2024-11-15T13:34:46-06:00 2023-12-31 990 2023-07-01 840438224 Portercare Adventist Health System PORT 3037656861 6061 S Willow Drive Greenwood Village CO 80111 Lynn C Addiscott Assistant Secretary 4073572317 2024-11-15 0 2023 2024-10-15 13:58:12Z Brett Spenst 6061 S Willow Drive Greenwood Village CO 80111 734552664 0 1071 X www.adventhealth.com X 1930 CO The provision of medical care to the community through the operation of five hospitals totaling 979 beds. 7 2 492 566 1851656 0 352291 0 1514190632 723753234 11152807 4386068 10341453 3036220 1536037183 731175522 2386590 1097553 0 0 571928748 327817288 0 0 0 894231813 495504716 1468547151 824419557 67490032 -93244035 1992859331 1847895763 499722731 526009951 1493136600 1321885812 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 744471649 1097553 724937798 Operation of 5 acute care hospitals with 17,434 patient admissions, 71,489 patient days and 684,498 outpatient visits in the current year. In addition to hospital operations, the corporation provides medical care through a number of other activities such as urgent care centers, physician clinics, home health services, hospice services, sleep centers, wound centers, therapy and rehab. 744471649 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 1 492 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 2 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 CO X Jeremy Pittman 3036431229 6061 S Willow Drive Greenwood Village CO 80111 X Bacon Kenneth Dir/Chairman Multi State CEO (end 11/23) 5.00 45.00 X 0 1770929 273737 Banks David Director/Chairman (beg 11/23) 5.00 45.00 X 0 2205351 180461 Houmann Lars Director 1.00 3.00 X 0 24761 0 Ordelheide Kris Director (beg 8/23) 1.00 50.00 X 0 1008974 93772 Randolph Karsten Director/Multi State CFO (beg 8/23) 5.00 45.00 X 0 2198983 169849 Rathbun Paul Director (end 8/23) 1.00 50.00 X 0 2655900 503993 Spenst Brett Director/CEO (beg 8/23) 50.00 0.00 X 0 956760 35847 Thurber Gary Director 1.00 3.00 X 0 6503 0 Thurber John Mic Director 1.00 3.00 X 0 5706 0 Enderson Dan Sec/Group President/CFO (beg 8/23) 45.00 5.00 X 0 3016062 311180 Gaasch Andrew Treasurer/CFO (end 8/23) 50.00 0.00 X 0 3099191 262309 Dodds Rick CEO Littleton Adventist Hospital 50.00 0.00 X 0 910939 129417 Erickson Jonathan CFO Avista Adventist Hospital (beg 9/23) 50.00 0.00 X 0 400025 37930 Folkenberg Todd CEO Porter Adventist Hospital 50.00 0.00 X 0 1270050 156472 Gal Matt CFO Castle Rock Adventist Hospital 50.00 0.00 X 0 284361 14530 Goebel Michael CEO Parker Adventist Hospital 50.00 0.00 X 0 1001751 122478 Pittman Jeremy CEO Castle Rock Adventist Hospital 50.00 0.00 X 0 681679 128327 Still Danae CFO Littleton Adventist Hospital 50.00 0.00 X 0 520487 51540 Travis Carol CFO Avista Adventist Hospital 50.00 0.00 X 0 375424 65321 Ward Erin CFO Parker Adventist Hospital 50.00 0.00 X 0 359020 6723 Whitlock Andrew CFO Porter Adventist Hospital 50.00 0.00 X 0 296582 34017 Finch Kenneth CEO Avista Adventist Hospital 50.00 0.00 X 0 306000 0 Ewell MD Nelson Surgeon-Neuro 50.00 0.00 X 1055986 0 52860 Jennings MD Jason Surgeon-Orthopedic 50.00 0.00 X 1163346 0 52435 Miner MD Todd Surgeon-Orthopedic 50.00 0.00 X 1109169 0 55060 RajpalMD Sharad Surgeon-Neuro 50.00 0.00 X 1672543 0 49807 Yang MD Charlie Surgeon-Orthopedic 50.00 0.00 X 1158921 0 48361 Banko Peter Former Officer 5.00 45.00 X 0 8101604 876505 Fisher Jonathan Former Key Employee 0.00 50.00 X 0 584185 97877 McKinney Jillyan Former Key Employee 0.00 50.00 X 0 647906 121514 Sendros Isaac Former Key Employee 0.00 50.00 X 0 930653 118304 6159965 33619786 4050626 169 1 1 0 South Denver Cardiology Associates PC 1000 SouthPark Dr Littleton CO 80120 Cardiology Services 35255450 Centura Health Corporation 9100 E Mineral Circle Centennial CO 80112 Billing, IT, and Lab Services 26612487 Neurosurgery One 7780 S Broadway 350 Littleton CO 80122 Neuro/Spine Services 11281562 HSS Security 1395 S Platte River Dr Denver CO 80223 Security Services 7631921 Peak Gastroenterology Associates 2920 N Cascade 3rd Floor Colorado Springs CO 80907 Gastroenterology Services 6225849 93 X Net Patient Revenue 622110 717621044 717621044 Cafeteria Revenue 622110 1927224 1927224 Pharmacy Revenue 622110 1798430 81218 1717212 Medical Office Building Rentals 622110 1619630 1485186 134444 Gift Shop Revenue 622110 129048 129048 657858 657858 723753234 7218113 7218113 54576 1600 52976 52976 52976 543497 3375542 0 -3375542 543497 -2832045 -2832045 Equity Earnings Subsidiaries 622110 2983244 2983244 2983244 731175522 724937798 1851656 4386068 X 553111 553111 544442 544442 4580643 4580643 242298217 242298217 10381707 10249226 132481 54149748 53217631 932117 16406973 16197604 209369 60935 60935 199139 199139 1176610 1176610 184055675 142374549 41681126 8653998 8653998 19261084 17122250 2138834 1180581 1113105 67476 18920264 18920264 424540 9880 414660 488791 488791 4499906 4499906 41950229 41950229 3834923 3714166 120757 Medical Supplies 135721257 133693552 2027705 State Assessment 43909214 43909214 Impairment Loss 14811026 14811026 Repairs and Maintenance 14028240 14028240 2328304 76063 2252241 824419557 744471649 79947908 0 X 1003815 23743 124258532 614315338 239805770 218899281 3766019 2559574 38911389 35182586 17645096 12183911 1770493121 1015064869 705693683 755428252 448880136 68550956 58030231 52844662 354864660 87907460 1992859331 1847895763 101057961 112190803 916807 397747963 413819148 499722731 526009951 X 1493032744 1320528654 103856 1357158 1493136600 1321885812 1992859331 1847895763 X -93244035 19439339 -97446092 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 0 Part II-B, Line 1i, Lobbying Activities: The filing organization typically reports lobbying related to American Hospital Association and Colorado Health Association dues. However, due to the short filing period, dues were not paid during this short period. 4927808 63399 4991207 4698235 229573 4927808 4012908 1050965 151945 517583 4698235 3870411 142497 4012908 3713610 156801 3870411 0.00000 0.69000 0.31000 0 0 130587489 130587489 969005367 550054717 418950650 508959339 432725222 76234117 161940926 32284930 129655996 755428252 Due to Related 62707795 Payable to Third Parties 14656575 Credit Balances in A/R -2644554 Other Deferred Revenue -131762 Accrued Interest Payable 251496 Interco Alloc of TE Bond Proceeds 303363130 Operating Lease Liability 23732770 Other Current Liabilities 11883698 413819148 X Part V, Line 4: Rocky Mountain Adventist Healthcare Foundation (RMAHF), a related organization formed and maintained exclusively to further the exempt purpose of Portercare Adventist Health System (PAHS), held assets in temporary endowment and permanent endowment funds during the current tax year. RMAHF's endowment consists of individual donor restricted endowment funds and pledges receivable where the assets have been designated for endowment. Temporarily and Permanently restricted endowment funds are intended to benefit various programs and departments of the five Hospitals and its patients. The endowment funds held by RMAHF were inadvertently omitted from prior years' Form 990 of the taxpayer. Additional information became available in the current year that provided the amounts now reflected in Schedule D, Part V. 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. The current year provision for federal and state income tax for the year ended December 31, 2023 is approximately $1,140. There was no current year tax provision for the year ended December 31, 2022 due to the utilization of net operating loss carryforwards in 2022. The Income Taxes Topic of the Accounting Standards Codification (ASC) 740, Income Taxes (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, 2023 and 2022. 0 Sub-Saharan Africa - Angola, Benin, Botswana, Burkina Faso, 0 0 Program Services Travel expenses, hospital construction 260101 South America - Argentina, Bolivia, Brazil, Chile, Columbia, Ecuador, 0 0 Program Services Travel expenses, Medical Mission Trip 172264 South Asia - Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, 0 0 Program Services Travel expenses, Medical Mission Trip 47177 Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Program Services Travel expenses, Medical Mission Trip 64900 0 0 0 0 0 0 544442 0 544442 0 0 0 0 0 0 Part I, Line 2: Foreign Grants are typically made only to the community organizations that are exempt from Federal Income Tax under 501(c)(3), other U.S. charitable organizations, or to foreign entities recognized as charitable by the foreign country in which they are located. Given that most grants are made to other U.S. or foreign charitable organizations, the filing organization has not established specific procedures for monitoring the use of grant funds outside the United States. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 14547888 14547888 0.01760 151285960 89570564 61715396 0.07490 165833848 89570564 76263284 0.09250 629761 10400 619361 0.00080 267303 267303 0.00030 897064 10400 886664 0.00110 166730912 89580964 77149948 0.09360 302074 302074 0.00040 302074 302074 0.00040 1 47629126 182339927 237035012 -54695085 X 1 1 1 Functional Neurosurgical Ambulatory Surgery Center LLC Surgery Center 0.51000 0.49000 2 Crown Point Surgery Center LLC Surgery Center 0.27990 0.41940 3 Flatirons Surgery Center LLC Surgery Center 0.25050 0.49900 4 Harvard Park Surgery Center LLC Surgery Center 0.25050 0.48500 5 South Denver Musculoskeletal Surgical Partners LLC Surgery Center 0.26850 0.46200 6 Summit View Surgery Center LLC Surgery Center 0.25000 0.45630 7 OnPoint OBGYN LLC OBGYN Center 0.51000 0.24500 5 1 AdventHealth Parker 9395 Crown Crest Blvd Parker CO 80138 adventhealth.com/hospital/adventhealth 01J544 X X X A 2 AdventHealth Littleton 7700 S Broadway Littleton CO 80122 adventhealth.com/hospital/adventhealth 010456 X X X A 3 AdventHealth Porter 2525 S Downing St Denver CO 80210 adventhealth.com/hospital/adventhealth 010424 X X X X A 4 AdventHealth Castle Rock 2350 Meadows Blvd Castle Rock CO 80109 adventhealth.com/hospital/adventhealth 01L581 X X X A 5 AdventHealth Avista 100 Health Park Drive Louisville CO 80027 adventhealth.com/hospital/adventhealth 010316 X X X A Facility Reporting Group A 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Part V, Page 8 X X 1 22 1 See Part V, Page 8 0 1 X 250.000000000000 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 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: AdventHealth Parker, - Facility 2: AdventHealth Littleton, - Facility 3: AdventHealth Porter, - Facility 4: AdventHealth Castle Rock, - Facility 5: AdventHealth Avista Facility Reporting Group A Part V, Section B, line 5: Facility Reporting Group - APart V, Section B, line 5: See Line 5 footnote below. Facility Reporting Group A Part V, Section B, line 7d: The Hospitals have adopted a policy that addresses the public posting requirements of the Community Health Needs Assessment. Under this policy, the Community Health Needs Assessment Reports must be posted on the 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 Hospitals will also make a paper copy of its Community Health Needs Assessment Report available for public inspection upon request and without charge, at least until the date the Hospital facility has made available for public inspection its two subsequent Community Health Needs Assessment Reports. Facility Reporting Group A Part V, Section B, line 11: Facility Reporting Group - APart V, Section B, line 11: See Line 11 footnote below. Part V, Section B, Line 5: Facility Reporting Group A - AdventHealth Parker:In order to ensure broad community input, AdventHealth Parker (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Douglas County School District, Town of Castle Rock, Castle Pines Chamber of Commerce, Denver Regional Council of Governments, Doctors Care, SECOR Cares, Elbert County Public Health, Douglas County Government, Douglas County Housing Partners, and the Hospital Team Members.The Hospital collaborated with Douglas County Public Health Department to inform our Community Health Needs Assessment Steering Committee as they cover the hospital service area. The public health department shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health department and community to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Douglas County has historically been a part.Facility Reporting Group A - AdventHealth Littleton:In order to ensure broad community input, AdventHealth Littleton (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Doctors Care, North Littleton Promise, City of Littleton, Littleton Public Schools, Mission Hills Church, Break Bread, Tri County Public Health, Mile High Health Alliance, and the Hospital Team Members.The Hospital collaborated with Tri County Public Health to inform our Community Health Needs Assessment Steering Committee as this public health department covers the majority of the hospital service area. Tri County Public shared the qualitative data they collected from residents to complement quantitative data to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health department to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Arapahoe and Douglas are a part.Facility Reporting Group A - AdventHealth Porter:In order to ensure broad community input, AdventHealth Porter (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Denver Department of Public Health and Environment, Mile High Health Alliance, Brother Jeff's Cultural Center, The Mental Health Center of Denver, Denver Health, Life Line, LifeSource Adventist Fellowship, Mile High Academy, Adventist Rocky Mountain Conference, Denver South Seventh-Day Adventist Church, Rocky Mountain Conference of Seventh-Day Adventist Church, and over 30 other organizations surveyed.The Hospital collaborated with Denver Department of Public Health and Environment to inform our Community Health Needs Assessment Steering Committee as this public health department covers the hospital service area. Public Health shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health department and community to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Denver County is a part.Facility Reporting Group A - AdventHealth Castle Rock:In order to ensure broad community input, AdventHealth Castle Rock (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Douglas County School District, Town of Castle Rock, Castle Pines Chamber of Commerce, Denver Regional Council of Governments, Doctors Care, SECOR Cares, Elbert County Public Health, Douglas County Government, Douglas County Housing Partners, and The Hospital Team Members.The Hospital collaborated with Douglas and Elbert County Public Health Departments to inform our Community Health Needs Assessment Steering Committee as these public health departments cover the hospital service area. Each public health department shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health departments and community to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Douglas County is a part. Part V, Section B, Line 5: Facility Reporting Group A - AdventHealth Avista:In order to ensure broad community input, AdventHealth Avista (the Hospital) created a Community Health Needs Assessment Committee (CHNAC) to help guide the Hospital through the assessment process. The CHNAC included representation from the Hospital, public health experts and the broad community. This included intentional representation from low-income, minority and other underserved populations.The CHNAC met to review the primary and secondary data, help define the priority issues to be addressed by the Hospital and to help develop the community health plan to address the priority issues. In addition to representation from the Hospital, the listing below reflects all of the organizations/community areas represented on the Hospital's CHNAC: Adventist Rocky Mountain Conference, Boulder County Public Health, Broomfield County Public Health, Coal Creek Meals on Wheels, Colorado Community Health Alliance, Community Food Share, SCL Health, Sister Carmen Community Center, and the Hospital Team Members.The Hospital collaborated closely with Boulder County Public Health and Broomfield County Public Health to inform our Community Health Needs Assessment Steering Committee as these public health departments cover the majority of the hospital service area. Each public health department shared their current community health priorities to inform the decision of our Steering Committee. The Hospital associates also participated in this process through meeting participation. The Hospital aligned its strategies with the public health departments to ensure greater movement toward the same goals and complementary efforts. In addition to local partnerships, Centura Health (JV mgmt company until 8/1/23) sits on the Metro Denver Partnership for Health, a partnership between nonprofit hospitals, Metro Denver public health departments, Regional Accountable Entities and Human Services departments to align community health efforts across the seven-county region, of which Boulder and Broomfield Counties are a part. Part V, Section B, Line 9: Portercare Adventist Health System (PAHS) adopted an implementation strategy on November 17, 2022 when the organization was being managed by Centura Health Corporation (CHC or Centura Health). CHC is an IRC 501(c)(3) tax exemption organization incorporated in December of 1995 and owned by jointly by Adventist Health System Sunbelt Healthcare Corporation (AHSSSHC) and Common Spirit to serve as a management company. However, effective August 1, 2023, AHSSHC and Common Spirit disaffiliated and AHSSHC, as the sole member of PAHS, assumed full management of the organization. AHSSHC and PAHS then re-reviewed the implementation strategy during the filing period and proposed a revised implementation strategy which was then adopted by the PAHS board in 2024. Additionally, as the result of the disaffiliation with CHC, PAHS changed from a fiscal year to a calendar year to align with AHSSHC, its sole member which began serving as its management company. All evaluations of the implementation strategy will now be evaluated on a calendar basis. Part V, Section B, Line 11: The filing organization is filing this short period return for the period from July 1, 2023, through December 31, 2023, as it is changing its tax year end from a fiscal June 30 year end to a calendar year end of December 31. As a fiscal-year taxpayer in the prior filing period, the filing organization completed its most recent Community Health Needs Assessment by June 30, 2022. The filing organization's 2023-2025 Implementation Strategy (Community Health Plan) was completed and adopted by November 17, 2023 as part of its Community Health Needs Assessment process. The narrative for this section, Schedule H, Part V, Schedule B, Line 11, explains how each Hospital facility addressed the significant health needs identified in its most recent Community Health Needs Assessment, any such needs that were not addressed, and the reasons why such needs were not addressed in this fiscal short period tax return (July 1, 2023 - December 31, 2023). This is the second-year update for the filing organization's Community Health Implementation Plan. Portercare Adventist Health System's (PAHS) five hospital campuses (cumulatively referred to as AdventHealth RMR) are addressed separately below with each hospital operating as a dba of PAHS. PAHS is a subsidiary of Adventist Health System Sunbelt Healthcare Corporation (AHSSSHC). AHSSHC is the 501(c)(3) parent organization of a hospital and healthcare system known as AdventHealth. The narrative below shows by hospital the current year progress on the Community Health Plan/Implementation Strategy. The narrative describes the priorities previously identified and give an update on the strategies addressing these prioritized needs. There is also a description of the identified needs that the Hospital did not prioritize to address. Group A Facility 1 - AdventHealth Parker:Description of CHNA Significant NeedsAdventHealth Parker (AHP or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Castle Rock and the Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with the Hospital and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. The Hospital recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.AHP's chosen priorities are listed below.1. Mental Health (Suicide Prevention)2. Substance Use Prevention3. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: In Douglas and Arapahoe Counties, suicide and depression rates remain high. 81.7 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 1662.7 per 100,000 patients were hospitalized for other mental health problems. 17.3 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear. There is a tension between immediate care and prevention that needs to be considered. Douglas and Arapahoe Counties have varying resources.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at AHP, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. AHP applied for an additional Zero Suicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024.Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at AHP from July 1, 2023 - December 31, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Substance Use PreventionDescription of the Priority: Douglas and Arapahoe Counties report that substance use has increased over the past three years and is important to address along with mental health. Adult smoking is 13.5% and excessive drinking is 19.6%. The community is experiencing an increase since the pandemic, as well.Current Year Update:Goal 2.1: Increase Emergency Department MOUD encounters (Buprenorphine inductions); increase administration and prescription of alternatives to opioids. Decrease in the administration and prescription of opioids; increase the distribution of Naloxone kits to support opioid overdose reversal.Objective 2.1.1: By 2023, develop a framework for an opioid addiction intervention and prevention outcomes initiative.The Hospital reports 9 MOUD (Medication for Opioid Use Disorder - provides patients in active opioid withdrawal with medication as a form of addiction treatment) interventions between July 1, 2023 - December 31, 2023. In addition, the Hospital has implemented the ALTO (Alternative to Opioids) program - focused on providing pain management options that do not include opioids in order to prevent possible addiction and participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. The Hospital also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.Goal 2.2: Advance Substance Use Disorder screening, Brief Intervention and Referral to Treatment (SBIRT) services.Objective 2.2.1: By 2023, implement Screening Brief Intervention and Referral to Treatment (SBIRT) initiative.AdventHealth RMR has implemented SBIRT (Screening, Brief Intervention & Referral to Treatment) initiative as a preventative approach for individuals who may be using substances at risky levels, or displaying substance use behaviors that may have negative impacts on their health. The Hospital reported 34 SBIRT encounters from July 1, 2023 - December 31, 2023. Part V, Section B, Line 11: Priority 3: Food SecurityDescription of the Priority: Although food security has improved, the cessation of benefits and extra services during the COVID pandemic, means that this is likely to worsen again in 2022 and beyond. The community would like to continue existing efforts to ensure families have access to healthy foods and enough to eat.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHP reported 29 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. AHP is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support the Parker's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. The Hospital also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Intentional Injury: Intentional Injury was prioritized recognizing the impact of injuries such as suicide, homicide and violence. Through discussions with the Steering Committee, it was recognized that a focus on Mental Health and Substance Abuse would be a prevention strategy for Intentional Injury. The Committee felt strongly that we address those issues that align closely with Intentional Injury, recognizing we could impact both with this common focus. We are, therefore, addressing Intentional Injury through prevention related to Mental Health and Substance Use. Access to Oral Health: Access to Oral Health Care was identified as a priority, in alignment with access to primary care in that there are fewer services and transportation can be a barrier. While oral health is an important part of human health, there was not alignment with community efforts nor Hospital efforts or capacity. We will monitor this over time and share with the community that this arose as an important health need. Access to Primary Care: The Hospital's strategic priorities are addressing access to primary care through two large initiatives. Therefore, we will not create new implementation plans this priority because it's already embedded in our strategic priorities.Group A Facility 2 - AdventHealth Littleton:Description of CHNA Significant NeedsAdventHealth Littleton (AHL or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Porter and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AHL and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. The Hospital recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment, as well as prevention through environmental and behavioral changes, were identified.AHL's chosen priorities are listed below.4. Mental Health (Suicide Prevention)5. Housing Stability6. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: Mental health helps to determine how we handle stress, relate to others and make choices. Additionally, poor mental health can increase risk for other chronic health problems. In Arapahoe County, mental health distress is higher among those with incomes $50K or less than those above, 40% and 22% respectively. Additionally, persons of color experience more mental distress than white, non-Hispanic community members, 33% and 30% respectively. Before the pandemic, mental health distress was high among high school students. Thirty-four percent experience mental distress, 13% made a suicide plan, 17% seriously considered suicide and 8% attempted suicide.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at AHL, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either be discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. AHL applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024.Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at the Hospital from July 1, 2023 - December 31, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year. Part V, Section B, Line 11: Priority 2: Housing StabilityDescription of the Priority: In Arapahoe County, Housing prices have sharply risen. Average monthly income rose 25% while average rent rose 25% between 2014 and 2019. Safe and stable, affordable, healthy housing is directly related to health. The housing crisis was exacerbated by COVID-19 pandemic. Additionally, people who rent their homes pay a higher percentage of income toward housing. Fifty percent of renters paid 30% or more of household income on housing in 2019, vs. 24% of homeowners.Current Year Update:Goal 2.1: Increase access to safe and stable housing and shelter within the community. Identify community members who report housing insecurity and refer them to appropriate resources in the community.Objective 2.1.1: By 2023, participate in collaborative efforts to address affordable housing and homelessness in Arapahoe and Douglas counties.AHL partnered with a local housing coalition made up of 30+ housing organizations that aim to prevent homelessness, and coordinate services for eligible households.Objective 2.1.2: By 2023, screen households for housing insecurity and refer them to resources in the community to promote stable housing.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHL reported 78 positive SDOH screenings for housing between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. Priority 3: Food SecurityDescription of the Priority: Our community initially identified economic security as a priority because qualitative data indicated that community members are having difficulty affording basic needs, including food and self-reported health has a direct relationship to household income. Between March and December 2020 unemployment insurance claims increased 938%. Based upon the resources identified in the community, this priority was transitioned to Food Security, as having access to affordable healthy foods provides more resources for other basic needs. Additionally, the cessation of food security benefits and extra services during the COVID pandemic means that this is likely to worsen again in 2022. The community would like to continue existing efforts to ensure families have access to healthy foods and enough to eat.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHL reported 79 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. AHL is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support the Littleton's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Injury: While the Hospital treats many patients due to injuries, this did not arise as a health priority in the conversation. It was, however, recognized that our work to focus on Mental Health will address injury through the links between mental health status and injury, intentional or unintentional. Substance Use: While substance use is an issue being seen in the community, there was a good discussion about the links between substance use and mental health and the need to focus on mental health at this point in time. Access to Primary Care: The Steering Committee discussed that access to care is a changing environment which we need to monitor due to continually changing guidelines and policies. After the pandemic, there will be a need to monitor how health coverage shifts when emergency coverage through Medicaid ends. However, they determined it would be best to focus on access to mental health care to maintain a strong focus on this issue and to have a greater impact with a greater focus on fewer priorities.Group A Facility 3 - AdventHealth Porter:Description of CHNA Significant NeedsAdventHealth Porter (Porter or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Littleton and the Denver and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with PAH and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. Porter recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.The Hospital's chosen priorities are listed below.1. Mental Health (Suicide Prevention)2. Substance Use Prevention3. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: In Denver County, suicide and depression rates remain high. 77.6 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 2493.8 per 100,000 patients were hospitalized for other mental health problems. 18.1 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at Porter, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either be discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. Porter applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024. Part V, Section B, Line 11: Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at Porter from July 1, 2023 - December 31, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Substance Use PreventionDescription of the Priority: Denver County reports that substance use has increased over the past three years and is important to address along with mental health. Adult smoking is 15.2% and excessive drinking is 22.3%. The community is experiencing an increase since the pandemic, as well. The community has seen an increase in youth nicotine use and drugs such as fentanyl are on the rise.Current Year Update:Goal 2.1: Increase Emergency Department MOUD encounters (Buprenorphine inductions); increase administration and prescription of alternatives to opioids. Decrease in the administration and prescription of opioids; increase the distribution of Naloxone kits to support opioid overdose reversal.Objective 2.1.1: By 2023, develop a framework for an opioid addiction intervention and prevention outcomes initiative.Porter reports seven MOUD (Medication for Opioid Use Disorder - provides patients in active opioid withdrawal with medication as a form of addiction treatment) interventions between July 1, 2023 - December 31, 2023. In addition, Porter has implemented the ALTO (Alternative to Opioids) program - focused on providing pain management options that do not include opioids in order to prevent possible addiction and participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. The Hospital also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.Goal 2.2: Advance Substance Use Disorder screening, Brief Intervention and Referral to Treatment (SBIRT) services.Objective 2.2.1: By 2023, implement Screening Brief Intervention and Referral to Treatment (SBIRT) initiative.AdventHealth RMR has implemented SBIRT (Screening, Brief Intervention & Referral to Treatment) initiative as a preventative approach for individuals who may be using substances at risky levels, or displaying substance use behaviors that may have negative impacts on their health. Porter reported 38 SBIRT encounters from July 1, 2023 -December 31, 2023Priority 3: Food SecurityDescription of the Priority: Although food security has improved, the cessation of benefits and extra services during the COVID pandemic, means that this is likely to worsen again in 2022. The community would like to continue existing efforts to ensure families have access to healthy foods and enough to eat.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity. SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. Porter reported 55 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. Porter is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support Porter's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.Porter partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Unintentional Injury: Intentional Injury was prioritized recognizing the impact of injuries such as suicide, homicide and violence. Through discussions with the Steering Committee, it was recognized that a focus on Mental Health and Substance Abuse would be a prevention strategy for Intentional Injury. The Committee felt strongly that we address those issues that align closely with Intentional Injury, recognizing we could impact both with this common focus. We are, therefore, addressing Intentional Injury through prevention related to Mental Health and Substance Use.Health Equity although not separately chosen as a selected priority, was identified as a need to be consciously integrated into the strategies of the above priorities that were selected.Group A Facility 4 - AdventHealth Castle Rock:Description of CHNA Significant NeedsAdventHealth Castle Rock (AHC) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with AdventHealth Parker and Tri-County Public Health Departments. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AHC and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. AHC recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.The Hospital's chosen priorities are listed below.7. Mental Health (Suicide Prevention)8. Substance Use Prevention 9. Food SecurityPriority 1: Mental Health (Suicide Prevention)Description of the Priority: In Douglas and Elbert counties, suicide and depression rates remain high. 75.7 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 1249.7 per 100,000 patients were hospitalized from other mental health problems. 16.3 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service. Part V, Section B, Line 11: A comprehensive suicide prevention pathway has been developed at the Hospital, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either be discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. AHC applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024.Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at AHC from July 1, 2023 - December 31, 2023. include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Substance Use PreventionDescription of the Priority: Douglas and Elbert Counties report that substance use has increased over the past three years and is important to address along with mental health. Adult smoking is 10.9% and excessive drinking is 20.8%. The community is experiencing an increase since the pandemic, as well.Current Year Update:Goal 2.1: Increase Emergency Department MOUD encounters (Buprenorphine inductions); increase administration and prescription of alternatives to opioids. Decrease in the administration and prescription of opioids; increase the distribution of Naloxone kits to support opioid overdose reversal.Objective 2.1.1: By 2023, develop a framework for an opioid addiction intervention and prevention outcomes initiative.AHC reports two MOUD (Medication for Opioid Use Disorder - provides patients in active opioid withdrawal with medication as a form of addiction treatment) interventions between July 1, 2023 - December 31, 2023. In addition, AHC has implemented the ALTO (Alternative to Opioids) program - focused on providing pain management options that do not include opioids in order to prevent possible addiction and participated in the Let's Talk Campaign, done in partnership with other organizations in the community, to reduce the stigma associated with mental health and has established partnerships with other community-based organizations that reach black and LatinX communities. The hospital also participated in the Lift The Label Campaign. Lift The Label is a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.Goal 2.2: Advance Substance Use Disorder screening, Brief Intervention and Referral to Treatment (SBIRT) services.Objective 2.2.1: By 2023, implement Screening Brief Intervention and Referral to Treatment (SBIRT) initiative.AdventHealth RMR has implemented SBIRT (Screening, Brief Intervention & Referral to Treatment) initiative as a preventative approach for individuals who may be using substances at risky levels, or displaying substance use behaviors that may have negative impacts on their health. AHC reported 11 SBIRT encounters from July 1, 2023 - December 31, 2023Priority 3: Food SecurityDescription of the Priority: According to Hunger Free Colorado, 1 in 3 people are struggling with hunger during the pandemic. A high cost of living exacerbates the gap between federal poverty guidelines and a living wage. In our service area, almost one in 10 people are food insecure. Blacks and Hispanics have greater rates of food insecurity at 14 and 13.4 percent, respectively.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. AHC reported 25 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. AHC is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support Castle Rock's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Intentional Injury: Intentional Injury was prioritized recognizing the impact of injuries such as suicide, homicide and violence. Through discussions with the Steering Committee, it was recognized that a focus on Mental Health and Substance Abuse would be a prevention strategy for Intentional Injury. The Committee felt strongly that we address those issues that align closely with Intentional Injury, recognizing we could impact both with this common focus. We are, therefore, addressing Intentional Injury through prevention related to Mental Health and Substance Use. Access to Oral Health: Access to Oral Health Care was identified as a priority, in alignment with access to primary care in that there are fewer services and transportation can be a barrier. While oral health is an important part of human health, there was not alignment with community efforts nor Hospital efforts or capacity. We will monitor this over time and share with the community that this arose as an important health need. Access to Primary Care: The Hospital's strategic priorities are addressing access to primary care through two large initiatives. Therefore, we will not create new implementation plans this priority because it's already embedded in our strategic priorities.Group A Facility 5 - AdventHealth Avista:Description of CHNA Significant NeedsAdventHealth Avista (AHA or the Hospital) conducted its most recent Community Health Needs Assessment (CHNA) through a collaborative partnership with the Boulder County Public Health Department, Broomfield Public Health, and community stakeholders. Both qualitative and quantitative primary and secondary data were gathered, along with numerous health indicators, and were prioritized by using a form of the Hanlon Method for Prioritizing Health Problems. Each identified need was rated against a) size, b) severity, and c) alignment with AHA and community existing efforts. Total scores were compiled and resulted in the identification of the below chosen priorities/health issues. AHA recognizes that focusing on a few health issues leads to greater progress than dispersing efforts across many issues. For each issue, best practices for screening and treatment as well as prevention through environmental and behavioral changes were identified.The Hospital's chosen priorities are listed below.1. Mental Health (Suicide Prevention)2. Housing Stability3. Food Security Part V, Section B, Line 11: Priority 1: Mental Health (Suicide Prevention)Description of the Priority: In Boulder and Broomfield counties, suicide and depression rates remain high. 50.2 per 100,000 patients were hospitalized in the ED for suicidal ideation and attempts. 1428.6 per 100,000 patients had other mental health problems. 17.3 per 100,000 population completed suicide in 2020. Rates of postpartum depression are rising as well. Stigma surrounding mental illness in our communities also prevents patients from seeking out care due to fear.Current Year Update:Goal 1.1: Increase identification of suicide risk by implementing Zero Suicide Framework, an evidence-based/informed mental health/suicide prevention trainings that will result in improved post-discharge patient and community member outcomes including reducing community risk of deaths by suicide.Objective 1.1.1: By 2024, scale the implementation of Zero Suicide post-discharge follow-up program for patients. This includes suicide screening and post-discharge follow-up support access to patients, including warm hand-off and referral to the Colorado State Crisis hospital post-discharge follow-up program, crisis service, and the National Suicide Prevention Service.A comprehensive suicide prevention pathway has been developed at the Hospital, including the universal screening of patients with the C-SSRS tool. Low-scoring patients are assessed by a behavioral health practitioner using the Safe-T model. Depending on need, the patient is provided with resources (including a connection to Caring Contact and a RMCP Hospital Follow-Up program) or referred to the crisis assessment team for a full assessment (Safe-T, Audit C+ Two, SBIRT, CALM (Counseling Access to Lethal Means) and a Stanley Brown Safety Plan (if discharged)). Patients are either discharged home, sent to a crisis stabilization unit, an acute treatment unit, or inpatient behavioral health unit based on risk assessment. The Hospital applied for an additional ZeroSuicide grant in 2023 from the Colorado Department of Public Health and Environment with funding due to begin in February 2024. Objective 1.1.2: By 2024, offer Zero Suicide training and best practices to clinicians and caregivers.In partnership with community-based organizations, 123 community clinical staff were trained, and two non-clinical community staff were trained. Trainings provided to staff members at AHA from July 1, 2023 - December, 2023 include: Assessing and Managing Suicide Risk (AMSR), Applied Suicide Intervention Skills Training (ASIST), Collaborative Assessment and Management of Suicidality (CAMS), Columbia Suicide Severity Rating Scale (CSSRS), Counseling on Access to Lethal Means (CALM), Dialectical Behavioral Therapy (DBT), LivingWorks Start or QPR, Mental Health First Aid (MHFA), Safety Planning, FAITH, VA Cultural Competency, VA Substance Abuse Training, Resiliency Training, and Gender Bias. Additional community and caregiver trainings are on track to be offered during the remainder of the year.Priority 2: Housing StabilityDescription of the Priority: In Boulder and Broomfield counties, housing prices have sharply risen. They are ranked 17 and 11 respectively amongst counties with more than 50% of household income spent on housing. Quality of housing is also a problem due to overcrowding, poor plumbing/kitchen utilities. Inflation during the pandemic has meant that families have less to spend on basic needs such as rental/mortgage payments and utilities.Current Year Update:Goal 2.1: Increase access to safe and stable housing and shelter within the community. Identify community members who report housing insecurity and refer them to appropriate resources in the community.Objective 2.1.1: By 2023, participate in collaborative efforts to address affordable housing and homelessness in Boulder and Broomfield Counties.The Hospital participates in workgroups led by the area's Continuum of Care to help improve care coordination efforts for our unhoused neighbors. In 2024, the Hospital, in partnership with other health systems and Broomfield Public Health and Boulder Public Health, will explore pathways to focus on upstream solutions to address affordable housing and homelessness.Objective 2.1.2: By 2023, screen households for housing insecurity and refer them to resources in the community to promote stable housing.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. The Hospital reported 64 positive SDOH screenings for housing between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs.Priority 3: Food SecurityDescription of the Priority: According to Hunger Free Colorado, 1 in 3 people are struggling with hunger during the pandemic. A high cost of living exacerbates the gap between federal poverty guidelines and a living wage. In our service area, one in 10 people are food insecure. Blacks and Hispanics have greater rates of food insecurity at 14 and 13.4 percent, respectively.Current Year Update:Goal 3.1: Increase utilization of and access to affordable, fresh produce and federal food assistance programs and enhancements.Objective 3.1.1: By 2023, screen and provide referrals for unmet social risks, including food insecurity.SDOH (Social Determinant of Health) screenings assessing food, housing, transportation, utilities and safety are universally administered at all inpatient encounters. The Hospital reported 65 positive SDOH screenings for food security between July 1, 2023 - December 31, 2023. These households were provided local resources to help meet their unique needs. The Hospital is building a collaboration with the Colorado Blueprint to End Hunger that will provide workgroup access, build food insecurity resources, and support the Hospital's needs assessment process.Objective 3.1.2: By 2024, partner with community-based organizations and businesses to increase utilization of benefits that promote food security.The Hospital partnered to conduct Double Up Food Bucks outreach to increase the number of people using this program for lower income families to purchase produce and increase the number of businesses offering the program. We also established a partnership with Nourish Colorado, an anti-hunger organization, to increase the number of stores accepting SNAP/WIC in communities. This program activated Community Health Navigators that focused on training and educating eligible bodegas on public assistance resources that would allow them to accept SNAP/WIC benefits.Priorities Not Addressed by the Hospital:The Community Health Needs Assessment identified multiple health needs through the collection of primary and secondary data. After reviewing the data, the Hospital and community stakeholders conducted a prioritization process. Listed below are the priorities not addressed and the reason why they were not selected to be addressed. Access to Primary Care: The Steering Committee discussed that access to care is a changing environment which we need to monitor due to continually changing guidelines and policies. After the pandemic, there will be a need to monitor how health coverage shifts when emergency coverage through Medicaid ends. However, they determined it would be best to focus on access to behavioral health care to maintain a strong focus on this issue and to have a greater impact with a greater focus on fewer priorities. Schedule H, Part V, Section B, Line 7a, Hospital Facility CHNA Website Facility 1 - AdventHealth Parkerhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 - AdventHealth Littletonhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 - AdventHealth Porterhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 4 - AdventHealth Castle Rockhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 5 - AdventHealth Avistahttps://www.adventhealth.com/community-health-needs-assessments Schedule H, Part V, Section B, Line 10: Each hospital facility's most recently adopted implementation strategy was made widely available through the following websites:Facility 1 - AdventHealth Parkerhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 2 - AdventHealth Littletonhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 3 - AdventHealth Porterhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 4 - AdventHealth Castle Rockhttps://www.adventhealth.com/community-health-needs-assessmentsFacility 5 - AdventHealth Avistahttps://www.adventhealth.com/community-health-needs-assessments Schedule H, Part V, Section B, Line 16a - c: Each hospital facility's FAP, FAP application form and plain language summary of the FAP was made widely available through the following websites:Facility 1 - AdventHealth Parkerhttps://www.adventhealth.com/legal/financial-assistanceFacility 2 - AdventHealth Littletonhttps://www.adventhealth.com/legal/financial-assistanceFacility 3 - AdventHealth Porterhttps://www.adventhealth.com/legal/financial-assistanceFacility 4 - AdventHealth Castle Rockhttps://www.adventhealth.com/legal/financial-assistanceFacility 5 - AdventHealth Avistahttps://www.adventhealth.com/legal/financial-assistance 70 1 - PAHS OnPoint Urgent Care LLC 9205 S Broadway Highlands Ranch CO 80129 Urgent Care Clinic 2 - AdventHealth Medical Group OBGYN at Littl 7720 S Broadway Ste 250 Littleton CO 801222634 Physician Clinic 3 - OnPoint OBGYN LLC 7780 S Broadway Ste 280 Littleton CO 80122 Physician Clinic 4 - AdventHealth Medical Group Orthopedics and 9949 S Oswego St Ste 200 Parker CO 801343753 Physician Clinic 5 - AdventHealth Medical Group Neurology at Li 7780 S Broadway Ste 350 Littleton CO 801222633 Physician Clinic 6 - AdventHealth ER & Urgent Care Southmoor 7000 East Hampden Ave Denver CO 80224 Urgent Care Clinic 7 - Functional Neurosurgical Ambulatory Surger 11 W Dry Creek Circle Ste 120 Littleton CO 80120 Ambulatory Surgery Center 8 - AdventHealth Medical Group OBGYN 9403 Crown Crest Blvd Ste 200 Parker CO 80138 Physician Clinic 9 - AdventHealth Medical Group Primary Care at 6069 South Southlands Parkway Suite C Aurora CO 80016 Physician Clinic 10 - AdventHealth Medical Group Multiple Specia 2352 Meadows Blvd Ste 300 Castle Rock CO 801098419 Physician Clinic 11 - AdventHealth Medical Group Orthopedics at 4350 Limelight Ave Ste 100 Castle Rock CO 80109 Physician Clinic 12 - AdventHealth Medical Group Primary Care at 7000 East Hampden Ave Ste 200 Denver CO 80224 Physician Clinic 13 - AdventHealth ER & Urgent Care Meridian 9949 S Oswego St Ste 100 Parker CO 801343753 Urgent Care Clinic 14 - AdventHealth Medical Group Colorado Joint 2535 S Downing St Ste 100 150 Denver CO 80210 Physician Clinic 15 - AdventHealth Medical Group PainJoint Repl 9695 S Yosemite St Ste 255C Lone Tree CO 80124 Physician Clinic 16 - AdventHealth Medical Group Ridgegate OBGY 2356 Meadows Blvd Ste 240B Castle Rock CO 80109 Physician Clinic 17 - AdventHealth Medical Group Family Medicine 2356 Meadows Blvd Ste 140B Castle Rock CO 80109 Physician Clinic 18 - AdventHealth Medical Group Primary CareIn 950 E Harvard Ave Ste 200 Denver CO 802107006 Physician Clinic 19 - AdventHealth Medical Group Primary Care at 9670 Coal Mine Ave Ste 200 Littleton CO 80122 Physician Clinic 20 - AdventHealth Medical Group Internal MedEN 9403 Crown Crest Blvd Ste 300 Parker CO 80138 Physician Clinic 21 - AdventHealth Medical Group OBGYN at Churc 7233 Church Ranch Blvd Suite A Westminster CO 800214094 Physician Clinic 22 - AdventHealth Medical Group Spine and Neuro 90 Health Park Dr Ste 350 Louisville CO 800279742 Physician Clinic 23 - AdventHealth Medical Group Complex Gynecol 2555 S Downing St 1st Floor Denver CO 802105855 Physician Clinic 24 - AdventHealth Medical Group Primary Care at 15901 E Briarwood Cir Ste 200 Aurora CO 80016 Physician Clinic 25 - AdventHealth Medical Group Multiple Specia 80 Health Park Dr Ste 270 Louisville CO 800279584 Physician Clinic 26 - AdventHealth Medical Group Internal Medici 9088 South Ridgeline Blvd Highlands Ranch CO 80129 Physician Clinic 27 - AdventHealth Medical Group Primary Care at 7720 South Broadway Ste 350 Littleton CO 80122 Physician Clinic 28 - AdventHealth Medical Group Gastroenterolog 2535 S Downing St Ste 410 Denver CO 802105850 Physician Clinic 29 - AdventHealth Medical Group OBGYN and Midw 90 Health Park Dr Ste 290 Louisville CO 80027 Physician Clinic 30 - AdventHealth Medical Group Primary Care at 2490 W 26th Ave Ste A120 Denver CO 802115317 Physician Clinic 31 - AdventHealth Medical Group Family Medicine 250 Max Drive Ste 102 Castle Pines CO 801089518 Physician Clinic 32 - AdventHealth Medical Group Primary Care at 9137 S Ridgeline Blvd Ste 190 Highlands Ranch CO 801292395 Physician Clinic 33 - AdventHealth Medical Group Multiple Specia 9403 Crown Crest Blvd Ste 200 Parker CO 80138 Physician Clinic 34 - AdventHealth Medical Group PrimaryUrogyne 9949 S Oswego St Ste 300 Parker CO 801343753 Physician Clinic 35 - AdventHealth Medical Group OBGYN at Louis 90 Health Park Dr Ste 260 Louisville CO 800279742 Physician Clinic 36 - AdventHealth Medical Group OBGYN at Louis 80 Health Park Dr Ste 250 Louisville CO 80027 Physician Clinic 37 - AdventHealth Hospice Care Porter 6061 S Willow Dr Ste 210 Greenwood Village CO 80111 Hospice Services 38 - AdventHealth Hospice Care Porter 6901 South Havana St Ste 250 Centennial CO 80111 Hospice Services 39 - AdventHealth Medical Group Family Medicine 19461 E Parker Square Dr Ste A Parker CO 80134 Physician Clinic 40 - AdventHealth Medical Group Gastroenterolog 9403 Crown Crest Blvd Ste 420 Parker CO 80138 Physician Clinic 41 - AdventHealth Medical Group Ridgegate OBGY 9695 S Yosemite St Ste 255B Lone Tree CO 801242890 Physician Clinic 42 - AdventHealth Medical Group Family Medicine 4345 Woodlands Blvd Ste 260 Castle Rock CO 80104 Physician Clinic 43 - AdventHealth Medical Group Internal Medici 9397 Crown Crest Blvd Ste 201 Parker CO 80138 Physician Clinic 44 - AdventHealth Medical Group Urogynecology a 7233 Church Ranch Blvd Ste B Westminster CO 800214094 Physician Clinic 45 - AdventHealth Medical Group Family Medicine 611 Mitchell Way Erie CO 805165443 Physician Clinic 46 - AdventHealth Medical Group OBGYN at Erie 611 Mitchell Way Ste 103 Erie CO 80516 Physician Clinic 47 - AdventHealth Medical Group Primary CareHi 5351 S Roslyn St Greenwood Village CO 80011 Physician Clinic 48 - AdventHealth Medical Group Family Medicine 425 S Cherry St Ste 410 GLENDALE CO 80246 Physician Clinic 49 - AdventHealth Medical Group Primary Care at 240 Elizabeth St Unit B Elizabeth CO 80107 Physician Clinic 50 - AdventHealth Medical Group Primary Care at 7233 Church Ranch Blvd Ste C Westminster CO 800214094 Physician Clinic 51 - AdventHealth Medical Group Gastroenterolog 7780 S Broadway Ste 260 Littleton CO 801222633 Physician Clinic 52 - AdventHealth Medical Group Primary Care at 511 Crossing Dr Ste 202 Lafayette CO 800262629 Physician Clinic 53 - AdventHealth Medical Group Primary Care at 4809 Argonne Ste 200 Denver CO 80249 Physician Clinic 54 - AdventHealth Medical Group Pain Management 2535 S Downing Ste 180F Denver CO 80210 Physician Clinic 55 - AdventHealth Medical Group Spine and Neuro 850 E Harvard Ave Ste 255 Denver CO 80210 Physician Clinic 56 - PAHS OnPoint Imaging LLC 9205 S Broadway Ste 101 Highlands Ranch CO 80129 Physician Clinic 57 - AdventHealth Medical Group Gynecologic Onc 2535 S Downing St Ste 430 Denver CO 80210 Physician Clinic 58 - AdventHealth Medical Group OBGYN at South 6069 S Southlands Parkway Suite B Aurora CO 80016 Physician Clinic 59 - Encompass Health Rehabilitation Hospital 1001 West Mineral Ave Littleton CO 80120 Rehabilitation Hospital 60 - PAHS OnPoint Urgent Care LLC 10120 E Dry Creek Rd Englewood CO 80112 Urgent Care Clinic 61 - PAHS OnPoint Urgent Care LLC 24300 E Smoky Hill Rd Aurora CO 80016 Urgent Care Clinic 62 - PAHS OnPoint Urgent Care LLC 9695 S Yosemite St Lone Tree CO 80124 Urgent Care Clinic 63 - AdventHealth Medical Group Colorado Joint 4028 Laramie Street Cheyenne WY 82001 Physician Clinic 64 - AdventHealth Transplant 1760 Prairie Ave Cheyenne WY 82009 Physician Clinic 65 - AdventHealth Transplant 1141 Wilkins Circle Casper WY 82601 Physician Clinic 66 - AdventHealth Transplant 640 Flormann Street Rapid City SD 57701 Physician Clinic 67 - AdventHealth Transplant Institute North 2900 12th Ave N Ste 400 Billings MT 59707 Physician Clinic 68 - AdventHealth Transplant Institute Billin 315 N 25th St Ste 21 Billings MT 59102 Physician Clinic 69 - Porter Hospice 5020 E Arapahoe Rd Centennial CO 80111 Hospice Services 70 - AdventHealth Medical Group Primary Care at 6081 S Quebec St Ste 100 Centennial CO 80111 Physician Clinic 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 33 tax-exempt 501(c)(3) hospital organizations and other subsidiary health care organizations that operated in 12 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. Part I, Line 7: Portercare Adventist Health System does not use a cost accounting system to determine the cost of charity care. The estimated cost of care is calculated as the ratio of each facility's total expenses to total gross revenue. Worksheet 2 was not used to develop the cost to charge ratio. There are no physician clinics included in subsidized health services. Part II, Community Building Activities: The costs of community building activities reported on Part II of Schedule H primarily represent the costs associated with providing education for the filing organization's staff physicians and employees. The filing organization's provision of these educational programs/activities to staff physicians and employees provides an opportunity for health care professionals to enhance their skills and expertise and keep up-to-date with the latest advancements in medical procedures and technology. In addition, training opportunities are often provided on-site at the filing organization's hospital facilities, thereby allowing for health care professionals to be more readily available to assist in meeting immediate patient care needs. Education and training provided to each facility's workforce is vital in assisting health care professionals directly involved in patient care with keeping abreast of the latest developments in their respective areas of expertise, learning possible new and innovative ways of delivering care to patients, and understanding the newest technologies available for the treatment of patients. Part III, Line 2: Portercare Adventist Health System (PAHS) uses the overall cost to gross charge ratio applicable to each facility to determine the costs in Part III Lines 2 and 3. PAHS automatically discounts all self pay patient accounts by 30% and also offers a prompt pay discount. This allowance is not included in the calculation of the cost of bad debts in instances where a patient does not pay his or her bill. Part III, Line 3: Portercare Adventist Health System does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care. 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 24/7 emergency rooms providing care to all whom present. When a patient's arrival and/or admission to a 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 24/7 Emergency Departments that accept 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 Departments 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 Departments 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: 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 7-9. 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 each hospital facility's office or department that can provide information about the Financial Assistance Policy, as well as contact information of each 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 all Medicare patients are as follows:- Medicare surplus/(shortfall) shown on line 7 of Section B of Schedule H: $ (54,695,085)- Difference in costing methodology: (32,700,603)- Unreimbursed costs incurred for services provided to Medicare patients that are not included in the organization's Medicare cost report: (133,769,655) -------------Total Unreimbursed costs of serving all Medicare patients per the filing organization's communitybenefit reporting $ (221,165,343)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 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 filing organization conducts community health needs assessments (CHNA) every three years. Its 2021 CHNA was adopted by its governing board on November 17, 2022, the end of the Hospital's taxable year in which it conducted the CHNA. The Hospital's 2021 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.The hospitals provide several services and resources to the communities they serve beyond the prioritized needs specifically identified in the Community Needs Assessment. They sponsor wellness events such as breast feeding education, asthma screenings, and financially support wellness initiatives of cities and public schools. They also provide transportation for low income patients and housing at no cost or very low cost for the families of low income patients of the hospitals that are far from their residence. They also support, financially and through volunteerism, initiatives such as soup kitchens and Meals on Wheels to provide food and nutrition education to address hunger issues. Hospital staff also volunteer to serve as preceptors for students of local health professional programs and serve on boards of local community organizations that provide social services to populations in need. Part VI, Line 3: The Financial Assistance Policy (FAP), Financial Assistance Application Form (FAA Form), and the Plain Language Summary of the Financial Assistance Policy (PLS) of the filing organization's hospital facilities are transparent and available to all individuals served at any point in the care continuum. The FAP, FAA Form, PLS, and contact information for each hospital facility's financial counselors are prominently and conspicuously posted on each filing organization's hospital facility's website. The websites indicate that a copy of the FAP, FAA Form, and PLS is available and how to obtain such copies in the primary languages of any populations with limited proficiency in English that constitute the lesser of 1,000 individuals or 5% of the members of the community served by each hospital facility (referred to below as LEP defined populations). Signage is displayed in public locations of each filing organization's hospital facility, including at all points of admission and registration and the Emergency Department. The signage contains each hospital facility's website address where the FAP, FAA Form, and PLS can be accessed and the telephone number and physical location that individuals can call or visit to obtain copies of the FAP, FAA Form and PLS or to obtain more information about the hospital facility's FAP, FAA Form and PLS. Paper copies of the hospital facility's FAP, FAA Form and PLS are available upon request and without charge, both in public locations in the hospital facility and by mail. Paper copies are made available in English and in the primary languages of any LEP defined populations. Each of the filing organization's hospital facility's financial counselors seek to provide personal financial counseling to all individuals admitted to the hospital facility who are classified as self-pay during the course of their hospital stay or at time of discharge to explain the FAP and FAA Form and to provide information concerning other sources of assistance that may be available, such as Medicaid. A paper copy of each 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 operates five hospitals. Each hospital's community served is outlined below.Parker Adventist HospitalTo understand the profile of Parker Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Ethnicity: 17.3% Hispanic or Latino.Approximately 39.1% of the Hospital's patients during the tax year were Medicare patients, about 15.3% were Medicaid patients, about 3.0% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 68.7% of the hospital's in-patients were admitted through the hospital's Emergency Department.Littleton Adventist HospitalTo understand the profile of Littleton Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 66% white, 7.1% black, 5.9% Asian, 0.4% Native American/Alaskan Native, 0.2% native Hawaiian/Pacific Islander, 17.4% some other race, and 3% multiple races.- Ethnicity: 17.3% Hispanic or Latino.Approximately 51.4% of the Hospital's patients during the tax year were Medicare patients, about 12% were Medicaid patients, about 2.6% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 65.9% of the hospital's in-patients were admitted through the hospital's Emergency Department.Porter Adventist HospitalTo understand the profile of Porter Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 53.1% white, 10.4% black, 5.3% Asian, .5% Native American/Alaskan Native, .2% native Hawaiian/Pacific Islander, 27.3% some other race, and 3.1% multiple races. - Ethnicity: 27.1% Hispanic or Latino.Approximately 49.2% of the Hospital's patients during the tax year were Medicare patients, about 15.5% were Medicaid patients, about 4.2% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 54% of the hospital's in-patients were admitted through the hospital's Emergency Department.Castle Rock Adventist HospitalTo understand the profile of Castle Rock Adventist Health Campus's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 82% white, 1.3% black, 4.9% Asian, 0.3% Native American/Alaskan Native, 0.1% native Hawaiian/Pacific Islander, 9% some other race, and 2.4% multiple races.- Ethnicity: 8.9% Hispanic or Latino. Approximately 38.8% of the Hospital's patients during the tax year were Medicare patients, about 12.% were Medicaid patients, about 4.5% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 61.3% of the hospital's in-patients were admitted through the hospital's Emergency Department.Avista Adventist HospitalTo understand the profile of Avista Adventist Hospital's community, we analyzed the demographic and health indicator data of the population within the defined service area. The demographic makeup of these communities is as follows: - Race: The population is 76.9% white, 1% black, 5.1% Asian, 0.4% Native American/Alaskan Native, 0.1% Native Hawaiian/Pacific Islander, 14.3% some other race, and 2.4% multiple races. - Ethnicity: 14.1% Hispanic or LatinoApproximately 38.1% of the Hospital's patients during the tax year were Medicare patients, about 14.6% were Medicaid patients, about 5.5% were self-pay patients, and the remaining percentage were patients covered under commercial insurance. In the current tax year, about 23.9% of the hospital's in-patients were admitted through the hospital's Emergency Department. Part VI, Line 5: The provision of community benefit is central to Portercare Adventist Health System's mission of service and compassion. Restoring and promoting the health and quality of life of those in the communities served by the filing organization is a function of "extending the healing ministry of Christ by caring for those who are ill and by nuturing the health of the people in our communities and embodies the filing organization's commitment to its values and principles. The filing organization commits substantial resources to provide a broad range of services to both the underprivileged as well as the broader community. In addition to the community benefit and community building information provided in Parts I, II and III of this Schedule H, the filing organization captures and reports the benefits provided to its community through faith-based care. Examples of such benefits include the cost associated with chaplaincy care programs and mission peer reviews and mission conferences. During the current year, the filing organization provided $ 649,426 of benefit with respect to the faith-based and spiritual needs of its communities in conjunction with its operation of community hospitals. The filing organization also provides benefits to each of its community's infrastructure by investing in capital improvements to ensure that facilities and technology provide the best possible care to the community. During the current year, the filing organization expended $60,602,997 in new capital improvements. As faith-based mission-driven community hospitals, the filing organization is continually involved in monitoring its communities, identifying unmet health care needs and developing solutions and programs to address those needs. In accordance with its conservative approach to fiscal responsibility, surplus funds of the filing organization are continually being invested in resources that improve the availability and quality of delivery of health care services and programs to its communities. Part VI, Line 6: As previously noted, prior to August 1, 2023, to the filing organization was managed by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995, between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). The disaffiliation between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH) was effective August 1, 2023 leaving AHSSHC is the sole member and management company of the filing organization.Prior to Aug. 1, 2023: Portercare Adventist Health System is operated as part of Centura Health Corporation ("Centura"). Centura and its affiliated organizations are dedicated to extending the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Specifically, Centura has launched a system-wide strategic plan to improve the quality, consistency, availability, and affordability of health care to communities throughout Colorado. The three main components of this strategy are (1) to continue investing in technology advancements that improve the quality, costs, and coordination of care including the establishment of electronic health records linking our physicians, clinics, hospitals, long-term facilities and home care services; (2) providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health, growing the level of support and outreach provided to rural communities, and increasing access, affordability and quality of health care; and (3) coordinate and develop systems of care, looking to each facility and entity in Centura to share best practices and improve overall efficiency and communication system-wide from birth to home care.Effective Aug. 1, 2023: 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 50 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 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. The filing organization pays a management fee to AHSSHC for the services provided by AHSSHC. As a result, management fee expense reported by the filing organization may appear greater in relation to management fee expense that may be reported by a single stand-alone hospital. The single stand-alone hospital would likely report costs associated with management and other professional services on various expense line items in its statement of revenue and expense as opposed to reporting such costs in one overall management fee expense. As the reporting of the Form 990 is done on an entity-by-entity basis, there is no single Form 990 that captures the programs and operations of AdventHealth 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 the filing organization. Part VI, Line 7, Reports Filed With States CO 1 CLINICA CAMPESINA FAMILY HEALTH SERVICES 345 PLAZA COURT NORTH LAFAYETTE CO 80026 840743432 501(c)(3) 47850 0 General Support Castle Rock Chamber of Commerce 420 Jerry St CASTLE ROCK CO 80104 840802658 501(c)(6) 6000 0 General Support COMMUNITY FOOD SHARE INC 650 S TAYLOR AVE LOUISVILLE CO 80027 742227731 501(c)(3) 17000 0 General Support DOCTORS CARE 609 W Littleton Blvd Suite 100 Littleton CO 80120 841150815 501(c)(3) 20000 0 General Support Erie Chamber of Commerce 235 Wells St Erie CO 80516 841325423 501(c)(6) 10510 0 General Support MILE HIGH ACADEMY Inc 1733 DAD CLARK DRIVE HIGHLANDS RANCH CO 80126 840525223 501(c)(3) 55000 0 General Support Stronger Faster Boulder CO 1420 Pearl St Boulder CO 80302 842863972 501(c)(3) 13000 0 General Support Rocky Mountain Adventist Healthcare Foundation 960 E Harvard Avenue Ste 230 Denver CO 80210 840745018 501(c)(3) 684007 0 General Support The Arapahoe County School District No 6 5776 South Crocker Street Littleton CO 80120 846000862 Gov't 17171 0 General Support Russell Westbrook Why Not You Foundation Inc 227 W Monroe St 5000 Chicago IL 60606 461322847 501(c)(3) 140000 0 General Support 8 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 1 1 0 1 0 0 0 0 0 0 0 Banko Peter Former Officer 0 1914510 0 2583661 0 3603433 0 847002 0 29503 0 8978109 0 0 Gaasch Andrew Treasurer/CFO (end 8/23) 0 1128052 0 1135433 0 835706 0 228657 0 33652 0 3361500 0 0 Enderson Dan Sec/Group President/CFO (beg 8/23) 0 833256 0 861315 0 1321491 0 280930 0 30250 0 3327242 0 0 Rathbun Paul Director (end 8/23) 0 1347228 0 441722 0 866950 0 473177 0 30816 0 3159893 0 150000 Banks David Director/Chairman (beg 11/23) 0 1427724 0 443692 0 333935 0 150677 0 29784 0 2385812 0 150000 Randolph Karsten Director/Multi State CFO (beg 8/23) 0 731672 0 168601 0 1298710 0 137475 0 32374 0 2368832 0 73650 Bacon Kenneth Dir/Chairman Multi State CEO (end 11 0 1284422 0 424601 0 61906 0 244496 0 29241 0 2044666 0 0 RajpalMD Sharad Surgeon-Neuro 1668892 0 0 0 3651 0 14665 0 35142 0 1722350 0 0 0 Folkenberg Todd CEO Porter Adventist Hospital 0 452825 0 305921 0 511304 0 113126 0 43346 0 1426522 0 0 Jennings MD Jason Surgeon-Orthopedic 1096075 0 63429 0 3842 0 19800 0 32635 0 1215781 0 0 0 Yang MD Charlie Surgeon-Orthopedic 997820 0 157535 0 3566 0 16125 0 32236 0 1207282 0 0 0 Miner MD Todd Surgeon-Orthopedic 1049690 0 52906 0 6573 0 26049 0 29011 0 1164229 0 0 0 Goebel Michael CEO Parker Adventist Hospital 0 461855 0 419197 0 120699 0 89280 0 33198 0 1124229 0 0 Ewell MD Nelson Surgeon-Neuro 1006659 0 44984 0 4343 0 19800 0 33060 0 1108846 0 0 0 Ordelheide Kris Director (beg 8/23) 0 433043 0 481317 0 94614 0 87780 0 5992 0 1102746 0 0 Sendros Isaac Former Key Employee 0 404558 0 156655 0 369440 0 87437 0 30867 0 1048957 0 0 Dodds Rick CEO Littleton Adventist Hospital 0 443673 0 340399 0 126867 0 95296 0 34121 0 1040356 0 0 Spenst Brett Director/CEO (beg 8/23) 0 583228 0 0 0 373532 0 11127 0 24720 0 992607 0 0 Pittman Jeremy CEO Castle Rock Adventist Hospital 0 349374 0 212442 0 119863 0 86888 0 41439 0 810006 0 0 McKinney Jillyan Former Key Employee 0 512879 0 107509 0 27518 0 89062 0 32452 0 769420 0 0 Fisher Jonathan Former Key Employee 0 321125 0 45997 0 217063 0 67527 0 30350 0 682062 0 0 Still Danae CFO Littleton Adventist Hospital 0 258726 0 72385 0 189376 0 8942 0 42598 0 572027 0 0 Travis Carol CFO Avista Adventist Hospital 0 289011 0 84400 0 2013 0 26287 0 39034 0 440745 0 0 Erickson Jonathan CFO Avista Adventist Hospital (beg 9 0 241741 0 29018 0 129266 0 9844 0 28086 0 437955 0 0 Ward Erin CFO Parker Adventist Hospital 0 279856 0 78194 0 970 0 6594 0 129 0 365743 0 0 Whitlock Andrew CFO Porter Adventist Hospital 0 242754 0 52640 0 1188 0 6820 0 27197 0 330599 0 0 Finch Kenneth CEO Avista Adventist Hospital 0 0 0 0 0 306000 0 0 0 0 0 306000 0 0 Gal Matt CFO Castle Rock Adventist Hospital 0 218935 0 64709 0 717 0 6929 0 7601 0 298891 0 0 Part I, Line 1a Prior to August 1, 2023, members of the filing organization's top management officials were compensated by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). As such, the officers and key employees salaries were paid to them by CHC, a related organization, for services rendered in their capacity as key employees or officers of PAHS. However, effective August 1, 2023, AHSSHC and CSH disaffiliated, and management of the filing organization was transferred back to its sole member, AHSSHC. After disaffiliation, members of the filing organization's executive management team that hold the position of Vice-President or above were 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. For this short year tax return, both parties (CHC and AHSSHC) compensated officer and key employees of the filing organization. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. 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 50 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 (15 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 45-55 individual executives). The filing organization's CEO, the Multi-State CEO and the Multi-State CFO for AdventHealth are members of the Board of Directors of the filing organization. These individuals are considered common law employees of and are on the payroll of AHSSHC. While the special travel allowance benefit is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and either wholly or partially reimbursed by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for first-class or charter travel since it has wholly or partially paid for the cost of providing this benefit. Those executives who receive the special travel allowance are responsible for tracking the expenses reimbursable under the special travel allowance and must submit such expenses on their accountable plan expense report. 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: 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: Prior to the AHSSHC and CSH disaffiliation effective Aug 1, 2023, CHC provided a cash discretionary spending account was provided to eligible executives in the form of a car allowance of $750 per month to help offset business travel expense. After the disaffiliation, only occasional discretionary spending amounts were 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. Part I, Line 3 As discussed in Part VI, Section B, Line 15, and in Line 1 above, the organization's top management officials' compensation was paid by Centura Health Corporation (CHC) prior to the disaffiliation on Aug 1, 2023 and after disaffiliation was paid by Adventist Health System Sunbelt Healthcare Corporation (ASHHSC). All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. The individual serving as the CEO of the filing organization was appointed effective Aug. 1, 2023 and is compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) (please see our response to Part I, Line 1a above regarding the disaffiliation). 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, Line 4b Line 4b: As discussed in Line 1 above, the organization's top management officials' compensation was paid by Centura Health Corporation (CHC) prior to the disaffiliation on Aug 1, 2023 and after disaffiliation was paid by Adventist Health System Sunbelt Healthcare Corporation (ASHHSC). All officers and key employees' salaries and all associated benefits were paid for services rendered in their capacity as key employees or officers of the filing organization. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. CHC Benefit plans (prior to Aug 1, 2023): Senior executives on the filing organization's management team that hold the position of Senior Vice-President or Hospital CEO are eligible to participate in the CHC EXECU-FLEX Benefit Plan (the Plan). In recognition of the contribution that each executive makes to the success of CHC, CHC provides for participation in the Plan to the eligible executives. The purpose of the Plan is to offer an opportunity to elect from among a variety of supplemental benefits to individually tailor a benefits program appropriate to each executive's needs. The executive is provided with a Flex allowance equivalent to 10% of base salary to purchase selected benefits and to contribute into a deferred non-qualified supplemental executive retirement plan. The Plan provides for a five-year cliff-vesting schedule with respect to amounts accumulated in the executive's deferred compensation account. CHC contributes into these deferred compensation accounts semi-annually and amounts are subject to a substantial risk of forfeiture with active participation required at time of vesting. In addition, CHC provides a Pension Restoration Benefit (PRB) to restore qualified plan contributions lost on income in excess of the current federal maximum allowable compensation to a qualified plan. The PRB provides contributions by restoring the amount that would have been contributed to the executive's retirement savings plan for compensation in excess of the legislative limits. Benefit amounts are added to the participant's flex allowance each year based on their total compensation from the prior year. The following received contributions to a non-qualified plan for the calendar year 2023: CY Employer CY Employer CY SERP CY PRB SERP Contr. PRB Contr. Distrib. Distrib. Peter Banko 441,351 395,151 1,482,363 1,304,913 Andrew Gaasch 126,891 93,891 427,812 254,242 Daniel Enderson 123,625 90,625 587,997 438,305 Todd Folkenberg 54,183 21,183 278,355 138,265 Michael Goebel 55,365 22,365 0 0 Kris Ordelheide 53,891 23,389 0 0 Isaac Sendros 18,078 0 154,563 37,206 Rick Dodds 45,743 12,743 70,841 7,515 Jeremy Pittman 44,158 11,158 74,364 18,555 Jillyan McKinney 0 0 144,130 50,660 Schedule J, Line 4b: AHSSHC benefit plans (effective Aug 1, 2023) 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 2023. 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 $330,000 in 2023 (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. Schedule J, Line 4b: continuation Flex Plan Flex Plan SERP II SERP III SERP III Contr. Distr.* Contr./Distr. Contr. Distr.* -------------------------------------------------------------- Dan Enderson $ 0 $ 0 $ 0 $ 56,180 $ 0 Paul Rathbun $155,450 $132,564 $ 632,721 $ 0 $ 0 David Banks $155,450 $152,379 $ 90,424 $ 0 $ 0 Karsten Randolph $119,748 $ 74,817 $1,188,200 $ 0 $ 0 Kenneth Bacon $ 0 $ 0 $ 0 $237,896 $ 0 Todd Folkenberg $ 0 $ 0 $ 0 $ 27,260 $ 0 Michael Goebel $ 0 $ 0 $ 0 $ 26,792 $ 26,792 Isaac Sendros $ 0 $ 0 $ 0 $ 49,615 $ 0 Rick Dodds $ 0 $ 0 $ 0 $ 25,260 $ 0 Brett Spenst $ 0 $ 0 $ 0 $105,231 $105,231 Jeremy Pittman $ 0 $ 0 $ 0 $ 20,322 $ 0 Jillyan McKinney $ 0 $ 0 $ 0 $ 77,935 $ 0 Jonathan Fisher $ 0 $ 0 $ 0 $ 49,800 $ 0 Carol Travis $ 0 $ 0 $ 0 $ 17,135 $ 0 * Including Investment Earnings Ryan Folkenberg Family of Key Employee 11743 Employee Compensation 0 Aaron Speegle Family of Officer 129528 Employee Compensation 0 Chali Enderson Family of Officer 41167 Employee Compensation 0 Part V, Line 1a As previously noted, prior to August 1, 2023, to the filing organization was managed by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995, between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). The disaffiliation between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH) was effective August 1, 2023 leaving AHSSHC is the sole member and management company of the filing organization. Prior to August 1, 2023: Pursuant to an Affiliation Agreement between Adventist Health System Sunbelt Healthcare Corporation and Common Spirit Health, Portercare Adventist Health System (the filing organization) is managed by Centura Health Corporation (CHC), a joint operating company. CHC is a Colorado, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). CHC has established a shared service center to centralize the Accounts Payable (A/P) functions. The facts and circumstances support a position that CHC, as a payor on behalf of its managed organizations in a shared service environment, will have sufficient management and oversight in connection with the managed organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). CHC will not merely be making payments at the direction of its managed organizations. Accordingly, CHC is considered the payor subject to the information reporting requirements of Section 6041. 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 CHC as the payor subject to the information reporting requirements of Section 6041. Effective after August 1, 2023: The parent corporation and sole top-tier member of Portercare Adventist Health System (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 2 Gary Thurber and John (Mic) Thurber - Family Relationship Form 990, Part VI, Section A, line 4 Changes to Bylaws during current period: Prior to August 1, 2023, Portercare Adventist Health System (PAHS) was operated as part of a regional health care delivery network operated and managed by Centura Health Corporation (CHC). CHC was a joint operating company between Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) and Catholic Health Initiatives Colorado (CHIC). AHSSHC was and remains the sole member of PAHS and is a 501(c)(3) organization. AHSSHC operates a healthcare delivery system known as AdventHealth. PAHS operates five hospitals within the greater Denver area. Effective August 1, 2023, AHSSHC and CHIC disaffiliated. It was agreed that the parties would end their affiliation and the operation of PAHS and all other entities under CHC would no longer be operated under the management control of the joint operating company. Accordingly, the Bylaws of the filing organization were amended effective August 1, 2023, to reflect the changes resulting from this disaffiliation. The August 1, 2023 Bylaws were revised to effectuate the terms of the disaffiliation. Accordingly, all relevant sections of the previous Bylaws were amended to remove all references and authorities, including reserved powers, that were granted to the joint operating company and its board of directors. The revised Bylaws provide that the sole member, AHSSHC to power to appoint the board of directors, proving a minimum one and a maximum of ten (10) voting members of the Board of Directors. The revision also provides that the Board shall appoint a separate governing board to oversee the operations of each Hospital and be the body legally responsible for such Hospital and associated Health Care Facilities (each a "Community Board and collectively the "Community Boards"). The responsibilities of each Community Board shall include, but not be limited to, legal responsibility for compliance with applicable Medicare Conditions of Participation and the safety and quality of care, treatment and services offered by such Hospital and associated Health Care Facilities, as more fully described in the Operating Bylaws of such Hospital. Committees of the Board of Directors which have as their primary purpose the discussion of issues which affect the discharge of responsibilities of the Hospital medical staff shall include in the committee membership a representative of the medical staff. The Bylaws were also revised to update the powers reserved to the Member. Please see our response to Section VI, Part A, Line 7b for a complete listing of the powers reserved to the Member. Form 990, Part VI, Section A, line 6 Portercare Adventist Health System (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 As previously noted, prior to August 1, 2023, to the filing organization was managed by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995, between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). The disaffiliation between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH) was effective August 1, 2023 leaving AHSSHC is the sole member and management company of the filing organization. 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 can be exercised by the board of directors or an authorized committee to the extent not prohibited by the Members bylaws, the Member's president or his/her designee. These reserved powers include: 6.1.1 To approve or disapprove the appointment, removal and compensation of the senior management of the Health Care Facilities, including without limitation, the chief executive officer, chief financial officer and any other executive level Officer deemed appropriate by the Member; 6.1.2 To approve or disapprove these Bylaws and amendments thereto, and any amendments (including a restatement) to the Articles; 6.1.3 To approve or disapprove material changes in the category of services offered by the Corporation; 6.1.4 To approve or disapprove capital expenditures in excess of ONE MILLION DOLLARS ($1,000,000), which action can be approved by specific authorization or as generally authorized in the Corporation's annual capital budget approved by the Member; 6.1.5 To approve or disapprove the sale, donation, or other transfer of real property in excess of ONE MILLION DOLLARS ($1,000,000) in each instance, which action can be approved by specific authorization or as generally authorized in the Corporation's annual operating and/or capital budgets approved by the Member; 6.1.6 The authority to require the Corporation's adherence to policies adopted by the Member; 6.1.7 The authority to set limits and terms for any and all types of financial transactions exceeding ONE HUNDRED THOUSAND DOLLARS ($100,000) for any single or related projects including, without limitation, borrowing of funds, any type of financing, any banking activities, accounts receivable securitization, sale of accounts receivable, letters of credit, credit lines, tax exempt and taxable debt programs and structures, any transactions permitted by the financial documents and financial structure of the Member and any of its affiliated organizations, and any other financing transactions not identified herein; 6.1.8 The authority to approve or disapprove the annual operating and capital budgets and strategic plans for the Corporation; 6.1.9 The authority to secure naming rights and to direct the placement of funds and capital and the making of gifts, sponsorships, donations, loans and transfers of funds or other assets by the Corporation in excess of ONE MILLION DOLLARS ($1,000,000), which action can be approved by specific authorization or as generally authorized in the Corporation's annual operating and/or capital budgets approved by the Member; 6.1.10 To approve or disapprove the sale, purchase, donation, or other conveyance of personal property with a value in excess of ONE MILLION DOLLARS ($1,000,000) not otherwise approved in the current capital or operating budgets, which action can be approved by specific authorization or as generally authorized in the Corporation's annual operating and/or capital budgets approved by the Member; 6.1.11 To approve or disapprove the implementation of non-traditional, non healthcare related activities; 6.1.12 To approve or disapprove performance/quality improvement, revenue cycle and case management programs; 6.1.13 To approve or disapprove the selection of the auditing firm retained to audit the books of the Corporation; 6.1.14 To approve or disapprove the election of the fiscal year of the Corporation; 6.1.15 To approve or disapprove the selection of the Corporation's group purchasing organization(s); 6.1.16 To approve or disapprove any joint venture or partnership in which the Corporation would be a member or partner; 6.1.17 To approve or disapprove the IT systems and other shared services used by the Corporation; 6.1.18 The authority to require the Corporation's adherence to the system-wide naming nomenclature and service standards adopted by the Member; 6.1.19 To set and enforce policies for physician compensation including commercial reasonableness and fair market value; and 6.1.20 To exercise such other powers as are necessary in connection with the foregoing. 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 Prior to August 1, 2023, members of the filing organization's top management officials were compensated by Centura Health Corporation (CHC). CHC was a joint operating management company who managed the daily activities of Portercare Adventist Health System under a joint operating agreement dated December 8, 1995 between Adventist Health System Sunbelt Healthcare Corporation (ASHHSC) and Common Spirit Health (CSH). As such, the officers and key employees salaries were paid to them by CHC, a related organization, for services rendered in their capacity as key employees or officers of PAHS. However, effective August 1, 2023, AHSSHC and CSH disaffiliated, and management of the filing organization was transferred back to its sole member, AHSSHC. After disaffiliation, 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. 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. For this short year tax return, both parties (CHC and AHSSHC) compensated officer and key employees of the filing organization. All of their reportable compensation is disclosed on Form 990, Schedule J, Part II, row (ii) and Form 990, Part VII, column (e) as compensation from related organizations. 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 conflict of interest policy available to the public. Part VII, Section A, Columns (E) & (F) For those Board of Director members and officer(s) who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position as an employee of Adventist Health System Sunbelt Healthcare Corporation. Part VIII, Lines 7a, b and c: The amounts shown in Part VIII, Line 7, column (i) of the Form 990 represent an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. Form 990, Part IX, line 11g Payments to Hlthcare Professionals: Program service expenses 66,231,240. Management and general expenses 0. Fundraising expenses 0. Total expenses 66,231,240. Professional Fees: Program service expenses 3,947,673. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,947,673. Purchased Medical Services: Program service expenses 3,383,766. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,383,766. Environmental Services: Program service expenses 3,269,308. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,269,308. Transcription Services: Program service expenses 69,375. Management and general expenses 0. Fundraising expenses 0. Total expenses 69,375. Recruiting: Program service expenses 5,792,438. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,792,438. Outsourced Food Services: Program service expenses 203,544. Management and general expenses 0. Fundraising expenses 0. Total expenses 203,544. Other Purchased Services: Program service expenses 59,477,205. Management and general expenses 0. Fundraising expenses 0. Total expenses 59,477,205. Management Fees: Program service expenses 0. Management and general expenses 18,624,270. Fundraising expenses 0. Total expenses 18,624,270. Billing and Collection Services: Program service expenses 0. Management and general expenses 2,375,594. Fundraising expenses 0. Total expenses 2,375,594. Management Fees JOA: Program service expenses 0. Management and general expenses 14,251,806. Fundraising expenses 0. Total expenses 14,251,806. AH Shared Services Fee: Program service expenses 0. Management and general expenses 6,429,456. Fundraising expenses 0. Total expenses 6,429,456. Part X, Line 2 The amounts shown on line 2 of Part X of this return include the filing organization's interest in a central investment pool maintained by Adventist Health System Sunbelt Healthcare Corporation, the filing organization's top-tier parent. The investments in the central investment pool are recorded at market value. Form 990, Part XI, line 9: Transfer to Tax-Exempt Parent -7,246,929. Transfer to/from Related Tax-Exempt Organizations -90,066,024. Prior Period Adjustment -4,699,708. Released from Restricted 103,857. Donated Property and Transfer from Related Tax-Exempt Foundation 3,313,266. Transfers from Restricted -103,856. Gifts 74,255. Transfer to Unrestricted 1,179,047. Form 990, 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, 2023, AdventHealth will file a consolidated Single Audit which will include all entities that are part of the controlled group. HealthFit Family Medicine LLC 9100 E Mineral Circle Centennial CO 80112 815310593 Medical Services - family practice (inactive) CO 0 0 Portercare Adventist Health System HealthFit Medical Professionals LLC 9100 E Mineral Circle Centennial CO 80112 473561708 Medical Services - family practice (inactive) CO 0 0 Portercare Adventist Health System HealthFit Wellness Professionals LLC 9100 E Mineral Circle Centennial CO 80112 815325418 Fitness Center (inactive) CO 0 0 Portercare Adventist Health System AdventHealth Asheville Inc 100 Hospital Drive Hendersonville NC 28792 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 Inc 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 Palm Coast Parkway Inc 1 AdventHealth Way Palm Coast FL 32137 882288563 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 Primary Care Network Inc (630-123123) 900 Hope Way Altamonte Springs FL 32714 932208118 Future Operation of Physician Practices & Medical 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 9330 US Highway 301 S 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 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 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 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 Employee Leasing of Personnel to Affiliated Hospitals TX 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 AHS Midwest Management Inc 500 Remington Blvd Bolingbrook IL 60440 363354567 Employee Leasing of Personnel to Supported Hospitals IL 501(c)(3) Line 12c, III-FI 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 Burleson Nursing & Rehab Center Inc 301 Huguley Blvd Burleson TX 76028 205782243 Operation of Home for the Aged/Hlthcare Delivery TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Centura Health Corporation (71-73123) 9100 E Mineral Circle Centennial CO 80112 841335382 Joint Operating Company CO 501(c)(3) 0 Chickasaw Health Care Properties Inc 250 S Chickasaw Trail Orlando FL 32825 510605681 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Chippewa Valley Hospital & Oakview Care Center Inc 1220 Third Avenue West Durand WI 54736 391365168 Operation of Hospital & Related Services WI 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Coalition For Physician Well-Being Inc 900 Hope Way Altamonte Springs FL 32714 463477012 Provide support for Physician well-being FL 501(c)(3) Line 10 Adventist Hlth System Sunbelt Hlthcare Corp 1 Courtland Health Care Properties Inc 730 Courtland Street Orlando FL 32804 510605682 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Dairy Road Health Care Properties Inc 7350 Dairy Road Zephyrhills FL 33540 510605684 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 East Orlando Health & Rehab Center Inc 250 S Chickasaw Trail Orlando FL 32825 205774748 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Fletcher Hospital Inc 100 Hospital Drive Hendersonville NC 28792 560543246 Operation of Hospital & Related Services NC 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 FLNC Inc 3355 E Semoran Blvd Apopka FL 32703 205774761 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Florida Hospital Dade City Inc 13100 Fort King Road Dade City FL 33525 822567308 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Healthcare Partners Inc 770 West Granada Blvd 101 Ormond Beach FL 32174 462354804 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Medical Group Inc 2600 Westhall Lane 4th Floor Maitland FL 32751 593214635 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Hospital Ocala Inc 1500 SW 1st Avenue Ocala FL 34471 824372339 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Physician Group Inc 12470 Telecom Dr 100 Tampa FL 33637 462021581 Operation of Physician Practices & Medical Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Waterman Inc 1000 Waterman Way Tavares FL 32778 593140669 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Florida Hospital Zephyrhills Inc 7050 Gall Blvd Zephyrhills FL 33541 592108057 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Florida Radiology Imaging at Lake Mary LLC 2600 Westhall Lane 4th Floor Maitland FL 32751 550789387 Imaging & Testing FL 501(c)(3) Line 3 Florida Hospital Medical Group Inc 1 Fountain Inn Nursing & Rehab Center Inc 4501 Waterman Way Tavares FL 32778 472180518 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Helen Ellis Memorial Hospital Auxiliary Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 592106043 Fund-raising for Tax-exempt hospital/foundation FL 501(c)(3) Line 12c, III-FI N/A 0 Helen Ellis Memorial Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 593690149 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Hospice of the Comforter Inc 480 W Central Parkway Altamonte Springs FL 32714 592935928 Operation of Hospice FL 501(c)(3) Line 10 The Comforter Health Care Group Inc 1 Lake County Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813923985 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Memorial Health Systems Foundation Inc 305 Memorial Medical Pkwy 212 Daytona Beach FL 32117 311771522 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 Memorial Health Systems Inc 301 Memorial Medical Parkway Daytona Beach FL 32117 590973502 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Memorial Hospital - West Volusia Inc 701 West Plymouth Avenue Deland FL 32720 593256803 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Flagler Inc 60 Memorial Medical Parkway Palm Coast FL 32164 592951990 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Memorial Hlth Systems Inc 1 Memorial Hospital Inc 210 Marie Langdon Drive Manchester KY 40962 610594620 Operation of Hospital & Related Services KY 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Adventist Hospital Inc 2201 S Clear Creek Road Killeen TX 76549 742225672 Operation of Hospital & Related Services TX 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Metroplex Clinic Physicians Inc 2201 S Clear Creek Road Killeen TX 76549 113762050 Physician Healthcare services to the community TX 501(c)(3) Line 3 Metroplex Adventist Hospital Inc 1 Mission Strategies of Georgia Inc 485 North Keller Road 250 Maitland FL 32751 900866024 Provision of support to the nursing home division GA 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Osceola Health Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813165729 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Overland Park Nursing & Rehab Center Inc 6501 West 75th Street Overland Park KS 66204 205774821 Operation of Home for the Aged/Hlthcare Delivery KS 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 PAHS Service Corporation (49 - 123123) 6061 S Willow Drive Greenwood Village CO 80111 923398616 Employee Leasing of Personnel to Related Hospitals CO 501(c)(3) Line 12c, III-FI Portercare Adventist Health System 1 Pasco-Pinellas Hillsborough Community Hlth System Inc 2600 Bruce B Downs Blvd Wesley Chapel FL 33544 208488713 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Portercare Adventist Health System 6061 S Willow Drive Greenwood Village CO 80111 840438224 Operation of Hospitals & Related Services CO 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Princeton Homecare Services LLC 602 Courtland Street 310 Orlando FL 32804 814196648 Home Health Care Services FL 501(c)(3) Line 10 Princeton Prof Services Inc 1 Princeton Professional Services Inc 601 E Rollins Street Orlando FL 32803 591191045 Provision of Healthcare Services FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Quality Circle for Healthcare Inc 900 Hope Way Altamonte Springs FL 32714 263789368 Healthcare Quality Services FL 501(c)(3) Line 12a, I Adventist Hlth System Sunbelt Hlthcare Corp 1 Redmond Park Hospital LLC 501 Redmond Road NW Rome GA 30165 581123037 Operation of Hospital & Related Services GA 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Resource Personnel Inc 485 North Keller Road 250 Maitland FL 32751 208040875 Provide administrative support to tax exempt nursing homes FL 501(c)(3) Line 12b, II Sunbelt Hlth Care Centers Inc 1 Rocky Mountain Adventist Hlthcare Foundation 950 E Harvard Avenue Ste 230 Denver CO 80210 840745018 Fund-raising for Tax-exempt hospital CO 501(c)(3) Line 7 Portercare Adventist Health System 0 Rollins Brook Community Care Corp 2201 S Clear Creek Road Killeen TX 76549 461656773 Support Operation of Hospital TX 501(c)(3) Line 12a, I Adventist Hlth SystemSunbelt Inc 1 San Marcos Nursing & Rehab Center Inc 1900 Medical Parkway San Marcos TX 78666 205782224 Inactive - In wind down TX 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Hlth Care Properties Inc 485 North Keller Road 250 Maitland FL 32751 813914908 Inactive - In wind down GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Health Care Inc 6501 West 75th Street Overland Park KS 66204 480952508 Lease to Related Organization KS 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Shawnee Mission Medical Center Inc 9100 W 74th Street Shawnee Mission KS 66204 480637331 Operation of Hospital & Related Services KS 501(c)(3) Line 3 Adventist Hlth Mid-America Inc 1 South Pasco Health Care Properties Inc 38250 A Avenue Zephyrhills FL 33542 510605679 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 Southeast Volusia Healthcare Corp 401 Palmetto Street New Smyrna Beach FL 32168 473793197 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 Southwest Volusia Health Services Inc 1055 Saxon Blvd Orange City FL 32763 593281591 Medical Office Building for Hospital FL 501(c)(3) Line 12a, I Southwest Volusia Hlthcare Corp 1 Southwest Volusia Healthcare Corp 1055 Saxon Blvd Orange City FL 32763 593149293 Operation of Hospital & Related Services FL 501(c)(3) Line 3 Adventist Hlth SystemSunbelt Inc 1 Sunbelt Health & Rehab Center - Apopka Inc 305 East Oak Street Apopka FL 32703 205774856 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Sunbelt Health Care Centers Inc 485 North Keller Road 250 Maitland FL 32751 581473135 Management Services TN 501(c)(3) Line 12b, II Adventist Hlth System Sunbelt Hlthcare Corp 1 Tarpon Springs Hospital Foundation Inc 1395 S Pinellas Ave Tarpon Springs FL 34689 590898901 Operation of Hospital & Related Services FL 501(c)(3) Line 3 University Community Hospital Inc 1 Tarrant County Health Care Properties Inc 301 Huguley Blvd Burleson TX 76028 510605677 Lease to Related Organization GA 501(c)(3) Line 12c, III-FI Sunbelt Hlth Care Centers Inc 1 The Comforter Health Care Group Inc 605 Montgomery Road Altamonte Springs FL 32714 271857940 Support Services to Related Hospice FL 501(c)(3) Line 12c, III-FI Adventist Hlth System Sunbelt Hlthcare Corp 1 Tri-County Nursing and Rehab Center Inc 1290 Celebration Blvd Kissimmee FL 34747 472219363 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 University Community Hospital Foundation Inc 3100 E Fletcher Ave Tampa FL 33613 592554889 Fund-raising for Tax-exempt hospital FL 501(c)(3) Line 7 N/A 0 University Community Hospital Inc 3100 E Fletcher Ave Tampa FL 33613 591113901 Operation of Hospitals & Related Services FL 501(c)(3) Line 3 Adventist Hlth System Sunbelt Hlthcare Corp 1 West Florida Health Home Care Inc 13601 Bruce B Downs Blvd Ste 110 Tampa FL 33613 593686109 Home Health Services GA 501(c)(3) Line 10 AdventHealth West Florida Ambulatory Services Inc 1 Zephyr Haven Health & Rehab Center Inc 38250 A Avenue Zephyrhills FL 33542 205774930 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 Zephyrhills Health & Rehab Center Inc 7350 Dairy Road Zephyrhills FL 33540 205774967 Operation of Home for the Aged/Hlthcare Delivery FL 501(c)(3) Line 10 Sunbelt Hlth Care Centers Inc 1 AdventHealth Surgery Center Daytona Beach LLC 103 Memorial Medical Pkwy Ste 300 Daytona Beach FL 32117 922967648 Surgery Center FL N/A 0 0 AdventHealth Surgery Center Innovation Tower LLC 265 E Rollins Street Orlando FL 32804 882744377 Surgery Center FL N/A 0 0 Fletcher Hospital Surgical Ventures LLC 9131 Anson Way Ste 304 Raleigh NC 27615 861482646 Indirect Interest in Surgery Center NC N/A 0 0 Florida Hospital DMERT LLC 500 Winderley Place Ste 324 Maitland FL 32751 202392253 Medical Equipment FL N/A 0 1 Florida Hospital Home Infusion LLP 500 Winderley Place Ste 226 Maitland FL 32751 593142824 Home Infusion Services FL N/A 0 1 Functional Neurosurgical Ambulatory Surgery Ctr LLC 11 W Dry Creek Circle 120 Littleton CO 80120 464426708 Surgery Center CO Portercare Adventist Health System Related 0 0 0.51000 M&O Orlando MOB I LLC 1125 Sanctuary Parkway Ste 410 Alpharetta GA 30009 844259138 Operation of Medical Office Building DE N/A 0 0 OnPoint OBGYN LLC 7780 S Broadway 280 Littleton CO 80122 873522453 Healthcare Services CO Portercare Adventist Health System Related 100189 694223 0 0 0.51000 Orange City Surgical LLC 1053 Medical Center Drive Ste 201 Orange City FL 32763 208105013 Surgery Center FL N/A 0 0 PAHS OnPoint Imaging LLC 9205 S Broadway Highlands Ranch CO 80129 833275105 Imaging Center CO Portercare Adventist Health System Related 400908 57771 0 0 0.51000 PAHS OnPoint Urgent Care LLC 9100 E Mineral Circle Centennial CO 80112 832465331 Urgent Care Center CO Portercare Adventist Health System Related -1100998 6151002 0 0 0.54000 Surgery Center of Rome LP 501 Redmond Road NW Rome GA 30165 200390305 Surgery Center GA N/A 0 0 SCA - Alliance LLC 569 Brookwood Village Ste 901 Birmingham AL 35209 471807383 Indirect Interest in Surgery Center DE N/A 0 0 SCA-Central Florida LLC 569 Brookwood Village Ste 901 Birmingham AL 35209 471535510 Indirect Interest in Surgery Center DE N/A 0 0 The Bariatric Center of Kansas City LLC 9100 W 74th Street Merriam KS 66204 823025378 Surgery Center KS N/A 0 0 Urgent Care Centers of Brevard County LLC 2600 Westhall Lane Ste 200 Maitland FL 32751 844261523 Urgent Care Centers FL N/A 0 1 AdventHealth at Overland Park-College MOB Condominium Assoc 9119 W 74th Street Ste 260 Merriam KS 66204 874353752 Condo Association KS N/A C 1 AdventHealth City Center North Owners' Assoc Inc (65-123123) 9119 W 74th Street Ste 260 Merriam KS 66204 991471046 Maintenance Association KS N/A C 1 AdventHealth Primary Care Inc fka AH North Polk Inc 900 Hope Way Altamonte Springs FL 32714 593231322 Inactive FL N/A C 1 AdventHealth Value Based Bundle Management LLC 2600 Lucien Way Maitland FL 32751 873487910 Medical Contracting and Billing FL N/A C 1 Altamonte Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855792 Condo Association FL N/A C 1 Apopka Medical Plaza Condominium Assoc Inc (11-123123) 601 East Rollins Street Orlando FL 32803 593000857 Condo Association FL N/A C 1 Battle Creek Adventist Hospital 900 Hope Way Altamonte Springs FL 32714 381359189 Inactive MI N/A C 1 Florida Hospital Flagler Medical Offices Association Inc 60 Memorial Medical Parkway Palm Coast FL 32164 262158309 Condo Association FL N/A C 1 Florida Hosp Hlth Village Property Owner's Assoc Inc 550 E Rollins Street 7th Floor Orlando FL 32803 821748255 Condo Association FL N/A C 1 Florida Hospital Healthcare System Inc 2600 Lucien Way Maitland FL 32751 593215680 PHSO / CIN FL N/A C 1 Florida Medical Plaza Condominium Association Inc 601 East Rollins Street Orlando FL 32803 592855791 Condo Association FL N/A C 1 Kissimmee Multispecialty Clinic Condominium Association Inc 201 Hilda Street Suite 30 Kissimmee FL 34741 593539564 Condo Association FL N/A C 1 Midwest Management Services Inc 9100 West 74th Street Shawnee Mission KS 66204 480901551 Inactive KS N/A C 1 North American Health Services Inc & Sub 900 Hope Way Altamonte Springs FL 32714 621041820 Holding Co. TN N/A C 1 Ormond Prof Associates Condo Assoc Inc (430 year end) 770 W Granada Blvd Ste 101 Ormond Beach FL 32174 592694434 Condo Association FL N/A C 1 Park Ridge Property Owner's Association Inc 1 Park Place Naples Road Fletcher NC 28732 030380531 Condo Association NC N/A C 1 Park Ridge Condominium #1 Unit Owners Association Inc 1 Park Place Naples Road Fletcher NC 28732 010584623 Condo Association NC N/A C 1 Redmond Park Health Services Inc 501 Redmond Rd NW Rome GA 30165 621330078 Holding Company GA N/A C 1 Surgicare of Rome Inc 501 Redmond Rd NW Rome GA 30165 200376307 Holding Company GA N/A C 1 The Garden Retirement Community Inc 485 North Keller Road Ste 250 Maitland FL 32751 593414055 Real Estate Rental FL N/A C 1 Winter Park Medical Office Building I Condo Assoc Inc 601 East Rollins Street Orlando FL 32803 452228478 Condo Association FL N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 Adventist Health System Sunbelt Healthcare Corporation B 7246929 Amount Given Adventist Health System Sunbelt Healthcare Corporation M 6230158 % of Facility's Operating Expense Adventist Health System Sunbelt Healthcare Corporation P 9345277 Cost Adventist Health System Sunbelt Healthcare Corpo dba AH Info Technology M 7516139 % of Facility's Operating Expense Adventist Health System Sunbelt Healthcare Corpo - Shared Services M 3214728 % of Facility's Operating Expense Rocky Mountain Adventist Healthcare Foundation B 684007 Amount Given Rocky Mountain Adventist Healthcare Foundation C 4665190 Amount Received PAHS Service Corporation P 199743830 Cost