2023-11-15T14:16:47-06:00 2022-12-31 990 2022-01-01 560543246 FLETCHER HOSPITAL INC FLET 8286848501 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 LYNN C ADDISCOTT ASSISTANT SECRETARY 8286848501 2023-11-07 LYNN ADDISCOTT 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ADVENTHEALTH HENDERSONVILLE BRANDON NUDD 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 240832106 0 X WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-HENDER X 1920 NC THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 103 BED HOSPITAL. 9 4 1679 62 69211 0 1544181 703812 251713749 234927755 10309312 2217409 17677 33989 263584919 237882965 905326 650675 0 0 110378639 115032092 0 0 0 130811868 121322520 242095833 237005287 21489086 877678 309247463 251870727 88958980 60841957 220288483 191028770 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 216165402 650675 234858544 THE HOSPITAL OPERATES A 103-BED ACUTE CARE HOSPITAL WITH 4,167 PATIENT ADMISSIONS, 19,329 PATIENT DAYS, 177,618 OUTPATIENT VISITS, AND 278,260 PHYSICIAN PRACTICE PATIENT VISITS IN THE CURRENT YEAR. 216165402 1 1 0 1 0 0 0 0 0 0 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 1 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 1679 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X STEVEN BURROUGHS 8286812102 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 X MURRILL MICHAEL DIRECTOR/CHAIR/CEO SE REGION 7.50 42.50 X X 0 898843 187713 GUYTON ALAN DIRECTOR/CFO SE REGION 9.15 40.85 X 0 560777 131096 NUDD BRANDON DIRECTOR/PRES/CEO 33.33 16.70 X X 0 511074 126438 STALFORD MDMICHAEL PHYSICIAN - MD (OTORHINOLARYNGEOLOGY) 43.20 0.00 X 557919 0 50373 DIMITROVA GERGANA PHYSICIAN - MD (PHYCHIATRY) 40.00 0.00 X 572653 0 34908 HERBERT MD TERESA CMO 50.00 0.00 X 0 482855 95183 LUGUS MDTHOMAS PHYSICIAN - MD (GEN MED/FP) 40.00 0.00 X 513816 0 31312 HARDIN MD JEFFREY PHYSICIAN - MD (CARDIOLOGY) 40.00 0.00 X 499248 0 45604 HARKHANI MD NINA PHYSICIAN - MD (UROLOGY) 40.00 0.00 X 473267 0 54698 BONNEY MD STEPHEN DIRECTOR (END 02/2022) 41.10 0.00 X 405200 0 50108 COSTON DO JEFFREY DIRECTOR 40.00 0.00 X 410921 0 41749 REEVES CORY FORMER CEO 0.00 0.00 X 0 410666 39111 MILLER SCOTT COO (END 12/2022) 50.00 0.00 X 0 340835 55833 STENSTROM ELLA CFO (END 12/2022) 50.00 0.00 X 0 297380 45287 DZIALO MAUREEN CNO 50.00 0.00 X 0 249667 51779 KIESSLING-URITIS MD MARY ANNE DIRECTOR 42.50 0.00 X 252508 0 43692 KECKLEY PAUL DIRECTOR (END 11/2022) 0.20 0.00 X 500 10000 0 LOUIS LESLIE DIRECTOR 0.20 0.00 X 46 5213 0 MCGRADY CHUCK DIRECTOR 0.20 0.00 X 546 0 0 HAMILTON TRISTAN DIRECTOR (BEG 02/2022) 0.20 0.00 X 46 0 0 LEATHERWOOD LAURA DIRECTOR 0.20 0.00 X 46 0 0 3686716 3767310 1084884 161 1 1 0 PT SOLUTIONS HOLDINGS LLC PO BOX 441146 KENNESAW GA 30160 PHYSICAL THERAPY SERVICES 8805750 VANNOY CONSTRUCTION PO BOX 635 JEFFERSON NC 28640 CONSTRUCTION SERVICES 6064403 MAXIM HEALTHCARE SERVICES INC 12558 COLLECTIONS CENTER DR CHICAGO IL 60693 AGENCY FEES 4683887 GENESISCARE USA OF NORTH CAROLINA PA 2234 COLONIAL BLVD BOX 50 FORT MYERS FL 33907 MEDICAL FEES 2090305 AMN HEALTHCARE SERVICES INC 2735 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 AGENCY FEES 1337809 59 X 587877 115935 703812 NET PATIENT REVENUE 622110 227649804 227649804 PHARMACY REVENUE 622110 6061798 6061798 CAFETERIA REVENUE 622110 411583 362109 49474 804570 784833 19737 234927755 5131925 5131925 42714 8725 33989 33989 33989 25900 2940416 0 -2940416 25900 -2914516 -2914516 237882965 234858544 69211 2251398 X 650675 650675 3750336 1204178 2546158 86936970 86527577 409393 2713651 2637623 76028 15720372 15185793 534579 5910763 5745161 165602 930904 930904 36392 36392 503329 503329 38288738 27063818 11224920 1283789 1283789 3739854 2315230 1424624 10936897 10343837 593060 7490425 7490425 515720 93242 422478 348619 348619 852543 852873 -330 6138499 6138499 1319241 1162704 156537 MEDICAL SUPPLIES 39461387 39461387 STATE TAX INDIGENT ASSE 4918341 4918341 REPAIRS & MAINTENANCE 4291028 4291028 UBI TAXES -4673 -4673 271487 83011 188476 237005287 216165402 20839885 0 X 9773 9963 197442681 137346722 27958122 27707096 -2042 -3900 4539842 4146560 8288947 8773653 152893165 84936811 61995556 67956354 9014584 5934279 309247463 251870727 16771227 12877227 121794 95113 72065959 47869617 88958980 60841957 X 220288483 191028770 220288483 191028770 309247463 251870727 X 877678 -27155370 -2982021 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15280 15280 0 PART II-B, LINE 1: DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE NORTH CAROLINA HEALTHCARE ASSOCIATION. 8437825 8437825 69674985 35935849 33739136 62739789 47932592 14807197 12040566 1068370 10972196 67956354 DUE TO RELATED 1887675 PAYABLE TO THIRD PARTIES 2174519 CREDIT BALANCES IN A/R 1003651 OTHER DEFERRED REVENUE 5146188 ACCRUED INTEREST PAYABLE 11160 INTERCO ALLOC OF TE BOND PROCEEDS 31360160 OPERATING LEASE LIABILITY 6261604 OTHER LIABILITIES 24660 47869617 X 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, 2022 AND 2021. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $18,200 AND $33,000 AT DECEMBER 31, 2022 AND 2021, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2022, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $10,000, EXPIRING IN 2023 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $4,500 AND $8,100 AT DECEMBER 31, 2022 AND 2021, 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, 2022 AND 2021 TO OFFSET THE DEFERRED TAX ASSET SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ACCOUNTING STANDARDS CODIFICATION (ASC) (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN, OR EXPECTED TO BE TAKEN, IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. 1 1 X 1 X 1 X 1 1 0 1 0 4257436 4257436 0.01800 25709312 19103732 6605580 0.02790 29966748 19103732 10863016 0.04590 106726 9915 96811 0.00040 1452116 1158988 293128 0.00120 263938 263938 0.00110 1822780 1168903 653877 0.00270 31789528 20272635 11516893 0.04860 13000 13000 0.00010 13000 13000 0.00010 1 12502033 885538 42109671 47499299 -5389628 X 1 1 1 SUMMIT HEALTH PARTNERS LLC AMBULATORY SURGERY CENTER 0.33000 0.49000 1 1 ADVENTHEALTH HENDERSONVILLE 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHE H0019 X X X ADVENTHEALTH HENDERSONVILLE 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V, PAGE 8 X X 1 20 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTHEALTH HENDERSONVILLE PART V, SECTION B, LINE 5: FLETCHER HOSPITAL, INC., D/B/A ADVENTHEALTH HENDERSONVILLE (AHH OR THE HOSPITAL), SERVES A COMMUNITY THAT INCLUDES HENDERSON COUNTY AND SOUTHERN BUNCOMBE COUNTY IN WESTERN NORTH CAROLINA. IN CONDUCTING ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), AHH COLLECTED INPUT FROM ORGANIZATIONS AND INDIVIDUALS THAT REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY, WITH SPECIFIC REPRESENTATION FROM THOSE ORGANIZATIONS THAT REPRESENT THE INTERESTS OF THE MEDICALLY UNDERSERVED AND LOW-INCOME POPULATIONS IN THE HOSPITAL'S COMMUNITY. PRIMARY AND SECONDARY DATA USED IN THE HEALTH ASSESSMENT PROCESS WAS COLLECTED IN COORDINATION WITH WNC HEALTHY IMPACT, A PARTNERSHIP BETWEEN PUBLIC HEALTH AGENCIES, HOSPITALS, AND KEY PARTNERS IN WESTERN NORTH CAROLINA THAT WORK TOWARD A VISION OF COMMUNITY HEALTH. PRIMARY DATA WAS COLLECTED THROUGH A WNC HEALTHY IMPACT COMMUNITY HEALTH SURVEY WHICH INCLUDED JUST OVER 4,800 RESPONSES. KEY INFORMANT INTERVIEWS WERE ALSO CONDUCTED WITH PARTICIPANTS CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. THIS INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS AND STAKEHOLDERS. THE HOSPITAL FORMED A COMMUNITY HEALTH ASSESSMENT TEAM TO HELP GUIDE THE COMMUNITY HEALTH NEEDS ASSESSMENT WORK. THE MEMBERS OF THE COMMUNITY HEALTH ASSESSMENT TEAM REPRESENTED NUMEROUS ORGANIZATIONS THAT SERVE THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. THE COMMUNITY HEALTH ASSESSMENT TEAM INCLUDED FOUR REPRESENTATIVES FROM THE HENDERSON COUNTY DEPARTMENT OF PUBLIC HEALTH. OTHER ORGANIZATIONS PARTICIPATING AS MEMBERS OF THE COMMUNITY HEALTH ASSESSMENT TEAM INCLUDED HOUSING ASSISTANCE CORPORATION, UNITED WAY OF HENDERSON COUNTY, INTERFAITH ASSISTANCE MINISTRY, HENDERSON COUNTY DEPARTMENT OF SOCIAL SERVICES, PARDEE UNC HEALTH CARE, THE FREE CLINICS, HOPE COALITION, COUNCIL ON AGING, THRIVE, BLUE RIDGE COMMUNITY COLLEGE, SAFELIGHT, HENDERSON FAMILY YMCA, HENDERSON COUNTY PUBLIC SCHOOLS, BLUE RIDGE COMMUNITY HEALTH SERVICES, AND CROSSNORE COMMUNITIES FOR CHILDREN. ADVENTHEALTH HENDERSONVILLE 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 HENDERSONVILLE PART V, SECTION B, LINE 11: FLETCHER HOSPITAL, INC., D/B/A ADVENTHEALTH HENDERSONVILLE, WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH HENDERSONVILLE OR "THE HOSPITAL". THE HOSPITAL IS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE 501(C)(3) PARENT ORGANIZATION OF A HOSPITAL AND HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN JANUARY 2019, EVERY WHOLLY OWNED ENTITY OF AHSSHC ADOPTED THE ADVENTHEALTH SYSTEM BRAND. OUR IDENTITY HAS BEEN UNIFIED TO REPRESENT THE FULL CONTINUUM OF CARE OUR SYSTEM OFFERS. ANY REFERENCES TO OUR PRIOR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) OR PRIOR COMMUNITY HEALTH PLANS (CHPS) WILL UTILIZE OUR NEW NAME FOR CONSISTENCY. ADVENTHEALTH HENDERSONVILLE IS PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH (THE DIVISION). THE DIVISION INCLUDES 22 HOSPITAL FACILITIES. THIS IS THE THIRD-YEAR UPDATE FOR ADVENTHEALTH HENDERSONVILLE'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. THE HOSPITAL DEVELOPED THIS PLAN AND POSTED IT IN MAY 2020 AS PART OF ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH HENDERSONVILLE WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL, AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2020-2022 COMMUNITY HEALTH PLAN. THE THIRD-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS. ADVENTHEALTH HENDERSONVILLE CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. MENTAL HEALTH2. SUBSTANCE ABUSE3. PHYSICAL ACTIVITY AND NUTRITION 4. SAFE AND AFFORDABLE HOUSINGPRIORITY 1: MENTAL HEALTH 2019 DESCRIPTION OF THE ISSUE:MENTAL HEALTH HAS BEEN A COMMUNITY HEALTH NEEDS ASSESSMENT HEALTH PRIORITY FOR HENDERSON COUNTY SINCE 2003. ACCESS TO AND THE QUALITY OF MENTAL HEALTH SERVICES HAVE BEEN A SOURCE OF CONCERN FOR MANY YEARS. OVER THE LAST 15 YEARS, MANY CHANGES TO THE MENTAL HEALTH SYSTEM HAVE OCCURRED, WHICH HAVE NEGATIVELY AFFECTED THOSE LIVING WITH MENTAL ILLNESS IN OUR COMMUNITY, AS WELL AS THEIR CAREGIVERS AND OTHER ORGANIZATIONS THAT PROVIDE SUPPORT. MENTAL HEALTH AND PHYSICAL HEALTH ARE INTRICATELY CONNECTED. MENTAL HEALTH PLAYS A KEY ROLE IN PEOPLE'S ABILITY TO MAINTAIN GOOD PHYSICAL HEALTH. MENTAL ILLNESSES, SUCH AS DEPRESSION AND ANXIETY, IMPACT PEOPLE'S ABILITY TO PARTICIPATE IN HEALTH-PROMOTING BEHAVIORS. IN TURN, PROBLEMS WITH PHYSICAL HEALTH, SUCH AS CHRONIC DISEASES, CAN HAVE A SERIOUS IMPACT ON MENTAL HEALTH AND DECREASE A PERSON'S ABILITY TO PARTICIPATE IN TREATMENT AND RECOVERY. MENTAL ILLNESS CAN AFFECT ANYONE, OF ANY AGE, AT ANY TIME IN THEIR LIVES. EVEN YOUTH ARE NOT IMMUNE. THERE IS OFTEN CO-OCCURRENCE WITH DRUG MISUSE, HOMELESSNESS, AND MENTAL ILLNESS. THE NUMBERS OF WESTERN NORTH CAROLINA RESIDENTS BEING SERVED BY MENTAL HEALTH PROGRAMS HAS DECREASED OVERALL BUT IS BEGINNING TO INCREASE AGAIN. IT IS IMPORTANT TO NOTE THAT DECREASED ACCESS DOES NOT NECESSARILY MEAN DECREASED NEED.WHEN ASKED, SURVEY AND FOCUS GROUP PARTICIPANTS MOST OFTEN REPORTED A GREATER NEED FOR SERVICES PROVIDED IN HENDERSON COUNTY. SERVICES FOR THE UNINSURED AND UNDER-INSURED POPULATIONS, AS WELL AS SERVICES PROVIDED IN SPANISH, ARE LIMITED. THE NEED TO TRAVEL TO BUNCOMBE COUNTY OR ELSEWHERE IN THE STATE TO RECEIVE SERVICES ALSO MAKES ACCESS A PROBLEM. FOR THOSE WHO HAVE INSURANCE, CO-PAYS WERE LISTED MOST FREQUENTLY AS A BARRIER TO CARE. - 14.4% OF ADULTS REPORTED MORE THAN SEVEN DAYS OF POOR MENTAL HEALTH IN THE PAST MONTH. (2018 COMMUNITY HEALTH SURVEY)- 9.2% OF ADULTS REPORTED INABILITY TO GET NEEDED MENTAL HEALTH CARE IN THE PAST YEAR. (2018 COMMUNITY HEALTH SURVEY)- SUICIDE MORTALITY RATE HAS INCREASED TO 18.8 PER 100,000.(NC STATE CENTER FOR HEALTH STATISTICS)- 21.4% OF 9TH GRADERS REPORTED SERIOUSLY CONSIDERING SUICIDE IN THE LAST YEAR.(2017 YOUTH RISK BEHAVIOR SURVEY)- 13% OF ADULTS REPORTED HAVING FOUR OR MORE ADVERSE CHILDHOOD EXPERIENCES.(2018 COMMUNITY HEALTH SURVEY)2022 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE MENTAL HEALTH PRIORITY. 1. PROVIDE NEEDED MENTAL HEALTH SERVICES AT THE RIGHT PLACE AND TIME2. ENHANCE THE COUNTY'S COMMUNITY-BASED MENTAL HEALTH SYSTEM TO FULLY SUPPORT RELATIONSHIP-BASED, PERSONALIZED CARE3. MAINTAIN SERVICES FOR THE CHRONICALLY MENTALLY ILL IN THE REGIONGOAL 1: PROVIDE NEEDED MENTAL HEALTH SERVICES AT THE RIGHT PLACE AND TIME OBJECTIVE 1: THE FIRST OBJECTIVE IS TO CONTINUE DEVELOPING THE NEXT PHASE OF A "LIVING ROAD MAP" FOCUSED SPECIFICALLY ON CAREGIVER/FAMILY SUPPORT TO HELP PATIENTS, PROVIDERS AND SAFETY-NET ORGANIZATIONS NAVIGATE THE REGION'S MENTAL HEALTH SYSTEM AND ACCESS APPROPRIATE COMMUNITY-BASED RESOURCES. THE INITIATIVE IS FUNDED AND MANAGED BY THE HENDERSON COUNTY PARTNERSHIP FOR HELP WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND A COMMITTEE OF LOCAL NON-PROFITS, GOVERNMENT AGENCIES AND HEALTH CARE PROVIDERS AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION AND ITS MEMBERSHIP. THE COMMITTEE AND THE HOSPITAL MET THIS OBJECTIVE BY COMPLETING THE PRELIMINARY RESEARCH ON EXISTING RESOURCES AND POTENTIAL GAPS FOR CAREGIVERS AND FAMILIES NAVIGATING THE REGION'S MENTAL HEALTH SYSTEM BY THE END OF YEAR THREE. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF CHILD MEDICAL EXAMS THROUGH THE BELIEVE CHILD ADVOCACY CENTER (CAC) BY AT LEAST 15% FROM A BENCHMARK OF 120 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION AND THE REPORTING HOSPITAL. SAFELIGHT MET ITS SET METRIC OF COMPLETING 140 CHILD MEDICAL EXAMS IN 2022. THE BELIEVE CHILD ADVOCACY CENTER (CAC)IN PARTNERSHIP WITH THE HOSPITAL COMPLETED 220 MEDICAL EXAMS IN 2022 AND MET THE OVERALL OBJECTIVE BY THE END OF YEAR THREE. THE HOSPITAL PROVIDED ITS ANNUAL $17,000 DONATION AND CONTINUED TO FUND THE PHYSICIAN ASSISTANT POSITION FOR THE CHILD ADVOCACY CENTER IN 2022. OBJECTIVE 3:THE THIRD OBJECTIVE IS TO INCREASE THE NUMBER OF CHILDREN SERVED BY CROSSNORE SCHOOL & CHILDREN'S HOME THROUGH ITS SCHOOL-BASED MENTAL HEALTH COUNSELING PROGRAM BY AT LEAST 10% FROM A BASELINE OF 150 STUDENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY CROSSNORE SCHOOL AND CHILDREN'S HOME WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. THE OBJECTIVE WAS MET. CROSSNORE SERVED 140 STUDENTS THROUGH ITS SCHOOL-BASED MENTAL HEALTH COUNSELING PROGRAM IN 2022 AND 634 STUDENTS OVER THE COURSE OF THE THREE-YEAR PLAN. THE HOSPITAL PROVIDED AN ANNUAL DONATION OF $5,000 TO HELP UNDERWRITE THE ORGANIZATION'S OPERATIONAL COSTS. OBJECTIVE 4:THE FOURTH OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE SURVIVORS RECEIVING SAFE, EFFECTIVE, AND TIMELY VICTIM ADVOCACY SERVICES TO ADDRESS THE EFFECTS OF TRAUMA THROUGH HELPMATE BY AT LEAST 5% FROM A BASELINE OF 3,200 WOMEN AND CHILDREN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HELPMATE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. THE OBJECTIVE WAS MET WITH HELPMATE SERVING 3,660 SURVIVORS IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL $5,000 DONATION TO THE ORGANIZATION IN 2022. THESE FUNDS HELP UNDERWRITE THE ORGANIZATION'S ANNUAL OPERATIONAL COSTS. OBJECTIVE 5:THE FIFTH OBJECTIVE IS TO INCREASE THE NUMBER OF SEXUAL ABUSE SURVIVORS SERVED BY OUR VOICE THROUGH ITS RECOVERY PROGRAMS BY AT LEAST 5% FROM A BASELINE OF 877 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY OUR VOICE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. THE OBJECTIVE WAS NOT MET BECAUSE ONGOING COVID-19 RESTRICTIONS IMPACTED OUR VOICE. OUR VOICE SERVED 549 SURVIVORS IN 2022 AND 2,031 SURVIVORS OVER THE COURSE OF THE THREE-YEAR PLAN. THE HOSPITAL PROVIDED ITS ANNUAL DONATION OF $5,000 IN 2022. THESE FUNDS HELP UNDERWRITE THE ORGANIZATION'S ANNUAL OPERATIONAL COSTS. (CONTINUED) ADVENTHEALTH HENDERSONVILLE PART V, SECTION B, LINE 13H: EFFECTIVE MARCH 1, 2020, THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) AUGMENTED THEIR FINANCIAL ASSISTANCE POLICY WITH A COVID-19 FINANCIAL GRACE ADDENDUM. PURSUANT TO THE COVID-19 FINANCIAL GRACE ADDENDUM, UNINSURED PATIENTS TREATED FOR COVID-19 RELATED EVALUATIONS ARE TO RECEIVE FREE OR DISCOUNTED CARE DEPENDING ON THE PATIENT'S COOPERATION IN SUBMITTING NECESSARY FINANCIAL ASSISTANCE INFORMATION. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS. SCHEDULE H, PART V, LINE 7A AND LINE 10A THE CHNA REPORT CAN BE FOUND AT URL: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSTHE IMPLEMENTATION STRATEGY REPORT CAN BE FOUND AT URL: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED: GOAL 2: ENHANCE THE COUNTY'S COMMUNITY-BASED MENTAL HEALTH SYSTEM TO FULLY SUPPORT RELATIONSHIP-BASED, PERSONALIZED CARE OBJECTIVE 1: THE FIRST OBJECTIVE IS TO SUPPORT AND EXPAND THE PHOENIX PROJECT IN PARTNERSHIP WITH SAFELIGHT AND THE FREE CLINICS TO ENHANCE ACCESS TO MENTAL HEALTH SERVICES AND TRAUMA-INFORMED PRIMARY CARE FOR SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT. THE PROGRAM WILL EXPAND THE NUMBER OF PATIENTS IT SERVES BY AT LEAST 10% FROM A BASELINE OF APPROXIMATELY 100 WOMEN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT AND THE FREE CLINICS WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THESE ORGANIZATIONS. THE PHOENIX PROJECT AND ITS PARTNERS SERVED 809 PATIENTS (ADULTS AND CHILDREN) BY THE END OF YEAR THREE, WITH 80 PATIENTS IN 2022. THE OBJECTIVE WAS MET. THE HOSPITAL CONTINUED TO BE THE FISCAL AGENT FOR THE GRANT SUPPORTING THIS PROGRAM, AND PROVIDED ITS ANNUAL $17,000 DONATION TO SAFELIGHT AND $10,000 DONATION TO THE FREE CLINICS IN 2022. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO IMPLEMENT AND EXPAND THE FREE CLINICS' BEHAVIORAL HEALTH OUTREACH IN THE HENDERSON COUNTY DETENTION CENTER. THE PROGRAM'S GOAL IS TO CONNECT WITH 75% OF INMATES WITHIN THE DETENTION CENTER TO SCREEN FOR MENTAL HEALTH NEEDS AND TO FOLLOW UP WITH 20% OF INMATES UPON DISCHARGE BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THE FREE CLINICS WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. AFTER THE PROGRAM'S GOAL WAS MET IN 2021, IT WAS ABSORBED BY THE HENDERSON COUNTY SHERIFF'S DEPARTMENT IN 2022. IT IS NOW ADMINISTERED, FUNDED, AND STAFFED BY HENDERSON COUNTY WITH A NEW SET OF METRICS. THE OVERALL OBJECTIVE WAS MET BY THE FREE CLINICS BY THE END OF YEAR THREE. THE HOSPITAL PROVIDED ITS ANNUAL $10,000 DONATION TO THE FREE CLINICS IN 2022. OBJECTIVE 3: THE THIRD OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS SERVED BY SAFELIGHT THROUGH ITS COUNSELING PROGRAMS BY AT LEAST 5% FROM A BASELINE OF 497 ADULTS AND CHILDREN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS NOT MET DUE TO THE PROFOUND IMPACTS OF COVID-19 ON A RESIDENTIAL DOMESTIC VIOLENCE SHELTER. SAFELIGHT SERVED 956 SURVIVORS BY THE END OF YEAR THREE, WITH 369 SURVIVORS IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL $17,000 DONATION TO SAFELIGHT IN 2022. OBJECTIVE 4: THE FOURTH OBJECTIVE IS TO INCREASE THE NUMBER OF YOUTH AND YOUNG ADULTS ON THE AUTISM SPECTRUM RECEIVING INTENSIVE APPLIED BEHAVIOR ANALYSIS (ABA) THROUGH ST. GERARD HOUSE BY AT LEAST 10% FROM A BASELINE OF 81 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ST. GERARD HOUSE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS NOT MET DUE TO THE PROFOUND IMPACTS OF COVID-19 ON ST. GERARD HOUSE'S YOUTH PROGRAMS. ST. GERARD HOUSE SERVED 258 YOUTH AND YOUNG ADULTS BY THE END OF YEAR THREE, WITH 71 SERVED IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL $5,000 DONATION TO THE ORGANIZATION IN 2022. GOAL 3: MAINTAIN SERVICES FOR THE CHRONICALLY MENTALLY ILL IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO CONTINUE SERVING INDIVIDUALS WITH SEVERE AND PERSISTENT MENTAL ILLNESS THROUGH THRIVE IN ITS CLUBHOUSE DAY PROGRAM BY MAINTAINING ITS BASELINE OF 55 ADULTS PER MONTH THROUGH THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THRIVE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE. THE OBJECTIVE WAS NOT MET DUE TO COVID-19 IMPACTS AND RESTRICTIONS WHICH PREVENTED THRIVE FROM SERVING MORE INDIVIDUALS IN ITS CLUBHOUSE DAY PROGRAM. THRIVE SERVED 41 ADULTS PER MONTH IN 2022 AND 121 ADULTS WITH SEVERE AND PERSISTENT MENTAL ILLNESS OVER THE THREE-YEAR PLAN. THE HOSPITAL PROVIDED ITS ANNUAL $7,500 DONATION TO THE ORGANIZATION IN 2022. PRIORITY 2: SUBSTANCE ABUSE 2019 DESCRIPTION OF THE ISSUE:SUBSTANCE ABUSE REFERS TO A SET OF RELATED CONDITIONS ASSOCIATED WITH THE CONSUMPTION OF MIND- AND BEHAVIOR-ALTERING SUBSTANCES THAT HAVE NEGATIVE BEHAVIORAL AND HEALTH OUTCOMES. SOCIAL ATTITUDES AND POLITICAL AND LEGAL RESPONSES TO THE CONSUMPTION OF ALCOHOL AND ILLICIT DRUGS MAKE SUBSTANCE ABUSE ONE OF THE MOST COMPLEX PUBLIC HEALTH ISSUES. SUBSTANCE ABUSE WAS IDENTIFIED AS A TOP PRIORITY IN ADVENTHEALTH HENDERSONVILLE'S PREVIOUS CHNAS.OPIOIDS CAUSED THE HIGHEST PROPORTION OF DRUG OVERDOSE DEATHS IN HENDERSON COUNTY AND IN THE STATE, AND THE RATES OF DEATHS ARE INCREASING. THIS CATEGORY OF DRUGS INCLUDES COMMONLY PRESCRIBED MEDICATIONS LIKE HYDROCODONE, OXYCODONE, MORPHINE, CODEINE, AND RELATED DRUGS. IT ALSO INCLUDES HEROIN AND SYNTHETIC NARCOTICS LIKE FENTANYL AND FENTANYL-ANALOGUES (DRUGS SIMILAR TO FENTANYL BUT HAVE BEEN CHEMICALLY MODIFIED TO BYPASS CURRENT DRUG LAWS).OPIOID-RELATED DEATHS INVOLVING PAIN MEDICATIONS LIKE OXYCODONE AND HYDROCODONE HAVE HISTORICALLY BEEN THE LEADING CAUSE OF OVERDOSE DEATHS. ILLICIT SUBSTANCES SUCH AS HEROIN, FENTANYL AND FENTANYL ANALOGUES ARE INCREASINGLY CONTRIBUTING TO OVERDOSE DEATHS, RESULTING IN HIGHER RATES OF OPIOID OVERDOSE DEATHS. AN INCREASE IN BEHAVIORS RELATED TO TOBACCO, ELECTRONIC VAPING AND ALCOHOL USAGE HAVE ALSO BEEN OF CONCERN FOR MANY COMMUNITY MEMBERS DURING THIS CHNA PROCESS.- 24 UNINTENTIONAL OPIOID DEATHS IN HENDERSON COUNTY IN 2017.(NORTH CAROLINA OPIOID DASHBOARD)- 71 OPIOID OVERDOSE EMERGENCY DEPARTMENT VISITS IN 2017.(NORTH CAROLINA OPIOID DASHBOARD)- 21.8% OF ADULTS REPORTED USING OPIATES/OPIOIDS IN THE PAST YEAR - WITH OR WITHOUT A PRESCRIPTION.(2018 COMMUNITY HEALTH SURVEY)- 21.4% OF FATAL CRASHES ARE ALCOHOL RELATED.(NCDOT)- 17.4% OF 9TH GRADERS REPORTED THAT THEY RODE WITH A DRIVER WHO HAD BEEN DRINKING ALCOHOL IN THE LAST 30 DAYS.(2017 YOUTH RISK BEHAVIOR SURVEY)- 39% OF 9TH GRADERS REPORTED THAT THEY HAVE USED ELECTRONIC VAPOR PRODUCTS.(2017 YOUTH RISK BEHAVIOR SURVEY)2022 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE SUBSTANCE ABUSE PRIORITY. 1. INCREASE AND ENHANCE COMMUNITY SUBSTANCE ABUSE, INCLUDING TOBACCO, VAPING AND ALCOHOL, EDUCATION AND PREVENTION PROGRAMS 2. REDUCE PRESCRIPTION DRUG DIVERSION AND MISUSE 3. DEVELOP COMMUNITY-BASED SUBSTANCE ABUSE TREATMENT OPTIONS AND SUPPORT PROGRAMSGOAL 1: INCREASE AND ENHANCE COMMUNITY SUBSTANCE ABUSE INCLUDING TOBACCO, VAPING AND ALCOHOL, EDUCATION AND PREVENTION PROGRAMS OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR HOPE RX (NOW HOPE COALITION) AND ITS COMMUNITY PARTNERS INCLUDING ADVENTHEALTH HENDERSONVILLE TO INCREASE THE NUMBER OF SUBSTANCE MISUSE-FOCUSED COMMUNITY EDUCATION EVENTS BY AT LEAST 15% FROM A BASELINE OF 20 EVENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HOPE RX WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. HOPE RX HOSTED 23 SUBSTANCE-MISUSE FOCUSED EVENTS IN 2022 AND MET THE OVERALL OBJECTIVE BY THE END OF YEAR THREE. THE HOSPITAL PROVIDED ITS ANNUAL $15,000 DONATION TO THE ORGANIZATION IN 2022.OBJECTIVE 2: THE SECOND OBJECTIVE IS FOR HOPE RX TO DEVELOP A LOCAL YOUTH COUNCIL TO ENGAGE HIGH SCHOOL STUDENTS IN SUBSTANCE MISUSE EDUCATION AND PREVENTION PROGRAMS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HOPE RX WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. HOPE RX DEVELOPED A LOCAL YOUTH COUNCIL AND MET THE OVERALL OBJECTIVE BY THE END OF YEAR THREE. THE 32-MEMBER YOUTH COUNCIL HOSTED SEVERAL PROGRAMS THROUGHOUT THE YEAR INCLUDING COMMUNITY EDUCATION CAMPAIGNS, SCHOOL FOOD DRIVES AND A RESEARCH PROJECT WITH UNC-CHAPEL HILL FOCUSED ON VAPING AND SUBSTANCE MISUSE. THE HOSPITAL PROVIDED ITS ANNUAL $15,000 DONATION TO THE ORGANIZATION IN 2022.GOAL 2: REDUCE PRESCRIPTION DRUG DIVERSION AND MISUSE OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR HOPE RX AND ITS COMMUNITY PARTNERS (INCLUDING ADVENTHEALTH HENDERSONVILLE) TO INCREASE THE ANNUAL NUMBER OF PRESCRIPTION DRUG DROP-OFF EVENTS BY AT LEAST 10% FROM A BASELINE OF 12 DRUG TAKE-BACK EVENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HOPE RX WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. HOPE RX HOSTED NINE PRESCRIPTION DRUG DROP-OFF EVENTS IN 2022. COVID-19 RESTRICTIONS CANCELLED MANY HOPE RX PROGRAMS DUE TO LIMITATIONS ON IN-PERSON GATHERINGS AND THE OVERALL OBJECTIVE WAS NOT MET BY THE END OF YEAR THREE. THE HOSPITAL PROVIDED ITS ANNUAL $15,000 DONATION TO THE ORGANIZATION IN 2022. SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED: GOAL 3: DEVELOP COMMUNITY-BASED SUBSTANCE ABUSE TREATMENT OPTIONS AND SUPPORT PROGRAMS OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR BLUE RIDGE HEALTH TO INCREASE PARTICIPATION IN MEDICATION ASSISTED THERAPY (MAT) PROGRAMS BY AT LEAST 10% IN WESTERN NORTH CAROLINA FROM A BASELINE OF APPROXIMATELY 200 PATIENTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY BLUE RIDGE HEALTH WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS MET BY BLUE RIDGE HEALTH WITH 1,140 PATIENTS SERVED THROUGH ITS MEDICATION ASSISTED THERAPY (MAT) PROGRAMS IN 2022. THE PROGRAM SERVED 2,424 PATIENTS OVER THE THREE-YEAR PLAN. THE HOSPITAL SUPPORTS BLUE RIDGE HEALTH THROUGH CLINICAL AND REFERRAL PARTNERSHIPS. OBJECTIVE 2: THE SECOND OBJECTIVE IS FOR FIRST CONTACT ADDICTION MINISTRIES TO EXPAND ITS SUBSTANCE ABUSE TREATMENT AND FAMILY SUPPORT PROGRAMS BY AT LEAST 10% FROM A BASELINE OF 1,100 CLIENT INTAKES BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY FIRST CONTACT ADDICTION MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. FIRST CONTACT ADDICTION MINISTRIES SERVED 2,382 CLIENTS IN 2022 AND MET THE OVERALL OBJECTIVE BY THE END OF YEAR THREE. THE HOSPITAL PROVIDED AN ANNUAL $5,000 DONATION IN 2022. OBJECTIVE 3:THE THIRD OBJECTIVE IS FOR WESTERN NORTH CAROLINA RESCUE MINISTRIES TO INCREASE THE NUMBER OF GRADUATES OF ITS ABBA'S HOUSE RESIDENTIAL PROGRAM FOR NEW MOTHERS STRUGGLING WITH DRUG ADDICTION BY AT LEAST 20% FROM A BASELINE OF 11 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY WESTERN NORTH CAROLINA RESCUE MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. WESTERN NORTH CAROLINA RESCUE MINISTRIES SERVED SEVEN PROGRAM GRADUATES IN 2022 AND MET THE OVERALL OBJECTIVE BY THE END OF YEAR THREE BY SERVING 37 TOTAL PROGRAM GRADUATES. THE HOSPITAL PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2022. OBJECTIVE 4:THE FOURTH OBJECTIVE IS FOR THE FREE CLINICS AND HENDERSON COUNTY TO PARTNER WITH AREA HOSPITALS TO DEVELOP A POST OVERDOSE RESPONSE TEAM (PORT) TO FOLLOW UP WITH PATIENTS 24 HOURS AFTER AN OVERDOSE AND CONNECT THEM WITH COMMUNITY RESOURCES AND RECOVERY PROGRAMS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THE FREE CLINICS AND HENDERSON COUNTY WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. IN 2022, THE FREE CLINICS AND HENDERSON COUNTY MET THE OBJECTIVE OF DEVELOPING A POST OVERDOSE RESPONSE TEAM (PORT). LOCAL HOSPITALS, INCLUDING ADVENTHEALTH HENDERSONVILLE, AND EMS AGENCIES REFERRED INDIVIDUALS WITH SUBSTANCE USE DISORDER (SUD) TO THE PORT TEAM AND THEN STAFF FOLLOWED UP TO HELP PATIENTS SEEK TREATMENT AND SUPPORT PROGRAMS. THE HOSPITAL PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2022. PRIORITY 3: PHYSICAL ACTIVITY AND NUTRITION 2019 DESCRIPTION OF THE ISSUE:OBESITY WAS A TOP HEALTH PRIORITY IN ADVENTHEALTH HENDERSONVILLE'S PAST CHNAS. BEING OVERWEIGHT OR OBESE IS A MAJOR RISK FACTOR FOR MANY CHRONIC DISEASES INCLUDING HEART DISEASE, TYPE 2 DIABETES, HYPERTENSION, AND CANCER. THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH CHANGED THE PRIORITY TO PHYSICAL ACTIVITY AND NUTRITION DURING THE LAST CHNA TO AVOID THE STIGMA ASSOCIATED WITH THE TERM "OBESITY AND ITS NEGATIVE CONNOTATIONS. OBESITY RATES ARE IMPORTANT, BUT NOT THE WHOLE STORY. THE COMMUNITY EMPHASIZED THAT PEOPLE CAN BE HEALTHIER AT ANY WEIGHT IF THEY MAKE EVEN MINOR LIFESTYLE CHANGES. EVIDENCE SHOWS THAT PHYSICAL ACTIVITY AND MAKING GOOD NUTRITIONAL CHOICES CAN HAVE A POSITIVE IMPACT ON OBESITY AND MANY OF THE CHRONIC DISEASES IMPACTED BY OBESITY. THE FOCUS HAS ALWAYS BEEN ON PHYSICAL ACTIVITY AND NUTRITION WHEN THE COMMUNITY WORKED TO ADDRESS "OBESITY" IN THE PAST.- 22.4% OF ADULTS IN HENDERSON COUNTY REPORT THEY GET THE RECOMMENDED AMOUNT OF PHYSICAL ACTIVITY.(2018 COMMUNITY HEALTH SURVEY) - 6.7% OF ADULTS REPORT THEY CONSUME FRUITS AND VEGETABLE FIVE OR MORE TIMES A DAY.(2018 COMMUNITY HEALTH SURVEY)- 68.5% (7 OUT OF 10) ADULTS REPORT THEY ARE OVERWEIGHT OR OBESE.(2018 COMMUNITY HEALTH SURVEY) - 1 OUT OF 5 ADULTS REPORT THEY HAVE RUN OUT OF FOOD OR WORRIED ABOUT RUNNING OUT OF FOOD AT LEAST ONCE IN THE PAST YEAR.(2018 COMMUNITY HEALTH SURVEY)- 1 OUT OF 3 CHILDREN ARE OVERWEIGHT OR OBESE.(NC-NPASS DATA: NORTH CAROLINA DIVISION OF PUBLIC HEALTH)2022 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE PHYSICAL ACTIVITY AND NUTRITION PRIORITY. 1. INCREASE PHYSICAL ACTIVITY AMONG YOUTH 2. REDUCE FOOD INSECURITY IN THE REGION 3. INCREASE ACCESS TO NUTRITIOUS FOOD FOR UNDERSERVED POPULATIONS GOAL 1: INCREASE PHYSICAL ACTIVITY AMONG YOUTH OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE PARTICIPATION IN GIRLS ON THE RUN OF WESTERN NORTH CAROLINA BY AT LEAST 10% FROM A BASELINE OF 1,002 PARTICIPANTS BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY GIRLS ON THE RUN OF WESTERN NORTH CAROLINA WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE GIRLS ON THE RUN PROGRAM RESTARTED IN 2022 IN LIMITED CAPACITY AFTER BEING PAUSED DUE TO THE IMPACTS OF COVID-19 ON AREA SCHOOLS. AS A RESULT OF THIS MODIFIED SEASON, GIRLS ON THE RUN ONLY SERVED 177 GIRLS IN 2022 AND DID NOT MEET THE OVERALL OBJECTIVE BY THE END OF YEAR THREE. DUE TO PAST POSTPONEMENTS, THE HOSPITAL'S PREVIOUS $5,000 ANNUAL DONATION WAS APPLIED IN 2022. GOAL 2: REDUCE FOOD INSECURITY IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF PEOPLE WHO RECEIVED MEALS FROM INTERFAITH ASSISTANCE MINISTRIES (IAM) BY AT LEAST 10% FROM A BASELINE OF 10,709 PEOPLE BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY INTERFAITH ASSISTANCE MINISTRIES (IAM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. INTERFAITH ASSISTANCE MINISTRIES (IAM) MET ITS SET METRIC WITH 67,492 PEOPLE SERVED MEALS IN 2022. THE OVERALL OBJECTIVE WAS MET BY THE END OF YEAR THREE. THE HOSPITAL PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2022.OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF MEALS/FOOD BOXES DISTRIBUTED BY THE STOREHOUSE BY AT LEAST 10% FROM A BASELINE OF 8,496 BOXES BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THE STOREHOUSE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE STOREHOUSE MET THE OBJECTIVE WITH 9,710 MEALS/FOOD BOXES IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL $5,000 DONATION TO THE ORGANIZATION IN 2022. OBJECTIVE 3: THE THIRD OBJECTIVE IS TO INCREASE THE NUMBER OF FOOD BOXES DISTRIBUTED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) BY AT LEAST 10% FROM A BASELINE OF 37,508 FOOD BOXES BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. DESPITE COVID IMPACTS AND RESTRICTIONS, ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES MET THE OBJECTIVE WITH 68,438 FOOD BOXES PROVIDED IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL $15,000 DONATION TO THE ORGANIZATION. OBJECTIVE 4: THE FOURTH OBJECTIVE IS TO INCREASE THE NUMBER OF HOT MEALS SERVED BY WESTERN CAROLINA RESCUE MINISTRIES BY AT LEAST 10% FROM A BASELINE OF 82,267 MEALS BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY WESTERN CAROLINA RESCUE MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. WESTERN CAROLINA RESCUE MINISTRIES MET THE OBJECTIVE WITH 70,830 HOT MEALS PROVIDED IN 2022 AND PROVIDED 315,640 MEALS OVER THE THREE-YEAR PLAN. ADVENTHEALTH HENDERSONVILLE PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2022. GOAL 3: INCREASE ACCESS TO NUTRITIOUS FOOD FOR UNDERSERVED POPULATIONS OBJECTIVE 1: THE FIRST OBJECTIVE IS FOR THE HENDERSON COUNTY COMMITTEE FOR ACTIVITY AND NUTRITION (CAN) AND ITS PARTNERS INCLUDING ADVENTHEALTH HENDERSONVILLE TO INCREASE THE NUMBER OF FARMERS MARKETS IN HENDERSON COUNTY THAT ACCEPT THE SNAP/DEBIT/CREDIT PROGRAM TO A TOTAL OF FOUR FROM A BASELINE OF TWO MARKETS BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HENDERSON COUNTY COMMITTEE FOR ACTIVITY AND NUTRITION (CAN) AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND ALL OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED: THE HENDERSON COUNTY COMMITTEE FOR ACTIVITY AND NUTRITION (CAN) DID NOT MEET THE OBJECTIVE. BY THE END OF YEAR THREE, A TOTAL OF THREE FARMERS MARKETS IN HENDERSON COUNTY ACCEPT THE SNAP/DEBIT/CREDIT PROGRAM. ONGOING COVID-19 REGULATIONS ON PUBLIC GATHERINGS IMPACTED FARMER'S MARKETS DURING THE THREE-YEAR PLAN AND LIMITED THE COMMITTEE'S ABILITY TO IMPLEMENT NEW PROGRAMS. PRIORITY 4: SAFE AND AFFORDABLE HOUSING: 2019 DESCRIPTION OF THE ISSUE:SAFE AND AFFORDABLE HOUSING WAS A PRIORITY IN ADVENTHEALTH HENDERSONVILLE'S LAST CHNA AND CONTINUES TO BE A COMMUNITY CONCERN. CONSIDERED A SOCIAL DETERMINANT OF HEALTH, HOUSING CAN AFFECT A WIDE RANGE OF HEALTH AND QUALITY-OF-LIFE OUTCOMES. EVERYONE NEEDS A PLACE TO LIVE, REGARDLESS OF AGE, JOB, RACE, DISABILITY, INCOME, OR POSITION IN LIFE. BUT NOT EVERYONE'S HOME IS AFFORDABLE. HENDERSON COUNTY RESIDENTS SPEND MORE FOR HOUSING (RENTAL AND MORTGAGES) ON AVERAGE THAN THE REST OF THE REGION. THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) DEFINES "AFFORDABLE HOUSING" AS CONSUMING NO MORE THAN 30% OF A HOUSEHOLD'S MONTHLY INCOME, INCLUDING UTILITIES. THIS IS THE MAXIMUM LEVEL A FAMILY SHOULD SPEND. GENERALLY, WHEN FAMILIES OR INDIVIDUALS SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING, THEY DO NOT HAVE ENOUGH INCOME TO WITHSTAND FINANCIAL SETBACKS OR MEET OTHER BASIC NEEDS SUCH AS FOOD, CLOTHING, AND MEDICAL INSURANCE.CRISIS HOUSING ADDRESSES THE IMMINENT HEALTH AND SAFETY ASPECTS OF THIS PRIORITY. THE CHNA IDENTIFIED THE NEED FOR ENSURING THAT DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS IN THE REGION HAD ACCESS TO CRISIS SHELTERS AND BASIC NEEDS.THE HOMELESS POPULATION IN HENDERSON COUNTY PEAKED IN 2017. ACCORDING TO THE POINT IN TIME SURVEY, AN AVERAGE OF 19% OF THE HOMELESS POPULATION WAS DEEMED "CHRONICALLY HOMELESS," WHICH MEANS THEY HAVE A DISABILITY AND HAVE BEEN HOMELESS FOR AT LEAST ONE YEAR OR HAVE HAD FOUR EPISODES OF HOMELESSNESS IN THREE YEARS.- 46.4% OF RENTERS SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING AND 18.8% OF RENTERS SPEND MORE THAN HALF THEIR INCOME ON HOUSING.(US CENSUS BUREAU)- 16.4% OF MORTGAGE OWNERS SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING AND 6.2% OF MORTGAGE OWNERS SPEND MORE THAN HALF THEIR INCOME ON HOUSING.(US CENSUS BUREAU)- 24% OF ALL HOUSEHOLDS IN HENDERSON COUNTY ARE COST BURDENED (SPEND MORE THAN 30% OF TOTAL INCOME ON HOUSING).(US CENSUS BUREAU)- 112 HOMELESS PERSONS WERE COUNTED IN THE ANNUAL POINT IN TIME COUNT IN 2017.(2017 HENDERSON COUNTY HOMELESS POINT IN TIME COUNT)2022 UPDATE: THE ADVENTHEALTH HENDERSONVILLE COMMUNITY HEALTH PLAN HAS THREE DESIRED GOAL STATEMENTS UNDER THE SAFE AND AFFORDABLE HOUSING PRIORITY. 1. INCREASE ACCESS TO CRISIS SHELTERS FOR SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT 2. INCREASE ACCESS TO EMERGENCY SHELTER FOR THE HOMELESS IN THE REGION 3. INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING IN THE REGION GOAL 1: INCREASE ACCESS TO CRISIS SHELTERS FOR SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS SERVED BY SAFELIGHT IN THE ORGANIZATION'S SHELTER BY AT LEAST 5% FROM A BASELINE OF 289 ADULTS AND CHILDREN BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY SAFELIGHT WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS NOT MET DUE TO COVID-19 IMPACTS AND RESTRICTIONS WHICH PREVENTED SAFELIGHT FROM SERVING AS MANY CLIENTS IN THEIR DOMESTIC VIOLENCE SHELTER. SAFELIGHT SERVED 162 INDIVIDUALS IN 2022 AND 619 INDIVIDUALS OVER THE THREE-YEAR PLAN. THE HOSPITAL PROVIDED ITS ANNUAL $17,000 DONATION TO THE ORGANIZATION IN 2022. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT SURVIVORS SERVED BY HELPMATE IN THE ORGANIZATION'S SHELTER BY AT LEAST 5% FROM A BASELINE OF 202 ADULTS AND CHILDREN BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HELPMATE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS MET WITH HELPMATE SERVING 271 ADULTS AND CHILDREN IN ITS SHELTER IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL $5,000 DONATION TO THE ORGANIZATION IN 2022. GOAL 2: INCREASE ACCESS TO EMERGENCY SHELTER FOR THE HOMELESS IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE ANNUAL NUMBER OF CLIENTS SERVED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) AT STEADFAST HOUSE BY AT LEAST 15% FROM A BASELINE OF 131 BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS MET WITH ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) SERVING 208 WOMEN AND CHILDREN IN THE PROGRAM IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL $15,000 DONATION TO THE ORGANIZATION IN 2022. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE ANNUAL NUMBER OF SAFE SHELTER BEDS THROUGH WESTERN CAROLINA RESCUE MINISTRIES BY AT LEAST 5% FROM A BASELINE OF 41,014 BY YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY WESTERN CAROLINA RESCUE MINISTRIES WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS NOT MET DUE TO COVID-19 RESTRICTIONS WHICH PREVENTED WESTERN CAROLINA RESCUE MINISTRIES FROM FILLING THE SHELTER TO FULL CAPACITY. IN 2022, WESTERN CAROLINA RESCUE MINISTRIES PROVIDED 26,480 SAFE SHELTER BEDS. THE HOSPITAL PROVIDED ITS ANNUAL $10,000 DONATION TO THE ORGANIZATION IN 2022. GOAL 3: INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING IN THE REGION OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF CLIENTS SERVED BY THRIVE'S HOUSING CASE MANAGEMENT PROGRAM BY AT LEAST 10% FROM A BASELINE OF APPROXIMATELY 65 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY THRIVE WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THIS ORGANIZATION. THE OBJECTIVE WAS MET WITH THRIVE SERVING 203 CLIENTS IN ITS PROGRAM IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL DONATION OF $7,500 TO THE ORGANIZATION IN 2022. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF PERMANENT HOUSING PLACEMENTS THROUGH ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES' (ABCCM) STEADFAST HOUSE FOR UNDERSERVED WOMEN AND CHILDREN IN BUNCOMBE COUNTY BY AT LEAST 10% FROM A BASELINE OF 70 BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. THE OBJECTIVE WAS MET WITH ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRIES (ABCCM) SERVING 187 WOMEN AND CHILDREN THROUGH THE PROGRAM IN 2022. THE HOSPITAL PROVIDED ITS ANNUAL DONATION OF $15,000 TO SUPPORT THE ORGANIZATION IN 2022. OBJECTIVE 3:THE THIRD OBJECTIVE IS TO CONTINUE SUPPORT FOR HENDERSON COUNTY HABITAT FOR HUMANITY AND INCREASE THE NUMBER OF HOUSES COMPLETED BY AT LEAST 10% FROM A BASELINE OF 17 HOMES BY THE END OF YEAR THREE. THE INITIATIVE IS FUNDED AND MANAGED BY HENDERSON COUNTY HABITAT FOR HUMANITY WITH SUPPORT FROM ADVENTHEALTH HENDERSONVILLE AND THE OUTCOMES ARE SPECIFIC TO THE ORGANIZATION. THE OBJECTIVE WAS NOT MET DUE TO COVID-19 RESTRICTIONS WHICH SEVERELY LIMITED HENDERSON COUNTY HABITAT FOR HUMANITY'S OPERATIONS. IN 2022, ONLY SEVEN HOUSES WERE COMPLETED. THE HOSPITAL DID NOT PROVIDE AN ANNUAL DONATION DUE TO PROGRAM AND VOLUNTEER EVENT CHANGES. COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH HENDERSONVILLE:THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. THE HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE, OR MULTIPLE GROUPS IN THE COMMUNITY, ALREADY WORKING ON THIS ISSUE?5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? SCHEDULE H, PART V, SECTION B, LINE 11, CONTINUED: BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES:1. VAPING WAS HIGHLIGHTED IN COMMUNITY SURVEYS, NAMELY THE YOUTH RISK BEHAVIOR SURVEY, AS AN ISSUE OF HIGH CONCERN. ADVENTHEALTH HENDERSONVILLE AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH DETERMINED THAT THE ISSUE OF VAPING WAS MORE EFFECTIVELY INCLUDED AND ADDRESSED IN THE BROADER PRIORITY OF SUBSTANCE ABUSE. 2. SUICIDE, SPECIFICALLY YOUTH CONSIDERING SUICIDE, WAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS AN ISSUE OF HIGH CONCERN. ADVENTHEALTH HENDERSONVILLE AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH DETERMINED THAT THE ISSUE OF SUICIDE WAS MORE EFFECTIVELY INCLUDED AND ADDRESSED IN THE BROADER PRIORITY OF MENTAL HEALTH. 3. ADVERSE CHILDHOOD EXPERIENCES (ACES) WERE A CONSISTENT AND PREVALENT CONCERN THROUGHOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ADVENTHEALTH HENDERSONVILLE AND THE HENDERSON COUNTY PARTNERSHIP FOR HEALTH DETERMINED THAT ACES, SPECIFICALLY TRAUMA-INFORMED CARE, SHOULD BE INCLUDED AS A COMPONENT OF ALL IDENTIFIED HEALTH PRIORITIES. 4. BIRTH OUTCOMES & INFANT MORTALITY: THE INTERNAL COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) FELT BIRTH OUTCOMES & INFANT MORTALITY WOULD BE ADDRESSED THROUGH THE COMBINATION OF OTHER PRIORITIES NAMELY FOCUSING ON NUTRITION, SUBSTANCE ABUSE, MENTAL HEALTH, AND SOCIAL DETERMINANTS OF HEALTH, SUCH AS SAFE AND AFFORDABLE HOUSING. MANY OF THE CONTRIBUTING FACTORS THAT IMPACT THESE HEALTH PRIORITIES ALSO CONTRIBUTE TO BIRTH OUTCOMES & INFANT MORTALITY. SCHEDULE H, PART V, LINE 16A, B, AND C: LINE 16A, FAP WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-HENDERSONVILLE/LEGAL/FINANCIAL-ASSISTANCELINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-HENDERSONVILLE/LEGAL/FINANCIAL-ASSISTANCELINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHEALTH-HENDERSONVILLE/LEGAL/FINANCIAL-ASSISTANCE 2 1 - ADVENTHEALTH CENTRA CARE ARDEN 430 AIRPORT ROAD ARDEN NC 28704 URGENT CARE 2 - ADVENTHEALTH MEDICAL GROUP PHYS CLINIC 123 EAST MAIN SUITE 102 BREVARD NC 28712 PHYSICIAN CLINIC PART I, LINE 3C: UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY, AN INDIVIDUAL IS ELIGIBLE FOR A 100% REDUCTION FROM APPLICABLE CHARGES IF THE INDIVIDUAL'S HOUSEHOLD INCOME IS AT OR BELOW 200% OF THE CURRENT FEDERAL POVERTY GUIDELINES. ALTERNATIVELY, A PATIENT MAY ALSO QUALIFY FOR A 100% REDUCTION FROM CHARGES WHEN THE UNPAID PORTION OF A PATIENT'S BILL EXCEEDS 25% OF THE INDIVIDUAL'S ANNUAL HOUSEHOLD INCOME AND WHERE THE TOTAL ANNUAL HOUSEHOLD INCOME IS LESS THAN 500% OF THE FEDERAL POVERTY GUIDELINES. MEDICARE RECIPIENTS MAY ALSO BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY DEPENDING UPON THE INDIVIDUAL'S INCOME AND RESOURCES. RESOURCES ARE GENERALLY DEFINED AS ASSETS SUCH AS MONEY IN CHECKING OR SAVINGS ACCOUNTS, STOCKS, AND BONDS. PART I, LINE 6A: THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTHEALTH". ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE. THE FILING ORGANIZATION PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT ON A SEPARATE ENTITY BASIS FOR THE HOSPITAL(S) THAT IT OWNS AND OPERATES. THE SEPARATE ANNUAL COMMUNITY BENEFIT REPORT IS GENERALLY UTILIZED FOR STATE COMMUNITY BENEFIT REPORTING AND/OR FOR OTHER LOCAL COMMUNITY PURPOSES. 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 I, LINE 7G: THE FILING ORGANIZATION REPORTED ON PART I, LINE 7G, COLUMN (E) COSTS ATTRIBUTABLE TO WOUND CARE. THE COSTS REPORTED AS COMMUNITY BENEFIT EXPENSE ASSOCIATED WITH WOUND CARE WERE $1,452,116. PART II, COMMUNITY BUILDING ACTIVITIES: ADVENTHEALTH HENDERSONVILLE (THE HOSPITAL) IS INVOLVED WITH AND SUPPORTIVE OF VARIOUS OTHER COMMUNITY AGENCIES IN ITS SERVICE AREA THAT WORK COLLABORATIVELY TO HELP THOSE IN NEED AND TO IMPROVE THE HEALTH AND SAFETY OF THE RESIDENTS OF THE COMMUNITY. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8 AND 9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. PART III, LINE 8: COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT. 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, LINE 8 RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH.THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS AS REPORTED IN THE AHS COMMUNITY BENEFIT REPORT ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ (5,389,628)- DIFFERENCE IN COSTING METHODOLOGY: (4,715,083)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (23,744,318) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(33,849,029) AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION. PART VI, LINE 2: THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2022 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2022, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2022 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE WEBSITE INDICATES THAT A COPY OF THE FAP, FAA FORM, AND PLS IS AVAILABLE AND HOW TO OBTAIN SUCH COPIES IN THE PRIMARY LANGUAGES OF ANY POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. PART VI, LINE 4: THE FILING ORGANIZATION IS LOCATED IN FLETCHER, NORTH CAROLINA SITUATED BETWEEN ASHEVILLE AND HENDERSONVILLE, NORTH CAROLINA. IT CURRENTLY OPERATES ADVENTHEALTH HENDERSONVILLE. ADVENTHEALTH HENDERSONVILLE IS A 103-BED, STATE OF THE ART HOSPITAL THAT INCLUDES CARDIAC CARE AND REHABILITATION, EMERGENCY SERVICES, NATIONALLY AWARDED CANCER CARE, STATE-OF-THE-ART SURGICAL CARE, FULL-SERVICE ORTHOPEDIC CARE, AN AWARD-WINNING LABOR AND DELIVERY EXPERIENCE, AND A FULL RANGE OF IMAGING SERVICES TO HELP PEOPLE ACROSS OUR REGION EXPERIENCE WHOLE HEALTH.ADVENTHEALTH HENDERSONVILLE (THE HOSPITAL) IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. HENDERSON COUNTY HAS A LARGE ELDERLY POPULATION DUE TO A FAVORABLE CLIMATE AND LOCATION FOR RETIREES.DURING 2022, 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 2022, ABOUT 70.9% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 55.3% - MEDICAID PATIENTS 9.3% - SELF-PAY PATIENTS 3.7% THE DEMOGRAPHIC MAKEUP OF HENDERSON COUNTY IS AS FOLLOWS: - POPULATION 114,913 - POPULATION OVER 65 25.4% - POVERTY (BELOW 100% FPL) 10.9% - HIGH SCHOOL GRADUATION RATE 91.5% - FOOD INSECURITY RATE 17.2% - POP. WITH LOW FOOD ACCESS 42.7% ADVENTHEALTH HENDERSONVILLE DEFINES ITS COMMUNITY AS ITS PRIMARY SERVICE AREA (PSA) FROM WHICH 75-80% OF ITS PATIENTS COME. THIS INCLUDES ALL OF HENDERSON COUNTY AND PORTIONS OF BUNCOMBE COUNTY - NAMELY ARDEN, BLACK MOUNTAIN, FAIRVIEW, FLETCHER, SKYLAND, AND SWANNANOA. PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO ADVENTHEALTH HENDERSONVILLE'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE HOSPITAL PROVIDED $279,570 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $13,475,024 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY. PART VI, LINE 6: THE FILING ORGANIZATION IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 49 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 10 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF ADVENTHEALTH, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS IT, CORPORATE COMPLIANCE, LEGAL, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. CERTAIN SUPPORT SERVICES, SUCH AS HUMAN RESOURCES, PAYROLL, A/P, AND SUPPLY CHAIN MANAGEMENT ARE PROVIDED PURSUANT TO A SHARED SERVICES MODEL BY AHSSHC TO ITS SUBSIDIARY ORGANIZATIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH ADVENTHEALTH SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH ADVENTHEALTH SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEBSITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH. PART VI, LINE 7: THE FILING ORGANIZATION DOES NOT FILE AN ANNUAL COMMUNITY BENEFIT REPORT WITH ANY STATE AGENCIES. 1 ASHEVILLE AREA CHAMBER OF COMMERCE PO BOX 1010 ASHEVILLE NC 28802 560125440 501(C)(6) 25770 0 GENERAL SUPPORT ASHEVILLE BUNCOMBE COMMUNITY CHRISTIAN MINISTRY INC 20 TWENTIETH STREET ASHEVILLE NC 28806 560945001 501(C)(3) 15000 0 GENERAL SUPPORT BUNCOMBE COUNTY SCHOOLS FOUNDATION INC 175 BINGHAM ROAD ASHEVILLE NC 28806 581685536 501(C)(3) 31000 0 GENERAL SUPPORT CHAMBER OF COMMERCE GREATER HENDERSONVILLE 204 KANUGA ROAD HENDERSONVILLE NC 28739 560258910 501(C)(6) 11413 0 GENERAL SUPPORT HENDERSON COUNTY EDUCATION FOUNDATION INC 414 4TH AVENUE W HENDERSONVILLE NC 28739 581734733 501(C)(3) 5966 0 GENERAL SUPPORT SAFELIGHT INC 133 FIFTH AVENUE HENDERSONVILLE NC 28792 561469847 501(C)(3) 17000 0 GENERAL SUPPORT ADVENTHEALTH FOUNDATION INC DBA ADVENTHEALTH HENDERSONVILLE FOUNDATION 100 HOSPITAL DRIVE HENDERSONVILLE NC 28792 592219301 501(C)(3) 0 399210 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT THRIVE 110-C CHADWICK SQUARE COURT HENDERSONVILLE NC 28739 205599815 501(C)(3) 7500 0 GENERAL SUPPORT WESTERN CAROLINA RESCUE MINISTRIES INC 225 PATTON AVENUE ASHEVILLE NC 28801 561249407 501(C)(3) 10000 0 GENERAL SUPPORT CONSERVING CAROLINA 847 CASE STREET HENDERSONVILLE NC 28792 566449365 501(C)(3) 20000 0 GENERAL SUPPORT HOPE COALITION CORPORATION 109 FLORENCE STREET HENDERSONVILLE NC 28792 861730600 501(C)(3) 15000 0 GENERAL SUPPORT ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION 950 E HARVARD AVENUE STE 230 DENVER CO 80210 840745018 501(C)(3) 10000 0 GENERAL SUPPORT ST GERARD HOUSE 620 OAKLAND STREET HENDERSONVILLE NC 28791 450948760 501(C)(3) 10000 0 GENERAL SUPPORT 11 2 PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), OR TO OTHER LOCAL CHARITABLE COMMUNITY ORGANIZATIONS, OR TO OTHER 501(C)(3) ORGANIZATIONS THAT ARE A PART OF THE GROUP EXEMPTION RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES. X X X X X X 1 1 1 1 0 0 0 0 0 0 0 MURRILL MICHAEL DIRECTOR/CHAIR/CEO SE REGION 0 711303 0 168833 0 18707 0 142054 0 45659 0 1086556 0 0 GUYTON ALAN DIRECTOR/CFO SE REGION 0 433022 0 86923 0 40832 0 80641 0 50455 0 691873 0 22285 NUDD BRANDON DIRECTOR/PRES/CEO 0 435598 0 40457 0 35019 0 81376 0 45062 0 637512 0 0 STALFORD MDMICHAEL PHYSICIAN - MD (OTORHINOLARYNGEOLOGY 520643 0 19887 0 17389 0 16400 0 33973 0 608292 0 0 0 DIMITROVA GERGANA PHYSICIAN - MD (PHYCHIATRY) 263077 0 291826 0 17750 0 16400 0 18508 0 607561 0 0 0 HERBERT MD TERESA CMO 0 355674 0 70171 0 57010 0 50636 0 44547 0 578038 0 5159 LUGUS MDTHOMAS PHYSICIAN - MD (GEN MED/FP) 397078 0 109722 0 7016 0 16400 0 14912 0 545128 0 0 0 HARDIN MD JEFFREY PHYSICIAN - MD (CARDIOLOGY) 491746 0 0 0 7502 0 16400 0 29204 0 544852 0 0 0 HARKHANI MD NINA PHYSICIAN - MD (UROLOGY) 467698 0 0 0 5569 0 16400 0 38298 0 527965 0 0 0 BONNEY MD STEPHEN DIRECTOR (END 02/2022) 399060 0 0 0 6140 0 16400 0 33708 0 455308 0 0 0 COSTON DO JEFFREY DIRECTOR 396835 0 0 0 14086 0 16400 0 25349 0 452670 0 0 0 REEVES CORY FORMER CEO 0 0 0 0 0 410666 0 0 0 39111 0 449777 0 0 MILLER SCOTT COO (END 12/2022) 0 275582 0 53228 0 12025 0 16400 0 39433 0 396668 0 0 STENSTROM ELLA CFO (END 12/2022) 0 238069 0 47498 0 11813 0 5897 0 39390 0 342667 0 0 DZIALO MAUREEN CNO 0 219140 0 12261 0 18266 0 12399 0 39380 0 301446 0 0 KIESSLING-URITIS MD MARY ANNE DIRECTOR 188902 0 45872 0 17734 0 13581 0 30111 0 296200 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 LISTED IN PART VII THAT ARE 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 49 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 (13 ADVENTHEALTH CABINET MEMBERS AND THE ADVENTHEALTH MULTI-STATE CFO) AND $15,000 FOR ADVENTHEALTH CORPORATE OFFICE SENIOR VICE PRESIDENTS, REGIONAL CEO'S, AND DIVISION CHIEF OFFICERS (GENERALLY 50 - 55 INDIVIDUAL EXECUTIVES). A REGIONAL CEO FOR ADVENTHEALTH IS A MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THE REGIONAL CEO IS CONSIDERED A COMMON LAW EMPLOYEE OF AND IS ON THE PAYROLL OF AHSSHC. WHILE THE SPECIAL TRAVEL ALLOWANCE BENEFIT IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND EITHER WHOLLY OR PARTIALLY REIMBURSED BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR FIRST-CLASS OR CHARTER TRAVEL SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. THOSE EXECUTIVES WHO RECEIVE THE SPECIAL TRAVEL ALLOWANCE ARE RESPONSIBLE FOR TRACKING THE EXPENSES REIMBURSABLE UNDER THE SPECIAL TRAVEL ALLOWANCE AND MUST SUBMIT SUCH EXPENSES ON THEIR ACCOUNTABLE PLAN EXPENSE REPORT. A REPORT ON CHARTER TRAVEL IS PROVIDED TO THE AHSSHC BOARD COMPENSATION COMMITTEE AT EACH MEETING. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES UNDER THE SPECIAL TRAVEL ALLOWANCE ARRANGEMENT ARE TREATED AS TAXABLE COMPENSATION TO THE EXECUTIVE. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: OCCASIONAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH PRESIDENT'S COUNCIL, CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING. PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ALL TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES BUSINESS DEVELOPMENT EXPENDITURES. UNDER THIS POLICY, TO ENCOURAGE EXECUTIVES TO ESTABLISH AND CULTIVATE STRONG WORKING RELATIONSHIPS WITH THE MEDICAL COMMUNITY AND OTHER LEADERS IN THE COMMUNITY AND INDUSTRY, CERTAIN ADVENTHEALTH EXECUTIVES MAY BE REIMBURSED FOR MEMBER DUES AND USAGE CHARGES FOR A COUNTRY CLUB OR OTHER SOCIAL CLUB UPON AUTHORIZATION. CLUB MEMBERSHIPS MUST BE APPROVED BY THE ADVENTHEALTH PRESIDENT/CEO INITIALLY AS WELL AS ON AN ANNUAL BASIS. EACH ADVENTHEALTH EXECUTIVE WHO IS APPROVED FOR A CLUB MEMBERSHIP MUST SUBMIT AN ANNUAL REPORT DESCRIBING HOW THEY USED THE MEMBERSHIP TO BENEFIT THEIR ORGANIZATION DURING THE PRECEDING YEAR SO THAT THE ADVENTHEALTH PRESIDENT/CEO CAN DETERMINE IF CONTINUANCE OF THE CLUB MEMBERSHIP FURTHERS THE BUSINESS INTERESTS OF ADVENTHEALTH. IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, THREE EXECUTIVES LISTED IN PART VII RECEIVED REIMBURSEMENT FOR CLUB FEES. WHILE THE CLUB DUES MEMBERSHIP IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND REIMBURSED IN WHOLE OR IN PART BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR HEALTH OR SOCIAL CLUB DUES SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. PART I, LINE 3 THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS APPOINTED AND COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION SECTION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT, OTHER THAN THE CHIEF PEOPLE OFFICER, WHO REMAINS AT THE REQUEST OF THE CHAIRMAN/COMMITTEE TO PROVIDE ASSISTANCE/INFORMATION AS NEEDED. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD-PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO ADVENTHEALTH AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF ADVENTHEALTH WILL NOT EXCEED THE 50TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP. PART I, LINES 4A-B DURING THE YEAR ENDING DECEMBER 31, 2022, CORY REEVES RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $400,372. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH ADVENTHEALTH. AS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS TO ELIGIBLE EXECUTIVES. AS THE SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS WERE UPDATED IN 2020 AND CERTAIN INDIVIDUALS STILL PARTICIPATE AS GRAND-FATHERED PARTICIPANTS IN CERTAIN PLANS, THE NARRATIVE BELOW DISCUSSES ALL PLANS IN WHICH THERE WERE ANY PARTICIPANTS IN 2022. THE SERP III PLAN EFFECTIVELY REPLACES THE PRIOR SERP II PLAN, THE EXECUTIVE FLEX BENEFIT PROGRAM PLAN, AND THE SENIOR EXECUTIVE DEATH BENEFIT PLAN FOR QUALIFIED EXECUTIVES EXCEPT FOR CERTAIN GRANDFATHERED EXECUTIVE EMPLOYEES. SERP III PLAN: THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $305,000 IN 2022 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN: THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER 31, 2027. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN: THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. IN 2020, THE FLEX PLAN WAS AMENDED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE FOR ANY PLAN YEAR SHALL NOT BE GREATER THAN THE MAXIMUM DOLLAR AMOUNT OR THE PERCENTAGE OF COMPENSATION AS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR. FLEX PLAN FLEX PLAN SERP II SERP III SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. DISTR.* MURRILL,MICHAEL $ 0 $ 0 $ 0 $ 125,654 $ 0 GUYTON,ALAN $ 50,988 $ 26,463 $ 0 $ 13,253 $ 0 HERBERT,MD,TERESA $ 35,393 $ 5,982 $ 0 $ 19,342 $ 0 NUDD,BRANDON $ 0 $ 0 $ 0 $ 64,976 $ 0 * INCLUDING INVESTMENT EARNINGS HERBERT-WIDMAN LLC OWNED BY KEY EMPLOYEE 116280 LEASE 0 CATHERINE LOUIS FAMILY OF BOARD MEMBER 44890 EMPLOYEE COMPENSATION 0 STEPHEN MCGRADY FAMILY OF BOARD MEMBER 69579 EMPLOYEE COMPENSATION 0 PART V, LINE 1A: THE PARENT CORPORATION AND SOLE TOP-TIER MEMBER OF FLETCHER 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 FLETCHER 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. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION ARE APPOINTED BY THE SOLE MEMBER, AHSSHC, WHO HAS THE RIGHT TO ELECT, APPOINT OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B AHSSHC, AS THE SOLE MEMBER OF THE FILING ORGANIZATION, HAS CERTAIN RESERVED POWERS AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE FOLLOWING: A) TO APPROVE AND DISAPPROVE THE EXECUTIVE AND/OR ADMINISTRATIVE LEADERSHIP OF THE FILING ORGANIZATION, AND THEIR SALARIES; B) TO ADOPT, AMEND, RESTATE, AND REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FILING ORGANIZATION, AND THE MEDICAL STAFF BYLAWS; C) TO SET LIMITS AND TERMS FOR THE BORROWING OF FUNDS; D) TO APPROVE OR DISAPPROVE MAJOR BUILDING PROGRAMS AND/OR PURCHASE OR SALE OF PERSONAL PROPERTY OR REAL PROPERTY EQUAL TO OR IN EXCESS OF ONE MILLION DOLLARS; E) TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION; F) TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION; G) TO ESTABLISH GENERAL GUIDING POLICIES, TO IMPLEMENT QUALITY ASSESSMENT, IMPROVEMENT AND UTILIZATION REVIEW PROGRAMS; AND H) TO APPROVE THE APPOINTMENT 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 THE BOARD CHAIRMAN, BOARD FINANCE COMMITTEE CHAIR, CEO AND THE CFO DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990 BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES ARE NOT COMPENSATED BY THE FILING ORGANIZATION. SUCH INDIVIDUALS ARE COMPENSATED BY THE RELATED TOP-TIER PARENT ORGANIZATION OF THE FILING ORGANIZATION. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY THE RELATED TOP-TIER PARENT ORGANIZATION IN DETERMINING EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH AND OF THE ADVENTHEALTH "OBLIGATED GROUP" ARE FILED ANNUALLY WITH THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB). THE "OBLIGATED GROUP" IS A GROUP OF AHSSHC SUBSIDIARIES THAT ARE JOINTLY AND SEVERALLY LIABLE UNDER A MASTER TRUST INDENTURE THAT SECURES DEBT PRIMARILY ISSUED ON A TAX-EXEMPT BASIS. UNAUDITED QUARTERLY FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) ARE ALSO FILED WITH MSRB FOR ADVENTHEALTH ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF ADVENTHEALTH SUBSIDIARIES COMPRISING THE "OBLIGATED GROUP". THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. PART VII, SECTION A: FOR THOSE BOARD OF DIRECTOR MEMBERS (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 AMOUNT SHOWN IN PART VIII, LINE 7C(I) OF THE FORM 990 REPRESENTS AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A SYSTEM WIDE, CORPORATE ADMINISTERED, INVESTMENT PROGRAM. FORM 990, PART IX, LINE 11G PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 10,860,286. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,860,286. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,065,693. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,065,693. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 10,345,203. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,345,203. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 1,913,272. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,913,272. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 341,727. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 341,727. RECRUITING: PROGRAM SERVICE EXPENSES 228,861. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 228,861. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 777. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 777. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 307,999. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 307,999. ADVENTHEALTH MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 5,291,860. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,291,860. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,738,442. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,738,442. ADVENTHEALTH SHARED SERVICE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,194,618. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,194,618. PART X, LINE 2: THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. FORM 990, PART XI, LINE 9: TRANSFER TO TOP-TIER TAX-EXEMPT PARENT -3,095,564. TRANSFERS FROM TAX EXEMPT AFFILIATE 274,180. TRANSFER TO SUBSIDIARY -295,994. DONATIONS FROM SUPPORTING FOUNDATION 135,357. PART XII, LINE 3B: ALTHOUGH THE TAXPAYER IS NOT REQUIRED TO UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133, THE TAXPAYER IS PART OF A CONTROLLED GROUP OF ORGANIZATIONS THAT COMPRISE A CONSOLIDATED FINANCIAL STATEMENT AUDIT. THE CONTROLLED GROUP'S PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), A 501(C)(3) ORGANIZATION. THE SYSTEM OF HEALTHCARE ENTITIES OWNED AND CONTROLLED BY AHSSHC IS KNOWN AS ADVENTHEALTH. FOR THE YEAR ENDED DECEMBER 31, 2022, ADVENTHEALTH WILL FILE A CONSOLIDATED SINGLE AUDIT WHICH WILL INCLUDE ALL ENTITIES THAT ARE PART OF THE CONTROLLED GROUP. ACCORDINGLY, THE TAXPAYER HAS CHECKED YES TO THE QUESTIONS ON PART XII, LINE 3A AND 3B. ADVENTHEALTH ASHVILLE INC (5922 - 123122) 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 921144574 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES NC 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS INC 187 PR 4060 LAMPASAS TX 76550 271858033 OPERATION OF RURAL HEALTH CLINICS & MEDICAL SERVICES FL 501(C)(3) LINE 3 METROPLEX ADVENTIST HOSPITAL INC 1 ADVENTHEALTH FOUNDATION FKA 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 ADVENTHEALTH HOME CARE EAST FLORIDA LLC 770 WEST GRANADA BLVD 319 ORMOND BEACH FL 32174 833768458 INACTIVE FL 501(C)(3) LINE 10 MEMORIAL HLTH SYSTEMS INC 1 ADVENTHEALTH HOSPICE CARE EAST FLORIDA INC 770 WEST GRANADA BLVD 304 ORMOND BEACH FL 32174 833748461 INACTIVE FL 501(C)(3) LINE 10 MEMORIAL HLTH SYSTEMS INC 1 ADVENTHEALTH KANSAS CITY FOUNDATION 7315 E FRONTAGE ROAD MERRIAM KS 66204 480868859 FUND-RAISING FOR TAX-EXEMPT HOSPITALS KS 501(C)(3) LINE 7 SHAWNEE MISSION MEDICAL CENTER INC 1 ADVENTHEALTH NORTH POLK INC 3100 E FLETCHER AVE TAMPA FL 33613 593231322 INACTIVE FL 501(C)(3) LINE 12A, I UNIVERSITY COMMUNITY HOSPITAL INC 1 ADVENTHEALTH PALM COAST PARKWAY INC FKA AH EAST FLORIDA INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 882288563 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH POLK NORTH INC 40100 US HIGHWAY 27 N DAVENPORT FL 33837 841793121 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH POLK SOUTH INC 410 SOUTH 11TH STREET LAKE WALES FL 33853 834672945 OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH 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 RIVERVIEW INC 14055 RIVEREDGE DRIVE STE 150 TAMPA FL 33637 870901094 FUTURE OPERATION OF HOSPITAL & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH SENIOR CARE INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 841817046 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH SOUTH OVERLAND PARK INC 7820 W 165TH STREET OVERLAND PARK KS 66223 364595806 OPERATION OF HOSPITAL & RELATED SERVICES KS 501(C)(3) LINE 3 ADVENTIST HLTH MID-AMERICA INC 1 ADVENTHEALTH UNIVERSITY INC 671 WINYAH DRIVE ORLANDO FL 32803 593069793 EDUCATION/OPERATION OF SCHOOL FL 501(C)(3) LINE 2 ADVENTIST HLTH SYSTEMSUNBELT INC 1 ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC 14055 RIVEREDGE DRIVE STE 250 TAMPA FL 33637 471881744 SUPPORT OF IMAGING CENTER & HOME HEALTH SUBSIDIARIES FL 501(C)(3) LINE 12B, II ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 ADVENTHEALTH WEST FLORIDA IMAGING INC 14055 RIVEREDGE DRIVE STE 250 TAMPA FL 33637 843225135 IMAGING & TESTING FL 501(C)(3) LINE 3 ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC 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 HEALTH MID-AMERICA INC 9100 W 74TH STREET SHAWNEE MISSION KS 66204 521347407 SUPPORT OF AFFILIATED HOSPITAL KS 501(C)(3) LINE 12C, III-FI ADVENTIST HLTH SYSTEMSUNBELT INC 1 ADVENTIST HEALTH PARTNERS INC 5101 S WILLOW SPRINGS RD SUITE B101 LA GRANGE IL 60525 364138353 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 ADVENTIST HEALTH SYSTEM GEORGIA INC 1035 RED BUD ROAD NE CALHOUN GA 30701 581425000 OPERATION OF HOSPITAL & RELATED SERVICES GA 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 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 SYSTEMSUNBELT INC 900 HOPE WAY ALTAMONTE SPRINGS FL 32714 591479658 OPERATION OF HOSPITALS & RELATED SERVICES FL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 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 HOSPITALS & RELATED SERVICES IL 501(C)(3) LINE 3 ADVENTIST HLTH SYSTEMSUNBELT INC 1 AHP SPECIALTY CARE NFP 5101 S WILLOW SPRINGS RD SUITE B101 LA GRANGE IL 60525 811105774 OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES IL 501(C)(3) LINE 3 ADVENTIST MIDWEST HEALTH 1 AHS MIDWEST MANAGEMENT INC 500 REMINGTON BLVD BOLINGBROOK IL 60440 363354567 OPERATION OF PHYSICIAN PRACTICE MANAGEMENT IL 501(C)(3) LINE 12A, I ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP 1 APOPKA HEALTH CARE PROPERTIES INC 305 E OAK STREET APOPKA FL 32703 510605694 LEASE TO RELATED ORGANIZATION GA 501(C)(3) LINE 12C, III-FI SUNBELT HLTH CARE CENTERS INC 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 SOUTHEAST VOLUSIA HEALTHCARE CORP 0 BRADFORD HEIGHTS HEALTH & REHAB CENTER INC (11-122222) 485 NORTH KELLER ROAD 250 MAITLAND FL 32751 205782342 INACTIVE - 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