2022-11-14T11:13:47-06:00 2021-12-31 990 2021-01-01 362276984 ADVENTIST MIDWEST HEALTH ADVE 6308569000 120 NORTH OAK STREET HINSDALE IL 60521 LYNN C ADDISCOTT ASSISTANT SECRETARY 6308566001 2022-11-11 LYNN ADDISCOTT 999009999 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ADAM MAYCOCK 120 NORTH OAK STREET HINSDALE IL 60521 570498301 0 X WWW.ADVENTHEALTH.COM/HOSPITAL/ X 1904 IL THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS. 18 11 2919 91 635184 223185 48723760 6863126 506041037 548303370 2665012 13407418 291882 203974 557721691 568777888 1501227 1461395 0 0 177456672 181358416 0 0 0 311276733 348335774 490234632 531155585 67487059 37622303 694030437 752894446 369116216 394706488 324914221 358187958 X 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. 0 0 461203581 1461395 547788587 AMITA HEALTH ADVENTIST MEDICAL CENTER HINSDALE (AMITA HEALTH HINSDALE, OR THE HOSPITAL) IS A 261-BED ACUTE-CARE HOSPITAL IN HINSDALE, ILLINOIS, THAT HAS SERVED THE HEALTHCARE NEEDS OF HINSDALE AND SURROUNDING AREAS FOR MORE THAN 100 YEARS. LOCATED AT 120 NORTH OAK STREET, AMITA HEALTH HINSDALE IS A FULL-SERVICE HOSPITAL THAT INCLUDES A LEVEL III NEONATAL INTENSIVE CARE UNIT AND THE AMITA HEALTH CANCER INSTITUTE & OUTPATIENT CENTER IN HINSDALE. THE HOSPITAL HAS ADDITIONAL SPECIALTIES IN BEHAVIORAL MEDICINE, CARDIOLOGY, NEUROSCIENCES AND ORTHOPEDICS. IT HAS EXPANDED ITS NEUROSCIENCES AND BEHAVIORAL MEDICINE PROGRAMS AND HAS BECOME A LEADER IN ROBOTIC SURGERY PROGRAMS INCLUDING DA VINCI ROBOTIC SURGERIES. OTHER SERVICES OFFERED BY THE HOSPITAL INCLUDE OPEN HEART SURGERY, EMERGENCY SERVICES, ENDOCRINOLOGY, GASTROENTEROLOGY, GERIATRICS, HOME HEALTH, HOSPICE, IMAGING, INTERVENTIONAL RADIOLOGY, OUTPATIENT SERVICES, A PAIN CENTER, PEDIATRIC SERVICES, PHYSICAL REHABILITATION, RHEUMATOLOGY, SLEEP DISORDERS, SURGICAL SERVICES, UROLOGY, VASCULAR LAB SERVICES AND WOMEN'S CARE. THE HOSPITAL OPERATES AN IMAGING CENTER IN WESTMONT AND WOODRIDGE, ILLINOIS; AN OUTPATIENT BEHAVIORAL HEALTH SITE IN WESTMONT; AND AN OUTPATIENT ADOLESCENT MENTAL HEALTH SITE IN WESTMONT. IN PARTNERSHIP WITH PT SOLUTIONS, THE HOSPITAL ALSO OPERATES AN OUTPATIENT PHYSICAL REHABILITATION SITE IN HINSDALE. A FIXTURE IN HINSDALE SINCE 1904, AMITA HEALTH HINSDALE PLAYS AN ACTIVE ROLE IN THE COMMUNITY, SPONSORING A VARIETY OF EVENTS AND PROVIDING WELLNESS SERVICES FOR THE VILLAGE'S EMPLOYEES. THE HOSPITAL HAS A SPECIAL COLLABORATIVE RELATIONSHIP WITH SISTER HOSPITAL AMITA HEALTH ADVENTIST MEDICAL CENTER LA GRANGE (AMITA HEALTH LA GRANGE) IN LA GRANGE, ILLINOIS. ABOUT TWO MILES SEPARATE THE HOSPITALS, AND BECAUSE OF THEIR PROXIMITY TO EACH OTHER, THEY HAVE WORKED TO INTEGRATE THEIR SERVICES AND TO WORK COLLABORATIVELY INSTEAD OF COMPETING AGAINST EACH OTHER. THE HOSPITALS SHARE THE SAME SENIOR MANAGEMENT TEAM, DEPARTMENT LEADERS, AND MEDICAL STAFF, AND THEY PARTNERED TO DEVELOP THE AMITA HEALTH CANCER INSTITUTE AND OUTPATIENT CENTER, WHICH OPENED IN 2016 IN HINSDALE. THE INTEGRATION PROCESS HAS REDUCED OPERATING COSTS FOR THE TWO HOSPITALS, AND THEY HAVE REINVESTED THE SAVINGS TO EXPAND AND ENHANCE SERVICES. THE TWO HOSPITALS OPERATE FAMILY-PRACTICE RESIDENCY PROGRAMS IN WHICH MEDICAL-SCHOOL GRADUATES SERVE THEIR RESIDENCIES, DOING CLINICAL ROTATIONS. THE PROGRAMS ARE A CONSISTENT SOURCE OF FAMILY-PRACTICE PHYSICIANS FOR THE COMMUNITY PROVIDING A FULL SCOPE OF PRIMARY CARE SERVICES. THE AMITA HEALTH LAGRANGE FAMILY MEDICINE CENTER ALSO PROVIDES OBSTETRICAL CARE AT A LOCAL FEDERALLY QUALIFIED HEALTH CENTER IN LAGRANGE (PILLARS COMMUNITY HEALTH). AMITA HEALTH HINSDALE IS AWARDED MAGNET NURSING DESIGNATION BY THE AMERICAN NURSES CREDENTIALING CENTER, CERTIFIED BY THE JOINT COMMISSION AND THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION AS A PRIMARY STROKE CENTER, AND HAS RECEIVED NATIONAL QUALITY APPROVAL FROM THE JOINT COMMISSION. THE BLUE CROSS AND BLUE SHIELD ASSOCIATION HAS AWARDED ITS BLUE DISTINCTION CENTER + DESIGNATION TO AMITA HEALTH HINSDALE FOR DELIVERING SAFE, HIGH-QUALITY AND COST-EFFICIENT CARDIAC CARE, MATERNITY CARE, SPINE SURGERY AND HIP AND KNEE REPLACEMENT. IN 2020, AMITA HEALTH HINSDALE AND LA GRANGE MAINTAINED A FIVE-STAR RATING -THE HIGHEST POSSIBLE- POSTED ON THE CENTERS FOR MEDICARE & MEDICAID SERVICES. THE HOSPITAL ALSO EARNED AN "A," THE HIGHEST POSSIBLE SCORE, IN THE SPRING 2020 AND FALL 2020 EDITIONS OF THE LEAPFROG GROUP'S BIANNUAL HOSPITAL SAFETY GRADE. IN 2019, AMITA HEALTH HINSDALE ALSO EARNED HEALTHGRADE'S PATIENT SAFETY EXCELLENCE AWARD AND HEALTHGRADE'S OUTSTANDING PATIENT EXPERIENCE AWARD. AMITA HEALTH HINSDALE IS RANKED 15TH IN THE CHICAGO AREA AND 18TH IN ILLINOIS IN U.S. NEWS & WORLD REPORT'S LATEST BEST HOSPITALS REPORT, EARNING RECOGNITION FOR HIGH PERFORMANCE IN ONE ADULT SPECIALTY (CARDIOLOGY AND HEART SURGERY) AND THREE ADULT PROCEDURES/CONDITIONS (HEART FAILURE, HIP REPLACEMENT, AND KNEE REPLACEMENT). THE AMITA HEALTH CANCER INSTITUTE AT HINSDALE WAS RECOGNIZED FOR OUTSTANDING ACHIVEMENT IN 2019 BY THE AMERICAN COLLEGE OF SURGEONS WHICH IS ACHIEVED BY FEWER THAN 10% OF CANCER PROGRAMS NATIONWIDE. IN 2021, AMITA HEALTH HINSDALE AND LAGRANGE COMBINED HAD 16,985 PATIENT ADMISSIONS, 82,588 PATIENT DAYS, AND 229,179 OUTPATIENT VISITS. AMITA HEALTH HINSDALE AND LAGRANGE PROVIDE CARE FOR ALL, INCLUDING THE FINANCIALLY DISADVANTAGED, UNINSURED, UNDERINSURED, HOMELESS AND THOSE WHO RECEIVE PUBLIC AID. IN 2021, AMITA HEALTH HINSDALE AND LAGRANGE PROVIDED $5,574,141 OF CHARITY CARE AT COST. THIS WAS IN ADDITION TO $16,314,036 IN COMMUNITY EDUCATION COSTS, INCLUDING THE HOSPITAL'S RESIDENCY PROGRAM AND $247,388 IN OTHER COMMUNITY BENEFITS SERVICES, $207,790 OF UNREIMBURSED MEDICARE COSTS TO PATIENTS, $106,356 OF BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO CHARITY CARE, AND $15,579,075 OF UNREIMBURSED MEDICAID AT COST. THE TOP-TIER PARENT OF THE FILING ORGANIZATION, ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, OWNS A REGIONAL HEALTH SYSTEM WHICH INCLUDES A NETWORK OF FOUR NOT-FOR-PROFIT HOSPITALS AND THEIR OUTPATIENT-BASED HEALTHCARE FACILITIES OPERATING IN CHICAGO'S WESTERN SUBURBS. THE FOUR CHICAGO NOT-FOR-PROFIT HOSPITALS TAKE A HOLISTIC APPROACH TO WELLNESS, ADDRESSING THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL NEEDS OF THE PEOPLE IT SERVES. THE FOUR HOSPITALS AND OTHER FACILITIES ARE INTEGRAL TO THE FABRIC OF THEIR COMMUNITIES. THE HOSPITALS PARTNER WITH LOCAL CIVIC ORGANIZATIONS AND BUSINESSES TO BRING STATE-OF-THE-ART TREATMENTS AND PREVENTIVE HEALTHCARE SERVICES CLOSE TO WHERE PEOPLE LIVE AND WORK. AS PART OF ADVENTHEALTH, THE LARGEST, NOT-FOR-PROFIT PROTESTANT HOSPITAL SYSTEM IN THE NATION, THE FILING ORGANIZATION IS GROUNDED IN CHRISTIAN VALUES AND COMMITTED TO EXTENDING THE HEALING MINISTRY OF CHRIST. THE FILING ORGANIZATION WELCOMES PATIENTS FROM ANY RELIGIOUS DENOMINATION AS WELL AS PATIENTS WHO DO NOT ASCRIBE TO ANY RELIGION. IN FEBRUARY 2015, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (ABHS) FORMED A JOINT OPERATING COMPANY (JOC). A JOC ALLOWS SEPARATE OWNERS TO INTEGRATE OPERATIONS TO ACHIEVE A COMMON GOAL WHILE MAINTAINING SEPARATE OWNERSHIP OF ASSETS. IT ALSO ALLOWS AMH AND ABHS TO WORK IN UNISON WHILE PRESERVING THE ADVENTIST AND CATHOLIC IDENTITIES AND MISSION PRIORITIES THAT DEFINE AMH AND ABHS, RESPECTIVELY. IN APRIL 2015, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., D/B/A AMITA HEALTH, WAS ANNOUNCED AS THE NEW NAME OF THE JOC. THE NAME AMITA IS INSPIRED BY THE MEANING IT HAS IN SEVERAL LANGUAGES -- FRIENDSHIP IN ITALIAN, HONESTY AND TRUTH IN HEBREW, AND SPIRITUAL LIGHT AND BOUNDLESSNESS IN HINDI. THE NAME REFLECTS AMITA HEALTH'S FAITH-BASED CALL TO HEALING, ITS CORE VALUES, AND THE COMPASSION AND DEDICATION THAT ITS CAREGIVERS SHOW EVERY DAY TO PATIENTS, THEIR FAMILIES AND EACH OTHER. 461203581 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 176 0 1 2919 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 IL X DANAE STILL 6308566006 120 N OAK STREET HINSDALE IL 60521 X HAFFNER PHD RANDALL DIR/CHAIRMAN (END 2/21) 0.30 50.00 X 0 3620109 209173 SNYDER BRENT DIRECTOR 0.30 50.00 X 0 1786890 41385 BACON KENNETH DIRECTOR (BEG 3/21) 0.30 50.00 X 0 1078033 201962 THORDARSON THOR DIR/PRES/SEC/EVP & COO 0.30 50.00 X 1157707 0 36164 BUCHANAN HERBERT DIRECTOR 5.00 45.00 X 72408 651670 73664 DE RAMOS DO DAVID DIRECTOR 0.30 50.00 X 0 193684 28847 GUTH MD SCOTT DIRECTOR 8.40 0.60 X 62213 0 0 MARTINEZ MD CARLOS DIRECTOR 0.30 4.40 X 0 29219 0 AGUILERA RONALD DIRECTOR 0.30 3.70 X 0 4602 0 SCOTT GLYNN DIRECTOR 0.30 3.70 X 0 4602 0 DENSLOW KENNETH DIR/VICE CHAIR (BEG 6/21) 0.30 3.70 X 0 4402 0 VALENTINE II MDIV MAURICE DIR/VICE CHAIR (END 4/21) 0.30 3.70 X 0 4200 0 ARQUILLA VENANZIO DIRECTOR 0.30 0.60 X 0 0 0 EASTMAN LINDA DIRECTOR 0.30 0.60 X 0 0 0 GRAY JR MARSHALL DIRECTOR 0.30 0.60 X 0 0 0 HAWKINS RONNIE DIRECTOR 0.30 0.60 X 0 0 0 HOLDER BILL DIRECTOR 0.30 0.60 X 0 0 0 MURREY MD SUSAN DIRECTOR 0.30 0.60 X 0 0 0 O'CONNOR PETER DIRECTOR 0.30 0.60 X 0 0 0 WRIGHT JONATHAN DIRECTOR 0.30 0.60 X 0 0 0 MAYCOCK ADAM CEO HINSDALE/LA GRANGE 50.00 0.00 X 576317 0 47578 STILL DANAE CFO 50.00 0.00 X 231554 0 49325 MURPHY MARY CNO HINSDALE/LA GRANGE 50.00 0.00 X 497136 0 29880 NAND MD BELA CMO HINSDALE/LA GRANGE 50.00 0.00 X 474687 0 24622 CARROLL MD RICHARD CMO BOLINGBROOK/GLENOAKS 0.00 50.00 X 555034 135352 37562 CHRISTIAN BRUCE PRES/CEO BOLINGBROOK.GLENOAKS 0.00 50.00 X 599233 0 37840 ROEHR RICHARD PRESIDENT - AFFILIATED ENTITY 0.00 50.00 X 518664 0 49402 RADIVOJEVIC VLADIMIR COO BOLINGBROOK/GLENOAKS 0.00 50.00 X 323556 0 46099 PALERMO MARY ANN VP/PATIENT SAFETY AND QUALITY 50.00 0.00 X 339670 0 21464 MURRILL MICHAEL CEO HINSDALE/LA GRANGE 0.00 50.00 X 0 700614 160963 5408179 8213377 1095930 232 1 1 1 R1 RCM INC 39918 TREASURY CENTER CHICAGO IL 60694 REVENUE CYCLE SERVICE 15947577 ALVERNO CLINICAL LABORATORIES LLC 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 LAB SERVICE 14050967 COMPASS GROUP USA INC PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 10789359 TRIMEDX LLC PO BOX 636129 CINCINNATI OH 45263 CLINICAL ENGINEERING SERVICES 5400268 PT SOLUTIONS HOLDINGS LLC PO BOX 441146 KENNESAW GA 30160 THERAPY SERVICE 4649064 57 X 1470072 5363224 29830 6863126 NET PATIENT REVENUE 622110 490136662 489708072 428590 MANAGEMENT SVCS TO RELATED 622110 51313834 51313834 RENT FROM EXEMPT AFFILIATES 622110 3098906 3098906 PROF. OFFICE BUILDING/EMP. HOUSIN 622110 1756671 1756671 CAFETERIA REVENUE 622110 851601 851601 1145696 1059503 86193 548303370 5651720 5651720 418117 129912 334544 9511 83573 120401 203974 120401 83573 6143658 2988398 0 1376358 6143658 1612040 7755698 7755698 568777888 547788587 635184 13490991 X 1443125 1443125 18270 18270 2073086 2073086 143205221 119175636 24029585 2166072 1779593 386479 23808104 19690609 4117495 10105933 8302792 1803141 129069 129069 164770 164770 481150 481150 105527647 71907033 33620614 -170792 -170792 21096203 19586168 1510035 13717162 12835813 881349 10289165 10289165 343389 343389 154226 154226 9231193 9231193 24985256 24985256 4752084 4690884 61200 MEDICAL SUPPLIES 70672154 70672154 OTHER OPERATING COSTS 43723628 43723628 STATE TAX INDIGENT ASSE 23912775 23912775 UNRELATED BUSINESS INCO 137500 137500 19189195 18805261 383934 531155585 461203581 69952004 0 X 7865 3817402 94973303 157465665 60993392 63291969 10988859 11720559 11870235 13657490 896904796 636111617 267380409 260793179 713390 808460 210000 210000 1489284 1323808 245403700 239805914 694030437 752894446 43088544 34532279 354491 408067 325673181 359766142 369116216 394706488 X 314696148 346427431 10218073 11760527 324914221 358187958 694030437 752894446 X 37622303 4384099 35018 -8767683 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 75182 75182 0 PART II-B, LINE 1: DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND ILLINOIS HOSPITAL ASSOCIATION. 2685040 103974 103974 2685040 2685040 103974 103974 2685040 2685040 302541 302541 2685040 2757867 351461 424288 2685040 2776135 349939 368207 2757867 1.00000 0 1 1 16430486 16430486 533128173 339273951 193854222 333624381 288600484 45023897 13721756 8237182 5484574 260793179 DUE FROM AFFILIATED 12813291 OTHER RECEIVABLES 8389963 RECEIVABLE FROM THIRD PARTIES 7207749 DUE FROM RELATED 36868473 BENEFICIAL INTEREST IN FOUNDATION 12929886 INTERCOMPANY RECEIVABLE 152799452 RIGHT OF USE ASSET-OPERATING LEASE 8205395 OTHER ASSETS 591705 239805914 DUE TO AFFILIATED 21130140 PAYABLE TO THIRD PARTIES 37143239 CREDIT BALANCES IN A/R 3652218 INTERCO. ALLOC. OF TE BOND PROCEEDS 266025031 OTHER NONCURRENT LIABILITIES 8023347 DUE TO RELATED 1542083 ACCRUED INTEREST PAYABLE 311352 OPERATING LEASE LIABILITY 9880772 OTHER LIABILITIES 12057960 359766142 X PART V, LINE 4: ALL ENDOWMENT FUNDS ARE HELD BY THE FOLLOWING RELATED 501(C)(3) EXEMPT FOUNDATIONS: HINSDALE HOSPITAL FOUNDATION (HHF): FORMED AND MAINTAINED EXCLUSIVELY TO FURTHER THE EXEMPT PURPOSE OF ADVENTHEALTH HINSDALE. HHF HELD ASSETS IN PERMANENT ENDOWMENT FUNDS DURING THE CURRENT YEAR. HHF'S ENDOWMENT CONSISTS OF THREE INDIVIDUAL FUNDS ESTABLISHED TO SUPPORT THE HOSPITAL'S OPLER CANCER CENTER AND CANCER CENTER NURSE NAVIGATION PROGRAM. MIDWEST HEALTH FOUNDATION (MHF): MAINTAINED TO HOLD ASSETS IN A PERMANENT ENDOWMENT FUND ESTABLISED TO SUPPORT NURSING SCHOLARSHIPS. THE FUND WAS ESTABLISHED BY LA GRANGE MEMORIAL HOSPITAL FOUNDATION, THEN WAS TRANSFERRED TO MHF ON 6/21/19 AS THE RESULT OF A LEGAL MERGER. 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. 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 5574141 5574141 0.01050 71120705 55541630 15579075 0.02930 76694846 55541630 21153216 0.03980 247388 247388 0.00050 16314036 5047981 11266055 0.02120 445098 445098 0.00080 17006522 5047981 11958541 0.02250 93701368 60589611 33111757 0.06230 32517 32517 0.00010 8062 8062 0.00000 219468 219468 0.00040 260047 260047 0.00050 1 595041 106356 133146188 140857382 -7711194 X 1 1 1 HINSDALE SURGICAL CENTER LLC SURGICAL SERVICES 0.28450 0.00000 0.43100 2 1 ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK STREET HINSDALE IL 60521 HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ 0000976 X X X X 2 ADVENTIST LA GRANGE MEMORIAL HOSPITAL 5101 S WILLOW SPRINGS ROAD LA GRANGE IL 60525 HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ 0005017 X X X X X ADVENTHEALTH HINSDALE 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE PART V, PAGE 8 X X 1 20 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 600.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTHEALTH LA GRANGE 2 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE PART V, PAGE 8 X X 1 20 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 600.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 5: ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE, (AMH HINSDALE OR THE HOSPITAL) COLLABORATED WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS TO CONDUCT A JOINT CHNA IN 2019. ALL THE COLLABORATORS IN THE 2019 JOINT CHNA DEFINED THEIR COMMUNITY TO BE DUPAGE COUNTY, ILLINOIS. DUPAGE COUNTY, ILLINOIS HAS A POPULATION OF OVER 900,000. THE 2019 JOINT CHNA WAS A COLLABORATIVE EFFORT OF IMPACT DUPAGE. IMPACT DUPAGE IS A COALITION OF ORGANIZATIONS THAT WAS FORMED WITH THE PURPOSE OF CREATING A COMMON UNDERSTANDING OF COMMUNITY NEEDS, GAPS, AND PRIORITIES THAT WILL ADVANCE THE WELL-BEING OF THE DUPAGE COUNTY COMMUNITY. THE HOSPITAL IS A MEMBER OF THE STEERING COMMITTEE OF IMPACT DUPAGE AS A HOSPITAL ORGANIZATION OF AMITA HEALTH THAT SERVES THE RESIDENTS OF DUPAGE COUNTY. IMPACT DUPAGE UTILIZED A COMMUNITY DRIVEN, STRATEGIC PLANNING PROCESS IN DEVELOPING AND IMPLEMENTING EFFORTS AROUND THE PRIORITIZATION OF PUBLIC HEALTH ISSUES. AS A PART OF THE COMMUNITY HEALTH ASSESSMENT AND DATA COLLECTION EFFORTS, A SPECIFIC EFFORT WAS MADE TO INCLUDE INPUT FROM UNDERREPRESENTED POPULATION GROUPS AND PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. IMPACT DUPAGE CONDUCTED A SURVEY AMONG DUPAGE COUNTY RESIDENTS TO ASSESS THE COMMUNITY'S PERCEPTIONS, THOUGHTS AND OPINIONS OF HEALTH AND THE QUALITY OF LIFE IN THEIR COMMUNITY. THE SURVEY WAS OPEN TO ALL DUPAGE COUNTY RESIDENTS AND 1,577 SURVEYS WERE COLLECTED. THE SURVEY WAS CONDUCTED ONLINE AND BY PAPER. PRIOR TO THE SURVEY LAUNCH, COMMUNICATION TOOLS WERE DEVELOPED AND DISSEMINATED TO PROMOTE THE SURVEY. THE SURVEY CONTAINED QUESTIONS ON DUPAGE COUNTY'S GREATEST STRENGTHS, IMPORTANT HEALTH CONCERNS, RISKY BEHAVIORS, COMMUNITY AND PERSONAL HEALTH, AND WHERE THE COMMUNITY SHOULD FOCUS ITS ATTENTION TO MAKE THINGS BETTER IN DUPAGE COUNTY. USING ITS NETWORK OF COMMITTEE MEMBERS, INFORMATION REGARDING THE LAUNCH OF THE SURVEY WAS DISTRIBUTED TO THE FOLLOWING ORGANIZATIONS IN ORDER TO ENSURE REPRESENTATION FROM THE BROAD COMMUNITY OF DUPAGE COUNTY: ADDISON RESOURCES CONNECTBENEDICTINE UNIVERSITYDUPAGE CHIEFS OF POLICE ASSOCIATIONDUPAGE COUNTY BOARD OF HEALTHDUPAGE COUNTY HEALTH DEPARTMENT PUBLIC HEALTH CLINICSDUPAGE COUNTY JUVENILE JUSTICE COUNCILDUPAGE COUNTYDUPAGE EARLY CHILDHOOD COLLABORATIONDUPAGE MAYORS AND MANAGERS CONFERENCEFAMILY SHELTER SERVICE GLENDALE HEIGHTS YOUTH COMMISSIONHEALTHY LOMBARDIMPACT DUPAGE NETWORKSLOVE CHRISTIAN CLEARINGHOUSE NEWSLETTERMUNICIPAL PIOSNORTH CENTRAL COLLEGEOHSEM EOC TOUR GIRL SCOUT PARENTSPEOPLE'S RESOURCE CENTER WEEKLY EMAILSPREVENTION LEADERSHIP TEAMVIRTUAL BACKPACKSWALK IN MINISTRIESWEATHER SPOTTER TRAINING COURSE ATTENDEES, ANDWOODRIDGE PARK DISTRICT. PAPER SURVEYS WERE LOCATED AT MULTIPLE DUPAGE COUNTY HEALTH DEPARTMENT PUBLIC HEALTH CLINICS THROUGHOUT THE COUNTY. THE SURVEY WAS FEATURED IN VILLAGE NEWSLETTERS AND VARIOUS AGENCY WEBSITES AND SOCIAL MEDIA ACCOUNTS. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 5: ADVENTIST MIDWEST HEALTH, DBA AMITA HEALTH ADVENTIST MEDICAL CENTER LA GRANGE (AMH LA GRANGE OR THE HOSPITAL) WAS A PARTICIPANT IN A COLLABORATIVE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT FOR CHICAGO AND SUBURBAN COOK COUNTY, ILLINOIS CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY. THE ALLIANCE FOR HEALTH EQUITY IS A COLLABORATIVE OF 37 HOSPITALS, 6 LOCAL HEALTH DEPARTMENTS INCLUDING THE CHICAGO DEPARTMENT OF PUBLIC HEALTH AND THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH, AND NEARLY 100 COMMUNITY-BASED ORGANIZATIONS. THE ILLINOIS PUBLIC HEALTH INSTITUTE SERVED AS THE BACKBONE ORGANIZATION TO FACILITATE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY. THE ALLIANCE FOR HEALTH EQUITY'S METHODS OF COMMUNITY ENGAGEMENT FOR THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDED AMONG OTHERS THE FOLLOWING: - GATHERING INPUT FROM COMMUNITY RESIDENTS WHO ARE UNDERREPRESENTED;- PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS FOR COLLECTION OF COMMUNITY INPUT THROUGH SURVEYS AND FOCUS GROUPS; AND - ENGAGING COMMUNITY-BASED ORGANIZATIONS AND COMMUNITY RESIDENTS AS MEMBERS OF IMPLEMENTATION COMMITTEES AND WORKGROUPS. PRIMARY DATA FOR THE CHNA WAS COLLECTED THROUGH COMMUNITY INPUT SURVEYS, COMMUNITY RESIDENT FOCUS GROUPS AND LEARNING MAP SESSIONS, HEALTH CARE AND SOCIAL SERVICE PROVIDER FOCUS GROUPS, AND TWO STAKEHOLDER ASSESSMENTS LED BY PARTNER HEALTH DEPARTMENTS. THE ALLIANCE FOR HEALTH EQUITY PARTNERS COLLECTED 5,934 COMMUNITY INPUT SURVEYS FROM INDIVIDUALS 18 OR OLDER LIVING IN CHICAGO AND SUBURBAN COOK COUNTY. THE SURVEYS WERE AVAILABLE ON PAPER AND ONLINE AND WERE DISSEMINATED IN ENGLISH, SPANISH, CHINESE, AND POLISH. HOSPITALS, COMMUNITY-BASED ORGANIZATIONS, AND HEALTH DEPARTMENTS DISTRIBUTED THE SURVEYS WITH THE INTENTION OF GAINING INSIGHT FROM PRIORITY POPULATIONS THAT ARE TYPICALLY UNDERREPRESENTED, SUCH AS COMMUNITIES OF COLOR, IMMIGRANTS, LGBTQ+ COMMUNITY MEMBERS, INDIVIDUALS WITH DISABILITIES, AND LOW-INCOME COMMUNITIES. A TOTAL OF 52 COMMUNITY INPUT SESSIONS (FOCUS GROUPS AND LEARNING MAP SESSIONS) WERE HELD IN 2018-2019 WITH PRIORITY POPULATIONS SUCH AS VETERANS, INDIVIDUALS LIVING WITH MENTAL ILLNESS, COMMUNITIES OF COLOR, OLDER ADULTS, CAREGIVERS, TEENS AND YOUNG ADULTS, LGBTQ+ COMMUNITY MEMBERS, ADULTS AND TEENS EXPERIENCING HOMELESSNESS, FAMILIES WITH CHILDREN, FAITH COMMUNITIES, ADULTS WITH DISABILITIES, AND CHILDREN AND ADULTS LIVING WITH CHRONIC CONDITIONS SUCH AS DIABETES AND ASTHMA. IN ADDITION TO THE 52 COMMUNITY INPUT SESSIONS, THERE WERE THREE FOCUS GROUPS WITH HEALTH CARE AND SOCIAL SERVICE PROVIDERS HOSTED BY THREE CHNA PARTICIPANT HOSPITALS. STAKEHOLDER ASSESSMENTS INCLUDED A FORCES OF CHANGE ASSESSMENT FOCUSING ON THE TRENDS, FACTORS AND EVENTS THAT ARE CURRENTLY AFFECTING OR ARE ANTICIPATED TO AFFECT THE PUBLIC HEALTH SYSTEM IN THE NEXT THREE TO FIVE YEARS AND CONSISTED OF AN ONLINE SURVEY OF 122 RESPONDENTS REPRESENTING 86 ORGANIZATIONS IN CHICAGO AND SUBURBAN COOK COUNTY. A HEALTH EQUITY CAPACITY STAKEHOLDER ASSESSMENT WAS ALSO CONDUCTED WITH 80 PEOPLE FROM ACROSS CHICAGO AND SUBURBAN COOK COUNTY. ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 6A: ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE (THE HOSPITAL), COLLABORATED WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS TO CONDUCT A JOINT CHNA IN 2019. ALL THE COLLABORATORS IN THE 2019 JOINT CHNA DEFINED THEIR COMMUNITY TO BE DUPAGE COUNTY, ILLINOIS. DUPAGE COUNTY, ILLINOIS HAS A POPULATION OF OVER 900,000. THE 2019 JOINT CHNA WAS A COLLABORATIVE EFFORT OF IMPACT DUPAGE, A COLLABORATION OF PARTNERS FORMED WITH THE PURPOSE OF CREATING A COMMON UNDERSTANDING OF COMMUNITY NEEDS, GAPS AND PRIORITIES THAT WILL ADVANCE THE WELL-BEING OF THE DUPAGE COUNTY COMMUNITY. THE HOSPITAL, AS A PART OF AMITA HEALTH SYSTEM, WAS A MEMBER OF THE STEERING COMMITTEE OF IMPACT DUPAGE, ALONG WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS AND INCLUDING THE DUPAGE COUNTY HEALTH DEPARTMENT. THE OTHER HOSPITAL ORGANIZATIONS THAT PARTICIPATED IN THE 2019 JOINT CHNA AS A MEMBER OF THE STEERING COMMITTEE OF IMPACT DUPAGE WERE ADVOCATE AURORA HEALTH CARE, EDWARD ELMHURST HEALTH AND NORTHWESTERN MEDICINE. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 6A: ADVENTIST MIDWEST HEALTH, DBA AMITA HEALTH ADVENTIST MEDICAL CENTER LA GRANGE (AMH LA GRANGE OR THE HOSPITAL) WAS A PARTICIPANT IN A COLLABORATIVE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT FOR CHICAGO AND SUBURBAN COOK COUNTY, ILLINOIS CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY. THE ALLIANCE FOR HEALTH EQUITY IS A COLLABORATIVE OF 37 HOSPITALS, 6 LOCAL HEALTH DEPARTMENTS INCLUDING THE CHICAGO DEPARTMENT OF PUBLIC HEALTH AND THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH, AND NEARLY 100 COMMUNITY-BASED ORGANIZATIONS. THE ILLINOIS PUBLIC HEALTH INSTITUTE SERVED AS THE BACKBONE ORGANIZATION TO FACILITATE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY. THE HOSPITAL PARTICIPANTS IN THE 2018-2018 CHNA CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY INCLUDED THE FOLLOWING: NONPROFIT HOSPITAL MEMBERSADVOCATE AURORA CHILDREN'S HOSPITALADVOCATE AURORA CHRIST MEDICAL CENTERADVOCATE AURORA ILLINOIS MASONIC MEDICAL CENTERADVOCATE AURORA LUTHERAN GENERAL HOSPITALADVOCATE AURORA SOUTH SUBURBAN HOSPITALADVOCATE AURORA TRINITY HOSPITALAMITA ADVENTIST MEDICAL CENTER LA GRANGEAMITA ALEXIAN BROTHERS MEDICAL CENTER, ELK GROVE VILLAGEAMITA HOLY FAMILY MEDICAL CENTERAMITA RESURRECTION MEDICAL CENTERAMITA ST. ALEXIUS MEDICAL CENTER AND ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITALAMITA SAINT FRANCIS HOSPITALAMITA SAINT JOSEPH HOSPITALAMITA SAINTS MARY AND ELIZABETH MEDICAL CENTERANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGOJACKSON PARK HOSPITALTHE LORETTO HOSPITALLOYOLA MEDICINE- GOTTLIEB MEMORIAL HOSPITALLOYOLA MEDICINE- LOYOLA UNIVERSITY MEDICAL CENTERLOYOLA MEDICINE- MACNEAL HOSPITALMERCY HOSPITAL & MEDICAL CENTERNORTHWESTERN MEMORIAL HOSPITALNORWEGIAN AMERICAN HOSPITALPALOS COMMUNITY HOSPITALROSELAND COMMUNITY HOSPITALRUSH OAK PARKRUSH UNIVERSITY MEDICAL CENTERSINAI HEALTH SYSTEM- HOLY CROSS HOSPITALSINAI HEALTH SYSTEM- MOUNT SINAI HOSPITALSINAI HEALTH SYSTEM- SCHWAB REHABILITATION HOSPITALSOUTH SHORE HOSPITALSWEDISH COVENANT HOSPITALUNIVERSITY OF CHICAGO MEDICINEUNIVERSITY OF CHICAGO MEDICINE-INGALLS MEMORIAL HOSPITAL PUBLIC HOSPITAL PARTNERSCOOK COUNTY HEALTH- STROGER HOSPITAL UNIVERSITY OF ILLINOIS HOSPITAL & HEALTH SCIENCES SYSTEMCOOK COUNTY HEALTH- PROVIDENT HOSPITAL PUBLIC HEALTH DEPARTMENT PARTNERSCHICAGO DEPARTMENT OF PUBLIC HEALTH COOK COUNTY DEPARTMENT OF PUBLIC HEALTH EVANSTON HEALTH AND HUMAN SERVICES DEPARTMENTVILLAGE OF SKOKIE, HEALTH DEPARTMENT ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 6B: ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE (THE HOSPITAL), COLLABORATED WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS TO CONDUCT A JOINT CHNA IN 2019. ALL THE COLLABORATORS IN THE 2019 JOINT CHNA DEFINED THEIR COMMUNITY TO BE DUPAGE COUNTY, ILLINOIS. DUPAGE COUNTY, ILLINOIS HAS A POPULATION OF OVER 900,000. THE 2019 JOINT CHNA WAS A COLLABORATIVE EFFORT OF IMPACT DUPAGE, A COLLABORATION OF PARTNERS FORMED WITH THE PURPOSE OF CREATING A COMMON UNDERSTANDING OF COMMUNITY NEEDS, GAPS AND PRIORITIES THAT WILL ADVANCE THE WELL-BEING OF THE DUPAGE COUNTY COMMUNITY. THE HOSPITAL, AS A PART OF AMITA HEALTH SYSTEM, WAS A MEMBER OF THE STEERING COMMITTEE OF IMPACT DUPAGE, ALONG WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS AND INCLUDING THE DUPAGE COUNTY HEALTH DEPARTMENT. THE OTHER NON-HOSPITAL ORGANIZATIONS THAT PARTICIPATED IN THE 2019 JOINT CHNA AS MEMBERS OF THE STEERING COMMITTEE OF IMPACT DUPAGE WERE ADVOCATE AURORA HEALTH CARE, COMMUNITY CONSOLIDATED SCHOOL DISTRICT 89, DUPAGE HEALTH COALITION, DUPAGE COUNTY COMMUNITY SERVICES, DUPAGE COUNTY HEALTH DEPARTMENT, DUPAGE COUNTY PUBLIC DEFENDER'S OFFICE, DUPAGE FEDERATION ON HUMAN SERVICES REFORM, DUPAGE FOUNDATION, DUPAGE PADS, FAMILY SHELTER SERVICE, LINDEN OAKS BEHAVIORAL HEALTH (EDWARD ELMHURST HEALTH), METROPOLITAN FAMILY SERVICES DUPAGE, NORTHWESTERN MEDICINE, PEOPLE'S RESOURCE CENTER, PRAIRIE STATE LEGAL SERVICES, INC., WORKNET DUPAGE DUPAGE COUNTY WORKFORCE DEVELOPMENT, AND UNITED WAY OF METRO CHICAGO. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 6B: ADVENTIST MIDWEST HEALTH, DBA AMITA HEALTH ADVENTIST MEDICAL CENTER LA GRANGE (AMH LA GRANGE OR THE HOSPITAL) WAS A PARTICIPANT IN A COLLABORATIVE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT FOR CHICAGO AND SUBURBAN COOK COUNTY, ILLINOIS CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY. THE ALLIANCE FOR HEALTH EQUITY IS A COLLABORATIVE OF 37 HOSPITALS, 6 LOCAL HEALTH DEPARTMENTS INCLUDING THE CHICAGO DEPARTMENT OF PUBLIC HEALTH AND THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH, AND NEARLY 100 COMMUNITY-BASED ORGANIZATIONS. THE ILLINOIS PUBLIC HEALTH INSTITUTE SERVED AS THE BACKBONE ORGANIZATION TO FACILITATE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY. THE NON-HOSPITAL PARTICIPANTS IN THE 2018-2018 CHNA CONDUCTED BY THE ALLIANCE FOR HEALTH EQUITY INCLUDED THE FOLLOWING 4 PUBLIC HEALTH DEPARTMENTS (TWO ADDITIONAL HEALTH DEPARTMENTS ARE PARTICIPANTS IN THE ALLIANCE FOR HEALTH EQUITY BUT WERE NOT DIRECT PARTNERS IN THIS CHNA PROCESS): NONPROFIT HOSPITAL MEMBERSADVOCATE AURORA CHILDREN'S HOSPITALADVOCATE AURORA CHRIST MEDICAL CENTERADVOCATE AURORA ILLINOIS MASONIC MEDICAL CENTERADVOCATE AURORA LUTHERAN GENERAL HOSPITALADVOCATE AURORA SOUTH SUBURBAN HOSPITALADVOCATE AURORA TRINITY HOSPITALAMITA ADVENTIST MEDICAL CENTER LA GRANGEAMITA ALEXIAN BROTHERS MEDICAL CENTER, ELK GROVE VILLAGEAMITA HOLY FAMILY MEDICAL CENTERAMITA RESURRECTION MEDICAL CENTERAMITA ST. ALEXIUS MEDICAL CENTER AND ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITALAMITA SAINT FRANCIS HOSPITALAMITA SAINT JOSEPH HOSPITALAMITA SAINTS MARY AND ELIZABETH MEDICAL CENTERANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGOJACKSON PARK HOSPITALTHE LORETTO HOSPITALLOYOLA MEDICINE- GOTTLIEB MEMORIAL HOSPITALLOYOLA MEDICINE- LOYOLA UNIVERSITY MEDICAL CENTERLOYOLA MEDICINE- MACNEAL HOSPITALMERCY HOSPITAL & MEDICAL CENTERNORTHWESTERN MEMORIAL HOSPITALNORWEGIAN AMERICAN HOSPITALPALOS COMMUNITY HOSPITALROSELAND COMMUNITY HOSPITALRUSH OAK PARKRUSH UNIVERSITY MEDICAL CENTERSINAI HEALTH SYSTEM- HOLY CROSS HOSPITALSINAI HEALTH SYSTEM- MOUNT SINAI HOSPITALSINAI HEALTH SYSTEM- SCHWAB REHABILITATION HOSPITALSOUTH SHORE HOSPITALSWEDISH COVENANT HOSPITALUNIVERSITY OF CHICAGO MEDICINEUNIVERSITY OF CHICAGO MEDICINE-INGALLS MEMORIAL HOSPITAL PUBLIC HOSPITAL PARTNERSCOOK COUNTY HEALTH- STROGER HOSPITAL UNIVERSITY OF ILLINOIS HOSPITAL & HEALTH SCIENCES SYSTEMCOOK COUNTY HEALTH- PROVIDENT HOSPITAL PUBLIC HEALTH DEPARTMENT PARTNERSCHICAGO DEPARTMENT OF PUBLIC HEALTH COOK COUNTY DEPARTMENT OF PUBLIC HEALTH EVANSTON HEALTH AND HUMAN SERVICES DEPARTMENTVILLAGE OF SKOKIE, HEALTH DEPARTMENT ADVENTHEALTH HINSDALE 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. COPIES OF THE CHNA REPORT WERE MAILED AND/OR E-MAILED TO COMMUNITY PARTNERS WHO PARTICIPATED IN THE CHNA PROCESS. PARTNERS WERE ALSO PROVIDED LINKS TO THE WEBSITE FOR DISSEMINATION TO THEIR MAILING LISTS AND RESPECTIVE CONSTITUENTS. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS AND IS ALSO BROADLY DISTRIBUTED WITHIN OUR COMMUNITY TO STAKEHOLDERS INCLUDING COMMUNITY LEADERS, GOVERNMENT OFFICIALS, AND SERVICE ORGANIZATIONS. ADVENTHEALTH LA GRANGE 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. COPIES OF THE CHNA REPORT WERE MAILED AND/OR E-MAILED TO COMMUNITY PARTNERS WHO PARTICIPATED IN THE CHNA PROCESS. PARTNERS WERE ALSO PROVIDED LINKS TO THE WEBSITE FOR DISSEMINATION TO THEIR MAILING LISTS AND RESPECTIVE CONSTITUENTS. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS AND IS ALSO BROADLY DISTRIBUTED WITHIN OUR COMMUNITY TO STAKEHOLDERS INCLUDING COMMUNITY LEADERS, GOVERNMENT OFFICIALS, AND SERVICE ORGANIZATIONS. ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 11: THE INFORMATION PROVIDED BELOW EXPLAINS HOW THE HOSPITAL FACILITY ADDRESSED IN 2021 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ANY SUCH NEEDS THAT WERE NOT ADDRESSED AND THE REASONS WHY SUCH NEEDS WERE NOT ADDRESSED. THE HOSPITAL FACILITY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT BY 12/31/19 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2020 PRIOR TO MAY 15, 2020. THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH HINSDALE'S (THE HOSPITAL) 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH HINSDALE 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 HINSDALE CHOSE TWO PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. BEHAVIORAL HEALTH 2. HEALTH STATUS IMPROVEMENT PRIORITY 1: BEHAVIORAL HEALTH 2019 DESCRIPTION OF THE ISSUE:BEHAVIORAL HEALTH IS A TERM THAT INCLUDES BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY FOR ADULTS, CHILDREN AND ADOLESCENTS. WHEN MENTAL HEALTH DISORDERS ARE UNTREATED, THOSE AFFECTED ARE AT HIGH RISK FOR MANY UNHEALTHY AND UNSAFE BEHAVIORS, INCLUDING ALCOHOL OR DRUG ABUSE, VIOLENT OR SELF-DESTRUCTIVE BEHAVIOR AND SUICIDE. MENTAL HEALTH DISORDERS ARE THE 11TH LEADING CAUSE OF DEATH IN THE UNITED STATES FOR ALL AGE GROUPS AND THE SECOND LEADING CAUSE OF DEATH AMONG PEOPLE AGES 25 TO 34. BEHAVIORAL HEALTH CONTINUES TO BE A PRIMARY CONCERN IN DUPAGE COUNTY. ADDRESSING BEHAVIORAL HEALTH REQUIRES ATTENTION TO SUBSTANCE USE DISORDERS AS WELL AS MENTAL HEALTH. THE RECENT CHNA ALSO EMPHASIZED THE NEED FOR PREVENTION OF SUBSTANCE USE AT AN EARLY AGE AND THE REDUCTION OF STIGMA SURROUNDING BEHAVIORAL HEALTH. DRUG ABUSE AND MENTAL HEALTH ISSUES WERE THE TOP TWO CONCERNS ON THE COMMUNITY SURVEY DURING THE LAST ASSESSMENT.2021 UPDATE: THE ADVENTHEALTH HINSDALE COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE BEHAVIORAL HEALTH PRIORITY. 1. IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE. GOAL 1: IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE. OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PERSONS TRAINED IN THE COMMUNITY ON MENTAL HEALTH FIRST AID (MHFA) TO INCREASE IDENTIFICATION OF THOSE IN A CRISIS AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH ISSUES IS FUNDED AND CONDUCTED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES A TRAINING FOR COMMUNITY RESIDENTS AND FIRST RESPONDERS TO RECOGNIZE, RESPOND AND SEEK ASSISTANCE FOR SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. THE HOSPITALS PROGRESSED ON THEIR SET METRIC OF 220 WITH 15 INDIVIDUALS SERVED. IN 2021 THERE WAS ONLY ONE MHFA FACILITATOR THAT WAS SHARED AMONGST 14 HOSPITALS AND ENDED IN AUGUST. NO FACILITATOR WAS AVAILABLE FOR THE REST OF 2021. PRIORITY 2: HEALTH STATUS IMPROVEMENT2019 DESCRIPTION OF THE ISSUE:DATA FROM THE MOST RECENT CHNA INDICATED A NEED FOR CONTINUED FOCUS ON ISSUES INVOLVING RESIDENTS' ACCESS TO HEALTH AND MOVEMENT TOWARDS MORE POSITIVE HEALTH OUTCOMES FOR DUPAGE RESIDENTS. ONE OF THE SOCIAL DETERMINANTS OF HEALTH CLOSELY ASSOCIATED WITH POSITIVE HEALTH OUTCOMES IS THE AVAILABILITY OF AFFORDABLE, HEALTHY FOODS. DATA FROM THE MOST RECENT CHNA INDICATED A NEED FOR CONTINUED FOCUS ON ISSUES INVOLVING RESIDENTS' ACCESS TO HEALTH AND MOVEMENT TOWARDS MORE POSITIVE HEALTH OUTCOMES FOR DUPAGE RESIDENTS. ACCESS TO HEALTH CARE AND HEALTH INSURANCE ESPECIALLY FOR LOW-INCOME PERSONS IN THE DUPAGE COMMUNITY CONTINUES TO BE AN ISSUE. EIGHTY-FIVE PERCENT OF DUPAGE COUNTY RESIDENTS REPORTED HAVING A USUAL HEALTH CARE PROVIDER WHILE A TOP "RISKY BEHAVIOR" GROUP NOTED ON THE LAST ASSESSMENT RESIDENT SURVEY REPORTED HAVING NO HEALTH INSURANCE. DATA FROM THE MOST RECENT CHNA INDICATED A NEED FOR CONTINUED FOCUS ON ISSUES INVOLVING RESIDENTS' ACCESS TO HEALTH AND MOVEMENT TOWARDS MORE POSITIVE HEALTH OUTCOMES FOR DUPAGE RESIDENTS. ASSISTING PATIENTS AND COMMUNITY MEMBERS TO PROGRAMS AND SERVICES THAT CAN IMPROVE THEIR SOCIAL DETERMINANTS OF HEALTH ARE NEEDED.2021 UPDATE: THE ADVENTHEALTH HINSDALE COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE HEALTH STATUS IMPROVEMENT PRIORITY. 1. INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.GOAL 1: INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH., THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THEIR OBJECTIVE, TO INCREASE THE AVAILABILITY OF HEALTHY FOODS WITHIN THE LOW-INCOME COMMUNITY, IS CONDUCTED THROUGH ADVENTHEALTH HINSDALE AND ALL FUNDING AND OUTCOMES REPORTED ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES IN COLLABORATION WITH NORTHERN ILLINOIS FOOD BANK, HINSDALE SEVENTH-DAY ADVENTIST CHURCH AND THE COMMUNITY MEMORIAL FOUNDATION THE RX MOBILE FOOD PANTRY, AN ON-SITE MOBILE FOOD PANTRY TWICE A MONTH. THE RX MOBILE FOOD PANTRY PROVIDES FREE PRODUCE, MEAT AND DAIRY TO PATIENTS SCREENED FOR FOOD INSECURITY AS WELL AS TO THE COMMUNITY AT LARGE. THE HOSPITAL EXCEEDED ITS SET METRIC OF 400 INDIVIDUALS PROVIDED WITH FREE HEALTHY FOOD OPTIONS A MONTH WITH 786 INDIVIDUALS SERVED. THIS INITIATIVE HAS BEEN A GREAT COLLABORATION IN WHICH MANY PEOPLE WHO ARE EXPERIENCING FOOD INSECURITY FOR THE FIRST TIME ARE CONNECTED TO FOOD. IN ADDITION, WRAP AROUND SERVICES SUCH AS SNAP BENEFIT ENROLLMENT OPPORTUNITIES ARE AVAILABLE AND HEALTH EDUCATION MATERIALS ARE OFTEN PROVIDED. OBJECTIVE 2: THE SECOND OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH HINSDALE AND ADVENTHEALTH GLENOAKS. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE PROVIDES FINANCIAL SUPPORT FOR SILVER ACCESS PROGRAM OF ACCESS DUPAGE AND IS FUNDED BY BOTH HOSPITALS. THIS SUPPORT PROVIDES SUPPORT FOR QUALIFYING RESIDENTS WITH A SUBSIDY FOR THEIR HEALTH INSURANCE PREMIUM TO INCREASE ACCESS TO HEALTH CARE. THE HOSPITALS PROGRESSED ON THEIR SET METRIC OF INCREASING MEMBERS IN TOTAL FUNDING WITH 476 INDIVIDUALS SERVED. THE CONTRIBUTION WAS SPLIT BETWEEN THE HOSPITALS WITH ADVENTHEALTH HINSDALE CONTRIBUTING $226,137 AND ADVENTHEALTH GLENOAKS CONTRIBUTING $130,757. ALTHOUGH THE NUMBER OF INDIVIDUALS SERVED DECREASED FROM 2020 THAT WAS DUE IN PART TO MORE INDIVIDUALS QUALIFYING FOR MEDICAID UNDER THE CORONAVIRUS AID RELIEF ECONOMIC SECURITY ACT. SEE CONTINUATION ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 11: THE INFORMATION PROVIDED BELOW EXPLAINS HOW THE HOSPITAL FACILITY ADDRESSED IN 2021 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ANY SUCH NEEDS THAT WERE NOT ADDRESSED AND THE REASONS WHY SUCH NEEDS WERE NOT ADDRESSED. THE HOSPITAL FACILITY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT BY 12/31/19 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2020 PRIOR TO MAY 15, 2020.THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH LA GRANGE'S (THE HOSPITAL) 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH LA GRANGE 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. ADVENTHEALTH LA GRANGE CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH2. ACCESS TO CARE, COMMUNITY RESOURCES AND SYSTEMS IMPROVEMENTS3. MENTAL HEALTH AND SUBSTANCE USE DISORDERS4. CHRONIC CONDITION PREVENTION AND MANAGEMENTPRIORITY 1: SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH2019 DESCRIPTION OF THE ISSUE:THE SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH SUCH AS POVERTY, UNEQUAL ACCESS TO COMMUNITY RESOURCES, UNEQUAL EDUCATION FUNDING AND QUALITY, STRUCTURAL RACISM, AND ENVIRONMENTAL CONDITIONS ARE UNDERLYING ROOT CAUSES OF HEALTH INEQUITIES. ADDITIONALLY, SOCIAL DETERMINANTS OF HEALTH OFTEN VARY BY GEOGRAPHY, GENDER, SEXUAL ORIENTATION, AGE, RACE, DISABILITY, AND ETHNICITY. THE STRONG CONNECTIONS BETWEEN SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS AND HEALTH ARE APPARENT IN CHICAGO AND SUBURBAN COOK COUNTY, WITH HEALTH INEQUITIES BEING EVEN MORE PRONOUNCED THAN MANY NATIONAL TRENDS. WITHIN THE ADVENTHEALTH LA GRANGE PRIMARY SERVICE AREA THERE ARE IDENTIFIED FOOD DESERTS ESPECIALLY NEAR LOW-INCOME AND HIGHER POVERTY COMMUNITIES.2021 UPDATE: THE ADVENTHEALTH LA GRANGE COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH PRIORITY. 1. TO DEVELOP AFFORDABLE, HEALTHY FOOD OPTIONS FOR ALL RESIDENTS OF WILL COUNTY GOAL 1: TO DEVELOP AFFORDABLE, HEALTHY FOOD OPTIONS FOR ALL RESIDENTS OF WILL COUNTYOBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE WITH ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THEIR OBJECTIVE, TO INCREASE THE AVAILABILITY OF HEALTHY FOODS WITHIN THE LOW-INCOME COMMUNITY, IS CONDUCTED THROUGH ADVENTHEALTH HINSDALE AND ALL FUNDING AND OUTCOMES REPORTED ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES IN COLLABORATION WITH NORTHERN ILLINOIS FOOD BANK, HINSDALE SEVENTH-DAY ADVENTIST CHURCH AND THE COMMUNITY MEMORIAL FOUNDATION THE RX MOBILE FOOD PANTRY, AN ON-SITE MOBILE FOOD PANTRY TWICE A MONTH. THE RX MOBILE FOOD PANTRY PROVIDES FREE PRODUCE, MEAT AND DAIRY TO PATIENTS SCREENED FOR FOOD INSECURITY AS WELL AS TO THE COMMUNITY AT LARGE. THE HOSPITAL EXCEEDED ITS SET METRIC OF 400 INDIVIDUALS PROVIDED WITH FREE HEALTHY FOOD OPTIONS A MONTH WITH 786 INDIVIDUALS SERVED. THIS INITIATIVE HAS BEEN A GREAT COLLABORATION IN WHICH MANY PEOPLE WHO ARE EXPERIENCING FOOD INSECURITY FOR THE FIRST TIME ARE CONNECTED TO FOOD. IN ADDITION, WRAP AROUND SERVICES SUCH AS SNAP BENEFIT ENROLLMENT OPPORTUNITIES ARE AVAILABLE AND HEALTH EDUCATION MATERIALS ARE OFTEN PROVIDED. PRIORITY 2: ACCESS TO CARE, COMMUNITY RESOURCES AND SYSTEMS IMPROVEMENTS2019 DESCRIPTION OF THE ISSUE:HEALTHY PEOPLE 2020 STATES THAT ACCESS TO COMPREHENSIVE HEALTHCARE SERVICES IS IMPORTANT FOR ACHIEVING HEALTH EQUITY AND IMPROVING QUALITY OF LIFE FOR EVERYONE. DISPARITIES IN ACCESS TO CARE AND COMMUNITY RESOURCES WERE IDENTIFIED AS UNDERLYING ROOT CAUSES OF MANY OF THE HEALTH INEQUITIES EXPERIENCED BY RESIDENTS IN COOK COUNTY. INCREASING TIMELY LINKAGE TO APPROPRIATE CARE INCLUDING BEHAVIORAL HEALTH AND SOCIAL SERVICES IS A PRIORITY. 2021 UPDATE: THE ADVENTHEALTH LA GRANGE COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE ACCESS TO CARE, COMMUNITY RESOURCES AND SYSTEMS IMPROVEMENTS PRIORITY. 1. INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.GOAL 1: INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE ACCESS TO HEALTH CARE FOR HOMELESS PERSONS IN THE ADVENTHEALTH LA GRANGE SERVICE AREA. THE BED PLUS COLLABORATION IS AN INITIATIVE IN COLLABORATION WITH PILLARS COMMUNITY HEALTH AND THE LA GRANGE FAMILY RESIDENCY CLINIC AND IS FUNDED THROUGH ADVENTHEALTH LA GRANGE AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE BEDS PLUS COLLABORATION PROVIDES DAY PROGRAM PARTICIPANTS HEALTH CONSULTATIONS AND LINKAGES TO ROUTINE HEALTH SERVICES WHICH INCREASES ACCESS TO CARE. THE HOSPITAL SURPASSED ITS SET METRIC OF 70% OF PERSONS UTILIZING THE BEDS PLUS DAY PROGRAM BEING CONNECTED TO A MEDICAL HOME WITH 90% OF INDIVIDUALS CONNECTED. THOSE INDIVIDUALS WHO ACCESSED THE DAY PROGRAM ALSO WERE CONNECTED TO DENTAL AND MENTAL HEALTH SERVICES, 22 INDIVIDUALS FOR DENTAL CARE AND 51 FOR MENTAL HEALTH, RESPECTIVELY. OBJECTIVE 2: THE SECOND OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH LA GRANGE, ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS AND ADVENTHEALTH HINSDALE. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH, THE SAME DIVISION AS THE REPORTING HOSPITAL. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PATIENT AND COMMUNITY MEMBERS CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY, IS FUNDED AND DEPLOYED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES AN ONLINE DIRECTORY OF FREE OR REDUCED COST SERVICES THAT ADDRESS SOCIAL NEEDS OF PATIENTS AND COMMUNITY MEMBERS, INCREASING ACCESS TO COMMUNITY RESOURCES. THE HOSPITALS DID NOT MEET THEIR SET METRIC OF 200 CONNECTIONS WITH 0 INDIVIDUALS SERVED. SEVERAL REASONS CONTRIBUTED TO NOT MEETING THIS METRIC. ONE OF THE PRIMARY REASONS WAS A LACK OF AWARENESS OF THE COMMUNITY RESOURCE DIRECTORY AVAILABILITY. THE COVID-19 PANDEMIC DELAYED THE PROGRAM. AS A RESULT OF THE CONTINUED PANDEMIC, ADVENTHEALTH HAS PIVOTED WHERE NECESSARY TO ADDRESS THE IMMEDIATE NEEDS OF OUR COMMUNITY. WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THOSE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATIONS DEVELOP. SEE CONTINUATION ADVENTHEALTH HINSDALE 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. ADVENTHEALTH LA GRANGE 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. ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 16J: THE FILING ORGANIZATION USES MULTIPLE METHODS OF COMMUNICATING ITS MISSION OF PROVIDING CARE TO ALL WHO NEED IT REGARDLESS OF ABILITY TO PAY. SIGNS POSTED AT REGISTRATION CLEARLY POINT OUT THAT CHARITY CARE OR FINANCIAL ASSISTANCE IS AVAILABLE. REGISTRATION IS EDUCATED ON PROVIDING FINANCIAL ASSISTANCE POLICY INFORMATION AND FORMS TO PATIENTS. THE MAIN WEBSITE FOR ALL SYSTEM HOSPITALS FEATURES INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE ON-LINE. IN THE HOSPITAL SETTING, WE EMPLOY FINANCIAL COUNSELORS WHO ARE AVAILABLE TO WORK WITH PATIENTS AND WE ALSO HAVE MEDICAID APPLICATION SPECIALISTS TO ASSIST PATIENTS THAT MAY QUALIFY. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 16J: THE FILING ORGANIZATION USES MULTIPLE METHODS OF COMMUNICATING ITS MISSION OF PROVIDING CARE TO ALL WHO NEED IT REGARDLESS OF ABILITY TO PAY. SIGNS POSTED AT REGISTRATION CLEARLY POINT OUT THAT CHARITY CARE OR FINANCIAL ASSISTANCE IS AVAILABLE. REGISTRATION IS EDUCATED ON PROVIDING FINANCIAL ASSISTANCE POLICY INFORMATION AND FORMS TO PATIENTS. THE MAIN WEBSITE FOR ALL SYSTEM HOSPITALS FEATURES INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE ON-LINE. IN THE HOSPITAL SETTING, WE EMPLOY FINANCIAL COUNSELORS WHO ARE AVAILABLE TO WORK WITH PATIENTS AND WE ALSO HAVE MEDICAID APPLICATION SPECIALISTS TO ASSIST PATIENTS THAT MAY QUALIFY. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 11: CONTINUATION FOR AMH HINSDALE OBJECTIVE 3: THE THIRD OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH HINSDALE, ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS AND ADVENTHEALTH LA GRANGE. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PATIENT AND COMMUNITY MEMBERS CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY, IS FUNDED AND DEPLOYED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES AN ONLINE DIRECTORY OF FREE OR REDUCED COST SERVICES THAT ADDRESS SOCIAL NEEDS OF PATIENTS AND COMMUNITY MEMBERS, INCREASING ACCESS TO COMMUNITY RESOURCES. THE HOSPITALS PROGRESSED ON THEIR SET METRIC OF 200 CONNECTIONS WITH 13 INDIVIDUALS SERVED. SEVERAL REASONS CONTRIBUTED TO NOT MEETING THIS METRIC. ONE OF THE PRIMARY REASONS WAS A LACK OF AWARENESS OF THE COMMUNITY RESOURCE DIRECTORY AVAILABILITY. THE COVID-19 PANDEMIC DELAYED THE PROGRAM. AS A RESULT OF THE CONTINUED PANDEMIC, ADVENTHEALTH HAS PIVOTED WHERE NECESSARY TO ADDRESS THE IMMEDIATE NEEDS OF OUR COMMUNITY. WE ARE WORKING TO IDENTIFY WAYS TO SUPPORT THOSE NEEDS ORIGINALLY IDENTIFIED IN OUR CHNAS, AS RESOURCES AND PUBLIC HEALTH RECOMMENDATIONS DEVELOP. 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: AFFORDABLE HOUSINGAFFORDABLE HOUSING, WHILE CRITICALLY IMPORTANT TO OVERALL COMMUNITY HEALTH, FOR THE AREA NOT CHOSEN, THERE ARE SERVICE PROVIDERS IN THE COMMUNITY BETTER RESOURCED TO ADDRESS THESE PRIORITIES. THE HOSPITAL WILL WORK COLLABORATIVELY WITH THESE ORGANIZATIONS AS APPROPRIATE TO ENSURE OPTIMAL SERVICE COORDINATION AND UTILIZATION. ADDITIONALLY, THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY TO ASSOCIATES AND PHYSICIANS, WILL CONNECT THOSE IN NEED TO FREE OR REDUCED COST SERVICES SUCH AS MEDICAL CARE, FOOD, JOB TRAINING, TRANSPORTATION, HOUSING, LEGAL, AND MORE. SCHEDULE H, PART V, SECTION B, LINE 11: CONTINUATION FOR LA GRANGE PRIORITY 3: MENTAL HEALTH AND SUBSTANCE USE DISORDERS2019 DESCRIPTION OF THE ISSUE:BEHAVIORAL HEALTH IS A TERM THAT INCLUDES BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY FOR ADULTS, CHILDREN AND ADOLESCENTS. WHEN MENTAL HEALTH DISORDERS ARE UNTREATED, THOSE AFFECTED ARE AT HIGH RISK FOR MANY UNHEALTHY AND UNSAFE BEHAVIORS, INCLUDING ALCOHOL OR DRUG ABUSE, VIOLENT OR SELF-DESTRUCTIVE BEHAVIOR AND SUICIDE. MENTAL HEALTH DISORDERS ARE THE 11TH LEADING CAUSE OF DEATH IN THE UNITED STATES FOR ALL AGE GROUPS AND THE SECOND LEADING CAUSE OF DEATH AMONG PEOPLE AGE 25 TO 34. BEHAVIORAL HEALTH CONTINUES TO BE A PRIMARY CONCERN IN COOK COUNTY. ADDRESSING BEHAVIORAL HEALTH REQUIRES ATTENTION TO SUBSTANCE USE DISORDERS AS WELL AS MENTAL HEALTH. THE ADVENTHEALTH LA GRANGE SERVICE AREA HAS A HIGHER INCIDENCE OF EMERGENCY DEPARTMENT VISITS FOR MENTAL HEALTH AND SUBSTANCE USE DISORDERS.2021 UPDATE: THE ADVENTHEALTH LA GRANGE COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE BEHAVIORAL HEALTH AND SUSTANCE USE PRIORITY. 2. IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.GOAL 1: IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH, THE SAME DIVISION AS THE REPORTING HOSPITAL. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE IS TO INCREASE PERSONS TRAINED IN THE COMMUNITY ON MENTAL HEALTH FIRST AID TO INCREASE IDENTIFICATION OF THOSE IN A CRISIS AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH ISSUES. THIS OBJECTIVE, IS FUNDED AND CONDUCTED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES A TRAINING FOR COMMUNITY RESIDENTS AND FIRST RESPONDERS TO RECOGNIZE, RESPOND AND SEEK ASSISTANCE FOR SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. THE HOSPITALS PROGRESSED ON THEIR SET METRIC OF 220 WITH 8 INDIVIDUALS SERVED. IN 2021 THERE WAS ONLY ONE MHFA FACILITATOR THAT WAS SHARED AMONGST 14 HOSPITALS AND ENDED IN AUGUST. NO FACILITATOR WAS AVAILABLE FOR THE REST OF 2021. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE ACCESS AND ENGAGEMENT IN MENTAL HEALTH SERVICES THAT ARE INTEGRATED IN THE PRIMARY CARE SETTING. THE PARTNERSHIP WITH PILLARS COMMUNITY HEALTH IS FUNDED THROUGH ADVENTHEALTH LA GRANGE AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE COLLABORATION WITH PILLARS COMMUNITY HEALTH PROVIDES ACCESS AND ENGAGEMENT IN MENTAL HEALTH SERVICES THAT ARE INTEGRATED IN THE PRIMARY CARE SETTING. THE PILLARS COMMUNITY HEALTH COLLABORATION IS AN ADVENTHEALTH PROGRAM WHICH INCREASES ACCESS TO MENTAL HEALTH SERVICES BY IDENTIFYING THOSE WITH MENTAL HEALTH NEEDS AND NAVIGATING SERVICES ESPECIALLY TO THE LOW-INCOME POPULATION . A MENTAL HEALTH SCREENING IS INTEGRATED TO ALL PRIMARY CARE VISITS. THROUGH THIS COLLABORATION WITH PILLARS COMMUNITY HEALTH, LOW INCOME/LOW ACCESS COMMUNITIES ARE PROVIDED WITH MENTAL HEALTH SERVICES. THE HOSPITAL EXCEEDED ITS SET METRIC THAT 70% OF PATIENTS IDENTIFIED AS NEEDING A BEHAVIORAL HEALTH APPOINTMENT WILL ENGAGE IN AT LEAST ONE VISIT WITH A BEHAVIORAL HEALTH CONSULTANT WITH 78% OF SUCH PATIENTS SEEN BY A BEHAVIORAL HEALTH CONSULTANT. IN ADDITION, 79% OF PATIENTS AGES 12 AND UP WERE SCREENED FOR DEPRESSION, ANXIETY, SUBSTANCE ABUSE AND DOMESTIC VIOLENCE. IF THE SCREENING IS POSITIVE A FOLLOW UP PLAN IS DOCUMENTED. SIXTY-NINE PERCENT OF PATIENTS AGES 4-11 WERE ALSO SCREENED FOR DEPRESSION, ANXIETY, DOMESTIC VIOLENCE AND DEVELOPMENTAL DELAYS AND IF THE SCREENING WAS POSITIVE A FOLLOW-UP PLAN WAS DOCUMENTED. PRIORITY 4: CHRONIC CONDITION PREVENTION AND MANAGEMENT2019 DESCRIPTION OF THE ISSUE:IN THE UNITED STATES, CHRONIC DISEASES ARE THE LEADING CAUSES OF DISABILITY AND DEATH. IN ADDITION, CHRONIC DISEASE RATES ARE ACCELERATING GLOBALLY ACROSS ALL SOCIOECONOMIC CLASSES. HOWEVER, SOCIOECONOMIC INEQUITIES HAVE PROFOUND IMPACTS ON POPULATIONS AND COMMUNITIES THAT HAVE THE GREATEST BURDEN OF DISEASE. CHRONIC CONDITIONS SUCH AS HEART DISEASE, STROKE, CANCER, DIABETES, ARTHRITIS, ASTHMA, MENTAL ILLNESS, AND HIV/AIDS ACCOUNT FOR 90% OF THE NATION'S $3.3 TRILLION IN ANNUAL HEALTH CARE EXPENDITURES. PREVENTION AND MANAGEMENT OF CHRONIC ILLNESS CAN HELP REDUCE THE COSTLY PHYSICAL AND SOCIOECONOMIC BURDEN OF THESE DISEASES FOR INDIVIDUALS AND SOCIETY AS A WHOLE. THE NUMBER OF INDIVIDUALS IN THE U.S. WHO ARE LIVING WITH A CHRONIC DISEASE IS PROJECTED TO CONTINUE INCREASING WELL INTO THE FUTURE. SIXTY-FIVE PERCENT OF DEATHS IN SUBURBAN COOK COUNTY WERE DUE TO CHRONIC DISEASES. AS A RESULT, IT WILL BE INCREASINGLY IMPORTANT FOR THE HEALTHCARE SYSTEM TO FOCUS ON PREVENTION OF CHRONIC DISEASE AND THE PROVISION OF ONGOING CARE MANAGEMENT.2021 UPDATE: THE ADVENTHEALTH LA GRANGE COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE CHRONIC CONDITION PREVENTION AND MANAGEMENT PRIORITY. 1. PREVENTING AND REDUCING CHRONIC CONDITIONS, WITH A FOCUS ON RISK FACTORS.GOAL 1: PREVENTING AND REDUCING CHRONIC CONDITIONS, WITH A FOCUS ON RISK FACTORS.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE ACCESS TO CARE FOR LOW-INCOME POPULATIONS IN THE LA GRANGE SERVICE AREA FOR THE PREVENTION AND MANAGEMENT OF CHRONIC CONDITIONS. THE COLLABORATION WITH PILLARS COMMUNITY HEALTH IS FUNDED THROUGH ADVENTHEALTH LA GRANGE AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE COLLABORATION WITH PILLARS COMMUNITY HEALTH ADDRESSES CHRONIC HEALTH ISSUES THAT DISPROPORTIONATELY AFFECTS THE LOW INCOME POPULATION, INCLUDING OBESITY AND DIABETES. ADULTS AND YOUTH (3-17) WITH ELEVATED BMI LEVELS WILL RECEIVE A DOCUMENTED FOLLOW UP PLAN INCLUDING NUTRITION AND PHYSICAL ACTIVITY AND COUNSELING SESSIONS. ADULTS WITH DIABETES WILL BE MANAGED TO KEEP HEMOGLOBIN A1C < 9. THE HOSPITAL MET ITS SET METRIC OF 70% OF ADULT PATIENTS DIAGNOSED WITH DIABETES KEEPING THEIR HEMOGLOBIN A1C < 9 WITH 72% OF ADULT PATIENTS DIAGNOSED WITH DIABETES KEEPING THEIR A1C < 9. ACCESS TO NUTRITION AND PHYSICAL ACTIVITY PROVIDES INDIVIDUALS AND FAMILIES THE TOOLS NEEDED TO ADDRESS ISSUES THAT DISPROPORTIONATELY AFFECT THIS TARGET POPULATION. OTHER CHRONIC DISEASES ADDRESSED THROUGH THIS EFFORT HAVE ALSO PROVIDED RESOURCES FOR BODY MASS INDEX (BMI), HYPERTENSION AND ASTHMA. COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH LA GRANGETHE 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?THE FOLLOWING PRIORITIZED HEALTH NEEDS WILL NOT BE DIRECTLY ADDRESSED IN THE 2020-2022 IMPLEMENTATION STRATEGY: MATERNAL & CHILD HEALTH SAFETY, TRAUMA & INJURYWHILE CRITICALLY IMPORTANT TO OVERALL COMMUNITY HEALTH, FOR THE AREAS NOT CHOSEN, THERE ARE SERVICE PROVIDERS IN THE COMMUNITY BETTER RESOURCED TO ADDRESS THESE PRIORITIES. AMITA HEALTH ADVENTIST MEDICAL CENTER LAGRANGE WILL WORK COLLABORATIVELY WITH THESE ORGANIZATIONS AS APPROPRIATE TO ENSURE OPTIMAL SERVICE COORDINATION AND UTILIZATION. ADDITIONALLY, THE PROVISION OF THE AMITA HEALTH COMMUNITY RESOURCE DIRECTORY (AUNT BERTHA) TO OUR ASSOCIATES AND PHYSICIANS, WILL CONNECT THOSE IN NEED TO FREE OR REDUCED COST SERVICES SUCH AS MEDICAL CARE, FOOD, JOB TRAINING, TRANSPORTATION, HOUSING, LEGAL, AND MORE. THIS IMPLEMENTATION STRATEGY WAS APPROVED BY THE ADVENTIST MIDWEST HEALTH BOARD ON JANUARY 23, 2020. THE COLLECTIVE MONITORING, REPORTING PROGRESS AND REVISING WILL ENSURE THE PLAN REMAINS RELEVANT AND EFFECTIVE. SCHEDULE H, PART V, SECTION B, LINE 7A EACH HOSPITAL FACILITY'S CHNA REPORT IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 10A: EACH HOSPITAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 16A,B,C: EACH HOSPITAL'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCEEACH HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY APPLICATION IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCEEACH HOSPITAL FACILITY'S PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCE 23 1 - ADVENTIST HEART & VASCULAR 908 N ELM ST SUITE 404 HINSDALE IL 60521 VASCULAR INTERVENTION CENTER 2 - AMITA WOODRIDGE IMAGING & THERAPY CENTER 2363 63RD ST WOODRIDGE IL 60517 IMAGING & OP REHABILITATION CENTER 3 - HINSDALE IMAGING CENTER 1 SALT CREEK LANE HINSDALE IL 60521 IMAGING CENTER 4 - HEALTH CARE AT HOME 5101 S WILLOW SPRINGS RD 2ND FLOOR LA GRANGE IL 60525 HOME HEALTH CARE 5 - NEW DAY CENTER FOR ADDICTIONSOPTIONS 740 PASQUINELLI DR SUITE 104 WESTMONT IL 60559 BEHAVIORAL HEALTH 6 - ST THOMAS HOSPICE & PALLIATIVE CARE 119 E OGDEN AVE SUITE 111 HINSDALE IL 60521 HOSPICE CARE 7 - ADVENTIST HINSDALE FAMILY MEDICAL CENTER 135 N OAK ST HINSDALE IL 60521 FAMILY MEDICINE CENTER 8 - WESTMONT IMAGING CENTER 6311 S CASS AVE WESTMONT IL 60559 IMAGING CENTER 9 - ADVENTIST PAULSON PEDIATRIC REHAB 222 E OGDEN AVE HINSDALE IL 60521 OUTPATIENT REHABILITATION FACILITY 10 - ADVENTIST PAULSON REHAB - WILLOWBROOK 7229 SOUTH KINGERY HIGHWAY WILLOWBROOK IL 60527 REHABILITATION CENTER 11 - ADVENTIST LA GRANGE FAMILY MEDICAL CENTE 5201 S WILLOW SPRINGS ROAD SUITE 300 LA GRANGE IL 60525 FAMILY MEDICAL CENTER 12 - ADVENTIST LAB PARTNERS 908 N ELM SUITE 116 HINSDALE IL 60521 LAB SERVICE CENTER 13 - ADVENTIST LAB PARTNERS 2323 63RD ST WOODRIDGE IL 60517 LAB SERVICE CENTER 14 - ADVENTIST LAB PARTNERS 235 REMINGTON SUITE G7 BOLINGBROOK IL 60440 LAB SERVICE CENTER 15 - ADVENTIST LAB PARTNERS 6311 S CASS AVE WESTMONT IL 60559 LAB SERVICE CENTER 16 - ADVENTIST LAB PARTNERS 2434 WOLF ROAD WESTCHESTER IL 60154 LAB SERVICE CENTER 17 - ADVENTIST LAB PARTNERS 908 N ELM ST SUITE 210 HINSDALE IL 60521 LAB SERVICE CENTER 18 - ADVENTIST LAB PARTNERS 630 E NORTH AVENUE CAROL STREAM IL 60188 LAB SERVICE CENTER 19 - ADVENTIST LAB PARTNERS 15720 SOUTH ROUTE 59 PLAINFIELD IL 60544 LAB SERVICE CENTER 20 - ADVENTIST LAB PARTNERS 412 63RD ST DOWNERS GROVE IL 60516 LAB SERVICE CENTER 21 - ADVENTIST LAB PARTNERS 130 N OAK ST HINSDALE IL 60521 LAB SERVICE CENTER 22 - ADVENTIST LAB PARTNERS 2425 W 22ND ST SUITE 104 OAKBROOK IL 60523 LAB SERVICE CENTER 23 - AMITA CANCER INSTITUTE-HINSDALE 1 SALT CREEK LANE HINSDALE IL 60521 CANCER TREATMENT CENTER PART I, LINE 3C: EVERY UNINSURED PERSON, REGARDLESS OF INCOME, RECEIVES AN AUTOMATIC 15% DISCOUNT OFF OF CHARGES. PERSONS WHO EARN LESS THAN 600% OF THE FEDERAL POVERTY GUIDELINES ARE GIVEN MORE SIGNIFICANT DISCOUNTS, DEPENDING ON THEIR INDIVIDUAL SITUATIONS.FEDERAL POVERTY LEVEL - 0-200% UNINSURED PATIENT DISCOUNT - 95%FEDERAL POVERTY LEVEL - 201-300% UNINSURED PATIENT DISCOUNT - 75%FEDERAL POVERTY LEVEL - 301-600% UNINSURED PATIENT DISCOUNT - 74%FEDERAL POVERTY LEVEL - > 600% UNINSURED PATIENT DISCOUNT - 74% 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. THE FILING ORGANIZATION IS INCLUDED IN THE SUBMISSION OF THE ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS REPORT IS PREPARED ON A CONSOLIDATED BASIS AND INCLUDES DATA FOR ADVENTIST MIDWEST HEALTH, ADVENTIST GLENOAKS HOSPITAL, AND ADVENTIST BOLINGBROOK HOSPITAL. THESE HOSPITAL ORGANIZATIONS ARE ALL RELATED ORGANIZATIONS. PART I, LINE 7: THE FOLLOWING COSTING METHODOLOGIES WERE USED: - CHARITY AT COST - A COST TO CHARGE METHODOLOGY BASED ON THE MOST RECENTLY FILED MEDICARE COST REPORT WAS USED TO CALCULATE COSTS. - UNREIMBURSED MEDICAID - COSTS ARE CALCULATED USING THE MOST RECENTLY FILED MEDICAID COST REPORT. - OTHER BENEFITS - COSTS ARE DETERMINED BY ACTIVITY REPORTED IN ACCORDANCE WITH GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION. COSTS COULD INCLUDE THE VALUE OF HOURLY WAGES, COSTS OF MATERIALS, VALUE OF SPACE LOANED TO COMMUNITY GROUPS FOR MEETINGS, AND INDIRECT COSTS WHERE APPLICABLE. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES INCLUDE PROGRAMS THAT IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL HAZARDS. PARTICIPATION IN COLLABORATIVE COMMUNITY EFFORTS TO PROMOTE PUBLIC HEALTH INITIATIVES IS ALSO INCLUDED, SUCH AS ENGAGEMENT IN COALITIONS AND ADVOCACY FOR HEALTH IMPROVEMENT. THESE ACTIVITIES STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF ITS RESIDENTS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION. ADVENTIST MIDWEST HEALTH ENGAGES IN A VARIETY OF COMMUNITY-BUILDING ACTIVITIES WHICH ULTIMATELY IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE ARE PRIVILEGED TO SERVE, EVEN THOUGH THEY ARE NOT SPECIFIC HEALTH ACTIVITIES. PART III, LINE 2: AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE FILING ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY AMITA HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE FILING ORGANIZATION'S POLICIES. PART III, LINE 3: THE FILING ORGANIZATION PROACTIVELY WORKS TO PRESUMPTIVELY ASSESS AND GRANT CHARITY TO ALL UNINSURED PATIENTS. THE HOSPITAL SCREENS ALL UNINSURED PATIENTS AGAINST CREDIT SCORE DATA IN ORDER TO PRESUMPTIVELY APPLY ITS FINANCIAL ASSISTANCE POLICY. BASED ON THIS PROCESS, APPROXIMATELY 96% OF THE UNINSURED PATIENT POPULATION IS DEFINED AS ELIGIBLE FOR A PARTIAL CHARITY ADJUSTMENT ON THEIR ACCOUNTS. THE AVERAGE DISCOUNT GIVEN TO THE UNINSURED PATIENT POPULATION IS 81%. IN PRIOR YEARS, PROACTIVE EFFORTS WERE LIMITED TO ONLY THOSE ACCOUNTS WITH BALANCES > $5,000. UNDER THAT SCENARIO, IT WAS ESTIMATED THAT 1/3 OF OUR BAD DEBT PLACEMENTS MAY HAVE BEEN ELIGIBLE FOR CHARITY CARE DISCOUNTS. WITH A MORE COMPREHENSIVE PRESUMPTIVE CHARITY PROGRAM, MANY MORE ACCOUNTS ARE GRANTED CHARITY EARLIER IN THE PROCESS AND PRIOR TO BAD DEBT PLACEMENT. THEREFORE, IT IS ESTIMATED THAT APPROXIMATELY 10% OF OUR CURRENT BAD DEBT PLACEMENTS WOULD BE ELIGIBLE FOR ADDITIONAL CHARITY IF A FULL PRESUMPTIVE CHARITY PROCESS WAS CONDUCTED ACROSS 100% OF OUR SELF-PAY AFTER INSURANCE ACCOUNTS.DISCOUNTS AND PAYMENTS ARE NOT INCLUDED IN BAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS UNLESS THE PAYMENT IS A RECOVERY OF AMOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT. RECOVERIES ARE CLASSIFIED AS A DECREASE TO BAD DEBT EXPENSE.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.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT. PART III, LINE 9B: IT IS THE POLICY OF THE FILING ORGANIZATION TO OFFER PATIENTS A PAYMENT PLAN AND/OR CHARITY ASSISTANCE WHEN IT BECOMES KNOWN OR EVEN SUSPECTED THAT A PATIENT NEEDS FINANCIAL ASSISTANCE. SIGNS AND BROCHURES ARE POSTED IN FACILITY REGISTRATION AREAS. FINANCIAL COUNSELORS ARE NOTIFIED AND EVERY ATTEMPT IS MADE TO CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP THEM COMPLETE A FINANCIAL ASSISTANCE APPLICATION WITH COMPASSION AND DIGNITY. FINANCIAL COUNSELORS WORK WITH PATIENTS TO HELP DETERMINE IF THERE ARE ANY THIRD-PARTY PAYORS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS. THE HOSPITAL WORKS WITH THE PATIENT TO DETERMINE IF THEY ARE ELIGIBLE FOR FEDERAL PROGRAMS INCLUDING MEDICAID, STATE FUNDED PROGRAMS INCLUDING CRIME VICTIMS, ALTERNATIVE INSURANCE INCLUDING COBRA, WORKER'S COMPENSATION AND OR OTHER SPECIALIZED GRANT PROGRAMS SUCH AS OUR MAMMOGRAPHY GRANT PROGRAM FOR LOW INCOME WOMEN. IN THE EVENT NO THIRD-PARTY PROGRAMS ARE IDENTIFIED, THE HOSPITAL THEN WORKS WITH THE PATIENT TO HELP THEM APPLY FOR FINANCIAL ASSISTANCE DISCOUNTS AND PAYMENT PLANS. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE. PART VI, LINE 2: THE FILING ORGANIZATION'S HOSPITALS CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2019 CHNAS WERE ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2019, THE END OF THE FILING ORGANIZATION'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNAS. THE FILING ORGANIZATION'S 2019 CHNAS COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNAS DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITIES. SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. HOSPITAL OPERATING/COMMUNITY BOARDS COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF EACH 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 COMMUNITIES; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITIES. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL FACILITIES ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR EACH HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON EACH OF THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITES. THE WEBSITES INDICATE THAT A COPY OF THE FAP, FAA FORM, AND PLS IS AVAILABLE AND HOW TO OBTAIN SUCH COPIES IN THE PRIMARY LANGUAGES OF ANY POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE MEMBERS OF THE COMMUNITY SERVED BY EACH HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITIES, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS EACH HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT EACH HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF EACH HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN EACH HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITIES' FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL 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: THE FILING ORGANIZATION CURRENTLY OPERATES 2 HOSPITAL FACILITIES, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. BOTH LOCATED IN ILLINOIS, THESE FACILITIES ARE MAJOR HEALTHCARE PROVIDERS IN THE COMMUNITIES THEY SERVE. ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE (AHH), IS LOCATED IN HINSDALE, ILLINOIS. IT CURRENTLY OPERATES A HOSPITAL FACILITY AND IS LICENSED FOR 261 BEDS. IN ADDITION TO OPERATING A HOSPITAL, AHH ALSO OPERATES A CANCER TREATMENT CENTER, 2 IMAGING CENTERS, 2 OUTPATIENT REHABILITATION FACILITIES, 1 BEHAVIORAL HEALTH CENTER, 1 VASCULAR INTERVENTION CENTER, AND 2 FAMILY HEALTH MEDICINE CENTERS. AHH IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. IT IS THE ONLY TEACHING HOSPITAL IN DUPAGE COUNTY, ILLINOIS. MANY OF THE MEDICAL STAFF MEMBERS HOLD TEACHING POSITIONS AT CHICAGO'S PREMIER MEDICAL SCHOOLS AND ACADEMIC MEDICAL CENTERS AND PARTICIPATE IN MEDICAL RESEARCH STUDIES AND CLINICAL TRIALS. PLEASE SEE OUR RESPONSE TO FORM 990 PART III, LINE 4A FOR A DETAILED EXPLANATION OF THE SERVICES AND PROGRAMS OFFERED BY AHH. THE AHH COMMUNITY CONSISTS PRIMARILY OF HINSDALE AND THE SURROUNDING AREA. WE DEFINE THE AHH PRIMARY SERVICE AREA AS THE COLLECTION OF ZIP CODES WHERE APPROXIMATELY 75% OF HOSPITAL PATIENTS RESIDE, AND WE FOCUS OUR COMMUNITY HEALTH IMPROVEMENT ON THIS SERVICE AREA. THE MAJORITY OF THE SERVICE AREA RESIDES IN DUPAGE COUNTY. THE EASTERN PART OF THE SERVICE AREA IS IN SUBURBAN COOK COUNTY. ACCORDING TO US CENSUS DATA (2018) THE POPULATION OF THIS SERVICE AREA IS 660,745. THE AVERAGE AGE IS 41.7 YEARS WITH AN AVERAGE FAMILY INCOME OF $92,006. THE AGE SPREAD OF THE PRIMARY SERVICE AREA IS SIMILAR IN DUPAGE COUNTY, COOK COUNTY AND ILLINOIS. SEVEN PERCENT OF THOSE THAT RESIDE IN THIS SERVICE AREA ARE LIVING IN POVERTY. THE PRIMARY SERVICE AREA OF AHH HAS A SLIGHTLY HIGHER HISPANIC/LATINO POPULATION AND NON-HISPANIC BLACK POPULATION THAN DUPAGE COUNTY.DURING 2021, THE AHH'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 51.7% OF AHH'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 42.5% - MEDICAID PATIENTS 12.6% - SELF-PAY PATIENTS 1.1% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S DUPAGE COUNTY COMMUNITY IS AS FOLLOWS: - POPULATION 929,026 - POPULATION OVER 65 15.67% - POVERTY (BELOW 100% FPL) 6.8% - UNINSURED ADULTS 6.3% - UNINSURED CHILDREN 3% ADVENTHEALTH LA GRANGE (THE HOSPITAL) IS A 186-BED FACILITY PROVIDING OUTPATIENT AND INPATIENT PRIMARY CARE, TRAUMA CARE AND WELLNESS SERVICES TO RESIDENTS OF CHICAGO'S WESTERN SUBURBS. THE HOSPITAL IS A LEADER IN OFFERING COMPREHENSIVE ONCOLOGY SERVICES, ORTHOPEDIC SERVICES, ADVANCED CARDIAC CARE, WOMEN'S HEALTH AND MATERNITY CARE, EMERGENCY, GERIATRIC AND MANY OTHER SPECIALTIES THAT CATER TO THE COMMUNITIES IT SERVES. THE HOSPITAL COMMUNITY CONSISTS PRIMARILY OF LA GRANGE AND THE SURROUNDING AREA. WE DEFINE THE PRIMARY SERVICE AREA (PSA) AS THE COLLECTION OF ZIP CODES WHERE APPROXIMATELY 75% OF HOSPITAL PATIENTS RESIDE, AND WE FOCUS OUR COMMUNITY HEALTH IMPROVEMENT ON THIS SERVICE AREA. THE MAJORITY OF THE SERVICE AREA POPULATION RESIDES IN SUBURBAN COOK COUNTY WITH PART OF THE WESTERN SERVICE AREA IN DUPAGE COUNTY. ACCORDING TO US CENSUS DATA (2018) THE POPULATION OF THIS SERVICE AREA IS 452,150. THE AVERAGE AGE IS 39.4 YEARS WITH AN AVERAGE FAMILY INCOME OF $77,969. THE AGE SPREAD OF THE PRIMARY SERVICE AREA IS SIMILAR TO DUPAGE COUNTY, COOK COUNTY AND ILLINOIS. TEN PERCENT OF THOSE THAT RESIDE IN THIS SERVICE AREA ARE LIVING IN POVERTY. LA GRANGE AND ITS SURROUNDING AREAS ARE ROUGHLY EQUALLY SPLIT BETWEEN HISPANIC/LATINO AND NON-HISPANIC WHITE POPULATIONS. 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 80.6% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 56.5% - MEDICAID PATIENTS 11.4% - SELF-PAY PATIENTS 1.5% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COOK COUNTY COMMUNITY IS AS FOLLOWS: - POPULATION 5,132,480 - POPULATION OVER 65 14% - POVERTY (BELOW 100% FPL) 16% - UNEMPLOYMENT RATE 10% - POP. AGE 25+ WITH NO HIGH SCHOOL DIPLOMA 15% - UNINSURED ADULTS 11% - UNINSURED CHILDREN 4% PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ORGANIZATION'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE FILING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE FILING ORGANIZATION CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. THE FILING ORGANIZATION 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 FILING ORGANIZATION EXPENDED $14,786,811 IN NEW CAPITAL IMPROVEMENTS. AS FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITALS, THE FILING ORGANIZATION IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITIES, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE FILING ORGANIZATION ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITIES. PART VI, LINE 6: 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. THE FILING ORGANIZATION IS ALSO A COVERED AFFILIATE OF A JOINT OPERATING COMPANY THAT DOES BUSINESS UNDER THE NAME OF AMITA HEALTH. AMITA HEALTH HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION UNDER IRC SECTION 501(C)(3). AMITA HEALTH PROVIDES VARIOUS MANAGEMENT AND EXECUTIVE SUPPORT SERVICES TO THE FILING ORGANIZATION. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AMITA HEALTH AND BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING THE 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 AS A COVERED AFFILIATE OF AMITA HEALTH AND AS PART OF A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITALS 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. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY THE FILING ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH OR OF AMITA HEALTH 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, REPORTS FILED WITH STATES IL 1 PRESENCE SENIOR SERVICES CHICAGOLAND DBA ASCENSION LIVING 18927 HICKORY CREEK DR STE 300 MOKENA IL 60448 237061646 501(C)(3) 5904 0 MEDICAL CARE DUPAGE HEALTH COALITION 511 THORNHILL DR STE E CAROL STREAM IL 60188 364448208 501(C)(3) 231791 0 GENERAL SUPPORT HINSDALE ADVENTIST ACADEMY 631 E HICKORY ST HINSDALE IL 60521 364090219 501(C)(3) 10000 0 GENERAL SUPPORT HINSDALE CHAMBER OF COMMERCE 22 E FIRST ST HINSDALE IL 60521 362030214 501(C)(6) 8000 0 GENERAL SUPPORT HINSDALE HOSPITAL FOUNDATION 7 SALT CREEK LANE HINSDALE IL 60521 521466387 501(C)(3) 0 174939 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT ILLINOIS PUBLIC HEALTH INSTITUTE 310 S PEORIA ST STE 404 NO 4 CHICAGO IL 60607 262757523 501(C)(3) 18700 0 PAYMENT FOR SERVICES MIDWEST HEALTH FOUNDATION 120 N OAK STREET HINSDALE IL 60521 352230515 501(C)(3) 0 849404 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT THE COMMUNITY HOUSE 415 W 8TH ST HINSDALE IL 60521 362167735 501(C)(3) 15000 0 GENERAL SUPPORT PILLARS COMMUNITY HEALTH 333 NORTH LA GRANGE RD LAGRANGE PARK IL 60526 364166490 501(C)(3) 50000 0 GENERAL SUPPORT 8 1 PAYMENTS FOR NURSING HOME/REHABILITATION POST-HOSPITAL STAY CHARGES 3 18270 PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3), 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, OR TO OTHER 501(C)(3) COMMUNITY ORGANIZATIONS INVOLVED IN HEALTH-RELATED CAUSES. 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. X X X X 1 1 0 1 0 0 0 0 0 0 0 HAFFNER PHD RANDALL DIR/CHAIRMAN (END 2/21) 0 1446809 0 989082 0 1184218 0 165548 0 43625 0 3829282 0 243228 SNYDER BRENT DIRECTOR 0 823942 0 460754 0 502194 0 15548 0 25837 0 1828275 0 277454 BACON KENNETH DIRECTOR (BEG 3/21) 0 840732 0 8687 0 228614 0 169010 0 32952 0 1279995 0 0 THORDARSON THOR DIR/PRES/SEC/EVP & COO 694451 0 350000 0 113256 0 15950 0 20214 0 1193871 0 0 0 MURRILL MICHAEL CEO HINSDALE/LA GRANGE 0 587700 0 93590 0 19324 0 117171 0 43792 0 861577 0 0 BUCHANAN HERBERT DIRECTOR 47886 430978 17106 153952 7416 66740 580 5220 6786 61078 79774 717968 0 0 CARROLL MD RICHARD CMO BOLINGBROOK/GLENOAKS 395099 0 82330 0 77605 135352 18850 0 18712 0 592596 135352 0 0 CHRISTIAN BRUCE PRES/CEO BOLINGBROOK.GLENOAKS 397427 0 142370 0 59436 0 18850 0 18990 0 637073 0 0 0 MAYCOCK ADAM CEO HINSDALE/LA GRANGE 390974 0 138816 0 46527 0 18850 0 28728 0 623895 0 0 0 ROEHR RICHARD PRESIDENT - AFFILIATED ENTITY 363889 0 122038 0 32737 0 18850 0 30552 0 568066 0 0 0 MURPHY MARY CNO HINSDALE/LA GRANGE 351316 0 100444 0 45376 0 18850 0 11030 0 527016 0 0 0 NAND MD BELA CMO HINSDALE/LA GRANGE 372719 0 77250 0 24718 0 14500 0 10122 0 499309 0 0 0 RADIVOJEVIC VLADIMIR COO BOLINGBROOK/GLENOAKS 256062 0 54704 0 12790 0 15950 0 30149 0 369655 0 0 0 PALERMO MARY ANN VP/PATIENT SAFETY AND QUALITY 269047 0 55123 0 15500 0 18333 0 3131 0 361134 0 0 0 STILL DANAE CFO 201446 0 29924 0 184 0 11988 0 37337 0 280879 0 0 0 DE RAMOS DO DAVID DIRECTOR 0 128341 0 0 0 65343 0 11297 0 17550 0 222531 0 0 PART I, LINE 1A 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 THE FILING ORGANIZATION. THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE TOP-TIER PARENT OF ADVENTHEALTH IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AS PART OF ADVENTHEALTH, THE FILING ORGANIZATION ADHERES TO CERTAIN AHSSHC POLICIES REGARDING ITS EXECUTIVES. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING 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: NOMINAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING ($300 OR LESS PER EXECUTIVE). PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: IN PRIOR YEARS, AHSSHC PROVIDED HOUSING ASSISTANCE IN THE FORM OF A SHARED EQUITY INTEREST IN A RESIDENCE TO ELIGIBLE EXECUTIVES WHO WERE EXPECTED TO LIVE WITHIN THE IMMEDIATE PROXIMITY OF HOSPITAL FACILITIES LOCATED IN HIGH-COST COMMUNITIES. AS WITH ALL AHSSHC CORPORATE EXECUTIVE POLICIES, THE HOUSING BENEFIT POLICY WAS ORIGINALLY AUTHORIZED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE AHSSHC BOARD OF DIRECTORS. THIS HOUSING ASSISTANCE POLICY WAS RETIRED IN 2018. AT THE TIME OF THE HOUSING ASSISTANCE POLICY'S RETIREMENT, THERE WAS ONLY ONE ELIGIBLE EXECUTIVE THAT IS LISTED ON PART VII OF THIS RETURN THAT REMAINS A PARTICIPANT IN THIS PROGRAM. THE APPROPRIATE ANNUAL DOLLAR AMOUNT OF THE HOUSING BENEFIT PROVIDED TO THE REMAINING ELIGIBLE EXECUTIVE IS TREATED AS TAXABLE COMPENSATION TO THE EMPLOYEE. PART I, LINE 3 THE FILING ORGANIZATION IS A COVERED AFFILIATE OF THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. D/B/A AMITA HEALTH (AMITA). AMITA UTILIZES VARIOUS COMPARABILITY DATA IN ESTABLISHING COMPENSATION FOR THOSE EXECUTIVES THAT PERFORM SERVICES FOR AMITA AND FOR ONE OR MORE COVERED AFFILIATES. COMPARABILITY DATA UTILIZED INCLUDES COMPENSATION SURVEYS AND STUDIES AND THE FORMS 990 OF OTHER UNRELATED COMPARABLE ORGANIZATIONS. AMITA ALSO HAS A COMPENSATION COMMITTEE THAT APPROVES ALL RELEVANT EXECUTIVE COMPENSATION. THE COMPENSATION OF THE FILING ORGANIZATION'S CEO WAS DETERMINED AND APPROVED BY AMITA'S EXECUTIVE COMPENSATION COMMITTEE. PART I, LINE 4B LINE 4B: RANDALL HAFFNER, BRENT SNYDER, KENNETH BACON, RICHARD CARROLL, MD, AND MICHAEL MURRILL RECEIVED COMPENSATION IN 2021 FROM ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE TOP-TIER PARENT OF THE FILING ORGANIZATION AND THE PARENT ORGANIZATION OF A 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. 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. RANDALL HAFFNER, PHD $ 150,000 $ 304,926 $ 829,185 $ 0 BRENT SNYDER $ 150,000 $ 444,551 $ 0 $ 0 KENNETH BACON $ 0 $ 0 $ 0 $ 153,462 RICHARD CARROLL, MD $ 0 $ 0 $ 135,352 $ 0 MICHAEL MURRILL $ 0 $ 0 $ 0 $ 107,423 * INCLUDING INVESTMENT EARNINGS HERBERT BUCHANAN WAS COMPENSATED BY ALEXIAN BROTHERS HEALTH SYSTEM IN 2021 FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. ALEXIAN BROTHERS HEALTH SYSTEM IS AFFILIATED WITH THE FILING ORGANIZATION. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 7B FOR A DISCUSSION CONCERNING THE FILING ORGANIZATION'S AFFILIATION WITH ALEXIAN BROTHERS HEALTH SYSTEM THROUGH THE JOINT OPERATING COMPANY KNOWN AS AMITA HEALTH. COMPENSATION FOR THESE INDIVIDUAL'S SERVICES PROVIDED TO THE FILING ORGANIZATION IS DISCLOSED IN PART VII, LINE 1A, AND SCHEDULE J, PART II. JOLENE WRIGHT FAMILY OF BOARD MEMBER 48707 EMPLOYEE COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 6 ADVENTIST MIDWEST HEALTH (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI 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 MEMBERS OF THE BOARD OF DIRECTORS (GOVERNING BOARD) OF THE FILING ORGANIZATION ARE APPOINTED BY THE CORPORATE MEMBER, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. THE CORPORATE MEMBER IS ENTITLED TO ELECT NOT LESS THAN EIGHTEEN (18) AND NO MORE THAN TWENTY THREE (23) VOTING MEMBERS TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION PURSUANT TO THE PROVISIONS OF THE BYLAWS, SUBJECT TO THE RATIFICATION OF THE AMITA HEALTH BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FILING ORGANIZATION IS ONE OF TWO MEMBERS AND IS A COVERED AFFILIATE OF THE JOC KNOWN AS AMITA HEALTH. THE OTHER MEMBER OF AMITA HEALTH IS ALEXIAN BROTHERS HEALTH SYSTEM. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). THE TOP-TIER PARENT OF AMH IS AHSSHC (SPONSOR). THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION PROVIDE FOR CERTAIN RESERVED POWERS TO EXERCISE FINANCIAL, MANAGERIAL, AND OPERATIONAL AUTHORITIES OVER THE FILING ORGANIZATION BY AHSSHC, AS SPONSOR, BY AHSSI AS MEMBER, BY BOTH MEMBERS OF THE JOC, NAMELY, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (MEMBERS), AND BY THE BOARD OF DIRECTORS OF THE JOC. CERTAIN GOVERNANCE POWERS ARE RESERVED TO AHSSI AS THE MEMBER OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE ALTERATION, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION, BYLAWS OR MISSION STATEMENT OF THE FILING ORGANIZATION, PROVIDED THAT SUCH ACTIONS ARE NOT INCONSISTENT WITH THE JOC BYLAWS OR THE AFFILIATION AGREEMENT AND THE APPOINTMENT OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION OF THE JOC BOARD OF DIRECTORS. FINANCIAL AUTHORITIES RESERVED TO THE SPONSOR, THE BOARD OF DIRECTORS OF THE JOC, AND BY BOTH MEMBERS OF THE JOC INCLUDE THE APPROVAL OF ANY DISPOSITION OF THE FILING ORGANIZATION'S ASSETS AND ANY INTERNAL TRANSFER OF THE FILING ORGANIZATION'S ASSETS. THE SPONSOR, THE BOARD OF DIRECTORS OF THE JOC, AND BOTH MEMBERS OF THE JOC MAY APPROVE SUCH DISPOSITIONS OR TRANSFERS UP TO ESTABLISHED ASSET DOLLAR VALUES AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION MUST BE RATIFIED BY BOTH SPONSORS OF THE JOC. THE BOARD OF DIRECTORS OF THE JOC MUST APPROVE ANY CAPITAL EXPENDITURE TO BE MADE BY THE FILING ORGANIZATION IN EXCESS OF $10 MILLION. OPERATIONAL AUTHORITIES RESERVED TO THE BOARD OF DIRECTORS OF THE JOC INCLUDE THE DETERMINATION OF THE SERVICES TO BE PROVIDED BY THE FILING ORGANIZATION, INCLUDING THE AUTHORITY TO DIRECT THE EXPANSION, REDUCTION AND CONSOLIDATION OF CLINICAL PROGRAMS, PATIENT CARE SERVICES AND ADMINISTRATIVE CAPABILITIES OR OTHER MAJOR CHANGES IN THE OPERATION OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, 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 CONFLICT OF INTERESTS, 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 ON THE PAYROLL OF THE FILING ORGANIZATION, HOWEVER THE COMPENSATION PACKAGE OF THESE EXECUTIVES IS DETERMINED BY THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. DBA AMITA HEALTH. AS NOTED IN OUR RESPONSE TO PART VI, SECTION A, LINE 7B, THE FILING ORGANIZATION IS A COVERED AFFILIATE IN THE JOC KNOWN AS AMITA HEALTH. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY AMITA HEALTH 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 (NOT INCLUDING PHYSICIAN MEMBERS OF THE BOARD) 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 WITHIN ADVENTHEALTH OR AMITA HEALTH. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. FORM 990, PART VIII, LINES 7A, B AND C: THE AMOUNTS SHOWN IN PART VIII, LINES 7A(I) AND 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 16,321,971. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,321,971. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,279,367. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,279,367. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 7,492,663. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,492,663. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 7,591,934. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,591,934. RECRUITING: PROGRAM SERVICE EXPENSES 60,910. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,910. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 7,789,952. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,789,952. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 26,370,236. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,370,236. ADVENTHEALTH MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 17,693,799. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,693,799. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 15,926,815. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,926,815. PART X, LINE 2 THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. FORM 990, PART XI, LINE 9: INTEREST IN FOUNDATION 1,687,162. TRANSFER TO TAX-EXEMPT PARENT -10,765,445. TRANSFER OF NET ASSETS RELEASED FROM RESTRICTIONS -25,000. NET FUNDS RELEASED FROM RESTRICTIONS 519,567. TRANSFERS TO RELATED TAX-EXEMPT ENTITIES -218,823. TEMPORARILY RESTRICTED GIFTS 42,505. OTHER -7,649. 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