Form990


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)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2022 , and ending 12-31-2022
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 $ 6,716,859,729
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 15
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 36,897
6 Total number of volunteers (estimate if necessary) ............. 6 1,539
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 27,850,887
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 4,019,418
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 71,730,639 104,069,888
9 Program service revenue (Part VIII, line 2g) ......... 5,645,631,821 6,021,551,256
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 175,291,624 128,778,123
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 14,652,267 -1,693,372
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 5,907,306,351 6,252,705,895
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 22,086,643 25,705,251
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) 2,133,046,330 2,473,662,371
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).... 2,993,275,611 3,309,863,414
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 5,148,408,584 5,809,231,036
19 Revenue less expenses. Subtract line 18 from line 12....... 758,897,767 443,474,859
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 11,276,131,812 11,012,939,296
21 Total liabilities (Part X, line 26)............. 5,196,868,532 4,982,376,731
22 Net assets or fund balances. Subtract line 21 from line 20..... 6,079,263,280 6,030,562,565
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
JumboBullet
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 (2021)
Form 990 (2021)
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 $ 5,328,982,795 including grants of $ 25,705,251 ) (Revenue $ 5,988,701,337 )
Operation of 11 acute care hospitals with 159,286 patient admissions, 900,829 patient days and 1,817,829 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 expensesMediumBullet5,328,982,795
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
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
List of Attached Documents:
// Content
.............
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
List of Attached Documents:
// Content
.........
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 Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
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
List of Attached Documents:
// Content
.........................
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
List of Attached Documents:
// Content
....
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
List of Attached Documents:
// Content
..............
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
List of Attached Documents:
// Content
..............
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
List of Attached Documents:
// Content
...................
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
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
............
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
......................
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
...........
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
List of Attached Documents:
// Content
.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the 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
List of Attached Documents:
// Content
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on 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 on 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
Yes
 
Form 990 (2021)
Form 990 (2021)
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
36,897
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 the 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
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
15
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
Yes
 
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
 
No
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 on 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 on 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 on 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 (1024 or 1024-A, if applicable), 990, and 990-T (section 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 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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 the 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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) Aguilera Ronald......................................................................
Director (End 5/22)
1.00
.................
2.00
X           0 6,088 0
(2) Bernard Roger A......................................................................
Director (End 9/22)
1.00
.................
2.00
X           0 5,708 0
(3) Bigalke John T......................................................................
Director
1.00
.................
2.00
X           0 37,511 0
(4) Brooks Stephen......................................................................
Director (Beg 9/22)
1.00
.................
1.50
X           0 5,238 0
(5) Cherry MD Robert A......................................................................
Director
1.00
.................
2.00
X           0 29,511 0
(6) Craig Carlos J......................................................................
Dir./Vice Chair/Secretary
1.00
.................
2.00
X           0 5,417 0
(7) Davidson James R......................................................................
Director (End 9/22)
1.00
.................
1.50
X           0 5,363 0
(8) Denslow Kenneth......................................................................
Dir./Vice Chair
2.00
.................
2.00
X           0 5,692 0
(9) Devore Susan D......................................................................
Director
1.00
.................
2.00
X           0 34,013 0
(10) Freedman David......................................................................
Director (Beg 9/22)
1.00
.................
1.50
X           0 5,363 0
(11) Gabriel Garth......................................................................
Director (Beg 9/22)
1.00
.................
1.00
X           0 5,088 0
(12) Grys DMin MD John......................................................................
Director (Beg 5/22)
1.00
.................
1.00
X           0 5,013 0
(13) Johnson Tidjani Michelle......................................................................
Director
1.00
.................
2.00
X           0 26,013 0
(14) Machado Allan......................................................................
Director
1.00
.................
1.50
X           0 5,088 0
(15) Morel Jr D Min Hubert J......................................................................
Director (Beg 9/22)
1.00
.................
1.00
X           0 5,238 0
(16) Morgan William H......................................................................
Director
1.00
.................
2.00
X           0 0 0
(17) Page John M......................................................................
Director (End 9/22)
1.00
.................
1.50
X           0 5,213 0
Form 990 (2021)
Form 990 (2021)
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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) Ramirez Elden........................................................................
Director (End 9/22)
1.00
.......................2.00
X           0 5,363 0
(19) Rustad Gary........................................................................
Director (Beg 9/22)
1.00
.......................1.50
X           0 6,913 0
(20) Sauder PhD Vinita........................................................................
Director
1.00
.......................1.00
X           0 5,213 0
(21) Scott Glynn CW........................................................................
Director (Beg 9/22)
1.00
.......................2.00
X           0 5,363 0
(22) Shaw EdD Kenneth........................................................................
Director
1.00
.......................1.50
X           0 5,613 0
(23) Shaw Terry D........................................................................
Dir/President/AdventHealth CEO
1.00
.......................50.00
X   X       0 4,723,276 955,707
(24) Smith DMin PhD Ron C........................................................................
Director/Chairperson
2.00
.......................2.00
X           0 5,542 0
(25) Thurber Gary F........................................................................
Director/Vice Chair
2.00
.......................2.00
X           0 6,063 0
(26) Thurber John Mic........................................................................
Director (End 9/22)
1.00
.......................2.00
X           0 5,088 0
(27) Tikker Blair........................................................................
Director
1.00
.......................2.00
X           0 34,013 0
(28) VandeVere David........................................................................
Director (End 9/22)
1.00
.......................1.00
X           0 5,888 0
(29) Werner Thomas L........................................................................
Director
1.00
.......................2.00
X           0 5,585 0
(30) Haffner PhD Randall........................................................................
CEO Central FL Division
1.00
.......................50.00
    X       0 2,420,244 190,032
(31) Rathbun Paul C........................................................................
AdventHealth CFO
1.00
.......................50.00
    X       0 2,536,010 211,956
(32) Adams Brian........................................................................
CEO Central FL Div. South Region
50.00
.......................0.00
      X     0 1,153,386 182,815
(33) Cook Timothy........................................................................
CEO AH Altamonte & Seminole Market
50.00
.......................0.00
      X     0 697,902 124,531
(34) Deininger Robert........................................................................
CEO AH Orlando
50.00
.......................0.00
      X     0 736,963 140,188
(35) Finkler MD Neil........................................................................
Chief Clinical Officer AH Central FL Div.
50.00
.......................0.00
      X     0 1,225,302 43,176
(36) Goodman Todd........................................................................
CFO, AH Central FL Division
1.00
.......................50.00
      X     0 1,822,857 204,341
(37) Harcombe Douglas........................................................................
CEO AH Celebration & South Market
50.00
.......................0.00
      X     0 692,609 132,260
(38) Hilliard Douglas........................................................................
Sr Finance Officer AH Orlando
50.00
.......................0.00
      X     0 1,006,458 138,480
(39) Moorhead Sheryl........................................................................
Chief People Off. AH Central FL Div.
50.00
.......................0.00
      X     0 748,807 35,912
(40) Thompson Michael........................................................................
CEO IHS Central FL Div-South Region
40.00
.......................10.00
      X     0 1,223,927 146,845
(41) Vargas Karilynn........................................................................
CEO AH Winter Garden & West Market
50.00
.......................0.00
      X     0 576,289 95,411
(42) Villanueva Jeffrey........................................................................
CEO AH East Orlando & East Market
50.00
.......................0.00
      X     0 1,314,892 119,592
(43) Zbaraschuk Amy........................................................................
Sr Fin Off. Central FL Div-South Region
40.00
.......................10.00
      X     0 680,236 122,000
(44) Accola MD Kevin........................................................................
Phy/Exec Med Dir/Cardio Surgery & Structural Heart
50.00
.......................0.00
        X   1,626,444 0 35,524
(45) Bogar MD Linda........................................................................
Physician - Heart Transplant
75.00
.......................0.00
        X   1,434,928 0 44,830
(46) Palmer MD George........................................................................
Phy/AH Celebration Cardio Surgery
50.00
.......................0.00
        X   1,416,890 0 44,716
(47) Silvestry MD Scott........................................................................
Phy/Dir AH Thoracic Transplant
85.00
.......................0.00
        X   2,909,076 0 47,861
(48) Zeeshan MD Ahmad........................................................................
Physician - Heart Transplant
75.00
.......................0.00
        X   1,458,296 0 35,593
(49) Tol Daryl........................................................................
Former SEVP/CEO Central FL Div
0.00
.......................0.00
          X 0 792,032 104
(50) Bradley Kenneth W........................................................................
Former Key Emp/AH Dir Emerging Leader
0.00
.......................50.00
          X 0 193,548 34,267
(51) Moorhead MD David........................................................................
Former EVP/Chief Clinical Officer
0.00
.......................50.00
          X 0 1,734,675 34,340
(52) Owen Terry R........................................................................
Former SVP Partnering Strategy CFD
0.00
.......................0.00
          X 0 305,559 16,138
(53) Wandersleben Jennifer........................................................................
Former CEO AH CFD So Acute Care S
0.00
.......................50.00
          X 0 949,270 170,444
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 8,845,634 25,816,443 3,307,063
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 MediumBullet5,089
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
AYA Healthcare Inc

PO Box 123519 Dept 3519
Dallas,TX75312
Healthcare Staffing 102,772,195
AMN Healthcare Inc

8840 Cypress Waters Blvd Ste 300
Dallas,TX75019
Healthcare Staffing 98,647,901
Maxim Healthcare Services Inc

12558 Collections Center Dr
Chicago,IL60693
Healthcare Staffing 62,626,668
Brasfield & Gorrie LLC

2999 Circle 75 Parkway Ste 100
Atlanta,GA30339
Construction Services 57,508,699
Cross Country Staffing Inc

PO Box 404674
Atlanta,GA30384
Healthcare Staffing 27,287,329
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet588
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 13,486,038
e Government grants (contributions)1e 12,567,034
f All other contributions, gifts, grants, and similar amounts not included above1f 78,016,816
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 104,069,888
 Program Service RevenueAmt Business Code
2a Patient Revenue 622110 5,932,837,048 5,911,465,769 21,371,279  
b Rent from Exempt Affiliates 622110 23,270,145 23,270,145    
c Cafeteria/Vending Revenue 622110 17,106,689 16,913,019 193,670  
d Research - Disease Related 622110 14,255,842 14,255,842    
e Laundry 622110 9,727,211 9,650,346 76,865  
f All other program service revenue. 24,354,321 18,224,956 6,129,365  
g Total. Add lines 2a–2f .....MediumBullet 6,021,551,256
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 115,433,160     115,433,160
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 337,604     337,604
(ii) Personal (i) Real
6a Gross rents 17,260 8,637,460 6a
b Less: rental expenses 7,024 5,599,932 6b
c Rental income or (loss) 10,236 3,037,528 6c
d Net rental income or (loss).......MediumBullet 3,047,764   70,943 2,976,821
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 471,891,841   7a
b Less: cost or other basis and sales expenses 392,971,249 65,575,629 7b
c Gain or (loss) 78,920,592 -65,575,629 7c
d Net gain or (loss).........MediumBullet 13,344,963     13,344,963
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 Investment in Subs 622110 -592,701 -592,701    
b Equity earnings (losses) from rel 622110 -4,486,039 -4,486,039    
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet -5,078,740
12 Total revenue. See instructions.....MediumBullet 6,252,705,895 5,988,701,337 27,842,122 132,092,548
Form 990 (2021)
Form 990 (2021)
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 .... 22,744,296 22,744,296
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. ............. 2,960,955 2,960,955
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 15,975,455   15,975,455  
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........ 1,854,795,319 1,836,385,698 18,409,621  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 71,701,005 70,441,756 1,259,249  
9 Other employee benefits ....... 391,320,370 375,710,019 15,610,351  
10 Payroll taxes ........... 139,870,222 137,418,446 2,451,776  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 2,048,671   2,048,671  
c Accounting ........... 1,139,554   1,139,554  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 11,225,841   11,225,841  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 1,058,277,854 836,133,278 222,144,576  
12 Advertising and promotion .... 41,728,674   41,728,674  
13 Office expenses ....... 105,808,193 81,435,454 24,372,739  
14 Information technology ...... 295,146,713 277,803,390 17,343,323  
15 Royalties ..        
16 Occupancy ........... 124,040,429 124,040,429    
17 Travel ............ 7,758,420 1,184,955 6,573,465  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 6,599,226   6,599,226  
20 Interest ........... 47,034,922 47,027,047 7,875  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 257,469,631 257,469,631    
23 Insurance ... 41,212,956 37,635,365 3,577,591  
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 883,948,770 883,948,770    
b Assessments 230,246,000 230,246,000    
c Repairs/Maintenance 98,537,408 98,537,408    
d Unrelated Business Inco 313,962   313,962  
e All other expenses 97,326,190 7,859,898 89,466,292  
25 Total functional expenses. Add lines 1 through 24e 5,809,231,036 5,328,982,795 480,248,241 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 (2021)
Form 990 (2021)
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 ........ 92,638 1 94,153
2 Savings and temporary cash investments ......... 3,689,627,590 2 3,635,731,209
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 794,375,439 4 904,155,025
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 ............ 142,220,964 8 143,584,990
9 Prepaid expenses and deferred charges ...... 62,449,459 9 67,823,674
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 6,182,143,912
b Less: accumulated depreciation 10b 2,890,536,665 3,216,229,323 10c 3,291,607,247
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 15,921,797 12 15,329,096
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 22,403,806 14 19,316,664
15 Other assets. See Part IV, line 11 ........... 3,332,810,796 15 2,935,297,238
16 Total assets. Add lines 1 through 15 (must equal line 33)... 11,276,131,812 16 11,012,939,296
Liabilities 17 Accounts payable and accrued expenses ..... 428,388,507 17 425,717,506
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 4,344,524,039 20 3,920,808,527
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 423,955,986 25 635,850,698
26 Total liabilities. Add lines 17 through 25.. 5,196,868,532 26 4,982,376,731
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 .......... 6,078,902,256 27 6,030,281,108
28 Net assets with donor restrictions ........... 361,024 28 281,457
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 ........... 6,079,263,280 32 6,030,562,565
33 Total liabilities and net assets/fund balances ........ 11,276,131,812 33 11,012,939,296
Form 990 (2021)
Form 990 (2021)
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
6,252,705,895
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
5,809,231,036
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
443,474,859
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
6,079,263,280
5
Net unrealized gains (losses) on investments ...............
5
-605,651,040
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
113,475,466
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
6,030,562,565
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 on
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 (2021)
Form 990 (2021)
Additional Data


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

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
2022
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) 2022

Schedule A (Form 990) 2022
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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
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) 2022

Schedule A (Form 990) 2022
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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 on 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
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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
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 on 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 on 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) 2022

Schedule A (Form 990) 2022
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 on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on 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 on 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) 2022

Schedule A (Form 990) 2022
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) 2022

Schedule A (Form 990) 2022
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 2022 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-2022
(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, 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 2022. 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 2023. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
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) 2022


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
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
2022
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) (2022)
Schedule B (Form 990) (2022) 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) (2022)
Schedule B (Form 990) (2022)
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) (2022)
Schedule B (Form 990) (2022)
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) (2022)
Additional Data


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Software Version:  
SCHEDULE C
(Form 990)

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
2021
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.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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
 
99,450
j
Total. Add lines 1c through 1i ....................................................................................................
99,450
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 and the Florida Hospital Association who use a portion of the dues to conduct lobbying activities.
Schedule C (Form 990) 2021


Additional Data


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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
2021
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) 2021

Schedule D (Form 990) 2021
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 .... 16,447,156 21,347,312 20,731,829 20,471,913 19,274,406
b Contributions ... 151,931   50,000 50,000 100,000
c Net investment earnings, gains, and losses 986,523 1,213,093 1,197,926 1,196,289 1,099,218
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
1,258,116 73,573 632,443 526,694 1,711
f Administrative expenses ....          
g End of year balance ...... 16,327,494 22,486,832 21,347,312 21,191,508 20,471,913
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet86.310 %
b
Permanent endowment SchDMd Bullet13.690 %
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 .....   345,612,674 345,612,674
b Buildings ....   2,421,285,045 862,871,716 1,558,413,329
c Leasehold improvements        
d Equipment ....   3,139,346,787 1,962,932,204 1,176,414,583
e Other .....   275,899,406 64,732,745 211,166,661
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 3,291,607,247
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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 57,701,363
(2)Long-term Investments 484,029,881
(3)Other Current Receivables 34,050,140
(4)Other Non-Current Assets 378,171,708
(5)Receivable - Interco Alloc of Tax-Exempt Bond Proceeds 1,755,720,217
(6)Receivable from Third Party 225,623,929
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 2,935,297,238
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 635,850,698
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) 2021

Schedule D (Form 990) 2021
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: The current year beginning balance of the endowment funds on Line 1(a) in column (a) has been adjusted to exclude restricted funds that were held by a related tax-exempt organization for the benefit of a second related tax-exempt entity. Those funds have been properly disclosed on the second related tax-exempt entity's Form 990. Therefore, the beginning balance of the current year does not equal the ending balance of the prior year in column (b). Part V, line 1a, column (c) Two years back - 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 (e) Four 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, 2022 and 2021. NAHS also has temporary deductible differences of approximately $18,200 and $33,000 at December 31, 2022 and 2021, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2022, NAHS had net operating loss carryforwards of approximately $10,000, expiring in 2023 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $4,500 and $8,100 at December 31, 2022 and 2021, 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, 2022 and 2021 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, 2022 and 2021.
Schedule D (Form 990) 2021


Additional Data


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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
2022
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   1,671,047
Central America and the Caribbean     Meetings   42,653
Central America and the Caribbean     Program Services Supplies, books, shipping costs 45,936
East Asia and the Pacific     Grantmaking   31,637
East Asia and the Pacific     Meetings   7,657
East Asia and the Pacific     Program Services Travel expenses (Hotels, luggage, insurance, materials) 1,064
Europe (including Iceland and Greenland)     Grantmaking   1,250
Europe (including Iceland and Greenland)     Meetings   16,210
Europe (including Iceland and Greenland)     Program Services Transportation expenses 1,744
Middle East and North Africa     Meetings   858
North America ( includes Canada & Mexico, but not the U.S.)     Grantmaking   40,665
North America (includes Canada & Mexico, but not the U.S.)     Meetings   180,466
North America (includes Canada & Mexico, but not the U.S.)     Program Services Monthly stipends; Supplies, travel expenses, surgery, shipping cost 46,876
Russia and Neighboring States     Grantmaking   212,112
South America     Grantmaking   485,665
South America     Meetings   81,146
South America     Program Services Surgeries, supplies, travel expenses, stipends 71,158
South Asia     Grantmaking   102,146
South Asia     Meetings   958
Sub-Saharan Africa     Grantmaking   414,454
Sub-Saharan Africa     Meetings   511
Sub-Saharan Africa     Program Services Transportation expense 26
3a Sub-total .... 0 0 1,817,454
b Total from continuation sheets to Part I ... 0 0 1,638,785
c Totals (add lines 3a and 3b) 0 0 3,456,239
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
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)
South Asia General Support 50,000 Cash Payment 0   Book
Russia and Neighboring States General Support 180,000 Electronic Funds 0   Book
Central America and the Caribbean Medical Supplies or Equipment 0   359,203 Medical Equipment FMV
Russia and Neighboring States Medical Supplies or Equipment 0   16,342 Medical Equipment FMV
Sub-Saharan Africa Medical Supplies or Equipment 0   24,419 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   10,460 Medical Equipment FMV
Russia and Neighboring States Medical Supplies or Equipment 0   10,770 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   43,205 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   284,222 Medical Equipment FMV
South America Medical Supplies or Equipment 0   210,540 Medical Equipment FMV
South America Medical Supplies or Equipment 0   62,033 Medical Equipment FMV
South America Medical Supplies or Equipment 0   31,670 Medical Equipment FMV
South America Medical Supplies or Equipment 0   40,350 Medical Equipment FMV
South America General Support/Medical Supplies or Equipment 100,000 Electronic Funds 9,750 Medical Equipment Book/FMV
South America Medical Supplies or Equipment 0   25,000 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   11,240 Medical Equipment FMV
Sub-Saharan Africa Medical Supplies or Equipment 0   8,965 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   682,859 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   81,334 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   31,974 Medical Equipment FMV
North America (which includes Canada and Mexico, but not the U.S.) Medical Supplies or Equipment 0   33,143 Medical Equipment FMV
Sub-Saharan Africa Medical Supplies or Equipment 0   330,790 Medical Equipment FMV
East Asia and the Pacific Medical Supplies or Equipment 0   30,000 Medical Equipment FMV
Sub-Saharan Africa Medical Supplies or Equipment 0   50,000 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   11,684 Medical Equipment FMV
Central America and the Caribbean Medical Supplies or Equipment 0   133,610 Medical Equipment FMV
South Asia General Support 50,000 Cash Payment 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
27
3 Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022Page 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)
Scholarship (Dental School Tuition) Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 2 7,724 Cash Payment     Book
Stipend - Sharing Smiles (Cleft Palate) North America - Canada and Mexico, but not the United States 1 7,522 Cash Payment     Book
Scholarship (Oral Surgery Tuition) South America - Argentina, Bolivia, Brazil, Chile, Columbia, Ecuador, 3 6,066 Cash Payment     Book
Expense Reimbursement (ACP Program) South Asia - Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Paki 1 2,146 Cash Payment     Book
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
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) 2022
Schedule F (Form 990) 2022
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) 2022
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 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
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
Yes
 
%
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) . . .
    156,466,629   156,466,629 2.690 %
b Medicaid (from Worksheet 3, column a) . . . . .     852,937,463 443,238,250 409,699,213 7.050 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     1,009,404,092 443,238,250 566,165,842 9.740 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     42,892,850 0 42,892,850 0.740 %
f Health professions education (from Worksheet 5) . . .     45,325,531 10,443,767 34,881,764 0.600 %
g Subsidized health services (from Worksheet 6) . . . .     0 0    
h Research (from Worksheet 7) .     6,653,608 5,118,160 1,535,448 0.030 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     22,679,474   22,679,474 0.390 %
j Total. Other Benefits . .     117,551,463 15,561,927 101,989,536 1.760 %
k Total. Add lines 7d and 7j .     1,126,955,555 458,800,177 668,155,378 11.500 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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     40,525,016 13,006,213 27,518,803 0.470 %
8 Workforce development     0 0    
9 Other     40,295   40,295 0 %
10 Total     40,565,311 13,006,213 27,559,098 0.470 %
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
244,559,375
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
4,024,045
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
766,487,884
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
993,516,324
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-227,028,440
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 M&O Orlando MOB I LLC
 
Manage & lease medical office building 78.530 % 0 % 14.190 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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?3Name, 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 and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 AdventHealth Orlando & Campuses
601 E Rollins Street
Orlando,FL32803
www.adventhealth.com/hospital/adventhe
4369
X X X X   X X   Therapy Center, EPS Cath Lab, 4 Off-site EDs, Cancer Center A
2 AdventHealth Sebring & Lake Placid
4200 Sun N Lake Blvd
Sebring,FL33825
www.adventhealth.com/hospital/adventhe
4171
X X         X     A
3 AdventHealth Wauchula
735 S 5th Avenue
Wauchula,FL33873
www.adventhealth.com/hospital/adventhe
4239
X X     X   X   Skilled Nursing A
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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 22
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) 2022
Schedule H (Form 990) 2022
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) 2022
Schedule H (Form 990) 2022
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) 2022
Schedule H (Form 990) 2022
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) 2022
Schedule H (Form 990) 2022
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 & Campuses, - Facility 2: AdventHealth Sebring & Lake Placid, - Facility 3: AdventHealth Wauchula
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, Line 5: Facility Reporting Group - AAdventHealth Orlando & CampusesIn 2022, Adventist Health System/Sunbelt, Inc. owned and operated eight hospital campuses under a single hospital license in the greater Orlando, Florida area. The eight separate campuses operate under the following dba names: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden, and AdventHealth Winter Park (the Hospitals). These eight hospitals comprise the AdventHealth Central Florida Division South (CFD-South). The CFD-South conducted its 2022 Community Health Needs Assessment (CHNA) as a collaborative process with the Central Florida Collaborative (CFC), which included hospital systems, behavior health providers and federally qualified health centers (FQHCs) in Orange, Seminole, Lake and Osceola Counties (these four counties would be considered the Greater Orlando area), as well as the Florida Department of Health in Orange, Seminole, Lake, and Osceola Counties. The primary and secondary data collected by the CFC was utilized by the CFD-South Hospitals to prioritize the top health care needs that would be addressed in the 2022-2024 CHNA. To ensure that input was received from organizations representing low-income, minority, and other underserved populations, the CFC created a team of Equity Champions composed of ten individuals or organizations that represented multiracial or other minority communities. The Equity Champions included organizations and individuals from the Black/African American community and Hispanic/Latino/Spanish language speakers community, the LGBTQ+ community, and from members of the community of people living with disabilities (including HIV/AIDS), people experiencing homelessness, immigrants/migrant workers, faith-based communities, inmates, and members of the veteran community. Primary data gathering included Equity Champions Diversity Group Outreach, Stakeholder one-to-one interviews, and focus group discussions. The CFC conducted a broad-based community survey among residents of Orange, Seminole, Lake, and Osceola Counties. The surveys were conducted from December 29, 2021, to February 22, 2022 and were conducted online and in paper and offered in five languages, with approximately 4,000 community members. The survey instrument included topic areas that emerged from secondary data analysis, literature reviews of existing documents, initial qualitative research, and other early-stage research activities.One-to-one interviews were conducted with key community stakeholders, policymakers, and local residents. Interviews were conducted between October 29, 2021, and January 31, 2022. Most of the 105 interviews lasted approximately 20-30 minutes, although a few continued for over an hour. In addition to interviews and the survey, 30 focus group discussions were held from October of 2021 through February of 2022. In total there were approximately 250 participants and included the following community organizations: PCAN, Health and Hunger Task Force, Creating a Resilient Community Network, Black Nurses Rock, True Health FQHC, the Center for Independent Living, the Mayors Council for mental and behavioral health, the Seminole County Opioid Council, the Healthy Seminole Collaborative, and the Children's Cabinet.**see continuation of footnote
Part V, Section B, Line 5 Continuation of Footnote: Facility Reporting Group - AAdventHealth Sebring & Lake Placid:Adventist Health System/Sunbelt, Inc. owns and operates a 171-bed hospital located in Highlands County, Florida. The hospital does business under the name of AdventHealth Sebring (AH Sebring). The primary service area of AH Sebring includes six zip codes across Highlands, Hardee and a small piece of Polk Counties. Adventist Health System/Sunbelt, Inc. owns and operates a 33-bed hospital located in Highlands County, Florida. The hospital does business under the name of AdventHealth Lake Placid (AH Lake Placid). The primary service area of AH Lake Placid includes five zip codes across Highlands and Hardee Counties. In conducting its 2022 Community Health Needs Assessment (CHNA), AH Sebring & Lake Placid solicited input directly from the community and from individuals who represent the broad interests of the community, including medically underserved, low-income and minority community members. AH Sebring & Lake Placid conducted their 2022 CHNAs from July to November of 2022. AH Sebring & Lake Placid partnered with the Florida Department of Health in Highlands County and in Hardee County to complete the community health needs assessment. AH Sebring & Lake Placid, in collaboration with the Departments of Health in Highlands and Hardee Counties, collected input directly from the community and from community stakeholders through a community survey and focus groups. Community surveys were made available to anyone in the community and were provided in three languages and were accessible through weblinks and QR codes. Five focus groups were held with community stakeholders specifically representing Black/African Americans, Hispanic/Latinos, Older Adults, and Parents of Pediatric Children. AH Sebring & Lake Placid also formed a Community Health Needs Assessment Committee (CHNAC) that included representatives from organizations that serve low-income, low-access individuals and communities. The purpose of the CHNAC was to select the needs the Hospitals would address from the findings in the community health needs assessment. Key CHNAC members that represented low-income and underserved populations were from the following organizations: Central Florida Area Health Education Center, Central Florida Health Care, Champion for Children Foundation, Drug Free Hardee, the Department of Health in Hardee County, the Department of Health in Highlands County, Hardee Help Center, Healthy Families Highlands County, Healthy Start Coalition of Hardee, Highlands, and Polk County, Heartland Core Wellness, Heartland Regional Transportation Planning Organization, Heartland Rural Health Network, the Highlands County Board of County Commissioners, Highlands County Veteran Services Office, Nu-Hope Elder Care Services, Peace River Center, Redlands Christian Migrant Association, Samaritan's Touch Care Center, South Florida State College, the Ruth E. Handley Children's Advocacy Center, Tri-County Human Services, and the United Way of Central Florida. AdventHealth Wauchula:Adventist Health System/Sunbelt, Inc. owns and operates a 25-bed critical access hospital located in Hardee County, Florida. The hospital does business under the name of AdventHealth Wauchula (AH Wauchula). The primary service area of AH Wauchula includes three zip codes across mainly Hardee County and a small part of Polk County. In conducting its 2022 Community Health Needs Assessment (CHNA), AH Wauchula solicited input directly from the community and from individuals who represent the broad interests of the community, including medically underserved, low-income and minority community members. AH Wauchula conducted its 2022 CHNA from July to November of 2022. AH Wauchula partnered with the Florida Department of Health in Highlands County and in Hardee County to complete the community health needs assessment. AH Wauchula, in collaboration with the Departments of Health in Highlands and Hardee Counties, collected input directly from the community and from community stakeholders through a community survey and focus groups. Community surveys were made available to anyone in the community and were provided in three languages and were accessible through weblinks and QR codes. Five focus groups were held with community stakeholders specifically representing Black/African Americans, Hispanic/Latinos, Older Adults, and Parents of Pediatric Children. AH Wauchula also formed a Community Health Needs Assessment Committee (CHNAC) that included representatives from organizations that serve low-income, low-access individuals and communities. The purpose of the CHNAC was to select the needs the Hospital would address from the findings in the community health needs assessment. Key CHNAC members that represented low-income and underserved populations were from the following organizations: Central Florida Area Health Education Center, Central Florida Health Care, Champion for Children Foundation, Drug Free Hardee, the Department of Health in Hardee County, the Department of Health in Highlands County, Hardee Help Center, Healthy Families Highlands County, Healthy Start Coalition of Hardee, Highlands, and Polk County, Heartland Core Wellness, Heartland Regional Transportation Planning Organization, Heartland Rural Health Network, the Highlands County Board of County Commissioners, Highlands County Veteran Services Office, Nu-Hope Elder Care Services, Peace River Center, Redlands Christian Migrant Association, Samaritan's Touch Care Center, South Florida State College, the Ruth E. Handley Children's Advocacy Center, Tri-County Human Services, and the United Way of Central Florida.
Part V, Section B, Line 7a: Each hospital facility's CHNA report was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlando & Campuseshttps://www.adventhealth.com/community-health-needs-assessments Facility 2 -- AdventHealth Sebring & Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 3 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments
Part V, Section B, Line 7d: 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, Lines 8-10a: The filing organization's hospital facilities adopted a Community Health Needs Assessment Report by 12/31/2022 and were in the process of developing their Community Health Needs Implementation Strategy at that time. The filing organization's hospital facilities 2023-2025 Community Health Needs Implementation Strategies are documented in written reports called the "Community Health Plan". The Community Health Plan (CHP) describes how the filing organization's hospital facilities plan to meet their identified prioritized health needs or identifies the health need as one the filing organization's hospital facilities do not intend to specifically address and provides an explanation as to why the filing organization's hospital facilities do not intend to address that health need. The filing organization's hospital facilities 2023-2025 CHPs were adopted by May 15, 2023 and are posted on each hospital facility's website. Part V, Section B, Line 10a:Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlando & Campuseshttps://www.adventhealth.com/community-health-needs-assessments Facility 2 -- AdventHealth Sebring & Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 3 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments
Part V, Section B, Line 11: 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 Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden and AdventHealth Winter Park to unify as one under the Central Florida Division (the Division). This is the third-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 third-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.2022 Update: 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. 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. The tri-county region is defined as Orange, Osceola, and Seminole counties. This objective is 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, was met by 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 Food Bank 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. In 2022, the reporting Hospital contributed 17,773 pounds of food or 14,811 meals toward this program.The second strategy, to support the objective through financial support, was met by sustaining 18 partnerships with community organizations in the Division. In 2022, the reporting Hospital contributed $259,519 in financial support toward the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained four of these partnerships. Some of these partnerships included financially supporting grassroot efforts at four nonprofit organizations to provide food to those in need through their food pantries or community gardens. 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 outcomes reported for this strategy, which supports the objective, are specific to Orange County.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 met by serving on three boards. In 2022, the Central Florida Division of AdventHealth team members continued to serve on the boards 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 nonprofit organizations that provide education on nutrition and food-related conditions.The reporting Hospital continued to provide representation to serve on two boards within their primary service area. The first is on the board of 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 Heart of Florida United Way, 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. 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 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 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued In 2022, the Division sustained their partnership with two local nonprofit organizations, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc. was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the past three-years, continued to increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $44,504 towards the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2022, 454 new, unique participants were referred to the Fresh Stop Veggie Rx & Diabetes Prevention Program and 1,086 food boxes were given to enrolled participants for food distribution. Through the reporting Hospital'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. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and education to the community at large. In 2022, the reporting Hospital provided funding to Infinite Zion Farms of $4,684 towards the installation of greenhouses to increase the 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 2022, the Division continued to provide 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 can 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 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. 2022 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. 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 the provision of in-kind 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 managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $46,847 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 $46,847 was contributed to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also contributed $79,639 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. 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 and Grace Medical Home. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofit organizations. 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. However, in 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division continues 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. After reassessing the Division's capacity, it was determined that the initiative could not be met. However, we are working to identify new ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. 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.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 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 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 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued 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 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital contributed funding of $56,216 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient with a transportation barrier, regardless of insurance or economic status. In total, the Road to Recovery program provided 1,111 rides for cancer patients.In 2022, the reporting Hospital also contributed $27,784 towards the three-year funding partnership with AdventHealth University's Hope Clinic. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. This partnership provides cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. In 2022, the Hope Clinic enrolled 34 patients into the program.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. This objective is 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 managed at a Divisional level. In 2022, the Division continued to support 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 reporting Hospital contributed $40,357 toward the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division met this objective by providing case management services to 83 unique individuals over three years. Additionally, in 2022, 189 referrals to services were provided, 162 individuals have improved their biometrics, and 200 individuals have improved health behaviors through the program.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 the local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2022 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2022, the Division sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, True Health's Mental Health Expansion Program and Central Florida Community Arts' Community Music Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $164,792. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service 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 Community 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 also established a new partnership to increase provider capacity with True Health, a local Federally Qualified Health Center (FQHC), to support their Mental Health Expansion Program which provided funding for a full-time psychiatrist.Other initiatives to address this objective include providing in-kind support through board service. In 2022, the reporting Hospital served on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and IMPOWER. The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of Orlando and surrounding Central Florida community. 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.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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital provided $2,342 to Bliss Cares to provide mental health services to their target clients. Bliss Cares is a nonprofit organization that has a mission to save lives by treating and preventing the spread of HIV, Hepatitis, and sexually transmitted diseases (STDs).Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the community **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued Objective 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. 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 that were identified as hot spots in the AdventHealth Orlando primary service area each year. The outcomes reported for this strategy, which support the objective, are specific to Orange County. In 2022, this objective was exceeded by the Division, with 28 schools in the reporting Hospital's primary service area receiving the program. 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 support the objective, are specific to reporting AdventHealth Hospitals. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $11,711 toward ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the 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 reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital.In 2022, the reporting Hospital also contributed funding of $59,729 toward the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma.Priority 4: Community Development: Affordable Housing & Homelessness2019 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 chronic physical 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.2022 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. 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 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 reporting Hospital met this metric by providing financial support of $58,556 to five organizations in the Hospital's primary service area. Samaritan Resource Center received $44,504 to increase access to mental health resources and job skills training which aims to increase positive outcomes and decrease recidivism in the cycle of homelessness. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing and diversion, received $2,342. Dave's House received $4,684 to further provide supportive housing for individuals with serious mental illness. Habitat for Humanity received $2,342 to support a special project that served individuals dealing with homelessness. United Against Poverty received $4,684 to serve those in poverty by providing crisis care, case management, transformative education, food and household subsidies, employment training and placement, personal empowerment training and active referrals to other collaborative social service providers.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 met this metric with in-kind services, including service on two boards. Boards served on include the Christian Service Center and The Sharing Center. Both organizations work to address the immediate and/or long-term needs of those experiencing homelessness.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:Community Resources Group: Although there are 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 1 -- AdventHealth CelebrationDescription of CHNA Significant Needs 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. Central Florida Division South Region (the Division) includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden and AdventHealth Winter Park. The Central Florida Division includes 14 hospitals. This is the third-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 third-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.2022 Update: 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. 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. The tri-county region is defined as Orange, Osceola, and Seminole counties. This objective is 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, was met by 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. In 2022, the reporting Hospital was unable to contribute towards this program due to staffing changes impacted by the COVID-19 pandemic. The second strategy, to support the objective through financial support, was met by sustaining 18 partnerships with community organizations in the Division. In 2022, the reporting Hospital contributed $34,271 in financial support towards the three-year goal of $455,000. Four of these partnerships were sustained by the Division on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained one of these partnerships. Financial support was provided to Celebration Foundation, an organization that leads the local Learning without Hunger program, which provides food to children living in Osceola County on the weekends. The outcomes reported for this strategy, which supports the objective, are specific to Osceola County.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 met by serving on three boards. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2022, the Central Florida Division of AdventHealth team members continued to serve on the boards 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 nonprofit organizations that provide education on nutrition and food-related conditions.The reporting Hospital continued to provide representation by serving on one board, the Celebration Foundation, within their primary service area. The Celebration Foundation is a local organization whose mission is to build better community through the arts, culture, and education.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. 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 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 1 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued In 2022, the Division met this objective by sustaining 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 past three-years, continued to increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $12,195 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2022, 454 new, unique participants were referred to the Fresh Stop Veggie Rx & Diabetes Prevention Program and 1,086 food boxes were given to enrolled participants for food distribution. In 2022, the reporting Hospital also sustained its partnership with the School District of Osceola County (SDOC)'s 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.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 2022, the Division continued to provide representation on behalf of the Hospital by participating in the Osceola County 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 can 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 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 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.2022 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. 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 the provision of in-kind 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 managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for a local Federally Qualified Health Center (FQHC). A $12,837 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. The reporting Hospital also provided $3,851 in financial contributions to Osceola Council on Aging to support clinical operations and $3,209 to Osceola Community Health Services, a local FQHC focused on meeting an individual's physical and mental health care needs through prevention, wellness, acute and chronic care, for operational support to increase the availability of affordable care.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 and Osceola Council on Aging. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofit organizations.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. However, in 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division continues 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. After reassessing the Division's capacity, it was determined that the initiative could not be met. However, we are working to identify new ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans 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.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 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital contributed $15,404 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient with a transportation barrier, regardless of insurance or economic status. In total, the Road to Recovery program provided 1,111 rides for cancer patients. In 2022, the reporting Hospital also contributed $7,476 towards the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides 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. In 2022, the Hope Clinic enrolled 34 patients into the program. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- 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 of 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. 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. This objective is 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 managed at a Divisional level. In 2022, the Division continued to support 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 reporting Hospital contributed $11,058 toward the Holistic Health program which focused its efforts in high-need communities identified in the CHNA. The Division met this objective by providing case management services to 83 unique individuals over three years. Additionally, in 2022, 189 referrals to services were provided, 162 individuals have improved their biometrics and 200 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there are enough 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 were 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.2022 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2022, the Division sustained partnerships with two partners to implement programs that serve the tri-county community: True Health's Mental Health Expansion Program and Central Florida Community Arts' Community Music Therapy Program. In 2022, the reporting Hospital did not meet its set metric of providing financial support to at least three partners. However, with the funding provided, True Health and Central Florida Community Arts were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. The Division 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 also established a new partnership with True Health, a local Federally Qualified Health Center (FQHC), to increase provider capacity and support their Mental Health Expansion Program which provided funding for a full-time psychiatrist. Other initiatives to address this objective include providing in-kind support through board service. In 2022, a Hospital representative served on the board of Freedom Ride, a local nonprofit dedicated to enriching the lives and experiences of children and adults with disabilities in the Central Florida area through therapeutic horseback riding and related activities.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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2022, the reporting Hospital met this objective and provided $32,092 to Park Place Behavioral Health Care for operational support. Park Place Behavioral Health Care is an organization that provides therapeutic, psychiatric and substance use disorder services in Central Florida. 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. 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 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 that were identified as hot spots in AdventHealth Celebration's primary service area each year. This objective was exceeded by the Division, with nine schools in the reporting Hospital's primary service area receiving the program. The outcomes reported for this strategy, which support 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. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued 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. The strategy was not conducted due to leadership changes.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 significant 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.2022 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. 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 managed at the Divisional level; however, all outcomes are specific to Hospitals in Osceola County.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. In 2022, the reporting Hospital met this metric by providing financial support to two organizations in the reporting Hospital's primary service area. Clarita's House received funding to support their emergency housing service for families in crisis and Habitat for Humanity received funding to support a special project that served individuals dealing with homelessness. 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. In 2022, the reporting Hospital partnered with the local Habitat for Humanity and team members volunteered, assisting with building homes for the surrounding community. 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. 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 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 reporting Hospital met this metric by providing financial support 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, to provide in-kind support to community partners to enhance their capacity to provide care, could not be met due to staffing shortages within the Hospital.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 significant 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 1 -- AdventHealth Altamonte SpringsDescription of CHNA Significant Needs Adventist 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. Central Florida Division South Region (the Division) includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden and AdventHealth Winter Park. The Central Florida Division includes 14 hospitals. This is the third-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 third-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 & Mentorship Priority 1: Food Security 2019 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.2022 Update: 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. 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 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, was met by 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. In 2022, the reporting Hospital was unable to contribute towards this program due to staffing changes impacted by the COVID-19 pandemic. The second strategy, to support the objective through financial support, was met by sustaining 18 partnerships with community organizations in the Division. In 2022, the reporting Hospital contributed $53,011 in financial support toward the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County, and Seminole County. The reporting Hospital sustained three of these partnerships. For the reporting Hospital, one of these partnerships included financially supporting a grassroot effort at one local church, Mars Hill, 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 and Harvest Time International which supports a family food voucher program. The outcomes reported for this strategy, which support the objective, are specific to Seminole County.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 met 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 2022, the Central Florida Division of AdventHealth team members continued to serve on boards 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 nonprofit organizations that provide education on nutrition and food-related conditions.The reporting Hospital continued to provide representation by serving on the board of Meals on Wheels of Seminole County, within their primary service area. Meals on Wheels of Seminole County is a local nonprofit that provides meals and assistance for vulnerable seniors living in Seminole County.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. 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 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 1 -- AdventHealth Altamonte SpringsDescription of CHNA Significant Needs Continued In 2022, the Division sustained 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 past three years, continued to increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultant's services include nutrition education and a mobile market. The reporting Hospital provided $10,901 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2022, 454 new, unique participants were referred to the Fresh Stop Veggie Rx & Diabetes Prevention Program and 1,086 food boxes were given to enrolled participants for food distribution. 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 2022, the Division continued to provide representation on behalf of the Hospital by participating 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 can 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 healthcare 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. 2022 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. 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 the provision of in-kind 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 managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support to two local Federally Qualified Health Centers (FQHCs). An $11,475 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 $11,475 was provided to True Health, which delivers medical and mental health services to underserved populations. The reporting Hospital contributed $19,507 to Shepherd's Hope which supported 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. The reporting Hospital also contributed to IDignity Seminole County which assists individuals in obtaining birth certificates, Social Security cards and other documentation needed to obtain a FL ID or license. 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 and Grace Medical Home. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofit organizations.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. However, in 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division continues 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. After reassessing the Division's capacity, it was determined that the initiative could not be met. However, we are working to identify new ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. 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: 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 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 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital contributed funding of $13,770 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient with a transportation barrier, regardless of insurance or economic status. In total, the Road to Recovery program provided 1,111 rides for cancer patients. In 2022, the reporting Hospital contributed $6,683 toward the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provided 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. In 2022, the Hope Clinic enrolled 34 patients into the program. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth Altamonte SpringsDescription of CHNA Significant Needs Continued The reporting Hospital achieved this objective and continues to identify organizations to expand 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. This objective is 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 managed at a Divisional level. In 2022, the Division continued to support 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 reporting Hospital contributed $5,495 toward the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division met this objective by providing case management services to 83 unique individuals over three years. Additionally, in 2022, 189 referrals to services were provided, 162 individuals have improved their biometrics and 200 individuals have improved health behaviors through the program. 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 enough 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. 2022 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. 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 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. In 2022, the Division sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, True Health's Mental Health Expansion Program and Central Florida Community Arts' Community Music Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $351,767. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's primary service 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 Community 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 also established a new partnership to increase provider capacity with True Health, a local Federally Qualified Health Center (FQHC), to support their Mental Health Expansion Program which provided funding for a full-time psychiatrist. Other initiatives to address this objective include providing in-kind support through board service. The reporting Hospital provided representation to serve on the board of True Health within their primary service area. True Health is a local federally qualified health center that serves low-income, uninsured, underinsured, and underserved populations 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 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital provided financial support to National Alliance on Mental Illness (NAMI) Greater Orlando to provide operational support to increase the existing capacity to expand health services for individuals impacted by mental health. NAMI Greater Orlando is dedicated to improving lives of millions of Americans affected by mental illness.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. 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 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 1 -- AdventHealth Altamonte SpringsDescription of CHNA Significant Needs Continued The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools that were identified as hot spots in the AdventHealth Altamonte Springs' primary service area each year. The outcomes reported for this strategy, which supports the objective, are specific to Seminole County. The Division met this objective by providing the program to one school in the reporting Hospital's primary service area. 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 support the objective, are specific to the reporting Hospital. In 2022, the reporting Hospital contributed funding of $14,630 toward the No Limit Counseling and Education's program, No Limit Unit. No Limit Counseling and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. 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. 2022 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. 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 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 2022, the reporting Hospital provided financial support to Boys Town Central Florida. Boys Town Central Florida is focused on changing the way America cares for children and families by providing an array of life-changing youth care and health care services for each child and family. 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. In 2022, the reporting Hospital served on the board of Kids House of Seminole, Inc., a local nonprofit whose mission is to prevent child abuse and to aid child abuse victims and families by providing coordinated services in a safe, child-friendly environment. The third strategy is to establish new partnerships to serve youth in the community. The Division met 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 adults in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. The Division continued to partner with No Limit Health and Education and, in 2022, 126 youth completed Flow Detox, increasing their understanding of personal triggers and how to process anger and hostile emotions. Community 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 the Hospital would have greater impact.
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth East OrlandoDescription of CHNA Significant Needs Adventist 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. Central Florida Division South Region (the Division) includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden and AdventHealth Winter Park. The Central Florida Division includes 14 hospitals. This is the third-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 third-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.2022 Update: 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. 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 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, was met by 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. In 2022, the reporting Hospital was unable to contribute towards this program due to staffing changes impacted by the COVID-19 pandemic. The second strategy, to support the objective through financial support, was met by sustaining 18 partnerships with community organizations in the Division. In 2022, the reporting Hospital contributed $49,309 in financial support towards the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained four of these partnerships. Some of these partnerships included financially supporting grassroots efforts at four nonprofit organizations to provide food to those in need through their food pantries or community gardens. 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 outcomes reported for this strategy, which support the objective, are specific to Orange County.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 met by serving on three boards. In 2022, the Central Florida Division of AdventHealth team members continued to serve on the boards 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 nonprofit organizations 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the Division sustained their partnership with two local nonprofit organizations, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc. was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the past three-years, continued to increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $8,455 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2022, 454 new, unique participants were referred to the Fresh Stop Veggie Rx & Diabetes Prevention Program and 1,086 food boxes were given to enrolled participants for food distribution. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth East OrlandoDescription of CHNA Significant Needs Continued In 2022, the reporting Hospital also provided funding to Infinite Zion Farms towards the installation of tower gardens to increase the fresh produce in Orange County, the county of the reporting Hospital. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and education to the community at large.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 2022, the Division continued to provide 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 can 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 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. 2022 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. 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 the 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 managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). An $8,901 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 $8,901 was provided to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also provided $15,131 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. 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 and Grace Medical Home. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofit organizations.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. However, in 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division continues 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. After reassessing the Division's capacity, it was determined that the initiative could not be met. However, we are working to identify new ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of the 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.The 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 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital contributed funding of $10,681 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient with a transportation barrier, regardless of insurance or economic status. In total, the Road to Recovery program provided 1,111 rides for cancer patients. In 2022 the reporting Hospital also contributed $5,184 in year three towards the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides 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. In 2022, the Hope Clinic enrolled 34 patients into the program.Goal 2: Decrease barriers community members encounter while seeking care **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth East OrlandoDescription of CHNA Significant Needs Continued Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of the 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. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The 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 managed at a Divisional level. In 2022, the Division continued to support 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 reporting Hospital contributed $7,667 toward the program which focuses its efforts in high-need communities identified in the CHNA. The Division met this objective by providing case management services to 83 unique individuals over three years. Additionally, in 2022, 189 referrals to services were provided, 162 individuals have improved their biometrics and 200 individuals have improved health behaviors through the program. 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 are 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.2022 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2022, the Division sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, True Health's Mental Health Expansion Program and Central Florida Center for the Arts' Community Music Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $31,310. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service 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 also established a new partnership to increase provider capacity with True Health, a local Federally Qualified Health Center (FQHC), to support their Mental Health Expansion Program which provided funding for a full-time psychiatrist. Other initiatives to address this objective include providing in-kind support through board service. In 2022, the reporting Hospital served on the board of Harbor House which focuses on providing critical life-saving services to survivors, implementing and advancing best practices, and educating and engaging the community in a united front.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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2022, the reporting Hospital provided funding to Bliss Cares to provide mental health services to their target clients. Bliss Cares is a nonprofit organization that has a mission to save lives by treating and preventing the spread of HIV, Hepatitis, and sexually transmitted diseases (STDs). The reporting Hospital also contributed $2,670 to support the Mental Health Association's East Orlando Choices Clinic to help individuals dealing with mental health illness in the reporting Hospital's primary service area.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. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth East 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 Hospitals in Orange County. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth East OrlandoDescription of CHNA Significant Needs Continued The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools that were identified as hot spots in the AdventHealth East Orlando primary service area each year. The outcomes reported for this strategy, which support the objective, are specific to Orange County. This objective was exceeded by the Division, with 28 schools in the reporting Hospital's primary service area receiving the program. 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 support the objective, are specific to the reporting Hospital. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $2,225 toward ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the 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 reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital. In 2022, the reporting Hospital also contributed funding of $11,348 towards the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. Priority 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 can more easily address health concerns. As an anchor organization in our community, the AdventHealth Central Florida Division can implement job training and education programs for communities in need.2022 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 managed by the Division, but all outcomes are specific to the reporting Hospital. The reporting Hospital met this metric by contributing $8,455 to Samaritan Resource Center, a local nonprofit that provides job skills training and support to persons living in homelessness 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 1 -- AdventHealth Winter ParkDescription of CHNA Significant Needs 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. Central Florida Division South Region (the Division) includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden and AdventHealth Winter Park. The Central Florida Division includes 14 hospitals. This is the third-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 third-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.2022 Update: 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. 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 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, was met by 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. In 2022, the reporting Hospital was unable to contribute towards this program due to staffing changes impacted by the COVID-19 pandemic. The second strategy, to support the objective through financial support, was met by sustaining 18 partnerships with community organizations in the Division. In 2022, the reporting Hospital contributed $41,331 in financial support in year three toward the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained four of these partnerships. Some of these partnerships included financially supporting grassroots efforts at four nonprofit organizations to provide food to those in need through their food pantries or community gardens. 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 outcomes reported for this strategy, which support the objective, are specific to Orange County.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 met by serving on three boards. In 2022, the Central Florida Division of AdventHealth team members continued to serve 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 nonprofit organizations 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the Division sustained their partnership with two local nonprofit organizations, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc. was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the past three-years, continued to increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $7,080 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2022, 454 new, unique participants were referred to the Fresh Stop Veggie Rx & Diabetes Prevention Program and 1,086 food boxes were given to enrolled participants for food distribution. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued Through the reporting Hospital'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. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and education to the community at large. In 2022, the reporting Hospital provided additional funding to Infinite Zion Farms toward the installation of greenhouses to increase the 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 2022, the Division continued to provide 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 can 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 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 healthcare 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. 2022 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. 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 the provision of in-kind 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 managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $7,461 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 $9,326 was provided to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also provided $12,683 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. 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 and Grace Medical Home. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofit organizations.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. However, in 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division continues 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. After reassessing the Division's capacity, it was determined that the initiative could not be met. However, we are working to identify new ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. 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.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 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital contributed funding of $8,953 to the American Cancer Society's Road to Recovery program. This program provides rides to and from cancer treatment for any cancer patient with a transportation barrier, regardless of insurance or economic status. In total, the Road to Recovery program provided 1,111 rides for cancer patients. The reporting Hospital achieved this objective and continues to identify organizations to expand 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 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. This objective is 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 1 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued The 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 managed at a Divisional level. In 2022, the Division continued to support 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 reporting Hospital contributed $6,427 toward the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division met this objective by providing case management services to 83 unique individuals over three years. Additionally, in 2022, 189 referrals to services were provided, 162 individuals have improved their biometrics and 200 individuals have improved health behaviors through the program. In 2022, the reporting Hospital also contributed $4,345 toward the three-year funding partnership with AdventHealth University's Hope Clinic. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. This partnership provided cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. In 2022, the Hope Clinic enrolled 34 patients into the program.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 local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2022 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2022, the Division sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, True Health's Mental Health Expansion Program and Central Florida Community Arts' Community Music Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $26,245. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service 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 Community 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 also established a new partnership to increase provider capacity with True Health, a local Federally Qualified Health Center (FQHC), to support their Mental Health Expansion Program which provided funding for a full-time psychiatrist. 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. The 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2022, the reporting Hospital provided funding to New Hope for Kids for their grief counseling program. New Hope for Kids is a nonprofit organization that helps children and their families during some of life's most difficult challenges. 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. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Winter Park 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 that were identified as hot spots in the AdventHealth Winter Park primary service area each year. The outcomes reported for this strategy, which support the objective, are specific to Orange County. In 2022, this objective was exceeded by the Division, with 28 schools in the reporting Hospital's primary service area receiving the program. 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 Winter ParkDescription of CHNA Significant Needs Continued 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 support the objective, are specific to the reporting Hospital. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $1,865 toward ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the 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 reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital. In 2022, the reporting Hospital also contributed funding of $9,512 towards the No Limit Health and Education's program, No Limit Unit. No Limit Health and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. Priority 4: Community Development: Senior Vulnerability 2019 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. 2022 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 managed by the Division, but all outcomes are specific to the reporting Hospital. The reporting Hospital met this objective by providing funding to Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors. A representative from the reporting Hospital also serves as a board member to Seniors First.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 managed by the Division, but all outcomes are specific to the reporting Hospital.The Division met this objective by funding a position, Senior Care Navigator, at the reporting Hospital's Emergency Department (ED) to help address the unique needs of seniors. In 2022, the Division continued to work on identifying a funding source to continue educating and supporting caregivers in the community. 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 1 -- AdventHealth KissimmeeDescription of CHNA Significant Needs Adventist 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. Central Florida Division South Region (the Division) includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden and AdventHealth Winter Park. The Central Florida Division includes 14 hospitals. This is the third-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 third-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.2022 Update: 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. 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 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, was met by 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. In 2022, the reporting Hospital was unable to contribute towards this program due to staffing changes impacted by the COVID-19 pandemic.The second strategy, to support the objective through financial support, was met by sustaining 18 partnerships with community organizations in the Division. In 2022, the reporting Hospital contributed $15,858 in financial support toward the three-year goal of $455,000. Four of these partnerships were sustained by the Division on a tri-county level, including Orange County, Osceola County and Seminole County. The reporting Hospital sustained one of these partnerships. Financial support was provided to Osceola Council on Aging, 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 met by serving on three boards. In 2022, the Central Florida Division of AdventHealth team members continued to serve on the boards 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 nonprofit organizations that provide education on nutrition and food-related conditions.The reporting Hospital continued to provide representation by serving on the board of the Osceola Council on Aging, within their primary service area. 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the Division met this objective by sustaining 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 past three-years, continued to increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $7,087 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2022, 454 new, unique participants were referred to the Fresh Stop Veggie Rx & Diabetes Prevention Program and 1,086 food boxes were given to enrolled participants for food distribution. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedIn 2022, the reporting Hospital also sustained its partnership with the School District of Osceola County (SDOC)'s 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.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.The 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 2022, the Division continued to provide representation on behalf of the Hospital by participating 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.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.2022 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. 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 the provision of in-kind 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 managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for a local Federally Qualified Health Center (FQHC). A $5,940 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. The reporting Hospital also provided $1,782 in financial contributions to Osceola Council on Aging to support clinical operations and $1,485 to Osceola Community Health Services, a local FQHC focused on meeting an individual's physical and mental health care needs through prevention, wellness, acute and chronic care.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 nonprofit organizations.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. However, in 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division continues 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. After reassessing the Division's capacity, it was determined that the initiative could not be met. However, we are working to identify new ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County and Seminole County to include 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.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 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital contributed $7,128 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient with a transportation barrier, regardless of insurance or economic status. In total, the Road to Recovery program provided 1,111 rides for cancer patients. In 2022, the reporting Hospital also contributed $3,459 toward the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides 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, allowing increased access to care regardless of financial circumstance. In 2022, the Hope Clinic enrolled 34 patients into the program.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 to include 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. This objective is 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 managed at a Divisional level. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedIn 2022, the Division continued to support 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 reporting Hospital contributed $5,117 toward the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division met this objective by providing case management services to 83 unique individuals over three years. Additionally, in 2022, 189 referrals to services were provided, 162 individuals have improved their biometrics and 200 individuals have improved health behaviors through the program. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there are 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. 2022 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2022, the Division sustained partnerships with two partners to implement programs that serve the tri-county community: True Health's Mental Health Expansion Program and Central Florida Community Arts' Community Music Therapy Program. In 2022, the reporting Hospital did not meet its set metric of providing financial support to at least three partners. However, with $12,374 in contributions made, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service area. The Division supports the Central Florida Community 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 also established a new partnership with True Health, a local Federally Qualified Health Center (FQHC), to increase provider capacity and support their Mental Health Expansion Program which provided funding for a full-time psychiatrist. Other initiatives to address this objective include providing in-kind support through board service. Due to the aftermath of the COVID-19 pandemic, the initiative was delayed. As a result of the continued pandemic, AdventHealth has pivoted where necessary to address the immediate needs of our community. 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. The 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2022, the reporting Hospital provided $14,850 to Park Place Behavioral Health Care for operational support. Park Place Behavioral Health Care is an organization that provides therapeutic, psychiatric and substance use disorder services in Central Florida. 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. 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 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 Osceola County.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools that were identified as hot spots in the AdventHealth Kissimmee primary service area each year. This objective was exceeded by the Division, with nine schools in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which support 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 training 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. The strategy was not conducted due to leadership changes within the organization.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. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth KissimmeeDescription of CHNA Significant Needs Continued 2022 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. 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 for care for our homeless population. This objective is managed at the Divisional level; however, all outcomes are specific to Hospitals in Osceola County.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. In 2022, the reporting Hospital met this metric by providing financial support to two organizations in the reporting Hospital's primary service area. Clarita's House received funding to support their emergency housing service for families in crisis and Habitat for Humanity received funding to support a special project that served individuals dealing with homelessness. 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. In 2022, the reporting Hospital partnered with the local Habitat for Humanity and team members volunteered with building homes for the surrounding community. 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. 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 for care for our homeless population. This objective is 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 reporting Hospital met this metric by providing financial support 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, to provide in-kind support to community partners to enhance their capacity to provide care, could not be met due to staffing shortages within the Hospital.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 1 -- AdventHealth ApopkaDescription of CHNA Significant Needs Adventist 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. Central Florida Division South Region (the Division) includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden and AdventHealth Winter Park. The Central Florida Division includes 14 hospitals. This is the third-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 from 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 third-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 & Mentorship Priority 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.2022 Update: 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. 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 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, was met by 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. In 2022, the reporting Hospital was unable to contribute towards this program due to staffing changes impacted by the COVID-19 pandemic. The second strategy, to support the objective through financial support, was met by sustaining 18 partnerships with community organizations in the Division. In 2022, the reporting Hospital contributed $25,994 in financial support toward the three-year goal of $455,000. Four of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County, and Seminole County. The reporting Hospital sustained one of these partnerships. Some of these partnerships included financially supporting grassroots efforts at four nonprofit organizations to provide food to those in need through their food pantries or community gardens. 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 outcomes reported for this strategy, which support the objective, are specific to Orange County.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 met 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 2022, the Central Florida Division of AdventHealth team members continued to serve on boards 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 nonprofit organizations 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. 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 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 1 -- AdventHealth ApopkaDescription of CHNA Significant Needs Continued In 2022, the Division sustained their partnership with two local nonprofit organizations, HEBNI Nutrition Consultants, Inc., and Infinite Zion Farms. HEBNI Nutrition Consultants, Inc. was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the past three-years, continued to increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The reporting Hospital provided $6,060 toward the mobile market which offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2022, 454 new, unique participants were referred to the Fresh Stop Veggie Rx & Diabetes Prevention Program and 1,086 food boxes were given to enrolled participants for food distribution. Through the reporting Hospital'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. Infinite Zion Farms is a local nonprofit that is working to establish affordable sources of organic produce and provide education to the community at large. In 2022, the reporting Hospital contributed funding to Infinite Zion Farms toward the installation of greenhouses to increase the 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 2022, the Division continued to provide 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 can 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 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. 2022 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 of Hospitals 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. 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 the provision of in-kind 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 managed at a Divisional level. The reporting Hospital's funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $6,379 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 $6,379 was provided to True Health, which delivers medical and mental health services to underserved populations.The reporting Hospital also provided $10,844 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. 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 and Grace Medical Home. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofit organizations.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. However, in 2021, for a multitude of reasons, including COVID-19, the program was discontinued. The Division continues 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. After reassessing the Division's capacity, it was determined that the initiative could not be met. However, we are working to identify new ways to support the needs originally identified in our CHNAs, as resources and public health recommendations develop. 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: 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.The 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 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2022, the reporting Hospital contributed funding of $7,654 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient with a transportation barrier, regardless of insurance or economic status. In total, the Road to Recovery program provided 1,111 rides for cancer patients. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedIn 2022, the reporting Hospital contributed $3,715 toward the three-year funding partnership with AdventHealth University's Hope Clinic. This partnership provides 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, allowing increased access to care regardless of financial circumstance. In 2022, the Hope Clinic enrolled 34 patients into the program.The reporting Hospital achieved this objective and continues 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 to include 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. This objective is managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. The 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 managed at a Divisional level.In 2022, the Division continued to support 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 reporting Hospital contributed $5,495 toward the Holistic Health program which focuses its efforts in high-need communities identified in the CHNA. The Division met this objective by providing case management services to 83 unique individuals over three years. Additionally, in 2022, 189 referrals to services were provided, 162 individuals have improved their biometrics and 200 individuals have improved health behaviors through the program. 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.2022 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. 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. This initiative provides an opportunity for the reporting Hospital to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. In 2022, the Division sustained partnerships with three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, True Health's Mental Health Expansion Program and Central Florida Center for the Arts' Community Music Therapy Program. The reporting Hospital met its set metric of providing financial support to at least three partners by funding these organizations for a total of $22,439. With the funding, they were able to provide programs that serve the underinsured and uninsured individuals in the reporting Hospital's service 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 also established a new partnership to increase provider capacity with True Health, a local Federally Qualified Health Center (FQHC), to support their Mental Health Expansion Program which provided funding for a full-time psychiatrist. Other initiatives to address this objective include providing in-kind support through board service. In 2022, the reporting Hospital served on the board of Dave's House which focuses on providing permanent supportive housing for individuals with serious mental illness (SMI) and co-occurring disabilities.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. The 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 managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2022, the reporting Hospital contributed funding to National Alliance on Mental Illness (NAMI) Greater Orlando to provide operational support to increase the existing capacity to expand health services for individuals impacted by mental health. NAMI Greater Orlando is dedicated to improving lives of millions of Americans affected by mental illness.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the community **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 1 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedObjective 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. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Apopka 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 training 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 that were identified as hot spots in the AdventHealth Apopka primary service area each year. Outcomes reported for this strategy, which support the objective, are specific to Orange County. In 2022, this objective was exceeded by the Division, with 28 schools in the reporting Hospital's primary service area receiving the program. 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 support the objective, are specific to the reporting Hospital. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). The reporting Hospital contributed $1,594 toward ELCOC's Circle of Security program. ELCOC is dedicated to the success of early childhood development in the 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 reporting Hospital was able to meet this objective in Orange County, the county of the reporting Hospital.In 2022, the reporting Hospital also contributed funding of $8,133 toward the No Limit Counseling and Education's program, No Limit Unit. No Limit Counseling and Education is a local nonprofit whose mission is to promote mental health (social, emotional, and psychological) wellness and awareness through advocacy, programs, services, and outreach. Through this partnership, No Limit Unit provides services to adults and youth for both individual empowerment and systemic change in the areas of mental and physical wellness. Barbershop Talk Tours, Thriving Moms Club and Flow Detox reach men, women and children through mental health education, support groups and reduction of stigma. 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. 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. 2022 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. 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 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 2022, the reporting Hospital provided financial support to Boys and Girls Central Florida, which is a nonprofit that works to inspire and enable all young people, especially those from disadvantaged circumstances, to realize their full potential as productive, responsible, and caring citizens.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. In 2022, AdventHealth's Volunteer Services department established a partnership with the Boys and Girls Club of Central Florida to provide a mentorship program between AdventHealth team members and participating youth. The third strategy is to establish new partnerships to serve youth in the community. The Division met 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 adults in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. The Division continued to partner with No Limit Health and Education and, in 2022, 126 youth completed Flow Detox, increasing their understanding of personal triggers and how to process anger and hostile emotions. 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 the Hospital would have greater impact.
Part V, Section B, Line 11 Footnote: Group A-Facility 2 -- AdventHealth Sebring & 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 13 hospital facilities. This is the third-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 third-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 selfreport 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.2022 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 2022. 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 destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of the 2020-2022 Community Health Plans: the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. The Hospitals 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 the Hospitals' Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for the Hospitals' social media campaigns moving forward, which will be depression and anxiety. The Hospitals did not meet the set metric. Although the Hospital did not meet the metric as written, AdventHealth did sponsor an enterprise-wide social media campaign across all markets to raise awareness about mental health. 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 2022. 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 Hospitals exceeded the set metric of providing three free Mental Health First Aid USA certification training classes to community members by offering four classes. A total of 44 participants were trained through this initiative.Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adults **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 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 2022. 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 costs associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, a community partner. This monetary assistance will help 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 met the set metric. In 2022, the Hospitals donated $2,760 collectively to the Peace River Center which equated to covering the cost of household supplies for 69 people at $40 per person. 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 2022. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides information about the 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, the Hospitals' 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 the Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from the Hospitals' free community programs. By sharing these programs with counselors, they can then share this information with their clients. The Hospitals did not meet the set metric. Year two was spent getting the Hospitals' programs back up and running in the community after setbacks due to COVID-19. In 2022, the Hospitals' focus was on the implementation of these programs across the Division. Leaders from PRC were informed of these programs through meetings, emails, and phone calls. Formal in-service presentations were not conducted, as the other methods used to deliver this information were deemed to be sufficient. 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 2022. 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. The Hospitals did not meet the set metric. Due to restrictions in place during the COVID-19 pandemic, such as requiring staff members to stay within the Hospital during their normal working hours, and the subsequent shortage of internal staff members across the healthcare industry, the Hospitals did not have the capacity to meet the 300 hours of volunteer time. Despite the pandemic restrictions, team members found ways to give back, for example, by volunteering to write letters of encouragement to individuals struggling with a mental health challenge. As the pandemic subsided, the West Florida Division (of which the Hospitals are a part of) created a volunteer portal to market volunteer opportunities to team members, track volunteer hours by team members, and notify community partners when team members sign up for events across the Division. 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%.2022 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 2022. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between the Hospitals and community organizations who also share a goal of reducing transportation challenges within the community. This collaboration fostered an exchange of ideas, resources, and programs. The Hospitals also evaluated what additional resources were available, or may become available, to community members with transportation challenges.The Hospitals did not meet its set metric. Due to restrictions in place during the COVID-19 pandemic, we could not host the in-person community summits we had originally planned during years one or two. In 2022, we hosted one virtual community summit with the Heartland Regional Transportation Planning Organization (HRTPO) who delivered an informative presentation about the various transportation programs available to the community. During the virtual summit, HRTPO was able to share, hear from, and collaborate with other community organizations and leaders to help spread the word and enroll participants in need. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedThe 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 Heartland Regional Transportation Planning Organization'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.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 2022. 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 met the set metric. The Heartland Regional Transportation Planning Organization already had a transportation taskforce in place that consisted of local community leaders and representatives for the underserved community. In lieu of creating a separate taskforce, we decided it was a better use of resources to have an AdventHealth team member join the one that was already established and led by the leader in transportation programming for the Hospitals' PSA. Through this partnership, AdventHealth co-hosted one virtual community summit in 2022. 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 2022. 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 did not meet its set metric. During the three-year plan, Food is Health classes were scheduled in partnership with the University of Florida/Institute of Food & Agricultural Sciences (UF/IFAS) Extension, but the classes did not meet the minimum number of required attendees (10) and were therefore cancelled. In 2022 attempts were made to enroll participants into classes through marketing efforts such as flyers distributed throughout the community, email blasts, promotion through partner organizations, and other online marketing efforts. However, attempts to reach the minimum number of participants needed to hold a class were unsuccessful. 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 2022. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Hospital did not meet its set metric. During the three-year plan, classes were scheduled but unfortunately did not meet the minimum registration number, therefore, the classes were cancelled. Additionally, in 2022, a new produce vendor, Burgin Farms, was onboarded to replace the previous vendor. Burgin Farms was able to service the PSA in Wauchula for a class series but shortly thereafter closed for the rest of the season and was not able to support classes in the Sebring PSA. In the future, Burgin Farms will expand their services into this region and will be the primary produce vendor for Sebring classes moving forward. 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 2022. 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 Hospital met its set metric. By the end of 2022, partnerships were built and maintained with UF/IFAS Extension, Central Florida Area Health Education Center, Senior Connection Center, Feeding Tampa Bay, Burgin Farms, and the local Department of Health. During 2022, Burgin Farms was onboarded as a new produce vendor for the Wauchula market with the intention to expand to the Sebring and Lake Placid markets in the future. Additionally, the local Department of Health offered the use of their space for future classes. With the addition of new partners and resources, the Hospitals will continue to schedule new class series and identify ways to attract community members to sign up. 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 2022. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Hospital did not meet its set metric. During the three-year plan, classes were scheduled but unfortunately did not meet the minimum registration number, therefore, the classes were cancelled. However, attempts were made to recruit participants through flyers, email blasts, and other online marketing efforts. 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 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 2022. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Hospital did not meet its set metric. Due to issues such as COVID-19 requiring staff members to stay within the Hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, there was no time available for nurses to volunteer to provide health screenings for these classes. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedPriority 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 age 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.2022 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 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 2022. 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. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. The Hospital met its set metric. In 2022, we delivered a class to a senior community and one to United Way employees. In total, we trained 48 participants in hands-only CPR. 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 2022. 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 Hospital did not meet the set metric. The internal plan for referring participants to the DSMES classes involved a tremendous amount of collaborative efforts with the AdventHealth Care 360 team to create an "at discharge" referral system to connect patients to the DSMES classes. In year two, the referral system was 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 (AHEC). After the pilot, many issues still needed to be resolved before the expansion of this service for the FDOH's DSMES classes. Unfortunately, they were not resolved before 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 2022. 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 Hospital did not meet the set metric. Due to issues such as COVID-19 requiring staff members to stay within the Hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, the Hospital did not have the capacity to meet the 200 hours of volunteer time in this three-year plan. 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 2022. 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 Hospitals did not meet the set metric. The Division created a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU states AHEC will offer tobacco cessation programming in partnership with the Hospitals, which includes flyer and promotion templates, program materials, and client communications on the Hospitals' behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to Hospital providers and staff, thereby resulting in earned CEUs and CMEs for these team members. Due to issues such as COVID-19, staff members were focused on treating patients and filling in where needed due to staffing shortages. Because their time was needed for focus in these important areas, we were not able to create a program to offer team members CEUs and CMEs for addressing tobacco cessation by the end of the three-year plan. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 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 2022. 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. 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 did not meet its set metric. The Division created a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU states AHEC will offer tobacco cessation programming in partnership with the Hospitals, which includes flyer and promotion templates, program materials and client communications on the Hospitals' behalf. The Division and the Hospitals' Care360 team created and piloted an internal referral system in year two. In 2022, no additional patients were referred through this system, leaving the total amount referred at 10 for the reporting Hospital (AdventHealth Sebring). Unfortunately, issues with the referral system needed to be resolved before referring additional patients.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 2022. 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 Hospitals exceeded the set metric. By the end of 2022, 37 tobacco cessation classes were offered at the Hospitals in partnership with Central Florida Area Health Education Center. 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.2022 Update: 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 2022. 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 did not meet the set metric. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is the primary deliverer of these workshops and programs. We decided it was a better use of resources to support their efforts by referring individuals to their programs and classes. Additionally, we provided South Florida State College with a monetary donation of $3,840 in total among the three hospitals ($1,280 donated was from AdventHealth Sebring) to help pay for adults in need of General Education Development (GED) classes or other technical skills trainings in lieu of providing these classes ourselves. 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. 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 facing underserved adults residing in the Hospital's PSA from a baseline of zero organizations to two by the end of 2022. 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. We established a partnership with three new community partners - CareerSource Heartland, South Florida State College, and the Panthers Youth Program. The metric was met in year two. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of the community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. In 2022, we provided donated funds in the amount of $3,840 in total from all three hospitals ($1,280 donated was from AdventHealth Sebring) to South Florida State College to help alleviate some of the financial constraints mentioned for those low-income individuals seeking to attain their high school diploma through the General Educational Development (GED) program. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedGoal 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 2022. 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 met the set metric. A monetary donation in the amount of $3,840 collectively ($1,280 was donated from AdventHealth Sebring) was delivered to South Florida State College in 2022 to support those low-income, underserved individuals seeking to attain their high school diploma through the GED program. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, 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 2022. 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 Hospital did not meet the set metric. Due to issues such as COVID-19 requiring staff members to stay within the Hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, the Hospitals did not have the capacity to meet the 150 hours of volunteer time in this three-year plan. Community Needs Not Chosen by AdventHealth Sebring: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 Sebring Primary Service Area (PSA), the access to dentists' rate per 100,000 population is 36.5 (in 2015), 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 selfreport 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 selfreport 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 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & 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 Lake Placid 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 Lake Placid is part of the West Florida Division (the Division) of AdventHealth. The Division includes 13 hospital facilities.This is the third-year update for AdventHealth Lake Placid'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 Lake Placid 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 third-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 Lake Placid chose four priorities for its 2020-2022 Community Health Plan:1. Mental Health (Behavioral Health)2. Transportation 3. Cardiovascular Disease4. 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 ages 25 to 34. In the AdventHealth Lake Placid primary service areas (PSA), the rate of death due to self harm (suicide) is 20.5 (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 selfreport 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. Furthermore, 17% of the Medicare-fee-for-service PSA population are depressed.2022 Update: The AdventHealth Lake Placid 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 Lake Placid, AdventHealth Sebring 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 the 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 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 did not meet the set metric. Although the Hospital did not meet the metric as written, AdventHealth did sponsor an enterprise-wide social media campaign across all markets to raise awareness about mental health. 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 Lake Placid, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Sebring, AdventHealth Tampa, AdventHealth Zephyrhills, AdventHealth Wauchula 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 Hospitals exceeded the set metric of providing three free Mental Health First Aid USA certification training classes to community members by offering four classes. A total of 44 participants were trained through this initiative. Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adults **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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 costs 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 met the set metric. In year three the Hospitals donated $2,760 collectively to Peace River Center which equated to covering the cost of household supplies for 69 people at $40 per person. Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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. The Hospitals did not meet the set metric. Year two was spent getting our programs back up and running in the community after setbacks due to COVID-19. In year three our focus was on the implementation of these programs across the Division. While leaders from PRC were informed of these programs through meetings, emails, and phone calls, formal in-service presentations were not conducted, as we deemed the other methods sufficient to deliver this information. Objective 3: The third objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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. 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. The Hospitals did not meet the set metric. Due to issues such as COVID-19 requiring staff members to stay within the Hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, the Hospital did not have the capacity to meet the 300 hours of volunteer time in this three-year plan. Despite pandemic restrictions, team members were able to volunteer by writing letters of encouragement to individuals struggling with a mental health challenge. As the pandemic has subsided, the West Florida Division (of which the Hospital is a part of) 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 across the Division. 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 Lake Placid primary service area (PSA), 3.62% (1,022 persons) of the population are currently using public transportation as their primary means of transportation to work. Additionally, approximately 30% of the population (22,810 persons) age 18 years and older do not have a regular healthcare provider, which is higher than the state average of 25%.2022 Update: The AdventHealth Lake Placid 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 Lake Placid, AdventHealth Sebring 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 Hospitals 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 Hospitals did not meet the set metric. Due to the restraints of COVID-19, we could not host in-person community summits in year one or two, as we originally aimed to do for this objective. Therefore, in year three, we hosted one virtual community summit where the Heartland Regional Transportation Planning Organization (HRTPO) was able to deliver an informative presentation about the various transportation programs available in our community. During this virtual summit, HRTPO was able to share, hear from, and collaborate with other community organizations and leaders to help spread the word and enroll participants in need. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedThe 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 Heartland Regional Transportation Planning Organization'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.Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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 County to co-host at least two community summits (with AdventHealth Wauchula and AdventHealth Sebring) 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 met the set metric. The Heartland Regional Transportation Planning Organization already had a transportation taskforce in place that consisted of local community leaders and representatives for the underserved community. In lieu of creating a separate taskforce, we decided it was a better use of resources to have an AdventHealth team member join the one that was already established and led by the leader in transportation programming for our Hospital's PSA. Through this partnership, AdventHealth co-hosted one virtual community summit in year three. 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 zero 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 did not meet its set metric. During the three-year plan, Food is Health classes were scheduled in partnership with the University of Florida/Institute of Food & Agricultural Sciences (UF/IFAS) Extension, but the classes did not meet the minimum number of required attendees (10) and were therefore cancelled. In year three attempts were made to enroll participants into classes through marketing efforts such as flyers distributed throughout the community, email blasts, promotion through partner organizations, and other online marketing efforts. However, attempts to reach the minimum number of participants needed to hold a class were unsuccessful. 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 zero 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 Hospital did not meet its set metric. During the three-year plan, classes were scheduled but unfortunately did not meet the minimum registration number, therefore, the classes were cancelled. Additionally, in year three, a new produce vendor, Burgin Farms, was onboarded, to replace the previous vendor. Burgin Farms was able to service the PSA in Wauchula for a class series but shortly thereafter closed for the rest of the season and was not able to support classes in our Lake Placid PSA.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 four community partners from a baseline of zero 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 Hospital exceeded its set metric. By the end of year three, partnerships were built and maintained with UF/IFAS Extension, Central Florida Area Health Education Center, Senior Connection Center, Feeding Tampa Bay, Burgin Farms, and the local Department of Health. During year three, Burgin Farms was onboarded as a new produce vendor for our Wauchula market with the intention to expand to our Sebring and Lake Placid markets in the future. Additionally, the local Department of Health offered the use of their space for future classes. With the addition of new partners and resources, the Hospitals will continue to schedule new class series and identify ways to attract community members to sign up.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 increase the number of participants among low-income families in the PSA to 30 from a baseline of zero 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 Hospital did not meet its set metric. During the three-year plan, classes were scheduled but unfortunately did not meet the minimum registration number, therefore, the classes were cancelled. However, attempts were made to recruit participants through flyers, email blasts, and other online marketing efforts. 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 increase the number of health screenings among adults living in food deserts or low-income/low-access communities to 45 from a baseline of zero 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 Hospital did not meet its set metric. Due to issues such as COVID-19 requiring staff members to stay within the hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, nurses were unavailable to volunteer time to provide health screenings for these classes. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedPriority 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 Lake Placid primary service area (PSA), 9% (7,820 persons) of adults age 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 151 (289 average annual deaths from 2012-2016), which is higher than the state rate of 150 and 22% (13,180 persons) of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2022 Update: The AdventHealth Lake Placid 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 did not meet its set metric of providing two classes sponsored by the end of year three. Due to low interest, we were not able to hold the two classes needed to meet this metric in the Lake Placid PSA. Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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 Hospital did not meet the set metric. The internal plan for referring participants to the DSMES classes involved a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an "at discharge" referral system to connect patients to the DSMES programs and initiatives. In year two, the referral system was 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 (AHEC). After the pilot, many issues still needed to be resolved before the expansion of this service for the FDOH's DSMES classes. Unfortunately, they were not resolved before the end of year three. Objective 3:The third objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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 100 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 Hospital did not meet the set metric. Due to issues such as COVID-19 requiring staff members to stay within the Hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, the Hospital did not have the capacity to meet the 100 hours of volunteer time in this three-year plan. Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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 Hospitals did not meet the set metric. The Division created a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU states AHEC will offer tobacco cessation programming in partnership with the Hospitals, which includes flyer and promotion templates, program materials and client communications on the Hospital's behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to Hospital providers and staff, thereby resulting in earned CEUs and CMEs for these team members. Due to issues such as COVID-19, staff members were focused on treating patients and filling in where needed due to staffing shortages. Because their time was needed for focus in these important areas, we were not able to create a program to offer team members CEUs and CMEs for addressing tobacco cessation by the end of the three-year plan. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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, create an internal referral system to link adults residing in the Hospital's PSA and provide resources for 18 patients from a baseline of zero by end of year three. The objective is funded through all Hospitals 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. 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 did not meet its set metric. The Division created a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU states AHEC will offer tobacco cessation programming in partnership with the Hospitals, which includes flyer and promotion templates, program materials and client communications on the Hospitals' behalf. The Division and the Hospitals' Care360 team created and piloted an internal referral system in year two at AdventHealth Sebring and other Hospitals within the Division. Unfortunately, issues with the referral system needed to be resolved before referring additional patients and expanding it to AdventHealth Lake Placid, which did not occur by the end of year three.Objective 3: The third objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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 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 Centers (AHEC).The Hospitals exceeded the set metric. By the end of year three, 37 tobacco cessation classes were offered at the Hospitals in partnership with Central Florida Area Health Education Center. Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Lake Placid primary service area, 17% (10,986 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.2022 Update: The AdventHealth Lake Placid 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 Lake Placid, AdventHealth Sebring 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 did not meet the set metric. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is the primary deliverer of these workshops and programs. We decided it was a better use of resources to support their efforts by referring individuals to their programs and classes. Additionally, we provided South Florida State College with a monetary donation of $3,840 in total between the three Hospitals ($1,280 donated was from AdventHealth Lake Placid) to help pay for adults in need of General Education Development (GED) classes or other technical skills trainings in lieu of providing these classes ourselves. 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. Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Sebring 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. We established a partnership with three new community partners - CareerSource Heartland, South Florida State College, and the Panthers Youth Program. The metric was met in year two.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. In year three we donated funds in the amount of $3,840 total from all three hospitals (of which $1,280 donated was from AdventHealth Lake Placid) to South Florida State College to help alleviate some of the financial constraints mentioned for those low-income individuals seeking to attain their high school diploma through the General Educational Development (GED) program. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedGoal 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 Lake Placid, AdventHealth Sebring 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 met the set metric. A monetary donation in the amount of $3,840 collectively ($1,280 was donated from AdventHealth Lake Placid) was delivered to South Florida State College in year three to support those low-income, underserved individuals seeking to attain their high school diploma through the GED program. Objective 2: The second objective is a shared initiative between AdventHealth Lake Placid, AdventHealth Wauchula 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 Hospital did not meet the set metric. Due to issues such as COVID-19 requiring staff members to stay within the Hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, the Hospitals did not have the capacity to meet the 150 hours of volunteer time in this three-year plan. Community Needs Not Chosen by AdventHealth Lake Placid: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 Lake Placid Primary Service Area (PSA), the access to dentists' rate per 100,000 population is 36 (in 2015), 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 Lake Placid PSA, an estimated 13,180 of adults aged 18 or older selfreport 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, 22.5% 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 Lake Placid PSA, approximately 33% of adults aged 20 and older (21,741 persons) selfreport that they have a Body Mass Index (BMI) greater than 30.0 (obese) in the reporting 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 Footnote: Group A-Facility 3 -- AdventHealth WauchulaDescription of CHNA Significant Needs Adventist 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 13 hospital facilities. This is the third-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 third-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 aged 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 selfreport 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 is depressed.2022 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 2022. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The 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 destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of the 2020-2022 Community Health Plans: the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. The Hospitals 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 the Hospital's Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for the Hospital's social media campaigns moving forward, which will be depression and anxiety. The Hospitals did not meet the set metric. Although the Hospital did not meet the metric as written, AdventHealth did sponsor an enterprise-wide social media campaign across all markets to raise awareness about mental health. 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 2022. 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.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 Hospitals exceeded the set metric of providing three free Mental Health First Aid USA certification training classes to community members by offering four classes. A total of 44 participants were trained through this initiative.Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adults **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 3 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 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 2022. 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 costs associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at the Peace River Center, a community partner. This monetary assistance will help 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 met the set metric. In 2022, the Hospitals donated $2,760 collectively to the Peace River Center which equated to covering the cost of household supplies for 69 people at $40 per person. 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 2022. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides information about the 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, the Hospital's 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 the Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from the Hospital's free community programs. By sharing these programs with counselors, they can then share this information with their clients. The Hospitals did not meet the set metric. Year two was spent getting the Hospital's programs back up and running in the community after setbacks due to COVID-19. In 2022, the Hospital's focus was on the implementation of these programs across the Division. Leaders from PRC were informed of these programs through meetings, emails, and phone calls. Formal in-service presentations were not conducted, as other methods used to deliver this information were deemed to be sufficient. 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 2022. 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. The Hospitals did not meet the set metric. Due to restrictions in place during the COVID-19 pandemic, such as requiring staff members to stay within the Hospital during their normal working hours, and the subsequent shortage of internal staff members across the healthcare industry, the Hospital did not have the capacity to meet the 200 hours of volunteer time. Despite the pandemic restrictions, team members found ways to give back, for example, by volunteering to write letters of encouragement to individuals struggling with a mental health challenge. As the pandemic subsided, the West Florida Division (of which the Hospital is a part of) created a volunteer portal to market volunteer opportunities to team members, track volunteer hours by team members, and notify community partners when team members sign up for events across the Division. 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%. 2022 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 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 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 2022. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between the Hospital and community organizations who also share a goal of reducing transportation challenges within the community. This collaboration fostered an exchange of ideas, resources, and programs. The Hospital also evaluated what additional resources were available, or may become available, to community members with transportation challenges. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 3 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThe Hospitals did not meet the set metric. Due to the restrictions in place during the COVID-19 pandemic, the Hospitals were not able to host the in-person community summits that were originally planned for years one or two. In 2022, the Hospitals hosted one virtual community summit with the Heartland Regional Transportation Planning Organization (HRTPO) who delivered an informative presentation about the various transportation programs available to the community. During the virtual summit, HRTPO was able to share, hear from, and collaborate with other community organizations and leaders to help spread the word and enroll participants in need. 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 Heartland Regional Transportation Planning Organization'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.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 2022. 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 met the set metric. The Heartland Regional Transportation Planning Organization already had a transportation taskforce in place that consisted of local community leaders and representatives for the underserved community. In lieu of creating a separate taskforce, we decided it was a better use of resources to have an AdventHealth team member join the one that was already established and led by the leader in transportation programming for the Hospital's PSA. Through this partnership, AdventHealth co-hosted one virtual community summit in 2022. 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 the "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 2022. 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 did not meet its set metric of providing three free "Health Insurance 101" workshops for the community by the end of 2022.The Hospital provided one free virtual workshop in 2021, but attendance was low. We had hoped to offer this class in-person, but due to restrictions implemented during the COVID-19 pandemic, the class was only available through a virtual platform. In 2022, the Hospital's partner lost the grant funding that enabled them to provide this workshop, therefore no additional classes could be offered.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 2022. 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 met its set metric by providing monetary donations to the Samaritan's Touch Care Center and Central Florida Health Care of Hardee County to be used toward the cost of medical supplies. 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. Central Florida Health Care of Hardee County is the local Federally Qualified Health Center (FQHC).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.2022 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 2022. 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 did not meet its set metric of providing two classes sponsored by the end of 2022. Due to low interest, we were not able to host the two classes needed to meet this metric in the Wauchula community. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 3 -- 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 or uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of 2022. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. The Hospital did not meet the set metric. The internal plan for referring participants to the DSMES classes involved a tremendous amount of collaborative effort 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 was 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 (AHEC). After the pilot, many issues still needed to be resolved before the expansion of this service for the FDOH's DSMES classes. Unfortunately, they were not resolved before 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 2022. 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 did not meet its set metric of providing five class series. In previous years we struggled with finding a health education partner to teach the classes, a produce vendor to provide the produce, and enough interest in the class to meet the minimum required number of participants to hold a class. By the end of 2022 we had an established partnership with UF/IFAS Extension to teach the nutrition education classes and we also onboarded Burgin Farms as our new produce vendor. Though interest remained low, we were still able to hold one class in 2022 before our produce vendor closed for the rest of the season. 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 2022. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Hospital did not meet its set metric of providing 200 produce vouchers due to not having an educational partner or a produce vendor in the first two years. However, we were able to schedule one class in 2022, before our produce vendor closed for the season, and provided 90 vouchers. 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 2022. 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 Hospital met its set metric. By the end of 2022, partnerships were built and maintained with the University of Florida/Institute of Food & Agricultural Sciences (UF/IFAS) Extension, the Central Florida Area Health Education Center, the Senior Connection Center, Feeding Tampa Bay, the Burgin Farms, the Hardee Help Center, and the local Department of Health. Objective 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 2022. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Hospital did not meet its set metric of increasing participants to 50 for the Food is Health program. In previous years we struggled with finding a health education partner to teach the classes, a produce vendor to provide the produce, and enough interest in the class to meet the minimum required number of participants to hold a class. By the end of 2022 we had an established partnership with UF/IFAS Extension to teach the nutrition education classes and we also onboarded Burgin Farms as our new produce vendor. Though interest remained low, we were still able to hold one class in 2022 before our produce vendor closed for the rest of the season.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 2022. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Hospitals did not meet the set metric. Due to restrictions in place during the COVID-19 pandemic, such as requiring staff members to stay within the Hospital during their normal working hours, and the subsequent shortage of internal staff members across the healthcare industry, the Hospital did not have the capacity to allow nurses to volunteer time to provide health screenings.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 2022. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote: Group A-Facility 3 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThis 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 did not meet the set metric. The Division created a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU states AHEC will offer tobacco cessation programming in partnership with the Hospitals, which includes flyers, promotion templates, program materials, and client communications on the Hospital's behalf. As part of the MOU, Central Florida AHEC will provide accredited tobacco cessation education to Hospital providers and staff, thereby resulting in earned CEUs and CMEs for these team members. However, due to restrictions in place as a result of the COVID-19 pandemic and healthcare staffing shortages, staff members were focused on treating patients and filling in where needed. As a result, we were not able to create a program to offer team members CEUs and CMEs for addressing tobacco cessation by the end of 2022.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 2022. 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. 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 did not meet its set metric. The Division and the Hospital's Care360 team created and piloted an internal referral system in 2021 at AdventHealth Sebring and other Hospitals within the Division. Unfortunately, issues with the referral system needed to be resolved before referring additional patients, therefore the system was not expanded into AdventHealth Wauchula by the end of 2022.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 2022. 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 Hospitals exceeded the set metric. By the end of 2022, 37 tobacco cessation classes were offered at the Hospitals in partnership with Central Florida Area Health Education Center. 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.2022 Update: 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 2022. 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 Hospital did not meet the set metric. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is the primary deliverer of these workshops and programs. We decided it was a better use of resources to support their efforts by referring individuals to their programs and classes. Additionally, we provided South Florida State College with a monetary donation of $3,840 in total between the three hospitals ($1,280 was donated from AdventHealth Wauchula) to help pay for adults in need of General Education Development (GED) classes or other technical skills trainings in lieu of providing these classes ourselves. 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 3 -- 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 establish a new partnership with local community organizations to identify education access barriers faced by underserved adults residing in the Hospital's PSA from a baseline of zero organizations to three by the end of 2022. 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. We established a partnership with three new community partners - CareerSource Heartland, South Florida State College, and the Panthers Youth Program. The metric was met in year two. 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. In 2022 we provided donated funds in the amount of $3,840 in total from all three hospitals ($1,280 donated was from AdventHealth Wauchula) to South Florida State College to help alleviate some of the financial constraints mentioned for those low-income individuals seeking to attain their high school diploma through the General Educational Development (GED) program. 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 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 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 2022. 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 met the set metric. A monetary donation in the amount of $3,840 collectively ($1,280 was donated from AdventHealth Wauchula) was delivered to South Florida State College in 2022 to support those low-income, underserved individuals seeking to attain their high school diploma through the GED program. 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 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 2022. 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 Hospital did not meet the set metric. Due to issues such as COVID-19 requiring staff members to stay within the Hospital during their normal working hours, and then a shortage of internal staff members in the subsequent years as seen across the healthcare industry, the Hospitals did not have the capacity to meet the 150 hours of volunteer time in this three-year plan. Community 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 population is 36 (in 2015), 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 aged 18 or older selfreport 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) selfreport 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 13h: 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 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 Orlando & Campuseshttps://www.adventhealth.com/legal/financial-assistance Facility 2 -- AdventHealth Sebring & Lake Placidhttps://www.adventhealth.com/legal/financial-assistance Facility 3 -- AdventHealth Wauchulahttps://www.adventhealth.com/legal/financial-assistance
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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?62
Name and address Type of Facility (describe)
1 1 - Health First AdventHealth Centra Care
1223 Gateway Drive Suite 1E
Melbourne,FL32901
Urgent Care Clinic
2 2 - AdventHealth Centra Care Lake Buena Vist
12500 South Apopka Vineland Road
Orlando,FL32836
Urgent Care Clinic
3 3 - AdventHealth Centra Care South Orange
2609 South Orange Avenue
Orlando,FL32806
Urgent Care Clinic & Employer Onsite Clinic
4 4 - AdventHealth Centra Care Waterford Lakes
250 North Alafaya Trail Suite 135
Orlando,FL32825
Urgent Care Clinic
5 5 - AdventHealth Centra Care Winter Garden
3005 Daniels Road
Winter Garden,FL34787
Urgent Care Clinic
6 6 - AdventHealth Centra Care Lake Nona
9637 Lake Nona Village Place
Orlando,FL32827
Urgent Care Clinic
7 7 - AdventHealth Centra Care Winter Haven
7375 Cypress Gardens Boulevard
Winter Haven,FL33884
Urgent Care Clinic
8 8 - AdventHealth Centra Care St Cloud
4660 13th Street
St Cloud,FL34769
Urgent Care Clinic
9 9 - AdventHealth Centra Care University
11550 University Boulevard
Orlando,FL32817
Urgent Care Clinic
10 10 - AdventHealth Centra Care Mt Dora
19015 US Highway 441
Mount Dora,FL32757
Urgent Care Clinic
11 11 - AdventHealth Centra Care Hunter's Creek
3293 Greenwald Way North
Kissimmee,FL34741
Urgent Care Clinic
12 12 - AdventHealth Centra Care Clermont
15701 State Road 50 Suite 101
Clermont,FL34711
Urgent Care Clinic
13 13 - AdventHealth Centra Care Winter Park
3099 Aloma Avenue
Winter Park,FL32792
Urgent Care Clinic
14 14 - AdventHealth Centra Care Altamonte Sprin
440 West State Road 436
Altamonte Springs,FL32714
Urgent Care Clinic
15 15 - AdventHealth Centra Care Orange Lake
8201 West Irlo Bronson Highway
Kissimmee,FL34747
Urgent Care Clinic
16 16 - AdventHealth Centra Care Poinciana
3759 Pleasant Hill Road
Kissimmee,FL34746
Urgent Care Clinic
17 17 - AdventHealth Centra Care Sanford
4451 West 1st Street
Sanford,FL32771
Urgent Care Clinic
18 18 - AdventHealth Centra Care Oviedo
8010 Red Bug Lake Road
Oviedo,FL32765
Urgent Care Clinic
19 19 - AdventHealth Centra Care Wesley Chapel
1127 Bruce B Downs Boulevard
Wesley Chapel,FL33544
Urgent Care Clinic
20 20 - AdventHealth Centra Care Lee Road
2540 Lee Road
Winter Park,FL32789
Urgent Care Clinic
21 21 - AdventHealth Centra Care Kissimmee
4320 West Vine Street
Kissimmee,FL34746
Urgent Care Clinic
22 22 - AdventHealth Centra Care Port Orange
1208 Dunlawton Avenue
Port Orange,FL32127
Urgent Care Clinic
23 23 - AdventHealth Centra Care Dr Phillips
8014 Conroy-Windermere Road Suite
104
Orlando,FL32835
Urgent Care Clinic
24 24 - AdventHealth Centra Care Apopka
1520 West Orange Blossom Trail
Apopka,FL32712
Urgent Care Clinic
25 25 - AdventHealth Centra Care Lake Mary
2948 West Lake Mary Boulevard
Lake Mary,FL32746
Urgent Care Clinic
26 26 - AdventHealth Centra Care Brandon
10222 Bloomingdale Avenue
Riverview,FL33578
Urgent Care Clinic
27 27 - AdventHealth Centra Care South Tampa
301 North Dale Mabry Highway
Tampa,FL33609
Urgent Care Clinic
28 28 - AdventHealth Centra Care Temple Terrace
5802 East Fowler Avenue
Temple Terrace,FL33617
Urgent Care Clinic
29 29 - AdventHealth Centra Care Azalea Park
509 South Semoran Boulevard
Orlando,FL32807
Urgent Care Clinic
30 30 - AdventHealth Centra Care Orange City
1360 Saxon Boulevard
Orange City,FL32763
Urgent Care Clinic
31 31 - AdventHealth Centra Care DeLand
2293 South Woodland Boulevard
Deland,FL32720
Urgent Care Clinic
32 32 - AdventHealth Centra Care Sand Lake Road
2301 Sand Lake Road
Orlando,FL32809
Urgent Care Clinic
33 33 - AdventHealth Centra Care Colonial Town
630 N Bumby Avenue
Orlando,FL32803
Urgent Care Clinic
34 34 - AdventHealth Centra Care Daytona
1014 West International Speedway
Bouleva
Daytona Beach,FL32114
Urgent Care Clinic
35 35 - AdventHealth Centra Care Ormond Beach
1245 West Granada Boulevard
Ormond Beach,FL32174
Urgent Care Clinic
36 36 - AdventHealth Centra Care Palm Coast
1270 Palm Coast Parkway NW
Palm Coast,FL32137
Urgent Care Clinic
37 37 - AdventHealth Centra Care Lakeland
3637 N Road 98
Lakeland,FL33809
Urgent Care Clinic
38 38 - AdventHealth Centra Care Longwood
855 North US Highway 17-92
Longwood,FL32750
Urgent Care Clinic
39 39 - AdventHealth Centra Care Carrollwood
4001 West Linebaugh Avenue
Tampa,FL33624
Urgent Care Clinic
40 40 - AdventHealth Centra Care Leesburg
1103 North 14th Street
Leesburg,FL34748
Urgent Care Clinic
41 41 - AdventHealth Centra Care Citrus Park
6930 Gunn Highway
Tampa,FL33625
Urgent Care Clinic
42 42 - AdventHealth Centra Care Kids Lake Mary
105 South Country Club Road
Lake Mary,FL32746
Urgent Care Clinic
43 43 - AdventHealth Centra Care Kids Winter Par
2325 West Fairbanks Avenue
Winter Park,FL32789
Urgent Care Clinic
44 44 - AdventHealth Centra Care Trinity
11826 State Road 54
Odessa,FL33556
Urgent Care Clinic
45 45 - AdventHealth Centra Care Conway
5810 South Semoran Boulevard
Orlando,FL32822
Urgent Care Clinic
46 46 - AdventHealth Medical Group Orthopedics a
4409 Sun N Lake Boulevard
Sebring,FL33872
Outpatient Phys Clinic
47 47 - AdventHealth Medical Group Cardiology at
4639 Sun N Lake Boulevard
Sebring,FL33872
Outpatient Phys Clinic
48 48 - AdventHealth Medical Group OB GYNPrompt
524 Carlton Street
Wauchula,FL33873
Outpatient Phys Clinic
49 49 - AdventHealth Primary Care Partin Settlem
2488 E Irlo Bronson Memorial Hwy
Suite 2
Kissimmee,FL34744
Primary Care
50 50 - AdventHealth Primary Care Winter Garden
3131 Daniels Road Suite 106
Winter Garden,FL32825
Primary Care
51 51 - AdventHealth Centra Care Ocala
3708 SW College Road
Ocala,FL34474
Urgent Care Clinic
52 52 - AdventHealth Medical Group Prompt Care a
2950 Alt US Hwy 27 S Suite B
Sebring,FL33870
Prompt Care
53 53 - Darden Onsite
1000 Darden Center Drive
Orlando,FL32837
Employer Onsite Clinic
54 54 - AdventHealth Medical Group Cardiology &
463 Carlton Street
Wauchula,FL33873
Outpatient Phys Clinic
55 55 - Bethune Cookman Onsite
633 State Street
Daytona Beach,FL32114
Employer Onsite Clinic
56 56 - SIEMENS Onsite
4400 North Alafaya Trail MC Q1-240
Orlando,FL32826
Employer Onsite Clinic
57 57 - AdventHealth Hope and Healing Center
212 Eslinger Way
Sanford,FL32773
Residential Level 2 Substance Abuse Center & Intensive Outpatient Program
58 58 - OCG Onsite
450 East South Street
Orlando,FL32802
Employer Onsite Clinic
59 59 - AdventHealth Waterman Employee Clinic
1000 Waterman Way
Tavares,FL32778
Employer Onsite Clinic
60 60 - AdventHealth Primary Care Waterford
885 N Alafaya Trail Unit G04
Orlando,FL32828
Primary Care
61 61 - AdventHealth Medical Group Breast Surger
4145 Sun N Lake Boulevard Suite B
Sebring,FL33872
Outpatient Phys Clinic
62 62 - AdventHealth Trina Hidalgo Heart Care Ce
101 South Westmoreland Drive
Orlando,FL32805
Community Clinic
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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 3c: Under each Hospital facility's Financial Assistance Policy, an individual is eligible for a 100% reduction from applicable charges if the individual's household income is at or below 200% of the current Federal Poverty Guidelines. Alternatively, a patient may also qualify for a 100% reduction from charges when the unpaid portion of a patient's bill exceeds 25% of the individual's annual household income and where the total annual household income is less than 500% of the Federal Poverty Guidelines. Medicare recipients may also be eligible for financial assistance under the Hospital's Financial Assistance Policy depending upon the individual's income and resources. Resources are generally defined as assets such as money in checking or savings accounts, stocks, and bonds.
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 30 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 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 Departments 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: $(227,028,440) - Difference in costing methodology: 39,591,732 - Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (380,611,304) ------------- Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $(568,048,011) 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 2022 CHNAs were adopted by all hospital governing boards by December 31, 2022, the end of the filing organization's taxable year in which the CHNAs were conducted. All of the filing organization's hospital facilities' 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: See Part VI, Line 4 footnote below.
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 $9,737,911 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 $317,707,701 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 49 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 10 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: In 2022, the filing organization operated 3 separately licensed hospitals that together encompassed 11 separate campus locations and 8 off-site emergency departments. The hospitals are located in Florida. A description of each hospital and the communities they serve is described below.Facility Reporting Group - AAdventist Health System/Sunbelt, Inc.:AdventHealth's Central Florida Division South Region consists of a 3,260-bed medical complex in Central Florida with eight separate hospital campuses and eight 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 8-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 7 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 8 hospitals, it also operates 61 full-service urgent care clinics in convenient community settings.During 2022, the patient percentage population for the eight campuses was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2022, about 72.9% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 42.9% - Medicaid Patients 14.4% - Self-Pay Patients 5.3%The demographic makeup of the communities served and a brief description of each of the hospital campuses is described below: Lake Orange Osceola Seminole - Population 383,956 1,429,908 388,656 470,856 (2020 Data) - Population Over 65 26.5% 11.6% 13.0% 15.2% (2019 Data) - Poverty (Below 100% FPL) 12.0% 14.9% 14.8% 10.6% (2015-2019 Data) - High School Graduation Rate 89.5% 88.5% 86.7% 94.3% (2015-2019 Data) - Uninsured Adults 10.6% 13.3% 13.2% 9.5% (2016-2020 Data) - Food Insecurity Rate 13.9% 14.2% 14.6% 11.9% (2021 Data)*AdventHealth Orlando (Orange County) - At the core of AdventHealth's Central Florida Division South Region, AdventHealth Orlando (AHO) is a 1,400-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. The campus also includes a state-of-the-art Cardiac Diagnostic Center, featuring 15 Cath and electro physiology (EPS) Labs, and an inpatient Hospice unit.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. 10 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 beds, 104 oncology beds which include GYN oncology, medical oncology, 32-bed ICU capable BMT unit, and a 36-bed thoracic pulmonary 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.*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 second 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, 10 new LDR rooms, 6 triage rooms, and a new C-section operating room and recovery unit. In 2018, a 10-bed Level II Neonatal Intensive Care Unit (NICU) was added. *** see continuation of footnote
Part VI, Line 4 Continuation of Footnote: Facility Reporting Group - ADescription of Community Information - Continued*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. In December, 2017, construction was completed on a $203 million replacement facility located approximately three miles from the existing facility. The new, 320,000 square foot facility was built on a 71-acre site. Five of the seven floors have been built out with the remaining two floors to be shelled in for future expansion. The 120-bed facility includes intensive care, emergency medicine, endoscopy, outpatient, diagnostic, respiratory, and rehabilitation services.*AdventHealth Celebration (Osceola County) - AdventHealth Celebration is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 357-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. In 2020, a five-story, 166,000 square foot tower was added which, in addition to 80 new acute care beds, includes a state-of-the art unit featuring six Cath labs and two cardiac operating rooms. The expansion allowed for the launch of comprehensive stroke care, which includes 24/7 emergency neurosurgery and interventional neurosurgery. 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. *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. *AdventHealth Kissimmee (Osceola County) - AdventHealth Kissimmee is a 242-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 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. *AdventHealth Winter Garden (Orange County) AdventHealth Winter Garden officially opened the inpatient pavilion May, 2022, to serve the residents of Winter Garden and West Orange County. The $229.5 million, five-story tower currently has 80 beds and compliments the existing 24-bed emergency department and medical office building. The hospital was designed to provide patients with a feeling of home and includes details such as single-occupancy rooms and private bathrooms, large windows that allow more natural light, an outdoor courtyard for patients and family to get sunshine and fresh air, and an indoor dining area with an array of food options so patients can access comfort food prepared in a healthier way. The tower also includes some high-tech features including a centralized patient monitoring system, a full service lab, seven surgery rooms and a dedicated imaging level. In addition to emergency services, the tower provides several new services, such as advanced gynecology, cardiology, gastroenterology, general surgery, neurology, spine health and urology. *AdventHealth Winter Park (Orange County) - AdventHealth Winter Park is a 373-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: Facility Reporting Group - ADescription of Community Information - ContinuedAdventist 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 2022, 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 2022, about 72.7% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 62.7% - Medicaid Patients 13.3% - Self-Pay Patients 4.1%*AdventHealth Sebring (Highlands County) - The main 171-bed hospital facility, located in north Sebring, was opened in 1998 to serve the Florida Heartland region which includes Highlands County and five surrounding inland, non-metropolitan counties. AdventHealth Sebring has key service lines, including a heart & vascular center, Cancer Institute, Breast Care Center, Blessed Beginnings Birthing Center, and Emergency Services. The Hospital has also 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. The Hospital has been recognized and received an "A" from the Leapfrog Group in patient safety.The demographic makeup of AdventHealth Sebring's community is as follows: - Population 108,442 - Population Over 65 32.3% - Poverty (Below 100% FPL) 16.9% - High School Graduation Rate 82.4% - Uninsured Adults 12.3% - Food Insecurity Rate 17.6% - Pop. with Low Food Access 44.5%*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 64,751 - Population Over 65 27.2% - Poverty (Below 100% FPL) 20.2% - High School Graduation Rate 80.7% - Uninsured Adults 12.3% - Food Insecurity Rate 18.0% - Pop. with Low Food Access 43.4%*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. The 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 113,160 - Population Over 65 31.6% - Poverty (Below 100% FPL) 17.5% - High School Graduation Rate 83.0% - Uninsured Adults 12.4% - Food Insecurity Rate 17.6% - Pop. with Low Food Access 45.3%
Part VI, Line 7: The filing organization does not file an annual community benefit report with any state agencies.
Schedule H (Form 990) 2022
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
2022
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) AdventHealth Foundation Inc
900 Hope Way
Altamonte Springs,FL32714
59-2219301 501(c)(3) 882,316 212,600 Book Other General Support
(2) Adventist Care Centers - Courtland Inc
730 Courtland St
Orlando,FL32804
20-5774723 501(c)(3) 1,240,913 0     General Support
(3) American Diabetes Association Inc
1101 N Lake Destiny Rd
Maitland,FL327517105
13-1623888 501(c)(3) 60,000 0     General Support
(4) American Cancer Society Inc
1100 Pennsylvania Ave
Kansas City,MO641050000
13-1788491 501(c)(3) 120,000 0     General Support
(5) American Heart Association Inc
10460 Roosevelt Blvd N 306
St Petersburg,FL337160000
13-5613797 501(c)(3) 200,000 0     General Support
(6) Aspire Health Partners Inc
5151 Adanson St
Orlando,FL328040000
59-2301233 501(c)(3) 874,458 0     General Support
(7) Bike Walk Central Florida Inc
100 E Pine St Ste 110
Orlando,FL328010000
46-1958502 501(c)(3) 6,000 0     General Support
(8) Boy Scouts of America Inc Central Florida Council
1951 S Orange Blossom Tr Ste 102
Apopka,FL327037747
59-0624376 501(c)(3) 82,000 0     General Support
(9) Boys & Girls Club of Central Florida
101 E Colonial Dr
Orlando,FL328010000
59-0951887 501(c)(3) 15,000 0     General Support
(10) Catholic Charities of Central Florida Inc
1819 N Semoran Blvd
Orlando,FL328070000
59-1214353 501(c)(3) 10,000 0     General Support
(11) Celebration Foundation Inc
610 Sycamore St
Celebration,FL347470000
59-3370753 501(c)(3) 40,000 0     General Support
(12) Center For Independent Living In Central Florida Inc
720 N Denning Dr
Winter Park,FL327890000
59-1828770 501(c)(3) 16,300 0     General Support
(13) Central Florida Family Health Center Inc Dba True Health
4930 E Lake Mary Blvd
Sanford,FL327716012
59-1741286 501(c)(3) 100,000 0     General Support
(14) Central Florida Pediatric Society Inc
1890 State Road 436 215
Winter Park,FL328040000
23-7422278 501(c)(3) 10,000 0     General Support
(15) Coalition For The Homeless of Central Florida Inc
18 North Terry Avenue
Orlando,FL328010000
59-2814255 501(c)(3) 10,500 0     General Support
(16) Community Health Centers Inc
110 S Woodland St
Winter Garden,FL347473546
59-1480970 501(c)(3) 106,000 0     General Support
(17) Daves House Inc
9152 Point Cypress Dr
Orlando,FL328360000
27-0533943 501(c)(3) 10,000 0     General Support
(18) East Orlando Health & Rehab Center Inc
250 South Chickasaw Trail
Orlando,FL32825
20-5774748 501(c)(3) 3,336,243 0     General Support
(19) Edible Education Experience Inc
26 E King St
Orlando,FL328040000
46-5655482 501(c)(3) 25,000 0     General Support
(20) Family Promise Of Greater Orlando Inc
1000 Clay Street
Winter Park,FL327890000
59-3679904 501(c)(3) 20,500 0     General Support
(21) Find Feed & Restore Inc
830 W Montrose Street
Clermont,FL347110000
86-3070194 501(c)(3) 15,000 0     General Support
(22) FLNC Inc
3355 E Semoran Blvd
Apopka,FL32703
20-5774761 501(c)(3) 11,057,850 0     General Support
(23) Forest City Spanish Seventh Day Adventist Church
7601 Forest City Rd
Orlando,FL328100000
59-3291153 501(c)(3) 22,000 0     General Support
(24) Forest Lake Academy
500 Education Loop
Apopka,FL327030000
59-0816443 501(c)(3) 15,000 0     General Support
(25) Foundation For Orange County Public Schools
445 W Amelia St Ste 901
Orlando,FL328010000
59-2788435 501(c)(3) 66,064 0     General Support
(26) Grace Medical Home Inc
1417 E Concord St
Orlando,FL328030000
26-1817966 501(c)(3) 168,000 0     General Support
(27) Harbor House of Central Florida Inc
Po Box 680748
Orlando,FL328680000
59-1712936 501(c)(3) 10,000 0     General Support
(28) Harvest Time International Inc
225 Harvest Time Dr
Sanford,FL327710000
54-1698630 501(c)(3) 10,000 0     General Support
(29) Health Care Center For The Homeless Inc
232 N Orange Blossom Trail
Orlando,FL328051612
59-3185020 501(c)(3) 100,000 0     General Support
(30) Healthy Start Coalition of Osceola County Inc
1014 Pennsylvania Ave
St Cloud,FL347690000
59-3212535 501(c)(3) 15,000 0     General Support
(31) Healthy Start Coalition of Seminole County Inc
820 W Lake Mary Blvd Ste 108
Sanford,FL327730000
46-4038747 501(c)(3) 6,000 0     General Support
(32) Heart of Florida United Way Inc
1940 Traylor Blvd
Orlando,FL328040000
59-0808854 501(c)(3) 65,000 0     General Support
(33) Help Now of Osceola Inc
108 Church Street
Kissimmee,FL347410000
59-2283508 501(c)(3) 12,985 0     General Support
(34) Hispanic Business Initiative Fund Inc
3201 E Colonial Dr Ste A20
Orlando,FL328030000
59-3341405 501(c)(3) 13,000 0     General Support
(35) Hispanic Heritage Scholarship Fund of Metro Orlando Inc
518 S Magnolia Ave Suite 100
Orlando,FL328010000
01-0807279 501(c)(3) 15,000 0     General Support
(36) Hope Community Center Inc
1016 N Park Ave
Apopka,FL327122720
56-2551312 501(c)(3) 21,000 0     General Support
(37) Hope Helps Inc
812 Eyrie Dr
Oviedo,FL327650000
20-8490916 501(c)(3) 15,000 0     General Support
(38) Hope Now International Inc
423 Sandringham Court Ste 200
Winter Springs,FL327080000
27-4498303 501(c)(3) 10,000 0     General Support
(39) Hope Partnership Inc dba Community Hope Center
2420 Old Vineland Road
Kissimmee,FL347460000
80-0855060 501(c)(3) 15,000 0     General Support
(40) Idignity Inc
424 E Central Blvd Ste 199
Orlando,FL328010000
01-0921490 501(c)(3) 10,000 0     General Support
(41) Iglesia Cristiana Pentecostal de Orlando Inc
5850 Clarcona Ocoee Rd
Orlando,FL328100000
59-3218454 501(c)(3) 20,000 0     General Support
(42) Impower Inc
2290 N Ronald Reagan Blvd
Longwood,FL327500000
65-0439778 501(c)(3) 80,000 0     General Support
(43) Interfaith Council of Central Florida
Po Box 3310
Winter Park,FL327900000
45-5420165 501(c)(3) 25,000 0     General Support
(44) Jdrf International Incorporated
1850 Lee Rd Ste 132
Winter Park,FL327890000
23-1907729 501(c)(3) 30,000 0     General Support
(45) Kids Beating Cancer
1720 Lee Rd
Winter Park,FL327890000
59-3136203 501(c)(3) 15,000 0     General Support
(46) Kids House of Seminole Inc
5467 N Ronald Reagan Blvd
Sanford,FL327730000
59-3415005 501(c)(3) 47,500 0     General Support
(47) Life Concepts Inc dba Quest Inc
1509 E Colonial Dr Ste 300
Orlando,FL328030000
59-2013160 501(c)(3) 20,000 0     General Support
(48) Lifework Leadership Orlando Inc
1220 E Concord St
Orlando,FL328035453
82-1245782 501(c)(3) 10,000 0     General Support
(49) Lift Orlando
2043 Jacobs Pl
Orlando,FL328050000
46-3607865 501(c)(3) 115,000 0     General Support
(50) Mars Hill Seventh Day Adventist Church
Po Box 1654
Sanford,FL327721654
26-4337526 501(c)(3) 25,000 0     General Support
(51) Matthews Hope Ministries Inc
611 Business Park Blvd 101
Winter Garden,FL347870000
27-2245867 501(c)(3) 15,000 0     General Support
(52) Meals on Wheels Etc Inc
2801 S Financial Ct
Sanford,FL327730000
59-2977907 501(c)(3) 15,000 0     General Support
(53) Mental Health Association of Central Florida Inc
1525 E Robinson St
Orlando,FL328010000
59-0816432 501(c)(3) 199,800 0     General Support
(54) Nami Greater Orlando Inc
300 Crown Oak Centre Dr
Longwood,FL327500000
59-2600149 501(c)(3) 15,000 0     General Support
(55) New Hope Missionary Baptist Church of Apopka Inc
927 South Central Ave
Apopka,FL327030000
32-2335714 501(c)(3) 15,000 0     General Support
(56) Nuevo Sendero Inc
1802 N Alafaya Trail Suite 156
Orlando,FL328260000
26-0298579 501(c)(3) 16,000 0     General Support
(57) Orange County School Readiness Coalition Inc dba Early Learning Coalition o
7700 Southland Blvd Ste 100
Orlando,FL328090000
31-1759186 501(c)(3) 10,000 0     General Support
(58) Orlando Economic Partnership Inc
200 South Orange Avenue No 200
Orlando,FL328010000
59-1767933 501(c)(3) 250,000 0     General Support
(59) Osceola County Council on Aging Inc
700 Generation Point
Kissimmee,FL347440000
59-1595398 501(c)(3) 30,000 0     General Support
(60) Osceola Mental Health Inc dba Park Place Behavioral Health Care
206 Park Place Blvd
Kissimmee,FL347410000
59-1677912 501(c)(3) 250,000 0     General Support
(61) Poverty Solutions Group Inc
1000 Lincoln Ter
Winter Garden,FL347872928
84-5151564 501(c)(3) 6,700 0     General Support
(62) Primary Care Medical Services of Poinciana Inc
1877 Fortune Road
Kissimmee,FL347440000
75-3147007 501(c)(3) 25,000 0     General Support
(63) Ronald Mcdonald House Charities of Central Florida Inc
1030 N Orange Ave Suite 105
Orlando,FL328010000
59-3211250 501(c)(3) 112,000 0     General Support
(64) Runway To Hope Inc
189 S Orange Ave
Orlando,FL328013261
27-3272616 501(c)(3) 15,000 0     General Support
(65) SOS Support Our Scholars Inc
Po Box 1985
Winter Park,FL327900000
26-0711355 501(c)(3) 7,500 0     General Support
(66) School District of Osceola County
817 Bill Beck Blvd
Kissimmee,FL347444495
59-6000779 Gov't 25,000 0     General Support
(67) Seminole State College of Florida
100 Weldon Blvd
Sanford,FL327730000
59-1210158 Gov't 250,000 0     General Support
(68) Seniors First Inc
5395 Lb Mcleod Rd
Orlando,FL328112952
59-2759603 501(c)(3) 15,000 0     General Support
(69) Shepherd'S Hope Inc
455 9Th St
Winter Garden,FL347870000
59-3420727 501(c)(3) 170,000 0     General Support
(70) South Florida State College
600 College Drive
Avon Park,FL33825
59-1218159 Gov't 18,785 0     General Support
(71) Sunbelt Health & Rehab Center - Apopka Inc
305 East Oak St
Apopka,FL32703
20-5774856 501(c)(3) 1,074,829 0     General Support
(72) Teen Challenge of Florida Inc
3706 S Sanford Ave
Sanford,FL327730000
59-2479228 501(c)(3) 10,000 0     General Support
(73) The Christian Sharing Center Inc
600 N Hwy 17-92 Ste 130
Longwood,FL327500000
59-2744535 501(c)(3) 100,000 0     General Support
(74) The Finley Project Inc
941 W Morse Blvd Ste 100
Winter Park,FL327890000
47-1325653 501(c)(3) 7,500 0     General Support
(75) The Florida Endowmnet Foudnation For Vocational Rehabiliatation Inc ba Th
1709 Hermitage Blvd Ste 100
Tallahassee,FL323080000
59-3052307 501(c)(3) 7,500 0     General Support
(76) The Foundation For Osceola Education Inc
2310 New Beginnings Rd Ste 118
Kissimmee,FL347440000
59-2960396 501(c)(3) 7,000 0     General Support
(77) The Foundation For Seminole County Public Schools Inc
400 E Lake Mary Blvd
Sanford,FL327730000
59-2775956 501(c)(3) 13,500 0     General Support
(78) The School Board Of Highlands CountySebring High School
426 School Street
Sebring,FL33870
59-6000654 Gov't 10,000 0     General Support
(79) Tri-County Nursing Rehabilitation Center Inc
11290 Celebration Blvd
Kissimmee,FL34747
47-2219363 501(c)(3) 210,168 0     General Support
(80) United Abolitionist Inc
Po Box 536832
Orlando,FL328530000
59-3178045 501(c)(3) 10,000 0     General Support
(81) United Against Poverty Inc
1400 27Th St
Vero Beach,FL329600000
11-3697936 501(c)(3) 10,000 0     General Support
(82) United Cerebral Palsy of Central Florida
4780 Data Ct
Orlando,FL328170000
59-0799925 501(c)(3) 7,000 0     General Support
(83) United Global Outreach
2301 N Orange Ave
Orlando,FL328045510
03-0511875 501(c)(3) 50,000 0     General Support
(84) Universal Orlando Foundation Inc
1000 Universal Studios Plz
Orlando,FL328197601
59-3510383 501(c)(3) 15,000 0     General Support
(85) Us Dream Academy Inc
5950 Symphony Woods Dr Ste 504
Columbia,MD210440000
59-3514841 501(c)(3) 10,000 0     General Support
(86) Valencia College Foundation Inc
1768 Park Center Drive
Orlando,FL328350000
23-7442785 501(c)(3) 255,000 0     General Support
(87) West Orange Chamber of Commerce
12184 W Colonial Drive
Winter Garden,FL34787
59-0576757 501(c)(6) 8,785 0     General Support
(88) Winter Park Library Association Inc
1052 W Morse Blvd
Winter Park,FL327890000
59-0794396 501(c)(3) 50,000 0     General Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
87
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) 2022

Schedule I (Form 990) 2022
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) 2022



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
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
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) 2022

Schedule J (Form 990) 2022
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, 1099-MISC compensation, and/or 1099-NEC (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
1Shaw Terry D
Dir/President/AdventHealth CEO
(i)

(ii)
0
-------------
2,220,503
0
-------------
879,735
0
-------------
1,623,038
0
-------------
895,900
0
-------------
59,807
0
-------------
5,678,983
0
-------------
130,500
2Silvestry MD Scott
Phy/Dir AH Thoracic Transplant
(i)

(ii)
1,741,716
-------------
0
1,144,480
-------------
0
22,880
-------------
0
16,400
-------------
0
31,461
-------------
0
2,956,937
-------------
0
0
-------------
0
3Rathbun Paul C
AdventHealth CFO
(i)

(ii)
0
-------------
1,218,839
0
-------------
421,406
0
-------------
895,765
0
-------------
166,400
0
-------------
45,556
0
-------------
2,747,966
0
-------------
150,000
4Haffner PhD Randall
CEO Central FL Division
(i)

(ii)
0
-------------
1,552,405
0
-------------
562,179
0
-------------
305,660
0
-------------
145,900
0
-------------
44,132
0
-------------
2,610,276
0
-------------
150,000
5Goodman Todd
CFO, AH Central FL Division
(i)

(ii)
0
-------------
860,712
0
-------------
218,316
0
-------------
743,829
0
-------------
145,900
0
-------------
58,441
0
-------------
2,027,198
0
-------------
117,093
6Moorhead MD David
Former EVP/Chief Clinical Officer
(i)

(ii)
0
-------------
943,380
0
-------------
295,926
0
-------------
495,369
0
-------------
16,400
0
-------------
17,940
0
-------------
1,769,015
0
-------------
0
7Accola MD Kevin
Phy/Exec Med Dir/Cardio Surgery & St
(i)

(ii)
1,409,335
-------------
0
200,000
-------------
0
17,109
-------------
0
16,400
-------------
0
19,124
-------------
0
1,661,968
-------------
0
0
-------------
0
8Zeeshan MD Ahmad
Physician - Heart Transplant
(i)

(ii)
770,956
-------------
0
678,152
-------------
0
9,188
-------------
0
16,400
-------------
0
19,193
-------------
0
1,493,889
-------------
0
0
-------------
0
9Bogar MD Linda
Physician - Heart Transplant
(i)

(ii)
742,977
-------------
0
678,152
-------------
0
13,799
-------------
0
16,400
-------------
0
28,430
-------------
0
1,479,758
-------------
0
0
-------------
0
10Palmer MD George
Phy/AH Celebration Cardio Surgery
(i)

(ii)
1,297,564
-------------
0
100,000
-------------
0
19,326
-------------
0
16,400
-------------
0
28,316
-------------
0
1,461,606
-------------
0
0
-------------
0
11Villanueva Jeffrey
CEO AH East Orlando & East Market
(i)

(ii)
0
-------------
454,778
0
-------------
101,425
0
-------------
758,689
0
-------------
72,620
0
-------------
46,972
0
-------------
1,434,484
0
-------------
36,453
12Thompson Michael
CEO IHS Central FL Div-South Region
(i)

(ii)
0
-------------
638,734
0
-------------
197,706
0
-------------
387,487
0
-------------
96,504
0
-------------
50,341
0
-------------
1,370,772
0
-------------
58,923
13Adams Brian
CEO Central FL Div. South Region
(i)

(ii)
0
-------------
736,878
0
-------------
158,876
0
-------------
257,632
0
-------------
130,406
0
-------------
52,409
0
-------------
1,336,201
0
-------------
52,409
14Finkler MD Neil
Chief Clinical Officer AH Central FL
(i)

(ii)
0
-------------
689,063
0
-------------
156,223
0
-------------
380,016
0
-------------
16,400
0
-------------
26,776
0
-------------
1,268,478
0
-------------
171,073
15Hilliard Douglas
Sr Finance Officer AH Orlando
(i)

(ii)
0
-------------
605,619
0
-------------
162,383
0
-------------
238,456
0
-------------
90,400
0
-------------
48,080
0
-------------
1,144,938
0
-------------
51,130
16Wandersleben Jennifer
Former CEO AH CFD So Acute Care S
(i)

(ii)
0
-------------
649,654
0
-------------
180,378
0
-------------
119,238
0
-------------
114,611
0
-------------
55,833
0
-------------
1,119,714
0
-------------
59,424
17Deininger Robert
CEO AH Orlando
(i)

(ii)
0
-------------
547,187
0
-------------
123,750
0
-------------
66,026
0
-------------
92,862
0
-------------
47,326
0
-------------
877,151
0
-------------
20,120
18Harcombe Douglas
CEO AH Celebration & South Market
(i)

(ii)
0
-------------
490,120
0
-------------
113,042
0
-------------
89,447
0
-------------
81,383
0
-------------
50,877
0
-------------
824,869
0
-------------
51,223
19Cook Timothy
CEO AH Altamonte & Seminole Market
(i)

(ii)
0
-------------
459,242
0
-------------
134,089
0
-------------
104,571
0
-------------
77,615
0
-------------
46,916
0
-------------
822,433
0
-------------
47,890
20Zbaraschuk Amy
Sr Fin Off. Central FL Div-South Reg
(i)

(ii)
0
-------------
468,436
0
-------------
132,293
0
-------------
79,507
0
-------------
75,918
0
-------------
46,082
0
-------------
802,236
0
-------------
48,981
21Tol Daryl
Former SEVP/CEO Central FL Div
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
792,032
0
-------------
0
0
-------------
104
0
-------------
792,136
0
-------------
0
22Moorhead Sheryl
Chief People Off. AH Central FL Div.
(i)

(ii)
0
-------------
481,561
0
-------------
131,228
0
-------------
136,018
0
-------------
16,400
0
-------------
19,512
0
-------------
784,719
0
-------------
0
23Vargas Karilynn
CEO AH Winter Garden & West Market
(i)

(ii)
0
-------------
411,728
0
-------------
101,483
0
-------------
63,078
0
-------------
45,268
0
-------------
50,143
0
-------------
671,700
0
-------------
21,775
24Owen Terry R
Former SVP Partnering Strategy CFD
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
305,559
0
-------------
0
0
-------------
16,138
0
-------------
321,697
0
-------------
0
25Bradley Kenneth W
Former Key Emp/AH Dir Emerging Leade
(i)

(ii)
0
-------------
158,577
0
-------------
21,765
0
-------------
13,206
0
-------------
9,165
0
-------------
25,102
0
-------------
227,815
0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
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 executive listed in Part VII that are 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 49 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 (13 AdventHealth Cabinet members and the AdventHealth Multi-State CFO) and $15,000 for AdventHealth Corporate Office Senior Vice Presidents, Regional CEO's, and Division Chief Officers (generally 50 - 55 individual executives). The CEO, CFO, Chief Clinical Officer and Chief People Officer of the AdventHealth Central FL Division, the Central FL-South Region CEO and the CEO of the IHS Division in Central FL South Region are officers or key employees of the filing organization. The CEO, CFO, Chief Clinical Officer and Chief People Officer of the AdventHealth Central FL Division, the Central FL-South Region CEO and the CEO of the IHS Division in Central FL South Region 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. A report on charter travel is provided to the AHSSHC Board Compensation Committee at each meeting. 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, to encourage executives to establish and cultivate strong working relationships with the medical community and other leaders in the community and industry, certain AdventHealth 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 AdventHealth President/CEO initially as well as on an annual basis. Each AdventHealth executive who is approved for a club membership must submit an annual report describing how they used the membership to benefit their organization during the preceding year so that the AdventHealth President/CEO can determine 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, other than the Chief People Officer, who remains at the request of the Chairman/committee to provide assistance/information as needed. 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, 2022, Daryl Tol and Terry Owen received severance payments in the amount of $776,484 and $290,319, 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. 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 retirement benefit plans to eligible executives. As the supplemental executive retirement benefit plans were updated in 2020 and certain individuals still participate as grand-fathered participants in certain plans, the narrative below discusses all plans in which there were any participants in 2022. 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. SERP III Plan: 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 $305,000 in 2022 (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: 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. 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. 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: 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. In 2020, the Flex Plan was amended 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. 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 for any plan year shall not be greater than the maximum dollar amount or the percentage of compensation as 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: FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. Shaw, Terry D. $ 150,000 $ 130,205 $1,369,868 $ 0 Rathbun, Paul C. $ 150,000 $ 197,530 $ 607,786 $ 0 Haffner, Randall $ 150,000 $ 221,968 $ 0 $ 0 Goodman, Todd $ 150,000 $ 157,963 $ 532,684 $ 0 FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. Moorhead, MD, David $ 150,000 $ 129,500 $ 251,506 $ 0 Villanueva, Jeffery $ 56,220 $ 46,826 $ 691,096 $ 0 Thompson, Michael $ 100,604 $ 58,939 $ 278,689 $ 0 Adams, Brian $ 130,775 $ 52,422 $ 0 $ 3,731 Finkler, Neil $ 127,597 $ 289,889 $ 0 $ 0 Hilliard, Douglas $ 94,500 $ 64,040 $ 129,257 $ 0 Wandersleben, Jennifer $ 108,827 $ 60,800 $ 0 $ 9,884 Deininger, Robert $ 78,654 $ 25,469 $ 0 $ 18,308 Harcombe, Douglas $ 64,983 $ 63,738 $ 0 $ 0 Cook, Timothy $ 61,215 $ 63,038 $ 0 $ 0 Zbaraschuk, Amy $ 59,518 $ 56,510 $ 0 $ 0 Moorhead, Sheryl $ 84,858 $ 64,358 $ 0 $ 0 Vargas, Karilynn $ 49,368 $ 25,621 $ 0 $ 0 * Including Investment Earnings
Schedule J (Form 990) 2022

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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
2021
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 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
C 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
D 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
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
Colorado Health Facilities Authority
 
84-0752932 19648FSJ4 07-01-2021 579,966,540 2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542AFE6 07-01-2021 238,025,567 2021B, Refund 2010C, 2017C; Expand/refurbish facilities X     X   X
Orange County Health Facilities Authority
 
52-1378595 68450LGB5 07-01-2021 62,003,621 2021C, Refund 2010B, 2017A; Expand/refurbish facilities X     X   X
Highlands County Health Facilities Authority
 
52-1313569 431022UJ9 07-01-2021 200,000,000 2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 06-01-2022 335,007,000 2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 281,555,000 210,000,000 297,345,000 258,665,000
2 Amount of bonds legally defeased .............. 22,900,000 3,025,000 2,800,000 8,535,000
3 Total proceeds of issue .................. 372,572,414 294,985,000 115,015,000 348,320,000
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 30,041,050 115,015,000 50,068,380
11 Other spent proceeds ............. 125,000,000 294,985,000 403,646,175 348,320,000
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2004 2012 2008
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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 % 0.200 % 0.840 % 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 % 0.200 % 0.840 % 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. .. 0.080 % 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) 2021

Schedule K (Form 990) 2021
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 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 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) 2021

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
2021
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 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
C 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
D 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
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
Colorado Health Facilities Authority
 
84-0752932 19648FSJ4 07-01-2021 579,966,540 2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542AFE6 07-01-2021 238,025,567 2021B, Refund 2010C, 2017C; Expand/refurbish facilities X     X   X
Orange County Health Facilities Authority
 
52-1378595 68450LGB5 07-01-2021 62,003,621 2021C, Refund 2010B, 2017A; Expand/refurbish facilities X     X   X
Highlands County Health Facilities Authority
 
52-1313569 431022UJ9 07-01-2021 200,000,000 2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 06-01-2022 335,007,000 2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 281,555,000 210,000,000 297,345,000 258,665,000
2 Amount of bonds legally defeased .............. 22,900,000 3,025,000 2,800,000 8,535,000
3 Total proceeds of issue .................. 372,572,414 294,985,000 115,015,000 348,320,000
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 30,041,050 115,015,000 50,068,380
11 Other spent proceeds ............. 125,000,000 294,985,000 403,646,175 348,320,000
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2004 2012 2008
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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 % 0.200 % 0.840 % 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 % 0.200 % 0.840 % 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. .. 0.080 % 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) 2021

Schedule K (Form 990) 2021
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 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 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) 2021

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
2021
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 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
C 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
D 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
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
Colorado Health Facilities Authority
 
84-0752932 19648FSJ4 07-01-2021 579,966,540 2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542AFE6 07-01-2021 238,025,567 2021B, Refund 2010C, 2017C; Expand/refurbish facilities X     X   X
Orange County Health Facilities Authority
 
52-1378595 68450LGB5 07-01-2021 62,003,621 2021C, Refund 2010B, 2017A; Expand/refurbish facilities X     X   X
Highlands County Health Facilities Authority
 
52-1313569 431022UJ9 07-01-2021 200,000,000 2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 06-01-2022 335,007,000 2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 281,555,000 210,000,000 297,345,000 258,665,000
2 Amount of bonds legally defeased .............. 22,900,000 3,025,000 2,800,000 8,535,000
3 Total proceeds of issue .................. 372,572,414 294,985,000 115,015,000 348,320,000
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 30,041,050 115,015,000 50,068,380
11 Other spent proceeds ............. 125,000,000 294,985,000 403,646,175 348,320,000
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2004 2012 2008
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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 % 0.200 % 0.840 % 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 % 0.200 % 0.840 % 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. .. 0.080 % 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) 2021

Schedule K (Form 990) 2021
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 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 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) 2021

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
2021
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 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
C 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
D 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
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
Colorado Health Facilities Authority
 
84-0752932 19648FSJ4 07-01-2021 579,966,540 2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542AFE6 07-01-2021 238,025,567 2021B, Refund 2010C, 2017C; Expand/refurbish facilities X     X   X
Orange County Health Facilities Authority
 
52-1378595 68450LGB5 07-01-2021 62,003,621 2021C, Refund 2010B, 2017A; Expand/refurbish facilities X     X   X
Highlands County Health Facilities Authority
 
52-1313569 431022UJ9 07-01-2021 200,000,000 2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 06-01-2022 335,007,000 2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 281,555,000 210,000,000 297,345,000 258,665,000
2 Amount of bonds legally defeased .............. 22,900,000 3,025,000 2,800,000 8,535,000
3 Total proceeds of issue .................. 372,572,414 294,985,000 115,015,000 348,320,000
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 30,041,050 115,015,000 50,068,380
11 Other spent proceeds ............. 125,000,000 294,985,000 403,646,175 348,320,000
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2004 2012 2008
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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 % 0.200 % 0.840 % 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 % 0.200 % 0.840 % 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. .. 0.080 % 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) 2021

Schedule K (Form 990) 2021
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 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 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) 2021

Additional Data


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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
2021
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 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
C 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
D 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
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
Colorado Health Facilities Authority
 
84-0752932 19648FSJ4 07-01-2021 579,966,540 2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment   X   X   X
Kansas Development Finance Authority
 
48-1066589 48542AFE6 07-01-2021 238,025,567 2021B, Refund 2010C, 2017C; Expand/refurbish facilities X     X   X
Orange County Health Facilities Authority
 
52-1378595 68450LGB5 07-01-2021 62,003,621 2021C, Refund 2010B, 2017A; Expand/refurbish facilities X     X   X
Highlands County Health Facilities Authority
 
52-1313569 431022UJ9 07-01-2021 200,000,000 2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities   X   X   X
Highlands County Health Facilities Authority
 
52-1313569 NoneAvail 06-01-2022 335,007,000 2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 281,555,000 210,000,000 297,345,000 258,665,000
2 Amount of bonds legally defeased .............. 22,900,000 3,025,000 2,800,000 8,535,000
3 Total proceeds of issue .................. 372,572,414 294,985,000 115,015,000 348,320,000
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 30,041,050 115,015,000 50,068,380
11 Other spent proceeds ............. 125,000,000 294,985,000 403,646,175 348,320,000
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2007 2004 2012 2008
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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 % 0.200 % 0.840 % 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 % 0.200 % 0.840 % 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. .. 0.080 % 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) 2021

Schedule K (Form 990) 2021
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 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 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) 2021

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990)
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
2021
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) 2021
Schedule L (Form 990) 2021
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) Amy Litzenberger Family of key employee 80,676 Employee Compensation   No
(2) Bailey Ringering Family of officer 116,028 Employee Compensation   No
(3) Jacob Cook Family of key employee 87,487 Employee Compensation   No
(4) Jeannette Carey Family of key employee 169,159 Employee Compensation   No
(5) Justin Cook Family of key employee 58,819 Employee Compensation   No
(6) Karis Zbaraschuk Family of key employee 84,146 Employee Compensation   No
(7) Martin Shaw Family of board member 91,959 Employee Compensation   No
(8) Martin Thompson Family of key employee 178,733 Employee Compensation   No
(9) Mary Rathbun Family of officer 33,187 Employee Compensation   No
(10) Vivian Cook Family of key employee 52,404 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) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
Adventist Health SystemSunbelt Inc
 
Employer identification number

59-1479658
Return Reference Explanation
Form 990, 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 2 Family Relationship - Gary F. Thurber and John (Mic) Thurber
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 the authority to secure naming rights; g) the authority to require adherence to policies adopted; h) to approve or disapprove the implementation of non-traditional, non-healthcare related activities; i) to approve or disapprove performance/quality improvement, revenue cycle and case management programs; j) to approve or disapprove the selection of the auditing firm retained to audit the books; k) to approve or disapprove the election of the fiscal year; l) to approve or disapprove the selection of the group purchasing organization(s); m) to approve or disapprove any joint venture or partnership in which the filing organization would be a member or partner; n) to approve or disapprove the IT systems and other shared services used; o) the authority to require adherence to the system-wide naming nomenclature and service standards apopted; p) to set and enforce policies for physician compensation including commercial reasonableness and fair market value; and o) to exercise such other powers as are necessary in connection with the foregoing.
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.
Form 990, Part VII, Section A, Column (E) & (F): For those Board of Director members, officers, 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.
Form 990, Part VIII, Lines 7a, b and c: The amounts shown in Part VIII, Lines 7a(i), 7b(i) and 7c(i) of the Form 990 represent 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 678,229,361. Management and general expenses 0. Fundraising expenses 0. Total expenses 678,229,361. Professional Fees: Program service expenses 108,645,516. Management and general expenses 0. Fundraising expenses 0. Total expenses 108,645,516. Purchased Medical Services: Program service expenses 23,011,732. Management and general expenses 0. Fundraising expenses 0. Total expenses 23,011,732. Environmental Services: Program service expenses 10,116,964. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,116,964. Transcription Services: Program service expenses 1,520,385. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,520,385. Recruiting: Program service expenses 6,568,882. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,568,882. Food Service Contracts: Program service expenses 6,426. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,426. Miscellaneous Purchased Services: Program service expenses 8,034,012. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,034,012. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 121,663,144. Fundraising expenses 0. Total expenses 121,663,144. Billing & Collection Services: Program service expenses 0. Management and general expenses 41,504,237. Fundraising expenses 0. Total expenses 41,504,237. AdventHealth Shared Services Fee: Program service expenses 0. Management and general expenses 58,977,195. Fundraising expenses 0. Total expenses 58,977,195.
Form 990, 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 76,492,442. Transfer from tax-exempt affiliate 2,000,000. Debt costs allocated to tax-exempt affiliates -14,800,358. Transfer to operations -140,653. Gifts 61,086. Transfer from supporting tax-exempt foundation 2,472,666. Carrying value of deconsolidated subsidiary pursuant to ASC 810 (GLR) 394,917,930. Change in intercompany allocation of tax-exempt bond proceeds -347,527,647.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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
2021
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
550 E Rollins St
Orlando,FL32803
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 Ashville Inc (5922 - 123122)
900 Hope Way

Altamonte Springs,FL32714
92-1144574
Future Operation of Hospital & Related Services NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(2)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
 
(3)AdventHealth Foundation fka 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
 
(4)AdventHealth Home Care East Florida LLC
770 West Granada Blvd 319

Ormond Beach,FL32174
83-3768458
Inactive FL 501(c)(3) Line 10 Memorial Hlth Systems Inc
 
Yes
 
(5)AdventHealth Hospice Care East Florida Inc
770 West Granada Blvd 304

Ormond Beach,FL32174
83-3748461
Inactive FL 501(c)(3) Line 10 Memorial Hlth Systems Inc
 
Yes
 
(6)AdventHealth Kansas City Foundation
7315 E Frontage Road

Merriam,KS66204
48-0868859
Fund-raising for Tax-exempt hospitals KS 501(c)(3) Line 7 Shawnee Mission Medical Center Inc
 
Yes
 
(7)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
 
(8)AdventHealth Palm Coast Parkway Inc fka AH East Florida Inc
900 Hope Way

Altamonte Springs,FL32714
88-2288563
Future Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(9)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
 
(10)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
 
(11)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
 
(12)AdventHealth Riverview Inc
14055 Riveredge Drive Ste 150

Tampa,FL33637
87-0901094
Future Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(13)AdventHealth Senior Care Inc
900 Hope Way

Altamonte Springs,FL32714
84-1817046
Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(14)AdventHealth South Overland Park Inc
7820 W 165th Street

Overland Park,KS66223
36-4595806
Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc
 
Yes
 
(15)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
 
(16)AdventHealth West Florida Ambulatory Services Inc
14055 Riveredge Drive Ste 250

Tampa,FL33637
47-1881744
Support of Imaging Center & Home Health Subsidiaries FL 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(17)AdventHealth West Florida Imaging Inc
14055 Riveredge Drive Ste 250

Tampa,FL33637
84-3225135
Imaging & Testing FL 501(c)(3) Line 3 AdventHealth West Florida Ambulatory Services Inc
 
Yes
 
(18)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
 
(19)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
 
(20)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
 
(21)Adventist Health 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
 
(22)Adventist Health Partners Inc
5101 S Willow Springs Rd Suite B101

La Grange,IL60525
36-4138353
Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 Adventist Midwest Health
 
Yes
 
(23)Adventist Health 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
 
(24)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
(25)Adventist Hlth SystemSunbelt Inc
900 Hope Way

Altamonte Springs,FL32714
59-1479658
Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(26)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
 
(27)Adventist Midwest Health
120 North Oak Street

Hinsdale,IL60521
36-2276984
Operation of Hospitals & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc
 
Yes
 
(28)AHP Specialty Care NFP
5101 S Willow Springs Rd Suite B101

La Grange,IL60525
81-1105774
Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 Adventist Midwest Health
 
Yes
 
(29)AHS Midwest Management Inc
500 Remington Blvd

Bolingbrook,IL60440
36-3354567
Operation of Physician Practice Management IL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(30)Apopka Health 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
 
(31)Bert Fish Medical Center Auxiliary Inc
401 Palmetto Street

New Smyrna Beach,FL32168
59-1054892
Volunteer support services FL 501(c)(3) Line 10 Southeast Volusia Healthcare Corp
 
 
No
(32)Bradford Heights Health & Rehab Center Inc (11-122222)
485 North Keller Road 250

Maitland,FL32751
20-5782342
Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(33)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
 
(34)Chickasaw Health 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
 
(35)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
 
(36)Coalition For Physician Well-Being Inc
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
 
(37)Courtland Health 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
 
(38)Creekwood Place Nursing & Rehab Center Inc (11-12622)
485 North Keller Road 250

Maitland,FL32751
20-5782260
Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(39)Dairy Road Health 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
 
(40)East Orlando Health & 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
 
(41)Fletcher Hospital Inc
100 Hospital Drive

Hendersonville,NC28792
56-0543246
Operation of Hospital & Related Services 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 Services 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 Services 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 (11-122722)
485 North Keller Road 250

Maitland,FL32751
20-8023411
Inactive KS 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc
 
Yes
 
(57)Lake County Health Care Properties Inc (11-122822)
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 Health 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 Health 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 Healthcare 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
Fund-Raising for Supported Exempt Hospitals IL 501(c)(3) Line 7 N/A
 
No
(66)Mills Health & Rehab Center Inc(11-12622)
485 North Keller Road 250

Maitland,FL32751
20-5782320
Inactive - Wind-Down 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 Health Care Services MO 501(c)(3) Line 12d, III-O Adventist Hlth Mid-America Inc
 
Yes
 
(69)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
 
(70)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
 
(71)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
 
(72)Portercare Adventist Health System (630 YE)
9100 E Mineral Circle

Centennial,CO80112
84-0438224
Operation of Hospitals & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(73)Princeton Health & Rehab Center Inc (11-12622)
485 North Keller Road 250

Maitland,FL32751
20-5782272
Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(74)Princeton Homecare Services LLC (81 - 123122)
602 Courtland Street 310

Orlando,FL32804
81-4196648
Home Health Care Servcies FL 501(c)(3) Line 10 Princeton Prof Services Inc
 
Yes
 
(75)Princeton Professional Services Inc
601 E Rollins Street

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

Altamonte Springs,FL32714
26-3789368
Healthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(77)Redmond Park Hospital LLC
501 Redmond Road NW

Rome,GA30165
58-1123037
Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(78)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
 
(79)Rocky Mountain Adventist Hlthcare Foundation (630 YE)
960 E Harvard Avenue Ste 230

Denver,CO80210
84-0745018
Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 N/A
 
No
(80)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
 
(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 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
 
(83)Shawnee Mission Health 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
 
(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 Health 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 Health 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 Healthcare 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)Spring View Health & Rehab Center Inc (11-122222)
485 North Keller Road 250

Maitland,FL32751
20-5782288
Inactive - Wind-Down KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc
 
Yes
 
(90)Sunbelt Health & 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
 
(91)Sunbelt Health 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
 
(92)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
 
(93)Tarrant County Health 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
 
(94)The Comforter Health Care Group Inc
605 Montgomery Road

Altamonte Springs,FL32714
27-1857940
Support Services to Related Hospice FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(95)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
 
(96)University Community Hospital Foundation Inc
3100 E Fletcher Ave

Tampa,FL33613
59-2554889
Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A
 
No
(97)University Community Hospital Inc
3100 E Fletcher Ave

Tampa,FL33613
59-1113901
Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp
 
Yes
 
(98)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
 
(99)Zephyr Haven Health & 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
 
(100)Zephyrhills Health & 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) 2021
Schedule R (Form 990) 2021
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) M&O Orlando MOB I LLC

1919 N Orange Ave Ste E
Orlando,FL32804
84-4259138
Operation of Medical Office Building DE Adventist Hlth SystemSunbelt Inc
 
Related 780,245 87,748,473   No     No 82.150 %
(6) OnPoint OBGYN LLC (21-123122)

7780 S Broadway 280
Littleton,CO80122
87-3522453
Healthcare Services CO N/A
        No     No  
(7) PAHS OnPoint Imaging LLC

9205 S Broadway
Highlands Ranch,CO80129
83-3275105
Imaging Center CO N/A
        No     No  
(8) PAHS OnPoint Urgent Care LLC

9100 E Mineral Circle
Centennial,CO80112
83-2465331
Urgent Care Center CO N/A
        No     No  
(9) Princeton Homecare Services LLC (11-8122)

602 Courtland Street 310
Orlando,FL32804
81-4196648
Operation of Home Health Agency FL N/A
        No     No  
(10) Surgery Center of Rome LP

501 Redmond Road NW
Rome,GA30165
20-0390305
Surgery Center GA N/A
        No     No  
(11) The Bariatric Center of Kansas City LLC

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

2600 Westhall Lane
Maitland,FL32751
84-4261523
Urgent Care Centers FL Adventist Hlth SystemSunbelt Inc
 
Related -466,525 5,111,652   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) AdventHealth Orlando Network Inc (11 - 41922)

900 Hope Way
Altamonte Springs,FL32714
86-2639185
Inactive FL N/A
C       Yes  
(2) AdventHealth Professional Staffing Inc (11 - 12822)

900 Hope Way
Altamonte Springs,FL32714
88-0742779
INACTIVE FL N/A
C       Yes  
(3) AdventHealth Tampa Network Inc (11 - 41922)

900 Hope Way
Altamonte Springs,FL32714
86-2666178
Inactive FL N/A
C       Yes  
(4) AdventHealth Team Members Inc (11 - 12822)

900 Hope Way
Altamonte Springs,FL32714
88-0763664
INACTIVE FL N/A
C       Yes  
(5) AdventHealth Value Based Bundle Management LLC (61-123122)

101 Southhall Lane Ste 150
Maitland,FL32751
87-3487910
Medical Contracting and Billing FL N/A
C       Yes  
(6) Altamonte Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-2855792
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 229,553 1,547,770 64.060 % Yes  
(7) Apopka Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-3000857
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 4,306 58,218 100.000 % Yes  
(8) Battle Creek Adventist Hospital

900 Hope Way
Altamonte Springs,FL32714
38-1359189
Inactive MI Adventist Hlth SystemSunbelt Inc
 
C     100.000 % Yes  
(9) Florida Hospital Flagler Medical Offices Association Inc

60 Memorial Medical Parkway
Palm Coast,FL32164
26-2158309
Condo Association FL N/A
C       Yes  
(10) 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  
(11) Florida Hospital Healthcare System Inc

101 Southhall Lane Ste 150
Maitland,FL32751
59-3215680
PHSO / CIN FL Adventist Hlth SystemSunbelt Inc
 
C 56,669,854 40,032,068 100.000 % Yes  
(12) Florida Medical Plaza Condominium Association Inc

601 East Rollins Street
Orlando,FL32803
59-2855791
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 1,142,468 6,728,792 87.110 % Yes  
(13) Kissimmee Multispecialty Clinic Condominium Association Inc

201 Hilda Street Suite 30
Kissimmee,FL34741
59-3539564
Condo Association FL Adventist Hlth SystemSunbelt Inc
 
C 62,219 44,675 54.400 % Yes  
(14) Midwest Management Services Inc

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

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

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

1 Park Place Naples Road
Fletcher,NC28732
03-0380531
Condo Association NC N/A
C       Yes  
(18) Park Ridge Condominium #1 Unit Owners Association Inc

1 Park Place Naples Road
Fletcher,NC28732
01-0584623
Condo Association NC N/A
C       Yes  
(19) Surgicare of Rome Inc

501 Redmond Rd
Rome,GA30165
20-0376307
Holding Company GA N/A
C       Yes  
(20) Redmond Park Health Services Inc

501 Redmond Rd
Rome,GA30165
62-1330078
Holding Company GA N/A
C       Yes  
(21) The Garden Retirement Community Inc

485 North Keller Road Ste 250
Maitland,FL32751
59-3414055
Real Estate Rental FL N/A
C       Yes  
(22) 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 175,487 315,939 51.580 % Yes  
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
Yes
 
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 Senior Care Inc

A 116,240 FMV
(2) AdventHealth University Inc

A 3,470,147 FMV
(3) Florida Hospital Medical Group Inc

A 5,361,643 FMV
(4) Florida Radiology Imaging at Lake Mary LLC

A 614,380 FMV
(5) AdventHealth Foundation Inc

B 6,804,745 Actual Amount Given
(6) AdventHealth University Inc

B 5,704,719 Actual Amount Given
(7) Adventist Health System Sunbelt Healthcare Corporation

B 58,633,791 Actual Amount Given
(8) AdventHealth Foundation Inc

C 13,486,038 Actual Amount Received
(9) Florida Hospital Medical Group Inc

K 207,672 FMV
(10) Hospice of the Comforter Inc

K 559,311 FMV
(11) AdventHealth Foundation Inc

L 4,580,201 Cost
(12) Fletcher Hospital Incorporated

L 105,457 Cost Plus Appropriate %
(13) Florida Hospital Medical Group Inc

L 558,295 Cost Plus Appropriate %
(14) Florida Hospital Medical Group Inc

L 500,890 Cost Plus Appropriate %
(15) Florida Hospital Physician Group Inc

L 71,932 Cost Plus Appropriate %
(16) Florida Hospital Waterman Inc

L 86,412 Cost Plus Appropriate %
(17) Memorial Health Systems Inc

L 87,271 Cost Plus Appropriate %
(18) Shawnee Mission Medical Center Inc

L 827,343 Cost Plus Appropriate %
(19) AdventHealth Polk North Inc

M 203,751 % of Facility's Operating Exp
(20) Adventist Health System Sunbelt Healthcare Corporation

M 113,152,717 % of Facility's Operating Exp
(21) Adventist Health System Sunbelt Healthcare Corporation dba AIT

M 200,467,545 % of Facility's Operating Exp
(22) Florida Hospital Medical Group Inc

M 280,324,276 % of Facility's Operating Exp
(23) Florida Hospital Medical Group Inc

O 34,152,097 Cost Allocation
(24) AdventHealth Polk North Inc

P 3,641,174 Cost
(25) AdventHealth Polk South Inc

P 721,418 Cost
(26) AdventHealth Riverview Inc

P 227,125 Cost
(27) AdventHealth Senior Care Inc

P 443,101 Cost
(28) AdventHealth University Inc

P 658,661 Cost
(29) AdventHealth West Florida Ambulatory Services Inc

P 628,558 Cost
(30) Adventist Care Centers - Courtland Inc

P 1,240,913 Cost
(31) Adventist Health System Georgia Inc

P 63,708 Cost
(32) Adventist Health System Sunbelt Healthcare Corporation

P 242,957,040 Cost
(33) Adventist Health System Sunbelt Healthcare Corporation dba AIT

P 3,282,810 Cost
(34) Adventist Midwest Health

P 27,689,121 Cost
(35) East Orlando Health & Rehab Center Inc

P 3,336,243 Cost
(36) Fletcher Hospital Incorporated

P 135,455 Cost
(37) FLNC Inc (Florida Living Nursing Center)

P 11,057,850 Cost
(38) Florida Hospital Dade City Inc

P 65,132 Cost
(39) Florida Hospital Healthcare System Inc

P 19,047,583 Cost
(40) Florida Hospital Medical Group Inc

P 12,947,429 Cost
(41) Florida Hospital Ocala Inc

P 270,122 Cost
(42) Florida Hospital Physician Group Inc

P 89,247 Cost
(43) Florida Hospital Waterman Inc

P 730,942 Cost
(44) Florida Hospital Zephyrhills Inc

P 234,449 Cost
(45) Florida Radiology Imaging at Lake Mary LLC

P 8,814,579 Cost
(46) Hospice of the Comforter Inc

P 1,154,810 Cost
(47) Memorial Health Systems Inc

P 20,619,461 Cost
(48) Memorial Hospital - Flagler Inc

P 1,808,309 Cost
(49) Memorial Hospital - West Volusia Inc

P 781,094 Cost
(50) Memorial Hospital Inc

P 630,611 Cost
(51) Pasco-Pinellas Hillsborough Community Health System Inc

P 709,266 Cost
(52) Pasco-Pinellas Hillsborough Community Health System Inc

P 567,942 Cost
(53) Princeton Professional Services Inc

P 91,752 Cost
(54) Redmond Park Hospital LLC

P 69,803 Cost
(55) Shawnee Mission Medical Center Inc

P 517,468 Cost
(56) Southeast Volusia Healthcare Corporation

P 2,782,782 Cost
(57) Southwest Volusia Healthcare Corporation

P 851,686 Cost
(58) Sunbelt Health & Rehab Center - Apopka Inc

P 1,074,829 Cost
(59) Tarpon Springs Hospital Foundation Inc

P 76,985 Cost
(60) Tri-County Nursing Rehabilitation Center Inc

P 210,168 Cost
(61) University Community Hospital Inc

P 12,143,708 Cost
(62) AdventHealth Polk North Inc

Q 2,737,575 Cost
(63) AdventHealth Polk South Inc

Q 929,878 Cost
(64) AdventHealth Polk South Inc

Q 66,104 Cost
(65) AdventHealth University Inc

Q 25,718,201 Cost
(66) Fletcher Hospital Incorporated

Q 1,119,390 Cost
(67) Florida Hospital Dade City Inc

Q 213,970 Cost
(68) Florida Hospital Medical Group Inc

Q 6,298,359 Cost
(69) Florida Hospital Ocala Inc

Q 967,444 Cost
(70) Florida Hospital Waterman Inc

Q 2,544,586 Cost
(71) Florida Hospital Zephyrhills Inc

Q 441,776 Cost
(72) Florida Radiology Imaging at Lake Mary LLC

Q 42,857,767 Cost
(73) Hospice of the Comforter Inc

Q 1,621,930 Cost
(74) Memorial Health Systems Inc

Q 19,929,567 Cost
(75) Memorial Hospital - Flagler Inc

Q 2,649,668 Cost
(76) Memorial Hospital - West Volusia Inc

Q 1,649,634 Cost
(77) Princeton Professional Services Inc

Q 277,154 Cost
(78) Shawnee Mission Medical Center Inc

Q 4,096,397 Cost
(79) Southeast Volusia Healthcare Corporation

Q 2,768,860 Cost
(80) Southwest Volusia Healthcare Corporation

Q 1,307,389 Cost
(81) Tarpon Springs Hospital Foundation Inc

Q 348,742 Cost
(82) University Community Hospital Inc

Q 1,914,913 Cost
(83) West Florida Health Home Care Inc

Q 105,961 Cost
(84) AdventHealth Polk North Inc

R 200,149 Actual Amount Given
(85) Hospice of the Comforter Inc

S 2,000,000 Actual Amount Received
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
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) 2021

Additional Data


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