC discussed potential solutions, which included creating community resource groups to inform community members of available resources, but it will not be included in the Community Health Plan. Although the Hospital did not choose to prioritize this issue and address it through the Community Health Plans, the Community Asset Inventory created for the CHNA report includes a list of available resources in the tri-county area. This Community Asset Inventory will be updated, shared with community organizations, and made publicly available.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Celebration will be referred to in this document as AdventHealth Celebration or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Celebration is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Celebration's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Celebration worked to define and address the needs of low-income, minority, and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Celebration chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:More than 40 percent of community survey respondents from Osceola County indicated that they do not have access to healthy, affordable food. Food security was also identified as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Division intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Celebration Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 515 pounds of food or 429 meals towards the larger Divisional goal. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The AdventHealth reporting Hospitals located in Osceola County sustained two of these partnerships and established one new partnership. The AdventHealth reporting Hospitals in Osceola County include AdventHealth Celebration and AdventHealth Kissimmee. One of the partnerships included financially supporting Meals on Wheels of Osceola operated by the Osceola Council on Aging. The Osceola Council on Aging is a nonprofit dedicated to providing services which enable independence and self-sufficiency in seniors, disabled adults, and more, and provides home meal deliveries to seniors. The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2020, the Division also established a new partnership with the School District of Osceola County (SDOC) to launch the SMART Bus. The SMART Bus provides food, education, access to Wi-Fi, and family support to meet the needs of the 2,500 homeless students enrolled in the SDOC. The new partnership is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals in Osceola County where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The Division is progressing on this objective and is actively working to identify the best practices to increase effectiveness of efforts to bring healthy food to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Osceola County. This initiative provides an opportunity to form and participate in multisector collaboratives within Osceola County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Osceola Health Leadership Council. This council is comprised of organizations throughout Osceola County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Celebration identified care coordination as a need, specifically preventative care/health screenings, access to care, and pediatric and women's health (including prenatal). Osceola County primary data respondents were less likely to indicate that they accessed preventative care services, such as PSA tests, lab work and Pap tests. In 2016, 23.6 percent of Osceola County adults could not see a doctor due to cost. Primary data respondents from Osceola County also identified transportation and care coordination as barriers to care in relation to chronic conditions when seeking care. A little more than 10 percent of Osceola County community survey respondents indicated that they have difficulty accessing prenatal care.2020 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind labs/imaging and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division provided $190,000 in financial contributions to Osceola Council on Aging to support clinical operations. Additionally, the Division provided $2,000 to Osceola Community Health Services, a local FQHC focused on meeting individuals' physical and mental health care needs, including prevention, wellness, acute and chronic care, for operational support to increase the availability of affordable care. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services were delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics, and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstance. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there is a sufficient number of mental health providers and nearly 60 percent of Osceola County community survey respondents indicated they feel depressed or hopeless. When discussing with primary research participants, it was stated that the high level of stress people are experiencing could make it difficult to cope with mental illness. This may be caused by lack of community support and available support services to manage mental health. The Central Florida Division of AdventHealth has several care options for mental health services. These include the Outlook Clinic and connections to FQHCs. The Central Florida Division of AdventHealth is funding several mental and behavioral health services in the community, including an eye movement desensitization and reprocessing (EMDR) psychotherapy treatment at a local FQHC and a music therapy program.2020 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, the representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Celebration's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Osceola County.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Celebration primary service area per year that were identified as hot spots. This objective was exceeded, with a total of four schools and five additional locations in AdventHealth Kissimmee and AdventHealth Celebration's shared primary service areas receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Osceola County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which support the objective, are specific to reporting Hospitals in Osceola County. This includes AdventHealth Celebration and AdventHealth Kissimmee. In 2020, this objective was met through an initiative, Digital Communal Gatherings, led by Peer Support Space. Peer Support Space is dedicated to being a local hub for diverse peer-led recovery communities. The Digital Communal Gatherings initiative offers a virtual space for peer-led support groups to meet and navigate their unique journeys with mental illness and/or substance misuse challenges, neurodivergence, disability, grief, trauma, or other obstacles to mental wellness. The Division was able to meet this objective in Osceola County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:Osceola County has the highest percentage of renter households who were cost burdened (24.4 percent) and severely cost burdened (25.1 percent). Osceola County also had 21.1 percent of homeowner residents who are severely cost burdened. Affordable housing has a large impact on other health outcomes and wellbeing. It enables families to have the opportunity to meet their respective health, education, and employment needs. The Central Florida Division of AdventHealth is heavily invested in addressing homelessness and is involved with partners such as: Coalition for the Homeless of Central Florida, Family Promise of Greater Orlando, Homeless Services Network of Central Florida, and others.2020 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless population2. Participate in advocacy efforts to provide affordable housing for community membersGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide financial and in-kind support to community partners to enhance their capacity to provide care. This objective is funded and managed at the Divisional level; outcomes reported for this objective are for the Division and not specific to the reporting Hospital.The first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric by providing financial support of $48,900 to three organizations in the Hospital's primary service area. The Family Promise of Greater Orlando was given $18,000 to support their work to help individuals experiencing homelessness sustain housing and self-sufficiency and increase the program's capacity. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing, and diversion received $5,000. Dave's House received $25,900 to further provide supportive housing for individuals with serious mental illness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric with in-kind services, including service on six boards. Boards served on include Christian Service Center, Dave's House, IDignity, Matthew's Hope, New Beginnings and Samaritan Resource Center. All these organizations work to address the immediate and/or long-term needs of those experiencing homelessness. Due to COVID-19, volunteer efforts were delayed. The Division pivoted where necessary to address the immediate needs of the community during the pandemic and will continue to do so. The Hospital will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Goal 2: Participate in advocacy efforts to provide affordable housing for community membersObjective 1: The first objective is a shared initiative between AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide annual financial and in-kind support, including board service and employee volunteers, to support community partners and increase the capacity to care for our homeless population. This objective is funded and managed at the Divisional level, but all outcomes are specific to the reporting Hospitals in Osceola County.The first strategy is to provide financial support to community partners to enhance their capacity to provide care. The Division progressed on this metric by providing financial support of $600,000 to Hope Partnership, a nonprofit organization that aims to provide a holistic continuum of care to end homelessness and poverty in Central Florida.The second strategy is to provide in-kind support to community partners to enhance their capacity to provide care. The reporting Hospital progressed on this metric with board service, including representation on Hope Partnership. Community Needs Not Chosen by AdventHealth CelebrationThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Poverty: The local Community Health Needs Assessment Committee (CHNAC) understands that poverty has a large impact on health and wellbeing. The CHNAC agreed that the scale of this need is too broad, and it would not be a realistic issue to be addressed with the resources available at this time. 2. Education: The local CHNAC discussed education, health education and literacy. It was determined that education was better addressed by existing organizations and resources in the community. Certain aspects of education such as health literacy will be addressed under care coordination initiatives.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt,Inc. d/b/a AdventHealth Altamonte Springs will be referred to in this document as AdventHealth Altamonte Springs or "the Hospital".The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency.AdventHealth Altamonte Springs is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth (the Division) now includes 15 hospitals.This is the first-year update for AdventHealth Altamonte Springs' 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Altamonte Springs worked to define and address the needs of low-income, minority and underserved populations in its service area.The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves.Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan.The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address.AdventHealth Altamonte Springs chose four priorities for its 2020-2022 Community Health Plan:1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Youth Development & MentorshipPriority 1: Food Security2019 Description of the Issue:More than 25% of community survey respondents from Seminole County indicated that they do not have access to healthy, affordable food. Food security was also defined as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update:Recognizing the impact of social determinants of health such as food security on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities.The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000, and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 2,683 pounds of food or 2,236 meals toward the larger Divisional goal.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained two of these partnerships. For the reporting Hospital, one of these partnerships included financially supporting a grassroots effort at one local church to provide food to those in need through their church food pantry. Financial support was also provided to Meals on Wheels of Seminole County, which provides home meal deliveries to seniors. The outcomes reported for this strategy, which supports the objective, are specific to Seminole County.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to the reporting Hospital. This initiative provides an opportunity to form and participate in multisector collaboratives within Seminole County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Seminole County Department of Health's Healthy Seminole committee. This committee is comprised of organizations throughout Seminole County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Altamonte Springs identified care coordination as a need, specifically affordable specialty care, efficient and holistic care coordination, childhood obesity, and efficient and affordable transportation. In Seminole County, 35.4% of community survey participants indicated that they lacked access to a healthcare provider specialist. Limited access to high quality specialists was identified as a community issue. Care coordination was identified by the local Community Health Needs Assessment Committee and primary data participants as a needed service. Seminole County has seen an increase in both middle school and high school students reporting a BMI at or above the 95th percentile. More than seven percent of Seminole County community survey respondents indicated that a family member had childhood obesity. Transportation was identified as a barrier related to economic conditions and public transportation was identified as a need. Transportation was also identified as a need related to mental health services, chronic conditions, and overall access to health care. 2020 Update: The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind labs/imaging, and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. Outcomes are reported for the Division and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in AdventHealth hospitals in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management services. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics, and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstances. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental and behavioral health, specifically the need for more providers and services, was identified as a top community need. Only 11% of community survey respondents in Seminole County believe there are a sufficient number of mental health providers. Nearly 60% of community survey respondents indicate that they feel depressed or hopeless. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. 2020 Update: The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction, and healing from past trauma.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs ContinuedOther initiatives to address this objective include providing in-kind support through board service. Currently, representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of Orlando and the surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Altamonte Springs' primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to the reporting Hospital in Seminole County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Altamonte Springs primary service area per year that were identified as hot spots. This objective was met by the Division, with two schools in the reporting Hospital's primary service area receiving the program. The outcomes reported for this strategy, which supports the objective, are specific to Seminole County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to the reporting Hospital in Seminole County. Due to COVID-19, these efforts were delayed for the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Youth Development & Mentorship 2019 Description of the Issue:Youth development and mentorship, specifically relating to youth education and enrichment, was identified by the local Community Health Needs Assessment Committee as a need. Seminole County has seen an increase in student absenteeism and high school gang activity. Positive influences combined with a strong education as a youth increases the chances for success in adulthood. 2020 Update: The AdventHealth Altamonte Springs Community Health Plan has one desired goal statement under the Community Development: Youth Development and Mentorship priority.1. Increase impact of efforts to provide positive experiences and healthy environments for youthGoal 1: Increase impact of efforts to provide positive experiences and healthy environments for youthObjective 1: The first objective is a shared initiative between AdventHealth Altamonte Springs and AdventHealth Apopka. These Hospitals are part of the Central Florida Division of AdventHealth. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to provide annual financial and in-kind support, including board service and employee volunteers, for continuation of annual school engagement events and growing new partnerships to serve youth in the community. This objective is funded and managed at the Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. The first strategy is to provide financial support to local organizations that are working to positively impact youth in the community. The Division provided financial support of $20,000 to the Kids House of Seminole County. Additionally, the Division provided in-kind support to the Kids House of Seminole County, including clinical staff and board service, to support their services for youth who have experienced physical and/or sexual abuse. Kids House provides clinical and mental health services for youth in Seminole County who have experienced abuse. The second strategy is to provide in-kind support, including board-service and employee volunteers, to local organizations that are working to positively impact youth and host annual school engagement events. The Division progressed on this metric by hosting one Take-over Day at Seminole County High School. The Take-over Day consists of AdventHealth team members volunteering their time to educate high school students on different health care career opportunities and develop career skills. The third strategy is to establish new partnerships to serve youth in the community. The Division progressed on this metric by establishing a partnership with No Limit Health and Education, Inc. which is a local nonprofit that hosts several programs., One of these programs, the Flow Detox program, teaches young men in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. The program will launch in 2021.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by AdventHealth Altamonte SpringsThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Affordable Housing: The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Seminole County that address affordable housing. The Hospital decided it would be better to target their efforts in areas where we would have greater impact.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth East Orlando will be referred to in this document as AdventHealth East Orlando or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth East Orlando is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth East Orlando's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth East Orlando worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth East Orlando chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Job Skills Training & EmployabilityPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update:Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, by providing financial support of at least $455,000, and by providing annual board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 1,040 pounds of food or 867 meals towards the larger Divisional goal.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support towards the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroot efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedThe third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and education to the community at large. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital. These partnerships increased the amount of healthy food available to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all of the communities they serve, regardless of geography.Priority 2: Care Coordination2019 Description of the Issue:AdventHealth East Orlando identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood access to care and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke.2020 Update:The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind provision of labs/imaging, volunteer services, etc.The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations.The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedThe Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division, is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations.The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging, and volunteer services were delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of Central Florida AdventHealth hospital facilities in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients.The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Central Florida AdventHealth hospital facilities in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program.The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstance. The Division is progressing on this objective.Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health, and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as the following: local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2020 Update: The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedThis initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000 dollars. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area.Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services.The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma.Other initiatives to address this objective include providing in-kind support through board service. Currently, the representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth East Orlando's primary service area that were identified as hot spots, and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth East Orlando primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as provide supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedPriority 4: Community Development: Job Skills Training & Employability2019 Description of the Issue:Job skills and training were identified as a top community need in the AdventHealth East Orlando breakout session. By attaining financial stability and alleviating the concerns associated with economic instability, individuals are able to more easily address health concerns. As an anchor organization in our community, AdventHealth Central Florida Division is able to implement job training and education programs for communities in need.2020 Update: The AdventHealth East Orlando Community Health Plan has one desired goal statement under the Community Development: Job Skills Training and Employability priority.1. Advocate and work within the community to remove barriers to employmentGoal 1: Advocate and work within the community to remove barriers to employmentObjective 1: The first objective is to collaborate with the community to enhance existing efforts to provide training, support, and social services to those currently unemployed and underemployed. The objective is funded and managed by the Division, but all outcomes are specific to the reporting Hospital. The first strategy is to collaborate with the community to enhance existing efforts to provide training, support, and social services to those currently unemployed and underemployed. The Division progressed on this metric by financially supporting Iniciativa Accion Puertorriquena, a local nonprofit, providing entry level English language classes to low-income residents in East Orlando.Community Needs Not Chosen by AdventHealth East OrlandoThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Adverse Childhood Events (ACEs): AdventHealth East Orlando will incorporate the issue of ACEs into their mental and behavioral health initiatives. The objective of working to identify and implement proactive mental health education and programs which focus on resiliency will include ACEs.2. Housing: By prioritizing job skills training and employability, the Hospital hopes to provide lasting solutions for community members to increase their ability to secure housing and decrease homelessness.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued Adventist Health System/Sunbelt Inc. d/b/a AdventHealth Winter Park will be referred to in this document as AdventHealth Winter Park or "the Hospital".The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency.AdventHealth Winter Park is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Winter Park's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Winter Park worked to define and address the needs of low-income, minority and underserved populations in its service area.The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves.Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address.AdventHealth Winter Park chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Senior VulnerabilityPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, financial support of at least $455,000, and annual board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with the Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 918 pounds of food or 765 meals towards the larger Divisional goal.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support towards the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroot efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the board of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts.The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and education to the community at large. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital by participating in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth was able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination2019 Description of the Issue:AdventHealth Winter Park identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care, and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies, and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke.2020 Update:The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, residency rotations, and to seek innovative ways to increase capacity through in-kind labs/imaging and volunteer services, etc.The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, not Hospital specific, and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations.The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County.The Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division, not Hospital specific, and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedThe fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients.The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, Advent Health Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program.The Division launched a new funding partnership of $335,288 over three years, with AdventHealth University's Hope Clinic. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. The Division is progressing on this objective.Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health2019 Description of the Issue:Mental health, behavioral health and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as: local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2020 Update:The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area.Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedThe Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction, and healing from past trauma.Other initiatives to address this objective include providing in-kind support through board service. Currently, the Division serves on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Winter Park's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Winter Park primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedPriority 4: Community Development: Senior Vulnerability2019 Description of the Issue:Seniors were identified as a unique population for AdventHealth Winter Park. Senior safety was identified as a community issue related to unintentional injuries by Orange County primary data participants. The senior population is especially vulnerable to negative effects of isolation including poor health outcomes and higher rates of depression. 2020 Update: The AdventHealth Winter Park Community Health Plan has one desired goal statement under the Community Development: Senior Vulnerability priority.1. Address unique mental, physical and spiritual needs of high senior populationGoal 1: Address unique mental, physical and spiritual needs of high senior populationObjective 1: The first objective is the reporting Hospital's initiative and appears only on the community health plan of AdventHealth Winter Park. The objective is to provide care navigation and social services for the senior population. The objective is funded and managed by the Division, but all outcomes are specific to the reporting Hospital. The Division progressed on this objective by partnering with Pinnacle Counseling to provide timely and affordable mental health services to seniors and their caregivers. Pinnacle Counseling is a local organization that provides the highest quality counseling by the most skilled and effective counselors to those in need of counseling. The reporting Hospital's Emergency Department (ED) team also has a direct referral line to contracted services at Pinnacle.Objective 2: The second objective is the reporting Hospital's initiative and appears only on the community health plan of AdventHealth Winter Park. The objective is to provide services to educate and support caregivers in the community to increase quality of life for both the caregiver and receiver of care. The objective is funded and managed by the Division, but all outcomes are specific to the reporting Hospital. The Division sustained and funded a position, Senior Care Navigator, at the reporting Hospital's Emergency Department (ED) to help address the unique needs of seniors. In 2020, more than 1,500 seniors and their caregivers were educated on additional social services and were referred for specialty consultations.Community Needs Not Chosen by AdventHealth Winter ParkThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issue:1. Built Environment (Affordable Housing): The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Orange County that address this issue. The Hospital decided it would be better to target their efforts in areas where it would have greater impact.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Kissimmee will be referred to in this document as AdventHealth Kissimmee or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Kissimmee is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Kissimmee's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Kissimmee worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Kissimmee chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:More than 40 percent of community survey respondents from Osceola County indicated that they do not have access to healthy, affordable food. Food security was also identified as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Division intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 515 pounds of food or 429 meals towards the larger Divisional goal. The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The AdventHealth reporting Hospitals located in Osceola County sustained two of these partnerships and established one new partnership. The AdventHealth reporting Hospitals in Osceola County include AdventHealth Celebration and AdventHealth Kissimmee. One of the partnerships included financially supporting Meals on Wheels of Osceola operated by the Osceola Council on Aging. The Osceola Council on Aging is a nonprofit dedicated to providing services which enable independence and self-sufficiency in seniors, disabled adults and more, and provides home meal deliveries to seniors. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedThe third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions. The reporting Hospital also provides representation to serve on the board of the Osceola Council on Aging. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2020, the Division also established a new partnership with the School District of Osceola County (SDOC) to launch the SMART Bus. The SMART Bus provides food, education, access to Wi-Fi and family support to meet the needs of the 2,500 homeless students enrolled in the SDOC. The new partnership is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals in Osceola County where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The Division is progressing on this objective and is actively working to identify the best practices to increase effectiveness of efforts to bring healthy food to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Osceola County. This initiative provides an opportunity to form and participate in multisector collaboratives within Osceola County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Osceola Health Leadership Council. This council is comprised of organizations throughout Osceola County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all of the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Kissimmee identified care coordination as a need, specifically preventative care/health screenings, access to care, and pediatric and women's health (including prenatal). Osceola County primary data respondents were less likely to indicate that they accessed preventative care services, such as a PSA test, lab work and Pap tests. In 2016, 23.6 percent of Osceola County adults could not see a doctor due to cost. Primary data respondents from Osceola County also identified transportation and care coordination as barriers to care in relation to chronic conditions when seeking care. A little more than 10 percent of Osceola County community survey respondents indicated that they have difficulty accessing prenatal care.2020 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations, and to seek innovative ways to increase capacity through in-kind labs/imaging and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division provided $190,000 in financial contributions to Osceola Council on Aging to support clinical operations. Additionally, the Division provided $2,000 to Osceola Community Health Services, a local FQHC focused on meeting individuals' physical and mental health care needs, including prevention, wellness, acute and chronic care, for operational support to increase the availability of affordable care. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedThe third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging, and volunteer services were delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstance. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there is a sufficient number of mental health providers and nearly 60 percent of Osceola County community survey respondents indicated they feel depressed or hopeless. When discussing with primary research participants, it was stated that the high level of stress people are experiencing could make it difficult to cope with mental illness. This may be caused by lack of community support and available support services to manage mental health. The Central Florida Division of AdventHealth has several care options for mental health services. These include the Outlook Clinic and connections to FQHCs. The Central Florida Division of AdventHealth is funding several mental and behavioral health services in the community, including an eye movement desensitization and reprocessing (EMDR) psychotherapy treatment at a local FQHC and a music therapy program.2020 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedAspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, the representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in AdventHealth Kissimmee's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Osceola County.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Kissimmee primary service area per year that were identified as hot spots. This objective was exceeded, with a total of four schools and five additional locations in AdventHealth Kissimmee and AdventHealth Celebration's shared primary service areas receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Osceola County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which support the objective, are specific to reporting Hospitals in Osceola County. This includes AdventHealth Celebration and AdventHealth Kissimmee. In 2020, this objective was met through an initiative, Digital Communal Gatherings led by Peer Support Space. Peer Support Space is dedicated to being a local hub for diverse peer-led recovery communities. The Digital Communal Gatherings initiative offers a virtual space for peer-led support groups to meet and navigate their unique journeys with mental illness and/or substance misuse challenges, neurodivergence, disability, grief, trauma, or other obstacles to mental wellness. The Division was able to meet this objective in Osceola County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:Osceola County has the highest percentage of renter households who were cost burdened (24.4 percent) and severely cost burdened (25.1 percent). Osceola County also had 21.1 percent of homeowner residents who are severely cost burdened. Affordable housing has a large impact on other health outcomes and wellbeing. It enables families to have the opportunity to meet their respective health, education, and employment needs. The Central Florida Division of AdventHealth is heavily invested in addressing homelessness and is involved with partners such as: Coalition for the Homeless of Central Florida, Family Promise of Greater Orlando, Homeless Services Network of Central Florida, and others.2020 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless population2. Participate in advocacy efforts to provide affordable housing for community membersGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide financial and in-kind support to community partners to enhance their capacity to provide care. This objective is funded and managed at the Divisional level; outcomes reported for this objective are for the Division and not specific to the reporting Hospital.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedThe first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric by providing financial support of $48,900 to three organizations in the Hospital's primary service area. The Family Promise of Greater Orlando was given $18,000 to support their work to help individuals experiencing homelessness sustain housing and self-sufficiency and increase the program's capacity. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing and diversion received $5,000. Dave's House received $25,900 to further provide supportive housing for individuals with serious mental illness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric with in-kind services, including service on six boards. Boards served on include Christian Service Center, Dave's House, IDignity, Matthew's Hope, New Beginnings and Samaritan Resource Center. All these organizations work to address the immediate and/or long-term needs of those experiencing homelessness. Due to COVID-19, volunteer efforts were delayed. The Division pivoted where necessary to address the immediate needs of the community during the pandemic and will continue to do so. The Hospital will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Goal 2: Participate in advocacy efforts to provide affordable housing for community membersObjective 1: The first objective is a shared initiative between AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide annual financial and in-kind support, including board service and employee volunteers to support community partners and increase the capacity to care for our homeless population. This objective is funded and managed at the Divisional level, but all outcomes are specific to the reporting Hospitals in Osceola County.The first strategy is to provide financial support to community partners to enhance their capacity to provide care. The Division progressed on this metric by providing financial support of $600,000 to Hope Partnership, a nonprofit organization that aims to provide a holistic continuum of care to end homelessness and poverty in Central Florida.The second strategy is to provide in-kind support to community partners to enhance their capacity to provide care. The Division progressed on this metric with in-kind services, including board service on Osceola County's Affordable Housing Advisory Committee and Hope Partnership. The Osceola County's Affordable Housing Advisory Committee reviews established policies and procedures, ordinances, land development regulations, and adopted local government comprehensive plans of the appointing local government and recommends initiatives to encourage affordable housing in the county. Community Needs Not Chosen by AdventHealth KissimmeeThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Poverty: The local Community Health Needs Assessment Committee (CHNAC) understands that poverty has a large impact on health and wellbeing. The CHNAC agreed that the scale of this need is too broad and would not be a realistic issue to be addressed with the resources available at this time. 2. Education: The local CHNAC discussed education, health education and literacy. It was determined that education was better addressed by existing organizations and resources in the community. Certain aspects of education such as health literacy will be addressed under care coordination initiatives.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Apopka will be referred to in this document as AdventHealth Apopka or "the Hospital".The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency.AdventHealth Apopka is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth (the Division) now includes 15 hospitals.This is the first-year update for AdventHealth Apopka's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Apopka worked to define and address the needs of low-income, minority and underserved populations in its service area.The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves.Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan.The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address.AdventHealth Apopka chose four priorities for its 2020-2022 Community Health Plan:1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Youth Development & MentorshipPriority 1: Food Security2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update:Recognizing the impact of social determinants of health such as food security on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities.The AdventHealth Apopka Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000, and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. Due to the COVID-19 pandemic, the reporting Hospital was not able to contribute toward the Division's total.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The AdventHealth reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The AdventHealth reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroots efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedThe third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and provide education to the community at large. These partnerships increased the amount of healthy food available to community members in need. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to the reporting Hospital. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination2019 Description of the Issue:AdventHealth Apopka identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care, and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies, and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a healthcare provider specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke.2020 Update:The AdventHealth Apopka Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind labs/imaging, and volunteer services, etc.The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations.The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedThe Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.In 2020, the reporting Hospital provided $106,000 to Community Health Centers (CHC), a local FQHC, to support the salary for a nurse navigator that helped uninsured and underinsured patients schedule appointments with CHC once discharged from the Hospital. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging, and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics, and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years, with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstances. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health, and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as: local Federally Qualified Health Centers (FQHCs), the Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2020 Update: The AdventHealth Apopka Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedThis initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000 dollars. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction, and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of Orlando and the surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching, and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Apopka's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Apopka primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedPriority 4: Community Development: Youth Development & Mentorship 2019 Description of the Issue:Youth development and mentorship, specifically relating to youth education and enrichment, was identified by the local Community Health Needs Assessment Committee as a need. Orange County has seen an increase in student absenteeism. Positive influences combined with a strong education as a youth increases the chances for success in adulthood. 2020 Update: The AdventHealth Apopka Community Health Plan has one desired goal statement under the Community Development: Youth Development and Mentorship priority.1. Increase impact of efforts to provide positive experiences and healthy environments for youthGoal 1: Increase impact of efforts to provide positive experiences and healthy environments for youthObjective 1: The first objective is a shared initiative between AdventHealth Altamonte Springs and AdventHealth Apopka. These Hospitals are part of the Central Florida Division of AdventHealth. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to provide annual financial and in-kind support, including board service and employee volunteers, for continuation of annual school engagement events and growing new partnerships to serve youth in the community. This objective is funded and managed at the Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. The first strategy is to provide financial support to local organizations that are working to positively impact youth in the community. In 2020, the Division provided financial support of $5,000 to AMIKids, which is an organization that works to protect public safety and positively impact as many youths as possible through the efforts of a diverse and innovative staff. AMIKids works in partnership with youth agencies, local communities, and families.The second strategy is to provide in-kind support, including board-service and employee volunteers, to local organizations that are working to positively impact youth and host annual school engagement events. The Division progressed on this metric by serving on the following boards: AMIKids, Reducing Obesity in Central Florida Kids (ROCK), Blanchard Park YMCA and The Nurture Place. These organizations all focus on curating healthy and positive spaces for youth in Orange County.The third strategy is to establish new partnerships to serve youth in the community. The Division progressed on this metric by establishing a new partnership with No Limit Health and Education, Inc., which is a local nonprofit that hosts several programs. One of these programs, the Flow Detox program, teaches young men in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. The program will launch in 2021. Community Needs Not Chosen by AdventHealth ApopkaThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Homelessness: The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Orange County that address this issue. The Hospital decided it would be better to target their efforts in areas where we would have greater impact.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc., dba AdventHealth Wauchula will be referred to in this document as AdventHealth Wauchula or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Wauchula is part of the West Florida Division (the Division) of AdventHealth. The Division includes 11 hospital facilities. This is the first-year update for AdventHealth Wauchula's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Wauchula worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Wauchula chose four priorities for its 2020-2022 Community Health Plan: 1. Mental Health (Behavioral Health)2. Access to Health Care 3. Cardiovascular Disease 4. Education (Social Determinant of Health) Priority 1: Mental Health (Behavioral Health)2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability for adults, children, and adolescents. When mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. Mental health disorders are the 11th leading cause of death in the United States for all age groups and the second leading cause of death among people age 25 to 34. In the AdventHealth Wauchula primary service areas (PSA), the rate of death due to self-harm (suicide) is 19 (per 100,000 population), which is higher than the state rate of 14 (per 100,000 population). Furthermore, 25% (16,345 persons) of the adults in the PSA population self report that they receive insufficient social and emotional support all or most of the time, which is higher than the state rate (21%). This indicator is relevant because social and emotional support is critical for navigating the challenges of daily life as well as for good mental health. Additionally, 17% (15,062 persons) of the Medicare-fee-for-service PSA population are depressed.2020 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Mental Health (Behavioral Health) priority.1. To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders2. To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsGoal 1: To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Champion for Children Advocacy Center to raise awareness of the impact of mental health in youth and adults residing in the Hospital's PSA by creating and implementing two local social media campaigns from a baseline of zero local social media campaigns by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This social media campaign initiative brings awareness to both youth and adult community members regarding mental illnesses and helps to encourage conversations around the topic of mental health to ultimately destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of our 2020-2022 Community Health Plans. The two new organizations are the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We are partnering with both organizations for this initiative. The Ruth E. Handley Children's Advocacy Center's mission is to minimize trauma of child abuse victims and provide prevention support to families needing assistance to keep them intact. The Champion for Children Foundation offers prevention services and assistance programs to protect children, educate parents, strengthen families, assist caregivers, reduce trauma, and provide resources. These partnerships, as well as insight from members of our Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for our social media campaigns moving forward, which will be depression and anxiety. The Hospitals progressed on the set metric of two local social media campaigns created and implemented by the end of year three. Throughout 2020, we connected with members in the community who address mental health and who work with youth and adults. We have established partnerships with those community organizations, including the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We will begin constructing and implementing the campaign in year two, after multiple discussions with the various parties involved who have helped determine the most important topics to highlight for the social media campaign. Additionally, we discussed the best methods of delivering these campaigns to reach both youth and adults and will work to implement these ideas in year two as well. We also learned of an opportunity to collaborate with a system-wide social media campaign that is underway in year two and are actively working to identify ways to incorporate our local mental health community benefit partnerships into the larger system-wide corporate campaign. We have also collected information on resources, local services, and self-management tools to be shared through the campaign and a Division-level community benefit website. Objective 2: The second objective is to increase the number of Mental Health First Aid USA certification training classes provided for free to community members residing in the Hospital's PSA to three certification classes from a baseline of zero by the end of year three. The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Wauchula, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Sebring, AdventHealth Tampa, AdventHealth Zephyrhills, AdventHealth Lake Placid and AdventHealth Wesley Chapel. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The initiative is managed at the Divisional level and funded through the Hospital and all reported outcomes are specific to the reporting Hospital.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThis initiative provides Mental Health First Aid USA certification classes to the community for free. The class is a course that teaches individuals how to help someone who may be experiencing mental health or substance use challenges. The training helps one to identify, understand and respond to signs of addictions and mental illnesses. Mental Health First Aid USA is a national program developed to teach the skills to respond to the signs of mental illness and substance use.The Hospital progressed on its set metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, our Divisional team members were unable to attend an in-person Mental Health First Aid instructor training, which would have certified them to provide the training to community members. Therefore, our 2020 progression focused on restructuring our approach and deployment strategy to develop new and safer ways to train our team members as instructors and to certify our community members in the Mental Health First Aid training. We identified virtual options to train our team, which created the opportunity to train four Divisional team members as Mental Health First Aid USA instructors, twice that of our original goal. Instructors are trained at the Divisional level to provide the classes for community members. In 2021, the Division will provide training for four team members to support the larger objective and will work to identify additional partners in the community for training and locations to begin classes.Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsObjective 1:The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide vouchers to cover the costs of household supplies for homeless adults residing in the Hospital's PSA who receive housing services at Peace River Center (PRC) from a baseline of zero vouchers to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved unless otherwise indicated.This initiative provides vouchers in the form of monetary funds to help cover some of the cost associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, who is our community partner. This will thereby lead to improved health outcomes by providing these essential supplies.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim services, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three vouchers to cover the cost of household supplies for those residents residing at Peace River Center by year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, information regarding their clients most immediate needs was also collected to best determine the amount and means of delivering this program, which will begin in year two. The vouchers will be distributed in the form of dollars funded by the reporting Hospital and will cover the cost of household supplies that may include, but not limited to, hygiene products, linens, cleaning supplies and household necessity items such as toilet paper and garbage bags for those residents living in Peace River Center's Domestic Violence Shelter.Objective 2:The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase awareness of Hospital sponsored community benefit programs and resources available to uninsured/underinsured adults and youth residing in the Hospital's PSA through a partnership with Peace River Center (PRC), by providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC from a baseline of zero presentations by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved.This initiative provides information about our Hospital sponsored Community Benefit programs that are free to community members and targeted to reach those uninsured/underinsured, underserved, low-income and minority members of the community. These programs include, but are not limited to, our Food is Health program that gives participants 10 dollars' worth of free produce for participating in an education class about nutrition and healthy living. These informative in-service presentations are presented to the Crisis Response Outreach Counselors at Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from our free community programs. By sharing our programs with these counselors, they can then share this information with their clients.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim services, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC by the end of year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, in 2020, due to COVID-19 many of our Hospital sponsored programs were put on hold as Division-wide restrictions on in-person gatherings were enforced. In year two, we have pivoted where necessary to address the immediate needs of our community and to find other means to deliver some of our programs. When these programs are back up and running successfully, we will then deliver these in-service presentations as planned.Objective 3:The third objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing mental health from a baseline of zero hours to 200 hours by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital.This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations addressing this priority area.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThe Hospitals progressed on the set metric of 200 hours of paid staff time spent volunteering in the community to address mental health by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal internally. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. Therefore, we have pivoted where necessary and in year two will have virtual volunteer opportunities available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal. Priority 2: Access to Health Care 2019 Description of the Issue:Access to health care is the equitable use of health services to achieve the highest level of health. Barriers to accessing healthcare services include cost of care, insurance coverage, availability of services and culturally competent care. Failure to overcome these barriers leads to delayed care, health complications and financial burdens. Accessing healthcare services is vital to prevent and treat diseases thereby reducing the likelihood of disability and premature death.In the AdventHealth Wauchula PSA, 24% of adults and 8% of children are uninsured or without medical insurance (both percentages are higher than the state averages). Additionally, 27% of adults do not have a regular doctor which is higher than the state average of 24.8%. 2020 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Access to Health Care priority. 1. To implement strategies to reduce transportation barriers leading to improved access to primary care providers2. To provide resources that support the expansion of services that are available to community members and increase access. To increase partnerships with local community organizations with resources to offer community members assistance with gaining health insurance coverageGoal 1: To implement strategies to reduce transportation barriers leading to improved access to primary care providers Objective 1: The first objective is shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to increase access to primary care by decreasing transportation challenges (barriers) among vulnerable adults residing in the Hospital's Primary Service Area (PSA) by developing, implementing and evaluating three new collaborative strategies with community partners from a baseline of zero strategies by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between our Hospital and community organizations who also share a goal to reduce transportation challenges within the community. Through this collaboration, we exchanged ideas, resources, and programs. We also evaluated what additional resources are available, or may become available, to community members with transportation challenges.The Hospital progressed on its set metric of implementing three new collaborative strategies to aid in decreasing transportation challenges among vulnerable adults residing in the Hospital's PSA by year three. Year one was spent identifying community organizations and community members to connect with and invite to be a part of our Community Health Needs Assessment Committee. Through this committee, we worked to discuss these challenges. We established new partnerships with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.We met with these partners, as well as the other community organization representatives, to discuss what transportation barriers exist within the Hospital's PSA. We identified that a public transit system does not exist but there are several transportation programs that are new and available to our underserved and transportation disadvantaged population. We discussed that the best strategy is to get the information about these programs out to our community members and those organizations who serve them and to help these individuals enroll in these programs. We have come up with a plan to execute this which includes a community summit that will be implemented in year two. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to establish a new transportation taskforce in Hardee and Highlands Counties to co-host at least two community summits (with AdventHealth Sebring and AdventHealth Lake Placid) from a baseline of zero summits to increase awareness of the impact of transportation accessibility on community health and wellness and employment sustainability for community members residing in the Hospital's PSA by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative brings together multiple organizations from the community who share a common goal in seeking to improve transportation access and a platform for getting the transportation programs available out to the communities we serve. The Hospitals progressed on the set metric of establishing a transportation taskforce to co-host two community summits by the end of year three. Year one was spent establishing a partnership with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThrough these partnerships we learned that a transportation taskforce already exists for Hardee and Highlands Counties and concluded it would be in our best interest to join this taskforce that is already in place. In year two, we will designate one of our Hospital team members to join this taskforce to represent AdventHealth. Year one was also spent discussing ideas and making plans for the community summit, which is scheduled to take place in year two, due to COVID-19 restrictions on in-person gatherings for 2020. The community summit in year two will be an in-person, informative, transportation health fair that will be held at our Hospital and will offer information and education regarding the transportation programs available. It will serve to inform the public, patients, families, and organizations who serve the transportation disadvantaged community members, about the transportation programs available in the Hospital's PSA and help them to enroll. Goal 2: To provide resources that support the expansion of services that are available to community members and increase access. To increase partnerships with local community organizations with resources to offer community members assistance with gaining health insurance coverageObjective 1: The first objective is to partner with the Florida Department of Health in Hardee and Highlands Counties to develop and implement "Health Insurance 101" community workshop series (enrollment, how to use insurance, KidCare education, terms, and definitions, etc.) for adults residing in the Hospital's PSA by providing three free community workshop series from a baseline of zero workshop series by the end of year three. The initiative is funded and managed through AdventHealth Wauchula and all outcomes are specific to the reporting Hospital. The initiative provides health education to uninsured and underinsured residents to help them understand how to enroll in affordable health insurance, utilize health insurance, and seek out primary care services. This is done in partnership with the Healthcare Planning Council of Southwest Florida. This organization employs health insurance navigators to educate the public on the health insurance marketplace and other government assisted health insurance programs. Their mission is to improve the health and wellness of the community by promoting healthy lifestyles, reducing health disparities, increasing access to quality health related services, detecting, and eliminating gaps in services, expanding knowledge through education, and facilitating community partnerships. The Hospital progressed on its set metric of providing three free "Health Insurance 101" workshops for the community by the end of year three. In year one, we met with the Florida Department of Health and other team members on our Community Health Needs Assessment Committee to discuss ideas, implementation, and potential partnerships for these workshops. It was decided that in year two we will partner with the Healthcare Planning Council of Southwest Florida to deliver these workshops that will begin in a virtual format and then resume to in-person workshops once the Division-wide restrictions for in-person gatherings have lifted. Objective 2: The second objective is to increase access to primary care services among underinsured/uninsured community members by providing donated medical supplies to two local community clinics from a baseline of one by the end of year three. The initiative is funded and managed through AdventHealth Wauchula and all outcomes are specific to the reporting Hospital. The initiative provides two identified clinics within the Hospital's PSA who serve low-income, uninsured, or underinsured populations with donated medical supplies. The Hospital progressed on its set metric of providing donated medical supplies to two local community clinics by the end of year three. Year one was spent identifying and creating partnerships with two community clinics who serve the underserved population. The clinics chosen were Samaritan's Touch Care Center and Central Florida Health Care (CFHC) of Hardee County. Samaritan's Touch is a faith-based, charitable healthcare center in Highlands County offering free primary and specialized medical, dental and vision care to uninsured financially struggling families who have no medical insurance of any kind and whose income is at or below 200% of the Federal Poverty Guidelines. CFHC of Hardee County is the local federally qualified healthcare clinic. In year two, information regarding medical supply needs and costs will be gathered for each facility to determine the quantity and type of medical supplies the Hospital will donate. The delivery of these supplies to the clinics will also take place in year two. Priority 3: Cardiovascular Disease2019 Description of the Issue:Coronary heart disease is a leading cause of death in the U.S. and is also related to high blood pressure, high cholesterol, and heart attacks. In the AdventHealth Wauchula primary service area (PSA), 9% (7,614 persons) of adults aged 18 and older have coronary heart disease or angina (heart related chest pain). Additionally, the rate of death due to heart disease per 100,000 population is 155 (268 average annual deaths from 2012 2016), which is higher than the state rate of 150 and 22% (13,201 persons) of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2020 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Cardiovascular Disease priority. 1. Improve access to health education, early intervention programs and resources related to cardiovascular disease2. Decrease tobacco use in adults and youth community membersGoal 1: Improve access to health education, early intervention programs and resources related to cardiovascular disease Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the number of Hospital sponsored American Heart Association (AHA) community CPR (Cardiopulmonary Resuscitation) out-of-hospital bystander classes for adults and youth from a baseline of zero to two by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. This initiative provides training to lay community members to be able to save the lives of individuals experiencing a cardiac event by administering the two-step, Hands-Only CPR. The Hospital progressed on its set metric of two classes sponsored by the end of year three. Throughout 2020, we have strengthened relationships with local community organizations that will host the train-the-trainer community CPR classes and promote the training among the community members they serve within our Hospital's PSA. In year one, the Division team met with our local American Heart Association on a bi-monthly basis to develop strategies and propose timelines for training and implementation in year two. As a result of our year one efforts, together with our local AHA team, we have created a novel train-the-trainer model for community CPR classes that will equip participants with the two-step, Hands-Only CPR skills to help save a life in the community setting. In addition, we received a donation of adult and child CPR Anytime training kits to launch our 2021 pilot of community CPR classes. Our Division team will complete the AHA instructor training in May 2021.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 2:The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Florida Department of Health (FDOH) in Highlands County to provide patient referrals at discharge to enroll in free Diabetes Self-Management Education and Support (DSMES) classes by creating an internal referral system to refer 75 underinsured/uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital.This initiative provides an internal referral system for the Hospital to directly enroll patients in need of the FDOH's DSMES classes. The Florida Department of Health works to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. The DSMES referral program connects diabetic and pre-diabetic individuals to health education that provides them with knowledge and tools to self-manage their chronic condition, improve health behaviors, and change health outcomes.The Hospitals progressed on the set metric of creating an internal referral system to refer 75 underinsured/uninsured adults residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, the Florida Department of Health of Highlands County temporarily cancelled DSMES classes in year one. Nevertheless, we have utilized this time to develop a tentative timeline and internal plan for referring participants to DSMES classes at the Florida Department of Health of Highlands County once classes resume. The internal plan for referring participants to the DSMES classes involves a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an "at discharge" referral system to connect patients to our Community Benefit programs and initiatives. In year two, the referral system will be piloted to connect patients (at discharge) with a history of tobacco use to free tobacco cessation classes offered by the Central Florida Area Health Education Center. This same referral system will soon be expanded to also refer patients to DSMES classes once in-person classes resume, ensuring that the Hospital will be able to refer 75 patients to these classes by the end of 2022.Objective 3:The third objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will support a series of five nutrition education class series among low-income families in the PSA from a baseline of two by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of five class series offered to low-income families by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 4:The fourth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will distribute 200 produce vouchers (valued at $10 each) to program participants from a baseline of 72 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of distributing 200 produce vouchers to program participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 5:The fifth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food Is Health program will build and maintain partnerships with local community organizations serving low-income/low access communities by engaging seven community partners from a baseline of four by the end of year three. This objective is managed at a Divisional level, and outcomes reported represent the Hospitals in Hardee and Highlands counties; AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of building and maintaining partnerships by recruiting three of the seven new community partner organizations by the end of year three. The first year was focused on creating a formal partnership with the local produce vendor, Solace Farms. We did this by onboarding the produce vendor and having them sign a memorandum of understanding (MOU) to agree to the terms of the program and accept the formal partnership. We also engaged a new educational partner, the University of Florida (UF)/IFAS Extension of Hardee, Desoto, and Manatee counties. UF/IFAS Extension is an outreach partnership between the state, federal and county governments to provide scientific knowledge and expertise to the public. This expertise includes educational nutrition programming targeted for the low-income, underserved and minority members of the population. Through this partnership, UF/IFAS Extension agreed to teach nutritional classes for the program. In year one, we connected with another community partner who also expressed interest in being a host site for the program once in-person classes resume. This organization is Heartland Core Wellness, whose mission is to address the health and wellness needs of the community with a focus on prevention education and the reduction of youth substance abuse.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 6: The sixth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will increase the number of participants among low-income families in the PSA to 50 from a baseline of 15 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of increasing program participation to 50 participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 7:The seventh objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will increase the number of health screenings among adults living in food deserts or low-income/low access communities to 75 from a baseline of 23 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of 75 health screenings by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. These modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with the Central Florida Area Health Education Center (AHEC) to provide continuing education classes to 50 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative provides educational classes that lead to an increase in knowledge for those AdventHealth team members who treat patients with tobacco use, or work with these patients at discharge, about tobacco cessation resources available, which could potentially improve patients' health through support for eliminating tobacco use. This is conducted through a partnership with Central Florida AHEC, the local affiliate of the national organization of AHEC, that is a community focused organization that develops and implements community-based health promotion activities and education programs which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital progressed on its set metric of educating 50 team members about tobacco cessation resources by the end of year three. In year one, the Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and Central Florida AHEC. The MOU illustrates how Central Florida AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to providers and staff of AdventHealth Wauchula, thereby resulting in earned CEUs and CMEs for these team members. In year one, our Hospital team members worked additional hours and jobs to meet the needs caused by the impact of COVID-19 on our Hospitals, patients, and community members; because of this, we delayed adding any additional training involving this objective for our team members during this time. In year two, AHEC will provide these trainings to our team members, either live or through a virtual format, in which team members will then earn their CEUs/CMEs, which are needed to keep their licenses and certifications for their positions. Additionally, the information learned in these classes will increase team members' knowledge and ability to offer treatment services for patients and community members who are tobacco users, thereby potentially improving their overall health. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide patient referrals at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit smoking tobacco through a partnership with AHEC and create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 18 patients from a baseline of zero by end of year three. The objective is funded through AdventHealth Sebring but managed by the Division. Reported referrals are specific to the reporting Hospital.This initiative provides an internal patient referral system at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit tobacco. This initiative is conducted through a partnership with AHEC and the Hospital's internal Care 360 team. AHEC is a community focused organization that develops and implements community-based health promotion activities and education programs which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital's internal Care 360 team works with patients at discharge and serves to identify patients needing tobacco cessation. Once identified, the Care 360 team can use this internal referral system to directly enroll patients into AHEC's tobacco cessation program. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThe Hospitals progressed on the set metric of providing resources for 18 patients at discharge through an internal referral system between the Hospital and AHEC by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Objective 3: The third objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase access to tobacco cessation classes for adults residing in the Hospital's PSA by five classes from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative increases access to tobacco cessation classes that improve health through a partnership with Central Florida Area Health Education Center (AHEC), the local affiliate of the national organization of AHEC, who is a community focused organization that develops and implements community-based health promotion activities and education programs which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospitals progressed on the set metric of increasing access to five tobacco cessation classes by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Unfortunately, in year one, all in-person AHEC free tobacco cessation classes were cancelled at the beginning of the COVID-19 pandemic. Furthermore, company policy has prevented us from hosting free tobacco cessation classes on our Hospital campuses. However, we were still able to promote AHEC's virtual classes in year one by sharing their flyers and class information with our community partners, posting flyers and dates on our internal CREATION Life/Wellness Center calendars and Hospital spaces, and sharing class information with our internal Care 360 team for them to inform patients at discharge of the program. In year two we will identify community locations that may allow in-person tobacco cessation classes and will work with AHEC to secure these locations, provide free marketing for the classes, sponsor costs associated with conducting these classes, and offer free class space to host classes within our Hospitals once our internal restrictions on in-person gatherings have lifted.Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Wauchula primary service area, 20% (12,547 persons) of the population aged 25 and older do not have a high school diploma (or equivalency) or higher and this percentage is higher than the state average of 12%. Educational attainment is a social determinant of health and is linked to health outcomes. Additionally, improving health literacy may be a useful strategy for reducing disparities in health related to education.2020 Update: Recognizing the impact of social determinants of health, like education, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach in addition to our partnership with Aunt Bertha will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Education (Social Determinant of Health) priority. 1. To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health2. To support community efforts that address the problem of educational attainment as a social determinant of healthGoal 1: To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with local community school and/or college programs to create a community-based professional development program (interviewing skills, resume writing, basic computer skills, mentoring) for underserved adults residing in the Hospital's PSA by providing three community workshops from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides underserved adults with educational and hands-on training skills, such as resume writing and computer skills, needed to enter the workforce. The Hospitals progressed on the set metric of providing three community workshops to underserved adults by the end of year three. Year one was spent identifying career readiness programs and organizations within the Hospital's PSA to partner with for this objective. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThrough these partnerships, we have identified resources - including teachers, classes, locations, and target audience members - for these development programs. Due to COVID-19, in year one, in-person classes and programs delivered through these organizations were cancelled. Additionally, Division-wide restrictions on in-person gatherings were also enforced for our Hospitals and company policy prevented us from hosting in-person classes on our Hospital campuses. We have pivoted where necessary and in year two will begin partnering with these organizations to deliver this program virtually or in-person when restrictions lift. We will do this by having our team members offer lessons about real-world career opportunities at AdventHealth and sharing the process of attaining and maintaining a successful career. Additionally, our Hospital will offer support in the form of free meeting space to host the classes for these partner organizations, free marketing materials, and additional costs covered of delivering these classes. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to establish a new partnership with local community organizations to identify education access barriers in underserved adults residing in the Hospital's PSA from a baseline of zero organizations to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved.This initiative creates a partnership with local community organizations working in adult education to help discover challenges to educational attainment and means to help resolve them. The Hospitals met the set metric of establishing three new partnerships with local community organizations to identify barriers for accessing education in underserved adults by the end of year three. We established a partnership with three new community partners - CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of our community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. We have also created ideas to overcome these barriers and in year two will begin implementing some of these solutions in conjunction with these partnerships.Goal 2: To support community efforts that address the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide education vouchers to cover the costs of General Educational Development (GED) materials (textbooks, registration fees and tests) for adults residing in the Hospital's PSA from a baseline of zero vouchers to three vouchers by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides education vouchers in the form of monetary funds to help cover some of the cost associated with the GED test. The Hospitals progressed on the set metric of providing three education vouchers in the form of monetary funds for adults residing in the Hospital's PSA by the end of year three. Year one was spent identifying and establishing a partnership with the local GED preparation and testing organization, South Florida State College. In doing so, we were able to learn more about their monetary needs to support the program. In addition, we gathered information from this organization relating to populations and number of adults served, need for financial assistance, and any programs offering assistance that are already available for eligible adults. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. Due to COVID-19, South Florida State College's GED classes were initially cancelled. In year two, the Hospital will determine the dollar amount to provide to cover the cost of this program for those underserved adults.Objective 2: The second objective is a shared initiative with AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing education (as a social determinant of health) from a baseline of zero hours to 150 hours by the end of year three. The objective is funded and managed through all Hospitals; however, outcomes are specific to the reporting Hospital. This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospitals progressed on the set metric of 150 hours of paid staff time spent volunteering in the community to address education (as a social determinant of health) by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. We have pivoted where necessary and in year two will have virtual volunteer opportunities also available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by AdventHealth Wauchula:The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Poor Dental Health: Many oral diseases can be prevented with routine care and regular dental checkups. The health of the teeth, the mouth and the surrounding craniofacial (skull and face) structures is central to a person's overall health and well-being. Lack of access to dental care for all ages remains a public health challenge. In the AdventHealth Wauchula Primary Service Area (PSA), the access to qualified dentists at a rate (per 100,000 pop.) is 36 (in 2015 year), as compared to the state rate of 56. The Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time.2. Tobacco Use: In the AdventHealth Wauchula PSA, an estimated 13,201 of adults age 18 or older self report currently smoking cigarettes some days or every day. This indicator is relevant because tobacco use is linked to leading causes of death such as cancer and cardiovascular disease. In the Hospital PSA, 22% of adults are currently smoking cigarettes, which is higher than the state percentage of 19%. The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address tobacco use will be wrapped into the priority area of heart disease.3. Obesity/Overweight/Obese: In the AdventHealth Wauchula PSA, approximately 33% of adults aged 20 and older (21,963 persons) self report that they have a Body Mass Index (BMI) greater than 30.0 (obese) in the report area. The state percentage is 27%. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address Obesity/Overweight/Obese will be wrapped into the education priority area. The Community Health Needs Assessment Committee (CHNAC) will approach this area of need more comprehensively, as other barriers contribute to negative health outcomes in this area of priority.
Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 11 -- Central Texas Medical CenterDescription of CHNA Significant Needs ContinuedOn March 31, 2020, all the net assets associated with the operation of the hospital known as Central Texas Medical Center (CTMC or the Hospital) were sold to Christus Santa Rosa Health Care Corporation. Prior to the sale on March 31, 2020, CTMC was owned and operated by Adventist Health System/Sunbelt, Inc. Christus Santa Rosa Health Care Corporation, the purchaser, is also an organization exempt from federal income tax under Internal Revenue Code Section 501(c)(3). Prior to the sale of the Hospital's assets on March 31, 2020, work has done on the development of the Community Health Plan and acquiring the board approval for it. Implementation of the goals and objectives outlined in the Community Health Plan/Implementation Strategy was not able to be initiated in sufficient scope and breadth prior to the sale in order to provide any meaningful feedback with respect to the results of the actions outlined in the Community Health Plan/Implementation Strategy. Accordingly, the only outcomes available to report are that of the successful development and approval of the 2020-2022 Implementation Plan.
Part V, Section B, Line 11 Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Sebring and AdventHealth Lake Placid, will be referred to in this document as AdventHealth Sebring or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Sebring is part of the West Florida Division (the Division) of AdventHealth. The Division includes 11 hospital facilities. This is the first-year update for AdventHealth Sebring's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Sebring worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Sebring chose four priorities for its 2020-2022 Community Health Plan: 1. Mental Health (Behavioral Health)2. Transportation 3. Cardiovascular Disease 4. Education (Social Determinant of Health) Priority 1: Mental Health (Behavioral Health)2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability for adults, children, and adolescents. When mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. Mental health disorders are the 11th leading cause of death in the United States for all age groups and the second leading cause of death among people age 25 to 34. In the AdventHealth Sebring primary service areas (PSA), the rate of death due to self-harm (suicide) is 19 (per 100,000 population), which is higher than the state rate of 14 (per 100,000 population). Furthermore, 25% of the adults in the PSA population self report that they receive insufficient social and emotional support all or most of the time, which is higher than the state rate (21%). This indicator is relevant because social and emotional support is critical for navigating the challenges of daily life as well as for good mental health. Additionally, 17% of the Medicare-fee-for-service PSA population are depressed.2020 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Mental Health (Behavioral Health) priority. 1. To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders2. To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsGoal 1: To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Champion for Children Advocacy Center to raise awareness of the impact of mental health in youth and adults residing in the Hospital's PSA by creating and implementing two local social media campaigns from a baseline of zero local social media campaigns by the end of year three. The objective is funded and managed through all Hospitals and outcomes reported represent all Hospitals involved. This social media campaign initiative brings awareness to both youth and adult community members regarding mental illnesses and helps to encourage conversations around the topic of mental health to ultimately destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of our 2020-2022 Community Health Plans. The two new organizations are the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We are partnering with both organizations for this initiative. The Ruth E. Handley Children's Advocacy Center's mission is to minimize the trauma of child abuse victims and provide prevention support to families needing assistance to keep them intact. The Champion for Children Foundation offers prevention services and assistance programs to protect children, educate parents, strengthen families, assist caregivers, reduce trauma, and provide resources. These partnerships, as well as insight from members of our Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for our social media campaigns moving forward, which will be depression and anxiety. The Hospitals progressed on the set metric of two local social media campaigns created and implemented by the end of year three. Throughout 2020, we connected with members in the community who address mental health and who work with youth and adults. We have established partnerships with those community organizations, including the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We will begin constructing and implementing the campaign in year two, after multiple discussions with the various parties involved who have helped determine the most important topics to highlight for the social media campaign. Additionally, we discussed the best methods of delivering these campaigns to reach both youth and adults and will work to implement these ideas in year two as well. We also learned of an opportunity to collaborate with a system-wide social media campaign that is underway in year two and are actively working to identify ways to incorporate our local mental health community benefit partnerships into the larger system-wide corporate campaign. We have also collected information on resources, local services, and self-management tools to be shared through the campaign and a Division-level community benefit website. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 2:The second objective is to increase the number of Mental Health First Aid USA certification training classes provided for free to community members residing in the Hospital's PSA to three certification classes from a baseline of zero by the end of year three.The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Sebring, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Tampa, AdventHealth Zephyrhills, AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Wesley Chapel. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The initiative is managed at the Divisional level and funded through the Hospital and all reported outcomes are specific to the reporting Hospital.This initiative provides Mental Health First Aid USA certification classes to the community for free. The class is a course that teaches individuals how to help someone who may be experiencing mental health or substance use challenges. The training helps one to identify, understand and respond to signs of addictions and mental illnesses. Mental Health First Aid USA is a national program developed to teach the skills to respond to the signs of mental illness and substance use.The Hospital progressed on its set metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, our Divisional team members were unable to attend an in-person Mental Health First Aid instructor training, which would have certified them to provide the training to community members. Therefore, our 2020 progression focused on restructuring our approach and deployment strategy to develop new and safer ways to train our team members as instructors and to certify our community members in the Mental Health First Aid training. We identified virtual options to train our team, which created the opportunity to train four Divisional team members as Mental Health First Aid USA instructors, twice that of our original goal. Instructors are trained at the Divisional level to provide the classes for community members. In 2021, the Division will provide training for four team members to support the larger objective and will work to identify additional partners in the community for training and locations to begin classes.Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsObjective 1:The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide vouchers to cover the costs of household supplies for homeless adults residing in the Hospital's PSA who receive housing services at Peace River Center (PRC) from a baseline of zero vouchers to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved unless otherwise indicated.This initiative provides vouchers in the form of monetary funds to help cover some of the cost associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, who is our community partner. This will thereby lead to improved health outcomes by providing these essential supplies.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three vouchers to cover the cost of household supplies for those residents residing at Peace River Center by year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, information regarding their clients most immediate needs was also collected to best determine the amount and means of delivering this program, which will begin in year two. The vouchers will be distributed in the form of dollars funded by the reporting Hospital and will cover the cost of household supplies that may include, but not limited to, hygiene products, linens, cleaning supplies and household necessity items such as toilet paper and garbage bags for those residents living in Peace River Center's Domestic Violence Shelter.Objective 2:The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase awareness of Hospital sponsored community benefit programs and resources available to uninsured/underinsured adults and youth residing in the Hospital's PSA through a partnership with Peace River Center (PRC) by providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC from a baseline of zero presentations by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved.This initiative provides information about our Hospital sponsored Community Benefit programs that are free to community members and targeted to reach those uninsured/underinsured, underserved, low-income and minority members of the community. These programs include, but are not limited to, our Food is Health program that gives participants 10 dollars' worth of free produce for participating in an education class about nutrition and healthy living. These informative in-service presentations are presented to the Crisis Response Outreach Counselors at Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from our free community programs. By sharing our programs with these counselors, they can then share this information with their clients.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim services, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC by the end of year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, in 2020, due to COVID-19 many of our Hospital sponsored programs were put on hold as Division-wide restrictions on in-person gatherings were enforced. In year two, we have pivoted where necessary to address the immediate needs of our community and to find other means to deliver some of our programs. When these programs are back up and running successfully, we will then deliver these in-service presentations as planned.Objective 3:The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing mental health from a baseline of zero hours to 300 hours by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThis initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations addressing this priority area. The Hospitals progressed on the set metric of 300 hours of paid staff time spent volunteering in the community to address mental health by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal internally. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. Therefore, we have pivoted where necessary and in year two will have virtual volunteer opportunities available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal. Priority 2: Transportation 2019 Description of the Issue:A poor transportation system prevents those who do not own a car or have reliable transportation from accessing healthcare. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. In the AdventHealth Sebring primary service area (PSA), 3% (1,026 persons) of the population are currently using public transportation as their primary means of transportation to work. Furthermore, 27% of the population (28,585 persons) age 18 years and older do not have a regular healthcare provider, which is higher than the state average of 25%.2020 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Transportation priority. 1. To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation2. To increase access to culturally appropriate nutritious food options in food desert or low income/low access areas by implementing the Food is Health programGoal 1: To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to decrease transportation challenges (barriers) among vulnerable adults residing in the Hospital's PSA by creating and implementing two new collaborative strategies from a baseline of zero strategies by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between our Hospital and community organizations who also share a goal to reduce transportation challenges within the community. Through this collaboration, we exchanged ideas, resources, and programs. We also evaluated what additional resources are available, or may become available, to community members with transportation challenges.The Hospital progressed on its set metric of implementing two new collaborative strategies to aid in decreasing transportation challenges among vulnerable adults residing in the Hospital's PSA by year three. Year one was spent identifying community organizations and community members to connect with and invite to be a part of our Community Health Needs Assessment Committee. Through this committee, we worked to discuss these challenges. We established new partnerships with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.We met with these partners, as well as the other community organization representatives, to discuss what transportation barriers exist within the Hospital's PSA. We identified that a public transit system does not exist but there are several transportation programs that are new and available to our underserved and transportation disadvantaged population. We discussed that the best strategy is to get the information about these programs out to our community members and those organizations who serve them and to help these individuals enroll in these programs. We have come up with a plan to execute this which includes a community summit that will be implemented in year two. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to establish a new transportation taskforce in Hardee/Highlands Counties to co-host at least two community summits (with AdventHealth Wauchula and AdventHealth Lake Placid) from a baseline of zero summits to increase awareness of the impact of transportation accessibility on community health, wellness and employment sustainability for community members residing in the Hospital's PSA by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative brings together multiple organizations from the community who share a common goal in seeking to improve transportation access and a platform for getting the transportation programs available out to the communities we serve. The Hospitals progressed on the set metric of establishing a transportation taskforce to co-host two community summits by the end of year three. Year one was spent establishing a partnership with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThrough these partnerships we learned that a transportation taskforce already exists for Hardee and Highlands Counties and concluded it would be in our best interest to join this taskforce that is already in place. In year two, we will designate one of our Hospital team members to join this taskforce to represent AdventHealth. Year one was also spent discussing ideas and making plans for the community summit, which is scheduled to take place in year two, due to COVID-19 restrictions on in-person gatherings for 2020. The community summit in year two will be an in-person, informative, transportation health fair that will be held at our Hospital and will offer information and education regarding the transportation programs available. It will serve to inform the public, patients, families, and organizations who serve the transportation disadvantaged community members, about the transportation programs available in the Hospital's PSA and help them to enroll. Goal 2: Increase access to culturally appropriate nutritious food options in food desert or low income/low access areas Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will support a series of three nutrition education class series among low-income families in the PSA from a baseline of one by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of three class series offered to low-income families by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will distribute 120 produce vouchers (valued at $10 each) to program participants from a baseline of 40 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of distributing 120 produce vouchers to program participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 3: The third objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food Is Health program will build and maintain partnerships with local community organizations serving low-income/low access communities by engaging six community partners from a baseline of three by the end of year three. This objective is managed at a Divisional level, and outcomes reported represent the Hospitals in Hardee and Highlands counties; AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of building and maintaining partnerships by recruiting three of the six new community partner organizations by the end of year three. The first year was focused on creating a formal partnership with the local produce vendor, Solace Farms. We did this by onboarding the produce vendor and having them sign a memorandum of understanding (MOU) to agree to the terms of the program and accept the formal partnership. We also engaged a new educational partner, the University of Florida (UF)/IFAS Extension of Hardee, Desoto, and Manatee counties. UF/IFAS Extension is an outreach partnership between the state, federal and county governments to provide scientific knowledge and expertise to the public. This expertise includes educational nutrition programming, targeted for the low-income, underserved and minority members of the population. Through this partnership, UF/IFAS Extension agreed to teach nutritional classes for the program. In year one, we connected with another community partner who also expressed interest in being a host site for the program once in-person classes resume. This organization is Heartland Core Wellness, whose mission is to address the health and wellness needs of the community with a focus on prevention education and the reduction of youth substance abuse. Objective 4: The fourth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states that the Food is Health program will increase the number of participants among low-income families in the PSA to 30 from a baseline of 11 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of increasing program participation to 30 participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 5:The fifth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will increase the number of health screenings among adults living in food deserts or low-income/low access communities to 45 from a baseline of 13 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of 45 health screenings by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Priority 3: Cardiovascular Disease2019 Description of the Issue:Coronary heart disease is a leading cause of death in the U.S. and is also related to high blood pressure, high cholesterol, and heart attacks. In the AdventHealth Sebring primary service area (PSA), 9% of adults aged 18 and older have coronary heart disease or angina (heart related chest pain). Additionally, the rate of death due to heart disease per 100,000 population is 156 (370 average annual deaths from 2012 2016), which is higher than the state rate of 150 and 22% of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2020 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Cardiovascular Disease priority.1. Improve access to health education, early intervention programs and resources related to cardiovascular disease2. Decrease tobacco use in adults and youth community membersGoal 1: Improve access to health education, early intervention programs and resources related to cardiovascular diseaseObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the number of Hospital sponsored American Heart Association (AHA) community CPR (Cardiopulmonary Resuscitation) out-of-hospital bystander classes for adults and youth from a baseline of zero to two by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. This initiative provides training to lay community members to be able to save the lives of individuals experiencing a cardiac event by administering the two-step, Hands-Only CPR.The Hospital progressed on its set metric of two classes sponsored by the end of year three. Throughout 2020, we have strengthened relationships with local community organizations that will host the train-the-trainer community CPR classes and promote the training among the community members they serve within our Hospital's PSA. In year one, the Division team met with our local American Heart Association on a bi-monthly basis to develop strategies and propose timelines for training and implementation in year two. As a result of our year one efforts, together with our local AHA team, we have created a novel train-the-trainer model for community CPR classes that will equip participants with the two-step, Hands-Only CPR skills to help save a life in the community setting. In addition, we received a donation of adult and child CPR Anytime training kits to launch our 2021 pilot of community CPR classes. Our Division team will complete the AHA instructor training in May 2021.Objective 2:The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Florida Department of Health (FDOH) in Highlands County to provide patient referrals at discharge to enroll in free Diabetes Self-Management Education and Support (DSMES) classes by creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital.This initiative provides an internal referral system for the Hospital to directly enroll patients in need in the FDOH's DSMES classes. The Florida Department of Health works to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. The DSMES referral program connects diabetic and pre-diabetic individuals to health education that provides them with knowledge and tools to self-manage their chronic condition, improve health behaviors, and change health outcomes.The Hospitals progressed on the set metric of creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, the Florida Department of Health of Highlands County temporarily cancelled DSMES classes in year one. Nevertheless, we have utilized this time to develop a tentative timeline and internal plan for referring participants to DSMES classes at the Florida Department of Health of Highlands County once classes resume. The internal plan for referring participants to the DSMES classes involves a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an "at discharge" referral system to connect patients to our Community Benefit programs and initiatives. In year two, the referral system will be piloted to connect patients (at discharge) with a history of tobacco use to free tobacco cessation classes offered by the Central Florida Area Health Education Center. This same referral system will soon be expanded to also refer patients to DSMES classes once in-person classes resume, ensuring that the Hospital will be able to refer 100 patients to these classes by the end of 2022.Objective 3:The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid time for Hospital staff/team members to volunteer with community organizations addressing heart disease and stroke from a baseline of zero hours to 200 hours by the end of year three. The objective is funded through all Hospitals and managed by the Division, however reported outcomes are specific to the reporting Hospital.This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area.The Hospitals progressed on the set metric of 200 hours of paid staff time spent volunteering in the community to address heart disease and stroke by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. We have pivoted where necessary and in year two will have virtual volunteer opportunities also available for our team members and will continue to gather in-person opportunities for when the restrictions lift.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedYear one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to enter in the volunteer portal for our team members. Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with Central Florida Area Health Education Center (AHEC) to provide continuing education classes to 50 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative provides educational classes that lead to an increase in knowledge for those AdventHealth team members who treat patients with tobacco use, or work with these patients at discharge, about tobacco cessation resources available, which could potentially improve patients' health through support for eliminating tobacco use. This is conducted through a partnership with Central Florida AHEC, the local affiliate of the national organization of AHEC, that is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital progressed on its set metric of educating 50 team members about tobacco cessation resources by the end of year three. In year one, the Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and Central Florida AHEC. The MOU illustrates how Central Florida AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to providers and staff of AdventHealth, thereby resulting in earned CEUs and CMEs for these team members. In year one, our Hospital team members worked additional hours and jobs to meet the needs created by the impact of COVID-19 on our Hospitals, patients, and community members; because of this, we delayed adding any additional training involving this objective for our team members during this time. In year two, AHEC will provide these trainings to our team members, either live or through a virtual format, in which team members will then earn their CEUs/CMEs, which are needed to keep their licenses and certifications for their positions. Additionally, the information learned in these classes will increase team members' knowledge and ability to offer treatment services for patients and community members who are tobacco users, thereby potentially improving their overall health. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide patient referrals at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit smoking tobacco through a partnership with AHEC and create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 18 patients from a baseline of zero by the end of year three. The objective is funded through AdventHealth Sebring but managed by the Division. Reported referrals are specific to the reporting Hospital.This initiative provides an internal patient referral system at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit tobacco. This initiative is conducted through a partnership with AHEC and the Hospital's internal Care 360 team. AHEC is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital's internal Care 360 team works with patients at discharge and serves to identify patients needing tobacco cessation. Once identified, the Care 360 team can use this internal referral system to directly enroll patients into AHEC's tobacco cessation program. The Hospital progressed on its set metric of providing resources for 18 patients at discharge through an internal referral system between the Hospital and AHEC by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Objective 3: The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase access to tobacco cessation classes in adults residing in the Hospital's PSA by five classes from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative increases access to tobacco cessation classes that improve health through a partnership with Central Florida Area Health Education Centers (AHEC), the local affiliate of the national organization of AHEC, who is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThe Hospitals progressed on the set metric of increasing access to five tobacco cessation classes by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Unfortunately, in year one, all in-person AHEC free tobacco cessation classes were cancelled at the beginning of the COVID-19 pandemic. Furthermore, company policy has prevented us from hosting in-person free tobacco cessation classes on our Hospital campuses. However, we were still able to promote AHEC's virtual classes in year one by sharing their flyers and class information with our community partners, posting flyers and dates on our internal CREATION Life/Wellness Center calendars and Hospital spaces, and sharing class information with our internal Care 360 team for them to inform patients at discharge of the program. In year two, we will identify community locations that may allow in-person tobacco cessation classes and will work with AHEC to secure these locations, provide free marketing for the classes, sponsor costs associated with conducting these classes and offer free class space to host classes within our Hospitals once our internal restrictions on in-person gatherings have lifted.Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Sebring primary service area, 17% (14,018 persons) of the population aged 25 and older do not have a high school diploma (or equivalency) or higher and is higher than the state average of 12%. Educational attainment is a social determinant of health and is linked to health outcomes. Additionally, improving health literacy may be a useful strategy for reducing disparities in health related to education.2020 Update: Recognizing the impact of social determinants of health, like education, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach in addition to our partnership with Aunt Bertha will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Sebring Community Health Plan has two desired goal statements under the Education (Social Determinant of Health) priority. 1. To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health2. To support community efforts to address the problem of educational attainment as a social determinant of healthGoal 1: To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with local community school and/or college programs to develop, implement and evaluate a community-based professional development program (interviewing skills, resume writing, basic computer skills, mentoring) for underserved adults residing in the Hospital's PSA by providing three community workshops from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides underserved adults with educational and hands-on training skills, such as resume writing and computer skills, needed to enter the workforce. The Hospitals progressed on the set metric of providing three community workshops to underserved adults by the end of year three. Year one was spent identifying career readiness programs and organizations within the Hospital's PSA to partner with for this objective. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands, and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through these partnerships, we have identified resources - including teachers, classes, locations, and target audience members- for these development programs. Due to COVID-19, in year one, in-person classes and programs delivered through these organizations were cancelled. Additionally, Division-wide restrictions on in-person gatherings were also enforced for our Hospitals and company policy prevented us from hosting in-person classes on our Hospital campuses. We have pivoted where necessary and in year two, will begin partnering with these organizations to deliver this program virtually or in-person when restrictions lift. We will do this by having our team members offer lessons about real-world career opportunities at AdventHealth and sharing the process of attaining and maintaining a successful career. Additionally, our Hospital will offer support in the form of free meeting space to host the classes for these partner organizations, free marketing materials and additional costs covered of delivering these classes. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to establish a new partnership with local community organizations to identify education access barriers in underserved adults residing in the Hospital's PSA from a baseline of zero organizations to two by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative creates a partnership with local community organizations working in adult education to help discover challenges to educational attainment and means to help resolve them. The Hospitals exceeded the set metric of establishing two new partnerships with local community organizations to identify barriers for accessing education in underserved adults by the end of year three. We established a partnership with three new community partners- CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands, and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedSouth Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of our community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. We have also created ideas to overcome these barriers and in year two will begin implementing some of these solutions in conjunction with these partnerships.Goal 2: To support community efforts that address the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to provide education vouchers to cover the costs of General Educational Development (GED) materials (textbooks, registration fees and tests) for adults residing in the Hospital's PSA from a baseline of zero vouchers to three vouchers by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides education vouchers in the form of monetary funds to help cover some of the cost associated with the GED test. The Hospitals progressed on the set metric of providing three education vouchers in the form of monetary funds for adults residing in the Hospital's PSA by the end of year three. Year one was spent identifying and establishing a partnership with the local GED preparation and testing organization, South Florida State College. In doing so, we were able to learn more about their monetary needs to support the program. In addition, we gathered information from this organization relating to populations and number of adults served, need for financial assistance, and any programs offering assistance that are already available for eligible adults. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. Due to COVID-19, South Florida State College's GED classes were initially cancelled. In year two, the Hospital will determine the dollar amount to provide to cover the cost of this program for those underserved adults. Objective 2: The second objective is a shared initiative with AdventHealth Wauchula and AdventHealth Lake Placid. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing education (as a social determinant of health) from a baseline of zero hours to 150 hours by the end of year three. The objective is funded and managed through all Hospitals; however, outcomes are specific to the reporting Hospital. This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospitals progressed on the set metric of 150 hours of paid staff time spent volunteering in the community to address education (as a social determinant of health) by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. We have pivoted where necessary and in year two, will have virtual volunteer opportunities also available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal.Community Needs Not Chosen by AdventHealth Sebring/AdventHealth Lake Placid: The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospitals and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospitals did not choose the following community issues:1. Poor Dental Health: Many oral diseases can be prevented with routine care and regular dental checkups. The health of the teeth, the mouth and the surrounding craniofacial (skull and face) structures is central to a person's overall health and well-being. Lack of access to dental care for all ages remains a public health challenge. In the AdventHealth Sebring Primary Service Area (PSA), the access to dentists' rate (per 100,000 pop.) is 36.5 (in 2015 year), as compared to the state rate of 56.The Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time.2. Tobacco Use: In the AdventHealth Sebring PSA, an estimated 16,314 of adults age 18 or older self report currently smoking cigarettes some days or every day. This indicator is relevant because tobacco use is linked to leading causes of death such as cancer and cardiovascular disease. In the Hospital PSA, 22% of adults are currently smoking cigarettes, which is higher than the state percentage of 19%.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address tobacco use will be wrapped into the priority area of heart disease.3. Obesity/Overweight/Obese: In the AdventHealth Sebring PSA, approximately 33% of adults aged 20 and older self report that they have a Body Mass Index (BMI) greater than 30 (obese) in the report area. The state percentage is 27%. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address Obesity/Overweight/Obese will be wrapped into the education priority area. The Community Health Needs Assessment Committee (CHNAC) will approach this area of need more comprehensively, as other barriers contribute to negative health outcomes in this area of priority.
Part V, Section B, Line 13h Footnote Facility Reporting Group - AEffective March 1, 2020, the filing organization's hospital facility (or facilities) augmented their Financial Assistance Policy with a COVID-19 Financial Grace Addendum. Pursuant to the COVID-19 Financial Grace Addendum, uninsured patients treated for COVID-19 related evaluations are to receive free or discounted care depending on the patient's cooperation in submitting necessary financial assistance information. Insured patients tested for COVID-19 are not expected to have out-of-pocket expenses based on insurance community response to waive patient financial responsibility. If a payer unexpectedly fails to waive patient responsibility for COVID-19 related testing, the filing organization will not balance bill patients for any out-of-pocket expenses related to COVID-19. In addition, patients with existing payment plans are provided opportunities for reducing their monthly payments.
Part V, Section B, Line 13h Footnote Facility Reporting Group - BEffective March 1, 2020, the filing organization's hospital facility (or facilities) augmented their Financial Assistance Policy with a COVID-19 Financial Grace Addendum. Pursuant to the COVID-19 Financial Grace Addendum, uninsured patients treated for COVID-19 related evaluations are to receive free or discounted care depending on the patient's cooperation in submitting necessary financial assistance information. Insured patients tested for COVID-19 are not expected to have out-of-pocket expenses based on insurance community response to waive patient financial responsibility. If a payer unexpectedly fails to waive patient responsibility for COVID-19 related testing, the filing organization will not balance bill patients for any out-of-pocket expenses related to COVID-19. In addition, patients with existing payment plans are provided opportunities for reducing their monthly payments.
Part V, Section B, Line 16a-16c Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites: Facility 1 -- AdventHealth Orlandohttps://www.adventhealth.com/legal/financial-assistance Facility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/legal/financial-assistance Facility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/legal/financial-assistance Facility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/legal/financial-assistance Facility 5 -- AdventHealth Winter Park https://www.adventhealth.com/legal/financial-assistance Facility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/legal/financial-assistance Facility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/legal/financial-assistance Facility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/legal/financial-assistance Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/legal/financial-assistance Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/legal/financial-assistance Facility 11 -- Central Texas Medical Centerhttps://www.ctmc.org/patients-visitors/after-my-stay/financial-assistance (only prior to 03/31/2020)
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?57
Name and address Type of Facility (describe)
1 1 - AdventHealth Centra Care Lake Buena Vist
12500 South Apopka Vineland Rd
Orlando,FL32836
Urgent Care Clinic
2 2 - AdventHealth Centra Care South Orange
2609 South Orange Ave
Orlando,FL32806
Urgent Care Clinic & Employer Onsite Clinic
3 3 - AdventHealth Centra Care Waterford Lakes
250 North Alafaya Trail Suite 135
Orlando,FL32825
Urgent Care Clinic
4 4 - AdventHealth Centra Care Winter Garden
3005 Daniels Road
Winter Garden,FL34787
Urgent Care Clinic/Primary Care
5 5 - AdventHealth Centra Care Port Orange
1208 Dunlawton Ave
Port Orange,FL32127
Urgent Care Clinic
6 6 - AdventHealth Centra Care Mt Dora
9015 US Highway 441
Mount Dora,FL32757
Urgent Care Clinic
7 7 - AdventHealth Centra Care Altamonte Sprin
440 West Highway 436
Altamonte Springs,FL32714
Urgent Care Clinic
8 8 - AdventHealth Centra Care Winter Park
3099 Aloma Avenue
Winter Park,FL32792
Urgent Care Clinic
9 9 - AdventHealth Centra Care Orange Lake
8201 West Irlo Bronson Highway
Kissimmee,FL34747
Urgent Care Clinic
10 10 - AdventHealth Centra Care Hunter's Creek
3293 Greenwald Way North
Kissimmee,FL34741
Urgent Care Clinic/Primary Care
11 11 - AdventHealth Centra Care Sanford
4451 West 1st Street
Sanford,FL32771
Urgent Care Clinic/Primary Care
12 12 - AdventHealth Centra Care St Cloud
4660 13th Street
St Cloud,FL34769
Urgent Care Clinic/Primary Care
13 13 - AdventHealth Centra Care Clermont
15701 State Road 50 Suite 101
Clermont,FL34711
Urgent Care Clinic
14 14 - AdventHealth Centra Care Lake Nona
9637 Lake Nona Village Place
Orlando,FL32827
Urgent Care Clinic
15 15 - AdventHealth Centra Care Dr Phillip's
8014 Conroy-Windermere Rd Suite 104
Orlando,FL32835
Urgent Care Clinic
16 16 - SDOC CLINIC
831 Simpson Rd
Kissimmee,FL34744
Employer Clinic
17 17 - AdventHealth Centra Care University
11550 University Blvd
Orlando,FL32817
Urgent Care Clinic
18 18 - AdventHealth Centra Care Brandon
10222 Bloomingdale Ave
Riverview,FL33578
Urgent Care Clinic
19 19 - AdventHealth Centra Care DeLand
2293 South Woodland Blvd
Deland,FL32720
Urgent Care Clinic
20 20 - AdventHealth Centra Care Lee Road
2540 Lee Road
Winter Park,FL32789
Urgent Care Clinic
21 21 - AdventHealth Centra Care Colonial Town
630 North Bumby Ave
Orlando,FL32803
Urgent Care Clinic/Primary Care
22 22 - AdventHealth Centra Care Orange City
1360 Saxon Blvd
Orange City,FL32763
Urgent Care Clinic
23 23 - AdventHealth Centra Care Wesley Chapel
1127 Bruce B Downs Blvd
Wesley Chapel,FL33544
Urgent Care Clinic
24 24 - AdventHealth Centra Care Oviedo
8010 Red Bug Road
Oviedo,FL32765
Urgent Care Clinic
25 25 - AdventHealth Centra Care Kissimmee
4320 West Vine Street
Kissimmee,FL34746
Urgent Care Clinic
26 26 - AdventHealth Centra Care Temple Terrace
5802 East Fowler Avenue
Temple Terrace,FL33617
Urgent Care Clinic
27 27 - AdventHealth Centra Care Daytona
1014 West International Speedway
Blvd
Daytona Beach,FL32114
Urgent Care Clinic
28 28 - AdventHealth Centra Care Leesburg
1103 North 14th Street
Leesburg,FL34748
Urgent Care Clinic
29 29 - AdventHealth Centra Care Sand Lake Road
2301 Sand Lake Road
Orlando,FL32809
Urgent Care Clinic
30 30 - AdventHealth Centra Care Azalea Park
509 South Semoran Blvd
Orlando,FL32807
Urgent Care Clinic
31 31 - AdventHealth Centra Care Palm Coast
1270 Palm Coast Parkway NW
Palm Coast,FL32137
Urgent Care Clinic
32 32 - San Marcos MRI LP
1330 Wonder World Dr
San Marcos,TX78666
Imaging Services
33 33 - AdventHealth Centra Care Longwood
855 South US Highway 17-92
Longwood,FL32750
Urgent Care Clinic
34 34 - CTMC Hospice
1315 IH 35 North
San Marcos,TX78666
Hospice Services
35 35 - AdventHealth Centra Care Ormond Beach
1245 West Granada Blvd
Ormond Beach,FL32174
Urgent Care Clinic
36 36 - AdventHealth Centra Care South Tampa
301 North Dale Mabry Hwy
Tampa,FL33609
Urgent Care Clinic & Employer Onsite Clinic
37 37 - AdventHealth Centra Care Kids Lake Mary
105 South Country Club Road
Lake Mary,FL32746
Urgent Care Clinic
38 38 - AdventHealth Centra Care Kids Winter Par
2325 West Fairbanks Ave
Winter Park,FL32789
Urgent Care Clinic
39 39 - AdventHealth Centra Care Carrollwood
4001 West Linebaugh Ave
Tampa,FL33624
Urgent Care Clinic
40 40 - AdventHealth Centra Care Lake Mary
2948 West Lake Mary Blvd
Lake Mary,FL32746
Urgent Care Clinic
41 41 - AdventHealth Centra Care Conway
5810 South Semoran Blvd
Orlando,FL32822
Urgent Care Clinic
42 42 - AdventHealth Centra Care Citrus Park
6930 Gunn Highway
Tampa,FL33625
Urgent Care Clinic
43 43 - AdventHealth Centra Care Winter Haven
7375 Cypress Gardens Blvd
Winter Haven,FL33884
Urgent Care Clinic
44 44 - CTMC Rehab Services
1340 Wonder World Dr
San Marcos,TX78666
OP Rehab Services
45 45 - AdventHealth Medical Group Cardiology at
4639 Sun N Lake Blvd
Sebring,FL33872
Physician Clinic
46 46 - AdventHealth Centra Care Poinciana
3759 Pleasant Hill Rd
Kissimmee,FL34746
Urgent Care Clinic
47 47 - Darden Onsite
1000 Darden Center Drive
Orlando,FL32837
Employer Onsite Clinic
48 48 - SIEMENS Onsite
4400 North Alafaya Trail MC Q1-240
Orlando,FL32826
Employer Onsite Clinic
49 49 - AdventHealth Medical Group Cardiology &
463 Carlton St
Wauchula,FL33873
Physician Clinic
50 50 - Wyndham Onsite
6277 Sea Harbor Dr
Orlando,FL32821
Employer Onsite Clinic
51 51 - AdventHealth Medical Group Orthopedics a
4409 Sun N Lake Blvd
Sebring,FL33872
Physician Clinic
52 52 - AdventHealth Centra Care Apopka
1520 West Orange Blossom Trail
Apopka,FL32712
Urgent Care Clinic
53 53 - OCG Onsite
450 East South Street
Orlando,FL32802
Employer Onsite Clinic
54 54 - AdventHealth Centra Care Corporate Care
40124 US Hwy 27 Suite 27
Davenport,FL33837
Occupational Medicine Services
55 55 - AdventHealth Waterman Employee Clinic
1000 Waterman Way
Tavares,FL32778
Employer Onsite Clinic
56 56 - AdventHealth Medical Group Breast Surger
4145 Sun N Lake Blvd Suite B
Sebring,FL33872
Physician Clinic
57 57 - AdventHealth Centra Care Corporate Care
1255 State Road Florida 60 East
Suite 30
Lake Wales,FL33853
Occupational Medicine Services
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Part I, Line 6a: The filing organization was a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) during its current tax year. During the current year, AHSSHC served as a parent organization to 29 tax-exempt 501(c)(3) hospital organizations and a number of other health care facilities that operated in 10 states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as "AdventHealth".All hospital organizations within AdventHealth collect, calculate, and report the community benefits they provide to the communities they serve. AdventHealth organizations exist solely to improve and enhance the local communities they serve. AdventHealth has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. Each AdventHealth hospital facility reports their community benefits to their Board of Directors and strives to communicate their community benefits to their local communities. Additionally, the filing organization's most recently conducted community health needs assessments and associated implementation strategies can be accessed on the filing organization's websites.
Part I, Line 7: The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.
Part II, Community Building Activities: The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with commercially sponsored research conducted by one of the organization's hospitals. This one hospital participates in clinical drug and device research that is performed on patients who have a condition or disease for which the eventual commercial use of a drug or device is intended. This research is related to patient care and serves to expand scientific knowledge with respect to potential treatments and cures for various diseases and conditions.The costs of community building activities reported on Part II of Schedule H also include the costs associated with providing education for the filing organization's staff physicians and employees. The filing organization's provision of these educational programs/activities to staff physicians and employees provides an opportunity for health care professionals to enhance their skills and expertise and keep up-to-date with the latest advancements in medical procedures and technology. In addition, training opportunities are often provided on-site at the filing organization's hospital facilities, thereby allowing for health care professionals to be more readily available to assist in meeting immediate patient care needs. Education and training provided to each facility's workforce is vital in assisting health care professionals directly involved in patient care with keeping abreast of the latest developments in their respective areas of expertise, learning possible new and innovate ways of delivering care to patients, and understanding the newest technologies available for the treatment of patients.The remainder of the costs incurred stem from the hospitals' involvement in and support of various other community agencies in its service area that work collaboratively to help those in need and to improve the health and safety of the residents of the community. The organization's hospitals participate with a number of other community organizations to address the healthcare needs of all its communities. Both cash and in-kind donations are made annually to various local charitable organizations.
Part III, Line 2: The amount of bad debt expense reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense.
Part III, Line 3: Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who Could Have Qualified under the Filing Organization's Financial Assistance Policy: Self-pay patients may apply for financial assistance by completing a Financial Assistance Application Form (FAA Form). If an individual does not submit a complete FAA Form within 240 days after the first post-discharge billing statement is sent to the individual, an individual may be considered for presumptive eligibility based upon a scoring tool that is designed to classify patients into groups of varying economic means. The scoring tool uses algorithms that incorporate data from credit bureaus, demographic databases, and hospital specific data to infer and classify patients into respective economic means categories. Individuals who earn a certain score on the scoring tool are considered to qualify as eligible for the most generous financial assistance under the filing organization's Financial Assistance Policy. As determined by the filing organization, a nominal amount of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the scoring tool is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit: The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Department should be considered community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.
Part III, Line 4: Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year. The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 8 and 9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands.
Part III, Line 8: Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio. Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government. Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries: The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement prepared by AdventHealth. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to all Medicare patients are as follows: - Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $(126,556,730) - Difference in costing methodology: (8,617,511) - Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (264,405,462) ------------- Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $(399,579,703) As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.
Part III, Line 9b: Collection Policies: The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier than 120 days after the first post-discharge billing statement is sent to the individual and is at least 30 days after the notice is provided. A reasonable attempt is also made to orally notify an individual about the filing organization's Financial Assistance Policy and how the individual may obtain assistance with the Financial Assistance application process. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first post-discharge billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus (or ceases any other ECA's) and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of the hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of the hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made.
Part VI, Line 2: As reported in Schedule H, Part V, Section B, the filing organization's hospital facilities conduct their community health needs assessments (CHNAs) every three years. Their 2019 CHNAs were adopted by all hospital governing boards by December 31, 2019, the end of the filing organization's taxable year in which the CHNAs were conducted. All of the filing organization's hospital facilities' 2019 CHNAs complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNAs discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of all of its communities. Such practices and processes involve the following:1. Hospitals' operating/community boards composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's hospital communities; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's hospital communities.
Part VI, Line 3: The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for the hospital facilities' financial counselors are prominently and conspicuously posted on the filing organization's hospital facilities' websites. Each hospital facility's website indicates that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by the relevant hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of the filing organization's hospital facilities, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of each hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. The filing organization's hospital facilities' financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facilities who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facilities' office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about the hospital facilities' FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of each hospital facility's community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance.
Part VI, Line 4: In 2020, the filing organization operated 4 separately licensed hospitals that together encompassed 11 separate campus locations and 7 off-site emergency departments. The hospitals are located in Florida and Texas. A description of each of the hospital campuses is described below. Effective 3/31/20 the filing organization sold the assets associated with the operation of Central Texas Medical Center (CTMC) to Christus Santa Rosa Health Care Corporation.Adventist Health System/Sunbelt, Inc. dba Central Texas Medical Center:Central Texas Medical Center is a 170-bed acute-care hospital providing a wide range of healthcare services in San Marcos, Texas and the neighboring communities within Hays and Caldwell counties, Texas. Special services offered at CTMC include a 24/7, Level 4 emergency and trauma center, state-of-the-art medical imaging and laboratory services, a women's center featuring a Level 2 Neonatal Intensive Care Unit, renovated and expanded surgery suites--including two equipped with robotic capabilities--a Rehabilitation Institute, a center for advanced wound healing and hyperbaric medicine, and two cardiac catheterization labs. As a health resource for their community, CTMC's Creation Health Institute also annually hosts the oldest and largest health screening and fair event in Hays County, as well as a number of ongoing classes and workshops ranging in topics from diabetes prevention and management to heart disease, stroke, arthritis, self-help, nutrition and more. For more than 20 consecutive years, CTMC has been named "The Best Hospital in Hays County" in the annual "Best of Hays" publication released by the San Marcos Daily Record. In addition to interventional cardiac services, CTMC is a Certified Chest Pain Center and an accredited Primary Stroke Center. The accreditation enhances CTMC's ability to receive and treat patients suffering from chest pain and/or a possible heart attack. The result is a focus on reduced time from symptom onset to diagnosis and treatment, getting patients treated more quickly during the critical window of time when the integrity of the heart muscle can be preserved, and monitoring of patients whose diagnosis is uncertain to ensure they are not sent home too quickly or admitted unnecessarily. CTMC leads the region in da Vinci robotic-assisted surgery and offers a variety of specialty care services including medical imaging, rehabilitation, hospice, women's services and more.From 1/01/2020-3/31/2020, CTMC's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. For the first three months of 2020, about 63.3% of the CTMC's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 45.8% - Medicaid Patients 11.6% - Self-Pay Patients 12.3% The demographic makeup of CTMC's community is as follows: - Population 366,191 - Population Over 65 12.83% - Poverty (Below 100% FPL) 15.30% - Unemployment Rate 4.70% - Violent Crime Rate (Per 100,000 Pop.) 247.3 - Pop. Age 25+ with No High School Diploma 13.70% - Uninsured Adults 18.45% - Uninsured Children 9.21% - Food Insecurity Rate 14.90% - Pop. with Low Food Access 22.80%Adventist Health System/Sunbelt, Inc. dba AdventHealth Sebring:AdventHealth Sebring is comprised of three separate hospital campuses with a total of 229 beds. Two of the hospital campuses are located in Highlands County, Florida and operate under a single hospital license and the third separately licensed campus is located in Hardee County, Florida. Highlands and Hardee counties are in the south central areas of Florida and are adjacent to each other.During 2020, the patient percentage population for all three campuses of AdventHealth Sebring was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2020, about 73.5% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 64.3% - Medicaid Patients 12.0% - Self-Pay Patients 4.2%*AdventHealth Sebring (Highlands County) - The main 171-bed hospital facility is located in north Sebring. AdventHealth Sebring has key service lines, including a heart & vascular center, Cancer Institute, Breast Care Center, Blessed Beginnings Birthing Center, and Emergency Services. Most recently, the Hospital has established a retail pharmacy and Orthopedic unit. AdventHealth Sebring is on the cutting edge of technology in Highlands County, being the only Orthopedic program to use the MAKOplasty Robot and only Surgical Services Program to use the da Vinci Robot. The Hospital has received recognition for its patient safety, orthopedics, heart care, and as a breast imaging center of excellence. In 2018, AdventHealth Sebring was named Highland News Sun "Business of the Year."The demographic makeup of AdventHealth Sebring's community is as follows: - Population 108,572 - Population Over 65 31.52% - Poverty (Below 100% FPL) 19.40% - Unemployment Rate 7.80% - Violent Crime Rate (Per 100,000 Pop.) 319.6 - Pop. Age 25+ with No High School Diploma 17.30% - Uninsured Adults 23.07% - Uninsured Children 7.77% - Food Insecurity Rate 15.80% - Pop. with Low Food Access 34.64%*AdventHealth Lake Placid (Highlands County) - This satellite facility houses 33 medical and surgical beds, the county's only 17-bed inpatient mental health unit and a wide range of services that are highly sophisticated for a small community hospital. This campus also specializes in inpatient geriatric psychiatric services within Highlands and Hardee counties. The need for behavioral health services is extreme in both counties since there is no other program closer than sixty miles. AdventHealth Lake Placid has received national recognition in patient safety, ultrasound and computed tomography (CT), and Emergency Department (ED) areas. To better meet the needs of Highlands County, the Hospital offers a Wellness Center, along with educational classes, for the community. Key service lines include ER, ICU and the Medical Surgical Unit. AdventHealth Lake Placid is on the leading edge of technology in Highlands County as the only Hospital to utilize virtual and room sterilization technology.The demographic makeup of AdventHealth Lake Placid's community is as follows: - Population 87,256 - Population Over 65 31.26% - Poverty (Below 100% FPL) 19.50% - Unemployment Rate 7.70% - Violent Crime Rate (Per 100,000 Pop.) 310.2 - Pop. Age 25+ with No High School Diploma 17.00% - Uninsured Adults 23.23% - Uninsured Children 7.78% - Food Insecurity Rate 15.70% - Pop. with Low Food Access 35.83%*AdventHealth Wauchula (Hardee County) - Built at a new location in 2017, this campus is licensed for 25 beds and specializes in emergency and outpatient care, while offering excellent medical inpatient services. The Hospital contains the only ER in Hardee County. AdventHealth Wauchula offers many inpatient and outpatient services, including physical & occupational therapy, a transitional care unit, medical surgical swing unit, and the only mammography unit in Hardee County, the Linda Adler Mammography Center. In 2019, AdventHealth Wauchula opened a Wellness Center to better meet the health needs of Hardee County. *** see continuation of footnote
Part VI, Line 5: The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $8,030,512 of benefit with respect to the faith-based and spiritual needs of the communities it serves in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care. During the current year, the filing organization expended $480,248,229 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospitals are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities.
Part VI, Line 6: The filing organization is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as AdventHealth. AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 48 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 11 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers.As the parent organization of AdventHealth, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others IT, corporate compliance, legal, reimbursement, risk management, and tax as well as treasury functions. Certain support services, such as human resources, payroll, A/P, and supply chain management are provided pursuant to a shared services model by AHSSHC to its subsidiary organizations. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AdventHealth subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AdventHealth subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by an AdventHealth subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AdventHealth as a whole. The reader is directed to visit the web-site of AdventHealth at www.adventhealth.com to learn more about the mission and operations of AdventHealth.
Part VI, Line 4 Continuation of Footnote Description of Community Information - ContinuedThe Hospital has been recognized as a Top Rural Hospital by The Leapfrog Group and best hospital for patient safety.The demographic makeup of AdventHealth Wauchula's community is as follows: - Population 90,145 - Population Over 65 27.66% - Poverty (Below 100% FPL) 21.00% - Unemployment Rate 7.50% - Violent Crime Rate (Per 100,000 Pop.) 303.7 - Pop. Age 25+ with No High School Diploma 19.50% - Uninsured Adults 23.93% - Uninsured Children 7.87% - Food Insecurity Rate 15.50% - Pop. with Low Food Access 34.42%Adventist Health System/Sunbelt, Inc.:AdventHealth's Central Florida Division South Region consists of a 3,141-bed medical complex in Central Florida with seven separate hospital campuses and 7 off-site emergency departments (the Hospitals) that operate under a single hospital license. The Hospitals serve the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake County) but also draw patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus health system is the largest healthcare provider in Central Florida with more than 2 million patient visits per year and is the nation's largest Medicare provider. It is the second largest employer in the area.The main campus of AdventHealth's Central Florida Division South Region is located in Orlando, Florida (Orange County) near the downtown area. The other 6 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 7 hospitals, it also operates 51 full-service urgent care clinics in convenient community settings.During 2020, the patient percentage population for all seven campuses was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2020, about 68.3% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 43.0% - Medicaid Patients 15.2% - Self-Pay Patients 6.7%A brief description of each of the 7 hospital campuses is described below:*AdventHealth Orlando (Orange County) - At the core of AdventHealth's Central Florida Division South Region, AdventHealth Orlando (AHO) is a 1,432-bed acute-care tertiary hospital. AHO is home to nationally recognized Centers of Excellence for cancer, cardiology, children's health, diabetes, neuroscience, orthopedics, transplant and global robotics. AdventHealth Orlando houses one of the largest Emergency Departments and cardiac catheterization labs in the country and is one of the busiest hospitals in the nation, providing service excellence to more than 48,000 inpatients and 175,000 outpatients in 2020. The campus also includes a state-of-the-art Cardiac Diagnostic Center featuring 15 Cath and electro physiology (EPS) Labs. The cardiology team performed over 18,000 cardiac catheterizations and over 1,700 open heart surgeries in 2020. In 2018, two orthopedic floors in the patient tower were totally renovated. In 2019, an inpatient Hospice unit was opened.Additionally, AHO houses the Translational Research Institute, a 54,000 square-foot facility devoted to the study of obesity and metabolic origins of cardiovascular disease with the aim of developing new treatments to battle diabetes and obesity. AHO also serves as a teaching hospital for family medicine, allopathic and osteopathic tracts, emergency medicine, neuromusculoskeletal medicine, general surgery, podiatric medicine and surgery, and internal medicine. As one of the premier health systems in the nation, AHO sets the standard for innovation, quality and comprehensive care.AdventHealth for Women at Orlando is a 12-story hospital located on the Orlando campus. The first floor houses the Breastfeeding Center, parent education classroom as well as obstetrical triage and registration. Ten of the 12 floors are complete, which include 72 mother-baby rooms and high-risk OB rooms, 14 labor and delivery suites, 13 operating rooms, 82 NICU and 104 oncology beds which include GYN oncology, medical oncology and an ICU capable BMT unit.Also located on the AHO Campus is the Walt Disney Pavilion at AdventHealth for Children. The Walt Disney Pavilion is not a stand-alone facility but rather a 7-story, 198-bed tower located on AHO's campus. It is a full-service facility served by more than 140 pediatric specialists and a highly trained pediatric team of more than 800 employees. The Walt Disney Pavilion at AdventHealth for Children delivers a complete range of pediatric health services for younger patients including advanced surgery, oncology, neurosurgery, cardiology and transplant services; full-service pediatrics; and an innovative health and obesity platform.The demographic makeup of AdventHealth Orlando's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.90% - Unemployment Rate 9.50% - Violent Crime Rate (Per 100,000 Pop.) 448.7 - Pop. Age 25+ with No High School Diploma 10.90% - Uninsured Adults 17.60% - Uninsured Children 6.70% - Food Insecurity Rate 13.30% - Pop. with Low Food Access 33.71%*AdventHealth Altamonte (Seminole County) - AdventHealth Altamonte is a 393-bed facility, which has recently doubled in size with a new patient tower to better serve a busy community. AdventHealth Altamonte was the first "satellite" hospital, built in 1973 on what was then pastureland, miles from the nearest business district. Located north of Orlando in fast-growing Seminole County, AdventHealth Altamonte is the largest satellite campus within AdventHealth's Central Florida Division South Region. In addition to maternity, pediatric, NICU, emergency, medical and surgical services, the hospital operates the Martin Andersen Cancer Center (along with the region's only Cancer Resource Library), a heart catheterization lab, and a comprehensive outpatient program which includes surgery, diagnostics, and medical treatment programs. In 2014, the Mother Baby Unit was expanded to provide a 15 bed CDU, ten new LDR rooms, six triage rooms, a new C-section operating room and a new recovery unit. In 2018, a 10-bed Level II Neonatal Intensive Care Unit (NICU) was added.The demographic makeup of AdventHealth Altamonte's community is as follows: - Population 473,408 - Population Over 65 16.30% - Poverty (Below 100% FPL) 12.42% - Unemployment Rate 8.50% - Violent Crime Rate (Per 100,000 Pop.) 421.8 - Pop. Age 25+ with No High School Diploma 7.90% - Uninsured Adults 14.00% - Uninsured Children 5.40% - Food Insecurity Rate 12.40% - Pop. with Low Food Access 33.37%*AdventHealth Apopka (Orange County) - In 1975, AdventHealth Apopka became the second satellite hospital. For over four decades, AdventHealth Apopka has set the standard in hometown health care by providing high-tech, quality care with a personalized touch. It is a 120-licensed-bed hospital, which includes intensive care services, emergency medicine, endoscopy, outpatient services, diagnostic services, respiratory services and rehabilitation services. A replacement, 320,000 square foot facility has been built on a 71-acre site located approximately three miles from the existing facility. Five of the seven floors have been completed with the remaining two floors to be shelled in for future expansion. The new facility features 120 private patient rooms, advanced surgical suites and a diagnostic catheterization lab.*** see continuation of footnote
Part VI, Line 4 Continuation of Footnote Description of Community Information - ContinuedCompletion of this $203 million project took place in December 2017. AdventHealth Apopka also operates AdventHealth Winter Garden ER, an off-site emergency room that provides urgent care to the community as well as specialized respiratory care and advanced stroke treatment as a designated stroke center. The demographic makeup of AdventHealth Apopka's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.24% - Unemployment Rate 11.40% - Violent Crime Rate (Per 100,000 Pop.) 596.6 - Pop. Age 25+ with No High School Diploma 12.60% - Uninsured Adults 18.30% - Uninsured Children 7.60% - Food Insecurity Rate 13.70% - Pop. with Low Food Access 31.30% *AdventHealth Celebration (Osceola County) - AdventHealth Celebration is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 237-bed acute care hospital delivers a state-of-the-art healing environment to residents of Osceola, Orange, Polk and Lake Counties, as well as to visitors from across the United States and the world. From its creation AdventHealth Celebration has been about promoting health and wellness as well as healing. Inside the resort-style hospital there is a wellness center, complete with workout area, pool, and rehabilitation facility. AdventHealth Celebration also houses the Global Robotics Institute, which provides patients with access to some of the most experienced robotic surgeons in the world. The Nicholson Center for Surgical Advancement also is a location where surgeons from around the world travel to learn the latest robotic surgery techniques. The Institute for Interactive Patient Care is a 234,000 square-foot patient tower with 62 beds and was the first of its kind in the nation where physicians can study everything from new patient safety technology to the impact of changing communication with patients about their care. In 2013, a four-story medical office building was added in which the Women's Institute is situated. In 2014, a new 5th floor inpatient 32 bed state-of-the art medical/surgical unit was added. In 2018, two inpatient surgical cardiovascular OR's were added. AdventHealth Celebration offers services in cancer, digestive health, neuroscience, weight-loss services and surgery, orthopedic health, spine health, thoracic surgery, women's and men's health, robotic-assisted surgeries and imaging diagnostics. The demographic makeup of AdventHealth Celebration's community is as follows: - Population 368,559 - Population Over 65 15.40% - Poverty (Below 100% FPL) 14.59% - Unemployment Rate 13.00% - Violent Crime Rate (Per 100,000 Pop.) 454.9 - Pop. Age 25+ with No High School Diploma 12.10% - Uninsured Adults 19.40% - Uninsured Children 7.00% - Food Insecurity Rate 11.90% - Pop. with Low Food Access 35.53%*AdventHealth East Orlando (Orange County) - AdventHealth East Orlando is an innovative local leader that fills a vital need in a fast-growing area. A recent 200,000 square-foot expansion project upgraded the Hospital to 295 beds, with a spacious patient tower and 80 new private rooms designed to enhance the holistic care experience. In 2014, an expanded ED provided 60 new treatment rooms. AdventHealth East Orlando includes a teaching hospital with residencies in family medicine, podiatry and emergency medicine. The campus is also home to an outpatient surgery center, a hospital-based Center for Medical Simulation and Education, a Cancer Institute featuring state-of-the-art technology for radiation oncology and a dedicated infusion center, as well as a 12-bed Children's Emergency Center. Alongside having the largest emergency room in Central Florida, other services include cardiovascular, pulmonary and digestive health, orthopedics and rehabilitation, ear/nose/throat, andrology, and urology. The Hospital also meets the diverse needs of its growing community at its brand-new, freestanding emergency room, AdventHealth Waterford Lakes ER, which offers hospital-based ER services by board-certified emergency physicians, critical care nurses, and stroke and chest pain experts. The demographic makeup of AdventHealth East Orlando's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 16.67% - Unemployment Rate 11.60% - Violent Crime Rate (Per 100,000 Pop.) 607.2 - Pop. Age 25+ with No High School Diploma 11.10% - Uninsured Adults 18.50% - Uninsured Children 7.70% - Food Insecurity Rate 13.80% - Pop. with Low Food Access 25.18%*AdventHealth Kissimmee (Osceola County) - AdventHealth Kissimmee is a 162-bed community-focused hospital, conveniently located near Walt Disney World. The team located at AdventHealth Kissimmee is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties. This facility has recently expanded to include a new medical office building, patient tower, new main entrance, expanded Emergency Department and a parking garage. The new three-story patient tower includes private patient rooms and a host of modern amenities and technologies. Services offered include cardiovascular services, orthopedics and rehabilitation, neuroscience, cancer, diabetes, gastroenterology, emergency services, urology, and imaging resources. The demographic makeup of AdventHealth Kissimmee's community is as follows: - Population 368,559 - Population Over 65 15.40% - Poverty (Below 100% FPL) 15.89% - Unemployment Rate 14.00% - Violent Crime Rate (Per 100,000 Pop.) 470.0 - Pop. Age 25+ with No High School Diploma 12.80% - Uninsured Adults 19.50% - Uninsured Children 6.90% - Food Insecurity Rate 11.10% - Pop. with Low Food Access 27.03%*AdventHealth Winter Park (Orange County) - AdventHealth Winter Park is a 422-bed facility that is a model of community health and wellness. The facility boasts spacious patient care areas and a full spectrum of specialties and services, including the Dr. P. Phillips Baby Place (with Level II NICU), AdventHealth Orthopedic Institute, and state-of-the-art surgery, recovery and rehabilitation at the AdventHealth Cancer Institute. In 2019, the new 5-story Nicholson Pavilion opened, adding 80 all-private rooms to the AdventHealth Winter Park campus. AdventHealth Winter Park has the Central Florida Region's only senior-friendly emergency room. Services offered at AdventHealth Winter Park include cancer, cardiovascular, digestive health, women's health, neuroscience, ophthalmology, orthopedics and rehabilitation, urology, and sports medicine. The Hospital also provides timely, convenient and quality emergency care at its state-of-the-art freestanding emergency room, AdventHealth Oviedo ER, which is staffed with physicians trained to provide medical treatments for adults and children. *** see continuation of footnote
Part VI, Line 4 Continuation of Footnote Description of Community Information - Continued The demographic makeup of AdventHealth Winter Park's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.99% - Unemployment Rate 10.10% - Violent Crime Rate (Per 100,000 Pop.) 517.6 - Pop. Age 25+ with No High School Diploma 9.50% - Uninsured Adults 18.50% - Uninsured Children 6.60% - Food Insecurity Rate 13.10% - Pop. with Low Food Access 27.31%
Part VI, Line 7 The filing organization does not file an annual community benefit report with any state agencies.
Schedule H (Form 990) 2020
Additional Data


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) Adventist Care Centers - Courtland Inc
730 Courtland Street
Orlando,FL32804
20-5774723 501(c)(3) 986,804       General Support
(2) Alzheimers & Dementia Resource Center
715 Douglas Avenue Ste 53
Altamonte Springs,FL32714
59-2496511 501(c)(3) 10,000       General Support
(3) American Diabetes Association Inc
1701 North Beauregard Street
Alexandria,VA22311
13-1623888 501(c)(3) 60,000       General Support
(4) American Cancer Society Inc
250 Williams Street NW Ste 400
Atlanta,GA30303
13-1788491 501(c)(3) 120,000       General Support
(5) American Heart AssociationGreater South Affiliate-Ar
9900 Ninth Street North
St Petersburg,FL33716
59-0637852 501(c)(3) 175,000       General Support
(6) Aspire Health Partners Inc
5151 Adanson Street
Orlando,FL32804
59-2301233 501(c)(3) 1,035,500       General Support
(7) Avon Park Seventh-Day Adventist Church
1410 W Avon Boulevard
Avon Park,FL33825
59-3057686 501(c)(3) 18,000       Other
(8) Bliss Cares Inc
2901 Curry Ford Road Ste 106
Orlando,FL32806
47-4565338 501(c)(3) 15,000       General Support
(9) Boy Scouts Of America Inc Central Florida Council
1951 S Orange Blossom Trail 102
Apopka,FL32703
59-0624376 501(c)(3) 22,500       General Support
(10) Boys & Girls Club Of Central Florida
PO Box 2987
Orlando,FL32802
59-0951887 501(c)(3) 15,000       General Support
(11) Boys & Girls Clubs Of Volusia Flagler Counties Inc
101 N Woodland Boulevard Ste 400
Deland,FL32720
59-3158162 501(c)(3) 35,000       General Support
(12) Celebration Foundation Inc
610 Sycamore Street
Celebration,FL34747
59-3370753 501(c)(3) 40,000       General Support
(13) Center For Change
6003 Silver Star Road Ste 3
Orlando,FL32808
20-3062727 501(c)(3) 36,763       General Support
(14) Center For Independent Living In Central Florida Inc
720 N Denning Drive
Winter Park,FL32789
59-1828770 501(c)(3) 11,000       General Support
(15) Center For Multicultural Wellness And Prevention Inc
641 N Rio Grande Avenue
Orlando,FL32805
59-3368679 501(c)(3) 10,025       General Support
(16) Central Florida Family Health Center Inc Dba True Health
4930 E Lake Mary Boulevard
Sanford,FL32771
59-1741286 501(c)(3) 100,000       General Support
(17) Central Florida Foundation Inc
800 N Magnolia Ave Ste 1200
Orlando,FL32803
59-3182886 501(c)(3) 10,000       General Support
(18) Central Texas Healthcare Collaborative
1301 Wonder World Drive
San Marcos,TX78666
45-3739929 501(c)(3) 265,152       Other
(19) Central Texas Medical Center Foundation
1301 Wonder World Drive
San Marcos,TX78666
74-2259907 501(c)(3)   26,693 Book Provision of general administrative support General Support
(20) Christian Service Center For Central Florida Inc
808 W Central Boulevard
Orlando,FL32805
59-1353031 501(c)(3) 10,000       General Support
(21) City Of Apopka
120 E Main Street
Apopka,FL32703
59-6000265 Gov't 98,000       General Support
(22) City Of Winter Park
401 Park Avenue South
Winter Park,FL32789
59-6000454 Gov't 50,000       General Support
(23) Community Health Centers Inc
110 S Woodland Street
Winter Garden,FL34747
59-1480970 501(c)(3) 106,940       General Support
(24) Community Hope Center Inc
2198 4 Winds Boulevard
Kissimmee,FL34746
80-0855060 501(c)(3) 613,500       General Support
(25) Daves House Inc
PO Box 1466
Windermeme,FL34786
27-0533943 501(c)(3) 35,900       General Support
(26) Debbie Turner Cancer Care Resources Inc
31138 Preswick Avenue
Sorrento,FL32776
80-0499456 501(c)(3) 11,000       General Support
(27) East Orlando Health & Rehab Center Inc
250 South Chickasaw Trail
Orlando,FL32825
20-5774748 501(c)(3) 3,367,450       General Support
(28) Edible Education Experience Inc
26 E King Street
Orlando,FL32804
46-5655482 501(c)(3) 50,000       General Support
(29) Family Promise Of Greater Orlando Inc
1000 Clay Street
Winter Park,FL32789
59-3679904 501(c)(3) 23,000       General Support
(30) Flagler Cares Inc
2561 Moody Boulevard Ste 206
Palm Coast,FL32136
47-4145174 501(c)(3) 102,000       General Support
(31) FLNC Inc
3355 E Semoran Boulevard
Apopka,FL32703
20-5774761 501(c)(3) 9,572,358       General Support
(32) Florida Abolitionist Inc
195 South Westmonte Drive
Altamonte Springs,FL32714
59-3178045 501(c)(3) 10,000       General Support
(33) Florida Hospital Seventh-Day Adventist Church
2800 N Orange Avenue
Orlando,FL32804
59-3039667 501(c)(3) 139,000       General Support
(34) Forest City Spanish Seventh-Day Adventist Church
7601 Forest City Rd
Orlando,FL32810
59-3291153 501(c)(3) 21,443       General Support
(35) Forest Lake Academy
500 Education Loop
Apopka,FL327036176
59-0816443 501(c)(3) 35,000       General Support
(36) Foundation For Orange County Public Schools Inc
445 W Amelia Street Ste 901
Orlando,FL328011153
59-2788435 501(c)(3) 45,000       General Support
(37) Foundation For Seminole State College Of Florida Inc
1055 AAA Drive Ste 209
Heathrow,FL32746
23-7033822 501(c)(3) 250,000       General Support
(38) Freedom Ride Inc
1905 Lee Road
Orlando,FL32810
59-3489545 501(c)(3) 350,000       General Support
(39) Give Kids The World Inc
210 South Bass Road
Kissimmee,FL34746
59-2654440 501(c)(3) 6,000       General Support
(40) Grace Medical Home Inc
51 Pennsylvania Street
Orlando,FL328062938
28-1817966 501(c)(3) 443,000       General Support
(41) Harbor House Of Central Florida Inc
PO Box 680748
Orlando,FL32868
59-1712936 501(c)(3) 10,000       General Support
(42) Harvest Time International Inc
225 Harvest Time Drive
Sanford,FL32771
54-1698630 501(c)(3) 10,000       General Support
(43) Health Care Center For The Homeless Inc
232 N Orange Blossom Trail
Orlando,FL32805
59-3185020 501(c)(3) 100,000       General Support
(44) Healthy Start Coalition Of Orange County Inc
1040 Woodcock Road Ste 215
Orlando,FL32803
59-3125675 501(c)(3) 17,500       General Support
(45) Healthy Start Coalition Of Osceola County Inc
PO Box 701995
St Cloud,FL34770
59-3212535 501(c)(3) 15,000       General Support
(46) Healthy Start Coalition Of Seminole County Inc
820 W Lake Mary Boulevard Ste 108
Sanford,FL32773
46-4038747 501(c)(3) 6,000       General Support
(47) Hope Community Center Inc
1016 N Park Avenue
Apopka,FL32712
56-2551312 501(c)(3) 7,500       General Support
(48) Hope Helps Inc
812 Eyrie Drive
Oviedo,FL32765
20-8490916 501(c)(3) 10,000       General Support
(49) Hope Now International Inc
PO Box 181173
Casselberry,FL327181173
27-4498303 501(c)(3) 10,000       General Support
(50) Idignity Inc
424 E Central Boulevard Ste 199
Orlando,FL32801
01-0921490 501(c)(3) 10,000       General Support
(51) Iglesia Chistiana Pentecostal De Orlando Inc
5850 Clarona Ocoee Road
Orlando,FL32810
59-3218454 501(c)(3) 15,000       General Support
(52) Impower Inc
111 W Magnolia Avenue
Longwood,FL32750
65-0439778 501(c)(3) 114,000       General Support
(53) Iniciativa Accion Puertorriquena
4545 Woodlands Village Drive
Orlando,FL32835
47-4537122 501(c)(3) 15,000       General Support
(54) Interfaith Council Of Central Florida
PO Box 3310
Winter Park,FL32790
45-5420165 501(c)(3) 25,000       General Support
(55) JDRF International
370 Center Pointe Circle Ste 1154
Altamonte Springs,FL32701
23-1907729 501(c)(3) 30,000       General Support
(56) Kids House Of Seminole Inc
5467 North Ronald Reagan Boulevard
Sanford,FL32773
59-3415005 501(c)(3) 20,000       General Support
(57) Lake Nona Institue Inc
6900 Tavistock Lakes Boulevard Ste
200
Orlando,FL32827
27-3346737 501(c)(3) 50,000       General Support
(58) Latino Leadership Inc
8617 E Colonial Drive Ste 1200
Orlando,FL32817
59-3702613 501(c)(3) 10,000       General Support
(59) Life Concepts Inc Dba Quest Inc
500 E Colonial Drive
Orlando,FL32803
59-2013160 501(c)(3) 20,000       General Support
(60) Lifestream Behavioral Center Foundation Inc
PO Box 491000
Leesburg,FL34749
59-2976392 501(c)(3) 50,000       General Support
(61) Lifework Leadership
1220 E Concord Street
Orlando,FL328035453
37-1592618 501(c)(3) 10,000       General Support
(62) Lift Orlando
215 East Central Boulevard
Orlando,FL32801
46-3607865 501(c)(3) 100,000       General Support
(63) Living Heart Foundation Inc
98 Greenfield Court
Little Silver,NJ07739
22-3796078 501(c)(3) 10,000       General Support
(64) Mars Hill Seventh Day Adventist Church
PO Box 1654
Sanford,FL32772
26-4337526 501(c)(3) 22,000       General Support
(65) Matthews Hope Ministries Inc
523 S Woodland Street
Winter Garden,FL34761
27-2245867 501(c)(3) 30,000       General Support
(66) Meals On Wheels Etc Inc
2801 S Financial Court
Sanford,FL32773
59-2977907 501(c)(3) 15,000       General Support
(67) Memorial Health Systems Inc
301 Memorial Medical Parkway
Daytona Beach,FL32117
59-0973502 501(c)(3) 557,216       General Support
(68) Mental Health Association Of Central Florida Inc
1525 E Robinson Street
Orlando,FL32801
59-0816432 501(c)(3) 192,848       General Support
(69) Mothers Milk Bank Of Florida
8669 Commodity Circle Ste 490
Orlando,FL32819
27-3939245 501(c)(3) 25,000       General Support
(70) One Heart For Women And Children Inc
2040 N Rio Grande Avenue
Orlando,FL32804
30-0584360 501(c)(3) 32,500       General Support
(71) Onepulse Foundation Inc
1227 E Concord Street
Orlando,FL32803
81-3142847 501(c)(3) 300,000       General Support
(72) Orange County School Readiness Coalition Inc Dba Early Learning Coalition O
7700 Southland Boulevard Ste 100
Orlando,FL32809
31-1759186 501(c)(3) 20,000       General Support
(73) Orlando Economic Partnership Inc
301 East Pine Street Ste 900
Orlando,FL32801
59-1767933 501(c)(3) 250,000       General Support
(74) Orlando Shakespeare Theather Inc
812 E Rollins Street Ste 100
Orlando,FL32803
59-2931698 501(c)(3) 6,000       General Support
(75) Osceola County Council On Aging Inc
700 Generation Point
Kissimmee,FL34744
59-1595398 501(c)(3) 35,000       General Support
(76) Park Maitland School Foundation Inc
465 S Orlando Avenue Ste 112
Maitland,FL32751
84-3613556 501(c)(3) 6,000       General Support
(77) Park Place Medical & Behavioral Health Care Inc
206 Park Place Boulevard
Kissimmee,FL34741
83-3269602 501(c)(3) 291,667       General Support
(78) Peer Support Space Inc
PO Box 677032
Orlando,FL32867
84-2070075 501(c)(3) 26,000       General Support
(79) Rescue Outreach Mission Of Central Florida Inc
1701 Historic Goldsboro Boulevard
Sanford,FL32771
59-2876415 501(c)(3) 55,500       General Support
(80) Ronald Mcdonald House Charities Of Central Florida Inc
1030 N Orange Avenue
Winter Park,FL327894709
59-3211250 501(c)(3) 104,000 456 Book Partnership & Sponsorships General Support
(81) Rustys Bicycle Recycle Inc
1275 Bennett Drive
Longwood,FL32750
82-4975971 501(c)(3) 10,000       General Support
(82) School District Of Osceola County Florida
817 Bill Beck Boulevard
Kissimmee,FL34744
59-6000779 501(c)(3) 25,750       General Support
(83) Seniors First Inc
5395 LB Mcleod Road
Orlando,FL32811
59-2759603 501(c)(3) 15,000       General Support
(84) Shepherd'S Hope Inc
455 9th Street
Winter Garden,FL34787
59-3420727 501(c)(3) 150,000       General Support
(85) Sunbelt Health & Rehab Center - Apopka Inc
305 East Oak Street
Apopka,FL32703
20-5774856 501(c)(3) 600,403       General Support
(86) Sunsystem Development Corporation
900 Hope Way
Altamonte Springs,FL32714
59-2219301 501(c)(3)   223,884 Book Provision of general administrative support General Support
(87) Sunsystem Development Corporation DBA Fh Foundation
900 Hope Way
Altamonte Springs,FL32714
59-2219301 501(c)(3)   4,937,522 Book Provision of general administrative support General Support
(88) Support Our Scholars (Sos)
PO Box 1985
Winter Park,FL32790
26-0711355 501(c)(3) 7,500       General Support
(89) Teen Challenge Of Florida Inc
3706 S Sanford Avenue
Sanford,FL32773
59-2479228 501(c)(3) 35,000       General Support
(90) The 4R Foundation Inc
210 N Park Avenue
Winter Park,FL32789
47-4062821 501(c)(3) 300,000       General Support
(91) The Finley Project Inc
941 W Morse Boulevard Ste 100
Winter Park,FL32789
47-1325653 501(c)(3) 7,500       General Support
(92) The School Board Of Highlands CountySebring High School
426 School Street
Sebring,FL33870
59-6000654 Gov't 10,000       Other
(93) Tri-County Nursing Rehabilitation Center Inc
1290 Celebration Boulevard
Kissimmee,FL34747
47-2219363 501(c)(3) 22,750       General Support
(94) United Global Outreach
2301 N Orange Avenue
Orlando,FL32804
03-0511875 501(c)(3) 138,766       General Support
(95) United Way - The Heart Of Florida
1940 Traylor Boulevard
Orlando,FL32804
59-0808854 501(c)(3) 45,000       General Support
(96) Universal Orlando Foundation
1000 Universal Studios Plaza
Orlando,FL32819
59-3510383 501(c)(3) 15,000       General Support
(97) US Dream Academy
5950 Symphony Woods Road
Columbia,MD21044
59-3514841 501(c)(3) 10,000       General Support
(98) Valencia College Foundation Inc
PO Box 3028
Orlando,FL32802
23-7442785 501(c)(3) 250,000       General Support
(99) Walker Memorial Academy
1525 W Avon Boulevard
Avon Park,FL33825
42-1748753 501(c)(3) 45,000       Other
(100) West Orange Chamber Of Commerce
12184 W Colonial Drive
Winter Garden,FL34787
59-0576757 501(c)(6) 15,525       General Support
(101) West Volusia Habitat For Humanity Inc
604 S Spring Garden Avenue
Deland,FL32720
59-2894153 501(c)(3) 50,000       General Support
(102) Zephyrhills Health & Rehab Center Inc
7350 Dairy Road
Zephyrhills,FL33540
20-5774967 501(c)(3) 16,225       General Support
(103) Zion Farms & Market Inc
PO Box 605
Orlando,FL34760
82-4080493 501(c)(3) 8,000       General Support
(104) Southern Adventist University
PO Box 567
Keene,TX76059
75-0891465 501(c)(3)   314,009 Book Other General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
103
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Part I, Line 2: Grants are generally made only to related organizations that are exempt from federal income tax under IRC Section 501(c)(3), or to other local charitable community organizations, or to other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures.
Schedule I (Form 990) 2020



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Rathbun Paul C
Dir(end 9/20)/AdventHealth CFO
(i)

(ii)
0
-------------
1,023,847
0
-------------
381,258
0
-------------
2,953,216
0
-------------
165,320
0
-------------
45,463
0
-------------
4,569,104
0
-------------
180,391
2Shaw Terry D
Dir/President/AdventHealth CEO
(i)

(ii)
0
-------------
1,802,963
0
-------------
753,747
0
-------------
437,823
0
-------------
145,820
0
-------------
58,139
0
-------------
3,198,492
0
-------------
321,384
3Tol Daryl
Dir(end 9/20)/CEO AH Central FL Div
(i)

(ii)
0
-------------
1,228,617
0
-------------
456,545
0
-------------
301,398
0
-------------
145,820
0
-------------
57,651
0
-------------
2,190,031
0
-------------
193,410
4Silvestry MD Scott
Phy/Dir AH Thoracic Transplant
(i)

(ii)
1,839,659
-------------
0
0
-------------
0
21,447
-------------
0
15,320
-------------
0
27,787
-------------
0
1,904,213
-------------
0
0
-------------
0
5Banks David
Former Key Emp - SEVP/CSO
(i)

(ii)
0
-------------
815,018
0
-------------
236,512
0
-------------
438,618
0
-------------
140,636
0
-------------
45,582
0
-------------
1,676,366
0
-------------
110,503
6Moorhead MD David
Former Key Emp - SEO/CCO
(i)

(ii)
0
-------------
811,900
0
-------------
240,204
0
-------------
532,925
0
-------------
15,320
0
-------------
13,468
0
-------------
1,613,817
0
-------------
0
7Accola MD Kevin
Exec Med Dir/Cardio Surgery & Struct
(i)

(ii)
1,468,941
-------------
0
85,710
-------------
0
15,483
-------------
0
15,320
-------------
0
23,157
-------------
0
1,608,611
-------------
0
0
-------------
0
8Goodman Todd A
CFO AH Central FL Division
(i)

(ii)
0
-------------
705,375
0
-------------
193,096
0
-------------
488,604
0
-------------
132,413
0
-------------
48,066
0
-------------
1,567,554
0
-------------
76,432
9Palmer MD George
Med Dir/ AH Celebration Cardio Surge
(i)

(ii)
1,283,546
-------------
0
85,710
-------------
0
15,058
-------------
0
15,320
-------------
0
20,832
-------------
0
1,420,466
-------------
0
0
-------------
0
10Soler Eddie
Former Key Emp - EVP/SFO
(i)

(ii)
0
-------------
772,770
0
-------------
253,149
0
-------------
184,559
0
-------------
161,326
0
-------------
26,194
0
-------------
1,397,998
0
-------------
136,730
11Stevens Eric A
Former Key Emp/CEO CFD So Acute Care
(i)

(ii)
0
-------------
18,631
0
-------------
227,251
0
-------------
998,059
0
-------------
9,620
0
-------------
33,462
0
-------------
1,287,023
0
-------------
180,646
12Davis JR MD Robert
Phy/Dir AH Cardovascular
(i)

(ii)
1,192,673
-------------
0
0
-------------
0
9,811
-------------
0
15,320
-------------
0
9,161
-------------
0
1,226,965
-------------
0
0
-------------
0
13Botta MD Donald
Phy/Dir AH Heart Transplant
(i)

(ii)
612,187
-------------
0
15,685
-------------
0
404,643
-------------
0
15,320
-------------
0
20,761
-------------
0
1,068,596
-------------
0
0
-------------
0
14Finkler Neil
CMO AH CFD So Acute Care Srvs
(i)

(ii)
0
-------------
571,010
0
-------------
129,327
0
-------------
140,245
0
-------------
90,877
0
-------------
26,818
0
-------------
958,277
0
-------------
72,993
15Thompson Michael J
CEO AH CFD Integrated Hlth Srvs
(i)

(ii)
0
-------------
552,001
0
-------------
144,310
0
-------------
98,770
0
-------------
74,243
0
-------------
46,075
0
-------------
915,399
0
-------------
59,986
16Hilliard Douglas W
CFO AH CFD South Region
(i)

(ii)
0
-------------
520,892
0
-------------
140,320
0
-------------
122,767
0
-------------
66,450
0
-------------
43,468
0
-------------
893,897
0
-------------
62,545
17Wandersleben Jennifer J
CEO AH CFD So Acute Care Srvs
(i)

(ii)
0
-------------
554,002
0
-------------
83,062
0
-------------
64,296
0
-------------
95,540
0
-------------
46,604
0
-------------
843,504
0
-------------
29,125
18Owen Terry R
Former Key Emp/SVP Partnering Strate
(i)

(ii)
0
-------------
249,353
0
-------------
132,136
0
-------------
414,386
0
-------------
20,485
0
-------------
24,799
0
-------------
841,159
0
-------------
102,317
19Cook Timothy W
CEO AH Alt & Seminole Mkt
(i)

(ii)
0
-------------
430,131
0
-------------
115,748
0
-------------
147,985
0
-------------
63,209
0
-------------
43,015
0
-------------
800,088
0
-------------
19,799
20Spenst Brett
CEO AH Orlando (end 11/20)
(i)

(ii)
0
-------------
498,554
0
-------------
103,732
0
-------------
81,471
0
-------------
75,698
0
-------------
22,399
0
-------------
781,854
0
-------------
0
21Harcombe Douglas W
CEO AH Celebration & Osecola Mkt
(i)

(ii)
0
-------------
443,433
0
-------------
100,511
0
-------------
77,223
0
-------------
66,542
0
-------------
46,186
0
-------------
733,895
0
-------------
46,097
22Zbaraschuk Amy L
CFO AH CFD Integrated Hlth Srvs
(i)

(ii)
0
-------------
434,484
0
-------------
118,200
0
-------------
69,579
0
-------------
64,300
0
-------------
42,376
0
-------------
728,939
0
-------------
44,496
23Hagensicker Janice K
Former Key Emp/Sr Fin Off AH Orl SW
(i)

(ii)
0
-------------
438,208
0
-------------
122,790
0
-------------
95,868
0
-------------
15,320
0
-------------
25,134
0
-------------
697,320
0
-------------
0
24Moorhead Sheryl D
AH CFD Chief People Officer
(i)

(ii)
0
-------------
420,257
0
-------------
114,372
0
-------------
108,040
0
-------------
15,320
0
-------------
14,151
0
-------------
672,140
0
-------------
0
25Deininger Robert
CEO AH Orlando (beg 11/20)
(i)

(ii)
0
-------------
397,123
0
-------------
89,419
0
-------------
66,298
0
-------------
67,209
0
-------------
40,499
0
-------------
660,548
0
-------------
11,017
26Villanueva Jeffrey
CEO AH E Orl & E Orange Mkt
(i)

(ii)
0
-------------
384,480
0
-------------
75,826
0
-------------
26,620
0
-------------
51,772
0
-------------
44,343
0
-------------
583,041
0
-------------
16,552
27Jernigan PhD Donald L
Dir/CEO Emeritus (end 3/20)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
443,591
0
-------------
0
0
-------------
5,635
0
-------------
449,226
0
-------------
407,940
28Reed MD Monica P
Former Key Employee
(i)

(ii)
0
-------------
0
0
-------------
0
8,280
-------------
366,974
0
-------------
0
0
-------------
25,227
8,280
-------------
392,201
0
-------------
0
29Bradley Kenneth W
Former Kep Emp/AH Dir Emerging Leade
(i)

(ii)
0
-------------
158,151
0
-------------
18,109
0
-------------
6,716
0
-------------
8,686
0
-------------
24,325
0
-------------
215,987
0
-------------
0
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Part I, Line 1a The filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 48 hospitals in 9 states, the senior leadership of AHSSHC travel extensively and often visit multiple hospital locations in different states as a part of a single business trip. The special travel allowance can provide reimbursements to the executive for such items as the purchase of air travel upgrade coupons, to cover the cost differential between coach and first-class travel, or to cover the cost of a charter flight. The special travel allowance benefit was originally authorized by and codified into a policy by the AHSSHC Board Compensation Committee (the Committee), an independent body of the AHSSHC Board of Directors, who also approves the annual cap on the amount of the allowance. The special travel allowance has an annual cap of $24,000 for members of the Leadership Executive Team (AdventHealth Cabinet - 13 members) and $15,000 for AdventHealth Corporate Office Senior Vice Presidents, Regional CEO's, and Division Chief Officers (generally 20-30 individual executives). The Divisional CEO and CFO for AdventHealth Central Florida Division, Central Florida CEO of Integrated Health Services, CEO of AdventHealth Central Florida South Acute Care Services, and Senior Vice President of Partnering Strategy are officers or key employees of the filing organization. The Divisional CEO and CFO for AdventHealth Central Florida Division, Central Florida CEO of Integrated Health Services, CEO of AdventHealth Central Florida South Acute Care Services, and Senior Vice President of Partnering Strategy are considered common law employees of and are on the payroll of AHSSHC. While the special travel allowance benefit is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and either wholly or partially reimbursed by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for first-class or charter travel since it has wholly or partially paid for the cost of providing this benefit. Those executives who receive the special travel allowance are responsible for tracking the expenses reimbursable under the special travel allowance and must submit such expenses on their accountable plan expense report. Any taxable reimbursements made to executives under the special travel allowance arrangement are treated as taxable compensation to the executive. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to certain executive leaders and is usually limited to one business trip per year beyond the annual AdventHealth President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AdventHealth has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval by the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: Occasional discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth President's Council, CFO Conference or the CMO/CNO business meeting. Payments provided to each executive are considered taxable compensation to the executive. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. All taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, certain AdventHealth eligible executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be approved by the board of directors of the AdventHealth organization for which they serve. Eligible executives are limited to certain senior level executives (hospital organization CEOs, the CEO of the nursing home division of AdventHealth, senior vice presidents at two large hospital organizations, divisional and regional CEOs and CFOs and the President/CEO, cabinet members and senior vice presidents of AHSSHC). Each AdventHealth executive who is approved for a club membership must submit an annual report to the AHSSHC President/CEO. The report is to describe how the membership benefited their organization during the preceding year so that the AHSSHC President/CEO can make a determination if continuance of the club membership furthers the business interests of AdventHealth. In the current year, for this filing organization, one executive listed in Part VII received reimbursement for club fees. While the club dues membership is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and reimbursed in whole or in part by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for health or social club dues since it has wholly or partially paid for the cost of providing this benefit.
Part I, Line 3 The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership.
Part I, Lines 4a-b During the year ending December 31, 2020, Terry Owen, Eric Stevens, and Monica Reed, MD received severance payments in the amount of $213,732, $673,371, and $353,755, respectively. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AdventHealth. Additionally, Donald Botta, MD received severance payment in the amount of $375,000 from the filing organization. As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive benefit plans to eligible executives. In 2020, AdventHealth restructured its executive supplemental retirement and benefit plans to reduce complexity, to increase predictability of benefits and to consolidate multiple supplemental executive benefit plans into one plan. Effective 1/1/2020, a new supplemental executive retirement plan (SERP III) was adopted and the three existing plans, described below, were amended and restated. The newly adopted SERP III plan, as well as the amended and restated plans, were reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. SERP III Plan (Effective 1/1/2020): To recognize the contribution each executive makes to the success of AdventHealth and to recognize the limitations available to executives in qualified retirement plans due to compensation limits set on such plans, AdventHealth adopted a new supplemental executive retirement plan (SERP III) in 2020. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. The SERP III plan provides eligible executives a percentage of their base pay, which is credited to a deferred compensation account. The plan also provides for compensation deferral and selection of life insurance coverage and long-term care insurance. To be eligible to participate in the SERP III plan, executives must be on the AHSSHC corporate payroll and be either a CEO of an AdventHealth entity, an AHSSHC Vice President (VP) or VP of an AdventHealth entity with a base salary of at least $285,000 in 2020 (adjusted annually by the same percentage as IRC Section 401(a)(17) limit increases), or other leader specifically approved by the AdventHealth President. Eligible executives do not include grandfathered executives, meaning those executives who would satisfy all the eligibility requirements of the SERP II plan prior to Dec 31, 2027, had the plan not been amended and restated as of Jan. 1, 2020. Contribution credits will be established and maintained by class year accounts for each participant using tiered contribution credit percentages of annual base compensation. Contribution credit percentages range between 15% and 19% of base compensation. Contribution credits will be made each quarter in 25% increments with reductions in contributions if the executive is also a grandfathered FLEX participant (see below). SERP III provides for a class year vesting and payment schedule (7 years for each class year) with respect to amounts accumulated in the executive's deferred compensation account. Upon attainment of a normal retirement age (age 62), or upon certain other circumstances as defined in the SERP III plan document, all deferred amounts are paid immediately to the participant. For any executives working beyond the normal retirement age, future employer contributions will be made quarterly from SERP III directly to the participant as a taxable cash bonus. SERP II Plan (Amended and Restated in 2020): In 2020, the SERP II plan was amended and restated to provide that eligible employees are restricted to those executives who, as of January 1, 2020, satisfied, or if employment continues, will satisfy the eligibility requirements of SERP II prior to December. 31, 2027. The SERP II plan is a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AdventHealth and/or to other Seventh-day Adventist Church hospitals or health care institutions. Under the provisions of the SERP II plan, benefits are provided to qualifying executive participants on a pro-rata schedule beginning with 20 years of service as an employee of AdventHealth and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP II) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AdventHealth active employment inclusive of income from all other Seventh-day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to SERP II and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. FLEX Plan (Amended and Restated in 2020): In 2020, the Flex Plan was amended and restated to exclude employed executives who are hired or promoted after a certain date from being eligible to participate in the Flex Plan except for certain insurance coverage features of the plan. Additionally, a provision was added to place a maximum limit on the amount of a participant's annual Flex allowance to not be greater than a maximum dollar amount or percentage of compensation as established by the AdventHealth Benefits Administration Committee. The Flex Plan was originally designed to provide eligible executives an opportunity to select from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. The Flex Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which the cost of mandatory and elective employee benefits is deducted. The benefits allowance credit percentage is determined by the AdventHealth Benefits Administration Committee. For grandfathered eligible employees, the annual pre-determined Flex allowance is contributed and any funds that remain after the cost of mandatory and elective benefits are subtracted are, at the employee's option, contributed to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account will be forfeited by the executive upon a voluntary separation. With respect to grandfathered participants, the Flex Plan documents define eligible employees to include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary was at least equal to the Internal Revenue Code Section 401(a)(17) compensation limit each year.
Schedule J, Part I, Line 4 b continued Senior Executive Death Benefit Plan (SEDB) (Amended and Restated in 2020): The SEDB plan was originally designed to provide a benefit in an amount equal to the amount the executive's benefit would have been under the SERP II Plan assuming that, on the date of the executive's death (and not before), the executive satisfied the last of the eligibility requirements of the SERP II Plan with present value recognizing an early benefit commencement. In conjunction with the amendment and restatement of the SERP II Plan, the SEDB was similarly amended in 2020 to limit eligible employees to only those who either satisfy the eligibility requirements of SERP II as of January 1 2020, or remain in active employment and will satisfy those requirements prior to December 31, 2027. An eligible executive becomes a participant in the SEDB Plan if the executive dies prior to termination of employment, provided the executive has not satisfied all the eligibility requirements of SERP II as of the executive's date of death but would have satisfied all those requirements within five (5) years following death had the executive lived and continued employment. The SEDB Plan will terminate automatically after December 31, 2027. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR. * CONTR./DISTR. CONTR. Rathbun, Paul C. $ 150,000 $ 213,814 $ 2,695,680 $ 0 Shaw, Terry D. $ 150,000 $ 350,945 $ 0 $ 0 Tol, Daryl $ 150,000 $ 224,875 $ 0 $ 0 Banks, David $ 144,816 $ 113,951 $ 266,649 $ 0 Moorhead, MD, David $ 150,000 $ 130,500 $ 295,270 $ 0 Goodman, Todd A. $ 117,093 $ 90,596 $ 380,832 $ 0 Soler, Eddie $ 146,006 $ 159,081 $ 0 $ 0 Stevens, Eric $ 0 $ 204,172 $ 0 $ 0 Finkler, Neil $ 95,057 $ 83,500 $ 0 $ 0 Thompson, Michael J. $ 78,423 $ 61,837 $ 0 $ 0 Hilliard, Douglas W. $ 70,630 $ 72,912 $ 0 $ 0 Wandersleben, Jennifer $ 78,924 $ 31,318 $ 0 $ 20,796 Owen, Terry R. $ 24,666 $ 120,569 $ 0 $ 0 Cook, Timothy W. $ 47,890 $ 23,816 $ 92,896 $ 0 Spenst, Brett $ 79,878 $ 0 $ 0 $ 0 Harcombe, Douglas W. $ 51,223 $ 53,110 $ 0 $ 0 Zbaraschuk, Amy L. $ 48,981 $ 50,590 $ 0 $ 0 Hagensicker, Janice $ 61,785 $ 42,285 $ 0 $ 0 Moorhead, Sheryl D. $ 69,659 $ 50,159 $ 0 $ 0 Deininger, Robert $ 39,620 $ 14,352 $ 0 $ 31,770 Villanueva, Jeffery $ 36,453 $ 19,302 $ 0 $ 0 Jernigan, Donald L. $ 0 $ 0 $ 0 $ 0 CY 457b Distr. Jernigan, Donald L. $ 407,940 * Including Investment Earnings
Schedule J (Form 990) 2020

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
B Orange County Health Facilities Authority
 
52-1378595 NoneAvail 12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
C Kansas Development Finance Authority
 
48-1066589 NoneAvail 12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
D Colorado Health Facilities Authority
 
84-0752932 NoneAvail 12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FAB0 07-21-2016 235,724,616 2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip   X   X   X
Colorado Health Facilities Authority
 
84-0752932 1964745K2 08-17-2016 216,517,920 2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-26-2017 44,750,000 2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-26-2017 50,750,000 2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-26-2017 45,250,000 2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FCN2 07-26-2017 97,750,000 2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FGN8 07-12-2018 375,008,542 2018A&B, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FJG0 08-20-2019 550,011,892 2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 262,025,000 9,000,000 9,000,000 9,000,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 372,572,414 25,008,422 25,007,891 25,008,355
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ...............        
8 Credit enhancement from proceeds ............. 5,560,382      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 367,012,032 25,008,422 25,007,891 25,008,355
11 Other spent proceeds ............. 348,320,000 294,985,000 232,125,000 310,952,245
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, a current refunding issue)? ........
  X   X   X   X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2019, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 1.420 % 0.900 % 0.200 % 0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet   0.070 %    
6 Total of lines 4 and 5 ............. 1.420 % 0.900 % 0.200 % 0.500 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.370 % 0.140 % 0.140 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X   X   X   X  
c No rebate due? .........   X   X   X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Orange County Health Facilities Authority 2010B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Kansas Development Finance Authority 2010C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Colorado Health Facilities Authority 2010D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
B Orange County Health Facilities Authority
 
52-1378595 NoneAvail 12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
C Kansas Development Finance Authority
 
48-1066589 NoneAvail 12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
D Colorado Health Facilities Authority
 
84-0752932 NoneAvail 12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FAB0 07-21-2016 235,724,616 2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip   X   X   X
Colorado Health Facilities Authority
 
84-0752932 1964745K2 08-17-2016 216,517,920 2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-26-2017 44,750,000 2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-26-2017 50,750,000 2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-26-2017 45,250,000 2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FCN2 07-26-2017 97,750,000 2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FGN8 07-12-2018 375,008,542 2018A&B, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FJG0 08-20-2019 550,011,892 2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 262,025,000 9,000,000 9,000,000 9,000,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 372,572,414 25,008,422 25,007,891 25,008,355
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ...............        
8 Credit enhancement from proceeds ............. 5,560,382      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 367,012,032 25,008,422 25,007,891 25,008,355
11 Other spent proceeds ............. 348,320,000 294,985,000 232,125,000 310,952,245
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, a current refunding issue)? ........
  X   X   X   X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2019, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 1.420 % 0.900 % 0.200 % 0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet   0.070 %    
6 Total of lines 4 and 5 ............. 1.420 % 0.900 % 0.200 % 0.500 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.370 % 0.140 % 0.140 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X   X   X   X  
c No rebate due? .........   X   X   X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Orange County Health Facilities Authority 2010B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Kansas Development Finance Authority 2010C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Colorado Health Facilities Authority 2010D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Schedule K (Form 990) 2020

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
B Orange County Health Facilities Authority
 
52-1378595 NoneAvail 12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
C Kansas Development Finance Authority
 
48-1066589 NoneAvail 12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
D Colorado Health Facilities Authority
 
84-0752932 NoneAvail 12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FAB0 07-21-2016 235,724,616 2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip   X   X   X
Colorado Health Facilities Authority
 
84-0752932 1964745K2 08-17-2016 216,517,920 2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-26-2017 44,750,000 2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-26-2017 50,750,000 2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-26-2017 45,250,000 2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FCN2 07-26-2017 97,750,000 2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FGN8 07-12-2018 375,008,542 2018A&B, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FJG0 08-20-2019 550,011,892 2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 262,025,000 9,000,000 9,000,000 9,000,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 372,572,414 25,008,422 25,007,891 25,008,355
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ...............        
8 Credit enhancement from proceeds ............. 5,560,382      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 367,012,032 25,008,422 25,007,891 25,008,355
11 Other spent proceeds ............. 348,320,000 294,985,000 232,125,000 310,952,245
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, a current refunding issue)? ........
  X   X   X   X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2019, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 1.420 % 0.900 % 0.200 % 0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet   0.070 %    
6 Total of lines 4 and 5 ............. 1.420 % 0.900 % 0.200 % 0.500 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.370 % 0.140 % 0.140 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X   X   X   X  
c No rebate due? .........   X   X   X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Orange County Health Facilities Authority 2010B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Kansas Development Finance Authority 2010C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Colorado Health Facilities Authority 2010D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
B Orange County Health Facilities Authority
 
52-1378595 NoneAvail 12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
C Kansas Development Finance Authority
 
48-1066589 NoneAvail 12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
D Colorado Health Facilities Authority
 
84-0752932 NoneAvail 12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FAB0 07-21-2016 235,724,616 2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip   X   X   X
Colorado Health Facilities Authority
 
84-0752932 1964745K2 08-17-2016 216,517,920 2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-26-2017 44,750,000 2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-26-2017 50,750,000 2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-26-2017 45,250,000 2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FCN2 07-26-2017 97,750,000 2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FGN8 07-12-2018 375,008,542 2018A&B, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FJG0 08-20-2019 550,011,892 2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 262,025,000 9,000,000 9,000,000 9,000,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 372,572,414 25,008,422 25,007,891 25,008,355
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ...............        
8 Credit enhancement from proceeds ............. 5,560,382      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 367,012,032 25,008,422 25,007,891 25,008,355
11 Other spent proceeds ............. 348,320,000 294,985,000 232,125,000 310,952,245
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, a current refunding issue)? ........
  X   X   X   X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2019, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 1.420 % 0.900 % 0.200 % 0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet   0.070 %    
6 Total of lines 4 and 5 ............. 1.420 % 0.900 % 0.200 % 0.500 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.370 % 0.140 % 0.140 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X   X   X   X  
c No rebate due? .........   X   X   X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Orange County Health Facilities Authority 2010B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Kansas Development Finance Authority 2010C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Colorado Health Facilities Authority 2010D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Schedule K (Form 990) 2020

Additional Data


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Software Version:  


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
B Orange County Health Facilities Authority
 
52-1378595 NoneAvail 12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
C Kansas Development Finance Authority
 
48-1066589 NoneAvail 12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
D Colorado Health Facilities Authority
 
84-0752932 NoneAvail 12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FAB0 07-21-2016 235,724,616 2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip   X   X   X
Colorado Health Facilities Authority
 
84-0752932 1964745K2 08-17-2016 216,517,920 2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-26-2017 44,750,000 2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-26-2017 50,750,000 2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-26-2017 45,250,000 2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FCN2 07-26-2017 97,750,000 2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FGN8 07-12-2018 375,008,542 2018A&B, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FJG0 08-20-2019 550,011,892 2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 262,025,000 9,000,000 9,000,000 9,000,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 372,572,414 25,008,422 25,007,891 25,008,355
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ...............        
8 Credit enhancement from proceeds ............. 5,560,382      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 367,012,032 25,008,422 25,007,891 25,008,355
11 Other spent proceeds ............. 348,320,000 294,985,000 232,125,000 310,952,245
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, a current refunding issue)? ........
  X   X   X   X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2019, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 1.420 % 0.900 % 0.200 % 0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet   0.070 %    
6 Total of lines 4 and 5 ............. 1.420 % 0.900 % 0.200 % 0.500 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.370 % 0.140 % 0.140 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X   X   X   X  
c No rebate due? .........   X   X   X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Orange County Health Facilities Authority 2010B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Kansas Development Finance Authority 2010C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Colorado Health Facilities Authority 2010D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number
59-1479658
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Highlands County Health Facilities Authority
 
52-1313569 431022KK7 08-08-2007 366,445,000 2007A B C D, Expand/refurbish facilities, purchase equipment   X   X   X
B Orange County Health Facilities Authority
 
52-1378595 NoneAvail 12-22-2010 25,000,000 2010B, Expand/refurbish facilities, purchase equipment   X   X   X
C Kansas Development Finance Authority
 
48-1066589 NoneAvail 12-22-2010 25,000,000 2010C, Expand/refurbish facilities, purchase equipment   X   X   X
D Colorado Health Facilities Authority
 
84-0752932 NoneAvail 12-22-2010 25,000,000 2010D, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 11-16-2011 80,000,000 2011A, Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 03-21-2012 294,985,000 2012A, AR Program - Refund 2009 A-F AR Program   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-25-2012 115,015,000 2012B, AR Program - Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542ADG3 08-29-2012 310,952,245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TL6 08-29-2012 348,320,000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 08-29-2012 125,000,000 2012G&H - Refund Highlands 2005I Conversion Bonds   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 431022TR3 11-08-2012 232,125,000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 09-18-2013 485,000,000 2013A B C, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-02-2014 110,000,000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-02-2014 50,000,000 2014B, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-02-2014 30,000,000 2014C, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648AT39 07-23-2014 82,501,800 2014E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FAB0 07-21-2016 235,724,616 2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip   X   X   X
Colorado Health Facilities Authority
 
84-0752932 1964745K2 08-17-2016 216,517,920 2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment   X   X   X
Orange County Health Facilities Authority
 
52-1378595 NoneAvail 07-26-2017 44,750,000 2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 07-26-2017 50,750,000 2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 NoneAvail 07-26-2017 45,250,000 2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FCN2 07-26-2017 97,750,000 2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FGN8 07-12-2018 375,008,542 2018A&B, Expand/refurbish facilities, purchase equipment   X   X   X
Colorado Health Facilities Authority
 
84-0752932 19648FJG0 08-20-2019 550,011,892 2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 262,025,000 9,000,000 9,000,000 9,000,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 372,572,414 25,008,422 25,007,891 25,008,355
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ...............        
8 Credit enhancement from proceeds ............. 5,560,382      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 367,012,032 25,008,422 25,007,891 25,008,355
11 Other spent proceeds ............. 348,320,000 294,985,000 232,125,000 310,952,245
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, a current refunding issue)? ........
  X   X   X   X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2019, an advance refunding issue)? ........
  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 1.420 % 0.900 % 0.200 % 0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet   0.070 %    
6 Total of lines 4 and 5 ............. 1.420 % 0.900 % 0.200 % 0.500 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.370 % 0.140 % 0.140 % 0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........ X   X   X   X  
c No rebate due? .........   X   X   X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Orange County Health Facilities Authority 2010B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Kansas Development Finance Authority 2010C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Colorado Health Facilities Authority 2010D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2020
Schedule L (Form 990 or 990-EZ) 2020
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Clifton Scott Family of board member 201,445 Employee Compensation   No
(2) Jeanette Vasquez Family of former key employee 47,359 Employee Compensation   No
(3) Mary Rathbun Family of board member and officer 87,272 Employee Compensation   No
(4) Karen Tilstra Family of former key employee 120,060 Consulting   No
(5) Meredith Bisbee Family of former key employee 127,633 Employee Compensation   No
(6) Martin Thompson Family of key employee 154,259 Employee Compensation   No
(7) Jocelyn Shaw Family of board member 11,270 Employee Compensation   No
(8) Kay Barnett Family of board member 197,585 Employee Compensation   No
(9) Ryan Barnett Family of board member 151,324 Employee Compensation   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Return Reference Explanation
Part V, Line 1a: The parent corporation and sole top-tier member of Adventist Health System/Sunbelt, Inc. (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041.
Form 990, Part VI, Section A, line 4 The Bylaws of Adventist Health System/Sunbelt, Inc. (AHSSI or the Corporation) were amended in 2020 to change one of the qualifications for members of the Board of Directors. Prior to amendment, the Board members of the Corporation were those members, in good standing, of the Executive Board of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent of AHSSI. In 2020, the Bylaws of AHSSHC were amended to change its Board of Director composition and to remove all references to its Executive Board. Accordingly, the Bylaws of AHSSI were amended in 2020 to stipulate that its Board of Director members will be those persons who are members, in good standing, of the Board of AHSSHC.
Form 990, Part VI, Section A, line 6 Adventist Health System/Sunbelt, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
Form 990, Part VI, Section A, line 7a The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization.
Form 990, Part VI, Section A, line 7b AHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to approve and disapprove the operating Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove major building programs and/or purchase or sale of personal property or real property equal to or in excess of One Million dollars; e) to approve or disapprove the annual operating and capital budgets of the filing organization; f) to direct the placement of funds and capital of the filing organization; and g) to establish general guiding policies.
Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the Senior VP/Chief Accounting Officer prior to its filing with the IRS. The review conducted by the Senior VP/Chief Accounting Officer did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
Form 990, Part VI, Section B, line 12c The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.
Form 990, Part VI, Section B, line 15 The filing organization's CEO, other officers and key employees are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3.
Form 990, Part VI, Section C, line 19 The filing organization is a part of the system of healthcare organizations known as AdventHealth. The audited consolidated financial statements of AdventHealth and of the AdventHealth "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AdventHealth on a consolidated basis and for the grouping of AdventHealth subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
Part VII, Section A: For those Board of Director members, officer(s), and key employees who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation.
Part VIII, Lines 7a, b and c: The amount shown in Part VIII, Line 7c(i) of the Form 990 represents an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program.
Form 990, Part IX, line 11g Payments to Healthcare Professionals: Program service expenses 320,741,439. Management and general expenses 0. Fundraising expenses 0. Total expenses 320,741,439. Professional Fees: Program service expenses 132,410,527. Management and general expenses 0. Fundraising expenses 0. Total expenses 132,410,527. Purchased Medical Services: Program service expenses 31,483,553. Management and general expenses 0. Fundraising expenses 0. Total expenses 31,483,553. Environmental Services: Program service expenses 4,206,076. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,206,076. Transcription Services: Program service expenses 1,748,261. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,748,261. Recruiting: Program service expenses 1,313,284. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,313,284. Food Service Contracts: Program service expenses 357,127. Management and general expenses 0. Fundraising expenses 0. Total expenses 357,127. Miscellaneous Purchased Services: Program service expenses 12,188,460. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,188,460. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 61,120,075. Fundraising expenses 0. Total expenses 61,120,075. Billing & Collection Services: Program service expenses 0. Management and general expenses 22,928,571. Fundraising expenses 0. Total expenses 22,928,571. AdventHealth Shared Services Fee: Program service expenses 0. Management and general expenses 41,831,127. Fundraising expenses 0. Total expenses 41,831,127.
Part X, Line 2: The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.
Form 990, Part XI, line 9: Transfer from tax-exempt parent 102,534,342. Transfer to tax-exempt parent -49,182,043. Transfer to tax-exempt affiliates -5,593,545. Transfer to taxable subsidiaries -6,095,536. Debt costs allocated to tax-exempt affiliates -1,534,150. Transfer for expenses -644,853. Gifts 441,745. Transfer from restricted 1,266,906. Loss on sale of hospital assets -12,671,315. Other 177,431.
Form 990, Part XII, Line 3b: For the 2020 fiscal year ending December 31, 2020, AdventHealth was subject to the Single Audit requirements, as set forth in the regulations at 2 CFR Part 200, Subpart F. As a calendar year taxpayer, the deadline to complete and submit the Single Audit Reporting Package to the Federal Audit Clearinghouse, as required under Subpart F of 2 CFR 200.501, is September 30, 2021. However, on March 19th, 2021, the Office of Management and Budget (OMB) issued Memorandum M21-20, which outlined the OMB's efforts to supplement the support in the American Rescue Plan Act of 2021 (ARP), promote public trust in the Federal Government's stewardship of taxpayer resources, and alleviate some of the administrative challenges related to the coronavirus pandemic. As part of the administrative relief included in Memorandum M21-20, the OMB provided a six-month extension of time to complete and submit the Single Audit Reporting Package. The extended reporting deadline for calendar year taxpayers is March 31, 2022.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) IQ Orlando LLC
235 E Princeton Street Suite 220
Orlando,FL328045555
47-1121247
Design and innovation FL 0 0 Adventist Hlth SystemSunbelt Inc
 










Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)AdventHealth Family Medicine Rural Health Clinics Inc
187 PR 4060

Lampasas,TX76550
27-1858033
Operation of Rural Health Clinics & Medical Services FL 501(c)(3) Line 3 Metroplex Adventist Hospital Inc
 
Yes
 
(2)AdventHealth Foundation Shawnee Mission
9100 W 74th Street

Shawnee Mission,KS66204
48-0868859
Fund-raising for Tax-exempt hospital KS 501(c)(3) Line 7 Shawnee Mission Medical Center Inc
 
Yes
 
(3)AdventHealth Home Care East Florida LLC
770 West Granada Blvd 319

Ormond Beach,FL32174
83-3768458
Inactive FL 501(c)(3) Line 12a, I Memorial Hlth Systems Inc
 
Yes
 
(4)AdventHealth Hospice Care East Florida Inc
770 West Granada Blvd 304

Ormond Beach,FL32174
83-3748461
Inactive FL 501(c)(3) Line 12a, I Memorial Hlth Systems Inc
 
Yes
 
(5)AdventHealth North Polk Inc
3100 E Fletcher Ave

Tampa,FL33613
59-3231322
Inactive FL 501(c)(3) Line 12a, I University Community Hospital Inc
 
Yes
 
(6)AdventHealth Polk North Inc
40100 US Highway 27 N

Davenport,FL33837
84-1793121
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(7)AdventHealth Polk South Inc
410 South 11th Street

Lake Wales,FL33853
83-4672945
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(8)AdventHealth Senior Care Inc fka AH Osceola South Inc
900 Hope Way

Altamonte Springs,FL32714
84-1817046
Inactive FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(9)AdventHealth South Overland ParkInc fka Merriam Hlth Care Prop
7820 W 165th Street

Overland Park,KS66223
36-4595806
Inactive KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc
 
Yes
 
(10)AdventHealth Ransom Memorial Inc
1301 S Main Street

Ottawa,KS66067
83-0976641
Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc
 
Yes
 
(11)AdventHealth University Inc
671 Winyah Drive

Orlando,FL32803
59-3069793
Education/Operation of School FL 501(c)(3) Line 2 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(12)AdventHealth West Florida Ambulatory Svcs Inc
14055 Riveredge Drive Ste 250

Tampa,FL33637
47-1881744
Operation of Imaging Center & Medical Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(13)AdventHealth West Florida Imaging Inc
14055 Riveredge Drive Ste 250

Tampa,FL33637
84-3225135
Imaging & Testing FL 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Services Inc
 
Yes
 
(14)Adventist Bolingbrook Hospital
500 Remington Blvd

Bolingbrook,IL60440
65-1219504
Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health
 
Yes
 
(15)Adventist Care Centers - Courtland Inc
730 Courtland Street

Orlando,FL32804
20-5774723
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(16)Adventist GlenOaks Hospital
701 Winthrop Avenue

Glendale Heights,IL60139
36-3208390
Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health
 
Yes
 
(17)Adventist Hlth Mid-America Inc
9100 W 74th Street

Shawnee Mission,KS66204
52-1347407
Support of Affiliated Hospital KS 501(c)(3) Line 12c, III-FI Adventist Hlth SystemSunbelt Inc
 
Yes
 
(18)Adventist Hlth Partners Inc
2601 Navistar Dr Bldg 4 Finance

Lisle,IL60532
36-4138353
Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc
 
Yes
 
(19)Adventist Hlth System Sunbelt Hlthcare Corp
900 Hope Way

Altamonte Springs,FL32714
59-2170012
Management Services FL 501(c)(3) Line 12a, I N/A
 
No
(20)Adventist Hlth System Georgia Inc
1035 Red Bud Road NE

Calhoun,GA30701
58-1425000
Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(21)Adventist Hlth SystemSunbelt Inc
900 Hope Way

Altamonte Springs,FL32714
59-1479658
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(22)Adventist Hlth SystemTexas Inc
11801 S Freeway

Burleson,TX76028
74-2578952
Leasing Personnel to Affiliated Hospital TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(23)Adventist Midwest Health
120 North Oak Street

Hinsdale,IL60521
36-2276984
Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(24)AHP Specialty Care NFP
2601 Navistar Dr Bldg 4 Finance

Lisle,IL60532
81-1105774
Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc
 
Yes
 
(25)AHS Midwest Management Inc
2601 Navistar Dr Bldg 4 Finance

Lisle,IL60532
36-3354567
Operation of Physician Practice Mgmt IL 501(c)(3) Line 12a, I Adventist Midwest Health
 
Yes
 
(26)AHSCentral Texas Inc (11-12142020)
11801 S Freeway

Burleson,TX76028
74-2621825
Provide Office Space - Medical Professionals TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(27)Apopka Hlth Care Properties Inc
305 E Oak Street

Apopka,FL32703
51-0605694
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(28)Battle Creek Adventist Hospital
900 Hope Way

Altamonte Springs,FL32714
38-1359189
Inactive MI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(29)Bert Fish Medical Center Auxiliary Inc
401 Palmetto Street

New Smyrna Beach,FL32168
59-1054892
Volunteer support services FL 501(c)(3) Line 10 N/A
 
No
(30)Bradford Heights Health & Rehab Center Inc
485 North Keller Road 250

Maitland,FL32751
20-5782342
Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(31)Burleson Nursing & Rehab Center Inc
301 Huguley Blvd

Burleson,TX76028
20-5782243
Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(32)Central Texas Hlthcare Collaborative (11-3312020)
1301 Wonder World Drive

San Marcos,TX78666
45-3739929
Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc
 
Yes
 
(33)Chickasaw Hlth Care Properties Inc
250 S Chickasaw Trail

Orlando,FL32825
51-0605681
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(34)Chippewa Valley Hospital & Oakview Care Center Inc
1220 Third Avenue West

Durand,WI54736
39-1365168
Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(35)Coalition For Physician Well-Being Inc (619 - 12312020)
900 Hope Way

Altamonte Springs,FL32714
46-3477012
Provide support for Physician well-being. FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(36)Courtland Hlth Care Properties Inc
730 Courtland Street

Orlando,FL32804
51-0605682
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(37)Creekwood Place Nursing & Rehab Center Inc
485 North Keller Road 250

Maitland,FL32751
20-5782260
Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(38)Dairy Road Hlth Care Properties Inc
7350 Dairy Road

Zephyrhills,FL33540
51-0605684
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(39)East Orlando Hlth & Rehab Center Inc
250 S Chickasaw Trail

Orlando,FL32825
20-5774748
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(40)Emory-Adventist Inc
900 Hope Way

Altamonte Springs,FL32714
58-2171011
Inactive GA 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(41)Fletcher Hospital Inc
100 Hospital Drive

Hendersonville,NC28792
56-0543246
Operation of Hospital & Related Svcs NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(42)FLNC Inc
3355 E Semoran Blvd

Apopka,FL32703
20-5774761
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(43)Florida Hospital Dade City Inc
13100 Fort King Road

Dade City,FL33525
82-2567308
Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(44)Florida Hospital Healthcare Partners Inc
770 West Granada Blvd 101

Ormond Beach,FL32174
46-2354804
Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(45)Florida Hospital Medical Group Inc
2600 Westhall Lane 4th Floor

Maitland,FL32751
59-3214635
Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(46)Florida Hospital Ocala Inc
1500 SW 1st Avenue

Ocala,FL34471
82-4372339
Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(47)Florida Hospital Physician Group Inc
12470 Telecom Dr 100

Tampa,FL33637
46-2021581
Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(48)Florida Hospital Waterman Inc
1000 Waterman Way

Tavares,FL32778
59-3140669
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(49)Florida Hospital Zephyrhills Inc
7050 Gall Blvd

Zephyrhills,FL33541
59-2108057
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(50)Florida Radiology Imaging at Lake Mary LLC
2600 Westhall Lane 4th Floor

Maitland,FL32751
55-0789387
Imaging & Testing FL 501(c)(3) Line 3 Florida Hospital Medical Group Inc
 
Yes
 
(51)Fountain Inn Nursing & Rehab Center Inc
4501 Waterman Way

Tavares,FL32778
47-2180518
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(52)Helen Ellis Memorial Hospital Auxiliary Inc
1395 S Pinellas Ave

Tarpon Springs,FL34689
59-2106043
Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 12c, III-FI N/A
 
No
(53)Helen Ellis Memorial Hospital Foundation Inc
1395 S Pinellas Ave

Tarpon Springs,FL34689
59-3690149
Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A
 
No
(54)Hinsdale Hospital Foundation
120 North Oak Street

Hinsdale,IL60521
52-1466387
Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation
 
 
No
(55)Hospice of the Comforter Inc
480 W Central Parkway

Altamonte Springs,FL32714
59-2935928
Operation of Hospice FL 501(c)(3) Line 10 The Comforter Health Care Group Inc
 
Yes
 
(56)In-Motion Rehab Inc
485 North Keller Road 250

Maitland,FL32751
20-8023411
Therapy services to tax exempt nursing homes KS 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc
 
Yes
 
(57)Lake County Health Care Properties Inc
485 North Keller Road 250

Maitland,FL32751
81-3923985
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(58)Memorial Hlth Systems Foundation Inc
305 Memorial Medical Pkwy 212

Daytona Beach,FL32117
31-1771522
Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A
 
No
(59)Memorial Hlth Systems Inc
301 Memorial Medical Parkway

Daytona Beach,FL32117
59-0973502
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(60)Memorial Hospital - West Volusia Inc
701 West Plymouth Avenue

Deland,FL32720
59-3256803
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc
 
Yes
 
(61)Memorial Hospital Flagler Inc
60 Memorial Medical Parkway

Palm Coast,FL32164
59-2951990
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc
 
Yes
 
(62)Memorial Hospital Inc
210 Marie Langdon Drive

Manchester,KY40962
61-0594620
Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(63)Metroplex Adventist Hospital Inc
2201 S Clear Creek Road

Killeen,TX76549
74-2225672
Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(64)Metroplex Clinic Physicians Inc
2201 S Clear Creek Road

Killeen,TX76549
11-3762050
Physician Hlthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc
 
Yes
 
(65)Midwest Health Foundation
120 North Oak Street

Hinsdale,IL60521
35-2230515
Support of subsidiary foundations IL 501(c)(3) Line 7 N/A
 
No
(66)Mills Health & Rehab Center Inc
485 North Keller Road 250

Maitland,FL32751
20-5782320
Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(67)Mission Strategies of Georgia Inc
485 North Keller Road 250

Maitland,FL32751
90-0866024
Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc
 
Yes
 
(68)Missouri Adventist Health Inc
9100 W 74th Street

Shawnee Mission,KS66204
43-1224729
Support Hlth Care Services MO 501(c)(3) Line 12d, III-O Adventist Hlth Mid-America Inc
 
Yes
 
(69)Ormond Beach Memorial Hospital Auxiliary Inc
301 Memorial Medical Parkway

Daytona Beach,FL32117
59-1721962
Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A
 
No
(70)Osceola Health Care Properties Inc
485 North Keller Road 250

Maitland,FL32751
81-3165729
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(71)Overland Park Nursing & Rehab Center Inc
6501 West 75th Street

Overland Park,KS66204
20-5774821
Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(72)Pasco-Pinellas Hillsborough Community Hlth System Inc
2600 Bruce B Downs Blvd

Wesley Chapel,FL33544
20-8488713
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(73)Portercare Adventist Health System (630 YE)
9100 E Mineral Circle

Centennial,CO80112
84-0438224
Operation of Hospital & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(74)Princeton Health & Rehab Center Inc
485 North Keller Road 250

Maitland,FL32751
20-5782272
Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(75)Princeton Professional Services Inc
601 E Rollins Street

Orlando,FL32803
59-1191045
Provision of Hlthcare Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(76)Quality Circle for Hlthcare Inc
900 Hope Way

Altamonte Springs,FL32714
26-3789368
Hlthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(77)Resource Personnel Inc
485 North Keller Road 250

Maitland,FL32751
20-8040875
Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc
 
Yes
 
(78)Rocky Mountain Adventist Hlthcare Foundation (630 Year End)
7995 E Prentice Ave 204

Greenwood Village,CO80111
84-0745018
Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 N/A
 
No
(79)Rollins Brook Community Care Corp
2201 S Clear Creek Road

Killeen,TX76549
46-1656773
Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc
 
Yes
 
(80)San Marcos Hlth Care Properties Inc
1900 Medical Parkway

San Marcos,TX78666
51-0605693
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(81)San Marcos Nursing & Rehab Center Inc
1900 Medical Parkway

San Marcos,TX78666
20-5782224
Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(82)Shawnee Mission Hlth Care Inc
6501 West 75th Street

Overland Park,KS66204
48-0952508
Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(83)Shawnee Mission Hlth Care Properties Inc
485 North Keller Road 250

Maitland,FL32751
81-3914908
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(84)Shawnee Mission Medical Center Inc
9100 W 74th Street

Shawnee Mission,KS66204
48-0637331
Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc
 
Yes
 
(85)South Pasco Hlth Care Properties Inc
38250 A Avenue

Zephyrhills,FL33542
51-0605679
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(86)Southeast Volusia Healthcare Corp
401 Palmetto Street

New Smyrna Beach,FL32168
47-3793197
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(87)Southwest Volusia Hlth Services Inc
1055 Saxon Blvd

Orange City,FL32763
59-3281591
Medical Office Building for Hospital FL 501(c)(3) Line 12a, I Southwest Volusia Hlthcare Corp
 
Yes
 
(88)Southwest Volusia Hlthcare Corp
1055 Saxon Blvd

Orange City,FL32763
59-3149293
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(89)Specialty Physicians of Central Texas Inc (11-3312020)
1301 Wonder World Drive

San Marcos,TX78666
20-8814408
Physician Hlthcare services to the community TX 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(90)Spring View Hlth & Rehab Center Inc
485 North Keller Road 250

Maitland,FL32751
20-5782288
Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(91)Sunbelt Hlth & Rehab Center - Apopka Inc
305 East Oak Street

Apopka,FL32703
20-5774856
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(92)Sunbelt Hlth Care Centers Inc
485 North Keller Road 250

Maitland,FL32751
58-1473135
Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(93)SunSystem Development Corp
900 Hope Way

Altamonte Springs,FL32714
59-2219301
Fund Raising for Affiliated Tax-Exempt Hospitals FL 501(c)(3) Line 7 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(94)Tarpon Springs Hospital Foundation Inc
1395 S Pinellas Ave

Tarpon Springs,FL34689
59-0898901
Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc
 
Yes
 
(95)Tarrant County Hlth Care Properties Inc
301 Huguley Blvd

Burleson,TX76028
51-0605677
Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc
 
Yes
 
(96)The Comforter Health Care Group Inc
605 Montgomery Road

Altamonte Springs,FL32714
27-1857940
Lease to Related Organization FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(97)The Volunteer Auxiliary of Florida Hospital - Flagler Inc
60 Memorial Medical Parkway

Palm Coast,FL32164
59-2486582
Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A
 
No
(98)Tri-County Nursing and Rehab Center Inc
1290 Celebration Blvd

Kissimmee,FL34747
47-2219363
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(99)Trinity Nursing & Rehab Center Inc (11-91020)
485 North Keller Road 250

Maitland,FL32751
20-5774890
Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(100)University Community Hospital Foundation Inc
3100 E Fletcher Ave

Tampa,FL33613
59-2554889
Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 12a, I N/A
 
No
(101)University Community Hospital Inc
3100 E Fletcher Ave

Tampa,FL33613
59-1113901
Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(102)West Florida Health Home Care Inc
13601 Bruce B Downs Blvd Ste 110

Tampa,FL33613
59-3686109
Home Health Services GA 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Svcs Inc
 
Yes
 
(103)Zephyr Haven Hlth & Rehab Center Inc
38250 A Avenue

Zephyrhills,FL33542
20-5774930
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(104)Zephyrhills Hlth & Rehab Center Inc
7350 Dairy Road

Zephyrhills,FL33540
20-5774967
Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) Fletcher Hospital Surgical Ventures LLC

9131 Anson Way Ste 304
Raleigh,NC27615
86-1482646
Indirect Interest in Surgery Center NC N/A
        No     No  
(2) Florida Hospital DMERT LLC

500 Winderley Place Ste 324
Maitland,FL32751
20-2392253
Medical Equipment FL N/A
        No   Yes    
(3) Florida Hospital Home Infusion LLP

500 Winderley Place Ste 226
Maitland,FL32751
59-3142824
Home Infusion Services FL N/A
        No   Yes    
(4) Functional Neurosurgical Ambulatory Surgery Ctr LLC

11 W Dry Creek Circle 120
Littleton,CO80120
46-4426708
Surgery Center CO N/A
        No     No  
(5) Heart of Florida Surgery Center LLC (11 -10152020)

410 Lionel Way 100
Davenport,FL33837
81-2235296
Surgery Center DE N/A
        No   Yes    
(6) PAHS OnPoint Urgent Care LLC

9100 E Mineral Circle
Centennial,CO80112
83-2465331
Urgent Care Center CO N/A
        No     No  
(7) Princeton Homecare Services LLC

1050 Forrer Blvd
Kettering,OH45420
81-4196648
Operation of Home Health Agency FL N/A
        No     No  
(8) San Marcos MRI LP

1330 Wonder World Dr Ste 202
San Marcos,TX78666
77-0597972
Imaging & Testing TX Adventist Hlth SystemSunbelt Inc
 
Related -173,141 563,753   No     No 58.000 %
(9) The Bariatric Center of Kansas City LLC

9100 W 74th Street
Merriam,KS66204
82-3025378
Surgery Center KS N/A
        No     No  
(10) Urgent Care Centers of Brevard County LLC (14-12312020)

2600 Westhall Lane
Maitland,FL32751
84-4261523
Urgent Care Centers FL Adventist Hlth SystemSunbelt Inc
 
Related 953,710 6,519,166   No   Yes   51.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Altamonte Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-2855792
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 301,233 1,605,131 64.080 % Yes  
(2) Apopka Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-3000857
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 29,197 53,223 100.000 % Yes  
(3) CC MOB Inc

2201 S Clear Creek Road
Killeen,TX76549
74-2616875
Real Estate Rental TX N/A
C       Yes  
(4) Central Texas Medical Associates

1301 Wonder World Drive
San Marcos,TX78666
74-2729873
Inactive TX Adventist Hlth SystemSunbelt Inc
 
C     100.000 % Yes  
(5) Central Texas Providers Network (11-3312020)

1301 Wonder World Drive
San Marcos,TX78666
74-2827652
Physician Hospital Org. TX Adventist Hlth SystemSunbelt Inc
 
C 10,753   100.000 % Yes  
(6) Florida Hospital Flagler Medical Offices Association Inc

60 Memorial Medical Parkway
Palm Coast,FL32164
26-2158309
Condo Association FL N/A
C       Yes  
(7) Florida Hosp Hlth Village Property Owner's Assoc Inc

550 E Rollins Street 7th Floor
Orlando,FL32803
82-1748255
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C     100.000 % Yes  
(8) Florida Hospital Healthcare System Inc

101 Southhall Lane Ste 150
Maitland,FL32751
59-3215680
PHSO FL Adventist Hlth SystemSunbelt Inc
 
C 48,944,814 38,363,644 100.000 % Yes  
(9) Florida Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-2855791
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 1,163,131 7,349,298 85.000 % Yes  
(10) Kissimmee Multispecialty Clinic Condominium Association Inc

201 Hilda Street Suite 30
Kissimmee,FL34741
59-3539564
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 125,990 262,556 54.400 % Yes  
(11) LN Health Partners Inc (11 - 9102020)

550 E Rollins Street 6th Floor
Orlando,FL32803
81-3556903
Inactive FL N/A
C       Yes  
(12) Midwest Management Services Inc

9100 West 74th Street
Shawnee Mission,KS66204
48-0901551
Inactive KS N/A
C       Yes  
(13) North American Health Services Inc & Sub

900 Hope Way
Altamonte Springs,FL32714
62-1041820
Lessor/Holding Co. TN N/A
C       Yes  
(14) Ormond Prof Associates Condo Assoc'n Inc (430 year end)

770 W Granada Blvd Ste 101
Ormond Beach,FL32174
59-2694434
Condo Association FL N/A
C       Yes  
(15) Park Ridge Property Owner's Association Inc

1 Park Place Naples Road
Fletcher,NC28732
03-0380531
Condo Association NC N/A
C       Yes  
(16) Porter Affiliated Health Services Inc

2525 S Downing Street
Denver,CO80210
84-0956175
Healthcare Services CO N/A
C       Yes  
(17) San Marcos Regional MRI Inc (11-3312020)

1301 Wonder World Drive
San Marcos,TX78666
77-0597968
Holding Company TX N/A
C       Yes  
(18) The Garden Retirement Community Inc

485 North Keller Road Ste 250
Maitland,FL32751
59-3414055
Real Estate Rental FL N/A
C       Yes  
(19) Winter Park Medical Office Building I Condo Assoc Inc

601 East Rollins Street
Orlando,FL32803
45-2228478
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 312,849 342,760 51.600 % Yes  
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) AdventHealth Polk North Inc

Q 196,878 Cost
(2) AdventHealth Polk North Inc

P 1,608,066 Cost
(3) AdventHealth Polk South Inc

P 1,641,271 Cost
(4) AdventHealth Ransom Memorial Inc

P 70,270 Cost
(5) AdventHealth University Inc

P 1,958,712 Cost
(6) AdventHealth West Florida Ambulatory Services Inc

Q 153,171 Cost
(7) Adventist Care Centers - Courtland Inc

B 986,804 Actual Amount Given
(8) Adventist Care Centers - Courtland Inc

P 870,520 Cost
(9) Adventist Health Georgia Inc

Q 496,258 Cost
(10) Adventist Health Georgia Inc

P 282,808 Cost
(11) Adventist Health System Sunbelt Healthcare Corporation

M 38,927,602 % of Facility's Operating Exp
(12) Adventist Health System Sunbelt Healthcare Corporation

B 49,182,043 Actual Amount Given
(13) Adventist Health System Sunbelt Healthcare Corporation

P 205,346,727 Cost
(14) Adventist Health System Sunbelt Healthcare Corporation

A 928,840 FMV
(15) Adventist Health System Sunbelt Healthcare Corporation

S 102,534,342 Actual Amount Received
(16) Adventist Health System Sunbelt Healthcare Corporation

P 178,927,437 Cost
(17) Adventist Health System Sunbelt Healthcare Corporation

L 138,658 Cost
(18) Adventist Health System Sunbelt Healthcare Corporation - Shared Services

M 35,472,982 % of Facility's Operating Exp
(19) Adventist Health System Sunbelt Healthcare Corporation dba AIT

M 161,682,475 % of Facility's Operating Exp
(20) Adventist Health System Sunbelt Healthcare Corporation dba AIT - Equip Fe

P 4,668,941 Cost
(21) Central Texas Healthcare Collaborative

B 265,152 Actual Amount Given
(22) East Orlando Health & Rehab Center Inc

B 3,367,450 Actual Amount Given
(23) East Orlando Health & Rehab Center Inc

P 3,072,450 Cost
(24) East Orlando Health & Rehab Center Inc

R 225,000 Actual Amount Given
(25) Fletcher Hospital Inc

P 424,077 Cost
(26) Fletcher Hospital Inc

Q 954,678 Cost
(27) Fletcher Hospital Inc

L 90,940 Cost
(28) FLNC Inc (Florida Living Nursing Center)

B 9,572,358 Actual Amount Given
(29) FLNC Inc (Florida Living Nursing Center)

R 4,392,985 Actual Amount Given
(30) FLNC Inc (Florida Living Nursing Center)

P 12,289,645 Cost
(31) Florida Hospital Dade City Inc

L 166,141 Cost Plus Appropriate %
(32) Florida Hospital Dade City Inc

P 73,832 Cost
(33) Florida Hospital Healthcare Partners Inc

P 844,996 Cost
(34) Florida Hospital Healthcare System Inc

P 21,218,918 Cost
(35) Florida Hospital Healthcare System Inc

S 3,750,095 Actual Amount Received
(36) Florida Hospital Medical Group Inc

Q 327,954 Cost
(37) Florida Hospital Medical Group Inc

L 642,091 Cost Plus Appropriate %
(38) Florida Hospital Medical Group Inc

K 1,033,040 FMV
(39) Florida Hospital Medical Group Inc

P 44,871,008 Cost
(40) Florida Hospital Medical Group Inc

M 161,833,975 Cost Plus Appropriate %
(41) Florida Hospital Medical Group Inc

A 595,202 FMV
(42) Florida Hospital Ocala Inc

L 887,510 Cost Plus Appropriate %
(43) Florida Hospital Ocala Inc

P 446,266 Cost
(44) Florida Hospital Physician Group Inc

P 130,535 Cost
(45) Florida Hospital Waterman Inc

P 2,600,660 Cost
(46) Florida Hospital Waterman Inc

Q 3,010,028 Cost
(47) Florida Hospital Waterman Inc

L 830,915 Cost Plus Appropriate %
(48) Florida Hospital Zephyrhills Inc

P 261,314 Cost
(49) Florida Hospital Zephyrhills Inc

L 397,227 Cost Plus Appropriate %
(50) Florida Radiology Imaging at Lake Mary LLC

P 4,333,968 Cost
(51) Florida Radiology Imaging at Lake Mary LLC

A 191,168 FMV
(52) Florida Radiology Imaging at Lake Mary LLC

Q 18,055,423 Cost
(53) Hospice of the Comforter Inc

Q 79,741 Cost
(54) Memorial Health Systems Inc

B 557,216 Actual Amount Given
(55) Memorial Health Systems Inc

Q 3,874,055 Cost
(56) Memorial Health Systems Inc

P 1,581,305 Cost
(57) Memorial Health Systems Inc

S 784,634 Actual Amount Received
(58) Memorial Health Systems Inc

L 889,660 Cost Plus Appropriate %
(59) Memorial Hospital - Flagler Inc

L 477,440 Cost Plus Appropriate %
(60) Memorial Hospital - Flagler Inc

P 417,651 Cost
(61) Memorial Hospital - Flagler Inc

Q 2,608,705 Cost
(62) Memorial Hospital - Flagler Inc

S 414,112 Actual Amount Received
(63) Memorial Hospital - West Volusia Inc

L 395,240 Cost Plus Appropriate %
(64) Memorial Hospital - West Volusia Inc

S 348,726 Actual Amount Received
(65) Memorial Hospital - West Volusia Inc

Q 1,788,813 Cost
(66) Memorial Hospital - West Volusia Inc

P 134,792 Cost
(67) Memorial Hospital Inc

P 85,135 Cost
(68) Metroplex Adventist Hospital Inc

P 227,267 Cost
(69) Pasco-Pinellas Hillsborough Community Health System Inc

P 1,107,873 Cost
(70) Pasco-Pinellas Hillsborough Community Health System Inc

L 429,148 Cost Plus Appropriate %
(71) Shawnee Mission Medical Center Inc

Q 6,558,642 Cost
(72) Shawnee Mission Medical Center Inc

P 1,192,825 Cost
(73) Shawnee Mission Medical Center Inc

L 982,157 Cost Plus Appropriate %
(74) Southeast Volusia Healthcare Corporation

P 239,380 Cost
(75) Southeast Volusia Healthcare Corporation

Q 1,883,060 Cost
(76) Southeast Volusia Healthcare Corporation

L 306,992 Cost Plus Appropriate %
(77) Southwest Volusia Healthcare Corporation

Q 1,450,316 Cost
(78) Southwest Volusia Healthcare Corporation

P 247,641 Cost
(79) Southwest Volusia Healthcare Corporation

L 526,834 Cost Plus Appropriate %
(80) Southwest Volusia Healthcare Corporation

S 370,522 Actual Amount Received
(81) Specialty Physicians of Central Texas Inc

R 975,560 Actual Amount Given
(82) Sunbelt Health & Rehab Center Apopka Inc

P 535,919 Cost
(83) Sunbelt Health & Rehab Center Apopka Inc

B 600,403 Actual Amount Given
(84) Sunbelt Health Care Centers Inc

M 716,565 Cost
(85) Sunbelt Health Care Centers Inc

K 294,490 FMV
(86) Sunbelt Health Care Centers Inc

P 4,426,389 Cost
(87) SunSystem Development Corporation

N 144,327 Cost Allocation
(88) SunSystem Development Corporation

C 7,788,994 Actual Amount Received
(89) SunSystem Development Corporation

B 659,402 Actual Amount Given
(90) SunSystem Development Corporation

L 4,230,816 Cost Plus Appropriate %
(91) Tarpon Springs Hospital Foundation Inc

L 302,992 Cost Plus Appropriate %
(92) Texas Health Huguley Inc

P 1,255,062 Cost
(93) University Community Hospital Inc

Q 165,542 Cost
(94) University Community Hospital Inc

P 5,073,214 Cost
(95) University Community Hospital Inc

L 1,709,499 Cost Plus Appropriate %
(96) Urgent Care Centers of Brevard County LLC

P 563,521 Cost
(97) Urgent Care Centers of Brevard County LLC

L 716,668 Cost
(98) Urgent Care Centers of Brevard County LLC

Q 4,772,826 Cost
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2020

Additional Data


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