2023-11-15T15:17:47-06:00 2022-12-31 990 2022-01-01 362276984 ADVENTIST MIDWEST HEALTH ADVE 6308569000 120 NORTH OAK STREET HINSDALE IL 60521 LYNN C ADDISCOTT ASSISTANT SECRETARY 6308566001 2023-11-10 LYNN ADDISCOTT 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ADAM MAYCOCK 120 NORTH OAK STREET HINSDALE IL 60521 518132906 0 X WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG X 1904 IL THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF TWO HOSPITALS. 19 10 3527 186 847924 221336 6863126 3268474 548303370 507737446 13407418 2252044 203974 218104 568777888 513476068 1461395 1247767 0 0 181358416 183377785 0 0 0 348335774 340394879 531155585 525020431 37622303 -11544363 752894446 609877328 394706488 123481637 358187958 486395691 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 480677973 1247767 507006284 OPERATION OF ADVENTHEALTH HINSDALE, A 261-BED ACUTE CARE HOSPITAL WITH 10,062 ADMISSIONS, 46,361 PATIENT DAYS AND 141,601 OUTPATIENT VISITS; AND ADVENTHEALTH LA GRANGE, A 177-BED ACUTE CARE HOSPITAL WITH 7,016 ADMISSIONS, 39,163 PATIENT DAYS AND 75,480 OUTPATIENT VISITS. 480677973 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 X 0 0 1 3527 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 10 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 IL X HARMAT BEEBE 6308566001 120 N OAK STREET HINSDALE IL 60521 X BACON KENNETH DIRECTOR/CHAIRMAN 0.30 50.00 X 0 1621638 290272 SNYDER BRENT DIRECTOR 0.30 50.00 X 0 1466962 43282 THORDARSON THOR DIR/PRES/SEC/EVP & COO 21.90 28.10 X 200311 1096943 147708 MURPHY MARY CNO HINSDALE/LA GRANGE (END 12/22) 40.00 10.00 X 110521 1252706 66690 MURRILL MICHAEL FORMER CEO 0.00 50.00 X 0 898843 187713 BUCHANAN HERBERT DIRECTOR 10.80 39.20 X 14517 781465 32818 MAYCOCK ADAM CEO HINSDALE/LA GRANGE 50.00 0.00 X 108827 489174 98624 NAND MD BELA CMO HINSDALE/LA GRANGE 50.00 0.00 X 100449 385096 75999 MATHIS REBECCA FORMER CFO 40.00 10.00 X 0 407099 112217 DAVARAPALLI MD RAMADEVI DIRECTOR (BEG 01/22) 0.30 50.00 X 0 432824 57036 LAYMAN BENJAMIN COO HINSDALE/LAGRANGE 50.00 0.00 X 107598 247483 45455 FORTMAN MD LISA PHYSICIAN ADVISOR 50.00 0.00 X 347839 0 38611 SLEUWEN MD LESLIE DIR-PHYSICIAN RES/STUDY PROGRAM 50.00 0.00 X 266762 0 53460 STILL DANAE CFO HINSDALE/LA GRANGE 50.00 0.00 X 51150 179316 50743 DE RAMOS DO DAVID DIRECTOR (END 12/22) 0.30 50.00 X 0 232083 38491 TSANG DAVID PHARMACY DIRECTOR 50.00 0.00 X 219488 0 37641 GUNNELL MD KATE PHYSICIAN 50.00 0.00 X 208250 0 40535 BORROWS KIMBERLY REGISTERED NURSE 50.00 0.00 X 236458 0 5756 MURREY MD SUSAN DIRECTOR 0.30 7.00 X 0 49200 0 KOHLI MD MANINDER DIRECTOR (BEG 01/22) 0.30 4.60 X 0 31350 0 AGUILERA RONALD DIRECTOR (END 03/22) 0.30 3.70 X 0 6088 0 DENSLOW KENNETH DIR/VICE CHAIR 0.30 3.70 X 0 5692 0 RAMIREZ ELDEN DIRECTOR (BEG 01/22) 0.30 2.70 X 0 5363 0 SCOTT GLYNN DIRECTOR 0.30 2.70 X 0 5363 0 ARQUILLA VENANZIO DIRECTOR 0.30 0.60 X 0 0 0 DIXON SUSAN DIRECTOR (BEG 01/22) 0.30 0.60 X 0 0 0 EASTMAN LINDA DIRECTOR 0.30 0.60 X 0 0 0 GRAY JR MARSHALL DIRECTOR 0.30 0.60 X 0 0 0 HAWKINS RONNIE DIRECTOR 0.30 0.60 X 0 0 0 HOLDER BILL DIRECTOR 0.30 0.60 X 0 0 0 O'CONNOR PETER DIRECTOR 0.30 0.60 X 0 0 0 WRIGHT JONATHAN DIRECTOR 0.30 0.60 X 0 0 0 1972170 9594688 1423051 291 1 1 1 AYA HEALTHCARE INC PO BOX 3519 DALLAS TX 75312 STAFFING SERVICES 18706204 AMN HEALTHCARE INC FILE 56157 LOS ANGELES CA 90074 STAFFING SERVICES 11310849 ALVERNO CLINICAL LABORATORIES LLC 2434 INTERSTATE PLAZA DRIVE HAMMOND IN 46324 LAB SERVICE 11288657 R1 RCM INC 39918 TREASURY CENTER CHICAGO IL 60694 REVENUE CYCLE SERVICE 11038939 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES 7009374 66 X 1434856 1832230 1388 3268474 NET PATIENT REVENUE 622110 492346147 491637666 708481 MANAGEMENT SVCS TO RELATED 622110 10713411 10713411 RENT FROM EXEMPT AFFILIATES 622110 1503390 1503390 PROF. OFFICE BUILDING/EMP. HOUSIN 622110 1493536 1493536 CAFETERIA REVENUE 622110 1009730 1009730 671232 648551 22681 507737446 6577492 6577492 368368 131109 267026 14347 101342 116762 218104 116762 101342 50017 3833147 542318 -3833147 -492301 -4325448 -4325448 513476068 507006284 847924 2353386 X 1247767 1247767 4171490 4171490 135086081 134913998 172083 4013802 3900356 113446 28708070 27240942 1467128 11398342 11076179 322163 753034 753034 144203 144203 656144 656144 137923826 115565002 22358824 1214696 1214696 15141125 12118911 3022214 21850636 20717480 1133156 10982681 10982681 516731 1561 515170 98250 98250 8665543 8665543 15621635 15621635 5147557 5147557 MEDICAL SUPPLIES 80534883 80534883 STATE TAX INDIGENT ASSE 22786424 22786424 OTHER OPERATING COSTS 10878135 10878135 UBI TAXES 152288 152288 7327088 4426476 2900612 525020431 480677973 44342458 0 X 3817402 6429 157465665 156828847 63291969 59139165 1065483 11720559 14395884 13657490 3204357 256305689 14122 260793179 256291567 808460 628749 210000 1323808 83391824 239805914 34925023 752894446 609877328 34532279 22442402 408067 359766142 101039235 394706488 123481637 X 346427431 476075966 11760527 10319725 358187958 486395691 752894446 609877328 X -11544363 -35399930 175152026 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 73547 73547 0 PART II-B, LINE 1: DUES WERE PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND ILLINOIS HOSPITAL ASSOCIATION. 2685040 103974 103974 2685040 2685040 103974 103974 2685040 2685040 103974 103974 2685040 2685040 302541 302541 2685040 2757867 351461 424288 2685040 1.00000 0 1 1 22134185 22134185 197038425 197038425 25700759 14122 25686637 11432320 11432320 256291567 OTHER RECEIVABLES 1973133 RECEIVABLE FROM THIRD PARTIES 10548382 RIGHT OF USE ASSET-OPERATING LEASE 11487524 BENEFICIAL INTEREST IN FOUNDATION 10864113 OTHER ASSETS 51871 34925023 91667 DUE TO RELATED 23092304 PAYABLE TO THIRD PARTIES 39558715 CREDIT BALANCES IN A/R 3577818 ACCRUED INTEREST PAYABLE 85399 DUE TO AFFILIATED 13647309 OPERATING LEASE LIABILITY 11393898 OTHER LIABILITIES 9592125 101039235 X PART V, LINE 4: ALL ENDOWMENT FUNDS ARE HELD BY THE FOLLOWING RELATED 501(C)(3) EXEMPT FOUNDATIONS: HINSDALE HOSPITAL FOUNDATION (HHF): FORMED AND MAINTAINED EXCLUSIVELY TO FURTHER THE EXEMPT PURPOSE OF ADVENTHEALTH HINSDALE. HHF HELD ASSETS IN PERMANENT ENDOWMENT FUNDS DURING THE CURRENT YEAR. HHF'S ENDOWMENT CONSISTS OF THREE INDIVIDUAL FUNDS ESTABLISHED TO SUPPORT THE HOSPITAL'S OPLER CANCER CENTER AND CANCER CENTER NURSE NAVIGATION PROGRAM. MIDWEST HEALTH FOUNDATION (MHF): MAINTAINED TO HOLD ASSETS IN A PERMANENT ENDOWMENT FUND ESTABLISED TO SUPPORT NURSING SCHOLARSHIPS. THE FUND WAS ESTABLISHED BY LA GRANGE MEMORIAL HOSPITAL FOUNDATION, THEN WAS TRANSFERRED TO MHF ON 6/21/19 AS THE RESULT OF A LEGAL MERGER. PART X, LINE 2: THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTHEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH CONTAIN THE FOLLOWING FIN 48 (ASC 740) FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARY (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARY ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. ALL TAXABLE INCOME WAS FULLY OFFSET BY NET OPERATING LOSS CARRYFORWARDS FOR FEDERAL INCOME TAX PURPOSES; AS SUCH, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $18,200 AND $33,000 AT DECEMBER 31, 2022 AND 2021, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2022, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $10,000, EXPIRING IN 2023 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $4,500 AND $8,100 AT DECEMBER 31, 2022 AND 2021, RESPECTIVELY. NAHS REMEASURED ITS DEFERRED TAX ASSETS AND LIABILITIES BASED ON THE RATES AT WHICH THEY ARE EXPECTED TO REVERSE IN THE FUTURE, WHICH IS GENERALLY 21%. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2022 AND 2021 TO OFFSET THE DEFERRED TAX ASSET SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ACCOUNTING STANDARDS CODIFICATION (ASC) (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN, OR EXPECTED TO BE TAKEN, IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. 1 1 X 1 X 250.000000000000 1 X 600.000000000000 1 1 1 0 1 1 5274504 5274504 0.01000 81083856 64230574 16853282 0.03210 86358360 64230574 22127786 0.04210 218477 218477 0.00040 16594166 5145357 11448809 0.02180 264862 264862 0.00050 17077505 5145357 11932148 0.02270 103435865 69375931 34059934 0.06480 11085 11085 0.00000 4382 4382 0.00000 259265 259265 0.00050 5091 5091 0.00000 279823 279823 0.00050 1 1131284 92510 136660329 161447029 -24786700 X 1 1 1 HINSDALE SURGICAL CENTER LLC SURGICAL SERVICES 0.28450 0.00000 0.43100 2 1 ADVENTIST HINSDALE HOSPITAL 120 NORTH OAK STREET HINSDALE IL 60521 WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG 0000976 X X X X 2 ADVENTIST LA GRANGE MEMORIAL HOSPITAL 5101 S WILLOW SPRINGS ROAD LA GRANGE IL 60525 WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG 0005017 X X X X X ADVENTHEALTH HINSDALE 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V, PAGE 8 X X 1 20 1 SEE PART V, PAGE 8 0 1 X 250.000000000000 600.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTHEALTH LA GRANGE 2 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V, PAGE 8 X X 1 20 1 SEE PART V, PAGE 8 0 1 X 250.000000000000 600.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 5: ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE (AHH OR THE HOSPITAL) IS A 261-BED ACUTE CARE HOSPITAL LOCATED IN THE VILLAGE OF HINSDALE IN DUPAGE COUNTY IN ILLINOIS. BEGINNING ON JANUARY 1, 2023, THE DBA NAME FOR THE HOSPITAL WAS CHANGED TO UCHICAGO MEDICINE ADVENTHEALTH HINSDALE. AHH'S PRIMARY SERVICE AREA INCLUDES 39 ZIP CODES ACROSS MAINLY DUPAGE COUNTY. IN CONDUCTING ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL SOLICITED INPUT DIRECTLY FROM THE COMMUNITY AND FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY COMMUNITY MEMBERS. THE HOSPITAL PARTNERED WITH THE IMPACT DUPAGE COLLABORATIVE IN CONDUCTING ITS 2022 CHNA. THE IMPACT DUPAGE COLLABORATIVE HAS REPRESENTATION FROM SOCIAL SUPPORT AND COMMUNITY ORGANIZATIONS, HEALTH CARE SYSTEMS, AS WELL AS PUBLIC HEALTH AND EDUCATION INSTITUTIONS. A SMALLER COMMITTEE WAS FORMED BY THE COLLABORATIVE TO LOCALIZE THE DATA COLLECTION AND COMMUNITY INPUT PROCESS FOR THE HOSPITAL. COMMUNITY ORGANIZATIONS INCLUDED IN THE SMALLER COMMITTEE INCLUDED UNITED WAY OF METRO CHICAGO, DUPAGE FEDERATION ON HUMAN SERVICES REFORM, DUPAGE FOUNDATION, DUPAGE COUNTY HEALTH DEPARTMENT, DUPAGE HEALTH COALITION, DUPAGE COUNTY PUBLIC DEFENDER'S OFFICE, DUPAGE COUNTY, AND PRAIRIE STATE LEGAL SERVICES, INC. AHH ALSO FORMED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) WHOSE PURPOSE WAS TO SELECT THE NEEDS THE HOSPITAL WOULD ADDRESS RESULTING FROM THE FINDINGS IN THE ASSESSMENT. THE COLLABORATIVE COLLECTED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA INCLUDED A COMMUNITY SURVEY, A LOCAL SYSTEM ASSESSMENT, AND A FORCES OF CHANGE ASSESSMENT. AN INTENTIONAL EFFORT WAS MADE TO COLLECT INPUT FROM ALL MEMBERS OF THE HOSPITAL'S COMMUNITY AND TO OBTAIN PERSPECTIVES ACROSS AGE, RACE/ETHNICITY, GENDER, PROFESSION, HOUSEHOLD INCOME, EDUCATION LEVEL, AND GEOGRAPHIC LOCATION. THE COMMUNITY SURVEY WAS PROVIDED IN ENGLISH AND SPANISH TO ANYONE IN DUPAGE COUNTY AND WAS ACCESSIBLE ONLINE THROUGH WEBLINKS AND QR CODES. THE LOCAL SYSTEM ASSESSMENT WAS AN ONLINE SURVEY TARGETING PUBLIC HEALTH, LOCAL HOSPITALS AND HEALTH SYSTEMS, MENTAL AND BEHAVIORAL HEALTH, EDUCATION, HOUSING, PUBLIC SAFETY, LOCAL GOVERNMENT, LOCAL NON-PROFIT AND FAITH-BASED ORGANIZATIONS. THE FORCES OF CHANGE ASSESSMENT WAS A SERIES OF BRAINSTORMING SESSIONS CONDUCTED WITH A NUMBER OF SOCIAL SERVICE ORGANIZATIONS AND THE DUPAGE COUNTY HEALTH DEPARTMENT. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 5: ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH LA GRANGE (AHLG OR THE HOSPITAL) IS A 177-BED ACUTE CARE HOSPITAL LOCATED IN THE VILLAGE OF LA GRANGE IN COOK COUNTY IN ILLINOIS. BEGINNING ON JANUARY 1, 2023, THE DBA NAME FOR THE HOSPITAL WAS CHANGED TO UCHICAGO MEDICINE ADVENTHEALTH LA GRANGE. AHLG'S PRIMARY SERVICE AREA INCLUDES 21 ZIP CODES ACROSS COOK AND DUPAGE COUNTIES. IN CONDUCTING ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL SOLICITED INPUT DIRECTLY FROM THE COMMUNITY AND FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY COMMUNITY MEMBERS. THE HOSPITAL COLLABORATED WITH THE COOK COUNTY ALLIANCE FOR HEALTH EQUITY IN CONDUCTING ITS 2022 CHNA. THE ALLIANCE FOR HEALTH EQUITY IS A COLLABORATIVE OF HEALTH CARE SYSTEMS AND PROVIDERS, WORKING WITH HEALTH DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS WITH A SHARED VISION TO IMPROVE HEALTH EQUITY, WELLNESS, AND QUALITY OF LIFE ACROSS CHICAGO AND COOK COUNTY. A SMALLER COMMITTEE WAS FORMED THROUGH THE ALLIANCE FOR HEALTH EQUITY COLLABORATIVE TO LOCALIZE THE DATA COLLECTION AND COMMUNITY INPUT PROCESS FOR THE COLLABORATING HOSPITALS. THE HEALTH CARE SYSTEMS AND PROVIDERS INCLUDED IN THE SMALLER COMMITTEE WERE ADVOCATE AURORA HEALTH, AMITA HEALTH, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL, JACKSON PARK HOSPITAL, LOYOLA UNIVERSITY HEALTH SYSTEM, MACNEAL HOSPITAL, MERCY HOSPITAL AND MEDICAL CENTER, NORTHWESTERN MEDICINE, NORWEGIAN AMERICAN HOSPITAL, PALOS HEALTH, ROSELAND COMMUNITY HOSPITAL, RUSH, SINAI HEALTH SYSTEM, SWEDISH HOSPITAL, AND THE UNIVERSITY OF ILLINOIS HOSPITAL & HEALTH SYSTEMS. THE SMALLER COMMITTEE ALSO INCLUDED REPRESENTATIVES FROM THE CHICAGO DEPARTMENT OF PUBLIC HEALTH AND THE COOK COUNTY DEPARTMENT OF PUBLIC HEALTH. AHLG ALSO FORMED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) WHOSE PURPOSE WAS TO SELECT THE NEEDS THE HOSPITAL WOULD ADDRESS RESULTING FROM THE FINDINGS IN THE ASSESSMENT. THE COLLABORATIVE COLLECTED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA INCLUDED A COMMUNITY SURVEY, COMMUNITY RESIDENT FOCUS GROUPS, AND A FORCES OF CHANGE ASSESSMENT. AN INTENTIONAL EFFORT WAS MADE TO COLLECT INPUT FROM ALL MEMBERS OF THE HOSPITAL'S COMMUNITY AND TO OBTAIN PERSPECTIVES ACROSS AGE, RACE/ETHNICITY, GENDER, PROFESSION, HOUSEHOLD INCOME, EDUCATION LEVEL, AND GEOGRAPHIC LOCATION. THE COMMUNITY SURVEY WAS PROVIDED IN ENGLISH AND SPANISH TO ANYONE 10 OR OLDER IN THE CHICAGO OR SUBURBAN COOK COUNTY AREA AND WAS ACCESSIBLE ONLINE THROUGH WEBLINKS AND QR CODES. BETWEEN SEPTEMBER OF 2021 AND APRIL OF 2022, 43 FOCUS GROUPS WITH COMMUNITY MEMBERS WERE HELD. PARTICIPANTS WERE 14 YEARS OF AGE OR OLDER AND REPRESENTED A DIVERSE RANGE OF ETHNIC, RACIAL, RELIGIOUS, AND SOCIOECONOMIC BACKGROUNDS. INPUT FROM COMMUNITIES THAT ARE HISTORICALLY MARGINALIZED AND SYSTEMATICALLY EXCLUDED FROM ASSESSMENT AND DECISION-MAKING PROCESSES WAS A FOCUS. THE FORCES OF CHANGE ASSESSMENT WAS A PROCESS OF SOLICITING INPUT FROM PARTICIPANTS TO IDENTIFY TRENDS, FACTORS, OR EVENTS THAT ARE IMPACTING THE HEALTH AND QUALITY OF LIFE FOR THE RESIDENTS OF COOK COUNTY. ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 11: SEE ADVENTHEALTH HINSDALE LINE 11 FOOTNOTE BELOW. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 11: SEE ADVENTHEALTH LA GRANGE LINE 11 FOOTNOTE BELOW. ADVENTHEALTH HINSDALE PART V, SECTION B, LINE 13H: EFFECTIVE MARCH 1, 2020, THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) AUGMENTED THEIR FINANCIAL ASSISTANCE POLICY WITH A COVID-19 FINANCIAL GRACE ADDENDUM. PURSUANT TO THE COVID-19 FINANCIAL GRACE ADDENDUM, UNINSURED PATIENTS TREATED FOR COVID-19 RELATED EVALUATIONS ARE TO RECEIVE FREE OR DISCOUNTED CARE DEPENDING ON THE PATIENT'S COOPERATION IN SUBMITTING NECESSARY FINANCIAL ASSISTANCE INFORMATION. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS. ADVENTHEALTH LA GRANGE PART V, SECTION B, LINE 13H: EFFECTIVE MARCH 1, 2020, THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) AUGMENTED THEIR FINANCIAL ASSISTANCE POLICY WITH A COVID-19 FINANCIAL GRACE ADDENDUM. PURSUANT TO THE COVID-19 FINANCIAL GRACE ADDENDUM, UNINSURED PATIENTS TREATED FOR COVID-19 RELATED EVALUATIONS ARE TO RECEIVE FREE OR DISCOUNTED CARE DEPENDING ON THE PATIENT'S COOPERATION IN SUBMITTING NECESSARY FINANCIAL ASSISTANCE INFORMATION. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS. SCHEDULE H, PART V, SECTION B, LINE 7A: EACH HOSPITAL FACILITY'S CHNA REPORT IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 8-10A: CHNA IMPLEMENTATION STRATEGY:THE FILING ORGANIZATION'S HOSPITAL FACILITIES EACH ADOPTED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT BY 12/31/2022 AND WERE IN THE PROCESS OF DEVELOPING THEIR COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGY REPORTS AT THAT TIME. THE FILING ORGANIZATION'S 2023-2025 COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGY REPORTS ARE DOCUMENTED IN A WRITTEN REPORT CALLED THE "COMMUNITY HEALTH PLAN". THE COMMUNITY HEALTH PLAN (CHP) DESCRIBES HOW EACH FILING ORGANIZATION'S HOSPITAL PLANS TO MEET ITS IDENTIFIED PRIORITIZED HEALTH NEEDS OR IDENTIFIES THE HEALTH NEED AS ONE THE FILING ORGANIZATION HOSPITAL DOES NOT INTEND TO SPECIFICALLY ADDRESS AND PROVIDES AN EXPLANATION AS TO WHY THE FILING ORGANIZATION HOSPITAL DOES NOT INTEND TO ADDRESS THAT HEALTH NEED. EACH OF THE FILING ORGANIZATION'S HOSPITAL FACILITIES 2023-2025 CHP WAS ADOPTED BY MAY 15, 2023 AND IS POSTED ON THE HOSPITAL FACILITY'S WEBSITE. SCH H, PART V, SECTION B, LINE 10A: EACH HOSPITAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE: HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 11: ADVENTHEALTH HINSDALE:THE INFORMATION PROVIDED BELOW EXPLAINS HOW ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE (AHH OR THE HOSPITAL) ADDRESSED IN 2022 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ANY SUCH NEEDS THAT WERE NOT ADDRESSED AND THE REASONS WHY SUCH NEEDS WERE NOT ADDRESSED. THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT BY 12/31/19 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2020 PRIOR TO MAY 15, 2020.THIS IS THE THIRD-YEAR UPDATE FOR AHH'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, AHH WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL, AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2020-2022 COMMUNITY HEALTH PLAN. THE THIRD-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS. AHH CHOSE TWO PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. BEHAVIORAL HEALTH 2. HEALTH STATUS IMPROVEMENT PRIORITY 1: BEHAVIORAL HEALTH 2019 DESCRIPTION OF THE ISSUE:BEHAVIORAL HEALTH IS A TERM THAT INCLUDES BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY FOR ADULTS, CHILDREN, AND ADOLESCENTS. WHEN MENTAL HEALTH DISORDERS ARE UNTREATED, THOSE AFFECTED ARE AT HIGH RISK FOR MANY UNHEALTHY AND UNSAFE BEHAVIORS, INCLUDING ALCOHOL OR DRUG ABUSE, VIOLENT OR SELF-DESTRUCTIVE BEHAVIOR AND SUICIDE. MENTAL HEALTH DISORDERS ARE THE 11TH LEADING CAUSE OF DEATH IN THE UNITED STATES FOR ALL AGE GROUPS AND THE SECOND LEADING CAUSE OF DEATH AMONG PEOPLE AGES 25 TO 34. BEHAVIORAL HEALTH CONTINUES TO BE A PRIMARY CONCERN IN DUPAGE COUNTY. ADDRESSING BEHAVIORAL HEALTH REQUIRES ATTENTION TO SUBSTANCE USE DISORDERS AS WELL AS MENTAL HEALTH. THE RECENT CHNA ALSO EMPHASIZED THE NEED FOR PREVENTION OF SUBSTANCE USE AT AN EARLY AGE AND THE REDUCTION OF STIGMA SURROUNDING BEHAVIORAL HEALTH. DRUG ABUSE AND MENTAL HEALTH ISSUES WERE THE TOP TWO CONCERNS ON THE COMMUNITY SURVEY DURING THE LAST ASSESSMENT.2022 UPDATE: THE AHH COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE BEHAVIORAL HEALTH PRIORITY. 1. IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.GOAL 1: IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE. OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE (THE HOSPITALS). THE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PERSONS TRAINED IN THE COMMUNITY ON MENTAL HEALTH FIRST AID (MHFA) TO INCREASE IDENTIFICATION OF THOSE IN A CRISIS AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH ISSUES, IS FUNDED AND CONDUCTED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES A TRAINING FOR COMMUNITY RESIDENTS AND FIRST RESPONDERS TO RECOGNIZE, RESPOND, AND SEEK ASSISTANCE FOR SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. THE HOSPITALS DID NOT MEET THE OBJECTIVE OF INCREASING PERSONS TRAINED IN THE COMMUNITY ON MHFA BECAUSE THERE WAS NOT A FACILITATOR AVAILABLE TO OFFER THE TRAININGS IN 2022. BY THE END OF YEAR THREE, A TOTAL OF 15 INDIVIDUALS WERE TRAINED. PRIORITY 2: HEALTH STATUS IMPROVEMENT2019 DESCRIPTION OF THE ISSUE:DATA FROM THE MOST RECENT CHNA INDICATED A NEED FOR CONTINUED FOCUS ON ISSUES INVOLVING RESIDENTS' ACCESS TO HEALTH AND MOVEMENT TOWARD MORE POSITIVE HEALTH OUTCOMES FOR DUPAGE RESIDENTS. ONE OF THE SOCIAL DETERMINANTS OF HEALTH CLOSELY ASSOCIATED WITH POSITIVE HEALTH OUTCOMES IS THE AVAILABILITY OF AFFORDABLE, HEALTHY FOODS. ACCESS TO HEALTH CARE AND HEALTH INSURANCE ESPECIALLY FOR LOW-INCOME PERSONS IN THE DUPAGE COMMUNITY CONTINUES TO BE AN ISSUE. EIGHTY-FIVE PERCENT OF DUPAGE COUNTY RESIDENTS REPORTED HAVING A USUAL HEALTH CARE PROVIDER WHILE A TOP "RISKY BEHAVIOR" GROUP NOTED ON THE LAST ASSESSMENT RESIDENT SURVEY REPORTED HAVING NO HEALTH INSURANCE. ASSISTING PATIENTS AND COMMUNITY MEMBERS TO PROGRAMS AND SERVICES THAT CAN IMPROVE THEIR SOCIAL DETERMINANTS OF HEALTH ARE NEEDED.2022 UPDATE: THE AHH COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE HEALTH STATUS IMPROVEMENT PRIORITY. 1. INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.GOAL 1: INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED CHNA PRIORITY AND INITIATIVE BETWEEN ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THE OBJECTIVE, TO INCREASE THE AVAILABILITY OF HEALTHY FOODS WITHIN THE LOW-INCOME COMMUNITY, IS CONDUCTED THROUGH ADVENTHEALTH HINSDALE AND ALL FUNDING AND OUTCOMES REPORTED ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES, IN COLLABORATION WITH NORTHERN ILLINOIS FOOD BANK, HINSDALE SEVENTH-DAY ADVENTIST CHURCH, AND THE COMMUNITY MEMORIAL FOUNDATION, THE RX MOBILE FOOD PANTRY, AN ON-SITE MOBILE FOOD PANTRY. TWICE A MONTH, THE RX MOBILE FOOD PANTRY PROVIDES FREE PRODUCE, MEAT AND DAIRY TO PATIENTS SCREENED FOR FOOD INSECURITY AS WELL AS TO THE COMMUNITY AT LARGE. THE HOSPITAL EXCEEDED ITS OBJECTIVE TO INCREASE THE AVAILABILITY OF HEALTHY FOOD WITHIN THE LOW-INCOME COMMUNITY. A TOTAL OF 480 INDIVIDUALS WERE PROVIDED WITH FREE HEALTHY FOOD OPTIONS A MONTH. THIS INITIATIVE HAS BEEN A GREAT COLLABORATION IN WHICH MANY PEOPLE WHO ARE EXPERIENCING FOOD INSECURITY FOR THE FIRST TIME ARE CONNECTED TO FOOD. IN ADDITION, WRAP-AROUND SERVICES SUCH AS SNAP BENEFIT ENROLLMENT OPPORTUNITIES ARE AVAILABLE, AND HEALTH EDUCATION MATERIALS ARE OFTEN PROVIDED. OBJECTIVE 2: THE SECOND OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH HINSDALE AND ADVENTHEALTH GLENOAKS (AHGO), WHICH ARE BOTH PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. AHH AND AHGO PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE PROVIDES FINANCIAL SUPPORT FOR THE SILVER ACCESS PROGRAM OF ACCESS DUPAGE, AND IS FUNDED BY BOTH AHH AND AHGO. THIS INITIATIVE PROVIDES SUPPORT FOR QUALIFYING RESIDENTS WITH A SUBSIDY FOR THEIR HEALTH INSURANCE PREMIUM TO INCREASE ACCESS TO HEALTH CARE. AHH AND AGOH DID NOT MEET THEIR OBJECTIVE TO PROVIDE FINANCIAL SUPPORT FOR THE SILVER ACCESS PROGRAM OF ACCESS DUPAGE TO SUPPORT QUALIFYING RESIDENTS WITH A SUBSIDY FOR THEIR HEALTH INSURANCE PREMIUM TO INCREASE ACCESS TO HEALTH CARE. APPROXIMATELY 406 INDIVIDUALS WERE HELPED WITH FINANCIAL SUPPORT WITH AGOH CONTRIBUTING $117,681 AND AHH CONTRIBUTING $90,455. THE DECREASE IN THE NUMBER OF INDIVIDUALS SERVED FROM 2021 WAS DUE IN PART TO MORE INDIVIDUALS QUALIFYING FOR MEDICAID UNDER THE CORONAVIRUS AID RELIEF ECONOMIC SECURITY ACT. **SEE CONTINUATION SCHEDULE H, PART V, SECTION B, LINE 11: CONTINUATION FOR AMH HINSDALE OBJECTIVE 3: THE THIRD OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH HINSDALE, ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS AND ADVENTHEALTH LA GRANGE (THE HOSPITALS). THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PATIENT AND COMMUNITY MEMBERS' CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY, IS FUNDED AND DEPLOYED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES AN ONLINE DIRECTORY OF FREE OR REDUCED COST SERVICES THAT ADDRESS SOCIAL NEEDS OF PATIENTS AND COMMUNITY MEMBERS, INCREASING ACCESS TO COMMUNITY RESOURCES. THE HOSPITALS DID NOT MEET THE OBJECTIVE OF 200 PATIENT AND COMMUNITY MEMBERS' CONNECTIONS TO SERVICES THROUGH THE COMMUNITY RESOURCE DIRECTORY. THE COMMUNITY RESOURCE DIRECTORY AS IT WAS BRANDED WAS NOT RETAINED AFTER THE UNWINDING OF THE JOINT VENTURE PARTNERSHIP. HOWEVER, A SOFT INTRODUCTION OF THE ADVENTHEALTH WHOLE HEALTH HUB, A SOCIAL NEEDS REFERRAL PLATFORM, WAS MADE. APPROXIMATELY 500 FAMILIES RECEIVED INFORMATION ABOUT THE WHOLE HEALTH HUB TO HELP LOOK FOR COMMUNITY RESOURCES AT A MOBILE FOOD PANTRY. COMMUNITY HEALTH NEEDS NOT CHOSEN BY ADVENTHEALTH HINSDALE:THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. THE HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE - OR MULTIPLE GROUPS - IN THE COMMUNITY ALREADY WORKING ON THIS ISSUE? 5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES: AFFORDABLE HOUSING:AFFORDABLE HOUSING, WHILE CRITICALLY IMPORTANT TO OVERALL COMMUNITY HEALTH, WAS NOT A COMMUNITY NEED CHOSEN TO BE ADDRESSED AS THERE ARE SERVICE PROVIDERS IN THE COMMUNITY BETTER RESOURCED TO ADDRESS THESE PRIORITIES. THE HOSPITAL WILL WORK COLLABORATIVELY WITH THESE ORGANIZATIONS AS APPROPRIATE TO ENSURE OPTIMAL SERVICE COORDINATION AND UTILIZATION. ADDITIONALLY, THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY TO ASSOCIATES AND PHYSICIANS WILL CONNECT THOSE IN NEED TO FREE OR REDUCED COST SERVICES SUCH AS MEDICAL CARE, FOOD, JOB TRAINING, TRANSPORTATION, HOUSING, LEGAL, AND MORE. SCHEDULE H, PART V, SECTION B, LINE 11: ADVENTHEALTH LA GRANGE:THE INFORMATION PROVIDED BELOW EXPLAINS HOW ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH LA GRANGE (AHLG OR THE HOSPITAL) ADDRESSED IN 2022 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ANY SUCH NEEDS THAT WERE NOT ADDRESSED AND THE REASONS WHY SUCH NEEDS WERE NOT ADDRESSED. THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT BY 12/31/19 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2020 PRIOR TO MAY 15, 2020.THIS IS THE THIRD-YEAR UPDATE FOR ADVENTHEALTH LA GRANGE'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, AHLG WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL, AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2020-2022 COMMUNITY HEALTH PLAN. THE THIRD-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. AHLG CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH2. ACCESS TO CARE, COMMUNITY RESOURCES AND SYSTEMS IMPROVEMENTS3. MENTAL HEALTH AND SUBSTANCE USE DISORDERS4. CHRONIC CONDITION PREVENTION AND MANAGEMENTPRIORITY 1: SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH2019 DESCRIPTION OF THE ISSUE:THE SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH SUCH AS POVERTY, UNEQUAL ACCESS TO COMMUNITY RESOURCES, UNEQUAL EDUCATION FUNDING AND QUALITY, STRUCTURAL RACISM, AND ENVIRONMENTAL CONDITIONS ARE UNDERLYING ROOT CAUSES OF HEALTH INEQUITIES. ADDITIONALLY, SOCIAL DETERMINANTS OF HEALTH OFTEN VARY BY GEOGRAPHY, GENDER, SEXUAL ORIENTATION, AGE, RACE, DISABILITY, AND ETHNICITY. THE STRONG CONNECTIONS BETWEEN SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS AND HEALTH ARE APPARENT IN CHICAGO AND SUBURBAN COOK COUNTY, WITH HEALTH INEQUITIES BEING EVEN MORE PRONOUNCED THAN MANY NATIONAL TRENDS. WITHIN THE AHLG PRIMARY SERVICE AREA, THERE ARE IDENTIFIED FOOD DESERTS ESPECIALLY NEAR LOW-INCOME AND HIGHER POVERTY COMMUNITIES.2022 UPDATE: THE AHLG COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH PRIORITY. 1. TO DEVELOP AFFORDABLE, HEALTHY FOOD OPTIONS FOR ALL RESIDENTS OF COOK COUNTY GOAL 1: TO DEVELOP AFFORDABLE, HEALTHY FOOD OPTIONS FOR ALL RESIDENTS OF COOK COUNTYOBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED CHNA PRIORITY AND INITIATIVE WITH AHH AND AHLG. THE OBJECTIVE, TO INCREASE THE AVAILABILITY OF HEALTHY FOODS WITHIN THE LOW-INCOME COMMUNITY, IS CONDUCTED THROUGH AHH, AND ALL FUNDING AND OUTCOMES REPORTED ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES, IN COLLABORATION WITH THE NORTHERN ILLINOIS FOOD BANK, HINSDALE SEVENTH-DAY ADVENTIST CHURCH AND COMMUNITY MEMORIAL FOUNDATION, THE RX MOBILE FOOD PANTRY, AN ON-SITE MOBILE FOOD PANTRY. TWICE A MONTH, THE RX MOBILE FOOD PANTRY PROVIDES FREE PRODUCE, MEAT AND DAIRY TO PATIENTS SCREENED FOR FOOD INSECURITY AS WELL AS TO THE COMMUNITY AT LARGE. THE HOSPITAL EXCEEDED ITS OBJECTIVE TO INCREASE THE AVAILABILITY OF HEALTHY FOOD WITHIN THE LOW-INCOME COMMUNITY. A TOTAL OF 480 INDIVIDUALS WERE PROVIDED WITH FREE HEALTHY FOOD OPTIONS A MONTH. THIS INITIATIVE HAS BEEN A GREAT COLLABORATION IN WHICH MANY PEOPLE WHO ARE EXPERIENCING FOOD INSECURITY FOR THE FIRST TIME ARE CONNECTED TO FOOD. IN ADDITION, WRAP AROUND SERVICES SUCH AS SNAP BENEFIT ENROLLMENT OPPORTUNITIES ARE AVAILABLE, AND HEALTH EDUCATION MATERIALS ARE OFTEN PROVIDED. PRIORITY 2: ACCESS TO CARE, COMMUNITY RESOURCES AND SYSTEMS IMPROVEMENTS2019 DESCRIPTION OF THE ISSUE:HEALTHY PEOPLE 2020 STATES THAT ACCESS TO COMPREHENSIVE HEALTHCARE SERVICES IS IMPORTANT FOR ACHIEVING HEALTH EQUITY AND IMPROVING QUALITY OF LIFE FOR EVERYONE. DISPARITIES IN ACCESS TO CARE AND COMMUNITY RESOURCES WERE IDENTIFIED AS UNDERLYING ROOT CAUSES OF MANY OF THE HEALTH INEQUITIES EXPERIENCED BY RESIDENTS IN COOK COUNTY. INCREASING TIMELY LINKAGE TO APPROPRIATE CARE, INCLUDING BEHAVIORAL HEALTH AND SOCIAL SERVICES, IS A PRIORITY. 2022 UPDATE: THE AHLG COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE ACCESS TO CARE, COMMUNITY RESOURCES AND SYSTEMS IMPROVEMENTS PRIORITY. 1. INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.GOAL 1: INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE ACCESS TO HEALTH CARE FOR HOMELESS PERSONS IN THE AHLG SERVICE AREA. THE BED PLUS DAY PROGRAM IS AN INITIATIVE IN COLLABORATION WITH PILLARS COMMUNITY HEALTH AND THE LA GRANGE FAMILY RESIDENCY CLINIC. THIS PROGRAM IS FUNDED THROUGH AHLG AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE BEDS PLUS DAY PROGRAM PROVIDES DAY PROGRAM PARTICIPANTS WITH HEALTH CONSULTATIONS AND LINKAGES TO ROUTINE HEALTH SERVICES WHICH INCREASES ACCESS TO CARE. THE HOSPITAL EXCEEDED ITS OBJECTIVE OF CONNECTING 90% OF INDIVIDUALS UTILIZING THE BEDS PLUS DAY PROGRAM FOR HOMELESS PERSONS IN THE AHLG SERVICE AREA WITH ROUTINE HEALTH SERVICES.OBJECTIVE 2: THE SECOND OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH LA GRANGE, ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS AND ADVENTHEALTH HINSDALE (THE HOSPITALS). THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH, THE SAME DIVISION AS THE REPORTING HOSPITAL. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PATIENT AND COMMUNITY MEMBERS' CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY, IS FUNDED AND DEPLOYED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES AN ONLINE DIRECTORY OF FREE OR REDUCED COST SERVICES THAT ADDRESS SOCIAL NEEDS OF PATIENTS AND COMMUNITY MEMBERS, INCREASING ACCESS TO COMMUNITY RESOURCES.THE HOSPITALS DID NOT MEET THE OBJECTIVE OF 200 PATIENT AND COMMUNITY MEMBERS' CONNECTIONS TO SERVICES THROUGH THE COMMUNITY RESOURCE DIRECTORY. THE COMMUNITY RESOURCE DIRECTORY AS IT WAS BRANDED WAS NOT RETAINED AFTER THE UNWINDING OF THE JOINT VENTURE PARTNERSHIP. HOWEVER, A SOFT INTRODUCTION OF THE ADVENTHEALTH WHOLE HEALTH HUB, A SOCIAL NEEDS REFERRAL PLATFORM, WAS MADE. APPROXIMATELY 500 FAMILIES RECEIVED INFORMATION ABOUT THE WHOLE HEALTH HUB TO HELP LOOK FOR COMMUNITY RESOURCES AT A MOBILE FOOD PANTRY. **SEE CONTINUATION SCHEDULE H, PART V, SECTION B, LINE 11: CONTINUATION FOR LA GRANGE PRIORITY 3: MENTAL HEALTH AND SUBSTANCE USE DISORDERS2019 DESCRIPTION OF THE ISSUE:BEHAVIORAL HEALTH IS A TERM THAT INCLUDES BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY FOR ADULTS, CHILDREN, AND ADOLESCENTS. WHEN MENTAL HEALTH DISORDERS ARE UNTREATED, THOSE AFFECTED ARE AT HIGH-RISK FOR MANY UNHEALTHY AND UNSAFE BEHAVIORS, INCLUDING ALCOHOL OR DRUG ABUSE, VIOLENT OR SELF-DESTRUCTIVE BEHAVIOR AND SUICIDE. MENTAL HEALTH DISORDERS ARE THE 11TH LEADING CAUSE OF DEATH IN THE UNITED STATES FOR ALL AGE GROUPS AND THE SECOND LEADING CAUSE OF DEATH AMONG PEOPLE AGED 25 TO 34. BEHAVIORAL HEALTH CONTINUES TO BE A PRIMARY CONCERN IN COOK COUNTY. ADDRESSING BEHAVIORAL HEALTH REQUIRES ATTENTION TO SUBSTANCE USE DISORDERS AS WELL AS MENTAL HEALTH. THE AHLG SERVICE AREA HAS A HIGHER INCIDENCE OF EMERGENCY DEPARTMENT VISITS FOR MENTAL HEALTH AND SUBSTANCE USE DISORDERS.2022 UPDATE: THE AHLG COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE BEHAVIORAL HEALTH AND SUBSTANCE USE PRIORITY. 1. IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.GOAL 1: IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THESE HOSPITALS ARE PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH, THE SAME DIVISION AS THE REPORTING HOSPITAL. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE IS TO INCREASE PERSONS TRAINED IN THE COMMUNITY ON MENTAL HEALTH FIRST AID TO INCREASE IDENTIFICATION OF THOSE IN A CRISIS AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH ISSUES. THIS OBJECTIVE IS FUNDED AND CONDUCTED THROUGH ALL HOSPITALS; HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES A TRAINING FOR COMMUNITY RESIDENTS AND FIRST RESPONDERS TO RECOGNIZE, RESPOND, AND SEEK ASSISTANCE FOR SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. THE HOSPITALS DID NOT MEET THE OBJECTIVE OF INCREASING PERSONS TRAINED IN THE COMMUNITY ON MHFA BECAUSE THERE WAS NOT A FACILITATOR AVAILABLE TO OFFER THE TRAININGS IN 2022. BY THE END OF YEAR THREE, A TOTAL OF EIGHT INDIVIDUALS WERE TRAINED. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE ACCESS AND ENGAGEMENT IN MENTAL HEALTH SERVICES THAT ARE INTEGRATED IN THE PRIMARY CARE SETTING. THE PARTNERSHIP WITH PILLARS COMMUNITY HEALTH IS FUNDED THROUGH AHLG, AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE COLLABORATION WITH PILLARS COMMUNITY HEALTH PROVIDES ACCESS AND ENGAGEMENT IN MENTAL HEALTH SERVICES THAT ARE INTEGRATED IN THE PRIMARY CARE SETTING. THE PILLARS COMMUNITY HEALTH COLLABORATION IS AN ADVENTHEALTH PROGRAM WHICH INCREASES ACCESS TO MENTAL HEALTH SERVICES BY IDENTIFYING THOSE WITH MENTAL HEALTH NEEDS AND NAVIGATING SERVICES ESPECIALLY TO THE LOW-INCOME POPULATION. A MENTAL HEALTH SCREENING IS INTEGRATED INTO ALL PRIMARY CARE VISITS. THROUGH THIS COLLABORATION WITH PILLARS COMMUNITY HEALTH, LOW INCOME/LOW ACCESS COMMUNITIES ARE PROVIDED WITH MENTAL HEALTH SERVICES. THE HOSPITAL EXCEEDED ITS OBJECTIVE TO INCREASE ACCESS AND ENGAGEMENT AS 72% OF PATIENTS WERE IDENTIFIED AS NEEDING A BEHAVIORAL HEALTH APPOINTMENT WITH A CONSULTANT IN MENTAL HEALTH SERVICES THAT ARE INTEGRATED INTO THE PRIMARY CARE SETTING. IN ADDITION, 94% OF PATIENTS AGES 12 AND UP WERE SCREENED FOR DEPRESSION, ANXIETY, SUBSTANCE ABUSE AND DOMESTIC VIOLENCE. IF THE SCREENING IS POSITIVE, A FOLLOW-UP PLAN IS DOCUMENTED. EIGHTY-FIVE PERCENT OF PATIENTS AGES 4-11 WERE ALSO SCREENED FOR DEPRESSION, ANXIETY, DOMESTIC VIOLENCE, AND DEVELOPMENTAL DELAYS AND IF THE SCREENING WAS POSITIVE, A FOLLOW-UP PLAN WAS DOCUMENTED. PRIORITY 4: CHRONIC CONDITION PREVENTION AND MANAGEMENT2019 DESCRIPTION OF THE ISSUE:IN THE UNITED STATES, CHRONIC DISEASES ARE THE LEADING CAUSES OF DISABILITY AND DEATH. IN ADDITION, CHRONIC DISEASE RATES ARE ACCELERATING GLOBALLY ACROSS ALL SOCIOECONOMIC CLASSES. HOWEVER, SOCIOECONOMIC INEQUITIES HAVE PROFOUND IMPACTS ON POPULATIONS AND COMMUNITIES THAT HAVE THE GREATEST BURDEN OF DISEASE. CHRONIC CONDITIONS SUCH AS HEART DISEASE, STROKE, CANCER, DIABETES, ARTHRITIS, ASTHMA, MENTAL ILLNESS, AND HIV/AIDS ACCOUNT FOR 90% OF THE NATION'S $3.3 TRILLION IN ANNUAL HEALTH CARE EXPENDITURES. PREVENTION AND MANAGEMENT OF CHRONIC ILLNESS CAN HELP REDUCE THE COSTLY PHYSICAL AND SOCIOECONOMIC BURDEN OF THESE DISEASES FOR INDIVIDUALS AND FOR SOCIETY AS A WHOLE. THE NUMBER OF INDIVIDUALS IN THE U.S. WHO ARE LIVING WITH A CHRONIC DISEASE IS PROJECTED TO CONTINUE INCREASING WELL INTO THE FUTURE. SIXTY-FIVE PERCENT OF DEATHS IN SUBURBAN COOK COUNTY WERE DUE TO CHRONIC DISEASES. AS A RESULT, IT WILL BE INCREASINGLY IMPORTANT FOR THE HEALTHCARE SYSTEM TO FOCUS ON PREVENTION OF CHRONIC DISEASE AND THE PROVISION OF ONGOING CARE MANAGEMENT.2022 UPDATE: THE AHLG COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE CHRONIC CONDITION PREVENTION AND MANAGEMENT PRIORITY. 1. PREVENTING AND REDUCING CHRONIC CONDITIONS, WITH A FOCUS ON RISK FACTORS.GOAL 1: PREVENTING AND REDUCING CHRONIC CONDITIONS, WITH A FOCUS ON RISK FACTORS.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE ACCESS TO CARE FOR LOW-INCOME POPULATIONS IN THE LA GRANGE SERVICE AREA FOR THE PREVENTION AND MANAGEMENT OF CHRONIC CONDITIONS. THE COLLABORATION WITH PILLARS COMMUNITY HEALTH IS FUNDED THROUGH AHLG, AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE COLLABORATION WITH PILLARS COMMUNITY HEALTH ADDRESSES CHRONIC HEALTH ISSUES THAT DISPROPORTIONATELY AFFECT THE LOW-INCOME POPULATION, INCLUDING OBESITY AND DIABETES. ADULTS AND YOUTH (3-17) WITH ELEVATED BMI LEVELS WILL RECEIVE A DOCUMENTED FOLLOW-UP PLAN INCLUDING NUTRITION AND PHYSICAL ACTIVITY AND COUNSELING SESSIONS. ADULTS WITH DIABETES WILL BE MANAGED TO KEEP HEMOGLOBIN A1C < 9. THE HOSPITAL DID NOT MEET ITS OBJECTIVE TO INCREASE ACCESS TO CARE FOR LOW-INCOME POPULATIONS IN THE LA GRANGE SERVICE AREA FOR THE PREVENTION AND MANAGEMENT OF CHRONIC CONDITIONS. ONLY 20% OF ADULT PATIENTS DIAGNOSED WITH DIABETES KEPT THEIR A1C < 9 WHICH IS LESS THAN THE SET METRIC OF 30%. PATIENTS HAD ACCESS TO NUTRITION AND PHYSICAL ACTIVITIES WHICH PROVIDES INDIVIDUALS AND FAMILIES WITH THE TOOLS NEEDED TO ADDRESS CHRONIC HEALTH ISSUES THAT DISPROPORTIONATELY AFFECT THEM. OTHER CHRONIC DISEASES ADDRESSED THROUGH THIS EFFORT HAVE ALSO PROVIDED RESOURCES FOR BODY MASS INDEX (BMI), HYPERTENSION AND ASTHMA. COMMUNITY HEALTH NEEDS NOT CHOSEN BY ADVENTHEALTH LA GRANGE:THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. THE HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE - OR MULTIPLE GROUPS - IN THE COMMUNITY ALREADY WORKING ON THIS ISSUE? 5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS?THE FOLLOWING PRIORITIZED HEALTH NEEDS WILL NOT BE DIRECTLY ADDRESSED IN THE 2020-2022 IMPLEMENTATION STRATEGY:MATERNAL & CHILD HEALTH SAFETY, TRAUMA & INJURY WHILE CRITICALLY IMPORTANT TO OVERALL COMMUNITY HEALTH, FOR THE AREAS NOT CHOSEN, THERE ARE SERVICE PROVIDERS IN THE COMMUNITY BETTER RESOURCED TO ADDRESS THESE PRIORITIES. AHLG WILL WORK COLLABORATIVELY WITH THESE ORGANIZATIONS AS APPROPRIATE TO ENSURE OPTIMAL SERVICE COORDINATION AND UTILIZATION. SCHEDULE H, PART V, SECTION B, LINE 16A,B,C: EACH HOSPITAL'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCEEACH HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY APPLICATION IS WIDELY AVAILABLE THROUGH THE FOLLOWING WEBSITE:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCEEACH HOSPITAL FACILITY'S PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.UCHICAGOMEDICINEADVENTHEALTH.ORG/FINANCIAL-ASSISTANCE 1 1 - ST THOMAS HOSPICE & PALLIATIVE CARE 119 E OGDEN AVE SUITE 111 HINSDALE IL 60521 HOSPICE CARE PART I, LINE 3C: UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY, AN INDIVIDUAL IS ELIGIBLE FOR A 100% REDUCTION FROM APPLICABLE CHARGES IF THE INDIVIDUAL'S HOUSEHOLD INCOME IS AT OR BELOW 250% OF THE CURRENT FEDERAL POVERTY GUIDELINES. A PATIENT MAY ALSO QUALIFY FOR A REDUCTION FROM CHARGES IF THE PATIENT HAS EXCESSIVE TOTAL MEDICAL DEBT THAT IS EQUAL TO OR GREATER THAN SUCH PATIENT'S HOUSEHOLD'S GROSS INCOME. FEDERAL POVERTY LEVEL - 0-250% UNINSURED PATIENT DISCOUNT - 100%FEDERAL POVERTY LEVEL - 251-300% UNINSURED PATIENT DISCOUNT - 95%FEDERAL POVERTY LEVEL - 301-400% UNINSURED PATIENT DISCOUNT - 90%FEDERAL POVERTY LEVEL - 401-600% UNINSURED PATIENT DISCOUNT - 85% PART I, LINE 6A: THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTHEALTH".ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE. THE FILING ORGANIZATION IS INCLUDED IN THE SUBMISSION OF THE ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS REPORT IS PREPARED ON A CONSOLIDATED BASIS AND INCLUDES DATA FOR ADVENTIST MIDWEST HEALTH, ADVENTIST GLENOAKS HOSPITAL, AND ADVENTIST BOLINGBROOK HOSPITAL. THESE HOSPITAL ORGANIZATIONS ARE ALL RELATED ORGANIZATIONS. PART I, LINE 7: THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS. PART II, COMMUNITY BUILDING ACTIVITIES: THE COSTS OF COMMUNITY BUILDING ACTIVITIES REPORTED ON PART II OF SCHEDULE H PRIMARILY REPRESENT THE COSTS ASSOCIATED WITH COMMERCIALLY SPONSORED RESEARCH. THE ORGANIZATION'S HOSPITALS PARTICIPATE IN CLINICAL DRUG AND DEVICE RESEARCH THAT IS PERFORMED ON PATIENTS WHO HAVE A CONDITION OR DISEASE FOR WHICH THE EVENTUAL COMMERCIAL USE OF A DRUG OR DEVICE IS INTENDED. THIS RESEARCH IS RELATED TO PATIENT CARE AND SERVES TO EXPAND SCIENTIFIC KNOWLEDGE WITH RESPECT TO POTENTIAL TREATMENTS AND CURES FOR VARIOUS DISEASES AND CONDITIONS. COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE PROGRAMS THAT IMPROVE THE COMMUNITY'S HEALTH AND SAFETY BY ADDRESSING THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL HAZARDS. PARTICIPATION IN COLLABORATIVE COMMUNITY EFFORTS TO PROMOTE PUBLIC HEALTH INITIATIVES IS ALSO INCLUDED, SUCH AS ENGAGEMENT IN COALITIONS AND ADVOCACY FOR HEALTH IMPROVEMENT. THESE ACTIVITIES STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF ITS RESIDENTS BY OFFERING THE EXPERTISE AND RESOURCES OF THE HEALTH CARE ORGANIZATION. ADVENTIST MIDWEST HEALTH ENGAGES IN A VARIETY OF COMMUNITY-BUILDING ACTIVITIES WHICH ULTIMATELY IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE ARE PRIVILEGED TO SERVE, EVEN THOUGH THEY ARE NOT SPECIFIC HEALTH ACTIVITIES. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE. PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8-9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. PART III, LINE 8: COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT. PART III, LINE 9B: THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2014 FINAL REGULATIONS REGARDING THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R)(4)-(R)(6). NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) ARE INITIATED BY THE HOSPITAL FILING ORGANIZATION IN THE 120-DAY PERIOD FOLLOWING THE DATE AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL (OR, IF LATER, THE SPECIFIED DEADLINE GIVEN IN A WRITTEN NOTICE OF ACTIONS THAT MAY BE TAKEN, AS DESCRIBED BELOW). INDIVIDUALS ARE PROVIDED WITH AT LEAST ONE WRITTEN NOTICE (NOTICE OF ACTIONS THAT MAY BE TAKEN) AND A COPY OF THE FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY THAT INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS IF THE INDIVIDUAL DOES NOT SUBMIT A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM) OR PAY THE AMOUNT DUE BY A SPECIFIED DEADLINE. THE SPECIFIED DEADLINE IS NOT EARLIER THAN 120 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. A REASONABLE ATTEMPT IS ALSO MADE TO ORALLY NOTIFY AN INDIVIDUAL ABOUT THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST POST-DISCHARGE BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS (OR CEASES ANY OTHER ECA'S) AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPLETE THE FAA FORM. THIS WRITTEN NOTICE CONTAINS CONTACT INFORMATION INCLUDING THE TELEPHONE NUMBER AND PHYSICAL LOCATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY, AS WELL AS CONTACT INFORMATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS OR, ALTERNATIVELY, A NONPROFIT ORGANIZATION OR GOVERNMENTAL AGENCY THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS IF THE HOSPITAL FACILITY IS UNABLE TO DO SO. IF AN INDIVIDUAL SUBMITS A COMPLETE FAA FORM WITHIN A REASONABLE TIME-PERIOD AS SET FORTH IN THE NOTICE DESCRIBED ABOVE, THE HOSPITAL FILING ORGANIZATION WILL SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE. PART VI, LINE 2: THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2022 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2022, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2022 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY. PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL 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 OF THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITES. 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 THE FILING ORGANIZATION'S HOSPITAL FACILITIES, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS EACH HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT EACH HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF EACH HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN EACH HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITIES' FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. PART VI, LINE 4: THE FILING ORGANIZATION CURRENTLY OPERATES 2 HOSPITAL FACILITIES, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. BOTH LOCATED IN ILLINOIS, THESE FACILITIES ARE MAJOR HEALTHCARE PROVIDERS IN THE COMMUNITIES THEY SERVE. ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH HINSDALE:ADVENTHEALTH HINSDALE (AHH), IS LOCATED IN HINSDALE, ILLINOIS. IT CURRENTLY OPERATES A HOSPITAL FACILITY AND IS LICENSED FOR 261 BEDS. IN ADDITION TO OPERATING A HOSPITAL, AHH ALSO OPERATES A CANCER TREATMENT CENTER, 3 IMAGING CENTERS, 7 OUTPATIENT REHABILITATION FACILITIES, 1 BEHAVIORAL HEALTH CENTER, 1 VASCULAR INTERVENTION CENTER, AND 2 FAMILY HEALTH MEDICINE CENTERS. THE AHH COMMUNITY CONSISTS PRIMARILY OF HINSDALE AND THE SURROUNDING AREA. THE AHH PRIMARY SERVICE AREA IS DEFINED AS THE AREA WHICH 75%-80% OF ITS PATIENT POPULATION LIVES. THIS INCLUDES 39 ZIP CODES ACROSS MAINLY DUPAGE COUNTY AND SMALLER AREAS IN WILL, KENDALL, AND COOK COUNTIES. DURING 2022, THE PATIENT PERCENTAGE POPULATION FOR AHH WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. IN 2022, ABOUT 60.8% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 44.2% - MEDICAID PATIENTS 13.0% - SELF-PAY PATIENTS 0.9% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 1,176,776 - POPULATION OVER 65 15.2% - POVERTY (BELOW 100% FPL) 8.0% - HIGH SCHOOL GRADUATION RATE 89.5% - UNINSURED ADULTS 7.1% - FOOD INSECURITY RATE 10.4% - POP. WITH LOW FOOD ACCESS 60.0% ADVENTIST MIDWEST HEALTH, DBA ADVENTHEALTH LA GRANGE:ADVENTHEALTH LA GRANGE (AHLG) IS A 177-BED FACILITY PROVIDING OUTPATIENT AND INPATIENT PRIMARY CARE, TRAUMA CARE AND WELLNESS SERVICES TO RESIDENTS OF CHICAGO'S WESTERN SUBURBS. THE HOSPITAL IS A LEADER IN OFFERING COMPREHENSIVE ONCOLOGY SERVICES, ORTHOPEDIC SERVICES, ADVANCED CARDIAC CARE, WOMEN'S HEALTH AND MATERNITY CARE, EMERGENCY, GERIATRIC AND MANY OTHER SPECIALTIES THAT CATER TO THE COMMUNITIES IT SERVES. THE AHLG COMMUNITY CONSISTS PRIMARILY OF LA GRANGE AND THE SURROUNDING AREA. THE AHLG PRIMARY SERVICE AREA IS DEFINED AS THE AREA WHICH 75%-80% OF ITS PATIENT POPULATION LIVES. THIS INCLUDES 21 ZIP CODES ACROSS COOK AND DUPAGE COUNTIES. DURING 2022, THE PATIENT PERCENTAGE POPULATION FOR AHLG WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. IN 2022, ABOUT 83.0% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 58.9% - MEDICAID PATIENTS 11.9% - SELF-PAY PATIENTS 1.5% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION 528,987 - POPULATION OVER 65 15.0% - POVERTY (BELOW 100% FPL) 9.4% - HIGH SCHOOL GRADUATION RATE 85.5% - UNINSURED ADULTS 9.1% - FOOD INSECURITY RATE 11.2% - POP. WITH LOW FOOD ACCESS 46.1% PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO THE FILING ORGANIZATION'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE FILING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE FILING ORGANIZATION CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. THE FILING ORGANIZATION ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE FILING ORGANIZATION EXPENDED $10,670,963 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: THE FILING ORGANIZATION IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 49 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 10 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF ADVENTHEALTH, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS IT, CORPORATE COMPLIANCE, LEGAL, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. CERTAIN SUPPORT SERVICES, SUCH AS HUMAN RESOURCES, PAYROLL, A/P, AND SUPPLY CHAIN MANAGEMENT ARE PROVIDED PURSUANT TO A SHARED SERVICES MODEL BY AHSSHC TO ITS SUBSIDIARY ORGANIZATIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH ADVENTHEALTH SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH ADVENTHEALTH SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEBSITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH. PART VI, LINE 7, REPORTS FILED WITH STATES IL 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 SERVICES TO 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: $ (24,786,700)- DIFFERENCE IN COSTING METHODOLOGY: 32,885,691- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (51,234,298) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITYBENEFIT REPORTING $ (43,135,307)AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION. 1 DUPAGE HEALTH COALITION 511 THORNHILL DRIVE STE E CAROL STREAM IL 60188 364448208 501(C)(3) 180910 0 GENERAL SUPPORT HINSDALE ADVENTIST ACADEMY 631 E HICKORY STREET HINSDALE IL 60521 364090219 501(C)(3) 10000 0 GENERAL SUPPORT HINSDALE CHAMBER OF COMMERCE 22 E FIRST STREET HINSDALE IL 60521 362030214 501(C)(6) 8000 0 GENERAL SUPPORT HINSDALE HOSPITAL FOUNDATION 7 SALT CREEK LANE HINSDALE IL 60521 521466387 501(C)(3) 0 104503 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT ILLINOIS PUBLIC HEALTH INSTITUTE 310 S PEORIA STREET STE 404 NO 4 CHICAGO IL 60607 262757523 501(C)(3) 18700 0 COMMUNITY BENEFIT SUPPORT MIDWEST HEALTH FOUNDATION 120 N OAK STREET HINSDALE IL 60521 352230515 501(C)(3) 0 751701 COST GENERAL ADMINISTRATIVE SUPPORT PROVISION OF GENERAL ADMINISTRATIVE SUPPORT THE COMMUNITY HOUSE 415 W 8TH STREET HINSDALE IL 60521 362167735 501(C)(3) 10000 0 GENERAL SUPPORT PILLARS COMMUNITY HEALTH 333 NORTH LA GRANGE ROAD LAGRANGE PARK IL 60526 362170869 501(C)(3) 50000 0 GENERAL SUPPORT OAK BROOK PARK DISTRICT 1450 FORREST GATE ROAD OAK BROOK IL 60523 362682363 GOV'T 27500 0 GENERAL SUPPORT AGING CARE CONNECTIONS 111 W HARRIS AVENUE LAGRANGE IL 60525 362721289 501(C)(3) 67500 0 GENERAL SUPPORT 9 1 PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3), OR TO OTHER 501(C)(3) ORGANIZATIONS THAT ARE A PART OF THE GROUP EXEMPTION RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS, OR TO OTHER 501(C)(3) COMMUNITY ORGANIZATIONS INVOLVED IN HEALTH-RELATED CAUSES. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES. X X X X X X 1 1 0 1 0 0 0 0 0 0 0 BACON KENNETH DIRECTOR/CHAIRMAN 0 1226644 0 338892 0 56102 0 243332 0 46940 0 1911910 0 0 SNYDER BRENT DIRECTOR 0 921439 0 281173 0 264350 0 16400 0 26882 0 1510244 0 0 THORDARSON THOR DIR/PRES/SEC/EVP & COO 173696 570693 0 0 26615 526250 3840 114472 4310 25086 208461 1236501 0 0 MURPHY MARY CNO HINSDALE/LA GRANGE (END 12/22) 99145 290348 0 0 11376 962358 2769 52273 1967 9681 115257 1314660 0 0 MURRILL MICHAEL FORMER CEO 0 711303 0 168833 0 18707 0 142054 0 45659 0 1086556 0 0 BUCHANAN HERBERT DIRECTOR 12097 464068 0 0 2420 317397 244 17011 468 15095 15229 813571 0 0 MAYCOCK ADAM CEO HINSDALE/LA GRANGE 97157 285270 0 0 11670 203904 2769 56241 7572 32042 119168 577457 0 0 NAND MD BELA CMO HINSDALE/LA GRANGE 98213 298760 0 0 2236 86336 2674 59019 1952 12354 105075 456469 0 0 MATHIS REBECCA FORMER CFO 0 370485 0 0 0 36614 0 71093 0 41124 0 519316 0 0 DAVARAPALLI MD RAMADEVI DIRECTOR (BEG 01/22) 0 349891 0 82933 0 0 0 30904 0 26132 0 489860 0 0 LAYMAN BENJAMIN COO HINSDALE/LAGRANGE 67529 197838 0 0 40069 49645 0 9846 6796 28813 114394 286142 0 0 FORTMAN MD LISA PHYSICIAN ADVISOR 279473 0 20549 0 47817 0 18846 0 19765 0 386450 0 0 0 SLEUWEN MD LESLIE DIR-PHYSICIAN RES/STUDY PROGRAM 248909 0 15261 0 2592 0 24289 0 29171 0 320222 0 0 0 STILL DANAE CFO HINSDALE/LA GRANGE 51053 150246 0 0 97 29070 1523 7602 9109 32509 61782 219427 0 0 DE RAMOS DO DAVID DIRECTOR (END 12/22) 0 198493 0 33590 0 0 0 20687 0 17804 0 270574 0 0 TSANG DAVID PHARMACY DIRECTOR 216226 0 0 0 3262 0 19443 0 18198 0 257129 0 0 0 GUNNELL MD KATE PHYSICIAN 190379 0 11219 0 6652 0 18199 0 22336 0 248785 0 0 0 BORROWS KIMBERLY REGISTERED NURSE 187917 0 20187 0 28354 0 5756 0 0 0 242214 0 0 0 PART I, LINE 1A PRIOR TO APRIL 1, 2022, MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HELD THE POSITION OF VICE-PRESIDENT OR ABOVE WERE COMPENSATED BY AND ON THE PAYROLL OF THE FILING ORGANIZATION. HOWEVER, AS A RESULT OF THE DISAFFILIATION AGREEMENT, BEGINNING APRIL 1, 2022, MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE NOW COMPENSATED BY AND ON THE PAYROLL OF THE FILING ORGANIZATION'S TOP-TIER PARENT. THE FILING ORGANIZATION AND ITS 501(C)(3) PARENT ARE PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE TOP-TIER PARENT OF ADVENTHEALTH IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES LISTED IN PART VII THAT ARE ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. FIRST-CLASS OR CHARTER TRAVEL: PURSUANT TO THE ADVENTHEALTH SYSTEM-WIDE GENERAL POLICY REGARDING BUSINESS TRAVEL, NO REIMBURSEMENT WILL BE PROVIDED FOR ANY ADDITIONAL COST INCURRED WITH RESPECT TO FIRST-CLASS OR CHARTER AIR TRAVEL BEYOND THE COST OF A REGULAR COACH AIRFARE. AS A MEANS OF PROVIDING ADDITIONAL BUSINESS TRAVEL REIMBURSEMENT FOR THOSE MEMBERS OF THE AHSSHC SENIOR EXECUTIVE MANAGEMENT TEAM THAT TRAVEL FREQUENTLY ON BEHALF OF ADVENTHEALTH, A SPECIAL ANNUAL TRAVEL ALLOWANCE IS PROVIDED FOR THOSE EXECUTIVES. AS ADVENTHEALTH OPERATES 49 HOSPITALS IN 9 STATES, THE SENIOR LEADERSHIP OF AHSSHC TRAVEL EXTENSIVELY AND OFTEN VISIT MULTIPLE HOSPITAL LOCATIONS IN DIFFERENT STATES AS A PART OF A SINGLE BUSINESS TRIP. THE SPECIAL TRAVEL ALLOWANCE CAN PROVIDE REIMBURSEMENTS TO THE EXECUTIVE FOR SUCH ITEMS AS THE PURCHASE OF AIR TRAVEL UPGRADE COUPONS, TO COVER THE COST DIFFERENTIAL BETWEEN COACH AND FIRST-CLASS TRAVEL, OR TO COVER THE COST OF A CHARTER FLIGHT. THE SPECIAL TRAVEL ALLOWANCE BENEFIT WAS ORIGINALLY AUTHORIZED BY AND CODIFIED INTO A POLICY BY THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE), AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS, WHO ALSO APPROVES THE ANNUAL CAP ON THE AMOUNT OF THE ALLOWANCE. THE SPECIAL TRAVEL ALLOWANCE HAS AN ANNUAL CAP OF $24,000 FOR MEMBERS OF THE LEADERSHIP EXECUTIVE TEAM (13 ADVENTHEALTH CABINET MEMBERS AND THE ADVENTHEALTH MULTI-STATE CFO) AND $15,000 FOR ADVENTHEALTH CORPORATE OFFICE SENIOR VICE PRESIDENTS, REGIONAL CEO'S, AND DIVISION CHIEF OFFICERS (GENERALLY 50 - 55 INDIVIDUAL EXECUTIVES). A REGIONAL CEO FOR ADVENTHEALTH IS A MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THE REGIONAL CEO IS CONSIDERED A COMMON LAW EMPLOYEE OF AND IS ON THE PAYROLL OF AHSSHC. WHILE THE SPECIAL TRAVEL ALLOWANCE BENEFIT IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND EITHER WHOLLY OR PARTIALLY REIMBURSED BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR FIRST-CLASS OR CHARTER TRAVEL SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. THOSE EXECUTIVES WHO RECEIVE THE SPECIAL TRAVEL ALLOWANCE ARE RESPONSIBLE FOR TRACKING THE EXPENSES REIMBURSABLE UNDER THE SPECIAL TRAVEL ALLOWANCE AND MUST SUBMIT SUCH EXPENSES ON THEIR ACCOUNTABLE PLAN EXPENSE REPORT. A REPORT ON CHARTER TRAVEL IS PROVIDED TO THE AHSSHC BOARD COMPENSATION COMMITTEE AT EACH MEETING. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES UNDER THE SPECIAL TRAVEL ALLOWANCE ARRANGEMENT ARE TREATED AS TAXABLE COMPENSATION TO THE EXECUTIVE. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: OCCASIONAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH PRESIDENT'S COUNCIL, CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING. PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES BUSINESS DEVELOPMENT EXPENDITURES. UNDER THIS POLICY, TO ENCOURAGE EXECUTIVES TO ESTABLISH AND CULTIVATE STRONG WORKING RELATIONSHIPS WITH THE MEDICAL COMMUNITY AND OTHER LEADERS IN THE COMMUNITY AND INDUSTRY, CERTAIN ADVENTHEALTH EXECUTIVES MAY BE REIMBURSED FOR MEMBER DUES AND USAGE CHARGES FOR A COUNTRY CLUB OR OTHER SOCIAL CLUB UPON AUTHORIZATION. CLUB MEMBERSHIPS MUST BE APPROVED BY THE ADVENTHEALTH PRESIDENT/CEO INITIALLY AS WELL AS ON AN ANNUAL BASIS. EACH ADVENTHEALTH EXECUTIVE WHO IS APPROVED FOR A CLUB MEMBERSHIP MUST SUBMIT AN ANNUAL REPORT DESCRIBING HOW THEY USED THE MEMBERSHIP TO BENEFIT THEIR ORGANIZATION DURING THE PRECEDING YEAR SO THAT THE ADVENTHEALTH PRESIDENT/CEO CAN DETERMINE IF CONTINUANCE OF THE CLUB MEMBERSHIP FURTHERS THE BUSINESS INTERESTS OF ADVENTHEALTH. IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, ONE EXECUTIVE LISTED IN PART VII RECEIVED REIMBURSEMENT FOR CLUB FEES. WHILE THE CLUB DUES MEMBERSHIP IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND REIMBURSED IN WHOLE OR IN PART BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR HEALTH OR SOCIAL CLUB DUES SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: IN PRIOR YEARS, AHSSHC PROVIDED HOUSING ASSISTANCE IN THE FORM OF A SHARED EQUITY INTEREST IN A RESIDENCE TO ELIGIBLE EXECUTIVES WHO WERE EXPECTED TO LIVE WITHIN THE IMMEDIATE PROXIMITY OF HOSPITAL FACILITIES LOCATED IN HIGH-COST COMMUNITIES. AS WITH ALL AHSSHC CORPORATE EXECUTIVE POLICIES, THE HOUSING BENEFIT POLICY WAS ORIGINALLY AUTHORIZED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE OF THE AHSSHC BOARD OF DIRECTORS. THIS HOUSING ASSISTANCE POLICY WAS RETIRED IN 2018. AT THE TIME OF THE HOUSING ASSISTANCE POLICY'S RETIREMENT, THERE WAS ONLY ONE ELIGIBLE EXECUTIVE THAT IS LISTED ON PART VII OF THIS RETURN THAT REMAINED A PARTICIPANT IN THIS PROGRAM. THE APPROPRIATE ANNUAL DOLLAR AMOUNT OF THE HOUSING BENEFIT PROVIDED TO THE REMAINING ELIGIBLE EXECUTIVE IS TREATED AS TAXABLE COMPENSATION TO THE EMPLOYEE. THE REMAINING PARTICIPANT'S HOUSE WAS SOLD AUGUST, 2022 AND THERE ARE NO REMAINING PARTICIPANTS UNDER THIS OBSOLETE POLICY. PART I, LINE 3 THE FILING ORGANIZATION WAS A COVERED AFFILIATE OF THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. D/B/A AMITA HEALTH (AMITA OR JOC) FOR THE PERIOD FROM JANUARY 1 TO MARCH 31 OF 2022. AS A RESULT OF THE DISAFFILIATION AGREEMENT BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH, THE FILING ORGANIZATION'S SOLE MEMBER, THE FILING ORGANIZATION CEASED TO BE A COVERED AFFILIATE OF THE JOC EFFECTIVE APRIL 1, 2022. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4 FOR ADDITIONAL INFORMATION CONCERNING THE DISAFFILIATION AGREEMENT. THE 2022 COMPENSATION OF THE EXECUTIVES LISTED IN PART VII, INCLUDING THE CEO, WAS DETERMINED BY AMITA. UPON THE DISAFFILIATION ON APRIL 1, 2022, THE COMPENSATION OF THE EXECUTIVES LISTED IN PART VII WAS REVIEWED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER 501(C)(3) PARENT ORGANIZATION, FOR REASONABLENESS AND APPROPRIATENESS AND LEFT UNCHANGED FOR 2022. AMITA UTILIZED VARIOUS COMPARABILITY DATA IN ESTABLISHING THE 2022 COMPENSATION FOR THOSE EXECUTIVES LISTED IN PART VII THAT PERFORMED SERVICES FOR AMITA DURING THE FIRST QUARTER OF 2022 AND FOR THE FILING ORGANIZATION AND FOR ITS RELATED 501(C)(3) HOSPITAL AND PHYSICIAN PRACTICE ENTITIES FOR CALENDAR YEAR 2022. COMPARABILITY DATA UTILIZED BY AMITA INCLUDED COMPENSATION SURVEYS AND STUDIES AND THE FORMS 990 OF OTHER UNRELATED COMPARABLE ORGANIZATIONS. AMITA ALSO HAD A COMPENSATION COMMITTEE THAT APPROVED ALL RELEVANT EXECUTIVE COMPENSATION, INCLUDING THE COMPENSATION OF THE FILING ORGANIZATION'S CEO FOR 2022. PART I, LINE 4B AS DISCUSSED IN LINE 1A ABOVE, BEGINNING APRIL 1, 2022, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS TO ELIGIBLE EXECUTIVES. AS THE SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS WERE UPDATED IN 2020 AND CERTAIN INDIVIDUALS STILL PARTICIPATE AS GRAND-FATHERED PARTICIPANTS IN CERTAIN PLANS, THE NARRATIVE BELOW DISCUSSES ALL PLANS IN WHICH THERE WERE ANY PARTICIPANTS IN 2022. THE SERP III PLAN EFFECTIVELY REPLACES THE PRIOR SERP II PLAN, THE EXECUTIVE FLEX BENEFIT PROGRAM PLAN, AND THE SENIOR EXECUTIVE DEATH BENEFIT PLAN FOR QUALIFIED EXECUTIVES EXCEPT FOR CERTAIN GRANDFATHERED EXECUTIVE EMPLOYEES. SERP III PLAN: THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $305,000 IN 2022 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN: THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER 31, 2027. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN: THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. IN 2020, THE FLEX PLAN WAS AMENDED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE FOR ANY PLAN YEAR SHALL NOT BE GREATER THAN THE MAXIMUM DOLLAR AMOUNT OR THE PERCENTAGE OF COMPENSATION AS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. BACON,KENNETH $ 0 $ 0 $ 0 $ 226,932 SNYDER,BRENT $ 150,000 $ 129,500 $ 56,411 $ 0 THORDARSON,THOR $ 0 $ 0 $ 0 $ 98,072 MURPHY,MARY $ 36,648 $ 0 $ 761,856 $ 0 MURRILL,MICHAEL $ 0 $ 0 $ 0 $ 125,654 BUCHANAN,HERBERT $ 0 $ 0 $ 0 $ 50,754 MAYCOCK,ADAM $ 0 $ 0 $ 0 $ 41,539 NAND,BELA $ 0 $ 0 $ 0 $ 42,880 MATHIS,REBECCA $ 0 $ 0 $ 0 $ 54,693 SERP III DISTR.* BACON,KENNETH $ 0 SNYDER,BRENT $ 0 THORDARSON,THOR $ 0 MURPHY,MARY $ 0 MURRILL,MICHAEL $ 0 BUCHANAN,HERBERT $ 50,754 MAYCOCK,ADAM $ 0 NAND,BELA $ 0 MATHIS,REBECCA $ 0 * INCLUDING INVESTMENT EARNINGS HERBERT BUCHANAN RECEIVED COMPENSATION FROM ALEXIAN BROTHERS HEALTH SYSTEM IN 2022 FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. ALEXIAN BROTHERS HEALTH SYSTEM WAS AFFILIATED WITH THE FILING ORGANIZATION FOR THE PERIOD FROM JANUARY 1 TO MARCH 31 OF 2022. AS A RESULT OF THE DISAFFILIATION AGREEMENT BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH, THE FILING ORGANIZATION'S SOLE MEMBER, THE FILING ORGANIZATION CEASED TO BE A COVERED AFFILIATE OF THE JOINT OPERATING COMPANY KNOWN AS AMITA HEALTH EFFECTIVE APRIL 1, 2022. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4 FOR ADDITIONAL INFORMATION CONCERNING THE DISAFFILIATION AGREEMENT. COMPENSATION FOR THE INDIVIDUAL'S SERVICES PROVIDED TO THE FILING ORGANIZATION IS DISCLOSED IN PART VII, LINE 1A, AND SCHEDULE J, PART II. JOLENE WRIGHT FAMILY OF BOARD MEMBER 73170 EMPLOYEE COMPENSATION 0 PART V, LINE 1A: THE PARENT CORPORATION AND SOLE TOP-TIER MEMBER OF ADVENTIST MIDWEST HEALTH (THE FILING ORGANIZATION) IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS A FLORIDA, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). AHSSHC HAS ESTABLISHED A SHARED SERVICE CENTER TO CENTRALIZE THE ACCOUNTS PAYABLE (A/P) FUNCTION FOR ALL AHSSHC SUBSIDIARY ORGANIZATIONS. THE FILING ORGANIZATION HAS ENTERED "0" IN PART V, LINE 1A BECAUSE THE FILING ORGANIZATION NO LONGER ISSUES FORM 1099 RETURNS, RATHER, ALL SUCH RETURNS ARE FILED BY AND UNDER THE NAME AND EIN OF AHSSHC AS THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. THE FACTS AND CIRCUMSTANCES SUPPORT A POSITION THAT AHSSHC, AS A PAYOR ON BEHALF OF ITS SUBSIDIARY ORGANIZATIONS IN A SHARED SERVICE ENVIRONMENT, WILL HAVE SUFFICIENT MANAGEMENT AND OVERSIGHT IN CONNECTION WITH THE SUBSIDIARY ORGANIZATIONS' PAYMENTS TO MEET THE STANDARD SET FORTH IN TREAS. REG. SECTION 1.6041-1(E). AHSSHC WILL NOT MERELY BE MAKING PAYMENTS AT THE DIRECTION OF ITS SUBSIDIARY ORGANIZATIONS. ACCORDINGLY, AHSSHC IS CONSIDERED THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. FORM 990, PART VI, SECTION A, LINE 4 APRIL 1, 2022 CHANGES TO BYLAWS: PRIOR TO APRIL 1, 2022, ADVENTIST MIDWEST HEALTH (AMH) WAS A COVERED AFFILIATE OF AN AFFILIATION COMPRISING A REGIONAL HEALTH CARE DELIVERY NETWORK OPERATED AND MANAGED BY ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., A JOINT OPERATING COMPANY BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH (THE JOINT OPERATING COMPANY). THE JOINT OPERATING COMPANY WAS KNOWN AS AMITA HEALTH. THROUGHOUT 2022, THE SOLE MEMBER OF AMH WAS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND INDIRECTLY WAS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, BOTH 501(C)(3) ORGANIZATIONS. THE HEALTHCARE SYSTEM WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION IS KNOWN AS ADVENTHEALTH. EFFECTIVE APRIL 1, 2022, ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH EXECUTED A DISAFFILIATION AGREEMENT (THE DISAFFILIATION) WHEREBY IT WAS AGREED THAT THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., WOULD WIND UP ITS AFFAIRS AND DISSOLVE AND THAT THE PARTIES TO THE ORIGINAL AFFILIATION AGREEMENT WOULD NO LONGER BE UNDER THE MANAGEMENT CONTROL OF THE JOINT OPERATING COMPANY. ACCORDINGLY, THE BYLAWS OF THE FILING ORGANIZATION WERE AMENDED EFFECTIVE APRIL 1, 2022, TO REFLECT THE CHANGES RESULTING FROM THE DISAFFILIATION. ADVENTIST MIDWEST HEALTH OWNS AND OPERATES TWO ACUTE-CARE HOSPITALS IN THE GREATER CHICAGO AREA IN THE VILLAGES OF HINSDALE AND LA GRANGE (THE HOSPITALS). THE APRIL 1, 2022 BYLAWS WERE REVISED TO EFFECTUATE THE TERMS OF THE DISAFFILIATION AGREEMENT. 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. ALL REFERENCES THROUGHOUT THE BYLAWS TO POTENTIAL LIMITATIONS IMPOSED ON ACTIONS OF THE HOSPITAL THAT MIGHT RESULT FROM INCONSISTENCIES WITH THE JOINT OPERATING COMPANY BYLAWS OR AFFILIATION AGREEMENT WERE REMOVED. PRIOR TO THE APRIL 1, 2022 REVISIONS TO THE BYLAWS, THE BOARD OF DIRECTORS OF AMH PROVIDED FOR TWO CLASSES OF DIRECTORS - VOTING AND NON-VOTING. THE REVISED BYLAWS PROVIDE FOR ONLY VOTING MEMBERS OF THE BOARD OF DIRECTORS. 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 REVISED BYLAWS INCLUDE PROVISIONS RELATED TO THE HOSPITAL'S MEDICAL STAFF AND ITS ORGANIZATION, APPOINTMENTS, AND DUE PROCESS PROCEDURES. THE BOARD OF DIRECTORS SHALL DETERMINE WHICH CATEGORIES OF PRACTITIONERS ARE ELIGIBLE CANDIDATES FOR APPOINTMENT TO THE HOSPITAL'S MEDICAL STAFF, AND THOSE PRACTITIONERS WHO MAY BE GRANTED CLINICAL PRIVILEGES WITHOUT THE GRANT OF MEMBERSHIP IN THE HOSPITAL'S MEDICAL STAFF. PRACTITIONERS ELIGIBLE FOR MEDICAL STAFF APPOINTMENT SHALL BE ORGANIZED INTO A MEDICAL STAFF UNDER MEDICAL STAFF BYLAWS. THE ORGANIZED MEDICAL STAFF STRUCTURE SHALL BE DETERMINED BY THE BOARD. THE BOARD SHALL DELEGATE TO THE HOSPITAL MEDICAL STAFF THE RESPONSIBILITY TO EVALUATE THE PROFESSIONAL COMPETENCE OF MEDICAL STAFF MEMBERS AND APPLICANTS AND THE QUALITY AND APPROPRIATENESS OF PROFESSIONAL CARE TO HOSPITAL PATIENTS. THERE SHALL BE BYLAWS, RULES, AND REGULATIONS FOR THE HOSPITAL MEDICAL STAFF SETTING FORTH ITS ORGANIZATION AND GOVERNMENT. THE BYLAWS WERE ALSO REVISED EFFECTIVE APRIL 1, 2022 TO UPDATE THE POWERS RESERVED TO THE MEMBER. THE FOLLOWING POWERS RESERVED TO THE MEMBER WERE ADDED TO THE APRIL 1, 2022 BYLAW REVISIONS: 1) THE AUTHORITY TO SET LIMITS AND TERMS FOR ALL TYPES OF FINANCIAL TRANSACTIONS EXCEEDING $100,000; 2) THE AUTHORITY TO SECURE NAMING RIGHTS AND TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION IN EXCESS OF $1,000,000; 3) THE AUTHORITY TO APPROVE OR DISAPPROVE THE IMPLEMENTATION OF NON-TRADITIONAL, NON-HEALTHCARE RELATED ACTIVITIES; 4) THE AUTHORITY TO APPROVE OR DISAPPROVE PERFORMANCE/QUALITY IMPROVEMENT, REVENUE CYCLE AND CASE MANAGEMENT PROGRAMS; 5) THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF THE AUDITING FIRM AND ELECTION OF THE FISCAL YEAR; 6) THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF THE HOSPITAL'S GROUP PURCHASING ORGANIZATION; 7) THE AUTHORITY TO APPROVE OR DISAPPROVE ANY JOINT VENTURE OR PARTNERSHIP IN WHICH THE AMH WOULD BE A MEMBER OR PARTNER; 8) THE AUTHORITY TO APPROVE OR DISAPPROVE THE IT SYSTEMS AND OTHER SHARED SERVICES USED; 9) THE AUTHORITY TO REQUIRE ADHERENCE TO THE SYSTEM-WIDE NAMING NOMENCLATURE AND SERVICE STANDARDS ADOPTED BY THE MEMBER; 10) THE AUTHORITY TO SET AND ENFORCE POLICES FOR PHYSICIAN COMPENSATION INCLUDING COMMERCIAL REASONABLENESS AND FAIR MARKET VALUE; AND 11) THE AUTHORITY TO EXERCISE SUCH OTHER POWERS AS ARE NECESSARY IN CONNECTION WITH ALL OTHER LISTED POWERS. A PROVISION WAS ADDED IN THE APRIL 1, 2022 BYLAWS TO PROVIDE THAT ADVENTIST HEALTH SYSTEM/SUNBELT, INC. SHALL RETAIN THE AUTHORITY AND RESPONSIBILITY FOR CORPORATE COMPLIANCE AND SHALL FUNCTION AS THE "GOVERNING AUTHORITY" FOR AMH FOR THE PURPOSES OF PROVIDING COMPLIANCE OVERSIGHT. DECEMBER 29, 2022 CHANGES TO ARTICLES OF INCORPORATION AND BYLAWS: ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, ADVENTIST HEALTH SYSTEM/SUNBELT, INC., AND ADVENTIST MIDWEST HEALTH ENTERED INTO AN AFFILIATION AGREEMENT WITH THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC), EFFECTIVE DECEMBER 31, 2022. UCMC IS A 501(C)(3) ACADEMIC HEALTH ORGANIZATION THAT OPERATES HOSPITALS, OUTPATIENT CLINICS AND PHYSICIAN PRACTICES IN THE GREATER CHICAGO AREA AND NORTHWEST INDIANA. UNDER THE AFFILIATION AGREEMENT, UCMC ACQUIRED A 51% MEMBERSHIP INTEREST IN ADVENTIST MIDWEST HEALTH. ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION WILL CONTINUE TO MANAGE THE HOSPITAL. AS A RESULT OF THE DECEMBER 31, 2022 AFFILIATION AGREEMENT WITH UCMC, THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION WERE AMENDED. A SUMMARY OF THE SIGNIFICANT CHANGES TO THE GOVERNING DOCUMENTS FOLLOWS. CHANGES TO THE ARTICLES OF INCORPORATION: THE REVISED ARTICLES OF INCORPORATION ARE EFFECTIVE JANUARY 1, 2023. UNDER THE PURPOSES CLAUSE OF THE ARTICLES OF INCORPORATION, TWO ADDITIONAL PURPOSES WERE ADDED TO PROVIDE THAT THE FILING ORGANIZATION WILL ASSIST IN PROMOTING THE CHARITABLE PURPOSES AND INTERESTS OF ITS 501(C)(3) MEMBERS AND ANY OTHER 501(C)(3) AFFILIATED ORGANIZATIONS WHOSE PURPOSES ARE CONSISTENT WITH THOSE OF THE FILING ORGANIZATION. A REQUIREMENT WAS ADDED TO THE AMENDED ARTICLES OF INCORPORATION TO PROVIDE THAT IN NO EVENT SHALL THE BOARD OF DIRECTORS CONSIST OF FEWER THAN THREE INDIVIDUALS AT ANY TIME. ARTICLE V OF THE REVISED ARTICLES OF INCORPORATION WAS UPDATED TO STATE THAT ADVENTIST MIDWEST HEALTH SHALL HAVE TWO MEMBERS, THE UNIVERSITY OF CHICAGO MEDICAL CENTER AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. THE DISSOLUTION CLAUSE OF THE AMENDED ARTICLES OF INCORPORATION WAS CHANGED TO PROVIDE THAT THE FIRST-NAMED TRANSFEREES UPON DISPOSITION WOULD BE ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND THE UNIVERSITY OF CHICAGO MEDICAL CENTER IN ACCORDANCE WITH THEIR RESPECTIVE MEMBERSHIP INTERESTS IN THE FILING ORGANIZATION AT THE TIME OF DISSOLUTION SO LONG AS SUCH ORGANIZATIONS ARE RECOGNIZED AS 501(C)(3) ORGANIZATIONS AT SUCH TIME. ARTICLE VIII OF THE RESTATED ARTICLES PROVIDES THAT ONLY THE MEMBERS HAVE THE POWER TO AMEND THE FILING ORGANIZATION'S ARTICLES OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO THE BYLAWS: THE REVISED BYLAWS ARE EFFECTIVE JANUARY 1, 2023. THE FORMATION, PURPOSE AND OBJECTIVES SECTION OF THE REVISED BYLAWS WAS AMENDED TO STATE THAT THE FILING ORGANIZATION, ADVENTIST MIDWEST HEALTH, IS NOW AFFILIATED WITH THE UNIVERSITY OF CHICAGO MEDICAL CENTER. PRIOR TO THE JANUARY 1, 2023 REVISIONS TO THE BYLAWS, THE SOLE MEMBER OF ADVENTIST MIDWEST HEALTH WAS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. THE REVISED BYLAWS NOW PROVIDE FOR TWO CLASSES OF MEMBERS: CLASS A AND CLASS B. THE UNIVERSITY OF CHICAGO MEDICAL CENTER SHALL BE THE SOLE CLASS A MEMBER AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. SHALL BE THE SOLE CLASS B MEMBER. EACH MEMBER MUST POSSESS AND MAINTAIN RECOGNITION AS A 501(C)(3) ORGANIZATION. AS OF THE ADOPTION DATE OF THE BYLAWS, JANUARY 1, 2023, THE CLASS A MEMBER SHALL POSSESS A 51% MEMBERSHIP INTEREST IN THE FILING ORGANIZATION AND THE CLASS B MEMBER SHALL POSSESS A 49% INTEREST IN THE FILING ORGANIZATION. EACH MEMBER SHALL DESIGNATE AN INDIVIDUAL WHO SHALL BE AUTHORIZED TO ACT ON SUCH MEMBER'S BEHALF. EXTENSIVE REVISIONS WERE MADE TO THE MEMBER'S RESERVED POWERS TO PROVIDE THAT CERTAIN RESERVED POWERS WERE RETAINED SOLELY BY THE MEMBER WITH CERTAIN OTHER RESERVED POWERS SUBJECT TO THE APPROVAL OF EITHER THE UNIVERSITY OF CHICAGO MEDICAL CENTER, ADVENTIST HEALTH SYSTEM/SUNBELT, INC., OR BOTH. UNDER THE REVISED BYLAWS, EACH MEMBER SHALL BE ENTITLED TO CERTAIN STIPULATED RESERVED POWERS AS IDENTIFIED BELOW. MATTERS REQUIRING AFFIRMATIVE APPROVAL OF THE CLASS A MEMBER: - APPOINTMENT AND COMPENSATION OF AN INDIVIDUAL PROPOSED BY ADVENTHEALTH TO HOLD THE OFFICE OF PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE FILING ORGANIZATION AND THE TERMINATION OF SUCH APPOINTMENT, EXCEPT FOR TERMINATIONS BY THE CLASS B MEMBER AS OUTLINED IN THE REVISED BYLAWS; - THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION AND ALL UNBUDGETED EXPENDITURES INDIVIDUALLY OR IN THE AGGREGATE OF RELATED ITEMS OF MORE THAN $5,000,000, CONTRACTUAL OBLIGATIONS IN EXCESS OF $5,000,000, AND THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION; - THE STRATEGIC AND OPERATING PLANS OF THE FILING ORGANIZATION; - THE SELECTION, REMOVAL AND/OR MODIFICATION OF THE AUTHORITY AND RESPONSIBILITIES OF ACCOUNTANTS AND AUDITORS; ANY INDEBTEDNESS OR CAPITAL LEASE OF MORE THAN $5,000,000 ON THE BALANCE SHEET OF THE FILING ORGANIZATION AND ITS SUBSIDIARIES; - THE APPROVAL OR AMENDMENT OF MANAGED CARE PRICING, PRICING STRATEGIES, AND CONTRACTING PARAMETERS FOR THOSE MANAGED CARE CONTRACTS TO WHICH THE FILING ORGANIZATION IS A PARTICIPATING PROVIDER; AND - THE CONFESSION OF A JUDGMENT OR SETTLEMENT OF A CLAIM THAT WOULD EXCEED INSURANCE LIMITS. MATTERS REQUIRING AFFIRMATIVE APPROVAL OF THE CLASS B MEMBER: - CHANGES TO THE RELIGIOUS AFFILIATION OF ANY FACILITY OWNED BY THE FILING ORGANIZATION; - CHANGES TO OPERATIONAL POLICIES, PLANS, AND PROCEDURES THAT ARE SPECIFICALLY RELATED TO A FACILITY'S RELIGIOUS AFFILIATION WITH THE SEVENTH-DAY ADVENTIST CHURCH; - THE TERMINATION OF THE PRESIDENT/CEO IF TERMINATION IS RELATED TO THAT PERSON'S MEMBERSHIP IN THE SEVENTH-DAY ADVENTIST CHURCH; - THE SELECTION, REMOVAL, OR MODIFICATION OF THE AUTHORITY AND RESPONSIBILITIES OF ACCOUNTANTS AND AUDITORS; AND - CHANGES TO THE MISSION, VISION, OR VALUES OF THE FILING ORGANIZATION. MATTERS REQUIRING AFFIRMATIVE APPROVAL OF THE CLASS A MEMBER AND THE CLASS B MEMBER: - AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OR THE GOVERNING DOCUMENTS OF THE ADVENTIST MIDWEST HEALTH SUBSIDIARIES; - THE FORMATION OF ANY SUBSIDIARY OF THE FILING ORGANIZATION; - ENTERING INTO ANY AFFILIATION AGREEMENT OR JOINT VENTURE AGREEMENT; - ANY CHANGE IN THE NAME OR BRANDING OF THE HOSPITAL; - THE ADDITION OF NEW MEMBERS OF THE FILING ORGANIZATION; - THE APPOINTMENT AND REMOVAL OF ANY MEMBER OF THE HOSPITAL BOARD; - DISTRIBUTIONS OF CASH AND OTHER PROPERTY TO THE MEMBERS OR OTHERWISE; - ANY AGREEMENT OR ARRANGEMENT BETWEEN THE FILING ORGANIZATION AND/OR ITS SUBSIDIARIES AND A MEMBER OR MEMBER AFFILIATE INCLUDING THE MANAGEMENT SERVICES AGREEMENT, THE ADMINISTRATIVE SERVICES AGREEMENT, AND THE CLINICAL AFFILIATION AGREEMENT; - TERMINATION OF ANY RELATED PARTY AGREEMENT; - THE ADOPTION AND AMENDMENT OF THE QUALITY AND/OR RISK MANAGEMENT PLANS OF THE HOSPITALS; - THE SELECTION OF THE ACCREDITING BODY OF THE HOSPITALS; - THE TRANSFER OF ANY PROPERTY OF THE HOSPITALS IN EXCESS OF $1 MILLION DOLLARS; - ANY SALE, LEASE, TRANSFER, MERGER OR CONSOLIDATION OF THE FILING ORGANIZATION; - THE DISSOLUTION OF THE FILING ORGANIZATION; - THE FILING OF ANY VOLUNTARY PETITION IN BANKRUPTCY; - REQUIRING ANY ADDITIONAL CAPITAL CONTRIBUTIONS FROM THE MEMBER; AND - THE APPOINTMENT OR REMOVAL OF THE BOARD CHAIR AND ANY OF THE OTHER BOARD OFFICERS. FORM 990, PART VI, SECTION A, LINE 4 PURSUANT TO THE REVISED BYLAWS, A QUORUM FOR ANY MEETING OF THE MEMBERS SHALL BE DEEMED TO EXIST WHERE BOTH MEMBERS (THROUGH THEIR RESPECTIVE MEMBER REPRESENTATIVES) ARE PRESENT. ASSUMING A QUORUM IS PRESENT, MATTERS MAY BE ADOPTED UPON THE AFFIRMATIVE VOTE OF ONLY THE CLASS A MEMBER OR ONLY THE CLASS B MEMBER OR BOTH, DEPENDING UPON THE SPECIFIC MATTER AND THE RESPECTIVE POWERS OF EACH MEMBER AS SPECIFIED ABOVE. THE CLASS A MEMBER REPRESENTATIVE SHALL CHAIR MEETINGS OF THE MEMBERS. THE CLASS A AND B MEMBER MAY DELEGATE CERTAIN RESERVED POWERS TO THEIR RESPECTIVE MEMBER, NAMELY THE UNIVERSITY OF CHICAGO OR ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, RESPECTIVELY. THE REVISED BYLAWS PROVIDE THAT THE BOARD OF DIRECTORS SHALL BE COMPRISED OF EIGHT DIRECTORS. FOUR OF THE DIRECTORS SHALL BE ELECTED BY THE CLASS A MEMBER AND FOUR DIRECTORS SHALL BE ELECTED BY THE CLASS B MEMBER. THE FILING ORGANIZATION'S PRESIDENT/CEO SHALL ALSO SERVE ON THE BOARD AS A NON-VOTING, EX OFFICIO MEMBER. THE TERM FOR EACH DIRECTOR SHALL BE THREE YEARS. A MAJORITY OF THE DIRECTORS SHALL CONSTITUTE A QUORUM PROVIDED AT LEAST 2 CLASS A DIRECTORS AND 2 CLASS B DIRECTORS ARE PRESENT. IF A QUORUM IS PRESENT, A MAJORITY VOTE OF THE DIRECTORS PRESENT IS AN ACT OF THE BOARD. AN AFFIRMATIVE VOTE OF SIX OR MORE OF THE TOTAL NUMBER OF DIRECTORS IS NECESSARY FOR APPROVING ANY CHANGE OR DISCONTINUATION OF AN ACUTE CARE HOSPITAL LICENSE HELD BY AN ADVENTIST MIDWEST HEALTH ENTITY OR A DISCONTINUATION OF ANY MATERIAL PATIENT CARE SERVICE LINE OFFERED BY AN ADVENTIST MIDWEST HEALTH ENTITY OR A DECISION TO CONFESS A JUDGMENT OR SETTLE A CLAIM IN EXCESS OF $3,000,000. THE REVISED BYLAWS CONTAIN A MORE DETAILED LISTING OF THE RESPONSIBILITIES OF THE BOARD OF DIRECTORS AND INCLUDE APPROVING ANY MATERIAL CHANGES IN THE CATEGORY OF SERVICES OFFERED BY THE FILING ORGANIZATION, REQUIRING ADHERENCE TO THE SYSTEM-WIDE NAMING NOMENCLATURE AND SERVICE STANDARDS, AND AUTHORITY TO SET AND ENFORCE POLICIES FOR PHYSICIAN COMPENSATION INCLUDING COMMERCIAL REASONABLENESS AND FAIR MARKET VALUE. THE CHAIR OF THE BOARD OF DIRECTORS SHALL BE FILLED ON A THREE-YEAR ROTATING BASIS BETWEEN A CLASS A DIRECTOR AND A CLASS B DIRECTOR. THE BOARD MAY CREATE COMMITTEES, INCLUDING A FINANCE, COMPLIANCE, AND QUALITY COMMITTEE. EACH COMMITTEE SHALL BE COMPRISED OF THE SAME PROPORTION OF CLASS A AND CLASS B DIRECTORS AS EACH RESPECTIVE MEMBER IS ENTITLED TO APPOINT TO THE BOARD. THE REVISED BYLAWS PROVIDE THAT THE FISCAL YEAR OF THE FILING ORGANIZATION SHALL END ON JUNE 30 OF EACH YEAR. IN ADDITION TO THE BOARD OF DIRECTORS, THE UPDATED BYLAWS PROVIDE THAT THE GOVERNANCE AND MANAGEMENT OF THE HOSPITALS SHALL BE OVERSEEN BY A HOSPITAL BOARD COMPOSED OF NO LESS THAN 18 AND NO MORE THAN 23 INDIVIDUALS APPOINTED BY THE MEMBERS. AT LEAST TWO OF THE APPOINTEES SHALL BE CLASS A REPRESENTATIVES. HOSPITAL BOARD MEMBERS SHALL BE APPOINTED FOR TERMS OF ONE TO FOUR YEARS. SUBJECT TO THE POWERS RETAINED BY THE BOARD OF DIRECTORS AND POWERS RETAINED BY THE MEMBERS, THE HOSPITAL BOARD SHALL ASSUME FULL LEGAL RESPONSIBILITY FOR THE OPERATIONS OF THE HOSPITALS AND OTHER OPERATIONS OF THE FILING ORGANIZATION, AS DELEGATED BY THE BOARD. THE REVISED BYLAWS CONTAIN A DETAILED LISTING OF THE RESPONSIBILITIES OF THE HOSPITAL BOARD AND ARE GROUPED INTO THE AREAS OF STRATEGY, GENERAL OPERATIONS, MEDICAL STAFF, SAFETY, QUALITY AND EDUCATION, COMMUNITY, HOSPITAL-BASED HOME HEALTH AGENCY, AND HOSPITAL-BASED HOSPICE. PROVISIONS WERE ADDED TO THE AMENDED BYLAWS TO PROVIDE FOR A MEANS OF RESOLVING A VOTING DEADLOCK IN THE EVENT THE APPLICABLE GOVERNING AUTHORITY (BE IT MEMBERS OR BOARD) IN UNABLE TO REACH A DECISION BY THE REQUIRED VOTE OR, IN THE CASE OF A BOARD DECISION, EITHER MEMBERS' APPOINTEES TO THE BOARD BELIEVES THAT FAVORABLE PASSAGE OF SUCH ACTION IS CRITICAL TO THE WELL-BEING OF THE ADVENTIST MIDWEST HEALTH ENTITIES. IN SUCH A CASE, THE ITEM SHALL BE REFERRED TO THE DEAN AND EXECUTIVE VICE PRESIDENT FOR MEDICAL AFFAIRS FOR THE UNIVERSITY OF CHICAGO AND PRESIDENT OF THE UNIVERSITY OF CHICAGO HEALTH SYSTEM AND THE PRESIDENT OF ADVENTIST HEALTH SYSTEM/SUNBELT, INC. AND THE PRESIDENT OF ADVENTHEALTH MULTI-STATE DIVISION WHO SHALL ATTEMPT TO RESOLVE THE MATTER. ANY MATTER NOT RESOLVED BY THIS PROCESS WILL BE REFERRED TO DISPUTE RESOLUTION AS PROVIDED IN THE AFFILIATION AGREEMENT. ANY AMENDMENTS MADE TO THE BYLAWS MUST BE APPROVED BY THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 ADVENTIST MIDWEST HEALTH (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI 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 MEMBERS OF THE BOARD OF DIRECTORS (GOVERNING BOARD) OF THE FILING ORGANIZATION ARE APPOINTED BY THE CORPORATE MEMBER, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. THE CORPORATE MEMBER IS ENTITLED TO ELECT NOT LESS THAN EIGHTEEN (18) AND NO MORE THAN TWENTY THREE (23) VOTING MEMBERS TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION PURSUANT TO THE PROVISIONS OF THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B PRIOR TO APRIL 1, 2022, ADVENTIST MIDWEST HEALTH (AMH) WAS A COVERED AFFILIATE OF AN AFFILIATION COMPRISING A REGIONAL HEALTH CARE DELIVERY NETWORK OPERATED AND MANAGED BY ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., A JOINT OPERATING COMPANY BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH (THE JOINT OPERATING COMPANY). THE JOINT OPERATING COMPANY WAS KNOWN AS AMITA HEALTH. THROUGHOUT 2022, THE SOLE MEMBER OF AMH WAS ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI) AND INDIRECTLY WAS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), BOTH 501(C)(3) ORGANIZATIONS. THE HEALTHCARE SYSTEM WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION IS KNOWN AS ADVENTHEALTH. EFFECTIVE APRIL 1, 2022, ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH EXECUTED A DISAFFILIATION AGREEMENT (THE DISAFFILIATION) WHEREBY IT WAS AGREED THAT THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., WOULD WIND UP ITS AFFAIRS AND DISSOLVE AND THAT THE PARTIES TO THE ORIGINAL AFFILIATION AGREEMENT WOULD NO LONGER BE UNDER THE MANAGEMENT CONTROL OF THE JOINT OPERATING COMPANY. ACCORDINGLY, THE BYLAWS OF THE FILING ORGANIZATION WERE AMENDED EFFECTIVE APRIL 1, 2022, TO REFLECT THE CHANGES RESULTING FROM THE DISAFFILIATION. FOR THE PERIOD FROM JANUARY 1 TO MARCH 31, 2022, THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION PROVIDED FOR CERTAIN RESERVED POWERS TO EXERCISE FINANCIAL, MANAGERIAL, AND OPERATIONAL AUTHORITIES OVER THE FILING ORGANIZATION BY AHSSHC, AS SPONSOR, BY AHSSI AS MEMBER, BY BOTH MEMBERS OF THE JOC, NAMELY, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (MEMBERS), AND BY THE BOARD OF DIRECTORS OF THE JOC. BEGINNING APRIL 1, 2022, THE BYLAWS OF ADVENTIST MIDWEST HEALTH WERE AMENDED. UPON AMENDMENT, THE FOLLOWING RESERVED POWERS WERE HELD BY AHSSI: 1) TO APPROVE OR DISAPPROVE THE APPOINTMENT, REMOVAL, AND COMPENSATION OF THE SENIOR MANAGEMENT OF THE FILING ORGANIZATION; 2) TO APPROVE OR DISAPPROVE ANY CHANGES OR AMENDMENTS TO THE BYLAWS OR ARTICLES OF INCORPORATION OF THE FILING ORGANIZATION; 3) TO APPROVE OR DISAPPROVE MATERIAL CHANGES IN THE CATEGORY OF SERVICES OFFERED BY THE FILING ORGANIZATION; 4) TO APPROVE OR DISAPPROVE CAPITAL EXPENDITURES OR THE SALE, DONATION, OR OTHER TRANSFER OF REAL AND PERSONAL PROPERTY WITH VALUES IN EXCESS OF $1,000,000; 5) THE AUTHORITY TO REQUIRE ADHERENCE TO POLICIES ADOPTED BY THE MEMBER AND ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION; 6) THE AUTHORITY TO SET LIMITS AND TERMS FOR ALL TYPES OF FINANCIAL TRANSACTIONS EXCEEDING $100,000 FOR ANY SINGLE OR RELATED PROJECTS; 7) THE AUTHORITY TO APPROVE OR DISAPPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS AND STRATEGIC PLANS OF THE FILING ORGANIZATION; 8) THE AUTHORITY TO SECURE NAMING RIGHTS AND TO DIRECT THE PLACEMENT OF FUNDS AND CAPITAL OF THE FILING ORGANIZATION IN EXCESS OF $1,000,000; 9) THE AUTHORITY TO APPROVE OR DISAPPROVE THE IMPLEMENTATION OF NON-TRADITIONAL, NON-HEALTHCARE RELATED ACTIVITIES; 10) THE AUTHORITY TO APPROVE OR DISAPPROVE PERFORMANCE/QUALITY IMPROVEMENT, REVENUE CYCLE AND CASE MANAGEMENT PROGRAMS; 11) THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF THE AUDITING FIRM AND ELECTION OF THE FISCAL YEAR; 12) THE AUTHORITY TO APPROVE OR DISAPPROVE THE SELECTION OF AMH'S GROUP PURCHASING ORGANIZATION; 13) THE AUTHORITY TO APPROVE OR DISAPPROVE ANY JOINT VENTURE OR PARTNERSHIP IN WHICH THE AMH WOULD BE A MEMBER OR PARTNER; 14) THE AUTHORITY TO APPROVE OR DISAPPROVE THE IT SYSTEMS AND OTHER SHARED SERVICES USED; 15) THE AUTHORITY TO REQUIRE ADHERENCE TO THE SYSTEM-WIDE NAMING NOMENCLATURE AND SERVICE STANDARDS ADOPTED BY THE MEMBER; 16) THE AUTHORITY TO SET AND ENFORCE POLICES FOR PHYSICIAN COMPENSATION INCLUDING COMMERCIAL REASONABLENESS AND FAIR MARKET VALUE; AND 17) THE AUTHORITY TO EXERCISE SUCH OTHER POWERS AS ARE NECESSARY IN CONNECTION WITH ALL OTHER LISTED POWERS. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD MEMBER/PRESIDENT, CEO AND BY THE CFO PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD MEMBER/PRESIDENT, 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 CONFLICT OF INTERESTS, 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 APRIL 1, 2022, THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES WERE ON THE PAYROLL OF THE FILING ORGANIZATION. FOR 2022, THE COMPENSATION PACKAGE FOR THESE INDIVIDUALS WAS INITIALLY DETERMINED BY THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., DBA AMITA HEALTH (AMITA HEALTH OR JOC). AS DISCUSSED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 4, THE FILING ORGANIZATION CEASED TO BE A COVERED AFFILIATE OF THE JOC EFFECTIVE APRIL 1, 2022, DUE TO THE DISAFFILIATION AGREEMENT BETWEEN ALEXIAN BROTHERS HEALTH SYSTEM AND ADVENTIST MIDWEST HEALTH, THE FILING ORGANIZATION'S 501(C)(3) SOLE MEMBER. AS A RESULT OF THE DISAFFILIATION AGREEMENT, BEGINNING APRIL 1, 2022, THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES ARE NOT COMPENSATED BY THE FILING ORGANIZATION. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY AMITA HEALTH IN DETERMINING 2022 EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH AND OF THE ADVENTHEALTH "OBLIGATED GROUP" ARE FILED ANNUALLY WITH THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB). THE "OBLIGATED GROUP" IS A GROUP OF AHSSHC SUBSIDIARIES THAT ARE JOINTLY AND SEVERALLY LIABLE UNDER A MASTER TRUST INDENTURE THAT SECURES DEBT PRIMARILY ISSUED ON A TAX-EXEMPT BASIS. UNAUDITED QUARTERLY FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) ARE ALSO FILED WITH MSRB FOR ADVENTHEALTH ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF ADVENTHEALTH SUBSIDIARIES COMPRISING THE "OBLIGATED GROUP". THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. PART VII, SECTION A: FOR THOSE BOARD OF DIRECTOR MEMBERS (NOT INCLUDING PHYSICIAN MEMBERS OF THE BOARD) 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 WITHIN ADVENTHEALTH OR AMITA HEALTH. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. FORM 990, PART VIII, LINES 7A, B AND C: THE AMOUNTS SHOWN IN PART VIII, LINES 7A(I), 7B(I) AND 7C(I) OF THE FORM 990 REPRESENT AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A SYSTEM WIDE, CORPORATE ADMINISTERED, INVESTMENT PROGRAM. FORM 990, PART IX, LINE 11G PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 46,028,772. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,028,772. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 14,026,636. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,026,636. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 10,263,507. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,263,507. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 7,013,470. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,013,470. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 138,676. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 138,676. RECRUITING: PROGRAM SERVICE EXPENSES 101,360. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 101,360. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 8,281,963. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,281,963. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 29,710,618. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,710,618. ADVENTHEALTH MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 11,265,333. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,265,333. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 311. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 311. AH SHARED SERVICES FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES -806,951. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -806,951. REGIONAL MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 11,900,131. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,900,131. 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: PRIOR PERIOD ADJUSTMENTS -849,408. GIFTS 1,145,937. OTHER -41,534. AMITA DISAFFILIATION COSTS -1,858,326. TRANSITION SERVICE AGREEMENT COSTS -3,026,608. UNREALIZED MARKET ADJUSTMENT -201,043. NET CHANGE IN INTEREST IN FOUNDATION -16,031,920. LEASE ACCOUNTING ADJUSTMENTS 989,660. PREPAID INTERCOMPANY IT COSTS -10,666,297. CHANGE IN INTERCOMPANY ALLOCATION OF TAX-EXEMPT BONDS 250,594,817. WORKING CAPITAL CASH CONTRIBUTION FROM TAX-EXEMPT PARENT 27,689,121. ACCOUNTING WRITE-UP OF ASSETS ON SALE OF MEMBERSHIP INTEREST 82,178,334. INVESTMENT IN FOUNDATION -270,943. FOUNDATION RESTRICTED FUNDS 10,059,725. TRANSFER TO TOP-TIER TAX-EXEMPT PARENT -4,552,680. REVERSAL OF PRIOR YEAR PURCHASE ACCOUNTING -160,006,812. ROUNDING 3. 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