ADVENTIST HEALTH SYSTEM SUNBELT INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: ADVENTIST HEALTH SYSTEM SUNBELT INC (EIN 59-1479658)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-11-16
IRS object ID: 202043219349320134
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-16T16:39:59-06:00	ReturnTs
Tax Period End	2019-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	591479658	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Adventist Health SystemSunbelt Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ADVE	BusinessNameControlTxt
Phone	4073572317	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	900 Hope Way	AddressLine1Txt
City	Altamonte Springs	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32714	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Lynn C Addiscott	PersonNm
Person Title	Asst. Secretary	PersonTitleTxt
Phone	4073572317	PhoneNum
Signature	2020-11-16	SignatureDt

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Terry Shaw	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	900 Hope Way	AddressLine1Txt
City	Altamonte Springs	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32714	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$4,695,540,113	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	1071	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.adventhealth.com	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1973	FormationYr
Legal Domicile State	FL	LegalDomicileStateCd
Activity Or Mission	Operation of 11 acute-care hospitals & related healthcare services.	ActivityOrMissionDesc
Voting Members Governing Body	24	VotingMembersGoverningBodyCnt
Voting Members Independent	19	VotingMembersIndependentCnt
Total Employee	31145	TotalEmployeeCnt
Total Volunteers	2638	TotalVolunteersCnt
Total Gross UBI	$17,974,929	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$1,206,540	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$21,817,289	PYContributionsGrantsAmt
CY Contributions Grants	$31,146,379	CYContributionsGrantsAmt
PY Program Service Revenue	$4,331,317,719	PYProgramServiceRevenueAmt
CY Program Service Revenue	$4,523,075,663	CYProgramServiceRevenueAmt
PY Investment Income	$60,971,258	PYInvestmentIncomeAmt
CY Investment Income	$118,616,621	CYInvestmentIncomeAmt
PY Other Revenue	$12,307,248	PYOtherRevenueAmt
CY Other Revenue	$21,068,685	CYOtherRevenueAmt
PY Total Revenue	$4,426,413,514	PYTotalRevenueAmt
CY Total Revenue	$4,693,907,348	CYTotalRevenueAmt
PY Grants And Similar Paid	$23,222,174	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$23,069,970	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,682,310,367	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$1,799,684,813	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$2,170,733,626	PYOtherExpensesAmt
CY Other Expenses	$2,176,601,308	CYOtherExpensesAmt
PY Total Expenses	$3,876,266,167	PYTotalExpensesAmt
CY Total Expenses	$3,999,356,091	CYTotalExpensesAmt
PY Revenues Less Expenses	$550,147,347	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$694,551,257	CYRevenuesLessExpensesAmt
Total Assets BOY	$8,117,641,825	TotalAssetsBOYAmt
Total Assets EOY	$8,921,698,765	TotalAssetsEOYAmt
Total Liabilities BOY	$4,036,105,065	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$4,010,328,109	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$4,081,536,760	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$4,911,370,656	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Adventist Health System Sunbelt Healthcare Corporation and all its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ. The hospital and healthcare system whose parent is Adventist Health System Sunbelt Healthcare Corporation is known as AdventHealth. AdventHealth seeks to be widely respected as a consumer-focused organization that engages individuals in their health by delivering wholistic, best practice care across a connected, comprehensive continuum of services. With Christ as our example, AdventHealth cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$3,685,598,199	ExpenseAmt
Grant	$23,069,970	GrantAmt
Revenue	$4,524,180,616	RevenueAmt
Desc	Operation of 11 acute care hospitals with 150,586 patient admissions, 745,554 patient days and 1,368,029 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.	Desc
Total Program Service Expenses	$3,685,598,199	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	Yes (1)	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	Yes (1)	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	1399	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	31145	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	24	GoverningBodyVotingMembersCnt
Independent Voting Member	19	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Paul Rathbun	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4073572419	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	900 Hope Way	AddressLine1Txt
City	Altamonte Springs	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	32714	ZIPCd

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

Form990 Part VII Section A Form990PartVIISectionAGrp (48 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Shaw Terry D
Dir/President/AdventHealth CEO	1.00	50.00	Yes (X)	Yes (X)	$0	$4,276,521	$435,698
Houmann Lars D
Dir/AH Crp Relations Off (end 12/19)	1.00	50.00	Yes (X)		$0	$2,609,062	$296,909
Tol Daryl
Pres/CEO Central FL Division	1.00	50.00		Yes (X)	$0	$1,857,791	$292,832
Rathbun Paul C
Director/AdventHealth CFO	1.00	50.00	Yes (X)	Yes (X)	$0	$1,594,684	$249,273
Stevens Eric A
CEO CF S Acute/AH Orl/Women (End 12/19)	1.00	50.00			$0	$1,468,816	$148,607	Yes (X)
Silvestry MD Scott
Physician/Director AH Thoracic Transplant	88.00	0.00			$1,499,528	$0	$21,827		Yes (X)
Soler Eddie
Former Key Emp/AH Sr Finance Officer	0.00	50.00			$0	$1,302,984	$188,801			Yes (X)
Banks David P
Former Key Emp/AH Chief Strategy Off	0.00	50.00			$0	$1,272,319	$176,260			Yes (X)
Goodman Todd A
CFO Central FL Division	1.00	50.00		Yes (X)	$0	$1,290,806	$154,429
Moorhead MD John David
Former Key Emp/AH Chief Clincial Officer	0.00	50.00			$0	$1,409,467	$29,601			Yes (X)
Davis Jr MD Robert Duane
Physician/Director AH Cardiovascular Institute	70.00	0.00			$1,202,139	$0	$23,035		Yes (X)
Botta MD Donald
Physician/Director AH Heart Transplant	50.00	0.00			$1,044,263	$0	$21,482		Yes (X)
Shimshak MD Thomas M
Interventional Cardiology Physician	50.00	0.00			$961,825	$0	$23,444		Yes (X)
Jones MD Phillip
Interventional Cardiology Physician	50.00	0.00			$943,888	$0	$31,941		Yes (X)
Hilliard Douglas W
Sr VP/Sr Finance Officer AH Orlando	50.00	0.00			$0	$733,295	$122,821	Yes (X)
Thompson Michael J
CEO Central FL South Integrated Hlth Serv	40.00	10.00			$0	$700,128	$129,291	Yes (X)
Hagensicker Janice K
Former Key Emp/Sr Fin Off AH Orl SW Mkt	50.00	0.00			$0	$771,807	$38,182			Yes (X)
Owen Terry R
Former Key Emp/SVP Partnering Strategy	50.00	0.00			$0	$711,730	$97,523			Yes (X)
Reed MD Monica P
Former Key Employee	0.00	0.00			$0	$724,580	$34,419			Yes (X)
Cook Timothy W
CEO AH Alt & West Orange Mkt	50.00	0.00			$0	$673,562	$77,704	Yes (X)
Spenst Brett
CEO AH Orlando (Beg 3/19)	50.00	0.00			$200	$638,553	$100,871	Yes (X)
Harcombe Douglas W
CEO AH Celebration & South Mkt	50.00	0.00			$0	$607,383	$107,345	Yes (X)
Zbaraschuk Amy L
Sr VP/Sr Finance Off CF S Integrated Hlth Svcs	50.00	0.00			$25	$601,450	$103,041	Yes (X)
Dodds Sheryl D
Chief People Off Central FL South	50.00	0.00			$0	$630,232	$26,860	Yes (X)
Wandersleben Jennifer J
CEO CF S Acute/AH Orl/Women (Beg 12/19)	50.00	0.00			$0	$509,265	$87,183	Yes (X)
Paradis J Brian
Former Key Employee	0.00	0.00			$0	$331,644	$13,889			Yes (X)
Bradley Kenneth W
Former Key Emp/AH Dir Emerging Leaders	0.00	50.00			$0	$214,004	$27,745			Yes (X)
Jernigan PhD Donald L
Dir/AH CEO Emeritus/Leadership Inst	1.00	3.00	Yes (X)		$0	$180,408	$22,322
Werner Thomas L
Director	1.00	3.30	Yes (X)		$0	$5,263	$0
Smith DMin PhD Ron C
Chairman/Director	2.00	3.00	Yes (X)		$300	$2,449	$0
Davidson James R
Director	1.00	3.00	Yes (X)		$300	$2,449	$0
Peoples Troy K
Director	1.00	3.00	Yes (X)		$0	$2,749	$0
Thurber Gary F
Vice Chairman/Director	2.00	3.00	Yes (X)		$0	$2,749	$0
Freedman David
Director (beg 1/19)	1.00	3.00	Yes (X)		$300	$2,249	$0
Griffith Jr Buford
Director	1.00	3.00	Yes (X)		$50	$2,449	$0
Moore MDiv Larry R
Vice Chairman/Secretary/Director	2.00	3.00	Yes (X)		$0	$2,449	$0
Page John M
Director	1.00	3.00	Yes (X)		$0	$2,449	$0
Poenitz Steven N
Director	1.00	3.00	Yes (X)		$0	$2,449	$0
Scott Glynn CW
Director	1.00	3.00	Yes (X)		$0	$2,449	$0
Valentine II MDiv Maurice R
Vice Chairman/Director	2.00	3.00	Yes (X)		$0	$2,449	$0
Webb Gil
Director	1.00	3.00	Yes (X)		$0	$2,449	$0
Carlson Ronald
Director	1.00	3.00	Yes (X)		$0	$2,029	$0
Machado Allan
Director	1.00	3.00	Yes (X)		$300	$1,699	$0
Aguilera Ronald
Director	1.00	3.00	Yes (X)		$0	$1,699	$0
Brown-Fraser PhD RD Sherine R
Director	1.00	3.00	Yes (X)		$0	$1,699	$0
Craig Carlos J
Director	1.00	3.00	Yes (X)		$0	$1,699	$0
Johnson MD Mark
Director	1.00	3.00	Yes (X)		$0	$1,699	$0
Shaw EdD Kenneth
Director	1.00	3.00	Yes (X)		$0	$1,699	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$5,653,118	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$25,157,765	TotReportableCompRltdOrgAmt
Total Other Compensation	$3,083,335	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1976	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Brasfield & Gorrie LLC
2999 Circle 75 Pkwy Suite 100	Atlanta	GA	30339	Design and Construction Services	$63,361,837
AMN Healthcare Inc
2735 Collections Center Dr	Chicago	IL	60693	Healthcare Staffing Services	$21,192,391
PricewaterhouseCoopers Advisory Product
PO Box 932011	Atlanta	GA	31193	Consulting Services	$12,259,754
Batson-Cook Company
PO Box 24697	Jacksonville	FL	32241	Design and Construction Services	$10,285,783
Brown Parker & Demarinis Advertising In
1825 NW Corporate Blvd Suite 250	Boca Raton	FL	33431	Advertising Services	$9,684,862

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	447	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$26,372,078	RelatedOrganizationsAmt
Government Grants	$4,557,367	GovernmentGrantsAmt
All Other Contributions	$216,934	AllOtherContributionsAmt
Total Contributions	$31,146,379	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Revenue	622110	$4,453,491,493	$4,440,513,368	$12,978,125
Rent from Exempt Affiliates	622110	$18,798,317	$18,798,317
Cafeteria/Vending Rev.	622110	$17,887,932	$17,460,852	$427,080
Gift Shop	622110	$6,632,199	$6,592,383	$39,816
Research	622110	$4,697,801	$4,697,801

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$21,567,921	TotalRevenueColumnAmt
Related Or Exempt Func Income	$17,190,774	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,377,147	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$4,523,075,663	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$77,570,994	TotalRevenueColumnAmt
Exclusion	$77,570,994	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$196,523	TotalRevenueColumnAmt
Exclusion	$196,523	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,110,758	RealAmt
Personal	$105,840	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,218,442	RealAmt
Personal	$53,115	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,892,316	RealAmt
Personal	$52,725	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,945,041	TotalRevenueColumnAmt
Unrelated Business Revenue	$152,761	UnrelatedBusinessRevenueAmt
Exclusion	$1,792,280	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$39,342,854	SecuritiesAmt
Other	$2,063,981	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$361,208	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$39,342,854	SecuritiesAmt
Other	$1,702,773	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$41,045,627	TotalRevenueColumnAmt
Exclusion	$41,045,627	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Equity earnings from related enti	622110	$17,726,281	$17,726,281
Investment in Subs	622110	$1,149,308	$1,149,308
EHR Revenue	622110	$51,532	$51,532

Field	Value	IRS element (for citing)
Other Revenue Total	$18,927,121	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,693,907,348	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,524,180,616	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$17,974,929	UnrelatedBusinessRevenueAmt
Exclusion	$120,605,424	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$22,836,511	TotalAmt
Program Services	$22,836,511	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$233,459	TotalAmt
Program Services	$233,459	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$11,062,490	TotalAmt
Management And General	$11,062,490	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,332,824,013	TotalAmt
Program Services	$1,312,897,601	ProgramServicesAmt
Management And General	$19,926,412	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$50,195,429	TotalAmt
Program Services	$49,096,349	ProgramServicesAmt
Management And General	$1,099,080	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$305,097,704	TotalAmt
Program Services	$293,024,998	ProgramServicesAmt
Management And General	$12,072,706	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$100,505,177	TotalAmt
Program Services	$98,288,808	ProgramServicesAmt
Management And General	$2,216,369	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$5,510,934	TotalAmt
Management And General	$5,510,934	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$760,625	TotalAmt
Management And General	$760,625	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$12,669,173	TotalAmt
Management And General	$12,669,173	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$502,671,025	TotalAmt
Program Services	$425,642,552	ProgramServicesAmt
Management And General	$77,028,473	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$35,504,141	TotalAmt
Management And General	$35,504,141	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$77,779,903	TotalAmt
Program Services	$47,061,834	ProgramServicesAmt
Management And General	$30,718,069	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$142,849,743	TotalAmt
Program Services	$126,718,187	ProgramServicesAmt
Management And General	$16,131,556	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$104,164,154	TotalAmt
Program Services	$104,164,154	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$6,979,597	TotalAmt
Program Services	$91,615	ProgramServicesAmt
Management And General	$6,887,982	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,811,620	TotalAmt
Management And General	$1,811,620	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$33,963,555	TotalAmt
Program Services	$33,963,555	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$209,523,329	TotalAmt
Program Services	$209,523,329	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$32,197,524	TotalAmt
Program Services	$31,424,445	ProgramServicesAmt
Management And General	$773,079	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$738,308,785	$738,308,785
Repairs/Maintenance	$85,141,611	$85,141,611
Assessments	$82,832,021	$82,832,021
UBI Tax	$724,539		$724,539

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$103,209,029	TotalAmt
Program Services	$24,348,385	ProgramServicesAmt
Management And General	$78,860,644	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,999,356,091	TotalAmt
Program Services	$3,685,598,199	ProgramServicesAmt
Management And General	$313,757,892	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

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

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$101,384	BOYAmt
EOY	$91,546	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,749,161,344	BOYAmt
EOY	$2,917,094,143	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$547,174,284	BOYAmt
EOY	$652,396,165	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$95,583,705	BOYAmt
EOY	$109,133,897	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$34,710,051	BOYAmt
EOY	$39,071,767	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$5,030,717,873	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,253,419,818	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,499,435,427	BOYAmt
EOY	$2,777,298,055	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$6,023,522	BOYAmt
EOY	$7,172,830	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$29,516,663	BOYAmt
EOY	$28,585,967	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,155,935,445	BOYAmt
EOY	$2,390,854,395	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$8,117,641,825	BOYAmt
EOY	$8,921,698,765	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$338,721,594	BOYAmt
EOY	$330,251,271	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,370,428,808	BOYAmt
EOY	$3,356,609,779	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$326,954,663	BOYAmt
EOY	$323,467,059	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,036,105,065	BOYAmt
EOY	$4,010,328,109	EOYAmt

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

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,080,199,116	BOYAmt
EOY	$4,909,860,928	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,337,644	BOYAmt
EOY	$1,509,728	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,081,536,760	BOYAmt
EOY	$4,911,370,656	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$8,117,641,825	BOYAmt
EOY	$8,921,698,765	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$694,551,257	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$244,008,776	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$108,726,137	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$139,303	OtherActivitiesAmt
Total Lobbying Expenditures	$139,303	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,471,913	BeginningYearBalanceAmt
Contributions	$50,000	ContributionsAmt
Investment Earnings Or Losses	$1,196,289	InvestmentEarningsOrLossesAmt
Other Expenditures	$526,694	OtherExpendituresAmt
End Year Balance	$21,191,508	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$19,274,406	BeginningYearBalanceAmt
Contributions	$100,000	ContributionsAmt
Investment Earnings Or Losses	$1,099,218	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,711	OtherExpendituresAmt
End Year Balance	$20,471,913	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$19,390,999	BeginningYearBalanceAmt
Contributions	$166,685	ContributionsAmt
Investment Earnings Or Losses	$1,051,467	InvestmentEarningsOrLossesAmt
Other Expenditures	$9,029	OtherExpendituresAmt
End Year Balance	$20,600,122	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$19,118,543	BeginningYearBalanceAmt
Contributions	$568,450	ContributionsAmt
Investment Earnings Or Losses	$277,615	InvestmentEarningsOrLossesAmt
Other Expenditures	$573,609	OtherExpendituresAmt
End Year Balance	$19,390,999	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$18,008,913	BeginningYearBalanceAmt
Contributions	$530,000	ContributionsAmt
Investment Earnings Or Losses	$911,157	InvestmentEarningsOrLossesAmt
Other Expenditures	$331,527	OtherExpendituresAmt
End Year Balance	$19,118,543	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.92460	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.07540	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$267,201,762	OtherCostOrOtherBasisAmt
Book Value	$267,201,762	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,821,163,946	OtherCostOrOtherBasisAmt
Depreciation	$715,241,856	DepreciationAmt
Book Value	$1,105,922,090	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,561,088,793	OtherCostOrOtherBasisAmt
Depreciation	$1,485,190,606	DepreciationAmt
Book Value	$1,075,898,187	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$381,263,372	OtherCostOrOtherBasisAmt
Depreciation	$52,987,356	DepreciationAmt
Book Value	$328,276,016	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,777,298,055	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDesc	Book ValueBookValueAmt
Funds Held in Trust	$8,462
Due From Related/Affiliated Entities	$9,610,397
Long-term Investments	$139,962,852
Other Non-Current Assets	$149,612,543
Receivable - Interco Alloc of Tax-Exempt Bond Proceeds	$1,966,544,182
Receivable from Third Party	$52,093,800
Board Designated Funds	$100
Other Current Receivables	$73,022,059

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$2,390,854,395	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
Payable to Third Party	$39,480,846
Due to Related/Affiliated Entities	$114,872,253
Other Current Liabilities	$40,536,174
Other Non-Current Liabilities	$125,967,397
Notes and Loans Payable	$257,224
Leases Payable	$2,353,165

Field	Value	IRS element (for citing)
Total Liability	$323,467,059	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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 (b) Prior year - 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 V, line 1a, column (d) Four years back - Explanation for change in opening balance: During year 2015, it came to the attention of the Foundation's management that an Endowment in the amount of $340,022 was mistakenly misclassified as of December 31, 2014. As a result, the Foundation restated beginning board-designated endowment funds in its 2015 tax year. Part V, line 1c, column (c) Three years back - During 2016, the Foundation agreed to a modification of a donor's endowment agreement, which resulted in an impairment of $722,928. This amount was netted with the Foundation's 2016 investment return.

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, 2019 and 2018. NAHS also has temporary deductible differences of approximately $46,500 and $53,000 at December 31, 2019 and 2018, respectively, primarily as a result of net operating loss carryforwards. At December 31, 2019, NAHS had net operating loss carryforwards of approximately $47,500, expiring beginning in 2022 through 2026. Deferred taxes have been provided for these amounts, resulting in a net deferred tax asset of approximately $11,400 and $13,400 at December 31, 2019 and 2018, 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, 2019 and 2018 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 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, 2019 and 2018. 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. While final regulations on these provisions have not yet been promulgated, the impact of these provisions on the consolidated financial statements is not expected to be significant.

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	0	GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (18 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Region Total ExpendituresRegionTotalExpendituresAmt	Specific Services ProvidedSpecificServicesProvidedTxt
Central America and the Caribbean	Grantmaking	$64,640
Central America and the Caribbean	Meetings	$1,956
Central America and the Caribbean	Program Services	$470,738	Mission Trips
East Asia and the Pacific	Fundraising	$2,549
East Asia and the Pacific	Grantmaking	$119,161
East Asia and the Pacific	Meetings	$16,104
East Asia and the Pacific	Program Services	$111,550	Mission Trips
Europe (including Iceland and Greenland)	Meetings	$59,088
Europe (including Iceland and Greenland)	Speakers	$1,632
Middle East and North Africa	Meetings	$5,832
North America (which includes Canada and Mexico, but not the U.S.)	Grantmaking	$10,500
North America (which includes Canada and Mexico, but not the U.S.)	Meetings	$6,774
North America (which includes Canada and Mexico, but not the U.S.)	Program Services	$58,848	Mission Trips
South America	Grantmaking	$10,396
South America	Meetings	$3,105
South America	Program Services	$271,132	Mission Trips
Sub-Saharan Africa	Grantmaking	$33,420
Sub-Saharan Africa	Program Services	$163,309	Mission Trips

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$845,786	SubtotalSpentAmt
Continuation Spent	$564,948	ContinuationSpentAmt
Total Spent	$1,410,734	TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp (10 entries)

RegionRegionTxt	Purpose Of GrantPurposeOfGrantTxt	Cash GrantCashGrantAmt	Manner Of Cash DisbursementMannerOfCashDisbursementTxt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceAmt	Description Of Non Cash AsstDescriptionOfNonCashAsstTxt
South America	General Support	$9,500	Check	Book
Central America and the Caribbean	Medical Supplies or Equipment			Other	$25,135	Medical Equipment
Central America and the Caribbean	Medical Supplies or Equipment			Other	$8,581	Medical Equipment
Central America and the Caribbean	Medical Supplies or Equipment			Other	$7,764	Medical Equipment
Central America and the Caribbean	Medical Supplies or Equipment			Other	$6,380	Medical Equipment
Central America and the Caribbean	Medical Supplies or Equipment			Other	$10,000	Medical Equipment
East Asia and the Pacific	Medical Supplies or Equipment			Other	$119,161	Medical Equipment
North America (which includes Canada and Mexico, but not the U.S.)	General Support	$10,500		Book
Sub-Saharan Africa	Medical Supplies or Equipment			Other	$13,500	Medical Equipment
Sub-Saharan Africa	Medical Supplies or Equipment			Other	$18,944	Medical Equipment

Field	Value	IRS element (for citing)
Total501c3 Org	10	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	0	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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:

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$259,648,780	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$259,648,780	NetCommunityBenefitExpnsAmt
Total Expense	0.06490	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$574,746,918	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$390,467,536	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$184,279,382	NetCommunityBenefitExpnsAmt
Total Expense	0.04610	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$834,395,698	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$390,467,536	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$443,928,162	NetCommunityBenefitExpnsAmt
Total Expense	0.11100	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,619,720	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$48,210	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,571,510	NetCommunityBenefitExpnsAmt
Total Expense	0.00640	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$46,606,465	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,689,161	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$36,917,304	NetCommunityBenefitExpnsAmt
Total Expense	0.00920	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,176,900	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,756,248	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,420,652	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,245,063	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,304,414	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$940,649	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,360,423	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$16,360,423	NetCommunityBenefitExpnsAmt
Total Expense	0.00410	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$108,008,571	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$26,798,033	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$81,210,538	NetCommunityBenefitExpnsAmt
Total Expense	0.02030	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$942,404,269	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$417,265,569	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$525,138,700	NetCommunityBenefitExpnsAmt
Total Expense	0.13130	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,061,279	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,314,222	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,747,057	NetCommunityBenefitExpnsAmt
Total Expense	0.00390	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$530,675	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,525	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$529,150	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$148,026	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$148,026	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,739,980	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,315,747	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,424,233	NetCommunityBenefitExpnsAmt
Total Expense	0.00400	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$283,933,952	BadDebtExpenseAmt
Bad Debt Expense Attributable	$14,857,529	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$736,646,994	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$859,530,208	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$122,883,214	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
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

Field	Value	IRS element (for citing)
Hospital Facilities	11	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (11 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Facility Reporting GroupFacilityReportingGroupCd	Critical Access HospitalCriticalAccessHospitalInd
AdventHealth Orlando
1	601 E Rollins Street	Orlando	FL	32803	www.adventhealth.com/hospital/adventh	4369	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Therapy Center, EPS Cath Lab, 4 Off-site EDs	A
AdventHealth Celebration
2	400 Celebration Place	Celebration	FL	34747	www.adventhealth.com/hospital/adventh	4369	Yes (X)	Yes (X)		Yes (X)		Yes (X)	Therapy Center	A
AdventHealth Altamonte Springs
3	601 E Altamonte Drive	Altamonte Springs	FL	32701	www.adventhealth.com/hospital/adventh	4369	Yes (X)	Yes (X)		Yes (X)		Yes (X)	Cancer Center, Therapy	A
AdventHealth East Orlando
4	7727 Lake Underhill Road	Orlando	FL	32822	www.adventhealth.com/hospital/adventh	4369	Yes (X)	Yes (X)		Yes (X)		Yes (X)		A
AdventHealth Winter Park
5	200 N Lakemont Avenue	Winter Park	FL	32792	www.adventhealth.com/hospital/adventh	4369	Yes (X)	Yes (X)		Yes (X)		Yes (X)		A
AdventHealth Kissimmee
6	2450 North Orange Blossom Trail	Kissimmee	FL	34744	www.adventhealth.com/hospital/adventh	4369	Yes (X)	Yes (X)		Yes (X)		Yes (X)		A
AdventHealth Sebring
7	4200 Sun N Lake Blvd	Sebring	FL	33825	www.adventhealth.com/hospital/adventh	4171	Yes (X)	Yes (X)				Yes (X)		B
AdventHealth Apopka
8	2100 Ocoee-Apopka Road	Apopka	FL	32703	www.adventhealth.com/hospital/adventh	4369	Yes (X)	Yes (X)		Yes (X)		Yes (X)		A
Central Texas Medical Center
9	1301 Wonder World Drive	San Marcos	TX	78666	www.ctmc.org	000556	Yes (X)	Yes (X)				Yes (X)		A
AdventHealth Lake Placid
10	1210 US Highway 27 North	Lake Placid	FL	33852	www.adventhealth.com/hospital/adventh	4171	Yes (X)	Yes (X)				Yes (X)	Senior Behavioral Unit, Outpatient Physical Therapy	B
AdventHealth Wauchula
11	735 S 5th Avenue	Wauchula	FL	33873	www.adventhealth.com/hospital/adventh	4239	Yes (X)	Yes (X)				Yes (X)	Skilled Nursing	A	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Provided Nonprofit ContactProvidedNonprofitContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	Provided Written NoticeProvidedWrittenNoticeInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Look Back Medicare PrivateLookBackMedicarePrivateInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd
Facility Reporting Group - A
0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	19	Yes (1)	0	0	Yes (1)	Yes (X)	See Part V, Page 8	Yes (X)	Yes (X)	Yes (1)	17	Yes (1)	See Part V, Page 8	0	Yes (1)	Yes (X)	200.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Part V, Page 8	Yes (X)	See Part V, Page 8	Yes (X)	See Part V, Page 8	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0
Facility Reporting Group - B
0	0	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	19	Yes (1)	Yes (1)	0	Yes (1)	Yes (X)	See Part V, Page 8	Yes (X)	Yes (X)	Yes (1)	17	Yes (1)	See Part V, Page 8	0	Yes (1)	Yes (X)	200.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	See Part V, Page 8	Yes (X)	See Part V, Page 8	Yes (X)	See Part V, Page 8	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	0

Supplemental Information SupplementalInformationGrp (34 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 9: Central Texas Medical Center, - Facility 11: AdventHealth Wauchula
Facility Reporting Group - A Part V, Section B, line 5:	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
Facility Reporting Group - A Part V, Section B, line 7d:	The 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.
Facility Reporting Group - A Part V, Section B, line 11:	Group A-Facility 1 -- AdventHealth OrlandoAdventist Health System/Sunbelt, Inc d/b/a AdventHealth Orlando will be referred to in this document as AdventHealth Orlando (AHO 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Orlando is part of the Central Florida Division South Region of AdventHealth. The division includes seven hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for AdventHealth Orlando's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 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 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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. AHO chose two areas of focus for its 2017-2019 Community Health Plan: 1. Access to Care - Preventative; and2. Access to Care - Primary and Behavioral/Mental Health. Priority 1: Access to Care - Preventative 2016 Description of the Issue:AHO recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to care and create opportunities for community members to lead healthier lives, in part by addressing issues involving preventative care impacted by food insecurity, obesity and maternal and child health.2019 Update: The AHO Community Health Plan has six desired outcome statements under the Access to Care - Preventative priority. 1. Improve access to healthy and nutritious foods;2. Improve access to knowledge around healthy nutrition and wellness;3. Educate and empower the faith community to promote health within congregations in critical areas;4. Support and create opportunities for increased quality of life for residents of Orange County;5. Increase access to knowledge of chronic disease self-management practices; and6. Support opportunities that promote knowledge of chronic diseases within the primary service area.Outcome 1: Improve access to healthy and nutritious foodsThe first Regional strategy focuses on supporting food distribution programs within the targeted zip codes. The Region established a partnership in 2017 to help fund a local church program in order to increase its impact. The church had established a fresh food co-op which supplies food pantries throughout the Orange, Osceola, and Seminole tri-county area with healthier options. 144,957 meals were provided in Orange County throughout 2019 through this initiative. The second Regional strategy began as a pilot at AHO. The AHO campus partnered with Second Harvest Food Bank, a local non-profit food bank, in 2017 to begin providing unused food from the AdventHealth Hospital campuses to Second Harvest so this food can be distributed throughout high need areas in the community. The number of meals provided from the Orlando campus was 17,476 in 2019. This Regional strategy expanded to all facilities in the Central Florida Division South Region in 2019. Outcome 2: Improve access to knowledge around healthy nutrition and wellnessThere are two Regional strategies for this outcome. 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. Seven schools in AHO's target zip codes received this program in 2019 meeting the goal. The second Regional strategy was to provide Nutrition Wellness classes to community members which would help with increasing access to knowledge around nutrition. This program was not deployed in 2019 due to a lack of resources.Outcome 3: Educate and empower the faith community to promote health within congregations in critical areasThe Regional strategy for this outcome is to create a network of faith partners that can promote health through congregational settings. This strategy is funded at a Regional level. The pilot was implemented at AHO. The AHO campus began developing and sharing best practices to be implemented across the South Region. In AdventHealth Orlando's primary service area, there are three faith partners that distributed 10,219 meals to community members in need in 2019.Outcome 4: Support and create opportunities for increased quality of life for residents of Orange CountyThe Regional strategy involved offering programming from Healthy Central Florida (HCF) to the service areas that AHO reaches. The goal of HCF is to make Central Florida communities the healthiest in the nation. This initiative began with three target communities Winter Park, Maitland and Eatonville. The program was not redeployed in 2019 due to staff and internal strategy changes, but AdventHealth Orlando continually seeks programs that would benefit the underserved populations. Outcome 5: Increase access to knowledge of chronic disease self-management practicesThe Regional strategy for this outcome is to fund and implement the evidence-based Stanford Chronic Disease Self-Management Program (CDSMP) in its targeted zip codes throughout the Region. In Orange County, 12 CDSMP classes were hosted with 167 participants in 2019. A graduation rate of 76.6 percent was achieved with 128 of those participating successfully completing the course.Outcome 6: Support opportunities that promote knowledge of chronic diseases within the primary service areaThe Regional strategy included monetary support for the American Heart Association for their disease education efforts. Funding continues to be provided at a Regional level of $500,000 over the course of three years. Since this strategy is implemented strictly as a funding donation on a Regional level, there is not a specific facility metric.The Hospital will look at the successes and challenges that have come from its third year of implementation of the 2017 Community Health Plan and how to better serve its target populations. There are ongoing conversations and future plans will incorporate these learnings. The Hospital collaborates with multiple community partners on the identified priorities. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities, and numerous non-profit entities. The biggest challenge that the Hospital has identified with this priority is aligning available programs with strong foundations and adequate resources for deployment.**see continuation of footnote
Part V, Section B	Facility Reporting Group B
Facility Reporting Group B consists of:	- Facility 7: AdventHealth Sebring, - Facility 10: AdventHealth Lake Placid
Facility Reporting Group - B Part V, Section B, line 5:	AdventHealth 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.
Facility Reporting Group - B Part V, Section B, line 6a:	AdventHealth Sebring and AdventHealth Lake Placid collaborated in conducting their Community Health Needs Assessments (CHNA) in 2019.
Facility Reporting Group - B Part V, Section B, line 7d:	The 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.
Facility Reporting Group - B Part V, Section B, line 11:	Adventist Health System/Sunbelt, Inc. d/b/a AdventHealth Sebring and AdventHealth Lake Placid will be referred to in this document as AdventHealth Sebring and AdventHealth Lake Placid or "The Hospitals". These two hospitals operate under a single hospital license.The Hospitals are wholly-owned subsidiaries 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Sebring and AdventHealth Lake Placid are part of the West Florida Division of the healthcare system known as AdventHealth. The West Florida Division of AdventHealth includes 11 hospital facilities.The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for AdventHealth Sebring and AdventHealth Lake Placid's 2017-2019 Community Health Plan/Implementation Strategy. The Hospitals developed this plan and posted it in May 2017 as part of its 2016 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Sebring and AdventHealth Lake Placid worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2016 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 Hospitals determine the health needs of the communities 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 Hospitals to address in the 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospitals did not address.AdventHealth Sebring and AdventHealth Lake Placid chose five areas of focus for their 2017-2019 Community Health Plan. 1. Heart Disease/Stroke/High Blood Pressure/Cholesterol; 2. Diabetes;3. Obesity/Nutrition; 4. Access to Care (Primary Care); and 5. Access to Care (Mental Health Services).Priority 1: Heart Disease/Stroke/High Blood Pressure/Cholesterol2016 Description of the Issue: Heart Disease is the second leading cause of death in the Primary Service Area (PSA). The service area also has a higher than state average rate of high blood pressure and cholesterol.2019 Update: AdventHealth Sebring and AdventHealth Lake Placid implemented two interventions to address issues related to Heart Disease/Stroke/High Blood Pressure/Cholesterol in all adults with chronic diseases residing in low income/low access areas throughout the communities in its PSA. In 2019, the Hospitals were unable to meet the participation numbers required to provide the evidence-based Stanford Chronic Disease Self- Management Program (CDSMP), which educates participants regarding chronic disease self-management. The Hospitals' greatest challenge was recruiting participants, even though efforts were made both in the Hospitals and through local community partners. The class requires a minimum number of participants and the expectation of a six-week commitment proved to be an engagement challenge the Hospitals were unable to meet. The second intervention was to provide the Complete Health Improvement Program (CHIP) class series, a lifestyle enrichment program designed to reduce disease risk through better health habits and appropriate lifestyle modifications. Goals included lowering cholesterol, hypertension and blood sugar levels, reducing excess weight through improved dietary choices, enhancing daily exercise, increasing support systems and decreasing stress in an evidence-based program. Classes are held twice a week for nine weeks. In 2019, 78 percent of participants had improved biometrics, surpassing the goal of 50 percent. Additionally, 100 percent of participants self-reported an improved knowledge around nutrition, exceeding the goal of 85 percent.Priority 2: Diabetes2016 Description of the Issue: Diabetes prevalence in the Primary Service Area (PSA) is higher than the state average of diabetes rates, and there is lower than average access to diabetes self-management and pre-diabetes education programs. 2019 Update: AdventHealth Sebring partnered with the American Diabetes Association (ADA) to provide the Morning Mile Program, a before-school walking program, at two Title I schools in its PSA. The ADA contracts Fitzness International, LLC who oversees the management of the Morning Mile (MM) program in Southwest Florida. The ADA implements and manages the program in schools on behalf of sponsors and adds a nutritional education component to increase its impact on school children. Although 2018 goals met expectations with 65 percent of the student population participating in the program, the program was discontinued for 2019 due to a lack of reporting of outcomes and poor management of the program overall by the ADA. A second intervention, added in 2018, included offering free, 3-hour pre-diabetes classes at the Hospitals and in the community. These classes are open to the public and offered by the Hospitals' Diabetes Center. Community partners are offering diabetes self-management education for those already diagnosed, but no pre-diabetes programs. Lack of transportation to attend classes continues to be a concern, and it has been difficult, historically, to entice residents to attend health lectures of classes. In 2019, the Hospitals continued its partnership with local community partners offering 20 pre-diabetes self-management education classes, meeting the goal for the year. Priority 3: Obesity/Nutrition2016 Description of the Issue: In the Hospitals' Primary Service Area (PSA), 41 percent of residents have low food access (food desert), 31.9 percent of adults aged 18 and older self-report that they have a Body Mass Index (BMI) in the "overweight" category and 34.7 percent of adults aged 20 and older self-report that they have a BMI in the "obese" category.2019 Update: AdventHealth Sebring and AdventHealth Lake Placid sponsored the CREATION Health (CH) program which is a faith-based holistic (mental, physical, and spiritual) wellness program with lifestyle seminars and training programs. It teaches eight universal principles of health (Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook, & Nutrition) for living a healthier and happier life. This 8-week seminar provides the best practices of whole person living based on Biblical principles and supported by evidence-based science. The Hospitals also provided free pre- and post-bio-metric screenings (blood pressure, blood sugar, and body mass index) and nursing services for CH program participants.In 2019, there were 26 graduates from the CH program, slightly less than the goal of 30. All program graduates (100 percent) reported making improved lifestyle choices as measured by a self-assessment form, surpassing the goal of 85 percent. The Hospitals also met the goal for new trainers by training two additional staff members to teach the CH program. **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. Group A-Facility 9 -- 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. **see continuation of footnote
Part V, Section B, Line 5 Continuation of Footnote	Group A-Facility 9 -- Central Texas Medical CenterCentral 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. Group A-Facility 11 -- 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.
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 -- Central Texas Medical Centerhttp://www.ctmc.org/about-us/community-benefit Facility 10 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 11 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessmentsPart 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-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-assessmentsFacility 9 -- Central Texas Medical Centerhttp://www.ctmc.org/about-us/community-benefitFacility 10 -- AdventHealth Lake Placidhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 11 -- AdventHealth Wauchulahttps://www.adventhealth.com/community-health-needs-assessments
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs ContinuedPriority 2: Access to Care - Primary and Behavioral/Mental Health 2016 Description of the Issue: AHO recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to primary and behavioral/mental health care. The approach for the priority involves addressing affordability and access to appropriate-level care utilizing care navigation and coordination. 2019 Update: The AHO Community Health Plan has four desired outcomes under the Access to Care - Primary and Behavioral/Mental Health priority. 1. Increase access to primary care services in Orange County;2. To increase access to primary care in Orange County by supporting community partners;3. Participate in strategic processes that combat the heroin epidemic; and4. Provide behavioral health resources for the uninsured. Outcome 1: Increase access to primary care services in Orange CountyStrategies were developed on both a Regional and facility level to increase access to care. The first strategy involves maintaining the Orlando Community Medicine Clinic, a clinic run by AHO to serve uninsured residents in Orange County. The clinic is funded by the Region. The metric for this strategy has a goal of the number of patients seen. The Hospital did not meet the goal of serving 4,500 with a total of 1,807 patients seen in 2019.The second Regional strategy was to connect residents to the Community Care program. The Community Care Program is a Regional initiative which focuses on clinically stabilizing patients in the community environment while addressing root causes (often social determinant based) of uninsured high utilizers of care with complex diagnoses. The Region funds the Community Care Program which enrolled 47 patients from the target population in the AHO area, surpassing the goal of 37. Another aspect of increasing access, which was implemented in 2018, has been to utilize a Care Navigation team across the Region to connect uninsured patients to permanent medical homes through a partnership with local federally qualified healthcare clinics. The team assists with identifying and scheduling appointments for patients in order to ensure follow-up care is accessible. In 2019, 4,414 appointments were scheduled from AHO, which did not meet the goal of 5,000.The Region has continued to fund the AdventHealth Transitions Clinic (also known as the Trina Hidalgo Heart Care Center). This clinic provides follow-up care for cardiac issues to the uninsured who lack primary care. All funding is provided at a Regional level. The clinic serves Orange, Osceola, Seminole, and Lake County residents. The current tracking structure for the clinic does not allow for extraction of metrics by county at this time. In 2019, 921 patients were seen for a total of 3,532 visits throughout the Region.The Region also continued to fund and staff the AdventHealth Transitions Lung Clinic. This clinic provides care for underinsured and uninsured who are impacted by respiratory issues. The current tracking structure for the clinic does not allow for extraction of metrics by county at this time. In 2019, 784 new and 2,700 total patients were served throughout the Region. Outcome 2: To increase access to primary care in Orange County by supporting community partnersThe Regional strategy for this outcome was to provide monetary support to three different organizations that provide health care to uninsured and underinsured residents of Orange and/or Seminole County. Although they only appear on the AHO plan, they do impact multiple AdventHealth facilities. AdventHealth provided funding to the following partners who are helping to provide care to the target population in Orange County as well as throughout the Region.1. Shepherd's Hope received $150,000 toward operation of their free clinics to provide access to free high quality, compassionate medical care.2. Grace Medical Home received $143,000 toward operations to continue being a place for Central Florida's most underserved residents to enjoy the benefit of quality, comprehensive, ongoing healthcare. 3. Health Care Center for the Homeless received $100,000 toward operations to continue their commitment to providing for the health care needs of the homeless and uninsured residents of Orlando, Florida and surrounding areas.Outcome 3: Participate in strategic processes that combat the heroin epidemicThe Regional strategy for this outcome was to actively participate in the Orange County Heroin Task Force in collaboration with the Orange County Government. This collaboration resulted in a grant that is being used to fund two navigator positions in the county's busiest emergency departments. The focus of these navigators is to help establish and coordinate substance abuse treatment for individuals who are brought into the emergency departments. This one-year strategy is complete and the navigators have been established in the Hospital. Outcome 4: Provide behavioral health resources for the uninsuredThere are two Regional strategies for this outcome statement. Both are funded Regionally. The first is to provide sponsorship dollars to the Outlook Clinic for Depression and Anxiety. The Outlook Clinic for Depression and Anxiety is a collaboration with the Mental Health Association, Orange County Government, UCF Social Work Department and additional partners. AHO donated $114,800 in 2019 to help meet the needs of uninsured residents in Orange County. The Region provided an annual $718,320 donation to Aspire Behavioral Health. Aspire Behavioral Health provides a full range of behavioral healthcare services designed to meet the diverse needs of the community including both inpatient and outpatient services. The funding increases capacity for Aspire Behavioral Health to operate beds that would have been closed otherwise due to funding cuts. AHO collaborates with multiple community partners on the priorities identified. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities and numerous non-profit entities. The greatest challenge identified in the work for this priority has been to recognize and break down silos. Often, it has been found that multiple organizations are working on similar initiatives. The Hospital is striving to act as a convener between partners to create alignments to better utilize resources. Community Needs Not Chosen by AdventHealth Orlando: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. High rates of substance abuse: This issue was not chosen because addiction is understood to be a component of mental health. If AHO can positively affect access to mental health services, a component of the top priority chosen, this may also affect rates of substance abuse.2. Homelessness: While homelessness is a serious issue in Central Florida, the issue was not chosen because AHO is already working with community partners, including the Regional Commission on Homelessness, on this issue. In late 2014, the Hospital donated $6 million to the Commission's Housing First initiative. 3. Lack of affordable housing: This issue was not chosen because the Hospital does not have the resources to effectively address this need. 4. Poverty: This issue was not chosen because the Hospital does not have the resources to effectively address this need.5. Asthma: While asthma did emerge as a serious health concern in the area assessed, the Hospital did not choose this as a top priority because if the community has access to preventative and primary care, a component of the top priority chosen, this may also affect the rates of asthma. 6. Sexually transmitted infections (STIs): This issue was not chosen as a top priority because while the Hospital has the means to treat STIs, it does not have the resources to effectively prevent them. Additionally, if the community has access to preventative and primary care, a component of the top priority chosen, this may affect the rates of STIs. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 1 -- AdventHealth OrlandoDescription of CHNA Significant Needs Continued 7. Diabetes in specific populations: This issue was not chosen specifically because it falls in the category of chronic disease, which relates to the top priority chosen. As AHO develops its Community Health Plan, it will factor in the higher prevalence of diabetes in minority populations. 8. Infant mortality in specific populations: This issue was not chosen specifically because it falls in the category of maternal and child health, which relates to the top priority chosen. As AHO develops its Community Health Plan, it will factor in the higher prevalence of infant mortality in minority populations.Group A-Facility 2 -- AdventHealth CelebrationAdventist Health System/Sunbelt, Inc d/b/a AdventHealth Celebration will be referred to in this document as AdventHealth Celebration (AHC 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Celebration is part of the Central Florida Division South Region of AdventHealth. The division includes seven hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for AdventHealth Celebration's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 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 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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. AHC chose two areas of focus for their 2017-2019 Community Health Plan:1. Access to Care - Preventative; and2. Access to Care - Primary and Behavioral/Mental Health. Priority 1: Access to Care - Preventative 2016 Description of the Issue:AHC recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to care and create opportunities for community members to lead healthier lives, in part by addressing issues involving preventative care impacted by food insecurity, obesity and maternal and child health.2019 Update:The AHC Community Health Plan has five desired outcome statements under the Access to Care - Preventative priority.1. Improve access to healthy and nutritious foods;2. Improve access to knowledge around healthy nutrition and wellness;3. Educate and empower the faith community to promote health within congregations in critical areas;4. Increase access to knowledge of chronic disease self-management practices; and5. Support opportunities that promote knowledge of chronic diseases within the primary service area.Outcome 1: Improve access to healthy and nutritious foodsThe first Regional strategy focuses on supporting food distribution programs within the targeted zip codes. The Region established a partnership in 2017 to help fund a local church program in order to increase its impact. The church had established a fresh food co-op which supplies food pantries throughout the Orange, Osceola, and Seminole tri-county area with healthier options. 20,400 meals were provided in Osceola County throughout 2019 through this initiative. The second Regional strategy began as a pilot at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus partnered with Second Harvest Food Bank, a local non-profit food bank, in 2017 to begin providing unused food from the AdventHealth Hospital campuses to Second Harvest so this food can be distributed throughout high need areas in the community. The number of meals provided from the Celebration campus was 1,926 in 2019. Outcome 2: Improve access to knowledge around healthy nutrition and wellnessThere are two Regional strategies for this outcome. 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. In 2019, AdventHealth Celebration did not finalize any school partnerships and will continue to work with the school district to implement this program in the next CHP cycle. The second Regional strategy was to provide Nutrition Wellness classes to community members which would help with increasing access to knowledge around nutrition. This program was not deployed in 2019 due to a lack of resources.Outcome 3: Educate and empower the faith community to promote health within congregations in critical areasThe Regional strategy for this outcome is to create a network of faith partners that can promote health through congregational settings. This strategy is funded at a Regional level. The pilot was implemented at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus began developing and sharing best practices to be implemented across the South Region. In 2019, AdventHealth Celebration was not able to finalize a partnership with the church partners in its primary service area so there are no church outcomes to report. Outcome 4: Increase access to knowledge of chronic disease self-management practicesThe Regional strategy for this outcome is to fund and implement the evidence-based Stanford Chronic Disease Self-Management Program (CDSMP) in its targeted zip codes throughout the Region. CDSMP provides education and care coordination services to target populations in the community. In Osceola County, CDSMP classes were hosted with 44 participants in 2019. A graduation rate of 93 percent was achieved with 41 of those participating successfully completing the course. Of the 41 people who completed the course, 20 were Spanish speaking with a graduation rate of 95 percent.Outcome 5: Support opportunities that promote knowledge of chronic diseases within the primary service areaThe Regional strategy included monetary support for the American Heart Association for their disease education efforts. Funding continues to be provided at a Regional level of $500,000 over the course of three years. Since this strategy is implemented strictly as a funding donation on a Regional level, there is not a specific facility metric. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 2 -- AdventHealth CelebrationDescription of CHNA Significant Needs Continued As the Hospital looks at the successes and challenges that have come from its third year of implementation of the 2017 Community Health Plan, there are opportunities to better define strategies and expand outcomes to better serve its target populations. There are ongoing conversations and future plans will incorporate these learnings. The Hospital collaborates with multiple community partners on the identified priorities. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities, and numerous non-profit entities. The biggest challenge that the Hospital has identified with this priority is aligning available programs with strong foundations and adequate resources for deployment.Priority 2: Access to Care - Primary and Behavioral/Mental Health 2016 Description of the Issue: AHC recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to primary and mental health care. The approach for the priority involves addressing affordability and access to appropriate-level care utilizing care navigation and coordination.2019 Update: The AHC Community Health Plan has six desired outcome statements under the Access to Care - Primary and Behavioral Health priority. 1. Increase access to primary care for uninsured and underinsured residents by supporting community partners;2. Increase dental care access for uninsured and underinsured adults;3. Build primary care and other medical capacity in Osceola County;4. Increase access to primary care in Osceola County;5. Improve access to primary care services through transportation strategies; and6. Provide behavioral health resources for the uninsured.Outcome 1: Increase access to primary care for uninsured and underinsured residents by supporting community partnersFunding was provided at a Regional level to support the Osceola Council of Aging Free Chronic Care Clinic. The clinic provides health care to the uninsured and underinsured residents of AHC's service area. The total grant funding of $500,000 over a three-year period beginning 2017 will continue to increase capacity of the clinic. Additional Regional funding was provided in the amount of $15,000 to support the organization's Meals on Wheels program in 2019. Outcome 2: Increase dental care access for uninsured and underinsured adultsFunding was provided at a Regional level to support a pilot Mobile Dental Van in conjunction with the Osceola Health Department and a larger pilot program. The program funding ended in 2018 and will not be continued in 2019. Outcome 3: Build primary care and other medical capacity in Osceola CountyAHC committed to provide monetary support as well as actively participate in the Community Vision's Health Leadership Council. The Council is the County's convening agency for health and social issues and is comprised of safety net providers. AHC currently has a representative serving on the Leadership Council. The convening and participation has led to several opportunities for alignment due to the opportunity to develop and strengthen partnerships with other organizations with a shared mission to serve the residents of Osceola County. Funding was provided at a Regional level in 2019 in the amount of $10,000. AHC will continue to support the work of the Council both financially and through council participation.Outcome 4: Increase access to primary care in Osceola CountyStrategies were developed on both a Regional and Hospital facility level to increase access to care. The first Regional strategy is to connect residents to the Community Care program. The Community Care Program is a Regional initiative which focuses on clinically stabilizing patients in the community environment while addressing root causes (often social determinant based) of uninsured high utilizers of care with complex diagnoses. The Region funds the Community Care Program which enrolled 25 patients from the target population in the AHC area.The second strategy for increasing access, which was implemented in 2018, has been to utilize a Care Navigation team across the Region to connect uninsured patients to permanent medical homes through a partnership with local federally qualified healthcare clinics. The team assists with identifying and scheduling appointments for patients in order to ensure follow-up care is accessible. In 2019, 1,498 appointments were scheduled for AdventHealth Celebration patients, which was less than the goal of 5,000. The goal was not reached due to a change in the criteria for tracking. The third strategy is to provide primary and secondary care services to underserved residents who would otherwise not have access to care through the HAPPI program. This Regionally funded program was implemented specifically for the Osceola County area. A total of 1,456 unique underserved residents of Osceola County received primary and secondary care services in 2019, which significantly surpassed the goal of 175. Outcome 5: Improve access to primary care services through transportation strategiesAHC partnered with the Florida Department of Transportation on their one-year Complete Streets Study. Complete Streets is a national initiative focused on building transportation infrastructure that is designed and operated to enable safe access for all users, including pedestrians, bicyclists, motorists and transit riders of all ages and abilities. The goal is to increase safety and ease for those crossing the street, walking to shops, and bicycling to work. In 2017, the Hospital participated in the study led by the Florida Department of Health, which also included another partner, the Federally Qualified Health Centers (FQHCs), in the Region. The hope is that the Hospital's participation will help reduce transportation barriers which have been cited as especially prevalent amongst those vulnerable populations across the Region. Outcome 6: Provide behavioral health resources for the uninsuredThe Region provides an annual $250,000 donation to Park Place Behavioral Health. Park Place Behavioral Health provides a full range of behavioral healthcare services designed to meet the diverse needs of the community including both inpatient and outpatient services. The funding increases capacity for Park Place Behavioral Health to operate beds that would have been closed otherwise due to funding cuts. AHC collaborates with multiple community partners on the priorities it has identified. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities and numerous non-profit entities. The greatest challenge AHC has identified in the work for this priority has been to recognize and break down silos. Often, AHC has found that multiple organizations are working on similar initiatives. AHC is striving to act as a convener between partners to create alignments to better utilize resources.Community Needs Not Chosen by AdventHealth Celebration: The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. High rates of substance abuse: This issue was not chosen because addiction is understood to be a component of mental health. If AHC can positively affect access to mental health services, a component of the top priority chosen, this may also affect rates of substance abuse.2. Homelessness: While homelessness is a serious issue in Central Florida, the issue was not chosen because AHC is already working with community partners, including the Regional Commission on Homelessness, on this issue. In late 2014, the Hospital donated $6 million to the Commission's Housing First initiative. 3. Lack of affordable housing: This issue was not chosen because the Hospital does not have the resources to effectively address this need. 4. Poverty: This issue was not chosen because the Hospital does not have the resources to effectively address this 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 5. Asthma: While asthma did emerge as a serious health concern in the area assessed, the Hospital did not choose this as a top priority because if the community has access to preventative and primary care, a component of the top priority chosen, this may also affect the rates of asthma. 6. Sexually transmitted infections (STIs): This issue was not chosen as a top priority because while the Hospital has the means to treat STIs, it does not have the resources to effectively prevent them. Additionally, if the community has access to preventative and primary care, a component of the top priority chosen, this may affect the rates of STIs.7. Diabetes in specific populations: This issue was not chosen specifically because it falls in the category of chronic disease, which relates to the top priority chosen. As AHC develops its Community Health Plan, it will factor in the higher prevalence of diabetes in minority populations. 8. Infant mortality in specific populations: This issue was not chosen specifically because it falls in the category of maternal and child health, which relates to the top priority chosen. As AHC develops its Community Health Plan, it will factor in the higher prevalence of infant mortality in minority populations.Group A-Facility 3 -- AdventHealth Altamonte SpringsAdventist Health System/Sunbelt, Inc d/b/a AdventHealth Altamonte will be referred to in this document as AdventHealth Altamonte (AHAlt 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Altamonte is part of the Central Florida Division South Region of AdventHealth. The division includes seven hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for AdventHealth Altamonte's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 Community Health Needs Assessment process. For the development of both the Community Health Needs Assessment and the Community Health Plan/Implementation Strategy, AdventHealth Altamonte worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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 chose two areas of focus for their 2017-2019 Community Health Plan: 1. Access to Care - Preventative; and2. Access to Care- Primary and Mental Health. Priority 1: Access to Care - Preventative 2016 Description of the Issue:AHAlt recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to care and create opportunities for community members to lead healthier lives, in part by addressing issues involving preventative care impacted by food insecurity, obesity, and maternal and child health.2019 Update: The AHAlt Community Health Plan has six desired outcome statements under the Access to Care - Preventative priority. 1. Improve access to healthy and nutritious foods;2. Improve access to knowledge around healthy nutrition and wellness;3. Educate and empower the faith community to promote health within congregations in critical areas;4. Support and create opportunities for increased quality of life for residents of Seminole County;5. Increase access to knowledge of chronic disease self-management practices; and6. Support opportunities that promote knowledge of chronic diseases within the primary service area.Outcome 1: Improve access to healthy and nutritious foodsThe first Regional strategy focuses on supporting food distribution programs within the targeted zip codes. The Region established a partnership in 2017 to help fund a local church program in order to increase its impact. The church had established a fresh food co-op which supplies food pantries throughout the Orange, Osceola, and Seminole tri-county area with healthier options. In 2019, the church partnered with one of the food pantries in the Hospital's targeted zip codes and has established a regular drop-off to provide fresh, nutritious food to the pantry and the people it serves. 10,219 meals were provided in Seminole County throughout 2019 through this initiative. The second Regional strategy began as a pilot at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus partnered with Second Harvest Food Bank, a local non-profit food bank, in 2017 to begin providing unused food from the AdventHealth Hospital campuses to Second Harvest so this food can be distributed throughout high need areas in the community. For the facility-level contribution, AHAlt provided 2,808 meals in 2019, which exceeded the goal for the facility.Outcome 2: Improve access to knowledge around healthy nutrition and wellnessThere are two Regional strategies for this outcome. 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. One school in AHAlt's target zip codes received this program in 2019 meeting the goal. The second Regional strategy was to provide Nutrition Wellness classes to community members which would help with increasing access to knowledge around nutrition. This program was not deployed in 2019 due to a lack of resources.Outcome 3: Educate and empower the faith community to promote health within congregations in critical areasThe Regional strategy for this outcome is to create a network of faith partners that can promote health through congregational settings. This strategy is funded at a Regional level. The pilot was implemented at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus began developing and sharing best practices to be implemented across the South Region. AdventHealth Altamonte finalized a partnership agreement in 2019 with a church in the Hospital's service area. Since the formalized agreement, the Hospital has provided a total of 12 "Community Resource Spot" days, an event at which the Region's Mission and Ministry team coordinate with local partners to provide resources and education to community members in need. In addition, funding was approved to support expansion of an existing food pantry for the church which will be enhanced in 2020.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued Outcome 4: Support and create opportunities for increased quality of life for residents of Seminole CountyThe Regional strategy involved offering programming from Healthy Central Florida (HCF) to the service areas that AHAlt reaches. The goal of HCF is to make Central Florida communities the healthiest in the nation. This initiative began with three target communities Winter Park, Maitland and Eatonville. The program was not redeployed in 2019 due to staff and internal strategy changes, but AdventHealth Altamonte continually seeks programs that would benefit the underserved populations. Outcome 5: Increase access to knowledge of chronic disease self-management practicesThe Regional strategy for this outcome is to fund and implement the evidence-based Stanford Chronic Disease Self-Management Program (CDSMP) in its targeted zip codes throughout the Region. In Seminole County, three CDSMP classes were hosted with 44 participants in 2019. A graduation rate of 84.1 percent was achieved with 37 of those participating successfully completing the course. Outcome 6: Support opportunities that promote knowledge of chronic diseases within the primary service areaThe Regional strategy included monetary support for the American Heart Association for their disease education efforts. Funding continues to be provided at a Regional level of $500,000 over the course of three years. Since this strategy is implemented strictly as a funding donation on a Regional level, there is not a specific facility metric.As the Hospital looks at the successes and challenges that have come from its third year of implementation of the 2017 Community Health Plan, there are opportunities to better define strategies and expand outcomes to better serve its target populations. There are ongoing conversations and future plans will incorporate these learnings. The Hospital collaborates with multiple community partners on the identified priorities. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities, and numerous non-profit entities. The biggest challenge that the Hospital has identified with this priority is aligning available programs with strong foundations and adequate resources for deployment.Priority 2: Access to Care - Primary and Mental Health 2016 Description of the Issue: AHAlt recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to primary and mental health care. The approach for the priority involves addressing affordability and access to appropriate-level care utilizing care navigation and coordination.2019 Update: The AHAlt Community Health Plan has four desired outcomes under the Access to Care - Primary and Mental Health priority. 1. Increase access to primary care services in Seminole County;2. Reduce emergency department readmissions;3. Maintain access to behavioral health services for victims of child abuse; and4. Provide behavioral health resources for the uninsured.Outcome 1: Increase access to primary services in Seminole CountyThe Community Care Program is a Regional initiative which focuses on clinically stabilizing patients in the community environment while addressing root causes (often social determinant based) of uninsured high utilizers of care with complex diagnoses. The Region funds the Community Care Program which enrolled 73 patients from the target population across the AHAlt area in 2019, exceeding the goal of 42 patients.Another aspect of increasing access, which was implemented in 2018, has been to utilize a Care Navigation team across the Region to connect uninsured patients to permanent medical homes through a partnership with local federally qualified healthcare clinics. The team assists with identifying and scheduling appointments for patients in order to ensure follow-up care is accessible. In 2019, 2,354 appointments were scheduled for Seminole County residents, which surpassed the goal of 1,200.Outcome 2: Reduce Emergency Department ReadmissionsThe Region funded the Community Paramedic Program which has been implemented at the AHAlt facility. The Community Paramedic Program provides a paramedic to help navigate the care of chronic patients for thirty days after discharge. The metric measured is the reduction in percentage of visits from chronic patients. A reduction of visits was seen in 20 percent of patients, which was slightly less than the goal of 25 percent. The main challenge for 2019 was a shortage of staff to meet the needs of the target population. This initiative will continue with Regional support and continued implementation at the Hospital campus.Outcome 3: Maintain access to behavioral health services for victims of child abuse The Regional strategy for this priority focused on providing monetary support to the Kid's House. Kid's House strives to serve victims of child abuse through offering coordinated services in a safe, child-friendly environment from report and investigation through treatment and resolution. The Region provided in-kind services in the amount of $400,000 in 2019, in addition to a $20,000 funding donation. Outcome 4: Provide behavioral health resources for the uninsuredThe Region provided an annual $718,320 donation to Aspire Behavioral Health. Aspire Behavioral Health provides a full range of behavioral healthcare services designed to meet the diverse needs of the community including both inpatient and outpatient services. The funding increases capacity for Aspire Behavioral Health to operate beds that would have been closed otherwise due to funding cuts. AHAlt collaborates with multiple community partners on its identified priorities. Partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities and numerous non-profit entities. The greatest challenge the Hospital has identified in the work for this priority has been to recognize and break down silos. Often the Hospital has found that multiple organizations are working on similar initiatives. The Hospital is striving to act as a convener between partners to create alignments and better utilize resources.Community Needs Not Chosen by AdventHealth Altamonte The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. High rates of substance abuse: This issue was not chosen because addiction is understood to be a component of mental health. If AHAlt can positively affect access to mental health services, a component of the top priority chosen, this may also affect rates of substance abuse.2. Homelessness: While homelessness is a serious issue in Central Florida, the issue was not chosen because AHAlt is already working with community partners, including the Regional Commission on Homelessness, on this issue. In late 2014, the Hospital donated $6 million to the Commission's Housing First initiative. 3. Lack of affordable housing: This issue was not chosen because the Hospital does not have the resources to effectively address this need. 4. Poverty: This issue was not chosen because the Hospital does not have the resources to effectively address this need.5. Asthma: While asthma did emerge as a serious health concern in the area assessed, the Hospital did not choose this as a top priority because if the community has access to preventative and primary care, a component of the top priority chosen, this may also affect the rates of asthma. 6. Sexually transmitted infections (STIs): This issue was not chosen as a top priority because while the Hospital has the means to treat STIs, it does not have the resources to effectively prevent them. Additionally, if the community has access to preventative and primary care, a component of the top priority chosen, this may affect the rates of STIs.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 3 -- AdventHealth AltamonteDescription of CHNA Significant Needs Continued 7. Diabetes in specific populations: This issue was not chosen specifically because it falls in the category of chronic disease, which relates to the top priority chosen. As AHAlt develops its Community Health Plan, it will factor in the higher prevalence of diabetes in minority populations. 8. Infant mortality in specific populations: This issue was not chosen specifically because it falls in the category of maternal and child health, which relates to the top priority chosen. As AHAlt develops its Community Health Plan, it will factor in the higher prevalence of infant mortality in minority populations.Group A-Facility 4 -- AdventHealth East OrlandoAdventist Health System/Sunbelt, Inc d/b/a AdventHealth East Orlando will be referred to in this document as AdventHealth East Orlando (AHEO 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth East Orlando is part of the Central Florida Division South Region of AdventHealth. The division includes seven hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for AdventHealth East Orlando's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 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 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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. AHEO chose two areas of focus for their 2017-2019 Community Health Plan: 1. Access to Care - Preventative; and2. Access to Care - Primary and Behavioral/Mental Health. Priority 1: Access to Care - Preventative 2016 Description of the Issue: AHEO recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to care and create opportunities for community members to lead healthier lives, in part by addressing issues involving preventative care impacted by food insecurity, obesity and maternal and child health.2019 Update: The AHEO Community Health Plan has six desired outcome statements under the Access to Care - Preventative priority. 1. Improve access to healthy and nutritious foods;2. Improve access to knowledge around healthy nutrition and wellness;3. Educate and empower the faith community to promote health within congregations in critical areas;4. Support and create opportunities for increased quality of life for residents of Orange County; 5. Increase access to knowledge of chronic disease self-management practices; and 6. Support opportunities that promote knowledge of chronic diseases within the primary service area.Outcome 1: Improve access to healthy and nutritious foodsThe first Regional strategy focuses on supporting food distribution programs within the targeted zip codes. The Region established a partnership in 2017 to help fund a local church program in order to increase its impact. The church had established a fresh food co-op which supplies food pantries throughout the Orange, Osceola, and Seminole tri-county area with healthier options. 144,957 meals were provided in Orange County throughout 2019 through this initiative. The second Regional strategy consisted of supporting a Second Harvest Food Bank program called Second Helpings. Through the Second Helpings program AHEO provided unused food from the Nutritional Services Department to Second Harvest, which was then distributed throughout high need areas in the community. This program was originally piloted at another hospital in the Central Florida Division South Region, AdventHealth Orlando. In 2019, AdventHealth East Orlando donated 2,578 pounds of food which helped provide 2,148 meals.Outcome 2: Improve access to knowledge around healthy nutrition and wellnessThere are two Regional strategies for this outcome. 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. Four schools in AHEO's target zip codes received this program in 2019, surpassing the goal of two schools. The second Regional strategy was to provide Nutrition Wellness classes to community members which would help with increasing access to knowledge around nutrition. This program was not deployed in 2019 due to a lack of resources.Outcome 3: Educate and empower the faith community to promote health within congregations in critical areas The Regional strategy for this outcome is to create a network of faith partners that can promote health through congregational settings. This strategy is funded at a Regional level. The pilot was implemented at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus began developing and sharing best practices to be implemented across the South Region. AHEO began establishing relationships with numerous faith partners in the East Orlando community and will continue working to identify and establish church partners in the community. In 2019, AdventHealth East Orlando was not able to finalize a partnership with the church partners in its primary service area so there are no church outcomes to report. Outcome 4: Support and create opportunities for increased quality of life for residents of Orange County The Regional strategy involved offering programming from Healthy Central Florida (HCF) to the service areas that AHEO reaches. The goal of HCF is to make Central Florida communities the healthiest in the nation. This initiative began with three target communities - Winter Park, Maitland and Eatonville. The program was not redeployed in 2019 due to staff and internal strategy changes, but AdventHealth East Orlando continually seeks programs that would benefit the underserved populations. Outcome 5: Increase access to knowledge of chronic disease self-management practices The Regional strategy for this outcome is to fund and offer the evidence-based Stanford Chronic Disease Self-Management Program (CDSMP) in targeted zip codes throughout the Region. CDSMP provides education and care coordination services to target populations in the community. In Orange County, 12 CDSMP classes were hosted with 167 participants in 2019. A graduation rate of 76.6 percent was achieved with 128 of those participating successfully completing the course.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 4 -- AdventHealth East OrlandoDescription of CHNA Significant Needs ContinuedOutcome 6: Support opportunities that promote knowledge of chronic diseases within the primary service areaThe Regional strategy included providing monetary support for the American Heart Association for their disease education efforts. Funding continues to be provided at a Regional level of $500,000 over the course of three years. Since this strategy is implemented strictly as a funding donation on a Regional level, there is not a specific facility metric.As the Hospital looks at the successes and challenges that have come from its third year of implementation of the 2017 Community Health Plan, there are opportunities to better define strategies and expand outcomes to better serve its target populations. There are ongoing conversations and future plans will incorporate these learnings. The Hospital collaborates with multiple community partners on the identified priorities. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities, and numerous non-profit entities. The biggest challenge that the Hospital has identified with this priority is aligning available programs with strong foundations and adequate resources for deployment.Priority 2: Access to Care - Primary and Behavioral/Mental Health 2016 Description of the Issue: AHEO recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to primary and mental health care. The approach for the priority involves addressing affordability and access to appropriate-level care utilizing care navigation and coordination.2019 Update: The AHEO Community Health Plan has two desired outcomes under the Access to Care - Primary and Behavioral/Mental Health priority. 1. Increase access to primary care services in Orange County; and2. Provide behavioral health resources for the uninsured.Outcome 1: Increase access to primary care services in Orange CountyThe Region has developed three strategies to accomplish the desired outcome. The first Regional strategy involved connecting uninsured patients to permanent medical homes. The strategy was developed by a partnership of the Care navigation team and local federally qualified healthcare clinics. The Care navigation team schedules appointments for the patients. In 2019, 6,883 referrals were provided through this initiative at the AHEO campus, surpassing the goal of 5,000. The second Regional strategy involved connecting residents to the Community Care program. All funding for this program is provided at the Regional level. The Community Care program focuses on clinically stabilizing the patient in the community environment and addressing root causes (often social determinant based) of utilization for high utilizers who are uninsured and complex patients. In 2019, 69 patients were enrolled, which surpassed the goal of 42. The final strategy is a Hospital strategy to connect eligible residents to permanent medical homes via an employee from a local federally qualified healthcare clinic who is embedded in the Hospital. All funding for this program is provided at the Regional level. In 2019, 1,957 appointments were made, which surpassed the goal of 900. Outcome 2: Provide behavioral health resources for the uninsuredThe Regional strategy is to provide Aspire Health Partners with funding to operate beds that would have been closed otherwise due to funding cuts. Aspire Health Partners is 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. All funding for this program is provided at the Regional level. The Hospital collaborates with multiple community partners on its identified priorities. Partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities and numerous non-profit entities. The greatest challenge the Hospital has identified in the work for this priority has been to recognize and break down silos. Often, the Hospital has found that multiple organizations are working on similar initiatives. The Hospital is striving to act as a convener between partners to create alignments to better utilize resources.Community Needs Not Chosen by AdventHealth East Orlando: The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. High rates of substance abuse: This issue was not chosen because addiction is understood to be a component of mental health. If AHEO can positively affect access to mental health services, a component of the top priority chosen, this may also affect rates of substance abuse.2. Homelessness: While homelessness is a serious issue in Central Florida, the issue was not chosen because AHEO is already working with community partners, including the Regional Commission on Homelessness, on this issue. In late 2014, the Hospital donated $6 million to the Commission's Housing First initiative. 3. Lack of affordable housing: This issue was not chosen because the Hospital does not have the resources to effectively address this need. 4. Poverty: This issue was not chosen because the Hospital does not have the resources to effectively address this need.5. Asthma: While asthma did emerge as a serious health concern in the area assessed, the Hospital did not choose this as a top priority because if the community has access to preventative and primary care, a component of the top priority chosen, this may also affect the rates of asthma. 6. Sexually transmitted infections (STIs): This issue was not chosen as a top priority because while the Hospital has the means to treat STIs, it does not have the resources to effectively prevent them. Additionally, if the community has access to preventative and primary care, a component of the top priority chosen, this may affect the rates of STIs.7. Diabetes in specific populations: This issue was not chosen specifically because it falls in the category of chronic disease, which relates to the top priority chosen. As AHEO develops its Community Health Plan, it will factor in the higher prevalence of diabetes in minority populations. 8. Infant mortality in specific populations: This issue was not chosen specifically because it falls in the category of maternal and child health, which relates to the top priority chosen. As AHEO develops its Community Health Plan, it will factor in the higher prevalence of infant mortality in minority populations.Group A-Facility 5 -- AdventHealth Winter ParkAdventist Health System/Sunbelt, Inc d/b/a AdventHealth Winter Park will be referred to in this document as AdventHealth Winter Park (AHWP 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Winter Park is part of the Central Florida Division South Region of AdventHealth. The division includes seven hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. **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 This is the third-year update for AdventHealth Winter Park's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 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 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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. AHWP chose two areas of focus for their 2017-2019 Community Health Plan: 1. Access to Care - Preventative; and2. Access to Care - Primary and Behavioral/Mental Health. Priority 1: Access to Care - Preventative 2016 Description of the Issue:AHWP recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to care and create opportunities for community members to lead healthier lives, in part by addressing issues involving preventative care impacted by food insecurity, obesity and maternal and child health.2019 Update: The AHWP Community Health Plan has six desired outcome statements under the Access to Care - Preventative priority. 1. Improve access to healthy and nutritious foods;2. Improve access to knowledge around healthy nutrition and wellness;3. Educate and empower the faith community to promote health within congregations in critical areas;4. Support and create opportunities for increased quality of life for residents of Orange County;5. Increase access to knowledge of chronic disease self-management practices; and6. Support opportunities that promote knowledge of chronic diseases within the primary service area.Outcome 1: Improve access to healthy and nutritious foodsThe first Regional strategy focuses on supporting food distribution programs within the targeted zip codes. The Region established a partnership in 2017 to begin funding a local church program in order to increase its impact. The church established a fresh food co-op which supplies food pantries throughout the Orange, Osceola, and Seminole tri-county area with healthier options. 144,957 meals were provided in Orange County throughout 2019 through this initiative. The second Regional strategy is to support a program called Second Helpings. Through the Second Helpings program AHWP provides unused food from the Nutritional Services Department to Second Harvest Food Bank, a local non-profit food bank. The donated food is then distributed throughout high need areas in the community. In 2019, AdventHealth Winter Park donated 1,857 pounds of food which helped provide over 1,548 meals.Outcome 2: Improve access to knowledge around healthy nutrition and wellnessThere are two strategies identified to achieve this outcome. 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. One school in AHWP's target zip codes received this program in 2019, less than the goal of two schools. The second Regional strategy was to provide Nutrition Wellness classes to community members which would help with increasing access to knowledge around nutrition. This program was not deployed in 2019 due to a lack of resources.Outcome 3: Educate and empower the faith community to promote health within congregations in critical areasThe Regional strategy for this outcome is to create a network of faith partners that can promote health through congregational settings. This strategy is funded at a Regional level. The pilot was implemented in another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus began developing and sharing best practices to be implemented across the South Region. AHWP began establishing relationships with numerous faith partners in the Winter Park community and will continue working to identify and establish church partners in the community. In 2019, AdventHealth Winter Park was not able to finalize a partnership with the church partners in its primary service area so there are no church outcomes to report. Outcome 4: Support and create opportunities for increased quality of life for residents of Orange CountyThe Regional strategy involved offering programming from Healthy Central Florida (HCF) to the service areas that AHWP reaches. The goal of HCF is to make Central Florida communities the healthiest in the nation. This initiative began with three target communities Winter Park, Maitland and Eatonville. The program was not redeployed in 2019 due to staff and internal strategy changes, but AdventHealth Winter Park continually seeks programs that would benefit the underserved populations. Outcome 5: Increase access to knowledge of chronic disease self-management practicesThe Regional strategy for this outcome is to fund and implement the evidence-based Stanford Chronic Disease Self-Management Program (CDSMP) in its targeted zip codes throughout the Region. In Orange County, 12 CDSMP classes were hosted with 167 participants in 2019. A graduation rate of 76.6 percent was achieved with 128 of those participating successfully completing the course.Outcome 6: Support opportunities that promote knowledge of chronic diseases within the primary service areaThe Regional strategy included providing monetary support for the American Heart Association for their disease education efforts. Funding continues to be provided at a Regional level of $500,000 over the course of three years. Since this strategy is implemented strictly as a funding donation on a Regional level, there is not a specific facility metric.As the Hospital looks at the successes and challenges that have come from its third year of implementation of the 2017 Community Health Plan, there are opportunities to better define strategies and expand outcomes to better serve its target populations. There are ongoing conversations and future plans will incorporate these learnings. The Hospital collaborates with multiple community partners on the identified priorities. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities, and numerous non-profit entities. The biggest challenge that the Hospital has identified with this priority is aligning available programs with strong foundations and adequate resources for deployment.Priority 2: Access to Care - Primary and Behavioral/Mental Health 2016 Description of the Issue: AHWP recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. AHWP strives to increase access to primary and mental health care. The approach for the priority involves addressing affordability and access to appropriate-level care utilizing care navigation and coordination.2019 Update: The AHWP Community Health Plan has two desired outcomes under the Access to Care - Primary and Behavioral/Mental Health priority. 1. Increase access to primary care services in Orange County; and2. Provide behavioral health resources for the uninsured.**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 Outcome 1: Increase access to primary care services in Orange CountyThere are three strategies associated with this outcome. The first strategy is to provide senior care navigation services for vulnerable seniors who have been identified in the Emergency Department. This program provides care plans after emergency department visits for seniors to minimize repeat visits. This program only runs and is funded through the AdventHealth Winter Park Campus. The Hospital surpassed its set metric of 1,500 with 1,529 seniors receiving services in the target area in 2019. The second Regional strategy is to connect uninsured patients to permanent medical homes. The strategy was developed through a partnership between the Care Navigation team and local federally qualified healthcare clinics. The Care Navigation team schedules the appointments for the patients. This Regional program originally tracked data at the Regional level. The Hospital is now able to capture and report impact on a campus level. In 2019, 874 patients received referrals from AHWP. The third Regional strategy is to connect residents to the Community Care program. All funding for this program is provided at the Regional level. The Community Care program focuses on clinically stabilizing the patient in the community environment and addressing root causes (often social determinant based) of utilization for high utilizers who are uninsured and complex patients. During program deployment, it was determined that AHWP would offer the program on a referral only basis based on the available resources and area of need. Outcome 2: Provide behavioral health resources for the uninsured The Regional strategy is to provide Aspire Health Partners with funding to operate beds that would have been closed otherwise due to funding cuts. Aspire Health Partners is 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. All funding for this program is provided at the Regional level. The Hospital collaborates with multiple community partners on its identified priorities. Partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities and numerous non-profit entities. The greatest challenge the Hospital has identified in the work for this priority has been to recognize and break down silos. Often, the Hospital has found that multiple organizations are working on similar initiatives. The Hospital is striving to act as a convener between partners to create alignments to better utilize resources.Community Needs Not Chosen by AdventHealth Winter Park: The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. High rates of substance abuse: This issue was not chosen because addiction is understood to be a component of mental health. If AHWP can positively affect access to mental health services, a component of the top priority chosen, this may also affect rates of substance abuse.2. Homelessness: While homelessness is a serious issue in Central Florida, the issue was not chosen because AHWP is already working with community partners, including the Regional Commission on Homelessness, on this issue. In late 2014, the Hospital donated $6 million to the Commission's Housing First initiative. 3. Lack of affordable housing: This issue was not chosen because the Hospital does not have the resources to effectively address this need. 4. Poverty: This issue was not chosen because the Hospital does not have the resources to effectively address this need.5. Asthma: While asthma did emerge as a serious health concern in the area assessed, the Hospital did not choose this as a top priority because if the community has access to preventative and primary care, a component of the top priority chosen, this may also affect the rates of asthma. 6. Sexually transmitted infections (STIs): This issue was not chosen as a top priority because while the Hospital has the means to treat STIs, it does not have the resources to effectively prevent them. Additionally, if the community has access to preventative and primary care, a component of the top priority chosen, this may affect the rates of STIs.7. Diabetes in specific populations: This issue was not chosen specifically because it falls in the category of chronic disease, which relates to the top priority chosen. As AHWP develops its Community Health Plan, it will factor in the higher prevalence of diabetes in minority populations. 8. Infant mortality in specific populations: This issue was not chosen specifically because it falls in the category of maternal and child health, which relates to the top priority chosen. As AHWP develops its Community Health Plan, it will factor in the higher prevalence of infant mortality in minority populations.Group A-Facility 6 -- AdventHealth KissimmeeAdventist Health System/Sunbelt, Inc d/b/a AdventHealth Kissimmee will be referred to in this document as AdventHealth Kissimmee (AHK 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Kissimmee is part of the Central Florida Division South Region of AdventHealth. The division includes seven hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017.This is the third-year update for AdventHealth Kissimmee's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 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 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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. AHK chose two areas of focus for their 2017-2019 Community Health Plan: 1. Access to Care - Preventative; and2. Access to Care - Primary and Behavioral/Mental Health. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs ContinuedPriority 1: Access to Care - Preventative 2016 Description of the Issue:AHK recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to care and create opportunities for community members to lead healthier lives, in part by addressing issues involving preventative care impacted by food insecurity, obesity and maternal and child health.2019 Update: The AHK Community Health Plan has five desired outcome statements under the Access to Care - Preventative priority. 1. Improve access to healthy and nutritious foods;2. Improve access to knowledge around healthy nutrition and wellness;3. Educate and empower the faith community to promote health within congregations in critical areas;4. Increase access to knowledge of chronic disease self-management practices; and5. Support opportunities that promote knowledge of chronic diseases within the primary service area.Outcome 1: Improve access to healthy and nutritious foodsThe Regional strategy focuses on supporting food distribution programs within the targeted zip codes. The Region established a partnership in 2017 to help fund a local church program in order to increase its impact. The church had established a fresh food co-op which supplies food pantries throughout the Orange, Osceola, and Seminole tri-county area with healthier options. In 2019, this partnership resulted in 20,400 meals being provided in Osceola County through the fresh food co-op. Outcome 2: Improve access to knowledge around healthy nutrition and wellnessThere are two Regional strategies for this outcome. 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. Four schools in AHK's target zip codes received this program in 2019 surpassing the goal. The second Regional strategy was to provide Nutrition Wellness classes to community members which would help with increasing access to knowledge around nutrition. This program was not deployed in 2019 due to a lack of resources.Outcome 3: Educate and empower the faith community to promote health within congregations in critical areasThe Regional strategy for this outcome is to create a network of faith partners that can promote health through congregational settings. This strategy is funded at a Regional level. The pilot was implemented at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus began developing and sharing best practices to be implemented across the South Region. In 2019, AdventHealth Kissimmee was not able to finalize a partnership with the church partners in its primary service area so there are no church outcomes to report.Outcome 4: Increase access to knowledge of chronic disease self-management practicesThe Regional strategy for this outcome is to fund and implement the evidence-based Stanford Chronic Disease Self-Management Program (CDSMP) in its targeted zip codes throughout the Region. CDSMP provides education and care coordination services to target populations in the community. In Osceola County, CDSMP classes were hosted with 44 participants in 2019. A graduation rate of 93 percent was achieved with 41 of those participating successfully completing the course. Of the 41 people who completed the course, 20 were Spanish speaking with a graduation rate of 95 percent.Outcome 5: Support opportunities that promote knowledge of chronic diseases within the primary service areaThe Regional strategy included monetary support for the American Heart Association for their disease education efforts. Funding continues to be provided at a Regional level of $500,000 over the course of three years. Since this strategy is implemented strictly as a funding donation on a Regional level, there is not a specific facility metric.As the Hospital looks at the successes and challenges that have come from its third year of implementation of the 2017 Community Health Plan, there are opportunities to better define strategies and expand outcomes to better serve its target populations. There are ongoing conversations and future plans will incorporate these learnings. The Hospital collaborates with multiple community partners on the identified priorities. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities, and numerous non-profit entities. The biggest challenge that the Hospital has identified with this priority is aligning available programs with strong foundations and adequate resources for deployment.Priority 2: Access to Care - Primary and Behavioral/Mental Health 2016 Description of the Issue: AHK recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to primary and mental health care. The approach for the priority involves addressing affordability and access to appropriate-level care, utilizing care navigation and coordination.2019 Update: The AHK Community Health Plan has six desired outcome statements under the Access to Care - Primary and Behavioral Health priority.1. Increase access to primary care for uninsured and underinsured residents by supporting community partners;2. Increase dental care access for uninsured and underinsured adults;3. Build primary care and other medical capacity in Osceola County;4. Increase access to primary care in Osceola County;5. Improve access to primary care services through transportation strategies; and6. Provide behavioral health resources for the uninsured.Outcome 1: Increase access to primary care for uninsured and underinsured residents by supporting community partnersFunding was provided at a Regional level to support the Osceola Council of Aging Free Chronic Care Clinic. The clinic provides health care to the uninsured and underinsured residents of AHK's service area. The total grant funding of $500,000 over a three-year period beginning 2017 will continue to increase capacity of the clinic. Additional Regional funding was provided in the amount of $15,000 to support the organization's Meals on Wheels program in 2019. Outcome 2: Increase dental care access for uninsured and underinsured adultsFunding was provided at a Regional level to support a pilot Mobile Dental Van in conjunction with the Osceola Health Department and a larger pilot program. The program funding ended in 2018 and did not continue in 2019. Outcome 3: Build primary care and other medical capacity in Osceola CountyAHK committed to provide monetary support as well as actively participate in the Community Vision's Health Leadership Council. The Council is the County's convening agency for health and social issues and is comprised of safety net providers. The Hospital currently has a representative serving on the Leadership Council. The convening and participation has led to several opportunities for alignment due to the opportunity to develop and strengthen partnerships with other organizations with a shared mission to serve the residents of Osceola County. Funding was provided at a Regional level in 2019 in the amount of $10,000. AHK will continue to support the work of the Council both financially and through council participation.Outcome 4: Increase access to primary care in Osceola CountyStrategies were developed on both a Regional and facility level to increase access to care. The first Regional strategy is to connect residents to the Community Care Program. The Community Care Program is a Regional initiative which focuses on clinically stabilizing patients in the community environment while addressing root causes (often social determinant based) of uninsured high utilizers of care with complex diagnoses. The Region funds the Community Care Program which enrolled 56 patients from the target population in the AHK area. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 6 -- AdventHealth KissimmeeDescription of CHNA Significant Needs Continued Another aspect of increasing access which was implemented in 2018 has been to utilize a Care Navigation team across the Region to connect uninsured patients to permanent medical homes through a partnership with local federally qualified healthcare clinics. The team assists with identifying and scheduling appointments for patients in order to ensure follow-up care is accessible. In 2019, 1,640 appointments were scheduled for AdventHealth Kissimmee patients, which was less than the goal of 5,000. The goal was not reached due to a change in the criteria for tracking. The third strategy is to provide primary and secondary care services to underserved residents who would otherwise not have access to care through the HAPPI program. This Regionally funded program was implemented specifically for the Osceola County area. A total of 1,456 unique underserved residents of Osceola County received primary and secondary care services in 2019, which significantly surpassed the goal of 175.Outcome 5: Improve access to primary care services through transportation strategiesAHK partnered with AdventHealth Celebration and the Florida Department of Transportation on their one-year Complete Streets Study. Complete Streets is a national initiative focused on building transportation infrastructure that is designed and operated to enable safe access for all users, including pedestrians, bicyclists, motorists and transit riders of all ages and abilities. The goal is to increase safety and ease for those crossing the street, walking to shops, and bicycling to work. In 2017, the Hospital participated in the study led by the Florida Department of Health, which also included another partner, the Federally Qualified Health Centers (FQHCs) in the Region. The hope is that the Hospital's participation will help reduce transportation barriers which have been cited as especially prevalent amongst those vulnerable populations across the Region. Outcome 6: Provide behavioral health resources for the uninsuredThe Region provides an annual $250,000 donation to Park Place Behavioral Health. Park Place Behavioral Health provides a full range of behavioral healthcare services designed to meet the diverse needs of the community including both inpatient and outpatient services. The funding increases capacity for Park Place Behavioral Health to operate beds that would have been closed otherwise due to funding cuts. AHK collaborates with multiple community partners on the priorities it has identified. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities and numerous non-profit entities. The greatest challenge the Hospital has identified in the work for this priority has been to recognize and break down silos. Often, the Hospital has found that multiple organizations are working on similar initiatives. AHK is striving to act as a convener between partners to create alignments to better utilize resources. Community Needs Not Chosen by AdventHealth Kissimmee: The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. High rates of substance abuse: This issue was not chosen because addiction is understood to be a component of mental health. If AHK can positively affect access to mental health services, a component of the top priority chosen, this may also affect rates of substance abuse.2. Homelessness: While homelessness is a serious issue in Central Florida, the issue was not chosen because AHK is already working with community partners, including the Regional Commission on Homelessness, on this issue. In late 2014, the Hospital donated $6 million to the Commission's Housing First initiative. 3. Lack of affordable housing: This issue was not chosen because the Hospital does not have the resources to effectively address this need. 4. Poverty: This issue was not chosen because the Hospital does not have the resources to effectively address this need.5. Asthma: While asthma did emerge as a serious health concern in the area assessed, the Hospital did not choose this as a top priority because if the community has access to preventative and primary care, a component of the top priority chosen, this may also affect the rates of asthma. 6. Sexually transmitted infections (STIs): This issue was not chosen as a top priority because while the Hospital has the means to treat STIs, it does not have the resources to effectively prevent them. Additionally, if the community has access to preventative and primary care, a component of the top priority chosen, this may affect the rates of STIs.7. Diabetes in specific populations: This issue was not chosen specifically because it falls in the category of chronic disease, which relates to the top priority chosen. As AHK develops its Community Health Plan, it will factor in the higher prevalence of diabetes in minority populations. 8. Infant mortality in specific populations: This issue was not chosen specifically because it falls in the category of maternal and child health, which relates to the top priority chosen. As AHK develops its Community Health Plan, it will factor in the higher prevalence of infant mortality in minority populations.Group A-Facility 8 -- AdventHealth ApopkaAdventist Health System/Sunbelt, Inc d/b/a AdventHealth Apopka will be referred to in this document as AdventHealth Apopka (AHApk 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Apopka is part of the Central Florida Division South Region of AdventHealth. The division includes seven hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for AdventHealth Apopka's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 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 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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 two areas of focus for their 2017-2019 Community Health Plan: 1. Access to Care - Preventative; and2. Access to Care - Primary and Behavioral/Mental Health. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs Continued Priority 1: Access to Care - Preventative 2016 Description of the Issue: AHApk recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to care and create opportunities for community members to lead healthier lives, in part by addressing issues involving preventative care impacted by food insecurity, obesity and maternal and child health.2019 Update: The AHApk Community Health Plan has five desired outcome statements under the Access to Care - Preventative priority. 1. Improve access to healthy and nutritious foods;2. Improve access to knowledge around healthy nutrition and wellness;3. Educate and empower the faith community to promote health within congregations in critical areas;4. Increase access to knowledge of chronic disease self-management practices; and5. Support opportunities that promote knowledge of chronic diseases within the primary service area.Outcome 1: Improve access to healthy and nutritious foodsThe first Regional strategy focuses on supporting food distribution programs within the targeted zip codes. The Region established a partnership in 2017 to help fund a local church program in order to increase its impact. The church had established a fresh food co-op which supplies food pantries throughout the Orange, Osceola, and Seminole tri-county area with healthier options. 144,957 meals were provided in Orange County throughout 2019 through this initiative. The second Regional strategy began as a pilot at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus partnered with Second Harvest Food Bank, a local non-profit food bank, in 2017 to begin providing unused food from the AdventHealth Hospital campuses to Second Harvest so this food can be distributed throughout high need areas in the community. This initiative, entitled the "Second Helping" program, was expanded to AHApk. In 2019, there were 600 meals provided from the Apopka Campus.Outcome 2: Improve access to knowledge around healthy nutrition and wellnessThere are two Regional strategies for this outcome. 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. Five schools in AHApk's target zip codes received this program which surpassed the Hospital goal of two schools. A second Regional strategy was to provide Nutrition Wellness classes to community members which would help with increasing access to knowledge around nutrition. This program was not deployed in 2019 due to a lack of resources.Outcome 3: Educate and empower the faith community to promote health within congregations in critical areasThe Regional strategy for this outcome is to create a network of faith partners that can promote health through congregational settings. This strategy is funded at a Regional level. The pilot was implemented at another AdventHealth hospital in the Central Florida Division South Region, AdventHealth Orlando. The AdventHealth Orlando campus began developing and sharing best practices to be implemented across the South Region of AdventHealth. A finalized partnership in AdventHealth Apopka's primary service area was formed with New Hope Missionary Baptist church in Apopka, FL in 2019. A total of six "Community Resource Spot" days were hosted, an event at which the Region's Mission and Ministry team coordinated with local partners to provide resources and education to community members in need. Over 500 meals were distributed along with health screenings during these events.Outcome 4: Increase access to knowledge of chronic disease self-management practicesThe Regional strategy for this outcome is to fund and offer the evidence-based Stanford Chronic Disease Self-Management Program (CDSMP) in targeted zip codes throughout the Region. CDSMP provides education and care coordination services to target populations in the community. In Orange County, 12 CDSMP classes were hosted with 167 participants in 2019. A graduation rate of 76.6 percent was achieved with 128 of those participating successfully completing the course. Outcome 5: Support opportunities that promote knowledge of chronic diseases within the primary service areaThe Regional strategy included monetary support for the American Heart Association for their disease education efforts. Funding continues to be provided at a Regional level of $500,000 over the course of three years. Since this strategy is implemented strictly as a funding donation on a Regional level, there is not a specific facility metric.As the Hospital looks at the successes and challenges that have come from its third year of implementation of the 2017 Community Health Plan, there are opportunities to better define strategies and expand outcomes to better serve its target populations. There are ongoing conversations and future plans will incorporate these learnings. The Hospital collaborates with multiple community partners on the identified priorities. These partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities, and numerous non-profit entities. The biggest challenge that the Hospital has identified with this priority is aligning available programs with strong foundations and adequate resources for deployment.Priority 2: Access to Care - Primary and Behavioral/Mental Health 2016 Description of the Issue: AHApk recognizes the important impact that access, knowledge and lifestyle have in the health and well-being of an individual. The Hospital strives to increase access to primary and mental health care. The approach for the priority involves addressing affordability and access to appropriate-level care utilizing care navigation and coordination.2019 Update: The AHApk Community Health Plan has two desired outcomes under the Access to Care - Primary and Behavioral/Mental Health priority. 1. Increase access to primary care services in Orange County; and2. Provide behavioral health resources for the uninsured.Outcome 1: Increase access to primary care services in Orange CountyThe Adventist University Hope Clinic is another resource funded at the Regional level. The clinic provides occupational and physical therapy as well as additional services to uninsured and underinsured individuals who experience financial barriers to care. Although the clinic is located in the AHApk area, it is able to serve patients from the entire Region's service area. In 2019, 107 patients received services during a total of 2,242 visits, which surpassed the annual goal.The Community Care Program is a Regional initiative which focuses on clinically stabilizing patients in the community environment while addressing root causes (often social determinant based) of uninsured high utilizers of care with complex diagnoses. The Region funds the Community Care Program which enrolled 52 patients from the target population at AHApk, surpassing the goal of 42.Another aspect of increasing access, which was implemented in 2018, was to utilize a Care Navigation team across the Region to connect uninsured patients to permanent medical homes through a partnership with local federally qualified healthcare clinics. The team assists with identifying and scheduling appointments for patients in order to ensure follow-up care is accessible. In 2019, 1,772 appointments were scheduled from the AdventHealth Apopka campus, less than the goal of 4,000. The goal was not reached due to a change in the criteria for tracking. This Regional strategy was strengthened even further by embedding a Federally Qualified Health Center (FQHC) employee into multiple AdventHealth hospital campuses to work directly with patients in finding a medical home. AHApk and AdventHealth East Orlando both included the employee on their campuses to help assist with making appointments for the target population of Orange County residents who require a medical home. In 2019, 1,174 patients from the Hospital's campus received appointments, which surpassed the goal of 800. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 8 -- AdventHealth ApopkaDescription of CHNA Significant Needs ContinuedOutcome 2: Provide behavioral health resources for the uninsuredThis Regional strategy includes partnering with Aspire Health Partners (Aspire). Aspire is a nonprofit which provides a full continuum of behavioral healthcare services across Central Florida Counties. The Region provides funding to enhance the capacity of Aspire to serve the community. The funding has become a necessity in order for Aspire to continue servicing the community due to behavioral health funding cuts. Although measured on a Regional level, the funding helps to serve patients for all of the Region's hospitals, including AHApk.AHApk collaborates with multiple community partners on its identified priorities. Partners include, but are not limited to, county health departments, federally qualified healthcare clinics, faith communities and numerous non-profit entities. The greatest challenge the Hospital has identified in the work for this priority has been to recognize and break down silos. Often, the Hospital has found that multiple organizations are working on similar initiatives. The Hospital is striving to act as a convener between partners to create alignments and better utilize resources.Issues that will not be addressed by AdventHealth ApopkaThe primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. High rates of substance abuse: This issue was not chosen because addiction is understood to be a component of mental health. If AHApk can positively affect access to mental health services, a component of the top priority chosen, this may also affect rates of substance abuse.2. Homelessness: While homelessness is a serious issue in Central Florida, the issue was not chosen because AHApk is already working with community partners, including the Regional Commission on Homelessness, on this issue. In late 2014, the Hospital donated $6 million to the Commission's Housing First initiative. 3. Lack of affordable housing: This issue was not chosen because the Hospital does not have the resources to effectively address this need. 4. Poverty: This issue was not chosen because the Hospital does not have the resources to effectively address this need.5. Asthma: While asthma did emerge as a serious health concern in the area assessed, the Hospital did not choose this as a top priority because if the community has access to preventative and primary care, a component of the top priority chosen, this may also affect the rates of asthma. 6. Sexually transmitted infections (STIs): This issue was not chosen as a top priority because while the Hospital has the means to treat STIs, it does not have the resources to effectively prevent them. Additionally, if the community has access to preventative and primary care, a component of the top priority chosen, this may affect the rates of STIs.7. Diabetes in specific populations: This issue was not chosen specifically because it falls in the category of chronic disease, which relates to the top priority chosen. As AHApk develops its Community Health Plan, it will factor in the higher prevalence of diabetes in minority populations. 8. Infant mortality in specific populations: This issue was not chosen specifically because it falls in the category of maternal and child health, which relates to the top priority chosen. As AHApk develops its Community Health Plan, it will factor in the higher prevalence of infant mortality in minority populations.Group A-Facility 9 -- Central Texas Medical CenterAdventist Health System/Sunbelt, Inc., d/b/a Central Texas Medical Center will be referred to in this document as Central Texas Medical Center (CTMC) or "the Hospital." Central Texas Medical Center is part of AdventHealth's Southwest Region. The Southwest Region includes four hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for Central Texas Medical Center's 2017-2019 Community Health Plan (Implementation Strategy). Central Texas Medical Center developed this Community Health Plan and posted it by May 15, 2017 as part of its 2016 Community Health Needs Assessment process.For the development of both the Community Health Needs Assessment and the Community Health Plan, Central Texas Medical Center worked to define and address the needs of low-income, minority and underserved populations in its service area. The 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 and gives an update on the strategies addressing those issues. There is also a description of the identified issues that the Hospital is not addressing.Central Texas Medical Center chose six areas of focus for its 2017-2019 Community Health Plan: 1. Primary Care: Timely access (including afterhours care) to Health Care Professionals, especially primary care; accessing care close to home when care is needed;2. Healthier Management of Lifestyle: Making good choices in the areas of nutrition, weight management and exercise;3. Management of Heart Disease/ Congestive Heart Failure (CHF) and Related Conditions: Prevalence and/or enhanced outpatient management of heart disease/Congestive Heart Failure (CHF) and related conditions/risk factors such as hypertension;4. Management of Diabetes: Prevalence and/or enhanced outpatient management of diabetes; programs to address anticipated growth of diabetes and related conditions;5. Education: Educating the population to better understand the health care resources available to them through various channels including those provided by Central Texas Medical Center, Live Oak Health Partners, a physician practice related entity, and other entities and a commitment to helping people (including the underserved) navigate those resources; and6. Management of Mental and Behavioral Healthcare: Prevalence and/or enhanced management of mental and behavioral health care options.Priority 1: Primary Care2016 Description of the Issue: In the Texas counties of Hays and Caldwell, low-income, uninsured adult residents have limited or few options for accessing primary care services. When health care is inaccessible, many individuals are forced to forego care or delay care, which can lead to avoidable complications, or overutilization of care via visits to hospital Emergency Departments (ED). This places a significant burden on hospital EDs within the counties. Patients that are medically screened and treated in an ED setting likely struggle with uncoordinated care and may not have the resources or funding to follow discharge instructions including access to prescriptions and appropriate follow up care. Our secondary data showed that Hays County had a significantly lower ratio of primary care physicians per 100,000 population at 46.7 compared to the State of Texas with a rate of 58.5 or the United States with 74.5. As a result, access to primary care is challenging, especially for low-income residents. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 9 -- Central Texas Medical CenterDescription of CHNA Significant Needs Continued2019 Update: CTMC's first priority was to provide timely access to primary care. One strategy to address this was to increase access to primary care physicians especially for uninsured, and underinsured Medicare and Medicaid patients. The Hospital's goal for 2019 was to recruit at least two primary care providers to the Live Oak Health Partner's employed physician group. The Hospital met this goal by recruiting two primary care physicians and two nurse practitioners who began with Live Oak Health Partners in 2019.The Hospital's second strategy was to increase capacity at Live Oak Health Partners' Community Clinic to ensure that Medicaid, low income and uninsured patients could have improved access to primary care services. The goal was to provide community outreach activities that increase the awareness of the Community Clinic's services and have patients establish Live Oak Health Partners' Community Clinic as their medical home. The goal in 2019 was to have 5,400 patient encounters at the Clinic, which was exceeded with a total of 10,538 patient encounters. The Hospital's third strategy was to expand primary care access at the Live Oak Health Partners' Walk-In Clinic and increase the number of patients declaring the physician at Live Oak Health Partners' Walk-In Clinic as their primary care provider. Due to continued transitions at the Clinic, interruptions in the continuity of staff, changes in the intake process, new hours and access availability due to a relocation, the decision was made to adjust the metric. The updated metric focused on patients establishing the clinic as their primary care facility versus a specific provider. The Hospital's goal in 2019 was to have 600 new patients declaring Live Oak Health Partners' Walk-In Clinic as their primary care provider, which was exceeded with a total of 824 new patients established at the Clinic. Although the Hospital met its goal, the number of new patients decreased from 1,213 in the prior year to 824 in 2019 due to several process related adjustments including filling new provider schedules with over-flow patients from the Walk-In Clinic. Process adjustments and improvements will continue to be evaluated. The Hospital's fourth strategy was to improve access for those with limited mobility or lack of transportation. The goal was to work with Texas State University to set up a program using students to drive patients to medical appointments. The 2019 goal was originally to expand this program to at least three service lines, but it was discovered that the grant for the program had been exhausted after 2018. The program originated within Central Texas Medical Center's Physical Therapy and Rehabilitation department and in 2018, Central Texas Medical Center's Physical Therapy and Rehabilitation department transitioned services to a management company called PT Solutions. With this transition, PT Solutions was not equipped to manage the program. The Live Oak Health Partners' Community Clinic picked up the program, which was very slow getting off the ground. In 2019, the Clinic struggled to locate patients who wanted to utilize this program. Priority 2: Healthier Management of Lifestyle2016 Description of the Issue: Hays and Caldwell Counties exceed the averages for a number of key health indicators, most notably the lack of physical activity. In the Hospital's Primary Service Area (PSA), 23 percent of adults aged 20 and older self-report no leisure time for activity, based on the question "during the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?" This indicator is relevant because current behaviors are determinants of future health and this indicator may illustrate a cause of significant health issues such as obesity and poor cardiovascular health. 2019 Update: The Hospital's second health priority was to promote healthier management of lifestyle in the community. To do this, the first strategy was to promote the ideals of healthy living by developing programs built on the AdventHealth CREATION Life principles. The 2019 goal was to offer eight CREATION Life workshops, and the Hospital exceeded this expectation by offering 10 workshops. The second strategy was to increase participation in Central Texas Medical Center's CREATION Life Fitness Day, which is offered free for the community. The 2019 goal was to have 475 attendees, and the Hospital exceeded that goal with an attendance of 497 people. The third strategy was to provide low income residents access to health screenings to provide a baseline for making healthier lifestyle choices. The Hospital collaborated with local organizations and distributed free vouchers to the annual Central Texas Medical Center HealthCheck. CTMC's HealthCheck is the oldest and largest health screening event in Hays County and offers free and/or dramatically discounted health screening services to the community. In addition to these screenings, HealthCheck concludes with a health fair that provides participants an opportunity to have their test results interpreted by medical providers. The event also provides access to dozens of health-related exhibitors who offer additional screenings and information. These vouchers provided free tests such as a lipid panel, complete blood cell count and complete metabolic panel. The 2019 goal was to distribute 350 vouchers and have 80 vouchers redeemed. The Hospital exceeded this goal with a total of 500 vouchers distributed and 111 redeemed. Priority 3: Management of Heart Disease/Congestive Heart Failure (CHF) and Related Conditions2016 Description of the Issue: Within the Hospital's Primary Service Area (PSA), the rate of death due to coronary heart disease per 100,000 population is 167.25. In Caldwell County, it is 186.7 as compared to the state number of 175.7 and the national rate of 175. This indicator is relevant because heart disease is a leading cause of death in the United States. These statistics are especially revealing as many patients with cardiovascular disease generally have multiple chronic diseases including diabetes. 2019 Update: The Hospital's first strategy to address the priority above was to provide access to uninsured and underinsured patients who qualify for outpatient cardiac rehab. The goal was to increase the capacity of outpatient cardiac rehabilitation and provide services to uninsured and underinsured patients to at least five patients in 2019. The Hospital was able to extend this offer to seven patients, three of which accepted and completed the program. The second strategy was to offer free blood pressure screenings at the Hospital and throughout the community with education on hypertension and heart disease. The goal for 2019 was to provide 450 blood pressure screenings, and the Hospital provided 534 blood pressure screenings. The third strategy was to collaborate with local organizations to distribute vouchers for free carotid artery and peripheral arterial disease screenings as well as provide education. The goal in 2019 was to distribute 30 carotid artery vouchers and 30 peripheral arterial disease vouchers. The Hospital exceeded this goal by distributing 35 carotid artery vouchers and 35 peripheral arterial disease vouchers. Priority 4: Management of Diabetes2016 Description of the Issue: It is projected that by 2040, 23.8 percent of Texans will have diabetes; 23.1 percent or 112,455 of Hays County residents and 25.2 percent or 12,436 of Caldwell County residents will be diagnosed with the disease. Research highlights that medical expenditures for people with diabetes is about 2.3 times higher than medical expenditures for those who are not diabetic. Expected population growth over the next several years is expected to exacerbate the prevalence of diabetes and associated complications, and consequently, the need for health care services and access to health care providers. 2019 Update: The Hospital's first strategy to address the priority listed above was to increase awareness and early detection of diabetes by offering free monthly blood glucose screenings and diabetes risk assessments based on American Diabetes Association guidelines. The 2019 goal was to average 56 blood glucose screenings and risk assessments monthly, and the Hospital exceeded this goal by averaging 61 per month. **see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 9 -- Central Texas Medical CenterDescription of CHNA Significant Needs ContinuedThe second strategy was to improve compliance with short and long-term diabetes control and management. The goal was to provide all diabetes education class participants with up to four individualized follow-up visits with a Diabetes Educator focusing on lifestyle changes (over a 12-month period). The 2019 goal was to have at least 45 percent of diabetes education participants receive at least two follow-up visits over a 12-month period. The Hospital exceeded this goal by having 52 percent of diabetes education participants receive at least two follow-up visits over a 12-month period. The third outcome statement is to provide individuals diagnosed with diabetes and their family members ongoing opportunities for education, accountability and encouragement to adopt and maintain successful diabetes management and control. The strategy is to offer a free diabetes support group every two weeks. The goal was to average 12 attendees throughout the year, and the Hospital averaged seven attendees. The main challenge is that there are other support groups that are taking place at CTMC with some of these same attendees (i.e. weight loss support group). Transportation is another barrier for those interested in attending. In addition, most of the population the Hospital serves at the support groups are those of low socio-economic status and compliance is a struggle. Priority 5: Education2016 Description of the Issue: According to participants in the primary data collection phase, a lack of education and economic inequalities lead to poor lifestyle decisions such as unhealthy diets and a lack of exercise. Diabetes is a significant health problem partly due to lack of access to healthy foods and lack of knowledge about healthy eating. Many health problems are exacerbated by the challenges of finding providers, navigating the health care system and managing medication. Assessment participants stressed the need for community-based strategies and interventions at early ages that promote healthy behaviors.2019 Update: The Hospital's first strategy to meet this priority was to improve the management of hospitalized uninsured and underinsured patients in an outpatient or home setting. The goal was to provide 85 percent of all unfunded patients a referral to a medical home prior to discharge at CTMC. The Hospital was able to provide 59.5 percent of uninsured and underinsured patients a referral to a medical home prior to discharge from Central Texas Medical Center. This was a small improvement over the prior year. However, the Hospital did not meet this goal. There are several barriers associated with meeting this strategy, including if the patient refuses follow-up assistance, resides outside of Hays County, or states they will call later to make their own appointment. The second strategy was to improve the community's understanding of health care resources provided through Central Texas Medical Center Live Oak Health Partners and associated clinics. A Patient Family Advisory Council (PFAC), comprised of community and Hospital team members was established to lead the strategy. The Council worked to improve communications with patients as a result of the needs identified from experiences with Central Texas Medical Center, Live Oak Health Partners and other associated clinics. The 2019 goal was for PFAC members to develop an action plan to improve communication and increase knowledge through three targeted initiatives, which was met. The first initiative was participation in and understanding of the Whole Care Experience to educate members of the community on the value of a whole person approach to care. The second was to gain mystery shopper insight in the emergency department and outpatient surgery waiting areas. This initiative led to feedback that families were not always aware of where in the surgery process their loved ones were. The result of this was a new method of communication to ensure families were updated at all times. The third was gathering input and support regarding the new emergency department patient communication boards. The feedback led to updated, less clinical language being used and a simplified version of the layout of the boards to make it accessible to all patients and their families.The third strategy was to develop support groups for individuals facing cancer, especially for the Spanish-speaking population. The strategy was to facilitate free breast cancer support groups with an emphasis on the navigation of health care resources. The 2018 goal was to provide 12 meetings. Due to transition of the Navigator position in late 2018, the Hospital did not meet this goal in the prior year. In 2019, the Navigator was in place and held six support groups but had very low turnout. This goal of 15 support groups was not met in 2019. Patients expressed that they were not interested in support groups and would rather have one-on-one conversations with the Navigator. It was determined that the needs of the patient population would be better met by individual consultation. The fourth strategy was to improve access to mammograms for low-income individuals. The strategy was to expand the timeframe to redeem free mammogram vouchers and conduct follow-ups to encourage individuals to access the screening. The 2019 goal was to have at least 100 vouchers redeemed and the Hospital was very close to meeting this goal by having 96 vouchers redeemed. Priority 6: Management of Mental and Behavioral Health2016 Description of the Issue: Hays County specifically has a mental health shortage with 86 providers per 100,000 population as compared to the state average of 96.7 and the national average of 189. The county, hospital EDs, police department and school counselors often have to respond to crises. There are very few mental and behavioral health care resources aimed at serving the mental health needs of the community, especially for children, before emergencies develop. Assessment participants raised concerns about residents with very serious mental health problems who often require extensive treatment and case management. 2019 Update: The first strategy was to increase coordination of community organizations to better meet the psychiatric needs of the community. The strategy was to develop a cross-functional community committee including law enforcement, Central Texas Medical Center, Texas State University, Live Oak Health Partners and local mental health providers. The 2019 goal was to provide four meetings and this goal was met with at least four meetings being held. In addition, CTMC gained a new ED Director in June of 2019 whose first initiative was to develop closer relationships with local EMS, police, etc. In addition, the ED Director developed a high-risk patient meeting, which is held twice per month with initiatives including policy updates, movement to 1:1 supervision for all high-risk psychiatric patients, increased security officers in-house, safer gowns for psychiatric patients and more. The Hospital also set a goal to provide family members ongoing opportunities for education and encouragement by offering a support group quarterly for coping with loved ones who experience mental/behavioral challenges. Unfortunately, CTMC's Senior Behavioral Health Unit closed April 2019. However, CTMC provided mental and behavioral health support through free counseling services at CTMC's grief center. Representatives from CTMC also spoke at local community support groups on mental/behavioral health issues. The Hospital did not meet the metric of providing its own support group. However, efforts were made to provide support in other capacities as it relates to mental/behavioral health.The third strategy was to educate the community residents about the mental and behavioral health care options available. The strategy was to offer eight free, educational presentations at local churches, businesses, civic groups, etc. Unfortunately, CTMC's Senior Behavioral Health Unit closed April 2019. However, through other clinicians/departments, CTMC provided mental and behavioral health education at a variety of presentations throughout the community including topics such as emotional suffering, mental health and suicide awareness. The goal was to provide eight presentations, and the Hospital met this goal.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 9 -- Central Texas Medical CenterDescription of CHNA Significant Needs ContinuedCommunity Needs Not Chosen by Central Texas Medical Center:The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. Prevalence and/or enhanced outpatient management of chronic respiratory diseases: While this is an important initiative, beyond adding two pulmonologists to the medical staff in recent months, the Committee determined that other needs were more acute and in need of additional focus and resources.2. Providing additional dental health resources: While serious in nature, Central Texas Medical Center does not currently have the resources to materially impact this community need at this time.3. Education and information related to alcohol, tobacco and substance abuse: The Committee believed that current programs available in the community were better suited to address the needs related to alcohol, tobacco and substance abuse.Group A-Facility 11 -- AdventHealth WauchulaAdventist Health System/Sunbelt, Inc. d/b/a 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 reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency. AdventHealth Wauchula is part of the West Florida Division of AdventHealth. The West Florida Division includes 11 hospital facilities. The information provided below explains how the hospital facility addressed in 2019 the significant health needs identified in its 2016 Community Health Needs Assessment, and any such needs that were not addressed and the reasons why such needs were not addressed. The hospital facility conducted a Community Health Needs Assessment in 2016 and adopted an implementation strategy to address the significant health needs identified in the 2016 Community Health Needs Assessment in 2017 prior to May 15, 2017. This is the third-year update for AdventHealth Wauchula's 2017-2019 Community Health Plan/Implementation Strategy. The Hospital developed this plan and posted it in May 2017 as part of its 2016 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 2016 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 2017-2019 Community Health Plan. The third-year progress on the Community Health Plan is noted below. The narrative describes the issues identified in 2016 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 five areas of focus for its 2017-2019 Community Health Plan.1. Diabetes;2. Obesity/Nutrition;3. Access to Primary Care;4. Heart Disease & Stroke (High Blood Pressure & Cholesterol); and5. Teen Pregnancy Prevention.Priority 1: Diabetes2016 Description of the Issue: In the Primary Service Area (PSA), 12.3 percent of adults, aged 20 and older, have been diagnosed with diabetes. This is higher than the state of Florida average of 8.89 percent. The Health Department is no longer providing diabetes self-management classes. Pre-diabetes education is also lacking in Hardee County.2019 Update: The Morning Mile program is a before-school walking/running program sponsored by the American Diabetes Association (ADA), that gives children a chance to start each day in an active way.The Hospital partnered with the ADA to pilot the Morning Mile Program at two Title I schools in its PSA for the 2018-2019 school year. As mentioned in 2018, due to a lack of reporting of outcomes and poor management of the program overall by the ADA, the contract for the program was not renewed for 2019. A second intervention, added in 2018, included offering free, 3-hour pre-diabetes classes at the Hospital and in the community. These classes are open to the public and offered by the Hospital's Diabetes Center. Community partners are now offering diabetes self-management education for those already diagnosed, but no pre-diabetes programs. Lack of transportation to attend classes continues to be a concern, and it has been difficult, historically, to entice residents to attend health lectures or classes. In 2019, the Hospital continued its partnership with local community partners offering seven pre-diabetes self-management education classes, surpassing the goal for the year. Priority 2: Obesity/Nutrition2016 Description of the Issue: In the Hospital's Primary Service Area (PSA), 33.4 percent of adults aged 20 and older self-reported no leisure time for activity. Additionally, 34.6 percent of adults aged 18 and older self-report they have a body mass index between 25.0 and 30.0 (overweight). 2019 Update: Strategies for this goal included offering the CREATION Health (CH) class series to the community, increasing the number of staff members or others trained to teach the series, and continuing to offer the Food is Health (FiH) program, formerly known as Food is Medicine. CREATION Health (based on the eight principles of Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook, and Nutrition) is a faith-based, 8-session, wellness program offering lifestyle seminars and training programs for those who want to live healthier and happier lives. The Hospital also sponsors free pre- and post-biometric screenings (blood pressure, blood sugar, and body mass index) and nursing services for CH participants. In 2019, there were six graduates from the CH program, less than the goal of 20. All program graduates (100 percent) reported making improved lifestyle choices as measured by a self-assessment form, surpassing the goal of 85 percent. The Hospital also met the goal for new trainers by training one additional staff member to teach the CH program. AdventHealth Wauchula partnered with local community organizations to address the nutritional needs of those in communities designated as food deserts or low income/low access areas with the Food is Health program (FiH). This is accomplished by increasing health and lifestyle educational opportunities, biometric screenings, and access to healthy produce and dry goods.The Food is Health program has been well-received by the targeted population. Blood sugar levels were measured for each participant before and after each educational series. In 2019, 63 percent of participants had reduced blood sugar levels following the program, surpassing the goal of 10 percent. In addition, a total of 72 fresh produce vouchers were distributed to participants. The Hospital found that the key to success of the FiH program has been partnerships. The Hospital cannot run this program without strong partnerships with health education providers, local fresh produce vendors, and other community-based organizations who are the boots on the ground addressing social determinants of health.**see continuation of footnote
Part V, Section B, Line 11 Continuation of Footnote	Group A-Facility 11 -- AdventHealth WauchulaDescription of CHNA Significant Needs ContinuedPriority 3: Access to Primary Care2016 Description of the Issue: In the Hospital's Primary Service Area (PSA), 38.86 percent of adults aged 19 and older are uninsured, more than the state rate of 28.78 percent, while the uninsured rate for children 18 and younger is 14.43 percent compared to the state rate of 11.86 percent. 26.9 percent of adults self-report that they do not have a source for primary care. The rate of dentists per 100,000 population is only 29.1. Hardee County is a socio-economically disadvantaged, rural, agricultural county officially designated as a Health Professionals Shortage Area by the US Department of Health and Human Services. Hardee County has shortages of primary medical care, dental and mental health providers. 2019 Update:Strategies for this priority included increasing community awareness of the availability of local health care services for the uninsured/under-insured by continuing the CREATION Health Ministry Outreach program, providing discounted home-supply prescriptions for low-income patients upon discharge and providing the Samaritan's Touch free clinic with in-kind lab and imaging services for its patients. Samaritan's Touch is a free health care clinic for the uninsured population, serving Highlands and Hardee counties. In 2019, AdventHealth Wauchula, together with AdventHealth Sebring and AdventHealth Lake Placid, donated $100,000 of in-kind lab and imaging services to Samaritan's Touch patients and contributed $4,547 to provide discounted home-supply prescriptions for low-income patients upon discharge. However, the decision was made in 2018 to discontinue additional monetary support to the organization. The CREATION Health Ministry had 10 volunteers in 2019. The Hospital hosts meetings where speakers and health education materials are provided for attendees, who in turn share with their respective churches or community organizations. Volunteers are primarily retired or active nurses. Priority 4: Heart Disease & Stroke (High Blood Pressure & Cholesterol)2016 Description of the Issue: In the Hospital's Primary Service Area (PSA), residents have been diagnosed with high blood pressure at a higher rate of 56.01 percent than the state rate of 29.6 percent. Additionally, 56.01 percent of adults have high cholesterol and 10.9 percent of adults in the PSA have been diagnosed with Coronary Artery Disease.2019 Update: In 2019, the Hospital was unable to meet the participation numbers required to provide the evidence-based Stanford Chronic Disease Self- Management Program (CDSMP), which educates participants regarding chronic disease self-management. The greatest challenge was recruiting participants, even though efforts were made both in the Hospital and through local community partners. The class requires a minimum number of participants and the expectation of a six-week commitment proved to be an engagement challenge the Hospital was unable to meet. A second intervention was to provide the Complete Health Improvement Program (CHIP) class series, a lifestyle enrichment program designed to reduce disease risk through better health habits and appropriate lifestyle modifications. Goals included lowering cholesterol, hypertension and blood sugar levels, reducing excess weight through improved dietary choices, enhancing daily exercise, increasing support systems and decreasing stress in an evidence-based program. No classes were provided in 2019 in the Hospital's PSA. Any interested individuals were offered the opportunity to join the class at the AdventHealth Lake Placid location. This change was made as part of a Division level decision to transition from the CHIP model to a new series that is in development. Priority 5: Teen Pregnancy Prevention2016 Description of the Issue: In the Hospital's Primary Service Area (PSA), the teen birth rate is 88.4 per 1000 population compared with the state rate of 36.1 and the country's rate of 36.6. Previous grant funding for public school pregnancy prevention programs has ceased.2019 Update: The intervention chosen was to send a representative from the Hospital to attend the local Teen Pregnancy Prevention Association meetings. The representative attended four meetings in 2019, surpassing the goal of three. Community Needs Not Chosen by AdventHealth Wauchula:The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. Cancer/Tobacco Use: The Hospital works with the Area Health Education Council and hosts tobacco cessation classes at the Hospital. 2. Access to Mental Health Services: The Hospital's Primary Service Area is designated a Health Professionals Shortage Area. The Hospital refers patients to local resources as available. This is not a line of service the Hospital provides.
Part V, Section B, Line 11 Continuation of Footnote	Group B-Facility 7 -- AdventHealth SebringGroup B-Facility 10 - AdventHealth Lake PlacidDescription of CHNA Significant Needs ContinuedA second strategy to reduce blood sugar levels is described below.AdventHealth Sebring and AdventHealth Lake Placid partnered with local community organizations to address the nutritional needs of those in communities designated as food deserts or low income/low access areas with the Food is Health program (formerly known as Food is Medicine). This is accomplished by increasing health and lifestyle educational opportunities, biometric screenings, and access to healthy produce and dry goods. In 2019, a total of 40 fresh produce vouchers were redeemed by participants, less than the goal. This was due to lower than anticipated program participation. Due to the low number of participants, there was also insufficient data to determine the percentage of participants showing a decrease in blood sugar.In 2019, the Hospitals continued to work on developing new relationships with community partnerships to increase awareness and participation in the Food is Health (FiH) program. The Hospitals cannot run this program without strong partnerships with health education providers, local fresh produce vendors and other community-based organizations who are the boots on the ground to addressing social determinants of health. Furthermore, the Hospitals worked to restructure the FiH program to improve its internal process for implementing and tracking outcomes for the program. Priority 4: Access to Care (Primary Care)2016 Description of the Issue: The Hospitals' Primary Service Area (PSA) is designated a Health Professional Shortage Area (HPSA).2019 Update: Strategies implemented to increase community awareness and availability of local health care services for uninsured and underinsured individuals included continuing the CREATION Health Ministry Outreach program, providing discounted home-supply prescriptions for low-income patients upon discharge and providing the Samaritan's Touch free clinic with in-kind lab and imaging services for its patients. Samaritan's Touch is a free health care clinic for the uninsured population, serving Highlands and Hardee counties in Florida. In 2019, AdventHealth Sebring and AdventHealth Lake Placid, together with AdventHealth Wauchula, donated $100,000 of in-kind lab and imaging services to Samaritan's Touch patients and contributed $4,547 to provide discounted home-supply prescriptions for low-income patients upon discharge. However, the decision was made in 2018 to discontinue additional monetary support to the organization.The CREATION Health Ministry had 54 volunteers in 2019. The Hospitals host meetings where speakers and health education materials are provided for attendees, who in turn share with their respective churches or community organizations. Volunteers are primarily retired or active nurses. Priority 5: Access to Care (Mental Health Services)2016 Description of the Issue: The Hospitals' Primary Service Area (PSA) is designated a Health Professional Shortage Area (HPSA), with very few physicians/agencies offering mental health services.2019 Update: Strategies were implemented to increase community awareness and availability of local mental health care services for uninsured and underinsured individuals in the community included hosting support group meetings at the Hospitals. In 2019, the Hospitals provided one support group for individuals with autoimmune disease. Additionally, the Hospitals partnered with the Alzheimer's Association to provide a class series called the "Caregiver College" to engage and empower individuals who serve as caregivers. The Hospitals continue to build on existing community relationships to increase the reach of support groups to address mental health in its communities.Community Needs Not Chosen by AdventHealth Sebring and AdventHealth Lake Placid:The primary and secondary data in the Community Health Needs Assessment identified multiple community issues. 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. Cancer Incidence/Screening/ Tobacco Cessation - the Hospitals already participate with the Area Health Education Center (AHEC) to offer community tobacco cessation classes. 2. Poverty/Unemployment/Low Literacy Rates - The Hospitals do not have the capacity to address these social determinants. 3. Chronic Obstructive Pulmonary Disease/Upper Respiratory Infection/Asthma - The CHNAC felt other issues would be better suited for the Hospitals to address. 4. Lack of Transportation - The community lacks public transportation services, and the Hospitals do not have the capacity to address public transportation.
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-assistanceFacility 2 -- AdventHealth Celebrationhttps://www.adventhealth.com/legal/financial-assistanceFacility 3 -- AdventHealth Altamonte Springshttps://www.adventhealth.com/legal/financial-assistanceFacility 4 -- AdventHealth East Orlandohttps://www.adventhealth.com/legal/financial-assistanceFacility 5 -- AdventHealth Winter Park https://www.adventhealth.com/legal/financial-assistanceFacility 6 -- AdventHealth Kissimmeehttps://www.adventhealth.com/legal/financial-assistanceFacility 7 -- AdventHealth Sebringhttps://www.adventhealth.com/legal/financial-assistanceFacility 8 -- AdventHealth Apopkahttps://www.adventhealth.com/legal/financial-assistanceFacility 9 -- Central Texas Medical Centerhttps://www.ctmc.org/patients-visitors/after-my-stay/financial-assistanceFacility 10 -- AdventHealth Lake Placidhttps://www.adventhealth.com/legal/financial-assistanceFacility 11 -- AdventHealth Wauchulahttps://www.adventhealth.com/legal/financial-assistance

Field	Value	IRS element (for citing)
Facility	57	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (57 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt	Address Line2USAddress/AddressLine2Txt
1 - AdventHealth Centra Care Lake Buena Vista
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 Springs
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	Daytona Beach	FL	32114	Urgent Care Clinic	Blvd
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 Park
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 S
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 & Va
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 at
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 Da
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 Surgery
4145 Sun N Lake Blvd Suite B	Sebring	FL	33872	Physician Clinic
57 - AdventHealth Centra Care Corporate Care La
1255 State Road Florida 60 East	Lake Wales	FL	33853	Occupational Medicine Services	Suite 300

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 6a:	The filing organization was a wholly owned subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) during its current tax year. During the current year, AHSSHC served as a parent organization to 27 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 two of the organization's hospitals. These two hospitals participate 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 8-9. 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: $(122,883,214) - Difference in costing methodology: 37,360,853 - Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (209,652,957) ------------- Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $(295,175,318) 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 2019, the filing organization operated 4 separately licensed hospitals that together encompassed 11 separate campus locations and 4 off-site emergency departments. The hospitals are located in Florida and Texas. A description of each of the hospital campuses is described below.Adventist Health System/Sunbelt, Inc. dba Central Texas Medical Center:Central Texas Medical Center (CTMC) 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. During 2019, CTMC's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2019, about 67.2% of the CTMC's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 46.6% - Medicaid Patients 10.4% - 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 205 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 2019, 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 2019, about 72.3% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 64.8% - Medicaid Patients 12.6% - Self-Pay Patients 5.2%AdventHealth Sebring (Highlands County) - The main 147-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. The Hospital has been recognized as a Top Rural Hospital by The Leapfrog Group and best hospital for patient safety. ** 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 $7,846,312 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 $480,999,723 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 47 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 12 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 7	The filing organization does not file an annual community benefit report with any state agencies.
Part VI, Line 4 Continuation of Footnote	Description of Community Information - ContinuedThe 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 2,993-bed medical complex in Central Florida with seven separate hospital campuses and four 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 35 full-service urgent care clinics in convenient community settings.During 2019, 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 2019, about 68% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 43.2% - Medicaid Patients 14.9% - Self-Pay Patients 7.6%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 1,364-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 52,000 inpatients and 172,000 outpatients in 2019. 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 21,000 cardiac catheterizations and over 2,300 open heart surgeries in 2019. 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 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 and includes AdventHealth Lake Mary ER, an off-site emergency room that provides quicker access to care the community needs. In addition to maternity, pediatric, 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.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. Completion of this $203 million project took place in December 2017. ** see continuation of footnote
Part VI, Line 4 Continuation of Footnote	Description of Community Information - ContinuedAdventHealth 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%

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (90 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
Adventist Care Centers - Courtland Inc
730 Courtland St	Orlando	FL	32804	205774723	501(c)(3)	$1,150,670	General Support
African American Chamber of Commerce
3201 E Colonial Drive	Orlando	FL	32803	593314330	501(c)(6)	$8,000	General Support
American Cancer Society Inc
250 Williams Street NW Ste 400	Atlanta	GA	30303	131788491	501(c)(3)	$129,000	General Support
Aspire Health Partners Inc
5151 Adanson Street	Orlando	FL	32804	592301233	501(c)(3)	$1,436,640	General Support
Boy Scouts Of America Inc Central Florida Council
1951 S Orange Blossom Trail 102	Apopka	FL	32703	590624376	501(c)(3)	$20,000	General Support
Boys & Girls Club of Central Florida
PO Box 2987	Orlando	FL	32802	590951887	501(c)(3)	$15,000	General Support
Building Us Inc dba Friend Talking Faith
PO Box 3310	Winter Park	FL	32790	455420165	501(c)(3)	$25,000	General Support
Celebration Foundation Inc
610 Sycamore St	Celebration	FL	34747	593370753	501(c)(3)	$40,000	General Support
Central Florida Association for Physicians
6735 Conroy Rd Ste 224	Orlando	FL	32835	262077247	501(c)(3)	$15,000	General Support
Central Florida Foundation Inc
800 N Magnolia Ave Ste 1200	Orlando	FL	32803	593182886	501(c)(3)	$59,231	General Support
Central Florida Young Men'S Christian Association
433 N Mills Avenue	Orlando	FL	328035721	590624430	501(c)(3)	$12,500	General Support
Central Texas Healthcare Collaborative
1301 Wonder World Dr	San Marcos	TX	78666	453739929	501(c)(3)	$857,584	Provision of Indigent Care
Central Texas Medical Center Foundation
1301 Wonder World Dr	San Marcos	TX	78666	742259907	501(c)(3)		General Support	$105,862	Book	Provision of general administrative support
Christian Service Center for Central Florida Inc
808 W Central Blvd	Orlando	FL	32805	591353031	501(c)(3)	$7,500	General Support
Community Health Centers Inc
110 S Woodland St	Winter Garden	FL	34747	591480970	501(c)(3)	$108,738	General Support
Community United Outreach Inc
2520 Hansrob Road	Orlando	FL	32804	453584062	501(c)(3)	$230,526	General Support
Community Vision
704 Generation Pt Apt 101	Kissimmee	FL	34744	592896657	501(c)(3)	$10,850	General Support
Cystic Fibrosis Foundation
1080 Woodcock Rd Ste 245	Orlando	FL	32803	131930701	501(c)(3)	$10,000	General Support
Debbie Turner Cancer Care Resources Inc
31138 Preswick Ave	Sorrento	FL	32776	800499456	501(c)(3)	$10,000	General Support
East Orlando Health & Rehab Center Inc
250 South Chickasaw Trail	Orlando	FL	32825	205774748	501(c)(3)	$3,262,448	General Support
Edible Education Experience Inc
26 E King Street	Orlando	FL	32804	465655482	501(c)(3)	$80,000	General Support
FLNC Inc
3355 E Semoran Blvd	Apopka	FL	32703	205774761	501(c)(3)	$5,408,704	General Support
Florida Abolitionist Inc
195 South Westmonte Dr	Altamonte Springs	FL	32714	593178045	501(c)(3)	$10,000	General Support
Florida Conference Association of Seventh-day Adventists
351 S State Road 434	Altamonte Springs	FL	32714	590806975	501(c)(3)	$6,000	General Support
Florida Hospital Seventh-day Adventist Church
2800 N Orange Ave	Orlando	FL	32804	593039667	501(c)(3)	$14,000	General Support
Forest City Spanish Seventh-day Adventist Church
7601 Forest City Rd	Orlando	FL	32810	593291153	501(c)(3)	$22,059	General Support
Forest Lake Academy
500 Education Loop	Apopka	FL	327036176	590816443	501(c)(3)	$20,000	General Support
Foundation For Building Community Inc
301 E Pine St Ste 900	Orlando	FL	32801	593678634	501(c)(3)	$150,000	General Support
Foundation For Orange County Public Schools Inc
445 W Amelia St Ste 901	Orlando	FL	328011153	592788435	501(c)(3)	$41,500	General Support
Foundation For Seminole State College Of Florida Inc
1055 Aaa Drive Ste 209	Heathrow	FL	32746	237033822	501(c)(3)	$250,000	General Support
Grace Medical Home Inc
51 Pennsylvania Street	Orlando	FL	328062938	281817966	501(c)(3)	$477,500	General Support
Greater San Marcos Partnership
1340 Wonder World Dr 108	San Marcos	TX	78666	800624502	501(c)(6)	$20,000	General Support
Guidewell Innovation LLC
6555 Sanger Road	Orlando	FL	32827	473453318	Other	$25,000	General Support
Harbor House Of Central Florida Inc
PO Box 680748	Orlando	FL	32868	591712936	501(c)(3)	$10,000	General Support
Healthcare Access Alliance
7124 Hiawassee Overlook Dr	Orlando	FL	32835	823211739	501(c)(3)	$7,500	General Support
Healthy Start Coalition of Orange County Inc
1040 Woodcock Rd Ste 215	Orlando	FL	32803	593125675	501(c)(3)	$17,500	General Support
Healthy Start Coalition of Osceola County Inc
PO Box 701995	St Cloud	FL	34770	593212535	501(c)(3)	$15,000	General Support
Healthy Start Coalition of Seminole County Inc
820 W Lake Mary Blvd Ste 108	Sanford	FL	32773	464038747	501(c)(3)	$6,000	General Support
Hope Community Center Inc
1016 N Park Ave	Apopka	FL	32712	562551312	501(c)(3)	$7,500	General Support
Hope Helps Inc
812 Eyrie Dr	Oviedo	FL	32765	208490916	501(c)(3)	$10,000	General Support
Hope Now International Inc
PO Box 181173	Casselberry	FL	327181173	274498303	501(c)(3)	$10,000	General Support
Iglesia Chistiana Pentecostal De Orlando Inc
5850 Clarona Ocoee Road	Orlando	FL	32810	593218454	501(c)(3)	$20,000	General Support
JDRF International
370 Center Pointe Cir Ste 1154	Altamonte Springs	FL	32701	231907729	501(c)(3)	$30,555	General Support
Jewish National Fund (Keren Kayemeth Leisrael) Inc
42 East 69Th St	New York	NY	10021	131659627	501(c)(3)	$10,000	General Support
Kids Beating Cancer Inc
615 E Princeton St Ste 400	Orlando	FL	32803	593136203	501(c)(3)	$10,300	General Support
Kids House of Seminole Inc
5467 North Ronald Reagan Blvd	Sanford	FL	32773	593415005	501(c)(3)	$10,000	General Support
Lake Nona Institute Inc
6900 Tavistock Lakes Blvd	Orlando	FL	32827	273346737	501(c)(3)	$166,666	General Support
Life Concepts Inc dba Quest Inc
500 E Colonial Dr	Orlando	FL	32803	592013160	501(c)(3)	$20,000	General Support
Lifework Leadership
1220 E Concord St	Orlando	FL	328035453	371592618	501(c)(3)	$12,500	General Support
Lift Orlando
215 East Central Blvd	Orlando	FL	32801	463607865	501(c)(3)	$63,500	General Support
Make A Wish Foundation of Central And Northern Florida Inc
1020 N Orlando Ave Ste 100	Maitland	FL	32751	593235806	501(c)(3)	$15,000	General Support
March of Dimes Inc
1550 Crystal Dr Ste 1300	Arlington	VA	22202	131846366	501(c)(3)	$20,000	General Support
Matthews Hope Ministries Inc
523 S Woodland St	Winter Garden	FL	34761	272245867	501(c)(3)	$30,000	General Support
Meals on Wheels Etc Inc
2801 S Financial Court	Sanford	FL	32773	592977907	501(c)(3)	$15,000	General Support
Mental Health Association Of Central Florida Inc
1525 E Robinson St	Orlando	FL	32801	590816432	501(c)(3)	$146,528	General Support
Mothers Milk Bank of Florida
8669 Commodity Circle Ste 490	Orlando	FL	32819	273939245	501(c)(3)	$40,000	General Support
My Neighbor'S Children
PO Box 617218	Orlando	FL	32861	260770494	501(c)(3)	$22,500	General Support
New Beginnings of Central Florida Inc
PO Box 121129	Clermont	FL	34712	260353679	501(c)(3)	$10,000	General Support
Onepulse Foundation Inc
1227 E Concord St	Orlando	FL	32803	813142847	501(c)(3)	$300,000	General Support
Osceola County Council on Aging Inc
700 Generation Pt	Kissimmee	FL	34744	591595398	501(c)(3)	$141,000	General Support
Osceola Mental Health Inc dba Park Place
206 Park Place Blvd	Kissimmee	FL	34741	591677912	501(c)(3)	$224,333	General Support
Pediatric Congenital Heart Association Inc
14 Ellis Potter Court No 100	Madison	WI	53711	463576700	501(c)(3)	$20,000	General Support
Ronald Mcdonald House Charities of Central Florida Inc
1030 N Orange Ave	Winter Park	FL	327894709	593211250	501(c)(3)	$104,000	General Support	$12,124	Estimated	Other
Rustys Bicycle Recycle Inc
1275 Bennett Dr	Longwood	FL	32750	824975971	501(c)(3)	$10,000	General Support
San Marcos Sights & Sounds of Christmas Inc
630 E Hopkins	San Marcos	TX	78666	742759206	501(c)(3)	$15,000	General Support
School Board of Orange County
901 N Lakemont Ave	Winter Park	FL	32792	596000771	Gov't	$7,575	General Support
Sebring Main Street Inc
PO Box 1243	Sebring	FL	33870	592626645	501(c)(3)	$5,850	General Support
Second Harvest Food Bank of Central Florida Inc
411 Mercy Dr	Orlando	FL	32805	592142315	501(c)(3)	$110,547	General Support
Seminole County Sheriffs Office Community Foundation Inc
100 Eslinger Way	Sanford	FL	32773	472640601	501(c)(3)	$7,500	General Support
Seniors First Inc
5395 LB Mcleod Road	Orlando	FL	32811	592759603	501(c)(3)	$15,000	General Support
Simple Truth Foundation Inc
1224 Lake Pointe Circle	Leesburg	FL	34748	273684092	501(c)(3)	$138,630	General Support
South Florida State College
600 W College Drive	Avon Park	FL	33825	591218159	Gov't	$79,250	Nursing Education
Sunbelt Health & Rehab Center - Apopka Inc
305 East Oak St	Apopka	FL	32703	205774856	501(c)(3)	$674,321	General Support
Sunsystem Development Corporation
900 Hope Way	Altamonte Springs	FL	32714	592219301	501(c)(3)		General Support	$5,261,611	Book	Provision of general administrative support
Texas State University
601 University Dr	San Marcos	TX	72893	746002248	Gov't	$9,100	General Support
The Able Charitable Foundation Inc
8177 Blue Quill Trail	Tallahassee	FL	32312	821822879	501(c)(3)	$10,000	General Support
The Christian Sharing Center Inc
600 N Hwy 17-92 No 158	Longwood	FL	32750	592744535	501(c)(3)	$15,000	General Support
The Leukemia & Lymphoma Society Inc
3 International Dr	Rye Brook	NY	10573	135644916	501(c)(3)	$7,500	General Support
The Morgan Center
26 Seafield Ln	Bay Shore	NY	11706	431995070	501(c)(3)	$10,000	General Support
The School Board Of Highlands County
426 School Street	Sebring	FL	33870	596000654	Gov't	$10,000	Senior Education
Tri-County Nursing Rehabilitation Center Inc
1290 Celebration Blvd	Kissimmee	FL	34747	472219363	501(c)(3)	$21,350	General Support
United Against Poverty Inc
2050 40Th Ave Ste 9	Vero Beach	FL	32960	113697936	501(c)(3)	$15,048	General Support
United Global Outreach
2301 N Orange Ave	Orlando	FL	32804	030511875	501(c)(3)	$81,494	General Support
United Way - The Heart of Florida
1940 Traylor Blvd	Orlando	FL	32804	590808854	501(c)(3)	$15,150	General Support
Universal Orlando Foundation
1000 Universal Studios Plaza	Orlando	FL	32819	593510383	501(c)(3)	$15,000	General Support
University of Central Florida Foundation Inc
12424 Research Parkway Ste 140	Orlando	FL	32826	596211832	501(c)(3)	$25,000	General Support
US Dream Academy
5950 Symphony Woods Rd	Columbia	MD	21044	593514841	501(c)(3)	$10,000	General Support
Valencia College Foundation Inc
PO Box 3028	Orlando	FL	32802	237442785	501(c)(3)	$250,000	General Support
West Orange Chamber of Commerce
12184 W Colonial Drive	Winter Garden	FL	34787	590576757	501(c)(6)	$20,000	General Support
Winter Park Chamber of Commerce
151 W Lyman Ave	Winter Park	FL	32789	590514615	501(c)(6)	$11,500	General Support

Field	Value	IRS element (for citing)
Total501c3 Org	85	Total501c3OrgCnt
Total Other Org	5	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	Grants are generally made only to related organizations that are exempt from federal income tax under IRC Section 501(c)(3), or to other local charitable community organizations, or to other 501(c)(3) organizations that are a part of the group exemption ruling issued to the General Conference of Seventh-Day Adventists. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures.	ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (28 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Shaw Terry D
Dir/President/AdventHealth CEO	$0	$1,745,693	$0	$712,420	$0	$1,818,408	$0	$380,390	$0	$55,308	$0	$4,712,219	$0	$312,231
Houmann Lars D
Dir/AH Crp Relations Off (end 12/19)	$0	$1,209,479	$0	$552,173	$0	$847,410	$0	$251,578	$0	$45,331	$0	$2,905,971	$0	$246,703
Tol Daryl
Pres/CEO Central FL Division	$0	$1,189,540	$0	$429,693	$0	$238,558	$0	$239,265	$0	$53,567	$0	$2,150,623	$0	$172,752
Rathbun Paul C
Director/AdventHealth CFO	$0	$993,376	$0	$380,674	$0	$220,634	$0	$208,495	$0	$40,778	$0	$1,843,957	$0	$171,802
Stevens Eric A
CEO CF S Acute/AH Orl/Women (End 12/	$0	$689,976	$0	$223,243	$0	$555,597	$0	$112,850	$0	$35,757	$0	$1,617,423	$0	$76,026
Silvestry MD Scott
Physician/Director AH Thoracic Trans	$1,396,868	$0	$93,750	$0	$8,910	$0	$15,087	$0	$6,740	$0	$1,521,355	$0	$0	$0
Soler Eddie
Former Key Emp/AH Sr Finance Officer	$0	$753,812	$0	$256,389	$0	$292,783	$0	$158,798	$0	$30,003	$0	$1,491,785	$0	$133,999
Banks David P
Former Key Emp/AH Chief Strategy Off	$0	$704,273	$0	$235,922	$0	$332,124	$0	$135,461	$0	$40,799	$0	$1,448,579	$0	$107,582
Goodman Todd A
CFO Central FL Division	$0	$676,730	$0	$183,480	$0	$430,596	$0	$109,503	$0	$44,926	$0	$1,445,235	$0	$70,311
Moorhead MD John David
Former Key Emp/AH Chief Clincial Off	$0	$734,400	$0	$209,610	$0	$465,457	$0	$15,087	$0	$14,514	$0	$1,439,068	$0	$0
Davis Jr MD Robert Duane
Physician/Director AH Cardiovascular	$1,192,327	$0	$0	$0	$9,812	$0	$15,087	$0	$7,948	$0	$1,225,174	$0	$0	$0
Botta MD Donald
Physician/Director AH Heart Transpla	$683,054	$0	$355,960	$0	$5,249	$0	$15,087	$0	$6,395	$0	$1,065,745	$0	$0	$0
Shimshak MD Thomas M
Interventional Cardiology Physician	$847,836	$0	$0	$0	$113,989	$0	$15,087	$0	$8,357	$0	$985,269	$0	$0	$0
Jones MD Phillip
Interventional Cardiology Physician	$694,425	$0	$204,374	$0	$45,089	$0	$15,087	$0	$16,854	$0	$975,829	$0	$0	$0
Hilliard Douglas W
Sr VP/Sr Finance Officer AH Orlando	$0	$500,770	$0	$144,000	$0	$88,525	$0	$84,281	$0	$38,540	$0	$856,116	$0	$62,242
Thompson Michael J
CEO Central FL South Integrated Hlth	$0	$511,178	$0	$141,654	$0	$47,296	$0	$86,885	$0	$42,406	$0	$829,419	$0	$27,170
Hagensicker Janice K
Former Key Emp/Sr Fin Off AH Orl SW	$0	$438,208	$0	$131,315	$0	$202,284	$0	$15,087	$0	$23,095	$0	$809,989	$0	$0
Owen Terry R
Former Key Emp/SVP Partnering Strate	$0	$463,085	$0	$138,851	$0	$109,794	$0	$66,669	$0	$30,854	$0	$809,253	$0	$53,601
Reed MD Monica P
Former Key Employee	$0	$20,002	$0	$0	$0	$704,578	$0	$982	$0	$33,437	$0	$758,999	$0	$148,059
Cook Timothy W
CEO AH Alt & West Orange Mkt	$0	$413,078	$0	$114,829	$0	$145,655	$0	$43,329	$0	$34,375	$0	$751,266	$0	$16,695
Spenst Brett
CEO AH Orlando (Beg 3/19)	$0	$444,232	$0	$0	$200	$194,321	$0	$81,070	$0	$19,801	$200	$739,424	$0	$0
Harcombe Douglas W
CEO AH Celebration & South Mkt	$0	$430,440	$0	$104,106	$0	$72,837	$0	$66,676	$0	$40,669	$0	$714,728	$0	$49,165
Zbaraschuk Amy L
Sr VP/Sr Finance Off CF S Integrated	$0	$421,829	$0	$123,000	$25	$56,621	$0	$64,521	$0	$38,520	$25	$704,491	$0	$46,491
Dodds Sheryl D
Chief People Off Central FL South	$0	$408,166	$0	$120,139	$0	$101,927	$0	$15,087	$0	$11,773	$0	$657,092	$0	$0
Wandersleben Jennifer J
CEO CF S Acute/AH Orl/Women (Beg 12/	$0	$355,713	$0	$87,087	$0	$66,465	$0	$47,971	$0	$39,212	$0	$596,448	$0	$60,227
Paradis J Brian
Former Key Employee	$0	$0	$0	$0	$0	$331,644	$0	$0	$0	$13,889	$0	$345,533	$0	$0
Bradley Kenneth W
Former Key Emp/AH Dir Emerging Leade	$0	$153,462	$0	$0	$0	$60,542	$0	$6,442	$0	$21,303	$0	$241,749	$0	$54,483
Jernigan PhD Donald L
Dir/AH CEO Emeritus/Leadership Inst	$0	$180,001	$0	$0	$0	$407	$0	$0	$0	$22,322	$0	$202,730	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 1a	The filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 47 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 for AdventHealth Central Florida Division, Central Florida Divisional CFO, Central Florida CEO of Integrated Health Services, and CEO of AdventHealth Central Florida South are officers or key employees of the filing organization. The Divisional CEO, Divisional CFO, CEO of Integrated Health Services and CEO of AdventHealth Cental Florida South 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 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 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: Nominal discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth CFO Conference or the CMO/CNO business meeting ($300 or less per executive). Payments provided to each executive are considered taxable compensation to the executive. 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 recommended by the CEO of the AdventHealth hospital organization and approved by the Chairman of the Board of Directors of the organization. In addition, the proposed membership must be approved annually by the AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Eligible executives are limited to certain senior level executives (hospital organization CEOs, the CEO of the nursing home region of AdventHealth, senior vice presidents at three large hospital organizations, regional CEOs and CFOs and the president and senior vice presidents of AHSSHC). In the current year, for this filing organization, one executive was eligible to receive reimbursement for club fees. Each AdventHealth executive who is approved for a club membership must submit an annual report to the AHSSHC Board Compensation Committee that describes how the membership benefited their organization during the preceding year. While the club dues membership is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and reimbursed 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 paid for the cost of providing this benefit.
Part I, Line 3	The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives of the community, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present. 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, 2019, Monica P. Reed, MD and J. Brian Paradis received severance payments in the amount of $500,054 and $332,173, 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. 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 a healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides to eligible executives participation in the AdventHealth Executive FLEX Benefit Program (the Plan). The purpose of the Plan is to offer eligible executives an opportunity to elect 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 Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which is deducted the cost of mandatory and elective employee benefits. The pre-determined benefits allowance credit percentage is approved by the AHSSHC Board Compensation Committee, an independent committee of the Board of Directors of AHSSHC. Any funds that remain after the cost of mandatory and elective benefits are subtracted from the annual pre-determined benefits allowance are contributed, at the employee's option, 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 documents define an employee who is eligible to participate in the Plan to generally include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary is at least $260,000. 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 is forfeited by the executive upon a voluntary separation. In addition to the Plan, AdventHealth has instituted 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. Participation in the plan is offered to AdventHealth executives 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) 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 the SERP and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. Additionally, AdventHealth has adopted a Senior Executive Death Benefit (SEDB) Plan in recognition of the considerable age and service requirements in the SERP. The SEDB Plan provides a benefit in an amount equal to the amount the executive's benefit would have been under the SERP 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 Plan with present value recognizing an early benefit commencement. 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 of the eligibility requirements of SERP as of the executive's date of death but would have satisfied all of those requirements within five (5) years following death had the executive lived and continued employment. The SEDB Plan was reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. Flex Plan Flex Plan/ SERP 457(b) CY CY Employer CY Contrib./ Distr.* Contrib. Distr.* Payment ------------------------------------------------------------------------ Shaw, Terry D. $384,304 $315,408 $1,407,121 $ 0 Houmann, Lars D. $255,491 $255,039 $ 487,733 $ 0 Tol, Daryl $243,179 $177,443 $ 0 $ 0 Rathbun, Paul C. $193,409 $178,953 $ 0 $ 0 Stevens, Eric A. $116,763 $ 76,400 $ 411,272 $ 0 Soler, Eddie $143,711 $137,666 $ 123,038 $ 0 Banks, David P. $120,374 $110,230 $ 175,905 $ 0 Goodman, Todd A. $113,417 $ 72,930 $ 320,312 $ 0 Moorhead, MD, John David $138,807 $119,807 $ 245,414 $ 0 Hilliard, Douglas W. $ 69,194 $ 63,315 $ 0 $ 0 Thompson, Michael J. $ 71,799 $ 27,839 $ 0 $ 0 Hagensicker, Janice K. $ 64,355 $ 45,355 $ 95,731 $ 0 Owen, Terry R. $ 70,582 $ 55,018 $ 0 $ 0 Reed, MD, Monica P. $ 982 $151,553 $ 0 $ 0 Cook, Timothy W. $ 47,243 $ 16,788 $ 80,104 $ 0 Spenst, Brett $ 65,984 $ 0 $ 0 $ 0 Harcombe, Douglas W. $ 51,589 $ 50,337 $ 0 $ 0 Zbaraschuk, Amy L. $ 49,434 $ 47,436 $ 0 $ 0 Dodds, Sheryl D. $ 68,083 $ 49,083 $ 0 $ 0 Wandersleben, Jennifer J. $ 32,884 $ 61,526 $ 0 $ 0 Bradley, Kenneth W. $ 0 $ 56,173 $ 0 $ 0 * Including Investment Earnings

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
Highlands County Health Facilities Authority
A	521313569	431022KK7	2007-08-08	$366,445,000	2007A B C D, Expand/refurbish facilities, purchase equipment	0	0	0
Orange County Health Facilities Authority
B	521378595	NoneAvail	2010-12-22	$25,000,000	2010B, Expand/refurbish facilities, purchase equipment	0	0	0
Kansas Development Finance Authority
C	481066589	NoneAvail	2010-12-22	$25,000,000	2010C, Expand/refurbish facilities, purchase equipment	0	0	0
Colorado Health Facilities Authority
D	840752932	NoneAvail	2010-12-22	$25,000,000	2010D, Expand/refurbish facilities, purchase equipment	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Credit EnhancementCreditEnhancementAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$262,025,000	$372,572,414	$5,560,382	$367,012,032	2007	Yes (1)	Yes (1)
B	$8,000,000	$25,008,422		$25,008,422	2010	Yes (1)	Yes (1)
C	$8,000,000	$25,007,891		$25,007,891	2010	Yes (1)	Yes (1)
D	$8,000,000	$25,008,355		$25,008,355	2010	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.01420	0.01420	Yes (1)
B	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)			Yes (1)
C	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)			Yes (1)
D	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)			Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
Highlands County Health Facilities Authority
A	521313569	NoneAvail	2011-11-16	$80,000,000	2011A, Expand/refurbish facilities	0	0	0
Highlands County Health Facilities Authority
B	521313569	NoneAvail	2012-03-21	$294,985,000	2012A, AR Program - Refund 2009 A-F AR Program	0	0	0
Highlands County Health Facilities Authority
C	521313569	NoneAvail	2012-07-25	$115,015,000	2012B, AR Program - Expand/refurbish facilities, purchase equipment	0	0	0
Kansas Development Finance Authority
D	481066589	48542ADG3	2012-08-29	$310,952,245	2012A - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt
A	$1,500,000	$80,000,000	$80,000,000	2011	0	Yes (1)	Yes (1)
B	$90,000,000	$294,985,000		2004	Yes (1)	Yes (1)	Yes (1)	$294,985,000
C		$115,015,000	$115,015,000	2012	0	Yes (1)	Yes (1)
D		$310,952,245		2008	Yes (1)	Yes (1)	Yes (1)	$310,952,245

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct
A	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0	Yes (1)
B	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00140	0
C	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00140	0
D	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00370	0	0.00500	0.00500

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
Highlands County Health Facilities Authority
A	521313569	431022TL6	2012-08-29	$348,320,000	2012B-F - Refund Or-1995; H-02,03C,05H,06B,07B,07D,08A; C-2004B; K-2004C	0	0	0
Highlands County Health Facilities Authority
B	521313569	NoneAvail	2012-08-29	$125,000,000	2012G&H - Refund Highlands 2005I Conversion Bonds	0	0	0
Highlands County Health Facilities Authority
C	521313569	431022TR3	2012-11-08	$232,125,000	2012I - Refunded Volusia 1994-A; Highlands 2004A, 2005E, 2005F, 2005G	0	0	0
Highlands County Health Facilities Authority
D	521313569	NoneAvail	2013-09-18	$485,000,000	2013A B C, Expand/refurbish facilities, purchase equipment	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capital ExpendituresCapitalExpendituresAmt
A	$150,635,000	$348,320,000	$348,320,000	2008	Yes (1)	Yes (1)	Yes (1)
B		$125,000,000	$125,000,000	2005	Yes (1)	Yes (1)	Yes (1)
C	$10,455,000	$232,125,000	$232,125,000	2005	Yes (1)	Yes (1)	Yes (1)
D	$281,610,000	$485,340,528		2013	0	Yes (1)	Yes (1)	$485,340,528

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00500	0.00500	Yes (1)	0.00370	0	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00900	0.00900	0			Yes (1)
C	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00200	0.00200	0			Yes (1)
D	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)			0			Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
Highlands County Health Facilities Authority
A	521313569	NoneAvail	2014-07-02	$110,000,000	2014A&D, Refund 2013C, expand/refurbish facilities, purchase equipment	0	0	0
Orange County Health Facilities Authority
B	521378595	NoneAvail	2014-07-02	$50,000,000	2014B, Expand/refurbish facilities, purchase equipment	0	0	0
Kansas Development Finance Authority
C	481066589	NoneAvail	2014-07-02	$30,000,000	2014C, Expand/refurbish facilities, purchase equipment	0	0	0
Colorado Health Facilities Authority
D	840752932	19648AT39	2014-07-23	$82,501,800	2014E, Expand/refurbish facilities, purchase equipment	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$28,248,337	$110,068,380	$50,068,380	$60,000,000	2015	Yes (1)	Yes (1)	Yes (1)
B	$18,333,337	$50,068,380	$50,068,380		2015	0	Yes (1)	Yes (1)
C	$11,000,000	$30,041,050	$30,041,050		2015	0	Yes (1)	Yes (1)
D		$82,616,012	$82,616,012		2015	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00090	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00080	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00080	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00110	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
Colorado Health Facilities Authority
A	840752932	19648FAB0	2016-07-21	$235,724,616	2016 A&B, Adv ref portion 2009D, Exp/refurbish facilities, purchase equip	0	0	0
Colorado Health Facilities Authority
B	840752932	1964745K2	2016-08-17	$216,517,920	2016C, Refund 2006C, Expand/refurbish facilities, purchase equipment	0	0	0
Orange County Health Facilities Authority
C	521378595	NoneAvail	2017-07-26	$44,750,000	2017A, Refund 2010A&E, Expand/refurbish facilities, purchase equipment	0	0	0
Highlands County Health Facilities Authority
D	521313569	NoneAvail	2017-07-26	$50,750,000	2017B, Refund 2010A&E, Expand/refurbish facilities, purchase equipment	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	RetiredRetiredAmt
A	$235,724,616	$169,561,866	$66,162,750	2016	0	Yes (1)	Yes (1)	Yes (1)
B	$216,517,920	$63,248,816	$153,269,104	2016	Yes (1)	0	Yes (1)	Yes (1)
C	$44,750,000	$1,125,787	$43,624,213	2017	Yes (1)	0	Yes (1)	Yes (1)	$3,750,000
D	$50,750,000	$1,276,730	$49,473,270	2017	Yes (1)	0	Yes (1)	Yes (1)	$3,750,000

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct
A	0	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00250	0.00070	0.00320
C	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)	0	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
Kansas Development Finance Authority
A	481066589	NoneAvail	2017-07-26	$45,250,000	2017C, Refund 2010A&E, Expand/refurbish facilities, purchase equipment	0	0	0
Colorado Health Facilities Authority
B	840752932	19648FCN2	2017-07-26	$97,750,000	2017D, Refund 2010A&E, Expand/refurbish facilities, purchase equipment	0	0	0
Colorado Health Facilities Authority
C	840752932	19648FGN8	2018-07-12	$375,008,542	2018A&B, Expand/refurbish facilities, purchase equipment	0	0	0
Colorado Health Facilities Authority
D	840752932	19648FJG0	2019-08-20	$550,011,892	2019A&B, Refund 05I, 09C, 09D, 09E&08B, 13B; expand/refurb fac, purch equip	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$3,750,000	$45,250,000	$1,138,365	$44,111,635	2017	Yes (1)	0	Yes (1)	Yes (1)
B	$11,250,000	$97,750,000	$2,459,118	$95,290,882	2017	Yes (1)	0	Yes (1)	Yes (1)
C		$375,008,542	$375,008,542		2018	0	Yes (1)	Yes (1)	Yes (1)
D		$550,011,892	$146,365,717	$403,646,175	2019	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct
A	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	0.00840	0.00840

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (10 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Kirsten Cutler
Family of board member	$58,733	Employee Compensation	0
Shelby Houmann
Family of board member	$40,451	Employee Compensation	0
Clifton Scott
Family of board member	$173,707	Employee Compensation	0
Jeanette Vasquez
Family of former key employee	$39,562	Employee Compensation	0
Sean Lemon
Family of former key employee	$191,186	Employee Compensation	0
Mary Rathbun
Family of board member and officer	$84,297	Employee Compensation	0
Karen Tilstra
Family of former key employee	$122,026	Consulting	0
Meredith Banks
Family of former key employee	$107,401	Employee Compensation	0
Darlene Stevens
Family of key employee	$56,058	Employee Compensation	0
Martin Thompson
Family of key employee	$151,454	Employee Compensation	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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. During 2019, some of the filing organization's hospitals transitioned their A/P function to AHSSHC. Accordingly, the number entered on line 1a represents the number reported on Box 3 of Form 1096 as filed by the filing organization for 2019. Subsequent to the transition of the A/P function for all hospitals to the AHSSHC shared service center, the filing organization will not enter any amount on Part V, line 1a. As a result of this transition, those hospitals no longer issue Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041.
Form 990, Part VI, Section A, line 2	Lars Houmann and Terry Owen - Family Relationship
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, Lines 7a(i) and 7c(i) of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program.
Form 990, Part IX, line 11g	Payments to Healthcare Professionals: Program service expenses 244,389,626. Management and general expenses 0. Fundraising expenses 0. Total expenses 244,389,626. Professional Fees: Program service expenses 150,374,347. Management and general expenses 0. Fundraising expenses 0. Total expenses 150,374,347. Purchased Medical Services: Program service expenses 17,531,009. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,531,009. Environmental Services: Program service expenses 1,411,924. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,411,924. Transcription Services: Program service expenses 254,185. Management and general expenses 0. Fundraising expenses 0. Total expenses 254,185. Recruiting: Program service expenses 1,912,670. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,912,670. Food Service Contracts: Program service expenses 1,768,299. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,768,299. Miscellaneous Purchased Services: Program service expenses 8,000,492. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,000,492. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 47,611,043. Fundraising expenses 0. Total expenses 47,611,043. Billing & Collection Services: Program service expenses 0. Management and general expenses 26,490,604. Fundraising expenses 0. Total expenses 26,490,604. AdventHealth Shared Services Fee: Program service expenses 0. Management and general expenses 2,926,826. Fundraising expenses 0. Total expenses 2,926,826.
Part X, Line 2	The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value.
Form 990, Part XI, line 9:	Transfer to tax-exempt affiliates -261,878,273. Transfer from tax-exempt parent 142,661,465. Debt costs allocated to tax-exempt affiliates 4,367,201. Transfer for expenses -199,239. Gifts 7,230,821. ASC 842 Lease Accounting Adjustments -1,219,548. Other 311,436.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	IQ Orlando LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	235 E Princeton Street Suite 220	AddressLine1Txt
City	Orlando	CityNm
State Abbreviation	FL	StateAbbreviationCd
ZIP	328045555	ZIPCd

Field	Value	IRS element (for citing)
EIN	471121247	EIN
Primary Activities	Design and innovation	PrimaryActivitiesTxt
Legal Domicile State	FL	LegalDomicileStateCd
Total Income	$0	TotalIncomeAmt
End Of Year Assets	$216,381	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Adventist Hlth SystemSunbelt Inc	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (111 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
AdventHealth Family Medicine Rural Health Clinics Inc fka Hospice of the C
187 PR 4060	Lampasas	TX	76550	271858033	Operation of Rural Health Clinics & Medical Services	FL	501(c)(3)	Line 3	Metroplex Adventist Hospital Inc	Yes (1)
AdventHealth 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	Yes (1)
AdventHealth Home Care East Florida LLC (218-123119)
770 West Granada Blvd 319	Ormond Beach	FL	32174	833768458	Inactive	FL	501(c)(3)	Line 12a, I	Memorial Hlth Systems Inc	Yes (1)
AdventHealth Hospice Care East Florida Inc (218-123119)
770 West Granada Blvd 304	Ormond Beach	FL	32174	833748461	Inactive	FL	501(c)(3)	Line 12a, I	Memorial Hlth Systems Inc	Yes (1)
AdventHealth North Polk Inc fka University Community Hospital Specialty Ca
3100 E Fletcher Ave	Tampa	FL	33613	593231322	Inactive	FL	501(c)(3)	Line 12a, I	University Community Hospital Inc	Yes (1)
AdventHealth Osceola South Inc (416-123119)
900 Hope Way	Altamonte Springs	FL	32714	841817046	Inactive	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
AdventHealth Polk North Inc (418-123119)
40100 US Highway 27 N	Davenport	FL	33837	841793121	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
AdventHealth Polk South Inc (415-123119)
410 South 11th Street	Lake Wales	FL	33853	834672945	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
AdventHealth Ransom Memorial Inc
1301 S Main Street	Ottawa	KS	66067	830976641	Operation of Hospital & Related Services	KS	501(c)(3)	Line 3	Adventist Hlth Mid-America Inc	Yes (1)
AdventHealth University Inc
671 Lake Winyah Drive	Orlando	FL	32803	593069793	Education/Operation of School	FL	501(c)(3)	Line 2	Adventist Hlth SystemSunbelt Inc	Yes (1)
AdventHealth West FL Ambulatory Svcs Inc fka West FL Hlth Inc
14055 Riveredge Drive	Tampa	FL	33637	471881744	Inactive	FL	501(c)(3)	Line 10	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
AdventHealth West Florida Imaging Inc (924-123119)
14055 Riveredge Drive Ste 250	Tampa	FL	33637	843225135	Imaging & Testing	FL	501(c)(3)	Line 12a, I	AdventHealth West Florida Ambulatory Services Inc	Yes (1)
Adventist Bolingbrook Hospital
500 Remington Blvd	Bolingbrook	IL	60440	651219504	Operation of Hospital & Related Services	IL	501(c)(3)	Line 3	Adventist Midwest Health	Yes (1)
Adventist Care Centers - Courtland Inc
730 Courtland Street	Orlando	FL	32804	205774723	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Adventist GlenOaks Hospital
701 Winthrop Avenue	Glendale Heights	IL	60139	363208390	Operation of Hospital & Related Services	IL	501(c)(3)	Line 3	Adventist Midwest Health	Yes (1)
Adventist 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	Yes (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	Yes (1)
Adventist Hlth System Sunbelt Hlthcare Corp
900 Hope Way	Altamonte Springs	FL	32714	592170012	Management Services	FL	501(c)(3)	Line 12a, I		0	N/A
Adventist Hlth System Georgia Inc
1035 Red Bud Road	Calhoun	GA	30701	581425000	Operation of Hospital & Related Services	GA	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Adventist Hlth 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	Yes (1)
Adventist Hlth SystemTexas Inc
11801 S Freeway	Burleson	TX	76028	742578952	Leasing Personnel to Affiliated Hospital	TX	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Adventist Midwest Health
120 North Oak Street	Hinsdale	IL	60521	362276984	Operation of Hospital & Related Services	IL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes (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	Yes (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	Yes (1)
AHSCentral Texas Inc
1301 Wonder World Drive	San Marcos	TX	78666	742621825	Provide Office Space - Medical Professionals	TX	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (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	Yes (1)
Battle Creek Adventist Hospital
900 Hope Way	Altamonte Springs	FL	32714	381359189	Inactive	MI	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes (1)
Bert Fish Medical Center Auxiliary Inc
401 Palmetto Street	New Smyrna Beach	FL	32168	591054892	Volunteer support services	FL	501(c)(3)	Line 10		0	N/A
Bolingbrook Hospital Foundation (1119-62119)
500 Remington Blvd	Bolingbrook	IL	60440	900494445	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation	0
Bradford Heights Hlth & Rehab Center Inc
950 Highpoint Drive	Hopkinsville	KY	42240	205782342	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Burleson Nursing & Rehab Center Inc
301 Huguley Blvd	Burleson	TX	76028	205782243	Operation of Home for the Aged/Hlthcare Delivery	TX	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Caldwell Hlth Care Properties Inc
1333 West Main	Princeton	KY	42445	510605680	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
Central Texas Hlthcare Collaborative
1301 Wonder World Drive	San Marcos	TX	78666	453739929	Support Operation of Hospital	TX	501(c)(3)	Line 12a, I	Adventist Hlth SystemSunbelt Inc	Yes (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	Yes (1)
Chippewa Valley Hospital & Oakview Care Center Inc
1220 Third Avenue West	Durand	WI	54736	391365168	Operation of Hospital & Related Services	WI	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes (1)
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	Yes (1)
Creekwood Place Nursing & Rehab Center Inc
107 Boyles Drive	Russellville	KY	42276	205782260	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (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	Yes (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	Yes (1)
Emory-Adventist Inc
900 Hope Way	Altamonte Springs	FL	32714	582171011	Inactive	GA	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes (1)
Fletcher Hospital Inc
100 Hospital Drive	Hendersonville	NC	28792	560543246	Operation of Hospital & Related Svcs	NC	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
FLNC Inc
3355 E Semoran Blvd	Apopka	FL	32703	205774761	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Florida Hospital Dade City Inc
13100 Fort King Road	Dade City	FL	33525	822567308	Operation of Hospital & Related Svcs	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Florida Hospital Healthcare Partners Inc
770 West Granada Blvd 101	Ormond Beach	FL	32174	462354804	Operation of Physician Practices & Medical Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes (1)
Florida Hospital Medical Group Inc
2600 Westhall Lane 4th Floor	Maitland	FL	32751	593214635	Operation of Physician Practices & Medical Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes (1)
Florida Hospital Ocala Inc
1500 SW 1st Avenue	Ocala	FL	34471	824372339	Operation of Hospital & Related Svcs	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Florida Hospital Physician Group Inc
12470 Telecom Dr 100	Tampa	FL	33637	462021581	Operation of Physician Practices & Medical Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Florida Hospital Waterman Inc
1000 Waterman Way	Tavares	FL	32778	593140669	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Florida Hospital Zephyrhills Inc
7050 Gall Blvd	Zephyrhills	FL	33541	592108057	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth SystemSunbelt Inc	Yes (1)
Florida Radiology Imaging at Lake Mary LLC
2600 Westhall Lane 4th Floor	Maitland	FL	32751	550789387	Imaging & Testing	FL	501(c)(3)	Line 3	Florida Hospital Medical Group Inc	Yes (1)
Fountain Inn Nursing & Rehab Center Inc
485 North Keller Road 250	Maitland	FL	32751	472180518	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
GlenOaks Hospital Foundation (11-62119)
701 Winthrop Avenue	Glendale Heights	IL	60139	363926044	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation	0
Helen Ellis Memorial Hospital Auxiliary Inc
1395 S Pinellas Ave	Tarpon Springs	FL	34689	592106043	Fund-raising for Tax-exempt hospital/foundation	FL	501(c)(3)	Line 12c, III-FI		0	N/A
Helen Ellis Memorial Hospital Foundation Inc
1395 S Pinellas Ave	Tarpon Springs	FL	34689	593690149	Fund-raising for Tax-exempt hospital	FL	501(c)(3)	Line 7		0	N/A
Hinsdale Hospital Foundation
120 North Oak Street	Hinsdale	IL	60521	521466387	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation	0
Hospice of the Comforter Inc
480 W Central Parkway	Altamonte Springs	FL	32714	592935928	Operation of Hospice	FL	501(c)(3)	Line 10	The Comforter Health Care Group Inc	Yes (1)
In-Motion Rehab Inc
485 North Keller Road 250	Maitland	FL	32751	208023411	Therapy services to tax exempt nursing homes	KS	501(c)(3)	Line 12b, II	Sunbelt Hlth Care Centers Inc	Yes (1)
La Grange Memorial Hospital Foundation (11-62119)
5101 S Willow Springs Rd	La Grange	IL	60525	300247776	Fund-raising for Tax-exempt hospital	IL	501(c)(3)	Line 7	Midwest Hlth Foundation	0
Lake County Health Care Properties Inc
485 North Keller Road 250	Maitland	FL	32751	813923985	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
Memorial 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		0	N/A
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	Yes (1)
Memorial Hospital - West Volusia Inc
701 West Plymouth Avenue	Deland	FL	32720	593256803	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Memorial Hlth Systems Inc	Yes (1)
Memorial Hospital Flagler Inc
60 Memorial Medical Parkway	Palm Coast	FL	32164	592951990	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Memorial Hlth Systems Inc	Yes (1)
Memorial Hospital Inc
210 Marie Langdon Drive	Manchester	KY	40962	610594620	Operation of Hospital & Related Services	KY	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Merriam Hlth Care Properties Inc
9700 West 62nd Street	Merriam	KS	66203	364595806	Lease to Related Organization	KS	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
Metroplex Adventist Hospital Inc
2201 S Clear Creek Road	Killeen	TX	76549	742225672	Operation of Hospital & Related Services	TX	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Metroplex Clinic Physicians Inc
2201 S Clear Creek Road	Killeen	TX	76549	113762050	Physician Hlthcare services to the community	TX	501(c)(3)	Line 3	Metroplex Adventist Hospital Inc	Yes (1)
Midwest Hlth Foundation
120 North Oak Street	Hinsdale	IL	60521	352230515	Support of subsidiary foundations	IL	501(c)(3)	Line 12b, II		0	N/A
Mills Hlth & Rehab Center Inc
500 Beck Lane	Mayfield	KY	42066	205782320	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Mission Strategies of Georgia Inc
485 North Keller Road 250	Maitland	FL	32751	900866024	Provision of support to the nursing home division	GA	501(c)(3)	Line 12b, II	Sunbelt Hlth Care Centers Inc	Yes (1)
Missouri Adventist Hlth 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	Yes (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		0	N/A
Osceola Health Care Properties Inc
485 North Keller Road 250	Maitland	FL	32751	813165729	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
Overland Park Nursing & Rehab Center Inc
6501 West 75th Street	Overland Park	KS	66204	205774821	Operation of Home for the Aged/Hlthcare Delivery	KS	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Paragon Hlth Care Properties Inc
950 Highpoint Drive	Hopkinsville	KY	42240	510605686	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
Pasco-Pinellas Hillsborough Community Hlth System Inc
2600 Bruce B Downs Blvd	Wesley Chapel	FL	33544	208488713	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Portercare Adventist Hlth System (630 Year End)
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	Yes (1)
Princeton Hlth & Rehab Center Inc
1333 West Main	Princeton	KY	42445	205782272	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Princeton Professional Services Inc
601 E Rollins Street	Orlando	FL	32803	591191045	Provision of Hlthcare Services	FL	501(c)(3)	Line 10	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (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	Yes (1)
Resource Personnel Inc
485 North Keller Road 250	Maitland	FL	32751	208040875	Provide administrative support to tax exempt nursing homes	FL	501(c)(3)	Line 12b, II	Sunbelt Hlth Care Centers Inc	Yes (1)
Rocky Mountain Adventist Hlthcare Foundation (630 Year End)
7995 E Prentice Ave 204	Greenwood Village	CO	80111	840745018	Fund-raising for Tax-exempt hospital	CO	501(c)(3)	Line 7		0	N/A
Rollins Brook Community Care Corp
2201 S Clear Creek Road	Killeen	TX	76549	461656773	Support Operation of Hospital	TX	501(c)(3)	Line 12a, I	Adventist Hlth SystemSunbelt Inc	Yes (1)
Russellville Hlth Care Properties Inc
683 East Third Street	Russellville	KY	42276	510605691	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (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	Yes (1)
San Marcos Nursing & Rehab Center Inc
1900 Medical Parkway	San Marcos	TX	78666	205782224	Operation of Home for the Aged/Hlthcare Delivery	TX	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Shawnee Mission Hlth Care Inc
6501 West 75th Street	Overland Park	KS	66204	480952508	Lease to Related Organization	KS	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
Shawnee Mission Hlth Care Properties Inc
485 North Keller Road 250	Maitland	FL	32751	813914908	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
Shawnee Mission Medical Center Inc
9100 W 74th Street	Shawnee Mission	KS	66204	480637331	Operation of Hospital & Related Services	KS	501(c)(3)	Line 3	Adventist Hlth Mid-America Inc	Yes (1)
South Pasco 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	Yes (1)
Southeast Volusia Healthcare Corp
401 Palmetto Street	New Smyrna Beach	FL	32168	473793197	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Southwest Volusia 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	Yes (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	Yes (1)
Specialty Physicians of Central Texas Inc
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	Yes (1)
Spring View Hlth & Rehab Center Inc
718 Goodwin Lane	Leitchfield	KY	42754	205782288	Operation of Home for the Aged/Hlthcare Delivery	KY	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (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	Yes (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	Yes (1)
SunSystem Development Corp
900 Hope Way	Altamonte Springs	FL	32714	592219301	Fund Raising for Affiliated Tax-Exempt Hospitals	FL	501(c)(3)	Line 7	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (1)
Tarpon Springs Hospital Foundation Inc
1395 S Pinellas Ave	Tarpon Springs	FL	34689	590898901	Operation of Hospital & Related Services	FL	501(c)(3)	Line 3	University Community Hospital Inc	Yes (1)
Tarrant County 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	Yes (1)
Taylor Creek Hlth Care Properties Inc
718 Goodwin Lane	Leitchfield	KY	42754	510605678	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (1)
The Comforter Health Care Group Inc
605 Montgomery Road	Altamonte Springs	FL	32714	271857940	Lease to Related Organization	FL	501(c)(3)	Line 12c, III-FI	Adventist Hlth System Sunbelt Hlthcare Corp	Yes (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		0	N/A
Tri-County Nursing and Rehab Center Inc
485 North Keller Road 250	Maitland	FL	32751	472219363	Operation of Home for the Aged/Hlthcare Delivery	FL	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
Trinity Nursing & Rehab Center Inc
9700 West 62nd Street	Merriam	KS	66203	205774890	Operation of Home for the Aged/Hlthcare Delivery	KS	501(c)(3)	Line 10	Sunbelt Hlth Care Centers Inc	Yes (1)
University Community Hospital Foundation Inc
3100 E Fletcher Ave	Tampa	FL	33613	592554889	Fund-raising for Tax-exempt hospital	FL	501(c)(3)	Line 12a, I		0	N/A
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	Yes (1)
West Florida Health Home Care Inc
13601 Bruce B Downs Blvd Ste 110	Tampa	FL	33613	593686109	Home Health Services	GA	501(c)(3)	Line 10	West Florida Health Inc	Yes (1)
West Kentucky Hlth Care Properties Inc
500 Beck Lane	Mayfield	KY	42066	510605676	Lease to Related Organization	GA	501(c)(3)	Line 12c, III-FI	Sunbelt Hlth Care Centers Inc	Yes (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	Yes (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	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
Clear Creek MOB Ltd (1119-3519)
2201 S Clear Creek Rd	Killeen	TX	76549	742609195	Real Estate	TX	N/A
Florida Hospital DMERT LLC
500 Winderley Place Ste 324	Maitland	FL	32751	202392253	Medical Equipment	FL	N/A
Florida Hospital Home Infusion LLP
500 Winderley Place Ste 226	Maitland	FL	32751	593142824	Home Infusion Services	FL	N/A
Heart of Florida Surgery Center LLC
410 Lionel Way 100	Davenport	FL	33837	812235296	Surgery Center	DE	N/A
Functional Neurosurgical Ambulatory Surgery Ctr LLC
11 W Dry Creek Circle 120	Littleton	CO	80120	464426708	Surgery Center	CO	N/A
PAHS OnPoint Urgent Care LLC (382019 - 12312019)
9100 E Mineral Circle	Centennial	CO	80112	832465331	Urgent Care Center	CO	N/A
Princeton Homecare Services LLC
1050 Forrer Blvd	Kettering	OH	45420	814196648	Operation of Home Health Agency	FL	N/A
San Marcos MRI LP
1330 Wonder World Dr Ste 202	San Marcos	TX	78666	770597972	Imaging & Testing	TX		Adventist Hlth SystemSunbelt Inc	Related	-$117,798	$425,953	0	0	0.60000
The Bariatric Center of Kansas City LLC
9100 W 74th Street	Merriam	KS	66204	823025378	Surgery Center	KS	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (20 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
Altamonte Medical Plaza Condominium Association Inc
601 East Rollins Street	Orlando	FL	32803	592855792	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	$143,184	$638,801	0.64080	Yes (1)
Apopka Medical Plaza Condominium Association Inc
601 East Rollins Street	Orlando	FL	32803	593000857	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	$31,082	$51,724	1.00000	Yes (1)
CC MOB Inc
2201 S Clear Creek Road	Killeen	TX	76549	742616875	Real Estate Rental	TX		C				Yes (1)	N/A
Central Texas Medical Associates
1301 Wonder World Drive	San Marcos	TX	78666	742729873	Inactive	TX	Adventist Hlth SystemSunbelt Inc	C			1.00000	Yes (1)
Central Texas Providers Network
1301 Wonder World Drive	San Marcos	TX	78666	742827652	Physician Hospital Org.	TX	Adventist Hlth SystemSunbelt Inc	C	$102,648	$296,837	1.00000	Yes (1)
Florida Hospital Flagler Medical Offices Association Inc
60 Memorial Medical Parkway	Palm Coast	FL	32164	262158309	Condo Association	FL		C				Yes (1)	N/A
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	Yes (1)
Florida Hospital Healthcare System Inc
101 Southhall Lane Ste 150	Maitland	FL	32751	593215680	PHSO	FL	Adventist Hlth SystemSunbelt Inc	C	$14,502,341	$36,670,959	1.00000	Yes (1)
Florida Medical Plaza Condominium Association Inc
601 East Rollins Street	Orlando	FL	32803	592855791	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	$707,623	$5,006,720	0.85000	Yes (1)
Florida Memorial Health Network Inc (11 - 102419)
770 W Granada Blvd Ste 317	Ormond Beach	FL	32174	593403558	Physician Hospital Org.	FL		C				Yes (1)	N/A
Kissimmee Multispecialty Clinic Condominium Association Inc
201 Hilda Street Suite 30	Kissimmee	FL	34741	593539564	Condo Association	FL	Adventist Hlth SystemSunbelt Inc	C	$58,151	$122,271	0.54400	Yes (1)
LN Health Partners Inc
550 E Rollins Street 6th Floor	Orlando	FL	32803	813556903	Inactive	FL		C				Yes (1)	N/A
Midwest Management Services Inc
9100 West 74th Street	Shawnee Mission	KS	66204	480901551	Inactive	KS		C				Yes (1)	N/A
North American Health Services Inc & Sub
900 Hope Way	Altamonte Springs	FL	32714	621041820	Lessor/Holding Co.	TN		C				Yes (1)	N/A
Ormond Prof Associates Condo Assoc'n Inc (430 year end)
770 W Granada Blvd Ste 101	Ormond Beach	FL	32174	592694434	Condo Association	FL		C				Yes (1)	N/A
Park Ridge Property Owner's Association Inc
1 Park Place Naples Road	Fletcher	NC	28732	030380531	Condo Association	NC		C				Yes (1)	N/A
Porter Affiliated Health Services Inc
2525 S Downing Street	Denver	CO	80210	840956175	Healthcare Services	CO		C				Yes (1)	N/A
San Marcos Regional MRI Inc
1301 Wonder World Drive	San Marcos	TX	78666	770597968	Holding Company	TX	Adventist Hlth SystemSunbelt Inc	C	$3	$13,188	1.00000	Yes (1)
The Garden Retirement Community Inc
485 North Keller Road Ste 250	Maitland	FL	32751	593414055	Real Estate Rental	FL		C				Yes (1)	N/A
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	$120,423	$138,839	0.51600	Yes (1)

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

Transactions Related Org TransactionsRelatedOrgGrp (88 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
AdventHealth Polk North Inc
P	$940,100	Cost
AdventHealth Polk North Inc
Q	$102,742	Cost
AdventHealth Polk North Inc
R	$175,498,409	Actual Amount Given
AdventHealth Polk South Inc
P	$194,209	Cost
AdventHealth Polk South Inc
R	$48,002,887	Actual Amount Given
AdventHealth Polk South Inc
Q	$904,358	Cost
AdventHealth University Inc
A	$3,233,895	FMV
AdventHealth University Inc
Q	$21,036,284	Cost
AdventHealth University Inc
B	$5,709,494	Actual Amount Given
AdventHealth West Florida Ambulatory Services Inc
R	$374,218	Actual Amount Given
AdventHealth West Florida Imaging Inc
R	$111,636	Actual Amount Given
Adventist Care Centers - Courtland Inc
B	$1,150,670	Actual Amount Given
Adventist Health System Sunbelt Healthcare Corporation
A	$940,199	FMV
Adventist Health System Sunbelt Healthcare Corporation
B	$48,161,679	Actual Amount Given
Adventist Health System Sunbelt Healthcare Corporation
C	$2,422,187	Actual Amount Received
Adventist Health System Sunbelt Healthcare Corporation
M	$36,706,615	% of Facility's Operating Exp
Adventist Health System Sunbelt Healthcare Corporation - Shared Services
M	$10,873,385	% of Facility's Operating Exp
Adventist Health System Sunbelt Healthcare Corporation dba AIT
M	$143,373,429	% of Facility's Operating Exp
Adventist Health System Sunbelt Healthcare Corporation
P	$323,951,242	Cost
Adventist Health System Sunbelt Healthcare Corporation - Insurance Alloc
P	$20,905,068	Cost
Adventist Health System Sunbelt Healthcare Corporation dba AIT
P	$854,275	Cost
Adventist Health System Sunbelt Healthcare Corporation
S	$215,235,749	Actual Amount Received
AHSCentral Texas Inc
A	$115,431	FMV
Central Texas Healthcare Collaborative
B	$857,584	Actual Amount Given
East Orlando Health & Rehab Center Inc
B	$3,262,448	Actual Amount Given
FLNC Inc (Florida Living Nursing Center)
B	$5,408,704	Actual Amount Given
Florida Hospital Dade City Inc
L	$79,233	Cost Plus Appropriate %
Florida Hospital Dade City Inc
P	$301,239	Cost
Florida Hospital Healthcare System Inc
Q	$325,683	Cost
Florida Hospital Healthcare System Inc
R	$36,846,520	Actual Amount Given
Florida Hospital Medical Group Inc
A	$12,523,732	FMV
Florida Hospital Medical Group Inc
B	$3,671,436	Actual Amount Given
Florida Hospital Medical Group Inc
K	$648,283	FMV
Florida Hospital Medical Group Inc
L	$3,671,342	Cost Plus Appropriate %
Florida Hospital Medical Group Inc
M	$131,010,769	Cost Plus Appropriate %
Florida Hospital Medical Group Inc
P	$26,209,715	Cost
Florida Hospital Medical Group Inc
Q	$23,744,938	Cost
Florida Hospital Medical Group Inc
R	$837,890	Actual Amount Given
Florida Hospital Ocala Inc
L	$698,309	Cost Plus Appropriate %
Florida Hospital Physician Group Inc
R	$105,276	Actual Amount Given
Florida Hospital Waterman Inc
L	$663,158	Cost Plus Appropriate %
Florida Hospital Waterman Inc
Q	$164,674	Cost
Florida Hospital Zephyrhills Inc
L	$268,172	Cost Plus Appropriate %
Florida Hospital Zephyrhills Inc
S	$346,274	Actual Amount Received
Florida Radiology Imaging at Lake Mary LLC
A	$1,091,840	FMV
Florida Radiology Imaging at Lake Mary LLC
B	$1,068,643	Actual Amount Given
Florida Radiology Imaging at Lake Mary LLC
P	$609,255	Cost
Florida Radiology Imaging at Lake Mary LLC
Q	$12,741,401	Cost
Hospice of the Comforter Inc
L	$108,768	Cost Plus Appropriate %
Hospice of the Comforter Inc
P	$59,281	Cost
Hospice of the Comforter Inc
Q	$1,028,262	Cost
Memorial Health Systems Inc
B	$548,981	Actual Amount Given
Memorial Health Systems Inc
L	$673,654	Cost Plus Appropriate %
Memorial Health Systems Inc
M	$63,015	Cost Plus Appropriate %
Memorial Health Systems Inc
P	$557,216	Cost
Memorial Health Systems Inc
Q	$340,045	Cost
Memorial Health Systems Inc
S	$4,803,116	Actual Amount Received
Memorial Health Systems Inc
P	$106,618	Cost
Memorial Hospital - Flagler Inc
L	$422,432	Cost Plus Appropriate %
Memorial Hospital - Flagler Inc
Q	$595,386	Cost
Memorial Hospital - West Volusia Inc
L	$339,262	Cost Plus Appropriate %
Memorial Hospital - West Volusia Inc
Q	$502,881	Cost
Pasco-Pinellas Hillsborough Community Health System Inc
L	$264,850	Cost Plus Appropriate %
Pasco-Pinellas Hillsborough Community Health System Inc
P	$227,654	Cost
Princeton Professional Services Inc
M	$1,484,753	Cost Plus Appropriate %
Shawnee Mission Medical Center Inc
L	$1,099,123	Cost Plus Appropriate %
Shawnee Mission Medical Center Inc
Q	$3,949,950	Cost
Southeast Volusia Healthcare Corporation
L	$373,931	Cost Plus Appropriate %
Southeast Volusia Healthcare Corporation
P	$61,916	Cost
Southeast Volusia Healthcare Corporation
Q	$275,109	Cost
Southwest Volusia Healthcare Corporation
L	$590,759	Cost Plus Appropriate %
Southwest Volusia Healthcare Corporation
Q	$222,125	Cost
Southwest Volusia Healthcare Corporation
S	$1,150,042	Actual Amount Received
Specialty Physicians of Central Texas Inc
B	$5,066,313	Actual Amount Given
Sunbelt Health & Rehab Center Apopka Inc
B	$674,321	Actual Amount Given
SunSystem Development Corporation
B	$5,271,111	Actual Amount Given
SunSystem Development Corporation
C	$30,763,007	Actual Amount Received
SunSystem Development Corporation
L	$316,159	Cost Plus Appropriate %
SunSystem Development Corporation
N	$272,015	Cost Allocation
Tarpon Springs Hospital Foundation Inc
L	$188,094	Cost Plus Appropriate %
University Community Hospital Inc
L	$1,117,802	Cost Plus Appropriate %
University Community Hospital Inc
P	$3,837,970	Cost
University Community Hospital Inc
Q	$295,258	Cost
Florida Hospital Healthcare System Inc
A	$32,200	FMV
Pasco-Pinellas Hillsborough Community Health System Inc
Q	$136,704	Cost
Princeton Professional Services Inc
A	$49,261	FMV
Tarpon Springs Hospital Foundation Inc
A	$3,485	FMV
San Marcos MRI LP
A	$42,807	FMV