TY 2023 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Bacon Kenneth...................................................................... Dir/Chairman Multi State CEO (end 11/23)	5.00 ................. 45.00	X			1,770,929	273,737
(2) Banks David...................................................................... Director/Chairman (beg 11/23)	5.00 ................. 45.00	X			2,205,351	180,461
(3) Houmann Lars...................................................................... Director	1.00 ................. 3.00	X			24,761	0
(4) Ordelheide Kris...................................................................... Director (beg 8/23)	1.00 ................. 50.00	X			1,008,974	93,772
(5) Randolph Karsten...................................................................... Director/Multi State CFO (beg 8/23)	5.00 ................. 45.00	X			2,198,983	169,849
(6) Rathbun Paul...................................................................... Director (end 8/23)	1.00 ................. 50.00	X			2,655,900	503,993
(7) Spenst Brett...................................................................... Director/CEO (beg 8/23)	50.00 ................. 0.00	X			956,760	35,847
(8) Thurber Gary...................................................................... Director	1.00 ................. 3.00	X			6,503	0
(9) Thurber John Mic...................................................................... Director	1.00 ................. 3.00	X			5,706	0
(10) Enderson Dan...................................................................... Sec/Group President/CFO (beg 8/23)	45.00 ................. 5.00		X		3,016,062	311,180
(11) Gaasch Andrew...................................................................... Treasurer/CFO (end 8/23)	50.00 ................. 0.00		X		3,099,191	262,309
(12) Dodds Rick...................................................................... CEO Littleton Adventist Hospital	50.00 ................. 0.00			X	910,939	129,417
(13) Erickson Jonathan...................................................................... CFO Avista Adventist Hospital (beg 9/23)	50.00 ................. 0.00			X	400,025	37,930
(14) Folkenberg Todd...................................................................... CEO Porter Adventist Hospital	50.00 ................. 0.00			X	1,270,050	156,472
(15) Gal Matt...................................................................... CFO Castle Rock Adventist Hospital	50.00 ................. 0.00			X	284,361	14,530
(16) Goebel Michael...................................................................... CEO Parker Adventist Hospital	50.00 ................. 0.00			X	1,001,751	122,478
(17) Pittman Jeremy...................................................................... CEO Castle Rock Adventist Hospital	50.00 ................. 0.00			X	681,679	128,327

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Still Danae........................................................................ CFO Littleton Adventist Hospital	50.00 .......................0.00	X			0	520,487	51,540
(19) Travis Carol........................................................................ CFO Avista Adventist Hospital	50.00 .......................0.00	X			0	375,424	65,321
(20) Ward Erin........................................................................ CFO Parker Adventist Hospital	50.00 .......................0.00	X			0	359,020	6,723
(21) Whitlock Andrew........................................................................ CFO Porter Adventist Hospital	50.00 .......................0.00	X			0	296,582	34,017
(22) Finch Kenneth........................................................................ CEO Avista Adventist Hospital	50.00 .......................0.00	X			0	306,000	0
(23) Ewell MD Nelson........................................................................ Surgeon-Neuro	50.00 .......................0.00		X		1,055,986	0	52,860
(24) Jennings MD Jason........................................................................ Surgeon-Orthopedic	50.00 .......................0.00		X		1,163,346	0	52,435
(25) Miner MD Todd........................................................................ Surgeon-Orthopedic	50.00 .......................0.00		X		1,109,169	0	55,060
(26) RajpalMD Sharad........................................................................ Surgeon-Neuro	50.00 .......................0.00		X		1,672,543	0	49,807
(27) Yang MD Charlie........................................................................ Surgeon-Orthopedic	50.00 .......................0.00		X		1,158,921	0	48,361
(28) Banko Peter........................................................................ Former Officer	5.00 .......................45.00			X	0	8,101,604	876,505
(29) Fisher Jonathan........................................................................ Former Key Employee	0.00 .......................50.00			X	0	584,185	97,877
(30) McKinney Jillyan........................................................................ Former Key Employee	0.00 .......................50.00			X	0	647,906	121,514
(31) Sendros Isaac........................................................................ Former Key Employee	0.00 .......................50.00			X	0	930,653	118,304

(A) Name and business address	(B) Description of services	(C) Compensation
South Denver Cardiology Associates PC 1000 SouthPark Dr Littleton,CO80120	Cardiology Services	35,255,450
Centura Health Corporation 9100 E Mineral Circle Centennial,CO80112	Billing, IT, and Lab Services	26,612,487
Neurosurgery One 7780 S Broadway 350 Littleton,CO80122	Neuro/Spine Services	11,281,562
HSS Security 1395 S Platte River Dr Denver,CO80223	Security Services	7,631,921
Peak Gastroenterology Associates 2920 N Cascade 3rd Floor Colorado Springs,CO80907	Gastroenterology Services	6,225,849
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 93

- TIN:

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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

33 1/3% support test—2022. 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—2023. 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

10%-facts-and-circumstances test—2022. 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

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) 2023

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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.)..

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

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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

33 1/3 % support tests—2022. 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

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) 2023

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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

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.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described on 11a above?

11b

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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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.

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.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization Portercare Adventist Health System

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization Portercare Adventist Health System		Employer identification number 84-0438224

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization Portercare Adventist Health System			Employer identification number 84-0438224
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

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

right arrow

Complete if the organization is described below. 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

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

Portercare Adventist Health System

Employer identification number

84-0438224

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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) 2022

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 right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

Total. Add lines 1c through 1i ....................................................................................................

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

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 1i, Lobbying Activities:	The filing organization typically reports lobbying related to American Hospital Association and Colorado Health Association dues. However, due to the short filing period, dues were not paid during this short period.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
right arrow

Attach to Form 990.
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

Portercare Adventist Health System

Employer identification number

84-0438224

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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)? .............................

Yes No

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.

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.

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	4,927,808	4,698,235	4,012,908	3,870,411	3,713,610
b	Contributions ...			1,050,965
c	Net investment earnings, gains, and losses	63,399	229,573	151,945	142,497	156,801
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...			517,583
f	Administrative expenses ....
g	End of year balance ......	4,991,207	4,927,808	4,698,235	4,012,908	3,870,411

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

69.000 %

Term endowment right arrow

31.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 .....	130,587,489		130,587,489
b	Buildings ....	969,005,367	550,054,717	418,950,650
c	Leasehold improvements
d	Equipment ....	508,959,339	432,725,222	76,234,117
e	Other .....	161,940,926	32,284,930	129,655,996
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				755,428,252

Schedule D (Form 990) 2022

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.)

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.)

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
Due to Related	62,707,795
Payable to Third Parties	14,656,575
Credit Balances in A/R	-2,644,554
Other Deferred Revenue	-131,762
Accrued Interest Payable	251,496
Interco Alloc of TE Bond Proceeds	303,363,130
Operating Lease Liability	23,732,770
Other Current Liabilities	11,883,698

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	413,819,148
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) 2022

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:

Rocky Mountain Adventist Healthcare Foundation (RMAHF), a related organization formed and maintained exclusively to further the exempt purpose of Portercare Adventist Health System (PAHS), held assets in temporary endowment and permanent endowment funds during the current tax year. RMAHF's endowment consists of individual donor restricted endowment funds and pledges receivable where the assets have been designated for endowment. Temporarily and Permanently restricted endowment funds are intended to benefit various programs and departments of the five Hospitals and its patients. The endowment funds held by RMAHF were inadvertently omitted from prior years' Form 990 of the taxpayer. Additional information became available in the current year that provided the amounts now reflected in Schedule D, Part V.

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. The current year provision for federal and state income tax for the year ended December 31, 2023 is approximately $1,140. There was no current year tax provision for the year ended December 31, 2022 due to the utilization of net operating loss carryforwards in 2022. The Income Taxes Topic of the Accounting Standards Codification (ASC) 740, Income Taxes (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, 2023 and 2022.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right arrow

Attach to Form 990. Right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
Portercare Adventist Health System

Employer identification number

84-0438224

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

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? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

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
	Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso,	0	0	Program Services	Travel expenses, hospital construction	260,101
	South America - Argentina, Bolivia, Brazil, Chile, Columbia, Ecuador,	0	0	Program Services	Travel expenses, Medical Mission Trip	172,264
	South Asia - Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal,	0	0	Program Services	Travel expenses, Medical Mission Trip	47,177
	Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas,	0	0	Program Services	Travel expenses, Medical Mission Trip	64,900













3a	Sub-total ....	0	0			544,442
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			544,442

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

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)

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2023

Schedule F (Form 990) 2023Page 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)

Schedule F (Form 990) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

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 typically made only to the community organizations that are exempt from Federal Income Tax under 501(c)(3), other U.S. charitable organizations, or to foreign entities recognized as charitable by the foreign country in which they are located. Given that most grants are made to 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.

Schedule F (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 25000.0000000000 %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	14,547,888		14,547,888	1.760 %
b	Medicaid (from Worksheet 3, column a) . . . . .	151,285,960	89,570,564	61,715,396	7.490 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	165,833,848	89,570,564	76,263,284	9.250 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	629,761	10,400	619,361	0.080 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	267,303		267,303	0.030 %
j	Total. Other Benefits . .	897,064	10,400	886,664	0.110 %
k	Total. Add lines 7d and 7j .	166,730,912	89,580,964	77,149,948	9.360 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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
8	Workforce development			302,074		302,074	0.040 %
9	Other
10	Total			302,074		302,074	0.040 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

47,629,126

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

182,339,927

Enter Medicare allowable costs of care relating to payments on line 5.....

237,035,012

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-54,695,085

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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 %	(e) Physicians' profit % or stock ownership %
11 Functional Neurosurgical Ambulatory Surgery Center LLC	Surgery Center	51.000 %	49.000 %
22 Crown Point Surgery Center LLC	Surgery Center	27.990 %	41.940 %
33 Flatirons Surgery Center LLC	Surgery Center	25.050 %	49.900 %
44 Harvard Park Surgery Center LLC	Surgery Center	25.050 %	48.500 %
55 South Denver Musculoskeletal Surgical Partners LLC	Surgery Center	26.850 %	46.200 %
66 Summit View Surgery Center LLC	Surgery Center	25.000 %	45.630 %
77 OnPoint OBGYN LLC	OBGYN Center	51.000 %	24.500 %
8
9
10
11
12
13

Schedule H (Form 990) 2023

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?5Name, 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)						Facility reporting group
1	AdventHealth Parker 9395 Crown Crest Blvd Parker,CO80138 adventhealth.com/hospital/adventhealth 01J544	X	X		X	A
2	AdventHealth Littleton 7700 S Broadway Littleton,CO80122 adventhealth.com/hospital/adventhealth 010456	X	X		X	A
3	AdventHealth Porter 2525 S Downing St Denver,CO80210 adventhealth.com/hospital/adventhealth 010424	X	X	X	X	A
4	AdventHealth Castle Rock 2350 Meadows Blvd Castle Rock,CO80109 adventhealth.com/hospital/adventhealth 01L581	X	X		X	A
5	AdventHealth Avista 100 Health Park Drive Louisville,CO80027 adventhealth.com/hospital/adventhealth 010316	X	X		X	A

Schedule H (Form 990) 2023

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

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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 .................

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..................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Part V, Page 8

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Part V, Page 8

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2023

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

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Part V, Page 8

The FAP application form was widely available on a website (list url):

See Part V, Page 8

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Page 8

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Reporting Group A
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

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

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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 Parker, - Facility 2: AdventHealth Littleton, - Facility 3: AdventHealth Porter, - Facility 4: AdventHealth Castle Rock, - Facility 5: AdventHealth Avista
Facility Reporting Group A Part V, Section B, line 5:	Facility Reporting Group - APart V, Section B, line 5: See Line 5 footnote below.
Facility Reporting Group A Part V, Section B, line 7d:	The Hospitals 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 Hospital's website at least until the date the Hospital facility has made widely available on its website 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 facility has made available for public inspection its two subsequent Community Health Needs Assessment Reports.
Facility Reporting Group A Part V, Section B, line 11:	Facility Reporting Group - APart V, Section B, line 11: See Line 11 footnote below.
Part V, Section B, Line 5:	Facility Reporting Group A - AdventHealth Parker:In order to ensure broad community input, AdventHealth Parker (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Douglas County School District, Town of Castle Rock, Castle Pines Chamber of Commerce, Denver Regional Council of Governments, Doctors Care, SECOR Cares, Elbert County Public Health, Douglas County Government, Douglas County Housing Partners, and the Hospital Team Members.The Hospital collaborated with Douglas County Public Health Department to inform our Community Health Needs Assessment Steering Committee as they cover the hospital service area. The public health department shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health department and community to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Douglas County has historically been a part.Facility Reporting Group A - AdventHealth Littleton:In order to ensure broad community input, AdventHealth Littleton (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Doctors Care, North Littleton Promise, City of Littleton, Littleton Public Schools, Mission Hills Church, Break Bread, Tri County Public Health, Mile High Health Alliance, and the Hospital Team Members.The Hospital collaborated with Tri County Public Health to inform our Community Health Needs Assessment Steering Committee as this public health department covers the majority of the hospital service area. Tri County Public shared the qualitative data they collected from residents to complement quantitative data to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health department to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Arapahoe and Douglas are a part.Facility Reporting Group A - AdventHealth Porter:In order to ensure broad community input, AdventHealth Porter (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Denver Department of Public Health and Environment, Mile High Health Alliance, Brother Jeff's Cultural Center, The Mental Health Center of Denver, Denver Health, Life Line, LifeSource Adventist Fellowship, Mile High Academy, Adventist Rocky Mountain Conference, Denver South Seventh-Day Adventist Church, Rocky Mountain Conference of Seventh-Day Adventist Church, and over 30 other organizations surveyed.The Hospital collaborated with Denver Department of Public Health and Environment to inform our Community Health Needs Assessment Steering Committee as this public health department covers the hospital service area. Public Health shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health department and community to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Denver County is a part.Facility Reporting Group A - AdventHealth Castle Rock:In order to ensure broad community input, AdventHealth Castle Rock (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Douglas County School District, Town of Castle Rock, Castle Pines Chamber of Commerce, Denver Regional Council of Governments, Doctors Care, SECOR Cares, Elbert County Public Health, Douglas County Government, Douglas County Housing Partners, and The Hospital Team Members.The Hospital collaborated with Douglas and Elbert County Public Health Departments to inform our Community Health Needs Assessment Steering Committee as these public health departments cover the hospital service area. Each public health department shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health departments and community to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Douglas County is a part.
Part V, Section B, Line 5:	Facility Reporting Group A - AdventHealth Avista:In order to ensure broad community input, AdventHealth Avista (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Adventist Rocky Mountain Conference, Boulder County Public Health, Broomfield County Public Health, Coal Creek Meals on Wheels, Colorado Community Health Alliance, Community Food Share, SCL Health, Sister Carmen Community Center, and the Hospital Team Members.The Hospital collaborated closely with Boulder County Public Health and Broomfield County Public Health to inform our Community Health Needs Assessment Steering Committee as these public health departments cover the majority of the hospital service area. Each public health department shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health departments to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Boulder and Broomfield Counties are a part.
Part V, Section B, Line 9:	Portercare Adventist Health System (PAHS) adopted an implementation strategy on November 17, 2022 when the organization was being managed by Centura Health Corporation (CHC or Centura Health). CHC is an IRC 501(c)(3) tax exemption organization incorporated in December of 1995 and owned by jointly by Adventist Health System Sunbelt Healthcare Corporation (AHSSSHC) and Common Spirit to serve as a management company. However, effective August 1, 2023, AHSSHC and Common Spirit disaffiliated and AHSSHC, as the sole member of PAHS, assumed full management of the organization. AHSSHC and PAHS then re-reviewed the implementation strategy during the filing period and proposed a revised implementation strategy which was then adopted by the PAHS board in 2024. Additionally, as the result of the disaffiliation with CHC, PAHS changed from a fiscal year to a calendar year to align with AHSSHC, its sole member which began serving as its management company. All evaluations of the implementation strategy will now be evaluated on a calendar basis.
Part V, Section B, Line 11:	The filing organization is filing this short period return for the period from July 1, 2023, through December 31, 2023, as it is changing its tax year end from a fiscal June 30 year end to a calendar year end of December 31. As a fiscal-year taxpayer in the prior filing period, the filing organization completed its most recent Community Health Needs Assessment by June 30, 2022. The filing organization's 2023-2025 Implementation Strategy (Community Health Plan) was completed and adopted by November 17, 2023 as part of its Community Health Needs Assessment process. The narrative for this section, Schedule H, Part V, Schedule B, Line 11, explains how each Hospital facility addressed the significant health needs identified in its most recent Community Health Needs Assessment, any such needs that were not addressed, and the reasons why such needs were not addressed in this fiscal short period tax return (July 1, 2023 - December 31, 2023). This is the second-year update for the filing organization's Community Health Implementation Plan. Portercare Adventist Health System's (PAHS) five hospital campuses (cumulatively referred to as AdventHealth RMR) are addressed separately below with each hospital operating as a dba of PAHS. PAHS is a subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. The narrative below shows by hospital the current year progress on the Community Health Plan/Implementation Strategy. The narrative describes the priorities previously identified and give an update on the strategies addressing these prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. Group A Facility 1 - AdventHealth Parker:Description of CHNA Significant NeedsAdventHealth Parker (AHP or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Castle Rock and the Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with the Hospital and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. The Hospital recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.AHP's chosen priorities are listed below.1. Mental Health (Suicide Prevention)2. Substance Use Prevention3. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: In Douglas and Arapahoe Counties, suicide and depression rates remain high. 81.7 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 1662.7 per 100,000 patients were hospitalized for other mental health problems. 17.3 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear. There is a tension between immediate care and prevention that needs to be considered. Douglas and Arapahoe Counties have varying resources.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at AHP, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. AHP applied for an additional Zero Suicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024.Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at AHP from July 1, 2023 - December 31, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Substance Use PreventionDescription of the Priority: Douglas and Arapahoe Counties report that substance use has increased over the past three years and is important to address along with mental health. Adult smoking is 13.5% and excessive drinking is 19.6%. The community is experiencing an increase since the pandemic, as well.Current Year Update:Goal 2.1: Increase Emergency Department MOUD encounters (Buprenorphine inductions); increase administration and prescription of alternatives to opioids. Decrease in the administration and prescription of opioids; increase the distribution of Naloxone kits to support opioid overdose reversal.Objective 2.1.1: By 2023, develop a framework for an opioid addiction intervention and prevention outcomes initiative.The Hospital reports 9 MOUD (Medication for Opioid Use Disorder - provides patients in active opioid withdrawal with medication as a form of addiction treatment) interventions between July 1, 2023 - December 31, 2023. In addition, the Hospital has implemented the ALTO (Alternative to Opioids) program - focused on providing pain management options that do not include opioids in order to prevent possible addiction and participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. The Hospital also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.Goal 2.2: Advance Substance Use Disorder screening, Brief Intervention and Referral to Treatment (SBIRT) services.Objective 2.2.1: By 2023, implement Screening Brief Intervention and Referral to Treatment (SBIRT) initiative.AdventHealth RMR has implemented SBIRT (Screening, Brief Intervention & Referral to Treatment) initiative as a preventative approach for individuals who may be using substances at risky levels, or displaying substance use behaviors that may have negative impacts on their health. The Hospital reported 34 SBIRT encounters from July 1, 2023 - December 31, 2023.
Part V, Section B, Line 11:	Priority 3: Food SecurityDescription of the Priority: Although food security has improved, the cessation of benefits and extra services during the COVID pandemic, means that this is likely to worsen again in 2022 and beyond. The community would like to continue existing efforts to ensure families have access to healthy foods and enough to eat.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHP reported 29 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. AHP is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support the Parker's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. The Hospital also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Intentional Injury: Intentional Injury was prioritized recognizing the impact of injuries such as suicide, homicide and violence. Through discussions with the Steering Committee, it was recognized that a focus on Mental Health and Substance Abuse would be a prevention strategy for Intentional Injury. The Committee felt strongly that we address those issues that align closely with Intentional Injury, recognizing we could impact both with this common focus. We are, therefore, addressing Intentional Injury through prevention related to Mental Health and Substance Use. Access to Oral Health: Access to Oral Health Care was identified as a priority, in alignment with access to primary care in that there are fewer services and transportation can be a barrier. While oral health is an important part of human health, there was not alignment with community efforts nor Hospital efforts or capacity. We will monitor this over time and share with the community that this arose as an important health need. Access to Primary Care: The Hospital's strategic priorities are addressing access to primary care through two large initiatives. Therefore, we will not create new implementation plans this priority because it's already embedded in our strategic priorities.Group A Facility 2 - AdventHealth Littleton:Description of CHNA Significant NeedsAdventHealth Littleton (AHL or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Porter and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AHL and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. The Hospital recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment, as well as prevention through environmental and behavioral changes, were identified.AHL's chosen priorities are listed below.4. Mental Health (Suicide Prevention)5. Housing Stability6. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: Mental health helps to determine how we handle stress, relate to others and make choices. Additionally, poor mental health can increase risk for other chronic health problems. In Arapahoe County, mental health distress is higher among those with incomes $50K or less than those above, 40% and 22% respectively. Additionally, persons of color experience more mental distress than white, non-Hispanic community members, 33% and 30% respectively. Before the pandemic, mental health distress was high among high school students. Thirty-four percent experience mental distress, 13% made a suicide plan, 17% seriously considered suicide and 8% attempted suicide.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at AHL, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either be discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. AHL applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024.Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at the Hospital from July 1, 2023 - December 31, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.
Part V, Section B, Line 11:	Priority 2: Housing StabilityDescription of the Priority: In Arapahoe County, Housing prices have sharply risen. Average monthly income rose 25% while average rent rose 25% between 2014 and 2019. Safe and stable, affordable, healthy housing is directly related to health. The housing crisis was exacerbated by COVID-19 pandemic. Additionally, people who rent their homes pay a higher percentage of income toward housing. Fifty percent of renters paid 30% or more of household income on housing in 2019, vs. 24% of homeowners.Current Year Update:Goal 2.1: Increase access to safe and stable housing and shelter within the community. Identify community members who report housing insecurity and refer them to appropriate resources in the community.Objective 2.1.1: By 2023, participate in collaborative efforts to address affordable housing and homelessness in Arapahoe and Douglas counties.AHL partnered with a local housing coalition made up of 30+ housing organizations that aim to prevent homelessness, and coordinate services for eligible households.Objective 2.1.2: By 2023, screen households for housing insecurity and refer them to resources in the community to promote stable housing.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHL reported 78 positive SDOH screenings for housing between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. Priority 3: Food SecurityDescription of the Priority: Our community initially identified economic security as a priority because qualitative data indicated that community members are having difficulty affording basic needs, including food and self-reported health has a direct relationship to household income. Between March and December 2020 unemployment insurance claims increased 938%. Based upon the resources identified in the community, this priority was transitioned to Food Security, as having access to affordable healthy foods provides more resources for other basic needs. Additionally, the cessation of food security benefits and extra services during the COVID pandemic means that this is likely to worsen again in 2022. The community would like to continue existing efforts to ensure families have access to healthy foods and enough to eat.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHL reported 79 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. AHL is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support the Littleton's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Injury: While the Hospital treats many patients due to injuries, this did not arise as a health priority in the conversation. It was, however, recognized that our work to focus on Mental Health will address injury through the links between mental health status and injury, intentional or unintentional. Substance Use: While substance use is an issue being seen in the community, there was a good discussion about the links between substance use and mental health and the need to focus on mental health at this point in time. Access to Primary Care: The Steering Committee discussed that access to care is a changing environment which we need to monitor due to continually changing guidelines and policies. After the pandemic, there will be a need to monitor how health coverage shifts when emergency coverage through Medicaid ends. However, they determined it would be best to focus on access to mental health care to maintain a strong focus on this issue and to have a greater impact with a greater focus on fewer priorities.Group A Facility 3 - AdventHealth Porter:Description of CHNA Significant NeedsAdventHealth Porter (Porter or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Littleton and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PAH and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. Porter recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.The Hospital's chosen priorities are listed below.1. Mental Health (Suicide Prevention)2. Substance Use Prevention3. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: In Denver County, suicide and depression rates remain high. 77.6 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 2493.8 per 100,000 patients were hospitalized for other mental health problems. 18.1 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at Porter, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either be discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. Porter applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024.
Part V, Section B, Line 11:	Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at Porter from July 1, 2023 - December 31, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Substance Use PreventionDescription of the Priority: Denver County reports that substance use has increased over the past three years and is important to address along with mental health. Adult smoking is 15.2% and excessive drinking is 22.3%. The community is experiencing an increase since the pandemic, as well. The community has seen an increase in youth nicotine use and drugs such as fentanyl are on the rise.Current Year Update:Goal 2.1: Increase Emergency Department MOUD encounters (Buprenorphine inductions); increase administration and prescription of alternatives to opioids. Decrease in the administration and prescription of opioids; increase the distribution of Naloxone kits to support opioid overdose reversal.Objective 2.1.1: By 2023, develop a framework for an opioid addiction intervention and prevention outcomes initiative.Porter reports seven MOUD (Medication for Opioid Use Disorder - provides patients in active opioid withdrawal with medication as a form of addiction treatment) interventions between July 1, 2023 - December 31, 2023. In addition, Porter has implemented the ALTO (Alternative to Opioids) program - focused on providing pain management options that do not include opioids in order to prevent possible addiction and participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. The Hospital also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.Goal 2.2: Advance Substance Use Disorder screening, Brief Intervention and Referral to Treatment (SBIRT) services.Objective 2.2.1: By 2023, implement Screening Brief Intervention and Referral to Treatment (SBIRT) initiative.AdventHealth RMR has implemented SBIRT (Screening, Brief Intervention & Referral to Treatment) initiative as a preventative approach for individuals who may be using substances at risky levels, or displaying substance use behaviors that may have negative impacts on their health. Porter reported 38 SBIRT encounters from July 1, 2023 -December 31, 2023Priority 3: Food SecurityDescription of the Priority: Although food security has improved, the cessation of benefits and extra services during the COVID pandemic, means that this is likely to worsen again in 2022. The community would like to continue existing efforts to ensure families have access to healthy foods and enough to eat.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity. SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. Porter reported 55 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. Porter is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support Porter's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.Porter partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Unintentional Injury: Intentional Injury was prioritized recognizing the impact of injuries such as suicide, homicide and violence. Through discussions with the Steering Committee, it was recognized that a focus on Mental Health and Substance Abuse would be a prevention strategy for Intentional Injury. The Committee felt strongly that we address those issues that align closely with Intentional Injury, recognizing we could impact both with this common focus. We are, therefore, addressing Intentional Injury through prevention related to Mental Health and Substance Use.Health Equity although not separately chosen as a selected priority, was identified as a need to be consciously integrated into the strategies of the above priorities that were selected.Group A Facility 4 - AdventHealth Castle Rock:Description of CHNA Significant NeedsAdventHealth Castle Rock (AHC) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Parker and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AHC and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. AHC recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.The Hospital's chosen priorities are listed below.7. Mental Health (Suicide Prevention)8. Substance Use Prevention 9. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: In Douglas and Elbert counties, suicide and depression rates remain high. 75.7 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 1249.7 per 100,000 patients were hospitalized from other mental health problems. 16.3 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.
Part V, Section B, Line 11:	A comprehensive suicide prevention pathway has been developed at the Hospital, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either be discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. AHC applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024.Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at AHC from July 1, 2023 - December 31, 2023. include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Substance Use PreventionDescription of the Priority: Douglas and Elbert Counties report that substance use has increased over the past three years and is important to address along with mental health. Adult smoking is 10.9% and excessive drinking is 20.8%. The community is experiencing an increase since the pandemic, as well.Current Year Update:Goal 2.1: Increase Emergency Department MOUD encounters (Buprenorphine inductions); increase administration and prescription of alternatives to opioids. Decrease in the administration and prescription of opioids; increase the distribution of Naloxone kits to support opioid overdose reversal.Objective 2.1.1: By 2023, develop a framework for an opioid addiction intervention and prevention outcomes initiative.AHC reports two MOUD (Medication for Opioid Use Disorder - provides patients in active opioid withdrawal with medication as a form of addiction treatment) interventions between July 1, 2023 - December 31, 2023. In addition, AHC has implemented the ALTO (Alternative to Opioids) program - focused on providing pain management options that do not include opioids in order to prevent possible addiction and participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. The hospital also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.Goal 2.2: Advance Substance Use Disorder screening, Brief Intervention and Referral to Treatment (SBIRT) services.Objective 2.2.1: By 2023, implement Screening Brief Intervention and Referral to Treatment (SBIRT) initiative.AdventHealth RMR has implemented SBIRT (Screening, Brief Intervention & Referral to Treatment) initiative as a preventative approach for individuals who may be using substances at risky levels, or displaying substance use behaviors that may have negative impacts on their health. AHC reported 11 SBIRT encounters from July 1, 2023 - December 31, 2023Priority 3: Food SecurityDescription of the Priority: According to Hunger Free Colorado, 1 in 3 people are struggling with hunger during the pandemic. A high cost of living exacerbates the gap between federal poverty guidelines and a living wage. In our service area, almost one in 10 people are food insecure. Blacks and Hispanics have greater rates of food insecurity at 14 and 13.4 percent, respectively.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHC reported 25 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. AHC is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support Castle Rock's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Intentional Injury: Intentional Injury was prioritized recognizing the impact of injuries such as suicide, homicide and violence. Through discussions with the Steering Committee, it was recognized that a focus on Mental Health and Substance Abuse would be a prevention strategy for Intentional Injury. The Committee felt strongly that we address those issues that align closely with Intentional Injury, recognizing we could impact both with this common focus. We are, therefore, addressing Intentional Injury through prevention related to Mental Health and Substance Use. Access to Oral Health: Access to Oral Health Care was identified as a priority, in alignment with access to primary care in that there are fewer services and transportation can be a barrier. While oral health is an important part of human health, there was not alignment with community efforts nor Hospital efforts or capacity. We will monitor this over time and share with the community that this arose as an important health need. Access to Primary Care: The Hospital's strategic priorities are addressing access to primary care through two large initiatives. Therefore, we will not create new implementation plans this priority because it's already embedded in our strategic priorities.Group A Facility 5 - AdventHealth Avista:Description of CHNA Significant NeedsAdventHealth Avista (AHA or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with the Boulder County Public Health Department, Broomfield Public Health, and community stakeholders. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AHA and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. AHA recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.The Hospital's chosen priorities are listed below.1. Mental Health (Suicide Prevention)2. Housing Stability3. Food Security
Part V, Section B, Line 11:	Priority 1: Mental Health (Suicide Prevention)Description of the Priority: In Boulder and Broomfield counties, suicide and depression rates remain high. 50.2 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 1428.6 per 100,000 patients had other mental health problems. 17.3 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at the Hospital, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. The Hospital applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024. Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at AHA from July 1, 2023 - December, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Housing StabilityDescription of the Priority: In Boulder and Broomfield counties, housing prices have sharply risen. They are ranked 17 and 11 respectively amongst counties with more than 50% of household income spent on housing. Quality of housing is also a problem due to overcrowding, poor plumbing/kitchen utilities. Inflation during the pandemic has meant that families have less to spend on basic needs such as rental/mortgage payments and utilities.Current Year Update:Goal 2.1: Increase access to safe and stable housing and shelter within the community. Identify community members who report housing insecurity and refer them to appropriate resources in the community.Objective 2.1.1: By 2023, participate in collaborative efforts to address affordable housing and homelessness in Boulder and Broomfield Counties.The Hospital participates in workgroups led by the area's Continuum of Care to help improve care coordination efforts for our unhoused neighbors. In 2024, the Hospital, in partnership with other health systems and Broomfield Public Health and Boulder Public Health, will explore pathways to focus on upstream solutions to address affordable housing and homelessness.Objective 2.1.2: By 2023, screen households for housing insecurity and refer them to resources in the community to promote stable housing.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. The Hospital reported 64 positive SDOH screenings for housing between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs.Priority 3: Food SecurityDescription of the Priority: According to Hunger Free Colorado, 1 in 3 people are struggling with hunger during the pandemic. A high cost of living exacerbates the gap between federal poverty guidelines and a living wage. In our service area, one in 10 people are food insecure. Blacks and Hispanics have greater rates of food insecurity at 14 and 13.4 percent, respectively.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. The Hospital reported 65 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. The Hospital is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support the Hospital's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Access to Primary Care: The Steering Committee discussed that access to care is a changing environment which we need to monitor due to continually changing guidelines and policies. After the pandemic, there will be a need to monitor how health coverage shifts when emergency coverage through Medicaid ends. However, they determined it would be best to focus on access to behavioral health care to maintain a strong focus on this issue and to have a greater impact with a greater focus on fewer priorities.
Schedule H, Part V, Section B, Line 7a, Hospital Facility CHNA Website	Facility 1 - AdventHealth Parkerhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 - AdventHealth Littletonhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 - AdventHealth Porterhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 4 - AdventHealth Castle Rockhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 5 - AdventHealth Avistahttps://www.adventhealth.com/community-health-needs-assessments
Schedule H, Part V, Section B, Line 10:	Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites:Facility 1 - AdventHealth Parkerhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 - AdventHealth Littletonhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 - AdventHealth Porterhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 4 - AdventHealth Castle Rockhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 5 - AdventHealth Avistahttps://www.adventhealth.com/community-health-needs-assessments
Schedule H, Part V, Section B, Line 16a - c:	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 Parkerhttps://www.adventhealth.com/legal/financial-assistanceFacility 2 - AdventHealth Littletonhttps://www.adventhealth.com/legal/financial-assistanceFacility 3 - AdventHealth Porterhttps://www.adventhealth.com/legal/financial-assistanceFacility 4 - AdventHealth Castle Rockhttps://www.adventhealth.com/legal/financial-assistanceFacility 5 - AdventHealth Avistahttps://www.adventhealth.com/legal/financial-assistance

Schedule H (Form 990) 2023

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?70
Name and address		Type of Facility (describe)
1	1 - PAHS OnPoint Urgent Care LLC 9205 S Broadway Highlands Ranch,CO80129	Urgent Care Clinic
2	2 - AdventHealth Medical Group OBGYN at Littl 7720 S Broadway Ste 250 Littleton,CO801222634	Physician Clinic
3	3 - OnPoint OBGYN LLC 7780 S Broadway Ste 280 Littleton,CO80122	Physician Clinic
4	4 - AdventHealth Medical Group Orthopedics and 9949 S Oswego St Ste 200 Parker,CO801343753	Physician Clinic
5	5 - AdventHealth Medical Group Neurology at Li 7780 S Broadway Ste 350 Littleton,CO801222633	Physician Clinic
6	6 - AdventHealth ER & Urgent Care Southmoor 7000 East Hampden Ave Denver,CO80224	Urgent Care Clinic
7	7 - Functional Neurosurgical Ambulatory Surger 11 W Dry Creek Circle Ste 120 Littleton,CO80120	Ambulatory Surgery Center
8	8 - AdventHealth Medical Group OBGYN 9403 Crown Crest Blvd Ste 200 Parker,CO80138	Physician Clinic
9	9 - AdventHealth Medical Group Primary Care at 6069 South Southlands Parkway Suite C Aurora,CO80016	Physician Clinic
10	10 - AdventHealth Medical Group Multiple Specia 2352 Meadows Blvd Ste 300 Castle Rock,CO801098419	Physician Clinic
11	11 - AdventHealth Medical Group Orthopedics at 4350 Limelight Ave Ste 100 Castle Rock,CO80109	Physician Clinic
12	12 - AdventHealth Medical Group Primary Care at 7000 East Hampden Ave Ste 200 Denver,CO80224	Physician Clinic
13	13 - AdventHealth ER & Urgent Care Meridian 9949 S Oswego St Ste 100 Parker,CO801343753	Urgent Care Clinic
14	14 - AdventHealth Medical Group Colorado Joint 2535 S Downing St Ste 100 150 Denver,CO80210	Physician Clinic
15	15 - AdventHealth Medical Group PainJoint Repl 9695 S Yosemite St Ste 255C Lone Tree,CO80124	Physician Clinic
16	16 - AdventHealth Medical Group Ridgegate OBGY 2356 Meadows Blvd Ste 240B Castle Rock,CO80109	Physician Clinic
17	17 - AdventHealth Medical Group Family Medicine 2356 Meadows Blvd Ste 140B Castle Rock,CO80109	Physician Clinic
18	18 - AdventHealth Medical Group Primary CareIn 950 E Harvard Ave Ste 200 Denver,CO802107006	Physician Clinic
19	19 - AdventHealth Medical Group Primary Care at 9670 Coal Mine Ave Ste 200 Littleton,CO80122	Physician Clinic
20	20 - AdventHealth Medical Group Internal MedEN 9403 Crown Crest Blvd Ste 300 Parker,CO80138	Physician Clinic
21	21 - AdventHealth Medical Group OBGYN at Churc 7233 Church Ranch Blvd Suite A Westminster,CO800214094	Physician Clinic
22	22 - AdventHealth Medical Group Spine and Neuro 90 Health Park Dr Ste 350 Louisville,CO800279742	Physician Clinic
23	23 - AdventHealth Medical Group Complex Gynecol 2555 S Downing St 1st Floor Denver,CO802105855	Physician Clinic
24	24 - AdventHealth Medical Group Primary Care at 15901 E Briarwood Cir Ste 200 Aurora,CO80016	Physician Clinic
25	25 - AdventHealth Medical Group Multiple Specia 80 Health Park Dr Ste 270 Louisville,CO800279584	Physician Clinic
26	26 - AdventHealth Medical Group Internal Medici 9088 South Ridgeline Blvd Highlands Ranch,CO80129	Physician Clinic
27	27 - AdventHealth Medical Group Primary Care at 7720 South Broadway Ste 350 Littleton,CO80122	Physician Clinic
28	28 - AdventHealth Medical Group Gastroenterolog 2535 S Downing St Ste 410 Denver,CO802105850	Physician Clinic
29	29 - AdventHealth Medical Group OBGYN and Midw 90 Health Park Dr Ste 290 Louisville,CO80027	Physician Clinic
30	30 - AdventHealth Medical Group Primary Care at 2490 W 26th Ave Ste A120 Denver,CO802115317	Physician Clinic
31	31 - AdventHealth Medical Group Family Medicine 250 Max Drive Ste 102 Castle Pines,CO801089518	Physician Clinic
32	32 - AdventHealth Medical Group Primary Care at 9137 S Ridgeline Blvd Ste 190 Highlands Ranch,CO801292395	Physician Clinic
33	33 - AdventHealth Medical Group Multiple Specia 9403 Crown Crest Blvd Ste 200 Parker,CO80138	Physician Clinic
34	34 - AdventHealth Medical Group PrimaryUrogyne 9949 S Oswego St Ste 300 Parker,CO801343753	Physician Clinic
35	35 - AdventHealth Medical Group OBGYN at Louis 90 Health Park Dr Ste 260 Louisville,CO800279742	Physician Clinic
36	36 - AdventHealth Medical Group OBGYN at Louis 80 Health Park Dr Ste 250 Louisville,CO80027	Physician Clinic
37	37 - AdventHealth Hospice Care Porter 6061 S Willow Dr Ste 210 Greenwood Village,CO80111	Hospice Services
38	38 - AdventHealth Hospice Care Porter 6901 South Havana St Ste 250 Centennial,CO80111	Hospice Services
39	39 - AdventHealth Medical Group Family Medicine 19461 E Parker Square Dr Ste A Parker,CO80134	Physician Clinic
40	40 - AdventHealth Medical Group Gastroenterolog 9403 Crown Crest Blvd Ste 420 Parker,CO80138	Physician Clinic
41	41 - AdventHealth Medical Group Ridgegate OBGY 9695 S Yosemite St Ste 255B Lone Tree,CO801242890	Physician Clinic
42	42 - AdventHealth Medical Group Family Medicine 4345 Woodlands Blvd Ste 260 Castle Rock,CO80104	Physician Clinic
43	43 - AdventHealth Medical Group Internal Medici 9397 Crown Crest Blvd Ste 201 Parker,CO80138	Physician Clinic
44	44 - AdventHealth Medical Group Urogynecology a 7233 Church Ranch Blvd Ste B Westminster,CO800214094	Physician Clinic
45	45 - AdventHealth Medical Group Family Medicine 611 Mitchell Way Erie,CO805165443	Physician Clinic
46	46 - AdventHealth Medical Group OBGYN at Erie 611 Mitchell Way Ste 103 Erie,CO80516	Physician Clinic
47	47 - AdventHealth Medical Group Primary CareHi 5351 S Roslyn St Greenwood Village,CO80011	Physician Clinic
48	48 - AdventHealth Medical Group Family Medicine 425 S Cherry St Ste 410 GLENDALE,CO80246	Physician Clinic
49	49 - AdventHealth Medical Group Primary Care at 240 Elizabeth St Unit B Elizabeth,CO80107	Physician Clinic
50	50 - AdventHealth Medical Group Primary Care at 7233 Church Ranch Blvd Ste C Westminster,CO800214094	Physician Clinic
51	51 - AdventHealth Medical Group Gastroenterolog 7780 S Broadway Ste 260 Littleton,CO801222633	Physician Clinic
52	52 - AdventHealth Medical Group Primary Care at 511 Crossing Dr Ste 202 Lafayette,CO800262629	Physician Clinic
53	53 - AdventHealth Medical Group Primary Care at 4809 Argonne Ste 200 Denver,CO80249	Physician Clinic
54	54 - AdventHealth Medical Group Pain Management 2535 S Downing Ste 180F Denver,CO80210	Physician Clinic
55	55 - AdventHealth Medical Group Spine and Neuro 850 E Harvard Ave Ste 255 Denver,CO80210	Physician Clinic
56	56 - PAHS OnPoint Imaging LLC 9205 S Broadway Ste 101 Highlands Ranch,CO80129	Physician Clinic
57	57 - AdventHealth Medical Group Gynecologic Onc 2535 S Downing St Ste 430 Denver,CO80210	Physician Clinic
58	58 - AdventHealth Medical Group OBGYN at South 6069 S Southlands Parkway Suite B Aurora,CO80016	Physician Clinic
59	59 - Encompass Health Rehabilitation Hospital 1001 West Mineral Ave Littleton,CO80120	Rehabilitation Hospital
60	60 - PAHS OnPoint Urgent Care LLC 10120 E Dry Creek Rd Englewood,CO80112	Urgent Care Clinic
61	61 - PAHS OnPoint Urgent Care LLC 24300 E Smoky Hill Rd Aurora,CO80016	Urgent Care Clinic
62	62 - PAHS OnPoint Urgent Care LLC 9695 S Yosemite St Lone Tree,CO80124	Urgent Care Clinic
63	63 - AdventHealth Medical Group Colorado Joint 4028 Laramie Street Cheyenne,WY82001	Physician Clinic
64	64 - AdventHealth Transplant 1760 Prairie Ave Cheyenne,WY82009	Physician Clinic
65	65 - AdventHealth Transplant 1141 Wilkins Circle Casper,WY82601	Physician Clinic
66	66 - AdventHealth Transplant 640 Flormann Street Rapid City,SD57701	Physician Clinic
67	67 - AdventHealth Transplant Institute North 2900 12th Ave N Ste 400 Billings,MT59707	Physician Clinic
68	68 - AdventHealth Transplant Institute Billin 315 N 25th St Ste 21 Billings,MT59102	Physician Clinic
69	69 - Porter Hospice 5020 E Arapahoe Rd Centennial,CO80111	Hospice Services
70	70 - AdventHealth Medical Group Primary Care at 6081 S Quebec St Ste 100 Centennial,CO80111	Physician Clinic

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 6a:	The filing organization was a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) during its current tax year. During the current year, AHSSHC served as a parent organization to 33 tax-exempt 501(c)(3) hospital organizations and other subsidiary health care organizations that operated in 12 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 assessment and associated implementation strategy can be accessed on the filing organization's website.
Part I, Line 7:	Portercare Adventist Health System does not use a cost accounting system to determine the cost of charity care. The estimated cost of care is calculated as the ratio of each facility's total expenses to total gross revenue. Worksheet 2 was not used to develop the cost to charge ratio. There are no physician clinics included in subsidized health services.
Part II, Community Building Activities:	The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with providing education for the filing organization's staff physicians and employees. The filing organization's provision of these educational programs/activities to staff physicians and employees provides an opportunity for health care professionals to enhance their skills and expertise and keep up-to-date with the latest advancements in medical procedures and technology. In addition, training opportunities are often provided on-site at the filing organization's hospital facilities, thereby allowing for health care professionals to be more readily available to assist in meeting immediate patient care needs. Education and training provided to each facility's workforce is vital in assisting health care professionals directly involved in patient care with keeping abreast of the latest developments in their respective areas of expertise, learning possible new and innovative ways of delivering care to patients, and understanding the newest technologies available for the treatment of patients.
Part III, Line 2:	Portercare Adventist Health System (PAHS) uses the overall cost to gross charge ratio applicable to each facility to determine the costs in Part III Lines 2 and 3. PAHS automatically discounts all self pay patient accounts by 30% and also offers a prompt pay discount. This allowance is not included in the calculation of the cost of bad debts in instances where a patient does not pay his or her bill.
Part III, Line 3:	Portercare Adventist Health System does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. 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 24/7 emergency rooms providing care to all whom present. When a patient's arrival and/or admission to a 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 24/7 Emergency Departments that accept 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 Departments 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:	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 7-9. 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.
Part III, Line 9b:	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 each hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of each 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.
Supplemental Schedule to Schedule H, Part III, Section B, Line 8:	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: $ (54,695,085)- Difference in costing methodology: (32,700,603)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (133,769,655) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $ (221,165,343)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 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 VI, Line 2:	The filing organization conducts community health needs assessments (CHNA) every three years. Its 2021 CHNA was adopted by its governing board on November 17, 2022, the end of the Hospital's taxable year in which it conducted the CHNA. The Hospital's 2021 CHNA complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNA discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of its community.Such practices and processes involve the following:1. A hospital operating/community board 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 community; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's community.The hospitals provide several services and resources to the communities they serve beyond the prioritized needs specifically identified in the Community Needs Assessment. They sponsor wellness events such as breast feeding education, asthma screenings, and financially support wellness initiatives of cities and public schools. They also provide transportation for low income patients and housing at no cost or very low cost for the families of low income patients of the hospitals that are far from their residence. They also support, financially and through volunteerism, initiatives such as soup kitchens and Meals on Wheels to provide food and nutrition education to address hunger issues. Hospital staff also volunteer to serve as preceptors for students of local health professional programs and serve on boards of local community organizations that provide social services to populations in need.
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 each hospital facility's financial counselors are prominently and conspicuously posted on each filing organization's hospital facility's website. The websites indicate 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 each hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of each filing organization's hospital facility, 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 the 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. Each of the filing organization's hospital facility's financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility 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 facility's 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 facility's FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of the 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:	The filing organization operates five hospitals. Each hospital's community served is outlined below.Parker Adventist HospitalTo understand the profile of Parker Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Ethnicity: 17.3% Hispanic or Latino.Approximately 39.1% of the Hospital's patients during the tax year were Medicare patients, about 15.3% were Medicaid patients, about 3.0% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 68.7% of the hospital's in-patients were admitted through the hospital's Emergency Department.Littleton Adventist HospitalTo understand the profile of Littleton Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Ethnicity: 17.3% Hispanic or Latino.Approximately 51.4% of the Hospital's patients during the tax year were Medicare patients, about 12% were Medicaid patients, about 2.6% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 65.9% of the hospital's in-patients were admitted through the hospital's Emergency Department.Porter Adventist HospitalTo understand the profile of Porter Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 53.1% white, 10.4% black, 5.3% Asian, .5% Native American/Alaskan Native, .2% native Hawaiian/Pacific Islander, 27.3% some other race, and 3.1% multiple races. - Ethnicity: 27.1% Hispanic or Latino.Approximately 49.2% of the Hospital's patients during the tax year were Medicare patients, about 15.5% were Medicaid patients, about 4.2% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 54% of the hospital's in-patients were admitted through the hospital's Emergency Department.Castle Rock Adventist HospitalTo understand the profile of Castle Rock Adventist Health Campus's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 82% white, 1.3% black, 4.9% Asian, 0.3% Native American/Alaskan Native, 0.1% native Hawaiian/Pacific Islander, 9% some other race, and 2.4% multiple races.- Ethnicity: 8.9% Hispanic or Latino. Approximately 38.8% of the Hospital's patients during the tax year were Medicare patients, about 12.% were Medicaid patients, about 4.5% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 61.3% of the hospital's in-patients were admitted through the hospital's Emergency Department.Avista Adventist HospitalTo understand the profile of Avista Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 76.9% white, 1% black, 5.1% Asian, 0.4% Native American/Alaskan Native, 0.1% Native Hawaiian/Pacific Islander, 14.3% some other race, and 2.4% multiple races. - Ethnicity: 14.1% Hispanic or LatinoApproximately 38.1% of the Hospital's patients during the tax year were Medicare patients, about 14.6% were Medicaid patients, about 5.5% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 23.9% of the hospital's in-patients were admitted through the hospital's Emergency Department.
Part VI, Line 5:	The provision of community benefit is central to Portercare Adventist Health System'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 by caring for those who are ill and by nuturing the health of the people in our communities 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 $ 649,426 of benefit with respect to the faith-based and spiritual needs of its communities in conjunction with its operation of community hospitals. The filing organization also provides benefits to each of its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the filing organization expended $60,602,997 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 filing organization 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:	As previously noted, prior to August 1, 2023, to the filing organization was managed by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995, between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). The disaffiliation between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH) was effective August 1, 2023 leaving AHSSHC is the sole member and management company of the filing organization.Prior to Aug. 1, 2023: Portercare Adventist Health System is operated as part of Centura Health Corporation ("Centura"). Centura and its affiliated organizations are dedicated to extending the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Specifically, Centura has launched a system-wide strategic plan to improve the quality, consistency, availability, and affordability of health care to communities throughout Colorado. The three main components of this strategy are (1) to continue investing in technology advancements that improve the quality, costs, and coordination of care including the establishment of electronic health records linking our physicians, clinics, hospitals, long-term facilities and home care services; (2) providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health, growing the level of support and outreach provided to rural communities, and increasing access, affordability and quality of health care; and (3) coordinate and develop systems of care, looking to each facility and entity in Centura to share best practices and improve overall efficiency and communication system-wide from birth to home care.Effective Aug. 1, 2023: 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 50 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 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. The filing organization pays a management fee to AHSSHC for the services provided by AHSSHC. As a result, management fee expense reported by the filing 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 website of AdventHealth at www.adventhealth.com to learn more about the mission and operations of the filing organization.
Part VI, Line 7, Reports Filed With States	CO

Schedule H (Form 990) 2023

Additional Data

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- TIN:

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

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

2023

Open to Public
Inspection

Name of the organization
Portercare Adventist Health System

Employer identification number
84-0438224

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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	(h) Purpose of grant or assistance
(1) CLINICA CAMPESINA FAMILY HEALTH SERVICES 345 PLAZA COURT NORTH LAFAYETTE,CO80026	84-0743432	501(c)(3)	47,850	General Support
(2) Castle Rock Chamber of Commerce 420 Jerry St CASTLE ROCK,CO80104	84-0802658	501(c)(6)	6,000	General Support
(3) COMMUNITY FOOD SHARE INC 650 S TAYLOR AVE LOUISVILLE,CO80027	74-2227731	501(c)(3)	17,000	General Support
(4) DOCTORS CARE 609 W Littleton Blvd Suite 100 Littleton,CO80120	84-1150815	501(c)(3)	20,000	General Support
(5) Erie Chamber of Commerce 235 Wells St Erie,CO80516	84-1325423	501(c)(6)	10,510	General Support
(6) MILE HIGH ACADEMY Inc 1733 DAD CLARK DRIVE HIGHLANDS RANCH,CO80126	84-0525223	501(c)(3)	55,000	General Support
(7) Stronger Faster Boulder CO 1420 Pearl St Boulder,CO80302	84-2863972	501(c)(3)	13,000	General Support
(8) Rocky Mountain Adventist Healthcare Foundation 960 E Harvard Avenue Ste 230 Denver,CO80210	84-0745018	501(c)(3)	684,007	General Support
(9) The Arapahoe County School District No 6 5776 South Crocker Street Littleton,CO80120	84-6000862	Gov't	17,171	General Support
(10) Russell Westbrook Why Not You Foundation Inc 227 W Monroe St 5000 Chicago,IL60606	46-1322847	501(c)(3)	140,000	General Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

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) 2023

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .....

Yes

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? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Banko Peter Former Officer	(i) (ii)	0 ------------- 1,914,510	0 ------------- 2,583,661	0 ------------- 3,603,433	0 ------------- 847,002	0 ------------- 29,503	0 ------------- 8,978,109	0 ------------- 0
2Gaasch Andrew Treasurer/CFO (end 8/23)	(i) (ii)	0 ------------- 1,128,052	0 ------------- 1,135,433	0 ------------- 835,706	0 ------------- 228,657	0 ------------- 33,652	0 ------------- 3,361,500	0 ------------- 0
3Enderson Dan Sec/Group President/CFO (beg 8/23)	(i) (ii)	0 ------------- 833,256	0 ------------- 861,315	0 ------------- 1,321,491	0 ------------- 280,930	0 ------------- 30,250	0 ------------- 3,327,242	0 ------------- 0
4Rathbun Paul Director (end 8/23)	(i) (ii)	0 ------------- 1,347,228	0 ------------- 441,722	0 ------------- 866,950	0 ------------- 473,177	0 ------------- 30,816	0 ------------- 3,159,893	0 ------------- 150,000
5Banks David Director/Chairman (beg 11/23)	(i) (ii)	0 ------------- 1,427,724	0 ------------- 443,692	0 ------------- 333,935	0 ------------- 150,677	0 ------------- 29,784	0 ------------- 2,385,812	0 ------------- 150,000
6Randolph Karsten Director/Multi State CFO (beg 8/23)	(i) (ii)	0 ------------- 731,672	0 ------------- 168,601	0 ------------- 1,298,710	0 ------------- 137,475	0 ------------- 32,374	0 ------------- 2,368,832	0 ------------- 73,650
7Bacon Kenneth Dir/Chairman Multi State CEO (end 11	(i) (ii)	0 ------------- 1,284,422	0 ------------- 424,601	0 ------------- 61,906	0 ------------- 244,496	0 ------------- 29,241	0 ------------- 2,044,666	0 ------------- 0
8RajpalMD Sharad Surgeon-Neuro	(i) (ii)	1,668,892 ------------- 0	0 ------------- 0	3,651 ------------- 0	14,665 ------------- 0	35,142 ------------- 0	1,722,350 ------------- 0	0 ------------- 0
9Folkenberg Todd CEO Porter Adventist Hospital	(i) (ii)	0 ------------- 452,825	0 ------------- 305,921	0 ------------- 511,304	0 ------------- 113,126	0 ------------- 43,346	0 ------------- 1,426,522	0 ------------- 0
10Jennings MD Jason Surgeon-Orthopedic	(i) (ii)	1,096,075 ------------- 0	63,429 ------------- 0	3,842 ------------- 0	19,800 ------------- 0	32,635 ------------- 0	1,215,781 ------------- 0	0 ------------- 0
11Yang MD Charlie Surgeon-Orthopedic	(i) (ii)	997,820 ------------- 0	157,535 ------------- 0	3,566 ------------- 0	16,125 ------------- 0	32,236 ------------- 0	1,207,282 ------------- 0	0 ------------- 0
12Miner MD Todd Surgeon-Orthopedic	(i) (ii)	1,049,690 ------------- 0	52,906 ------------- 0	6,573 ------------- 0	26,049 ------------- 0	29,011 ------------- 0	1,164,229 ------------- 0	0 ------------- 0
13Goebel Michael CEO Parker Adventist Hospital	(i) (ii)	0 ------------- 461,855	0 ------------- 419,197	0 ------------- 120,699	0 ------------- 89,280	0 ------------- 33,198	0 ------------- 1,124,229	0 ------------- 0
14Ewell MD Nelson Surgeon-Neuro	(i) (ii)	1,006,659 ------------- 0	44,984 ------------- 0	4,343 ------------- 0	19,800 ------------- 0	33,060 ------------- 0	1,108,846 ------------- 0	0 ------------- 0
15Ordelheide Kris Director (beg 8/23)	(i) (ii)	0 ------------- 433,043	0 ------------- 481,317	0 ------------- 94,614	0 ------------- 87,780	0 ------------- 5,992	0 ------------- 1,102,746	0 ------------- 0
16Sendros Isaac Former Key Employee	(i) (ii)	0 ------------- 404,558	0 ------------- 156,655	0 ------------- 369,440	0 ------------- 87,437	0 ------------- 30,867	0 ------------- 1,048,957	0 ------------- 0
17Dodds Rick CEO Littleton Adventist Hospital	(i) (ii)	0 ------------- 443,673	0 ------------- 340,399	0 ------------- 126,867	0 ------------- 95,296	0 ------------- 34,121	0 ------------- 1,040,356	0 ------------- 0
18Spenst Brett Director/CEO (beg 8/23)	(i) (ii)	0 ------------- 583,228	0 ------------- 0	0 ------------- 373,532	0 ------------- 11,127	0 ------------- 24,720	0 ------------- 992,607	0 ------------- 0
19Pittman Jeremy CEO Castle Rock Adventist Hospital	(i) (ii)	0 ------------- 349,374	0 ------------- 212,442	0 ------------- 119,863	0 ------------- 86,888	0 ------------- 41,439	0 ------------- 810,006	0 ------------- 0
20McKinney Jillyan Former Key Employee	(i) (ii)	0 ------------- 512,879	0 ------------- 107,509	0 ------------- 27,518	0 ------------- 89,062	0 ------------- 32,452	0 ------------- 769,420	0 ------------- 0
21Fisher Jonathan Former Key Employee	(i) (ii)	0 ------------- 321,125	0 ------------- 45,997	0 ------------- 217,063	0 ------------- 67,527	0 ------------- 30,350	0 ------------- 682,062	0 ------------- 0
22Still Danae CFO Littleton Adventist Hospital	(i) (ii)	0 ------------- 258,726	0 ------------- 72,385	0 ------------- 189,376	0 ------------- 8,942	0 ------------- 42,598	0 ------------- 572,027	0 ------------- 0
23Travis Carol CFO Avista Adventist Hospital	(i) (ii)	0 ------------- 289,011	0 ------------- 84,400	0 ------------- 2,013	0 ------------- 26,287	0 ------------- 39,034	0 ------------- 440,745	0 ------------- 0
24Erickson Jonathan CFO Avista Adventist Hospital (beg 9	(i) (ii)	0 ------------- 241,741	0 ------------- 29,018	0 ------------- 129,266	0 ------------- 9,844	0 ------------- 28,086	0 ------------- 437,955	0 ------------- 0
25Ward Erin CFO Parker Adventist Hospital	(i) (ii)	0 ------------- 279,856	0 ------------- 78,194	0 ------------- 970	0 ------------- 6,594	0 ------------- 129	0 ------------- 365,743	0 ------------- 0
26Whitlock Andrew CFO Porter Adventist Hospital	(i) (ii)	0 ------------- 242,754	0 ------------- 52,640	0 ------------- 1,188	0 ------------- 6,820	0 ------------- 27,197	0 ------------- 330,599	0 ------------- 0
27Finch Kenneth CEO Avista Adventist Hospital	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 306,000	0 ------------- 0	0 ------------- 0	0 ------------- 306,000	0 ------------- 0
28Gal Matt CFO Castle Rock Adventist Hospital	(i) (ii)	0 ------------- 218,935	0 ------------- 64,709	0 ------------- 717	0 ------------- 6,929	0 ------------- 7,601	0 ------------- 298,891	0 ------------- 0

Schedule J (Form 990) 2023

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	Prior to August 1, 2023, members of the filing organization's top management officials were compensated by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). As such, the officers and key employees salaries were paid to them by CHC, a related organization, for services rendered in their capacity as key employees or officers of PAHS. However, effective August 1, 2023, AHSSHC and CSH disaffiliated, and management of the filing organization was transferred back to its sole member, AHSSHC. After disaffiliation, members of the filing organization's executive management team that hold the position of Vice-President or above were compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives 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. For this short year tax return, both parties (CHC and AHSSHC) compensated officer and key employees of the filing organization. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. 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 50 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 (15 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 45-55 individual executives). The filing organization's CEO, the Multi-State CEO and the Multi-State CFO for AdventHealth are members of the Board of Directors of the filing organization. These individuals 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: 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: Prior to the AHSSHC and CSH disaffiliation effective Aug 1, 2023, CHC provided a cash discretionary spending account was provided to eligible executives in the form of a car allowance of $750 per month to help offset business travel expense. After the disaffiliation, only occasional discretionary spending amounts were 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.
Part I, Line 3	As discussed in Part VI, Section B, Line 15, and in Line 1 above, the organization's top management officials' compensation was paid by Centura Health Corporation (CHC) prior to the disaffiliation on Aug 1, 2023 and after disaffiliation was paid by Adventist Health System Sunbelt Healthcare Corporation (ASHHSC). All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. The individual serving as the CEO of the filing organization was appointed effective Aug. 1, 2023 and is compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) (please see our response to Part I, Line 1a above regarding the disaffiliation). 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, Line 4b	Line 4b: As discussed in Line 1 above, the organization's top management officials' compensation was paid by Centura Health Corporation (CHC) prior to the disaffiliation on Aug 1, 2023 and after disaffiliation was paid by Adventist Health System Sunbelt Healthcare Corporation (ASHHSC). All officers and key employees' salaries and all associated benefits were paid for services rendered in their capacity as key employees or officers of the filing organization. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. CHC Benefit plans (prior to Aug 1, 2023): Senior executives on the filing organization's management team that hold the position of Senior Vice-President or Hospital CEO are eligible to participate in the CHC EXECU-FLEX Benefit Plan (the Plan). In recognition of the contribution that each executive makes to the success of CHC, CHC provides for participation in the Plan to the eligible executives. The purpose of the Plan is to offer an opportunity to elect from among a variety of supplemental benefits to individually tailor a benefits program appropriate to each executive's needs. The executive is provided with a Flex allowance equivalent to 10% of base salary to purchase selected benefits and to contribute into a deferred non-qualified supplemental executive retirement plan. The Plan provides for a five-year cliff-vesting schedule with respect to amounts accumulated in the executive's deferred compensation account. CHC contributes into these deferred compensation accounts semi-annually and amounts are subject to a substantial risk of forfeiture with active participation required at time of vesting. In addition, CHC provides a Pension Restoration Benefit (PRB) to restore qualified plan contributions lost on income in excess of the current federal maximum allowable compensation to a qualified plan. The PRB provides contributions by restoring the amount that would have been contributed to the executive's retirement savings plan for compensation in excess of the legislative limits. Benefit amounts are added to the participant's flex allowance each year based on their total compensation from the prior year. The following received contributions to a non-qualified plan for the calendar year 2023: CY Employer CY Employer CY SERP CY PRB SERP Contr. PRB Contr. Distrib. Distrib. Peter Banko 441,351 395,151 1,482,363 1,304,913 Andrew Gaasch 126,891 93,891 427,812 254,242 Daniel Enderson 123,625 90,625 587,997 438,305 Todd Folkenberg 54,183 21,183 278,355 138,265 Michael Goebel 55,365 22,365 0 0 Kris Ordelheide 53,891 23,389 0 0 Isaac Sendros 18,078 0 154,563 37,206 Rick Dodds 45,743 12,743 70,841 7,515 Jeremy Pittman 44,158 11,158 74,364 18,555 Jillyan McKinney 0 0 144,130 50,660
Schedule J, Line 4b:	AHSSHC benefit plans (effective Aug 1, 2023) 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 2023. 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 $330,000 in 2023 (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, Line 4b: continuation	Flex Plan Flex Plan SERP II SERP III SERP III Contr. Distr.* Contr./Distr. Contr. Distr.* -------------------------------------------------------------- Dan Enderson $ 0 $ 0 $ 0 $ 56,180 $ 0 Paul Rathbun $155,450 $132,564 $ 632,721 $ 0 $ 0 David Banks $155,450 $152,379 $ 90,424 $ 0 $ 0 Karsten Randolph $119,748 $ 74,817 $1,188,200 $ 0 $ 0 Kenneth Bacon $ 0 $ 0 $ 0 $237,896 $ 0 Todd Folkenberg $ 0 $ 0 $ 0 $ 27,260 $ 0 Michael Goebel $ 0 $ 0 $ 0 $ 26,792 $ 26,792 Isaac Sendros $ 0 $ 0 $ 0 $ 49,615 $ 0 Rick Dodds $ 0 $ 0 $ 0 $ 25,260 $ 0 Brett Spenst $ 0 $ 0 $ 0 $105,231 $105,231 Jeremy Pittman $ 0 $ 0 $ 0 $ 20,322 $ 0 Jillyan McKinney $ 0 $ 0 $ 0 $ 77,935 $ 0 Jonathan Fisher $ 0 $ 0 $ 0 $ 49,800 $ 0 Carol Travis $ 0 $ 0 $ 0 $ 17,135 $ 0 * Including Investment Earnings

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No




Total ............... $

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) 2023

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Ryan Folkenberg	Family of Key Employee	11,743	Employee Compensation		No
(2) Aaron Speegle	Family of Officer	129,528	Employee Compensation		No
(3) Chali Enderson	Family of Officer	41,167	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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

Return Reference	Explanation
Part V, Line 1a	As previously noted, prior to August 1, 2023, to the filing organization was managed by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995, between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). The disaffiliation between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH) was effective August 1, 2023 leaving AHSSHC is the sole member and management company of the filing organization. Prior to August 1, 2023: Pursuant to an Affiliation Agreement between Adventist Health System Sunbelt Healthcare Corporation and Common Spirit Health, Portercare Adventist Health System (the filing organization) is managed by Centura Health Corporation (CHC), a joint operating company. CHC is a Colorado, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). CHC has established a shared service center to centralize the Accounts Payable (A/P) functions. The facts and circumstances support a position that CHC, as a payor on behalf of its managed organizations in a shared service environment, will have sufficient management and oversight in connection with the managed organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). CHC will not merely be making payments at the direction of its managed organizations. Accordingly, CHC is considered the payor subject to the information reporting requirements of Section 6041. 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 CHC as the payor subject to the information reporting requirements of Section 6041. Effective after August 1, 2023: The parent corporation and sole top-tier member of Portercare Adventist Health System (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	Gary Thurber and John (Mic) Thurber - Family Relationship
Form 990, Part VI, Section A, line 4	Changes to Bylaws during current period: Prior to August 1, 2023, Portercare Adventist Health System (PAHS) was operated as part of a regional health care delivery network operated and managed by Centura Health Corporation (CHC). CHC was a joint operating company between Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) and Catholic Health Initiatives Colorado (CHIC). AHSSHC was and remains the sole member of PAHS and is a 501(c)(3) organization. AHSSHC operates a healthcare delivery system known as AdventHealth. PAHS operates five hospitals within the greater Denver area. Effective August 1, 2023, AHSSHC and CHIC disaffiliated. It was agreed that the parties would end their affiliation and the operation of PAHS and all other entities under CHC would no longer be operated under the management control of the joint operating company. Accordingly, the Bylaws of the filing organization were amended effective August 1, 2023, to reflect the changes resulting from this disaffiliation. The August 1, 2023 Bylaws were revised to effectuate the terms of the disaffiliation. Accordingly, all relevant sections of the previous Bylaws were amended to remove all references and authorities, including reserved powers, that were granted to the joint operating company and its board of directors. The revised Bylaws provide that the sole member, AHSSHC to power to appoint the board of directors, proving a minimum one and a maximum of ten (10) voting members of the Board of Directors. The revision also provides that the Board shall appoint a separate governing board to oversee the operations of each Hospital and be the body legally responsible for such Hospital and associated Health Care Facilities (each a "Community Board and collectively the "Community Boards"). The responsibilities of each Community Board shall include, but not be limited to, legal responsibility for compliance with applicable Medicare Conditions of Participation and the safety and quality of care, treatment and services offered by such Hospital and associated Health Care Facilities, as more fully described in the Operating Bylaws of such Hospital. Committees of the Board of Directors which have as their primary purpose the discussion of issues which affect the discharge of responsibilities of the Hospital medical staff shall include in the committee membership a representative of the medical staff. The Bylaws were also revised to update the powers reserved to the Member. Please see our response to Section VI, Part A, Line 7b for a complete listing of the powers reserved to the Member.
Form 990, Part VI, Section A, line 6	Portercare Adventist Health System (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	As previously noted, prior to August 1, 2023, to the filing organization was managed by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995, between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). The disaffiliation between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH) was effective August 1, 2023 leaving AHSSHC is the sole member and management company of the filing organization. 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 can be exercised by the board of directors or an authorized committee to the extent not prohibited by the Members bylaws, the Member's president or his/her designee. These reserved powers include: 6.1.1 To approve or disapprove the appointment, removal and compensation of the senior management of the Health Care Facilities, including without limitation, the chief executive officer, chief financial officer and any other executive level Officer deemed appropriate by the Member; 6.1.2 To approve or disapprove these Bylaws and amendments thereto, and any amendments (including a restatement) to the Articles; 6.1.3 To approve or disapprove material changes in the category of services offered by the Corporation; 6.1.4 To approve or disapprove capital expenditures in excess of ONE MILLION DOLLARS ($1,000,000), which action can be approved by specific authorization or as generally authorized in the Corporation's annual capital budget approved by the Member; 6.1.5 To approve or disapprove the sale, donation, or other transfer of real property in excess of ONE MILLION DOLLARS ($1,000,000) in each instance, which action can be approved by specific authorization or as generally authorized in the Corporation's annual operating and/or capital budgets approved by the Member; 6.1.6 The authority to require the Corporation's adherence to policies adopted by the Member; 6.1.7 The authority to set limits and terms for any and all types of financial transactions exceeding ONE HUNDRED THOUSAND DOLLARS ($100,000) for any single or related projects including, without limitation, borrowing of funds, any type of financing, any banking activities, accounts receivable securitization, sale of accounts receivable, letters of credit, credit lines, tax exempt and taxable debt programs and structures, any transactions permitted by the financial documents and financial structure of the Member and any of its affiliated organizations, and any other financing transactions not identified herein; 6.1.8 The authority to approve or disapprove the annual operating and capital budgets and strategic plans for the Corporation; 6.1.9 The authority to secure naming rights and to direct the placement of funds and capital and the making of gifts, sponsorships, donations, loans and transfers of funds or other assets by the Corporation in excess of ONE MILLION DOLLARS ($1,000,000), which action can be approved by specific authorization or as generally authorized in the Corporation's annual operating and/or capital budgets approved by the Member; 6.1.10 To approve or disapprove the sale, purchase, donation, or other conveyance of personal property with a value in excess of ONE MILLION DOLLARS ($1,000,000) not otherwise approved in the current capital or operating budgets, which action can be approved by specific authorization or as generally authorized in the Corporation's annual operating and/or capital budgets approved by the Member; 6.1.11 To approve or disapprove the implementation of non-traditional, non healthcare related activities; 6.1.12 To approve or disapprove performance/quality improvement, revenue cycle and case management programs; 6.1.13 To approve or disapprove the selection of the auditing firm retained to audit the books of the Corporation; 6.1.14 To approve or disapprove the election of the fiscal year of the Corporation; 6.1.15 To approve or disapprove the selection of the Corporation's group purchasing organization(s); 6.1.16 To approve or disapprove any joint venture or partnership in which the Corporation would be a member or partner; 6.1.17 To approve or disapprove the IT systems and other shared services used by the Corporation; 6.1.18 The authority to require the Corporation's adherence to the system-wide naming nomenclature and service standards adopted by the Member; 6.1.19 To set and enforce policies for physician compensation including commercial reasonableness and fair market value; and 6.1.20 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 Board Chairman, Board Finance Committee Chair, CEO and by the CFO prior to its filing with the IRS. The review conducted by the Board Chairman, Board Finance Committee Chair, CEO and the CFO 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	Prior to August 1, 2023, members of the filing organization's top management officials were compensated by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). As such, the officers and key employees salaries were paid to them by CHC, a related organization, for services rendered in their capacity as key employees or officers of PAHS. However, effective August 1, 2023, AHSSHC and CSH disaffiliated, and management of the filing organization was transferred back to its sole member, AHSSHC. After disaffiliation, 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. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives 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. For this short year tax return, both parties (CHC and AHSSHC) compensated officer and key employees of the filing organization. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations.
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 conflict of interest policy available to the public.
Part VII, Section A, Columns (E) & (F)	For those Board of Director members and officer(s) who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation.
Part VIII, Lines 7a, b and c:	The amounts shown in Part VIII, Line 7, column (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 Hlthcare Professionals: Program service expenses 66,231,240. Management and general expenses 0. Fundraising expenses 0. Total expenses 66,231,240. Professional Fees: Program service expenses 3,947,673. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,947,673. Purchased Medical Services: Program service expenses 3,383,766. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,383,766. Environmental Services: Program service expenses 3,269,308. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,269,308. Transcription Services: Program service expenses 69,375. Management and general expenses 0. Fundraising expenses 0. Total expenses 69,375. Recruiting: Program service expenses 5,792,438. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,792,438. Outsourced Food Services: Program service expenses 203,544. Management and general expenses 0. Fundraising expenses 0. Total expenses 203,544. Other Purchased Services: Program service expenses 59,477,205. Management and general expenses 0. Fundraising expenses 0. Total expenses 59,477,205. Management Fees: Program service expenses 0. Management and general expenses 18,624,270. Fundraising expenses 0. Total expenses 18,624,270. Billing and Collection Services: Program service expenses 0. Management and general expenses 2,375,594. Fundraising expenses 0. Total expenses 2,375,594. Management Fees JOA: Program service expenses 0. Management and general expenses 14,251,806. Fundraising expenses 0. Total expenses 14,251,806. AH Shared Services Fee: Program service expenses 0. Management and general expenses 6,429,456. Fundraising expenses 0. Total expenses 6,429,456.
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 to Tax-Exempt Parent -7,246,929. Transfer to/from Related Tax-Exempt Organizations -90,066,024. Prior Period Adjustment -4,699,708. Released from Restricted 103,857. Donated Property and Transfer from Related Tax-Exempt Foundation 3,313,266. Transfers from Restricted -103,856. Gifts 74,255. Transfer to Unrestricted 1,179,047.
Form 990, Part XII, Line 3b	Although the taxpayer is not required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, the taxpayer is part of a controlled group of organizations that comprise a consolidated financial statement audit. The controlled group's parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), a 501(c)(3) organization. The system of healthcare entities owned and controlled by AHSSHC is known as AdventHealth. For the year ended December 31, 2023, AdventHealth will file a consolidated Single Audit which will include all entities that are part of the controlled group.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Portercare Adventist Health System

Employer identification number

84-0438224

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) HealthFit Family Medicine LLC 9100 E Mineral Circle Centennial,CO80112 81-5310593	Medical Services - family practice (inactive)	CO	0	0	Portercare Adventist Health System
(2) HealthFit Medical Professionals LLC 9100 E Mineral Circle Centennial,CO80112 47-3561708	Medical Services - family practice (inactive)	CO	0	0	Portercare Adventist Health System
(3) HealthFit Wellness Professionals LLC 9100 E Mineral Circle Centennial,CO80112 81-5325418	Fitness Center (inactive)	CO	0	0	Portercare Adventist Health System

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?
(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	Yes	No
(1)AdventHealth Asheville Inc 100 Hospital Drive Hendersonville,NC28792 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 Inc 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 Palm Coast Parkway Inc 1 AdventHealth Way Palm Coast,FL32137 88-2288563	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(8)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
(9)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
(10)AdventHealth Primary Care Network Inc (630-123123) 900 Hope Way Altamonte Springs,FL32714 93-2208118	Future Operation of Physician Practices & Medical 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 9330 US Highway 301 S 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 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
(19)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
(20)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
(21)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
(22)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
(23)Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson,TX76028 74-2578952	Employee Leasing of Personnel to Affiliated Hospitals	TX	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(24)AHS Midwest Management Inc 500 Remington Blvd Bolingbrook,IL60440 36-3354567	Employee Leasing of Personnel to Supported Hospitals	IL	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(25)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
(26)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
(27)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
(28)Centura Health Corporation (71-73123) 9100 E Mineral Circle Centennial,CO80112 84-1335382	Joint Operating Company	CO	501(c)(3)				No
(29)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
(30)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
(31)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
(32)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
(33)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
(34)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
(35)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
(36)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
(37)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
(38)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
(39)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
(40)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
(41)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
(42)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
(43)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
(44)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
(45)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
(46)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
(47)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
(48)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
(49)Lake County Health Care Properties Inc 485 North Keller Road 250 Maitland,FL32751 81-3923985	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(50)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
(51)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
(52)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
(53)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
(54)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
(55)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
(56)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
(57)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
(58)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
(59)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
(60)PAHS Service Corporation (49 - 123123) 6061 S Willow Drive Greenwood Village,CO80111 92-3398616	Employee Leasing of Personnel to Related Hospitals	CO	501(c)(3)	Line 12c, III-FI	Portercare Adventist Health System	Yes
(61)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
(62)Portercare Adventist Health System 6061 S Willow Drive Greenwood Village,CO80111 84-0438224	Operation of Hospitals & Related Services	CO	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(63)Princeton Homecare Services LLC 602 Courtland Street 310 Orlando,FL32804 81-4196648	Home Health Care Services	FL	501(c)(3)	Line 10	Princeton Prof Services Inc	Yes
(64)Princeton Professional Services Inc 601 E Rollins Street Orlando,FL32803 59-1191045	Provision of Healthcare Services	FL	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes
(65)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
(66)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
(67)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
(68)Rocky Mountain Adventist Hlthcare Foundation 950 E Harvard Avenue Ste 230 Denver,CO80210 84-0745018	Fund-raising for Tax-exempt hospital	CO	501(c)(3)	Line 7	Portercare Adventist Health System		No
(69)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
(70)San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos,TX78666 20-5782224	Inactive - In wind down	TX	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes
(71)Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland,FL32751 81-3914908	Inactive - In wind down	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes
(72)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
(73)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
(74)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
(75)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
(76)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
(77)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
(78)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
(79)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
(80)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
(81)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
(82)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
(83)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
(84)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
(85)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
(86)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 Services Inc	Yes
(87)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
(88)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) 2023

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) AdventHealth Surgery Center Daytona Beach LLC 103 Memorial Medical Pkwy Ste 300 Daytona Beach,FL32117 92-2967648	Surgery Center	FL	N/A					No			No
(2) AdventHealth Surgery Center Innovation Tower LLC 265 E Rollins Street Orlando,FL32804 88-2744377	Surgery Center	FL	N/A					No			No
(3) Fletcher Hospital Surgical Ventures LLC 9131 Anson Way Ste 304 Raleigh,NC27615 86-1482646	Indirect Interest in Surgery Center	NC	N/A					No			No
(4) Florida Hospital DMERT LLC 500 Winderley Place Ste 324 Maitland,FL32751 20-2392253	Medical Equipment	FL	N/A					No		Yes
(5) Florida Hospital Home Infusion LLP 500 Winderley Place Ste 226 Maitland,FL32751 59-3142824	Home Infusion Services	FL	N/A					No		Yes
(6) Functional Neurosurgical Ambulatory Surgery Ctr LLC 11 W Dry Creek Circle 120 Littleton,CO80120 46-4426708	Surgery Center	CO	Portercare Adventist Health System	Related				No			No	51.000 %
(7) M&O Orlando MOB I LLC 1125 Sanctuary Parkway Ste 410 Alpharetta,GA30009 84-4259138	Operation of Medical Office Building	DE	N/A					No			No
(8) OnPoint OBGYN LLC 7780 S Broadway 280 Littleton,CO80122 87-3522453	Healthcare Services	CO	Portercare Adventist Health System	Related	100,189	694,223		No			No	51.000 %
(9) Orange City Surgical LLC 1053 Medical Center Drive Ste 201 Orange City,FL32763 20-8105013	Surgery Center	FL	N/A					No			No
(10) PAHS OnPoint Imaging LLC 9205 S Broadway Highlands Ranch,CO80129 83-3275105	Imaging Center	CO	Portercare Adventist Health System	Related	400,908	57,771		No			No	51.000 %
(11) PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial,CO80112 83-2465331	Urgent Care Center	CO	Portercare Adventist Health System	Related	-1,100,998	6,151,002		No			No	54.000 %
(12) Surgery Center of Rome LP 501 Redmond Road NW Rome,GA30165 20-0390305	Surgery Center	GA	N/A					No			No
(13) SCA - Alliance LLC 569 Brookwood Village Ste 901 Birmingham,AL35209 47-1807383	Indirect Interest in Surgery Center	DE	N/A					No			No
(14) SCA-Central Florida LLC 569 Brookwood Village Ste 901 Birmingham,AL35209 47-1535510	Indirect Interest in Surgery Center	DE	N/A					No			No
(15) The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam,KS66204 82-3025378	Surgery Center	KS	N/A					No			No
(16) Urgent Care Centers of Brevard County LLC 2600 Westhall Lane Ste 200 Maitland,FL32751 84-4261523	Urgent Care Centers	FL	N/A					No		Yes

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?
(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	Yes	No
(1) AdventHealth at Overland Park-College MOB Condominium Assoc 9119 W 74th Street Ste 260 Merriam,KS66204 87-4353752	Condo Association	KS	N/A	C				Yes
(2) AdventHealth City Center North Owners' Assoc Inc (65-123123) 9119 W 74th Street Ste 260 Merriam,KS66204 99-1471046	Maintenance Association	KS	N/A	C				Yes
(3) AdventHealth Primary Care Inc fka AH North Polk Inc 900 Hope Way Altamonte Springs,FL32714 59-3231322	Inactive	FL	N/A	C				Yes
(4) AdventHealth Value Based Bundle Management LLC 2600 Lucien Way Maitland,FL32751 87-3487910	Medical Contracting and Billing	FL	N/A	C				Yes
(5) Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-2855792	Condo Association	FL	N/A	C				Yes
(6) Apopka Medical Plaza Condominium Assoc Inc (11-123123) 601 East Rollins Street Orlando,FL32803 59-3000857	Condo Association	FL	N/A	C				Yes
(7) Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs,FL32714 38-1359189	Inactive	MI	N/A	C				Yes
(8) Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast,FL32164 26-2158309	Condo Association	FL	N/A	C				Yes
(9) Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando,FL32803 82-1748255	Condo Association	FL	N/A	C				Yes
(10) Florida Hospital Healthcare System Inc 2600 Lucien Way Maitland,FL32751 59-3215680	PHSO / CIN	FL	N/A	C				Yes
(11) Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-2855791	Condo Association	FL	N/A	C				Yes
(12) Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee,FL34741 59-3539564	Condo Association	FL	N/A	C				Yes
(13) Midwest Management Services Inc 9100 West 74th Street Shawnee Mission,KS66204 48-0901551	Inactive	KS	N/A	C				Yes
(14) North American Health Services Inc & Sub 900 Hope Way Altamonte Springs,FL32714 62-1041820	Holding Co.	TN	N/A	C				Yes
(15) 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
(16) Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher,NC28732 03-0380531	Condo Association	NC	N/A	C				Yes
(17) Park Ridge Condominium #1 Unit Owners Association Inc 1 Park Place Naples Road Fletcher,NC28732 01-0584623	Condo Association	NC	N/A	C				Yes
(18) Redmond Park Health Services Inc 501 Redmond Rd NW Rome,GA30165 62-1330078	Holding Company	GA	N/A	C				Yes
(19) Surgicare of Rome Inc 501 Redmond Rd NW Rome,GA30165 20-0376307	Holding Company	GA	N/A	C				Yes
(20) The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland,FL32751 59-3414055	Real Estate Rental	FL	N/A	C				Yes
(21) Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando,FL32803 45-2228478	Condo Association	FL	N/A	C				Yes

Schedule R (Form 990) 2023

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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) Adventist Health System Sunbelt Healthcare Corporation	B	7,246,929	Amount Given
(2) Adventist Health System Sunbelt Healthcare Corporation	M	6,230,158	% of Facility's Operating Expense
(3) Adventist Health System Sunbelt Healthcare Corporation	P	9,345,277	Cost
(4) Adventist Health System Sunbelt Healthcare Corpo dba AH Info Technology	M	7,516,139	% of Facility's Operating Expense
(5) Adventist Health System Sunbelt Healthcare Corpo - Shared Services	M	3,214,728	% of Facility's Operating Expense
(6) Rocky Mountain Adventist Healthcare Foundation	B	684,007	Amount Given
(7) Rocky Mountain Adventist Healthcare Foundation	C	4,665,190	Amount Received
(8) PAHS Service Corporation	P	199,743,830	Cost

Schedule R (Form 990) 2023

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: The provision of medical care to the community through the operation of five hospitals totaling 979 beds.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	2
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	492
6	Total number of volunteers (estimate if necessary) .............	6	566
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,851,656
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	352,291	0
9	Program service revenue (Part VIII, line 2g) .........	1,514,190,632	723,753,234
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	11,152,807	4,386,068
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	10,341,453	3,036,220
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,536,037,183	731,175,522
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,386,590	1,097,553
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)	571,928,748	327,817,288
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	894,231,813	495,504,716
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,468,547,151	824,419,557
19	Revenue less expenses. Subtract line 18 from line 12.......	67,490,032	-93,244,035
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,992,859,331	1,847,895,763
21	Total liabilities (Part X, line 26).............	499,722,731	526,009,951
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,493,136,600	1,321,885,812

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 744,471,649 including grants of $ 1,097,553 ) (Revenue $ 724,937,798 )
	Operation of 5 acute care hospitals with 17,434 patient admissions, 71,489 patient days and 684,498 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 expenses744,471,649

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	6,159,965	33,619,786	4,050,626

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a - 1f:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	Net Patient Revenue	622110	717,621,044	717,621,044
b	Cafeteria Revenue	622110	1,927,224	1,927,224
c	Pharmacy Revenue	622110	1,798,430	81,218	1,717,212
d	Medical Office Building Rentals	622110	1,619,630	1,485,186	134,444
e	Gift Shop Revenue	622110	129,048	129,048
f	All other program service revenue.		657,858	657,858
g	Total. Add lines 2a–2f .....		723,753,234

3 Investment income (including dividends, interest, and othersimilar amounts) ......			7,218,113			7,218,113
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	54,576
b	Less: rental expenses	6b	1,600
c	Rental income or (loss)	6c	52,976
d	Net rental income or (loss).......			52,976	52,976
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		543,497
b	Less: cost or other basis and sales expenses	7b	3,375,542	0
c	Gain or (loss)	7c	-3,375,542	543,497
d	Net gain or (loss).........			-2,832,045			-2,832,045
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..
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..
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..

Business Code
11a	Equity Earnings Subsidiaries		622110	2,983,244	2,983,244
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,983,244
12	Total revenue. See instructions.....			731,175,522	724,937,798	1,851,656	4,386,068

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	553,111	553,111
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. .............	544,442	544,442
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	4,580,643		4,580,643
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........	242,298,217	242,298,217
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	10,381,707	10,249,226	132,481
9	Other employee benefits .......	54,149,748	53,217,631	932,117
10	Payroll taxes ...........	16,406,973	16,197,604	209,369
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	60,935		60,935
c	Accounting ...........	199,139		199,139
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,176,610		1,176,610
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	184,055,675	142,374,549	41,681,126
12	Advertising and promotion ....	8,653,998		8,653,998
13	Office expenses .......	19,261,084	17,122,250	2,138,834
14	Information technology ......	1,180,581	1,113,105	67,476
15	Royalties ..
16	Occupancy ...........	18,920,264	18,920,264
17	Travel ............	424,540	9,880	414,660
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	488,791		488,791
20	Interest ...........	4,499,906	4,499,906
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	41,950,229	41,950,229
23	Insurance ...	3,834,923	3,714,166	120,757
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	135,721,257	133,693,552	2,027,705
b	State Assessment	43,909,214	43,909,214
c	Impairment Loss	14,811,026		14,811,026
d	Repairs and Maintenance	14,028,240	14,028,240
e	All other expenses	2,328,304	76,063	2,252,241
25	Total functional expenses. Add lines 1 through 24e	824,419,557	744,471,649	79,947,908	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,003,815	1	23,743
2	Savings and temporary cash investments .........			124,258,532	2	614,315,338
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			239,805,770	4	218,899,281
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 ...........			3,766,019	7	2,559,574
8	Inventories for sale or use ............			38,911,389	8	35,182,586
9	Prepaid expenses and deferred charges ......			17,645,096	9	12,183,911
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,770,493,121
b	Less: accumulated depreciation	10b	1,015,064,869	705,693,683	10c	755,428,252
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			448,880,136	12	68,550,956
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			58,030,231	14	52,844,662
15	Other assets. See Part IV, line 11 ...........			354,864,660	15	87,907,460
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,992,859,331	16	1,847,895,763

17	Accounts payable and accrued expenses .....	101,057,961	17	112,190,803
18	Grants payable ...		18
19	Deferred revenue .........	916,807	19
20	Tax-exempt bond liabilities .........		20
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	397,747,963	25	413,819,148
26	Total liabilities. Add lines 17 through 25..	499,722,731	26	526,009,951

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,493,032,744	27	1,320,528,654
28	Net assets with donor restrictions ...........	103,856	28	1,357,158
	Organizations that do not follow FASB ASC 958, check here 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 ...........	1,493,136,600	32	1,321,885,812
33	Total liabilities and net assets/fund balances ........	1,992,859,331	33	1,847,895,763

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No