2021-11-15T20:41:30-06:00 2020-12-31 990 2020-01-01 591479658 Adventist Health SystemSunbelt Inc ADVE 4073572317 900 Hope Way Altamonte Springs FL 32714 Lynn C Addiscott Asst. Secretary 4073572317 2021-11-15 Lynn Addiscott 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Terry Shaw 900 Hope Way Altamonte Springs FL 32714 4834488128 0 1071 X www.adventhealth.com X 1973 FL Operation of 11 acute-care hospitals & related healthcare services. 22 16 31944 2331 15945467 257396 31146379 213695716 4523075663 4562883817 118616621 33458778 21068685 16434372 4693907348 4826472683 23069970 23860271 0 0 1799684813 1863860613 0 0 0 2176601308 2562510999 3999356091 4450231883 694551257 376240800 8921698765 9561434235 4010328109 4198376273 4911370656 5363057962 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 4053421963 23860271 4562023014 Operation of 11 acute care hospitals with 139,632 patient admissions, 755,751 patient days and 1,247,836 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab. 4053421963 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 1 1 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 31944 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 22 16 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X Paul Rathbun 4073572419 900 Hope Way Altamonte Springs FL 32714 X Rathbun Paul C Dir(end 9/20)/AdventHealth CFO 1.00 50.00 X X 0 4358321 210783 Shaw Terry D Dir/President/AdventHealth CEO 1.00 50.00 X X 0 2994533 203959 Tol Daryl Dir(end 9/20)/CEO AH Central FL Div 1.00 50.00 X 0 1986560 203471 Silvestry MD Scott Phy/Dir AH Thoracic Transplant 75.00 0.00 X 1861106 0 43107 Banks David Former Key Emp - SEVP/CSO 0.00 50.00 X 0 1490148 186218 Moorhead MD David Former Key Emp - SEO/CCO 0.00 50.00 X 0 1585029 28788 Accola MD Kevin Exec Med Dir/Cardio Surgery & Structual Heart Prog 55.38 0.00 X 1570134 0 38477 Goodman Todd A CFO AH Central FL Division 1.00 50.00 X 0 1387075 180479 Palmer MD George Med Dir/ AH Celebration Cardio Surgery Prog 46.15 0.00 X 1384314 0 36152 Soler Eddie Former Key Emp - EVP/SFO 0.00 50.00 X 0 1210478 187520 Stevens Eric A Former Key Emp/CEO CFD So Acute Care Srvs 0.00 0.00 X 0 1243941 43082 Davis JR MD Robert Phy/Dir AH Cardovascular 70.00 0.00 X 1202484 0 24481 Botta MD Donald Phy/Dir AH Heart Transplant 40.00 0.00 X 1032515 0 36081 Finkler Neil CMO AH CFD So Acute Care Srvs 50.00 0.00 X 0 840582 117695 Thompson Michael J CEO AH CFD Integrated Hlth Srvs 40.00 10.00 X 0 795081 120318 Hilliard Douglas W CFO AH CFD South Region 50.00 0.00 X 0 783979 109918 Wandersleben Jennifer J CEO AH CFD So Acute Care Srvs 50.00 0.00 X 0 701360 142144 Owen Terry R Former Key Emp/SVP Partnering Strategy 0.00 50.00 X 0 795875 45284 Cook Timothy W CEO AH Alt & Seminole Mkt 50.00 0.00 X 0 693864 106224 Spenst Brett CEO AH Orlando (end 11/20) 50.00 0.00 X 0 683757 98097 Harcombe Douglas W CEO AH Celebration & Osecola Mkt 50.00 0.00 X 0 621167 112728 Zbaraschuk Amy L CFO AH CFD Integrated Hlth Srvs 50.00 0.00 X 0 622263 106676 Hagensicker Janice K Former Key Emp/Sr Fin Off AH Orl SW 0.00 50.00 X 0 656866 40454 Moorhead Sheryl D AH CFD Chief People Officer 50.00 0.00 X 0 642669 29471 Deininger Robert CEO AH Orlando (beg 11/20) 50.00 0.00 X 0 552840 107708 Villanueva Jeffrey CEO AH E Orl & E Orange Mkt 50.00 0.00 X 0 486926 96115 Jernigan PhD Donald L Dir/CEO Emeritus (end 3/20) 1.00 1.00 X 0 443591 5635 Reed MD Monica P Former Key Employee 0.00 0.00 X 8280 366974 25227 Bradley Kenneth W Former Kep Emp/AH Dir Emerging Leadership 0.00 50.00 X 0 182976 33011 Bigalke John T Director (beg 9/20) 1.00 1.00 X 0 33482 0 Cherry MD Robert A Director (beg 9/20) 1.00 1.00 X 0 10790 0 Johnson Tidjani Michelle Director (beg 9/20) 1.00 1.00 X 0 8924 0 Tikker Blair Director (beg 9/20) 1.00 1.00 X 0 8924 0 Freedman David Director 1.00 1.00 X 0 4464 0 Page John M Director (end 9/20) 1.00 1.00 X 0 4281 0 Moore MDiv Larry R Vice Chairman/Sec/Dir 1.00 2.00 X 0 4176 0 Thurber Gary F Vice Chairman/Director 2.00 2.00 X 0 4161 0 Smith DMin PhD Ron C Chairman/Director 2.00 2.00 X 0 4159 0 Poenitz Steven N Director (end 9/20) 1.00 1.00 X 0 4104 0 Griffith Jr Buford Director 1.00 2.00 X 0 4081 0 Valentine II MDiv Maurice R Vice Chairman/Director 2.00 2.00 X 0 4072 0 Peoples Troy K Director (end 9/20) 1.00 2.00 X 0 4002 0 Scott Glynn CW Director 1.00 2.00 X 0 3974 0 Werner Thomas L Director 1.00 3.00 X 0 3954 0 Webb Gil Director (end 12/20) 1.00 1.00 X 0 3854 0 Davidson James R Director (end 9/20) 1.00 1.00 X 0 3849 0 Shaw EdD Kenneth Director 1.00 2.00 X 0 2852 0 Aguilera Ronald Director (end 9/20) 1.00 2.00 X 0 2851 0 Barnett D Edward Director (beg 9/20) 1.00 1.00 X 0 2749 0 Lyons Justin C Director (beg 9/20) 1.00 1.00 X 0 2731 0 Van Schaik Vic Director (beg 9/20) 1.00 1.00 X 0 2731 0 Bernard Roger A Director (beg 9/20) 1.00 2.00 X 0 2715 0 Carlson Ronald Director (end 9/20) 1.00 4.00 X 0 2656 0 Craig Carlos J Director (end 9/20) 1.00 1.00 X 0 2624 0 Machado Allan Director 1.00 2.00 X 0 2424 0 Johnson MD Mark Director (end 9/20) 1.00 1.00 X 0 1837 0 Brown-Fraser PhD RD Sherine R Director (end 9/20) 1.00 1.00 X 0 1801 0 Devore Susan D Director (beg 9/20) 1.00 1.00 X 0 0 0 Morgan William H Director (beg 9/20) 1.00 1.00 X 0 0 0 7058833 26270077 2719303 2160 1 1 0 Brasfield & Gorrie LLC 941 West Morse Blvd Suite 200 Winter Park FL 32789 Design and Construction Services 111407994 Engie Insight Services Inc 1313 N Atlantic St Suite 5000 Spokane WA 99201 Professional Services (Energy Strategy) 37932038 AMN Healthcare Inc 1950 Sawtelle Blvd Suite 120 Los Angeles CA 90025 Healthcare Staffing Services 25032907 Trane US Inc PO Box 406469 Atlanta GA 30384 Construction/Energy Services 19485802 Batson-Cook Company 2859 Paces Ferry SE Suite 200 Atlanta GA 30339 Design and Construction Services 14996881 505 X 6611327 199794276 7290113 213695716 Patient Revenue 622110 4504937879 4491429392 13508487 Rent from Exempt Affiliates 622110 19827618 19827618 Cafeteria/Vending Rev. 622110 11872826 11787571 85255 Laundry 622110 7595248 7511743 83505 Gift Shop 622110 5412418 5403855 8563 13237828 11116396 2121432 4562883817 33477104 33477104 139812 139812 3007635 44449 1691607 12356 1316028 32093 1348121 138225 1209896 730 6292426 1093766 5217716 -1093036 1074710 -18326 -18326 Equity earnings from related enti 622110 10416428 10416428 Investment in Subs 622110 4530011 4530011 14946439 4826472683 4562023014 15945467 34808486 X 22529137 22529137 1331134 1331134 12329164 12329164 1371379475 1351140066 20239409 57256751 56010412 1246339 317701143 305792112 11909031 105194080 102875451 2318629 5494735 5494735 878214 878214 5902507 5902507 630328500 504448727 125879773 61260188 61260188 184485776 153652856 30832920 173232072 159298875 13933197 105642343 105642343 3695815 127412 3568403 671599 671599 27656448 27656448 233374957 233374957 33751700 33086735 664965 Medical Supplies 793050390 793050390 Assessments 93597878 93597878 Repairs/Maintenance 93079131 93079131 UBI Tax 278641 278641 116130105 16727899 99402206 4450231883 4053421963 396809920 0 X 91546 93806 2917094143 3085669421 652396165 692175855 109133897 181578520 39071767 39503014 5396576477 2408623707 2777298055 2987952770 7172830 11702841 28585967 25490949 2390854395 2537267059 8921698765 9561434235 330251271 371315945 3356609779 3251968063 323467059 575092265 4010328109 4198376273 X 4909860928 5362777186 1509728 280776 4911370656 5363057962 8921698765 9561434235 X 376240800 46747524 28698982 X 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 173050 173050 0 Part II-B, Line 1: The corporation paid dues to the American Hospital Association, Florida Hospital Association, Texas Hospital Association, and Association of Organ Procurement who use a portion of the dues to conduct lobbying activities. 20731829 50000 1197926 632443 21347312 20471913 50000 1196289 526694 21191508 19274406 100000 1099218 1711 20471913 19390999 166685 1051467 9029 20600122 19118543 568450 277615 573609 19390999 0.92350 0.07650 0.00000 0 1 1 264206155 264206155 1950189591 739051523 1211138068 2779403491 1613592922 1165810569 402777240 55979262 346797978 2987952770 Due From Related/Affiliated Entities 17390431 Long-term Investments 189853153 Other Non-Current Assets 225388247 Receivable - Interco Alloc of Tax-Exempt Bond Proceeds 1915960358 Receivable from Third Party 59362902 Board Designated Funds 100 Other Current Receivables 129311868 2537267059 Payable to Third Party 50967779 Due to Related/Affiliated Entities 118475413 Other Current Liabilities 207693492 Other Non-Current Liabilities 197876377 Notes and Loans Payable 79204 575092265 X Part V, Line 4: All endowment funds are held by related 501(c)(3) exempt foundations. These endowment funds have been established for a variety of purposes in support of related tax-exempt hospitals. All of the foundation's permanently restricted endowment funds are required to be retained permanently either by explicit donor stipulation or by the Florida Uniform Prudent Management of Institutional Funds Act. Part V, line 1a, column (a) Current year - Explanation for change in opening balance: During 2021 it was determined that endowments in the amount of $459,679, received prior to 2020, should be excluded as these funds do not represent endowments held for the benefit of the filing organization. As a result, the filing organization restated the beginning endowment fund balance in its 2020 tax year. Part V, line 1a, column (c) Two years back - Explanation for change in opening balance: During 2018, it was determined that an Endowment in the amount of $1,325,716 received prior to 2018 should be reclassified from permanent endowment to a temporarily restricted asset. Part X, Line 2: The filing organization is a subsidiary organization within AdventHealth. The consolidated financial statements of AdventHealth contain the following FIN 48 (ASC 740) footnote: Please note that dollar amounts are in thousands. Healthcare Corporation and its affiliated organizations, other than North American Health Services, Inc. and its subsidiary (NAHS), are exempt from state and federal income taxes. Accordingly, Healthcare Corporation and its tax-exempt affiliates are not subject to federal, state or local income taxes except for any net unrelated business taxable income. NAHS is a wholly owned, for-profit subsidiary of Healthcare Corporation. NAHS and its subsidiary are subject to federal and state income taxes. NAHS files a consolidated federal income tax return and, where appropriate, consolidated state income tax returns. All taxable income was fully offset by net operating loss carryforwards for federal income tax purposes; as such, there is no provision for current federal or state income tax for the years ended December 31, 2020 and 2019. NAHS also has temporary deductible differences of approximately $41,800 and $46,500 at December 31, 2020 and 2019, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2020, NAHS had net operating loss carryforwards of approximately $43,500, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $10,200 and $11,400 at December 31, 2020 and 2019, 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, 2020 and 2019 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, 2020 and 2019. On December 22, 2017, the United States enacted tax reform legislation commonly known as the Tax Cuts and Jobs Act (Act), resulting in significant modifications to existing law. Certain provisions impact tax-exempt organizations, including revisions to taxes on unrelated business activities, excise taxes on compensation of certain employees, and various other provisions. The impact of these provisions on the consolidated financial statements is not, and is not expected, to be significant. 0 Central America and the Caribbean Grantmaking 839162 Central America and the Caribbean Program Services Mission Trips, Wheelchair Fitting, etc. 36547 East Asia and the Pacific Grantmaking 24940 East Asia and the Pacific Program Services Mission Trips 22957 Europe (including Iceland and Greenland) Meetings 6795 Middle East and North Africa Meetings 1476 Middle East and North Africa Grantmaking 34444 North America (which includes Canada and Mexico, but not the U.S.) Grantmaking 39128 North America (which includes Canada and Mexico, but not the U.S.) Meetings 892 North America (which includes Canada and Mexico, but not the U.S.) Program Services Mission Trips, Cleft Clinic 15352 South America Grantmaking 217420 South America Meetings 2386 South America Program Services Travel for Global Mission 3899 Sub-Saharan Africa Grantmaking 178352 Sub-Saharan Africa Program Services Mission Trips 2035 South Asia Grantmaking 17500 South Asia Program Services 935 0 0 0 0 0 0 1005449 438771 1444220 Central America and the Caribbean Medical Supplies or Equipment 13500 Medical Supplies Other East Asia and the Pacific Medical Supplies or Equipment 16800 Book Central America and the Caribbean Medical Supplies or Equipment 20600 Medical Supplies Other Middle East and North Africa Medical Supplies or Equipment 15766 Medical Supplies Other Middle East and North Africa Medical Supplies or Equipment 18678 Medical Supplies Other Central America and the Caribbean Medical Supplies or Equipment 9907 Medical Supplies Book Central America and the Caribbean Medical Supplies or Equipment 44542 Medical Supplies Other South America Medical Supplies or Equipment 149398 Book South America Other 9530 Other Other South America Medical Supplies or Equipment 26887 Book Sub-Saharan Africa Medical Supplies or Equipment 6243 Medical Supplies Other South Asia General Support 17500 Book South America Medical Supplies or Equipment 11006 Medical Equipment Other Central America and the Caribbean Medical Supplies or Equipment 66988 Medical Supplies Other Central America and the Caribbean Other 362199 Book Central America and the Caribbean Medical Supplies or Equipment 205444 Medical Supplies Other North America (which includes Canada and Mexico, but not the U.S.) Medical Supplies or Equipment 23219 Medical Supplies Other North America (which includes Canada and Mexico, but not the U.S.) Medical Supplies or Equipment 5832 Medical Supplies Book South America Medical Supplies or Equipment 14430 Medical Supplies Other Sub-Saharan Africa School Construction 156958 Book Sub-Saharan Africa Medical Supplies or Equipment 13211 Medical Supplies Other Central America and the Caribbean Medical Supplies or Equipment 46340 Medical Supplies Other East Asia and the Pacific Medical Supplies or Equipment 7550 Medical Supplies Other Central America and the Caribbean Medical Supplies or Equipment 54819 Medical Supplies Other Central America and the Caribbean Medical Supplies or Equipment 8000 0 Book 25 General Support North America 1 5788 Cash Payment Book 1 0 0 0 0 0 Part I, Line 2: Foreign grants are generally non-cash donations of medical equipment and supplies to assist foreign health care providers in fulfilling their mission of providing health care services to the populations they serve. The foreign health care providers are often hospitals and/or clinics operated and/or sponsored by or affiliated with the Seventh-Day Adventist Church. The foreign hospitals/clinics may be located in remote and/or underserved villages and townships of developing countries. Grants are typically made to other U.S. charitable organizations or foreign entities recognized as charitable by the foreign country in which they are located. As a result of the nature of the grants as non-cash medical equipment and supplies and the fact that most grants are made indirectly through other U.S. or foreign charitable organizations, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States. Part III Accounting Method: 1 1 X 1 X 0 1 1 0 1 0 204271827 204271827 0.04590 658506131 340719244 317786887 0.07140 862777958 340719244 522058714 0.11730 26145000 22282 26122718 0.00590 46658203 9985227 36672976 0.00820 12511016 11519513 991503 0.00020 5476241 4153681 1322560 0.00030 22582465 22582465 0.00510 113372925 25680703 87692222 0.01970 976150883 366399947 609750936 0.13700 34047796 7178281 26869515 0.00600 150628 100 150528 0.00000 53582 53582 0.00000 34252006 7178381 27073625 0.00600 1 188833913 16279137 718961591 845518321 -126556730 X 1 1 1 San Marcos MRI LP Imaging Center 0.60000 0.00000 0.40000 2 Central Texas Ambulatory Endoscopy Endoscopy Center 0.18800 0.00000 0.81200 3 Surgery Management Associates of Kissimmee LLC Management/Admin 0.30000 0.00000 0.70000 11 1 AdventHealth Orlando 601 E Rollins Street Orlando FL 32803 www.adventhealth.com/hospital/adventh 4369 X X X X X X Therapy Center, EPS Cath Lab, 4 Off-site EDs A 2 AdventHealth Celebration 400 Celebration Place Celebration FL 34747 www.adventhealth.com/hospital/adventh 4369 X X X X Therapy Center A 3 AdventHealth Altamonte Springs 601 E Altamonte Drive Altamonte Springs FL 32701 www.adventhealth.com/hospital/adventh 4369 X X X X Cancer Center, Therapy A 4 AdventHealth East Orlando 7727 Lake Underhill Road Orlando FL 32822 www.adventhealth.com/hospital/adventh 4369 X X X X A 5 AdventHealth Winter Park 200 N Lakemont Avenue Winter Park FL 32792 www.adventhealth.com/hospital/adventh 4369 X X X X A 6 AdventHealth Kissimmee 2450 North Orange Blossom Trail Kissimmee FL 34744 www.adventhealth.com/hospital/adventh 4369 X X X X A 7 AdventHealth Sebring 4200 Sun N Lake Blvd Sebring FL 33825 www.adventhealth.com/hospital/adventh 4171 X X X B 8 AdventHealth Apopka 2100 Ocoee-Apopka Road Apopka FL 32703 www.adventhealth.com/hospital/adventh 4369 X X X X A 9 AdventHealth Lake Placid 1210 US Highway 27 North Lake Placid FL 33852 www.adventhealth.com/hospital/adventh 4171 X X X Senior Behavioral Unit, Outpatient Physical Therapy B 10 AdventHealth Wauchula 735 S 5th Avenue Wauchula FL 33873 www.adventhealth.com/hospital/adventh 4239 X X X X Skilled Nursing A 11 Central Texas Medical Center (through 04/01/20 1301 Wonder World Drive San Marcos TX 78666 www.ctmc.org 000556 X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 19 1 0 0 1 X See Part V, Page 8 X X 1 20 1 See Part V, Page 8 0 1 X 200.000000000000 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 1 X 0 X X X X 1 X 0 0 Facility Reporting Group - B 0 0 1 X X X X X X X X X 19 1 1 0 1 X See Part V, Page 8 X X 1 20 1 See Part V, Page 8 0 1 X 200.000000000000 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 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: AdventHealth Orlando, - Facility 2: AdventHealth Celebration, - Facility 3: AdventHealth Altamonte Springs, - Facility 4: AdventHealth East Orlando, - Facility 5: AdventHealth Winter Park, - Facility 6: AdventHealth Kissimmee, - Facility 8: AdventHealth Apopka, - Facility 10: AdventHealth Wauchula, - Facility 11: Central Texas Medical Center (through Facility Reporting Group - A Part V, Section B, line 5: See Line 5 footnote below. Facility Reporting Group - A Part V, Section B, line 7d: See Line 7d footnote below. Facility Reporting Group - A Part V, Section B, line 11: See Line 11 footnote below. Facility Reporting Group - A Part V, Section B, line 13h: See Line 13h footnote below. Part V, Section B Facility Reporting Group B Facility Reporting Group B consists of: - Facility 7: AdventHealth Sebring, - Facility 9: AdventHealth Lake Placid Facility Reporting Group - B Part V, Section B, line 5: See Line 5 footnote below. Facility Reporting Group - B Part V, Section B, line 6a: See Line 6a footnote below. Facility Reporting Group - B Part V, Section B, line 7d: See Line 7d footnote below. Facility Reporting Group - B Part V, Section B, line 11: See Line 11 footnote below. Facility Reporting Group - B Part V, Section B, line 13h: See Line 13h footnote below. Part V, Section B, Line 5 Footnote Group A-Facility 1 -- AdventHealth OrlandoAdventHealth Orlando (AHO or the Hospital) is the flagship hospital of the seven hospital campuses that operate under a single hospital license. The seven campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHO is located in and serves the residents of Orange County. AHO has become one of the most trusted and comprehensive hospitals in the region. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHO was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHO had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHO's community/service area. The following organizations participated in AHO's CHNAC and specifically represented low-income, minority and other medically underserved populations:Second Harvest Food Bank - a non-profit organization that operates a food bank throughout the six counties that make up most of Central Florida and provides a workforce development program for populations at risk for food insecurity;Grace Medical Home - a patient-centered medical home that focuses on serving the clinically underserved through the provision of continuous and comprehensive primary care;Juvenile Diabetes Research Foundation;Ronald McDonald House;United Against Poverty;Healthy Start Coalition of Orange County;Mother's Milk Bank of Central Florida; andOrange County Public Health Department.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents.Group A-Facility 2 -- AdventHealth CelebrationAdventHealth (AHC or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHC is located in Osceola County and it primarily serves residents from Osceola County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHC was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHC had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHC's community/service area. The following organizations participated in AHC's CHNAC and specifically represented low-income, minority and other medically underserved populations:Osceola Council of Aging - a non-profit organization with a focus on providing care and essential social services to seniors and families; Community Vision of Osceola County - a community planning non-profit that works to convene regional stakeholders to create a shared vision for a healthy and prosperous Osceola County; Hope Community Center - a social service non-profit that works to connect socioeconomically disadvantaged families to essential services with the goal of helping them to become self-sustaining; The Osceola County Health Department;Celebration Foundation;The City of Kissimmee;Osceola Community Health Services; Park Place Behavioral Health; REACH Marketing; andSecond Harvest Food Bank.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 289 surveys were completed by Osceola County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of nine focus groups were held which included representatives from organizations that serve underrepresented populations in Osceola County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Ninety-seven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, nine intercept surveys were conducted with patients at a local federally qualified health center. Group A-Facility 3 -- AdventHealth AltamonteAdventHealth Altamonte Springs (AHAlt or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHAlt is located in Seminole County and its primary service area encompasses all of Seminole County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. **see continuation of footnote Part V, Section B, Line 5 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteThe 2019 CHNA conducted for AHAlt was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHAlt had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHAlt's community/service area. The following organizations participated in AHAlt's CHNAC and specifically represented low-income, minority and other medically underserved populations:Community Health Centers - an organization providing medical services and representing low-income, minority, and other underrepresented populations;Second Harvest Food Bank; Shepherd's Hope - a primary care clinic serving low-income, minority, and other underrepresented populations; Hope Community Center - an organization that provides education, immigration services, youth and family services and other community programs to low-income, minority, and other underrepresented populations; and The Department of Health in Seminole County. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 523 surveys were completed by Seminole County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 10 focus groups were held which included representatives from organizations that serve underrepresented populations in Seminole County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Eighty-three key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, fourteen intercept surveys were conducted with patients at a local federally qualified health center. Group A-Facility 4 -- AdventHealth East OrlandoAdventHealth East Orlando (AHEO or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHEO is located in and serves the residents of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHEO was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHEO had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHEO's community/service area. The following organizations participated in AHEO's CHNAC and specifically represented low-income, minority and other medically underserved populations:True Health - a multi-county Federally Qualified Health Center that provides access to care for low-income, uninsured, underinsured and underserved populations in Seminole and Orange Counties regardless of ability to pay;United Global Outreach;Orange County Government; and Second Harvest Food Bank. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents. Group A-Facility 5 -- AdventHealth Winter ParkAdventHealth Winter Park (AHWP or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHWP is located in and primarily serves the residents of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHWP was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHWP had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHWP's community/service area. The following organizations participated in AHWP's CHNAC and specifically represented low-income, minority and other medically underserved populations:Second Harvest Food Bank;Seniors First, Inc.;Fleet Farming; andOrange County Health Department. In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers.**see continuation Part V, Section B, Line 5 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkA total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents.Group A-Facility 7 -- AdventHealth KissimmeeAdventHealth Kissimmee (AHK or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHK is located in and serves the residents of Osceola County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHK was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHK had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHK's community/service area. The following organizations participated in AHK's CHNAC and specifically represented low-income, minority and other medically underserved populations:Osceola Council of Aging - a non-profit organization with a focus on providing care and essential social services to seniors and families; Community Vision of Osceola County - a community planning non-profit that works to convene regional stakeholders to create a shared vision for a healthy and prosperous Osceola County; Hope Community Center - a social service non-profit that works to connect socioeconomically disadvantaged families to essential services with the goal of helping them to become self-sustaining; The Osceola County Health Department;Celebration Foundation;The City of Kissimmee;Osceola Community Health Services; Park Place Behavioral Health; REACH Marketing; andSecond Harvest Food Bank.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of 289 surveys were completed by Osceola County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of nine focus groups were held which included representatives from organizations that serve underrepresented populations in Osceola County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. Ninety-seven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, nine intercept surveys were conducted with patients at a local federally qualified health center.Group A-Facility 8 -- AdventHealth ApopkaAdventHealth Apopka (AHApk or the Hospital) is one of seven campuses that operate under a single hospital license. The seven hospital campuses of AdventHealth in Central Florida are known as the AdventHealth Central Florida Division South Region (CFD-South) and are located in the Central Florida counties of Seminole, Orange, and Osceola. AHApk is located in Orange County and its primary service area encompasses all of Orange County. The CFD-South conducted its 2019 Community Health Needs Assessment (CHNA) in two parts: a regional health needs assessment for four counties in Central Florida (Lake, Orange, Osceola and Seminole) (a sister hospital is located in Lake County, Florida and was a participant in the regional health needs assessment) and a separate health needs assessment focused on each of the seven separate CFD-South hospital campuses. The 2019 CHNA conducted for AHApk was built on input from people representing the broad and local community, as well as low-income, minority and other medically underserved populations. This input was solicited throughout 2019 and was gathered and considered in multiple ways as described below.AHApk had a local Community Health Needs Assessment Committee (CHNAC) that included representatives from the Hospital and community with a special focus on underserved populations within AHApk's community/service area. The following organizations participated in AHApk's CHNAC and specifically represented low-income, minority and other medically underserved populations:Community Health Centers - a federally qualified health center serving Central Florida residents;Seminole County Department of Health;Second Harvest Food Bank; Shepherd's Hope - a free and charitable clinic that provides care to the underinsured and uninsured; andHope Community Center.In order to ensure that input was solicited and gathered from low-income, minority, medically underserved, and other underrepresented community members, a variety of primary data collection efforts were made. Primary data for the 2019 CHNA was collected through a community survey, stakeholder interviews, focus groups, key informant surveys and intercept surveys. The audience for the community survey was the general community with a concentration on underrepresented populations. Both online and paper surveys were made available in four languages. A total of over 1,240 surveys were completed by Orange County residents. Stakeholder interviews were collected from community members who represented underserved populations through the programs and services they offer, such as local food banks and federally qualified health centers. A total of 9 focus groups were held which included representatives from organizations that serve underrepresented populations in Orange County, including organizations that provide services primarily to the homeless populations, seniors, and incarcerated individuals as well as mental health providers. One hundred and eleven key information surveys were collected from individuals who represented a particular population and/or sector in the community that was not able to be included in the stakeholder interviews or focus groups. Additionally, a total of 86 intercept surveys were conducted with individuals at United Against Poverty, AdventHealth Community Medicine Clinic and the Christian Service Center that focused on the health needs of underrepresented Orange County residents. **see continuation of footnote Part V, Section B, Line 5 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaAdventHealth Wauchula is a 25-bed hospital located in Wauchula, Florida in Hardee County. It serves the same communities as its sister hospitals, AdventHealth Sebring and AdventHealth Lake Placid. AdventHealth Wauchula is designated by the state of Florida as a Critical Access Hospital. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews. AH Wauchula formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of AH Wauchula. Key members of the CHNAC included representatives from the following organizations:Drug Free Hardee;MV Transportation - an organization involved in helping to meet transportation needs of those living in disadvantaged communities;Peace River Center - a domestic violence center;Healthy Start Coalition of Hardee, Highlands, and Polk Counties;Highlands County Board of County Commissioners;Nu-Hope Elder Care Services, Inc.;Heartland Regional Transportation Planning Organization;Florida Department of Health in Hardee County;Samaritan's Touch Care Center;Heartland Rural Health Network;Hardee Help Center; RCMA - an organization that provides child-care and child and parent education for migrant and other low-income families; and Central Florida Health Care - a federally qualified health center.Community surveys were completed on-line and in person by participants in community settings. Local community organizations assisted in survey participation efforts by providing access to a computer at community events. Community surveys were also made available at local clinics, community events, department of motor vehicle locations, and the community locations. A total of 578 residents participated in the Community Health Needs Assessment survey. AH Wauchula also gathered primary data through stakeholder interviews. Interviews were conducted on-line by members of the CHNAC. Group A-Facility 11 -- Central Texas Medical CenterCentral Texas Medical Center (CTMC or the Hospital) is a 170-bed hospital located in San Marcos, Texas. The Hospital's service area consists of Hays and Caldwell counties. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews.Central Texas Medical Center formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of Central Texas Medical Center. Key members of the CHNAC included representatives from the following organizations:Texas State Student Health Center;Women, Infants and Children (WIC);Community Action, Inc.;San Marcos - Hays County EMS;San Marcos Consolidated Independent School District;Scheib Mental Health;Hays County Commission; andCommuniCare Health Centers. CTMC also gathered primary data through focus groups, interviews, and an online survey. Focus groups were conducted at the Dr. Eugene Clark Central Library, the Hays County Library, WIC Programs Center of Caldwell County and Hays County Community Action, Inc. One-hundred and twenty-two online surveys were completed by community residents. Part V, Section B, Line 5 Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidAdventHealth Sebring (AH Sebring) and AdventHealth Lake Placid (AH Lake Placid) are both located in Highlands County Florida and operate under a single hospital license. AH Sebring and AH Lake Placid share the same service area which includes Highlands County and portions of adjacent Hardee County. In conducting its 2019 Community Health Needs Assessment (CHNA), primary and secondary health data was collected and analyzed. Primary data was gathered based upon input from individuals representing the broad community, as well as low-income, minority, and other medically underserved populations. Primary data input was primarily gathered through the establishment of a Community Health Needs Assessment Committee, community surveys, and stakeholder interviews. AH Sebring and AH Lake Placid formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community, with a special focus on underserved populations. Many of the CHNAC members were selected because of their direct ties to the underserved and impoverished communities in the primary service area of AH Sebring and AH Lake Placid. Key members of the CHNAC included representatives from the following organizations:Drug Free Highlands;Highlands County Sheriff's Office;MV Transportation - an organization involved in helping to meet transportation needs of those living in disadvantaged communities;Peace River Center - a domestic violence center;Healthy Start Coalition of Hardee, Highlands, and Polk Counties; Highlands County Board of County Commissioners;Nu-Hope Elder Care Services, Inc.;Highway Park Neighborhood Council;Heartland Regional Transportation Planning Organization;Florida Department of Health in Highland County;Samaritan's Touch Care Center;Wings of Faith Christian Worship Center;Heartland Rural Health Network;Highlands County Veteran Services Office;RCMA - an organization that provides child-care and child and parent education for migrant and other low-income families; and Central Florida Health Care - a federally qualified health center.Community surveys were completed on-line and in person by participants in community settings. Local community organizations assisted in survey participation efforts by providing access to a computer at community events. Community surveys were also made available at local clinics, community events, department of motor vehicle locations, and the community locations. A total of 578 residents from Highlands County participated in the Community Health Needs Assessment survey. AH Sebring and AH Lake Placid also gathered primary data through stakeholder interviews. Interviews were conducted on-line by members of the CHNAC. Part V, Section B, Line 6a Footnote Facility Reporting Group - BAdventHealth Sebring and AdventHealth Lake Placid collaborated in conducting their Community Health Needs Assessments (CHNA) in 2019. Part V, Section B, Line 7a Each hospital facility's CHNA report was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlandohttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/community-health-needs-assessmentsFacility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/community-health-needs-assessmentsFacility 5 -- AdventHealth Winter Parkhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/community-health-needs-assessmentsFacility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/community-health-needs-assessments Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments Facility 11 -- Central Texas Medical Centerhttps://www.adventhealth.com/community-health-needs-assessments Part V, Section B, Line 10aEach hospital facility's most recently adopted implementation strategy was made widely available through the following websites: Facility 1 -- AdventHealth Hospital Orlandohttps://www.adventhealth.com/community-health-needs-assessments Facility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/community-health-needs-assessments Facility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/community-health-needs-assessments Facility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/community-health-needs-assessments Facility 5 -- AdventHealth Winter Parkhttps://www.adventhealth.com/community-health-needs-assessments Facility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/community-health-needs-assessments Facility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/community-health-needs-assessments Facility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/community-health-needs-assessments Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessments Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments Facility 11 -- Central Texas Medical CenterThe 2020-2022 Implementation Plan is posted on the website of the 501(c)(3) unrelated successor organization. Part V, Section B, Line 7d Footnote Facility Reporting Group - AThe Hospital facilities have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospitals' websites at least until the date the hospital facilities have made widely available on its websites its two subsequent Community Health Needs Assessment Reports. The Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facilities have made available for public inspection its two subsequent Community Health Needs Assessment Reports. Part V, Section B, Line 7d Footnote Facility Reporting Group - BThe Hospital facilities have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospitals' websites at least until the date the hospital facility has made widely available on its websites its two subsequent Community Health Needs Assessment Reports. The Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facilities have made available for public inspection its two subsequent Community Health Needs Assessment Reports. Part V, Section B, Line 11 Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant NeedsAdventist Health System/Sunbelt Inc. d/b/a AdventHealth Orlando will be referred to in this document as AdventHealth Orlando or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Orlando is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Orlando's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Orlando worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Orlando chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. AdventHealth intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Orlando Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective, to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, providing financial support of at least $455,000 and annual board service over the next three years throughout the tri-county region. The tri-county region is defined as Orange, Osceola, and Seminole counties. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each AdventHealth Central Florida Division hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest Food Bank to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 4,945 pounds of food or 4,121 meals towards the larger Divisional goal. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedThe second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County, and Seminole County. The reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroot efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the board of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.The reporting Hospital provided representation to serve on two boards within their primary service area. The first is on the board of the UP (United Against Poverty) Orlando, a local nonprofit that serves those in poverty by providing crisis case management, transformative education, food and household subsidies, job training and placement, personal empowerment training and referrals to other collaborative social service providers. The reporting Hospital also provides representation on the board of the Heart of Florida, a local nonprofit that provides education, health, and financial stability for every person in Central Florida.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and education to the community at large. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse, to provide additional fresh produce in Orange County, the county of the reporting Hospital. These partnerships increased the amount of healthy food available to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity. In 2020, the Division provided representation on behalf of the Hospital to participate in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Orlando identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care, and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke. 2020 Update: The AdventHealth Orlando Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, residency rotations, and to seek innovative ways to increase capacity through the provision of in-kind labs/imaging, volunteer services, etc. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County. The Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported by the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County, and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in Orange County, Osceola County, and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedPriority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health, and substance use were all identified as top community needs by stakeholders, key informants, and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as the local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness. 2020 Update: The AdventHealth Orlando Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, the Division serves on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Orlando primary service area that were identified as hot spots; and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to AdventHealth Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Orlando primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedThe second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting AdventHealth Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:There were over 1,500 individuals experiencing homelessness in Orange County in 2018. When individuals are experiencing homelessness, it is more difficult to access health care and manage chronicphysical and mental conditions. The AdventHealth Central Florida Division is heavily invested in addressing homelessness and is involved with partners such as: Christian Service Center, Coalition for the Homeless of Central Florida, Dave's House, Family Promise of Greater Orlando, Homeless Services Network of Central Florida and others.2020 Update: The AdventHealth Orlando Community Health Plan has one desired goal statement under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless populationGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide annual financial and in-kind support, including board service and employee volunteers to support community partners and increase the capacity to care for our homeless population. This objective is funded and managed at the Divisional level; outcomes reported for this objective are for the Division and not specific to the reporting Hospital. The first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric by providing financial support of $48,900 to three organizations in the Hospital's primary service area. Family Promise of Greater Orlando was given $18,000 to support their work to help individuals experiencing homelessness sustain housing and self-sufficiency and increase the program's capacity. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing and diversion received $5,000. Dave's House received $25,900 to further provide supportive housing for individuals with serious mental illness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The reporting Hospital progressed on this metric with in-kind services, including service on three boards. Boards served on include Christian Service Center, The Sharing Center, and Samaritan Resource Center. All of these organizations work to address the immediate and/or long-term needs of those experiencing homelessness. Due to COVID-19, volunteer efforts were delayed. The reporting Hospital pivoted where necessary to address the immediate needs of the community during the pandemic and will continue to do so. The Hospital will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Community Needs Not Chosen by AdventHealth OrlandoThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Community Resources Group: Although there is a multitude of resources available in the community, many community members may not know of these services or how to access them. To optimize utilization of available resources, the local CHNAC discussed potential solutions, which included creating community resource groups to inform community members of available resources, but it will not be included in the Community Health Plan. Although the Hospital did not choose to prioritize this issue and address it through the Community Health Plans, the Community Asset Inventory created for the CHNA report includes a list of available resources in the tri-county area. This Community Asset Inventory will be updated, shared with community organizations, and made publicly available. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Celebration will be referred to in this document as AdventHealth Celebration or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Celebration is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Celebration's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Celebration worked to define and address the needs of low-income, minority, and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Celebration chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:More than 40 percent of community survey respondents from Osceola County indicated that they do not have access to healthy, affordable food. Food security was also identified as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Division intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Celebration Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 515 pounds of food or 429 meals towards the larger Divisional goal. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The AdventHealth reporting Hospitals located in Osceola County sustained two of these partnerships and established one new partnership. The AdventHealth reporting Hospitals in Osceola County include AdventHealth Celebration and AdventHealth Kissimmee. One of the partnerships included financially supporting Meals on Wheels of Osceola operated by the Osceola Council on Aging. The Osceola Council on Aging is a nonprofit dedicated to providing services which enable independence and self-sufficiency in seniors, disabled adults, and more, and provides home meal deliveries to seniors. The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2020, the Division also established a new partnership with the School District of Osceola County (SDOC) to launch the SMART Bus. The SMART Bus provides food, education, access to Wi-Fi, and family support to meet the needs of the 2,500 homeless students enrolled in the SDOC. The new partnership is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals in Osceola County where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The Division is progressing on this objective and is actively working to identify the best practices to increase effectiveness of efforts to bring healthy food to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Osceola County. This initiative provides an opportunity to form and participate in multisector collaboratives within Osceola County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Osceola Health Leadership Council. This council is comprised of organizations throughout Osceola County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Celebration identified care coordination as a need, specifically preventative care/health screenings, access to care, and pediatric and women's health (including prenatal). Osceola County primary data respondents were less likely to indicate that they accessed preventative care services, such as PSA tests, lab work and Pap tests. In 2016, 23.6 percent of Osceola County adults could not see a doctor due to cost. Primary data respondents from Osceola County also identified transportation and care coordination as barriers to care in relation to chronic conditions when seeking care. A little more than 10 percent of Osceola County community survey respondents indicated that they have difficulty accessing prenatal care.2020 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind labs/imaging and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division provided $190,000 in financial contributions to Osceola Council on Aging to support clinical operations. Additionally, the Division provided $2,000 to Osceola Community Health Services, a local FQHC focused on meeting individuals' physical and mental health care needs, including prevention, wellness, acute and chronic care, for operational support to increase the availability of affordable care. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services were delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics, and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstance. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there is a sufficient number of mental health providers and nearly 60 percent of Osceola County community survey respondents indicated they feel depressed or hopeless. When discussing with primary research participants, it was stated that the high level of stress people are experiencing could make it difficult to cope with mental illness. This may be caused by lack of community support and available support services to manage mental health. The Central Florida Division of AdventHealth has several care options for mental health services. These include the Outlook Clinic and connections to FQHCs. The Central Florida Division of AdventHealth is funding several mental and behavioral health services in the community, including an eye movement desensitization and reprocessing (EMDR) psychotherapy treatment at a local FQHC and a music therapy program.2020 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, the representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Celebration's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Osceola County.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Celebration primary service area per year that were identified as hot spots. This objective was exceeded, with a total of four schools and five additional locations in AdventHealth Kissimmee and AdventHealth Celebration's shared primary service areas receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Osceola County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which support the objective, are specific to reporting Hospitals in Osceola County. This includes AdventHealth Celebration and AdventHealth Kissimmee. In 2020, this objective was met through an initiative, Digital Communal Gatherings, led by Peer Support Space. Peer Support Space is dedicated to being a local hub for diverse peer-led recovery communities. The Digital Communal Gatherings initiative offers a virtual space for peer-led support groups to meet and navigate their unique journeys with mental illness and/or substance misuse challenges, neurodivergence, disability, grief, trauma, or other obstacles to mental wellness. The Division was able to meet this objective in Osceola County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:Osceola County has the highest percentage of renter households who were cost burdened (24.4 percent) and severely cost burdened (25.1 percent). Osceola County also had 21.1 percent of homeowner residents who are severely cost burdened. Affordable housing has a large impact on other health outcomes and wellbeing. It enables families to have the opportunity to meet their respective health, education, and employment needs. The Central Florida Division of AdventHealth is heavily invested in addressing homelessness and is involved with partners such as: Coalition for the Homeless of Central Florida, Family Promise of Greater Orlando, Homeless Services Network of Central Florida, and others.2020 Update: The AdventHealth Celebration Community Health Plan has two desired goal statements under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless population2. Participate in advocacy efforts to provide affordable housing for community membersGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide financial and in-kind support to community partners to enhance their capacity to provide care. This objective is funded and managed at the Divisional level; outcomes reported for this objective are for the Division and not specific to the reporting Hospital.The first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric by providing financial support of $48,900 to three organizations in the Hospital's primary service area. The Family Promise of Greater Orlando was given $18,000 to support their work to help individuals experiencing homelessness sustain housing and self-sufficiency and increase the program's capacity. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing, and diversion received $5,000. Dave's House received $25,900 to further provide supportive housing for individuals with serious mental illness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric with in-kind services, including service on six boards. Boards served on include Christian Service Center, Dave's House, IDignity, Matthew's Hope, New Beginnings and Samaritan Resource Center. All these organizations work to address the immediate and/or long-term needs of those experiencing homelessness. Due to COVID-19, volunteer efforts were delayed. The Division pivoted where necessary to address the immediate needs of the community during the pandemic and will continue to do so. The Hospital will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued Goal 2: Participate in advocacy efforts to provide affordable housing for community membersObjective 1: The first objective is a shared initiative between AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide annual financial and in-kind support, including board service and employee volunteers, to support community partners and increase the capacity to care for our homeless population. This objective is funded and managed at the Divisional level, but all outcomes are specific to the reporting Hospitals in Osceola County.The first strategy is to provide financial support to community partners to enhance their capacity to provide care. The Division progressed on this metric by providing financial support of $600,000 to Hope Partnership, a nonprofit organization that aims to provide a holistic continuum of care to end homelessness and poverty in Central Florida.The second strategy is to provide in-kind support to community partners to enhance their capacity to provide care. The reporting Hospital progressed on this metric with board service, including representation on Hope Partnership. Community Needs Not Chosen by AdventHealth CelebrationThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Poverty: The local Community Health Needs Assessment Committee (CHNAC) understands that poverty has a large impact on health and wellbeing. The CHNAC agreed that the scale of this need is too broad, and it would not be a realistic issue to be addressed with the resources available at this time. 2. Education: The local CHNAC discussed education, health education and literacy. It was determined that education was better addressed by existing organizations and resources in the community. Certain aspects of education such as health literacy will be addressed under care coordination initiatives. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt,Inc. d/b/a AdventHealth Altamonte Springs will be referred to in this document as AdventHealth Altamonte Springs or "the Hospital".The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency.AdventHealth Altamonte Springs is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth (the Division) now includes 15 hospitals.This is the first-year update for AdventHealth Altamonte Springs' 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Altamonte Springs worked to define and address the needs of low-income, minority and underserved populations in its service area.The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves.Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan.The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address.AdventHealth Altamonte Springs chose four priorities for its 2020-2022 Community Health Plan:1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Youth Development & MentorshipPriority 1: Food Security2019 Description of the Issue:More than 25% of community survey respondents from Seminole County indicated that they do not have access to healthy, affordable food. Food security was also defined as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update:Recognizing the impact of social determinants of health such as food security on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities.The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000, and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 2,683 pounds of food or 2,236 meals toward the larger Divisional goal.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospital sustained two of these partnerships. For the reporting Hospital, one of these partnerships included financially supporting a grassroots effort at one local church to provide food to those in need through their church food pantry. Financial support was also provided to Meals on Wheels of Seminole County, which provides home meal deliveries to seniors. The outcomes reported for this strategy, which supports the objective, are specific to Seminole County.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to identify new partners and best practices to increase the effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority. This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to the reporting Hospital. This initiative provides an opportunity to form and participate in multisector collaboratives within Seminole County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Seminole County Department of Health's Healthy Seminole committee. This committee is comprised of organizations throughout Seminole County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Altamonte Springs identified care coordination as a need, specifically affordable specialty care, efficient and holistic care coordination, childhood obesity, and efficient and affordable transportation. In Seminole County, 35.4% of community survey participants indicated that they lacked access to a healthcare provider specialist. Limited access to high quality specialists was identified as a community issue. Care coordination was identified by the local Community Health Needs Assessment Committee and primary data participants as a needed service. Seminole County has seen an increase in both middle school and high school students reporting a BMI at or above the 95th percentile. More than seven percent of Seminole County community survey respondents indicated that a family member had childhood obesity. Transportation was identified as a barrier related to economic conditions and public transportation was identified as a need. Transportation was also identified as a need related to mental health services, chronic conditions, and overall access to health care. 2020 Update: The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind labs/imaging, and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. Outcomes are reported for the Division and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in AdventHealth hospitals in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management services. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics, and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstances. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental and behavioral health, specifically the need for more providers and services, was identified as a top community need. Only 11% of community survey respondents in Seminole County believe there are a sufficient number of mental health providers. Nearly 60% of community survey respondents indicate that they feel depressed or hopeless. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. 2020 Update: The AdventHealth Altamonte Springs Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction, and healing from past trauma.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs ContinuedOther initiatives to address this objective include providing in-kind support through board service. Currently, representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of Orlando and the surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Altamonte Springs' primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to the reporting Hospital in Seminole County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Altamonte Springs primary service area per year that were identified as hot spots. This objective was met by the Division, with two schools in the reporting Hospital's primary service area receiving the program. The outcomes reported for this strategy, which supports the objective, are specific to Seminole County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to the reporting Hospital in Seminole County. Due to COVID-19, these efforts were delayed for the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Youth Development & Mentorship 2019 Description of the Issue:Youth development and mentorship, specifically relating to youth education and enrichment, was identified by the local Community Health Needs Assessment Committee as a need. Seminole County has seen an increase in student absenteeism and high school gang activity. Positive influences combined with a strong education as a youth increases the chances for success in adulthood. 2020 Update: The AdventHealth Altamonte Springs Community Health Plan has one desired goal statement under the Community Development: Youth Development and Mentorship priority.1. Increase impact of efforts to provide positive experiences and healthy environments for youthGoal 1: Increase impact of efforts to provide positive experiences and healthy environments for youthObjective 1: The first objective is a shared initiative between AdventHealth Altamonte Springs and AdventHealth Apopka. These Hospitals are part of the Central Florida Division of AdventHealth. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to provide annual financial and in-kind support, including board service and employee volunteers, for continuation of annual school engagement events and growing new partnerships to serve youth in the community. This objective is funded and managed at the Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. The first strategy is to provide financial support to local organizations that are working to positively impact youth in the community. The Division provided financial support of $20,000 to the Kids House of Seminole County. Additionally, the Division provided in-kind support to the Kids House of Seminole County, including clinical staff and board service, to support their services for youth who have experienced physical and/or sexual abuse. Kids House provides clinical and mental health services for youth in Seminole County who have experienced abuse. The second strategy is to provide in-kind support, including board-service and employee volunteers, to local organizations that are working to positively impact youth and host annual school engagement events. The Division progressed on this metric by hosting one Take-over Day at Seminole County High School. The Take-over Day consists of AdventHealth team members volunteering their time to educate high school students on different health care career opportunities and develop career skills. The third strategy is to establish new partnerships to serve youth in the community. The Division progressed on this metric by establishing a partnership with No Limit Health and Education, Inc. which is a local nonprofit that hosts several programs., One of these programs, the Flow Detox program, teaches young men in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. The program will launch in 2021.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by AdventHealth Altamonte SpringsThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Affordable Housing: The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Seminole County that address affordable housing. The Hospital decided it would be better to target their efforts in areas where we would have greater impact. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth East Orlando will be referred to in this document as AdventHealth East Orlando or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth East Orlando is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth East Orlando's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth East Orlando worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth East Orlando chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Job Skills Training & EmployabilityPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update:Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, by providing financial support of at least $455,000, and by providing annual board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 1,040 pounds of food or 867 meals towards the larger Divisional goal.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support towards the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroot efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedThe third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and education to the community at large. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital. These partnerships increased the amount of healthy food available to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all of the communities they serve, regardless of geography.Priority 2: Care Coordination2019 Description of the Issue:AdventHealth East Orlando identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood access to care and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke.2020 Update:The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind provision of labs/imaging, volunteer services, etc.The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations.The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedThe Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division, is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations.The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging, and volunteer services were delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of Central Florida AdventHealth hospital facilities in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients.The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Central Florida AdventHealth hospital facilities in Orange County, Osceola County and Seminole County: AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program.The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstance. The Division is progressing on this objective.Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health, and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as the following: local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2020 Update: The AdventHealth East Orlando Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedThis initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000 dollars. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area.Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services.The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma.Other initiatives to address this objective include providing in-kind support through board service. Currently, the representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth East Orlando's primary service area that were identified as hot spots, and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth East Orlando primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as provide supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security, led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedPriority 4: Community Development: Job Skills Training & Employability2019 Description of the Issue:Job skills and training were identified as a top community need in the AdventHealth East Orlando breakout session. By attaining financial stability and alleviating the concerns associated with economic instability, individuals are able to more easily address health concerns. As an anchor organization in our community, AdventHealth Central Florida Division is able to implement job training and education programs for communities in need.2020 Update: The AdventHealth East Orlando Community Health Plan has one desired goal statement under the Community Development: Job Skills Training and Employability priority.1. Advocate and work within the community to remove barriers to employmentGoal 1: Advocate and work within the community to remove barriers to employmentObjective 1: The first objective is to collaborate with the community to enhance existing efforts to provide training, support, and social services to those currently unemployed and underemployed. The objective is funded and managed by the Division, but all outcomes are specific to the reporting Hospital. The first strategy is to collaborate with the community to enhance existing efforts to provide training, support, and social services to those currently unemployed and underemployed. The Division progressed on this metric by financially supporting Iniciativa Accion Puertorriquena, a local nonprofit, providing entry level English language classes to low-income residents in East Orlando.Community Needs Not Chosen by AdventHealth East OrlandoThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Adverse Childhood Events (ACEs): AdventHealth East Orlando will incorporate the issue of ACEs into their mental and behavioral health initiatives. The objective of working to identify and implement proactive mental health education and programs which focus on resiliency will include ACEs.2. Housing: By prioritizing job skills training and employability, the Hospital hopes to provide lasting solutions for community members to increase their ability to secure housing and decrease homelessness. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued Adventist Health System/Sunbelt Inc. d/b/a AdventHealth Winter Park will be referred to in this document as AdventHealth Winter Park or "the Hospital".The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency.AdventHealth Winter Park is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Winter Park's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Winter Park worked to define and address the needs of low-income, minority and underserved populations in its service area.The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves.Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address.AdventHealth Winter Park chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Senior VulnerabilityPriority 1: Food Security 2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective to sustain or build partnerships with at least six community organizations that focus on addressing food security is supported by multiple strategies: by providing in-kind contributions, financial support of at least $455,000, and annual board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with the Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 918 pounds of food or 765 meals towards the larger Divisional goal.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support towards the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroot efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.The third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the board of the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs Continued Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts.The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and education to the community at large. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Orange County. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital by participating in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth was able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination2019 Description of the Issue:AdventHealth Winter Park identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care, and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies, and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke.2020 Update:The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, residency rotations, and to seek innovative ways to increase capacity through in-kind labs/imaging and volunteer services, etc.The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, not Hospital specific, and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations.The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County.The Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division, not Hospital specific, and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedThe fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients.The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in Orange County, Osceola County and Seminole County including AdventHealth Altamonte Springs, AdventHealth Apopka, Advent Health Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. These Hospitals are part of the Central Florida Division of AdventHealth and are in the same Division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program.The Division launched a new funding partnership of $335,288 over three years, with AdventHealth University's Hope Clinic. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, to increase access to care regardless of financial circumstance. The Division is progressing on this objective.Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health2019 Description of the Issue:Mental health, behavioral health and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as: local Federally Qualified Health Centers (FQHCs), Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2020 Update:The AdventHealth Winter Park Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area.Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedThe Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction, and healing from past trauma.Other initiatives to address this objective include providing in-kind support through board service. Currently, the Division serves on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of AdventHealth hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Winter Park's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Winter Park primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 5 -- AdventHealth Winter ParkDescription of CHNA Significant Needs ContinuedPriority 4: Community Development: Senior Vulnerability2019 Description of the Issue:Seniors were identified as a unique population for AdventHealth Winter Park. Senior safety was identified as a community issue related to unintentional injuries by Orange County primary data participants. The senior population is especially vulnerable to negative effects of isolation including poor health outcomes and higher rates of depression. 2020 Update: The AdventHealth Winter Park Community Health Plan has one desired goal statement under the Community Development: Senior Vulnerability priority.1. Address unique mental, physical and spiritual needs of high senior populationGoal 1: Address unique mental, physical and spiritual needs of high senior populationObjective 1: The first objective is the reporting Hospital's initiative and appears only on the community health plan of AdventHealth Winter Park. The objective is to provide care navigation and social services for the senior population. The objective is funded and managed by the Division, but all outcomes are specific to the reporting Hospital. The Division progressed on this objective by partnering with Pinnacle Counseling to provide timely and affordable mental health services to seniors and their caregivers. Pinnacle Counseling is a local organization that provides the highest quality counseling by the most skilled and effective counselors to those in need of counseling. The reporting Hospital's Emergency Department (ED) team also has a direct referral line to contracted services at Pinnacle.Objective 2: The second objective is the reporting Hospital's initiative and appears only on the community health plan of AdventHealth Winter Park. The objective is to provide services to educate and support caregivers in the community to increase quality of life for both the caregiver and receiver of care. The objective is funded and managed by the Division, but all outcomes are specific to the reporting Hospital. The Division sustained and funded a position, Senior Care Navigator, at the reporting Hospital's Emergency Department (ED) to help address the unique needs of seniors. In 2020, more than 1,500 seniors and their caregivers were educated on additional social services and were referred for specialty consultations.Community Needs Not Chosen by AdventHealth Winter ParkThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issue:1. Built Environment (Affordable Housing): The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Orange County that address this issue. The Hospital decided it would be better to target their efforts in areas where it would have greater impact. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Kissimmee will be referred to in this document as AdventHealth Kissimmee or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Kissimmee is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth now includes 15 hospitals.This is the first-year update for AdventHealth Kissimmee's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Kissimmee worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Kissimmee chose four priorities for its 2020-2022 Community Health Plan: 1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Affordable Housing & HomelessnessPriority 1: Food Security 2019 Description of the Issue:More than 40 percent of community survey respondents from Osceola County indicated that they do not have access to healthy, affordable food. Food security was also identified as a need related to chronic conditions. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth (the Division) is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Division intends to expand this work through current and future initiatives.2020 Update: Recognizing the impact of social determinants of health, like food security, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000 and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. The reporting Hospital contributed 515 pounds of food or 429 meals towards the larger Divisional goal. The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The AdventHealth reporting Hospitals located in Osceola County sustained two of these partnerships and established one new partnership. The AdventHealth reporting Hospitals in Osceola County include AdventHealth Celebration and AdventHealth Kissimmee. One of the partnerships included financially supporting Meals on Wheels of Osceola operated by the Osceola Council on Aging. The Osceola Council on Aging is a nonprofit dedicated to providing services which enable independence and self-sufficiency in seniors, disabled adults and more, and provides home meal deliveries to seniors. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedThe third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions. The reporting Hospital also provides representation to serve on the board of the Osceola Council on Aging. Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three-years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. In 2020, the Division also established a new partnership with the School District of Osceola County (SDOC) to launch the SMART Bus. The SMART Bus provides food, education, access to Wi-Fi and family support to meet the needs of the 2,500 homeless students enrolled in the SDOC. The new partnership is reported for the Division, not Hospital specific and appears on the community health plans of all Hospitals in Osceola County where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The Division is progressing on this objective and is actively working to identify the best practices to increase effectiveness of efforts to bring healthy food to community members in need.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to Osceola County. This initiative provides an opportunity to form and participate in multisector collaboratives within Osceola County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Osceola Health Leadership Council. This council is comprised of organizations throughout Osceola County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all of the communities they serve, regardless of geography.Priority 2: Care Coordination 2019 Description of the Issue:AdventHealth Kissimmee identified care coordination as a need, specifically preventative care/health screenings, access to care, and pediatric and women's health (including prenatal). Osceola County primary data respondents were less likely to indicate that they accessed preventative care services, such as a PSA test, lab work and Pap tests. In 2016, 23.6 percent of Osceola County adults could not see a doctor due to cost. Primary data respondents from Osceola County also identified transportation and care coordination as barriers to care in relation to chronic conditions when seeking care. A little more than 10 percent of Osceola County community survey respondents indicated that they have difficulty accessing prenatal care.2020 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations, and to seek innovative ways to increase capacity through in-kind labs/imaging and volunteer services, etc. The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division, and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations. The Division provided $190,000 in financial contributions to Osceola Council on Aging to support clinical operations. Additionally, the Division provided $2,000 to Osceola Community Health Services, a local FQHC focused on meeting individuals' physical and mental health care needs, including prevention, wellness, acute and chronic care, for operational support to increase the availability of affordable care. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Celebration and AdventHealth Kissimmee.The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedThe third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging, and volunteer services were delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstance. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Less than 10 percent of community survey respondents from Osceola County believe there is a sufficient number of mental health providers and nearly 60 percent of Osceola County community survey respondents indicated they feel depressed or hopeless. When discussing with primary research participants, it was stated that the high level of stress people are experiencing could make it difficult to cope with mental illness. This may be caused by lack of community support and available support services to manage mental health. The Central Florida Division of AdventHealth has several care options for mental health services. These include the Outlook Clinic and connections to FQHCs. The Central Florida Division of AdventHealth is funding several mental and behavioral health services in the community, including an eye movement desensitization and reprocessing (EMDR) psychotherapy treatment at a local FQHC and a music therapy program.2020 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedAspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured, and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, the representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of our Orlando and surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in AdventHealth Kissimmee's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Osceola County.The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Kissimmee primary service area per year that were identified as hot spots. This objective was exceeded, with a total of four schools and five additional locations in AdventHealth Kissimmee and AdventHealth Celebration's shared primary service areas receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Osceola County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactivity educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which support the objective, are specific to reporting Hospitals in Osceola County. This includes AdventHealth Celebration and AdventHealth Kissimmee. In 2020, this objective was met through an initiative, Digital Communal Gatherings led by Peer Support Space. Peer Support Space is dedicated to being a local hub for diverse peer-led recovery communities. The Digital Communal Gatherings initiative offers a virtual space for peer-led support groups to meet and navigate their unique journeys with mental illness and/or substance misuse challenges, neurodivergence, disability, grief, trauma, or other obstacles to mental wellness. The Division was able to meet this objective in Osceola County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.Priority 4: Community Development: Affordable Housing & Homelessness 2019 Description of the Issue:Osceola County has the highest percentage of renter households who were cost burdened (24.4 percent) and severely cost burdened (25.1 percent). Osceola County also had 21.1 percent of homeowner residents who are severely cost burdened. Affordable housing has a large impact on other health outcomes and wellbeing. It enables families to have the opportunity to meet their respective health, education, and employment needs. The Central Florida Division of AdventHealth is heavily invested in addressing homelessness and is involved with partners such as: Coalition for the Homeless of Central Florida, Family Promise of Greater Orlando, Homeless Services Network of Central Florida, and others.2020 Update: The AdventHealth Kissimmee Community Health Plan has two desired goal statements under the Community Development: Affordable Housing & Homelessness priority.1. Support efforts to increase access to care and provide services to our homeless population2. Participate in advocacy efforts to provide affordable housing for community membersGoal 1: Support efforts to increase access to care and provide services to our homeless populationObjective 1: The first objective is a shared initiative between AdventHealth Orlando, AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide financial and in-kind support to community partners to enhance their capacity to provide care. This objective is funded and managed at the Divisional level; outcomes reported for this objective are for the Division and not specific to the reporting Hospital.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedThe first strategy is to provide financial support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric by providing financial support of $48,900 to three organizations in the Hospital's primary service area. The Family Promise of Greater Orlando was given $18,000 to support their work to help individuals experiencing homelessness sustain housing and self-sufficiency and increase the program's capacity. The Coalition for the Homeless, a low-barrier shelter focusing on stabilization, rehousing and diversion received $5,000. Dave's House received $25,900 to further provide supportive housing for individuals with serious mental illness. The second strategy is to provide in-kind support to local organizations that are working to address the affordable housing needs and immediate needs of individuals experiencing homelessness. The Division progressed on this metric with in-kind services, including service on six boards. Boards served on include Christian Service Center, Dave's House, IDignity, Matthew's Hope, New Beginnings and Samaritan Resource Center. All these organizations work to address the immediate and/or long-term needs of those experiencing homelessness. Due to COVID-19, volunteer efforts were delayed. The Division pivoted where necessary to address the immediate needs of the community during the pandemic and will continue to do so. The Hospital will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. Goal 2: Participate in advocacy efforts to provide affordable housing for community membersObjective 1: The first objective is a shared initiative between AdventHealth Celebration and AdventHealth Kissimmee. These Hospitals are part of the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide annual financial and in-kind support, including board service and employee volunteers to support community partners and increase the capacity to care for our homeless population. This objective is funded and managed at the Divisional level, but all outcomes are specific to the reporting Hospitals in Osceola County.The first strategy is to provide financial support to community partners to enhance their capacity to provide care. The Division progressed on this metric by providing financial support of $600,000 to Hope Partnership, a nonprofit organization that aims to provide a holistic continuum of care to end homelessness and poverty in Central Florida.The second strategy is to provide in-kind support to community partners to enhance their capacity to provide care. The Division progressed on this metric with in-kind services, including board service on Osceola County's Affordable Housing Advisory Committee and Hope Partnership. The Osceola County's Affordable Housing Advisory Committee reviews established policies and procedures, ordinances, land development regulations, and adopted local government comprehensive plans of the appointing local government and recommends initiatives to encourage affordable housing in the county. Community Needs Not Chosen by AdventHealth KissimmeeThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Poverty: The local Community Health Needs Assessment Committee (CHNAC) understands that poverty has a large impact on health and wellbeing. The CHNAC agreed that the scale of this need is too broad and would not be a realistic issue to be addressed with the resources available at this time. 2. Education: The local CHNAC discussed education, health education and literacy. It was determined that education was better addressed by existing organizations and resources in the community. Certain aspects of education such as health literacy will be addressed under care coordination initiatives. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Apopka will be referred to in this document as AdventHealth Apopka or "the Hospital".The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency.AdventHealth Apopka is part of the Central Florida Division of AdventHealth. In 2020, the Central Florida Division North-Region (CFD-N), which includes AdventHealth Daytona Beach, AdventHealth DeLand, AdventHealth Fish Memorial, AdventHealth New Smyrna, AdventHealth Palm Coast and AdventHealth Waterman was combined with the Central Florida Division South-Region (CFD-S), which includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Heart of Florida, AdventHealth Kissimmee, AdventHealth Lake Wales, AdventHealth Orlando and AdventHealth Winter Park to unify as one under the Central Florida Division. The combination included six hospitals from CFD-N and nine hospitals from CFD-S. The Community Health Plans/Implementation Strategies for both regions were finalized before the combination. The Central Florida Division of AdventHealth (the Division) now includes 15 hospitals.This is the first-year update for AdventHealth Apopka's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Apopka worked to define and address the needs of low-income, minority and underserved populations in its service area.The 2019 Community Health Needs Assessment used primary data 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 first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address.AdventHealth Apopka chose four priorities for its 2020-2022 Community Health Plan:1. Food Security2. Care Coordination3. Mental & Behavioral Health4. Community Development: Youth Development & MentorshipPriority 1: Food Security2019 Description of the Issue:Over one-third of community survey respondents indicated they lack access to high quality, affordable, healthy food. Having access to proper nutrition is necessary for a healthy life. Proper nutrition can also reduce the risk of, or complications from, certain diseases, such as diabetes. The Central Florida Division of AdventHealth is currently working to address food security with multiple partners, including Second Harvest Food Bank. The Central Florida Division of AdventHealth intends to expand this work through current and future initiatives.2020 Update:Recognizing the impact of social determinants of health such as food security on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach, in addition to our partnership with Aunt Bertha, will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities.The AdventHealth Apopka Community Health Plan has two desired goal statements under the Food Security priority.1. Increase access to healthy and affordable food for community members in need2. Work with community and government officials to address the root causes of food insecurity in our communitiesGoal 1: Increase access to healthy and affordable food for community members in needObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to sustain or build partnerships with at least six community organizations that focus on addressing food security and is supported by multiple strategies including the provision of in-kind contributions, financial support of at least $455,000, and annual volunteer board service over the next three years throughout the tri-county region. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The first strategy, to support the objective through in-kind contributions, resulted in sustaining one partnership with a community organization in the Division. This sustained partnership was with Second Harvest Food Bank of Central Florida, a private, nonprofit organization that collects, stores, and distributes donated food to more than 550 feeding partners in six Central Florida counties. The Division continued its support to Second Harvest through the Second Helpings program. This program enables each hospital campus, including the reporting Hospital, to make in-kind donations of excess food to Second Harvest to be distributed through local food pantries. The Division provided a total of 10,616 pounds of food or an equivalent of 8,847 meals. Due to the COVID-19 pandemic, the reporting Hospital was not able to contribute toward the Division's total.The second strategy, to support the objective through financial support, resulted in sustaining 13 partnerships and establishing two new partnerships with community organizations in the Division. The Division progressed on the objective by providing $207,927 in financial support toward the three-year goal of $455,000. Three of these partnerships were sustained on a tri-county level, this includes Orange County, Osceola County and Seminole County. The AdventHealth reporting Hospitals located in Orange County sustained six of these partnerships and established one new partnership. The AdventHealth reporting Hospitals in Orange County include AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. Some of these partnerships included financially supporting grassroots efforts at four local churches to provide food to those in need through their church food pantries. Financial support was also provided for Seniors First, an organization that leads the local Meals on Wheels program, which provides home meal deliveries to seniors.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedThe third strategy to support the objective, providing annual representation on boards of organizations focusing on food security which support the tri-county region (Orange, Osceola, and Seminole counties), was progressed on by serving on three boards. Knowing that food security is a large-scale community issue, the Central Florida Division of AdventHealth will continue its efforts to serve on boards, coalitions and taskforces which work with local and state officials to address the root causes of food insecurity. This strategy also focuses on advocacy and food system reform to ensure equitable access to healthy food across the community. In 2020, the Central Florida Division of AdventHealth team members served on the Second Harvest Food Bank of Central Florida, the American Diabetes Association, and the American Heart Association, all of which impact the Central Florida Division's primary service area. Both the American Diabetes Association and the American Heart Association are nonprofits that provide education on nutrition and food-related conditions.Objective 2:The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to identify new partners and best practices to increase effectiveness of efforts to bring healthy food to community members in need. These partnerships will be utilized to drive strategies across the tri-county area. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.In 2020, the Division expanded their partnership with one local nonprofit, HEBNI Nutrition Consultants, Inc., which was formed to educate high-risk, culturally diverse populations about nutrition strategies to prevent diet-related diseases. This partnership, over the next three years, will increase the amount of healthy food available to community members in need. HEBNI Nutrition Consultants' services include nutrition education and a mobile market. The mobile market is funded by the Central Florida Division of AdventHealth and offers produce at a reduced cost in low-income, high-risk communities and food deserts. The Division also established a new partnership with Infinite Zion Farms in Central Florida, which is working to establish affordable sources of organic produce and provide education to the community at large. These partnerships increased the amount of healthy food available to community members in need. Through the Division's funding, Infinite Zion Farms was able to build its first pilot greenhouse to provide additional fresh produce in Orange County, the county of the reporting Hospital.Goal 2: Work with community and government officials to address the root causes of food insecurity in our communitiesObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital; this includes AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority.This shared objective, to identify leadership from the tri-county area to participate in local coalitions focused on advocacy and reform to ensure equitable access to healthy food, is managed at a Divisional level, however all outcomes reported are specific to the reporting Hospital. This initiative provides an opportunity to form and participate in multisector collaboratives within Orange County, which are working on a shared goal to identify and strategize on best practices to address the root causes of food insecurity.In 2020, the Division provided representation on behalf of the Hospital to participate in the Orange County Department of Health's Community Health Improvement Planning Committee. This committee is comprised of organizations throughout Orange County that plan and implement community improvement programs. By providing representation at a Divisional level, the Central Florida Division of AdventHealth is able to identify cross-county and various organizational partnerships that will benefit all the communities they serve, regardless of geography.Priority 2: Care Coordination2019 Description of the Issue:AdventHealth Apopka identified care coordination as a need, specifically in the areas of prenatal care/early intervention/early childhood, access to care, and chronic disease management. Orange County had an increase in infant deaths, low birthweight babies, and preterm births. There was also a decrease in the percentage of mothers who had prenatal care in the first trimester. In Orange County, 31.6 percent of community survey respondents indicated that they lacked access to a primary care provider. An additional 35.5 percent indicated they lacked access to a healthcare provider specialist. Limited access to high quality primary care physicians and specialists was identified as a community issue by primary research participants. Orange County also had an increase in individuals who were obese, middle school and high school students who are reporting a body mass index at or above the 95th percentile, adults with diabetes, diabetes hospitalizations for children ages 12 to 18, adults with hypertension, and adults who have been told they had a stroke.2020 Update:The AdventHealth Apopka Community Health Plan has two desired goal statements under the Care Coordination priority.1. Increase the availability of appropriate and affordable care2. Decrease barriers community members encounter while seeking careGoal 1: Increase the availability of appropriate and affordable careObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. The objective is to provide support to existing care facilities through multiple strategies, including financial contributions, in-kind labs, and residency rotations and to seek innovative ways to increase capacity through in-kind labs/imaging, and volunteer services, etc.The first strategy is to provide support to existing care facilities through financial contributions. The strategy to support this objective is funded and managed at a Divisional level. However, outcomes are reported for the Division and are not Hospital specific and appear on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Central Florida Division of AdventHealth funding included, but was not limited to, contributions for operational support for two local Federally Qualified Health Centers (FQHCs). A $100,000 contribution was made to the Health Care Center for the Homeless, which provides primary medical care, oral health services, behavioral health, and substance use services for underinsured and uninsured individuals. An additional $100,000 was provided to True Health, which delivers medical and mental health services to underserved populations.The Division also provided $443,000 in financial contributions to Grace Medical Home to support operations, spiritual health, and medical services. However, funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Apopka, AdventHealth East Orlando and AdventHealth Winter Park in Orange County.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedThe Division also provided $150,000 to Shepherd's Hope which will support medical homes to increase the availability of affordable care. Shepherd's Hope is a faith-based organization of volunteers who provide access to healthcare for uninsured patients. Funding is reported for the Division and is not Hospital specific and appears on the community health plans of all Hospitals where the initiative is conducted. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park.In 2020, the reporting Hospital provided $106,000 to Community Health Centers (CHC), a local FQHC, to support the salary for a nurse navigator that helped uninsured and underinsured patients schedule appointments with CHC once discharged from the Hospital. The second strategy is to provide in-kind labs to existing care facilities. The Division provided in-kind labs to The Health Care Center for the Homeless. In the future, the Division will develop a process to track and quantify in-kind labs and imaging provided to local nonprofits.The third strategy is to support a residency rotation to existing care facilities. The Division had a residency rotation program established with a local nonprofit. In 2020, for a multitude of reasons, including COVID-19, the program was discontinued. The Division has pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that may support residency rotations. The fourth strategy is to seek innovative ways to increase capacity through in-kind labs, imaging, and volunteer services. Due to COVID-19, seeking innovative ways to increase capacity through in-kind labs, imaging, and volunteer services was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it. In the future, the Division will develop a thorough and consistent process to track and quantify in-kind labs and imaging provided.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget.This shared objective, to expand on existing care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need, is funded and managed at a Divisional level. This initiative provides an opportunity to support organizations with a shared goal to increase accessible entry points. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.The Division has contributed funding of $60,000 to the American Cancer Society's Road to Recovery Program. This program provides rides to and from cancer treatment for any cancer patient, regardless of insurance or economic status, that has a transportation barrier. In 2020, The Road to Recovery program provided 4,100 rides for cancer patients. The Division is progressing on this objective and is actively working to identify organizations to expand on existing external care navigation services to ensure uninsured and underinsured patients have an accessible entry point to the level of care they need.Goal 2: Decrease barriers community members encounter while seeking careObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.This shared objective, to provide case management services for at least 81 patients over three years while identifying additional partners and methods to decrease barriers community members encounter while seeking care, is funded and managed at a Divisional level. In 2020, the Division supported the Holistic Health program led by Center for Change, a local nonprofit, which aims to provide health education and social services to individuals and families who lack access to economic, social and health resources. The Holistic Health program focuses its efforts in high-need communities identified in the CHNA. The Division is progressing on this objective and 15 individuals have been provided case management service. Additionally, in 2020, 105 referrals to services have been provided, 60 individuals have improved their biometrics, and 84 individuals have improved health behaviors through the program. The Division launched a new funding partnership of $335,288 over three years, with AdventHealth University's Hope Clinic. AdventHealth University, Inc. is a related 501(c)(3) educational organization. This partnership will provide cardiac rehabilitation (wellness maintenance) services to uninsured and underinsured individuals to improve health outcomes and reduce readmissions. The Hope Clinic provides free care to individuals with socio-economic barriers, thereby increasing access to care regardless of financial circumstances. The Division is progressing on this objective. Due to COVID-19, identifying additional partners for the Division was delayed. As a result of the pandemic, the needs and resources in our community have changed and AdventHealth is attentive to that. During the past year, we have pivoted where necessary to address the immediate needs of our community during the pandemic and will continue to do so. We will work to identify ways to support our community and the community-based organizations that aid it, while finding new ways to meet the new and existing needs in it.Priority 3: Mental & Behavioral Health 2019 Description of the Issue:Mental health, behavioral health, and substance use were all identified as top community needs by stakeholders, key informants and focus groups. Only one in ten community survey respondents from Orange County believe there is sufficient substance abuse services. Poor mental health can exacerbate physical health conditions, decreasing quality of life and making it more difficult to maintain stable housing. The Central Florida Division of AdventHealth is heavily invested in addressing mental health and substance abuse and has partnered with community organizations such as: local Federally Qualified Health Centers (FQHCs), the Seminole County Sheriff's Office, Aspire Health Partners, and the National Alliance on Mental Illness.2020 Update: The AdventHealth Apopka Community Health Plan has two desired goal statements under the Mental & Behavioral Health priority.1. Increase access to mental and behavioral health services2. Support existing resources and identify new partners and programs that proactively strengthen the communityGoal 1: Increase access to mental and behavioral health servicesObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to increase provider capacity through financial and in-kind support to at least three partners serving the tri-county community. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedThis initiative provides an opportunity for the Division to support at least three partners that have a shared goal of increasing provider capacity in the space of mental and behavioral health. As a Division, we are currently funding three partners to implement programs that serve the tri-county community: Aspire Health Partners' Psychosocial Rehabilitation Program, Central Florida Center for the Arts' Community Music Therapy Program and Health Care Center for the Homeless' Eye Movement Desensitization and Reprocessing (EMDR) therapy program. The Division met its set metric of providing financial support to at least three partners by funding these organizations for a total of $1,308,000 dollars. With the funding, they are able to provide programs that serve the underinsured and uninsured individuals in the tri-county area. Aspire Health Partners is an organization committed to providing individuals and families of Central Florida with compassionate, comprehensive, and cost-effective behavioral health care services that lead to successful living and healthy, responsible lifestyles. Not only does Aspire Health Partners receive financial funding for the Psychosocial Rehabilitation Program, but the Division also leases five crisis stabilization unit (CSU) beds to connect individuals who have acute needs to mental health services. The Division also supports the Central Florida Center for the Arts which exists to serve and build community through the arts. Through the Music Therapy Program, the organization hired a music therapist to support individual and group music therapy across the tri-county area. The Division partnered with the Health Care Center for the Homeless to launch the EMDR therapy program for homeless and low-income, uninsured and underinsured community members in need. This therapy will help community members with conditions such as Post-Traumatic Stress Disorder (PTSD), addiction, and healing from past trauma. Other initiatives to address this objective include providing in-kind support through board service. Currently, representatives from the Division serve on the following boards which focus on addressing the mental health needs of Central Floridians: Mental Health Association of Central Florida and National Alliance on Mental Illness of Greater Orlando (NAMIGO). The Mental Health Association of Central Florida is an organization that provides mental health services, support, and information to the members of Orlando and the surrounding Central Florida community. NAMIGO is dedicated to improving the quality of life for individuals and supporting families affected by mental illness through education, support, and advocacy.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to develop and support pathways to mental and behavioral healthcare for those in need by expanding care navigation models to include mental and behavioral health focused initiatives over the next three years. This shared objective is funded and managed at a Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. In 2020, the Division contributed funding of $114,000 to IMPOWER's telehealth mental health services program to expand availability to under and uninsured residents in need of mental health services. IMPOWER is a nonprofit organization based in Central Florida that focuses on changing lives by protecting, counseling, teaching, and inspiring individuals and families to reach their full potential. This funded program helps expand the referral pipeline and the availability of telehealth services across Central Florida. The Division's funding was key in the timely and successful launch of the program. The Division will continue to progress on this objective by identifying other opportunities to develop and support pathways to mental and behavioral health care.Goal 2: Support existing resources and identify new partners and programs that proactively strengthen the communityObjective 1: The first objective is a Divisional initiative and appears on multiple community health plans in the Central Florida Division of AdventHealth, the same division as the reporting Hospital. This includes the plans of AdventHealth Altamonte Springs, AdventHealth Apopka, AdventHealth Celebration, AdventHealth East Orlando, AdventHealth Kissimmee, AdventHealth Orlando and AdventHealth Winter Park. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is supported by multiple strategies: provide the Mission: FIT POSSIBLE program to at least two schools annually in the AdventHealth Apopka's primary service area that were identified as hot spots and collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. This shared objective is managed at a Divisional level; however, all outcomes are specific to Hospitals in Orange County. The first strategy was to provide the Mission: FIT POSSIBLE program to at least two schools in the AdventHealth Apopka primary service area per year that were identified as hot spots. This objective was exceeded by the Division, with 26 schools and five additional locations in the reporting Hospital's primary service area receiving the program. Outcomes reported for this strategy, which supports the objective, are specific to Orange County. The Mission: FIT POSSIBLE program is a comprehensive wellness program which brings health and wellness education to schools, churches, and community centers. Health and wellness educators provide education during regular visits, as well as supplemental education for teachers and staff to engage kids in activities that teach them how to be physically and emotionally healthy.The second strategy is to collaborate with partners to strengthen community resiliency by proactively educating and identifying resources to deliver resiliency-focused trainings and resources to the community. Outcomes reported for this strategy, which supports the objective, are specific to reporting Hospitals in Orange County. This includes AdventHealth Apopka, AdventHealth East Orlando, AdventHealth Orlando and AdventHealth Winter Park. This objective was met through an initiative, Circle of Security led by the Early Learning Coalition of Orange County (ELCOC). ELCOC is dedicated to the success of early childhood development in our community through early education. The Circle of Security program builds teachers' responsiveness to young children's emotional needs to better support their positive mental health. The ELCOC seeks to provide the Circle of Security attachment training to early childhood teachers in Orange County's most under-resourced communities. The Division was able to meet this objective in Orange County, the county of the reporting Hospital. The Division will continue to seek additional community partners to collaborate with and strengthen community resiliency in the remaining counties it serves.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedPriority 4: Community Development: Youth Development & Mentorship 2019 Description of the Issue:Youth development and mentorship, specifically relating to youth education and enrichment, was identified by the local Community Health Needs Assessment Committee as a need. Orange County has seen an increase in student absenteeism. Positive influences combined with a strong education as a youth increases the chances for success in adulthood. 2020 Update: The AdventHealth Apopka Community Health Plan has one desired goal statement under the Community Development: Youth Development and Mentorship priority.1. Increase impact of efforts to provide positive experiences and healthy environments for youthGoal 1: Increase impact of efforts to provide positive experiences and healthy environments for youthObjective 1: The first objective is a shared initiative between AdventHealth Altamonte Springs and AdventHealth Apopka. These Hospitals are part of the Central Florida Division of AdventHealth. The Hospitals partnered on this initiative because of a shared CHNA priority and budget. This objective is to provide annual financial and in-kind support, including board service and employee volunteers, for continuation of annual school engagement events and growing new partnerships to serve youth in the community. This objective is funded and managed at the Divisional level and outcomes are reported at a Divisional level unless otherwise indicated. The first strategy is to provide financial support to local organizations that are working to positively impact youth in the community. In 2020, the Division provided financial support of $5,000 to AMIKids, which is an organization that works to protect public safety and positively impact as many youths as possible through the efforts of a diverse and innovative staff. AMIKids works in partnership with youth agencies, local communities, and families.The second strategy is to provide in-kind support, including board-service and employee volunteers, to local organizations that are working to positively impact youth and host annual school engagement events. The Division progressed on this metric by serving on the following boards: AMIKids, Reducing Obesity in Central Florida Kids (ROCK), Blanchard Park YMCA and The Nurture Place. These organizations all focus on curating healthy and positive spaces for youth in Orange County.The third strategy is to establish new partnerships to serve youth in the community. The Division progressed on this metric by establishing a new partnership with No Limit Health and Education, Inc., which is a local nonprofit that hosts several programs. One of these programs, the Flow Detox program, teaches young men in historically underserved neighborhoods how to process anger and hostile emotions as well as to positively express themselves. The program will launch in 2021. Community Needs Not Chosen by AdventHealth ApopkaThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Homelessness: The local Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to improve upon the resources that already exist in Orange County that address this issue. The Hospital decided it would be better to target their efforts in areas where we would have greater impact. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedAdventist Health System/Sunbelt, Inc., dba AdventHealth Wauchula will be referred to in this document as AdventHealth Wauchula or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Wauchula is part of the West Florida Division (the Division) of AdventHealth. The Division includes 11 hospital facilities. This is the first-year update for AdventHealth Wauchula's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Wauchula worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Wauchula chose four priorities for its 2020-2022 Community Health Plan: 1. Mental Health (Behavioral Health)2. Access to Health Care 3. Cardiovascular Disease 4. Education (Social Determinant of Health) Priority 1: Mental Health (Behavioral Health)2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability for adults, children, and adolescents. When mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. Mental health disorders are the 11th leading cause of death in the United States for all age groups and the second leading cause of death among people age 25 to 34. In the AdventHealth Wauchula primary service areas (PSA), the rate of death due to self-harm (suicide) is 19 (per 100,000 population), which is higher than the state rate of 14 (per 100,000 population). Furthermore, 25% (16,345 persons) of the adults in the PSA population self report that they receive insufficient social and emotional support all or most of the time, which is higher than the state rate (21%). This indicator is relevant because social and emotional support is critical for navigating the challenges of daily life as well as for good mental health. Additionally, 17% (15,062 persons) of the Medicare-fee-for-service PSA population are depressed.2020 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Mental Health (Behavioral Health) priority.1. To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders2. To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsGoal 1: To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Champion for Children Advocacy Center to raise awareness of the impact of mental health in youth and adults residing in the Hospital's PSA by creating and implementing two local social media campaigns from a baseline of zero local social media campaigns by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This social media campaign initiative brings awareness to both youth and adult community members regarding mental illnesses and helps to encourage conversations around the topic of mental health to ultimately destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of our 2020-2022 Community Health Plans. The two new organizations are the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We are partnering with both organizations for this initiative. The Ruth E. Handley Children's Advocacy Center's mission is to minimize trauma of child abuse victims and provide prevention support to families needing assistance to keep them intact. The Champion for Children Foundation offers prevention services and assistance programs to protect children, educate parents, strengthen families, assist caregivers, reduce trauma, and provide resources. These partnerships, as well as insight from members of our Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for our social media campaigns moving forward, which will be depression and anxiety. The Hospitals progressed on the set metric of two local social media campaigns created and implemented by the end of year three. Throughout 2020, we connected with members in the community who address mental health and who work with youth and adults. We have established partnerships with those community organizations, including the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We will begin constructing and implementing the campaign in year two, after multiple discussions with the various parties involved who have helped determine the most important topics to highlight for the social media campaign. Additionally, we discussed the best methods of delivering these campaigns to reach both youth and adults and will work to implement these ideas in year two as well. We also learned of an opportunity to collaborate with a system-wide social media campaign that is underway in year two and are actively working to identify ways to incorporate our local mental health community benefit partnerships into the larger system-wide corporate campaign. We have also collected information on resources, local services, and self-management tools to be shared through the campaign and a Division-level community benefit website. Objective 2: The second objective is to increase the number of Mental Health First Aid USA certification training classes provided for free to community members residing in the Hospital's PSA to three certification classes from a baseline of zero by the end of year three. The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Wauchula, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Sebring, AdventHealth Tampa, AdventHealth Zephyrhills, AdventHealth Lake Placid and AdventHealth Wesley Chapel. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The initiative is managed at the Divisional level and funded through the Hospital and all reported outcomes are specific to the reporting Hospital.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThis initiative provides Mental Health First Aid USA certification classes to the community for free. The class is a course that teaches individuals how to help someone who may be experiencing mental health or substance use challenges. The training helps one to identify, understand and respond to signs of addictions and mental illnesses. Mental Health First Aid USA is a national program developed to teach the skills to respond to the signs of mental illness and substance use.The Hospital progressed on its set metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, our Divisional team members were unable to attend an in-person Mental Health First Aid instructor training, which would have certified them to provide the training to community members. Therefore, our 2020 progression focused on restructuring our approach and deployment strategy to develop new and safer ways to train our team members as instructors and to certify our community members in the Mental Health First Aid training. We identified virtual options to train our team, which created the opportunity to train four Divisional team members as Mental Health First Aid USA instructors, twice that of our original goal. Instructors are trained at the Divisional level to provide the classes for community members. In 2021, the Division will provide training for four team members to support the larger objective and will work to identify additional partners in the community for training and locations to begin classes.Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsObjective 1:The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide vouchers to cover the costs of household supplies for homeless adults residing in the Hospital's PSA who receive housing services at Peace River Center (PRC) from a baseline of zero vouchers to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved unless otherwise indicated.This initiative provides vouchers in the form of monetary funds to help cover some of the cost associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, who is our community partner. This will thereby lead to improved health outcomes by providing these essential supplies.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim services, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three vouchers to cover the cost of household supplies for those residents residing at Peace River Center by year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, information regarding their clients most immediate needs was also collected to best determine the amount and means of delivering this program, which will begin in year two. The vouchers will be distributed in the form of dollars funded by the reporting Hospital and will cover the cost of household supplies that may include, but not limited to, hygiene products, linens, cleaning supplies and household necessity items such as toilet paper and garbage bags for those residents living in Peace River Center's Domestic Violence Shelter.Objective 2:The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase awareness of Hospital sponsored community benefit programs and resources available to uninsured/underinsured adults and youth residing in the Hospital's PSA through a partnership with Peace River Center (PRC), by providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC from a baseline of zero presentations by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved.This initiative provides information about our Hospital sponsored Community Benefit programs that are free to community members and targeted to reach those uninsured/underinsured, underserved, low-income and minority members of the community. These programs include, but are not limited to, our Food is Health program that gives participants 10 dollars' worth of free produce for participating in an education class about nutrition and healthy living. These informative in-service presentations are presented to the Crisis Response Outreach Counselors at Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from our free community programs. By sharing our programs with these counselors, they can then share this information with their clients.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim services, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC by the end of year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, in 2020, due to COVID-19 many of our Hospital sponsored programs were put on hold as Division-wide restrictions on in-person gatherings were enforced. In year two, we have pivoted where necessary to address the immediate needs of our community and to find other means to deliver some of our programs. When these programs are back up and running successfully, we will then deliver these in-service presentations as planned.Objective 3:The third objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing mental health from a baseline of zero hours to 200 hours by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital.This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations addressing this priority area.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThe Hospitals progressed on the set metric of 200 hours of paid staff time spent volunteering in the community to address mental health by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal internally. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. Therefore, we have pivoted where necessary and in year two will have virtual volunteer opportunities available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal. Priority 2: Access to Health Care 2019 Description of the Issue:Access to health care is the equitable use of health services to achieve the highest level of health. Barriers to accessing healthcare services include cost of care, insurance coverage, availability of services and culturally competent care. Failure to overcome these barriers leads to delayed care, health complications and financial burdens. Accessing healthcare services is vital to prevent and treat diseases thereby reducing the likelihood of disability and premature death.In the AdventHealth Wauchula PSA, 24% of adults and 8% of children are uninsured or without medical insurance (both percentages are higher than the state averages). Additionally, 27% of adults do not have a regular doctor which is higher than the state average of 24.8%. 2020 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Access to Health Care priority. 1. To implement strategies to reduce transportation barriers leading to improved access to primary care providers2. To provide resources that support the expansion of services that are available to community members and increase access. To increase partnerships with local community organizations with resources to offer community members assistance with gaining health insurance coverageGoal 1: To implement strategies to reduce transportation barriers leading to improved access to primary care providers Objective 1: The first objective is shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to increase access to primary care by decreasing transportation challenges (barriers) among vulnerable adults residing in the Hospital's Primary Service Area (PSA) by developing, implementing and evaluating three new collaborative strategies with community partners from a baseline of zero strategies by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between our Hospital and community organizations who also share a goal to reduce transportation challenges within the community. Through this collaboration, we exchanged ideas, resources, and programs. We also evaluated what additional resources are available, or may become available, to community members with transportation challenges.The Hospital progressed on its set metric of implementing three new collaborative strategies to aid in decreasing transportation challenges among vulnerable adults residing in the Hospital's PSA by year three. Year one was spent identifying community organizations and community members to connect with and invite to be a part of our Community Health Needs Assessment Committee. Through this committee, we worked to discuss these challenges. We established new partnerships with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.We met with these partners, as well as the other community organization representatives, to discuss what transportation barriers exist within the Hospital's PSA. We identified that a public transit system does not exist but there are several transportation programs that are new and available to our underserved and transportation disadvantaged population. We discussed that the best strategy is to get the information about these programs out to our community members and those organizations who serve them and to help these individuals enroll in these programs. We have come up with a plan to execute this which includes a community summit that will be implemented in year two. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to establish a new transportation taskforce in Hardee and Highlands Counties to co-host at least two community summits (with AdventHealth Sebring and AdventHealth Lake Placid) from a baseline of zero summits to increase awareness of the impact of transportation accessibility on community health and wellness and employment sustainability for community members residing in the Hospital's PSA by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative brings together multiple organizations from the community who share a common goal in seeking to improve transportation access and a platform for getting the transportation programs available out to the communities we serve. The Hospitals progressed on the set metric of establishing a transportation taskforce to co-host two community summits by the end of year three. Year one was spent establishing a partnership with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThrough these partnerships we learned that a transportation taskforce already exists for Hardee and Highlands Counties and concluded it would be in our best interest to join this taskforce that is already in place. In year two, we will designate one of our Hospital team members to join this taskforce to represent AdventHealth. Year one was also spent discussing ideas and making plans for the community summit, which is scheduled to take place in year two, due to COVID-19 restrictions on in-person gatherings for 2020. The community summit in year two will be an in-person, informative, transportation health fair that will be held at our Hospital and will offer information and education regarding the transportation programs available. It will serve to inform the public, patients, families, and organizations who serve the transportation disadvantaged community members, about the transportation programs available in the Hospital's PSA and help them to enroll. Goal 2: To provide resources that support the expansion of services that are available to community members and increase access. To increase partnerships with local community organizations with resources to offer community members assistance with gaining health insurance coverageObjective 1: The first objective is to partner with the Florida Department of Health in Hardee and Highlands Counties to develop and implement "Health Insurance 101" community workshop series (enrollment, how to use insurance, KidCare education, terms, and definitions, etc.) for adults residing in the Hospital's PSA by providing three free community workshop series from a baseline of zero workshop series by the end of year three. The initiative is funded and managed through AdventHealth Wauchula and all outcomes are specific to the reporting Hospital. The initiative provides health education to uninsured and underinsured residents to help them understand how to enroll in affordable health insurance, utilize health insurance, and seek out primary care services. This is done in partnership with the Healthcare Planning Council of Southwest Florida. This organization employs health insurance navigators to educate the public on the health insurance marketplace and other government assisted health insurance programs. Their mission is to improve the health and wellness of the community by promoting healthy lifestyles, reducing health disparities, increasing access to quality health related services, detecting, and eliminating gaps in services, expanding knowledge through education, and facilitating community partnerships. The Hospital progressed on its set metric of providing three free "Health Insurance 101" workshops for the community by the end of year three. In year one, we met with the Florida Department of Health and other team members on our Community Health Needs Assessment Committee to discuss ideas, implementation, and potential partnerships for these workshops. It was decided that in year two we will partner with the Healthcare Planning Council of Southwest Florida to deliver these workshops that will begin in a virtual format and then resume to in-person workshops once the Division-wide restrictions for in-person gatherings have lifted. Objective 2: The second objective is to increase access to primary care services among underinsured/uninsured community members by providing donated medical supplies to two local community clinics from a baseline of one by the end of year three. The initiative is funded and managed through AdventHealth Wauchula and all outcomes are specific to the reporting Hospital. The initiative provides two identified clinics within the Hospital's PSA who serve low-income, uninsured, or underinsured populations with donated medical supplies. The Hospital progressed on its set metric of providing donated medical supplies to two local community clinics by the end of year three. Year one was spent identifying and creating partnerships with two community clinics who serve the underserved population. The clinics chosen were Samaritan's Touch Care Center and Central Florida Health Care (CFHC) of Hardee County. Samaritan's Touch is a faith-based, charitable healthcare center in Highlands County offering free primary and specialized medical, dental and vision care to uninsured financially struggling families who have no medical insurance of any kind and whose income is at or below 200% of the Federal Poverty Guidelines. CFHC of Hardee County is the local federally qualified healthcare clinic. In year two, information regarding medical supply needs and costs will be gathered for each facility to determine the quantity and type of medical supplies the Hospital will donate. The delivery of these supplies to the clinics will also take place in year two. Priority 3: Cardiovascular Disease2019 Description of the Issue:Coronary heart disease is a leading cause of death in the U.S. and is also related to high blood pressure, high cholesterol, and heart attacks. In the AdventHealth Wauchula primary service area (PSA), 9% (7,614 persons) of adults aged 18 and older have coronary heart disease or angina (heart related chest pain). Additionally, the rate of death due to heart disease per 100,000 population is 155 (268 average annual deaths from 2012 2016), which is higher than the state rate of 150 and 22% (13,201 persons) of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2020 Update: The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Cardiovascular Disease priority. 1. Improve access to health education, early intervention programs and resources related to cardiovascular disease2. Decrease tobacco use in adults and youth community membersGoal 1: Improve access to health education, early intervention programs and resources related to cardiovascular disease Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the number of Hospital sponsored American Heart Association (AHA) community CPR (Cardiopulmonary Resuscitation) out-of-hospital bystander classes for adults and youth from a baseline of zero to two by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. This initiative provides training to lay community members to be able to save the lives of individuals experiencing a cardiac event by administering the two-step, Hands-Only CPR. The Hospital progressed on its set metric of two classes sponsored by the end of year three. Throughout 2020, we have strengthened relationships with local community organizations that will host the train-the-trainer community CPR classes and promote the training among the community members they serve within our Hospital's PSA. In year one, the Division team met with our local American Heart Association on a bi-monthly basis to develop strategies and propose timelines for training and implementation in year two. As a result of our year one efforts, together with our local AHA team, we have created a novel train-the-trainer model for community CPR classes that will equip participants with the two-step, Hands-Only CPR skills to help save a life in the community setting. In addition, we received a donation of adult and child CPR Anytime training kits to launch our 2021 pilot of community CPR classes. Our Division team will complete the AHA instructor training in May 2021.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 2:The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Florida Department of Health (FDOH) in Highlands County to provide patient referrals at discharge to enroll in free Diabetes Self-Management Education and Support (DSMES) classes by creating an internal referral system to refer 75 underinsured/uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital.This initiative provides an internal referral system for the Hospital to directly enroll patients in need of the FDOH's DSMES classes. The Florida Department of Health works to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. The DSMES referral program connects diabetic and pre-diabetic individuals to health education that provides them with knowledge and tools to self-manage their chronic condition, improve health behaviors, and change health outcomes.The Hospitals progressed on the set metric of creating an internal referral system to refer 75 underinsured/uninsured adults residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, the Florida Department of Health of Highlands County temporarily cancelled DSMES classes in year one. Nevertheless, we have utilized this time to develop a tentative timeline and internal plan for referring participants to DSMES classes at the Florida Department of Health of Highlands County once classes resume. The internal plan for referring participants to the DSMES classes involves a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an "at discharge" referral system to connect patients to our Community Benefit programs and initiatives. In year two, the referral system will be piloted to connect patients (at discharge) with a history of tobacco use to free tobacco cessation classes offered by the Central Florida Area Health Education Center. This same referral system will soon be expanded to also refer patients to DSMES classes once in-person classes resume, ensuring that the Hospital will be able to refer 75 patients to these classes by the end of 2022.Objective 3:The third objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will support a series of five nutrition education class series among low-income families in the PSA from a baseline of two by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of five class series offered to low-income families by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 4:The fourth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will distribute 200 produce vouchers (valued at $10 each) to program participants from a baseline of 72 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of distributing 200 produce vouchers to program participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 5:The fifth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food Is Health program will build and maintain partnerships with local community organizations serving low-income/low access communities by engaging seven community partners from a baseline of four by the end of year three. This objective is managed at a Divisional level, and outcomes reported represent the Hospitals in Hardee and Highlands counties; AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of building and maintaining partnerships by recruiting three of the seven new community partner organizations by the end of year three. The first year was focused on creating a formal partnership with the local produce vendor, Solace Farms. We did this by onboarding the produce vendor and having them sign a memorandum of understanding (MOU) to agree to the terms of the program and accept the formal partnership. We also engaged a new educational partner, the University of Florida (UF)/IFAS Extension of Hardee, Desoto, and Manatee counties. UF/IFAS Extension is an outreach partnership between the state, federal and county governments to provide scientific knowledge and expertise to the public. This expertise includes educational nutrition programming targeted for the low-income, underserved and minority members of the population. Through this partnership, UF/IFAS Extension agreed to teach nutritional classes for the program. In year one, we connected with another community partner who also expressed interest in being a host site for the program once in-person classes resume. This organization is Heartland Core Wellness, whose mission is to address the health and wellness needs of the community with a focus on prevention education and the reduction of youth substance abuse.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedObjective 6: The sixth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will increase the number of participants among low-income families in the PSA to 50 from a baseline of 15 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of increasing program participation to 50 participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 7:The seventh objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will increase the number of health screenings among adults living in food deserts or low-income/low access communities to 75 from a baseline of 23 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of 75 health screenings by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. These modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with the Central Florida Area Health Education Center (AHEC) to provide continuing education classes to 50 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative provides educational classes that lead to an increase in knowledge for those AdventHealth team members who treat patients with tobacco use, or work with these patients at discharge, about tobacco cessation resources available, which could potentially improve patients' health through support for eliminating tobacco use. This is conducted through a partnership with Central Florida AHEC, the local affiliate of the national organization of AHEC, that is a community focused organization that develops and implements community-based health promotion activities and education programs which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital progressed on its set metric of educating 50 team members about tobacco cessation resources by the end of year three. In year one, the Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and Central Florida AHEC. The MOU illustrates how Central Florida AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to providers and staff of AdventHealth Wauchula, thereby resulting in earned CEUs and CMEs for these team members. In year one, our Hospital team members worked additional hours and jobs to meet the needs caused by the impact of COVID-19 on our Hospitals, patients, and community members; because of this, we delayed adding any additional training involving this objective for our team members during this time. In year two, AHEC will provide these trainings to our team members, either live or through a virtual format, in which team members will then earn their CEUs/CMEs, which are needed to keep their licenses and certifications for their positions. Additionally, the information learned in these classes will increase team members' knowledge and ability to offer treatment services for patients and community members who are tobacco users, thereby potentially improving their overall health. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide patient referrals at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit smoking tobacco through a partnership with AHEC and create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 18 patients from a baseline of zero by end of year three. The objective is funded through AdventHealth Sebring but managed by the Division. Reported referrals are specific to the reporting Hospital.This initiative provides an internal patient referral system at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit tobacco. This initiative is conducted through a partnership with AHEC and the Hospital's internal Care 360 team. AHEC is a community focused organization that develops and implements community-based health promotion activities and education programs which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital's internal Care 360 team works with patients at discharge and serves to identify patients needing tobacco cessation. Once identified, the Care 360 team can use this internal referral system to directly enroll patients into AHEC's tobacco cessation program. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThe Hospitals progressed on the set metric of providing resources for 18 patients at discharge through an internal referral system between the Hospital and AHEC by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Objective 3: The third objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase access to tobacco cessation classes for adults residing in the Hospital's PSA by five classes from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative increases access to tobacco cessation classes that improve health through a partnership with Central Florida Area Health Education Center (AHEC), the local affiliate of the national organization of AHEC, who is a community focused organization that develops and implements community-based health promotion activities and education programs which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospitals progressed on the set metric of increasing access to five tobacco cessation classes by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Unfortunately, in year one, all in-person AHEC free tobacco cessation classes were cancelled at the beginning of the COVID-19 pandemic. Furthermore, company policy has prevented us from hosting free tobacco cessation classes on our Hospital campuses. However, we were still able to promote AHEC's virtual classes in year one by sharing their flyers and class information with our community partners, posting flyers and dates on our internal CREATION Life/Wellness Center calendars and Hospital spaces, and sharing class information with our internal Care 360 team for them to inform patients at discharge of the program. In year two we will identify community locations that may allow in-person tobacco cessation classes and will work with AHEC to secure these locations, provide free marketing for the classes, sponsor costs associated with conducting these classes, and offer free class space to host classes within our Hospitals once our internal restrictions on in-person gatherings have lifted.Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Wauchula primary service area, 20% (12,547 persons) of the population aged 25 and older do not have a high school diploma (or equivalency) or higher and this percentage is higher than the state average of 12%. Educational attainment is a social determinant of health and is linked to health outcomes. Additionally, improving health literacy may be a useful strategy for reducing disparities in health related to education.2020 Update: Recognizing the impact of social determinants of health, like education, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach in addition to our partnership with Aunt Bertha will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Wauchula Community Health Plan has two desired goal statements under the Education (Social Determinant of Health) priority. 1. To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health2. To support community efforts that address the problem of educational attainment as a social determinant of healthGoal 1: To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with local community school and/or college programs to create a community-based professional development program (interviewing skills, resume writing, basic computer skills, mentoring) for underserved adults residing in the Hospital's PSA by providing three community workshops from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides underserved adults with educational and hands-on training skills, such as resume writing and computer skills, needed to enter the workforce. The Hospitals progressed on the set metric of providing three community workshops to underserved adults by the end of year three. Year one was spent identifying career readiness programs and organizations within the Hospital's PSA to partner with for this objective. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedThrough these partnerships, we have identified resources - including teachers, classes, locations, and target audience members - for these development programs. Due to COVID-19, in year one, in-person classes and programs delivered through these organizations were cancelled. Additionally, Division-wide restrictions on in-person gatherings were also enforced for our Hospitals and company policy prevented us from hosting in-person classes on our Hospital campuses. We have pivoted where necessary and in year two will begin partnering with these organizations to deliver this program virtually or in-person when restrictions lift. We will do this by having our team members offer lessons about real-world career opportunities at AdventHealth and sharing the process of attaining and maintaining a successful career. Additionally, our Hospital will offer support in the form of free meeting space to host the classes for these partner organizations, free marketing materials, and additional costs covered of delivering these classes. Objective 2: The second objective is a shared initiative between AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to establish a new partnership with local community organizations to identify education access barriers in underserved adults residing in the Hospital's PSA from a baseline of zero organizations to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved.This initiative creates a partnership with local community organizations working in adult education to help discover challenges to educational attainment and means to help resolve them. The Hospitals met the set metric of establishing three new partnerships with local community organizations to identify barriers for accessing education in underserved adults by the end of year three. We established a partnership with three new community partners - CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of our community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. We have also created ideas to overcome these barriers and in year two will begin implementing some of these solutions in conjunction with these partnerships.Goal 2: To support community efforts that address the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide education vouchers to cover the costs of General Educational Development (GED) materials (textbooks, registration fees and tests) for adults residing in the Hospital's PSA from a baseline of zero vouchers to three vouchers by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides education vouchers in the form of monetary funds to help cover some of the cost associated with the GED test. The Hospitals progressed on the set metric of providing three education vouchers in the form of monetary funds for adults residing in the Hospital's PSA by the end of year three. Year one was spent identifying and establishing a partnership with the local GED preparation and testing organization, South Florida State College. In doing so, we were able to learn more about their monetary needs to support the program. In addition, we gathered information from this organization relating to populations and number of adults served, need for financial assistance, and any programs offering assistance that are already available for eligible adults. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. Due to COVID-19, South Florida State College's GED classes were initially cancelled. In year two, the Hospital will determine the dollar amount to provide to cover the cost of this program for those underserved adults.Objective 2: The second objective is a shared initiative with AdventHealth Lake Placid and AdventHealth Sebring. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing education (as a social determinant of health) from a baseline of zero hours to 150 hours by the end of year three. The objective is funded and managed through all Hospitals; however, outcomes are specific to the reporting Hospital. This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospitals progressed on the set metric of 150 hours of paid staff time spent volunteering in the community to address education (as a social determinant of health) by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. We have pivoted where necessary and in year two will have virtual volunteer opportunities also available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 10 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by AdventHealth Wauchula:The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospital and community stakeholders used the following criteria to narrow the larger list to the priority areas noted above:1. How acute is the need? (based on data and community concern)2. What is the trend? Is the need getting worse?3. Does the Hospital provide services that relate to the priority? 4. Is someone else - or multiple groups - in the community already working on this issue? 5. If the Hospital were to address this issue, are there opportunities to work with community partners? Based on this prioritization process, the Hospital did not choose the following community issues:1. Poor Dental Health: Many oral diseases can be prevented with routine care and regular dental checkups. The health of the teeth, the mouth and the surrounding craniofacial (skull and face) structures is central to a person's overall health and well-being. Lack of access to dental care for all ages remains a public health challenge. In the AdventHealth Wauchula Primary Service Area (PSA), the access to qualified dentists at a rate (per 100,000 pop.) is 36 (in 2015 year), as compared to the state rate of 56. The Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time.2. Tobacco Use: In the AdventHealth Wauchula PSA, an estimated 13,201 of adults age 18 or older self report currently smoking cigarettes some days or every day. This indicator is relevant because tobacco use is linked to leading causes of death such as cancer and cardiovascular disease. In the Hospital PSA, 22% of adults are currently smoking cigarettes, which is higher than the state percentage of 19%. The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address tobacco use will be wrapped into the priority area of heart disease.3. Obesity/Overweight/Obese: In the AdventHealth Wauchula PSA, approximately 33% of adults aged 20 and older (21,963 persons) self report that they have a Body Mass Index (BMI) greater than 30.0 (obese) in the report area. The state percentage is 27%. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address Obesity/Overweight/Obese will be wrapped into the education priority area. The Community Health Needs Assessment Committee (CHNAC) will approach this area of need more comprehensively, as other barriers contribute to negative health outcomes in this area of priority. Part V, Section B, Line 11 Continuation of Footnote Group A-Facility 11 -- Central Texas Medical CenterDescription of CHNA Significant Needs ContinuedOn March 31, 2020, all the net assets associated with the operation of the hospital known as Central Texas Medical Center (CTMC or the Hospital) were sold to Christus Santa Rosa Health Care Corporation. Prior to the sale on March 31, 2020, CTMC was owned and operated by Adventist Health System/Sunbelt, Inc. Christus Santa Rosa Health Care Corporation, the purchaser, is also an organization exempt from federal income tax under Internal Revenue Code Section 501(c)(3). Prior to the sale of the Hospital's assets on March 31, 2020, work has done on the development of the Community Health Plan and acquiring the board approval for it. Implementation of the goals and objectives outlined in the Community Health Plan/Implementation Strategy was not able to be initiated in sufficient scope and breadth prior to the sale in order to provide any meaningful feedback with respect to the results of the actions outlined in the Community Health Plan/Implementation Strategy. Accordingly, the only outcomes available to report are that of the successful development and approval of the 2020-2022 Implementation Plan. Part V, Section B, Line 11 Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant NeedsAdventist Health System/Sunbelt, Inc. d/b/a AdventHealth Sebring and AdventHealth Lake Placid, will be referred to in this document as AdventHealth Sebring or "the Hospital". The Hospital is a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. In January 2019, every wholly-owned entity of AHSSHC adopted the AdventHealth system brand. Our identity has been unified to represent the full continuum of care our system offers. Any references to our prior Community Health Needs Assessments (CHNAs) or prior Community Health Plans (CHPs) will utilize our new name for consistency. AdventHealth Sebring is part of the West Florida Division (the Division) of AdventHealth. The Division includes 11 hospital facilities. This is the first-year update for AdventHealth Sebring's 2020-2022 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2020 as part of its 2019 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Sebring worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2019 Community Health Needs Assessment used primary data interviews and surveys; secondary data from local, regional, and national health-related sources; and Hospital prevalence data to help the Hospital determine the health needs of the community it serves. Once the data was gathered, the primary issues identified in the community health needs assessment were prioritized by community and Hospital stakeholders, who then selected key issues for the Hospital to address in its 2020-2022 Community Health Plan. The first-year progress on the Community Health Plan is noted below. The narrative describes the prioritized issues identified in 2019 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital did not address. AdventHealth Sebring chose four priorities for its 2020-2022 Community Health Plan: 1. Mental Health (Behavioral Health)2. Transportation 3. Cardiovascular Disease 4. Education (Social Determinant of Health) Priority 1: Mental Health (Behavioral Health)2019 Description of the Issue:The burden of mental illness in the United States is among the highest of all diseases, and mental disorders are among the most common causes of disability for adults, children, and adolescents. When mental health disorders are untreated, those affected are at high risk for many unhealthy and unsafe behaviors, including alcohol or drug abuse, violent or self-destructive behavior and suicide. Mental health disorders are the 11th leading cause of death in the United States for all age groups and the second leading cause of death among people age 25 to 34. In the AdventHealth Sebring primary service areas (PSA), the rate of death due to self-harm (suicide) is 19 (per 100,000 population), which is higher than the state rate of 14 (per 100,000 population). Furthermore, 25% of the adults in the PSA population self report that they receive insufficient social and emotional support all or most of the time, which is higher than the state rate (21%). This indicator is relevant because social and emotional support is critical for navigating the challenges of daily life as well as for good mental health. Additionally, 17% of the Medicare-fee-for-service PSA population are depressed.2020 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Mental Health (Behavioral Health) priority. 1. To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders2. To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsGoal 1: To increase education and awareness related to mental health by engaging public schools, community members, organizations and stakeholders Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Champion for Children Advocacy Center to raise awareness of the impact of mental health in youth and adults residing in the Hospital's PSA by creating and implementing two local social media campaigns from a baseline of zero local social media campaigns by the end of year three. The objective is funded and managed through all Hospitals and outcomes reported represent all Hospitals involved. This social media campaign initiative brings awareness to both youth and adult community members regarding mental illnesses and helps to encourage conversations around the topic of mental health to ultimately destigmatize mental illnesses and encourage those suffering to seek help. Champion for Children's Advocacy Center split into two organizations after the creation of our 2020-2022 Community Health Plans. The two new organizations are the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We are partnering with both organizations for this initiative. The Ruth E. Handley Children's Advocacy Center's mission is to minimize the trauma of child abuse victims and provide prevention support to families needing assistance to keep them intact. The Champion for Children Foundation offers prevention services and assistance programs to protect children, educate parents, strengthen families, assist caregivers, reduce trauma, and provide resources. These partnerships, as well as insight from members of our Community Health Needs Assessment Committee (CHNAC), have helped us to determine the most important topics to address for our social media campaigns moving forward, which will be depression and anxiety. The Hospitals progressed on the set metric of two local social media campaigns created and implemented by the end of year three. Throughout 2020, we connected with members in the community who address mental health and who work with youth and adults. We have established partnerships with those community organizations, including the Ruth E. Handley Children's Advocacy Center and the Champion for Children Foundation. We will begin constructing and implementing the campaign in year two, after multiple discussions with the various parties involved who have helped determine the most important topics to highlight for the social media campaign. Additionally, we discussed the best methods of delivering these campaigns to reach both youth and adults and will work to implement these ideas in year two as well. We also learned of an opportunity to collaborate with a system-wide social media campaign that is underway in year two and are actively working to identify ways to incorporate our local mental health community benefit partnerships into the larger system-wide corporate campaign. We have also collected information on resources, local services, and self-management tools to be shared through the campaign and a Division-level community benefit website. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 2:The second objective is to increase the number of Mental Health First Aid USA certification training classes provided for free to community members residing in the Hospital's PSA to three certification classes from a baseline of zero by the end of year three.The deployment of the Mental Health First Aid classes is a shared initiative between AdventHealth Sebring, AdventHealth Carrollwood, AdventHealth Connerton, AdventHealth Dade City, AdventHealth North Pinellas, AdventHealth Ocala, AdventHealth Tampa, AdventHealth Zephyrhills, AdventHealth Wauchula, AdventHealth Lake Placid and AdventHealth Wesley Chapel. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The initiative is managed at the Divisional level and funded through the Hospital and all reported outcomes are specific to the reporting Hospital.This initiative provides Mental Health First Aid USA certification classes to the community for free. The class is a course that teaches individuals how to help someone who may be experiencing mental health or substance use challenges. The training helps one to identify, understand and respond to signs of addictions and mental illnesses. Mental Health First Aid USA is a national program developed to teach the skills to respond to the signs of mental illness and substance use.The Hospital progressed on its set metric of providing three free Mental Health First Aid USA certification training classes to community members residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, our Divisional team members were unable to attend an in-person Mental Health First Aid instructor training, which would have certified them to provide the training to community members. Therefore, our 2020 progression focused on restructuring our approach and deployment strategy to develop new and safer ways to train our team members as instructors and to certify our community members in the Mental Health First Aid training. We identified virtual options to train our team, which created the opportunity to train four Divisional team members as Mental Health First Aid USA instructors, twice that of our original goal. Instructors are trained at the Divisional level to provide the classes for community members. In 2021, the Division will provide training for four team members to support the larger objective and will work to identify additional partners in the community for training and locations to begin classes.Goal 2: To increase community-level partnerships to enhance existing efforts currently addressing factors that impact mental health in youth and adultsObjective 1:The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide vouchers to cover the costs of household supplies for homeless adults residing in the Hospital's PSA who receive housing services at Peace River Center (PRC) from a baseline of zero vouchers to three by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved unless otherwise indicated.This initiative provides vouchers in the form of monetary funds to help cover some of the cost associated with purchasing household and personal supplies for community members that are supported by the residential housing programs offered at Peace River Center, who is our community partner. This will thereby lead to improved health outcomes by providing these essential supplies.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three vouchers to cover the cost of household supplies for those residents residing at Peace River Center by year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, information regarding their clients most immediate needs was also collected to best determine the amount and means of delivering this program, which will begin in year two. The vouchers will be distributed in the form of dollars funded by the reporting Hospital and will cover the cost of household supplies that may include, but not limited to, hygiene products, linens, cleaning supplies and household necessity items such as toilet paper and garbage bags for those residents living in Peace River Center's Domestic Violence Shelter.Objective 2:The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase awareness of Hospital sponsored community benefit programs and resources available to uninsured/underinsured adults and youth residing in the Hospital's PSA through a partnership with Peace River Center (PRC) by providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC from a baseline of zero presentations by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved.This initiative provides information about our Hospital sponsored Community Benefit programs that are free to community members and targeted to reach those uninsured/underinsured, underserved, low-income and minority members of the community. These programs include, but are not limited to, our Food is Health program that gives participants 10 dollars' worth of free produce for participating in an education class about nutrition and healthy living. These informative in-service presentations are presented to the Crisis Response Outreach Counselors at Peace River Center who connect directly with those community members in need of mental health and crisis response counseling. They may also benefit from our free community programs. By sharing our programs with these counselors, they can then share this information with their clients.Peace River Center is a 501(c)(3) not-for-profit organization that strives to impact the lives of its clients and the community they serve by engaging, restoring, and empowering individuals to reach their fullest potential by offering a broad range of mental health, victim services, and substance use disorder services throughout Polk, Highlands, and Hardee counties, including housing and domestic violence shelters.The Hospitals progressed on the set metric of providing three informative in-service presentations to Crisis Response Outreach Counselors at PRC by the end of year three. The first year was spent establishing the partnership with Peace River Center, as well as collecting data and information about the organization and the population they serve. Additionally, in 2020, due to COVID-19 many of our Hospital sponsored programs were put on hold as Division-wide restrictions on in-person gatherings were enforced. In year two, we have pivoted where necessary to address the immediate needs of our community and to find other means to deliver some of our programs. When these programs are back up and running successfully, we will then deliver these in-service presentations as planned.Objective 3:The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing mental health from a baseline of zero hours to 300 hours by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThis initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations addressing this priority area. The Hospitals progressed on the set metric of 300 hours of paid staff time spent volunteering in the community to address mental health by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal internally. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. Therefore, we have pivoted where necessary and in year two will have virtual volunteer opportunities available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal. Priority 2: Transportation 2019 Description of the Issue:A poor transportation system prevents those who do not own a car or have reliable transportation from accessing healthcare. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. In the AdventHealth Sebring primary service area (PSA), 3% (1,026 persons) of the population are currently using public transportation as their primary means of transportation to work. Furthermore, 27% of the population (28,585 persons) age 18 years and older do not have a regular healthcare provider, which is higher than the state average of 25%.2020 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Transportation priority. 1. To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation2. To increase access to culturally appropriate nutritious food options in food desert or low income/low access areas by implementing the Food is Health programGoal 1: To increase community partnerships with local transportation systems, leaders, and businesses to develop new strategies for improving access to transportation Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to decrease transportation challenges (barriers) among vulnerable adults residing in the Hospital's PSA by creating and implementing two new collaborative strategies from a baseline of zero strategies by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. The initiative created a partnership between our Hospital and community organizations who also share a goal to reduce transportation challenges within the community. Through this collaboration, we exchanged ideas, resources, and programs. We also evaluated what additional resources are available, or may become available, to community members with transportation challenges.The Hospital progressed on its set metric of implementing two new collaborative strategies to aid in decreasing transportation challenges among vulnerable adults residing in the Hospital's PSA by year three. Year one was spent identifying community organizations and community members to connect with and invite to be a part of our Community Health Needs Assessment Committee. Through this committee, we worked to discuss these challenges. We established new partnerships with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.We met with these partners, as well as the other community organization representatives, to discuss what transportation barriers exist within the Hospital's PSA. We identified that a public transit system does not exist but there are several transportation programs that are new and available to our underserved and transportation disadvantaged population. We discussed that the best strategy is to get the information about these programs out to our community members and those organizations who serve them and to help these individuals enroll in these programs. We have come up with a plan to execute this which includes a community summit that will be implemented in year two. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared primary service area. The objective is to establish a new transportation taskforce in Hardee/Highlands Counties to co-host at least two community summits (with AdventHealth Wauchula and AdventHealth Lake Placid) from a baseline of zero summits to increase awareness of the impact of transportation accessibility on community health, wellness and employment sustainability for community members residing in the Hospital's PSA by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative brings together multiple organizations from the community who share a common goal in seeking to improve transportation access and a platform for getting the transportation programs available out to the communities we serve. The Hospitals progressed on the set metric of establishing a transportation taskforce to co-host two community summits by the end of year three. Year one was spent establishing a partnership with the Heartland Regional Transportation Planning Organization and the Central Florida Regional Planning Council. The Heartland Regional Transportation Planning Organization coordinates transportation plans for the Heartland Region including the six counties of DeSoto, Glades, Hardee, Hendry, Highlands and Okeechobee and the urbanized area of Highlands County, including the cities of Sebring and Avon Park. The Central Florida Regional Planning Council's mission is to provide support to the citizens and counties of the Heartland region and to seek ways to improve the quality of life of the citizens of the Heartland.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThrough these partnerships we learned that a transportation taskforce already exists for Hardee and Highlands Counties and concluded it would be in our best interest to join this taskforce that is already in place. In year two, we will designate one of our Hospital team members to join this taskforce to represent AdventHealth. Year one was also spent discussing ideas and making plans for the community summit, which is scheduled to take place in year two, due to COVID-19 restrictions on in-person gatherings for 2020. The community summit in year two will be an in-person, informative, transportation health fair that will be held at our Hospital and will offer information and education regarding the transportation programs available. It will serve to inform the public, patients, families, and organizations who serve the transportation disadvantaged community members, about the transportation programs available in the Hospital's PSA and help them to enroll. Goal 2: Increase access to culturally appropriate nutritious food options in food desert or low income/low access areas Objective 1: The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will support a series of three nutrition education class series among low-income families in the PSA from a baseline of one by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of three class series offered to low-income families by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 2: The second objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will distribute 120 produce vouchers (valued at $10 each) to program participants from a baseline of 40 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of distributing 120 produce vouchers to program participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. We switched from paper to electronic produce vouchers, created a process to allow drive-thru produce pick-up and consulted with our educational partners to convert classes to a virtual format. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Objective 3: The third objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food Is Health program will build and maintain partnerships with local community organizations serving low-income/low access communities by engaging six community partners from a baseline of three by the end of year three. This objective is managed at a Divisional level, and outcomes reported represent the Hospitals in Hardee and Highlands counties; AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of building and maintaining partnerships by recruiting three of the six new community partner organizations by the end of year three. The first year was focused on creating a formal partnership with the local produce vendor, Solace Farms. We did this by onboarding the produce vendor and having them sign a memorandum of understanding (MOU) to agree to the terms of the program and accept the formal partnership. We also engaged a new educational partner, the University of Florida (UF)/IFAS Extension of Hardee, Desoto, and Manatee counties. UF/IFAS Extension is an outreach partnership between the state, federal and county governments to provide scientific knowledge and expertise to the public. This expertise includes educational nutrition programming, targeted for the low-income, underserved and minority members of the population. Through this partnership, UF/IFAS Extension agreed to teach nutritional classes for the program. In year one, we connected with another community partner who also expressed interest in being a host site for the program once in-person classes resume. This organization is Heartland Core Wellness, whose mission is to address the health and wellness needs of the community with a focus on prevention education and the reduction of youth substance abuse. Objective 4: The fourth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states that the Food is Health program will increase the number of participants among low-income families in the PSA to 30 from a baseline of 11 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners, the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of increasing program participation to 30 participants by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedObjective 5:The fifth objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The objective states the Food is Health program will increase the number of health screenings among adults living in food deserts or low-income/low access communities to 45 from a baseline of 13 by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital.The Food is Health program is an AdventHealth West Florida Division program which increases access to health education and healthy foods to improve the overall health of the communities the Hospital serves. Through collaboration with community partners the program connects with low-income/low access communities and provides free health education, health screenings, and produce vouchers which are used to purchase fresh fruits and vegetables.The Hospital progressed on its set metric of 45 health screenings by the end of year three. The first year was focused on establishing partnerships with local produce vendors, educational partners, and community sites. Due to COVID-19, we also modified several components of the Food is Health program to offer it virtually. The modifications will make it easy to relaunch the Food is Health program safely for our communities in year two.Priority 3: Cardiovascular Disease2019 Description of the Issue:Coronary heart disease is a leading cause of death in the U.S. and is also related to high blood pressure, high cholesterol, and heart attacks. In the AdventHealth Sebring primary service area (PSA), 9% of adults aged 18 and older have coronary heart disease or angina (heart related chest pain). Additionally, the rate of death due to heart disease per 100,000 population is 156 (370 average annual deaths from 2012 2016), which is higher than the state rate of 150 and 22% of the PSA population smoke cigarettes (higher than the state rate of 19%). Tobacco use is also linked to cardiovascular disease.2020 Update: The AdventHealth Sebring Community Health Plan has two desired goal statements under the Cardiovascular Disease priority.1. Improve access to health education, early intervention programs and resources related to cardiovascular disease2. Decrease tobacco use in adults and youth community membersGoal 1: Improve access to health education, early intervention programs and resources related to cardiovascular diseaseObjective 1:The first objective is a Divisional initiative and appears on multiple community health plans of Hospitals in the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the number of Hospital sponsored American Heart Association (AHA) community CPR (Cardiopulmonary Resuscitation) out-of-hospital bystander classes for adults and youth from a baseline of zero to two by the end of year three. This objective is managed at a Divisional level, however all funding and outcomes reported are specific to the reporting Hospital. This initiative provides training to lay community members to be able to save the lives of individuals experiencing a cardiac event by administering the two-step, Hands-Only CPR.The Hospital progressed on its set metric of two classes sponsored by the end of year three. Throughout 2020, we have strengthened relationships with local community organizations that will host the train-the-trainer community CPR classes and promote the training among the community members they serve within our Hospital's PSA. In year one, the Division team met with our local American Heart Association on a bi-monthly basis to develop strategies and propose timelines for training and implementation in year two. As a result of our year one efforts, together with our local AHA team, we have created a novel train-the-trainer model for community CPR classes that will equip participants with the two-step, Hands-Only CPR skills to help save a life in the community setting. In addition, we received a donation of adult and child CPR Anytime training kits to launch our 2021 pilot of community CPR classes. Our Division team will complete the AHA instructor training in May 2021.Objective 2:The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with the Florida Department of Health (FDOH) in Highlands County to provide patient referrals at discharge to enroll in free Diabetes Self-Management Education and Support (DSMES) classes by creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals, however reported outcomes are specific to the reporting Hospital.This initiative provides an internal referral system for the Hospital to directly enroll patients in need in the FDOH's DSMES classes. The Florida Department of Health works to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. The DSMES referral program connects diabetic and pre-diabetic individuals to health education that provides them with knowledge and tools to self-manage their chronic condition, improve health behaviors, and change health outcomes.The Hospitals progressed on the set metric of creating an internal referral system to refer 100 underinsured/uninsured adults residing in the Hospital's PSA by the end of year three. Due to the COVID-19 pandemic, the Florida Department of Health of Highlands County temporarily cancelled DSMES classes in year one. Nevertheless, we have utilized this time to develop a tentative timeline and internal plan for referring participants to DSMES classes at the Florida Department of Health of Highlands County once classes resume. The internal plan for referring participants to the DSMES classes involves a tremendous amount of collaborative efforts with our AdventHealth Care 360 team to create an "at discharge" referral system to connect patients to our Community Benefit programs and initiatives. In year two, the referral system will be piloted to connect patients (at discharge) with a history of tobacco use to free tobacco cessation classes offered by the Central Florida Area Health Education Center. This same referral system will soon be expanded to also refer patients to DSMES classes once in-person classes resume, ensuring that the Hospital will be able to refer 100 patients to these classes by the end of 2022.Objective 3:The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid time for Hospital staff/team members to volunteer with community organizations addressing heart disease and stroke from a baseline of zero hours to 200 hours by the end of year three. The objective is funded through all Hospitals and managed by the Division, however reported outcomes are specific to the reporting Hospital.This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area.The Hospitals progressed on the set metric of 200 hours of paid staff time spent volunteering in the community to address heart disease and stroke by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. We have pivoted where necessary and in year two will have virtual volunteer opportunities also available for our team members and will continue to gather in-person opportunities for when the restrictions lift.**see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedYear one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to enter in the volunteer portal for our team members. Goal 2: Decrease tobacco use in adults and youth community members Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the knowledge of free tobacco cessation programs and tobacco prevention/treatment resources for patients at discharge by partnering with Central Florida Area Health Education Center (AHEC) to provide continuing education classes to 50 team members (treating patients with tobacco use) from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative provides educational classes that lead to an increase in knowledge for those AdventHealth team members who treat patients with tobacco use, or work with these patients at discharge, about tobacco cessation resources available, which could potentially improve patients' health through support for eliminating tobacco use. This is conducted through a partnership with Central Florida AHEC, the local affiliate of the national organization of AHEC, that is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital progressed on its set metric of educating 50 team members about tobacco cessation resources by the end of year three. In year one, the Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and Central Florida AHEC. The MOU illustrates how Central Florida AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. This also includes the understanding that Central Florida AHEC will provide accredited tobacco cessation education to providers and staff of AdventHealth, thereby resulting in earned CEUs and CMEs for these team members. In year one, our Hospital team members worked additional hours and jobs to meet the needs created by the impact of COVID-19 on our Hospitals, patients, and community members; because of this, we delayed adding any additional training involving this objective for our team members during this time. In year two, AHEC will provide these trainings to our team members, either live or through a virtual format, in which team members will then earn their CEUs/CMEs, which are needed to keep their licenses and certifications for their positions. Additionally, the information learned in these classes will increase team members' knowledge and ability to offer treatment services for patients and community members who are tobacco users, thereby potentially improving their overall health. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to provide patient referrals at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit smoking tobacco through a partnership with AHEC and create an internal referral system to link adults residing in the Hospital's PSA, providing resources for 18 patients from a baseline of zero by the end of year three. The objective is funded through AdventHealth Sebring but managed by the Division. Reported referrals are specific to the reporting Hospital.This initiative provides an internal patient referral system at discharge to enroll in free AHEC tobacco cessation programs and receive free intervention therapies to quit tobacco. This initiative is conducted through a partnership with AHEC and the Hospital's internal Care 360 team. AHEC is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. The Hospital's internal Care 360 team works with patients at discharge and serves to identify patients needing tobacco cessation. Once identified, the Care 360 team can use this internal referral system to directly enroll patients into AHEC's tobacco cessation program. The Hospital progressed on its set metric of providing resources for 18 patients at discharge through an internal referral system between the Hospital and AHEC by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Objective 3: The third objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase access to tobacco cessation classes in adults residing in the Hospital's PSA by five classes from a baseline of zero by the end of year three. The objective is funded through all Hospitals but managed by the Division. Funding and outcomes reported represent all Hospitals involved. This initiative increases access to tobacco cessation classes that improve health through a partnership with Central Florida Area Health Education Centers (AHEC), the local affiliate of the national organization of AHEC, who is a community focused organization that develops and implements community-based health promotion activities and education programs, which target the underserved. AHEC also provides community members tools and resources to assist with tobacco cessation, including tobacco replacement when medically necessary and available, and accredited classes for continuing education units (CEUs) and continuing medical education (CMEs) for Hospital team members. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedThe Hospitals progressed on the set metric of increasing access to five tobacco cessation classes by the end of year three. In year one, our Division team successfully completed a memorandum of understanding (MOU) between the Hospitals and AHEC. The MOU illustrates how AHEC will offer tobacco cessation programming in partnership with us, which includes flyer and promotion templates, program materials and client communications on our behalf. Additionally, the Division team formed a partnership between AHEC and our internal Care 360 team and the creation of the internal referral system began. In year two, the Care 360 team will implement the internal referral system and collect data to share with our team on the success of this initiative. Unfortunately, in year one, all in-person AHEC free tobacco cessation classes were cancelled at the beginning of the COVID-19 pandemic. Furthermore, company policy has prevented us from hosting in-person free tobacco cessation classes on our Hospital campuses. However, we were still able to promote AHEC's virtual classes in year one by sharing their flyers and class information with our community partners, posting flyers and dates on our internal CREATION Life/Wellness Center calendars and Hospital spaces, and sharing class information with our internal Care 360 team for them to inform patients at discharge of the program. In year two, we will identify community locations that may allow in-person tobacco cessation classes and will work with AHEC to secure these locations, provide free marketing for the classes, sponsor costs associated with conducting these classes and offer free class space to host classes within our Hospitals once our internal restrictions on in-person gatherings have lifted.Priority 4: Education (Social Determinant of Health)2019 Description of the Issue:In the AdventHealth Sebring primary service area, 17% (14,018 persons) of the population aged 25 and older do not have a high school diploma (or equivalency) or higher and is higher than the state average of 12%. Educational attainment is a social determinant of health and is linked to health outcomes. Additionally, improving health literacy may be a useful strategy for reducing disparities in health related to education.2020 Update: Recognizing the impact of social determinants of health, like education, on individuals' health outcomes, AdventHealth recently partnered with Aunt Bertha, a social care network, to connect patients to programs in the communities that address social needs. This partnership will help AdventHealth team members to more fully integrate social care into our whole-person care model. Our whole-person approach to care is designed to empower individuals to take their health into their own hands. This approach in addition to our partnership with Aunt Bertha will allow us to connect patients to needed resources, which is a key step in creating healthier people and communities. The AdventHealth Sebring Community Health Plan has two desired goal statements under the Education (Social Determinant of Health) priority. 1. To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health2. To support community efforts to address the problem of educational attainment as a social determinant of healthGoal 1: To increase partnerships with local school-based programs to better understand the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to partner with local community school and/or college programs to develop, implement and evaluate a community-based professional development program (interviewing skills, resume writing, basic computer skills, mentoring) for underserved adults residing in the Hospital's PSA by providing three community workshops from a baseline of zero by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides underserved adults with educational and hands-on training skills, such as resume writing and computer skills, needed to enter the workforce. The Hospitals progressed on the set metric of providing three community workshops to underserved adults by the end of year three. Year one was spent identifying career readiness programs and organizations within the Hospital's PSA to partner with for this objective. We established a partnership with CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands, and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through these partnerships, we have identified resources - including teachers, classes, locations, and target audience members- for these development programs. Due to COVID-19, in year one, in-person classes and programs delivered through these organizations were cancelled. Additionally, Division-wide restrictions on in-person gatherings were also enforced for our Hospitals and company policy prevented us from hosting in-person classes on our Hospital campuses. We have pivoted where necessary and in year two, will begin partnering with these organizations to deliver this program virtually or in-person when restrictions lift. We will do this by having our team members offer lessons about real-world career opportunities at AdventHealth and sharing the process of attaining and maintaining a successful career. Additionally, our Hospital will offer support in the form of free meeting space to host the classes for these partner organizations, free marketing materials and additional costs covered of delivering these classes. Objective 2: The second objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to establish a new partnership with local community organizations to identify education access barriers in underserved adults residing in the Hospital's PSA from a baseline of zero organizations to two by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative creates a partnership with local community organizations working in adult education to help discover challenges to educational attainment and means to help resolve them. The Hospitals exceeded the set metric of establishing two new partnerships with local community organizations to identify barriers for accessing education in underserved adults by the end of year three. We established a partnership with three new community partners- CareerSource Heartland, South Florida State College, and the Panthers Youth Program. CareerSource Heartland is a not-for-profit corporation that operates as a demand-driven and business focused public-private partnership. Through oversight provided by the local elected officials from DeSoto, Hardee, Highlands, and Okeechobee counties, their Board of Directors offer workforce development related growth opportunities to business customers and job seekers throughout their four-county service delivery area. **see continuation of footnote Part V, Section B, Line 11 Continuation of Footnote Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 9 -- AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedSouth Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. The Panthers Youth Partners program is affiliated with CareerSource Heartland and South Florida State College and serves to provide youth with services that will develop and strengthen employability skills, talents, and interests. Through the formation of these three new partnerships, we were able to discuss barriers to educational access for those underserved members of our community. The barriers identified include inaccessible or unreliable means of transportation, lack of child-care, work-hour inflexibility, financial constraints, and home-life challenges. We have also created ideas to overcome these barriers and in year two will begin implementing some of these solutions in conjunction with these partnerships.Goal 2: To support community efforts that address the problem of educational attainment as a social determinant of health Objective 1: The first objective is a shared initiative between AdventHealth Sebring, AdventHealth Lake Placid and AdventHealth Wauchula. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. This objective is to provide education vouchers to cover the costs of General Educational Development (GED) materials (textbooks, registration fees and tests) for adults residing in the Hospital's PSA from a baseline of zero vouchers to three vouchers by the end of year three. The objective is funded and managed through all Hospitals. Funding and outcomes reported represent all Hospitals involved. This initiative provides education vouchers in the form of monetary funds to help cover some of the cost associated with the GED test. The Hospitals progressed on the set metric of providing three education vouchers in the form of monetary funds for adults residing in the Hospital's PSA by the end of year three. Year one was spent identifying and establishing a partnership with the local GED preparation and testing organization, South Florida State College. In doing so, we were able to learn more about their monetary needs to support the program. In addition, we gathered information from this organization relating to populations and number of adults served, need for financial assistance, and any programs offering assistance that are already available for eligible adults. South Florida State College is a public college in Florida with campuses in Highlands, Desoto and Hardee counties and is part of the Florida College System. The South Florida State College Adult Education Program provides General Education Development (GED) preparation and testing. Due to COVID-19, South Florida State College's GED classes were initially cancelled. In year two, the Hospital will determine the dollar amount to provide to cover the cost of this program for those underserved adults. Objective 2: The second objective is a shared initiative with AdventHealth Wauchula and AdventHealth Lake Placid. These Hospitals are part of the West Florida Division of AdventHealth, the same division as the reporting Hospital. The Hospitals partnered on this initiative because of a shared CHNA priority. The objective is to increase the amount of paid staff time for Hospital staff/team members to volunteer with community organizations addressing education (as a social determinant of health) from a baseline of zero hours to 150 hours by the end of year three. The objective is funded and managed through all Hospitals; however, outcomes are specific to the reporting Hospital. This initiative provides a paid volunteerism program through which AdventHealth employees are paid at their normal rate to volunteer at community organizations which are addressing this priority area. The Hospitals progressed on the set metric of 150 hours of paid staff time spent volunteering in the community to address education (as a social determinant of health) by the end of year three. In year one, Division employees created a volunteer portal to market volunteer opportunities to team members, track volunteer hours and notify community partners when team members sign up for an event. The Division team also created screensavers to advertise the volunteer portal. Unfortunately, the COVID-19 pandemic led to many of our community partners cancelling their volunteer opportunities for 2020. Additionally, Division-wide restrictions on in-person gatherings were also enforced. We have pivoted where necessary and in year two, will have virtual volunteer opportunities also available for our team members and will continue to gather in-person opportunities for when the restrictions lift. Year one was also spent creating partnerships with organizations that would potentially have volunteer opportunities related to this priority area. We have established a partnership with the United Way of Central Florida who will be providing us with volunteer opportunities to share with our Hospital team members in year two. United Way of Central Florida is the local chapter of the global organization, United Way Worldwide. United Way's mission is to improve lives by mobilizing the caring power of communities around the world to advance the common good. They do this by creating opportunities for all, specifically with a focus on education, income, and health. In year two, United Way will continue to send volunteer opportunities for us to promote to our team members via the volunteer portal.Community Needs Not Chosen by AdventHealth Sebring/AdventHealth Lake Placid: The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. The Hospitals 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 Hospitals did not choose the following community issues:1. Poor Dental Health: Many oral diseases can be prevented with routine care and regular dental checkups. The health of the teeth, the mouth and the surrounding craniofacial (skull and face) structures is central to a person's overall health and well-being. Lack of access to dental care for all ages remains a public health challenge. In the AdventHealth Sebring Primary Service Area (PSA), the access to dentists' rate (per 100,000 pop.) is 36.5 (in 2015 year), as compared to the state rate of 56.The Community Health Needs Assessment Committee (CHNAC) did not perceive the ability to have a measurable impact on the issue within the three years allotted for the Community Health Plan with the current resources available to the community and the Hospital at this time.2. Tobacco Use: In the AdventHealth Sebring PSA, an estimated 16,314 of adults age 18 or older self report currently smoking cigarettes some days or every day. This indicator is relevant because tobacco use is linked to leading causes of death such as cancer and cardiovascular disease. In the Hospital PSA, 22% of adults are currently smoking cigarettes, which is higher than the state percentage of 19%.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address tobacco use will be wrapped into the priority area of heart disease.3. Obesity/Overweight/Obese: In the AdventHealth Sebring PSA, approximately 33% of adults aged 20 and older self report that they have a Body Mass Index (BMI) greater than 30 (obese) in the report area. The state percentage is 27%. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.The CHNAC felt the issue should not be addressed as an individual problem. Therefore, interventions to address Obesity/Overweight/Obese will be wrapped into the education priority area. The Community Health Needs Assessment Committee (CHNAC) will approach this area of need more comprehensively, as other barriers contribute to negative health outcomes in this area of priority. Part V, Section B, Line 13h Footnote Facility Reporting Group - AEffective March 1, 2020, the filing organization's hospital facility (or facilities) augmented their Financial Assistance Policy with a COVID-19 Financial Grace Addendum. Pursuant to the COVID-19 Financial Grace Addendum, uninsured patients treated for COVID-19 related evaluations are to receive free or discounted care depending on the patient's cooperation in submitting necessary financial assistance information. Insured patients tested for COVID-19 are not expected to have out-of-pocket expenses based on insurance community response to waive patient financial responsibility. If a payer unexpectedly fails to waive patient responsibility for COVID-19 related testing, the filing organization will not balance bill patients for any out-of-pocket expenses related to COVID-19. In addition, patients with existing payment plans are provided opportunities for reducing their monthly payments. Part V, Section B, Line 13h Footnote Facility Reporting Group - BEffective March 1, 2020, the filing organization's hospital facility (or facilities) augmented their Financial Assistance Policy with a COVID-19 Financial Grace Addendum. Pursuant to the COVID-19 Financial Grace Addendum, uninsured patients treated for COVID-19 related evaluations are to receive free or discounted care depending on the patient's cooperation in submitting necessary financial assistance information. Insured patients tested for COVID-19 are not expected to have out-of-pocket expenses based on insurance community response to waive patient financial responsibility. If a payer unexpectedly fails to waive patient responsibility for COVID-19 related testing, the filing organization will not balance bill patients for any out-of-pocket expenses related to COVID-19. In addition, patients with existing payment plans are provided opportunities for reducing their monthly payments. Part V, Section B, Line 16a-16c Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites: Facility 1 -- AdventHealth Orlandohttps://www.adventhealth.com/legal/financial-assistance Facility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/legal/financial-assistance Facility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/legal/financial-assistance Facility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/legal/financial-assistance Facility 5 -- AdventHealth Winter Park https://www.adventhealth.com/legal/financial-assistance Facility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/legal/financial-assistance Facility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/legal/financial-assistance Facility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/legal/financial-assistance Facility 9 -- AdventHealth Lake Placidhttps://www.adventhealth.com/legal/financial-assistance Facility 10 -- AdventHealth Wauchulahttps://www.adventhealth.com/legal/financial-assistance Facility 11 -- Central Texas Medical Centerhttps://www.ctmc.org/patients-visitors/after-my-stay/financial-assistance (only prior to 03/31/2020) 57 1 - AdventHealth Centra Care Lake Buena Vist 12500 South Apopka Vineland Rd Orlando FL 32836 Urgent Care Clinic 2 - AdventHealth Centra Care South Orange 2609 South Orange Ave Orlando FL 32806 Urgent Care Clinic & Employer Onsite Clinic 3 - AdventHealth Centra Care Waterford Lakes 250 North Alafaya Trail Suite 135 Orlando FL 32825 Urgent Care Clinic 4 - AdventHealth Centra Care Winter Garden 3005 Daniels Road Winter Garden FL 34787 Urgent Care Clinic/Primary Care 5 - AdventHealth Centra Care Port Orange 1208 Dunlawton Ave Port Orange FL 32127 Urgent Care Clinic 6 - AdventHealth Centra Care Mt Dora 9015 US Highway 441 Mount Dora FL 32757 Urgent Care Clinic 7 - AdventHealth Centra Care Altamonte Sprin 440 West Highway 436 Altamonte Springs FL 32714 Urgent Care Clinic 8 - AdventHealth Centra Care Winter Park 3099 Aloma Avenue Winter Park FL 32792 Urgent Care Clinic 9 - AdventHealth Centra Care Orange Lake 8201 West Irlo Bronson Highway Kissimmee FL 34747 Urgent Care Clinic 10 - AdventHealth Centra Care Hunter's Creek 3293 Greenwald Way North Kissimmee FL 34741 Urgent Care Clinic/Primary Care 11 - AdventHealth Centra Care Sanford 4451 West 1st Street Sanford FL 32771 Urgent Care Clinic/Primary Care 12 - AdventHealth Centra Care St Cloud 4660 13th Street St Cloud FL 34769 Urgent Care Clinic/Primary Care 13 - AdventHealth Centra Care Clermont 15701 State Road 50 Suite 101 Clermont FL 34711 Urgent Care Clinic 14 - AdventHealth Centra Care Lake Nona 9637 Lake Nona Village Place Orlando FL 32827 Urgent Care Clinic 15 - AdventHealth Centra Care Dr Phillip's 8014 Conroy-Windermere Rd Suite 104 Orlando FL 32835 Urgent Care Clinic 16 - SDOC CLINIC 831 Simpson Rd Kissimmee FL 34744 Employer Clinic 17 - AdventHealth Centra Care University 11550 University Blvd Orlando FL 32817 Urgent Care Clinic 18 - AdventHealth Centra Care Brandon 10222 Bloomingdale Ave Riverview FL 33578 Urgent Care Clinic 19 - AdventHealth Centra Care DeLand 2293 South Woodland Blvd Deland FL 32720 Urgent Care Clinic 20 - AdventHealth Centra Care Lee Road 2540 Lee Road Winter Park FL 32789 Urgent Care Clinic 21 - AdventHealth Centra Care Colonial Town 630 North Bumby Ave Orlando FL 32803 Urgent Care Clinic/Primary Care 22 - AdventHealth Centra Care Orange City 1360 Saxon Blvd Orange City FL 32763 Urgent Care Clinic 23 - AdventHealth Centra Care Wesley Chapel 1127 Bruce B Downs Blvd Wesley Chapel FL 33544 Urgent Care Clinic 24 - AdventHealth Centra Care Oviedo 8010 Red Bug Road Oviedo FL 32765 Urgent Care Clinic 25 - AdventHealth Centra Care Kissimmee 4320 West Vine Street Kissimmee FL 34746 Urgent Care Clinic 26 - AdventHealth Centra Care Temple Terrace 5802 East Fowler Avenue Temple Terrace FL 33617 Urgent Care Clinic 27 - AdventHealth Centra Care Daytona 1014 West International Speedway Blvd Daytona Beach FL 32114 Urgent Care Clinic 28 - AdventHealth Centra Care Leesburg 1103 North 14th Street Leesburg FL 34748 Urgent Care Clinic 29 - AdventHealth Centra Care Sand Lake Road 2301 Sand Lake Road Orlando FL 32809 Urgent Care Clinic 30 - AdventHealth Centra Care Azalea Park 509 South Semoran Blvd Orlando FL 32807 Urgent Care Clinic 31 - AdventHealth Centra Care Palm Coast 1270 Palm Coast Parkway NW Palm Coast FL 32137 Urgent Care Clinic 32 - San Marcos MRI LP 1330 Wonder World Dr San Marcos TX 78666 Imaging Services 33 - AdventHealth Centra Care Longwood 855 South US Highway 17-92 Longwood FL 32750 Urgent Care Clinic 34 - CTMC Hospice 1315 IH 35 North San Marcos TX 78666 Hospice Services 35 - AdventHealth Centra Care Ormond Beach 1245 West Granada Blvd Ormond Beach FL 32174 Urgent Care Clinic 36 - AdventHealth Centra Care South Tampa 301 North Dale Mabry Hwy Tampa FL 33609 Urgent Care Clinic & Employer Onsite Clinic 37 - AdventHealth Centra Care Kids Lake Mary 105 South Country Club Road Lake Mary FL 32746 Urgent Care Clinic 38 - AdventHealth Centra Care Kids Winter Par 2325 West Fairbanks Ave Winter Park FL 32789 Urgent Care Clinic 39 - AdventHealth Centra Care Carrollwood 4001 West Linebaugh Ave Tampa FL 33624 Urgent Care Clinic 40 - AdventHealth Centra Care Lake Mary 2948 West Lake Mary Blvd Lake Mary FL 32746 Urgent Care Clinic 41 - AdventHealth Centra Care Conway 5810 South Semoran Blvd Orlando FL 32822 Urgent Care Clinic 42 - AdventHealth Centra Care Citrus Park 6930 Gunn Highway Tampa FL 33625 Urgent Care Clinic 43 - AdventHealth Centra Care Winter Haven 7375 Cypress Gardens Blvd Winter Haven FL 33884 Urgent Care Clinic 44 - CTMC Rehab Services 1340 Wonder World Dr San Marcos TX 78666 OP Rehab Services 45 - AdventHealth Medical Group Cardiology at 4639 Sun N Lake Blvd Sebring FL 33872 Physician Clinic 46 - AdventHealth Centra Care Poinciana 3759 Pleasant Hill Rd Kissimmee FL 34746 Urgent Care Clinic 47 - Darden Onsite 1000 Darden Center Drive Orlando FL 32837 Employer Onsite Clinic 48 - SIEMENS Onsite 4400 North Alafaya Trail MC Q1-240 Orlando FL 32826 Employer Onsite Clinic 49 - AdventHealth Medical Group Cardiology & 463 Carlton St Wauchula FL 33873 Physician Clinic 50 - Wyndham Onsite 6277 Sea Harbor Dr Orlando FL 32821 Employer Onsite Clinic 51 - AdventHealth Medical Group Orthopedics a 4409 Sun N Lake Blvd Sebring FL 33872 Physician Clinic 52 - AdventHealth Centra Care Apopka 1520 West Orange Blossom Trail Apopka FL 32712 Urgent Care Clinic 53 - OCG Onsite 450 East South Street Orlando FL 32802 Employer Onsite Clinic 54 - AdventHealth Centra Care Corporate Care 40124 US Hwy 27 Suite 27 Davenport FL 33837 Occupational Medicine Services 55 - AdventHealth Waterman Employee Clinic 1000 Waterman Way Tavares FL 32778 Employer Onsite Clinic 56 - AdventHealth Medical Group Breast Surger 4145 Sun N Lake Blvd Suite B Sebring FL 33872 Physician Clinic 57 - AdventHealth Centra Care Corporate Care 1255 State Road Florida 60 East Suite 30 Lake Wales FL 33853 Occupational Medicine Services 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 29 tax-exempt 501(c)(3) hospital organizations and a number of other health care facilities that operated in 10 states within the U.S. The system of organizations under the control and ownership of AHSSHC is known as "AdventHealth".All hospital organizations within AdventHealth collect, calculate, and report the community benefits they provide to the communities they serve. AdventHealth organizations exist solely to improve and enhance the local communities they serve. AdventHealth has a system-wide community benefits accounting policy that provides guidelines for its health care provider organizations to capture and report the costs of services provided to the underprivileged and to the broader community. Each AdventHealth hospital facility reports their community benefits to their Board of Directors and strives to communicate their community benefits to their local communities. Additionally, the filing organization's most recently conducted community health needs assessments and associated implementation strategies can be accessed on the filing organization's websites. Part I, Line 7: The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions. Part II, Community Building Activities: The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with commercially sponsored research conducted by one of the organization's hospitals. This one hospital participates in clinical drug and device research that is performed on patients who have a condition or disease for which the eventual commercial use of a drug or device is intended. This research is related to patient care and serves to expand scientific knowledge with respect to potential treatments and cures for various diseases and conditions.The costs of community building activities reported on Part II of Schedule H also include the costs associated with providing education for the filing organization's staff physicians and employees. The filing organization's provision of these educational programs/activities to staff physicians and employees provides an opportunity for health care professionals to enhance their skills and expertise and keep up-to-date with the latest advancements in medical procedures and technology. In addition, training opportunities are often provided on-site at the filing organization's hospital facilities, thereby allowing for health care professionals to be more readily available to assist in meeting immediate patient care needs. Education and training provided to each facility's workforce is vital in assisting health care professionals directly involved in patient care with keeping abreast of the latest developments in their respective areas of expertise, learning possible new and innovate ways of delivering care to patients, and understanding the newest technologies available for the treatment of patients.The remainder of the costs incurred stem from the hospitals' involvement in and support of various other community agencies in its service area that work collaboratively to help those in need and to improve the health and safety of the residents of the community. The organization's hospitals participate with a number of other community organizations to address the healthcare needs of all its communities. Both cash and in-kind donations are made annually to various local charitable organizations. Part III, Line 2: The amount of bad debt expense reported on line 2 of Section A of Part III is recorded in accordance with Healthcare Financial Management Association Statement No. 15. Discounts and payments on patient accounts are recorded as adjustments to revenue, not bad debt expense. Part III, Line 3: Methodology for Determining the Estimated Amount of Bad Debt Expense that May Represent Patients who Could Have Qualified under the Filing Organization's Financial Assistance Policy: Self-pay patients may apply for financial assistance by completing a Financial Assistance Application Form (FAA Form). If an individual does not submit a complete FAA Form within 240 days after the first post-discharge billing statement is sent to the individual, an individual may be considered for presumptive eligibility based upon a scoring tool that is designed to classify patients into groups of varying economic means. The scoring tool uses algorithms that incorporate data from credit bureaus, demographic databases, and hospital specific data to infer and classify patients into respective economic means categories. Individuals who earn a certain score on the scoring tool are considered to qualify as eligible for the most generous financial assistance under the filing organization's Financial Assistance Policy. As determined by the filing organization, a nominal amount of such a patient's bill is written off as bad debt expense, while the remaining portion of the patient's bill is considered non-state charity. The amount written off as bad debt expense for those patients who potentially qualify as non-state charity using the scoring tool is the amount shown on line 3 of Section A of Part III. Rationale for Including Certain Bad Debts in Community Benefit: The filing organization is dedicated to the view that medically necessary health care for emergency and non-elective patients should be accessible to all, regardless of age, gender, geographic location, cultural background, physician mobility, or ability to pay. The filing organization treats emergency and non-elective patients regardless of their ability to pay or the availability of third-party coverage. By providing health care to all who require emergency or non-elective care in a non-discriminatory manner, the filing organization is providing health care to the broad community it serves. As a 501(c)(3) hospital organization, the filing organization maintains a 24/7 emergency room providing care to all whom present. When a patient's arrival and/or admission to the facility begins within the Emergency Department, triage and medical screening are always completed prior to registration staff proceeding with the determination of a patient's source of payment. If the patient requires admission and continued non-elective care, the filing organization provides the necessary care regardless of the patient's ability to pay. The filing organization's operation of a 24/7 Emergency Department that accepts all individuals in need of care promotes the health of the community through the provision of care to all whom present. Current Internal Revenue Service guidance that tax-exempt hospitals maintain such emergency rooms was established to ensure that emergency care would be provided to all without discrimination. The treatment of all at the filing organization's Emergency Department is a community benefit. Under the filing organization's Financial Assistance Policy, every effort is made to obtain a patient's necessary financial information to determine eligibility for financial assistance. However, not all patients will cooperate with such efforts and a financial assistance eligibility determination cannot be made based upon information supplied by the individual. In this case, a patient's portion of a bill that remains unpaid for a certain stipulated time period is wholly or partially classified as bad debt. Bad debts associated with patients who have received care through the filing organization's Emergency 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 and 9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands. Part III, Line 8: Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio. Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government. Reconciliation of Schedule H Reported Medicare Surplus/(Shortfall) to Unreimbursed Medicare Costs Associated with the Provision of ServicesTo All Medicare Beneficiaries: The Medicare revenue and allowable costs of care reported in Section B of Part III of Schedule H are based upon the amounts reported in the filing organization's Medicare cost report in accordance with the IRS instructions for Schedule H. On an annual basis, the filing organization also determines its total unreimbursed costs associated with providing services to all Medicare patients. Unreimbursed costs are considered a community benefit to the elderly and are combined into an annual Community Benefit Statement prepared by AdventHealth. The primary reconciling items between the Medicare surplus/(shortfall) shown on line 7 of Section B of Part III of Schedule H and the filing organization's unreimbursed costs of services provided to all Medicare patients are as follows: - Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $(126,556,730) - Difference in costing methodology: (8,617,511) - Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (264,405,462) ------------- Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $(399,579,703) As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization. Part III, Line 9b: Collection Policies: The hospital filing organization's collection practices are in conformity with the requirements set forth in the 2014 Final Regulations regarding the requirements of Internal Revenue Code Section 501(r)(4) - (r)(6). No extraordinary collection actions (ECA's) are initiated by the hospital filing organization in the 120-day period following the date after the first post-discharge billing statement is sent to the individual (or, if later, the specified deadline given in a written notice of actions that may be taken, as described below). Individuals are provided with at least one written notice (notice of actions that may be taken) and a copy of the filing organization's Plain Language Summary of the Financial Assistance Policy that informs the individual that the hospital filing organization may take actions to report adverse information to credit reporting agencies/bureaus if the individual does not submit a Financial Assistance Application Form (FAA Form) or pay the amount due by a specified deadline. The specified deadline is not earlier than 120 days after the first post-discharge billing statement is sent to the individual and is at least 30 days after the notice is provided. A reasonable attempt is also made to orally notify an individual about the filing organization's Financial Assistance Policy and how the individual may obtain assistance with the Financial Assistance application process. If an individual submits an incomplete FAA Form during the 240-day period following the date on which the first post-discharge billing statement was sent to the individual, the hospital filing organization suspends any reporting to consumer credit reporting agencies/bureaus (or ceases any other ECA's) and provides a written notice to the individual describing what additional information or documentation is needed to complete the FAA Form. This written notice contains contact information including the telephone number and physical location of the hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of the hospital facility's office or department that can provide assistance with the financial assistance application process or, alternatively, a nonprofit organization or governmental agency that can provide assistance with the financial assistance application process if the hospital facility is unable to do so. If an individual submits a complete FAA Form within a reasonable time-period as set forth in the notice described above, the hospital filing organization will suspend any adverse reporting to consumer credit reporting agencies/bureaus until a financial assistance policy eligibility determination can be made. Part VI, Line 2: As reported in Schedule H, Part V, Section B, the filing organization's hospital facilities conduct their community health needs assessments (CHNAs) every three years. Their 2019 CHNAs were adopted by all hospital governing boards by December 31, 2019, the end of the filing organization's taxable year in which the CHNAs were conducted. All of the filing organization's hospital facilities' 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 all of its communities. Such practices and processes involve the following:1. Hospitals' operating/community boards composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's hospital communities; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's hospital communities. Part VI, Line 3: The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for the hospital facilities' financial counselors are prominently and conspicuously posted on the filing organization's hospital facilities' websites. Each hospital facility's website indicates that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by the relevant hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of the filing organization's hospital facilities, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of each hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. The filing organization's hospital facilities' financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facilities who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the hospital facilities' office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about the hospital facilities' FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of each hospital facility's community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance. Part VI, Line 4: In 2020, the filing organization operated 4 separately licensed hospitals that together encompassed 11 separate campus locations and 7 off-site emergency departments. The hospitals are located in Florida and Texas. A description of each of the hospital campuses is described below. Effective 3/31/20 the filing organization sold the assets associated with the operation of Central Texas Medical Center (CTMC) to Christus Santa Rosa Health Care Corporation.Adventist Health System/Sunbelt, Inc. dba Central Texas Medical Center:Central Texas Medical Center is a 170-bed acute-care hospital providing a wide range of healthcare services in San Marcos, Texas and the neighboring communities within Hays and Caldwell counties, Texas. Special services offered at CTMC include a 24/7, Level 4 emergency and trauma center, state-of-the-art medical imaging and laboratory services, a women's center featuring a Level 2 Neonatal Intensive Care Unit, renovated and expanded surgery suites--including two equipped with robotic capabilities--a Rehabilitation Institute, a center for advanced wound healing and hyperbaric medicine, and two cardiac catheterization labs. As a health resource for their community, CTMC's Creation Health Institute also annually hosts the oldest and largest health screening and fair event in Hays County, as well as a number of ongoing classes and workshops ranging in topics from diabetes prevention and management to heart disease, stroke, arthritis, self-help, nutrition and more. For more than 20 consecutive years, CTMC has been named "The Best Hospital in Hays County" in the annual "Best of Hays" publication released by the San Marcos Daily Record. In addition to interventional cardiac services, CTMC is a Certified Chest Pain Center and an accredited Primary Stroke Center. The accreditation enhances CTMC's ability to receive and treat patients suffering from chest pain and/or a possible heart attack. The result is a focus on reduced time from symptom onset to diagnosis and treatment, getting patients treated more quickly during the critical window of time when the integrity of the heart muscle can be preserved, and monitoring of patients whose diagnosis is uncertain to ensure they are not sent home too quickly or admitted unnecessarily. CTMC leads the region in da Vinci robotic-assisted surgery and offers a variety of specialty care services including medical imaging, rehabilitation, hospice, women's services and more.From 1/01/2020-3/31/2020, CTMC's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. For the first three months of 2020, about 63.3% of the CTMC's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 45.8% - Medicaid Patients 11.6% - Self-Pay Patients 12.3% The demographic makeup of CTMC's community is as follows: - Population 366,191 - Population Over 65 12.83% - Poverty (Below 100% FPL) 15.30% - Unemployment Rate 4.70% - Violent Crime Rate (Per 100,000 Pop.) 247.3 - Pop. Age 25+ with No High School Diploma 13.70% - Uninsured Adults 18.45% - Uninsured Children 9.21% - Food Insecurity Rate 14.90% - Pop. with Low Food Access 22.80%Adventist Health System/Sunbelt, Inc. dba AdventHealth Sebring:AdventHealth Sebring is comprised of three separate hospital campuses with a total of 229 beds. Two of the hospital campuses are located in Highlands County, Florida and operate under a single hospital license and the third separately licensed campus is located in Hardee County, Florida. Highlands and Hardee counties are in the south central areas of Florida and are adjacent to each other.During 2020, the patient percentage population for all three campuses of AdventHealth Sebring was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2020, about 73.5% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 64.3% - Medicaid Patients 12.0% - Self-Pay Patients 4.2%*AdventHealth Sebring (Highlands County) - The main 171-bed hospital facility is located in north Sebring. AdventHealth Sebring has key service lines, including a heart & vascular center, Cancer Institute, Breast Care Center, Blessed Beginnings Birthing Center, and Emergency Services. Most recently, the Hospital has established a retail pharmacy and Orthopedic unit. AdventHealth Sebring is on the cutting edge of technology in Highlands County, being the only Orthopedic program to use the MAKOplasty Robot and only Surgical Services Program to use the da Vinci Robot. The Hospital has received recognition for its patient safety, orthopedics, heart care, and as a breast imaging center of excellence. In 2018, AdventHealth Sebring was named Highland News Sun "Business of the Year."The demographic makeup of AdventHealth Sebring's community is as follows: - Population 108,572 - Population Over 65 31.52% - Poverty (Below 100% FPL) 19.40% - Unemployment Rate 7.80% - Violent Crime Rate (Per 100,000 Pop.) 319.6 - Pop. Age 25+ with No High School Diploma 17.30% - Uninsured Adults 23.07% - Uninsured Children 7.77% - Food Insecurity Rate 15.80% - Pop. with Low Food Access 34.64%*AdventHealth Lake Placid (Highlands County) - This satellite facility houses 33 medical and surgical beds, the county's only 17-bed inpatient mental health unit and a wide range of services that are highly sophisticated for a small community hospital. This campus also specializes in inpatient geriatric psychiatric services within Highlands and Hardee counties. The need for behavioral health services is extreme in both counties since there is no other program closer than sixty miles. AdventHealth Lake Placid has received national recognition in patient safety, ultrasound and computed tomography (CT), and Emergency Department (ED) areas. To better meet the needs of Highlands County, the Hospital offers a Wellness Center, along with educational classes, for the community. Key service lines include ER, ICU and the Medical Surgical Unit. AdventHealth Lake Placid is on the leading edge of technology in Highlands County as the only Hospital to utilize virtual and room sterilization technology.The demographic makeup of AdventHealth Lake Placid's community is as follows: - Population 87,256 - Population Over 65 31.26% - Poverty (Below 100% FPL) 19.50% - Unemployment Rate 7.70% - Violent Crime Rate (Per 100,000 Pop.) 310.2 - Pop. Age 25+ with No High School Diploma 17.00% - Uninsured Adults 23.23% - Uninsured Children 7.78% - Food Insecurity Rate 15.70% - Pop. with Low Food Access 35.83%*AdventHealth Wauchula (Hardee County) - Built at a new location in 2017, this campus is licensed for 25 beds and specializes in emergency and outpatient care, while offering excellent medical inpatient services. The Hospital contains the only ER in Hardee County. AdventHealth Wauchula offers many inpatient and outpatient services, including physical & occupational therapy, a transitional care unit, medical surgical swing unit, and the only mammography unit in Hardee County, the Linda Adler Mammography Center. In 2019, AdventHealth Wauchula opened a Wellness Center to better meet the health needs of Hardee County. *** see continuation of footnote Part VI, Line 5: The provision of community benefit is central to the filing organization's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $8,030,512 of benefit with respect to the faith-based and spiritual needs of the communities it serves in conjunction with its operation of community hospitals. The filing organization also provides benefits to its communities' infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care. During the current year, the filing organization expended $480,248,229 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the Hospitals are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities. Part VI, Line 6: The filing organization is a part of a faith-based healthcare system of organizations whose parent is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). The system is known as AdventHealth. AHSSHC is an organization exempt from federal income tax under IRC Section 501(c)(3). AHSSHC and its subsidiary organizations operate 48 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 11 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers.As the parent organization of AdventHealth, AHSSHC provides executive leadership and other professional support services to its subsidiary organizations. Professional support services include among others IT, corporate compliance, legal, reimbursement, risk management, and tax as well as treasury functions. Certain support services, such as human resources, payroll, A/P, and supply chain management are provided pursuant to a shared services model by AHSSHC to its subsidiary organizations. The provision of these executive and support services on a centralized basis by AHSSHC provides an appropriate balance between providing each AdventHealth subsidiary hospital organization with mission-driven consistent leadership and support while allowing the hospital organization to focus its resources on meeting the specific health care needs of the community it serves. The reader of this Form 990 should keep in mind that this reporting entity may differ in certain areas from that of a stand-alone hospital organization due to its inclusion in a larger system of healthcare organizations. As a part of a system of hospital and other health care organizations, the filing organization benefits from reduced costs due to system efficiencies, such as large group purchasing discounts, and the availability of internal resources such as internal legal counsel. Each AdventHealth subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by an AdventHealth subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AdventHealth as a whole. The reader is directed to visit the web-site of AdventHealth at www.adventhealth.com to learn more about the mission and operations of AdventHealth. Part VI, Line 4 Continuation of Footnote Description of Community Information - ContinuedThe Hospital has been recognized as a Top Rural Hospital by The Leapfrog Group and best hospital for patient safety.The demographic makeup of AdventHealth Wauchula's community is as follows: - Population 90,145 - Population Over 65 27.66% - Poverty (Below 100% FPL) 21.00% - Unemployment Rate 7.50% - Violent Crime Rate (Per 100,000 Pop.) 303.7 - Pop. Age 25+ with No High School Diploma 19.50% - Uninsured Adults 23.93% - Uninsured Children 7.87% - Food Insecurity Rate 15.50% - Pop. with Low Food Access 34.42%Adventist Health System/Sunbelt, Inc.:AdventHealth's Central Florida Division South Region consists of a 3,141-bed medical complex in Central Florida with seven separate hospital campuses and 7 off-site emergency departments (the Hospitals) that operate under a single hospital license. The Hospitals serve the residents of Central Florida (primarily serving the residents of Orange, Osceola, Seminole and Lake County) but also draw patients from other parts of the Southeastern United States, the Caribbean and South America. The 7-campus health system is the largest healthcare provider in Central Florida with more than 2 million patient visits per year and is the nation's largest Medicare provider. It is the second largest employer in the area.The main campus of AdventHealth's Central Florida Division South Region is located in Orlando, Florida (Orange County) near the downtown area. The other 6 campuses are located in surrounding communities in the counties of Orange, Osceola, and Seminole. In addition to operating the 7 hospitals, it also operates 51 full-service urgent care clinics in convenient community settings.During 2020, the patient percentage population for all seven campuses was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2020, about 68.3% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 43.0% - Medicaid Patients 15.2% - Self-Pay Patients 6.7%A brief description of each of the 7 hospital campuses is described below:*AdventHealth Orlando (Orange County) - At the core of AdventHealth's Central Florida Division South Region, AdventHealth Orlando (AHO) is a 1,432-bed acute-care tertiary hospital. AHO is home to nationally recognized Centers of Excellence for cancer, cardiology, children's health, diabetes, neuroscience, orthopedics, transplant and global robotics. AdventHealth Orlando houses one of the largest Emergency Departments and cardiac catheterization labs in the country and is one of the busiest hospitals in the nation, providing service excellence to more than 48,000 inpatients and 175,000 outpatients in 2020. The campus also includes a state-of-the-art Cardiac Diagnostic Center featuring 15 Cath and electro physiology (EPS) Labs. The cardiology team performed over 18,000 cardiac catheterizations and over 1,700 open heart surgeries in 2020. In 2018, two orthopedic floors in the patient tower were totally renovated. In 2019, an inpatient Hospice unit was opened.Additionally, AHO houses the Translational Research Institute, a 54,000 square-foot facility devoted to the study of obesity and metabolic origins of cardiovascular disease with the aim of developing new treatments to battle diabetes and obesity. AHO also serves as a teaching hospital for family medicine, allopathic and osteopathic tracts, emergency medicine, neuromusculoskeletal medicine, general surgery, podiatric medicine and surgery, and internal medicine. As one of the premier health systems in the nation, AHO sets the standard for innovation, quality and comprehensive care.AdventHealth for Women at Orlando is a 12-story hospital located on the Orlando campus. The first floor houses the Breastfeeding Center, parent education classroom as well as obstetrical triage and registration. Ten of the 12 floors are complete, which include 72 mother-baby rooms and high-risk OB rooms, 14 labor and delivery suites, 13 operating rooms, 82 NICU and 104 oncology beds which include GYN oncology, medical oncology and an ICU capable BMT unit.Also located on the AHO Campus is the Walt Disney Pavilion at AdventHealth for Children. The Walt Disney Pavilion is not a stand-alone facility but rather a 7-story, 198-bed tower located on AHO's campus. It is a full-service facility served by more than 140 pediatric specialists and a highly trained pediatric team of more than 800 employees. The Walt Disney Pavilion at AdventHealth for Children delivers a complete range of pediatric health services for younger patients including advanced surgery, oncology, neurosurgery, cardiology and transplant services; full-service pediatrics; and an innovative health and obesity platform.The demographic makeup of AdventHealth Orlando's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.90% - Unemployment Rate 9.50% - Violent Crime Rate (Per 100,000 Pop.) 448.7 - Pop. Age 25+ with No High School Diploma 10.90% - Uninsured Adults 17.60% - Uninsured Children 6.70% - Food Insecurity Rate 13.30% - Pop. with Low Food Access 33.71%*AdventHealth Altamonte (Seminole County) - AdventHealth Altamonte is a 393-bed facility, which has recently doubled in size with a new patient tower to better serve a busy community. AdventHealth Altamonte was the first "satellite" hospital, built in 1973 on what was then pastureland, miles from the nearest business district. Located north of Orlando in fast-growing Seminole County, AdventHealth Altamonte is the largest satellite campus within AdventHealth's Central Florida Division South Region. In addition to maternity, pediatric, NICU, emergency, medical and surgical services, the hospital operates the Martin Andersen Cancer Center (along with the region's only Cancer Resource Library), a heart catheterization lab, and a comprehensive outpatient program which includes surgery, diagnostics, and medical treatment programs. In 2014, the Mother Baby Unit was expanded to provide a 15 bed CDU, ten new LDR rooms, six triage rooms, a new C-section operating room and a new recovery unit. In 2018, a 10-bed Level II Neonatal Intensive Care Unit (NICU) was added.The demographic makeup of AdventHealth Altamonte's community is as follows: - Population 473,408 - Population Over 65 16.30% - Poverty (Below 100% FPL) 12.42% - Unemployment Rate 8.50% - Violent Crime Rate (Per 100,000 Pop.) 421.8 - Pop. Age 25+ with No High School Diploma 7.90% - Uninsured Adults 14.00% - Uninsured Children 5.40% - Food Insecurity Rate 12.40% - Pop. with Low Food Access 33.37%*AdventHealth Apopka (Orange County) - In 1975, AdventHealth Apopka became the second satellite hospital. For over four decades, AdventHealth Apopka has set the standard in hometown health care by providing high-tech, quality care with a personalized touch. It is a 120-licensed-bed hospital, which includes intensive care services, emergency medicine, endoscopy, outpatient services, diagnostic services, respiratory services and rehabilitation services. A replacement, 320,000 square foot facility has been built on a 71-acre site located approximately three miles from the existing facility. Five of the seven floors have been completed with the remaining two floors to be shelled in for future expansion. The new facility features 120 private patient rooms, advanced surgical suites and a diagnostic catheterization lab.*** see continuation of footnote Part VI, Line 4 Continuation of Footnote Description of Community Information - ContinuedCompletion of this $203 million project took place in December 2017. AdventHealth Apopka also operates AdventHealth Winter Garden ER, an off-site emergency room that provides urgent care to the community as well as specialized respiratory care and advanced stroke treatment as a designated stroke center. The demographic makeup of AdventHealth Apopka's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.24% - Unemployment Rate 11.40% - Violent Crime Rate (Per 100,000 Pop.) 596.6 - Pop. Age 25+ with No High School Diploma 12.60% - Uninsured Adults 18.30% - Uninsured Children 7.60% - Food Insecurity Rate 13.70% - Pop. with Low Food Access 31.30% *AdventHealth Celebration (Osceola County) - AdventHealth Celebration is a cornerstone of Disney's planned community in Celebration, Florida. Today, this 237-bed acute care hospital delivers a state-of-the-art healing environment to residents of Osceola, Orange, Polk and Lake Counties, as well as to visitors from across the United States and the world. From its creation AdventHealth Celebration has been about promoting health and wellness as well as healing. Inside the resort-style hospital there is a wellness center, complete with workout area, pool, and rehabilitation facility. AdventHealth Celebration also houses the Global Robotics Institute, which provides patients with access to some of the most experienced robotic surgeons in the world. The Nicholson Center for Surgical Advancement also is a location where surgeons from around the world travel to learn the latest robotic surgery techniques. The Institute for Interactive Patient Care is a 234,000 square-foot patient tower with 62 beds and was the first of its kind in the nation where physicians can study everything from new patient safety technology to the impact of changing communication with patients about their care. In 2013, a four-story medical office building was added in which the Women's Institute is situated. In 2014, a new 5th floor inpatient 32 bed state-of-the art medical/surgical unit was added. In 2018, two inpatient surgical cardiovascular OR's were added. AdventHealth Celebration offers services in cancer, digestive health, neuroscience, weight-loss services and surgery, orthopedic health, spine health, thoracic surgery, women's and men's health, robotic-assisted surgeries and imaging diagnostics. The demographic makeup of AdventHealth Celebration's community is as follows: - Population 368,559 - Population Over 65 15.40% - Poverty (Below 100% FPL) 14.59% - Unemployment Rate 13.00% - Violent Crime Rate (Per 100,000 Pop.) 454.9 - Pop. Age 25+ with No High School Diploma 12.10% - Uninsured Adults 19.40% - Uninsured Children 7.00% - Food Insecurity Rate 11.90% - Pop. with Low Food Access 35.53%*AdventHealth East Orlando (Orange County) - AdventHealth East Orlando is an innovative local leader that fills a vital need in a fast-growing area. A recent 200,000 square-foot expansion project upgraded the Hospital to 295 beds, with a spacious patient tower and 80 new private rooms designed to enhance the holistic care experience. In 2014, an expanded ED provided 60 new treatment rooms. AdventHealth East Orlando includes a teaching hospital with residencies in family medicine, podiatry and emergency medicine. The campus is also home to an outpatient surgery center, a hospital-based Center for Medical Simulation and Education, a Cancer Institute featuring state-of-the-art technology for radiation oncology and a dedicated infusion center, as well as a 12-bed Children's Emergency Center. Alongside having the largest emergency room in Central Florida, other services include cardiovascular, pulmonary and digestive health, orthopedics and rehabilitation, ear/nose/throat, andrology, and urology. The Hospital also meets the diverse needs of its growing community at its brand-new, freestanding emergency room, AdventHealth Waterford Lakes ER, which offers hospital-based ER services by board-certified emergency physicians, critical care nurses, and stroke and chest pain experts. The demographic makeup of AdventHealth East Orlando's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 16.67% - Unemployment Rate 11.60% - Violent Crime Rate (Per 100,000 Pop.) 607.2 - Pop. Age 25+ with No High School Diploma 11.10% - Uninsured Adults 18.50% - Uninsured Children 7.70% - Food Insecurity Rate 13.80% - Pop. with Low Food Access 25.18%*AdventHealth Kissimmee (Osceola County) - AdventHealth Kissimmee is a 162-bed community-focused hospital, conveniently located near Walt Disney World. The team located at AdventHealth Kissimmee is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties. This facility has recently expanded to include a new medical office building, patient tower, new main entrance, expanded Emergency Department and a parking garage. The new three-story patient tower includes private patient rooms and a host of modern amenities and technologies. Services offered include cardiovascular services, orthopedics and rehabilitation, neuroscience, cancer, diabetes, gastroenterology, emergency services, urology, and imaging resources. The demographic makeup of AdventHealth Kissimmee's community is as follows: - Population 368,559 - Population Over 65 15.40% - Poverty (Below 100% FPL) 15.89% - Unemployment Rate 14.00% - Violent Crime Rate (Per 100,000 Pop.) 470.0 - Pop. Age 25+ with No High School Diploma 12.80% - Uninsured Adults 19.50% - Uninsured Children 6.90% - Food Insecurity Rate 11.10% - Pop. with Low Food Access 27.03%*AdventHealth Winter Park (Orange County) - AdventHealth Winter Park is a 422-bed facility that is a model of community health and wellness. The facility boasts spacious patient care areas and a full spectrum of specialties and services, including the Dr. P. Phillips Baby Place (with Level II NICU), AdventHealth Orthopedic Institute, and state-of-the-art surgery, recovery and rehabilitation at the AdventHealth Cancer Institute. In 2019, the new 5-story Nicholson Pavilion opened, adding 80 all-private rooms to the AdventHealth Winter Park campus. AdventHealth Winter Park has the Central Florida Region's only senior-friendly emergency room. Services offered at AdventHealth Winter Park include cancer, cardiovascular, digestive health, women's health, neuroscience, ophthalmology, orthopedics and rehabilitation, urology, and sports medicine. The Hospital also provides timely, convenient and quality emergency care at its state-of-the-art freestanding emergency room, AdventHealth Oviedo ER, which is staffed with physicians trained to provide medical treatments for adults and children. *** see continuation of footnote Part VI, Line 4 Continuation of Footnote Description of Community Information - Continued The demographic makeup of AdventHealth Winter Park's community is as follows: - Population 1,391,240 - Population Over 65 12.20% - Poverty (Below 100% FPL) 14.99% - Unemployment Rate 10.10% - Violent Crime Rate (Per 100,000 Pop.) 517.6 - Pop. Age 25+ with No High School Diploma 9.50% - Uninsured Adults 18.50% - Uninsured Children 6.60% - Food Insecurity Rate 13.10% - Pop. with Low Food Access 27.31% Part VI, Line 7 The filing organization does not file an annual community benefit report with any state agencies. 1 Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando FL 32804 205774723 501(c)(3) 986804 General Support Alzheimers & Dementia Resource Center 715 Douglas Avenue Ste 53 Altamonte Springs FL 32714 592496511 501(c)(3) 10000 General Support American Diabetes Association Inc 1701 North Beauregard Street Alexandria VA 22311 131623888 501(c)(3) 60000 General Support American Cancer Society Inc 250 Williams Street NW Ste 400 Atlanta GA 30303 131788491 501(c)(3) 120000 General Support American Heart AssociationGreater South Affiliate-Ar 9900 Ninth Street North St Petersburg FL 33716 590637852 501(c)(3) 175000 General Support Aspire Health Partners Inc 5151 Adanson Street Orlando FL 32804 592301233 501(c)(3) 1035500 General Support Avon Park Seventh-Day Adventist Church 1410 W Avon Boulevard Avon Park FL 33825 593057686 501(c)(3) 18000 Other Bliss Cares Inc 2901 Curry Ford Road Ste 106 Orlando FL 32806 474565338 501(c)(3) 15000 General Support Boy Scouts Of America Inc Central Florida Council 1951 S Orange Blossom Trail 102 Apopka FL 32703 590624376 501(c)(3) 22500 General Support Boys & Girls Club Of Central Florida PO Box 2987 Orlando FL 32802 590951887 501(c)(3) 15000 General Support Boys & Girls Clubs Of Volusia Flagler Counties Inc 101 N Woodland Boulevard Ste 400 Deland FL 32720 593158162 501(c)(3) 35000 General Support Celebration Foundation Inc 610 Sycamore Street Celebration FL 34747 593370753 501(c)(3) 40000 General Support Center For Change 6003 Silver Star Road Ste 3 Orlando FL 32808 203062727 501(c)(3) 36763 General Support Center For Independent Living In Central Florida Inc 720 N Denning Drive Winter Park FL 32789 591828770 501(c)(3) 11000 General Support Center For Multicultural Wellness And Prevention Inc 641 N Rio Grande Avenue Orlando FL 32805 593368679 501(c)(3) 10025 General Support Central Florida Family Health Center Inc Dba True Health 4930 E Lake Mary Boulevard Sanford FL 32771 591741286 501(c)(3) 100000 General Support Central Florida Foundation Inc 800 N Magnolia Ave Ste 1200 Orlando FL 32803 593182886 501(c)(3) 10000 General Support Central Texas Healthcare Collaborative 1301 Wonder World Drive San Marcos TX 78666 453739929 501(c)(3) 265152 Other Central Texas Medical Center Foundation 1301 Wonder World Drive San Marcos TX 78666 742259907 501(c)(3) 26693 Book Provision of general administrative support General Support Christian Service Center For Central Florida Inc 808 W Central Boulevard Orlando FL 32805 591353031 501(c)(3) 10000 General Support City Of Apopka 120 E Main Street Apopka FL 32703 596000265 Gov't 98000 General Support City Of Winter Park 401 Park Avenue South Winter Park FL 32789 596000454 Gov't 50000 General Support Community Health Centers Inc 110 S Woodland Street Winter Garden FL 34747 591480970 501(c)(3) 106940 General Support Community Hope Center Inc 2198 4 Winds Boulevard Kissimmee FL 34746 800855060 501(c)(3) 613500 General Support Daves House Inc PO Box 1466 Windermeme FL 34786 270533943 501(c)(3) 35900 General Support Debbie Turner Cancer Care Resources Inc 31138 Preswick Avenue Sorrento FL 32776 800499456 501(c)(3) 11000 General Support East Orlando Health & Rehab Center Inc 250 South Chickasaw Trail Orlando FL 32825 205774748 501(c)(3) 3367450 General Support Edible Education Experience Inc 26 E King Street Orlando FL 32804 465655482 501(c)(3) 50000 General Support Family Promise Of Greater Orlando Inc 1000 Clay Street Winter Park FL 32789 593679904 501(c)(3) 23000 General Support Flagler Cares Inc 2561 Moody Boulevard Ste 206 Palm Coast FL 32136 474145174 501(c)(3) 102000 General Support FLNC Inc 3355 E Semoran Boulevard Apopka FL 32703 205774761 501(c)(3) 9572358 General Support Florida Abolitionist Inc 195 South Westmonte Drive Altamonte Springs FL 32714 593178045 501(c)(3) 10000 General Support Florida Hospital Seventh-Day Adventist Church 2800 N Orange Avenue Orlando FL 32804 593039667 501(c)(3) 139000 General Support Forest City Spanish Seventh-Day Adventist Church 7601 Forest City Rd Orlando FL 32810 593291153 501(c)(3) 21443 General Support Forest Lake Academy 500 Education Loop Apopka FL 327036176 590816443 501(c)(3) 35000 General Support Foundation For Orange County Public Schools Inc 445 W Amelia Street Ste 901 Orlando FL 328011153 592788435 501(c)(3) 45000 General Support Foundation For Seminole State College Of Florida Inc 1055 AAA Drive Ste 209 Heathrow FL 32746 237033822 501(c)(3) 250000 General Support Freedom Ride Inc 1905 Lee Road Orlando FL 32810 593489545 501(c)(3) 350000 General Support Give Kids The World Inc 210 South Bass Road Kissimmee FL 34746 592654440 501(c)(3) 6000 General Support Grace Medical Home Inc 51 Pennsylvania Street Orlando FL 328062938 281817966 501(c)(3) 443000 General Support Harbor House Of Central Florida Inc PO Box 680748 Orlando FL 32868 591712936 501(c)(3) 10000 General Support Harvest Time International Inc 225 Harvest Time Drive Sanford FL 32771 541698630 501(c)(3) 10000 General Support Health Care Center For The Homeless Inc 232 N Orange Blossom Trail Orlando FL 32805 593185020 501(c)(3) 100000 General Support Healthy Start Coalition Of Orange County Inc 1040 Woodcock Road Ste 215 Orlando FL 32803 593125675 501(c)(3) 17500 General Support Healthy Start Coalition Of Osceola County Inc PO Box 701995 St Cloud FL 34770 593212535 501(c)(3) 15000 General Support Healthy Start Coalition Of Seminole County Inc 820 W Lake Mary Boulevard Ste 108 Sanford FL 32773 464038747 501(c)(3) 6000 General Support Hope Community Center Inc 1016 N Park Avenue Apopka FL 32712 562551312 501(c)(3) 7500 General Support Hope Helps Inc 812 Eyrie Drive Oviedo FL 32765 208490916 501(c)(3) 10000 General Support Hope Now International Inc PO Box 181173 Casselberry FL 327181173 274498303 501(c)(3) 10000 General Support Idignity Inc 424 E Central Boulevard Ste 199 Orlando FL 32801 010921490 501(c)(3) 10000 General Support Iglesia Chistiana Pentecostal De Orlando Inc 5850 Clarona Ocoee Road Orlando FL 32810 593218454 501(c)(3) 15000 General Support Impower Inc 111 W Magnolia Avenue Longwood FL 32750 650439778 501(c)(3) 114000 General Support Iniciativa Accion Puertorriquena 4545 Woodlands Village Drive Orlando FL 32835 474537122 501(c)(3) 15000 General Support Interfaith Council Of Central Florida PO Box 3310 Winter Park FL 32790 455420165 501(c)(3) 25000 General Support JDRF International 370 Center Pointe Circle Ste 1154 Altamonte Springs FL 32701 231907729 501(c)(3) 30000 General Support Kids House Of Seminole Inc 5467 North Ronald Reagan Boulevard Sanford FL 32773 593415005 501(c)(3) 20000 General Support Lake Nona Institue Inc 6900 Tavistock Lakes Boulevard Ste 200 Orlando FL 32827 273346737 501(c)(3) 50000 General Support Latino Leadership Inc 8617 E Colonial Drive Ste 1200 Orlando FL 32817 593702613 501(c)(3) 10000 General Support Life Concepts Inc Dba Quest Inc 500 E Colonial Drive Orlando FL 32803 592013160 501(c)(3) 20000 General Support Lifestream Behavioral Center Foundation Inc PO Box 491000 Leesburg FL 34749 592976392 501(c)(3) 50000 General Support Lifework Leadership 1220 E Concord Street Orlando FL 328035453 371592618 501(c)(3) 10000 General Support Lift Orlando 215 East Central Boulevard Orlando FL 32801 463607865 501(c)(3) 100000 General Support Living Heart Foundation Inc 98 Greenfield Court Little Silver NJ 07739 223796078 501(c)(3) 10000 General Support Mars Hill Seventh Day Adventist Church PO Box 1654 Sanford FL 32772 264337526 501(c)(3) 22000 General Support Matthews Hope Ministries Inc 523 S Woodland Street Winter Garden FL 34761 272245867 501(c)(3) 30000 General Support Meals On Wheels Etc Inc 2801 S Financial Court Sanford FL 32773 592977907 501(c)(3) 15000 General Support Memorial Health Systems Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 590973502 501(c)(3) 557216 General Support Mental Health Association Of Central Florida Inc 1525 E Robinson Street Orlando FL 32801 590816432 501(c)(3) 192848 General Support Mothers Milk Bank Of Florida 8669 Commodity Circle Ste 490 Orlando FL 32819 273939245 501(c)(3) 25000 General Support One Heart For Women And Children Inc 2040 N Rio Grande Avenue Orlando FL 32804 300584360 501(c)(3) 32500 General Support Onepulse Foundation Inc 1227 E Concord Street Orlando FL 32803 813142847 501(c)(3) 300000 General Support Orange County School Readiness Coalition Inc Dba Early Learning Coalition O 7700 Southland Boulevard Ste 100 Orlando FL 32809 311759186 501(c)(3) 20000 General Support Orlando Economic Partnership Inc 301 East Pine Street Ste 900 Orlando FL 32801 591767933 501(c)(3) 250000 General Support Orlando Shakespeare Theather Inc 812 E Rollins Street Ste 100 Orlando FL 32803 592931698 501(c)(3) 6000 General Support Osceola County Council On Aging Inc 700 Generation Point Kissimmee FL 34744 591595398 501(c)(3) 35000 General Support Park Maitland School Foundation Inc 465 S Orlando Avenue Ste 112 Maitland FL 32751 843613556 501(c)(3) 6000 General Support Park Place Medical & Behavioral Health Care Inc 206 Park Place Boulevard Kissimmee FL 34741 833269602 501(c)(3) 291667 General Support Peer Support Space Inc PO Box 677032 Orlando FL 32867 842070075 501(c)(3) 26000 General Support Rescue Outreach Mission Of Central Florida Inc 1701 Historic Goldsboro Boulevard Sanford FL 32771 592876415 501(c)(3) 55500 General Support Ronald Mcdonald House Charities Of Central Florida Inc 1030 N Orange Avenue Winter Park FL 327894709 593211250 501(c)(3) 104000 456 Book Partnership & Sponsorships General Support Rustys Bicycle Recycle Inc 1275 Bennett Drive Longwood FL 32750 824975971 501(c)(3) 10000 General Support School District Of Osceola County Florida 817 Bill Beck Boulevard Kissimmee FL 34744 596000779 501(c)(3) 25750 General Support Seniors First Inc 5395 LB Mcleod Road Orlando FL 32811 592759603 501(c)(3) 15000 General Support Shepherd'S Hope Inc 455 9th Street Winter Garden FL 34787 593420727 501(c)(3) 150000 General Support Sunbelt Health & Rehab Center - Apopka Inc 305 East Oak Street Apopka FL 32703 205774856 501(c)(3) 600403 General Support Sunsystem Development Corporation 900 Hope Way Altamonte Springs FL 32714 592219301 501(c)(3) 223884 Book Provision of general administrative support General Support Sunsystem Development Corporation DBA Fh Foundation 900 Hope Way Altamonte Springs FL 32714 592219301 501(c)(3) 4937522 Book Provision of general administrative support General Support Support Our Scholars (Sos) PO Box 1985 Winter Park FL 32790 260711355 501(c)(3) 7500 General Support Teen Challenge Of Florida Inc 3706 S Sanford Avenue Sanford FL 32773 592479228 501(c)(3) 35000 General Support The 4R Foundation Inc 210 N Park Avenue Winter Park FL 32789 474062821 501(c)(3) 300000 General Support The Finley Project Inc 941 W Morse Boulevard Ste 100 Winter Park FL 32789 471325653 501(c)(3) 7500 General Support The School Board Of Highlands CountySebring High School 426 School Street Sebring FL 33870 596000654 Gov't 10000 Other Tri-County Nursing Rehabilitation Center Inc 1290 Celebration Boulevard Kissimmee FL 34747 472219363 501(c)(3) 22750 General Support United Global Outreach 2301 N Orange Avenue Orlando FL 32804 030511875 501(c)(3) 138766 General Support United Way - The Heart Of Florida 1940 Traylor Boulevard Orlando FL 32804 590808854 501(c)(3) 45000 General Support Universal Orlando Foundation 1000 Universal Studios Plaza Orlando FL 32819 593510383 501(c)(3) 15000 General Support US Dream Academy 5950 Symphony Woods Road Columbia MD 21044 593514841 501(c)(3) 10000 General Support Valencia College Foundation Inc PO Box 3028 Orlando FL 32802 237442785 501(c)(3) 250000 General Support Walker Memorial Academy 1525 W Avon Boulevard Avon Park FL 33825 421748753 501(c)(3) 45000 Other West Orange Chamber Of Commerce 12184 W Colonial Drive Winter Garden FL 34787 590576757 501(c)(6) 15525 General Support West Volusia Habitat For Humanity Inc 604 S Spring Garden Avenue Deland FL 32720 592894153 501(c)(3) 50000 General Support Zephyrhills Health & Rehab Center Inc 7350 Dairy Road Zephyrhills FL 33540 205774967 501(c)(3) 16225 General Support Zion Farms & Market Inc PO Box 605 Orlando FL 34760 824080493 501(c)(3) 8000 General Support Southern Adventist University PO Box 567 Keene TX 76059 750891465 501(c)(3) 314009 Book Other General Support 103 1 Part I, Line 2: Grants are generally made only to related organizations that are exempt from federal income tax under IRC Section 501(c)(3), or to other local charitable community organizations, or to other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures. X X X X X X 1 1 1 1 0 0 0 0 0 0 0 Rathbun Paul C Dir(end 9/20)/AdventHealth CFO 0 1023847 0 381258 0 2953216 0 165320 0 45463 0 4569104 0 180391 Shaw Terry D Dir/President/AdventHealth CEO 0 1802963 0 753747 0 437823 0 145820 0 58139 0 3198492 0 321384 Tol Daryl Dir(end 9/20)/CEO AH Central FL Div 0 1228617 0 456545 0 301398 0 145820 0 57651 0 2190031 0 193410 Silvestry MD Scott Phy/Dir AH Thoracic Transplant 1839659 0 0 0 21447 0 15320 0 27787 0 1904213 0 0 0 Banks David Former Key Emp - SEVP/CSO 0 815018 0 236512 0 438618 0 140636 0 45582 0 1676366 0 110503 Moorhead MD David Former Key Emp - SEO/CCO 0 811900 0 240204 0 532925 0 15320 0 13468 0 1613817 0 0 Accola MD Kevin Exec Med Dir/Cardio Surgery & Struct 1468941 0 85710 0 15483 0 15320 0 23157 0 1608611 0 0 0 Goodman Todd A CFO AH Central FL Division 0 705375 0 193096 0 488604 0 132413 0 48066 0 1567554 0 76432 Palmer MD George Med Dir/ AH Celebration Cardio Surge 1283546 0 85710 0 15058 0 15320 0 20832 0 1420466 0 0 0 Soler Eddie Former Key Emp - EVP/SFO 0 772770 0 253149 0 184559 0 161326 0 26194 0 1397998 0 136730 Stevens Eric A Former Key Emp/CEO CFD So Acute Care 0 18631 0 227251 0 998059 0 9620 0 33462 0 1287023 0 180646 Davis JR MD Robert Phy/Dir AH Cardovascular 1192673 0 0 0 9811 0 15320 0 9161 0 1226965 0 0 0 Botta MD Donald Phy/Dir AH Heart Transplant 612187 0 15685 0 404643 0 15320 0 20761 0 1068596 0 0 0 Finkler Neil CMO AH CFD So Acute Care Srvs 0 571010 0 129327 0 140245 0 90877 0 26818 0 958277 0 72993 Thompson Michael J CEO AH CFD Integrated Hlth Srvs 0 552001 0 144310 0 98770 0 74243 0 46075 0 915399 0 59986 Hilliard Douglas W CFO AH CFD South Region 0 520892 0 140320 0 122767 0 66450 0 43468 0 893897 0 62545 Wandersleben Jennifer J CEO AH CFD So Acute Care Srvs 0 554002 0 83062 0 64296 0 95540 0 46604 0 843504 0 29125 Owen Terry R Former Key Emp/SVP Partnering Strate 0 249353 0 132136 0 414386 0 20485 0 24799 0 841159 0 102317 Cook Timothy W CEO AH Alt & Seminole Mkt 0 430131 0 115748 0 147985 0 63209 0 43015 0 800088 0 19799 Spenst Brett CEO AH Orlando (end 11/20) 0 498554 0 103732 0 81471 0 75698 0 22399 0 781854 0 0 Harcombe Douglas W CEO AH Celebration & Osecola Mkt 0 443433 0 100511 0 77223 0 66542 0 46186 0 733895 0 46097 Zbaraschuk Amy L CFO AH CFD Integrated Hlth Srvs 0 434484 0 118200 0 69579 0 64300 0 42376 0 728939 0 44496 Hagensicker Janice K Former Key Emp/Sr Fin Off AH Orl SW 0 438208 0 122790 0 95868 0 15320 0 25134 0 697320 0 0 Moorhead Sheryl D AH CFD Chief People Officer 0 420257 0 114372 0 108040 0 15320 0 14151 0 672140 0 0 Deininger Robert CEO AH Orlando (beg 11/20) 0 397123 0 89419 0 66298 0 67209 0 40499 0 660548 0 11017 Villanueva Jeffrey CEO AH E Orl & E Orange Mkt 0 384480 0 75826 0 26620 0 51772 0 44343 0 583041 0 16552 Jernigan PhD Donald L Dir/CEO Emeritus (end 3/20) 0 0 0 0 0 443591 0 0 0 5635 0 449226 0 407940 Reed MD Monica P Former Key Employee 0 0 0 0 8280 366974 0 0 0 25227 8280 392201 0 0 Bradley Kenneth W Former Kep Emp/AH Dir Emerging Leade 0 158151 0 18109 0 6716 0 8686 0 24325 0 215987 0 0 Part I, Line 1a The filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 48 hospitals in 9 states, the senior leadership of AHSSHC travel extensively and often visit multiple hospital locations in different states as a part of a single business trip. The special travel allowance can provide reimbursements to the executive for such items as the purchase of air travel upgrade coupons, to cover the cost differential between coach and first-class travel, or to cover the cost of a charter flight. The special travel allowance benefit was originally authorized by and codified into a policy by the AHSSHC Board Compensation Committee (the Committee), an independent body of the AHSSHC Board of Directors, who also approves the annual cap on the amount of the allowance. The special travel allowance has an annual cap of $24,000 for members of the Leadership Executive Team (AdventHealth Cabinet - 13 members) and $15,000 for AdventHealth Corporate Office Senior Vice Presidents, Regional CEO's, and Division Chief Officers (generally 20-30 individual executives). The Divisional CEO and CFO for AdventHealth Central Florida Division, Central Florida CEO of Integrated Health Services, CEO of AdventHealth Central Florida South Acute Care Services, and Senior Vice President of Partnering Strategy are officers or key employees of the filing organization. The Divisional CEO and CFO for AdventHealth Central Florida Division, Central Florida CEO of Integrated Health Services, CEO of AdventHealth Central Florida South Acute Care Services, and Senior Vice President of Partnering Strategy are considered common law employees of and are on the payroll of AHSSHC. While the special travel allowance benefit is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and either wholly or partially reimbursed by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for first-class or charter travel since it has wholly or partially paid for the cost of providing this benefit. Those executives who receive the special travel allowance are responsible for tracking the expenses reimbursable under the special travel allowance and must submit such expenses on their accountable plan expense report. Any taxable reimbursements made to executives under the special travel allowance arrangement are treated as taxable compensation to the executive. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to certain executive leaders and is usually limited to one business trip per year beyond the annual AdventHealth President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AdventHealth has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval by the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: Occasional discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth President's Council, CFO Conference or the CMO/CNO business meeting. Payments provided to each executive are considered taxable compensation to the executive. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. All taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, certain AdventHealth eligible executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be approved by the board of directors of the AdventHealth organization for which they serve. Eligible executives are limited to certain senior level executives (hospital organization CEOs, the CEO of the nursing home division of AdventHealth, senior vice presidents at two large hospital organizations, divisional and regional CEOs and CFOs and the President/CEO, cabinet members and senior vice presidents of AHSSHC). Each AdventHealth executive who is approved for a club membership must submit an annual report to the AHSSHC President/CEO. The report is to describe how the membership benefited their organization during the preceding year so that the AHSSHC President/CEO can make a determination if continuance of the club membership furthers the business interests of AdventHealth. In the current year, for this filing organization, one executive listed in Part VII received reimbursement for club fees. While the club dues membership is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and reimbursed in whole or in part by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for health or social club dues since it has wholly or partially paid for the cost of providing this benefit. Part I, Line 3 The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership. Part I, Lines 4a-b During the year ending December 31, 2020, Terry Owen, Eric Stevens, and Monica Reed, MD received severance payments in the amount of $213,732, $673,371, and $353,755, respectively. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AdventHealth. Additionally, Donald Botta, MD received severance payment in the amount of $375,000 from the filing organization. As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive benefit plans to eligible executives. In 2020, AdventHealth restructured its executive supplemental retirement and benefit plans to reduce complexity, to increase predictability of benefits and to consolidate multiple supplemental executive benefit plans into one plan. Effective 1/1/2020, a new supplemental executive retirement plan (SERP III) was adopted and the three existing plans, described below, were amended and restated. The newly adopted SERP III plan, as well as the amended and restated plans, were reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. SERP III Plan (Effective 1/1/2020): To recognize the contribution each executive makes to the success of AdventHealth and to recognize the limitations available to executives in qualified retirement plans due to compensation limits set on such plans, AdventHealth adopted a new supplemental executive retirement plan (SERP III) in 2020. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. The SERP III plan provides eligible executives a percentage of their base pay, which is credited to a deferred compensation account. The plan also provides for compensation deferral and selection of life insurance coverage and long-term care insurance. To be eligible to participate in the SERP III plan, executives must be on the AHSSHC corporate payroll and be either a CEO of an AdventHealth entity, an AHSSHC Vice President (VP) or VP of an AdventHealth entity with a base salary of at least $285,000 in 2020 (adjusted annually by the same percentage as IRC Section 401(a)(17) limit increases), or other leader specifically approved by the AdventHealth President. Eligible executives do not include grandfathered executives, meaning those executives who would satisfy all the eligibility requirements of the SERP II plan prior to Dec 31, 2027, had the plan not been amended and restated as of Jan. 1, 2020. Contribution credits will be established and maintained by class year accounts for each participant using tiered contribution credit percentages of annual base compensation. Contribution credit percentages range between 15% and 19% of base compensation. Contribution credits will be made each quarter in 25% increments with reductions in contributions if the executive is also a grandfathered FLEX participant (see below). SERP III provides for a class year vesting and payment schedule (7 years for each class year) with respect to amounts accumulated in the executive's deferred compensation account. Upon attainment of a normal retirement age (age 62), or upon certain other circumstances as defined in the SERP III plan document, all deferred amounts are paid immediately to the participant. For any executives working beyond the normal retirement age, future employer contributions will be made quarterly from SERP III directly to the participant as a taxable cash bonus. SERP II Plan (Amended and Restated in 2020): In 2020, the SERP II plan was amended and restated to provide that eligible employees are restricted to those executives who, as of January 1, 2020, satisfied, or if employment continues, will satisfy the eligibility requirements of SERP II prior to December. 31, 2027. The SERP II plan is a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AdventHealth and/or to other Seventh-day Adventist Church hospitals or health care institutions. Under the provisions of the SERP II plan, benefits are provided to qualifying executive participants on a pro-rata schedule beginning with 20 years of service as an employee of AdventHealth and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP II) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AdventHealth active employment inclusive of income from all other Seventh-day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to SERP II and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. FLEX Plan (Amended and Restated in 2020): In 2020, the Flex Plan was amended and restated to exclude employed executives who are hired or promoted after a certain date from being eligible to participate in the Flex Plan except for certain insurance coverage features of the plan. Additionally, a provision was added to place a maximum limit on the amount of a participant's annual Flex allowance to not be greater than a maximum dollar amount or percentage of compensation as established by the AdventHealth Benefits Administration Committee. The Flex Plan was originally designed to provide eligible executives an opportunity to select from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. The Flex Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which the cost of mandatory and elective employee benefits is deducted. The benefits allowance credit percentage is determined by the AdventHealth Benefits Administration Committee. For grandfathered eligible employees, the annual pre-determined Flex allowance is contributed and any funds that remain after the cost of mandatory and elective benefits are subtracted are, at the employee's option, contributed to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account will be forfeited by the executive upon a voluntary separation. With respect to grandfathered participants, the Flex Plan documents define eligible employees to include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary was at least equal to the Internal Revenue Code Section 401(a)(17) compensation limit each year. Schedule J, Part I, Line 4 b continued 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. Rathbun, Paul C. $ 150,000 $ 213,814 $ 2,695,680 $ 0 Shaw, Terry D. $ 150,000 $ 350,945 $ 0 $ 0 Tol, Daryl $ 150,000 $ 224,875 $ 0 $ 0 Banks, David $ 144,816 $ 113,951 $ 266,649 $ 0 Moorhead, MD, David $ 150,000 $ 130,500 $ 295,270 $ 0 Goodman, Todd A. $ 117,093 $ 90,596 $ 380,832 $ 0 Soler, Eddie $ 146,006 $ 159,081 $ 0 $ 0 Stevens, Eric $ 0 $ 204,172 $ 0 $ 0 Finkler, Neil $ 95,057 $ 83,500 $ 0 $ 0 Thompson, Michael J. $ 78,423 $ 61,837 $ 0 $ 0 Hilliard, Douglas W. $ 70,630 $ 72,912 $ 0 $ 0 Wandersleben, Jennifer $ 78,924 $ 31,318 $ 0 $ 20,796 Owen, Terry R. $ 24,666 $ 120,569 $ 0 $ 0 Cook, Timothy W. $ 47,890 $ 23,816 $ 92,896 $ 0 Spenst, Brett $ 79,878 $ 0 $ 0 $ 0 Harcombe, Douglas W. $ 51,223 $ 53,110 $ 0 $ 0 Zbaraschuk, Amy L. $ 48,981 $ 50,590 $ 0 $ 0 Hagensicker, Janice $ 61,785 $ 42,285 $ 0 $ 0 Moorhead, Sheryl D. $ 69,659 $ 50,159 $ 0 $ 0 Deininger, Robert $ 39,620 $ 14,352 $ 0 $ 31,770 Villanueva, Jeffery $ 36,453 $ 19,302 $ 0 $ 0 Jernigan, Donald L. $ 0 $ 0 $ 0 $ 0 CY 457b Distr. Jernigan, Donald L. $ 407,940 * Including Investment Earnings A Highlands County Health Facilities Authority 521313569 431022KK7 2007-08-08 366445000 2007A B C D, Expand/refurbish facilities, purchase equipment 0 0 0 B Orange County Health Facilities Authority 521378595 NoneAvail 2010-12-22 25000000 2010B, Expand/refurbish facilities, purchase equipment 0 0 0 C Kansas Development Finance Authority 481066589 NoneAvail 2010-12-22 25000000 2010C, Expand/refurbish facilities, purchase equipment 0 0 0 D Colorado Health Facilities Authority 840752932 NoneAvail 2010-12-22 25000000 2010D, Expand/refurbish facilities, purchase equipment 0 0 0 A 262025000 372572414 5560382 367012032 2007 0 0 1 1 B 9000000 25008422 25008422 2010 0 0 1 1 C 9000000 25007891 25007891 2010 0 0 1 1 D 9000000 25008355 25008355 2010 0 0 1 1 A 0 1 1 1 1 1 0.01420 0.01420 0 0 1 B 0 0 1 1 1 1 0 0 1 C 0 0 1 1 1 1 0 0 1 D 0 0 1 1 1 1 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2007A B C D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Orange County Health Facilities Authority 2010B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Kansas Development Finance Authority 2010C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Colorado Health Facilities Authority 2010D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2013A-C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014A&D: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014B: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014C: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part II, Line 3, Total Proceeds of Issue Highlands County Health Facilities Authority 2014E: The difference between Total Proceeds of Issue reported on Part II, Line 3 and the Issue Price reported on Part I, column (e) is attributed to investment earnings. Part III, Line 8c Highlands County Health Facilities Authority 2012A, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds. Part III, Line 8c Highlands County Health Facilities Authority 2012B, AR Program: A sale of bond-financed assets in 2006 was identified in early 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 25, 2013. A Closing Agreement was finalized with the IRS on February 11, 2015. A subsequent sale of assets occurred in 2014. Remedial action was taken as proscribed in Treasury Regulation Section 1.141-12 to preserve the tax-exempt status of the interest on the bonds. Part III, Line 8c Kansas Development Finance Authority 2012A: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015. Part III, Line 8c Highlands County Health Facilities Authority 2012B-F: A sale of bond-financed assets in 2003 was identified in July 2013. The taxpayer has paid off the bonds related to this asset sale and filed a VCAP request pursuant to Notice 2008-31, 2008-11 IRB 592, on October 15, 2014. A Closing Agreement was finalized with the IRS on December 18, 2015. A Highlands County Health Facilities Authority 521313569 NoneAvail 2011-11-16 80000000 2011A, Expand/refurbish facilities 0 0 0 B Highlands County Health Facilities Authority 521313569 NoneAvail 2012-03-21 294985000 2012A, AR Program - Refund 2009 A-F AR Program 0 0 0 C Highlands County Health Facilities Authority 521313569 NoneAvail 2012-07-25 115015000 2012B, AR Program - Expand/refurbish facilities, purchase equipment 0 0 0 D Kansas Development Finance Authority 481066589 48542ADG3 2012-08-29 310952245 2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C 0 0 0 A 1700000 80000000 80000000 2011 0 0 1 1 B 130000000 294985000 294985000 2004 1 0 1 1 C 115015000 115015000 2012 0 0 1 1 D 310952245 310952245 2008 1 0 1 1 A 0 0 1 1 1 1 0 0 1 B 0 0 1 1 1 1 0 1 0.00140 0 1 C 0 0 1 1 1 1 0 1 0.00140 0 1 D 0 1 1 1 1 1 0.00500 0.00500 0 1 0.00370 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A Highlands County Health Facilities Authority 521313569 431022TL6 2012-08-29 348320000 2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C 0 0 0 B Highlands County Health Facilities Authority 521313569 NoneAvail 2012-08-29 125000000 2012G&H - Refund Highlands 2005I Conversion Bonds 0 0 0 C Highlands County Health Facilities Authority 521313569 431022TR3 2012-11-08 232125000 2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G 0 0 0 D Highlands County Health Facilities Authority 521313569 NoneAvail 2013-09-18 485000000 2013A B C, Expand/refurbish facilities, purchase equipment 0 0 0 A 170530000 348320000 348320000 2008 1 0 1 1 B 125000000 125000000 2005 1 0 1 1 C 12260000 232125000 232125000 2005 1 0 1 1 D 136065000 485340528 485340528 2013 0 0 1 1 A 0 1 1 1 1 1 0.00500 0.00500 0 1 0.00370 0 1 B 0 1 1 1 1 1 0.00900 0.00900 0 0 1 C 0 1 1 1 1 1 0.00200 0.00200 0 0 1 D 0 0 1 1 1 1 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A Highlands County Health Facilities Authority 521313569 NoneAvail 2014-07-02 110000000 2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment 0 0 0 B Orange County Health Facilities Authority 521378595 NoneAvail 2014-07-02 50000000 2014B, Expand/refurbish facilities, purchase equipment 0 0 0 C Kansas Development Finance Authority 481066589 NoneAvail 2014-07-02 30000000 2014C, Expand/refurbish facilities, purchase equipment 0 0 0 D Colorado Health Facilities Authority 840752932 19648AT39 2014-07-23 82501800 2014E, Expand/refurbish facilities, purchase equipment 0 0 0 A 32616671 110068380 50068380 60000000 2015 1 0 1 1 B 21666671 50068380 50068380 2015 0 0 1 1 C 13000000 30041050 30041050 2015 0 0 1 1 D 82616012 82616012 2015 0 0 1 1 A 0 0 1 1 1 1 0 1 0.00090 1 1 B 0 0 1 1 1 1 0 1 0.00080 1 1 C 0 0 1 1 1 1 0 1 0.00080 1 1 D 0 0 1 1 1 1 0 1 0.00110 1 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A Colorado Health Facilities Authority 840752932 19648FAB0 2016-07-21 235724616 2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip 0 0 0 B Colorado Health Facilities Authority 840752932 1964745K2 2016-08-17 216517920 2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment 0 0 0 C Orange County Health Facilities Authority 521378595 NoneAvail 2017-07-26 44750000 2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment 0 0 0 D Highlands County Health Facilities Authority 521313569 NoneAvail 2017-07-26 50750000 2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment 0 0 0 A 235724616 169561866 66162750 2016 0 1 1 1 B 216517920 63248816 153269104 2016 1 0 1 1 C 5250000 44750000 1125787 43624213 2017 1 0 1 1 D 5250000 50750000 1276730 49473270 2017 1 0 1 1 A 0 0 1 1 1 1 0 0 1 B 0 1 1 1 1 1 0.00250 0.00070 0.00320 0 0 1 C 0 1 1 1 1 1 0 0 1 D 0 1 1 1 1 1 0 0 1 A 0 1 1 0 0 0 0 0 1 B 0 1 1 0 1 0 0 0 1 C 0 1 1 0 1 0 0 0 1 D 0 1 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A Kansas Development Finance Authority 481066589 NoneAvail 2017-07-26 45250000 2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment 0 0 0 B Colorado Health Facilities Authority 840752932 19648FCN2 2017-07-26 97750000 2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment 0 0 0 C Colorado Health Facilities Authority 840752932 19648FGN8 2018-07-12 375008542 2018A&B, Expand/refurbish facilities, purchase equipment 0 0 0 D Colorado Health Facilities Authority 840752932 19648FJG0 2019-08-20 550011892 2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip 0 0 0 A 5250000 45250000 1138365 44111635 2017 1 0 1 1 B 15750000 97750000 2459118 95290882 2017 1 0 1 1 C 375008542 375008542 2018 0 1 1 1 D 550011892 146365717 403646175 2019 1 0 1 1 A 0 1 1 1 1 1 0 0 1 B 0 1 1 1 1 1 0 0 1 C 0 1 1 1 1 1 0 0 1 D 0 1 1 1 1 1 0.00840 0.00840 0 0 1 A 0 1 1 0 1 0 0 0 1 B 0 1 1 0 1 0 0 0 1 C 0 1 1 0 1 0 0 0 1 D 0 1 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 Clifton Scott Family of board member 201445 Employee Compensation 0 Jeanette Vasquez Family of former key employee 47359 Employee Compensation 0 Mary Rathbun Family of board member and officer 87272 Employee Compensation 0 Karen Tilstra Family of former key employee 120060 Consulting 0 Meredith Bisbee Family of former key employee 127633 Employee Compensation 0 Martin Thompson Family of key employee 154259 Employee Compensation 0 Jocelyn Shaw Family of board member 11270 Employee Compensation 0 Kay Barnett Family of board member 197585 Employee Compensation 0 Ryan Barnett Family of board member 151324 Employee Compensation 0 Part V, Line 1a: The parent corporation and sole top-tier member of Adventist Health System/Sunbelt, Inc. (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041. Form 990, Part VI, Section A, line 4 The Bylaws of Adventist Health System/Sunbelt, Inc. (AHSSI or the Corporation) were amended in 2020 to change one of the qualifications for members of the Board of Directors. Prior to amendment, the Board members of the Corporation were those members, in good standing, of the Executive Board of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the 501(c)(3) parent of AHSSI. In 2020, the Bylaws of AHSSHC were amended to change its Board of Director composition and to remove all references to its Executive Board. Accordingly, the Bylaws of AHSSI were amended in 2020 to stipulate that its Board of Director members will be those persons who are members, in good standing, of the Board of AHSSHC. Form 990, Part VI, Section A, line 6 Adventist Health System/Sunbelt, Inc. (the filing organization) has one member. The sole member of the filing organization is Adventist Health System Sunbelt Healthcare Corporation. Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization. Form 990, Part VI, Section A, line 7a The sole member of the filing organization is AHSSHC. The Board of Directors of the filing organization are appointed by the sole member, AHSSHC, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization. Form 990, Part VI, Section A, line 7b AHSSHC, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the executive and/or administrative leadership of the filing organization, and their salaries; b) to approve and disapprove the operating Bylaws of the filing organization; c) to set limits and terms for the borrowing of funds; d) to approve or disapprove major building programs and/or purchase or sale of personal property or real property equal to or in excess of One Million dollars; e) to approve or disapprove the annual operating and capital budgets of the filing organization; f) to direct the placement of funds and capital of the filing organization; and g) to establish general guiding policies. Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the Senior VP/Chief Accounting Officer prior to its filing with the IRS. The review conducted by the Senior VP/Chief Accounting Officer did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules. Form 990, Part VI, Section B, line 12c The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes. Form 990, Part VI, Section B, line 15 The filing organization's CEO, other officers and key employees are not compensated by the filing organization. Such individuals are compensated by the related top-tier parent organization of the filing organization. Please see the discussion concerning the process followed by the related top-tier parent organization in determining executive compensation in our response to Schedule J, Line 3. Form 990, Part VI, Section C, line 19 The filing organization is a part of the system of healthcare organizations known as AdventHealth. The audited consolidated financial statements of AdventHealth and of the AdventHealth "Obligated Group" are filed annually with the Municipal Securities Rulemaking Board (MSRB). The "Obligated Group" is a group of AHSSHC subsidiaries that are jointly and severally liable under a Master Trust Indenture that secures debt primarily issued on a tax-exempt basis. Unaudited quarterly financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP) are also filed with MSRB for AdventHealth on a consolidated basis and for the grouping of AdventHealth subsidiaries comprising the "Obligated Group". The filing organization does not generally make its governing documents or conflict of interest policy available to the public. Part VII, Section A: For those Board of Director members, officer(s), and key employees who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation. Part VIII, Lines 7a, b and c: The amount shown in Part VIII, Line 7c(i) of the Form 990 represents an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. Form 990, Part IX, line 11g Payments to Healthcare Professionals: Program service expenses 320,741,439. Management and general expenses 0. Fundraising expenses 0. Total expenses 320,741,439. Professional Fees: Program service expenses 132,410,527. Management and general expenses 0. Fundraising expenses 0. Total expenses 132,410,527. Purchased Medical Services: Program service expenses 31,483,553. Management and general expenses 0. Fundraising expenses 0. Total expenses 31,483,553. Environmental Services: Program service expenses 4,206,076. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,206,076. Transcription Services: Program service expenses 1,748,261. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,748,261. Recruiting: Program service expenses 1,313,284. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,313,284. Food Service Contracts: Program service expenses 357,127. Management and general expenses 0. Fundraising expenses 0. Total expenses 357,127. Miscellaneous Purchased Services: Program service expenses 12,188,460. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,188,460. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 61,120,075. Fundraising expenses 0. Total expenses 61,120,075. Billing & Collection Services: Program service expenses 0. Management and general expenses 22,928,571. Fundraising expenses 0. Total expenses 22,928,571. AdventHealth Shared Services Fee: Program service expenses 0. Management and general expenses 41,831,127. Fundraising expenses 0. Total expenses 41,831,127. Part X, Line 2: The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value. Form 990, Part XI, line 9: Transfer from tax-exempt parent 102,534,342. Transfer to tax-exempt parent -49,182,043. Transfer to tax-exempt affiliates -5,593,545. Transfer to taxable subsidiaries -6,095,536. Debt costs allocated to tax-exempt affiliates -1,534,150. Transfer for expenses -644,853. Gifts 441,745. Transfer from restricted 1,266,906. Loss on sale of hospital assets -12,671,315. Other 177,431. Form 990, Part XII, Line 3b: For the 2020 fiscal year ending December 31, 2020, AdventHealth was subject to the Single Audit requirements, as set forth in the regulations at 2 CFR Part 200, Subpart F. As a calendar year taxpayer, the deadline to complete and submit the Single Audit Reporting Package to the Federal Audit Clearinghouse, as required under Subpart F of 2 CFR 200.501, is September 30, 2021. However, on March 19th, 2021, the Office of Management and Budget (OMB) issued Memorandum M21-20, which outlined the OMB's efforts to supplement the support in the American Rescue Plan Act of 2021 (ARP), promote public trust in the Federal Government's stewardship of taxpayer resources, and alleviate some of the administrative challenges related to the coronavirus pandemic. As part of the administrative relief included in Memorandum M21-20, the OMB provided a six-month extension of time to complete and submit the Single Audit Reporting Package. The extended reporting deadline for calendar year taxpayers is March 31, 2022. IQ Orlando LLC 235 E Princeton Street Suite 220 Orlando FL 328045555 471121247 Design and innovation FL 0 0 Adventist Hlth SystemSunbelt Inc AdventHealth Family Medicine Rural Health Clinics Inc 187 PR 4060 Lampasas TX 76550 271858033 Operation of Rural Health Clinics & Medical Services FL 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 AdventHealth Foundation Shawnee Mission 9100 W 74th Street Shawnee Mission KS 66204 480868859 Fund-raising for Tax-exempt hospital KS 501(c)(3) Line 7 Shawnee Mission Medical Center Inc 1 AdventHealth Home Care East Florida LLC 770 West Granada Blvd 319 Ormond Beach FL 32174 833768458 Inactive FL 501(c)(3) Line 12a, I Memorial Hlth Systems Inc 1 AdventHealth Hospice Care East Florida Inc 770 West Granada Blvd 304 Ormond Beach FL 32174 833748461 Inactive FL 501(c)(3) Line 12a, I Memorial Hlth Systems Inc 1 AdventHealth North Polk Inc 3100 E Fletcher Ave Tampa FL 33613 593231322 Inactive FL 501(c)(3) Line 12a, I University Community Hospital Inc 1 AdventHealth Polk North Inc 40100 US Highway 27 N Davenport FL 33837 841793121 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Polk South Inc 410 South 11th Street Lake Wales FL 33853 834672945 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth Senior Care Inc fka AH Osceola South Inc 900 Hope Way Altamonte Springs FL 32714 841817046 Inactive FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth South Overland ParkInc fka Merriam Hlth Care Prop 7820 W 165th Street Overland Park KS 66223 364595806 Inactive KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 AdventHealth Ransom Memorial Inc 1301 S Main Street Ottawa KS 66067 830976641 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 AdventHealth University Inc 671 Winyah Drive Orlando FL 32803 593069793 Education/Operation of School FL 501(c)(3) Line 2 Adventist Hlth SystemSunbelt Inc 1 AdventHealth West Florida Ambulatory Svcs Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 471881744 Operation of Imaging Center & Medical Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 AdventHealth West Florida Imaging Inc 14055 Riveredge Drive Ste 250 Tampa FL 33637 843225135 Imaging & Testing FL 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Services Inc 1 Adventist Bolingbrook Hospital 500 Remington Blvd Bolingbrook IL 60440 651219504 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando FL 32804 205774723 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights IL 60139 363208390 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 Adventist Hlth Mid-America Inc 9100 W 74th Street Shawnee Mission KS 66204 521347407 Support of Affiliated Hospital KS 501(c)(3) Line 12c, III-FI Adventist Hlth SystemSunbelt Inc 1 Adventist Hlth Partners Inc 2601 Navistar Dr Bldg 4 Finance Lisle IL 60532 364138353 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc 1 Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs FL 32714 592170012 Management Services FL 501(c)(3) Line 12a, I N/A 0 Adventist Hlth System Georgia Inc 1035 Red Bud Road NE Calhoun GA 30701 581425000 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs FL 32714 591479658 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson TX 76028 742578952 Leasing Personnel to Affiliated Hospital TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Midwest Health 120 North Oak Street Hinsdale IL 60521 362276984 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 AHP Specialty Care NFP 2601 Navistar Dr Bldg 4 Finance Lisle IL 60532 811105774 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc 1 AHS Midwest Management Inc 2601 Navistar Dr Bldg 4 Finance Lisle IL 60532 363354567 Operation of Physician Practice Mgmt IL 501(c)(3) Line 12a, I Adventist Midwest Health 1 AHSCentral Texas Inc (11-12142020) 11801 S Freeway Burleson TX 76028 742621825 Provide Office Space - Medical Professionals TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Apopka Hlth Care Properties Inc 305 E Oak Street Apopka FL 32703 510605694 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs FL 32714 381359189 Inactive MI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Bert Fish Medical Center Auxiliary Inc 401 Palmetto Street New Smyrna Beach FL 32168 591054892 Volunteer support services FL 501(c)(3) Line 10 N/A 0 Bradford Heights Health & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782342 Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Burleson Nursing & Rehab Center Inc 301 Huguley Blvd Burleson TX 76028 205782243 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Central Texas Hlthcare Collaborative (11-3312020) 1301 Wonder World Drive San Marcos TX 78666 453739929 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 Chickasaw Hlth Care Properties Inc 250 S Chickasaw Trail Orlando FL 32825 510605681 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Chippewa Valley Hospital & Oakview Care Center Inc 1220 Third Avenue West Durand WI 54736 391365168 Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Coalition For Physician Well-Being Inc (619 - 12312020) 900 Hope Way Altamonte Springs FL 32714 463477012 Provide support for Physician well-being. FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Courtland Hlth Care Properties Inc 730 Courtland Street Orlando FL 32804 510605682 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Creekwood Place Nursing & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782260 Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Dairy Road Hlth Care Properties Inc 7350 Dairy Road Zephyrhills FL 33540 510605684 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 East Orlando Hlth & Rehab Center Inc 250 S Chickasaw Trail Orlando FL 32825 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Emory-Adventist Inc 900 Hope Way Altamonte Springs FL 32714 582171011 Inactive GA 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospital & Related Svcs NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 FLNC Inc 3355 E Semoran Blvd Apopka FL 32703 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Florida Hospital Dade City Inc 13100 Fort King Road Dade City FL 33525 822567308 Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Healthcare Partners Inc 770 West Granada Blvd 101 Ormond Beach FL 32174 462354804 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Medical Group Inc 2600 Westhall Lane 4th Floor Maitland FL 32751 593214635 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Ocala Inc 1500 SW 1st Avenue Ocala FL 34471 824372339 Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Physician Group Inc 12470 Telecom Dr 100 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Waterman Inc 1000 Waterman Way Tavares FL 32778 593140669 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills FL 33541 592108057 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Radiology Imaging at Lake Mary LLC 2600 Westhall Lane 4th Floor Maitland FL 32751 550789387 Imaging & Testing FL 501(c)(3) Line 3 Florida Hospital Medical Group Inc 1 Fountain Inn Nursing & Rehab Center Inc 4501 Waterman Way Tavares FL 32778 472180518 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Helen Ellis Memorial Hospital Auxiliary Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 592106043 Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 12c, III-FI N/A 0 Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Hinsdale Hospital Foundation 120 North Oak Street Hinsdale IL 60521 521466387 Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 Hospice of the Comforter Inc 480 W Central Parkway Altamonte Springs FL 32714 592935928 Operation of Hospice FL 501(c)(3) Line 10 The Comforter Health Care Group Inc 1 In-Motion Rehab Inc 485 North Keller Road 250 Maitland FL 32751 208023411 Therapy services to tax exempt nursing homes KS 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Lake County Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813923985 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Memorial Hlth Systems Foundation Inc 305 Memorial Medical Pkwy 212 Daytona Beach FL 32117 311771522 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Memorial Hlth Systems Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 590973502 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland FL 32720 593256803 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592951990 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Inc 210 Marie Langdon Drive Manchester KY 40962 610594620 Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Physician Hlthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 Midwest Health Foundation 120 North Oak Street Hinsdale IL 60521 352230515 Support of subsidiary foundations IL 501(c)(3) Line 7 N/A 0 Mills Health & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782320 Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Mission Strategies of Georgia Inc 485 North Keller Road 250 Maitland FL 32751 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Missouri Adventist Health Inc 9100 W 74th Street Shawnee Mission KS 66204 431224729 Support Hlth Care Services MO 501(c)(3) Line 12d, III-O Adventist Hlth Mid-America Inc 1 Ormond Beach Memorial Hospital Auxiliary Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 591721962 Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A 0 Osceola Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813165729 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park KS 66204 205774821 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel FL 33544 208488713 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Portercare Adventist Health System (630 YE) 9100 E Mineral Circle Centennial CO 80112 840438224 Operation of Hospital & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Princeton Health & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782272 Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Princeton Professional Services Inc 601 E Rollins Street Orlando FL 32803 591191045 Provision of Hlthcare Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Quality Circle for Hlthcare Inc 900 Hope Way Altamonte Springs FL 32714 263789368 Hlthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 Resource Personnel Inc 485 North Keller Road 250 Maitland FL 32751 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Rocky Mountain Adventist Hlthcare Foundation (630 Year End) 7995 E Prentice Ave 204 Greenwood Village CO 80111 840745018 Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 N/A 0 Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen TX 76549 461656773 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 San Marcos Hlth Care Properties Inc 1900 Medical Parkway San Marcos TX 78666 510605693 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos TX 78666 205782224 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Inc 6501 West 75th Street Overland Park KS 66204 480952508 Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813914908 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 South Pasco Hlth Care Properties Inc 38250 A Avenue Zephyrhills FL 33542 510605679 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Southeast Volusia Healthcare Corp 401 Palmetto Street New Smyrna Beach FL 32168 473793197 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Southwest Volusia Hlth Services Inc 1055 Saxon Blvd Orange City FL 32763 593281591 Medical Office Building for Hospital FL 501(c)(3) Line 12a, I Southwest Volusia Hlthcare Corp 1 Southwest Volusia Hlthcare Corp 1055 Saxon Blvd Orange City FL 32763 593149293 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Specialty Physicians of Central Texas Inc (11-3312020) 1301 Wonder World Drive San Marcos TX 78666 208814408 Physician Hlthcare services to the community TX 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Spring View Hlth & Rehab Center Inc 485 North Keller Road 250 Maitland FL 32751 205782288 Inactive KY 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Hlth & Rehab Center - Apopka Inc 305 East Oak Street Apopka FL 32703 205774856 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Hlth Care Centers Inc 485 North Keller Road 250 Maitland FL 32751 581473135 Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 SunSystem Development Corp 900 Hope Way Altamonte Springs FL 32714 592219301 Fund Raising for Affiliated Tax-Exempt Hospitals FL 501(c)(3) Line 7 Adventist Hlth System Sunbelt Hlthcare Corp 1 Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 590898901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc 1 Tarrant County Hlth Care Properties Inc 301 Huguley Blvd Burleson TX 76028 510605677 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs FL 32714 271857940 Lease to Related Organization FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 The Volunteer Auxiliary of Florida Hospital - Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592486582 Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A 0 Tri-County Nursing and Rehab Center Inc 1290 Celebration Blvd Kissimmee FL 34747 472219363 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Trinity Nursing & Rehab Center Inc (11-91020) 485 North Keller Road 250 Maitland FL 32751 205774890 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa FL 33613 592554889 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 12a, I N/A 0 University Community Hospital Inc 3100 E Fletcher Ave Tampa FL 33613 591113901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 West Florida Health Home Care Inc 13601 Bruce B Downs Blvd Ste 110 Tampa FL 33613 593686109 Home Health Services GA 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Svcs Inc 1 Zephyr Haven Hlth & Rehab Center Inc 38250 A Avenue Zephyrhills FL 33542 205774930 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Zephyrhills Hlth & Rehab Center Inc 7350 Dairy Road Zephyrhills FL 33540 205774967 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Fletcher Hospital Surgical Ventures LLC 9131 Anson Way Ste 304 Raleigh NC 27615 861482646 Indirect Interest in Surgery Center NC N/A 0 0 Florida Hospital DMERT LLC 500 Winderley Place Ste 324 Maitland FL 32751 202392253 Medical Equipment FL N/A 0 1 Florida Hospital Home Infusion LLP 500 Winderley Place Ste 226 Maitland FL 32751 593142824 Home Infusion Services FL N/A 0 1 Functional Neurosurgical Ambulatory Surgery Ctr LLC 11 W Dry Creek Circle 120 Littleton CO 80120 464426708 Surgery Center CO N/A 0 0 Heart of Florida Surgery Center LLC (11 -10152020) 410 Lionel Way 100 Davenport FL 33837 812235296 Surgery Center DE N/A 0 1 PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial CO 80112 832465331 Urgent Care Center CO N/A 0 0 Princeton Homecare Services LLC 1050 Forrer Blvd Kettering OH 45420 814196648 Operation of Home Health Agency FL N/A 0 0 San Marcos MRI LP 1330 Wonder World Dr Ste 202 San Marcos TX 78666 770597972 Imaging & Testing TX Adventist Hlth SystemSunbelt Inc Related -173141 563753 0 0 0.58000 The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam KS 66204 823025378 Surgery Center KS N/A 0 0 Urgent Care Centers of Brevard County LLC (14-12312020) 2600 Westhall Lane Maitland FL 32751 844261523 Urgent Care Centers FL Adventist Hlth SystemSunbelt Inc Related 953710 6519166 0 1 0.51000 Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL Adventist Hlth SystemSunbelt Inc C 301233 1605131 0.64080 1 Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 593000857 Condo Association FL Adventist Hlth SystemSunbelt Inc C 29197 53223 1.00000 1 CC MOB Inc 2201 S Clear Creek Road Killeen TX 76549 742616875 Real Estate Rental TX N/A C 1 Central Texas Medical Associates 1301 Wonder World Drive San Marcos TX 78666 742729873 Inactive TX Adventist Hlth SystemSunbelt Inc C 1.00000 1 Central Texas Providers Network (11-3312020) 1301 Wonder World Drive San Marcos TX 78666 742827652 Physician Hospital Org. TX Adventist Hlth SystemSunbelt Inc C 10753 1.00000 1 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 1 Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando FL 32803 821748255 Condo Association FL Adventist Hlth SystemSunbelt Inc C 1.00000 1 Florida Hospital Healthcare System Inc 101 Southhall Lane Ste 150 Maitland FL 32751 593215680 PHSO FL Adventist Hlth SystemSunbelt Inc C 48944814 38363644 1.00000 1 Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL Adventist Hlth SystemSunbelt Inc C 1163131 7349298 0.85000 1 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL Adventist Hlth SystemSunbelt Inc C 125990 262556 0.54400 1 LN Health Partners Inc (11 - 9102020) 550 E Rollins Street 6th Floor Orlando FL 32803 813556903 Inactive FL N/A C 1 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Inactive KS N/A C 1 North American Health Services Inc & Sub 900 Hope Way Altamonte Springs FL 32714 621041820 Lessor/Holding Co. TN N/A C 1 Ormond Prof Associates Condo Assoc'n Inc (430 year end) 770 W Granada Blvd Ste 101 Ormond Beach FL 32174 592694434 Condo Association FL N/A C 1 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 1 Porter Affiliated Health Services Inc 2525 S Downing Street Denver CO 80210 840956175 Healthcare Services CO N/A C 1 San Marcos Regional MRI Inc (11-3312020) 1301 Wonder World Drive San Marcos TX 78666 770597968 Holding Company TX N/A C 1 The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland FL 32751 593414055 Real Estate Rental FL N/A C 1 Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando FL 32803 452228478 Condo Association FL Adventist Hlth SystemSunbelt Inc C 312849 342760 0.51600 1 1 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1 1 AdventHealth Polk North Inc Q 196878 Cost AdventHealth Polk North Inc P 1608066 Cost AdventHealth Polk South Inc P 1641271 Cost AdventHealth Ransom Memorial Inc P 70270 Cost AdventHealth University Inc P 1958712 Cost AdventHealth West Florida Ambulatory Services Inc Q 153171 Cost Adventist Care Centers - Courtland Inc B 986804 Actual Amount Given Adventist Care Centers - Courtland Inc P 870520 Cost Adventist Health Georgia Inc Q 496258 Cost Adventist Health Georgia Inc P 282808 Cost Adventist Health System Sunbelt Healthcare Corporation M 38927602 % of Facility's Operating Exp Adventist Health System Sunbelt Healthcare Corporation B 49182043 Actual Amount Given Adventist Health System Sunbelt Healthcare Corporation P 205346727 Cost Adventist Health System Sunbelt Healthcare Corporation A 928840 FMV Adventist Health System Sunbelt Healthcare Corporation S 102534342 Actual Amount Received Adventist Health System Sunbelt Healthcare Corporation P 178927437 Cost Adventist Health System Sunbelt Healthcare Corporation L 138658 Cost Adventist Health System Sunbelt Healthcare Corporation - Shared Services M 35472982 % of Facility's Operating Exp Adventist Health System Sunbelt Healthcare Corporation dba AIT M 161682475 % of Facility's Operating Exp Adventist Health System Sunbelt Healthcare Corporation dba AIT - Equip Fe P 4668941 Cost Central Texas Healthcare Collaborative B 265152 Actual Amount Given East Orlando Health & Rehab Center Inc B 3367450 Actual Amount Given East Orlando Health & Rehab Center Inc P 3072450 Cost East Orlando Health & Rehab Center Inc R 225000 Actual Amount Given Fletcher Hospital Inc P 424077 Cost Fletcher Hospital Inc Q 954678 Cost Fletcher Hospital Inc L 90940 Cost FLNC Inc (Florida Living Nursing Center) B 9572358 Actual Amount Given FLNC Inc (Florida Living Nursing Center) R 4392985 Actual Amount Given FLNC Inc (Florida Living Nursing Center) P 12289645 Cost Florida Hospital Dade City Inc L 166141 Cost Plus Appropriate % Florida Hospital Dade City Inc P 73832 Cost Florida Hospital Healthcare Partners Inc P 844996 Cost Florida Hospital Healthcare System Inc P 21218918 Cost Florida Hospital Healthcare System Inc S 3750095 Actual Amount Received Florida Hospital Medical Group Inc Q 327954 Cost Florida Hospital Medical Group Inc L 642091 Cost Plus Appropriate % Florida Hospital Medical Group Inc K 1033040 FMV Florida Hospital Medical Group Inc P 44871008 Cost Florida Hospital Medical Group Inc M 161833975 Cost Plus Appropriate % Florida Hospital Medical Group Inc A 595202 FMV Florida Hospital Ocala Inc L 887510 Cost Plus Appropriate % Florida Hospital Ocala Inc P 446266 Cost Florida Hospital Physician Group Inc P 130535 Cost Florida Hospital Waterman Inc P 2600660 Cost Florida Hospital Waterman Inc Q 3010028 Cost Florida Hospital Waterman Inc L 830915 Cost Plus Appropriate % Florida Hospital Zephyrhills Inc P 261314 Cost Florida Hospital Zephyrhills Inc L 397227 Cost Plus Appropriate % Florida Radiology Imaging at Lake Mary LLC P 4333968 Cost Florida Radiology Imaging at Lake Mary LLC A 191168 FMV Florida Radiology Imaging at Lake Mary LLC Q 18055423 Cost Hospice of the Comforter Inc Q 79741 Cost Memorial Health Systems Inc B 557216 Actual Amount Given Memorial Health Systems Inc Q 3874055 Cost Memorial Health Systems Inc P 1581305 Cost Memorial Health Systems Inc S 784634 Actual Amount Received Memorial Health Systems Inc L 889660 Cost Plus Appropriate % Memorial Hospital - Flagler Inc L 477440 Cost Plus Appropriate % Memorial Hospital - Flagler Inc P 417651 Cost Memorial Hospital - Flagler Inc Q 2608705 Cost Memorial Hospital - Flagler Inc S 414112 Actual Amount Received Memorial Hospital - West Volusia Inc L 395240 Cost Plus Appropriate % Memorial Hospital - West Volusia Inc S 348726 Actual Amount Received Memorial Hospital - West Volusia Inc Q 1788813 Cost Memorial Hospital - West Volusia Inc P 134792 Cost Memorial Hospital Inc P 85135 Cost Metroplex Adventist Hospital Inc P 227267 Cost Pasco-Pinellas Hillsborough Community Health System Inc P 1107873 Cost Pasco-Pinellas Hillsborough Community Health System Inc L 429148 Cost Plus Appropriate % Shawnee Mission Medical Center Inc Q 6558642 Cost Shawnee Mission Medical Center Inc P 1192825 Cost Shawnee Mission Medical Center Inc L 982157 Cost Plus Appropriate % Southeast Volusia Healthcare Corporation P 239380 Cost Southeast Volusia Healthcare Corporation Q 1883060 Cost Southeast Volusia Healthcare Corporation L 306992 Cost Plus Appropriate % Southwest Volusia Healthcare Corporation Q 1450316 Cost Southwest Volusia Healthcare Corporation P 247641 Cost Southwest Volusia Healthcare Corporation L 526834 Cost Plus Appropriate % Southwest Volusia Healthcare Corporation S 370522 Actual Amount Received Specialty Physicians of Central Texas Inc R 975560 Actual Amount Given Sunbelt Health & Rehab Center Apopka Inc P 535919 Cost Sunbelt Health & Rehab Center Apopka Inc B 600403 Actual Amount Given Sunbelt Health Care Centers Inc M 716565 Cost Sunbelt Health Care Centers Inc K 294490 FMV Sunbelt Health Care Centers Inc P 4426389 Cost SunSystem Development Corporation N 144327 Cost Allocation SunSystem Development Corporation C 7788994 Actual Amount Received SunSystem Development Corporation B 659402 Actual Amount Given SunSystem Development Corporation L 4230816 Cost Plus Appropriate % Tarpon Springs Hospital Foundation Inc L 302992 Cost Plus Appropriate % Texas Health Huguley Inc P 1255062 Cost University Community Hospital Inc Q 165542 Cost University Community Hospital Inc P 5073214 Cost University Community Hospital Inc L 1709499 Cost Plus Appropriate % Urgent Care Centers of Brevard County LLC P 563521 Cost Urgent Care Centers of Brevard County LLC L 716668 Cost Urgent Care Centers of Brevard County LLC Q 4772826 Cost