MEMORIAL HOSPITAL FLAGLER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: MEMORIAL HOSPITAL FLAGLER INC (EIN 59-2951990)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-11
IRS object ID: 202233159349306103
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-11T14:43:30-06:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	592951990	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MEMORIAL HOSPITAL FLAGLER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MEMO	BusinessNameControlTxt
Phone	3865862000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	LYNN C ADDISCOTT	PersonNm
Person Title	ASSISTANT SECRETARY	PersonTitleTxt
Phone	4073572317	PhoneNum
Signature	2022-10-26	SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	LYNN	PersonFirstNm
Person Last	ADDISCOTT	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	ADVENTHEALTH PALM COAST	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	DENYSE BALES-CHUBB	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$307,764,247	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.ADVENTHEALTH.COM/HOSPITAL	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1989	FormationYr
Legal Domicile State	FL	LegalDomicileStateCd
Activity Or Mission	THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 99 BED HOSPITAL.	ActivityOrMissionDesc
Voting Members Governing Body	17	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	1547	TotalEmployeeCnt
Total Volunteers	89	TotalVolunteersCnt
Total Gross UBI	$205,622	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$91,454	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$11,737,698	PYContributionsGrantsAmt
CY Contributions Grants	$4,183,199	CYContributionsGrantsAmt
PY Program Service Revenue	$234,155,109	PYProgramServiceRevenueAmt
CY Program Service Revenue	$283,882,906	CYProgramServiceRevenueAmt
PY Investment Income	$4,212,582	PYInvestmentIncomeAmt
CY Investment Income	$19,657,592	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$250,105,389	PYTotalRevenueAmt
CY Total Revenue	$307,723,697	CYTotalRevenueAmt
PY Grants And Similar Paid	$430,147	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$424,224	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$79,720,504	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$64,523,492	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$126,568,595	PYOtherExpensesAmt
CY Other Expenses	$185,029,258	CYOtherExpensesAmt
PY Total Expenses	$206,719,246	PYTotalExpensesAmt
CY Total Expenses	$249,976,974	CYTotalExpensesAmt
PY Revenues Less Expenses	$43,386,143	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$57,746,723	CYRevenuesLessExpensesAmt
Total Assets BOY	$477,258,544	TotalAssetsBOYAmt
Total Assets EOY	$540,444,241	TotalAssetsEOYAmt
Total Liabilities BOY	$82,492,241	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$93,726,624	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$394,766,303	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$446,717,617	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL ITS SUBSIDIARY ORGANIZATIONS WERE ESTABLISHED BY THE SEVENTH-DAY ADVENTIST CHURCH TO BRING A MINISTRY OF HEALING AND HEALTH TO THE COMMUNITIES SERVED. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST.THE HOSPITAL AND HEALTHCARE SYSTEM WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION IS KNOWN AS ADVENTHEALTH. ADVENTHEALTH SEEKS TO BE WIDELY RESPECTED AS A CONSUMER-FOCUSED ORGANIZATION THAT ENGAGES INDIVIDUALS IN THEIR HEALTH BY DELIVERING WHOLISTIC, BEST PRACTICE CARE ACROSS A CONNECTED, COMPREHENSIVE CONTINUUM OF SERVICES. WITH CHRIST AS OUR EXAMPLE, ADVENTHEALTH CARES FOR AND NURTURES PEOPLE: OUR EMPLOYEES, OUR COMMUNITIES, OUR HEALTHCARE PROFESSIONALS, AND THOSE WHO TRUST US FOR CARE AND HEALING.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$231,121,636	ExpenseAmt
Grant	$424,224	GrantAmt
Revenue	$283,677,284	RevenueAmt
Desc	PROVISION OF MEDICAL CARE TO BOTH INPATIENTS AND OUTPATIENTS. DURING THE CURRENT YEAR, THE HOSPITAL HAD 8,586 PATIENT ADMISSIONS WHICH RESULTED IN 44,867 PATIENT DAYS, 169,263 OUTPATIENT VISITS, AND 174,631 PHYSICIAN PRACTICE PATIENT VISITS. THE HOSPITAL IS A 99-BED ACUTE CARE HOSPITAL LOCATED IN FLAGLER COUNTY, FLORIDA.	Desc
Total Program Service Expenses	$231,121,636	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	Yes (1)	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1547	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	17	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	FL	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARK RATHBUN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	3865864301	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
HAFFNER PHD RANDALL
DIRECTOR (BEG 2/21)	0.20	50.00	Yes (X)	$0	$3,620,109	$209,173
TOL DARYL
DIR/AH CEN FL DIV CEO (END 1/21)	0.10	50.00	Yes (X)	$0	$2,712,537	$8,693
GOODMAN TODD
DIR/AH CEN FL DIV CFO	0.50	50.00	Yes (X)	$0	$1,698,001	$183,060
JIMENEZ MD RONALD
SEC/DIR/FACILITY CEO	50.00	0.00	Yes (X)	$0	$1,520,578	$88,933	Yes (X)
OTTATI DAVID
CHAIR/DIR/AH CEN FL REG (END 12/21)	7.00	43.00	Yes (X)	$0	$1,287,575	$204,455	Yes (X)
NOSEWORTHY G ED
DIRECTOR/CEO AHDB	0.20	50.00	Yes (X)	$0	$1,084,117	$48,700
ALTER MD DENNIS
DIRECTOR	0.20	50.00	Yes (X)	$0	$925,161	$77,266
THOMAS DEBORA
FORMER OFFICER	0.00	50.00		$0	$830,633	$99,955		Yes (X)
CELANO PATRICIA
DIRECTOR (BEG 1/21)	0.20	50.00	Yes (X)	$0	$647,089	$128,755
DAVIS BRENT
DIR/AH CFD N REG CFO	7.00	43.00	Yes (X)	$0	$527,787	$125,817
KILMAN MD MARK
CMO - HOSPITAL FACILITY	50.00	0.00		$0	$430,219	$94,490			Yes (X)
DOMAYER CORY
FORMER CFO	0.00	50.00		$0	$355,865	$102,343		Yes (X)
GREGORY PHD AUDREY
DIR/CHAIRMAN/TREAS (BEG 12/21)	7.00	43.00	Yes (X)	$0	$416,334	$25,988	Yes (X)
RATHBUN MARK
CFO	50.00	0.00		$0	$307,166	$53,080	Yes (X)
GOVER MARY KATHY
CNO - HOSPITAL FACILITY	50.00	0.00		$0	$276,735	$39,101			Yes (X)
DEAQUINO WALMIR
COO - HOSPITAL FACILITY	50.00	0.00		$0	$257,329	$50,959			Yes (X)
TAYLOR WAYNE
AHPC DIRECTOR OF PHARMACY	50.00	0.00		$180,632	$0	$44,740				Yes (X)
BATTANI RHONDA
AHPC DIR QUALITY/REGULATIONS	50.00	0.00		$182,795	$0	$15,086				Yes (X)
SAMRAI BALRAJ
AHPC CLINICAL STAFF PHARMA	50.00	0.00		$168,756	$0	$29,070				Yes (X)
MOTZNY SEAN
AHPC REG MED DIR HOSPICE	50.00	0.00		$172,508	$0	$15,894				Yes (X)
SEGALL GRANT
AHPC CLINICAL STAFF PHARMA	50.00	0.00		$153,257	$0	$25,600				Yes (X)
REGAN MD TERRENCE
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
CHIUMENTO MICHAEL
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
FOWLER DAVID
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
LEVERTON ROGER
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
PAPANDREA TONY
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
REVELS BARBARA
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
SOWERS SCOTT
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
SWORD RAVEN
DIRECTOR	0.20	0.00	Yes (X)	$540	$0	$0
MUCCIOLO MD PAUL
DIR / CHIEF OF STAFF	0.20	0.00	Yes (X)	$540	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$862,808	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$16,897,235	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,671,158	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	72	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt	Address Line1ContractorAddress/ForeignAddress/AddressLine1Txt	CityContractorAddress/ForeignAddress/CityNm	CountryContractorAddress/ForeignAddress/CountryCd	Foreign PostalContractorAddress/ForeignAddress/ForeignPostalCd
AMN HEALTHCARE INC
2735 COLLECTIONS CENTER DR	CHICAGO	IL	60693	AGENCY LABOR	$12,592,337
HUNTON BRADY ARCHITECTS PA
333 S GARLAND AVE SUITE 1100	ORLANDO	FL	32801	ARCHITECTURE SERVICES	$4,016,864
THE ROBINS AND MORTON GROUP
400 SHADES CREEK PKWY	BIRMINGHAM	AL	35209	GENERAL CONTRACTOR	$2,626,676
ROCHE DIAGNOSTICS CORPORATION
MAIL CODE 5508	CHARLOTTE	NC	28272	LAB SERVICES	$1,078,276
JUBILANT DRAXIMAGE INC- RADIOPHARMA
				NUCLEAR MEDICINE SERVICES	$440,259	16751 TRANS CANADA HIGHWAY	KIRKLAND	CA	H9H 4J4 CAN

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	21	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$53,809	RelatedOrganizationsAmt
Government Grants	$4,129,390	GovernmentGrantsAmt
Total Contributions	$4,183,199	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REVENUE	622110	$280,656,640	$280,451,018	$205,622
REIMB OF EXP-TE AFFILIATE	622110	$1,411,519	$1,411,519
RENT FROM EXEMPT AFFILIATES	622110	$1,160,884	$1,160,884
CAFETERIA REVENUE	622110	$562,771	$562,771
GIFT SHOP REVENUE	622110	$77,422	$77,422

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,670	TotalRevenueColumnAmt
Related Or Exempt Func Income	$13,670	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$283,882,906	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,400,847	TotalRevenueColumnAmt
Exclusion	$9,400,847	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$10,265,719	SecuritiesAmt
Other	$31,576	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$40,550	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$10,265,719	SecuritiesAmt
Other	-$8,974	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,256,745	TotalRevenueColumnAmt
Exclusion	$10,256,745	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$307,723,697	TotalRevenueColumnAmt
Related Or Exempt Func Income	$283,677,284	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$205,622	UnrelatedBusinessRevenueAmt
Exclusion	$19,657,592	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$424,224	TotalAmt
Program Services	$424,224	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,389,399	TotalAmt
Management And General	$3,389,399	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$42,516,623	TotalAmt
Program Services	$42,516,623	ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,579,518	TotalAmt
Program Services	$2,501,155	ProgramServicesAmt
Management And General	$78,363	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$11,220,517	TotalAmt
Program Services	$10,860,424	ProgramServicesAmt
Management And General	$360,093	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,817,435	TotalAmt
Program Services	$4,671,086	ProgramServicesAmt
Management And General	$146,349	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,894,666	TotalAmt
Management And General	$2,894,666	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$56,595	TotalAmt
Management And General	$56,595	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$803,976	TotalAmt
Management And General	$803,976	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$107,124,908	TotalAmt
Program Services	$99,299,838	ProgramServicesAmt
Management And General	$7,825,070	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$837,262	TotalAmt
Management And General	$837,262	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,532,709	TotalAmt
Program Services	$2,370,540	ProgramServicesAmt
Management And General	$1,162,169	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$7,970,162	TotalAmt
Program Services	$7,536,162	ProgramServicesAmt
Management And General	$434,000	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$4,122,632	TotalAmt
Program Services	$4,122,632	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$431,006	TotalAmt
Management And General	$431,006	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$87,114	TotalAmt
Management And General	$87,114	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,479,880	TotalAmt
Program Services	$1,479,880	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$10,352,772	TotalAmt
Program Services	$10,352,772	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,027,916	TotalAmt
Program Services	$1,978,356	ProgramServicesAmt
Management And General	$49,560	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$34,358,860	$34,358,860
REPAIRS & MAINTENANCE	$4,771,857	$4,771,857
STATE TAX INDIGENT ASSE	$3,715,169	$3,715,169
UBI TAXES	$24,677		$24,677

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$437,097	TotalAmt
Program Services	$162,058	ProgramServicesAmt
Management And General	$275,039	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$249,976,974	TotalAmt
Program Services	$231,121,636	ProgramServicesAmt
Management And General	$18,855,338	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,148	BOYAmt
EOY	$2,404	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$330,719,632	BOYAmt
EOY	$369,674,220	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$26,228,070	BOYAmt
EOY	$31,001,605	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,535,117	BOYAmt
EOY	$3,565,288	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$8,369,597	BOYAmt
EOY	$12,385,146	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$212,847,146	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$112,048,244	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$86,467,266	BOYAmt
EOY	$100,798,902	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$13,066,395	BOYAmt
EOY	$11,614,573	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$8,869,319	BOYAmt
EOY	$11,402,103	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$477,258,544	BOYAmt
EOY	$540,444,241	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$13,219,849	BOYAmt
EOY	$23,899,946	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$114,606	BOYAmt
EOY	$125,307	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$69,157,786	BOYAmt
EOY	$69,701,371	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$82,492,241	BOYAmt
EOY	$93,726,624	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$394,497,278	BOYAmt
EOY	$446,448,592	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$269,025	BOYAmt
EOY	$269,025	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$394,766,303	BOYAmt
EOY	$446,717,617	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$477,258,544	BOYAmt
EOY	$540,444,241	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$57,746,723	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$7,325,591	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$13,121,000	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$6,955	OtherActivitiesAmt
Total Lobbying Expenditures	$6,955	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	AMERICAN HOSPITAL ASSOCIATION AND FLORIDA HOSPITAL ASSOCIATION DUES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Protection Natural Habitat	Yes (X)	ProtectionNaturalHabitatInd
States Easements Held	1	StatesEasementsHeldCnt
Written Policy Monitoring	0	WrittenPolicyMonitoringInd
Staff Hours Spent Enforcement	0.00	StaffHoursSpentEnforcementCnt
Expenses Incurred Enforcement	$0	ExpensesIncurredEnforcementAmt
Section170h Rqr Stsfd	0	Section170hRqrStsfdInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,868,680	OtherCostOrOtherBasisAmt
Book Value	$12,868,680	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$78,102,851	OtherCostOrOtherBasisAmt
Depreciation	$34,711,814	DepreciationAmt
Book Value	$43,391,037	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$95,420,517	OtherCostOrOtherBasisAmt
Depreciation	$71,736,548	DepreciationAmt
Book Value	$23,683,969	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$26,455,098	OtherCostOrOtherBasisAmt
Depreciation	$5,599,882	DepreciationAmt
Book Value	$20,855,216	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$100,798,902	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)

DescDesc	AmtAmt
DUE TO RELATED	$6,289,210
PAYABLE TO THIRD PARTIES	$2,685,686
CREDIT BALANCES IN A/R	$1,145,502
ACCRUED INTEREST PAYABLE	$947
OTHER DEFERRED REVENUE	$2,500
INTERCO ALLOC OF TE BOND PROCEEDS	$58,402,960
DUE TO AFFILIATED	$136,809
OPERATING LEASE LIABILITY	$911,598
OTHER LIABILITIES	$126,159

Field	Value	IRS element (for citing)
Total Liability	$69,701,371	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART II, LINE 9:

THE FILING ORGANIZATION HAS RECORDED THE LAND CONSERVATION EASEMENT ON ITS FINANCIAL STATEMENTS AS A PROPERTY, PLANT, AND EQUIPMENT ASSET. THE CONSERVATION EASEMENT GENERATES NO REVENUE AND THE FILING ORGANIZATION DID NOT INCUR ANY EXPENSE RELATED TO THE MAINTENANCE AND MONITORING OF THE CONSERVATION EASEMENT.

PART X, LINE 2:

THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTHEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH CONTAIN THE FOLLOWING FIN 48 (ASC 740) FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARY (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARY ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. ALL TAXABLE INCOME WAS FULLY OFFSET BY NET OPERATING LOSS CARRYFORWARDS FOR FEDERAL INCOME TAX PURPOSES; AS SUCH, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $33,000 AND $41,800 AT DECEMBER 31, 2021 AND 2020, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2021, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $34,000, EXPIRING BEGINNING IN 2022 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $8,100 AND $10,200 AT DECEMBER 31, 2021 AND 2020, RESPECTIVELY. NAHS REMEASURED ITS DEFERRED TAX ASSETS AND LIABILITIES BASED ON THE RATES AT WHICH THEY ARE EXPECTED TO REVERSE IN THE FUTURE, WHICH IS GENERALLY 21%. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2021 AND 2020 TO OFFSET THE DEFERRED TAX ASSET SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ACCOUNTING STANDARDS CODIFICATION (ASC) (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN, OR EXPECTED TO BE TAKEN, IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 AND 2020.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	0	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	0	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,690,466	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,690,466	NetCommunityBenefitExpnsAmt
Total Expense	0.02680	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,060,796	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,736,157	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,324,639	NetCommunityBenefitExpnsAmt
Total Expense	0.02130	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,751,262	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,736,157	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,015,105	NetCommunityBenefitExpnsAmt
Total Expense	0.04810	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$801,299	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$801,299	NetCommunityBenefitExpnsAmt
Total Expense	0.00320	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,138	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$30,138	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$831,437	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$831,437	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$31,582,699	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,736,157	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,846,542	NetCommunityBenefitExpnsAmt
Total Expense	0.05140	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$8,825,727	BadDebtExpenseAmt
Bad Debt Expense Attributable	$2,531,895	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$71,479,779	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$67,692,290	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$3,787,489	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ADVENTHEALTH PALM COAST	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	60 MEMORIAL MEDICAL PARKWAY	AddressLine1Txt
City	PALM COAST	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32164	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.ADVENTHEALTH.COM	WebsiteAddressTxt
State License	4465	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MEMORIAL HOSPITAL FLAGLER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, PAGE 8	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	20	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, PAGE 8	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, PAGE 8	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, PAGE 8	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, PAGE 8	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
MEMORIAL HOSPITAL FLAGLER, INC.	PART V, SECTION B, LINE 5: MEMORIAL HOSPITAL FLAGLER INC., D/B/A ADVENTHEALTH PALM COAST, (AHPC OR THE HOSPITAL) OPERATES A HOSPITAL IN VOLUSIA COUNTY, FLORIDA WITH A TOTAL OF 99 LICENSED BEDS. FOR PURPOSES OF ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL DEFINED ITS COMMUNITY AS ITS PRIMARY SERVICE AREA FROM WHICH 82% OF ITS PATIENTS COME. AS A PART OF ITS EFFORTS TO ENSURE BROAD COMMUNITY-BASED INPUT INTO THE CHNA PROCESS, THE HOSPITAL ESTABLISHED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) TO HELP GUIDE THE HOSPITAL THROUGH THE ASSESSMENT PROCESS. THE CHNAC INCLUDED REPRESENTATION FROM THE HOSPITAL, PUBLIC HEALTH EXPERTS AND THE BROAD COMMUNITY WITH INTENTIONAL REPRESENTATION FROM LOW-INCOME, MINORITY AND OTHER UNDERSERVED POPULATIONS. THE FOLLOWING ORGANIZATIONS WERE MEMBERS OF THE CHNAC. AZALEA HEALTH, A FEDERALLY QUALIFIED HEALTH CENTER,COQUINA CONSTRUCTION,COMMUNITY PARTNERSHIP FOR CHILDREN,FLORIDA DEPARTMENT OF HEALTH - FLAGLER,FLAGLER CARES,THE DEPARTMENT OF CHILDREN AND FAMILIES,THE EARLY LEARNING COALITION OF FLAGLER AND VOLUSIA COUNTIES,FLAGLER FREE CLINIC,COUNTY OF FLAGLER,FLAGLER COUNTY SCHOOLS,FAMILY LIFE CENTER,HALIFAX HEALTH,CITY OF PALM COAST,CITY OF FLAGLER BEACH,CITY OF BUNNELL,UNITED WAY OF VOLUSIA/FLAGLER,SMA HEALTHCARE,VOLUSIA/FLAGLER BEHAVIORAL HEALTH CONSORTIUM, ANDVOLUSIA/FLAGLER COALITION FOR THE HOMELESS.COMMUNITY INPUT WAS GATHERED THROUGH COMMUNITY SURVEYS ADMINISTERED BY THE VOLUSIA COUNTY DEPARTMENT OF HEALTH. THE INTERVIEWS WERE PRIMARILY INTERNET BASED AND WERE COMPLETED BY 3,692 INDIVIDUALS, INCLUDING 966 FLAGLER RESIDENTS.
MEMORIAL HOSPITAL FLAGLER, INC.	PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.
MEMORIAL HOSPITAL FLAGLER, INC.	PART V, SECTION B, LINE 11: MEMORIAL HOSPITAL - FLAGLER, INC. D/B/A ADVENTHEALTH PALM COAST WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH PALM COAST OR "THE HOSPITAL". THE HOSPITAL IS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE 501(C)(3) PARENT ORGANIZATION OF A HOSPITAL AND HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN JANUARY 2019, EVERY WHOLLY-OWNED ENTITY OF AHSSHC ADOPTED THE ADVENTHEALTH SYSTEM BRAND. OUR IDENTITY HAS BEEN UNIFIED TO REPRESENT THE FULL CONTINUUM OF CARE OUR SYSTEM OFFERS. ANY REFERENCES TO OUR PRIOR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) OR PRIOR COMMUNITY HEALTH PLANS (CHPS) WILL UTILIZE OUR NEW NAME FOR CONSISTENCY. ADVENTHEALTH PALM COAST IS PART OF THE CENTRAL FLORIDA DIVISION (THE DIVISION) OF ADVENTHEALTH. IN 2020, THE CENTRAL FLORIDA DIVISION NORTH-REGION (CFD-N), WHICH INCLUDES ADVENTHEALTH DAYTONA BEACH, ADVENTHEALTH DELAND, ADVENTHEALTH FISH MEMORIAL, ADVENTHEALTH NEW SMYRNA, ADVENTHEALTH PALM COAST AND ADVENTHEALTH WATERMAN WAS COMBINED WITH THE CENTRAL FLORIDA DIVISION SOUTH-REGION (CFD-S), WHICH INCLUDES ADVENTHEALTH ALTAMONTE, ADVENTHEALTH APOPKA, ADVENTHEALTH CELEBRATION, ADVENTHEALTH EAST ORLANDO, ADVENTHEALTH HEART OF FLORIDA, ADVENTHEALTH KISSIMMEE, ADVENTHEALTH LAKE WALES, ADVENTHEALTH ORLANDO AND ADVENTHEALTH WINTER PARK TO UNIFY AS ONE UNDER THE CENTRAL FLORIDA DIVISION. THE COMBINATION INCLUDED SIX HOSPITALS FROM CFD-N AND NINE HOSPITALS FROM CFD-S. THE COMMUNITY HEALTH PLANS/IMPLEMENTATION STRATEGIES FOR BOTH REGIONS WERE FINALIZED BEFORE THE COMBINATION. THE CENTRAL FLORIDA DIVISION OF ADVENTHEALTH NOW INCLUDES 15 HOSPITALS.THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH PALM COAST'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. THE HOSPITAL DEVELOPED THIS PLAN AND POSTED IT IN MAY 2020 AS PART OF ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH PALM COAST WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL, AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2020-2022 COMMUNITY HEALTH PLAN. THE SECOND-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS. ADVENTHEALTH PALM COAST CHOSE FIVE PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. ADULT BEHAVIORAL HEALTH 2. YOUTH BEHAVIORAL HEALTH 3. CARDIOVASCULAR DISEASES & DIABETES 4. MOTHERS AND CHILDREN UNDER AGE 5 5. FAMILY VIOLENCE PRIORITY 1: ADULT BEHAVIORAL HEALTH 2019 DESCRIPTION OF THE ISSUE:ALCOHOL USE - BINGE DRINKING AMONG FLAGLER COUNTY ADULTS IS LOWER THAN IN 2013 AND LOWER THAN FLORIDA'S PERCENT. - ALCOHOL-SUSPECTED MOTOR VEHICLE CRASH DEATHS HAVE INCREASED IN FLAGLER COUNTY AND ARE HIGHER THAN THE FLORIDA RATE. - FLAGLER COUNTY'S DEATH RATE IS HIGHER THAN FLORIDA AND THE RATE OF DEATH FOR HISPANICS HAS INCREASED. SMOKING AND SUBSTANCE MISUSE - FLAGLER'S DEATHS FROM OPIOID OVERDOSES HAVE INCREASED AS HAS ITS USE AMONG INDIVIDUALS SEEKING TREATMENT FOR ADDICTION. - THE PERCENT OF FLAGLER WOMEN AND BLACK INDIVIDUALS USING TOBACCO EXCEEDS THE FLORIDA PERCENT. MENTAL HEALTH - 9.3% OF FLAGLER COUNTY ADULTS HAD 14 OR MORE POOR MENTAL HEALTH DAYS IN THE LAST MONTH AND 12.6% HAVE A DEPRESSIVE DISORDER (BOTH FIGURES ARE LOWER THAN FLORIDA). - FLAGLER COUNTY HAS THE HIGHEST SUICIDE RATE IN FLORIDA AND THE RATE IS INCREASING. 2021 UPDATE: THE ADVENTHEALTH PALM COAST COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE ADULT BEHAVIORAL HEALTH PRIORITY. 1. ESTABLISH A NEW EMERGENCY DEPARTMENT (ED) INTERVENTION PROJECT BY PLACING A PEER SPECIALIST IN THE ED OF ADVENTHEALTH PALM COAST TO ENGAGE INDIVIDUALS IN AN OPIOID CRISIS AND CONNECT THEM WITH TREATMENT.2. ESTABLISH A MULTI-AGENCY REFERRAL AND COMMUNICATION MANAGEMENT SYSTEM IN VOLUSIA/FLAGLER COUNTY TO EFFECTIVELY CONNECT INDIVIDUALS IN NEED TO BEHAVIORAL HEALTH CARE SERVICES.3. INCREASE THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO TOBACCO CESSATION SUPPORT.GOAL 1: ESTABLISH A NEW EMERGENCY DEPARTMENT (ED) INTERVENTION PROJECT BY PLACING A PEER SPECIALIST IN THE ED OF ADVENTHEALTH PALM COAST TO ENGAGE INDIVIDUALS IN AN OPIOID CRISIS AND CONNECT THEM WITH TREATMENT.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO ESTABLISH A PARTNERSHIP WITH SMA HEALTHCARE TO CREATE A NEW PEER SPECIALIST POSITION WORKING IN THE EMERGENCY DEPARTMENT TO ENGAGE AT LEAST 50 PATIENTS IN SUBSTANCE USE DISORDER TREATMENT. SMA HEALTHCARE IS A PROVIDER OF BEHAVIORAL HEALTHCARE SERVICES AND PROVIDES COMPREHENSIVE SERVICES FOR INDIVIDUALS SUFFERING FROM MENTAL ILLNESS AND/OR ADDICTION IN FLAGLER, VOLUSIA, ST. JOHNS, AND PUTNAM COUNTIES. THE SMA PEER INITIATIVE IS DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE SMA PEER INITIATIVE PROVIDES TIMELY ACCESS TO A PEER SUPPORT SPECIALIST WHO WILL OUTREACH TO INDIVIDUALS WITH SUBSTANCE USE DISORDERS OR AN INDIVIDUAL AFTER AN OVERDOSE TO ENGAGE THEM IN SUBSTANCE USE DISORDER TREATMENT. THE HOSPITAL PROGRESSED ON ITS SET METRIC OF CREATING A NEW PEER SPECIALIST POSITION IN 2020, BY FINALIZING THE POSITION AND BEGINNING RECRUITMENT EFFORTS FOR A 2021 PLACEMENT. ALTHOUGH THE POSITION WAS CREATED AND FUNDED, SMA HEALTHCARE WAS NOT ABLE TO FILL THE OPEN POSITION IN 2021. TO SUPPORT INDIVIDUALS AT RISK OF OVERDOSE, ADVENTHEALTH PALM COAST DISTRIBUTED 14 NARCAN KITS TO PATIENTS. AS AN EXPANSION OF THEIR COMMITMENT TO ADULT BEHAVIORAL HEALTH, ADVENTHEALTH PALM COAST PROVIDED FLAGLER CARES $25,000 IN FINANCIAL SUPPORT FOR A NEW ONE-STOP SERVICE LOCATION CALLED THE FLAGLER COUNTY VILLAGE. THE NEW ACCESS POINT OPENED IN NOVEMBER 2021 AND HOUSES STAFF FROM 4 ORGANIZATIONS PROVIDING SOCIAL, HEALTH, EDUCATIONAL, FINANCIAL, AND BEHAVIORAL HEALTH SERVICES. GOAL 2: ESTABLISH A MULTI-AGENCY REFERRAL AND COMMUNICATION MANAGEMENT SYSTEM IN VOLUSIA/FLAGLER COUNTY TO EFFECTIVELY CONNECT INDIVIDUALS IN NEED TO BEHAVIORAL HEALTH CARE SERVICES.OBJECTIVE 1: THE FIRST OBJECTIVE IS A DIVISIONAL INITIATIVE AND APPEARS ON MULTIPLE COMMUNITY HEALTH PLANS OF HOSPITALS IN THE CENTRAL FLORIDA DIVISION OF ADVENTHEALTH, THE SAME DIVISION AS THE REPORTING HOSPITAL. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE OBJECTIVE IS TO SUPPORT THE DEVELOPMENT OF A PILOT PROJECT TO CONNECT HEALTH AND BEHAVIORAL HEALTH SYSTEMS THROUGH THE UTILIZATION OF A REFERRAL AND COMMUNICATION MANAGEMENT TECHNOLOGY SYSTEM TO BE LAUNCHED BY THE END OF YEAR TWO. THIS OBJECTIVE IS MANAGED AT A DIVISIONAL LEVEL AND OUTCOMES ARE REPORTED AT A DIVISIONAL LEVEL; HOWEVER, ALL FUNDING IS SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL'S SUPPORT PROVIDES FUNDING TO FLAGLER CARES, A LOCAL NOT-FOR-PROFIT, WHICH FOCUSES ON INCREASING CAPACITY AND COORDINATION FOR HEALTH AND HUMAN SERVICES PROGRAMS, FOR THE PLANNING AND IMPLEMENTATION OF A DIGITAL SOLUTION TO FACILITATE REFERRALS TO BEHAVIORAL HEALTH SERVICES, AND TO INCREASE ACCESS TO CARE AND IMPROVE HEALTH. THE DIVISION PROGRESSED ON ITS SET METRIC THROUGH THE LAUNCH OF A PLAN TO SUPPORT THE LARGER OBJECTIVE. FLAGLER CARES LAUNCHED THE LINC FLAGLER VOLUSIA REFERRAL MANAGEMENT SYSTEM IN AUGUST 2021 WITH AN INITIAL FOCUS ON BEHAVIORAL HEALTH SERVICES. BY THE END OF 2021, FOURTEEN ORGANIZATIONS WERE PARTICIPATING IN THE NETWORK AND 889 REFERRALS WERE SENT THROUGH THE SYSTEM. SEE CONTINUATION 2
MEMORIAL HOSPITAL FLAGLER, INC.	PART V, SECTION B, LINE 13H: EFFECTIVE MARCH 1, 2020, THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) AUGMENTED THEIR FINANCIAL ASSISTANCE POLICY WITH A COVID-19 FINANCIAL GRACE ADDENDUM. PURSUANT TO THE COVID-19 FINANCIAL GRACE ADDENDUM, UNINSURED PATIENTS TREATED FOR COVID-19 RELATED EVALUATIONS ARE TO RECEIVE FREE OR DISCOUNTED CARE DEPENDING ON THE PATIENT'S COOPERATION IN SUBMITTING NECESSARY FINANCIAL ASSISTANCE INFORMATION. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS.
PART V, SECTION B, LINE 11: CONTINUATION 2	GOAL 3: INCREASE THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO TOBACCO CESSATION SUPPORT.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF INDIVIDUALS PARTICIPATING IN FREE TOOLS TO QUIT TOBACCO CESSATION PROGRAMS BY AT LEAST 10% OVER THE NUMBER OF PARTICIPANTS IN 2019 (82). THE OBJECTIVE IS MANAGED BY THE DIVISION; HOWEVER, THE HOSPITAL PROVIDES IN-KIND RESOURCES AND ALL OUTCOMES REPORTED ARE SPECIFIC TO THE REPORTING HOSPITAL. THE NORTHEAST FLORIDA AREA HEALTH EDUCATION CENTER (NEFAHEC) TOBACCO CESSATION PROGRAMS PROVIDE FREE INTERVENTION THERAPIES TO QUIT SMOKING TOBACCO. THROUGH A PARTNERSHIP WITH NEFAHEC, A LOCAL CHAPTER OF THE NATIONAL AREA HEALTH EDUCATION CENTER (AHEC) ORGANIZATION, WE WILL INCREASE THE NUMBER OF INDIVIDUALS PARTICIPATING IN THE CLASSES BY PROVIDING CONNECTION POINTS TO NEFAHEC'S CLASSES THROUGH SOCIAL MEDIA POSTS AND INTERNAL RESOURCES. NEFAHEC IS A COMMUNITY FOCUSED ORGANIZATION THAT DEVELOPS AND IMPLEMENTS COMMUNITY-BASED HEALTH PROMOTION ACTIVITIES AND EDUCATION PROGRAMS, WHICH TARGET THE UNDERSERVED. AS IT RELATES TO OUR RELATIONSHIP WITH NEFAHEC, WE ARE PARTNERING WITH NEFAHEC TO PROVIDE COMMUNITY MEMBERS THE TOOLS AND RESOURCES TO ASSIST WITH TOBACCO CESSATION. THE HOSPITAL PROGRESSED ON ITS SET METRIC. ADVENTHEALTH PALM COAST REFERRED 696 INDIVIDUALS FOR SMOKING CESSATION SERVICES PROVIDED BY AHEC IN 2021. THERE WERE 86 INDIVIDUALS WHO ACCEPTED SERVICES AND/OR ENROLLED IN A CESSATION CLASS. PRIORITY 2: YOUTH BEHAVIORAL HEALTH 2019 DESCRIPTION OF THE ISSUE:ALCOHOL USE - FLAGLER MIDDLE AND HIGH SCHOOL STUDENTS USE ALCOHOL AT A SLIGHTLY HIGHER RATE THAN FLORIDA, BUT THE RATE HAS BEEN DECREASING SINCE 2008 (SAME FOR BINGE DRINKING). SMOKING AND SUBSTANCE MISUSE - FLAGLER MIDDLE SCHOOL STUDENTS REPORTED A HIGHER RATE OF MARIJUANA USE THAN FLORIDA AND THE TREND INCREASED BETWEEN 2016 AND 2018. FLAGLER HIGH SCHOOL STUDENTS REPORTED MARIJUANA USE INCREASED FROM 2014-2018. - REPORTED CIGARETTE USE AMONG FLAGLER MIDDLE AND HIGH SCHOOL STUDENTS HAS DECLINED, BUT THE HIGH SCHOOL RATE IS HIGHER THAN FLORIDA. - THE MIDDLE AND HIGH SCHOOL USE OF VAPORIZERS/E-CIGARETTES HAS INCREASED SINCE 2016 AND FAR EXCEEDS CIGARETTE USE AMONG MIDDLE AND HIGH SCHOOLERS (DATA ONLY COLLECTED SINCE 2016). MENTAL HEALTH - FLAGLER COUNTY'S SUICIDE RATE AMONG YOUTH AGE 12-18 IS HIGHER THAN FLORIDA, PEAKING IN 2013-15 (ALTHOUGH A RELATIVELY SMALL NUMBER/COUNT). - FLAGLER'S K-12 OUT OF SCHOOL SUSPENSION RATE IS HIGHER THAN FLORIDA AND HAS BEEN INCREASING SINCE 2014. 2021 UPDATE: THE ADVENTHEALTH PALM COAST COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE YOUTH BEHAVIORAL HEALTH PRIORITY. 1. INCREASE YOUTH ACCESS TO PSYCHIATRIC SERVICES IN FLAGLER COUNTY THROUGH THE ESTABLISHMENT OF A NEW PROGRAM IN SCHOOL AND IN THE COMMUNITY.2. ESTABLISH A MULTI-AGENCY REFERRAL AND COMMUNICATION MANAGEMENT SYSTEM IN VOLUSIA/FLAGLER COUNTY TO EFFECTIVELY CONNECT INDIVIDUALS IN NEED TO BEHAVIORAL HEALTH CARE SERVICES.GOAL 1: INCREASE YOUTH ACCESS TO PSYCHIATRIC SERVICES IN FLAGLER COUNTY THROUGH THE ESTABLISHMENT OF A NEW PROGRAM IN SCHOOL AND IN THE COMMUNITY. OBJECTIVE 1: THE FIRST OBJECTIVE IS TO WORK WITH FLAGLER SCHOOLS AND COMMUNITY STAKEHOLDERS TO IDENTIFY WHICH PSYCHIATRIC GAP WILL BE THE PRIORITY TO ADDRESS BY THE END OF YEAR ONE. THE EFFORT TO IDENTIFY PRIORITIES IS CONDUCTED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE EFFORT TO IDENTIFY A SPECIFIC YOUTH MENTAL HEALTH PRIORITY IN PARTNERSHIP WITH COMMUNITY STAKEHOLDERS, INCLUDING FLAGLER SCHOOLS, WAS THE IDENTIFIED ACTIVITY FOR 2020 IMPLEMENTATION. THE HOSPITAL MET ITS SET METRIC WITH ONE PRIORITY IDENTIFIED. IN 2020, ADVENTHEALTH PALM COAST BEGAN DISCUSSIONS WITH IMPOWER TO HELP ADDRESS YOUTH BEHAVIORAL HEALTH NEEDS IN THE COMMUNITY. IMPOWER IS A LEADING NON-PROFIT MENTAL HEALTH, SUBSTANCE MISUSE AND CHILD WELL-BEING ORGANIZATION FOUNDED IN 1994, WHICH OFFERS TELEHEALTH SERVICES FOR MENTAL HEALTH NEEDS. IN 2021, ADVENTHEALTH PALM COAST EXPANDED THEIR COMMITMENT TO SUPPORT MENTAL HEALTH CAPACITY BY ESTABLISHING A FIVE-YEAR PARTNERSHIP WITH FLAGLER SCHOOLS AND BY MAKING A FINANCIAL INVESTMENT OF $750,000 THAT INCLUDED $10,000 PER YEAR FOR A MENTAL HEALTH FUND WITH IMPOWER FOR STUDENTS WHO COULD NOT AFFORD THE COST OF CARE. OBJECTIVE 2:THE SECOND OBJECTIVE IS TO PROVIDE NEW SCHOOL-BASED PSYCHIATRIC OUTPATIENT SERVICES TO AT LEAST 50 STUDENTS PER YEAR BY YEAR TWO TO ADDRESS THE NEED IDENTIFIED IN OBJECTIVE ONE. THE PROGRAM, WHICH WILL PROVIDE INCREASED PSYCHIATRIC SERVICES, IS DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON ITS SET METRIC OF 50 YOUTH REFERRED BY THE IDENTIFICATION OF A SPECIFIC CAPACITY GAP IN FLAGLER COUNTY. DURING THE 2021-22 SCHOOL YEAR, 12 REFERRALS WERE MADE BY FLAGLER SCHOOLS TO ACCESS THE IMPOWER SERVICES FUNDED BY ADVENTHEALTH PALM COAST. GOAL 2: ESTABLISH A MULTI-AGENCY REFERRAL AND COMMUNICATION MANAGEMENT SYSTEM IN VOLUSIA/FLAGLER COUNTY TO EFFECTIVELY CONNECT INDIVIDUALS IN NEED TO BEHAVIORAL HEALTH CARE SERVICES.OBJECTIVE 1: THE FIRST OBJECTIVE IS A DIVISIONAL INITIATIVE AND APPEARS ON MULTIPLE COMMUNITY HEALTH PLANS OF HOSPITALS IN THE CENTRAL FLORIDA DIVISION OF ADVENTHEALTH, THE SAME DIVISION AS THE REPORTING HOSPITAL. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE OBJECTIVE IS TO SUPPORT THE DEVELOPMENT OF A PILOT PROJECT TO CONNECT FLAGLER SCHOOLS, HEALTH, AND BEHAVIORAL HEALTH SYSTEMS THROUGH THE UTILIZATION OF A REFERRAL AND COMMUNICATION MANAGEMENT TECHNOLOGY SYSTEM TO BE LAUNCHED BY THE END OF YEAR TWO. THIS OBJECTIVE IS MANAGED AT A DIVISIONAL LEVEL AND OUTCOMES ARE REPORTED AT A DIVISIONAL LEVEL; HOWEVER, ALL FUNDING IS SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL'S SUPPORT PROVIDES FUNDING TO FLAGLER CARES, A LOCAL NOT-FOR-PROFIT, WHICH FOCUSES ON INCREASING CAPACITY AND COORDINATION FOR HEALTH AND HUMAN SERVICES PROGRAMS, FOR THE PLANNING AND IMPLEMENTATION OF A DIGITAL SOLUTION TO FACILITATE REFERRALS TO BEHAVIORAL HEALTH SERVICES, AND TO INCREASE ACCESS TO CARE AND IMPROVE HEALTH. THE DIVISION PROGRESSED ON ITS SET METRIC THROUGH THE LAUNCH OF A PLAN TO SUPPORT THE LARGER OBJECTIVE. FLAGLER CARES LAUNCHED THE LINC FLAGLER VOLUSIA REFERRAL MANAGEMENT SYSTEM IN AUGUST 2021 WITH AN INITIAL FOCUS ON BEHAVIORAL HEALTH SERVICES. BY THE END OF 2021, FOURTEEN ORGANIZATIONS WERE PARTICIPATING IN THE NETWORK AND 889 REFERRALS WERE SENT THROUGH THE SYSTEM.SEE CONTINUATION 3
PART V, SECTION B, LINE 11: CONTINUATION 3	PRIORITY 3: CARDIOVASCULAR DISEASES & DIABETES 2019 DESCRIPTION OF THE ISSUE: - THE FLAGLER COUNTY DEATH RATE FOR HEART FAILURE IS HIGHER THAN FLORIDA AND HIGHEST FOR WHITE INDIVIDUALS. FLAGLER HOSPITALIZATION RATES FOR CONGESTIVE HEART FAILURE ARE LOWER THAN FLORIDA EXCEPT AMONG BLACK INDIVIDUALS THAT RATE IS HIGHER. THE CORONARY HEART DISEASE DEATH RATE IS HIGHER FOR MEN THAN WOMEN. - THE FLAGLER COUNTY HOSPITALIZATION RATE FOR STROKE IS HIGHER FOR BLACK INDIVIDUALS THAN OTHER GROUPS. THE FLAGLER COUNTY DEATH RATE FOR STROKE IS INCREASING FOR FLAGLER COUNTY AND IS INCREASING SIGNIFICANTLY FOR HISPANIC INDIVIDUALS. THE FLAGLER COUNTY STROKE DEATH RATE HAS BEEN HIGHER THAN FLORIDA FOR THE PAST THREE YEARS. - THE PERCENT OF ADULTS WITH DIABETES IN 2016 IS HIGHER IN FLAGLER COUNTY THAN FLORIDA. - OVER 70% OF FLAGLER COUNTY MIDDLE AND HIGH SCHOOL STUDENTS LACK VIGOROUS PHYSICAL ACTIVITY. THE FLAGLER COUNTY PERCENT IS BETTER THAN FLORIDA. ALSO, 47% OF FLAGLER COUNTY ADULTS ARE INACTIVE OR INSUFFICIENTLY ACTIVE (FLORIDA'S PERCENT IS WORSE). - THE PERCENT OF ADULTS WHO ARE OBESE INCREASED IN FLAGLER COUNTY BETWEEN 2013 AND 2016. - THE YEARS OF POTENTIAL LIFE LOST (YPLL) RATE FOR FLAGLER COUNTY WAS HIGHER THAN FLORIDA FOR FOUR OF THE FIVE PAST YEARS AND INCREASED FROM 2016 TO 2017.2021 UPDATE: THE ADVENTHEALTH PALM COAST COMMUNITY HEALTH PLAN HAS FOUR DESIRED GOAL STATEMENTS UNDER THE CARDIOVASCULAR DISEASES & DIABETES PRIORITY. 1. PROVIDE FINANCIAL SUPPORT TO THE FLAGLER COUNTY FREE CLINIC TO SUPPORT ACCESS TO CARE FOR THE UNINSURED. 2. INCREASE PHYSICAL ACTIVITY AND HEALTHY EATING AMONG VULNERABLE YOUTH.3. PROVIDE DIABETES EDUCATION IN PARTNERSHIP WITH ADVENTHEALTH PALM COAST FOUNDATION AND DIABEATES ALLIANCE TO RAISE AWARENESS TO PREVENT AND MANAGE TYPE 1 AND TYPE 2 DIABETES IN PALM COAST COMMUNITY.4. PROVIDE CREATION LIFE EDUCATIONAL SESSIONS FOR AREA RESIDENTS.GOAL 1: PROVIDE FINANCIAL SUPPORT TO THE FLAGLER COUNTY FREE CLINIC TO SUPPORT ACCESS TO CARE FOR THE UNINSURED. OBJECTIVE 1: THE FIRST OBJECTIVE IS TO PROVIDE 250 VOUCHERS FOR NO COST LABS AND DIAGNOSTICS, TO BE REDEEMED ANNUALLY BY PATIENTS REFERRED THROUGH THE FLAGLER COUNTY FREE CLINIC TO INCREASE ACCESS TO PRIMARY CARE FOR UNINSURED AT-RISK INDIVIDUALS. THE FLAGLER COUNTY FREE CLINIC IS A LOCAL NONPROFIT, WHICH PROVIDES CARE TO UNINSURED AND UNDERINSURED FLAGLER COUNTY RESIDENTS. THE OBJECTIVE IS FUNDED SOLELY THROUGH THE REPORTING HOSPITAL AND DOES NOT APPEAR ON OTHER COMMUNITY HEALTH PLANS WITHIN THE CENTRAL FLORIDA DIVISION. THIS SUPPORT PROVIDES FLAGLER COUNTY FREE CLINIC PATIENTS, WHO ARE UNINSURED, ACCESS TO NECESSARY LABS AND OTHER DIAGNOSTIC PROCEDURES. THE HOSPITAL EXCEEDED ITS METRIC OF 250 VOUCHERS WITH 429 VOUCHERS PROVIDED. ADVENTHEALTH PALM COAST PROVIDED FLAGLER COUNTY FREE CLINIC PATIENTS WITH 429 VOUCHERS FOR CARE VALUED AT $745,035. GOAL 2: INCREASE PHYSICAL ACTIVITY AND HEALTHY EATING AMONG VULNERABLE YOUTH.OBJECTIVE 1: THE FIRST OBJECTIVE, A DIVISIONAL INITIATIVE WHICH APPEARS ON MULTIPLE COMMUNITY HEALTH PLANS OF HOSPITALS IN THE CENTRAL FLORIDA DIVISION OF ADVENTHEALTH, IS TO PROVIDE EDUCATION ABOUT HEALTHY EATING AND PHYSICAL ACTIVITY TO 75% OF BOYS & GIRLS CLUBS MEMBERS FOUR TIMES ANNUALLY. THE BOYS & GIRLS CLUBS EDUCATION INITIATIVE IS FUNDED AND DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE BOYS & GIRLS CLUBS EDUCATION INITIATIVE IS FOCUSED ON PROVIDING AT LEAST FOUR EDUCATION SESSIONS A YEAR TO CLUB PARTICIPANTS TO INCREASE THEIR UNDERSTANDING OF HEALTHY EATING AND PHYSICAL ACTIVITY. THE HOSPITAL EXCEEDED ITS SET METRIC AND PROVIDED EIGHT HEALTHY LIFESTYLE VIDEOS AND ACTIVITIES TO PUT WHAT THE YOUTH LEARNED INTO ACTION. 75% OF THE 70 CLUB MEMBERS PARTICIPATED AT RYMFIRE ELEMENTARY BOYS & GIRLS CLUB IN PALM COAST.OBJECTIVE 2: THE SECOND OBJECTIVE IS A DIVISIONAL INITIATIVE AND APPEARS ON MULTIPLE COMMUNITY HEALTH PLANS OF HOSPITALS IN THE CENTRAL FLORIDA DIVISION OF ADVENTHEALTH, THE SAME DIVISION AS THE REPORTING HOSPITAL. THE DIVISION CHOSE THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO PROVIDE $4,000 IN FINANCIAL SUPPORT ANNUALLY TO THE BOYS & GIRLS CLUBS AS PART OF A STRATEGIC PARTNERSHIP, IS TO PROVIDE DAILY FRESH FRUIT AND WHOLE GRAIN SNACKS TO CLUB MEMBERS. THE OBJECTIVE IS FUNDED THROUGH THE HOSPITAL AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL, HOWEVER THE INITIATIVE IS MANAGED BY THE DIVISION. THIS INITIATIVE PROVIDES FINANCIAL SUPPORT SO THAT YOUTH PARTICIPATING IN LOCAL BOYS & GIRLS CLUBS CAN HAVE ACCESS TO DAILY HEALTHY SNACKS. THE HOSPITAL MET ITS SET METRIC OF PROVIDING FUNDING SUPPORT WITH $4,000 DOLLARS PROVIDED. THE PROVIDED FUNDING WAS ABLE TO MAKE UP FOR A SHORTFALL IN THE USDA GRANT THAT THE BOYS & GIRLS CLUBS OF VOLUSIA/FLAGLER PREVIOUSLY USED TO PROVIDE RYMFIRE BOYS & GIRLS CLUB MEMBERS WITH DAILY FRESH FRUIT AND WHOLE GRAIN SNACKS. THE WEEK OF CARING 2021 ADVENTHEALTH TEAM MEMBERS MADE A TOTAL OF 480 TRAIL MIX BAGS FOR THE BOYS & GIRLS CLUBS OF VOLUSIA AND FLAGLER COUNTIES FOR DISTRIBUTION TO EACH OF THE EIGHT CLUBS THROUGHOUT VOLUSIA AND FLAGLER.GOAL 3: PROVIDE DIABETES EDUCATION IN PARTNERSHIP WITH ADVENTHEALTH PALM COAST FOUNDATION AND DIABEATES ALLIANCE TO RAISE AWARENESS TO PREVENT AND MANAGE TYPE 1 AND TYPE 2 DIABETES IN PALM COAST COMMUNITY.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO PROVIDE DIABETES EDUCATION TO INCREASE AWARENESS TO PREVENT AND MANAGE TYPE 1 AND TYPE 2 DIABETES TOUCHING 1,000 PALM COAST RESIDENTS DURING YEAR ONE AND WITH A FOCUS ON DIABETES AWARENESS MONTH NOVEMBER 2020. THE EDUCATION INITIATIVE IS DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE DIABETES ALLIANCE, AN INITIATIVE OF THE ADVENTHEALTH PALM COAST FOUNDATION, LEADS THIS EDUCATIONAL CAMPAIGN IN PARTNERSHIP WITH THE FLAGLER COUNTY HEALTH DEPARTMENT AND MANY OTHER COMMUNITY ORGANIZATIONS. THE HOSPITAL FELL SHORT OF ITS SET METRIC OF REACHING 1,000 RESIDENTS WITH 110 RESIDENTS REACHED. DUE TO COVID-19, THE METRIC WAS NOT REACHED DUE TO THE LACK OF EVENTS AND NECESSARY PUBLIC HEALTH MEASURES. THE DIVISION PARTNERED WITH MISSION FIT; A NATIONAL INITIATIVE PROVIDED BY ADVENTHEALTH FOR CHILDREN. IT IS A COMPREHENSIVE WELLNESS PROGRAM THAT INCLUDES 4 COMPONENTS: HEALTHY EATING, EMOTIONAL WELLBEING, PHYSICAL ACTIVITY, AND REST. THE MISSION FIT PROGRAM WAS PROVIDED TO 169 STUDENTS AT RYMFIRE ELEMENTARY SCHOOL.OBJECTIVE 2: THE SECOND OBJECTIVE IS TO ENGAGE 100 AT RISK RESIDENTS IN DIABETES BLOOD SUGAR AND RETINOPATHY SCREENINGS IN PARTNERSHIP WITH THE FLAGLER COUNTY HEALTH DEPARTMENT AND ADVENTHEALTH PALM COAST FOUNDATION BY END OF YEAR ONE. THE SCREENING INITIATIVE IS DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE SCREENING INITIATIVE IS IMPLEMENTED IN PARTNERSHIP WITH THE FLAGLER COUNTY HEALTH DEPARTMENT AND FOCUSED ON PROVIDING IMPORTANT SCREENINGS TO VULNERABLE POPULATIONS. THE HOSPITAL FELL SHORT OF ITS SET METRIC OF 100 INDIVIDUALS SCREENED WITH 40 INDIVIDUALS SCREENED. AWARENESS EVENTS WERE HELD IN NOVEMBER 2021 IN OBSERVANCE OF DIABETES AWARENESS MONTH, REACHING 80 INDIVIDUALS WITH 50 INDIVIDUALS PARTICIPATING IN BLOOD SUGAR AND RETINOPATHY SCREENINGS. GOAL 4: PROVIDE CREATION LIFE EDUCATIONAL SESSIONS FOR AREA RESIDENTS.OBJECTIVE 1: THE FIRST OBJECTIVE IS THAT 75% OF CREATION LIFE SESSION ATTENDEES WHO COMPLETE THE PROGRAM WILL DEMONSTRATE AN IMPROVEMENT IN KNOWLEDGE AND/OR ATTITUDE AFTER COMPLETING A SESSION (TWO SESSIONS WITH 50 PARTICIPANTS IN EACH SESSION). THE CREATION LIFE PROGRAM IS A DIVISIONAL PROGRAM; HOWEVER, IT IS FUNDED AND DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE CREATION LIFE PROGRAM IS A SERIES OF EDUCATIONAL AND WELLNESS SESSIONS FOCUSED ON EIGHT HEALTH PRINCIPLES: CHOICE, REST, ENVIRONMENT, ACTIVITY, TRUST, INTERPERSONAL RELATIONSHIPS, OUTLOOK, AND NUTRITION. THE HOSPITAL FELL SHORT OF ITS SET METRIC OF 50 PARTICIPANTS IN TWO SESSIONS, HAVING ONLY BEEN ABLE TO PROVIDE TWO SESSIONS WITH 44 PEOPLE EDUCATED. SEE CONTINUATION 4
PART V, SECTION B, LINE 11: CONTINUATION 4	PRIORITY 4: MOTHERS AND CHILDREN UNDER AGE 5 2019 DESCRIPTION OF THE ISSUE: - BIRTHS TO FLAGLER COUNTY MOTHERS AGE 15-19 INCREASED FROM 2015 TO 2017 AND THE LATEST RATE IS HIGHER THAN FLORIDA. - THE FLAGLER COUNTY RATE OF BACTERIAL STDS AMONG WOMEN 15-34 HAS STEADILY INCREASED SINCE 2013. - THE RATE OF VERY LOW BIRTH WEIGHT BABIES BORN TO BLACK FLAGLER WOMEN HAS INCREASED SINCE 2012 AND EXCEEDS THE FLORIDA RATE. THE RATE OF LOW-BIRTH-WEIGHT BABIES BORN TO BLACK FLAGLER COUNTY MOTHERS IS ALSO HIGHER THAN THE FLORIDA RATE. - BIRTHS TO FLAGLER COUNTY WOMEN WITH NO PRENATAL CARE HAS STEADILY INCREASED FOR BLACK WOMEN SINCE 2011 AND INCREASED IN THE LAST 3 YEARS FOR WHITE WOMEN AND ALL WOMEN IN FLAGLER COUNTY. - THE PERCENT OF FLAGLER COUNTY MOMS WHO INITIATED BREASTFEEDING HAS BEEN LOWER THAN FLORIDA FOR THE LAST 5 YEARS. THE PERCENT OF BLACK MOMS WHO INITIATIVE BREASTFEEDING IS LOWER THAN ALL OTHER GROUPS. CHILDREN UNDER 5 - THE PERCENT OF FLAGLER COUNTY CHILDREN "READY FOR KINDERGARTEN" IS LOWER THAN FLORIDA. - THE PERCENT OF FLAGLER COUNTY CHILDREN FULLY IMMUNIZED HAS DECREASED FROM 2016 TO 2018 AND THE FLAGLER COUNTY PERCENT WAS LOWER THAN FLORIDA IN 2017 AND 2018. - THE FLAGLER COUNTY RATE OF INFANT MORTALITY FOR HISPANIC BABIES HAS INCREASED SINCE 2011 AND IS HIGHER THAN ALL OTHER GROUPS. 2021 UPDATE: THE ADVENTHEALTH PALM COAST COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE MOTHERS AND CHILDREN UNDER AGE 5 PRIORITY. 1. PROVIDE FREE PRENATAL AND OB EDUCATION TO LOW INCOME WOMEN. GOAL 1: PROVIDE FREE PRENATAL AND OB EDUCATION TO LOW INCOME WOMEN. OBJECTIVE 1: THE FIRST OBJECTIVE IS TO PROVIDE FREE PRENATAL AND OBSTETRICS (OB) EDUCATION CLASSES TO 25% OF LOW-INCOME WOMEN ANNUALLY. THE EDUCATION PROGRAM IS DRIVEN BY THE DIVISION; HOWEVER, IT IS DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE EDUCATION PROGRAM WAS ESTABLISHED TO PROVIDE EDUCATION TO LOW-INCOME WOMEN IN CONVENIENT LOCATIONS IN FLAGLER COUNTY TO CREATE ACCESS FOR WOMEN WHO MUST DELIVER THEIR BABIES IN ANOTHER COUNTY. THE HOSPITAL DID NOT MEET ITS SET METRIC WITH ZERO PEOPLE EDUCATED. DUE TO COVID-19, THE PROGRAM WAS DELAYED. AS A RESULT OF THE PANDEMIC, THE NEEDS AND RESOURCES IN OUR COMMUNITY HAVE CHANGED AND ADVENTHEALTH IS ATTENTIVE TO THAT. DURING THE PAST YEAR, WE HAVE PIVOTED WHERE NECESSARY TO ADDRESS THE IMMEDIATE NEEDS OF OUR COMMUNITY DURING THE PANDEMIC AND WILL CONTINUE TO DO SO. WE WILL WORK TO IDENTIFY WAYS TO SUPPORT OUR COMMUNITY AND THE COMMUNITY-BASED ORGANIZATIONS THAT AID IT, WHILE FINDING NEW WAYS TO MEET THE NEW AND EXISTING NEEDS IN IT. IN 2021 PRENATAL AND OB EDUCATION CLASSES WERE PROVIDED IN VIRTUAL FORMAT. ALTHOUGH NOT ATTRIBUTABLE TO JUST ADVENTHEALTH PALM COAST, 508 INDIVIDUALS FROM VOLUSIA AND FLAGLER COUNTIES PARTICIPATED IN VIRTUAL EDUCATION SESSIONS. PRIORITY 5: FAMILY VIOLENCE 2019 DESCRIPTION OF THE ISSUE: - FLAGLER COUNTY'S DOMESTIC VIOLENCE OFFENSE RATE IS HIGHER THAN FLORIDA. - FLAGLER COUNTY'S CHILD ABUSE RATES FOR CHILDREN AGE 5-11 EXCEEDED FLORIDA IN 2014 TO 2017 AND THE RATE OF CHILDREN THE SAME AGE EXPERIENCING SEXUAL VIOLENCE IS HIGHER THAN FLORIDA AND INCREASING. THE NUMBER OF FLAGLER COUNTY INFANTS, CHILDREN AGE 1-5 AND CHILDREN AGE 12-17 IN FOSTER CARE HAS BEEN INCREASING SINCE 2012. THE NUMBER OF INFANTS IN FOSTER CARE IS HIGHER THAN FLORIDA SINCE 2014. 2021 UPDATE: THE ADVENTHEALTH PALM COAST COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE FAMILY VIOLENCE PRIORITY. 1. PARTNER WITH THE FAMILY LIFE CENTER TO PROVIDE DOMESTIC VIOLENCE AND SEXUAL ASSAULT AWARENESS TRAINING TO ADVENTHEALTH STAFF.GOAL 1: PARTNER WITH THE FAMILY LIFE CENTER TO PROVIDE DOMESTIC VIOLENCE AND SEXUAL ASSAULT AWARENESS TRAINING TO ADVENTHEALTH STAFF.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO PROVIDE QUARTERLY ONE-HOUR TRAINING SESSIONS TO AT LEAST 50 STAFF MEMBERS ANNUALLY THROUGH PROGRAMMING VALUED AT $3,000 FROM THE FAMILY LIFE CENTER. THE TRAINING PROGRAM IS FUNDED AND DEPLOYED THROUGH ADVENTHEALTH PALM COAST AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE TRAINING PROGRAM WAS DESIGNED TO INCREASE THE UNDERSTANDING AND ABILITY OF ADVENTHEALTH PALM COAST STAFF TO IDENTIFY THE SIGNS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT AND TO PROVIDE THEM WITH INFORMATION ABOUT LOCAL RESOURCES AVAILABLE. THE HOSPITAL DID NOT MEET ITS SET METRIC OF 50 STAFF TRAINED WITH NO PEOPLE EDUCATED. DUE TO COVID-19, THE PROGRAM WAS DELAYED. AS A RESULT OF THE PANDEMIC, THE NEEDS AND RESOURCES IN OUR COMMUNITY HAVE CHANGED AND ADVENTHEALTH IS ATTENTIVE TO THAT. DURING THE PAST YEAR, WE HAVE PIVOTED WHERE NECESSARY TO ADDRESS THE IMMEDIATE NEEDS OF OUR COMMUNITY DURING THE PANDEMIC AND WILL CONTINUE TO DO SO. FAMILY LIFE CENTER IS SCHEDULED TO OFFER THE PROGRAM IN MAY 2022 TO ADVENTHEALTH PALM COAST TEAM MEMBERS.COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH PALM COAST:THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. THE HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE - OR MULTIPLE GROUPS - IN THE COMMUNITY ALREADY WORKING ON THIS ISSUE? 5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES:1. AVAILABILITY OF HEALTH RESOURCES THE DATA COLLECTED DID NOT DEMONSTRATE SIGNIFICANT NEGATIVE TRENDS OR NEGATIVE COMPARISON TO STATE DATA. MANY ACCESS ISSUES WILL BE ADDRESSED AS A COMPONENT OF OTHER HEALTH PRIORITIES. 2. SOCIAL AND ECONOMIC ISSUES SOCIAL AND ECONOMIC ISSUES WILL BE CONSIDERED AS A COMPONENT OF ALL PRIORITY INDICATORS.
SCHEDULE H, PART V, SECTION B, LINE 7A:	THE CHNA REPORT CAN BE FOUND AT URL: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS
SCHEDULE H, PART V, SECTION B, LINE 10A:	THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS
SCHEDULE H, PART V, SECTION B, LINE 16A,B,C:	THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCE

Field	Value	IRS element (for citing)
Facility	27	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (27 entries)

Address Line1USAddress/AddressLine1Txt	Address Line2USAddress/AddressLine2Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	2811	PALM COAST	FL	32164	PHYSICIAN CLINIC
2 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
21 HOSPITAL DRIVE SUITE 110		PALM COAST	FL	32164	PHYSICIAN CLINIC
3 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	2801	PALM COAST	FL	32164	PHYSICIAN CLINIC
4 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	2815	PALM COAST	FL	32164	PHYSICIAN CLINIC
5 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	1800-B	PALM COAST	FL	32164	PHYSICIAN CLINIC
6 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 202		PALM COAST	FL	32164	PHYSICIAN CLINIC
7 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3811	PALM COAST	FL	32164	PHYSICIAN CLINIC
8 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3803	PALM COAST	FL	32164	PHYSICIAN CLINIC
9 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3802	PALM COAST	FL	32164	PHYSICIAN CLINIC
10 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3807	PALM COAST	FL	32164	PHYSICIAN CLINIC
11 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 207		PALM COAST	FL	32164	PHYSICIAN CLINIC
12 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	2806	PALM COAST	FL	32164	PHYSICIAN CLINIC
13 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3805	PALM COAST	FL	32164	PHYSICIAN CLINIC
14 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 209		PALM COAST	FL	32164	PHYSICIAN CLINIC
15 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 204		PALM COAST	FL	32164	PHYSICIAN CLINIC
16 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3806	PALM COAST	FL	32164	PHYSICIAN CLINIC
17 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 PINNACLES DRIVE SUITE 1		PALM COAST	FL	32164	PHYSICIAN CLINIC
18 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3808	PALM COAST	FL	32164	PHYSICIAN CLINIC
19 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 208		PALM COAST	FL	32164	PHYSICIAN CLINIC
20 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3804	PALM COAST	FL	32164	PHYSICIAN CLINIC
21 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	2808	PALM COAST	FL	32164	PHYSICIAN CLINIC
22 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 203		PALM COAST	FL	32164	PHYSICIAN CLINIC
23 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3813	PALM COAST	FL	32164	PHYSICIAN CLINIC
24 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 206		PALM COAST	FL	32164	PHYSICIAN CLINIC
25 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
21 HOSPITAL DRIVE SUITE 230		PALM COAST	FL	32164	PHYSICIAN CLINIC
26 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
61 MEMORIAL MEDICAL PARKWAY SUITE	3808	PALM COAST	FL	32164	PHYSICIAN CLINIC
27 - ADVENTHEALTH MEDICAL GROUP PHY CLINIC
120 CYPRESS EDGE DRIVE SUITE 210		PALM COAST	FL	32164	PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTHEALTH".ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE.
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 III, LINE 2:	THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE.
PART III, LINE 3:	METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY.
PART III, LINE 4:	FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8-9. 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.
PART III, LINE 9B:	THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2014 FINAL REGULATIONS REGARDING THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R)(4)-(R)(6). NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) ARE INITIATED BY THE HOSPITAL FILING ORGANIZATION IN THE 120-DAY PERIOD FOLLOWING THE DATE AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL (OR, IF LATER, THE SPECIFIED DEADLINE GIVEN IN A WRITTEN NOTICE OF ACTIONS THAT MAY BE TAKEN, AS DESCRIBED BELOW). INDIVIDUALS ARE PROVIDED WITH AT LEAST ONE WRITTEN NOTICE (NOTICE OF ACTIONS THAT MAY BE TAKEN) AND A COPY OF THE FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY THAT INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS IF THE INDIVIDUAL DOES NOT SUBMIT A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM) OR PAY THE AMOUNT DUE BY A SPECIFIED DEADLINE. THE SPECIFIED DEADLINE IS NOT EARLIER THAN 120 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. A REASONABLE ATTEMPT IS ALSO MADE TO ORALLY NOTIFY AN INDIVIDUAL ABOUT THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST POST-DISCHARGE BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS (OR CEASES ANY OTHER ECA'S) AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPLETE THE FAA FORM. THIS WRITTEN NOTICE CONTAINS CONTACT INFORMATION INCLUDING THE TELEPHONE NUMBER AND PHYSICAL LOCATION OF 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.
SCHEDULE H, PART III, SECTION B	SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B, LINE 8 RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO ALL MEDICARE PATIENTS ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ 3,787,489- DIFFERENCE IN COSTING METHODOLOGY: (3,559,094)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (2,914,820) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITYBENEFIT REPORTING $ (2,686,425)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 VI, LINE 2:	THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2019 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2019, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2019 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1.A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2.POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3.SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4.COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY.
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 FACILITY 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 FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE 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 HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE.
PART VI, LINE 4:	MEMORIAL HOSPITAL FLAGLER (THE HOSPITAL) IS A 99-BED ACUTE CARE FACILITY THAT PROVIDES QUALITY HEALTH CARE SERVICES TO THE RESIDENTS OF PALM COAST AND SURROUNDING FLAGLER COUNTY IN THE STATE OF FLORIDA. THE HOSPITAL IS THE SOLE PROVIDER OF EMERGENCY HOSPITAL SERVICES IN FLAGLER COUNTY. THE HOSPITAL IS LOCATED IN A RURAL COMMUNITY LOCATED BETWEEN TWO LARGER CITIES. DURING 2021, THE HOSPITAL'S PATIENT PERCENTAGE POPULATION WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. IN 2021, ABOUT 93.9% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 62% - MEDICAID PATIENTS 8.3% - SELF-PAY PATIENTS 3.6% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 97,207 - POPULATION OVER 65 29.5% - POVERTY (BELOW 100% FPL) 13.8% - UNEMPLOYMENT RATE 7.7% - VIOLENT CRIME RATE (PER 100,000 POP.) 265 - POP. AGE 25+ WITH NO HIGH SCHOOL DIPLOMA 8.2% - UNINSURED ADULTS 17.82% - UNINSURED CHILDREN 8.02% - FOOD INSECURITY RATE 17.2% - POP. WITH LOW FOOD ACCESS 54.13%
PART VI, LINE 5:	THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ORGANIZAN'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL 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 HOSPITAL 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 HOSPITAL PROVIDED $418,111 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $24,684,408 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, 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 HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 6:	THE FILING ORGANIZATION IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 48 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 10 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF ADVENTHEALTH, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS IT, CORPORATE COMPLIANCE, LEGAL, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. CERTAIN SUPPORT SERVICES, SUCH AS HUMAN RESOURCES, PAYROLL, A/P, AND SUPPLY CHAIN MANAGEMENT ARE PROVIDED PURSUANT TO A SHARED SERVICES MODEL BY AHSSHC TO ITS SUBSIDIARY ORGANIZATIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH ADVENTHEALTH SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH AHS SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH.
PART VI, LINE 7:	THE FILING ORGANIZATION DOES NOT FILE AN ANNUAL COMMUNITY BENEFIT REPORT WITH ANY STATE AGENCIES.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
PALM COAST SEVENTH DAY ADVENTIST CHURCH
5650 BELLE TERRE PARKWAY	PALM COAST	FL	32137	590806975	501(C)(3)	$50,000	$0	GENERAL SUPPORT
FLAGLER CARES INC
2561 MOODY BLVD SUITE 206	PALM COAST	FL	32137	474145174	501(C)(3)	$13,000	$0	GENERAL SUPPORT
SUNSYSTEM DEVELOPMENT CORP DBA ADVENTHEALTH PALM COAST FOUNDATION
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	592219301	501(C)(3)	$0	$361,224	PROVISION OF GENERAL ADMINISTRATIVE SUPPORT	COST	GENERAL ADMINISTRATIVE SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Travel For Companions	Yes (X)	TravelForCompanionsInd
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Discretionary Spending Acct	Yes (X)	DiscretionarySpendingAcctInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
HAFFNER PHD RANDALL
DIRECTOR (BEG 2/21)	$0	$1,446,809	$0	$989,082	$0	$1,184,218	$0	$165,548	$0	$43,625	$0	$3,829,282	$0	$243,228
TOL DARYL
DIR/AH CEN FL DIV CEO (END 1/21)	$0	$128,869	$0	$922,947	$0	$1,660,721	$0	$0	$0	$8,693	$0	$2,721,230	$0	$354,679
GOODMAN TODD
DIR/AH CEN FL DIV CFO	$0	$719,496	$0	$353,016	$0	$625,489	$0	$128,293	$0	$54,767	$0	$1,881,061	$0	$94,417
JIMENEZ MD RONALD
SEC/DIR/FACILITY CEO	$0	$425,485	$0	$171,265	$0	$923,828	$0	$60,867	$0	$28,066	$0	$1,609,511	$0	$37,381
OTTATI DAVID
CHAIR/DIR/AH CEN FL REG (END 12/21)	$0	$758,048	$0	$329,302	$0	$200,225	$0	$156,314	$0	$48,141	$0	$1,492,030	$0	$119,809
NOSEWORTHY G ED
DIRECTOR/CEO AHDB	$0	$510,680	$0	$195,542	$0	$377,895	$0	$15,548	$0	$33,152	$0	$1,132,817	$0	$123,231
ALTER MD DENNIS
DIRECTOR	$0	$521,840	$0	$390,436	$0	$12,885	$0	$15,548	$0	$61,718	$0	$1,002,427	$0	$0
THOMAS DEBORA
FORMER OFFICER	$0	$478,415	$0	$121,101	$0	$231,117	$0	$70,791	$0	$29,164	$0	$930,588	$0	$55,923
CELANO PATRICIA
DIRECTOR (BEG 1/21)	$0	$472,725	$0	$98,101	$0	$76,263	$0	$84,121	$0	$44,634	$0	$775,844	$0	$40,348
DAVIS BRENT
DIR/AH CFD N REG CFO	$0	$430,002	$0	$82,242	$0	$15,543	$0	$81,750	$0	$44,067	$0	$653,604	$0	$0
KILMAN MD MARK
CMO - HOSPITAL FACILITY	$0	$323,741	$0	$55,455	$0	$51,023	$0	$64,982	$0	$29,508	$0	$524,709	$0	$30,938
DOMAYER CORY
FORMER CFO	$0	$294,137	$0	$48,117	$0	$13,611	$0	$61,033	$0	$41,310	$0	$458,208	$0	$0
GREGORY PHD AUDREY
DIR/CHAIRMAN/TREAS (BEG 12/21)	$0	$137,063	$0	$0	$0	$279,271	$0	$19,731	$0	$6,257	$0	$442,322	$0	$0
RATHBUN MARK
CFO	$0	$255,713	$0	$41,096	$0	$10,357	$0	$15,548	$0	$37,532	$0	$360,246	$0	$0
GOVER MARY KATHY
CNO - HOSPITAL FACILITY	$0	$229,436	$0	$39,971	$0	$7,328	$0	$13,847	$0	$25,254	$0	$315,836	$0	$0
DEAQUINO WALMIR
COO - HOSPITAL FACILITY	$0	$210,362	$0	$36,928	$0	$10,039	$0	$13,497	$0	$37,462	$0	$308,288	$0	$0
TAYLOR WAYNE
AHPC DIRECTOR OF PHARMACY	$157,700	$0	$14,159	$0	$8,773	$0	$9,089	$0	$35,651	$0	$225,372	$0	$0	$0
BATTANI RHONDA
AHPC DIR QUALITY/REGULATIONS	$153,450	$0	$23,523	$0	$5,822	$0	$8,383	$0	$6,703	$0	$197,881	$0	$0	$0
SAMRAI BALRAJ
AHPC CLINICAL STAFF PHARMA	$163,043	$0	$1,369	$0	$4,344	$0	$8,091	$0	$20,979	$0	$197,826	$0	$0	$0
MOTZNY SEAN
AHPC REG MED DIR HOSPICE	$171,731	$0	$0	$0	$777	$0	$3,435	$0	$12,459	$0	$188,402	$0	$0	$0
SEGALL GRANT
AHPC CLINICAL STAFF PHARMA	$151,856	$0	$685	$0	$716	$0	$5,064	$0	$20,536	$0	$178,857	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. FIRST-CLASS OR CHARTER TRAVEL: PURSUANT TO THE ADVENTHEALTH SYSTEM-WIDE GENERAL POLICY REGARDING BUSINESS TRAVEL, NO REIMBURSEMENT WILL BE PROVIDED FOR ANY ADDITIONAL COST INCURRED WITH RESPECT TO FIRST-CLASS OR CHARTER AIR TRAVEL BEYOND THE COST OF A REGULAR COACH AIRFARE. AS A MEANS OF PROVIDING ADDITIONAL BUSINESS TRAVEL REIMBURSEMENT FOR THOSE MEMBERS OF THE AHSSHC SENIOR EXECUTIVE MANAGEMENT TEAM THAT TRAVEL FREQUENTLY ON BEHALF OF ADVENTHEALTH, A SPECIAL ANNUAL TRAVEL ALLOWANCE IS PROVIDED FOR THOSE EXECUTIVES. AS ADVENTHEALTH OPERATES 48 HOSPITALS IN 9 STATES, THE SENIOR LEADERSHIP OF AHSSHC TRAVEL EXTENSIVELY AND OFTEN VISIT MULTIPLE HOSPITAL LOCATIONS IN DIFFERENT STATES AS A PART OF A SINGLE BUSINESS TRIP. THE SPECIAL TRAVEL ALLOWANCE CAN PROVIDE REIMBURSEMENTS TO THE EXECUTIVE FOR SUCH ITEMS AS THE PURCHASE OF AIR TRAVEL UPGRADE COUPONS, TO COVER THE COST DIFFERENTIAL BETWEEN COACH AND FIRST-CLASS TRAVEL, OR TO COVER THE COST OF A CHARTER FLIGHT. THE SPECIAL TRAVEL ALLOWANCE BENEFIT WAS ORIGINALLY AUTHORIZED BY AND CODIFIED INTO A POLICY BY THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE), AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS, WHO ALSO APPROVES THE ANNUAL CAP ON THE AMOUNT OF THE ALLOWANCE. THE SPECIAL TRAVEL ALLOWANCE HAS AN ANNUAL CAP OF $24,000 FOR MEMBERS OF THE LEADERSHIP EXECUTIVE TEAM (ADVENTHEALTH CABINET-13 MEMBERS) AND $15,000 FOR ADVENTHEALTH CORPORATE OFFICE SENIOR VICE PRESIDENTS, REGIONAL CEO'S AND DIVISION CHIEF OFFICERS (GENERALLY 20-35 INDIVIDUAL EXECUTIVES). THE REGIONAL CEO FOR THE ADVENTHEALTH CENTRAL FLORIDA REGION-NORTH IS A MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THIS REGIONAL POSITION IS CONSIDERED A COMMON LAW EMPLOYEE OF AND IS 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 PARTIALLY ALLOCATED TO AND 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 PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. THOSE EXECUTIVES WHO RECEIVE THE SPECIAL TRAVEL ALLOWANCE ARE RESPONSIBLE FOR TRACKING THE EXPENSES REIMBURSABLE UNDER THE SPECIAL TRAVEL ALLOWANCE AND MUST SUBMIT SUCH EXPENSES ON THEIR ACCOUNTABLE PLAN EXPENSE REPORT. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES UNDER THE SPECIAL TRAVEL ALLOWANCE ARRANGEMENT ARE TREATED AS TAXABLE COMPENSATION TO THE EXECUTIVE. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: OCCASIONAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH PRESIDENT'S COUNCIL, CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING. PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. 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 MAKE A DETERMINATION IF CONTINUANCE OF THE CLUB MEMBERSHIP FURTHERS THE BUSINESS INTERESTS OF ADVENTHEALTH. IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, ONE EXECUTIVE LISTED IN PART VII RECEIVED REIMBURSEMENT FOR CLUB FEES. WHILE THE CLUB DUES MEMBERSHIP IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND REIMBURSED IN WHOLE OR IN PART BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR HEALTH OR SOCIAL CLUB DUES SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT.
PART I, LINE 3	THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS APPOINTED AND COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION 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 OF THE COMMUNITY, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT, OTHER THAN THE CHIEF PEOPLE OFFICER, WHO REMAINS AT THE REQUEST OF THE CHAIRMAN/COMMITTEE TO PROVIDE ASSISTANCE/INFORMATION AS NEEDED. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD-PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO ADVENTHEALTH AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF ADVENTHEALTH WILL NOT EXCEED THE 50TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP.
PART I, LINES 4A-B	PART I, LINE 4A: DURING THE YEAR ENDING DECEMBER 31, 2021, DARYLE TOL RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $1,169,453. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH ADVENTHEALTH. PART I, LINE 4B: EXECUTIVE PLAN AS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE BENEFIT PLANS TO ELIGIBLE EXECUTIVES. IN 2020, ADVENTHEALTH RESTRUCTURED ITS EXECUTIVE SUPPLEMENTAL RETIREMENT AND BENEFIT PLANS TO REDUCE COMPLEXITY, TO INCREASE PREDICTABILITY OF BENEFITS AND TO CONSOLIDATE MULTIPLE SUPPLEMENTAL EXECUTIVE BENEFIT PLANS INTO ONE PLAN. EFFECTIVE 1/1/2020, A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP III) WAS ADOPTED AND THE THREE EXISTING PLANS, DESCRIBED BELOW, WERE AMENDED AND RESTATED. THE NEWLY ADOPTED SERP III PLAN, AS WELL AS THE AMENDED AND RESTATED PLANS, WERE REVIEWED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. SERP III PLAN (EFFECTIVE 1/1/2020): TO RECOGNIZE THE CONTRIBUTION EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH AND TO RECOGNIZE THE LIMITATIONS AVAILABLE TO EXECUTIVES IN QUALIFIED RETIREMENT PLANS DUE TO COMPENSATION LIMITS SET ON SUCH PLANS, ADVENTHEALTH ADOPTED A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP III) IN 2020. THE SERP III PLAN EFFECTIVELY REPLACES THE PRIOR SERP II PLAN, THE EXECUTIVE FLEX BENEFIT PROGRAM PLAN, AND THE SENIOR EXECUTIVE DEATH BENEFIT PLAN FOR QUALIFIED EXECUTIVES EXCEPT FOR CERTAIN GRANDFATHERED EXECUTIVE EMPLOYEES. THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $290,000 IN 2021 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN (AMENDED AND RESTATED IN 2020): IN 2020, THE SERP II PLAN WAS AMENDED AND RESTATED TO PROVIDE THAT ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER. 31, 2027. THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN (AMENDED AND RESTATED IN 2020): IN 2020, THE FLEX PLAN WAS AMENDED AND RESTATED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. ADDITIONALLY, A PROVISION WAS ADDED TO PLACE A MAXIMUM LIMIT ON THE AMOUNT OF A PARTICIPANT'S ANNUAL FLEX ALLOWANCE TO NOT BE GREATER THAN A MAXIMUM DOLLAR AMOUNT OR PERCENTAGE OF COMPENSATION AS ESTABLISHED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE IS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR.
SCHEDULE J, PART I, LINE 4B CONTINUATION	SENIOR EXECUTIVE DEATH BENEFIT PLAN (SEDB) (AMENDED AND RESTATED IN 2020): THE SEDB PLAN WAS ORIGINALLY DESIGNED TO PROVIDE A BENEFIT IN AN AMOUNT EQUAL TO THE AMOUNT THE EXECUTIVE'S BENEFIT WOULD HAVE BEEN UNDER THE SERP II PLAN ASSUMING THAT, ON THE DATE OF THE EXECUTIVE'S DEATH (AND NOT BEFORE), THE EXECUTIVE SATISFIED THE LAST OF THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN WITH PRESENT VALUE RECOGNIZING AN EARLY BENEFIT COMMENCEMENT. IN CONJUNCTION WITH THE AMENDMENT AND RESTATEMENT OF THE SERP II PLAN, THE SEDB WAS SIMILARLY AMENDED IN 2020 TO LIMIT ELIGIBLE EMPLOYEES TO ONLY THOSE WHO EITHER SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II AS OF JANUARY 1 2020, OR REMAIN IN ACTIVE EMPLOYMENT AND WILL SATISFY THOSE REQUIREMENTS PRIOR TO DECEMBER 31, 2027. AN ELIGIBLE EXECUTIVE BECOMES A PARTICIPANT IN THE SEDB PLAN IF THE EXECUTIVE DIES PRIOR TO TERMINATION OF EMPLOYMENT, PROVIDED THE EXECUTIVE HAS NOT SATISFIED ALL THE ELIGIBILITY REQUIREMENTS OF SERP II AS OF THE EXECUTIVE'S DATE OF DEATH BUT WOULD HAVE SATISFIED ALL THOSE REQUIREMENTS WITHIN FIVE (5) YEARS FOLLOWING DEATH HAD THE EXECUTIVE LIVED AND CONTINUED EMPLOYMENT. THE SEDB PLAN WILL TERMINATE AUTOMATICALLY AFTER DECEMBER 31, 2027. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. HAFFNER PHD, RANDALL $ 150,000 $ 304,926 $ 829,185 $ 0 TOL, DARYL $ 10,167 $ 477,704 $ 0 $ 0 GOODMAN, TODD $ 132,245 $ 116,878 $ 456,377 $ 0 JIMENEZ MD, RONALD $ 64,819 $ 37,716 $ 845,247 $ 0 OTTATI, DAVID $ 140,766 $ 173,800 $ 0 $ 0 NOSEWORTHY, G. ED $ 86,260 $ 211,839 $ 96,013 $ 0 THOMAS, DEBORA $ 74,743 $ 56,605 $ 127,294 $ 0 CELANO, PATRICIA $ 68,573 $ 46,777 $ 0 $ 0 DAVIS, BRENT $ 0 $ 0 $ 0 $ 66,202 KILMAN MD, MARK $ 39,213 $ 42,250 $ 0 $ 10,221 DOMAYER, CORY $ 0 $ 0 $ 0 $ 45,485 GREGORY PHD, AUDREY $ 0 $ 0 $ 0 $ 19,731 * INCLUDING INVESTMENT EARNINGS

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	KAYLA MOWERY	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	FAMILY OF BOARD MEMBER	RelationshipDescriptionTxt
Transaction	$42,821	TransactionAmt
Transaction	EMPLOYEE COMPENSATION	TransactionDesc
Sharing Of Revenues	0	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 1A	THE PARENT CORPORATION AND SOLE TOP-TIER MEMBER OF MEMORIAL HOSPITAL FLAGLER, 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	MEMORIAL HOSPITAL - FLAGLER, INC. (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS MEMORIAL HEALTH SYSTEMS, INC. MEMORIAL HEALTH SYSTEMS, INC. (MHS) 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 MHS. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, MHS, 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	MEMORIAL HEALTH SYSTEMS, INC, AS THE SOLE MEMBER OF THE FILING ORGANIZATION, AND ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, AS THE TOP-TIER MEMBER OF THE FILING ORGANIZATION, HAVE 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 ADOPT, AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FILING ORGANIZATION; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS EXCEEDING $100,000; D) TO APPROVE OR DISAPPROVE THE PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF CERTAIN DOLLAR AMOUNT THRESHOLDS; E) TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS AND STRATEGIC PLANS OF THE FILING ORGANIZATION; F) TO APPROVE OR DISAPPROVE CAPITAL EXPENDITURES IN EXCESS OF $1,000,000; G) TO APPROVE OR DISAPPROVE PERFORMANCE/QUALITY IMPROVEMENT AND CASE MANAGEMENT PROGRAMS; H) TO APPROVE THE APPOINTMENT OF AN AUDITING FIRM AND ELECTION OF THE FISCAL YEAR FOR THE FILING ORGANIZATION; I) TO APPROVE OR DISAPPROVE MATERIAL CHANGES IN SERVICES OFFERED BY THE FILING ORGANIZATION; J) THE AUTHORITY TO REQUIRE THE FILING ORGANIZATION'S ADHERENCE TO POLICIES ADOPTED BY THE MEMBER OR AHSSHC; K) THE AUTHORITY TO SECURE NAMING RIGHTS AND TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL AND THE MAKING OF GIFTS, SPONSORSHIPS, DONATIONS, LOANS AND TRANSFERS OF FUNDS OR OTHER ASSETS BY THE FILING ORGANIZATION IN EXCESS OF $100,000; L) TO APPROVE OR DISAPPROVE THE SALE, PURCHASE, DONATION, OR OTHER CONVEYANCE OF PERSONAL PROPERTY WITH A VALUE IN EXCESS OF $1,000,000 NOT OTHERWISE APPROVED IN THE CURRENT CAPITAL OR OPERATING BUDGETS; M) TO APPROVE OR DISAPPROVE THE IMPLEMENTATION OF NON-TRADITIONAL, NON-HEALTHCARE RELATED ACTIVITIES; N) TO APPROVE OR DISAPPROVE THE SELECTION OF THE FILING ORGANIZATION'S GROUP PURCHASING ORGANIZATION(S); O) TO APPROVE OR DISAPPROVE ANY JOINT VENTURE OR PARTNERSHIP IN WHICH THE FILING ORGANIZATION WOULD BE A MEMBER OR PARTNER; P) TO APPROVE THE IT SYSTEMS USED BY THE FILING ORGANIZATION; AND Q) THE AUTHORITY TO REQUIRE THE FILING ORGANIZATION'S ADHERENCE TO THE SYSTEM-WIDE NAMING NOMENCLATURE ADOPTED BY THE MEMBER OR AHSSHC.
FORM 990, PART VI, SECTION B, LINE 11B	THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND THE CFO DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15	THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES ARE NOT COMPENSATED BY THE FILING ORGANIZATION. SUCH INDIVIDUALS ARE COMPENSATED BY THE RELATED TOP-TIER PARENT ORGANIZATION OF THE FILING ORGANIZATION. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY THE RELATED TOP-TIER PARENT ORGANIZATION IN DETERMINING EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3.
FORM 990, PART VI, SECTION C, LINE 19	THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH AND OF THE ADVENTHEALTH "OBLIGATED GROUP" ARE FILED ANNUALLY WITH THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB). THE "OBLIGATED GROUP" IS A GROUP OF AHSSHC SUBSIDIARIES THAT ARE JOINTLY AND SEVERALLY LIABLE UNDER A MASTER TRUST INDENTURE THAT SECURES DEBT PRIMARILY ISSUED ON A TAX-EXEMPT BASIS. UNAUDITED QUARTERLY FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) ARE ALSO FILED WITH MSRB FOR ADVENTHEALTH ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF ADVENTHEALTH SUBSIDIARIES COMPRISING THE "OBLIGATED GROUP". THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
PART VII, SECTION A	FOR THOSE BOARD OF DIRECTOR MEMBERS (EXCLUDING PHYSICIAN MEMBERS) 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. CERTAIN PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM A RELATED TAX-EXEMPT AFFILIATE FOR THE PROVISION OF MEDICAL SERVICES.
PART VIII, LINES 7A, B AND C:	THE AMOUNT SHOWN IN PART VIII, LINE 7C(I) OF THE FORM 990 REPRESENTS AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A SYSTEM WIDE, CORPORATE ADMINISTERED, INVESTMENT PROGRAM.
FORM 990, PART IX, LINE 11G	PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 53,984,534. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,984,534. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 5,192,038. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,192,038. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 35,801,266. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,801,266. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 636,720. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 636,720. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 58,220. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,220. RECRUITING: PROGRAM SERVICE EXPENSES 75,455. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,455. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,551,605. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,551,605. ADVENTHEALTH MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,941,898. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,941,898. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 493,118. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 493,118. ADVENTHEALTH SHARED SERVICES FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,390,054. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,390,054.
FORM 990, PART XI, LINE 9:	ALLOCATION TO/FROM TAX-EXEMPT PARENT WITH RESPECT TO DEBT -53,814. INVENTORY DONATION -1,342. TRANSFER TO TOP-TIER TAX-EXEMPT PARENT -13,214,390. GIFTS 50,603. TRANSFER FROM RESTRICTED 97,941. ROUNDING 2.
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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (102 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
ADVENTHEALTH EAST FLORIDA INC (3521 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	882288563	FUTURE OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS INC
187 PR 4060	LAMPASAS	TX	76550	271858033	OPERATION OF RURAL HEALTH CLINICS & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	METROPLEX ADVENTIST HOSPITAL INC	Yes (1)
ADVENTHEALTH KANSAS CITY FOUNDATION FKA AH FDN SHAWNEE MISSION
7315 E FRONTAGE ROAD	MERRIAM	KS	66204	480868859	FUND-RAISING FOR TAX-EXEMPT HOSPITALS	KS	501(C)(3)	LINE 7	SHAWNEE MISSION MEDICAL CENTER INC	Yes (1)
ADVENTHEALTH HOME CARE EAST FLORIDA LLC
770 WEST GRANADA BLVD 319	ORMOND BEACH	FL	32174	833768458	INACTIVE	FL	501(C)(3)	LINE 10	MEMORIAL HLTH SYSTEMS INC	Yes (1)
ADVENTHEALTH HOSPICE CARE EAST FLORIDA INC
770 WEST GRANADA BLVD 304	ORMOND BEACH	FL	32174	833748461	INACTIVE	FL	501(C)(3)	LINE 10	MEMORIAL HLTH SYSTEMS INC	Yes (1)
ADVENTHEALTH NORTH POLK INC
3100 E FLETCHER AVE	TAMPA	FL	33613	593231322	INACTIVE	FL	501(C)(3)	LINE 12A, I	UNIVERSITY COMMUNITY HOSPITAL INC	Yes (1)
ADVENTHEALTH POLK NORTH INC
40100 US HIGHWAY 27 N	DAVENPORT	FL	33837	841793121	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTHEALTH POLK SOUTH INC
410 SOUTH 11TH STREET	LAKE WALES	FL	33853	834672945	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTHEALTH RANSOM MEMORIAL INC
1301 S MAIN STREET	OTTAWA	KS	66067	830976641	OPERATION OF HOSPITAL & RELATED SERVICES	KS	501(C)(3)	LINE 3	ADVENTIST HLTH MID-AMERICA INC	Yes (1)
ADVENTHEALTH RIVERVIEW INC (5321 - 123121)
14055 RIVEREDGE DRIVE STE 150	TAMPA	FL	33637	870901094	FUTURE OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTHEALTH SENIOR CARE INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	841817046	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTHEALTH SOUTH OVERLAND PARKINC
7820 W 165TH STREET	OVERLAND PARK	KS	66223	364595806	OPERATION OF HOSPITAL & RELATED SERVICES	KS	501(C)(3)	LINE 3	ADVENTIST HLTH MID-AMERICA INC	Yes (1)
ADVENTHEALTH UNIVERSITY INC
671 WINYAH DRIVE	ORLANDO	FL	32803	593069793	EDUCATION/OPERATION OF SCHOOL	FL	501(C)(3)	LINE 2	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC
14055 RIVEREDGE DRIVE STE 250	TAMPA	FL	33637	471881744	SUPPORT OF IMAGING CENTER & HOME HEALTH SUBSIDIARIES	FL	501(C)(3)	LINE 12B, II	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTHEALTH WEST FLORIDA IMAGING INC
14055 RIVEREDGE DRIVE STE 250	TAMPA	FL	33637	843225135	IMAGING & TESTING	FL	501(C)(3)	LINE 3	ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC	Yes (1)
ADVENTIST BOLINGBROOK HOSPITAL
500 REMINGTON BLVD	BOLINGBROOK	IL	60440	651219504	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	LINE 3	ADVENTIST MIDWEST HEALTH	Yes (1)
ADVENTIST CARE CENTERS - COURTLAND INC
730 COURTLAND STREET	ORLANDO	FL	32804	205774723	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
ADVENTIST GLENOAKS HOSPITAL
701 WINTHROP AVENUE	GLENDALE HEIGHTS	IL	60139	363208390	OPERATION OF HOSPITAL & RELATED SERVICES	IL	501(C)(3)	LINE 3	ADVENTIST MIDWEST HEALTH	Yes (1)
ADVENTIST HEALTH MID-AMERICA INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	521347407	SUPPORT OF AFFILIATED HOSPITAL	KS	501(C)(3)	LINE 12C, III-FI	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
ADVENTIST HEALTH PARTNERS INC
5101 S WILLOW SPRINGS RD SUITE B101	LA GRANGE	IL	60525	364138353	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	IL	501(C)(3)	LINE 3	AHS MIDWEST MANAGEMENT INC	Yes (1)
ADVENTIST HEALTH SYSTEM GEORGIA INC
1035 RED BUD ROAD NE	CALHOUN	GA	30701	581425000	OPERATION OF HOSPITAL & RELATED SERVICES	GA	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	592170012	MANAGEMENT SERVICES	FL	501(C)(3)	LINE 12A, I		0	N/A
ADVENTIST HLTH SYSTEMSUNBELT INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	591479658	OPERATION OF HOSPITALS & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTIST HLTH SYSTEMTEXAS INC
11801 S FREEWAY	BURLESON	TX	76028	742578952	LEASING PERSONNEL TO AFFILIATED HOSPITAL	TX	501(C)(3)	LINE 12C, III-FI	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
ADVENTIST MIDWEST HEALTH
120 NORTH OAK STREET	HINSDALE	IL	60521	362276984	OPERATION OF HOSPITALS & RELATED SERVICES	IL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
AHP SPECIALTY CARE NFP
5101 S WILLOW SPRINGS RD SUITE B101	LA GRANGE	IL	60525	811105774	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	IL	501(C)(3)	LINE 3	AHS MIDWEST MANAGEMENT INC	Yes (1)
AHS MIDWEST MANAGEMENT INC
5101 S WILLOW SPRINGS RD SUITE B101	LA GRANGE	IL	60525	363354567	OPERATION OF PHYSICIAN PRACTICE MANAGEMENT	IL	501(C)(3)	LINE 12A, I	ADVENTIST MIDWEST HEALTH	Yes (1)
APOPKA HEALTH CARE PROPERTIES INC
305 E OAK STREET	APOPKA	FL	32703	510605694	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
BERT FISH MEDICAL CENTER AUXILIARY INC
401 PALMETTO STREET	NEW SMYRNA BEACH	FL	32168	591054892	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	LINE 10		0	N/A
BRADFORD HEIGHTS HEALTH & REHAB CENTER INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	205782342	INACTIVE - WIND-DOWN	KY	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
BURLESON NURSING & REHAB CENTER INC
301 HUGULEY BLVD	BURLESON	TX	76028	205782243	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TX	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CHICKASAW HEALTH CARE PROPERTIES INC
250 S CHICKASAW TRAIL	ORLANDO	FL	32825	510605681	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC
1220 THIRD AVENUE WEST	DURAND	WI	54736	391365168	OPERATION OF HOSPITAL & RELATED SERVICES	WI	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
COALITION FOR PHYSICIAN WELL-BEING INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	463477012	PROVIDE SUPPORT FOR PHYSICIAN WELL-BEING	FL	501(C)(3)	LINE 10	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
COURTLAND HEALTH CARE PROPERTIES INC
730 COURTLAND STREET	ORLANDO	FL	32804	510605682	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
CREEKWOOD PLACE NURSING & REHAB CENTER INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	205782260	INACTIVE - WIND-DOWN	KY	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
DAIRY ROAD HEALTH CARE PROPERTIES INC
7350 DAIRY ROAD	ZEPHYRHILLS	FL	33540	510605684	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
EAST ORLANDO HEALTH & REHAB CENTER INC
250 S CHICKASAW TRAIL	ORLANDO	FL	32825	205774748	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
EMORY-ADVENTIST INC (1121 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	582171011	INACTIVE	GA	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLETCHER HOSPITAL INC
100 HOSPITAL DRIVE	HENDERSONVILLE	NC	28792	560543246	OPERATION OF HOSPITAL & RELATED SERVICES	NC	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLNC INC
3355 E SEMORAN BLVD	APOPKA	FL	32703	205774761	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
FLORIDA HOSPITAL DADE CITY INC
13100 FORT KING ROAD	DADE CITY	FL	33525	822567308	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLORIDA HOSPITAL HEALTHCARE PARTNERS INC
770 WEST GRANADA BLVD 101	ORMOND BEACH	FL	32174	462354804	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLORIDA HOSPITAL MEDICAL GROUP INC
2600 WESTHALL LANE 4TH FLOOR	MAITLAND	FL	32751	593214635	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLORIDA HOSPITAL OCALA INC
1500 SW 1ST AVENUE	OCALA	FL	34471	824372339	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLORIDA HOSPITAL PHYSICIAN GROUP INC
12470 TELECOM DR 100	TAMPA	FL	33637	462021581	OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLORIDA HOSPITAL WATERMAN INC
1000 WATERMAN WAY	TAVARES	FL	32778	593140669	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
FLORIDA HOSPITAL ZEPHYRHILLS INC
7050 GALL BLVD	ZEPHYRHILLS	FL	33541	592108057	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC
2600 WESTHALL LANE 4TH FLOOR	MAITLAND	FL	32751	550789387	IMAGING & TESTING	FL	501(C)(3)	LINE 3	FLORIDA HOSPITAL MEDICAL GROUP INC	Yes (1)
FOUNTAIN INN NURSING & REHAB CENTER INC
4501 WATERMAN WAY	TAVARES	FL	32778	472180518	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	592106043	FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION	FL	501(C)(3)	LINE 12C, III-FI		0	N/A
HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	593690149	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	LINE 7		0	N/A
HINSDALE HOSPITAL FOUNDATION
120 NORTH OAK STREET	HINSDALE	IL	60521	521466387	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	IL	501(C)(3)	LINE 7	MIDWEST HLTH FOUNDATION	0
HOSPICE OF THE COMFORTER INC
480 W CENTRAL PARKWAY	ALTAMONTE SPRINGS	FL	32714	592935928	OPERATION OF HOSPICE	FL	501(C)(3)	LINE 10	THE COMFORTER HEALTH CARE GROUP INC	Yes (1)
IN-MOTION REHAB INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	208023411	INACTIVE	KS	501(C)(3)	LINE 12B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
LAKE COUNTY HEALTH CARE PROPERTIES INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	813923985	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MEMORIAL HEALTH SYSTEMS FOUNDATION INC
305 MEMORIAL MEDICAL PKWY 212	DAYTONA BEACH	FL	32117	311771522	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	LINE 7		0	N/A
MEMORIAL HEALTH SYSTEMS INC
301 MEMORIAL MEDICAL PARKWAY	DAYTONA BEACH	FL	32117	590973502	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
MEMORIAL HOSPITAL - WEST VOLUSIA INC
701 WEST PLYMOUTH AVENUE	DELAND	FL	32720	593256803	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	MEMORIAL HLTH SYSTEMS INC	Yes (1)
MEMORIAL HOSPITAL FLAGLER INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	592951990	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	MEMORIAL HLTH SYSTEMS INC	Yes (1)
MEMORIAL HOSPITAL INC
210 MARIE LANGDON DRIVE	MANCHESTER	KY	40962	610594620	OPERATION OF HOSPITAL & RELATED SERVICES	KY	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
METROPLEX ADVENTIST HOSPITAL INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	742225672	OPERATION OF HOSPITAL & RELATED SERVICES	TX	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
METROPLEX CLINIC PHYSICIANS INC
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	113762050	PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITY	TX	501(C)(3)	LINE 3	METROPLEX ADVENTIST HOSPITAL INC	Yes (1)
MIDWEST HEALTH FOUNDATION
120 NORTH OAK STREET	HINSDALE	IL	60521	352230515	FUND-RAISING FOR SUPPORTED EXEMPT HOSPITALS	IL	501(C)(3)	LINE 7		0	N/A
MILLS HEALTH & REHAB CENTER INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	205782320	INACTIVE - WIND-DOWN	KY	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MISSION STRATEGIES OF GEORGIA INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	900866024	PROVISION OF SUPPORT TO THE NURSING HOME DIVISION	GA	501(C)(3)	LINE 12B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
MISSOURI ADVENTIST HEALTH INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	431224729	SUPPORT HEALTH CARE SERVICES	MO	501(C)(3)	LINE 12D, III-O	ADVENTIST HLTH MID-AMERICA INC	Yes (1)
ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC(11-123121)
301 MEMORIAL MEDICAL PKWY	DAYTONA BEACH	FL	32117	591721962	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	LINE 12C, III-FI		0	N/A
OSCEOLA HEALTH CARE PROPERTIES INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	813165729	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
OVERLAND PARK NURSING & REHAB CENTER INC
6501 WEST 75TH STREET	OVERLAND PARK	KS	66204	205774821	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	KS	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
PASCO-PINELLAS HILLSBOROUGH COMMUNITY HLTH SYSTEM INC
2600 BRUCE B DOWNS BLVD	WESLEY CHAPEL	FL	33544	208488713	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
PORTERCARE ADVENTIST HEALTH SYSTEM (630 YE)
9100 E MINERAL CIRCLE	CENTENNIAL	CO	80112	840438224	OPERATION OF HOSPITALS & RELATED SERVICES	CO	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
PRINCETON HEALTH & REHAB CENTER INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	205782272	INACTIVE - WIND-DOWN	KY	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
PRINCETON PROFESSIONAL SERVICES INC
601 E ROLLINS STREET	ORLANDO	FL	32803	591191045	PROVISION OF HEALTHCARE SERVICES	FL	501(C)(3)	LINE 10	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
QUALITY CIRCLE FOR HEALTHCARE INC
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	263789368	HEALTHCARE QUALITY SERVICES	FL	501(C)(3)	LINE 12A, I	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
REDMOND PARK HOSPITAL LLC (10121 - 123121)
501 REDMOND ROAD NW	ROME	GA	30165	581123037	OPERATION OF HOSPITAL & RELATED SERVICES	GA	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
RESOURCE PERSONNEL INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	208040875	PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES	FL	501(C)(3)	LINE 12B, II	SUNBELT HLTH CARE CENTERS INC	Yes (1)
ROCKY MOUNTAIN ADVENTIST HLTHCARE FOUNDATION (630 YE)
960 E HARVARD AVENUE STE 230	DENVER	CO	80210	840745018	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	CO	501(C)(3)	LINE 7		0	N/A
ROLLINS BROOK COMMUNITY CARE CORP
2201 S CLEAR CREEK ROAD	KILLEEN	TX	76549	461656773	SUPPORT OPERATION OF HOSPITAL	TX	501(C)(3)	LINE 12A, I	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
SAN MARCOS HEALTH CARE PROPERTIES INC (11 - 123021)
1900 MEDICAL PARKWAY	SAN MARCOS	TX	78666	510605693	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SAN MARCOS NURSING & REHAB CENTER INC
1900 MEDICAL PARKWAY	SAN MARCOS	TX	78666	205782224	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	TX	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SHAWNEE MISSION HLTH CARE PROPERTIES INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	813914908	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SHAWNEE MISSION HEALTH CARE INC
6501 WEST 75TH STREET	OVERLAND PARK	KS	66204	480952508	LEASE TO RELATED ORGANIZATION	KS	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SHAWNEE MISSION MEDICAL CENTER INC
9100 W 74TH STREET	SHAWNEE MISSION	KS	66204	480637331	OPERATION OF HOSPITAL & RELATED SERVICES	KS	501(C)(3)	LINE 3	ADVENTIST HLTH MID-AMERICA INC	Yes (1)
SOUTH PASCO HEALTH CARE PROPERTIES INC
38250 A AVENUE	ZEPHYRHILLS	FL	33542	510605679	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SOUTHEAST VOLUSIA HEALTHCARE CORP
401 PALMETTO STREET	NEW SMYRNA BEACH	FL	32168	473793197	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
SOUTHWEST VOLUSIA HEALTH SERVICES INC
1055 SAXON BLVD	ORANGE CITY	FL	32763	593281591	MEDICAL OFFICE BUILDING FOR HOSPITAL	FL	501(C)(3)	LINE 12A, I	SOUTHWEST VOLUSIA HLTHCARE CORP	Yes (1)
SOUTHWEST VOLUSIA HEALTHCARE CORP
1055 SAXON BLVD	ORANGE CITY	FL	32763	593149293	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEMSUNBELT INC	Yes (1)
SPRING VIEW HEALTH & REHAB CENTER INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	205782288	INACTIVE - WIND-DOWN	KY	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SUNBELT HEALTH & REHAB CENTER - APOPKA INC
305 EAST OAK STREET	APOPKA	FL	32703	205774856	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
SUNBELT HEALTH CARE CENTERS INC
485 NORTH KELLER ROAD 250	MAITLAND	FL	32751	581473135	MANAGEMENT SERVICES	TN	501(C)(3)	LINE 12B, II	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
SUNSYSTEM DEVELOPMENT CORP
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	592219301	FUND-RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS	FL	501(C)(3)	LINE 7	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
TARPON SPRINGS HOSPITAL FOUNDATION INC
1395 S PINELLAS AVE	TARPON SPRINGS	FL	34689	590898901	OPERATION OF HOSPITAL & RELATED SERVICES	FL	501(C)(3)	LINE 3	UNIVERSITY COMMUNITY HOSPITAL INC	Yes (1)
TARRANT COUNTY HEALTH CARE PROPERTIES INC
301 HUGULEY BLVD	BURLESON	TX	76028	510605677	LEASE TO RELATED ORGANIZATION	GA	501(C)(3)	LINE 12C, III-FI	SUNBELT HLTH CARE CENTERS INC	Yes (1)
THE COMFORTER HEALTH CARE GROUP INC
605 MONTGOMERY ROAD	ALTAMONTE SPRINGS	FL	32714	271857940	SUPPORT SERVICES TO RELATED HOSPICE	FL	501(C)(3)	LINE 12C, III-FI	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
THE VOLUNTEER AUXILIARY OF FLORIDA HOSP FLAGLER INC(11-8321)
60 MEMORIAL MEDICAL PKWY	PALM COAST	FL	32164	592486582	VOLUNTEER SUPPORT SERVICES	FL	501(C)(3)	LINE 12C, III-FI		0	N/A
TRI-COUNTY NURSING AND REHAB CENTER INC
1290 CELEBRATION BLVD	KISSIMMEE	FL	34747	472219363	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC
3100 E FLETCHER AVE	TAMPA	FL	33613	592554889	FUND-RAISING FOR TAX-EXEMPT HOSPITAL	FL	501(C)(3)	LINE 7		0	N/A
UNIVERSITY COMMUNITY HOSPITAL INC
3100 E FLETCHER AVE	TAMPA	FL	33613	591113901	OPERATION OF HOSPITALS & RELATED SERVICES	FL	501(C)(3)	LINE 3	ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP	Yes (1)
WEST FLORIDA HEALTH HOME CARE INC
13601 BRUCE B DOWNS BLVD STE 110	TAMPA	FL	33613	593686109	HOME HEALTH SERVICES	GA	501(C)(3)	LINE 10	ADVENTHEALTH WEST FLORIDA AMBULATORY SVCS INC	Yes (1)
ZEPHYR HAVEN HEALTH & REHAB CENTER INC
38250 A AVENUE	ZEPHYRHILLS	FL	33542	205774930	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)
ZEPHYRHILLS HEALTH & REHAB CENTER INC
7350 DAIRY ROAD	ZEPHYRHILLS	FL	33540	205774967	OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY	FL	501(C)(3)	LINE 10	SUNBELT HLTH CARE CENTERS INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
FLETCHER HOSPITAL SURGICAL VENTURES LLC
9131 ANSON WAY STE 304	RALEIGH	NC	27615	861482646	INDIRECT INTEREST IN SURGERY CENTER	NC	N/A	0	0
FLORIDA HOSPITAL DMERT LLC
500 WINDERLEY PLACE STE 324	MAITLAND	FL	32751	202392253	MEDICAL EQUIPMENT	FL	N/A	0	Yes (1)
FLORIDA HOSPITAL HOME INFUSION LLP
500 WINDERLEY PLACE STE 226	MAITLAND	FL	32751	593142824	HOME INFUSION SERVICES	FL	N/A	0	Yes (1)
FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CTR LLC
11 W DRY CREEK CIRCLE 120	LITTLETON	CO	80120	464426708	SURGERY CENTER	CO	N/A	0	0
PAHS ONPOINT URGENT CARE LLC
9100 E MINERAL CIRCLE	CENTENNIAL	CO	80112	832465331	URGENT CARE CENTER	CO	N/A	0	0
PRINCETON HOMECARE SERVICES LLC
1050 FORRER BLVD	KETTERING	OH	45420	814196648	OPERATION OF HOME HEALTH AGENCY	FL	N/A	0	0
SAN MARCOS MRI LP (1121-8121)
1330 WONDER WORLD DR STE 202	SAN MARCOS	TX	78666	770597972	IMAGING & TESTING	TX	N/A	0	0
SURGERY CENTER OF ROME LP
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	200390305	SURGERY CENTER	FL	N/A	0	0
THE BARIATRIC CENTER OF KANSAS CITY LLC
9100 W 74TH STREET	MERRIAM	KS	66204	823025378	SURGERY CENTER	KS	N/A	0	0
URGENT CARE CENTERS OF BREVARD COUNTY LLC
2600 WESTHALL LANE	MAITLAND	FL	32751	844261523	URGENT CARE CENTERS	FL	N/A	0	Yes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
ADVENTHEALTH ORLANDO NETWORK INC (35 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	862639185	INACTIVE	FL	N/A	C	Yes (1)
ADVENTHEALTH PROFESSIONAL STAFFING INC (35 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	880742779	INACTIVE	FL	N/A	C	Yes (1)
ADVENTHEALTH TAMPA NETWORK INC (35 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	862666178	INACTIVE	FL	N/A	C	Yes (1)
ADVENTHEALTH TEAM MEMBERS INC (35 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	880763664	INACTIVE	FL	N/A	C	Yes (1)
ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	592855792	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	593000857	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
BATTLE CREEK ADVENTIST HOSPITAL
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	381359189	INACTIVE	MI	N/A	C	Yes (1)
CENTRAL TEXAS MEDICAL ASSOCIATES (11-12252021)
1301 WONDER WORLD DRIVE	SAN MARCOS	TX	78666	742729873	INACTIVE	TX	N/A	C	Yes (1)
FLORIDA HOSPITAL FLAGLER MEDICAL OFFICES ASSOCIATION INC
60 MEMORIAL MEDICAL PARKWAY	PALM COAST	FL	32164	262158309	CONDO ASSOCIATION	FL		C	Yes (1)	MEMORIAL HOSPITAL FLAGLER INC	$315,338	$130,055	0.91280
FLORIDA HOSP HLTH VILLAGE PROPERTY OWNER'S ASSOC INC
550 E ROLLINS STREET 7TH FLOOR	ORLANDO	FL	32803	821748255	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
FLORIDA HOSPITAL HEALTHCARE SYSTEM INC
101 SOUTHHALL LANE STE 150	MAITLAND	FL	32751	593215680	PHSO / CIN	FL	N/A	C	Yes (1)
FLORIDA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	592855791	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC
201 HILDA STREET SUITE 30	KISSIMMEE	FL	34741	593539564	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
MIDWEST MANAGEMENT SERVICES INC
9100 WEST 74TH STREET	SHAWNEE MISSION	KS	66204	480901551	INACTIVE	KS	N/A	C	Yes (1)
NORTH AMERICAN HEALTH SERVICES INC & SUB
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	621041820	HOLDING CO.	TN	N/A	C	Yes (1)
ORMOND PROF ASSOCIATES CONDO ASSOC INC (430 YEAR END)
770 W GRANADA BLVD STE 101	ORMOND BEACH	FL	32174	592694434	CONDO ASSOCIATION	FL	N/A	C	Yes (1)
PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC
1 PARK PLACE NAPLES ROAD	FLETCHER	NC	28732	030380531	CONDO ASSOCIATION	NC	N/A	C	Yes (1)
PORTER AFFILIATED HEALTH SERVICES INC (11-63021)
2525 S DOWNING STREET	DENVER	CO	80210	840956175	INACTIVE	CO	N/A	C	Yes (1)
SURGICARE OF ROME INC (10121 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	200376307	HOLDING COMPANY	GA	N/A	C	Yes (1)
REDMOND PARK HEALTH SERVICES INC (10121 - 123121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	621330078	HOLDING COMPANY	GA	N/A	C	Yes (1)
REDMOND PHYSICIAN PRACTICE COMPANY (10121 - 10121)
900 HOPE WAY	ALTAMONTE SPRINGS	FL	32714	621662134	MEDICAL CLINICS	GA	N/A	C	Yes (1)
THE GARDEN RETIREMENT COMMUNITY INC
485 NORTH KELLER ROAD STE 250	MAITLAND	FL	32751	593414055	REAL ESTATE RENTAL	FL	N/A	C	Yes (1)
WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC
601 EAST ROLLINS STREET	ORLANDO	FL	32803	452228478	CONDO ASSOCIATION	FL	N/A	C	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (25 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
M	$2,021,512	% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION-SHARED SERVICES
M	$2,236,084	% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORP DBA AH INFO TECHNOLOGY
M	$7,296,776	% OF FACILITY'S OPERATING EXP.
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORP DBA AH INFO TECHNOLOGY
P	$137,909	COST
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
P	$10,829,146	COST
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION
B	$13,214,390	ACTUAL AMOUNT GIVEN
FLORIDA HOSPITAL MEDICAL GROUP INC
Q	$144,294	COST
FLORIDA HOSPITAL HEALTHCARE SYSTEM INC
P	$10,630,442	COST
FLORIDA HOSPITAL MEDICAL GROUP INC
P	$322,719	COST
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION DBA ADVENTHEALTH FISH MEMORIAL
P	$18,352,994	COST
MEMORIAL HEALTH SYSTEMS INC
Q	$56,045,968	COST
MEMORIAL HEALTH SYSTEMS INC
P	$24,088,851	COST
MEMORIAL HOSPITAL - WEST VOLUSIA INC DBA ADVENTHEALTH DELAND
Q	$4,498,037	COST
MEMORIAL HOSPITAL - WEST VOLUSIA INC DBA ADVENTHEALTH DELAND
P	$19,048,233	COST
SOUTHWEST VOLUSIA HEALTHCARE CORPORATION DBA ADVENTHEALTH FISH MEMORIAL
Q	$6,053,615	COST
SUNSYSTEM DEVELOPMENT CORPORATION DBA ADVENTHEALTH PALM COAST FOUNDATION
B	$361,224	ACTUAL AMOUNT GIVEN
FLORIDA HOSPITAL HEALTHCARE PARTNERS INC
P	$46,754,311	COST
SOUTHEAST VOLUSIA HEALTHCARE CORPORATION DBA ADVENTHEALTH NEW SMYRNA BEACH
Q	$3,416,780	COST
SOUTHEAST VOLUSIA HEALTHCARE CORPORATION DBA ADVENTHEALTH NEW SMYRNA BEACH
P	$13,257,288	COST
SUNSYSTEM DEVELOPMENT CORPORATION DBA ADVENTHEALTH PALM COAST FOUNDATION
C	$140,652	ACTUAL AMOUNT RECEIVED
FLORIDA HOSPITAL HEALTHCARE PARTNERS INC
Q	$60,813,657	COST
FLORIDA HOSPITAL WATERMAN INC
Q	$2,035,911	COST
FLORIDA HOSPITAL WATERMAN INC
P	$4,338,074	COST
SOUTHWEST VOLUSIA HEALTH SERVICES INC
Q	$65,057	COST
SOUTHWEST VOLUSIA HEALTH SERVICES INC
P	$603,120	COST