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)
(1) Allen Kimberly...................................................................... Director (Beg 12/23)	0.30 ................. 1.40	X	10,606
(2) Bigalke John T...................................................................... Director	0.40 ................. 1.70	X	42,605
(3) Brooks Stephen...................................................................... Director (End 9/23)	0.30 ................. 1.20	X	5,806
(4) Carlson Ronald...................................................................... Director (Beg 9/23)	0.30 ................. 2.10	X	6,128
(5) Cherry MD Robert A...................................................................... Director	0.40 ................. 1.50	X	29,105
(6) Craig Carlos J...................................................................... Dir./Vice Chair/Secretary	0.80 ................. 3.20	X	6,181
(7) Davidson James R...................................................................... Director (Beg 9/23)	0.50 ................. 2.50	X	6,166
(8) Denslow Kenneth...................................................................... Dir./Vice Chair	0.80 ................. 3.30	X	6,181
(9) Devore Susan D...................................................................... Director	0.30 ................. 1.40	X	29,606
(10) Freedman David...................................................................... Director (End 9/23)	0.60 ................. 3.00	X	6,166
(11) Freese Decker Christina...................................................................... Director (Beg 3/23)	0.30 ................. 1.40	X	18,606
(12) Gabriel Garth...................................................................... Director	0.30 ................. 1.10	X	5,806
(13) Grys DMin MD John...................................................................... Director	0.30 ................. 1.10	X	5,806
(14) Johnson Tidjani Michelle...................................................................... Director (End 12/23)	0.30 ................. 1.40	X	25,606
(15) Machado Allan...................................................................... Director (End 9/23)	0.30 ................. 1.60	X	6,066
(16) Morel Jr D Min Hubert J...................................................................... Director (End 9/23)	0.50 ................. 2.00	X	5,806
(17) Morgan William H...................................................................... Director	0.30 ................. 1.40	X	0

(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
(18) Page John M........................................................................ Director (Beg 9/23)	0.60 .......................3.00	X					0	5,806	0
(19) Patterson Ana........................................................................ Director (Beg 9/23)	0.30 .......................1.10	X					0	5,806	0
(20) Ramirez Elden........................................................................ Director (Beg 9/23)	0.50 .......................2.00	X					0	5,806	0
(21) Rustad Gary........................................................................ Director	0.30 .......................1.60	X					0	6,306	0
(22) Sauder PhD Vinita........................................................................ Director	0.30 .......................1.10	X					0	5,806	0
(23) Scott Glynn CW........................................................................ Director (End 9/23)	0.60 .......................2.50	X					0	5,806	0
(24) Shaw EdD Kenneth........................................................................ Director (End 9/23)	0.30 .......................1.60	X					0	6,066	0
(25) Shaw Terry D........................................................................ Dir/President/AdventHealth CEO	1.00 .......................50.00	X	X				0	5,008,968	1,335,139
(26) Smith DMin PhD Ron C........................................................................ Director/Chairperson	0.80 .......................4.30	X					0	11,541	0
(27) Thurber Gary F........................................................................ Director/Chairperson	0.80 .......................4.30	X					0	6,503	0
(28) Tikker Blair........................................................................ Director	0.30 .......................1.40	X					0	29,606	0
(29) VandeVere David........................................................................ Director (Beg 9/23)	0.60 .......................3.50	X					0	6,128	0
(30) Werner Thomas L........................................................................ Director	0.30 .......................2.10	X					0	6,835	0
(31) Haffner PhD Randall........................................................................ Group CEO FL & Clinical	1.00 .......................50.00		X				0	2,445,711	205,401
(32) Rathbun Paul C........................................................................ AdventHealth CFO	1.00 .......................50.00		X				0	2,658,136	503,993
(33) Adams Brian........................................................................ CEO AH Central FL Division	50.00 .......................1.00			X			0	1,225,857	183,603
(34) Deininger Robert........................................................................ CEO AH Central FL Market	50.00 .......................0.00			X			0	897,194	139,020
(35) Edris Tricia........................................................................ Chief Innovation & Partnership Off.	50.00 .......................0.00			X			0	820,052	106,072
(36) Finkler MD Neil........................................................................ Chief Clncl Off. AH Central FL (End 7/23)	50.00 .......................0.00			X			0	838,204	40,818
(37) Goodman Todd........................................................................ Group CFO FL & Clinical	1.00 .......................50.00			X			0	1,595,485	187,885
(38) Harcombe Douglas........................................................................ CEO AH South FL Market	50.00 .......................0.00			X			0	808,582	128,222
(39) Herrera MD Victor........................................................................ Chief Clinical Off. AH Central FL Div.	50.00 .......................0.00			X			0	679,252	153,303
(40) Hilliard Douglas........................................................................ CFO AH Central FL Division	50.00 .......................0.00			X			0	967,544	131,368
(41) Jimenez Kristin........................................................................ Chief Strategy Officer, AH Central FL	50.00 .......................0.00			X			0	674,834	101,645
(42) Johnson Linnette........................................................................ Chief Clinical Operations Off. AH Central FL	50.00 .......................0.00			X			0	603,590	115,147
(43) Mckinney Jillyan........................................................................ CEO, AHMG & Ambulatory Serv. Central FL Div.	50.00 .......................0.00			X			0	647,906	121,514
(44) Moorhead Sheryl........................................................................ Chief People Off. AH Central FL Div.	50.00 .......................0.00			X			0	805,412	26,972
(45) Stankiewicz Catherine........................................................................ CNO AH Central FL Division	50.00 .......................0.00			X			0	563,768	89,519
(46) Thompson Michael........................................................................ CEO IHS Central FL Div-South Region	50.00 .......................0.00			X			0	1,343,101	144,054
(47) Vargas Karilynn........................................................................ CEO AH NW Market Central FL	50.00 .......................0.00			X			0	652,279	103,484
(48) Bellam MD Naveen........................................................................ Physician-Cardiologist/Transplant	75.00 .......................0.00				X		1,025,509	0	53,541
(49) Bogar MD Linda........................................................................ Physician - Heart Transplant	75.00 .......................0.00				X		1,069,030	0	46,687
(50) Davis JrMD Robert Duane........................................................................ Physician/Medical Director	50.00 .......................0.00				X		2,611,260	0	25,398
(51) Silvestry MD Scott........................................................................ Phy/Dir AH Thoracic Transplant	85.00 .......................0.00				X		2,155,348	0	49,818
(52) Zeeshan MD Ahmad........................................................................ Physician - Heart Transplant	85.00 .......................0.00				X		1,120,901	0	37,268
(53) Bradley Kenneth W........................................................................ Former Key Employee	0.00 .......................50.00					X	0	204,129	27,352
(54) Cook Timothy........................................................................ Former Key Employee	0.00 .......................50.00					X	0	748,120	111,566
(55) Moorhead MD David........................................................................ Former Key Employee	0.00 .......................50.00					X	0	1,879,026	27,212
(56) Owen Terry R........................................................................ Former Key Employee	0.00 .......................0.00					X	0	140,310	0
(57) Spenst Brett........................................................................ Former Key Employee	0.00 .......................50.00					X	0	956,760	35,847
(58) Villanueva Jeffrey........................................................................ Former Key Employee	50.00 .......................0.00					X	0	829,625	112,410
(59) Wandersleben Jennifer........................................................................ Former Key Employee	0.00 .......................50.00					X	0	1,220,343	161,468
(60) Zbaraschuk Amy........................................................................ Former Key Employee	40.00 .......................10.00					X	0	1,515,552	111,230

(A) Name and business address	(B) Description of services	(C) Compensation
Brasfield & Gorrie LLC 2999 Circle 75 Parkway Ste 100 Atlanta,GA30339	Construction Services	40,491,565
AMN Healthcare Inc 8840 Cypress Waters Blvd Ste 300 Dallas,TX75019	Healthcare Staffing	29,010,607
Brown Parker & Demarinis Advertising Inc PO Box 932011 Atlanta,GA31193	Marketing Services	17,131,924
AYA Healthcare Inc PO Box 123519 Dept 3519 Dallas,TX75312	Healthcare Staffing	16,560,037
Rothman Orthopaedics of Florida PLLC 925 Chestnut Street 5th Floor Philadelphia,PA19107	Medical Services	15,720,266
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 606

- 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.
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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

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 Adventist Health SystemSunbelt Inc

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 Adventist Health SystemSunbelt Inc		Employer identification number 59-1479658

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization Adventist Health SystemSunbelt Inc			Employer identification number 59-1479658
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ 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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I-A

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

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

114,221

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

114,221

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 1:	The corporation paid dues to the American Hospital Association and the Florida Hospital Association who use a portion of the dues to conduct lobbying activities.

Schedule C (Form 990) 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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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 ....	33,020,094	24,054,814	21,835,332	21,191,508	20,471,913
b	Contributions ...	509,929	372,177		50,000	50,000
c	Net investment earnings, gains, and losses	750,734	1,470,505	1,243,055	1,226,267	1,196,289
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,909,084	1,667,805	73,573	632,443	526,694
f	Administrative expenses ....
g	End of year balance ......	32,371,673	24,229,691	23,004,814	21,835,332	21,191,508

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

Board designated or quasi-endowment right arrow

88.350 %

Permanent endowment right arrow

11.650 %

Term endowment right arrow

0 %

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)

Yes

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

Yes

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 .....	313,518,141		313,518,141
b	Buildings ....	2,421,586,744	936,467,772	1,485,118,972
c	Leasehold improvements
d	Equipment ....	3,362,158,260	2,139,027,635	1,223,130,625
e	Other .....	290,074,778	69,006,794	221,067,984
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				3,242,835,722

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)Due From Related/Affiliated Entities				95,640,837
(2)Funds Held in Trust				-394,465
(3)Long-term Investments				572,731,600
(4)Other Current Receivables				289,345,740
(5)Other Non-Current Assets				412,240,149
(6)Receivable - Interco Alloc of Tax-Exempt Bond Proceeds				1,870,213,873
(7)Receivable from Third Party				333,796,424
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				3,573,574,158

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/Affiliated Entities	183,847,261
Notes and Loans Payable	24,404
Other Current Liabilities	140,570,622
Other Non-Current Liabilities	231,049,661
Payable to Third Party	106,168,819




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	661,660,767
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:

All endowment funds are held by related 501(c)(3) exempt foundations. These endowment funds have been established for a variety of purposes in support of related tax-exempt hospitals. All of the foundation's permanently restricted endowment funds are required to be retained permanently either by explicit donor stipulation or by the Florida Uniform Prudent Management of Institutional Funds Act. Part V, Columns (b), (c), and (d) - Explanation for Change from 2022 Reporting: The endowment funds of the filing organization are held in a related Foundation. The presentation for the prior three years has been adjusted to agree to the endowment footnote in the Foundation's audited financial statements for those years. The following explanations represent adjustments made in the Foundation's audit for the years in question. Part V, line 1a, column (a) Current year - Explanation for change in opening balance: During 2023, it was determined that a board-designated fund previously excluded, should be accounted for as an Endowment. Due to this change in reporting, the additional amount of $8,790,403 was included in the opening balance for 2023. Part V, line 1a, column (b) prior year - Explanation for change in opening balance: During 2022, it was determined that a new Endowment in the amount of $1,050,000 was received in 2021 and should be included in the opening balance for 2022.

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
Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

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

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		(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	Grantmaking		1,107,339
	Central America and the Caribbean	Meetings		4,748
	Central America and the Caribbean	Program Services	Supplies and resources	15,427
	East Asia and the Pacific	Grantmaking		212,807
	East Asia and the Pacific	Meetings		11,458
	East Asia and the Pacific	Program Services	Supplies and resources	13,359
	Europe (including Iceland and Greenland)	Grantmaking		500
	Europe (including Iceland and Greenland)	Meetings		9,533
	Middle East and North Africa	Grantmaking		22,225
	North America (which includes Canada and Mexico, but not the U.S.)	Grantmaking		94,277
	North America (which includes Canada and Mexico, but not the U.S.)	Program Services	Transportation Expenses	10,800
	Russia and Neighboring States	Grantmaking		68,042
	South America	Grantmaking		360,021
	South America	Meetings		2,315
	South America	Program Services	Transportation Expenses	15,804
	South Asia	Grantmaking		50,000
	Sub-Saharan Africa	Grantmaking		191,148
	Sub-Saharan Africa	Program Services	Supplies and resources	1,150
3a	Sub-total ....			1,375,171
b	Total from continuation sheets to Part I ...			815,782
c	Totals (add lines 3a and 3b)			2,190,953

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.

(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)
Russia and Neighboring States	General Support	68,042	Electronic Funds	0		Book
East Asia and the Pacific	General Support/Medical Supplies or Equipment	82,696	Electronic Funds	130,111	Medical Supplies/ Equipment	Book/FMV
Central America and the Caribbean	General Support/Medical Supplies or Equipment	41,860	Electronic Funds	315,065	Medical Supplies/ Equipment	Book/FMV
Central America and the Caribbean	Medical Supplies or Equipment	0		6,230	Medical Supplies	FMV
South America	General Support	77,500	Electronic Funds	0		Book
South America	General Support/Medical Supplies or Equipment	48,277	Electronic Funds	7,000	Medical Equipment	Book/FMV
Central America and the Caribbean	Medical Supplies or Equipment	0		7,950	Medical Equipment	FMV
Central America and the Caribbean	General Support/Medical Supplies or Equipment	67,811	Electronic Funds	39,308	Medical Supplies	Book/FMV
South America	General Support/Medical Supplies or Equipment	44,400	Electronic Funds	3,200	Medical Equipment	Book/FMV
South America	General Support/Medical Supplies or Equipment	50,000	Electronic Funds	68,922	Medical Supplies/ Equipment	Book/FMV
Central America and the Caribbean	Medical Supplies or Equipment	0		15,250	Medical Supplies	FMV
Sub-Saharan Africa	Medical Supplies or Equipment	0		12,849	Medical Supplies	FMV
South America	Medical Supplies or Equipment	0		31,393	Medical Supplies/ Equipment	FMV
Central America and the Caribbean	General Support	330,615	Electronic Funds	0		Book
North America (which includes Canada and Mexico, but not the U.S.)	Medical Supplies or Equipment	0		16,388	Medical Supplies/ Equipment	FMV
Central America and the Caribbean	General Support/Medical Supplies or Equipment	108,410	Electronic Funds	23,928	Medical Supplies/ Equipment	Book/FMV
North America (which includes Canada and Mexico, but not the U.S.)	General Support	9,040	Electronic Funds	0		Book
South America	Medical Supplies or Equipment	0		11,000	Medical Supplies	FMV
Central America and the Caribbean	Medical Supplies or Equipment	0		19,175	Medical Supplies	FMV
Sub-Saharan Africa	General Support	154,450	Electronic Funds	0		Book
North America (which includes Canada and Mexico, but not the U.S.)	Medical Supplies or Equipment	0		67,475	Medical Supplies	FMV
Sub-Saharan Africa	Medical Supplies or Equipment	0		9,700	Medical Supplies	FMV
Sub-Saharan Africa	Medical Supplies or Equipment	0		7,306	Medical Supplies	FMV
Sub-Saharan Africa	Medical Supplies or Equipment	0		5,343	Medical Supplies	FMV
Central America and the Caribbean	Medical Supplies or Equipment	0		114,700	Medical Equipment	FMV
South Asia	General Support	50,000	Electronic Funds	0		Book
Middle East and North Africa	Medical Supplies or Equipment	0		21,400	Medical Supplies	FMV
South America	Medical Supplies or Equipment	0		12,450	Medical Equipment	FMV
Central America and the Caribbean	Medical Supplies or Equipment	0		5,585	Medical Supplies	FMV
Central America and the Caribbean	Medical Supplies or Equipment	0		5,327	Medical Supplies	FMV

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 .......	30
3	Enter total number of other organizations or entities .......................	0

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 generally non-cash donations of medical equipment and supplies to assist foreign health care providers in fulfilling their mission of providing health care services to the populations they serve. The foreign health care providers are often hospitals and/or clinics operated and/or sponsored by or affiliated with the Seventh-Day Adventist Church. The foreign hospitals/clinics may be located in remote and/or underserved villages and townships of developing countries. Grants are typically made to other U.S. charitable organizations or foreign entities recognized as charitable by the foreign country in which they are located. As a result of the nature of the grants as non-cash medical equipment and supplies and the fact that most grants are made indirectly through other U.S. or foreign charitable organizations, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States.

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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

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 %

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

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) . . .	218,883,841		218,883,841	3.490 %
b	Medicaid (from Worksheet 3, column a) . . . . .	981,296,340	702,269,573	279,026,767	4.440 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	1,200,180,181	702,269,573	497,910,608	7.930 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	60,899,072	11,930	60,887,142	0.970 %
f	Health professions education (from Worksheet 5) . . .	56,737,855	11,390,938	45,346,917	0.720 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	8,581,673	6,601,287	1,980,386	0.030 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	29,554,878		29,554,878	0.470 %
j	Total. Other Benefits . .	155,773,478	18,004,155	137,769,323	2.190 %
k	Total. Add lines 7d and 7j .	1,355,953,659	720,273,728	635,679,931	10.120 %

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			36,303,645	15,667,990	20,635,655	0.330 %
8	Workforce development			0	0
9	Other			356,364		356,364	0.010 %
10	Total			36,660,009	15,667,990	20,992,019	0.340 %

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. ......

211,900,425

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. ......

36,225,619

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).....

815,404,593

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

965,118,427

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

-149,713,834

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 %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 M&O Orlando MOB I LLC	Manage & lease medical office building	82.150 %	0 %	12.850 %
2
3
4
5
6
7
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?3Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)									Other (describe)	Facility reporting group
1	AdventHealth Orlando & Campuses 601 E Rollins Street Orlando,FL32803 www.adventhealth.com/hospital/adventhe 4369	X	X	X	X		X	X	9 Off-site EDs	A
2	AdventHealth Sebring & Lake Placid 4200 Sun N Lake Blvd Sebring,FL33825 www.adventhealth.com/hospital/adventhe 4171	X	X					X		A
3	AdventHealth Wauchula 735 S 5th Avenue Wauchula,FL33873 www.adventhealth.com/hospital/adventhe 4239	X	X			X		X		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 22

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 23

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 200.000000000000%
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 Orlando & Campuses, - Facility 2: AdventHealth Sebring & Lake Placid, - Facility 3: AdventHealth Wauchula
Facility Reporting Group - A Part V, Section B, line 5:	See Line 5 footnote below.
Facility Reporting Group - A Part V, Section B, line 7d:	See Line 7d footnote below.
Facility Reporting Group - A Part V, Section B, line 11:	See Line 11 footnote below.
Part V, Section B, Line 5:	Facility Reporting Group - AAdventHealth Orlando & CampusesIn 2023, Adventist Health System/Sunbelt, Inc. owned and operated eight hospital campuses under a single hospital license in the greater Orlando, Florida area. The eight separate campuses operate under the following dba names: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando, AdventHealth Winter Garden, and AdventHealth Winter Park (the Hospitals). These eight hospitals comprise the AdventHealth Central Florida Division South (CFD-South). The CFD-South conducted its 2022 Community Health Needs Assessment (CHNA) as a collaborative process with the Central Florida Collaborative (CFC), which included hospital systems, behavior health providers and federally qualified health centers (FQHCs) in Orange, Seminole, Lake and Osceola Counties (these four counties would be considered the Greater Orlando area), as well as the Florida Department of Health in Orange, Seminole, Lake, and Osceola Counties. The primary and secondary data collected by the CFC was utilized by the CFD-South Hospitals to prioritize the top health care needs that would be addressed in the 2022-2024 CHNA. To ensure that input was received from organizations representing low-income, minority, and other underserved populations, the CFC created a team of Equity Champions composed of ten individuals or organizations that represented multiracial or other minority communities. The Equity Champions included organizations and individuals from the Black/African American community and Hispanic/Latino/Spanish language speakers community, the LGBTQ+ community, and from members of the community of people living with disabilities (including HIV/AIDS), people experiencing homelessness, immigrants/migrant workers, faith-based communities, inmates, and members of the veteran community. Primary data gathering included Equity Champions Diversity Group Outreach, Stakeholder one-to-one interviews, and focus group discussions. The CFC conducted a broad-based community survey among residents of Orange, Seminole, Lake, and Osceola Counties. The surveys were conducted from December 29, 2021, to February 22, 2022 and were conducted online and in paper and offered in five languages, with approximately 4,000 community members. The survey instrument included topic areas that emerged from secondary data analysis, literature reviews of existing documents, initial qualitative research, and other early-stage research activities.One-to-one interviews were conducted with key community stakeholders, policymakers, and local residents. Interviews were conducted between October 29, 2021, and January 31, 2022. Most of the 105 interviews lasted approximately 20-30 minutes, although a few continued for over an hour. In addition to interviews and the survey, 30 focus group discussions were held from October of 2021 through February of 2022. In total there were approximately 250 participants and included the following community organizations: PCAN, Health and Hunger Task Force, Creating a Resilient Community Network, Black Nurses Rock, True Health FQHC, the Center for Independent Living, the Mayors Council for mental and behavioral health, the Seminole County Opioid Council, the Healthy Seminole Collaborative, and the Children's Cabinet.**see continuation of footnote
Part V, Section B, Line 5 Continuation of Footnote:	Facility Reporting Group - AAdventHealth Sebring & Lake Placid:Adventist Health System/Sunbelt, Inc. owns and operates a 171-bed hospital located in Highlands County, Florida. The hospital does business under the name of AdventHealth Sebring (AH Sebring). The primary service area of AH Sebring includes six zip codes across Highlands, Hardee and a small piece of Polk Counties. Adventist Health System/Sunbelt, Inc. owns and operates a 33-bed hospital located in Highlands County, Florida. The hospital does business under the name of AdventHealth Lake Placid (AH Lake Placid). The primary service area of AH Lake Placid includes five zip codes across Highlands and Hardee Counties. In conducting its 2022 Community Health Needs Assessment (CHNA), AH Sebring & Lake Placid solicited input directly from the community and from individuals who represent the broad interests of the community, including medically underserved, low-income and minority community members. AH Sebring & Lake Placid conducted their 2022 CHNAs from July to November of 2022. AH Sebring & Lake Placid partnered with the Florida Department of Health in Highlands County and in Hardee County to complete the community health needs assessment. AH Sebring & Lake Placid, in collaboration with the Departments of Health in Highlands and Hardee Counties, collected input directly from the community and from community stakeholders through a community survey and focus groups. Community surveys were made available to anyone in the community and were provided in three languages and were accessible through weblinks and QR codes. Five focus groups were held with community stakeholders specifically representing Black/African Americans, Hispanic/Latinos, Older Adults, and Parents of Pediatric Children. AH Sebring & Lake Placid also formed a Community Health Needs Assessment Committee (CHNAC) that included representatives from organizations that serve low-income, low-access individuals and communities. The purpose of the CHNAC was to select the needs the Hospitals would address from the findings in the community health needs assessment. Key CHNAC members that represented low-income and underserved populations were from the following organizations: Central Florida Area Health Education Center, Central Florida Health Care, Champion for Children Foundation, Drug Free Hardee, the Department of Health in Hardee County, the Department of Health in Highlands County, Hardee Help Center, Healthy Families Highlands County, Healthy Start Coalition of Hardee, Highlands, and Polk County, Heartland Core Wellness, Heartland Regional Transportation Planning Organization, Heartland Rural Health Network, the Highlands County Board of County Commissioners, Highlands County Veteran Services Office, Nu-Hope Elder Care Services, Peace River Center, Redlands Christian Migrant Association, Samaritan's Touch Care Center, South Florida State College, the Ruth E. Handley Children's Advocacy Center, Tri-County Human Services, and the United Way of Central Florida. AdventHealth Wauchula:Adventist Health System/Sunbelt, Inc. owns and operates a 25-bed critical access hospital located in Hardee County, Florida. The hospital does business under the name of AdventHealth Wauchula (AH Wauchula). The primary service area of AH Wauchula includes three zip codes across mainly Hardee County and a small part of Polk County. In conducting its 2022 Community Health Needs Assessment (CHNA), AH Wauchula solicited input directly from the community and from individuals who represent the broad interests of the community, including medically underserved, low-income and minority community members. AH Wauchula conducted its 2022 CHNA from July to November of 2022. AH Wauchula partnered with the Florida Department of Health in Highlands County and in Hardee County to complete the community health needs assessment. AH Wauchula, in collaboration with the Departments of Health in Highlands and Hardee Counties, collected input directly from the community and from community stakeholders through a community survey and focus groups. Community surveys were made available to anyone in the community and were provided in three languages and were accessible through weblinks and QR codes. Five focus groups were held with community stakeholders specifically representing Black/African Americans, Hispanic/Latinos, Older Adults, and Parents of Pediatric Children. AH Wauchula also formed a Community Health Needs Assessment Committee (CHNAC) that included representatives from organizations that serve low-income, low-access individuals and communities. The purpose of the CHNAC was to select the needs the Hospital would address from the findings in the community health needs assessment. Key CHNAC members that represented low-income and underserved populations were from the following organizations: Central Florida Area Health Education Center, Central Florida Health Care, Champion for Children Foundation, Drug Free Hardee, the Department of Health in Hardee County, the Department of Health in Highlands County, Hardee Help Center, Healthy Families Highlands County, Healthy Start Coalition of Hardee, Highlands, and Polk County, Heartland Core Wellness, Heartland Regional Transportation Planning Organization, Heartland Rural Health Network, the Highlands County Board of County Commissioners, Highlands County Veteran Services Office, Nu-Hope Elder Care Services, Peace River Center, Redlands Christian Migrant Association, Samaritan's Touch Care Center, South Florida State College, the Ruth E. Handley Children's Advocacy Center, Tri-County Human Services, and the United Way of Central Florida.
Part V, Section B, Line 7a:	Each hospital facility's CHNA report was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlando & Campuseshttps://www.adventhealth.com/community-health-needs-assessments Facility 2 -- AdventHealth Sebring & Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 3 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments
Part V, Section B, Line 7d:	Facility Reporting Group - AThe Hospital facilities have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospitals' websites at least until the date the hospital facilities have made widely available on its websites its two subsequent Community Health Needs Assessment Reports. The Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facilities have made available for public inspection its two subsequent Community Health Needs Assessment Reports.
Part V, Section B, Line 10a:	Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlando & Campuseshttps://www.adventhealth.com/community-health-needs-assessments Facility 2 -- AdventHealth Sebring & Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 3 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments
Part V, Section B, Line 11:	Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Orlando will be referred to in this document as AdventHealth Orlando or "the Hospital." The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Orlando worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce Development Priority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued Priority 2: Social Determinants of Health Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDOH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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. 1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth CelebrationDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Celebration will be referred to in this document as AdventHealth Celebration or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Celebration worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce Development Priority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Priority 2: Social Determinants of Health - Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDoH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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. 1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth Altamonte SpringsDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Altamonte Springs will be referred to in this document as AdventHealth Altamonte Springs or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Altamonte Springs worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce Development Priority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola, and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola, and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth Altamonte SpringsDescription of CHNA Significant Needs Continued Priority 2: Social Determinants of Health - Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDOH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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.1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth East OrlandoDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth East Orlando will be referred to in this document as AdventHealth East Orlando or "the Hospital." The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth East Orlando worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce DevelopmentPriority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola, and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola, and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth East OrlandoDescription of CHNA Significant Needs Continued Priority 2: Social Determinants of Health - Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDOH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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. 1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Winter Park will be referred to in this document as AdventHealth Winter Park or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Winter Park worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce Development Priority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola, and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola, and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued Priority 2: Social Determinants of Health - Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDOH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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. 1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth KissimmeeDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Kissimmee will be referred to in this document as AdventHealth Kissimmee or "The Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Kissimmee worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce Development Priority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola, and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola, and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedPriority 2: Social Determinants of Health - Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDOH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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.1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth ApopkaDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Apopka will be referred to in this document as AdventHealth Apopka or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Apopka worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce Development Priority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola, and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola, and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth ApopkaDescription of CHNA Significant Needs Continued Priority 2: Social Determinants of Health - Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDOH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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.1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 11 Footnote:	Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Lake Placid will be referred to in this document as AdventHealth Lake Placid or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023-2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Lake Placid worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below.1. Access to Healthy Foods (and Diabetes Prevention) 2. Access to Quality Health Care3. Behavioral Health (Mental Health & Substance Misuse)Priority 1: Access to Healthy Foods (and Diabetes Prevention) 2022 Description of the Priority: In Highlands County, one-third of residents live in an area where there is low access to a grocery store, which can make having a healthy, nutrient-dense diet more challenging. Also, almost a fifth (17.9%) of community survey respondents shared they were worried that they would run out of food before they had money to buy more. Respondents also expressed concern about increasing food prices and the lack of healthy food options in local neighborhoods. During the prioritization process, the decision was made to address diabetes through the access to healthy foods priority. An individual's quality of life when living with diabetes is heavily influenced by how well they can manage their blood sugar and eating well is key to blood sugar management. According to secondary data, diabetes in the Medicare population in Highlands County is at 30%, which is slightly higher than the state (27.8%) and the US (27%). 2023 Update: Goal 1.1: Increase access to nutritious foods, resources, and nutrition education to help promote diabetes prevention and healthy living. Objective 1.1.1: By December 31, 2025, increase the percentage of adults in the AdventHealth Food is Health program who report redeeming at least five produce vouchers to access nutritious foods for their families from a baseline of 57% to 68% (Division-wide). This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. The AdventHealth Food is Health program provides series-based nutrition education and culturally appropriate, nutritious foods to participants in low income/low access areas in the Hospital's community. The program involves collaborations from a variety of community partners, including subject matter experts providing education, mobile produce vendors, and sites in the community where classes are held. AdventHealth sponsors the cost of produce for participants and assists with coordinating classes. Team members managing this program experienced challenges accurately calculating the percent of program attendees redeeming at least five produce vouchers. This was due to limited attendance data being tracked and shared by educational partners. Instead, the Hospital will track and report the pounds of produce distributed to program attendees. In 2023, a total of 44,387 lbs. of produce have been distributed to community members throughout the West Florida Division. Community partners in the Hospital's area include Feeding Tampa Bay, an organization that improves access to healthy foods for low-income/low-access populations. Objective 1.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored diabetes prevention and wellness programs from a baseline of 68 participants to 235 participants. The outcomes below are specific to the reporting Hospital. Although AdventHealth Lake Placid did not sponsor a diabetes prevention and wellness program in 2023 due to staff availability, discussions will continue into 2024 on new program proposals. Program plans include Pre-diabetes Nutrition/Diabetes Prevention, Gestational Diabetes, Diabetes Support Group, Lifestyle & Longevity Series, and other classes of interest to the community. In 2023, AdventHealth Lake Placid supported local Tobacco Cessation classes hosted by Central Florida Area Health Education Center (AHEC). Community partners include Department of Health Highlands County, offering Diabetes Self-Management Education classes; Senior Connection Center, offering chronic disease and diabetes programs; and various faith community locations. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedPriority 2: Access to Quality Health Care 2022 Description of the Priority: Community members cited barriers to accessing quality health care such as cost or financial concerns, lack of trust in the providers, lack of insurance or limited coverage, inability to take time off work for appointments, lack of awareness or difficulty navigating the healthcare system and language barriers for non-English speakers when trying to sign up for insurance or complete paperwork. More than half (60%) of community survey respondents reported accessing care in the emergency department for non-emergency needs. Inadequate health insurance coverage is one of the largest barriers to health care access and the unequal distribution of coverage contributes to disparities in health. Highlands County falls within the lower 25% of counties in both the state and in the US for adults who do not have any kind of health insurance coverage. Out-of-pocket medical care costs may lead individuals to delay or forgo needed care (such as doctor visits, dental care, and medications), and medical debt is common among both insured and uninsured individuals. Highlands County also has a lower rate of primary care providers in the area compared to the state, 57 providers per 100,000 versus 73 providers per 100,000. 2023 Update: Goal 2.1: Promote the attainment and maintenance of health through health education and access to care. Objective 2.1.1: By December 31, 2025, increase the number of community members trained in Hospital-sponsored American Heart Association (AHA) Hands-Only CPR classes for adults and youth from a baseline of 573 to 4,200 people trained (Division-wide). This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. In 2023, the Hospitals supported the American Heart Association, a nonprofit organization dedicated to fighting heart disease and stroke, in training 3,257 people in hands-only CPR. AdventHealth Lake Placid contributed 11 people to this objective. The West Florida Division provided $40,000 towards CPR training for the community while the community benefit team, led by Director Kimberly Williams, coordinated classes with community partners and community members. The Hospital provided and will continue to provide Hands Only CPR kits and meeting spaces for the classes. Community partners include Highlands County schools, faith communities, and senior living centers. Objective 2.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored access to care programs from a baseline of 20 participants to 100 participants. This initiative is focused on providing support to community organizations with programs increasing access to care (ex. health screening events). The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Lake Placid had 11 participants in their access to care program, featuring Hands-Only CPR/EHAC classes. Lake Placid Middle School and AdventHealth Lake Placid Wellness Center served as meeting locations. Two and a half staff hours were provided for this objective. The Hospital will continue to search for additional support and participation for their Access to Care programs. Community partners include Department of Health Highlands County, offering health care services to low-income/low access individuals; senior living centers, faith communities; and Highlands County schools. Priority 3: Behavioral Health (Mental Health and Substance Misuse) 2022 Description of the Priority: In Highlands County, 27% of community survey respondents reported having been diagnosed with a depressive disorder or anxiety disorder. In Highlands County the age-adjusted death rate due to suicide is 25.2 per 100,000 which is twice that of the state (13.1 per 100,000) and the US (13.5 per 100,000). More than ten percent (12.1%) of community survey respondents were unable to access mental health resources when needed in the last 12 months. The top reasons cited were inability to pay for care, to schedule an appointment when needed and to take time off work for appointments. Substance misuse also emerged as a top concern, reflected in both primary and secondary data. Teen vaping was cited as the highest area of concern for tobacco use in the county from primary data. Secondary data showed the rate of drug and opioid-involved deaths as 35.4 per 100,000 in Highlands County, higher than both the state (26.7 per 100,000) and the nation (23 per 100,000). 2023 Update: Goal 3.1: Reduce the impact of mental, emotional, and behavioral health disorders. Objective 3.1.1: By December 31, 2025, increase the number of participants who attend Hospital-sponsored Mental Health First Aid certification classes from a baseline of 258 participants to 700 participants (Division-wide). Mental Health First Aid teaches individuals how to help someone who may be experiencing a mental health or substance use challenge. The training helps individuals identify, understand, and respond to signs of addictions and mental illnesses. This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. The Hospitals contracted with Safe and Sound Hillsborough to teach Mental Health First Aid classes in the community. Safe and Sound Hillsborough is a collaborative of community and professional stakeholders transforming the way local policy makers address violence in the community. The goal is to shift policy from a public safety to a public health model and develop a comprehensive prevention and intervention approach. In 2023, a total of 134 people were trained with most classes offered virtually. Of all Mental Health First Aid participants surveyed, 89% indicated they felt confident or strongly confident in having a supportive conversation with anyone about a mental health or substance use challenge after completing the class. The Hospitals cover class enrollment fees and meal expenses. The Hospital will collaborate with community partners to continue classes and will work towards hosting a Mental Health First Aid class at their facility. The West Florida Division community benefit team, led by Director Kimberly Williams, coordinated classes between community organizations and community members. The Hospital marketing and spiritual teams will promote the classes to the community. Community partners include Safe & Sound Hillsborough, providing free Mental Health First Aid classes; Heartland Core Wellness, providing mental health advocacy, substance abuse prevention education, and acting as a host location for Mental Health First Aid; and various faith communities.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 3.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored behavioral health education programs from a baseline of 40 participants to 140 participants. The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Lake Placid hosted participants in their behavioral health education program with Central Florida Area Health Education Center (AHEC). Using internal referral systems CARE 360 and Whole Health Hub, AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula collectively referred 12 patients to Central Florida Area Health Education Center (AHEC) in 2023 for tobacco cessation programs. Community partners include Safe and Sound, offering Mental Health First Aid classes; Central Florida Area Health Education Center (AHEC), offering Tobacco Cessation programs; Heartland Core Wellness, providing mental health advocacy and substance abuse prevention education to the community; and various faith communities. 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.1. Economy: While a strong economy is important in the overall health needs of the community, the CHNAC did not perceive this priority area as one that could be easily addressed within the three-year CHP cycle. It was voted the lowest in the ability to impact category in the prioritization meeting. Therefore, the Hospital will not work to address this priority area in the upcoming CHP.2. Older Adult Health: Older Adult Health ranked seventh among the other topic areas in the secondary data analysis with a score of 1.97 but was ultimately not selected as one of the top three priority areas to address in the next three-year plan. Participants in the prioritization selection meeting felt the top three priority areas chosen were significant and easier to address with the resources available and therefore, the Hospital will not be addressing Older Adult Health directly in the upcoming CHP.3. Prevention and Safety: Prevention and Safety ranked eighth out of nine total significant health needs identified from both primary and secondary data sources and was not voted as a top priority to address by the CHNAC in the upcoming three-year Community Health Plan.4. Children's Health: Children's health is of utmost importance, but the Collaborative decided that instead of focusing on it as a stand-alone priority area, instead children would be a target population group to focus on among all the priority areas.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. dba AdventHealth Sebring, will be referred to in this document as AdventHealth Sebring or "The Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Sebring worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below.1. Access to Healthy Foods (and Diabetes Prevention) 2. Access to Quality Health Care3. Behavioral Health (Mental Health & Substance Misuse) Priority 1: Access to Healthy Foods (and Diabetes Prevention) 2022 Description of the Priority: In Highlands County, one-third of residents live in an area where there is low access to a grocery store, which can make having a healthy, nutrient-dense diet more challenging. Also, almost a fifth (17.9%) of community survey respondents shared they were worried that they would run out of food before they had money to buy more. Respondents also expressed concern about increasing food prices and the lack of healthy food options in local neighborhoods. During the prioritization process, the decision was made to address diabetes through the access to healthy foods priority. An individual's quality of life when living with diabetes is heavily influenced by how well they can manage their blood sugar and eating well is key to blood sugar management. According to secondary data, diabetes in the Medicare population in Highlands County is at 30%, which is slightly higher than the state (27.8%) and the US (27%). 2023 Update: Goal 1.1: Increase access to nutritious foods, resources, and nutrition education to help promote diabetes prevention and healthy living. Objective 1.1.1: By December 31, 2025, increase the percentage of adults in the AdventHealth Food is Health program who report redeeming at least five produce vouchers to access nutritious foods for their families from a baseline of 57% to 68% (Division-wide). This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. The AdventHealth Food is Health program provides series-based nutrition education and culturally appropriate, nutritious foods to participants in low income/low access areas in the Hospital's community. The program involves collaborations from a variety of community partners, including subject matter experts providing education, mobile produce vendors, and sites in the community where classes are held. AdventHealth sponsors the cost of produce for participants and assists with coordinating classes. Team members managing this program experienced challenges accurately calculating the percent of program attendees redeeming at least five produce vouchers. This was due to limited attendance data being tracked and shared by educational partners. Instead, the Hospital will track and report the pounds of produce distributed to program attendees. In 2023, a total of 44,387 lbs. of produce have been distributed to community members throughout the West Florida Division. AdventHealth Sebring supported one Food is Health nutrition education class with 17 participants. AdventHealth Sebring sponsored the cost of produce ($2,700) for participants. Community partners include Feeding Tampa Bay, an organization that improves access to healthy foods for low-income/low-access populations and provides produce and health education; Burgin Farms, a local farm providing fresh food in underserved parts of the community, as the primary produce vendor; and Hands for Homeless, a nonprofit organization that helps the homeless and low-income population of the community have access to healthy food, hygiene, and financial assistance. Objective 1.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored diabetes prevention and wellness programs from a baseline of 68 participants to 235 participants. The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Sebring had 273 community members that participated in their diabetes prevention and wellness program. Additional programs provided to the community included Diabetes Support Groups, Pre-diabetes Nutrition classes, Gestational Diabetes Classes, and a plant-based cooking and a nutrition lecture series called the Lifestyle & Longevity Series. The Hospital provided $4,089.30 in 2023 to the various sponsored programs and provided 172 staff hours. AdventHealth Sebring donated $2,000 to Cutting Edge Ministries, Inc, a food pantry in Wauchula. Community partners include Feeding Tampa Bay, providing healthy food and health education for low-income/low-access populations; Burgin Farms, providing fresh food in underserved parts of the community; Highlands County Children's Museum, providing free health education to young children; and various local physicians providing free health education to the community.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs ContinuedPriority 2: Access to Quality Health Care 2022 Description of the Priority: Community members cited barriers to accessing quality health care such as cost or financial concerns, lack of trust in the providers, lack of insurance or limited coverage, inability to take time off work for appointments, lack of awareness or difficulty navigating the healthcare system and language barriers for non-English speakers when trying to sign up for insurance or complete paperwork. More than half (60%) of community survey respondents reported accessing care in the emergency department for non-emergency needs. Inadequate health insurance coverage is one of the largest barriers to health care access and the unequal distribution of coverage contributes to disparities in health. Highlands County falls within the lower 25% of counties in both the state and in the US for adults who do not have any kind of health insurance coverage. Out-of-pocket medical care costs may lead individuals to delay or forgo needed care (such as doctor visits, dental care, and medications), and medical debt is common among both insured and uninsured individuals. Highlands County also has a lower rate of primary care providers in the area compared to the state, 57 providers per 100,000 versus 73 providers per 100,000. 2023 Update: Goal 2.1: Promote the attainment and maintenance of health through health education and access to care. Objective 2.1.1: By December 31, 2025, increase the number of community members trained in Hospital-sponsored American Heart Association (AHA) Hands-Only CPR classes for adults and youth from a baseline of 573 to 4,200 people trained (Division-wide). This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. In 2023, the Hospitals supported the American Heart Association, a nonprofit organization dedicated to fighting heart disease and stroke, in training 3,257 people in hands-only CPR. AdventHealth Sebring contributed 21 people and one class to this objective. The West Florida Division provided $40,000 towards CPR training for the community while the community benefit team, led by Director Kimberly Williams, coordinated classes with community partners and community members. The Hospital provided Hands Only CPR kits and meeting spaces for the classes. Community partners include Highlands County schools, faith communities, senior living centers, and low-income housing complexes. Objective 2.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored access to care programs from a baseline of 20 participants to 100 participants. This initiative is focused on providing support to community organizations with programs increasing access to care (ex. health screening events). The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Sebring had 60 participants in their access to care programs. The Hospital will continue to utilize their internal referral systems, Care 360, and Whole Health Hub, to refer patients to community partners for follow-up and specialist care. Meeting room locations and in-kind medical supplies, valued at $5,650 plus 10 staff hours were provided towards this initiative. Community partners include Neuro Challenge Foundation for Parkinsons, a nonprofit organization improving access to care for patients with Parkinson's Disease through free health education and professional care advising, and various senior living centers and faith communities. Priority 3: Behavioral Health (Mental Health and Substance Misuse) 2022 Description of the Priority: In Highlands County, 27% of community survey respondents reported having been diagnosed with a depressive disorder or anxiety disorder. In Highlands County the age-adjusted death rate due to suicide is 25.2 per 100,000 which is twice that of the state (13.1 per 100,000) and the US (13.5 per 100,000). More than ten percent (12.1%) of community survey respondents were unable to access mental health resources when needed in the last 12 months. The top reasons cited were inability to pay for care, to schedule an appointment when needed and to take time off work for appointments. Substance misuse also emerged as a top concern, reflected in both primary and secondary data. Teen vaping was cited as the highest area of concern for tobacco use in the county from primary data. Secondary data showed the rate of drug and opioid involved deaths as 35.4 per 100,000 in Highlands County, higher than both the state (26.7 per 100,000) and the nation (23 per 100,000). **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 2 -- AdventHealth Sebring & Lake PlacidDescription of CHNA Significant Needs Continued2023 Update: Goal 3.1: Reduce the impact of mental, emotional, and behavioral health disorders. Objective 3.1.1: By December 31, 2025, increase the number of participants who attend Hospital-sponsored Mental Health First Aid certification classes from a baseline of 258 participants to 700 participants (Division-wide). Mental Health First Aid teaches individuals how to help someone who may be experiencing a mental health or substance use challenge. The training helps individuals identify, understand, and respond to signs of addictions and mental illnesses. This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. The Hospitals contracted with Safe and Sound Hillsborough to teach Mental Health First Aid classes in the community. Safe and Sound Hillsborough is a collaborative of community and professional stakeholders transforming the way local policy makers address violence in the community. The goal is to shift policy from a public safety to a public health model and develop a comprehensive prevention and intervention approach. In 2023, a total of 134 people were trained with most classes offered virtually. Of all Mental Health First Aid participants surveyed, 89% indicated they felt confident or strongly confident in having a supportive conversation with anyone about a mental health or substance use challenge after completing the class. The Hospital will collaborate with community partners to continue classes and will work towards hosting a Mental Health First Aid class at their facility. The West Florida Division community benefit team, led by Director Kimberly Williams, coordinated classes between community organizations and community members. The Hospital marketing and spiritual teams will promote the classes to the community. AdventHealth Sebring will sponsor class participants by covering class enrollment fees, and meal expenses. Community partners include Safe & Sound Hillsborough, providing free Mental Health First Aid classes; Heartland Core Wellness, providing mental health advocacy, substance abuse prevention education, and acting as a host location for Mental Health First Aid; and various faith communities. Objective 3.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored behavioral health education programs from a baseline of 40 participants to 140 participants. The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Sebring had 122 participants in their behavioral health education program and contributed two staff hours to the initiative. Meeting room fees were waived for education programs, totaling $26,400 in 2023. Using internal referral systems CARE 360 and Whole Health Hub, AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula collectively referred 12 patients to Central Florida Area Health Education Center (AHEC) in 2023 for tobacco cessation programs. Community partners include Safe and Sound, offering Mental Health First Aid classes; Central Florida Area Health Education Center (AHEC), offering Tobacco Cessation programs; Heartland Core Wellness, providing mental health advocacy and substance abuse prevention education to the community; and various faith communities. 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. 1. Economy: While a strong economy is important in the overall health needs of the community, the CHNAC did not perceive this priority area as one that could be easily addressed within the three-year CHP cycle. It was voted the lowest in the ability to impact category in the prioritization meeting. Therefore, the Hospital will not work to address this priority area in the upcoming CHP.2. Older Adult Health: Older Adult Health ranked seventh among the other topic areas in the secondary data analysis with a score of 1.97 but was ultimately not selected as one of the top three priority areas to address in the next three-year plan. Participants in the prioritization selection meeting felt the top three priority areas chosen were significant and easier to address with the resources available and therefore, the Hospital will not be addressing Older Adult Health directly in the upcoming CHP.3. Prevention and Safety: Prevention and Safety ranked eighth out of nine total significant health needs identified from both primary and secondary data sources and was not voted as a top priority to address by the CHNAC in the upcoming three-year Community Health Plan.4. Children's Health: Children's health is of utmost importance, but the Collaborative decided that instead of focusing on it as a stand-alone priority area, instead children would be a target population group to focus on among all the priority areas.
Part V, Section B, Line 11 Footnote:	Group A-Facility 3 -- AdventHealth WauchulaDescription of CHNA Significant Needs Adventist Health System/Sunbelt, Inc., dba AdventHealth Wauchula, will be referred to in this document as AdventHealth Wauchula or "the Hospital." The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Wauchula worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Access to Healthy Foods (and Diabetes Prevention)2. Access to Quality Health Care3. Behavioral Health (Mental Health & Substance Misuse) Priority 1: Access to Healthy Foods 2022 Description of the Priority: Access to quality healthy food was a top need prioritized during the assessment. In Hardee County, one-quarter of residents live in an area where there is low access to a grocery store, which can make having a healthy, nutrient-dense diet more challenging. Almost one-fifth (20%) of community survey respondents reported that within the past 12 months, the food they had purchased from the store did not last and they did not have the money to purchase more. Also, more than a quarter (28.6%) of community survey respondents shared they were worried that they would run out of food before they had money to buy more. Respondents also expressed concern about increasing food prices. 2023 Update: Goal 1.1: Increase access to nutritious foods, resources, and nutrition education to help promote diabetes prevention and healthy living. Objective 1.1.1: By December 31, 2025, increase the percentage of adults in the AdventHealth Food is Health program who report redeeming at least five produce vouchers to access nutritious foods for their families from a baseline of 57% to 68% (Division-wide). This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. The AdventHealth Food is Health program provides series-based nutrition education and culturally appropriate, nutritious foods to participants in low income/low access areas in the Hospital's community. The program involves collaborations from a variety of community partners, including subject matter experts providing education, mobile produce vendors, and sites in the community where classes are held. AdventHealth sponsors the cost of produce for participants and assists with coordinating classes. Team members managing this program experienced challenges accurately calculating the percent of program attendees redeeming at least five produce vouchers. This was due to limited attendance data being tracked and shared by educational partners. Instead, the Hospital will track and report the pounds of produce distributed to program attendees. AdventHealth Wauchula contributed 623 pounds of produce towards this objective while the West Florida Division has collectively distributed 44,387 pounds of produce at Food is Health classes in the community. Community partners include Feeding Tampa Bay, an organization that improves access to healthy foods for low-income/low-access populations and provides health education classes; Burgin Farms, a local farm providing fresh food in underserved parts of the community and the produce vendor supplying fruits and vegetables; and various organizations to host classes at their respective organizations, including Department of Health - Hardee County, providing health care services to low-income, low-access individuals; Valencia Gardens, a low-income housing complex; and various faith community locations. Objective 1.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored diabetes prevention and wellness programs from a baseline of 68 participants to 235 participants. The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Wauchula supported two Food is Health classes with a total of 25 participants by donating supplies worth $1,937.91. Community partners include the Department of Health - Hardee County providing health care services to low-income, low-access individuals; and Chatham Pointe, a low-access senior living community center, who both hosted a Food is Health program, as well as Burgin Farms, a local farm providing fresh food in underserved parts of the community; and Feeding Tampa Bay, an organization that improves access to healthy foods for low-income/low-access populations. The Hospital also supported expenses and provided staff hours towards the Wauchula Community Garden Committee. Staff spent time educating the garden committee on proper gardening techniques. This garden was a community effort, spearheaded by the Hardee County Health Department. It is free and open to the community in a low-income, low-access area. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 3 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedPriority 2: Access to Quality Health Care 2022 Description of the Priority: More than one-third (39%) of community survey respondents reported accessing care in the emergency department for non-emergency needs. While 14.5% of respondents shared that they needed medical care in the last 12 months, but they did not receive it. Some of the top barriers that prevented care included cost, inability to schedule an appointment, inability to take time off from work, transportation barriers, lack of health insurance coverage, lack of trust in providers and an inability to find a doctor who accepts certain types of health insurance. Inadequate health insurance coverage is one of the largest barriers to health care access and the unequal distribution of coverage contributes to disparities in health. Out-of-pocket medical care costs may lead individuals to delay or forgo needed care (such as doctor visits, dental care, and medications), and medical debt is common among both insured and uninsured individuals. Hardee County falls within the lower 25% of counties in both the state of Florida and in the US for adults who do not have any kind of health insurance coverage. Hardee County also has a lower rate of primary care providers (11 per 100,000) compared to the state, 57 per 100,000. 2023 Update: Goal 2.1: Promote the attainment and maintenance of health through health education and access to care. Objective 2.1.1: By December 31, 2025, increase the number of community members trained in Hospital-sponsored American Heart Association (AHA) Hands-Only CPR classes for adults and youth from a baseline of 573 to 4,200 people trained (Division-wide). This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. In 2023, the Hospitals supported the American Heart Association, a nonprofit organization dedicated to fighting heart disease and stroke, in training 3,257 people in hands-only CPR. AdventHealth Wauchula contributed 28 people to this objective by Hospital staff independently facilitating Hands-Only CPR classes at the AdventHealth Wauchula Wellness Center and Hardee County Junior High School. The West Florida Division provided $40,000 towards CPR training for the community while the community benefit team, led by Director Kimberly Williams, coordinated classes with community partners and community members. The Hospital will continue to provide Hands Only CPR kits. Community partners include Hardee County schools, faith communities, senior living centers, and low-income housing complexes. Objective 2.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored access to care programs from a baseline of 20 participants to 100 participants. This initiative is focused on providing support to community organizations with programs increasing access to care (ex. health screening events). The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Wauchula had 48 participants in their access to care programs, which included 28 participants in Community CPR classes, and 20 in Community Health Screenings at Valencia Gardens (a low-income housing complex). Staff contributed 17 hours to the programs. Community partners include Department of Health - Hardee County, providing health care services to low-income, low-access individuals. Priority 3: Behavioral Health (Mental Health and Substance Misuse) 2022 Description of the Priority: In Hardee County, secondary data showed the age-adjusted death rate due to suicide is 19.9 per 100,000. This is almost one and a half times the state (13.1/100,000) and the US (13.5/100,000). The assessment also found more than ten percent (11.5%) of community survey respondents were unable to access mental health resources when needed in the last 12 months. The top reasons cited were inability to pay for care, stigma associated with mental health issues and lack of knowledge on how to access a mental health doctor or counselor. Substance misuse also emerged as a top concern, reflected in both primary and secondary data sources. Binge drinking in teens was cited as a specific concern in the primary data. Secondary data showed just over 12% of teens reported binge drinking, higher than the state rate of 9.2%. The assessment also found in secondary data a higher percentage of teens who have used methamphetamines in Hardee County (2.6%), than the state rate (0.8%). **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 3 -- AdventHealth WauchulaDescription of CHNA Significant Needs Continued2023 Update: Goal 3.1: Reduce the impact of mental, emotional, and behavioral health disorders. Objective 3.1.1: By December 31, 2025, increase the number of participants who attend Hospital-sponsored Mental Health First Aid certification classes from a baseline of 258 participants to 700 participants (Division-wide). Mental Health First Aid teaches individuals how to help someone who may be experiencing a mental health or substance use challenge. The training helps individuals identify, understand, and respond to signs of addictions and mental illnesses. This initiative and the reported outcomes are shared across multiple facilities in the West Florida Division. The Hospitals contracted with Safe and Sound Hillsborough to teach Mental Health First Aid classes in the community. Safe and Sound Hillsborough is a collaborative of community and professional stakeholders transforming the way local policy makers address violence in the community. The goal is to shift policy from a public safety to a public health model and develop a comprehensive prevention and intervention approach. In 2023, a total of 134 people were trained with most classes offered virtually. Of all Mental Health First Aid participants surveyed, 89% indicated they felt confident or strongly confident in having a supportive conversation with anyone about a mental health or substance use challenge after completing the class. Objective 3.1.2: By December 31, 2025, increase the number of participants in Hospital-sponsored behavioral health education programs from a baseline of 40 participants to 140 participants. The outcomes below are specific to the reporting Hospital. In 2023, AdventHealth Wauchula supported a Tobacco Cessation class with eight participants and donated the meeting space worth $800. Using internal referral systems CARE 360 and Whole Health Hub, AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula collectively referred 12 patients to Central Florida Area Health Education Center (AHEC) in 2023 for tobacco cessation programs. Community partners include Safe and Sound for Mental Health First Aid; Central Florida Area Health Education Center (AHEC) for Tobacco Cessation; Department of Health - Hardee County for their substance use and prevention symposium; and Heartland Core Wellness, providing mental health advocacy and substance abuse prevention education to the community. 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.1. Children's Health: Children's health is of utmost importance, but the Collaborative decided that instead of focusing on it as a stand-alone priority area, children would be a target population group to focus on among all the priority areas.2. Economy: While a strong economy is important in the overall health needs of the community, the CHNAC did not perceive this priority area as one that could be easily addressed within the three-year CHP cycle. It was voted the lowest in the ability to impact category in the prioritization meeting. Therefore, the Hospital will not work to address this priority area in the upcoming CHP.3. Older Adult Health: Participants in the prioritization selection meeting felt the top three priority areas chosen were significant and easier to address with the resources available and therefore, the Hospital will not be addressing Older Adult Health directly in the upcoming CHP.4. Diabetes: Diabetes was not selected as a priority by the Hospital as there are other community partners who are addressing this need. The Hospital will support these efforts where possible and hopes to address diabetes indirectly through the access to healthy foods priority.
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth Winter GardenDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. dba AdventHealth Winter Garden will be referred to in this document as AdventHealth Winter Garden or "The Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. This is the first-year update for the Hospital's 2023 - 2025 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2023 as part of its 2022 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Winter Garden worked to define and address the needs of low-income, minority and underserved populations in its service area. The Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the health issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key priorities for the Hospital to address in its Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the priorities identified in 2022 and gives an update on the strategies addressing those prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. The Hospital's chosen priorities are listed below:1. Enhance Mental Health Outreach2. Social Determinant of Health: Workforce Development Priority 1: Enhance Mental Health Outreach 2022 Description of the Priority: Mental health outreach and treatment were identified as top needs from the CHNA. This includes mental health crisis services and community awareness of available resources, mental health outpatient services capacity, behavioral health outpatient services for children, mental health inpatient bed capacity, mental health and substance use disorder transition care for inmates being released from jail, and mental health stigma reduction. There is a growing need in Orange, Osceola, and Seminole County to increase the available resources addressing mental health needs. 2023 Update: Goal 1.1: Expand access to mental health services for community members by partnering with faith and community partners. Objective 1.1.1: By the end of year 1, establish a Community Resource Spot in Osceola County to ensure access within the hospital service area. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Community Resource Spot: Definition and Function: A Community Resource Spot is a designated area within a community health framework that serves as a central hub for accessing a variety of resources and services aimed at supporting the health and well-being of community members. Community Resource Spot Purpose: The primary purpose of the Community Resource Spot is to provide easily accessible, comprehensive support to individuals and families, addressing a wide range of needs such as health care, social services, education, and community engagement. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.2: By the end of year 3, increase the mental health programming available to residents in Orange, Osceola, and Seminole county through the Community Resource Spots. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. Vicmael Arroyo, Chaplain, advised he has made good progress with Holy Redeemer Catholic Church in Osceola County, and they have begun working on logistics for the new Community Resource Center (CRS). They are currently focusing efforts on all the necessary training and resources and have a tentative ETA to be ready to launch by the end of this year. Objective 1.3: By the end of year 3, increase percentage of funding provided to partners who actively support mental health outreach and treatment by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The RFP grant cycle is in its final stage to select the new grant partners with a focus on mental health. Objective 1.4: Increase the number of area mental health nonprofit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's (WHH) Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 30 from a baseline of 19. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. Objective 1.5: By the end of year 3, increase the closed loop referrals in the Whole Health Hub community resource network for mental health services and preventative programming in Whole Health Hub to 25% from baseline of 13%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote:	Group A-Facility 1 -- AdventHealth Winter GardenDescription of CHNA Significant Needs ContinuedPriority 2: Social Determinants of Health - Workforce Development 2022 Description of the Priority: According to the CDC, social determinants of health (SDOH) are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Social determinants of health are increasingly seen as the largest contributing factor to health inequities in communities throughout the country. Based on the significance of need and available resources, the Hospitals will address social determinants of health with a focus on workforce as the Hospital believes that initially focusing on community workforce development will reduce housing burden and address other priorities identified, such as increasing access to care and mental health. 2023 Update: Goal 2.1: Increase support for career training and education programs. Objective 2.1.1: By the end of year 3, increase percentage of funding provided to partners who actively support community workforce training and education opportunities by 25%. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. The 2024 3C social determinant of health priority will be Workforce Development. More updates will come in 2024. The Collaborative Community Council (3C), a subcommittee of the AdventHealth Orlando Board of Directors, funds projects identified in the Community Health Needs Assessment (CHNA). Managed by AdventHealth Orlando, we partner with community organizations to create impactful solutions that enhance community health and reduce preventable medical costs. Our focus includes addressing the Social Determinants of Health (SDOH) to improve overall quality and longevity of life. Objective 2.1.2: Increase the number of area workforce development non-profit organizations trained on the Whole Health Hub and thus added to the Whole Health Hub's Trusted Network. The Whole Health Hub is a free website that allows anyone to search and connect to a wide variety of social services based on their location. By the end of year 3, we will increase the number of claimed profiles to 12 from a baseline of 5. This initiative and the reported outcomes are shared across all facilities in the Central Florida Division. No progress has been made on this objective. 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. 1. Health Care Access and Quality: This need was not chosen as a priority because the Hospital is already collaborating with several partners in the community and has launched several initiatives designed to address Health Care Access and Quality.
Part V, Section B, Line 16a-16c:	Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites: Facility 1 -- AdventHealth Orlando & Campuseshttps://www.adventhealth.com/legal/financial-assistance Facility 2 -- AdventHealth Sebring & Lake Placidhttps://www.adventhealth.com/legal/financial-assistance Facility 3 -- AdventHealth Wauchulahttps://www.adventhealth.com/legal/financial-assistance

Schedule H (Form 990) 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?76
Name and address		Type of Facility (describe)
1	1 - AdventHealth Centra Care Lake Buena Vist 12500 South Apopka Vineland Road Orlando,FL32836	Urgent Care Clinic
2	2 - AdventHealth Centra Care Mt Dora 19015 US Highway 441 Mount Dora,FL32757	Urgent Care Clinic
3	3 - AdventHealth Centra Care Winter Haven 7375 Cypress Gardens Boulevard Winter Haven,FL33884	Urgent Care Clinic
4	4 - AdventHealth Centra Care St Cloud 4660 13th Street St Cloud,FL34769	Urgent Care Clinic
5	5 - AdventHealth Centra Care Waterford Lakes 250 North Alafaya Trail Suite 135 Orlando,FL32825	Urgent Care Clinic
6	6 - AdventHealth Centra Care Orange Lake 8201 West Irlo Bronson Highway Kissimmee,FL34747	Urgent Care Clinic
7	7 - AdventHealth Centra Care Lake Nona 9637 Lake Nona Village Place Orlando,FL32827	Urgent Care Clinic
8	8 - AdventHealth Centra Care Hunter's Creek 3293 Greenwald Way North Kissimmee,FL34741	Urgent Care Clinic
9	9 - AdventHealth Centra Care Orange City 1360 Saxon Boulevard Orange City,FL32763	Urgent Care Clinic
10	10 - AdventHealth Centra Care Colonial Town 630 N Bumby Avenue Orlando,FL32803	Urgent Care Clinic
11	11 - AdventHealth Centra Care Port Orange 1208 Dunlawton Avenue Port Orange,FL32127	Urgent Care Clinic
12	12 - AdventHealth Centra Care Winter Garden 3005 Daniels Road Winter Garden,FL34787	Urgent Care Clinic
13	13 - AdventHealth Centra Care South Orange 2609 South Orange Avenue Orlando,FL32806	Urgent Care Clinic & Employer Onsite Clinic
14	14 - AdventHealth Centra Care Clermont 15701 State Road 50 Suite 101 Clermont,FL34711	Urgent Care Clinic
15	15 - AdventHealth Centra Care Sanford 4451 West 1st Street Sanford,FL32771	Urgent Care Clinic
16	16 - AdventHealth Centra Care Oviedo 8010 Red Bug Lake Road Oviedo,FL32765	Urgent Care Clinic
17	17 - AdventHealth Centra Care Poinciana 3759 Pleasant Hill Road Kissimmee,FL34746	Urgent Care Clinic
18	18 - AdventHealth Centra Care Apopka 1520 West Orange Blossom Trail Apopka,FL32712	Urgent Care Clinic
19	19 - AdventHealth Centra Care DeLand 2293 South Woodland Boulevard Deland,FL32720	Urgent Care Clinic
20	20 - AdventHealth Centra Care Daytona 1014 West International Speedway Boulevard Daytona Beach,FL32114	Urgent Care Clinic
21	21 - AdventHealth Centra Care Altamonte Sprin 440 West State Road 436 Altamonte Springs,FL32714	Urgent Care Clinic
22	22 - AdventHealth Centra Care Wesley Chapel 1127 Bruce B Downs Boulevard Wesley Chapel,FL33544	Urgent Care Clinic
23	23 - AdventHealth Centra Care Palm Coast 1270 Palm Coast Parkway Northwest Palm Coast,FL32137	Urgent Care Clinic
24	24 - AdventHealth Centra Care Winter Park 3099 Aloma Avenue Winter Park,FL32792	Urgent Care Clinic
25	25 - AdventHealth Centra Care Ormond Beach 1245 West Granada Boulevard Ormond Beach,FL32174	Urgent Care Clinic
26	26 - Health First AH Centra Care Gateway 1223 Gateway Drive Suite 1E Melbourne,FL32901	Urgent Care Clinic
27	27 - AdventHealth Centra Care Dr Phillips 8014 Conroy-Windermere Rd Suite 104 Orlando,FL32835	Urgent Care Clinic
28	28 - AdventHealth Centra Care Kissimmee 4320 West Vine Street Kissimmee,FL34746	Urgent Care Clinic
29	29 - AdventHealth Centra Care Lee Road 2540 Lee Road Winter Park,FL32789	Urgent Care Clinic
30	30 - AdventHealth Centra Care Lake Mary 2948 West Lake Mary Boulevard Lake Mary,FL32746	Urgent Care Clinic
31	31 - AdventHealth Centra Care Kids Winter Par 2325 West Fairbanks Avenue Winter Park,FL32789	Urgent Care Clinic/Ortho Urgent Care
32	32 - AdventHealth Centra Care Temple Terrace 5802 East Fowler Avenue Temple Terrace,FL33617	Urgent Care Clinic
33	33 - AdventHealth Centra Care Horizons West 9225 Miley Drive Suite 100 Winter Garden,FL34787	Urgent Care Clinic
34	34 - AdventHealth Medical Group Family Medicine 6325 US Highway 27 N Sebring,FL33872	Physician Clinic/Prompt care
35	35 - AdventHealth Centra Care Leesburg 1103 North 14th Street Leesburg,FL34748	Urgent Care Clinic
36	36 - AdventHealth Centra Care University 11550 University Boulevard Orlando,FL32817	Urgent Care Clinic
37	37 - AdventHealth Centra Care Brandon 10222 Bloomingdale Avenue Riverview,FL33578	Urgent Care Clinic
38	38 - AdventHealth Centra Care Azalea Park 509 South Semoran Boulevard Orlando,FL32807	Urgent Care Clinic
39	39 - AdventHealth Centra Care Longwood 855 North US Highway 17-92 Longwood,FL32750	Urgent Care Clinic
40	40 - Health First AH Centra Care Malabar 730 Malabar Road NE Suite B Malabar,FL32950	Urgent Care Clinic
41	41 - AdventHealth Centra Care Ocoee 11001 West Colonial Drive Suite 110 Ocoee,FL34761	Urgent Care Clinic
42	42 - AdventHealth Centra Care Sand Lake Road 2301 Sand Lake Road Orlando,FL32809	Urgent Care Clinic
43	43 - AdventHealth Centra Care Lakeland 3637 N Road 98 Lakeland,FL33809	Urgent Care Clinic
44	44 - AdventHealth Centra Care Conway 5810 South Semoran Blvd Orlando,FL32822	Urgent Care Clinic
45	45 - Health First AH Centra Care Titusville 2335 South Washington Ave Titusville,FL32780	Urgent Care Clinic
46	46 - AdventHealth Centra Care South Tampa 301 North Dale Mabry Highway Tampa,FL33609	Urgent Care Clinic
47	47 - AdventHealth Centra Care Kids Lake Mary 105 South Country Club Road Lake Mary,FL32746	Urgent Care Clinic
48	48 - AdventHealth Centra Care Ocala 3708 SW College Road Ocala,FL34474	Urgent Care Clinic
49	49 - AdventHealth Medical Group Orthopedics a 4409 Sun N Lake Boulevard Sebring,FL33872	Outpatient Phys Clinic
50	50 - AdventHealth Centra Care Carrollwood 4001 West Linebaugh Avenue Tampa,FL33624	Urgent Care Clinic
51	51 - AdventHealth Centra Care Citrus Park 6930 Gunn Highway Tampa,FL33625	Urgent Care Clinic
52	52 - AdventHealth Centra Care Trinity 11826 State Road 54 Odessa,FL33556	Urgent Care Clinic
53	53 - AdventHealth Primary Care Waterford 885 N Alafaya Trail Unit G04 Orlando,FL32828	Primary Care
54	54 - Health First AH Centra Care Cocoa Beach 105 S Banana River Blvd Unit SBPP Cocoa Beach,FL32931	Urgent Care Clinic
55	55 - AdventHealth Primary Care Clermont 1919 E Hwy 50 Suite 205 Clermont,FL34711	Primary Care
56	56 - AdventHealth Primary Care Partin Settlem 2488 E Irlo Bronson Memorial Hwy204 Kissimmee,FL34744	Primary Care
57	57 - AdventHealth Primary Care Winter Garden 3131 Daniels Road Suite 106 Winter Garden,FL32825	Primary Care
58	58 - AdventHealth Primary Care Sanford 4425 West State Rd 46 Sanford,FL32771	Primary Care
59	59 - AdventHealth Primary Care Apopka 3030 East Semoran Blvd Apopka,FL32703	Primary Care
60	60 - Health First AH Centra Care Melbourne 6345 N Wickham Rd Suite 101 Melbourne,FL32940	Urgent Care Clinic
61	61 - AdventHealth Primary Care Ocoee 11001 West Colonial Drive Suite 120 Ocoee,FL34761	Primary Care
62	62 - AdventHealth Primary Care Windermere 4757 The Grove Drive Unit 132 Windermere,FL34786	Primary Care
63	63 - AdventHealth Medical Group OB GYNPrompt 524 Carlton Street Wauchula,FL33873	Outpatient Phys Clinic/Urgent Care
64	64 - AdventHealth Primary Care Flamingo Crossin 153 Sugar Belle Drive Suite J Winter Gardens,FL34787	Primary Care
65	65 - Bethune Cookman Onsite 633 State Street Daytona Beach,FL32114	Employer Onsite Clinic
66	66 - AdventHealth Primary CareTraining Ctr 25 South Terry Avenue Orlando,FL32801	Primary Care
67	67 - AdventHealth Primary Care Port Orange 58210 S Williamson Blvd Suite 205 Port Orange,FL32128	Primary Care
68	68 - SIEMENS Onsite 4400 North Alafaya Trail MC Q1-240 Orlando,FL32826	Employer Onsite Clinic
69	69 - AdventHealth Medical Group Prompt Care a 2950 Alt US Hwy 27 S Suite B Sebring,FL33870	Prompt Care
70	70 - OCG Onsite 450 East South Street Orlando,FL32802	Employer Onsite Clinic
71	71 - AdventHealth Medical Group Cardiology & 463 Carlton Street Wauchula,FL33873	Outpatient Phys Clinic
72	72 - Darden Onsite 1000 Darden Center Drive Orlando,FL32837	Employer Onsite Clinic
73	73 - AdventHealth Primary Care Lakeland 6419 South Florida Avenue Suite 109 Lakeland,FL33813	Primary Care
74	74 - AdventHealth Waterman Employee Clinic 1000 Waterman Way Tavares,FL32778	Employer Onsite Clinic
75	75 - AdventHealth Hope and Healing Center 212 Eslinger Way Sanford,FL32773	Residential Level 2 Substance Abuse Center & Intensive Outpatient Program
76	76 - AdventHealth Trina Hidalgo Heart Care Ce 101 South Westmoreland Drive Orlando,FL32805	Community 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 3c:	Under each Hospital facility's Financial Assistance Policy, an individual is eligible for a 100% reduction from applicable charges if the individual's household income is at or below 200% of the current Federal Poverty Guidelines. Alternatively, a patient may also qualify for a 100% reduction from charges when the unpaid portion of a patient's bill exceeds 25% of the individual's annual household income and where the total annual household income is less than 500% of the Federal Poverty Guidelines. Medicare recipients may also be eligible for financial assistance under the Hospital's Financial Assistance Policy depending upon the individual's income and resources. Resources are generally defined as assets such as money in checking or savings accounts, stocks, and bonds.
Part I, Line 6a:	The filing organization was a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) during its current tax year. During the current year, AHSSHC served as a parent organization to 33 tax-exempt 501(c)(3) hospital organizations and a number of other health care facilities 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 assessments and associated implementation strategies can be accessed on the filing organization's websites.
Part I, Line 7:	The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions.
Part II, Community Building Activities:	The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with commercially sponsored research conducted by one of the organization's hospitals. This one hospital participates in clinical drug and device research that is performed on patients who have a condition or disease for which the eventual commercial use of a drug or device is intended. This research is related to patient care and serves to expand scientific knowledge with respect to potential treatments and cures for various diseases and conditions. The remainder of the costs incurred stem from the hospitals' involvement in and support of various other community agencies in its service area that work collaboratively to help those in need and to improve the health and safety of the residents of the community. The organization's hospitals participate with a number of other community organizations to address the healthcare needs of all its communities. Both cash and in-kind donations are made annually to various local charitable organizations.
Part III, Line 2:	The amount of bad debt expense reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense.
Part III, Line 3:	Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who Could Have Qualified under the Filing Organization's Financial Assistance Policy: Self-pay patients may apply for financial assistance by completing a Financial Assistance Application Form (FAA Form). If an individual does not submit a complete FAA Form within 240 days after the first post-discharge billing statement is sent to the individual, an individual may be considered for presumptive eligibility based upon a scoring tool that is designed to classify patients into groups of varying economic means. The scoring tool uses algorithms that incorporate data from credit bureaus, demographic databases, and hospital specific data to infer and classify patients into respective economic means categories. Individuals who earn a certain score on the scoring tool are considered to qualify as eligible for the most generous financial assistance under the filing organization's Financial Assistance Policy. As determined by the filing organization, a nominal amount of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the scoring tool is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit: The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains one or more 24/7 emergency room(s) providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency Departments should be considered community benefit as charitable hospitals exist to provide such care in pursuit of their purpose of meeting the need for emergency medical care services available to all in the community.
Part III, Line 4:	Financial Statement Footnote Related to Accounts Receivable and Allowance for Uncollectible Accounts:The financial information of the filing organization is included in a consolidated audited financial statement for the current year. The applicable footnote from the attached consolidated audited financial statements that addresses accounts receivable, the allowance for uncollectible accounts, and the provision for bad debts can be found on pages 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. 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: $(149,713,834) - Difference in costing methodology: 15,398,713 - Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (324,343,361) ------------- Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $(458,658,483) As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization.
Part III, Line 9b:	Collection Policies: The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier than 120 days after the first post-discharge billing statement is sent to the individual and is at least 30 days after the notice is provided. A reasonable attempt is also made to orally notify an individual about the filing organization's Financial Assistance Policy and how the individual may obtain assistance with the Financial Assistance application process. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first post-discharge billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus (or ceases any other ECA's) and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of the hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of the hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made.
Part VI, Line 2:	As reported in Schedule H, Part V, Section B, the filing organization's hospital facilities conduct their community health needs assessments (CHNAs) every three years. Their 2022 CHNAs were adopted by all hospital governing boards by December 31, 2022, the end of the filing organization's taxable year in which the CHNAs were conducted. All of the filing organization's hospital facilities' CHNAs complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNAs discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of all of its communities. Such practices and processes involve the following:1. Hospitals' operating/community boards composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's hospital communities; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's hospital communities.
Part VI, Line 3:	The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for the hospital facilities' financial counselors are prominently and conspicuously posted on the filing organization's hospital facilities' websites. Each hospital facility's website indicates that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by the relevant hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of the filing organization's hospital facilities, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of each hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. The filing organization's hospital facilities' financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facilities who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facilities' office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about the hospital facilities' FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of each hospital facility's community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance.
Part VI, Line 4:	See Part VI, Line 4 footnote below.
Part VI, Line 5:	The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $10,097,658 of benefit with respect to the faith-based and spiritual needs of the communities it serves in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care. During the current year, the filing organization expended $211,278,302 in new capital improvements.As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospitals are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities.
Part VI, Line 6:	The filing organization is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as AdventHealth. AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 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 4:	In 2023, the filing organization operated 3 separately licensed hospitals that together encompassed 11 separate campus locations and 9 off-site emergency departments. The hospitals are located in Florida. A description of each hospital and the communities they serve is described below.Facility Reporting Group - AAdventist Health System/Sunbelt, Inc.:AdventHealth's Central Florida Division South Region consists of a 3,251-bed medical complex in Central Florida with eight separate hospital campuses and nine off-site emergency departments (the Hospitals) that operate under a single hospital license. The Hospitals serve the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake County) but also draw patients from other parts of the Southeastern United States, the Caribbean and South America. The 8-campus health system is the largest healthcare provider in Central Florida with more than 2 million patient visits per year and is the nation's largest Medicare provider. It is the second largest employer in the area.The main campus of AdventHealth's Central Florida Division South Region is located in Orlando, Florida (Orange County) near the downtown area. The other 7 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 8 hospitals, it also operates 57 full-service urgent care clinics in convenient community settings.During 2023, the patient percentage population for the eight campuses was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2023, about 74.9% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 43.6% - Medicaid Patients 13.3% - Self-Pay Patients 4.7%The demographic makeup of the communities served and a brief description of each of the hospital campuses is described below: Lake Orange Osceola Seminole - Population 383,956 1,429,908 388,656 470,856 (2020 Data) - Population Over 65 26.5% 11.6% 13.0% 15.2% (2019 Data) - Poverty (Below 100% FPL) 12.0% 14.9% 14.8% 10.6% (2015-2019 Data) - High School Graduation Rate 89.5% 88.5% 86.7% 94.3% (2015-2019 Data) - Uninsured Adults 10.6% 13.3% 13.2% 9.5% (2016-2020 Data) - Food Insecurity Rate 13.9% 14.2% 14.6% 11.9% (2021 Data)AdventHealth Orlando (Orange County) - At the core of AdventHealth's Central Florida Division South Region, AdventHealth Orlando (AHO) is a 1,395-bed acute-care tertiary hospital. AHO is home to nationally recognized Centers of Excellence for cancer, cardiology, children's health, diabetes, neuroscience, orthopedics, transplant and global robotics. AdventHealth Orlando houses one of the largest Emergency Departments and cardiac catheterization labs in the country and is one of the busiest hospitals in the nation. The campus also includes a state-of-the-art Cardiac Diagnostic Center, featuring 15 Cath and electro physiology (EPS) Labs, and an inpatient Hospice unit.Additionally, AHO houses the Translational Research Institute, a 54,000 square-foot facility devoted to the study of obesity and metabolic origins of cardiovascular disease with the aim of developing new treatments to battle diabetes and obesity. AHO also serves as a teaching hospital for family medicine, allopathic and osteopathic tracts, emergency medicine, neuromusculoskeletal medicine, general surgery, podiatric medicine and surgery, and internal medicine. As one of the premier health systems in the nation, AHO sets the standard for innovation, quality, and comprehensive care.AdventHealth for Women at Orlando is a 12-story hospital located on the Orlando campus. The first floor houses the Breastfeeding Center, parent education classroom as well as obstetrical triage and registration. 10 of the 12 floors are complete, which include 72 mother-baby rooms and high-risk OB rooms, 14 labor and delivery suites, 13 operating rooms, 82 NICU beds, 104 oncology beds which include GYN oncology, medical oncology, 32-bed ICU capable BMT unit, and a 36-bed thoracic pulmonary Unit.Also located on the AHO Campus is the Walt Disney Pavilion at AdventHealth for Children. The Walt Disney Pavilion is not a stand-alone facility but rather a 7-story, 198-bed tower located on AHO's campus. It is a full-service facility served by more than 140 pediatric specialists and a highly trained pediatric team of more than 800 employees. The Walt Disney Pavilion at AdventHealth for Children delivers a complete range of pediatric health services for younger patients including advanced surgery, oncology, neurosurgery, cardiology and transplant services; full-service pediatrics; and an innovative health and obesity platform.AdventHealth Altamonte (Seminole County) - AdventHealth Altamonte is a 389-bed facility, which has recently doubled in size with a new patient tower to better serve a busy community. AdventHealth Altamonte was the first "satellite" hospital, built in 1973 on what was then pastureland, miles from the nearest business district. Located north of Orlando in fast-growing Seminole County, AdventHealth Altamonte is the second largest satellite campus within AdventHealth's Central Florida Division South Region. In addition to maternity, pediatric, NICU, emergency, medical and surgical services, the hospital operates the Martin Andersen Cancer Center (along with the region's only Cancer Resource Library), a heart catheterization lab, and a comprehensive outpatient program which includes surgery, diagnostics, and medical treatment programs. In 2014, the Mother Baby Unit was expanded to provide a 15-bed CDU, 10 new LDR rooms, 6 triage rooms, and a new C-section operating room and recovery unit. In 2018, a 10-bed Level II Neonatal Intensive Care Unit (NICU) was added. *** see continuation of footnote
Part VI, Line 4 Continuation of Footnote:	Facility Reporting Group - ADescription of Community Information - ContinuedAdventHealth Apopka (Orange County) - In 1975, AdventHealth Apopka became the second satellite hospital. For over four decades, AdventHealth Apopka has set the standard in hometown health care by providing high-tech, quality care with a personalized touch. In December, 2017, construction was completed on a $203 million replacement facility located approximately three miles from the existing facility. The new, 320,000 square foot facility was built on a 71-acre site. Five of the seven floors have been built out with the remaining two floors to be shelled in for future expansion. The 120-bed facility includes intensive care, emergency medicine, endoscopy, outpatient, diagnostic, respiratory, and rehabilitation services.AdventHealth Celebration (Osceola County) - AdventHealth Celebration is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 357-bed acute care hospital delivers a state-of-the-art healing environment to residents of Osceola, Orange, Polk and Lake Counties, as well as to visitors from across the United States and the world. From its creation, AdventHealth Celebration has been about promoting health and wellness as well as healing. Inside the resort-style hospital there is a wellness center, complete with workout area, pool, and rehabilitation facility. AdventHealth Celebration also houses the Global Robotics Institute, which provides patients with access to some of the most experienced robotic surgeons in the world. The Nicholson Center for Surgical Advancement also is a location where surgeons from around the world travel to learn the latest robotic surgery techniques. The Institute for Interactive Patient Care is a 234,000 square-foot patient tower with 62 beds and was the first of its kind in the nation where physicians can study everything from new patient safety technology to the impact of changing communication with patients about their care. In 2013, a four-story medical office building was added in which the Women's Institute is situated. In 2014, a new 5th floor inpatient 32 bed state-of-the art medical/surgical unit was added. In 2018, two inpatient surgical cardiovascular OR's were added. In 2020, a five-story, 166,000 square foot tower was added which, in addition to 80 new acute care beds, includes a state-of-the art unit featuring six Cath labs and two cardiac operating rooms. The expansion allowed for the launch of comprehensive stroke care, which includes 24/7 emergency neurosurgery and interventional neurosurgery. AdventHealth Celebration offers services in cancer, digestive health, neuroscience, weight-loss services and surgery, orthopedic health, spine health, thoracic surgery, women's and men's health, robotic-assisted surgeries, and imaging diagnostics. AdventHealth East Orlando (Orange County) - AdventHealth East Orlando is an innovative local leader that fills a vital need in a fast-growing area. A recent 200,000 square-foot expansion project upgraded the Hospital to 295 beds, with a spacious patient tower and 80 new private rooms designed to enhance the holistic care experience. In 2014, an expanded ED provided 60 new treatment rooms. AdventHealth East Orlando includes a teaching hospital with residencies in family medicine, podiatry, and emergency medicine. The campus is also home to an outpatient surgery center, a hospital-based Center for Medical Simulation and Education, a Cancer Institute featuring state-of-the-art technology for radiation oncology and a dedicated infusion center, as well as a 12-bed Children's Emergency Center. Alongside having the largest emergency room in Central Florida, other services include cardiovascular, pulmonary, and digestive health, orthopedics and rehabilitation, ear/nose/throat, andrology, and urology. The Hospital also meets the diverse needs of its growing community at its brand-new, freestanding emergency room, AdventHealth Waterford Lakes ER, which offers hospital-based ER services by board-certified emergency physicians, critical care nurses, and stroke and chest pain experts. AdventHealth Kissimmee (Osceola County) - AdventHealth Kissimmee is a 242-bed community-focused hospital, conveniently located near Walt Disney World. The team located at AdventHealth Kissimmee is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties. This facility has recently expanded to include a new medical office building, patient tower, new main entrance, expanded Emergency Department and a parking garage. The three-story patient tower includes private patient rooms and a host of modern amenities and technologies. Services offered include cardiovascular services, orthopedics and rehabilitation, neuroscience, cancer, diabetes, gastroenterology, emergency services, urology, and imaging resources. AdventHealth Winter Garden (Orange County) - AdventHealth Winter Garden officially opened the inpatient pavilion May, 2022, to serve the residents of Winter Garden and West Orange County. The $229.5 million, five-story tower currently has 80 beds and compliments the existing 24-bed emergency department and medical office building. The hospital was designed to provide patients with a feeling of home and includes details such as single-occupancy rooms and private bathrooms, large windows that allow more natural light, an outdoor courtyard for patients and family to get sunshine and fresh air, and an indoor dining area with an array of food options so patients can access comfort food prepared in a healthier way. The tower also includes some high-tech features including a centralized patient monitoring system, a full service lab, seven surgery rooms and a dedicated imaging level. In addition to emergency services, the tower provides several new services, such as advanced gynecology, cardiology, gastroenterology, general surgery, neurology, spine health and urology. AdventHealth Winter Park (Orange County) - AdventHealth Winter Park is a 373-bed facility that is a model of community health and wellness. The facility boasts spacious patient care areas and a full spectrum of specialties and services, including the Dr. P. Phillips Baby Place (with Level II NICU), AdventHealth Orthopedic Institute, and state-of-the-art surgery, recovery and rehabilitation at the AdventHealth Cancer Institute. In 2019, the new 5-story Nicholson Pavilion opened, adding 80 all-private rooms to the AdventHealth Winter Park campus. AdventHealth Winter Park has the Central Florida Region's only senior-friendly emergency room. Services offered at AdventHealth Winter Park include cancer, cardiovascular, digestive health, women's health, neuroscience, ophthalmology, orthopedics and rehabilitation, urology, and sports medicine The Hospital also provides timely, convenient and quality emergency care at its state-of-the-art freestanding emergency room, AdventHealth Oviedo ER, which is staffed with physicians trained to provide medical treatments for adults and children. *** see continuation of footnote
Part VI, Line 4 Continuation of Footnote:	Facility Reporting Group - ADescription of Community Information - ContinuedAdventist Health System/Sunbelt, Inc. dba AdventHealth Sebring:AdventHealth Sebring is comprised of three separate hospital campuses with a total of 229 beds. Two of the hospital campuses are located in Highlands County, Florida and operate under a single hospital license and the third separately licensed campus is located in Hardee County, Florida. Highlands and Hardee counties are in the south central areas of Florida and are adjacent to each other.During 2023, the patient percentage population for all three campuses of AdventHealth Sebring was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2023, about 74.0% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 61.5% - Medicaid Patients 12.9% - Self-Pay Patients 4.6%AdventHealth Sebring (Highlands County) - The main 171-bed hospital facility, located in north Sebring, was opened in 1998 to serve the Florida Heartland region which includes Highlands County and five surrounding inland, non-metropolitan counties. AdventHealth Sebring has key service lines, including a heart & vascular center, Cancer Institute, Breast Care Center, Blessed Beginnings Birthing Center, and Emergency Services. The Hospital has also established a retail pharmacy and Orthopedic unit. AdventHealth Sebring is on the cutting edge of technology in Highlands County, being the only Orthopedic program to use the MAKOplasty Robot and only Surgical Services Program to use the da Vinci Robot. The Hospital has received recognition for its patient safety, orthopedics, heart care, and as a breast imaging center of excellence. The Hospital has been recognized and received an "A" from the Leapfrog Group in patient safety.The demographic makeup of AdventHealth Sebring's community is as follows: - Population 108,442 - Population Over 65 32.3% - Poverty (Below 100% FPL) 16.9% - High School Graduation Rate 82.4% - Uninsured Adults 12.3% - Food Insecurity Rate 17.6% - Pop. with Low Food Access 44.5%AdventHealth Lake Placid (Highlands County) - This satellite facility houses 33 medical and surgical beds, and provides a wide range of services that are highly sophisticated for a small community hospital. This campus also specializes in inpatient geriatric psychiatric services within Highlands and Hardee counties. The need for behavioral health services is extreme in both counties since there is no other program closer than sixty miles. AdventHealth Lake Placid has received national recognition in patient safety, ultrasound and computed tomography (CT), and Emergency Department (ED) areas. To better meet the needs of Highlands County, the Hospital offers a Wellness Center, along with educational classes, for the community. Key service lines include ER, ICU and the Medical Surgical Unit. AdventHealth Lake Placid is on the leading edge of technology in Highlands County as the only Hospital to utilize virtual and room sterilization technology.The demographic makeup of AdventHealth Lake Placid's community is as follows: - Population 64,751 - Population Over 65 27.2% - Poverty (Below 100% FPL) 20.2% - High School Graduation Rate 80.7% - Uninsured Adults 12.3% - Food Insecurity Rate 18.0% - Pop. with Low Food Access 43.4% *AdventHealth Wauchula (Hardee County) - Built at a new location in 2017, this campus is licensed for 25 beds and specializes in emergency and outpatient care, while offering excellent medical inpatient services. The Hospital contains the only ER in Hardee County. AdventHealth Wauchula offers many inpatient and outpatient services, including physical & occupational therapy, a transitional care unit, medical surgical swing unit, and the only mammography unit in Hardee County, the Linda Adler Mammography Center. In 2019, AdventHealth Wauchula opened a Wellness Center to better meet the health needs of Hardee County. The Hospital has been recognized as a Top Rural Hospital by The Leapfrog Group and best hospital for patient safety. The demographic makeup of AdventHealth Wauchula's community is as follows: - Population 113,160 - Population Over 65 31.6% - Poverty (Below 100% FPL) 17.5% - High School Graduation Rate 83.0% - Uninsured Adults 12.4% - Food Insecurity Rate 17.6% - Pop. with Low Food Access 45.3%
Part VI, Line 7:	The filing organization does not file an annual community benefit report with any state agencies.

Schedule H (Form 990) 2023

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part I

General Information on Grants and Assistance

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	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Adventhealth Foundation Inc 900 Hope Way ALTAMONTE SPRINGS,FL32714	59-2219301	501(c)(3)	951,015	159,478	Book	Other	General Support
(2) Adventhealth University Inc 671 Winyah Dr Orlando,FL32803	59-3069793	501(c)(3)	0	22,390	Book	Medical Supplies	General Support
(3) Adventist Care Centers - Courtland Inc 730 Courtland St Orlando,FL32804	20-5774723	501(c)(3)	447,425	0			General Support
(4) Advocates For World Health Inc 13200 Belcher Road S Largo,FL33773	26-4695101	501(c)(3)	0	68,600	Book	Medical Supplies	General Support
(5) African-American Chamber Of Commerce Of Central Florida Inc 3201 E Colonial Drive A-20 Orlando,FL32803	59-3314330	501(c)(6)	11,500	0			General Support
(6) Ali's Hope Foundation Inc 1180 Spring Centre S Blvd 210 Altamonte Springs,FL32714	46-1222839	501(c)(3)	7,500	0			General Support
(7) Alzheimer's & Dementia Resource Center Inc 1410A Gene Street Winter Park,FL32789	59-2496511	501(c)(3)	8,250	0			General Support
(8) American Diabetes Association Inc 1101 N Lake Destiny Rd Maitland,FL327517105	13-1623888	501(c)(3)	30,000	0			General Support
(9) American Cancer Society Inc 1100 Pennsylvania Ave Kansas City,MO64105	13-1788491	501(c)(3)	120,000	0			General Support
(10) American Heart Association Inc 10460 Roosevelt Blvd N 306 St Petersburg,FL33716	13-5613797	501(c)(3)	185,000	0			General Support
(11) American Muslim Social Services Inc 588 S Wilma St Longwood,FL32750	81-4681715	501(c)(3)	24,000	0			General Support
(12) Arts Foundation For Seniors Inc Po Box 3269 Orlando,FL32802	92-0800650	501(c)(3)	200,000	0			General Support
(13) Aspire Health Partners Inc 5151 Adanson St Orlando,FL32804	59-2301233	501(c)(3)	826,917	0			General Support
(14) Association Of Women'S Health Obstetric And Neonatal Nurses 1800 M Street Nw 740S Washington,DC20036	52-1788738	501(c)(3)	6,000	0			General Support
(15) Avon Park Seventh-Day Adventist Church 1410 W Avon Boulevard Avon Park,FL33825	59-3057686	501(c)(3)	108,365	0			General Support
(16) Boy Scouts Of America Inc Central Florida Council 1951 S Orange Blossom Tr Ste 102 Apopka,FL327037747	59-0624376	501(c)(3)	28,000	0			General Support
(17) Boys Town Central Florida Inc 975 Oklahoma Street Oviedo,FL32765	20-0654235	501(c)(3)	7,500	0			General Support
(18) Center For Independent Living In Central Florida Inc 720 N Denning Dr Winter Park,FL32789	59-1828770	501(c)(3)	6,000	0			General Support
(19) Central Florida Family Health Center Inc dba True Health 4930 E Lake Mary Blvd Sanford,FL327716012	59-1741286	501(c)(3)	100,000	0			General Support
(20) Central Florida Health Care Coalition Inc 5717 Red Bug Lake Road Suite 118 Winter Springs,FL32708	59-2500692	501(c)(3)	10,000	0			General Support
(21) Central Florida Pediatric Society Inc 1890 State Road 436 215 Winter Park,FL32804	23-7422278	501(c)(3)	10,000	0			General Support
(22) Champion for Children Foundation of Highlands County Inc 419 E Center Avenue Sebring,FL33870	65-0444941	501(c)(3)	13,000	0			General Support
(23) Christian Service Center For Central Florida Inc 808 West Central Blvd Orlando,FL32805	59-1353031	501(c)(3)	15,000	0			General Support
(24) Christian Tech Center Ministries Inc 1006 W State Road 434 Longwood,FL32750	88-1085380	501(c)(3)	12,500	0			General Support
(25) City Of Apopka 11 North Forest Ave Apopka,FL32703	59-6000265	Gov't	50,000	0			General Support
(26) Creation Development Foundation Inc 599 Celebration Place Celebration,FL34747	45-3411581	501(c)(3)	40,000	0			General Support
(27) Daves House Inc 9152 Point Cypress Dr Orlando,FL32836	27-0533943	501(c)(3)	10,000	0			General Support
(28) East Orlando Health & Rehab Center Inc 250 South Chickasaw Trail Orlando,FL32825	20-5774748	501(c)(3)	1,485,742	0			General Support
(29) Edible Education Experience Inc 26 E King St Orlando,FL32804	46-5655482	501(c)(3)	15,000	0			General Support
(30) Find Feed & Restore Inc 830 W Montrose Street Clermont,FL34711	86-3070194	501(c)(3)	21,000	0			General Support
(31) FLNC Inc 3355 E Semoran Blvd Apopka,FL32703	20-5774761	501(c)(3)	4,688,825	0			General Support
(32) Florida Hospital Waterman Inc 1000 Waterman Way Tavares,FL32778	59-3140669	501(c)(3)	7,286	0			General Support
(33) Florida Senior Housing Initiative Inc 10151 Deerwood Park Blvd Bld 300ST300 Jacksonville,FL32256	93-1704402	501(c)(3)	11,441,000	0			General Support
(34) Forest City Spanish Seventh Day Adventist Church 7601 Forest City Rd Orlando,FL32810	59-3291153	501(c)(3)	18,000	0			General Support
(35) Forest Lake Academy 500 Education Loop Apopka,FL32703	59-0816443	501(c)(3)	25,000	0			General Support
(36) Forest Lake Education Center 1275 Learning Loop Longwood,FL32779	59-3143238	501(c)(3)	500,000	0			General Support
(37) Foundation For Orange County Public Schools 445 W Amelia St Ste 901 Orlando,FL32801	59-2788435	501(c)(3)	73,612	0			General Support
(38) Foundation For Seminole State College Of Florida Inc 1055 AAA Drive Heathrow,FL32746	23-7033822	501(c)(3)	250,000	0			General Support
(39) Give Kids The World Inc 210 South Bass Road Kissimmee,FL34746	59-2654440	501(c)(3)	10,000	0			General Support
(40) Grace Medical Home Inc 1417 E Concord St Orlando,FL32803	26-1817966	501(c)(3)	168,000	0			General Support
(41) Harbor House Of Central Florida Inc Po Box 680748 Orlando,FL32868	59-1712936	501(c)(3)	10,000	0			General Support
(42) Harvest Time International Inc 225 Harvest Time Dr Sanford,FL32771	54-1698630	501(c)(3)	8,000	0			General Support
(43) Health Care Center For The Homeless Inc 234 North Orange Blossom Trail Orlando,FL32805	59-3185020	501(c)(3)	100,000	0			General Support
(44) Healthy Start Coalition Of Osceola County Inc 1014 Pennsylvania Ave St Cloud,FL34769	59-3212535	501(c)(3)	12,000	0			General Support
(45) Heart Of Florida United Way Inc 1940 Traylor Blvd Orlando,FL32804	59-0808854	501(c)(3)	35,000	0			General Support
(46) Hebni Nutrition Consultants Inc 2009 W Central Blvd Orlando,FL32805	59-3258397	501(c)(3)	150,000	0			General Support
(47) Help Now Of Osceola Inc 108 Church Street Kissimmee,FL34741	59-2283508	501(c)(3)	15,000	0			General Support
(48) Hispanic Business Initiative Fund Of Florida Inc 3201 E Colonial Dr Ste A20 Orlando,FL32803	59-3341405	501(c)(3)	13,000	0			General Support
(49) Hispanic Heritage Scholarship Fund Of Metro Orlando Inc 518 S Magnolia Ave Suite 100 Orlando,FL32801	01-0807279	501(c)(3)	12,500	0			General Support
(50) Hope Community Center Inc 1016 N Park Ave Apopka,FL327122720	56-2551312	501(c)(3)	7,500	0			General Support
(51) Hope Helps Inc 812 Eyrie Dr Oviedo,FL32765	20-8490916	501(c)(3)	10,000	0			General Support
(52) Hope Partnership Inc dba Community Hope Center 2420 Old Vineland Road Kissimmee,FL34746	80-0855060	501(c)(3)	40,000	0			General Support
(53) Idignity Inc 424 E Central Blvd Ste 199 Orlando,FL32801	01-0921490	501(c)(3)	1,010,000	0			General Support
(54) Iglesia Cristiana Pentecostal De Orlando Inc 5850 Clarcona Ocoee Rd Orlando,FL32810	59-3218454	501(c)(3)	16,000	0			General Support
(55) Impower Inc 2290 N Ronald Reagan Blvd Ste 116 Longwood,FL32750	65-0439778	501(c)(3)	30,000	0			General Support
(56) Jdrf International Incorporated 1850 Lee Rd Ste 132 Winter Park,FL32789	23-1907729	501(c)(3)	30,000	0			General Support
(57) Kids Beating Cancer Inc 1720 Lee Rd Winter Park,FL32789	59-3136203	501(c)(3)	21,750	0			General Support
(58) Kids House Of Seminole Inc 5467 N Ronald Reagan Blvd Sanford,FL32773	59-3415005	501(c)(3)	45,000	0			General Support
(59) Life Concepts Inc Dba Quest Inc 1509 E Colonial Dr Ste 300 Orlando,FL32803	59-2013160	501(c)(3)	15,000	0			General Support
(60) Lift Orlando Inc 710 South Tampa Avenue Suite 209 Orlando,FL32805	46-3607865	501(c)(3)	100,000	0			General Support
(61) Loaves & Fishes Inc 206 E 8Th Street Apopka,FL32703	59-2792540	501(c)(3)	25,000	0			General Support
(62) Make-A-Wish Foundation Of Central & Northern Florida 1020 North Orlando Avenue 100 Maitland,FL32751	59-3235806	501(c)(3)	11,000	0			General Support
(63) Mars Hill Seventh Day Adventist Church Po Box 1654 Sanford,FL327721654	26-4337526	501(c)(3)	18,000	0			General Support
(64) Matthews Hope Ministries Inc 611 Business Park Blvd 101 Winter Garden,FL34787	27-2245867	501(c)(3)	15,000	0			General Support
(65) Meals On Wheels Etc Inc 2801 S Financial Ct Sanford,FL32773	59-2977907	501(c)(3)	15,000	0			General Support
(66) Mental Health Association Of Central Florida Inc 1525 E Robinson St Orlando,FL32801	59-0816432	501(c)(3)	186,648	0			General Support
(67) Mothers Milk Bank Of Florida 8669 Commodity Circle 490 Orlando,FL32819	27-3939245	501(c)(3)	20,000	0			General Support
(68) Nami Greater Orlando Inc 300 Crown Oak Centre Dr Longwood,FL32750	59-2600149	501(c)(3)	7,500	0			General Support
(69) New Hope Missionary Baptist Church Of Apopka Inc 927 South Central Ave Apopka,FL32703	32-2335714	501(c)(3)	15,000	0			General Support
(70) New Image Youth Center 212 S Parramore Avenue Orlando,FL32805	56-2482818	501(c)(3)	1,000,000	0			General Support
(71) Nuevo Sendero Inc 1802 N Alafaya Trail Suite 156 Orlando,FL32826	26-0298579	501(c)(3)	7,500	0			General Support
(72) One Heart For Women And Children Inc 2040 N Rio Grande Ave Orlando,FL32804	30-0584360	501(c)(3)	17,500	0			General Support
(73) Orange County School Readiness Coalition Inc dba Early Earning Coalition 7700 Southland Blvd Ste 100 Orlando,FL32809	31-1759186	501(c)(3)	7,500	0			General Support
(74) Orangewood Christian School Inc 1300 W Maitland Blvd Maitland,FL32751	20-5639902	501(c)(3)	507,500	0			General Support
(75) Orlando Economic Partnership Inc 200 South Orange Avenue No 200 Orlando,FL32801	59-1767933	501(c)(3)	200,000	0			General Support
(76) Orlando Police Foundation Inc 1250 W South Street Orlando,FL32805	85-1820258	501(c)(3)	10,000	0			General Support
(77) Osceola County Council On Aging Inc 700 Generation Point Kissimmee,FL34744	59-1595398	501(c)(3)	30,000	0			General Support
(78) Osceola Mental Health Inc dba Park Place Behavioral Health Care 206 Park Place Blvd Kissimmee,FL34741	59-1677912	501(c)(3)	251,000	0			General Support
(79) Pace Center For Girls Inc 6745 Philips Industrial Blvd Jacksonville,FL32256	59-2414492	501(c)(3)	5,500	0			General Support
(80) Rescue Outreach Mission Of Central Florida Inc 1701 Historic Goldsboro Blvd Sanford,FL32771	59-2876415	501(c)(3)	17,500	0			General Support
(81) Ronald Mcdonald House Charities Of Central Florida Inc 1030 N Orange Ave Suite 105 Orlando,FL32801	59-3211250	501(c)(3)	129,717	0			General Support
(82) Runway To Hope Inc 189 S Orange Ave Orlando,FL328013261	27-3272616	501(c)(3)	16,500	0			General Support
(83) SOS Support Our Scholars Inc Po Box 1985 Winter Park,FL32790	26-0711355	501(c)(3)	7,500	0			General Support
(84) Samaritan Resource Center Inc 9837 E Colonial Drive Orlando,FL32817	35-2409476	501(c)(3)	25,000	0			General Support
(85) School District Of Osceola County 817 Bill Beck Blvd Kissimmee,FL347444495	59-6000779	Gov't	25,000	0			General Support
(86) Second Harvest Food Bank Of Central Florida Inc 411 Mercy Drive Orlando,FL32805	59-2142315	501(c)(3)	12,500	0			General Support
(87) Seminole County Sheriff'S Office Community Foundation Inc 100 Eslinger Way Sanford,FL32773	47-2640601	501(c)(3)	8,000	0			General Support
(88) Seniors First Inc 5395 Lb Mcleod Rd Orlando,FL328112952	59-2759603	501(c)(3)	37,000	0			General Support
(89) Shepherd'S Hope Inc 455 9Th St Winter Garden,FL34787	59-3420727	501(c)(3)	170,000	0			General Support
(90) South Florida State College 600 College Drive Avon Park,FL33825	59-1218159	Gov't	20,000	0			General Support
(91) Sunbelt Health & Rehab Center - Apopka Inc 305 East Oak St Apopka,FL32703	20-5774856	501(c)(3)	440,775	0			General Support
(92) Teen Challenge Of Florida Inc 3706 S Sanford Ave Sanford,FL32773	59-2479228	501(c)(3)	10,000	0			General Support
(93) The Avon Park Chamber of Commerce 28 E Main Street Avon Park,FL33825	59-1975354	501(c)(6)	10,000	0			General Support
(94) The Chamber Foundation Inc 1425 E Vine St Kissimmee,FL34744	59-3183973	501(c)(3)	12,000	0			General Support
(95) The Christian Sharing Center Inc 600 N Hwy 17-92 Ste 130 Longwood,FL32750	59-2744535	501(c)(3)	50,000	7,984	Book	Medical Supplies	General Support
(96) The Florida Endowment Foundation For Vocational Rehabilitation Inc dba Th 1709 Hermitage Blvd No 100 Tallahassee,FL32308	59-3052307	501(c)(3)	7,500	0			General Support
(97) The Foundation For Osceola Education Inc 2310 New Beginnings Rd Ste 118 Kissimmee,FL34744	59-2960396	501(c)(3)	11,000	0			General Support
(98) The Foundation For Seminole County Public Schools Inc 400 E Lake Mary Blvd Sanford,FL32773	59-2775956	501(c)(3)	9,500	0			General Support
(99) The Leukemia & Lymphoma SocietyInc 3 International Drive Suite 200 Rye Brook,NY10573	13-5644916	501(c)(3)	30,000	0			General Support
(100) The Nurture Place Inc 507 Macchi Avenue Winter Garden,FL34787	84-4334332	501(c)(3)	10,000	0			General Support
(101) The Salvation Army A Georgia Corporation 1424 Northeast Expressway Ne Atlanta,GA30329	58-0660607	501(c)(3)	50,000	0			General Support
(102) United Abolitionist Inc Po Box 536832 Orlando,FL32853	59-3178045	501(c)(3)	10,000	0			General Support
(103) United Against Poverty Inc 1400 27Th St Vero Beach,FL32960	11-3697936	501(c)(3)	15,000	0			General Support
(104) United Global Outreach 2301 N Orange Ave Orlando,FL328045510	03-0511875	501(c)(3)	12,000	0			General Support
(105) Universal Orlando Foundation Inc 1000 Universal Studios Plz Orlando,FL328197601	59-3510383	501(c)(3)	15,000	0			General Support
(106) Us Dream Academy Inc 5950 Symphony Woods Dr Ste 504 Columbia,MD21044	59-3514841	501(c)(3)	10,000	0			General Support
(107) Valencia College Foundation Inc 1768 Park Center Drive Orlando,FL32835	23-7442785	501(c)(3)	250,000	0			General Support
(108) Volusia League Of Cities Inc 12443 Research Pkwy No 402 Orlando,FL328263243	27-4413059	501(c)(4)	9,500	0			General Support
(109) West Orange Chamber Of Commerce 12184 W Colonial Drive Winter Garden,FL34787	59-0576757	501(c)(6)	10,265	0			General Support
(110) Whole Life Seventh-Day Adventist Church 2800 North Orange Ave Orlando,FL32804	59-3039667	501(c)(3)	6,000	0			General Support
(111) Winter Park Chamber Of Commerce 151 West Lyman Avenue Winter Park,FL32789	59-0514615	501(c)(6)	16,040	0			General Support
(112) Winter Park Library Association Inc 1052 W Morse Blvd Winter Park,FL32789	59-0794396	501(c)(3)	50,000	0			General Support
(113) Zion Farms & Market Inc P O Box 605 Orlando,FL34760	82-4080493	501(c)(3)	10,000	0			General Support

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

108

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

Software ID:
Software Version:

- TIN:

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.
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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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

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)
1Shaw Terry D Dir/President/AdventHealth CEO	(i) (ii)	0 ------------- 2,360,310	0 ------------- 1,055,799	0 ------------- 1,592,859	0 ------------- 1,298,177	0 ------------- 36,962	0 ------------- 6,344,107	0 ------------- 130,500
2Rathbun Paul C AdventHealth CFO	(i) (ii)	0 ------------- 1,347,228	0 ------------- 441,722	0 ------------- 869,186	0 ------------- 473,177	0 ------------- 30,816	0 ------------- 3,162,129	0 ------------- 150,000
3Haffner PhD Randall Group CEO FL & Clinical	(i) (ii)	0 ------------- 1,675,408	0 ------------- 536,559	0 ------------- 233,744	0 ------------- 173,177	0 ------------- 32,224	0 ------------- 2,651,112	0 ------------- 150,000
4Davis JrMD Robert Duane Physician/Medical Director	(i) (ii)	1,220,289 ------------- 0	1,375,642 ------------- 0	15,329 ------------- 0	17,727 ------------- 0	7,671 ------------- 0	2,636,658 ------------- 0	0 ------------- 0
5Silvestry MD Scott Phy/Dir AH Thoracic Transplant	(i) (ii)	1,715,031 ------------- 0	420,000 ------------- 0	20,317 ------------- 0	17,727 ------------- 0	32,091 ------------- 0	2,205,166 ------------- 0	0 ------------- 0
6Moorhead MD David Former Key Employee	(i) (ii)	0 ------------- 1,017,115	0 ------------- 298,956	0 ------------- 562,955	0 ------------- 17,727	0 ------------- 9,485	0 ------------- 1,906,238	0 ------------- 0
7Goodman Todd Group CFO FL & Clinical	(i) (ii)	0 ------------- 926,071	0 ------------- 256,883	0 ------------- 412,531	0 ------------- 150,677	0 ------------- 37,208	0 ------------- 1,783,370	0 ------------- 112,745
8Zbaraschuk Amy Former Key Employee	(i) (ii)	0 ------------- 479,084	0 ------------- 117,625	0 ------------- 918,843	0 ------------- 73,198	0 ------------- 38,032	0 ------------- 1,626,782	0 ------------- 59,414
9Thompson Michael CEO IHS Central FL Div-South Region	(i) (ii)	0 ------------- 695,764	0 ------------- 212,727	0 ------------- 434,610	0 ------------- 106,792	0 ------------- 37,262	0 ------------- 1,487,155	0 ------------- 71,411
10Adams Brian CEO AH Central FL Division	(i) (ii)	0 ------------- 848,940	0 ------------- 253,454	0 ------------- 123,463	0 ------------- 153,128	0 ------------- 30,475	0 ------------- 1,409,460	0 ------------- 61,392
11Wandersleben Jennifer Former Key Employee	(i) (ii)	0 ------------- 680,694	0 ------------- 216,920	0 ------------- 322,729	0 ------------- 121,227	0 ------------- 40,241	0 ------------- 1,381,811	0 ------------- 80,851
12Zeeshan MD Ahmad Physician - Heart Transplant	(i) (ii)	778,289 ------------- 0	334,780 ------------- 0	7,832 ------------- 0	17,727 ------------- 0	19,541 ------------- 0	1,158,169 ------------- 0	0 ------------- 0
13Bogar MD Linda Physician - Heart Transplant	(i) (ii)	744,375 ------------- 0	312,919 ------------- 0	11,736 ------------- 0	17,727 ------------- 0	28,960 ------------- 0	1,115,717 ------------- 0	0 ------------- 0
14Hilliard Douglas CFO AH Central FL Division	(i) (ii)	0 ------------- 612,235	0 ------------- 153,364	0 ------------- 201,945	0 ------------- 92,068	0 ------------- 39,300	0 ------------- 1,098,912	0 ------------- 84,913
15Bellam MD Naveen Physician-Cardiologist/Transplant	(i) (ii)	488,623 ------------- 0	463,557 ------------- 0	73,329 ------------- 0	17,727 ------------- 0	35,814 ------------- 0	1,079,050 ------------- 0	0 ------------- 0
16Deininger Robert CEO AH Central FL Market	(i) (ii)	0 ------------- 629,398	0 ------------- 160,042	0 ------------- 107,754	0 ------------- 106,828	0 ------------- 32,192	0 ------------- 1,036,214	0 ------------- 53,648
17Spenst Brett Former Key Employee	(i) (ii)	0 ------------- 583,228	0 ------------- 0	0 ------------- 373,532	0 ------------- 11,127	0 ------------- 24,720	0 ------------- 992,607	0 ------------- 0
18Villanueva Jeffrey Former Key Employee	(i) (ii)	0 ------------- 477,494	0 ------------- 133,299	0 ------------- 218,832	0 ------------- 72,784	0 ------------- 39,626	0 ------------- 942,035	0 ------------- 50,448
19Harcombe Douglas CEO AH South FL Market	(i) (ii)	0 ------------- 567,047	0 ------------- 143,744	0 ------------- 97,791	0 ------------- 97,423	0 ------------- 30,799	0 ------------- 936,804	0 ------------- 62,260
20Edris Tricia Chief Innovation & Partnership Off.	(i) (ii)	0 ------------- 536,877	0 ------------- 161,100	0 ------------- 122,075	0 ------------- 71,594	0 ------------- 34,478	0 ------------- 926,124	0 ------------- 65,136
21Finkler MD Neil Chief Clncl Off. AH Central FL (End	(i) (ii)	0 ------------- 521,413	0 ------------- 211,176	0 ------------- 105,615	0 ------------- 17,727	0 ------------- 23,091	0 ------------- 879,022	0 ------------- 0
22Cook Timothy Former Key Employee	(i) (ii)	0 ------------- 497,492	0 ------------- 138,445	0 ------------- 112,183	0 ------------- 84,172	0 ------------- 27,394	0 ------------- 859,686	0 ------------- 60,937
23Herrera MD Victor Chief Clinical Off. AH Central FL Di	(i) (ii)	0 ------------- 554,237	0 ------------- 101,921	0 ------------- 23,094	0 ------------- 119,885	0 ------------- 33,418	0 ------------- 832,555	0 ------------- 0
24Moorhead Sheryl Chief People Off. AH Central FL Div.	(i) (ii)	0 ------------- 503,745	0 ------------- 147,113	0 ------------- 154,554	0 ------------- 17,727	0 ------------- 9,245	0 ------------- 832,384	0 ------------- 0
25Jimenez Kristin Chief Strategy Officer, AH Central F	(i) (ii)	0 ------------- 493,052	0 ------------- 102,949	0 ------------- 78,833	0 ------------- 69,250	0 ------------- 32,395	0 ------------- 776,479	0 ------------- 29,944
26Mckinney Jillyan CEO, AHMG & Ambulatory Serv. Central	(i) (ii)	0 ------------- 512,879	0 ------------- 107,509	0 ------------- 27,518	0 ------------- 89,062	0 ------------- 32,452	0 ------------- 769,420	0 ------------- 0
27Vargas Karilynn CEO AH NW Market Central FL	(i) (ii)	0 ------------- 468,107	0 ------------- 125,131	0 ------------- 59,041	0 ------------- 81,937	0 ------------- 21,547	0 ------------- 755,763	0 ------------- 31,005
28Johnson Linnette Chief Clinical Operations Off. AH Ce	(i) (ii)	0 ------------- 434,087	0 ------------- 103,820	0 ------------- 65,683	0 ------------- 82,247	0 ------------- 32,900	0 ------------- 718,737	0 ------------- 39,633
29Stankiewicz Catherine CNO AH Central FL Division	(i) (ii)	0 ------------- 425,687	0 ------------- 81,044	0 ------------- 57,037	0 ------------- 58,501	0 ------------- 31,018	0 ------------- 653,287	0 ------------- 8,434
30Bradley Kenneth W Former Key Employee	(i) (ii)	0 ------------- 165,680	0 ------------- 20,743	0 ------------- 17,706	0 ------------- 9,347	0 ------------- 18,005	0 ------------- 231,481	0 ------------- 0
31Owen Terry R Former Key Employee	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 140,310	0 ------------- 0	0 ------------- 0	0 ------------- 140,310	0 ------------- 119,784

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	The filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executive listed in Part VII that are on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 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 Group CEO & CFO for FL & Clinical, the CEO of the IHS Division in Central FL South Region, the AH Central FL Division's CEO, CFO, Chief Innovation & Partnership Officer, Chief Clinical Officer, Chief Strategy Officer, Chief Clinical Operations Officer, and the Chief Nursing Officer (CNO) are officers or key employees. 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: AdventHealth has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval by the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: Occasional discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth President's Council, CFO Conference or the CMO/CNO business meeting. Payments provided to each executive are considered taxable compensation to the executive. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. All taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, to encourage executives to establish and cultivate strong working relationships with the medical community and other leaders in the community and industry, certain AdventHealth executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be approved by the AdventHealth President/CEO initially as well as on an annual basis. Each AdventHealth executive who is approved for a club membership must submit an annual report describing how they used the membership to benefit their organization during the preceding year so that the AdventHealth President/CEO can determine if continuance of the club membership furthers the business interests of AdventHealth. In the current year, for this filing organization, one executive listed in Part VII received reimbursement for club fees. While the club dues membership is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and reimbursed in whole or in part by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for health or social club dues since it has wholly or partially paid for the cost of providing this benefit.
Part I, Line 3	The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present, other than the Chief People Officer, who remains at the request of the Chairman/committee to provide assistance/information as needed. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership.
Part I, Line 4b	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. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. Shaw, Terry D. $ 155,450 $ 132,569 $1,334,441 $ 0 Rathbun, Paul C. $ 155,450 $ 132,564 $ 632.721 $ 0 Haffner, Randall $ 155,450 $ 152,379 $ 0 $ 0 Moorhead, MD, David $ 155,450 $ 132,950 $ 291,354 $ 0 Goodman, Todd $ 155,450 $ 114,532 $ 217,202 $ 0 Zbaraschuk, Amy $ 55,471 $ 60,357 $ 828,437 $ 0 Thompson, Michael $ 111,565 $ 72,543 $ 291,806 $ 0 Adams, Brian $ 148,620 $ 62,365 $ 0 $ 9,281 Wandersleben, Jennifer $ 115,299 $ 82,132 $ 0 $ 10,702 Hilliard, Douglas $ 96,841 $ 74,749 $ 65,701 $ 0 Deininger, Robert $ 94,960 $ 54,498 $ 0 $ 16,641 Spenst, Brett $ 0 $ 0 $ 0 $ 105,231 Villanueva, Jeffery $ 55,057 $ 51,248 $ 134,780 $ 0 Harcombe, Douglas $ 79,696 $ 63,248 $ 0 $ 0
Schedule J, Part I, Line 4b continued:	FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. Edris, Tricia $ 76,367 $ 66,169 $ 0 $ 0 Finkler, Neil $ 60,217 $ 37,717 $ 0 $ 0 Cook, Timothy $ 66,445 $ 61,903 $ 0 $ 0 Herrera, Victor $ 0 $ 0 $ 0 $ 102,158 Moorhead, Sheryl $ 89,113 $ 66,613 $ 0 $ 0 Jimenez, Kristin $ 63,039 $ 30,419 $ 0 $ 10,984 Mckinney, Jillyan $ 0 $ 0 $ 0 $ 77,935 Vargas, Karilynn $ 64,210 $ 31,496 $ 0 $ 0 Johnson, Linnette $ 47,077 $ 40,262 $ 0 $ 17,442 Stankiewicz, Catherine $ 44,986 $ 8,568 $ 0 $ 18,288 SERP III AHS 457b Distr.* Distr.* Spenst, Brett $ 105,231 $ 0 Owen, Terry $ 0 $ 119,784 * Including Investment Earnings

Schedule J (Form 990) 2023

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
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
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	NoneAvail	03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	09-18-2013	485,000,000	2013A B C, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-02-2014	110,000,000	2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595	NoneAvail	07-02-2014	50,000,000	2014B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	NoneAvail	07-02-2014	30,000,000	2014C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AT39	07-23-2014	82,501,800	2014E, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FAB0	07-21-2016	235,724,616	2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	1964745K2	08-17-2016	216,517,920	2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FGN8	07-12-2018	375,008,542	2018A&B, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FJG0	08-20-2019	550,011,892	2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FSJ4	07-01-2021	579,966,540	2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542AFE6	07-01-2021	238,025,567	2021B, Refund 2010C, 2017C; Expand/refurbish facilities	X			X		X
	Orange County Health Facilities Authority	52-1378595	68450LGB5	07-01-2021	62,033,621	2021C, Refund 2010B, 2017A; Expand/refurbish facilities	X			X		X
	Highlands County Health Facilities Authority	52-1313569	431022UJ9	07-01-2021	200,000,000	2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	06-01-2022	335,007,000	2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXD1	07-12-2023	252,722,621	2023 A-1&2; Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXF6	08-17-2023	64,418,097	2023 B; Refund 2016C-1		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	281,555,000		210,000,000		302,985,000		276,165,000
2 Amount of bonds legally defeased ..............	22,900,000		3,025,000		2,800,000		8,535,000
3 Total proceeds of issue ..................	372,572,414		294,985,000		115,015,000		348,320,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............	5,560,382
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	367,012,032		30,041,050		115,015,000		50,068,380
11 Other spent proceeds .............	125,000,000		294,985,000		403,646,175		348,320,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2004		2012		2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.420 %		0.200 %		0.840 %		0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.070 %
6 Total of lines 4 and 5 .............	1.420 %		0.200 %		0.840 %		0.500 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X	X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0.080 %		0.140 %		0.140 %		0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............	X			X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c	Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	NoneAvail	03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	09-18-2013	485,000,000	2013A B C, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-02-2014	110,000,000	2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595	NoneAvail	07-02-2014	50,000,000	2014B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	NoneAvail	07-02-2014	30,000,000	2014C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AT39	07-23-2014	82,501,800	2014E, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FAB0	07-21-2016	235,724,616	2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	1964745K2	08-17-2016	216,517,920	2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FGN8	07-12-2018	375,008,542	2018A&B, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FJG0	08-20-2019	550,011,892	2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FSJ4	07-01-2021	579,966,540	2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542AFE6	07-01-2021	238,025,567	2021B, Refund 2010C, 2017C; Expand/refurbish facilities	X			X		X
	Orange County Health Facilities Authority	52-1378595	68450LGB5	07-01-2021	62,033,621	2021C, Refund 2010B, 2017A; Expand/refurbish facilities	X			X		X
	Highlands County Health Facilities Authority	52-1313569	431022UJ9	07-01-2021	200,000,000	2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	06-01-2022	335,007,000	2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXD1	07-12-2023	252,722,621	2023 A-1&2; Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXF6	08-17-2023	64,418,097	2023 B; Refund 2016C-1		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	281,555,000		210,000,000		302,985,000		276,165,000
2 Amount of bonds legally defeased ..............	22,900,000		3,025,000		2,800,000		8,535,000
3 Total proceeds of issue ..................	372,572,414		294,985,000		115,015,000		348,320,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............	5,560,382
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	367,012,032		30,041,050		115,015,000		50,068,380
11 Other spent proceeds .............	125,000,000		294,985,000		403,646,175		348,320,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2004		2012		2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.420 %		0.200 %		0.840 %		0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.070 %
6 Total of lines 4 and 5 .............	1.420 %		0.200 %		0.840 %		0.500 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X	X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0.080 %		0.140 %		0.140 %		0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............	X			X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c	Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	NoneAvail	03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	09-18-2013	485,000,000	2013A B C, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-02-2014	110,000,000	2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595	NoneAvail	07-02-2014	50,000,000	2014B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	NoneAvail	07-02-2014	30,000,000	2014C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AT39	07-23-2014	82,501,800	2014E, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FAB0	07-21-2016	235,724,616	2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	1964745K2	08-17-2016	216,517,920	2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FGN8	07-12-2018	375,008,542	2018A&B, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FJG0	08-20-2019	550,011,892	2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FSJ4	07-01-2021	579,966,540	2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542AFE6	07-01-2021	238,025,567	2021B, Refund 2010C, 2017C; Expand/refurbish facilities	X			X		X
	Orange County Health Facilities Authority	52-1378595	68450LGB5	07-01-2021	62,033,621	2021C, Refund 2010B, 2017A; Expand/refurbish facilities	X			X		X
	Highlands County Health Facilities Authority	52-1313569	431022UJ9	07-01-2021	200,000,000	2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	06-01-2022	335,007,000	2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXD1	07-12-2023	252,722,621	2023 A-1&2; Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXF6	08-17-2023	64,418,097	2023 B; Refund 2016C-1		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	281,555,000		210,000,000		302,985,000		276,165,000
2 Amount of bonds legally defeased ..............	22,900,000		3,025,000		2,800,000		8,535,000
3 Total proceeds of issue ..................	372,572,414		294,985,000		115,015,000		348,320,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............	5,560,382
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	367,012,032		30,041,050		115,015,000		50,068,380
11 Other spent proceeds .............	125,000,000		294,985,000		403,646,175		348,320,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2004		2012		2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.420 %		0.200 %		0.840 %		0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.070 %
6 Total of lines 4 and 5 .............	1.420 %		0.200 %		0.840 %		0.500 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X	X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0.080 %		0.140 %		0.140 %		0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............	X			X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c	Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	NoneAvail	03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	09-18-2013	485,000,000	2013A B C, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-02-2014	110,000,000	2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595	NoneAvail	07-02-2014	50,000,000	2014B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	NoneAvail	07-02-2014	30,000,000	2014C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AT39	07-23-2014	82,501,800	2014E, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FAB0	07-21-2016	235,724,616	2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	1964745K2	08-17-2016	216,517,920	2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FGN8	07-12-2018	375,008,542	2018A&B, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FJG0	08-20-2019	550,011,892	2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FSJ4	07-01-2021	579,966,540	2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542AFE6	07-01-2021	238,025,567	2021B, Refund 2010C, 2017C; Expand/refurbish facilities	X			X		X
	Orange County Health Facilities Authority	52-1378595	68450LGB5	07-01-2021	62,033,621	2021C, Refund 2010B, 2017A; Expand/refurbish facilities	X			X		X
	Highlands County Health Facilities Authority	52-1313569	431022UJ9	07-01-2021	200,000,000	2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	06-01-2022	335,007,000	2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXD1	07-12-2023	252,722,621	2023 A-1&2; Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXF6	08-17-2023	64,418,097	2023 B; Refund 2016C-1		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	281,555,000		210,000,000		302,985,000		276,165,000
2 Amount of bonds legally defeased ..............	22,900,000		3,025,000		2,800,000		8,535,000
3 Total proceeds of issue ..................	372,572,414		294,985,000		115,015,000		348,320,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............	5,560,382
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	367,012,032		30,041,050		115,015,000		50,068,380
11 Other spent proceeds .............	125,000,000		294,985,000		403,646,175		348,320,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2004		2012		2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.420 %		0.200 %		0.840 %		0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.070 %
6 Total of lines 4 and 5 .............	1.420 %		0.200 %		0.840 %		0.500 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X	X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0.080 %		0.140 %		0.140 %		0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............	X			X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c	Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	NoneAvail	03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	09-18-2013	485,000,000	2013A B C, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-02-2014	110,000,000	2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595	NoneAvail	07-02-2014	50,000,000	2014B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	NoneAvail	07-02-2014	30,000,000	2014C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AT39	07-23-2014	82,501,800	2014E, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FAB0	07-21-2016	235,724,616	2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	1964745K2	08-17-2016	216,517,920	2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FGN8	07-12-2018	375,008,542	2018A&B, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FJG0	08-20-2019	550,011,892	2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FSJ4	07-01-2021	579,966,540	2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542AFE6	07-01-2021	238,025,567	2021B, Refund 2010C, 2017C; Expand/refurbish facilities	X			X		X
	Orange County Health Facilities Authority	52-1378595	68450LGB5	07-01-2021	62,033,621	2021C, Refund 2010B, 2017A; Expand/refurbish facilities	X			X		X
	Highlands County Health Facilities Authority	52-1313569	431022UJ9	07-01-2021	200,000,000	2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	06-01-2022	335,007,000	2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXD1	07-12-2023	252,722,621	2023 A-1&2; Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXF6	08-17-2023	64,418,097	2023 B; Refund 2016C-1		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	281,555,000		210,000,000		302,985,000		276,165,000
2 Amount of bonds legally defeased ..............	22,900,000		3,025,000		2,800,000		8,535,000
3 Total proceeds of issue ..................	372,572,414		294,985,000		115,015,000		348,320,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............	5,560,382
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	367,012,032		30,041,050		115,015,000		50,068,380
11 Other spent proceeds .............	125,000,000		294,985,000		403,646,175		348,320,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2004		2012		2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.420 %		0.200 %		0.840 %		0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.070 %
6 Total of lines 4 and 5 .............	1.420 %		0.200 %		0.840 %		0.500 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X	X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0.080 %		0.140 %		0.140 %		0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............	X			X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c	Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.

Schedule K (Form 990) 2023

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Adventist Health SystemSunbelt Inc

Employer identification number
59-1479658

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Highlands County Health Facilities Authority	52-1313569	431022KK7	08-08-2007	366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment		X		X		X
B	Highlands County Health Facilities Authority	52-1313569	NoneAvail	03-21-2012	294,985,000	2012A, AR Program - Refund 2009 A-F AR Program		X		X		X
C	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-25-2012	115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment		X		X		X
D	Highlands County Health Facilities Authority	52-1313569	431022TL6	08-29-2012	348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	08-29-2012	125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds		X		X		X
	Highlands County Health Facilities Authority	52-1313569	431022TR3	11-08-2012	232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	09-18-2013	485,000,000	2013A B C, Expand/refurbish facilities, purchase equipment		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	07-02-2014	110,000,000	2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment		X		X		X
	Orange County Health Facilities Authority	52-1378595	NoneAvail	07-02-2014	50,000,000	2014B, Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	NoneAvail	07-02-2014	30,000,000	2014C, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648AT39	07-23-2014	82,501,800	2014E, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FAB0	07-21-2016	235,724,616	2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	1964745K2	08-17-2016	216,517,920	2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FGN8	07-12-2018	375,008,542	2018A&B, Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FJG0	08-20-2019	550,011,892	2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip	X			X		X
	Colorado Health Facilities Authority	84-0752932	19648FSJ4	07-01-2021	579,966,540	2021A, Refund 2010D, 2017D; Expand/refurbish facilities, purchase equipment		X		X		X
	Kansas Development Finance Authority	48-1066589	48542AFE6	07-01-2021	238,025,567	2021B, Refund 2010C, 2017C; Expand/refurbish facilities	X			X		X
	Orange County Health Facilities Authority	52-1378595	68450LGB5	07-01-2021	62,033,621	2021C, Refund 2010B, 2017A; Expand/refurbish facilities	X			X		X
	Highlands County Health Facilities Authority	52-1313569	431022UJ9	07-01-2021	200,000,000	2021D, Refund 2011A, 2012G, 2017B; Expand/refurbish facilities		X		X		X
	Highlands County Health Facilities Authority	52-1313569	NoneAvail	06-01-2022	335,007,000	2022A-C, Refund 2012A, 2012C; Expand/refurbish facilities		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXD1	07-12-2023	252,722,621	2023 A-1&2; Expand/refurbish facilities, purchase equipment		X		X		X
	Colorado Health Facilities Authority	84-0752932	19648FXF6	08-17-2023	64,418,097	2023 B; Refund 2016C-1		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	281,555,000		210,000,000		302,985,000		276,165,000
2 Amount of bonds legally defeased ..............	22,900,000		3,025,000		2,800,000		8,535,000
3 Total proceeds of issue ..................	372,572,414		294,985,000		115,015,000		348,320,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............	5,560,382
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	367,012,032		30,041,050		115,015,000		50,068,380
11 Other spent proceeds .............	125,000,000		294,985,000		403,646,175		348,320,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2004		2012		2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	1.420 %		0.200 %		0.840 %		0.500 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.070 %
6 Total of lines 4 and 5 .............	1.420 %		0.200 %		0.840 %		0.500 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X	X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0.080 %		0.140 %		0.140 %		0.370 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............	X			X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part II, Line 3, Total Proceeds of Issue	Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings.
Part III, Line 8c	Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds.
Part III, Line 8c	Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015.

Schedule K (Form 990) 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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(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) Amy Litzenberger	Family of Former Key Employee	17,891	Employee Compensation		No
(2) Bailey Ringering	Family of Officer	131,075	Employee Compensation		No
(3) Janie Thompson	Family of Key Employee	10,007	Employee Compensation		No
(4) Jeannette Carey	Family of Former Key Employee	174,177	Employee Compensation		No
(5) Justin Cook	Family of Former Key Employee	78,556	Employee Compensation		No
(6) Karis Zbaraschuk	Family of Former Key Employee	85,072	Employee Compensation		No
(7) Logan Johnson	Family of Key Employee	25,940	Employee Compensation		No
(8) Martin Shaw	Family of Board Member	98,801	Employee Compensation		No
(9) Martin Thompson	Family of Key Employee	176,881	Employee Compensation		No
(10) Vivian Cook	Family of Former Key Employee	95,209	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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Return Reference	Explanation
Form 990, Part V, Line 1a:	The parent corporation and sole top-tier member of Adventist Health System/Sunbelt, Inc. (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041.
Form 990, Part VI, Section A, line 6	Adventist Health System/Sunbelt, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization.
Form 990, Part VI, Section A, line 7a	The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization.
Form 990, Part VI, Section A, line 7b	AHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to approve and disapprove the operating Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove major building programs and/or purchase or sale of personal property or real property equal to or in excess of One Million dollars; e) to approve or disapprove the annual operating and capital budgets of the filing organization; f) to direct the placement of funds and capital of the filing organization, and the authority to secure naming rights; g) the authority to require adherence to policies adopted; h) to approve or disapprove the implementation of non-traditional, non-healthcare related activities; i) to approve or disapprove performance/quality improvement, revenue cycle and case management programs; j) to approve or disapprove the selection of the auditing firm retained to audit the books; k) to approve or disapprove the election of the fiscal year; l) to approve or disapprove the selection of the group purchasing organization(s); m) to approve or disapprove any joint venture or partnership in which the filing organization would be a member or partner; n) to approve or disapprove the IT systems and other shared services used; o) the authority to require adherence to the system-wide naming nomenclature and service standards apopted; p) to set and enforce policies for physician compensation including commercial reasonableness and fair market value; and q) to exercise such other powers as are necessary in connection with the foregoing.
Form 990, Part VI, Section B, line 11b	The filing organization's current year Form 990 was reviewed by the Senior VP/Chief Accounting Officer prior to its filing with the IRS. The review conducted by the Senior VP/Chief Accounting Officer did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules.
Form 990, Part VI, Section B, line 12c	The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes.
Form 990, Part VI, Section B, line 15	The filing organization's CEO, other officers and key employees are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3.
Form 990, Part VI, Section C, line 19	The filing organization is a part of the system of healthcare organizations known as AdventHealth. The audited consolidated financial statements of AdventHealth and of the AdventHealth "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AdventHealth on a consolidated basis and for the grouping of AdventHealth subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public.
Form 990, Part VII, Section A, Column (E) & (F):	For those Board of Director members, officers, and key employees who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation.
Form 990, Part VIII, Lines 7a, b and c:	The amounts shown in Part VIII, Lines 7a(i), 7b(i) and 7c(i) of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program.
Form 990, Part IX, line 11g	Payments to Healthcare Professionals: Program service expenses 550,330,818. Management and general expenses 0. Fundraising expenses 0. Total expenses 550,330,818. Professional Fees: Program service expenses 132,007,378. Management and general expenses 8,063. Fundraising expenses 0. Total expenses 132,015,441. Purchased Medical Services: Program service expenses 26,962,774. Management and general expenses 0. Fundraising expenses 0. Total expenses 26,962,774. Environmental Services: Program service expenses 13,544,334. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,544,334. Transcription Services: Program service expenses 1,484,036. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,484,036. Recruiting: Program service expenses 7,329,951. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,329,951. Miscellaneous Purchased Services: Program service expenses 8,337,080. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,337,080. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 148,381,838. Fundraising expenses 0. Total expenses 148,381,838. Billing & Collection Services: Program service expenses 0. Management and general expenses 35,524,099. Fundraising expenses 0. Total expenses 35,524,099. AdventHealth Shared Services Fee: Program service expenses 0. Management and general expenses 69,692,706. Fundraising expenses 0. Total expenses 69,692,706.
Form 990, Part X, Line 2:	The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.
Form 990, Part XI, line 9:	Transfer from tax-exempt parent 96,538,748. Transfer to tax-exempt affiliate -1,100,170. Debt costs allocated to tax-exempt affiliates -37,713. Gifts 2,000. Transfer from supporting tax-exempt foundation 1,828,971. Lease receivable adjustment from tax-exempt subs 1,582,767. Unrealized loss from joint operating company disaffiliation -8,190,540. Donated property 100,000. Other -8,186.

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

Adventist Health SystemSunbelt Inc

Employer identification number

59-1479658

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) IQ Orlando LLC 550 E Rollins St Orlando,FL32803 47-1121247	Design and innovation	FL	0	0	Adventist Hlth SystemSunbelt Inc

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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)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
(29)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
(30)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
(31)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
(32)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
(33)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
(34)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
(35)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
(36)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
(37)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
(38)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
(39)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
(40)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
(41)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
(42)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
(43)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
(44)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
(45)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
(46)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
(47)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
(48)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
(49)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
(50)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
(51)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
(52)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
(53)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
(54)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
(55)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
(56)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
(57)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
(58)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
(59)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
(60)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
(61)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
(62)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
(63)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
(64)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
(65)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
(66)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
(67)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	N/A		No
(68)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
(69)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
(70)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
(71)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
(72)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
(73)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
(74)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
(75)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
(76)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
(77)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
(78)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
(79)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
(80)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
(81)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
(82)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
(83)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
(84)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
(85)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
(86)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
(87)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	N/A					No			No
(7) M&O Orlando MOB I LLC 1125 Sanctuary Parkway Ste 410 Alpharetta,GA30009 84-4259138	Operation of Medical Office Building	DE	Adventist Hlth SystemSunbelt Inc	Related	5,936,797	97,438,263		No			No	93.840 %
(8) OnPoint OBGYN LLC 7780 S Broadway 280 Littleton,CO80122 87-3522453	Healthcare Services	CO	N/A					No			No
(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	N/A					No			No
(11) PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial,CO80112 83-2465331	Urgent Care Center	CO	N/A					No			No
(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	Adventist Hlth SystemSunbelt Inc	Related	175,407	5,666,771		No		Yes		51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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	Adventist Hlth SystemSunbelt Inc	C	150,527	1,827,712	67.810 %	Yes
(6) Apopka Medical Plaza Condominium Assoc Inc (11-123123) 601 East Rollins Street Orlando,FL32803 59-3000857	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	2,430		100.000 %	Yes
(7) Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs,FL32714 38-1359189	Inactive	MI	Adventist Hlth SystemSunbelt Inc	C			100.000 %	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	Adventist Hlth SystemSunbelt Inc	C			100.000 %	Yes
(10) Florida Hospital Healthcare System Inc 2600 Lucien Way Maitland,FL32751 59-3215680	PHSO / CIN	FL	Adventist Hlth SystemSunbelt Inc	C	105,734,063	53,980,654	100.000 %	Yes
(11) Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando,FL32803 59-2855791	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	957,493	7,068,040	87.990 %	Yes
(12) Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee,FL34741 59-3539564	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	55,005	59,850	54.400 %	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	Adventist Hlth SystemSunbelt Inc	C	163,421	342,153	51.580 %	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 .....................

Yes

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) .......................

Yes

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

Yes

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

Yes

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) ...................

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) AdventHealth Foundation Inc	A	548,002	FMV
(2) AdventHealth University Inc	A	3,414,737	FMV
(3) Florida Hospital Medical Group Inc	A	20,951,985	FMV
(4) Florida Hospital Physician Group Inc	A	489	FMV
(5) Florida Radiology Imaging at Lake Mary LLC	A	1,550,174	FMV
(6) Hospice of the Comforter Inc	A	226,095	FMV
(7) Memorial Health Systems Inc	A	28,011	FMV
(8) Princeton Homecare Services LLC	A	66,100	FMV
(9) Princeton Professional Services Inc	A	1,396	FMV
(10) AdventHealth Foundation Inc	B	1,110,493	Actual Amount Given
(11) Adventist Care Centers - Courtland Inc	B	447,425	Actual Amount Given
(12) Adventist Health System Sunbelt Healthcare Corporation	B	70,377,228	Actual Amount Given
(13) East Orlando Health & Rehab Center Inc	B	1,485,742	Actual Amount Given
(14) FLNC Inc	B	4,688,825	Actual Amount Given
(15) Sunbelt Health & Rehab Center - Apopka Inc	B	440,775	Actual Amount Given
(16) AdventHealth Foundation Inc	C	10,421,905	Actual Amount Received
(17) Florida Hospital Medical Group Inc	J	79,579	FMV
(18) AdventHealth University Inc	K	3,331,729	FMV
(19) Florida Hospital Medical Group Inc	K	104,272	FMV
(20) Hospice of the Comforter Inc	K	488,825	FMV
(21) AdventHealth Foundation Inc	L	4,756,598	Cost Plus Appropriate %
(22) AdventHealth Polk North Inc	L	54,129	Cost Plus Appropriate %
(23) Fletcher Hospital Inc	L	139,105	Cost Plus Appropriate %
(24) Florida Hospital Medical Group Inc	L	98,212	Cost Plus Appropriate %
(25) Florida Hospital Waterman Inc	L	76,846	Cost Plus Appropriate %
(26) Memorial Health Systems Inc	L	109,879	Cost Plus Appropriate %
(27) Memorial Hospital Flagler Inc	L	53,983	Cost Plus Appropriate %
(28) Shawnee Mission Medical Center Inc	L	810,182	Cost Plus Appropriate %
(29) Southwest Volusia Healthcare Corporation	L	56,962	Cost Plus Appropriate %
(30) Urgent Care Centers of Brevard County LLC	L	1,007,296	Cost Plus Appropriate %
(31) Adventist Health System Sunbelt Healthcare Corporation	M	132,933,712	% of Facility's Operating Exp
(32) Adventist Health System Sunbelt Healthcare Corporation dba AIT	M	210,214,615	% of Facility's Operating Exp
(33) Florida Hospital Medical Group Inc	M	345,014,255	% of Facility's Operating Exp
(34) AdventHealth Foundation Inc	N	351,586	Cost Plus Appropriate %
(35) AdventHealth Polk North Inc	P	2,581,227	Cost
(36) AdventHealth Polk South Inc	P	442,311	Cost
(37) AdventHealth Senior Care Inc	P	475,220	Cost
(38) AdventHealth University Inc	P	25,105,208	Cost
(39) AdventHealth West Florida Ambulatory Services Inc	P	2,908,258	Cost
(40) Adventist Care Centers - Courtland Inc	P	515,849	Cost
(41) Adventist Health System Sunbelt Healthcare Corporation	P	241,601,991	Cost
(42) Adventist Health System Sunbelt Healthcare Corporation dba AIT	P	1,875,963	Cost
(43) East Orlando Health & Rehab Center Inc	P	1,758,518	Cost
(44) Fletcher Hospital Inc	P	230,987	Cost
(45) FLNC Inc	P	5,614,642	Cost
(46) Florida Hospital Dade City Inc	P	52,484	Cost
(47) Florida Hospital Healthcare Partners Inc	P	1,494,709	Cost
(48) Florida Hospital Healthcare System Inc	P	33,817,735	Cost
(49) Florida Hospital Medical Group Inc	P	344,586,823	Cost
(50) Florida Hospital Ocala Inc	P	483,996	Cost
(51) Florida Hospital Physician Group Inc	P	64,925	Cost
(52) Florida Hospital Waterman Inc	P	3,698,674	Cost
(53) Florida Hospital Zephyrhills Inc	P	209,641	Cost
(54) Florida Radiology Imaging at Lake Mary LLC	P	7,262,909	Cost
(55) Hospice of the Comforter Inc	P	1,301,245	Cost
(56) Memorial Health Systems Inc	P	44,114,754	Cost
(57) Memorial Hospital Flagler Inc	P	3,403,423	Cost
(58) Memorial Hospital-West Volusia Inc	P	1,483,063	Cost
(59) Pasco-Pinellas Hillsborough Community Health System Inc	P	723,361	Cost
(60) Princeton Professional Services Inc	P	335,112	Cost
(61) Shawnee Mission Medical Center Inc	P	260,975	Cost
(62) Southeast Volusia Healthcare Corporation	P	1,159,512	Cost
(63) Southwest Volusia Healthcare Corporation	P	1,820,502	Cost
(64) Sunbelt Health & Rehab Center - Apopka Inc	P	538,292	Cost
(65) Tarpon Springs Hospital Foundation Inc	P	50,737	Cost
(66) University Community Hospital Inc	P	15,339,713	Cost
(67) Urgent Care Centers of Brevard County LLC	P	334,115	Cost
(68) AdventHealth Polk North Inc	Q	5,386,842	Cost
(69) AdventHealth Polk South Inc	Q	1,250,560	Cost
(70) AdventHealth Riverview Inc	Q	241,801	Cost
(71) AdventHealth Senior Care Inc	Q	9,139,599	Cost
(72) AdventHealth University Inc	Q	23,030,108	Cost
(73) AdventHealth West Florida Ambulatory Services Inc	Q	2,900,920	Cost
(74) Fletcher Hospital Inc	Q	1,354,584	Cost
(75) Florida Hospital Healthcare Partners Inc	Q	1,493,892	Cost
(76) Florida Hospital Healthcare System Inc	Q	37,374,092	Cost
(77) Florida Hospital Medical Group Inc	Q	4,419,961	Cost
(78) Florida Hospital Ocala Inc	Q	492,093	Cost
(79) Florida Hospital Waterman Inc	Q	4,746,666	Cost
(80) Florida Hospital Zephyrhills Inc	Q	189,762	Cost
(81) Florida Radiology Imaging at Lake Mary LLC	Q	32,939,602	Cost
(82) Hospice of the Comforter Inc	Q	1,048,410	Cost
(83) Memorial Health Systems Inc	Q	23,032,858	Cost
(84) Memorial Hospital Flagler Inc	Q	4,630,476	Cost
(85) Memorial Hospital-West Volusia Inc	Q	2,588,017	Cost
(86) Pasco-Pinellas Hillsborough Community Health System Inc	Q	234,882	Cost
(87) Princeton Professional Services Inc	Q	704,272	Cost
(88) Shawnee Mission Medical Center Inc	Q	3,863,189	Cost
(89) Southeast Volusia Healthcare Corporation	Q	2,413,591	Cost
(90) Southwest Volusia Healthcare Corporation	Q	2,466,141	Cost
(91) Tarpon Springs Hospital Foundation Inc	Q	51,308	Cost
(92) University Community Hospital Inc	Q	1,727,644	Cost
(93) Urgent Care Centers of Brevard County LLC	Q	4,887,444	Cost
(94) West Florida Health Home Care Inc	Q	106,145	Cost
(95) West Florida Health Home Care Inc	R	1,100,170	Actual Amount Given
(96) Adventist Health System Sunbelt Healthcare Corporation	S	166,915,977	Actual Amount Received
(97) Urgent Care Centers of Brevard County LLC	S	233,861	Actual Amount Received

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: Operation of 11 acute-care hospitals & related healthcare services.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	23
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	39,028
6	Total number of volunteers (estimate if necessary) .............	6	1,704
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	20,917,635
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	2,741,992

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	104,069,888	73,184,553
9	Program service revenue (Part VIII, line 2g) .........	6,021,551,256	6,926,914,433
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	128,778,123	59,913,880
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-1,693,372	8,764,178
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	6,252,705,895	7,068,777,044
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	25,705,251	33,705,906
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	2,473,662,371	2,654,327,909
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)....	3,309,863,414	3,591,211,455
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	5,809,231,036	6,279,245,270
19	Revenue less expenses. Subtract line 18 from line 12.......	443,474,859	789,531,774
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	11,012,939,296	12,364,542,205
21	Total liabilities (Part X, line 26).............	4,982,376,731	5,198,821,137
22	Net assets or fund balances. Subtract line 21 from line 20.....	6,030,562,565	7,165,721,068

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 5,607,633,847 including grants of $ 33,705,906 ) (Revenue $ 6,911,995,656 )
	Operation of 11 acute care hospitals with 177,684 patient admissions, 931,164 patient days and 2,279,292 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 expenses5,607,633,847

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	7,982,048	31,048,001	4,616,956

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	10,287,188
e	Government grants (contributions)		1e	62,474,448

f	All other contributions, gifts, grants, and similar amounts not included above		1f	422,917

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

h Total. Add lines 1a-1f.......		73,184,553

		Business Code
2a	Patient Revenue	622110	6,820,317,731	6,806,809,442	13,508,289
b	Rent from Exempt Affiliates	622110	27,134,428	27,134,428
c	Cafeteria/Vending Revenue	622110	20,451,318	20,253,912	197,406
d	Research - Disease Related	622110	18,305,730	18,305,730
e	Laundry	622110	12,707,594	12,642,557	65,037
f	All other program service revenue.		27,997,632	20,904,054	7,093,578
g	Total. Add lines 2a–2f .....		6,926,914,433

3 Investment income (including dividends, interest, and othersimilar amounts) ......			97,544,490			97,544,490
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			140,733			140,733
			(i) Real	(ii) Personal
6a	Gross rents	6a	4,337,471	21,467
b	Less: rental expenses	6b	1,671,715	9,311
c	Rental income or (loss)	6c	2,665,756	12,156
d	Net rental income or (loss).......			2,677,912			2,624,587
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		7,923,564
b	Less: cost or other basis and sales expenses	7b	44,183,579	1,370,595
c	Gain or (loss)	7c	-44,183,579	6,552,969
d	Net gain or (loss).........			-37,630,610			-37,630,610
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 (losses) from tax		622110	7,926,441	7,926,441
b	Investment in tax-exempt Sub		622110	-1,980,908	-1,980,908
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			5,945,533
12	Total revenue. See instructions.....			7,068,777,044	6,911,995,656	20,917,635	62,679,200

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	31,599,546	31,599,546
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	2,106,360	2,106,360
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	15,414,153		15,414,153
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	1,971,579,154	1,944,532,317	27,046,837
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	73,487,603	72,092,679	1,394,924
9	Other employee benefits .......	443,841,832	426,505,654	17,336,178
10	Payroll taxes ...........	150,005,167	147,155,987	2,849,180
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	20,614,059		20,614,059
c	Accounting ...........	1,086,295		1,086,295
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	15,409,093		15,409,093
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	993,603,077	739,996,371	253,606,706
12	Advertising and promotion ....	57,494,848		57,494,848
13	Office expenses .......	111,175,726	82,929,640	28,246,086
14	Information technology ......	267,430,474	244,778,971	22,651,503
15	Royalties ..
16	Occupancy ...........	145,835,022	145,835,022
17	Travel ............	7,942,980	436,481	7,506,499
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	8,524,748		8,524,748
20	Interest ...........	65,148,210	65,148,210
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	263,226,960	263,226,960
23	Insurance ...	49,782,397	46,478,981	3,303,416
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	998,835,446	998,835,446
b	Assessments	268,245,527	268,245,527
c	Repairs/Maintenance	98,459,104	98,459,104
d	Unrelated Business Inco	1,039,253		1,039,253
e	All other expenses	217,358,236	29,270,591	188,087,645
25	Total functional expenses. Add lines 1 through 24e	6,279,245,270	5,607,633,847	671,611,423	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 ........			94,153	1	87,125
2	Savings and temporary cash investments .........			3,635,731,209	2	4,423,967,171
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			904,155,025	4	929,927,583
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			143,584,990	8	120,253,504
9	Prepaid expenses and deferred charges ......			67,823,674	9	44,219,233
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	6,387,337,923
b	Less: accumulated depreciation	10b	3,144,502,201	3,291,607,247	10c	3,242,835,722
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			15,329,096	12	13,448,188
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			19,316,664	14	16,229,521
15	Other assets. See Part IV, line 11 ...........			2,935,297,238	15	3,573,574,158
16	Total assets. Add lines 1 through 15 (must equal line 33)...			11,012,939,296	16	12,364,542,205

17	Accounts payable and accrued expenses .....	425,717,506	17	453,339,356
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	3,920,808,527	20	4,083,821,014
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	635,850,698	25	661,660,767
26	Total liabilities. Add lines 17 through 25..	4,982,376,731	26	5,198,821,137

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	6,030,281,108	27	7,165,437,611
28	Net assets with donor restrictions ...........	281,457	28	283,457
	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 ...........	6,030,562,565	32	7,165,721,068
33	Total liabilities and net assets/fund balances ........	11,012,939,296	33	12,364,542,205

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