2020-11-05T09:48:00-06:00 2019-12-31 990 2019-01-01 591113901 University Community Hospital Inc UNIV 8139716000 3100 East Fletcher Avenue Tampa FL 33613 Lynn Addiscott Assistant Secretary 8139716000 2020-10-23 204.139.85.142 2020-10-23 14:10:20 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 12841AD40E8BDE8F2A214B1E8B2FAB2FB37BA08E 2019 2021-01-29 14:40:06Z Denyse Bales-Chubb 3100 East Fletcher Avenue Tampa FL 33613 761962370 0 X www.adventhealth.com/hospital X 1966 FL The provision of medical care to the community through the operation of two hospitals and a long-term acute care facility. 24 16 5498 794 0 0 100341 212637 713805731 751359565 4829753 10284718 5754 15965 718741579 761872885 10000 134446 0 0 270072085 280318403 0 0 0 389376955 419100722 659459040 699553571 59282539 62319314 1029722584 1125458239 354487182 448362261 675235402 677095978 X Adventist Health System Sunbelt Healthcare Corporation and all its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ.The hospital and healthcare system whose parent is Adventist Health System Sunbelt Healthcare Corporation is known as AdventHealth. AdventHealth seeks to be widely respected as a consumer-focused organization that engages individuals in their health by delivering wholistic, best practice care across a connected, comprehensive continuum of services. With Christ as our example, AdventHealth cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing. 0 0 633416543 134446 751375530 Operation of AdventHealth Tampa, a 536-bed general acute care hospital, AdventHealth Pepin Heart Institute, a 75-bed facility, AdventHealth Carrollwood, a 103-bed general acute care hospital, and AdventHealth Connerton a 77-bed Long-Term Acute Care Hospital. Combined these facilities generated 28,404 patient admissions, 162,126 patient days, and 193,273 outpatient visits during the current tax year. 633416543 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 5498 1 0 0 0 0 0 0 0 0 0 0 0 0 X 24 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X Tyson Davis 8136157853 3100 East Fletcher Avenue Tampa FL 33613 X Schultz Michael H Vice Chair/CEO West FL Reg 17.86 32.15 X 0 1857887 50309 Bergherm Bruce Dir/SEO West FL Region 17.86 32.15 X X 0 1043562 124279 Johnson Joel Former CEO - Carrollwood 0.00 50.00 X 0 895869 80966 Adams Brian S Director/CEO (end 5/19) 50.00 0.00 X X 0 734618 112067 Didenko Vadym V Former Officer - CFO West FL Region 17.86 32.15 X 0 709399 107808 Bales-Chubb Denyse Director/CEO (beg 7/19) 50.00 0.00 X X 0 606197 115154 Skula Erika CEO - Carrollwood 50.00 0.50 X X 0 651754 53053 Mcguinness Robin J Former Key Emp-CNO West Region 17.86 32.15 X 0 506282 89653 Torres MD Michael A Former CMO - Tampa 0.00 50.00 X 0 508254 69799 Jiang-Saldana Hui Former COO - Tampa 0.00 50.00 X 0 457140 65545 Coe Jason COO - Tampa 50.00 0.00 X 0 426036 75481 Bjornstad MD Brad CMO - Carrollwood 50.00 0.00 X 0 473952 26683 Ross MD Douglas CMO - Tampa 50.00 0.00 X 0 435819 47969 Lambert MD Charles Physician/Medical Director 40.00 0.00 X 441961 0 33242 Heinrich William CFO - Tampa (end 6/19) 50.00 0.00 X 0 387766 54889 Dunkel Jason Director (beg 5/19) 0.20 50.00 X 0 382654 52472 Shaw Brigitte W CBDO - Tampa 50.00 0.00 X 0 367726 47535 Cox Shane H Former CFO - Carrollwood 0.00 50.00 X 0 360128 51235 Davis Tyson CFO - Tampa (beg 10/19) 50.00 0.00 X 0 332428 48390 Trivette Theresa CNO - (end 10/19) 50.00 0.00 X 0 308568 35263 Chubb John Former COO-Carrollwood 0.00 0.00 X 0 224976 3725 Sauder Christopher CFO - Carrollwood 50.00 0.00 X 0 252529 46750 Escousse Thomas AVP & ED Cardio Services 40.00 0.00 X 246630 0 32705 Strech Scott AVP Cardio Services 40.00 0.00 X 220717 0 24436 Chu Loc Cardio Invasive Specialist 66.00 0.00 X 221070 0 20240 Long Tammy Exec Dir of Nursing 40.00 0.00 X 215847 0 25263 Patel MD Sharad Director 2.80 0.00 X 18721 0 0 Cannella MD Xavier Director 2.00 0.00 X 13006 0 0 Anderson PhD Robert Chairman/Director 2.00 0.00 X 0 0 0 Butcher Jack Director 0.20 0.50 X 0 0 0 Edmister Lee Director 0.20 0.00 X 0 0 0 Ennis Jr Henry Director 0.20 0.00 X 0 0 0 Jimenez David Director 0.20 0.00 X 0 0 0 Joyner Arthenia Director 0.20 0.00 X 0 0 0 Lightfoot Ken Director 0.20 0.00 X 0 0 0 Mahon Mary Director (end 3/19) 0.20 0.00 X 0 0 0 Meyer Fred Director 0.20 0.00 X 0 0 0 Muniz Tony Director 0.20 0.00 X 0 0 0 Newman Eric Director 0.20 0.00 X 0 0 0 O'Malley MD Brendan Director 0.20 0.00 X 0 0 0 Parker IV Thaddeus Director 0.20 0.00 X 0 0 0 Robbins Charlie Director 0.20 0.00 X 0 0 0 Scaglione Basil Director 0.20 0.00 X 0 0 0 Stonesifer MD Kurt Director 0.20 0.00 X 0 0 0 Vivero Jose Director 0.20 0.00 X 0 0 0 Taneja Supriya Director (beg 5/19) 0.20 0.00 X 0 0 0 1377952 11923544 1494911 238 1 1 0 Crothall Healthcare Inc 13028 Collections Center Dr Chicago IL 60693 Housekeeping, Transportation & Biomedica 9822729 AMN Healthcare Inc 2735 Collections Center Dr Chicago IL 60693 Medical Staffing Agency 6180619 Morrison Healthcare PO Box 102289 Atlanta GA 30368 Food Service 4549947 Comprehensive Pharmacy Services LLC 6409 Quail Hollow Road Memphis TN 38120 Pharmacy Services 3293005 Patient Engagement Advisors LLC 3179 Green Valley Road 501 Birmingham AL 35243 Online Patient Advisors 3190494 141 X 158250 54387 212637 Net patient revenue 622110 744046278 744046278 Cafeteria revenue 622110 2906588 2906588 Medical office building 622110 1339148 1339148 Medical Staff Dues 622110 819187 819187 Research Revenue 622110 799165 799165 1449199 1449199 751359565 5817981 5817981 2913977 1642245 0 89485 2913977 1552760 4466737 4466737 EHR Revenue 622110 15965 15965 15965 761872885 751375530 0 10284718 X 134446 134446 5409291 31727 5377564 204930245 200897214 4033031 6559969 6282528 277441 46008184 42678796 3329388 17410714 16674363 736351 1094100 1094100 186434 186434 938358 938358 105416074 85232872 20183202 11555169 11555169 13164424 9676667 3487757 24813872 22210448 2603424 17328690 17328690 726223 726223 2212920 2212920 6661716 6661716 50965142 50965142 6446027 6105189 340838 Medical Supplies 147771132 147771132 Repairs & maintenance 11894188 11894188 State Tax Indigent Asse 8858959 8858959 CON write off 5358500 5358500 3708794 12466 3696328 699553571 633416543 66137028 0 10396 10244 166352121 209076225 95648659 103500014 23784451 22692864 25447680 26640415 1072847996 367018750 618059986 705829246 10958496 4759996 89460795 52949235 1029722584 1125458239 53216429 74230961 767382 300503371 374131300 354487182 448362261 X 660394548 660671968 14840854 16424010 675235402 677095978 1029722584 1125458239 X 62319314 18072813 -78531551 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 86903 86903 0 Part II-B, Line 1: Dues were paid to the American Hospital Association and Florida Hospital Association. Outside Consultants were used during the current year for lobbying on behalf of the filing organization with respect to legislative matters impacting the delivery of health as follows: 1. Mark Sharpe - $33,000 2. RSA Consultants - $27,500 12768809 1909563 1943089 4524465 12096996 10595999 2886156 1124167 1837513 12768809 24197844 792339 1852663 16246847 10595999 24210901 1750326 1960207 3581619 141971 24197844 19917358 408643 1086497 20907 21391591 0.19340 0.08270 0.72390 0 1 1 34671556 34671556 632243340 176790060 455453280 294293026 182664217 111628809 111640074 7564473 104075601 705829246 Due to related 12278353 Payable to third parties 3515276 Credit balances in A/R 2328017 Accrued interest payable 48668 Interco. Alloc. of TE Bond Proceeds 313216987 Operating Lease Liability 21462691 Other liabilities 21281308 374131300 X Part V, Line 4: University Community Hospital Foundation, Inc. (UCHF), a related organization formed and maintained exclusively to further the exempt purpose of University Community Hospital, Inc. (the Hospital), held assets in temporary endowment and permanent endowment funds during the current tax year. UCHF's endowment consists of individual donor restricted endowment funds and pledges receivable where the assets have been designated for endowment. Temporarily and Permanently restricted endowment funds are intended to benefit various programs and departments of the Hospital and its patients. Endowment funds have also been designated by the Board of UCHF to support various Hospital initiatives. 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. Part V, Line 1a - column (d) Three years back: Explanation for change in opening balance: During 2016, it came to the attention of the UCHF's management that certain temporarily restricted funds in the amount of $2,819,310 were incorrectly classified as unrestricted. As a result, the UCHF restated the beginning endowment fund balance in its 2016 tax year. Part V, column (b) Prior Year and column (c) Two years back: Explanation for change in column (b) lines 1a thru 1g and column (c) lines 1b thru 1g: During 2020, it came to the attention of the UCHF's management that certain assets were mistakenly classified as endowments during years 2017 and 2018. This reclassification resulted in a total decrease of $951,003. 1 1 X 1 X 0 1 1 1 0 1 0 40566368 40566368 0.05800 94303841 39728430 54575411 0.07800 134870209 39728430 95141779 0.13600 25527 25527 0.00000 2583473 2583473 0.00370 2609000 2609000 0.00370 137479209 39728430 97750779 0.13970 5209 5209 0.00000 5209 5209 0.00000 1 41542731 3840427 128937916 145220520 -16282604 X 1 1 3 1 AdventHealth Tampa 3100 E Fletcher Avenue Tampa FL 33613 www.adventhealth.com/hospital/adventhe 4035 X X X X 2 AdventHealth Carrollwood 7171 N Dale Mabry Hwy Tampa FL 33614 www.adventhealth.com/hospital/adventhe 4179 X X X 3 AdventHealth Connerton 9441 Health Center Drive Land OLakes FL 34637 www.adventhealth.com/hospital/adventhe 4499 X X AdventHealth Tampa 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X See Part V, Page 8 X X 1 17 1 See Part V, Page 8 0 1 X 200.000000000000 X X X X 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 AdventHealth Carrollwood 2 0 0 1 X X X X X X X X X 19 1 0 0 1 X See Part V, Page 8 X X 1 17 1 See Part V, Page 8 0 1 X 200.000000000000 X X X X 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 AdventHealth Connerton 3 0 0 1 X X X X X X X X X 19 1 0 0 1 X See Part V, Page 8 X X 1 17 1 See Part V, Page 8 0 1 X 200.000000000000 X X X X 1 1 X X X X 1 X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X X 1 X 0 X X X X 1 X 0 0 AdventHealth Tampa Part V, Section B, Line 5: University Community Hospital, Inc. d/b/a AdventHealth Tampa, (AHT or the Hospital) is a 536-bed hospital facility located in Hillsborough County in Florida. The Hospital's primary service area is nestled in Hillsborough County, adjacent to the University of South Florida, and is primarily comprised of 27 zip codes surrounding the Hospital. Several of the primary service area zip codes include communities that are fundamentally underserved. The Hospital's primary service area includes diverse micro-communities which vary in income, education level, and living conditions and are ethnically and culturally diverse. 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, stakeholder interviews, focus groups, and Public Health input and expertise. The Hospital formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community and the Hospital, 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 Hospital's primary service area. Members of the CHNAC included representatives from Hillsborough County Public Schools, the Brain Expansion Scholastic Training Program, a not-for-profit dedicated to creating a long-lasting positive impact in the lives of under-represented and disadvantaged youth, the Hillsborough County Department of Health, and the University Area Community Development Center, an organization that provides economic, education, and public services in the University of South Florida area community where 95% of the population is below the poverty level. Other members of the CHNAC included representatives from Tampa Innovation Alliance, the Healthy Council of West Central Florida, the Crisis Center of Tampa Bay, Gracepoint, a behavioral health provider, the Tampa 1st Seventh Day Adventist Church, and Tampa Family Health Centers. The community health survey was done in collaboration with the Hillsborough County Department of Health. A total of 5,304 Hillsborough County residents participated in the collaborative community health survey. Special efforts were made to engage community members to participate in the survey, including the provision of computers at local community centers so that community members could access the survey online. Stakeholder interviews were conducted by members of the CHNAC. Focus groups were conducted in partnership with the Florida Department of Health in Hillsborough County and occurred in person at health department locations and at the University Area Community Development Center, which resides in the Hospital's service area. Various sources of secondary data were also reviewed to understand the larger issues plaguing the Hospital's primary service area. AdventHealth Carrollwood Part V, Section B, Line 5: University Community Hospital, Inc., d/b/a AdventHealth Carrollwood (AHCW or the Hospital), is a 103-bed community hospital specializing in Spine, Orthopedic, and Bariatric Surgery, as well as Emergency, Cardiology, and Wound Healing services. The Hospital's primary service area is comprised of 19 zip codes located within the Florida counties of Hillsborough and Pasco. The total population in the Hospital's primary service area is approximately 547,000. Approximately 20% of the individuals living in the Hospital's primary service area live in households with incomes below the Federal poverty level. 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, stakeholder interviews, focus groups, and Public Health input and expertise. The Hospital formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community and the Hospital, 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 Hospital's primary service area. Members of the CHNAC included representatives from the University of South Florida - Office of Community Engagement and Partnerships, Carrollwood Seventh-Day Adventist Church, LifeSpring Seventh-Day Adventist Church and Tampa 1st Seventh-Day Adventist Church, the Crisis Center of Tampa Bay, the Tampa Bay Healthcare Collaborative, Feeding Tampa Bay, the Health Council of West Central Florida, the Tampa Bay Network to End Hunger, and the Hillsborough County Department of Health. The community health survey was done in collaboration with the Hillsborough County Department of Health. A total of 5,304 Hillsborough County residents participated in the collaborative community health survey. Special efforts were made to engage community members to participate in the survey, including the provision of computers at local community centers so that community members could access the survey online. Stakeholder interviews were conducted by members of the CHNAC. Focus groups were conducted in partnership with the Florida Department of Health in Hillsborough County and occurred in person at the Hillsborough County Health Department and at the University Area Community Development Center. Various sources of secondary data were also reviewed to understand the larger issues plaguing the Hospital's primary service area. AdventHealth Connerton Part V, Section B, Line 5: AdventHealth Connerton is a 50-bed long-term acute care hospital to which patients are referred from 25 other hospital facilities in the state of Florida. AdventHealth Connerton serves patients with medically complex conditions that require additional weeks of specialized hospital care (following a hospitalization), have a history of failed treatment in a lower level of care, or have a high rate of recidivism. 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 Public Health input and expertise. The Hospital formed a Community Health Needs Assessment Committee (CHNAC) that included representatives of the community and the Hospital, with a special focus on underserved populations. CHNAC members included a community member and representatives from the Pasco County Health Department, the Pasco County Fire Department, North Tampa Christian Academy, Gulfcoast North Area Health Education Center, and St. Leo University. AdventHealth Connerton worked with the Florida Department of Health in Pasco County to gather community input by participating in a joint county-wide community health survey and stakeholder interviews. Community surveys were completed on-line and in person in community settings. Community surveys were made available at local clinics, community events, department of motor vehicle locations, and other community locations throughout Pasco County. A total of 3,038 Pasco County residents participated in the community surveys. Stakeholder interviews were conducted with members of the CHNAC. Various sources of secondary data were also gathered as a part of the data collection process. AdventHealth Tampa Part V, Section B, Line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospital's website at least until the date the hospital facility has made widely available on its website its two subsequent Community Health Needs Assessment Reports. The Hospital will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facility has made available for public inspection its two subsequent Community Health Needs Assessment Reports. AdventHealth Carrollwood Part V, Section B, Line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospital's website at least until the date the hospital facility has made widely available on its website its two subsequent Community Health Needs Assessment Reports. The Hospital will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facility has made available for public inspection its two subsequent Community Health Needs Assessment Reports. AdventHealth Connerton Part V, Section B, Line 7d: The Hospital has adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the Hospital's website at least until the date the hospital facility has made widely available on its website its two subsequent Community Health Needs Assessment Reports. The Hospital will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the hospital facility has made available for public inspection its two subsequent Community Health Needs Assessment Reports. AdventHealth Tampa Part V, Section B, Line 11: University Community Hospital, Inc., d/b/a AdventHealth Tampa, will be referred to in this document as AdventHealth Tampa or "the Hospital". In January of 2019, every wholly-owned entity across our organization adopted the AdventHealth system brand. University Community Hospital, Inc. d/b/a AdventHealth Tampa will be referred to in this document as AdventHealth Tampa or "the Hospital". Our identify 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 Tampa is part of the West Florida Division of AdventHealth which 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 Tampa's 2017-2019 Community Health Plan (Implementation Strategy). AdventHealth Tampa developed this 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/Implementation Strategy, AdventHealth Tampa 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.AdventHealth Tampa chose five areas of focus for its 2017-2019 Community Health Plan: Obesity, Diabetes, Low Food Access/Nutrition, Mental Health Disorders/Substance Abuse (Drugs and Alcohol) and Access to Care (Primary and Dental/Smoking Cessation).Priority 1: Obesity 2016 Description of the Issue: This need met the criteria for prioritization as it was ranked high in relevance as an issue within the Hospital's primary service area (PSA). It was also identified as being addressed by other community groups and something that the Hospital has the capacity to positively impact. 2019 Update: The Hospital implemented several strategies to empower community members to improve their lifestyle choices through nutritional education and opportunities to exercise. In year one, AdventHealth Tampa 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 is supported by evidence-based science. Two faith congregations were invited to attend the CREATION Health "Train the Trainer" session hosted by the Mission and Ministry/Community Benefits departments. The outcome metrics for the CH seminars and subsequent goals were not met for years two and three as a result of a change in staffing and the decision to replace the CH program with a new initiative that would be developed at the division level.AdventHealth Tampa also sponsored the Complete Health Improvement Program (CHIP) in year one. CHIP is a lifestyle enrichment program designed to reduce disease risk factors through better health habits and appropriate lifestyle modifications. Program goals include lower cholesterol, hypertension, and blood sugar levels and to reduce excess weight and stress through improved dietary choices, enhanced daily exercise and increased support systems. The outcome metrics for the CHIP program and subsequent goals were not met for years two and three as a result of a change in staffing which lead to a lack of staff to implement and manage the classes.Priority 2: Diabetes2016 Description of the Issue: This need was identified as a significant health priority due to the high incidence of diabetes in the primary service area.2019 Update: AdventHealth Tampa partnered with the American Diabetes Association (ADA) to host a pilot Morning Mile Program (before-school walking program) at two Title I schools in their PSA for the 2018 - 2019 school year. AdventHealth Tampa sponsored three schools for the 2018-2019 school year Apollo Beach Elementary, Shaw Elementary School and Forest Hills Elementary School. The American Diabetes Association (ADA) in partnership with Fitzness International, LLC 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 nutrition education component to increase its impact on school children. The ADA reported in October 2018 during year two of the implementation plan, of their struggle to maintain consistent communication with the designated point-of-contact at schools sponsored by AdventHealth. AdventHealth's Community Health Coordinator scheduled site visits to all sponsored schools to re-establish contact and determine what, if any, struggles they encountered implementing and managing the Morning Mile program at their schools. Additionally, the school site visits revealed variations between schools in how the program was managed and how data was tracked. A common barrier was an inability to use the data tracking program, Mileage Master, to record student participation data. This severely affected the ADA's ability to collect and report data outcomes for the MM program. There is no year three data available for Morning Mile outcomes for our AdventHealth Tampa sponsored school sites.Due to a lack of reporting outcomes and extremely poor management of the program by the ADA, as mentioned in year two, the program and partnership with ADA was not renewed for year three.See Continuation AdventHealth Carrollwood Part V, Section B, Line 11: University Community Hospital, Inc. d/b/a AdventHealth Carrollwood will be referred to in this document as AdventHealth Carrollwood or "the Hospital". In January of 2019, every wholly-owned entity across our organization adopted the AdventHealth system brand. Our identify has been unified to represent the full continuum of care our system offers. Throughout this report, we will refer to our hospital by AdventHealth Carrollwood. Any reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency.AdventHealth Carrollwood 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 Carrollwood's 2017-2019 Community Health Plan (Implementation Strategy). AdventHealth Carrollwood developed this 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/Implementation Strategy, AdventHealth Carrollwood 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 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.AdventHealth Carrollwood chose four areas of focus for the 2017-2019 Community Health Plan: Diabetes/Obesity/Nutrition Gap Prevalence, Access to Health (Elderly/Seniors Barriers), Childhood Obesity, and Family Support.Priority 1: Diabetes/Obesity/Nutrition Gap Prevalence2016 Description of the Issue: Obesity is related to diabetes, poor nutrition, and access to healthy food. These health indicators may indicate an unhealthy lifestyle and put individuals at risk for future health issues. AdventHealth Carrollwood is addressing the nutritional needs of those in communities designated as food deserts or low income/low access areas. There are high levels of diabetes and obesity in these communities due to the lack of access to food and specifically nutritious food. AdventHealth Carrollwood is uniquely positioned to address this need through its Food is Health program (formally Food is Medicine).2019 Update: AdventHealth Carrollwood partnered with local community organizations to address the nutritional needs of those in food deserts or low income/low access areas through the Food is Health program (FiH). The program provides educational opportunities on health and lifestyle, biometric screenings and increased access to healthy produce and dry goods. In year three, the program was implemented in five food deserts and eight sites within the Hospital's service area, this did not meet the target outcome of seven food deserts and 12 sites. The outcome goals for years two and three were updated in year one to reflect a change from 13 food deserts and 25 sites to only seven food deserts and 12 sites due to 2018 budget constraints. A total of 15 diabetes and obesity courses were facilitated with at least ten participants attending each class as part of the Food is Health program. The number of courses offered increased compared to year two, when only 12 classes were taught. This was due to a renewed partnership with the Central City YMCA and a new partnership with Moffitt Cancer Center. Year three biometric outcomes showed that 52% of participants had a decrease in blood sugar, which increased from last year's 45% reduction in blood sugar. Of those participants who had a decrease in their blood sugar levels, 42% also had a decrease in body mass index (BMI), an increase from 38% in year two. Although we did not meet the goal of 65% reduced BMI, the decrease represents a significant health behavior change in the smaller sample size of participants. Since implementing the FiH program, we have begun to utilize the data trends to develop more realistic outcome goals. Furthermore, we also adjusted the outcome statements and metrics for this program in year two. The strategy to develop and administer a survey to measure improved knowledge and behavior change from program participants was removed as it was not an area where resources could be allocated. Additionally, the strategy and subsequent outcomes and metrics for establishing access points in communities for healthy foods was removed to reallocate available funding to the Food is Health program. The increased success of the FiH program has been due to our active participation in maintaining community partnerships, the restructure of the program implementation strategies to reflect available resources and opportunities, and the increase of internal organizational support to hire additional coordinators to manage the program. We continue to realize that we 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.Our West Florida Division Community Benefit team continues to manage our community partnerships by regularly attending community meetings and actively engaging with food security initiatives. In year two, we launched new strategies for marketing the free FiH classes to the community and hope to engage our community in much more effective ways to encourage participation. Examples of the marketing strategies implemented in year three include: local advertisement in community newspapers, media interviews to educate the community on the FiH program and its partnerships, internal education campaigns with Hospital team members and a collaboration with internal marketing teams to develop strategies to increase program awareness.In year two, there were challenges establishing reliable local produce vendor partnerships and stable local community sites for conducting FiH classes. In year three, we pilot tested a new process for securing local produce vendors (visiting local farmers markets, slightly increasing the payment to help with costs of mobile set up, et.) and have found some success from the new changes. In year one of the implementation plan, AdventHealth Carrollwood 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 is supported by evidence-based science. Two faith congregations were invited by the chaplain at the Hospital to attend the AdventHealth West Florida Division CREATION Health "Train the Trainer" session hosted by the Mission and Ministry/Community Benefit departments. Only one congregation attended and sent three delegates: Town N' Country Seventh-day Adventist (SDA) Church. The delegates received a CH Leadership Kit valued at $350. The CH Kit contains the CH seminar Power Point, CH topic videos, CH leadership manual, a small group discussion guide, a seminar personal study guide and participant pre-post self-assessments. The outcome metrics for the number of CH seminars provided were adjusted for years two and three to zero as a result of the decision to replace the CH program with a new program that would be developed at the division level.See Continuation AdventHealth Connerton Part V, Section B, Line 11: University Community Hospital, Inc. d/b/a AdventHealth Connerton will be referred to in this document as AdventHealth Connerton or "the Hospital". AdventHealth Connerton is a long-term acute-care hospital (LTAC).In January of 2019, every wholly-owned entity across our organization adopted the AdventHealth system brand. Our identify has been unified to represent the full continuum of care our system offers. Throughout this report, we will refer to our hospital by AdventHealth Connerton (AHC-LTAC). Any reference to our 2016 Community Health Needs Assessment (CHNA) or 2017 Community Health Plan (CHP) will utilize our new name for consistency.AdventHealth Connerton 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 Connerton's 2017-2019 Community Health Plan (Implementation Strategy). AdventHealth Connerton developed this 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/Implementation Strategy, AdventHealth Connerton 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 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.AdventHealth Connerton chose five areas of focus for their 2017-2019 Community Health Plan: Obesity, Respiratory Diseases, Health Education, Family/Caregiver Burnout & Compassion Fatigue, and Transportation.Priority 1: Obesity2016 Description of the Issue: In the Hospital's provider service area: 23.9% of the population do not have leisure time for physical activity; 36.2% of adults aged 18 and older self-report to be clinically overweight; and 29% of adults aged 20 and older self-report being clinically obese. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues.2019 Update: AHC-LTAC partnered with the American Diabetes Association (ADA) to host a pilot Morning Mile (MM) Program (before-school walking program) at two Title I schools in their PSA for the 2018 - 2019 school year. AdventHealth Connerton LTAC sponsored one school for the 2018-2019 school year - Pine View Elementary School. Due to challenges in the previous year with the ADA, the contract was not renewed for year three. This was due to a lack of the ADA reporting program outcomes and extremely poor management of the program overall by the ADA. Priority 2: Respiratory Diseases (as related to Adult Smoking)2016 Description of the Issue: In the Hospital's service area 21.7% of adults aged 18 and older smoke some days or every day. Tobacco use is linked to leading causes of death including cancer and cardiovascular diseases.2019 Update: AHC-LTAC renewed a partnership with Gulf Coast North Area Health Education Center, a part of the University of South Florida Area Health Education Council (AHEC), to host community smoking cessation classes at the Hospital. The AHEC program conducts a 7-month follow-up with class participants and results show a statewide quit rate of 37% (2015 state statistics). AHC-LTAC planned to waive any room rental fees. The target was to host five classes in 2019, but no classes were completed in 2019 and the subsequent targets were not met. Part of the work done in 2019 for this priority was reestablishing a value partnership with AHEC and development of a new referral process for the upcoming years to increase access, awareness and enrollment into the classes.Priority 3: Health Education2016 Description of the Issue: Patterns of health statistics shown in the secondary data for the AdventHealth Connerton-LTAC Community Health Needs Assessment indicate significant need for healthy lifestyle education in the community.2019 Update: AHC-LTAC sponsored the CREATION Health (CH) program which is a faith-based holistic (mental, physical, and spiritual) wellness program with lifestyle seminars and training programs in 2017. It taught eight universal principles of health (Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook, & Nutrition) for living a healthier and happier life. The eight-week seminar provided the best practices of whole person living based on Biblical principles and supported by evidence-based science. The outcome metrics for number of CH seminars provided and subsequent attached goals were adjusted to zero for year three. This decision was the result of the decision to develop programming at the division level that could be more accessible for community members while also having more internal support for successful deployment. AHC-LTAC sponsored the Complete Health Improvement Program (CHIP). CHIP is a lifestyle enrichment program designed to reduce disease risk factors through better health habits and appropriate lifestyle modifications. Program goals include: lower blood cholesterol, hypertension, and blood sugar levels, and reduce excess weight and stress through improved dietary choices, enhanced daily exercise, and increased support systems. No classes were implemented in year 3 due to the challenges identified in previous years, which are identified below.Some key challenges identified included class scheduling and longevity of individuals as participants in classes. Classes are held twice a week for nine weeks. This represents a serious commitment for participation and lifestyle changes. For our community populations, this commitment presents some challenges. We plan to consider future programming that will make it easy for the community to access and attend the health education classes for this area of priority. See Continuation AdventHealth Carrollwood - Part V, Section B, Line 11 (Continuation): Priority 1: Diabetes/Obesity/Nutrition Gap Prevalence -continuedAdventHealth Carrollwood sponsored the Complete Health Improvement Program (CHIP) in the first year of the implementation plan. CHIP is a lifestyle enrichment program designed to reduce disease risk factors through better health habits and appropriate lifestyle modifications. Program goals include: lower blood cholesterol, hypertension, and blood sugar levels, and reduce excess weight and stress through improved dietary choices, enhanced daily exercise and increased support systems. No classes were implemented in year three due to the challenges outlined below.A key challenge included the time commitment required to complete a twice weekly, nine-week program. For many participants this proved to be a barrier to successfully completing the program. Successful completion of the program also requires significant lifestyle changes that were unsustainable over the length of the program for many participants. For the populations we serve these barriers were insurmountable. We plan to consider future programming that will be easier for the community to access, attend and achieve success.Priority 2: Access to Health (Elderly/Seniors Barriers)2016 Description of the Issue: AdventHealth Carrollwood (AHCW) is addressing the increasing social isolation, barriers to health access and food insecurity issues facing the senior population in its service area.2019 Update: There were two strategies to address this priority initially. The first strategy and subsequent goals were based on the development of a pilot program that would utilize technology to decrease social isolation and increase transportation access for seniors. This was removed from the implementation plan in 2017 when the community benefit manager position was eliminated and there was no longer an individual to run point on the initiative. The second strategy was to collaborate with local community partners on the creation of health/nutrition programs that would be accessible for seniors. The Hospital partnered with the Senior Connection Center and the Health Services Advisory Group to offer health and nutrition related classes to seniors participating in the Food is Health program. The classes focused on chronic diseases, such as diabetes, and were offered at churches, community, and senior centers in food deserts and/or low income/low access communities. In year three, the Hospital also partnered with the Senior Connection Center to offer one series-based nutrition class for a senior's group at Highland Pines Park Community Center. The Hospital also partners with one county-run senior center (Town & Country Senior Center) and one city-run senior center (Barksdale Senior Center) for the Food is Health program. Additionally, in year three, a new partnership with the Health Council of West Central Florida was established to discuss ways to help address social isolation in the elderly/senior population. This collaboration resulted in a plan to incorporate this strategy into mental health interventions/activities in the 2020 - 2022 Community Health Plans.Priority 3: Childhood Obesity 2016 Description of the Issue: In the 2016 CHNA, lack of exercise was identified as a priority, which we are addressing through our childhood obesity work. With 1.1 million children in Florida classified as obese, AdventHealth Carrollwood wants to encourage a healthier lifestyle and dietary habits with youth in its service area. The journey to better choices will lead to decreased need for healthcare treatments for chronic diseases in the future. 2019 Update: The Hospital partnered with the American Diabetes Association (ADA) to host a pilot Morning Mile (MM) Program (before-school walking program) at two Title I schools in their PSA for the 2018 - 2019 school year. AdventHealth Carrollwood sponsored two schools, Dunbar Elementary Magnet School and Sligh Middle Magnet School. Although, year two goals exceeded expectations with 95% of the student population participating in the program, we decided not to renew the contract for the MM program for a third year. This decision was made due to a lack of reporting in outcomes and extremely poor management of the program overall by the ADA. In the original implementation plan, there was also a strategy to implement a "Fun Bites" program, with the goal of decreasing childhood obesity through increasing access to healthy snack food. The local Department of Health took over the program and the Hospital is no longer involved in it. As a result, the strategy was removed from the original plan. Priority 4: Family Support2016 Description of the Issue: Current environmental factors, such as sub-standard housing, multi-generational families under one roof, un-or underemployment, and lack of consistent access to food and healthy food may put individuals at risk for further health issues. In Hillsborough County, the eighth largest public-school system in the country, more than 3,000 children are self-identified as homeless. This has impact on their physical, emotional, and behavioral health as well as that of their families. AdventHealth Carrollwood is creating a collaborative to prevent and ease the health impacts of this environmental issue.2019 Update: The goal of this strategy was to convene community experts to create a model for ensuring physical and emotional health support for homeless children in public schools through stable housing and health support resources. As mentioned in our year two updates, due to the elimination of the community benefit manager position in 2017, there was no staff available to initiate this priority strategy. In year three, the West Florida Division Community Benefit team worked to incorporate family support into the FiH program to address lack of consistent access to food for families.Community Needs Not Chosen by AdventHealth Carrollwood: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:A. Mental Health: AdventHealth Carrollwood does not provide mental health services. The Hospital makes referrals to other local agencies that are better skilled at serving these needs.B. Low-income Poverty: AdventHealth Carrollwood does not have the ability to directly impact this population. Other collaborations in the community are addressing this issue.C. Education/Literacy: AdventHealth Carrollwood does not have the ability to directly impact this issue. Other collaborations in the community are working on these issues. AdventHealth Tampa - Part V, Section B, Line 11 (Continuation): Priority 3: Low Food Access/Nutrition2016 Description of the Issue: This need was identified as one for which lacked sufficient resources in the community.2019 Update: The strategy to address this need was to provide nutrition education and access to healthy food for under and uninsured individuals in targeted zip codes through the Food is Health Program (formally called Food is Medicine). AdventHealth Tampa partnered with local community organizations to address the nutritional needs of those in communities designated as food deserts or low income/low food access areas with the Food is Health Program. The Food is Health (FiH) program provides health and lifestyle educational opportunities, biometric screenings, and access to healthy produce and dry goods. In year three, 360 fresh produce vouchers were distributed to participants, which fell below the goal of 400. However, AdventHealth Tampa did exceed the goal of a reduction of 10% in blood sugar levels for participants. Blood sugar levels were measured by blood draws the first and last day of the education series with the actual number reached being 30%. In year three, the program had 49 participants, which did fall short of the targeted goal.The increased success of the FiH program has been due to our active participation in maintaining community partnerships, the restructure of the program implementation strategies to reflect available resources and opportunities, and the increase of internal organizational support to hire additional coordinators to manage the program. We continue to realize that we cannot run this program without strong partnerships with health education providers, local fresh produce vendors and other community-based organizations that are the boots on the ground addressing social determinants of health. Our West Florida Division Community Benefit team continues to manage our community partnerships by regularly attending community meetings and actively engaging with food security initiatives. In year two, we launched new strategies for marketing the free FiH classes to the community and hope to engage our community in more effective ways to encourage participation. Examples of the marketing strategies implemented in year three include: local advertisement in community newspapers, media interviews to educate the community on the FiH program and its partnerships, internal education campaigns with Hospital team members and a collaboration with internal marketing teams to develop strategies to increase program awareness. Priority 4: Mental Health Disorders/Substance Abuse (Drugs and Alcohol)2016 Description of the Issue: This need was identified as one which lacked sufficient resources and referral networks in the community. More than 800 people were referred from the Hospital's emergency department to mental health providers in 2015, indicating a need for additional resources and referral networks.2019 Update: In year three, our CARE 360 transition specialists and Case Management teams have worked to increase awareness and access to mental health networks available throughout the AdventHealth Tampa primary service area. Patients that are identified as needing mental health and/or behavioral health services in our emergency department are provided referrals to appropriate avenues of care. An immediate connection or referral can be made to a local community partner called Gracepoint, a private, non-profit behavioral health center, with whom the Hospital has a long-standing relationship. Located in the Hospital's emergency department is a Gracepoint Care Navigator, who can provide an immediate connection or referral as needed. In year three 64% (1,067 patients) of referrals were from the targeted under/uninsured zip codes within our community, this did fall short of our target goal of 95%. Overall, this partnership has been one of the most successful in achieving the goals of the implementation plan and we continue to look for additional opportunities to grow this relationship.Priority 5: Access to Care (Primary and Dental/Smoking Cessation)2016 Description of the Issue: This need was identified as having insufficient community resources to address it, giving the Hospital an opportunity to collaborate and link available services.2019 Update: The Hospital had two strategies to address the access to care priority. The first, to provide smoking/tobacco cessation classes and the second, to connect emergency room patients to the Tampa Family Health Federally Qualified Health Center through a referral system. AdventHealth Tampa offered the "iQuit Tobacco" program in partnership with AHEC (Area Health Education Centers). The AHEC program has a 7-month follow-up with class participants and results in a statewide quite rate of 37% (as of 2015).The year three goal was to offer 10 classes or sessions. However, this goal was not met, with only six classes/sessions offered. Challenges that impacted the success of the strategy were low attendance in sessions and a lack of enrollment and participation. This is not unusual for smoking cessation programs, but data has shown that those who attend classes are more likely to maintain cessation. In 2019, AdventHealth Tampa did increase efforts to collaborate with AHEC to improve attendance. New recruitment strategies include working more closely with community partners to identify residents in the target population who may want to attend. The Hospital did not meet the referral goal that had been set of 64% but did provide 54% of uninsured/underinsured patients from targeted zip codes successful referrals to primary care at Tampa Family Health (FQHC) a federally qualified health center.Community Needs Not Chosen by AdventHealth Tampa: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: There are existing community resources and internal Hospital resources in place.2. Heart Disease: This issue is a significant health priority for the AdventHealth Tampa service area and is already being addressed. The Pepin Heart Institute at AdventHealth Tampa already provides heart disease treatment as well as screenings and support groups such as Mended Hearts.3. Preventable Hospital Events: By addressing other priority areas, a correlating decrease in Preventable Hospital events should follow.4. Maternal and Child Health: AdventHealth Tampa provides OB and maternal-infant services as well as many new-mother and parent support programs. The Hospital is working with local FQHCs (Federally Qualified Health Centers) to increase the number of low-income women who receive early prenatal care and is working with the All Baby & Child Spring Educational Conference as well as Healthy Start programs to increase the number of women who attend prepared childbirth classes. In addition, the Community Health Needs Assessment Committee determined that multiple community partners are already working on this issue, including the local Health Department, the federal Healthy Start Coalition and the Maternal & Child Health Program at the University of South Florida, and the Tampa Bay Doula program.5. Teen Pregnancy: Teen pregnancy prevention is not a core competency of AdventHealth Tampa. The Hospital does provide and support the services noted above.6. Respiratory Diseases/Asthma: The Community Health Needs Assessment Committee determined that, while these are important health issues, AdventHealth Tampa does not have the outreach capacity to build a new program around respiratory disease. AdventHealth Connerton - Part V, Section B, Line 11 (Continuation): Priority 4: Family/Caregiver Burnout & Compassion Fatigue2016 Description of the Issue: Programming and support for community first responders as well as employees and family members. 2019 Update: AHC-LTAC's leadership team has been trained in Critical Incident Debriefing, a program which provides resources for first responders to better equip them to meet the needs of their communities. This team now works with patients, families and employees. The Critical Incident Debriefing service was expanded to community caregivers and first responders in 2016. AHC-LTAC also implemented a Caring for Caregivers program for patient families, community, first responders and staff. The Hospital has allocated $14,300 to the Caring for Caregivers Program Coordinator. The goals are to help LTAC families reduce their stress levels. Program components include screening for stressors, counseling and support and an updated reporting system for families who have concerns about their loved ones. This program has created a roving comfort cart with healthy snacks and bottled water for staff and visitors, a Recharge Room that includes soft music, aromatherapy and relaxing activities and Zumba classes. In year three outcomes show a 100% increase in rate of completion of activities implemented to reduce stress, 35% engaged in the healthy snacks program (which exceeds the expected outcome of 20% increase), and 86% of employees reported being engaged by the program initiatives to assess and identify stressors (which exceeds the expected outcome of 78%). Furthermore, the Hospital continued to offer a healing area onsite (healing environment) and provided essential oils, adult coloring books and sand bar to patients and families.Priority 5: Transportation2016 Description of the Issue: Some family members of patients come from long distances in Florida or from out-of-state. They may not have rental cars, and the nearest lodging is 13 miles away.2019 Update: AHC-LTAC provides family transportation to LTAC families without automobiles. AHC-LTAC continues to collaborate with the Pasco Economic Development Commission to find lodging solutions (for families) closer to the Hospital. In 2019, over 1200 free shuttle runs were provided to AdventHealth Connerton patient families. The Hospital provided a total of $38,000 to cover costs associated with the shuttle.Community Needs Not Chosen by AdventHealth Connerton: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:A. Lack of Access to Healthcare: No LTAC Capacity;B. Heart Disease/Stroke: LTAC can refer to other AdventHealth facilities;C. Access to Dental Care: No LTAC capacity, not a patient need;D. Low-income/poverty: No LTAC Capacity;E. Access to Healthy Food: LTAC does not provide similar lines of services. Part V, Section B, Line 7a Each hospital facility's CHNA report was made widely available through the following websites:Facility 1 -- AdventHealth Tampahttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 -- AdventHealth Carrollwoodhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 -- AdventHealth Connertonhttps://www.adventhealth.com/community-health-needs-assessments Part V, Section B, Line 10a Each hospital facility's Implementation plan was made widely available through the following websites:Facility 1 -- AdventHealth Tampahttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 -- AdventHealth Carrollwoodhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 -- AdventHealth Connertonhttps://www.adventhealth.com/community-health-needs-assessments Part V, Section B, Line 16a, b, and c: The Financial Assistance Policy for each facility can be found at URL:https://www.adventhealth.com/legal/financial-assistanceThe Financial Assistance Policy application for each facility can be found at:https://www.adventhealth.com/legal/financial-assistanceThe plain language summary for each facility is available at:https://www.adventhealth.com/legal/financial-assistance Schedule H, Part V, Section B, Line 8 - 10a The filing organization's three hospital faciities adopted a Community Health Needs Assessment Report by 12/31/2019 and were in the process of developing Community Health Needs Implementation Strategies at that time. Each of the hospital facility's 2020-2022 Community Health Needs Implementation Strategy is documented in a written report called the "Community Health Plan". The Community Health Plan (CHP) describes how the hospital facility plans to meet its identified prioritized health needs or identifies the health need as one the hospital facility does not intend to specifically address and provides an explanation as to why the hospital facility does not intend to address that health need. Each of the hospital facility's 2020-2022 CHP was adopted by May 15, 2020 and is posted on each of the hospital facility's websites.As each of the hospital facility's 2020-2022 Community Health Needs Implementation Strategy was not adopted by the end of the hospital organization's taxable year of December 31, 2019, Schedule H, Part V, Section B, line 9 indicates that 2017 was the tax year in which each of the hospital facilities last adopted an implementation strategy. Schedule H, Part V, Section B, Line 10a reflects the website address for each of the hospital facility's 2014-2016, 2017-2019, and 2020-2022 Implementation Strategies. 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 each of the filing organization's hospital facility's website. Part I, Line 7: The amounts of costs reported in the table in line 7 of Part I of Schedule H were determined by utilizing a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, contained in the Schedule H instructions. Part II, Community Building Activities: The filing organization is involved with and supportive of various other organizations in its community that work collaboratively to help those in need and to improve the health and safety of the residents of the community. The filing organization supports and participates with a number of other community 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 page 8-9. Please note that dollar amounts on the attached consolidated audited financial statements are in thousands. Part III, Line 8: Costing Methodology: Medicare allowable costs were calculated using a cost-to-charge ratio.Rationale for Including a Medicare Shortfall as Community Benefit:As a 501(c)(3) organization, the filing organization provides emergency and non-elective care to all regardless of ability to pay. All hospital services are provided in a non-discriminatory manner to patients who are covered beneficiaries under the Medicare program. As a public insurance program, Medicare provides a pre-established reimbursement rate/amount to health care providers for the services they provide to patients. In some cases, the reimbursement amount provided to a hospital may exceed its costs of providing a particular service or services to a patient. In other cases, the Medicare reimbursement amount may result in the hospital experiencing a shortfall of reimbursement received over costs incurred. In those cases where an overall shortfall is generated for providing services to all Medicare patients, the shortfall amount should be considered as a benefit to the community. Tax-exempt hospitals are required to accept all Medicare patients regardless of the profitability, or lack thereof, with respect to the services they provide to Medicare patients. The population of individuals covered under the Medicare program is sufficiently large so that the provision of services to the population is a benefit to the community and relieves the burdens of government. In those situations where the provision of services to the total Medicare patient population of a tax-exempt hospital during any year results in a shortfall of reimbursement received over the cost of providing care, the tax-exempt hospital has provided a benefit to a class of persons broad enough to be considered a benefit to the community. Despite a financial shortfall, a tax-exempt hospital must and will continue to accept and care for Medicare patients. Typically, tax-exempt hospitals provide health care services based upon an assessment of the health care needs of their community as opposed to their taxable counterparts where profitability often drives decisions about patient care services that are offered. Patient care provided by tax-exempt hospitals that results in Medicare shortfalls should be considered as providing a benefit to the community and relieving the burdens of government. Part III, Line 9b: 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. Supplemental Schedule to Schedule H, Part III, Section B: 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: $ (16,282,604)- Difference in costing methodology: (8,038,218)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (47,315,770) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $ (71,636,592)As indicated above, the primary differences between the Medicare surplus/(shortfall) reported on Schedule H, Part III, Section B, line 7 and the filing organization's portion of the Company's annual community benefit statement is due to a difference in the costing methodology and differences in the population of Medicare patients within the calculation. The cost methodology utilized in calculating any Medicare surplus/(shortfall) for purposes of the annual community benefit reporting is based upon the cost-to-charge ratio outlined in Worksheet 2 of the Schedule H instructions. The same cost-to-charge ratio is used to determine the costs associated with services provided to charity care patients and Medicaid patients as reported in Schedule H, Part I, line 7. In addition, the Medicare cost report excludes services provided to Medicare patients for physician services, services provided to patients enrolled in Medicare HMOs, and certain services provided by outpatient departments of the filing organization that are reimbursed on a fee schedule. The Company's own community benefit statement captures the unreimbursed cost of providing services to all Medicare beneficiaries throughout the organization. Part VI, Line 2: The three hospitals operated by the filing organization conduct community health needs assessments (CHNA) every three years. The 2019 CHNAs were adopted by the filing organization's governing board by December 31, 2019, the end of the filing organization's taxable year in which it conducted the CHNAs. The filing organization's 2019 CHNAs complied with the guidance set forth by the IRS in Final Regulation Section 1.501(r)-3. In addition to the CHNAs discussed above, a variety of practices and processes are in place to ensure that the filing organization is responsive to the health needs of the communities it serves.Such practices and processes involve the following:1. A hospital operating/community board composed of individuals broadly representative of the community, community leaders, and those with specialized medical training and expertise;2. Post-discharge patient follow-up related to the on-going care and treatment of patients who suffer from chronic diseases; 3. Sponsorship and participation in community health and wellness activities that reach a broad spectrum of the filing organization's community; and 4. Collaboration with other local community groups to address the health care needs of the filing organization's community. Part VI, Line 3: The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of each of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. For each of the filing organization's hospital facilities, the FAP, FAA Form, PLS, and contact information for the hospital facility's financial counselors are prominently and conspicuously posted on each of the filing organization's hospital facility's websites. Each website indicates that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by the hospital facility (referred to below as LEP populations). Signage is displayed in public locations of each of the filing organization's hospital facilities, including at all points of admission and registration and the Emergency Department. The signage contains each of the hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of each of the hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. Each of the filing organization's hospital facility's financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each of the hospital facility's PLS will be offered to every patient as a part of the intake or discharge process. A conspicuous written notice is included on all billing statements sent to patients that notifies and informs recipients about the availability of financial assistance under the filing organization's financial assistance policy, including the following: 1) the telephone number of the relevant hospital facility's office or department that can provide information about the FAP and the FAA Form; and 2) the website address where copies of the FAP, FAA Form and PLS may be obtained. Reasonable attempts are made to inform individuals about each of the hospital facility's FAP in all oral communications regarding the amount due for the individual's care. Copies of the PLS are distributed to members of the community in a manner reasonably calculated to reach those members of the community who are most likely to require financial assistance. Part VI, Line 4: The filing organization currently operates 3 hospital facilities, AdventHealth Tampa, including a Heart Hospital, AdventHealth Carrollwood, and AdventHealth Connerton, a long-term acute care hospital, on three campuses in and around the Tampa Bay Area. Combined, these facilities are a major healthcare provider caring for close to 200,000 patients each year residing in Hillsborough, Pasco and surrounding Counties. A description of each of the hospital campuses is described below. University Community Hospital, Inc. dba AdventHealth Tampa;AdventHealth Tampa (AHT), located in Hillsborough County in close proximity to the University of South Florida, is licensed for 536 acute-care beds. AHT is home to six Centers of Excellence that focus resources on major disease areas including cardiac treatment, women's health, stroke, pediatrics, diabetes management and orthopaedics. AdventHealth Pepin Heart Institute (AHPHI), located adjacent to AHT, is licensed for 75 beds. This free-standing heart hospital is filled with advancements in technology, techniques, and revolutionary patient-centered care and is raising expectations when it comes to the diagnosis, treatment, and study of cardiovascular disease. Most importantly, AHPHI is filled with a team of physicians, nurses, technicians, and staff who have worked together for more than 20 years to create one of the most successful heart programs in the Tampa Bay Area. AHPHI's physicians and clinical specialists have built a comprehensive cardiovascular program with the experience of providing thousands of angioplasty procedures and open heart surgeries.During 2019, the Hospital's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2019, about 61.5% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 47.9% - Medicaid Patients 13.9% - Self-Pay Patients 6.9% The demographic makeup of the Hospital's community is as follows: - Population 719,068 - Population Over 65 14.23% - Poverty (Below 100% FPL) 17.8% - Unemployment Rate 5.7% - Violent Crime Rate (Per 100,000 Pop.) 327.9 - Pop. Age 25+ with No High School Diploma 12.8% - Uninsured Adults 17.47% - Uninsured Children 5.55% - Food Insecurity Rate 15.5% - Pop. with Low Food Access 30.65% University Community Hospital, Inc. dba AdventHealth Carrollwood;AdventHealth Carrollwood (AHCW), also located in Hillsborough County, is licensed for 103 beds and offers comprehensive medical and surgical care, many specialized services, as well as a wide range of radiological procedures available for diagnosis and treatment of injuries and illnesses. Diagnostic imaging services offered include x-rays, ultrasound, mammography, nuclear medicine, CT Scan and special procedures. AHCW's five-story medical tower also houses a six-suite surgery unit that offers advanced technologies in gynecologic, vascular surgery and joint replacement procedures.During 2019, the Hospital's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. In 2019, about 72.3% of the Hospital's in-patients were admitted through the Hospital's Emergency Department. - Medicare Patients 50.2% - Medicaid Patients 10.1% - Self-Pay Patients 6.6% The demographic makeup of the Hospital's community is as follows: - Population 547,282 - Population Over 65 12.85% - Poverty (Below 100% FPL) 20.4% - Unemployment Rate 5.5% - Violent Crime Rate (Per 100,000 Pop.) 338.8 - Pop. Age 25+ with No High School Diploma 13.7% - Uninsured Adults 17.24% - Uninsured Children 5.5% - Food Insecurity Rate 15.7% - Pop. with Low Food Access 17.26%University Community Hospital, Inc. dba AdventHealth Connerton;AdventHealth Connerton (AHC), located in Pasco County is licensed for 77 beds. This facility is designed to serve individuals who have medically complex illnesses, requiring additional weeks of specialized hospital care. AdventHealth Connerton (AHC) is a long-term acute care hospital located in rural Pasco County, Florida. When AHC conducted its most recent Community Health Needs Assessment, its Community Health Needs Assessment Committee noted the unique nature of the AdventHealth Connerton facility. AHC does not have an Emergency Department and is not a "community" hospital with a defined geographic service area. In 2015, patient referrals came from 25 other hospitals; patients themselves came from 52 different counties mostly in, but not limited to, Florida. During 2019, the Hospital's patient percentage population was made up of the below payors with the remaining percentage of the patients being covered under commercial insurance. - Medicare Patients 84.6% - Medicaid Patients 1.7% The demographic makeup of the Hospital's community is as follows: - Population 1,347,505 - Population Over 65 17.5% - Poverty (Below 100% FPL) 15.7% - Unemployment Rate 6.3% - Violent Crime Rate (Per 100,000 Pop.) 317.6 - Pop. Age 25+ with No High School Diploma 11.7% - Uninsured Adults 17.6% - Uninsured Children 5.62% - Food Insecurity Rate 15.5% - Pop. with Low Food Access 31.86% The filing organization (UCH) is a crucial community and regional asset. UCH provides necessary medical services to the already large and rapidly expanding Tampa Area. With the exception of AHC, each facility is located in Tampa, Florida and primarily serves patients residing in Hillsborough County which is located on the west coast of central Florida. 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 $718,193 of benefit with respect to the faith-based and spiritual needs of the community in conjunction with its operation of its community hospitals. The filing organization also provides benefits to its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the filing organization expended $137,725,306 in new capital improvements. As a faith-based mission-driven community hospital organization, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the filing organization are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities.The filing organization's community outreach efforts are focused on health education, wellness information, physician referral, and screening services. Each month, the filing organization offers a variety of health and wellness classes taught by members of its medical staff and other health care professionals. The filing organization also maintains a speakers' bureau whereby qualified speakers are provided to community groups to deliver the latest information on health, wellness, and prevention. Because prevention and early detection are key components of maintaining good health for individuals of all ages, UCH regularly conducts a variety of free and low-cost health screening events. Such screenings include cholesterol, blood pressure checks, body fat and osteoporosis screenings. Part VI, Line 6: University Community Hospital, Inc. 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 AHS subsidiary pays a management fee to AHSSHC for the internal services provided by AHSSHC. As a result, management fee expense reported by an AdventHealth subsidiary organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity by entity basis, there is no single Form 990 that captures the programs and operations of AdventHealth as a whole. The reader is directed to visit the web-site of AdventHealth at www.adventhealth.com to learn more about the mission and operations of AdventHealth. Part VI, Line 7: The filing organization does not file a community benefit report with any state. 1 American Heart Association Inc 11207 Blue Heron Blvd N St Petersburg FL 33716 135613797 501(c)(3) 30000 General Support Lowry Park Zoological Society of Tampa Inc 1101 W Sligh Ave Tampa FL 33604 592328289 501(c)(3) 15000 General Support University Area Community Development Corp Inc 14013 N 22nd St Suite A Tampa FL 33613 311624121 501(c)(3) 10000 General Support American Lung Association 100 S Ashley Drive Suite 275 Tampa FL 33602 131632524 501(c)(3) 7500 General Support Bret Miller 1T Foundation 4222 W 69th Terrace Prairie Village KS 66208 300629446 501(c)(3) 7500 General Support 5 0 Part I, Line 2: Grants are generally made only to related organizations that are exempt from Federal Income Tax under 501(c)(3), or to other non-profit community organizations. Accordingly, the filing organization has not established specific procedures for monitoring the use of grant funds in the United States as the filing organization does not have a grant making program that would necessitate such procedures. X X X X X X 1 1 1 1 0 0 0 0 0 0 0 Schultz Michael H Vice Chair/CEO West FL Reg 0 898069 0 339520 0 620298 0 15087 0 35222 0 1908196 0 0 Bergherm Bruce Dir/SEO West FL Region 0 549470 0 152709 0 341383 0 97292 0 26987 0 1167841 0 41695 Johnson Joel Former CEO - Carrollwood 0 420002 0 109324 0 366543 0 45063 0 35903 0 976835 0 23449 Adams Brian S Director/CEO (end 5/19) 0 525143 0 116724 0 92751 0 71381 0 40686 0 846685 0 67282 Didenko Vadym V Former Officer - CFO West FL Region 0 504495 0 114100 0 90804 0 66213 0 41595 0 817207 0 51481 Bales-Chubb Denyse Director/CEO (beg 7/19) 0 458932 0 89200 0 58065 0 84630 0 30524 0 721351 0 42579 Skula Erika CEO - Carrollwood 0 316654 0 47646 0 287454 0 30016 0 23037 0 704807 0 5449 Mcguinness Robin J Former Key Emp-CNO West Region 0 386439 0 75290 0 44553 0 66484 0 23169 0 595935 0 28554 Torres MD Michael A Former CMO - Tampa 0 374999 0 69691 0 63564 0 44621 0 25178 0 578053 0 28782 Jiang-Saldana Hui Former COO - Tampa 0 353348 0 48951 0 54841 0 28379 0 37166 0 522685 0 24479 Coe Jason COO - Tampa 0 339662 0 60939 0 25435 0 38953 0 36528 0 501517 0 9819 Bjornstad MD Brad CMO - Carrollwood 0 336798 0 65274 0 71880 0 15087 0 11596 0 500635 0 0 Ross MD Douglas CMO - Tampa 0 288905 0 0 0 146914 0 21754 0 26215 0 483788 0 0 Lambert MD Charles Physician/Medical Director 382028 0 30600 0 29333 0 15087 0 18155 0 475203 0 0 0 Heinrich William CFO - Tampa (end 6/19) 0 306519 0 55072 0 26175 0 16657 0 38232 0 442655 0 0 Dunkel Jason Director (beg 5/19) 0 305675 0 43431 0 33548 0 16446 0 36026 0 435126 0 0 Shaw Brigitte W CBDO - Tampa 0 285796 0 39029 0 42901 0 22292 0 25243 0 415261 0 13626 Cox Shane H Former CFO - Carrollwood 0 283252 0 39724 0 37152 0 21654 0 29581 0 411363 0 6677 Davis Tyson CFO - Tampa (beg 10/19) 0 264979 0 45335 0 22114 0 15087 0 33303 0 380818 0 0 Trivette Theresa CNO - (end 10/19) 0 195649 0 36184 0 76735 0 12693 0 22570 0 343831 0 0 Chubb John Former COO-Carrollwood 0 0 0 43563 0 181413 0 1133 0 2592 0 228701 0 80736 Sauder Christopher CFO - Carrollwood 0 211267 0 39666 0 1596 0 13313 0 33437 0 299279 0 0 Escousse Thomas AVP & ED Cardio Services 221829 0 19048 0 5753 0 13083 0 19622 0 279335 0 0 0 Strech Scott AVP Cardio Services 147704 0 13860 0 59153 0 8675 0 15761 0 245153 0 0 0 Chu Loc Cardio Invasive Specialist 65065 0 5695 0 150310 0 11604 0 8636 0 241310 0 0 0 Long Tammy Exec Dir of Nursing 56872 0 5328 0 153647 0 5108 0 20155 0 241110 0 0 0 Part I, Line 1a The filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 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 Regional SEO and the Regional CEO for the AdventHealth West Florida Division are members of the Board of Directors of the filing organization. The AdventHealth West Florida Region CFO and CNO are also listed on Part VII and are eligible for the special travel allowance. All of the individuals serving in these roles 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 in part by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for first-class or charter travel since it has partially paid for the cost of providing this benefit. Those executives who receive the special travel allowance are responsible for tracking the expenses reimbursable under the special travel allowance and must submit such expenses on their accountable plan expense report. Any taxable reimbursements made to executives under the special travel allowance arrangement are treated as taxable compensation to the executive. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to certain executive leaders and is usually limited to one business trip per year beyond the annual AdventHealth President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AdventHealth has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval by the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: Nominal discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth CFO Conference or the CMO/CNO business meeting ($300 or less per executive). Payments provided to each executive are considered taxable compensation to the executive. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. Any taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, certain AdventHealth eligible executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be 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. Additionally the Regional CEO and SEO of the West Florida Division of AdventHealth are listed on Part VII of the Form 990 and were reimbursed for social club dues. While the club dues membership is an AHSSHC compensation policy and practice, the cost of providing this benefit for the Regional CEO and SEO is allocated to and partially reimbursed by the filing organization. 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, John Chubb and Theresa Trivette received severance payments in the amount of $96,836 and $46,877 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. Schedule J, Part I, Line 4b: As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of a healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides to eligible executive's 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./ Distributions Contrib. Distributions* Payment ------------------------------------------------------- Schultz, Michael $169,331 $150,331 $275,464 $ 0 Bergherm, Bruce $ 92,206 $ 42,088 $249,122 $ 0 Johnson, Joel $ 48,976 $ 23,688 $302,346 $ 0 Adams, Brian $ 75,294 $ 68,937 $ 0 $ 0 Didenko, Vadym $ 70,126 $ 56,302 $ 0 $ 0 Bales-Chubb, Denyse $ 69,543 $ 42,449 $ 0 $ 0 Skula, Erika $ 33,929 $ 5,505 $ 0 $ 0 McGuinness, Robin $ 51,397 $ 29,014 $ 0 $ 0 Torres, MD, Michael $ 48,534 $ 29,378 $ 0 $ 0 Jiang-Saldana, Hui $ 32,292 $ 25,825 $ 0 $ 0 Coe, Jason $ 28,867 $ 9,772 $ 0 $ 0 Bjornstad, MD, Brad $ 47,795 $ 28,795 $ 0 $ 0 Ross, MD, Douglas $ 26,160 $ 0 $ 0 $ 0 Heinrich, William $ 20,570 $ 0 $ 0 $ 0 Dunkel, Jason $ 20,359 $ 0 $ 0 $ 0 Shaw, Brigitte $ 26,205 $ 13,960 $ 0 $ 0 Cox, Shane $ 25,568 $ 6,551 $ 0 $ 0 Davis, Tyson $ 3,125 $ 0 $ 0 $ 0 Chubb, John $ 0 $ 48,129 $ 0 $ 32,607 * Including Investment Earnings Nicholas Boigenzahn Family of Board Member 36832 Employee Compensation 0 Part V, Line 1a The parent corporation and sole top-tier member of University Community Hospital, Inc. (the filing organization) is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization no longer issues Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041. Form 990, Part VI, Section A, line 6 University Community Hospital, 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. AHSSHC appoints all voting members to the Board of Directors of UCH. Regular directors are nominated by the Board of Directors of UCH but must be appointed by the member. 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: 1) The approval or disapproval of the Bylaws of the filing organization; 2) To set limits and terms for the borrowing of funds in excess of $100,000; 3) The approval or disapproval of single expenditures and/or the purchase or sale of real property in excess of one million dollars; 4) To direct the placement of funds and capital of the filing organization; 5) To establish general guiding policies; and 6) To approve the identity of an auditing firm and election of the fiscal year for the filing organization. Form 990, Part VI, Section B, line 11b The filing organization's current year Form 990 was reviewed by the Board Chairman, Board Finance Committee Chair, CEO and by the CFO prior to its filing with the IRS. The review conducted by these individuals 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 (not including physician members of the board), 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. Physician members of the Board of Directors received compensation from related organizations as a result of providing various medical services to those related entities. Part VIII, Lines 7a, b and c: The amounts shown in Part VIII, Lines 7a(i) and 7c(i) of the Form 990 represents an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. Form 990, Part IX, line 11g Payments to Healthcare Professionals: Program service expenses 53,978,413. Management and general expenses 0. Fundraising expenses 0. Total expenses 53,978,413. Professional Fees: Program service expenses 9,029,049. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,029,049. Purchased Medical Services: Program service expenses 13,281,684. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,281,684. Environmental Services: Program service expenses 1,970,551. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,970,551. Transcription Services: Program service expenses 235,810. Management and general expenses 0. Fundraising expenses 0. Total expenses 235,810. Recruiting: Program service expenses 555,357. Management and general expenses 0. Fundraising expenses 0. Total expenses 555,357. Food Service Contracts: Program service expenses 169. Management and general expenses 0. Fundraising expenses 0. Total expenses 169. Miscellaneous Purchased Services: Program service expenses 6,181,839. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,181,839. AdventHealth Management Fees: Program service expenses 0. Management and general expenses 8,596,036. Fundraising expenses 0. Total expenses 8,596,036. Billing & Collection Services: Program service expenses 0. Management and general expenses 5,669,434. Fundraising expenses 0. Total expenses 5,669,434. AdventHealth Shared Services Fees: Program service expenses 0. Management and general expenses 5,917,732. Fundraising expenses 0. Total expenses 5,917,732. Form 990, Part XI, line 9: ASC 842 Lease Accounting Adjustments -1,276,099. Pension Liability Adjustment -1,981,222. Transfer to top-tier tax-exempt parent -10,847,066. Transfer from tax-exempt sub 260,665. Gift from Foundation 4,133,866. Interest in Foundation Restricted Earnings 1,583,155. Allocation to tax-exempt parent with respect to debt -634,598. Net Transfer to tax-exempt affiliates -69,770,256. Rounding 4. 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. 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 1 AdventHealth Foundation Shawnee Mission 9100 W 74th Street Shawnee Mission KS 66204 480868859 Fund-raising for Tax-exempt hospital KS 501(c)(3) Line 7 Shawnee Mission Medical Center Inc 1 AdventHealth Home Care East Florida LLC (218-123119) 770 West Granada Blvd 319 Ormond Beach FL 32174 833768458 Inactive FL 501(c)(3) Line 12a, I Memorial Hlth Systems Inc 1 AdventHealth Hospice Care East Florida Inc (218-123119) 770 West Granada Blvd 304 Ormond Beach FL 32174 833748461 Inactive FL 501(c)(3) Line 12a, I Memorial Hlth Systems Inc 1 AdventHealth North Polk Inc 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 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 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 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 1 AdventHealth Ransom Memorial Inc 1301 S Main Street Ottawa KS 66067 830976641 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 AdventHealth University Inc 671 Lake Winyah Drive Orlando FL 32803 593069793 Education/Operation of School FL 501(c)(3) Line 2 Adventist Hlth SystemSunbelt Inc 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 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 1 Adventist Bolingbrook Hospital 500 Remington Blvd Bolingbrook IL 60440 651219504 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 Adventist Care Centers - Courtland Inc 730 Courtland Street Orlando FL 32804 205774723 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights IL 60139 363208390 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Midwest Health 1 Adventist Hlth Mid-America Inc 9100 W 74th Street Shawnee Mission KS 66204 521347407 Support of Affiliated Hospital KS 501(c)(3) Line 12c, III-FI Adventist Hlth SystemSunbelt Inc 1 Adventist Hlth Partners Inc 2601 Navistar Dr Bldg 4 Finance Lisle IL 60532 364138353 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc 1 Adventist Hlth System Sunbelt Hlthcare Corp 900 Hope Way Altamonte Springs FL 32714 592170012 Management Services FL 501(c)(3) Line 12a, I N/A 0 Adventist Hlth System Georgia Inc 1035 Red Bud Road Calhoun GA 30701 581425000 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemSunbelt Inc 900 Hope Way Altamonte Springs FL 32714 591479658 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Hlth SystemTexas Inc 11801 S Freeway Burleson TX 76028 742578952 Leasing Personnel to Affiliated Hospital TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Adventist Midwest Health 120 North Oak Street Hinsdale IL 60521 362276984 Operation of Hospital & Related Services IL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 AHP Specialty Care NFP 2601 Navistar Dr Bldg 4 Finance Lisle IL 60532 811105774 Operation of Physician Practices & Medical Services IL 501(c)(3) Line 3 AHS Midwest Management Inc 1 AHS Midwest Management Inc 2601 Navistar Dr Bldg 4 Finance Lisle IL 60532 363354567 Operation of Physician Practice Mgmt IL 501(c)(3) Line 12a, I Adventist Midwest Health 1 AHSCentral Texas Inc 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 1 Apopka Hlth Care Properties Inc 305 E Oak Street Apopka FL 32703 510605694 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs FL 32714 381359189 Inactive MI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Bert Fish Medical Center Auxiliary Inc 401 Palmetto Street New Smyrna Beach FL 32168 591054892 Volunteer support services FL 501(c)(3) Line 10 N/A 0 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 1 Burleson Nursing & Rehab Center Inc 301 Huguley Blvd Burleson TX 76028 205782243 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 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 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 1 Chickasaw Hlth Care Properties Inc 250 S Chickasaw Trail Orlando FL 32825 510605681 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Chippewa Valley Hospital & Oakview Care Center Inc 1220 Third Avenue West Durand WI 54736 391365168 Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Courtland Hlth Care Properties Inc 730 Courtland Street Orlando FL 32804 510605682 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Creekwood Place Nursing & Rehab Center Inc 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 1 Dairy Road Hlth Care Properties Inc 7350 Dairy Road Zephyrhills FL 33540 510605684 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 East Orlando Hlth & Rehab Center Inc 250 S Chickasaw Trail Orlando FL 32825 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Emory-Adventist Inc 900 Hope Way Altamonte Springs FL 32714 582171011 Inactive GA 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospital & Related Svcs NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 FLNC Inc 3355 E Semoran Blvd Apopka FL 32703 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Florida Hospital Dade City Inc 13100 Fort King Road Dade City FL 33525 822567308 Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Healthcare Partners Inc 770 West Granada Blvd 101 Ormond Beach FL 32174 462354804 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Medical Group Inc 2600 Westhall Lane 4th Floor Maitland FL 32751 593214635 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Ocala Inc 1500 SW 1st Avenue Ocala FL 34471 824372339 Operation of Hospital & Related Svcs FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Physician Group Inc 12470 Telecom Dr 100 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Waterman Inc 1000 Waterman Way Tavares FL 32778 593140669 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills FL 33541 592108057 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Radiology Imaging at Lake Mary LLC 2600 Westhall Lane 4th Floor Maitland FL 32751 550789387 Imaging & Testing FL 501(c)(3) Line 3 Florida Hospital Medical Group Inc 1 Fountain Inn Nursing & Rehab Center Inc 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 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 N/A 0 Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Hinsdale Hospital Foundation 120 North Oak Street Hinsdale IL 60521 521466387 Fund-raising for Tax-exempt hospital IL 501(c)(3) Line 7 Midwest Hlth Foundation 0 Hospice of the Comforter Inc 480 W Central Parkway Altamonte Springs FL 32714 592935928 Operation of Hospice FL 501(c)(3) Line 10 The Comforter Health Care Group Inc 1 In-Motion Rehab Inc 485 North Keller Road 250 Maitland FL 32751 208023411 Therapy services to tax exempt nursing homes KS 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 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 1 Memorial Hlth Systems Foundation Inc 305 Memorial Medical Pkwy 212 Daytona Beach FL 32117 311771522 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Memorial Hlth Systems Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 590973502 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland FL 32720 593256803 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592951990 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Inc 210 Marie Langdon Drive Manchester KY 40962 610594620 Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 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 1 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Physician Hlthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 Midwest Hlth Foundation 120 North Oak Street Hinsdale IL 60521 352230515 Support of subsidiary foundations IL 501(c)(3) Line 12b, II N/A 0 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 1 Mission Strategies of Georgia Inc 485 North Keller Road 250 Maitland FL 32751 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Missouri Adventist 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 1 Ormond Beach Memorial Hospital Auxiliary Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 591721962 Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A 0 Osceola Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813165729 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park KS 66204 205774821 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 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 1 Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel FL 33544 208488713 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Portercare Adventist 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 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 1 Princeton Professional Services Inc 601 E Rollins Street Orlando FL 32803 591191045 Provision of Hlthcare Services FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Quality Circle for Hlthcare Inc 900 Hope Way Altamonte Springs FL 32714 263789368 Hlthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 Resource Personnel Inc 485 North Keller Road 250 Maitland FL 32751 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Rocky Mountain Adventist Hlthcare Foundation (630 Year End) 7995 E Prentice Ave 204 Greenwood Village CO 80111 840745018 Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 N/A 0 Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen TX 76549 461656773 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 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 1 San Marcos Hlth Care Properties Inc 1900 Medical Parkway San Marcos TX 78666 510605693 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos TX 78666 205782224 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Inc 6501 West 75th Street Overland Park KS 66204 480952508 Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813914908 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 South Pasco Hlth Care Properties Inc 38250 A Avenue Zephyrhills FL 33542 510605679 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Southeast Volusia Healthcare Corp 401 Palmetto Street New Smyrna Beach FL 32168 473793197 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Southwest Volusia Hlth Services Inc 1055 Saxon Blvd Orange City FL 32763 593281591 Medical Office Building for Hospital FL 501(c)(3) Line 12a, I Southwest Volusia Hlthcare Corp 1 Southwest Volusia Hlthcare Corp 1055 Saxon Blvd Orange City FL 32763 593149293 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Specialty Physicians of Central Texas Inc 1301 Wonder World Drive San Marcos TX 78666 208814408 Physician Hlthcare services to the community TX 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Spring View Hlth & Rehab Center Inc 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 1 Sunbelt Hlth & Rehab Center - Apopka Inc 305 East Oak Street Apopka FL 32703 205774856 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Hlth Care Centers Inc 485 North Keller Road 250 Maitland FL 32751 581473135 Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 SunSystem Development Corp 900 Hope Way Altamonte Springs FL 32714 592219301 Fund Raising for Affiliated Tax-Exempt Hospitals FL 501(c)(3) Line 7 Adventist Hlth System Sunbelt Hlthcare Corp 1 Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 590898901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc 1 Tarrant County Hlth Care Properties Inc 301 Huguley Blvd Burleson TX 76028 510605677 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 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 1 The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs FL 32714 271857940 Lease to Related Organization FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 The Volunteer Auxiliary of Florida Hospital - Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592486582 Volunteer support services FL 501(c)(3) Line 12c, III-FI N/A 0 Tri-County Nursing and Rehab Center Inc 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 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 1 University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa FL 33613 592554889 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 12a, I N/A 0 University Community Hospital Inc 3100 E Fletcher Ave Tampa FL 33613 591113901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 West Florida Health Home Care Inc 13601 Bruce B Downs Blvd Ste 110 Tampa FL 33613 593686109 Home Health Services GA 501(c)(3) Line 10 West Florida Health Inc 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 1 Zephyr Haven Hlth & Rehab Center Inc 38250 A Avenue Zephyrhills FL 33542 205774930 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Zephyrhills Hlth & Rehab Center Inc 7350 Dairy Road Zephyrhills FL 33540 205774967 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 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 N/A The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam KS 66204 823025378 Surgery Center KS N/A Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL N/A C 1 Apopka Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 593000857 Condo Association FL N/A C 1 CC MOB Inc 2201 S Clear Creek Road Killeen TX 76549 742616875 Real Estate Rental TX N/A C 1 Central Texas Medical Associates 1301 Wonder World Drive San Marcos TX 78666 742729873 Inactive TX N/A C 1 Central Texas Providers Network 1301 Wonder World Drive San Marcos TX 78666 742827652 Physician Hospital Org. TX N/A C 1 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 1 Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando FL 32803 821748255 Condo Association FL N/A C 1 Florida Hospital Healthcare System Inc 101 Southhall Lane Ste 150 Maitland FL 32751 593215680 PHSO FL N/A C 1 Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL N/A C 1 Florida Memorial Health Network Inc (11 - 102419) 770 W Granada Blvd Ste 317 Ormond Beach FL 32174 593403558 Physician Hospital Org. FL N/A C 1 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL N/A C 1 LN Health Partners Inc 550 E Rollins Street 6th Floor Orlando FL 32803 813556903 Inactive FL N/A C 1 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Inactive KS N/A C 1 North American Health Services Inc & Sub 900 Hope Way Altamonte Springs FL 32714 621041820 Lessor/Holding Co. TN N/A C 1 Ormond Prof Associates Condo Assoc'n Inc (430 year end) 770 W Granada Blvd Ste 101 Ormond Beach FL 32174 592694434 Condo Association FL N/A C 1 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 1 Porter Affiliated Health Services Inc 2525 S Downing Street Denver CO 80210 840956175 Healthcare Services CO N/A C 1 San Marcos Regional MRI Inc 1301 Wonder World Drive San Marcos TX 78666 770597968 Holding Company TX N/A C 1 The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland FL 32751 593414055 Real Estate Rental FL N/A C 1 Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando FL 32803 452228478 Condo Association FL N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 Adventist Health System Sunbelt Healthcare Corp M 5500376 % of Facility's Operating Exp. Adventist Health System Sunbelt Healthcare Corp P 30047389 Cost Adventist Health System Sunbelt Healthcare Corp-Shared Svcs M 5917732 % of Facility's Operating Exp. Adventist Health System Sunbelt Healthcare Corp dba AIT M 23354768 % of Facility's Operating Exp. Adventist Health System Sunbelt Healthcare Corp R 1650463 Actual Amount Given Florida Hospital Physician Group Inc P 25639530 Cost Florida Hospital Zephyrhills Inc Q 9314862 Cost Pasco-Pinellas Hillsborough Community Health System Inc Q 11933614 Cost Tarpon Springs Hospital Foundation Inc Q 7269398 Cost University Community Hospital Foundation Inc Q 4070742 Cost Pasco-Pinellas Hillsborough Community Health System Inc P 391521 Cost Florida Hospital Zephyrhills Inc P 91429 Cost Adventist Health SystemSunbelt Inc dba AdventHealth Sebring Q 3864791 Cost Adventist Health SystemSunbelt Inc dba AdventHealth Orlando P 1160871 Cost Adventist Health System Sunbelt Healthcare Corp B 5858783 Actual Amount Given University Community Hospital Foundation Inc P 222241 Cost Florida Hospital Dade City Inc Q 1833071 Cost Florida Hospital Ocala Inc Q 9992498 Cost West Florida Health Home Care Inc Q 1717200 Cost Adventist Health System Sunbelt Healthcare Corp - Insurance Allocation P 3337820 Cost SunSystem Development Corp -dba AH Foundation West Florida Q 776146 Cost AdventHealth West Florida Imaging Inc R 837603 Actual Transfer AdventHealth West Florida Ambulatory Services Inc R 2017861 Actual Transfer Adventist Health System Sunbelt Healthcare Corp R 1650463 Actual Transfer Florida Hospital Physician Group Inc R 808113 Actual Transfer Florida Hospital Ocala Inc R 51068634 Actual Transfer Tarpon Springs Hospital Foundation Inc R 15013016 Actual Transfer Florida Hospital Dade City Inc R 2619827 Actual Transfer Adventist Health System Sunbelt Healthcare Corp P 215721 Cost University Community Hospital Foundation Inc C 4133866 Actual Amount Received Zephyrhills Health & Rehab Center Inc B 51547 Actual Amount Given